Diet and exercise in type 2 diabetes mellitus

Feuerstein, Barbara L.

doi:10.1016/s0899-9007(96)00398-x

Cited by 11 publications

(6 citation statements)

References 67 publications

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“…For the effects of exercise training on insulin sensitivity, independent of weight loss, the picture is even less clear. Although the present study found little effect of exercise alone on insulin sensitivity, previous reports [46][47][48] have shown that aerobic exercise im- Resting hemodynamic measures after treatment, adjusting for pretreatment levels. Mean arterial pressure (A), total peripheral resistance (B), heart rate (C), and cardiac output (D) are plotted separately.…”

Section: Commentcontrasting

confidence: 89%

“…The failure of aerobic exercise alone to affect glucose levels is consistent with other data showing no enduring effect of such training on glucose metabolism, despite the positive effects on glucose associated with acute aerobic exercise and resistance training. 46,47 Moreover, the few studies 48 that have shown improvements in glucose control after exercise training have not clearly demonstrated whether these effects are due to exercise independent of weight loss. For the effects of exercise training on insulin sensitivity, independent of weight loss, the picture is even less clear.…”

Section: Commentmentioning

confidence: 99%

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Exercise and Weight Loss Reduce Blood Pressure in Men and Women With Mild Hypertension

Blumenthal¹,

Sherwood²,

Gullette³

et al. 2000

Arch Intern Med

241

104

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Background: Lifestyle modifications have been recommended as the initial treatment strategy for lowering high blood pressure (BP). However, evidence for the efficacy of exercise and weight loss in the management of high BP remains controversial. Methods:One hundred thirty-three sedentary, overweight men and women with unmedicated high normal BP or stage 1 to 2 hypertension were randomly assigned to aerobic exercise only; a behavioral weight management program, including exercise; or a waiting list control group. Before and following treatment, systolic and diastolic BPs were measured in the clinic, during daily life, and during exercise and mental stress testing. Hemodynamic measures and metabolic functioning also were assessed.Results: Although participants in both active treatment groups exhibited significant reductions in BP relative to controls, those in the weight management group generally had larger reductions. Weight management was associated with a 7-mm Hg systolic and a 5-mm Hg diastolic clinic BP reduction, compared with a 4-mm Hg systolic and diastolic BP reduction associated with aerobic exercise; the BP for controls did not change. Participants in both treatment groups also displayed reduced peripheral resistance and increased cardiac output compared with controls, with the greatest reductions in peripheral resistance in those in the weight management group. Weight management participants also exhibited significantly lower fasting and postprandial glucose and insulin levels than participants in the other groups.Conclusions: Although exercise alone was effective in reducing BP, the addition of a behavioral weight loss program enhanced this effect. Aerobic exercise combined with weight loss is recommended for the management of elevated BP in sedentary, overweight individuals. Med. 2000;160:1947-1958 H YPERTENSION IS a major health problem in this country, affecting more than 43 million people in the United States. Arch Intern1 Hypertension is among the most common reasons for outpatient visits.2 Despite this, blood pressure (BP) control is often inadequate. 3Although BP can be lowered pharmacologically in hypertensive individuals, 4,5 antihypertensive medications are not effective for everyone, may be costly, and may induce adverse effects 6-9 that impair quality of life and reduce adherence. Moreover, abnormalities associated with hypertension, such as insulin resistance and lipemia, may persist or may even be exacerbated by some antihypertensive medications.10-13 As a result, nonpharmacological approaches to the treatment of hypertension have received growing attention.The 1997 report 5 of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends that lifestyle modifications be the initial treatment strategy for lowering high BP. Despite these recommendations, however, empirical data supporting the efficacy of exercise and weight loss in the management of hypertension are relatively limited. Numerous observational studies [14][15][16] have de...

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Section: Commentcontrasting

confidence: 89%

Section: Commentmentioning

confidence: 99%

Exercise and Weight Loss Reduce Blood Pressure in Men and Women With Mild Hypertension

Blumenthal¹,

Sherwood²,

Gullette³

et al. 2000

Arch Intern Med

241

104

View full text Add to dashboard Cite

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“…Some studies have demonstrated that exercise training is associated with reduced glucose levels and improved glycemic control40–44, while others have not45–50. Because studies that have shown improvements in glucose control after exercise training have not established that these effects are due to exercise independent of weight loss51, the extent to which the exercise component of the DASH-WM condition contributed to the metabolic improvements observed in the ENCORE study is not known. The effects of exercise training on lipids also have provided mixed results52 although recent evidence suggests that high levels of exercise without weight loss may be required to achieve improvements in lipid and lipoprotein variables53.…”

Section: Discussionmentioning

confidence: 99%

Effects of the Dietary Approaches to Stop Hypertension Diet Alone and in Combination With Exercise and Caloric Restriction on Insulin Sensitivity and Lipids

et al. 2010

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Abstract-This study examined the effects of the Dietary Approaches to Stop Hypertension (DASH) diet on insulin sensitivity and lipids. In a randomized control trial, 144 overweight (body mass index: 25 to 40) men (nϭ47) and women (nϭ97) with high blood pressure (130 to 159/85 to 99 mm Hg) were randomly assigned to one of the following groups: (1) DASH diet alone; (2) DASH diet with aerobic exercise and caloric restriction; or (3) usual diet controls (UC). Body composition, fitness, insulin sensitivity, and fasting lipids were measured before and after 4 months of treatment. Insulin sensitivity was estimated on the basis of glucose and insulin levels in the fasting state and after an oral glucose load. Participants in the DASH diet with aerobic exercise and caloric restriction condition lost weight (Ϫ8.7 kg [95% CI: Ϫ2.0 to Ϫ9.7 kg]) and exhibited a significant increase in aerobic capacity, whereas the DASH diet alone and UC participants maintained their weight (Ϫ0.3 kg [95% CI: Ϫ1.2 to 0.5 kg] and ϩ0.9 kg [95% CI: 0.0 to 1.7 kg], respectively) and had no improvement in exercise capacity. DASH diet with aerobic exercise and caloric restriction demonstrated lower glucose levels after the oral glucose load, improved insulin sensitivity, and lower total cholesterol and triglycerides compared with both DASH diet alone and UC, as well as lower fasting glucose and low-density lipoprotein cholesterol compared with UC. DASH diet alone participants generally did not differ from UC in these measures. Combining the DASH diet with exercise and weight loss resulted in significant improvements in insulin sensitivity and lipids. Despite clinically significant reductions in blood pressure, the DASH diet alone, without caloric restriction or exercise, resulted in minimal improvements in insulin sensitivity or lipids. (Hypertension. 2010; 55:1199-1205.)

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“…Several studies have found that WC has been the best of the anthropometric indicators, with excellent correlation to abdominal imaging and high association with cardiovascular risk factors, especially diabetes [ 8 , 25 , 26 ]. WC evaluates the fat deposition in the abdominal region, and abdominal visceral obesity is a more severe cardiovascular risk factor than general obesity [ 27 – 29 ] that is usually assessed by BMI.…”

Section: Discussionmentioning

confidence: 99%

Comparing the Ability of Anthropometric Indicators in Identifying Metabolic Syndrome in HIV Patients

et al. 2016

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BackgroundHighly active antiretroviral therapy (HAART) can cause side effects in HIV patients, as the metabolic syndrome. Early identification of risk for development of cardiovascular diseases using available reliable and practical methods is fundamental. On this basis, the aim of this study was to compare the effectiveness of anthropometric indicators to identify metabolic syndrome in HIV patients on HAART.MethodsIt is a cross-sectional study. A number of 280 stable HIV patients were studied. It measured weight, height, waist circumference (WC), hip circumference (HP), thigh circumference (TC) and calculated body mass index (BMI), body adiposity index (BAI), waist to hip ratio (WHR) and waist to thigh ratio (WTR). There was also a performance of biochemical tests of lipid profile and fasting glucose. Systemic blood pressure was measured. The criteria proposed by the National Cholesterol Education Program III (NCEP-ATP III) to metabolic syndrome classification was used. Individuals were divided in groups with or without metabolic alterations and their anthropometric indicators were compared. Receiver operating characteristic (ROC) curves were designed for each anthropometric indicator using the metabolic syndrome classification to identify sensitivity and specificity.ResultsWC was a good tool to identify each metabolic disorder separately: total cholesterol (only females, p<0.05), triglycerides (only males, p<0.001), HDL cholesterol (p<0.05), LDL cholesterol (p<005) and fasting glycemic (p<005). WC also showed the best performance to identify metabolic syndrome in both genders (areas under the curve (AUCs): 0.79 and 0.76 for male and female, respectively), while BAI proved to be an inadequate indicator (AUCs: 0.63 and 0.67 for males and females), respectively, in this population.ConclusionsThe central adiposity measure (WC) had the best performance to identify metabolic syndrome, and it is a convenient, cheap and reliable tool that can be used in clinical practice routinely to prevent cardiovascular complications in HIV patients.

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Diet and exercise in type 2 diabetes mellitus

Cited by 11 publications

References 67 publications

Exercise and Weight Loss Reduce Blood Pressure in Men and Women With Mild Hypertension

Exercise and Weight Loss Reduce Blood Pressure in Men and Women With Mild Hypertension

Effects of the Dietary Approaches to Stop Hypertension Diet Alone and in Combination With Exercise and Caloric Restriction on Insulin Sensitivity and Lipids

Comparing the Ability of Anthropometric Indicators in Identifying Metabolic Syndrome in HIV Patients

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