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Achieving the three therapeutics targets known as ABC (A1c ≤ 7.0%, LDL-C

Type 2 diabetes is associated with a higher risk of cardiovascular diseases, lowering the quality of life and increasing mortality rates of affected individuals. Circulating monocytes are tightly involved in the atherosclerosis process leading to cardiovascular diseases (CVD), and their inflammatory profile can be modified by exercise. The objective was to exploratory identify genes associated with CVD that could be regulated by high-intensity interval training (HIIT) in monocytes of type 2 diabetes patients.Next-generation RNA sequencing (RNA-seq) analyses were conducted on isolated circulating monocytes (CD14Following the intervention, a reduction of resting diastolic blood pressure was observed. Concomitant with this result, 56 genes were found to be downregulated following HIIT intervention in isolated monocytes. A large proportion of the regulated genes was involved in cellular adhesion, migration and differentiation into an "atherosclerosis-specific" macrophage phenotype.The downregulation of transcripts in monocytes globally suggests a favorable cardiovascular effect of the HIIT in older women with type 2 diabetes. In the context of precision medicine and personalized exercise prescription, shedding light on the fundamental mechanisms underlying HIIT effects on the gene profile of immune cells is essential to develop efficient nonpharmacological strategies to prevent CVD in high-risk population.

Background It is well established that body composition influences metabolic health, but emerging data are conflicting with the largely purported idea that a large fat‐free mass (FFM) has a protective effect on health. A potential explanation for these discrepancies is the way FFM is represented. The first objective is to determine the association between the metabolic syndrome (MetS) and FFM when the latter was represented in three different ways: 1—absolute FFM; 2—relative to squared height (FFMi); and 3—relative to body weight (FFM%). The second objective is to assess the impact of FFM on the relative risk of having the MetS after taking fat mass, physical activity, and sociodemographic variables into account. Methods A total of 5274 individuals from the National Health and Nutrition Examination Survey database were studied. Age‐specific and sex‐specific quartiles of the three representations of FFM were defined, and the prevalence of MetS was determined in each of them. Quartiles of FFMi (kg/m2) were used to calculate the odds ratios of having the MetS independently of FM, physical activity levels, and sociodemographic variables. Results The prevalence of MetS decreased with increasing quartiles of whole‐body FFM% (Q1: 40%; Q4: 10%) but grew with increasing quartiles of absolute FFM (Q1: 13%; Q4: 40%) and FFMi (Q1: 10%; Q4: 44%). Similar results were observed for appendicular and truncal FFM. The odds ratios of having the MetS, independently of fat mass, physical activity, and sociodemographic variables, were significantly greater in the fourth quartile of FFMi when compared with the first quartiles of each specific subgroup [Q4 vs. Q1: younger men: 4.16 (1.99–8.68); younger women: 5.74 (2.46–13.39); older men: 1.98 (1.22–3.22); older women: 2.88 (1.69–4.90); all P ≤ 0.01]. Conclusions These results support the notion that the representation of FFM significantly influences its association with MetS and that a larger FFM, whether absolute or relative to height, is associated with alterations in cardiometabolic health.

Background: Various pharmacological treatments have been used to relieve pain and reduce the duration and occurrence of cluster headache (CH) attacks, but these treatments remain partially effective for many patients. Aerobic exercises have been proposed to decrease the prevalence and severity of symptoms associated with other types of headaches, but the effectiveness of aerobic exercise for CH management has not yet been investigated. Case presentation: This report describes the case of a 24 yearold male patient diagnosed with episodic CH (1/day; > 1 h). Thirteen days after the first episode, moderate-intensity continuous aerobic exercise was performed (10–30 min) at the onset of CH attack. Aerobic exercise reduced both severity and duration of CH attacks. Conclusions: This case report suggests that performing moderate-intensity aerobic exercise at the onset of a CH attack may be an interesting non-pharmacologic intervention that can be used to ease pain symptoms.

Despite extensive research on the effect of supervised exercise therapy (SET) on walking performance in patients with symptomatic peripheral arterial disease (PAD), it remains unclear which training modality provides the greatest improvement in walking capacity. Thus, a random-effect network meta-analysis was performed to compare the effect of different types of SET on walking capacity in individuals with symptomatic PAD. The following databases were searched from January 1966 to April 2021: SPORTDiscus, CINAHL, MEDLINE, AMED, Academic Search Complete, and Scopus. Trials must include at least one type of supervised exercise therapy for patients with symptomatic PAD, with a minimum of 5 exercise sessions, and an objective measure of walking capacity. Eighteen studies were included for a total sample of 1135 participants. Intervention duration ranged from 6 to 24 weeks and included aerobic exercise (treadmill walking, cycling, Nordic walking), resistance training (lower and/or upper body), a combination of both, and underwater exercises. Results showed that combined training improved walking capacity to a comparable extent to aerobic walking (+122.0 [24.2-219.8] m vs. +106.8 [34.2-179.4] m), but with a larger effect size (1.20 [0.50-1.90] vs 0.67 [0.22-1.11]). Similar results were observed for the distance performed during the 6-minute walking test, with combined training being the most promising modality (+57.3 [16.2; 98.5] m), followed by underwater training (+56.5 [22.4-90.5] m) and aerobic walking (+39.0 [12.8-65.1] m). While combined exercise seems to be the most promising training modality, aerobic walking, and underwater training also improved walking capacity for patients with symptomatic PAD.

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 ps ≥ .38). Conclusion: A short-term HIIT program is feasible and provides as much benefits as MICT in older women.

To document changes in prevalence of the metabolic syndrome (MetS) in the United States adult population between 1999 and 2014 and to explore how variations in the dietary intakes explain changes in MetS prevalence and its components over time. A total of 38 541 individuals (aged 20–85 years; National Health and Nutrition Examination Survey 1999–2014) were studied. Outcome variables were MetS, waist circumference (WC), plasma high-density lipoprotein cholesterol (HDL-c), triglycerides, fasting glucose (FG) levels, resting systolic and diastolic blood pressure, dietary intakes (total daily energy, carbohydrates, proteins, fats, sodium, and alcohol intakes), the poverty income ratio (PIR) and sociodemographic data (age, sex, ethnicity). Overall, the prevalence of the MetS significantly increased between 1999 and 2014 (27.9% to 31.5%). High plasma FG levels and high WC increased between 1999 and 2014, while the prevalence of the other components of MetS decreased or remained stable. Interestingly, a significant peak in MetS prevalence was observed in 2007–2008 compared with 1999–2006 (34.4% vs 27.6%), accompanied by a concomitant increase in WC and plasma FG levels, as well as a decrease in plasma HDL-c. Finally, significant decreases were observed for the PIR, total daily energy intake, sodium, and all macronutrient intakes in 2007–2008 compared with 1999–2006 (all P < 0.01). Results showed that the MetS prevalence significantly increased between 1999 and 2014 in the United States adult population, with a peak in 2007–2008. Interestingly, the 2007–2008 peak in MetS prevalence was accompanied by decreases in the PIR, total daily energy, and macronutrients intakes, suggesting potential impact of the 2007–2008 recession.

Aim To examine the effect of walking before dinner on 24-h glycemic control in individuals with type 2 diabetes using the standardized multi-site Exercise-Physical Activity and Diabetes Glucose Monitoring (E-PAraDiGM) Protocol. Methods Eighty participants were studied under two conditions (exercise vs. non-exercise control) separated by 72 h in a randomized crossover design. Each condition lasted 2 days during which standardized meals were provided. Exercise consisted of 50 min of treadmill walking at 5.0 km/h before the evening meal, while control involved 50 min of sitting. The primary outcome measure was mean glucose during the 24-h period following exercise (or sitting) measured by continuous glucose monitoring. Results Of the 80 participants who were initially randomized, 73 completed both exercise and control. Sixty-three participants [29 males, 34 females; age = 64 ± 8 years, body mass index = 30.5 ± 6.5 kg/m2 and HbA1c = 51 ± 8 mmol/mol (6.8 ± 0.7%), mean ± SD] complied with the standardized diets and had complete continuous glucose monitoring data. Exercise did not affect mean 24-h glucose compared to control (0.03 mmol/L; 95% CI − 0.17, 0.22, P = 0.778) but individual differences between conditions ranged from − 2.8 to +1.8 mmol/L. Exercise did not affect fasting glucose, postprandial glucose or glucose variability. Glucose concentrations measured by continuous glucose monitoring were reduced during the 50 min of walking in exercise compared to sitting in control (− 1.56 mmol/L; 95% CI − 2.18, − 0.95, p ˂ 0.001). Conclusion Contrary to previous acute exercise studies, 50 min of walking before dinner in the E-PAraDiGM protocol did not affect 24-h glucose profiles. However, highly heterogeneous responses to exercise were observed.

Objective: To compare the acute and chronic effects of low-volume high-intensity interval training (HIIT) to moderate-intensity continuous training (MICT) on glycemic control, body composition and continuous glucose monitoring (CGM) in older women with type 2 diabetes (T2D). Methods: Thirty older women (68 ± 5 years) with T2D were randomized in two groups—HIIT (75 min/week) or MICT (150 min/week). Glucose homeostasis (A1c, glucose, insulin, HOMA-IR2) and body composition (iDXA) were measured before and after the 12-week exercise intervention. During the first and last week of training (24-h before and 48-h after exercise), the following CGM-derived data were measured: 24-h and peak glucose levels, glucose variability and time spent in hypoglycemia as well as severe and mild hyperglycemia. Results: While lean body mass increased (p = 0.035), total and trunk fat mass decreased (p ≤ 0.007), without any difference between groups (p ≥ 0.81). Fasting glucose levels (p = 0.001) and A1c (p = 0.014) significantly improved in MICT only, with a significant difference between groups for fasting glucose (p = 0.02). Neither HIIT nor MICT impacted CGM-derived data at week 1 (p ≥ 0.25). However, 24-h and peak glucose levels, as well as time spent in mild hyperglycemia, decreased in HIIT at week 12 (p ≤ 0.03). Conclusion: These results suggest that 12 weeks of low-volume HIIT is enough to provide similar benefit to MICT for body composition and improve the acute effect of exercise when measured with CGM.

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.

Objectives First, to establish the respective ability of body mass index (BMI), waist circumference (WC), and relative fat mass index (RFM), to estimate body fat (BF%) measured by DXA (DXA-BF%) and correctly identify postmenopausal women living with obesity (BF% > 35). Second, to identify the best indicator of successful weight-loss intervention in postmenopausal women living with obesity. Methods A total of 277 women (age: 59.8 ± 5.3 y; BF%: 43.4 ± 5.3) from five weight-loss studies with complete data for anthropometric measurements [BMI = weight/height (kg/m2); WC (cm)] and BF% were pooled together. Statistical performance indicators were determined to assess ability of RFM [64-(20 × height/waist circumference) + (12 × sex)], BMI and WC to estimate BF% before and after weight-loss intervention and to correctly identify postmenopausal women living with obesity. Results Compared with RFM (r = 0.51; r2 = 0.27; RMSE = 4.4%; Lin's CCC = 0.46) and WC (r = 0.49; r2 = 0.25; RMSE = 4.8%; Lin's CCC = 0.41), BMI (r = 0.73; r2 = 0.52; RMSE = 3.7%; Lin's CCC = 0.71) was the best anthropometric index to estimate DXA-BF% and correctly identify postmenopausal women living with obesity (sensitivity + specificity: BMI = 193; RFM = 152; WC = 158), with lower misclassification error, before weight-loss intervention. After weight-loss, the change in BMI was strongly correlated with change in DXA-BF%, indicating that the BMI is the best indicator of success weight-loss intervention. Conclusion In the absence of more objective measures of adiposity, BMI is a suitable proxy measure for BF% in postmenopausal women, for whom a lifestyle intervention is relevant. Furthermore, BMI can be used as an indicator to assess success of weight-loss intervention in this subpopulation.

In this paper, I examine Strauss’s critique of Collingwood’s interpretive approach and argue that Strauss’s accusation of historicism partly misses its target. While Collingwood can be said to be a “historicist” thinker insofar as he pursues the project of the German historicist tradition and attempts to establish the autonomy and specificity of philosophy of history as a discipline, he does not endorse the premises of radical historicism according to which all thought is historically relative. Although many of Strauss’s arguments against interpretive historicism are valid, they do not apply to Collingwood’s enterprise. In creating a dialogue between the two thinkers, I demonstrate that their respective theories of interpretation are as a matter of fact closer than they appear at first sight. Both philosophers defend the possibility of understanding past authors as they understood themselves, they maintain the importance of the quest for philosophical truth in interpreting the past texts and make the case for the necessity of history for philosophy.