Preexercise Breakfast Ingestion versus Extended Overnight Fasting Increases Postprandial Glucose Flux after Exercise in Healthy Men

Citation

Edinburgh RM, Hengist A, Smith HA, Travers RL, Koumanov F, Betts JA, Thompson D, Walhin J, Wallis GA, Hamilton DL, Stevenson EJ, Tipton KD & Gonzalez JT (2018) Preexercise Breakfast Ingestion versus Extended Overnight Fasting Increases Postprandial Glucose Flux after Exercise in Healthy Men. American Journal of Physiology-Endocrinology and Metabolism, 315 (5), pp. E1062-E1074. https://doi.org/10.1152/ajpendo.00163.2018

Abstract
Aims To characterize postprandial glucose flux after exercise in the fed versus overnight fasted-state and to investigate potential underlying mechanisms. Methods In a randomized order, twelve men underwent breakfast-rest (BR; 3 h semi-recumbent), breakfast-exercise (BE; 2 h semi-recumbent before 60-min of cycling (50% peak power output) and overnight fasted-exercise (FE; as per BE omitting breakfast) trials. An oral glucose tolerance test (OGTT) was completed post-exercise (post-rest on BR). Dual stable isotope tracers ([U-13C] glucose ingestion and [6,6-2H2] glucose infusion) and muscle biopsies were combined to assess postprandial plasma glucose kinetics and intramuscular signaling, respectively. Plasma intestinal fatty acid binding (I-FABP) concentrations were determined as a marker of intestinal damage. Results Breakfast before exercise increased post-exercise plasma glucose disposal rates during the OGTT, from 44 g•120 min-1 in FE [35 to 53 g•120 min-1] (mean [normalized 95% CI]) to 73 g•120 min-1 in BE [55 to 90 g•120 min-1; p = 0.01]. This higher plasma glucose disposal rate was, however, offset by increased plasma glucose appearance rates (principally OGTT-derived), resulting in a glycemic response that did not differ between BE and FE (p = 0.11). Plasma I-FABP concentrations during exercise were 264 pg•mL-1 [196 to 332 pg•mL-1] lower in BE versus FE (p = 0.01). Conclusion Breakfast before exercise increases post-exercise postprandial plasma glucose disposal, which is offset (primarily) by increased appearance rates of orally-ingested glucose. Therefore, metabolic responses to fed-state exercise cannot be readily inferred from studies conducted in a fasted state.

Keywords
Physiology (medical); Physiology; Endocrinology, Diabetes and Metabolism

Journal
American Journal of Physiology-Endocrinology and Metabolism: Volume 315, Issue 5