A Randomised Controlled Trial to Reduce Sedentary Time in Young Adults at Risk of Type 2 Diabetes Mellitus: Project STAND (Sedentary Time ANd Diabetes)

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Abstract

Aims

Type 2 diabetes mellitus (T2DM), a serious and prevalent chronic disease, is traditionally associated with older age. However, due to the rising rates of obesity and sedentary lifestyles, it is increasingly being diagnosed in the younger population. Sedentary (sitting) behaviour has been shown to be associated with greater risk of cardio-metabolic health outcomes, including T2DM. Little is known about effective interventions to reduce sedentary behaviour in younger adults at risk of T2DM. We aimed to investigate, through a randomised controlled trial (RCT) design, whether a group-based structured education workshop focused on sitting reduction, with self-monitoring, reduced sitting time.

Methods

Adults aged 18–40 years who were either overweight (with an additional risk factor for T2DM) or obese were recruited for the Sedentary Time ANd Diabetes (STAND) RCT. The intervention programme comprised of a 3-hour group-based structured education workshop, use of a self-monitoring tool, and follow-up motivational phone call. Data were collected at three time points: baseline, 3 and 12 months after baseline. The primary outcome measure was accelerometer-assessed sedentary behaviour after 12 months. Secondary outcomes included other objective (activPAL) and self-reported measures of sedentary behaviour and physical activity, and biochemical, anthropometric, and psycho-social variables.

Results

187 individuals (69% female; mean age 33 years; mean BMI 35 kg/m ²) were randomised to intervention and control groups. 12 month data, when analysed using intention-to-treat analysis (ITT) and per-protocol analyses, showed no significant difference in the primary outcome variable, nor in the majority of the secondary outcome measures.

Conclusions

A structured education intervention designed to reduce sitting in young adults at risk of T2DM was not successful in changing behaviour at 12 months. Lack of change may be due to the brief nature of such an intervention and lack of focus on environmental change. Moreover, some participants reported a focus on physical activity rather than reductions in sitting per se. The habitual nature of sedentary behaviour means that behaviour change is challenging.

Trial Registration

Controlled-Trials.com ISRCTN08434554

Related collections

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Author and article information

Contributors

Yiqing Song: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 1 December 2015

Publication date Collection: 2015

Volume: 10

Issue: 12

Electronic Location Identifier: e0143398

Affiliations

[1 ]School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, United Kingdom

[2 ]Leicester Diabetes Research Centre, University of Leicester, Leicester, United Kingdom

[3 ]School of Health Sciences, University of Stirling, Stirling, United Kingdom

[4 ]The NIHR Leicester Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester and Loughborough, United Kingdom

Indiana University Richard M. Fairbanks School of Public Health, UNITED STATES

Author notes

Competing Interests: The authors have declared that no competing interests exist.

Conceived and designed the experiments: SJHB MJD TG KK MAN TY CLE EGW. Performed the experiments: CLE EGW. Analyzed the data: DHB NA. Wrote the paper: SJHB MJD TG KK MAN TY CLE EGW DHB.

[¤a]

Current address: Institute of Sport, Exercise & Active Living, Victoria University, Melbourne, Australia

[¤b]

Current address: Royal Derby Hospital, Derby, United Kingdom

[¤c]

Current address: College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom

* E-mail: stuart.biddle@ 123456vu.edu.au

Article

Publisher ID: PONE-D-15-30570

DOI: 10.1371/journal.pone.0143398

PMC ID: 4666612

PubMed ID: 26623654

SO-VID: 15f40e2a-03f4-4d0c-a154-22ae2dd57a75

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

History

Date received : 28 July 2015

Date accepted : 3 November 2015

Page count

Figures: 1, Tables: 2, Pages: 13

Funding

The STAND study was funded by a grant from the Medical Research Council (UK) under the National Prevention Research Initiative (Project #91409). The research was also supported by the National Institute for Health Research (NIHR) Diet, Lifestyle & Physical Activity Biomedical Research Unit based at University Hospitals of Leicester and Loughborough University, the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care – East Midlands (NIHR CLAHRC – EM) and the Leicester Clinical Trials Unit. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

Custom metadata

Data Availability Data cannot be made publicly available due to ethical restrictions. An anonymized minimal dataset can be made available through requests sent to the lead author ( stuart.biddle@ 123456vu.edu.au ).