Best Exercise for Blood Sugar: Intensity & Type Compared (Science-Backed Guide)

Exercise is crucial for healthy blood sugar control. STRRIDE trials published in the journal Sports Medicine- Open showed moderate-intensity aerobic exercise might be better for specific markers like insulin sensitivity compared to vigorous intensity. Combining aerobic and resistance training seems most beneficial. STRRIDE also highlighted the effectiveness of combining moderate-intensity exercise with weight loss for glycemic control. Research confirms that combining caloric restriction and exercise is superior for blood sugar management to either alone. Moderate intensity appears better for some markers, while vigorous intensity might be better for others.

Key Points

1. Aerobic Exercise Improves Insulin Sensitivity: Regardless of intensity or amount, most studies showed that aerobic exercise improves various markers of insulin sensitivity and glucose homeostasis. This happens through mechanisms like increased muscle glucose uptake and storage, along with decreased liver glucose production.

2. Amount and Intensity Can Have Nuanced Effects:

• Moderate Intensity for Muscle Insulin Sensitivity: STRRIDE I suggested that moderate-intensity exercise might be more effective for improving insulin sensitivity in muscles (Si) compared to vigorous intensity.

• Moderate Intensity for Glucose Tolerance: STRRIDE-PD suggested that moderate-intensity exercise might be better for glucose tolerance when matched for exercise volume relative to body weight compared to vigorous intensity.

• Peripheral Insulin Sensitivity: Studies suggest higher-intensity exercise might have a stronger effect, but more research is needed.

• β-Cell Function: Regardless of intensity, exercise appears to improve β-cell function that helps regulate blood sugar.

3. The Optimal Exercise Prescription Matters:

The amount and intensity of the best insulin sensitivity benefits might depend on individual factors and goals. Consulting a healthcare professional for personalized advice is recommended.

4. STRRIDE Studies on Prediabetes/Metabolic Risk:

• Both moderate and vigorous intensity aerobic exercise improved insulin sensitivity and glucose homeostasis markers.

• STRRIDE I showed moderate intensity led to the greatest improvement in a combined insulin sensitivity and β-cell function marker (DI).

• STRRIDE-PD suggested moderate intensity might be superior for glucose tolerance when matched for exercise volume relative to body weight.

5. Aerobic vs. Resistance Training Effects (STRRIDE AT/RT):

• This study compared the effects on insulin sensitivity markers.

• Both aerobic and combined training were more effective than resistance training alone.

• Only combined training significantly improved markers suggesting a synergistic effect.

6. Combining Exercise with Weight Loss is Most Effective:

Clinical lifestyle interventions combining moderate-intensity exercise with weight loss through caloric restriction led to the most significant improvements in insulin sensitivity and glucose tolerance compared to exercise alone.

Optimizing Exercise for Blood Sugar Control:

Maintaining healthy blood sugar levels is crucial for overall health, and exercise plays a vital role in achieving this goal. This blog post delves into the findings of the Studies of Targeted Risk Reduction Interventions Through Defined Exercise (STRRIDE) trials alongside broader research on exercise and glycemic control. We'll explore how exercise amount, intensity, and type (aerobic vs. resistance) influence insulin sensitivity and glucose homeostasis markers.

STRRIDE Findings: Aerobic Exercise and Glycemic Markers

The STRRIDE trials investigated the effects of various exercise programs on insulin sensitivity and glucose control in participants with prediabetes or dyslipidemia. While all exercise groups showed improvements, the specific impact on markers varied based on exercise characteristics:

• Moderate-intensity Advantage for Skeletal Muscle Insulin Sensitivity: STRRIDE I suggested that low-amount/moderate-intensity aerobic exercise might be more effective for improving skeletal muscle insulin sensitivity measured using the IVGTT compared to vigorous intensity exercise.

• Moderate Intensity for Glucose Tolerance: STRRIDE-PD indicated that moderate-intensity exercise might have a greater effect on glucose tolerance (glucose AUC) when matched for exercise volume relative to body weight compared to vigorous intensity.

• Peripheral Insulin Sensitivity and Intensity: Hyperinsulinemic-euglycemic clamps (a more precise method) used in STRRIDE trials suggested that higher-intensity exercise might have a stronger effect on peripheral insulin sensitivity, though specific data weren't shown.

• β-Cell Function: A short-term study by Malin et al. (not part of STRRIDE) found that exercise, regardless of intensity (moderate vs. high-intensity interval training), improved β-cell function when adjusted for factors like muscle insulin sensitivity.

Comparison with Other Literature:

The STRRIDE findings align with broader literature on exercise and glycemic control:

• Combined Training (Aerobic + Resistance): Studies generally support that combining aerobic and resistance training offers the greatest benefits for insulin sensitivity and glycemic control compared to either mode alone. Both modalities can provide some improvements individually.

• Resistance Training Effects: Studies like DARE and HART-D with type 2 diabetes participants showed mixed results on resistance training's independent effect on HbA1c (glycemic control marker). The value of combined training seems evident.

Clinical Lifestyle Interventions: The Power of Combined Strategies

The STRRIDE trials also highlighted the effectiveness of clinical lifestyle interventions that combine moderate-intensity aerobic exercise with a goal of 7% weight loss through caloric restriction. These interventions led to significant improvements in various measures of glycemic status compared to exercise alone:

• Improved Fasting Measures: Fasting insulin, HOMA-IR, and fasting glucose all showed significant reductions in the clinical lifestyle group compared to exercise-only groups.

• Enhanced Insulin Sensitivity: Spectroscopy-derived markers indicated the most robust decrease in insulin resistance in the clinical lifestyle group.

• Better Glucose Tolerance: The clinical lifestyle group was the only one to significantly improve glucose AUC during an OGTT.

Previous Findings in the Literature:

These findings align with previous research demonstrating the superiority of combining caloric restriction and exercise for improving glycemic control compared to either intervention alone. Here are some key points from existing studies:

• Dose Matters: Both caloric restriction and exercise provide a potent strategy, but the combination produces superior effects on insulin sensitivity and glucose homeostasis.

• Calorie Restriction Alone: Can lead to modest improvements in insulin sensitivity, but may also reduce lean mass and muscle strength.

• Exercise Without Weight Loss: May have limited effects on insulin sensitivity, especially for peripheral insulin sensitivity.

• Combined Benefits: Combining caloric restriction and exercise offers a more robust impact on skeletal muscle insulin sensitivity, maintains muscle mass, and reduces ectopic fat deposition.

• Intensity Considerations: While moderate intensity appears beneficial for skeletal muscle insulin sensitivity and glucose tolerance, vigorous intensity might have a stronger effect on peripheral insulin sensitivity measured using hyperinsulinemic-euglycemic clamps.

• Unknown Mechanisms: The precise physiological pathways by which different exercise types and combined approaches influence insulin sensitivity remain unclear.

Unresolved Questions and Future Directions:

Despite the valuable insights gained from STRRIDE and other research, some key questions remain:

• Optimal Exercise Prescription: The most effective amount, intensity, and mode of exercise for maximizing insulin sensitivity improvements in diverse populations with varying health conditions require further research.

• Physiological Pathways: More research is needed to understand the mechanisms by which different exercise types (with or without weight loss) impact glycemic status. Does combined training offer a greater total exercise volume effect, or is there a synergistic interaction between aerobic and resistance exercise?

In Conclusion:

Maintaining healthy blood sugar control is crucial, and exercise plays a vital role. This analysis highlights the importance of considering exercise amount, intensity, and mode when designing interventions. Here's what we learned:

• Moderate-intensity aerobic exercise might be more effective for specific markers like muscle insulin sensitivity and glucose tolerance compared to vigorous intensity.

• Combining aerobic and resistance training appears to offer the greatest overall benefits for glycemic control.

• Clinical lifestyle interventions that combine exercise with weight loss are most effective for improving blood sugar management.

Moving Forward:

• Optimal exercise prescription for diverse populations needs further investigation.

• Research is needed to understand the precise physiological pathways by which different exercise types influence insulin sensitivity.

Journal Reference

Collins, K.A., Ross, L.M., Slentz, C.A. et al. Differential Effects of Amount, Intensity, and Mode of Exercise Training on Insulin Sensitivity and Glucose Homeostasis: A Narrative Review. Sports Med - Open 8, 90 (2022). https://doi.org/10.1186/s40798-022-00480-5

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https://healthnewstrend.com/why-exercise-is-your-secret-weapon-against-stress-and-heart-disease-especially-if-youre-depressed

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