title: Effects of Nordic walking on cardiovascular risk factors in overweight individuals with type 2 diabetes, impaired or normal glucose tolerance.
abstract: BACKGROUND
  Physical activity remains a valuable prevention for metabolic disease. The effects of Nordic walking on cardiovascular risk factors were determined in overweight individuals with normal or disturbed glucose regulation.
  
  
  METHODS
  We included 213 individuals, aged 60 ± 5.3 years and with body mass index (BMI) of 30.2 ± 3.8 kg/m(2); of these, 128 had normal glucose tolerance (NGT), 35 had impaired glucose tolerance (IGT) and 50 had type 2 diabetes mellitus (T2DM). Participants were randomized to unaltered physical activity or to 5 h per week of Nordic walking with poles, for a 4-month period. Dietary habits were unaltered. BMI, waist circumference, blood pressure, glucose tolerance, clinical chemistry, maximal oxygen uptake (peak VO(2)) and self-reported physical activity (questionnaire) were assessed at the time of inclusion and after 4 months. The participants in the exercise-intervention group kept a walking diary.
  
  
  RESULTS
  In the NGT exercise group, self-reported physical activity increased markedly, and body weight (-2.0 ± 3.8 kg), BMI (-0.8 ± 1.4 kg/m(2)) and waist circumference (-4.9 ± 4.4 cm) (mean ± SD) decreased. Exercise power output (12.9 ± 9.9 W) and peak VO(2) (2.7 ± 2.8 mL/kg/min) increased in the IGT exercise group. More cardiovascular risk factors were improved after exercise intervention in people with NGT compared with those with IGT or T2DM. Exercise capacity improved significantly in all three groups of participants who reported at least 80% compliance with the scheduled exercise.
  
  
  CONCLUSIONS
  Nordic walking improved anthropometric measurements and exercise capacity. However, unsupervised Nordic walking may not provide a sufficient increase in exercise intensity to achieve ultimate health-promoting benefits on the cardiovascular parameters assessed in this study, particularly for those with disturbed glucose regulation.
authors.affiliation: Center for Family and Community Medicine, Karolinska Institutet, Huddinge, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Fritz
authors.forename: K
authors.initials: K
authors.lastname: Caidahl
authors.forename: A
authors.initials: A
authors.lastname: Krook
authors.forename: P
authors.initials: P
authors.lastname: Lundström
authors.forename: F
authors.initials: F
authors.lastname: Mashili
authors.forename: M
authors.initials: M
authors.lastname: Osler
authors.forename: F L M
authors.initials: FL
authors.lastname: Szekeres
authors.forename: C G
authors.initials: CG
authors.lastname: Östenson
authors.forename: P
authors.initials: P
authors.lastname: Wändell
authors.forename: J R
authors.initials: JR
authors.lastname: Zierath
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D018149:Glucose Intolerance / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D005951:Glucose Tolerance Test; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D050177:Overweight / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D010101:Oxygen Consumption / Q000502:physiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055105:Waist Circumference / Q000502:physiology; D016138:Walking / Q000502:physiology*