Original ArticleRegular 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
Graphical abstract
Introduction
Sedentary behavior increases the risk of all-cause mortality, cardiovascular disease, and type II diabetes.1, 2 The association is attenuated by physical activity, but disappears only in those who exceed 60 to 70 minutes of physical activity per day.3 The pattern in which sedentary time is accumulated may also contribute to disease risk. Extended periods of sitting are associated with larger waist circumferences and higher 2-hour plasma glucose concentrations compared with similar durations of sedentary time regularly interrupted with activity.4, 5
The lack of an association between breaks in sedentary behavior and conventional risk factors for heart disease and diabetes, such as fasting insulin and cholesterol concentrations,4, 5 has focused attention on the possibility that the health effects of interrupting sedentary behavior may be mediated primarily through effects on postprandial metabolism. Indeed, current experimental evidence indicates that breaking prolonged sitting with ∼2 to 5 minutes of light or moderate intensity activity every 20 to 30 minutes lowers postprandial glucose and insulin responses, when the activity is performed during the postprandial period.6, 7, 8, 9, 10, 11, 12
Continuous or intermittent (3 × 10 minutes) bouts of physical activity exert strong effects on postprandial lipidemia, with the triglyceride-lowering effects occurring most consistently when measured 12 to 24 hours after the initiation of a physical activity pattern.13 However, to date, the results of the vast majority of studies indicate that aerobically based regular activity breaks (2–5 minutes every 20–30 minutes) do not affect postprandial triglyceride responses.6, 7, 9, 11, 12, 14 The discrepancy may arise because in the later studies, there is no time gap between the regular activity breaks and measurement of postprandial triglyceride concentrations; whereas in the former, the effects have been measured 12 to 24 hours after the initiation of activity.
It seems that regularly performed, short bouts of activity exert immediate effects on glucose and insulin, but effects on postprandial triglyceride concentrations may be delayed. Therefore, the aim of this study was to compare the effects of prolonged sitting and regular activity breaks (2 minutes every 30 minutes) with or without an additional 30 minutes of continuous physical activity on the afternoon of Day 1, on postprandial metabolism measured on the morning of Day 2.
Section snippets
Study design
This randomized, crossover trial took place at the University of Otago, in Dunedin, New Zealand, between June 2014 and November 2016. The trial was approved by the University of Otago Human Ethics Committee (approval number 13/112), and written informed consent was obtained from all participants before screening. The study is registered with the Australian New Zealand Clinical Trial Registry (ANZCTR12614000624684).
Participants
Participants were recruited through the distribution of e-mails and
Results
Of the 42 participants who were scheduled to participate, 6 withdrew after randomization; 2 did not complete the first session, a further 2 withdrew after completing the first session and 2 completed both the first and second sessions but did not complete the third (see Fig. 1). Thirty-six participants completed all 4 interventions sessions and were included in the final analysis. Participant characteristics at the time of recruitment are summarized in Table 1.
The mean percent of maximal
Discussion
Performing regular activity breaks—2 minutes of moderate intensity walking every 30 minutes—both the day before and during the postprandial measurement period, lowered postprandial triglyceride response, as measured by tAUC, in healthy, normal weight individuals. This effect occurred regardless of whether regular activity breaks were performed alone or in combination with a 30-minute continuous bout of physical activity the afternoon before the postprandial measurement period. Performing a
Conclusion
Requiring participants to perform regular activity breaks both the day before and during the postprandial period is a unique aspect of the study and more accurately reflects the pattern of activity that should be performed if avoidance of prolonged sitting is considered to be an important health message. The intervention that combines a 30-minute bout of continuous of physical activity with regular activity breaks most closely represents the pattern of activity currently being recommended in
Acknowledgement
The authors thank Glenna Paterson, Andrea Samson, and Angel Temple, Research Nurses (Department of Human Nutrition, University of Otago, Dunedin, New Zealand), who inserted the cannulas and assisted with the blood collection; Ashley Duncan and Michelle Harper, Laboratory Technicians (Department of Human Nutrition, University of Otago, Dunedin, New Zealand), who advised and assisted with the laboratory analyses; Grace Allen and Hannah Gentle, Research Assistants (Department of Human Nutrition,
References (31)
- 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
Lancet
(2016) - et al.
Breaking up prolonged sitting with light-intensity walking improves postprandial glycemia, but breaking up sitting with standing does not
J Sci Med Sport
(2015) - et al.
Multiple short bouts of exercise over 12-h period reduce glucose excursions more than an energy-matched single bout of exercise
Metabolism
(2014) - et al.
Breaking prolonged sitting reduces postprandial glycemia in healthy, normal-weight adults: a randomized crossover trial
Am J Clin Nutr
(2013) - et al.
Physical activity and postprandial lipidemia: are energy expenditure and lipoprotein lipase activity the real modulators of the positive effect?
Prog Lipid Res
(2012) - et al.
A spectrophotometric method for the determination of free fatty acid in serum using acyl-coenzyme A synthetase and acyl-coenzyme A oxidase
Anal Biochem
(1983) - et al.
Retention of chylomicron remnants by arterial tissue; Importance of an efficient clearance mechanism from plasma
Atherosclerosis
(1998) - et al.
Television viewing time and mortality: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab)
Circulation
(2010) - et al.
Television viewing and risk of type II diabetes, cardiovascular disease, and all-cause mortality: a meta-analysis
J Am Med Assoc
(2011) - et al.
Breaks in sedentary time: beneficial associations with metabolic risk
Diabetes Care
(2008)
Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003-06
Eur Heart J
Benefits for Type 2 diabetes of interrupting prolonged sitting with brief bouts of light walking or simple resistance activities
Diabetes Care
Breaking up prolonged sitting reduces postprandial glucose and insulin responses
Diabetes Care
Breaking up prolonged sitting with standing or walking attenuates the postprandial metabolic response in postmenopausal women: a randomized acute study
Diabetes Care
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
Clin Sci
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