4 years ago

Carbohydrate-restriction with Postmeal Walking Effectively Mitigates Postprandial Hyperglycemia and Improves Endothelial Function in Type 2 Diabetes.

Jonathan Peter Little, Monique Emily Francois, Tyler Daniel Bammert, Cody Durrer, Christopher A DeSouza, Helena Neudorf, Etienne Myette-Cote
Postprandial hyperglycemia has deleterious effects on endothelial function. Restricting carbohydrate intake and postmeal walking have each been shown to reduce postprandial hyperglycemia but their combination and subsequent effects on endothelial function have not been investigated. Here, we sought to examine the effect of blunting postprandial hyperglycemia by following a low-carbohydrate diet, with or without postmeal walking exercise, on markers of vascular health in type 2 diabetes (T2D). In a randomized crossover design, individuals with T2D (N=11) completed three four-day controlled diet interventions consisting of i) low-carbohydrate diet alone (LC), ii) low-carbohydrate diet with 15-minute postmeal walks (LC+Ex), and iii) Low-fat control diet (CON). Fasting blood samples and brachial artery flow-mediated dilation (%FMD) were measured before and after each intervention. Total circulating microparticles (MPs), endothelial MPs (EMPs), platelet MPs (PMPs), monocyte-platelet aggregates (MPAs), and adhesion molecules were assessed as biomarkers of vascular health. There was a significant conditionXtime interaction for %FMD (p=0.01), with post-hoc tests revealing improved %FMD after LC+Ex (+0.8±1.0%, p=0.02), with no change after LC or CON. EMPs were significantly reduced with the LC diet by ~45% (from 99±60 to 44±31 MP/μL, p=0.02), with no change after LC+Ex or CON (interaction: p=0.04). Total MPs were lower (main effect time: p=0.02), whereas, MPAs were higher (main effect time: p<0.01) after all interventions. Plasma adhesion molecules and c-reactive protein were unaltered. Attenuating postprandial hyperglycemic excursions using a low-carbohydrate diet combined with postmeal walking appears to be an effective strategy to improve endothelial function in individuals with T2D.

Publisher URL: http://doi.org/10.1152/ajpheart.00524.2017

DOI: 10.1152/ajpheart.00524.2017

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