Exercising Before Mealtime Improves Postprandial Endothelial Function

There is now a large body of evidence indicating that a single session of moderate exercise before a meal can reduce subsequent postprandial lipemia by ~20% to 25%.”

Exercising before a meal improves postprandial endothelial function, according to the results of a study published in the Dec. 21 issue of the Journal of the American College of Cardiology.

"Free-living humans spend the majority of their lives in the postprandial state, up to 18 hours on average and the changes to metabolism seen during the hours after meal ingestion are likely to play an important role in the atherosclerotic disease process," write Jason M.R. Gill, PhD, from the University of Glasgow and Glasgow Royal Infirmary in the U.K., and colleagues. "

In this study, 10 lean (waist circumference, less than 90 cm) and 10 centrally obese (waist circumference, more than 100 cm) middle-aged men each had two oral fat tolerance tests, in which blood was drawn when the men were fasting and for eight hours after a high-fat meal containing 80 g of fat and 70 g of carbohydrate. On the afternoon before one of these tests, subjects performed a 90-minute treadmill walk (exercise trial), and no exercise was performed before the control test. Laser Doppler imaging evaluated endothelium-dependent and endothelium-independent microvascular function in the fasted state and at two hourly intervals during the eight-hour postprandial period.

In both the lean and centrally obese groups, exercise reduced both fasting and postprandial triglyceride concentrations by 25% (P < .001). For all subjects taken together, exercise improved fasting endothelium-dependent function by 25% (P < .05). There was a postprandial decrease in both endothelium-dependent and endothelium-independent function in both the control and exercise trials (P < .01). However, endothelium-dependent and endothelium-independent postprandial function were 15% and 20% higher, respectively, in the exercise trial than in the control trial (both P < .05).

"A session of prior exercise improves fasting and postprandial vascular function in middle-aged men," the authors write. "This may be one mechanism by which exercise influences cardiovascular risk."

Importantly, despite many of the men being unused to walking long distances, all managed to complete the 90-minute treadmill walk without difficulty, and none complained of undue tiredness or muscle soreness," the authors conclude. "Although this goes beyond the current ’30 minute per day’ exercise recommendation, walks of this intensity and duration are not beyond the capability of inactive centrally obese middle-aged men."

Clinical Notes: The postprandial state is associated with lipemia, systemic inflammatory response, adverse endothelial function, and change in insulin sensitivity in both lean and obese subjects.

Exercise is associated with a reduction in the postprandial triglyceride rise and endothelial dysfunction for both lean and obese subjects. Obese subjects also show a benefit in insulin sensitivity.
J Am Coll Cardiol. 2004;44:2375-2382

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Department of Clinical Pharmacology and Therapeutics, University of Dundee, Ninewells Hospital, Dundee, UK