Accumulated or continuous exercise for glycaemic regulation and control: a systematic review with meta-analysis

Abstract

ObjectiveTo compare the effectiveness of accumulating exercise in multiple bouts of at least 10 min throughout a day with exercise completed in a single bout (continuous or interval), or no exercise, on glycaemic control and regulation in inactive people without diagnosed glycaemic dysfunction.DesignSystematic review and meta-analysis.Data sourcesSeven electronic databases were searched: CINAHL (EBSCO), Cochrane Library, EMBASE (Ovid), MEDLINE 1948-(Ovid), SCOPUS (Elsevier), SPORTDiscus (EBSCO) and Web of Science (ISI) with no restrictions on date and included all titles indexed up to February 2018.Eligibility criteria for selecting studiesArticles reporting insufficiently active adults (19 to 64 years) without metabolic dysfunction, measuring glycaemic control or regulation following at least 6 weeks of aerobic exercise.ResultsOnly one study compared accumulated exercise to single-bout exercise with no significant effect on fasting glucose (95% CI: −0.04 to 0.24 mmol·L-1) or fasting insulin (95% CI: −1.79 to 9.85 pmol·L-1) reported 48 hours after the final bout. No studies compared accumulated exercise with no-exercise. Compared with no-exercise, single-bout exercise reduces insulin resistance (mean difference (MD): −0.53 pmol·L-1; 95% CI: −0.93 to −0.13). Insulin resistance was clearly reduced with moderate-intensity (−0.68 (−1.28 to −0.09)) but not with high-intensity (−0.38 (−1.20 to 0.44)) exercise. Single-bout exercise was not statistically more beneficial than no-exercise for glycated haemoglobin (HbA1c) (MD: −0.11 %; 95% CI: −0.24 to 0.02) in metabolically healthy individuals.Summary/conclusionThe glycaemic response to accumulated exercise or single-bout exercise might not be different, however exercise intensity might influence the mechanisms generating the response.PROSPERO registration numberCRD42015025042.

Physiology of sedentary behavior

“…It is important to highlight that mean baseline levels of fasting glucose, insulin and HbA1c were mostly within normal ranges in available meta-analyses (78,134,135), which may partly explain the small magnitude of reported changes following SB interventions. In fact, these small changes are comparable to the findings that have been observed with continuous exercise in people without glycemic dysfunction (230).…”

Effects of cycling workstation to get tertiary employee moving on their overall health: study protocol for a REMOVE trial

“…On top of that, multiple short periods of PA (< 10 min) have been shown to be more attractive for the sedentary populations than longer continuous bouts, while they still significantly improve physical fitness [119,120]. Accumulated and continuous exercises have shown to elicit similar effects on physical fitness, cardiovascular and cardiometabolic parameters in inactive and sedentary populations [121,122].…”

Time spent in hypoglycemia is comparable when the same amount of exercise is performed 5 or 2 days weekly: a randomized crossover study in people with type 1 diabetes

“… 23 24 Murphy and colleagues 23 reviewed 16 studies and reported similar health benefits in blood pressure, weight loss, and lipid profiles of dividing the same amount of exercise into frequent shorter or fewer longer sessions. Furthermore, Shambrook and colleagues 24 performed a systematic review of 16 studies in sedentary healthy persons and concluded that the glycemic response to accumulated exercise or single-bout exercise was the same.…”