2021年
9月23日
Thursday

国际糖尿病 >> 专家视点 >> 专家访谈 >> 正文

[ADA2012]糖尿病的运动治疗:被遗忘的工具——美国弗尼吉亚大学Sheri R. Colberg-Ochs教授访谈
国际糖尿病网版权所有,谢绝任何形式转载,侵犯版权者必予法律追究。

专家访谈 临床科研  作者:  S.R.Colberg-Ochs 来源:国际糖尿病 2012/6/10 15:56:00    加入收藏
内容概要:Colberg-Ochs博士:以前的体育锻炼通常仅仅是有氧运动,但过去10年中很多研究开始关注抗阻力锻炼。其结果显示,对控制2型糖尿病患者的血糖水平而言,即使不比有氧运动更有效,抗阻力锻炼也具有与有氧运动相当的疗效。

  <International Diabetes>: Could you explain how important resistance training is in the overall scope of exercise for sedentary people and why?

  Dr Colberg-Ochs: The push before was always just on aerobic exercise but in the last decade or so there have been a lot of studies that have looked at resistance training. We know from those training studies using resistance training that it can be as effective, if not more effective, than aerobic training in managing blood glucose levels in people with type 2 diabetes. For a number of different reasons it helps lower the overall blood glucose, it helps with insulin action and it helps either increase muscle mass from some of the losses that come with ageing or inactivity or help patients retain it. For that reason alone and because muscle is the most important storage depot for carbohydrates, resistance training is really critical. When people ask me, if they aren’t doing any exercise now, then what should they do? I will usually tell them resistance training. Most people do some walking around during the day and normal daily movement but I tell them that they need to recruit the muscle fibers that they are not recruiting doing those activities because when we do low level activity we don’t recruit all of our muscle fibers. When you do resistance training, you recruit them. The ones you recruit are the ones that you keep.

  《国际糖尿病》:抗阻力锻炼在久坐人群的体育锻炼中的重要性如何?原因何在?
  Colberg-Ochs博士:以前的体育锻炼通常仅仅是有氧运动,但过去10年中很多研究开始关注抗阻力锻炼。其结果显示,对控制2型糖尿病患者的血糖水平而言,即使不比有氧运动更有效,抗阻力锻炼也具有与有氧运动相当的疗效。因为各种不同原因,其有助于降低患者的整体血糖,改善胰岛素的作用,并能够增加肌肉质量以改善老龄或体力活动不足所引发的肌肉质量的损失。仅仅是出于这个原因,因为肌肉是碳水化合物最重要的储存库,所以抗阻力锻炼是非常重要的。当人们问我如果他们现在没做任何的体育锻炼,他们应该做什么锻炼时,我通常会告诉他们要进行抗阻力锻炼。多数人会在白天进行散步和一些日常运动,但是我告诉他们,他们需要动员其肌肉纤维,而散步及日常运动是无法动员这些肌肉纤维的,因为进行低水平体力活动时我们无法动员所有的肌纤维。但是进行抗阻力锻炼则能够充分地动员他们,一旦你能够动员这些肌纤维,便能够长期保持。

  <International Diabetes>:Are you saying it is important to have a combination or if you are only doing a very small amount of exercise now, you should do resistance training because you won’t get that type of exercise during the daily routine?

  Dr Colberg-Ochs: I would say that if you don’t have time to do combination training then you should add in resistance training first. They work through different mechanisms. The aerobic training does help use up some of the glycogen in muscle and it does improve insulin action and it also increases your fat burning capacity so all of those things help keep insulin action heightened for at least 24 to 48 hours after aerobic training. For resistance training, not all studies show an acute impact on insulin action but what it does show is that the increase in muscle mass is beneficial overall for insulin action. So the main mechanism of action is the increase, or at least maintenance or prevention of additional loss of muscle mass. We are all losing muscle mass. We start losing it in our mid-20s just routinely and when we are inactive we lose it that much faster. So this training helps to prevent the normal loss of muscle mass with ageing and that can also have a big impact on insulin action.

  《国际糖尿病》:您是否是说进行联合锻炼是非常重要的?或者说如果现在你仅进行极少量体育锻炼则需要进行抗阻力锻炼?
Colberg-Ochs博士:我认为如果你没有时间进行联合体育锻炼时,你应该首先进行抗阻力锻炼。抗阻力锻炼可通过多种不同的机制发挥其作用。有氧锻炼能够促进肌肉中糖原的利用,增强胰岛素的作用,增加脂肪的燃烧能力,因而有助于使胰岛素的作用在运动后的至少24~48小时呈增强状态。就抗阻力锻炼而言,并不是所有的研究都显示,其对胰岛素作用具有影响,但是研究发现,其能增加肌肉质量,而这对胰岛素的全身作用是有益的。因此,抗阻力锻炼发挥作用的机制在于增加或者至少是维持或避免肌肉的额外损失。我们的肌肉都处在不断的损失过程中,一般来说20多岁时就开始损失了。当我们的体力活动不足时,其损失的速度会更快。因此,抗阻力锻炼有助于预防肌肉质量随年龄增长的生理性损失,并对胰岛素作用有重大的影响。

  <International Diabetes>:There are problems that arise when clinicians try prescribing exercise. Firstly, Chinese doctors and perhaps doctors in general, tend to emphasize pharmaceutical therapy more. What kind of advice can you give doctors to help them use exercise as part of their strategies and how can they think about this as it applies to daily practice?

 Dr Colberg-Ochs: At the point when people develop diabetes, their lifestyle has not been the best and their fitness levels have deteriorated and they are not active, so getting those people into planned regular activity is a really tough thing to do. Even to get inactive people who don’t have diabetes to start exercising is difficult; it’s a cultural concept. Where I usually start is with daily movement such as just standing up more. You wouldn’t think that that would be a big deal but there have been some studies that have looked at how much people weigh and they correlate that to how much they stand during the day. Between a group of lean and overweight individuals, the lean individuals stood up for 2 ? hours longer than the overweight individuals. Standing alone is a physical activity and although it’s not going to make you super fit, when we are talking about people who are trying to increase their fitness level from the bottom level up and are overweight and trying to lose weight or not to gain additional weight, then doing anything (standing, fidgeting, taking more steps) has a huge impact. It is the people with the lowest fitness who it is going to have the biggest impact on doing the least amount of physical activity.

  《国际糖尿病》:医生尝试开出运动处方的时候会存在很多的问题。首先,中国的医生更多地强调药物治疗。您有哪些建议帮助他们将体育锻炼纳入至其治疗策略中?他们又应当怎样将体育锻炼应用至日常实践中?
  Colberg-Ochs博士:糖尿病患者的生活方式通常不是很好,其健康水平恶化,体力活动减少,因此让这些人进行有计划性的规律的体力活动是很难的。实际上让那些体力活动不足的非糖尿病人群开始体育锻炼也是非常难的,这是一个文化概念。我通常首先开始的是多站立等日常运动。你可能并不认为这是个大问题,但是很多研究发现,人们的体重与其白天的站立时间具有相关性。对瘦人及超重人群的研究发现,与超重者相比,瘦人每天的站立时间更长,平均为2.5小时。站立本身就是一种体力活动,尽管它无法让你变得非常苗条,但对那些想要改变体型的人、想要减重或不继续增重的超重者来说,站立、烦躁不安以及多走动均具有重要的意义。体型最差的人能够从最少量的体力活动中获得最大程度的获益。



[1]  [2]  下一页



微信扫码支付查看全文
分享到: 更多
网站用户: 丁小玲 时间:2012/11/19 11:03:07
读了文章,获益很多,平常多进行抗阻力锻炼非常好。

网站用户: miyie 时间:2012/7/10 17:37:03
very good.I hope learne more.

网站用户: 张淑萍 时间:2012/7/2 13:10:49
这是不错的建议,对非内科医生对糖尿病患者的管理也非常有帮助。

网站用户: 范美珠 时间:2012/6/12 11:56:19
这篇文章太好了。提示我们的医生,不同的患者让其运动要采取不同的方法,对那些从不愿意动的人则从最简单的开始哪怕上班时坐久了站一下走两步都可以,回到家,拿饮料瓶装上水举几下也是可以的,慢慢的、而且正重的告诉我们的患者运动的好处。

网站用户: 靳素梅 时间:2012/6/10 22:29:52
关于抗阻力锻炼再具体一些就好了。

注册

网友评论仅供其表达个人看法,并不表明国际糖尿病同意其观点或证实其描述。 发表评论需登陆

相关标签

作者资源

相关文章

热门新闻

相关幻灯

相关视频

 

国际循环网

国际眼科时讯

国际肝病网

肿瘤瞭望网
关于本站 | 设为首页 | 加入收藏 | 站长邮箱 | 友情链接 | 招贤纳士| 版权申明

国际糖尿病(www.idiabetes.com.cn)对刊载的所有文章、视频、幻灯、音频等资源拥有全部版权。未经本站许可,不得转载。

京ICP备18007927号-1  京公网安备 11010502033361号   (京)-非经营性-2018-0224  增值电信业务经营许可证:京B2-20200034
国际糖尿病 版权所有    2007-2021 www.idiabetes.com.cn  All Rights Reserved