Effects of Interrupting Sedentary Behavior on Metabolic and Cognitive Outcomes in Children
Condition: Healthy Volunteer
Study type: Interventional
Phase: Phase 1/Phase 2

Summary: 
      Background:

      - Some studies in adults have found that insulin and glucose blood levels are lower when a
      long period of sitting is broken up with walking, compared to sitting without breaks. This
      means that the body can better process sugars when there are walking breaks during the day.
      Researchers want to know if this is also true for children. Some studies have found that
      children s attention and memory might be better after exercise. Researchers want to know if
      short walking breaks have the same effects.

      Objectives:

      - To understand if breaking up sitting with walking helps children s bodies better use sugars
      and improves children s concentration.

      Eligibility:

      - Healthy children ages 7 to 11.

      Design:

        -  Participants will be screened with a physical exam, medical history, exercise test,
           picture vocabulary test, and medical tests including blood tests and X-rays.

        -  Participants will return for two 7-hour visits. In the month before the visits, they
           will wear a physical activity monitor for one week so researchers know how active they
           are. Once they will take the sitting only test and once the sitting breaks test.

        -  During the sitting only test, participants will sit for 3 hours.

        -  During the sitting breaks test, they will sit for 3 hours with 3-minute walking breaks
           every 30 minutes.

        -  Both days, they will drink sugar water. Then the participants will have blood drawn from
           a needle that is kept in place, and they will wear a heart monitor. They will take
           attention and working memory tests on a computer and answer questions about how they
           feel. They will eat a meal at the end of the test day.
    

Detailed description: 
      Prevention of pediatric obesity and its complications are U.S. public health priorities.
      Promoting physical activity has been proposed as an intervention strategy. Apart from
      reducing excessive weight, physical activity improves cardiovascular fitness, insulin
      sensitivity, and academic performance. However, emerging evidence in adults suggests that
      increased physical activity may not entirely counteract the negative health effects of a
      sedentary lifestyle.

      Sedentary behavior is defined as a set of low-intensity activities involving limited body
      movement (e.g.: TV viewing, prolonged sitting). TV viewing is associated with lower cognitive
      functioning and depressive symptoms. Some studies found higher levels of childhood sedentary
      behavior predicted higher body mass index (BMI) and cholesterol in adulthood, suggesting that
      negative health consequences may begin early. Dunstan et al. conducted the first lab-based
      study in adults investigating interrupting prolonged sedentary behavior with physical
      activity breaks. The authors found that for overweight adults, adding 2-minute
      moderate-intensity walking breaks every 20 minutes reduced postprandial insulin and glucose
      responses by 23.0% and 29.6%, respectively. Thus, interrupting sedentary behavior may be an
      intervention strategy to reduce health risks.

      In children, cross-sectional observational studies indicate that sedentary behavior patterns
      characterized by short bouts of activity are not associated with increased cardiometabolic
      risk. However to date, no in-lab studies have manipulated sedentary behavior in children.
      Therefore, we propose to conduct a randomized crossover pilot feasibility study to assess
      whether interrupting sedentary behavior influences metabolic and executive function,
      attention, mood, anxiety, and dietary intake. Children, ages 7-11 years, will complete two
      conditions in random order: 3 hours of prolonged sitting and 3 hours of sitting interrupted
      with 3 minutes of moderate-intensity walking every 30 minutes. The specific aim of this
      project is to investigate whether interrupting sedentary behavior improves metabolic
      parameters and changes executive function, attention, mood, anxiety, and dietary intake. The
      primary hypothesis is that postprandial insulin incremental area under the curve (iAUC) will
      be lower in the interrupted sitting vs. the prolonged sitting condition. The exploratory
      secondary hypotheses are that glucose iAUC, executive function, attention, mood, anxiety, and
      dietary intake will differ between the two conditions.

      This project will investigate if interrupting sedentary time affects potential negative
      health consequences of sedentary behavior in children. If interrupting sedentary time in
      short bouts has beneficial effects among children, interventions examining the frequency,
      duration, and intensity of such interruptions could be developed. Thus, these results have
      the potential to provide insight into novel behavioral intervention targets in youth.
    

Intervention name(s): Walking on a Treadmill; Sedendary Activities Only
Intervention type(s): Other; Other
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Executive Function; Child; Obesity; Exercise; Insulin Sensitivity