Acute effects of breaking up prolonged sedentary time on cardiovascular disease risk markers in adults with paraplegia.

Elevated levels of cardiovascular disease (CVD) risk markers are highly prevalent in people with a spinal cord injury (SCI). Breaking up prolonged sedentary time with short, regular bouts of physical activity can reduce postprandial glucose and lipid levels in able-bodied individuals. The effects in people with paraplegia are unknown. The study aims were to examine the acute postprandial glucose (primary aim), lipid, blood pressure, and psychological responses (secondary aims) to breaking up prolonged sedentary time in individuals with paraplegia. This was a randomized crossover design trial. Fourteen participants with paraplegia (age 51 ± 9 years, trunk fat mass 44.3 ± 7.7%) took part in the following two, 5.5-hour conditions: (1) uninterrupted sedentary time (SED), and (2) sedentary time interrupted with 2 minutes of moderate-intensity arm crank ergometer physical activity every 20 minutes (SED-ACT). Standardized breakfast and lunch test meals were consumed during each condition. The outcomes were compared between conditions using linear mixed models. Glucose area under the curve (AUC) was significantly lower during the lunch postprandial period in SED-ACT vs SED (incremental AUC 1.9 [95% CI 1.0, 2.7) and 3.0 [2.1, 3.9] mmol/L∙2.5 hour, respectively, P = .015, f = 0.34). There were no differences between conditions for the breakfast or total 5.5 hours postprandial periods (P > .05). Positive affect was higher in SED-ACT than SED (P = .001). Breaking up prolonged sedentary time acutely attenuates lunch postprandial glucose and improves positive affect in people with paraplegia. This may have clinical relevance for reducing CVD risk and improving psychological well-being in this population.

Effects of Interrupting Sitting with Use of a Treadmill Desk Versus Prolonged Sitting on Postural Stability.

High amounts of sitting increase the risk of non-communicable disease and mortality. Treadmill desks make it possible to reduce sitting during the desk-based worker's day. This study investigated the acute effect on postural stability of interrupting prolonged sitting with an accumulated 2-h of light-intensity treadmill desk walking. Twenty-one sedentary adults participated in this randomized acute crossover trial, with two 6.5 h conditions: 1) uninterrupted sitting and 2) interrupted sitting with accumulated 2 h light-intensity treadmill desk walking. Pre- and post-condition, participants performed four postural stability tests on a pressure plate (bipedal and unipedal standing stance, eyes open and eyes closed). Anteroposterior center of pressure amplitude showed a significant condition x time interaction in bipedal eyes closed (F(1,20)=4.62, p=0.046) and unipedal eyes open (F(1,20)=9.42, p=0.006) tests, and mediolateral center of pressure amplitude in bipedal eyes closed (F(1,20)=6.12, p=0.023) and bipedal eyes open (F(1,12)=5.55, p=0.029) tests. In the significant interactions, amplitude increased pre to post condition in the uninterrupted sitting condition. The accumulated 2 h light-intensity treadmill desk walking ameliorated the negative effect of 6.5 h prolonged sitting on postural sway, supporting workplace treadmill desk use.

Reducing prolonged sedentary time using a treadmill desk acutely improves cardiometabolic risk markers in male and female adults.

This study evaluated the acute effects of interrupting prolonged sitting with an accumulated 2 h of light-intensity walking on postprandial cardiometabolic risk markers. In this randomised crossover trial, 24 participants (twelve males) aged 18-55 years took part in two, 6.5 h conditions: 1) prolonged sitting (SIT) and 2) sitting interrupted hourly with 20 min light-intensity treadmill desk walking at between 1.2-3.5 km/h-1 (INT-SIT). Standardized meals were provided at 0 h and 3 h. Blood samples and blood pressure measures were taken hourly. Statistical analyses were completed using linear mixed models. Postprandial incremental area under the curve responses (mmol/L∙6.5 h) for glucose (4.52 [3.47, 5.56] and 6.66 [5.62, 7.71] for INT-SIT and SIT, respectively) and triglycerides (1.96 [0.96, 2.96] and 2.71 [1.70, 3.71] for INT-SIT and SIT, respectively) were significantly lower in INT-SIT than SIT. Mean systolic and diastolic blood pressure responses were lower by 3% and 4%, respectively, in INT-SIT than SIT (P < 0.05). There was no significant condition x sex interaction effect for any outcomes (P > 0.05). These findings suggest that interrupting sitting with an accumulated 2 h of light-intensity walking acutely improves cardiometabolic risk levels in males and females compared with prolonged sitting.

Acute Cardiometabolic and Exercise Responses to Breakfast Omission Versus Breakfast Consumption in Adolescent Girls: A Randomised Crossover Trial.

Girls often begin to skip breakfast during adolescence. This study compared the acute effect of breakfast omission versus consumption on cardiometabolic risk markers and perceived appetite and mood during rest and/or exercise in adolescent girls classified as habitual breakfast consumers. Girls (aged 13.2 ± 0.7 years) completed two 5.5 h conditions in a randomised crossover design: breakfast omission (BO) and standardised breakfast consumption (BC). A standardised lunch was provided at 3 h. Incremental cycling exercise was performed at 5 h. Blood and expired gas samples were taken at regular intervals. Whilst pre-lunch plasma glucose, insulin, and Metabolic Load Index incremental area under the curve (IAUC) were significantly lower in BO versus BC, post-lunch differences were reversed and larger in magnitude. Peak plasma glucose and insulin were significantly higher in BO versus BC. Pre-lunch perceived fullness and hunger were significantly lower and higher, respectively, in BO versus BC. Perceived energy and concentration were lower, and tiredness was higher, in BO versus BC. Exercise peak fat oxidation and Fatmax were unaffected. The lower physical activity enjoyment in BO versus BC approached significance. To conclude, acutely omitting breakfast adversely affects cardiometabolic risk markers and exercise enjoyment among adolescent girls who habitually consume breakfast.

Sitting Time and Risk of Cardiovascular Disease and Diabetes: A Systematic Review and Meta-Analysis.

CONTEXT: Whether physical activity attenuates the association of total daily sitting time with cardiovascular disease and diabetes incidence is unclear. This systematic review and meta-analysis examined the association of total daily sitting time with cardiovascular disease and diabetes with and without adjustment for physical activity. EVIDENCE ACQUISITION: PubMed, Web of Science, BASE, MEDLINE, Academic Search Elite, and ScienceDirect were searched for prospective studies, published between January 1, 1989, and February 15, 2019, examining the association of total daily sitting time with cardiovascular disease or diabetes outcomes. Data extraction and study quality assessments were conducted by 2 independent reviewers. Pooled hazard ratios (HRs) were calculated using a fixed-effects model. The quality assessment and meta-analysis procedures were completed in 2018. EVIDENCE SYNTHESIS: Nine studies with 448,285 participants were included. A higher total daily sitting time was associated with a significantly increased risk of cardiovascular disease (HR=1.29, 95% CI=1.27, 1.30, p<0.001) and diabetes (HR=1.13, 95% CI=1.04, 1.22, p<0.001) incidence when not adjusted for physical activity. The increased risk for diabetes was unaffected when adjusting for physical activity (HR=1.11, 95% CI=1.01, 1.19, p<0.001). For cardiovascular disease, the increased risk was attenuated but remained significant (HR=1.14, 95% CI=1.04, 1.23, p<0.001). CONCLUSIONS: Higher levels of total daily sitting time are associated with an increased risk of cardiovascular disease and diabetes, independent of physical activity. Reductions in total daily sitting may be recommended in public health guidelines.

Efficacy of a Multicomponent Intervention to Reduce Workplace Sitting Time in Office Workers: A Cluster Randomized Controlled Trial.

OBJECTIVE: The aim of this study was to investigate the efficacy of a work-based multicomponent intervention to reduce office workers' sitting time. METHODS: Offices (n = 12; 89 workers) were randomized into an 8-week intervention (n = 48) incorporating organizational, individual, and environmental elements or control arm. Sitting time, physical activity, and cardiometabolic health were measured at baseline and after the intervention. RESULTS: Linear mixed modelling revealed no significant change in workplace sitting time, but changes in workplace prolonged sitting time (-39 min/shift), sit-upright transitions (7.8 per shift), and stepping time (12 min/shift) at follow-up were observed, in favor of the intervention group (P < 0.001). Results for cardiometabolic health markers were mixed. CONCLUSION: This short multicomponent workplace intervention was successful in reducing prolonged sitting and increasing physical activity in the workplace, although total sitting time was not reduced and the impact on cardiometabolic health was minimal.