A randomized, crossover intervention study confirmed previous research that standing more and walking can help improve the metabolic health of postmenopausal women with insulin sensitivity.
The study evaluated 12 overweight and obese women assigned 4-day activity regimens. The regimens included a sitting regimen of sitting for 14 hours per day, an exercise regimen, which included sitting for 13 hours and one hour of exercise, and a sitting less regimen, which included sitting for 9 hours per day, standing for four hours, and walking for three hours per day. In addition to the exercise component of the study, participants also had similar diets to ensure consistent findings. For example, participants could not drink alcohol or caffeine-rich drinks during five intervention days. The participants also tracked all dairy consumption during the first activity regimen. Similar diets were followed in the second and third activity periods. The primary outcome was insulin sensitivity while also evaluating metabolomics on muscle biopsies.
According to results published in Diabetologia, participants who walked over four days improved peripheral insulin sensitivity with data similar to people who engage in moderate-to-vigorous exercise. Insulin sensitivity increased by 13% among patients in the sitting less regimen compared with 20% improvement among patients in the exercise regimen. Sitting less also provided a similar benefit as moderate-to-vigorous exercise in regards to a participant’s muscle metabolome compared with those who sat more.
The patient’s fasting plasma glucose levels were evaluated using a two-step hyperinsulinemic-euglycemic clamp and were similar between the three groups. The glucose Rd during a high rate of insulin infusion was “significantly higher” in the sitting less regimen (33.1 ± 3.2 μmol kg−1 min−1, P = 0.03) and exercise regimen (35.2 ± 3.8 μmol kg−1 min−1, P < 0.01) regimen compared to the sitting more group (29.4 ± 3.7 μmol kg−1 min−1).
“Sedentary behavior is considered a major cause of metabolic disease, and regular exercise is the superior intervention for preventing this. However, long-term adherence to exercise programs is often low,” the authors said. “Recently, it has been suggested that reducing sedentary behavior per se can improve markers of glucose homeostasis, although underlying mechanisms and a direct comparison with exercise are lacking.”
The authors said their findings show sitting less and standing and walking more for four days can have the same benefit for some patients as daily exercise.
“We conclude that replacing sitting time with standing and walking is an attractive and highly feasible alternative to moderate-to-vigorous exercise to improve metabolic health.”
While encouraged by their findings, the authors said more extended studies are needed to see if changes in a patient’s metabolic profile mean changes in functional metabolic adaptations and functional consequences of those changes.
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