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The cross‐sectional associations between objectively measured sedentary time and cardiometabolic health markers in adults – a systematic review with meta‐analysis component
Abstract
Sedentary time is viewed as an independent risk factor for adverse cardiometabolic health (CMH). No systematic review and meta-analysis on the cross-sectional associations between objectively measured sedentary time and CMH markers has been conducted. PubMed, Scopus and Web of Science Core Collection were searched for papers that examined the cross-sectional association between objectively measured sedentary time and CMH markers in adults. Forty-six papers met the inclusion criteria. The included papers had a combined sample size of 70,576 and an age range of 18–87 years. To examine the effect of increased levels of sedentary time on CMH markers, data on effect sizes and moderators were extracted, where possible. By pooling the unadjusted data from the included papers, increased sedentary time was shown to have a significant detrimental association with fasting glucose (Δ = 0.12, 95% confidence interval [CI]: 0.02, 0.23), fasting insulin (Δ = 0.19, 95% CI: 0.06, 0.32), triglycerides (Δ = 0.25, 95% CI: 0.14, 0.37), high-density lipoprotein cholesterol (Δ = −0.20, 95% CI: −0.28, −0.13) and waist circumference (Δ = 0.25, 95% CI: 0.15, 0.35). How sedentary time was quantified and the device used to measure sedentary time significantly influence the size of the effect reported. Future interventions focused on both decreasing sedentary time and increasing physical activity may be the most effective strategy to improve CMH.
... Although SB patterns seem to differ across these domains, whether associations between SB and CVD risk measures also differ across domains have been largely overlooked. [14][15][16] This research gap is of clinical importance as emerging data suggest that occupational PA may increase the risk of CVD, while nonoccupational or leisure-time PA seems to be beneficial. 17 Thus, clarification of the relationship between domain-specific SB and CVD risk measures is important to inform comprehensive interventions that modify SB and PA within a particular domain such as work. ...
... The epidemiological relationships between SB and resting BP were previously summarized in systematic reviews and meta-analyses. 14,18 In these reports, only self-reported SB, without examining the role of domain, was associated with higher BP. 18 On the other hand, devicemeasured SB did not correlate to BP, especially when adjusting for MVPA. ...
... First, we used best practice, thigh-worn accelerometer measures of SB with an accompanying time use diary to accurately determine time spent in different domains of SB. This was an improvement from many previous studies that examined the associations of SB with CVD risk measures by using self-reported instruments or hip/wrist worn monitors, [14][15][16]18 which have lower accuracy for measuring SB. 49 Furthermore, most previous studies have been agnostic to the domain in which SB is accumulated. We also implemented the gold standard noninvasive measure of arterial stiffness, PWV captured using tonometry. ...
Objectives:
We assessed sedentary behavior (SB) patterns and examined its associations, by domain, with cardiovascular disease (CVD) risk measures in desk workers (n = 273).
Methods:
SB was measured by activPAL3 and partitioned into occupational and non-occupational SB. CVD risk measures included blood pressure, pulse wave velocity, heart rate, and heart rate variability. Paired-t-tests evaluated patterns of SB across domains. Linear regressions estimated associations of occupational and non-occupational SB with CVD risk measures.
Results:
Participants spent 69% of their time in SB; higher proportions were accumulated during occupational vs. non-occupational time. Higher all-domain SB was only associated with higher pulse wave velocity. Paradoxically, greater non-occupational SB unfavorably associated with CVD risk measures, while higher occupational SB favorably correlated to CVD risk measures.
Conclusions:
Observed paradoxical associations suggest that domain should be considered in efforts to improve cardiovascular health by reducing SB.
... No obstante, habría que esperar varios siglos para conocer mejor los riesgos potenciales del sedentarismo. No es sino a partir de la mitad de la década del 50 del siglo pasado cuando se empieza a conocer con rigurosidad científica la relación entre inactividad física y riesgo de enfermedad crónica (8) y con ello se incrementa el interés en su estudio e investigación en razón de la evidencia fisiopatológica de efectos adversos específicos, propios de esta condición que cursan con la aparición de afecciones cardiometabólicas como la obesidad, diabetes mellitus tipo 2 (DM2), hipertensión arterial (HTA), aterosclerosis y la enfermedad cardiovascular aterosclerótica (ECVA) (1,2,9,10) con sus dos grandes expresiones clínicas: la enfermedad arterial coronaria (EAC) y la enfermedad vascular cerebral. Más aún, hoy conocemos que al igual que la actividad física, pero en sentido contrario, la conducta sedentaria también muestra una relación del tipo dosis/respuesta, es decir, mayor tiempo sedentario se traduce en mayor riesgo de mortalidad y/o desenlaces adversos, especialmente cardiometabólicos. ...
... Más aún, hoy conocemos que al igual que la actividad física, pero en sentido contrario, la conducta sedentaria también muestra una relación del tipo dosis/respuesta, es decir, mayor tiempo sedentario se traduce en mayor riesgo de mortalidad y/o desenlaces adversos, especialmente cardiometabólicos. Aparte además, que a mayor tiempo viviendo bajo una conducta sedentaria, hay una mayor agregación de los factores de riesgo cardiovascular (1,2,9,10) . ...
... Las consecuencias clínicas del sedentarismo sobre los diversos sistemas del organismo son amplias y conexas entre sí, resumidas a continuación (1,9,10,14,(21)(22)(23)(24)(25)(26) : ...
Sedentary behavior is spreading among society, especially since the rise of technology and progress. The sedentary lifestyle habits are being transmitted to young people, who increase the time they spend in sedentary activities like video games or TV. It has been demonstrated that both sedentary behavior and physical inactivity have negative cardiometabolic consequences for the health, and they become a serious problem for public health, as it has been claimed in several studies and by scientific statements. This review intent to make a call of attention to this problem that will have profound impact in the near future in many countries in Latin America.
... However, it would take several centuries to better understand the potential risks of a sedentary lifestyle. It is not until the middle of the 1950s that the close relationship between physical inactivity and risk of chronic disease is known with scientific rigor [8]; in consequence, the interest and research on sedentarism has increased due to of the pathophysiological evidence of specific adverse effects that occur with the appearance of cardiometabolic conditions such as obesity, type 2 diabetes mellitus (T2DM), high blood pressure (HBP), atherosclerosis and atherosclerotic cardiovascular disease (ACVD) [1,2,9,10] with its two major clinical expressions: coronary artery disease (CAD) and cerebral vascular disease. Furthermore, today we know that just like physical activity, sedentary behavior also shows a dose/response relationship, but in the opposite direction; more sedentary time translates into a higher risk of mortality and / or adverse outcomes, especially cardiometabolic ones; indeed, the longer the sedentary behavior, the greater aggregation and burden of cardiometabolic risk factors will be [1,2,[9][10][11]. ...
... It is not until the middle of the 1950s that the close relationship between physical inactivity and risk of chronic disease is known with scientific rigor [8]; in consequence, the interest and research on sedentarism has increased due to of the pathophysiological evidence of specific adverse effects that occur with the appearance of cardiometabolic conditions such as obesity, type 2 diabetes mellitus (T2DM), high blood pressure (HBP), atherosclerosis and atherosclerotic cardiovascular disease (ACVD) [1,2,9,10] with its two major clinical expressions: coronary artery disease (CAD) and cerebral vascular disease. Furthermore, today we know that just like physical activity, sedentary behavior also shows a dose/response relationship, but in the opposite direction; more sedentary time translates into a higher risk of mortality and / or adverse outcomes, especially cardiometabolic ones; indeed, the longer the sedentary behavior, the greater aggregation and burden of cardiometabolic risk factors will be [1,2,[9][10][11]. ...
... The clinical consequences of a sedentary lifestyle on the various systems of the body are extensive and interconnected, summarized below [1,9,10,14,[22][23][24][25][26][27][28][29][30]: 1) Metabolic: Obesity, decreased sensitivity to insulin, T2DM, dyslipidemia, metabolic syndrome, hyperuricemia. 2) Cardiovascular: Atherosclerosis, coronary heart disease, unstable angina, myocardial infarction, heart failure, stroke, intermittent claudication, thrombosis, and arterial hypertension. ...
Sedentary behavior is spreading in society, a phenomenon especially aggravated by the rise of modern technology. Sedentary lifestyle habits are being adopted by young people, who increase the time they spend in stationary activities like video games, TV and, most recently handheld digital devices like smartphones and tablets. Today many daily activities can be carried out without greater muscular activity, transforming an active and dynamic being into a sedentary one, with less energy expenditure. It has been demonstrated that both sedentary behavior and physical inactivity impact negatively on cardiometabolic well-being, and they become a serious problem for public health, as it has been claimed in several studies and by scientific statements. People need to reduce the amount of time they waste being sedentary, especially during infancy and youthhood to avoid the increase in cardiometabolic risk during adulthood and reach the advanced age with a better functional capacity and more active. Further observational and experimental studies are needed to define relationships between total sedentary time and patterns of sedentary time with biomarkers of cardiometabolic risk and its impact on health outcomes. This review intends to outline the facts of sedentarism as a cardiometabolic risk factor specially in youngest people and claim for more attention by medical care to this problem.
... The progression of atherosclerosis and incidence of CVD is largely attributable to haemodynamic, chemical and behavioural risk factors such as high blood pressure, increased low-density lipoprotein cholesterol (LDL-C), high glucose, increased adiposity, smoking and low levels of physical activity (defined as any bodily movement resulting in energy expenditure) [6][7][8][9]. Sedentary behaviour refers to a low energy expenditure (≤1.5 METs) while in a reclined, lying or seated posture during waking hours [10]. Technological advances and changes in society have led to significant increases in sedentary time in the general population. ...
... There is a growing evidence base of observational studies exploring the associations of sedentary behaviour with CVD risk markers [7,17]. Findings from the Nord-Trondelag Health (HUNT) study demonstrated that self-reported sitting ≥10 h per day was significantly associated with adverse CVD risk marker levels (body mass index (BMI), waist circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides and non-fasting glucose) compared with sitting <4 h per day [18]. ...
... It could be argued that the most convincing evidence supporting the theory that sedentary time is adversely associated with cardiovascular risk is from meta-analyses that pool data from the available evidence to provide greater statistical power. A meta-analysis of 46 studies including 70,576 participants aged 18-87 years reported that increasing device-measured total sedentary time was associated with higher fasting glucose, fasting insulin, triglycerides, waist circumference and lower HDL-C [7]. ...
Cardiovascular disease (CVD) is highly prevalent and can lead to disability and premature mortality. Sedentary behaviour, defined as a low energy expenditure while sitting or lying down, has been identified as an independent risk factor for CVD. This article discusses (1) the association of total sedentary time and patterns of accumulating sedentary time with CVD risk markers, CVD incidence and mortality; (2) acute experimental evidence regarding the acute effects of reducing and breaking up sedentary time on CVD risk markers; and (3) the effectiveness of longer-term sedentary behaviour interventions on CVD risk. Findings suggest that under rigorously controlled laboratory and free-living conditions, breaking up sedentary time improves cardiovascular risk markers in individuals who are healthy, overweight or obese, or have impaired cardiovascular health. Breaking up sedentary time with walking may have the most widespread benefits, whereas standing breaks may be less effective, especially in healthy individuals. There is also growing evidence that sedentary behaviour interventions may benefit cardiovascular risk in the longer term (i.e., weeks to months). Reducing and breaking up sedentary time may, therefore, be considered a target for preventing and managing CVD. Further research is needed to determine the effectiveness of sedentary behaviour interventions over the long-term to appropriately inform guidelines for the management of CVD.
... Although compositional data analysis approaches can address co-dependency of PA intensities, it remains common to collapse detailed PA intensity information into broad summary variables (e.g. time spent in moderate-to-vigorous intensity activity, sedentary time) using pre-defined cutpoints to give behavioural and biological meaning (Whitaker et al., 2019;Swindell et al., 2018;Powell et al., 2018;LaMonte et al., 2017;Alessa et al., 2017;Brocklebank et al., 2015;Henson et al., 2013;Healy et al., 2008;Healy et al., 2007). While this approach can lead to more easily interpretable messages, it can lead to loss of information and, importantly, pre-supposes which intensities are most important to examine with respect to health, rather than letting this information arise in a data-driven manner (Rowlands, 2018;Troiano et al., 2014;Trost, 2007). ...
... However, it is unclear whether the relative importance of more vigorous intensity activity seen in children holds true in middle-aged to older adults, who generally accumulate much less vigorous PA (Strain et al., 2020;Whitaker et al., 2019;Swindell et al., 2018;Powell et al., 2018;LaMonte et al., 2017;Alessa et al., 2017;Brocklebank et al., 2015;Henson et al., 2013;Healy et al., 2008;Healy et al., 2007). The influence of confounding factors on PA intensity associations with CMR, as well as potential sex differences, may also be more pertinent factors to consider in adult populations. ...
... These studies suggest that associations with CMR are strongest for time spent at the 'vigorous' end of the intensity spectrum, with weaker associations for 'moderate' intensities, and more trivial associations for time spent in 'light' intensity or 'sedentary' activities (Aadland et al., 2018a;Aadland et al., 2020a;Aadland et al., 2018b;Aadland et al., 2019c). The current findings in middle-aged to older adults are consistent with recent guidelines Bull and Willumsen, 2020;UK Chief Medical Officers' Physical Activity Guidelines, 2019;Piercy et al., 2018), and previous research using more traditional analytical approaches, and support the potential benefits to cardiometabolic health of encouraging both light and moderate-to-vigorous intensity PA (Whitaker et al., 2019;Swindell et al., 2018;Powell et al., 2018;LaMonte et al., 2017;Healy et al., 2007). Notably, the analytical approach used here allowed us to model relationships with CMR across the full PA intensity spectrum in more detail than has previously been done in adults, without the implications associated with only using a few pre-defined PA intensity categories covering wide ranges (Rowlands, 2018;Troiano et al., 2014;Aadland et al., 2019a). ...
Accelerometers provide detailed data about physical activity (PA) across the full intensity spectrum. However, when examining associations with health, results are often aggregated to only a few summary measures [e.g. time spent “sedentary” or “moderate-to-vigorous” intensity PA]. Using multivariate pattern analysis, which can handle collinear exposure variables, we examined associations between the full PA intensity spectrum and cardiometabolic risk (CMR) in a population-based sample of middle-aged to older adults. Participants (n = 3660; mean ± SD age = 69 ± 8y and BMI = 26.7 ± 4.2 kg/m²; 55% female) from the EPIC-Norfolk study (UK) with valid accelerometry (ActiGraph-GT1M) data were included. We used multivariate pattern analysis with partial least squares regression to examine cross-sectional multivariate associations (r) across the full PA intensity spectrum [minutes/day at 0–5000 counts-per-minute (cpm); 5 s epoch] with a continuous CMR score (reflecting waist, blood pressure, lipid, and glucose metabolism). Models were sex-stratified and adjusted for potential confounders. There was a positive (detrimental) association between PA and CMR at 0-12 cpm (maximally-adjusted r = 0.08 (95%CI 0.06–0.10). PA was negatively (favourably) associated with CMR at all intensities above 13 cpm ranging between r = −0.09 (0.07–0.12) at 800-999 cpm and r = −0.14 (0.11–0.16) at 75–99 and 4000-4999 cpm. The strongest favourable associations were from 50 to 800 cpm (r = 0.10–0.12) in men, but from ≥2500 cpm (r = 0.18–0.20) in women; with higher proportions of model explained variance for women (R² = 7.4% vs. 2.3%). Most of the PA intensity spectrum was beneficially associated with CMR in middle-aged to older adults, even at intensities lower than what has traditionally been considered “sedentary” or “light-intensity” activity. This supports encouragement of PA at almost any intensity in this age-group.
... Available data suggest that ST is detrimental to cardiometabolic health [18] and is associated with increased risk of all-cause mortality in adults [19,20]. Regarding adults' physical fitness, evidence shows that larger amounts of ST are associated with lower muscular strength [21][22][23][24], lower CRF [25][26][27][28] and lower balance [21,29]. ...
... Even though some studies have focused on this topic, the associations between total ST and physical fitness components are still unclear. Moreover, it should be noted that a lot of studies employ subjective measures of ST, which are known to reduce data accuracy significantly, because of misreporting and recall bias [18,36]. Furthermore, cultural and linguistic issues in the interpretation of questions and/or concepts used could make comparability between countries and cultures difficult [17]. ...
... According to the results of individual studies, 8 of 13 studies included found a significant negative association [22,[25][26][27]49,50,54,55], whereas 5 studies found no association [33][34][35]51,53]. These discrepancies between studies may be attributable, at least in part, to the heterogeneity of the participants from the different study samples analyzed and the characteristics of device/ data reduction procedures [18,58]. Studies carried out by Gennuso et al. [51] and Silva et al. [53] had a reduced sample size when compared with all the other studies. ...
Background: Sedentary behavior has been considered an independent risk factor to health. The aim of this systematic review and meta-analysis was to examine associations between objectively measured sedentary time and physical fitness components in healthy adults. Methods: Four electronic databases (Web of Science, Scopus, Pubmed and Sport Discus) were searched (up to 20 September 2020) to retrieve studies on healthy adults which used observational, cohort and cross-sectional designs. Studies were included if sedentary time was measured objectively and examined associations with the health-or skill-related attributes of physical fitness (e.g., muscular strength, cardiorespiratory fitness, balance). After applying additional search criteria, 21 papers (11,101 participants) were selected from an initial pool of 5192 identified papers. Results: Significant negative associations were found between total sedentary time with cardiorespiratory fitness (r = −0.164, 95%CI: −0.240, −0.086, p < 0.001), muscular strength (r = −0.147, 95%CI: −0.266, −0.024, p = 0.020) and balance (r = −0.133, 95%CI: −0.255, −0.006, p = 0.040). Conclusions: The evidence found suggests that sedentary time can be associated with poor physical fitness in adults (i.e., muscular strength, cardiorespiratory fitness and balance), so strategies should be created to encourage behavioral changes.
... Higher levels of sitting time have been shown to be associated with greater diseases of the heart and blood vessels and with premature mortality (Biswas et al., 2015;Patterson et al., 2018;Powell et al., 2018;Wilmot et al., 2012). This is a world-wide phenomenon occurring both in developed and developing countries (Roth et al., 2017). ...
... Time spent in cars was found to be associated with cardiovascular mortality, clustered cardio-metabolic risk score, and fasting plasma glucose, but not with 2-hr postload plasma glucose, blood lipids, blood pressure, and the number of chronic condition (Russell and Chase, 2019;Sugiyama et al., 2016;Warren et al., 2010). A recent review with meta-analysis summarised the findings on associations of device-measured sedentary time with markers of cardiovascular risk and found evidence of adverse associations of sitting time with blood glucose and blood lipid measures but not with blood pressure (Powell et al., 2018). One study included in the current review also examined blood profile and produced findings consistent with the meta-analysis only in blood pressure for which there was no evidence supporting associations with car use (Sugiyama et al., 2016). ...
... The number of studies examining effect modification is limited, but the findings seem to suggest that the association of car use and body weight may be more pronounced for men and in younger (working-age) adults. The review on device-based measures of sedentary behaviour and cardiovascular risk did not find any evidence of effect modification by gender for waist circumference (Powell et al., 2018). Men tend to drive for a longer duration (e.g., for commuting) than women (Australian Bureau of Statistics, 2018): the gender difference in the duration of bouts may be a contributor to the differential associations. ...
Introduction
Time spent sitting in cars is a prevalent form of sedentary behaviour. Overall time spent sitting and specific sedentary behaviours such as TV viewing have been shown to be associated with cardiovascular disease – a major contributor to premature death. A previous review found that motor vehicle use (including public transport) was associated with obesity. We update the relevant evidence base, focusing specifically on car use as the risk exposure, and expanding the outcomes to relevant indices of cardiovascular disease risk including obesity.
Methods
The initial search using four databases (Web of Science, Scopus, Medline, and Transport Research International Documentation) produced 3481 hits. After screening and excluding articles included in the previous review, nine articles were found eligible for review. Of these, five examined cross-sectional associations, three examined longitudinal associations, and one examined both.
Results
One study found longer car use to be related to higher risk of cardiovascular disease as a cause of death. Six out of six cases examining relationships of car use duration with obesity-related outcomes reported significant detrimental associations. However, car use frequency was associated with obesity outcomes in only one out of four cases. Findings were mixed or null for other cardiovascular disease risk markers (blood glucose, blood lipids, blood pressure and composite risk indices. Studies examining effect modification by gender and age found associations of car use with obesity to be more pronounced in men and working-age adults, relative to women and older adults.
Conclusion
This review found strong evidence supporting detrimental associations of prolonged car use with obesity. However, none of the studies used device-measured time spent sitting in cars. Robust evidence of health risk associated with car use can inform initiatives to lower high levels of car dependency, which is an important goal of the transport and health sectors.
... Sedentary behavior (SB) is associated with poor health outcomes, including mortality, diabetes mellitus, and cardiovascular events in the general population (1). SB is defined as any waking behavior characterized by an energy expenditure of ≤1.5 metabolic equivalents and a sitting or reclining posture (e.g., television viewing, computer use, reading, and driving) (2). ...
... Greene et al (15) focused exclusively on pain intensity and employed a self-report method of SB measurement. Such subjective measurements are known to be at risk of measurement bias due to misreporting and recall bias (1,16). Objective measurement of SB using accelerometers has become more feasible and affordable and, importantly, is more rigorous and addresses some of the limitations of selfreport methods (1). ...
... Such subjective measurements are known to be at risk of measurement bias due to misreporting and recall bias (1,16). Objective measurement of SB using accelerometers has become more feasible and affordable and, importantly, is more rigorous and addresses some of the limitations of selfreport methods (1). Accelerometers are small, lightweight devices that record data on movement patterns continuously over several days (16). ...
Objective
Despite the known benefits of physical activity, high numbers of individuals with rheumatoid arthritis (RA) remain physically inactive and sedentary. Little is known about the determinants of sedentary behavior (SB) in RA. This cross‐sectional study was undertaken to examine a range of pain characteristics and RA‐related symptoms and their relationship with objectively measured SB.
Methods
In total, 76 adults with RA wore an activPAL4 accelerometer (PAL Technologies) over a 7‐day period. Pain characteristics (pain intensity, painful joint count, nonarticular pain), fatigue, sleep, depression, anxiety, and disease activity were assessed. Analyses were first conducted to evaluate correlations with sedentary time. The independent contribution of pain characteristics to variation in SB was analyzed with multivariable linear regression (adjusted for demographic data and disease activity).
Results
Participants with valid accelerometer data (n = 72) spent a mean ± SD of 533.7 ± 100.1 minutes/day in SB. Positive associations with daily SB were found for pain intensity (r = 0.31, P < 0.01) and number of painful joints (r = 0.24, P < 0.05) but not nonarticular pain. In multivariable analyses, pain characteristics were not independently associated with SB. Analyses indicated that disease activity had an indirect association with SB mediated by pain intensity. Other correlates of daily SB included anxiety and depression but not fatigue or sleep.
Conclusion
Results suggest that while pain and other RA‐related factors do play a role in SB, they do not appear to have a significant influence after accounting for other variables. Future research should investigate SB and the role of factors unrelated to the symptoms of RA.
... MVPA is defined based on the intensity of the activity and typically requires individuals to use at least three (moderate) or six (vigorous) times as much energy per minute as they would do when sitting quietly (16). Other studies show that additional forms of activity related energy expenditure (i.e., LiPA, standing) or reducing sedentary time, or both, are associated with health benefits (17)(18)(19). ...
... p < 0.001), more active (activPAL MVPA mins (10 min bouts) 32.12 vs. 13.06, p < 0.001) and more males (29.9% vs. 19.6%, p < 0.01) than included. ...
Background
Move for Life (MFL) is a theory-informed intervention that was developed to augment established physical activity (PA) programmes and enable inactive adults aged 50 years and older to be more active. This study examined the feasibility of MFL and sought to provide evidence of its potential for improving PA and associated health outcomes.
Methods
A 3-arm cluster randomised feasibility trial compared MFL intervention, usual provision (UP) and control (CON) groups at baseline (T0), post-intervention (T1, at 8, 10 or 12- weeks) and 6-month follow up (T2). We used purposive sampling strategies to recruit participants according to characteristics of interest. Feasibility outcomes assessed recruitment, fidelity, adherence, retention and data completion rates based on pre-set criteria. Primary outcomes were accelerometer-based moderate-to-vigorous intensity PA (MVPA) and self-reported compliance with physical activity guidelines (PAGL). Secondary outcomes included light intensity PA (LiPA), standing time, sedentary time, body composition (adiposity), physical function and psychological well-being. We used linear mixed models (continuous outcomes) or generalized estimated equations (categorical outcomes) to estimate group differences over time in the study outcomes.
Results
Progression criteria for feasibility outcomes were met, and 733 individuals were recruited. Considering a 6-month period (T0-T2), while self-reported compliance with PAGL increased in MFL relative to UP and CON and in UP relative to CON, standing time decreased in MFL relative to CON and sedentary time increased in the latter compared to UP. Waist circumference decreased in MFL relative to UP and CON. MFL outperformed UP in the Timed Up and Go Test while MFL and UP increased the distance covered in the Six-Minute Walk Test compared to CON. Psychological well-being increased in MFL relative to CON (all p < 0.05).
Conclusion
Findings show that MFL is feasible, while data are promising with regards to the potential of improving community PA programmes for adults aged 50 or more years.
Clinical trial registration
https://www.isrctn.com/Registration#ISRCTN11235176.
... The Baecke Habitual Physical Activity Questionnaire has 16 individual items, all of which are ranked on a fivepoint scale 10 . The total sum score of the questionnaire (Baecke Score, [3][4][5][6][7][8][9][10][11][12][13][14][15] as well as Work, Leisure, and Sport Indexes (1)(2)(3)(4)(5) were calculated based on the individual items 10 . Additionally, as the Sport Index correlated poorly with the accelerometry, the Work and Leisure Indexes were combined to further elucidate the correlations. ...
... The Baecke Habitual Physical Activity Questionnaire has 16 individual items, all of which are ranked on a fivepoint scale 10 . The total sum score of the questionnaire (Baecke Score, [3][4][5][6][7][8][9][10][11][12][13][14][15] as well as Work, Leisure, and Sport Indexes (1)(2)(3)(4)(5) were calculated based on the individual items 10 . Additionally, as the Sport Index correlated poorly with the accelerometry, the Work and Leisure Indexes were combined to further elucidate the correlations. ...
Physical activities and sedentary behaviors take place in different contexts. This study aimed to determine if the context, total score, and leisure-time MET-index assessed by the Baecke questionnaire associate with each other or with sedentary behavior and physical activity outcomes from a 4-week accelerometer measurement in physically inactive adults with overweight. The item “After working I am tired” correlated negatively with items related to leisure-time physical activity and sports participation. The total Baecke Score showed weak but significant correlations with accelerometer-measured sedentary behavior, physical activity, daily steps, and mean activity intensity of the day (r = − 0.33, 0.41, 0.35, and 0.41, respectively). The associations strengthened when the Sport Index was omitted from the Score. The leisure-time MET-Index did not correlate with accelerometer-measured sedentary behavior or physical activity. Tiredness after working associated with less self-reported physical activity during leisure time. This suggests that better recovery from work-related stress could increase leisure-time physical activity, or increasing leisure-time physical activity could reduce tiredness after working. Moreover, among self-reportedly inactive adults with overweight, focusing the questionnaire on work and non-sport leisure time instead of total time might give more accurate estimates of sedentary behavior and physical activity when compared to accelerometry.
The study is registered at ClinicalTrials.gov (NCT03101228, 05/04/2017).
... Older adults have been reported to spend approximately 5-9 hr/day being sedentary, depending on how the behavior is defined and assessed (Harvey, Chastin, & Skelton, 2015). Increased sedentary time is associated with increased adiposity, cardiovascular disease, and all-cause mortality (Ekelund et al., 2019;Elhakeem et al., 2018;Powell et al., 2020;Powell, Herring, Dowd, Donnelly, & Carson, 2018). In addition, previous work by Powell et al. (2020) highlighted that older adults spend a considerable proportion of time in PA behaviors of low intensity, including standing (5.3 hr/ day) and light-intensity physical activity (LIPA) (1.7 hr/day). ...
... Put simply, there is a positive relationship between fat mass and fat-free mass, which could be due to several factors, including increased organ size (Naeye & Roode, 1970) and blood volume (Messerli, 1982; both which would be classified under fatfree mass) of obese individuals, compared with their nonobese counterparts. Prolonged sitting is not something that the authors would endorse, given the extensive literature around the detrimental association between sitting/sedentary time, and a whole host of cardiometabolic health markers (Bellettiere et al., 2017;Carson et al., 2014;Gennuso, Gangnon, Thraen-Borowski, & Colbert, 2015;Healy et al., 2015;Powell et al., 2020;Powell et al., 2018). This may be something that was specific and unique to the included sample. ...
Aside from total time spent in physical activity behaviors, how time is accumulated is important for health. This study examined associations between sitting, standing, and stepping bouts, with cardiometabolic health markers in older adults. Participants from the Mitchelstown Cohort Rescreen Study ( N = 221) provided cross-sectional data on activity behaviors (assessed via an activPAL3 Micro) and cardiometabolic health. Bouts of ≥10-, ≥30-, and ≥60-min sitting, standing, and stepping were calculated. Linear regression models were fitted to examine the associations between bouts and cardiometabolic health markers. Sitting (≥10, ≥30, and ≥60 min) and standing (≥10 and ≥30 min) bouts were detrimentally associated with body composition measures, lipid markers, and fasting glucose. The effect for time spent in ≥60-min sitting and ≥30-min standing bouts was larger than shorter bouts. Fragmenting sitting with bouts of stepping may be targeted to benefit cardiometabolic health. Further insights for the role of standing need to be elicited.
... Prolonged sitters had no significant differences in the cardiometabolic health markers compared to Couch potatoes, when the models were adjusted for all potential confounders, even though their sedentary breaks included more LPA and MVPA time and were longer in duration. This finding, overall, accords with findings of existing studies, likewise reporting that accumulating sedentary time in uninterrupted bouts is detrimentally associated with cardiometabolic health outcomes 37 and mortality risk 38 in adults. However, our results further indicate that longer sedentary breaks after prolonged sedentary bouts, at least to the extent that was performed in this sample of adults, may not alone be adequate to have favorable differences in cardiometabolic health markers compared with Couch potatoes. ...
... Currently, little is known about the underlying mechanisms by which prolonged sedentary time may cause detrimental changes to cardiometabolic outcomes. 37 Hence, epidemiological evidence is continuing to accumulate that frequent sedentary breaks could be beneficial for counteracting such detrimental changes to cardiometabolic health markers in adults caused by sedentary time. [3][4][5]31,32 Experimental studies have generally supported this evidence and shown that avoiding prolonged sedentary bouts with light-intensity activities (eg, walking) could be beneficial for cardiometabolic health in adults. ...
Breaking up sedentary time with physical activity (PA) could modify the detrimental cardiometabolic health effects of sedentary time. Our aim was to identify profiles according to distinct accumulation patterns of sedentary time and breaks in adults, and to investigate how these profiles are associated with cardiometabolic outcomes. Participants (n = 4439) of the Northern Finland Birth Cohort 1966 at age 46 years wore a hip‐worn accelerometer for 7 consecutive days during waking hours. Uninterrupted ≥1‐min sedentary bouts were identified, and non‐sedentary bouts in between two consecutive sedentary bouts were considered as sedentary breaks. K‐means clustering was performed with 65 variables characterizing how sedentary time was accumulated and interrupted. Linear regression was used to determine the association of accumulation patterns with cardiometabolic health markers. Four distinct groups were formed as follows: “Couch potatoes” (n = 1222), “Prolonged sitters” (n = 1179), “Shortened sitters” (n = 1529), and “Breakers” (n = 509). Couch potatoes had the highest level of sedentariness and the shortest sedentary breaks. Prolonged sitters, accumulating sedentary time in bouts of ≥15–30 min, had no differences in cardiometabolic outcomes compared with Couch potatoes. Shortened sitters accumulated sedentary time in bouts lasting <15 min and performed more light‐intensity PA in their sedentary breaks, and Breakers performed more light‐intensity and moderate‐to‐vigorous PA. These latter two profiles had lower levels of adiposity, blood lipids, and insulin sensitivity, compared with Couch potatoes (1.1–25.0% lower values depending on the cardiometabolic health outcome, group, and adjustments for potential confounders). Avoiding uninterrupted sedentary time with any active behavior from light‐intensity upwards could be beneficial for cardiometabolic health in adults.
... There is increasing interest among researchers and health care providers in objective methods for measuring sedentary time and patterns; such measurements have been most commonly achieved using hip-worn accelerometers. In a review of 46 studies of sedentary behavior using objective measurement methods, 34 utilized a hip-worn accelerometer; 31 out of these 34 used an ActiGraph device (Powell, Herring, Dowd, Donnelly, & Carson, 2018). Objective measurement of an adult's sedentary time from hip-worn accelerometers is most often quantified using a cut-point-based threshold of <100 counts/min that is applied to the vertical axis (Migueles et al., 2017), even on triaxial accelerometers. ...
... Ground truth activity labels were produced from a thigh-mounted activPAL device (PAL Technologies, Glasgow, Scotland, United Kingdom), which contains starting and ending events of standing, stepping, and sitting. ActivPAL has been shown to be a good measure of sitting time and of sit-stand transitions and has been used in previous studies for ground truth posture labeling (Barreira et al., 2015;Carlson et al., 2019;Kerr et al., 2018;Powell et al., 2018). ...
Background:
Machine learning has been used for classification of physical behavior bouts from hip-worn accelerometers; however, this research has been limited due to the challenges of directly observing and coding human behavior "in the wild." Deep learning algorithms, such as convolutional neural networks (CNNs), may offer better representation of data than other machine learning algorithms without the need for engineered features and may be better suited to dealing with free-living data. The purpose of this study was to develop a modeling pipeline for evaluation of a CNN model on a free-living data set and compare CNN inputs and results with the commonly used machine learning random forest and logistic regression algorithms.
Method:
Twenty-eight free-living women wore an ActiGraph GT3X+accelerometer on their right hip for 7 days. A concurrently worn thigh-mounted activPAL device captured ground truth activity labels. The authors evaluated logistic regression, random forest, and CNN models for classifying sitting, standing, and stepping bouts. The authors also assessed the benefit of performing feature engineering for this task.
Results:
The CNN classifier performed best (average balanced accuracy for bout classification of sitting, standing, and stepping was 84%) compared with the other methods (56% for logistic regression and 76% for random forest), even without performing any feature engineering.
Conclusion:
Using the recent advancements in deep neural networks, the authors showed that a CNN model can outperform other methods even without feature engineering. This has important implications for both the model's ability to deal with the complexity of free-living data and its potential transferability to new populations.
... The negative effects of sedentary behaviour (SB) and a lack of physical activity (PA) on health have been well documented [1][2][3][4][5][6][7][8]. SB is defined as any waking time activity during which one is seated, reclined or lying, having an energy expenditure ≤1.5 metabolic equivalents (METs), while PA is defined as any activity with an energy expenditure > 1.5 METs [9][10][11]. ...
... High levels of SB are associated with a 112% increase in the risk of diabetes, 147% increase in the risk of cardiovascular disease, 90% increase in the risk of cardiovascular mortality and 49% increase in the risk of all-cause mortality [4]. In addition, SB has detrimental associations with fasting glucose, fasting insulin, triglycerides, high-density lipoprotein cholesterol and waist circumference [1]. ...
Background:
High levels of sedentary behaviour (SB) are associated with non-communicable diseases. In 2016, the estimated total healthcare expenditure from physical activity (PA) in Thailand added up to $190 million in international dollars. The challenge to reduce SB and increase PA among office workers is more urgent now than ever as Thailand is transforming itself from a predominantly rural country to an increasingly urban one. This study will investigate the effectiveness of a multicomponent short break intervention on the reduction of SB during office hours.
Methods/design:
This two-armed Physical Activity at Work (PAW) cluster randomised controlled trial will recruit 360 office workers from 18 offices in the Thailand's Ministry of Public Health (MOPH). Offices will be randomised to either the intervention group or the control group. The multicomponent intervention is informed by the Social Ecological Model and Behaviour Change Techniques (BCTs) and contains four components: (i) organisational, including heads of the participating divisions leading exercises, sending encouragement text messages and acknowledging efforts; (ii) social, including team movement breaks and team-based incentives; (iii) environmental, including posters to encourage exercise; and (iv) individual components including real-time PA feedback via an individual device. The main intervention component will be a short break intervention. The primary outcome of this study is the sedentary time of office workers. Secondary outcomes include time spent on PA, cardiometabolic outcomes, work productivity, musculoskeletal pain, and quality of life. The study also includes process and economic evaluations from the individual and societal perspective.
Discussion:
The study will be the first experimental study in Thailand to investigate the effect of a short-break intervention at the workplace on SBs of office workers and health outcomes. The study will also include a cost-effectiveness analysis to inform investments on short break interventions under the Universal Healthcare Coverage in Thailand, which includes health promotion and disease prevention component.
Trial registration:
The PAW study has been registered at the Thai Clinical Trials Registry (TCTR) under the study ID TCTR20200604007 . Registered 02 June 2020,.
... It increases risk of all-cause mortality, cardiovascular diseases mortality and incidence of type 2 diabetes [29]. A meta-analysis including 70,576 participants aged 18-87 years reported that increasing device-measured total sedentary time was associated with higher fasting glucose, fasting insulin, triglycerides, waist circumference and lower HDL-C [30]. Hypothesized mechanisms by which prolonged sitting may influence risk for hypertension and cardiovascular complications include reduction in metabolic demands and systemic blood flow, and stimulating the sympathetic nervous system which decrease insulin sensitivity and vascular function while promoting oxidative stress and low-grade inflammatory cascade [31]. ...
Introduction and purpose Physical activity protects both physical and mental health. However, widespread physical inactivity is the leading risk factor for global mortality. Despite the promotion of healthy lifestyle, there has been no improvement in global levels of physical activity since 2001. This review aims to present the prevalence of physical activity and inactivity across Poland, the European Union (EU) and the world. This cross-national compilation can be used to create campaigns to raise social awareness around physical activity as well as to help health-care providers encourage patients to limit sedentary time. It provides a reliable comparison and indicates vulnerable points regarding the physical activity levels in our societies that should be monitored in further researches. Additionally, there is a summary of the most important health benefits associated with being more active and health risks arising from prolonged sitting time. Brief description of the state of knowledge World Health Organization (WHO) recommends adults to do at least 150 minutes of moderate-intensity, or 75 minutes of vigorous-intensity physical activity per week (or an equivalent combination of the two). Globally, more than 1 in 4 adults are insufficiently physically active. Summary If current trends in insufficient physical activity continue, the global target of a 15% relative reduction between 2018 and 2030 will not be met for adults. Investing in policies to promote active recreation and transport, creating affordable and safe spaces and conducting national and community-based campaigns play a key role in limitting sedentary behaviour and increasing physical activity.
... Metabolic syndrome (MetS) refers to a set of various cardiometabolic risk factors including dyslipidemias (high triglycerides [TG], low high-density lipoprotein cholesterol [HDL]), high blood pressure, high fasting glucose and central obesity 5,6 . These elements are associated with a high amount of devicemeasured SB 7 , and an increased risk of cardiovascular diseases 8,9 and mortality 10 . ...
The aim of this study was to investigate whether a reduction in accelerometer-measured sedentary behavior (SB) improves blood lipids in inactive adults with metabolic syndrome (MetS). Sixty-four participants were randomly assigned into intervention (INT, n = 33) and control (CONT, n = 31) groups. The INT group was instructed to reduce SB by 1 h/day without increasing formal exercise, whereas the CONT group was advised to maintain usual SB habits. SB and physical activity (PA) were measured with accelerometers throughout the intervention. Plasma lipid concentrations and dietary intake by food diaries were assessed at baseline and at the end of the intervention. High-density lipoprotein percentage of total cholesterol decreased during the intervention similarly in both groups (p = 0.047). Other blood lipids did not change from baseline to six months in either group. The CONT group had a statistically significant reduction in the intake of saturated fatty acids compared to the INT group (p = 0.03). Intervention resulting in a 40-minute reduction in daily SB and 20-minute increase in habitual MVPA seems to not be effective in improving blood lipids in adults with MetS. Reducing SB together with a higher volume and/or intensity of PA and proper nutrition may be needed to reduce the risk of cardiometabolic diseases.
Trial registration. This study is registered at ClinicalTrials.gov (NCT03101228, 05/04/2017). https://www.clinicaltrials.gov/ct2/show/NCT03101228?term=NCT03101228&draw=2&rank=1.
... 10 In addition, SB has detrimental associations with fasting glucose, fasting insulin, triglycerides, high-density lipoprotein cholesterol and waist circumference. 11 A sedentary lifestyle also accelerates secondary ageing of skeletal muscle power. 12 It can also contribute to mood disorders and work dissatisfaction, Open access which in turn can impair productivity. ...
Sedentary behaviour (SB) is associated with an increased risk of metabolic issues (negative effects on diabetes, fasting glucose, fasting insulin, triglycerides, high-density lipoprotein cholesterol and waist circumference), cardiovascular diseases, increased risk of all-cause mortality and accelerated ageing of skeletal muscle power. The research on SB is relatively new, with much evidence regarding its negative health effects gathered within the last decade. Office workers exhibit pronounced sedentary habits, with studies indicating they can spend up to 82% of their working day sitting. To address this issue, workplaces are responsible for promoting physical activity and minimising SB among employees. In this context, one potential strategy for reducing SB and its associated risks could be implementing active breaks (ABs). ABs are defined as brief, structured periods of physical activity or exercise. This quasi-experimental pilot study aims to implement workplace ABs programme aimed at interrupting SB among the University of Bologna (Italy) workers, and it will include both intervention and control groups. The intervention group will participate in an 8-week ABs programme. The findings from this study could establish a robust basis for future large-scale research on the effectiveness of ABs interventions in workplace settings.
... 27,35 Social participation may promote health by influencing health-related behaviors relevant to HD (such as smoking cessation, adherence to medical treatment, and access to health information) on one hand, and psychological processes (such as emotional support and stress management) on the other. 36,37 Furthermore, sedentary behavior has been adversely associated with fasting glucose, triglycerides, high-density lipoprotein cholesterol, and waist circumference, 38 and these risk factors may further decrease insulin sensitivity and impair vascular endothelial-dependent dilation, key antecedents of HD. 39 In our study, high CR was associated with larger LVEDV, LVESV, LVSV, and LVEF, suggesting that CR might reduce HD risk by enhancing left ventricular contractile function and improving the pattern of ventricular remodeling. However, further clinicopathologic research will be needed to identify the structural, biochemical, and molecular mechanisms underlying the ability of CR to improve cardiac pathology. ...
Background
High cognitive reserve (CR) has been related to lower dementia risk, but its association with heart disease (HD) is unknown. We aimed to explore the relation of CR to HD and cardiac structure and function.
Methods and Results
Within the UK Biobank, 349 907 HD‐free participants were followed up. A composite CR indicator involving education/occupation attainment/television viewing time/confiding frequency/social connection frequency/variety of leisure activities was generated, and further categorized into low/moderate/high levels. Incident HD, including coronary HD, cardiac arrhythmia, and heart failure, was ascertained on the basis of medical records. During the follow‐up, a subsample (n=31 182) underwent cardiac magnetic resonance imaging to assess ventricular structure and function. Data were analyzed using Cox regression, Laplace regression, and linear regression. Compared with low CR, the hazard ratio and 95% CI of any HD for high CR was 0.78 (0.75–0.80) (including 0.68 [0.66–0.71] for coronary HD, 0.91 [0.87–0.95] for cardiac arrhythmia, and 0.63 [0.58–0.68] for heart failure). Furthermore, high CR was associated with delayed HD onset by 1.59 (95% CI, 1.37–1.82) years compared with low CR. In cardiac magnetic resonance imaging data analysis, compared with low CR, high CR was associated with larger left ventricular end‐diastolic volume (β, 0.13 [95% CI, 0.09–0.17]), left ventricular end‐systolic volume (β, 0.05 [95% CI, 0.01–0.10]), left ventricular stroke volume (β, 0.16 [95% CI, 0.12–0.21]), and left ventricular ejection fraction (β, 0.08 [95% CI, 0.03–0.13]).
Conclusions
High CR is associated with favorable HD health. Our findings suggest that the beneficial effect of CR is not limited to dementia but also HD.
... During sedentary time, there is no muscle contraction of the legs, which causes decreasing insulin sensitivity, vascular dysfunction, and activation of low-grade inflammatory cascades [14]. As a result, greater total sedentary time is related to increased CVD risk [15], including decreased high-density lipoprotein (HDL) and increased triglycerides (TG), fasting glucose [16], BMI, and waist circumference (WC) [17]. Prolonged sedentary time is also associated with a 12% higher risk of incidental CVD [18] and an increased risk of CVD mortality regardless of PA levels [19,20]. ...
Sedentary behavior, a key modifiable risk factor for cardiovascular disease, is prevalent among cardiovascular disease patients. However, few interventions target sedentary behavior in this group. This paper describes the protocol of a parallel two-group randomized controlled trial for a novel multi-technology sedentary behavior reduction intervention for cardiovascular disease patients (registered at Clinicaltrial.gov, NCT05534256). The pilot trial (n = 70) will test a 12-week “Sit Less” program, based on Habit Formation theory. The 35 participants in the intervention group will receive an instructional goal-setting session, a Fitbit for movement prompts, a smart water bottle (HidrateSpark) to promote hydration and encourage restroom breaks, and weekly personalized text messages. A control group of 35 will receive the American Heart Association’s “Answers by Heart” fact sheets. This trial will assess the feasibility and acceptability of implementing the “Sit Less” program with cardiovascular disease patients and the program’s primary efficacy in changing sedentary behavior, measured by the activPAL activity tracker. Secondary outcomes include physical activity levels, cardiometabolic biomarkers, and patient-centered outcomes (i.e. sedentary behavior self-efficacy, habit strength, and fear of movement). This study leverages commonly used mobile and wearable technologies to address sedentary behavior in cardiovascular disease patients, a high-risk group. Its findings on the feasibility, acceptability and primary efficacy of the intervention hold promise for broad dissemination.
... This study also showed that a lack of physical activity was associated with an increased incidence of diabetes mellitus in the unadjusted model. In line with this study, previous crosssectional studies have also shown that there is a relationship between low physical activity and increased blood glucose levels (Powell et al., 2018;Suliga et al., 2018). Another study stated that in obese subjects with low physical activity, the risk of increased GDP was 1,66 times greater (Suliga et al., 2018). ...
The prevalence of diabetes mellitus (DM) in Indonesia is increasing. A significant risk factor for developing DM is central obesity. Lifestyles, including diet and physical activity, strongly influence the high prevalence of DM and obesity. The study aimed to analyze the association between unhealthy food consumption and physical activity among adults with central obesity in Indonesia. This study used secondary data from Riskesdas 2018 with a cross-sectional design. The subjects in this study were adults (≥ 19 years old) with central obesity. A total of 7493 subjects were included in the analysis. Food intake data were taken using a validated FFQ, and physical activity using the GPAQ questionnaire. The data were analyzed using a chi-square test and multiple logistic regression. Frequent consumption of sweet foods (p=0,001, OR=1,235), sweetened beverages (p=0,042, OR=1,157), carbonated drinks (p=0,001, OR=1,324), instant noodles (p<0,001, OR=1,845), salty foods (p<0,001, OR=1,669), seasoning (p<0,001, OR=1,514), processed meats (p=0,009, OR=1,199), fatty foods (p<0,001, OR=1,687), and grilled foods (p<0,001, OR=1,243) were positively associated with the incidence of DM among adults with central obesity after adjusted with confounding variables. Low physical activity increased the incidence of DM among adults with central obesity in the unadjusted model (p=1,161, OR=1,161). In conclusion, there is a relationship between the consumption of unhealthy foods and physical activity with the incidence of DM in Indonesian adults with central obesity.
... Mynarski et al. investigated the effects of regular physical activities on unemployed or retired patients with type 2 diabetes using an accelerometer and the IPAQ and found that regular daily physical activity did not influence HbA1c levels [56]. Sedentary time (daily/weekly sitting time) was associated with a significantly higher risk of metabolic syndrome [57]. In our study, age was inversely correlated with physical activity level, a result similar to that obtained by Dillman et al. [58]. ...
Modern lifestyles have led to sedentary behavior, lower participation in active movement and physical activities during leisure time, unhealthy diets, and increased exposure to stress. It is important to examine the interaction of several lifestyle risk factors instead of focusing on one alone. The purpose of this study was to identify lifestyle patterns in a group of patients with type 2 diabetes and the associations of its components with certain metabolic parameters. Using principal component analysis, we identified three dietary patterns: the prudent pattern (fat, oil, cereals, potatoes, vegetables, fish, nuts, seeds and fruits), the Western pattern (meat and meat products, eggs and soft drinks) and the traditional pattern (milk and its derivatives, soups and sauces, with a low intake of sugar/snacks). In addition, using the same method of analysis, we identified two lifestyle patterns: the inadequate lifestyle pattern (Western dietary pattern, increased hours of sleep and lower levels of stress) and the traditional lifestyle pattern (traditional dietary pattern, increased physical activity (PA) and non-smoking status). The inadequate lifestyle pattern was associated with younger age, hypertension and diabetic neuropathy. The traditional lifestyle pattern was related to lower postprandial blood glucose levels. Sedentary individuals were more likely to be over 65 years old and to have higher glycated hemoglobin (HbA1c). Smokers were also more likely to have inadequate glycemic and lipid profile control.
... More recent reports show longer daily averages and suggest the problem of sedentary behavior is worsening [3]. Obesity is a known risk factor for premature cardiovascular disease and has been linked to adult sedentary behavior [4,5]. Strong evidence in adults also links sedentary behaviors with adverse cardiovascular disease outcomes [6][7][8][9] and allcause mortality [10][11][12][13][14]. ...
Purpose of Review
Decreasing sedentary behaviors has been proposed as one approach to reduce the rate of obesity in youth. This review summarizes the contemporary literature examining the efficacy of these interventions in the school and community along with an additional focus on the role of socioeconomic status in these interventions.
Recent Findings
Studies that focus on decreasing sedentary behavior have utilized a wide variety of strategies in a number of settings. The effects of these interventions are often hindered by non-standard outcome measures, study infidelity, and subjective measures of sedentary time. However, interventions that incorporate engaged stakeholders and include younger subjects appear to be the most likely to succeed.
Summary
Promising interventions to decrease sedentary behaviors have been shown in recent clinical trials; however, replicating and sustaining these results is challenging. From the available literature, school-based interventions have the potential of reaching the largest group of children. In contrast, interventions in younger children, particularly those with invested parents, seem to be the most effective.
... Metabolic syndrome (MetS) is a lifestyle-related cluster of metabolic disorders that are associated with a sedentary lifestyle and a positive energy balance and can lead to type 2 diabetes and cardiovascular diseases (9). Device-measured SB has been associated with several elements of MetS (10). However, these associations can be mediated by different behavior patterns and the amount of concomitant MVPA (11)(12)(13). ...
Purpose:
To investigate whether a reduction in daily sedentary behavior (SB) improves insulin sensitivity in adults with metabolic syndrome in 6 months, without adding intentional exercise training.
Methods:
Sixty-four sedentary inactive middle-aged adults with overweight and metabolic syndrome [mean age 58 (SD 7) years, mean BMI 31.6 (SD 4.3) kg/m2; 27 men] were randomized into intervention and control groups. The 6-month individualized behavioral intervention supported by an interactive accelerometer and a mobile application aimed at reducing daily SB by 1 h compared to baseline. Insulin sensitivity by hyperinsulinemic euglycemic clamp, body composition by air displacement plethysmography and fasting blood samples were analyzed before and after the intervention. SB and physical activity were measured with hip-worn accelerometers throughout the intervention.
Results:
SB decreased by 40 (95%CI 17-65) min/day and moderate-to-vigorous physical activity increased by 20 (95%CI 11-28) min/day on average in the intervention group with no significant changes in these outcomes in the control group. After 6 months, fasting plasma insulin decreased (~1 mU/L) in the intervention group compared to the control group (time*group p = 0.0081), but insulin sensitivity did not change in either group. The changes in body mass or adiposity did not differ between groups. Among all participants, the changes in SB and body mass correlated inversely with the change in insulin sensitivity (r = -0.31, -0.44; p = 0.025, 0.0005; respectively).
Conclusions:
An intervention aimed at reducing daily SB resulted in slightly decreased fasting insulin, but had no effects on insulin sensitivity or body adiposity. However, as the change in insulin sensitivity associated with the changes in SB and body mass, multifaceted interventions targeting to weight loss are likely to be beneficial in improving whole-body insulin sensitivity.
... Conversely, excessive sedentary time has been associated with poor cardiometabolic health (6). ...
Purpose:
This study aimed to identify and characterize joint profiles of sedentary time and physical activity among adults and investigate how these profiles are associated with markers of cardiometabolic health.
Methods:
The participants included 3,702 of the Northern Finland Birth Cohort 1966 at age 46 years, who wore a hip-worn accelerometer during waking hours and provided 7 consecutive days of valid data. Sedentary time, LPA, and MVPA on each valid day were obtained, and a data-driven clustering approach ("KmL3D") was used to characterize distinct joint profiles of sedentary time and physical activity intensities. Participants self-reported their sleep duration and performed a submaximal step test with continuous heart rate measurement to estimate their cardiorespiratory fitness (peak heart rate). Linear regression was used to determine the association between joint profiles of sedentary time and physical activities with cardiometabolic health markers, including adiposity markers and blood lipid, glucose, and insulin levels.
Results:
Four distinct groups were identified: "Active couch potatoes" (n = 1,173), "Sedentary light movers" (n = 1,199), "Sedentary exercisers" (n = 694), and "Movers" (n = 636). Although sufficiently active, Active couch potatoes had the highest daily sedentary time (>10 hours) and lowest LPA. Compared to Active couch potatoes, Sedentary light movers, Sedentary exercisers, and Movers spent less time in sedentary by performing more physical activity at light-intensity upward and had favorable differences in their cardiometabolic health markers after accounting for potential confounders (1.1%-25.0% lower values depending on the health marker and profile).
Conclusions:
After accounting for sleep duration and cardiorespiratory fitness, waking activity profiles characterized by performing more physical activity at light-intensity upward, resulting in less time spent in sedentary, were associated with better cardiometabolic health.
... Our nding is consistent with several cross-sectional studies 27,28 , that have found a deleterious association with clustered cardiometabolic risk markers 14,19,[27][28][29][30] . Moreover, evidence also showed sedentary time associated with fasting plasma glucose, triglycerides, and waist circumferences 31 .This might be due to the extended period of sedentary time in and outside of the working area 23 .Another consideration is that typical jobs in the study participants often more involve non-manual labor, thus resulting in less physical activity and high sedentary time 32 .This can explain the positive effect of an increasing amount of sedentary time is associated with a reduction in lipoprotein lipase activity 33 , which reduces the absorption of plasma triglycerides, particularly by the skeletal muscle, and fats are deposited in the vessels or adipose tissue and increase the plasma triglyceride levels 34 .On the other, a decrease in skeletal muscle contractions from prolonged sedentary time may reduce the uptake of plasma triglycerides and free fatty acid into skeletal muscle through suppression of lipoprotein lipase activity 35 , and reduction of plasma glucose uptake 36 . ...
This study aimed to examine the associations of sedentary time and cardiometabolic risk markers among working adults in Eastern Ethiopia. A cross-sectional study was conducted among 1,200 participants. Data were collected using the World Health Organization NCD STEPS survey instrument, and the sedentary behavior questionnaire. The biochemical parameters were analyzed by using the Mindray BS-200 chemistry analyzer. STATA version 16.1 software was used for analysis. The associations between sedentary time and cardiometabolic risk markers controlling confounders were examined using linear regression models. An adjusted coe cient (β) with the 95% con dence interval (CI) was used to report the results. P-value < 0.05 was considered for statistical signi cance. One hour per day increases in total sedentary time increases the average body mass index (β = 0.61kg/m 2 : 95% CI: 0.49, 0.71), waist circumference (β = 1.48cm: 95% CI:1.14-1.82), diastolic blood pressure (β = 0.87mmHg: 95% CI: 0.56-1.18), systolic blood pressure (β = 0.95mmHg: 95% CI: 0.45, 1.48), triglycerides (β = 7.07mg/dl: 95% CI: 4.01-10.14), total cholesterol (β = 3.52mg/dl: 95% CI: 2.02-5.02), fasting plasma glucose (β = 4.15mg/dl: 95% CI: 5.31-4.98) and low-density lipoprotein cholesterol (β = 2.14mg/dl: 95% CI: 0.96-3.33). Long sedentary time is signi cantly associated with cardiometabolic risk markers. Interventions to reduce sedentary time to decreasing the risk of cardiovascular diseases among working adults.
... For example, five systematic reviews have focused on intensity of device-measured physical activity. They reported that light-, moderate-, and vigorous-intensity physical activity are beneficially associated with a range of health outcomes, including cardiometabolic health markers (8), frailty (9), carotid-femoral pulse wave velocity (10), and mortality (11,12). In relation to bout duration, one systematic review (conducted for the 2018 US Physical Activity Guidelines Advisory Committee Report), has reported that average time per day accumulated in frequent shorter bouts of physical activity of at least moderate intensity has similar effects to those observed when average time per day is accumulated in bouts of at least moderate intensity that last at least 10 min in duration (13). ...
Purpose:
The aim of this study was to systematically review the literature on accelerometer-measured physical activity and health outcomes in adults.
Methods:
Eight electronic databases were searched for relevant articles published up to March 2021. Only population-based studies of adults (≥18 years) which directly compared two or more categories of physical activity (i.e. bout duration, intensity, and daily/weekly frequency) with a health outcome (e.g. mortality, cardiometabolic, healthy ageing, depression, sleep and brain structure) were included.
Results:
Of the 15,923 publications retrieved, 52 articles were included. Twenty-eight studies directly compared the associations between physical activity accumulated in different bout durations, thirty-one studies directly compared the associations between physical activity accumulated in different intensities, and nine directly compared the associations between the effects of varying daily and weekly frequencies of physical activity, with health outcomes. Most showed no differences in relationships with health outcomes when physical activity was accumulated in short (<10 minute) or long (≥10 minute) bouts. Overall, there were no differences in the relationships with most health outcomes when different intensities and daily/weekly frequencies were compared. However, in most studies, researchers did not adjust their analyses for total volume of physical activity. Moreover, variations in researcher-driven decisions about data collection and processing methods made it difficult to compare study findings.
Conclusions:
These findings suggest that physical activity accumulated in many patterns of bout-duration, intensity or daily/weekly frequency is associated with a range of beneficial health outcomes in adults. Lack of adjustment for total volume of physical activity in most studies, and inconsistent methods for defining components of physical activity, prevent firm conclusions about which specific patterns of bout duration, intensity, and daily/weekly frequency are most important for health benefits.
... High amounts of sedentary time (daily/weekly sitting time) have been associated with a significantly greater risk for metabolic syndrome and DM2 [22,[54][55][56][57]. As found by Balducci et al. (2019) [58], who reported that an exercise intervention strategy resulted in increased physical activity level and decreased sedentary time, in our study, we observed an improvement in PAL and a decrease in SIT for the entire sample, although the SIT reduction was not statistically significant. ...
Physical activity level and sedentary behaviors affect health status in people with obesity and type 2 diabetes (DM2); their assessment is mandatory to properly prescribe exercise programs. From January 2011 to February 2014, 293 overweight/obese adults (165 women and 128 men, mean age of 51.9 ± 9.5 years and 54.6 ± 8.3 years, respectively), with and without DM2, participated in a three-month intensive exercise program. Before starting, participants were allocated into three subgroups (overweight, body mass index or BMI = 25–29.9; class 1 of obesity, BMI = 30–34.4; or class 2 (or superior) of obesity, BMI > 35). The international physical activity questionnaire (IPAQ-it) was used to evaluate participants’ baseline sitting time (SIT) and physical activity level (PAL). Stratified multiple analyses were performed using four subgroups of SIT level according to Ekelund et al., 2016 (low, 8 h/day of SIT) and three subgroups for PAL (high, moderate, and low). Health-related measures such as anthropometric variables, body composition, hematic parameters, blood pressure values, and functional capacities were studied at the beginning and at the end of the training period. An overall improvement of PAL was observed in the entire sample following the three-month intensive exercise program together with a general improvement in several health-related measures. The BMI group factor influenced the VO2 max variations, leg press values, triglycerides, and anthropometric variables, while the SIT group factor impacted the sitting time, VO2 max, glycemic profile, and fat mass. In this study, baseline PAL and SIT did not seem to influence the effects of an exercise intervention. The characteristics of our educational program, which also included a physical exercise protocol, allowed us to obtain positive results.
... Our nding is consistent with several cross-sectional studies 27,28 , that have found a deleterious association with clustered cardiometabolic risk markers 14,19,[27][28][29][30] . Moreover, evidence also showed sedentary time associated with fasting plasma glucose, triglycerides, and waist circumferences 31 .This might be due to the extended period of sedentary time in and outside of the working area 23 .Another consideration is that typical jobs in the study participants often more involve non-manual labor, thus resulting in less physical activity and high sedentary time 32 .This can explain the positive effect of an increasing amount of sedentary time is associated with a reduction in lipoprotein lipase activity 33 , which reduces the absorption of plasma triglycerides, particularly by the skeletal muscle, and fats are deposited in the vessels or adipose tissue and increase the plasma triglyceride levels 34 .On the other, a decrease in skeletal muscle contractions from prolonged sedentary time may reduce the uptake of plasma triglycerides and free fatty acid into skeletal muscle through suppression of lipoprotein lipase activity 35 , and reduction of plasma glucose uptake 36 . ...
This study aimed to examine the associations of sedentary time and cardiometabolic risk markers among working adults in Eastern Ethiopia. A cross-sectional study was conducted among 1,200 participants. Data were collected using the World Health Organization NCD STEPS survey instrument, and the sedentary behavior questionnaire. The biochemical parameters were analyzed by using the Mindray BS-200 chemistry analyzer. STATA version 16.1 software was used for analysis. The associations between sedentary time and cardiometabolic risk markers controlling confounders were examined using linear regression models. An adjusted coefficient (β) with the 95% confidence interval (CI) was used to report the results. P-value < 0.05 was considered for statistical significance. One hour per day increases in total sedentary time increases the average body mass index (β = 0.61kg/m ² : 95% CI: 0.49, 0.71), waist circumference (β = 1.48cm: 95% CI:1.14-1.82), diastolic blood pressure (β = 0.87mmHg: 95% CI: 0.56-1.18), systolic blood pressure (β = 0.95mmHg: 95% CI: 0.45, 1.48), triglycerides (β = 7.07mg/dl: 95% CI: 4.01-10.14), total cholesterol (β = 3.52mg/dl: 95% CI: 2.02-5.02), fasting plasma glucose (β = 4.15mg/dl: 95% CI: 5.31-4.98) and low-density lipoprotein cholesterol (β = 2.14mg/dl: 95% CI: 0.96-3.33). Long sedentary time is significantly associated with cardiometabolic risk markers. Interventions to reduce sedentary time to decreasing the risk of cardiovascular diseases among working adults.
... Sedentary time, defined as time spent in a sitting or reclining posture with low energy expenditure during waking hours (Sedentary Behaviour Research Network, 2012), has been linked to the development of poor health outcomes, including all-cause mortality and incident type 2 diabetes, after adjustment for physical activity (Patterson et al., 2018). Sedentary time (ST) is also associated with biomarkers indicative of cardiometabolic risk, including higher levels of plasma glucose, insulin and triglycerides (Powell et al., 2018). The way in which ST is accumulated throughout the day may also be important, as evidence suggests that prolonged ST (i.e. ...
Little is known about the relationship between socioeconomic position (SEP) and duration and patterning of objectively measured sedentary time (ST) among adults, especially adults at high risk of diabetes. The aim of this study was to examine cross-sectional associations of SEP with ST (total, prolonged ST, breaks in ST) and self-reported TV time among pregnant women at risk of gestational diabetes in the UK. At 20 weeks' gestation, pregnant women (n=174) wore an activPAL accelerometer and reported their usual TV time. Generalized linear mixed models were used to test associations of education, household income and area-level deprivation (separately and with mutual adjustment) with total ST, prolonged ST and breaks in ST. Logistic regression models were used to test associations between SEP indicators and high (≥2h/day) TV time. Those with the lowest education, lowest household income and highest area-level deprivation had the lowest ST and lowest prolonged ST. After mutual adjustment, area-level deprivation remained associated with total ST (β=0.10 [0.01, 0.20]). There was an inverse association between area-level deprivation and breaks in sedentary time (exp(b)=1.11 [1.01, 1.22]). Education was the only SEP correlate of high TV time, with more of those with least education reporting high TV time; this association persisted after adjustment for household income and area-level deprivation. The association between SEP and total and prolonged ST (positive) was the opposite of the association between education and high TV time (negative) in this sample of high-risk pregnant women. These findings should inform interventions to reduce sedentary time.
... Considerable evidence suggests that sedentary behavior is associated with increased mortality. 13,[18][19][20] The results of this study confirm the association that each 2-hour increment in sedentary time was associated with a 15.3% increase in the risk of mortality among all participants and a 41.7% increase in the risk of mortality among participants with hypertension, dyslipidemia, and diabetes mellitus. Thus, our results suggest that the well-established association between sedentary time and increased mortality is stronger among patients with a medical history of hypertension, dyslipidemia, and diabetes mellitus. ...
Background
This study aimed to determine the association between sedentary time and mortality with regard to leisure‐time physical activity with or without cardiometabolic diseases such as hypertension, dyslipidemia, and diabetes mellitus.
Methods and Results
Using data from the J‐MICC (Japan Multi‐Institutional Collaborative Cohort) Study, 64 456 participants (29 022 men, 35 434 women) were analyzed. Hazard ratios (HRs) and 95% CIs were used to characterize the relative risk of all‐cause mortality to evaluate its association with sedentary time (categorical variables: <5, 5 to <7, 7 to <9, ≥9 h/d and 2‐hour increments in exposure) according to the self‐reported hypertension, dyslipidemia, and diabetes mellitus using a Cox proportional hazards model. A total of 2257 participants died during 7.7 years of follow‐up. The corresponding HRs for each 2‐hour increment in sedentary time among participants with all factors, no factors, hypertension, dyslipidemia, and diabetes mellitus were 1.153 (95% CI, 1.114–1.194), 1.125 (95% CI, 1.074–1.179), 1.202 (95% CI, 1.129–1.279), 1.176 (95% CI, 1.087–1.273), and 1.272 (95% CI, 1.159–1.396), respectively. Furthermore, when analyzed according to the combined different factors (hypertension, dyslipidemia, and diabetes mellitus), HRs increased with each additional factor, and participants reporting all 3 conditions had the highest HR of 1.417 (95% CI, 1.162–1.728) independently of leisure‐time metabolic equivalents.
Conclusions
The association between sedentary time and increased mortality is stronger among patients with hypertension, dyslipidemia, and diabetes mellitus regardless of leisure‐time physical activity in a large Japanese population.
... Total physical activity volume was decreased by 14% and 21% and moderate-to-vigorous physical activity by 24% and 38% in those with moderate and severe obesity, respectively [4]. On a cross-sectional basis, sedentary time was also found associated with increased indicators of obesity and metabolic health [5,6]. ...
Physical activity and exercise have many benefits in persons with obesity, helping with weight loss, body fat loss, abdominal visceral fat loss and possibly with weight maintenance after weight loss. The effect of exercise training (endurance or endurance plus resistance or high-intensity interval training) alone on weight loss as outcome appears relatively modest, amounting to only a few kg. However, endurance training during weight loss has been shown to increase V̇O2max and resistance training during weight loss leads to lower loss in lean body mass and increased muscle strength. In addition, higher physical activity levels improve cardiovascular risk, whatever weight variations. Specifically, physical activity or exercise is part of lifestyle measures for prevention of type 2 diabetes and substantially helps with metabolic control in patients with type 2 diabetes. The importance of physical activity counselling and exercise prescription in the management strategy will depend on specific treatment objectives as defined for a given patient, including weight loss, prevention of weigh regain, prevention of cardio-metabolic comorbidities, lean body mass preservation but also improvement in quality of life or development of social links. The 5 A's strategy consisting in: Ask, Assess, Advise, Agree, Assist (or Arrange) appears well adapted in this setting. Professionals need to be aware of the many barriers patients with obesity may meet on their way to increase habitual physical activity as specific solutions should be proposed. A major challenge is how to improve adherence to new physical activity habits over time.
... Optimal health appears to be influenced by the major PA behaviours that adults engage in daily. For example, increased time spent sedentary has been linked with adverse cardiometabolic health (26), while the protective role of PA is well understood (27). More recently, the important role that the gut microbiota plays in the development of health and the prevention of disease has been explored (28). ...
ObjectiveA 24-hour day is made up of time spent in a range of physical activity (PA) behaviours, including sleep, sedentary time, standing, light-intensity PA (LIPA) and moderate-to-vigorous PA (MVPA), all of which may have the potential to alter an individual’s health through various different pathways and mechanisms. This study aimed to explore the relationship between PA behaviours and the gut microbiome in older adults.DesignCross-sectional study.Settings and ParticipantsParticipants (n=100; age 69.0 [3.0] years; 44% female) from the Mitchelstown Cohort Rescreen (MCR) Study (2015–2017).Methods
Participants provided measures of gut microbiome composition (profiled by sequencing 16S rRNA gene amplicons), and objective measures of PA behaviours (by a 7-day wear protocol using an activPAL3 Micro).ResultsStanding time was positively correlated with the abundance of butyrate-producing and anti-inflammatory bacteria, including Ruminococcaceae, Lachnospiraceae and Bifidobacterium, MVPA was positively associated with the abundance of Lachnospiraceae bacteria, while sedentary time was associated with lower abundance of Ruminococcaceae and higher abundance of Streptococcus spp.Conclusion
Physical activity behaviours appear to influence gut microbiota composition in older adults, with different PA behaviours having diverging effects on gut microbiota composition.
... Physical activity and exercise are crucial in promoting health and in protecting from disabilities. Increasing physical activity and reducing total sedentary time has been emphasized in recent literature as having fundamental role in improving health outcomes [1][2][3][4][5] . Ainsworth and their team defined sedentary behavior as any activity with an energy expenditure below 1.5 times the resting metabolic rate which include sitting [6] . ...
... A systematic review of cross-sectional studies using hip/wrist-worn accelerometry has shown deleterious associations with insulin and TG but not with HDL-C and blood glucose. 24 Based on prospective cohort studies with predominantly self-reported measurements, meta-analyses have shown relatively consistently deleterious associations of total sedentary time with incident type 2 diabetes. 25,26 These equivocal findings may imply that each measurement method captures different aspects of sedentary behaviour, and inconsistent results may also be explained by issues such as reverse causation and residual confounding. ...
Aims
This study aimed to examine the cross‐sectional associations of thigh accelerometry‐assessed sedentary behaviour and moderate‐to‐vigorous physical activity (MVPA) with cardio‐metabolic health markers and prevalent diabetes in a population sample of middle‐aged British adults.
Methods
Participants (n = 4892) from the age‐46‐to‐48 wave of the 1970 British Cohort Study were fitted with a waterproofed activPAL3 micro device. Total/prolonged sedentary time, breaks and MVPA were the main exposures. We dichotomized prolonged sedentary time and MVPA based on the corresponding median, generating four combinations as categorical exposures. Outcomes comprised of diabetes and seven cardio‐metabolic health markers. We used logistic regression and generalized linear models to examine independent/joint associations, conducting a minimally adjusted model including demographics and contextual covariates, and further adjusted for total sedentary time and/or MVPA as applicable.
Results
Each set of 10 sedentary breaks and 1 h of prolonged sedentary time were associated with HbA1c (mmol/mol) [B = −0.18 (−0.33, −0.03) and 2.35 (1.01, 3.69), respectively]. Each set of 10 sedentary breaks and 1 h of MVPA were favourably associated with diabetes [adjusted odds ratio (AOR): 0.80 (0.71, 0.99) and 0.42 (0.26, 0.67), respectively]. Joint analyses showed that only the low MVPA × long sedentary time combination had significantly higher odds for diabetes than the referent high MVPA × short sedentary time combination [AOR: 1.89 (1.17, 3.03)].
Conclusions
Each set of additional 10 sedentary breaks per day was associated with 20% lower odds for diabetes. A low physical activity level combined with long sedentary time might synergistically deteriorate cardio‐metabolic health.
... Considerable evidence suggests that sedentary time affects health outcomes regardless of physical activity4. Especially, many previous studies showed that cardiovascular disease and its risk factors are associated with sedentary time 3,[15][16][17] . This study was conducted to determine the associations of sedentary behavior with cardiometabolic diseases such as hypertension, dyslipidemia, and diabetes mellitus in a large Japanese population according to age and sex. ...
Aim: Accumulating evidence reveals that sedentary behavior is associated with mortality and cardiometabolic disease; however, there are potential age and sex differences in sedentary behavior and health outcomes that have not been adequately addressed. This study aimed to determine the association of sedentary behavior with cardiometabolic diseases such as hypertension, dyslipidemia, diabetes mellitus, and its risk factors in a large Japanese population according to age and sex.
Methods: Using data from the Japan Multi-Institutional Collaborative Cohort Study obtained from baseline surveys, data of 62,754 participants (27,930 males, 34,824 females) were analyzed. This study uses a cross-sectional design and self-administered questionnaires to evaluate sedentary time and anamnesis. For the logistic regression analysis, sedentary time ＜5 h/day was used as the reference and then adjusted for age, research areas, leisure-time metabolic equivalents, and alcohol and smoking status. From the analysis of anthropometric and blood examinations, 35,973 participants (17,109 males, 18,864 females) were analyzed.
Results: For hypertension and diabetes, sedentary time was associated with a significantly higher proportion of male participants. Both sexes were associated with a significantly higher proportion of participants with dyslipidemia. Participants who had longer sedentary time tended to have increased levels of blood pressure, triglycerides, and non-high-density lipoprotein cholesterol (HDL-C), and decreased levels of HDL-C, especially in the 60–69 years group.
Conclusions: Independent of leisure-time physical activity, sedentary time was associated with cardiometabolic diseases in a large Japanese population classified by age and sex. Our findings indicate that regularly interrupting and replacing sedentary time may contribute to better physical health-related quality of life.
... Physical activity reduces cardiometabolic risk, whereas sedentary behaviors favor the development of chronic diseases (Janiszewski and Ross, 2009;Booth et al., 2017;Powell et al., 2018). These observations led to the concept that exercise, by stimulating muscle contraction, participates in the regulation of energy homeostasis and organ function. ...
Physical activity reduces cardiometabolic risk, while physical inactivity increases chronic diseases risk. This led to the idea that exercise-induced muscle contraction contributes to metabolic regulation and health. It is now well established that skeletal muscle, through the release of endocrine factors, i.e., so-called myokines, crosstalk with metabolic organs such as adipose tissue, liver and pancreas. Recent advances suggested that a number of myokines are able to modulate adipose tissue metabolism and thermogenic activity, liver endogenous glucose production and β-cell insulin secretion. This novel paradigm offers a compelling hypothesis and molecular basis to explain the link between physical inactivity and chronic diseases. Herein, we review major findings and recent advances linking exercise, myokines secretion and inter-organ crosstalk. Identifying the molecular mediators linking physical activity to metabolic health could open the path toward novel therapeutic targets in metabolic diseases.
... Our findings suggested that total sedentary time was adversely associated with TG and HDL-C but not associated with other selected cardiometabolic health markers. Inconsistent with this study, systematic reviews of cross-sectional studies using wrist/waist-worn accelerometry have shown discrepant results of associations of total sedentary time with HDL-C and blood glucose despite conclusive adverse associations with insulin and TG (24,25). However, systematic reviews and meta-analyses based on prospective cohort studies showed harmonious results on the detrimental associations of total sedentary time with type 2 diabetes, all-cause mortality, and CVD-related mortality (26)(27)(28). ...
Objective
To examine the independent and joint associations thigh-worn accelerometry assessed sedentary time and moderate to vigorous physical activity with cardiometabolic health markers.
Design
Cross-sectional study embedded in the age-46 wave an established birth cohort, the 1970 British Birth Cohort.
Setting
Population-based sample from Great Britain (England, Scotland, and Wales).
Methods
Outcome measures included: body mass index, waist-to-hip ratio, blood pressure, glycated hemoglobin, high-density lipoprotein cholesterol, total cholesterol, triglycerides, and c-reactive protein. Sedentary behavior and other physical activity exposures, recorded by a thigh-worn activPAL3 accelerometry, included: daily sedentary time, breaks in sedentary time, daily time spent in moderate-to-vigorous physical activity. Multiple linear regression analyses, multiple logistic regression analyses, and general linear models were conducted as applicable.
Results
4,634 participants were available for the final analysis. After adjusting for potential confounders and moderate-to-vigorous physical activity, daily sedentary time was positively associated with triglycerides (β=0.052 [0.015, 0.089]) and inversely associated with high-density lipoprotein cholesterol (β=-0.015 [-0.022, -0.010]). Daily prolonged sedentary time (≥ 60 minutes) was positively associated with both glycated hemoglobin and log-transformed c-reactive protein (β=0.240 [0.030, 0.440] and 0.026 [0.007, 0.045], respectively) and inversely associated with systolic blood pressure and high-density lipoprotein cholesterol (β=-0.450 [-0.760, -0.150] and -0.013 [-0.022, -0.003], respectively). After adjusting for potential confounders and daily sedentary time, daily breaks in sedentary time were inversely associated with glycated hemoglobin (β=-0.020 [-0.037, -0.003]), and positively associated with both triglycerides and systolic blood pressure (β=0.006 [0.002, 0.010] and 0.030 [0.002, 0.050], respectively). The joint associations of prolonged sedentary time and moderate-to-vigorous physical activity with the prevalence of diabetes were not statistically significant.
Conclusion
Prolonged sedentary time (≥ 60 minutes) and daily breaks in sedentary time were deleteriously associated with glycated hemoglobin, although we found no evidence that there were joint moderate-to-vigorous physical activity and sitting associations.
... In contrast, SB (e.g., sitting) is linked to elevated triglycerides, HDLs, glucose [11], and other cardiometabolic health markers [12]. Understanding whether patients can be classified based on lifestyle factors would be helpful for researchers to determine how lifestyle influences dyslipidemia incidence. ...
Despite the increasing prevalence and economic burden of dyslipidemia in South Korea, we have little data on the physical activity of patients. Thus, we aimed to investigate how quality of life among patients with dyslipidemia is influenced by a combination of the following variables: light physical activity (PA), sedentary behavior (SB), perceived body shape, and body mass index (BMI). We examined data from the Sixth Korean National Health and Nutrition Examination Survey (KNHANES VI 2015), collected in 2015 by the Korean Centers for Disease Control and Prevention. The analysis included 534 individuals with dyslipidemia out of 7380 survey participants. Latent profile analysis identified three latent classes of individuals based on their physical profiles. Class 1 patients (active; n = 48) were more active, possessed more positive views of their body shape, were less sedentary, and had a lower BMI than Class 3 patients (inactive; n = 154). Class 2 patients (moderate; n = 331) had profiles in between the other two classes. Additionally, Class 1 and 2 patients had better quality of life than Class 3 patients. Our results suggest that promoting light PA and altering perceived body shape through counselling may improve quality of life in patients with dyslipidemia.
Background and Purpose: Inactivity and on the other hand physical exercise are known as factors related to indicators of liver damage. However, the role of many types of interval, including interval and resistance training, and the consumption of certain dietary supplements, including spirulina, on immune and inflam-matory factors is not fully understood. Therefore, the aim of this research was to determine the effect of eight weeks of spirulina supplementation and resistance and intermittent aerobic training on liver tissue activity and CXCL1 gene expression in muscle tissue of Males rats. Materials and Methods: In this semi-experimental research, 65-weeks-old male Wistar rats with an average weight of 246.4 ± 24.6g were randomly assigned to six groups: interval training + spirulina supplement, resistance training + spirulina supplement, control + spirulina supplement, interval training + saline, resistance training + saline, control + saline. Based on this, the amount of spirulina supplement in the spirulina supplement consumption groups was 500 mg/kg body weight. The interval training group performed five sessions per week for eight weeks, and the resistance training group performed three sessions per week with increasing load. 48 hours after the last training session, the animals in the experimental groups were anesthetized with ketamine and xylazine, blood samples were taken from the inferior vein, and quadriceps muscle tissue was quickly removed. CXCL1 gene expression level in quadriceps muscle and liver enzymes were measured as an indicator of liver function in serum. Statistical data were analyzed using one-way analysis of variance (P < 0.05). Results: The results of this research showed that after 8-weeks of interval and resistance training with increasing load, the expression level of the CXCL1 gene was higher in the quadriceps muscle of the control group, but no significant difference was found. The level of liver enzymes was significantly higher than the control group. The results also showed that spirulina consumption combined with interval aerobic and resistance exercise can significantly alter liver function indicators compared to the control group. However, the expression of the CXCL1 gene in the groups consuming spirulina and aerobic and resistance training did not show a significant change compared to the control group. Conclusion: the results of this research showed that spirulina and interval and resistance exercises can modulate the functional indicators of the liver and the gene expression of CXCL1 in the quadriceps muscle tissue. These results show that spirulina can be involved in the occurrence of adaptive responses related to metabolic damage. How to cite this article: Fathi1 R, Jalali M, Nasiri Kh, Akbari A. The effect of eight weeks of spirulina sup-plementation and resistance and interval aerobic training on skeletal muscle CXCL1 gene expression and liver enzymes in male rats.
Sedentary behavior (SB) and physical inactivity associate with impaired insulin sensitivity. We investigated whether an intervention aimed at a 1h reduction in daily SB during 6 months would improve insulin sensitivity in the weight-bearing thigh muscles. Forty-four sedentary inactive adults [mean age 58 (SD 7) years; 43% men] with metabolic syndrome were randomized into intervention and control groups. The individualized behavioral intervention was supported by an interactive accelerometer and a mobile application. SB, measured with hip-worn accelerometers in 6-s intervals throughout the 6-month intervention, decreased by 51 (95%CI 22-80) min/day and physical activity (PA) increased by 37 (95%CI 18-55) min/day in the intervention group with non-significant changes in these outcomes in the control group. Insulin sensitivity in the whole body and in the quadriceps femoris and hamstring muscles, measured with hyperinsulinemic euglycemic clamp combined with [18F]fluoro-deoxy-glucose PET, did not significantly change during the intervention in either group. However, the changes in hamstring and whole-body insulin sensitivity correlated inversely with the change in SB and positively with the changes in moderate-to-vigorous PA and daily steps. In conclusion, these results suggest that the more the participants were able to reduce their SB, the more their individual insulin sensitivity increased in the whole body and in the hamstring muscles, but not in quadriceps femoris. However, according to our primary RCT results, this kind of behavioral interventions targeted to reduce sedentariness may not be effective in increasing skeletal muscle and whole-body insulin sensitivity in people with metabolic syndrome at the population level.
Abstract Sedentary time is associated with increased risks of detrimental health outcomes. Prolonged sedentary time associates with cardiometabolic risk factors and increased mortality regardless of physical activity. Therefore, the purpose of this study was to examine the associations of sedentary time and cardiometabolic risk factors among university employees in Eastern Ethiopia. A cross-sectional study was conducted among 1200 participants. Data were collected using the World Health Organization STEPS survey instrument, and sedentary behavior questionnaire in hour per day. Sedentary time is the time spent for any duration (minutes per day or hours per day) by considering a local context. Study participants were asked how many minutes or hours they spent in sedentary time at work, their leisure time and in transportation. Finally, the total sedentary time was calculated by the sum of the individual spent in sedentary time at work, leisure, and transportation. Cardiometabolic risk factors were assessed with blood samples analysis and anthropometric measurements. The associations between sedentary time and cardiometabolic risk factors were examined using linear regression models. An adjusted coefficient (β) with the 95% confidence interval (CI) was used to report the results. p value
Purpose: Cross-sectional investigation of the association of sedentary behavior and physical activity with metabolic syndrome (MetS) among the African American participants in the Jackson Heart Study (JHS).
Methods: Prevalence, number of individual components, and MetS severity z-score (MetS-Z) were examined. MetS was classified using ATP-III thresholds. MetS-Z was calculated using sex-, race-, and ethnicity-specific formulas. Sedentary behavior and physical activity were calculated from the JHS Physical Activity Cohort survey (JPAC). Associations between sedentary behavior and physical activity with MetS were assessed by logistic, negative binomial, and ordinary least squares regressions.
Results: The mean participant age ( N = 3370) was 61.7 ± 11.9 years and most were female (63.9%). Among all participants, 60.5% were classified with MetS. Overall MetS-Z was moderately high (.31 ± 1.07). Most waking hours were sedentary, with just under 40 daily minutes of self-reported physical activity. Physical activity was associated with lower prevalence of MetS the number of individual components, and MetS-Z score ( p < .05). Sedentary behavior was not associated with MetS in any fully adjusted models ( p > .05).
Conclusions: Physical activity was associated with lower cardiometabolic risk, irrespective of sedentary behavior. Further studies are needed to better understand why no relation was found between sedentary behavior and cardiometabolic risk in this cohort of African American adults.
The negative effect of sedentary behaviour on type 2 diabetes markers is established, but the interaction with measures of physical activity is still largely unknown. Previous studies have analysed associations with single-activity models, which ignore the interaction with other behaviours. By including results from various analytical approaches, this review critically summarises the effects of sedentary behaviour on diabetes markers and the benefits of substitutions and compositions of physical activity. Ovid Medline, Embase and Cochrane Library databases were systematically searched. Studies were selected if sedentary behaviour and physical activity were measured by accelerometer in the general population, and if associations were reported with glucose, insulin, HOMA-IR, insulin sensitivity, HbA1c, diabetes incidence, CRP and IL-6. Forty-five studies were included in the review. Conclusive detrimental associations with sedentary behaviour were determined for 2-h insulin (6/12 studies found associations), fasting insulin (15/19 studies), insulin sensitivity (4/6 studies), diabetes (3/4 studies) and IL-6 (2/3 studies). Reallocating sedentary behaviour to light or moderate-to-vigorous activity has a beneficial effect for 2-h glucose (1/1 studies), fasting insulin (3/3 studies), HOMA-IR (1/1 studies) and insulin sensitivity (1/1 studies). Compositional measures of sedentary behaviour were found to affect 2-h glucose (1/1 studies), fasting insulin (2/3 studies), 2-h insulin (1/1 studies), HOMA-IR (2/2 studies) and CRP (1/1 studies). Different analytical methods produced conflicting results for fasting glucose, 2-h glucose, 2-h insulin, insulin sensitivity, HOMA-IR, diabetes, hbA1c, CRP and IL-6. Studies analysing data by quartiles report independent associations between sedentary behaviour and fasting insulin, HOMA-IR and diabetes only for high duration of sedentary time (7–9 hours/day). However, this review could not provide sufficient evidence for a time-specific cut-off of sedentary behaviour for diabetes biomarkers. While substituting sedentary behaviour with moderate-to-vigorous activity brings greater improvements for health, light activity also benefits metabolic health. Future research should elucidate the effects of substituting and combining different activity durations and modalities.
Introduction
Physical activity is the foundation to staying healthy, but sedentary activities have become not uncommon that ought to be mitigated immediately. The study aims to highlight the role of a transport system that encourages physical activity among users by applying an active door-to-door transport system. Users’ mode choice is studied to understand their preferences for active commuting. The use of machine learning has since been ubiquitous in a myriad of fields, including transportation studies and hence is also investigated towards its efficacy in predicting travel mode choice.
Methodology
The application of the Random Forest (RF) model to identify travel mode choice is explored using the Revealed/Stated Preferences (RP/SP) Survey data in Kuantan City during weekdays. A total of 386 respondents were involved in this survey. The efficacy of the tuned RF models towards predicting the travel mode choice is evaluated via the Classification Accuracy (CA) performance indicator. In addition, a Feature Importance study is also carried out in order to identify significant factors that contribute towards travel mode choice.
Results
The results from the present investigation demonstrated that the default RF model has acceptable predictability for both training and test dataset of users’ mode choice, with a CA of 70.2% and 69.3%, respectively. Upon identifying the significant features and further refining the hyperparameters of the RF model heuristically, it was shown that with 145 trees, the CA improved to up to 71.6% and 70.1% for both the training and test dataset, respectively. Through the feature selection technique, the most significant features that affect users mode choice are total travel time (TT), waiting time at a public transport stop (WT), region, walking distance from the last stop to destination (WD2), and walking distance from home to the nearest bus stop (WD1).
Conclusions
The study has illustrated the efficacy of the optimised RF in predicting travel mode choice as well as identified the significant factors for the selection. The findings of the present study provide significant insight for policymakers to improve the performance of the public transportation system so that the users will benefit in terms of health and well-being from active commuting.
Background
Both physical inactivity and sedentary behavior are considered modifiable risk factors for chronic diseases and all-cause mortality. Adult office-workers spend most of their working day in sedentary behaviors, so they are particularly at high risk of developed chronic diseases (e.g., cardiovascular diseases, metabolic disorders like diabetes mellitus, …). It seems important to promote behavioral changes that could prevent or delay metabolic disease development. Evidence supports the use of exercise programs, however, to date there are several knowledge gaps and inconsistencies in the literature regarding the effects of Combined Training (i.e., aerobic plus resistance training) in sedentary healthy adults. This paper outlines an RCT designed to evaluate the effects of a 16-week combined training program on biochemical and immune markers of metabolic disease, lung function, salivary stress hormones and subjective quality of life (primary outcomes), as well as on body composition and physical fitness (secondary outcomes) in sedentary middle-aged office-workers. Furthermore, we aimed to assess the associations between the changes promoted by the exercise program and the different variables studied.
Methods and design
This is a single-blinded two-arm RCT with parallel groups. A minimum of healthy 40 office-workers aged 40–64 years will be recruited to engage in a 16-week intervention study. After baseline assessments, participants will be randomized to one of the two groups: (1) combined training group or (2) control group. Baseline assessments will be repeated after 8 weeks of intervention (mid-testing) and upon completion of the intervention (post-testing).
Discussion
This RCT involves a multi-disciplinary approach and seems to be a relevant contribution to understanding the potential role of combined training in improving the metabolic profile, lung function, stress, and quality of life in adults. The results can provide important insights for clinical recommendations and for the optimization of strategies to prevent metabolic disorders in adults with sedentary jobs.
Trial registration
This trial is registered with ClinicalTrials.gov (registration number: NCT04868240; date of registration April 30, 2021).
Background:
This study examined the effectiveness of a 12-month activity tracker-based intervention on activity behavior among recent retirees (Enhancing physical ACTivity and healthy aging among recent REtirees [REACT]) in subgroups based on body mass index.
Methods:
REACT trial randomized 231 participants (mean age 65.2) into intervention and control groups. Main outcomes were accelerometer-measured moderate-to-vigorous (MVPA) and light physical activity (LPA) and sedentary time (SED) measured at baseline and 3-, 6-, and 12-month follow-ups. As a post hoc analysis, the intervention effect was examined among participants with normal weight (n = 77), overweight (n = 89), and obesity (n = 61).
Results:
An intervention effect was observed among participants with obesity in LPA (time × group P = .045) mirrored by a similar, albeit nonsignificant, effect in SED (P = .067), but not in MVPA (P = .92). A transient increase of 41 minutes per day (95% confidence interval, 14 to 68) in LPA was observed at 6 months among the intervention group, with a concomitant decrease of 42 minutes per day (-72 to -12) in SED. However, these changes were not maintained at 12 months. No between-group differences in changes over time were observed among participants with normal or overweight.
Conclusions:
Activity trackers may be particularly suitable for promoting changes in LPA and SED among older adults with obesity. However, their long-term effectiveness might be limited.
BACKGROUND
Stay-at-home orders have proven a controversial, while effective, method of SARS-CoV-2 containment. However objective measures of how the pandemic and stay-at-home orders are affecting the daily health of uninfected individuals have been lacking.
METHODS
We investigated the effect of pandemic-related events on 61 individuals in San Antonio, Texas whose daily activity and sleep data were recorded via wearable activity trackers from April 2019 to August 2020. We assessed changes in six fitness metrics (steps walked, resting heart rate, sedentary minutes, wake duration after sleep onset, rapid eye movement (REM) duration, total sleep duration). Cluster analysis and time-course analysis identified trends in activity before, after and during stay-at-home orders. Quantitative measures of activities were compared to survey responses.
RESULTS
Four behavior patterns during stay-at-home orders were identified. Most individuals suffered declines in healthy habits compared to their daily activity in 2019 and early 2020 (e.g., up to −60% steps walked). Inflection points corresponded with key dates relevant to SARS-CoV-2 including the first reported case in the U.S. (Feb 29) and city-wide stay-at-home orders (Mar 23). Pre-existing conditions (diabetes, asthma) were associated with a steeper than average decline in sleep quality during stay-at-home orders. Unexpectedly, we also identified a group of predominately male individuals who improved their daily fitness during stay-at-home orders.
CONCLUSIONS
Objective measures of daily activity indicated most individuals’ fitness suffered at the onset of stay-at-home orders and slowly returned towards baseline. For a subset of individuals, fitness quantitatively improved – better sleep, more exercise, lower resting heart rate – during stay-at-home orders.
The aim of this study was to examine the associations of cardiometabolic health markers with device-measured sedentary behavior (SB) duration and different intensities of physical activity (PA) among overweight working-aged adults with low self-reported PA levels. This cross-sectional analysis included 144 subjects (42 men) with mean age of 57 (SD 6.5) years and mean BMI of 31.7 (SD 4) kg/m². SB and standing time, breaks in sedentary time, light PA (LPA) and moderate-to-vigorous PA (MVPA) were measured for 4 consecutive weeks (mean 25 days, SD 4) with hip-worn accelerometers. Fasting plasma glucose, insulin, HbA1c, triglycerides and total cholesterol, HDL and LDL were measured from venous blood samples. HOMA-IR index was calculated as a surrogate of insulin resistance. The associations were examined using linear models. LPA, MVPA, and daily steps associated with better insulin sensitivity and favorable plasma lipid profile, when adjusted for age, sex and BMI, whereas greater proportion of SB associated with insulin resistance and unfavorable lipid profile. As all PA intensities associated with better cardiometabolic health, the total daily duration of PA may be more relevant than intensity in maintaining metabolic health in overweight adults, if the current guidelines for PA are not met.
Trial Registration: ClinicalTrials.gov NCT03101228, registered 05/04/2017, https://clinicaltrials.gov/show/NCT03101228.
Depression is a common mental problem and is also a leading cause of disability, which serves as an important contributor to the overall global burden of disease. It may lead to serious consequences including increased risk of morbidity and mortality. This warrants the need to identify correlates such as modifiable lifestyle behaviors that can prevent or delay the onset of depressive symptoms in aging populations. Sedentary behaviors such as TV viewing, reading, mobile phone/computer use, social chatting, and passive transport etc. are prevalent among older adults. Unfortunately, sedentary behaviors have been increasingly recognized as an independent risk factor for different
health outcomes. Although the link between sedentary behaviors and several geriatric health outcomes including allcause mortality, cardio-metabolic diseases and obesity in later life has been established, the associations of sedentary behaviors with depressive symptoms have not been comprehensively investigated. Therefore, this study aimed to
provide a narrative review by scrutinizing the recent epidemiologic evidence for prospective cohort studies of sedentary behaviors and depressive symptoms in older adults. To fulfill the aim, the following issues were raised and analyzed in an effort to disentangle the complex relationships between late-life sedentary behaviors and depressive symptoms. First, the prevalence and correlates of geriatric depressive symptoms were presented and discussed. Second, the
definition of sedentary behaviors and the prevalence of late-life sedentary behaviors were described. Third, the relevant issues of measuring sedentary behaviors were addressed. Fourth, the effects of sedentary behaviors on various health outcomes were identified. Fifth, the prospective studies regarding sedentary behaviors and depressive symptoms in older adults were examined based on epidemiological perspectives. Sixth, based on the preceding information, research gaps in the literature were identified and discussed. Conclusions and suggestions for future research on this topic were proposed. Based on limited evidence, late-life sedentary behaviors are associated with higher risk of depressive symptoms. Future studies on the current topic are recommended to conduct large-scale prospective cohort studies with multiple waves of data collection employs a combination of subjective and objective measures of sedentary behaviors, such as a questionnaire and accelerometry, by which studies could explore the bi-directional relationships of different types of sedentary behaviors with depressive symptoms in older adults and the mechanism between them.
Background : The accuracy of wrist-worn accelerometers in identifying sedentary time has been scarcely studied in free-living conditions. The aim of this study was to compare daily sedentary time estimates between a thigh-worn accelerometer, which measured sitting and lying postures, and a wrist-worn accelerometer, which measured low levels of movement. Methods : The study population consisted of 259 participants ( M age = 62.8 years, SD = 0.9) from the Finnish Retirement and Aging Study (FIREA). Participants wore an Axivity AX3 accelerometer on their mid-thigh and an Actigraph wActiSleep-BT accelerometer on their non-dominant wrist simultaneously for a minimum of 4 days in free-living conditions. Two definitions to estimate daily sedentary time were used for data from the wrist-worn accelerometer: 1) the count cutpoint, ≤1853 counts per minute; and 2) the Euclidean Norm Minus One (ENMO) cutpoint, <30 m g . Results : Compared to the thigh-worn accelerometer, daily sedentary time estimate was 63 min (95% confidence interval [CI] = −53 to −73) lower by the count cutpoint and 50 min (95% CI = 34 to 67) lower by the ENMO cutpoint. The limits of agreement in daily sedentary time estimates between the thigh- and cutpoint methods for wrist-worn accelerometers were wide (the count cutpoint: −117 to 243, the ENMO cutpoint: −212 to 313 min). Conclusions : Currently established cutpoint-based methods to estimate sedentary time from wrist-worn accelerometers result in underestimation of daily sedentary time compared to posture-based estimates of thigh-worn accelerometers. Thus, sedentary time estimates obtained from wrist-worn accelerometers using currently available cutpoint-based methods should be interpreted with caution and future work is needed to improve their accuracy.
Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September, 2004, with methodologists, researchers, and journal editors to draft a che-cklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed explanation and elaboration document is published separately and is freely available on the websites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE statement will contribute to improving the quality of reporting of observational studies.
Purpose
A central aspect of physical activity and sedentary behaviour research is accurate exposure assessment in the context of disease outcomes. The primary objectives of this study were to evaluate the convergent validity and test–retest reliability of the ActiGraph GT3X+ and activPAL3 accelerometers.
Methods
Participants from the Breast Cancer and Exercise Trial in Alberta (n=266) wore both devices concurrently during waking hours for 7 days. Summary measures of time (hours/day) for physical activity and sedentary behaviour were compared between devices using Student’s t-tests. Bland-Altman plots were used to assess or evaluate the mean differences and limits of agreement between monitors, and intraclass correlation coefficients (ICCs) were used to assess the test–retest reliability of two 7-day activity monitor administrations separated by 2 weeks (n=29).
Results
When comparing the ActiGraph Vector Magnitude (VM), which incorporates all three axes of movement (x, y, z), and the Vertical Axis (VT), which detects movement on the vertical or y-axis only, with the activPAL3, all measures of physical activity were statistically significantly different. The difference in measured time in sedentary behaviour was not statistically significant different when comparing the activPAL3 and ActiGraph (VT) estimates (p=0.47) but was statistically significant different for activPAL3 compared with ActiGraph (VM) (p<0.001). ICCs were high and consistent for each method across all behaviours, ranging from 0.87 to 0.93, with the exception of moderate activity and moderate-to-vigorous activity by the ActiGraph (VT) at 0.66 and 0.67, respectively.
Conclusion
Despite small mean differences and comparable recordings by both devices at the group level, the precision of estimates between methods was low with wide limits of agreement, suggesting these devices may not be used interchangeably for measuring physical activity and sedentary behaviour using common data reduction methods.
Background:
The relationship between metabolic risk and time spent sitting, standing and stepping has not been well established. The present study aimed to determine associations of objectively measured time spent siting, standing and stepping, with coronary heart disease (CHD) risk.
Methods:
A cross-sectional study of healthy non-smoking Glasgow postal workers, n=111 (55 office-workers, 5 women, and 56 walking/delivery-workers, 10 women), who wore activPAL physical activity monitors for seven days. Cardiovascular risks were assessed by metabolic syndrome categorisation and 10-y PROCAM risk.
Results:
Mean(s.d.) age was 40(8) years, BMI 26.9(3.9)kg/m(2) and waist circumference 95.4(11.9)cm. Mean(s.d.) HDL-cholesterol 1.33(0.31), LDL-cholesterol 3.11(0.87), triglycerides 1.23(0.64)mmol/l and 10-y PROCAM risk 1.8(1.7)%. Participants spent mean(s.d.) 9.1(1.8)h/d sedentary, 7.6(1.2)h/d sleeping, 3.9(1.1)h/d standing and 3.3(0.9)h/d stepping, accumulating 14,708(4,984)steps/d in 61(25) sit-to-stand transitions per day. In univariate regressions-adjusting for age, sex, family history of CHD, shift worked, job type and socio-economic status-waist circumference (P=0.005), fasting triglycerides (P=0.002), HDL-cholesterol (P=0.001) and PROCAM-risk (P=0.047) were detrimentally associated with sedentary time. These associations remained significant after further adjustment for sleep, standing and stepping in stepwise regression models. However, after further adjustment for waist circumference, the associations were not significant. Compared to those without the metabolic syndrome, participants with the metabolic syndrome were significantly less active-fewer steps, shorter stepping duration and longer time sitting. Those with no metabolic syndrome features walked >15 000 steps/day, or spent >7 h/day upright.
Conclusion:
Longer time spent in sedentary posture is significantly associated with higher CHD risk and larger waist circumference.International Journal of Obesity accepted article preview online, 31 January 2017. doi:10.1038/ijo.2017.30.
Background
Increasing population-levels of physical activity (PA) is a controversial strategy for managing the obesity epidemic, given the conflicting evidence for weight loss from PA alone per se . We measured PA and weight change in a three-year prospective cohort study in young adults from five countries (Ghana, South Africa, Jamaica, Seychelles and USA).
Methods
A total of 1,944 men and women had baseline data, and at least 1 follow-up examination including measures of anthropometry (weight/BMI), and objective PA (accelerometer, 7-day) following the three-year study period. PA was explored as 1-minute bouts of moderate and vigorous PA (MVPA) as well as daily sedentary time.
Results
At baseline; Ghanaian and South African men had the lowest body weights (63.4 ± 9.5, 64.9 ± 11.8 kg, respectively) and men and women from the USA the highest (93.6 ± 25.9, 91.7 ± 23.4 kg, respectively). Prevalence of normal weight ranged from 85% in Ghanaian men to 29% in USA men and 52% in Ghanaian women to 15% in USA women. Over the two-year follow-up period, USA men and Jamaican women experienced the smallest yearly weight change rate (0.1 ± 3.3 kg/yr; −0.03 ± 3.0 kg/yr, respectively), compared to South African men and Ghanaian women greatest yearly change (0.6.0 ± 3.0 kg/yr; 1.22 ± 2.6 kg/yr, respectively). Mean yearly weight gain tended to be larger among normal weight participants at baseline than overweight/obese at baseline. Neither baseline MVPA nor sedentary time were associated with weight gain. Using multiple linear regression, only baseline weight, age and gender were significantly associated with weight gain.
Discussion
From our study it is not evident that higher volumes of PA alone are protective against future weight gain, and by deduction our data suggest that other environmental factors such as the food environment may have a more critical role.
OBJECTIVE:
Pathomechanisms of sedentary behavior (SB) are unclear. We conducted a systematic review to investigate the associations between SB and various biomarkers in older adults.
METHODS:
Electronic databases were searched (MEDLINE, EMBASE, CINAHL, AMED) up to July 2015 to identify studies with objective or subjective measures of SB, sample size≥50, mean age≥60years and accelerometer wear time ≥3 days. Methodological quality was appraised with the CASP tool. The protocol was pre-specified (PROSPERO CRD42015023731).
RESULTS:
12701 abstracts were retrieved, 275 full text articles further explored, from which 249 were excluded. In the final sample (26 articles) a total of 63 biomarkers were detected. Most investigated markers were: body mass index (BMI, n=15), waist circumference (WC, n=15), blood pressure (n=11), triglycerides (n=12) and high density lipoprotein (HDL, n=15). Some inflammation markers were identified such as interleukin-6, C-reactive protein or tumor necrosis factor alpha. There was a lack of renal, muscle or bone biomarkers. Randomized controlled trials found a positive correlation for SB with BMI, neck circumference, fat mass, HbA1C, cholesterol and insulin levels, cohort studies additionally for WC, leptin, C-peptide, ApoA1 and Low density lipoprotein and a negative correlation for HDL.
CONCLUSION:
Most studied biomarkers associated with SB were of cardiovascular or metabolic origin. There is a suggestion of a negative impact of SB on biomarkers but still a paucity of high quality investigations exist. Longitudinal studies with objectively measured SB are needed to further elucidate the pathophysiological pathways and possible associations of unexplored biomarkers.
Objective:
To determine whether meeting physical activity (PA) recommendations and/or having high age-specific cardiorespiratory fitness (CRF) attenuate the adverse effect of prolonged sedentary time on cardiovascular risk factor (CV-RF) clustering in older adults.
Patients and methods:
We conducted a cross-sectional study of Norwegian women (495) and men (379) aged 70 to 77 years from August 22, 2012, through June 30, 2013. Sedentary time and PA were assessed by accelerometers and CRF by directly measured peak oxygen uptake (VO2peak). Logistic regression was used to estimate adjusted odds ratios (ORs) and CIs for the association between sedentary time and prevalence of CV-RF clustering (≥3 of the following: hypertension, high blood glucose level, high waist circumference, low high-density lipoprotein cholesterol level, or high triglyceride level) and for the modifying effect of PA and CRF.
Results:
Overall, 163 of the 495 women (32.9%) and 140 of the 379 men (36.9%) had CV-RF clustering. Each additional hour of sedentary time was associated with 22% (OR, 1.22; 95% CI, 1.02-1.45) and 27% (OR, 1.27; 95% CI, 1.04-1.55) higher likelihood of having CV-RF clustering in women and men, respectively, whereas a 1-metabolic equivalent decrement in VO2peak corresponded to 57% (OR, 1.57; 95% CI, 1.34-1.84) and 67% (OR, 1.67; 95% CI, 1.44-1.95) higher likelihood of CV-RF clustering in women and men, respectively. High CRF (VO2peak >27.5 mL/kg per minute in women and >34.4 mL/kg per minute in men) attenuated the adverse effects of high sedentary time on CV-RF clustering, even among individuals not meeting recommendations for PA.
Conclusion:
High age-specific CRF fully attenuates the adverse effect of prolonged sedentary time on CV-RF clustering, independent of meeting the PA consensus recommendation in older adults.
Objective . Epidemiologic studies suggest an inverse relationship between nonalcoholic fatty liver disease (NAFLD), visceral adipose tissue (VAT), and self-reported physical activity levels. However, subjective measurements can be inaccurate and prone to reporter bias. We investigated whether objectively quantified physical activity levels predicted liver fat and VAT in overweight/obese adults. Methods . Habitual physical activity was measured by triaxial accelerometry for four days ( n = 82 ). Time spent in sedentary behavior (MET < 1.6) and light (MET 1.6 < 3), moderate (MET 3 < 6), and vigorous (MET 6 < 9) physical activity was quantified. Magnetic resonance imaging and spectroscopy were used to quantify visceral and liver fat. Bivariate correlations and hierarchical multiple regression analyses were performed. Results . There were no associations between physical activity or sedentary behavior and liver lipid. Sedentary behavior and moderate and vigorous physical activity accounted for just 3% of variance for VAT ( p = 0.14 ) and 0.003% for liver fat ( p = 0.96 ). Higher levels of VAT were associated with time spent in moderate activity ( r = 0.294 , p = 0.007 ), but there was no association with sedentary behavior. Known risk factors for obesity-related NAFLD accounted for 62% and 40% of variance in VAT and liver fat, respectively ( p < 0.01 ). Conclusion . Objectively measured levels of habitual physical activity and sedentary behavior did not influence VAT or liver fat.
Objectives:
To investigate associations between self-reported and objectively measured physical activity, sedentary behavior and overweight/obesity based on percent body fat measured with Dual Energy X-Ray Absorptiometry (DXA), waist circumference (WC), waist-to-height ratio (WHtR) and body mass index (BMI), focusing on different intensities and domains of physical activity.
Methods:
Data from NHANES 2003-2006 were analyzed using linear and ordered logistic regression analyses. A total of 4794 individuals aged 18-69 years with valid physical activity and DXA data were included. Objectively measured physical activity and sedentary behavior were assessed using accelerometers, self-reported physical activity using the NHANES physical activity questionnaire. Weight, height, WC and DXA measures were assessed in the mobile examination centers.
Results:
We observed statistically significant associations between objectively measured moderate and vigorous physical activity and all definitions of overweight/obesity. For total physical activity, the odds of being in the higher percent body fat category were 0.56 (95% CI 0.41, 0.77) for the medium and 0.30 (95% CI 0.22, 0.40) for the highest physical activity tertile compared to the lowest. For light activities, lifestyle activities and sedentary behavior, associations were only observed in the linear models with percent total body fat but not in the ordered logistic regression models. Regarding self-reported physical activity, consistent significant associations with overweight/obesity were only observed for vigorous and for transport activity.
Conclusions:
Regarding moderate and vigorous physical activity, more active individuals were less affected by overweight/obesity than less active individuals, emphasizing the public health effect of physical activity in the prevention of overweight/obesity. The fact that associations were more consistent for objectively measured than for self-reported physical activity may be due to bias related to self-reporting. Associations between lower intensity activities and overweight/obesity were weak or inexistent.International Journal of Obesity accepted article preview online, 28 September 2016. doi:10.1038/ijo.2016.168.
Background: This study aimed to examine the associations between time spent in prolonged and non-prolonged sedentary bouts and the development of metabolic syndrome.
Methods: We used data from a prospective study of Japanese workers. Baseline examination was conducted between 2010 and 2011. A total of 430 office workers (58 women) aged 40-64 years without metabolic syndrome were followed up by annual health checkups until 2014. Metabolic syndrome was defined as having ≥ 3 out of 5 diagnostic criteria from the Joint Interim Statement 2009 definition. Sedentary time was assessed using a tri-axial accelerometer. Time spent in total, prolonged (accumulated ≥ 30 min) and non-prolonged sedentary bouts (accumulated < 30 min) was calculated. Cox proportional hazards models were used to estimate the risk of developing metabolic syndrome.
Results: During a median follow-up of 3 years, 83 participants developed metabolic syndrome. After adjustment for age, sex, education, smoking, and family income, positive associations were observed between time spent in prolonged sedentary bouts and the development of metabolic syndrome. After additional adjustment for moderate-to-vigorous physical activity, those in the three highest quartiles of time spent in prolonged sedentary bouts showed higher risk of metabolic syndrome compared to the lowest quartile group, with adjusted hazard ratios (95 % confidence intervals) of 2.72 (1.30 – 5.73), 2.42 (1.11 – 5.50), and 2.85 (1.31 – 6.18), respectively. No associations were seen for time spent in total and non-prolonged sedentary bouts.
Conclusions: Sedentary behavior accumulated in a prolonged manner was associated with an increased risk of metabolic syndrome. In devising public health recommendations for the prevention of metabolic disease, the avoidance of prolonged uninterrupted periods of sedentary behavior should be considered.
We aimed to study the independent associations of sedentary time (ST), moderate-to-vigorous physical activity (MVPA), and objectively measured cardiorespiratory fitness (CRF) with clustered cardio-metabolic risk and its individual components (waist circumference, fasting glucose, HDL-cholesterol, triglycerides and blood pressure). We also investigated whether any associations between MVPA or ST and clustered cardio-metabolic risk were mediated by CRF. MVPA, ST, CRF and individual cardio-metabolic components were measured in a population-based sample of 341 adults (age 53.8 ± 8.9 years; 61% men) between 2012 and 2014. MVPA and ST were measured with the SenseWear pro 3 Armband and CRF was measured with a maximal exercise test. Multiple linear regression models and the product of coefficients method were used to examine independent associations and mediation effects, respectively. Results showed that low MVPA and low CRF were associated with a higher clustered cardio-metabolic risk (β = -0.26 and β = -0.43, both p<0.001, respectively). CRF explained 73% of the variance in the association between MVPA and clustered cardio-metabolic risk and attenuated this association to non-significance. After mutual adjustment for MVPA and ST, CRF was the most important risk factor for a higher clustered cardio-metabolic risk (β = -0.39, p<0.001). In conclusion, because of the mediating role of CRF, lifestyle-interventions need to be feasible yet challenging enough to lead to increases in CRF to improve someone's cardio-metabolic health.
Background
Sedentary behaviour is increasingly recognized as a public health risk that needs to be monitored at the population level. Across Europe, there is increasing interest in assessing population levels of sedentary time. This systematic literature review aims to provide an overview of all existing cross-European studies that measure sedentary time in adults, to describe the variation in population levels across these studies and to discuss the impact of assessment methods.
Methods
Six literature databases (PubMed, EMBASE, CINAHL, PsycINFO, SportDiscus and OpenGrey) were searched, supplemented with backward- and forward tracking and searching authors’ and experts’ literature databases. Articles were included if they reported on observational studies measuring any form of sedentary time in the general population in two or more European countries. Each record was reviewed, extracted and assessed by two independent researchers, and disagreements were resolved by a third researcher. The review protocol of this review is registered in the PROSPERO database under registration number CRD42014010335.
Results
Of the 9,756 unique articles that were identified in the search, twelve articles were eligible for inclusion in this review, reporting on six individual studies and three Eurobarometer surveys. These studies represented 2 to 29 countries, and 321 to 65,790 participants. Eleven studies focused on total sedentary time, while one studied screen time. The majority of studies used questionnaires to assess sedentary time, while two studies used accelerometers. Total sedentary time was reported most frequently and varied from 150 (median) to 620 (mean) minutes per day across studies and countries.
Conclusions
One third of European countries were not included in any of the studies. Objective measures of European adults are currently limited, and most studies used single-item self-reported questions without assessing sedentary behaviour types or domains. Findings varied substantially between studies, meaning that population levels of sedentary time in European adults are currently unknown. In general, people living in northern Europe countries appear to report more sedentary time than southern Europeans. The findings of this review highlight the need for standardisation of the measurement methods and the added value of cross-European surveillance of sedentary behaviour.
Electronic supplementary material
The online version of this article (doi:10.1186/s12966-016-0397-3) contains supplementary material, which is available to authorized users.
Background:
There is considerable disagreement about the association between free-living physical activity (PA) and sedentary behaviour and obesity. Moreover studies frequently do not include measures that could mediate between PA and adiposity. The present study used a validated instrument for continuous tracking of sedentary and active behaviours as part of habitual daily living, together with measures of energy expenditure, body composition and appetite dysregulation. This cross-sectional study tested the relationship between inactivity and obesity.
Methods:
71 participants (81.7% women) aged 37.4 years (±14) with a body mass index of 29.9 kg/m(2) (±5.2) were continuously monitored for 6-7 days to track free-living PA (light 1.5-3 metabolic equivalents (METs), moderate 3-6 METs and vigorous >6 METs) and sedentary behaviour (<1.5 METs) with the SenseWear Armband. Additional measures included body composition, waist circumference, cardiovascular fitness, total and resting energy expenditure, and various health markers. Appetite control was assessed by validated eating behaviour questionnaires.
Results:
Sedentary behaviour (11.06±1.72 h/day) was positively correlated with fat mass (r=0.50, p<0.001) and waist circumference (r=-0.65, p<0.001). Moderate-to-vigorous PA was negatively associated with fat mass (r=-0.72, p<0.001) and remained significantly correlated with adiposity after controlling for sedentary behaviour. Activity energy expenditure was positively associated with the level of PA and negatively associated with fat mass. Disinhibition and binge eating behaviours were positively associated with fat mass (r=0.58 and 0.47, respectively, p<0.001).
Conclusions:
This study demonstrated clear associations among objective measures of PA (and sedentary behaviour), energy expenditure, adiposity and appetite control. The data indicate strong links between physical inactivity and obesity. This relationship is likely to be bidirectional.
Background:
Little is known about associations of temporal patterns of sitting (i.e., distribution of sitting across time) with obesity. We aimed investigating the association between temporal patterns of sitting (long, moderate and brief uninterrupted bouts) and obesity indicators (body mass index (BMI), waist circumference and fat percentage), independently from moderate-vigorous physical activity (MVPA) and total sitting time among blue-collar workers.
Methods:
Workers (n = 205) wore Actigraph GT3X+ accelerometers on the thigh and trunk for 1-4 working days. Using the validated Acti4 software, the total sitting time and time spent sitting in brief (≤5 mins), moderate (>5 and ≤30 mins), and long (>30mins) bouts on working days were determined for the whole day, and for leisure and work separately. BMI (kg/m(2)), waist circumference (cm) and fat percentage were objectively measured.
Results:
Results of linear regression analysis adjusted for multiple confounders indicated that brief bouts of sitting was negatively associated with obesity for the whole day (BMI, P < 0.01; fat percentage, P < 0.01; waist circumference, P < 0.01) and work (BMI, P < 0.01; fat percentage, P < 0.01; waist circumference, P < 0.01), but not for leisure. Sitting time in long bouts was positively associated with obesity indicators for the whole day (waist circumference, P = 0.05) and work (waist circumference, P = 0.01; BMI, P = 0.04), but not leisure.
Conclusions:
For the whole day as well as for work, brief bouts and long bouts of sitting showed opposite associations with obesity even after adjusting for MVPA and total sitting time, while sitting during leisure did not show these associations. Thus, the temporal distribution of sitting seems to influence the relationship between sitting and obesity.
Background
Both physical activity and sedentary behaviour have been individually associated with health, however, the extent to which the combination of these behaviours influence health is less well-known. The aim of this study was to examine the associations of four mutually exclusive categories of objectively measured physical activity and sedentary time on markers of cardiometabolic health in a nationally representative sample of English adults.
Methods
Using the 2008 Health Survey for England dataset, 2131 participants aged ≥18 years, who provided valid accelerometry data, were included for analysis and grouped into one of four behavioural categories: (1) ‘Busy Bees’: physically active & low sedentary, (2) ‘Sedentary Exercisers’: physically active & high sedentary, (3) ‘Light Movers’: physically inactive & low sedentary, and (4) ‘Couch Potatoes’: physically inactive & high sedentary. ‘Physically active’ was defined as accumulating at least 150 min of moderate-to-vigorous physical activity (MVPA) per week. ‘Low sedentary’ was defined as residing in the lowest quartile of the ratio between the average sedentary time and the average light-intensity physical activity time. Weighted multiple linear regression models, adjusting for measured confounders, investigated the differences in markers of health across the derived behavioural categories. The associations between continuous measures of physical activity and sedentary levels with markers of health were also explored, as well as a number of sensitivity analyses.
Results
In comparison to ‘Couch Potatoes’, ‘Busy Bees’ [body mass index: −1.67 kg/m² (p < 0.001); waist circumference: −1.17 cm (p = 0.007); glycated haemoglobin: −0.12 % (p = 0.003); HDL-cholesterol: 0.09 mmol/L (p = 0.001)], ‘Sedentary Exercisers’ [body mass index: −1.64 kg/m² (p < 0.001); glycated haemoglobin: −0.11 % (p = 0.009); HDL-cholesterol: 0.07 mmol/L (p < 0.001)] and ‘Light Movers’ [HDL-cholesterol: 0.11 mmol/L (p = 0.004)] had more favourable health markers. The continuous analyses showed consistency with the categorical analyses and the sensitivity analyses indicated robustness and stability.
Conclusions
In this national sample of English adults, being physically active was associated with a better health profile, even in those with concomitant high sedentary time. Low sedentary time independent of physical activity had a positive association with HDL-cholesterol.
Background:
This study examined the association between objectively measured physical activity patterns and risk factors of metabolic syndrome (MetS) in Saudi men.
Methods:
The study was cross-sectional, and 84 healthy men from the Saudi population (age 37.6 ± 8.8 years, body mass index [BMI] 28.4 ± 5.4 kg/m(2)) were recruited. Measurements of physical activity were made using triaxial accelerometers over 7 consecutive days of leisure time physical activity. Waist circumference and blood pressure were measured, and fasting blood samples taken to measure glucose, high density lipoprotein cholesterol (HDL), and triglycerides (TG).
Results:
A total 21.4 % of participants had three or more risk factors for MetS, with low HDL levels the most frequent factor. Light physical activity (LPA) and BMI explained 13 % of the variation in TG. Moderate to vigorous physical activity (MVPA) with a minimum 10-min per session (10-min MVPA), LPA, and BMI explained 16 % of the variation in HDL. Sedentary behavior was not significantly associated with risk factors of MetS, although odds ratios indicated that decreased sedentarism does have a protective effect against MetS.
Conclusions:
LPA and 10-min MVPA were associated with elevated HDL levels among Saudi men. Future studies should confirm whether time spent physically active independent of intensity is an important factor in improving HDL levels.
Systematic reviews should build on a protocol that describes the rationale, hypothesis, and planned methods of the review; few reviews report whether a protocol exists. Detailed, well-described protocols can facilitate the understanding and appraisal of the review methods, as well as the detection of modifications to methods and selective reporting in completed reviews. We describe the development of a reporting guideline, the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015). PRISMA-P consists of a 17-item checklist intended to facilitate the preparation and reporting of a robust protocol for the systematic review. Funders and those commissioning reviews might consider mandating the use of the checklist to facilitate the submission of relevant protocol information in funding applications. Similarly, peer reviewers and editors can use the guidance to gauge the completeness and transparency of a systematic review protocol submitted for publication in a journal or other medium.
Previous studies on the relation between lifestyle and the metabolic syndrome lack one or several aspects of the physical activity pattern in the analyses or cardiorespiratory fitness. Likewise, both uni- and triaxial accelerometry have been used, though, the predictive validity of these two modes has not been compared.
The aims of the present study were firstly to investigate the independent relation between cardiorespiratory fitness and physical activity pattern to the metabolic syndrome (MetS) and secondly to examine the predictive validity of uni- and triaxial accelerometry, respectively.
Data was extracted from the SCAPIS pilot study (n=930, mean age 57.7 yrs). Physical activity pattern was assessed by accelerometry. Cardiorespiratory fitness was estimated using cycle ergometry. MetS was defined per the Adult Treatment Panel III from the National Cholesterol Education Program definition.
Time spent sedentary (OR: 2.38, 95% CI: 1.54-4.24 for T3 vs T1), in light intensity (OR: 0.50, 95% CI: 0.28-0.90) and in moderate-to-vigorous activity (OR: 0.33, 95% CI: 0.18-0.61), as well as cardiorespiratory fitness (OR: 0.24, 95% CI:0.12-0.48), were all independently related to the prevalence of MetS after adjustment for potential confounders, fitness and/or the other aspects of the physical activity pattern. In addition, we found that triaxial analyses were more discriminant, with ORs farther away from the reference group and additional significant ORs.
The finding that several aspects of the physical activity pattern reveal independent relations to the MetS makes new possible targets for behaviour change of interest, focusing on both exercise and everyday life. When assessing the risk status of a patient, it is advised that triaxial accelerometry is used.
We conducted a systematic review to investigate the cross-sectional and prospective associations of accelerometer-measured total sedentary time and breaks in sedentary time with individual cardiometabolic biomarkers in adults ≥18 years of age.
Ovid Medline, Embase, Web of Science and the Cochrane Library were searched for studies meeting the inclusion criteria. Due to inconsistencies in the measurement and analysis of sedentary time, data was synthesised and presented narratively rather than as a meta-analysis.
Twenty-nine studies were included in the review; twenty-eight reported on total sedentary time and six on breaks in sedentary time. There was consistent evidence from cross-sectional data of an unfavourable association between total sedentary time and insulin sensitivity. There was also some evidence of unfavourable associations with fasting insulin, insulin resistance and triglycerides. Furthermore, there was some evidence from cross-sectional data of a favourable association between breaks in sedentary time and triglycerides.
Total sedentary time was consistently shown to be associated with poorer insulin sensitivity, even after adjusting for time spent in physical activity. This finding supports the proposed association between sedentary time and the development of Type 2 diabetes and reinforces the need to identify interventions to reduce time spent sedentary.
Copyright © 2015. Published by Elsevier Inc.
This cross-sectional study is one of the first to examine and compare the independent associations of objectively measured sedentary time, moderate to vigorous physical activity (MVPA) and fitness with cardio-metabolic risk factors. We studied 543 men and women (aged 18-49 years) from the NHANES 2003-2004 survey. Sedentary time and MVPA were measured by accelerometry. Fitness was assessed with a submaximal treadmill test. Cardio-metabolic risk factors included: waist circumference (WC), BMI, blood pressure, fasting glucose, HDL- and non HDL cholesterol, triglycerides (TG), and C-reactive protein (CRP). Sedentary time, MVPA and fitness were used as predictors for the cardio-metabolic outcomes in a multiple regression analysis. Standardized regression coefficients were computed. Results show that sedentary time was associated with HDL-cholesterol (β = -0.080, p = 0.05) and TG (β = 0.080, p = 0.03). These results became non-significant after adjustment for MVPA and fitness. MVPA was associated with WC (β = -0.226), BMI (β = -0.239), TG (β = -0.108) and HDL-cholesterol (β = 0.144) (all p < 0.05). These results remained significant after adjustment for sedentary time and fitness. Fitness was associated with WC (β = -0.287), BMI (β = -0.266), systolic blood pressure (β = -0.159), TG (β = -0.092), and CRP (β = -0.130) (all p < 0.05). After adjustment for sedentary time and MVPA these results remained significant. These differences in relative importance of sedentary time, MVPA and fitness on cardio-metabolic-risk are important in the design of prevention programs. In this population, the strength of the associations between MVPA and fitness with cardio-metabolic markers appeared to be similar; both MVPA and fitness showed independent associations with cardio-metabolic risk factors. In contrast, sedentary time showed no independent associations with cardio-metabolic risk after correction for fitness and MVPA.
Risk factors associated with many chronic diseases can be improved through regular physical activity. This study investigated whether cross-sectional associations between physical activity, assessed by the Exercise Vital Sign (EVS), and cardiometabolic risk factors can be detected in clinical settings.
We used electronic records from Kaiser Permanente Southern California members (N = 622,897) to examine the association of EVS category with blood pressure, fasting glucose, random glucose, and glycosylated hemoglobin. Adults aged 18 years or older with at least 3 EVS measures between April 2010 and December 2012, without comorbid conditions, and not taking antihypertension or glucose-lowering medications were included. We compared consistently inactive (EVS = 0 min/wk for every measure) with consistently active (EVS ≥150 min/wk) and irregularly active (EVS 1-149 min/wk or not meeting the consistently active or inactive criteria) patients. Separate linear regression analyses were conducted controlling for age, sex, race/ethnicity, body mass index, and smoking status.
Consistently active women had lower systolic (-4.60 mm Hg; 95% confidence interval [CI], -4.70 to -4.44) and diastolic (-3.28 mm Hg; 95% CI, -3.40 to -3.17) blood pressure than inactive women. Active men had lower diastolic blood pressure than inactive men. Consistently active patients (women, -5.27 mg/dL [95% CI, -5.56 to -4.97]; men, -1.45 mg/dL [95% CI, -1.75 to -1.16] and irregularly active patients (women, -4.57 mg/dL [95% CI, -4.80 to -4.34]; men, -0.42 mg/dL [95% CI, -0.66 to -0.19]) had lower fasting glucose than consistently inactive patients. Consistently active and irregularly active men and women also had favorable random glucose and HbA1c compared with consistently inactive patients.
Routine clinical physical activity assessment may give health care providers additional information about their patients' cardiometabolic risk factors.
Sedentary behavior has been reported to be associated with metabolic and vascular health independent of moderate-to-vigorous physical activity (MVPA). In order to select appropriate options to measure sedentary behavior in practice and research settings, it is worthwhile to characterize the extent to which objective and subjective measures of sedentary behavior quantify adverse health risks in the same population. This cross-sectional analysis compared accelerometer-derived and self-reported sedentary time to identify their association with cardio-metabolic risk factors.
Cross-sectional analysis was conducted using data from 661 Japanese workers (145 women) aged 20–64 years. Participants wore a tri-axial accelerometer device for 10 consecutive days and completed the Japan Atherosclerosis Longitudinal Study Physical Activity Questionnaire. Data on body mass index, waist circumference, resting blood pressure, triglycerides, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, total:HDL cholesterol ratio, blood glucose, and glycosylated hemoglobin (HbA1c) were obtained from annual health examinations.
Both accelerometer-derived and self-reported sedentary time were deleteriously associated with triglycerides, HDL-cholesterol, total:HDL ratio, and HbA1c after adjustment for potential confounders including MVPA. There were no significant differences in regression coefficients between the two measures. Thus, the magnitude of the associations of both measures with cardio-metabolic risk factors was similar, despite poor agreement between them. Occupational sedentary time was correlated with both measures of total sedentary time, and more consistently associated with cardio-metabolic risk factors than sedentary leisure time.
Both accelerometer and self-report measurements are similarly associated with cardio-metabolic risk factors in a Japanese working adult population. Subjective and objective measures of sedentary behaviors appear to capture different aspects of behaviors. Further efforts to establish data processing methods integrating objective and subjective measures are needed to more effectively assess sedentary time’s relationship to health outcomes.
Background
The study objectives were to examine whether: 1) sedentary time is associated with sleep duration, 2) sedentary time predicts the metabolic syndrome (MetS) independent of sleep duration and vice versa, and 3) sedentary time and sleep duration have an interactive effect on the MetS.
Methods
This cross-sectional study is based on the 2003–2006 National Health and Nutrition Examination Survey. A sample of 1371 adults (aged ≥20 years) were studied. Average daily sedentary time and sleep duration were determined via 7-day accelerometry. Screen time was determined via questionnaire. The MetS was determined using standard criteria. Analysis of variance was used to examine relationships among sedentary time and screen time with sleep duration. Logistic regression was used to examine associations between sedentary time, screen time, and sleep duration with the MetS after controlling for several confounders.
Results
Sedentary time and screen time did not vary across sleep duration quartiles. Participants in the highest quartile of sedentary time were more likely to have the MetS than participants in the lowest quartile (odds ratio = 1.60, 95% CI:1.05-2.45). The odds of the MetS was higher in participants in the highest screen time tertile as compared to the lowest tertile (odds ratio = 1.67, 95% confidence interval:1.13-2.48). Sleep duration was not independently related to the MetS. There were no significant sedentary time X sleep duration interactions on the MetS.
Conclusion
Highly sedentary individuals and individuals with a high screen time are more likely to have the MetS.
Objective To investigate the association between objectively measured sitting and standing, using a postural allocation technique, with MRI-assessed body composition.
Design The present study was a cross-sectional pilot study.
Setting Participants were examined at one centre located in London, UK.
Participants Normal weight Caucasian women (30.9±6.1 years; body mass index (BMI), 22.9±3.4 kg/m2) with desk-bound occupations were recruited to minimise variability in body composition outcomes. A convenience sample of 12 women was recruited in January 2014 from University College London.
Outcome measures For each participant a number of body composition variables were attained from a single whole-body MRI session. Main outcome variables included: total and liver adiposity, visceral/subcutaneous fat ratio and BMI. Main exposure variables included: average sitting time, standing:sitting ratio and step count. Pearson correlations were carried out to examine associations between different activity categories and body composition variables.
Results There were significant correlations between average daily sitting and liver adiposity and visceral/subcutaneous abdominal fat ratio (r=0.66 and 0.64, respectively); standing:sitting ratio was moderately correlated with liver adiposity and visceral/subcutaneous abdominal fat ratio (r=−0.53 and −0.45); average daily step count was moderately correlated with liver adiposity, total adiposity and visceral/subcutaneous abdominal fat ratio (r=−0.45, −0.46 and −0.51, respectively).
Conclusions This pilot study has provided preliminary evidence of relationships between objectively measured sitting and standing and precise measures of body composition.
In the last decade, sedentary behavior has emerged as a new risk factor for health. The elderly spend most of their awake time in sedentary activities. Despite this high exposure, the impact of this sedentary behavior on the health of this population has not yet been reviewed. We systematically reviewed evidence for associations between sedentary behavior and multiple health outcomes in adults over 60 years of age.
We searched the Medline, Embase, Web of Science, SPORTDiscus, PsycINFO, CINAHL, LILLACS, and Sedentary Research Database for observational studies published up to May 2013. Additionally, we contacted members of the Sedentary Behaviour Research Network to identify articles that were potentially eligible. After inclusion, the methodological quality of the evidence was assessed in each study.
We included 24 eligible articles in our systematic review, of which only 2 (8%) provided high-quality evidence. Greater sedentary time was related to an increased risk of all-cause mortality in the older adults. Some studies with a moderate quality of evidence indicated a relationship between sedentary behavior and metabolic syndrome, waist circumference, and overweightness/obesity. The findings for other outcomes such as mental health, renal cancer cells, and falls remain insufficient to draw conclusions.
This systematic review supports the relationship between sedentary behavior and mortality in older adults. Additional studies with high methodological quality are still needed to develop informed guidelines for addressing sedentary behavior in older adults.
Purpose:
Sedentary behavior has been proposed as an independent cardio-metabolic risk factor even in adults who are physically active through recreational activity. Because little is known about the metabolic effects of sedentariness in seniors, the relationship between sedentary behavior and cardio-metabolic risk was examined in physically active older adults.
Methods:
Fifty-four community dwelling men and women > 65 years of age (mean 71.5 years) were enrolled in this cross-sectional observational study. Subjects were in good health and free of known diabetes. Activity levels (sedentary, light, moderate to vigorous activity time per day) were recorded with accelerometers worn continuously for 7 days. Cardio-metabolic risk factors measured consisted of the American Heart Association diagnostic criteria for metabolic syndrome (waist circumference, triglycerides, high-density lipoprotein, systolic blood pressure and fasting glucose) as well as low-density lipoprotein (LDL). The relationships between activity measures and cardio-metabolic risk factors were examined. Significant variables were then entered into a stepwise multivariate regression model.
Results:
All but one subject achieved exercise levels recommended by the American College of Sports Medicine. The average proportion of time spent at a sedentary activity level each day was 72.7%. From the regression analysis, the only significant association found between cardio-metabolic risk outcomes and activity predictors was between LDL and sedentary time, with LDL detrimentally associated with average sedentary time per day (Standardized Beta Correlation Coefficient 0.302, p < 0.05).
Conclusion:
Sedentary behavior is associated with an adverse metabolic effect on LDL in seniors, even those who meet guideline recommendations for an active "fit" adult.
Lack of appropriate reporting of methodological details has previously been shown to distort risk of bias assessments in randomized controlled trials. The same might be true for observational studies. The goal of this study was to compare the Newcastle-Ottawa Scale (NOS) assessment for risk of bias between reviewers and authors of cohort studies included in a published systematic review on risk factors for severe outcomes in patients infected with influenza.
Cohort studies included in the systematic review and published between 2008-2011 were included. The corresponding or first authors completed a survey covering all NOS items. Results were compared with the NOS assessment applied by reviewers of the systematic review. Inter-rater reliability was calculated using kappa (K) statistics.
Authors of 65/182 (36%) studies completed the survey. The overall NOS score was significantly higher (p < 0.001) in the reviewers' assessment (median = 6; interquartile range [IQR] 6-6) compared with those by authors (median = 5, IQR 4-6). Inter-rater reliability by item ranged from slight (K = 0.15, 95% confidence interval [CI] = -0.19, 0.48) to poor (K = -0.06, 95% CI = -0.22, 0.10). Reliability for the overall score was poor (K = -0.004, 95% CI = -0.11, 0.11).
Differences in assessment and low agreement between reviewers and authors suggest the need to contact authors for information not published in studies when applying the NOS in systematic reviews.
When faced with a P value that has failed to reach some specific threshold (generally P>0.05), authors of scientific articles may imply a "trend towards statistical significance" or otherwise suggest that the failure to achieve statistical significance was due to insufficient data. This paper presents a quantitative analysis to show that such descriptions give a misleading impression and undermine the principle of accurate reporting.
Objectives:
High levels of physical activity (PA) may prevent the development of obesity. However, the magnitude and direction of the association between PA of various intensities, sedentary time and weight status remain unclear. Thus, we examined whether objectively measured sedentary time and PA independently predict gain in body weight, change in body weight and to examine the possibility of reverse causation.
Methods:
We examined the prospective associations between sedentary time, PA and body weight (BW). Baseline measurements were conducted in 2008/2009 and follow-up measurements in 2014/2015 in a random sample of the adult Norwegian population (N=1710, 45.1% men). Moderate and vigorous intensity PA (MVPA) and sedentary time were measured by accelerometry and BW and height self-reported. We first modelled the associations between baseline sedentary time and PA with BW at follow-up. We then modelled the reverse associations (BW as the exposure) and sedentary time and PA (as outcomes) in separate models. All models were adjusted for age, sex, baseline value of the outcome, socio-economic status, alcohol consumption, smoking, monitor wear time and follow-up time.
Results:
Body mass index (BMI) increased by 0.2 units (P=0.003) between baseline and follow-up, and 46.5% of participants were either overweight (36.4%) or obese (10.1%) at baseline increasing to 49.6% (11.7% obese) at follow-up. Baseline sedentary time, MVPA and vigorous PA were not associated with BW at follow-up after adjustment for covariates. In contrast, baseline BW was inversely associated with MVPA (β=−0.11; 95% confidence interval (CI); −0.21, −0.009) and VPA (β=−0.035; 95% CI; −0.059, −0.011) in adjusted models. These associations were unchanged when BW was substituted by BMI.
Conclusions:
Baseline BW seems to determine a decrease in MVPA in healthy adult Norwegian men and women, more so than the reverse.
The purpose of this review was to provide an overview of the descriptive epidemiology of physical activity (PA) and exercise training in the United States. Overall, there is a low prevalence of meeting the current PA guidelines in all age, sex and race/ethnic groups. Among adults the prevalence of meeting the aerobic component of the guidelines is approximately 51%, whereas the prevalence of meeting both the aerobic and muscle-strengthening guidelines is approximately 23%. Approximately 27% of high school students meet the aerobic component of the pediatric guidelines (60 minutes of daily moderate-to-vigorous activity), and the proportion of youth meeting the guidelines decreases with advancing age. Further research is required to promote physically active lifestyles across the age spectrum in order to achieve optimal health benefits for the overall population.
Background:
High amounts of sedentary behaviour have been associated with increased risks of several chronic conditions and mortality. However, it is unclear whether physical activity attenuates or even eliminates the detrimental effects of prolonged sitting. We examined the associations of sedentary behaviour and physical activity with all-cause mortality.
Methods:
We did a systematic review, searching six databases (PubMed, PsycINFO, Embase, Web of Science, Sport Discus, and Scopus) from database inception until October, 2015, for prospective cohort studies that had individual level exposure and outcome data, provided data on both daily sitting or TV-viewing time and physical activity, and reported effect estimates for all-cause mortality, cardiovascular disease mortality, or breast, colon, and colorectal cancer mortality. We included data from 16 studies, of which 14 were identified through a systematic review and two were additional unpublished studies where pertinent data were available. All study data were analysed according to a harmonised protocol, which categorised reported daily sitting time and TV-viewing time into four standardised groups each, and physical activity into quartiles (in metabolic equivalent of task [MET]-hours per week). We then combined data across all studies to analyse the association of daily sitting time and physical activity with all-cause mortality, and estimated summary hazard ratios using Cox regression. We repeated these analyses using TV-viewing time instead of daily sitting time.
Findings:
Of the 16 studies included in the meta-analysis, 13 studies provided data on sitting time and all-cause mortality. These studies included 1 005 791 individuals who were followed up for 2-18·1 years, during which 84 609 (8·4%) died. Compared with the referent group (ie, those sitting <4 h/day and in the most active quartile [>35·5 MET-h per week]), mortality rates during follow-up were 12-59% higher in the two lowest quartiles of physical activity (from HR=1·12, 95% CI 1·08-1·16, for the second lowest quartile of physical activity [<16 MET-h per week] and sitting <4 h/day; to HR=1·59, 1·52-1·66, for the lowest quartile of physical activity [<2·5 MET-h per week] and sitting >8 h/day). Daily sitting time was not associated with increased all-cause mortality in those in the most active quartile of physical activity. Compared with the referent (<4 h of sitting per day and highest quartile of physical activity [>35·5 MET-h per week]), there was no increased risk of mortality during follow-up in those who sat for more than 8 h/day but who also reported >35·5 MET-h per week of activity (HR=1·04; 95% CI 0·99-1·10). By contrast, those who sat the least (<4 h/day) and were in the lowest activity quartile (<2·5 MET-h per week) had a significantly increased risk of dying during follow-up (HR=1·27, 95% CI 1·22-1·31). Six studies had data on TV-viewing time (N=465 450; 43 740 deaths). Watching TV for 3 h or more per day was associated with increased mortality regardless of physical activity, except in the most active quartile, where mortality was significantly increased only in people who watched TV for 5 h/day or more (HR=1·16, 1·05-1·28).
Interpretation:
High levels of moderate intensity physical activity (ie, about 60-75 min per day) seem to eliminate the increased risk of death associated with high sitting time. However, this high activity level attenuates, but does not eliminate the increased risk associated with high TV-viewing time. These results provide further evidence on the benefits of physical activity, particularly in societies where increasing numbers of people have to sit for long hours for work and may also inform future public health recommendations.
Funding:
None.
This study examined the combined effects of sedentary behavior and moderate-vigorous physical activity (MVPA) on cardiovascular health in older Latinos. In a cross-sectional sample of 147 older, community-dwelling Latinos, time spent in sedentary behavior and MVPA were obtained using accelerometers. Analyses examined the effects of a measure of physical activity that combined levels of sedentary behavior (±10 daily hours) and MVPA (<30, 30-150, or >150 weekly minutes) on cardiovascular health outcomes (blood pressure, BMI, waist circumference, cardiorespiratory fitness). Results suggest that cardiovascular health benefits of MVPA on BMI (p=.005), waist circumference (p=.002), and cardiorespiratory fitness (p=.012) may depend upon participants' level of sedentary behavior. For all three, health benefits of 30-150 weekly minutes of MVPA were found only for those without excessive sedentary behavior (≥10 hours). Sedentary behavior may negatively impact cardiovascular health despite moderate participation in MVPA. Health guidelines should suggest reducing sedentary behavior while increasing MVPA.
Background: Sedentary behavior is recognized as a distinct construct that is qualitatively different from lack of physical activity and it has been suggested to be associated with increased risk of cardiometabolic diseases. Data on relationship between objectively measured sedentary behavior and cardiometabolic biomarkers are sparse, especially among US Hispanics/Latinos.
Methods: Sedentary behavior and physical activity were measured using Acticala accelerometers for a 7-day period in 12,443 participants from the Hispanic Community Health Study/Study of Latinos, a population-based study of Hispanics/Latinos aged 18-74 years recruited from randomly selected households in 4 US cities conducted between 2008 and 2011. Participants with at least 10-hour/day of accelerometer wear on at least three days were included in the current analysis. Sedentary behavior was defined as average accelerometer counts per minute <100. Sedentary time was standardized to 16-hour/day of wear time.
Results: The mean sedentary time was 11.9 hours/day (74% of accelerometer wear time). After adjustment for age, gender and other demographic, socioeconomic and lifestyle variables, diastolic blood pressure, LDL-cholesterol, triglycerides, 2-hour glucose, fasting insulin and HOMA-IR increased, while HDL-cholesterol decreased across the quartiles of sedentary time (all P for trend <0.015). Most associations were attenuated but remained significant after further adjustment for BMI and physical activity. Even among individuals meeting physical activity recommendations, sedentary time remained associated with higher levels of diastolic blood pressure, 2-hour glucose, fasting insulin and HOMA-IR (Figure).
Conclusions: Sedentary time is high in US Hispanic/Latino adults and it is associated with an adverse cardiometabolic biomarker profile, independent of physical activity. Our results emphasize the importance of reducing sedentary behavior beyond increasing physical activity in the prevention of cardiometabolic diseases.
Aims:
While excessive sitting time is related adversely to cardio-metabolic health, it is unknown whether standing is a suitable replacement activity or whether ambulatory movement is required. Using isotemporal substitution analyses, we modelled cross-sectional associations with cardio-metabolic risk biomarkers of reallocating time (2 h/day) from sitting to standing or to stepping.
Methods and results:
A subsample of participants from the 2011/12 Australian Diabetes, Obesity, and Lifestyle Study wore the posture-based activPAL3 monitor [36-80 years (mean 57.9, SD 9.9 years); 57% women; n = 698 with data]. Associations of activPAL3-derived mean daily time sitting/lying (sitting), standing and stepping with body mass index (BMI), waist circumference, blood pressure, HbA1c, fasting glucose and lipids (high-density lipoprotein-, HDL, and low-density lipoprotein-cholesterol, total/HDL-cholesterol ratio, and triglycerides), and 2-h plasma glucose were examined. Adjusted for relevant confounders, sitting-to-standing reallocations were only significantly (P < 0.05) associated with approximately 2% lower fasting plasma glucose, 11% lower triglycerides, 6% lower total/HDL-cholesterol ratio, and 0.06 mmol/L higher HDL-cholesterol per 2 h/day. Sitting-to-stepping reallocations were only significantly associated with approximately 11% lower BMI, 7.5 cm lower waist circumference, 11% lower 2-h plasma glucose, 14% lower triglycerides, and 0.10 mmol/L higher HDL-cholesterol per 2 h/ day, while standing-to-stepping reallocations were only significantly associated with ∼10% lower BMI, 7 cm lower waist circumference, and 11% lower 2-h plasma glucose.
Conclusion:
Findings suggested that sitting-reduction strategies targeting increased standing, stepping, or both, may benefit cardio-metabolic health. Standing is a simple alternative to sitting, and requires further examination in prospective and intervention studies.
Prolonged sedentary time (ST) might be contributing to the diabetes epidemic, but most studies have been cross-sectional and few have objectively measured ST. The purpose of this study was to evaluate cross-sectional and 5-year longitudinal relationships between ST and metabolic parameters and outcomes.
This was an analysis of 2,027 Coronary Artery Risk Development in Young Adults (CARDIA) study participants (aged 38-50 years, 57% female, and mean BMI of 29.0 ± 7.0 kg/m(2)) with accelerometry data (≥4 days with ≥10 h/day) measured at the year 20 follow-up exam (2005-2006). Metabolic variables (fasting glucose, fasting insulin, 2-h postchallenge glucose, HOMA of insulin resistance [HOMA-IR], and HbA1c) and outcomes (impaired fasting glucose [IFG], impaired glucose tolerance [IGT], prediabetes by HbA1c, and diabetes) were assessed concurrently and 5 years later.
Average ST was 8.1 ± 1.7 h/day or 55 ± 10% of wear time. Each additional hour per day of ST was cross-sectionally associated with a 3% higher fasting insulin and HOMA-IR (both P < 0.01) but not 5-year changes in metabolic parameters. Having ≥10 h/day vs. <6 h/day of ST was associated with an odds ratio (OR) = 2.74 (95% CI 1.13, 6.62) for IGT and an OR = 3.80 (95% CI 1.39, 10.35) for diabetes. ST was not associated with prevalent IFG, prevalent prediabetes by HbA1c, or 5-year incidence of any metabolic outcomes (all P > 0.05).
ST was independently related to insulin, HOMA-IR, prevalent diabetes and IGT but did not predict 5-year changes in metabolic parameters or incidence of metabolic outcomes. These results suggest that higher ST may not be a risk factor for future metabolic outcomes, but more research with repeated ST measurement and longer follow-up is needed.
© 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
The aim of this study was to analyze the association between sedentary behaviour, as assessed by an accelerometer, and mean carotid intima-media thickness (IMT).
The study included 263 healthy subjects belonging to the EVIDENT study (59.3% women). Carotid IMT was measured by carotid ultrasonography. Sedentary behaviour was measured objectively over 7 days using ActiGraph accelerometers. Thresholds of 10 consecutive minutes were used to establish sedentary bouts, and assess the number (n/day), and length ≥10 min (min/day).
Total sedentary time and sedentary time in bouts ≥10 min was higher in participants with a larger mean carotid IMT (>P75). Otherwise, this sedentary time in bouts ≥10 min parameter was weakly associated with augmented carotid IMT injury in the logistic regression model.
Total sedentary time and sedentary time in bouts ≥10 min, as assessed by accelerometer, was positively but weakly associated with carotid IMT. Equally, this sedentary time in bouts ≥10 min was associated with carotid injury, but disappears after adjusting for potential confounders. These findings support that reducing sedentary time and increasing breaks in bouts of sedentary time might represent a useful additional strategy in the cardiovascular disease prevention.
Clinical Trials.gov Identifier: NCT01083082.
Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Background:
The magnitude, consistency, and manner of association between sedentary time and outcomes independent of physical activity remain unclear.
Purpose:
To quantify the association between sedentary time and hospitalizations, all-cause mortality, cardiovascular disease, diabetes, and cancer in adults independent of physical activity.
Data sources:
English-language studies in MEDLINE, PubMed, EMBASE, CINAHL, Cochrane Library, Web of Knowledge, and Google Scholar databases were searched through August 2014 with hand-searching of in-text citations and no publication date limitations.
Study selection:
Studies assessing sedentary behavior in adults, adjusted for physical activity and correlated to at least 1 outcome.
Data extraction:
Two independent reviewers performed data abstraction and quality assessment, and a third reviewer resolved inconsistencies.
Data synthesis:
Forty-seven articles met our eligibility criteria. Meta-analyses were performed on outcomes for cardiovascular disease and diabetes (14 studies), cancer (14 studies), and all-cause mortality (13 studies). Prospective cohort designs were used in all but 3 studies; sedentary times were quantified using self-report in all but 1 study. Significant hazard ratio (HR) associations were found with all-cause mortality (HR, 1.240 [95% CI, 1.090 to 1.410]), cardiovascular disease mortality (HR, 1.179 [CI, 1.106 to 1.257]), cardiovascular disease incidence (HR, 1.143 [CI, 1.002 to 1.729]), cancer mortality (HR, 1.173 [CI, 1.108 to 1.242]), cancer incidence (HR, 1.130 [CI, 1.053 to 1.213]), and type 2 diabetes incidence (HR, 1.910 [CI, 1.642 to 2.222]). Hazard ratios associated with sedentary time and outcomes were generally more pronounced at lower levels of physical activity than at higher levels.
Limitation:
There was marked heterogeneity in research designs and the assessment of sedentary time and physical activity.
Conclusion:
Prolonged sedentary time was independently associated with deleterious health outcomes regardless of physical activity.
Primary funding source:
None.
The aim of this study was to examine the relationship among sedentary behaviour (SB) and the metabolic syndrome and its components by age, moderate-to-vigorous physical activity (MVPA) and sex.
A cross-sectional analysis was performed on 2003-2006 National Health and Nutrition Examination Survey data from 5,076 adults aged ≥18 years (mean ± SD = 43.8 ± 19.5). SB was measured using ActiGraph accelerometers worn for 1 week and defined as <100 counts/min. Metabolic syndrome was defined using the Adult Treatment Panel III criteria. Natural cubic spline logistic regression models were used to estimate the odds of meeting criteria for the metabolic syndrome and its components by total daily SB time and breaks in SB. Statistical interactions between SB and age, sex and MVPA were explored.
The prevalence of the metabolic syndrome was 19% and the average daily SB time was 8.1 ± 2.8 h, with 90 ± 25 breaks/day. The relationship between daily SB time and the metabolic syndrome was linear and characterised by an OR of 1.09 (95% CI 1.01, 1.18) for each hour of SB. Total SB was associated with the following components: high triacylglycerol, low HDL-cholesterol and high fasting glucose. All three associations were modified by MVPA level. No relationship between breaks in SB and the metabolic syndrome was found.
There appears to be no SB threshold at which the risk of the metabolic syndrome is elevated. Therefore, an effort should be made to maintain low levels of total time spent in SB and so lessen the risk of the metabolic syndrome.
Objectives
To investigate whether having multiple risk factors for cardio-metabolic disease is associated with objectively measured physical activity or sedentary behavior within a sample of Yakut (Sakha) of Siberia.Methods
This cross sectional study involved 63 Yakut adults (32 men) who were measured for cardio-metabolic risk factors. Free living physical activity and sedentary behavior were calculated from waist accelerometry. Correlations and t-tests were used to assess the relationship between moderate-vigorous physical activity (MVPA), sedentary behavior (SB), and individual risk factors and clustering of risk factors.ResultsThese Yakut were physically active, with 54.4% spending at least 30 min in MVPA, with men being more active than women and women having less favorable cardio-metabolic profiles. These Yakut spent about 7.5 h in SB a day. SB was not related to cardio-metabolic risk factors. MVPA was significantly and negatively related to waist circumference and risk factor clustering in men and the total sample. MVPA was not related to women's risk factors.Conclusions
Objectively measured physical activity was related to lower risk of cardio-metabolic risk factor clustering within this sample of Yakut men, but not women. SB was not related to cardio-metabolic indicators. Physical activity may contribute to a reduction in clustering of metabolic risk factors within indigenous circumpolar populations. Am. J. Hum. Biol., 2014. © 2014 Wiley Periodicals, Inc.
Background:
Physical activity (PA) has been consistently implicated in the etiology of obesity, whereas recent evidence on the importance of sedentary time remains inconsistent. Understanding of dose-response associations of PA and sedentary time with overweight and obesity in adults can be improved with large-scale studies using objective measures of PA and sedentary time. The purpose of this study was to examine the strength, direction and shape of dose-response associations of accelerometer-based PA and sedentary time with body mass index (BMI) and weight status in 10 countries, and the moderating effects of study site and gender.
Methods:
Data from the International Physical activity and the Environment Network (IPEN) Adult study were used. IPEN Adult is an observational multi-country cross-sectional study, and 12 sites in 10 countries are included. Participants wore an accelerometer for seven consecutive days, completed a socio-demographic questionnaire and reported height and weight. In total, 5712 adults (18-65 years) were included in the analyses. Generalized additive mixed models, conducted in R, were used to estimate the strength and shape of the associations.
Results:
A curvilinear relationship of accelerometer-based moderate-to-vigorous PA and total counts per minute with BMI and the probability of being overweight/obese was identified. The associations were negative, but weakened at higher levels of moderate-to-vigorous PA (>50 min per day) and higher counts per minute. No associations between sedentary time and weight outcomes were found. Complex site- and gender-specific findings were revealed for BMI, but not for weight status.
Conclusions:
On the basis of these results, the current Institute of Medicine recommendation of 60 min per day of moderate-to-vigorous PA to prevent weight gain in normal-weight adults was supported. No relationship between sedentary time and the weight outcomes was present, calling for further examination. If moderator findings are confirmed, the relationship between PA and BMI may be country- and gender-dependent, which could have important implications for country-specific health guidelines.
To examine the associations of total sedentary time and patterns of sedentary time with cardiometabolic biomarkers in a large representative sample of Canadian adults.
The study is based on 4,935 adults aged 20-79 years, from the 2007/09 and 2009/11 Canadian Health Measures Survey. Total sedentary time, patterns of sedentary time (≥20minute prolonged sedentary bouts, number of sedentary breaks), and moderate- to vigorous-intensity physical activity (MVPA) were accelerometer-derived. Waist circumference, systolic and diastolic blood pressure, high-density lipoprotein (HDL) cholesterol, and C-reactive protein were measured. Triglycerides, low-density lipoprotein (LDL) cholesterol, insulin, and glucose were also measured in a fasting sub-sample (n=2120).
Total sedentary time and time in ≥20minute prolonged sedentary bouts were associated with higher insulin and lower diastolic blood pressure levels (P<0.05). On average, each additional 10 breaks/day was associated with 0.83 (95%CI: 1.35, 0.31) cm lower waist circumference, 0.32 (0.62, 0.02) mmHg lower systolic blood pressure, 0.01 (0.00, 0.02) mmol/l higher HDL-cholesterol, 3.72 (1.34, 6.13) % lower triglycerides, 0.57 (0.23, 0.92) % lower glucose, and 4.19 (1.80, 6.63) % lower insulin.
These findings in a large representative sample of Canadian adults indicate breaking up sedentary time may be particularly important for cardiometabolic health.