Healthy aging and physical activity practice: The missing link Isabelle J. Dionne, PhD, Professor... more Healthy aging and physical activity practice: The missing link Isabelle J. Dionne, PhD, Professor, Université de Sherbrooke, walks us through physical activity practice and how it impacts research on healthy aging. Major public health agencies around the world urge the older population to get on the move while cities and states invest more and more in safe and attractive infrastructures and programs. Nonetheless, physical activity (PA) levels of aging adults remain low in most developed societies. It appears that the healthcare systems and the general public do not take advantage of the skills and competencies of qualified PA professionals trained in universities around the globe to support evidence- based physical activity practice and healthy aging. This weakest link needs reinforcement.
Diabetic older adults are at a higher risk of muscle strength (MS) decline than their non-diabeti... more Diabetic older adults are at a higher risk of muscle strength (MS) decline than their non-diabetic counterparts. Adequate protein and energy intakes and physical activity (PA) may preserve MS during aging. However, the role of diet quality (DQ) in MS maintenance is still unknown. This study aimed to determine the association between DQ - alone or combined with PA - and changes in MS over 3 years in diabetic participants aged 67 to 84 years at recruitment in a secondary analysis of the longitudinal observational NuAge study. Changes in handgrip, knee extensor and elbow flexor strengths were calculated as the difference between recruitment (T1) and after 3 years (T4) in 156 diabetic older adults. Baseline DQ was calculated from 3 non-consecutive 24-hour dietary recalls collected at T1 using the validated Canadian Healthy Eating Index (C-HEI). Change in PA was calculated from Physical Activity Scale for the Elderly (PASE) as PASE T4-PASE T1. Four combinations of variables were created: C-HEI<70 with PASE change either < or > median and C-HEI ≥ 70 with PASE change either < or > median. The association between these four categories and MS maintenance was evaluated using General Linear Modeling (GLM). Analyses were stratified by sex and controlled for covariates. Baseline DQ alone was not associated with MS maintenance. Baseline DQ combined with PASE change showed associations with crude and baseline adjusted handgrip strength (p=0.031, p=0.018) and crude and baseline adjusted elbow flexor change (p=0.028, p=0.017) in males only; no significant results were found for knee extensor strength in either males or females. While findings for females were inconclusive, results demonstrate that better adherence to dietary guidelines combined with a more active lifestyle may prevent MS decline among diabetic older males. Additional research is needed on a larger sample since generalization of these results is limited by the small sample size.
Applied Physiology, Nutrition, and Metabolism, 2021
Menopause transition is associated with detrimental changes in physical activity, body compositio... more Menopause transition is associated with detrimental changes in physical activity, body composition, and metabolic profile. Although physical activity energy expenditure (PAEE) is inversely associated with metabolic syndrome (MetS) in individuals at higher risk of cardiovascular disease, the association is unknown in low-risk individuals. The aim of the study was to investigate the association between PAEE and MetS (prevalence and severity) in inactive overweight or obese postmenopausal women with a low Framingham Risk Score (<10%). Cross-sectional data of 126 participants were divided into quartiles based on PAEE (Quartile (Q)1 = lowest PAEE) while fat-free mass (FFM) and fat mass were measured by dual-energy X-ray absorptiometry. MetS prevalence was significantly different between Q1 and Q4 (37.9% vs 13.3%, p = 0.03). After controlling for potential confounders, MetS severity was negatively associated with PAEE (B = −0.057, p < 0.01) and positively with FFM (B = 0.038, p <...
Skeletal muscle (SM) tissue has been repetitively shown to play a major role in whole-body glucos... more Skeletal muscle (SM) tissue has been repetitively shown to play a major role in whole-body glucose homeostasis and overall metabolic health. Hence, SM hypertrophy through resistance training (RT) has been suggested to be favorable to glucose homeostasis in different populations, from young healthy to type 2 diabetic (T2D) individuals. While RT has been shown to contribute to improved metabolic health, including insulin sensitivity surrogates, in multiple studies, a universal understanding of a mechanistic explanation is currently lacking. Furthermore, exercised-improved glucose homeostasis and quantitative changes of SM mass have been hypothesized to be concurrent but not necessarily causally associated. With a straightforward focus on exercise interventions, this narrative review aims to highlight the current level of evidence of the impact of SM hypertrophy on glucose homeostasis, as well various mechanisms that are likely to explain those effects. These mechanistic insights could...
Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2021
BACKGROUND AND AIMS To compare the effect of a low-volume walking high-intensity interval trainin... more BACKGROUND AND AIMS To compare the effect of a low-volume walking high-intensity interval training (HIIT) to moderate-intensity continuous training (MICT) on risk of cardiovascular diseases and physical capacity in older women with type 2 diabetes (T2D). METHODS Thirty inactive older women with T2D were randomized into either HIIT (75 min/week) or MICT (150 min/week). Cardiovascular risk profile (lipid profile; waist circumference and fat mass; resting, post-exercise and ambulatory blood pressure [BP]; VO2 peak; UKPDS score; ABC's) and physical capacity were assessed before and after a 12-week intervention. RESULTS While resting systolic and diastolic BP (all p ≤ 0.01) were reduced, ambulatory BP (p ≥ 0.49) and lipid profile (p ≥ 0.40) remained unchanged after the intervention. Although VO2 peak increased to a similar extent in both groups (p = 0.015), the distance covered during the 6MWT (p = 0.01) and grip strength (p = 0.02) increased to a greater extend in HIIT. The UKPDS risk score decreased in both groups after the intervention (p = 0.03) and 31% of the participants reached the ABC's compared to 24% at baseline. CONCLUSION Low-volume walking HIIT is an efficient exercise intervention for older women with T2D as it improved some CVD risk factors and physical capacity. Nevertheless, neither low-volume HIIT nor MICT is sufficient to affect ambulatory blood pressure in T2D patients.
Abstract Objective: A sex-specific standard waist circumference (WC) is widely used to determine ... more Abstract Objective: A sex-specific standard waist circumference (WC) is widely used to determine cardiometabolic risk across ages even though aging impacts the link between fat distribution and cardiometabolic risk. The objective was to propose WC thresholds that better predict metabolic abnormalities according to sex, age, and body mass index (BMI) categories. Methods: First, receiver operating characteristic analyses were performed to identify optimal age (20–49, 50–64, and 65–80 years) and BMI (normal weight, overweight, obese I, and obese II+) specific WC thresholds to correctly identify at-risk individuals, that is, presenting ≥2 cardiometabolic risk factors of metabolic syndrome (n = 23,482; NHANES 2007–2014). Second, cross-validation analyses (n = 18,686; NHANES 1999–2006) were used to validate these WC optimal thresholds. Univariate logistic regression models with WC as an independent predictor were performed to quantify odds of being at-risk for each age and BMI subgroups. Results: When age and B...
Objectives: To compare the effect of low-volume high-intensity interval training (HIIT) with mode... more Objectives: To compare the effect of low-volume high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) on fat mass, cardiometabolic profile, and physical capacity, and confirm its feasibility in older women. Methods: Inactive older women (60–75 years) were randomly assigned to 8 weeks of either HIIT (75 min/week; n = 9) or MICT (150 min/week; n = 9). Body composition, fasting metabolic profile, cardiovascular risk (Framingham score), and physical capacity (senior fitness test, peak oxygen uptake) were assessed before and after the intervention. Feasibility was evaluated with completion rate (training compliance; dropout rate) and affective response (Feeling Scale; pre- and postexercise). Results: Total cholesterol level, non-high-density lipoprotein cholesterol level, and the Framingham risk score decreased in both groups (ps ≤ .03). Although peak oxygen uptake remained unchanged, the 6-min walk test distance increased (p < .0001), irrespective...
Applied Physiology, Nutrition, and Metabolism, 2018
The objectives of this study were to determine (i) whether a 5-day aerobic exercise (AE) program ... more The objectives of this study were to determine (i) whether a 5-day aerobic exercise (AE) program combined with a medium-chain triglyceride (MCT) supplement would increase the plasma ketone response in older women more than either intervention alone and (ii) whether ketonemia after these combined or separate treatments was alike in normoglycemic (NG) and prediabetic (PD) women. Older women (NG, n = 10; PD, n = 9) underwent a 4-h metabolic study after each of 4 different treatments: (i) no treatment (control), (ii) 5 days of MCT alone (30 g·day−1), (iii) 1 session of 30 min of AE alone, and (iv) 5 days of MCT and AE combined (MCT+AE). Blood was sampled every 30 min over 4 h for analysis. In NG, MCT+AE induced the highest area under the curve (AUC) for plasma ketones (835 ± 341 μmol·h·L−1); this value was 69% higher than that observed with MCT alone (P < 0.05). AUCs were not different between MCT alone and MCT+AE in PD, but both treatments induced a significantly higher AUC than the...
Abstract Introduction: Conflicting results have been reported concerning the prevalence of cardio... more Abstract Introduction: Conflicting results have been reported concerning the prevalence of cardiometabolic risk factors in women experiencing vasomotor symptoms (VMS). Objectives: To compare cardiometabolic risk factors between women with and without VMS during the menopause transition and to determine the influence of physical activity on the prevalence of VMS. Methods: Yearly assessment of women transitioning through menopause included self-reported VMS (hot flushes and night sweats), body composition and fat distribution, fasting glucose, insulin and lipids, and physical activity levels. Results: Eighty-five of the 102 premenopausal women at baseline were included (age: 49.9 ± 2.0 years; body mass index: 23.2 ± 2.2 kg/m2). According to linear mixed model analyses, no statistically significant differences were observed for fat mass, lean body mass, body fat distribution indices and cardiometabolic risk factors, when comparing symptomatic vs. asymptomatic women. Neither physical activity levels nor intensity were associated with the prevalence of VMS. Conclusion: Our results suggest that women transitioning through menopause who reported VMS did not show greater deteriorations in body composition, body fat distribution and cardiometabolic risk factors. Furthermore, physical activity levels were not associated with lower prevalence of vasomotor symptoms in the present cohort.
Healthy aging and physical activity practice: The missing link Isabelle J. Dionne, PhD, Professor... more Healthy aging and physical activity practice: The missing link Isabelle J. Dionne, PhD, Professor, Université de Sherbrooke, walks us through physical activity practice and how it impacts research on healthy aging. Major public health agencies around the world urge the older population to get on the move while cities and states invest more and more in safe and attractive infrastructures and programs. Nonetheless, physical activity (PA) levels of aging adults remain low in most developed societies. It appears that the healthcare systems and the general public do not take advantage of the skills and competencies of qualified PA professionals trained in universities around the globe to support evidence- based physical activity practice and healthy aging. This weakest link needs reinforcement.
Diabetic older adults are at a higher risk of muscle strength (MS) decline than their non-diabeti... more Diabetic older adults are at a higher risk of muscle strength (MS) decline than their non-diabetic counterparts. Adequate protein and energy intakes and physical activity (PA) may preserve MS during aging. However, the role of diet quality (DQ) in MS maintenance is still unknown. This study aimed to determine the association between DQ - alone or combined with PA - and changes in MS over 3 years in diabetic participants aged 67 to 84 years at recruitment in a secondary analysis of the longitudinal observational NuAge study. Changes in handgrip, knee extensor and elbow flexor strengths were calculated as the difference between recruitment (T1) and after 3 years (T4) in 156 diabetic older adults. Baseline DQ was calculated from 3 non-consecutive 24-hour dietary recalls collected at T1 using the validated Canadian Healthy Eating Index (C-HEI). Change in PA was calculated from Physical Activity Scale for the Elderly (PASE) as PASE T4-PASE T1. Four combinations of variables were created: C-HEI&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;70 with PASE change either &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; median and C-HEI ≥ 70 with PASE change either &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; median. The association between these four categories and MS maintenance was evaluated using General Linear Modeling (GLM). Analyses were stratified by sex and controlled for covariates. Baseline DQ alone was not associated with MS maintenance. Baseline DQ combined with PASE change showed associations with crude and baseline adjusted handgrip strength (p=0.031, p=0.018) and crude and baseline adjusted elbow flexor change (p=0.028, p=0.017) in males only; no significant results were found for knee extensor strength in either males or females. While findings for females were inconclusive, results demonstrate that better adherence to dietary guidelines combined with a more active lifestyle may prevent MS decline among diabetic older males. Additional research is needed on a larger sample since generalization of these results is limited by the small sample size.
Applied Physiology, Nutrition, and Metabolism, 2021
Menopause transition is associated with detrimental changes in physical activity, body compositio... more Menopause transition is associated with detrimental changes in physical activity, body composition, and metabolic profile. Although physical activity energy expenditure (PAEE) is inversely associated with metabolic syndrome (MetS) in individuals at higher risk of cardiovascular disease, the association is unknown in low-risk individuals. The aim of the study was to investigate the association between PAEE and MetS (prevalence and severity) in inactive overweight or obese postmenopausal women with a low Framingham Risk Score (<10%). Cross-sectional data of 126 participants were divided into quartiles based on PAEE (Quartile (Q)1 = lowest PAEE) while fat-free mass (FFM) and fat mass were measured by dual-energy X-ray absorptiometry. MetS prevalence was significantly different between Q1 and Q4 (37.9% vs 13.3%, p = 0.03). After controlling for potential confounders, MetS severity was negatively associated with PAEE (B = −0.057, p < 0.01) and positively with FFM (B = 0.038, p <...
Skeletal muscle (SM) tissue has been repetitively shown to play a major role in whole-body glucos... more Skeletal muscle (SM) tissue has been repetitively shown to play a major role in whole-body glucose homeostasis and overall metabolic health. Hence, SM hypertrophy through resistance training (RT) has been suggested to be favorable to glucose homeostasis in different populations, from young healthy to type 2 diabetic (T2D) individuals. While RT has been shown to contribute to improved metabolic health, including insulin sensitivity surrogates, in multiple studies, a universal understanding of a mechanistic explanation is currently lacking. Furthermore, exercised-improved glucose homeostasis and quantitative changes of SM mass have been hypothesized to be concurrent but not necessarily causally associated. With a straightforward focus on exercise interventions, this narrative review aims to highlight the current level of evidence of the impact of SM hypertrophy on glucose homeostasis, as well various mechanisms that are likely to explain those effects. These mechanistic insights could...
Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2021
BACKGROUND AND AIMS To compare the effect of a low-volume walking high-intensity interval trainin... more BACKGROUND AND AIMS To compare the effect of a low-volume walking high-intensity interval training (HIIT) to moderate-intensity continuous training (MICT) on risk of cardiovascular diseases and physical capacity in older women with type 2 diabetes (T2D). METHODS Thirty inactive older women with T2D were randomized into either HIIT (75 min/week) or MICT (150 min/week). Cardiovascular risk profile (lipid profile; waist circumference and fat mass; resting, post-exercise and ambulatory blood pressure [BP]; VO2 peak; UKPDS score; ABC's) and physical capacity were assessed before and after a 12-week intervention. RESULTS While resting systolic and diastolic BP (all p ≤ 0.01) were reduced, ambulatory BP (p ≥ 0.49) and lipid profile (p ≥ 0.40) remained unchanged after the intervention. Although VO2 peak increased to a similar extent in both groups (p = 0.015), the distance covered during the 6MWT (p = 0.01) and grip strength (p = 0.02) increased to a greater extend in HIIT. The UKPDS risk score decreased in both groups after the intervention (p = 0.03) and 31% of the participants reached the ABC's compared to 24% at baseline. CONCLUSION Low-volume walking HIIT is an efficient exercise intervention for older women with T2D as it improved some CVD risk factors and physical capacity. Nevertheless, neither low-volume HIIT nor MICT is sufficient to affect ambulatory blood pressure in T2D patients.
Abstract Objective: A sex-specific standard waist circumference (WC) is widely used to determine ... more Abstract Objective: A sex-specific standard waist circumference (WC) is widely used to determine cardiometabolic risk across ages even though aging impacts the link between fat distribution and cardiometabolic risk. The objective was to propose WC thresholds that better predict metabolic abnormalities according to sex, age, and body mass index (BMI) categories. Methods: First, receiver operating characteristic analyses were performed to identify optimal age (20–49, 50–64, and 65–80 years) and BMI (normal weight, overweight, obese I, and obese II+) specific WC thresholds to correctly identify at-risk individuals, that is, presenting ≥2 cardiometabolic risk factors of metabolic syndrome (n = 23,482; NHANES 2007–2014). Second, cross-validation analyses (n = 18,686; NHANES 1999–2006) were used to validate these WC optimal thresholds. Univariate logistic regression models with WC as an independent predictor were performed to quantify odds of being at-risk for each age and BMI subgroups. Results: When age and B...
Objectives: To compare the effect of low-volume high-intensity interval training (HIIT) with mode... more Objectives: To compare the effect of low-volume high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) on fat mass, cardiometabolic profile, and physical capacity, and confirm its feasibility in older women. Methods: Inactive older women (60–75 years) were randomly assigned to 8 weeks of either HIIT (75 min/week; n = 9) or MICT (150 min/week; n = 9). Body composition, fasting metabolic profile, cardiovascular risk (Framingham score), and physical capacity (senior fitness test, peak oxygen uptake) were assessed before and after the intervention. Feasibility was evaluated with completion rate (training compliance; dropout rate) and affective response (Feeling Scale; pre- and postexercise). Results: Total cholesterol level, non-high-density lipoprotein cholesterol level, and the Framingham risk score decreased in both groups (ps ≤ .03). Although peak oxygen uptake remained unchanged, the 6-min walk test distance increased (p < .0001), irrespective...
Applied Physiology, Nutrition, and Metabolism, 2018
The objectives of this study were to determine (i) whether a 5-day aerobic exercise (AE) program ... more The objectives of this study were to determine (i) whether a 5-day aerobic exercise (AE) program combined with a medium-chain triglyceride (MCT) supplement would increase the plasma ketone response in older women more than either intervention alone and (ii) whether ketonemia after these combined or separate treatments was alike in normoglycemic (NG) and prediabetic (PD) women. Older women (NG, n = 10; PD, n = 9) underwent a 4-h metabolic study after each of 4 different treatments: (i) no treatment (control), (ii) 5 days of MCT alone (30 g·day−1), (iii) 1 session of 30 min of AE alone, and (iv) 5 days of MCT and AE combined (MCT+AE). Blood was sampled every 30 min over 4 h for analysis. In NG, MCT+AE induced the highest area under the curve (AUC) for plasma ketones (835 ± 341 μmol·h·L−1); this value was 69% higher than that observed with MCT alone (P < 0.05). AUCs were not different between MCT alone and MCT+AE in PD, but both treatments induced a significantly higher AUC than the...
Abstract Introduction: Conflicting results have been reported concerning the prevalence of cardio... more Abstract Introduction: Conflicting results have been reported concerning the prevalence of cardiometabolic risk factors in women experiencing vasomotor symptoms (VMS). Objectives: To compare cardiometabolic risk factors between women with and without VMS during the menopause transition and to determine the influence of physical activity on the prevalence of VMS. Methods: Yearly assessment of women transitioning through menopause included self-reported VMS (hot flushes and night sweats), body composition and fat distribution, fasting glucose, insulin and lipids, and physical activity levels. Results: Eighty-five of the 102 premenopausal women at baseline were included (age: 49.9 ± 2.0 years; body mass index: 23.2 ± 2.2 kg/m2). According to linear mixed model analyses, no statistically significant differences were observed for fat mass, lean body mass, body fat distribution indices and cardiometabolic risk factors, when comparing symptomatic vs. asymptomatic women. Neither physical activity levels nor intensity were associated with the prevalence of VMS. Conclusion: Our results suggest that women transitioning through menopause who reported VMS did not show greater deteriorations in body composition, body fat distribution and cardiometabolic risk factors. Furthermore, physical activity levels were not associated with lower prevalence of vasomotor symptoms in the present cohort.
Uploads
Papers by Isabelle Dionne