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Sports Medicine
Published in: Sports Medicine 2/2020

Open Access 01-02-2020 | Insulins | Systematic Review

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

Authors: Roland Loh, Emmanuel Stamatakis, Dirk Folkerts, Judith E. Allgrove, Hannah J. Moir

Published in: Sports Medicine | Issue 2/2020

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Abstract

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 meta-analysis. 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.
Appendix
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Metadata
Title
Effects of Interrupting Prolonged Sitting with Physical Activity Breaks on Blood Glucose, Insulin and Triacylglycerol Measures: A Systematic Review and Meta-analysis
Authors
Roland Loh
Emmanuel Stamatakis
Dirk Folkerts
Judith E. Allgrove
Hannah J. Moir
Publication date
01-02-2020
Publisher
Springer International Publishing
Published in
Sports Medicine / Issue 2/2020
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI
https://doi.org/10.1007/s40279-019-01183-w

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