Research Article: What is the effect of a Mediterranean compared with a Fast Food meal on the exercise induced adipokine changes? A randomized cross-over clinical trial

Date Published: April 18, 2019

Publisher: Public Library of Science

Author(s): Diana Silva, Rita Moreira, Marília Beltrão, Oksana Sokhatska, Tiago Montanha, Andreia Pizarro, Vanessa Garcia-Larsen, Rodrigo Villegas, Luís Delgado, Pedro Moreira, Joana Carvalho, André Moreira, Massimiliano Ruscica.


Adipose tissue-derived adipokines are pro-inflammatory cytokines involved in metabolic-related diseases and can be influenced by diet and exercise. We aimed to compare the effect of a Mediterranean (MdM) compared with Fast Food (FFM) meal on the exercise induced adipokines changes.

In a double blinded cross over trial, 46 participants were randomly assigned to one of two standardized iso-energy pre-exercise meals: FFM or MdM-type. Three hours after each meal, participants completed a treadmill exercise test (EC). Serum adiponectin, resistin, PAI-1, lipocalin-2/NGAL and adipsin were determined by Luminex magnetic bead immunoassay. Wilcoxon signed rank test compared changes before/after meal and before/after EC and a linear mixed model evaluated the effect of meals on the adipokine response to exercise, adjusted for confounders.

Thirty-nine participants (mean age of 25, with a standard deviation of 5 years) completed the trial (56% females). For both interventions, a significant reduction of adipsin after each meal and a significant increase of lipocalin, PAI-1, adipsin and resistin, after exercise was observed. When exercise was preceded by a MdM meal a higher increase in adipsin levels was seen.

Acute exercise induced an increase of circulatory levels of adipsin, resistin, lipocalin and PAI-1, but not adiponectin. A pre-exercise Mediterranean meal potentiated the increase of adipsin after the exercise test, which possibly relates to the immune regulatory role of adipsin. These changes suggest a cross-talk between the immune and metabolic immediate response to exercise and its modulation by the pre-exercise diet composition.

Partial Text

Unhealthy dietary intake and sedentary behavior in a genetically susceptible individual have been associated with adipokine dysregulation resulting both in adverse metabolic and immune responses [1]. Adiposity modulates inflammation and metabolic balance, both through adipokines, like adiponectin, as well as cytokines produced within the non-adipocyte tissue fraction, namely resistin [2]. These biomarkers might mediate the effect of obesity on other inflammatory diseases, namely in asthma[3]. This pro-inflammatory profile may be counteracted by exercise-induced fatness decrease[4]. Changes in dietary content, towards an increase of omega-3-fatty acid intake, induced an increase in adiponectin levels[5]. Taken together, evidence suggests that dietary habits and physical activity, in a long-term perspective, may modulate these adipokine influences on the metabolic and immune profile. Nevertheless, the effects of short-term interventions such as a single meal and an exercise bout remain poorly recognized.

After recruitment strategy, from participants that met the eligibility criteria, 61 attended the screening visit. A total of 46 participants were included, of those 5 withdraw before any of the interventions and 2 before the second meal (Fig 1). Baseline demographic and clinical characteristics of the participants are presented in Table 1.

Our study shows that a Mediterranean meal (MdM) may blunt the adipsin immediate response and potentiate its exercise induced increase in comparison with a fast food meal (FFM). MdM attenuated, non-significantly, the exercise induced cortisol increase. Exercise challenge(EC) induced an acute inflammatory response represented by an increase of lipocalin, PAI-1 and resistin independent of the previous type of meal. These findings highlight the importance of the pre-exercise dietary intake on both the immune and metabolic response to acute exercise.




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