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      Impact of lifestyle moderate‐to‐vigorous physical activity timing on glycemic control in sedentary adults with overweight/obesity and metabolic impairments

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          Abstract

          Objective

          Moderate‐to‐vigorous physical activity (MVPA) improves glucose levels; however, whether its timing affects daily glycemic control remains unclear. This study aims to investigate the impact of lifestyle MVPA timing on daily glycemic control in sedentary adults with overweight/obesity and metabolic impairments.

          Methods

          A total of 186 adults (50% women; age, 46.8 [SD 6.2] years) with overweight/obesity (BMI, 32.9 [SD 3.5] kg/m 2) and at least one metabolic impairment participated in this cross‐sectional study. MVPA and glucose patterns were simultaneously monitored over a 14‐day period using a triaxial accelerometer worn on the nondominant wrist and a continuous glucose‐monitoring device, respectively. Each day was classified as “inactive” if no MVPA was accumulated; as “morning,” “afternoon,” or “evening” if >50% of the MVPA minutes for that day were accumulated between 0600 and 1200, 1200 and 1800, or 1800 and 0000 hours, respectively; or as “mixed” if none of the defined time windows accounted for >50% of the MVPA for that day.

          Results

          Accumulating >50% of total MVPA during the evening was associated with lower 24‐h (mean difference [95% CI], −1.26 mg/dL [95% CI: −2.2 to −0.4]), diurnal (−1.10 mg/dL [95% CI: −2.0 to −0.2]), and nocturnal mean glucose levels (−2.16 mg/dL [95% CI: −3.5 to −0.8]) compared with being inactive. This association was stronger in those participants with impaired glucose regulation. The pattern of these associations was similar in both men and women.

          Conclusions

          These findings suggest that timing of lifestyle MVPA is significant. Specifically, accumulating more MVPA during the evening appears to have a beneficial effect on glucose homeostasis in sedentary adults with overweight/obesity and metabolic impairments.

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          Most cited references34

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          World Health Organization 2020 guidelines on physical activity and sedentary behaviour

          Objectives To describe new WHO 2020 guidelines on physical activity and sedentary behaviour. Methods The guidelines were developed in accordance with WHO protocols. An expert Guideline Development Group reviewed evidence to assess associations between physical activity and sedentary behaviour for an agreed set of health outcomes and population groups. The assessment used and systematically updated recent relevant systematic reviews; new primary reviews addressed additional health outcomes or subpopulations. Results The new guidelines address children, adolescents, adults, older adults and include new specific recommendations for pregnant and postpartum women and people living with chronic conditions or disability. All adults should undertake 150–300 min of moderate-intensity, or 75–150 min of vigorous-intensity physical activity, or some equivalent combination of moderate-intensity and vigorous-intensity aerobic physical activity, per week. Among children and adolescents, an average of 60 min/day of moderate-to-vigorous intensity aerobic physical activity across the week provides health benefits. The guidelines recommend regular muscle-strengthening activity for all age groups. Additionally, reducing sedentary behaviours is recommended across all age groups and abilities, although evidence was insufficient to quantify a sedentary behaviour threshold. Conclusion These 2020 WHO guidelines update previous WHO recommendations released in 2010. They reaffirm messages that some physical activity is better than none, that more physical activity is better for optimal health outcomes and provide a new recommendation on reducing sedentary behaviours. These guidelines highlight the importance of regularly undertaking both aerobic and muscle strengthening activities and for the first time, there are specific recommendations for specific populations including for pregnant and postpartum women and people living with chronic conditions or disability. These guidelines should be used to inform national health policies aligned with the WHO Global Action Plan on Physical Activity 2018–2030 and to strengthen surveillance systems that track progress towards national and global targets.
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            Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement

            Findings from epidemiological studies over the past 30 years have shown that visceral adipose tissue, accurately measured by CT or MRI, is an independent risk marker of cardiovascular and metabolic morbidity and mortality. Emerging evidence also suggests that ectopic fat deposition, including hepatic and epicardial fat, might contribute to increased atherosclerosis and cardiometabolic risk. This joint position statement from the International Atherosclerosis Society and the International Chair on Cardiometabolic Risk Working Group on Visceral Obesity summarises the evidence for visceral adiposity and ectopic fat as emerging risk factors for type 2 diabetes, atherosclerosis, and cardiovascular disease, with a focus on practical recommendations for health professionals and future directions for research and clinical practice. We discuss the measurement of visceral and ectopic fat, pathophysiology and contribution to adverse health outcomes, response to treatment, and lessons from a public health programme targeting visceral and ectopic fat. We identify knowledge gaps and note the need to develop simple, clinically applicable tools to be able to monitor changes in visceral and ectopic fat over time. Finally, we recognise the need for public health messaging to focus on visceral and ectopic fat in addition to excess bodyweight to better combat the growing epidemic of obesity worldwide.
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              GGIR: A Research Community–Driven Open Source R Package for Generating Physical Activity and Sleep Outcomes From Multi-Day Raw Accelerometer Data

              Recent technological advances have transformed the research on physical activity initially based on questionnaire data to the most recent objective data from accelerometers. The shift to availability of raw accelerations has increased measurement accuracy, transparency, and the potential for data harmonization. However, it has also shifted the need for considerable processing expertise to the researcher. Many users do not have this expertise. The R package GGIR has been made available to all as a tool to convermulti-day high resolution raw accelerometer data from wearable movement sensors into meaningful evidence-based outcomes and insightful reports for the study of human daily physical activity and sleep. This paper aims to provide a one-stop overview of GGIR package, the papers underpinning the theory of GGIR, and how research contributes to the continued growth of the GGIR package. The package includes a range of literature-supported methods to clean the data and provide day-by-day, as well as full recording, weekly, weekend, and weekday estimates of physical activity and sleep parameters. In addition, the package also comes with a shell function that enables the user to process a set of input files and produce csv summary reports with a single function call, ideal for users less proficient in R. GGIR has been used in over 90 peer-reviewed scientific publications to date. The evolution of GGIR over time and widespread use across a range of research areas highlights the importance of open source software development for the research community and advancing methods in physical behavior research.
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                Author and article information

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                Journal
                Obesity
                Obesity
                Wiley
                1930-7381
                1930-739X
                June 10 2024
                Affiliations
                [1 ] Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS) University of Granada Granada Spain
                [2 ] Department of Health Sciences, Institute for Sustainability & Food Chain Innovation Public University of Navarre Pamplona Spain
                [3 ] Navarra Institute for Health Research (IdiSNA) Pamplona Spain
                [4 ] Center for Biomedical Research Network Pathophysiology of Obesity and Nutrition (CIBERobn) Carlos III Health Institute Madrid Spain
                [5 ] ibs.GRANADA Biosanitary Research Institute Granada Spain
                [6 ] Endocrinology and Nutrition Unit University Hospital San Cecilio Clinic Granada Spain
                [7 ] Department of Medicine University of Granada Granada Spain
                [8 ] CIBER on Frailty and Healthy Aging (CIBERFES) Carlos III Health Institute Madrid Spain
                Article
                10.1002/oby.24063
                4f22d5a9-f389-4ac1-ba61-03659b8481a7
                © 2024

                http://creativecommons.org/licenses/by-nc-nd/4.0/

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