Exercise duration may be as important as intensity for people with prediabetes
medwireNews: Objectively measured physical activity is associated with a reduction in cardiometabolic risk markers among people with prediabetes, and the total time spent being active is at least as important as exercise intensity, researchers report.
“[T]hese findings suggest that replacing [sedentary time] with light activity may provide a practical approach to improve cardiometabolic health in a population with low engagement in [moderate-to-vigorous exercise],” say Nils Swindell (Swansea University, UK) and study co-authors.
The team analyzed the association between different measures of physical activity and cardiometabolic risk factors among 2326 overweight and obese people with prediabetes who participated in the multinational PREVIEW study of lifestyle interventions for the prevention of diabetes.
In all, participants with a higher level of total physical activity – measured by mean activity count per minute (CPM) using an accelerometer – had a significantly smaller waist circumference, significantly lower levels of fasting insulin, 2-hour plasma glucose, and triglycerides, and a significantly lower homeostasis model assessment of insulin resistance (HOMA-IR) index score than those with lower levels of physical activity.
These inverse associations were “comparable or stronger” relative to those between the time spent doing moderate-to-vigorous activity (≥100 CPM) and cardiometabolic risk factors, say the researchers. For example, the standardized regression coefficients were –0.179 versus –0.177 for waist circumference and –0.139 versus –0.115 for fasting insulin after adjustment for factors including age, sex, ethnicity, and smoking.
On the other hand, the team observed a positive association between sedentary time and these cardiometabolic risk factors.
A higher degree of total activity and moderate-to-vigorous intensity exercise, and a lower time spent being sedentary, were also positively associated with high density lipoprotein (HDL) cholesterol levels, but the association between exercise intensity and HDL cholesterol was no longer significant after additional adjustment for sedentary time.
Despite current guidelines’ focus on exercise intensity, these results “may imply that the accumulation of total [physical activity] over the day is as important as achieving the intensity of [moderate-to-vigorous activity]” for people with prediabetes, write Swindell et al in Diabetes Care.
They believe that these findings “may be important considering the levels of [physical activity] in this population.”
And they add that “[l]ight activity may be more readily adopted [than intense exercise] by individuals with prediabetes, particularly if they are physically inactive, overweight/obese, or reluctant to engage in structured exercise.”
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