Article

Standardized use of the terms “sedentary” and “sedentary behaviours”

January 2012
Mental Health and Physical Activity 37(3):540-542

DOI:10.1016/j.mhpa.2012.06.001

Authors:

Association between Sedentary Time and Cardiovascular Risk Factors in Korean Adults

Article

Full-text available

Jan 2018

Background Sedentary behavior has been shown to have deleterious effects on cardiovascular outcomes. This study aimed to examine the association between sedentary time and cardiovascular risk factors in Korean adults. Methods A cross-sectional study was performed using data from adults aged 19 years and above in the 2013 Korean National Health and Nutrition Examination Survey. Sedentary time was self-reported and categorized into quintiles. Cardiovascular risk factors, including blood pressure (BP), total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, low-density lipoprotein cholesterol, and fasting glucose levels, were categorized into dichotomous variables according to the Adult Treatment Panel III criteria. Multivariate logistic regression was performed with adjustment for various demographic and lifestyle variables, body mass index (BMI), waist circumference (WC), and moderate-to-vigorous physical activity. Complex sampling design was used, and survey weights and sample design variables were applied in analyses. Results A total of 3,301 individuals were included in the analyses, and mean sedentary time was 6.1 h/d. Prolonged sedentary time was significantly associated with high diastolic BP (top vs. bottom quintile: adjusted odds ratio [OR], 1.71; 95% confidence interval [CI], 1.09–2.68; Ptrend=0.03) and low HDL cholesterol level (top vs. bottom quintile: adjusted OR, 1.42; 95% CI, 1.02–1.98; Ptrend=0.02) after adjustment for BMI, WC, moderate-to-vigorous physical activity, and other variables. No significant associations were found between sedentary time and other cardiovascular risk factors. Conclusion Prolonged sedentary time was significantly associated with high diastolic BP and low HDL cholesterol level in Korean adults. The associations were independent of general and abdominal obesity and moderate-to-vigorous physical activities.

Sedentary Behavior Is Associated With Low Leisure-Time Physical Activity and High Body Fatness in Older Brazilian Adults

Article

Jan 2018

Sedentary behavior (SB) has emerged as a new health risk factor, including risk of premature death. This study examined the association between SB and measures of physical activity and body fatness in older Brazilian adults. Self-report measures of SB (ie, sitting time [ST]), leisure-time physical activity (LTPA), and body fatness (body mass index [BMI]) were collected from 355 older adults aged 60 years and older by trained interviewers. Statistical procedures were conducted using SPSS software with significance set at P < .05. Overall, the median ST was 3 hours per day. Mean values of LTPA and BMI for the entire sample were 90.0 (197.4) min/week and 26.5 (4.9) kg/m², respectively. Partial correlations controlling for age revealed that ST was negatively associated with LTPA (pr = −.15 [−.25; −.04]; P = .006) and positively associated with BMI (pr = .25 [.14; .35]; P < .001). Age, BMI, and LTPA emerged as independent predictors of ST, explaining a small but significant variance in ST (R² = .12; P = .02). Furthermore, t test revealed a significant difference in LTPA and BMI between groups of different amounts of sitting. The findings suggest that prolonged ST may have a negative impact on LTPA and BMI in older Brazilian adults.

Changes in Physical Activities and Body Composition after Roux-Y Gastric Bypass Surgery

Article

Full-text available

Jun 2018
OBES SURG

Purpose: Given the importance of physical activities for health outcomes, it is still unclear whether bariatric surgery per se and the standard care after surgery would result in an increase of physical activity level. This study aimed to determine physical activities preoperatively and at 6 and 12 months postoperatively among female patients who underwent bariatric surgery, and to investigate its relationship with body composition changes. Material and methods: Thirty-four women who had Roux-Y gastric bypass (RYGB) surgery completed the study. Physical activity was measured objectively for 7 consecutive days by using an ActiGraph GT3X+ accelerometer. Body composition was estimated by using multifrequency bioimpedance analysis. Results: The percentage of time spent in moderate-to-vigorous physical activity (MVPA) changed significantly from preoperatively to 6 months postoperatively; however, no difference was observed at 12 months. No significant changes were detected for other physical activity variables. Multivariable regression analysis suggested that the percentage of time spent in sedentary activity was associated with fat-free mass loss at 6 months (β = - 0.323; 95% CI = - 0.649 to 0.003) and 12 months (β = - 0.510; 95% CI = - 0.867 to - 0.154) postoperatively. Conclusion: The overall MVPA increased at 6 months post-RYGB surgery; however, this change was not maintained at 12 months. Despite the considerable body mass loss postoperatively, most of the subjects were classified as being physically inactive and did not change their sedentary behavior. These findings indicate that female patients undergoing bariatric surgery should be encouraged to increase their physical activity level.

Effects of Breaking Up Sedentary Behavior With Short Bouts of Yoga and Tai-Chi on Glycemia, Concentration, and Well-Being

Article

Full-text available

Nov 2023

Background : Investigating the effects of breaking up sedentary behavior with short bouts of Yoga and Tai-Chi on glycemic control, concentration, and well-being in healthy individuals. Methods : In this randomized balanced incomplete block study, 15 adults (age = 26 [2.50] y, 8 females) completed 2 of 3 protocols: uninterrupted sitting (Control), sitting interrupted with 3 minutes of Yoga every 30 minutes, or with 3 minutes of Tai-Chi every 30 minutes. Protocols lasted 7.5 hours and included a standardized diet. Glucose was measured every 30 minutes with a glucometer (Abbott FreeStyle Libre). Concentration and well-being were recorded with self-reported ecological momentary assessment. Area under the curve was calculated for glucose data. Statistical analyses were performed as a hierarchical repeated-measures model. Results : Glucose area under the curve for the Yoga intervention (34.55 [3.12] mmol/L) was significantly lower than the Control (38.14 [3.18] mmol/L; P < .05). There was a trend toward lower glucose in the Tai-Chi group compared with the Control, but no significant differences were found (AUC Tai-Chi = 36.64 [3.11] mmol/L; P = .57). Mean concentration in all groups decreased throughout the day, with the largest decrease in the Control. Well-being for the Yoga and Control groups decreased but increased with Tai-Chi. Concentration and well-being responses were not statistically significant between intervention groups. Conclusions : Breaking up sedentary behavior using 3-minute bouts of Yoga significantly lowers blood glucose in healthy individuals without compromising concentration or well-being. Tai-Chi did not provide the same significant effect on glucose levels but allowed better maintenance of concentration and well-being. These interventions provide effective ways to combat the deleterious effects of prolonged sedentary time while maintaining concentration and well-being.

Revisión: Sedentarismo y vida activa. Impacto sobre el Estado Nutricional y la Salud en adultos

Article

Feb 2014

The alarming data on overweight and obesity that affect most of developed and developing countries have focused since many years ago the attention of experts and institutions trying to stop this problem to the study of daily behaviors of physical activity and sedentarism. For most of the citizens, the hours dedicated to perform physical activity during their professional activity, at home or while commuting from one place to another are very few. By contrast, physical inactivity ranks as the fourth mortality risk factor for nontransmissible disease and, according to the WHO, individuals not sufficiently active increase by 20-30% the risk of dying from any cause. The problem poses two issues: on the one hand, not practicing physical activity implies not enjoying the benefits of exercising; on the other hand, current knowledge shows that the effects of physical inactivity on the body are not merely the other face of the positive effects of exercising. Therefore, the lack of physical activity and the excess of sedentarism should be fought separately. Current recommendations of the WHO for adults (including those older than 65 years) are at least 150 minutes per week of moderate to vigorous aerobic physical activity, at least two days of strength training and, in the elderly, exercises to maintain the balance and coordination. If it is not possible to comply with the official recommendations, sedentary habits may be broken every 30 minutes, at least by standing up from the chair and walking for one minute, and by not accumulating too many hours of a sedentary behavior, such as being seated. This paper insights in the pathophysiological mechanism that explains the benefits of physical activity and the detrimental effects of sedentarism in most of the non-transmissible diseases (hypercholesterolemia, hypertension, cardiovascular diseases, cancer, sarcopenia, neurological diseases) and not only in obesity, in which the relationship is more uncertain. In fact, it is possible to be a little overweight, have good physical condition, and being metabolically healthy. The authors advocate for physical activity being introduced in primary care as a preventive and therapeutic tool that, not being a panacea, contributes to better health status and better quality of life. Sport Sciences professionals should be part of a multidisciplinary team in charge of supervising the physical activity and training programs for the different sectors of the population.

Development and Prospect of Isotemporal Substitution Model in Physical Activity Research: A Narrative Review

Chapter

Jun 2023

Human health promotion is an important research field in sports science and public health. Several studies have investigated the association of physical activity, sedentary behavior, and sleep, with various health outcomes in isolation, yet the timing of different behavioral activities within a limited 24-h day is dependent on each other. The proposal of Isotemporal Substitution Model (ISM) research method finds the best time allocation method to maximize health benefits by reallocating the time use of each activity behavior. A literature search was conducted using major computerized databases and library holdings for peer-reviewed articles. The inclusion of articles followed a three-phased approach using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The studies included in this review were divided into three categories. The first category uses qualitative research to sort out the concepts related to ISM and PA, the second category uses quantitative research to review the application of ISM in PA research along the time line, and the third category describes current human 24-h activity measurement tools. Finally, the controversial points of the current ISM research and suggestions for future research development are discussed. Through literature review, scholars are suggested to improve the following research in the later research: standardize the definition and application of ISM; consider human 24-h activity behavior in a more specific manner; establish an evaluation and monitoring system for ISM research in human activities; develop convenient and scientific human activities. The evaluation tool of ISM; in-depth research and discussion on the dose–response relationship of ISM.KeywordsIsotemporal substitution modelPhysical activity24-h behavioral activity

Levels of sedentary behaviour in people with fibromyalgia: a systematic review and meta-analysis

Article

May 2023
DISABIL REHABIL

Purpose: Sedentary behaviour is associated with pain, fatigue, and a more severe impact of the disease in fibromyalgia, independently of physical activity levels. Despite this knowledge, little attention has been attributed to estimate sedentary behaviour in this population. The aims of this meta-analysis were to: (a) establish the pooled mean time spent sedentary, (b) investigate moderators of sedentary levels, and (c) explore differences with age- and gender-matched general population controls in people with fibromyalgia (PwF). Methods: Two independent authors searched major databases until 1 December 2022. A random effects meta-analysis was performed. The methodological quality of included studies was assessed with the Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. Results: Across 7 cross-sectional studies of fair methodological quality, there were 1500 patients with fibromyalgia (age range = 43-53 years). PwF spent 545.6 min/day (95% CI = 523.7-567.5, p < 0.001, N = 3) engaging in sedentary behaviour. Self-reported questionnaires overestimate sedentary levels with 314.3 min/day (95% CI = 302.0-326.6, p = 0.001, N = 2). PwF spent 36.14 min/day (95% CI = 16.3-55.9, p < 0.001) more in sedentary behaviour than general population controls. Conclusions: PwF are more sedentary than the general population. The limited available data should however be considered with caution due to substantial heterogeneity.IMPLICATIONS FOR REHABILITATIONRehabilitation for fibromyalgia should emphasize reducing sedentary behaviour.Health professionals should measure sedentary levels objectively in fibromyalgia since self-report underestimates the actual levels severely.More research on risk factors for sedentary behaviour in fibromyalgia is needed before detailed recommendations can be formulated.

Validity of the Danish Physical Activity Scale, adapted to Spanish speaking population

Article

Full-text available

May 2021

A novel behavioural INTErvention to REduce Sitting Time in older adults undergoing orthopaedic surgery (INTEREST): results of a randomised‑controlled feasibility study

Article

Full-text available

Dec 2020
AGING CLIN EXP RES

Background Osteoarthritis is a prevalent condition in older adults that causes many patients to require a hip or knee replacement. Reducing patients’ sedentariness prior to surgery may improve physical function and post-operative outcomes. Methods We conducted a pragmatic randomised-controlled feasibility study with 2:1 allocation into intervention or usual care groups. The intervention, based on Self-Determination Theory, involved techniques to reduce sedentary behaviour, including motivational interviewing, setting of behavioural goals, and more. The primary outcome was feasibility, assessed using mixed methods. We included exploratory measures to inform a future definitive trial, such as ActivPal3 accelerometry to measure movement, the Short Physical Performance Battery (SPPB), Basic Psychological Needs, and cardiometabolic biomarkers. Assessments were at baseline, 1-week pre-surgery, and 6-week post-surgery. Results We recruited 35 participants aged ≥ 60 years approximately 8 weeks before hip or knee arthroplasty. Participant uptake rate was 14.2%, and retention rate 85.7%. Participants were very satisfied with the study which was found to be feasible with some modifications. Exploratory within-group comparisons found that the intervention has potential to improve SPPB by 0.71 points from baseline to pre-surgery, a clinically significant increase, and reduce sedentary time by up to 66 min d⁻¹. Conclusion In this older surgical population, it is feasible to use behavioural techniques to displace sedentary time to activity and to conduct a trial spanning the period of surgical intervention. This may improve physical function and surgical outcomes. The INTEREST intervention is now ready for evaluation in a full-scale randomised-controlled trial. Registration This trial was registered on Clinicaltrials.gov on 13/11/2018. ID: NCT03740412.

Prenatal and birth predictors of objectively measured physical activity and sedentary time in three population-based birth cohorts in Brazil

Article

Full-text available

Jan 2020

Physical inactivity is a global pandemic with no signs of improvement. Prolonged sitting time is an emerging risk factor that exacerbates the health consequences of physical inactivity. Both behaviours are influenced by various individual and environmental factors but it remains unknown whether early-life exposures “program” these behaviours in later life. The current evidence is limited by a small number of studies which were primarily conducted in high-income countries, and a narrow range of early-life variables examined. Using data from three population-based Brazilian birth cohorts (analytical samples: n = 2740 for 1982 cohort, aged 30 years; n = 3592 for 1993 cohort, aged 18; n = 2603 for 2004 cohort, aged 6), we show that being female and higher family socioeconomic status at birth are strong and consistent predictors of lower physical activity and higher sedentary time from childhood to adulthood. Meanwhile, higher birth weight and lower birth order may also predict lower physical activity and higher sedentary time. Our findings are distinct from evidence from high-income countries, suggesting the importance of broader socioeconomic context in determining individual’s activity patterns through the life- course. Such evidence is essential for understanding the biological etiology and socioeconomic context of physical activity and sedentary behaviour at an early stage in life.

Magnitude of sedentary behavior and associated factors among secondary school adolescents in Debre Berhan town, Ethiopia

Article

Full-text available

Jan 2020
BMC PUBLIC HEALTH

Background: Sedentary life style is becoming increasingly common in this industrial age due to changes on the way people manufacture, transport and communicate. Sedentary lifestyle is associated with chronic diseases (diabetes, cardiovascular disease, and cancer), depression, obesity and premature mortality. The objective of this study was to assess the magnitude and associated factors of sedentary behavior. Methods: School based cross sectional study was conducted among 580 students from April 20 to May 10, 2019 in secondary schools in Debre Berhan City Administration. Sedentary behavior was measured using time spent on four activities (watching TV/Video, listening to music, surfing internet and playing games). Adolescents are considered sedentary if they spend two or more hours in one or all listed activities per day. Data was entered to Epidata version 4.2.2.1 and exported to SPSS version 20 for analysis. Result: A total of 580 (44.3% male and 55.7% female) students participated in this study. The magnitude of sedentary behavior (≥2 h per day) was 65.5% (95% CI = 61.32% - 69.08). Family monthly income greater than 8000 birr (AOR: 6.42, 95%CI = 2.18-18.78), maternal education (AOR: 5.12, 95%CI = 1.09-23.83), access to TV (AOR: 4.87, 95%CI = 1.99-11.87), access to mobile internet (AOR: 2.37, 95% CI = 1.14-4.93) and utilization of social media (AOR: 2.98, 95%CI = 1.43-6.17) were positively associated with adolescent sedentary behavior. Conclusion: The prevalence of sedentary behavior was high among adolescents of Debre Berhan town. Therefore, schools in the town should work towards creating awareness on the wise use of screen based entertainments.

Long-Term Relationship between Psychological Distress and Continuous Sedentary Behavior in Healthy Older Adults: A Three Panel Study

Article

Full-text available

Aug 2019
MED LITH

Background and objectives: Psychological distress (PD) is associated with continuous sedentary behaviors (CSB; based on the ratio of 1.5 metabolic equivalents (METs) sessions or more continuing for over 30 min) in older adults, but the long-term relation is not sufficiently clarified. This study aims to clarify the long-term relationship between PD and the rate of CSB. Materials and Methods: In this secondary analysis, a sample population of 72 healthy elderly people aged 65 years or older participated in a health club of college A from 2016 to 2018. We conducted structural equation modeling (SEM) using the cross-lagged and synchronous effects models. We adopted the following as proxy variables: CSB and PD (based on the Kessler 6 scale (K6) scores). Results: “2016 K6” to“2017 CSB” (standardization factor (β = 0.141, p = 0.025), “2017 K6” to “2018 CSB” (β = 0.187, p < 0.001) and “2016 CSB” to “2018 CSB” (β = 0.188, p < 0.001) were all statistically significant using the cross-lagged effects models. Fit indices were adjusted goodness of fit index (AGFI) = 0.961, comparative fit index (CFI) = 1.000, and root mean square error of approximation (RMSEA) = 0.000. Conclusion: The results suggest that PD may affect the ratio of CSB one year later, and CSB may affect the ratio of PD two year later.

Physical Activity and Nutrition INfluences in Ageing: Current Findings from the PANINI Project

Article

Full-text available

Jul 2019

Background: The ageing of the population is a global challenge and the period of life spent in good health, although increasing, is not keeping pace with lifespan. Consequently, understanding the important factors that contribute to healthy ageing and validating interventions and influencing policy to promote healthy ageing are vital research priorities. Method: The PANINI project is a collaboration of 20 partners across Europe examining the influence of physical activity and nutrition in ageing. Methods utilised encompass the biological to the social, from genetics to the influence of social context. For example, epigenetic, immunological, and psychological assessments, and nutritional and sports science-based interventions have been used among older adults, as well as mathematical modelling and epidemiology. The projects are multi-disciplinary and examine health outcomes in ageing from a range of perspectives. Results: The results discussed here are those emerging thus far in PANINI from 11 distinct programmes of research within PANINI as well as projects cross-cutting the network. New approaches, and the latest results are discussed. Conclusions: The PANINI project has been addressing the impact of physical activity and nutrition on healthy ageing from diverse but interlinked perspectives. It emphasises the importance of using standardized measures and the advantages of combining data to compare biomarkers and interventions across different settings and typologies of older adults. As the projects conclude, the current results and final data will form part of a shared dataset, which will be made open access for other researchers into ageing processes.

High sedentary time in children is not only due to screen media use: A cross-sectional study

Article

Full-text available

May 2019
BMC Pediatr

Abstract Background Sedentary behaviour has become a growing public health concern. Currently, it is a common belief that screen time (SCT) is a key factor in high overall sedentary time (ST) and is often used as a primary outcome. However, the evidence is lacking. Therefore, this study investigated the association of objectively assessed total ST with SCT among children. Further, SCT was investigated separately for sedentary level, weight status, gender, and migration background. Methods For 198 primary school children (7.1 ± 0.7 years, boys: 43.9%) ST was assessed objectively using a multi-sensor device (Actiheart®; CamNtech, Cambridge, UK). The sample was split into three groups (tertiles) to investigate SCT of children with low, medium and high ST. SCT and socio-demographic parameters, such as migration background, were assessed using a parental questionnaire; anthropometric data was collected at schools. Results Absolut SCT did not differ significantly among the three sedentary groups: Daily average of SCT was 83.8 ± 55.0 min (27.4% of ST) for children with high ST, 82.8 ± 50.5 min (39.8% of ST) for children with medium ST, and 77.2 ± 59.4 min (71.3% of ST) for those with low ST. However, relatively the SCT percentage of total ST was significantly higher among children with low ST (p

Intervening to reduce sedentary behavior in older adults – Pilot results

Article

Full-text available

Jan 2019

Background: Older adults spend most of their day in sedentary behavior (SB) (i.e., prolonged sitting), increasing risk for negative health outcomes, functional loss, and diminished ability for activities of daily living. The purpose of this study was to develop and pilot test an intervention designed to reduce SB in older adults that could be translated to communities. Methods: Two pilot studies implementing a 4-week SB intervention were conducted. SB,physical function, and health-related quality of life were measured via self-report and objective measures. Participants (N=21) completed assessments pre- and post-intervention (studies 1 and 2) and at follow-up (4-weeks post-intervention; study 2). Due to the pilot nature of this research, data were analyzed with Cohen’s d effect sizes to examine the magnitude of change in outcomes following the intervention. Results: Results for study 1 indicated moderate (d=0.53) decreases in accelerometry-obtained total SB and increases (d=0.52) in light intensity physical activity post-intervention. In study 2,there was a moderate decrease (d=0.57) in SB evident at follow-up. On average SB decreased by approximately 60 min/d in both studies. Also, there were moderate-to-large improvements in vitality (d=0.74; study 1) and gait speed (d=1.15; study 2) following the intervention. Further,the intervention was found to be feasible for staff to implement in the community. Conclusion: These pilot results informed the design of an ongoing federally funded randomized controlled trial with a larger sample of older adults from underserved communities. Effective,feasible, and readily-accessible interventions have potential to improve the health and function of older adults.

Reducing sedentary behavior and cardiovascular disease risk factors in office workers: a study protocol

Article

Full-text available

Jan 2018

Background: Sedentary lifestyle are public health concerns that threatening human health, and sedentary behavior(SB) intervention in the workplace has attracted wide attention in the field of public health. Methods: A quasi-experimental design with randomized treatment assignment will be used to test the effect of breaking up prolonged sitting during work hours on SB and cardiometabolic risk in professional office workers in China. There are two intervention protocols: A) Interrupting SB prompted by timer app every 60- min of sitting during work hours; B) Participating in 30 min of moderate to vigorous physical activity at work. The intervention will be implemented in 2 worksite locations for 12 months. Study outcomes include SB and physical activity measured by accelerometry, and cardiometabolic risk factors and will be assessed at baseline and 12-month posttest. Discussion and conclusion: The intervention protocols integrate a few health behavior promotion theories, will provide a reference for electing appropriate intervention measures to conduct an effectiveness on SB interruption at work, decrease in SB duration, and influence on cardiovascular risk factors.

Sedentary time, physical activity, and sleep quality in fibromyalgia: The al-Ándalus project

Article

Full-text available

Oct 2018
SCAND J MED SCI SPOR

Purpose To get insight into the potential significance of objectively measured sedentary time (ST) and physical activity (PA) intensity levels on sleep quality (SQ) in women with fibromyalgia; and to assess if those who meet moderate‐to‐vigorous PA (MVPA) recommendations have better SQ than their counterparts. Methods Four‐hundred and nine female women with fibromyalgia (age range 30‐65 years old) from Andalusia (southern Spain) were included in this cross‐sectional study. Sedentary time, PA intensity levels (light, moderate, and MVPA), and total PA were assessed with accelerometers during 7 consecutive days. Sleep quality was measured with the Pittsburgh Sleep Quality Index self‐report questionnaire. Results Higher ST was associated with worse subjective SQ, sleep duration, sleep disturbances, daytime dysfunction, and SQ global score (all, P<0.05). All PA levels were associated with better subjective SQ and sleep latency and with less sleep medication and daytime dysfunction (all, P<0.05). In addition, light and total PA were associated with better sleep efficiency, SQ global score, and less sleep disturbances (all, P<0.05). Finally, women meeting bouted PA recommendations displayed better SQ than patients not meeting the recommendations (bouted or non‐bouted). Conclusion Lower ST and greater PA levels are associated with better SQ in women with fibromyalgia. This result demonstrates that those patients with fibromyalgia who reduce long periods of inactivity and perform PA could be better sleepers, which might contribute to a lower severity of the disease. It is noteworthy that meeting bouted PA recommendations is associated with better SQ. This article is protected by copyright. All rights reserved.

Interventions targeting sedentary behavior in non-working older adults: a systematic review

Article

Full-text available

Aug 2018
MATURITAS

Sedentary behavior has been found to be associated with negative health outcomes independently of physical activity in older adults. This systematic review collates interventions to reduce sedentary behavior in non-working older adults, assessing whether they are effective, feasible, and safe. A systematic search identified 2560 studies across five databases. Studies were included where participants were ≥60 years on average with none younger than 45, and participants did not work >2 days per week. A total of six studies were identified, three of which included control groups, while the other three were repeated-measures pre-post designs. Only one study randomised participants. The overall level of quality of included studies was poor. A narrative synthesis was conducted, as the level of heterogeneity in outcomes and outcome reporting were too high for a meta-analysis to be performed. The narrative synthesis suggested that interventions have the potential to reduce sitting time in non-working older adults. Included studies reported feasible and safe implementations of their interventions in most samples, except for one subsample from a study of people in sheltered housing. Objectively measured reductions in sitting time were between 3.2% and 5.3% of waking time, or up to 53.9 min per day. Future studies should employ more rigorous designs to assess the effects of reducing sedentary behavior on health and physical function, and should include follow-ups to measure the duration of behavior change.

A US/Mexico Study of Joint Associations of Physical Activity and Sedentary Behavior on Anthropometric Indicators, Migration Status, Country of Birth and Country of Residence

Article

Full-text available

Jun 2018
Int J Environ Res Publ Health

Background: This study examined the influence of migration status, nativity and country of residence on joint associations of physical activity (PA) and sedentary behavior (SB) in anthropometric indicators of Mexicans and Mexican-Americans living in the US and in Mexico. Methods: We examined data from two large national surveys, the National Health and Nutrition Examination Survey from the US (NHANES, 2011⁻2012) and Mexico (ENSANUT, 2012). Using self-reported minutes of moderate to vigorous physical activity and SB, we calculated four categories for analyses. Anthropometric measures consisted of body mass index (BMI) and waist circumference (WC). We used data of migration status, nativity and country of residence. Linear regression models examined how joint categories of PA and SB were associated with BMI and WC according to migration status, nativity and country of residence, controlling for health risk behaviors. Results: Analyses showed that even among those in the category with the lowest risk behavior, “physically active and low sedentary”, there were differences in BMI and WC by migration status, nativity and country of residence. Within this lower risk category, Mexican immigrants living in the US had the greatest association with high BMI, while US-born Mexican-Americans living in the US had the highest WC values when compared with the group of Mexicans living in Mexico. Conclusions: Joint categories of PA and SB were associated with BMI and WC by migration status, nativity and country of residence among populations with Mexican ethnicity.

Is the time right for quantitative public health guidelines on sitting? A narrative review of sedentary behaviour research paradigms and findings

Article

Full-text available

Jun 2018

Sedentary behaviour (SB) has been proposed as an ‘independent’ risk factor for chronic disease risk, attracting much research and media attention. Many countries have included generic, non-quantitative reductions in SB in their public health guidelines and calls for quantitative SB targets are increasing. The aim of this narrative review is to critically evaluate key evidence areas relating to the development of guidance on sitting for adults. We carried out a non-systematic narrative evidence synthesis across seven key areas: (1) definition of SB, (2) independence of sitting from physical activity, (3) use of television viewing as a proxy of sitting, (4) interpretation of SB evidence, (5) evidence on ‘sedentary breaks’, (6) evidence on objectively measured sedentary SB and mortality and (7) dose response of sitting and mortality/cardiovascular disease. Despite research progress, we still know little about the independent detrimental health effects of sitting, and the possibility that sitting is mostly the inverse of physical activity remains. Unresolved issues include an unclear definition, inconsistencies between mechanistic and epidemiological studies, over-reliance on surrogate outcomes, a very weak epidemiological evidence base to support the inclusion of ‘sedentary breaks’ in guidelines, reliance on self-reported sitting measures, and misinterpretation of data whereby methodologically inconsistent associations are claimed to be strong evidence. In conclusion, public health guidance requires a consistent evidence base but this is lacking for SB. The development of quantitative SB guidance, using an underdeveloped evidence base, is premature; any further recommendations for sedentary behaviour require development of the evidence base and refinement of the research paradigms used in the field.

Systematic comparative validation of self-report measures of sedentary time against an objective measure of postural sitting (activPAL)

Article

Full-text available

Feb 2018
INT J BEHAV NUTR PHY

Background: Sedentary behaviour is a public health concern that requires surveillance and epidemiological research. For such large scale studies, self-report tools are a pragmatic measurement solution. A large number of self-report tools are currently in use, but few have been validated against an objective measure of sedentary time and there is no comparative information between tools to guide choice or to enable comparison between studies. The aim of this study was to provide a systematic comparison, generalisable to all tools, of the validity of self-report measures of sedentary time against a gold standard sedentary time objective monitor. Methods: Cross sectional data from three cohorts (N = 700) were used in this validation study. Eighteen self-report measures of sedentary time, based on the TAxonomy of Self-report SB Tools (TASST) framework, were compared against an objective measure of postural sitting (activPAL) to provide information, generalizable to all existing tools, on agreement and precision using Bland-Altman statistics, on criterion validity using Pearson correlation, and on data loss. Results: All self-report measures showed poor accuracy compared with the objective measure of sedentary time, with very wide limits of agreement and poor precision (random error > 2.5 h). Most tools under-reported total sedentary time and demonstrated low correlations with objective data. The type of assessment used by the tool, whether direct, proxy, or a composite measure, influenced the measurement characteristics. Proxy measures (TV time) and single item direct measures using a visual analogue scale to assess the proportion of the day spent sitting, showed the best combination of precision and data loss. The recall period (e.g. previous week) had little influence on measurement characteristics. Conclusion: Self-report measures of sedentary time result in large bias, poor precision and low correlation with an objective measure of sedentary time. Choice of tool depends on the research context, design and question. Choice can be guided by this systematic comparative validation and, in the case of population surveillance, it recommends to use a visual analog scale and a 7 day recall period. Comparison between studies and improving population estimates of average sedentary time, is possible with the comparative correction factors provided.

Physical activity and sedentary behavior following pediatric burns – a preliminary investigation using objective activity monitoring

Article

Full-text available

Feb 2018

Abstract Background Adequate levels of regular physical activity (PA) are crucial for health and well-being. Pediatric burn injuries can have major physiological consequences in both the short and long term. The question is whether these consequences affect post burn PA levels. This study therefore aimed to describe PA and sedentary behavior (SB) in children and adolescents 1–5 years after burn injury. Methods Daily PA and SB were monitored in 20 children and adolescents (12 boys and 8 girls, aged 6–17 years, with burns covering 10–37% of total body surface area, 1–5 years post burn) for 1 week using the ActiGraph GTX3+ accelerometer. Activity counts were categorized into SB, light PA, moderate PA, vigorous PA, moderate-to-vigorous PA (MVPA), and total PA. Outcomes were compared with non-burned reference values and PA levels recommended by the World Health Organization (WHO). Results The participants spent about 5.1 h per day on total PA and 7.4 h on SB. Most of the active time (~ 83%) was categorized as light PA. Thirty-five percent of the group, especially the young boys, spent on average ≥ 60 min on MVPA per day. The boys, although with large interindividual differences, spent more time on MVPA than the girls (p

Article

Full-text available

Jan 2018

Objective: To explore diabetes-related behaviours and their influencing factors among elderly individuals with pre-diabetes in rural areas of China. Design, setting and participants: A cross-sectional survey was conducted among elderly individuals (≥60 years) in rural communities in Yiyang City of China. Multistaged cluster random sampling was carried out to select 42 areas, and interviews were conducted among 434 elderly individuals with pre-diabetes (fasting plasma glucose 6.1-7.0 mmol/L and/or 2-hour post-glucose load of 7.8-11.1 mmol/L) using questionnaires on diabetes-related behaviours. The diabetes-related behaviours included eight categories: average daily sedentary time; frequency of physical activities per week; regular or irregular diet; whether paying attention to diet control or not; daily dietary preferences; frequency of physical examinations per year; current smoking status; and current consumption of alcohol. Each of the risky behaviours was scored -1 and each of the healthy behaviours was scored +1. Each individual's score of diabetes-related behaviours was the sum of the score for all behaviours. Main outcome measures: Participants were asked about general information (age, gender, marital status, history of hyperglycaemia, family history of diabetes mellitus, presence of other diseases, body mass index, waist-to-hip ratio and education) and their diabetes-related behaviours. Multivariate linear regression analysis was performed to identify the risk factors for diabetes-related behaviour among elderly individuals with pre-diabetes. Results: The average score of diabetes-related behaviours of elderly individuals with pre-diabetes in rural China was 2.7. The prevalences of risky diabetes-related behaviours were as follows: <1 physical examination per year (57.6%), insufficient physical activities (55.3%), lack of attention paid to diet control (51.4%), high-salt and high-fat diets (41.0%), sedentary lifestyle (35.9%), smoking (22.8%), regular alcohol uptake (15.0%) and irregular diet (3.9%). Gender and a history of hyperglycaemia were found to be influencing factors of the diabetes-related behaviour score. Conclusions: The prevalence of risky diabetes-related behaviours was high among pre-diabetic elderly individuals in rural China. More effort should be made to promote the prevention and control of diabetes in rural China. Future studies should be undertaken on diabetes prevention strategies tailored specially for this population. Trial registration number: ChiCTR-IOR-15007033; Results.

Replacing sedentary time with physical activity: a 15-year follow-up of mortality in a national cohort

Article

Full-text available

Jan 2018

Background Sedentary behavior is associated with health risks in adults. The potential benefits of reducing sedentary time may be dependent not only on decrease per se, but also on the type of activity it replaces. Few longitudinal studies have investigated the effects on mortality when replacing objectively assessed sedentary time with another physical activity (PA) behavior. Objective To investigate the effects of replacing objectively assessed sedentary time with time in light-intensity PA or moderate-vigorous PA (MVPA) on all-cause mortality, cardiovascular disease (CVD) mortality or cancer mortality in a cohort with 15 years follow-up time. Methods In total, 851 women and men from the population-based Sweden Attitude Behaviour and Change study were included. Time spent sedentary, in light-intensity PA and in MVPA were assessed using an Actigraph 7164 accelerometer. Mortality data were obtained from Swedish registers. Cox proportional hazards models estimated hazard ratios (HR) of mortality with 95% confidence intervals (CI) and isotemporal substitution models were used to estimate the effect of replacing sedentary behavior with PA for the same amount of time. Results Over a follow-up of 14.2 years (SD 1.9) with 12,117 person-years at risk, 79 deaths occurred, 24 deaths from CVD, 27 from cancer, and 28 from other causes. Replacing 30 minutes/day of sedentary time with light-intensity PA was associated with significant reduction in all-cause mortality risk (HR: 0.89, 95% CI: 0.81–0.98) and CVD mortality risk (HR: 0.76, 95% CI: 0.63–0.92). Replacing 10 minutes of sedentary time with MVPA was associated with reduction in CVD mortality risk (HR: 0.62, 95% CI: 0.42–0.91). No statistically significant reductions were found for cancer mortality. Conclusion This statistical modelling study suggests that replacing sedentary time with light-intensity PA could have beneficial effect on both all-cause mortality and CVD mortality. Replacing sedentary time with MVPA could reduce CVD mortality.

Breaks in sedentary time could have similar effects as moderate-to-vigorous physical activity on the reduction of frailty in older people with comorbidities

Conference Paper

Dec 2017

Breaks in sedentary time could have similar effects as moderate-to-vigorous physical activity on the reduction of frailty in older people with comorbidities

Comportamento sedentário e massa muscular reduzida em idosos: um estudo de base populacional

Article

Full-text available

Dec 2017

The loss of muscle mass in older adults is negatively associated with health, which makes it necessary to identify modifiable behavioral habits that may aggravate this condition in this population. In this context, the objectives of the present study were to describe the characteristics of older adults according to reduced muscle mass status and verify its association with sedentary behavior. This was a cross-sectional population-based study, conducted in 24 cities in the Regional Healthcare Administration of Uberaba/Minas Gerais. Older adults (≥ 60 years) from both sexes meeting the inclusion criteria answered a structured questionnaire on sociodemographic, health, and habits information. Participants also underwent measurement of anthropometric variables. Sitting time was measured using the validated questions from the IPAQ. The chi-square statistic was used to examine differences between the prevalence of reduced muscle mass and sociodemographic variables, health and habits. Poisson regression was used to analyze the association between reduced muscle mass and exposure to sedentary behavior. Results: 3.223 older adults with mean age of 70 years (SD = 7.26) took part in the study. Of these total, 20.9% (n = 674) presented reduced muscle mass, being statistically different according to age, schooling, marital status, monthly family income, waist circumference, body mass index, smoking and sedentary behavior. According to the adjusted analysis, older adults who spent ≥ 330 minutes/day sitting demonstrated higher likelihood for reduced muscle mass (PR = 1.18; CI95%: 1.04-1.34). Prolonged sitting time is associated with reduced muscle mass in older adults.

Relationship between sedentary behavior and depression: A mediation analysis of influential factors across the lifespan among 42,469 people in low- and middle-income countries

Article

Jan 2018
J AFFECT DISORDERS

Background: Sedentary behavior (SB) is associated with diabetes, cardiovascular disease and low mood. There is a paucity of multi-national research investigating SB and depression, particularly among low- and middle-income countries. This study investigated the association between SB and depression, and factors which influence this. Methods: Cross-sectional data were analyzed from the World Health Organization’s Study on Global Ageing and Adult Health. Depression was based on the Composite International Diagnostic Interview. The association between depression and SB (self-report) was estimated by multivariable linear and logistic regression analyses. Mediation analysis was used to identify influential factors. Results: A total of 42,469 individuals (50.1% female, mean 43.8 years) were included. People with depression spent 25.6 (95%CI8.5-42.7) more daily minutes in SB than non-depressed participants. This discrepancy was most notable in adults aged ≥65y (35.6 minutes in those with depression). Overall, adjusting for socio-demographics and country, depression was associated with a 1.94 (95%CI1.31 2.85) times higher odds for high SB (i.e., ≥8h/day). The largest proportion of the SB-depression relationship was explained by mobility limitations (49.9%), followed by impairments in sleep/energy (43.4%), pain/discomfort (31.1%), anxiety (30.0%), disability (25.6%), cognition (16.1%), and problems with vision (11.0%). Other health behaviors (physical activity, alcohol consumption, smoking), body mass index, and social cohesion did not influence the SB-depression relationship. Conclusion: People with depression are at increased risk of engaging in high levels of SB. This first multi-national study offers potentially valuable insight for a number of hypotheses which may influence this relationship, although testing with longitudinal studies is needed.

Physiological Responses to Sedentary Behaviour

Chapter

Jan 2018

Sedentary behaviours—too much sitting as distinct from too little exercise—are emerging as a ubiquitous, modern-day health hazard. Epidemiological evidence is accumulating that indicates greater time spent in sedentary behaviour is associated with increased cardiometabolic risk, even when controlling for the influence of leisure time moderate-to-vigorous physical activity. Based on these observations and preliminary experimental work, it has been proposed that sedentary behaviour influences health risk in part through some distinct mechanisms that act independently of lack of physical activity. However, the observational evidence is well ahead of evidence on physiological responses and potential biological mechanisms that may underlie the observed associations. Here, we summarize and discuss experimental evidence to date on the physiological effects of sedentary behaviours (prolonged sitting), including potential countermeasures aiming to address too much sitting as a health risk. We also highlight future research that is needed to further ascertain the impact of sedentary behaviour on altering physiology.

Reallocating Accelerometer-Assessed Sedentary Time to Light or Moderate- to Vigorous-Intensity Physical Activity Reduces Frailty Levels in Older Adults: An Isotemporal Substitution Approach in the TSHA Study

Article

Full-text available

Dec 2017
J AM MED DIR ASSOC

Introduction: The effects of replacing sedentary time with light or moderate- to vigorous-intensity physical activity on frailty are not well known. Aim: To examine the mutually independent associations of sedentary time (ST), light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (MVPA) with frailty status in older adults. Methods: A total of 628 people aged ≥65 years from the Toledo Study of Healthy Aging (TSHA) participated in this cross-sectional study. Frailty was measured using the Frailty Trait Scale. Hip-worn accelerometers were used to capture objective measurements of ST, LPA, and MVPA. Linear regression and isotemporal substitution analyses were used to examine associations of ST, LPA, and MVPA with frailty status. Analyses were also stratified by comorbidity. Results: In single and partition models, LPA and MVPA were negatively associated with frailty. Time in sedentary behavior was not associated with frailty in these models. In the isotemporal substitution models, replacing 30 minutes/d of ST with MVPA was associated with a decrease in frailty [β -2.460; 95% confidence interval (CI): -3.782, -1.139]. In contrast, replacing ST with LPA was not associated with favorable effects on this outcome. However, when the models were stratified by comorbidity, replacing ST with MVPA had the greatest effect on frailty in both the comorbidity (β -2.556; 95% CI: -4.451, -0.661) and the no comorbidity group (β -2.535; 95% CI: -4.343, -0.726). Moreover, the favorable effects of LPA in people with comorbidities was found when replacing 30 minutes/d of ST with LPA (β -0.568; 95% CI: -1.050, -0.086). Conclusions: Substituting ST with MVPA is associated with theoretical positive effects on frailty. People with comorbidity may also benefit from replacing ST with LPA, which may have important clinical implications in order to decrease the levels of physical frailty.

Exposure to simultaneous sedentary behavior domains and sociodemographic factors associated in public servants

Article

Nov 2017

DOI: http://dx.doi.org/10.5007/1980-0037.2017v19n4p469 Exposure to sedentary behavior may contribute to health problems. This study aimed to estimate the prevalence of exposure to simultaneous sedentary behavior domains and verify associated sociodemographic characteristics among technical and administrative servers of a Brazilian university. This is a cross-sectional epidemiological study carried out with 623 technical and administrative servers. Sedentary behavior was identified through a questionnaire in the following domains: commuting (active / passive), sitting time at work, daily time spent watching television and computer use (≥3 hours / day). Sociodemographic variables were age, sex and educational level. The prevalence of servers that had one, two, three and four simultaneous sedentary behavior was 28.4%, 43.2%, 22.5% and 4.3%, respectively. Women were more likely to have three sedentary behavior simultaneously (OR = 1.61, CI 95% = 1.02, 2.56). Servers with 9-11 years of schooling were less exposed to two (OR = 0.27, CI 95% = 0.17, 0.44), three (OR = 0.39, CI 95% = 0.23, 0.66) and four (OR = 0.22, CI 95% = 0.07; 0.69) sedentary behavior simultaneously and those over 12 years of schooling were less likely of having two (OR = 0.22, CI 95% = 0.10; 0.49) and three (OR = 0.15, CI 95% = 0.05, 0.46) sedentary behavior simultaneously. More than half of servers have two sedentary behavior during the week. Having sedentary behavior in more than one domain simultaneously was associated with sex and educational level.

The Theory of Planned Behavior as a model for understanding sedentary behavior

Article

Full-text available

Feb 2015
PSYCHOL SPORT EXERC

Take a load off: Skeletal implications of sedentism in the feet of modern body donors

Article

Full-text available

Dec 2023

Malorie Albee

Background and Objectives Modern biocultural environments continue to place selective pressures on our skeletons. In the past century, a major cultural pressure has been the rise in sedentism. However, studies considering the effects of sedentism on the foot have largely considered pathological changes to the gross foot without particular regard for the pedal skeleton. To address this gap in the literature, temporal trends in the development of osteoarthritis and entheseal changes on the tarsals and metatarsals were analyzed in the context of biodemographic data for recent modern humans. Methodology The sample utilized for this project is comprised of 71 individuals from the William M. Bass Donated Skeletal Collection, with birth years ranging from 1909 to 1993. Temporal trends in osteoarthritis and entheseal changes were determined via ANCOVA, using year of birth as the explanatory variable and biodemographic variables (age, sex, stature, Body Mass Index, and tibial robusticity) as covariates. Results Results indicate that entheseal changes and osteoarthritis have decreased over time, and these trends are statistically significant. Temporal trends in pedal entheseal changes and osteoarthritis vary by sex. Conclusions and Implications The increase in sedentary behavior over time has usually been framed as a net negative for human health and well-being. However, considered in isolation, the decrease in entheseal changes and osteoarthritis presented here might be considered a positive development as they suggest overall less stress on the modern human foot. This study also has the potential to inform the health sciences and general public about biocultural contributors to modern foot health.

Dynamics of Sedentary Behaviours and System-Based Approach: Future Challenges and Opportunities in the Life-Course Epidemiology of Sedentary Behaviours

Chapter

Dec 2023

This chapter challenges our current thinking about sedentary behaviour and offers new paradigms to move forward to understand the complex nature of sedentary behaviours and their determinants. Sedentary behaviours are ubiquitous and changing in nature over time: with advances in media and IT technology, television (TV) time is decreasing, but overall screen time is growing. Understanding the non-linear temporal dynamics of sedentary behaviours and how people accumulate, or break, sitting time appears a crucial step to design innovative strategies. Since multiple factors at different levels (proximal, distal) are interacting to drive sedentary time, new perspectives combining a life-course perspective and complexity science are needed. System-based approach and adaptive dynamical systems modelling will help model the interaction between factors and feedback loops. A system-based framework for the study of sedentary behaviours called SOS (Systems of Sedentary behaviours) has been established by a transdisciplinary research group within the framework of the European DEDIPAC Knowledge Hub. Novel methods of enquiry are required to progress the field, including methodologies for analysis such as probabilistic modelling techniques (Bayesian Networks), simulation studies investigating different scenarios of possible societal changes and their effect on sedentary behaviours, and innovations in measuring accurately other dimensions such as context and type of sedentary behaviours. Finally, future opportunities for innovative data collection (e.g., ecological momentary assessment) and analysis (big data) and innovative interventions (natural experiments, just-in-time adaptive interventions, solutionist, and participatory approach) are highlighted for their potential to benefit sedentary behaviours research and work more efficiently towards public health solutions to tackle this new threat of modern life.

Predictive factors for maxillofacial fractures, sedentary behavior, and dental trauma literacy

Article

Sep 2023

Effects of Interactive Telerehabilitation Practices in Office Workers with Chronic Nonspecific Neck Pain: Randomized Controlled Study

Article

Jul 2023
TELEMED J E-HEALTH

Aim: Aim of this study is to investigate the effects of interactive telerehabilitation exercises in office workers with chronic nonspecific neck pain. Methods: Office workers (n = 120) were randomly divided into three groups between February and July 2022, taking into account the inclusion and exclusion criteria, and office ergonomics training was given to all of the participants. Group 1 participants were given an interactive telerehabilitation program (strengthening, motor control, and posture correction exercises) for 45 min per day, 3 days a week, for a total of 6 weeks. Group 2 participants were trained to do the home exercise program on their own for 45 min per day, 3 days a week, for a total of 6 weeks. Only office ergonomics training was given to Group 3 patients. Results: Statistically significant improvement in pain (p < 0.001), range of motion (ROM) (p < 0.001), neck disability status (p < 0.001), functional status (p < 0.001), and quality of life (p < 0.001) of 6-week interactive telerehabilitation application in office workers was found. Discussion: In addition to office ergonomics training, interactive telerehabilitation program is the most effective method on pain, ROM, and neck disability compared with home exercise program and office ergonomics training alone, and studies are needed on the long-term effectiveness of telerehabilitation applications and telerehabilitation treatment diversity.

Sedentary behaviour and traumatic dental injuries in adolescents: A population-based study

Article

Apr 2023
DENT TRAUMATOL

Objective: Analyse factors associated with dental trauma in 12-year-old adolescents. Methods: An epidemiological survey was carried out in the five largest cities in the state of Mato Grosso do Sul, Brazil. Data on traumatic dental injuries (TDI) based on the World Health Organization (WHO), sociodemographic characteristics and individual clinical and behavioural characteristics in 615 adolescents were collected. Univariate and adjusted multilevel logistic regressions were performed to test the association of dental trauma with behavioural and sociodemographic factors. The study was approved by the Ethics Committee (CAAE number 85647518.4.0000.0021). Results: The prevalence of TDI at 12 years was 3.4% (95% CI 1.8; 6.4). In the adjusted models, clinical characteristics of adolescents such as overjet >3 mm (OR = 1.51 [95% CI 1.00; 2.41]) were associated with trauma. Sociodemographic characteristics such as female sex (OR = 0.13 [95% CI 0.07; 0.25]), income above the poverty level (OR = 0.34 [95% CI 0.15; 0.78]), who declared themselves white (OR = 0.23 [95% CI 0.11; 0.47]) and with sedentary behaviour (OR = 0.69 [95% CI 0.59; 0.80]) were associated with trauma, as protective factors. Conclusion: Sociodemographic, behavioural and individual clinical characteristics were associated with TDI in adolescents. Oral health teams should focus on the most vulnerable groups, encouraging the use of mouthguards and access to treatment services.

Development of a Physical Activity and Sedentary Behaviour Policy for Canadian Childcare Settings: A Delphi Study

Article

Full-text available

Mar 2023
Early Child Educ J

Unlabelled: This study aimed to obtain consensus on physical activity (PA) and sedentary behaviour (SB) policy items for use in Canadian childcare settings. Purposeful sampling of Canadian experts in PA/SB (n = 19) and Early Childhood Education (ECE; n = 20) was used to form two distinct (i.e., PA/SB and ECE) panels for a 3-round Delphi study. In round 1, the PA/SB experts suggested their top 10 items for a Canadian childcare PA/SB policy. Policy items were then pooled to generate a list of 24 unique items. In round 2, experts in both panels rated the importance of the 24 policy items using a 7-point Likert scale (i.e., 1 = Not at all important to 7 = Extremely important). The ECE panel was also asked to report on the feasibility of the policy items using a 4-point Likert scale (i.e., 1 = Not at all feasible to 4 = Very feasible). Policy items that received an interquartile deviation (IQD) score of ≤ 1 (indicating consensus) and a median score of ≥ 6 (indicating importance) in both panels were considered shared priorities. In round 3, members of both panels re-rated the importance of the policy items that did not achieve consensus among their respective panel in round 2 and were asked to order items based on importance. Descriptive statistics were used to assess feasibility of policy items, and differences in panel ratings were quantified using Mann Whitney U tests. Consensus was achieved for 23 policy items in the PA/SB panel and 17 items in the ECE panel. Overall, 15 shared priorities were identified (e.g., provide 120 min of outdoor time per day, sedentary behaviour should not be used as a punishment), and six policy items exhibited a statistical difference in ratings across panels. Members of the ECE panel indicated that the policy item, "children should be permitted to go outside whenever they want, for as long as they want" (M = 1.78; SD = 0.65) was lowest in terms of feasibility, and the policy item, "children should receive opportunities to engage in both unstructured and structured physical activity opportunities daily" (M = 3.89; SD = 0.32) was the most feasible for daily implementation. Findings from this study can inform the development of an expert-generated and feasibility-informed institutional PA/SB policy for use in Canadian childcare settings. Supplementary information: The online version contains supplementary material available at 10.1007/s10643-023-01473-z.

Accelerometer-Measured Physical Activity and Sedentary Behavior of Adults with Prader-Willi Syndrome Attending and Not Attending a Small-Scale Community Workshop

Article

Full-text available

Jul 2022
Int J Environ Res Publ Health

This cross-sectional study aimed to compare the accelerometer-assessed physical activity (PA) and sedentary behavior (SB) of adults with Prader-Willi syndrome (PWS) attending or not attending a small-scale community workshop (SSCW). A total of 18 adults with PWS were recruited in this study. Of these participants, 10 regularly attended an SSCW and 8 did not. All of the participants were asked to wear accelerometers for eight continuous days for measuring their PA and SB. The independent sample t-test was used. The results showed that the adults with PWS who attended the SSCW engaged in more moderate-to-vigorous PA (MVPA) and daily steps than those who did not. By stratifying between daytime/nighttime on weekdays, we found the participants who attended the SSCW had higher total PA, MVPA, daily steps, as well as lower total sedentary time, during the daytime on weekdays than those who did not. Policies or programs promoting PA and reducing SB among adults with PWS should thus consider providing structured programs or courses in a community center.

Does tutors’ support contribute to a telehealth program that aims to promote the quality of life of office workers? A cluster randomized controlled trial

Article

Full-text available

Feb 2021

The quality of life in the workplace can be achieved by creating a place more humanized and strategies that provide wellness to workers. The aim of this study was to investigate the effectiveness of telehealth education program to promote quality of life of office workers. This is a cluster randomized controlled trial (RCT). The participants were office workers computer users (n = 326). All received 9 audiovisual content (grouped into topics: musculoskeletal health, healthy diet, and mental health) that addresses the real needs identified by them in the focus groups. The intervention group (n = 178) was instructed to seek the tutor support about topics addressed by the audiovisual content. The primary outcome measure was quality of life by WHOQOL-BREF. The secondary outcome measure was level of physical activity of the participants. Data analysis was performed by General Linear Mixed Model. After six months of telehealth education program a general improvement in health and environmental domain, was observed in the intervention group. During that period, a within-group analysis showed that there was a significant improvement in the intervention group, with respect to quality of life in general health (p < 0.05) and in the environmental domain (p < 0.01). In the baseline to the eighth month, there were statistically significant changes within-group for the general health (p < 0.05) and for the physical domain (p < 0.01) in both groups (p < 0.01). Telehealth education program promoted an improvement in the participants' quality of life. There was no benefit in favor of the telehealth education program, with tutor support in relation to the conventional program. Trial registration : The trial was prospectively registered at ClinicalTrial.gov (NCT02980237). The date of registration was August 23, 2016.

INTERVENÇÃO VOLTADA À REDUÇÃO DO TEMPO DE TELA EM ESCOLARES DE FORTALEZA, CEARÁ: EFEITO E VARIÁVEIS MEDIADORAS

Thesis

Jan 2017

Introduction: High exposures to screen time justify interventions to reduce this behavior in children and adolescents. Objective: To evaluate the effect of an intervention on screen time and to identify possible mediating variables (attitude, self-efficacy, support of the family and school members) of the intervention effect among students. Method: This was a cluster-randomized controlled trial. Of the six full-time schools in Fortaleza, northeastern Brazil, three were submitted to the "Fortaleça sua Saúde" program and three comprised the control group during the second half of 2014 (July to December). The study involved students aged 11 to 17 years, who were in the 7th to 9th grade of elementary school. Thus, 548 students in the intervention group and 537 in the control group. The intervention focused on the training of teachers, opportunities to practice physical activity in school and reduction of screen time, as well as health education. The students answered a pre- and post-intervention questionnaire about sedentary issues. TV time, computer / video game and total screen time were the dependent variables. The potential mediating variables were obtained through scales of intrapersonal (self-efficacy and attitude) and interpersonal factors (support of the family and school members). Control variables were sex, age, school and economic class measured at baseline. The interventions’ effect were analyzed by McNemar test, binary logistic regression models, generalized linear models and effect sizes. For the mediation analysis was applied the product approach of the coefficients a and b. The significance level of 5% was adopted. All analyzes were performed using statistical software STATA v.13.0 and SPSS v.23.0. Results: During follow-up, students in the intervention group had a better chance of reducing TV time (boys) and computer / video game (girls and younger adolescents) to less than two hours per day (p <0.05). Positive intervention effect on attitude was observed among girls and adolescents of both age groups (p <0.05), and school support for all subgroups (p <0.05). Finally, the attitude was found as a mediating variable of the interventions’ effect on girls and adolescents of both age groups. Conclusion: The intervention had an impact on both subgroups, improving components of screen time as well as in intrapersonal and interpersonal aspects. Attitude had a role as a mediator on interventions’ effects on screen time. These findings may help fill the gaps about strategies to interventions for reduce screen time in schoolchildren.

The effect of a three month, low-load- high-repetitions group-based exercise program versus pilates on physical fitness and body composition in inactive women

Article

Sep 2020

Objective Both low-load-high-repetitions (LLHR) and Pilates programs constitute popular forms of exercise, accompanied by health benefits for the participants involved. Notably, the effect of such programs on aerobic fitness is still controversial. The aim of this study was to examine the effects of both programs on physical fitness and body composition on previously inactive adult women. Methods Twenty-six women (39.8 ± 9.1y) were assigned to a LLHR program, and sixteen women (39.1 ± 12.2y) were assigned to a Pilates program. Both programs were performed in a group setting, 3 times per week for 3 months. Aerobic fitness, flexibility, handgrip strength and lower extremities explosiveness were assessed by a battery of field testing. Total body fat and trunk fat levels were assessed by bioelectrical impedance analysis. Heart rate response during exercise was recorded once every month by using a telemetry system. Results Aerobic fitness, lower extremities explosive power, left arm handgrip strength and body composition significantly improved in the LLHR group; while flexibility significantly improved only in the Pilates group, following the intervention period (p < 0.05). LLHR was superior to the Pilates program in improving aerobic fitness and body composition; whilst Pilates was superior in improving flexibility (p < 0.05). Conclusion LLHR group-based exercise programs may improve various aspects of physical fitness, including aerobic fitness, in inactive adult women. This medium-intensity form of exercise is generally well tolerated and might be used as an option for women who cannot perform training on higher intensities. In contrast, the Pilates program failed to improve physical fitness-related parameters except flexibility levels.

Interventions to Reduce Sedentary Time in Older Adults With and Without Mobility Limitations

Thesis

Full-text available

Aug 2019

Justin Aunger

Older adults are a growing portion of the population and are most at-risk of the negative health effects of sedentary behaviour. In this PhD, a systematic review was presented which assessed existing interventions to reduce sedentary behaviour in older adults and found that to date, none have recruited older adults with co-morbidities or mobility limitations, and have not assessed clinical outcomes. Older adults with osteoarthritis are highly sedentary, and thus reducing their sedentariness prior to hip or knee replacement surgeries may be pertinent to improve their health and post-surgical outcomes. A randomised controlled feasibility study based on Self-Determination Theory was conducted in 35 patients waiting for surgery using a range of behavioural techniques to increase activity and reduce sitting. It was found that the study was feasible to patients, and that it had potential to improve physical function and reduce sedentary behaviour but required some modification to be feasible to deliver. More robust trials to test efficacy of the intervention are required; thus, the design of a future RCT was presented, requiring multi-site design and 188 participants to detect meaningful changes in physical function post-surgery.

Gender Differences in Subjective Well-Being of Healthy High-School Students

Article

Full-text available

Nov 2019

The objective of this study was to analyse the level of subjective well-being (SWB) through five SWB dimensions and compare it between healthy male and healthy female high school students preferring sedentary leisure time activities. The research sample comprised of 90 male high school students (mean age 16.72 ± 1.33) and 126 female high school students (mean age 16.71 ± 1.36) who preferred sedentary types of leisure time activities with self-reported good health status. A standardized The Bern Subjective Well-Being Questionnaire for Adolescents (BFW) was used as a primary research method. We found significantly higher level of positive SWB dimension (U = 4281, p = 0.002, r = 172) and significantly lower level of negative SWB dimension (U = 2835, p = 0.000, r = 424) in the group of male high school students with self-reported good health status in comparison to female high school students. Parents should be involved in the selection of their children's leisure time activities, so it should not have only the sedentary character but also sport leisure time activities, mainly among young girls.

Physical activity and sedentary levels among people living with epilepsy: A systematic review and meta-analysis

Article

Aug 2019

How physically active and sedentary people with epilepsy are is unclear. We conducted a meta-analysis to investigate physical activity and sedentary behavior levels compared with the general population in people with epilepsy across the lifespan. Embase, PubMed, PsycARTICLES, and CINAHL Plus were searched from inception until 1/3/2019. A random effects meta-analysis was conducted. Adults with epilepsy (mean age range = 30-47 years) were significantly less likely to comply with physical activity recommendations [odds ratio (OR) = 0.68; 95% confidence interval (CI) = 0.53-0.87; P < 0.001; N analyses = 10; n epilepsy = 1599; n controls = 137,800] and more likely to be inactive (as defined by individual study criteria) (OR = 1.57; 95% CI = 1.34-1.84; P < 0.001; N analyses = 6; n epilepsy = 6032; n controls = 928,184). Data in children (mean age range = 10-12 years) were limited (N = 4; n = 170) and inconsistent while there were no data available for middle-aged and old age (>65 years) people with epilepsy. Our data demonstrate that adults with epilepsy are less physically active than the general population. Public health campaigns specifically targeting the prevention of physical inactivity in adults with epilepsy are warranted. More research on physical activity and sedentary levels in children, adolescents, middle-aged, and old age but also adult people with epilepsy is needed before specific recommendations can be formulated.

A novel behavioural INTErvention to REduce Sitting Time in older adults undergoing orthopaedic surgery (INTEREST): protocol for a randomised controlled feasibility study

Article

Full-text available

Apr 2019

Background Osteoarthritis is a highly prevalent condition in older adults, that causes many sufferers to require a hip or knee replacement in order to improve their quality of life and reduce pain. Individuals waiting for hip or knee replacements are often highly sedentary; thus, it is pertinent to assess whether reducing their sedentariness prior to surgery may aid in improving post-operative outcomes. Methods/design The study will be a randomised controlled feasibility trial design, with 2:1 randomisation into an intervention and usual care group respectively. A target of 45 patients aged 60 years or older waiting for elective hip and knee replacements will be recruited from Russells Hall Hospital, Dudley, UK, approximately 8–10 weeks before surgery. The intervention, informed by Self-Determination Theory (SDT), will be composed of multiple behaviour change techniques, namely, motivational interviewing, feedback on current objectively measured sedentary behaviour and activity, goal-setting, environmental modification, self-monitoring, and social support. Assessments will occur at baseline, 1 week pre-surgery, and 6 weeks post-surgery. The primary outcome will be the feasibility of intervention delivery and of the trial procedures, assessed quantitatively based on rates of recruitment, retention, measures-completion, and intervention fidelity assessment, and with mixed-methods assessment of acceptability, practicality, adaption, satisfaction, and safety. Exploratory outcomes will include physical function, cardiometabolic biomarkers, measurement of SDT constructs, and both objective and subjective measurement of physical activity and sedentariness. The study will last up to 18 weeks per participant. No formal between-group comparisons are planned, but the variance in within-group changes and differences between groups in outcome measures will be explored and reported with 95% confidence intervals. Discussion This is the first study assessing the feasibility of an intervention to reduce sedentary behaviour in older adults with mobility limitations, and the first to assess whether such a reduction could work in a prehabilitative context prior to surgery. The results of this study will help inform the design of a definitive randomised controlled trial.

Income inequalities in leisure time physical inactivity in northern Sweden: A decomposition analysis

Article

Jan 2019

Aims: Increasing income inequalities in leisure time physical inactivity have been reported in the relatively socially equal setting of northern Sweden. The present report seeks to contribute to the literature by exploring the contribution of different factors to the income inequalities in leisure time physical inactivity in northern Sweden. Methods: This study was based on the 2014 Health on Equal Terms survey, distributed in the four northernmost counties of Sweden. The analytical sample consisted of 21,000 respondents aged 16–84. Six thematic groups of explanatory variables were used: demographic variables, socioeconomic factors, material resources, family-, psychosocial conditions and functional limitations. Income inequalities in leisure time physical inactivity were decomposed by Wagstaff-type decomposition analysis. Results: Income inequalities in leisure time physical inactivity were found to be explained to a considerable degree by health-related limitations and unfavourable socioeconomic conditions. Material and psychosocial conditions seemed to be of moderate importance, whereas family and demographic characteristics were of minor importance. Conclusions: This study suggests that in order to achieve an economically equal leisure time physical inactivity, policy may need to target the two main barriers of functional limitations and socioeconomic disadvantages.

Contribution to the surveillance and measurement of physical activity and sedentary behaviors

Thesis

Dec 2017

Fabien Rivière

Physical activity and sedentary behaviors are major health determinants and are being surveyed worldwide. Objective: The aim of this thesis was to contribute to the surveillance and measurement of physical activity and sedentary behaviors. Method: This thesis includes four studies. The first study analyzes and discusses the present situation of French national surveillance studies. The second study presents the results from the first French report card on physical activity for children and adolescents. The third study discusses the validity and reliability properties of the French version of the Global Physical Activity Questionnaire (GPAQ). The fourth study examines the content of questionnaires measuring sedentary behaviors. Results: Studies 1 and 2 reported measurement issues impairing the overall data quality, inter-study comparisons and survey of changes over time. The study of GPAQ reported limited but acceptable reliability and validity for the measurement of physical activity and sedentary time in France. Finally, the systematic review on sedentary behaviors questionnaires reported large differences in the population targeted (ex: adults, youth, elderly), recall frame (ex: previous day, last 7 days, last month), the number of item (from 1 to more than 100), and the sedentary behaviors characteristics measured (from only sitting time to up to 27 sedentary behaviors). Conclusion: The work realized during this thesis allows the formulation of recommendations to improve the surveillance of physical activity and sedentary behaviors in France

The role of exercise combined with tocilizumab in visceral and epicardial adipose tissue and gastric emptying rate in abdominally obese participants: Protocol for a randomised controlled trial

Article

Full-text available

May 2018
TRIALS

Background: Exercise reduces the amount of visceral adipose tissue (VAT) and the risk of cardiometabolic diseases. The underlying mechanisms responsible for these exercise-induced adaptations are unclear, but they may involve lipolytic actions of interleukin-6 (IL-6). Contracting skeletal muscles secrete IL-6, leading to increased circulating IL-6 levels in response to exercise. The aim of this study is to investigate whether IL-6 is involved in mediating the effects of exercise on visceral and epicardial adipose tissue volume and glycaemic control. Methods/design: Seventy-five physically inactive males and females aged > 18 years with a waist-to-height ratio > 0.5 and/or waist circumference ≥ 88 cm (females) or ≥ 102 cm (males) are being recruited to participate in a 12-week intervention study. Participants are randomly allocated to one of five groups (1:1:1:1:1). Two groups consist of supervised endurance exercise training combined with the IL-6 blocker tocilizumab (ET) or saline used as placebo (EP), two groups consist of no exercise combined with tocilizumab (NT) or placebo (NP), and one group consists of resistance exercise and placebo (RP). Although the study is an exploratory trial, the primary outcome is change in VAT volume from before to after intervention, with secondary outcomes being changes in (1) epicardial adipose tissue, (2) pericardial adipose tissue and (3) gastric emptying. Depots of adipose tissue are quantitated by magnetic resonance imaging Gastric emptying and glucose metabolism are assessed using mixed-meal tolerance tests. Discussion: Understanding the role of IL-6 in mediating the effects of exercise on visceral and epicardial adipose tissue and glycaemic control may lead to novel therapeutic approaches in the prevention of cardiometabolic diseases. Trial registration: ClinicalTrials.gov, NCT02901496 . Registered on 1 August 2016 and posted retrospectively on 15 September 2016.

The Effectiveness of Standing on a Balance Board for Increasing Energy Expenditure

Article

Full-text available

Mar 2018

Purpose: To investigate differences in energy expenditure (EE), heart rate (HR), productivity, fatigue, and pain while performing desk work while sitting (SIT), standing (STAND), and standing on a balance board (BOARD). Methods: Thirty healthy adults (60% female; age 39.7 ± 11.8 y; BMI 26.7 ± 5.0 kg·m) employed in sedentary-based jobs volunteered for this randomized crossover trial. Participants performed typing work in three different positions: SIT, STAND, and BOARD; each condition lasting 30 min. Oxygen consumption (VO2) was measured via indirect calorimetry and EE was calculated using respiratory quotient and corresponding caloric equivalent values. Productivity was quantified by measuring words typed per min, accuracy, and typing mistakes. Overall feelings of fatigue and pain were self-reported three times during each position using validated 10-cm visual analog scales. Repeated measures ANOVA were used to assess differences in outcome variables across conditions. Results: VO2 was significantly different among all conditions regardless of current standing desk use (SIT 3.35 ± 0.53; STAND 3.77 ± 0.48; BOARD 3.92 ± 0.54 mL·kg·min, p<0.001). EE (kcal·min) also differed (p<0.001) among SIT (1.27 ± 0.22), STAND (1.42 ± 0.26) and BOARD (1.48 ± 0.29). Compared to sitting (67 ± 9 bpm), HR was higher in STAND (76 ± 11 bpm) and BOARD (76 ± 11 bpm, p<0.001). Measures of productivity were not different across conditions (p>0.05). Fatigue progressively increased over each 30 min condition whereas pain in SIT and BOARD increased from min 10 to 20, then leveled off between min 20 to 30. For STAND, pain continued to increase over time. Conclusion: Compared with sitting, a balance board may be effective for increasing EE without interfering with productivity in an occupational setting.

Why is excessive sitting a health risk?

Article

Jan 2016

Increased epidemiological evidence over the past few years has shown excessive sitting to be a health risk even if recommendations for physical activity are fulfilled. Sitting is an independent health risk for two reasons: sitting and physical activity exhibit poor correlation, and an increase in physical activity does not contribute to all mechanisms underlying the health risks of sitting. During sitting, muscular passivity increases insulin resistance and influences the transport and oxidation of fatty acids in muscular tissue, and acute exercise is not sufficient to restore all changes. Accordingly, adequate everyday physical activity seems to be important for maintaining the signaling pathways affecting insulin sensitivity.

Measuring enjoyment of physical activity in older adults: invariance of the Physical ACtivity Enjoyment Scale (PACES) across groups and time

Article

Full-text available

Sep 2011
INT J BEHAV NUTR PHY

The purpose of this study was to validate the Physical Activity Enjoyment Scale (PACES) in a sample of older adults. Participants within two different exercise groups were assessed at two time points, 6 months apart. Group and longitudinal invariance was established for a novel, 8-item version of the PACES. The shortened, psychometrically sound measure provides researchers and practitioners an expedited and reliable instrument for assessing the enjoyment of physical activity.

Physical Activity and Body Mass: Changes in Younger versus Older Postmenopausal Women

Article

Full-text available

Jun 2011
MED SCI SPORT EXER

The study's purpose was to investigate the relationship of sedentary (≤ 100 MET · min · wk(-1)), low (>100-500 MET · min · wk(-1)), moderate (>500-1200 MET · min · wk(-1)), and high (>1200 MET · min · wk(-1)) habitual physical activity with body weight, body mass index, and measures of fat distribution (waist-to-hip ratio) in postmenopausal women by age decades. A prospective cohort study of 58,610 postmenopausal women age 50-79 yr weighed annually during 8 yr at one of 40 US clinical centers was analyzed to determine the relationship of high versus low habitual physical activity with changes in body weight and fat distribution by age group. Among women age 50-59 yr, there was significant weight loss in those expending >500-1200 MET · min · wk(-1) (coefficient = -0.30, 95% confidence interval = -0.53 to -0.07) compared with the group expending ≤ 100 MET · min · wk(-1). Among women age 70-79 yr, higher physical activity was associated with less weight loss (coefficient = 0.34, 95% confidence interval = 0.04-0.63). Age at baseline significantly modified the association between physical activity and total weight change, whereas baseline body mass index did not. High habitual physical activity is associated with less weight gain in younger postmenopausal women and less weight loss in older postmenopausal women. These findings suggest that promoting physical activity among postmenopausal women may be important for managing body weight changes that accompany aging.

Physiological and health implications of a sedentary lifestyle

Article

Full-text available

Nov 2010

Sedentary behaviour is associated with deleterious health outcomes, which differ from those that can be attributed to a lack of moderate to vigorous physical activity. This has led to the field of sedentary physiology, which may be considered as separate and distinct from exercise physiology. This paper gives an overview of this emerging area of research and highlights the ways that it differs from traditional exercise physiology. Definitions of key terms associated with the field of sedentary physiology and a review of the self-report and objective methods for assessing sedentary behaviour are provided. Proposed mechanisms of sedentary physiology are examined, and how they differ from those linking physical activity and health are highlighted. Evidence relating to associations of sedentary behaviours with major health outcomes and the population prevalence and correlates of sedentary behaviours are reviewed. Recommendations for future research are proposed.

Physiological effects of caffeine, epigallocatechin-3-gallate, and exercise inoverweight and obese women

Article

Full-text available

Sep 2010

The aim of this study was to evaluate the combined effects of a 10-week exercise program with ingestion of caffeine and epigallocatechin-3-gallate (EGCG) on body composition, cardiovascular fitness, and strength in overweight and obese women. In a double-blind, placebo-controlled approach, overweight and obese women (n = 27) were randomly assigned to treatment groups with exercise (an active-supplementing group with exercise (EX-Act) and a placebo group with exercise (EX-PL)) or without exercise (an active-supplementing group without exercise (NEX-Act) and a placebo group without exercise (NEX-PL)). All participants consumed 1 drink per day for 10weeks EX-Act and EX-PL participated in a concurrent endurance and resistance training program. Changes in body composition were assessed using a 4-compartment model. Changes in muscle mass (MM) were evaluated using a DXA-derived appendicular leansoft tissue equation. There was a significant time treatment interaction for MM (p = 0.026) and total cholesterol (TC) (p = 0.047), and a significant time training interaction for peak oxygen consumption (p = 0.046) and upper-body and lower-body strength (p< 0.05). Significant differences between the EX groups and NEX groups for percentage change in MM and peak oxygen consumption, and upper-body and lower-body strength, were revealed. Clinical markers for hepatic and renal function revealed no adverse effects. TC significantly decreased for the active-supplementing groups (EX-Act, NEX-Act). The current study suggests that implementing a caffeineEGCG-containing drink prior to exercise may improve MM, fitness, and lipid profiles in overweight women.

Too Much Sitting: The Population Health Science of Sedentary Behavior

Article

Full-text available

Jul 2010
EXERC SPORT SCI REV

OWEN, N., G.N. HEALY, C.E. MATTHEWS, and D.W. DUNSTAN. Too much sitting: the population health science sedentary behavior. Exerc. Sport Sci. Rev., Vol. 38, No. 3, pp. 105-113, 2010. Even when adults meet physical activity guidelines, sitting for prolonged periods can compromise metabolic health. Television (TV) time and objective measurement studies show associations, and breaking up sedentary time is beneficial. Sitting time, TV time, and time sitting in automobiles increase premature mortality risk. Further evidence from prospective studies, intervention trials, and population-based behavioral studies is required.

Television viewing time independently predicts all-cause and cardiovascular mortality: The EPIC Norfolk study

Article

Full-text available

Feb 2011
INT J EPIDEMIOL

Television viewing (TV), a highly prevalent behaviour, is associated with higher cardiovascular risk independently of physical activity. The relationship with mortality, however, is relatively unknown. We examined the prospective relationship between TV time and all-cause, cardiovascular and cancer mortality in a population-based cohort [The European Prospective Investigation into Cancer and Nutrition (EPIC), Norfolk] of 13 197 men and women {age [SD (standard deviation)]: 61.5 ± 9.0 years}. Participants were free from stroke, myocardial infarction and cancer at baseline in 1998-2000 and were followed up for death ascertainment until 2009 (9.5 ± 1.6 years). TV time, total physical activity energy expenditure (PAEE), education level, smoking status, alcohol consumption, anti-hypertensive and lipid-lowering medication use, participant and family history of disease and total energy intake were self-reported; height and weight were measured by standardized procedures. Hazard ratios (HRs) [95% confidence interval (CI)] for mortality were estimated per 1-h/day increase in TV. Each 1-h/day increase in TV time was associated with increased hazard of all-cause (HR = 1.04, 95% CI = 1.01-1.09; 1270 deaths) and cardiovascular (HR = 1.07, 95% CI = 1.01-1.15; 373 deaths), but not cancer mortality (HR = 1.04, 95% CI = 0.98-1.10; 570 deaths). This was independent of gender, age, education, smoking, alcohol, medication, diabetes history, family history of cardiovascular disease and cancer, body mass index (BMI) and PAEE. They were similar when stratified by gender, age, education, BMI and PAEE. The population-attributable fraction for all-cause mortality comparing the highest TV tertile (>3.6 h/day) with the lowest (<2.5 h/day) was 5.4%. These findings suggest that public health recommendations should consider advising a reduction in TV time, a predominant leisure activity in modern society, in addition to advocating physical activity.

Changes in Weight, Waist Circumference and Compensatory Responses with Different Doses of Exercise among Sedentary, Overweight Postmenopausal Women

Article

Full-text available

Feb 2009
PLOS ONE

It has been suggested that exercise training results in compensatory mechanisms that attenuate weight loss. However, this has only been examined with large doses of exercise. The goal of this analysis was to examine actual weight loss compared to predicted weight loss (compensation) across different doses of exercise in a controlled trial of sedentary, overweight or obese postmenopausal women (n = 411).Participants were randomized to a non-exercise control (n = 94) or 1 of 3 exercise groups; exercise energy expenditure of 4 (n = 139), 8 (n = 85), or 12 (n = 93) kcal/kg/week (KKW). Training intensity was set at the heart rate associated with 50% of each woman's peak VO(2) and the intervention period was 6 months. All exercise was supervised. The main outcomes were actual weight loss, predicted weight loss (exercise energy expenditure/ 7700 kcal per kg), compensation (actual minus predicted weight loss) and waist circumference. The study sample had a mean (SD) age 57.2 (6.3) years, BMI of 31.7 (3.8) kg/m(2), and was 63.5% Caucasian. The adherence to the intervention was >99% in all exercise groups. The mean (95% CI) weight loss in the 4, 8 and 12 KKW groups was -1.4 (-2.0, -0.8), -2.1 (-2.9, -1.4) and -1.5 (-2.2, -0.8) kg, respectively. In the 4 and 8 KKW groups the actual weight loss closely matched the predicted weight loss of -1.0 and -2.0 kg, respectively, resulting in no significant compensation. In the 12 KKW group the actual weight loss was less than the predicted weight loss (-2.7 kg) resulting in 1.2 (0.5, 1.9) kg of compensation (P

Association Between Sedentary Behavior, Physical Activity, and Obesity: Inactivity Among Active Kids

Article

Full-text available

Feb 2009

Sedentary behavior and physical activity are not mutually exclusive behaviors. The relative risk of overweight for adolescents who are highly sedentary and highly physically active is unclear. A better understanding of the relationship between sedentary behaviors, physical activity, and body mass index (BMI) would provide insight for developing interventions to prevent or reduce overweight. Using the physical activity module of the School Health Action, Planning and Evaluation System (SHAPES), we collected data from 25,060 students in grades 9 through 12 from 76 secondary schools in Ontario, Canada. Sex-specific logistic regression analyses were performed to examine how BMI, weight perceptions, social influences, team sports participation, and smoking behavior were associated with being 1) high active-high sedentary, 2) low active-low sedentary, and 3) low active-high sedentary. Low active-high sedentary boys were more likely to be overweight than high active-low sedentary boys (adjusted odds ratio [AOR], 1.60; 95% confidence interval [CI], 1.01-2.58). When compared with high active-low sedentary girls, girls who were low active-high sedentary (OR, 2.24; 95% CI, 1.23-4.09) or high active-high sedentary (OR, 1.91; 95% CI, 1.01-3.61) were more likely to be overweight. Sedentary behavior may moderate the relationship between physical activity and overweight. Developing a better understanding of sedentary behavior in relation to physical activity and overweight is critical for preventing and reducing overweight among youth.

Physical activity and sedentary behaviours in youth: Issues and controversies

Article

Full-text available

Feb 2004
J R SOC PROMO HEALTH

There is growing concern over the effects of sedentary lifestyles on the health of young people. Recent rapid increases in juvenile obesity have received a great deal of attention in the scientific and popular press and have been attributed partly to television viewing, computer games and other sedentary behaviours. These are thought to compete with physical activity. There is a ‘moral panic’ concerning the ‘couch kids’ culture in modern western society. Project STIL (Sedentary Teenagers and Inactive Lifestyles) at Loughborough University is investigating ‘what young people do’ and focuses on active and inactive pursuits chosen in their leisure time. The following issues are addressed in this paper with specific reference to young people: how do we define ‘sedentary behaviour’ and do key sedentary behaviours displace physical activity? Are key sedentary behaviours obesogenic? What are the secular trends for children and youth for TV viewing? Our results for young people suggest that:1. TV viewing and video-game playing are largely uncorrelated with physical activity, suggesting that there is time for both2. meta-analytic findings show that body fatness is not related in any clinically meaningful way with key sedentary behaviours3. although more children and youth have greater access to TVs than in previous generations, the amount of TV watched per head has not changed for 40 years. Preliminary findings from Project STIL suggest that inactivity is more complex than we sometimes think. Indeed, measures of ‘couch potato-ism’, such as TV viewing, may be inappropriate markers of inactivity.

TV Viewing and Physical Activity Are Independently Associated with Metabolic Risk in Children: The European Youth Heart Study

Article

Full-text available

Dec 2006
PLOS MED

TV viewing has been linked to metabolic-risk factors in youth. However, it is unclear whether this association is independent of physical activity (PA) and obesity. We did a population-based, cross-sectional study in 9- to 10-y-old and 15- to 16-y-old boys and girls from three regions in Europe (n = 1,921). We examined the independent associations between TV viewing, PA measured by accelerometry, and metabolic-risk factors (body fatness, blood pressure, fasting triglycerides, inverted high-density lipoprotein (HDL) cholesterol, glucose, and insulin levels). Clustered metabolic risk was expressed as a continuously distributed score calculated as the average of the standardized values of the six subcomponents. There was a positive association between TV viewing and adiposity (p = 0.021). However, after adjustment for PA, gender, age group, study location, sexual maturity, smoking status, birth weight, and parental socio-economic status, the association of TV viewing with clustered metabolic risk was no longer significant (p = 0.053). PA was independently and inversely associated with systolic and diastolic blood pressure, fasting glucose, insulin (all p < 0.01), and triglycerides (p = 0.02). PA was also significantly and inversely associated with the clustered risk score (p < 0.0001), independently of obesity and other confounding factors. TV viewing and PA may be separate entities and differently associated with adiposity and metabolic risk. The association between TV viewing and clustered metabolic risk is mediated by adiposity, whereas PA is associated with individual and clustered metabolic-risk indicators independently of obesity. Thus, preventive action against metabolic risk in children may need to target TV viewing and PA separately.

Sedentary Behaviors and Subsequent Health Outcomes in Adults:: A Systematic Review of Longitudinal Studies, 1996-2011

Article

Aug 2011

To systematically review and provide an informative synthesis of findings from longitudinal studies published since 1996 reporting on relationships between self-reported sedentary behavior and device-based measures of sedentary time with health-related outcomes in adults. Studies published between 1996 and January 2011 were identified by examining existing literature reviews and by systematic searches in Web of Science, MEDLINE, PubMed, and PsycINFO. English-written articles were selected according to study design, targeted behavior, and health outcome. Forty-eight articles met the inclusion criteria; of these, 46 incorporated self-reported measures including total sitting time; TV viewing time only; TV viewing time and other screen-time behaviors; and TV viewing time plus other sedentary behaviors. Findings indicate a consistent relationship of self-reported sedentary behavior with mortality and with weight gain from childhood to the adult years. However, findings were mixed for associations with disease incidence, weight gain during adulthood, and cardiometabolic risk. Of the three studies that used device-based measures of sedentary time, one showed that markers of obesity predicted sedentary time, whereas inconclusive findings have been observed for markers of insulin resistance. There is a growing body of evidence that sedentary behavior may be a distinct risk factor, independent of physical activity, for multiple adverse health outcomes in adults. Prospective studies using device-based measures are required to provide a clearer understanding of the impact of sedentary time on health outcomes.

Television Viewing and Risk of Type 2 Diabetes, Cardiovascular Disease, and All-Cause Mortality A Meta-analysis

Article

Jun 2011
J Am Med Assoc

Prolonged television (TV) viewing is the most prevalent and pervasive sedentary behavior in industrialized countries and has been associated with morbidity and mortality. However, a systematic and quantitative assessment of published studies is not available. To perform a meta-analysis of all prospective cohort studies to determine the association between TV viewing and risk of type 2 diabetes, fatal or nonfatal cardiovascular disease, and all-cause mortality. Relevant studies were identified by searches of the MEDLINE database from 1970 to March 2011 and the EMBASE database from 1974 to March 2011 without restrictions and by reviewing reference lists from retrieved articles. Cohort studies that reported relative risk estimates with 95% confidence intervals (CIs) for the associations of interest were included. Data were extracted independently by each author and summary estimates of association were obtained using a random-effects model. Of the 8 studies included, 4 reported results on type 2 diabetes (175,938 individuals; 6428 incident cases during 1.1 million person-years of follow-up), 4 reported on fatal or nonfatal cardiovascular disease (34,253 individuals; 1052 incident cases), and 3 reported on all-cause mortality (26,509 individuals; 1879 deaths during 202,353 person-years of follow-up). The pooled relative risks per 2 hours of TV viewing per day were 1.20 (95% CI, 1.14-1.27) for type 2 diabetes, 1.15 (95% CI, 1.06-1.23) for fatal or nonfatal cardiovascular disease, and 1.13 (95% CI, 1.07-1.18) for all-cause mortality. While the associations between time spent viewing TV and risk of type 2 diabetes and cardiovascular disease were linear, the risk of all-cause mortality appeared to increase with TV viewing duration of greater than 3 hours per day. The estimated absolute risk differences per every 2 hours of TV viewing per day were 176 cases of type 2 diabetes per 100,000 individuals per year, 38 cases of fatal cardiovascular disease per 100,000 individuals per year, and 104 deaths for all-cause mortality per 100,000 individuals per year. Prolonged TV viewing was associated with increased risk of type 2 diabetes, cardiovascular disease, and all-cause mortality.

Television Viewing Time and Mortality: The Australian Diabetes, Obesity and Lifestyle Study (AusDiab)

Article

Jan 2010
CIRCULATION

Television viewing time, the predominant leisure-time sedentary behavior, is associated with biomarkers of cardiometabolic risk, but its relationship with mortality has not been studied. We examined the associations of prolonged television viewing time with all-cause, cardiovascular disease (CVD), cancer, and non-CVD/noncancer mortality in Australian adults. Television viewing time in relation to subsequent all-cause, CVD, and cancer mortality (median follow-up, 6.6 years) was examined among 8800 adults > or =25 years of age in the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). During 58 087 person-years of follow-up, there were 284 deaths (87 CVD deaths, 125 cancer deaths). After adjustment for age, sex, waist circumference, and exercise, the hazard ratios for each 1-hour increment in television viewing time per day were 1.11 (95% confidence interval [CI], 1.03 to 1.20) for all-cause mortality, 1.18 (95% CI, 1.03 to 1.35) for CVD mortality, and 1.09 (95% CI, 0.96 to 1.23) for cancer mortality. Compared with a television viewing time of <2 h/d, the fully adjusted hazard ratios for all-cause mortality were 1.13 (95% CI, 0.87 to 1.36) for > or =2 to <4 h/d and 1.46 (95% CI, 1.04 to 2.05) for > or =4 h/d. For CVD mortality, corresponding hazard ratios were 1.19 (95% CI, 0.72 to 1.99) and 1.80 (95% CI, 1.00 to 3.25). The associations with both cancer mortality and non-CVD/noncancer mortality were not significant. Television viewing time was associated with increased risk of all-cause and CVD mortality. In addition to the promotion of exercise, chronic disease prevention strategies could focus on reducing sitting time, particularly prolonged television viewing.

When energy balance is maintained, exercise does not induce negative fat balance in lean sedentary, obese sedentary, or lean endurance-trained individuals

Article

Oct 2009
J APPL PHYSIOL

Fat oxidation during exercise is increased by endurance training, and evidence suggests that fat oxidation during exercise is impaired in obesity. Thus the primary aim of this study was to compare the acute effects of exercise on 24-h fat oxidation and fat balance in lean sedentary [LS, n = 10, body mass index (BMI) = 22.5 +/- 6.5 kg/m(2)], lean endurance-trained (LT, n = 10, BMI = 21.2 +/- 1.2 kg/m(2)), and obese sedentary (OS, n = 7, BMI = 35.5 +/- 4.4 kg/m(2)) men and women. Twenty-four-hour energy expenditure and substrate oxidation were measured under sedentary (control; CON) and exercise (EX) conditions while maintaining energy balance. During EX, subjects performed 1 h of stationary cycling at 55% of aerobic capacity. Twenty-four-hour fat oxidation did not differ on the CON or EX day in LS (43 +/- 9 vs. 29 +/- 7 g/day, respectively), LT (53 +/- 8 vs. 42 +/- 5 g/day), or OS (58 +/- 7 vs. 80 +/- 9 g/day). However, 24-h fat balance was significantly more positive on EX compared with CON (P < 0.01). Twenty-four-hour glucose, insulin, and free fatty acid (FFA) profiles were similar on the EX and CON days, but after consumption of the first meal, FFA concentrations remained below fasting levels for the remainder of the day. These data suggest that when exercise is performed with energy replacement (i.e., energy balance is maintained), 24-h fat oxidation does not increase and in fact, may be slightly decreased. It appears that the state of energy balance is an underappreciated factor determining the impact of exercise on fat oxidation.

Sitting Time and Mortality from All Causes, Cardiovascular Disease, and Cancer

Article

Apr 2009
MED SCI SPORT EXER

Although moderate-to-vigorous physical activity is related to premature mortality, the relationship between sedentary behaviors and mortality has not been fully explored and may represent a different paradigm than that associated with lack of exercise. We prospectively examined sitting time and mortality in a representative sample of 17,013 Canadians 18-90 yr of age. Evaluation of daily sitting time (almost none of the time, one fourth of the time, half of the time, three fourths of the time, almost all of the time), leisure time physical activity, smoking status, and alcohol consumption was conducted at baseline. Participants were followed prospectively for an average of 12.0 yr for the ascertainment of mortality status. There were 1832 deaths (759 of cardiovascular disease (CVD) and 547 of cancer) during 204,732 person-yr of follow-up. After adjustment for potential confounders, there was a progressively higher risk of mortality across higher levels of sitting time from all causes (hazard ratios (HR): 1.00, 1.00, 1.11, 1.36, 1.54; P for trend <0.0001) and CVD (HR:1.00, 1.01, 1.22, 1.47, 1.54; P for trend <0.0001) but not cancer. Similar results were obtained when stratified by sex, age, smoking status, and body mass index. Age-adjusted all-cause mortality rates per 10,000 person-yr of follow-up were 87, 86, 105, 130, and 161 (P for trend <0.0001) in physically inactive participants and 75, 69, 76, 98, 105 (P for trend = 0.008) in active participants across sitting time categories. These data demonstrate a dose-response association between sitting time and mortality from all causes and CVD, independent of leisure time physical activity. In addition to the promotion of moderate-to-vigorous physical activity and a healthy weight, physicians should discourage sitting for extended periods.

The Evolving Definition of "Sedentary"

Article

Nov 2008
EXERC SPORT SCI REV

Studies that did not directly measure sedentary behavior often have been used to draw conclusions about the health effects of sedentariness. Future claims about the effects of sedentary, light, and moderate-to-vigorous activities on health outcomes should be supported by data from studies in which all levels of physical activity are differentiated clearly and measured independently.

Television Time and Continuous Metabolic Risk in Physically Active Adults

Article

May 2008

Among Australian adults who met the public health guideline for the minimum health-enhancing levels of physical activity, we examined the dose-response associations of television-viewing time with continuous metabolic risk variables. Data were analyzed on 2031 men and 2033 women aged > or = 25 yr from the 1999-2000 Australian Diabetes, Obesity and Lifestyle study without clinically diagnosed diabetes or heart disease, who reported at least 2.5 h.wk of moderate- to vigorous-intensity physical activity. Waist circumference, resting blood pressure, and fasting and 2-h plasma glucose, triglycerides, and high-density-lipoprotein cholesterol (HDL-C) were measured. The cross-sectional associations of these metabolic variables with quartiles and hours per day of self-reported television-viewing time were examined separately for men and for women. Analyses were adjusted for age, education, income, smoking, diet quality, alcohol intake, parental history of diabetes, and total physical activity time, as well as menopausal status and current use of postmenopausal hormones for women. Significant, detrimental dose-response associations of television-viewing time were observed with waist circumference, systolic blood pressure, and 2-h plasma glucose in men and women, and with fasting plasma glucose, triglycerides, and HDL-C in women. The associations were stronger in women than in men, with significant gender interactions observed for triglycerides and HDL-C. Though waist circumference attenuated the associations, they remained statistically significant for 2-h plasma glucose in men and women, and for triglycerides and HDL-C in women. In a population of healthy Australian adults who met the public health guideline for physical activity, television-viewing time was positively associated with a number of metabolic risk variables. These findings support the case for a concurrent sedentary behavior and health guideline for adults, which is in addition to the public health guideline on physical activity.

Standardized use of the terms “sedentary” and “sedentary behaviours”

No full-text available

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