Abstract
PURPOSE: To examine the effects of amount, intensity, and mode of exercise training on HOMA (a marker of fasting insulin resistance) across 10 exercise-only interventions from the three STRRIDE (Studies of Targeted Risk Reduction Interventions through Defined Exercise) clinical trials. METHODS: A total of 518 subjects completed the three trials with pre and post intervention HOMA values. Subjects with dyslipidemia [STRRIDE I (n=224) and STRRIDE AT/RT (n=144)] or prediabetes [STRRIDE-PD (n=150)] were randomized to either control group or one of 10 interventions, ranging from doses of 8-22 kcal/kg/week (KKW); intensities of 50-75% V̇O2peak; and durations of 6-9 months. Two groups included resistance training and one group included diet intervention (weight loss of 7%). Fasting blood samples were obtained at baseline and 16-24 h after the final exercise bout. Paired t-tests determined within group change score significance (p<0.05). RESULTS: In the inactive controls. HOMA increased significantly —became more insulin resistant. After training, all intervention groups became more insulin sensitive; 6 of these 10 groups had significant improvements in HOMA. In non-statistical comparisons across the trials, the diet + exercise group had the greatest improvement (-0.90 ± 0.9); resistance training alone experienced the least improvement in HOMA. The 14 KKW moderate intensity (STRRIDE I) and the aerobic + resistance training (STRRIDE AT/RT) groups obtained 77% and 55% of the improvement observed in the diet + exercise group from STRRIDE-PD. Only 4 of the 7 aerobic exercise groups had significant improvements. CONCLUSION: On average, STRRIDE interventions improved fasting insulin resistance. Adding resistance to aerobic training elicits an additive training effect on insulin resistance. In individuals with prediabetes, incorporating dietary intervention with aerobic training results in the most robust improvement in fasting insulin resistance.
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