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Effects of Exercise Training on Glucose Homeostasis

The HERITAGE Family Study

  1. Normand G. Boulé, MA1,
  2. S. John Weisnagel, MD12,
  3. Timo A. Lakka, MD, PHD34,
  4. Angelo Tremblay, PHD1,
  5. Richard N. Bergman, PHD5,
  6. Tuomo Rankinen, PHD3,
  7. Arthur S. Leon, MD6,
  8. James S. Skinner, PHD7,
  9. Jack H. Wilmore, PHD8,
  10. D.C. Rao, PHD9 and
  11. Claude Bouchard, PHD3
  1. 1Division of Kinesiology, Laval University, Ste-Foy, Québec, Canada
  2. 2Diabetes Research Unit, Centre de Recherche sur les Maladies Lipidiques, Laval University, Ste-Foy, Québec, Canada
  3. 3Human Genomics Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
  4. 4Kuopio Research Institute of Exercise Medicine and the Department of Physiology, University of Kuopio, Kuopio, Finland
  5. 5Keck School of Medicine, University of Southern California, Los Angeles, California
  6. 6Laboratory of Physiological Hygiene and Exercise Science, Division of Kinesiology, University of Minnesota, Minneapolis, Minnesota
  7. 7Department of Kinesiology, Indiana University, Bloomington, Indiana
  8. 8Department of Health and Kinesiology, Texas A&M University, College Station, Texas
  9. 9Departments of Genetics and Psychiatry, Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri
  1. Address correspondence and reprint requests to S. John Weisnagel, MD, FRCPC, Diabetes Research Unit, S-27, Centre Hospitalier Université Laval, Laval University, 2705 Boulevard Laurier Sainte-Foy, Québec, Canada, G1V 4G2. E-mail: john.weisnagel{at}kin.msp.ulaval.ca

Abstract

OBJECTIVE—To determine the effect of a 20-week endurance training program in healthy, previously sedentary participants on measures derived from an intravenous glucose tolerance test (IVGTT).

RESEARCH DESIGN AND METHODS—An IVGTT was performed before and after a standardized training program in 316 women and 280 men (173 blacks and 423 whites). Participants exercised on cycle ergometers 3 days per week for 60 sessions. The exercise intensity was progressively increased from 55% Vo2max for 30 min per session to 75% Vo2max for 50 min per session.

RESULTS—Mean insulin sensitivity increased by 10% (P < 0.001) following the intervention, but the variability in the changes was high. Men had larger improvements than women (P = 0.02). Improvements in fasting insulin were transitory, disappearing 72 h after the last bout of exercise. There were also significant mean increases in the glucose disappearance index (3%, P = 0.02) and in glucose effectiveness (11%, P < 0.001), measures of glucose tolerance and of the capacity of glucose to mediate its own disposal, respectively. The acute insulin response to glucose, a measure of insulin secretion, increased by 7% in the quartile with the lowest baseline glucose tolerance and decreased by 14% in the quartile with the highest baseline glucose tolerance (P < 0.001). The glucose area below fasting levels during the IVGTT was reduced by 7% (P = 0.02).

CONCLUSIONS—Although the effects of structured regular exercise were highly variable, there were improvements in virtually all IVGTT-derived variables. In the absence of substantial weight loss, regular exercise is required for sustained improvements in glucose homeostasis.

Footnotes

  • N.G.B. is currently affiliated with the Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada.

    N.G.B. and S.J.W. contributed equally as first authors to this article.

    C.B. has been on advisory panels for Baylor Children’s Nutrition Research Center, the Boston Obesity & Nutrition Research Center of the National Institutes of Health, the Institutes for Pharmaceutical Discovery, Mars, Sanofi-Synthelabo, the Cooper Institute for Aerobic Research, and Weight Watchers International; has been on the board of directors for the Pennington Biomedical Research Center; has received consulting fees from the Pennington Biomedical Research Center, the Almond Board of California, and Bristol-Myers Squibb; and has received research/grant support from Bristol-Myers Squibb.

    • Accepted September 21, 2004.
    • Received April 27, 2004.
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