Key result
Continuous walking outperforms active breaks for insulin sensitivity, improving HOMA-IR by ~12%.
Why the study?
Do short active breaks from sitting improve glucose homeostasis more than a duration-matched continuous physical activity bout in sedentary adults with prediabetes?
RCT (n=48)
randomized
Do short active breaks from sitting improve glucose homeostasis more than a duration-matched continuous physical activity bout in sedentary adults with prediabetes?
In adults with prediabetes, continuous physical activity elicited greater improvements in insulin sensitivity compared to duration-matched active breaks, though both improved glycemic variability and fat mass.
Introduction and Objective: Prolonged sedentary behavior (SB) is a major risk factor for type 2 diabetes (T2D). Acute studies suggest that short active breaks from SB improve glycemic control more than continuous physical activity (PA), but longer-term effects are unknown. We tested whether 12 weeks of active breaks would improve glucose homeostasis more than a duration-matched continuous PA bout in adults at risk for T2D. Methods: In a 12-week RCT (NCT05041491), 48 sedentary adults with pre-diabetes (ADA criteria, 39F/9M, 49±9 y, 31±5 kg/m2) were randomized to one of two free-living, but monitored, interventions, performed 5 d/wk: BREAK (nine 5-min bouts of moderate-intensity walking) or ONE (one 45-min bout of moderate-intensity walking). Daily SB/PA (accelerometry), fasting glucose, insulin, HbA1c, daily glycemic variability (CGM), fasting lipids, and body composition (DXA) were assessed pre- and post-intervention. Linear mixed models tested time effects and group-by-time interactions. Results: Adherence to BREAK and ONE was high and similar between groups (88±15% vs. 88±16%; p=0.979). Both interventions increased moderate-to-vigorous PA (+20 min/d; p<0.001) and reduced total SB (-35 min/d; p=0.013). However, BREAK did not significantly reduce prolonged SB (p=0.179). Both interventions improved multiple indices of glycemic variability (-4 to -12%; all p≤0.041), peak glycemia (-7%, p<0.001), fasting total (-8%; p<0.001) and LDL (-5%; p=0.027) cholesterol, and fat mass (-0.8 kg, p=0.005). Fasting insulin, triglycerides, and HOMA-IR decreased in ONE but not in BREAK (-10 to -13%; all p≤0.029), with a trend toward better fasting glucose preservation in ONE (p=0.056). Conclusion: Both PA prescriptions improved glycemic variability, cholesterol, and fat mass in adults with pre-diabetes. Continuous PA elicited greater improvements in insulin sensitivity, suggesting additional benefits over active breaks for T2D prevention. Future analyses should explore the relationships with changes in prolonged SB. Disclosure A.J. Pinto: None. I. Gudewicz: None. H. Santo André: None. C.P. Ortega-Santos: None. M.L. Mamele: None. P.R. Smith: None. N.M. Sowell: None. R. Rinaldi: None. F. Isoton Novelli: None. S. Steinke: None. D. Bessesen: Research Support; Current; Novo Nordisk, Eli Lilly and Company, Pfizer Inc. Advisory Panel; Ended; Eli Lilly and Company. A. Bergouignan: None.
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PINTO et al. (2026) conducted an RCT in pre-diabetes (n=48). Active breaks (BREAK) vs. Continuous walking (ONE: one 45-min bout of moderate-intensity walking, 5 d/wk) was evaluated on Glucose homeostasis (glycemic variability, fasting glucose, insulin, HbA1c). Both active breaks and continuous walking improved glycemic variability (-4 to -12%), but continuous walking elicited greater improvements in insulin sensitivity (HOMA-IR decreased -10 to -13%).
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