Continuous exercises versus intermittent exercises on postprandial glucose, insulin and triglycerides in obese children

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BACKGROUND

Childhood weight problems has emerged as a important worldwide fitness difficulty, affecting millions of youngsters and teenagers worldwide. This condition is related to a number of metabolic issues, inclusive of type 2 diabetes, high blood pressure, dyslipidemia, and insulin resistance, which together increase the threat of growing cardiovascular sicknesses and different severe health complications in adulthood [1, 2]. The occurrence of weight problems amongst kids has risen dramatically in recent many years, with estimates suggesting that approximately 2 hundred million school-aged children are each obese or overweight. This alarming style underscores the pressing need for effective intervention strategies to mitigate the related fitness risks and enhance the lengthy-term outcomes for affected individuals [3].

Among the severa metabolic markers stimulated via weight troubles, postprandial glucose, insulin, and triglyceride levels are specifically crucial. Elevated postprandial glucose and insulin levels are key symptoms of insulin resistance, a state of affairs in which the body’s cells become much less attentive to insulin, most important to impaired glucose uptake and prolonged blood sugar ranges [4].

Similarly, increased postprandial triglyceride levels are associated with an improved chance of atherosclerosis and cardiovascular diseases, similarly complicating the health profile of overweight individuals. Therefore, dealing with those postprandial metabolic markers is crucial for reducing the chance of long-time period headaches in overweight kids [5].

Physical pastime, mainly based exercising programs, plays a important function in coping with obesity and its related metabolic disorders. Regular workout has been shown to improve insulin sensitivity, beautify glucose uptake, and decrease postprandial lipid stages, making it an crucial thing of weight problems control [6]. Among the one-of-a-kind forms of exercise, non-stop and intermittent sporting events have won good sized interest due to their potential blessings in enhancing metabolic health [7, 8]. Continuous exercise, which involves sustained, steady-state physical activity such as walking, jogging, or cycling, is known to increase aerobic capacity, improve cardiovascular fitness, and enhance insulin sensitivity [9]. On the alternative hand, intermittent workout, which alternates between durations of excessive-intensity pastime and rest or low-depth hobby, is in particular effective in unexpectedly reducing postprandial glucose tiers and enhancing metabolic flexibility [10].

Several research have proven the effect of continuous and intermittent sporting activities on metabolic markers in adults and adolescents, with considerable enhancements observed in insulin sensitivity, glucose manipulate, and lipid profiles [11, 12]. These studies have hooked up that each exercise modalities are powerful in coping with postprandial metabolic markers; however, there’s constrained research targeted specially on the pediatric population, especially on how those exercise modalities have an effect on postprandial metabolic markers in obese children [13].

Given the rapid rise in childhood obesity and its associated adverse health outcomes, it is important to define how various exercise modes impact postprandial metabolic markers in obese children as a determinant for creating targeted interventions. The study aimed to examine and compare the effect of these two exercise modalities on changes in the above-mentioned metabolic markers, while also determining which intervention would be more beneficial for managing obesity-related disturbances.

Aim

This study aimed to evaluate the effect of continuous versus intermittent exercises on postprandial glucose, insulin, and triglyceride levels in obese children.

METHODS

Study Design

This study was a randomized controlled trial (RCT) designed to compare the effects of continuous versus intermittent exercise training on postprandial glucose, insulin, and triglyceride levels in obese children. The study followed a parallel-group experimental design with two intervention arms over a 12-week intervention duration.

Research Question

Does continuous exercise differ from intermittent exercise in improving postprandial glucose, insulin, and triglyceride levels in obese children?

Hypotheses

H1: Both continuous and intermittent exercise training will significantly improve postprandial glucose, insulin, and triglyceride levels after 12 weeks.

H2: There will be a statistically significant difference between the two exercise modalities in the magnitude of improvement.

H0: No significant difference will exist between continuous and intermittent exercise groups.

Independent and Dependent Variables:

• Independent variable: Type of exercise intervention (continuous vs. intermittent).
• Dependent variables:
  
  • Postprandial blood glucose levels
  • Insulin sensitivity
  • Triglyceride levels

Enrollment, Sampling, and Randomization

Fifty obese children meeting predefined eligibility criteria were recruited from Abu Kir General Hospital. Enrollment followed a consecutive sampling approach, with children assessed for eligibility and included based on inclusion/exclusion criteria.

Participants were randomly allocated (1:1 ratio) into two groups using a computer-generated randomization sequence created by an independent researcher. Allocation concealment was implemented via sealed, opaque, sequentially numbered envelopes, opened only after baseline assessments to prevent selection bias.

Interventions (Medical Exercise Intervention)

• Continuous Exercise Group:
  
  • 30 min treadmill walking (5 km/h) + 30 min cycling at moderate intensity
  • 3 sessions / week for 12 weeks

• Intermittent Exercise Group:
  
  • Alternating bouts of 10 min treadmill walking + 10 min rest
  • Followed by 10 min cycling + 10 min rest
  • Repeated over a 2-hour structured session
  • 3 sessions / week for 12 weeks

Both interventions were supervised by qualified physical therapists.

Data Collection Methods

Measurements were performed at baseline and after the 12-week intervention.

• Postprandial Blood Glucose (PPG):

Measured after 12-hour fasting followed by a carbohydrate-rich meal (≥75 g). Glucose measured at standard postprandial intervals using a validated glucometer.

• Insulin Sensitivity:

Assessed using the Insulin Tolerance Test (ITT), with serial blood glucose sampling after intravenous insulin administration.

• Triglyceride Levels:

Measured using a standard biochemical enzymatic assay after fasting for 12 hours.

Demographic and clinical data were collected via structured forms and hospital records.

Statistical Analysis

Sample size calculation was conducted using the G*Power software, with a type I error (α) of 0.05, a power (1-α error probability) of 0.80, and an effect size of 0.9. The required sample size was determined to be 21 participants per group, accounting for potential dropouts. Data were analyzed using SPSS (Statistical Package for the Social Sciences) version 25.0. Descriptive statistics were performed for all parameters. Comparisons between groups were conducted using an Independent t-test for quantitative data with parametric distribution and a Chi-square test for qualitative data. Repeated Measures ANOVA was used to compare results across different time points. Statistical significance was set at p < 0.05.

RESULTS

Demographic Data

The demographic characteristics of the study participants are summarized in Table 1. The study included 50 obese children, with 25 participants in the continuous exercise group and 25 in the intermittent exercise group. The mean age was 13.64 ± 1.11 years in the continuous exercise group and 13.4 ± 1.19 years in the intermittent exercise group. No significant differences were observed between the two groups in terms of age, gender, height, weight, BMI, or BMI percentile (p >0.05).

 

Table 1. Demographic Data of the Studied Groups

Таблица 1. Демографические характеристики исследуемых групп

Characteristic	Continuous Exercise Group (n=25)	Intermittent Exercise Group (n=25)	p-value
Age (years)	13.64 ± 1.11	13.4 ± 1.19	0.465
Gender (Male)	12 (48%)	12 (48%)	1.000
Height (cm)	157.04 ± 4.07	157.56 ± 4.02	0.651
Weight (kg)	77.96 ± 5.03	79.12 ± 4.86	0.411
BMI (kg/m²)	31.58 ± 0.6	31.82 ± 0.44	0.102
BMI Percentile	97.6 ± 0.71	97.96 ± 0.79	0.096

 

Insulin Sensitivity

Insulin sensitivity levels significantly increased post-intervention compared to pre-intervention in both the continuous exercise group (p < 0.001) and the intermittent exercise group (p < 0.001). However, there were no significant differences between the two groups post-intervention (p >0.05), as shown in Table 2 and Fig. 1.

 

Table 2. Insulin Sensitivity Levels (mmol/L⁻¹ · min⁻¹) of the Studied Groups

Таблица 2. Показатели чувствительности к инсулину (ммоль/л⁻¹ · мин⁻¹) в исследуемых группах

Group	Pre-Intervention (Mean ± SD)	Post-Intervention (Mean ± SD)	p-value†	p-value‡
Continuous Exercise	0.015 ± 0.001	0.019 ± 0.002	< 0.001*	0.081
Intermittent Exercise	0.014 ± 0.001	0.019 ± 0.002	< 0.001*	0.081

Note. ^† p-value within the same group (pre- vs post-intervention), ^‡ p-value between groups (post-intervention), * significant as p-value ≤0.05.

 

Fig. 1. Insulin Sensitivity Levels in Continuous vs. Intermittent Exercise Groups.

Рис. 1. Показатели чувствительности к инсулину в группах непрерывных и интервальных физических упражнений.

 

Triglyceride Levels

Triglyceride levels decreased significantly post-intervention in both groups (p < 0.001), with no significant difference observed between the continuous and intermittent exercise groups (p=0.920). Table 3 and Fig. 2 display the triglyceride levels before and after the intervention.

 

Table 3. Triglyceride Levels (mg/dL) of the Studied Groups

Таблица 3. Уровни триглицеридов (мг/дл) в исследуемых группах

Group	Pre-Intervention (Mean ± SD)	Post-Intervention (Mean ± SD)	p-value†	p-value‡
Continuous Exercise	96.48 ± 7.81	85.8 ± 6.72	< 0.001*	0.920
Intermittent Exercise	97.32 ± 8.63	86 ± 7.22	< 0.001*	0.920

Note. ^† p-value within the same group (pre- vs post-intervention), ^‡ p-value between groups (post-intervention), * significant as p-value ≤0.05.

 

Fig. 2. Triglyceride Levels in Continuous vs. Intermittent Exercise Groups.

Рис. 2. Уровни триглицеридов в группах непрерывных и интервальных физических упражнений.

 

Postprandial Blood Glucose

Postprandial Blood Glucose (PPG) levels were significantly reduced at day 36 post-intervention compared to pre-intervention (day 1) in both groups (p < 0.001). There was no significant difference in PPG reduction between the continuous and intermittent exercise groups (p=0.123). The PPG levels across the study period are presented in Table 4 and Fig. 3.

 

Table 4. Postprandial Blood Glucose Levels (mg/dL) of the Studied Groups

Таблица 4. Уровни постпрандиальной глюкозы крови (мг/дл) в исследуемых группах

Group	Day 1 (Mean ± SD)	Day 36 (Mean ± SD)	p-value†	p-value‡
Continuous Exercise	152.24 ± 10.5	139.88 ± 8.97	< 0.001*	0.123
Intermittent Exercise	155.08 ± 6.66	143.32 ± 6.3	< 0.001*	0.123

Note. ^† p-value within the same group (pre- vs post-intervention), ^‡ p-value between groups (post-intervention), * significant as p-value ≤0.05.

 

Fig. 3. Postprandial Blood Glucose (PPG) Levels in Continuous vs. Intermittent Exercise Groups.

Рис. 3. Уровни постпрандиальной глюкозы крови (ППГ) в группах непрерывных и интервальных физических упражнений.

 

DISCUSSION

Our study’s findings align with several earlier studies that consistently demonstrate the effectiveness of both continuous and intermittent exercises in improving postprandial metabolic markers. Wheeler et al. [10] conducted a randomized crossover trial to evaluate the acute effects of interrupting prolonged sitting with intermittent (4 min) bouts of exercise or continuous energy intake in adults with obesity on postprandial glucose, insulin, and triglyceride levels. Both exercise modalities significantly reduced postprandial insulin and triglyceride levels compared to uninterrupted sitting, with intermittent exercise providing additional benefits. This aligns with our results, suggesting that both continuous and intermittent exercises enhance metabolic health, with intermittent exercise offering a slight advantage.

Zhang et al. [14] aimed to determine the impact of individualized accumulated versus continuous post-meal physical activity on day-long blood glucose regulation in young adults with obesity. The findings showed that both exercise types significantly decreased postprandial glucose, insulin, and C-peptide concentrations, with accumulated exercise maintaining lower glucose levels for a longer duration compared to continuous exercise. This is consistent with our findings, indicating that both activities effectively manage postprandial glucose and insulin levels.

Ferreira et al. [15] also showed reductions in postprandial triglycerides and very low-density lipoprotein levels following intense intermittent exercise, similar to those observed with moderate continuous exercise, indicating that different types and intensities of physical activity can be beneficial for managing dyslipidemia.

Contrary to these consistent findings, Holmstrup et al. [16] reported that intermittent exercise bouts were more effective at attenuating glucose excursions and insulin concentrations over 12 hours than a single continuous exercise session in obese individuals with impaired glucose tolerance. These results highlight intermittent exercise as a viable option for optimizing metabolic control in specific at-risk populations.

Similarly, Dehghani Yunarti and Minasian [17] demonstrated that a short bout of exercise significantly reduced postprandial glucose levels, but found no significant differences between pre-prandial and postprandial exercise, suggesting that the timing of exercise relative to meals plays an important role in glycemic management.

Limitations

The limitations of this study include its relatively small sample size and small pattern length and the short duration of the intervention. Future research have to aim to consist of larger, greater various populations and make bigger the follow-up length to assess the long-term outcomes of continuous and intermittent physical activities on metabolic fitness.

CONCLUSION

This have a look at gives robust proof that each continuous and intermittent exercising regimens notably enhance postprandial glucose, insulin, and triglyceride stages in obese children. These findings guide the mixing of structured workout programs, whether non-stop or intermittent, into weight problems management techniques to enhance metabolic health and reduce the risk of lengthy-time period complications. Tailoring those exercising interventions to person wishes and conditions may additionally similarly optimize results and contribute to better standard fitness in this prone population.

ADDITIONAL INFORMATION

Author contribution: Mohammed Abd El Salam Abo Kela and Hebatallah Mohamed Kamal: conceived and supervised the study; Asmaa Osama Sayed and Atef Abd El Khalek Shahein: were responsible for data collection; Mohammed Abd El Salam Abo Kela and Asmaa Osama Sayed: analysed and interpreted the data. All authors provided comments on the manuscript at various stages of development. All authors read and approved the final manuscript.

Ethical approval: Ethical approval was obtained from Cairo University IRB. Written informed consent was obtained from all participants and their parents prior to participation.

Consent to publication: All authors confirm their full consent to the publication of this manuscript. No individual personal data (images, videos, or identifiable information) are included in this article; therefore, consent for publication from participants is not required.

Funding source: No funding.

Disclosure of interests: The authors declare the absence of relationships, activities and interests (personal, professional or financial) related to third parties (commercial, non-profit, private), whose interests may be affected by the content of the article, as well as other relationships, activities and interests over the past three years, which must be reported.

Statement of originality: The authors did not use previously published information (text, data) to create this paper.

Data availability statement: The editorial policy regarding data sharing does not apply to this work, and no new data was collected or created.

Generative AI: Generative AI technologies were not used for this article creation.

Provenance and peer-review: This paper was submitted to the journal on an initiative basis and reviewed according to the usual procedure. Two external reviewers, a member of the editorial board and the scientific editor of the publication participated in the review.

ДОПОЛНИТЕЛЬНАЯ ИНФОРМАЦИЯ

Вклад авторов. Мохаммед Абд Эль Салам Або Кела и Хебаталлах Мохамед Камал — разработка концепции исследования и осуществление научного руководства; Асмаа Осама Саид и Атеф Абд Эль Халек Шахейн — сбор данных; Мохаммед Абд Эль Салам Або Кела и Асмаа Осама Саид — анализ и интерпретация данных. Все авторы предоставляли комментарии к рукописи на различных этапах её подготовки. Все авторы одобрили рукопись (версию для публикации).

Этическая экспертиза. Исследование было одобрено Комитетом по этике Каирского университета. Авторы получили письменное информированное добровольное согласие от всех участников и их законных представителей до начала исследования.

Согласие на публикацию. Все авторы подтверждают согласие на публикацию данной рукописи. В статье не содержатся индивидуальные персональные данные (изображения, видеоматериалы или иная идентифицирующая информация). В связи с этим получение согласия участников на публикацию не требуется.

Источники финансирования. Отсутствуют.

Раскрытие интересов. Авторы заявляют об отсутствии отношений, деятельности и интересов за последние три года, связанных с третьими лицами (коммерческими и некоммерческими организациями), интересы которых могут быть затронуты содержанием статьи.

Оригинальность. При проведении исследования и создании настоящей статьи авторы не использовали ранее полученные и опубликованные сведения (данные, текст).

Доступ к данным. Редакционная политика в отношении совместного использования данных к настоящей работе не применима, новые данные не собирали и не создавали.

Генеративный искусственный интеллект. При создании настоящей статьи технологии генеративного искусственного интеллекта не использовали.

Рассмотрение и рецензирование. Настоящая работа подана в журнал в инициативном порядке и рассмотрена по обычной процедуре. В рецензировании участвовали два внешних рецензента, член редакционной коллегии и научный редактор издания.

About the authors

Mohammed Abd El Salam Abo Kela

Cairo University

Author for correspondence.
Email: Abokela.Mohamed1488@gmail.com
ORCID iD: 0009-0005-1369-9206

MD, M.Sc.; Ph.D. Candidate, Faculty of Physical Therapy for Pediatrics

Egypt, Cairo

Hebatallah M. Kamal

Cairo University

Email: Ouda_heba@yahoo.com
ORCID iD: 0000-0002-8042-262X

MD, Professor, Faculty of Physical Therapy for Pediatrics

Egypt, Cairo

Asmaa O. Sayed

Cairo University

Email: asmaaosamapt@gmail.com
ORCID iD: 0000-0003-1567-2101

MD, Assistant Professor, Faculty of Physical Therapy for Pediatrics

Egypt, Cairo

Atef Abd El Khalek Shahein

Hospitals Ministry of Health

Email: Atifshahin56@gmail.com

MD, Consultant of Internal Medicine

Egypt, Alexandria

References

Supplementary files