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The insulin-sensitizing effects of exercise appear predominantly during insulin-stimulated conditions, but brain glucose uptake was measured in the fasted state in our current study. We previously reported that HIIT increased peripheral insulin sensitivity, but not endogenous glucose output, during higher insulin concentrations 1.
Our current results indicate no correlation between changes in brain glucose uptake and HOMA-IR in healthy adults after HIIT. HIIT is a potent stimulus for cardiorespiratory adaptations.
We incorporated HIIT with moderate-intensity treadmill walking for 2 days per week. The increase in brain glucose metabolism in the current study is likely a chronic training effect given that the PET scans were performed at 96 hours after exercise.
Brain glucose uptake has been reported to decrease during and immediately after aerobic exercise, and the declines are greater at higher intensity The reason for this phenomenon remains to be fully understood but may be related to a decline in plasma glucose.
We cannot exclude the possibility that lower-intensity aerobic training, or other forms of training such as resistance, could alter brain metabolism. For example, lower-intensity aerobic training for 1 year has been shown to stimulate brain hypertrophy and cognitive benefits in older adults 3.
We did not assess cognitive function, and the potential effects of cognitive decline associated with aging are less known. In summary, aerobic training that included HIIT improved glucose uptake in parietal-temporal and caudate regions in younger and older adults.
Our current results provide indication that healthy adults can improve brain metabolism in a relatively short time period of 12 weeks. These improvements occurred alongside robust gains in cardiorespiratory fitness and indicate that aerobic exercise can stimulate metabolic adaptations in the brain.
We thank the participants for their time and enthusiasm during the project. We acknowledge the skillful assistance of Kera Hoff along with the staff of the Dan Abraham Healthy Living Center and Clinical Research Unit at Mayo Clinic.
and T32DK M. and by the Elsie and Marvin Dekelboum Family Foundation and institutional funds to V. Additional support was provided by the Mayo Foundation and the Murdock-Dole Professorship to K.
This publication was made possible by the Mayo Clinic Metabolomics Resource Core through Grant U24DK from the National Institute of Diabetes and Digestive and Kidney Diseases and Mayo Clinic Clinical and Translational Sciences Award CTSA Grant UL1TR from the National Center for Advancing Translational Sciences NCATs.
gov no. NCT registered 30 November supervised exercise training, analyzed data, and wrote the manuscript. provided support for PET scans, reviewed and interpreted data, and edited the manuscript. designed the study, obtained funding, interpreted data, and edited the manuscript.
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Endocrine Society Journals. Advanced Search. Search Menu. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents Abstract. Materials and Methods. Journal Article. Increased Brain Glucose Uptake After 12 Weeks of Aerobic High-Intensity Interval Training in Young and Older Adults.
Matthew M Robinson , Matthew M Robinson. Division of Endocrinology, Diabetes and Nutrition, Mayo Clinic, Rochester, Minnesota.
Oxford Academic. Val J Lowe. Division of Nuclear Medicine, Mayo Clinic, Rochester, Minnesota. K Sreekumaran Nair. Sreekumaran Nair, MD, PhD, First Street SW, Joseph , Mayo Clinic, Rochester, Minnesota E-mail: nair mayo.
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Figure 1. Open in new tab Download slide. Table 2. Moreover, we also excluded the work of Dolatkhah et al.
In our analysis, we additionally deliberated on the differences between probiotic and synbiotic effect on glucose metabolism, while Peng et al. We additionally estimated the effect size using the pretest—posttest—control method, whereas Peng et al.
A positive effect of probiotic supplementation on glycemic control has been shown in other studies. A recent meta-analysis of 17 RCTs which included adults with and without hyperglycemia revealed that probiotic supplementation lowers serum glucose, insulin, and HOMA-IR; this effect was greater in hyperglycemic subjects Similar results were found in our meta-analysis, showing that women with GDM benefit more than women without GDM.
This may result from the fact that those with GDM or hyperglycemia may have more disrupted microbiota composition, which probiotic supplementation can restore By contrast, people lacking problems with glucose metabolism may have healthy gut microbiota composition and probiotic supplementation does not alter this state much.
The differences in gut microbiota composition between people with and without type-2 diabetes mellitus T2DM have been indicated to play a role in the development and control of this disease.
It has been reported that a high prevalence of insulin resistance is correlated with low gut microbiota diversity, which entails proinflammatory properties.
It has been suggested that these properties are caused by a reduction in the amount of butyrate-producing bacteria and an increase in mucin-degrading bacteria. These changes may impair the gut integrity through endotoxemia, which causes low-grade inflammation.
In endotoxemia, elevated plasma levels of lipopolysaccharides LPS impair glucose metabolism. Moreover, lower concentrations of SCFAs, such as butyrate, may lead to a decrease in the intestinal expression of genes encoding satiety hormones, such as peptide YY and glucagon-like peptide The bacteria that are less abundant in subjects with T2DM belong to the phylum Firmicutes , and the most prominent decline is observed for Roseburia and Faecalibacterium prausnitzii 3 , These bacteria are known as human gut colonizers and butyrate producers, and have been reported to improve diabetic control and insulin sensitivity.
The different composition of the community of gut microbiota in people with T2DM is associated with changes in the metabolic capacity of this community. The pathways that are more abundant in T2DM subjects are for starch and simple sugar metabolism.
This supports the concept of an increased capacity for energy harvest in people with T2DM, which can lead to obesity 3. In our meta-analysis, we examined the impact of probiotic supplementation on glucose metabolism in pregnant women and determined whether GDM has an effect on the effectiveness of such interventions.
Although, as mentioned above, a positive effect of probiotic supplementation has been demonstrated in people with T2DM, GDM is not the same condition as T2DM.
First of all, pregnancy alters the metabolism. Secondly, the duration of disrupted glucose metabolism in women with GDM is short, comparing to subjects with T2DM taking part in the studies, where a disrupted glucose metabolism may have existed for many years. This is important given that gut microbiota composition may change over time and is different in prediabetic and diabetic people.
It has been shown that a total of 28 operational taxonomic units OTUs are related to T2DM status and that the relative abundances of Bacteroides and Clostridium undergo marked changes with progression of the disease Taking this into consideration, it is possible that different probiotics may be needed to restore proper microbiota composition in those with prediabetes and in those with T2DM or GDM.
As the microbiota of people with T2DM is more disrupted, they may be more responsive to manipulations of the gut microbiota aimed at improving glucose metabolism The effect of microbiota on glucose metabolism in pregnant women, which this meta-analysis has focused on, may be different than in non-pregnant women.
This is because the gut microbiota of pregnant women especially in the third trimester and nonpregnant women differs, and because pregnancy implies some adaptations in the metabolism, such as insulin resistance, in order to facilitate fetal growth and development.
Koren et al. For example, Faecalibacterium are less abundant and Proteobacteria and Actinobacteria are enriched in women in third trimester. Moreover, a loss of microbiota richness is observed. Such changes predispose to inflammation-associated dysbiosis.
Dysbiosis, inflammation, and weight gain characterize metabolic syndrome, and are generally considered to negatively affect health; however, they seem to be normal or even beneficial in pregnancy, as they promote energy storage in fat tissue and provide for the growth of the fetus Taking this into account—as well as the results of this meta-analysis, which showed that probiotic supplementation does not have a significant impact on glucose metabolism of pregnant women without GDM—it seems that such attempts aimed at lowering glucose and insulin concentration in women without GDM are pointless.
However, it should be added that this may be due to the insufficient number of studies included in the analysis, as there were only four studies with women without GDM. It should also be noted that an additional determinant of the effectiveness of probiotic therapy in preventing GDM in pregnant women, which may be worthy of analysis, is the assessment of the frequency of GDM development in the supplemented population.
Such a procedure would also make it possible to conclude whether insulin and fasting glucose levels, the HOMA index, or the frequency of GDM development are better indicators of the effectiveness of probiotic therapy in pregnant women.
Unfortunately, this was not possible with the studies considered there, because only Lindsay et al. gave data on the frequency of GDM development in the study group—this was The beneficial effects of probiotic supplementation in pregnant women with GDM may arise from the fact that, according to Crusell et al.
Although the diversity of microbiota is similar, these authors identified seventeen species-level OTUs, predominantly within the phylum Firmicutes , which were differentially abundant in women with and without GDM in the third trimester.
They suggested some genera as biomarkers of GDM, including Collinsella , Rothia , Actinomyces , Desulfovibrio , Leuconostoc , and Mogibacterium. This study also shows that other disturbances appear in GDM which differed from those in T2DM mentioned earlier. It can thus be assumed that probiotic therapies that working on T2DM subjects may not work on GDM women, and vice-versa.
This shows the importance of such studies. Interestingly, we have found that adding prebiotics to probiotics as a synbiotic is no more beneficial in lowering glucose concentration than probiotics alone. For insulin, the effect was the same as for probiotics, while for HOMA-IR the effect was slightly better than for solely probiotic supplementation.
Prebiotics, such as inulin or fructooligosaccharides FOS , are substrates with which probiotic bacteria can produce SCFA. Most human intervention studies have shown a positive effect of synbiotic supplementation on glucose metabolism 60 , However, few studies have compared the effects of probiotic and synbiotic supplementation.
One such study was performed by Kassaian et al. However, the effect of synbiotics was not better than that of probiotics alone. In two studies included in this meta-analysis 39 , 49 , the probiotic part of the synbiotic included different strains of Lactobacillus , whereas another two studies 26 , 47 used both Lactobacillus and Bifidobacterium.
It was found that not all strains of Lactobacillus and Bifidobacterium have the ability to ferment FOS and inulin, and that the metabolic potential to ferment those prebiotics may differ between various strains of these probiotic bacteria 63 , Those results may partly explain the results of our meta-analysis, and this emphasizes the importance of the proper selection of probiotics and prebiotic, and their combination as synbiotic supplements.
The results of some individual studies 41 , 47 show that probiotic supplementation does not improve glucose metabolism.
This may be due to the different formulations of probiotics and synbiotics used in those studies. Some studies used only Lactobacillus species, while others employed combinations of Lactobacillus , Bifidobacterium , and Streptococcus 39 , 40 , 41 , There are studies indicating that multistrain probiotics appear to show better efficacy than single strains in treating various conditions The duration of the supplementation also seems to be important: in the studies included in this meta-analysis, the duration of intervention lasted from four to twelve weeks.
The observed effects may be dose-dependent 66 , which may also explain the differences seen in the results of the studies, where the dose varied from 10 6 to over 10 10 CFU per capsule; however, some studies did not indicate the dose of bacteria used.
The strength of our meta-analysis is that the studies included are characterized by similar groups of people pregnant adult women and that the only experimental factor tested was the use of probiotic or synbiotic supplementation.
Moreover, our statistical analysis considered both the presupplementation and postsupplementation concentration in the placebo and intervention groups, whereas many analyses only make use of the postintervention concentrations.
The limitations of our study include not considering the dose, duration, or week of pregnancy at the start of supplementation. Most of the studies used different doses and different species of probiotic bacteria, which made it impossible to include these factors in the meta-analysis.
Furthermore, most included samples consisted of relatively small groups, typically of 30—40 women. The results of the individual studies may also have been affected by many other factors that were not taken into account. In conclusion, probiotic supplementation may improve glucose metabolism in pregnant women, especially in those with GDM.
There is a need for more randomized controlled trials of women with and without GDM, with larger sample sizes, in order to better determine this effect. Moreover, it is necessary to determine the best timing, duration, composition, and dose of such supplementation.
Dietary intake, physical activity, and baseline gut microbiota composition should also be examined in such studies, as the effectiveness of probiotic supplementation may depend on these factors. Kampmann, U.
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Stephen L. Fat burners with no side effectsMetabolisj Berkowitz metagolism, Barb ShreinerLaura Want; Glucose Metabilism and Regulation: Beyond Glicose and Glucagon. Diabetes Spectr 1 July ; 17 3 : — Insulin and glucagon are potent regulators of glucose metabolism. For decades, we have viewed diabetes from a bi-hormonal perspective of glucose regulation. This perspective is incomplete and inadequate in explaining some of the difficulties that patients and practitioners face when attempting to tightly control blood glucose concentrations. Intensively managing diabetes with insulin is fraught with frustration and risk.
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