Accelerometer-Assessed Physical Activity in People with Type 2 Diabetes: Accounting for Sleep when Determining Associations with Markers of Health

Alex V Rowlands; Vincent T van Hees; Nathan P Dawkins; Benjamin D Maylor; Tatiana Plekhanova; Joseph Henson; Charlotte L Edwardson; Emer M Brady; Andrew P Hall; Melanie J Davies; Thomas Yates

doi:10.3390/s23125382

Accelerometer-Assessed Physical Activity in People with Type 2 Diabetes: Accounting for Sleep when Determining Associations with Markers of Health

Sensors (Basel). 2023 Jun 7;23(12):5382. doi: 10.3390/s23125382.

Authors

Alex V Rowlands^{1

2}, Vincent T van Hees³, Nathan P Dawkins⁴, Benjamin D Maylor^{1

2}, Tatiana Plekhanova^{1

2}, Joseph Henson^{2

5}, Charlotte L Edwardson^{1

2}, Emer M Brady⁶, Andrew P Hall⁷, Melanie J Davies², Thomas Yates^{2

5}

Affiliations

¹ Assessment of Movement Behaviours Group (AMBer), Leicester Lifestyle and Health Research Group, Diabetes Research Centre, University of Leicester, Leicester LE5 4PW, UK.
² National Institute for Health Research, Leicester Biomedical Research Centre, Leicester LE3 9QP, UK.
³ Accelting, 1363 CH Almere, The Netherlands.
⁴ School of Sport and Wellbeing, Leeds Trinity University, Leeds LS18 5HD, UK.
⁵ Leicester Lifestyle and Health Research Group, Diabetes Research Centre, University of Leicester, Leicester LE5 4PW, UK.
⁶ Department of Cardiovascular Sciences, University of Leicester, Leicester LE1 7RH, UK.
⁷ Hanning Sleep Laboratory and Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester LE5 4PW, UK.

Abstract

High physical activity levels during wake are beneficial for health, while high movement levels during sleep are detrimental to health. Our aim was to compare the associations of accelerometer-assessed physical activity and sleep disruption with adiposity and fitness using standardized and individualized wake and sleep windows. People (N = 609) with type 2 diabetes wore an accelerometer for up to 8 days. Waist circumference, body fat percentage, Short Physical Performance Battery (SPPB) test score, sit-to-stands, and resting heart rate were assessed. Physical activity was assessed via the average acceleration and intensity distribution (intensity gradient) over standardized (most active 16 continuous hours (M16h)) and individualized wake windows. Sleep disruption was assessed via the average acceleration over standardized (least active 8 continuous hours (L8h)) and individualized sleep windows. Average acceleration and intensity distribution during the wake window were beneficially associated with adiposity and fitness, while average acceleration during the sleep window was detrimentally associated with adiposity and fitness. Point estimates for the associations were slightly stronger for the standardized than for individualized wake/sleep windows. In conclusion, standardized wake and sleep windows may have stronger associations with health due to capturing variations in sleep durations across individuals, while individualized windows represent a purer measure of wake/sleep behaviors.

Keywords: GENEActiv; GGIR; adiposity; average acceleration; intensity gradient; physical function; sleep disruption; wake.

MeSH terms

Accelerometry
Diabetes Mellitus, Type 2*
Exercise / physiology
Humans
Obesity
Sleep / physiology

Grants and funding

This research was carried out at the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre (BRC). The authors at the University of Leicester are supported by the NIHR Leicester BRC and the NIHR Applied Research Collaboration (ARC) East Midlands. The views expressed herein are those of the authors and not necessarily those of the NHS, NIHR, or Department of Health.