Type 2 Diabetes Clinical Trial
Official title:
Nutrient Timing Following Resistance Exercise in Young Overweight and Obese Young Men With a Family History of Diabetes
The purpose of the proposed study is to examine the timing of post-exercise feeding on 15
hours post-exercise glycemic control and metabolic flexibility and in overweight and obese
young men with a family history of type 2 diabetes.
Aim 1 - To determine the temporal effects of post-exercise feeding (i.e., immediate
post-exercise vs. 3 hours post-exercise) on glycemic control, peripheral insulin
sensitivity, and metabolic flexibility (as evaluated by sleep RQ) in this same group of
participants. We hypothesize that a 3 hour delay in nutrient ingestion will promote
significantly greater improvements in glucose tolerance, metabolic flexibility, and
peripheral insulin sensitivity both immediately and several hours post-ingestion.
The proposed study is cross-sectional and utilizes a within-subject design to study young
men under two different nutrient timing protocols, which are randomly-ordered and spaced at
least 2 weeks apart.
1. Participants will be screened for eligibility via phone or email and scheduled for an
initial visit, in order to consent to the study and undergo some basic baseline
evaluations. We will rely on participant self-report to verify absence of chronic
disease or drug use.
2. After consenting to the study, fasting blood glucose, height, weight, and air
displacement plethysmography (BodPod®) will be conducted in the Clinical Exercise
Physiology Laboratory at The George Washington University, in Washington, DC. These
measures may occur on the same day as consent or at another scheduled time.
3. After screening, consenting, and baseline assessments, participants will undergo 2
experimental conditions, which will be randomly-ordered and approximately 2 weeks
apart. If possible, both of these experimental visits will be scheduled shortly after
the consent form is signed.
4. A registered dietitian will instruct participants to eat a standardized (35 kcal∙kg
body weight-1∙day-1) diet comprising 60% carbohydrate, 20% protein, and 20% fat for 3
days prior to both experimental sessions. This instruction will be administered after
the BodPod® assessment is completed.
5. Participants will report to the USDA Laboratory chamber at 7:30 AM for the experimental
sessions. Height, weight blood pressure and heart rate will be measured, then a fasting
blood sample (5 cc) will be obtained for determination of basal glucose & insulin
concentrations. A Hidalgo Ambulatory Monitoring Sensor Array Vest (Equivital I: Hidalgo
Ltd., Cambridge UK) will be worn by all participants measured in the calorimeter for
the entire 48 period. This device measures heart rate (HR), heat flux, core body
temperature, posture and physical activity (PA) from a built-in accelerometer.
6. Then, the sensor portion of the CGMS then will be placed subcutaneously and the CGMS
calibrated with whole blood using the Accu-Check Advantage (Roche Diagnostics,
Indianapolis, IL) glucometer. Participants will then enter the whole room calorimeter
(metabolic chamber) and complete a hunger scale. Hunger will be evaluated 10-20 minutes
before the start of each meal and 2 hours after the resistance exercise bout. On the
first day, participants eat a standard breakfast provided by the USDA kitchen at
approximately 7:45-8:00AM.
7. Gutierrez or a research assistant will take obtain glucometer readings before and 60
minutes after each meal to calibrate the the CGMS. These evaluations will occur 4-6
times over the course of the day.
8. Standardized meals (lunch at 11:00AM and dinner at 7:00PM) will be provided for
subjects by the USDA. Blood samples (5 cc each) will be collected prior to and 120
minutes after breakfast and lunch; and prior to and 30-, 60-, 90-, and 120-min
following the start of the evening meal for the determination of post-meal responses in
glucose & insulin. A trained phlebotomist with at least 50 successful IV catheter
placements will place an IV catheter into the participant's median antecubital vein
before the evening meal to facilitate multiple draws after the meal.
9. On the second day, subjects will awake in the calorimeter at approximately 7:00 AM and
a fasting blood sample (5 cc) will be obtained for determination of basal
concentrations of glucose & insulin.
10. At about 7:30 AM, subjects will eat a standardized breakfast to be consumed by 8:00 AM.
Two hours after a standardized lunch meal, served at 11:00AM, participants will perform
one of the following resistance exercise nutrient-timing protocols: immediate
post-exercise nutrition at approximately 2:00 PM 3 hour post exercise nutrition at
approximately 5:00 PM). All participants will undergo both experimental conditions at
different testing sessions.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Prevention
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