Exercise’s effects on cognitive function varies based on glucose tolerance

(Photo credit: Adobe Stock)

Obesity is linked to several health complications. Alarmingly, it also correlates with cognitive decline and dementia. A recent study published in the journal Physiology & Behavior explored how high-intensity aerobic exercise impacts cognitive function among adults, highlighting that outcomes vary significantly depending on individuals’ glucose tolerance.

Obesity has been a growing concern worldwide, with its prevalence tripling since the 1970s. This increase in obesity rates has been accompanied by a heightened risk of various diseases, including cardiovascular conditions, diabetes, and certain forms of cancer.

Research over the past few decades has also established a concerning link between obesity and cognitive decline. Studies have shown that individuals who are obese, particularly during middle age, are at a significantly higher risk of developing cognitive impairments and dementia later in life compared to their non-obese counterparts.

A central focus of previous research has been on understanding the mechanisms through which obesity contributes to cognitive decline. Two major factors identified are impaired glucose tolerance and insulin resistance. These conditions are not only pivotal in the development of type 2 diabetes but have also been implicated in cognitive deficiencies.

Impaired glucose tolerance is a condition where blood sugar levels are higher than normal after eating, but not high enough to be classified as diabetes. It indicates a reduced efficiency in processing glucose, often serving as a precursor to type 2 diabetes.

Insulin resistance, on the other hand, occurs when cells in the body do not respond effectively to insulin, a hormone that regulates blood sugar. As a result, the body needs higher amounts of insulin to help glucose enter cells. Both conditions are involved in metabolic syndrome and can increase the risk of developing several chronic diseases.

Acute bouts of exercise have been shown to improve cognitive function in lean individuals. However, there was a notable gap in understanding how obesity and associated metabolic conditions like impaired glucose tolerance and insulin resistance influence cognitive responses to exercise.

Gregory N. Ruegsegger and his colleagues at the University of Wisconsin-River Falls conducted their study to address this gap. Their research aimed to specifically investigate how acute high-intensity aerobic exercise impacts cognitive function in obese adults with differing glucose tolerance levels.

The study involved a total of 49 adult participants who were divided into three groups based on their body mass index (BMI) and glucose tolerance status. These groups included lean individuals with normal glucose tolerance, obese individuals with normal glucose tolerance, and obese individuals with impaired glucose tolerance.

Before engaging in any exercise, participants underwent a comprehensive screening that included body composition analysis, BMI calculation, and metabolic health assessments through blood tests. These tests measured fasting blood glucose, insulin levels, and lipid profiles, among other markers. To assess glucose tolerance specifically, participants completed a 2-hour oral glucose tolerance test (OGTT). Cognitive function was initially assessed using a battery of tests designed to evaluate attention, executive function, and memory.

The core of the study was the exercise session, which consisted of high-intensity aerobic activity performed on an electronically braked cycle ergometer. This session included a 10-minute warm-up, followed by four 4-minute high-intensity intervals separated by 3-minute rest periods, and a 5-minute cooldown. The intensity of the exercise was set to 75% of each participant’s maximal watt output as determined by a preliminary VO2peak test, which measures the maximum amount of oxygen a person can utilize during intense exercise.

Following the exercise, cognitive tests were repeated to measure any changes due to the exercise session. Additionally, blood samples were taken before, immediately after, and one hour post-exercise to assess acute metabolic responses and inflammation markers such as interleukin-6 (IL-6) and C-reactive protein (CRP).

The researchers discovered that acute high-intensity aerobic exercise improved cognitive function in both lean individuals and obese individuals with normal glucose tolerance. In contrast, the cognitive function of obese individuals with impaired glucose tolerance did not show any improvement following the exercise session. This group also exhibited an increase in proinflammatory markers, which did not subside as quickly as it did in the other groups. This persistent inflammatory response is noteworthy as it suggests a link between inflammation, glucose intolerance, and non-responsiveness to the cognitive benefits of acute exercise.

These findings indicate that while acute exercise is beneficial for cognitive function in individuals without glucose metabolism issues, the presence of metabolic dysfunctions like impaired glucose tolerance can negate these benefits. This could be due to the exacerbated inflammatory response which is known to adversely affect cognitive processes.

However, it is important to note that the study focused on the immediate effects of a single session of high-intensity aerobic exercise. Previous research has consistently demonstrated the long-term beneficial impacts of routine exercise on cognitive function and metabolic health.

“Our data indicate that improvements in cognitive function following acute, high-intensity aerobic exercise associate with glucose tolerance status independent of body weight or body composition, suggesting that insulin sensitivity may be predictive of changes in cognitive function following acute exercise,” the researchers concluded. “Further studies are warranted to clarify the influence of insulin sensitivity of cognitive responses to acute exercise.”

The study, “Glucose tolerance status associates with improvements in cognitive function following high-intensity exercise in adults with obesity,” was authored by Gregory N. Ruegsegger, Emily R. Ekholm, Chandler E. Monroe, Chapin I. Rappaport, Rocco D. Huppert, Caleb R. Anton, and Mia J. Ferguson.