There is a growing health burden in Sweden and Europe arising from the interrelated sequelae of metabolic disorders comprising impaired glucose tolerance (IGT), obesity and T2DM. Obesity and inactivity are the main drivers of IGT and T2DM and are responsible for up to 8% of health costs and 13% of deaths in Europe, with the risk of co-morbidities rising in parallel with increasing body weight. IGT and T2DM are the paradigm of inactivity-related disorders: the majority of people who have IGT or T2DM are overweight and inactive, with up to 80% being obese. A recent meta-analysis of 42 studies concluded that sedentary time was independently associated with a greater risk of T2D, all-cause mortality, cardiovascular disease incidence and mortality, and cancer incidence and mortality (breast, colon, colorectal, endometrial and epithelial ovarian cancers) (Ann Intern Med. 2015;162:123-32). A recent systematic review of trials published up to April 2014 identified 16 separate studies and concluded that there is considerable evidence of the positive effects of breaking up prolonged sitting time with light-intensity ambulatory physical activity and standing on postprandial metabolic parameters, including glucose, insulin and triglyceride levels (Med Sci Sports Exerc. 2015:47:2053-61). However, to date, all of the published experimental trials describing the beneficial effects of breaking up sitting time on metabolic risk markers have been restricted to acute exposure periods (1-5 days). We will perform a RCT intervention study, which examines the efficacy (clinically relevant responses) and practical implementation of low-impact training in sedentary obese individuals during the day.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
20
Normal lifestyle
Mild exercise 3 min every half hour
Biopsy under local anesthesia
Glucose concentrations during the study period
Objective measurements of standing and sitting time
Danderyd Hospital
Stockholm, Sweden
Change in metabolic health including insulin resistance
Oral glucose tolerance test including baseline glucose and insulin
Time frame: Change from baseline and 4 week intervention
Changes at the molecular level in skeletal and fat muscle biopsies
insulin signalling cascade, the pathways that regulate protein synthesis and atrophy, as well as the content and function of mitochondria
Time frame: Change from baseline and 4 week intervention
Changes at the molecular level in skeletal and fat muscle biopsies
The pathways that regulate protein synthesis and atrophy
Time frame: Change from baseline and 4 week intervention
Changes at the molecular level in skeletal and fat muscle biopsies
Lipid, protein and metabolites
Time frame: Change from baseline and 4 week intervention
Changes in gene expression
RNA, mRNA, DNA methylation
Time frame: Change from baseline and 4 week intervention
Changes in physical activity
Objective measures of standing and sitting
Time frame: Change from baseline and 4 week intervention
Changes in plasma glucose
Continuous glucose monitoring
Time frame: Change from baseline and 4 week intervention
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