A Low-Glycemic Index Diet and Exercise Intervention Reduces TNFα in Isolated Mononuclear Cells of Older, Obese Adults

Abstract

AbstractLow-glycemic index diets and exercise independently improve glucose tolerance and reduce diabetes risk. However, the combined effect of a low-glycemic index diet and exercise on inflammation and glucose metabolism is not known. Therefore, we randomized 28 insulin-resistant adults (age: 66 ± 1 y; BMI: 34.2 ± 0.7 kgm–2) to a 12-wk, low (LGI = 40) or high- (HGI = 80) glycemic index diet plus aerobic exercise (5 dwk–1, 60 mind–1, 80–85% heart ratemax) intervention. All food and fluids were provided during the study. Inflammation was assessed from cytokine (TNFa and IL-6) secretion using peripheral blood mononuclear cells (MNC) stimulated overnight with LPS. Glycemic response was determined following ingestion of a 75-g glucose solution. Fasting blood samples were collected for additional cytokine [TNFa, IL-6, and monocyte chemoattractant protein 1 (MCP-1)] analysis. Both interventions decreased BMI (P< 0.001), fasting plasma glucose (P= 0.01), and insulin (P= 0.02). The glycemic response was reduced only in the LGI group (P= 0.04). Plasma and MNC-derived TNFa secretion were reduced in the LGI group (P= 0.02) but increased in the HGI group (P= 0.02). Secretion of IL-6 from MNC and plasma IL-6 and MCP-1 concentrations were reduced in the LGI group. The change in MNC-derived TNFa (r= 0.43;P= 0.04) and plasma MCP-1 (r= 0.44;P= 0.04) correlated with decreases in the glycemic response. These data highlight the importance of diet composition in the treatment and prevention of inflammation and hyperglycemia. A low-glycemic index diet has antiinflammatory and antidiabetogenic effects when combined with exercise in older, obese prediabetics.