TY - JOUR
T1 - Optimal Frequency of Interrupting Prolonged Sitting for Cardiometabolic Health
T2 - A Systematic Review and Meta-Analysis of Randomized Crossover Trials
AU - Yin, Mingyue
AU - Xu, Kai
AU - Deng, Jianfeng
AU - Deng, Shengji
AU - Chen, Zhili
AU - Zhang, Boyi
AU - Zhong, Yuming
AU - Li, Hansen
AU - Zhang, Xing
AU - Toledo, Meynard John L.
AU - Diaz, Keith M.
AU - Li, Yongming
N1 - Publisher Copyright:
© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
PY - 2024/12
Y1 - 2024/12
N2 - 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.
AB - 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.
KW - cardiometabolic health
KW - exercise snacks
KW - glucose control
KW - interrupting prolonged sitting
KW - meta-analysis
KW - prolonged sitting
KW - sedentary behavior
KW - sedentary breaks
UR - http://www.scopus.com/inward/record.url?scp=85211104009&partnerID=8YFLogxK
U2 - 10.1111/sms.14769
DO - 10.1111/sms.14769
M3 - Review article
C2 - 39630056
AN - SCOPUS:85211104009
SN - 0905-7188
VL - 34
JO - Scandinavian Journal of Medicine and Science in Sports
JF - Scandinavian Journal of Medicine and Science in Sports
IS - 12
M1 - e14769
ER -