Combined Interval Training and Post-exercise Nutrition in Type 2 Diabetes: A Randomized Control Trial

Abstract

Background: High-intensity interval training (HIIT) can improve several aspects of cardiometabolic health. Previous studies have suggested that adaptations to exercise training can be augmented with post-exercise milk or protein consumption, but whether this nutritional strategy can impact the cardiometabolic adaptations to HIIT in type 2 diabetes is unknown.Objective: To determine if the addition of a post-exercise milk or protein beverage to a high-intensity interval training (HIIT) intervention improves cardiometabolic health in individuals with type 2 diabetes.Design: In a proof-of-concept, double-blind clinical trial 53 adults with uncomplicated type 2 diabetes were randomized to one of three nutritional beverages (500 mL skim-milk, macronutrient control, or flavored water placebo) consumed after exercise (3 days/week) during a 12 week low-volume HIIT intervention. HIIT involved 10 X 1-min high-intensity intervals separated by 1-min low-intensity recovery periods. Two sessions per week were cardio-based (at ~90% of heart rate max) and one session involved resistance-based exercises (at RPE of 5–6; CR-10 scale) in the same interval pattern. Continuous glucose monitoring (CGM), glycosylated hemoglobin (HbA1c), body composition (dual-energy X-ray absorptiometry), cardiorespiratory fitness (trueV˙textO2textpeak), blood pressure, and endothelial function (%FMD) were measured before and after the intervention.Results: There were significant main effects of time (all p < 0.05) but no difference between groups (Interaction: all p > 0.71) for CGM 24-h mean glucose (−0.5 ± 1.1 mmol/L), HbA1c (−0.2 ± 0.4%), percent body fat (−0.8 ± 1.6%), and lean mass (+1.1 ± 2.8 kg). Similarly, trueV˙textO2textpeak (+2.5 ± 1.6 mL/kg/min) and %FMD (+1.4 ± 1.9%) were increased, and mean arterial blood pressure reduced (−6 ± 7 mmHg), after 12 weeks of HIIT (all p < 0.01) with no difference between beverage groups (Interaction: all p > 0.11).Conclusion: High-intensity interval training is a potent stimulus for improving several important metabolic and cardiovascular risk factors in type 2 diabetes. The benefits of HIIT are not augmented by the addition of post-exercise protein.

Meal intake increases circulating procoagulant microparticles in patients with type 1 and type 2 diabetes mellitus

“…Following four days of low fat (20% fat) mixed meals, EMPs and PMPs did not change in 11 patients with T2DM, whereas following 4 days of a low-carbohydrate diet that lowers PPH, EMPs were reduced (23). Interestingly, there was an increase in the number platelet-monocyte aggregates after both types of meals, as a surrogate for platelet activation (23).…”

Effects of Physical Exercise on the Quality of Life of Type 2 Diabetes Patients

“…More precisely, after 12 weeks of HIIT, the 53 adults with T2D reduced the continuous glucose monitoring (−0.5 ± 1.1 mmol/L), HbA1c (−0.2 ± 0.4%), percent body fat (−0.8 ± 1.6%), and increased lean mass (+1.1 ± 2.8 kg). Besides these variables, there were still improvements in the VO 2 peak (+2.5 ± 1.6 mL/kg/min) and %FMD (+1.4 ± 1.9%), as well as on arterial blood pressure (−6 ± 7 mmHg) [42]. Interestingly, those adaptations resulting from interventions of some duration (12 or more weeks) are also present as an acute adaptation to the exercise [43].…”

“…Besides these variables, there were still improvements in the VO 2 peak (+2.5 ± 1.6 mL/kg/min) and %FMD (+1.4 ± 1.9%), as well as on arterial blood pressure (−6 ± 7 mmHg) [42]. Interestingly, those adaptations resulting from interventions of some duration (12 or more weeks) are also present as an acute adaptation to the exercise [43].…”

The influence of concurrent training intensity on serum irisin and abdominal fat in postmenopausal women

“…The study group's warm-up and cool-down were performed prior to and after each session (both of 5-10 minutes duration, and consisting of walking and light, static stretching [avoiding muscle pain] in most muscle groups). In order to involve the major muscle groups, the RT procedure was followed, using a full range of motion that is considered an accurate method for the studies [21,22]. To avoid potential risks, as 1RM -one repetition maximum, volume = sets × repetitions a rule, the following activities were avoided: 1) events associated with Valsalva's mechanism, 2) ballistic and plyometric movements, and 3) positions of extreme muscular tension.…”