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      How does light-intensity physical activity associate with adult cardiometabolic health and mortality? Systematic review with meta-analysis of experimental and observational studies

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          Abstract

          Aim

          To assess the relationship between time spent in light physical activity and cardiometabolic health and mortality in adults.

          Design

          Systematic review and meta-analysis.

          Data sources

          Searches in Medline, Embase, PsycInfo, CINAHL and three rounds of hand searches.

          Eligibility criteria for selecting studies

          Experimental (including acute mechanistic studies and physical activity intervention programme) and observational studies (excluding case and case–control studies) conducted in adults (aged ≥18 years) published in English before February 2018 and reporting on the relationship between light physical activity (<3 metabolic equivalents) and cardiometabolic health outcomes or all-cause mortality.

          Study appraisal and synthesis

          Study quality appraisal with QUALSYST tool and random effects inverse variance meta-analysis.

          Results

          Seventy-two studies were eligible including 27 experimental studies (and 45 observational studies). Mechanistic experimental studies showed that short but frequent bouts of light-intensity activity throughout the day reduced postprandial glucose (−17.5%; 95% CI −26.2 to −8.7) and insulin (−25.1%; 95% CI −31.8 to –18.3) levels compared with continuous sitting, but there was very limited evidence for it affecting other cardiometabolic markers. Three light physical activity programme intervention studies (n ranging from 12 to 58) reduced adiposity, improved blood pressure and lipidaemia; the programmes consisted of activity of >150 min/week for at least 12 weeks. Six out of eight prospective observational studies that were entered in the meta-analysis reported that more time spent in daily light activity reduced risk of all-cause mortality (pooled HR 0.71; 95% CI 0.62 to 0.83).

          Conclusions

          Light-intensity physical activity could play a role in improving adult cardiometabolic health and reducing mortality risk. Frequent short bouts of light activity improve glycaemic control. Nevertheless, the modest volume of the prospective epidemiological evidence base and the moderate consistency between observational and laboratory evidence inhibits definitive conclusions.

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          Most cited references31

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          Suppression of skeletal muscle lipoprotein lipase activity during physical inactivity: a molecular reason to maintain daily low-intensity activity.

          We have examined the regulation of lipoprotein lipase (LPL) activity in skeletal muscle during physical inactivity in comparison to low-intensity contractile activity of ambulatory controls. From studies acutely preventing ambulatory activity of one or both the hindlimbs in rats, it was shown that approximately 90-95 % of the heparin-releasable (HR) LPL activity normally present in rat muscle with ambulatory activity is lost, and thus dependent on local contractile activity. Similarly, approximately 95 % of the differences in LPL activity between muscles of different fibre types was dependent on ambulatory activity. The robustness of the finding that physical inactivity significantly decreases muscle LPL activity was evident from confirmatory studies with different models of inactivity, in many rats and mice, both sexes, three muscle types and during both acute and chronic (11 days) treatment. Inactivity caused a local reduction of plasma [3H]triglyceride uptake into muscle and a decrease in high density lipoprotein cholesterol concentration. LPL mRNA was not differentially expressed between ambulatory controls and either the acutely or chronically inactive groups. Instead, the process involved a rapid loss of the HR-LPL protein mass (the portion of LPL largely associated with the vascular endothelium) by an actinomycin D-sensitive signalling mechanism (i.e. transcriptionally dependent process). Significant decreases of intracellular LPL protein content lagged behind the loss of HR-LPL protein. Treadmill walking raised LPL activity approximately 8-fold (P < 0.01) within 4 h after inactivity. The striking sensitivity of muscle LPL to inactivity and low-intensity contractile activity may provide one piece of the puzzle for why inactivity is a risk factor for metabolic diseases and why even non-vigorous activity provides marked protection against disorders involving poor lipid metabolism.
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            Accelerometer-measured dose-response for physical activity, sedentary time, and mortality in US adults.

            Moderate-to-vigorous-intensity physical activity is recommended to maintain and improve health, but the mortality benefits of light activity and risk for sedentary time remain uncertain.
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              • Article: not found

              Benefits for Type 2 Diabetes of Interrupting Prolonged Sitting With Brief Bouts of Light Walking or Simple Resistance Activities.

              To determine whether interrupting prolonged sitting with brief bouts of light-intensity walking (LW) or simple resistance activities (SRA) improves postprandial cardiometabolic risk markers in adults with type 2 diabetes (T2D).
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                Author and article information

                Journal
                Br J Sports Med
                Br J Sports Med
                bjsports
                bjsm
                British Journal of Sports Medicine
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0306-3674
                1473-0480
                March 2019
                25 April 2018
                : 53
                : 6
                : 370-376
                Affiliations
                [1 ] departmentSchool of Health and Life Science, Institute for Applied Health Research , Glasgow Caledonian University , Glasgow, UK
                [2 ] departmentDepartment of Movement and Sport Sciences , Ghent University , Ghent, Belgium
                [3 ] Research Foundation Flanders , Brussels, Belgium
                [4 ] departmentInstitute for Resilient Regions , University of Southern Queensland , Toowoomba, Queensland, Australia
                [5 ] departmentEpidemiology Unit, Charles Perkins Centre , University of Sydney , Sydney, New South Wales, Australia
                [6 ] departmentPrevention Research Collaboration, School of Public Health , University of Sydney , Sydney, New South Wales, Australia
                [7 ] departmentDepartment of Public Health , Ghent University , Ghent, Belgium
                [8 ] departmentSchool of Sport, Exercise and Health Sciences , Loughborough University , Loughborough, UK
                Author notes
                [Correspondence to ] Dr Sebastien F M Chastin, School of Health and Life Sciences, Institute for Applied Health Research, Glasgow Caledonian University, Glasgow G4 0BA, UK; Sebastien.Chastin@ 123456gcu.ac.uk
                Author information
                http://orcid.org/0000-0001-7323-3225
                Article
                bjsports-2017-097563
                10.1136/bjsports-2017-097563
                6579499
                29695511
                53950abe-9406-4c1a-9066-7b7fc909d0df
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 26 March 2018
                Categories
                Review
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                1507
                2314
                Custom metadata
                unlocked
                editors-choice

                Sports medicine
                sedentary,risk factor,public health,physical activity,cardiovascular
                Sports medicine
                sedentary, risk factor, public health, physical activity, cardiovascular

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