E-scooter use linked to lingering glucose control issues

In a pilot study conducted at Miami University, researchers found that a modest one-week reduction in daily step counts, facilitated by the use of electric scooters, led to measurable changes in glycemic control among healthy adults. This finding suggests that the threshold for metabolic disruption may be lower than previously established in studies involving more severe step reductions.

The research team aimed to investigate the cardiometabolic effects of a step reduction model that is more ecologically valid than previous laboratory-based studies. While prior research has demonstrated that large step reductions of 60% or more lead to deleterious health effects, including altered body composition and reduced insulin sensitivity, limited data existed regarding the impact of more modest reductions. The authors hypothesized that seven days of modest step reduction would negatively affect blood glucose regulation, vascular function, and body composition, with partial or full recovery following the resumption of baseline physical activity levels.

The study utilized a longitudinal, quasi-experimental design over three consecutive weeks. Twelve healthy adults, comprising five males and seven females with a mean age of 20.3 years, participated in the investigation. Participants were recruited from the Miami University campus and the surrounding Oxford, Ohio community, with inclusion criteria requiring self-reported walking of more than 20 minutes per day and over 7,000 steps per day. The study protocol involved a baseline week, a reduced activity week, and a recovery week, with standardized laboratory assessments conducted at the end of each phase.

During the reduced activity week, participants were provided with electric scooters to substitute for walking, resulting in an average daily step reduction of approximately 33%, or roughly 3,500 steps per day. GPS tracking data revealed that participants used the scooters for an average of 18.4 minutes per day, covering a distance of 3.8 kilometers. This shift in transportation mode was accompanied by a significant increase in sitting time and a decrease in total stepping time, reflecting a realistic behavioral change associated with micro-mobility technology.

Continuous glucose monitoring (CGM) was employed to assess free-living glycemic control throughout the study period. The use of CGM provided an ecologically valid assessment of glucose dynamics, capturing variations in blood sugar levels over 24-hour periods. Compared to the baseline week, the reduced activity week was associated with significant increases in 24-hour interstitial glucose median, mean amplitude of glycemic excursions (MAGE), and mean interstitial glucose. These changes indicate a higher overall glucose load and increased variability in glycemic control during the period of reduced physical activity.

Notably, the recovery phase revealed incomplete restoration of glycemic metrics. While some measures returned toward baseline, the 24-hour MAGE remained significantly elevated compared to the baseline week even after a full week of resumed normal activity. This persistence of altered glycemic variability suggests a lag in metabolic recovery, where the body’s glucose regulation mechanisms do not immediately revert to their pre-intervention state. The authors noted that despite these changes, all participants remained within the typical range for healthy non-diabetic individuals, but the direction of change and lack of full recovery raise questions about the cumulative effects of repeated bouts of inactivity.

Body composition assessments using bioelectrical impedance analysis showed transient changes in lean mass. Total lean mass decreased by approximately 0.53 kilograms during the reduced activity week, a change that was statistically significant. However, this decrease was reversible, with lean mass recovering during the subsequent week. In contrast, no significant changes were observed in body fat percentage, visceral adipose tissue, or skeletal muscle mass, indicating that the metabolic impact of the step reduction was primarily manifested in glycemic control rather than long-term body composition shifts.

Vascular function was assessed using carotid-femoral pulse wave velocity (cf-PWV), a measure of arterial stiffness. Interestingly, cf-PWV was unchanged during the reduced activity week but was significantly lower at the end of the recovery week compared to the baseline. This finding suggests that resuming normal physical activity after a period of reduced activity may be associated with improved central arterial stiffness in healthy individuals. The authors contrasted this with previous studies showing that short-term sitting can negatively affect arterial stiffness, highlighting the complex relationship between physical activity levels and vascular health.

Fasting blood lipids, glucose, and serum insulin levels remained largely unchanged across the three-week study period, with the exception of a slight decrease in high-density lipoprotein cholesterol during the recovery week. The stability of these metabolic markers suggests that the observed changes in glycemic control were not driven by significant alterations in lipid profiles or insulin resistance over the short term. Dietary intake was monitored using the Automated Self-Administered 24-hour Dietary Assessment Tool, and results indicated that protein, carbohydrate, fat, and added sugar consumption remained consistent across the study weeks, ruling out dietary changes as a primary driver of the metabolic shifts.

The study has several limitations that must be considered when interpreting the results. The small sample size of 12 participants limits the generalizability of the findings to broader populations, particularly those with baseline metabolic dysfunction. Additionally, the one-week intervention duration precludes extrapolating these findings to chronic step reduction, although it was sufficient to demonstrate rapid glycemic impairment.

The authors emphasize that the practical implications of these findings extend to public health and clinical interventions. Modest reductions in daily steps, facilitated by micro-mobility technology, can lead to transient decreases in lean body mass and negative alterations in glycemic variability. These changes may persist longer than body composition changes, suggesting a lag in metabolic recovery. The study underscores the importance of maintaining regular physical activity to preserve long-term metabolic health, even in the face of minor deviations in ambulatory behavior.

Future research should investigate whether incomplete recovery between repeated bouts of reduced activity contributes to the development of cardiometabolic disease. The current findings define a new, lower threshold for metabolic changes, indicating that even subtle reductions in physical activity can disrupt metabolic homeostasis. As electric transportation options become increasingly prevalent, understanding the physiological impacts of these lifestyle choices is crucial for developing strategies to mitigate potential health risks associated with reduced ambulatory activity.

The broader context of the trial highlights rapid shifts in urban transportation. Following the introduction of electric scooter sharing programs across more than 65 U.S. cities since 2017, motorized micro-mobility has increasingly substituted for active transit modes such as walking, cycling, or running. Survey data cited by the authors revealed that 43.5% of e-scooter users reported replacing active transportation with motorized transit, affirming they would have walked if scooters had been unavailable. This behavioral change occurs amid widespread inactivity, with 2022 World Health Organization estimates indicating that approximately 31% of adults globally, representing around 1.8 billion people, and 80% of adolescents failed to meet physical activity targets, alongside declining ambulation tracked by the Centers for Disease Control and Prevention.

To evaluate physiological changes accurately, the researchers enforced standardized pre-test controls across the three-week study. Before each laboratory visit, participants abstained from alcohol for 48 hours, exercise for 24 hours, and caffeine for 12 hours, while fasting from food and beverages other than water after 22:00 the prior evening. Free-living movement was tracked using activPAL accelerometers secured to the right thigh, excluding days with under 1,000 minutes of wear time. During the intervention, participants rode either Fucare H3 or Ancheer IPX5 scooters, logging trips through private Strava GPS accounts.

The trial also documented specific responses in aerobic fitness, regional musculature, and glycemic parameters. Cardiorespiratory fitness, estimated from the YMCA submaximal cycle ergometer test, moved from 41.3 mL/kg/min at baseline to 37.2 mL/kg/min during the scooter week, although this four-unit reduction was not statistically significant before increasing to 39.7 mL/kg/min at recovery. For localized tissue composition, bioelectrical impedance analysis detected a statistical trend toward reduced leg lean mass during the step-reduction week, followed by a significant 0.20-kilogram increase upon returning to regular activity, which the investigators attributed to transient fluid shifts. Furthermore, while the percentage coefficient of variation and time in range showed no significant changes during step reduction, time spent below 70 mg/dL decreased significantly during the recovery week compared to baseline.

Examining potential mechanisms, the authors contrasted their observations with prior step-reduction trials. Unlike a 10-day experiment by Winn and colleagues that counteracted inactivity with a daily 400-kilocalorie deficit to preserve glycemic control, the current study maintained stable dietary intake, suggesting that a real-world energy surplus drove the metabolic disruptions. The researchers also linked the persistent glycemic elevations to the catabolic crisis concept described by English and Paddon-Jones, which outlines how repeated bouts of physical inactivity followed by incomplete recovery can progressively lower baseline health reserves. By demonstrating that even a modest 33% reduction in ambulatory movement leaves lingering alterations in glycemic variability, the findings emphasize how sensitive metabolic homeostasis remains to modern conveniences that replace routine daily walking.

Subject of Research: Cardiometabolic effects of micro-mobility-induced step reduction in healthy adults

Article Title: Impact of micro‐mobility‐induced step reduction in healthy adults on vascular and glycemic health: A real‐world investigation

Article References: Reidy, P. T., Betz, A. C., Yeager, J. P., Liu, Y., Binion, R. A., Ayton, S., Lefkowitz, L., Slattery, E., Skujins, R. J., Walsh, A., Scerbo, M., Timmerman, K. L., & Ballard, K. D. (2026). Impact of micro‐mobility‐induced step reduction in healthy adults on vascular and glycemic health: A real‐world investigation. Physiological Reports, 14(21), Article e71151. https://doi.org/10.14814/phy2.71151

Image Credits: AI Generated

DOI: 10.14814/phy2.71151

Keywords: physical activity, glycemic control, e-scooters, metabolic health, vascular function, step reduction, continuous glucose monitoring, sedentary behavior, Impact, micro, mobility, induced