Abstract

Exercise is a well-established tool for cardiovascular risk reduction. Particularly eccentric exercise, which essentially means walking downwards could favour more people becoming physically active. With the present controlled study, we tested the hypothesis that eccentric exercise can improve insulin sensitivity, triglyceride handling, body mass index, glucose tolerance and inflammation. We allocated 127 healthy sedentary individuals to one of two groups: (i) an active group of 102 individuals walking downwards a predefined route three to five times per week over two months, covering a difference in altitude of 540 m; for the upward route a cable car was used, for which adherence was recorded electronically and (ii) a matched control group of 25 individuals who stayed sedentary. Fasting and postprandial metabolic profiles were obtained at baseline and after two months. Compared to baseline, eccentric exercise significantly improved HOMA insulin resistance (1.94 ± 1.65 vs. 1.71 ± 1.36 (µU−1 ml) × ((mmol/l)−122.5); p = 0.038) and resulted in a decrease in fasting glucose (97 ± 15 vs. 94 ± 9 mg dl−1; p = 0.025) and glucose tolerance (238 ± 50 vs. 217 ± 47 mg dl−1 h−1; p < 0.001), whereas these parameters did not change significantly in the control group. Eccentric exercise significantly improved triglyceride tolerance (1923 ± 1295 vs. 1670 ± 1085 mg dl−1 h−1; p = 0.003), whereas triglyceride tolerance remained unchanged in the control group (p = 0.819). Furthermore, body mass index (27.7 ± 4.3 vs. 27.4 ± 4.3 kg m−2; p = 0.003) and C-reactive protein (0.27 ± 0.42 vs. 0.23 ± 0.25 mg dl−1; p = 0.031) were significantly lowered in the eccentric exercise group but not in the control group. Downhill walking, a type of exercise is a promising unusual exercise modality with favorable effects on body mass index, insulin action, on postprandial glucose and triglyceride handling and on C-reactive protein.ClinicalTrials.gov Identifier: NCT00386854.

Highlights

  • Exercise is a well-established tool for cardiovascular risk reduction

  • Individuals often encounter barriers to exercise such as obesity, congestive heart failure and atherosclerotic cardiovascular disease (ASCVD) itself

  • Effects of uphill and downhill hiking on glucose metabolism and blood lipids were demonstrated and the benefit of downhill hiking appears to depend on the energy e­ xpenditure[9]

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Summary

Introduction

Exercise is a well-established tool for cardiovascular risk reduction. eccentric exercise, which essentially means walking downwards could favour more people becoming physically active. With the present controlled study, we tested the hypothesis that eccentric exercise can improve insulin sensitivity, triglyceride handling, body mass index, glucose tolerance and inflammation. A type of exercise is a promising unusual exercise modality with favorable effects on body mass index, insulin action, on postprandial glucose and triglyceride handling and on C-reactive protein. Even a small intervention such as descending stair walking solely could show positive effects such as increasing muscle strength in elderly or obese p­ articipants[11,12]. It is a promising exercise modality for individuals who are not able to participate in more strenuous exercise ­regimens[10]. There are still only a few and mostly small, studies focusing on eccentric exercise (EE)[13,14,15], underlying the necessity of larger controlled clinical trials

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