o This combination group was total combined resistance training and aerobic training. o In HART-D we reduced it to guidelines o This study shows the efect of doing more than what is recommended (optimized program)- no more and get greater health benefits. o Look at the diference (1 whole percent) when you have people do more than what is recommended. Doing more than what is recommended helps your diabetes. o On average, they had a much bigger afect than HART-D did.
o In this study, they did NOT allow them to change their medications. As people started feeling better they were not allowed to get of of the medicine. This helped them even further. o **Combined efect of a larger dose of aerobic and resistance AND medications. o The big diference that you see here is due to extra exercise. Combination of Aerobic and Resistance: o Greater improvements in glucose control. o Higher reduction in body fat (data not shown). o Results dependent on medications. Higher reduction in body fat in the groups that did aerobic and resistance training (not shown here but it happened). If you lose weight during aerobic exercise alone, what type of weight do you lose? o Around 60% fat and 40% muscle. If you go on a diet, and you lose 20 kilos. How much is fat and how much is muscle? o 60% fat and 40% muscle loss. Found this same thing in the HART-D muscle. Lost fat and muscle as if they had been on a diet. Resistance training loss fat and gained muscle but their cardiovascular efects weren’t improved Do both and you lose only fat as well as improve cardiovascular efects. Summary Most recommendations are based on epidemiologic data. In sedentary people, low dose exercise is beneficial. Greater quantities of exercise are necessary to further improve health outcomes. “The appropriate type of activity is best determined by the individual’s preference and what will be sustained” – NIH Consensus Development Panel NEED large clinical trials to further understand the appropriate dose (>2 doses) and to confirm results from epidemiologic studies. o Clinical outcomes
o Mechanistic targets SCREENING FOR PA Pre-participation Health Screening and Preliminary Testing Corresponding Reading: Guidelines: Chapters 2 and 3 Resource M: Chapters 11, 12, and 13 Building individual in our mind, getting idea of what their risk factors and health outcomes are. Start with pre screening, categorizing people. You can bring people in the lab and then you can prescribe exercise and then you can do follow up testing and use this to modify continued intervention. Wihtout follow up, we really don’t know what happened with our individual. Does VO2 max pre screened really tell you anything?? Until we put them through an intervention and do a follow up test, THEN we know. CHANGE in fitness is much more important than baseline fitness level.
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- Fall '09