Abstract
Simple SummaryIn this study, we investigated the cardio-autonomic stress responses to the ingestion of liquid glucose, fructose, a combination thereof and a placebo in healthy individuals at rest. The cardio-autonomic response was more pronounced in all groups with carbohydrates compared to placebo indicating an increased cardio-autonomic stress response resulting in a reduced heart-rate variability. When investigating different levels of blood glucose, the findings showed a significant decline in heart-rate variability with increasing blood glucose levels. This was also seen with severely low levels of blood glucose. The speed of how quick blood glucose increased and decreased also impacted the cardio-autonomic response which further deteriorated heart-rate variability. These findings indicate that healthy human’s autonomic system responds quickly to changes in their blood glucose.Background: It is unknown how different types of carbohydrates alter the cardio-autonomic system in healthy individuals. Therefore, the aim of this study was to investigate how heart-rate variability changes to single dose ingestion of glucose, fructose, glucose and fructose, and an artificial sweetener (sucralose). Methods: In a double-blind randomized crossover placebo-controlled setting, 15 participants received all study-specific substances in liquid form. During each 2-h visit, venous blood glucose was measured in a 5-min interval while heart-rate variability was measured continuously via Holter-electrocardiograph. Results: Ingestion of different types of carbohydrates and sucralose showed significant differences for heart rate (p < 0.001), SDNN (p < 0.008), RMSSD (p < 0.001), pNN50 (p < 0.001) and blood pressure (p < 0.001). Different glucose levels significantly altered parameters of heart-rate variability and blood pressure (all p < 0.001), while the rate of change in blood glucose led to changes in heart rate variability, but not in heart rate (p = 0.25) or blood pressure (p = 0.99). Conclusions: Ingestion of different types of carbohydrates lead to reductions in heart-rate variability compared to a placebo. Blood glucose values above or below 70–90 mg/dL decreased heart rate variability while this was also seen for rapid glucose changes, yet not as pronounced. Healthy individuals should be conscious about carbohydrate intake while maintaining blood glucose levels between 70–90 mg/dL.
Highlights
Heart rate variability (HRV) is a widely used marker of the cardiac autonomic nervous system, well known for its versatile applicability in health and disease [1–4]
This study was performed as a single center, randomized, double-blind, placebocontrolled crossover trial investigating the effects of different types of carbohydrates and their effect on cardiac autonomic response measured via HRV
Suc showed a significantly lower heart rate compared to Glu (59 ± 2 bpm vs. 63 ± 2 bpm, p < 0.001), Fructose (63 ± 2 bpm and Glu and 50% Fru (GluFru) 65 ± 2 bpm p < 0.001)
Summary
Heart rate variability (HRV) is a widely used marker of the cardiac autonomic nervous system, well known for its versatile applicability in health and disease [1–4]. In individuals with impaired glucose metabolism, as it is the case in type 1 diabetes (T1DM) and type 2 diabetes mellitus (T2DM), the appearance of diabetic cardiac autonomic neuropathy is associated with chronically decreased HRV [8]. In case of diabetes mellitus, impaired cardiac autonomic modulation appears to be a progressive phenomenon that may be associated with dysglycemia with extended periods of hypoglycemia and hyperglycemia deteriorating overall glycemic control [9,10]. Blood glucose ranges in individuals with diabetes are separated in hypoglycemia (10.0 mmol/L) [14] It is unknown how different types of carbohydrates alter the cardio-autonomic system in healthy individuals. Conclusions: Ingestion of different types of carbohydrates lead to reductions in heart-rate variability compared to a placebo. Healthy individuals should be conscious about carbohydrate intake while maintaining blood glucose levels between 70–90 mg/dL
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