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Blood Sugar Balancing Act: How Exercise Tips the Scales

Difficulty
Time Required Long (2-4 weeks)
Prerequisites Informed consent must be obtained from participants in this experiment (parental consent must be granted for minors). The experimental design (including consent forms) must be approved by your fair's Scientific Review Committee (SRC).
Material Availability A blood glucose monitoring system is required to do this science project. See the Materials and Equipment list for details.
Cost Average ($40 - $80)
Safety Follow all safety precautions when using the blood glucose monitoring kit and when handling blood, as described in the Procedure. If somebody who has diabetes wants to participate in this science project, review the safety notes at the beginning of the Procedure before starting.

Abstract

You are probably very familiar with the fact that over time, exercise changes your muscles, your lungs, your bones, and even your mindset; but did you know it has an immediate effect on your body's biochemistry? You can see this in the amount of glucose (a type of sugar your body uses for fuel) circulating in your blood. Blood glucose levels change as you exercise. For most people, this is not a big deal. But for top-level athletes in the middle of intense exercise (like a marathon), or for diabetics who need to tightly control their blood sugar levels, the stakes are higher. This is because too much glucose or too little glucose is harmful for our bodies and in the case of diabetics, it can even be lethal. So what does happen to blood sugar levels during exercise? Does the amount of circulating glucose rise or fall? In this science project, you will answer this fundamental question and investigate how blood sugar levels can be stabilized, even during exercise.

Objective

Investigate how blood glucose (sugar) levels change with exercise, and how to stabilize those levels during and after exercise.

Credits

Teisha Rowland, PhD, Science Buddies

Cite This Page

MLA Style

Science Buddies Staff. "Blood Sugar Balancing Act: How Exercise Tips the Scales" Science Buddies. Science Buddies, 21 Aug. 2014. Web. 21 Sep. 2014 <http://www.sciencebuddies.org/science-fair-projects/project_ideas/HumBio_p039.shtml>

APA Style

Science Buddies Staff. (2014, August 21). Blood Sugar Balancing Act: How Exercise Tips the Scales. Retrieved September 21, 2014 from http://www.sciencebuddies.org/science-fair-projects/project_ideas/HumBio_p039.shtml

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Last edit date: 2014-08-21

Introduction

Everyone needs exercise. Granted, an 18-year-old teenager and an 87-year-old grandparent are not going to benefit from the same intensity or necessarily the same types of exercise, but generally speaking, some form of exercise is healthy no matter who you are. Lots of complex biology happens when you are exercising, including changes to your biochemistry. Many of those changes are hard to track at home, but there is at least one that is fairly easy to track yourself: blood sugar levels, also called blood glucose levels. As the term "blood sugar" suggests, glucose is a simple sugar. It is also the primary fuel, or energy source, used by cells, such as brain cells, muscle cells, and cells in other tissues of the body. The work your body does during exercise changes the amount of glucose circulating in your blood. Why does this matter? Well, your body is like the fairytale character Goldilocks; it likes things to be "just right." This means there is an ideal blood glucose range. Too much glucose (hyperglycemia) or too little glucose (hypoglycemia) damages the body and can lead to a range of side effects, including a coma. You can read more about the symptoms and effects of hyperglycemia and hypoglycemia in the resources in the Bibliography, below.

Fortunately, for most of us, hypoglycemia and hyperglycemia are unlikely to occur because our bodies carefully regulate our blood glucose levels. The level of glucose in your blood is regulated by insulin, a hormone made by the pancreas. When blood glucose levels rise after eating a meal, the pancreas releases insulin, which causes cells in the body (such as liver, muscle, and fat cells) to take up glucose, removing it from the blood and storing it to use for energy. When the blood glucose levels start falling, the pancreas stops releasing insulin, and the stored glucose is used for energy. Watch this video to see how blood glucose levels can change over time for different people.


This video shows how blood glucose levels change over time for people with and without diabetes (Khan Academy, 2011).
This video shows how blood glucose levels change over time for people with and without diabetes (Khan Academy, 2011). http://www.youtube.com/watch?v=JSFiOF7xGfE

Of course, in order to regulate glucose, our bodies need to have some to work with in the first place. We get glucose from the food we eat. Both table sugar (sucrose) and other types of carbohydrates, such as starch (found in large quantities in pasta and other grain-rich foods), are broken down by our bodies to make glucose.

Although blood glucose levels stay in a safe range for most people, they do fluctuate over the course of a day based on when, how much, and what you eat. Because food can be broken down to make glucose, your blood glucose levels usually go up after you eat. See Figure 1, below, for typical blood glucose level fluctuations for a person over the course of a day. (Blood glucose is typically measured in milligrams per deciliter [mg/dL], but it can also be measured in millimoles per liter [mmol/L].)

Graph of typical blood glucose levels over a day.
Figure 1. This graph shows how a person's blood glucose levels may change over the course of a day, and how eating a meal with lots of sugar (sucrose) can affect blood glucose levels. (Image credits: Adaptation of graph created by Jakob Suckale, Michele Solimena, Wikimedia Commons)

Exercise also either increases or decreases blood glucose levels, depending on the person and other factors (the effects of exercise will be further explained in the next paragraph). This is fine for most people, but for those with diabetes it is a different story. There are two types of diabetes: type 1 diabetes and type 2 diabetes. If there is too much glucose in the blood (hyperglycemia), it can be a sign of diabetes, which is a serious, incurable, and growing health problem. Watch the video below to see how glucose is normally taken up from the blood by cells, and how problems with this process define the two types of diabetes. Type 1 diabetes is caused by an autoimmune response, and was formerly known as juvenile diabetes. Type 1 diabetes occurs when the pancreas no longer makes insulin, and the lack of insulin can cause increased blood glucose levels. Currently, a person with type 1 diabetes must take insulin supplements to treat the condition. Type 2 diabetes is thought to be primarily caused by obesity, and makes up the vast majority of diabetes cases. Type 2 diabetes occurs when a person has insulin resistance, which means the person's body does not respond to insulin, or their pancreas does not make enough insulin. Type 2 diabetes is managed by increasing exercise, changing diet, and possibly by taking medications such as insulin. (A complication of treating diabetes is that it can actually cause hypoglycemia in certain conditions.) In both cases, the diabetic has to manually monitor his or her blood sugar levels, and may need to adjust them with insulin and/or food.


This video shows how glucose is normally taken up from the blood by cells, and how problems with this process occur in diabetes.
This video shows how glucose is normally taken up from the blood by cells, and how problems with this process occur in diabetes. http://www.youtube.com/watch?v=rPLjSY00JlE

As mentioned above, exercise can cause blood glucose levels to decrease or increase. Levels can decrease because glucose in the blood (and stored glucose) is used up during exercise. To prevent blood glucose levels from dropping too much (and causing hypoglycemia), it is sometimes recommended that people with type 1 diabetes have a snack before and while exercising. However, exercise can also cause blood glucose levels to increase if too much stored glucose gets released when a person exercises and it is not used up while exercising. If there is not enough insulin around, the glucose in the blood will not get stored again, and will remain in the blood (which can cause hyperglycemia). For people with diabetes, this can be addressed by taking an insulin shot after exercising.

In this science project, you will do two things. First, you will use a blood glucose monitoring kit to see how exercise affects your (or a volunteer's) blood glucose levels. These kits are primarily made for people with diabetes to check their blood glucose levels. You will need to read the packaging within the kit to know how to properly use it. Once you have a clear idea of the effects of exercise on blood glucose levels, you will try to diminish the changes by eating food, or by changing the intensity of the exercise or the exercise time. To come up with a hypothesis of what will work, you will need to do a bit of research about how fast different foods are converted to glucose and how much glucose they create, as well as how exercise time and intensity affects blood glucose levels. If a person's blood glucose levels clearly decrease from exercising, what steps could be taken to prevent this drop? For example, if the person ate a snack before and/or during exercising, would it make a difference? On the other hand, if a person is diabetic and his or her blood glucose levels do not decrease from exercising, does exercising for a shorter amount of time, or doing a less intense exercise, help fix this?

Terms and Concepts

  • Blood glucose levels
  • Glucose
  • Hyperglycemia
  • Hypoglycemia
  • Insulin
  • Milligrams per deciliter (mg/dL)
  • Diabetes
  • Type 1 diabetes
  • Type 2 diabetes
  • Insulin resistance
  • Baseline

Questions

  • How are type 1 diabetes and type 2 diabetes different? How are they similar?
  • What causes hypoglycemia and hyperglycemia?
  • In what situations might a person with diabetes take an insulin shot?
  • How can exercise affect a person's blood glucose levels?
  • What are typical blood glucose levels in a person without diabetes? What about in a person with diabetes?

Bibliography

Here are some useful resources on diabetes and exercise:

These are additional useful resources on diabetes and blood glucose levels:

Materials and Equipment

  • Blood glucose monitoring system and additional test strips and lancets, which are small surgical blades used to obtain a drop of blood. Note: You will test blood glucose levels at least 24 times, and since a lancet and test strip are needed for each test, you will need at least 24 lancets and 24 test strips that work with the monitoring system. Here are some possible systems to use:
  • Volunteer (at least 1). The volunteer does not have to have diabetes to do this science project. The volunteer could be you or somebody else.
    • Note: If the volunteer has diabetes and often has blood glucose levels above 250 mg/dL, read step 4 in the first section of the Procedure to make sure the volunteer is able to participate in this science project. If he or she is unable to, you may need to find a different volunteer.
    • If the volunteer has diabetes and commonly has blood glucose levels above 250 mg/dL, it is also recommended to have urinalysis strips available that measure ketones. Strips like these are available through Amazon.com. See step 4 in the first section of the Procedure for details.
  • Optional: Simple and fun exercise equipment. You could pick one piece of equipment or rotate between multiple items. The volunteer will be exercising for 20 minutes, so make sure to pick an activity that is not too vigorous for your volunteer. Some equipment ideas include: jump rope, bicycle, hula hoop, 2 lb (or 1 kg) weight.
  • Clock
  • Lab notebook

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Experimental Procedure

Working with Biological Agents

For health and safety reasons, science fairs regulate what kinds of biological materials can be used in science fair projects. You should check with your science fair's Scientific Review Committee before starting this experiment to make sure your science fair project complies with all local rules. Many science fairs follow Intel® International Science and Engineering Fair (ISEF) regulations. For more information, visit these Science Buddies pages: Projects Involving Potentially Hazardous Biological Agents and Scientific Review Committee. You can also visit the webpage ISEF Rules & Guidelines directly.

Working with Human Test Subjects

There are special considerations when designing an experiment involving human subjects. Fairs affiliated with Intel International Science and Engineering Fair (ISEF) often require an Informed Consent Form (permission sheet) for every participant who is questioned. Consult the rules and regulations of the science fair that you are entering, prior to performing experiments or surveys. Please refer to the Science Buddies documents Projects Involving Human Subjects and Scientific Review Committee for additional important requirements. If you are working with minors, you must get advance permission from the children's parents or guardians (and teachers if you are performing the test while they are in school) to make sure that it is all right for the children to participate in the science fair project. Here are suggested guidelines for obtaining permission for working with minors:

  1. Write a clear description of your science fair project, what you are studying, and what you hope to learn. Include how the child will be tested. Include a paragraph where you get a parent's or guardian's and/or teacher's signature.
  2. Print out as many copies as you need for each child you will be surveying.
  3. Pass out the permission sheet to the children or to the teachers of the children to give to the parents. You must have permission for all the children in order to be able to use them as test subjects.
Important Safety Notes Before Starting: If somebody who has diabetes wants to participate in this science project, they should do the following:
  • Before participating, discuss the science project (and any exercise routine required) with his or her doctor.
  • Limit exercise to 1–2 sessions a day (to avoid hypoglycemia).
  • Not exercise within 2 hours of going to sleep (to avoid changes in blood glucose levels while the person is asleep).

Creating a Baseline

Before testing how exercise affects a volunteer's blood glucose levels, establish a baseline of blood glucose levels for that person. A baseline is a typical amount that can be used to compare to experimental amounts to see if they are much larger, or smaller, than normal. To create a baseline of blood glucose levels, you will measure the volunteer's blood glucose levels over three days, twice a day: right before the volunteer eats a meal (which is called the preprandial plasma glucose) and 2 hours after they started eating the meal (called the postprandial plasma glucose).

  1. Become familiar with the blood glucose monitoring system and how to use it to check a person's blood glucose levels. Be sure to read through all of the instructions that came with the system before you start using it.
  2. In your lab notebook, make a data table to record your volunteer's baseline blood glucose measurements. Include space to record the date, time, and the blood glucose levels (in milligrams per deciliter [mg/dL]) for before and after eating a meal. Remember you will be taking measurements for three days in a row.
  3. Right before the volunteer eats either breakfast or lunch, use the blood glucose monitoring system to measure his or her blood glucose levels. Record this (along with the date and time) in the data table in your lab notebook. Be sure to follow the exact instructions that came with the system, which may be similar to the following:
    1. Have the volunteer wash and dry his or her hands.
    2. Insert a test strip into the meter.
    3. Use the lancet to get a drop of blood from the volunteer's finger. Be sure to use a new, clean lancet each time a blood sample is taken.
    4. Touch the test strip down onto the drop of blood, allowing the blood to be drawn into the strip.
    5. Read the result on the blood glucose meter, as shown in Figure 2, below.
    6. Once you are done taking the measurement, properly dispose of the test strip and have the volunteer wash his or her hands.
Blood drop being read on a blood glucose meter.
Figure 2. After a drop of blood has been touched to the test strip, you can read the test strip results on the blood glucose meter. (Image credits: Tomwsulcer, Wikimedia Commons)
  1. Two hours after the volunteer started eating the meal, check his or her blood glucose levels again, as you did in step 3, above. Be sure to record the measurements in the data table in your lab notebook.
    1. If the volunteer has diabetes and has post-meal blood glucose levels above 250 mg/dL, you should also use strips for urinalysis to test for the presence of ketones. (Ketones are a substance found in the blood that the body makes when it breaks fat down for energy. If there are too many ketones in the blood, it could mean that a person does not have enough insulin to lower his or her blood glucose levels.) The ketone results may affect whether the person can later safely do the exercise activity required for participating in this science project, and whether you may need to find a new volunteer(s) because of this. Specifically, if a person's glucose levels are above 250 mg/dL, the following guidelines are recommended based on their ketone levels:
      1. If the person has ketones, they should not exercise.
      2. If the person has no ketones, has type 1 diabetes, and blood glucose levels are over 300 mg/dL, they can exercise if they are re-tested 5–10 minutes after they started exercising and their levels are dropping.
      3. If the person has no ketones, has type 1 diabetes, and blood glucose levels are over 400 mg/dL, they should not exercise.
  2. Repeat steps 3–4 for the next two days so that you have taken these measurements for three days in a row. Take the measurements for the same meal (and around the same times) each day.
    1. If possible, try to also have the volunteer keep his or her diet relatively consistent over the three-day period, before and while you take measurements. Big changes in the type of food the volunteer eats could significantly affect his or her blood glucose levels (as shown in Figure 1, in the Background tab), but you are taking measurements over three days to try and account for these fluctuations.
  3. Take a look at the baseline blood glucose levels. Here are some ranges to give you an idea of what kind of results to expect. Note that for people who do not have diabetes, these are possible upper limits, while targets are listed for people who do have diabetes:
    1. For people who do not have diabetes, pre-meal glucose levels may be less than 110 mg/dL, and post-meal glucose levels may be less than 140 mg/dL.
    2. For people who have diabetes, the American Diabetes Association suggests the following targets for most adults who are not pregnant: pre-meal glucose levels of 70–130 mg/dL, and post-meal glucose levels less than 180 mg/dL.
  4. Calculate the average pre-meal glucose levels and post-meal glucose levels for three days. Record these average baseline levels in your lab notebook.
    1. For example, if the volunteer had pre-meal glucose levels of 100 mg/dL, 95 mg/dL, and 105 mg/dL for the three days, the average pre-meal glucose levels would be 100 mg/dL (since 100 mg/dL + 95 mg/dL + 105 mg/dL = 300 mg/dL, and 300 ÷ 3 = 100 mg/dL).
    2. How did the person's blood glucose levels change from before eating a meal to after eating a meal?
  5. Repeat steps 3–7 with any other volunteers you are using in your project.

Investigating the Effects of Exercise

You will now measure the volunteer's blood glucose levels before, during, and after exercising for 20 minutes. This will be done over three days (exercising once a day).

  1. Note: A person with diabetes should limit exercise to 1 to 2 sessions a day (to avoid hypoglycemia), so if your volunteer has diabetes, find out his or her schedule for the three days you will be doing exercise testing.
  2. Choose which exercise activity (or combination of activities) you want your volunteer to do. The volunteer will exercise for 20 minutes, so make sure that the exercise planned is not too vigorous for your volunteer.
  3. Figure out when to have the volunteer do the exercise activity (either right before they eat breakfast or lunch, or 2 hours after he or she has started eating the meal). For testing, pick the same meal (and around the same times) that you used before. Base this on the average baseline glucose levels you determined in step 7 (and any ketone data from step 4) of the previous section, as well as any known medical history the person has.
    1. If the volunteer does not have diabetes, and their blood glucose levels are not abnormal, it should be safe to have them exercise at either time.
    2. If the volunteer has diabetes, it is recommended that exercise is done after eating a meal to prevent low blood glucose levels (hypoglycemia). They should generally not exercise if their blood glucose levels are less than 100 mg/dL. If their blood glucose levels are above 250 mg/dL, be sure to follow the guidelines in step 4.a. of the previous section to determine whether it is recommended that they participate in the activity or not.
    3. Note: A person with diabetes should not exercise within 2 hours of going to sleep (to avoid changes in blood glucose levels while the person is asleep), which is why testing at breakfast or lunch is recommended for this science project.
  4. In your lab notebook, make a data table to record your volunteer's blood glucose measurements. Include space to record the date, time, and whether the measurements are before or after eating a meal. Also include columns to record the blood glucose levels (in mg/dL) for before, during, and after exercising.
  5. If your volunteer has diabetes, make sure he or she has a carbohydrate snack (e.g., juice, glucose tablets, etc.) to eat while exercising, if necessary.
  6. Right before the volunteer starts the exercise activity, use the blood glucose monitoring system to measure his or her blood glucose levels, as you did in step 3 of the previous section. Be sure to follow the exact instructions that came with the system. Record the measurement in the data table in your lab notebook.
    1. Safety Note: Do not have the volunteer exercise if his or her blood glucose levels (and ketone levels, if relevant) are not within the ranges described in step 3.b., above.
  7. After the volunteer has exercised for 5–10 minutes, measure his or her blood glucose levels again, as you did in step 3 of the previous section. Record this measurement as the blood glucose level during exercising.
    1. Safety Note: If the blood glucose levels are not dropping after exercising for 5–10 minutes, it is recommended that the volunteer stop exercising to avoid having high blood glucose levels (hyperglycemia).
    2. Safety Note: If the person has diabetes and blood glucose levels have significantly dropped (i.e., there is risk of hypoglycemia), he or she should have a carbohydrate snack and can stop exercising. If this happens, be sure to make a note of this in your lab notebook.
  8. After the volunteer has finished exercising (for 20 minutes), measure his or her blood glucose levels again, as you did in step 3 of the previous section. Record this measurement as the blood glucose level after exercising.
    1. Safety Note: Checking blood glucose levels after exercising is important for a person with diabetes so he or she can prevent low blood glucose levels (hypoglycemia) hours later.
  9. Repeat steps 6–8 for the next two days so that you have taken these exercise-related measurements for three days in a row. Be sure to do it around the same time (right before or after the same meal you decided on in step 3) for each day.
    1. If possible, before the measurements are taken each day, try to also have the volunteer keep his or her diet relatively consistent over the three-day period, and consistent to when you took the original blood glucose measurements.
  10. Make a line graph of your results. On the x-axis put the time (before exercising, while exercising, and after exercising) and on the y-axis put the blood glucose levels (in mg/dL). Make a separate line for each day.
  11. Calculate the average glucose levels for before exercising, during exercising, and after exercising for the three days. Record these averages in your lab notebook.
  12. Look at your graph and the average glucose levels you calculated and try to interpret your data.
    1. Did the volunteer's blood glucose levels generally increase, decrease, or stay about the same when they exercised? Was there much variation from day to day?
    2. Can you explain why you might have gotten the results that you did? Hint: You may want to refer to the information in the Introduction in the Background to help you explain the results.
  13. Repeat steps 3–12 with any other volunteers you are using in your science project.

Managing Blood Glucose Levels

You will now investigate how the effects of exercise on blood glucose levels could be managed and lessened, keeping the blood glucose levels more stable. Based on your results from the previous section, you will pick one of the following factors to explore over three days: (1) eating food, (2) intensity of the exercise, or (3) time spent exercising.

  1. Look at your results from the previous section and figure out whether the blood glucose levels were relatively high or low at any point.
    1. For an idea of blood glucose level ranges, see step 6 in the "Creating a Baseline" section, above, and the resources in the Bibliography in the Background section.
  2. Make a plan for how to lessen the effects of exercise on the volunteer's blood glucose levels by changing only one of the following three factors: (1) eating food, (2) intensity of exercise, and (3) exercise time.
    1. Here are some ideas to keep in mind, but you should do additional background research (and refer to the Safety Notes in the previous section, as well as the information from the Introduction in the Background section) to come up with your own plan:
      1. Eating food: If a person's blood glucose levels clearly drop during exercise, then eating a carbohydrate snack may help increase his or her blood glucose levels.
      2. Intensity of the exercise and time spent exercising: If a person's blood glucose levels clearly decrease or increase during exercise, then doing a less intense exercise or exercising for less time may help.
      3. Safety note: If your volunteer has diabetes, they should talk to their doctor before doing a more intense, or longer, exercise activity.
    2. If you have more than one volunteer, make a plan for each volunteer based on their individual results.
  3. Once you have planned how the activity will be changed, repeat steps 4–9 of the "Investigating the Effects of Exercise" section, but this time use your modified activity. Be sure to still follow all of the Safety Notes.
  4. Make a line graph of your results. On the x-axis put the time (before exercising, while exercising, and after exercising) and on the y-axis put the blood glucose levels (in mg/dL). Make a separate line for each day.
  5. Calculate the average glucose levels for before exercising, during exercising, and after exercising for the three days. Record these averages in your lab notebook.
  6. If you want, you can make a line graph of the averages from the modified activity and the original activity.
    1. Again, put time on the x-axis and the blood glucose levels on the y-axis.
    2. You should end up with six lines, with three from the averages of each type of activity tested.
  7. Look at your graphs and the average blood glucose levels you calculated and try to interpret your data.
    1. Did the volunteer's blood glucose levels generally increase, decrease, or stay about the same when he or she exercised? Was there much variation from day to day? How does this compare to your results using the original exercise plan?
    2. Does it look like your plan helped make the volunteer's blood glucose levels more stable when he or she exercised?
    3. Can you explain why you might have gotten the results that you did? Hint: You may want to refer to the information in the Introduction in the Background section to help you explain the results.
  8. Repeat steps 3–7 with any other volunteers you are using in your science project.
  9. Overall, were you able to help lessen the effects of exercise on blood glucose levels by changing the volunteer's exercise routine or having them eat?
    1. Can you explain your results in terms of the biology that is going on? Hint: You may want to re-read the Introduction in the Background section to explain the results.

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Variations

  • Exercise can affect blood glucose levels, but so can other factors. Research what factors affect blood glucose levels and then investigate how exactly they affect it using a blood glucose monitoring system. If the investigation is being done on a person with diabetes, they should talk to their doctor before doing testing.
  • Eating food changes our blood glucose levels, and different types of foods may affect it differently. Do some background research into this topic to investigate how blood glucose levels change (over time) when a person eats different foods. Do some foods change the levels more dramatically, or more quickly, than others?
  • Another way to measure glucose levels in the body is using strips for urinalysis. How do the results from urinalysis strips compare to the results from a glucose monitoring system? How do these systems work differently? You can purchase these strips from a pharmacy or from online suppliers such as Amazon.com.
  • How does eating a certain, defined amount of glucose affect a person's blood glucose levels immediately and over time? To investigate this, you could use 4 gram (g) glucose tablets (available from a pharmacy or online suppliers such as Amazon.com).
  • For a science project on measuring the amount of glucose in foods, see: How Sweet It Is! Measuring Glucose in Your Food.
  • For more advanced science projects on measuring different types of sugars in foods, see: Sucrose & Glucose & Fructose, Oh My! Uncovering Hidden Sugar in Your Food and Lactose, Sucrose, and Glucose: How Many Sugars are in Your Smoothie?.
  • For science projects on how exercise affects a person, see: Heart Rate Recovery Times and Heart Health: How Does Heart Rate Change with Exercise?.

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