Acute effects of a high fat and high carbohydrate meal with and without subsequent physical activity on cardiac autonomic modulation in people with type 2 diabetes

Sci Rep. 2025 Sep 17;15(1):32580. doi: 10.1038/s41598-025-19506-5.

Abstract

The impact of different dietary interventions on autonomic cardiac modulation (ACM) in people with type 2 diabetes (T2D) is a remarkable, albeit scarcely studied topic. The aim of this secondary outcome analysis was to evaluate the effects of a high-carbohydrate (CHO) and high-fat meal (FAT) with and without subsequent physical activity (PA, CHO + PA and FAT + PA) on baseline electrocardiographic and heart rate variability (HRV) parameters in people with T2D. Eleven individuals with T2D (five females, 65.8 ± 5.9 years, body mass index: 29.5 ± 5.2 kg·m-2, HbA1c: 7.0 ± 0.8%) participated in this study. Electrocardiogram (ECG) and HRV parameters before and after the meal intake as well as during physical activity, a 30-minute self-paced treadmill walk, were analyzed. Baseline ECG parameters included resting heart rate (73 ± 8 beats per minute), PQ interval (160 ± 24 ms), QRS interval (92 ± 11 ms), QT (387 ± 17 ms) and QTc time interval (420 ± 20 ms) without clinically relevant dynamics. No negative impact of either dietary interventions or PA on HRV parameters, i.e. standard deviation of the NN interval (SDNN, (F [1.9] = 0.28), root mean square of successive differences (RMSSD, (F [1.9] = 0.09) and ln LF/HF (low frequency/high frequency) (F [1.9] = 0.00) could be revealed displaying preserved ACM. In conclusion, our secondary outcome analysis displayed preserved ACM in T2D independently of dietary intervention or additional PA. Finally, our research might strengthen the scientific data on dietary intervention in T2D and demonstrate future preventive options in the context of T2D and nutrition.

Keywords: ACM; Electrocardiogram, glucose; Fructose; Holter; Palm fat; Treadmill walking.

MeSH terms

  • Aged
  • Autonomic Nervous System* / drug effects
  • Autonomic Nervous System* / physiopathology
  • Diabetes Mellitus, Type 2* / diet therapy
  • Diabetes Mellitus, Type 2* / physiopathology
  • Diet, High-Fat*
  • Dietary Carbohydrates* / administration & dosage
  • Dietary Fats*
  • Electrocardiography
  • Exercise* / physiology
  • Female
  • Heart Rate / drug effects
  • Heart Rate / physiology
  • Heart* / physiopathology
  • Humans
  • Male
  • Meals
  • Middle Aged

Substances

  • Dietary Carbohydrates
  • Dietary Fats