Lipid Metabolism Links Nutrient-Exercise Timing to Insulin Sensitivity in Men Classified as Overweight or Obese

J Clin Endocrinol Metab. 2020 Mar 1;105(3):660-676. doi: 10.1210/clinem/dgz104.

Abstract

Context: Pre-exercise nutrient availability alters acute metabolic responses to exercise, which could modulate training responsiveness.

Objective: To assess acute and chronic effects of exercise performed before versus after nutrient ingestion on whole-body and intramuscular lipid utilization and postprandial glucose metabolism.

Design: (1) Acute, randomized, crossover design (Acute Study); (2) 6-week, randomized, controlled design (Training Study).

Setting: General community.

Participants: Men with overweight/obesity (mean ± standard deviation, body mass index: 30.2 ± 3.5 kg⋅m-2 for Acute Study, 30.9 ± 4.5 kg⋅m-2 for Training Study).

Interventions: Moderate-intensity cycling performed before versus after mixed-macronutrient breakfast (Acute Study) or carbohydrate (Training Study) ingestion.

Results: Acute Study-exercise before versus after breakfast consumption increased net intramuscular lipid utilization in type I (net change: -3.44 ± 2.63% versus 1.44 ± 4.18% area lipid staining, P < 0.01) and type II fibers (-1.89 ± 2.48% versus 1.83 ± 1.92% area lipid staining, P < 0.05). Training Study-postprandial glycemia was not differentially affected by 6 weeks of exercise training performed before versus after carbohydrate intake (P > 0.05). However, postprandial insulinemia was reduced with exercise training performed before but not after carbohydrate ingestion (P = 0.03). This resulted in increased oral glucose insulin sensitivity (25 ± 38 vs -21 ± 32 mL⋅min-1⋅m-2; P = 0.01), associated with increased lipid utilization during exercise (r = 0.50, P = 0.02). Regular exercise before nutrient provision also augmented remodeling of skeletal muscle phospholipids and protein content of the glucose transport protein GLUT4 (P < 0.05).

Conclusions: Experiments investigating exercise training and metabolic health should consider nutrient-exercise timing, and exercise performed before versus after nutrient intake (ie, in the fasted state) may exert beneficial effects on lipid utilization and reduce postprandial insulinemia.

Trial registration: ClinicalTrials.gov NCT02744183 NCT02397304.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Energy Intake
  • Energy Metabolism
  • Exercise Therapy / methods*
  • Follow-Up Studies
  • Humans
  • Insulin Resistance*
  • Lipid Metabolism*
  • Lipids / analysis
  • Male
  • Metabolic Syndrome / epidemiology
  • Metabolic Syndrome / prevention & control*
  • Nutrients
  • Obesity / physiopathology
  • Obesity / therapy*
  • Overweight / physiopathology
  • Overweight / therapy*
  • United Kingdom / epidemiology

Substances

  • Lipids

Associated data

  • ClinicalTrials.gov/NCT02744183
  • ClinicalTrials.gov/NCT02397304