Systematic literature review of determinants of sedentary behaviour in older adults: a DEDIPAC study

Correlates of Sedentary Behaviour in Adults with Intellectual Disabilities-A Systematic Review

Individuals with intellectual disabilities (ID) are at high risk for high levels of sedentary behaviour. To inform the development of programmes to reduce sedentary behaviour, insight into the correlates is needed. Therefore, the aim of this study is to review the evidence on correlates of sedentary behaviour in adults with ID. We performed a systematic literature search in Ovid Medline, Ovid Embase, Web of Science and Google Scholar up to 19 January 2018, resulting in nine included studies that were published from 2011 to 2018. Correlates were categorized according to the ecological model. Studies predominantly focused on individual level correlates. Of those correlates studied in more than one study, having epilepsy was associated with less sedentary behaviour and inconsistent results were found for sex, genetic syndromes, weight status, physical health, mobility, level of ID, and mental health. Of the few interpersonal and environmental factors studied, only living arrangements were studied in more than one study, with inconsistent results. To date, we have limited and inconclusive evidence about correlates of sedentary behaviour in adults with ID. Only when future studies unravel correlates and determinants, across all domains of the ecological model, will the potential opportunities to improve health by reducing sedentary behaviour come within reach.

Integrated primary and geriatric care for frail older adults in the community: Implementation of a complex intervention into real life

BACKGROUND

Frailty is highly prevalent in older persons and associated with negative health-related events and costs. Despite successful clinical trials, translation of evidence into implementation of dedicated programs has been scarce. This is probably due to funding limitations and lack of generalizability of rigid schemes adopted in controlled studies. We propose a guidance to implement complex interventions against frailty in the community, and describe the design and early findings of the +AGIL Barcelona program.

METHODS

A guidance "decalogue" resulted from an experts' panel prioritization of recommendations by international independent bodies. On this basis, we reorganized existing primary care, geriatrics and community-based resources to implement our program, which includes a screening, a multi-component intervention modulated on the comprehensive geriatric assessment and integrated follow-up plus continuity through community-based resources. The pre-post impact of the program on physical function, as well as on clinical endpoints, person-center outcomes and costs will be assessed.

RESULTS

Integrated care, multi-component, person-centered strategies to empower the final users in a flexible and adaptable way should be promoted after raising awareness and potentially convey long term investments. In 22 months, 185 participants (mean age ± SD = 81.6 ± 5.7 years, 72% women) joined the program. Although independent in the activities of daily living, participants showed clear indicators of frailty (Short Physical Performance Battery = 7.1 ± 2.5; gait speed = 0.69 ± 0.2 m/s).

CONCLUSIONS

+AGIL Barcelona may represent a unique model to manage frailty in older community-dwellers, translating evidence into pragmatic clinical practice. Further research will clarify the effects of this intervention.

Relationship of Time-Activity-Adjusted Particle Number Concentration with Blood Pressure

Emerging evidence suggests long-term exposure to ultrafine particulate matter (UFP, aerodynamic diameter < 0.1 µm) is associated with adverse cardiovascular outcomes. We investigated whether annual average UFP exposure was associated with measured systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and hypertension prevalence among 409 adults participating in the cross-sectional Community Assessment of Freeway Exposure and Health (CAFEH) study. We used measurements of particle number concentration (PNC, a proxy for UFP) obtained from mobile monitoring campaigns in three near-highway and three urban background areas in and near Boston, Massachusetts to develop PNC regression models (20-m spatial and hourly temporal resolution). Individual modeled estimates were adjusted for time spent in different micro-environments (time-activity-adjusted PNC, TAA-PNC). Mean TAA-PNC was 22,000 particles/cm³ (sd = 6500). In linear models (logistic for hypertension) adjusted for the minimally sufficient set of covariates indicated by a directed acyclic graph (DAG), we found positive, non-significant associations between natural log-transformed TAA-PNC and SBP (β = 5.23, 95%CI: −0.68, 11.14 mmHg), PP (β = 4.27, 95%CI: −0.79, 9.32 mmHg), and hypertension (OR = 1.81, 95%CI: 0.94, 3.48), but not DBP (β = 0.96, 95%CI: −2.08, 4.00 mmHg). Associations were stronger among non-Hispanic white participants and among diabetics in analyses stratified by race/ethnicity and, separately, by health status.

The Influence of Daily Stress on Sedentary Behavior: Group and Person (N of 1) Level Results of a 1-Year Observational Study

OBJECTIVE

The purpose of this study, which used mobile technologies to continuously collect data for 1 year, was to examine the association of psychological stress with objectively measured sedentary behavior in adults at both the group (e.g., nomothetic approach) and individual (e.g., idiographic approach) level.

METHODS

Data were collected in an observational study of healthy adults (n = 79) residing in the New York City metro area who were studied for 365 days from 2014 to 2015. Sedentary behavior was objectively measured via accelerometry. A smartphone-based electronic diary was used to assess level of stress ("Overall, how stressful was your day?" 0-10 scale) and sources of stress.

RESULTS

The end-of-day stress rating was not associated with total sedentary time (B = -1.34, p = .767) at the group level. When specific sources of stress were evaluated at the group level, argument-related stress was associated with increased sedentariness, whereas running late- and work-related stress were associated with decreased sedentariness. There was a substantial degree of interindividual variability in the relationship of stress with sedentary behavior. Both the level and sources of stress were associated with increased sedentariness for some, decreased sedentariness for others, and had no effect for many (within-person variance p < .001).

CONCLUSIONS

These findings suggest that the influence of stress on sedentary behavior varies by source of stress and from person to person. A precision medicine approach may be warranted to target reductions in sedentary time, although further studies are needed to confirm the observed findings in light of study limitations including a small sample size and enrollment of participants from a single, urban metropolitan area.

Potential determinants of physical inactivity among long-term colorectal cancer survivors

PURPOSE

Since physical activity (PA) has been shown to be associated with better prognosis and quality of life (QOL) in colorectal cancer (CRC) patients, this study focuses on the barriers of PA among CRC survivors.

METHODS

This study is based on a population-based study from Germany of 1343 women and men, diagnosed with CRC between 2003 and 2008 and being alive five years later. Multivariable logistic regression was used to explore associations between baseline as well as five-year follow-up (5YFU) characteristics and physical inactivity (PIA) at 5YFU. Quartiles were calculated based on metabolic equivalent hours per week of PA at baseline and at 5YFU. Participants in quartile 1 were defined as physically inactive, and patients in quartile 2 to quartile 4 were defined as physically active.

RESULTS

Cancer-specific factors such as having a stoma (odds ratio (OR) = 1.51, 95% confidence interval (CI) = 1.12-2.04), demographic factors such as living in a small town or city (OR = 1.46, 95% CI = 1.05-2.02; OR = 1.42, 95% CI = 1.01-2.02), older age (OR = 1.44, 95% CI = 0.80-2.58), or being divorced (OR = 1.72, 95% CI = 0.96-3.07), as well as lifestyle factors such as being a current smoker (OR = 1.54, 95% CI = 1.04-2.29) or being obese (OR = 1.43, 95% CI = 0.96-2.13) were associated with PIA at 5YFU. Subgroup analyses showed that the association between body mass index  and PIA was stronger in women than in men. Baseline PA was identified as a strong predictor of PIA at 5YFU.

CONCLUSIONS

Findings suggest that predominately patients with a stoma, patients living in a more populated area, being older, divorced, a current smoker, or obese were more likely to be physically inactive and therefore could be targeted to be more physically active.

IMPLICATIONS FOR CANCER SURVIVORS

Addressing barriers for PA might help to develop specific, individually tailored PA interventions to overcome PIA and improve the long-term outcome of CRC survivors.

Association between education and television viewing among older working and retired people: a comparative study of Finland and Japan

Background

Educational attainment is associated with physical activity among older people. However, little is known about its association with sedentary lifestyle in European as well as Asian nations. This study aims to examine the associations between educational attainment and daily television viewing as an indicator of a sedentary lifestyle among older working and retired people in Finland and Japan.

Methods

We used cross-sectional harmonized data from two cohorts, the Finnish Public Sector study (n = 10,744) and the Japan Gerontological Evaluation Study (n = 2493), evaluating individuals aged 65–75 years old. We defined high-duration television viewing as ≥4 h per day. Poisson regression was used to examine the association between educational attainment and high-duration television viewing, stratified by the current working status. Models were adjusted for age, sex, household size, smoking, alcohol, body mass index, chronic diseases, mental disorders, and physical activity.

Results

Of the participants, 27% in Finland and 30% in Japan reported high-duration television viewing. Compared with a low education (≤9 years), Finnish and Japanese retirees with a high education (≥13 years) had less high-duration television viewing [prevalence ratio, PR 0.68 (95% confidence interval 0.63–0.73) and 0.66 (0.55–0.79), respectively]. The corresponding PRs for Finnish and Japanese retirees with intermediate education were also lowered [0.89 (0.83–0.95) and 0.79 (0.68–0.91), respectively]. Among older people still at work, educational attainment was associated with high-duration television viewing among the Japanese but not among the Finnish.

Conclusion

A similar association between educational attainment and high-duration television viewing in Finland and Japan particularly after retirement suggests a robust and consistent impact of educational attainment on a sedentary lifestyle after retirements.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5860-4) contains supplementary material, which is available to authorized users.

Towards a demographic risk profile for sedentary behaviours in middle-aged British adults: a cross-sectional population study

OBJECTIVES

In response to a call from the American Heart Association to more clearly identify the demographic factors associated with sedentary behaviours, this study aimed to identify the hierarchy of demographic characteristics associated with the sedentary behaviours of television viewing, recreational computer use and driving.

DESIGN

Cross-sectional analysis of baseline data collected as part of the UK Biobank. The UK Biobank is a population cohort recruited from 22 centres across the UK. Participants aged between 37 and 73 years were recruited between 2006 and 2010.

METHODS

Decision tree models were generated for the sedentary behaviour outcomes of hours/day spent television viewing, recreational computer use and all driving; a sum of time spent in these sedentary behaviours ('overall') was computed. Age, sex, race, college attendance, employment, shift-work, urban versus rural residence as well as physical activity were considered as predictors.

RESULTS

The analytic sample comprised 415 666 adults who were mostly female (54.2%), white (95.2%), non-college attendee (64.5%), employed (61.7%), lived in an urban centre (85.5%), with a mean age of 56.6 (SD=8.1) years. Television viewing was most common sedentary behaviour (2.7 hour/day vs 1.1 for recreational computer use and 1.0 for all driving). Males (tier 1), who did not attend college (tier 2) were the highest risk group for overall sedentary time. Adults with no college attendance (tier 1) and were retired (tier 2) were the most high-risk demographic group for television viewing. College attendees (tier 1) were highest risk for recreational computer use. Adults who were employed (tier 1), male (tier 2) and did not attend college (tier 3) were most at risk for driving CONCLUSIONS: Daily time spent in different sedentary behaviours varies by sex, employment status and college attendance status. The development of targeted interventions to reduce sedentary behaviour in different demographic subgroups is needed.

Data on Determinants Are Needed to Curb the Sedentary Epidemic in Europe. Lessons Learnt from the DEDIPAC European Knowledge Hub

Societal and technological changes have resulted in sitting being the dominant posture during most activities of daily living, such as learning, working, travelling and leisure time. Too much time spent in seated activities, referred to as sedentary behaviour, is a novel concern for public health as it is one of the key lifestyle causes of poor health. The European DEDIPAC (Determinants of Diet and Physical Activity) Knowledge Hub coordinated the work of 35 institutions across 12 European member states to investigate the determinants of sedentary behaviour. DEDIPAC reviewed current evidence, set a theoretical framework and harmonised the available epidemiological data. The main results are summarised. The conclusion is that there is a dire lack of data that is exploitable across Europe to inform policy and intervention. There is an urgent need to develop international data collection compliant with FAIR (Findable, Accessible, Interoperable, Re-usable) and standardised surveillance systems for sedentary behaviour.

The Association of Sitting Time With Sarcopenia Status and Physical Performance at Baseline and 18-Month Follow-Up in the Residential Aged Care Setting

This study investigated the association of sitting time with sarcopenia and physical performance in residential aged care residents at baseline and 18-month follow-up. Measures included the International Physical Activity Questionnaire (sitting time), European Working Group definition of sarcopenia, and the short physical performance battery (physical performance). Logistic regression and linear regression analyses were used to investigate associations. For each hour of sitting, the unadjusted odds ratio of sarcopenia was 1.16 (95% confidence interval [0.98, 1.37]). Linear regression showed that each hour of sitting was significantly associated with a 0.2-unit lower score for performance. Associations of baseline sitting with follow-up sarcopenia status and performance were nonsignificant. Cross-sectionally, increased sitting time in residential aged care may be detrimentally associated with sarcopenia and physical performance. Based on current reablement models of care, future studies should investigate if reducing sedentary time improves performance among adults in end of life care.

Sleep Duration and Hypertension: Analysis of > 700,000 Adults by Age and Sex

STUDY OBJECTIVES

The objective of this study was to evaluate the cross-sectional relationship between sleep duration and hypertension in a large, nationally-representative dataset that spans 10 years. This analysis may provide detailed information with high resolution about how sleep duration is related to hypertension and how this differs by demographic group.

METHODS

Data were aggregated from the 2013 Behavioral Risk Factor Surveillance System (n = 433,386) and the combined 2007-2016 National Health Interview Surveys (n = 295,331). These data were collected by the Centers for Disease Control and Prevention from nationally-representative samples. Surveys were combined, and survey-specific weights were used in all analyses. Sleep duration was assessed with the item, "On average, how many hours of sleep do you get in a 24-hour period?" in both surveys. Hypertension was assessed as self-reported history. Covariates were assessed identically in both datasets and included, age (in 5-year groupings), sex, race/ethnicity, and employment status.

RESULTS

In adjusted analyses, compared to 7 hours, increased risk of hypertension was seen among those sleeping ≤ 4 hours (odds ratio [OR] = 1.86, P < .0005), 5 hours (OR = 1.56, P < .0005), 6 hours (OR = 1.27, P < .0005), 9 hours (OR = 1.19, P < .0005), and ≥ 10 hours (OR = 1.41, P < .0005). When stratified by age, sex, and race/ethnicity groups, short sleep was associated with increased risk for all age groups < 70 years, and long sleep (≥ 10 hours only) was associated with risk for all except < 24 years and > 74 years. Findings for short sleep were relatively consistent across all race/ethnicities, although findings for long sleep were less pronounced among Black/African-American and Other/Multiracial groups. A significant sleep by 3-way sleep × age × sex interaction (P < .0005) suggests that the relationship depends on both age and sex. For both men and women, the OR of having hypertension associated with short sleep decreases with increasing age, but there is a higher association between short sleep and hypertension for women, throughout the adult lifespan.

CONCLUSIONS

Both short and long sleep duration are associated with increased hypertension risk across most age groups. The influence of covariates is stronger upon long sleep relationships. Relationships with short sleep were stronger among younger adults and women.

Demographic characteristics and type/frequency of physical activity participation in a large sample of 21,603 Australian people

BACKGROUND

Regular physical activity (PA) is imperative for good health and there are many different ways that people can be active. There are a range of health, PA and sport policies aiming to get more people active more often. Much research has been directed towards understanding the determinants of inactivity and PA. However, it is important to understand the differences not only between inactive and active people, but also between activity contexts (for example participation in sport compared to non-sport activities), in order to align policies and strategies to engage market segments who have different participation preferences and accessibility. The aim of this study was to investigate demographic correlates of the propensity to be physically inactive or active within different contexts, and at different levels of frequency of participation.

METHODS

Data from the Australian Exercise, Recreation and Sport Survey was used for this analysis. This included information on the type, frequency and duration of leisure-time PA for Australians aged 15 years and over. Reported PA participation in the two-week period prior to the survey was used to allocate respondents into three categories: no PA, non-sport PA only, and sport. Subsequently, sport participants were further categorised according to frequency of participation. Potential demographic correlates included sex, age, education, employment, marital status, language spoken, having a condition that restricts life, children, and socio-economic status.

RESULTS

The survey included 21,603 people. Bivariate chi-squared analysis showed that there were significant differences between the profiles of leisure-time PA participation across all demographic variables, except the variable languages spoken at home. Ordinal regression analysis showed that the same demographic variables were also correlated with the propensity to engage in more organised and competitive PA contexts, and to participate more frequently.

CONCLUSIONS

People who were female, older, married or had a disability were less likely to participate in sport. Therefore when designing PA opportunities to engage those who are inactive, particularly those that are organised by a club or group, we need to ensure that appropriate strategies are developed, and tailored sport products offered, to ensure greater opportunities for increased diversity of participation in sport.

A prospective investigation of neighborhood socioeconomic deprivation and physical activity and sedentary behavior in older adults

Neighborhood conditions may have an important impact on physical activity and sedentary behaviors in the older population. Most previous studies in this area are cross-sectional and report mixed findings regarding the effects of neighborhood environment on different types of physical activity. Moreover, little is known about the prospective relationship between neighborhood environment and sedentary behaviors. Our analysis included 136,526 participants from the NIH-AARP Diet and Health Study (age 51-70). Neighborhood socioeconomic deprivation was measured with an index based on census variables and developed using principal component analysis. Physical activity and sedentary behaviors were measured both at baseline (1995-1996) and follow-up (2004-2006). Multiple regression analyses were conducted to examine the prospective relationship between neighborhood deprivation and exercise, non-exercise physical activity, and sedentary behaviors, adjusting for baseline physical activity and sedentary behaviors as well as potential confounders. We found that more severe neighborhood socioeconomic deprivation was prospectively associated with reduced time for exercise (β _Q5 vs _Q1 (95% confidence interval), hour, -0.85 (-0.95, -0.75)) but increased time spent in non-exercise physical activities (1.16 (0.97, 1.34)), such as household activities, outdoor chores, and walking for transportation. Moreover, people from more deprived neighborhoods were also more likely to engage in prolonged (≥5 h/day) TV viewing (Odds ratio _Q5 vs _Q1 (95% confidence interval), 1.21 (1.15, 1.27)). In conclusion, neighborhood socioeconomic deprivation is associated with physical activity and sedentary behavior in the older population. These associations may differ for different types of physical activities.

Attitudes to ageing and objectively-measured sedentary and walking behaviour in older people: The Lothian Birth Cohort 1936

BACKGROUND

Prolonged sitting and low activity-both common in older people-are associated with increased mortality and poorer health. Whether having a more negative attitude to ageing is associated with higher levels of these behaviours is unclear.

OBJECTIVE

We investigated the prospective relationship between attitudes to ageing and objectively measured sedentary and walking behaviour.

METHODS

Participants were 271 members of the Lothian Birth Cohort 1936. At age 72 years, participants completed the Attitudes to Ageing Questionnaire which assesses attitudes on three domains-Psychosocial loss, Physical change and Psychological growth. At age 79 years, participants wore an activPAL activity monitor for seven days. The outcome measures were average daily time spent sedentary, number of sit-to-stand transitions, and step count.

RESULTS

There were no significant associations between any of the Attitude to Ageing domain scores and time spent sedentary or number of sit-to-stand transitions. In sex-adjusted analysis, having a more positive attitude to ageing as regards Physical change was associated with a slightly higher daily step count, for a SD increment in score, average daily step count was greater by 1.5% (95% CI 0.6%, 2.4%). On further adjustment for potential confounding factors these associations were no longer significant.

CONCLUSION

We found no evidence that attitudes to ageing at age 72 were predictive of sedentary or walking behaviour seven years later. Future studies should examine whether attitudes to ageing are associated with objectively measured walking or sedentary behaviour at the same point in time. The existence of such an association could inform the development of interventions.

Factors Associated with Physical Activity and Sedentary Behavior in Older Adults from Six Low- and Middle-Income Countries

Rising life expectancy in low- and middle-income countries (LMIC), coupled with the increasing burden of non-communicable diseases, accentuates the importance of generating information to support public health strategies. With this aim in mind, the purpose of this study was to identify correlates of physical activity and sedentary behavior in LMIC. We analyzed Wave 1 data (collected 2007–2010) from the World Health Organization’s longitudinal Study on global AGEing and adult health (SAGE), which focuses on nationally representative samples of adults aged 50 years and older from six countries (China, n = 13,157; India, n = 6560; Mexico, n = 2301; Russian Federation, n = 3763; South Africa, n = 3836; and Ghana, n = 4305). Associations of physical activity (operationalized as meeting physical activity guidelines of ≥150 min/week of moderate-to-vigorous physical activity or not) and sedentary behavior (≥4 h/day versus <4 h/day) with demographic, health and health risk, functional, interpersonal, and environmental factors were assessed using multivariate logistic models. Across the six countries, we found fairly consistent and reasonably strong associations between both physical activity and sedentary behavior and several demographic factors (age and employment, in particular), self-reported health, instrumental activities of daily living, factors relating to socializing, and household location. Correlates of physical activity and sedentary behavior in LMIC appear to be similar to those found in high-income countries.

Cross-sectional and longitudinal factors influencing physical activity of 65 to 75-year-olds: a pan European cohort study based on the survey of health, ageing and retirement in Europe (SHARE)

Background

The promotion of physical activity (PA) plays a major role for healthy ageing even in older age. There is a lack of cross-sectional and longitudinal studies explicitly dealing with barriers and drivers to PA in older adults. Therefore the aims of this study are a) to determine the prevalence of insufficient physical activity (IPA) in 65 to 75-year-olds in Europe and to identify factors associated with IPA in cross-section and b) to identify longitudinal risk factors for IPA in prior active persons.

Methods

This study is using data of the Survey of Health, Ageing and Retirement in Europe (SHARE). SHARE is a cross-national panel database including individual data of the non-institutionalised population aged 50+ from 27 European countries. For the present paper, we included a cohort that participated in all first four waves of SHARE (2004–2011) aged 65-to-75–years at wave four (male n = 1761, female n = 2085) from 10 European countries. To identify cross-sectional and longitudinal associations, we calculated prevalence odds ratios and hazard ratios with 95% confidence intervals.

Results

The prevalence of IPA in 65–75-year-olds varied widely between countries, ranging from 55.4% to 83.3% in women and from 46.6% to 73.7% in men. IPA was associated with several intrapersonal factors and strength of association was similar for men and women for almost all investigated factors. Statistically significant associated with IPA were socioeconomic factors as low educational level (own and parental) and financial difficulties (male: POR: 1.60: 95%-CI: 1.26–2.03; female: POR: 1.58; 95%-CI: 1.26–1.97) and health-related factors as e.g. number of chronic diseases (male: POR: 1.34: 95%-CI: 1.23–1.45; female: POR: 1.31; 95%-CI: 1.21–1.42). Interpersonal only the size of social network was associated with IPA (male and female: POR: 0.88, 95%-CI: 0.81–0.95). Longitudinally in a fully adjusted model, only grip strength (HR: 0.99; CI-95%: 0.98–0.99) and BMI (HR: 1.02; CI-95%: 1.00–1.04) were statistically significant risk factors for IPA.

Conclusions

PA promotion programs for older adults should incorporate the heterogeneity of health status and physical condition that can typically occur in this age group.

Electronic supplementary material

The online version of this article (10.1186/s12877-018-0781-8) contains supplementary material, which is available to authorized users.

Changes in non-occupational sedentary behaviours across the retirement transition: the Finnish Retirement and Aging (FIREA) study

Background

Retirement is a major life transition which may influence health behaviours and time use. Little is known about how sedentary behaviour changes as a result of increased time availability after retirement. The aim of this study was to examine changes in non-occupational sedentary behaviours across the retirement transition. In addition, we examined which preretirement characteristics were associated with these changes.

Methods

The study population consisted of 2011 participants from the Finnish Retirement and Aging Study. Repeated postal survey including questions on sedentary behaviour domains (television viewing, computer use at home, sitting in a vehicle and other sitting) were conducted once a year across the retirement transition, covering on average 3.4 study waves. Linear regression with generalised estimating equations was used for the analyses.

Results

Total sedentary time increased by 73 (95% CI 66 to 80) min/day during the retirement transition. Of the domain-specific sedentary behaviours, television viewing time increased by 28 (95% CI 25 to 32) min/day, computer use at home by 19 (95% CI 17 to 22) min/day and other sitting time by 37 (95% CI 33 to 41) min/day, while time sitting in a vehicle decreased by 6 (95% CI 4 to 9) min/day. Highest increase in total sedentary time was among women and persons who had high occupational sitting time, low physical activity level, sleep difficulties, mental disorders or poor health before retirement (all p values for interaction <0.03).

Conclusion

Total and domain-specific sedentary time, except sitting in a vehicle, increased during the retirement transition.

The epigenetic clock and objectively measured sedentary and walking behavior in older adults: the Lothian Birth Cohort 1936

Background

Estimates of biological age derived from DNA-methylation patterns-known as the epigenetic clock-are associated with mortality, physical and cognitive function, and frailty, but little is known about their relationship with sedentary behavior or physical activity. We investigated the cross-sectional relationship between two such estimates of biological age and objectively measured sedentary and walking behavior in older people.

Methods

Participants were 248 members of the Lothian Birth Cohort 1936. At age 79 years, sedentary behavior and physical activity were measured over 7 days using an activPAL activity monitor. Biological age was estimated using two measures of DNA methylation-based age acceleration-i.e., extrinsic and intrinsic epigenetic age acceleration. We used linear regression to assess the relationship between these two estimates of biological age and average daily time spent sedentary, number of sit-to-stand transitions, and step count.

Results

Of the six associations examined, only two were statistically significant in initial models adjusted for age and sex alone. Greater extrinsic age acceleration was associated with taking fewer steps (regression coefficient (95% CI) - 0.100 (- 0.008, - 0.001), and greater intrinsic age acceleration was associated with making more sit-to-stand transitions (regression coefficient (95% CI) 0.006 (0.0001, 0.012). When we controlled for multiple statistical testing, neither of these associations survived correction (both P ≥ 0.17).

Conclusion

In this cross-sectional study of 79-year-olds, we found no convincing evidence that biological age, as indexed by extrinsic or intrinsic epigenetic age acceleration, was associated with objectively measured sedentary or walking behavior.

Changes in physical activity during the retirement transition: a series of novel n-of-1 natural experiments

Background

Existing evidence about the impact of retirement on physical activity (PA) has primarily focused on the average change in PA level after retirement in group-based studies. It is unclear whether findings regarding the direction of PA change after retirement from group-based studies apply to individuals. This study aimed to explore changes in PA, PA determinants and their inter-relationships during the retirement transition at the individual level.

Methods

A series of n-of-1 natural experiments were conducted with seven individuals who were aged 55–76 years and approaching retirement. PA was measured by tri-axial accelerometry. Twice-daily self-report and ecological momentary assessments of evidence- and theory-based determinants of PA (e.g. sleep length/quality, happiness, tiredness, stress, time pressure, pain, intention, perceived behavioural control, priority, goal conflict and goal facilitation) were collected via a questionnaire for a period of between 3 and 7 months, which included time before and after the participant’s retirement date. A personalised PA determinant was also identified by each participant and measured daily for the duration of the study. Dynamic regression models for discrete time binary data were used to analyse data for each individual participant.

Results

Two participants showed a statistically significant increase in the probability of engaging in PA bouts after retirement and two participants showed a significant time trend for a decrease and increase in PA bouts over time during the pre- to post-retirement period, respectively. There was no statistically significant change in PA after retirement for the remaining participants. Most of the daily questionnaire variables were significantly associated with PA for one or more participants but there were no consistent pattern of PA predictors across participants. For some participants, the relationship between questionnaire variables and PA changed from pre- to post-retirement.

Conclusions

The findings from this study demonstrate the impact of retirement on individual PA trajectories. Using n-of-1 methods can provide information about unique patterns and determinants of individual behaviour over time, which has been obscured in previous research. N-of-1 methods can be used as a tool to inform personalised PA interventions for individuals within the retirement transition.

Electronic supplementary material

The online version of this article (10.1186/s12966-017-0623-7) contains supplementary material, which is available to authorized users.

Twelve-Year Television Viewing Time Trajectories and Physical Function in Older Adults

INTRODUCTION

The purposes of this study were to identify trajectories of older adults' television viewing (TV) time for 12 yr and to examine their associations with performance-based measures of physical function.

METHODS

Data on TV time (h·wk) and sociodemographic factors were collected at each assessment of the Australian Diabetes, Obesity and Lifestyle Study (1999/2000, 2004/2005, and 2011/2012), with objective measures of physical function (2.44 m timed up and go [TUG, s] and knee extensor strength [KES, kg] tests) collected at the final (2011/2012) assessment. Regression analyses examined predictors of trajectory membership and associations with TUG and KES in those 60+ yr of age in 2011/2012.

RESULTS

Six TV time trajectories were identified among the 1938 participants (age, 60-97 yr; 54% female): consistently low (9.7%), low-increasing (22.3%), moderate-decreasing (13.5%), moderate-increasing (30.3%), consistently high (18.9%), and high-increasing (5.2%). There were no statistically significant relationships with TUG (P > 0.05). In the fully adjusted model, KES performance was significantly better in the consistently low, low-increasing, and consistently high trajectories, compared with the moderate-increasing trajectory (P < 0.001, R = 0.33).

CONCLUSION

Twelve-year trajectories of TV time were associated with muscle strength in older adults. These findings suggest that patterns of sedentary behavior can be a determinant of muscle strength in later life.

Low Levels of Physical Activity and Sedentary Behavior in Adults with Intellectual Disabilities

Adults with intellectual disabilities (ID) are more likely to lead sedentary lifestyles and have low levels of physical activity (LLPA). The present study investigated the prevalence of reported LLPA and time spent watching TV in adults with ID and identified the associated factors for these behaviors. The proxy informants of 1618 adults with ID completed the surveys regarding their health behaviors. Multiple logistic regressions were employed for LLPA and multiple linear regressions for time spent watching TV. About 60% of adults with ID had LLPA and average time spent watching TV was 3.4 h a day. Some characteristics and health and function variables were identified as associated factors. While engaging in community activities and involvement in Special Olympics were inversely associated with LLPA, they were not associated with time spent watching TV. Attending day/educational programs or being employed were associated with spending less time watching TV. Findings highlight differential factors associated with LLPA versus TV-watching behavior in adults with ID. Hence, a key strategy aimed at increasing physical activity includes promoting participation in social and community activities, while targeted activities for reducing sedentary behavior might focus on providing day programs or employment opportunities for adults with ID.

Determinants of diet and physical activity (DEDIPAC): a summary of findings

The establishment of the Determinants of Diet and Physical Activity (DEDIPAC) Knowledge Hub, 2013-2016, was the first action taken by the 'Healthy Diet for a Healthy Life' European Joint Programming Initiative. DEDIPAC aimed to provide better insight into the determinants of diet, physical activity and sedentary behaviour across the life course, i.e. insight into the causes of the causes of important, non-communicable diseases across Europe and beyond. DEDIPAC was launched in late 2013, and delivered its final report in late 2016. In this paper we give an overview of what was achieved in terms of furthering measurement and monitoring, providing overviews of the state-of-the-art in the field, and building toolboxes for further research and practice. Additionally, we propose some of the next steps that are now required to move forward in this field, arguing in favour of 1) sustaining the Knowledge Hub and developing it into a European virtual research institute and knowledge centre for determinants of behavioural nutrition and physical activity with close links to other parts of the world; 2) establishing a cohort study of families across all regions of Europe focusing specifically on the individual and contextual determinants of major, non-communicable disease; and 3) furthering DEDIPAC's work on nutrition, physical activity, and sedentary behaviour policy evaluation and benchmarking across Europe by aligning with other international initiatives and by supporting harmonisation of pan-European surveillance.

Identifying and sharing data for secondary data analysis of physical activity, sedentary behaviour and their determinants across the life course in Europe: general principles and an example from DEDIPAC

BACKGROUND

The utilisation of available cross-European data for secondary data analyses on physical activity, sedentary behaviours and their underlying determinants may benefit from the wide variation that exists across Europe in terms of these behaviours and their determinants. Such reuse of existing data for further research requires Findable; Accessible; Interoperable; Reusable (FAIR) data management and stewardship. We here describe the inventory and development of a comprehensive European dataset compendium and the process towards cross-European secondary data analyses of pooled data on physical activity, sedentary behaviour and their correlates across the life course.

METHODS

A five-step methodology was followed by the European Determinants of Diet and Physical Activity (DEDIPAC) Knowledge Hub, covering the (1) identification of relevant datasets across Europe, (2) development of a compendium including details on the design, study population, measures and level of accessibility of data from each study, (3) definition of key topics and approaches for secondary analyses, (4) process of gaining access to datasets and (5) pooling and harmonisation of the data and the development of a data harmonisation platform.

RESULTS

A total of 114 unique datasets were found for inclusion within the DEDIPAC compendium. Of these datasets, 14 were eventually obtained and reused to address 10 exemplar research questions. The DEDIPAC data harmonisation platform proved to be useful for pooling, but in general, harmonisation was often restricted to just a few core (crude) outcome variables and some individual-level sociodemographic correlates of these behaviours.

CONCLUSIONS

Obtaining, pooling and harmonising data for secondary data analyses proved to be difficult and sometimes even impossible. Compliance to FAIR data management and stewardship principles currently appears to be limited for research in the field of physical activity and sedentary behaviour. We discuss some of the reasons why this might be the case and present recommendations based on our experience.

Correlates of sedentary behaviour in adults: a systematic review

OBJECTIVE

The objective of this study was to systematically review evidence to identify intrapersonal, social environmental, physical environmental and policy correlates of sedentary behaviour (SB) among adults.

METHODS

Six databases were searched to identify studies that reported on intrapersonal, social, physical environmental and/or policy correlates of SB across domains (i.e. occupational, leisure and transportation) in adults (mean ≥ 18 years old). Subgroup differences (sex, age, disease status, publication status and date, weekdays vs. weekend) were examined. Risk of bias was assessed, and a qualitative synthesis completed.

PROSPERO

CRD42014009814 RESULTS: Searching identified 22,779 articles; 257 were used in the analysis. Most studies used self-reported SB and were cross-sectional. The most studied domain of SB and correlate was leisure and intrapersonal, respectively. Consistent evidence found positive relationships between full-time employment and higher transportation and lower leisure SB; higher income/socioeconomic status and greater transportation and occupation SB; living in more urban areas and greater sitting time and total SB; ownership of televisions and greater leisure SB; and, active workstations and lower occupational SB.

CONCLUSIONS

The review identifies the need for longitudinal studies, as well as further research on factors in the physical, social and policy environments. The review also recognizes the need to standardize methodology for collecting, defining and reporting SB and correlates.

Systematic mapping review of the factors influencing physical activity and sedentary behaviour in ethnic minority groups in Europe: a DEDIPAC study

Background

Physical activity and sedentary behaviour are associated with health and wellbeing. Studies indicate that ethnic minority groups are both less active and more sedentary than the majority population and that factors influencing these behaviours may differ. Mapping the factors influencing physical activity and sedentary behaviour among ethnic minority groups living in Europe can help to identify determinants of physical activity and sedentary behaviour, research gaps and guide future research.

Methods

A systematic mapping review was conducted to map the factors associated with physical activity and sedentary behaviour among ethnic minority groups living in Europe (protocol PROSPERO ID = CRD42014014575). Six databases were searched for quantitative and qualitative research published between 1999 and 2014. In synthesizing the findings, all factors were sorted and structured into clusters following a data driven approach and concept mapping.

Results

Sixty-three articles were identified out of 7794 returned by the systematic search. These included 41 quantitative and 22 qualitative studies. Of these 58 focused on physical activity, 5 on both physical activity and sedentary behaviour and none focused on sedentary behaviour. The factors associated with physical activity and sedentary behaviour were grouped into eight clusters. Social & cultural environment (n = 55) and Psychosocial (39) were the clusters containing most factors, followed by Physical environment & accessibility (33), Migration context (15), Institutional environment (14), Social & material resources (12), Health and health communication (12), Political environment (3). An important finding was that cultural and religious issues, in particular those related to gender issues, were recurring factors across the clusters.

Conclusion

Physical activity and sedentary behaviour among ethnic minority groups living in Europe are influenced by a wide variety of factors, especially informed by qualitative studies. More comparative studies are needed as well as inclusion of a wider spectrum of the diverse ethnic minority groups resettled in different European countries. Few studies have investigated factors influencing sedentary behaviour. It is important in the future to address specific factors influencing physical activity and sedentary behaviour among different ethnic minority groups in order to plan and implement effective interventions.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-017-0554-3) contains supplementary material, which is available to authorized users.

Sedentary time in older adults: a critical review of measurement, associations with health, and interventions

Sedentary time (ST) is an important risk factor for a variety of health outcomes in older adults. Consensus is needed on future research directions so that collaborative and timely efforts can be made globally to address this modifiable risk factor. In this review, we examined current literature to identify gaps and inform future research priorities on ST and healthy ageing. We reviewed three primary topics:(1) the validity/reliability of self-report measurement tools, (2) the consequences of prolonged ST on geriatric-relevant health outcomes (physical function, cognitive function, mental health, incontinence and quality of life) and(3) the effectiveness of interventions to reduce ST in older adults.

METHODS

A trained librarian created a search strategy that was peer reviewed for completeness.

RESULTS

Self-report assessment of the context and type of ST is important but the tools tend to underestimate total ST. There appears to be an association between ST and geriatric-relevant health outcomes, although there is insufficient longitudinal evidence to determine a dose-response relationship or a threshold for clinically relevant risk. The type of ST may also affect health; some cognitively engaging sedentary behaviours appear to benefit health, while time spent in more passive activities may be detrimental. Short-term feasibility studies of individual-level ST interventions have been conducted; however, few studies have appropriately assessed the impact of these interventions on geriatric-relevant health outcomes, nor have they addressed organisation or environment level changes. Research is specifically needed to inform evidence-based interventions that help maintain functional autonomy among older adults.This consensus statement has been endorsed by the following societies: Academy of Geriatric Physical Therapy, Exercise & Sports Science Australia, Canadian Centre for Activity and Aging, Society of Behavioral Medicine, and the National Centre for Sport and Exercise Medicine.

Sedentary time in older men and women: an international consensus statement and research priorities

Sedentary time is a modifiable determinant of poor health, and in older adults, reducing sedentary time may be an important first step in adopting and maintaining a more active lifestyle. The primary purpose of this consensus statement is to provide an integrated perspective on current knowledge and expert opinion pertaining to sedentary behaviour in older adults on the topics of measurement, associations with health outcomes, and interventions. A secondary yet equally important purpose is to suggest priorities for future research and knowledge translation based on gaps identified. A five-step Delphi consensus process was used. Experts in the area of sedentary behaviour and older adults (n=15) participated in three surveys, an in-person consensus meeting, and a validation process. The surveys specifically probed measurement, health outcomes, interventions, and research priorities. The meeting was informed by a literature review and conference symposium, and it was used to create statements on each of the areas addressed in this document. Knowledge users (n=3) also participated in the consensus meeting. Statements were then sent to the experts for validation. It was agreed that self-report tools need to be developed for understanding the context in which sedentary time is accumulated. For health outcomes, it was agreed that the focus of sedentary time research in older adults needs to include geriatric-relevant health outcomes, that there is insufficient evidence to quantify the dose–response relationship, that there is a lack of evidence on sedentary time from older adults in assisted facilities, and that evidence on the association between sedentary time and sleep is lacking. For interventions, research is needed to assess the impact that reducing sedentary time, or breaking up prolonged bouts of sedentary time has on geriatric-relevant health outcomes. Research priorities listed for each of these areas should be considered by researchers and funding agencies.

This consensus statement has been endorsed by the following societies: Academy of Geriatric Physical Therapy, Exercise & Sports Science Australia, Canadian Centre for Activity and Aging, Society of Behavioral Medicine, and the National Centre for Sport and Exercise Medicine.

Level of Sedentary Behavior and Its Associated Factors among Saudi Women Working in Office-Based Jobs in Saudi Arabia

Research in Saudi Arabia has revealed a shocking level of insufficiently physically active adults, particularly women. The risk of sedentary behavior will likely increase as the number of women with office-based jobs increases. The aim of this study is to determine the level of sedentary behavior, and its associated factors, among Saudi women working office-based jobs in the city of Riyadh. A cross-sectional study of 420 Saudi female employees at 8 office-based worksites were measured to determine body mass index and were given a self-administered survey to evaluate their level of physical activity and sedentary behavior. Median sitting time on work days was 690 min per day (interquartile range, IQR 541–870), with nearly half accumulated during work hours, and 575 min per day (IQR 360–780) on non-work days. Predictors of work day sitting time were level of education, number of children, and working in the private sector. Number of children, whether they were single, and whether they lived in a small home were found to predict non-work day sitting time. This study identifies Saudi women in office-based jobs as a high-risk group for sedentary behavior. There is a need to promote physical activity at worksites and reduce prolonged sitting.

Relationships between socioeconomic position and objectively measured sedentary behaviour in older adults in three prospective cohorts

OBJECTIVES

To investigate whether sedentary behaviour in older adults is associated with a systematic and comprehensive range of socioeconomic position (SEP) measures across the life course. SEP measures included prospective measures of social class, income, educational qualifications and parental social class and contemporaneous measures of area deprivation.

SETTING

Glasgow and the surrounding (West of Scotland) combined with Edinburgh and the surrounding area (the Lothians).

PARTICIPANTS

Community-dwelling adults aged around 79, 83, and 64 years from, respectively, the Lothian Birth Cohort 1936 (LBC1936) (n=271) and the 1930s (n=119) and 1950s (n=310) cohorts of the West of Scotland Twenty-07 study.

PRIMARY OUTCOME MEASURE

Sedentary behaviour was measured objectively using an activPAL activity monitor worn continuously for 7 days and used to calculate percentage of waking time spent sedentary.

RESULTS

Among retired participants, for most cohort and SEP combinations, greater social disadvantage was associated with increased sedentary time. For example, in the Twenty-07 1930s cohort, those most deprived on the Carstairs measure spent 6.5% (95% CI 0.3 to 12.7) more of their waking time sedentary than the least deprived. However, for employed people, the relationship between SEP and sedentary behaviour was much weaker. For example, in terms of social class differences, among the retired, the most disadvantaged spent 5.7% more waking time sedentary (95% CI 2.6% to 87%), whereas among the employed, there was effectively no difference (-0.5%; 95% CI -9.0 to 8.0).

CONCLUSIONS

Diverse SEP measures were associated with increased sedentary behaviour among retired people. There was little evidence for a relationship between SEP measures and sedentary behaviour among employed older adults. Prior to retirement, the constraints of the workplace may be masking effects that are only apparent at weekends.

Screen Time, Other Sedentary Behaviours, and Obesity Risk in Adults: A Review of Reviews

PURPOSE OF REVIEW

The aim of this paper is to assess the association between sedentary behaviours, including screen time, and risk of obesity in adults. A review of 10 systematic reviews was undertaken.

RECENT FINDINGS

Available evidence is generally not supportive of associations between sedentary behaviour and obesity in adults. Most studies that found significant associations indicated mostly small effect sizes. Somewhat more consistent associations were shown for screen time (mainly TV viewing), among older adults, and for pre-adult sedentary behaviour to increase the risk of obesity in adulthood. Some evidence also exists for breaks in sedentary time to be associated with a more favourable BMI, and for use of a car to be associated with greater risk of obesity. There is limited evidence for an association between sedentary behaviour in adulthood and obesity and any association that exists does not seem to be causal. Future research is required investigating potentially positive effects for frequent breaks from sitting, less car use, and an uncoupling of TV viewing and dietary intake.

The Influence of Neighbourhoods and the Social Environment on Sedentary Behaviour in Older Adults in Three Prospective Cohorts

Sedentary behaviour is an emerging risk factor for poor health. This study aimed to identify ecological determinants of sedentary behaviour, for which evidence is currently scarce. The study participants were community dwelling adults from, respectively, the Lothian Birth Cohort 1936 (n = 271, mean age 79) and the 1930s (n = 119, mean age 83) and 1950s (n = 310, mean age 64) cohorts of the West of Scotland Twenty-07 study. The outcome measure, percentage of waking time spent sedentary (sedentary time), was measured using an activPAL activity monitor worn continuously for seven days. Potential determinants included objective and subjective neighbourhood measures such as natural space, crime, social cohesion and fear of crime. Other determinants included measures of social participation such as social support, social group membership and providing care. Results from multivariable regression analyses indicated that providing care was associated with reduced sedentary time in retired participants in all cohorts. Fear of crime and perceived absence of services were associated with increased sedentary time for retired 1950s cohort members. Higher crime rates were associated with increased sedentary time in all cohorts but this was not significant after adjustment for socio-demographic characteristics. Most other neighbourhood and social participation measures showed no association with sedentary time.

Which psychological, social and physical environmental characteristics predict changes in physical activity and sedentary behaviors during early retirement? A longitudinal study

BACKGROUND

In the context of healthy ageing, it is necessary to identify opportunities to implement health interventions in order to develop an active lifestyle with sufficient physical activity and limited sedentary time in middle-aged and older adults. The transition to retirement is such an opportunity, as individuals tend to establish new routines at the start of retirement. Before health interventions can be developed, the psychological, social and physical environmental determinants of physical activity and sedentary behaviors during early retirement should be identified, ideally with longitudinal studies. The aim of this paper was first to examine whether psychological, social and physical environmental factors at the start of retirement predict longitudinal changes in physical activity and sedentary behaviors during the first years of retirement. Second, moderating effects of gender and educational levels were examined.

METHODS

This longitudinal study was conducted in Flanders, Belgium. In total, 180 recently retired (>1 month, <2 years at baseline) adults completed a postal questionnaire twice (in 2012-2013 and two years later in 2014-2015). The validated questionnaire assessed socio-demographic information, physical activity, sedentary behaviors, and psychological, social and physical environmental characteristics. Multiple moderated hierarchic regression analyses were conducted in SPSS 22.0.

RESULTS

Higher perceived residential density (p < 0.001) and lower aesthetics (p = 0.08) predicted an increase in active transportation (adjusted R² = 0.18). Higher baseline self-efficacy was associated with an increase in leisure-time physical activity (p = 0.001, adjusted R² = 0.13). A more positive perception of old age (p = 0.04) and perceiving less street connectivity (p = 0.001) were associated with an increase in screen time (adjusted R² = 0.06). Finally, higher baseline levels of modeling from friends (p = 0.06) and lower perceived land use mix access (p = 0.09) predicted an increase in car use (adjusted R² = 0.06). A few moderating effects, mainly of educational level, were found.

DISCUSSION

Walkability characteristics (perceived residential density) and self-efficacy at the start of retirement are the most important predictors of longitudinal changes in active transportation and leisure-time physical activity. Few moderating effects were found, so health interventions at the start of retirement focusing on self-efficacy and specific walkability characteristics could be effective to increase physical activity in recently retired adults. No firm conclusions can be drawn on the importance of the examined predictors to explain change in car use and screen time, possibly other factors like the home environment, or automatic processes and habit strength are more important to explain sedentary behaviors.

Leisure-time Physical Activity and Sedentary Behaviour in Older People: The Influence of Sport Involvement on Behaviour Patterns in Later Life

Given the dramatic demographic change underway in most industrialized nations, the health of older adults is a major concern, particularly given the prevalence of sedentary behaviours and physical inactivity among ageing populations. Researchers have suggested sport participation in later life promotes other health-related behaviours, however, these relationships are poorly understood. It is possible for individuals to be classified as sufficiently active and still spend most of their day involved in sedentary pursuits. Moreover, there is little information on older sport participants' use of time compared to leisurely active or inactive peers and whether type of physical activity involvement is associated with differences in older adults' behaviour patterns. With this in mind, data from 1,723 respondents (65 years and older) who completed the sport module of the 2010 Canadian General Social Survey-Time Use were used to investigate the influence of physical activity involvement (competitive sport vs. non-competitive sport vs. physically active leisure vs. inactivity) on time spent in leisure-time physical activity and sedentary behaviours. Results indicated that competitive sport participants spent less time engaging in sedentary behaviours compared to the physically active leisure or inactive respondents; however, sport participants (both competitive and non-competitive) also spent less time engaging in leisure-time physical activities than the physically active leisure group. Implications of these findings to assumptions related to the activity levels of older sport participants, suggestions for future research, and considerations for sport-related interventions aimed at enhancing health in older adulthood are discussed.

Source and Size of Social Support Network on Sedentary Behavior Among Older Adults

PURPOSE

To examine the association of source of social support and size of social support network on sedentary behavior among older adults.

DESIGN

Cross-sectional.

SETTING

National Health and Nutrition Examination Survey 2003 to 2006.

PARTICIPANTS

2519 older adults (60+ years).

MEASURES

Sedentary behavior was assessed via accelerometry over a 7-day period. Social support was assessed via self-report. Sources evaluated include spouse, son, daughter, sibling, neighbor, church member, and friend. Regarding size of social network, participants were asked, "In general, how many close friends do you have?"

ANALYSIS

Multivariable linear regression.

RESULTS

After adjustment, there was no evidence of an association between the size of social support network and sedentary behavior. With regard to specific sources of social support, spousal social support was associated with less sedentary behavior (β = -11.6; 95% confidence interval: -20.7 to -2.5), with evidence to suggest that this was only true for men. Further, an inverse association was observed between household size and sedentary behavior, with those having a greater number of individuals in the house having lower levels of sedentary behavior. These associations occurred independent of moderate-to-vigorous physical activity, age, gender, race-ethnicity, measured body mass index, total cholesterol, self-reported smoking status, and physician diagnosis of congestive heart failure, coronary artery disease, stroke, cancer, hypertension, or diabetes.

CONCLUSION

Spouse-specific emotion-related social support (particularly for men) and household size were associated with less sedentary behavior.

Association of Maximum Temperature With Sedentary Time in Older British Men

Background

Sedentary behavior is very common in older adults and a risk factor for mortality. Understanding determinants of sedentary behavior may help in defining strategies aimed to reduce the time spent sedentary. The degree of difference in sedentary time attributable to varying temperatures has not been yet estimated in older men.

Methods

Men aged 71 to 91 years participating in an established UK population-based cohort study were invited to wear an Actigraph GT3X accelerometer for 1 week in 2010–12. Outcome was sedentary time (<1.5 Metabolic Equivalent of Task) in minutes per day. Associations between daily outdoor maximum temperature and accelerometer-measured sedentary time were estimated using multilevel models.

Results

43% (1361/3137) of invited men participated in the study and provided adequate data. Men spent on average 615 minutes in sedentary time per day (72% of the total accelerometer-wear time). After adjusting for covariates, men spent 26 minutes more per day (P < .001) in sedentary time when temperatures were in the lowest (–3.5; 9.2°C) versus highest quintile (19.1; 29.5°C).

Conclusions

Sedentary time in older adults is highest at lowest temperatures, typically recorded in winter. Findings are relevant for guidelines: interventions may consider targeting older men in winter providing recommendations for minimizing sedentariness on daily basis.

Socio-Ecological Variables Associated with Context-Specific Sitting Time in Belgian Older Adults: A One-Year Follow-Up Study

INTRODUCTION

Knowledge about variables associated with context-specific sitting time in older adults is limited. Therefore, this study explored cross-sectional and longitudinal associations of socio-demographic, social-cognitive, physical-environmental and health-related variables with sitting during TV viewing, computer use and motorized transport in older adults.

METHODS

A sample of Belgian older adults completed structured interviews on context-specific sitting time and associated variables using a longitudinal study design. Objective measurements of grip strength and physical performance were also completed. Complete baseline data were available of 258 participants (73.98±6.16 years) of which 229 participants remained in the study at one year follow-up (retention rate: 91.60%). Cross-sectional correlates (baseline data) and longitudinal predictors (change-scores in relation with change in sitting time) were explored through multiple linear regression analyses.

RESULTS

Per context-specific sitting time, most of the cross-sectional correlates differed from the longitudinal predictors. Increases over time in enjoyment of watching TV (+one unit), encouragement of partner to watch less TV (+one unit) and TV time of partner (+30.0 min/day) were associated with respectively 9.1 min/day (p<0.001), 16.0 min/day (p<0.001) and 12.0 min/day (p<0.001) more sitting during TV viewing at follow-up. Increases over time in enjoyment of using a computer (+one unit), the number of smartphones and tablets (+1) and computer use of the partner (+30.0 min/day) were associated with respectively 5.5 min/day (p < .01), 10.4 min/day (p < .05) and 3.0 min/day (p < .05) more sitting during computer use at follow-up. An increase over time in self-efficacy regarding taking a bicycle or walking was associated with 2.9 min/day (p < .05) less sitting during motorized transport at follow-up.

CONCLUSIONS

The results stressed the importance of looking at separate contexts of sitting. Further, the results highlighted the importance of longitudinal research in order to reveal which changes in particular variables predicted changes in context-specific sitting time. Variables at the social-cognitive level were most frequently related to context-specific sitting.

Body Composition Outcomes of a Qigong Intervention Among Community-Dwelling Aging Adults

Aging causes various changes in body composition, which are critical implications for health and physical functioning in aging adults. The aim of this study was to explore the body composition outcomes of a qigong intervention among community-dwelling aging adults. This was a quasi-experimental study in which 90 participants were recruited. Forty-eight participants (experimental group) attended a 30-min qigong program 3 times per week for 12 weeks, whereas 42 participants (control group) continued performing their usual daily activities. The experimental group achieved a greater reduction in the fat mass percentage at the posttest, and exhibited increased fat-free mass, lean body mass percentage, and lean body mass to fat mass ratio compared with the controls. No difference between the two groups in body mass index, fat mass, and lean body mass was observed. These results indicated that the qigong intervention showed beneficial outcomes of body composition among community-dwelling aging adults.

Correlates of sedentary time in different age groups: results from a large cross sectional Dutch survey

BACKGROUND

Evidence shows that prolonged sitting is associated with an increased risk of mortality, independent of physical activity (PA). The aim of the study was to identify correlates of sedentary time (ST) in different age groups and day types (i.e. school-/work day versus non-school-/non-work day).

METHODS

The study sample consisted of 1895 Dutch children (4-11 years), 1131 adolescents (12-17 years), 8003 adults (18-64 years) and 1569 elderly (65 years and older) who enrolled in the Dutch continuous national survey 'Injuries and Physical Activity in the Netherlands' between 2006 and 2011. Respondents estimated the number of sitting hours during a regular school-/workday and a regular non-school/non-work day. Multiple linear regression analyses on cross-sectional data were used to identify correlates of ST.

RESULTS

Significant positive associations with ST were observed for: higher age (4-to-17-year-olds and elderly), male gender (adults), overweight (children), higher education (adults ≥ 30 years), urban environment (adults), chronic disease (adults ≥ 30 years), sedentary work (adults), not meeting the moderate to vigorous PA (MVPA) guideline (children and adults ≥ 30 years) and not meeting the vigorous PA (VPA) guideline (4-to-17-year-olds). Correlates of ST that significantly differed between day types were working hours and meeting the VPA guideline. More working hours were associated with more ST on school-/work days. In children and adolescents, meeting the VPA guideline was associated with less ST on non-school/non-working days only.

CONCLUSIONS

This study provides new insights in the correlates of ST in different age groups and thus possibilities for interventions in these groups. Correlates of ST appear to differ between age groups and to a lesser degree between day types. This implies that interventions to reduce ST should be age specific. Longitudinal studies are needed to draw conclusions on causality of the relationship between identified correlates and ST.

Factors Associated with Sedentary Behavior in Patients with Intermittent Claudication

OBJECTIVES

Time spent in sedentary behavior has been associated with cardio-metabolic risk factors in the general population and in patients with symptomatic peripheral artery disease (PAD). Given the association of sedentary behavior and poor health outcomes, it is important to identify factors associated with sedentary behavior in these patients. The aim of this study was to identify factors associated with the sedentary time in patients with symptomatic PAD.

METHODS

The sample included 297 patients with symptomatic PAD. Sedentary behavior was assessed using a step activity monitor and the patients were divided into tertiles. Demographic data, body mass index, comorbid conditions, and measures of severity of PAD (ankle brachial index, ischemic window, claudication measurements, peak oxygen uptake and walking economy) were obtained.

RESULTS

Patients in the highest tertile (i.e. more sedentary) had a higher body mass index and a higher prevalence of diabetes mellitus, metabolic syndrome, and obesity than patients in the lowest tertile, whereas their peak walking time, peak oxygen uptake, and walking economy were lower (p < .05 for all). Using multiple regression procedures, the factors associated with the sedentary time were male sex (b = .217, R² = .180, p = .001), body mass index (b = .154, R² = .059, p = .013), peak walking time (b = -.360, R² = .066, p ≤ .001), and walking economy (b = -.187, R² = .142, p = .004).

CONCLUSION

In patients with symptomatic PAD, greater time spent in sedentary behavior was found in men, and in patients with higher body mass index, lower peak walking time, and lower walking economy.

Modifying Older Adults' Daily Sedentary Behaviour Using an Asset-based Solution: Views from Older Adults

OBJECTIVE

There is a growing public health focus on the promotion of successful and active ageing. Interventions to reduce sedentary behaviour (SB) in older adults are feasible and are improved by tailoring to individuals' context and circumstances. SB is ubiquitous; therefore part of the tailoring process is to ensure individuals' daily sedentary routine can be modified. The aim of this study was to understand the views of older adults and identify important considerations when creating a solution to modify daily sedentary patterns.

METHOD

This was a qualitative research study. Fifteen older adult volunteers (mean age = 78 years) participated in 1 of 4 focus groups to identify solutions to modify daily sedentary routine. Two researchers conducted the focus groups whilst a third took detailed fieldnotes on a flipchart to member check the findings. Data were recorded and analysed thematically.

RESULTS

Participants wanted a solution with a range of options which could be tailored to individual needs and circumstances. The strategy suggested was to use the activities of daily routine and reasons why individuals already naturally interrupting their SB, collectively framed as assets. These assets were categorised into 5 sub-themes: physical assets (eg. standing up to reduce stiffness); psychological assets (eg. standing up to reduce feelings of guilt); interpersonal assets (eg. standing up to answer the phone); knowledge assets (eg. standing up due to knowing the benefits of breaking SB) and activities of daily living assets (eg. standing up to get a drink).

CONCLUSION

This study provides important considerations from older adults' perspectives to modify their daily sedentary patterns. The assets identified by participants could be used to co-create a tailored intervention with older adults to reduce SB, which may increase effectiveness and adherence.

Systematic mapping review of the factors influencing dietary behaviour in ethnic minority groups living in Europe: a DEDIPAC study

Background

Europe has a growing population of ethnic minority groups whose dietary behaviours are potentially of public health concern. To promote healthier diets, the factors driving dietary behaviours need to be understood. This review mapped the broad range of factors influencing dietary behaviour among ethnic minority groups living in Europe, in order to identify research gaps in the literature to guide future research.

Methods

A systematic mapping review was conducted (protocol registered with PROSPERO 2014: CRD42014013549). Nine databases were searched for quantitative and qualitative primary research published between 1999 and 2014. Ethnic minority groups were defined as immigrants/populations of immigrant background from low and middle income countries, population groups from former Eastern Bloc countries and minority indigenous populations. In synthesizing the findings, all factors were sorted and structured into emerging clusters according to how they were seen to relate to each other.

Results

Thirty-seven of 2965 studies met the inclusion criteria (n = 18 quantitative; n = 19 qualitative). Most studies were conducted in Northern Europe and were limited to specific European countries, and focused on a selected number of ethnic minority groups, predominantly among populations of South Asian origin. The 63 factors influencing dietary behaviour that emerged were sorted into seven clusters: social and cultural environment (16 factors), food beliefs and perceptions (11 factors), psychosocial (9 factors), social and material resources (5 factors), accessibility of food (10 factors), migration context (7 factors), and the body (5 factors).

Conclusion

This review identified a broad range of factors and clusters influencing dietary behaviour among ethnic minority groups. Gaps in the literature identified a need for researchers to explore the underlying mechanisms that shape dietary behaviours, which can be gleaned from more holistic, systems-based studies exploring relationships between factors and clusters. The dominance of studies exploring ‘differences’ between ethnic minority groups and the majority population in terms of the socio-cultural environment and food beliefs suggests a need for research exploring ‘similarities’. The evidence from this review will feed into developing a framework for the study of factors influencing dietary behaviours in ethnic minority groups in Europe.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-016-0412-8) contains supplementary material, which is available to authorized users.

The SOS-framework (Systems of Sedentary behaviours): an international transdisciplinary consensus framework for the study of determinants, research priorities and policy on sedentary behaviour across the life course: a DEDIPAC-study

BACKGROUND

Ecological models are currently the most used approaches to classify and conceptualise determinants of sedentary behaviour, but these approaches are limited in their ability to capture the complexity of and interplay between determinants. The aim of the project described here was to develop a transdisciplinary dynamic framework, grounded in a system-based approach, for research on determinants of sedentary behaviour across the life span and intervention and policy planning and evaluation.

METHODS

A comprehensive concept mapping approach was used to develop the Systems Of Sedentary behaviours (SOS) framework, involving four main phases: (1) preparation, (2) generation of statements, (3) structuring (sorting and ranking), and (4) analysis and interpretation. The first two phases were undertaken between December 2013 and February 2015 by the DEDIPAC KH team (DEterminants of DIet and Physical Activity Knowledge Hub). The last two phases were completed during a two-day consensus meeting in June 2015.

RESULTS

During the first phase, 550 factors regarding sedentary behaviour were listed across three age groups (i.e., youths, adults and older adults), which were reduced to a final list of 190 life course factors in phase 2 used during the consensus meeting. In total, 69 international delegates, seven invited experts and one concept mapping consultant attended the consensus meeting. The final framework obtained during that meeting consisted of six clusters of determinants: Physical Health and Wellbeing (71% consensus), Social and Cultural Context (59% consensus), Built and Natural Environment (65% consensus), Psychology and Behaviour (80% consensus), Politics and Economics (78% consensus), and Institutional and Home Settings (78% consensus). Conducting studies on Institutional Settings was ranked as the first research priority. The view that this framework captures a system-based map of determinants of sedentary behaviour was expressed by 89% of the participants.

CONCLUSION

Through an international transdisciplinary consensus process, the SOS framework was developed for the determinants of sedentary behaviour through the life course. Investigating the influence of Institutional and Home Settings was deemed to be the most important area of research to focus on at present and potentially the most modifiable. The SOS framework can be used as an important tool to prioritise future research and to develop policies to reduce sedentary time.

The descriptive epidemiology of total physical activity, muscle-strengthening exercises and sedentary behaviour among Australian adults--results from the National Nutrition and Physical Activity Survey

BACKGROUND

The current Australia's Physical Activity and Sedentary Behaviour Guidelines recommend that adults engage in regular moderate-to-vigorous-intensity physical activity (MVPA) and strength training (ST), and minimise time spent in sedentary behaviours (SB). However, evidence about the specific individual and concurrent distribution of these behaviours in Australia is scarce. Therefore, the aim of this study was to determine the prevalence and sociodemographic correlates of MVPA, ST and SB in a national-representative sample of Australian adults.

METHODS

Data were collected using face-to-face interviews, as part of the National Nutrition and Physical Activity Survey 2011-12. The population-weighted proportions meeting the MVPA (≥ 150 min/week), ST (≥ 2 sessions/week) and combined MVPA-ST guidelines, and proportions classified as having 'low levels of SB' (< 480 min/day) were calculated, and their associations with selected sociodemographic and health-related variables were assessed using multiple logistic regression analyses. This was also done for those at potentially 'high-risk', defined as insufficient MVPA-ST and 'high-sedentary' behaviour.

RESULTS

Out of 9345 participants (response rate = 77.0 %), aged 18-85 years, 52.6 % (95 % CI: 51.2 %-54.0 %), 18.6 % (95 % CI: 17.5 %-19.7 %) and 15.0 % (95 % CI: 13.9 %-16.1 %) met the MVPA, ST and combined MVPA-ST guidelines, respectively. Female gender, older age, low/medium education, poorer self-rated health, being classified as underweight or obese, and being a current smoker were independently associated with lower odds of meeting the MVPA, ST and combined MVPA-ST guidelines. A total of 78.9 % (95 % CI: 77.9 %-80.0 %) were classified as having low levels of SB. Females, older adults and those with lower education were more likely to report lower levels of SB, whilst those with poor self-rated health and obese individuals were less likely to report lower levels of SB (i.e. SB = ≥ 480 min/day). A total of 8.9 % (95 % CI: 8.1 %-9.6 %) were categorised as individuals at potentially 'high-risk'. Those with poorer self-rated health, obese individuals, those aged 25-44, and current smokers were more likely to be in the 'high risk' group.

CONCLUSIONS

The large majority of Australian adults do not meet the full physical activity guidelines and/or report excessive SB. Our results call for public health interventions to reduce physical inactivity and SB in Australia, particularly among the subgroups at the highest risk of these unhealthy behaviours.

Determinants of engaging in sedentary behavior across the lifespan; lessons learned from two systematic reviews conducted within DEDIPAC

The present commentary provides a brief overview of and reflections on the joint findings of two reviews of the present evidence regarding correlates, predictors and/or determinants of sedentary behavior among youth and older adults published in the International Journal of Behavioral Nutrition & Physical Activity.In both reviews, the included studies were predominantly conducted in Europe, the US, and Australia. Most studies were limited to TV or 'screen' time rather than sedentary behavior and relied on self-report. In both age groups there is a lack of qualitative studies as well as studies looking into the more motivational and contextual potential determinants of sedentary behavior. Both reviews indicate that to date there is limited evidence on the determinants of sedentary behaviour in youth and older adults. In youth, age and weight status were identified as determinants of sedentary behavior, with more sedentary time among older and heavier kids. In adults, age and retirement were determinants, with older and retired elderly sitting more.