The Acute Metabolic and Vascular Impact of Interrupting Prolonged Sitting: A Systematic Review and Meta-Analysis

Abstract

Objective

The aim was to conduct a systematic review and meta-analysis analyzing the impact of up to 24 h of prolonged sitting on postprandial glucose, insulin and triglyceride responses, blood pressure and vascular function, in comparison to sitting interrupted with light- to moderate-intensity physical activity.

Methods

To be included, studies had to examine the impact of prolonged sitting lasting < 24 h in apparently healthy males or females of any age. Studies were identified from searches of the MEDLINE, CINAHL and SportDISCUS databases on July 6, 2016. Study quality was assessed using the Downs and Black Checklist; publication bias was assessed via funnel plot.

Results

Forty-four studies met the inclusion criteria for the systematic review; of these, 20 were included in the meta-analysis, which compared prolonged sitting to the effects of interrupting sitting with regular activity breaks on postprandial glucose, insulin and triglycerides. When compared to prolonged sitting, regular activity breaks lowered postprandial glucose (d = − 0.36, 95% confidence interval [CI] − 0.50 to − 0.21) and insulin (d = − 0.37, 95% CI − 0.53 to − 0.20), but not triglyceride responses (d = 0.06, 95% CI − 0.15 to 0.26). Subgroup analyses indicated reductions in postprandial triglyceride responses only occurred 12–16 h after the intervention. The magnitude of the reductions in glucose, insulin or triglyceride response was not modified by the intensity of the activity breaks, the macronutrient composition of the test meal, or the age or body mass index of participants.

Conclusion

Prolonged sitting results in moderate elevations in postprandial glucose and insulin responses when compared to sitting interrupted with activity breaks.

PROSPERO ID

CRD42015020907.

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Correspondence to Travis J. Saunders.

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Funding

Meredith Peddie’s work was supported by a Research Fellowship from the National Heart Foundation of New Zealand (Grant no. 1745). Hayden Atkinson’s work was supported by a Summer Undergraduate Research Award from the University of Prince Edward Island. Travis Saunders is supported by the Jeanne and J.-Louis Lévesque Research Professorship in Nutrisciences and Health. No other sources of funding were used to assist in the preparation of this article.

Conflict of interest

Travis Saunders has received research and/or in-kind support from Stepscount, Fitabase, and Ergotron. Hayden Atkinson, Jamie Burr, Brittany MacEwen, Murray Skeaff and Meredith Peddie declare that they have no conflicts of interest.

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Figure S1 Effect (Cohen’s d) of regular activity breaks (< 10 min in duration) compared to prolonged sitting on postprandial glucose responses, stratified by intensity of activity breaks. Studies are sorted within each subgroup by age of participants. The diamond indicates the standardized mean difference (SMD) with associated 95% confidence interval for each subgroup (TIFF 929 kb)

Figure S2 Effect (Cohen’s d) of regular activity breaks (< 10 min in duration) compared to prolonged sitting on postprandial insulin responses, stratified by intensity of activity breaks. Studies are sorted within each subgroup by age of participants. The diamond indicates the standardized mean difference (SMD) with associated 95% confidence interval for each subgroup (TIFF 1019 kb)

Figure S3 Effect (Cohen’s d) of regular activity breaks (< 10 min in duration) compared to prolonged sitting on postprandial triglyceride responses, stratified by intensity of activity breaks. Studies are sorted within each subgroup by age of participants. The diamond indicates the standardized mean difference (SMD) with associated 95% confidence interval for each subgroup (TIFF 1092 kb)

Figure S4 Effect (Cohen’s d) of regular activity breaks (< 10 min in duration) compared to prolonged sitting on postprandial glucose responses, stratified by timing of the test meal. The diamond indicates the standardized mean difference (SMD) with associated 95% confidence interval for each subgroup (TIFF 1006 kb)

Figure S5 Effect (Cohen’s d) of regular activity breaks (< 10 min in duration) compared to prolonged sitting on postprandial insulin responses, stratified by timing of the test meal. The diamond indicates the standardized mean difference (SMD) with associated 95% confidence interval for each subgroup (TIFF 1105 kb)

Figure S6 Effect (Cohen’s d) of regular activity breaks (< 10 min in duration) compared to prolonged sitting on postprandial triglyceride responses, stratified by timing of the test meal. The diamond indicates the standardized mean difference (SMD) with associated 95% confidence interval for each subgroup (TIFF 1156 kb)

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Saunders, T.J., Atkinson, H.F., Burr, J. et al. The Acute Metabolic and Vascular Impact of Interrupting Prolonged Sitting: A Systematic Review and Meta-Analysis. Sports Med 48, 2347–2366 (2018). https://doi.org/10.1007/s40279-018-0963-8

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