Gymnasium-based unsupervised exercise maintains benefits in oxygen uptake kinetics obtained following supervised training in type 2 diabetes

Supervised exercise (SE) in patients with type 2 diabetes improves oxygen uptake kinetics at the onset of exercise. Maintenance of these improvements, however, has not been examined when supervision is removed. We explored if potential improvements in oxygen uptake kinetics following a 12-week SE that combined aerobic and resistance training were maintained after a subsequent 12-week unsupervised exercise (UE). The involvement of cardiac output (CO) in these improvements was also tested. Nineteen volunteers with type 2 diabetes were recruited. Oxygen uptake kinetics and CO (inert gas rebreathing) responses to constant-load cycling at 50% ventilatory threshold (V_T), 80% V_T, and mid-point between V_T and peak workload (50% Δ) were examined at baseline (on 2 occasions) and following each 12-week training period. Participants decided to exercise at a local gymnasium during the UE. Thirteen subjects completed all the interventions. The time constant of phase 2 of oxygen uptake was significantly faster (p < 0.05) post-SE and post-UE compared with baseline at 50% V_T (17.3 ± 10.7 s and 17.5 ± 5.9 s vs. 29.9 ± 10.7 s), 80% V_T (18.9 ± 4.7 and 20.9 ± 8.4 vs. 34.3 ± 12.7s), and 50% Δ (20.4 ± 8.2 s and 20.2 ± 6.0 s vs. 27.6 ± 3.7 s). SE also induced faster heart rate kinetics at all 3 intensities and a larger increase in CO at 30 s in relation to 240 s at 80% V_T; and these responses were maintained post-UE. Unsupervised exercise maintained benefits in oxygen uptake kinetics obtained during a supervised exercise in subjects with diabetes, and these benefits were associated with a faster dynamic response of heart rate after training.

Oxygen (O2) kinetics during early recovery from peak exercise in patients with type 2 diabetes

Aims To examine the oxygen (O₂) kinetics during early recovery from peak exercise in patients with Type 2 diabetes and to examine whether oxygen O₂ recovery is associated with fasting glucose and HbA_1c in this population.

Methods Eighty-nine participants (52 men) aged 51.8 ± 7.1 years (mean ± sd) were divided into three groups: normal weight (BMI ≤ 25.0 kg/m²), overweight/obese without diabetes (BMI ≥ 26 kg/m²) and overweight/obese with Type 2 diabetes. Participants were assessed for their aerobic power (VO_2peak) on a cycle ergometer, provided a fasting blood sample and underwent a series of anthropometric measurements. Early recovery period was measured for 60 s from cessation of exercise and expressed as percentage of VO_2peak (higher percentage represents slower recovery).

Results No significant differences were observed for age between the three study groups. Both the overweight/obese groups without diabetes and with Type 2 diabetes had higher BMI than the normal weight group, with no significant differences between overweight/obese participants without diabetes and those with diabetes. Participants with Type 2 diabetes had lower VO_2peak than overweight/obese participants without diabetes and normal weight individuals (19.6 ± 4.8, 22.6 ± 5.4 and 25.7 ± 5.3 ml kg⁻¹ min⁻¹, respectively, P < 0.004 for overall trends). Participants with Type 2 diabetes also had slower recovery in oxygen O₂ kinetics after exercise, compared with both normal weight and overweight/obese individuals without diabetes (56.5 ± 7.7, 49.2 ± 7.2, 47.7 ± 7.4%, P < 0.004 for overall trends). Multiple regression analysis revealed that percentage of oxygen O₂ recovery was a stronger predictor than VO_2peak, BMI or age for fasting glucose and HbA_1c.

Conclusions Patients with Type 2 diabetes have lower VO_2peak and prolonged oxygen O₂ recovery from peak exercise. However, only prolonged oxygen O₂ recovery was associated with fasting glucose and HbA_1c.

Peak oxygen uptake of 12-18-year-old boys living in a densely populated urban environment

The purposes of this study were to provide data on the peak Vo 2 of 12-18-year-old boys from Hong Kong, a densely populated urban environment; to compare these data with those for other similarly aged populations; and to examine the correlations between peak Vo 2 and various anthropometric parameters of this group. A stratified, random sample of 86 ethnic Chinese boys had their peak Vo 2 determined using an on-line gas analysis system during incremental, treadmill running. The mean peak 17o2 of the boys was 2.7 SD 0.44 1- rain - 1 or, when expressed in relation to body mass, 52.0 SD 5-8 ml- kg- 1. min - 1. Peak Vo 2 (1. min - 1) was significantly correlated with body mass (r = 0.72, p < 0.001, age (r = 0.49, p < 0.001) and height (r = 0.71, p = 0-001). Peak Vo 2 (ml 'kg- 1. min- 1) showed no correlation with age or height. These data suggest that this population group has peak Vo 2 values very similar to those observed in boys from most other population groups.

Oxygen uptake and heart rate during simulated wildfire suppression tasks performed by Australian rural firefighters

Objective: Australian rural fire crews safeguard the nation against the annual devastation of wildfire. We have previously reported that experienced firefighters identified seven physically demanding tasks for Australian rural fire crews suppressing wildfires. These firefighters rated the operational importance, typical duration, core fitness components, and likely frequency of the seven tasks. The intensity of these duties remains unknown. The aim of this study was to quantify the oxygen uptake (VO2), heart rate (HR) and movement speed responses during simulations of these physically demanding wildfire suppression tasks. Method: Twenty six rural firefighters (20 men, six women) performed up to seven tasks, during which time their HR and movement speed were recorded. The VO2 for each task was also calculated from the analysis of expired air collected in Douglas bags. Firefighters’ HR and movement speed were measured using HR monitors and portable global positioning system units, respectively. Results: The hose work tasks elicited a VO2 of 21-27 mL·kg-1·min-1 and peak HR of 77-87% age-predicted maximal HR (HRmax). Hand tool tasks were accompanied by VO2 of 28-34 mL·kg-1·min-1 and peak HR of 85-95%HRmax. Firefighters’ movement speed spanned 0.2 ± 0.1 to 1.8 ± 0.2 m·s-1 across the seven tasks. The cardiovascular responses in the hand tool tasks were, in most cases, higher (P<0.05) than during those elicited by the hose work tasks. Conclusions: The cardiovascular responses elicited during simulations of physically demanding wildfire suppression approximated those reported for similar tasks in urban and forestry fire fighting jurisdictions. The findings may prompt Australian rural fire agencies to consider cardiovascular disease risk screening and physical selection testing to ensure that healthy and fit firefighters are deployed to the fire ground.

Effect of carbohydrate ingestion on glucose kinetics during exercise in the heat

Six endurance-trained men [peak oxygen uptake (VO₂) = 4.58 ± 0.50 (SE) l/min] completed 60 min of exercise at a workload requiring 68 ± 2% peak VO₂ in an environmental chamber maintained at 35°C (<50% relative humidity) on two occasions, separated by at least 1 wk. Subjects ingested either a 6% glucose solution containing 1 µCi [3-³H]glucose/g glucose (CHO trial) or a sweet placebo (Con trial) during the trials. Rates of hepatic glucose production [HGP = glucose rate of appearance (R_a) in Con trial] and glucose disappearance (R_d), were measured using a primed, continuous infusion of [6,6-^₂H]glucose, corrected for gut-derived glucose (gut R_a) in the CHO trial. No differences in heart rate, VO₂, respiratory exchange ratio, or rectal temperature were observed between trials. Plasma glucose concentrations were similar at rest but increased (P < 0.05) to a greater extent in the CHO trial compared with the Con trial. This was due to the absorption of ingested glucose in the CHO trial, because gut R_a after 30 and 50 min (16 ± 5 µmol · kg^-1 · min^-1) was higher (P < 0.05) compared with rest, whereas HGP during exercise was not different between trials. Glucose R_d was higher (P < 0.05) in the CHO trial after 30 and 50 min (48.0 ± 6.3 vs 34.6 ± 3.8 µmol · kg^-1 · min^-1, CHO vs. Con, respectively). These results indicate that ingestion of carbohydrate, at a rate of ~1.0 g/min, increases glucose Rd but does not blunt the rise in HGP during exercise in the heat.

Slow component of VO2 kinetics: the effect of training status, fibre type, UCP3 mRNA and citrate synthase activity

Examines the relationship between the magnitude of the relative slow component (SC) of pulmonary oxygen uptake VO[sub 2], citrate synthase activity, UCP2 and UCP3 mRNA levels and muscle fiber composition in both endurance-trained and recreationally active subjects. Magnitude of the relative SC of the Tr group; Indicators of aerobic fitness; High negative correlations between the magnitude of the relative SC and citrate synthase activity and VO[sub 2] peak.

Exercise performance and V0₂ kinetics during upright and recumbent high-intensity cycling exercise

This study investigated cycling performance and oxygen uptake (VO₂) kinetics between upright and two commonly used recumbent (R) postures, 65ºR and 30ºR. On three occasions, ten young active males performed three bouts of high-intensity constant-load (85% peak workload achieved during a graded test) cycling in one of the three randomly assigned postures (upright, 65ºR or 30ºR). The first bout was performed to fatigue and second and third bouts were limited to 7 min. A subset of seven subjects performed a final constant-load test to failure in the supine posture. Exercise time to failure was not altered when the body inclination was lowered from the upright (13.1 ± 4.5 min) to 65ºR (10.5 ± 2.7 min) and 30ºR (11.5 ± 4.6 min) postures; but it was significantly shorter in the supine posture (5.8 ± 2.1 min) when compared with the three inclined postures. Resulting kinetic parameters from a tri-exponential analysis of breath-by-breath VO₂ data during the first 7 min of exercise were also not different between the three inclined postures. However, inert gas rebreathing analysis of cardiac output revealed a greater cardiac output and stroke volume in both recumbent postures compared with the upright posture at 30 s into the exercise. These data suggest that increased cardiac function may counteract the reduction of hydrostatic pressure from upright ~25 mmHg; to 65ºR ~22 mmHg; and 30ºR ~18 mmHg such that perfusion of active muscle presumably remains largely unchanged, and also therefore, VO₂ kinetics and performance during high-intensity cycling.

Effect of increased blood glucose availability on glucose kinetics during exercise

This study examined the effect of increased blood glucose availability on glucose kinetics during exercise. Five trained men cycled for 40 min at 77 ± 1% peak oxygen uptake on two occasions. During the second trial (Glu), glucose was infused at a rate equal to the average hepatic glucose production (HGP) measured during exercise in the control trial (Con). Glucose kinetics were measured by a primed continuous infusion ofd-[3-3H]glucose. Plasma glucose increased during exercise in both trials and was significantly higher in Glu. HGP was similar at rest (Con, 11.4 ± 1.2; Glu, 10.6 ± 0.6 μmol ⋅ kg−1 ⋅ min−1). After 40 min of exercise, HGP reached a peak of 40.2 ± 5.5 μmol ⋅ kg−1 ⋅ min−1in Con; however, in Glu, there was complete inhibition of the increase in HGP during exercise that never rose above the preexercise level. The rate of glucose disappearance was greater (P < 0.05) during the last 15 min of exercise in Glu. These results indicate that an increase in glucose availability inhibits the rise in HGP during exercise, suggesting that metabolic feedback signals can override feed-forward activation of HGP during strenuous exercise.

Effect of heat stress on glucose kinetics during exercise

To identify the mechanism underlying the exaggerated hyperglycemia during exercise in the heat, six trained men were studied during 40 min of cycling exercise at a workload requiring 65% peak pulmonary oxygen uptake (V˙o 2 peak) on two occasions at least 1 wk apart. On one occasion, the ambient temperature was 20°C [control (Con)], whereas on the other, it was 40°C [high temperature (HT)]. Rates of glucose appearance and disappearance were measured by using a primed continuous infusion of [6,6-2H]glucose. No differences in oxygen uptake during exercise were observed between trials. After 40 min of exercise, heart rate, rectal temperature, respiratory exchange ratio, and plasma lactate were all higher in HT compared with Con (P < 0.05). Plasma glucose levels were similar at rest (Con, 4.54 ± 0.19 mmol/l; HT, 4.81 ± 0.19 mmol/l) but increased to a greater extent during exercise in HT (6.96 ± 0.16) compared with Con (5.45 ± 0.18;P < 0.05). This was the result of a higher glucose rate of appearance in HT during the last 30 min of exercise. In contrast, the glucose rate of disappearance and metabolic clearance rate were not different at any time point during exercise. Plasma catecholamines were higher after 10 and 40 min of exercise in HT compared with Con (P < 0.05), whereas plasma glucagon, cortisol, and growth hormone were higher in HT after 40 min. These results indicate that the hyperglycemia observed during exercise in the heat is caused by an increase in liver glucose output without any change in whole body glucose utilization.

Adrenaline increases skeletal muscle glycogenolysis, pyruvate dehydrogenase activation and carbohydrate oxidation during moderate exercise in humans

# 1.
To evaluate the role of adrenaline in regulating carbohydrate metabolism during moderate exercise, 10 moderately trained men completed two 20 min exercise bouts at 58 ± 2 % peak pulmonary oxygen uptake (̇V_o2,peak). On one occasion saline was infused (CON), and on the other adrenaline was infused intravenously for 5 min prior to and throughout exercise (ADR). Glucose kinetics were measured by a primed, continuous infusion of 6,6-[2H]glucose and muscle samples were obtained prior to and at 1 and 20 min of exercise.

# 2.
The infusion of adrenaline elevated (P < 0.01) plasma adrenaline concentrations at rest (pre-infusion, 0.28 ± 0.09; post-infusion, 1.70 ± 0.45 nmol l−1; means ±s.e.m.) and this effect was maintained throughout exercise. Total carbohydrate oxidation increased by 18 % and this effect was due to greater skeletal muscle glycogenolysis (P < 0.05) and pyruvate dehydrogenase (PDH) activation (P < 0.05, treatment effect). Glucose rate of appearance was not different between trials, but the infusion of adrenaline decreased (P < 0.05, treatment effect) skeletal muscle glucose uptake in ADR.

# 3.
During exercise muscle glucose 6-phosphate (G-6-P) (P = 0.055, treatment effect) and lactate (P < 0.05) were elevated in ADR compared with CON and no changes were observed for pyruvate, creatine, phosphocreatine, ATP and the calculated free concentrations of ADP and AMP.

# 4.
The data demonstrate that elevated plasma adrenaline levels during moderate exercise in untrained men increase skeletal muscle glycogen breakdown and PDH activation, which results in greater carbohydrate oxidation. The greater muscle glycogenolysis appears to be due to increased glycogen phosphorylase transformation whilst the increased PDH activity cannot be readily explained. Finally, the decreased glucose uptake observed during exercise in ADR is likely to be due to the increased intracellular G-6-P and a subsequent decrease in glucose phosphorylation.

Carbohydrate metabolism during exercise in females : effect of reduced fat availability

This study examined the effect of reduced plasma free fatty acid (FFA) availability on carbohydrate metabolism during exercise. Six untrained women cycled for 60 minutes at approximately 58% of maximum oxygen uptake after ingestion of a placebo (CON) or nicotinic acid (NA), 30 minutes before exercise (7.4 ± 0.5 mg·kg⁻¹ body weight), and at 0 minutes (3.7 ± 0.3 mg·kg⁻¹) and 30 minutes (3.7 ± 0.3 mg·kg⁻¹) of exercise. Glucose kinetics were measured using a primed, continuous infusion of [6,6-²H] glucose. Plasma FFA (CON, 0.86 ± 0.12; NA, 0.21 ± 0.11 mmol·L⁻¹ at 60 minutes, P < .05) and glycerol (CON, 0.34 ± 0.05; NA, 0.10 ± 0.04 mmol·L⁻¹ at 60 minutes, P < .05) were suppressed throughout exercise. Mean respiratory exchange ratio (RER) during exercise was higher (P < .05) in NA (0.89 ± 0.02) than CON (0.83 ± 0.02). Plasma glucose and glucose production were similar between trials. Total glucose uptake during exercise was greater (P < .05) in NA (1,876 ± 161 μmol·kg⁻¹) than in CON (1,525 ± 107 μmol·kg⁻¹). Total fat oxidation was reduced (P < .05) by approximately 32% during exercise in NA. Total carbohydrate oxidized was approximately 42% greater (P < .05) in NA (412 ± 40 mmol) than CON (290 ± 37 mmol), of which, approximately 16% (20 ± 10 mmol) could be attributed to glucose. Plasma insulin and glucagon were similar between trials. Catecholamines were higher (P < .05) during exercise in NA. In summary, during prolonged moderate exercise in untrained women, reduced FFA availability results in a compensatory increase in carbohydrate oxidation, which appears to be due predominantly to an increase in glycogen utilization, although there was a small, but significant, increase in whole body glucose uptake.

Slow component of VO2 during level and uphill treadmill running : relationship to aerobic fitness in endurance runners

The aim of this study was to compare the oxygen uptake (VO^sub 2^) slow component (SC) during level and uphill running in endurance runners, and to identify associations between the SC and the following aerobic fitness indicators: peak VO^sub 2^, running speed associated with the peak VO^sub 2^ (Vpeak), running speed at the lactic threshold and the VO^sub 2^ fraction elicited at the lactic threshold. Fourteen male endurance-trained runners underwent several 6-min bouts of level (LTR) and 10.5% uphill treadmill running. VO^sub 2^ SC was calculated as the difference between mean VO^sub 2^ during the 6th and the 3rd minutes. The highest mean values for the SC were 181.9±240.2 mL*min^sup -1^ for level running at ~94% peak VO^sub 2^ and 105.4±154.6 mL*min^sup -1^ for uphill running at ~90% peak VO^sub 2^. The SC observed during the last bout of the LTR correlated with peak VO^sub 2^ and with Vpeak (-0.71 and -0.76, P<0.05, respectively). The results show that for endurance-trained runners the magnitude of the SC is not affected by the treadmill gradient and that within a homogeneous sample of endurance-trained runners the SC does not correlate with indicators of aerobic fitness.

Glucose production during strenuous exercise in humans : role of epinephrine

The increase in hepatic glucose production (HGP) that occurs during intense exercise is accompanied by a simultaneous increase in epinephrine, which suggests that epinephrine may be important in regulating HGP. To further investigate this, six trained men were studied twice. The first trial [control (Con)] consisted of 20 min of cycling at 40 ± 1% peak oxygen uptake (V˙o 2 peak) followed by 20 min at 80 ± 2%V˙o 2 peak. During the second trial [epinephrine (Epi)], subjects exercised for 40 min at 41 ± 2%V˙o 2 peak. Epinephrine was infused during the latter 20 min of exercise and resulted in plasma levels similar to those measured during intense exercise in Con. Glucose kinetics were measured using a primed, continuous infusion of [3-3H]glucose. HGP was similar at rest (Con, 11.0 ± 0.5 and Epi, 11.1 ± 0.5 μmol ⋅ kg−1 ⋅ min−1). In Con, HGP increased (P < 0.05) during exercise to 41.0 ± 5.2 μmol ⋅ kg−1 ⋅ min−1at 40 min. In Epi, HGP was similar to Con during the first 20 min of exercise. Epinephrine infusion increased (P < 0.05) HGP to 24.0 ± 2.5 μmol ⋅ kg−1 ⋅ min−1at 40 min, although this was less (P< 0.05) than the value in Con. The results suggest that epinephrine can increase HGP during exercise in trained men; however, epinephrine during intense exercise cannot fully account for the rise in HGP. Other glucoregulatory factors must contribute to the increase in HGP during intense exercise.