Effects of Different Exercise Strategies to Improve Postprandial Glycemia in Healthy Individuals

Bellini, Alessio; Nicolò, Andrea; Bazzucchi, Ilenia; Sacchetti, Massimo

doi:10.1249/mss.0000000000002607

Cited by 18 publications

(57 citation statements)

References 42 publications

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“…An accumulating body of evidence now suggests that postprandial glucose (PPG) is more closely correlated with microvascular and macrovascular morbidities and cardiovascular mortality than hemoglobin A1c (HbA1c) or fasting glucose [ 3 – 5 ]. The role of exercise in reducing PPG levels [ 6 , 7 ] and improving glycemic control and overall health [ 8 – 10 ] in diabetic, as well as in healthy, populations has been well established [ 11 , 12 ]. However, how and when aerobic exercise should be prescribed to optimize glucose control remains controversial [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

The Effects of Accumulated Versus Continuous Exercise on Postprandial Glycemia, Insulin, and Triglycerides in Adults with or Without Diabetes: A Systematic Review and Meta-Analysis

Zhang

Zheng

et al. 2022

Sports Med - Open

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Background Postprandial dysmetabolism, an important cardiovascular disease risk factor, can be improved by exercise. Further systematic review and meta-analysis is needed to compare the effects of accumulated exercise with a single session of energy-matched continuous exercise on postprandial glucose (PPG), insulin, and triglycerides in adults with or without diabetes. Methods Eight electronic databases were searched on August 28, 2020, and updated on April 27, 2021. Eligible studies were randomized, quasi-randomized, or non-randomized controlled or crossover trials that evaluated the acute or longitudinal effects of accumulated exercise compared with a single session of energy-matched continuous exercise on PPG, postprandial insulin, and triglycerides in diabetic and non-diabetic adults. Same-day and second-morning effects were assessed separately for acute intervention studies. Subgroup analyses were conducted based on the number of exercise bouts (2–3 bouts or frequent brief bouts (e.g., 1–6 min) throughout the day at 20–60-min intervals (known as physical activity [PA] breaks, ≥ 5 bouts)), exercise intensity, and populations. Risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials. Pooled effects were reported as standardized mean differences (SMD) and 95% CI using a random effects model. Results Twenty-seven studies (635 participants) were included. A significant difference was found for same-day PPG control, which favored accumulated exercise over one bout of energy-matched continuous exercise (SMD − 0.36 [95%CI: (− 0.56, − 0.17)], P = 0.0002, I2 = 1%), specifically in accumulated exercise with PA breaks (SMD − 0.36 [95%CI: (− 0.64, − 0.08)], P = 0.01, I2 = 30%), low-moderate intensity exercise (SMD − 0.38 [(95%CI: (− 0.59, − 0.17)], P = 0.0005, I2 = 0%), and in non-diabetic populations (SMD − 0.36 [95%CI: (− 0.62, − 0.10)], P = 0.007, I2 = 16%). No differences were found for same-day postprandial insulin and triglycerides, and second-morning effects (postprandial or fasting glucose, insulin, and triglycerides) between different exercise patterns. Conclusion Compared with one session of continuous exercise, accumulated exercise—specifically in subgroups of PA breaks, low-moderate intensity exercises—produced greater acute effects on same-day PPG control for non-diabetic adults. There were no differences between continuous and accumulated patterns of exercise in terms of same-day postprandial insulin and triglycerides, and second-morning effects on all previously mentioned markers. The findings provide additional PA options for PPG control for individuals with limited time or exercise capacity to engage in PA in one session. Registration: PROSPERO (identification code: CRD42021251325).

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Section: Introductionmentioning

confidence: 99%

The Effects of Accumulated Versus Continuous Exercise on Postprandial Glycemia, Insulin, and Triglycerides in Adults with or Without Diabetes: A Systematic Review and Meta-Analysis

Zhang

Zheng

et al. 2022

Sports Med - Open

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“…Beyond pharmacological treatments, different lifestyle strategies can attenuate postprandial glycemic excursions. Among these, exercise is widely recognized as a valid tool for improving glycemic control and post-meal glycemic response, not only in patients with diabetes but also in healthy individuals [ 3 , 4 , 5 , 6 ]. Given that various exercise strategies can potentially be used to improve postprandial glycemia, it is important to understand how exercise should be prescribed for this purpose.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Different Postprandial Exercise Types on Glucose Response to Breakfast in Individuals with Type 2 Diabetes

Bellini

Nicolò

Bulzomì³

et al. 2021

Nutrients

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Postprandial exercise represents an important tool for improving the glycemic response to a meal. This study evaluates the effects of the combination and sequence of different exercise types on the postprandial glycemic response in patients with type 2 diabetes. In this repeated-measures crossover study, eight patients with type 2 diabetes performed five experimental conditions in a randomized order: (i) uninterrupted sitting (CON); (ii) 30 min of moderate intensity aerobic exercise (walking) (A); (iii) 30 min of combined aerobic and resistance exercise (AR); (iv) 30 min of combined resistance and aerobic exercise (RA); and (v) 15 min of resistance exercise (R). All the exercise sessions started 30 min after the beginning of a standardized breakfast. All the exercise conditions showed a significant attenuation of the post-meal glycemic excursion (P < 0.003) and the glucose incremental area under the curve at 0–120 min (P < 0.028) and 0–180 min (P < 0.048) compared with CON. A greater reduction in the glycemic peak was observed in A and AR compared to RA (P < 0.02). All the exercise types improved the post-meal glycemic response in patients with type 2 diabetes, with greater benefits when walking was performed alone or before resistance exercise.

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“…The aim of this proof-of-concept study was to see if WI could provide comparable effects as an exercise substitute for those who cannot perform sufficient volumes of exercise. Previous research comparing 30–45 min of post-meal exercise has found similar benefits for post-prandial glucose, however, benefit to fitness and exercise performance needs to be further investigated ( Bellini et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Post-exercise Warm or Cold Water Immersion to Augment the Cardiometabolic Benefits of Exercise Training: A Proof of Concept Trial

et al. 2021

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We investigated whether substituting the final half within 60-min bouts of exercise with passive warm or cold water immersion would provide similar or greater benefits for cardiometabolic health. Thirty healthy participants were randomized to two of three short-term training interventions in a partial crossover (12 sessions over 14–16 days, 4 week washout): (i) EXS: 60 min cycling 70% maximum heart rate (HRmax), (ii) WWI: 30 min cycling then 30 min warm water (38–40°C) immersion, and/or (iii) CWI: 30 min cycling then 30 min cold water (10–12°C) immersion. Before and after, participants completed a 20 min cycle work trial, V.O2max test, and an Oral Glucose Tolerance Test during which indirect calorimetry was used to measure substrate oxidation and metabolic flexibility (slope of fasting to post-prandial carbohydrate oxidation). Data from twenty two participants (25 ± 5 year, BMI 23 ± 3 kg/m2, Female = 11) were analyzed using a fixed-effects linear mixed model. V.O2max increased more in EXS (interaction p = 0.004) than CWI (95% CI: 1.1, 5.3 mL/kg/min, Cohen’s d = 1.35), but not WWI (CI: −0.4, 3.9 mL/kg/min, d = 0.72). Work trial distance and power increased 383 ± 223 m and 20 ± 6 W, respectively, without differences between interventions (interaction both p > 0.68). WWI lowered post-prandial glucose ∼9% (CI −1.9, −0.5 mmol/L; d = 0.63), with no difference between interventions (interaction p = 0.469). Substituting the second half of exercise with WWI provides similar cardiometabolic health benefits to time matched exercise, however, substituting with CWI does not.

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Effects of Different Exercise Strategies to Improve Postprandial Glycemia in Healthy Individuals

Cited by 18 publications

References 42 publications

The Effects of Accumulated Versus Continuous Exercise on Postprandial Glycemia, Insulin, and Triglycerides in Adults with or Without Diabetes: A Systematic Review and Meta-Analysis

The Effects of Accumulated Versus Continuous Exercise on Postprandial Glycemia, Insulin, and Triglycerides in Adults with or Without Diabetes: A Systematic Review and Meta-Analysis

The Effect of Different Postprandial Exercise Types on Glucose Response to Breakfast in Individuals with Type 2 Diabetes

Post-exercise Warm or Cold Water Immersion to Augment the Cardiometabolic Benefits of Exercise Training: A Proof of Concept Trial

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