Effect of Combined Interval and Continuous Exercise Training on Gastric Emptying, Appetite, and Adaptive Responses in Men With Overweight and Obesity

Abstract

Background/Objectives: Characterizing compensatory and adaptive responses to exercise assists in understanding changes in energy balance and health outcomes with exercise interventions. This study investigated the effects of a short-term exercise intervention (combining high intensity interval (HII) and continuous exercise) on (1) gastric emptying, appetite and energy intake; and (2) other adaptive responses including cardiorespiratory fitness, in inactive men with overweight/obesity.Methods: Fifteen men (BMI: 29.7 ± 3.3 kg/m−2) completed a 4-wk supervised exercise intervention, consisting of 5 exercise sessions per week alternating between HII (30 s at 100% VO2max followed by 30 s recovery) and continuous (at 50% VO2max) training on a cycle ergometer, progressing from 30 to 45 min session duration. Gastric emptying (13C-octanoic acid breath test), appetite (visual analog scale), energy intake (ad libitum lunch meal), body composition (air displacement plethysmography), non-exercise activity (accelerometery) VO2max, blood pressure, and fasting concentrations of glucose, insulin, and ghrelin were measured before and after (≥48 h) the intervention.Results: Gastric emptying, glucose, insulin and ghrelin were unchanged, but energy intake at the ad libitum lunch test meal significantly increased at post-intervention (+171 ± 116 kcal, p < 0.01). Body weight (−0.9 ± 1.1 kg), waist circumference (−2.3 ± 3.5 cm) and percent body fat (−0.9 ± 1.1%) were modestly reduced (P < 0.05). VO2max increased (+4.4 ± 2.1 ml.kg.min−1) by 13% and systolic (−6.2 ± 8.4 mmHg) and diastolic (−5.8 ± 2.2 mmHg) blood pressure were significantly reduced (P ≤ 0.01 for all).Conclusions: Four weeks of exercise training did not alter gastric emptying, indicating gastric emptying may only adapt to a higher volume/longer duration of exercise or changes in other characteristics associated with regular exercise. The combination of HII and continuous exercise training had beneficial effects on body composition, cardiorespiratory fitness, and blood pressure and warrants further investigation in larger randomized controlled trials.

The [13C]octanoic acid breath test for gastric emptying quantification: A focus on nutrition and modeling

“…intervention study with young obese men could not detect a difference in GE in response to a 4 week period of regular chronic low intensity exercise (Horner et al, 2021). Similarly, healthy un-trained adult males showed no difference in GE in a study comparing no exercise with acute 60 min low and high lower-body exercise before breakfast (Mattin et al, 2018).…”

“…A meta‐analysis from 2015 using data from 20 studies, mainly using a liquid bolus delivered pre‐exercise to measure GE, concluded that chronic low intensity exercise results in faster GE whilst high intensity exercise results in slower GE (Horner et al, 2015). However, an intervention study with young obese men could not detect a difference in GE in response to a 4 week period of regular chronic low intensity exercise (Horner et al, 2021). Similarly, healthy un‐trained adult males showed no difference in GE in a study comparing no exercise with acute 60 min low and high lower‐body exercise before breakfast (Mattin et al, 2018).…”

Modulation of gastrointestinal transit by circadian rhythms and lifestyle

“…Intervention studies have also explored the link between physical activity and gastric emptying, with mixed results. Most studies have shown no effect on gastric emptying after four weeks to three months of moderate to vigorous intensity exercise 140,144,145 . However, in one study, three months of vigorous intensity exercise training did not affect gastric emptying, whereas gastric emptying was accelerated after six months 140 .…”