Combined effects of continuous exercise and intermittent active interruptions to prolonged sitting on postprandial glucose, insulin, and triglycerides in adults with obesity: a randomized crossover trial

Abstract Background Postprandial glucose, insulin, and triglyceride metabolism is impaired by prolonged sitting, but enhanced by exercise. The aim of this study was to assess the effects of a continuous exercise bout with and without intermittent active interruptions to prolonged sitting on postprandial glucose, insulin, and triglycerides. Methods Sedentary adults who were overweight to obese (n = 67; mean age 67 yr SD ± 7; BMI 31.2 kg∙m− 2 SD ± 4.1), completed three conditions: SIT: uninterrupted sitting (8-h, control); EX+SIT: sitting (1-h), moderate-intensity walking (30-min), uninterrupted sitting (6.5-h); EX+BR: sitting (1-h), moderate-intensity walking (30- min), sitting interrupted every 30-min with 3-min of light-intensity walking (6.5 h). Participants consumed standardized breakfast and lunch meals and blood was sampled at 13 time-points. Results When compared to SIT, EX+SIT increased total area under the curve (tAUC) for glucose by 2% [0.1–4.1%] and EX+BR by 3% [0.6–4.7%] (all p < 0.05). Compared to SIT, EX+SIT reduced insulin and insulin:glucose ratio tAUC by 18% [11–22%] and 21% [8–33%], respectively; and EX+BR reduced values by 25% [19–31%] and 28% [15–38%], respectively (all p < 0.001 vs SIT, all p < 0.05 EX+SIT-vs-EX+BR). Compared to SIT, EX+BR reduced triglyceride tAUC by 6% [1–10%] (p = 0.01 vs SIT), and compared to EX+SIT, EX+BR reduced this value by 5% [0.1–8.8%] (p = 0.047 vs EX+SIT). The magnitude of reduction in insulin tAUC from SIT-to-EX+BR was greater in those with increased basal insulin resistance. No reduction in triglyceride tAUC from SIT-to-EX+BR was apparent in those with high fasting triglycerides. Conclusions Additional reductions in postprandial insulin-glucose dynamics and triglycerides may be achieved by combining exercise with breaks in sitting. Relative to uninterrupted sitting, this strategy may reduce postprandial insulin more in those with high basal insulin resistance, but those with high fasting triglycerides may be resistant to such intervention-induced reductions in triglycerides. Trial registration Australia New Zealand Clinical Trials Registry (ACTRN12614000737639).

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Postprandial Metabolic Effects of Accelerometer Measured Spontaneous Low-Level Activity

Journal of Physical Activity and Health ◽

10.1123/jpah.2014-0298 ◽

2015 ◽

Vol 12 (8) ◽

pp. 1133-1138 ◽

Cited By ~ 1

Author(s):

Meredith C. Peddie ◽

Claire Cameron ◽

Nancy Rehrer ◽

Tracy Perry

Keyword(s):

Heart Rate ◽

Glucose Metabolism ◽

Sedentary Time ◽

Area Under The Curve ◽

Postprandial Glucose ◽

Metabolic Effects ◽

Negative Effects ◽

Prolonged Sitting ◽

Total Movement ◽

Mean Heart Rate

Background:Interrupting sedentary time induces improvements in glucose metabolism; however, it is unclear how much activity is required to reduce the negative effects of prolonged sitting.Methods:Sixty-six participants sat continuously for 9 hours except for required bathroom breaks. Participants were fed meal replacement beverages at 60, 240 and 420 min. Blood samples were obtained hourly for 9 hours, with additional samples collected 30 and 45 min after each feeding. Responses were calculated as incremental area under the curve (iAUC) for plasma glucose, insulin and triglyceride. Participants wore a triaxial accelerometer and a heart rate monitor. Energy expenditure was estimated using indirect calorimetry.Results:After controlling for age, sex and BMI, every 100 count increase in accelerometer derived total movement was associated with a 0.06 mmol·L-1·9 hours decrease in glucose iAUC (95% CI 0.004–0.1; P = .035), but not associated with changes in insulin or triglyceride iAUC. Every 1 bpm increase in mean heart rate was associated with a 0.76 mmol·L-1·9 hours increase in triglyceride iAUC (95% CI 0.13–1.38).Conclusion:Accelerometer measured movement during periods of prolonged sitting can result in minor improvements in postprandial glucose metabolism, but not lipid metabolism.

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Effects of high-intensity interval exercise versus continuous moderate-intensity exercise on postprandial glycemic control assessed by continuous glucose monitoring in obese adults

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2013-0512 ◽

2014 ◽

Vol 39 (7) ◽

pp. 835-841 ◽

Cited By ~ 80

Author(s):

Jonathan P. Little ◽

Mary E. Jung ◽

Amy E. Wright ◽

Wendi Wright ◽

Ralph J.F. Manders

Keyword(s):

Continuous Glucose Monitoring ◽

High Intensity ◽

Glucose Monitoring ◽

Area Under The Curve ◽

Postprandial Glucose ◽

Moderate Intensity ◽

Moderate Intensity Exercise ◽

Obese Adults ◽

High Intensity Interval ◽

The Impact

The purpose of this study was to examine the impact of acute high-intensity interval training (HIIT) compared with continuous moderate-intensity (CMI) exercise on postprandial hyperglycemia in overweight or obese adults. Ten inactive, overweight or obese adults (41 ± 11 yrs, BMI = 36 ± 7 kg/m2) performed an acute bout of HIIT (10 × 1 min at approximately 90% peak heart rate (HRpeak) with 1-min recovery periods) or matched work CMI (30 min at approximately 65% HRpeak) in a randomized, counterbalanced fashion. Exercise was performed 2 h after breakfast, and glucose control was assessed by continuous glucose monitoring under standardized dietary conditions over 24 h. Postprandial glucose (PPG) responses to lunch, dinner, and the following day’s breakfast were analyzed and compared with a no-exercise control day. Exercise did not affect the PPG responses to lunch, but performing both HIIT and CMI in the morning significantly reduced the PPG incremental area under the curve (AUC) following dinner when compared with control (HIIT = 110 ± 35, CMI = 125 ± 34, control = 162 ± 46 mmol/L × 2 h, p < 0.05). The PPG AUC (HIIT = 125 ± 53, CMI = 186 ± 55, control = 194 ± 96 mmol/L × 2 h) and the PPG spike (HIIT = Δ2.1 ± 0.9, CMI = Δ3.0 ± 0.9, control = Δ3.0 ± 1.5 mmol/l) following breakfast on the following day were significantly lower following HIIT compared with both CMI and control (p < 0.05). Absolute AUC and absolute glucose spikes were not different between HIIT, CMI, or control for any meal (p > 0.05 for all). We conclude that a single session of HIIT has greater and more lasting effects on reducing incremental PPG when compared with CMI.

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Does the type of activity “break” from prolonged sitting differentially impact on postprandial blood glucose reductions? An exploratory analysis

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2016-0642 ◽

2017 ◽

Vol 42 (8) ◽

pp. 897-900 ◽

Cited By ~ 11

Author(s):

Robyn N. Larsen ◽

Paddy C. Dempsey ◽

Francis Dillon ◽

Megan Grace ◽

Bronwyn A. Kingwell ◽

...

Keyword(s):

Analysis Data ◽

Postprandial Glucose ◽

Exploratory Analysis ◽

Postprandial Blood Glucose ◽

Moderate Intensity ◽

Dependent Manner ◽

Energy Expenditures ◽

Prolonged Sitting ◽

Insulin Responses ◽

Dose Dependent

Frequent breaks in prolonged sitting are associated beneficially with glycaemic control. However, the contribution of energy expenditure to this relationship has not been well characterised. In this exploratory analysis, data from 3 laboratory trials that standardised test meals, cohort characteristics (overweight/obese, sedentary), and break frequency and duration were pooled. Higher energy expenditures of different types of breaks (standing, light- or moderate-intensity walking) were associated with lower postprandial glucose and insulin responses in a dose-dependent manner.

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PO-271 Effects of accumulated exercise with different intensities on insulin resistance in mice

Exercise Biochemistry Review ◽

10.14428/ebr.v1i5.11203 ◽

2018 ◽

Vol 1 (5) ◽

Author(s):

Yuli Zhang ◽

Songtao Wang ◽

Fei Liang ◽

Xiangyu Shuai ◽

Weibao Liang ◽

...

Keyword(s):

Insulin Resistance ◽

Body Weight ◽

High Intensity ◽

Exercise Intervention ◽

Exercise Program ◽

Exercise Group ◽

The Body ◽

Moderate Intensity ◽

Control Group ◽

Continuous Exercise

Objective The aim of this study was to investigate the effect of 8-week moderate-intensity and high-intensity accumulated exercise on insulin resistance in mice, compared with the moderate intensity continuous exercise with equal workload, which will provide an experimental reference for seeking a more reasonable and effective exercise program to break sedentary behavior and improve metabolic diseases such as IR. Methods Eighty 4-week-old C57BL/6J mice were randomly divided into normal diet group (group C) and high-fat diet group (group H), fed with different diet. At the 10th weekend, insulin resistance model was judged by OGTT curve (AUC) and fasting blood glucose. All mice with insulin resistance were randomly divided into four groups: IR control group (IC), IR moderate-intensity continuous exercise group (IE), IR moderate-intensity accumulated exercise group (IM), IR high-intensity accumulated exercise group (IH), retained normal diet control group (C), with 12 mice for each group. All groups were fed with normal feed. The three exercise-related group performed an 8-week’s treadmill exercise program with equal workload (involve preparation and relaxation activities,0°platform slope, 5 days/week). For IE group, mice run 50min continuously with the velocity of 11m/min. For IM group，mice exercised 12.5 min per session, total 4 sessions per day, with 3-hour’s interval and the velocity of 11m/min. The IH group performed an alike exercise program with IM group, except the running speed (19m/min) and exercise time (7.5min). On the 8th weekend of exercise, FBG, OCTT, FINS, HOME- IR, and ISI were tested for each groups. Results 1. Compared with group C, body weight, FBG and OGTT-AUC were significantly increased in group H (P<0.05 or P<0.01). 76% mice were induced to insulin resistance successfully. 2. Before and after exercise intervention of 8 weeks, there were no significant changes in body weight and OGTT-AUC, while the FBG was significantly increased in IC group (P<0.05). Body weight, FBG, and OGTT-AUC significantly decreased in IE group, IM group and IH group (P<0.05 or P<0.01). 3. After 8 weeks of exercise intervention, the FBG in the IE group, IM group, and IH group were significantly lower than that in C group (P<0.05 or P<0.01). Compared with the IC group, the FBG, FINS, OGTT-AUC, and HOME-IR in IM group, IH group and IE group were lower than those in the IC group (P<0.05 or P<0.01). Compared with the IE group, the body weight and HOME-IR index of IH group were significantly lower than those in IE group (P<0.01). Compared with IH group, the HOME-IR in IH group was lower than that in IM group (P<0.05); There was no significant difference between IM group and IE group. Conclusions 1. Chronic moderate-intensity continuous exercise, moderate-intensity accumulated exercise, and high-intensity accumulated exercise all can effectively improve the glucose metabolism and insulin resistance in IR mice. 2.Compared with moderate-intensity accumulated exercise and moderate-intensity continuous exercise, the high-intensity accumulated exercise with equal workload is more effective in reducing the body weight and improving insulin resistance in IR mice.

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Improvements in Glycemic Control After Acute ModerateIntensity Continuous or HighIntensity Interval Exercise Are Greater in South Asians Than White Europeans With Nondiabetic Hyperglycemia: A Randomized Crossover Study

10.2337/figshare.13046297 ◽

2020 ◽

Author(s):

Jack A. Sargeant ◽

Charlotte Jelleyman ◽

Nicole A. Coull ◽

Charlotte L. Edwardson ◽

Joseph Henson ◽

...

Keyword(s):

Insulin Resistance ◽

South Asians ◽

Area Under The Curve ◽

Resistance Index ◽

Moderate Intensity ◽

Cardiometabolic Health ◽

Interval Exercise ◽

High Intensity Interval ◽

Design And Methods ◽

Insulin Responses

Objective: To examine whether circulating metabolic responses to low-volume high-intensity interval (LV-HIIE) or continuous moderate-intensity aerobic (CME) exercise differ between white Europeans and South Asians with nondiabetic hyperglycaemia (NDH). <div>Research Design and Methods: 13 white Europeans and 10 South Asians (combined median (IQR) age 67 (60–68) years, HbA1c 5.9 (5.8–6.1)% [41.0 (39.9–43.2) mmol·mol-1]) completed three 6-hour conditions (sedentary control [CON], LV-HIIE, CME) in a randomised order. Exercise conditions contained a single bout of LV-HIIE and CME respectively (each ending at 2h), with meals provided at 0 and 3h. Circulating glucose (primary outcome), insulin, insulin resistance index (IRI), triglyceride and non-esterified fatty acids were measured at 0, 0.5, 1, 2, 3, 3.5, 4, 5 and 6h. Data were analysed as post-exercise time-averaged area under the curve (AUC), adjusted for age, sex and pre-exercise AUC. Results: Glucose was similar in each condition and ethnicity, with no condition-by-ethnicity interaction (P≥0.28). However, insulin was lower in LV-HIIE (mean [95% CI]: -44.4 [-23.7, -65.1] mU·L-1) and CME (-33.8 [-13.7, -53.9] mU·L-1) compared to CON. Insulin responses were greater in South Asians (interaction P=0.03) such that values were similar in each ethnicity during exercise conditions, despite being 33% higher in South Asians during CON. IRI followed a similar pattern to insulin. Lipids were unaffected by exercise. Conclusions: Reductions in insulin and insulin resistance after acute LV-HIIE and CME are greater in South Asians than white Europeans with NDH. Further trials are required to examine longer-term impact of LV-HIIE and CME on cardiometabolic health. </div>

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Effects of Frequency and Duration of Interrupting Sitting on Cardiometabolic Risk Markers

International Journal of Sports Medicine ◽

10.1055/a-0997-6650 ◽

2019 ◽

Vol 40 (13) ◽

pp. 818-824 ◽

Cited By ~ 5

Author(s):

Benjamin D. Maylor ◽

Julia K. Zakrzewski-Fruer ◽

David J. Stensel ◽

Charlie J. Orton ◽

Daniel P. Bailey

Keyword(s):

Cardiometabolic Risk ◽

Area Under The Curve ◽

Low Frequency ◽

Peak Oxygen Uptake ◽

Moderate Intensity ◽

Risk Markers ◽

Moderate Intensity Physical Activity ◽

Prolonged Sitting ◽

Intensity Physical Activity ◽

Cardiometabolic Risk Markers

AbstractInterrupting prolonged sitting with short multiple bouts of moderate-intensity physical activity (PA) can improve postprandial cardiometabolic risk markers. This study examined the effect of high and low frequency PA bouts (matched for total PA duration and energy expenditure) on postprandial cardiometabolic responses when compared with prolonged sitting. In this three-condition randomised crossover trial, 14 sedentary, inactive females (33.8±13.4 years, BMI 27.1±6.3 kg/m2) completed 3, 7.5 h conditions: 1) prolonged sitting (SIT), 2) high-frequency PA breaks (HIGH-FREQ) consisting of 15 ×2 min bouts of moderate-intensity treadmill PA every 30 min, and 3) low-frequency PA breaks (LOW-FREQ) consisting of 3 ×10 min bouts of moderate-intensity treadmill PA every 180 min. The PA bouts were performed at 65% of peak oxygen uptake. Net incremental area under the curve (iAUC) for each 7.5 h condition was calculated for glucose, insulin and triacylglycerol (TAG) concentrations. Insulin iAUC was significantly (p<0.026) lower during HIGH-FREQ (mean [95%CI]; 82.86 [55.02, 110.70] µU/mL∙7.5 h) than LOW-FREQ (116.61 [88.50, 144.73] µU/mL∙7.5 h) and SIT (119.98 [92.42, 147.53] µU/mL∙7.5 h). Glucose and TAG iAUC did not differ between conditions. Engaging in higher-frequency PA breaks may be effective in attenuating postprandial insulin responses compared with lower-frequency PA breaks and prolonged sitting.

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Metabolic and Molecular Subacute Effects of a Single Moderate-Intensity Exercise Bout, Performed in the Fasted State, in Obese Male Rats

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147543 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7543

Author(s):

Éverton Lopes Vogt ◽

Maiza Cristina Von Dentz ◽

Débora Santos Rocha ◽

Jorge Felipe Argenta Model ◽

Lucas Stahlhöfer Kowalewski ◽

...

Keyword(s):

Insulin Resistance ◽

Heat Shock ◽

Exercise Bout ◽

Male Rats ◽

Moderate Intensity ◽

Exercise Session ◽

Hepatic Glycogen ◽

Moderate Intensity Exercise ◽

Fasted State ◽

Obese Male

Introduction and objectives: Obesity represents a major global public health problem. Its etiology is multifactorial and includes poor dietary habits, such as hypercaloric and hyperlipidic diets (HFDs), physical inactivity, and genetic factors. Regular exercise is, per se, a tool for the treatment and prevention of obesity, and recent studies suggest that the beneficial effects of exercise can be potentiated by the fasting state, thus potentially promoting additional effects. Despite the significant number of studies showing results that corroborate such hypothesis, very few have evaluated the effects of fasted-state exercise in overweight/obese populations. Therefore, the aim of this study was to evaluate the subacute effects (12 h after conclusion) of a single moderate-intensity exercise bout, performed in either a fed or an 8 h fasted state, on serum profile, substrate-content and heat shock pathway–related muscle protein immunocontent in obese male rats. Methods: Male Wistar rats received a modified high-fat diet for 12 weeks to induce obesity and insulin resistance. The animals were allocated to four groups: fed rest (FER), fed exercise (FEE), fasted rest (FAR) and fasted exercise (FAE). The exercise protocol was a 30 min session on a treadmill, with an intensity of 60% of VO2max. The duration of the fasting period was 8 h prior to the exercise session. After a 12 h recovery, the animals were killed and metabolic parameters of blood, liver, heart, gastrocnemius and soleus muscles were evaluated, as well as SIRT1 and HSP70 immunocontent in the muscles. Results: HFD induced obesity and insulin resistance. Soleus glycogen concentration decreased in the fasted groups and hepatic glycogen decreased in the fed exercise group. The combination of exercise and fasting promoted a decreased concentration of serum total cholesterol and triglycerides. In the heart, combination fasting plus exercise was able to decrease triglycerides to control levels. In the soleus muscle, both fasting and fasting plus exercise were able to decrease triglyceride concentrations. In addition, heat shock protein 70 and sirtuin 1 immunocontent increased after exercise in the gastrocnemius and soleus muscles. Conclusions: An acute bout of moderate intensity aerobic exercise, when realized in fasting, may induce, in obese rats with metabolic dysfunctions, beneficial adaptations to their health, such as better biochemical and molecular adaptations that last for at least 12 h. Considering the fact that overweight/obese populations present an increased risk of cardiovascular events/diseases, significant reductions in such plasma markers of lipid metabolism are an important achievement for these populations.

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Postmeal exercise blunts postprandial glucose excursions in people on metformin monotherapy

Journal of Applied Physiology ◽

10.1152/japplphysiol.00213.2017 ◽

2017 ◽

Vol 123 (2) ◽

pp. 444-450 ◽

Cited By ~ 12

Author(s):

Melissa L. Erickson ◽

Jonathan P. Little ◽

Jennifer L. Gay ◽

Kevin K. McCully ◽

Nathan T. Jenkins

Keyword(s):

Time Window ◽

Glucose Monitoring ◽

Area Under The Curve ◽

Postprandial Glucose ◽

Interactive Effects ◽

Moderate Intensity ◽

Glucose Excursion ◽

Metformin Monotherapy ◽

Physiological Outcomes ◽

Postprandial Glucose Excursion

Metformin is used clinically to reduce fasting glucose with minimal effects on postprandial glucose. Postmeal exercise reduces postprandial glucose and may offer additional glucose-lowering benefit beyond that of metformin alone, yet controversy exists surrounding exercise and metformin interactions. It is currently unknown how postmeal exercise and metformin monotherapy in combination will affect postprandial glucose. Thus, we examined the independent and combined effects of postmeal exercise and metformin monotherapy on postprandial glucose. A randomized crossover design was used to assess the influence of postmeal exercise on postprandial glucose excursions in 10 people treated with metformin monotherapy (57 ± 10 yr, HbA1C = 6.3 ± 0.6%). Each participant completed the following four conditions: sedentary and postmeal exercise (5 × 10-min bouts of treadmill walking at 60% V̇o2max) with metformin and sedentary and postmeal exercise without metformin. Peak postprandial glucose within a 2-h time window and 2-h total area under the curve was assessed after a standardized breakfast meal, using continuous glucose monitoring. Postmeal exercise significantly blunted 2-h peak ( P = 0.001) and 2-h area under the curve ( P = 0.006), with the lowest peak postprandial glucose excursion observed with postmeal exercise and metformin combined ( P < 0.05 vs. all other conditions: metformin/sedentary: 12 ± 3.4, metformin/exercise: 9.7 ± 2.3, washout/sedentary: 13.3 ± 3.2, washout/exercise: 11.1 ± 3.4 mmol/l). Postmeal exercise and metformin in combination resulted in the lowest peak postprandial glucose excursion compared with either treatment modality alone. Exercise timed to the postprandial phase may be important for optimizing glucose control during metformin monotherapy. NEW & NOTEWORTHY The interactive effects of metformin and exercise on key physiological outcomes remain an area of controversy. Findings from this study show that the combination of metformin monotherapy and moderate-intensity postmeal exercise led to beneficial reductions in postprandial glucose excursions. Postmeal exercise may be a useful strategy for the management of postprandial glucose in people on metformin.

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Plasma Branched-Chain Amino Acids Are Associated With Greater Fasting and Postprandial Insulin Secretion in Non-diabetic Chinese Adults

Frontiers in Nutrition ◽

10.3389/fnut.2021.664939 ◽

2021 ◽

Vol 8 ◽

Author(s):

Cherlyn Ding ◽

Leonie Egli ◽

Nabil Bosco ◽

Lijuan Sun ◽

Hui Jen Goh ◽

...

Keyword(s):

Insulin Resistance ◽

Amino Acids ◽

Insulin Secretion ◽

Postprandial Glucose ◽

Branched Chain Amino Acids ◽

Insulin Clearance ◽

Clearance Rates ◽

Branched Chain ◽

Chinese Subjects ◽

Postprandial Insulin

Background: Plasma branched-chain amino acids (BCAA) are consistently elevated in subjects with obesity and type 2 diabetes (T2DM) and correlate with insulin resistance. The association of BCAA with insulin secretion and clearance rates has not been adequately described.Objective: To evaluate the relationships between fasting and postprandial plasma BCAA, insulin secretion and insulin clearance.Design: Ninety-five non-diabetic Chinese subjects (43 females) underwent a mixed-meal tolerance test; blood biomarkers including BCAAs (leucine, isoleucine, valine) were measured for 6 h. Fasting and postprandial insulin secretion rates (ISR) and insulin clearance were determined by oral minimal modeling of glucose and C-peptide.Results: Fasting and postprandial plasma BCAA correlated strongly with each other (ρ = 0.796, P < 0.001), and both were positively associated with basal ISR (ρ = 0.45/0.36, P < 0.001), total postprandial ISR AUC (ρ = 0.37/0.45, P < 0.001), and negatively with insulin clearance (ρ = −0.29/−0.29, P < 0.01), after adjusting for sex and body mass index. These relationships largely persisted after adjusting further for insulin resistance and postprandial glucose. Compared with subjects in the middle and lowest tertiles for fasting or postprandial plasma BCAA, subjects in the highest tertile had significantly greater postprandial glucose (by 7–10%) and insulin (by 74–98%) concentrations, basal ISRs (by 34–53%), postprandial ISR AUCs (by 41–49%), and lower insulin clearance rates (by 17–22%) (all P < 0.05).Conclusions: Fasting and postprandial plasma BCAA levels are associated with greater fasting and postprandial insulin secretion and reduced insulin clearance in healthy Chinese subjects. These observations potentially highlight an additional layer of involvement of BCAA in the regulation of glucose homeostasis.

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