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How does light-intensity physical activity associate with adult cardiometabolic health and mortality? Systematic review with meta-analysis of experimental and observational studies
  1. Sebastien F M Chastin1,2,
  2. Marieke De Craemer2,
  3. Katrien De Cocker2,3,4,
  4. Lauren Powell5,6,
  5. Jelle Van Cauwenberg3,7,
  6. Philippa Dall1,
  7. Mark Hamer8,
  8. Emmanuel Stamatakis5,6
  1. 1 School of Health and Life Science, Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK
  2. 2 Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
  3. 3 Research Foundation Flanders, Brussels, Belgium
  4. 4 Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
  5. 5 Epidemiology Unit, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
  6. 6 Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  7. 7 Department of Public Health, Ghent University, Ghent, Belgium
  8. 8 School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
  1. Correspondence to Dr Sebastien F M Chastin, School of Health and Life Sciences, Institute for Applied Health Research, Glasgow Caledonian University, Glasgow G4 0BA, UK; Sebastien.Chastin{at}gcu.ac.uk

Abstract

Aim To assess the relationship between time spent in light physical activity and cardiometabolic health and mortality in adults.

Design Systematic review and meta-analysis.

Data sources Searches in Medline, Embase, PsycInfo, CINAHL and three rounds of hand searches.

Eligibility criteria for selecting studies Experimental (including acute mechanistic studies and physical activity intervention programme) and observational studies (excluding case and case–control studies) conducted in adults (aged ≥18 years) published in English before February 2018 and reporting on the relationship between light physical activity (<3 metabolic equivalents) and cardiometabolic health outcomes or all-cause mortality.

Study appraisal and synthesis Study quality appraisal with QUALSYST tool and random effects inverse variance meta-analysis.

Results Seventy-two studies were eligible including 27 experimental studies (and 45 observational studies). Mechanistic experimental studies showed that short but frequent bouts of light-intensity activity throughout the day reduced postprandial glucose (−17.5%; 95% CI −26.2 to −8.7) and insulin (−25.1%; 95% CI −31.8 to –18.3) levels compared with continuous sitting, but there was very limited evidence for it affecting other cardiometabolic markers. Three light physical activity programme intervention studies (n ranging from 12 to 58) reduced adiposity, improved blood pressure and lipidaemia; the programmes consisted of activity of >150 min/week for at least 12 weeks. Six out of eight prospective observational studies that were entered in the meta-analysis reported that more time spent in daily light activity reduced risk of all-cause mortality (pooled HR 0.71; 95% CI 0.62 to 0.83).

Conclusions Light-intensity physical activity could play a role in improving adult cardiometabolic health and reducing mortality risk. Frequent short bouts of light activity improve glycaemic control. Nevertheless, the modest volume of the prospective epidemiological evidence base and the moderate consistency between observational and laboratory evidence inhibits definitive conclusions.

  • sedentary
  • risk factor
  • public health
  • physical activity
  • cardiovascular

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Footnotes

  • Contributors SFMC led the review and meta-analysis and wrote the manuscript. ES and MH contributed to the design, hand searches and revisions of the manuscript. MDC, KDC, JVC, PD and LP contributed to the selection, appraisal, data extraction of the article and revisions of the manuscript. LP conducted the initial searches and updated the searches.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Correction notice This article has been corrected since it was published Online First. The reference list has been updated, and other minor corrections in the text have been implemented.

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