The Influence of Family History of Type 2 Diabetes on Metabolism during Submaximal Aerobic Exercise and in the Recovery Period in Postmenopausal Women.

Aging and family history of type 2 diabetes (T2D) are known risk factors of T2D. Younger first-degree relatives (FDR) of T2D patients have shown early metabolic alterations, which could limit exercise's ability to prevent T2D. Thus, the objective was to determine whether exercise metabolism was altered during submaximal exercise in FDR postmenopausal women. Nineteen inactive postmenopausal women (control: 10, FDR: 9) aged 60 to 75 years old underwent an incremental test on a cycle ergometer with intensity ranging from 40 to 70% of peak power output. Participants consumed 50 mg of 13C-palmitate 2 h before the test. At the end of each stage, glucose, lactate, glycerol, non-esterified fatty acids and 13C-palmitate were measured in plasma, and 13CO2 was measured in breath samples. Gas exchanges and heart rate were both monitored continuously. There were no between-group differences in substrate oxidation, plasma substrate concentrations or 13C recovered in plasma or breath. Interestingly, despite exercising at a similar relative intensity to control, FDR were consistently at a lower percentage of heart rate reserve. Overall, substrate plasma concentration and oxidation are not affected by family history of T2D in postmenopausal women and therefore not a participating mechanism in the altered response to exercise previously reported. More studies are required to better understand the mechanisms involved in this response.

Increased odds of having the metabolic syndrome with greater fat-free mass: counterintuitive results from the National Health and Nutrition Examination Survey database.

BACKGROUND: It is well established that body composition influences metabolic health, but emerging data are conflicting with the largely purported idea that a large fat-free mass (FFM) has a protective effect on health. A potential explanation for these discrepancies is the way FFM is represented. The first objective is to determine the association between the metabolic syndrome (MetS) and FFM when the latter was represented in three different ways: 1-absolute FFM; 2-relative to squared height (FFMi); and 3-relative to body weight (FFM%). The second objective is to assess the impact of FFM on the relative risk of having the MetS after taking fat mass, physical activity, and sociodemographic variables into account. METHODS: A total of 5274 individuals from the National Health and Nutrition Examination Survey database were studied. Age-specific and sex-specific quartiles of the three representations of FFM were defined, and the prevalence of MetS was determined in each of them. Quartiles of FFMi (kg/m2 ) were used to calculate the odds ratios of having the MetS independently of FM, physical activity levels, and sociodemographic variables. RESULTS: The prevalence of MetS decreased with increasing quartiles of whole-body FFM% (Q1: 40%; Q4: 10%) but grew with increasing quartiles of absolute FFM (Q1: 13%; Q4: 40%) and FFMi (Q1: 10%; Q4: 44%). Similar results were observed for appendicular and truncal FFM. The odds ratios of having the MetS, independently of fat mass, physical activity, and sociodemographic variables, were significantly greater in the fourth quartile of FFMi when compared with the first quartiles of each specific subgroup [Q4 vs. Q1: younger men: 4.16 (1.99-8.68); younger women: 5.74 (2.46-13.39); older men: 1.98 (1.22-3.22); older women: 2.88 (1.69-4.90); all P ≤ 0.01]. CONCLUSIONS: These results support the notion that the representation of FFM significantly influences its association with MetS and that a larger FFM, whether absolute or relative to height, is associated with alterations in cardiometabolic health.

Exercising for Insulin Sensitivity - Is There a Mechanistic Relationship With Quantitative Changes in Skeletal Muscle Mass?

Skeletal muscle (SM) tissue has been repetitively shown to play a major role in whole-body glucose homeostasis and overall metabolic health. Hence, SM hypertrophy through resistance training (RT) has been suggested to be favorable to glucose homeostasis in different populations, from young healthy to type 2 diabetic (T2D) individuals. While RT has been shown to contribute to improved metabolic health, including insulin sensitivity surrogates, in multiple studies, a universal understanding of a mechanistic explanation is currently lacking. Furthermore, exercised-improved glucose homeostasis and quantitative changes of SM mass have been hypothesized to be concurrent but not necessarily causally associated. With a straightforward focus on exercise interventions, this narrative review aims to highlight the current level of evidence of the impact of SM hypertrophy on glucose homeostasis, as well various mechanisms that are likely to explain those effects. These mechanistic insights could provide a strengthened rationale for future research assessing alternative RT strategies to the current classical modalities, such as low-load, high repetition RT or high-volume circuit-style RT, in metabolically impaired populations.

Should Waist Circumference Cutoffs in the Context of Cardiometabolic Risk Factor Assessment be Specific to Sex, Age, and BMI?

OBJECTIVE: A sex-specific standard waist circumference (WC) is widely used to determine cardiometabolic risk across ages even though aging impacts the link between fat distribution and cardiometabolic risk. The objective was to propose WC thresholds that better predict metabolic abnormalities according to sex, age, and body mass index (BMI) categories. METHODS: First, receiver operating characteristic analyses were performed to identify optimal age (20-49, 50-64, and 65-80 years) and BMI (normal weight, overweight, obese I, and obese II+) specific WC thresholds to correctly identify at-risk individuals, that is, presenting ≥2 cardiometabolic risk factors of metabolic syndrome (n = 23,482; NHANES 2007-2014). Second, cross-validation analyses (n = 18,686; NHANES 1999-2006) were used to validate these WC optimal thresholds. Univariate logistic regression models with WC as an independent predictor were performed to quantify odds of being at-risk for each age and BMI subgroups. RESULTS: When age and BMI categories were considered in the identification of optimal WC thresholds, sensitivity to correctly identify at-risk individuals significantly improved. CONCLUSIONS: Our results indicate that the use of WC thresholds that are specific to age and BMI subcategories significantly increases the capacity to accurately identify at-risk individuals. They would thus be highly appropriate for clinicians in the context of efficient cardiometabolic risk assessment and intervention recommendations.

Impact of Mild Hypohydration on Muscle Endurance, Power, and Strength in Healthy, Active Older Men.

Goulet, EDB, Mélançon, MO, Lafrenière, D, Paquin, J, Maltais, M, and Morais, JA. Impact of mild hypohydration on muscle endurance, power, and strength in healthy, active older men. J Strength Cond Res 32(12): 3414-3424, 2018-Under particular circumstances older persons may be vulnerable to developing mild chronic hypohydration. In young adults, hypohydration has been shown to impair muscle endurance, power and strength. Muscle performance declines with aging, a condition known as dynapenia. How hypohydration impacts muscle performance in older persons remains unclear. In this study, we examined this question, believing it may identify a factor exacerbating dynapenia. One-hour after having been passively exposed to heat where either a body mass loss of 1% was induced or euhydration maintained with fluid ingestion, 8 healthy, active older men (age: 68 ± 5 years) completed an exercise testing session where indices of muscle strength (30-second chair stand, grip strength, maximal isometric seated leg-press extension), endurance (seated leg-curl flexion + seated leg-press extension to exhaustion at 60% of 1 repetition maximum), and power (30-second Wingate test) were assessed. Gastrointestinal temperature before exercise testing was not significantly different from that measured before heat exposure with neither hydration regimen. Magnitude-based inferential statistics indicate that from a clinical perspective, the effect of hypohydration on 30-second chair stand (-1.0 ± 4.4%) is possibly harmful, for grip strength (-2.4 ± 4.1%), lower limbs endurance (-7.5 ± 11.2%), and anaerobic power (-3.9 ± 4.3%) likely detrimental, and unclear with respect to maximal isometric lower limb strength. Maintaining adequate hydration in older men is important, since hypohydration of only 1% body mass could impede muscle endurance, power and strength and, consequently, worsen the impact of dynapenia.