{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T05:25:55Z","timestamp":1769837155954,"version":"3.49.0"},"reference-count":75,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,5,26]],"date-time":"2024-05-26T00:00:00Z","timestamp":1716681600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Foundation for Science and Technology","award":["2020.06520.BD"],"award-info":[{"award-number":["2020.06520.BD"]}]},{"name":"Foundation for Science and Technology","award":["FCT\/UIDB\/00617\/2020"],"award-info":[{"award-number":["FCT\/UIDB\/00617\/2020"]}]},{"name":"Foundation for Science and Technology","award":["LA\/P\/0064\/2020"],"award-info":[{"award-number":["LA\/P\/0064\/2020"]}]}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Nutrients"],"abstract":"<jats:p>In an increasingly aging and overweight population, osteoporosis and type 2 diabetes (T2DM) are major public health concerns. T2DM patients experience prejudicial effects on their bone health, affecting their physical capacity. Exercise in hypoxia (EH) and a low-carbohydrate diet (LCD) have been suggested for therapeutic benefits in T2DM, improving bone mineral content (BMC) and glycemic control. This study investigated the effects of EH combined with an LCD on body composition and functional and physiologic capacity in T2DM patients. Older T2DM patients (n = 42) were randomly assigned to the following groups: (1) control group: control diet + exercise in normoxia; (2) EH group: control diet + EH; (3) intervention group: LCD + EH. Cardiopulmonary tests (BRUCE protocol), body composition (DEXA), and functional capacity (6MWT, handgrip strength) were evaluated. Body mass index (kg\/m2) and body fat (%) decreased in all groups (p &lt; 0.001). BMC (kg) increased in all groups (p &lt; 0.001) and was significantly higher in the EH and EH + LCD groups (p &lt; 0.001). VO2peak improved in all groups (p &lt; 0.001), but more so in the hypoxia groups (p = 0.019). Functional capacity was increased in all groups (p &lt; 0.001), but more so in the EH group in 6MWT (p = 0.030). EH with and without an LCD is a therapeutic strategy for improving bone mass in T2DM, which is associated with cardiorespiratory and functional improvements.<\/jats:p>","DOI":"10.3390\/nu16111624","type":"journal-article","created":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T05:14:02Z","timestamp":1716786842000},"page":"1624","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Eight Weeks of Intermittent Exercise in Hypoxia, with or without a Low-Carbohydrate Diet, Improves Bone Mass and Functional and Physiological Capacity in Older Adults with Type 2 Diabetes"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2720-0603","authenticated-orcid":false,"given":"Raquel","family":"Kindlovits","sequence":"first","affiliation":[{"name":"Faculty of Nutrition and Food Sciences, University of Porto, FCNAUP, 4150-180 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7790-732X","authenticated-orcid":false,"given":"Ana Catarina","family":"Sousa","sequence":"additional","affiliation":[{"name":"Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, 4475-690 Maia, Portugal"}]},{"given":"Jo\u00e3o Lu\u00eds","family":"Viana","sequence":"additional","affiliation":[{"name":"Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, 4475-690 Maia, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7393-0599","authenticated-orcid":false,"given":"Jaime","family":"Milheiro","sequence":"additional","affiliation":[{"name":"CMEP, Exercise Medical Centre Laboratory, 4150-044 Porto, Portugal"},{"name":"Centre of Research, Education, Innovation and Intervention in Sport, CIFI2D, Faculty of Sport, University of Porto, 4200-540 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7710-4284","authenticated-orcid":false,"given":"Bruno M. P. M.","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition and Food Sciences, University of Porto, FCNAUP, 4150-180 Porto, Portugal"},{"name":"Laboratory of Artificial Intelligence and Decision Support, Institute for Systems and Computer Engineering, Technology and Science (LIAAD, INESC-TEC), 4200-465 Porto, Portugal"}]},{"given":"Franklim","family":"Marques","sequence":"additional","affiliation":[{"name":"Laboratory of Biochemistry, Department of Biological Sciences, UCIBIO, REQUIMTE, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0706-5301","authenticated-orcid":false,"given":"Alejandro","family":"Santos","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition and Food Sciences, University of Porto, FCNAUP, 4150-180 Porto, Portugal"},{"name":"Institute for Research and Innovation in Health, i3S, 4200-135 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9286-4716","authenticated-orcid":false,"given":"Vitor Hugo","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition and Food Sciences, University of Porto, FCNAUP, 4150-180 Porto, Portugal"},{"name":"Research Center in Physical Activity, Health and Leisure, CIAFEL, Faculty of Sports, University of Porto, FADEUP, 4200-540 Porto, Portugal"},{"name":"Laboratory for Integrative and Translational Research in Population Health, ITR, 4050-600 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,26]]},"reference":[{"key":"ref_1","unstructured":"Magliano, D.J., and Boyko, E.J. 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