ORCID Profile
0000-0002-1999-2498
Current Organisation
Deakin University
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Publisher: Wiley
Date: 18-09-2016
DOI: 10.1111/HEPR.12781
Abstract: Regular aerobic exercise reduces visceral adipose tissue (VAT) and liver fat, however, not all in iduals are able to adopt and adhere to such programs. Progressive resistance training (PRT) may be an alternative therapy, but there is limited available evidence. We examined the efficacy of PRT as per current exercise guidelines, compared with sham exercise placebo on liver fat and VAT. Twenty-nine inactive and overweight/obese (body mass index ≥25 kg/m There were no significant group by time interactions for change in liver fat in PRT versus CON groups (-0.07 ± 0.31% vs. 0.55 ± 0.77%, respectively, P = 0.19), VAT (-175 ± 85 cm Traditional PRT is not effective for reducing liver fat in overweight/obese adults compared with placebo control. Although PRT has known metabolic benefits, an adequate volume of aerobic exercise should be promoted if liver fat is the therapeutic target.
Publisher: Springer Science and Business Media LLC
Date: 19-09-2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 15-01-2021
DOI: 10.1249/MSS.0000000000002596
Abstract: Cardiorespiratory fitness (CRF) is an independent predictor of mortality, and females typically achieve smaller improvements in CRF than males after exercise-based cardiac rehabilitation. High-intensity interval training (HIIT) has been shown to produce superior improvements in CRF than traditional cardiac rehabilitation, but the sex differences are unknown. The purpose of this systematic review and meta-analysis was to evaluate sex differences for changes in CRF and cardiometabolic health indicators after HIIT in adults with coronary artery disease (CAD). A systemic search of five electronic databases for studies examining the effect of HIIT on measured CRF and cardiometabolic health indicators in adults with CAD was performed. Data (published and unpublished) from 14 studies were included in the meta-analyses with approximately eightfold greater male than female participation ( n = 836 vs n = 103). Males with CAD achieved a near-significant absolute improvement in CRF (mean difference [MD] = 1.07, 95% confidence interval [CI] = −0.08 to 2.23 mL·kg −1 ⋅min −1 , P = 0.07) after HIIT when compared with control there were insufficient data to conduct such an analysis in females. Significantly smaller improvements in CRF were experienced by females than males (MD = −1.10, 95% CI = −2.08 to −0.12 mL·kg −1 ⋅min −1 , P = 0.03) there was no sex difference for the relative (percentage) change in CRF after HIIT. Females achieved significantly smaller reductions in body mass index (MD = −0.25, 95% CI = −0.03 to −0.47 kg·m −2 , P = 0.02) and fasting blood glucose (MD = −0.38, 95% CI = −0.05 to −0.72, P = 0.03) no sex differences were observed for other cardiometabolic health indicators. There are no sex differences for relative improvements in CRF after HIIT however, females are greatly underrepresented in trials. Future studies should increase female participation and perform sex-based analyses to determine sex-specific outcomes following HIIT.
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.DIABET.2016.12.006
Abstract: Ectopic adipose tissue surrounding the intra-abdominal organs (visceral fat) and located in the liver, heart, pancreas and muscle, is linked to cardio-metabolic complications commonly experienced in type 2 diabetes. A systematic review and meta-analysis was performed to determine the effect of exercise on ectopic fat in adults with type 2 diabetes. Relevant databases were searched to February 2016. Included were randomised controlled studies, which implemented≥4 weeks of aerobic and/or resistance exercise and quantified ectopic fat via magnetic resonance imaging, computed tomography, proton magnetic resonance spectroscopy or muscle biopsy before and after intervention. Risk of bias and study quality was assessed using Egger's funnel plot test and modified Downs and Black checklist, respectively. Of the 10,750 studies retrieved, 24 were included involving 1383 participants. No studies were found assessing the interaction between exercise and cardiac or pancreas fat. One study assessed the effect of exercise on intramyocellular triglyceride concentration. There was a significant pooled effect size for the meta-analysis comparing exercise vs. control on visceral adiposity (ES=-0.21, 95% CI: -0.37 to -0.05 P=0.010) and a near-significant pooled effect size for liver steatosis reduction with exercise (ES=-0.28, 95% CI: -0.57 to 0.01 P=0.054). Aerobic exercise (ES=-0.23, 95% CI: -0.44 to -0.03 P=0.025) but not resistance training exercise (ES=-0.13, 95% CI: -0.37 to 0.12 P=0.307) was effective for reducing visceral fat in overweight/obese adults with type 2 diabetes. These data suggest that exercise effectively reduces visceral and perhaps liver adipose tissue and that aerobic exercise should be a key feature of exercise programs aimed at reducing visceral fat in obesity-related type 2 diabetes. Further studies are required to assess the relative efficacy of exercise modality on liver fat reduction and the effect of exercise on pancreas, heart, and intramyocellular fat in type 2 diabetes and to clarify the effect of exercise on ectopic fat independent of weight loss.
Publisher: Elsevier BV
Date: 10-2021
Publisher: Elsevier BV
Date: 07-2021
Publisher: Bentham Science Publishers Ltd.
Date: 26-10-2016
DOI: 10.2174/1573399811666150817124601
Abstract: Deterioration of the structure and function of the vascular system is the underlying feature in cardiovascular disease (CVD), which is the highest cause of mortality in type 2 diabetes (T2D). Studies assessing the effect of exercise on vascular function and stiffness have used different measurement techniques and small cohorts, making it difficult to conclude on the overall efficacy of exercise on these outcomes. The aim of this study was to assess the effect of exercise on vascular function and stiffness in T2D. Electronic database searches were performed in AMED, MEDLINE, MEDLINE Daily Update, PREMEDLINE, SPORTDiscus, CINAHL, EMBASE and Web of Science. The effect size (ES), and 95% confidence intervals (CIs) of eligible studies were calculated. Pooled estimates of the effect of aerobic exercise (AEx) on vascular function and stiffness, using ES, were obtained. Results show that AEx led to a near-significant reduction in PWV (ES = -0.472 95% CI: -0.949 to 0.005 P = 0.052), a significant reduction in EID (ES = 0.416, 95% CI: 0.062 to 0.769 P= 0.021), and a non-significant benefit in FMD measures. There were limited studies using resistance training or in combination with aerobic exercise, to assess a pooled effect on vascular function or stiffness. These data suggest that aerobic exercise training should be used as a primary treatment strategy for improving vascular smooth muscle function as measured by EID in in iduals with T2D. There is currently insufficient evidence concerning the efficacy of regular exercise for improving vascular function and stiffness as measured by FMD and PWV.
Publisher: Springer Science and Business Media LLC
Date: 16-04-2021
DOI: 10.1186/S13102-021-00261-9
Abstract: Exercise-induced improvements in cardiorespiratory fitness (CRF) often coincide with improvements in insulin sensitivity and reductions in liver fat content. However, there are limited data concerning the relationship between CRF and liver fat content in adults with varying degrees of metabolic dysfunction. The aim of this study was to examine the association between CRF, liver fat content, and insulin resistance in inactive adults with obesity and with or without type 2 diabetes (T2D), via cross-sectional analysis. CRF was determined via a graded exercise test. Liver fat content was assessed via proton magnetic resonance spectroscopy and insulin resistance was assessed via homeostatic model of insulin resistance (HOMA-IR). A partial correlation analysis, controlling for age and gender, was performed to determine the association between CRF, demographic, cardiometabolic, and anthropometric variables. Independent t tests were performed to compare cardiometabolic outcomes between participants with T2D and participants without T2D. Seventy-two adults (46% male) with a mean age of 49.28 ± 10.8 years, BMI of 34.69 ± 4.87 kg/m 2 , liver fat content of 8.37 ± 6.90%, HOMA-IR of 3.07 ± 2.33 and CRF of 21.52 ± 3.77 mL/kg/min participated in this study. CRF was inversely associated with liver fat content ( r = − 0.28, p = 0.019) and HOMA-IR ( r = − 0.40, p 0.001). Participants with T2D had significantly higher liver fat content (+ 3.66%, p = 0.024) and HOMA-IR (+ 2.44, p 0.001) than participants without T2D. Participants with T2D tended to have lower CRF than participants without T2D (− 1.5 ml/kg/min, p = 0.094). CRF was inversely associated with liver fat content and insulin resistance. Participants with T2D had lower CRF than those without T2D, however, the difference was not statistically significant. Further longitudinal studies are required to elucidate the relationship between CRF and the progression of obesity-related diseases such as T2D. Registration: ACTRN12614001220651 (retrospectively registered on the 19th November 2014) and ACTRN12614000723684 (prospectively registered on the 8th July 2014).
Publisher: Elsevier BV
Date: 2021
Publisher: Hindawi Limited
Date: 17-11-2020
DOI: 10.1111/JONM.13204
Publisher: Elsevier BV
Date: 12-2020
Publisher: American Diabetes Association
Date: 30-07-2020
DOI: 10.2337/DC19-2523
Abstract: The aim of this study was to examine the effect of a novel low-volume high-intensity interval training (HIIT), moderate-intensity continuous training (MICT), or placebo (PLA) intervention on liver fat, glycemia, and cardiorespiratory fitness using a randomized placebo-controlled design. Thirty-five inactive adults (age 54.6 ± 1.4 years, 54% male BMI 35.9 ± 0.9 kg/m2) with obesity and type 2 diabetes were randomized to 12 weeks of supervised MICT (n = 12) at 60% VO2peak for 45 min, 3 days/week HIIT (n = 12) at 90% VO2peak for 4 min, 3 days/week or PLA (n = 11). Liver fat percentage was quantified through proton MRS. Liver fat reduced in MICT (−0.9 ± 0.7%) and HIIT (−1.7 ± 1.1%) but increased in PLA (1.2 ± 0.5%) (P = 0.046). HbA1c improved in MICT (−0.3 ± 0.3%) and HIIT (−0.3 ± 0.3%) but not in PLA (0.5 ± 0.2%) (P = 0.014). Cardiorespiratory fitness improved in MICT (2.3 ± 1.2 mL/kg/min) and HIIT (1.1 ± 0.5 mL/kg/min) but not in PLA (−1.5 ± 0.9 mL/kg/min) (P = 0.006). MICT or a low-volume HIIT approach involving 12 min of weekly high-intensity aerobic exercise may improve liver fat, glycemia, and cardiorespiratory fitness in people with type 2 diabetes in the absence of weight loss. Further studies are required to elucidate the relationship between exercise-induced reductions in liver fat and improvements in glycemia.
Publisher: Elsevier BV
Date: 03-2020
DOI: 10.1016/J.JDIACOMP.2019.107514
Abstract: We aimed to examine the feasibility and safety of undertaking high-intensity interval exercise (HIIE) with evening basal insulin dose reduction on exercise-related hypoglycaemia following an afternoon bout of HIIE, compared with moderate-intensity continuous exercise and a non-exercise control day in adults with type 1 diabetes in a free-living environment. Twelve adults with type 1 diabetes participated in a randomised, crossover trial (9 female/3 male, mean age 40.4 ± 9.9 years, duration 16.5 ± 9.8 years, HbA1c 8.0 ± 0.8%). Each participant undertook five conditions: a non-exercise day, and four exercise conditions on separate afternoons: a moderate-intensity continuous exercise bout and three HIIE bouts with 10%, 20% and 30% evening basal insulin reduction. Post-exercise glucose response was measured for 24 h by continuous glucose monitoring and compared across conditions. HIIE with 10%, 20% and 30% evening basal insulin dose reduction was not associated with an increase in hypoglycaemia compared with moderate-intensity continuous exercise, or the non-exercise day. There was no difference in hyperglycaemia, time-in-range or glucose variability across all exercise regimens and the non-exercise day (p > .05). Exercise-related hypoglycaemia was not increased following afternoon HIIE when diabetes management strategies incorporating evening basal insulin dose reduction were utilised.
Publisher: Research Square Platform LLC
Date: 03-06-2020
Abstract: Background : Cardiovascular disease is the leading cause of death worldwide. Notwithstanding the well-known benefits of cardiac rehabilitation (CR), adherence to CR remains low, particularly in women. High-intensity interval training (HIIT) has received specific attention as an emerging exercise-training paradigm that addresses frequently cited barriers to CR (i.e. lack of motivation/enjoyment and time, perceiving exercise regime as tiring/boring) and improves cardiovascular risk factors. Previous studies have examined the safety of HIIT in CR there is little evidence on the feasibility of HIIT in CR. The aims of this study were to evaluate the feasibility of HIIT within a CR setting and examine the sex differences regarding the feasibility of such programming. Methods: Patients attended an on-site HIIT CR program (10-minute warm-up, 25 minutes of interspersed high [HI - 4 minutes at 85-95% HRpeak] and low [LO - 3 minutes at 60-70% HRpeak] intervals, 10-minute cool-down) twice weekly for 10 weeks. Heart rate (HR) and the Borg rating of perceived exertion (RPE) scale (6-20 points) were recorded at each session. Feasibility was assessed by: (1) attendance and compliance: the number of sessions attended and the compliance to the prescribed HI and LO HR ranges (2) the patient experience: patients’ perceived effort, program difficulty, if the program was challenging and satisfying and, (3) safety. Descriptive statistics were used to report the means and their variations. Mann-Whitney U tests and Chi-square analyses were performed to examine sex-differences. Results: A total of 151 patients (33% women, 57.5 ± 9.1 years) attended the HIIT program and completed 16±5 classes with a low attrition rate (11.3%). Most patients met or exceeded the prescribed target HR for the HI (80%) and LO (84%) intervals, respectively. Patients reported a “somewhat hard” RPE for HI (14 ± 2) and “very light” for LO (10 ± 2) intervals. All patients were satisfied with the program and found it challenging. Most patients found HIIT to be difficult (7 ± 2 points, scale range 0-10 points), yet safe (97%). Three vasovagal episodes occurred and more women dropped-out of the program than men (p .01). Conclusions: HIIT is a feasible, safe and well-received exercise paradigm in a CR setting.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-03-2019
Publisher: Research Square Platform LLC
Date: 23-01-2020
Abstract: Background: Cardiovascular disease is the leading cause of death worldwide. Notwithstanding the well-known benefits of cardiac rehabilitation (CR), adherence to CR remains low, particularly in women. Aerobic interval training (AIT) has received specific attention as an emerging exercise-training paradigm that addresses frequently cited barriers to CR (i.e. lack of motivation/enjoyment and time, perceiving exercise regime as tiring/boring) and improves cardiovascular risk factors. Previous studies have examined the safety of AIT in CR settings there is little evidence on the feasibility of AIT in CR. The aims of this study were to evaluate the feasibility of AIT within a CR setting and examine the sex differences regarding the feasibility of such programming. Methods: Patients attended an on-site AIT CR program (10-minute warm-up, 25 minutes of interspersed high [HI - 4 minutes at 85-95% HRpeak] and low [LO - 3 minutes at 60-70% HRpeak] intervals, 10-minute cool-down) twice weekly for 10 weeks. Heart rate (HR) and the Borg rating of perceived exertion (RPE) scale were recorded at each session. Feasibility was assessed by: (1) attendance and compliance: the number of sessions attended and the compliance to the prescribed HI and LO HR ranges (2) the patient experience: patients’ perceived effort, program difficulty, if the program was challenging and satisfying and, (3) safety. Descriptive statistics were used to report the means and their variations. Mann-Whitney U tests and Chi-square analyses were performed to examine sex-differences. Results: A total of 160 patients (33% women, 67% men, 57.2 ± 9.6 years) attended the AIT program and completed 16±5 classes with a low attrition rate (11.3%). Most patients met or exceeded the prescribed target HR for the HI (80%) and LO (84%) intervals, respectively. Patients reported a “somewhat hard” RPE for HI (14±1) and “very light” for LO (10±2) intervals. All patients were satisfied with the program and found it challenging. Most patients found AIT to be difficult (7±2), yet safe (97%). Three vasovagal episodes occurred and more women dropped-out of the program than men (p .01). Conclusions: AIT is a feasible, safe and well-received exercise paradigm in a CR setting.
Publisher: MDPI AG
Date: 26-08-2022
DOI: 10.3390/JCM11175018
Abstract: It is unclear if cutaneous microvascular dysfunction associated with diabetes and obesity can be ameliorated with exercise. We investigated the effect of 12-weeks of exercise training on cutaneous microvascular reactivity in the foot. Thirty-three inactive adults with type 2 diabetes and obesity (55% male, 56.1 ± 7.9 years, BMI: 35.8 ± 5, diabetes duration: 7.9 ± 6.3 years) were randomly allocated to 12-weeks of either (i) moderate-intensity continuous training [50–60% peak oxygen consumption (VO2peak), 30–45 min, 3 d/week], (ii) low-volume high-intensity interval training (90% VO2peak, 1–4 min, 3 d/week) or (iii) sham exercise placebo. Post-occlusive reactive hyperaemia at the hallux was determined by laser-Doppler fluxmetry. Though time to peak flux post-occlusion almost halved following moderate intensity exercise, no outcome measure reached statistical significance (p 0.05). These secondary findings from a randomised controlled trial are the first data reporting the effect of exercise interventions on cutaneous microvascular reactivity in the foot in people with diabetes. A period of 12 weeks of moderate-intensity or low-volume high-intensity exercise may not be enough to elicit functional improvements in foot microvascular reactivity in adults with type 2 diabetes and obesity. Larger, sufficiently powered, prospective studies are necessary to determine if additional weight loss and/or higher exercise volume is required.
Publisher: Korean Diabetes Association
Date: 2016
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.JSAMS.2018.09.228
Abstract: Greater arterial stiffness and poor 24h blood pressure (BP) are recognized as indicators of poor cardiovascular health. Evidence has shown that high intensity interval training (HIIT) may be a superior alternative to moderate intensity continuous training (MICT) for improving cardiovascular disease risk factors such as cardiorespiratory fitness and vascular function. However, there are limited data comparing the effect of HIIT to MICT on central arterial stiffness and/or 24h BP response. The purpose of this study was to compare HIIT versus MICT on central arterial stiffness and 24h BP outcomes by systematic review and meta-analysis. A systematic review and meta-analysis was conducted. Eligible studies were exercise training interventions (≥4weeks) that included both HIIT and MICT and reported central arterial stiffness, as measured by pulse wave velocity and augmentation index and/or 24h BP outcome measures. HIIT was found to be superior to MICT for reducing night-time diastolic BP (ES: -0.456, 95% CI: -0.826 to -0.086mmHg P=0.016). A near-significant greater reduction in daytime systolic (ES: -0.349, 95% CI: -0.740 to 0.041mmHg p=0.079) and diastolic BP was observed with HIIT compared to MICT (ES: -0.349, 95% CI: -0.717 to 0.020mmHg p=0.063). No significant difference was found for other BP responses or arterial stiffness outcomes. HIIT leads to a superior reduction in night-time diastolic BP compared to MICT. Furthermore, a near-significant greater reduction in daytime BP was found with HIIT compared to MICT. No significant difference was observed for changes to central arterial stiffness between HIIT and MICT.
Publisher: MDPI AG
Date: 04-02-2023
DOI: 10.3390/JCM12041255
Abstract: Females with type 2 diabetes (T2D) have a 25–50% greater risk of developing cardiovascular disease compared with males. While aerobic exercise training is effective for improving cardiometabolic health outcomes, there is limited sex-segregated evidence on the feasibility of aerobic training in adults with T2D. A secondary analysis of a 12-week randomized controlled trial examining aerobic training in inactive adults with T2D was conducted. Feasibility outcomes were recruitment, retention, treatment fidelity, and safety. Sex differences and intervention effects were assessed using two-way analyses of variances. Thirty-five participants (14 females) were recruited. The recruitment rate was significantly lower among females (9% versus 18% p = 0.022). Females in the intervention were less adherent (50% versus 93% p = 0.016), and experienced minor adverse events more frequently (0.08% versus 0.03% p = 0.003). Aerobically trained females experienced clinically meaningful reductions in pulse wave velocity (−1.25 m/s, 95%CI [−2.54, 0.04] p = 0.648), and significantly greater reductions in brachial systolic pressure (−9 mmHg, 95%CI (3, 15) p = 0.011) and waist circumference (−3.8 cm, 95%CI (1.6, 6.1) p 0.001) than males. To enhance the feasibility of future trials, targeted strategies to improve female recruitment and adherence are needed. Females with T2D may experience greater cardiometabolic health improvements from aerobic training than males.
Publisher: Elsevier BV
Date: 07-2021
Publisher: Oxford University Press (OUP)
Date: 06-03-2020
Abstract: Cardiovascular disease remains a leading cause of death in women. Despite the well-known benefits of cardiac rehabilitation, it remains underutilized, especially among women. Physical activity programs in the community, however, attract a large female population, suggesting that they overcome barriers to physical activity encountered by women. The characteristics of interventions that extend beyond the traditional cardiac rehabilitation model and promote physical activity merit examination. This narrative review aimed to: (a) summarize women’s barriers to attend cardiac rehabilitation (b) examine the characteristics of community- and home-based physical activity or lifestyle coaching interventions and (c) discuss which barriers may be addressed by these alternative programs. Studies were included if they: (a) were published within the past 10 years (b) included ≥70% women with a mean age ≥45 years (c) implemented a community- or home-based physical activity intervention or a lifestyle education/behavioral coaching program and (d) aimed to improve physical activity levels or physical function. Most interventions reported high (≥70%) participation rates and significant increases in physical activity levels at follow-up some improved physical function and/or cardiovascular disease risk factors. Community- and home-based interventions address women’s cardiac rehabilitation barriers by: implementing appealing modes of physical activity (e.g. dancing, group-walking, technology-based balance exercises) adapting the program to meet participants’ needs offering flexible options regarding timing and setting (e.g. closer to home, the workplace or faith-based institutions) and promoting social interactions. Cardiac rehabilitation can be enhanced by understanding the specific needs of women novel elements such as program offerings, convenient settings and opportunities for socialization should be considered when designing cardiac rehabilitation programs.
No related grants have been discovered for Kimberley Way.