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Prince SA, Dempsey PC, Reed JL, Rubin L, Saunders TJ, Ta J, Tomkinson GR, Merucci K, Lang JJ. The Effect of Sedentary Behaviour on Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis. Sports Med 2024; 54:997-1013. [PMID: 38225444 PMCID: PMC11052788 DOI: 10.1007/s40279-023-01986-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND Cardiorespiratory fitness (CRF) is an important indicator of current and future health. While the impact of habitual physical activity on CRF is well established, the role of sedentary behaviour (SB) remains less understood. OBJECTIVE We aimed to determine the effect of SB on CRF. METHODS Searches were conducted in MEDLINE, Embase, PsycINFO, CINAHL and SPORTDiscus from inception to August 2022. Randomised controlled trials, quasi-experimental studies and cohort studies that assessed the relationship between SB and CRF were eligible. Narrative syntheses and meta-analyses summarised the evidence, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) certainty was based on evidence from randomised controlled trials. RESULTS This review included 18 studies that focused on youth (four randomised controlled trials, three quasi-experimental studies, 11 cohort studies) and 24 on adult populations (15 randomised controlled trials, five quasi-experimental studies, four cohort studies). In youth and adults, evidence from randomised controlled trials suggests mixed effects of SB on CRF, but with the potential for interventions to improve CRF. Quasi-experimental and cohort studies also support similar conclusions. Certainty of evidence was very low for both age groups. A meta-analysis of adult randomised controlled trials found that interventions targeting reducing SB, or increasing physical activity and reducing SB, had a significant effect on post-peak oxygen consumption (mean difference = 3.16 mL.kg-1.min-1, 95% confidence interval: 1.76, 4.57). CONCLUSIONS Evidence from randomised controlled trials indicates mixed associations between SB and CRF, with the potential for SB to influence CRF, as supported by meta-analytical findings. Further well-designed trials are warranted to confirm the relationship between SB and CRF, explore the effects of SB independent from higher intensity activity, and investigate the existence of such relationships in paediatric populations. CLINICAL TRIAL REGISTRATION PROSPERO CRD42022356218.
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Affiliation(s)
- Stephanie A Prince
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, K1A 0K9, Canada.
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - Paddy C Dempsey
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Jennifer L Reed
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Exercise Physiology and Cardiovascular Health Lab, University of Ottawa Heart Institute, Ottawa, ON, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Lukas Rubin
- Department of Physical Education and Sport, Faculty of Science, Humanities and Education, Technical University of Liberec, Liberec, Czech Republic
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Travis J Saunders
- Department Applied Human Sciences, University of Prince Edward Island, Charlottetown, PEI, Canada
| | - Josephine Ta
- Telfer School of Management, University of Ottawa, Ottawa, ON, Canada
| | - Grant R Tomkinson
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | | | - Justin J Lang
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, K1A 0K9, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
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Amin M, Kerr D, Atiase Y, Aldwikat RK, Driscoll A. Effect of Physical Activity on Metabolic Syndrome Markers in Adults with Type 2 Diabetes: A Systematic Review and Meta-Analysis. Sports (Basel) 2023; 11:sports11050101. [PMID: 37234057 DOI: 10.3390/sports11050101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 04/24/2023] [Accepted: 05/04/2023] [Indexed: 05/27/2023] Open
Abstract
People with Type 2 diabetes mellitus (T2DM) are reported to have a high prevalence of metabolic syndrome (MetS), which increases their risk of cardiovascular events. Our aim was to determine the effect of physical activity (PA) on metabolic syndrome markers in people with T2DM. The study design was a systematic review and meta-analysis of randomised controlled trials evaluating the effect of PA on MetS in adults with T2DM. Relevant databases including SPORTdiscus, Cochrane Central Register of Controlled Trials, CINAHL, MEDLINE, PsycINFO, EMBASE, SocINDEX were searched up to August 2022. Primary endpoints were changes in MetS markers (blood pressure, triglyceride, high-density lipoprotein, fasting blood sugar, and waist circumference) after an exercise intervention. Using a random effect model with 95% confidence interval (CI), the mean difference between intervention groups and control groups were calculated. Twenty-six articles were included in the review. Overall, aerobic exercise had a significant effect on waist circumference (Mean Difference: -0.34 cm, 95% CI: -0.84, -0.05; effect size: 2.29, I2 = 10.78%). The effect sizes on blood pressure, triglyceride, high-density lipoprotein, fasting blood sugar were not statistically significant. No significant differences were found between exercise and control group following resistance training. Our findings suggest that aerobic exercise can improve waist circumference in people with T2DM and MetS. However, both aerobic and resistance exercise produced no significant difference in the remaining MetS markers. Larger and higher-quality studies are required to determine the full effects of PA on MetS markers in this population.
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Affiliation(s)
- Mohammed Amin
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
| | - Debra Kerr
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
| | - Yacoba Atiase
- National Diabetes Management and Research Centre, Korle-Bu Teaching Hospital, University of Ghana Medical School, Accra P.O. Box GP 4236, Ghana
| | - Rami Kamel Aldwikat
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
- School of Nursing and Midwifery, Monash University, 35 Rainforest Walk, Clayton, VIC 3800, Australia
| | - Andrea Driscoll
- Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
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Lee SE, Yoo J, Kim BS, Kim KA, Han K, Choi HS. Association between exercise and risk of fractures in new-onset type 2 diabetes: a retrospective cohort study. Arch Osteoporos 2023; 18:61. [PMID: 37129630 DOI: 10.1007/s11657-023-01240-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/03/2023] [Indexed: 05/03/2023]
Abstract
In this population-based retrospective cohort study, exercising before and after the diagnosis of type 2 diabetes was significantly associated with lower risk of fractures. This result suggested that exercising might be effective in reducing fracture risk. PURPOSE Patients with diabetes have a significantly higher risk of fractures. We aimed to investigate the association between exercise and fracture risk in new-onset type 2 diabetes. METHODS This retrospective cohort study using the Korean National Health Insurance Service database included 170,148 patients with new-onset type 2 diabetes who underwent two cycles of health checkup between 2009-2012 and 2011-2014. The patients were classified into four groups (non-exercising, newly exercising, previously exercising, and continuously exercising) and followed up until the date of fracture, death, or December 31, 2018. Hip fractures, vertebral fractures, and any fractures were defined using diagnostic codes. RESULTS The proportions of non-exercising, newly exercising, previously exercising, and continuously exercising patients were 65.1%, 15.7%, 10.9%, and 8.3%, respectively. Continuously exercising patients showed the lowest risk for fractures, followed by newly exercising patients using the non-exercising group as a reference. The adjusted hazard ratios (95% confidence intervals) for hip fracture, vertebral fracture, and any fracture were 0.69 (0.50-0.94), 0.73 (0.63-0.84), and 0.90 (0.83-0.97), respectively, in the continuously exercising group and 0.76 (0.61-0.95), 0.85 (0.76-0.94), and 0.93 (0.88-0.98) in the newly exercising group. The risk was lower in patients who lost less than 5% of their body weight than in those who lost 5% or more. CONCLUSION Exercising was associated with lower risk of fractures in newly diagnosed diabetes. However, exercise accompanied by excessive weight loss may not have a significant association with a lower risk of fractures.
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Affiliation(s)
- Seung Eun Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dongguk University Ilsan Hospital, 27, Dongguk-Ro, Ilsandong-Gu, Goyang-Si, Gyeonggi-Do, Republic of Korea
| | - Juhwan Yoo
- Department of Biomedicine & Health Science, The Catholic University of Korea, Seoul, Korea
| | - Bong-Seong Kim
- Department of Statistics and Actuarial Science, Soongsil University, 369, Sangdo-Ro, Dongjak-Gu, Seoul, Republic of Korea
| | - Kyoung-Ah Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dongguk University Ilsan Hospital, 27, Dongguk-Ro, Ilsandong-Gu, Goyang-Si, Gyeonggi-Do, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, 369, Sangdo-Ro, Dongjak-Gu, Seoul, Republic of Korea
| | - Han Seok Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dongguk University Ilsan Hospital, 27, Dongguk-Ro, Ilsandong-Gu, Goyang-Si, Gyeonggi-Do, Republic of Korea.
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Viggers R, Al-Mashhadi Z, Fuglsang-Nielsen R, Gregersen S, Starup-Linde J. The Impact of Exercise on Bone Health in Type 2 Diabetes Mellitus-a Systematic Review. Curr Osteoporos Rep 2020; 18:357-370. [PMID: 32529455 DOI: 10.1007/s11914-020-00597-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Type 2 diabetes mellitus (T2DM) is associated with an increased fracture risk. Weight loss in T2DM management may result in lowering of bone mass. In this systematic literature review, we aimed to investigate how exercise affects bone health in people with T2DM. Furthermore, we examined the types of exercise with the potential to prevent and treat bone fragility in people with T2DM. RECENT FINDINGS Exercise differs in type, mechanical load, and intensity, as does the osteogenic response to exercise. Aerobic exercise improves metabolic health in people with T2DM. However, the weight-bearing component of exercise is essential to bone health. Weight loss interventions in T2DM induce a loss of bone mass that may be attenuated if accompanied by resistance or weight-bearing exercise. Combination of weight-bearing aerobic and resistance exercise seems to be preventive against excessive bone loss in people with T2DM. However, evidence is sparse and clinical trials investigating the effects of exercise on bone health in people with T2DM are warranted.
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Affiliation(s)
- R Viggers
- Steno Diabetes Center North Jutland, Aalborg University Hospital, Mølleparkvej 4, 9000, Aalborg, Denmark.
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Z Al-Mashhadi
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus C, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus C, Denmark
| | - R Fuglsang-Nielsen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus C, Denmark
- Department of Internal Medicine, Regional Hospital Randers, Randers, Denmark
| | - S Gregersen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus C, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus C, Denmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus C, Denmark
| | - J Starup-Linde
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus C, Denmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus C, Denmark
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