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Metabolic training: new paradigms of exercise training for metabolic diseases with exercise calorimetry targeting individuals

Annales de Réadaptation et de Médecine Physique
Publication Date
DOI: 10.1016/j.annrmp.2007.04.008
  • Obesity
  • Diabetes
  • Exercise
  • Lipoxmax
  • Training
  • Lipid Oxidation
  • Medicine


Abstract For patients with metabolic diseases, as with other diseases, exercise training is a fully recognized therapy. Such training helps obese patients stabilize weight after slimming. For patients with type 2 diabetics, it is both a prevention and a glucose-lowering treatment and reduces health care costs. We propose a targeted training for individuals at the level of maximal lipid oxidation (LIPOX max) with a protocol of exercise calorimetry (four 6-min workloads) based on Brooks and Mercier's crossover concept. Calorimetric interpretation of gas exchange at the fifth and sixth minutes of each stage shows a bell-shaped curve for lipid oxidation that peaks at LIPOX max, a point that varies considerably among individuals. As well, glucose oxidation is a linear function of power (carbohydrate cost of the watt). Such a calculation predicts fairly actual lipid oxidation over 45 min at the same level. Other protocols, with 3-min workloads used in sports medicine, are not reliable for patients with metabolic diseases. For obese adults and teenagers, as well as those with type 2 diabetes, 2 months' training at the LIPOX max (three sessions at 45 min per week) results in a net loss of fat mass, with preserved fat-free mass, and increased ability to oxidize lipids. At the end of this period, training can be “re-targeted” to be more effective and, possibly, associated with other strategies with stronger exercise intensities. Therefore, metabolic training is a viable option for patients with metabolic diseases, but the full concept is still evolving. However, the major challenge remains to transform inactive individuals into active ones.

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