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Sports Medicine (Auckland, N.Z.) Aug 2022Increasing evidence highlights that accumulating sitting time in prolonged bouts is detrimental to cardiometabolic health. (Meta-Analysis)
Meta-Analysis
The Acute Effects of Interrupting Prolonged Sitting Time in Adults with Standing and Light-Intensity Walking on Biomarkers of Cardiometabolic Health in Adults: A Systematic Review and Meta-analysis.
BACKGROUND
Increasing evidence highlights that accumulating sitting time in prolonged bouts is detrimental to cardiometabolic health.
OBJECTIVES
This systematic review aimed to compare the effects of fractionating prolonged sitting with frequent short bouts of standing and light-intensity walking on cardiometabolic health markers and conduct a meta-analysis for differences in systolic blood pressure (SBP), postprandial glucose and insulin.
METHODS
Experimental randomised crossover trials with at least three intervention arms that assessed interrupting sitting with frequent short bouts of standing and light-intensity walking over a single day compared to a prolonged sitting condition were retrieved. These studies measured at minimum one marker of cardiometabolic health in adults > 18 years. An electronic search was completed on the 2nd of August 2021, searching PubMed and Web of Science Core Collection, Scopus, Embase, Cochrane Library and APA PsycINFO. Risk of bias was assessed using a modified Downs and Black checklist. A meta-analysis was conducted using calculated Cohen's d quantifying the magnitude of difference between experimental conditions.
RESULTS
Seven studies met the inclusion criteria for the systematic review. All seven studies were included within the meta-analysis for postprandial glucose, four studies were pooled for postprandial insulin and three for SBP. Biomarkers of cardiometabolic health were discussed qualitatively if fewer than three studies measured and reported the variable. A meta-analysis of seven acute, 1-day randomised crossover trials that sampled mixed-sex adults (aged > 18 years) who were predominately overweight or participants with obesity found that standing as an interruption to prolonged sitting significantly reduced postprandial glucose (∆ = - 0.31, 95% CI - 0.60, - 0.03; z = - 2.15, p < 0.04) but had no significant effect on insulin or SBP. Light-intensity walking was shown to significantly attenuate postprandial glucose (∆ = - 0.72, 95% CI - 1.03, - 0.41; z = - 4.57, p < 0.001) and insulin (∆ = - 0.83, 95% CI - 1.18, - 0.48; z = - 4.66, p < 0.001) compared to continued sitting. When comparing light-intensity walking breaks compared to standing breaks a significant reduction in glucose (∆ = - 0.30, 95% CI - 0.52, - 0.08; z = -2.64, p < 0.009) and insulin (∆ = - 0.54, 95% CI - 0.75, - 0.33; z = -4.98, p < 0.001) was observed. Both standing and light-intensity walking showed no effect on SBP.
CONCLUSIONS
Frequent short interruptions of standing significantly attenuated postprandial glucose compared to prolonged sitting; however, light-intensity walking was found to represent a superior physical activity break. The feasibility and longitudinal implications of breaking sedentary behaviour with light-intensity walking should be investigated in a free-living setting.
REGISTRATION
Not available.
Topics: Adult; Biomarkers; Blood Glucose; Cardiovascular Diseases; Humans; Insulin; Postprandial Period; Walking
PubMed: 35147898
DOI: 10.1007/s40279-022-01649-4 -
The American Journal of Clinical... Aug 2021Starchy foods can have a profound effect on metabolism. The structural properties of starchy foods can affect their digestibility and postprandial metabolic responses,... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Starchy foods can have a profound effect on metabolism. The structural properties of starchy foods can affect their digestibility and postprandial metabolic responses, which in the long term may be associated with the risk of type 2 diabetes and obesity.
OBJECTIVES
This systematic review sought to evaluate the clinical evidence regarding the impact of the microstructures within starchy foods on postprandial glucose and insulin responses alongside appetite regulation.
METHODS
A systematic search was performed in the PUBMED, Ovid Medicine, EMBASE, and Google Scholar databases for data published up to 18 January 2021. Data were extracted by 3 independent reviewers from randomized crossover trials (RCTs) that investigated the effect of microstructural factors on postprandial glucose, insulin, appetite-regulating hormone responses, and subjective satiety scores in healthy participants.
RESULTS
We identified 745 potential articles, and 25 RCTs (n = 369 participants) met our inclusion criteria: 6 evaluated the amylose-to-amylopectin ratio, 6 evaluated the degree of starch gelatinization, 2 evaluated the degree of starch retrogradation, 1 studied starch-protein interactions, and 12 investigated cell and tissue structures. Meta-analyses showed that significant reductions in postprandial glucose and insulin levels was caused by starch with a high amylose content [standardized mean difference (SMD) = -0.64 mmol/L*min (95% CI: -0.83 to -0.46) and SMD = -0.81 pmol/L*min (95% CI: -1.07 to -0.55), respectively], less-gelatinized starch [SMD = -0.54 mmol/L*min (95% CI: -0.75 to -0.34) and SMD = -0.48 pmol/L*min (95% CI: -0.75 to -0.21), respectively], retrograded starch (for glucose incremental AUC; SMD = -0.46 pmol/L*min; 95% CI: -0.80 to -0.12), and intact and large particles [SMD = -0.43 mmol/L*min (95% CI: -0.58 to -0.28) and SMD = -0.63 pmol/L*min (95% CI: -0.86 to -0.40), respectively]. All analyses showed minor or moderate heterogeneity (I2 < 50%). Sufficient evidence was not found to suggest how these structural factors influence appetite.
CONCLUSIONS
The manipulation of microstructures in starchy food may be an effective way to improve postprandial glycemia and insulinemia in the healthy population. The protocol for this systematic review and meta-analysis was registered in the international prospective register of systematic reviews (PROSPERO) as CRD42020190873.
Topics: Blood Glucose; Dietary Carbohydrates; Food Analysis; Humans; Postprandial Period; Starch
PubMed: 34049391
DOI: 10.1093/ajcn/nqab098 -
Redox Biology Oct 2021Postprandial oxidative stress markers in blood are generated transiently from various tissues and cells following high-fat and/or high-carbohydrate (HFHC) meals, and may... (Review)
Review
BACKGROUND
Postprandial oxidative stress markers in blood are generated transiently from various tissues and cells following high-fat and/or high-carbohydrate (HFHC) meals, and may be suppressed by certain phytonutrients, such as polyphenols and carotenoids. However, the transient presence of phytonutrients in circulation suggests that timing of consumption, relative to the meal, could be important. This systematic review investigates the effect of timing of phytonutrient intake on blood markers of postprandial oxidative processes.
METHOD
EMBASE, Medline, Scopus and Web of Science were searched up to December 2020. Eligible studies met the criteria: 1) healthy human adults; 2) phytonutrient(s) consumed in solid form within 24 h of a HFHC meal; 3) postprandial measurements of oxidative stress or antioxidants in blood; and 4) controlled study design. Cohen's d effect sizes were calculated to compare studies.
RESULTS
Nine studies, involving 256 participants, were included. Phytonutrients were consumed either at the same time, 1 h before, or the day (>12 h) before a HFHC meal. Significant decreases in blood markers - plasma lipid hydroperoxides, plasma malondialdehyde, serum sNox2-dp, serum 8-iso-PGF2α, platelet p47 phosphorylation, and Keap-1 and p47 protein levels in mononuclear cells (MNCs) - were observed where the phytonutrient was consumed together with the challenge meal (n = 4). Lack of any effect on oxidative stress markers was observed where phytonutrients were consumed with (n = 1), 1 h before (n = 1), and the day before (n = 2) the HFHC meal.
CONCLUSION
Phytonutrients consumed with a HFHC meal significantly suppressed some markers of oxidative stress in blood. Although there were only a limited number of studies, it appears that suppression appeared effective at the time of peak phytonutrient concentration in plasma. However, further studies are required to confirm the observations and systematically optimise the effect of timing.
Topics: Antioxidants; Cross-Over Studies; Humans; Malondialdehyde; Oxidative Stress; Phytochemicals; Postprandial Period
PubMed: 34488026
DOI: 10.1016/j.redox.2021.102123 -
Journal of Sports Sciences Mar 2024Stair climbing exercise (SE) provides a feasible approach to elevate physical activity, but the effects on metabolic health are unclear. We systematically reviewed the... (Review)
Review
Stair climbing exercise (SE) provides a feasible approach to elevate physical activity, but the effects on metabolic health are unclear. We systematically reviewed the currently available evidence on the effects of SE on fasting and postprandial glycaemia and lipidaemia. Studies were included if they investigated the effects of acute or chronic (at least 2 weeks) SE on fasting and/or postprandial glycaemic (insulin and glucose) and lipidaemic (triacylglycerols and non-esterified fatty acids) responses in healthy, prediabetic or type 2 diabetic adult populations. PubMed, Web of Science and Scopus were searched for eligible studies until July 2022. A total of 25 studies (14 acute and 11 chronic) were eligible for review. Acute bout(s) of SE can reduce postprandial glycaemia in individuals with prediabetes and type 2 diabetes (8 of 9 studies), but not in normoglycemic individuals. The effects of acute SE on postprandial lipidaemic responses and SE training on both fasting and postprandial glycaemia/lipidaemia were unclear. Acute SE may reduce postprandial glucose concentrations in people with impaired glycaemic control, but high-quality studies are needed. More studies are needed to determine the effect of chronic SE training on postprandial glucose and lipid responses, and the acute effects of SE on lipid responses.
Topics: Humans; Postprandial Period; Blood Glucose; Diabetes Mellitus, Type 2; Stair Climbing; Fasting; Prediabetic State; Insulin; Triglycerides; Fatty Acids, Nonesterified; Lipids
PubMed: 38695325
DOI: 10.1080/02640414.2024.2345414 -
Aging Clinical and Experimental Research Jul 2020Ageing is associated with reduced appetite and energy intakes. However, the mechanisms underlying this phenomenon are not fully understood. This systematic review and... (Meta-Analysis)
Meta-Analysis
Ageing is associated with reduced appetite and energy intakes. However, the mechanisms underlying this phenomenon are not fully understood. This systematic review and meta-analysis quantified differences in circulating concentrations of appetite-related hormones between healthy older and younger adults. Six databases were searched through 12th June 2018 for studies that compared appetite-related hormone concentrations between older and younger adults. Data were pooled using random-effects meta-analysis and are presented as standardised mean difference (Hedges' g) with 95% confidence intervals (95% CI). Thirty-five studies were included involving 710 older adults (mean ± SD; age: 73 ± 5 years) and 713 younger adults (age: 28 ± 7 years). Compared with younger adults, older adults exhibited higher fasted and postprandial concentrations of the anorectic hormones cholecystokinin (Fasted: SMD 0.41 (95% CI 0.24, 0.57); p < 0.001. Postprandial: SMD 0.41 (0.20, 0.62); p < 0.001), leptin [Fasted: SMD 1.23 (0.15, 2.30); p = 0.025. Postprandial: SMD 0.62 (0.23, 1.01); p = 0.002] and insulin [Fasted: SMD 0.24 (- 0.02, 0.50); p = 0.073. Postprandial: SMD 0.16 (0.01, 0.32); p = 0.043]. Higher postprandial concentrations of peptide-YY were also observed in older adults compared with younger adults [SMD 0.31 (- 0.03, 0.65); p = 0.075]. Compared with younger adults, older adults had lower energy intakes [SMD - 0.98 (- 1.74, - 0.22); p = 0.011], and lower hunger perceptions in the fasted [SMD - 1.00 (- 1.54, - 0.46); p < 0.001] and postprandial states [SMD - 0.31, (- 0.64, 0.02); p = 0.064]. Higher circulating concentrations of insulin, leptin, cholecystokinin and peptide-YY accord with reduced appetite and energy intakes in healthy older adults. Interventions to reduce circulating levels of these hormones may be beneficial for combatting the anorexia of ageing.
Topics: Adult; Aged; Appetite; Energy Intake; Fasting; Hormones; Humans; Postprandial Period; Young Adult
PubMed: 31432431
DOI: 10.1007/s40520-019-01292-6 -
BMJ Open Aug 2022Patients with type 2 diabetes mellitus (T2DM) have been shown to have thiamine deficiency. Dietary supplementation is an economic strategy to control blood glucose. To... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Patients with type 2 diabetes mellitus (T2DM) have been shown to have thiamine deficiency. Dietary supplementation is an economic strategy to control blood glucose. To evaluate effectiveness of thiamine supplementation on glycaemic outcomes in patients with T2DM.
METHODS
Studies that assessed effect of thiamine supplementation in adults with T2DM which measured glycaemic outcomes-HbA1c, fasting blood glucose (FBG) and/or postprandial blood glucose (PPG) were included. PUBMED, Tripdatabase, the Cochrane Central Register, National Institute of Health Clinical Database and Google Scholar were searched until December 2021 for RCTs. It was assessed using standardised critical appraisal instruments from the Joanna Briggs Institute for RCTs. Where possible, studies were pooled in a meta-analysis. Results were presented in a narrative format if statistical pooling was not possible.
RESULTS
Six trials involving 364 participants. : No significant beneficial effects were observed on glycaemic outcomes with 100-900 mg/day of thiamine or benfotiamine for up to 3 months (HbA1c: MD, -0.02%, 95% CI: -0.35 to 0.31; FBG: MD,-0.20 mmol/L; 95% CI: -0.69 to 0.29; PPG: MD, - 0.20 mmol/L, 95% CI: -2.05 to 1.65 (mean difference, MD)). There was a significant increase in high-density lipoprotein (HDL) (MD, 0.10; 95% CI: 0.10 to 0.20) at 3-month follow-up. Benfotiamine reduced triglyceride level (MD, -1.10; 95% CI: -1.90 to -0.30) in 120 mg/day dose as compared with placebo 150 mg/day, however this was not demonstrated in higher doses.
DISCUSSION
Inclusion of single-centre trials published only in English, small sample sizes of included studies, lack of trials investigating outcomes for same comparisons and varying follow-up periods. Thiamine supplementation does not affect glycaemic outcomes, however reduces triglycerides while increasing HDL. Multicentre well-designed RCT with higher doses of thiamine and a follow-up period of 1-2 years will provide better evidence.
PROSPERO REGISTRATION NUMBER
CRD42020170520.
Topics: Adult; Blood Glucose; Diabetes Mellitus, Type 2; Dietary Supplements; Glycated Hemoglobin; Humans; Thiamine
PubMed: 36008064
DOI: 10.1136/bmjopen-2021-059834 -
Advances in Nutrition (Bethesda, Md.) Feb 2022Consuming fat results in postprandial lipemia, which is defined as an increase in blood triglyceride (TG) concentration. According to current knowledge, an excessively...
Impact of Meal Fatty Acid Composition on Postprandial Lipemia in Metabolically Healthy Adults and Individuals with Cardiovascular Disease Risk Factors: A Systematic Review.
Consuming fat results in postprandial lipemia, which is defined as an increase in blood triglyceride (TG) concentration. According to current knowledge, an excessively elevated postprandial TG concentration increases the risk of cardiovascular disease (CVD). It is well known that meal-dependent (e.g., nutrient composition) as well as meal-independent factors (e.g., age) determine the magnitude of the lipemic response. However, there is conflicting evidence concerning the influence of fatty acid (FA) composition on postprandial TG concentration. The FA composition of a meal depends on the fat source used; for example, butter and coconut oil are rich in SFAs, while olive oil and canola oil have a high content of unsaturated FAs. To investigate the influence of meals prepared with fat sources rich in either SFAs or unsaturated FAs on postprandial lipemia, we carried out a systematic literature search in PubMed, Scopus, and the Cochrane Library. Randomized crossover studies were analyzed and the AUC of postprandial TG concentration served as the primary outcome measure. To examine the influence of health status, we differentiated between metabolically healthy individuals and those with CVD risk factors. In total, 23 studies were included. The results show that, in metabolically healthy adults, the FA composition of a meal is not a relevant determinant of postprandial lipemia. However, in individuals with CVD risk factors, SFA-rich meals (>32 g SFA/meal) often elicited a stronger lipemic response than meals rich in unsaturated FAs. The results suggest that adults with hypertriglyceridemia, an elevated BMI (≥30 kg/m2), and/or who are older (>40 y) may benefit from replacing SFA sources with unsaturated FAs. These hypotheses need to be verified by further studies in people with CVD risk factors using standardized postprandial protocols. This review was registered in PROSPERO as CRD42021214508 (https://www.crd.york.ac.uk/prospero/).
Topics: Adult; Cardiovascular Diseases; Dietary Fats; Fatty Acids; Humans; Hyperlipidemias; Meals; Postprandial Period; Triglycerides
PubMed: 34427586
DOI: 10.1093/advances/nmab096 -
Molecular Nutrition & Food Research Dec 2023Metabolic flexibility is essential for a healthy response to a high fat meal, and is assessed by measuring postprandial changes in blood markers including peripheral...
Systematic Review and Quantitative Data Synthesis of Peripheral Blood Mononuclear Cell Transcriptomics Reveals Consensus Gene Expression Changes in Response to a High Fat Meal.
SCOPE
Metabolic flexibility is essential for a healthy response to a high fat meal, and is assessed by measuring postprandial changes in blood markers including peripheral blood mononuclear cells (PBMCs; lymphocytes and monocytes). However, there is no clear consensus on postprandial gene expression and protein changes in these cells.
METHOD AND RESULTS
The study systematically reviews the literature reporting transcriptional and proteomic changes in PBMCs after consumption of a high fat meal. After re-analysis of the raw data to ensure equivalence between studies, ≈85 genes are significantly changed (defined as in the same direction in ≥3 studies) with about half involved in four processes: inflammation/oxidative stress, GTP metabolism, apoptosis, and lipid localization/transport. For meals consisting predominantly of unsaturated fatty acids (UFA), notable additional processes are phosphorylation and glucocorticoid response. For saturated fatty acids (SFA), genes related to migration/angiogenesis and platelet aggregation are also changed.
CONCLUSION
Despite differences in study design, common gene changes are identified in PBMCs following a high fat meal. These common genes and processes will facilitate definition of the postprandial transcriptome as part of the overall postcibalome, linking all molecules and processes that change in the blood after a meal.
Topics: Dietary Fats; Transcriptome; Leukocytes, Mononuclear; Consensus; Proteomics; Meals; Postprandial Period; Cross-Over Studies; Triglycerides
PubMed: 37817369
DOI: 10.1002/mnfr.202300512 -
Nutrients Oct 2021Carbohydrate counting (CHC) is the established form of calculating bolus insulin for meals in children with type 1 diabetes (T1DM). With the widespread use of continuous...
Carbohydrate counting (CHC) is the established form of calculating bolus insulin for meals in children with type 1 diabetes (T1DM). With the widespread use of continuous glucose monitoring (CGM) observation time has become gapless. Recently, the impact of fat, protein and not only carbohydrates on prolonged postprandial hyperglycaemia have become more evident to patients and health-care professionals alike. However, there is no unified recommendation on how to calculate and best administer additional bolus insulin for these two macronutrients. The aim of this review is to investigate: the scientific evidence of how dietary fat and protein influence postprandial glucose levels; current recommendations on the adjustment of bolus insulin; and algorithms for insulin application in children with T1DM. A PubMed search for all articles addressing the role of fat and protein in paediatric (sub-)populations (<18 years old) and a mixed age population (paediatric and adult) with T1DM published in the last 10 years was performed. Conclusion: Only a small number of studies with a very low number of participants and high degree of heterogeneity was identified. While all studies concluded that additional bolus insulin for (high) fat and (high) protein is necessary, no consensus on when dietary fat and/or protein should be taken into calculation and no unified algorithm for insulin therapy in this context exists. A prolonged postprandial observation time is necessary to improve individual metabolic control. Further studies focusing on a stratified paediatric population to create a safe and effective algorithm, taking fat and protein into account, are necessary.
Topics: Adolescent; Algorithms; Blood Glucose; Child; Diabetes Mellitus, Type 1; Dietary Fats; Dietary Proteins; Drug Dosage Calculations; Eating; Female; Glycemic Control; Humans; Hyperglycemia; Hypoglycemic Agents; Insulin; Insulin Infusion Systems; Male; Postprandial Period
PubMed: 34684559
DOI: 10.3390/nu13103558 -
Journal of Pediatric Gastroenterology... Jul 2021Electrogastrography (EGG) is a non-invasive method of measuring gastric electrophysiology. Abnormal gastric electrophysiology is thought to contribute to disease... (Meta-Analysis)
Meta-Analysis
Electrogastrography (EGG) is a non-invasive method of measuring gastric electrophysiology. Abnormal gastric electrophysiology is thought to contribute to disease pathophysiology in patients with gastroduodenal symptoms but this has not been comprehensively quantified in pediatric populations. This study aimed to quantify the abnormalities in gastric electrophysiology on EGG in neonatal and pediatric patients.Databases were systematically searched for articles utilizing EGG in neonatal and pediatric patients (≤18 years). Primary outcomes were prevalence of abnormality, percentage of time in normal rhythm, and power ratio. Secondary outcomes were correlations between patient symptoms and abnormal gastric electrophysiology on EGG.A total of 33 articles (1444 participants) were included. EGG methodologies were variable. Pooled prevalence of abnormalities on EGG ranged from 61% to 86% in patients with functional dyspepsia (FD), gastro-esophageal reflux disease (GERD), and type 1 diabetes mellitus (T1DM). FD patients averaged 20.8% (P = 0.011) less preprandial and 21.6% (P = 0.031) less postprandial time in normogastria compared with controls. Electrophysiological abnormalities were inconsistent in GERD. T1DM patients averaged 46.2% (P = 0.0003) less preprandial and similar (P = 0.32) postprandial time in normogastria compared with controls, and had a lower power ratio (SMD -2.20, 95% confidence interval [CI]: -4.25 to -0.15; P = 0.036). Symptom correlations with gastric electrophysiology were inconsistently reported.Abnormalities in gastric electrophysiology were identifiable across a range of pediatric patients with gastroduodenal symptoms on meta-analysis. However, techniques have been inconsistent, and standardized and more reliable EGG methods are desirable to further define these findings and their potential utility in clinical practice.
Topics: Child; Dyspepsia; Gastric Emptying; Humans; Infant, Newborn; Postprandial Period; Stomach; Stomach Diseases
PubMed: 33797449
DOI: 10.1097/MPG.0000000000003140