The impact of acute bouts of interval and continuous walking on energy‐intake and appetite regulation in subjects with type 2 diabetes

Abstract

In healthy subjects, it has been suggested that exercise may acutely suppress energy‐intake and appetite, with peak intensity being an important determinant for this effect. In subjects with type 2 diabetes (T2D), the effect of exercise on appetite‐related variables is, however, virtually unknown. We aimed to assess the effects of two exercise interventions, differing with regards to peak intensity, on energy‐intake, satiety and appetite‐related hormones in subjects with T2D. Thirteen subjects with T2D completed three 60‐min interventions with continuous measurement of oxygen consumption in a randomized and counterbalanced order: (1) Control, (2) Continuous walking (CW; intended 73% of VO 2peak), (3) Interval‐walking (IW; repeated cycles of 3 min slow [54% of VO 2peak] and 3 min fast walking [89% of VO 2peak]). Forty‐five minutes after completion of the intervention, a 3‐h liquid mixed meal tolerance test (MMTT, 450 kcal) with regular satiety assessments and blood samples for appetite‐related hormones commenced. An ad libitum meal was served after the MMTT, with subsequent calculation of energy‐intake. Moreover, free‐living diet records were completed for the following ~32 h. Exercise interventions were well‐matched for mean oxygen consumption (CW = 77 ± 2% of VO 2peak; IW = 76 ± 1% of VO 2peak, P > 0.05). No differences in appetite‐related hormones or energy‐intake were found (P > 0.05 for all comparisons). IW increased fullness compared to Control shortly after the intervention (P < 0.05) and tended to reduce hunger 2 h into the MMTT compared to CW and Control (P < 0.10). In conclusion, a single exercise session does not affect energy‐intake during the following ~4–36 h in subjects with T2D. However, satiety may be affected up to ~3 h after the exercise session, dependent on peak intensity.

The Influence of Acute and Chronic Exercise on Appetite and Appetite Regulation in Patients with Prediabetes or Type 2 Diabetes Mellitus—A Systematic Review

“…Following acute endurance exercise (aerobic or high-intensity endurance exercise), either no effect or the suppression of appetite was observed for up to 180 min after the training session [ 48 , 49 ]. One of two studies that measured appetite ratings the day after exercise [ 46 , 49 ] found an increase in appetite on day 2 [ 46 ].…”

“…The above-mentioned effects of endurance exercise on appetite ratings were inconsistently supported by changes in appetite hormones. Two studies observed no significant changes in the measured appetite hormones (ghrelin, PP, PYY, and leptin), although the feeling of fullness increased at certain measurement timepoints [ 48 , 49 ].…”

“…The increase in appetite the day after exercising that was observed in one study was not supported by corresponding changes in appetite hormones [ 49 ]. Instead, the small increases observed in GIP and GLP-1 would indicate a decrease in appetite.…”

Psychobiology of Appetite and Food Reward in Adults with Type 1 and Type 2 Diabetes: Is there a Role for Exercise?

“…Pancreatic polypeptide concentrations were also reduced immediately after exercise, but were not different to the non-exercise control condition ~20-30 minutes post-exercise. Müller et al [63] reported that ad libitum meal intake and self-reported EI did not change 4-36 hours after one hour of continuous (~70% peak maximal aerobic capacity) or intermittent walking (intervals of 3 minutes slow [~55% of peak maximal aerobic capacity] & 3 minutes fast walking [~90% of peak maximal aerobic capacity]) in 13 individuals with T2D. Interestingly, it has been reported that individuals with overweight and T2D (n=8) displayed reduced post-prandial fullness in response to a 75-g oral glucose load as compared to those without T2D (n=7) [37].…”

Acute Strength Exercise Decreases Satiety by Modifying Blood Cytokines Levels in Physically Active Men

“…In humans, recent evidence suggests that exercises above 75% of maximum oxygen consumption (VO 2 max) can suppress hunger by regulating appetite hormones, a phenomenon known as "exercise-induced anorexia," which may restrict energy intake 6 . Thus, exercise intensity appears to be an important determinant of appetite regulation in humans 7 . In a meta-analysis, Horner et al 8 investigated the effect of acute exercise on gastric emptying and reported controversial results, because the training protocols analyzed were mostly aerobic.…”