Abstract
Background: High-intensity interval training (HIIT) can improve several aspects of cardiometabolic health. Previous studies have suggested that adaptations to exercise training can be augmented with post-exercise milk or protein consumption, but whether this nutritional strategy can impact the cardiometabolic adaptations to HIIT in type 2 diabetes is unknown.Objective: To determine if the addition of a post-exercise milk or protein beverage to a high-intensity interval training (HIIT) intervention improves cardiometabolic health in individuals with type 2 diabetes.Design: In a proof-of-concept, double-blind clinical trial 53 adults with uncomplicated type 2 diabetes were randomized to one of three nutritional beverages (500 mL skim-milk, macronutrient control, or flavored water placebo) consumed after exercise (3 days/week) during a 12 week low-volume HIIT intervention. HIIT involved 10 X 1-min high-intensity intervals separated by 1-min low-intensity recovery periods. Two sessions per week were cardio-based (at ~90% of heart rate max) and one session involved resistance-based exercises (at RPE of 5–6; CR-10 scale) in the same interval pattern. Continuous glucose monitoring (CGM), glycosylated hemoglobin (HbA1c), body composition (dual-energy X-ray absorptiometry), cardiorespiratory fitness (), blood pressure, and endothelial function (%FMD) were measured before and after the intervention.Results: There were significant main effects of time (all p < 0.05) but no difference between groups (Interaction: all p > 0.71) for CGM 24-h mean glucose (−0.5 ± 1.1 mmol/L), HbA1c (−0.2 ± 0.4%), percent body fat (−0.8 ± 1.6%), and lean mass (+1.1 ± 2.8 kg). Similarly, (+2.5 ± 1.6 mL/kg/min) and %FMD (+1.4 ± 1.9%) were increased, and mean arterial blood pressure reduced (−6 ± 7 mmHg), after 12 weeks of HIIT (all p < 0.01) with no difference between beverage groups (Interaction: all p > 0.11).Conclusion: High-intensity interval training is a potent stimulus for improving several important metabolic and cardiovascular risk factors in type 2 diabetes. The benefits of HIIT are not augmented by the addition of post-exercise protein.
Highlights
Worldwide more than 257 million people have type 2 diabetes, a figure projected to reach 395 million by 2030 (Shaw et al, 2010)
Fasted blood and body composition measures were obtained on day 1 and continuous glucose monitoring (CGM) was performed across days 2–4 while participants followed a standardized diet
There were no reports of hypoglycemia after exercise or at home throughout the intervention
Summary
Worldwide more than 257 million people have type 2 diabetes, a figure projected to reach 395 million by 2030 (Shaw et al, 2010). Interventions that improve both glycemic control and reduce cardiovascular risk factors are central to reducing the burden of type 2 diabetes (Inzucchi et al, 2012). Large controlled trials and numerous experimental studies reveal the widespread benefits of exercise for people with type 2 diabetes (Marwick et al, 2009; Lin et al, 2015). The Look AHEAD (Action for Health in Diabetes) trial showed that moderate continuous exercise and a caloric restrictive diet leads to sustained reductions in cardiometabolic risk factors, diabetes complications, and health costs (Wing et al, 2013). Previous studies have suggested that adaptations to exercise training can be augmented with post-exercise milk or protein consumption, but whether this nutritional strategy can impact the cardiometabolic adaptations to HIIT in type 2 diabetes is unknown
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