Abstract
BackgroundType 2 diabetes aggravates the postprandial metabolic effects of food, which increase cardiovascular risk. We investigated the acute effects of fast food on postprandial left ventricular (LV) function and the potential effects of pre-exercise in type 2 diabetes individuals.MethodsWe used a cross-over study including 10 type 2 diabetes individuals (7 male and 3 females; 53.4 ± 8.1 years; 28.3 ± 3.8 kg/m2; type 2 diabetes duration 3.1 ± 1.8 years) and 10 controls (7 male and 3 females; 52.8 ± 10.1 years; 28.5 ± 4.2 kg/m2) performing high intensity interval exercise (HIIE; 40 min, 4 × 4min intervals, 90–95 % HRmax), moderate intensity exercise (MIE; 47 min, 70 % HRmax) and no exercise (NE) in a random order 16–18 hours prior to fast-food ingestion. Baseline echocardiography, blood pressure and biochemical measurements were recorded prior to and 16–18 hours after exercise, and 30 minutes, 2 hours and 4 hours after fast food ingestion.ResultsLV diastolic (peak early diastolic tissue velocity, peak early diastolic filling velocity), and systolic workload (global strain rate, peak systolic tissue velocity, rate pressure product) increased after consumption of fast food in both groups. In contrast to controls, the type 2 diabetes group had prolonged elevations in resting heart rate and indications of prolonged elevations in diastolic workload (peak early diastolic tissue velocity) as well as reduced systolic blood pressure after fast food consumption. No significant modifications due to exercise in the postprandial phase were seen in any group.ConclusionsOur findings indicate that fast-food induces greater and sustained overall cardiac workload in type 2 diabetes individuals versus body mass index and age matched controls; exercise 16–18 hours pre-meal has no acute effects to the postprandial phase.Trial registrationClinicalTrials.gov: NCT01991769.
Highlights
Type 2 diabetes aggravates the postprandial metabolic effects of food, which increase cardiovascular risk
Few studies have investigated the acute effects of fast food on cardiac function, it is observed that foodinduced elevation of circulating glucose and oxidative stress reduce diastolic function in insulin-treated type 2 diabetes patients [9], and that acute elevations in circulating triglycerides yield compensatory increases in systolic function of the left ventricle in healthy individuals [10]
We found that the shortened isovolumic relaxation time (IVRT) and lack of changes to deceleration time might be due to the same mechanism
Summary
Type 2 diabetes aggravates the postprandial metabolic effects of food, which increase cardiovascular risk. Type 2 diabetes aggravates the postprandial metabolic effects of food because it impairs the transport, delivery and/or storage of carbohydrates and fats [4]. Endothelial function is impaired after fast food ingestion, which is related to increases in circulating glucose, triglycerides and/or elevated oxidative stress [7, 8]. Few studies have investigated the acute effects of fast food on cardiac function, it is observed that foodinduced elevation of circulating glucose and oxidative stress reduce diastolic function in insulin-treated type 2 diabetes patients [9], and that acute elevations in circulating triglycerides yield compensatory increases in systolic function of the left ventricle in healthy individuals [10].
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