Abstract
0150 Exercise training reverses insulin resistance in obese and elderly adults, but there is a wide variation in the magnitude of the response. The reason for this variation remains unknown. PURPOSE: To determine the contribution of altered macronutrient intake and improved aerobic fitness on the variation in improved insulin sensitivity in obese elderly men and women participating in an aerobic exercise training program. METHODS: Twenty-two obese men and women (Age = 63±1 years, BMI = 33.6±1.1 kg/m2) volunteered to participate in a 12-week supervised exercise program (5 d/wk, 60 min/day, treadmill/cycle ergometry @ 85% of heart rate max). Insulin resistance was determined before and after the 12-week program using the euglycemic (5.0 mM) hyperinsulinemic (40 mU.m2.min−1) clamp procedure. Aerobic fitness was assessed during a treadmill VO2max test and macronutrient intake was determined from multiple 3-day food records. RESULTS: After the exercise training program insulin sensitivity was increased by 36% (3.6±0.4 to 4.9±0.6 mg.kg FFM.min−1). VO2max improved 15%, from 21.1±0.8 to 24.3±1.3 ml.kg.min−1 (P<0.003). Total caloric intake and macronutrient (carbohydrate, protein, fat) content of the diet was similar before and at the end of the program. Stepwise multiple regression analysis indicated that the significant change achieved in VO2max, explained 39% of the variance in improved insulin sensitivity, while subtle increases in carbohydrate intake, (expressed per/kgdelta) accounted for an additional 13% of the variance. Together, these two variables combined, could explain 52% of the variance in insulin sensitivity (r = 0.72, P<0.001). CONCLUSION: Observing the impact of altered VO2max on insulin stimulated glucose disposal has reinforced our understanding that the metabolic effect of any given therapeutic manipulation is strongly influenced by the degree of biologic adaptation, as well as the specific dietary intake. Supported by NIH grants AG12834, RR00080 and the Diabetes Assoc. of Greater Cleveland.
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