Sex-specific differences in insulin response and substrate oxidation after repeated, brief whole-body immersion in 45 °C water: A prospective, interventional study

Abstract

Prolonged heat exposure is suggested to improve glucose metabolism and fat oxidation, but no studies have addressed whether brief heat stimuli represent a viable, time-efficient, alternative approach. Consequently, we examined the ability of brief stimuli evoked by 45 °C water to improve glucose tolerance, insulin sensitivity, and fat oxidation in young, non-obese, males and females. Twenty-four participants completed fourteen 5-min sessions involving whole body passive heating in 45 °C water. Changes in resting catecholamines, cytokines, substrate oxidation, resting energy expenditure, glucose tolerance, and insulin release in response to an oral glucose tolerance test, were assessed before and 24-h after intervention, and 1 month after the end of the intervention. The results showed that repeated short-duration heat intervention had no significant effects on epinephrine, norepinephrine, interleukin-6, and tumor necrosis factor alpha production in both sexes. Glucose area under the curve (AUC) was not affected. However, females had a lower insulin AUC and improved insulin sensitivity as indicated by a decrease in homeostatic model assessment for insulin resistance, and an increase in the quantitative insulin sensitivity check index and the Matsuda insulin sensitivity index values one month after the end of the heat intervention. No effect was observed in resting energy expenditure, but carbohydrate oxidation per kilogram increased in females, and this substrate oxidation change was maintained after one month. In conclusion, fourteen sessions of brief 5-min whole-body immersion in 45 °C water produced an improvement in insulin sensitivity and increased reliance on carbohydrate oxidation in females.