Impact of energy turnover on the regulation of glucose homeostasis in healthy subjects

• Published in: Nutrition & diabetes 2019-08, Vol.9 (1), p.22-10, Article 22
• Main Authors: Büsing, Franziska, Hägele, Franziska Anna, Nas, Alessa, Hasler, Mario, Müller, Manfred James, Bosy-Westphal, Anja
• Format: Article
• Language: English
• Subjects: 692/308/2779/777; 692/499; Adult; Blood Glucose - metabolism; C-Peptide - blood; Caloric Restriction; Clinical Nutrition; Cross-Over Studies; Diabetes; Energy; Energy Intake - physiology; Energy Metabolism - physiology; Epidemiology; Exercise; Exercise - physiology; Female; Glucose; Healthy Volunteers; Homeostasis; Homeostasis - physiology; Humans; Insulin; Insulin Resistance - physiology; Internal Medicine; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolism; Nutrition research; Physical fitness; Postprandial Period; Studies; Systematic review; Walking; Young Adult
• ISSN: 2044-4052; 2044-4052
• DOI: 10.1038/s41387-019-0089-6

Objective Sedentary lifestyle increases the risk of type 2 diabetes. The aim of this study was to investigate the impact of different levels of energy turnover (ET; low, medium, and high level of physical activity and the corresponding energy intake) on glucose metabolism at zero energy balance, caloric restriction, and overfeeding. Methods Sixteen healthy individuals (13 men, 3 women, 25.1 ± 3.9 years, BMI 24.0 ± 3.2 kg/m 2 ) participated in a randomized crossover intervention under metabolic ward conditions. Subjects passed 3 × 3 intervention days. Three levels of physical activity (PAL: low 1.3, medium 1.6, and high 1.8 achieved by walking at 4 km/h for 0, 3 × 55, or 3 × 110 min) were compared under three levels of energy balance (zero energy balance (EB): 100% of energy requirement (Ereq); caloric restriction (CR): 75% Ereq, and overfeeding (OF): 125% Ereq). Continuous interstitial glucose monitoring, C-peptide excretion, and HOMA–IR, as well as postprandial glucose and insulin were measured. Results Daylong glycemia and insulin secretion did not increase with higher ET at all conditions of energy balance (EB, CR, and OF), despite a correspondingly higher CHO intake (Δ low vs. high ET: +86 to 135 g of CHO/d). At CR, daylong glycemia ( p  = 0.02) and insulin secretion ( p  = 0.04) were even reduced with high compared with low ET. HOMA–IR was impaired with OF and improved with CR, whereas ET had no effect on fasting insulin sensitivity. A higher ET led to lower postprandial glucose and insulin levels under conditions of CR and OF. Conclusion Low-intensity physical activity can significantly improve postprandial glycemic response of healthy individuals, independent of energy balance.