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      Associations of total amount and patterns of sedentary behaviour with type 2 diabetes and the metabolic syndrome: The Maastricht Study

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          Abstract

          Aims/hypothesis

          The study investigated cross-sectional associations of total amount and patterns of sedentary behaviour with glucose metabolism status and the metabolic syndrome.

          Methods

          We included 2,497 participants (mean age 60.0 ± 8.1 years, 52% men) from The Maastricht Study who were asked to wear an activPAL accelerometer 24 h/day for 8 consecutive days. We calculated the daily amount of sedentary time, daily number of sedentary breaks and prolonged sedentary bouts (≥30 min), and the average duration of the sedentary bouts. To determine glucose metabolism status, participants underwent an oral glucose tolerance test. Associations of sedentary behaviour variables with glucose metabolism status and the metabolic syndrome were examined using multinomial logistic regression analyses.

          Results

          Overall, 1,395 (55.9%) participants had normal glucose metabolism, 388 (15.5%) had impaired glucose metabolism and 714 (28.6%) had type 2 diabetes. The odds ratio per additional hour of sedentary time was 1.22 (95% CI 1.13, 1.32) for type 2 diabetes and 1.39 (1.27, 1.53) for the metabolic syndrome. No significant or only weak associations were seen for the number of sedentary breaks, number of prolonged sedentary bouts or average bout duration with either glucose metabolism status or the metabolic syndrome.

          Conclusions/interpretation

          An extra hour of sedentary time was associated with a 22% increased odds for type 2 diabetes and a 39% increased odds for the metabolic syndrome. The pattern in which sedentary time was accumulated was weakly associated with the presence of the metabolic syndrome. These results suggest that sedentary behaviour may play a significant role in the development and prevention of type 2 diabetes, although longitudinal studies are needed to confirm our findings.

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          Most cited references16

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          Global prevalence of diabetes: estimates for the year 2000 and projections for 2030.

          The goal of this study was to estimate the prevalence of diabetes and the number of people of all ages with diabetes for years 2000 and 2030. Data on diabetes prevalence by age and sex from a limited number of countries were extrapolated to all 191 World Health Organization member states and applied to United Nations' population estimates for 2000 and 2030. Urban and rural populations were considered separately for developing countries. The prevalence of diabetes for all age-groups worldwide was estimated to be 2.8% in 2000 and 4.4% in 2030. The total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030. The prevalence of diabetes is higher in men than women, but there are more women with diabetes than men. The urban population in developing countries is projected to double between 2000 and 2030. The most important demographic change to diabetes prevalence across the world appears to be the increase in the proportion of people >65 years of age. These findings indicate that the "diabetes epidemic" will continue even if levels of obesity remain constant. Given the increasing prevalence of obesity, it is likely that these figures provide an underestimate of future diabetes prevalence.
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            Breaks in sedentary time: beneficial associations with metabolic risk.

            Total sedentary (absence of whole-body movement) time is associated with obesity, abnormal glucose metabolism, and the metabolic syndrome. In addition to the effects of total sedentary time, the manner in which it is accumulated may also be important. We examined the association of breaks in objectively measured sedentary time with biological markers of metabolic risk. Participants (n = 168, mean age 53.4 years) for this cross-sectional study were recruited from the 2004-2005 Australian Diabetes, Obesity and Lifestyle study. Sedentary time was measured by an accelerometer (counts/minute(-1) or = 100) was considered a break. Fasting plasma glucose, 2-h plasma glucose, serum triglycerides, HDL cholesterol, weight, height, waist circumference, and resting blood pressure were measured. MatLab was used to derive the breaks variable; SPSS was used for the statistical analysis. Independent of total sedentary time and moderate-to-vigorous intensity activity time, increased breaks in sedentary time were beneficially associated with waist circumference (standardized beta = -0.16, 95% CI -0.31 to -0.02, P = 0.026), BMI (beta = -0.19, -0.35 to -0.02, P = 0.026), triglycerides (beta = -0.18, -0.34 to -0.02, P = 0.029), and 2-h plasma glucose (beta = -0.18, -0.34 to -0.02, P = 0.025). This study provides evidence of the importance of avoiding prolonged uninterrupted periods of sedentary (primarily sitting) time. These findings suggest new public health recommendations regarding breaking up sedentary time that are complementary to those for physical activity.
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              Objectively measured sedentary time, physical activity, and metabolic risk: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab).

              We examined the associations of objectively measured sedentary time and physical activity with continuous indexes of metabolic risk in Australian adults without known diabetes. An accelerometer was used to derive the percentage of monitoring time spent sedentary and in light-intensity and moderate-to-vigorous-intensity activity, as well as mean activity intensity, in 169 Australian Diabetes, Obesity and Lifestyle Study (AusDiab) participants (mean age 53.4 years). Associations with waist circumference, triglycerides, HDL cholesterol, resting blood pressure, fasting plasma glucose, and a clustered metabolic risk score were examined. Independent of time spent in moderate-to-vigorous-intensity activity, there were significant associations of sedentary time, light-intensity time, and mean activity intensity with waist circumference and clustered metabolic risk. Independent of waist circumference, moderate-to-vigorous-intensity activity time was significantly beneficially associated with triglycerides. These findings highlight the importance of decreasing sedentary time, as well as increasing time spent in physical activity, for metabolic health.
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                Author and article information

                Contributors
                j.vanderberg@maastrichtuniversity.nl
                Journal
                Diabetologia
                Diabetologia
                Diabetologia
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0012-186X
                1432-0428
                2 February 2016
                2 February 2016
                2016
                : 59
                : 709-718
                Affiliations
                [ ]Department of Social Medicine, Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands
                [ ]CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands
                [ ]Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, the Netherlands
                [ ]CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
                [ ]Department of Human Movement Sciences, Maastricht University, Maastricht, the Netherlands
                [ ]NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
                [ ]Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
                Article
                3861
                10.1007/s00125-015-3861-8
                4779127
                26831300
                74b1b5d6-76c3-4582-b6d0-f9ec85b4d625
                © The Author(s) 2016

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 22 October 2015
                : 14 December 2015
                Funding
                Funded by: the Province of Limburg
                Funded by: European Regional Development Fund via OP-Zuid
                Funded by: the Pearl String Initiative Diabetes (Amsterdam, the Netherlands)
                Funded by: Stichting De Weijerhorst (Maastricht, the Netherlands)
                Funded by: the Dutch Ministry of Economic Affairs
                Award ID: 31O.041
                Funded by: European Union Seventh Framework Programme
                Award ID: PCIG09-GA-2011-293621
                Funded by: Novo Nordisk Farma B.V. (Alphen aan den Rijn, the Netherlands)
                Funded by: Sanofi-Aventis Netherlands B.V. (Gouda, the Netherlands)
                Funded by: Cardiovascular Research Institute Maastricht (CARIM, Maastricht, the Netherlands)
                Funded by: School for Public Health and Primary Care (CAPHRI, Maastricht, the Netherlands)
                Funded by: the Cardiovascular Center (CVC, Maastricht, the Netherlands)
                Funded by: Health Foundation Limburg (Maastricht, the Netherlands)
                Funded by: Janssen-Cilag B.V. (Tilburg, the Netherlands)
                Funded by: School for Nutrition and Translational Research in Metabolism (NUTRIM, Maastricht, the Netherlands)
                Funded by: Stichting Annadal (Maastricht, the Netherlands)
                Categories
                Article
                Custom metadata
                © Springer-Verlag Berlin Heidelberg 2016

                Endocrinology & Diabetes
                accelerometry,diabetes mellitus type 2,metabolic syndrome,sedentary bouts,sedentary breaks,sedentary lifestyle,sedentary time

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