Association between Physical Activity Energy Expenditure and Continuous Glucose Monitor-Derived Metrics: Data from the ZOE PREDICT 1 Study

Harry A. Smith, Kate M. Bermingham, Anna May, Jonathan Wolf, Javier T. Gonzalez, Tim D. Spector, Sarah E. Berry

Research output: Chapter or section in a book/report/conference proceedingChapter in a published conference proceeding

Abstract

Background and objectives: Physical activity can improve glucose variability (GV) and time in range (TIR) in people with impaired glucose tolerance/diabetes [1,2]. However, the effects of physical activity on these parameters in people within normo-glycaemic ranges are unclear. This study explores the associations between physical activity, GV, and TIR in normo-glycaemic individuals from the ZOE PREDICT 1 cohort.

Methods: Free-living continuous interstitial glucose (using continuous glucose monitoring) and activity energy expenditure (AEE; mean of 14 days using a wrist-based accelerometer [ENMO]) were collected in the ZOE PREDICT 1 study (n = 1002). TIR was calculated using (1) the American Diabetes Association criteria (TIR 3.9–7.8 mmol∙L−1) and (2) a novel ‘stringent’ range (TIR 3.9–5.6 mmol∙L−1) [3]. The relationship between AEE and glycaemic outcomes (GV and TIR) was assessed using partial correlations (adjusted for age, sex, and BMI).

Results: Data from 698 participants (186 M/512 F) were analysed (mean ± SD; age: 45 ± 12 y; body mass index (BMI): 25.4 ± 4.8 kg∙m−2; and estimated basal metabolic rate (BMR; Harris–Benedict equation): 1456 ± 225 kcal∙d−1). The mean fasting glucose concentration was 4.93 ± 0.42 mmol∙L−1 (range: 3.58–6.07 mmol∙L−1), and the mean daily glucose concentration was 5.02 ± 0.54 mmol∙L−1 (range: 3.43–7.19 mmol∙L−1). The median GV was 16.1% (IQR: 13.1–18.5%), and the median proportion of time spent in TIR 3.9–5.6 was 72.4% (IQR: 62.0–80.7%) compared to 95.3% (IQR: 87.7–99.0%) in TIR ADA. AEE was inversely associated with TIR 3.9–5.6 (r = −0.09 p = 0.02), but not with TIR ADA (r = 0.03 p = 0.43), and positively associated with daily mean glucose concentration (r = 0.13, p < 0.001).

Discussion: The data presented in this study suggest that, in normo-glycaemic individuals, higher activity energy expenditure is associated with a lower proportion of time spent within a novel ‘stringent’ range of interstitial glucose concentrations. However, the causality of this relationship is unclear, and future research should establish whether a higher physical activity level drives a higher glucose level, or vice versa.
Original languageEnglish
Title of host publicationProceedings of the 14th European Nutrition Conference FENS 2023
Volume91
Edition1
DOIs
Publication statusPublished - 7 Dec 2023
EventThe 14th European Nutrition Conference FENS 2023 - Belgrade, Serbia
Duration: 14 Nov 202317 Nov 2023

Conference

ConferenceThe 14th European Nutrition Conference FENS 2023
Country/TerritorySerbia
CityBelgrade
Period14/11/2317/11/23

Data Availability Statement

The data used for analysis in this study are held by the Department of Twin Research at King’s College London and access can be requested from https://twinsuk.ac.uk/resources-for-researchers/access-our-data/ (accessed on 10 November 2023) to allow for anonymisation and compliance with GDPR standards.

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