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Exercise and improved insulin sensitivity in older women: evidence of the enduring benefits of higher intensity training

¹The John B. Pierce Laboratory, and the Departments of ²Epidemiology and Public Health, ³Internal Medicine, and ⁴Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, Connecticut

Submitted 25 April 2005 ; accepted in final form 29 August 2005

Few studies have compared the relative benefits of moderate- vs. higher intensity exercise training on improving insulin sensitivity in older people while holding exercise volume constant. Healthy older (73 ± 10 yr) women (N = 25) who were inactive, but not obese, were randomized into one of three training programs (9-mo duration): 1) high-intensity [80% peak aerobic capacity (O_{2 peak}); T_H] aerobic training; 2) moderate-intensity (65% O_{2 peak}; T_M) aerobic training; or 3) low-intensity (stretching) placebo control (50% O_{2 peak}; C_TB). Importantly, exercise volume (300 kcal/session) was held constant for subjects in both the T_H and the T_M groups. O_{2 peak} was determined by using a graded exercise challenge on a treadmill. Total body fat and lean mass were determined with dual-energy X-ray absorptiometry. The rate of insulin-stimulated glucose utilization as well as the suppression of lipolysis were determined 72 h after the final exercise bout by using a two-step euglycemic-hyperinsulinemic clamp. We observed improved glucose utilization at the higher insulin dose with training, but these improvements were statistically significant only in the T_H (21%; P = 0.02) compared with the T_M (16%; P = 0.17) and C_TB (8%; P = 0.37) groups and were observed without changes in either body composition or O_{2 peak}. Likewise in the T_H group, we detected a significant improvement in insulin-stimulated suppression (%) of adipose tissue lipolysis at the low-insulin dose (38–55%, P < 0.05). Our findings suggest that long-term higher intensity exercise training provides more enduring benefits to insulin action compared with moderate- or low-intensity exercise, likely due to greater transient effects.

elderly; endurance training; diabetes

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