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Impact of Dietary Intake and Cardiorespiratory Fitness on Glycemic Variability in Adolescents: An Observational Study

Mingliang Ge¹, Stephanie R Lebby², Shivani Chowkwale²

¹Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States.

Current Developments in Nutrition

|February 25, 2025

Abstract

Background:

Cardiorespiratory fitness (CRF), estimated by maximum oxygen consumption (VO₂ max) during exercise, is worsening among adolescents and associated with a decline in metabolic health into adulthood. Glycemic patterns may provide a mechanism between CRF and health.

Objectives:

This study assessed the feasibility of measuring glycemic patterns using continuous glucose monitoring (CGM) in adolescents, aged 14-22 y, to estimate the relationship between VO₂ max and glucose patterns.

Methods:

Healthy adolescents (n = 30) were recruited for a treadmill VO₂ max test and to complete the following activities for 7-10 d: 1) wear a Dexcom G6 CGM, 2) complete ≥3 24-h dietary recalls, and 3) complete 1 at-home oral glucose tolerance test (OGTT, 75 g glucose). Glycemic patterns were extracted as mean glucose, the coefficient of variance, the mean amplitude of glycemic excursions, and the mean of daily differences. The 2-h glucose responses to the OGTT and individual meals were extracted. Statistical analyses evaluated the relationship between VO₂ max and 1) overall glycemic patterns and 2) the maximum glucose level and AUC response to OGTT and meals, stratified by sex.

Results:

Participant feasibility demonstrated that 90% completed CGM data (n = 27), 87% ≥7 d of CGM data (n = 26), 97% attempted OGTT (n = 29), and 93% completed ≥3 dietary recalls (n = 28). Most participants had normal BMI (70%) with an even distribution of sex (44% male). Males exhibited an inverse relationship between VO₂ max and overall mean glucose (ß= -7.7, P = 0.04). Males demonstrated an inverse relationship between VO₂ max and 1) maximum glucose (ß = -29, P = 0.006) and AUC (ß = -2702, P = 0.001) in response to the OGTT and 2) AUC (ß = -1293, P = 0.03) in response to meals. No association was observed between VO₂ max and glucose patterns in females.

Conclusions:

A sex-specific relationship between VO₂ max and glycemic patterns was observed, suggesting a unique metabolic capacity during late adolescence by sex.This trial was registered at clinicaltrials.gov as NCT05845827.

Keywords:

24-h dietary recalls acute response adolescents continuous glucose monitoring maximum oxygen consumption physical activity

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