Reallocating sitting time to standing or stepping through isotemporal analysis: associations with markers of chronic low-grade inflammation

Abstract

Although high levels of sitting time are adversely related to health, it is unclear whether moving from sitting to standing provides a sufficient stimulus to elicit benefits upon markers of chronic low-grade inflammation in a population at high risk of type 2 diabetes (T2DM). Three hundred and seventy two participants (age = 66.8 ± 7.5years; body mass index (BMI) = 31.7 ± 5.5kg/m; Male = 61%) were included. Sitting, standing and stepping was determined using the activPAL3 device. Linear regression modelling employing an isotemporal substitution approach was used to quantify the association of theoretically substituting 60 minutes of sitting per day for standing or stepping on interleukin-6 (IL-6), C-reactive protein (CRP) and leptin. Reallocating 60 minutes of sitting time per day for standing was associated with a -4% (95% CI -7%, -1%) reduction in IL-6 (p = 0.048). Reallocating 60 minutes of sitting time for light stepping was also associated with lower IL-6 levels (-28% (-46%, -4%; p = 0.025)). Substituting sitting for moderate-to-vigorous (MVPA) stepping was associated with lower CRP (-41% (-75%, -8%; p = 0.032)), leptin (-24% (-34%, -12%; p ≤ 0.001)) and IL-6 (-16% (-28%, 10%; p = 0.036). Theoretically replacing 60 minutes of sitting per day with an equal amount of either standing or stepping yields beneficial associations upon markers of chronic-low grade inflammation.

Associations of Physical Behaviours and Behavioural Reallocations with Markers of Metabolic Health: A Compositional Data Analysis

“…These results are broadly similar to previous evidence from compositional data analyses [ 23 , 25 , 37 , 38 , 39 , 40 ], as well as previous isotemporal substitutional analyses using traditional methodologies [ 13 , 14 , 15 , 16 , 17 ]. As with previous evidence, movement appears to be the most influential physical behaviour.…”

“…Physical activity has been shown to reduce morbidity and mortality [ 10 , 11 , 12 ]. Research has examined reallocating one behaviour to another, showing positive results for increasing movement (stepping, LIPA, and MVPA) by decreasing sedentary time [ 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. With the growing interest in sedentary behaviour, there has been an increase in the use of thigh-worn accelerometers that can measure the postures of sitting and standing, rather than infer sitting time through lack of movement, which has been done with waist-worn accelerometers [ 20 ].…”

“…The activPAL is increasingly being used in sedentary behaviour and physical activity research [ 21 ]. A small number of isotemporal substitution studies have utilised the activPAL accelerometer for physical behaviour measurement to date [ 14 , 15 , 16 ]. All three employed a traditional isotemporal substitution approach, developed by Mekary et al [ 22 ], to model the associations of reallocating time from sitting to standing or stepping.…”

“…All three employed a traditional isotemporal substitution approach, developed by Mekary et al [ 22 ], to model the associations of reallocating time from sitting to standing or stepping. The evidence shows that reallocating time from sitting to standing or stepping is associated with favourable health markers [ 14 , 15 , 16 ]. However, there is a growing body of evidence using a different analytical approach, this being compositional data analysis.…”

A three arm cluster randomised controlled trial to test the effectiveness and cost-effectiveness of the SMART Work & Life intervention for reducing daily sitting time in office workers: study protocol

“…Recent experimental evidence has demonstrated a reduction in glucose, insulin and blood pressure following regular standing and walking breaks (i.e., every 20–30 min), with total reductions in sitting varying from 28 min to 60 min across the course of a day [ 12 , 13 , 15 , 16 , 18 ]. Furthermore, using statistical modelling we have observed that interchanging 30 mins/day of sitting (measured with the activPAL) with standing and stepping is associated with favourable differences in insulin sensitivity [ 9 ] and inflammation [ 10 ]. In a similar analysis, interchanging 2 h of sitting/day with standing or stepping was associated with favourable differences in glucose, triglycerides, cholesterol and waist circumference [ 11 ].…”