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Does high-intensity resistance training maintain bone mass during moderate weight loss in older overweight adults with type 2 diabetes?

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Abstract

The aim was to investigate whether the addition of supervised high intensity progressive resistance training to a moderate weight loss program (RT+WLoss) could maintain bone mineral density (BMD) and lean mass compared to moderate weight loss (WLoss) alone in older overweight adults with type 2 diabetes. We also investigated whether any benefits derived from a supervised RT program could be sustained through an additional home-based program. This was a 12-month trial in which 36 sedentary, overweight adults aged 60 to 80 years with type 2 diabetes were randomized to either a supervised gymnasium-based RT+WLoss or WLoss program for 6 months (phase 1). Thereafter, all participants completed an additional 6-month home-based training without further dietary modification (phase 2). Total body and regional BMD and bone mineral content (BMC), fat mass (FM) and lean mass (LM) were assessed by DXA every 6 months. Diet, muscle strength (1-RM) and serum total testosterone, estradiol, SHBG, insulin and IGF-1 were measured every 3 months. No between group differences were detected for changes in any of the hormonal parameters at any measurement point. In phase 1, after 6 months of gymnasium-based training, weight and FM decreased similarly in both groups (P<0.01), but LM tended to increase in the RT+WLoss (n=16) relative to the WLoss (n=13) group [net difference (95% CI), 1.8% (0.2, 3.5), P<0.05]. Total body BMD and BMC remained unchanged in the RT+WLoss group, but decreased by 0.9 and 1.5%, respectively, in the WLoss group (interaction, P<0.05). Similar, though non-significant, changes were detected at the femoral neck and lumbar spine (L2-L4). In phase 2, after a further 6 months of home-based training, weight and FM increased significantly in both the RT+WLoss (n=14) and WLoss (n=12) group, but there were no significant changes in LM or total body or regional BMD or BMC in either group from 6 to 12 months. These results indicate that in older, overweight adults with type 2 diabetes, dietary modification should be combined with progressive resistance training to optimize the effects on body composition without having a negative effect on bone health.

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Acknowledgements

Dr. Robin Daly and Dr. David Dunstan are both supported by National Health and Medical Research Council (NHMRC) Research Fellowships. Professor Owen is supported by Queensland Health and by the National Health and Medical Research Council. This study was financially supported by a grant from the Victorian Health Promotion Foundation (VicHealth). Funds for the purchase of exercise equipment were kindly provided by the Rotary Club of Kew, Victoria, and the Soroptimist International, Brighton Division. We wish to thank Lucy Robinson and Elena Vulikh for their kind assistance in the clinical management of our volunteers. We are also grateful for the dietary assistance of Kathy McConell and Helen Bauzon. Most importantly, the authors are indebted to the volunteers whose cooperation and dedication made this study possible.

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Correspondence to Robin M. Daly.

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Daly, R.M., Dunstan, D.W., Owen, N. et al. Does high-intensity resistance training maintain bone mass during moderate weight loss in older overweight adults with type 2 diabetes?. Osteoporos Int 16, 1703–1712 (2005). https://doi.org/10.1007/s00198-005-1906-4

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  • DOI: https://doi.org/10.1007/s00198-005-1906-4

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