肥胖和不健康的生活方式也是2型糖尿病(T2DM)的危险因素。TMEP部分编辑Thomas Yates的研究小组通过题为“运动、药物治疗和2型糖尿病:从血糖控制到全身健康和功能”的叙述综述，强调了运动和医学治疗相结合的研究机遇和挑战。作者提供了新一代降糖疗法的证据，这些疗法也能诱导伴随的体重减轻，特别是胰高血糖素样肽-1受体激动剂(GLP-1RAs)和钠-葡萄糖共转运蛋白2抑制剂(SGLT2is)。基于目前的知识，他们强调了研究运动与其他降糖或减肥疗法之间的相互作用或协同作用的重要性，使运动成为治疗2型糖尿病的量身定制的治疗方法，而不是通用的治疗方法。因此，这篇综述清楚地强调了精确运动处方的必要性，这源于对运动效果的深入机制理解。癌症是另一种重要的代谢和慢性炎症性疾病，也可能与肥胖有关。TMEP部分编辑Jesper F Christensen和副编辑Ciaran M Fairman在他们的文章《针对癌症患者的运动训练:超越临床肿瘤学的一般运动指南》中提供了一个非常有趣的观点。本文旨在更新运动肿瘤学中有针对性的运动干预的现有知识和临床依据。此外，本文还提出了一个系统指导肿瘤学中有针对性的运动干预的设计和执行的框架。作者希望他们的框架可以鼓励对肿瘤中有针对性的运动干预的进一步研究，也可以作为未来试验设计的指导方针，以提高质量和影响。TMEP章节编辑Helen Dawes小组在题为“多发性硬化症中的体力活动和疲劳:可可类黄酮饮料双盲随机对照试验的次要结果”的文章中分享了他们在神经和精神疾病背景下的原始数据。在这项研究中，他们对一天中的时间、身体活动水平和疲劳之间的相互关系进行了密集的表型分析，以确定一组多发性硬化症(MS)患者的运动处方，这些患者参加了一项为期六周的早晨类黄酮摄入量随机对照试验。研究发现，白天的疲劳程度会增加，而疲劳程度越高，体力活动就越少;然而，体育活动本身并不会增加疲劳。此外，早上摄入可可可以减少白天的疲劳和随后的体力活动引起的疲劳。因此，晨操和膳食黄酮类化合物的联合处方可能会优化ms患者的运动和身体活动潜力。这项研究很好地说明了理解和考虑营养和时间生物学等可能的协变量对于确定最佳运动处方模型的重要性。TMEP部分编辑Jonathan Myers和同事Baruch Vainshelboim对“特发性肺纤维化患者康复的阻力训练”进行了叙述性回顾。本文综述了特发性肺纤维化(IPF)的病理生理学和临床表现，重点介绍了老年人和患有这种呼吸系统疾病的患者进行抗阻训练的众多健康和临床益处。本文有效地探讨了系统阻力训练可能有助于克服IPF运动限制的潜在机制，为康复提供治疗机会。此外，作者还为IPF患者提供了基于阻力训练的肺康复方案的重要建议。在这篇论文中，作者强调，适应疾病的运动处方需要病理生理学的理解来证明特定运动方案的合理性。在本期特刊的最后一篇论文中，章节编辑Anthony C Hackney的研究小组分享了他们关于“竞技、非精英男性耐力运动员的能量可用性和RED-S风险因素”的原始数据。本文特别强调了TMEP的整个范围，即不仅仅是最常见的非传染性疾病类型，还包括可能由运动训练引起的慢性病。在这项研究中，作者评估了60名竞技性、娱乐性训练的男性耐力运动员的能量可用性和运动中相对能量缺乏(RED-S)的风险因素之间的关系。他们发现，即使在能量可用性较低的情况下，激素和骨骼生物标志物也在正常的临床范围内。
Amy R. Lane, A. Hackney, A. Smith‐Ryan, Kristen L. Kucera, J. Register-Mihalik, K. Ondrak
Relative Energy Deficiency in Sport (RED-S) is predicated on the assumption that low energy availability (EA) induces deficiencies-dysfunction in multiple physiologic systems. However, research on RED-S and EA in male athletes is limited in comparison to women. The aim of this study is to investigate EA and the risk factors for RED-S, and their potential associations in non-elite male endurance athletes. Laboratory assessments for resting metabolic rate (RMR), bone mineral density (BMD), blood hormonal biomarkers and maximal aerobic capacity were conducted on 60 competitive, recreationally trained male endurance athletes (age=43.4±11.6 years [mean±SD], training=10.9±2.7 h/wk, 7.1±8.8 years). Participants provided 7-days of training logs and 4-days of diet records. Diet and training records were used to calculate EA. Correlations were used to examine associations between EA and RMR, BMD, stress fractures and reproductive, metabolic and bone biomarkers. Mean EA was 28.7±13.4 kcal/kg fat free mass (FFM), which categorized our sample as low EA (based upon published criterion, < 30 kcal/kg FFM) and at a high risk for RED-S. Hormonal and bone biomarkers were in normal clinical ranges, even though EA was low. The only interesting significant association was EA being negatively associated with total body BMD (r = -0.360, P =0.005), opposite of expectations. On average our subjects displayed a state of low EA based upon the criterion which has been primarily developed from female-based research. Nonetheless, our participants displayed no major hormonal or bone health disturbances found in athletes diagnosed with RED-S. A value of < 30 kcal/kg FFM to diagnose low EA may not be appropriate for non-elite endurance trained men.
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Amy R Lane, Anthony C Hackney, Abbie E Smith-Ryan, Kristen Kucera, Johna K Register-Mihalik, Kristin Ondrak
Relative Energy Deficiency in Sport (RED-S) is predicated on the assumption that low energy availability (EA) induces deficiencies-dysfunction in multiple physiologic systems. However, research on RED-S and EA in male athletes is limited in comparison to women. The aim of this study is to investigate EA and the risk factors for RED-S, and their potential associations in non-elite male endurance athletes. Laboratory assessments for resting metabolic rate (RMR), bone mineral density (BMD), blood hormonal biomarkers and maximal aerobic capacity were conducted on 60 competitive, recreationally trained male endurance athletes (age=43.4±11.6 years [mean±SD], training=10.9±2.7 h/wk, 7.1±8.8 years). Participants provided 7-days of training logs and 4-days of diet records. Diet and training records were used to calculate EA. Correlations were used to examine associations between EA and RMR, BMD, stress fractures and reproductive, metabolic and bone biomarkers. Mean EA was 28.7±13.4 kcal/kg fat free mass (FFM), which categorized our sample as low EA (based upon published criterion, < 30 kcal/kg FFM) and at a high risk for RED-S. Hormonal and bone biomarkers were in normal clinical ranges, even though EA was low. The only interesting significant association was EA being negatively associated with total body BMD (r = -0.360, P =0.005), opposite of expectations. On average our subjects displayed a state of low EA based upon the criterion which has been primarily developed from female-based research. Nonetheless, our participants displayed no major hormonal or bone health disturbances found in athletes diagnosed with RED-S. A value of < 30 kcal/kg FFM to diagnose low EA may not be appropriate for non-elite endurance trained men.
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