The effects of exercise training on postprandial glycemia and insulinemia in adults with overweight or obesity and with cardiometabolic disorders: A systematic review and meta-analysis

Background: We performed a systematic review and meta-analysis to investigate the effects of exercise training on postprandial glycemia (PPG) and insulinemia (PPI) in adults with overweight or obesity and with cardiometabolic disorders.

Methods: PubMed, Web of Science, and Scopus databases were searched until May 2022 using the key words "exercise," "postprandial," and "randomized control trial" to identify original studies investigating the effects of exercise training on PPG and/or PPI in adults with a body mass indexes (BMI) ≥ 25 kg.m². Standardized mean differences (SMD) and 95 % confidence intervals (CIs) were calculated using random effects models to calculate effect sizes for outcomes and to generate forest plots. Sub-group analyses and meta-regressions were performed for potential categorical and continuous moderators.

Results: Twenty-nine studies involving 41 intervention arms and 1,401 participants were included in the systematic review and meta-analysis. Overall, exercise training significantly decreased PPG [-0.36 (95 % CI -0.50 to -0.22), p = 0.001] and PPI [-0.37 (95 % CI -0.52 to -0.21), p = 0.001]. Subgroup analyses showed that PPG decreased following both aerobic and resistance training; whereas PPI was reduced following aerobic training, independent of age, BMI, and baseline glucose levels. Meta-regression analyses showed that frequency of exercise sessions, intervention durations, and duration of exercise time, did not moderate the effects of exercise training on PPI or PPG (p > 0.05).

Conclusion: In adults with overweight or obesity and with cardiometabolic disorders, exercise training is effective for reducing PPG and PPI, across ages and BMIs, irrespective of baseline glucose levels and exercise training characteristics.