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Published: 2021-03-26

Continuous or intermittent walking, the effect on glycated hemoglobin in sedentary employees during 10-week intervention

Department of Education Sciences, University of Costa Rica, San Ramon, Alajuela, Costa Rica, 20201

Mynor Rodriguez-Hernandez

Dr. Mynor Rodriguez-Hernandez lives in San Ramon Costa Rica, He is a full Professor at the University of Costa Rica, Western Campus. His research focuses on projects that would impact community needs in terms of physical activity, health, and quality of life. All contributions of physical activity behavior, sedentary behavior, sitting time, breaking sedentary time to health and quality of life. As well as possible ways to increase exercise adherence in adult populations. He is member of the American College of Sports Medicine, the International Society for Physical Activity and Health and of the American Network for Research in Human Movement Sciences. He has participated as a presenter in international conferences. He also collaborates as reviewer of important journals related to the field of human movement sciences.

School of Kinesiology, Auburn University, Auburn, AL USA 36849

James R. McDonald

Dr. McDonald has been a clinical professor at Auburn University since 2012. His TigerFit laboratory conducts health and fitness testing for the Auburn community.  The program allows students to get “hands-on” experience in all aspect of health and fitness testing and prescription working with a cross section of the local community.  Dr. McDonald came to academia later in life following a 30-year career in the U.S. Air Force where he served as a fighter pilot and military diplomat, retiring at the rank of Colonel.  After a few years working in industry, he came to Auburn in pursuit of a PhD in exercise physiology and after completing the degree, he was hired as clinical faculty.  He has done research in basic muscle oxygen on-kinetics, lactate metabolism, and role of exercise in weight loss and health across various human populations.

School of Kinesiology, Auburn University, Auburn, AL USA 36849

Danielle W. Wadsworth

Dr. Danielle D. Wadsworth is an associate professor at Auburn University in the School of Kinesiology and Director of the Exercise Adherence and Obesity prevention laboratory. Her research focuses on identifying environmental, psychological and social underpinnings of exercise adherence and translating these findings to effective evidence-based interventions, primarily for women and children. Dr. Wadsworth has served as a co-investigator on National Institutes of Health and Robert Wood Johnson Foundation grants aimed at examining the impact of physical activity policies on children’s physical activity levels at school and during physical education. Over the past year, she has concentrated her efforts on identifying factors to long-term exercise adherence in young children. Dr. Wadsworth lives with her husband and three children in Auburn, Alabama.

Physical activity Social distancing Blood glucose Glycated hemoglobin


To examine long term changes on glycated hemoglobin in sedentary employees exposed to two different walking programs during a 10-week intervention. A total of 68 sedentary employees participated in a 10-week walking intervention and were randomly assigned to one of three groups: intermittent walking, continuous walking or control group. Hemoglobin A1cNOW+ device tested glycated hemoglobin and accelerometry assessed physical activity. Results showed glycated hemoglobin significantly decreased over the ten weeks (5.82±0.49, 5.66±0.44) F(1,64) =4.229, p=.044) in the continuous walking group. Post-Hoc test showed the continuous walking group was significantly affected, F=8.463, p=.009, with a large size effect n2=.297. There were no changes within the intermittent group (5.69±0.63, 5.63±0.6) or control group (5.59±0.6, 5.6±0.54) (p>0.05). Accelerometry showed a main effect of time by group interaction F(4,124) =4.688, p=0.001). Post-Hoc indicated that the continuous walking group took significantly longer bouts of moderate to vigorous intensity walking at week-6 compared to pre-test (p=0.006) at this could have influenced the results, there were no changes in the length of bouts in the intermittent or control groups (p>0.05). Sedentary employees who perform a moderate intensity continuous walking program show benefits in controlling blood glucose, thereby, reducing the risk of developing type 2 diabetes.


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  1. Marc T. Hamilton, Genevieve N. Healy, David W. Dunstan, Theodore W. Zderic and Neville Owen, Too Little Exercise and Too Much Sitting: Inactivity Physiology and the Need for New Recommendations on Sedentary Behavior, Current Cardiovascular Risk Reports, 2(4) (2008) 292-298.
  2. Karin I Proper, Amika S Singh, Willem van Mechelen, Mai J M Chinapaw, Sedentary behaviors and health outcomes among adults: a systematic review of prospective studies, American Journal of Preventive Medicine, 40(2) (2011) 174-82.
  3. E. Stamatakis, M. Hamer, and D.W. Dunstan, Screen-based entertainment time, all-cause mortality, and cardiovascular events: population-based study with ongoing mortality and hospital events follow-up, Journal of the American College of Cardiology, 57(3) (2011) 292-9.
  4. Tatiana Y Warren, Vaughn Barry, Steven P Hooker, Xuemei Sui, Timothy S Church, Steven N Blair, Sedentary behaviors increase risk of cardiovascular disease mortality in men, Medicine and Science in Sports and Exercise, 42(5) (2010) 879-85.
  5. Christie Y Jeon, R Peter Lokken, Frank B Hu, Rob M van Dam, Physical activity of moderate intensity and risk of type 2 diabetes: a systematic review. Diabetes Care, 30(3) (2007) 744-52.
  6. F.B. Hu, R.J. Sigal, J.W. Rich-Edwards, G.A. Colditz, C.G. Solomon, W.C. Willett, F.E. Speizer, J.E. Manson, Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study, Journal of the American Medical Association, 282(15) (1999) 1433-9.
  7. R Graham Barr, David M Nathan, James B Meigs, Daniel E Singer, Tests of glycemia for the diagnosis of type 2 diabetes mellitus, Annals of Internal Medicine, 137(4) (2002) 263-72.
  8. Douglas J Oberlin, Catherine R Mikus, Monica L Kearney, Pamela S Hinton, Camila Manrique, Heather J Leidy, Jill A Kanaley, R Scott Rector, John P Thyfault, One bout of exercise alters free-living postprandial glycemia in type 2 diabetes, Medicine and Science in Sports and Exercise, 46(2) (2014) 232-8.
  9. Matthew C Riddle, Julio Rosenstock, John Gerich, Insulin Glargine 4002 Study Investigators, The treat-to-target trial: randomized addition of glargine or human NPH insulin to oral therapy of type 2 diabetic patients, Diabetes Care, 26(11) (2003) 3080-6.
  10. Daniel Umpierre, Paula A B Ribeiro, Caroline K Kramer, Cristiane B Leitão, Alessandra T N Zucatti, Mirela J Azevedo, Jorge L Gross, Jorge P Ribeiro, Beatriz D Schaan, Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis, JAMA, 305(17) (2011) 1790-9. [DOI] [PubMed]
  11. Matthew Hollings, Yorgi Mavros, Jonathan Freeston, Maria Fiatarone Singh, The effect of progressive resistance training on aerobic fitness and strength in adults with coronary heart disease: A systematic review and meta-analysis of randomised controlled trials, European Journal of Preventive Cardiology, 24(12) (2017) 1242-1259. [DOI] [PubMed]
  12. Judith C Kuenen, Rikke Borg, Dirk J Kuik, Hui Zheng, David Schoenfeld, Michaela Diamant, David M Nathan, Robert J Heine, ADAG Study Group, Does glucose variability influence the relationship between mean plasma glucose and HbA1c levels in type 1 and type 2 diabetic patients?, Diabetes Care, 34(8) (2011) 1843-7. [DOI] [PubMed]
  13. Monnier, L., H. Lapinski, and C. Colette, Contributions of fasting and postprandial plasma glucose increments to the overall diurnal hyperglycemia of type 2 diabetic patients: variations with increasing levels of HbA(1c), Diabetes Care, 26(3) (2003) 881-5. [DOI] [PubMed]
  14. T.M. Wolever, J.L. Chiasson, A. Csima, J.A. Hunt, C. Palmason, S.A. Ross, E.A. Ryan, Variation of postprandial plasma glucose, palatability, and symptoms associated with a standardized mixed test meal versus 75 g oral glucose, Diabetes Care, 21(3) (1998) 336-40.
  15. Ronald J Sigal, Glen P Kenny, Normand G Boulé, George A Wells, Denis Prud'homme, Michelle Fortier, Robert D Reid, Heather Tulloch, Douglas Coyle, Penny Phillips, Alison Jennings, James Jaffey, Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial, Annals of Internal Medicine, 147(6) (2007) 357-69.
  16. N.G. Boulé, G.P. Kenny, E. Haddad, G.A. Wells, R.J. Sigal, Meta-analysis of the effect of structured exercise training on cardiorespiratory fitness in Type 2 diabetes mellitus, Diabetologia, 46(8) (2003) 1071-81.
  17. T.D. Agurs-Collins, S.K. Kumanyika, T.R. Ten Have, L.L. Adams-Campbell, A randomized controlled trial of weight reduction and exercise for diabetes management in older African-American subjects, Diabetes Care, 20(10) (1997) 1503-11.
  18. Tapani Rönnemaa, Kari Mattila, Aapo Lehtonen, Veikko Kallio, A controlled randomized study on the effect of long-term physical exercise on the metabolic control in type 2 diabetic patients, Acta Medica Scandinavica, 220(3) (1986) 219-24.
  19. N.G. Boulé, E. Haddad, G.P. Kenny, G.A. Wells, R.J. Sigal, Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trials, Journal of the American Medical Association, 286(10) (2001) 1218-27.
  20. D. Tessier, J. Ménard, T. Fülöp, J. Ardilouze, M. Roy, N. Dubuc, M. Dubois, P. Gauthier, Effects of aerobic physical exercise in the elderly with type 2 diabetes mellitus, Archives of Gerontology and Geriatrics, 31(2) (2000) 121-132.
  21. Alison J Dunkley, Danielle H Bodicoat, Colin J Greaves, Claire Russell, Thomas Yates, Melanie J Davies, Kamlesh Khunti, Diabetes prevention in the real world: effectiveness of pragmatic lifestyle interventions for the prevention of type 2 diabetes and of the impact of adherence to guideline recommendations: a systematic review and meta-analysis, Diabetes Care, 37(4) (2014) 922-33.
  22. D.E. Laaksonen, et al., Physical activity in the prevention of type 2 diabetes: the Finnish diabetes prevention study, Diabetes, 54(1) (2005) 158-65.
  23. Matthew McCarthy, Charlotte L Edwardson, Melanie J Davies, Joseph Henson, Laura Gray, Kamlesh Khunti, Thomas Yates, Change in Sedentary Time, Physical Activity, Bodyweight, and Hba1c in High-Risk Adults, Medicine and Science in Sports and Exercise, 49(6) (2017) 1120-1125.
  24. Paddy C Dempsey, Neville Owen, Stuart J H Biddle, David W Dunstan, Managing sedentary behavior to reduce the risk of diabetes and cardiovascular disease, Current Diabetes Reports, 14(9) (2014) 522.
  25. Michael Holmstrup, Timothy Fairchild, Stefan Keslacy, Ruth Weinstock, Jill Kanaley, Multiple short bouts of exercise over 12-h period reduce glucose excursions more than an energy-matched single bout of exercise, Metabolism, 63(4) (2014) 510-9.
  26. Kristian Karstoft, Camilla S Christensen, Bente K Pedersen, Thomas P J Solomon, The acute effects of interval- Vs continuous-walking exercise on glycemic control in subjects with type 2 diabetes: a crossover, controlled study, Journal of Clinical Endocrinology & Metabolism, 99(9) (2014) 3334-42.
  27. E. Valenti, The effects of continuous exercise versus intermittent exercise on glucose levels in sedentary individuals, in Department of Exercise and Sport Science. 2013, University of Central Missouri: UNIVERSITY OF CENTRAL MISSOURI, WARRENSBURG, MISSOURI.
  28. M. Rodriguez-Hernandez, and D.W. Wadsworth, The effect of 2 walking programs on aerobic fitness, body composition, and physical activity in sedentary office employees, PLoS One, 14(1) (2019) e0210447.
  29. M.G .Rodriguez-Hernandez, and D.W. Wdasworth, A walking intervention for sedentary employees: effects on self-regulation and self-efficacy. Pensar en movimiento: Revista de ciencias del ejercicio y la salud, 18(1) (2020) 1-17.
  30. J.D. Cohen, Statistical Power Analysis for the Behavioral Sciences 2nd Edition ed. 1988, Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers.
  31. National Glycohemoglobin Standardization Program. Harmonizng Hemoglobin A1c Testing, Acessed on 2/14/2017.
  32. Polymer Technology Systems, I., A1cNOW+ Professional-Use Product Insert.
  33. John, D. and P. Freedson, ActiGraph and Actical physical activity monitors: a peek under the hood, Medicine and Science in Sports and Exercise, 44(1 Suppl 1) (2012) S86-9.
  34. Cain, K.L. and C.M. Geremia, Accelerometer Data Collection and Scoring Manual for Adult & Senior Studies. 2012.
  35. Dianne S Ward, Kelly R Evenson, Amber Vaughn, Anne Brown Rodgers, Richard P Troiano, Accelerometer use in physical activity: best practices and research recommendations. Medicine and Science in Sports and Exercise, 37(11 Suppl) (2005) S582-8.
  36. S.G. Trost, K.L. McIver, and R.R. Pate, Conducting accelerometer-based activity assessments in field-based research, Medicine and Science in Sports and Exercise, 37(11 Suppl) (2005) S531-43.
  37. Charles E Matthews, Kong Y Chen, Patty S Freedson, Maciej S Buchowski, Bettina M Beech, Russell R Pate, Richard P Troiano, Amount of time spent in sedentary behaviors in the United States, 2003-2004, American Journal of Epidemiology, 167(7) (2008) 875-81.
  38. Teresa L Hart, Ann M Swartz, Susan E Cashin, Scott J Strath, How many days of monitoring predict physical activity and sedentary behaviour in older adults?, International Journal of Behavioral Nutrition and Physical Activity, 8 (2011) 62.
  39. Richard P Troiano, David Berrigan, Kevin W Dodd, Louise C Mâsse, Timothy Tilert, Margaret McDowell, Physical activity in the United States measured by accelerometer. Medicine and Science in Sports and Exercise, 40(1) (2008) 181-8.
  40. C. Tudor-Locke, W.D. Johnson, and P.T. Katzmarzyk, Accelerometer-determined steps per day in US adults, Medicine and Science in Sports and Exercise, 41(7) (2009) 1384-91.
  41. D. J. Chinn, M. White, J. Harland, C. Drinkwater, and S. Raybould, Barriers to physical activity and socioeconomic position: implications for health promotion, Journal of Epidemiology and Community Health, 53(3) (1999) 191-192.
  42. Linke, S.E., L.C. Gallo, and G.J. Norman, Attrition and adherence rates of sustained vs. intermittent exercise interventions, Annals of Behavioral Medicine, 42(2) (2011) 197-209.
  43. Snowling, N.J. and W.G. Hopkins, Effects of different modes of exercise training on glucose control and risk factors for complications in type 2 diabetic patients: a meta-analysis, Diabetes Care, 29(11) (2006) 2518-27.
  44. Riddell, M. and B.A. Perkins, Exercise and glucose metabolism in persons with diabetes mellitus: perspectives on the role for continuous glucose monitoring, Journal of Diabetes Science and Technology, 3(4) (2009) 914-23.
  45. Kristian Karstoft, Kamilla Winding, Sine H Knudsen, Jens S Nielsen, Carsten Thomsen, Bente K Pedersen, Thomas P J Solomon, The effects of free-living interval-walking training on glycemic control, body composition, and physical fitness in type 2 diabetic patients: a randomized, controlled trial, Diabetes Care, 36(2) (2013) 228-36.
  46. P. Manjoo, L. Joseph, and K. Dasgupta, Abdominal adiposity and daily step counts as determinants of glycemic control in a cohort of patients with type 2 diabetes mellitus, Nutrition and Diabetes, 2 (2012) e25.
  47. Tomas Fritz, Per Wändell, Hans Aberg, Peter Engfeldt, Walking for exercise--does three times per week influence risk factors in type 2 diabetes?, Diabetes Research and Clinical Practice, 71(1) (2006) 21-27.
  48. Shanhu Qiu, Xue Cai, Uwe Schumann, Martina Velders, Zilin Sun and Jürgen Michael Steinacker, Impact of walking on glycemic control and other cardiovascular risk factors in type 2 diabetes: a meta-analysis, PLoS One, 9(10) (2014) e109767.
  49. J.L. Gay, D.M. Buchner, and M.D. Schmidt, Dose-response association of physical activity with HbA1c: Intensity and bout length, Preventive Medicine, 86 (2016) 58-63.
  50. David W Dunstan, Bronwyn A Kingwell, Robyn Larsen, Genevieve N Healy, Ester Cerin, Marc T Hamilton, Jonathan E Shaw, David A Bertovic, Paul Z Zimmet, Jo Salmon, Neville Owen, Breaking up prolonged sitting reduces postprandial glucose and insulin responses, Diabetes Care, 35(5) (2012) 976-83.
  51. Justin R. Arrendale, Sonia E. Cherian, Issam Zineh, Mark J. Chirico, James R. Taylor, Assessment of glycated hemoglobin using A1CNow+TM point-of-care device as compared to central laboratory testing, Journal of Diabetes Science and Technology, 2(5) (2008) 822-827.
  52. Bruce W. Bode, Benjamin R. Irvin, Jeffrey A. Pierce, Michael Allen and Annette L. Clark, Advances in hemoglobin A1c point of care technology, Journal of Diabetes Science and Technology, 1(3) (2007) 405-11.
  53. A.W. Carter, An analysis of the assessment of glycated hemoglobin using A1cNow+ point-of-care device compared to central laboratory testing--an important addition to pharmacist-managed diabetes programs?, Journal of Diabetes Science and Technology, 2(5) (2008) 828-830.


How to Cite

Rodriguez-Hernandez, M., McDonald, J. R., & W. Wadsworth, D. (2021). Continuous or intermittent walking, the effect on glycated hemoglobin in sedentary employees during 10-week intervention. International Journal of Physical Education, Fitness and Sports, 10(1), 24-33.

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