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Time for precision exercise prescription: the same timing may not fit all 精确运动处方的时机:同样的时机未必适合所有人
Pub Date : 2023-12-13 DOI: 10.1113/jp285958
Jonatan R. Ruiz, Raquel Sevilla-Lorente, Francisco J. Amaro-Gahete

Precision medicine is a transformative approach to health care that addresses the inherent variability among individuals in terms of genetics, environment and lifestyle. It involves the customization of medical care to the unique characteristics of each individual, with the aim of optimizing treatment efficacy and minimizing adverse effects. This paradigm shift is made possible by the integration of comprehensive data, including multi-omics and clinical information, which allows for a more nuanced understanding of pathophysiological mechanisms and individual responses to interventions. One of them, also considered as medicine, is exercise. In the realm of exercise programmes for the prevention and treatment of a range of acute and chronic conditions, precision exercise prescription becomes particularly crucial. The variable nature of individual responses to exercise requires a tailored approach to maximize the benefits for each person, while reducing the risks of injury. Within the context of metabolic syndrome (MetS) acting as a crucial factor in the ongoing global cardiovascular crisis, and knowing the key role of exercise in the development and progression of MetS, the capability to forecast individual responses facilitates the development of personalized exercise strategies designed to address an individual's distinct risk profile.

A widely recognized approach for customizing and adjusting exercise programming to align with individual goals, lifestyle, preferences and progress is encapsulated in the FITT principle, which includes frequency, intensity, time and type of exercise. By manipulating FITT criteria, a nearly limitless number of combinations can be devised to suit specific objectives. There is increasing evidence on the potential need to include a new principle, which also starts with T, and stands for time of the day when the exercise is performed. A new study by Morales-Palomo and collaborators shows that morning high-intensity interval exercise is more effective on reducing systolic blood pressure and insulin levels that afternoon exercise in adults with MetS (Morales-Palomo et al., 2023). They conducted a 16-week exercise-based randomized controlled trial, in which 139 middle-aged adults (49 women, body mass index 30.6 ± 3.0 kg m−2) were allocated into morning exercise, afternoon exercise or a non-exercise control group. As expected, both exercise groups improved several cardiovascular disease risk factors, including total and central body fat, systolic blood pressure, insulin levels and cardiorespiratory fitness, compared with the control group. Interestingly, they showed that the morning exercise group improved their systolic blood pressure and insulin levels to a greater extent than those who exercised in the afternoon, yet no differences in fasting glucose levels were noted between the morning and afternoon exercise groups. Previous exercise interventions conducted on both healthy and metaboli

重要的是,以往的研究侧重于空腹状态下的血糖水平,尽管人一天中大部分时间都处于餐后状态,但这可能无法完全反映真实世界的日常血糖控制情况。因此,在评估血糖控制情况时,连续血糖监测设备是不可或缺的,因为它们能提供 24 小时平均血糖水平的详细信息,从而能进行更精确的分析。另一个需要考虑的相关方面是,尽管女性通常比男性表现出更高的胰岛素敏感性,但之前的大多数研究要么主要以男性为中心,要么将男性和女性结合起来进行分析。这凸显了在实施运动干预时考虑性别差异的重要性,并强调了对男性和女性进行单独分析的必要性。此外,由于缺乏对运动对健康结果影响的性别差异的全面研究,近来人们开始强调在研究中将性别作为一个生物变量来考虑。为解决这一问题,研究人员开发了运动报告模板共识(CERT),为报告可复制的运动项目提供了一套被认为至关重要的基本要素指导(Slade 等人,2016 年)。在这份 CERT 清单中,没有包括每天进行锻炼的时间。随着我们对个人健康的了解越来越多,个性化运动处方正成为改善健康和降低疾病风险的主要方式。
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The Journal of Physiology
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