NEAT! Technology to Increase Breaks in Sedentary Behavior in Adults With Diabetes

Sedentary behavior is associated with an increased risk of mortality and many health
conditions including type 2 diabetes, obesity, cardiovascular disease, and metabolic
syndrome, independent of the time spent in moderate-to-vigorous intensity physical activity
(MVPA). Furthermore, independent of total sedentary time and MVPA, Healy et al. observed
that individuals who had more breaks in sedentary time had lower 2-h plasma glucose. Recent
experimental findings also suggests that breaking up prolonged bouts of sedentary behavior
(≥ 20 minutes) with either light or moderate intensity activity for 2 minutes reduces
postprandial glucose and insulin responses.10 Replacing sedentary time with light-intensity
activity or nonexercise activity thermogenesis (NEAT) may help to reduce the health
consequences of sedentary behavior. The purpose of this study is to develop a smartphone
application (NEAT!) to encourage sedentary adults with diabetes to increase breaks in
prolonged bouts of sedentary behavior objectively measured by an accelerometer. NEAT! will
be refined by modifying technology created for the ENGAGED trial (RC1DK087126) and will work
in conjunction with a Bluetooth enabled accelerometer that can detect bouts of sedentary
behavior. When a sedentary bout (≥ 20 minutes) is detected, the smartphone application will
trigger a reminder prompt to the user encouraging him/her to participate in NEAT for at
least 2 minutes. Following the development, testing, and refining of the application, a
sample of 10 sedentary adults with type 2 diabetes will be recruited to participate in a one
month trial to examine the feasibility and acceptability of NEAT!. To our knowledge, this is
the first study to design and examine the acceptability of a smartphone application that
will target interrupting sedentary behavior with NEAT using objectively measured sedentary
time in a diabetic population.