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April 3, 2026European Journal of Preventive Cardiology3 citations

Optimizing physical activity bouts to interrupt sedentary behaviour for cardiometabolic health: a systematic review and meta-analyses of randomized controlled trials

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JVJen VanherleGFGregor H. L. M. FranssenAIAnna Ivanova

Key Result

Frequent physical activity bouts to interrupt sedentary behavior significantly reduced blood glucose (SMD -0.22; 95% CI -0.27 to -0.16) compared to sedentary control conditions.

Key Points

  • The review aims to determine how different characteristics of physical activity bouts influence cardiometabolic health.
  • Included randomized controlled trials comparing physical activity interventions to sedentary controls.
  • Evaluated studies involving adults aged 18–65 years.
  • Conducted meta-analyses using random-effects models for standardized mean differences.
  • Performed subgroup and meta-regression analyses to identify moderators.
  • Reviewed a total of 144 studies with 2216 participants.
  • Frequent physical activity bouts reduced blood glucose levels.
  • Longer and more intense physical activity bouts significantly decreased triglyceride levels.
  • Moderate-to-vigorous physical activity improved endothelial function.
  • Physical activity bouts lowered both systolic and diastolic blood pressure.
  • Glucose regulation benefits from frequent bouts; triglyceride levels respond better to greater duration and intensity.

Study Design

Type

Meta-Analysis (n=2,216)

Structured PICO

Do physical activity bouts interrupting sedentary behavior improve cardiometabolic outcomes in adults aged 18-65 years?

P
Population
2,216 adults aged 18-65 years, with or without cardiometabolic conditions, pooled from 144 randomized controlled trials (247 intervention arms)
I
Intervention
Physical activity (PA) bouts of varying frequency, duration, and intensity to interrupt sedentary behavior
C
Comparator
Sedentary control conditions
O
Outcome
Cardiometabolic outcomes including blood glucose, triglycerides, endothelial function, insulin, and blood pressuresurrogate

Interrupting sedentary behavior with frequent physical activity bouts improves acute glucose regulation, while longer or more intense bouts improve triglycerides and endothelial function.

Main Result

Effect estimate: SMD -0.22 (95% CI -0.27 to -0.16)

Abstract

AIMS: Chronic diseases such as type 2 diabetes mellitus and cardiovascular diseases are leading causes of mortality worldwide, with sedentary behaviour (SB) and physical inactivity recognized as major interrelated risk factors. Prolonged SB, particularly when combined with insufficient physical activity, adversely affects cardiometabolic health. This systematic review aimed to evaluate which characteristics of physical activity (PA) bouts, in terms of frequency, duration, and intensity, are associated with improvements in cardiometabolic outcomes. METHODS AND RESULTS: Studies assessing physical activity interventions compared with sedentary control conditions were included. Eligible studies involved adults aged 18-65 years, with or without cardiometabolic conditions. PubMed, Cochrane Central, Embase, and Web of Science were searched to February 2025. Random-effects models were used to calculate pooled standardized mean differences (SMD) with 95% confidence interval (CI). Subgroup and meta-regression analyses explored potential moderators. A total of 144 studies (247 intervention arms; 2216 participants) were included. Frequent PA bouts reduced blood glucose SMD -0.22 (95% CI -0.27 to -0.16). Longer and/or more intense PA bouts decreased triglycerides SMD -0.27 (-0.34 to -0.19), with significant duration × intensity interactions for glucose (P = 0.032) and triglycerides (P < 0.001). Moderate-to-vigorous PA bouts improved endothelial function flow-mediated dilation SMD 0.88 (0.47-2.24); shear rate SMD 0.54 (0.31-0.78). PA bouts also lowered insulin SMD -0.26 (-0.32 to -0.19), systolic BP SMD -0.29 (-0.39 to -0.19), and diastolic BP SMD -0.16 (-0.26 to -0.05). CONCLUSION: In acute experimental settings, glucose regulation appears to benefit more from frequent PA bouts, while triglyceride responses are more closely related to greater duration and/or intensity. Blood pressure shows favourable acute responses across PA types, whereas higher PA intensity is associated with improved endothelial function. Tailoring strategies to interrupt SB with PA bouts may help inform approaches to improve cardiometabolic health. This study identifies how the frequency, duration, and intensity of physical activity bouts produce distinct short-term benefits for blood sugar, blood lipids, blood pressure, and vascular function when used to interrupt prolonged sitting. Key findings Frequent physical activity bouts most effectively improve blood sugar, while longer or more intense bouts are needed to reduce blood lipids.Blood pressure improves with a wide range of physical activity bouts, whereas vascular function benefits mainly from higher-intensity activity. Registration PROSPERO 2023 CRD42023495310.

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Cite This Study

Vanherle et al. (2026) conducted a meta-analysis in Sedentary behaviour (n=2,216). Physical activity bouts vs. Sedentary control conditions was evaluated on Blood glucose (SMD -0.22, 95% CI -0.27 to -0.16). Frequent physical activity bouts to interrupt sedentary behavior significantly reduced blood glucose (SMD -0.22; 95% CI -0.27 to -0.16) compared to sedentary control conditions.

synapsesocial.com/papers/69cf5de95a333a821460bed7https://doi.org/10.1093/eurjpc/zwag079
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