title: Physical training in the prophylaxis and treatment of obesity, hypertension and diabetes.
abstract: The results of physical training in 600 obese and 100 diabetic patients are described and discussed. Three months of physical training (55 min 3 times/week) without dietary restriction did not result in any change in body weight and composition either in obese or diabetic female patients. However, the male patients remained their body weight unchanged and body fat decreased and lean body mass increased after training. The combination of exercise with a very low calorie diet in obese women neither prevents the erosion of lean body mass nor the diet-induced decrease in oxygen uptake. Local exercise could not evoke a local decrease in the thickness of adipose tissue. The addition of physical training to the low calorie diet leads to better social and psychological compliance and a more equal distribution of adipose tissue. A close relationship has been found between the muscle morphology and glucose metabolism in obese patients. Insulin concentration appeared to be positively correlated to the percentage of FTb fibers and inversely correlated to the capillary density. The decrease in the percentage of FTb muscle fibers and the increase in the number of capillaries were correlated to the decrease in plasma insulin levels. The capillary density appeared to be reduced with decreasing degrees of glucose tolerance. In patients with diabetes type I it was found diminished so much that the diffusion distance in muscle increased after training. The most interesting results related to glucose metabolism were found otherwise as follows: The sum of insulin (276.4 +/- 20.1 before and 255.1 +/- 19.0 after p less than 0.05) and glucose levels (but not fasting values) decreased (28.3 +/- 1.6 before and 27.8 +/- 1.4 after p less than 0.01) after training in obesity. In obese and diabetic patients with initially high insulin values physical training resulted in a decrease in insulin level, while in those patients with initially low values it resulted in an increase. As judged from the insulin C-peptide ratio, patients who decreased their insulin levels after training increased their liver uptake of insulin. The increased hepatic extraction of insulin without the decrease of insulin production was also noted in patients with diabetes type II. After training both obese patients and those with diabetes I and II increased their glucose metabolism (disposal rate) during insulin euglycemic clamp. Patients with diabetes type II showed initially lower basal and insulin-stimulated glucose incorporation into triglycerides.(ABSTRACT TRUNCATED AT 400 WORDS)
mesh_terms: D000222:Adaptation, Physiological; D001341:Autonomic Nervous System / Q000378:metabolism; D001823:Body Composition; D002196:Capillaries / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000628:therapy*; D004038:Diet, Reducing; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000378:metabolism / Q000628:therapy*; D007328:Insulin / Q000097:blood; D008297:Male; D009132:Muscles / Q000098:blood supply / Q000201:enzymology; D009765:Obesity / Q000378:metabolism / Q000628:therapy*; D010806:Physical Education and Training; D014280:Triglycerides / Q000097:blood
chemical_list: D007328:Insulin; D014280:Triglycerides; D005947:Glucose