The Acute Effects of Interrupting Prolonged Sitting With Regular Activity Breaks on Postprandial Glucose and Insulin in Adults: A Systematic Review and Meta‐analysis

Abstract

Background Regular activity breaks improve postprandial glycemia, but the effects across different population groups and modes of breaks remain unclear. This systematic review and meta-analysis examined the impact of activity breaks on postprandial glucose and insulin response in adult populations.

Methods Studies were identified from five databases until October 9, 2024. Eligible studies were acute (< 24-h duration) laboratory-based randomized crossover trials comparing postprandial glucose and/or insulin response between prolonged sitting and activity breaks (< 10 min, ≥ 3 breaks over 3 h). Risk of bias was assessed using the Downs and Black quality assessment tool. Random-effects meta-analysis was conducted including subgroup analyses by activity mode, frequency, and participant health/weight status.

Results Overall 53 studies met the eligibility criteria; 39 were included in the meta-analysis. Compared with prolonged sitting, activity breaks lowered postprandial glucose incremental area under the curve (iAUC) (SMD −0.30, 95% CI −0.43 to −0.13) and insulin iAUC (SMD −0.30, 95% CI −0.46 to −0.14). Walking breaks had the greatest effect on glucose iAUC (SMD −0.33, 95% CI −0.48 to −0.17) and insulin iAUC (SMD −0.44, 95% CI −0.62 to −0.27), compared with other modes. Interrupting sitting every 15–20 min produced the largest reductions in glucose (SMD −0.51, 95% CI −0.83 to −0.19) and insulin iAUC (SMD −0.41, 95% CI −0.77 to −0.06). The largest reduction in glucose iAUC was observed in those living with obesity (SMD −0.52, 95% CI −1.07 to 0.03).

Conclusion Frequent short walking breaks, performed every 20 min, provide the most improvement in postprandial glucose and insulin response in adults.