Reducing sedentary time in clinical populations: The Take a STAND for health study

• Grant number: 22/12770-4
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• Effective date (Start): November 01, 2022
• Effective date (End): October 31, 2023
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Bruno Gualano
• Grantee: Rafael de Almeida Azevedo
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Associated research grant: 17/13552-2 - Reducing sedentary time in clinical populations: the take a stand for health study, AP.TEM

Abstract

A growing body of evidence demonstrates that sedentary behavior (i.e., excessive time spent sitting or lying down) is an independent risk factor that predisposes to worse health indicators and higher all-cause mortality in diverse populations. In this context, new interventions focused on reducing sedentary time could be of great therapeutic relevance. To date, however, few studies have investigated this topic. This research program will aim to comprehensively investigate the clinical, physiological, metabolic and molecular effects of reducing sedentary behavior in specific clinical populations. To this end, we will carry out 3 randomized controlled clinical trials and 3 acute laboratory studies involving patients with rheumatoid arthritis, undergoing bariatric surgery and with mild cognitive impairment. All these studies are under the heading Take a STAND for health. The 4-month parallel-group randomized controlled trials aim to investigate the feasibility and effectiveness of a new intervention focused on replacing sedentary time with light (or very light) physical activity in these populations. A series of gold standard techniques will be applied to assess the effects of the intervention on various outcomes, including sedentary time (primary outcome), physical activity level, condition-specific clinical parameters, cardiometabolic risk factors, immune function, and quality of life. life. In addition, molecular analyzes will be performed in skeletal muscle and blood in order to investigate possible mechanisms related to this intervention.Acute crossover studies aim to investigate potential mechanisms related to the effects of regular interruptions to sedentary behavior (i.e., 3 minutes of walking every 30 minutes for 8 hours) versus a 30-minute exercise session followed by prolonged sedentary behavior, or just staying in continuous sedentary behavior (control), under well-controlled laboratory conditions. In these studies, we will assess physiological and metabolic parameters (i.e., blood pressure, parameters related to insulin sensitivity, lipid profile and inflammatory markers) throughout the experimental sessions. Furthermore, we will explore molecular responses in skeletal muscle and blood caused by different conditions through the analysis of genes and proteins potentially modulated by physical (in)activity; as well as performing untargeted analyzes (i.e., proteomics and metabolomics). Our research team involves several national and international experts who work from clinical to translational science; and our research facilities offer full capacity to carry out the planned studies. The findings of this research program will be of paramount clinical relevance, as they may provide the basis for new prescriptions aimed at reducing sedentary behavior, which is an important, modifiable and, until now, ignored risk factor in clinical populations. From a scientific point of view, this project will generate cutting-edge data that could be highly influential in several areas, including Medical Sciences, Exercise Science, Public Health and Basic Sciences.