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Journal of Endocrinological Investigation

Erschienen in:

01.12.2019 | Original Article

One-year caloric restriction and 12-week exercise training intervention in obese adults with type 2 diabetes: emphasis on metabolic control and resting metabolic rate

verfasst von: F. Zurlo, C. Trevisan, N. Vitturi, E. Ravussin, C. Salvò, S. Carraro, M. Siffi, I. Iob, A. Saller, L. Previato, G. Sergi, S. de Kreutzenberg, A. Maran, A. Avogaro

Erschienen in: Journal of Endocrinological Investigation | Ausgabe 12/2019

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Abstract

Purpose

The effect of combined lifestyle interventions (LSI) including dietary and physical activity on metabolic health, energy metabolism and VO₂max in diabetic patients has provided mixed results. We evaluated the impact of 1-year caloric restriction (CR), and 12-week supervised structured exercise training (SSET) on metabolic health, RMR and VO₂max in obese adults with type 2 diabetes.

Methods

After 1-month education for LSI, 33 participants had anthropometric, biochemical and metabolic assessments. They then started CR based on RMR, and 3-month SSET during the months 1–3 (Early-SSET) or 4–6 (Late-SSET). Reassessments were planned after 3, 6 and 12 months. Using a per-protocol analysis, we evaluated parameter changes from baseline and their associations for the 23 participants (11 Early-SSET, 12 Late-SSET) who completed the study. RMR was adjusted (adjRMR) for age, sex, fat-free mass (FFM) and fat mass (FM).

Results

Compared with baseline, after 6 months we found significant increases in VO₂max (+ 14%) and HDL-cholesterol (+ 13%), and reduction in body mass index (− 3%), FM (− 8%) and glycated hemoglobin (HbA1c, − 7%). Training-related caloric expenditure negatively correlated with changes in body weight (p < 0.001), FM (p < 0.001) and HbA1c (p = 0.006). These results were confirmed at the 12-month follow-up. Pooling together all follow-up data, adjRMR changes correlated with changes in glycemia (r = 0.29, p = 0.02), total-cholesterol (r = 0.29, p = 0.02) and VO₂max (r = − 0.26,p = 0.02). No significant differences emerged between the Early- and Late-SSET groups.

Conclusions

Combined intervention with SSET and CR improved metabolic control. Changes in metabolic health and fitness correlated with changes of adjRMR, which was reduced improving fitness, glycemia and cholesterolemia.

Clinical trial registry

Trial registration number: NCT03785379. URL of registration: http://clinicaltrials.gov.

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Titel: One-year caloric restriction and 12-week exercise training intervention in obese adults with type 2 diabetes: emphasis on metabolic control and resting metabolic rate
verfasst von: F. Zurlo
C. Trevisan
N. Vitturi
E. Ravussin
C. Salvò
S. Carraro
M. Siffi
I. Iob
A. Saller
L. Previato
G. Sergi
S. de Kreutzenberg
A. Maran
A. Avogaro
Publikationsdatum: 01.12.2019
Verlag: Springer International Publishing
Erschienen in: Journal of Endocrinological Investigation / Ausgabe 12/2019
Elektronische ISSN: 1720-8386
DOI: https://doi.org/10.1007/s40618-019-01090-x

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