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Metabolic, physiologic and molecular effects of breaking sedentary time in rheumatoid arthritis patients: a randomized crossover study

Grant number: 17/02546-1
Support Opportunities:Scholarships in Brazil - Post-Doctoral
Effective date (Start): June 01, 2017
Effective date (End): February 25, 2018
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal Investigator:Bruno Gualano
Grantee:Fabiana Braga Benatti
Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil


Rheumatoid Arthritis (RA) is an inflammatory autoimmune disease characterized by the involvement of synovial joints and clinical manifestations such as chronic pain, fatigue and muscle weakness, in addition to a substantially increased cardiovascular morbidity and mortality. Clinical symptoms and an increased prevalence of cardiovascular risk factors seem to ultimately lead to functional disability and decreased physical capacity, contributing to the onset of a sedentary lifestyle. Physical exercise programs are effective in improving aerobic capacity, muscle strength, functional capacity, cardiovascular risk factors and body composition in patients with RA. However, a growing body of evidence suggests that adherence to physical activity recommendations (i.e., 150 min/wk of Moderate-to-Vigorous Physical Activity - MVPA) is not sufficient to counteract the health hazards caused by prolonged sedentary time, i.e., prolonged time spent in reclining positions daily. Moreover, experimental and epidemiological studies suggest that frequently breaking prolonged sedentary time, even with light physical activity (e.g., light-intensity walking or standing), is associated with improved cardiometabolic risk factors and decreased all-cause mortality. Thus, it is plausible to assume that interventions aimed at breaking sedentary time with light physical activity may beneficially impact cardiometabolic risk factors in patients with RA. However, to the best of our knowledge, no studies have yet tested this hypothesis. Therefore, the aim of the present study is to investigate the effects of breaking sedentary time with light-physical activity bouts on metabolic markers (post-prandial glucose, insulin, C-peptide, lipids, and inflammatory cytokines), blood pressure, beat-to-beat heart rate, and the expression of skeletal muscle proteins and genes associated with physical activity and energy metabolism, when compared with prolonged sedentary time and with an MVPA bout followed by sedentary behavior. To that end, a randomized crossover study will be conducted with 10 RA patients, where each patient will undergo three 8-h experimental conditions separated by at least 6 days: SED - 8-h continuous sitting; AFL - 3-min light-intensity physical activity bouts every 30 min during the 8-h sitting; and EX - 30-min MVPA bout followed by 7.5 h of sitting. Two standardized meals will be served during the experiment moments 0h and 4h. Before (0 min), 30, 60, 120, 180 and 240 min after each meal blood will collected for post-prandial assessments. Blood pressure will be assessed at rest and hourly. Beat-to-beat heart rate will be assessed with a heart-rate monitor throughout the experiment. Finally, skeletal muscle biopsies will be performed at the end of each experimental condition. (AU)

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Scientific publications (4)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
ATALLA, MARCIO; PINTO, ANA JESSICA; MIELKE, GREGORE IVEN; BENATTI, FABIANA BRAGA; GUALANO, BRUNO. Impact of a Real-World Lifestyle Intervention in an Entire Latin American City with More Than 50,000 People. OBESITY, v. 27, n. 12, p. 1967-1974, . (17/02546-1, 15/26937-4)
BENATTI, FABIANA B.; MIYAKE, CINTIA N. H.; DANTAS, WAGNER S.; ZAMBELLI, VANESSA O.; SHINJO, SAMUEL K.; PEREIRA, ROSA M. R.; SILVA, MARIA ELIZABETH R.; SA-PINTO, ANA LUCIA; BORBA, EDUARDO; BONFA, ELOISA; et al. Exercise Increases Insulin Sensitivity and Skeletal Muscle AMPK Expression in Systemic Lupus Erythematosus: A Randomized Controlled Trial. FRONTIERS IN IMMUNOLOGY, v. 9, . (11/08302-0, 15/03756-4, 11/24093-2, 17/02546-1)
ATALLA, MARCIO; PINTO, ANA JESSICA; MIELKE, GREGORE IVEN; BACIUK, ERICA PASSOS; BENATTI, FABIANA BRAGA; GUALANO, BRUNO. Tackling Youth Inactivity and Sedentary Behavior in an Entire Latin America City. FRONTIERS IN PEDIATRICS, v. 6, . (15/26937-4, 17/02546-1)
FELAU, SHEYLLA M.; SALES, LUCAS P.; SOLIS, MARINA Y.; HAYASHI, ANA PAULA; ROSCHEL, HAMILTON; SA-PINTO, ANA LUCIA; OLIVEIRA DE ANDRADE, DANIELI CASTRO; KATAYAMA, KEYLA Y.; IRIGOYEN, MARIA CLAUDIA; CONSOLIM-COLOMBO, FERNANDA; et al. Omega-3 Fatty Acid Supplementation Improves Endothelial Function in Primary Antiphospholipid Syndrome: A Small-Scale Randomized Double-Blind Placebo-Controlled Trial. FRONTIERS IN IMMUNOLOGY, v. 9, . (17/02546-1, 14/06911-8)

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