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Topical Area: Sports Nutrition and Physical Activity

Sports Nutrition and Physical Activity (Poster Session)

(P32-010-23) BG Management in PWD2 Thru-Hiking the Appalachian Trail

Monday, July 24, 2023
12:45 PM - 1:45 PM ET
Location: Poster Board 393
Disclosure(s):
Ann W. Johnson, PhD, MBA, RD, SNS: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: A case study of the effect of food and hiking the Appalachian Trail on blood glucose (BG) in individual with T2DM.

Outcome measures included (pre and post hike):
  • Anthropometrics: Weight, BMI, % lean body mass
  • HbA1c
  • Lipid panel: total cholesterol, LDL, HDL, triglycerides

    Data collected during the hike:
  • BG: Daily Avg, Min, and Max BG; % Time in range
  • Daily food consumption including: g CHO; % kcal of CHO, total kcal

    Methods: Pre- and post-hike anthropometrics were measured using a Tanita body composition analyzer (TBF-215GS). Pre- and post-hike HbA1c and lipid panel labs were drawn at Joslin clinic, Boston, MA.

    BG during the hike was tracked with Dexcom G6 CGM including daily average, max, and min BG.

    Food: A menu plan was developed for the thru-hike including meals that were CHO controlled, high in calories. Breakfasts contained < 30g CHO and ~400 kcal. Dinners contained < 60g CHO and 500-750 kcal. Lunches contained < 45g of CHO and ~500 kcal. Meals consumed in towns differed from the above. Food was logged using MyFitnessPal which calculated daily g CHO; % kcal from CHO; and total kcal.

    Physical Activity: Thru-hike the 2193 miles of AT.

    Results: BMI decreased from 27.6 to 22.0. Weight decreased from 175.8 to 141.5 lb. Fat% dropped from 39.3 to 24.1%. Fat Free Mass increased from 106.7 to 107.4 lb. HbA1c dropped from 7.1 to 6.4% with 25% drop in oral hypoglycemic agent (OHA) dose. Total cholesterol increased from 165 to 191. HDL increased from 59 to 99 mg/dL. LDL dropped from 89 to 75 mg/dL. TG were 84 and 83 mg/dL at the beginning and end of the hike.

    BG time in target was >92%. Avg and max BG on a daily basis had high variability as food intake varied significantly between food consumed on trail vs in town. Changes from first to last 5 weeks on trial included: CHO < 30% kcals to < 38%; 142g CHO to 280g; and 2125 kcal to 2980.

    Conclusions: Managing BG with diet and OHA at this level of physical activity is challenging. It is not possible to carry enough food when hiking to meet daily calorie needs. Arriving in a trail town, eating at restaurants and grocery stores significantly increased calorie and CHO consumption. Analyzing BG readings showed exercise increased CHO sensitivity as evidenced by BG response to breakfast and lunch immediately followed by hiking.

    Funding Sources: FSU CELTSS $1500
    FSU, Dept of NHS $2275