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The Effect of Vigorous- Versus Moderate-Intensity Aerobic Exercise on Insulin Action

  • Diabetes and Cardiovascular Disease (S Malik, Section Editor)
  • Published:
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Abstract

Due to the beneficial effects on a wide range of modern medical conditions, most professional societies recommend regular aerobic exercise as part of a healthy lifestyle. Many of the exercise-related health benefits exhibit a dose-response relationship: Up to a point, more exercise is more beneficial. However, recent studies have suggested that different exercise intensities may provide distinct health benefits, independent of energy expenditure (i.e., exercise dose). One of these benefits, primarily mediated by the skeletal muscle, is exercise-related changes in insulin action and glucose homeostasis. Glucose uptake in the exercising muscle occurs through insulin-independent mechanisms whose downstream signaling events ultimately converge with insulin-signaling pathways, a fact that may explain why exercise and insulin have additive effect on skeletal muscle glucose uptake. Although the existing evidence is somewhat conflicting, well-controlled randomized studies suggest that, when controlled for total energy expenditure, moderate-intensity aerobic exercise improves insulin sensitivity more than vigorous-intensity aerobic exercise. The mechanisms underlying this difference are largely unknown. One possible explanation involves enhanced metabolism of fatty acid stores in the skeletal muscle by moderate-intensity exercise, which may directly improve insulin sensitivity. Overall, new technologic and physiologic investigative tools are beginning to shed light on the biology. Further understanding of these mechanisms will lead to better understanding of the clinical implications of a healthy lifestyle and may ultimately offer new therapeutic targets for common medical conditions such as insulin resistance and diabetes.

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Authors and Affiliations

  1. Duke Molecular Physiology Institute, Duke University Medical Center, 300 North Duke Street, Durham, NC, 27701, USA

    Robert W. McGarrah, Cris A. Slentz & William E. Kraus

  2. Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC, USA

    Robert W. McGarrah & William E. Kraus

Authors
  1. Robert W. McGarrah
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  2. Cris A. Slentz
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  3. William E. Kraus
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Correspondence to Robert W. McGarrah.

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Robert W. McGarrah, Cris A. Slentz, and William E. Kraus declare that no relevant conflicts of interest exist.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Diabetes and Cardiovascular Disease

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McGarrah, R.W., Slentz, C.A. & Kraus, W.E. The Effect of Vigorous- Versus Moderate-Intensity Aerobic Exercise on Insulin Action. Curr Cardiol Rep 18, 117 (2016). https://doi.org/10.1007/s11886-016-0797-7

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  • DOI: https://doi.org/10.1007/s11886-016-0797-7

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