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Diets along with interval training regimes improves inflammatory & anti-inflammatory condition in obesity with type 2 diabetes subjects

  • Mahmoud Asle Mohammadi Zadeh
  • Mehdi KargarfardEmail author
  • Syed Mohamad Marandi
  • Abdolhamid Habibi
Research Article

Abstract

Background

Different physical activities and diets change the regulation of inflammations in both type 2 diabetes (T2D) patients and obese individuals, but the effect of both (Physical activity and diet) on pro/anti-inflammations has remained unknown. We investigated pro/anti-inflammations control, cardiovascular function, and total physiological parameters before and after 24 weeks of low volume high intensity interval training (HIIT) on a cycle ergometer along with four dietary regimes in obesity with T2D patients.

Methods

33 non-active obesity T2D patients (BMI ≥ 30) midges (47 yrs. ± 5) were volunteered to participate and randomly divided into three experimental(n = 11) [(1) LCD = low Carbohydrate Diet, (2) LFD = Low Fat Diet and (3) HFD = High Fat Diet)] and one control (n = 9) [ND = normal diet] groups. The whole groups performed underwent 8-week dietary regimes and then performed 3 days/weeks (3 set 10 × 60 s) HIIT on a cycle ergometer for 12 weeks, which followed by a 4-week diet period again. Also, prior to and after 8 weeks diet-12 weeks High Intensity Interval Training (HIIT) and 4 weeks diet 2-h oral glucose tolerance test (OGTT), resting blood pressure, incremental maximal oxygen uptake (VO2peak) cycle ergometer test and blood sample was collected from the subjects in order to measure pro/anti-inflammatory cytokines (IL-6, TNF-α, leptin, resistin, adiponectin, and FGF21).

Results

After 24 weeks of intervention, the results indicated that the highest improvement in the percentage of changes in glucose happened in LCD (−34.76), insulin in ND (+16.43), cholesterol in LCD (−33.35), LDL in LFD (−9.14), HDL in LCD (+41.81), TG in LCD (−40.71), weight in LCD (−12.49) and HOMA-IR in HFD (−6.82). The results also indicated that after 24 weeks of HIIT and diet interventions, highest benefit percentage change IL-6, resistin and leptin occurred in LCD (−32.10, −28.29 and − 53.92, respectively), TNF-α, FGF21 and adiponectin in LFD (−48.06, +55.30 and + 42.32, respectively). However, these changes were observed in other groups.

Conclusions

These results demonstrated that HIIT along with low carbohydrate regimes improves overall cardiovascular parameters and reduce pro-inflammatory markers and increase anti-inflammatory markers in type 2 diabetic patients. Additionally, as with HIIT along with low carbohydrate, HIIT coupled with low fat would improve inflammation markers, though these effects were less significant. These findings suggest that HIIT along with low carbohydrate is a beneficial exercise and dietary strategy in T2D patients.

Keywords

Pro/anti- inflammatory T2D patients Obesity Adipokines HIIT 

Abbreviations

HIIT

High Intensity Interval Training

LCD

Low Carbohydrate Diet

LFD

Low Fat Diet

HFD

High Fat Diet

FGF21

Fibroblast growth factor 21

T2D

type 2 diabetic

ND

Normal Diet

OGTT

oral glucose tolerance test

Notes

Acknowledgements

We highly appreciate Professors Mehdi kargarfard and Syed Mohamad Marandi for their great support with data collection. Further, we feel obliged to thank the patients who participated in this study.

Funding

This study was supported by the Faculty of Physical Education and Sports Sciences, Isfahan University, Iran.

Compliance with ethical standards

Conflict of interests

The authors declare that there is no conflict of interest associated with this manuscript.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of Ethics Committee in College of Medicine, Isfahan University, Iran as well as with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Approval of the study was issued by the Ethics Committee at College of Medicine, Isfahan University, Iran.

Informed consent

Informed consent was obtained from all individual participants taking part in the study.

References

  1. 1.
    Park Y-M, Zhang J, Steck SE, Fung TT, Hazlett LJ, Han K, et al. Obesity mediates the association between Mediterranean diet consumption and insulin resistance and inflammation in US adults. J Nutr. 2017;147(4):563–71.CrossRefGoogle Scholar
  2. 2.
    Kolb H, Martin S. Environmental/lifestyle factors in the pathogenesis and prevention of type 2 diabetes. BMC Med. 2017;15(1):131.CrossRefGoogle Scholar
  3. 3.
    McMacken M, Shah S. A plant-based diet for the prevention and treatment of type 2 diabetes. J Geriatr Cardiol. 2017;14(5):342–54.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Madsen SM. Investigations of the effects of high intensity interval training – studies in type 2 diabetes and subjects at high risk of metabolic syndrome PhD dissertation. Heal Aarhus Univ. 2015:1–194.Google Scholar
  5. 5.
    Perry BD, Caldow MK, Brennan-Speranza TC, Sbaraglia M, Jerums G, Garnham A, et al. Muscle atrophy in patients with type 2 diabetes mellitus: roles of inflammatory pathways, physical activity and exercise. Exerc Immunol Rev. 2016;22:94.PubMedPubMedCentralGoogle Scholar
  6. 6.
    Morettini M, Storm F, Sacchetti M, Cappozzo A, Mazzà C. Effects of walking on low-grade inflammation and their implications for type 2 diabetes. Prev Med Rep. 2015;2:538–47.CrossRefGoogle Scholar
  7. 7.
    Kim Y, Chen J, Wirth MD, Shivappa N, Hebert JR. Lower dietary inflammatory index scores are associated with lower glycemic index scores among college students. Nutrients. 2018;10(2):182.CrossRefGoogle Scholar
  8. 8.
    Farooq W, Farwa U, Khan FR. The metabolic syndrome and inflammation: role of insulin resistance and increased adiposity. Oman Med J. 2015;30(2):100–3.CrossRefGoogle Scholar
  9. 9.
    García-Hermoso A, Ceballos-Ceballos RJM, Poblete-Aro CE, Hackney AC, Mota J, Ramírez-Vélez R. Exercise, adipokines and pediatric obesity: a meta-analysis of randomized controlled trials. Int J Obes. 2017;41(4):475–82.CrossRefGoogle Scholar
  10. 10.
    Wolever TMS, Gibbs AL, Mehling C, Chiasson J, Philip W, Josse RG, et al. Combined interval training and post-exercise nutrition in type 2 diabetes: a randomized control trial. Prev Med Rep. 2017;2(1):1–11.Google Scholar
  11. 11.
    Rajkovic N, Zamaklar M, Lalic K, Jotic A, Lukic L, Milicic T, et al. Relationship between obesity, adipocytokines and inflammatory markers in type 2 diabetes: relevance for cardiovascular risk prevention. Int J Environ Res Public Health. 2014;11(4):4049–65.CrossRefGoogle Scholar
  12. 12.
    Francois ME, Durrer C, Pistawka KJ, Halperin FA, Chang C, Little JP. Combined interval training and post-exercise nutrition in type 2 diabetes: a randomized control trial. Front Physiol. 2017;8:528.CrossRefGoogle Scholar
  13. 13.
    Melo LC, Dativo-Medeiros J, Menezes-Silva CE, Barbosa FT, de Sousa-Rodrigues CF, Rabelo LA. Physical exercise on inflammatory markers in type 2 diabetes patients: a systematic review of randomized controlled trials. Oxidative Med Cell Longev. 2017;2017:1–10.CrossRefGoogle Scholar
  14. 14.
    Jung C-H, Choi KM. Impact of high-carbohydrate diet on metabolic parameters in patients with type 2 diabetes. Nutrients. 2017;9(4):1–21.CrossRefGoogle Scholar
  15. 15.
    Azadbakht L, Surkan PJ, Esmaillzadeh A, Willett WC. The dietary approaches to stop hypertension eating plan affects C-reactive protein, coagulation abnormalities, and hepatic function tests among type 2 diabetic patients--4. J Nutr. 2011;141(6):1083–8.CrossRefGoogle Scholar
  16. 16.
    Kozłowska L, Rydzewski A, Fiderkiewicz B, Wasińska-Krawczyk A, Grzechnik A, Rosołowska-Huszcz D. Adiponectin, Resistin and leptin response to dietary intervention in diabetic nephropathy. J Ren Nutr. 2010;20(4):255–62.CrossRefGoogle Scholar
  17. 17.
    Barnard ND, Cohen J, Jenkins DJA, Turner-McGrievy G, Gloede L, Green A, et al. A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. In: American Journal of Clinical Nutrition. Oxford University Press; 2009. p. 1588–96.Google Scholar
  18. 18.
    Khoo J, Piantadosi C, Duncan R, Worthley SG, Jenkins A, Noakes M, et al. Comparing effects of a low & energy diet and a high & protein low & fat diet on sexual and endothelial function, urinary tract symptoms, and inflammation in obese diabetic men. J Sex Med. 2011;8(10):2868–75.CrossRefGoogle Scholar
  19. 19.
    Brinkworth GD, Noakes M, Parker B, Foster P, Clifton PM. Long-term effects of advice to consume a high-protein, low-fat diet, rather than a conventional weight-loss diet, in obese adults with type 2 diabetes: one-year follow-up of a randomised trial. Diabetologia. 2004;47(10):1677–86.CrossRefGoogle Scholar
  20. 20.
    Nowlin SY, Hammer MJ, D’Eramo Melkus G. Diet, inflammation, and glycemic control in type 2 diabetes: an integrative review of the literature. J Nutr Metab. 2012;2012:1–21.CrossRefGoogle Scholar
  21. 21.
    Jonasson L, Guldbrand H, Lundberg AK, Nystrom FH. Advice to follow a low-carbohydrate diet has a favourable impact on low-grade inflammation in type 2 diabetes compared with advice to follow a low-fat diet. Ann Med. 2014;46(3):182–7.CrossRefGoogle Scholar
  22. 22.
    Juraschek SP, Miller ER, Selvin E, Carey VJ, Appel LJ, Christenson RH, et al. Effect of type and amount of dietary carbohydrate on biomarkers of glucose homeostasis and C reactive protein in overweight or obese adults: results from the OmniCarb trial. BMJ Open Diabetes Res Care. 2016;4(1):1–9.CrossRefGoogle Scholar
  23. 23.
    Clark JE. Diet, exercise or diet with exercise: comparing the effectiveness of treatment options for weight-loss and changes in fitness for adults (18-65 years old) who are overfat, or obese; systematic review and meta-analysis. J Diabetes Metab Disord. 2015;14(1):31.CrossRefGoogle Scholar
  24. 24.
    Madsen SM, Thorup AC, Overgaard K, Jeppesen PB. High intensity interval training improves glycaemic control and pancreatic β cell function of type 2 diabetes patients. PLoS One. 2015;10(8):1–24.Google Scholar
  25. 25.
    Káfuňková P, Kvapil M. Interval training and compensation of type 2 diabetes. Open J Clin Diagnostics. 2017;7(01):20–30.CrossRefGoogle Scholar
  26. 26.
    Gibala MJ, Little JP, Macdonald MJ, Hawley JA. Physiological adaptations to low-volume, high-intensity interval training in health and disease. J Physiol. 2012;590(5):1077–84.CrossRefGoogle Scholar
  27. 27.
    Elsisi H, Aneis Y, Mounir K. Impact of high-intensity interval training on HbA1c in patients with type 2 diabetes mellitus. Bull Fac Phys Ther. 2015;20(2):168.CrossRefGoogle Scholar
  28. 28.
    Marquis-Gravel G, Hayami D, Juneau M, Nigam A, Guilbeault V, Latour É, et al. Intensive lifestyle intervention including high-intensity interval training program improves insulin resistance and fasting plasma glucose in obese patients. Prev Med Rep. 2015;2:314–8.CrossRefGoogle Scholar
  29. 29.
    Rohlfing CL, Wiedmeyer HM, Little RR, England JD, Tennill AGD. Defining the relationship between plasma glucose and HbA(1c): analysis of glucose profiles and HbA(1c) in the diabetes control and complications trial. Diabetes Care. 2002;25(2):275–8.CrossRefGoogle Scholar
  30. 30.
    Matthews DR, Hosker JP, Rudenski a S, Naylor B a, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412–9.CrossRefGoogle Scholar
  31. 31.
    Ma Y, Olendzki BC, Hafner AR, Chiriboga DE, Culver AL, Andersen VA, et al. Low-carbohydrate and high-fat intake among adult patients with poorly controlled type 2 diabetes mellitus. Nutrition. 2006;22(11–12):1129–36.CrossRefGoogle Scholar
  32. 32.
    Terada T. Effects of high intensity interval exercise versus moderate intensity continuous exercise on blood glucose profiles of individuals with type 2 diabetes. Univ Alberta. 2014:1–204.Google Scholar
  33. 33.
    Teixeira-Lemos E, Nunes S, Teixeira F, Reis F. Regular physical exercise training assists in preventing type 2 diabetes development: focus on its antioxidant and anti-inflammatory properties. Cardiovasc Diabetol. 2011;10(1):12.CrossRefGoogle Scholar
  34. 34.
    de Oliveira VN, Bessa A, Jorge MLMP, Oliveira RJ da S, de Mello MT, De Agostini GG, et al. The effect of different training programs on antioxidant status, oxidative stress, and metabolic control in type 2 diabetes. Appl Physiol Nutr Metab. 2012;37(2):334–44.CrossRefGoogle Scholar
  35. 35.
    Álvarez C, Ramírez-Campillo R, Ramírez-Vélez R, Izquierdo M. Effects and prevalence of nonresponders after 12 weeks of high-intensity interval or resistance training in women with insulin resistance: a randomized trial. J Appl Physiol. 2017;122(4):985–96.CrossRefGoogle Scholar
  36. 36.
    Kadoglou NP, Perrea D, Iliadis F, Angelopoulou N, Liapis C, Alevizos M. Exercise reduces resistin and inflammatory cytokines in patients with type 2 diabetes. Diabetes Care. 2007;30(3):719–21.CrossRefGoogle Scholar
  37. 37.
    Desch S, Sonnabend M, Niebauer J, Sixt S, Sareban M, Eitel I, et al. Effects of physical exercise versus rosiglitazone on endothelial function in coronary artery disease patients with prediabetes. Diabetes Obes Metab. 2010;12(9):825–8.CrossRefGoogle Scholar
  38. 38.
    Aguiar EJ, Morgan PJ, Collins CE, Plotnikoff RC, Callister R, Collins APJ, et al. Efficacy of interventions that include diet, aerobic and resistance training components for type 2 diabetes prevention: a systematic review with meta-analysis. Int J Behav Nutr Phys Act. 2014;11(2):1–10.Google Scholar
  39. 39.
    Loimaala A, Huikuri HV, Kööbi T, Rinne M, Nenonen A, Vuori I. Exercise training improves baroreflex sensitivity in type 2 diabetes. Diabetes. 2003;52(7):1837–42.CrossRefGoogle Scholar
  40. 40.
    Araiza P, Hewes H, Gashetewa C, Vella CA, Burge MR. Efficacy of a pedometer-based physical activity program on parameters of diabetes control in type 2 diabetes mellitus. Metab Exp. 2006;55(10):1382–7.CrossRefGoogle Scholar
  41. 41.
    Cauza E, Hanusch-Enserer U, Strasser B, Kostner K, Dunky A, Haber P. The metabolic effects of long term exercise in type 2 diabetes patients. Wien Med Wochenschr. 2006;156(17–18):515–9.CrossRefGoogle Scholar
  42. 42.
    Gram B, Christensen R, Christiansen C, Gram J. Effects of nordic walking and exercise in type 2 diabetes mellitus: a randomized controlled trial. Clin J Sport Med. 2010;20(5):355–61.PubMedGoogle Scholar
  43. 43.
    Gordon LA, Morrison EY, McGrowder DA, Young R, Fraser YTP, Zamora EM, et al. Effect of exercise therapy on lipid profile and oxidative stress indicators in patients with type 2 diabetes. BMC Complement Altern Med. 2008;8(1):21.CrossRefGoogle Scholar
  44. 44.
    Fritz T, Caidahl K, Krook A, Lundström P, Mashili F, Osler M, et al. Effects of Nordic walking on cardiovascular risk factors in overweight individuals with type 2 diabetes, impaired or normal glucose tolerance. Diabetes Metab Res Rev. 2013;29(1):25–32.CrossRefGoogle Scholar
  45. 45.
    Lambers S, Van Laethem C, Van Acker K, Calders P. Influence of combined exercise training on indices of obesity, diabetes and cardiovascular risk in type 2 diabetes patients. Clin Rehabil. 2008;22(6):483–92.CrossRefGoogle Scholar
  46. 46.
    Hordern MD, Cooney LM, Beller EM, Prins JB, Marwick TH, Coombes JS. Determinants of changes in blood glucose response to short-term exercise training in patients with type 2 diabetes. Clin Sci. 2008;115(9):273–81.CrossRefGoogle Scholar
  47. 47.
    Sigal RJ, Kenny GP, Boulé NG, Wells GA, Prud’homme D, Fortier M, et al. Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial. Ann Intern Med. 2007;147(6):357–69.CrossRefGoogle Scholar
  48. 48.
    Kuehnbaum NL, Gillen JB, Gibala MJ, Britz-McKibbin P (2014) Personalized metabolomics for predicting glucose tolerance changes in sedentary women after high-intensity interval training. Sci Rep 28;4(1):6166.Google Scholar
  49. 49.
    Dobrosielski DA, Gibbs BB, Ouyang P, Bonekamp S, Clark JM, Wang N-Y, et al. Effect of exercise on blood pressure in type 2 diabetes: a randomized controlled trial. J Gen Intern Med. 2012;27(11):1453–9.CrossRefGoogle Scholar
  50. 50.
    Feinman RD, Pogozelski WK, Astrup A, Bernstein RK, Fine EJ, Westman EC, et al. Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition. 2015;31(1):1–13.CrossRefGoogle Scholar
  51. 51.
    Juanola-Falgarona MM, Salas-Salvadó J, Ibarrola-Jurado N, Rabassa-Soler A, Diaz-López A, Guasch-Ferré M, et al. Effect of the glycemic index of the diet on weight loss, modulation of satiety, inflammation, and other metabolic risk factors: a randomized controlled trial. Am J Clin Nutr. 2014;100(1):27–35.CrossRefGoogle Scholar
  52. 52.
    Giannopoulou I, Fernhall B, Carhart R, Weinstock RS, Baynard T, Figueroa A, et al. Effects of diet and/or exercise on the adipocytokine and inflammatory cytokine levels of postmenopausal women with type 2 diabetes. Metab Exp. 2005;54(7):866–75.CrossRefGoogle Scholar
  53. 53.
    Sukala WR, Page R, Rowlands DS, Krebs J, Lys I, Leikis M, et al. South Pacific islanders resist type 2 diabetes: comparison of aerobic and resistance training. Eur J Appl Physiol. 2012;112(1):317–25.CrossRefGoogle Scholar
  54. 54.
    Moghadasi M, Mohebbi H, Rahmani-Nia F, Hassan-Nia S, Noroozi H. Effects of short-term lifestyle activity modification on adiponectin mRNA expression and plasma concentrations. Eur J Sport Sci. 2013;13(4):378–85.CrossRefGoogle Scholar
  55. 55.
    Swift DL, Johannsen NM, Earnest CP, Blair SN, Church TS. The effect of exercise training modality on C-reactive protein in Type-2 diabetes. Med Sci Sports Exerc. 2012;44(6):1028–34.CrossRefGoogle Scholar
  56. 56.
    Hopps E, Canino B, Caimi G. Effects of exercise on inflammation markers in type 2 diabetic subjects. Acta Diabetol. 2011;48(3):183–9.CrossRefGoogle Scholar
  57. 57.
    Van Tong H, Luu NK, Son HA, Van Hoan N, Hung TT, Velavan TP, et al. Adiponectin and pro-inflammatory cytokines are modulated in Vietnamese patients with type 2 diabetes mellitus. J Diabetes Investig. 2017;8(3):295–305.CrossRefGoogle Scholar
  58. 58.
    Wolever TMS, Gibbs AL, Mehling C, Chiasson J-L, Connelly PW, Josse RG, et al. The Canadian trial of carbohydrates in diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein. Am J Clin Nutr. 2008;87(1):114–25.CrossRefGoogle Scholar
  59. 59.
    Qatanani M, Lazar MA. Mechanisms of obesity-associated insulin resistance: many choices on the menu. Genes Dev. 2007;21(12):1443–55.CrossRefGoogle Scholar
  60. 60.
    Marfella R, Cacciapuoti F, Siniscalchi M, Sasso FC, Marchese F, Cinone F, et al. Effect of moderate red wine intake on cardiac prognosis after recent acute myocardial infarction of subjects with type 2 diabetes mellitus. Diabet Med. 2006;23(9):974–81.CrossRefGoogle Scholar
  61. 61.
    Oberbach A, Lehmann S, Kirsch K, Krist J, Sonnabend M, Linke A et al (2008) Long-term exercise training decreases interleukin-6 (IL-6) serum levels in subjects with impaired glucose tolerance: effect of the- 174G/C variant in IL-6 gene. Eur J Endocrinol 159(2):129–136.CrossRefGoogle Scholar
  62. 62.
    Jorge MLMP, de Oliveira VN, Resende NM, Paraiso LF, Calixto A, Diniz ALD, et al. The effects of aerobic, resistance, and combined exercise on metabolic control, inflammatory markers, adipocytokines, and muscle insulin signaling in patients with type 2 diabetes mellitus. Metab Exp. 2011;60(9):1244–52.CrossRefGoogle Scholar
  63. 63.
    Nadeem A, Naveed AK, Hussain MM, Raza SI, Sciences M. Correlation of inflammatory markers with type 2 diabetes mellitus in Pakistani patients. J Postgrad Med Inst. 2013;27(3):267–73.Google Scholar
  64. 64.
    Jelleyman C, Yates T, O’Donovan G, Gray LJ, King JA, Khunti K, et al. The effects of high-intensity interval training on glucose regulation and insulin resistance: a meta-analysis. Obes Rev. 2015;16(11):942–61.CrossRefGoogle Scholar
  65. 65.
    Tofighi A, Alizadeh R, Azar JT (2017) The effect of eight weeks high intensity interval training (Hiit) on serum. amounts of Fgf21 and Irisin In 28:453–466.Google Scholar
  66. 66.
    Mohammadi M, Gozashti MH, Aghadavood M, Mehdizadeh MR, Hayatbakhsh MM. Clinical significance of serum IL- 6 and TNF - α levels in patients with metabolic syndrome. Reports Biochem. Mol Biol. 2017;6(1):74–9.Google Scholar
  67. 67.
    Jamali E, Asad MR, Rasoli A. The effect of high-intensity interval training (HIIT) on resistin gene expression in visceral adipose tissue in obese male rats. Int J Appl Exerc Physiol. 2016;5(1):17–25.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Mahmoud Asle Mohammadi Zadeh
    • 1
  • Mehdi Kargarfard
    • 1
    Email author
  • Syed Mohamad Marandi
    • 1
  • Abdolhamid Habibi
    • 2
  1. 1.Department of Exercise Physiology, Faculty of Sport SciencesUniversity of IsfahanIsfahanIran
  2. 2.Department of Physical Education and Sport SciencesShahid Chamran UniversityAhwazIran

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