# Exercise as it relates to Disease/Break up your sitting with light-intensity walking to reduce your chances of diabetes
## What is the background to this research and where did it come from?

This Wiki reviews the article "Breaking up prolonged sitting with light-intensity walking improves *postprandial glycemia", by Daniel Bailey and Christopher Locke. This article can be viewed via this link. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329818/
In a modern day approach to a normal lifestyle, a lot of sitting or sedentary behaviour is present. There are many causes to this change. The invention of Television and video games, and the usual working day is spent sitting in front of a computer all day. Due to this, it is highly speculated that this sort of lifestyle has caused a high rise in the prevalence of cardio-metabolic diseases.
Cardio-metabolic diseases include; diabetes, heart disease or having a stroke. The most alarming statistic is that the high levels of sedentary behavior has increased the risk of getting diabetes by around 112%
* Postprandial means what happens after a meal.
* Glycemia means the sugar levels in your blood.

## What kind of research was this and what did it involve?

This research tested the effects of extended inactivity after a meal against breaks in the extended activity either via light exercise or simply standing. It majority focuses on blood sugar (glucose), but there was some mention of triglycerides (fat) and were used as a marker to explore the differences.
10 participants were split into three separate groups, all of which completed each of the three different testing methods in a randomised order.
| Group type | Classification | What they did |
| Control | Uninterrupted sitting | 5 hours of sitting as still as possible |
| Standing | Sitting + standing breaks | 5 hours of sitting, with every 20 minutes, they would stand as still as possible for 2 minutes |
| Exercise | Sitting + exercise breaks | 5 hours of sitting, but every 20 minutes, they would undergo moderate exercise for 2 minutes |
Each participant was asked not to have any caffeine or alcohol, and not to participate in any exercise 24 hours prior to participating in each part of the study. Participants were also asked to complete an overnight fast before coming in to the laboratory at 9am. Upon arrival, each participant was seated for an hour so that a resting blood pressure and a blood sample could be taken.
Once the resting measures were taken, they were offered two drinks.
The first drink was an all sugary drink, 75g of carbohydrates mixed in 200mls of water.
The second drink contained fats; 50g and protein; 4g, to help slow down the digestion of the sugary drink and somewhat simulate a normal meal. After consuming the two drinks, the five hour testing period began.
Following each session, there was a minimum six days break before the next period. This is due to the reasoning that a session of physical exertion can increase insulin sensitivity for up to 72 hours.
By having an increase in insulin sensitivity, it may augment the results with an improved response to glucose.

## What were the basic results?

A study was done by Dunstan et al. Whose results were used in comparison to this study. A few differences were made, however, as Dunstan did not test healthy individuals. Obese individuals were tested.
There was no significant change in triglycerides when measured, however they were not measured hourly and may not be an accurate measure.
While there may not have been any major change in triglyceride levels, the positive results of the blood glucose levels are beneficial to ones health. Even if you do not have diabetes.

## What conclusions can we take from this research?

Postprandial hyperglycemia (high blood sugar after a meal) has been counted as a cardiac risk factor for both people with diabetes and people without. Backed up by Dunstan and Peddie, it can be assumed that breaking your sitting with frequent bouts of light intensity exercise can be a good way to improve your postprandial glycemia and overall risk of metabolic diseases. and
While we may be able to draw these conclusions from these few studies. A much larger sample size, more variables and extended testing periods would be beneficial to discover the long term effects of breaking up your sitting.

## Practical advice

If you work at a desk, why not stand up every 20 minutes and go for a quick walk? Go to the toilet, go to the water fountain and get a drink. The only issue would be getting your boss to allow such a thing to happen. Maybe it is time to present these findings to your boss, make it an office wide idea.
Get off the bus a few stops earlier, even if it means leaving home a bit earlier. Waking up early is always good for you! Or if you drive, park in a different car park than what you would normally. Who knows, this new car park may not be as busy as your usual one.
The classic as always, take the stairs instead of the lift.
Try and get a walk in on your lunch break.
Don't spend hours at a time watching T.V on the weekend. Try and break up this time with chores around the house. Maybe in the ad break you can vacuum a room of the house. You will even find if you do the household chores bit by bit like that the chores will get done very quickly and you won't even notice how hard it was!
Breaking up your after work hours television time. A good time is spent winding down in front of a T.V after work. Try to get things done during ad breaks, or if you are watching a movie pause the movie every half an hour and do some exercise. You will be better off for it in the long run!

## Further information/resources

Are you feeling worried? Check your risk of Diabetes using the Australian Diabetes calculator.
Diabetes risk calculator
Further information about the different types of diabetes
Type 1 diabetes
Type 2 diabetes
You can get a temporary bout of diabetes while pregnant!
Gestational diabetes
Have you just been diagnosed?
Manage your new diabetes status

### References

* 1 2 3 D.P. Bailey, C.D. Locke. Breaking up prolonged sitting with light-intensity walking improves postprandial glycemia, but breaking up sitting with standing does not. Journal of Science and Medicine in Sport 2015; 18(3): 294-298.
* ↑ Dunstan DW, Thorp AA, Healy GN. Prolonged sitting: is it a distinct coronary heart disease risk factor? Curr Opin Cardiol 2011; 26(5):412–419.
* ↑ Mikines KJ, Sonne B, Farrell PA et al. Effect of physical exercise on sensitivity and responsiveness to insulin in humans. Am J Physiol 1988; 254(3 Pt 1):E248–E259.
* 1 2 Dunstan DW, Kingwell BA, Larsen R et al. Breaking up prolonged sitting reduces postprandial glucose and insulin responses. Diabetes Care 2012; 35(5):976–983.
* ↑ . Cavalot F, Petrelli A, Traversa M et al. Postprandial blood glucose is a stronger predictor of cardiovascular events than fasting blood glucose in type 2 diabetes mellitus, particularly in women: lessons from the San Luigi Gonzaga Diabetes Study. J Clin Endocrinol Metab 2006; 91(3):813–819.
* ↑ Peddie MC, Bone JL, Rehrer NJ et al. Breaking prolonged sitting reduces postprandial glycemia in healthy, normal-weight adults: a randomized crossover trial. Am J Clin Nutr 2013; 98(2):358–366.