Preventive Medicine 42 (2006) 369 371 www.elsevier.

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Postprandial light physical activity blunts the blood glucose increase

Arne T. Hstmark a,b,, Gunn Seim Ekeland b , Anne Cathrine Beckstrm b , Helge Dyre Meen b
a

Section of Preventive Medicine and Epidemiology, Department of General Practice and Community Medicine, University of Oslo, 0318 Oslo, Norway b Norwegian University of Sport and Physical Education, Oslo, Norway Available online 20 March 2006

Abstract Background. The magnitude and duration of postprandial blood glucose elevation seem to be important risk factors for diabetes Type 2 and coronary heart disease. Aim. To investigate whether post-meal light physical activity might reduce the blood glucose increase. Methods. Nine young (1825 years) and 10 middle-aged (4565 years) sedentary women, and 10 young and 10 middle-aged trained women participated in a meal/physical activity trial. Commencing after an overnight fast, each subject participated in two experiments, carried out on separate days: Day 1, the subjects were given cornflakes (1 g carbohydrate per kg body weight) to be ingested during 15 min. Blood glucose was determined while resting, before meal, and each 15 min for the next 120 min. Day 2 was similar to Day 1 but included light bicycling exercise for 30 min after finishing the meal. Results. In all trials, irrespective of age and training condition, light bicycling for 30 min after the carbohydrate meal blunted the rise in blood glucose. Conclusion. The results demonstrate an acute blood glucose reducing effect of light physical activity and of a magnitude similar to that obtained by hypoglycemic drugs, even after intake of a large dose of high glycemic food. 2005 Elsevier Inc. All rights reserved.
Keywords: Blood glucose; Postprandial; Physical activity; Women

Introduction The magnitude and duration of postprandial blood glucose elevation seem to be an important risk factor for diabetes Type 2 and coronary heart disease (Gugliano and Ceriello, 2001). Drugs have been developed to reduce hyperglycemia (Chiasson et al., 1996; Feinglos et al., 1997). Also, lifestyle interventions may prevent high blood glucose levels, such as small carbohydrate meals, diets with a low glycemic index, and physical training (Jenkins et al., 2002). Since light physical activity should increase the glucose utilization by muscle, we reasoned that such exercise in the postprandial period might reduce glycemia after a carbohydrate meal. To our knowledge,
This work was done at the Norwegian University of Sport and Physical Education, Oslo, Norway, 20022003. Corresponding author. Section of Preventive Medicine and Epidemiology, Department of General Practice and Community Medicine, University of Oslo, Box 1130 Blindern, 0318 Oslo, Norway. Fax: +47 22 85 82 80. E-mail address: a.t.hostmark@medisin.uio.no (A.T. Hstmark). 0091-7435/$ - see front matter 2005 Elsevier Inc. All rights reserved. doi:10.1016/j.ypmed.2005.10.001

studies on the acute effect of light postprandial physical activity on the blood glucose concentration after a high carbohydrate meal are scarce. In a study by Achten and Jeukendrup (2003) in 8 trained men, exercise was carried out 45 min after intake of 75 g carbohydrates. They observed a subsequent decrease in the blood glucose concentration. However, since the exercise in their study took place in the time period after reaching the peak glucose value, i.e. when the glucose curve was already decreasing, it is hard to appreciate the contribution of exercise to the blood glucose decrease in this period. In general, most exercise studies are carried out in men. In the present study, both trained and sedentary, young, and middleaged women participated in a trial to study their blood glucose responses to a high carbohydrate meal, as influenced by light postprandial exercise carried out immediately after the meal.
Methods
After approval by the regional ethics committee in Norway, we did a trial in 9 young (1825 years) and 10 middle-aged (5565 years) healthy

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A.T. Hstmark et al. / Preventive Medicine 42 (2006) 369371

Results and discussion A consistent picture was obtained, irrespective of age and training condition (Fig. 1): in both trained and sedentary, young, and middle-aged women, the increase in blood glucose level after intake of cornflakes (1 g carbohydrate/kg body weight) was appreciably reduced when performing light bicycling physical activity for 30 min after finishing the meal. Post-exercise, the blood glucose concentration rose again, but the peak value was lower than that found without exercise. As found by repeated measures ANOVA, there was a significant main effect of time and interaction between time and exercise. P < 0.05 for the difference between corresponding mean values in the same panel at 30 and 45 min after the meal (paired t test with Bonferroni correction). We also calculated the difference in area under the curves (control experiment minus that involving post-meal exercise) for the time interval 15 to 75 min (where the curves differ). Using ANOVA, it was found that for the sedentary group the glycemic effect was greater in middle-aged than in young women (P = 0.04). Additionally, in middle-aged sedentary women, there was at 60 min a significant (P = 0.001) difference (1.5 0.3 mmol/l) in blood glucose. These observations suggest that this group of women had the greatest benefit of post-meal exercise (Table 1). Glycosylation and oxidation caused by elevated blood glucose may be harmful. For example, glyco-oxidation of LDL seems to make this lipoprotein more atherogenic (Knott et al., 2003). Our results demonstrate an acute blood sugar reducing effect of light exercise and of a magnitude similar to that obtained by hypoglycemic drugs (Chiasson et al., 1996; Feinglos et al., 1997), even after intake of a large dose of high glycemic food. We suggest that the lowered glycemic response by light post-meal exercise could be due to increased glucose extraction in the working muscle. For the general public, a brisk walk (or any other form of light endurance exercise) could serve to blunt the blood sugar rise after carbohydrate ingestion. For patients, who are not fit for such activities, an even lighter exercise might have a similar effect. Studies are currently in progress to define the lowest work intensity required to obtain a blood glucose reducing effect.

Fig. 1. Glycemic responses after intake of cornflakes (1 g carbohydrate/kg BW, ingested in the time period 015 min), as influenced by 30 min of postprandial light physical activity (in the time period 1545 min), in two groups of trained and sedentary women (top panels: young = 1825 years; middle-aged = 4555 years; lower panels: young = 1825 years; middle-aged = 5565 years). Filled symbols = resting after the meal; open symbols = light bicycling exercise in the time period 1545 min. Mean values SEM (n = 10 in all groups, except young sedentary: n = 9; i.e. a total of 39 women). Significant main effect of time and interaction between time and exercise (repeated measure ANOVA). P < 0.05 for the difference between corresponding mean values in the same panel at 30 and 45 min after the meal (paired t test with Bonferroni correction).

sedentary women (physical activity less than once a week), and in 10 young (1825 years), and 10 middle-aged (4555 years) healthy trained women (regular training 3 times/week). Thus, a total of 39 women participated. Commencing after an overnight fast, each subject participated in two experiments, carried out on separate days (with at least 2 days between the experiments): Day 1, the subjects were given cornflakes (1 g carbohydrate per kg body weight) to be ingested during 15 min. Blood glucose was determined (Glucometer Elite, BayerA/S, Japan) while resting, before meal, and each 15 min for the next 120 min. Day 2 was similar to Day 1 but included light bicycling exercise (Monark Cardiocare, 837E, Exercise, Vansbro, Sweden) for 30 min after finishing the meal. During exercise, the heart rate was (mean SE) 120 3 and 112 3 beats/min in the young and middle-aged sedentary women, respectively. Corresponding values in the trained group were 139 9 and 125 11 beats/min, i.e. in both groups representing about 70% of their estimated maximal heart rate and characterized as light exercise. The exercise intensity was adjusted according to the heart rate, using 220 minus age as an estimate of the maximal heart rate. Furthermore, the Borg scale of perceived exertion (Borg, 1974) was used. The relative intensity was not significantly different in trained and sedentary women. The subjects wore a pulse registration device, including an electronic belt (Polar Sportstester, Polar Electro OY, Finland). For each group, a two-factor within-subject repeated measure ANOVA was used to test main effects of time, and interaction between time and exercise, using SPSS 11.0. Post hoc testing for significance between corresponding mean values was assessed by paired t test and Bonferroni correction. The figure was produced by SigmaPlot.

Table 1 Basic anthropomorphic and clinical data Trained Young (n = 10) Age (years) Body weight (kg) Height (m) BMI (kg/m2) SBP (mm Hg) DBP (mm Hg)
a b

Sedentary Middle-aged (n = 10) 49.2 1.3 a 69.2 2.2 168.6 1.0 20.5 0.7 130.1 4.6 76.9 3.3 Young (n = 9) 24.1 0.7 71.1 3.2 171.4 1.8 20.7 0.8 115.1 3.5 68.9 2.1 Middle-aged (n = 10) 59.2 1.7 a, b 69.7 2.9 166.8 1.6 20.9 0.8 124.7 5.4 76.6 1.4

22.5 0.5 64.7 2.3 170.0 0.8 19.0 0.6 116.7 3.3 73.8 3.2

P < 0.01 vs. young. P < 0.01 vs. trained, middle-aged (ANOVA with Bonferroni correction).

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Acknowledgment The authors gratefully acknowledge the technical assistance of Eva Kristensen. References
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