The Acute Metabolic and Vascular Impact of Interrupting Prolonged Sitting: A Systematic Review and Meta-Analysis

Saunders, Travis J.; Atkinson, Hayden F.; Burr, Jamie F.; MacEwen, Brittany T.; Skeaff, C. Murray; Peddie, Meredith C.

doi:10.1007/s40279-018-0963-8

Cited by 133 publications

(177 citation statements)

References 73 publications

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“…Recently, a meta-analysis [93] reported that activity breaks compared to sitting lowered post-prandial glucose by Cohen [93] for glucose and insulin outcomes were broadly similar to our findings, but with smaller effect sizes. However, we found that PA breaks lowered post-prandial TAG outcomes, in contrast to Saunders et al [93]. The differences in results could be explained by differences in inclusion criteria.…”

Section: Discussionsupporting

confidence: 87%

“…The differences in results could be explained by differences in inclusion criteria. Saunders et al included adolescents and teenagers [94][95][96][97][98] in their meta-analysis [93], whereas we did not. Furthermore, whereas we included studies with people with type 2 diabetes in our meta-analysis, Saunders et al [93] did not.…”

Section: Discussionmentioning

confidence: 61%

“…Saunders et al included adolescents and teenagers [94][95][96][97][98] in their meta-analysis [93], whereas we did not. Furthermore, whereas we included studies with people with type 2 diabetes in our meta-analysis, Saunders et al [93] did not. It is possible that we found that PA breaks compared to sitting had greater benefits on glucose, insulin and TAG outcomes than Saunders et al [93] because participants in their meta-analysis were healthier and younger.…”

Section: Discussionmentioning

confidence: 61%

“…This is supported generally by our meta-regression and subgroup analyses, which suggested that people with higher BMI, lower cardiovascular fitness, impaired fasting glucose or type 2 diabetes, experienced greater reductions in post-prandial glucose and insulin, compared to those with lower BMI or who were healthier. However, Saunders et al [93] reported that neither glucose nor insulin outcomes were associated with BMI. This discrepancy between their findings and ours might again be due to the younger and healthier participants in their analyses, as transport, uptake and metabolism of glucose might be greater in the insulin sensitive compared to the insulin resistant [44].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, whereas we included studies with people with type 2 diabetes in our meta-analysis, Saunders et al [93] did not. It is possible that we found that PA breaks compared to sitting had greater benefits on glucose, insulin and TAG outcomes than Saunders et al [93] because participants in their meta-analysis were healthier and younger. This is supported generally by our meta-regression and subgroup analyses, which suggested that people with higher BMI, lower cardiovascular fitness, impaired fasting glucose or type 2 diabetes, experienced greater reductions in post-prandial glucose and insulin, compared to those with lower BMI or who were healthier.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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Background Physical activity (PA) breaks in sitting time might attenuate metabolic markers relevant to the prevention of type 2 diabetes. Objectives The primary aim of this paper was to systematically review and meta-analyse trials that compared the effects of breaking up prolonged sitting with bouts of PA throughout the day (INT) versus continuous sitting (SIT) on glucose, insulin and triacylglycerol (TAG) measures. A second aim was to compare the effects of INT versus continuous exercise (EX) on glucose, insulin and TAG measures. Methods The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) recommendations. Eligibility criteria consisted of trials comparing INT vs. SIT or INT vs. one bout of EX before or after sitting, in participants aged 18 or above, who were classified as either metabolically healthy or impaired, but not with other major health conditions such as chronic obstructive pulmonary disease or peripheral arterial disease. Results A total of 42 studies were included in the overall review, whereas a total of 37 studies were included in the metaanalysis. There was a standardised mean difference (SMD) of − 0.54 (95% CI − 0.70, − 0.37, p = 0.00001) in favour of INT compared to SIT for glucose. With respect to insulin, there was an SMD of − 0.56 (95% CI − 0.74, − 0.38, p = 0.00001) in favour of INT. For TAG, there was an SMD of − 0.26 (95% CI − 0.44, − 0.09, p = 0.002) in favour of INT. Body mass index (BMI) was associated with glucose responses (β = − 0.05, 95% CI − 0.09, − 0.01, p = 0.01), and insulin (β = − 0.05, 95% CI − 0.10, − 0.006, p = 0.03), but not TAG (β = 0.02, 95% CI − 0.02, 0.06, p = 0.37). When energy expenditure was matched, there was an SMD of − 0.26 (95% CI − 0.50, − 0.02, p = 0.03) in favour of INT for glucose, but no statistically significant SMDs for insulin, i.e. 0.35 (95% CI − 0.37, 1.07, p = 0.35), or TAG i.e. 0.08 (95% CI − 0.22, 0.37, p = 0.62). It is worth noting that there was possible publication bias for TAG outcomes when PA breaks were compared with sitting. Conclusion The use of PA breaks during sitting moderately attenuated post-prandial glucose, insulin, and TAG, with greater glycaemic attenuation in people with higher BMI. There was a statistically significant small advantage for PA breaks over continuous exercise for attenuating glucose measures when exercise protocols were energy matched, but no statistically significant differences for insulin and TAG. PROSPERO Registration: CRD42017080982. PROSPERO Registration CRD42017080982. Key PointsBreaking up sitting with physical activity (PA) moderately attenuated post-prandial glucose and insulin, with a small effect size attenuation for TAG.There was greater glycaemic attenuation in people with higher body mass index (BMI).PA breaks were slightly more effective for glycaemic attenuation compared to one continuous bout of PA when experimental conditions were energy expenditure matched. Affiliations

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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Leg Fidgeting During Prolonged Sitting Improves Postprandial Glycemic Control in People with Obesity

Pettit‐Mee

Ready

Padilla

et al. 2021

Obesity

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ObjectiveStudies have shown that fidgeting augments metabolic demand and increases blood flow to the moving limbs, whereas prolonged sitting suppresses these factors and exacerbates postprandial glucose excursions. Therefore, the hypothesis of this study was that leg fidgeting during prolonged sitting would improve postprandial glycemic control.MethodsAdults with obesity (n = 20) participated in a randomized crossover trial in which blood glucose and insulin concentrations were measured during a 3‐hour sitting period following the ingestion of a glucose load (75 g). During sitting, participants either remained stationary or intermittently fidgeted both legs (2.5 minutes off and 2.5 minutes on). Accelerometer counts, oxygen consumption, and popliteal‐artery blood flow were also measured during the sitting period.ResultsAs expected, fidgeting increased accelerometer counts (P < 0.01), oxygen consumption (P < 0.01), and blood flow through the popliteal artery (P < 0.05). Notably, fidgeting lowered both glucose (P < 0.01) and insulin (P < 0.05) total area under the curve (AUC) and glucose incremental AUC (P < 0.05). Additionally, there was a strong negative correlation between fidgeting‐induced increases in blood flow and reduced postprandial glucose AUC within the first hour (r = −0.569, P < 0.01).ConclusionsLeg fidgeting is a simple, light‐intensity physical activity that enhances limb blood flow and can be incorporated during prolonged sitting to improve postprandial glycemic control in people with obesity.

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The Paradoxical Health Effects of Occupational Versus Leisure-Time Physical Activity

Holtermann¹,

Coenen²,

Krause³

2020

Handbook of Socioeconomic Determinants of Occupational Health

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The Acute Metabolic and Vascular Impact of Interrupting Prolonged Sitting: A Systematic Review and Meta-Analysis

Abstract: CRD42015020907.

Cited by 133 publications

References 73 publications

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

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

Leg Fidgeting During Prolonged Sitting Improves Postprandial Glycemic Control in People with Obesity

The Paradoxical Health Effects of Occupational Versus Leisure-Time Physical Activity

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