Reallocating sitting time to standing or stepping through isotemporal analysis: associations with markers of chronic low-grade inflammation

ABSTRACT

Although high levels of sitting time are adversely related to health, it is unclear whether moving from sitting to standing provides a sufficient stimulus to elicit benefits upon markers of chronic low-grade inflammation in a population at high risk of type 2 diabetes (T2DM). Three hundred and seventy two participants (age = 66.8 ± 7.5years; body mass index (BMI) = 31.7 ± 5.5kg/m²; Male = 61%) were included. Sitting, standing and stepping was determined using the activPAL3^TM device. Linear regression modelling employing an isotemporal substitution approach was used to quantify the association of theoretically substituting 60 minutes of sitting per day for standing or stepping on interleukin-6 (IL-6), C-reactive protein (CRP) and leptin. Reallocating 60 minutes of sitting time per day for standing was associated with a −4% (95% CI −7%, −1%) reduction in IL-6 (p = 0.048). Reallocating 60 minutes of sitting time for light stepping was also associated with lower IL-6 levels (−28% (−46%, −4%; p = 0.025)). Substituting sitting for moderate-to-vigorous (MVPA) stepping was associated with lower CRP (−41% (−75%, −8%; p = 0.032)), leptin (−24% (−34%, −12%; p ≤ 0.001)) and IL-6 (−16% (−28%, 10%; p = 0.036). Theoretically replacing 60 minutes of sitting per day with an equal amount of either standing or stepping yields beneficial associations upon markers of chronic-low grade inflammation.

KEYWORDS:

• Sitting
• standing
• stepping
• type 2 diabetes
• inflammation

Acknowledgements

The Walking Away trial was funded by The National Institute for Health Research [NIHR] Collaboration for Leadership in Applied Health Research and Care for Leicestershire, Northamptonshire and Rutland [NIHR CLAHRC – LNR] and East Midlands [NIHR CLAHRC EM]. The research was supported by the NIHR Leicester Biomedical Research Centre which is a partnership between University Hospitals of Leicester NHS Trust, Loughborough University and the University of Leicester and the University of Leicester Clinical Trials Unit.  The views expressed are those of the author[s] and not necessarily those of the NHS, the NIHR or the Department of Health. Analysis of IL-6, CRP and Leptin levels was funded by Unilever R&D, UK.

Clinical Trials Registration: ClinicalTrials.gov NCT: NCT00941954. The authors would also like to thank Charlotte Jelleyman and Matthew McCarthy for their help with analysing the inflammatory markers and the participants for taking the time to take part.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary material

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Additional information

Funding

This work was supported by The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care - Leicestershire, Northamptonshire and Rutland (NIHR CLAHRC – LNR) and East Midlands (NIHR CLAHRC EM). The research was supported by the NIHR Leicester Biomedical Research Centre which is a partnership between University Hospitals of Leicester NHS Trust, Loughborough University and the University of Leicester and the University of Leicester Clinical Trials Unit.