Intermittent walking, but not standing, improves postprandial insulin and glucose relative to sustained sitting: A randomised cross-over study in middle-aged men

ArticleObjectives Interrupting prolonged periods of sitting may improve postprandial insulin and glucose although it is unclear whether interruptions need to involve physical activity or simply a change in posture (from sitting to standing) to benefit adults without metabolic impairment. This study examined effects of interrupting sitting with intermittent walking, and intermittent standing on dynamic insulin and glucose responses in men without known metabolic impairment. Design A randomised three-arm, cross-over experimental study comprising three seven-hour days of sustained sitting. Methods Twenty-five inactive men (aged 40.2 ± 12.2 years) took part. The three interventions were; SIT-ONLY (uninterrupted sitting), SIT-STAND (sitting interrupted with 2 min standing bouts every 20 min) and SIT-WALK (sitting interrupted with 2 min light-intensity walking bouts every 20 min). An oral glucose tolerance test was administered at baseline and a standardised mixed test meal at hour three. Comparisons of Matsuda Index, and area under the curve (AUC) for insulin and glucose were made between interventions using generalised estimating equation models. Results Matsuda index was 16% higher (mean difference 1.2 [95%CI 0.1, 2.2] p = 0.02), AUC for glucose 9% lower (−2.5 mmol/L × 7 h [−3.7, −1.3 mmol/L × 7 h] p < 0.001) and AUC for insulin 21% lower (−546.5 pmol/L × 7 h [−723.6, −369.3 pmol/L × 7 h] p < 0.001) in SIT-WALK compared to SIT-ONLY. There were no significant differences between SIT-STAND and SIT-ONLY in any main outcome measure. Conclusions Interrupting sustained sitting with brief repeated bouts of light-intensity walking but not standing reduced insulin demand and improved glucose uptake during a simulated sedentary working day. The benefits of such minor behavioural changes could inform future workplace health interventions.We would like to acknowledge the study participants, without whom this research would not have been possible. This research was funded internally through a University of Exeter Science Strategy PhD Studentship (Richard Pulsford) in collaboration with the National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care (CLAHRC). The research was supported by the National Institute for Health research (NIHR) Exeter Clinical Research Facility. The views expressed in this publication are those of the authors and not necessarily those of the National Health Service, the NIHR or the Department of Health