Postprandial Metabolism and Physical Activity in Asians: A Narrative Review

Abstract

The widespread benefits of physical activity in enhancing health and lowering the risk of non-communicable chronic diseases are well established across populations globally. Nevertheless, the prevalence of several lifestyle-related chronic diseases, including cardiovascular disease, varies markedly across countries and ethnicities. Direct ethnic comparative studies on the health benefits of physical activity are sparse and evidence-based physical activity guidelines are not ethnicity-specific. Indeed, physical activity guidelines in some Asian countries were developed primarily based on data from Western populations even though the magnitude of potential benefit may not be the same among different ethnic groups. Unfavorable diurnal perturbations in postprandial triglycerides and glucose are risk factors for cardiovascular disease. This narrative review summarizes differences in these risk factors primarily between individuals of Asian and white European descent but also within different Asian groups. Moreover, the variable effects of physical activity on mitigating risk factors among these ethnic groups are highlighted along with the underlying metabolic and hormonal factors that potentially account for these differences. Future ethnic comparative studies should include investigations in understudied ethnic groups, such as those of East Asian origin, given that the effectiveness of physical activity for ameliorating cardiovascular disease varies even among Asian groups.

Key words

postprandial triglyceridemia - postprandial glycemia - ethnicity - cardiovascular disease risk factors

Publikationsverlauf

Eingereicht: 23. Januar 2021

Angenommen: 15. April 2021

Artikel online veröffentlicht:
09. August 2021

• References

• 1 Tominaga M, Eguchi H, Manaka H. et al. Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose. The Funagata Diabetes Study. Diabetes Care 1999; 22: 920-924
• 2 The DECODE Study Group. Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria. Lancet 1999; 354: 617-621
• 3 Iso H, Naito Y, Sato S. et al. Serum triglycerides and risk of coronary heart disease among Japanese men and women. Am J Epidemiol 2001; 153: 490-499
• 4 Nordestgaard BG, Benn M, Schnohr P. et al. Nonfasting triglycerides and risk of myocardial infarction, ischemic heart disease, and death in men and women. JAMA 2007; 298: 299-308
• 5 Zilversmit DB. Atherogenesis : A postprandial phenomenon. Circulation 1979; 60: 473-485
• 6 Marcovecchio ML, Lucantoni M, Chiarelli F. Role of chronic and acute hyperglycemia in the development of diabetes complications. Diabetes Technol Ther 2011; 13: 389-394
• 7 Peddie MC, Rehrer NJ, Perry TL. Physical activity and postprandial lipidemia: are energy expenditure and lipoprotein lipase activity the real modulators of the positive effect?. Prog Lipid Res 2012; 51: 11-22
• 8 Maraki M, Sidossis L. The latest on the effect of prior exercise on postprandial lipaemia. Sports Med 2013; 43: 463-481
• 9 Freese EC, Gist NH, Cureton KJ. Effect of prior exercise on postprandial lipemia: an updated quantitative review. J Appl Physiol (1985) 2014; 116: 67-75
• 10 Haxhi J, Scotto A, Sacchetti M. Exercising for metabolic control: is timing important?. Ann Nutr Metab 2013; 62: 14-25
• 11 Aqeel M, Forster A, Richards EA. et al. Correction: The effect of timing of exercise and eating on postprandial response in adults: a systematic review. Nutrients 2020; 12: 221
• 12 Lye CT, Mukherjee S, Burns SF. Combining plant sterols with walking lowers postprandial triacylglycerol more than walking only in Chinese men with elevated body mass index. Int J Sport Nutr Exerc Metab 2019; 29: 576-582
• 13 Miyashita M, Hamada Y, Fujihira K. et al. Energy replacement diminishes the postprandial triglyceride-lowering effect from accumulated walking in older women. Eur J Nutr 2020; 59: 2261-2270
• 14 Miyashita M, Edamoto K, Kidokoro T. et al. Interrupting sitting time with regular walks attenuates postprandial triglycerides. Int J Sports Med 2016; 37: 97-103
• 15 Hatamoto Y, Goya R, Yamada Y. et al. Effect of exercise timing on elevated postprandial glucose levels. J Appl Physiol (1985) 2017; 123: 278-284
• 16 Celis-Morales CA, Ghouri N, Bailey MES. et al. Should physical activity recommendations be ethnicity-specific? Evidence from a cross-sectional study of South Asian and European men. PLoS One 2013; 8: e82568
• 17 Arjunan SP, Bishop NC, Reischak-Oliveira A. et al. Exercise and coronary heart disease risk markers in south Asian and European men. Med Sci Sports Exerc 2013; 45: 1261-1268
• 18 Arjunan SP, Deighton K, Bishop NC. et al. The effect of prior walking on coronary heart disease risk markers in South Asian and European men. Eur J Appl Physiol 2015; 115: 2641-2651
• 19 Henson J, Edwardson CL, Celis-Morales CA. et al. Predictors of the acute postprandial response to breaking up prolonged sitting. Med Sci Sports Exerc 2020; 52: 1385-1393
• 20 Sargeant J, Jelleyman C, Coull NA. et al. Improvements in glycaemic control after acute moderate-intensity continuous or high-intensity interval exercise are greater in South Asians than white Europeans with nondiabetic hyperglycaemia : A randomised crossover study. Diabetes Care 2021; 44: 201-209
• 21 Yates T, Edwardson CL, Celis-Morales C. et al. Metabolic effects of breaking prolonged sitting with standing or light walking in older south asians and white Europeans: a randomized acute study. J Gerontol A Biol Sci Med Sci 2020; 75: 139-146
• 22 Kodama K, Tojjar D, Yamada S. et al. Ethnic differences in the relationship between insulin sensitivity and insulin response: a systematic review and meta-analysis. Diabetes Care 2013; 36: 1789-1796
• 23 Hall LML, Moran CN, Milne GR. et al. Fat oxidation, fitness and skeletal muscle expression of oxidative/lipid metabolism genes in South Asians: implications for insulin resistance?. PLoS One 2010; 5: e14197
• 24 Friday KE, Srinivasan SR, Elkasabany A. et al. Black-white differences in postprandial triglyceride response and postheparin lipoprotein lipase and hepatic triglyceride lipase among young men. Metabolism 1999; 48: 749-754
• 25 Bower JF, Deshaies Y, Pfeifer M. et al. Ethnic differences in postprandial triglyceride response to a fatty meal and lipoprotein lipase in lean and obese African American and Caucasian women. Metabolism 2002; 51: 211-217
• 26 World Health Organization, WHO. WHO Guidelines on Physical Activity and Sedentary Behaviour. 2020; Available from: https://apps.who.int/iris/bitstream/handle/10665/44399/9789241599979_eng.pdf?sequence=1. Accessed: 12 May 2021
• 27 Department of Health and Social Care. UK Chief Medical Officers’ Physical Activity Guidelines.. 2019 Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/832868/uk-chief-medical-officers-physical-activity-guidelines.pdf. Accessed: 25 March 2021
• 28 Physical Activity Guidelines Advisory Committee. U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans (2nd edition). 2018; Available from: https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf. Accessed: 25 March 2021
• 29 Gill JMR, Celis-Morales CA, Ghouri N. Physical activity, ethnicity and cardio-metabolic health: does one size fit all?. Atherosclerosis 2014; 232: 319-333
• 30 International Diabetes Federation. IDF Diabetes Atlas. 9th ed.. Brussels: International Diabetes Federation; 2019
• 31 Roth GA, Johnson C, Abajobir A. et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990–2015. J Am Coll Cardiol 2017; 70: 1-25
• 32 Gholap N, Davies M, Patel K. et al. Type 2 diabetes and cardiovascular disease in South Asians. Prim Care Diabetes 2011; 5: 45-56
• 33 Sattar N, Gill JMR. Type 2 diabetes in migrant south Asians: mechanisms, mitigation, and management. Lancet Diabetes Endocrinol 2015; 3: 1004-1016
• 34 Cruz ML, Evans K, Frayn KN. Postprandial lipid metabolism and insulin sensitivity in young Northern Europeans, South Asians and Latin Americans in the UK. Atherosclerosis 2001; 159: 441-449
• 35 Lopez-Miranda J, Williams C, Larion D. Dietary, physiological, genetic and pathological influences on postprandial lipid metabolism. Br J Nutr 2007; 98: 458-473
• 36 Couillard C, Bergeron N, Prud’Homme D. et al. Postprandial triglyceride response in visceral obesity in men. Diabetes 1998; 47: 953-960
• 37 Hocking S, Samocha-Bonet D, Milner KL. et al. Adiposity and insulin resistance in humans: the role of the different tissue and cellular lipid depots. Endocr Rev 2013; 34: 463-500
• 38 Pollare T, Vessby B, Lithell H. Lipoprotein lipase activity in skeletal muscle is related to insulin sensitivity. Arterioscler Thromb 1991; 11: 1192-1203
• 39 Malmström R, Packard CJ, Caslake M. et al. Defective regulation of triglyceride metabolism by insulin in the liver in NIDDM. Diabetologia 1997; 40: 454-462
• 40 Chandalia M, Abate N, Garg A. et al. Relationship between generalized and upper body obesity to insulin resistance in Asian Indian men. J Clin Endocrinol Metab 1999; 84: 2329-2335
• 41 Dickinson S, Colagiuri S, Faramus E. et al. Postprandial hyperglycemia and insulin sensitivity differ among lean young adults of different ethnicities. J Nutr 2002; 132: 2574-2579
• 42 Wang X, Xie C, Marathe CS. et al. Disparities in gastric emptying and postprandial glycaemia between Han Chinese and Caucasians with type 2 diabetes. Diabetes Res Clin Pract 2020; 159: 107951
• 43 Simper T, Dalton C, Broom D. et al. Greater glycaemic response to an oral glucose load in healthy, lean, active and young chinese adults compared to matched Caucasians. Nutrients 2018; 10: 487
• 44 Kataoka M, Venn BJ, Williams SM. et al. Glycaemic responses to glucose and rice in people of Chinese and European ethnicity. Diabet Med 2013; 30: e101-107
• 45 Venn BJ, Williams SM, Mann JI. Comparison of postprandial glycaemia in Asians and Caucasians. Diabet Med 2010; 27: 1205-1208
• 46 Raji A, Seely EW, Arky RA. et al. Body fat distribution and insulin resistance in healthy Asian Indians and Caucasians. J Clin Endocrinol Metab 2001; 86: 5366-5371
• 47 Møller JB, Man CD, Overgaard RV. et al. Ethnic differences in insulin sensitivity, β-cell function, and hepatic extraction between Japanese and Caucasians: a minimal model analysis. J Clin Endocrinol Metab 2014; 99: 4273-4280
• 48 Tan VMH, Wu T, Henry CJ. et al. Glycaemic and insulin responses, glycaemic index and insulinaemic index values of rice between three Asian ethnic groups. Br J Nutr 2015; 113: 1228-1236
• 49 Henson J, Davies MJ, Bodicoat DH. et al. Breaking up prolonged sitting with standing or walking attenuates the postprandial metabolic response in postmenopausal women: a randomized acute study. Diabetes Care 2016; 39: 130-138
• 50 McCarthy M, Edwardson CL, Davies MJ. et al. Fitness moderates glycemic responses to sitting and light activity breaks. Med Sci Sports Exerc 2017; 49: 2216-2222
• 51 McCarthy M, Edwardson CL, Davies MJ. et al. Breaking up sedentary time with seated upper body activity can regulate metabolic health in obese high-risk adults: a randomized crossover trial. Diabetes Obes Metab 2017; 19: 1732-1739
• 52 Leroith D. β-cell dysfunction and insulin resistance in type 2 diabetes: role of metabolic and genetic abnormalities. Am J Med 2002; 113: 3S-11S
• 53 Jitrapakdee S, Wutthisathapornchai A, Wallace J. et al. Regulation of insulin secretion: role of mitochondrial signalling. Diabetologia 2010; 53: 1019-1032
• 54 Del Prato S. Loss of early insulin secretion leads to postprandial hyperglycaemia. Diabetologia 2003; 46: M2-M8
• 55 Yajnik CS, Lubree HG, Rege SS. et al. Adiposity and hyperinsulinemia in Indians are present at birth. J Clin Endocrinol Metab 2002; 87: 5575-5580
• 56 Ehtisham S, Crabtree N, Clark P. et al. Ethnic differences in insulin resistance and body composition in United Kingdom adolescents. J Clin Endocrinol Metab 2005; 90: 3963-3969
• 57 Forouhi NG, Jenkinson G, Thomas EL. et al. Relation of triglyceride stores in skeletal muscle cells to central obesity and insulin sensitivity in European and South Asian men. Diabetologia 1999; 42: 932-935
• 58 Lear SA, Kohli S, Bondy GP. et al. Ethnic variation in fat and lean body mass and the association with insulin resistance. J Clin Endocrinol Metab 2009; 94: 4696-4702
• 59 Mente A, Razak F, Blankenberg S. et al. Ethnic variation in adiponectin and leptin levels and their association with adiposity and insulin resistance. Diabetes Care 2010; 33: 1629-1634
• 60 Torréns JI, Skurnick J, Davidow AL. et al. Ethnic differences in insulin sensitivity and β-cell function in premenopausal or early perimenopausal women without diabetes: the Study of Women's Health Across the Nation (SWAN). Diabetes Care 2004; 27: 354-361
• 61 Sulistyoningrum DC, Gasevic D, Lear SA. et al. Total and high molecular weight adiponectin and ethnic-specific differences in adiposity and insulin resistance: a cross-sectional study. Cardiovasc Diabetol 2013; 12: 170
• 62 Ralston JC, Zulyniak MA, Nielsen DE. et al. Ethnic- and sex-specific associations between plasma fatty acids and markers of insulin resistance in healthy young adults. Nutr Metab 2013; 10: 42
• 63 Lillioja S, Nyomba B, Saad MF. et al. Exaggerated early insulin release and insulin resistance in a diabetes-prone population: a metabolic comparison of Pima Indians and Caucasians. J Clin Endocrinol Metab 1991; 73: 866-876
• 64 Raygor V, Abbasi F, Lazzeroni LC. et al. Impact of race/ethnicity on insulin resistance and hypertriglyceridaemia. Diabetes Vasc Dis Res 2019; 16: 153-159
• 65 Fukushima M, Usami M, Ikeda M. et al. Insulin secretion and insulin sensitivity at different stages of glucose tolerance: a cross-sectional study of Japanese type 2 diabetes. Metabolism 2004; 53: 831-835
• 66 Matsuda M, DeFronzo RA. Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care 1999; 22: 1462-1470
• 67 Kuroe A, Fukushima M, Usami M. et al. Impaired β-cell function and insulin sensitivity in Japanese subjects with normal glucose tolerance. Diabetes Res Clin Pract 2003; 59: 71-77
• 68 Nakanishi S, Okubo M, Yoneda M. et al. A comparison between Japanese-Americans living in Hawaii and Los Angeles and native Japanese: the impact of lifestyle westernization on diabetes mellitus. Biomed Pharmacother 2004; 58: 571-577
• 69 Gao H, Salim A, Lee J. et al. Can body fat distribution, adiponectin levels and inflammation explain differences in insulin resistance between ethnic Chinese, Malays and Asian Indians. Int J Obes 2012; 36: 1086-1093
• 70 Tan VMH, Lee YS, Venkataraman K. et al. Ethnic differences in insulin sensitivity and beta-cell function among Asian men. Nutr Diabetes 2015; 5: e173
• 71 Saad MF, Knowler WC, Pettitt DJ. et al. A two-step model for development of non-insulin-dependent diabetes. Am J Med 1991; 90: 229-235
• 72 Yabe D, Seino Y, Fukushima M. et al. β cell dysfunction versus insulin resistance in the pathogenesis of type 2 diabetes in East Asians. Curr Diab Rep 2015; 15: 602
• 73 Lear SA, Humphries KH, Kohli S. et al. The use of BMI and waist circumference as surrogates of body fat differs by ethnicity. Obesity 2007; 15: 2817-2824
• 74 Lear SA, Humphries KH, Kohli S. et al. Visceral adipose tissue accumulation differs according to ethnic background: results of the Multicultural Community Health Assessment Trial (M-CHAT). Am J Clin Nutr 2007; 86: 353-359
• 75 Anand SS, Tarnopolsky MA, Rashid S. et al. Adipocyte hypertrophy, fatty liver and metabolic risk factors in South Asians: the Molecular Study Of Health and Risk in Ethnic Groups (mol-SHARE). PLoS One 2011; 6: e22112
• 76 Marathe CS, Bound M, Lange K. et al. Ethnic disparities in insulin and glucose-dependent insulinotropic peptide (GIP) responses to intraduodenal glucose in health. Acta Diabetol 2015; 52: 817-819
• 77 Korn ED. Clearing factor, a heparin-activated lipoprotein lipase. I. Isolation and characterization of the enzyme from normal rat heart. J Biol Chem 1955; 215: 1-14
• 78 Korn ED. Clearing factor, a heparin-activated lipoprotein lipase. II. Substrate specificity and activation of coconut oil. J Biol Chem 1955; 215: 15-26
• 79 Bergeron J, Couillard C, Després JP. et al. Race differences in the response of postheparin plasma lipoprotein lipase and hepatic lipase activities to endurance exercise training in men: results from the HERITAGE Family Study. Atherosclerosis 2001; 159: 399-406
• 80 Jeppesen J, Hollenbeck CB, Zhou MY. et al. Relation between insulin resistance, hyperinsulinemia, postheparin plasma lipoprotein lipase activity, and postprandial lipemia. Arterioscler Thromb Vasc Biol 1995; 15: 320-324
• 81 Kiens B, Lithell H, Mikines KJ. et al. Effects of insulin and exercise on muscle lipoprotein lipase activity in man and its relation to insulin action. J Clin Invest 1989; 84: 1124-1129
• 82 Seip RL, Angelopoulos TJ, Semenkovich CF. Exercise induces human lipoprotein lipase gene expression in skeletal muscle but not adipose tissue. Am J Physiol 1995; 268: E229-E236
• 83 Després JP, Couillard C, Gagnon J. et al. Race, visceral adipose tissue, plasma lipids, and lipoprotein lipase activity in men and women: the Health, Risk Factors, Exercise Training, and Genetics (HERITAGE) family study. Arterioscler Thromb Vasc Biol 2000; 20: 1932-1938
• 84 Deo RC, Reich D, Tandon A. et al. Genetic differences between the determinants of lipid profile phenotypes in African and European Americans: the Jackson Heart Study. PLoS Genet 2009; 5: e1000342
• 85 Talmud PJ, Hall S, Holleran S. et al. LPL promoter -93T/G transition influences fasting and postprandial plasma triglycerides response in African-Americans and Hispanics. J Lipid Res 1998; 39: 1189-1196
• 86 Ehrenborg E, Clee SM, Pimstone SN. et al. Ethnic variation and in vivo effects of the -93t→g promoter variant in the lipoprotein lipase gene. Arterioscler Thromb Vasc Biol 1997; 17: 2672-2678
• 87 Hall S, Chu G, Miller G. et al. A common mutation in the lipoprotein lipase gene promoter, -93T/G, is associated with lower plasma triglyceride levels and increased promoter activity in vitro. Arterioscler Thromb Vasc Biol 1997; 17: 1969-1976
• 88 Hall S, Talmud PJ, Cook DG. et al. Frequency and allelic association of common variants in the lipoprotein lipase gene in different ethnic groups: the Wandsworth Heart and Stroke Study. Genet Epidemiol 2000; 18: 203-216
• 89 Mailly F, Tugrul Y, Reymer PWA. et al. A common variant in the gene for lipoprotein lipase (Asp9→Asn). Functional implications and prevalence in normal and hyperlipidemic subjects. Arterioscler Thromb Vasc Biol 1995; 15: 468-478
• 90 Palacio Rojas M, Prieto C, Bermúdez V. et al. Dyslipidemia: genetics, lipoprotein lipase and HindIII polymorphism. F1000Res 2017; 6: 2073
• 91 Ukkola O, Garenc C, Pérusse L. et al. Genetic variation at the lipoprotein lipase locus and plasma lipoprotein and insulin levels in the Québec Family Study. Atherosclerosis 2001; 158: 199-206
• 92 Wittrup HH, Andersen RV, Tybjærg-hansen A. et al. Combined analysis of six lipoprotein lipase genetic variants on triglycerides, high-density lipoprotein, and ischemic heart disease: cross-sectional, prospective, and case-control studies from the Copenhagen City Heart Study. J Clin Endocrinol Metab 2006; 91: 1438-1445
• 93 Bruce CR, Anderson MJ, Carey AL. et al. Muscle oxidative capacity is a better predictor of insulin sensitivity than lipid status. J Clin Endocrinol Metab 2003; 88: 5444-5451
• 94 Nyholm B, Nielsen MF, Kristensen K. et al. Evidence of increased visceral obesity and reduced physical fitness in healthy insulin-resistant first-degree relatives of type 2 diabetic patients. Eur J Endocrinol 2004; 150: 207-214
• 95 Goodpaster BH, Brown NF. Skeletal muscle lipid and its association with insulin resistance: what is the role for exercise?. Exerc Sport Sci Rev 2005; 33: 150-154
• 96 Nair KS, Bigelow ML, Asmann YW. et al. Asian Indians have enhanced skeletal muscle mitochondrial capacity to produce ATP in association with severe insulin resistance. Diabetes 2008; 57: 1166-1175
• 97 Murphy C, Kanaganayagam GS, Jiang B. et al. Vascular dysfunction and reduced circulating endothelial progenitor cells in young healthy UK South Asian men. Arterioscler Thromb Vasc Biol 2007; 27: 936-942
• 98 Cubbon RM, Murgatroyd SR, Ferguson C. et al. Human exercise-induced circulating progenitor cell mobilization is nitric oxide-dependent and is blunted in South Asian men. Arterioscler Thromb Vasc Biol 2010; 30: 878-884
• 99 Williams CJ, Williams MG, Eynon N. et al. Genes to predict VO2max trainability: A systematic review. BMC Genomics 2017; 18: 831
• 100 Nagayama C, Burns SF, Stensel DJ. et al. Effects of a single bout of walking on postprandial triglycerides in men of Chinese, European and Japanese descent: a multisite randomised crossover trial. BMJ Open Sport Exerc Med 2020; 6: e000928
• 101 National Institute of Health and Nutrition. The national health and nutrition survey in Japan: annual changes in primary health indicators; Available from: https://www.nibiohn.go.jp/eiken/kenkounippon21/en/eiyouchousa/. Accessed: 12 May 2021
• 102 Ministry of Health. National Health Survey 2010 Singapore. 2010. Available from: https://www.moh.gov.sg/docs/librariesprovider5/resources-statistics/reports/nhs2010---low-res.pdf. Accessed: 12 May 2021
• 103 Guthold R, Stevens GA, Riley LM. et al. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants. Lancet Glob Health 2018; 6: e1077-e1086
• 104 Harriss DJ, Macsween A, Atkinson G. Ethical standards in sport and exercise science research: 2020 update. Int J Sports Med 2019; 40: 813-817