Low Intensity Post Meal Walking and Glycemic Control in Older People

老年人低强度餐后步行与血糖控制

• 批准号: 9144988
• 负责人: LORETTA DIPIETRO
• 金额: $ 38.04万
• 依托单位: GEORGE WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-30 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9144988
• 关键词: Adherence; Age; Aging; Back; Biological Markers; Data; Elderly; Exercise; Fatty acid glycerol esters; Glucose; Glycosylated hemoglobin A; Health; Health Benefit; Home environment; Human; Hyperglycemia; Impaired fasting glycaemia; Insulin; Insulin Resistance; Kinetics; Life; Life Style; Measures; Metabolic; Metabolic Control; Muscle Contraction; Non-Insulin-Dependent Diabetes Mellitus; OGTT; Outcome; Peripheral; Physiological; Population; Prevalence; Protocols documentation; Public Health; Regulation; Resistance; Risk; Sampling Studies; Secondary to; Study Subject; Testing; Time; Tissues; Training; Variant; Walking; base; blood glucose regulation; burden of illness; design; flexibility; glucose monitor; glucose uptake; glycemic control; improved; insulin secretion; insulin sensitivity; lipid metabolism; oxidation; programs; response; sedentary; sedentary lifestyle

 DESCRIPTION (provided by applicant): The modern-day lifestyle is characterized by a majority of time spent sitting throughout the day. Older people may be especially vulnerable to the harmful effects of prolonged sitting due to a loss of physiologic reserve and the fact that the prevalence of excessive sitting may be especially high in this sector of the population. Metabolic flexibility and glycemic control decline progressively with aging; however, this can be attributed primarily to factors secondary to aging. Indeed, sedentary living is a challenge to metabolic control -especially in older age when insufficient insulin secretion and multi-tissue insulin resistance are also important contributors to impaired glycemic control. Unfortunately, there are few well-controlled human studies testing variations in the degree of metabolic dysregulation resulting from prolonged sitting and whether minimal intensity walking can improve resistance to such dysregulation. The purpose of this proposal is to examine whether low-intensity post-meal walking is an effective counter-measure to prolonged (uninterrupted) sitting for improving glycemic control and metabolic flexibility in older people (=65 y) at risk for type 2 diabetes due o impaired fasting glucose (IFG). Specific aims are: 1) to determine the continuous kinetics of 24h glycemic control under separate conditions of prolonged sitting or intermittent, low-intensity post-meal walking in inactive older people (N=45) with IFG; 2) to determine the enduring effects of a 16-week home-based program of low- intensity post-meal (PM) walking (3x15 min/day performed 1/2 h after each meal on 5 days/week; n=15) vs. intermittent (INT) walking (3x15 min performed 1h before each meal on 5 days/week; n=15) vs. 45 min of sustained (SUS)walking (performed between 9 and 10:30 AM on 5 days/week; n=15) on several biomarkers of insulin sensitivity, glycemic control and lipid metabolism in this same study sample; and 3) to determine whether 16 weeks of lower-intensity training improves resistance to metabolic dysregulation with prolonged sitting. If successful, this strategy would have substantial geriatric relevance - especially since it can be utilized by more frail segments of the older adult population. Given the prominence of the sedentary lifestyle and the excess disease burden associated with disuse and hyperglycemia in older age, there are enormous public health benefits to designing countermeasures that are enjoyable and effective within the populations needing them the most.

 描述（由申请人提供）：现代生活方式的特点是大部分时间都是坐着的。老年人可能特别容易受到长期坐着的有害影响，这是由于生理储备的丧失以及 在这部分人口中，久坐的比例可能特别高。代谢灵活性和血糖控制随着年龄的增长而逐渐下降;然而，这主要归因于继发于衰老的因素。事实上，久坐不动的生活对代谢控制是一个挑战-特别是在老年人中，胰岛素分泌不足和多组织胰岛素抵抗也是血糖控制受损的重要因素。不幸的是，很少有控制良好的人体研究测试长时间坐着导致的代谢失调程度的变化，以及最小强度的步行是否可以提高对这种失调的抵抗力。本提案的目的是检查低强度餐后步行是否是一种有效的对策，以改善血糖控制和代谢灵活性的老年人（≥ 65岁）的2型糖尿病风险由于空腹血糖受损（IFG）长期（不间断）坐着。具体目标是：1）确定IFG不活动老年人（N=45）在长时间坐姿或间歇性低强度餐后步行的单独条件下24小时血糖控制的连续动力学; 2）确定16周低强度餐后（PM）步行的家庭计划的持久效果（每周5天，每次进餐后1/2小时进行3 × 15分钟/天; n=15）与间歇性（INT）步行（每周5天，每次进餐前1小时进行3x 15分钟; n=15）与45分钟持续（SUS）步行（在9和10：30 AM之间进行，5天/周; n=15）在该相同研究样品中对胰岛素敏感性、血糖控制和脂质代谢的几种生物标志物的影响;和3）确定16周的低强度训练是否改善了对长时间坐着的代谢失调的抵抗。如果成功，这一战略将具有重大的老年相关性-特别是因为它可以被老年人口中更虚弱的部分所利用。鉴于 由于久坐不动的生活方式以及与老年人废用和高血糖症相关的过度疾病负担的突出，设计在最需要的人群中令人愉快和有效的对策对公共卫生有巨大的好处。