Gymnastik- och idrottshögskolan, GIH

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Reduced glucose tolerance and insulin sensitivity after prolonged exercise in endurance athletes.
Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.ORCID iD: 0000-0002-7743-9295
Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.ORCID iD: 0000-0001-8095-0628
Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.ORCID iD: 0000-0001-8314-7814
Swedish School of Sport and Health Sciences, GIH, Department of Physiology, Nutrition and Biomechanics.ORCID iD: 0000-0002-4853-6627
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2023 (English)In: Acta Physiologica, ISSN 1748-1708, E-ISSN 1748-1716, Vol. 238, no 4, article id e13972Article in journal (Refereed) Published
Abstract [en]

AIM: The purpose of this study was to 1. investigate if glucose tolerance is affected after one acute bout of different types of exercise; 2. assess if potential differences between two exercise paradigms are related to changes in mitochondrial function; and 3. determine if endurance athletes differ from nonendurance-trained controls in their metabolic responses to the exercise paradigms.

METHODS: Nine endurance athletes (END) and eight healthy nonendurance-trained controls (CON) were studied. Oral glucose tolerance tests (OGTT) and mitochondrial function were assessed on three occasions: in the morning, 14 h after an overnight fast without prior exercise (RE), as well as after 3 h of prolonged continuous exercise at 65% of VO2 max (PE) or 5 × 4 min at ~95% of VO2 max (HIIT) on a cycle ergometer.

RESULTS: Glucose tolerance was markedly reduced in END after PE compared with RE. END also exhibited elevated fasting serum FFA and ketones levels, reduced insulin sensitivity and glucose oxidation, and increased fat oxidation during the OGTT. CON showed insignificant changes in glucose tolerance and the aforementioned measurements compared with RE. HIIT did not alter glucose tolerance in either group. Neither PE nor HIIT affected mitochondrial function in either group. END also exhibited increased activity of 3-hydroxyacyl-CoA dehydrogenase activity in muscle extracts vs. CON.

CONCLUSION: Prolonged exercise reduces glucose tolerance and increases insulin resistance in endurance athletes the following day. These findings are associated with an increased lipid load, a high capacity to oxidize lipids, and increased fat oxidation.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023. Vol. 238, no 4, article id e13972
Keywords [en]
endurance athletes, endurance exercise, glucose tolerance, insulin sensitivity, mitochondria, reactive oxygen species
National Category
Sport and Fitness Sciences Endocrinology and Diabetes
Research subject
Medicine/Technology
Identifiers
URN: urn:nbn:se:gih:diva-7627DOI: 10.1111/apha.13972ISI: 000972308100001PubMedID: 37017615OAI: oai:DiVA.org:gih-7627DiVA, id: diva2:1755613
Funder
Swedish National Centre for Research in Sports, P2017-0067, P2018-0083, P2019-0062, P2020-0061
Note

At the time of Mikael Flockhart's dissertation, this article was a submitted manuscript.

Available from: 2023-05-08 Created: 2023-05-08 Last updated: 2025-02-11
In thesis
1. Exercising on the edge: mitochondrial and metabolic responses to intense training
Open this publication in new window or tab >>Exercising on the edge: mitochondrial and metabolic responses to intense training
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Exercise and exercise training induces several physiological adaptations that increase the oxidative capacity of the muscles and improve glucose regulation. While the positive metabolic adaptations and effects on glucose regulation after exercise and exercise training have been extensively studied, negative outcomes have not. This thesis aims to address these questions and investigate possible negative effects of intensified training on mitochondrial parameters and glucose regulation.

In two separate interventions, we studied these outcomes after progressive exercise training, and after different intensities of exercise. Mitochondrial respiration was assessed in muscle biopsies taken from m. vastus lateralis 14 hours after exercise and oral glucose tolerance tests were performed at the same time point.

In paper I, we demonstrate that there is an upper limit of training load that can be tolerated without the manifestation of negative outcomes. After administrating almost daily sessions of high-intensity interval training, mitochondrial function and glucose control were impaired. In paper II, we used mitochondrial function as a novel biomarker of maladaptive training loads and constructed a diagnostic model that can be used for the early detection of maladaptations to exercise training. In paper III, we further demonstrated that endurance-trained athletes can have decreased glucose tolerance and increased insulin resistance the day after three hours of continuous cycling whereas these responses were not accentuated in healthy controls. Our results indicate that a metabolic switch in favor of lipid metabolism is the probable cause of this phenomenon. In paper IV, we briefly commented on a publication that described changes in whole-body VO2 responses to work rates in the athlete with the highest recorded VO2max. We provided arguments that the observed changes in VO2 and gross efficiency can in part have their origin in the mitochondria.

We here combine measurements in muscle tissue with physiological measurements in an applied context. Using this integrated approach, we investigated the effects of intensified training on health-related and performance outcomes, thereby presenting insights into what maladaptations to exercise can constitute. We hope that our results and conclusions can help to further understand the complex relationship between exercise and health and to guide athletes and coaches to optimize training outcomes.

Place, publisher, year, edition, pages
Stockholm: Gymnastik och idrottshögskolan, GIH, 2022. p. 67
Series
Avhandlingsserie för Gymnastik- och idrottshögskolan ; 25
Keywords
Exercise, training, mitochondria, performance, glucose tolerance, proteins, oxygen uptake, metabolism, cycling
National Category
Sport and Fitness Sciences Endocrinology and Diabetes Physiology and Anatomy
Research subject
Medicine/Technology
Identifiers
urn:nbn:se:gih:diva-7114 (URN)978-91-986490-7-9 (ISBN)
Public defence
2022-09-22, Aulan, Lidingövägen 1, Stockholm, 09:00 (English)
Opponent
Supervisors
Funder
Swedish National Centre for Research in Sports
Available from: 2022-08-24 Created: 2022-08-23 Last updated: 2025-02-11Bibliographically approved

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Flockhart, MikaelTischer, DominikNilsson, Lina C.Blackwood, Sarah JEkblom, BjörnKatz, AbramApro, WilliamLarsen, Filip J

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Flockhart, MikaelTischer, DominikNilsson, Lina C.Blackwood, Sarah JEkblom, BjörnKatz, AbramApro, WilliamLarsen, Filip J
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