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The Effects of Acute Exposure to Prolonged Sitting, With and Without Interruption, on Vascular Function Among Adults: A Meta-analysis

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Abstract

Background

Exposure to acute prolonged sitting can result in vascular dysfunction, particularly within the legs. This vascular dysfunction, assessed using flow-mediated dilation (FMD), is likely the consequence of decreased blood flow-induced shear stress. With mixed success, several sitting interruption strategies have been trialled to preserve vascular function.

Objectives

The objectives of this meta-analysis were to (1) assess the effects of acute prolonged sitting exposure on vascular function in the upper- and lower-limb arteries, and (2) evaluate the effectiveness of sitting interruption strategies in preserving vascular function. Sub-group analyses were conducted to determine whether artery location or interruption modality explain heterogeneity.

Data Sources

Electronic databases (PubMed, Web of Science, SPORTDiscus, and Google Scholar) were searched from inception to January 2020. Reference lists of eligible studies and relevant reviews were also checked.

Study Selection

Inclusion criteria for objective (1) were: (i) FMD% was assessed pre- and post-sitting; (ii) studies were either randomised-controlled, randomised-crossover, or quasi-experimental trials; (iii) the sitting period was ≥ 1 h; and (iv) participants were healthy non-smoking adults (≥ 18 years), and free of vascular-acting medication and disease at the time of testing. Additional inclusion criteria for objective (2) were: (i) the interruption strategy must have been during the sitting period; (ii) there was a control (uninterrupted sitting) group/arm; and (iii) the interruption strategy must have involved the participants actively moving their lower- or upper-limbs.

Appraisal and Synthesis Methods

One thousand eight hundred and two articles were identified, of which 17 (22 trials, n = 269) met inclusion criteria for objective (1). Of those 17 articles, 6 studies (9 trials, n = 127) met the inclusion criteria for objective (2). Weighted mean differences (WMD), 95% confidence intervals (95% CI), and standardised mean difference (SMD) were calculated for all trials using random-effects meta-analysis modelling. SMD was used to determine the magnitude of effect, where < 0.2, 0.2, 0.5, and 0.8 was defined as trivial, small, moderate, and large respectively.

Results

(1) Random-effects modelling showed uninterrupted bouts of prolonged sitting resulted in a significant decrease in FMD% (WMD = − 2.12%, 95% CI − 2.66 to − 1.59, SMD = 0.84). Subgroup analysis revealed reductions in lower- but not upper-limb FMD%. (2) Random-effects modelling showed that interrupting bouts of sitting resulted in a significantly higher FMD% compared to uninterrupted sitting (WMD = 1.91%, 95% CI 0.40 to 3.42, SMD = 0.57). Subgroup analyses failed to identify an optimum interruption strategy but revealed moderate non-significant effects for aerobic interventions (WMD = 2.17%, 95% CI − 0.34 to 4.67, SMD = 0.69) and simple resistance activities (WMD = 2.40%, 95% CI − 0.08 to 4.88, SMD = 0.55) and a trivial effect for standing interruptions (WMD = 0.24%, 95% CI − 0.90 to 1.38, SMD = 0.16).

Conclusions

Exposure to acute prolonged sitting leads to significant vascular dysfunction in arteries of the lower, but not upper, limbs. The limited available data indicate that vascular dysfunction can be prevented by regularly interrupting sitting, particularly with aerobic or simple resistance activities.

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Data Availability

The data analysed for this meta-analysis are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. School of Sport and Exercise, University of Gloucestershire, Gloucester, UK

    Craig Paterson, Simon Fryer, Keeron Stone & John K. Parker

  2. Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Gabriel Zieff & Lee Stoner

  3. Department of Biology, Ave Maria University, Ave Maria, FL, USA

    Daniel P. Credeur

  4. Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA, USA

    Bethany Barone Gibbs

  5. Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO, USA

    Jaume Padilla

  6. Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, USA

    Jaume Padilla

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Contributions

CP and GZ completed the literature search. CP, SF, and LS completed quality assessment. CP and GZ extracted all relevant data from selected articles. CP and LS conducted data analysis. CP, SF, KS, and LS wrote the first draft of the manuscript. GZ, BBG, JP, and JP revised the original manuscript. All authors read and approved the final manuscript.

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Correspondence to Craig Paterson.

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Craig Paterson, Simon Fryer, Gabriel Zieff, Keeron Stone, Daniel Credeur, Bethany Barone Gibbs, Jaume Padilla, John Parker, and Lee Stoner declare that they have no conflicts of interest relevant to the content of this review.

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Paterson, C., Fryer, S., Zieff, G. et al. The Effects of Acute Exposure to Prolonged Sitting, With and Without Interruption, on Vascular Function Among Adults: A Meta-analysis. Sports Med 50, 1929–1942 (2020). https://doi.org/10.1007/s40279-020-01325-5

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