Lifestyle interventions to reduce sedentary behaviour in clinical populations: A systematic review and meta-analysis of different strategies and effects on cardiometabolic health

Abstract

Cardiometabolic comorbidities are highly prevalent in clinical populations, and have been associated (partly) with their sedentary lifestyle. Although lifestyle interventions targeting sedentary behaviour (SB) have been studied extensively in the general population, the effect of such strategies in clinical populations is not yet clear. Therefore, this systematic review and meta-analysis evaluated the effect of different lifestyle interventions on SB and cardiometabolic health in clinical populations.Randomised controlled trials were collected from five bibliographic databases (PubMed, Embase, Web of Science, The Cochrane Central Register of Controlled Trials, and Scopus). Studies were eligible for inclusion if they evaluated a lifestyle intervention to reduce objectively measured SB, in comparison with a control intervention among persons with a clinical condition. Data were pooled using a random-effects meta-analysis.In total, 7094 studies were identified. Eighteen studies met the inclusion criteria and were categorised in five population groups: overweight/obesity, type 2 diabetes mellitus, cardiovascular, neurological/cognitive and musculoskeletal diseases. Participants reduced their SB by 64 min/day (95%CI: [− 91, − 38] min/day; p < 0.001), with larger within-group differences of multicomponent behavioural interventions including motivational counselling, self-monitoring, social facilitation and technologies (− 89 min/day; 95%CI: [− 132, − 46] min/day; p < 0.001). Blood glycated haemoglobin concentration (− 0.17%; 95% CI: [− 0.30, − 0.04]%; p = 0.01), fat percentage (− 0.66%; 95% CI: [− 1.26, − 0.06]%, p = 0.03) and waist circumference (− 1.52 cm; 95%CI: [− 2.84, − 0.21] cm; p = 0.02) were significantly reduced in the intervention groups compared to control groups. Behavioural lifestyle interventions reduce SB among clinical populations and improve cardiometabolic risk markers such as waist circumference, fat percentage, and glycaemic control.Sedentary behaviour, Cardiometabolic health, Clinical populations.

How to improve the physical health of people with severe mental illness? A multicentric randomized controlled trial on the efficacy of a lifestyle group intervention

“…Our findings confirmed our hypothesis, with a significant reduction in BMI, body weight, and waist circumference in patients receiving the experimental intervention. Our results also support the recent finding that people with SMI can achieve healthy lifestyle through the provision of behavioral programs [ 67 ].…”

Association between sedentary behavior and low back pain; A systematic review and meta-analysis

“…The interventions consisted of the use of technologies, social facilitation, motivational counselling and self-monitoring. 76 As LBP is a complex disorder, health education to reduce the prevalence or occurrence of LBP should be address the risk factors as much as possible including sedentary behavior.…”

Association of sedentary time and carotid atherosclerotic plaques in patients with type 2 diabetes

“…19 In the meantime, a meta-analysis suggested that reducing sedentary behavior among clinical populations could improve cardiometabolic risk markers such as waist circumference, fat percentage, and glycemic control. 20 Moreover, we found that differences in age were associated with the different levels of sedentary time. Surprisingly and interestingly, our data showed that older adults have the least sedentary time than other age groups, which is contrary to our speculation and studies in other countries.…”

“… 19 In the meantime, a meta‐analysis suggested that reducing sedentary behavior among clinical populations could improve cardiometabolic risk markers such as waist circumference, fat percentage, and glycemic control. 20 …”