Breaking up prolonged sitting reduces postprandial glucose and insulin responses

David W Dunstan, Bronwyn A Kingwell, Robyn Larsen, Genevieve N Healy, Ester Cerin, Marc T Hamilton, Jonathan E Shaw, David A Bertovic, Paul Z Zimmet, Jo Salmon, Neville Owen, David W Dunstan, Bronwyn A Kingwell, Robyn Larsen, Genevieve N Healy, Ester Cerin, Marc T Hamilton, Jonathan E Shaw, David A Bertovic, Paul Z Zimmet, Jo Salmon, Neville Owen

Abstract

Objective: Observational studies show breaking up prolonged sitting has beneficial associations with cardiometabolic risk markers, but intervention studies are required to investigate causality. We examined the acute effects on postprandial glucose and insulin levels of uninterrupted sitting compared with sitting interrupted by brief bouts of light- or moderate-intensity walking.

Research design and methods: Overweight/obese adults (n = 19), aged 45-65 years, were recruited for a randomized three-period, three-treatment acute crossover trial: 1) uninterrupted sitting; 2) seated with 2-min bouts of light-intensity walking every 20 min; and 3) seated with 2-min bouts of moderate-intensity walking every 20 min. A standardized test drink was provided after an initial 2-h period of uninterrupted sitting. The positive incremental area under curves (iAUC) for glucose and insulin (mean [95% CI]) for the 5 h after the test drink (75 g glucose, 50 g fat) were calculated for the respective treatments.

Results: The glucose iAUC (mmol/L) · h after both activity-break conditions was reduced (light: 5.2 [4.1-6.6]; moderate: 4.9 [3.8-6.1]; both P < 0.01) compared with uninterrupted sitting (6.9 [5.5-8.7]). Insulin iAUC (pmol/L) · h was also reduced with both activity-break conditions (light: 633.6 [552.4-727.1]; moderate: 637.6 [555.5-731.9], P < 0.0001) compared with uninterrupted sitting (828.6 [722.0-950.9]).

Conclusions: Interrupting sitting time with short bouts of light- or moderate-intensity walking lowers postprandial glucose and insulin levels in overweight/obese adults. This may improve glucose metabolism and potentially be an important public health and clinical intervention strategy for reducing cardiovascular risk.

Figures

Figure 1
Figure 1
Trial CONSORT diagram.
Figure 2
Figure 2
Study protocol. Std, standard.
Figure 3
Figure 3
The effect of the three trial conditions on postprandial plasma glucose levels (A); positive (5-h postprandial) glucose iAUC (B); postprandial serum insulin levels (C); and positive (5-h postprandial) iAUC (D). Data for postprandial plasma glucose and serum insulin levels represent mean ± SE. Data for glucose and insulin positive iAUC represent marginal means ± SE (adjusted for age, sex, body weight, period effects, and predrink levels). *Significantly different from uninterrupted sitting condition, P < 0.001. †Significantly different from uninterrupted sitting condition, P < 0.01.
Figure 3
Figure 3
The effect of the three trial conditions on postprandial plasma glucose levels (A); positive (5-h postprandial) glucose iAUC (B); postprandial serum insulin levels (C); and positive (5-h postprandial) iAUC (D). Data for postprandial plasma glucose and serum insulin levels represent mean ± SE. Data for glucose and insulin positive iAUC represent marginal means ± SE (adjusted for age, sex, body weight, period effects, and predrink levels). *Significantly different from uninterrupted sitting condition, P < 0.001. †Significantly different from uninterrupted sitting condition, P < 0.01.

References

    1. Dunstan DW, Barr EL, Healy GN, et al. Television viewing time and mortality: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Circulation 2010;121:384–391
    1. Patel AV, Bernstein L, Deka A, et al. Leisure time spent sitting in relation to total mortality in a prospective cohort of US adults. Am J Epidemiol 2010;172:419–429
    1. Healy GN, Dunstan DW, Salmon J, et al. Breaks in sedentary time: beneficial associations with metabolic risk. Diabetes Care 2008;31:661–666
    1. Healy GN, Matthews CE, Dunstan DW, Winkler EA, Owen N. Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003-06. Eur Heart J 2011;32:590–597
    1. Ceriello A, Esposito K, Piconi L, et al. Oscillating glucose is more deleterious to endothelial function and oxidative stress than mean glucose in normal and type 2 diabetic patients. Diabetes 2008;57:1349–1354
    1. Ceriello A, Quagliaro L, Piconi L, et al. Effect of postprandial hypertriglyceridemia and hyperglycemia on circulating adhesion molecules and oxidative stress generation and the possible role of simvastatin treatment. Diabetes 2004;53:701–710
    1. Esposito K, Nappo F, Marfella R, et al. Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation 2002;106:2067–2072
    1. Monnier L, Mas E, Ginet C, et al. Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. JAMA 2006;295:1681–1687
    1. O’Keefe JH, Bell DSH. Postprandial hyperglycemia/hyperlipidemia (postprandial dysmetabolism) is a cardiovascular risk factor. Am J Cardiol 2007;100:899–904
    1. Ceriello A, Davidson J, Hanefeld M, et al. International Prandial Glucose Regulation Study Group Postprandial hyperglycaemia and cardiovascular complications of diabetes: an update. Nutr Metab Cardiovasc Dis 2006;16:453–456
    1. Esposito K, Giugliano D, Nappo F, Marfella R, Campanian Postprandial Hyperglycemia Study Group Regression of carotid atherosclerosis by control of postprandial hyperglycemia in type 2 diabetes mellitus. Circulation 2004;110:214–219
    1. Hanefeld M, Fischer S, Schmechel H, et al. Diabetes Intervention Study. Multi-intervention trial in newly diagnosed NIDDM. Diabetes Care 1991;14:308–317
    1. Snell-Bergeon JK, Roman R, Rodbard D, et al. Glycaemic variability is associated with coronary artery calcium in men with type 1 diabetes: the Coronary Artery Calcification in Type 1 Diabetes study. Diabet Med 2010;27:1436–1442
    1. Gimeno-Orna JA, Castro-Alonso FJ, Boned-Juliani B, Lou-Arnal LM. Fasting plasma glucose variability as a risk factor of retinopathy in Type 2 diabetic patients. J Diabetes Complications 2003;17:78–81
    1. Shiraiwa T, Kaneto H, Miyatsuka T, et al. Post-prandial hyperglycemia is an important predictor of the incidence of diabetic microangiopathy in Japanese type 2 diabetic patients. Biochem Biophys Res Commun 2005;336:339–345
    1. Cavalot F, Petrelli A, Traversa M, et al. Postprandial blood glucose is a stronger predictor of cardiovascular events than fasting blood glucose in type 2 diabetes mellitus, particularly in women: lessons from the San Luigi Gonzaga Diabetes Study. J Clin Endocrinol Metab 2006;91:813–819
    1. Muggeo M, Verlato G, Bonora E, Zoppini G, Corbellini M, de Marco R. Long-term instability of fasting plasma glucose, a novel predictor of cardiovascular mortality in elderly patients with non-insulin-dependent diabetes mellitus: the Verona Diabetes Study. Circulation 1997;96:1750–1754
    1. Ceriello A, Colagiuri S, Gerich J, Tuomilehto J, Guideline Development Group Guideline for management of postmeal glucose. Nutr Metab Cardiovasc Dis 2008;18:S17–S33
    1. Aldred HE, Hardman AE, Taylor S. Influence of 12 weeks of training by brisk walking on postprandial lipemia and insulinemia in sedentary middle-aged women. Metabolism 1995;44:390–397
    1. Hughes VA, Fiatarone MA, Fielding RA, et al. Exercise increases muscle GLUT-4 levels and insulin action in subjects with impaired glucose tolerance. Am J Physiol 1993;264:E855–E862
    1. Perseghin G, Price TB, Petersen KF, et al. Increased glucose transport-phosphorylation and muscle glycogen synthesis after exercise training in insulin-resistant subjects. N Engl J Med 1996;335:1357–1362
    1. Healy GN, Dunstan DW, Salmon J, et al. Objectively measured light-intensity physical activity is independently associated with 2-h plasma glucose. Diabetes Care 2007;30:1384–1389
    1. Nygaard H, Tomten SE, Høstmark AT. Slow postmeal walking reduces postprandial glycemia in middle-aged women. Appl Physiol Nutr Metab 2009;34:1087–1092
    1. Stephens BR, Granados K, Zderic TW, Hamilton MT, Braun B. Effects of 1 day of inactivity on insulin action in healthy men and women: interaction with energy intake. Metabolism 2011;60:941–949
    1. Achten J, Jeukendrup AE. Effects of pre-exercise ingestion of carbohydrate on glycaemic and insulinaemic responses during subsequent exercise at differing intensities. Eur J Appl Physiol 2003;88:466–471
    1. Mikines KJ, Sonne B, Farrell PA, Tronier B, Galbo H. Effect of physical exercise on sensitivity and responsiveness to insulin in humans. Am J Physiol 1988;254:E248–E259
    1. Dunstan DW, Zimmet PZ, Welborn TA, et al. The rising prevalence of diabetes and impaired glucose tolerance: the Australian Diabetes, Obesity and Lifestyle Study. Diabetes Care 2002;25:829–834
    1. Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982;14:377–381
    1. Freedson PS, Melanson E, Sirard J. Calibration of the Computer Science and Applications, Inc. accelerometer. Med Sci Sports Exerc 1998;30:777–781
    1. Mills EJ, Chan AW, Wu P, Vail A, Guyatt GH, Altman DG. Design, analysis, and presentation of crossover trials. Trials 2009;10:27.
    1. Senn S. Cross-over Trials in Clinical Research. 2nd ed. Chichester, Wiley, 2002
    1. Ho SS, Dhaliwal SS, Hills A, Pal S. Acute exercise improves postprandial cardiovascular risk factors in overweight and obese individuals. Atherosclerosis 2011;214:178–184
    1. Ceriello A, Assaloni R, Da Ros R, et al. Effect of atorvastatin and irbesartan, alone and in combination, on postprandial endothelial dysfunction, oxidative stress, and inflammation in type 2 diabetic patients. Circulation 2005;111:2518–2524
    1. Haskell WL, Lee IM, Pate RR, et al. American College of Sports Medicine. American Heart Association Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation 2007;116:1081–1093
    1. Jennings G, Nelson L, Nestel P, et al. The effects of changes in physical activity on major cardiovascular risk factors, hemodynamics, sympathetic function, and glucose utilization in man: a controlled study of four levels of activity. Circulation 1986;73:30–40
    1. Jans MP, Proper KI, Hildebrandt VH. Sedentary behavior in Dutch workers: differences between occupations and business sectors. Am J Prev Med 2007;33:450–454
    1. Hamilton MT, Hamilton DG, Zderic TW. Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes 2007;56:2655–2667
    1. Levine JA, Schleusner SJ, Jensen MD. Energy expenditure of nonexercise activity. Am J Clin Nutr 2000;72:1451–1454
    1. Jones-Smith JC, Gordon-Larsen P, Siddiqi A, Popkin BM. Cross-national comparisons of time trends in overweight inequality by socioeconomic status among women using repeated cross-sectional surveys from 37 developing countries, 1989-2007. Am J Epidemiol 2011;173:667–675
    1. Owen N, Healy GN, Matthews CE, Dunstan DW. Too much sitting: the population health science of sedentary behavior. Exerc Sport Sci Rev 2010;38:105–113

Source: PubMed

Подписаться