Purpose: Overweight individuals are at risk of intermediate hyperglycemia (IHG) [1]. Increasing physical activity (PA) in IHG is one method to reduce the risk of glucometabolic and cardiovascular (CV) complications [2]. This study investigates walking to music as a modality to increase moderate intensity PA and regulate glucometabolic disturbances. Patients and Methods: Participants were randomized to usual care (UC) or intervention group (IG) who completed a 6 month walking to music program. Physiological assessments for a range of variables (DEXA, flow mediated dilatation (FMD) and glucometabolic biomarkers) were completed at baseline, 4, 6 and 9 months (follow-up). Results: For IG group, walking compliance decreased with time however 71.4%, 79.5% and 73% of walking completed was moderate intensity at 4, 6 and 9 months. At 6 months IG FMD was significantly lower than UC and HbA1Cwas 5% lower. Other physiological markers were not altered. Conclusion: Walking to music may be a novel method to encourage moderate intensity PA. However, the majority of results demonstrate that this intervention was not more effective than UC in managing glucometabolic and CV biomarkers in IHG. Future interventions should include additional support for the entire study duration however this has cost implications.
References
[1]
Tarasova, V.D., Caballero, J.A., Turner, P. and Inzucchi, S.E. (2014) Speaking to Patients about Diabetes Risk: Is Terminology Important? Clinical Diabetes, 32, 90-95. https://doi.org/10.2337/diaclin.32.2.90
[2]
Diabetes, U.K. (2015) Diabetes: Facts and Stats. https://www.diabetes.org.uk/Documents/About%20Us/Statistics/Diabetes-key-stats-guidelines-April2014.pdf
[3]
World Health Organisation (2015) Overweight and Obesity: Fact Sheet. http://www.who.int/mediacentre/factsheets/fs311/en/
[4]
Tobias, D.K., Pan, A., Jackson, C.L., O’Reilly, E.J., Ding, E.L., Willett, W.C., Manson, J.E. and Hu, F.B. (2014) Body-Mass Index and Mortality among Adults with Incident Type 2 Diabetes. The New England Journal of Medicine, 370, 233-244. https://doi.org/10.1056/NEJMoa1304501
[5]
Yang, L. and Colditz, G.A. (2015) Prevalence of Overweight and Obesity in the United States 2007-2012. JAMA Internal Medicine, 175, 1412-1413. https://doi.org/10.1001/jamainternmed.2015.2405
[6]
Bansal, N. (2015) Prediabetes Diagnosis and Treatment: A Review. World Journal of Diabetes, 6, 296-303. http://dx.doi.org/10.4239/wjd.v6.i2.296
[7]
McNeilly, A.M., Davison, G.W., Murphy, M.H., Nadeem, N., Trinick, T., Duly, E., Novials, A. and McEneny, J. (2011) Effect of α-Lipoic Acid and EXERCISE training on Cardiovascular Disease Risk in Obesity with Impaired Glucose Tolerance. Lipids in Health and Disease, 10, Article No. 217. https://doi.org/10.1186/1476-511X-10-217
[8]
Shah, A.D., Vittinghoff, E., Kandula, N.R., Srivastava, S. and Kanaya, A.M. (2015) Correlates of Prediabetes and Type II Diabetes in US South Asians: Findings from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. Annals of Epidemiology, 25, 77-83. https://doi.org/10.1016/j.annepidem.2014.10.013
[9]
Centre for Disease Control and Prevention (2014) Estimates of Diabetes and Its Burden in the United States. United States Department of Health and Human Services, Washington DC. https://www.cdc.gov/diabetes/data/statistics/statistics-report.html
[10]
Mainous, A.G., Tanner, R.J., Baker, R., Zayas, C.E. and Harle, C.A. (2014) Prevalence of Prediabetes in England from 2003 to 2011: Population-Based, Cross-Sectional Study. BMJ Open, 4, e005002. https://doi.org/10.1136/bmjopen-2014-005002
[11]
Gopalan, A., Lorincz, I.S., Wirtalla, C., Marcus, S.C. and Long, J.A. (2015) Awareness of Prediabetes and Engagement in Diabetes Risk-Reducing Behaviors. American Journal of Preventive Medicine, 49, 512-519. https://doi.org/10.1016/j.amepre.2015.03.007
[12]
Ruiz-Alcaraz, A.J., Lipina, C., Petrie, J.R., Murphy, M.J., Morris, A.D., Sutherland, C. and Cuthbertson, D.J. (2013) Obesity-Induced Insulin Resistance in Human Skeletal Muscle Is Characterised by Defective Activation of p42/p44 MAP Kinase. PLoS ONE, 8, e56928. https://doi.org/10.1371/journal.pone.0056928
[13]
Teixeira-Lemos, E., Nunes, S., Teixeira, F. and Reis, F. (2011) Regular Physical Exercise Training Assists in Preventing Type 2 Diabetes Development: Focus on Its Antioxidant and Anti-Inflammatory Properties. Cardiovascular Diabetology, 28, Article No. 12. https://doi.org/10.1186/1475-2840-10-12
[14]
Hex, N., Bartlett, C., Wright, D., Taylor, M. and Varley, D. (2012) Estimating the Current and Future Costs of Type 1 and Type 2 Diabetes in the UK, Including Direct Health Costs and Indirect Societal and Productivity Costs. Diabetic Medicine, 29, 855-862. https://doi.org/10.1111/j.1464-5491.2012.03698.x
[15]
Tudor-Locke, C. and Bassett, D. (2004) How Many Steps/Day Are Enough? Sports Medicine, 34, 1-8. https://doi.org/10.2165/00007256-200434010-00001
[16]
Tudor-Locke, C. and Rowe, D.A. (2012) Using Cadence to Study Free-Living Ambulatory Behaviour. Sports Med, 42, 381-398. https://doi.org/10.2165/11599170-000000000-00000
[17]
Physical Activity Guidelines: UK Chief Medical Officers’ Report. A Report from the Chief Medical Officers in the UK on the Amount and Type of Physical Activity People Should Be Doing to Improve Their Health (2019). https://www.gov.uk/government/publications/physical-activity-guidelines-uk-chief-medical-officers-report
[18]
Rowe, D.A., Welk, G.J., Heil, D.P., Mahar, M.T., Kemble, C.D., Calabró, M.A. and Camenisch, K. (2011) Stride Rate Recommendations for Moderate-Intensity Walking. Medicine & Science in Sports & Exercise, 43, 312-318. https://doi.org/10.1249/MSS.0b013e3181e9d99a
[19]
Kirk, A., Barnett, J., Leese, G. and Mutrie, N. (2009) A Randomized Trial Investigating the 12-Month Changes in Physical Activity and Health Outcomes following a Physical Activity Consultation Delivered by a Person or in Written form in Type 2 Diabetes: Time2Act. Diabetic Medicine, 26, 293-301. https://doi.org/10.1111/j.1464-5491.2009.02675.x
[20]
Scholfield, W.N., Scholfield, C. and James, W.P.T. (1985) Human Nutrition. Human Nutrition: Clinical Nutrition, 39, 1-96.
[21]
Harris, R.A. (2010) FMD, Reproducibility, and Acute Exercise in the Obese: Are the Results Confounded? European Journal of Applied Physiology, 109, 357-358. https://doi.org/10.1007/s00421-009-1343-8
[22]
Glass, S. and Dwyer, G.B. (2007) ACSM’s Metabolic Calculations Handbook (American College of Sports Medicine). Lippincott Williams & Wilkins, Baltimore.
[23]
Craig, C., Marshall, A., Sjöström, M., Bauman, A., Booth, M., Ainsworth, B., Pratt, M., Ekelund, U., Yngve, A., Sallis, J., IPAQ Consensus Group and the IPAQ Reliability and Validity Study Group (2003) International Physical Activity Questionnaire (IPAQ): 12-Country Reliability and Validity. Medicine & Science in Sports & Exercise, 35, 1381-1395. https://doi.org/10.1249/01.MSS.0000078924.61453.FB
[24]
World Health Organisation (2006) Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycemia: Report of a WHO/IDF Consultation. https://www.who.int/diabetes/publications/Definition%20and%20 diagnosis%20of%20diabetes_new.pdf
[25]
Friedwald, W.T., Levy, R.I. and Fredrickson, D.S. (1972) Estimation of the Concentration of Low-Density Lipoprotein Cholesterol in Plasma, without the Use of Preparative Ultracentrifuge. Clinical Chemistry, 18, 449-502. https://doi.org/10.1093/clinchem/18.6.499
[26]
Ziccardi, P., Nappo, F., Giugliano, G., Esposito, K., Marfella, R., Cioffi, M., D’Andrea, F., Molinari, A.M. and Giugliano, D. (2002) Reduction of Inflammatory Cytokine Concentrations and Improvement of Endothelial Functions in Obese Women after Weight Loss over One Year. Circulation, 105, 804-809. https://doi.org/10.1161/hc0702.104279
[27]
Ras, R.T., Streppel, M.T., Draijer, R. and Zock, P.L. (2013) Flow-Mediated Dilation and Cardiovascular Risk Prediction: A Systematic Review with Meta-Analysis. International Journal of Cardiology, 168, 344-351. https://doi.org/10.1016/j.ijcard.2012.09.047
[28]
Inaba, Y., Chen, J.A. and Bergmann, S.R. (2010) Prediction of Future Cardiovascular Outcomes by Flow-Mediated Vasodilatation of Brachial Artery: A Meta-Analysis. The International Journal of Cardiovascular Imaging, 26, 631-640. https://doi.org/10.1007/s10554-010-9616-1
[29]
Onkelinx, S., Cornelissen, V., Goetschalckx, K., Thomaes, T., Verhamme, P. and Vanhees, L. (2012) Reproducibility of Different Methods to Measure the Endothelial Function. Vascular Medicine, 17, 79-84. https://doi.org/10.1177/1358863X12436708
[30]
Thijssen, D.H., Black, M.A., Pyke, K.E., Padilla, J., Atkinson, G., Harris, R.A., Parker, B., Widlansky, M.E., Tschakovsky, M.E. and Green, D.J. (2011) Assessment of Flow-Mediated Dilation in Humans: A Methodological and Physiological Guideline. American Journal of Physiology-Heart and Circulatory Physiology, 300, H2-H12. https://doi.org/10.1152/ajpheart.00471.2010
[31]
Mozos, I., Malainer, C., Horbańczuk, J., Gug, C., Stoiam, D., Tudor Luca, C. and Atanasov, A.G. (2017) Inflammatory Markers for Arterial Stiffness in Cardiovascular Diseases. Frontiers in Immunology, 8, 1058. https://doi.org/10.3389/fimmu.2017.01058
[32]
Yates, T., Davies, M., Gorely, T., Bull, F. and Khunti, K. (2009) Effectiveness of a Pragmatic Education Program Designed to Promote Walking Activity in Individuals with Impaired Glucose Tolerance. Diabetes Care, 32, 1404-1410. https://doi.org/10.2337/dc09-0130
[33]
Skinner, T.C., Carey, M.E., Cradock, S., Daly, H., Davies, M.J., Doherty, Y., Heller, S., Khunti, K. and Oliver, L. (2006) Diabetes Education and Self-Management for Ongoing and Newly Diagnosed (DESMON); Process Modelling of Pilot Study. Patient Education and Counseling, 64, 369-377. https://doi.org/10.1016/j.pec.2006.04.007
[34]
Tuomilehto, J., Lindström, J., Eriksson, J.G., Valle, T.T., Hämäläinen, H., Ilanne-Parikka, P., Keinänen-Kiukaanniemi, S., Laakso, M., Louherantan, A. and Rastas, M. (2001) Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle among Subjects with Impaired Glucose Tolerance. The New England Journal of Medicine, 344, 1343-1350. https://doi.org/10.1056/NEJM200105033441801
[35]
Yates, T., Davies, M., Gorely, T., Bull, F. and Khunti, K. (2008) Rationale, Design and Baseline Data from the Pre-Diabetes Risk Education and Physical Activity Recommendation and Encouragement (PREPARE) Program Study: A Randomized Controlled Trial. Patient Education and Counseling, 73, 264-271. https://doi.org/10.1016/j.pec.2008.06.010
[36]
Stratton, I.M., Adler, A.I., Neil, H.A., Matthews, D.R., Manley, S.E., Cull, C.A., Hadden, D., Turner, R.C. and Holman, R.R. (2000) Association of Glycaemia with Macrovascular and Microvascular Complications of Type 2 Diabetes (UKPDS 35): Prospective Observational Study. BMJ, 321, 405-412. https://doi.org/10.1136/bmj.321.7258.405
[37]
Ponsonby, A., Sun, C., Ukoumunne, O.C., Pezic, A., Venn, A., Shaw, J.E., Dunstan, D.W., Barr, E.L., Blair, S.N. and Cochrane, J. (2011) Objectively Measured Physical Activity and the Subsequent Risk of Incident Dysglycemia: The Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Diabetes Care, 34, 1497-1502. https://doi.org/10.2337/dc10-2386
[38]
Hariri, A.A., Oliver, N.S., Johnston, D.G., Stevenson, J.C. and Godsland, I.F. (2013) Adiposity Measurements by BMI, Skinfolds and Dual Energy X-Ray Absorptiometry in Relation to Risk Markers for Cardiovascular Disease and Diabetes in Adult Males. Disease Markers, 35, Article ID: 763907. https://doi.org/10.1155/2013/763907
[39]
Hardman, A.E., Stensel, D.J. (2009) Physical Activity and Health: The Evidence Explained. Routledge, London. https://doi.org/10.4324/9780203890714
[40]
Evans, J.L., Goldfine, I.D., Maddux, B.A. and Grodsky, G.M. (2002) Oxidative Stress and Stress-Activated Signaling Pathways: A Unifying Hypothesis of Type 2 Diabetes. Endocrine Reviews, 23, 599-622. https://doi.org/10.1210/er.2001-0039
[41]
Harris, R.A., Padilla, J., Hanlon, K.P., Rink, L.D. and Wallace, J.P. (2008) The Flow-Mediated Dilation Response to Acute Exercise in Overweight Active and Inactive Men. Obesity, 16, 578-584. https://doi.org/10.1038/oby.2007.87
[42]
Katsuki, A., Sumida, Y., Murashima, S., Murata, K., Takarada, Y., Ito, K., Fujii, M., Tsuchihashi, K., Goto, H. and Nakatani, K. (1998) Serum Levels of Tumor Necrosis Factor-α Are Increased in Obese Patients with Noninsulin-Dependent Diabetes Mellitus 1. The Journal of Clinical Endocrinology & Metabolism, 83, 859-862. https://doi.org/10.1210/jcem.83.3.4618
[43]
Peitri, S., Segin, J.R., d’Arbigny, P.D. and Culcasi, M. (1994) Ascorbyl Free Radical: A Noninvasive Marker of Oxidative Stress in Human Open-Heart Surgery. Free Radical Biology and Medicine, 16, 523-528. https://doi.org/10.1016/0891-5849(94)90131-7
[44]
Leon, A.S., Conrad, J., Hunninghake, D.B. and Serfass, R. (1979) Effects of a Vigorous Walking Program on Body Composition, and Carbohydrate and Lipid Metabolism of Obese Young Men. The American Journal of Clinical Nutrition, 32, 1776-1787. https://doi.org/10.1093/ajcn/32.9.1776
