V. Guilbeault

Intensive lifestyle intervention including high-intensity interval training program improves insulin resistance and fasting plasma glucose in obese patients.

Objectives To analyze the effects of a long-term intensive lifestyle intervention including high-intensity interval training (HIIT) and Mediterranean diet (MedD) counseling on glycemic control parameters, insulin resistance and β-cell function in obese subjects. Methods The glycemic control parameters (fasting plasma glucose, glycated hemoglobin), insulin resistance, and β-cell function of 72 obese subjects (54 women; mean age = 53 ± 9 years) were assessed at baseline and upon completion of a 9-month intensive lifestyle intervention program conducted at the cardiovascular prevention and rehabilitation center of the Montreal Heart Institute, from 2009 to 2012. The program included 2–3 weekly supervised exercise training sessions (HIIT and resistance exercise), combined to MedD counseling. Results Fasting plasma glucose (FPG) (mmol/L) (before: 5.5 ± 0.9; after: 5.2 ± 0.6; P < 0.0001), fasting insulin (pmol/L) (before: 98 ± 57; after: 82 ± 43; P = 0.003), and insulin resistance, as assessed by the HOMA-IR score (before: 3.6 ± 2.5; after: 2.8 ± 1.6; P = 0.0008) significantly improved, but not HbA1c (%) (before: 5.72 ± 0.55; after: 5.69 ± 0.39; P = 0.448), nor β-cell function (HOMA-β, %) (before: 149 ± 78; after: 144 ± 75; P = 0.58). Conclusion Following a 9-month intensive lifestyle intervention combining HIIT and MedD counseling, obese subjects experienced significant improvements of FPG and insulin resistance. This is the first study to expose the effects of a long-term program combining HIIT and MedD on glycemic control parameters among obese subjects.

Long-term lifestyle intervention and optimized high intensity interval training program improve body composition, cardiovascular risk and exercise capacity in obese patients with or without metabolic syndrome

bjectives.– To evaluate the feasibility at rest with reproducibility of the ntra-operator and inter-operator measurement of CO and to compare with easurements obtained by transthoracic echocardiography (TTE). To estimate he feasibility during effort and during the recovery effort. To determine the iagnostic, therapeutic and prospective implication. ethods.– Observational study based on 142 consecutive outpatients included rom cardiac rehabilitation (CHU Dijon). IGR was performed before and/or uring and/or after the cardiac stress test by photoacoustic analysis using two nert gases: 0.5% nitrous oxide and 0.1% sulfur hexafluoride (indirect oxyen Fick Method Innocor®). Statistical analysis based on correlation analysis, land and Altman, and standardization. esults.– At rest, the correlation coefficient was 0.91 (P< 0.001) between two O in intra-operator in 26 patients, 0.89 (P< 0.001) between two CO in interperator in 30 patients, 0.38 (P= 0.039) between the CO measured by IGR and TE in 30 patients. Using the method of Bland and Altman, the range of variation f repeatability was respectively± 27%, ± 33%± 42%. During the effort in 45 atients, formulas of standardization were used to assess components: stroke olume (SV) and heart rate (HR). Two populations were isolated: preferential ncrease in SV or HR. onclusion.– At rest, feasibility, repeatability and reproducibility of the meaurements are correct (despite the dispersion related to measurement of CO). t submaximal exercise, feasibility is good. The measurement to quantify the emodynamic changes during rehabilitation is valid and applicable in various athological conditions (heart failure in high CO at rest, etc), and could help to dapt the use of chronotopic drug. eferences 1] Goda A et al. Usefulness of non-invasive measurement of cardiac output uring sub-maximal exercise to predict outcome in patients with chronic heart ailure. AM J Cardiol 2009; 104(Suppl. 11):1556–60. 2] Follath F. Challenging the dogma of high target doses in the treatment of eart failure: is more always better? Arch Cardiovasc Dis 2009;102:785–9.