‘Exercise snacks’ before meals: a novel strategy to improve glycaemic control in individuals with insulin resistance

Abstract

Aims/hypothesis

The aim of this study was to investigate whether small doses of intense exercise before each main meal (‘exercise snacks’) would result in better blood glucose control than a single bout of prolonged, continuous, moderate-intensity exercise in individuals with insulin resistance.

Methods

Nine individuals completed three exercise interventions in randomised order. Measures were recorded across 3 days with exercise performed on the middle day, as either: (1) traditional continuous exercise (CONT), comprising 30 min moderate-intensity (60% of maximal heart rate [HRmax]) incline walking before dinner; (2) exercise snacking (ES), consisting of 6 × 1 min intense (90% HRmax) incline walking intervals 30 min before each meal; or (3) composite exercise snacking (CES), encompassing 6 × 1 min intervals alternating between walking and resistance-based exercise, 30 min before meals. Meal timing and composition were controlled within participants for exercise interventions.

Results

ES attenuated mean 3 h postprandial glucose concentration following breakfast (by 1.4 ± 1.5 mmol/l, p = 0.02) but not lunch (0.4 ± 1.0 mmol/l, p = 0.22), and was more effective than CONT following dinner (0.7 ± 1.5 mmol/l below CONT; p = 0.04). ES also reduced 24 h mean glucose concentration by 0.7 ± 0.6 mmol/l (p = 0.01) and this reduction persisted for the subsequent 24 h (lower by 0.6 ± 0.4 mmol/l vs CONT, relative to their baselines; p = 0.01). CES was just as effective as ES (p > 0.05 for all glycaemic variables) at improving glycaemic control.

Conclusions/interpretation

Dosing exercise as brief, intense ‘exercise snacks’ before main meals is a time-efficient and effective approach to improve glycaemic control in individuals with insulin resistance.

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Abbreviations

CVD:

Cardiovascular disease

CES:

Composite exercise snacking

CGM:

Continuous blood glucose monitoring

CONT:

Traditional continuous exercise

ES:

Exercise snacking protocol

HIT:

High-intensity interval training

HR:

Heart rate

HRmax :

Maximal heart rate

PPG:

Postprandial glucose

RER:

Respiratory exchange ratio

RPE:

Rating of perceived exertion

\( \dot{V}{\mathrm{O}}_{2 \max } \) :

Maximal oxygen consumption

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Acknowledgements

We would like to acknowledge the dedication and commitment of our participants, and thank L. Hughes (School of Physical Education, Sport and Exercise Sciences, University of Otago) for technical assistance.

Duality of interest

The authors declare that there is no duality of interest associated with this manuscript.

Contribution statement

MEF and JDC conceived the study, with guidance and knowledge on design from PJM, JCB, MJAW, SJEL and JAH. MEF performed the data collection with help from JCB and MJAW for cardiovascular screening. MEF and JDC contributed to the data analysis. MEF drafted the manuscript and all other authors contributed critically to revisions. All authors declare that they read and approved the final version of the manuscript before submission. JDC is responsible for the integrity of the work as a whole.

Funding

This study was supported by the School of Physical Education, Sport and Exercise Sciences and Dunedin School of Medicine, University of Otago.

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Correspondence to James D. Cotter.

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Cite this article

Francois, M.E., Baldi, J.C., Manning, P.J. et al. ‘Exercise snacks’ before meals: a novel strategy to improve glycaemic control in individuals with insulin resistance. Diabetologia 57, 1437–1445 (2014). https://doi.org/10.1007/s00125-014-3244-6

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Keywords

  • Continuous glucose monitoring
  • High-intensity interval exercise
  • Postprandial glucose
  • Type 2 diabetes