Fast food increases postprandial cardiac workload in type 2 diabetes independent of pre-exercise: A pilot study

Siri Marte Hollekim-Strand, Vegard Malmo, Turid Follestad, Ulrik Wisløff, Charlotte Björk Ingul, Siri Marte Hollekim-Strand, Vegard Malmo, Turid Follestad, Ulrik Wisløff, Charlotte Björk Ingul

Abstract

Background: Type 2 diabetes aggravates the postprandial metabolic effects of food, which increase cardiovascular risk. We investigated the acute effects of fast food on postprandial left ventricular (LV) function and the potential effects of pre-exercise in type 2 diabetes individuals.

Methods: We used a cross-over study including 10 type 2 diabetes individuals (7 male and 3 females; 53.4 ± 8.1 years; 28.3 ± 3.8 kg/m(2); type 2 diabetes duration 3.1 ± 1.8 years) and 10 controls (7 male and 3 females; 52.8 ± 10.1 years; 28.5 ± 4.2 kg/m(2)) performing high intensity interval exercise (HIIE; 40 min, 4 × 4 min intervals, 90-95% HRmax), moderate intensity exercise (MIE; 47 min, 70% HRmax) and no exercise (NE) in a random order 16-18 hours prior to fast-food ingestion. Baseline echocardiography, blood pressure and biochemical measurements were recorded prior to and 16-18 hours after exercise, and 30 minutes, 2 hours and 4 hours after fast food ingestion.

Results: LV diastolic (peak early diastolic tissue velocity, peak early diastolic filling velocity), and systolic workload (global strain rate, peak systolic tissue velocity, rate pressure product) increased after consumption of fast food in both groups. In contrast to controls, the type 2 diabetes group had prolonged elevations in resting heart rate and indications of prolonged elevations in diastolic workload (peak early diastolic tissue velocity) as well as reduced systolic blood pressure after fast food consumption. No significant modifications due to exercise in the postprandial phase were seen in any group.

Conclusions: Our findings indicate that fast-food induces greater and sustained overall cardiac workload in type 2 diabetes individuals versus body mass index and age matched controls; exercise 16-18 hours pre-meal has no acute effects to the postprandial phase.

Trial registration: ClinicalTrials.gov: NCT01991769.

Figures

Fig. 1
Fig. 1
Effects of fast food (left panel; all trials combined) and exercise (right panel; high intensity interval exercise +moderate intensity exercise vs. no exercise) on left ventricular diastolic function. Abbreviations: BL, baseline; C, control group; e’, peak early diastolic tissue Doppler velocity; E/e’ , filling pressure; E, peak early filling velocity; HIIE, high intensity interval exercise; HIIE+MIE, exercise combined; IVRT, isovolumic relaxation time; MIE, moderate intensity exercise; NE, no exercise; T2D, type 2 diabetes group. Estimated means and 95 % CIs from LMMs with the factors time, group and their interaction (left panel, figures a-d), and with the factors time, group, trial and their interactions (right panel, figures E-H). In the left panel significant (p < 0.01) time differences are indicated by *(from BL1), † (from BL2), ‡ (from food +30 min) and § (from food +2 h). For peak early filling velocity (e) there is no significant time and group interaction, and the indicated significant time differences refer to the main effect of time for both groups
Fig. 2
Fig. 2
Effects of fast food (left panel; all trials combined) and exercise (right panel; high intensity interval exercise +moderate intensity exercise vs. no exercise) on left ventricular systolic function. Abbreviations: BL, baseline; C, control group; HIIE, high intensity exercise; HIIE+MIE, exercise combined; MIE, moderate intensity exercise; NE, no exercise; S' , peak systolic tissue Doppler velocity; T2D, type 2 diabetes group. Estimated means and 95 % CIs from LMMs with the factors time, group and their interaction (left panel, figures a-b), and with the factors time, group, trial and their interactions (right panel, figures c-d). In the left panel significant (p < 0.01) time differences are indicated by *(from BL1), † (from BL2), ‡ (from food +30 min) and § (from food +2 h). For S' and global strain rate there is no significant time and group interaction, and the indicated significant time differences refer to the main effect of time for both groups
Fig. 3
Fig. 3
Effects of fast food (left panel; all trials combined) and exercise (right panel; high intensity interval exercise+moderate intensity exercise vs. no exercise) on resting heart rate and blood pressure. Abbreviations: BL, baseline; BP, blood pressure; C, control group; HIIE, high intensity exercise; HIIE+MIE, exercise combined; HR, resting heart rate; MIE; moderate intensity exercise; NE, no exercise; RPP, rate pressure product; T2D, type 2 diabetes group. Estimated means and 95 % CIs from LMMs with the factors time, group and their interaction (left panel, figures a-d), and with the factors time, group, trial and their interactions (right panel, figures e-h). In the left panel significant (p < 0.01) time differences are indicated by *(from BL1), † (from BL2), ‡ (from food +30 min) and § (from food +2 h). For diastolic BP there is no significant time and group interaction, and the indicated significant time differences refer to the main effect of time for both groups. For RPP, the means and CIs are shown as back-transformed values, computed by direct exponentiation of the means and CIs from the LMM based on log-transformed data
Fig. 4
Fig. 4
Effects of fast food (left panel, trials combined) and exercise (right panel; high intensity interval exercise+moderate intensity exercise vs. no exercise) on blood glucose, C-peptide, triglycerides and total antioxidant status. Abbreviations: BL, baseline; C, control group; HIIE,  high intensity exercise; HIIE+MIE, exercise combined; MIE, moderate intensity exercise; NE, no exercise; TAS, total antioxidant status; T2D, type 2 diabetes group. Estimated means and 95 % CIs from LMMs with the factors time, group and their interaction (left panel, figures a-d), and with the factors time, group, trial and their interactions (right panel, figures e-h). In the left panel significant (p < 0.01) time differences are indicated by *(from BL1), † (from BL2), ‡ (from food +30 min) and § (from food +2 h). For triglycerides there is no significant time and group interaction, and the indicated significant time differences refer to the main effect of time for both groups. Except for TAS, the means and CIs are shown as back-transformed values, computed by direct exponentiation of the means and CIs from the LMMs based on log-transformed data

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