Sedentary behavior as a mediator of type 2 diabetes
Open accessAbstract
Over the past 5 years, the fastest growing new area of physical activity research centered around the concept that the large amount of time people spend sitting inactive may have significant physiological consequences hazardous to human health, including risk for type 2 diabetes and poor metabolism of lipids and glucose. Meta-analysis (10 studies) suggests there is a 112% greater relative risk associated with a large duration of sedentary behavior for type 2 diabetes. Meta-analysis also indicates significantly greater odds for metabolic syndrome. We also summarize results for 7 studies using objective measures of total sedentary time and focusing on cardiometabolic risks in persons at high risk for type 2 diabetes or already diagnosed with type 2 diabetes. The underlying hypothesis introduced in 2004 by the inactivity physiology paradigm has been that frequent and abundant contractile activity by certain types of skeletal muscle can have a potent influence on key physiological processes, even when the intensity is below that achieved through exercise. We explain some of the mechanisms for why the metabolism in slow-twitch oxidative skeletal muscle is key for understanding the healthy responses to low-intensity physical activity (LIPA). Findings from objective measures from inclinometry indicated that the quartile range for weekly sedentary time is ∼29 h/week. The total daily time that people sit, stand, and accumulate nonexercise steps is independent of traditionally recommended moderate-vigorous physical activity. The large amount of sedentary time associated with risk for disease can only be reduced significantly with safe and nonfatiguing LIPA, especially in the most at-risk proportion of the population. Importantly, experimental studies are starting to indicate that it will be especially insightful to understand the acute dose-response effects of LIPA in order to understand why reducing sedentary time can improve lipid and glucose metabolism for the prevention and treatment of chronic disorders related to type 2 diabetes.
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Written from the paper’s full text.
TL;DR
This review argues that prolonged sedentary behavior is a distinct risk factor for type 2 diabetes and metabolic syndrome, independent of moderate-vigorous physical activity. It synthesizes epidemiological and acute physiological evidence to propose that replacing sitting with frequent, non-fatiguing low-intensity physical activity may improve glucose and lipid metabolism.
Key findings
- In a meta-analysis of 10 studies (6 prospective; 505,045 participants), large vs. small TV time was associated with a 112% greater pooled relative risk of type 2 diabetes, independent of self-reported physical activity.
- In a meta-analysis of 10 cross-sectional studies (21,393 participants), the most sedentary categories had 73% greater odds of metabolic syndrome, even after some studies adjusted for BMI and MVPA.
- Objective inclinometry indicated a ~29 hr/week difference between the most and least sedentary quartiles; people sat 50% to 75% of the waking day, and sedentary time was independent of recommended MVPA.
- Acute experimental evidence: one day of sitting reduced insulin-stimulated glucose uptake by 39% vs. LIPA; another study found ~20% differences in postprandial glucose and insulin between sedentary and active conditions, with similar responses across two walking intensities.
Methods
- Narrative review of inactivity physiology, contrasting sedentary behavior with exercise physiology and summarizing epidemiological, objective-monitoring, acute experimental, and animal/molecular studies.
- Data summarized include meta-analyses (10 studies, 505,045 participants; 10 cross-sectional studies, 21,393 participants), 7 studies using objective measures in people at high risk for or diagnosed with type 2 diabetes, and acute trials of sitting vs. low-intensity activity.
- Main analysis is qualitative synthesis of reported relative risks, odds ratios, and physiological mechanisms; no new primary data or meta-analysis is presented.
Limitations
- Stated: bedrest studies require cautious interpretation; datasets not designed for sedentary behavior may have unanticipated confounding; most objective studies do not report timing of sedentary assessment relative to blood sampling; accelerometry has error in the low-intensity range; no reports relate breaks in sedentary time to type 2 diabetes.
- Stated: evidence more strongly supports total sedentary time than pattern/breaks for disease risk; after adjustment for waist or BMI, some break associations were no longer significant.
- Evident: as a narrative review, it does not describe a systematic search strategy or formal quality appraisal, and many included epidemiological studies rely on self-reported TV/sedentary time, limiting causal inference.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
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Cites
Statistics
Claims the paper makes
0 of 87 cited sources checked · 0 supported · 0 flagged
- Findingcitation
Recent studies using inclinometers to quantify all of the non-sitting and total sedentary time indicate that most people sit more than half of every day, or between 50% (1st quartile) to 75% (4th quartile) of the waking day.
“recent studies using inclinometers to quantify all of the non-sitting and total sedentary time (12) indicate that most people sit more than half of every day, or between 50% (1st quartile) to 75% (4th quartile) of the waking day (Fig 4A).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [12] Craft LL Zderic TW Gapstur SM Vaniterson EH Thomas DM Siddique J Hamilton MT Evidence that women meeting physical activity guidelines do not sit less: an observational inclinometry study Int J Behav Nutr Phys Act 2012 10 4 9 122 23034100 PMC3490758
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- Findingcitation
Global gene profiling indicates diversity and potency of responses potentially important for prevention of type 2 diabetes and related metabolic risks, including genes previously shown to modulate glucose metabolism and processes such as inflammation and thrombosis.
“Global gene profiling indicates diversity and potency of the responses potentially important for prevention of type 2 diabetes and related metabolic risks, including genes previously shown to modulate glucose metabolism (e.g., GLUT1, OGTase P110, SNAP-23, and Rad) and frequently associated processes such as inflammation and thrombosis (e.g. LPP1).”
Quote in the paperNot a substantial claim - Findingown data
There was a large cluster of genes with significant increase in expression during prolonged inactivity for 12 hours that did not reverse back to normal within several hours after regaining contractile activity.
“there was a large cluster of genes that had a significant increase in expression during a period of prolonged inactivity for 12 hours, yet unexpectedly did not reverse back to normal within several hours after regaining contractile activity (Fig 1B).”
Quote in the paperSubstantial claim - Findingown data
Even in individuals who exercised at twice the 150 min/week level in the recommendations, sitting time and the total daily non-exercise activity was not different from those who almost never exercised.
“Figure 4B also illustrates that even in the individuals who exercised at twice the 150 min/week level in the recommendations, sitting time and the total daily non-exercise activity was not different from those who almost never exercised.”
Quote in the paperSubstantial claim - Findingown data
There was a difference of ~29 hrs/week between the most and least sedentary quartiles.
“Quantitatively, we found there was a difference of ~29 hrs/week between the most and least sedentary quartiles (Figure 4A).”
Quote in the paperNot a substantial claim
- Premisecitation
The most sedentary categories had 73% greater odds for metabolic syndrome compared with relatively low sedentary time categories.
“Comparing relatively low and high categories of sedentary time, the most sedentary categories had 73% greater odds for metabolic syndrome, even after some of these studies apparently adjusted for BMI and MVPA.”
- Also stated in: § Abstract · hedged
“Meta-analysis also indicates significantly greater odds for metabolic syndrome.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [3] Edwardson CL Gorely T Davies MJ Gray LJ Khunti K Wilmot EG Yates T Biddle SJ Association of sedentary behaviour with metabolic syndrome: a meta-analysis PLoS One 2012 7 4 PMC3325927 22514690
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- Also stated in: § Abstract · hedged
- Premisecitation
The relationships between TV time and type 2 diabetes were independent of self-reported physical activity.
“the relationships between TV time and type 2 diabetes were independent of self-reported “physical activity” (meaning exercise-like behaviors).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [10] Wilmot EG Edwardson CL Achana FA Davies MJ Gorely T Gray LJ Khunti K Yates T Biddle SJ Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis Diabetologia 2012 55 11 2895 905 22890825
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- Premisecitation
The meta-analysis supporting the current U.S. federal physical activity guidelines found a 1.4-fold greater pooled relative risk of diabetes for people who did not meet guideline-defined activity.
“the meta-analysis providing support for the current U.S. federal physical activity guidelines was associated with a 1.4 fold greater pooled relative risk of diabetes for people who did not meet the guideline-defined types of activity, such as brisk walking (2).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [2] 2008 Physical Activity Guidelines for Americans US Department of Health and Human Services 2008 www.health.gov/paguidelines/
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- Premisecitation
The total daily time that people sit, stand, and accumulate non-exercise steps is independent of traditionally recommended moderate-vigorous physical activity (MVPA).
“The total daily time that people sit, stand, and accumulate non-exercise steps is independent of traditionally recommended moderate-vigorous physical activity (MVPA).”
- Also stated in: § Associations between sedentary behaviors and type 2 diabetes · hedged
“This is likely relevant to the objective evidence that sedentary time is unrelated to the time that people engage in the activity profile currently recommended in the U.S. federal guidelines (12).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [12] Craft LL Zderic TW Gapstur SM Vaniterson EH Thomas DM Siddique J Hamilton MT Evidence that women meeting physical activity guidelines do not sit less: an observational inclinometry study Int J Behav Nutr Phys Act 2012 10 4 9 122 23034100 PMC3490758
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- Also stated in: § Associations between sedentary behaviors and type 2 diabetes · hedged
- Premisecitation
A large duration of sedentary behavior is associated with a 112% greater relative risk of type 2 diabetes.
“Meta-analysis (10 studies) suggest there is a 112% greater relative risk associated with a large duration of sedentary behavior for type 2 diabetes.”
- Also stated in: § Associations between sedentary behaviors and type 2 diabetes · plain
“One meta-analysis examined 10 studies (6 prospective) including 505,045 participants (10) and found that there was a 112% greater pooled relative risk of diabetes associated with large vs. small amounts of TV time (typically differing by a few hours per day as shown in Table 1, column 4).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [10] Wilmot EG Edwardson CL Achana FA Davies MJ Gorely T Gray LJ Khunti K Yates T Biddle SJ Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis Diabetologia 2012 55 11 2895 905 22890825
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- Also stated in: § Associations between sedentary behaviors and type 2 diabetes · plain
- Premisecitation
The relationship between sedentary time and insulin sensitivity was independent of the amount of MVPA.
“This relationship was independent of the amount of MVPA (43), as suggested previously for surrogate markers of insulin sensitivity (49).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [43] Balkau B Mhamdi L Oppert JM Nolan J Golay A Porcellati F Laakso M Ferrannini E EGIR-RISC Study Group Physical activity and insulin sensitivity: the RISC study Diabetes 2008 57 10 2613 8 18591396 PMC2551669
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- cites [49] Helmerhorst HJ Wijndaele K Brage S Wareham NJ Ekelund U Objectively measured sedentary time may predict insulin resistance independent of moderate- and vigorous-intensity physical activity Diabetes 2009 58 8 1776 9 19470610 PMC2712788
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- Premisecitation
The risk factors noted above remained significant for total sedentary time even when further adjusted for waist or BMI.
“However, the risk factors noted above remained significant for total sedentary time even when further adjusted for waist or BMI (36,38,41,47).”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [36] Cooper AR Sebire S Montgomery AA Peters TJ Sharp DJ Jackson N Fitzsimons K Dayan CM Andrews RC Sedentary time, breaks in sedentary time and metabolic variables in people with newly diagnosed type 2 diabetes Diabetologia 2012 55 3 589 99 22167127
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- cites [38] Henson J Yates T Biddle SJ Edwardson CL Khunti K Wilmot EG Gray LJ Gorely T Nimmo MA Davies MJ Associations of objectively measured sedentary behaviour and physical activity with markers of cardiometabolic health Diabetologia 2013 56 5 1012 20 23456209
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- cites [41] Henson J Yates T Edwardson CL Khunti K Talbot D Gray LJ Leigh TM Carter P Davies MJ Sedentary time and markers of chronic low-grade inflammation in a high risk population PLoS One 2013 8 10 e78350 24205208 PMC3812126
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- Interpretationreasoning
The available evidence at present most strongly supports the central importance of paying attention to the large total duration of sedentary time in mediating risk for type 2 diabetes.
“the available evidence at present most strongly supports the central importance of paying attention to the large total duration of sedentary time in mediating risk for type 2 diabetes.”
Quote in the paperSubstantial claim - Interpretationcitation
Sedentary time is a behavioral risk factor for the severity of cardiometabolic risk in people at high risk for type 2 diabetes.
“A number of other reports have shown that sedentary time is a behavioral risk factor for the severity of cardiometabolic risk in people at high risk for type 2 diabetes (e.g. adult offspring with a diagnosed parent).”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [38] Henson J Yates T Biddle SJ Edwardson CL Khunti K Wilmot EG Gray LJ Gorely T Nimmo MA Davies MJ Associations of objectively measured sedentary behaviour and physical activity with markers of cardiometabolic health Diabetologia 2013 56 5 1012 20 23456209
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- cites [39] Wijndaele K Orrow G Ekelund U Sharp SJ Brage S Griffin SJ Simmons RK Increasing objectively measured sedentary time increases clustered cardiometabolic risk: a 6 year analysis of the ProActive study Diabetologia 2014 57 2 305 12 24194101 PMC3889989
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- cites [40] Ekelund U Griffin SJ Wareham NJ Physical activity and metabolic risk in individuals with a family history of type 2 diabetes Diabetes Care 2007 30 2 337 42 17259504
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- Premisecitation
More total sitting time across the lifespan appears to be associated with diabetes independent of BMI in youth and adults with type 2 diabetes.
“two recent studies concluded from self-reported total sitting time both in youth (13) and adults with type 2 diabetes (11), that more total sitting time across the lifespan appears to be associated with diabetes independent of BMI.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [13] Kriska A Delahanty L Edelstein S Amodei N Chadwick J Copeland K Galvin B El ghormli L Haymond M Kelsey M Lassiter C Mayer-Davis E Milaszewski K Syme A Sedentary behavior and physical activity in youth with recent onset of type 2 diabetes Pediatrics 2013 131 3 e850 6 23400602 PMC3581838
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- cites [11] George ES Rosenkranz RR Kolt GS Chronic disease and sitting time in middle-aged Australian males: findings from the 45 and Up Study Int J Behav Nutr Phys Act 2013 2 8 10 20 23394382 PMC3571940
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- Interpretationreasoning
The relative balance between total inactivity (sedentary time) and total cumulative daily activity is key for insulin sensitivity.
“Consistent with the logical proposition that sedentary time is a risk because of not enough total activity, the relative balance between total inactivity (sedentary time) and total cumulative daily activity was key for insulin sensitivity.”
Quote in the paperSubstantial claim - Premisecitation
In 801 apparently healthy participants, sedentary time measured using accelerometry was inversely associated with insulin sensitivity measured by hyperinsulinemic-euglycemic clamp.
“A study of 801 apparently healthy participants, in which sedentary time was measured using accelerometry showed that sedentary time was inversely associated with insulin sensitivity, measured using a hyperinsulinemic-euglycemic clamp (43).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [43] Balkau B Mhamdi L Oppert JM Nolan J Golay A Porcellati F Laakso M Ferrannini E EGIR-RISC Study Group Physical activity and insulin sensitivity: the RISC study Diabetes 2008 57 10 2613 8 18591396 PMC2551669
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- Premisecitation
Stephens et al. observed a 39% reduction in insulin-stimulated glucose uptake after a day of sitting compared to a trial with LIPA when energy intake was held constant by controlled feedings.
“Stephens et al. (53) observed a 39% reduction in insulin stimulated glucose uptake (tracer determined plasma glucose uptake per unit insulin) after a day of sitting compared to a trial with LIPA when energy intake was held constant by controlled feedings.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [53] Stephens BR Granados K Zderic TW Hamilton MT Braun B Effects of 1 day of inactivity on insulin action in healthy men and women: interaction with energy intake Metabolism 2011 60 7 941 9 21067784
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- Premisecitation
After adjustment for waist circumference or BMI, the 2-hour glucose and TG relationships with sedentary breaks were no longer significant.
“After adjustment for waist circumference or BMI, the 2 hr glucose and TG relationships with sedentary breaks were no longer significant (30,45).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [30] Bankoski A Harris TB McClain JJ Brychta RJ Caserotti P Chen KY Berrigan D Troiano RP Koster A Sedentary activity associated with metabolic syndrome independent of physical activity Diabetes Care 2011 34 2 497 503 21270206 PMC3024375
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- cites [45] Healy GN Dunstan DW Salmon J Cerin E Shaw JE Zimmet PZ Owen N Breaks in sedentary time: beneficial associations with metabolic risk Diabetes Care 2008 31 4 661 6 18252901
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- Interpretationreasoning
The epidemiological data suggest the need to consider additional mechanisms beyond BMI and body fat for the relationship between sedentary behavior and diabetes risk.
“these epidemiological data are also alluding to the need to consider additional and more distinct mechanisms beyond BMI and body fat.”
Quote in the paperSubstantial claim - Premisecitation
Activation of muscle fibers generally follows an almost all-or-none/on-off type of dichotomy at the single fiber level because of orderly recruitment of motor units.
“Because of the well-appreciated concept of orderly recruitment of motor units, activation of muscle fibers generally follows an almost all-or-none/on-off type of dichotomy at the single fiber level (see Fig 4.2 in reference 7).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [7] Hamilton MT Owen N Sedentary Behavior and Inactivity Physiology Physical Activity and Health 2 Bouchard C Blair SN Haskell WL Human Kinetics 2011 53 68
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- Interpretationreasoning
These insights may explain at least some of the links between sedentary behavior, local processes impinging upon the need for slow oxidative fibers to contract at a high duration for many hours each day, and the regulation of metabolic risk factors present in people at risk for type 2 diabetes.
“Taken together, these insights may explain at least some of the links between sedentary behavior, local processes impinging upon the need for slow oxidative fibers to contract at a high duration for many hours each day, and the regulation of metabolic risk factors present in people at risk for type 2 diabetes.”
Quote in the paperSubstantial claim - Premisecitation
LPP1 was apparently unresponsive to an hour per day of intense exercise.
“Follow-up studies (Fig 1D; 61) confirmed these responses and extended the findings to reveal that LPP1 is rapidly reduced in both rats and humans when skeletal muscle is inactive; yet this gene was apparently unresponsive to an hour per day of intense exercise.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [61] Zderic TW Hamilton MT Identification of hemostatic genes expressed in human and rat leg muscles and a novel gene (LPP1/PAP2A) suppressed during prolonged physical inactivity (sitting) Lipids Health Dis 2012 12;11 137 PMC3539950 23061662
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- Premisecitation
Low levels of LPL expression is a cause for lower than normal mitochondrial content in skeletal muscle of insulin resistant offspring whose parents have type 2 diabetes.
“there is evidence that low levels of LPL expression is a cause for lower than normal mitochondrial content in skeletal muscle of insulin resistant offspring whose parents have type 2 diabetes (67).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [67] Morino K Petersen KF Sono S Choi CS Samuel VT Lin A Gallo A Zhao H Kashiwagi A Goldberg IJ Wang H Eckel RH Maegawa H Shulman GI Regulation of mitochondrial biogenesis by lipoprotein lipase in muscle of insulin-resistant offspring of parents with type 2 diabetes Diabetes 2012 61 4 877 87 22368174 PMC3314372
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- Interpretationreasoning
Muscle tissue is potentially responsive to the balance of total time spent without contractile activity (sedentary) versus in contractile activity, not just during the hour of formal exercise.
“With regards to sedentary time, this means that muscle tissue is potentially responsive to the balance of total time spent either without contractile activity (sedentary) or in contractile activity, not just in the hour during formal exercise.”
Quote in the paperSubstantial claim- Rests on an assumption: Muscle cells are constantly sensing and responding to their environment, so contractile activity and inactivity over the whole day counts.
- Study design and conductown data
Most if not all studies assessing sedentary time with objective measures do not report when the sedentary time assessment is performed in relation to blood sampling for cardiometabolic risk factors.
“most if not all studies assessing sedentary time with objective measures do not report when the sedentary time assessment is performed in relation to the blood sampling for cardiometabolic risk factors (see last column of Table 2).”
Quote in the paperSubstantial claim - Interpretationcitation
Acute metabolic responses in relatively fatigue-resistant slow twitch oxidative skeletal muscle may play a central role in combating the diseases associated with too much sitting.
“acute metabolic responses in relatively fatigue-resistant slow twitch oxidative skeletal muscle may play a central role in combating the diseases associated with too much sitting (7).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [7] Hamilton MT Owen N Sedentary Behavior and Inactivity Physiology Physical Activity and Health 2 Bouchard C Blair SN Haskell WL Human Kinetics 2011 53 68
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- Rests on an assumption: Acute contractile activity induces local signals stimulating glucose uptake independent of insulin signaling.
- Premisecitation
The slow oxidative soleus muscle of rats had a significantly greater plasma triglyceride uptake during contractile activity than other muscles.
“studies have also found that the slow oxidative soleus muscle of rats had a significantly greater plasma triglyceride uptake during contractile activity than other muscles (63).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [63] Mackie BG Dudley GA Kaciuba-Uscilko H Terjung RL Uptake of chylomicron triglycerides by contracting skeletal muscle in rats J Appl Physiol Respir Environ Exerc Physiol 1980 49 5 851 5 7429908
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- Premisecitation
In conscious and unrestrained rats performing only light non-exercising activities, insulin-induced increases in total peripheral glucose disposal occurred predominantly in muscles containing a high proportion of slow oxidative fibers.
“In conscious and unrestrained rats performing only light non-exercising activities, James et al (62) found that insulin-induced increases in total peripheral glucose disposal occurred predominantly in muscles containing a high proportion of slow oxidative fibers.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [62] James DE Jenkins AB Kraegen EW Heterogeneity of insulin action in individual muscles in vivo: euglycemic clamp studies in rats Am J Physiol 1985 248 5 Pt 1 E567 74 3887942
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- Interpretationcitation
Type 2 diabetes and metabolic syndrome risks are independent of the type of well-established MVPA recommended in the existing guidelines.
“Type 2 diabetes and metabolic syndrome risks are independent of the type of well-established MVPA recommended in the existing guidelines.”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [4] Hamilton MT Hamilton DG Zderic TW Exercise physiology versus inactivity physiology: an essential concept for understanding lipoprotein lipase regulation Exerc Sport Sci Rev 2004 32 4 161 6 15604935 PMC4312662
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- cites [5] Hamilton MT Hamilton DG Zderic TW Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease Diabetes 2007 56 11 2655 67 17827399
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- cites [6] Hamilton MT Healy GN Dunstan DW Zderic TW Owen N Too little exercise and too much sitting: inactivity physiology and the need for new recommendations on sedentary behavior Current Cardiovascular Risk Reports 2008 2 292 298 22905272 PMC3419586
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- cites [7] Hamilton MT Owen N Sedentary Behavior and Inactivity Physiology Physical Activity and Health 2 Bouchard C Blair SN Haskell WL Human Kinetics 2011 53 68
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- Premisecitation
One study identified over 100 genes with significantly altered expression during transitions between periods of acute inactivity and activity.
“One study identified over 100 genes with significantly altered expression during the transitions between periods of acute inactivity and activity (58).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [58] Bey L Akunuri N Zhao P Hoffman EP Hamilton DG Hamilton MT Patterns of global gene expression in rat skeletal muscle during unloading and low-intensity ambulatory activity Physiol Genomics 2003 13 2 157 67 12582208
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- Premisecitation
LPP1 is involved in inactivating a subfamily of lysophospholipids known to cause impaired glucose tolerance in obese mice.
“LPP1 is involved in inactivating a subfamily of lysophospholipids known to cause impaired glucose tolerance in obese mice (68).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [68] Rancoule C Attané C Grès S Fournel A Dusaulcy R Bertrand C Vinel C Tréguer K Prentki M Valet P Saulnier-Blache JS Lysophosphatidic acid impairs glucose homeostasis and inhibits insulin secretion in high-fat diet obese mice Diabetologia 2013 56 6 1394 402 23508306
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- Premisecitation
Duvivier et al. reported that replacing sedentary time with a large amount of non-exercise physical activity was more effective than exercise in reducing plasma triglyceride, non-HDL cholesterol, and postprandial insulin.
“Duvivier et al (54) reported that replacing sedentary time with a large amount of non-exercise physical activity was more effective than exercise in reducing plasma triglyceride, non-HDL cholesterol, postprandial insulin.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [54] Duvivier BM Schaper NC Bremers MA van Crombrugge G Menheere PP Kars M Savelberg HH Minimal intensity physical activity (standing and walking) of longer duration improves insulin action and plasma lipids more than shorter periods of moderate to vigorous exercise (cycling) in sedentary subjects when energy expenditure is comparable PLoS One 2013 8 2 e55542 23418444 PMC3572053
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- Premisecitation
Based on arteriovenous measurements, there was a very large influence of contractile activity on glucose uptake into the working legs.
“Based on arteriovenous measurements (57), there was a very large influence of contractile activity on glucose uptake into the working legs.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [57] DeFronzo RA Ferrannini E Sato Y Felig P Wahren J Synergistic interaction between exercise and insulin on peripheral glucose uptake J Clin Invest 1981 68 6 1468 74 7033285 PMC370949
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- Premisecitation
Acute contractile activity provides not just an additive effect with insulin, but synergistic effects on plasma glucose disposal/utilization when combined with hyperinsulinemia.
“two fascinating studies by Wasserman’s (56) and DeFronso’s (57) groups concluded that acute contractile activity provides not just an additive effect with insulin, but synergistic effects on plasma glucose disposal/utilization when combined with hyperinsulinemia.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [56] Wasserman DH Geer RJ Rice DE Bracy D Flakoll PJ Brown LL Hill JO Abumrad NN Interaction of exercise and insulin action in humans Am J Physiol 1991 260 1 Pt 1 E37 45 1987792
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- cites [57] DeFronzo RA Ferrannini E Sato Y Felig P Wahren J Synergistic interaction between exercise and insulin on peripheral glucose uptake J Clin Invest 1981 68 6 1468 74 7033285 PMC370949
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- Interpretationreasoning
It is likely that some of the most oxidative and fatigue resistant muscle can play a dominant role in the energetics and fuel utilization during many hours per day of light activity, while the vast majority of the body's muscle mass may remain relatively inactive.
“Thus, it is likely that some of the most oxidative and fatigue resistant muscle can play a dominant role in the energetics and fuel utilization during many hours per day of light activity, while the vast majority of the body’s muscle mass may remain relatively inactive.”
Quote in the paperSubstantial claim - Premisecitation
The dynamic rise and fall in the energy demands of contracting and inactive states is greater in skeletal muscle than any other cell type.
“The dynamic rise and fall in the energy demands of contracting and inactive states is greater in skeletal muscle than any other cell type (7).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [7] Hamilton MT Owen N Sedentary Behavior and Inactivity Physiology Physical Activity and Health 2 Bouchard C Blair SN Haskell WL Human Kinetics 2011 53 68
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- Premisecitation
The 39% effect on insulin action was evident the next morning after a night of rest and before getting out of bed.
“this rather large 39% effect on insulin action was evident even though it was assessed the next morning after a night of rest and before getting out of bed.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [53] Stephens BR Granados K Zderic TW Hamilton MT Braun B Effects of 1 day of inactivity on insulin action in healthy men and women: interaction with energy intake Metabolism 2011 60 7 941 9 21067784
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- Interpretationreasoning
The glucose abnormalities present in people who either have pre-diabetes or diabetes may be influenced by acute contractile activity.
“the glucose abnormalities present in people who either have pre-diabetes or diabetes may be influenced by acute contractile activity.”
Quote in the paperSubstantial claim- Rests on an assumption: Acute contractile activity induces local signals stimulating glucose uptake independent of insulin signaling.
- Interpretationreasoning
The benefit of this range of intermittent activity on glucose and insulin was independent of intensity.
“These findings suggest that the benefit of this range of intermittent activity on glucose and insulin was independent of intensity.”
Quote in the paperSubstantial claim - Premisecitation
Despite a two-fold difference in walking speeds (2.0 mph versus 3.6-4.0 mph), the glucose and insulin responses throughout the postprandial period were essentially identical.
“despite a two-fold difference in walking speeds (2.0 mph versus 3.6–4.0 mph), the glucose and insulin responses throughout the postprandial period were essentially identical.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [53] Stephens BR Granados K Zderic TW Hamilton MT Braun B Effects of 1 day of inactivity on insulin action in healthy men and women: interaction with energy intake Metabolism 2011 60 7 941 9 21067784
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- Interpretationcitation
The greater plasma triglyceride uptake in slow oxidative soleus muscle could be explained by a significantly greater lipoprotein lipase (LPL) activity in the slow oxidative muscle possessing a relatively low threshold for activation.
“This could be explained by a significantly greater lipoprotein lipase (LPL) activity in the slow oxidative muscle possessing a relatively low threshold for activation (59,64; Fig 3).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [59] Bey L Hamilton MT Suppression of skeletal muscle lipoprotein lipase activity during physical inactivity: a molecular reason to maintain daily low-intensity activity J Physiol 2003 551 Pt 2 673 82 12815182 PMC2343229
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- cites [64] Hamilton MT Etienne J McClure WC Pavey BS Holloway AK Role of local contractile activity and muscle fiber type on LPL regulation during exercise Am J Physiol 1998 275 38 E1016 E1022 9843744
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- Premisecitation
LPP1 is rapidly reduced in both rats and humans when skeletal muscle is inactive.
“Follow-up studies (Fig 1D; 61) confirmed these responses and extended the findings to reveal that LPP1 is rapidly reduced in both rats and humans when skeletal muscle is inactive; yet this gene was apparently unresponsive to an hour per day of intense exercise.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [61] Zderic TW Hamilton MT Identification of hemostatic genes expressed in human and rat leg muscles and a novel gene (LPP1/PAP2A) suppressed during prolonged physical inactivity (sitting) Lipids Health Dis 2012 12;11 137 PMC3539950 23061662
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- Premisecitation
The 3-6 fold difference between muscle types was associated with a 65% greater hexokinase activity in the red oxidative muscles compared to the more white glycolytic muscles.
“The 3–6 fold difference between muscle types was associated with a 65% greater hexokinase activity in the red oxidative muscles compared to the more white glycolytic muscles.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [62] James DE Jenkins AB Kraegen EW Heterogeneity of insulin action in individual muscles in vivo: euglycemic clamp studies in rats Am J Physiol 1985 248 5 Pt 1 E567 74 3887942
Not checked in the free run.
- Interpretationreasoning
Such data looks to be especially significant for mediating risk factors independent of weight changes.
“Such data looks to be especially significant for mediating risk factors independent of weight changes.”
Quote in the paperSubstantial claim - Interpretationreasoning
Molecular processes governing plasma glucose utilization and other risk factors can show potent responses in slow oxidative skeletal muscles.
“Molecular processes governing plasma glucose utilization and other risk factors can show potent responses in slow oxidative skeletal muscles.”
Quote in the paperSubstantial claim - Interpretationcitation
The effect of "too much sitting" (actually, contractile inactivity) is not the same as too little exercise (i.e., the narrowly defined type of activity recommended by the current guidelines).
“Put simplistically (4–7), the effect of “too much sitting” (actually, contractile inactivity) is not the same as too little exercise (i.e., the narrowly defined type of activity recommended by the current guidelines).”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [4] Hamilton MT Hamilton DG Zderic TW Exercise physiology versus inactivity physiology: an essential concept for understanding lipoprotein lipase regulation Exerc Sport Sci Rev 2004 32 4 161 6 15604935 PMC4312662
Not checked in the free run.
- cites [5] Hamilton MT Hamilton DG Zderic TW Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease Diabetes 2007 56 11 2655 67 17827399
Not checked in the free run.
- cites [6] Hamilton MT Healy GN Dunstan DW Zderic TW Owen N Too little exercise and too much sitting: inactivity physiology and the need for new recommendations on sedentary behavior Current Cardiovascular Risk Reports 2008 2 292 298 22905272 PMC3419586
Not checked in the free run.
- cites [7] Hamilton MT Owen N Sedentary Behavior and Inactivity Physiology Physical Activity and Health 2 Bouchard C Blair SN Haskell WL Human Kinetics 2011 53 68
Not checked in the free run.
- Interpretationnone given
Existing evidence has consistently indicated that the most meaningful relationships were associated with large amounts of time, when comparing individuals with the most and least sedentary time.
“Notice also that the existing evidence has consistently indicated that the most meaningful relationships were associated with large amounts of time, when comparing individuals with the most and least sedentary time.”
Quote in the paperSubstantial claim - Premisecitation
Studies have concluded that there are potent molecular effects of maintaining a high daily duration of non-fatiguing contractile activity.
“As we have reviewed in this article and elsewhere (45,6,59), studies have concluded that there are potent molecular effects of maintaining a high daily duration of non-fatiguing contractile activity (59).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [59] Bey L Hamilton MT Suppression of skeletal muscle lipoprotein lipase activity during physical inactivity: a molecular reason to maintain daily low-intensity activity J Physiol 2003 551 Pt 2 673 82 12815182 PMC2343229
Not checked in the free run.
- Classified as probably not a substantial claim. 6
- May combine two claims. 19
Probably not a substantial claim: may not pass S3 (load-bearing).
Premiseown dataThe quartile range for weekly sedentary time is approximately 29 hours per week.
“Findings from objective measures from inclinometry indicated that the quartile range for weekly sedentary time is ~29 hours/week.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationSaunders et al. concluded that overall there were moderate to large unfavorable effects of high amounts of sedentary time on plasma triglyceride, glucose tolerance, and insulin sensitivity.
“They concluded that overall there were moderate to large unfavorable effects of high amounts of sedentary time on plasma triglyceride, glucose tolerance, and insulin sensitivity.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [8] Saunders TJ Larouche R Colley RC Tremblay MS Acute sedentary behaviour and markers of cardiometabolic risk: a systematic review of intervention studies J Nutr Metab 2012 2012 712435 22754695 PMC3382951
Not checked in the free run.
May combine two claims.
PremisecitationSedentary time is associated with an increased risk of cardiovascular disease and all-cause mortality, with the strength of association most consistent for type 2 diabetes.
“Authors also concluded from meta-analysis that sedentary time is associated with an increased risk of cardiovascular disease and all-cause mortality, while the strength of the association is most consistent for type 2 diabetes (10).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [10] Wilmot EG Edwardson CL Achana FA Davies MJ Gorely T Gray LJ Khunti K Yates T Biddle SJ Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis Diabetologia 2012 55 11 2895 905 22890825
Not checked in the free run.
May combine two claims.
PremisecitationThere is an inverse relationship between breaks in sedentary time and waist circumference and BMI.
“there is an inverse relationship between breaks in sedentary time with waist circumference (36,38,45,46) and BMI (45).”
Quote in the paperNot a substantial claim0 of 4 sources checked- cites [36] Cooper AR Sebire S Montgomery AA Peters TJ Sharp DJ Jackson N Fitzsimons K Dayan CM Andrews RC Sedentary time, breaks in sedentary time and metabolic variables in people with newly diagnosed type 2 diabetes Diabetologia 2012 55 3 589 99 22167127
Not checked in the free run.
- cites [38] Henson J Yates T Biddle SJ Edwardson CL Khunti K Wilmot EG Gray LJ Gorely T Nimmo MA Davies MJ Associations of objectively measured sedentary behaviour and physical activity with markers of cardiometabolic health Diabetologia 2013 56 5 1012 20 23456209
Not checked in the free run.
- cites [45] Healy GN Dunstan DW Salmon J Cerin E Shaw JE Zimmet PZ Owen N Breaks in sedentary time: beneficial associations with metabolic risk Diabetes Care 2008 31 4 661 6 18252901
Not checked in the free run.
- cites [46] Healy GN Matthews CE Dunstan DW Winkler EA Owen N Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003–06 Eur Heart J 2011 32 5 590 7 21224291 PMC3634159
Not checked in the free run.
May combine two claims.
PremisecitationIn adults, total sedentary time was significantly related to metabolic syndrome, insulin, HOMA-IR, 2-hour glucose, TG concentration, HDL, CRP, and IL-6.
“total sedentary time was significantly related to metabolic syndrome (30), insulin (36,46), HOMA-IR (36,46), 2 hr glucose (38,47), TG concentration (38,45,46), HDL (36,38,46), CRP (46), and IL-6 (41).”
Quote in the paperSubstantial claim0 of 5 sources checked- cites [30] Bankoski A Harris TB McClain JJ Brychta RJ Caserotti P Chen KY Berrigan D Troiano RP Koster A Sedentary activity associated with metabolic syndrome independent of physical activity Diabetes Care 2011 34 2 497 503 21270206 PMC3024375
Not checked in the free run.
- cites [36] Cooper AR Sebire S Montgomery AA Peters TJ Sharp DJ Jackson N Fitzsimons K Dayan CM Andrews RC Sedentary time, breaks in sedentary time and metabolic variables in people with newly diagnosed type 2 diabetes Diabetologia 2012 55 3 589 99 22167127
Not checked in the free run.
- cites [46] Healy GN Matthews CE Dunstan DW Winkler EA Owen N Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003–06 Eur Heart J 2011 32 5 590 7 21224291 PMC3634159
Not checked in the free run.
- cites [38] Henson J Yates T Biddle SJ Edwardson CL Khunti K Wilmot EG Gray LJ Gorely T Nimmo MA Davies MJ Associations of objectively measured sedentary behaviour and physical activity with markers of cardiometabolic health Diabetologia 2013 56 5 1012 20 23456209
Not checked in the free run.
- cites [47] Healy GN Dunstan DW Salmon J Cerin E Shaw JE Zimmet PZ Owen N Objectively measured light-intensity physical activity is independently associated with 2-hr plasma glucose Diabetes Care 2007 30 6 1384 9 17473059
Not checked in the free run.
May combine two claims.
PremisecitationIn a cross-sectional analysis using a heart rate method, sedentary time was unfavorably related to plasma TG and HDL concentrations, waist circumference, and a clustered metabolic risk score.
“A similar cross-sectional analysis using a heart rate method (35) reported that sedentary time was unfavorably related to plasma TG and HDL concentrations, waist circumference, and a clustered metabolic risk score (HbA1C, TG, inverse of HDL, waist).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [35] Matthews CE George SM Moore SC Bowles HR Blair A Park Y Troiano RP Hollenbeck A Schatzkin A Amount of time spent in sedentary behaviors and cause-specific mortality in US adults Am J Clin Nutr 2012 95 2 437 45 22218159 PMC3260070
Not checked in the free run.
May combine two claims.
PremisecitationThere was about a 4-hour difference between the groups with the most and least sedentary time and a ~40% range in insulin-stimulated glucose uptake.
“There was about 4 hr difference between the groups with the most and the least sedentary time and ~40% range in insulin-stimulated glucose uptake (43).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [43] Balkau B Mhamdi L Oppert JM Nolan J Golay A Porcellati F Laakso M Ferrannini E EGIR-RISC Study Group Physical activity and insulin sensitivity: the RISC study Diabetes 2008 57 10 2613 8 18591396 PMC2551669
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationInsulin resistance is thought to be an underlying culprit in metabolic syndrome.
“Insulin resistance is thought to be an underlying culprit in much of this condition (20).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [20] Jornayvaz FR Samuel VT Shulman GI The role of muscle insulin resistance in the pathogenesis of atherogenic dyslipidemia and nonalcoholic fatty liver disease associated with the metabolic syndrome Annu Rev Nutr 2010 30 273 90 20645852 PMC3730129
Not checked in the free run.
May combine two claims.
PremisecitationIn these studies, breaks were related to 2-hour glucose, TG, CRP, and metabolic syndrome.
“breaks were related to 2 hr glucose (45), TG (45), CRP (46), and metabolic syndrome (30).”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [45] Healy GN Dunstan DW Salmon J Cerin E Shaw JE Zimmet PZ Owen N Breaks in sedentary time: beneficial associations with metabolic risk Diabetes Care 2008 31 4 661 6 18252901
Not checked in the free run.
- cites [46] Healy GN Matthews CE Dunstan DW Winkler EA Owen N Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003–06 Eur Heart J 2011 32 5 590 7 21224291 PMC3634159
Not checked in the free run.
- cites [30] Bankoski A Harris TB McClain JJ Brychta RJ Caserotti P Chen KY Berrigan D Troiano RP Koster A Sedentary activity associated with metabolic syndrome independent of physical activity Diabetes Care 2011 34 2 497 503 21270206 PMC3024375
Not checked in the free run.
May combine two claims.
PremisecitationSedentary time was directly associated with an insulin secretion index derived from an OGTT even after adjustment for clamp-determined insulin sensitivity, and with higher TG and lower HDL-C independent of sustained MVPA but related to total daily activity.
“Sedentary time in this cohort was also directly associated with an insulin secretion index derived from an OGTT even after adjustment for clamp determined insulin sensitivity, and also with higher TG, and lower HDL-C independent of sustained MVPA but instead related to total daily activity (44).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [44] Lahjibi E Heude B Dekker JM Højlund K Laville M Nolan J Oppert JM Balkau B RISC Study Group Impact of objectively measured sedentary behaviour on changes in insulin resistance and secretion over 3 years in the RISC study: interaction with weight gain Diabetes Metab 2013 39 3 217 25 23541222
Not checked in the free run.
May combine two claims.
PremisecitationThe relationships between sedentary behavior and disease rates remained significant in some studies additionally modeling for BMI but not in all situations.
“these relationships with disease rates remained significant in some of the studies additionally modeling for BMI (14–16) but not in all situations (17,18).”
Quote in the paperSubstantial claim0 of 5 sources checked- cites [14] Hu FB Leitzmann MF Stampfer MJ Colditz GA Willett WC Rimm EB Physical activity and television watching in relation to risk for type 2 diabetes mellitus in men Arch Intern Med 2001 161 12 1542 8 11427103
Not checked in the free run.
- cites [15] Krishnan S Rosenberg L Palmer JR Physical activity and television watching in relation to risk of type 2 diabetes: the Black Women’s Health Study Am J Epidemiol 2009 169 4 428 34 19056835 PMC2726641
Not checked in the free run.
- cites [16] Tonstad S Butler T Yan R Fraser GE Type of vegetarian diet, body weight, and prevalence of type 2 diabetes Diabetes Care 2009 32 5 791 6 19351712 PMC2671114
Not checked in the free run.
- cites [17] Ford ES Schulze MB Kröger J Pischon T Bergmann MM Boeing H Television watching and incident diabetes: Findings from the European Prospective Investigation into Cancer and Nutrition-Potsdam Study J Diabetes 2010 2 1 23 7 20923471
Not checked in the free run.
- cites [18] Dunstan DW Salmon J Owen N Armstrong T Zimmet PZ Welborn TA Cameron AJ Dwyer T Jolley D Shaw JE AusDiab Steering Committee Physical activity and television viewing in relation to risk of undiagnosed abnormal glucose metabolism in adults Diabetes Care 2004 27 11 2603 9 15504993
Not checked in the free run.
May combine two claims.
PremisecitationThe risk of too much sedentary time was independent of both the amount of accumulative MVPA and body composition indices such as BMI and waist.
“the risk of too much sedentary time was independent of both the amount of accumulative MVPA and body composition indices (BMI, waist).”
Quote in the paperSubstantial claim0 of 6 sources checked- cites [36] Cooper AR Sebire S Montgomery AA Peters TJ Sharp DJ Jackson N Fitzsimons K Dayan CM Andrews RC Sedentary time, breaks in sedentary time and metabolic variables in people with newly diagnosed type 2 diabetes Diabetologia 2012 55 3 589 99 22167127
Not checked in the free run.
- cites [37] Cooper AJ Brage S Ekelund U Wareham NJ Griffin SJ Simmons RK Association between objectively assessed sedentary time and physical activity with metabolic risk factors among people with recently diagnosed type 2 diabetes Diabetologia 2014 57 1 73 82 24196189 PMC3857880
Not checked in the free run.
- cites [38] Henson J Yates T Biddle SJ Edwardson CL Khunti K Wilmot EG Gray LJ Gorely T Nimmo MA Davies MJ Associations of objectively measured sedentary behaviour and physical activity with markers of cardiometabolic health Diabetologia 2013 56 5 1012 20 23456209
Not checked in the free run.
- cites [39] Wijndaele K Orrow G Ekelund U Sharp SJ Brage S Griffin SJ Simmons RK Increasing objectively measured sedentary time increases clustered cardiometabolic risk: a 6 year analysis of the ProActive study Diabetologia 2014 57 2 305 12 24194101 PMC3889989
Not checked in the free run.
- cites [40] Ekelund U Griffin SJ Wareham NJ Physical activity and metabolic risk in individuals with a family history of type 2 diabetes Diabetes Care 2007 30 2 337 42 17259504
Not checked in the free run.
- cites [41] Henson J Yates T Edwardson CL Khunti K Talbot D Gray LJ Leigh TM Carter P Davies MJ Sedentary time and markers of chronic low-grade inflammation in a high risk population PLoS One 2013 8 10 e78350 24205208 PMC3812126
Not checked in the free run.
May combine two claims.
PremisecitationIn a cross-sectional and prospective study of 528 people, sedentary time estimated from hip-mounted accelerometry was unfavorably related to fasting insulin, HOMA-IR, and HDL-C at baseline and after 6 months follow-up.
“In a cross-sectional and prospective study of 528 people, sedentary time, as estimated from hip mounted accelerometry, was unfavorably related to fasting insulin, HOMA-IR, and HDL-C, both at baseline and after 6 months follow up (36).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [36] Cooper AR Sebire S Montgomery AA Peters TJ Sharp DJ Jackson N Fitzsimons K Dayan CM Andrews RC Sedentary time, breaks in sedentary time and metabolic variables in people with newly diagnosed type 2 diabetes Diabetologia 2012 55 3 589 99 22167127
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.
InterpretationreasoningThe prescription for exercise is too brief and too intense to be used as replacement for the vast amount of sedentary time currently linked with disease.
“The prescription for exercise is not only too brief but also too intense to be used as replacement for the vast amount of sedentary time currently linked with disease.”
Quote in the paperNot a substantial claimMay combine two claims.
Premisenone givenSkeletal muscle is a highly heterogeneous tissue and both the threshold for recruitment and the metabolic responses to contractile activity are very much dependent upon fiber type.
“Skeletal muscle is a highly heterogeneous tissue and both the threshold for recruitment and the metabolic responses to contractile activity are very much dependent upon fiber type.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationInactivity stimulated the rise in expression of just as many genes as it repressed gene expression, invoking molecular processes turned on in response to sedentary behavior.
“Notice that inactivity actually stimulated the rise in the expression of just as many genes as it did repress gene expression, invoking molecular processes turned on in response to sedentary behavior.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [58] Bey L Akunuri N Zhao P Hoffman EP Hamilton DG Hamilton MT Patterns of global gene expression in rat skeletal muscle during unloading and low-intensity ambulatory activity Physiol Genomics 2003 13 2 157 67 12582208
Not checked in the free run.
May combine two claims.
PremisecitationThe energy demands of working fibers typically increase 50-100-fold greater in the working muscle mass, while other parts of the musculature can remain at resting levels.
“Because of this, the energy demands of working fibers typically increase 50–100-fold greater in the working muscle mass, while other parts of the musculature can remain at resting levels (7).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [7] Hamilton MT Owen N Sedentary Behavior and Inactivity Physiology Physical Activity and Health 2 Bouchard C Blair SN Haskell WL Human Kinetics 2011 53 68
Not checked in the free run.
May combine two claims.
Interpretationnone givenBoth experimental and epidemiological studies have recently been providing evidence that there may be unhealthy effects of large amounts of sedentary time, and inversely of small amounts of total non-exercise physical activity time.
“Both experimental and epidemiological studies have recently been providing evidence that there may be unhealthy effects of large amounts of sedentary time (and inversely, small amounts of total non-exercise physical activity time, Fig 4A).”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationIn overweight/obese middle-aged adults, there were ~20% differences for both glucose and insulin responses in the sedentary vs. active condition, but the two active trials were similar.
“Most importantly, there were ~20% differences for both the glucose and insulin responses in the sedentary vs. active condition, but the 2 active trials were similar.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [53] Stephens BR Granados K Zderic TW Hamilton MT Braun B Effects of 1 day of inactivity on insulin action in healthy men and women: interaction with energy intake Metabolism 2011 60 7 941 9 21067784
Not checked in the free run.
Probably not a substantial claim: may not pass S4 (based).
InterpretationreasoningThe large amount of sedentary time associated with risk for disease can only be reduced significantly with safe and non-fatiguing LIPA, especially in the most at-risk proportion of the population.
“The large amount of sedentary time associated with risk for disease can only be reduced significantly with safe and non-fatiguing LIPA, especially in the most at risk proportion of the population.”
Quote in the paperNot a substantial claim- Rests on an assumption: Safe and non-fatiguing low-intensity physical activity can significantly reduce the large amount of sedentary time associated with disease risk in the most at-risk population.
Classified as probably not a substantial claim. May combine two claims.
PremisecitationIn that intervention, the conclusion was that duration was more important than intensity because the caloric expenditure of exercise versus non-exercise activity was matched.
“In that intervention, the conclusion was the duration was more important than intensity because the caloric expenditure of exercise versus non-exercise activity was matched (54).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [54] Duvivier BM Schaper NC Bremers MA van Crombrugge G Menheere PP Kars M Savelberg HH Minimal intensity physical activity (standing and walking) of longer duration improves insulin action and plasma lipids more than shorter periods of moderate to vigorous exercise (cycling) in sedentary subjects when energy expenditure is comparable PLoS One 2013 8 2 e55542 23418444 PMC3572053
Not checked in the free run.
May combine two claims.
PremisereasoningSlow oxidative muscle can be heavily engaged during low intensity efforts, while at the same time the fast glycolytic type of muscle may remain inactive.
“A fundamental point is that slow oxidative muscle can be heavily engaged during low intensity efforts, while at the same time the fast glycolytic type of muscle may remain inactive.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationDuring periods of acute contractile inactivity and during reduced spontaneous ambulatory activity associated with aging, LPL activity decreases significantly, but primarily in the slow oxidative muscles where its actions are normally most important.
“During periods of acute contractile inactivity (59,60,64) and during reduced spontaneous ambulatory activity associated with aging (65,66), LPL activity decreases significantly, but primarily in the slow oxidative muscles where its actions are normally most important (Fig 3).”
Quote in the paperSubstantial claim0 of 5 sources checked- cites [59] Bey L Hamilton MT Suppression of skeletal muscle lipoprotein lipase activity during physical inactivity: a molecular reason to maintain daily low-intensity activity J Physiol 2003 551 Pt 2 673 82 12815182 PMC2343229
Not checked in the free run.
- cites [60] Zderic TW Hamilton MT Physical inactivity amplifies the sensitivity of skeletal muscle to the lipid-induced downregulation of lipoprotein lipase activity J Appl Physiol 2006 100 1 249 57 16195388
Not checked in the free run.
- cites [64] Hamilton MT Etienne J McClure WC Pavey BS Holloway AK Role of local contractile activity and muscle fiber type on LPL regulation during exercise Am J Physiol 1998 275 38 E1016 E1022 9843744
Not checked in the free run.
- cites [65] Bey L Areiqat E Sano A Hamilton MT Reduced lipoprotein lipase activity in postural skeletal muscle during aging J Appl Physiol 2001 91 687 692 11457782
Not checked in the free run.
- cites [66] Hamilton MT Areiqat E Hamilton DG Bey L Plasma triglyceride metabolism in humans and rats during aging and physical inactivity International Journal of Sports Nutrition and Exercise Metabolism 2001 11 95 102 11915936
Not checked in the free run.
The paper relies on this without support.
Skeletal muscle insulin resistance is a key element in the development and progression of type 2 diabetes.
“Skeletal muscle insulin resistance is a key element in the development and progression of type 2 diabetes.”
The paper relies on this without support.
Acute contractile activity induces local signals stimulating glucose uptake independent of insulin signaling.
“First, independent of insulin signaling, acute contractile activity induces local signals stimulating glucose uptake.”
The paper relies on this without support.
Disease risks are associated with many hours per day of sitting idle, averaging approximately 10 hours per day or 70 hours each week.
“Disease risks are associated with many hours per day of sitting idle, averaging ~10 hrs/day or 70 hrs each week.”
The paper relies on this without support.
Safe and non-fatiguing low-intensity physical activity can significantly reduce the large amount of sedentary time associated with disease risk in the most at-risk population.
“The large amount of sedentary time associated with risk for disease can only be reduced significantly with safe and non-fatiguing LIPA, especially in the most at risk proportion of the population.”
The paper relies on this without support.
Muscle cells are constantly sensing and responding to their environment, so contractile activity and inactivity over the whole day counts.
“A remarkably fundamental concept that is useful for guiding inactivity physiology is simply that muscle cells are constantly sensing and responding to their environment, thus contractile activity and inactivity over the whole day counts.”
The paper relies on this without support.
Sitting at work and in leisure is ubiquitous in modern society.
“In conclusion, sitting at work and in leisure is ubiquitous in modern society.”
The paper relies on this without support.
LPL deficiencies are linked to lipoprotein parameters, inflammatory processes, and blood pressure.
“LPL deficiencies also have been linked to lipoprotein parameters, inflammatory processes, and blood pressure.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Modifying the characteristic sedentary patterns of adults with type 2 diabetes could tackle a modifiable risk factor for type 2 diabetes that is scarcely addressed from clinical practice.
“Modifying these characteristic sedentary patterns of adults with T2D could tackle a modifiable risk factor for T2D [12] that is scarcely addressed from clinical practice, which mainly focuses on increasing moderate and vigorous activity [13].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Newly diagnosed diabetes study is cited as a mortality study
MinorThe cited reference 35 is titled as a study of sedentary behavior and mortality in US adults, not a study of cardiometabolic measurements in people newly diagnosed with type 2 diabetes. Reference 37 is titled as a study of the latter population and outcomes.
“A similar cross-sectional analysis using a heart rate method (35) reported that sedentary time was unfavorably related to plasma TG and HDL concentrations, waist circumference, and a clustered metabolic risk score (HbA1C, TG, inverse of HDL, waist).”
“35. Matthews CE George SM Moore SC Bowles HR Blair A Park Y Troiano RP Hollenbeck A Schatzkin A Amount of time spent in sedentary behaviors and cause-specific mortality in US adults Am J Clin Nutr 2012 95 2 437 45 22218159 PMC3260070”
Two distinct acute studies are both identified as reference 53
MinorThe text identifies Stephens et al. (53) as one acute study, then calls a study in overweight or obese middle-aged adults the second acute study while also citing (53). These cannot be two distinct studies under the same reference number.
“The second of these acute studies was performed in overweight/obese middle age adults (53).”
“Stephens et al. (53) observed a 39% reduction in insulin stimulated glucose uptake (tracer determined plasma glucose uptake per unit insulin) after a day of sitting compared to a trial with LIPA when energy intake was held constant by controlled feedings.”
Cites
Colberg, S. R., Sigal, R. J., Fernhall, B., Regensteiner, J. G., Blissmer, B. J., Rubin, R. R., Chasan-Taber, L., Albright, A. L., & Braun, B. (2010) · Diabetes Care · doi:10.2337/dc10-9990 · Cited by 1,955 · see citing works
Hu, F. B., Li, T. Y., Colditz, G. A., Willett, W. C., & Manson, J. E. (2003) · JAMA · doi:10.1001/jama.289.14.1785 · Cited by 1,892 · see citing works
Wilmot, E. G., Edwardson, C. L., Achana, F. A., Davies, M. J., Gorely, T., Gray, L. J., Khunti, K., Yates, T., & Biddle, S. J. H. (2012) · Diabetologia · doi:10.1007/s00125-012-2677-z · Cited by 1,789 · see citing works
Hamilton, M. T., Hamilton, D. G., & Zderic, T. W. (2007) · Diabetes · doi:10.2337/db07-0882 · Cited by 1,655 · see citing works
Self-citationHealy, G. N., Dunstan, D. W., Salmon, J., Cerin, E., Shaw, J. E., Zimmet, P. Z., & Owen, N. (2008) · Diabetes Care · doi:10.2337/dc07-2046 · Cited by 1,465 · see citing works
Sedentary Behaviors and Subsequent Health Outcomes in Adults
Thorp, A. A., Owen, N., Neuhaus, M., & Dunstan, D. W. (2011) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2011.05.004 · Cited by 1,455 · see citing works
Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003–06
Healy, G. N., Matthews, C. E., Dunstan, D. W., Winkler, E. A. H., & Owen, N. (2011) · European Heart Journal · doi:10.1093/eurheartj/ehq451 · Cited by 1,368 · see citing works
Breaking Up Prolonged Sitting Reduces Postprandial Glucose and Insulin Responses
Dunstan, D. W., Kingwell, B. A., Larsen, R., Healy, G. N., Cerin, E., Hamilton, M. T., Shaw, J. E., Bertovic, D. A., Zimmet, P. Z., Salmon, J., et al. (2012) · Diabetes Care · doi:10.2337/dc11-1931 · Cited by 1,203 · see citing works
Self-citationHamilton, M. T., Healy, G. N., Dunstan, D. W., Zderic, T. W., & Owen, N. G. (2008) · Current Cardiovascular Risk Reports · doi:10.1007/s12170-008-0054-8 · Cited by 854 · see citing works
Self-citationPhysical Activity and Television Watching in Relation to Risk for Type 2 Diabetes Mellitus in Men
Hu, F. B., Leitzmann, M. F., Stampfer, M. J., Colditz, G. A., Willett, W. C., & Rimm, E. B. (2001) · Archives of Internal Medicine · doi:10.1001/archinte.161.12.1542 · Cited by 828 · see citing works
Amount of time spent in sedentary behaviors and cause-specific mortality in US adults
Matthews, C. E., George, S. M., Moore, S. C., Bowles, H. R., Blair, A., Park, Y., Troiano, R. P., Hollenbeck, A., & Schatzkin, A. (2012) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.111.019620 · Cited by 655 · see citing works
Type of vegetarian diet, body weight, and prevalence of type 2 diabetes
Tonstad, S., Butler, T., Yan, R., & Fraser, G. E. (2009) · Diabetes Care · doi:10.2337/dc08-1886 · Cited by 641 · see citing works
Healy, G. N., Dunstan, D. W., Salmon, J., Cerin, E., Shaw, J. E., Zimmet, P. Z., & Owen, N. (2007) · Diabetes Care · doi:10.2337/dc07-0114 · Cited by 627 · see citing works
Garvey, W. T., Kwon, S., Zheng, D., Shaughnessy, S., Wallace, P., Hutto, A. C., Pugh, K. B., Jenkins, A. J., Klein, R. L., & Liao, Y. (2003) · Diabetes · doi:10.2337/diabetes.52.2.453 · Cited by 606 · see citing works
Sedentary Behavior, Physical Activity, and the Metabolic Syndrome among U.S. Adults
Ford, E. S., Kohl, H. W., Mokdad, A. H., & Ajani, U. A. (2005) · Obesity Research · doi:10.1038/oby.2005.65 · Cited by 549 · see citing works
Association of Sedentary Behaviour with Metabolic Syndrome: A Meta-Analysis
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- Authors
- Hamilton, M. T., Hamilton, D. G., & Zderic, T. W.
- Affiliations
- Pennington Biomedical Research Center (US)
- ORCID
- Hamilton, Marc T.
- Venue
- Medicine and Sport Science
- Publisher
- S. Karger AG
- Published
- 2014
- Volume
- 60
- Pages
- 11-26
- ISSN
- 0076-6070 (ISSN-L)
- 0254-5020
- 1662-2812
- PMC
- PMC4364419
- OpenAlex
- W1538864188
- Semantic Scholar
- 1bc1a33006b6ec6419416d1babe77310bd0b049d
- Cited by
- 185
- References
- 72
- Citations by year
- 2026: 11 · 2025: 19 · 2024: 18 · 2023: 19 · 2022: 30 · 2021: 18 · 2020: 11 · 2019: 12 · 2018: 11 · 2017: 19 · 2016: 6 · 2015: 10 · 2014: 1
- FWCI
- 31.05
- Type
- book chapter
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Medicine and sport science/Medicine and sport (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Public Health Service (00119611)
- National Heart, Lung, and Blood Institute (HL-70482, HL-52490, R01HL057367, HL-57367, P01HL052490, F32HL070482)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (F32AR008455)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- sedentary behavior, type 2 diabetes, light physical activity, metabolic syndrome, cardiometabolic risk, slow-twitch muscle, glucose metabolism, lipid metabolism, inclinometry, sedentary time, dose-response relationship
- MeSH terms
- Animals, Diabetes Mellitus, Type 2, Glucose, Humans, Motor Activity, Risk Factors, Time Factors, Muscle, Skeletal, Metabolic Syndrome, Lipid Metabolism, Actigraphy, Sedentary Behavior
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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