# Substituting sitting with standing and walking in free-living conditions improves daily glucose concentrations in South Asian adults living with overweight/obesity

## TL;DR

Replacing sitting with standing and walking during the day can help lower blood sugar levels in South Asian adults with overweight or obesity.

## Contribution

This study shows that substituting sitting with standing and walking improves glucose levels in free-living conditions for South Asian adults.

## Key findings

- Interstitial glucose net incremental area under the curve was significantly lower during waking hours in the SITless regimen.
- Lunch postprandial glucose was significantly reduced in the SITless condition compared to sitting.
- Standing and walking time increased significantly in the SITless regimen compared to sitting.

## Abstract

Controlled laboratory studies have demonstrated that breaking up sitting can reduce postprandial glucose in South Asian adults. This study examined the effects of substituting sitting with standing and walking on interstitial glucose in South Asian individuals under free-living conditions.

South Asian adults (n = 14 [50% male]; body mass index 26.5 ± 0.8 kg·m−2) aged 41 ± 3 years completed two, 4-day regimens in a counter-balanced order: (1) SIT (restrict walking and standing to ≤ 1 h/day each) and (2) SITless (substitute ≥ 5 h/day of sitting with ≥ 3 h of standing and ≥ 2 h of walking, and interrupt sitting every 30 min). Interstitial glucose was measured using Flash glucose monitoring. Sitting and physical activity were measured with the activPAL3. Outcomes were compared between regimens using linear mixed models.

Interstitial glucose net incremental area under the curve (iAUC) for waking hours was lower by − 9.2 mmol L−1·16 h−1 (95% Confidence Interval [CI]: − 18.1, − 0.3) in SITless than SIT (p = 0.04), while lunch postprandial glucose iAUC was significantly lower by -1.0 mmol L−1.2 h−1 (95% CI − 1.8, 0.2) in SITless (p = 0.02). There were no significant differences in other 24 h or 16 h glucose metrics (p ≥ 0.06). Compared to SIT, sitting was lower by − 3.6 h/day (95% CI − 4.9, − 2.3) in SITless (p < 0.01). Standing and stepping time were higher by 1.9 h/day (95% CI 0.6, 3.2) and 1.6 h/day (95% CI 1.2, 2.1) in SITless (p ≤ 0.01).

Substituting sitting with standing and walking under free-living conditions can be used to effectively attenuate glycaemia during waking hours, but not across 24 h, in South Asian adults.

NCT04645875..

The online version contains supplementary material available at 10.1007/s00421-025-05919-7.