Impact of Endurance Exercise Training in the Fasted State on Muscle Biochemistry and Metabolism in Healthy Subjects: Can
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REVIEW ARTICLE
Impact of Endurance Exercise Training in the Fasted State on Muscle Biochemistry and Metabolism in Healthy Subjects: Can These Effects be of Particular Clinical Benefit to Type 2 Diabetes Mellitus and Insulin-Resistant Patients? Dominique Hansen1,2 • Dorien De Strijcker3 • Patrick Calders3
Ó Springer International Publishing Switzerland 2016
Abstract Exercise training intervention is a cornerstone in the care of type 2 diabetes mellitus (T2DM) and insulin resistance (IR), and it is pursued in order to optimize exercise interventions for these patients. In this regard, the nutritional state of patients during exercise (being in the fed or fasted state) can be of particular interest. The aim of the present review is to describe the impact of endurance exercise (training) in the fasted versus fed state on parameters of muscle biochemistry and metabolism linked to glycemic control or insulin sensitivity in healthy subjects. From these data it can then be deduced whether exercise training in the fasted state may be relevant to patients with T2DM or IR. In healthy subjects, acute endurance exercise in the fasted state is accompanied by lower blood insulin and elevated blood free fatty acid concentrations, stable blood glucose concentrations (in the first 60–90 min), superior intramyocellular triacylglycerol oxidation and whole-body lipolysis, and muscle glycogen preservation. Long-term exercise training in the fasted state in healthy subjects is associated with greater improvements in insulin sensitivity, basal muscle fat uptake capacity, and oxidation. Therefore, promising results of exercise (training) in the fasted state have been found in healthy subjects on parameters of muscle biochemistry and metabolism linked to insulin sensitivity and glycemic control. Whether exercise training intervention in which
exercise sessions are organized in the fasted state may be more effective in improving insulin sensitivity or glycemic control in T2DM patients and insulin-resistant individuals warrants investigation.
Key Points Exercise training intervention is a cornerstone in the care of type 2 diabetes mellitus (T2DM) and insulin resistance, and the optimization of exercise interventions for these patients should be pursued by, for example, manipulating the nutritional state during exercise (training). In healthy subjects, acute endurance exercise and exercise training in the fasted state are accompanied by significantly greater beneficial adaptations that lead to improvements in insulin sensitivity. Whether exercise training intervention in which exercise sessions are organized in the fasted state may be more effective in improving insulin sensitivity or glycemic control in T2DM patients and insulin-resistant individuals warrants further investigation.
& Dominique Hansen [email protected] 1
Faculty of Medicine and Life Sciences, Rehabilitation Research Center, Hasselt University, REVAL, Agoralaan, Building A, 3590, Diepenbeek, Belgium
2
Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
3
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