Abstract

Ambiguous results have been reported regarding the effects of training on resting metabolic rate (RMR), and the importance of training type and intensity is unclear. Moreover, studies in subjects with type 2 diabetes (T2D) are sparse. In this study, we evaluated the effects of interval and continuous training on RMR in subjects with T2D. Furthermore, we explored the determinants for training-induced alterations in RMR. Data from two studies, both including T2D subjects, were encompassed in this manuscript. Study 1 was a randomized, crossover study where subjects (n = 14) completed three, 2-week interventions [control, continuous walking training (CWT), interval-walking training (IWT)] separated by washout periods. Training included 10 supervised treadmill sessions, 60 min/session. CWT was performed at moderate walking speed [aiming for 73% of walking peak oxygen uptake (VO2peak)], while IWT was performed as alternating 3-min repetitions at slow (54% VO2peak) and fast (89% VO2peak) walking speed. Study 2 was a single-arm training intervention study where subjects (n = 23) were prescribed 12 weeks of free-living IWT (at least 3 sessions/week, 30 min/session). Before and after interventions, RMR, physical fitness, body composition, and glycemic control parameters were assessed. No overall intervention-induced changes in RMR were seen across the studies, but considerable inter-individual differences in RMR changes were seen in Study 2. At baseline, total body mass (TBM), fat-free mass (FFM), and fat mass were all associated with RMR. Changes in RMR were associated with changes in TBM and fat mass, and subjects who decreased body mass and fat mass also decreased their RMR. No associations were seen between changes in physical fitness, glycemic control, or FFM and changes in RMR. Neither short-term continuous or interval-type training, nor longer term interval training affects RMR in subjects with T2D when no overall changes in body composition are seen. If training occurs concomitant with a reduction in fat mass, however, RMR is decreased. NCT02320526 and NCT02089477.

Highlights

  • Most subjects with type 2 diabetes (T2D) are overweight or obese, and overweight/obesity is considered to be a central component of the pathogenesis and pathology of T2D [1, 2]

  • If training occurs concomitant with a reduction in fat mass, resting metabolic rate (RMR) is decreased

  • The increased energy expenditure in the hours following an exercise session is known as excess post-exercise oxygen consumption (EPOC), and this is dependent on both exercise duration and exercise intensity [6]

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Summary

Introduction

Most subjects with type 2 diabetes (T2D) are overweight or obese, and overweight/obesity is considered to be a central component of the pathogenesis and pathology of T2D [1, 2]. Energy consumption is dependent on several factors, with resting metabolic rate (RMR) being responsible for 60–70% of the total energy consumption in subjects who are not very active [4]. Other studies have found that training interventions do not affect RMR [13, 14]. Whereas these discrepancies between studies may be dependent on different factors, it has been suggested that VO2max is an important determinant for changes in RMR [9, 15], and so the ability of a training intervention to increase VO2max may be essential. Ambiguous results have been reported regarding the effects of training on resting metabolic rate (RMR), and the importance of training type and intensity is unclear. We explored the determinants for training-induced alterations in RMR

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