Frequency of interruptions to prolonged sitting and postprandial metabolic responses in young, obese, Chinese men

Optimal Frequency of Interrupting Prolonged Sitting for Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Crossover Trials

Increasing evidence highlights the efficacy of interruptions in prolonged sitting (i.e., activity/sedentary breaks) for improving cardiometabolic health, but precise conclusions and recommendations regarding the optimal interruption frequency remain poorly defined. This systematic review and meta-analysis aimed to directly compare the effect of different frequencies of interrupting prolonged sitting on cardiometabolic health and to determine potential moderators. Randomized crossover trials with at least two frequency interruptions compared to a prolonged sitting condition were identified via systematic review. We compared the acute effects of high-frequency (≤ 30 min per bout, HF) versus low-frequency (> 30 min per bout, LF) interruption protocols on various cardiometabolic health outcomes via three-level meta-analysis with pooled effects evaluated within a random-effects model and exploration of potential sources of heterogeneity through subgroup analyses. The quality of evidence was assessed using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Thirteen studies with 211 participants (24-66 years, 41% female) were included. When comparing HF to LF condition, the HF had a significantly greater reduction in glucose (9 studies [n = 740]; Hedge's g = -0.30, 95% CI [-0.57, -0.03], p = 0.03; I2-level 3 = 42%, PI [-1.01, 0.41]). However, there was no difference in insulin (4 studies [n = 304]; Hedge's g = -0.22, 95% CI [-0.73, 0.29], p = 0.35; I2-level 3 = 52%, PI [-1.18, 0.74]), triglyceride (3 studies [n = 484]; Hedge's g = 0.11, 95% CI [-0.10, 0.30], p = 0.29; I2-level 3 = 0%, PI [-0.10, 0.30]), blood pressure (5 studies [n = 352]; Hedge's g = -0.06, 95% CI [-0.41, 0.28], p = 0.69; I2-level 3 = 35%, PI [-0.81, 0.62]), and superficial femoral flow-mediated dilation (3 studies [n = 98]; Hedge's g = -0.42, 95% CI [-2.43, 1.60], p = 0.47; I2-level 3 = 78%, PI [-4.09, 3.25]) between the two conditions. The quality of evidence was low GRADE for all outcomes. The present study suggests that a higher sedentary interruption frequency might be more efficacious than a lower frequency/higher duration protocol for reducing glucose levels. Based on these findings, interrupting sedentary time at least, every 30 min may be an ideal strategy to improve glucose control.

Enhanced muscle activity during interrupted sitting improves glycemic control in overweight and obese men

The efficacy of interrupting prolonged sitting may be influenced by muscle activity patterns. This study examined the effects of interrupting prolonged sitting time with different muscle activity patterns on continuously monitored postprandial glycemic response. Eighteen overweight and obese men (21.0 ± 1.2 years; 28.8 ± 2.2 kg/m2) participated in this randomized four-arm crossover study, including uninterrupted sitting for 8.5 h (SIT) and interruptions in sitting with matched energy expenditure and duration but varying muscle activity: 30-min walking at 4 km/h (ONE), sitting with 3-min walking at 4 km/h (WALK) or squatting (SQUAT) every 45 min for 10 times. Net incremental area under the curve (netiAUC) for glucose was compared between conditions. Quadriceps, hamstring, and gluteal muscles electromyogram (EMG) patterns including averaged muscle EMG amplitude (aEMG) and EMG activity duration were used to predict the effects on glucose netiAUC. Compared with SIT (10.2 mmol/L/h [95%CI 6.3 to 11.7]), glucose netiAUC was lower during sitting interrupted with any countermeasure (ONE 9.2 mmol/L/h [8.0 to 10.4], WALK 7.9 mmol/L/h [6.4 to 9.3], and SQUAT 7.9 mmol/L/h [6.4 to 9.3], all p < 0.05). Furthermore, WALK and SQUAT resulted in a lower glucose netiAUC compared with ONE (both p < 0.05). Only increased aEMG in quadriceps (-0.383 mmol/L/h [-0.581 to -0.184], p < 0.001) and gluteal muscles (-0.322 mmol/L/h [-0.593 to -0.051], p = 0.022) was associated with a reduction in postprandial glycemic response. Collectively, short, frequent walking or squatting breaks effectively enhance glycemic control in overweight and obese men compared to a single bout of walking within prolonged sitting. These superior benefits seem to be associated with increased muscle activity intensity in the targeted muscle groups during frequent transitions from sitting to activity.

Exercise to lower postprandial lipemia: why, when, what and how

We review recent findings on the ability of exercise to lower postprandial lipemia (PPL). Specifically, we answer why exercise is important in lowering PPL, when it is most effective to exercise to achieve this, what the preferred exercise is and how exercise reduces PPL. Most findings confirm the power of exercise to lower PPL, which is an independent risk factor for cardiovascular disease. Exercise is most effective when performed on the day preceding a high- or moderate-fat meal. This effect lasts up to approximately two days; therefore, one should exercise frequently to maintain this benefit. However, the time of exercise relative to a meal is not that important in real-life conditions, since one consumes several meals during the day; thus, an exercise bout will inevitably exert its lowering effect on PPL in one or more of the subsequent meals. Although moderate-intensity continuous exercise, high-intensity intermittent exercise (HIIE), resistance exercise and accumulation of short bouts of exercise throughout the day are all effective in lowering PPL, submaximal, high-volume interval exercise seems to be superior, provided it is tolerable. Finally, exercise reduces PPL by both lowering the rate of appearance and increasing the clearance of triacylglycerol-rich lipoproteins from the circulation.