ONLINE DRIVERS MEDIA

Resistance training alone wont make up for a sloppy diet - no matter if you do it before or after meals.

I am not sure how feasible this is going to be for you, but if you are a type II diabetic or anyone concerned about the potential detrimental health effects of the rise in glucose and triglycerides after a meal, working out 45 minutes after dinner is the way to go.

Abnormally elevated postprandial glucose and triacylglycerol (TAG) concentrations are strong risk factors for cardiovascular disease (CVD) in patients with type-2 diabetes. Therefore, scientists expect that interventions that reduce postprandial glucose and TAG concentrations should lower the risk of CVD (Krook. 2003; OGorman. 2008).
Previous studies have shown that acute exercise typically lowers postprandial glucose and TAG concentrations (Tobin. 2008) in patients with type-2 diabetes, but as Timothy D. Heden et al. point out, there is considerable heterogeneity in the responses with some individuals not experiencing beneficial changes in these risk factors (Gill. 2007; van Dijk. 2012).

"One potential explanation why some patients with type-2 diabetes do not have beneficial changes in postprandial glucose and TAG with acute exercise is because of the timing of the acute exercise session relative to meal consumption. Limited evidence suggests that the timing of aerobic exercise around a meal may be important and might explain why some individuals are exercise “insensitive” or “non responders”." (Heden. 2014) 

The only study to directly compare the effect of pre-meal and post-meal aerobic exercise on postprandial glucose concentrations in patients with type-2 diabetes showed that post-dinner, but not pre-dinner walking, lowered postprandial glucose concentrations (Colberg. 2009).

Figure 1: Previous studies indicate that aerobic workouts after meals have more beneficial effects on the potentially unhealthy increases in glucose or triglycerides (Collberg. 2009)

Although no study has directly examined the effect of exercise timing on postprandial TAG in patients with type-2 diabetes, there is evidence that exercise performed the day prior to a high fat meal has no effect on postprandial TAG responses (Dalgaard. 2004; Gill. 2007), while post-breakfast aerobic exercise reduced the postprandial TAG response (Tobin. 2008). Taken together, it appears that aerobic exercise may have its most powerful effect to lower postprandial glucose and TAG responses when performed after a meal, possibly because of slowed gastric emptying and/or greater skeletal muscle glucose and TAG uptake and utilization at this time.

The question that remained was: Is the same true for resistance training?

Since resistance exercise (RE) has a more pronounced long(er)-lasting effect on ones metabolism than aerobic training, the researchers from the University of Missouri tested the hypothesis that post-dinner RE, compared to pre-dinner RE, would in fact be more effective at improving two clinically important postprandial risk factors (glucose and 109 TAG) for CVD at a time of day when they are typically highest in obese patients with type-2 diabetes.

The standardized test workout consisted of the following exercises (in this order): leg press, seated calf raises, seated chest flyes, seated back flyes, back extensions, shoulder raises, leg curls, and abdominal crunches. All exercises were performed for three sets (1-2 min rest between sets) of 10-repetitions for each RE. During this session, the first set for each exercise was a warm-up set and the weight used was 50% of the participants 10-RM. After the warm-up set, the weight for the next two sets was the participants previously determined 10-RM.

Figure 2: Postrandial lipid response in the obese type II diabetics (Heden. 2014)

As you can see in Figure 2 the scientists suspicion was right, the postprandial workout (M-RE) had significantly more pronounced beneficial effects on the lipid metabolism of the type II diabetic subjects who consumed a standardized breakfasts (English muffin, cheddar cheese, one large egg, ham, hash brown, ketchup, and apple or orange juice) lunch (white bread, ham, mayonnaise, cheddar cheese, a granola bar, and apple or orange juice) and dinner meals (spaghetti noodles, spaghetti sauce with beef added, garlic bread, a lemon lime flavored soda, and 1.5 g of acetaminophen (to assess gastric emptying)) containing ~50% carbohydrate, 35% fat, and 15% protein.

Similar effects were observed for the insulin and glucose responses (see Figure 3) which were significantly improved and should thus complement the beneficial effects of the reduced triglyceride and very low density lipoprotein (VLDL) levels.
References:

• Colberg, Sheri R., et al. "Postprandial walking is better for lowering the glycemic effect of dinner than pre-dinner exercise in type 2 diabetic individuals." Journal of the American Medical Directors Association 10.6 (2009): 394-397. 
• Dalgaard, Marian, Claus Thomsen, and Kjeld Hermansen. "Effects of one single bout of low-intensity exercise on postprandial lipaemia in type 2 diabetic men." British Journal of Nutrition 92.03 (2004): 469-476.
• Gill, Jason MR, et al. "Effect of prior moderate exercise on postprandial metabolism in men with type 2 diabetes: heterogeneity of responses." Atherosclerosis 194.1 (2007): 134-143.
• Heden, Timothy D., et al. "Post-dinner resistance exercise improves postprandial risk factors more effectively than pre-dinner resistance exercise in patients with type 2 diabetes."
  Journal of Applied Physiology (2014). Ahead of print.
• Krook, Anna, et al. "Reduction of risk factors following lifestyle modification programme in subjects with type 2 (non?insulin dependent) diabetes mellitus." Clinical physiology and functional imaging 23.1 (2003): 21-30.
• OGorman, Donal J., and Anna Krook. "Exercise and the treatment of diabetes and obesity." Endocrinology and metabolism clinics of North America 37.4 (2008): 887-903.
• Tobin, L. W. L., Bente Kiens, and Henrik Galbo. "The effect of exercise on postprandial lipidemia in type 2 diabetic patients." European journal of applied physiology 102.3 (2008): 361-370.
• van Dijk, Jan-Willem, et al. "Exercise and 24-h glycemic control: equal effects for all type 2 diabetic patients?." Medicine and science in sports and exercise (2012).

Fight your fat with a high intensity interval training program thats similar to that of pro-/amateur boxers.

Actually, it should not surprise you that the latest study from the University of Western Sydney shows that boxing training (HIIT) in adults with abdominal obesity is (a) feasible and may (b) elicit a better therapeutic effect on obesity, cardiovascular, and health-related quality of life (HRQoL) outcomes than an equivalent dose of brisk walking (MICT).

What may surprise you, though, is that Birinder S Cheema et al. still feel that more "[r]obustly designed randomized controlled trials are required toconfirm these findings and inform clinical guidelines and practice for obesity treatment" (Cheema. 2015).

In view of the ever-increasing number of studies that show that HIIT training is vastly superior to moderate or even low-intensity exercise in obesity treatment, the guidelines should have been changed all along. But lets forget about politics for the moment. In the study at hand, the basically healthy, yet overweight or obese study participants performed only one of the following training programs:

• Boxing training - Four 50-min sessions of supervised boxing training per week - The interval-based exercises were preceded by a 5 min warm-up of continuous skipping at a self-selected intensity. Intervals were prescribed at 2:1 (i.e. 2 min of high-intensity activity followed by 1 min of rest (standing or pacing) between intervals and exercises). Three intervals of each of the following five exercises were performed for a total of 30 min of high-intensity effort: (1) heavy bag, (2) focus mitts, (3) circular body bag, (4) footwork drills, and (4) skipping. The total amount of physical activity (excluding warm up and rest periods) was computed as 30 min x 6 metabolic equivalents (MET) per minute = 180 MET min [24]. During the high-intensity bouts, participants were instructed to exercise at a rating of perceived exertion of 15-17/20 (“hard” to “very hard”) with the goal of achieving >75% of age-predicted maximal heart rate (i.e. 220-age; HRmax).
• Walking training - Four 50-min sessions of supervised brisk walking training - Participants were instructed to begin each session with a 5-min gradual warm-up and walk as quickly as possible for the remainder of the session (45 min). The total amount of physical activity (excluding warm up) was computed as 45 min x 4 metabolic equivalents (MET) per minute = 180 MET-min.

Needless to say that the boxing group trained at a significantly higher intensity each week versus the brisk walking group (p < 0.05) - intense enough for two participants to require modifications to their exercise program.

Figure 1: Changes in physique markers and parameters of real world well-being (Cheema. 2015).

Since both participants were able to continue the exercise intervention, both still saw similar beneficial effects as their peers who trained according to the original boxing HIIT protocol. These benefits included...

• Figure 2: Significant improvements in markers of cardiovascular health were achieved only with HIIT boxing, not with brisk walking (Cheema. 2015).

  having a lower attrition rate (n = 0 vs. n = 2) than the subjects in the walking group
• greater improvements in body fat percentage (p = 0.047),
• more pronounced reductions in systolic blood pressure (p = 0.026) and central aortic pressure (augmentation index | AIx; p < 0.001)),
• significantly more pronounced improvements in fitness (VO2Max), physical functioning and vitality, as well as
• greater improvements in health-related quality of life scores

over time. The walking group on the other hand, did not improve any clinical outcomes, and experienced a worsening of vitality (p = 0.043).
References:

• Arena, Ross, et al. "Should high-intensity-aerobic interval training become the clinical standard in heart failure?." Heart failure reviews 18.1 (2013): 95-105. 
• Ashor, Ammar W., et al. "Exercise Modalities and Endothelial Function: A Systematic Review and Dose–Response Meta-Analysis of Randomized Controlled Trials." Sports Medicine (2014): 1-18.
• Cheema, Birinder S., et al. "The feasibility and effectiveness of high-intensity boxing training versus moderate-intensity brisk walking in adults with abdominal obesity: a pilot study." BMC Sports Science, Medicine and Rehabilitation 7.1 (2015): 3.
• Gillen, J. B., et al. "Acute high?intensity interval exercise reduces the postprandial glucose response and prevalence of hyperglycaemia in patients with type 2 diabetes." Diabetes, Obesity and Metabolism 14.6 (2012): 575-577.
• Guiraud, Thibaut, et al. "High-intensity interval training in cardiac rehabilitation." Sports medicine 42.7 (2012): 587-605.

Sled pulling in the sand?! For someone with her height, but twice or thrice the weight with a primary on fat loss, on the other hand, its suboptimal.

"HIIT", about a year ago this was the buzzword in the health and fitness industry. Doing anything but "hiiting it hard" was thought to be a waste of time and the acronym "LISS" [Light Intensity Steady State] became synonymous with "lose" as in loser.

As a SuppVersity reader youre immune against hype and constant overgenerealization. You are aware of the "specificity principle", and the usefulness of all type of exercise. And you know that there is a place and time for each form of cardio training: Light, moderate and high intensity (interval) training.

Speaking of cardio,...

... if your main concern really is your myocardium (=the large heart muscle), what type of exercise do you have to perform then? Right! "CARDIO" = Light exercise as a replacement for the daily activity most of us pencil pushers are lacking and HIIT as a means to actually train your heart.

In the end, it doesnt really depend on your current fitness level. The "no pain, no gain" principle is true for everyone. And with "light" always being defined against your current VO2max (the standard measure of cardio-respiratory fitness) - "light" exercise such as the Continuous Endurance Training (CONT) program, 13 out of the 38 subjects in a recent study by Shelley E. Keating and her colleagues from the University of Sydney and the University of Sydney is always defined relative to the your personal fitness level.

Table 1: Frequency, intensity, work : recovery ratio, no. of intervals (INT), duration of continuous work (DUR) and total session time per week (in min; incl. warm-up, cool-down, etc.; Keating. 2014)

For the 38 inactive (exercising <3 days/week) and overweight (BMI 25 to 29.9) 18- to 55-year-old year-old slackers (7 men and 31 women) who were randomly assigned to receive three sessions/week for 12 weeks of

• HIIT (HIIT), or
• Continuous Moderate Intensity (CONT)

training or a sedentary control group (PLA). As you can see in the tabular overview below, the researchers made sure to gradually increase both the volume and intensity of the workouts.

When I am talking to people who complain about not seeing the results they want (strength, size,  conditioning and fat loss - it does not matter), not making "progress" an obligatory part of their training regimen is second only to eating processed foods (no fat loss) and eating way to little (no performance and size increases), when it comes to the most "popular" ;-) reasons for failure.

Dont make either of these mistakes!

What kind of mistakes? Well, the first one is not to acknowledge the progressive overload principle and its reign in both endurance and strength training. You will probably remember the bottom line from the "block peridization article" (see "Block Periodization - Impressive Performance Gains in Pro-Athletes: Revolutionary Training Concept, Or Just a Good Way to Eventually Break Out of the Comfort Zone?" | read more): There is no progression without progression! In other words, if you aint willing to kick your own ass, you better hire a trainer to do that for your or content yourself with mediocrity.

Figure 1: Changes in body composition (left) and conditioning parameters (right) after 12 weeks (Keating. 2014)

As the results from the study at hand show (see Figure 1), progression is fine and dandy, but without specificity and the blind faith that there was one training method that would deliver it all, i.e

• increases in VO2 (=cardiovascular fitness)
• loss of body fat, and
• compensation for the daily activity you dont get,

... you are off the track. Seriously. Doing only HIIT will help you compensate for the daily activity you dont get, it will also help you lose body fat. However...

• HIIT is not a sensible way to compensate for the lack of daily activity in the long term (specifically for people who lift weights and have another highly CNS taxing type of workout in their routine), and
• HIIT is neither the most effective way to shed body fat for those who need it the most

I know that you will read the exact opposite on all kinds of websites, but the study at hand clearly demonstrates that exercise-induced weight loss, which is what most people want to achieve, when theyre hitting the gym. Is not going to happen with HIIT, alone. The data in figure 1 does also leave no doubt that the lack of weight loss in the HIIT group of the Keating study is not a consequence of increases in lean mass.

Figure 2: Greater mass and fat gains in the CONT group are not what the slowly abating hype around HIIT would have you expect (from Keating. 2014)

As the b/w figures on the right hand side of this paragraph reveal (Figure 2), its actually quite the opposite: The lean mass gains in the "average subject" of the continuous exercise group were (albeit non-significantly) more pronounced than than those of the 13 "HIITer" (2 dropouts in both groups).

In the absence of differences in total energy intake (p = 0.44) or the macronutrient ratios (33% | 42 % | 25% from fat, carbs and protein, respectively), identical sedentary times, a similar energy total expenditure per day (~10,000kJ/day), the training modalities, i.e. CONT vs. HIIT are the only parameter to explain why this "first study to examine the efficacy of HIIT versus that of continuous aerobic exercise training on body fat levels in previously inactive, overweight adults" (Keating. 2014 says: If you want to lose body fat without dieting, you better stick to (relative) low intensity steady state exercise.

Dont worry, HIITers! There is more to it...

... if your goal is a different one, though - in other words, if you aspire to achieve maximal fitness in minimal time, you will appreciate that the HIIT group achieved similar improvements in cardio-respiratory fitness (VO2max) with only "50–60% of the time taken for the same gain in fitness via
continuous aerobic exercise (60–72 versus 108–144 minutes per week)." (Keating. 2014).
References

• Keating, Shelley E., Elizabeth A. Machan, Helen T. OConnor, et al., "Continuous Exercise but Not High Intensity Interval Training Improves Fat Distribution in Overweight Adults". Journal of Obesity, vol. 2014. 2014. Article ID 834865. 
• Heydari, M., J. Freund, and S. H. Boutcher. "The effect of high-intensity intermittent exercise on body composition of overweight young males." Journal of obesity 2012 (2012).
• Tjonna, A., et al. "Aerobic interval training reduces cardiovascular risk factors more than a multitreatment approach in overweight adolescents." Clinical science 116 (2009): 317-326.
• Tremblay, Angelo, Jean-Aimé Simoneau, and Claude Bouchard. "Impact of exercise intensity on body fatness and skeletal muscle metabolism." Metabolism 43.7 (1994): 814-818.