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The primary objective of this randomized controlled cross-over study is to investigate if an acute, glycogen lowering exercise bout performed either in the morning or late afternoon differentially affects the respiratory exchange ratio at night in men and women with prediabetes. For this purpose, participants will stay in a respiration chamber and will be subjected to either an exercise bout in the morning or late afternoon.
Appropriate timing of lifestyle interventions may facilitate healthy rhythmicity in metabolism and optimize the effectiveness of such interventions in improving metabolic health. In this context, exercise is well-known to improve (skeletal muscle) energy metabolism and is an established intervention to improve muscle insulin sensitivity and to counter the development of type 2 diabetes (T2D). In addition, exercise may also have beneficial effects on the immune response that is known to impact on insulin sensitivity and overall metabolic health. In this study it is hypothesized that exercise performed at different times of the day exerts a differential effect on 24h metabolism in people at risk for developing T2D. To test this, a randomized controlled cross-over study is conducted in which participants are subjected to either an exercise in the morning or late afternoon while staying in the respiration chamber. Main outcome is substrate utilization during the night as measured with the respiration chamber, but 24-hrs blood draws will also be performed to examine effect of exercise on circulating metabolites.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AM exercise | Experimental |
| |
| PM exercise | Experimental |
| |
| Control | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Timing of exercise | Behavioral | An acute exercise bout of cycling performed in the morning at 9 AM or at 5 PM |
|
| Measure | Description | Time Frame |
|---|---|---|
| Nocturnal respiratory exchange ratio | Relative carbohydrate/fat oxidation during the night | 35 hours respiration chamber stay per intervention arm |
| Measure | Description | Time Frame |
|---|---|---|
| 24 hour energy and substrate metabolism determined using oxygen and carbondioxide levels as measured with whole-chamber respirometry | 35 hours respiration chamber stay per intervention arm | |
| Immune cell phenotypes determined using blood samples obtained during the interventions |
| Measure | Description | Time Frame |
|---|---|---|
| Diurnal variation in circulating glucoregulatory hormones (e.g. insulin) analysed in blood samples obtained throughout the day | 35 hours respiration chamber stay per intervention arm | |
| Feet sensitivity based on score on a neuropathy questionnaire | Baseline visit |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Joris Hoeks, Dr | Maastricht University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Maastricht University | Maastricht | Limburg | 6229 ER | Netherlands |
Participant data will only discussed with other researcher on group level. We are not interested in individual participant data
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| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| D050177 | Overweight |
| D009765 | Obesity |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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Participants will receive a code so that the person in charge with the data quality check and the data analyses will be blinded to the interventions.
| Control | Behavioral | No exercise |
|
| 35 hours respiration chamber stay per intervention arm |
| Blood glucose levels following the exercise intervention measured continuously using a continuous glucose monitor device | 7 days post the exercise intervention |
| Diurnal variation in metabolite levels (e.g. glucose, free fatty acids) analysed in blood samples obtained throughout the day | 35 hours respiration chamber stay per intervention arm |
| Diurnal variation in core body temperature using a core temperature pill that measures 24hrs | 35 hours respiration chamber stay per intervention arm |
| Feet sensitivity based on a clinical foot assessment | Baseline visit |
| D004700 | Endocrine System Diseases |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001519 | Behavior |