Effects of a high-sugar mixed-meal on cerebral hemodynamics in young versus middle-aged adults
Authors: Reed Krista S , Frescoln Abby M , Crew Molly R , Valentine Rudy J , Lefferts Wesley K 
Published: May 2024

High-sugar mixed-meal consumption increases both glucose and insulin and elicits mixed vascular effects, with impairments in peripheral microvascular but improved conduit artery function. It is underexplored 1) if a high-sugar mixed-meal elicits vascular segment-specific effects within cerebrovasculature and 2) whether these responses are altered in middle-aged adults with cardiovascular disease (CVD) risk factors. This study sought to test the hypotheses that a high-sugar mixed-meal would elicit differential effects within the middle cerebral artery (MCA) versus downstream hemodynamics, and that changes in cerebral hemodynamics would be blunted among at-risk middle-aged adults compared to young adults. 21 young, healthy adults (24±6 years; 23.7±3.0 kg/m2) and 20 middle-aged adults (55±5 years; 28.2±5.2 kg/m2) with CVD risk factors (hypertension, obesity, or dyslipidemia) consumed a high-sugar mixed-meal consisting of 930 kcals (35.5 g fat, 129 g carbohydrates, 100.5 g sugar, 14 g protein). Vascular measures were taken prior to meal consumption and 30- and 60-min post-meal. MCA pulsatility index (PI), resistance index (RI), mean velocity, and conductance were assessed via transcranial Doppler. Mean arterial pressure (MAP) and common carotid artery diameter were assessed via automated oscillometric cuff and ultrasound, respectively. MCA PI and RI were taken as proxy measures of downstream vascular tone, while MCA mean velocity and conductance, and carotid artery diameter were taken as measures of larger artery cerebrovascular hemodynamics. MCA PI and RI were unchanged in middle-aged adults but increased at 30- (PI+Δ0.13±0.13 au; RI+Δ0.05±0.05 au) and 60-min (PI+Δ0.10 ±0.11 au; RI+Δ0.04±0.05 au) compared to baseline in young adults (p<0.05). MCA conductance increased at 30-min (+Δ0.04±0.08 cm/s per mmHg, p<0.05), carotid diameter increased at 60-min (+Δ0.13±0.20 mm, p<0.05), and MAP tended (p=0.07-0.09) to decrease at 30- (-Δ2.01±5.7 mmHg) and 60-min (-Δ2.26±6.54 mmHg) compared to baseline in both groups. MCA mean velocity was not significantly different across timepoints in both groups. These data suggest a high-sugar mixed-meal may transiently dilate larger cerebral arteries in both young and middle-aged adults but elicit vasoconstriction downstream of the MCA in young adults only. As such, our data suggest that 1) cerebrovascular response to a high-sugar mixed-meal may be vascular segment-specific, and 2) age and risk-factor burden may alter the sensitivity of vasculature downstream of the MCA to a high-sugar mixed-meal. Further research is needed to dissect mechanisms underlying the complex cerebrovascular response to a high-sugar mixed-meal in young versus middle-aged adults with CVD risk factors. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.