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Purpose

Newly released guidelines recommend increased physical activity (PA) and reduced sedentary behaviors (SB) to improve glycemia and prevent the onset and progression of type 2 diabetes (T2D). Typically, 30-60 min bouts of PA are advocated per day. Although this approach increases PA, it does not decrease the length of the sedentary periods through the day. This is important because recent epidemiological data suggest that frequently interrupting sedentary time improves glucose control even in people who achieve the recommended levels of PA. Preliminary experimental data suggest that breaking up prolonged sedentary time by performing multiple short bouts (5 min) of PA throughout the day, may improve glycemia more than performing a single continuous bout of PA, and thereby potentially be a novel strategy to prevent T2D. The improvement in glycemia was observed even when the total amount of PA and total energy expenditure were matched, suggesting that how and when PA is performed over the day may matter more than how much PA is done. However, important gaps in knowledge remain including: (1) whether similar benefits on glucose control would be observed in adults with prediabetes, a clinically relevant population that is at high risk of developing T2D; (2) whether these effects are sustained or diluted over time, and (3) what are the mechanistic underpinnings. To address these gaps, the investigators propose to measure the acute and chronic effects of PA breaks on glucose control and the underlying mechanisms in individuals at risk of developing T2D. Sedentary men and women with prediabetes (n=66, 50% F) will be randomized to either an intervention designed to interrupt SB with 5-min bouts of brisk walking performed hourly for 9 hours/day, 5 days/week (BREAK) or a control condition consisting of 45-min of brisk walking performed as a single daily continuous bout, 5 days/week (ONE). The two 3-months interventions will be matched for total active time.

Condition

Eligibility

Eligible Ages
Between 18 Years and 64 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Male and female - BMI of 18.5-40 kg/m2and weight stable over the previous 6 months. - Age, 18-64 years old. - Fasting glucose of 100-125 mg/dL or fasting HbA1c of 5.7-6.4%, or 2h OGTT blood glucose of 140-199mg/dL based on the American Diabetes Association (ADA) criteria for pre-diabetes. - Less than 150 minutes of moderate-to-vigorous physical activity (MVPA) per week and more than 6 hours of sitting time per day, as self-reported by the volunteers using the International Physical Activity Questionnaire (IPAQ). - Less than 6500 of steps per day as measured by a pedometer over 5 days (at least 1 weekend day). - Passing medical and physical screening, and analysis of blood and urine screening samples. - Low-moderate caffeine use (<3 cups/day). - Agree to refrain from any other structured exercise than the physical activity prescribed in each arm of the study. - Agree to eat control diets for 3 days before and during the Clinical and Translational Research Center (CTRC) visits; - Agree to refrain from taking any over-the-counter (including nonsteroidal anti-inflammatory drugs) or prescribed medication (apart from oral contraceptives) for 3 days prior to the inpatient CTRC visits; - Agree to wear a Fitbit® activity monitor and upload data on the website on a daily basis for the whole duration of the study. - Agree to follow the physical activity interventions and to be randomly assigned to one of the two arms of the study. - Agree to complete all the study procedures.

Exclusion Criteria

  • Pregnancy, breast-feeding or post-menopause for women. - Being considered unsafe to participate as determined by the study physician. - Ever having a history of systemic, psychiatric, neurological disease, or drug and alcohol abuse. - History of cardiovascular disease, diabetes, uncontrolled hypertension, untreated thyroid, renal, hepatic diseases, dyslipidemia or any other medical condition affecting weight or lipid metabolism. - Being positive for human immunodeficiency virus or hepatitis B or C. - Taking medications affecting weight, triglycerides, energy intake/energy expenditure, or sleep in the last 3 months. - Having abnormal blood chemistry and/or hematology as deemed significant by the study physician. - Being a smoker or having been a smoker in the 3 months prior to their screening visit. - Having donated over 400 mL of blood within 3 months (90 days) of screening for the study; - Working night shifts or traveling across more than 2 time zones within 1 month of and throughout the study. - Not completing the trial days of BREAK and ONE during the screening period to assess the willingness and ability of the participant to perform each of the interventions.

Study Design

Phase
Early Phase 1
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Intervention Model Description
Participants will be randomized to either the BREAK condition (5-min bouts of brisk walking performed hourly for 9 hours/day, 5 days/wk) or the ONE condition (45-min of brisk walking performed as a single continuous bout, 5 days/wk) for 3 months. Participants will complete all study visits in only one group.
Primary Purpose
Prevention
Masking
Single (Outcomes Assessor)
Masking Description
A study research assistant that is not involved in the study participants' allocation process will create opaque, sealed envelopes with allocation sequences based on the randomization table created by the study statistician. The assignment of intervention to study participants will be based on the study allocation sequence generated by the statistician and the study team will enroll study participants and assign them to the interventions. The study team will be blinded until study participants' allocation (the day before visit G). After this, the study team will not be blinded to study participants' allocation as they will be responsible for assigning study participants, and for applying and monitoring the interventions. The study statistician will always be blinded.

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
BREAK Intervention 		Participants in the BREAK condition will perform 5-minute bouts of brisk walking hourly for 9 hours/day, 5 days/week for 3 months.
  • Behavioral: BREAK
    The BREAK intervention is a physical activity regimen.
Active Comparator
ONE Intervention 		Participants in the ONE condition will perform 45 minutes of brisk walking as a single continuous bout, 5 days/week for 3 months.
  • Behavioral: ONE
    The ONE intervention is a physical activity regimen.

Recruiting Locations

University of Colorado Anschutz Medical Campus
Aurora, Colorado 80045

More Details

NCT ID
NCT05041491
Status
Recruiting
Sponsor
University of Colorado, Denver

Study Contact

Patricia Smith, MS, RDN
303.724.6821
trish.smith@cuanschutz.edu

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.

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ResearchMatch is funded in part by the National Institutes of Health (NIH) Clinical and Translational Science Award (CTSA) program, led by the NIH’s National Center for Advancing Translational Sciences (NCATS), grants UL1TR000445 and 1U54RR032646-01, and grant U24TR001579 from NCATS and the National Library of Medicine. The content of this website is solely the responsibility of ResearchMatch and Vanderbilt University and does not necessarily represent the official views of the NIH, NCATS, or NLM.

Vanderbilt University Medical Center