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      Exercise Improves Cognitive Function—A Randomized Trial on the Effects of Physical Activity on Cognition in Type 2 Diabetes Patients

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          Abstract

          Background: Lifestyle habits strongly influence health. It is strongly believed that physical activity may improve cognitive function. We examined the association between two kinds of physical activity and cognitive function in patients with type 2 diabetes. Methods: Using a random allocation sequence, 49 patients with type 2 diabetes (metformin, insulin, and diet-controlled) were randomized to a 12-week intervention of either walking 40 min three times a week ( n = 17), performing pedometer-controlled activity (E-health, goal 10,000 steps a day, n = 17), or receiving standard care ( n = 16 controls). We prospectively examined cognitive function, metabolic parameters, height, and weight. The groups were compared using linear regression adjusted for age. Results: Compared with the control group ( n = 16), nonverbal memory improved significantly after the intervention in the walking group ( n = 16) (28.2 (+/−6.1) vs. 35.3 (+/−5.3) p < 0.001) and the E-health (pedometer) group (( n = 17) (29.7 (+/−3.9) vs. 35.6 (+/−3.8) p < 0.001). The verbal memory test showed improvement in the walking and E-health groups. Cognitive attention/performance measured by the FAIR-test was also significantly enhanced in the walking group (252.4/304.3 p < 0.001, 51.87 (CI 27.13–76.62)) and the E-health-group (85.65 (CI: 52.04–119.26, p < 0.001)). Abdominal circumference (−3 cm (CI: −9.69–3.31, p < 0.001)), heart rate (−6.50 (CI: −9.69, −3.31, p < 0.001)) and fat percentage (−2.74 (CI: −4.71, −0.76, p < 0.007)) changed significantly in only the walking group. Conclusions: This is the first intervention study in patients with type 2 diabetes that shows that pedometer-supported training significantly improves brain function. Walking additionally improves body composition and waist circumference. Physical activity is an inexpensive treatment with substantial preventative and restorative properties for cognitive and memory brain function in patients with type 2 diabetes.

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          Global estimates of diabetes prevalence for 2013 and projections for 2035.

          Diabetes is a serious and increasing global health burden and estimates of prevalence are essential for appropriate allocation of resources and monitoring of trends. We conducted a literature search of studies reporting the age-specific prevalence for diabetes and used the Analytic Hierarchy Process to systematically select studies to generate estimates for 219 countries and territories. Estimates for countries without available source data were modelled from pooled estimates of countries that were similar in regard to geography, ethnicity, and economic development. Logistic regression was applied to generate smoothed age-specific prevalence estimates for adults 20-79 years which were then applied to population estimates for 2013 and 2035. A total of 744 data sources were considered and 174 included, representing 130 countries. In 2013, 382 million people had diabetes; this number is expected to rise to 592 million by 2035. Most people with diabetes live in low- and middle-income countries and these will experience the greatest increase in cases of diabetes over the next 22 years. The new estimates of diabetes in adults confirm the large burden of diabetes, especially in developing countries. Estimates will be updated annually including the most recent, high-quality data available. Copyright © 2013. Published by Elsevier Ireland Ltd.
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            Exercise, cognition, and the aging brain.

            We provide a brief review of the literature on exercise effects on brain and cognition. To this end, we focus on both prospective and retrospective human epidemiological studies that have examined the influence of exercise and physical activity on cognition and dementia. We then examine the relatively small set of human randomized clinical trials that have, for the most part, focused on exercise training effects on cognition. Next, we discuss animal research that has examined the molecular, cellular, and behavioral effects of exercise training. Finally, we conclude with a summary and brief discussion of important future directions of research on fitness cognition and brain.
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              Exercise is the real polypill.

              The concept of a "polypill" is receiving growing attention to prevent cardiovascular disease. Yet similar if not overall higher benefits are achievable with regular exercise, a drug-free intervention for which our genome has been haped over evolution. Compared with drugs, exercise is available at low cost and relatively free of adverse effects. We summarize epidemiological evidence on the preventive/therapeutic benefits of exercise and on the main biological mediators involved.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                J Pers Med
                J Pers Med
                jpm
                Journal of Personalized Medicine
                MDPI
                2075-4426
                09 June 2021
                June 2021
                : 11
                : 6
                Affiliations
                [1 ]Department of Cardiology, Prevention and Sports Medicine, Faculty of Health, School of Medicine, University Witten/Herdecke, 58095 Hagen, Germany; katharina.schwarz@ 123456pinshof.de (K.S.); patrick.bank@ 123456rub.de (P.B.); B.Dworrak@ 123456gmx.de (B.D.); markus.strauss@ 123456uni-wh.de (M.S.); h.littwitz@ 123456gmx.de (H.L.); ceegerlach@ 123456googlemail.com (C.E.G.)
                [2 ]Department of Physiotherapy, Chair of Physiotherapy, School of Health Sciences, Medical University of Silesia, 40-007 Katowice, Poland; aniabrzek@ 123456interia.pl
                [3 ]Department of Cardiology I—Coronary and Peripheral Vascular Disease, Heart Failure Medicine, University Hospital Muenster, Cardiol, 48149 Muenster, Germany
                Author notes
                Article
                jpm-11-00530
                10.3390/jpm11060530
                8229798
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

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