TL;DR: A 2026 90-person prediabetes trial in Pakistan Journal of Pharmaceutical Sciences found Huatuo Five-Animal Play improved glucose control and insulin resistance while shifting GLP-1, a metabolic hormone, and Wnt5a, an inflammation-linked pathway marker.
Key Findings
- Five-Animal Play matched probiotic capsules: Post-treatment glucose-metabolism outcomes were not significantly different between the movement and bifidobacterium groups.
- Five-Animal Play beat cycling on key markers: Larger drops in fasting glucose, 2-hour glucose, HOMA-IR, and Wnt5a vs. low-intensity aerobic exercise (P < 0.05).
- All three interventions worked vs. baseline: Fasting glucose, 2-hour glucose, HbA1c, fasting insulin, and HOMA-IR all fell significantly across all arms.
- GLP-1 increases tracked glucose drops: Larger GLP-1 rises correlated with larger drops in fasting glucose (r = −0.34) and HOMA-IR (r = −0.39) — behavior moving the same pathway as injectable GLP-1 agonists.
- Wnt5a fell, Sfrp5 rose: The pro-inflammatory Wnt5a/Sfrp5 axis shifted in the metabolic-health direction, with Wnt5a falling further with Five-Animal Play than with cycling.
- No safety findings: No adverse reactions, no liver or kidney toxicity over the 4-week window.
Source: Pakistan Journal of Pharmaceutical Sciences (2026) | Yang et al.
Impaired glucose tolerance sits between normal glucose regulation and type 2 diabetes, which makes it a useful testing ground for low-risk interventions. This trial used that window to compare a probiotic capsule, conventional cycling, and Huatuo Five-Animal Play under the same 4-week protocol.
Prediabetes Comparator Groups Clarified the Five-Animal Play GLP-1 Result
Impaired glucose tolerance is the stage where blood sugar is already abnormal but type 2 diabetes is not yet established. Insulin resistance is active, beta cells are under pressure, and daily behavior can still bend the trajectory.
The unusual part was the comparator set. Researchers compared three very different ways of trying to change metabolism: a bifidobacterium probiotic, standard low-intensity cycling, and Huatuo Five-Animal Play — a structured mind-body routine built around slow coordinated movements, breathing, and repeated practice.
The biomarker panel made the trial more than a lifestyle pamphlet. They tracked fasting glucose, GLP-1 (the incretin pathway central to modern obesity and diabetes drugs), and the inflammatory-metabolic signaling pair Wnt5a/Sfrp5.
4 Weeks Across 90 Patients Improved Glucose and Insulin Measures
At the broadest level, all three interventions worked. After 4 weeks, every group showed significant reductions in fasting blood glucose, 2-hour post-load glucose, HbA1c, fasting insulin, and HOMA-IR.
That baseline movement anchors interpretation — the trial did not hinge on an implausibly weak control. Even the cycling arm shifted core glucose markers.
The sharper comparison is relative performance. Five-Animal Play held up surprisingly well.
Compared with the cycling arm, it produced larger improvements in fasting glucose, 2-hour glucose, and HOMA-IR.
Against the probiotic arm, it was broadly comparable on the main glycemic outcomes. A movement routine that may seem like general wellness practice produced changes closer to a targeted metabolic intervention than a soft adjunct.
The intervention was structured: about 30 minutes, three times daily, 6 days per week for 4 weeks, with professional guidance and home practice support. Intensive enough to count as a real protocol, light enough to be plausible for older or deconditioned people who would not start standard gym exercise.
Wnt5a Fell Further With Movement Than With Cycling
The most distinctive result was the Wnt5a/Sfrp5 axis moving in the direction expected with lower metabolic inflammation. Wnt5a is a pro-inflammatory non-canonical Wnt ligand linked to insulin resistance and obesity-related metabolic dysfunction.
Sfrp5 acts as a counterweight, dampening that pathway. All groups increased GLP-1 and Sfrp5 while reducing or trending Wnt5a downward — but Five-Animal Play achieved a more pronounced Wnt5a decline than cycling.
That points beyond calorie burning alone. The movement routine combines low-intensity activity with paced breathing, repeated practice, and likely autonomic effects that standard cycling does not necessarily reproduce.
Over 4 weeks, Five-Animal Play was associated with a stronger shift in one inflammatory signaling marker than basic aerobic cycling — which justifies testing the movement routine as more than a generic activity control.
GLP-1 and Sfrp5 Correlations Linked Movement to Insulin Resistance
The correlation analysis is where the biomarker argument moves past decoration. Three findings tracked the glucose and insulin-resistance results:
- GLP-1: larger increases linked to larger drops in fasting glucose (r = −0.34) and HOMA-IR (r = −0.39).
- Wnt5a: larger decreases linked to larger reductions in insulin resistance (r = 0.41 between Wnt5a change and HOMA-IR change).
- Sfrp5: higher increases linked to lower HOMA-IR (r = −0.36) and lower fasting glucose (r = −0.28).
Those correlations gave the trial a mechanistic backbone. Blood sugar improved while a coherent signaling network moved in the same direction.
Most readers now hear “GLP-1” and think semaglutide or tirzepatide. This trial points to a different scale of GLP-1 biology — behavior, gut signaling, and non-drug interventions can move the same pathway, even if the size and durability won’t match injectables.
Four-Week Single-Site Prediabetes Trial Has Real Limits
The trial was randomized but small — 30 per group, single site, 4 weeks. Long enough to detect a short-term change; not enough to settle long-term diabetes prevention.
The lipid findings are harder to interpret than the glucose and signaling-marker results. The glucose, insulin-resistance, GLP-1, Wnt5a, and Sfrp5 outcomes form the coherent core; lipid indices moved favorably but secondarily.
The study was not prospectively registered. Intervention intensity also differed between groups: Five-Animal Play participants practiced multiple times per day with guidance and home follow-up, which may improve adherence relative to simpler cycling instructions.
Even with those caveats, the mind-body exercise group improved several glucose and insulin-resistance endpoints more than the low-intensity cycling group.
Five-Animal Play May Fit Alongside GLP-1-Focused Prediabetes Care
The drug comparison should be kept in proportion. A movement routine does not need to compete with injectable GLP-1 receptor agonists for severe obesity or established diabetes to have metabolic value.
The more relevant setting is earlier in the pipeline — people with rising glucose, rising insulin resistance, and enough physiologic flexibility left that a safe daily practice could still bend the curve.
The study ties a traditional movement routine to a biomarker language modern metabolic medicine takes seriously.
Follow-up would help measure durability and adherence, but the short-term result already matters. The simpler claim is enough: a consistent, structured movement routine may help glucose control, insulin resistance, and GLP-1-linked metabolic signaling in people with impaired glucose tolerance.
In plain terms: this was a 90-person trial with 30 people in each arm. Over 4 weeks, the Five-Animal Play group improved several glucose and insulin-resistance markers more than cycling and looked similar to the probiotic group on the main glucose outcomes.
Citation: DOI: 10.36721/PJPS.2026.39.5.REG.15722.1; Yang et al; Pharmacological and metabolic effects of Bifidobacterium triple viable capsules and Five-Animal Play in patients with impaired glucose tolerance; Pakistan Journal of Pharmaceutical Sciences; 2026;39(5):1242–1253.
Study Design: Randomized 3-arm trial comparing bifidobacterium triple viable capsules, low-intensity cycling, and Huatuo Five-Animal Play in adults with impaired glucose tolerance over 4 weeks.
Sample Size: 90 adults, 30 per arm, single site.
Key Statistic: All 3 groups significantly improved fasting glucose, 2-hour glucose, HbA1c, fasting insulin, and HOMA-IR. Five-Animal Play matched probiotic and beat cycling on glucose, HOMA-IR, and Wnt5a. GLP-1 rise tracked glucose drop (r = −0.34).
Caveat: Single-site, 4-week, not prospectively registered — this supports a short-term metabolic signal, not proof of durable diabetes prevention.
