There is clear evidence regarding the health benefits of physical activity. These benefits follow a dose-response relationship with a particular respect to exercise intensity. Guidelines for exercise testing and prescription have been established to provide optimal standards for exercise training. A wide range of intensities is used to prescribe exercise, but this approach is limited. Usually percentages of maximal oxygen uptake (VO₂) or heart rate (HR) are applied to set exercise training intensity but this approach yields substantially variable metabolic and cardiocirculatory responses. Heterogeneous acute responses and training effects are explained by the nonuniform heart rate performance curve during incremental exercise which significantly alters the calculations of %HR_maxand %HRR target HR data. Similar limitations hold true for using %VO_2maxand %VO₂R. The solution of these shortcomings is to strictly apply objective submaximal markers such as thresholds or turn points and to tailor exercise training within defined regions.

The regulation of endurance training is usually based on the prescription of exercise intensity. Exercise duration, another important variable of training load, is rarely prescribed by individual measures and mostly set from experience. As the specific exercise duration for any intensity plays a substantial role regarding the different kind of cellular stressors, degree and kind of fatigue as well as training effects, concepts integrating the prescription of both intensity and duration within one model are needed. An according recent approach was the critical power concept which seems to have a physiological basis; however, the mathematical approach of this concept does not allow applying the three zones / two threshold model of metabolism and its different physiological consequences. Here we show the combination of exercise intensity and duration prescription on an individual basis applying the power/speed to distance/time relationship. The concept is based on both the differentiation of intensities by two lactate or gas exchange variables derived turn points, and on the relationship between power (or velocity) and duration (or distance). The turn points define three zones of intensities with distinct acute metabolic, hormonal and cardio-respiratory responses for endurance exercise. A maximal duration exists for any single power or velocity such as described in the power-duration relationship. Using percentages of the maximal duration allows regulating fatigue, recovery time and adaptation for any single endurance training session. Four domains of duration with respect to induced fatigue can be derived from maximal duration obtained by the power-duration curve. For any micro-cycle, target intensities and durations may be chosen on an individual basis. The model described here is the first conceptual framework of integrating physiologically defined intensities and fatigue related durations to optimize high-performance exercise training.

Continuous exercise (CON) and high-intensity interval exercise (HIIE) can be safely performed with type 1 diabetes mellitus (T1DM). Additionally, continuous glucose monitoring (CGM) systems may serve as a tool to reduce the risk of exercise-induced hypoglycemia. It is unclear if CGM is accurate during CON and HIIE at different mean workloads. Seven T1DM patients performed CON and HIIE at 5% below (L) and above (M) the first lactate turn point (LTP₁), and 5% below the second lactate turn point (LTP₂) (H) on a cycle ergometer. Glucose was measured via CGM and in capillary blood (BG). Differences were found in comparison of CGM vs. BG in three out of the six tests (p < 0.05). In CON, bias and levels of agreement for L, M, and H were found at: 0.85 (−3.44, 5.15) mmol·L⁻¹, −0.45 (−3.95, 3.05) mmol·L⁻¹, −0.31 (−8.83, 8.20) mmol·L⁻¹ and at 1.17 (−2.06, 4.40) mmol·L⁻¹, 0.11 (−5.79, 6.01) mmol·L⁻¹, 1.48 (−2.60, 5.57) mmol·L⁻¹ in HIIE for the same intensities. Clinically-acceptable results (except for CON H) were found. CGM estimated BG to be clinically acceptable, except for CON H. Additionally, using CGM may increase avoidance of exercise-induced hypoglycemia, but usual BG control should be performed during intense exercise.

There is ample evidence that regular moderate to vigorous aerobic physical activity is related to a reduced risk for various forms of cancer to suggest a causal relationship. Exercise is associated with positive changes in fitness, body composition, and physical functioning as well as in patient-reported outcomes such as fatigue, sleep quality, or health-related quality of life. Emerging evidence indicates that exercise may also be directly linked to the control of tumour biology through direct effects on tumour-intrinsic factors. Beside a multitude of effects of exercise on the human body, one underscored effect of exercise training is to target the specific metabolism of tumour cells, namely the Warburg-type highly glycolytic metabolism. Tumour metabolism as well as the tumour–host interaction may be selectively influenced by single bouts as well as regularly applied exercise, dependent on exercise intensity, duration, frequency and mode. High-intensity anaerobic exercise was shown to inhibit glycolysis and some studies in animals showed that effects on tumour growth might be stronger compared with moderate-intensity aerobic exercise. High-intensity exercise was shown to be safe in patients; however, it has to be applied carefully with an individualized prescription of exercise.

: ype 1 diabetes is characterized by an autoimmune β-cell destruction resulting in endogenous insulin deficiency, potentially leading to micro- and macrovascular complications. Besides an exogenous insulin therapy and continuous glucose monitoring, physical exercise is recommended in adults with type 1 diabetes to improve overall health. The close relationship between physical exercise, inflammation, muscle contraction, and macronutrient intake has never been discussed in detail about type 1 diabetes. The aim of this narrative review was to detail the role of physical exercise in improving clinical outcomes, physiological responses to exercise and different nutrition and therapy strategies around exercise. : Physical exercise has several positive effects on glucose uptake and systemic inflammation in adults with type 1 diabetes. A new approach via personalized therapy adaptations must be applied to target beneficial effects on complications as well as on body weight management. In combination with pre-defined macronutrient intake around exercise, adults with type 1 diabetes can expect similar physiological responses to physical exercise, as seen in their healthy counterparts. : This review highlights interesting findings from recent studies related to exercise and type 1 diabetes. However, there is limited research available accompanied by a proper number of participants in the cohort of type 1 diabetes. Especially for this group of patients, an increased understanding of the impact of physical exercise can improve its effectiveness as an adjuvant therapy to move (forward).