![]() The objective was to make physical-activity assessment/promotion standard in clinical practice so that healthcare can be augmented by evidence-based physical-activity resources. ‘Exercise is medicine’ is an initiative launched by the American Medical Association and American College of Sports Medicine in 2007. However, ‘metabolically-healthy obese’ and ‘metabolically-obese normal-weight’ (MONW) phenotypes indicate greater complexity at least partially rooted in genetic predisposition. Excess body-fat deposition is a risk factor for T2D with 10-year risk increasing by 4.6- and 10.0-fold for females and 3.5- and 11.2-fold for males classified as overweight (BMI, 25.0–29.9 kg/m 2) or obese (BMI, 30.0–34.9 kg/m 2), respectively. Intervention at the prediabetic stage is, therefore, critical. Predictions suggest up to 70% of individuals with prediabetes will develop T2D such that total prevalence in 2050 could increase to as much as 33% of the population (compared to, for example, 14% in 2010). fasting level of 100–125 mg/dL compared to 125 for normal and T2D, respectively). Furthermore, it is estimated that ~88 million have prediabetes, which means blood-glucose concentration is higher than normal, but not yet high enough for T2D diagnosis (e.g. However, one thing is certain: when it comes to the effect of exercise on insulin sensitivity, nothing lasts forever.Įstimates indicate that ~34 million US citizens have diabetes with 90–95% suffering from T2D. For example, some adaptations comprising the acute effect might be longer lasting while some chronic changes are shorter lived. Finally, referring to either as a singular entity is an oversimplification because each likely includes multiple alterations in anatomy/physiology which might have different time courses for dissipation. Granted, ‘detraining’ has a longer time course compared to dissipation of the acute effect however, chronic adaptations do indeed wane if regular workouts are not continued. Moreover, in reality, the highly-touted chronic effect is also a bit of a misrepresentation because it, too, must be maintained. However, the need to discount the lingering effect of an exercise bout in these circumstances contrasts an acute effect’s potential role as a therapeutic agent for individuals who exercise frequently enough such that it is present most/all of the time. Importantly, this is also the case in the research setting where it is necessary to control for PAE when assessing previously-sedentary individuals for example, before and after a training intervention if the objective is to determine the chronic effect that accumulates from repeat training (i.e. Conversely, for those who exercise regularly and, therefore, benefit from the ‘continuous’ presence of such an effect, the representation would be accurate. For example, if a habitually-sedentary person performed a bout of exercise the day before a physician’s visit, the prolonged acute effect (PAE) of exercise on insulin sensitivity could mask an elevated reading on an oral glucose tolerance test (OGTT). acute effect) can provide misleading information regarding a person’s health status in some circumstances. The lingering effects of a single exercise bout (i.e. Consequently, exercise to combat insulin resistance that begins the pathological journey to cardiometabolic diseases including type 2 diabetes (T2D) should be prescribed with precision to elicit a PAE on insulin sensitivity to serve as a first-line defense prior to pharmaceutical intervention or, when such intervention is necessary, a potential adjunct to it. Untrained individuals and individuals with lower insulin sensitivity benefit more from this effect and even trained individuals with high insulin sensitivity restore most of a detraining-induced loss following one session of resumed training. ![]() For example, in contrast to chronic adaptations, the effect of exercise on insulin sensitivity is predominantly rooted in a prolonged acute effect (PAE) that can last up to 72 h. However, transient changes in function that occur following each exercise bout (acute effect) are also important to consider. Regular exercise causes chronic adaptations in anatomy/physiology that provide first-line defense for disease prevention/treatment (‘exercise is medicine’).
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