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Aim To examine the effect of walking before dinner on 24-h glycemic control in individuals with type 2 diabetes using the standardized multi-site Exercise-Physical Activity and Diabetes Glucose Monitoring (E-PAraDiGM) Protocol. Methods Eighty participants were studied under two conditions (exercise vs. non-exercise control) separated by 72 h in a randomized crossover design. Each condition lasted 2 days during which standardized meals were provided. Exercise consisted of 50 min of treadmill walking at 5.0 km/h before the evening meal, while control involved 50 min of sitting. The primary outcome measure was mean glucose during the 24-h period following exercise (or sitting) measured by continuous glucose monitoring. Results Of the 80 participants who were initially randomized, 73 completed both exercise and control. Sixty-three participants [29 males, 34 females; age = 64 ± 8 years, body mass index = 30.5 ± 6.5 kg/m2 and HbA1c = 51 ± 8 mmol/mol (6.8 ± 0.7%), mean ± SD] complied with the standardized diets and had complete continuous glucose monitoring data. Exercise did not affect mean 24-h glucose compared to control (0.03 mmol/L; 95% CI − 0.17, 0.22, P = 0.778) but individual differences between conditions ranged from − 2.8 to +1.8 mmol/L. Exercise did not affect fasting glucose, postprandial glucose or glucose variability. Glucose concentrations measured by continuous glucose monitoring were reduced during the 50 min of walking in exercise compared to sitting in control (− 1.56 mmol/L; 95% CI − 2.18, − 0.95, p ˂ 0.001). Conclusion Contrary to previous acute exercise studies, 50 min of walking before dinner in the E-PAraDiGM protocol did not affect 24-h glucose profiles. However, highly heterogeneous responses to exercise were observed.

To verify the efficacy of phytoestrogen supplementation combined with aerobic and resistance training on the improvement of climacteric symptoms and health-related quality of life (HRQoL) in postmenopausal women.From a pool of women who had participated in a 1-year intervention study and were randomly assigned to either exercise + phytoestrogen (EX + PHY) or exercise + placebo (EX + PL), a total of 31 healthy but overweight women (mean age 59.2 ± 4.8 years, body mass index 29.1 ± 3.5 kg/mAfter 1 year of intervention, physical functioning (p = 0.003), role-emotional (p = 0.031), vitality (p = 0.007), and global health (p 0.001) were significantly and similarly increased in both groups. Regarding climacteric symptoms, an improvement in the Kupperman index total score (p = 0.015) was observed.Our results demonstrate that adding phytoestrogens to exercise training does not provide the additive effect for HRQoL in postmenopausal and overweight women. Moreover, exercise and phytoestrogen may interfere in the improvement of climacteric symptoms in the long term.

Cancer-related fatigue (CRF) is a major issue in older cancer patients as it is associated with functional decline and a lower quality of life, and an increased inflammatory activity during cancer therapy is suspected to play a key role in CRF etiology. Combined aerobic and resistance exercise training is known to reduce CRF, and this could be mediated by a protective effect against this increased inflammatory activity. Hence, the main objective was to measure the effect of a 12-week combined exercise training on the inflammatory profile of older cancer patients undergoing systemic therapy. A secondary objective was to verify if there was an association between inflammatory profile and CRF. Methods Twenty older non-metastatic cancer patients initiating chemotherapy and/or hormone therapy were randomly assigned to 12 weeks of supervised, combined exercise or a control group (static stretching). Primary outcomes were the inflammatory profile, Indoleamine 2,3-deoxygenase activity (KYN/TRP ratio), and CRF (FACIT-F questionnaire). Control outcomes were the fasting nutritional and hormonal blood profiles, body composition (iDXA), physical activity habits (PASE questionnaire), nutritional habits (3-day log), and treatment-related variables. Results No worsening of the inflammatory profile was observed in both arms of the study after the intervention. No significant change in CRF was observed, although there was a trend for a reduction in the experimental group (p ​= ​0.10). Significant correlations were found at both timepoints between the KYN/TRP ratio and the delay with the previous treatment received (p ​≤ ​0.03). Conclusion These results suggest that exercise might have elicited a positive effect on CRF, which was not mediated by the modulation of the pro-inflammatory cytokine profile. However, the decrease in IL-6/IL-10 ratio in the exercise group might reflect a possible anti-inflammatory effect of exercise. Moreover, exploratory analyses suggest that an acute effect of chemotherapy treatments influenced the inflammatory profile measurements, which could explain the absence of change in the fasting inflammatory profile., Highlights • We studied the anti-inflammatory effect of exercise in older cancer patients undergoing chemotherapy. • Exercise could alter the ratio of anti-to pro-inflammatory markers during chemotherapy. • Chemotherapy might induce acute inflammatory peaks in the week following treatment. • We propose that exercise could interact acutely with these pro-inflammatory peaks.

Background: It was reported that cow’s milk-based supplementation after resistance training reduced fat mass in older men. The reasons behind this beneficial impact remain to be elucidated. Hence, the aim of this study was to determine the effect of a cow’s milk-based supplementation after resistance exercise on lipid oxidation and systemic fat mobilization in older men. Methods: Older men (age range: 60–75 years) participated in a randomized, double-blind, crossover study with the two following conditions: (1) Resistance exercise + Cow’s milk (C-milk) and (2) Resistance exercise + Rice milk (R-milk; isocaloric control). During a 180-min post-exercise period, energy expenditure, substrate oxidation (indirect calorimetry), plasma levels of glycerol (systemic fat mobilization) and free fatty acids (FFA) were measured. Results: During the 180-min post-exercise period, lipid oxidation remained similar in both conditions. Glycerol levels decreased similarly in C-milk and R-milk (p ≤ 0.045). Although FFA levels increased progressively from 60 min to 180 min post-exercise in both conditions, the magnitude of changes (∆) was greater in C-milk condition between 60 and 120 min post-exercise (p < 0.018). Conclusions: These results do not support a large impact of cow’s milk supplementation after resistance exercise on lipid oxidation and systemic fat mobilization. However, the greater increase in FFA levels suggests that re-esterification may be influenced.

Background: Kinesiophobia, the fear that movement and physical activity could worsen side effects such as fatigue and pain, is a barrier to exercise in cancer patients. Physical inactivity and deconditioning can lead to functional decline, higher mortality risk and lower quality of life, in older adults, and even more in oncogeriatrics because of a lower physical activity level during cancer treatments. The case: We present the case of an older breast cancer patient recruited in a controlled exercise trial and randomized to the control arm of the study (a 12-week supervised static stretching program). She expressed fear that physical activity might exacerbate some of her cancer-related symptoms during baseline physical capacity assessment (Senior Fitness Test, handgrip strength and maximal lower body strength). After completing the 12-week supervised static stretching program, she exhibited similar and/or larger improvements in many of the physical capacity tests than the mixed exercise intervention group, despite being in the control arm. Conclusions: These observations and physical capacity results have led us to emit the hypothesis that (1) this participant’s baseline physical capacity assessment might have been biased by kinesiophobia and (2) the supervision by exercise physiologist might have mitigated this fear over time. Hence, based on this case, we suggest that kinesiophobia should be measured in future exercise trials and clinical interventions targeting older cancer patients.

Aging, cancer and its treatment all contribute to increase the risk of deconditioning and sedentary behaviors. Mixed exercise is recognized to counteract the effects of aging and deconditioning as well as improving physical capacity during cancer treatment in adults. To determine the impact of a mixed exercise program (MXEP) to improve physical capacity and decrease sedentary behavior time (SBT) in older adults during cancer treatment. Fourteen participants (68.8 ± 3.4 years) completed 12 weeks of a mixed exercise program (MEXP) (n = 6) or stretching (n = 8) while they were under cancer treatment. Five tests of the Senior Fitness Test (Chair Stand, 8-Foot Up & Go, Arm Curl, Sit & Reach, 6 min Walk Test), two maximal strength tests (leg press and handgrip) and a Global Physical Capacity Score (GPCS) were used to assess physical capacity. For the amount of SBT (min/day), we used question 1 of the Physical Activity Scale for the Elderly. Both groups presented significant pre- vs post-intervention differences for the Chair Stand, Arm Curl, 6 min Walk Tests and also GPCS. Nevertheless, this difference was significantly greater in the MEXP group only for the Chair Stand Test (4.3 ± 2.2 vs 1.0 ± 1.3 reps; p = 0.01) and the GPCS (4.0 ± 0.6 vs 1.5 ± 2.3 points; p = 0.047). A tend to display a greater decrease in SBT (− 295 ± 241 min/week vs − 11 ± 290 min/week; p = 0.079) was observed in favor of MEXP. A 12-week mixed exercise program led to significant improvements in physical capacity and may reduce SBT.

Despite the high prevalence of cancer in the elderly, there is no strong evidence regarding the efficacy of exercise training for reducing debilitating effect of cancer-related fatigue (CRF) and improving quality of life (QoL) in the oncogeriatric population. Hence, the objective of our study is to determine the impact of combined aerobic and resistance training on CRF and QoL in older adults undergoing cancer treatment. A total of 40 older adults (65–80 years) with an ongoing treatment for a curable cancer will be recruited and randomised in two groups: 1) combined training (EX, n=20) and 2) control group (CON, n=20). All variables will be measured before and after 12 weeks of intervention: CRF (FACIT-Fatigue), QoL (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire), physical capacity (Senior Fitness Test) and body composition (fat and lean body mass, DXA). Our preliminary results show that 12 weeks of mixed exercise training alleviated CRF (ΔEX: -5 vs. ΔCON: -15) and the deterioration of global QoL (ΔEX: -16.7; ΔCON: -41.7). Physical functioning remained stable (ΔEX: 0 vs. ΔCON: -20) and cognitive functioning improved (ΔEX: 33.3 vs. ΔCON: 0), both in EX group only. Finally, lean body mass (ΔEX: +0.5 kg; ΔCON: -3.0 kg) and physical capacity improved in EX while it declined in CON. To conclude, our preliminary results show that combined training is feasible and have a positive impact on CRF and physical capacity. Furthermore, our intervention mitigated the reduction of QoL in older adults undergoing cancer therapy.