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Guidelines for Endothelial Testing

Considerations for Maximizing the Exercise “Drug” to Combat Insulin Resistance: Role of Nutrition, Sleep, and Alcohol

Considerations for Maximizing the Exercise “Drug” to Combat Insulin Resistance: Role of Nutrition, Sleep, and Alcohol
  • 1 Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ 08901, USA.
  • 2 Division of Cardiovascular Medicine, Rutgers University, New Brunswick, NJ 08901, USA.
  • 3 Center of Alcohol Studies, Rutgers University, Piscataway, NJ 08854, USA.
  • 4 Division of Endocrinology, Metabolism & Nutrition, Rutgers University, New Brunswick, NJ 08901, USA.
  • 5 New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, NJ 08901, USA.
  • 6 Institute of Translational Medicine and Science, Rutgers University, New Brunswick, NJ 08901, USA.
Abstract
Insulin resistance is a key etiological factor in promoting not only type 2 diabetes mellitus but also cardiovascular disease (CVD). Exercise is a first-line therapy for combating chronic disease by improving insulin action through, in part, reducing hepatic glucose production and lipolysis as well as increasing skeletal muscle glucose uptake and vasodilation. Just like a pharmaceutical agent, exercise can be viewed as a “drug” such that identifying an optimal prescription requires a determination of mode, intensity, and timing as well as consideration of how much exercise is done relative to sitting for prolonged periods (e.g., desk job at work). Furthermore, proximal nutrition (nutrient timing, carbohydrate intake, etc.), sleep (or lack thereof), as well as alcohol consumption are likely important considerations for enhancing adaptations to exercise. Thus, identifying the maximal exercise “drug” for reducing insulin resistance will require a multi-health behavior approach to optimize type 2 diabetes and CVD care.
Keywords: cardiovascular disease; circadian rhythm; diet; endothelial function; glycemic control; physical activity.
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