Physical inactivity and prolonged sedentary behavior are major health concerns, especially for individuals with chronic conditions such as diabetes and prediabetes. Many patients have difficulty following traditional exercise recommendations due to time constraints, limited physical capacity, comorbidities, or lack of access to exercise facilities. Therefore, new and more practical exercise strategies are needed. "Exercise Snacks" is a novel physical activity approach that involves short bouts of exercise performed multiple times throughout the day. Each session is brief and easy to integrate into daily life, such as performing short periods of resistance exercises, brisk walking, stair climbing, or other simple activities. This approach may improve exercise adherence and provide health benefits without requiring long exercise sessions. The purpose of this study is to evaluate the feasibility and acceptability of an Exercise Snacks intervention in sedentary adults with diabetes or prediabetes and to explore its potential effects on cardiovascular and metabolic health, physical function, and body composition. In this study, sedentary adults aged 18-65 years with diabetes or prediabetes will participate in a 12-week study and will be randomly assigned to either an Exercise Snacks group or a control group. Participants in the Exercise Snacks group will perform short exercise sessions lasting approximately 3-5 minutes, including simple resistance exercises and short aerobic activities. These exercise sessions will be performed several times per day and integrated into daily routines. The control group will maintain their usual lifestyle without additional exercise intervention. Participants may use wearable devices or mobile applications to receive reminders and record exercise activity. Assessments will be conducted before and after the intervention to evaluate physical activity adherence, physical function, body composition, blood pressure, blood glucose, and other cardiovascular and metabolic health indicators. This study aims to determine whether short, frequent exercise sessions are a practical and effective alternative to traditional exercise recommendations for sedentary individuals with diabetes or prediabetes. The results of this study may help develop more feasible lifestyle intervention strategies to improve long-term exercise adherence and overall health in individuals with chronic diseases.
Physical inactivity and prolonged sedentary behavior are recognized as major risk factors for cardiovascular disease, type 2 diabetes, obesity, and metabolic syndrome. Although current physical activity guidelines recommend at least 150 minutes of moderate-intensity exercise per week, many individuals with chronic conditions such as diabetes or prediabetes are unable to meet these recommendations due to time constraints, low exercise tolerance, comorbidities, or lack of access to exercise facilities. Therefore, alternative exercise strategies that are feasible, flexible, and sustainable are needed for sedentary populations with chronic diseases. Exercise Snacks is an emerging exercise concept that involves performing short bouts of physical activity multiple times throughout the day rather than completing a single continuous exercise session. These short sessions typically last from 1 to 5 minutes and may include resistance exercises, stair climbing, brisk walking, or other moderate-to-high intensity activities. Previous studies suggest that accumulating short bouts of exercise throughout the day may improve glycemic control, cardiovascular fitness, muscle strength, and exercise adherence. However, the feasibility and acceptability of Exercise Snacks in sedentary individuals with diabetes or prediabetes remain insufficiently studied in clinical settings. The primary aim of this study is to evaluate the feasibility and acceptability of an Exercise Snacks intervention among sedentary adults with diabetes or prediabetes. Secondary aims include evaluating the preliminary effects of the Exercise Snacks intervention on cardiovascular and metabolic health indicators, physical function, and body composition. This study will recruit sedentary adults aged 18 to 65 years who have been diagnosed with diabetes or prediabetes. Participants will be randomly assigned to either the Exercise Snacks intervention group or the control group. The intervention period will last 12 weeks. Participants in the Exercise Snacks group will perform short exercise sessions multiple times per day. Each exercise session will last approximately 3 to 5 minutes and will include simple resistance exercises (such as squats, split squats, resistance band exercises, and curl-ups) and short aerobic activities (such as brisk walking, stair climbing, running in place, or jumping jacks). Participants will be encouraged to perform at least 3 to 4 exercise sessions per day and integrate these activities into their daily routines. Exercise intensity and exercise type will be adjusted based on individual physical capacity and safety considerations. Participants in the control group will maintain their usual lifestyle and will not receive the Exercise Snacks intervention during the study period. Wearable devices or mobile applications may be used to provide exercise reminders, monitor exercise adherence, and record physical activity data. Assessments will be conducted before and after the 12-week intervention. Outcome measurements will include feasibility and acceptability questionnaires, physical function tests (such as the 6-Minute Walk Test and 3-Minute Step Test), body composition measurements (including body weight, body mass index, body fat percentage, muscle mass, waist circumference, and waist-to-hip ratio), and cardiovascular and metabolic indicators (including blood pressure, fasting blood glucose, and HbA1c). The results of this study will help determine whether Exercise Snacks is a feasible and practical lifestyle intervention strategy for sedentary individuals with diabetes or prediabetes. This study may provide preliminary evidence for integrating short-duration, high-frequency physical activity into clinical lifestyle management programs for chronic disease populations.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
58
The Exercise Snacks intervention consists of short bouts of physical activity performed multiple times throughout the day. Each exercise session lasts approximately 3 to 5 minutes and includes simple resistance exercises and short aerobic activities. Resistance exercises may include squats, split squats, resistance band exercises, and curl-ups, while aerobic activities may include brisk walking, stair climbing, running in place, or jumping jacks. Participants will be encouraged to perform at least 3 to 4 exercise sessions per day and integrate these short exercise sessions into their daily routines. Exercise intensity and exercise type will be adjusted according to individual physical capacity and safety considerations. The intervention will be conducted over a 12-week period. Wearable devices or mobile applications may be used to provide exercise reminders, monitor adherence, and record physical activity.
ChiMei Medical Center
Tainan, Yongkang Dist, Taiwan
Feasibility and acceptability of the Exercise Snacks intervention
Feasibility and acceptability will be evaluated based on participant adherence, completion of the intervention, and participant-reported questionnaires assessing convenience, satisfaction, and willingness to continue the intervention. Additionally, adherence and satisfaction will be quantified using standardized indicators, with higher scores indicating better adherence and greater satisfaction and acceptability. The questionnaire will be assessed using a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree), e.g., assessed using the Exercise Adherence Rating Scale, EARS with items 2, 3, 4, and 6 being reverse-scored.
Time frame: Baseline to 12 weeks
Change in physical function assessed by the 3-Minute Step Test
Physical function and cardiopulmonary endurance will be assessed using the 3-Minute Step Test, which evaluates participants' exercise capacity and functional fitness. Participants will perform a stepping exercise on a standardized step for 3 minutes at a fixed stepping rate. Heart rate will be measured immediately after exercise to assess cardiopulmonary endurance and recovery capacity. Lower post-exercise heart rates indicate better cardiovascular fitness. The Step Test Index will be calculated using the following formula: Step Test Index = Exercise duration (seconds) × 100 ÷ \[2 × (sum of the three pulse counts)\]. The calculated index will be classified into five fitness levels, with higher scores indicating better cardiopulmonary endurance and cardiovascular fitness.
Time frame: Baseline to 12 weeks
Change in body weight (kg)
Body weight (kg) will be assessed at baseline and after the 12-week intervention to evaluate changes in body weight associated with the exercise snacks intervention. Comparisons of pre- and post-intervention measurements will be used to determine the potential effects of short-duration intermittent physical activity on body weight and overall body composition status.
Time frame: Baseline to 12 weeks
Change in body mass index (BMI)
Body Mass Index (BMI) is calculated by dividing body weight in kilograms by height in meters squared. Body mass index (BMI, kg/m²) will be assessed at baseline and after the 12-week intervention to evaluate changes in body composition associated with the exercise snacks intervention. Comparisons between pre- and post-intervention measurements will be used to determine the effects of short-duration intermittent physical activity on overall weight status.
Time frame: Baseline to 12 weeks
Change in body fat percentage (%)
Body fat percentage (%) will be measured before and after the intervention to evaluate changes in adiposity following the exercise snacks intervention. Pre- and post-intervention comparisons will be conducted to assess the potential effects of intermittent physical activity on body fat reduction and body composition improvement.
Time frame: Baseline to 12 weeks
Change in muscle mass (kg)
Muscle mass (kg) will be assessed at baseline and after the intervention to evaluate changes in skeletal muscle status associated with the exercise snacks intervention. Comparisons of pre- and post-intervention measurements will be used to assess the potential effects of short-duration physical activity on muscle preservation and muscle mass improvement.
Time frame: Baseline to 12 weeks
Change in waist circumference (cm)
Waist circumference (cm) will be measured before and after the intervention to evaluate changes in central adiposity and abdominal obesity. Pre- and post-intervention comparisons will be conducted to assess the effects of the exercise snacks intervention on abdominal fat distribution and anthropometric status.
Time frame: Baseline to 12 weeks
Change in blood pressure (mmHg)
Blood pressure (mmHg) will be measured at baseline and after the 12-week intervention to evaluate changes in cardiovascular status associated with the exercise snacks intervention. Comparisons between pre- and post-intervention measurements will be used to assess the potential effects of short-duration intermittent physical activity on blood pressure control and cardiovascular health.
Time frame: Baseline to 12 weeks
Change in low-density lipoprotein cholesterol (LDL-C)
Low-density lipoprotein cholesterol (LDL-C) levels (mg/dL) will be assessed before and after the intervention to evaluate changes in lipid metabolism and cardiovascular risk factors. Pre- and post-intervention comparisons will be conducted to assess the effects of the exercise snacks intervention on LDL-C levels and metabolic health.
Time frame: Baseline to 12 weeks
Change in total cholesterol (CHOL)
Total cholesterol (CHOL) levels (mg/dL) will be assessed before and after the intervention to evaluate changes in lipid metabolism and cardiovascular risk factors. Pre- and post-intervention comparisons will be conducted to assess the effects of the exercise snacks intervention on total cholesterol levels and metabolic health.
Time frame: Baseline to 12 weeks
Change in high-density lipoprotein cholesterol (HDL-C)
High-density lipoprotein cholesterol (HDL-C) levels (mg/dL) will be assessed before and after the intervention to evaluate changes in lipid metabolism and cardiovascular risk factors. Pre- and post-intervention comparisons will be conducted to assess the effects of the exercise snacks intervention on HDL-C levels and metabolic health.
Time frame: Baseline to 12 weeks
Change in triglycerides (TG)
Triglyceride (TG) levels (mg/dL) will be assessed before and after the intervention to evaluate changes in lipid metabolism and cardiovascular risk factors. Pre- and post-intervention comparisons will be conducted to assess the effects of the exercise snacks intervention on triglyceride levels and metabolic health.
Time frame: Baseline to 12 weeks
Change in fasting blood glucose (mg/dL)
Fasting blood glucose (mg/dL) will be measured at baseline and after the intervention to evaluate changes in glycemic control associated with the exercise snacks intervention. Comparisons of pre- and post-intervention measurements will be used to assess the potential effects of intermittent physical activity on glucose regulation and metabolic status.
Time frame: Baseline to 12 weeks
Change in hemoglobin A1c (HbA1c)
Hemoglobin A1c (HbA1c, %) will be assessed before and after the 12-week intervention to evaluate long-term glycemic control. Pre- and post-intervention comparisons will be conducted to assess the effects of the exercise snacks intervention on average blood glucose levels and diabetes-related metabolic outcomes.
Time frame: Baseline to 12 weeks
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