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1 The John B. Pierce Laboratory, New Haven, CT, USA; Epidemiology & Public Health, Yale University School of Medicine, New Haven, CT, USA
2 The John B. Pierce Laboratory, New Haven, CT, USA; Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
3 The John B. Pierce Laboratory, New Haven, CT, USA; Cellular & Molecular Physiology, Yale University School of Medicine, New Haven, CT, USA
* To whom correspondence should be addressed. E-mail: ldipietro{at}jbpierce.org.
Few studies have compared the relative benefits of moderate versus higher-intensity exercise training on improving insulin sensitivity in older people while holding exercise volume constant. Healthy older (73±10 y) women (N=25) who were inactive, but not obese were randomized into one of three training programs (9-month duration):1) higher-intensity (80% VO2peak; TH ) or 2) moderate-intensity (65% VO2peak;TM ) aerobic training; or 3) low-intensity (stretching) placebo control (50% VO2peak;CTB). Importantly, exercise volume (300 kcal/session-1)was held constant for subjects in both the TH and the TM groups. Peak aerobic capacity (VO2peak) was determined using a graded exercise challenge on a treadmill. Total body fat and lean mass were determined with DXA. The rate of insulin-stimulated glucose utilization (M-value), as well as the suppression of lipolysis, were determined ~72 h after the final exercise bout using a 2-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 TH (21%; p=0.02) compared with the TM (16%; p=0.17) and CTB (8%; p=0.37) groups, and were observed without changes in either body composition or peak aerobic capacity. Likewise in the TH group, we detected a significant improvement in insulin-stimulated suppression (%) of adipose tissue lipolysis at the low insulin dose (38% to 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
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