Pre-Exercise Maltodextrin Ingestion and Transient Hypoglycemia in Cycling and Running

International Journal of Exercise Science 13(2): 1691-1704, 2020. This study examined the phenomenon of transient hypoglycemia and metabolic responses to pre-exercise carbohydrate (CHO) maltodextrin ingestion in cycling and running on the same individuals. Eleven active males cycled or ran for 30 min at 80% maximal heart rate (HRmax) after ingestion of either 1g/kg body mass maltodextrin (CHO-Cycle and CHO-Run respectively) or placebo (PL-Cycle and PL-Run) solutions. Fluids were ingested 30min before exercise in a double-blind and random manner.Blood glucose and serum insulin were higher before exercise in CHO (mean CHO-Cycle+CHO-Run) (Glucose: 7.4 ± 0.3 mmol.l-1; Insulin: 59 ± 10 mU.l-1) compared to placebo (mean PL-Cycle+PL-Run) (Glucose: 4.7 ± 0.1 mmol.l-1; Insulin: 8 ± 1 mU.l-1) (p\u3c0.01), but no differences were observed during exercise among the 4 conditions. Mean blood glucose did not drop below 4.1 mmol.l-1 in any trial. However, six volunteers in CHO-Cycle and seven in CHO-Run experienced blood glucose concentration \u3c 3.5 mmol.l-1 at 20min of exercise and similar degree of transient hypoglycemia in both exercise modes. No association was found between insulin response to maltodextrin ingestion and drop in blood glucose during exercise. Blood lactate increased with exercise more in cycling compared to running, and plasma free fatty acids (FFA) concentrations were higher in placebo compared to CHO irrespective of exercise mode (p\u3c0.01). The ingestion of maltodextrin 30min before exercise at about 80% HRmax produced similar glucose and insulin responses in cycling and running in active males. Lactate was higher in cycling, whereas maltodextrin reduced FFA concentrations independently of exercise mode

Εκτίμηση της μεταγευματικής λιπαιμίας στις δύο φάσεις του εμμηνορρυσιακού κύκλου μετά την κατανάλωση πρότυπου γεύματος

Σκοπός: Σκοπός αυτής της μελέτης παρέμβασης είναι ο έλεγχος της ακρίβειας και της επαναληψιμότητας της χρήσης του Lipotest® πρότυπου γεύματος για την εκτίμηση της μεταγευματικής λιπαιμίας στις δύο φάσεις του εμμηνορρυσιακού κύκλου. Υλικά και μέθοδος: Είκοσι πέντε υγιείς γυναίκες, αναπαραγωγικής ηλικίας έλαβαν μέρος στη μελέτη. Κάθε εξεταζόμενη υποβλήθηκε σε από του στόματος δοκιμασία ανοχής λίπους σε δύο ξεχωριστές περιπτώσεις, μία κατά την ωοθυλακική και μία κατά την ωχρινική φάση του εμμηνορρυσιακού κύκλου, μετά από ολονύκτια νηστεία 10-12 ωρών. Σε κάθε επίσκεψη λαμβάνονταν δείγματα αίματος πριν (νηστείας, χρόνος 0) και κάθε μία ώρα για 6 ώρες μετά την κατανάλωση του πρότυπου γεύματος (χρόνοι 1,2,3,4,5,6), με σκοπό τον προσδιορισμό των τριγλυκεριδίων (ΤG) και της ολικής απολιποπρωτεΐνης Β (ApoB). Εξετάσαμε την ακρίβεια, την αξιοπιστία και τη συμφωνία του Lipotest® γεύματος ανάμεσα στις δύο φάσεις του εμμηνορρυσιακού κύκλου, χρησιμοποιώντας διαγράμματα Bland-Altman, τον συντελεστή συσχέτιση (r value) και τον συντελεστή συσχέτισης συμφωνίας (CCC) για τις τιμές των TG και της ApoB. Η επαναληψιμότητα επίσης εκτιμήθηκε με τη χρήση του intraclass correlation coefficient (ICC). Τέλος, υπολογίστηκε η περιοχή κάτω από την καμπύλη (AUC) για τις τιμές TG και για τις τιμές ApoB προκειμένου να εκτιμηθεί η συνολική μεταγευματική απάντηση. Αποτελέσματα: Η ακρίβεια και η αξιοπιστία των μετρήσεων για τα TG (r≤ 0.64, p<0.05, CCC<0.7,) ήταν μέτρια ενώ για την την ApoB ήταν μέτριες έως ικανοποιητικές (r > 0.7, p<0.001, CCC<0.7). Τα Bland-Altman διαγράμματα έδειξαν υψηλή συμφωνία των μετρήσεων τόσο για τα TG όσο και για την ApoB. Η επαναληψιμότητα ήταν καλή έως υψηλή (ICC 0.689-0.848 για τα TG, 0.721-0.771 για την ApoB). Η συνολική μεταγευματική απάντηση όπως εκτιμήθηκε με την AUC δε διέφερε σημαντικά ανάμεσα στις δύο φάσεις, τόσο για τα TG όσο και για την ApoB (p=0.114 και p=0.915 αντίστοιχα). Συμπεράσματα: To Lipotest® ως πρότυπο γεύμα για τη μελέτη της μεταγευματικής λιπαιμίας σε υγιείς γυναίκες αναπαραγωγικής ηλικίας παρουσιάσε μέτρια ακρίβεια, ικανοποιητική συμφωνία και καλή επαναληψιμότητα των μετρήσεων ανάμεσα στις δύο φάσεις του εμμηνορρυσιακού κύκλου όταν η εκτίμηση της μεταγευματικής λιπαιμίας έγινε με χρήση μόνο της τιμής των TG, η ακρίβεια και η συμφωνία των μετρήσεων όμως αυξήθηκαν όταν έγινε εκτίμηση και των τιμών της ApoB.Aim: The aim of this intervational study was to evaluate the precision and reproducibility of examination using Lipotest® meal to assess postprandial lipaemia on two different occasions; luteal and follicular phase of menstrual cycle. Material and Methods: Twenty five healthy, menstruating women participated in the trial. Each of them underwent an oral fat tolerance test (OFTT) twice; once during the follicular phase of menstrual cycle and once during the luteal phase. Prior to each visit participants had fasted overnight for 10-12 hours. Blood samples were collected at baseline (time 0, fasting) and 1, 2, 3, 4, 5 and 6 hours after consumption of the Lipotest® meal. Concentrations of triglycerides (TG) and apolipoprotein B (ApoB) were measured. The accuracy, precision and agreement of Lipotest® meal between the two phases of menstrual cycle were examined using Bland-Altman plots, correlation coefficient (r-value) and concordance correlation coefficient (CCC). Reproducibility was tested using the intraclass correlation coefficient (ICC). The area under the curve (AUC) of both TG and ApoB was also calculated. Results: The precision and accuracy between the visits of luteal and follicular phase were moderate for TG values (r≤ 0.64, p<0.05, CCC<0.7,) and moderate to high for ApoB values(r > 0.7, p<0.001, CCC<0.7). The Bland-Altman plots depicted high agreement for both TG and ApoB values. Reproducibility of the measurements was good to excellent (ICC 0.689-0.848 for TG and 0.721-0.771 for ApoB). The values of the AUC between the two visits were not different for both TG and ApoB (p=0.114 and p=0.915 respectively) Conclusion: This study has shown that an OFTT using Lipotest® meal for the assessment of postprandial lipemia among healthy, menstruating women has moderate accuracy, satisfactory precision and fair reproducibility of the TG measurements between the two menstrual phases; when ApoB values are taken into account, accuracy and precision are reinforced

SGLT2 Inhibitors: A Review of Their Antidiabetic and Cardioprotective Effects

Type 2 diabetes mellitus is a chronic metabolic disease associated with high cardiovascular (CV) risk. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are the latest class of antidiabetic medication that inhibit the absorption of glucose from the proximal tubule of the kidney and hence cause glycosuria. Four SGLT2i are currently commercially available in many countries: canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin. SGLT2i reduce glycated hemoglobin by 0.5%–1.0% and have shown favorable effects on body weight, blood pressure, lipid profile, arterial stiffness and endothelial function. More importantly, SGLT2i have demonstrated impressive cardioprotective and renoprotective effects. The main mechanisms underlying their cardioprotective effects have been attributed to improvement in cardiac cell metabolism, improvement in ventricular loading conditions, inhibition of the Na+/H+ exchange in the myocardial cells, alteration in adipokines and cytokines production, as well as reduction of cardiac cells necrosis and cardiac fibrosis. The main adverse events of SGLT2i include urinary tract and genital infections, as well as euglycemic diabetic ketoacidosis. Concerns have also been raised about the association of SGLT2i with lower limb amputations, Fournier gangrene, risk of bone fractures, female breast cancer, male bladder cancer, orthostatic hypotension, and acute kidney injury

Diet induced thermogenesis, older and newer data with emphasis on obesity and diabetes mellitus - A narrative review

Obesity is a major public health problem with a prevalence increasing at an alarming rate worldwide. There is an urgent need for efficient approaches to weight management. Diet induced thermogenesis (DIT) is the process by which the body increases its energy expenditure in response to a meal. It is estimated to account for approximately 10 % of total energy expenditure and is considered a potentially modifiable component of energy expenditure. The palatability of food, meal's composition in macronutrients, the circadian rhythm and sleep, as well as individual's characteristics such as age, the presence of obesity or diabetes mellitus, and the proportion of physical activity are the main factors that affect DIT. However, studies examining DIT are mostly characterized by small sample size and the methodology varies considerably between studies. It seems that even today there is a lot of contradiction between the relative studies. Inspite of that, future research might lead to the modification of DIT in order to achieve some weight loss in obese people