VAN DER Berg Julianne D, VAN DER Velde Jeroen H P M, DE Waard Ellis A C, Bosma Hans, Savelberg Hans H C M, Schaper Nicolaas C, VAN DEN Bergh Joop P W, Geusens Piet P M M, Schram Miranda T, Sep Simone J S, VAN DER Kallen Carla J H, Henry Ronald M A, Dagnelie Pieter C, Eussen Simone J P M, VAN Dongen Martien C J M, Köhler Sebastian, Kroon Abraham A, Stehouwer Coen D A, Koster Annemarie
1Department of Social Medicine, Maastricht University, Maastricht, THE NETHERLANDS; 2CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, THE NETHERLANDS; 3Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, THE NETHERLANDS; 4Department of Human Movement Sciences, Maastricht University, Maastricht, THE NETHERLANDS; 5NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, THE NETHERLANDS; 6Department of Internal Medicine, Maastricht University Medical Center, Maastricht, THE NETHERLANDS; 7CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, THE NETHERLANDS; 8Biomedical Research Institute, University of Hasselt, Diepenbeek, BELGIUM; 9Department of Internal Medicine, VieCuri Medical Centre, Venlo, THE NETHERLANDS; 10Department of Epidemiology, Maastricht University, Maastricht, THE NETHERLANDS; 11Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, THE NETHERLANDS; and 12MHeNS School for Mental Health and Neuroscience, Maastricht University, Maastricht, THE NETHERLANDS.
Med Sci Sports Exerc. 2017 Jul;49(7):1351-1358. doi: 10.1249/MSS.0000000000001248.
Sedentary time has been associated with detrimental health effects, so in some countries, guidelines to reduce sedentary time have been developed. As reducing sedentary time inevitably results in more nonsedentary time, effects of this reduction may depend on the activity with which it is replaced.
This study aimed to examine associations of theoretical reallocations of sedentary time to standing or stepping with cardiometabolic outcomes and type 2 diabetes.
We included 2213 participants (51% men, mean ± SD age = 60.0 ± 8.1 yr) of the Maastricht Study who were asked to wear an accelerometer 24 h·d for a week. We calculated daily sedentary, standing, and stepping time. An isotemporal substitution modeling approach was applied to examine effects on waist circumference; body mass index; cholesterol, triacylglycerol, glucose, and insulin levels; metabolic syndrome; and type 2 diabetes.
Replacement of sedentary time (30 min·d) with stepping was associated with lower odds for metabolic syndrome (odds ratio [OR] = 0.72, 95% confidence interval [CI] = 0.66-0.78) and type 2 diabetes (OR = 0.79, 95% CI = 0.72-0.87), more favorable waist circumference (B = -1.42, 95% CI = -1.78 to -1.06), and body mass index (B = -0.48, 95% CI = -0.62 to -0.35) and improved cholesterol, triacylglycerol, glucose, and insulin levels. Replacing sedentary time with standing was associated with lower odds for metabolic syndrome and type 2 diabetes and favorable outcomes in waist circumference, cholesterol, triacylglycerol, and insulin levels.
Theoretical replacements of sedentary time with nonsedentary time (both standing and stepping) were associated with lower odds for metabolic syndrome, type 2 diabetes, and beneficial metabolic outcomes. These results could be important for the general population, including those who cannot meet physical activity guidelines. Consideration should be given to developing recommendations for daily reallocating sedentary time.
久坐时间已被证实与对健康有害的影响相关，因此在一些国家，已制定了减少久坐时间的指南。由于减少久坐时间不可避免地会导致更多的非久坐时间，这种减少的影响可能取决于被替代的活动。
本研究旨在探讨将久坐时间理论上重新分配为站立或行走与心血管代谢结局及2型糖尿病之间的关联。
我们纳入了马斯特里赫特研究中的2213名参与者（51%为男性，平均年龄±标准差 = 60.0 ± 8.1岁），要求他们连续一周每天佩戴加速度计24小时。我们计算了每日的久坐、站立和行走时间。采用等时替代建模方法来研究对腰围、体重指数、胆固醇、甘油三酯、血糖和胰岛素水平、代谢综合征以及2型糖尿病的影响。
用行走替代久坐时间（每天30分钟）与代谢综合征（优势比[OR] = 0.72，95%置信区间[CI] = 0.66 - 0.78）和2型糖尿病（OR = 0.79，95% CI = 0.72 - 0.87）的较低患病几率相关，腰围更有利（B = -1.42，95% CI = -1.78至 -1.06），体重指数（B = -0.48，95% CI = -0.62至 -0.35）以及胆固醇、甘油三酯、血糖和胰岛素水平得到改善。用站立替代久坐时间与代谢综合征和2型糖尿病的较低患病几率以及腰围、胆固醇、甘油三酯和胰岛素水平的良好结局相关。
理论上用非久坐时间（站立和行走）替代久坐时间与代谢综合征、2型糖尿病的较低患病几率以及有益的代谢结局相关。这些结果对于普通人群（包括那些无法达到身体活动指南要求的人）可能很重要。应考虑制定关于每日重新分配久坐时间的建议。
