Exercise as an intervention to improve metabolic outcomes after intrauterine growth restriction

Kathryn L. Gatford, Gunveen Kaur, Filippe Falcão-Tebas, Glenn D. Wadley, Mary E. Wlodek, Rhianna C. Laker, Peter R. Ebeling, Glenn K. McConell

Research output: Contribution to journalReview ArticleResearchpeer-review

16 Citations (Scopus)

Abstract

Individuals born after intrauterine growth restriction (IUGR) are at an increased risk of developing diabetes in their adult life. IUGR impairs β-cell function and reduces β-cell mass thereby diminishing insulin secretion. IUGR also induces insulin resistance, with impaired insulin signaling in muscle in adult humans who were small for gestational age (SGA) and in rodent models of IUGR. There is epidemiological evidence in humans that exercise in adults can reduce the risk of metabolic disease following IUGR. However, it is not clear whether adult IUGR individuals benefit to the same extent from exercise as do normal birth weight individuals, as our rat studies suggest less of a benefit in those born IUGR. Importantly, however, there is some evidence from studies in rats that exercise in early life might be able to reverse or reprogram the long-term metabolic effects of IUGR. Studies are needed to address gaps in current knowledge, including determining the mechanisms involved in the reprogramming effects of early exercise in rats, whether exercise early in life or in adulthood has similar beneficial metabolic effects in larger animal models in which insulin resistance develops after IUGR. Human studies are also needed to determine whether exercise training improves insulin secretion and insulin sensitivity to the same extent in IUGR adults as in as control populations. Such investigations will have implications for customising the recommended level and timing of exercise to improve metabolic health after IUGR.

Original languageEnglish
Pages (from-to)E999-E1012
Number of pages14
JournalAmerican Journal of Physiology - Endocrinology and Metabolism
Volume306
Issue number9
DOIs
Publication statusPublished - 1 May 2014
Externally publishedYes

Keywords

  • Glucose tolerance
  • Insulin secretion
  • Insulin sensitivity
  • IUGR
  • Physical activity
  • Training
  • β-cells

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