Meta‐analysis of the relationship between breaks in sedentary behavior and cardiometabolic health
Open accessAbstract
Objective: The concept of “breaks” in sedentary behavior has emerged as a potential modifier of detrimental effects on adiposity caused by sedentary behavior. The existing research investigating the relationship between breaks in sedentary behavior with adiposity and cardiometabolic health in adults was systematically reviewed and quantitatively synthesized by this study. Methods: Observational and experimental studies that examined the relationships between the frequency of interruptions of sedentary behavior and markers of adiposity and cardiometabolic health in adults were identified by a systematic search of the literature. A meta‐analysis was conducted by using the inverse variance method for experimental trials and a Bayesian posterior probability of existence of an association between breaks with adiposity and cardiometabolic markers for observational studies. Results: It was revealed by the pooled results from nine experimental studies that breaks in sedentary periods of at least light intensity may have a positive effect on glycemia but not on lipidemia for adults. It is unclear whether this effect is independent of total sitting time. However, the 10 identified observational studies showed an association with breaks, which was independent of total sedentary time, but only for obesity metrics. Conclusions: The theory that interrupting bouts of sedentary behavior with light‐intensity activity might help control adiposity and postprandial glycemia was supported by the evidence. Further investigations with better methods of measuring sedentary behavior patterns and improved study designs are necessary to confirm this preliminary evidence.
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Frequent standing or walking can reduce total sedentary time and disrupt prolonged sitting, changing physiological pathways and improving cardiometabolic outcomes.
“Frequent standing or walking can reduce total sedentary time and disrupt prolonged sitting, changing physiological pathways and improving cardiometabolic outcomes [12-14].”
From Feasibility and Preliminary Efficacy of a “Sit Less” Program Leveraging Fitbit Tracking and Tailored Text Messages in Cardiometabolic Disease: Findings From 2 Parallel Randomized Controlled Trials in Coronary Artery Disease and Type 2 Diabetes (2026) · cites this paper as [12]
The Discussion (page not available) reports that light-intensity activity breaks improve acute glycemic control, supporting the walking-related part of the claim. It also says standing breaks generally did not improve cardiometabolic markers and that the studies could not determine whether benefits came from less total sitting, added activity, or the interruption itself. The proposed physiological mechanism is therefore not established by this paper. (LLM, conf=0.88)
Experimental — accuracy not yet measuredExperimental studies confirm that sedentary breaks can improve glucose levels by 2% to 17% and fasting insulin levels by 15%.
“Experimental studies confirm that sedentary breaks can improve glucose levels by 2% to 17% and fasting insulin levels by 15% [12,14].”
From Feasibility and Preliminary Efficacy of a “Sit Less” Program Leveraging Fitbit Tracking and Tailored Text Messages in Cardiometabolic Disease: Findings From 2 Parallel Randomized Controlled Trials in Coronary Artery Disease and Type 2 Diabetes (2026) · cites this paper as [12]
The experimental-results sections report significant reductions in postprandial glucose response with activity breaks (about 1.4% and 17.4%) and a roughly 15% reduction in insulin with light-activity breaks. They do not identify that insulin result as a reduction in fasting insulin; the Discussion also cautions that the studies cannot establish whether the benefit comes from breaking up sitting rather than adding activity. Standing breaks did not significantly reduce glucose. (LLM, conf=0.87)
Experimental — accuracy not yet measuredA recent meta-analysis, while accounting for total sedentary time and moderate-to-vigorous physical activity time, revealed that even a single break per hour can modestly improve BMI, waist circumference, inflammation, and blood pressure.
“A recent meta-analysis, while accounting for total sedentary time and moderate-to-vigorous physical activity time, revealed that even a single break per hour can modestly improve BMI, waist circumference, inflammation, and blood pressure [12,13].”
From Feasibility and Preliminary Efficacy of a “Sit Less” Program Leveraging Fitbit Tracking and Tailored Text Messages in Cardiometabolic Disease: Findings From 2 Parallel Randomized Controlled Trials in Coronary Artery Disease and Type 2 Diabetes (2026) · cites this paper as [12]
The Results synthesis–observational studies (p. 1802) reports modest associations between more breaks and lower BMI and waist circumference. It reports no detected association for cardiovascular or inflammatory markers, apart from one study’s C-reactive protein finding. The paper therefore does not support the claim that a single break per hour improves all four outcomes; its observational associations also do not establish improvement caused by breaks. (LLM, conf=0.89)
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Metabolic Effect of Breaking Up Prolonged Sitting with Stair Climbing Exercise Snacks
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Bellettiere, J., Healy, G. N., LaMonte, M. J., Kerr, J., Evenson, K. R., Rillamas‐Sun, E., Di, C., Büchner, D. M., Hovell, M. F., & LaCroix, A. Z. (2018) · The Journals of Gerontology Series A · doi:10.1093/gerona/gly101 · Cited by 63 · see citing works
“Epidemiologic studies suggest that prolonged accumulation patterns have detrimental associations with diabetes risk factors such as obesity, triglycerides, 2-h post-load glucose, and HDL cholesterol (12,49).”
BackgroundHamer, M., Aggio, D., Knock, G., Kipps, C., Shankar, A., & Smith, L. (2017) · BMC Public Health · doi:10.1186/s12889-017-4483-5 · Cited by 61 · see citing works
“Stronger evidence on health effects of sedentary behaviour exists in adult populations [38, 39] and sedentary habits are likely to track across the lifecourse [4] thus reducing sedentary time in childhood may yield more active behaviours in adulthood.”
BackgroundDempsey, P. C., Larsen, R. N., WINKLER, E. A. H., Owen, N. G., Kingwell, B. A., & Dunstan, D. W. (2018) · Diabetes Obesity and Metabolism · doi:10.1111/dom.13254 · Cited by 61 · see citing works
“However, whether the magnitude of postprandial dysglycaemia in response to prolonged sitting is dependent upon the underlying degree of glycaemic control, β-cell function or insulin resistance remains unclear.(9,10) Three similar laboratory-based controlled trials involving participants across the diabetes risk contin…”
BackgroundMethodReprint of: Healthy Weight and Obesity Prevention
Lavie, C. J., Laddu, D., Arena, R. A., Ortega, F. B., Alpert, M., & Kushner, R. F. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.10.024 · Cited by 58 · see citing works
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“A recent metaanalysis, however, cautioned that more research is needed to better understand the relative importance of the frequency, duration, and intensity of activity breaks (Chastin et al., 2015).”
BackgroundOccupational health risks and intervention strategies for US taxi drivers
Murray, K. E., Buul, A., Aden, R., Cavanaugh, A. M., Kidane, L., hussein, M. K., Eastman, A. S., & Checkoway, H. (2017) · Health Promotion International · doi:10.1093/heapro/dax082 · Cited by 60 · see citing works
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“or MVPA to counteract the deleterious effects of prolonged sedentary time on health (Benatti & Ried-Larsen, 2015; Chastin et al., 2015).”
BackgroundObjectively Measured Total and Occupational Sedentary Time in Three Work Settings
van Dommelen, P., Coffeng, J. K., van der Ploeg, H. P., van der Beek, A. J., Boot, C. R. L., & Hendriksen, I. J. M. (2016) · PLoS ONE · doi:10.1371/journal.pone.0149951 · Cited by 58 · see citing works
“A meta-analysis showed that interrupting bouts of sedentary behavior with light-intensity activity might help control adiposity and postprandial glycemia [13].”
Bailey, D. P., Charman, S. J., Plötz, T., Savory, L. A., & Kerr, C. J. (2016) · Journal of Sports Sciences · doi:10.1080/02640414.2016.1260150 · Cited by 56 · see citing works
“…acute declines in cardiometabolic function can be mitigated by breaking up prolonged sedentary time with regular short bouts of physical activity (Chastin et al., 2015), whereas in children the evidence is not consistent (Belcher et al., 2015; Heden, Liu, Park, Winn, & Kanaley, 2015; McManus et…”
BackgroundSardinha, L., Magalhães, J., Santos, D., & Júdice, P. (2017) · Frontiers in Physiology · doi:10.3389/fphys.2017.00262 · Cited by 57 · see citing works
“Accelerometer counts ≥100 cpm were classified as PA with additional separation into light-intensity (LIPA: 100–2,019 cpm) and moderate-to-vigorous intensity (MVPA ≥ 2,020 cpm) (Troiano et al., 2008; Colley et al., 2010).”
BackgroundBotero, J. P., Farah, B. Q., Correia, M. D. A., Lofrano‐Prado, M. C., Cucato, G. G., Shumate, G., Ritti‐Dias, R. M., & do Prado, W. L. (2021) · Einstein (São Paulo) · doi:10.31744/einstein_journal/2021ae6156 · Cited by 64 · see citing works
“The adverse effects of the variables physical inactivity and sedentary behavior are multiple and directly related to sarcopenia,(8) increased falls in elderly people,(9,10) hypertension,(11) insulin resistance and type II diabetes,(12) obesity,(13) cancer(14) and ultimately higher mortality rate.”
Collaborators, O. B. O. T. I. C. A. D. (., van Ekris, E., Wijndaele, K., Altenburg, T. M., Atkin, A. J., Twisk, J. W. R., Andersen, L. B., Janz, K. F., Froberg, K., Northstone, K., et al. (2020) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-020-00960-5 · Cited by 55 · see citing works
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“Nevertheless, recent studies indicate that light activity is better than SB for health [56].”
BackgroundCorrelates of sedentary behaviour in Asian adults: A systematic review
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Health behaviours during the coronavirus disease 2019 pandemic: implications for obesity
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“sitting-related health risks and are associated with lower BMI and improved cardiometabolic health biomarkers(13).”
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Frequency of interruptions to sitting time: benefits for postprandial metabolism in type 2 diabetes
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Interventions for reducing sedentary behaviour in community-dwelling older adults
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“466 This is consistent with the emerging evidence that breaking up prolong sedentary time can have 467 multiples positive effects including improvement of cardiovascular and cardiometabolic health 468 [3,5,6,24,26,53,54].”
BackgroundEffects of Light Intensity Activity on CVD Risk Factors: A Systematic Review of Intervention Studies
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Associations of sedentary behavior bouts with community‐dwelling older adults' physical function
Wilson, J. J., McMullan, I., Blackburn, N. E., Skjødt, M., Caserotti, P., Giné‐Garriga, M., Farche, A. C. S., Klenk, J., Dallmeier, D., Deidda, M., et al. (2020) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.13827 · Cited by 46 · see citing works
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“The inclusion criteria of this study (wear time of 20 hr/d) for PA data are stricter than those suggested in the literature ( 10 hr/d) [31], which we believe is necessary to overcome limitations in monitoring sedentary time, as recently reported [32].”
Association between sedentary behavior, obesity and hypertension in public school teachers
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Objectively Measured Patterns of Daily Physical Activity and Phenotypic Frailty
Wanigatunga, A. A., Cai, Y., Urbanek, J. K., MITCHELL, C. M., Roth, D. L., Miller, E. R., Michos, E. D., Juraschek, S. P., Walston, J. D., Xue, Q., et al. (2021) · The Journals of Gerontology Series A · doi:10.1093/gerona/glab278 · Cited by 40 · see citing works
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“…were measured during clinic or home visits and chosen a priori based on previous literature indicating that they were likely confounders [33, 42, 43] These were age (years), sex (male/female), smoking status (non-smoker/current smoker), alcohol consumption (cohort-specific tertiles based on…”
MethodSelf-citationTong, H. L., Coiera, E. W., Tong, W., Wang, Y., Quiroz, J. C., Martin, P. B., & Laranjo, L. (2019) · JMIR mhealth and uhealth · doi:10.2196/12181 · Cited by 39 · see citing works
“Future research might consider other measures, such as intensity of physical activity (light, moderate, and vigorous) or sedentary time [83,84].”
BackgroundBiddle, S., Bennie, J. A., Cocker, K. A. D., Dunstan, D. W., Gardiner, P. A., Healy, G. N., Lynch, B. M., Owen, N. G., Brakenridge, C. L., Brown, W. J., et al. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16234762 · Cited by 39 · see citing works
“[81] found that, in observational studies, the only consistent beneficial association for breaks in sedentary time, once the analysis adjusted for total sedentary time, was with indices of obesity.”
BackgroundDempsey, P. C., Strain, T., WINKLER, E. A. H., Westgate, K. L., Rennie, K. L., Wareham, N. J., Brage, S., & Wijndaele, K. (2022) · Journal of the American Heart Association · doi:10.1161/jaha.121.023845 · Cited by 40 · see citing works
Acute cardiometabolic effects of interrupting sitting with resistance exercise breaks
Kowalsky, R. J., Jakicic, J. M., Hergenroeder, A. L., Rogers, R. J., & Gibbs, B. B. (2019) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/apnm-2018-0633 · Cited by 40 · see citing works
Delfino, L. D., Tebar, W. R., Gil, F. C. S., Souza, J. M. D., Romanzini, M., Fernandes, R. A., & Christófaro, D. G. D. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-034322 · Cited by 39 · see citing works
Verswijveren, S. J. J. M., Lamb, K. E., Fernández, J. A. M., WINKLER, E. A. H., Leech, R. M., Timperio, A. F., Salmon, J., Daly, R. M., Cerin, E., Dunstan, D. W., et al. (2021) · Journal of sport and health science/Journal of Sport and Health Science · doi:10.1016/j.jshs.2021.03.004 · Cited by 39 · see citing works
“Both total SED and longer average SED bout durations are associated with higher mortality risk,(5) but breaking up SED with light-intensity PA (LPA) helps improve adiposity and postprandial glycaemia.(6) Whilst evidence in adults suggests that different PA and SED accumulation patterns play an important role in cardio…”
BackgroundFarrahi, V., Kangas, M., Kiviniemi, A. M., Puukka, K. S., Korpelainen, R., & Jämsä, T. J. (2021) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.13958 · Cited by 42 · see citing works
Peiris, C. L., O’Donoghue, G., Rippon, L., Meyers, D., Hahne, A., De Noronha, M., Lynch, J., & Hanson, L. C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18115589 · Cited by 38 · see citing works
“Breaking sedentary time with regular, brief, physical activity has general health benefits such as helping to control obesity and glycaemia in adults [12] and may improve cognitive capacity and academic performance in university students [8].”
BackgroundHulsegge, G., Gupta, N., Holtermann, A., Jørgensen, M. B., Proper, K. I., & van der Beek, A. J. (2016) · Scandinavian Journal of Work Environment & Health · doi:10.5271/sjweh.3614 · Cited by 38 · see citing works
“Increased sedentary behavior due to irregular shifts may have health implications since sedentary behavior, especially uninterrupted bouts, are associated with adverse cardiometabolic health outcomes, such as overweight and glycaemia (41).”
BackgroundHallman, D., Mathiassen, S. E., & Jahncke, H. (2017) · Preventive Medicine · doi:10.1016/j.ypmed.2017.11.031 · Cited by 38 · see citing works
Sedentariness: A Need for a Definition
Magnon, V., Dutheil, F., & Auxiette, C. (2018) · Frontiers in Public Health · doi:10.3389/fpubh.2018.00372 · Cited by 38 · see citing works
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“Although numerous systematic reviews have summarized the effect of sedentary breaks/interruptions on cardiometabolic health [9–16], the optimal dose of breaks/interruptions on cardiometabolic health in terms of frequency has largely not been elucidated among existing systematic reviews.”
van Greevenbroek, M. M. J., Schalkwijk, C. G., & Stehouwer, C. D. A. (2016) · F1000Research · doi:10.12688/f1000research.8971.1 · Cited by 37 · see citing works
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“Moreover, integrating enjoyable movement into daily life is likely to be more attainable for individuals with different functional abilities and preferences, and it has the added benefit of indirectly breaking up SB, as breaking prolonged sedentary time is widely associated with a host of favorable cardiometabolic hea…”
BackgroundSedentary Behaviour—A Target for the Prevention and Management of Cardiovascular Disease
Bell, A. C., Richards, J. C., Zakrzewski-Fruer, J. K., Smith, L. R., & Bailey, D. P. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010532 · Cited by 36 · see citing works
“There was, however, beneficial associations of increased breaks with BMI and waist circumference [33].”
BackgroundPaing, A. C., McMillan, K. A., Kirk, A. F., Collier, A., Hewitt, A., & CHASTIN, S. F. M. (2018) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2018.09.002 · Cited by 35 · see citing works
“interrupting sedentary time with short frequent breaks reduces postprandial glucose, daily glucose and insulin resistance (Chastin et al., 2015; Dempsey et al., 2016; Duvivier et al., 2017).”
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“breaks from prolonged sitting have been beneficially associated with markers of body composition and metabolic health in adults [7].”
BackgroundActivity Accumulation and Cardiometabolic Risk in Youth: A Latent Profile Approach
Verswijveren, S. J. J. M., Lamb, K. E., Leech, R. M., Salmon, J., Timperio, A. F., Telford, R. M., McNarry, M. A., Mackintosh, K. A., Daly, R. M., Dunstan, D. W., et al. (2020) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000002275 · Cited by 35 · see citing works
“In adults, evidence suggests 74 breaking up SED time and that engagement in short and sustained activity bouts are associated 75 with a reduction in cardiometabolic risk factors (5, 6).”
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Smith, J. A. B., Savikj, M., Sethi, P., Platt, S., Gabriel, B., Hawley, J., Dunstan, D., Krook, A., Zierath, J., & Näslund, E. (2021) · American Journal of Physiology. Endocrinology and Metabolism · doi:10.1152/ajpendo.00599.2020 · Cited by 25 · see citing works
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“Chastin et al. 48 conducted the first meta-analysis on the acute effects of SBAE, which included 6 studies, and reported that low-to moderate-intensity SBAE significantly reduced postprandial blood glucose, insulin, and C-peptide concentrations in both healthy adults and individuals with type two diabetes (T2D) compared…”
Reducing Office Workers’ Sitting Time at Work Using Sit-Stand Protocols
Li, I., Mackey, M., Foley, B. C., Pappas, E., Edwards, K. M., Chau, J. Y., Engelen, L., Voukelatos, A., Whelan, A. K., Bauman, A. E., et al. (2017) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000001018 · Cited by 34 · see citing works
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“In addition, short-term intervention studies have shown that breaking up prolonged sedentary time with periods of light activity or standing provides favourable changes to the cardiometabolic risk profile.(6) 7 Evidence syntheses have reported that a statistically significant reduction in sedentary behaviour in adults…”
BackgroundKallings, L., Olsson, S. J. G., Ekblom, Ö. B., Ekblom‐Bak, E., & Börjesson, M. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16234766 · Cited by 33 · see citing works
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Breaking up sedentary time, physical activity and lipoprotein metabolism
Engeroff, T., Füzéki, E., Vogt, L., & Banzer, W. E. (2017) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2016.11.018 · Cited by 32 · see citing works
- Authors
- Chastin, S. F. M., Egerton, T., Leask, C., & Stamatakis, E.
- Affiliations
- Glasgow Caledonian University (GB)
- Norwegian University of Science and Technology (NO)
- The University of Sydney (AU)
- Corresponding author
- Chastin, Sebastien F.M.
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2015-08-26
- Volume
- 23
- Issue
- 9
- Pages
- 1800-1810
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- OpenAlex
- W2110356995
- Cited by
- 363
- References
- 37
- Citations by year
- 2026: 20 · 2025: 22 · 2024: 31 · 2023: 32 · 2022: 29 · 2021: 48 · 2020: 45 · 2019: 42 · 2018: 38 · 2017: 32 · 2016: 18 · 2015: 5
- FWCI
- 3.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Obesity (publishedVersion)
- PubMed (publishedVersion)
- ResearchOnline (Glasgow Caledonian University) (acceptedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Social Sciences › Psychology › Social Psychology › Ergonomics and Musculoskeletal Disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- sedentary behavior, light physical activity, cardiometabolic health, adiposity, glycemia, postprandial blood glucose, lipidemia
- MeSH terms
- Adult, Cardiovascular Diseases, Female, Humans, Male, Motor Activity, Obesity, Posture, Risk Factors, Health Behavior, Exercise, Metabolic Syndrome, Adiposity, Sedentary Behavior
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Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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