Moderate Exercise Associated With Improved Glucose Regulation in Older Men

A grandpa smiling while carrying his granddaughter on his shoulders, on a day out at the park together.
Habitual physical activity, such as walking or gardening, may decrease fasting GLP-1 concentrations and increase glucose-stimulated GLP-1 responses independent of insulin sensitivity.

Studies have found that acute exercise increases the postprandial levels of glucagon-like peptide-1 (GLP-1) in adults who are within normal weight range.1-5 Similar studies in overweight cohorts have had contradictory results.2, 6-12 While the effect of acute exercise on GLP-1 response has been studied, the association between habitual physical activity and GLP-1 secretion in an overweight population has yet to be determined. According to longitudinal study results published in Endocrine Connections, habitual physical activity, even at moderate levels, decreased fasting GLP-1 concentrations and increased glucose-stimulated GLP-1 responses.13

GLP-1 reduces glucose-stimulated blood glucose levels by stimulating secretion of insulin14 and is responsible for up to 70% of the postprandial insulin response in healthy individuals.15 GLP-1 responses have been shown to be abnormal in individuals with overweight and obesity.16

Longitudinal health examination data from a total of 1326 individuals in the 2009 to 2011 ADDITION-PRO study were used to examine the associations between habitual physical activity and both fasting and glucose-stimulated GLP-1 levels in overweight individuals. Patients with known diabetes or with incomplete information regarding glucose, GLP-1, and activity levels were excluded.

Individually calibrated heart rate and movement sensors worn by patients for 7 consecutive days were used to calculate frequency and intensity of physical activity. Using a standard value for resting metabolic rate of 71 J/min/mg, intensity of activity was defined by multiples of metabolic equivalent tasks (METs): sedentary was defined as activity <1.5 METs, light intensity between 1.5 and 3.0 METs, and moderate to vigorous intensity >3.0 METs.

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Fasting GLP-1 levels were measured via blood samples taken after 8 hours of fasting. Glucose-stimulated GLP-1 secretion levels were measured using plasma samples from a 2-hour oral glucose tolerance test, during which patients ingested 75 g of glucose dissolved in 250 mL of water.

The average age of study patients was 66±7.1 years and average body mass index was 27.1±4.5 kg/m2. More than 98% of patients spent some time in moderate to vigorous physical activity, with 44% of men and 39% of women meeting the daily requirement of at least 30 minutes of moderate to vigorous physical activity per day.

Fasting levels of GLP-1 were 19.5% lower (95% CI, -33.0% to -3.3%; P =.021) for every 60-minute increase in moderate to vigorous physical activity in men. In a similar fashion, glucose-stimulated GLP-1 responses 2 hours after glucose intake were 20.0% greater (95% CI, 2.6%-40.3%; P =.022) for every 60-minute increase in moderate to vigorous physical activity in men. No significant associations were found in women, who spent less time exercising overall.

This study suggests that older men at risk for type 2 diabetes may be able to modulate their blood glucose levels through moderate exercise. It is important to note that no individuals in the study engaged in vigorous activity, showing that activities such as cleaning, gardening, and playing games with children or grandchildren may be sufficiently vigorous to affect GLP-1 levels.

Study limitations included the use of cross-sectional data. In addition, men and women were not matched for amount of time spent in moderate physical activity and there was an average daily difference of 10 minutes.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry through funding. Please see the original reference for a full list of authors’ disclosures.

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