Insulin Resistance, Obesity, Sedentary Lifestyle
Conditions
Brief summary
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.
Interventions
DEVICEActivity monitoring (ActivePal)
Objective measurements of standing and sitting time
BEHAVIORALExercise
Mild exercise 3 min every half hour
PROCEDUREmuscle and fat biopsy
Biopsy under local anesthesia
DEVICEContinuous glucose monitoring
Glucose concentrations during the study period
BEHAVIORALNormal lifestyle
Normal lifestyle
Sponsors
Baker Heart and Diabetes Institute
Australian Catholic University
Region Stockholm
Karolinska Institutet
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Sedentary lifestyle, * BMI 30-40 kg/m2
Exclusion criteria
* Unable to read Swedish (for informed consent), * anticoagulant therapy, * unability to perform intervention
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in metabolic health including insulin resistance | Change from baseline and 4 week intervention | Oral glucose tolerance test including baseline glucose and insulin |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes at the molecular level in skeletal and fat muscle biopsies | Change from baseline and 4 week intervention | insulin signalling cascade, the pathways that regulate protein synthesis and atrophy, as well as the content and function of mitochondria |
| Changes in gene expression | Change from baseline and 4 week intervention | RNA, mRNA, DNA methylation |
| Changes in physical activity | Change from baseline and 4 week intervention | Objective measures of standing and sitting |
| Changes in plasma glucose | Change from baseline and 4 week intervention | Continuous glucose monitoring |
Countries
Sweden
Outcome results
None listed