There is strong evidence that short bouts of light-intensity post-meal exercise are effective at lowering post-prandial and 24-h glucose concentrations in older people with impaired glucose tolerance (IGT). It is unknown, however, whether these transient benefits result in more enduring improvements in glycemic control after training. PURPOSE: To determine the effects of a home-based, 12-week post-meal walking program on improvements in glucose metabolism, as well as on changes in body composition in overweight (BMI=30±1.8 kg/m2) older adults (N=6; 72±5.3 years) with IGT. METHODS: Participants performed three 15-minute bouts of low-intensity (3 METs) walking beginning 30 minutes after each meal on five days per week for 12 weeks. Glucose and insulin responses to an oral glucose tolerance test were determined 48 h after the last exercise bout before and after training. Changes in body composition were determined using iDXA. RESULTS: Overall adherence to the total training program (180 post-meal walking bouts) was 65%; however, participants reported completing an average of 82% of the post-dinner walks across the 12 weeks. Total areas under the curve for both glucose [29.5±9.3 vs. 29.5±8.9 (mg·dL-1)·3h·103] and insulin [9.2±5.4 vs. 9.0±4.4 (mg·dL-1)·3h·103] responses did not change between baseline and follow-up; however, HbA1c levels (6.45% vs.5.86%) and the Whole Body Insulin Sensitivity Index (4.5± 3.6 vs. 5.8 ± 8.7) showed promising improvements following training. There were no changes to body weight, body fat, or lean mass; however, visceral fat volume decreased (688.7±311.4 vs. 584.3±306.0 cm3), and four of the six participants reduced their visceral fat mass by over 37g. CONCLUSIONS: Data from this pilot study suggest that the benefits of regular, low-intensity post-meal walking on glycemic control may not last beyond 24h in older adults with IGT. On the other hand, if performed consistently over time, the transient benefits may result in more enduring improvements in HbA1c and particularly in visceral fat mass. Supported by NIH/NIA R56 AG050661
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