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Kuo FC, Lin YT, Chueh TY, Chang YK, Hung TM, Chen YC. Breaking prolonged sitting increases 24-h physical activity and self-perceived energy levels but does not acutely affect cognition in healthy adults. Eur J Appl Physiol 2024; 124:445-455. [PMID: 37543544 DOI: 10.1007/s00421-023-05278-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 07/17/2023] [Indexed: 08/07/2023]
Abstract
INTRODUCTION It is unknown whether predetermined (un)interrupted sitting within a laboratory setting will induce compensatory changes in human behaviours (energy intake and physical activity) once people return to a free-living environment. The effects of breaking up prolonged sitting on cognition are also unclear. METHODS Twenty-four (male = 13) healthy participants [age 31 ± 8 y, BMI 22.7 ± 2.3 kg/m2 (mean ± SD)] completed 320 min mixed-feeding trials under prolonged sitting (SIT) or with 2 min walking at 6.4 km/h every 20 min (ACTIVE), in a randomised crossover design. Human behaviours were recorded post-trial under free-living conditions until midnight. Cognitive performance was evaluated before and immediately after SIT and ACTIVE trials. Self-perceived sensations (appetite, energy and mood) and finger prick blood glucose levels were collected at regular intervals throughout the trials. RESULTS There were no differences between trials in eating behaviour and spontaneous physical activity (both, p > 0.05) in free-living conditions, resulting in greater overall total step counts [11,680 (10740,12620) versus 6049 (4845,7253) steps] and physical activity energy expenditure (PAEE) over 24-h period in ACTIVE compared to SIT (all, p < 0.05). Greater self-perceived levels of energy and lower blood glucose iAUC were found in ACTIVE trial compared to SIT trial (both, p < 0.05). No differences were found in cognitive performance between trials (all, p > 0.05). CONCLUSION Breaking up sitting does not elicit subsequent behavioural compensation, resulting in greater 24-h step counts and PAEE in healthy adults. Breaking up sitting reduces postprandial glucose concentrations and elicits greater self-perceived energy levels, but these positive effects do not acutely translate into improved cognitive function.
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Affiliation(s)
- Feng-Chih Kuo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yun-Ting Lin
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, 162, Section 1, Heping E. Rd, Taipei, Taiwan
| | - Ting-Yu Chueh
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, 162, Section 1, Heping E. Rd, Taipei, Taiwan
| | - Yu-Kai Chang
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, 162, Section 1, Heping E. Rd, Taipei, Taiwan
| | - Tsung-Min Hung
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, 162, Section 1, Heping E. Rd, Taipei, Taiwan
| | - Yung-Chih Chen
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, 162, Section 1, Heping E. Rd, Taipei, Taiwan.
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Pinto AJ, Bergouignan A, Dempsey PC, Roschel H, Owen N, Gualano B, Dunstan DW. Physiology of sedentary behavior. Physiol Rev 2023; 103:2561-2622. [PMID: 37326297 PMCID: PMC10625842 DOI: 10.1152/physrev.00022.2022] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 05/10/2023] [Accepted: 06/14/2023] [Indexed: 06/17/2023] Open
Abstract
Sedentary behaviors (SB) are characterized by low energy expenditure while in a sitting or reclining posture. Evidence relevant to understanding the physiology of SB can be derived from studies employing several experimental models: bed rest, immobilization, reduced step count, and reducing/interrupting prolonged SB. We examine the relevant physiological evidence relating to body weight and energy balance, intermediary metabolism, cardiovascular and respiratory systems, the musculoskeletal system, the central nervous system, and immunity and inflammatory responses. Excessive and prolonged SB can lead to insulin resistance, vascular dysfunction, shift in substrate use toward carbohydrate oxidation, shift in muscle fiber from oxidative to glycolytic type, reduced cardiorespiratory fitness, loss of muscle mass and strength and bone mass, and increased total body fat mass and visceral fat depot, blood lipid concentrations, and inflammation. Despite marked differences across individual studies, longer term interventions aimed at reducing/interrupting SB have resulted in small, albeit marginally clinically meaningful, benefits on body weight, waist circumference, percent body fat, fasting glucose, insulin, HbA1c and HDL concentrations, systolic blood pressure, and vascular function in adults and older adults. There is more limited evidence for other health-related outcomes and physiological systems and for children and adolescents. Future research should focus on the investigation of molecular and cellular mechanisms underpinning adaptations to increasing and reducing/interrupting SB and the necessary changes in SB and physical activity to impact physiological systems and overall health in diverse population groups.
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Affiliation(s)
- Ana J Pinto
- Division of Endocrinology, Metabolism, and Diabetes, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Applied Physiology & Nutrition Research Group, Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Audrey Bergouignan
- Division of Endocrinology, Metabolism, and Diabetes, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Institut Pluridisciplinaire Hubert Curien, Centre National de la Recherche Scientifique, Université de Strasbourg, Strasbourg, France
| | - Paddy C Dempsey
- Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, United Kingdom
| | - Hamilton Roschel
- Applied Physiology & Nutrition Research Group, Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Neville Owen
- Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group, Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Food Research Center, University of Sao Paulo, Sao Paulo, Brazil
| | - David W Dunstan
- Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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GALE JENNIFERT, WEI DOROTHYL, HASZARD JILLIANJ, BROWN RACHELC, TAYLOR RACHAELW, PEDDIE MEREDITHC. Breaking Up Evening Sitting with Resistance Activity Improves Postprandial Glycemic Response: A Randomized Crossover Study. Med Sci Sports Exerc 2023; 55:1471-1480. [PMID: 36921112 PMCID: PMC10348652 DOI: 10.1249/mss.0000000000003166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
INTRODUCTION Interrupting sedentary time during the day reduces postprandial glycemia (a risk factor for cardiometabolic disease). However, it is not known if benefits exist for postprandial glucose, insulin and triglyceride responses in the evening, and if these benefits differ by body mass index (BMI) category. METHODS In a randomized crossover study, 30 participants (25.4 ± 5.4 yr old; BMI 18.5-24.9: n = 10, BMI 25-29.9: n = 10, BMI ≥30: n = 10) completed two intervention arms, beginning at ~1700 h: prolonged sitting for 4 h, and sitting with regular activity breaks of 3 min of resistance exercises every 30 min. Plasma glucose, insulin, and triglyceride concentrations were measured in response to two meals fed at baseline and 120 min. Four-hour incremental area under the curve was compared between interventions. Moderation by BMI status was explored. RESULTS Overall, when compared with prolonged sitting, regular activity breaks lowered plasma glucose and insulin incremental area under the curve by 31.5% (95% confidence interval = -49.3% to -13.8%) and 26.6% (-39.6% to -9.9%), respectively. No significant differences were found for plasma triglyceride area under the curve. Interactions between BMI status and intervention was not statistically significant. CONCLUSIONS Interventions that interrupt sedentary time in the evening may improve cardiometabolic health by some magnitude in all participants regardless of bodyweight.
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Affiliation(s)
- JENNIFER T. GALE
- Department of Human Nutrition, University of Otago, Dunedin, NEW ZEALAND
| | - DOROTHY L. WEI
- Department of Human Nutrition, University of Otago, Dunedin, NEW ZEALAND
| | | | - RACHEL C. BROWN
- Department of Human Nutrition, University of Otago, Dunedin, NEW ZEALAND
| | | | - MEREDITH C. PEDDIE
- Department of Human Nutrition, University of Otago, Dunedin, NEW ZEALAND
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Chandran O, Shruthi P, Sukumar S, Kadavigere R, Chakravarthy K, Rao CR, Chandrasekaran B. Effects of physical activity breaks during prolonged sitting on vascular and executive function—A randomised cross-over trial. J Taibah Univ Med Sci 2023; 18:1065-1075. [PMID: 36994221 PMCID: PMC10040888 DOI: 10.1016/j.jtumed.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/25/2023] [Accepted: 03/03/2023] [Indexed: 03/15/2023] Open
Abstract
Objectives High sedentary behaviour is associated with adverse effects on central vascular function and cognitive function. Although interventions to mitigate the adverse effects of workplace sitting are intriguing, evidence of the efficacy of such interventions remains lacking. This randomised cross-over trial was aimed at exploring the effectiveness of prolonged sitting, with or without physical activity breaks, on central, peripheral vascular and cognitive function in adults. Methods Twenty one healthy adults completed 4 h of simulated work conditions in three experimental visits: (1) uninterrupted sitting (SIT); (2) sitting interrupted by 3 min of walking every hour (LIT); and (3) sitting interrupted by 3 min of stair climbing every hour (MIT). Carotid (CA) and superficial femoral artery (SFA) diameter, velocity, shear rate and blood flow were measured with Duplex ultrasound at 50 MHz at three time points (hours 0, 2 and 4), and executive function was assessed with the computer based Eriksen Flanker task every hour. Results The decreases in reaction time (-30.59%) and accuracy (-10.56%) during SIT conditions were statistically significant, and less of a decrease was observed under LIT and MIT conditions. No significant differences in CA and SFA function were observed with LIT and MIT interventions. Conclusion Physical activity breaks of varying intensity during prolonged sitting improve reaction time. However, the vascular benefits of physical activity breaks should be confirmed in the future through long term studies in natural environment.
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Malin SK, Stewart NR, Ude AA, Alderman BL. Brain insulin resistance and cognitive function: influence of exercise. J Appl Physiol (1985) 2022; 133:1368-1380. [PMID: 36269295 PMCID: PMC9744647 DOI: 10.1152/japplphysiol.00375.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/12/2022] [Accepted: 10/12/2022] [Indexed: 12/15/2022] Open
Abstract
Exercise has systemic health benefits in people, in part, through improving whole body insulin sensitivity. The brain is an insulin-sensitive organ that is often underdiscussed relative to skeletal muscle, liver, and adipose tissue. Although brain insulin action may have only subtle impacts on peripheral regulation of systemic glucose homeostasis, it is important for weight regulation as well as mental health. In fact, brain insulin signaling is also involved in processes that support healthy cognition. Furthermore, brain insulin resistance has been associated with age-related declines in memory and executive function as well as Alzheimer's disease pathology. Herein, we provide an overview of brain insulin sensitivity in relation to cognitive function from animal and human studies, with particular emphasis placed on the impact exercise may have on brain insulin sensitivity. Mechanisms discussed include mitochondrial function, brain growth factors, and neurogenesis, which collectively help combat obesity-related metabolic disease and Alzheimer's dementia.
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Affiliation(s)
- Steven K Malin
- Department of Kinesiology & Health, Rutgers University, New Brunswick, New Jersey
- Division of Endocrinology, Metabolism & Nutrition, Rutgers University, New Brunswick, New Jersey
- New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, New Jersey
- Institute of Translational Medicine and Science, Rutgers University, New Brunswick, New Jersey
| | - Nathan R Stewart
- Department of Kinesiology & Health, Rutgers University, New Brunswick, New Jersey
| | - Andrew A Ude
- Department of Kinesiology & Health, Rutgers University, New Brunswick, New Jersey
| | - Brandon L Alderman
- Department of Kinesiology & Health, Rutgers University, New Brunswick, New Jersey
- Center of Alcohol and Substance Use Studies, Rutgers University, New Brunswick, New Jersey
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Pindus DM, Selzer-Ninomiya A, Nayak A, Pionke JJ, Raine LB. Effects of reducing sedentary behaviour duration by increasing physical activity, on cognitive function, brain function and structure across the lifespan: a systematic review protocol. BMJ Open 2022; 12:e046077. [PMID: 36270758 PMCID: PMC9594536 DOI: 10.1136/bmjopen-2020-046077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Greater engagement in sedentary behaviours has been related to poorer cognitive functions in epidemiological research. However, the effects of reducing sedentary behaviour duration on cognitive function, brain function, and structure remain poorly understood. This systematic review aims to synthesise the evidence on the effects of reducing sedentary behaviour duration by increasing time spent in physical activity on cognitive function, brain structure and function in apparently healthy children, adolescents and adults. METHODS AND ANALYSIS The protocol follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search will be conducted (search dates: August-September 2022) across six databases: PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (via EBSCO Host), PsycINFO (via ProQuest), SPORTDiscus and Web of Science (Science and Social Science Citation Index). The inclusion criteria are as follows: randomised and non-randomised experimental studies as defined by the Cochrane Handbook, published in English, in peer-reviewed journals, and as theses or dissertations. References of included papers will be screened for additional studies. Acute and chronic interventions targeting children (≥ 4 years), adolescents, younger adults (≥ 18-40 years), middle-aged (40-64 years) and older adults (65+ years) will be eligible. Methodological quality will be assessed with the Effective Public Health Practice Project quality assessment tool for quantitative studies. Qualitative synthesis will be stratified by intervention type (acute vs chronic), intervention content (reducing sedentary time or interrupting prolonged sitting) and outcome (cognitive, brain structure and function). ETHICS AND DISSEMINATION No primary data collection will be conducted as part of this systematic review. Study findings will be disseminated through peer-reviewed publications, conference presentations and social media. PROSPERO REGISTRATION NUMBER CRD42020200998.
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Affiliation(s)
- Dominika M Pindus
- Kinesiology and Community Health, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Ana Selzer-Ninomiya
- Kinesiology and Community Health, University of Illinois at Urbana-Champaign College of Applied Health Sciences, Champaign, Illinois, USA
| | - Apurva Nayak
- Molecular and Cellular Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - J J Pionke
- University Library, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Lauren B Raine
- Department of Psychology, Northeastern University, Boston, Massachusetts, USA
- Department of Medical Sciences, Department of Physical Therapy, Movement & Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA
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Dillon K, Morava A, Prapavessis H, Grigsby-Duffy L, Novic A, Gardiner PA. Total Sedentary Time and Cognitive Function in Middle-Aged and Older Adults: A Systematic Review and Meta-analysis. SPORTS MEDICINE - OPEN 2022; 8:127. [PMID: 36224459 PMCID: PMC9556686 DOI: 10.1186/s40798-022-00507-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 08/14/2022] [Indexed: 11/06/2022]
Abstract
Background An estimated 47 million people have dementia globally, and around 10 million new cases are diagnosed each year. Many lifestyle factors have been linked to cognitive impairment; one emerging modifiable lifestyle factor is sedentary time. Objective To conduct a systematic review and meta-analysis of peer-reviewed literature examining the association between total sedentary time with cognitive function in middle-aged and older adults under the moderating conditions of (a) type of sedentary time measurement; (b) the cognitive domain being assessed; (c) looking at sedentary time using categorical variables (i.e., high versus low sedentary time); and (d) the pattern of sedentary time accumulation (e.g., longer versus shorter bouts). We also aimed to examine the prevalence of sedentary time in healthy versus cognitively impaired populations and to explore how experimental studies reducing or breaking up sedentary time affect cognitive function. Lastly, we aimed to conduct a quantitative pooled analysis of all individual studies through meta-analysis procedures to derive conclusions about these relationships. Methods Eight electronic databases (EMBASE; Web of Science; PsycINFO; CINAHL; SciELO; SPORTDiscus; PubMed; and Scopus) were searched from inception to February 2021. Our search included terms related to the exposure (i.e., sedentary time), the population (i.e., middle-aged and older adults), and the outcome of interest (i.e., cognitive function). PICOS framework used middle-aged and older adults where there was an intervention or exposure of any sedentary time compared to any or no comparison, where cognitive function and/or cognitive impairment was measured, and all types of quantitative, empirical, observational data published in any year were included that were published in English. Risk of bias was assessed using QualSyst. Results Fifty-three studies including 83,137 participants met the inclusion criteria of which 23 studies had appropriate data for inclusion in the main meta-analysis. The overall meta-analysis suggested that total sedentary time has no association with cognitive function (r = −0.012 [95% CI − 0.035, 0.011], p = 0.296) with marked heterogeneity (I2 = 89%). Subgroup analyses demonstrated a significant negative association for studies using a device to capture sedentary time r = −0.035 [95% CI − 0.063, − 0.008], p = 0.012). Specifically, the domains of global cognitive function (r = −0.061 [95% CI − 0.100, − 0.022], p = 0.002) and processing speed (r = −0.067, [95% CI − 0.103, − 0.030], p < 0.001). A significant positive association was found for studies using self-report (r = 0.037 [95% CI − 0.019, 0.054], p < 0.001). Specifically, the domain of processing speed showed a significant positive association (r = 0.057 [95% CI 0.045, 0.069], p < 0.001). For prevalence, populations diagnosed with cognitive impairment spent significantly more time sedentary compared to populations with no known cognitive impairments (standard difference in mean = −0.219 [95% CI − 0.310, − 0.128], p < 0.001). Conclusions The association of total sedentary time with cognitive function is weak and varies based on measurement of sedentary time and domain being assessed. Future research is needed to better categorize domains of sedentary behaviour with both a validated self-report and device-based measure in order to improve the strength of this relationship. PROSPERO registration number: CRD42018082384. Supplementary Information The online version contains supplementary material available at 10.1186/s40798-022-00507-x.
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Affiliation(s)
- Kirsten Dillon
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, The University of Western Ontario, Kinesiology, London, ON Canada
| | - Anisa Morava
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, The University of Western Ontario, Kinesiology, London, ON Canada
| | - Harry Prapavessis
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, The University of Western Ontario, Kinesiology, London, ON Canada
| | - Lily Grigsby-Duffy
- grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Australia ,grid.1021.20000 0001 0526 7079Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, VIC 3220 Australia
| | - Adam Novic
- grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Australia ,grid.1022.10000 0004 0437 5432School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Paul A. Gardiner
- grid.39381.300000 0004 1936 8884Faculty of Health Sciences, The University of Western Ontario, Kinesiology, London, ON Canada ,grid.1003.20000 0000 9320 7537The University of Queensland, Brisbane, Australia ,grid.1048.d0000 0004 0473 0844Faculty of Health, Engineering and Sciences, The University of Southern Queensland, Brisbane, Australia
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Li J, Herold F, Ludyga S, Yu Q, Zhang X, Zou L. The acute effects of physical exercise breaks on cognitive function during prolonged sitting: The first quantitative evidence. Complement Ther Clin Pract 2022; 48:101594. [DOI: 10.1016/j.ctcp.2022.101594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/04/2022] [Accepted: 04/12/2022] [Indexed: 01/02/2023]
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Leg Fidgeting Improves Executive Function following Prolonged Sitting with a Typical Western Meal: A Randomized, Controlled Cross-Over Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031357. [PMID: 35162381 PMCID: PMC8834958 DOI: 10.3390/ijerph19031357] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/20/2022] [Accepted: 01/22/2022] [Indexed: 12/02/2022]
Abstract
Prolonged uninterrupted sitting and a typical Western meal, high in fat and refined sugar, can additively impair cognitive and cerebrovascular functions. However, it is unknown whether interrupting these behaviours, with a simple desk-based activity, can attenuate the impairment. The aim of this study was to determine whether regular leg fidgeting can off-set the detrimental effects of prolonged sitting following the consumption of a typical Western meal, on executive and cerebrovascular function. Using a randomized cross-over design, 13 healthy males consumed a Western meal and completed 180-min of prolonged sitting with leg fidgeting of 1 min on/4 min off (intervention [INT]) and without (control [CON]). Cognitive function was assessed pre and post sitting using the Trail Maker Test (TMT) parts A and B. Common carotid artery (CCA) blood flow, as an index of brain flow, was measured pre and post, and cerebral (FP1) perfusion was measured continuously. For TMT B the CON trial significantly increased (worsened) completion time (mean difference [MD] = 5.2 s, d = 0.38), the number of errors (MD = 3.33, d = 0.68) and cognitive fatigue (MD = 0.73, d = 0.92). Compared to CON, the INT trial significantly improved completion time (MD = 2.3 s, d = 0.97), and prevented declines in cognitive fatigue and a reduction in the number of errors. No significant changes in cerebral perfusion or CCA blood flow were found. Leg fidgeting for 1-min on/4-min off following a meal high in fats and refined sugars attenuated the impairment in executive function. This attenuation in executive function may not be caused by alterations in CCA blood flow or cerebral perfusion.
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