U. of I. trial will test if exercise can improve protein efficiency for older adults with type 2 diabetes



From left: University of Illinois Professor Nick Burd, postdoc Mikaela Kasperek, Ph.D. student Gena Irwin, and Associate Professor Jacob Allen pose inside Freer Hall’s gym, where their labs will train participants in a 12-week exercise program for a clinical trial.

For healthy adults, roughly .8 grams of protein per kilogram of bodyweight per day is enough to maintain muscle mass and support daily function.

But for adults with type 2 diabetes, an estimated 1 in 10 adults in the United States, their protein requirements remain relatively undefined, but are believed to be elevated when compared to their non-diabetic counterparts. Especially as diabetic individuals age, their bodies often become more anabolic resistant: less responsive to the muscle-building effects of exercise and protein intake.

Researchers from the Department of Health and Kinesiology at the University of Illinois Urbana-Champaign are recruiting participants for a human clinical trial to understand the protein needs of older adults with type 2 diabetes, and whether regular exercise can help their bodies use protein more efficiently.

“The problem with current strategies for type 2 diabetes is they largely try to keep throwing protein in people’s diets: eat more, eat more, eat more,” HK Professor Nicholas Burd said.  

Piling on the protein could have detrimental effects. There’s evidence that circulating amino acids, including branch chain amino acids that promote muscle mass, are associated with poorer outcomes for people with diabetes, said HK Associate Professor Jacob Allen.

Their upcoming study, “Exercise impact on dietary protein efficiency in older adults with type 2 diabetes,” is funded by a grant from the American Diabetes Association. The principal investigators are Burd, who researches protein metabolism, and Allen, who studies how exercise and nutrition impact the gut microbiome.

Health and Kinesiology professors Jack Senefeld and Steve Petruzzello are co-investigators on the study.

HK Assistant Professor Jack Senefeld and Professor Steve Petruzzello are co-investigators on the study, bringing expertise on training diabetic individuals and psychological well-being during exercise. Ph.D. candidate Gena Irwin and postdoc Mikaela Kasperek will lead the work from the Burd’s Exercise Performance Lab and Allen’s Integrative Microbiota Physiology labs respectively.

Starting this fall, the researchers will recruit 30 older adults to participate in this study—15 individuals living with type 2 diabetes and 15 without—and bring them into Freer Hall’s gym for a 12-week fitness program that mixes weight training with endurance exercise.

The researchers will use sensitive tools in their labs to figure out how efficiently participants’ bodies utilize protein, and whether that efficiency varies for older adults with and without diabetes. After participants wrap the exercise program, the team will test whether resistance training improved their bodies’ usage of protein overall, lessening their daily protein needs.

“To make an older person’s muscles more youthful, you can exercise them,” Burd said. “But we don’t know how the gut’s being impacted, and we don’t know how type 2 diabetes interferes with some of the ‘youthfulness’ effects of exercise.”

Some of our dietary protein ends up in our skeletal muscle, through muscle-protein synthesis, and some of it is used for energy. But there’s a “black box” around where the rest of our protein goes in the body, Allen said.

“We think that the microbes in the gut, the gut microbiome, might be responsible for some of this, but this has never been studied,” Allen said. “We’ve run some pilot work that fueled part of this study, where we can show that indeed, ingested amino acids are converted into these microbial metabolites.”

Why might that matter? Some of these metabolites are important for human health overall, Allen said. For example, short chain fatty acids—the byproducts of dietary fiber being processed in our gut—bring a host of benefits for metabolism and the immune system.

The research teams will host intervention days at the beginning and end of the 12-week exercise program, to see how participants’ bodies are using the protein in their muscle and gut.

Participants will consume amino acids labeled with stable isotope tracers. The labs will collect breath samples to see how much of the labeled amino acid is showing up in the breath—if more of that labeled protein appears in participants’ breath, their bodies aren’t as good at incorporating it into muscle.

Blood samples will help the scientists understand how the gut is taking those amino acids and converting them into potentially beneficial metabolites.

The second intervention day at the end of the trial will determine whether an exercise program changed the way participants’ bodies use protein.

“There are very few labs in the U.S that not only have the expertise, but have the infrastructure to be able to do this kind of work, so we’re very fortunate for Illinois and our department,” Burd said. “Stable isotope tracers require expensive machines to analyze.”

What’s in it for participants? On top of helping the scientists form dietary guidelines for older adults with type 2 diabetes, they’ll receive progressive exercise training from expert students and faculty at the college, that will hopefully serve them well beyond their last visit.

“A big goal is to change behavior, too, to make them healthier,” Allen said. “That’s ultimately what we’re trying to do.”

Editor’s note:

Interested in participating in this study? Take the survey to see if you qualify, or email the organizers at HK-ADA-Study@illinois.edu

To reach Nick Burd, email naburd@illinois.edu
To reach Jacob Allen, email jmallen5@illinois.edu

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