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Greater sedentary time associated with metabolic syndrome despite physical activity, cardiorespiratory fitness
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Cardiorespiratory fitness, higher intensity physical activity and sedentary time each affect metabolic health independently and in combination, indicating that all three should be addressed for disease prevention, according to findings published in Diabetologia.
“Studies have indicated that large amounts of sedentary behavior (sitting time), low physical activity and low cardiorespiratory fitness are each determinants of cardiometabolic health. These studies have mainly looked at these factors individually,” Jeroen H.P.M. van der Velde, PhD, a post-doctoral researcher in the department of nutrition and movement sciences at Maastricht University, in the Netherlands, told Endocrine Today. “However, these factors should not be viewed in isolation, as they occur concurrently. For example, people can be fit but sit a lot throughout the day, or people can be physically active without having a high a fitness level.”
Van der Velde and colleagues examined data on 1,993 participants aged 40 to 75 years (mean age, 59.7 years; 49.4% men) without diabetes at baseline from The Maastricht Study, a prospective population cohort study focusing on type 2 diabetes. All participants were from the southern portion of the Netherlands and were recruited between 2010 and 2013.
Diabetes status was established following an OGTT. An accelerometer was worn on each participant’s right thigh for 8 days to determine daily activity. Time spent producing more than 110 steps per minute was considered intense physical activity. Sedentary time was recorded only during waking hours. Cardiorespiratory fitness was measured as body-weight adjusted maximum power output.
By themselves, less sedentary time, more time spent in higher intensity physical activity and greater cardiorespiratory fitness were associated with lower odds for developing metabolic syndrome; in addition, less sedentary time and greater cardiorespiratory fitness, but not higher intensity physical activity, were also independently associated with less type 2 diabetes. Higher intensity physical activity was associated with lower odds for type 2 diabetes only in conjunction with greater cardiorespiratory fitness. Odds of developing metabolic syndrome, type 2 diabetes and prediabetes were lowest among the participants with high cardiorespiratory fitness.
More specifically, metabolic syndrome was more likely among participants with low levels of both cardiorespiratory fitness and higher intensity physical activity, with cardiorespiratory fitness being the more important variable. Extended periods of sedentary time together with low cardiorespiratory fitness were associated with greater likelihood of metabolic syndrome as well, as participants with low cardiorespiratory fitness consistently exhibited higher odds for metabolic syndrome in comparison with participants with any level of sedentary time.
As for type 2 diabetes, odds for development were high for those with either low or moderate cardiorespiratory fitness when coupled with low amounts of higher intensity physical activity. However, the greatest odds for diabetes were among participants with low levels of both. Participants with low cardiorespiratory fitness and low sedentary time had the greatest likelihood for developing type 2 diabetes, with cardiorespiratory fitness level once again having a larger impact on the results.
Sedentary time was associated with larger waist circumference and higher fasting glucose and triacylglycerol levels even without considering cardiorespiratory fitness and higher intensity physical activity. The opposite was observed in cardiorespiratory fitness and higher intensity physical activity, with the former also lowering blood pressure.
“We were not surprised to find individual associations for sedentary time, higher intensity physical activity and cardiorespiratory fitness. Many years of physical activity research has taught us that physical activity and cardiorespiratory fitness are important factors that reduce the risk for diseases such as cardiovascular diseases and diabetes. More recently, also the amount of daily sedentary time has been associated with many adverse health outcomes, including in a previous article from The Maastricht Study,” van der Velde said. “However, we were surprised that the observed associations between sedentary time and the metabolic syndrome and type 2 diabetes persisted after correcting for cardiorespiratory fitness. And even more so that in the combined analyses, a high level of sedentary time was associated with these outcomes in people with high cardiorespiratory fitness.” - by Phil Neuffer
Disclosures: This study was supported by the European Regional Development Fund. Please see the study for all other authors’ relevant financial disclosures.
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