Effects of subtracting sitting versus adding exercise on glycemic control and variability in sedentary office workers

Recent evidence suggests that, like adding exercise, reducing sitting time may improve cardiometabolic health. There has not been a direct comparison of the 2 strategies with energy expenditure held constant. The purpose of this study was to compare fasting and postmeal glucose and insulin concentrations in response to a day with frequent breaks from sitting but no exercise versus considerable sitting plus moderate exercise. Ten sedentary overweight/obese office workers were tested in 3 conditions: (i) walking per activity guidelines (AGW): sitting for majority of workday with a 30 min pre-lunch walk; (ii) frequent long breaks (FLB): no structured exercise but frequent breaks from sitting during workday with energy expenditure matched to AGW; and (iii) frequent short breaks (FSB): number of breaks matched to FLB, but duration of breaks were shorter. Plasma glucose and insulin areas under the curve were measured in response to a meal tolerance test (MTT) at the end of the workday and interstitial glucose was evaluated throughout the day and overnight using continuous glucose monitoring. Using repeated-measures linear mixed models, area under the curve of plasma glucose or insulin after the MTT was not different between conditions. Glycemic variability was lower in FLB compared with AGW (p < 0.05), and nocturnal duration of elevated glucose (>7.8 mmol/L) was shorter after FLB (2.5 ± 2.5 min) than AGW (32.7 ± 16.4 min) or FSB (45.6 ± 29.6 min, p = 0.05). When energy expenditure was matched, breaks from sitting approximated the effects of moderate-intensity exercise on postmeal glucose and insulin responses and more effectively constrained glycemic variability.