Objectively Measured Moderate- and Vigorous-Intensity Physical Activity but Not Sedentary Time Predicts Insulin Resistance in High-Risk Individuals
Open accessAbstract
OBJECTIVE: Low levels of physical activity appear to be associated with insulin resistance. However, the detailed associations of these complex relationships remain elusive. We examined the prospective associations between self-reported TV viewing time, objectively measured time spent sedentary, at light-intensity activity, and at moderate- and vigorous-intensity physical activity (MVPA) with insulin resistance. RESEARCH DESIGN AND METHODS: In 192 individuals (81 men and 111 women) with a family history of type 2 diabetes, we measured physical activity and anthropometric and metabolic variables at baseline and after 1 year of follow-up in the ProActive UK trial. Physical activity was measured objectively by accelerometry. Insulin resistance was expressed as fasting insulin and the homeostasis model assessment score (HOMA-IR). RESULTS: Baseline MVPA was a significant predictor of fasting insulin at follow-up (β = −0.004 [95% CI −0.007 to −0.0001], P = 0.022), and the association approached significance for HOMA-IR (β = −0.003 [−0.007 to 0.000002], P = 0.052), independent of time spent sedentary, at light-intensity activity, sex, age, smoking status, waist circumference, and self-reported TV viewing. Time spent sedentary and at light-intensity activity were not significantly associated with insulin resistance. The change in MVPA between baseline and follow-up was inversely related to fasting insulin (β = −0.003 [−0.007 to −0.0003], P = 0.032) and the HOMA-IR score (β = −0.004 [−0.008 to −0.001], P = 0.015) at follow-up, after adjustment for baseline phenotype in addition to the same confounders as above. CONCLUSIONS: These results highlight the importance of promoting moderate-intensity activity such as brisk walking for improving insulin sensitivity and possibly other metabolic risk factors to prevent type 2 diabetes.
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Data from several studies using accelerometers to objectively measure sedentary behavior show unfavourable associations with risk factors.
“There do exist data from several studies that used accelerometers to objectively measure sedentary behavior, showing unfavourable associations with risk factors (e.g., the Australian AusDiab study,[24] the Proactiv UK trial,[25] the US National Health and Nutrition Examination Survey[26]).”
From Using accelerometers to measure physical activity in large-scale epidemiological studies: issues and challenges (2014) · cites this paper as [25]
Most analyses to date integrate acceleration data from the vertical axis only into counts per user-specified time period and utilize cutpoints for classifying time spent in sedentary behaviour or physical activity, which are then related to health outcomes.
“Most analyses to date integrate acceleration data from the vertical axis only into counts per user-specified time period (e.g., counts per minute, cpm) and utilize cutpoints for classifying time spent in sedentary behaviour or physical activity (higher cpm reflects higher intensity activities), which are then related to health outcomes.[24-26]”
From Using accelerometers to measure physical activity in large-scale epidemiological studies: issues and challenges (2014) · cites this paper as [25]
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- Authors
- Ekelund, U., Brage, S., Griffin, S. J., & Wareham, N. J.
- Affiliations
- MRC Epidemiology Unit (GB)
- Medical Research Council Epidemiology Unit, Cambridge, U.K.
- Corresponding author
- Ekelund, Ulf
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2009-02-27
- Volume
- 32
- Issue
- 6
- Pages
- 1081-1086
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC2681043
- OpenAlex
- W1973332708
- Cited by
- 186
- References
- 24
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 6 · 2023: 5 · 2022: 9 · 2021: 8 · 2020: 6 · 2019: 8 · 2018: 10 · 2017: 11 · 2016: 7 · 2015: 16 · 2014: 24 · 2013: 23 · 2012: 12
- FWCI
- 10.38
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Bristol Research (University of Bristol) (publishedVersion)
- Explore Bristol Research (submittedVersion)
- Funders
- Diabetes UK
- Medical Research Council
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- insulin resistance, sedentary behavior, light physical activity, television viewing, type 2 diabetes prevention, family history of type 2 diabetes, accelerometry, HOMA-IR, fasting insulin, brisk walking
- MeSH terms
- Adipose Tissue, Aging, Diabetes Mellitus, Type 2, Family, Female, Humans, Insulin, Insulin Resistance, Life Style, Male, Motor Activity, Predictive Value of Tests, Rest, Risk Factors, Smoking, Television, Exercise, Body Mass Index, Evidence-Based Medicine, Waist Circumference
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