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J Appl Physiol 96: 101-106, 2004. First published September 12, 2003; doi:10.1152/japplphysiol.00707.2003
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Effect of the volume and intensity of exercise training on insulin sensitivity

Joseph A. Houmard,1,2,3 Charles J. Tanner,1,2 Cris A. Slentz,4 Brian D. Duscha,4 Jennifer S. McCartney,1,2 and William E. Kraus4,5

1Department of Exercise and Sports Science, 2Human Performance Laboratory, and 3Diabetes/Obesity Center, East Carolina University, Greenville 27858; and 4Division of Cardiology, Department of Medicine, and 5Duke Center for Living, Duke University Medical Center, Durham, North Carolina 27710

Submitted 8 July 2003 ; accepted in final form 10 September 2003

Physical activity enhances insulin action in obese/overweight individuals. However, the exercise prescription required for the optimal enhancement is not known. The purpose of this study was to test the hypothesis that exercise training consisting of vigorous-intensity activity would enhance insulin sensitivity more substantially than moderate-intensity activity. Sedentary, overweight/obese subjects (n = 154) were randomly assigned to either control or an exercise group for 6 mo: 1) low-volume/moderate-intensity group [~12 miles walking/wk at 40–55% peak O2 consumption (O2 peak)], 2) low-volume/high-intensity group (~12 miles jogging/wk at 65–80% O2 peak), and 3) high-volume/high-intensity group (~20 miles jogging/wk at 65–80% O2 peak). Training volume (miles/wk) was achieved by exercising ~115 min/wk (low-volume/high-intensity group) or ~170 min/wk (low-volume/moderate-intensity and high-volume/high-intensity groups). Insulin action was measured with an insulin sensitivity index (SI) from an intravenous glucose tolerance test. In the control group, there was a decrement (P < 0.05) in SI. In contrast, all the exercise groups significantly (P < 0.05) increased SI; the relative increment in the low-volume/moderate-intensity and high-volume/high-intensity groups (~85%) were greater than in the low-volume/high-intensity group (~40%). In conclusion, physical activity encompassing a wide range of intensity and volume minimizes the insulin resistance that develops with a sedentary lifestyle. However, an exercise prescription that incorporated ~170 min of exercise/wk improved insulin sensitivity more substantially than a program utilizing ~115 min of exercise/wk, regardless of exercise intensity and volume. Total exercise duration should thus be considered when designing training programs with the intent of improving insulin action.

obesity; cardiovascular disease; diabetes


Address for reprint requests and other correspondence: J. A. Houmard, Human Performance Laboratory, Ward Sports Medicine Bldg., East Carolina Univ., Greenville, NC 27858 (E-mail: HOUMARDJ{at}MAIL.ECU.EDU).




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