Physical Activity, Sedentary Time May Increase Cardiometabolic Risk Markers in Prediabetes

A woman running on a treadmill
A woman running on a treadmill
A study sought to clarify whether total physical activity during the day is equally as important as achieving high levels of intensity associated with moderate-to-vigorous physical activity.

Adults diagnosed with prediabetes who are physically active during the day may achieve cardiometabolic risk marker values comparable to those who participate in moderate-to-vigorous physical activity (MVPA), according to a study published in Diabetes Care.

Researchers identified 2326 individuals 25 to 70 years of age from 8 different countries with a body mass index >25 to participate in wearing an ActiSleep+ accelerometer (ActiGraph LLC, Pensacola, FL) for 24 hours a day for a total of 7 days (with the exception of participation in water activities) in an effort to measure objectively the association between physical activity levels and sedentary time (ST) on cardiometabolic health and risk for diabetes.

The study investigators found a positive association between ST and homeostatic model assessment insulin resistance (HOMA-IR), waist circumference (WC), fasting insulin, triglycerides, C-reactive protein (CRP), systolic blood pressure, and diastolic blood pressure (β =0.175 [95% CI, 0.114, 0.236], β =0.215 [0.026, 0.131], β =0.115 [0.092, 0.219], β=0.078 [0.026, 0.131], and β =0.106 [0.39, -0.172], respectively).

In addition, a negative association was found between MVPA and HOMA-IR, WC, fasting insulin, 2-hour glucose, triglycerides, and CRP (β =-0.178 [-0.128, -0.027], β =-0.177 [-0.122, -0.134], β =-0.115 [-0.158, -0.072], β =-0.069 [-0.112, -0.125], β =-0.091 [-0.138, -0.44], and β = -0.086 [-0.127, -0.045], respectively). 

Interestingly, the associations between total PA and MVPA were found to be similar, if not better for those reporting a total PA as noted in data from HOMA-IR, WC, fasting insulin, 2-hour glucose, triglycerides, and CRP (β =-0.151 [-0.194, -0.107], β =-0.179 [-0.124, -0.134], β =-0.139 [-0.183, -0.096], β =-0.088 [-0.131, -0.045], β =-0.117 [-0.162, -0.071], and β =-0.104 [-0.146, -0.062], respectively).

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Researchers concluded that PA and ST were indeed associated with cardiometabolic risk factors when measured objectively during this study, with the total amount of PA during the day being just as strongly associated with cardiometabolic risk factors as MVPA.  

Therefore, clinicians should explain the benefits of both total daily PA and MVPA to individuals diagnosed with prediabetes to encourage the type of exercise regimen that fits the daily schedule and preferences of individuals who are overweight, inactive, and reluctant to participate in PA, as both PA and MVPA have similar outcomes despite their differences in level of intensity.


Swindell N, Mackintosh K, McNarry M, et al. Objectively measured physical activity and sedentary time are associated with cardiometabolic risk factors in adults with prediabetes: the PREVIEW study [published online November 20, 2017]. Diabetes Care. doi: 10.2337/dc17-1057