Obesity Clinical Trial
Official title:
The High Intensity Exercise to Promote Accelerated Improvements in CardiorEspiratory Fitness (HI-PACE) Study
African Americans are at a substantially greater type 2 diabetes risk compared to Caucasians; however, very little data are available on the effects of exercise training on type 2 diabetes risk factors in at risk African Americans. The present proposal will evaluate the effects of 6 months of moderate versus vigorous intensity aerobic exercise training on fitness, insulin sensitivity, mitochondrial capacity, skeletal muscle oxidative/insulin sensitivity markers, adiposity, and quality of life in African Americans.
African Americans have a much greater risk of type 2 diabetes compared to Caucasians in the
United States. Similarly, recent evidence has emerged that fitness level, a major risk factor
for type 2 diabetes also tends to be lower in African Americans. Many scientific studies have
shown that exercise training has a beneficial impact on fitness levels and a variety of other
type 2 diabetes risk factors such as the reduction of glucose/insulin levels, and body fat
Importantly, studies performed in mostly Caucasian populations suggest that exercise training
at a vigorous intensity may promote greater improvements in type 2 diabetes risk factors
compared to moderate intensity exercise, which may suggest that it has greater promise in
reducing type 2 diabetes risk. However, few exercise training studies compare the health
benefits of different exercise training programs (such as exercise intensity) in African
Americans, which is clinically important due to their greater type 2 diabetes risk, and that
fact that they are less likely to meet public health recommendations for physical activity
compared to their Caucasian counterparts.
The High Intensity exercise to Promote Accelerated improvements in CardiorEspiratory fitness
(HI-PACE) study will evaluate the effect of exercise intensity on cardiorespiratory fitness
(CRF) and insulin sensitivity in obese (BMI: 30-45) African Americans (40-65 yrs.) with at
least 1 additional T2D risk factor. Participants (n=60) will be recruited in collaboration
with the ECU Center for Health Disparities, and subsequently randomized to moderate intensity
(MOD-INT, n=20) or high intensity (HIGH-INT, n=20) aerobic exercise training, or to a control
group (CON, n=20) for 24 weeks. Supervised exercise training will be performed at a heart
rate associated with ~50% and ~75% of VO2 max in the MOD-INT and the HIGH-INT groups,
respectively at the same exercise volume of 600 MET-minutes per week (consistent with public
health recommendations). The primary outcome is the change in CRF, which will be assessed at
baseline, mid-intervention, and follow-up. Insulin sensitivity will be measured via an
intravenous glucose tolerance test at baseline and follow-up. Other secondary measures
include mitochondrial oxidative capacity using infrared and measurements on muscle biopsies
(PGC-1α and other indices of mitochondrial content), the expression of a protein involved
with insulin action (GLUT-4 expression) in skeletal muscle as well as systemic inflammation,
adiposity, quality of life and exercise enjoyment measures.
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