Chronic exercise tied to lower appetite in patients with type 2 diabetes: Study

The review of seven studies involving individuals with prediabetes or Type 2 diabetes found that chronic exercise may be associated with reduced appetite. The findings showed aerobic endurance exercise like brisk walking done consistently for 150 minutes weekly or more was most likely to lead to reduced hunger and increased satiety in participants diagnosed with diabetes.

The study results provided more evidence for an appetite-reducing rather than an appetite-increasing effect of (chronic) exercise on patients with prediabetes or T2DM.

Prediabetes and T2DM represent significant public health concerns globally, with their prevalence on the rise. Lifestyle interventions, including exercise, are important in managing these conditions. However, understanding the influence of exercise on appetite regulation in individuals with prediabetes or T2DM is crucial for optimizing treatment strategies.

Against the above background, Christoph Konitz, German Sport University Cologne, Cologne, Germany, and colleagues aimed to analyze the effects of acute and chronic exercise on appetite and appetite regulation in patients with abnormal glycemic control.

For this purpose, the researchers searched online databases for eligible studies. The included studies had to report assessments of appetite (primary outcome). Appetite-regulating hormone levels were analyzed as secondary outcomes (considered, if additionally reported).

Seven studies with a total of 211 patients with prediabetes or type 2 diabetes mellitus met the inclusion criteria.

The researchers reported the following findings:

• Ratings of hunger, satiety, fullness, prospective food consumption, nausea, and desire to eat, as well as levels of (des-)acylated ghrelin, glucagon-like peptide 1, glucose-dependent insulinotropic peptide, pancreatic polypeptide, peptide tyrosine tyrosine, leptin, and spexin were considered.
• Following acute exercise, the effects on appetite (measured up to one-day post-exercise) varied, there were either no changes or a decrease in appetite ratings following chronic exercise, both compared to control conditions (without exercise).
• Inconsistent changes in appetite-regulating hormone levels accompanied these results. The overall risk of bias was low.

"The present results provide more evidence for an appetite-reducing rather than an appetite-increasing effect of (chronic) exercise on patients with T2DM or prediabetes," the researchers wrote.

The researchers suggest that practitioners should, however, consider possible inter-individual differences in appetite responses to exercise.

"It is necessary to conduct studies on the effects of training interventions on appetite that also examine changes in free-living energy intake and components of energy expenditure to draw definite conclusions about the effectiveness of exercise in impacting long-term energy balance," they concluded.

Reference:

Konitz, C., Schwensfeier, L., Predel, H., & Brinkmann, C. (2023). The Influence of Acute and Chronic Exercise on Appetite and Appetite Regulation in Patients with Prediabetes or Type 2 Diabetes Mellitus—A Systematic Review. Nutrients, 16(8), 1126. https://doi.org/10.3390/nu16081126