Faculty of Science, Medicine and Health, School of Medicine, University of Wollongong, New South Wales, Australia; Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia.
Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; Institute of Metabolic Science, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.
Can J Diabetes. 2020 Dec;44(8):759-767. doi: 10.1016/j.jcjd.2020.10.013. Epub 2020 Oct 28.
Clinical practice guidelines on physical activity and diabetes currently stipulate physical activity can be accumulated in bouts of ≥10 minutes to meet recommendations for health benefits. Individuals are also encouraged to interrupt prolonged sitting with brief activity breaks of ∼1 to 5 minutes in duration. Growing research highlights accumulating activity in shorter bouts across the day as a potential strategy to improve glycemic control and to help those who are largely sedentary meet physical activity guidelines. Research has shown favourable glycemic benefits for postprandial glucose and glycated hemoglobin with either 3 short (10 to 15 minutes) or frequent brief (1 to 5 minutes) bouts of activity spread around meals or throughout the day. To date, most studies examining accumulated activity were done with people with type 2 diabetes compared with sedentary conditions, were short term and measured various indices of glycemic control using continuous glucose monitoring. The 7 trials comparing accumulating 3 short bouts to a single bout showed comparable benefits for glycemic control (i.e. fasting glucose, 24 h mean glucose and postprandial hyperglycemia). Furthermore, timing short bouts around meals may improve postprandial glucose and hyperglycemia more than a single bout. It is unknown whether a threshold for the duration of accumulated bouts exists---that is, "how much is enough?" In this narrative review, we focus on the glycemic effects of physical activity accumulated in short or brief bouts for people with prediabetes and diabetes as compared with a single continuous bout. Given that poor adherence to physical activity recommendations and that fewer opportunities exist in modern societies for incidental (nonexercise) physical activity, accumulating activity may be a choice strategy for improving glycemic control in those with and at risk of diabetes.
目前，关于体力活动与糖尿病的临床实践指南规定，体力活动可以累计进行，每次持续时间≥10 分钟，以达到有益于健康的推荐量。此外，还鼓励人们通过每次持续 1 至 5 分钟的短暂活动来打断长时间的静坐。越来越多的研究强调，在一天中进行较短时间的多次活动可能是改善血糖控制的一种策略，有助于那些久坐不动的人达到体力活动指南的要求。研究表明，对于餐后血糖和糖化血红蛋白，无论是 3 次较短（10 至 15 分钟）还是频繁的短暂（1 至 5 分钟）活动，分散在餐间或全天进行，都有有利的血糖益处。迄今为止，大多数研究都比较了 2 型糖尿病患者与久坐不动的情况，观察了在短时间内使用连续血糖监测测量各种血糖控制指标的情况，发现累计活动量对血糖控制有类似的益处（即空腹血糖、24 小时平均血糖和餐后高血糖）。此外，将短时间活动分散在进餐时间进行可能比单次活动更能改善餐后血糖和高血糖。目前尚不清楚累计的短时间活动是否存在一个持续时间的阈值，也就是说，“活动多久才算足够？”在本叙述性综述中，我们主要关注的是与单次连续活动相比，对于前驱糖尿病和糖尿病患者而言，较短或短暂的体力活动累计对血糖的影响。鉴于体力活动建议的依从性较差，而且现代社会中几乎没有偶然（非运动）体力活动的机会，对于那些有糖尿病或有糖尿病风险的人来说，累计活动可能是改善血糖控制的一种选择策略。
