INSÄNT AV Red DiabetologNytt - Senaste Nytt DEN 03 :e FEBRUARI, 1997 vid 23 - tiden
High Carbohydrate Intake Before Exercise Triggers Earlier Ischemia
Onset of ischemia and limiting angina during
exercise testing occurs earlier after a high-carbohydrate meal but not after a high fat
meal. British investigators report the novel and important finding in this month's
issue of the Journal of the American College of Cardiology.
Dr. Ian A. Macdonald of the Queen's Medical Centre in Nottingham and
colleagues made the observation in their analysis of the effects of meal composition
on time-to-onset of more than 1-mm ST-segment depression and angina pectoris
during exercise. The patients studied had coronary artery disease with normal left
ventricular systolic function. We showed that a solid, high-carbohydrate meal
results in an earlier onset of myocardial ischemia and leads to a reduction in
exercise tolerance in patients not complaining of postprandial worsening of
Although both high-fat and high-carbohydrate meals led to declines in BP during
exercise, a high-fat meal had no effect on exercise tolerance or ischemia. Dr.
Macdonald says that this finding is ...both intriguing and difficult to explain. He
suggests that ...the meals had different effects on myocardial oxygen supply by
affecting coronary vascular tone.
Although the mechanisms are still to be resolved, the British researchers point
out that "the results of this study should enable us to clarify the timing of activities
after eating in patients with angina.
J Am Coll Cardiol 1997;29:302-307.
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