Trends in television viewing and overweight /obesity among Nepalese women: Findings from 2006, 2011 and 2016 Nepal Demographic and Health Surveys

BACKGROUND AND AIMS

Associations between overweight/obesity and television (TV) viewing have been identified in high-income countries, but little evidence is available from low- and middle-income countries. This study examined the trends and correlates of television viewing and overweight/obesity among Nepalese women between 2006 and 2016.

METHODS AND RESULTS

We analysed the data from 22,161 women aged 15-49 years who took part in Nepal Demographic Health Surveys 2006 (n = 10,115), 2011 (n = 5,881) or 2016 (n = 6,165). Trained staff collected data on TV viewing and sociodemographic attributes from a face-to-face survey while height and weight were measured objectively to determine body mass index. Around 38% of the study participants watched TV at least once a week in 2006, which increased to 49% in 2011 and 46% in 2016. The prevalence of overweight and obesity increased from 8% in 2006 to 14.6% in 2011 and 19.8% in 2016. Compared to those who did not watch TV at all, those watching it at least once a week were at 1.54 (95% CI: 1.02-2.33), 1.79 (95% CI: 1.23-2.60) and 1.46 (95% CI: 1.13-1.88) times higher odds of being overweight/obese in 2006, 2011 and 2016 respectively.

CONCLUSION

The prevalence of TV viewing rose among women in Nepal between 2006 and 2016 and was associated with overweight/obesity, which also increased dramatically over this period. Future studies examining the use of multiple screen devices, daily usage duration and content viewed are recommended to understand better the health impacts of transitions to more sedentary living in Nepal and similar settings.

Measurement of Physical Fitness and 24/7 Physical Activity, Standing, Sedentary Behavior, and Time in Bed in Working-Age Finns: Study Protocol for FINFIT 2021

Background: Population studies gathering measured data on fitness and physical behavior, covering physical activity, standing, sedentary behavior, and time in bed, are scarce. This article describes the protocol of the FINFIT 2021 study that measures fitness and physical behavior in a population-based sample of adults and analyzes their associations and dose–response relationships with several health indicators. Methods: The study comprises a stratified random sample of 20–69-year-old men and women (n = 16,500) from seven city-centered regions in Finland. Physical behavior is measured 24/7 by tri-axial accelerometry and analyzed with validated MAD-APE algorithms. Health and fitness examinations include fasting blood samples, measurements of blood pressure, anthropometry, and health-related fitness. Domains of health, functioning, well-being, and socio-demographics are assessed by a questionnaire. The data are being collected between September 2021 and February 2022. Discussion: The study provides population data on physical fitness and physical behavior 24/7. Physical behavior patterns by intensity and duration on an hour-by-hour basis will be provided. In the future, the baseline data will be assessed against prospective register-based data on incident diseases, healthcare utilization, sickness absence, premature retirement, and death. A similar study will be conducted every fourth year with a new random population sample.

Factors impacting workplace investment in sit-stand workstations from the perspective of purchasing decision-makers

This explanatory sequential mixed-method study explored the factors associated with the investment (or not) in sit-stand workstations (SSWs) and alternative initiatives to reduce prolonged sitting at work from the perspective of furniture purchasing decision-makers in Australian workplaces. Participants (n = 270) from >200 organisations across 19 industry sectors completed an online survey. Seven interviews were conducted in a sub-sample of participants from organisations without SSWs. The majority (80%) of workplaces reported having invested in SSWs. Workplaces without SSWs, opposed to those with SSWs, were more likely to be private (79.6% vs. 43.5%), of small/medium size (70.4% vs. 35.6%) and without a wellness program (57.4% vs. 22.2%) (all p < 0.05). Financial implications were the main reason for not investing in SSWs. Exercise and stretch breaks were alternative initiatives to reducing sedentary behaviour at work. Better evidence on the return on investment is needed to support purchasing decisions on SSWs.

Factors associated with antihypertensive medication use and blood pressure control in a rural area in Bangladesh: baseline data from a cluster randomised control trial

BACKGROUND

The use of antihypertensive medications is critical for controlling high blood pressure. We aimed to investigate associations between socio-demographic factors and antihypertensive medications use, and antihypertensive medications use with different types of drugs use with levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP).

METHODS

For the present report we derived data from the baseline measurements of a cluster randomised control trial on 307 participants with previously diagnosed hypertension from the rural district of Narial in Bangladesh. We measured the participant's current blood pressure levels and recorded antihypertensive medications uses. Associated factors included socio-economic status, diabetes, antihypertensive medications use, and types of drugs and doses used for controlling blood pressure. We applied analysis of variance and logistic regression techniques to identify factors associated with blood pressure.

RESULTS

Of the total participants, 144 (46.9%) were on antihypertensive medications. After multivariate adjustment, binary logistic regression revealed that employees (odds ratio, (95% confidence interval (CI)) (OR 3.58, 95%CI 1.38-9.28) compared to farmers, and people with diabetes (OR 2.43, 95%CI 1.13-5.26) compared to people without diabetes were associated with a higher proportion of antihypertensive medications use. Of 144 participants on antihypertensive medications, 7 (5%) had taken two doses, 114 (79%) had taken one dose per day and the rest were irregular in medication use. The mean (standard deviation) [min, max] SBP and DBP were 149 (19) mmHg [114, 217] and 90 (10) mmHg [75, 126], respectively. Overall, there was no significant difference in SBP (p = 0.10) or DBP (p = 0.67) between participants with or without antihypertensive medications or using any type of medications (p = 0.54 for SBP and 0.76 for DBP). There was no significant association between antihypertensive medications use and elevated BP levels SBP/DBP≥140/90 mmHg (p = 0.42) CONCLUSION: Less than half of the people with hypertension were on medication. Irrespective of the antihypertensive medications use, most of the participant's blood pressure was high. Further study is needed with a large sample to understand the factors and aetiology of unmanaged hypertension in rural areas of Bangladesh where the prevalence of hypertension is very high.

Active Aging and Public Health: Evidence, Implications, and Opportunities

By 2050, 20% of the world's population will be over the age of 65 years, with projections that 80% of older adults will be living in low- to middle-income countries. Physical inactivity and sedentary time are particularly high in older adults, presenting unique public health challenges. In this article, we first review evidence that points to multiple beneficial outcomes of active aging, including better physical function, cognitive function, mental health, social health, and sleep and suggest the need to shift the research focus from chronic disease outcomes to more relevant outcomes that affect independence and quality of life. Second, we review the critical role of age-friendly environments in facilitating active aging equitably across different countries and cultures. Finally, we consider emerging opportunities related to social engagement and technology-enabled mobility that can facilitate active aging. In all these contexts, it is a priority to understand and address diversity within the global aging population. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Correlates of screen-based behaviors among adults from the 2019 Brazilian National Health Survey

We aimed to investigate correlates of TV viewing and other types of screen-based behaviors in a nationally representative sample of Brazilian adults. In the 2019 Brazilian National Health Survey (including 88,509 adults), TV viewing time and other types of screen behaviors (computer, tablet, and cellphone use) were self-reported and different geographical, sociodemographic, behavioral, and health status factors were investigated as potential correlates. Multinomial logistic regression models were used for the main analyses. Living in capital cities, urban areas, being unemployed, high consumption of soft drinks, obesity, and elevated depressive symptoms were each associated with more TV viewing and more time using other types of screens. There were differential associations between TV viewing and the use of other types of screen across age and socioeconomic variables. For instance, younger adults have a more diverse portfolio of screen time than older adults. To conclude, levels of screen-based behaviors vary by geographical, sociodemographic, behavioral, and health status characteristics. Interventions should focus on high-risk population groups and may benefit from targeting specific sedentary behaviors of interest.

Physical Activity and Dietary Composition Relate to Differences in Gut Microbial Patterns in a Multi-Ethnic Cohort-The HELIUS Study

Physical activity (PA) at recommended levels contributes to the prevention of non-communicable diseases, such as atherosclerotic cardiovascular disease (asCVD) and type 2 diabetes mellitus (T2DM). Since the composition of the gut microbiota is strongly intertwined with dietary intake, the specific effect of exercise on the gut microbiota is not known. Moreover, multiple other factors, such as ethnicity, influence the composition of the gut microbiota, and this may be derived by distinct diet as well as PA patterns. Here we aim to untangle the associations between PA and the gut microbiota in a sample (n = 1334) from the Healthy Life In an Urban Setting (HELIUS) multi-ethnic cohort. The associations of different food groups and gut microbiota were also analyzed. PA was monitored using subjective (n = 1309) and objective (n = 162) methods, and dietary intake was assessed with ethnic-specific food frequency questionnaire (FFQ). The gut microbiota was profiled using 16S rRNA gene amplicon sequencing, and the functional composition was generated with the Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt2). Associations were assessed using multivariable and machine learning models. In this cohort, a distinct gut microbiota composition was associated with meeting the Dutch PA norm as well as with dietary intake, e.g., grains. PA related parameters such as muscle strength and calf circumference correlated with gut microbiota diversity. Furthermore, gut microbial functionality differed between active and sedentary groups. Differential representation of ethnicities in active and sedentary groups in both monitor methods hampered the detection of ethnic-specific effects. In conclusion, both PA and dietary intake were associated with gut microbiota composition in our multi-ethnic cohort. Future studies should further elucidate the role of ethnicity and diet in this association.

Emerging Qualitative Research Trends (2010-2021) on Sedentary Behaviour among Older Adults: A Systematic Literature Review Protocol

In recent years, research on sedentary behaviour has increased. In this regard, there is a need for theoretical reviews that allow us to determine the past, analyse the present, and prepare the future of research in this field. The purpose of this review paper was to analyse and organise the emerging qualitative research trends (2010-2021) on the sedentary behaviour of older adults. A systematic literature search strategy was developed in various electronic scientific databases (e.g., PubMed, Web of Science, ScienceDirect, Scielo, and Scopus). The included studies were required to have different qualitative methodological approaches in terms of data collection and methods of data analysis. Studies conducted in any country and published in a peer-reviewed journal in English, Spanish, and Portuguese were considered. A thematic analysis approach was used for data extraction and synthesis, and confidence in the results was assessed using the GRADE-CERQual approach. This study may enable accurate guidelines to be established for future primary qualitative research related to sedentary behaviour.

Concordance between Different Criteria for Self-Reported Physical Activity Levels and Risk Factors in People with High Blood Pressure in a Rural District in Bangladesh

Self-reported assessment of physical activity (PA) is commonly used in public health research. The present study investigated the concordance of self-reported PA assessed using the global physical activity questionnaire (GPAQ) and two different measurement approaches. Participants (n = 307, aged 30–75 years with hypertension) were recruited from a rural area in Bangladesh. We analyzed the difference between the World Health Organization (WHO) recommendations of more than 600 metabolic-equivalent time-minutes (MET-min) and the self-reported active hours, at least 2.5 h per week. Tests of sensitivity and specificity were conducted to determine concordance between the two measures. According to the WHO criteria, 255 (83%) participants were active more than 600 MET-min per week and 172 (56%) people were physically active 2.5 h or more per week, indicating a 27% difference in self-reported PA. The sensitivity, specificity, positive and negative predictive values and concordance between the two measures were 64%, 92%, 98%, 34% and 70%, respectively. Considering the WHO MET-min as the appropriate measure, 89 (35%) were false negative (FN). Older age, professionals and businesspersons were associated with a higher proportion of FN. There is a gap between self-reported PA, thus a better estimate of PA may result from combining two criteria to measure PA levels.

Knowledge of and Intention to Participate in Physical Activity Programs and Their Associated Sociodemographic Factors in People with High Blood Pressure in a Rural Area of Bangladesh: Initial Investigation from a Cluster Randomized Controlled Trial

This initial investigation aimed to investigate the knowledge of the health benefits of physical activity (PA) and attitudes towards participation in PA. The study recruited 307 people aged 30-75 years with hypertension as part of a cluster randomized controlled trial from a rural area in Bangladesh. Of the 307 participants, 135 participated less than 2.5 h of physical activity per week, from which we collected data on attitudes toward PA. Regression analysis and Rasch analysis were used. More than 85% of homemakers, employees or businesspersons were willing to take part in PA. Based on the combined score from the knowledge and attitude items, 46% of people endorsed PA programs; proportions were higher in men than women (53% vs. 41%). After adjusting for covariates, men (odds ratio, 95% confidence interval (CI) 3.50, 1.72-7.11) compared to women and people with at least primary levels of schooling (OR 3.06, 95% CI, 1.27-7.38) compared with those with no education were more likely to organize or take part in any PA programs. People have positive attitudes towards PA but do not feel obligated to participate in PA programs. Future programs are needed to promote awareness and motivational interventions for PA, especially targeting women and people with low education levels, should be developed and implemented.

Efficacy, characteristics, behavioural models and behaviour change strategies, of non-workplace interventions specifically targeting sedentary behaviour; a systematic review and meta-analysis of randomised control trials in healthy ambulatory adults

BACKGROUND

Sedentary behaviour (SB) research has grown exponentially but efficacy for interventions to reduce sedentary behaviour is often contaminated by interventions primarily or co-targeting other behaviours and outcomes. The primary aim of this research therefore, was to systematically review the efficacy of interventions specifically targeting sedentary behaviour reduction, as a sole primary outcome, from randomised control trials in healthy ambulatory adults. This research also sought to identify the successful interventions characteristics, behaviour change techniques (BCT's) and underlying theories, and their relation to intervention effectiveness.

METHODS

We followed PRISMA reporting guidelines for this systematic review. Six electronic databases were searched and a grey literature review conducted. Only randomised or cluster randomised controlled trials, from 2000 to 2020, in adult populations with a sole primary outcome of change in sedentary behaviour were included. Data codebooks were developed, data were extracted, and a narrative synthesis and meta-analysis was conducted using mixed methods random effects models.

RESULTS

Of 5589 studies identified, 7 studies met the inclusion criteria. Six studies reported activPAL3 measures of mean daily sitting time, and four reported mean daily standing time, stepping time and number of sedentary breaks. Pooled analysis of weighted mean differences revealed a reduction in mean daily sitting time of -32.4mins CI (-50.3, -14.4), an increase in mean daily standing time of 31.75mins CI (13.7, 49.8), and mean daily stepping time of 9.5mins CI (2.8, 16.3), and an increase in rate of sedentary breaks per day of 3.6 (CI 1.6, 5.6). BCTs used exclusively in two of the three most effective interventions are 'feedback on behaviour' and 'goal setting behaviour' whilst all three most effective interventions included 'instruction on how to perform the behaviour' and 'adding objects to the environment', BCTs which were also used in less effective interventions.

CONCLUSIONS

Although limited by small sample sizes and short follow up periods, this review suggests that interventions specifically designed to change sedentary behaviour, reduce overall daily sitting time by half an hour, with an equivalent increase in standing time, in the short to medium term. Effective characteristics and behaviour change strategies are identified for future development of high quality interventions targeting change in sedentary behaviour.

PROSPERO REGISTRATION

PROSPERO 2020 CRD42020172457 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172457.

Can individual, dyadic, or collaborative planning reduce sedentary behavior? A randomized controlled trial

RATIONALE

Although effects of individual planning interventions on physical activity (PA) are well established, less is known about the relationships between planning and sedentary behavior (SB).

OBJECTIVE

This study evaluated the efficacy of individual planning, dyadic planning (i.e., joint planning, targeting the behavior of one person only: the target person), and collaborative planning (i.e., joint planning and joint behavioral performance) on sedentary behavior among dyads.

METHODS

Dyads (N = 320 target persons and their partners, aged 18-90 years) were randomized into three PA planning conditions (individual, dyadic, or collaborative) or an active (education) control condition. Main outcomes, i.e., sedentary time, proportion of time spent in SB and light-intensity PA, proportion of time spent in SB and total PA were measured with GT3X-BT accelerometers at baseline, 1-week follow-up, and 36-week follow-up. Two-level models with measurement points nested in participants were fit, separately for target persons and partners.

RESULTS

Findings for target persons obtained at 1-week follow-up indicated that in the collaborative planning condition SB time significantly decreased, compared to the control condition (p = .013). There was an improvement in the proportion of time spent in SB and light-intensity PA (p = .019), and the proportion of time spent in SB and total PA (p = .018), indicating that SB time was displaced by PA. Effects of individual and dyadic planning were not significant, compared to the control condition. None of interventions had a significant effect on SB indices at 36-week follow-up. Regarding dyadic partners, there were no effects of planning interventions at 1-week follow-up or 36-week follow-up, compared to the control condition.

CONCLUSIONS

Collaborative planning may prompt a short-term reduction of SB time and result in a shift towards a healthier balance between SB time and PA time among target persons, who did not adhere to PA guidelines at baseline.

Sit less and move more for cardiovascular health: emerging insights and opportunities

Sedentary behaviour - put simply, too much sitting, as a distinct concept from too little exercise - is a novel determinant of cardiovascular risk. This definition provides a perspective that is complementary to the well-understood detrimental effects of physical inactivity. Sitting occupies the majority of the daily waking hours in most adults and has become even more pervasive owing to the COVID-19 pandemic. The potential for a broad cardiovascular health benefit exists through an integrated approach that involves 'sitting less and moving more'. In this Review, we first consider observational and experimental evidence on the adverse effects of prolonged, uninterrupted sitting and the evidence identifying the possible mechanisms underlying the associated risk. We summarize the results of randomized controlled trials demonstrating the feasibility of changing sedentary behaviour. We also highlight evidence on the deleterious synergies between sedentary behaviour and physical inactivity as the underpinnings of our case for addressing them jointly in mitigating cardiovascular risk. This integrated approach should not only reduce the specific risks of too much sitting but also have a positive effect on the total amount of physical activity, with the potential to more broadly benefit the health of individuals living with or at risk of developing cardiovascular disease.

Health Issues Due to the Global Prevalence of Sedentariness and Recommendations towards Achieving a Healthier Behaviour

Sedentariness has progressed in recent years. Here, we summarize the high prevalence of objectively measured sedentariness and the list of health problems associated with sedentariness. According to the literature, a minimum sedentary time of 8 h/d may avoid the harmful effects of sedentariness. Our review of the literature shows that many countries worldwide exceed this threshold. The coronavirus disease 2019 pandemic has increased the proportion of time spent seated in chairs and/or other types of furniture. Furthermore, prolonged sedentariness will continue to increase because it is assumed that people, at least those in desk jobs, perform their work better when sitting than when standing. Many practical solutions should be implemented to help people reduce their sedentary time. People need to be aware that prolonged sedentariness causes health problems. They need to measure the amount of time spent being sedentary to self-guide their behaviour. They should adopt a new lifestyle to avoid prolonged sedentariness and prolonged standing. In addition, we point out that they should frequently change their posture to avoid fatigue and health issues. For global public health, there is an urgent need to adopt an intermediate healthy/healthier behaviour between too much time spent in the sitting and standing positions.

The association between cardiovascular risk factors and major cardiovascular diseases decreases with increasing frailty levels in geriatric outpatients

BACKGROUND

Frailty marks a process of increasing dysregulation of physiological systems which increases the risk of adverse health outcomes. This study examines the hypothesis that the association between multiple cardiovascular risk factors (CVRF) and cardiovascular diseases (CVD) becomes stronger with increasing frailty severity.

METHODS

Cross-sectional analysis of 339 older adults (55.2% women; aged 75.2 ± 9.1 years) from an outpatient geriatric clinic from a middle-income country. The frailty index (FI) was calculated as the proportion of 30 possible health deficits. We assessed hypertension, diabetes, obesity, dyslipidemia, sedentarism and smoking as CVRF (determinants) and myocardial infarction, stroke, heart failure as CVD. Poisson regression models adjusted for age, sex, and education was applied to estimate the association between frailty as well as CVRF (independent variables) with CVD (dependent variable).

RESULTS

Of the 339 patients, 18,3% were frail (FI ≥ 0.25) and 32.7% had at least one CVD. Both frailty and CVRF were significantly associated with CVD (PR = 1.03, 95% CI 1.01 to 1.05; p = 0.001, and PR = 1.46, 95% 1.24 to 1.71; p < 0.001, respectively) adjusted for covariates. The strength of the association between CVRF and CVD decreased with increasing frailty levels, as indicated by a significant interaction term of frailty and CVRF (p < 0.001).

CONCLUSION

Frailty and CVRF are both associated with CVD, but the impact of CVRF decreases in the presence of frailty. When confirmed in longitudinal studies, randomized controlled trials or causal inference methods like Mendelian randomization should be applied to assess whether a shift from traditional CVRF to frailty would improve cardiovascular outcome in the oldest old.

Exercise and health: historical perspectives and new insights

Since ancient times, the health benefits of regular physical activity/exercise have been recognized and the classic studies of Morris and Paffenbarger provided the epidemiological evidence in support of such an association. Cardiorespiratory fitness, often measured by maximal oxygen uptake, and habitual physical activity levels are inversely related to mortality. Thus, studies exploring the biological bases of the health benefits of exercise have largely focused on the cardiovascular system and skeletal muscle (mass and metabolism), although there is increasing evidence that multiple tissues and organ systems are influenced by regular exercise. Communication between contracting skeletal muscle and multiple organs has been implicated in exercise benefits, as indeed has other interorgan "cross-talk." The application of molecular biology techniques and "omics" approaches to questions in exercise biology has opened new lines of investigation to better understand the beneficial effects of exercise and, in so doing, inform the optimization of exercise regimens and the identification of novel therapeutic strategies to enhance health and well-being.

Sedentary time in a nationally representative sample of adults in Japan: Prevalence and sociodemographic correlates

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Japanese adults spent on average 5.3 h each day sedentary.

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Compared to other countries, more adults were found to be highly sedentary in Japan.

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High sedentary time was associated with several sociodemographic characteristics.

Sedentary behaviour is associated with risks of detrimental health outcomes. It is crucial to understand how much time people spend in sedentary behaviour and what factors affect too much sedentary time for effective intervention. However, few studies examined the prevalence and the correlates of sedentary behaviour in Japan. Therefore, we assessed total sedentary time and its sociodemographic correlates using a nationally representative sample of adults in Japan. Cross-sectional data from Sports-Life Survey in 2016 and 2018 conducted by Sasagawa Sports Foundation was used. Participants’ sociodemographic factors and total sedentary time were collected by questionnaires. We classified those with <8 h/day of total sedentary time as “low-sedentary” and those with ≥8 h/day of total sedentary time as “high-sedentary”. A multiple logistic regression model was applied to calculate adjusted odds ratios and 95% confidence intervals (95% CIs) for the association of each variable with the “high-sedentary” group (≥8 h/day). In total, 5,346 participants were included in the analyses. On average, time spent in sedentary behaviour was 5.3 h/day (SD = 3.7) among Japanese adults. The percentage of “high-sedentary” was 25.3% (95% CI: 24.1–26.4) and higher body mass index (≥25 kg/m²), being unmarried, unemployment, and higher educational level (graduate school or university) were positively associated with being “high-sedentary”. In conclusion, higher sedentary time was among people with higher body mass index, being unmarried, unemployed, and higher education. Intervention for reducing sedentary time should be developed, targeting people with these characteristics.

Rationale for the Essential Components of Physical Education

Purpose: This introductory article provides the context and rationale for conducting systematic literature reviews on each of the essential components of physical education, including policy and environment, curriculum, appropriate instruction, and student assessment. Methods: Four research teams from Doctoral Physical Education Teacher Education programs (D-PETE) conducted these systematic reviews using the PRISMA guidelines process. Results: This article explains the role of the national framework for increasing physical education and physical activity (i.e., Comprehensive School Physical Activity Program) in supporting the essential components of physical education. It also highlights the expectations for physical education and provides a brief history of these components. Lastly, this article highlights each of the articles presented in the special feature. Conclusion: Understanding the implementation of these components may be important for improving the physical education experience for all students and creating a foundation for lifelong physical activity and health.

A Comparison of Associations Between Self-Reported and Device-Based Sedentary Behavior and Obesity Markers in Adults: A Multi-National Cross-Sectional Study

The purpose of this study was to examine the associations between self-reported and device-based measures of sedentary behavior (SB) with obesity markers in adults from Latin American countries. Sitting time and total time spent in different SBs were self-reported using two different questionnaires. Accelerometers were used to assess total sedentary time. Body mass index, waist, and neck circumferences were assessed. The highest self-reported sitting time was in Argentina, the highest total time spent in different SBs was in Brazil and Costa Rica, and the highest device-based sedentary time was observed in Peru. Neither self-reported sitting time, total time spent in different SBs or device-based sedentary time were associated with body mass index. Device-based sedentary time was positively associated with waist circumference and self-reported sitting time was positively associated with neck circumference. Caution is warranted when comparing the associations of self-reported and device-based assessments of SB with anthropometric variables.

Device-assessed total and prolonged sitting time: associations with anxiety, depression, and health-related quality of life in adults

OBJECTIVE

Assessment of sitting has been challenging and nuances in the length of sitting are often missed.

METHODS

The present study assessed total, short and prolonged sitting time, and number of breaks from sitting, and their association with anxiety, depression, and health-related quality of life (HRQoL). Adults (M=59.1 years) in three studies (n=1,574) wore the activPAL accelerometer (thigh) to obtain a measure of sitting, and the Actigraph accelerometer (hip) for estimating moderate-to-vigorous physical activity (MVPA). Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale, and HRQoL using the EQ-5D-5L (for health state and utility scores). Generalised linear modelling tested associations.

RESULTS

Total and prolonged sitting were associated with higher depression [total: β = 0.132 (0.010, 0.254); prolonged: β = 0.178 (0.053, 0.304)] and worse HRQoL health state scores [(total: β = -0.985 (-1.471, -0.499); prolonged: β = -0.834 (-1.301, -0.367)] and utility scores [(total: β = -0.008 (-0.012, -0.003); prolonged: β = -0.008 (-0.012, -0.004)], after controlling for covariates. MVPA was associated with better HRQoL health state and utility scores [health state: β =0.554 (0.187, 0.922); utility: β = 0.001 (0.001, 0.002)]. Total and prolonged sitting were associated with a 14% increased odds of being in the borderline/abnormal category for depression. No interactions were observed between MVPA status (active vs. inactive) and total or prolonged sitting. Anxiety was unrelated to any sitting variable.

CONCLUSION

Device-based measures of both total and prolonged sitting time were associated with depression and health-related quality of life, but not anxiety.

Weekday-Weekend Sedentary Behavior and Recreational Screen Time Patterns in Families with Preschoolers, Schoolchildren, and Adolescents: Cross-Sectional Three Cohort Study

Background: Excessive recreational screen time (RST) has been associated with negative health consequences already being apparent in preschoolers. Therefore, the aim of this study was to reveal parent-child sedentary behavior, and RST patterns and associations with respect to the gender, age category of children, and days of the week. Methods: Our cross-sectional survey included 1175 parent-child dyads with proxy-reported RST data collected during a regular school week during the spring and fall between 2013 and 2019. The parent-child RST (age and RST) relationship was quantified using Pearson’s (r_P) correlation coefficient. Results: Weekends were characterized by longer RST for all family members (daughters/sons: +34/+33 min/day, mothers/fathers: +43/+14 min/day) and closer parent-child RST associations than on weekdays. The increasing age of children was positively associated with an increase in RST on weekdays (+6.4/+7.2 min per year of age of the daughter/son) and weekends (+5.8/+7.5 min per year of age of the daughter/son). Conclusions: Weekends provide a suitable target for implementation of programs aimed at reducing excessive RST involving not only children, but preferably parent-child dyads.

The Effect of Containment Measures during the Covid-19 Pandemic to Sedentary Behavior of Thai Adults: Evidence from Thailand's Surveillance on Physical Activity 2019-2020

Measures to contain the spread of coronavirus disease 2019 (Covid-19) imposed by governments have undoubtedly impacted on preventing its spread but may have also produced longer periods of sedentary living across all segments of society. To examine this phenomenon, this study compared the sedentary behavior (SB) of Thai adults before and during the Covid-19 pandemic. The 2019 and 2020 datasets of Thailand's Surveillance on Physical Activity (SPA) were employed. A total of 5379 (SPA2019) and 6531 (SPA202020) persons age 18-64 years who had access to the Internet were included in the analysis. Measures imposed to contain the spread of Covid-19 infection were significantly associated with lower opportunity of Thai adults for work-related physical movement, and that increased their SB, particularly with the shift from onsite to online working platforms. Cumulative SB increased from 824 (before the pandemic) to 875 min/day during the pandemic. The odds of accumulating >13 h/day of SB was highest among females, young adults, those who completed post-secondary education, unemployed or working in the non-agriculture sector, having a chronic disease/condition, residing in an urban area, and living in a 'higher-risk' pandemic zone. The insignificant association of physical activity (PA) and the Fit from Home (FFH) intervention in reducing SB during the pandemic suggests that PA is not directly associated with SB, and that the FFH intervention was insufficient to prevent SB.

Sedentary Work and Physiological Markers of Health

The purpose of this study is to examine associations between objectively measured workplace sedentary behavior and physiological markers of health. We hypothesize that increased sedentary time and more frequent bouts of uninterrupted sitting are associated with increased hemoglobin A1c, increased blood pressure, and impaired endothelial function. Call center employees (N = 241) were enrolled from four worksites in the United States. Participants completed a survey and a physical health assessment. Sedentary behavior and sitting/standing time at work were quantified using an accelerometer. Hemoglobin A1c was measured using a finger-prick and portable analyzer. Blood pressure was measured with an automated cuff, and vascular endothelial function was assessed in a subsample of participants (n = 56) using EndoPAT. We analyzed data with two series of ordinary least squares regressions, first to examine relationships between bouts of uninterrupted sitting and physiological outcomes, and second to examine relationships between physical activity and sitting/standing time at work and physiological outcomes. The sample was primarily female, and on average was obese, prehypertensive, and prediabetic. There were no significant relationships between bouts of uninterrupted sitting or physical activity/sitting/standing time at work and physiological outcomes. In a sample that is predominantly sedentary, at risk for cardiovascular disease, and prediabetic, there are no significant associations between workplace sedentary behavior and physiological markers. The lack of associations could be related to either physiological adaptations or ceiling effects in this sample.

Dual-Task Exercise to Improve Cognition and Functional Capacity of Healthy Older Adults

Background

It has been suggested that physical inactivity and lack of stimulating cognitive activity are the two most significant modifiable risk factors to impair cognitive function. Although many studies that investigated the cognitive effects of physical exercise and cognitive stimuli in dual-task conditions showed improved cognitive performance, others have not confirmed these findings. The main aim of the present work is to analyze the effects of a dual-task multimodal physical exercise training, at moderate intensity, and cognitive stimulation on cognitive and physical function in healthy older adults.

Methods

This clinical trial was registered on the Brazilian Registry of Clinical Trials (RBR-9zrx3d). Here we tested the effects of a dual-task multimodal physical exercise training, at moderate intensity, on cognitive and physical function and quality of life in community dwelling older adults. The training protocol included 24 group sessions, 2/week, per 75 min. Cognition was assessed using CANTAB automated neuropsychological tests and Functional Capacity to Exercise tests. Performance was compared from baseline to post intervention and to a non-exercise control group using Mixed Linear Model for repeated measures.

Results

Control (CG) and dual-task (DTEx) groups progressed differentially over time on performance of episodic memory, sustained visual attention, functional mobility, cardiorespiratory fitness, lower limbs strength resistance, agility, quality of life and dual-task performance with significant improved DTEx performance. Control group did not show any significant changes on these tests except for showing a reduction in dual-task performance.

Conclusion

We suggest that the dual-task combination of multisensory cognitive stimulation and multimodal moderate physical exercise training, twice a week, may be adopted as an effective program to reduce progression of age-related cognitive decline and improve physical fitness and quality of life on healthy older adults.

Clinical Trial Registration

Brazilian Registry of Clinical Trials: https://ensaiosclinicos.gov.br/rg/RBR-9zrx3d -UTN code: U1111-1233-6349.

Agreement Between Self-Reported and Device-Based Sedentary Time among Eight Countries: Findings from the ELANS

The purpose of this study was to analyze the agreement between self-reported and device-based sedentary time among eight countries in Latin America. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants (18-65 years) across eight countries. Participants reported time spent sedentary in different activities (computer use at home, videogame use, reading, sitting down to chat with friends/relatives or listening to music, speaking on the phone, watching TV, and riding in a car). Overall sitting time was assessed using a single item from the International Physical Activity Questionnaire (IPAQ). Device-based sedentary time was assessed using Actigraph GT3X accelerometers. Self-reported overall sitting time (227.1 min/day) produced the lowest values of the three assessment methods, followed by self-reported sum of different types of sedentary behavior (364.1 min/day) and device-based sedentary time (568.6 min/day). Overall, correlation coefficients and ICC varied from weak to moderate (rho: 0.25-0.39; ICC: 0.21:0.39) between self-reported sum of different types of sedentary behavior, self-reported overall sitting time, and device-based sedentary time. The Bland-Altman plots indicated low to moderate agreement between self-reported overall sitting time and device-based sedentary time by sex. Self-report measures underestimate sedentary behavior and overall sitting time when compared with device-based measures. The weak and moderate level of agreement between methods indicates that caution is required when comparing associations between different self-report and device-based measures of sedentary behavior with health outcomes.

"Occupational sitting kills; but who cares?": Quantitative analysis of barriers and facilitators of sedentary behavior in Indian white-collar workers

The knowledge, attitude and practices of employees and employers toward reducing sedentary behavior (SB) and improving physical activity (PA) at Indian workplaces remain unclear. A bespoke questionnaire assessing barriers and facilitators of occupational SB and PA practices as informed by the theoretical framework and behavioral change wheel model was adapted. Two hundred and three white-collar workers (both employees and managers) from eight corporate sectors were inquired about the SB, and PA practices at workplaces. The dichotomous variables of barriers and facilitators were analyzed by nonparametric tests. Excessive sitters had good knowledge (>75%), good attitude (>85%) but poor workplace SB and PA practice (>90%). Workplace SB, or PA practices differed between employers and employees. Low practice of workplace PA or SB interventions may be due to lack of workplace policies for SB interventions.

Sitting at work & waist circumference-A cross-sectional study of Australian workers

Studies examining associations of sitting time at work with obesity measures have produced inconsistent findings. Different sample characteristics across studies, e.g., the composition of different occupational groups, may be one explanation for the mixed findings. We examined cross-sectional associations of workplace sitting time with waist circumference in workers engaged in desk-based work and those engaged in other work settings using a population-based sample of Australian workers. Participants (5878 full-time workers in the 2014-15 Australian National Health Survey) were categorized into desk-based (N = 3006) or non-desk-based (N = 2872) workers, based on self-reported predominant behavior at work (sitting, standing, walking, and physical labor) and occupational group. Linear regression analyses examined associations of measured waist circumference with self-reported sitting time at work for each group, which was further stratified by gender and leisure-time physical activity level. Longer sitting time at work was associated with greater waist circumference in desk-based workers (b = 0.45 [95%CI: 0.09, 0.80] cm for a 1 h/day increment of sitting) but not in non-desk-based workers (b = 0.25 [95%CI: -0.12, 0.63]). For desk-based workers, stratified analyses found significant associations in men and those who were insufficiently physically active during leisure time. Our findings support interventions to decrease occupational sitting time for desk-based workers to reduce their cardio-metabolic risk. Differential associations observed between desk-based and non-desk-based workers and between genders may be attributable to the ways in which sitting time is accumulated. Future research is needed to examine the impact of behavior patterns at work (sitting breaks, occupational physical activity) on adiposity in working adults.

Prospective study on sedentary behaviour patterns and changes in body composition parameters in older women: A compositional and isotemporal substitution analysis

BACKGROUND & AIMS

The aims of this study were to examine the prospective compositional associations between sedentary behaviour (SB) patterns and longitudinal changes in body composition parameters, and to use compositional isotemporal substitution modelling to analyse the longitudinal changes in body composition parameters associated with time reallocation from SB to physical activity (PA) in older women.

METHODS

The study included women aged 60 years and older (n = 182) with valid data at baseline and at the subsequent 7-year follow-up. For both time points, the ActiGraph GT1M accelerometer was used for SB and PA assessments and multi-frequency bioimpedance analysis was used to assess the body composition parameters related to adiposity and muscle mass. Compositional regression models were used to analyse the associations between proportion of time spent in sedentary bouts of different duration and longitudinal changes in body composition parameters. A compositional isotemporal substitution model was created to estimate the differences in body composition parameters associated with one-to-one time reallocations between baseline SB and PA.

RESULTS

A significant increase in fat mass index (β_ilr1 = 0.61, 95% confidence interval [CI]: 0.18, 1.04) and visceral adipose tissue (β_ilr1 = 6.01, 95% CI: 1.52, 10.5) was associated with a higher baseline proportion of time spent in long sedentary bouts (i.e. sedentary bout of ≥30 min). Reallocating 1 h/week and 3.5 h/week from the time spent in long sedentary bouts in favour of light PA was associated with a significant decrease in fat mass index by 0.78% (95% CI: 0.24, 1.32) and 3.13% (95% CI: 0.97, 5.29), respectively. No association was found for indicators of muscle mass.

CONCLUSIONS

This study suggests that long-term adiposity status could be improved by increasing the proportion of time spent in light PA at the expense of time spent in prolonged SB. This finding may help in designing more effective and feasible interventions for the maintenance of healthy body composition in advanced age.

"Oh-oh, the others are standing up... I better do the same". Mixed-method evaluation of the implementation process of 'Take a Stand!' - a cluster randomized controlled trial of a multicomponent intervention to reduce sitting time among office workers

Background

Multicomponent workplace-based interventions aimed at reducing sitting time among office workers are becoming increasingly popular. ‘Take a Stand!’ was such an intervention, reducing sitting time by 71 min after 1 month and 48 min after 3 months. However, it is unclear how the implementation process of ‘Take a Stand!’ affected these results. The present study explored how individual factors and organizational context influenced implementation and effect in ‘Take a Stand!’

Methods

This was a mixed-methods study, combining data from interviews, questionnaires and accelerometers. Directed content analysis was used for analysing interviews with participants, ambassadors and managers from the 10 intervention offices in the ‘Take a Stand!’ study. Categories for analysis were taken from Framework for Evaluating Organizational-level Interventions. Interview data were combined with questionnaire and activity data, and multilevel analysis was undertaken to assess how changes in sitting time varied depending on the assessed factors. In addition, interview data were used to underpin results from the multilevel analysis.

Results

Concurrent institutional changes were found to be a barrier for the intervention by ambassadors, while participants and managers did not find it to be an issue. Management support was consistently highlighted as very important. Participants evaluated ambassadors as being generally adequately active but also, that the role had a greater potential.

The motivational and social aspects of the intervention were considered important for the effect. This was supported by regression analyses, which showed that a strong desire to change sitting time habits, strong motivation towards the project, and a high sense of collective engagement were associated to less sitting time at 3 months of about 30 min/8 h working day compared to participants with low scores. Influence from other participants (e.g. seeing others raise their tables) and the use of humour were continuously highlighted by participants as positive for implementation. Finally, the intervention was found to influence the social climate at the workplace positively.

Conclusion

Individual motivation was related to the sitting time effect of ‘Take a Stand!’, but the organizational culture was relevant both to the implementation and effect within the office community. The organizational culture included among others to ensure general participation, to uphold management and peer-support, and maintain a positive environment during the intervention period.

Trial registration

ClinicalTrials.gov, NCT01996176. Prospectively registered 21 November 2013.

Socio-Demographic Correlates of Total and Domain-Specific Sedentary Behavior in Latin America: A Population-Based Study

Purpose: The aim of this study was to identify socio-demographic correlates of total and domain-specific sedentary behavior (SB). Methods: Cross-sectional findings are based on 9218 participants (15–65 years) from the Latin American Study of Nutrition and Health. Data were collected between September 2014 and February 2015. Participants reported time spent in SB across specific domains. Sex, age, ethnicity, socioeconomic (SEL), and education level were used as sociodemographic indicators. Results: Participants spent a total of 373.3 min/day engaged in total SB. Men, younger adults, other ethnicities, higher SEL and educational level presented higher total SB when compared with women, older adults, white/Caucasian, and low SEL and educational level. Men spent more time on the playing videogames (b: 32.8: 95% CI: 14.6;51.1) and riding in an automobile (40.5: 31.3; 49.8). Computer time, reading, socializing or listening to music was higher in younger participants (<30 years) compared with those ≥50 years in the total sample. Compared to the low SEL and educational level groups, middle (11.7: 5.7; 17.6) and higher (15.1: 5.3; 24.9) SEL groups as well as middle (9.8: 3.6; 15.9) and higher (16.6: 6.5; 26.8) education level groups reported more time spent reading. Conclusion: Socio-demographic characteristics are associated with SB patterns (total and specific) across Latin American countries.