PURPOSE: Persons with Multiple Sclerosis (PwMS) are physically inactive and spend more time in sedentary behaviours than healthy persons, which increases the risk of developing cardiometabolic diseases. In this randomised crossover study, the cardiometabolic health effects of replacing sitting with light-intensity physical activity (LIPA) and exercise (EX) were investigated. MATERIALS AND METHODS: Twenty-eight mildly disabled PwMS performed four 4-day activity regimens in free-living conditions; CONTROL (habitual activity), SIT, LIPA, and EX. Plasma glucose and insulin (oral glucose tolerance test), plasma lipids, inflammation, resting heart rate, blood pressure, body weight, and perceived exertion were measured (ClinicalTrials.gov: NCT03919058). RESULTS: CONTROL: 9.7 hours sitting/day, SIT: 13.3 hours sitting/day, LIPA: 8.3 hours sitting, 4.7 hours standing, and 2.7 hours light-intensity walking/day, and EX: 11.6 hours sitting/day with 1.3 hours vigorous-intensity cycling. Compared to SIT, improvements (p < 0.001) after LIPA and EX were found for insulin total area under the curve (-17 019 +/- 5708 and -23 303 +/- 7953 pmol/Lmin), insulin sensitivity (Matsuda index +1.8 +/- 0.3 and +1.9 +/- 0.4) and blood lipids (triglycerides: -0.4 +/- 0.1 and -0.5 +/- 0.1 mmol/L; non-high-density lipoprotein cholesterol: -0.3 +/- 0.1 and -0.5 +/- 0.1 mmol/L), with no difference between LIPA and EX. Perceived exertion was higher after EX compared to LIPA (Borg score (6 to 20): +2.6 +/- 3.3, p = 0.002). CONCLUSION: Replacing sitting with LIPA throughout the day exerts similar cardiometabolic health effects as a vigorous-intensity exercise in PwMS.

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