PHYMEDEXP, Université de Montpellier, CNRS, INSERM, CHU de Montpellier, 34295 Montpellier, France.
IBMM, Université de Montpellier, CNRS, CHU de Montpellier, 34090 Montpellier, France.
Nutrients. 2022 Apr 12;14(8):1605. doi: 10.3390/nu14081605.
Recent literature shows that exercise is not simply a way to generate a calorie deficit as an add-on to restrictive diets but exerts powerful additional biological effects via its impact on mitochondrial function, the release of chemical messengers induced by muscular activity, and its ability to reverse epigenetic alterations. This review aims to summarize the current literature dealing with the hypothesis that some of these effects of exercise unexplained by an energy deficit are related to the balance of substrates used as fuel by the exercising muscle. This balance of substrates can be measured with reliable techniques, which provide information about metabolic disturbances associated with sedentarity and obesity, as well as adaptations of fuel metabolism in trained individuals. The exercise intensity that elicits maximal oxidation of lipids, termed LIPOXmax, FATOXmax, or FATmax, provides a marker of the mitochondrial ability to oxidize fatty acids and predicts how much fat will be oxidized over 45-60 min of low- to moderate-intensity training performed at the corresponding intensity. LIPOXmax is a reproducible parameter that can be modified by many physiological and lifestyle influences (exercise, diet, gender, age, hormones such as catecholamines, and the growth hormone-Insulin-like growth factor I axis). Individuals told to select an exercise intensity to maintain for 45 min or more spontaneously select a level close to this intensity. There is increasing evidence that training targeted at this level is efficient for reducing fat mass, sparing muscle mass, increasing the ability to oxidize lipids during exercise, lowering blood pressure and low-grade inflammation, improving insulin secretion and insulin sensitivity, reducing blood glucose and HbA in type 2 diabetes, and decreasing the circulating cholesterol level. Training protocols based on this concept are easy to implement and accept in very sedentary patients and have shown an unexpected efficacy over the long term. They also represent a useful add-on to bariatric surgery in order to maintain and improve its weight-lowering effect. Additional studies are required to confirm and more precisely analyze the determinants of LIPOXmax and the long-term effects of training at this level on body composition, metabolism, and health.
最近的文献表明，运动不仅仅是作为限制饮食的附加手段来产生热量不足，它还通过影响线粒体功能、肌肉活动诱导的化学信使释放以及逆转表观遗传改变来产生强大的额外生物学效应。本综述旨在总结目前关于以下假设的文献：运动的一些无法用能量不足来解释的效应与作为运动肌肉燃料的底物平衡有关。这种底物平衡可以通过可靠的技术来测量，这些技术提供了与久坐不动和肥胖相关的代谢紊乱以及训练个体中燃料代谢适应的信息。最大程度地氧化脂肪的运动强度称为 LIPOXmax、FATOXmax 或 FATmax，它提供了一个衡量线粒体氧化脂肪酸能力的标志物，并预测在相应强度下进行 45-60 分钟的低至中等强度训练中会氧化多少脂肪。LIPOXmax 是一个可重复的参数，它可以通过许多生理和生活方式的影响（运动、饮食、性别、年龄、儿茶酚胺等激素以及生长激素-胰岛素样生长因子 I 轴）来改变。让人们选择一个要维持 45 分钟或更长时间的运动强度，他们会自发地选择接近这个强度的水平。越来越多的证据表明，针对这个水平的训练对于减少脂肪量、保持肌肉量、增加运动中氧化脂肪的能力、降低血压和低度炎症、改善胰岛素分泌和胰岛素敏感性、降低 2 型糖尿病患者的血糖和 HbA 以及降低循环胆固醇水平是有效的。基于这个概念的训练方案易于在非常久坐不动的患者中实施和接受，并在长期内显示出意想不到的效果。它们还可以作为减重手术的有益附加手段，以维持和提高其减肥效果。需要进一步的研究来确认和更精确地分析 LIPOXmax 的决定因素以及在这个水平上训练对身体成分、代谢和健康的长期影响。
