Meal Glycaemic Index and Exercise After Gastric Bypass

Kirstine Nyvold Bojsen-Moeller20 enrolled

Overview

The study will evaluate postprandial glucose excursions and gut hormone secretion after ingestion of meals with different glycaemic index (GI) values (high vs low) followed by an acute bout of exercise or rest in gastric bypass operated subjects and matched control subjects.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

Conditions

Roux-en-Y Gastric Bypass Obesity

Interventions

Low GI mealtestOTHER

Meal with low glycaemic index (GI) is consumed over 20 min

Low GI mealtest and subsequent exerciseOTHER

Meal with low glycaemic index (GI) is consumed over 20 min and the subject postprandially exercises for 30 min

High GI mealtestOTHER

Meal with high glycaemic index (GI) is consumed over 20 min

Eligibility

Sex: ALLMin age: 20 YearsMax age: 75 YearsHealthy volunteers:

Medical Language ↔ Plain English

RYGB patients: Inclusion Criteria: * Undergone Roux-en-Y gastric bypass (RYGB) without complications at least 12 months prior to inclusion. * Achieved \> 50% Excess BMI Loss * Weight stability (no fluctuations over ± 5 kg the last 3 months) * HBA1c \< 48 mmol/mol before and after surgery without the use of anti-diabetic medication * The participant must be able to ingest the meals Exclusion Criteria: * Low hemoglobin levels (\< 6.5 mM) * Pregnancy (determined by human chorionic gonadotropin (hCG) test) or breastfeeding * Dysregulated thyroid gland affection * The use of medication which affects heart frequency (i.e. Beta-blockers) * Complications following RYGB consisting of dysphagia or other problems associated with ingestion of normal foods (i.e. vomit, diarrhea or strong abdominal pain). Control group: Inclusion Criteria: * Matched with the RYGB patients on gender, age (± 5 years), menopausal state (pre- versus post-menopausal) and BMI (± 3 points). * Weight stable ( ± 5 kg during 3 months) * HBA1c \< 48 mmol/mol Exclusion Criteria: * Prior bariatric surgery or prior surgery in the upper gastrointestinal tract.

Locations (1)

Department of Endocrinology, Hvidovre Hospital

Hvidovre, Denmark

Outcomes

Primary Outcomes

Impact of acute bout of exercise on nadir plasma glucose within groups for each intervention

Comparison of nadir plasma glucose in response to an acute bout of exercise internally in groups a) RYGB and b) control group

Time frame: The lowest plasma glucose concentration at 5, 10, 15 ,20, 30, 45, 60, 70, 80, 90, 100, 110, 120, 135, 150, 180, 210 OR 240 min after ingestion of meal

Impact of glycaemic index on nadir plasma glucose within groups for each intervention

Comparison of nadir plasma glucose in response to meals with high vs low glycaemic index internally in groups a) RYGB and b) control group

Time frame: The lowest plasma glucose concentration at 5, 10, 15 ,20, 30, 45, 60, 70, 80, 90, 100, 110, 120, 135, 150, 180, 210 OR 240 min after ingestion of meal

Secondary Outcomes

Impact of acute bout of exercise on AUC glucose within groups

Comparison of plasma glucose excursions in response to an acute bout of exercise internally in groups a) RYGB and b) control group determined by differences in area under curve (AUC)

Time frame: AUC time-concentration-curve for plasma glucose from 0, 5, 10, 15 ,20, 30, 45, 60, 70, 80, 90, 100, 110, 120, 135, 150, 180, 210, 240 min after ingestion of meal

Impact of acute bout of exercise on delta-fasting-peak glucose within groups

Comparison of plasma glucose excursions in response to an acute bout of exercise internally in groups a) RYGB and b) control group determined by delta-fasting-to-peak concentrations of glucose

Time frame: Difference between fasting plasma glucose and highest plasma glucose at 5, 10, 15 ,20, 30, 45, 60, 70, 80, 90, 100, 110, 120, 135, 150, 180, 210, 240 min after ingestion of meal

Impact of glycaemic index on AUC glucose within groups

Comparison of plasma glucose excursions in response to meals with high vs low glycaemic index internally in groups a) RYGB and b) control group determined by differences in area-under-the-curve of glucose

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.

Meal with high glycaemic index (GI) is consumed over 20 min and the subject postprandially exercises for 30 min

Time frame: AUC time-concentration-curve for plasma glucose from 0, 5, 10, 15 ,20, 30, 45, 60, 70, 80, 90, 100, 110, 120, 135, 150, 180, 210, 240 min after ingestion of meal

Impact of glycaemic index on delta-fasting-peak glucose within groups

Comparison of plasma glucose excursions in response to meals with high vs low glycaemic index internally in groups a) RYGB and b) control group determined by differences in delta-fasting-peak glucose

Time frame: Difference between fasting plasma glucose and highest plasma glucose at 5, 10, 15 ,20, 30, 45, 60, 70, 80, 90, 100, 110, 120, 135, 150, 180, 210, 240 min after ingestion of meal

Impact of postprandial exercise and meal glycaemic index on glucagon-like peptide-1 (GLP-1) secretion within the groups determined by differences in AUC

AUC GLP-1 will be compared for meals with high vs low glycaemic index and with and without acute bout of exercise within the RYGB and control group

Time frame: AUC for time concentration curve of GLP-1 at 0, 10, 20, 30, 35, 60, 90, 120, 150, 180, 240 min after ingestion of meal

Impact of postprandial exercise and meal glycaemic index on glucagon-like peptide-1 (GLP-1) secretion within the groups determined by differences in peak concentration

Peak GLP-1 will be compared for meals with high vs low glycaemic index and with and without acute bout of exercise within the RYGB and control group

Time frame: Highest GLP-1 at 10, 20, 30, 35, 60, 90, 120, 150, 180, 240 min after ingestion of meal

Impact of postprandial exercise and meal glycaemic index on ghrelin secretion within the groups determined by differences in suppression from basal values

decremental AUC of ghrelin will be compared for meals with high vs low glycaemic index and with and without acute bout of exercise within the RYGB and control group

Time frame: Decremental AUC for the time concentration curve of ghrelin at 0, 10, 20, 30, 35, 60, 90, 120, 150, 180, 240 min after ingestion of meal

Impact of postprandial exercise and meal glycaemic index on peptide YY (PYY) secretion within the groups determined by differences in AUC

AUC PYY will be compared for meals with high vs low glycaemic index and with and without acute bout of exercise within the RYGB and control group

Time frame: AUC for time concentration curve of PYY at 0, 10, 20, 30, 35, 60, 90, 120, 150, 180, 240 min after ingestion of meal

Impact of postprandial exercise and meal glycaemic index on peptide YY secretion within the groups determined by differences in peak concentration

Peak PYY will be compared for meals with high vs low glycaemic index and with and without acute bout of exercise within the RYGB and control group

Time frame: Highest PYY concentration at 10, 20, 30, 35, 60, 90, 120, 150, 180, 240 min after ingestion of meal

Impact of postprandial exercise and meal glycaemic index on glucose-dependent insulinotropic peptide (GIP) secretion within the groups determined by differences in AUC

AUC GIP will be compared for meals with high vs low glycaemic index and with and without acute bout of exercise within the RYGB and control group

Time frame: AUC for time concentration curve of GIP at 0,10, 20, 30, 35, 60, 90, 120, 150, 180, 240 min after ingestion of meal

Impact of postprandial exercise and meal glycaemic index on glucose-dependent insulinotropic peptide (GIP) secretion within the groups determined by differences in peak concentration

Peak GIP will be compared for meals with high vs low glycaemic index and with and without acute bout of exercise within the RYGB and control group

Time frame: Highest concentration of GIP at 10, 20, 30, 35, 60, 90, 120, 150, 180, 240 min after ingestion of meal

Impact of postprandial exercise and meal glycaemic index on glucagon secretion within the groups determined by differences in AUC

AUC glucagon will be compared for meals with high vs low glycaemic index and with and without acute bout of exercise within the RYGB and control group

Time frame: AUC for time concentration curve of glucagon at 0, 10, 20, 30, 35, 60, 90, 120, 150, 180, 240 min after ingestion of meal

Impact of postprandial exercise and meal glycaemic index on blood lactate levels within the groups determined by differences in AUC

AUC lactate will be compared for meals with high vs low glycaemic index and with and without acute bout of exercise within the RYGB and control group

Time frame: AUC of the time-concentration curve of lactate at 0, 10, 20, 30, 45, 60, 70, 80, 90, 100, 110, 120, 150, 180, 240 min after ingestion of meal

Impact of postprandial exercise and meal glycaemic index on blood lactate levels within the groups determined by differences in peak concentration

Peak lactate will be compared for meals with high vs low glycaemic index and with and without acute bout of exercise within the RYGB and control group

Time frame: Highest lactate at 10, 20, 30, 45, 60, 70, 80, 90, 100, 110, 120, 150, 180, 240 min after ingestion of meal

Impact of postprandial exercise and meal glycaemic index on insulin secretion within the groups determined by differences in AUC

AUC insulin will be compared for meals with high vs low glycaemic index and with and without acute bout of exercise within the RYGB and control group

Time frame: AUC of time-concentration curve of insulin 0, 10, 20, 30, 35, 60, 90, 120, 150, 180, 240 min after ingestion of meal

Impact of postprandial exercise and meal glycemic index on insulin secretion within the groups determined by differences in peak concentration

Peak insulin will be compared for meals with high vs low glycaemic index and with and without acute bout of exercise within the RYGB and control group

Time frame: Highest insulin at 10, 20, 30, 35, 60, 90, 120, 150, 180, 240 min after ingestion of meal

Impact of postprandial exercise and meal glycaemic index on ad libitum food intake within the groups determined by differences in ingested amount of ad libitum meal in grams

Grams of ad libitum food intake. Food will be served at 240 minutes after fixed breakfast meal

Time frame: at 240 min following ingestion of test meal