Diabetes Mellitus, Type 2 Clinical Trial
Official title:
Influence of Prior Walking on Endothelial Function and Coronary Heart Disease Risk Markers in Centrally Obese South Asian and White European Men
The present study will investigate the effect of prior walking on postprandial metabolism and
endothelial function in centrally obese South Asian and White European men.
Participants will complete two, 2-day trials in a random, crossover design separated by at
least a week.
On day 1, participants will either rest or complete a 60 minute walk at 60% maximal oxygen
uptake. On day 2, participants will arrive at 08:00 having fasted overnight and a baseline
venous blood sample and endothelial function measurement will be taken. Participants will
consume a high-fat breakfast and lunch and 12 subsequent venous blood samples will be taken
throughout the day at standardised intervals to measure a variety of coronary heart disease
risk markers. A second endothelial function measurement will be completed 2 hours after the
breakfast. Blood pressure will be measured every hour.
It is expected that the South Asian participants will have impaired metabolism and
endothelial function compared to their European counterparts but the bout of exercise
performed on day 1 will mitigate these responses.
South Asians have a higher-than-average risk of coronary heart disease. The reasons for this
are unclear, but physical inactivity and/or poor responsiveness to exercise may play a role.
It is important to understand the effect of exercise on endothelial function and coronary
heart disease risk markers in the hope that exercise can be prescribed as an effective
treatment to mitigate endothelial dysfunction and the risk of heart disease.
Previous research from the investigators' laboratory has indicated that postprandial
metabolism is impaired in South Asian men, but this, and other coronary heart disease risk
markers, can be improved with acute exercise. However, the previous research was conducted in
apparently healthy South Asian and White European men. The investigators now wish to quantify
and compare the coronary heart disease risk marker and endothelial function response to acute
exercise in centrally obese South Asian and White European individuals who are at a higher
risk for diabetes and cardiovascular disease.
On visit 1, participants will attend the laboratory to undergo preliminary assessments and to
be familiarised with the laboratory environment and study procedures. Specifically, health
status, habitual physical activity, dietary habits and anthropometric data (height, weight,
waist and hip circumference, body fat) will be collected. A HbA1c test will be performed to
check participants are not diabetic. The modified Bruce Treadmill test will be performed to
predict maximal oxygen uptake.
On visit 2, participants will undergo a magnetic resonance imaging (MRI) scan to quantify
regional body composition comprising abdominal subcutaneous adipose tissue, visceral adipose
tissue, liver fat percentage, thigh intramuscular adipose tissue and thigh muscle volume.
On visits 3-6 participants will complete two, 2-day trials in a random, crossover design
separated by at least 1 week. On day 1 of both trials, participants will arrive fasted at
08:00 and a baseline blood sample, blood pressure and endothelial function measurement will
be taken. Participants will consume a standardised high fat breakfast at 09:00 and lunch at
13:00. At 15:30 the participants will walk for 60 minutes at 60% maximal oxygen uptake and
complete a second endothelial function measurement at 16:45. Participants will leave the
laboratory with a standardised evening meal to consume before 22:00. The control trial will
be the same, except no exercise will be performed.
On day 2, participants will arrive at 08:00 having fasted overnight for 10h (except plain
water). A cannula will be inserted into the antecubital vein for collection of venous blood
samples. Blood pressure will be measured at 08:00 (0h) and again at hourly intervals
throughout the day. Endothelial function will measured at 08:15 (0.25h) and again at 3h. At
0h, a fasting blood sample will be collected. Subsequent venous blood samples will be
collected at 1.5, 1.75, 2, 3, 4, 5, 5.5, 5.75, 6, 7, 8 and 9h. Participants will consume a
standardised high fat breakfast at 1h and a standardised high fat lunch at 5h. The meals
consist of 57% fat, 32% carbohydrate and 11% protein. The meals provide 14.3 kcal per kg of
body mass.
Participants will rest in the laboratory throughout day 2 of both the exercise and control
trials.
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