Studies have found that acute exercise increases the postprandial levels of glucagon-like peptide-1 (GLP-1) in adults who are within normal weight range.1-5 Similar studies in overweight cohorts have had contradictory results.2, 6-12 While the effect of acute exercise on GLP-1 response has been studied, the association between habitual physical activity and GLP-1 secretion in an overweight population has yet to be determined. According to longitudinal study results published in Endocrine Connections, habitual physical activity, even at moderate levels, decreased fasting GLP-1 concentrations and increased glucose-stimulated GLP-1 responses.13
GLP-1 reduces glucose-stimulated blood glucose levels by stimulating secretion of insulin14 and is responsible for up to 70% of the postprandial insulin response in healthy individuals.15 GLP-1 responses have been shown to be abnormal in individuals with overweight and obesity.16
Longitudinal health examination data from a total of 1326 individuals in the 2009 to 2011 ADDITION-PRO study were used to examine the associations between habitual physical activity and both fasting and glucose-stimulated GLP-1 levels in overweight individuals. Patients with known diabetes or with incomplete information regarding glucose, GLP-1, and activity levels were excluded.
Individually calibrated heart rate and movement sensors worn by patients for 7 consecutive days were used to calculate frequency and intensity of physical activity. Using a standard value for resting metabolic rate of 71 J/min/mg, intensity of activity was defined by multiples of metabolic equivalent tasks (METs): sedentary was defined as activity <1.5 METs, light intensity between 1.5 and 3.0 METs, and moderate to vigorous intensity >3.0 METs.
Fasting GLP-1 levels were measured via blood samples taken after 8 hours of fasting. Glucose-stimulated GLP-1 secretion levels were measured using plasma samples from a 2-hour oral glucose tolerance test, during which patients ingested 75 g of glucose dissolved in 250 mL of water.
The average age of study patients was 66±7.1 years and average body mass index was 27.1±4.5 kg/m2. More than 98% of patients spent some time in moderate to vigorous physical activity, with 44% of men and 39% of women meeting the daily requirement of at least 30 minutes of moderate to vigorous physical activity per day.
Fasting levels of GLP-1 were 19.5% lower (95% CI, -33.0% to -3.3%; P =.021) for every 60-minute increase in moderate to vigorous physical activity in men. In a similar fashion, glucose-stimulated GLP-1 responses 2 hours after glucose intake were 20.0% greater (95% CI, 2.6%-40.3%; P =.022) for every 60-minute increase in moderate to vigorous physical activity in men. No significant associations were found in women, who spent less time exercising overall.
This study suggests that older men at risk for type 2 diabetes may be able to modulate their blood glucose levels through moderate exercise. It is important to note that no individuals in the study engaged in vigorous activity, showing that activities such as cleaning, gardening, and playing games with children or grandchildren may be sufficiently vigorous to affect GLP-1 levels.
Study limitations included the use of cross-sectional data. In addition, men and women were not matched for amount of time spent in moderate physical activity and there was an average daily difference of 10 minutes.
Disclosure: Several study authors declared affiliations with the pharmaceutical industry through funding. Please see the original reference for a full list of authors’ disclosures.
1. Ueda SY, Yoshikawa T, Katsura Y, Usui T, Nakao H, Fujimoto S. Changes in gut hormone levels and negative energy balance during aerobic exercise in obese young males. J Endocrinol. 2009;201(1):151-159.
2. Ueda SY, Yoshikawa T, Katsura Y, Usui T, Fujimoto S. Comparable effects of moderate intensity exercise on changes in anorectic gut hormone levels and energy intake to high intensity exercise. J Endocrinol. 2009;203(3):357-364.
3. Martins C, Morgan LM, Bloom SR, Robertson MD. Effects of exercise on gut peptides, energy intake and appetite. J Endocrinol. 2007;193(2):251-258.
4. Howe SM, Hand TM, Larson-Meyer DE, Austin KJ, Alexander BM, Manore MM. No effect of exercise intensity on appetite in highly-trained endurance women. Nutrients. 2016;8(4):223.
5. Holliday A, Blannin A. Appetite, food intake and gut hormone responses to intense aerobic exercise of different duration. J Endocrinol. 2017;235(3):193-205.
6. Unick JL, Otto AD, Goodpaster BH, Helsel DL, Pellegrini CA, Jakicic JM. Acute effect of walking on energy intake in overweight/obese women. Appetite. 2010;55(3):413-419.
7. Heden TD, Liu Y, Kearney ML, et al. Prior exercise and postprandial incretin responses in lean and obese individuals. Med Sci Sports Exerc. 2013;45(10):1897-1905.
8. Chanoine JP, Mackelvie KJ, Barr SI, Wong AC, Meneilly GS, Elahi DH. GLP-1 and appetite responses to a meal in lean and overweight adolescents following exercise. Obesity (Silver Spring). 2008;16(1):202-204.
9. Adam TCM, Westerterp-Plantenga MS. Activity-induced GLP-1 release in lean and obese subjects. Physiol Behav. 2004;83(3):459-466.
10. Quist JS, Blond MB, Gram AS, et al. Effects of active commuting and leisure-time exercise on appetite in individuals with overweight and obesity. J Appl Physiol (1985). 2019;126(4):941-951.
11. Flack KD, Ufholz K, Johnson L, Fitzgerald JS, Roemmich JN. Energy compensation in response to aerobic exercise training in overweight adults. Am J Physiol Regul Integr Comp Physiol. 2018;315(4):R619-R626.
12. Martins C, Stensvold D, Finlayson G, et al. Effect of moderate- and high-intensity acute exercise on appetite in obese individuals. Med Sci Sports Exerc. 2015;47(1):40-48.
13. Janus C, Vistisen D, Amadid H, et al. Habitual activity associates with lower fasting and greater glucose-induced GLP-1 response in men. Endocr Connect. 2019;8(12):1607-1617.
14. Holst JJ. The physiology of glucagon-like peptide 1. Physiol Rev. 2007;87(4):1409-1439.
15. Drucker DJ, Habener JF, Holst JJ. Discovery, characterization, and clinical development of the glucagon-like peptides. J Clin Invest. 2017;127(12):4217-4227.
16. Færch K, Torekov SS, Vistisen D, et al. GLP-1 response to oral glucose is reduced in prediabetes, screen-detected type 2 diabetes, and obesity and influenced by sex: the ADDITION-PRO study. Diabetes. 2015;64(7):2513-2525.
This article originally appeared on Endocrinology Advisor