Effects of a workplace exercise intervention on cardiometabolic health: study protocol for a randomised controlled trial

Ali Muneer Alrahma, Mansoor Anwar Habib, Abderrahim Oulhaj, Tom Loney, Thomas Boillat, Syed M Shah, Luai A Ahmed, Javaid Nauman, Ali Muneer Alrahma, Mansoor Anwar Habib, Abderrahim Oulhaj, Tom Loney, Thomas Boillat, Syed M Shah, Luai A Ahmed, Javaid Nauman

Abstract

Introduction: The worldwide rising levels of physical inactivity especially in the United Arab Emirates (UAE) and the Eastern Mediterranean region are alarming. The UAE reports one of the highest rates of non-communicable disease mortality and insufficient physical activity (PA) is a major underlying cause. Therefore, action is required to reduce physical inactivity using evidence-based strategies. This study aimed to evaluate the efficacy of a worksite exercise intervention on cardiometabolic health in the UAE.

Methods and analysis: This is a protocol for a pragmatic parallel randomised controlled trial with a 1:1 allocation ratio to the intervention group and delayed intervention group. A total of 150 participants will be recruited from a semigovernment telecommunications company in Dubai (UAE) after meeting the eligibility criteria. The intervention group will receive 2 hours of exercise per week during working hours for 12 weeks (maximum 1 hour/day). The intervention group will be assigned to attend personal trainer sessions in the workplace gym throughout the intervention period. After the intervention is completed, the delayed intervention group will also receive 2 hours of exercise time per week from working hours for 4 weeks. The main outcome measure is the change in the cardiometabolic risk components, that is, systolic or diastolic blood pressure, waist circumference, glycated haemoglobin, fasting plasma glucose, low-density lipoprotein cholesterol from baseline to the end of the intervention. The secondary outcome is to examine whether the workplace exercise intervention improves PA levels 4 weeks postintervention.

Ethics and dissemination: The study has been approved by the Dubai Scientific Research Ethics Committee (DSREC-SR-08/2019_02). The results will be disseminated as follows: at various national and international scientific conferences; as part of a PhD thesis in Public Health at the College of Medicine and Health Sciences, UAE University; and in a manuscript submitted to a peer-reviewed journal.

Trial registration number: NCT04403789.

Keywords: diabetes & endocrinology; hypertension; occupational & industrial medicine; preventive medicine; public health.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Consolidated Standards of Reporting Trials flow diagram.
Figure 2
Figure 2
Schematic diagram for schedule of enrolment, interventions, and assessments. HbA1c, glycated haemoglobin; LDL, low-density lipoprotein.

References

    1. Kyu HH, Bachman VF, Alexander LT, et al. . Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the global burden of disease study 2013. BMJ 2016;354:i3857. 10.1136/bmj.i3857
    1. Virtanen M, Ervasti J, Head J, et al. . Lifestyle factors and risk of sickness absence from work: a multicohort study. Lancet Public Health 2018;3:e545–54. 10.1016/S2468-2667(18)30201-9
    1. Ding D, Lawson KD, Kolbe-Alexander TL, et al. . The economic burden of physical inactivity: a global analysis of major non-communicable diseases. Lancet 2016;388:1311–24. 10.1016/S0140-6736(16)30383-X
    1. Das P, Horton R. Physical activity—time to take it seriously and regularly. The Lancet 2016;388:1254–5. 10.1016/S0140-6736(16)31070-4
    1. Piercy KL, Troiano RP, Ballard RM, et al. . The physical activity guidelines for Americans. JAMA 2018;320:2020–8. 10.1001/jama.2018.14854
    1. Wisloff U, Lavie CJ. Taking physical activity, exercise, and fitness to a higher level. Prog Cardiovasc Dis 2017;60:1–2. 10.1016/j.pcad.2017.06.002
    1. WHO . Who guidelines on physical activity and sedentary behaviour, 2020. Available: [Accessed 7 Dec 2020].
    1. Fletcher GF, Landolfo C, Niebauer J, et al. . Promoting physical activity and exercise: JACC health promotion series. J Am Coll Cardiol 2018;72:1622–39. 10.1016/j.jacc.2018.08.2141
    1. Kraus WE, Bittner V, Appel L, Kraus William E, Vera B, Lawrence A, et al. . The National physical activity plan: a call to action from the American heart association. Circulation 2015;131:1932–40. 10.1161/CIR.0000000000000203
    1. Cannon CP. Cardiovascular disease and modifiable cardiometabolic risk factors. Clin Cornerstone 2007;8:11–28. 10.1016/S1098-3597(07)80025-1
    1. Nichols GA, Horberg M, Koebnick C, et al. . Cardiometabolic risk factors among 1.3 million adults with overweight or obesity, but not diabetes, in 10 geographically diverse regions of the United States, 2012-2013. Prev Chronic Dis 2017;14:E22. 10.5888/pcd14.160438
    1. Grundy Scott M, Stone Neil J, Bailey Alison L. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: Executive summary. Circulation 2018. 10.1161/CIR.0000000000000624
    1. Klein S, Allison DB, Heymsfield SB, et al. . Waist circumference and cardiometabolic risk: a consensus statement from shaping America's health: association for weight management and obesity prevention; NAASO, the obesity Society; the American Society for nutrition; and the American diabetes association. Diabetes Care 2007;30:1647–52. 10.2337/dc07-9921
    1. WHO . Who | waist circumference and waist–hip ratio. who, 2008. Available: [Accessed 12 Dec 2018].
    1. Arija V, Villalobos F, Pedret R, et al. . Effectiveness of a physical activity program on cardiovascular disease risk in adult primary health-care users: the "Pas-a-Pas" community intervention trial. BMC Public Health 2017;17:576. 10.1186/s12889-017-4485-3
    1. Heath GW, Parra DC, Sarmiento OL, et al. . Evidence-Based intervention in physical activity: lessons from around the world. Lancet 2012;380:272–81. 10.1016/S0140-6736(12)60816-2
    1. Marcus BH, Williams DM, Dubbert PM, Dubbert Patricia M, et al. . Physical activity intervention studies. Circulation 2006;114:2739–52. 10.1161/CIRCULATIONAHA.106.179683
    1. Dowell D, Farley TA. Prevention of non-communicable diseases in New York City. The Lancet 2012;380:1787–9. 10.1016/S0140-6736(12)60733-8
    1. WHO . Global action plan on physical activity 2018-2030, 2018. Available: [Accessed 16 Oct 2018].
    1. WHO . Interventions on diet and physical activity: what works : summary report, 2009. Available: [Accessed 9 Oct 2018].
    1. Proper KI, Staal BJ, Hildebrandt VH, et al. . Effectiveness of physical activity programs at worksites with respect to work-related outcomes. Scand J Work Environ Health 2002;28:75–84. 10.5271/sjweh.651
    1. Proper KI, Koning M, van der Beek AJ, et al. . The effectiveness of worksite physical activity programs on physical activity, physical fitness, and health. Clin J Sport Med 2003;13:106–17. 10.1097/00042752-200303000-00008
    1. Engbers LH, van Poppel MNM, Chin A Paw MJM, et al. . Worksite health promotion programs with environmental changes: a systematic review. Am J Prev Med 2005;29:61–70. 10.1016/j.amepre.2005.03.001
    1. Chau JY, der Ploeg HPvan, van Uffelen JGZ, et al. . Are workplace interventions to reduce sitting effective? A systematic review. Prev Med 2010;51:352–6. 10.1016/j.ypmed.2010.08.012
    1. Conn VS, Hafdahl AR, Cooper PS, et al. . Meta-Analysis of workplace physical activity interventions. Am J Prev Med 2009;37:330–9. 10.1016/j.amepre.2009.06.008
    1. Bergman F, Wahlström V, Stomby A, et al. . Treadmill workstations in office workers who are overweight or obese: a randomised controlled trial. Lancet Public Health 2018;3:e523–35. 10.1016/S2468-2667(18)30163-4
    1. Guazzi M, Faggiano P, Mureddu GF, et al. . Worksite health and wellness in the European Union. Prog Cardiovasc Dis 2014;56:508–14. 10.1016/j.pcad.2013.11.003
    1. Guthold R, Stevens GA, Riley LM, et al. . Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants. Lancet Glob Health 2018;6:e1077–86. 10.1016/S2214-109X(18)30357-7
    1. WHO . United Arab Emirates health profile 2015, 2016. Available:
    1. United Arab Emirates. vision 2021, 2010. Available: [Accessed 6 May 2019].
    1. Finucane FM, Sharp SJ, Purslow LR, et al. . The effects of aerobic exercise on metabolic risk, insulin sensitivity and intrahepatic lipid in healthy older people from the Hertfordshire cohort study: a randomised controlled trial. Diabetologia 2010;53:624–31. 10.1007/s00125-009-1641-z
    1. Klika B, Jordan C. High-Intensity circuit training using body weight: maximum results with minimal investment. ACSM’s Health & Fitness Journal 2013;17:8–13. 10.1249/FIT.0b013e31828cb1e8
    1. Irving BA, Davis CK, Brock DW, et al. . Effect of exercise training intensity on abdominal visceral fat and body composition. Med Sci Sports Exerc 2008;40:1863–72. 10.1249/MSS.0b013e3181801d40
    1. Molmen-Hansen HE, Stolen T, Tjonna AE, et al. . Aerobic interval training reduces blood pressure and improves myocardial function in hypertensive patients. Eur J Prev Cardiol 2012;19:151–60. 10.1177/1741826711400512
    1. Tomeleri CM, Ribeiro AS, Souza MF, et al. . Resistance training improves inflammatory level, lipid and glycemic profiles in obese older women: a randomized controlled trial. Exp Gerontol 2016;84:80–7. 10.1016/j.exger.2016.09.005
    1. Tomeleri CM, Souza MF, Burini RC, et al. . Resistance training reduces metabolic syndrome and inflammatory markers in older women: a randomized controlled trial. J Diabetes 2018;10:328–37. 10.1111/1753-0407.12614
    1. Tjønna AE, Ramos JS, Pressler A, et al. . EX-MET study: exercise in prevention on of metabolic syndrome - a randomized multicenter trial: rational and design. BMC Public Health 2018;18:437. 10.1186/s12889-018-5343-7
    1. Kim Y, Wijndaele K, Sharp SJ, et al. . Specific physical activities, sedentary behaviours and sleep as long-term predictors of accelerometer-measured physical activity in 91,648 adults: a prospective cohort study. Int J Behav Nutr Phys Act 2019;16:41. 10.1186/s12966-019-0802-9
    1. Doherty A, Jackson D, Hammerla N, et al. . Large scale population assessment of physical activity using wrist worn Accelerometers: the UK Biobank study. PLoS One 2017;12:e0169649. 10.1371/journal.pone.0169649
    1. International Physical Activity Questionnaire . IPAQ scoring protocol - International Physical Activity Questionnaire, 2005. Available: [Accessed 27 Jan 2019].
    1. Topp CW, Østergaard SD, Søndergaard S, et al. . The WHO-5 well-being index: a systematic review of the literature. Psychother Psychosom 2015;84:167–76. 10.1159/000376585
    1. Cheikh Ismail L, Osaili TM, Mohamad MN, et al. . Eating habits and lifestyle during COVID-19 Lockdown in the United Arab Emirates: a cross-sectional study. Nutrients 2020;12:3314. 10.3390/nu12113314
    1. Hopkins WG, Batterham AM, Rates E. Error rates, decisive outcomes and publication bias with several Inferential methods. Sports Med 2016;46:1563–73. 10.1007/s40279-016-0517-x
    1. Flynn R, Rotter T, Hartfield D, et al. . A realist evaluation to identify contexts and mechanisms that enabled and hindered implementation and had an effect on sustainability of a lean intervention in pediatric healthcare. BMC Health Serv Res 2019;19:912. 10.1186/s12913-019-4744-3
    1. Whelton PK, Carey RM, Aronow WS, et al. . 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. J Am Coll Cardiol 2018;71:e127–248. 10.1016/j.jacc.2017.11.006

Source: PubMed

3
Předplatit