1

Are all types of exercise the same?Aerobic vs resistance vs combinedGlycemic control, weight reduction

2218 middle-aged diabetic patients22 wks

Reid 2010

318 morbidly obese diabetic Polynesians, 16 wk

Sukala 2010

418 morbidly obese diabetic Polynesians, 16 wk

Sukala 2010

5DM patients, > 50 yo, 8 wkResistance (Exp) vs aerobic (Con)

Ng 2010

6DM patients, > 50 yo, 8 wkResistance (Exp) vs aerobic (Con)

Ng 2010

748 diabetic men/women, 12 wkno difference across groups

Jorge 2011

848 diabetic men/women, 12 wkIRS-1: insulin receptor substrate-1

Jorge 2011

9

DM patients, 39-70 yo, 22 wk

Both aerobic and resistance exercise improve glycemic control, best when combined Sigal 2007

10

DM patients, 16 wk

Marcus 2008

11

Combined ex on glycemic control in diabetes

Oliveira 2012

12Aerobic or resistance ex on glycemic control in diabetes

Oliveira 2012

13

Review by Oliveira et al, 2012

combined exercise improve glycemic control to a greater extent than either ex alone.

Supervised training sessions, recommended structured exercises, and splitting aerobic and resistance training in separate sessions may be relevant for best results.

Future directions: different aerobic and resistance training modes different training and progression methods whether one type of exercise is optimal

Type 2 diabetes

Combined aerobic exercise and RT, as well as aerobic along, > 2 times/week, at 60–85% HRmax Statistically significant ↓ in HbA1c, TG, waist

circumference, SBP in type 2 diabetes NOT related to significant changes in weight or

BMI, HDL-C, LDL-C When RT is NOT combined with other

forms of exercise, NO effect in changes in HbA1c, SBP, CVD risk factors

14

Chudyk, 2011

15Overweight/obese male, >1 risk factor for MS, 6 months

Potteiger 2012

16Overweight/obese male, >1 risk factor for MS, 6 months

Potteiger 2012

17

Sedentary women, 50-70 yo, avg BMI~26walking vs swimming

Cox, 2010

18

Overweight Korean Adolescents, 12 wksimilar effect in DO, AE, RT

Suh, 2011

19Blood pressure during ex in middle-aged overweight female

Circuit weight training

Walking

Jurimae 2000

20Blood pressure during ex in middle-aged overweight female

Circuit weight training

Walking

Jurimae 2000

21

Sedentary women, 50-70 yo, avg BMI~26walking vs swimming

Cox, 2010

22Sedentary, overweight dyslipidemic adults, 18-70 yo, 6 months, AT > RT

Bateman 2011

23Sedentary, overweight dyslipidemic adults, 18-70 yo, 6 months, AT > RT

Bateman 2011

24

Overweight Korean Adolescents, 12 wk

25

26Exercise types and reduction in visceral fat on OW and obese adults

Effect: aerobic exercise > control (-0.33, 95% CI: -0.52 to -0.14; P < 0.01)

Effect: resistance exercise = control (0.09, 95% CI: -0.17 to -0.36; P = 0.49).

Effect: aerobic exercise = resistance exercise (ES = 0.23, 95% CI: -0.02 to 0.50; P = 0.07 favouring aerobic). aerobic + resistance exercise = control (-0.28,

95% CI: -0.69 to 0.14; P = 0.19) Aerobic exercise essential for reducing

visceral fat Ismall 2012

27

Ismall 2012

28

Ismall 2012

29

Ismall 2012

PRT: progressive resistance training

Recommendations

combined interventions should not sacrifice an adequate volume of aerobic training for the inclusion of resistance exercise >150 min/week of moderate intensity aerobic

activity

30

Ismall 2012

31

endurance training (ET); mixed-intensity interval ET (MI-ET); circuit-interval resistance training (CRT)

Clark 2010

32

endurance training (ET); mixed-intensity interval ET (MI-ET); circuit-interval resistance training (CRT)

Clark 2010

33

13 obese men/women

Clark 2010

34

13 obese men/women

Clark 2010