Fast food increases postprandial cardiac workload in type 2 diabetes independent of pre-exercise: A pilot study

BACKGROUND Type 2 diabetes aggravates the postprandial metabolic effects of food, which increase cardiovascular risk. We investigated the acute effects of fast food on postprandial left ventricular (LV) function and the potential effects of pre-exercise in type 2 diabetes individuals. METHODS We used a cross-over study including 10 type 2 diabetes individuals (7 male and 3 females; 53.4 ± 8.1 years; 28.3 ± 3.8 kg/m(2); type 2 diabetes duration 3.1 ± 1.8 years) and 10 controls (7 male and 3 females; 52.8 ± 10.1 years; 28.5 ± 4.2 kg/m(2)) performing high intensity interval exercise (HIIE; 40 min, 4 × 4 min intervals, 90-95% HRmax), moderate intensity exercise (MIE; 47 min, 70% HRmax) and no exercise (NE) in a random order 16-18 hours prior to fast-food ingestion. Baseline echocardiography, blood pressure and biochemical measurements were recorded prior to and 16-18 hours after exercise, and 30 minutes, 2 hours and 4 hours after fast food ingestion. RESULTS LV diastolic (peak early diastolic tissue velocity, peak early diastolic filling velocity), and systolic workload (global strain rate, peak systolic tissue velocity, rate pressure product) increased after consumption of fast food in both groups. In contrast to controls, the type 2 diabetes group had prolonged elevations in resting heart rate and indications of prolonged elevations in diastolic workload (peak early diastolic tissue velocity) as well as reduced systolic blood pressure after fast food consumption. No significant modifications due to exercise in the postprandial phase were seen in any group. CONCLUSIONS Our findings indicate that fast-food induces greater and sustained overall cardiac workload in type 2 diabetes individuals versus body mass index and age matched controls; exercise 16-18 hours pre-meal has no acute effects to the postprandial phase. TRIAL REGISTRATION ClinicalTrials.gov: NCT01991769.