Relative protein intake and associations with markers of physical function in those with type 2 diabetes.

AIMS: To examine the independent associations between relative protein intake (g kg-1  day 1 ) and markers of physical function in those with type 2 diabetes, while also comparing with current guidelines for protein intake. METHODS: This analysis reports data from the ongoing Chronotype of Patients with Type 2 Diabetes and Effect on Glycaemic Control (CODEC) study. Functional assessments included: Short Physical Performance Battery (SPPB), 60 s sit-to-stand (STS-60), 4-m gait speed, time to rise from a chair (×5) and handgrip strength. Participants also completed a self-reported 4 day diet diary. Regression analyses assessed whether relative protein intake was associated with markers of physical function. Interaction terms assessed whether the associations were modified by sex, age, HbA1c or body mass index (BMI). RESULTS: 413 participants were included (mean ± SD:age = 65.0 ± 7.7 years, 33% female, BMI = 30.6 ± 5.1 kg/m2 ). The average total protein intake was 0.88 ± 0.31 g kg-1  day-1 . 33% of individuals failed to meet the reference nutrient intake for the United Kingdom (≥0.75 g kg-1  day-1 ), and 87% for European recommendations (≥1.2 g kg-1  day-1 ). After adjustment, each 0.5 g/kg of protein intake was associated with an 18.9% (95% CI: 2.3, 35.5) higher SPPB score, 22.7% (1.1, 44.3) more repetitions in STS-60, 21.1% (4.5, 37.7) faster gait speed and 33.2% (16.9, 49.5) lower chair rise time. There were no associations with handgrip strength or any interactions. CONCLUSIONS: Relative protein intake was positively associated with physical function outcomes, even after consideration of total energy intake. As a number of individuals were below the current guidelines, protein intake may be a modifiable factor of importance for people with type 2 diabetes.

Age comparison of changes in local warm and cold sensitivity due to whole body cooling.

PURPOSE: This study investigated the influence of whole body cooling on local thermal sensitivity to warm (40°C) and cold (20°C) stimuli in 10 young (age: 24 ± 2 yrs) and 10 older males (age: 69 ± 4 yrs). METHODS: Local warm and cold sensitivity was assessed at eight body regions using a 25 cm2 pressure controlled thermal probe after 40 min of whole body exposure to a thermoneutral (NEUT: 25°C/40% RH) and a cold (COLD: 12°C/50% RH) environment. Gastrointestinal temperature (Tgi), mean and local skin temperature, heart rate, whole body thermal sensation and comfort, and skin blood flow were also measured. RESULTS: Whole body cooling blunted local cold sensitivity but warm sensitivity was maintained in both age groups. Furthermore, a significant age-related decline (from young to older group) in sensitivity to a warm stimulus was observed in both NEUT and COLD conditions. Older males also had a greater ΔTgi compared to the young but had similar thermal sensation and comfort responses. CONCLUSION: The observed interaction effect of local cold stimulation and whole body cooling may be related to both stimuli triggering similar TRP channels, whereas the lack of interaction between local warm stimuli and whole body cooling may be related to these two stimuli triggering different TRP channels. The findings reiterate the potential thermoregulatory risks (e.g. cold injury and hypothermia) associated with ageing, even with such short exposure times.

The impact of COVID-19 restrictions on accelerometer-assessed physical activity and sleep in individuals with type 2 diabetes.

AIMS: Restrictions during the COVID-19 crisis will have impacted on opportunities to be active. We aimed to (a) quantify the impact of COVID-19 restrictions on accelerometer-assessed physical activity and sleep in people with type 2 diabetes and (b) identify predictors of physical activity during COVID-19 restrictions. METHODS: Participants were from the UK Chronotype of Patients with type 2 diabetes and Effect on Glycaemic Control (CODEC) observational study. Participants wore an accelerometer on their wrist for 8 days before and during COVID-19 restrictions. Accelerometer outcomes included the following: overall physical activity, moderate-to-vigorous physical activity (MVPA), time spent inactive, days/week with ≥30-minute continuous MVPA and sleep. Predictors of change in physical activity taken pre-COVID included the following: age, sex, ethnicity, body mass index (BMI), socio-economic status and medical history. RESULTS: In all, 165 participants (age (mean±S.D = 64.2 ± 8.3 years, BMI=31.4 ± 5.4 kg/m2 , 45% women) were included. During restrictions, overall physical activity was lower by 1.7 mg (~800 steps/day) and inactive time 21.9 minutes/day higher, but time in MVPA and sleep did not statistically significantly change. In contrast, the percentage of people with ≥1 day/week with ≥30-minute continuous MVPA was higher (34% cf. 24%). Consistent predictors of lower physical activity and/or higher inactive time were higher BMI and/or being a woman. Being older and/or from ethnic minorities groups was associated with higher inactive time. CONCLUSIONS: Overall physical activity, but not MVPA, was lower in adults with type 2 diabetes during COVID-19 restrictions. Women and individuals who were heavier, older, inactive and/or from ethnic minority groups were most at risk of lower physical activity during restrictions.

Body mapping of regional sweat distribution in young and older males.

PURPOSE: Given the pressing impact of global warming and its detrimental effect on the health of older populations, understanding age-related changes in thermoregulatory function is essential. Age differences in regional sweat distribution have been observed previously, but given the typically small measurement areas assessed, the development of whole body sweat maps for older individuals is required. Therefore, this study investigated age-related differences in regional sweat distribution in a hot environment (32 °C/50%RH) in young and older adults, using a body mapping approach. METHODS: Technical absorbent pads were applied to the skin of 14 young (age 24 ± 2 years) and 14 older (68 ± 5 years) males to measure regional sweat rate (RSR) at rest (30 min) and during exercise (30 min), at a fixed heat production (200 W m-2). Gastrointestinal (Tgi) and skin temperature (Tsk), heart rate, thermal sensation, and thermal comfort were also measured. RESULTS: Whole body sweat maps showed that despite equal heat production, healthy older males had significantly lower gross sweat loss (GSL) than the young and significantly lower RSR at almost all body regions at rest and at the hands, legs, ankles, and feet during exercise. The lower sweat loss in the older group coincided with a greater increase in Tgi and a consistently higher Tsk at the legs, despite subjectively feeling slightly cooler than younger individuals. CONCLUSION: These findings support the evidence of age-related deterioration in both autonomic and subjective responses in the heat and highlight the lower extremities as the most affected body region.

Improvements in Glycemic Control After Acute Moderate-Intensity Continuous or High-Intensity Interval Exercise Are Greater in South Asians Than White Europeans With Nondiabetic Hyperglycemia: A Randomized Crossover Study.

OBJECTIVE: To examine whether circulating metabolic responses to low-volume high-intensity interval exercise (LV-HIIE) or continuous moderate-intensity aerobic exercise (CME) differ between white Europeans and South Asians with nondiabetic hyperglycemia (NDH). RESEARCH DESIGN AND METHODS: Thirteen white Europeans and 10 South Asians (combined median [interquartile range] age 67 [60-68] years, HbA1c 5.9% [5.8-6.1%] [41.0 (39.9-43.2) mmol ⋅ mol-1]) completed three 6-h conditions (sedentary control [CON], LV-HIIE, and CME) in a randomized order. Exercise conditions contained a single bout of LV-HIIE and CME, respectively (each ending at 2 h), with meals provided at 0 and 3 h. Circulating glucose (primary outcome), insulin, insulin resistance index (IRI), triglycerides, and nonesterified fatty acids were measured at 0, 0.5, 1, 2, 3, 3.5, 4, 5, and 6 h. Data were analyzed as postexercise time-averaged area under the curve (AUC) adjusted for age, sex, and preexercise AUC. RESULTS: Glucose was similar in each condition and with ethnicity, with no condition-by-ethnicity interaction (P ≥ 0.28). However, insulin was lower in LV-HIIE (mean [95% CI] -44.4 [-23.7, -65.1] mU ⋅ L-1) and CME (-33.8 [-13.7, -53.9] mU ⋅ L-1) compared with CON. Insulin responses were greater in South Asians (interaction P = 0.03) such that values were similar in each ethnicity during exercise conditions, despite being 33% higher in South Asians during CON. IRI followed a similar pattern to insulin. Lipids were unaffected by exercise. CONCLUSIONS: Reductions in insulin and insulin resistance after acute LV-HIIE and CME are greater in South Asians than in white Europeans with NDH. Further trials are required to examine the longer-term impact of LV-HIIE and CME on cardiometabolic health.

Effect of tyrosine ingestion on cognitive and physical performance utilising an intermittent soccer performance test (iSPT) in a warm environment.

PURPOSE: The aim of this study was to investigate the effect of tyrosine (TYR) ingestion on cognitive and physical performance during soccer-specific exercise in a warm environment. METHODS: Eight male soccer players completed an individualised 90 min soccer-simulation intermittent soccer performance test (iSPT), on a non-motorised treadmill, on two occasions, within an environmental chamber (25 °C, 40 % RH). Participants ingested tyrosine (TYR; 250 mL sugar free drink plus 150 mg kg body mass(-1) TYR) at both 5 h and 1 h pre-exercise or a placebo control (PLA; 250 mL sugar free drink only) in a double-blind, randomised, crossover design. Cognitive performance (vigilance and dual-task) and perceived readiness to invest physical effort (RTIPE) and mental effort (RTIME) were assessed: pre-exercise, half-time, end of half-time and immediately post-exercise. Physical performance was assessed using the total distance covered in both halves of iSPT. RESULTS: Positive vigilance responses (HIT) were significantly higher (12.6 ± 1.7 vs 11.5 ± 2.4, p = 0.015) with negative responses (MISS) significantly lower (2.4 ± 1.8 vs 3.5 ± 2.4, p = 0.013) in TYR compared to PLA. RTIME scores were significantly higher in the TYR trial when compared to PLA (6.7 ± 1.2 vs 5.9 ± 1.2, p = 0.039). TYR had no significant (p > 0.05) influence on any other cognitive or physical performance measure. CONCLUSION: The results show that TYR ingestion is associated with improved vigilance and RTIME when exposed to individualised soccer-specific exercise (iSPT) in a warm environment. This suggests that increasing the availability of TYR may improve cognitive function during exposure to exercise-heat stress.