SHR

As of 2014, the standard of care for the management of type-2 diabetes (T2D) includes at least 150 minutes per week of moderate-intensity aerobic activity (50–70% of maximum heart rate) in combination with resistance training at least twice per week. These recommendations are based on the well-established benefits of exercise, including improved blood glucose control, reduced cardiovascular risk factors, facilitation of weight loss, and improved well-being. More recently, the Italian Diabetes Exercise Study (IDES) demonstrated that exercise volume is a better predictor of health improvements than exercise intensity, at least when working within the recommended 50-70% maximum heart rate recommendation. This study also found greater reductions in visceral fat and parameters of non-alcoholic fatty liver disease with increasing cardiorespiratory fitness. However, increased volume means more time spent exercising, which can present as a huge barrier to partaking in any exercise. There has been a growing interest in the beneficial effects of high-intensity interval...

Generally speaking, with age comes a natural loss of muscle mass and function that is owed in no small part to a reduction in physical activity. This may be because protein metabolism is greatly influenced by the contractile activity of skeletal muscle, and it has been shown that muscular disuse results in a reduction in muscle protein synthesis (MPS) both after a meal and when in the fasting state. Even modest reductions in muscular loading through step‐reduction (SR; <1500 steps/day) for 2-weeks has been shown to reduce MPS in older adults, further supporting the notion that sedentariness plays a large role in the anabolic resistance of aging. Somewhat obviously, resistance training (RT) is the foundation of any intervention that seeks to counteract muscle and strength loss, and there is no shortage of evidence showing older individuals to benefit. However, many interventions use high-load programs that may not always be feasible for...

In the U.S., it has been estimated that one-third of adults spend at least 9 waking hours and over two-thirds spend more than 7.5 waking hours being sedentary (SED) every day. In addition, more than two-thirds of adults achieve zero minutes of moderate-to-vigorous physical activity (MVPA). Interestingly enough, one-third of adults are obese and two-thirds are overweight. Coincidence? Not according to research suggesting that both increasing MVPA and reducing SED are required to substantially reduce the risk of obesity. More recently, a wave of publications has appeared in several journals that continue to support the what-should-be-obvious-by-now association between SED and/or MVPA and health. Although all these studies are epidemiological and thus prevent causal inferences, they still provide interesting information and identify associations for future direct testing. First up is the work of Maddison et al from University of Auckland, who sought to characterize typical activity profiles of Americans and determine their...

Is Exercise Really Medicine? An Evolutionary Perspective Daniel Lieberman from the Department of Human Evolutionary Biology, Harvard University recently published an editorial in Current Sports Medicine Reports asking several questions: Why do so many people fail to act in their own best self-interest, at least in terms of promoting good health? Why is exercise actually necessary for health? And what explains the exercise paradox: most people avoid exercise even though physical activity is vital for health? To answer these questions, Lieberman adopts an evolutionary perspective, asking first what types of exercise humans are adapted for and then why exercise may be considered medicine. Obviously all animals are adapted for some type of physical activity, but humans are unique among the primates in that we evolved to run; we became bipedal, started sweating, and developed big butts. In short, the demands of hunting and gathering account for a wide range of novel...

Adjectives are relative, and while I would not consider any obese person to be healthy in general, there is no doubt that some obese individuals are healthier than other obese individuals. This is no different from how some normal-weight people are going to be healthier than other normal-weight people. The divide between healthy and unhealthy is typically the criterion for metabolic syndrome, which requires that an individual possess three or more of the following: abdominal obesity, hypertension, low HDL-c, high triglycerides, and prediabetes. Taking medications to manage any of these conditions also counts. Regardless of weight, common sense tells us that someone without metabolic syndrome is going to be healthier in general than someone with metabolic syndrome, and meta-analyses support this for type-2 diabetes and cardiovascular disease and mortality. A question we might ask is why some people become metabolically unhealthy? Given the vast literature base supporting the health benefits of...