Effects of accumulated versus continuous individualized exercise on postprandial glycemia in young adults with obesity

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Abstract
Elevated postprandial glucose (PPG) is an independent risk factor for cardiovascular disease. Post-meal exercise effectively reduces PPG concentrations. However, the effect of accumulated versus continuous post-meal exercise on PPG control remains unclear. This study aimed to investigate the effects of individualized accumulated or continuous exercise on PPG in young adults with obesity. Twenty young adults with obesity (11 males) completed three 4-h randomized crossover trials with 6–14-day washout periods: 1) sitting (SIT), 2) one 30-min walking bout (CONT), and 3) three 10-min walking bouts separated by 20-min resting (ACCU). Walking was initiated 20 min before individual PPG peak after breakfast, which was predetermined by continuous glucose monitoring. Blood samples were collected at 15-30 min intervals, and the 24-h glucose was monitored via continuous glucose monitoring. The 4-h PPG incremental area under the curve (iAUC) was 12.1%±30.9% and 21.5%±21.5% smaller after CONT (P = 0.022) and ACCU (P ˂0.001), respectively, than after SIT. PPG concentrations were lower during CONT at 30–60 min and during ACCU at 30–105 min after breakfast than during SIT (all P ˂0.05). The 4-h plasma insulin and C-peptide iAUC, and mean amplitude of glycemic excursions were lower after CONT and ACCU than after SIT (all P ˂0.05). Both continuous and accumulated exercises reduced PPG, insulin, and C-peptide concentrations and improved glucose fluctuations. Accumulated exercise maintained lower PPG concentrations for a longer time than continuous exercise in young adults with obesity.

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