HealthProtocols
← All sources

After Dinner Rest a While, After Supper Walk a Mile? A Systematic Review with Meta-analysis on the Acute Postprandial Glycemic Response to Exercise Before and After Meal Ingestion in Healthy Subjects and Patients with Impaired Glucose Tolerance.

PROSPERO-registered meta-analysis of eight crossover RCTs (n=116): post-meal exercise showed lower postprandial glucose excursions than pre-meal exercise (pooled SMD 0.47) and than no-exercise control (SMD 0.55); shorter delay between meal and walking predicted larger benefit.

Design

  • Systematic review + meta-analysis; PROSPERO CRD42022324070; databases searched to 1 May 2022
  • Included: 8 crossover RCTs, 30 intervention contrasts, n = 116 (47 with type 2 diabetes, 69 without)
  • Comparison: pre-meal exercise vs post-meal exercise vs inactive control (acute postprandial glucose)

Pooled standardized effects (Hedges' g; abstract)

  • Post-meal vs pre-meal exercise: SMD 0.47 (95% CI 0.23–0.70; k = 15 effect sizes)
  • Post-meal exercise vs inactive control: SMD 0.55 (95% CI 0.34–0.75; k = 15)
  • Pre-meal exercise vs control: SMD −0.13 (95% CI −0.42–0.17) — not statistically significant
  • Meta-regression: shorter interval between meal and exercise associated with larger glucose benefit (estimate −0.0151, SE 0.00473, Z = −3.19, P = 0.001)

Evidence hygiene

All trials rated high risk of bias with crossover tool—acute physiology anchor, not a substitute for HbA1c outcome trials.

Publication

Engeroff T, Groneberg D, Wilke J. Sports Med. 2023 Apr;53(4):769-789. PMID 36715875.

Outcomes

  • Effect Size (Cohen's d / SMD)
    0.55
    d (Cohen's d)
  • Post-meal exercise superior to pre-meal exercise for acute postprandial glucose (SMD 0.47, 95% CI 0.23–0.70); meta-regression supports sooner-after-meal activity (abstract).
View original paper →