Diabetes is the second most prevalent non-communicable chronic diseases (NCDs) in patients with coronavirus disease 2019 (COVID-19) and is highly associated with increased incidence of disease severity and mortality. Individuals with diabetes and poor glycemic control have an even worse prognosis. Despite of the need/effectiveness of social distancing measures (i.e.: home confinement, quarantine and/or lockdown) during COVID-19 outbreak, preliminary findings showed an increase in negative behaviors during COVID-19 home confinement (i.e.:~33.5% reduction in physical activity,~28.6% (~3.10h) increase in sedentary behavior (i.e.: daily sitting, reclining and lying down time), and more unhealthy food consumption and meal pattern), which may have important clinical implications. For example, we estimated that this reduction in physical activity can increase the cases of type 2 diabetes (from~7.2% to~9.6%;~11.1 million cases per year) and all-cause mortality (from~9.4% to~12.5%;~1.7 million deaths per year) worldwide. Few weeks of reduction in physical activity levels result in deleterious effects on several cardiometabolic (i.e.: glycemic control, body composition, inflammatory cytokines, blood pressure, vascular function…) and functional parameters (i.e.: cardiorespiratory/muscle fitness, balance, agility…). In contrast, physical activity and exercise are important tools for preventing and treating diabetes and others NCDs. Home-based exercise programs are useful, safe and effective for the management of diabetes, and could be widely used during COVID-19 outbreak. In this context, there is an urgent need for recommending physical activity/exercise, during and beyond COVID-19 outbreak, for improving the management of diabetes, as well as to prevent the increase in global burden of COVID-19, diabetes and others NCDs.

Purpose: To investigate the effect of high-intensity interval training (HIIT) versus moderate-intensity continuous exercise training (MICE) on hemodynamic and functional variables in individuals with Parkinson’s disease. Methods: Twenty participants (13 men) were randomly assigned to a thrice-weekly HIIT (n = 12) or MICE (n = 8) for 12 weeks. Hemodynamic (resting heart rate and blood pressure, carotid femoral pulse wave velocity, endothelial reactivity, and heart rate variability) and functional variables (5-time sit-to-stand, timed up and go, and 6-min walking tests) assessed before and after training. Results: Demographic, hemodynamic and functional variables were similar between groups at baseline. Endothelial reactivity tended to increase after HIIT, but not after MICE, resulting in improved level (∼8%, P < .01) of this variable in HIIT versus MICE during follow-up. Six-minute walking test improved after HIIT (10.4 ± 3.8%, P < .05), but did not change after MICE. Sit to stand improved similarly after HIIT (27.2 ± 6.1%, P < .05) and MICE (21.5 ± 5.4%, P < .05). No significant changes were found after HIIT or MICE in any other variable assessed. Conclusion: These results suggest that exercise intensity may influence training-induced adaptation on endothelial reactivity and aerobic capacity in individuals with Parkinson’s disease.

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KeywordsScanning electron microscopy, morphometrics, intestinal mucosa, intestinal wall.Submitted: May/2013 Approved: February/2014 ABStRACt This study aimed at evaluating the intestinal integrity, using light and scanning electron microscopy (SEM), and the performance of broiler chickens fed additives alternative to antimicrobials. A total of 1080 male chicks were distributed according to a completely randomized experimental design, with six treatments with six replicates of 30 birds each. The following treatments were evaluated: basal diet (control), basal diet supplemented with an antimicrobial, basal diet supplemented with a probiotic, basal diet supplemented with a prebiotic, basal diet with a symbiotic, and basal diet supplemented with organic acids. Weight gain, feed intake, feed conversion ratio and livability were recorded when broiler chickens were 10, 21, 35, and 42 days old. On day 42, 72 birds were individually weighed and sacrificed. In order to evaluate the morphometrics of the different intestinal wall layers, segments of the small intestine and the cecum were collected from two birds per replicate, and intestinal integrity (SEM) was evaluated in the same segments of two birds per treatment. During the starter period (1-21 days old), birds fed the alternative additives presented similar weight gain as those fed the antimicrobial product, but were not different from control birds. Feed conversion ratio of birds fed alternative additives was better than that of the control birds from one to 10 days of age, but not during the remaining rearing period, and was similar to the birds receiving the antimicrobial. The morphometric parameters of the different intestinal wall layers was not influenced by the treatments. During the total rearing period, the evaluated alternative additives did not improve intestinal integrity or broiler performance.

We tested the hypothesis that rating of perceived exertion (RPE) is a tool as efficient as heart rate (HR) response to cardiopulmonary exercise test (CPX) for prescribing and self-regulating high-intensity interval exercise (HIIE), and that metabolic and hemodynamic response to HIIE is superior than to continuous moderate-intensity exercise (MICE) in individuals with type 2 diabetes mellitus (T2DM). Eleven participants (age=52.3±3yr) underwent HIIE prescribed and self-regulated by RPE (HIIERPE; 25 min), HIIE prescribed and regulated by individuals' HR response to CPX (HIIEHR; 25 min), MICE prescribed and self-regulated by RPE (30 min) and control (CON; 30 min of seated resting) intervention in random order. HR, blood pressure (BP), capillary glucose, endothelial reactivity and carotid-femoral pulse wave velocity (PWV) were assessed before, immediately after and 45 min after each intervention. Exercise HR, speed and distance were measured during exercise sessions. 24-h ambulatory BP was measured after each intervention. Exercise HR, speed and distance were similar between HIIERPE and HIIEHR. BP response was not different among HIIERPE, HIIEHR, and MICE. Capillary glycaemia reduction was greater (P < 0.05) after HIIERPE (48.6±9.6 mg/dL) and HIIEHR (47.2±9.5 mg/dL) than MICE (29.5±11.5 mg/dL). Reduction (P < 0.05) in 24-h (6.7±2.2 mmHg) and tendency toward reduction (P = 0.06) in daytime systolic (7.0±2.5 mmHg) ambulatory BP were found only after HIIERPE. These results suggest that HIIE is superior to MICE for reducing glycaemia and ambulatory BP, and that the 6 to 20 RPE scale is an useful tool for prescribing and self-regulating HIIE in individuals with T2DM.