Efficacy of Postprandial Exercise in Mitigating Glycemic Responses in Overweight Individuals and Individuals with Obesity and Type 2 Diabetes—A Systematic Review and Meta-Analysis

Abstract

Studies investigating the acute effect of postprandial exercise (PPE) on glucose responses exhibit significant heterogeneity in terms of participant demographic, exercise protocol, and exercise timing post-meal. As such, this study aimed to further analyze the existing literature on the impact of PPE on glycemic control in overweight individuals and individuals with obesity and type 2 diabetes (T2DM). A literature search was conducted through databases such as PubMed, CINAHL, and Google Scholar. Thirty-one original research studies that met the inclusion criteria were selected. A random-effect meta-analysis was performed to compare postprandial glucose area under the curve (AUC) and 24 h mean glucose levels between PPE and the time-matched no-exercise control (CON). Subgroup analyses were conducted to explore whether the glucose-lowering effect of PPE could be influenced by exercise duration, exercise timing post-meal, and the disease status of participants. This study revealed a significantly reduced glucose AUC (Hedges’ g = −0.317; SE = 0.057; p < 0.05) and 24 h mean glucose levels (Hedges’ g = −0.328; SE = 0.062; p < 0.05) following PPE compared to CON. The reduction in glucose AUC was greater (p < 0.05) following PPE lasting >30 min compared to ≤30 min. The reduction in 24 h mean glucose levels was also greater (p < 0.05) following PPE for ≥60 min compared to <60 min post-meal and in those with T2DM compared to those without T2DM. PPE offers a viable approach for glucose management and can be performed in various forms so long as exercise duration is sufficient. The glucose-lowering effect of PPE may be further enhanced by initiating it after the first hour post-meal. PPE is a promising strategy, particularly for patients with T2DM. This manuscript is registered with Research Registry (UIN: reviewregistry1693).

Exercise Prescription for Postprandial Glycemic Management

“…With regards to the time window for postprandial exercise, it has been suggested that exercising too early after the meal may initially lower glucose levels, but could lead to a rebound increase later, diminishing the beneficial effects [ 12 ]. Therefore, it has been proposed that exercising in the so-called mid-postprandial period may represent the optimal choice for improving both the immediate post-meal glucose peak and overall daily glucose management in individuals with T2D or insulin resistance [ 43 ].…”

“…Additionally, high-intensity exercise, due to the adrenergic response, may increase the rate of glucose appearance, resulting in the undesirable effect of blood glucose levels rising [12,42]. However, it has been previously shown that high-intensity interval exercise may increase glucose tolerance and insulin sensitivity, resulting in an enhanced glucose disposal to skeletal muscles, especially when performed after meals [43]. Therefore, the picture emerging from the current knowledge emphasizes the need to tailor exercise prescriptions to individual preferences and requirements.…”