The effect of a pre-meal snack and/or postprandial exercise on breakfast glycemic excursion in adults with cystic fibrosis: A pilot study

Clin Nutr ESPEN. 2024 Oct:63:952-958. doi: 10.1016/j.clnesp.2024.08.016. Epub 2024 Aug 24.

Abstract

Background & aims: Cystic fibrosis (CF)-related diabetes (CFRD), a common comorbidity in CF, is often preceded and characterized with elevated postprandial glycemic (PPG) excursions. In the general population, the consumption of a pre-meal protein snack and/or physical activity (PA) hinder the elevation of PPG levels. Our objective is to evaluate the effect of a pre-meal snack and/or post-meal PA on PPG excursions in CF.

Methods: This is a double-blinded randomized controlled crossover interventional study in 14 adults with CF, with 4 interventions: placebo pre-meal snack + no PA (control: CTL), pre-meal soy snack + no PA (SK), placebo pre-meal snack + PA (PA), and pre-meal soy snack + PA (SK + PA). The pre-meal soy snack or placebo beverage (vanilla flavoured water) is served at 8 AM, followed by a standardized breakfast at 9 AM and, postprandially, 5 repeated bouts of 3-min walk every 30 min or sedentary activity. Blood glucose and insulin were measured every 15-30 min during the interventions.

Results: Plasma glucose (PG) was higher 30 min after snack consumption compared to placebo beverage. One-hour post-breakfast, PG levels were lower during both PA interventions than with sedentary behavior. However, the overall 3 h post-breakfast glucose area under the curve (AUC) was similar between interventions. Post-breakfast 3 h insulin AUC was significantly lower during the SK + PA intervention compared to the sedentary behavior interventions.

Conclusion: Repeated short bouts of post-meal physical activity may positively impact PPG control in adults with CF, with or without the addition of a pre-meal soy snack. A pre-meal snack alone does not improve PPG.

Keywords: CF-Related diabetes; Cystic fibrosis; Nutrition; Physical activity; Soy protein.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Blood Glucose / metabolism
  • Breakfast*
  • Cross-Over Studies
  • Cystic Fibrosis* / blood
  • Double-Blind Method
  • Exercise*
  • Female
  • Glycemic Index
  • Humans
  • Insulin* / blood
  • Male
  • Pilot Projects
  • Postprandial Period*
  • Snacks*
  • Young Adult

Substances

  • Blood Glucose
  • Insulin