Key result
Substituting 1 hour of sitting with moderate-to-vigorous exercise significantly improved endothelial dysfunction compared to prolonged sitting (p=0.003), whereas substituting 5-6 hours of sitting with light physical activity improved insulin sensitivity and plasma lipids.
Why the study?
Does substituting sitting with exercise or light physical activity improve biomarkers of endothelial dysfunction and metabolic risk in subjects with normal weight, overweight, and type 2 diabetes?
RCT (n=61)
Counterbalanced randomized cross-over
No
Does substituting sitting with exercise or light physical activity improve biomarkers of endothelial dysfunction and metabolic risk in subjects with normal weight, overweight, and type 2 diabetes?
p-value: p=0.003
Moderate-to-vigorous exercise improves endothelial function, while reducing sitting time with light activity improves metabolic markers, suggesting both are needed for optimal cardio-metabolic health.
Both moderate-to-vigorous and light activity substitutions merit promotion to address complementary cardiometabolic risks; extends sedentary behavior evidence across populations.
Recent studies suggest that substituting sitting with light physical activity has beneficial metabolic effects, but it is unclear if this is associated with parallel changes in endothelial function. Data from three randomized cross-over studies were analyzed, in which 61 subjects (with normal weight, overweight and type 2 diabetes) followed different activity regimens (Sit, SitLess and/or Exercise) of four days each. Subjects were instructed to sit 14 h/day ('Sit'), to substitute 1 h/day of sitting with moderate-to-vigorous cycling ('Exercise') or to substitute 5-6 h/day sitting with light-intensity walking and standing ('SitLess'). Physical activity was assessed 24 h/day by accelerometry (ActivPAL) and diet was standardized. Fasted circulating biomarkers of endothelial dysfunction, lipids and insulin sensitivity were assessed the morning after each activity regimen. The endothelial dysfunction score (ED-score) was computed by averaging the Z-scores of the circulating biomarkers of endothelial dysfunction. Compared to Sit, Exercise resulted in lower ED-score, sICAM1 and sE-selectin (p < 0.05), while no significant changes were observed after SitLess. The ED-score, sVCAM1 and sE-selectin were lower after Exercise compared to SitLess (p < 0.05). In contrast, compared to Sit, insulin sensitivity (HOMA2-IR) and plasma lipids (HDL-cholesterol, non-HDL-cholesterol, total cholesterol and Apo B) did not change significantly after Exercise but were improved after SitLess (p < 0.05). In conclusion, light physical activity and moderate-to-vigorous physical activity had a differential effect on risk markers of cardio-metabolic health and suggest the need of both performing structured exercise as well as reducing sitting time on a daily basis.
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Duvivier et al. (2018) conducted an RCT in Sedentary lifestyle (normal weight, overweight, and type 2 diabetes) (n=61). Exercise (cycling) or SitLess (light walking/standing) vs. Sit (14 h/day sitting) was evaluated on Endothelial dysfunction score (ED-score) (p=0.003). Substituting 1 hour of sitting with moderate-to-vigorous exercise significantly improved endothelial dysfunction compared to prolonged sitting (p=0.003), whereas substituting 5-6 hours of sitting with light physical activity improved insulin sensitivity and plasma lipids.
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