Roberto Codella

Sugars, exercise and health

BACKGROUND There is a direct link between a variety of addictions and mood states to which exercise could be relieving. Sugar addiction has been recently counted as another binge/compulsive/addictive eating behavior, differently induced, leading to a high-significant health problem. Regularly exercising at moderate intensity has been shown to efficiently and positively impact upon physiological imbalances caused by several morbid conditions, including affective disorders. Even in a wider set of physchiatric diseases, physical exercise has been prescribed as a complementary therapeutic strategy. METHOD A comprehensive literature search was carried out in the Cochrane Library and MEDLINE databases (search terms: sugar addiction, food craving, exercise therapy, training, physical fitness, physical activity, rehabilitation and aerobic). RESULTS Seeking high-sugar diets, also in a reward- or craving-addiction fashion, can generate drastic metabolic derangements, often interpolated with affective disorders, for which exercise may represent a valuable, universal, non-pharmachological barrier. LIMITATIONS More research in humans is needed to confirm potential exercise-mechanisms that may break the bond between sugar over-consumption and affective disorders. CONCLUSIONS The purpose of this review is to address the importance of physical exercise in reversing the gloomy scenario of unhealthy diets and sedentary lifestyles in our modern society.

Metformin Treatment Prevents Sedentariness Related Damages in Mice

Metformin (METF), historical antihyperglycemic drug, is a likely candidate for lifespan extension, treatment and prevention of sedentariness damages, insulin resistance, and obesity. Skeletal muscle is a highly adaptable tissue, capable of hypertrophy response to resistance training and of regeneration after damage. Aims of this work were to investigate METF ability to prevent sedentariness damage and to enhance skeletal muscle function. Sedentary 12-week-old C57BL/6 mice were treated with METF (250 mg/kg per day, in drinking water) for 60 days. METF role on skeletal muscle differentiation was studied in vitro using murine C2C12 myoblasts. Muscular performance evaluation revealed that METF enhanced mice physical performance (Estimated VO2max). Biochemical analyses of hepatic and muscular tissues indicated that in liver METF increased AMPK and CAMKII signaling. In contrast, METF inactivated ERKs, the principal kinases involved in hepatic stress. In skeletal muscle, METF activated AKT, key kinase in skeletal muscle mass maintenance. In in vitro studies, METF did not modify the C2C12 proliferation capacity, while it positively influenced the differentiation process and myotube maturation. In conclusion, our novel results suggest that METF has a positive action not only on the promotion of healthy aging but also on the prevention of sedentariness damages.

Active subjects with autoimmune type 1 diabetes have better metabolic profiles than sedentary controls

Previous studies in humans with type 1 diabetes mellitus (T1D) and in nonobese diabetic mice have investigated the beneficial immunomodulatory potential of aerobic physical activity. Performing high volume of aerobic exercise may favorably regulate autoimmunity in diabetes. We tested whether increased physical activity is a self-sufficient positive factor in T1D subjects. During a 3-month observational period, active (six males; 40.5 ± 6.1 years; BMI: 24.5 ± 2.1) and sedentary (four males, three females; 35.9 ± 8.9 years; BMI: 25.7 ± 3.8) T1D individuals on insulin pump therapy were studied for metabolic, inflammatory, and autoimmune parameters. At baseline and at the end of a 3-month period, glycosylated hemoglobin (HbA1c), autoantibodies (anti-GAD, anti-ZnT8, anti-IA2, and ICA) and proinflammatory cytokines (IL-6 and TNF-α) were evaluated. During the third month of the period, physically active T1D patients showed a significant reduction in the average glucose levels (-9%, p = 0.025, by CGM) compared to the first month values, and even their hyperglycemic episodes (>180 mg/dl) diminished significantly (-24.2%, p = 0.032 vs. first month). Moreover, active T1D subjects exhibited an improved body composition with respect to sedentary controls. No significant changes were detected as to the autoimmune and inflammatory profiles. This study confirms the beneficial role of physical exercise associated with insulin pump therapy in order to improve metabolic control in individuals with T1D. These preliminary positive observations need to be challenged in a prolonged interventional follow-up.

Ultra-marathon 100 km in an islet-transplanted runner.

Following pancreatic islet transplantation (IT), the major barriers to the long-term insulin independence of type 1 diabetic patients are the progressive deterioration of b-cell function and the need for immunosuppressive therapy.Within this context, we found favorable effects for physical exercise in several studies [1]. In particular, we monitored metabolic, autoimmune, and inflammatory profiles of an islet-transplanted marathon runner (10-year transplanted) during his training and participation in a variety of ultra-endurance events. The subject raced in a competitive 100-km ultramarathon, a 50-kmmarathon and a half-marathon in less than 70 days. He had a weekly average training volume of 75 km. With respect to the time preceding and following the intense endurance efforts, the hematochemical parameters of the competitive period showed an adequate glycemic control (HbA1c) and unchanged antibody titer (anti-GAD, anti-IA2, anti-ZnT8) despite systemic inflammation (Table 1). The extraordinary aerobic activity was compatible with the treatment of this transplanted diabetic patient.

Effect of Sugar versus Mixed Breakfast on Metabolic and Neurofunctional Responses in Healthy Individuals

We investigated the effects of glucose and diverse breakfasts on glucose increment and ghrelin suppression and cognitive processing of sensory information assessed by frontal P300 evoked potentials. In a randomized crossover design, 12 healthy individuals (6M/6F; BMI 22.2 ± 0.4 kg/m2; 27 ± 1.3 years, mean ± SEM) underwent 50 g OGTT (A) and 3 breakfasts (B1: milk and cereals; B2: milk, apple, and chocolate cream-filled sponge cake; B3: milk, apple, bread, and hazelnut chocolate cream) to assess plasma glucose-, insulin-, and ghrelin excursions. An electroencephalography was performed before and 100 min after consumption of each load to measure the latency of frontal P300 evoked potentials as index of cognitive performance. Breakfasts B1 and B2 exhibited significantly lower glycemic and insulinemic responses as compared to A. Breakfast B3 exhibited significantly lower glycemic, but not insulinemic response, as compared to A. Final plasma ghrelin inhibition was more pronounced, albeit not significantly, in all breakfasts with respect to A. P300 latency tended to decrease following each of the three breakfasts, but B3 was the only breakfast capable to elicit a statistically significant reduction in P300 latency with respect to A (p < 0.01), suggesting ameliorated cognitive performance. Such amelioration was correlated with the 2-hour final inhibition of plasma ghrelin concentration (r = 0.61, p = 0.01).

Why should people with type 1 diabetes exercise regularly

Plethoric evidence reminds of the protective effects of exercise against a number of health risks, across all ages, in the general population. The benefits of exercise for individuals with type 2 diabetes are indisputable. An in-depth understanding of energy metabolism has reasonably entailed exercise as a cornerstone in the lifestyle of almost all subjects with type 1 diabetes. Nevertheless, individuals with type 1 diabetes often fail in accomplishing exercise guidelines and they are less active than their peer without diabetes. Two major obstacles are feared by people with type 1 diabetes who wish to exercise regularly: management of blood glucose control and hypoglycemia. Nowadays, strategies, including glucose monitoring technology and insulin pump therapy, have significantly contributed to the participation in regular physical activity, and even in competitive sports, for people with type 1 diabetes. Novel modalities of training, like different intensity, interspersed exercise, are as well promising. The beneficial potential of exercise in type 1 diabetes is multi-faceted, and it has to be fully exploited because it goes beyond the insulin-mimetic action, possibly through immunomodulation.

Exercise has the guts: How physical activity may positively modulate gut microbiota in chronic and immune-based diseases

Limited animal and human research findings suggests that exercise might have a beneficial role for health gut. Cardiorespiratory fitness correlates with health-associated gut parameters such as taxonomic diversity and richness. Physical exercise may augment intestinal microbial diversity through several mechanisms including promotion of an anti-inflammatory state. Disease-associated microbial functions were linked to distinct taxa in previous studies of familial type 1 diabetes mellitus (T1D). An integrated multi-approach in the study of T1D, including physical exercise, is advocated. The present review explores how exercise might modulate gut microbiota and microbiome characteristics in chronic and immune-based diseases, given the demonstrated relationship between gut function and human health.

May the force be with you: why resistance training is essential for subjects with type 2 diabetes mellitus without complications

Physical activity, together with diet and pharmacological therapy, represents one of the three cornerstones in type 2 diabetes mellitus treatment and care. The therapeutic appeal of regular physical activity stems from: (i) its non-pharmacological nature; (ii) its beneficial effects on the metabolic risk factors associated with diabetes complications; (iii) its low costs. Evidence accumulated in the last years suggests that aerobic training—endurance training—constitutes a safe modality of intervention, achievable, and effective in diabetes treatment, whenever it is not limited by comorbidities. Aerobic training exerts insulin-mimetic effects and has been shown to lower mortality risk too. Anaerobic, intense physical activity, such as that of strength or power sports disciplines, is not univocally recognized as safe and simple to realize, however, it is important in stimulating energy and glucose metabolism. According to recent evidence, high-intensity training may be prescribed even in the face of cardiovascular diseases, peripheral vascular disease, or osteoarthritis. Some studies have shown resistance training to be more efficient than aerobic exercise in improving glycemic control. This review explores the most up-to-date indications emerging from literature in support of the beneficial effects of strength stimulation and resistance training in patients with type 2 diabetes without complications.

Effects of endurance exercise training on metabolic and inflammatory parameters in HIV-1-infected patients with secondary lipodystrophy and diabetes

Regular physical exercise exerts positive effects, prolonging survival and improving quality of life of HIV-1-infected patients. A 3-month supervised endurance training program in subjects with AIDS-related lipodystrophy and type 2 diabetes mellitus improved aerobic capacity, pancreatic beta-cell function and immune profile, with a reduction in the proinflammatory cytokines monocyte chemotactic protein-1 and tumor necrosis factor-alpha. Appropriate physical exercise combined with specific pharmacological and dietetic therapies could prevent the development of secondary metabolic and cardiovascular disorders.

Cross–sectional and retrospective questionnaire-trial to evaluate exercise habits in a sample of HIV–infected individuals with type 2 diabetes mellitus

The purpose of this observational and epidemiological study was to determine the quantity and quality of physical activity performed by 70 HIV–infected individuals with type 2 diabetes mellitus (DM). We formulated a questionnaire to describe the tendency to physical exercise with regard to the present and the past of these subjects. The semi–structured questionnaire allowed us to collect details on typology and intensity of exercise done, on rate of perceived exertion, on sensations felt during and after exercise, and on progressive (immunological and general) deterioration caused by these diseases. In the group of HIV–diabetic patients, 10% conducted “heavy” physical activity (PA), 16% did “moderate” PA, and 73% was physically inactive. Among metabolic parameters, participants in heavy PA reported a glycemic trend and glycosylated hemoglobin progressively decreasing with respect to sedentary persons (glucose: 139 vs. 160 mg/dl, p<0.05; HbA1c: 6.81% vs. 7.35%). Other data, especially for lipidic profile, did not show so clear a picture. Approximately three–quarters of interviewed subjects, who belong to both experimental and control groups, were not performing any kind of physical activity. Nonetheless, in most cases, the questionnaire did not find so debilitating clinical conditions to follow exercise interventions improving quality of life and several other aspects.