Tan 1 Tan, Tiffany Nufs 106A, Section 1 9 September 2012 Physical Activity is Important According to the article, Lowering

Physical Activity Impairs Glycemic Control in Healthy Volunteers, (Mikus et al, 2012, p. 225) researchers are trying to see if being inactive effects PPG, which is an independent predictor of cardiovascular events and death, regardless of diabetes status, (Mikus et al, 2012, p. 225) in an individual who is healthy and active since they know that insulin sensitivity affects those who are sedentary. The reason why they are conducting this study is because type 2 diabetes is increasing in the Unites States, so they are trying to observe ways to prevent this. Based on epidemiological evidence, not enough exercise incorporated in a daily lifestyle is likely to result in insulin resistance and type 2 diabetes. On the other hand, exercising is likely to prevent cardiovascular diseases and developing insulin resistance, which may lead to type 2 diabetes. The purpose of this study was to see how reducing physical activity from walking more than or equal to 10,000 steps a day to the typical range of about 5,000 steps a day affects PPG and glycemic variability in a healthy person. Their hypothesis was that short-term changes in physical activity would increase glycemic variability and PPG while consuming meals. The participants of this study consisted of healthy individuals based on a medical history questionnaire. Their ages ranged from 20-35, and there were eight men and four women. These participants all did greater than or equal to 10,000 steps a day as measured by a pedometer. Volunteers who took less than 10,000 steps a day were excluded. The following participants were not allowed to be part of the study: had a body mass index greater than or equal to 30 kg.m, were

Tan 2 pregnant, smoked, drank more than or equal to 14 servings of alcohol a week, breast-feeding, or were involved in competitive endurance events. On the first day of the study, the participants were equipped with Continuous Glucose Monitor (CGMS), pedometers, and Intelligent Device for Energy Expenditure and Physical Activity monitors (IDEEA). While being instrumented with these three items, the participants were told to keep a fixed physical activity schedule, and also to keep a detailed record of their diet and physical activity for three days. In order for the 120-min glucose response to be recorded efficiently after eating a meal, the volunteers were asked to have two hours or more between meals and snacks. On the fourth day, a two-hour OGTT was performed in the morning after fasting the previous night. After seven days or more, the participants repeated the protocol, and were told to exercise less during the inactive phase, which was where physical activity was decreased. They had to collect less than or equal to 5,000 steps a day for three days, and they tracked their steps using a pedometer. To avoid errors in the test, four participants repeated the protocol starting with inactive before active phase. The participants had to make sure they were consuming the same food around the same time during the active and inactive phases to conclude that PPG changes were caused by physical activity and not diet. To prevent diurnal influences, OGTTs were done in the morning at the same time during the active and inactive phases. For demographic measures, the following were measured at baseline: height, weight, and body composition. The Food Processor SQL was used for diet records to search for micro and macronutrient information. VO2max, which is maximal oxygen consumption, were measured by indirect calorimetry. During the continuous glucose monitoring period, a glucose sensor was

Tan 3 placed below the skin in the periumbilical region, and it was connected to the continuous glucose monitor for three days. The results from the study showed that PPG at 30 and 60 minutes increased during three days of less physical activity in the previous healthy active participants. PPG excursion, which is postmeal-premeal blood glucose, increased also by 42 percent for 30 minutes, 97 percent by 60 minutes, and 33 percent by 90 minutes after a meal. After three days though, insulin and c-peptide responses to the OGTT increased, but the glucose during an OGTT did not change very much. After the study, the researchers found that it is important to be active everyday in order to control glycemic levels. Therefore, the study results did support the authors hypothesis. Data from the study showed that small changes in physical activity for a short period indicated changes in PPG and glycemic variability. Even though PPG and the change of PPG increased when the participants went from 12,000 steps to 5,000 steps a day for three days, OGTT and fasting glucose concentration did not indicate glucose levels increasing. A limitation to this study was how small the sample was. The study could have had better results if there was a larger sample. The author concluded that physical activity is important for a healthy lifestyle. Those who have type 2 diabetes are able to improve their sensitivity by just exercising. Physical activity also benefits individuals who are healthy and are non-diabetic as well. Hence, the study not only proved that low physical activity increased insulin resistance, but that exercising is always important in order to prevent other diseases such as cardiovascular disease and type 2 diabetes.

Reference Booth W. F., Libla L. J., Mikus R. C., Douglas J. O., Taylor M. A., & Thyfault P. J. (2011) Lowering Physical Activity Impairs Glycemic Control in Healthy Volunteers. Journal

Tan 4 of the American College of Sports Medicine. (225-231). Retrieved from: http://www.sjsu.edu/people/izzie.brown/courses/nufs106a/