Non-pharmacological interventions for the treatment and prevention of cardio-metabolic disease

In recent years there has been a surge in interest concerning high intensity intermittent exercise training (HIT) due to its ability to confer rapid notable cardio-metabolic health benefits. Specifically, HIT has been shown to improve insulin sensitivity and glycaemic control as well as other cardiovascular health factors after just 2 weeks of training (typically 6 training sessions). This thesis investigated the potential therapeutic role of HIT training within obese cohorts specifically addressing metabolic health, inclusive of inflammatory profiles and glycaemic control. [Continues.

An evaluation of low volume high-intensity intermittent training (HIIT) for health risk reduction in overweight and obese men

Both sprint interval training (SIT) and high-intensity intermittent training (HIIT) have been described as time-efficient strategies for inducing favourable metabolic and cardiorespiratory adaptations in healthy and diseased participants. BACKGROUND: To date, little attention has been given to profiling the potential health benefits of HIIT or modified HIIT training within overweight and obese cohorts with particular focus on inflammation. Within this pilot trial, we tested the hypothesis that 6 sessions of HIIT performed over 2 weeks with 1-2 days’rest would improve aerobic capacity, glucose metabolism and inflammatory profile in an overweight and obese male cohort. Additionally, we profiled the potential health benefits of 4 HIIT sessions performed over the same period. METHODS: 18 overweight or obese males (BMI = 31.2 ± 3.6; V̇O2 = 30.3 ± 4.4 ml.kg.min-1) were studied before and 72 h after HIIT. Training sessions consisted of 10 x 1 min intervals at 90% HRpeak separated by 1 min recovery periods. Exercise was performed either 6 (group 1, n = 8) or 4 (group 2, n = 10)times over a 2 week period. RESULTS: After training no changes were detected from baseline for body composition, aerobic capacity, glucose metabolism or inflammatory profile(p > 0.05) in either group. CONCLUSION: Both 6 and 4 sessions of HIIT performed over a 2-week period are ineffective in improving selected health markers within an overweight and obese cohort

The impact of high intensity intermittent exercise on resting metabolic rate in healthy males

Introduction High-intensity intermittent exercise training (HIT) may favourably alter body composition despite low training volumes and predicted energy expenditure (EE). Purpose To characterise the acute impact of two common HIT protocols on EE and post-exercise oxygen consumption (11 h EPOC). Methods Oxygen consumption (l min−1), respiratory exchange ratio (RER) and EE were measured in nine healthy, lean males over 12 h under three conditions: control (CON), HIT1 (10 × 1 min high-intensity cycling bouts followed by 1 min rest) and HIT2 (10 × 4 min high-intensity cycling bouts followed by 2 min rest). Results Total exercise period EE during HIT1 (1,151 ± 205 kJ) (mean ± SD) was significantly lower than HIT2 (2,788 ± 322 kJ; p < 0.001). EE within the 60 min after exercise was significantly albeit marginally higher after HIT1 (388 ± 44 kJ; p = 0.02) and HIT2 (389 ± 39 kJ; p = 0.01) compared with CON (329 ± 39 kJ), with no difference between exercise conditions (p = 0.778). RER during this period was significantly lower in HIT1 (0.78 ± 0.06; p = 0.011) and HIT2 (0.76 ± 0.04; p = 0.004) compared with CON (0.87 ± 0.06). During the ‘slow phase’ of EPOC (1.25–9.75 h), there were no significant differences in EE (p = 0.07) or RER (p = 0.173) between trials

Appetite regulatory hormone responses on the day following a prolonged bout of moderate-intensity exercise

Exercise increases energy expenditure however acutely this does not cause compensatory changes in appetite or food intake. This unresponsiveness contrasts the rapid counter-regulatory changes seen after food restriction. The present investigation examined whether corrective changes in appetite-regulatory parameters occur after a time delay, namely, on the day after a single bout of exercise. Nine healthy males completed two, two-day trials (exercise & control) in a random order. On the exercise trial participants completed 90 min of moderate-intensity treadmill running on day one (10:30–12:00 h). On day two appetite-regulatory hormones and subjective appetite perceptions were assessed frequently in response to two test meals provided at 08:00 and 12:00 h. Identical procedures occurred in the control trial except no exercise was performed on day one. Circulating levels of leptin were reduced on the day after exercise (AUC 5841 ± 3335 vs. 7266 ± 3949 ng− 1·mL− 1 · 7 h, P = 0.012). Conversely, no compensatory changes were seen for circulating acylated ghrelin, total PYY, insulin or appetite perceptions. Unexpectedly, levels of acylated ghrelin were reduced on the exercise trial following the second test meal on day two (AUC 279 ± 136 vs. 326 ± 136 pg− 1·mL− 1 · 3 h, P = 0.021). These findings indicate that short-term energy deficits induced by exercise initially prompt a compensatory response by chronic but not acute hormonal regulators of appetite and energy balance. Within this 24 h time-frame however there is no conscious recognition of the perturbation to energy balance

Table1_A scalable 12-week exercise and education programme reduces symptoms and improves function and wellbeing in people with hip and knee osteoarthritis.docx

IntroductionOsteoarthritis is a chronic musculoskeletal condition that impacts more than 300 million people worldwide, with 43 million people experiencing moderate to severe disability due to the disease. This service evaluation provides the results from a tailored blended model of care on joint health, physical function, and personal wellbeing.Methods1,593 adult participants with osteoarthritis completed the Nuffield Health Joint Pain Programme between February 2019 and May 2022. The 12-week programme included two 40-min exercise sessions per week. All exercise sessions were conducted face-to-face and were followed by 20 min of education to provide information and advice on managing osteoarthritis.ResultsThe 12-week joint pain programme significantly improved Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) global scores (Week 0: 37.5 [17.2]; Week 12: 24.0 [16.6]; p 2; Week 12: 28.6 [4.4] kg/m2; p DiscussionWith reductions in physical symptoms of osteoarthritis and improvements in personal wellbeing, the joint pain programme delivered by personal trainers in a gym-setting offers a nationally scalable, non-pharmacological treatment pathway for osteoarthritis.</p