What is the effect of interrupting prolonged sitting with frequent bouts of physical activity or standing on first or recurrent stroke risk factors? A scoping review

Paul Mackie, Ishanka Weerasekara, Gary Crowfoot, Heidi Janssen, Elizabeth Holliday, David Dunstan, Coralie English, Paul Mackie, Ishanka Weerasekara, Gary Crowfoot, Heidi Janssen, Elizabeth Holliday, David Dunstan, Coralie English

Abstract

The objective of this review was to ascertain the scope of the available literature on the effects of interrupting prolonged sitting time with frequent bouts of physical activity or standing on stroke and recurrent stroke risk factors. Databases Medline, Embase, AMED, CINAHL and Cochrane library were comprehensively searched from inception until 21st February 2018. Experimental trials which interrupted sitting time with frequent bouts of physical activity or standing in adults (≥ 18 years) were included. Comparison to a bout of prolonged sitting and a measure of at least one first or recurrent stroke risk factor was required to be included. Overall, 30 trials (35 articles) were identified to meet the inclusion criteria. Fifteen trials were completed in participants at an increased risk of having a first stroke and one trial in participants at risk of a recurrent stroke. Outcomes of hypertension and dysglycemia were found to be more favourable following predominately light- to moderate-intensity bouts of physical activity or standing compared to sitting in the majority of trials in participants at risk of having a first stroke. In the one trial of stroke survivors, only outcomes of hypertension were significantly improved. These findings are of significant importance taking into consideration hypertension is the leading risk factor for first and recurrent stroke. However, trials primarily focused on measuring outcomes of dysglycemia and without assessing a dose-response effect. Additional research is required on the dose-response effect of interrupting sitting with frequent bouts of physical activity or standing on first and recurrent stroke risk factors, in those high risk population groups.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Flow chart of database search.
Fig 1. Flow chart of database search.

References

    1. Petersen CB, Bauman A, Grønbæk M, Helge JW, Thygesen LC, Tolstrup JS. Total sitting time and risk of myocardial infarction, coronary heart disease and all-cause mortality in a prospective cohort of Danish adults. International Journal of Behavioral Nutrition and Physical Activity. 2014;11(1):13 10.1186/1479-5868-11-13
    1. Katzmarzyk PT, Church TS, Craig CL, Bouchard C. Sitting time and mortality from all causes, cardiovascular disease, and cancer. Medicine & Science in Sports & Exercise. 2009;41(5):998–1005.
    1. Wilmot E, Edwardson C, Achana F, Davies M, Gorely T, Gray L, et al. Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis. Diabetologia. 2012;55:2895–905. 10.1007/s00125-012-2677-z
    1. Jette M, Sidney K, Blümchen G. Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity. Clinical cardiology. 1990;13(8):555–65. 10.1002/clc.4960130809
    1. Ekelund U, Steene-Johannessen J, Brown WJ, Fagerland MW, Owen N, Powell KE, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. The Lancet. 2016.
    1. English C, Healy GN, Coates A, Lewis L, Olds T, Bernhardt J. Sitting and activity time in people with stroke. Phys Ther. 2016;96(2):193 10.2522/ptj.20140522
    1. Butler EN, Evenson KR. Prevalence of physical activity and sedentary behavior among stroke survivors in the United States. Top Stroke Rehabil. 2014;21(3):246–55. 10.1310/tscir2101-246 .
    1. O'Donnell MJ, Chin SL, Rangarajan S, Xavier D, Liu L, Zhang H, et al. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. The Lancet. 2016;388(10046):761–75. 10.1016/S0140-6736(16)30506-2
    1. Turan TN, Nizam A, Lynn MJ, Egan BM, Le N-A, Lopes-Virella MF, et al. Relationship between risk factor control and vascular events in the SAMMPRIS trial. Neurology. 2017;88(4):379–85. 10.1212/WNL.0000000000003534 .
    1. Lee CD, Folsom AR, Blair SN. Physical Activity and Stroke Risk. Stroke. 2003;34(10):2475–81. 10.1161/01.STR.0000091843.02517.9D
    1. Flemming KD, Brown RD Jr, editors. Secondary prevention strategies in ischemic stroke: identification and optimal management of modifiable risk factors Mayo Clinic Proceedings; 2004: Elsevier.
    1. Dunstan DW, Kingwell BA, Larsen R, Healy GN, Cerin E, Hamilton MT, et al. Breaking up prolonged sitting reduces postprandial glucose and insulin responses. Diabetes Care. 2012;35(5):976–83. Epub 2012/03/01. 10.2337/dc11-1931
    1. Dempsey PC, Sacre JW, Larsen RN, Straznicky NE, Sethi P, Cohen ND, et al. Interrupting prolonged sitting with brief bouts of light walking or simple resistance activities reduces resting blood pressure and plasma noradrenaline in type 2 diabetes. J Hypertens. 2016;34(12):2376–82. 10.1097/HJH.0000000000001101
    1. Zeigler ZS, Mullane SL, Crespo NC, Buman MP, Gaesser GA. Effects of Standing and Light-Intensity Activity on Ambulatory Blood Pressure. Medicine and science in sports and exercise. 2016;48(2):175–81. 10.1249/MSS.0000000000000754
    1. Larsen R, Kingwell B, Sethi P, Cerin E, Owen N, Dunstan D. Breaking up prolonged sitting reduces resting blood pressure in overweight/obese adults. Nutrition, Metabolism and Cardiovascular Diseases. 2014;24(9):976–82. 10.1016/j.numecd.2014.04.011
    1. Dempsey PC, Sacre JW, Larsen RN, Straznicky NE, Sethi P, Cohen ND, et al. Interrupting prolonged sitting with brief bouts of light walking or simple resistance activities reduces resting blood pressure and plasma noradrenaline in type 2 diabetes. Journal of Hypertension. 2016;34(12):2376–82. 10.1097/HJH.0000000000001101 .
    1. Dempsey P, Sacre J, Straznicky N, Lambert G, Cohen N, Owen N, et al. Interrupting prolonged sitting reduces resting blood pressure and plasma norepinephrine in adults with type 2 diabetes 2015; 132(no pagination). Available from: .
    1. Henson J, Davies M, Bodicoat D, Edwardson C, Gill J, Stensel D, et al. Breaking Up Prolonged Sitting With Standing or Walking Attenuates the Postprandial Metabolic Response in Postmenopausal Women: A Randomized Acute Study 2016; 39(1):[130–8 pp.]. Available from: 10.2337/dc15-1240
    1. Peddie M, Bone J, Rehrer N, Skeaff C, Gray A, Perry T. Breaking prolonged sitting reduces postprandial glycemia in healthy, normal-weight adults: a randomized crossover trial 2013; 98(2):[358–66 pp.]. Available from: .
    1. English C, Janssen H, Crowfoot G, Bourne J, Callister R, Dunn A, et al. Frequent, short bouts of light-intensity exercises while standing decreases systolic blood pressure: Breaking Up Sitting Time after Stroke (BUST-Stroke) trial. International journal of stroke. 2018.
    1. Chastin SFM, De Craemer M, De Cocker K, Powell L, Van Cauwenberg J, Dall P, et al. How does light-intensity physical activity associate with adult cardiometabolic health and mortality? Systematic review with meta-analysis of experimental and observational studies. British Journal of Sports Medicine. 2018. 10.1136/bjsports-2017-097563
    1. Keadle SK, Conroy DE, Buman MP, Dunstan DW, Matthews CE. Targeting Reductions in Sitting Time to Increase Physical Activity and Improve Health. Medicine and science in sports and exercise. 2017;49(8):1572–82. 10.1249/MSS.0000000000001257 .
    1. Chastin SF, Egerton T, Leask C, Stamatakis E. Meta‐analysis of the relationship between breaks in sedentary behavior and cardiometabolic health. Obesity. 2015;23(9):1800–10. 10.1002/oby.21180
    1. Benatti FB, Ried-Larsen M. The effects of breaking up prolonged sitting time: a review of experimental studies. Medicine & Science in Sports & Exercise. 2015;47(10):2053–61.
    1. Arksey H, O'Malley L. Scoping studies: towards a methodological framework. International journal of social research methodology. 2005;8(1):19–32.
    1. Levac D, Colquhoun H, O'Brien KK. Scoping studies: advancing the methodology. Implementation Science. 2010;5(1):69.
    1. Feigin VL, Roth GA, Naghavi M, Parmar P, Krishnamurthi R, Chugh S, et al. Global burden of stroke and risk factors in 188 countries, during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet Neurology. 2016;15(9):913–24. 10.1016/S1474-4422(16)30073-4
    1. Glasser SP, Halberg DL, Sands CD, Mosher A, Muntner PM, Howard G. Is Pulse Pressure an Independent Risk Factor for Incident Stroke, REasons for Geographic And Racial Differences in Stroke. American Journal of Hypertension. 2015;28(8):987–94. 10.1093/ajh/hpu265 PubMed PMID: PMC4542637.
    1. MEMBERS WG, Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, et al. Heart disease and stroke statistics—2017 update: a report from the American Heart Association. Circulation. 2017;135(10):e146 10.1161/CIR.0000000000000485
    1. English C, Janssen H, Crowfoot G, Callister R, Dunn A, Mackie P, et al. Breaking up sitting time after stroke (BUST-stroke). International journal of stroke. 2018:1747493018801222.
    1. Engeroff T, Fuzeki E, Vogt L, Banzer W. Breaking up sedentary time, physical activity and lipoprotein metabolism. Journal of Science and Medicine in Sport. 2017;20(7):678–83. 10.1016/j.jsams.2016.11.018 .
    1. Altenburg T, Rotteveel J, Dunstan D, Salmon J, Chinapaw M. The effect of interrupting prolonged sitting time with short, hourly, moderate-intensity cycling bouts on cardiometabolic risk factors in healthy, young adults 2013; 115(12):[1751–6 pp.]. Available from: .
    1. Bhammar DM, Sawyer BJ, Tucker WJ, Gaesser GA. Breaks in Sitting Time: Effects on Continuously Monitored Glucose and Blood Pressure. Medicine & Science in Sports & Exercise. 2017;49(10):2119–30. 10.1249/MSS.0000000000001315 .
    1. Kerr J, Crist K, Vital DG, Dillon L, Aden SA, Trivedi M, et al. Acute glucoregulatory and vascular outcomes of three strategies for interrupting prolonged sitting time in postmenopausal women: A pilot, laboratory-based, randomized, controlled, 4-condition, 4-period crossover trial. PLoS ONE [Electronic Resource]. 2017;12 (11) (no pagination)(e0188544). 10.1371/journal.pone.0188544 .
    1. Larsen R, Kingwell B, Robinson C, Hammond L, Cerin E, Shaw J, et al. Breaking up of prolonged sitting over three days sustains, but does not enhance, lowering of postprandial plasma glucose and insulin in overweight and obese adults 2015; 129(2):[117–27 pp.]. Available from: 10.1042/CS20140790
    1. Larsen R, Kingwell B, Sethi P, Cerin E, Owen N, Dunstan D. Breaking up prolonged sitting reduces resting blood pressure in overweight/obese adults 2014; 24(9):[976–82 pp.]. Available from: .
    1. Latouche C, Jowett J, Carey A, Bertovic D, Owen N, Dunstan D, et al. Effects of breaking up prolonged sitting on skeletal muscle gene expression 2013; 114(4):[453–60 pp.]. Available from: .
    1. McCarthy M, Edwardson CL, Davies MJ, Henson J, Rowlands A, King JA, et al. Breaking up sedentary time with seated upper body activity can regulate metabolic health in obese high-risk adults: A randomized crossover trial. Diabetes, Obesity and Metabolism. 2017;19(12):1732–9. 10.1111/dom.13016 .
    1. McCarthy M, Edwardson CL, Davies MJ, Henson J, Bodicoat DH, Khunti K, et al. Fitness Moderates Glycemic Responses to Sitting and Light Activity Breaks. Medicine & Science in Sports & Exercise. 2017;49(11):2216–22. 10.1249/MSS.0000000000001338 .
    1. Bailey D, Broom D, Chrismas B, Taylor L, Flynn E, Hough J. Breaking up prolonged sitting time with walking does not affect appetite or gut hormone concentrations but does induce an energy deficit and suppresses postprandial glycaemia in sedentary adults 2016; 41(3):[324–31 pp.]. Available from: .
    1. Bailey D, Locke C. Breaking up prolonged sitting with light-intensity walking improves postprandial glycemia, but breaking up sitting with standing does not 2015; 18(3):[294–8 pp.]. Available from: 10.1016/j.jsams.2014.03.008
    1. Barone Gibbs B, Kowalsky RJ, Perdomo SJ, Taormina JM, Balzer JR, Jakicic JM. Effect of alternating standing and sitting on blood pressure and pulse wave velocity during a simulated workday in adults with overweight/obesity. Journal of Hypertension. 2017;35(12):2411–8. 10.1097/HJH.0000000000001463 .
    1. Benatti FB, Larsen SA, Kofoed K, Nielsen ST, Harder-Lauridsen NM, Lyngbaek MP, et al. Intermittent Standing but not a Moderate Exercise Bout Reduces Postprandial Glycemia. Medicine & Science in Sports & Exercise. 2017;49(11):2305–14. 10.1249/MSS.0000000000001354 .
    1. Dempsey P, Larsen R, Sethi P, Sacre J, Straznicky N, Cohen N, et al. Benefits for Type 2 Diabetes of Interrupting Prolonged Sitting With Brief Bouts of Light Walking or Simple Resistance Activities 2016; 39(6):[964–72 pp.]. Available from: 10.2337/dc15-2336
    1. Dempsey P, Blankenship J, Larsen R, Sacre J, Sethi P, Straznicky N, et al. Interrupting prolonged sitting in type 2 diabetes: nocturnal persistence of improved glycaemic control 2017; 60(3):[499–507 pp.]. Available from: .
    1. Dijk J, Venema M, Mechelen W, Stehouwer C, Hartgens F, Loon L. Effect of moderate-intensity exercise versus activities of daily living on 24-hour blood glucose homeostasis in male patients with type 2 diabetes 2013; 36(11):[3448–53 pp.]. Available from: .
    1. Homer AR, Fenemor SP, Perry TL, Rehrer NJ, Cameron CM, Skeaff CM, et al. Regular activity breaks combined with physical activity improve postprandial plasma triglyceride, nonesterified fatty acid, and insulin responses in healthy, normal weight adults: A randomized crossover trial. Journal of Clinical Lipidology. 2017. 10.1016/j.jacl.2017.06.007 .
    1. Pulsford R, Blackwell J, Hillsdon M, Kos K. Intermittent walking, but not standing, improves postprandial insulin and glucose relative to sustained sitting: a randomised cross-over study in inactive middle-aged men 2017; 20(3):[278–83 pp.]. Available from: 10.1016/j.jsams.2016.08.012
    1. Thorp A, Kingwell B, Sethi P, Hammond L, Owen N, Dunstan D. Alternating bouts of sitting and standing attenuate postprandial glucose responses 2014; 46(11):[2053–61 pp.]. Available from: .
    1. Wennberg P, Boraxbekk CJ, Wheeler M, Howard B, Dempsey PC, Lambert G, et al. Acute effects of breaking up prolonged sitting on fatigue and cognition: a pilot study. BMJ Open. 2016;6(2):e009630 10.1136/bmjopen-2015-009630 .
    1. Brocklebank LA, Andrews RC, Page A, Falconer CL, Leary S, Cooper A. The Acute Effects of Breaking Up Seated Office Work With Standing or Light-Intensity Walking on Interstitial Glucose Concentration: A Randomized Crossover Trial. Journal of Physical Activity & Health. 2017;14(8):617–25. 10.1123/jpah.2016-0366 .
    1. Carter SE, Gladwell VF. Effect of breaking up sedentary time with callisthenics on endothelial function. Journal of Sports Sciences. 2017;35(15):1508–14. 10.1080/02640414.2016.1223331 . Language: English. Entry Date: 20170511. Revision Date: 20170513. Publication Type: Article. Journal Subset: Allied Health.
    1. Hansen R, Andersen J, Vinther A, Pielmeier U, Larsen R. Breaking up Prolonged Sitting does not Alter Postprandial Glycemia in Young, Normal-Weight Men and Women 2016; 37(14):[1097–102 pp.]. Available from: 10.1055/s-0042-113466
    1. Hawari NSA, Al-Shayji I, Wilson J, Gill JMR. Frequency of Breaks in Sedentary Time and Postprandial Metabolic Responses. Medicine & Science in Sports & Exercise. 2016;48(12):2495–502. 10.1249/MSS.0000000000001034 . Language: English. Entry Date: 20170103. Revision Date: 20170103. Publication Type: Article. Journal Subset: Allied Health.
    1. Holmstrup M, Fairchild T, Keslacy S, Weinstock R, Kanaley J. Multiple short bouts of exercise over 12-h period reduce glucose excursions more than an energy-matched single bout of exercise. Metabolism. 2014;63(4):510–9. 10.1016/j.metabol.2013.12.006 .
    1. Il-Young K, Sanghee P, Trombold JR, Coyle EF. Effects of Moderate- and Intermittent Low-Intensity Exercise on Postprandial Lipemia. Medicine & Science in Sports & Exercise. 2014;46(10):1882–90. 10.1249/MSS.0000000000000324 . Language: English. Entry Date: 20140929. Revision Date: 20150712. Publication Type: Journal Article.
    1. Miyashita M, Park J, Takahashi M, Suzuki K, Stensel D, Nakamura Y. Postprandial lipaemia: effects of sitting, standing and walking in healthy normolipidaemic humans 2013; 34(1):[21–7 pp.]. Available from: .
    1. Miyashita M, Edamoto K, Kidokoro T, Yanaoka T, Kashiwabara K, Takahashi M, et al. Interrupting Sitting Time with Regular Walks Attenuates Postprandial Triglycerides. Int J Sports Med. 2016;37(2):97–103. 10.1055/s-0035-1559791 .
    1. Kissela BM, Khoury JC, Alwell K, Moomaw CJ, Woo D, Adeoye O, et al. Age at stroke: temporal trends in stroke incidence in a large, biracial population. Neurology. 2012;79(17):1781–7. 10.1212/WNL.0b013e318270401d
    1. Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. The Lancet. 2014;383(9913):245–55.
    1. Billinger SA, Arena R, Bernhardt J, Eng JJ, Franklin BA, Johnson CM, et al. Physical activity and exercise recommendations for stroke survivors: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(8):2532–53. 10.1161/STR.0000000000000022
    1. Dempsey PC, Larsen RN, Dunstan DW, Owen N, Kingwell BA. Sitting Less and Moving More: Implications for Hypertension. Hypertension (Dallas, Tex: 1979). 2018;72(5):1037–46. Epub 2018/10/26. 10.1161/hypertensionaha.118.11190 .
    1. Thomas DE, Elliott EJ, Naughton GA. Exercise for type 2 diabetes mellitus. The Cochrane database of systematic reviews. 2006;(3):Cd002968 Epub 2006/07/21. 10.1002/14651858.CD002968.pub2 .
    1. MacLeod SF, Terada T, Chahal BS, Boule NG. Exercise lowers postprandial glucose but not fasting glucose in type 2 diabetes: a meta-analysis of studies using continuous glucose monitoring. Diabetes/metabolism research and reviews. 2013;29(8):593–603. Epub 2013/09/17. 10.1002/dmrr.2461 .
    1. Imano H, Iso H, Kitamura A, Yamagishi K, Hayama-Terada M, Muraki I, et al. Nonfasting Glucose and Incident Stroke and Its Types― The Circulatory Risk in Communities Study (CIRCS) ―. Circulation Journal. 2018;advpub. 10.1253/circj.CJ-17-0950
    1. Mabire L. Physical activity guidelines for weight loss: global and national perspectives. British Journal of Sports Medicine. 2016;50(20):1235–6. 10.1136/bjsports-2015-095863
    1. Reina SA, Llabre MM, Allison MA, Wilkins JT, Mendez AJ, Arnan MK, et al. HDL cholesterol and stroke risk: the Multi-Ethnic Study of Atherosclerosis. Atherosclerosis. 2015;243(1):314–9. 10.1016/j.atherosclerosis.2015.09.031

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa