Effects of Microbouts of Activity on Metabolic Health

Health Behavior Clinical Trial

Official title:

Effects of Microbouts of Activity on Metabolic Health

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02998892
• Other study ID #: 16-1769
• Status: Completed
• Phase: N/A
• Start date: May 9, 2017
• Est. completion date: October 8, 2021

Study information

• Verified date: January 2022
• Source: University of Colorado, Denver
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Population studies suggest that time spent in sedentary behaviors is associated with all-cause mortality including obesity, diabetes, and cardiovascular diseases, independent of time spent in exercise. Frequent interruptions to sedentary time are however beneficially associated with metabolic health outcomes, even in individuals who exercise regularly. The goal is to use integrative approach to understand the biological mechanisms that underlie these associations in a longitudinal intervention study in overweight sedentary adults. The investigators believe that the proposed study will provide an initial evidence base for the health benefits of breaking up prolonged sitting with short bursts of activity. This innovative strategy may be more effective at combating the adverse effects of sedentary behaviors than more traditional approaches.

Description:

To compare the effects of 4-weeks of microbursts of moderate-intensity activity to a calorically equivalent single bout of 45 minutes of moderate-intensity exercise training, both performed 5 days per week for a total of 45 minutes, in free-living sedentary overweight adults on: Aim 1: plasma inflammatory and cardiometabolic health biomarkers in association with total energy expenditure and time spent in sedentary behaviors. H1: Microbursts of activity will result in higher daily energy expenditure and lower time spent sedentary, as respectively measured with doubly labeled water and accelerometry, than traditional exercise training. This will be associated with healthier inflammatory Interleukin 1 alpha (IL1a), Interleukin 6 (IL6), Interleukin 10 (IL10), Tumour Necrosis Factor alpha (TNFa) and cardiometabolic (triglycerides, cholesterol, C-Reactive Protein (CRP), High-density lipoprotein (HDL), and Low-density lipoprotein (LDL) profiles compared to those obtained with traditional exercise training program. Aim 2: 24-hr total fat and carbohydrate oxidation, exogenous carbohydrate oxidation, dietary fat trafficking between oxidation and incorporation into muscle lipid fractions, and mitochondrial function. H2: Both one single continuous bout and microbouts of activity will increase 24-hr total (whole-room calorimetry) and dietary (D9-palmitate) fat oxidation due to greater mitochondrial lipid oxidation (high resolution respirometry) and lower incorporation of dietary fatty acid into muscle lipid fractions (D9-palmitate), as compared to baseline sedentary control condition. Microbouts of activity will further result in greater increases in 24-hr total (whole-room calorimetry) and exogenous (U-13C6 glucose) carbohydrate oxidation and in mitochondrial carbohydrate-linked oxidation, than traditional isocaloric exercise training. Aim 3: Whole-body insulin sensitivity. H3: Both one single continuous bout and microbouts of activity will improve whole-body insulin sensitivity Intravenous Glucose Tolerance Test (IVGTT) compared to the baseline sedentary condition, but the improvement will likely be higher with the microbouts of activity. Exploratory aim: Self-perceived appetite, hunger, and levels of mood, fatigue and vigor/energy. H3: Microbursts of activity will result in less appetite, hunger and fatigue but in greater feelings of vigor and overall well-being than traditional isocaloric exercise training. As a result adherence to microbursts will be better than adherence to single bouts of physical activity.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 32
• Est. completion date: October 8, 2021
• Est. primary completion date: October 8, 2021
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 45 Years

Eligibility

Inclusion Criteria:

• Overweight but weight stable (+/- 3kg over previous 6 months) sedentary male and female adults (n=30) will be recruited.
• Ages between 18-45 years old
• BMI of 25-35 kg/m2
• Sedentary (< 1hr/wk of moderate-to-vigorous activity, less than 6,500 steps per day as measured for 5 days in free-living conditions with a pedometer). Based on subjects self-report during the H&P visit
• The use of birth pill control will be accepted

Exclusion criteria:

• Any history of renal (present or past kidney failure, kidney transplant, dialysis or kidney cysts),
• Uncontrolled hypertension
• Cardiovascular (present or past atherosclerosis, heart attack, ischemic stroke, heart failure)
• Hepatic diseases (past or present hepatitis B or C, fibrosis, cirrhosis, NAFLD/NASH)
• Type 1 or 2 diabetes
• Cancer
• Smoking
• Consumption of drugs (marijuana included)
• Consumption of alcohol (>40g/d)
• HIV positivity
• Psychiatric disorders
• Any medications known to interfere with lipid or energy metabolism
• Known physical activity contraindications
• Major illness/physical problems (acute or chronic) that may limit their ability to perform the walking activities
• The blood draw will be used to objectively exclude peri- or postmenopausal women (FSH>25 mlU/mL in early follicular phase)
• Hypertriglyceridemia (triglycerides > 400mg/dL).

Related Conditions & MeSH terms

• Health Behavior

Intervention

Behavioral:
• Traditional Exercise Training
Participants will be asked to perform moderate-intensity exercise (brisk walking) for 45 minutes for 5 days/week for 4 weeks. This intervention corresponds to the current recommendations.
• Daily Microbursts of Activity
Participants will be asked to break up their sedentary activities of daily living for 5-minutes every hour for 10 hours, 5 days/week, by brisk walking for 4 weeks.

Locations

Country	Name	City	State
United States	University of Colorado Hospital	Aurora	Colorado

Sponsors (2)

Lead Sponsor	Collaborator
University of Colorado, Denver	National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Changes in sedentary time as measured by ActiPAL	Over each 2 week period, participants will be instructed to wear an ActiPAL (PALTechnologies: Glasgow, Scotland) activity monitor on their right leg. Participants will be instructed to wear the monitors at all times except when sleeping or participating in water-based activities. The time-stamped "event" data file from the activPAL software will be used to determine time spent sitting/lying, standing and stepping per day.	weeks 1-2 and weeks 5-6
Primary	Changes in total substrate oxidation	Total fat oxidation during the test day will be determined using whole-room indirect calorimetry. O2 consumption and CO2 production will be determined from the flow rates and differences in gas concentrations between air entering and air exiting the calorimeter as previously described	week 2 and week 7
Primary	Changes in insulin sensitivity	Insulin sensitivity will be determined via an insulin modified frequently sampled intra-venous glucose tolerance test (IVGTT). After baseline samples, intravenous glucose (0.3 g/kg) will be infused over 1 minute, followed by insulin at 0.03 U/kg, 20 minutes after glucose administration. Blood samples will be frequently sampled over 5 hours, and insulin sensitivity will be calculated using the Bergman minimal model.	week 2 and week 7
Secondary	Changes in total energy expenditure (TEE)	Total energy expenditure (TEE) will be measured before and at the end of the intervention using doubly labeled water (DLW) over a 10-day period, as previously described (31). Subjects will ingest premixed 2g/kg total body water (TBW), estimated as 73% of fat free mass) dose of DLW composed of 0.2 and 0.15 g/kg estimated TBW of H218O and 2H2O, respectively. Urine samples will be collected in duplicate on days 0, 6, 8 and 10. 2H and 18O enrichment will be determined in urine samples by isotope ratio mass spectrometry (Delta V Advantage IRMS)	week 1-2 and week 5-6
Secondary	Changes in Moderate-to-vigorous physical activity as measured by ActiGraph	Over the same 10-day period, participants will be instructed to wear an Actigraph GT3X+ accelerometer (Actigraph, LLC, Fort Walton Beach, FL) on their hip. Participants will be instructed to wear the monitors at all times except when sleeping or participating in water-based activities.	weeks 1-6
Secondary	Changes in plasma CRP concentration	Weekly fasting blood samples will be obtained for the measurements of CRP (mg/dL).	Once weekly for 5 weeks
Secondary	Changes in Dietary Carbohydrate Oxidation	After the investigators have shown the subjects the procedure, subjects will collect their own hourly breath sampling for CO2 by blowing through a straw into two 15ml Vacutainers. Breath CO2 will be sampled directly from the Vacutainer with a syringe, and 13CO2 /12CO2 measured with IRMS.	week 2 and week 7
Secondary	Changes in Dietary Fat Oxidation	Hourly urine sampling will be collected by the subjects for 24 hours and stored in 5mL cryovials at -20C until further analysis. To measure 2 hour fat oxidation, 2 hour/1 hour ratios from urine samples will be analyzed, as above described for the doubly labeled water method. The oxidation rate of glucose/water will be calculated from the cumulative recovery of 2 hours in total body water (TBW) as detailed previously.	week 2 and week 7
Secondary	Changes in Mitochondria function	Freshly isolated skeletal muscle biopsies will be cut into small samples, the fibre bundles separated mechanically and partially teased apart and permeabilised. Small samples (2-5mg) will be added to the 2ml chamber of an Oroboros high-resolution respirometer with a mitochondrial respiration buffer. With the addition of several substrates, different states will be reached to analyse mitochondrial function. Pyruvate, malate and glutamate will be added as substrates to examine respiration through Complex I, succinate will be used to examine respiration through Complex II and octanoylcarnitine will be used to examine respiration through the electron-transferring flavoprotein, ETF.	week 2 and week 7