PA includes all movements that increase energy expenditure, improve blood glucose control in type 2 diabetes, reduce cardiovascular risk factors, contribute to weight loss, and enhance well-being [29]. Our results from a cohort study indicate an inverse association between PA and incidence of type 2 diabetes, which was consistently observed across the different studies [29–32].
Our study has presented evidence linking sedentary behavior to conditions such as hypertension, ischemic heart disease, myocardial infarction, and stroke. In alignment with our findings, Soares-Miranda et al. conducted a study examining the potential connection between PA and sedentary behavior with the risk of coronary heart disease and stroke in older adults. They discovered that among US men and women with an average age of 73 years at baseline, increased levels of walking, leisure-time activity, and exercise intensity were inversely linked to coronary heart disease, stroke (especially ischemic stroke), and overall cardiovascular disease [33]. Similarly, Kim et al. also found significant association between PA and lowest risk of stroke, hypertension and T2DM [34]. Conversely, Doherty et al. conducted a recent one-sample Mendelian randomization analysis to examine potential associations between device-measured physical activity and sedentary behavior with coronary artery disease, stroke, heart failure, blood pressure, hypertension, and anthropometric traits such as BMI and body fat percentage [35]. The differences between our and previous findings may be explained by the definitions and assessments of PA and sedentary behavior.
Our findings revealed a significant increase in weight, waist circumference, hip circumference, BMI, waist–hip ratio, FBS, TG, and cholesterol among sedentary participants compared to active participants. This aligns with the results of the study by Salahshoornezhad et al., which aimed to investigate the effects of a multi-disciplinary program on anthropometric and biochemical parameters in obese and overweight elementary school girls. The intervention group in their study demonstrated more favorable outcomes in terms of weight loss, waist circumference, hip circumference, total cholesterol, low-density lipoprotein cholesterol, TG, and FBS when compared to the control group [36]. Furthermore, in another study, the findings revealed that An intervention group that participated in training sessions for 8 weeks. These sessions included exercise for 3 days a week for one hour (60–70% of the maximum heart rate), a noteworthy increase in vaspin level and a significant decrease in body weight, BMI, waist circumference, fat percentage, fat mass, fat-free mass, total cholesterol, FBS, and insulin level. However, there were no significant changes in hip circumference, waist-to-hip ratio, TG, HOMA-IR, and Quantitative Insulin Sensitivity Check Index (QUICKI) in intervention group compared to control groups [37].
Additionally, the duration of night sleep, mid-day napping, and laying down without falling asleep were significantly higher in sedentary participants compared to active participants. Several previous studies have identified a positive association between sedentary behavior and these factors [38–40]. According to the documents of the World Health Organization, inactivity or lack of regular PA is the fourth risk factor for global mortality, which accounts for approximately 7% of deaths worldwide. The level of inactivity is increasing in many countries and has unfortunate consequences such as high blood pressure, increased blood sugar, overweight and obesity. Therefore, PA is a low-cost solution to prevent many diseases [41].
The study revealed that the average age, mid-day sleep duration, 24-hour rest duration, weight, waist circumference, hip circumference, BMI, waist–hip ratio, FBS, and TG were higher among participants with T2DM. According to Al-Abri et al., there were no significant differences in daytime sleepiness and daytime naps between the T2DM and control groups. However, patients with diabetes had significantly higher BMI, fasting glucose, and TG, as well as lower total cholesterol and low-density lipoprotein levels compared to controls. High-density lipoprotein levels were similar in both groups [42]. Several studies have reported a high prevalence of these factors in patients with diabetes, finding higher BMI, waist circumference, waist-hip ratio, and FBS in patients with T2DM [43, 44]. A screening measure should be both efficient and practical. While BMI is calculated using weight and height, it does not reflect the distribution of an individual's fat, such as general versus abdominal obesity. It has been noted that individuals with the same BMI may have different waist circumferences. Since people with abdominal obesity are more susceptible to cardiovascular diseases and hypertension, it is crucial to utilize a measure that takes into account waist circumference and either the waist–hip ratio or waist-to-height ratio [44].