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J Appl Physiol (September 12, 2003). doi:10.1152/japplphysiol.00707.2003
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Submitted on July 8, 2003
Accepted on September 10, 2003

The effect of the volume and intensity of exercise training on insulin sensitivity

Joseph A Houmard1*, Charles J Tanner2, Cris A Slentz3, Brian D Duscha3, Jennifer S McCartney2, and William E Kraus4

1 Department of Exercise and Sport Science, East Carolina University, Greenville, NC, USA; Human Performance Laboratory, East Carolina University, Greenville, NC, USA; Diabetes/Obesity Center, East Carolina University, Greenville, NC, USA
2 Department of Exercise and Sport Science, East Carolina University, Greenville, NC, USA; Human Performance Laboratory, East Carolina University, Greenville, NC, USA
3 Divisions of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC, USA
4 Divisions of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC, USA; Duke Center for Living, Duke University Medical Center, Durham, NC, USA

* To whom correspondence should be addressed. E-mail: HOUMARDJ{at}MAIL.ECU.EDU.

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-months: 1) Low Volume/Moderate Intensity [~12 miles walking/wk at 40-55% VO2peak]; 2) Low Volume/High Intensity [~12 miles jogging/wk at 65-80% VO2peak], and 3) High Volume/High Intensity [~20 miles jogging/wk at 65-80% VO2peak]. Training volume (mi/wk) was achieved by exercising ~115 min/wk (Low Volume/High Intensity) or ~170 min/week (Low Volume/Moderate Intensity and High Volume/High Intensity). 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.




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