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Total amount and patterns of sedentary behaviour &
glucose metabolism status
Julianne van der Berg – PhD candidate [email protected]
INTRO
METHODS
RESULTS
CONCLUSIONS
THE PROBLEM
Long periods of sedentary behaviour (sitting, watching TV, using the computer)
unfavourably associated with several
metabolic health outcomes
Waist circumference Cholesterol levels Triglycerides levels Metabolic syndrome
Also, pattern in which sedentary time is
accumulated seems important for health
→ sedentary breaks
→ sedentary bouts
White bars = sedentary time Grey bars = standing or stepping time (physical activity)
Examples of different sedentary behaviour patterns
I
II
III
→ time break
bout
STUDY AIM
Examine associations of
volume and patterns
of sedentary behaviour
with glucose metabolism status
INTRO
METHODS
RESULTS
CONCLUSIONS
STUDY SAMPLE The Maastricht Study: • 10,000 participants • Type 2 diabetes oversampled
• Aetiology • Pathophysiology • Complications
• Current study
• 2,497 participants
INTRO
METHODS
RESULTS
CONCLUSIONS
Maastricht
SEDENTARY BEHAVIOUR
activPAL™ physical activity monitor o 24h/day for 7 days
INTRO
METHODS
RESULTS
CONCLUSIONS
SEDENTARY BEHAVIOUR
activPAL™ physical activity monitor o 24h/day for 7 days
→ Sitting (h/day) → Standing (h/day) → Stepping (h/day) → Sedentary breaks (#/day) → Sedentary bouts ≥ 30 min (#/day) → Average bout duration (min)
INTRO
METHODS
RESULTS
CONCLUSIONS
OUTCOME MEASURE
• Glucose metabolism status - OGTT
→ normal glucose metabolism (NGM)
→ impaired glucose metabolism (IGM) o impaired fasting glucose
o impaired glucose tolerance
→ type 2 diabetes (T2DM)
INTRO
METHODS
RESULTS
CONCLUSIONS
BASELINE CHARACTERISTICS
NGM (n=1395)
IGM (n=388)
T2DM (n=714)
Sex (%men) 41.9 54.9 70.2
Age (years) 58.1 (8.1) 61.9 (7.2) 62.7 (7.7)
Low educated (%) 26.7 36.9 45.0
BMI (kg/m2) 25.5 (3.6) 27.7 (4.3) 29.8 (4.9) Diabetes duration (years), median (IQR) n/a n/a 6.0 (3.0-12.0)
HbA1c (%) 5.4 (0.3) 5.7 (0.4) 6.9 (1.0)
Mean (SD), unless stated otherwise
INTRO
METHODS
RESULTS
CONCLUSIONS
ACCELEROMETER WEAR DAYS
INTRO
METHODS
RESULTS
CONCLUSIONS
0
200
400
600
800
1000
1200
1400
1600
1 2 3 4 5 6 7
n >90%
DAILY ACTIVITY BY GMS
8.3 8.2 8.3
9.1 9.5 10.1
4.5 4.3 3.9
0
4
8
12
16
20
24
Non Pre Diabetes
Hours Stepping
Standing
Sitting
Sleeping
2.0 1.7 2.1
NGM IGM T2DM
INTRO
METHODS
RESULTS
CONCLUSIONS
SEDENTARY TIME BY GMS
9.3 9.4 9.7
0
2
4
6
8
10
Hours/day
NGM IGM T2DM
Adjusted for sex, age, level of education, waking time, smoking status, alcohol consumption, health status, mobility limitation, BMI, and high-intensity physical activity
26 minutes (p < 0.001)
20 minutes (p = 0.001)
6 minutes (p = 0.761)
INTRO
METHODS
RESULTS
CONCLUSIONS
SEDENTARY TIME BY GMS
OR
1.07
1.22
1.0
1.2
1.4
0
INTRO
METHODS
RESULTS
CONCLUSIONS
Adjusted for sex, age, level of education, waking time, smoking status, alcohol consumption, health status, mobility limitation, BMI, and high-intensity physical activity NGM IGM T2DM
SEDENTARY BREAKS BY GMS
54.4 55.5 55.0
0
10
20
30
40
50
60
#sedentary breaks/day
INTRO
METHODS
RESULTS
CONCLUSIONS
Adjusted for sex, age, level of education, waking time, smoking status, alcohol consumption, health status, mobility limitation, BMI, sedentary time, and high-intensity physical activity
NGM IGM T2DM
4.9 4.8 4.8
0
1
2
3
4
5
6
#sedentary bouts
≥30min/day
SEDENTARY BOUTS ≥30 min BY GMS
INTRO
METHODS
RESULTS
CONCLUSIONS
Adjusted for sex, age, level of education, waking time, smoking status, alcohol consumption, health status, mobility limitation, BMI, sedentary time, and high-intensity physical activity
NGM IGM T2DM
11.3 11.0 11.3
0
2
4
6
8
10
12
14
average bout duration (min)
SEDENTARY BOUT DURATION BY GMS
INTRO
METHODS
RESULTS
CONCLUSIONS
Adjusted for sex, age, level of education, waking time, smoking status, alcohol consumption, health status, mobility limitation, BMI, sedentary time, and high-intensity physical activity
NGM IGM T2DM
TO CONCLUDE
Total volume but not
≡ patterns ≡ of sedentary behaviour
associated with
type 2 diabetes
• Participants with type 2 diabetes ~25 minutes more sedentary time per day than participants without diabetes
• Each extra hour of sedentary time was associated with a 22% increased odds for type 2 diabetes
• No difference in sedentary breaks, long sedentary bouts, and sedentary bout duration
INTRO
METHODS
RESULTS
CONCLUSIONS
THANKS TO COAUTHORS: Coen DA Stehouwer
Hans Bosma
Jeroen HPM van der Velde
Paul JB Willems
Hans HCM Savelberg
Miranda T Schram
Simone JS Sep
Carla JH van der Kallen
Ronald MA Henry
Pieter C Dagnelie
Nicolaas C Schaper
Annemarie Koster
INTRO
METHODS
RESULTS
CONCLUSIONS
Julianne van der Berg:
Paper submitted:
Associations of total volume and patterns of sedentary behaviour
with type 2 diabetes and metabolic syndrome – The Maastricht Study
Van der Berg et al. 2015