Can any new information be added to the question of insulin resistance after menopause? Yes, as it is not clear whether there is any benefit from moderate-to-vigorous aerobic exercise in postmenopausal women that are unsuccessful in losing weight. Do older women benefit from exercise? The study of Mason and colleagues  investigated the independent and combined effects of dietary weight loss and exercise on insulin sensitivity and restoration of normal fasting glucose in middle-aged and older women. The Nutrition and Exercise in Women (NEW) study was a 12-month, randomized, controlled trial, conducted from 2005 to 2009 on 439 inactive, overweight, postmenopausal women. Women were randomized to dietary weight loss, moderate-to-vigorous intensity aerobic exercise, combined diet and exercise, or no intervention. They attended weekly group meetings in the first 6 months, followed by monthly meetings, in addition to biweekly phone or e-mail contacts. Body mass index, body fat, waist circumference, VO[-]2max[/-], pedometer steps and average energy consumed were monitored. Insulin resistance was assessed at base line and after 12 months of intervention through insulin, C-peptide, fasting plasma glucose levels and calculated HOMA-IR model. At 12 months, the greatest weight loss was achieved in the diet + exercise group, followed by the diet group. Women in the diet and diet + exercise groups experienced significant reductions in insulin, C-peptide, HOMA-IR and fasting plasma glucose levels, when compared to the exercise-alone and control groups. This reduced the 1-year incidence of developing impaired fasting glucose. However, moderate-to-vigorous exercise was most effective in reverting from impaired fasting to normal glucose levels, independent of weight loss. The authors concluded that dietary weight loss, with or without exercise, significantly improved insulin resistance in both younger and older postmenopausal women.
Teodora Beljic Zivkovic
Faculty of Medicine, University of Belgrade, Zvezdara University Medical Center, Belgrade, Serbia
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