Prolonged sitting may increase diabetes risk in physically inactive individuals: an 11 year follow-up of the HUNT Study, Norway

Abstract

Aims/hypothesis We examined the association between sitting time and diabetes incidence, overall and by strata of leisuretime physical activity and BMI. Methods We followed 28,051 adult participants of the NordTrøndelag Health Study (the HUNT Study), a populationbased study, for diabetes incidence from 1995-1997 to 2006-2008 and estimated HRs of any diabetes by categories of self-reported total daily sitting time at baseline. Results Of 28,051 participants, 1253 (4.5%) developed diabetes during 11 years of follow-up. Overall, sitting ≥8 h/day was associated with a 17% (95% CI 2, 34) higher risk of developing diabetes compared with sitting ≤4 h/day, adjusted for age, sex and education. However, the association was attenuated to a non-significant 9% (95% CI −5, 26) increase in risk after adjustment for leisure-time physical activity and BMI. The association between sitting time and diabetes risk differed by leisure-time physical activity (p Interaction = 0.01). Among participants with low leisure-time physical activity (≤2 h light activity per week and no vigorous activity), sitting 5-7 h/day and ≥8 h/day were associated with a 26% (95% CI 2, 57) and 30% (95% CI 5, 61) higher risk of diabetes, respectively, compared with sitting ≤4 h/day. There was no corresponding association among participants with high leisuretime physical activity (≥3 h light activity or >0 h vigorous activity per week). There was no statistical evidence that the association between sitting time and diabetes risk differed by obesity (p Interaction = 0.65). Conclusions/interpretation Our findings suggest that total sitting time has little association with diabetes risk in the population as a whole, but prolonged sitting may contribute to an increased diabetes risk among physically inactive people.

Effects of Interrupting Prolonged Sitting with Physical Activity Breaks on Blood Glucose, Insulin and Triacylglycerol Measures: A Systematic Review and Meta-analysis

“…The evidence on the effects of sitting on metabolic health generated in our review is supported modestly by epidemiological evidence. Recent prospective studies of total sitting time and incident type 2 diabetes, in contrast to crosssectional studies of sedentary time and breaks measured by self-report [117], found little evidence for an association [118], or associations, between sitting behaviour or time and incident type 2 diabetes, but were limited to inactive [119] or obese [120] participants only. To resolve the discordant findings of prospective versus cross-sectional epidemiological studies, which do suggest an association between sitting time and type 2 diabetes [117], future prospective studies utilising accelerometer assessed total sitting time need to be conducted.…”

Association of total sedentary behaviour and television viewing with risk of overweight/obesity, type 2 diabetes and hypertension: A dose–response meta‐analysis

“…Eight articles reporting more than one health outcome were treated as independent studies . Among these studies, 21 studies (six cohort and 15 cross‐sectional studies) examined the association between total sedentary behaviour and overweight/obesity, 23 studies (13 cohort and 10 cross‐sectional studies) examined the association between total sedentary behaviour and type 2 diabetes, and 14 studies (one cohort and 13 cross‐sectional studies) examined the association between total sedentary behaviour and hypertension . Ten studies were conducted in North America, two in South America, nine in Australia, 18 in Europe, seven in Asia, and two in other regions .…”

“…Eight articles reporting more than one health outcome were treated as independent studies. [28][29][30][31][32][33][34][35] Among these studies, 21 studies (six cohort and 15 cross-sectional studies) examined the association between total sedentary behaviour and overweight/obesity, 32-52 23 studies (13 cohort and 10 cross-sectional studies) examined the association between total sedentary behaviour and type 2 diabetes, [28][29][30][31][32][33]35,[53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68] and 14 studies (one cohort and 13 cross-sectional studies) examined the association between total sedentary behaviour and hypertension. 27 Research and Quality scale for cross-sectional studies, which indicated that the included studies were of high quality (Table S3A,B in Appendix S1).…”

“…-31,33-35,69-74 Ten studies were conducted in North America,27,32,34,39,49,53,58,62,65,73 two in South America,67,68 nine in Australia,30,31,[42][43][44][45]50,64,70 18 in Europe,29,33,36,37,40,41,46,47,51,[54][55][56]60,63,66,69,71,72 seven in Asia,28,35,38,48,52,57,74 and two in other regions 59,61. Total sedentary behaviour was objectively assessed in five studies using accelerometers,61,65,66,…”

Objectively measured sedentary time and diabetes mellitus in a general Japanese population: The Hisayama Study

“…Our findings have extended these works by showing the associations in an Asian population. In addition, several studies have shown an association between self-reported sitting time and the presence of diabetes mellitus 8,14,27,28 . The present findings support the notion that prolonged sedentary time increases the risk of having diabetes independent of physical activity levels.…”