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Item
#6
Intensive Lifestyle Changes
Are Necessary to Improve Insulin Sensitivity
Aerobic Fitness is the major difference in improving insulin
sensitivity.
The extent to which lifestyle must be altered to improve insulin
sensitivity has not been established. This study compares the
effect on insulin sensitivity of current dietary and exercise
recommendations with a more intensive intervention in
normoglycemic insulin-resistant individuals.
Seventy-nine normoglycemic insulin-resistant (determined by the
euglycemic insulin clamp) men and women were randomized to either
a control group or one of two combined dietary and exercise
programs. One group (modest level) was based on current
recommendations and the other on a more intensive dietary and
exercise program. Insulin sensitivity was measured using a
euglycemic insulin clamp, body composition was measured using
dual-energy X-ray absorptiometry, and anthropometry and aerobic
fitness were assessed before and after a 4-month intervention
period. Four-day dietary intakes were recorded, and fasting
glucose, insulin, and lipids were measured.
Results:
Only the intensive group showed a significant improvement in
insulin sensitivity (23% increase, P=0.006 vs. 9% in the
modest group, P=0.23). This was associated with a
significant improvement in aerobic fitness (11% increase in the
intensive group, P=0.02 vs. 1% in the modest group, P=0.94)
and a greater fiber intake, but no difference in reported total or
saturated dietary fat.
Conclusions:
Current clinical dietary and exercise recommendations, even when
vigorously implemented, did not significantly improve insulin
sensitivity; however, a more intensive program did. Improved
aerobic fitness appeared to be the major difference between the
two intervention groups, although weight loss and diet composition
may have also played an important role in determining insulin
sensitivity. Diabetes Care 25(3):445-452, 2002
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FACT:
Americans
have the lowest life expectancy of all industrialized nations,
according to Jeffrey D. Koplan, M.D., director of the CDC
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