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Brian D. Tran, Szu-Yun Leu, Stacy Oliver, Scott Graf, Diana Vigil, and Pietro Galassetti

Pediatric obesity typically induces insulin resistance, often later evolving into type 2 diabetes. While exercise, enhancing insulin sensitivity, is broadly used to prevent this transition, it is unknown whether alterations in the exercise insulin response pattern occur in obese children. Therefore, we measured exercise insulin responses in 57 healthy weight (NW), 20 overweight (OW), and 56 obese (Ob) children. Blood samples were drawn before and after 30min of intermittent (2min on, 1min off) cycling at ~80% VO2max. In a smaller group (14 NW, 6 OW, 15 Ob), a high-fat meal was ingested 45 min preexercise. Baseline glycemia was similar and increased slightly and similarly in all groups during exercise. Basal insulin (pmol/L) was significantly higher in Ob vs. other groups; postexercise, insulin increased in NW (+7 ± 3) and OW (+5 ± 8), but decreased in Ob (−15 ±5, p < .0167 vs. NW). This insulin drop in Ob was disproportionately more pronounced in the half of Ob children with higher basal insulin (Ob-H). In all groups, high-fat feeding caused a rapid rise in insulin, promptly corrected by exercise. In Ob, however, insulin rose again 30 min postexercise. Our data indicates a distinct pattern of exercise-induced insulin modulation in pediatric obesity, possibly modulated by basal insulin concentrations.

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Zandrie Hofman, Harm Kuipers, Hans A. Keizer, Erik J. Fransen, and Roderique C.J. Servais

This investigation examined the plasma glucose and insulin response in 6 trained athletes after consumption of four commercially available sport feedings 2 hr before as well as immediately after 1 hr of running under common training conditions. Four feedings were compared: Feeding 1, 160 g CHO/400 ml; Feeding 2, 69 g CHO/400 ml; Feeding 3, 69 g CHO + 6 g protein/400 ml; and Feeding 4, solid 69 g CHO + 5 g protein + 4 g fat. Before the training session, there were no differences between the four sport feedings in the area under the glucose and insulin curves and the insulin/glucose ratio. However, after exercise, Feeding 2 resulted in a significantly greater area under the glucose curve compared with Feedings 1, 3, and 4 (respectively, 352 vs. 241, 251, and 182) and a significantly lower insulin/glucose ratio compared with Feeding 1 (respectively, 6.2 vs. 15.8). Therefore, it is concluded that the kind of sport feeding may influence postexercise glucose and insulin responses.

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Roy L.P.G. Jentjens and Asker E. Jeukendrup

Pre-exercise carbohydrate feeding may result in rebound hypoglycemia in some but not all athletes. The aim of the present study was to examine whether insulin sensitivity in athletes who develop rebound hypoglycemia is higher compared with those who do not show rebound hypoglycemia. Twenty trained athletes (V̇O2max of 61.8 ± 1.4 ml · kg−1 · min−1) performed an exercise trial on a cycle ergometer. Forty-five minutes before the start of exercise, subjects consumed 500 ml of a beverage containing 75 g of glucose. The exercise trial consisted of · 20 min of submaximal exercise at 74 ± 1% V̇O2max immediately followed by a time trial. Based upon the plasma glucose nadir reached during submaximal exercise, subjects were assigned to a Hypo group (<3.5 mmol/L) and a Non-hypo group (≥3.5 mmol/L). An oral glucose tolerance test was performed to obtain an index of insulin sensitivity (ISI). The plasma glucose nadir during submaximal exercise was significantly lower (p < .01) in the Hypo-group (n = 10) compared with the Non-hypo group (n = 10) (2.7 ± 0.1 vs. 4.1 ± 0.2 mmol/L, respectively). No difference was found in ISI between the Hypo and the Non-hypo group (3.7 ± 0.4 vs. 3.8 ± 0.5, respectively). The present results suggest that insulin sensitivity does not play an important role in the occurrence of rebound hypoglycemia.

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Hilkka Kontro, Marta Kozior, Gráinne Whelehan, Miryam Amigo-Benavent, Catherine Norton, Brian P. Carson, and Phil Jakeman

next-day time-trial (TT) performance, and secondary outcomes were glucose and insulin responses to the postexercise drinks. We hypothesized that immediate protein supplementation postexercise would improve TT performance the next day due to increased glycogen resynthesis in the early phase of recovery

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Emily Arentson-Lantz, Elfego Galvan, Adam Wacher, Christopher S. Fry, and Douglas Paddon-Jones

.T. , . . . Owen , N. ( 2012 ). Breaking up prolonged sitting reduces postprandial glucose and insulin responses . Diabetes Care, 35 ( 5 ), 976 – 983 . PubMed ID: 22374636 doi:10.2337/dc11-1931 10.2337/dc11-1931 Evans , W.J. ( 2002 ). Effects of exercise on senescent muscle . Clinical Orthopaedics and

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Kevin R. Short, Melinda Sheffield-Moore, and David L. Costill

This investigation was undertaken to determine whether consuming several small feedings of preexercise carbohydrate (CHO), rather than a single bolus, would affect blood glucose and insulin responses during rest and exercise. Eight trained cyclists ingested 22.5,45, or 75 total g maltodextrin and dextrose dissolved in 473 ml of water or an equal volume of placebo (PL). Drinks were divided into four portions and consumed at 15-min intervals in the hour before a 120-min ride at 66% VO2max. Serum glucose values were elevated by the CHO feedings at rest and fell significantly below baseline and PL at 15 min of exercise. However, glucose concentrations were similar in each of the CHO trials. Insulin concentrations also increased rapidly during rest, then fell sharply at the onset of exercise. The findings demonstrate that CHO consumed within an hour before exercise, even when taken in several small feedings, can produce transient hypoglycemia near the onset of exercise. Additionally, the magnitude of the response appears to be unrelated to either the amount of CHO ingested or the insulin response.

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Krista Casazza, Barbara A. Gower, Amanda L. Willig, Gary R. Hunter, and José R. Fernández

The objectives of this study were to identify the independent effect of physical activity and fitness on insulin dynamics in a cohort of European-, African-, and Hispanic-American children (n = 215) age 7–12 years and to determine if racial/ethnic differences in insulin dynamics could be statistically explained by racial/ethnic differences in physical activity or fitness. An intravenous glucose tolerance test and minimal modeling were used to derive the insulin sensitivity index (SI) and acute insulin response to glucose (AIRg). Fitness was assessed as VO2-170 and physical activity by accelerometer. Multiple regression models were tested for contributions of fitness and physical activity to SI and AIRg. Fitness was a stronger predictor of SI and AIRg than physical activity regardless of ethnicity; racial/ethnic differences in insulin dynamics were not accounted for by differences in fitness and/or physical activity.

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William M. Sherman, Julie M. Lash, John C. Simonsen, and Susan A. Bloomfield

Because muscle damage from eccentric exercise has been associated with alterations in muscle glycogen metabolism, this study determined the effects of exercise on the insulin and glucose responses to an oral glucose tolerance test (OGTT). In a repeated-measures design, 11 subjects undertook either no exercise, 2 min of isokinetic leg exercise, or 50 min of level or downhill running. No exercise was performed and diet was controlled during the 48 hrs after the treatments and before the OGTT. Ratings of muscle soreness and CK activity were significantly elevated 48 hrs after downhill running. Level running also increased CK activity but did not induce muscle soreness. Isokinetic exercise did not affect either one. Blood glucose responses to the OGTT were similar among the treatments. In contrast, the insulin responses to the OGTT following downhill running were significantly increased. These results suggest that eccentric exercise associated with downhill running that results in delayed muscle soreness is associated with the development of a mild insulin-resistant condition.

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John L. Ivy, Peter T. Res, Robert C. Sprague, and Matthew O. Widzer

Increasing the plasma glucose and insulin concentrations during prolonged variable intensity exercise by supplementing with carbohydrate has been found to spare muscle glycogen and increase aerobic endurance. Furthermore, the addition of protein to a carbohydrate supplement will enhance the insulin response of a carbohydrate supplement. The purpose of the present study was to compare the effects of a carbohydrate and a carbohydrate-protein supplement on aerobic endurance performance. Nine trained cyclists exercised on 3 separate occasions at intensities that varied between 45% and 75% VO2max for 3 h and then at 85% VO2max until fatigued. Supplements (200 ml) were provided every 20 min and consisted of placebo, a 7.75% carbohydrate solution, and a 7.75% carbohydrate / 1.94% protein solution. Treatments were administered using a double-blind randomized design. Carbohydrate supplementation significantly increased time to exhaustion (carbohydrate 19.7 ± 4.6 min vs. placebo 12.7 ± 3.1 min), while the addition of protein enhanced the effect of the carbohydrate supplement (carbohydrate-protein 26.9 ± 4.5 min, p < .05). Blood glucose and plasma insulin levels were elevated above placebo during carbohydrate and carbohydrate-protein supplementation, but no differences were found between the carbohydrate and carbohydrate-protein treatments. In summary, we found that the addition of protein to a carbohydrate supplement enhanced aerobic endurance performance above that which occurred with carbohydrate alone, but the reason for this improvement in performance was not evident.

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Cynthia M. Ferrara, Susan H. McCrone, David Brendle, Alice S. Ryan, and Andrew P. Goldberg

The metabolic changes associated with the addition of 4 months of resistive exercise to an existing aerobic exercise program (AEX+RT, n = 7) were compared to a maintenance aerobic exercise program (AEX, n = 8) in overweight, older men. The subjects in this study had recently completed a 6-month aerobic exercise program (treadmill walking, 45 min/d, 2 d/wk). The AEX+RT group added 6 exercises on upper- and lower-body pneumatic-resistance machines (2 sets, 15 repetitions each, 2 d/wk) to an aerobic exercise program at ≥ 70% heart rate reserve for 30–40 min, 2 d/wk on treadmill, while the AEX group continued the same maintenance treadmill AEX program. There were no baseline differences in body weight, VO2max, or glucose metabolism between groups. The AEX+RT group increased upper- and lower-extremity strength by 28 ± 4% and 46 ± 6%, respectively (p < .05), despite a 9% decrease in VO2max (p < .05). VO2max did not change in the AEX group. There was no change in the fasting glucose or insulin levels, or the 3-h glucose responses to an oral glucose load in either group. The insulin responses decreased by 25 ± 4% in the AEX+RT group (p < .01) but did not change in the AEX group. In conclusion, the addition of resistive exercise training to an existing aerobic exercise program may improve insulin sensitivity in overweight, older men, and thus prevent the development of type 2 diabetes.