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Smith S, Salmani B, LeSarge J, Dillon-Rossiter K, Morava A, Prapavessis H. Interventions to reduce sedentary behaviour in adults with type 2 diabetes: A systematic review and meta-analysis. PLoS One 2024; 19:e0306439. [PMID: 39078846 PMCID: PMC11288443 DOI: 10.1371/journal.pone.0306439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/18/2024] [Indexed: 08/02/2024] Open
Abstract
Treatment and management of Type 2 Diabetes (T2D) includes physical activity, nutrition, and pharmacological management. Recently, the importance of reducing and breaking up sedentary behaviour has become recognized. This review aimed to summarize and synthesize the effectiveness of interventions in reducing and/or breaking up sedentary behaviour and cardiometabolic biomarkers in adults with T2D. A study protocol was preregistered on PROSPERO (CRD42022357281) and a database search (PubMed, EMBASE, Scopus, Web of Science, PsycINFO, SPORTDiscus, CINAHL, and Cochrane Library) was conducted on 16/09/2022 and updated on 03/01/2024. This review followed PRISMA guidelines and study quality was assessed with the Cochrane risk of Bias Tools. Twenty-eight articles were included in the review. The meta-analysis of short-term (Range: 3 hours- 4 days) sedentary behaviour interventions found significant improvement in continuous interstitial glucose measured for 24 hours after the sedentary behaviour intervention compared to control (SMD:-0.819,95%CI:-1.255,-0.383,p<0.001). Similarly, there was a significant improvement in postprandial interstitial glucose after the sedentary behaviour intervention compared to control (SMD:-0.347,95%CI:-0.584,-0.110,p = 0.004). Ten out of eleven longer-term (Range: 5 weeks- 3 years) sedentary behaviour interventions improved at least one measure of sedentary behaviour compared to control. Eight out of eight longer-term sedentary behaviour interventions improved at least one cardiometabolic biomarker compared to control. Reducing sedentary behaviour, independent of physical activity, can improve glycemic control in adults with T2D. Further, sedentary behaviour may be a feasible/ sustainable behaviour change.
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Affiliation(s)
- Siobhan Smith
- Department of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Babac Salmani
- Department of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Jordan LeSarge
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Kirsten Dillon-Rossiter
- Department of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Anisa Morava
- Department of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Harry Prapavessis
- Department of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
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Silva JKTNF, Menêses AL, Silva GO, O'Driscoll JM, Ritti-Dias RM, Correia MA, Farah BQ. Acute Effects of Breaking up Sitting Time With Isometric Wall Squat Exercise on Vascular Function and Blood Pressure in Sedentary Adults: Randomized Crossover Trial. J Cardiopulm Rehabil Prev 2024:01273116-990000000-00158. [PMID: 38885063 DOI: 10.1097/hcr.0000000000000877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
PURPOSE The World Health Organization has recommended breaking up sitting time to improve cardiovascular health. However, whether isometric exercise can be effectively used as a strategy to break up sitting time remains unclear. Thus, the aim of this study was to analyze the acute effects of breaking up prolonged sitting with isometric wall squat exercise (IWSE) on vascular function and blood pressure (BP) in sedentary adults. METHODS This randomized crossover trial included 17 adults (53% male, 26 ± 6 yr, 22.4 ± 3.6 kg/m2) with high sedentary behavior (≥ 6 hr/d). The participants completed 2 experimental sessions in a randomized order, both sharing a common sitting period of 180 min: Breaks (2-min breaks were incorporated into the IWSE, with participants maintaining their knees at the angle determined by the incremental test, which occurred every 30 min) and Control (sitting for 180 min continuously). Popliteal artery flow-mediated dilation (FMD) and brachial BP were measured before and at 10 and 30 min after the experimental sessions. RESULTS The results did not indicate significant session vs time interaction effects on popliteal FMD and brachial BP (P > .05). A subanalysis including only participants with popliteal FMD reduction after the Control session (n = 11) revealed that Breaks enhanced popliteal FMD after 10 min (1.38 ± 6.45% vs -4.87 ± 2.95%, P= .002) and 30 min (-0.43 ± 2.48% vs -2.11 ± 5.22%, P= .047). CONCLUSION Breaking up prolonged sitting with IWSE mitigates impaired vascular function resulting from prolonged sitting but has no effect on BP in sedentary adults.
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Affiliation(s)
- Jéssika K T N F Silva
- Author Affiliations: Department of Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, São Paulo, Brazil (Ms Silva, Mr O. Silva, and Drs Ritti-Dias, Correia, and Farah); Graduate Program in Physical Education, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil (Ms Silva and Dr Farah); University of Pernambuco (UPE), Recife, Pernambuco, Brazil (Dr Menêses); School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, United Kingdom (Dr O'Driscoll); Department of Physical Education, Federal Rural University of Pernambuco (UFRPE), Recife, Pernambuco, Brazil (Dr Farah)
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Niklasson J, Fagerström C, Backåberg S, Lindberg T, Bergman P. Daily activity patterns in older adults receiving initial support: the association between daily steps and sitting in bouts of at least 60 min. BMC Geriatr 2024; 24:88. [PMID: 38263077 PMCID: PMC10807219 DOI: 10.1186/s12877-024-04681-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 01/06/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Aging has a significant impact on health, underlining the importance of maintaining physical function and reducing time spent sitting among older adults. To understand how to reduce prolonged sitting or increase physical activity, factors related to the daily living and observed daily activity patterns should be explored. This study aimed to investigate the association between daily steps, self-rated health, physical activity, sedentary behavior, motivation to exercise and fear of falling among older adults receiving initial support. METHOD Cross-sectional design with total population questionnaire data from adults aged ≥ 60 years (n = 917), living at home with initial support from municipal care in southern Sweden. The older adults were offered to participate in a follow-up study measuring daily activity patterns with accelerometers (n = 72). Linear regression was used to analyze associations between daily steps and possible predictors. RESULTS The linear model ([Formula: see text]0.478) showed that sitting in unbroken bouts of > 60 min (β = -0.313, p < 0.05), walking independently outdoors (β = 0.301, p < 0.05), intending to increase physical activity (β = -0.294, p < 0.05), sex (β = 0.279, p < 0.05), relative autonomy index (β = 0.258, p < 0.05), fear of falling (β = -0.238, p < 0.05), and self-rated health (β = 0.213, p < 0.05) predicted daily steps. CONCLUSION The model of predictors brings new understanding regarding daily steps among community-dwelling older adults. The association between sitting in bouts of > 60 min and daily steps is interesting as 35% of participants had a number of sitting bouts that on average, showed 30% less steps taken. Minimizing long sitting bouts and maintaining physical functioning to promote independence when walking outdoors can be tools for clinical practitioners devising interventions to break prolonged sitting among community-dwelling older adults. Future research should prioritize studying older adults' outdoor walking independence, including its relation to walking with or without assistive devices and its impact on physical activity and sedentary behavior.
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Affiliation(s)
- Joakim Niklasson
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.
| | - Cecilia Fagerström
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
- Department of Research, Region Kalmar County, Kalmar, Sweden
| | - Sofia Backåberg
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Terese Lindberg
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - Patrick Bergman
- Faculty of Health and Life Sciences, Department of Medicine and Optometry, Linnaeus University, eHealth Institute, Kalmar, Sweden
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Schwartz BD, Shivgulam ME, Petterson JL, Wu Y, Frayne RJ, Kimmerly DS, O'Brien MW. More moderate-intensity physical activity and less prolonged sedentary time are associated with better very short-term systolic blood pressure variability in healthy adults. J Hum Hypertens 2023; 37:1015-1020. [PMID: 37185597 DOI: 10.1038/s41371-023-00832-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 03/23/2023] [Accepted: 04/14/2023] [Indexed: 05/17/2023]
Abstract
Whole-day movement guidelines for improving health, recommend that adults engage in at least 150 min week-1 of moderate-to-vigorous aerobic physical activity and limit their sedentary time. In young adults, higher systolic blood pressure variability (BPV) is a precursor for the development of hypertension. The impact of habitual activity that comprises (inter)national guidelines on BPV is unclear. We tested the hypothesis that less habitual physical activity and greater sedentary time would be associated with larger BPV. Ninety-two normotensive participants [age: 19-38 years, body mass index (BMI): 23.6 ± 3.3 kg/m2, 44♀] wore an activPAL monitor on their thigh for 7.0 ± 0.3 days. Ten minutes of supine systolic arterial pressure was measured via finger photoplethysmography (115 ± 11 mmHg). Beat-by-beat systolic BPV was measured using the average real variability index (1.1 ± 0.6 mmHg). Relationships between habitual activity outcomes and BPV were assessed via multiple regressions adjusted for age, sex, and BMI. Moderate-intensity physical activity (average: 36 ± 19 min day-1; β = -0.010, p = 0.02) and time spent in sedentary bouts >1-h (245 ± 134 min day-1; β = 0.002, p < 0.001), but not light-intensity activity, vigorous-intensity activity, standing time, sedentary breaks, or time spent in sedentary bouts <1-h (all, p > 0.10) were predictors of systolic BPV. Higher moderate physical activity and lower prolonged sedentary time were associated with attenuated systolic BPV responses in young adults. These findings highlight the cardiovascular benefits of habitual activity among younger adults and suggest that simple strategies such as reducing long periods of uninterrupted sitting and increasing moderate-intensity physical activity may be efficacious for reducing the risk of developing or delaying the onset of hypertension.
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Affiliation(s)
- Beverly D Schwartz
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Madeline E Shivgulam
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Jennifer L Petterson
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Yanlin Wu
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Ryan J Frayne
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Derek S Kimmerly
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Myles W O'Brien
- School of Physiotherapy (Faculty of Health) & Department of Medicine (Faculty of Medicine), Dalhousie University, Halifax, NS, Canada.
- Geriatric Medicine Research, Dalhousie University & Nova Scotia Health, Halifax, NS, Canada.
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Fenton SAM, O’Brien CM, Kitas GD, Duda JL, Veldhuijzen van Zanten JJCS, Metsios GS. The behavioural epidemiology of sedentary behaviour in inflammatory arthritis: where are we, and where do we need to go? Rheumatol Adv Pract 2023; 7:rkac097. [PMID: 36699551 PMCID: PMC9870708 DOI: 10.1093/rap/rkac097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/22/2022] [Indexed: 01/25/2023] Open
Abstract
In the last decade, studies into sedentary behaviour in inflammatory arthritis have raised important questions regarding its role in this condition. Specifically, evidence is needed on whether sedentary behaviour might exacerbate adverse inflammatory arthritis outcomes, and whether reducing sedentary behaviour might offer an effective avenue for self-management in this population. Research exploring these important research questions is still very much in its infancy and lacks the direction and scientific rigour required to inform effective intervention design, delivery and evaluation. Behavioural epidemiology refers to research that aims explicitly to understand and influence health behaviour patterns to prevent disease and improve health. To this end, the Behavioural Epidemiology Framework specifies a focused approach to health behaviour research, which leads to the development of evidence-based interventions directed at specific populations. In this review, we introduce the Behavioural Epidemiology Framework in the context of research into sedentary behaviour in inflammatory arthritis and ask: where are we, and where do we need to go?
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Affiliation(s)
- Sally A M Fenton
- Correspondence to: Sally A. M. Fenton, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. E-mail:
| | - Ciara M O’Brien
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Surrey, UK
| | - George D Kitas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK,Department of Rheumatology, Russells Hall Hospital, The Dudley Group NHS Foundation Trust, Dudley, UK
| | - Joan L Duda
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Jet J C S Veldhuijzen van Zanten
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK,Department of Rheumatology, Russells Hall Hospital, The Dudley Group NHS Foundation Trust, Dudley, UK
| | - George S Metsios
- Department of Rheumatology, Russells Hall Hospital, The Dudley Group NHS Foundation Trust, Dudley, UK,Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Volos, Greece
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De Carvalho D, Callaghan JP. Does a break from sitting change biomechanical outcome measures or transient pain? A laboratory-based experimental study. Work 2023:WOR211266. [PMID: 36641712 DOI: 10.3233/wor-211266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Sitting can induce transient low back pain (LBP) in healthy individuals. A rest from sitting should provide relief, however, the parameters of breaks (activity type, intensity, duration, and timing) are not currently known. OBJECTIVE The purpose of this study was to examine the effect of 2-minute walking breaks at 40-minute intervals on sitting-induced LBP. METHODS Thirty-two healthy participants were recruited for a within-control study: two randomly presented sessions of sitting for 2 hours with and without breaks. Outcome measures were compared between condition and pain group using a three-way ANOVA with significance atp > 0.05. RESULTS Walking breaks at 40-minute intervals result in significantly lower pain ratings than those taken immediately before the break for sitting-induced back pain developers. However, this relief is short lived (<10 minutes), with ratings increasing to pre-break levels once the sitting exposure resumes. There were no differences in biomechanical factors between sessions. Regardless of session type, pain developers displayed higher spine fidget frequency than non-pain developers, females sat with less spine flexion, with greater gluteal activation levels, and with their center of pressure approximately half a centimeter to the left and forward compared to males, and males had significantly greater peak pressures over a smaller area compared to females. CONCLUSION Walking breaks at 40-minute intervals provide significant, but temporary, relief of sitting-induced back pain for pain developers. Future work should optimize break parameters and examine the longer-term benefit of breaks, especially for individuals that are not able to tolerate sitting for extended durations.
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Affiliation(s)
- D De Carvalho
- Faculty of Medicine,Memorial University of Newfoundland, St. John's, NL, Canada
| | - J P Callaghan
- Department of Kinesiology, Faculty of Applied Health Sciences,University of Waterloo, Waterloo, ON, Canada
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Yerramalla MS, van Hees VT, Chen M, Fayosse A, Chastin SFM, Sabia S. Objectively Measured Total Sedentary Time and Pattern of Sedentary Accumulation in Older Adults: Associations With Incident Cardiovascular Disease and All-Cause Mortality. J Gerontol A Biol Sci Med Sci 2022; 77:842-850. [PMID: 35094083 PMCID: PMC8974336 DOI: 10.1093/gerona/glac023] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We examined associations of total duration and pattern of accumulation of objectively measured sedentary behavior (SB) with incident cardiovascular disease (CVD) and all-cause mortality among older adults. METHODS Total sedentary time and 8 sedentary accumulation pattern metrics were extracted from accelerometer data of 3 991 Whitehall II study participants aged 60-83 years in 2012-2013. Incident CVD and all-cause mortality were ascertained up to March 2019. RESULTS Two hundred and ninety-nine CVD cases and 260 deaths were recorded over a mean (standard deviation [SD]) follow-up of 6.2 (1.3) and 6.4 (0.8) years, respectively. Adjusting for sociodemographic and behavioral factors, 1-SD (100.2 minutes) increase in total sedentary time was associated with 20% higher CVD risk (hazard ratio [95% confidence interval]: 1.20 [1.05-1.37]). More fragmented SB was associated with reduced CVD risk (eg, 0.86 [0.76-0.97] for 1-SD [6.2] increase in breaks per sedentary hour). Associations were not evident once health-related factors and moderate-to-vigorous physical activity (MVPA) were considered. For all-cause mortality, associations with more fragmented SB (eg, 0.73 [0.59-0.91] for breaks per sedentary hour) were found only among the youngest older group (<74 years; p for interaction with age < .01) independently from all covariates. CONCLUSIONS In this study, no associations of total sedentary time and sedentary accumulation patterns with incident CVD and all-cause mortality were found in the total sample once MVPA was considered. Our findings of reduced mortality risk with less total and more fragmented SB independent from MVPA among individuals <74 years need to be replicated to support the recent recommendations to reduce and fragment SB.
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Affiliation(s)
- Manasa Shanta Yerramalla
- Université de Paris, INSERM U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris,France
| | | | - Mathilde Chen
- Université de Paris, INSERM U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris,France
| | - Aurore Fayosse
- Université de Paris, INSERM U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris,France
| | - Sebastien F M Chastin
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.,Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Séverine Sabia
- Université de Paris, INSERM U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris,France.,Department of Epidemiology and Public Health, University College London, London, UK
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