The Influence of Pre- and Post Meal Exercise in Relation to Postp

Fort Hays State University FHSU Scholars Repository Master's Theses Graduate School Spring 2019 The Influence of Pre- and Post Meal Exercise in Relation to Postprandial Blood Glucose Levels in Type II Diabetics Jessica Johnson Fort Hays State University, jmjohnson3700@gmail.com Follow this and additional works at: https://scholars.fhsu.edu/theses Part of the Endocrine System Commons, and the Exercise Science Commons Recommended Citation Johnson, Jessica, "The Influence of Pre- and Post Meal Exercise in Relation to Postprandial Blood Glucose Levels in Type II Diabetics" (2019) Master's Theses 3139 https://scholars.fhsu.edu/theses/3139 This Thesis is brought to you for free and open access by the Graduate School at FHSU Scholars Repository It has been accepted for inclusion in Master's Theses by an authorized administrator of FHSU Scholars Repository ABSTRACT The purpose of this study was to investigate the relationship of pre and post evening meal exercise in relation to postprandial blood glucose levels in type II diabetics Fifteen participants diagnosed with type II diabetes volunteered to participate in this 21 day study During the first seven days, participants were told to change nothing about their daily routine Throughout the study they were asked to track all food consumption in the MyFitnessPal application and to record their blood glucose levels fasting, before their evening meal, and 120 minutes after their evening meal At the end of day seven, each participant’s carbohydrate intake was classified into the following three diets according to the American Diabetes Association: moderately low-carbohydrate diet (30-40%), moderate carbohydrate diet (40-65%) or high carbohydrate diet (> 65%) The participants were then directed to eat within their carbohydrate allowance for the remainder of the 21 days On day eight, participants were split into the three groups: the NA group made no alterations to their daily activities, the BEM group exercised before their evening meal, and the AEM group exercised 30 minutes after their evening meal Participants completed the study with their given treatments Data was collected and a one-way ANOVA was performed showing statistical significance The Tukey-Kramer Post Hoc Test was performed to investigate Statistical significance (alpha >.05) was found between the NA vs BEM groups and the NA vs AEM groups, but no significance was found between the BEM vs AEM group i ACKNOWLEDGEMENTS I would like to thank the faculty of the Health and Human Performance Department at Fort Hays State University for their continuous guidance and support I would like to thank my thesis chair, Dr Zody, for his extra time and commitment in helping me complete this project I would also like to thank my thesis committee members, Dr Maska, Dr Kandt, and Ms Ward for their expertise and input on my project ii TABLE OF CONTENTS ABSTRACT i ACKNOWLEDGEMENTS ii TABLE OF CONTENTS iii TABLE OF APPENDICES vi INTRODUCTION .1 Problem Statement Sub Problems Definition of Terms Delimitations Limitations .4 Assumptions .4 Null Hypothesis Significance of Study .5 REVIEW OF LITERATURE Diabetes Mellitus Type I Type II Treatment of Diabetes Through Medication Treatment/Prevention of Type II Diabetes Through Diet and Exercise 10 Influence of Pre- and Post-dinner Exercise on Blood Glucose Levels 11 iii Summary 13 METHODS AND PROCEDURES 14 Introduction 14 Preliminary Procedures 14 Subjects 14 Instrumentation 15 Research Design 16 Operational Procedures 17 Testing Methods 17 Data Collection 19 RESULTS AND DISCUSSION 20 Results 21 Hypothesis 23 Hypothesis 23 Hypothesis 24 Hypothesis 24 Discussion 24 SUMMARY CONCLUSIONS AND RECOMMENDATIONS 26 Summary 26 Conclusions 27 Recommendations for Future Studies 28 iv REFERENCES 29 v LIST OF APPENDICES Appendix Page A First Email to Staff .34 B Second Email to Staff 36 C Informed Consent Statement 39 D Participant Approval 46 E Instrumentation Competency Form .47 F Data Reporting Sheet .48 G Participant Blood Glucose and Macronutrient Records .49 H IRB Approval Letter 64 vi INTRODUCTION According to the National Diabetes Statistics Report 2017 from the Center for Disease Control and Prevention (CDC), the prevalence of diabetes mellitus (diabetes) around the world has steadily risen to over 30.3 million, with 9.3% of all cases from the United States (Center for Disease Control and Prevention, [CDC], 2017, p 1) A closer look at this data shows type II diabetes mellitus (type II diabetes), more commonly known as non-insulin dependent diabetes, accounting for 95% of all diagnoses This report implies that as our nation’s habits and lifestyles change, so our health and our body’s natural homeostatic mechanisms Fox and Kilvert (2007) explained that when a person develops type II diabetes, the beta cells in the pancreas not produce enough insulin or; in most cases, the body resists responding to sufficient levels of insulin Insulin helps the body store glucose in the cells, so when glucose is not stored properly for the body to use for energy, the extra sugars circulate in the bloodstream allowing blood glucose levels rise If this level rises or falls too quickly, too often, or by too much, serious health complications can arise such as retinal hemorrhaging, degenerative joint diseases, diabetic comas, or heart disease (Katch, McArdle, & Katch, 2011) Although the consequences of type II diabetes can be severe, or even fatal, numerous studies support that physical activity and diet alterations can help lower blood glucose levels, improve insulin resistance, and aid in weight loss maintenance of type II diabetics (Guthrie & Guthrie, 2009) Dietitians suggest pairing a serving of protein with every meal, cutting back on fast digesting carbohydrates, and eating a variety of fruits and vegetables When correct nutrition is paired with exercise, many patients lose body fat Exercise is important because the muscles in the body burn their glycogen stores, so they are ready to take up the glucose circulating in the blood stream (Colberg et al., 2010) Problem Statement While many studies have been conducted on diet and exercise, such as the Honda et al (2016) study on stair climbing in relation to decreases in blood glucose levels or the Dempsey et al study (2016) on brief bouts of exercise in type II diabetes, there is little information about postprandial blood glucose levels and the timing of exercise in relation to evening meal consumption The purpose of this study was to investigate the effects of pre- and post evening meal exercise on blood glucose levels in type II diabetics Sub Problems Within the problem of the study, the following sub-problems were investigated: The difference in postprandial blood glucose levels between the control (NA) group and the exercise before evening meal group (BEM) The difference in postprandial blood glucose levels between the control group (NA) and the exercise after evening meal group (AEM) The difference in postprandial blood glucose levels between the exercise before evening meal group (BEM) and the exercise after evening meal group (AEM) Definition of Terms Specific terms that were used in this study included: A1C A test of a person’s average blood glucose levels over to months by detecting what percentage of hemoglobin is coated with sugar; diagnoses a person with diabetes according to the following scale: non-diabetic- a person with an A1C reading of 52 Table BEM Participant Day 10 11 12 13 14 15 16 17 18 19 20 21 BG Fasting 132 128 144 142 124 124 126 131 157 147 146 156 159 157 158 160 162 146 142 138 47 BG Before BG After Evening Evening Meal Meal % Protein % Fat 101 121 21 111 156 30 98 132 29 103 156 20 90 132 25 95 151 14 152 179 23 103 115 27 120 112 25 226 177 19 83 103 17 122 82 14 117 96 18 188 135 16 136 161 20 95 93 26 113 118 24 96 215 15 95 99 22 135 121 20 42 140 18 % Carbs 20 25 38 24 19 24 25 26 20 17 37 24 20 34 18 31 12 24 14 14 20 59 45 33 56 56 62 52 47 55 64 46 62 62 50 62 43 64 61 64 66 62 53 Table BEM Participant Day 10 11 12 13 14 15 16 17 18 19 20 21 BG Fasting 156 146 137 144 164 156 164 155 154 169 150 152 161 172 175 162 172 152 165 163 158 BG Before BG After Evening Evening Meal Meal % Protein % Fat 127 143 22 127 207 13 126 218 14 131 142 23 140 238 14 138 299 14 144 223 26 129 299 26 156 158 21 145 212 33 162 260 132 195 21 140 282 18 124 307 13 123 225 19 142 291 20 149 270 13 105 296 115 248 19 143 230 13 227 231 15 % Carbs 63 59 39 46 47 61 47 47 55 42 33 44 55 50 51 41 43 54 53 53 49 15 28 47 31 39 25 27 27 24 25 60 35 27 37 30 39 44 38 28 34 36 54 Table AEM Participant Day 10 11 12 13 14 15 16 17 18 19 20 21 BG Fasting 104 127 148 131 126 131 151 112 109 129 100 121 133 141 130 154 125 58 141 123 147 BG Before BG After Evening Evening Meal Meal % Protein % Fat 151 127 23 178 157 22 105 125 26 95 112 20 122 114 19 144 121 28 99 200 16 109 113 28 143 151 30 177 102 18 90 151 28 116 178 28 171 120 32 158 127 30 92 109 23 94 146 19 110 236 18 172 98 29 127 130 22 116 123 27 127 176 32 % Carbs 25 25 19 16 22 22 18 22 22 16 15 17 24 17 24 24 11 19 23 21 24 52 53 55 64 59 50 66 50 48 66 57 55 44 53 53 57 71 52 55 52 44 55 Table AEM Participant Day 10 11 12 13 14 15 16 17 18 19 20 21 BG Fasting 122 154 132 121 124 135 144 147 118 130 142 131 138 145 121 108 107 122 137 149 165 BG Before BG After Evening Evening Meal Meal % Protein % Fat 127 102 26 105 113 25 115 107 19 103 100 22 94 131 18 131 156 10 164 188 13 90 92 20 97 161 15 89 190 21 168 137 21 114 107 19 166 203 13 131 119 18 101 108 16 91 97 20 99 172 19 118 221 17 141 240 17 103 217 16 186 209 16 % Carbs 48 41 53 38 47 45 41 34 50 36 46 41 42 42 48 38 44 46 44 51 46 26 34 28 40 35 45 46 46 35 43 33 40 45 40 36 42 37 37 39 33 38 56 Table AEM Participant Day 10 11 12 13 14 15 16 17 18 19 20 21 BG Fasting 290 156 165 131 256 313 355 206 241 288 256 337 251 226 244 290 178 190 208 256 313 BG Before BG After Evening Evening Meal Meal % Protein % Fat 357 428 33 164 336 26 274 315 15 157 587 32 208 250 32 169 234 35 251 265 35 222 288 14 122 360 168 288 26 129 353 18 102 486 12 204 402 18 184 320 32 198 243 16 357 428 29 164 336 15 274 315 31 303 587 33 201 250 20 169 347 14 % Carbs 27 25 27 26 16 16 15 39 26 36 30 32 34 33 16 22 32 30 27 37 46 40 49 58 42 52 49 50 47 67 38 52 56 48 35 68 49 53 39 40 43 40 57 Table AEM Participant Day 10 11 12 13 14 15 16 17 18 19 20 21 BG Fasting 103 144 135 100 98 140 133 181 123 172 109 188 143 97 109 144 157 127 143 128 111 BG Before BG After Evening Evening Meal Meal % Protein % Fat 128 166 11 163 196 28 102 155 12 94 207 14 130 245 16 143 187 32 154 199 34 127 149 21 131 173 129 247 21 144 220 35 185 185 38 106 147 46 85 189 12 150 202 15 99 144 21 137 159 34 97 129 32 152 199 33 198 265 20 122 156 24 % Carbs 44 25 32 31 43 29 24 35 16 37 27 26 18 16 28 35 24 29 23 15 20 45 47 56 55 41 39 42 44 77 42 38 36 36 72 57 44 42 39 44 65 56 58 Table 10 AEM Participant Day 10 11 12 13 14 15 16 17 18 19 20 21 BG Fasting 128 123 164 135 138 151 117 144 142 113 132 112 144 162 128 123 139 126 144 140 119 BG Before BG After Evening Evening Meal Meal % Protein % Fat 127 219 12 113 240 16 108 196 30 191 159 15 137 210 24 184 218 12 167 163 17 193 128 22 131 163 20 164 168 18 164 145 21 172 136 24 210 162 15 114 185 12 123 148 18 139 138 18 297 197 11 161 191 19 152 158 15 115 226 16 121 223 21 % Carbs 39 41 30 41 34 42 32 40 37 19 41 35 38 33 42 33 59 48 23 65 42 49 43 40 44 42 46 51 38 43 63 38 41 47 55 40 49 30 33 62 19 37 59 Table 11 NA Participant Day 10 11 12 13 14 15 16 17 18 19 20 21 BG Fasting 103 102 124 127 100 96 91 117 105 176 111 84 109 97 118 108 109 118 104 109 130 BG Before BG After Evening Evening Meal Meal % Protein % Fat 113 74 15 195 126 33 158 55 12 121 85 24 140 86 23 90 133 21 165 65 14 84 84 14 128 49 12 147 49 17 122 89 16 127 109 11 124 136 17 170 156 17 109 114 21 200 70 22 142 110 139 126 45 145 96 21 94 70 19 298 102 25 % Carbs 33 40 36 39 29 25 24 21 37 35 35 39 15 17 33 54 33 29 21 37 24 52 27 52 37 48 54 62 65 51 48 49 50 68 66 46 24 60 26 58 44 51 60 Table 12 NA Participant Day 10 11 12 13 14 15 16 17 18 19 20 21 BG Fasting 128 147 126 124 129 149 105 124 137 140 133 132 131 138 135 130 135 131 144 134 134 BG Before BG After Evening Evening Meal Meal % Protein % Fat 98 94 14 91 155 23 105 113 16 81 156 22 79 126 93 107 10 104 154 18 84 160 158 134 11 130 164 94 162 16 105 127 16 104 90 39 103 128 32 126 117 102 120 19 114 130 19 120 127 15 108 120 14 110 137 14 116 124 21 % Carbs 21 24 32 34 47 37 30 31 29 34 34 34 19 20 39 26 41 22 30 37 33 65 53 52 44 46 53 52 63 60 61 50 50 42 48 56 55 40 63 56 49 45 61 Table 13 NA Participant Day 10 11 12 13 14 15 16 17 18 19 20 21 BG Fasting 127 130 122 116 121 119 125 119 134 112 123 122 124 119 131 127 112 117 67 125 114 BG Before BG After Evening Evening Meal Meal % Protein % Fat 113 108 17 109 103 23 100 132 14 82 127 16 97 130 104 198 13 112 102 18 102 142 14 130 121 19 105 124 19 119 148 129 154 15 114 129 20 130 101 16 110 108 26 120 101 13 113 114 30 139 77 11 134 103 14 106 108 13 106 128 17 % Carbs 43 34 44 44 29 45 38 35 31 32 62 25 33 35 23 32 48 36 42 28 36 40 43 42 40 63 42 44 51 50 49 30 60 47 49 51 55 22 53 44 59 47 62 Table 14 NA Participant Day 10 11 12 13 14 15 16 17 18 19 20 21 BG Fasting 100 102 101 104 97 115 110 95 105 106 110 96 101 92 101 93 97 120 103 118 117 BG Before BG After Evening Evening Meal Meal % Protein % Fat 99 116 16 89 138 23 100 114 11 110 135 25 131 97 135 106 17 112 85 10 105 135 20 118 108 15 93 101 23 101 140 13 119 110 11 107 128 27 118 106 128 102 11 119 101 19 117 153 10 107 134 103 94 14 95 109 16 109 125 15 % Carbs 51 63 51 42 29 65 44 19 46 59 48 43 37 43 52 47 42 34 44 44 48 33 14 38 33 64 18 46 61 39 18 39 46 36 49 37 34 48 58 42 40 37 63 Table 15 NA Participant Day BG Fasting 147 173 145 140 139 136 153 121 135 10 124 11 144 12 134 13 130 14 148 15 121 16 131 17 135 18 135 19 150 20 135 21 146 BG Before BG After Evening Evening Meal Meal % Protein % Fat 173 125 14 118 129 12 120 114 15 109 102 22 123 142 23 119 128 11 144 121 11 219 123 21 121 80 22 94 146 17 145 129 17 114 187 22 152 87 24 100 125 17 122 131 166 143 12 98 93 16 153 215 23 128 97 94 149 28 112 106 26 % Carbs 22 12 20 15 22 29 30 16 36 18 27 20 19 14 25 17 21 33 18 25 27 64 76 65 63 55 60 59 63 42 65 56 58 57 69 66 71 63 44 74 47 47 64 Appendix H IRB Approval Letter 65 ... Appendix C Informed Consent Statement THE INFLUENCE OF PRE- AND POSTDINNER EXERCISE IN RELATION TO POSTPRANDIAL BLOOD GLUCOSE LEVELS IN TYPE II DIABETICS INTRODUCTION The Department of Health and Human... diabetes, there is little information about postprandial blood glucose levels and the timing of exercise in relation to evening meal consumption The purpose of this study was to investigate the effects... (NA) and the exercise after evening meal group (AEM) The difference in postprandial blood glucose levels between the exercise before evening meal group (BEM) and the exercise after evening meal