Sitting less and moving more: A contemporary public health approach for the prevention and management of Type 2 diabetes

Professor David Dunstan

Australian Catholic University


The 2018 Physical Activity Guidelines Advisory Committee Scientific Report from the USA recently concluded that there is strong epidemiological evidence of a significant relationship between greater time spent in sedentary behavior and higher risk of type 2 diabetes.

Human experimental studies have begun to corroborate and extend the experimental evidence by showing that reducing and frequently breaking up prolonged sitting with light-intensity physical activities may be practical strategies for improving type 2 diabetes prevention and management. Studies have consistently showed clinically meaningful acute improvements in postprandial glucose metabolism following the initiation of frequent (every 20–30 min) short (2–3 min) interruptions during prolonged sitting involving either light-intensity or moderate-intensity ambulation, standing, or simple resistance activities. Some have also demonstrated improved responses in blood pressure, lipids, haemostatic markers and cognitive function. Thus far, the original published observational and experimental findings have provided strong indications that the potential benefits of reducing and breaking up sitting time are likely to be most pronounced in those with, or at risk of, dysglycemia.

Working from a behavior-change model positing that sitting time is highly contextually driven, we have begun to shape behavior change frameworks pertaining to reducing and breaking up sitting time through multicomponent interventions in real-world settings as part of an integrated research program underpinned by the laboratory evidence. These short- and medium-term multi-component interventions that incorporate environmental, organisational, policy and individual-level change elements in workplace and domestic settings in adults have consistently demonstrated that these approaches are feasible and can result in substantial reductions in prolonged sitting time.

In this presentation I will discuss current research efforts directed at gaining a better understanding of whether making sustained changes in a ubiquitous risk exposure in people’s daily lives – prolonged periods of time spent sitting – can influence or modify type 2 diabetes risk.


David is Head of the Physical Activity laboratory at the Baker Heart and Diabetes Institute in Melbourne and is an NHMRC Senior Research Fellow and Baker Fellow. He also holds the position of Professor within the Centre for Exercise and Nutrition at the Mary MacKillop Institute for Health Research, Australian Catholic University. His research focuses on the role of physical activity and sedentary behaviour in the prevention and management of chronic diseases. He has published over 200 peer reviewed papers, including publications in high impact journals such as Circulation, Diabetes Care and Diabetologia. Over the past 15 years David has extensive media interest in his research including interviews with ABC CatalystSBS Insight60 Minutes AustraliaNational Public Radio, Wall Street Journal, CNN, the New York Times and the LA Times.