1601
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Loitz CC, Potter RJ, Walker JL, McLeod NC, Johnston NJ. The effectiveness of workplace interventions to increase physical activity and decrease sedentary behaviour in adults: protocol for a systematic review. Syst Rev 2015; 4:178. [PMID: 26653146 PMCID: PMC4676873 DOI: 10.1186/s13643-015-0166-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 12/03/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A physically active lifestyle plays a preventative role in the development of various chronic diseases and mental health conditions. Unfortunately, few adults achieve the minimum amount of physical activity and spend excessive time sitting. Developing targeted interventions to increase active living among adults is an important endeavour for public health. One plausible context to reach adults is the workplace. This systematic review aims to review the effectiveness of workplace interventions on increasing physical activity and decreasing sedentary behaviour in the workplace. METHODS An advisory group of practitioners will work in collaboration with the research team to inform the systematic review and knowledge mobilization. Fifteen electronic databases will be searched to identify studies examining the effectiveness of workplace interventions on physical activity and sedentary behaviour. All experimental designs and observational studies (non-experimental intervention studies) meeting the study criteria will be included. Studies examining generally healthy, employed, adult participants will be included for the review. Interventions will focus on increasing physical activity and/or decreasing sedentary behaviour from the individual to policy level. The primary outcome variables will be reported or observed physical activity and/or sedentary behaviour in the workplace. Secondary outcomes will include variables ranging from return on investment to quality of life. Study quality will be assessed for risk of bias following the protocol identified in the Cochrane Handbook for Systematic Reviews of Interventions and supplemented by the guidelines developed by the Cochrane Effective Practice and Organisation of Care group, using RevMan. The quality of the evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach. Meta-analyses, forest plots, and harvest plots will be used where appropriate to assess the direction, size, and consistency of the intervention effect across the studies using similar intervention strategies. Follow-up knowledge mobilization activities and products will be developed to support the use of this knowledge in practice. DISCUSSION This protocol paper describes a systematic review assessing the effectiveness of various types of workplace interventions on increasing physical activity and decreasing sedentary behaviour at work. Collaborating with an advisory group of potential knowledge users throughout the process postulates a greater use and reach of the information gained from this systematic review by knowledge users. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42015019398.
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Affiliation(s)
- Christina C Loitz
- Alberta Centre for Active Living, Faculty of Physical Education and Recreation, University of Alberta, 3rd floor, 11759 Groat Road, T5M 3K6, Edmonton, Alberta, Canada.
- UWALK, Faculty of Physical Education and Recreation, University of Alberta, 3rd floor, 11759 Groat Road, T5M 3K6, Edmonton, Alberta, Canada.
| | - Robert J Potter
- Alberta Centre for Active Living, Faculty of Physical Education and Recreation, University of Alberta, 3rd floor, 11759 Groat Road, T5M 3K6, Edmonton, Alberta, Canada.
| | - Jessica L Walker
- Alberta Centre for Active Living, Faculty of Physical Education and Recreation, University of Alberta, 3rd floor, 11759 Groat Road, T5M 3K6, Edmonton, Alberta, Canada.
| | - Nicole C McLeod
- UWALK, Faculty of Physical Education and Recreation, University of Alberta, 3rd floor, 11759 Groat Road, T5M 3K6, Edmonton, Alberta, Canada.
| | - Nora J Johnston
- Alberta Centre for Active Living, Faculty of Physical Education and Recreation, University of Alberta, 3rd floor, 11759 Groat Road, T5M 3K6, Edmonton, Alberta, Canada.
- UWALK, Faculty of Physical Education and Recreation, University of Alberta, 3rd floor, 11759 Groat Road, T5M 3K6, Edmonton, Alberta, Canada.
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1602
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Redfield MM, Anstrom KJ, Levine JA, Koepp GA, Borlaug BA, Chen HH, LeWinter MM, Joseph SM, Shah SJ, Semigran MJ, Felker GM, Cole RT, Reeves GR, Tedford RJ, Tang WHW, McNulty SE, Velazquez EJ, Shah MR, Braunwald E. Isosorbide Mononitrate in Heart Failure with Preserved Ejection Fraction. N Engl J Med 2015; 373:2314-24. [PMID: 26549714 PMCID: PMC4712067 DOI: 10.1056/nejmoa1510774] [Citation(s) in RCA: 408] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Nitrates are commonly prescribed to enhance activity tolerance in patients with heart failure and a preserved ejection fraction. We compared the effect of isosorbide mononitrate or placebo on daily activity in such patients. METHODS In this multicenter, double-blind, crossover study, 110 patients with heart failure and a preserved ejection fraction were randomly assigned to a 6-week dose-escalation regimen of isosorbide mononitrate (from 30 mg to 60 mg to 120 mg once daily) or placebo, with subsequent crossover to the other group for 6 weeks. The primary end point was the daily activity level, quantified as the average daily accelerometer units during the 120-mg phase, as assessed by patient-worn accelerometers. Secondary end points included hours of activity per day during the 120-mg phase, daily accelerometer units during all three dose regimens, quality-of-life scores, 6-minute walk distance, and levels of N-terminal pro-brain natriuretic peptide (NT-proBNP). RESULTS In the group receiving the 120-mg dose of isosorbide mononitrate, as compared with the placebo group, there was a nonsignificant trend toward lower daily activity (-381 accelerometer units; 95% confidence interval [CI], -780 to 17; P=0.06) and a significant decrease in hours of activity per day (-0.30 hours; 95% CI, -0.55 to -0.05; P=0.02). During all dose regimens, activity in the isosorbide mononitrate group was lower than that in the placebo group (-439 accelerometer units; 95% CI, -792 to -86; P=0.02). Activity levels decreased progressively and significantly with increased doses of isosorbide mononitrate (but not placebo). There were no significant between-group differences in the 6-minute walk distance, quality-of-life scores, or NT-proBNP levels. CONCLUSIONS Patients with heart failure and a preserved ejection fraction who received isosorbide mononitrate were less active and did not have better quality of life or submaximal exercise capacity than did patients who received placebo. (Funded by the National Heart, Lung, and Blood Institute; ClinicalTrials.gov number, NCT02053493.).
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Affiliation(s)
- Margaret M Redfield
- From the Mayo Clinic, Rochester, MN (M.M.R., B.A.B., H.H.C.); Duke Clinical Research Institute (K.J.A., S.E.M., E.J.V.) and Duke University Medical Center (G.M.F.) - both in Durham, NC; Mayo Clinic, Scottsdale, AZ (J.A.L., G.A.K.); University of Vermont Medical Center, Burlington (M.M.L.); Washington University School of Medicine, St. Louis (S.M.J.); Northwestern University, Chicago (S.J.S.); Massachusetts General Hospital (M.J.S.) and Harvard Medical School (E.B.) - both in Boston; Emory University, Atlanta (R.T.C.); Thomas Jefferson University, Philadelphia (G.R.R.); Johns Hopkins University School of Medicine, Baltimore (R.J.T.), and the National Heart, Lung, and Blood Institute, Bethesda (M.R.S.) - both in Maryland; and the Cleveland Clinic Foundation, Cleveland (W.H.W.T.)
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1603
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Ried-Larsen M, Christensen R, Hansen KB, Johansen MY, Pedersen M, Zacho M, Hansen LS, Kofoed K, Thomsen K, Jensen MS, Nielsen RO, MacDonald C, Langberg H, Vaag AA, Pedersen BK, Karstoft K. Head-to-head comparison of intensive lifestyle intervention (U-TURN) versus conventional multifactorial care in patients with type 2 diabetes: protocol and rationale for an assessor-blinded, parallel group and randomised trial. BMJ Open 2015; 5:e009764. [PMID: 26656025 PMCID: PMC4679918 DOI: 10.1136/bmjopen-2015-009764] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Current pharmacological therapies in patients with type 2 diabetes (T2D) are challenged by lack of sustainability and borderline firm evidence of real long-term health benefits. Accordingly, lifestyle intervention remains the corner stone in the management of T2D. However, there is a lack of knowledge regarding the optimal intervention programmes in T2D ensuring both compliance as well as long-term health outcomes. Our objective is to assess the effects of an intensive lifestyle intervention (the U-TURN intervention) on glycaemic control in patients with T2D. Our hypothesis is that intensive lifestyle changes are equally effective as standard diabetes care, including pharmacological treatment in maintaining glycaemic control (ie, glycated haemoglobin (HbA1c)) in patients with T2D. Furthermore, we expect that intensive lifestyle changes will decrease the need for antidiabetic medications. METHODS AND ANALYSIS The study is an assessor-blinded, parallel group and a 1-year randomised trial. The primary outcome is change in glycaemic control (HbA1c), with the key secondary outcome being reductions in antidiabetic medication. Participants will be patients with T2D (T2D duration <10 years) without complications who are randomised into an intensive lifestyle intervention (U-TURN) or a standard care intervention in a 2:1 fashion. Both groups will be exposed to the same standardised, blinded, target-driven pharmacological treatment and can thus maintain, increase, reduce or discontinue the pharmacological treatment. The decision is based on the standardised algorithm. The U-TURN intervention consists of increased training and basal physical activity level, and an antidiabetic diet including an intended weight loss. The standard care group as well as the U-TURN group is offered individual diabetes management counselling on top of the pharmacological treatment. ETHICS AND DISSEMINATION This study has been approved by the Scientific Ethical Committee at the Capital Region of Denmark (H-1-2014-114). Positive, negative or inconclusive findings will be disseminated in peer-reviewed journals, at national and international conferences. TRIAL REGISTRATION NUMBER NCT02417012.
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Affiliation(s)
- Mathias Ried-Larsen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
- The Danish Diabetes Academy, Odense University Hospital, Odense, Denmark
| | - Robin Christensen
- Musculoskeletal Statistics Unit, Department of Rheum, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Katrine B Hansen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Diabetes and Metabolism, Copenhagen University Hospital, Copenhagen, Denmark
| | - Mette Y Johansen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Pedersen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Morten Zacho
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Louise S Hansen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Katja Kofoed
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Katja Thomsen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Mette S Jensen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Rasmus O Nielsen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Chris MacDonald
- Department of CopenRehab, Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark
| | - Henning Langberg
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
- Department of CopenRehab, Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark
| | - Allan A Vaag
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Diabetes and Metabolism, Copenhagen University Hospital, Copenhagen, Denmark
| | - Bente K Pedersen
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kristian Karstoft
- Center for Physical Activity Research, Copenhagen University Hospital, Copenhagen, Denmark
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1604
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O'Connell SE, Jackson BR, Edwardson CL, Yates T, Biddle SJH, Davies MJ, Dunstan D, Esliger D, Gray L, Miller P, Munir F. Providing NHS staff with height-adjustable workstations and behaviour change strategies to reduce workplace sitting time: protocol for the Stand More AT (SMArT) Work cluster randomised controlled trial. BMC Public Health 2015; 15:1219. [PMID: 26646026 PMCID: PMC4673711 DOI: 10.1186/s12889-015-2532-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 11/19/2015] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND High levels of sedentary behaviour (i.e., sitting) are a risk factor for poor health. With high levels of sitting widespread in desk-based office workers, office workplaces are an appropriate setting for interventions aimed at reducing sedentary behaviour. This paper describes the development processes and proposed intervention procedures of Stand More AT (SMArT) Work, a multi-component randomised control (RCT) trial which aims to reduce occupational sitting time in desk-based office workers within the National Health Service (NHS). METHODS/DESIGN SMArT Work consists of 2 phases: 1) intervention development: The development of the SMArT Work intervention takes a community-based participatory research approach using the Behaviour Change Wheel. Focus groups will collect detailed information to gain a better understanding of the most appropriate strategies, to sit alongside the provision of height-adjustable workstations, at the environmental, organisational and individual level that support less occupational sitting. 2) intervention delivery and evaluation: The 12 month cluster RCT aims to reduce workplace sitting in the University Hospitals of Leicester NHS Trust. Desk-based office workers (n = 238) will be randomised to control or intervention clusters, with the intervention group receiving height-adjustable workstations and supporting techniques based on the feedback received from the development phase. Data will be collected at four time points; baseline, 3, 6 and 12 months. The primary outcome is a reduction in sitting time, measured by the activPAL(TM) micro at 12 months. Secondary outcomes include objectively measured physical activity and a variety of work-related health and psycho-social measures. A process evaluation will also take place. DISCUSSION This study will be the first long-term, evidence-based, multi-component cluster RCT aimed at reducing occupational sitting within the NHS. This study will help form a better understanding and knowledge base of facilitators and barriers to creating a healthier work environment and contribute to health and wellbeing policy. TRIAL REGISTRATION ISRCTN10967042 . Registered 2 February 2015.
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Affiliation(s)
- S E O'Connell
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK.
| | - B R Jackson
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK.
| | - C L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester, UK.
- NIHR Leicester-Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester, UK.
| | - T Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK.
- NIHR Leicester-Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester, UK.
| | - S J H Biddle
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK.
- NIHR Leicester-Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester, UK.
- Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Australia.
| | - M J Davies
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK.
- Diabetes Research Centre, University of Leicester, Leicester, UK.
- NIHR Leicester-Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester, UK.
| | - D Dunstan
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.
- Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia.
- Department of Medicine, Monash University, Melbourne, VIC, Australia.
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
- School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia.
- School of Sport Science, Exercise and Health, The University of Western Australia, Perth, WA, Australia.
- Mary MacKillop Institute for Health Research, The Australian Catholic University, Melbourne, VIC, Australia.
| | - D Esliger
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK.
- NIHR Leicester-Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester, UK.
| | - L Gray
- Diabetes Research Centre, University of Leicester, Leicester, UK.
| | - P Miller
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK.
| | - F Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK.
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1605
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Ekblom-Bak E, Ekblom Ö, Bergström G, Börjesson M. Isotemporal substitution of sedentary time by physical activity of different intensities and bout lengths, and its associations with metabolic risk. Eur J Prev Cardiol 2015; 23:967-74. [PMID: 26635358 DOI: 10.1177/2047487315619734] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 11/08/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Time spent being sedentary, regardless of time in exercise, has been associated with metabolic risk using regression modelling. By using isotemporal substitution modelling, the effect of replacing sedentary time with an equal amount of time in physical activity (PA) of different intensities can be considered. The present study aims to investigate the effect of replacing sedentary time with time in light, moderate and vigorous PA to the prevalence of the metabolic syndrome (MetS). Also, replacement of sedentary time by PA of different bout lengths was studied. METHODS In total, 836 participants (52% women), aged 50-64 years, from the SCAPIS pilot study were included. Daily time spent sedentary and in PA of different intensities was assessed using hip-worn accelerometers. RESULTS In this cross-sectional study, replacing 10 minutes of sedentary time with the same amount of light PA was associated with significant lower MetS prevalence, odds ratio (OR) 0.96 (95% confidence interval 0.93-0.98). Replacement with moderate PA resulted in even lower OR, 0.89 (0.82-0.97), with the lowest OR for vigorous PA, 0.41 (0.26-0.66). Participants with high energy intake and high daily sedentary time benefitted more from the replacement of sedentary time with light PA. Significant associations were seen for all bout lengths of light, moderate and vigorous PA in a stepwise-like fashion from one minute to up to 120 minute bouts. CONCLUSION Theoretical substitutions of sedentary time with PA of any intensity and of as little as one minute were associated with significantly lower ORs for MetS. This may be an easily communicable message in clinical practice and for public health purposes.
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Affiliation(s)
- Elin Ekblom-Bak
- Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Sweden
| | - Örjan Ekblom
- Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Sweden
| | - Göran Bergström
- Department of Molecular and Clinical Medicine, University of Gothenburg, Sweden Sahlgrenska Centre for Cardiovascular and Metabolic Research, Sahlgrenska University Hospital, Sweden
| | - Mats Börjesson
- Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Sweden Department of Cardiology, Karolinska University Hospital, Sweden
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1606
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Effectiveness of Facebook-Delivered Lifestyle Counselling and Physical Activity Self-Monitoring on Physical Activity and Body Mass Index in Overweight and Obese Adolescents: A Randomized Controlled Trial. Nurs Res Pract 2015; 2015:159205. [PMID: 26697218 PMCID: PMC4678089 DOI: 10.1155/2015/159205] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 11/12/2015] [Indexed: 11/19/2022] Open
Abstract
Background. The aim was to evaluate the effects of a 12-week, Facebook-delivered lifestyle counselling intervention, with or without physical activity self-monitoring, on physical activity and body mass index (BMI) in overweight and obese 13–16-year-old adolescents. Methods. Three-arm randomized controlled trial. Participants (n = 46) were randomly assigned to intervention and control groups: one group received Facebook-delivered lifestyle counselling and monitoring of their physical activity (Fb + Act, n = 15), whereas a second experimental group received the same Facebook-delivered lifestyle counselling without self-monitoring (Fb, n = 16) and a third group served as the control group (n = 15). Objective and self-reported physical activity assessment were used. Nonparametric statistical tests were used. Results. There were no significant intervention effects in terms of changes in physical activity levels or BMI from baseline to the 12-week postintervention measurements between the intervention and control groups. The Fb + Act group had lower sedentary time on weekdays compared to the control group during postintervention measurements (p = 0.021), but there was no interaction between time and group. Conclusions. Interventions were not effective at increasing physical activity in overweight and obese adolescents. Before implementing such interventions, more evaluations on their effectiveness are needed. This trial is registered with ClinicalTrials.gov identifier NCT02295761 (2014-11-17).
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1607
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Ding D, Rogers K, van der Ploeg H, Stamatakis E, Bauman AE. Traditional and Emerging Lifestyle Risk Behaviors and All-Cause Mortality in Middle-Aged and Older Adults: Evidence from a Large Population-Based Australian Cohort. PLoS Med 2015; 12:e1001917. [PMID: 26645683 PMCID: PMC4672919 DOI: 10.1371/journal.pmed.1001917] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 10/30/2015] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Lifestyle risk behaviors are responsible for a large proportion of disease burden worldwide. Behavioral risk factors, such as smoking, poor diet, and physical inactivity, tend to cluster within populations and may have synergistic effects on health. As evidence continues to accumulate on emerging lifestyle risk factors, such as prolonged sitting and unhealthy sleep patterns, incorporating these new risk factors will provide clinically relevant information on combinations of lifestyle risk factors. METHODS AND FINDINGS Using data from a large Australian cohort of middle-aged and older adults, this is the first study to our knowledge to examine a lifestyle risk index incorporating sedentary behavior and sleep in relation to all-cause mortality. Baseline data (February 2006- April 2009) were linked to mortality registration data until June 15, 2014. Smoking, high alcohol intake, poor diet, physical inactivity, prolonged sitting, and unhealthy (short/long) sleep duration were measured by questionnaires and summed into an index score. Cox proportional hazards analysis was used with the index score and each unique risk combination as exposure variables, adjusted for socio-demographic characteristics. During 6 y of follow-up of 231,048 participants for 1,409,591 person-years, 15,635 deaths were registered. Of all participants, 31.2%, 36.9%, 21.4%, and 10.6% reported 0, 1, 2, and 3+ risk factors, respectively. There was a strong relationship between the lifestyle risk index score and all-cause mortality. The index score had good predictive validity (c index = 0.763), and the partial population attributable risk was 31.3%. Out of all 96 possible risk combinations, the 30 most commonly occurring combinations accounted for more than 90% of the participants. Among those, combinations involving physical inactivity, prolonged sitting, and/or long sleep duration and combinations involving smoking and high alcohol intake had the strongest associations with all-cause mortality. Limitations of the study include self-reported and under-specified measures, dichotomized risk scores, lack of long-term patterns of lifestyle behaviors, and lack of cause-specific mortality data. CONCLUSIONS Adherence to healthy lifestyle behaviors could reduce the risk for death from all causes. Specific combinations of lifestyle risk behaviors may be more harmful than others, suggesting synergistic relationships among risk factors.
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Affiliation(s)
- Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia
- * E-mail:
| | - Kris Rogers
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
- George Institute for Global Health, Sydney, New South Wales, Australia
| | - Hidde van der Ploeg
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands
| | - Emmanuel Stamatakis
- Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia
- Exercise and Sports Science, Faculty of Health Sciences, University of Sydney, Camperdown, New South Wales, Australia
| | - Adrian E. Bauman
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia
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1608
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van Nassau F, Chau JY, Lakerveld J, Bauman AE, van der Ploeg HP. Validity and responsiveness of four measures of occupational sitting and standing. Int J Behav Nutr Phys Act 2015; 12:144. [PMID: 26608219 PMCID: PMC4660635 DOI: 10.1186/s12966-015-0306-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 11/17/2015] [Indexed: 12/11/2022] Open
Abstract
Background Evidence on the detrimental health effects of prolonged sedentary behavior is accumulating. Interventions need to have a specific focus on sedentary behavior in order to generate clinically meaningful decreases in sedentary time. When evaluating such intervention, the question whether a participant improved or deteriorated their behavior is fundamental and instruments that are able to detect those changes are essential. Therefore, the aim of this study was to determine the criterion validity against activPAL and responsiveness to change of two activity monitors (ActiGraph and activPAL) and two questionnaires for the assessment of occupational sitting and standing time. Methods 42 participants took part in the Stand@Work intervention trial. Six (T0) and two (T1) weeks before they received a sit-stand workstation and three weeks thereafter (T2), participants wore an ActiGraph and an activPAL activity monitor, and completed the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) and the Workforce Sitting Questionnaire (WSQ). The activPAL was used as the criterion validity measure. Results The ActiGraph showed strong validity for occupational sedentary time at T0 and T1 (Spearman rho = 0.77 and 0.69), but its validity dropped substantially after introduction of the sit-stand workstation (rho = 0.19). Correlations between occupational light-intensity activity assessed by the ActiGraph and occupational standing time assessed by the activPAL varied between 0.25–0.63. The occupational sitting validity correlation of the OSPAQ and WSQ varied from 0.35-0.48 and 0.25-0.30, respectively, and between 0.16–0.68 for the OSPAQ for occupational standing time. The intervention-induced changes in occupational sitting and standing time were well detected by the activPAL, OSPAQ and WSQ (sitting only), but not by the ActiGraph, which had the lowest responsiveness to change. Conclusions This study suggests that studies aimed at determining differences in occupational sitting and standing time should use activPAL-type inclinometers as a preferred type of objective measure. Simple questionnaires showed sufficient validity and are usable in addition to an objective measure or alone when objective monitoring is not possible. The hip-worn ActiGraph was unable to distinguish between occupational sitting and standing time, when using uniaxial data and traditional cut-points for sedentary time and light-intensity activity. Trial registration The study was registered with the Australian New Zealand Clinical Trials Registry (No. ACTRN 12612000072819).
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Affiliation(s)
- Femke van Nassau
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands.
| | - Josephine Y Chau
- Sydney School of Public Health, University of Sydney, L6 Charles Perkins Centre, University of Sydney, Sydney, NSW, 2006, Australia.
| | - Jeroen Lakerveld
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Adrian E Bauman
- Sydney School of Public Health, University of Sydney, L6 Charles Perkins Centre, University of Sydney, Sydney, NSW, 2006, Australia.
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands. .,Sydney School of Public Health, University of Sydney, L6 Charles Perkins Centre, University of Sydney, Sydney, NSW, 2006, Australia.
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1609
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Prince SA, Blanchard CM, Grace SL, Reid RD. Objectively-measured sedentary time and its association with markers of cardiometabolic health and fitness among cardiac rehabilitation graduates. Eur J Prev Cardiol 2015; 23:818-25. [PMID: 26607698 DOI: 10.1177/2047487315617101] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 10/20/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND Sedentary time is an independent risk factor for cardiometabolic disease and mortality. It is unknown how much time individuals with coronary artery disease spend being sedentary or how their sedentary time relates to markers of health. The objectives of this study were to: (a) quantify sedentary time in a post-cardiac rehabilitation (CR) population, and (b) assess association with cardiometabolic risk, independent of moderate-to-vigorous physical activity. DESIGN Cross-sectional. METHODS As part of a larger trial, 263 recent CR graduates (∼10 days post-CR, mean age 63.6 ± 9.3 years, 75% male) wore an ActiGraph GT3X accelerometer during waking hours (≥4 days, ≥10 hours/day) to quantify sedentary time (≤150 counts per minute). Spearman correlations were computed to assess relationships between sedentary time (adjusted for wear time) with markers of cardiometabolic health and fitness. Significant markers were examined using multiple linear regressions. RESULTS Participants spent an average of 8 hours/day sedentary (∼14 bouts/day). Sedentary time was negatively correlated with high-density lipoprotein and [Formula: see text]O2peak and positively correlated with triglycerides, body mass index and waist circumference. After adjusting for age, sex, medications and moderate-to-vigorous physical activity, hours/day of sedentary time remained significantly associated with log[Formula: see text]O2peak (β = -0.02, p = 0.001) and body mass index (β = 0.49, p = 0.02). CONCLUSIONS Findings suggest that even among a group of post-CR individuals who are already probably more active than patients who have not undergone CR, sedentary time remains high and is associated with poorer cardiorespiratory fitness, suggesting a possible new area of focus among CR programs.
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Affiliation(s)
- Stephanie A Prince
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
| | | | - Sherry L Grace
- School of Kinesiology and Health Science, York University and Toronto Rehabilitation Institute, University Health Network, Canada
| | - Robert D Reid
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada
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1610
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Pyky R, Jauho AM, Ahola R, Ikäheimo TM, Koivumaa-Honkanen H, Mäntysaari M, Jämsä T, Korpelainen R. Profiles of sedentary and non-sedentary young men - a population-based MOPO study. BMC Public Health 2015; 15:1164. [PMID: 26596355 PMCID: PMC4657332 DOI: 10.1186/s12889-015-2495-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 11/17/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sedentary behavior is associated with poor well-being in youth with adverse trajectories spanning to adulthood. Still, its determinants are poorly known. Our aim was to profile sedentary and non-sedentary young men and to clarify their differences in a population-based setting. METHODS A total of 616 men (mean age 17.9, SD 0.6) attending compulsory conscription for military service completed a questionnaire on health, health behavior, socioeconomic situation and media use. They underwent a physical (body composition, muscle and aerobic fitness) and medical examination. Profiles were formed by principal component analysis (PCA). RESULTS A total of 30.1 % men were sedentary (daily leisure-time sitting ≥5 h) and 28.9 % non-sedentary (sitting ≤2 h). The sedentary men had more body fat, more depressive symptoms, but lower fitness and life satisfaction than non-sedentary men. However, according to PCA, profiles of unhealthy eating, life-dissatisfaction, and gaming were detected both among sedentary and non-sedentary men, as well as high self-rated PA and motives to exercise. CONCLUSION Determinants of sedentary and non-sedentary lifestyles were multiple and partially overlapping. Recognizing individual patterns and underlying factors of the sedentary lifestyle is essential for tailored health promotion and interventions.
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Affiliation(s)
- Riitta Pyky
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Albertinkatu 18A, P. O. Box 365, 90100, Oulu, Finland.
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, University of Oulu, Oulu, Finland.
| | - Anna-Maiju Jauho
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Albertinkatu 18A, P. O. Box 365, 90100, Oulu, Finland.
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
- Infotech Oulu, University of Oulu, Oulu, Finland.
| | - Riikka Ahola
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, University of Oulu, Oulu, Finland.
| | - Tiina M Ikäheimo
- Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland.
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, University of Oulu, Oulu, Finland.
| | - Heli Koivumaa-Honkanen
- Department of Psychiatry, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
- Department of Child Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland.
- Departments of Psychiatry, Kuopio University Hospital (KUH), Kuopio, Finland.
- Departments of Psychiatry, South-Savonia Hospital District, Mikkeli, Finland.
- Departments of Psychiatry, North Karelia Central Hospital, Joensuu, Finland.
- Departments of Psychiatry, SOSTERI, Savonlinna, Finland.
- Departments of Psychiatry, SOTE, Iisalmi, Finland.
- Departments of Psychiatry, Lapland Hospital District, Rovaniemi, Finland.
| | - Matti Mäntysaari
- Centre for Military Medicine, The Finnish Defence Forces, Helsinki, Finland.
| | - Timo Jämsä
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, University of Oulu, Oulu, Finland.
| | - Raija Korpelainen
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Albertinkatu 18A, P. O. Box 365, 90100, Oulu, Finland.
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, University of Oulu, Oulu, Finland.
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1611
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Prolonged Sitting is Associated with Attenuated Heart Rate Variability during Sleep in Blue-Collar Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:14811-27. [PMID: 26610534 PMCID: PMC4661681 DOI: 10.3390/ijerph121114811] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 11/02/2015] [Accepted: 11/17/2015] [Indexed: 11/17/2022]
Abstract
Prolonged sitting is associated with increased risk for cardiovascular diseases and mortality. However, research into the physiological determinants underlying this relationship is still in its infancy. The aim of the study was to determine the extent to which occupational and leisure-time sitting are associated with nocturnal heart rate variability (HRV) in blue-collar workers. The study included 138 blue-collar workers (mean age 45.5 (SD 9.4) years). Sitting-time was measured objectively for four days using tri-axial accelerometers (Actigraph GT3X+) worn on the thigh and trunk. During the same period, a heart rate monitor (Actiheart) was used to sample R-R intervals from the electrocardiogram. Time and frequency domain indices of HRV were only derived during nighttime sleep, and used as markers of cardiac autonomic modulation. Regression analyses with multiple adjustments (age, gender, body mass index, smoking, job-seniority, physical work-load, influence at work, and moderate-to-vigorous physical activity) were used to investigate the association between sitting time and nocturnal HRV. We found that occupational sitting-time was negatively associated (p < 0.05) with time and frequency domain HRV indices. Sitting-time explained up to 6% of the variance in HRV, independent of the covariates. Leisure-time sitting was not significantly associated with any HRV indices (p > 0.05). In conclusion, objectively measured occupational sitting-time was associated with reduced nocturnal HRV in blue-collar workers. This indicates an attenuated cardiac autonomic regulation with increasing sitting-time at work regardless of moderate-to-vigorous physical activity. The implications of this association for cardiovascular disease risk warrant further investigation via long-term prospective studies and intervention studies.
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1612
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Loprinzi PD. Joint associations of objectively-measured sedentary behavior and physical activity with health-related quality of life. Prev Med Rep 2015; 2:959-61. [PMID: 26844174 PMCID: PMC4721439 DOI: 10.1016/j.pmedr.2015.11.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
No studies, to my knowledge, have examined the joint effects of physical activity and sedentary behavior on health-related quality of life (HRQOL), which was the purpose of this study. Data from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) were used (N = 5,536). Moderate-to-vigorous physical activity (MVPA) and sedentary behavior were assessed using an ActiGraph 7164 accelerometer, with HRQOL assessed using the Centers for Disease Control and Prevention 4-item HRQOL index. MVPA (βadjusted = - 0.01; 95% CI: - 0.01 to - 0.004; P < 0.001), but not sedentary behavior (βadjusted = - 0.0003; 95% CI: - 0.001-0.0001; P = 0.37), was associated with HRQOL. MVPA was associated with HRQOL among those above the median (≥ 487.5 min/day) level of sedentary behavior (βadjusted = - 0.02; 95% CI: - 0.03 to - 0.01; P = 0.006; N = 2769). The results of this brief report do not demonstrate that sedentary behavior, independent of MVPA, is associated with HRQOL. The independent association of MVPA on HRQOL confirms previous work that used self-report measures of MVPA.
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Affiliation(s)
- Paul D. Loprinzi
- Center for Health Behavior Research, The University of Mississippi, 229 Turner Center, University, MS 38677, United States. Fax: + 1 662 915 5525.Center for Health Behavior ResearchThe University of Mississippi229 Turner CenterUniversityMS38677United States
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1613
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Cavalheri V, Straker L, Gucciardi DF, Gardiner PA, Hill K. Changing physical activity and sedentary behaviour in people with COPD. Respirology 2015; 21:419-26. [PMID: 26560834 DOI: 10.1111/resp.12680] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 09/13/2015] [Accepted: 09/24/2015] [Indexed: 01/28/2023]
Abstract
People with chronic obstructive pulmonary disease (COPD) engage in low levels of physical activity (PA). Given the evidence for the health benefits associated with participating in 150 min of moderate-to-vigorous intensity PA each week, there is considerable interest in methods to increase PA in people with COPD. Studies to date have focused largely on exercise training and behavioural approaches, and many have demonstrated minimal, if any effect. An intermediate goal that focuses on reducing time spent in sedentary behaviour (SB) and increasing participation in light intensity PA is a more realistic goal in this population and offers a gateway to higher intensity PA. Although strategies that are capable of reducing time spent in SB in COPD are unknown, studies that have shown some increase in PA in this population often provide individualized goal setting, motivational interviewing and frequent contact with health-care professionals to provide advice regarding strategies to overcome barriers. Therefore, these approaches should be considered in interventions to reduce time in SB. There are a range of devices available to monitor time in SB for use in both clinical and research settings. To move this area forward, a theoretically informed and systematic approach to behaviour change is needed. The theoretical model, the 'behaviour change wheel', is described and an example is provided of how it can be applied to a person with COPD.
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Affiliation(s)
- Vinicius Cavalheri
- School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia.,Institute for Respiratory Health, University of Western Australia, Perth, Western Australia, Australia
| | - Leon Straker
- School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia
| | - Daniel F Gucciardi
- School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia
| | - Paul A Gardiner
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.,Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Kylie Hill
- School of Physiotherapy and Exercise Science, Faculty of Health Science, Curtin University, Perth, Western Australia, Australia.,Institute for Respiratory Health, University of Western Australia, Perth, Western Australia, Australia
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1614
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Gao Y, Nevala N, Cronin NJ, Finni T. Effects of environmental intervention on sedentary time, musculoskeletal comfort and work ability in office workers. Eur J Sport Sci 2015; 16:747-54. [DOI: 10.1080/17461391.2015.1106590] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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1615
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Pettapiece-Phillips R, Kotlyar M, Chehade R, Salmena L, Narod SA, Akbari M, Jurisica I, Kotsopoulos J. Uninterrupted Sedentary Behavior Downregulates BRCA1 Gene Expression. Cancer Prev Res (Phila) 2015; 9:83-8. [DOI: 10.1158/1940-6207.capr-15-0291] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 10/21/2015] [Indexed: 11/16/2022]
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1616
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Shuval K, Finley CE, Barlow CE, Nguyen BT, Njike VY, Pettee Gabriel K. Independent and joint effects of sedentary time and cardiorespiratory fitness on all-cause mortality: the Cooper Center Longitudinal Study. BMJ Open 2015; 5:e008956. [PMID: 26525421 PMCID: PMC4636648 DOI: 10.1136/bmjopen-2015-008956] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/10/2015] [Accepted: 10/06/2015] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To examine the independent and joint effects of sedentary time and cardiorespiratory fitness (fitness) on all-cause mortality. DESIGN, SETTING, PARTICIPANTS A prospective study of 3141 Cooper Center Longitudinal Study participants. Participants provided information on television (TV) viewing and car time in 1982 and completed a maximal exercise test during a 1-year time frame; they were then followed until mortality or through 2010. TV viewing, car time, total sedentary time and fitness were the primary exposures and all-cause mortality was the outcome. The relationship between the exposures and outcome was examined utilising Cox proportional hazard models. RESULTS A total of 581 deaths occurred over a median follow-up period of 28.7 years (SD=4.4). At baseline, participants' mean age was 45.0 years (SD=9.6), 86.5% were men and their mean body mass index was 24.6 (SD=3.0). Multivariable analyses revealed a significant linear relationship between increased fitness and lower mortality risk, even while adjusting for total sedentary time and covariates (p=0.02). The effects of total sedentary time on increased mortality risk did not quite reach statistical significance once fitness and covariates were adjusted for (p=0.05). When examining this relationship categorically, in comparison to the reference category (≤10 h/week), being sedentary for ≥23 h weekly increased mortality risk by 29% without controlling for fitness (HR=1.29, 95% CI 1.03 to 1.63); however, once fitness and covariates were taken into account this relationship did not reach statistical significance (HR=1.20, 95% CI 0.95 to 1.51). Moreover, spending >10 h in the car weekly significantly increased mortality risk by 27% in the fully adjusted model. The association between TV viewing and mortality was not significant. CONCLUSIONS The relationship between total sedentary time and higher mortality risk is less pronounced when fitness is taken into account. Increased car time, but not TV viewing, is significantly related to higher mortality risk, even when taking fitness into account, in this cohort.
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Affiliation(s)
- Kerem Shuval
- Intramural Research Department, American Cancer Society, Atlanta, Georgia, USA
| | | | | | - Binh T Nguyen
- Intramural Research Department, American Cancer Society, Atlanta, Georgia, USA
| | - Valentine Y Njike
- Yale University Prevention Research Center, Griffin Hospital, Derby, Connecticut, USA
| | - Kelley Pettee Gabriel
- Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas, School of Public Health, Austin, Texas, USA
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1617
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Relationship of sitting time and physical activity with non-alcoholic fatty liver disease. J Hepatol 2015; 63:1229-37. [PMID: 26385766 DOI: 10.1016/j.jhep.2015.07.010] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 07/02/2015] [Accepted: 07/09/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND & AIMS The goal of this study was to examine the association of sitting time and physical activity level with non-alcoholic fatty liver disease (NAFLD) in Korean men and women and to explore whether any observed associations were mediated by adiposity. METHODS A cross-sectional study was performed on 139,056 Koreans, who underwent a health examination between March 2011 and December 2013. Physical activity level and sitting time were assessed using the validated Korean version of the international Physical Activity Questionnaire Short Form. The presence of fatty liver was determined using ultrasonographic findings. Poisson regression models with robust variance were used to evaluate the association of sitting time and physical activity level with NAFLD. RESULTS Of the 139,056 subjects, 39,257 had NAFLD. In a multivariable-adjusted model, both prolonged sitting time and decreased physical activity level were independently associated with increasing prevalence of NAFLD. The prevalence ratios (95% CIs) for NAFLD comparing 5-9 and ⩾10 h/day sitting time to <5h/day were 1.04 (1.02-1.07) and 1.09 (1.06-1.11), respectively (p for trend <0.001). These associations were still observed in subjects with BMI <23 kg/m(2). The prevalence ratios (95% CIs) for NAFLD comparing minimally active and health-enhancing physically active groups to the inactive group were 0.94 (0.92-0.95) and 0.80 (0.78-0.82), respectively (p for trend <0.001). CONCLUSIONS Prolonged sitting time and decreased physical activity level were positively associated with the prevalence of NAFLD in a large sample of middle-aged Koreans, supporting the importance of reducing time spent sitting in addition to promoting physical activity.
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1618
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Bouchard C, Blair SN, Katzmarzyk PT. Less Sitting, More Physical Activity, or Higher Fitness? Mayo Clin Proc 2015; 90:1533-40. [PMID: 26422244 DOI: 10.1016/j.mayocp.2015.08.005] [Citation(s) in RCA: 132] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 08/12/2015] [Accepted: 08/14/2015] [Indexed: 10/23/2022]
Abstract
Epidemiological studies have found that time spent in sedentary behaviors, levels of physical activity, and cardiorespiratory fitness are all associated with mortality rates. They are also related to the risks of obesity, type 2 diabetes mellitus, hypertension, cardiovascular disease, aging-associated frailty, and cancer. The evidence is such that the National Institutes of Health recently launched a new Common Fund initiative aimed at identifying the molecular transducers of adaptation to physical activity in various tissues and organs. It has been estimated that 9.4% of all 57 million deaths in the world in 2008 could be attributed to physical inactivity, which translates into more than 5 million deaths worldwide. Physical inactivity has a deleterious effect that is comparable to smoking and obesity. Importantly, this global estimate relates to levels of physical activity and does not take into account sedentary behavior and cardiorespiratory fitness. Currently, there are national and international guidelines for physical activity level that are highly concordant. The weekly recommendations include 150 minutes of moderate-intensity activity, 75 minutes of vigorous-intensity activity, or some combination of moderate and vigorous activity with 2 days of resistance exercise. However, these guidelines offer no recommendations regarding sedentary time or goals for cardiorespiratory fitness levels. It will be increasingly important for disease prevention, successful aging, and reduction of premature mortality to broaden the focus of the public health message to include not only more physical activity but also less sitting and higher cardiorespiratory fitness. We briefly review the evidence and discuss key issues to be addressed to make this approach a reality.
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Affiliation(s)
| | - Steven N Blair
- Arnold School of Public Health, University of South Carolina, Columbia
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1619
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Horta BL, Schaan BD, Bielemann RM, Vianna CÁ, Gigante DP, Barros FC, Ekelund U, Hallal PC. Objectively measured physical activity and sedentary-time are associated with arterial stiffness in Brazilian young adults. Atherosclerosis 2015; 243:148-54. [PMID: 26386211 PMCID: PMC4678284 DOI: 10.1016/j.atherosclerosis.2015.09.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 08/28/2015] [Accepted: 09/03/2015] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To examine the associations between objectively measured physical activity and sedentary time with pulse wave velocity (PWV) in Brazilian young adults. METHODS Cross-sectional analysis with participants of the 1982 Pelotas (Brazil) Birth Cohort who were followed-up from birth to 30 years of age. Overall physical activity (PA) assessed as the average acceleration (mg), time spent in moderate-to-vigorous physical activity (MVPA - min/day) and sedentary time (min/day) were calculated from acceleration data. Carotid-femoral PWV (m/s) was assessed using a portable ultrasound. Systolic and diastolic blood pressure (SBP/DBP), waist circumference (WC) and body mass index (BMI) were analyzed as possible mediators. Multiple linear regression and g-computation formula were used in the analyses. RESULTS Complete data were available for 1241 individuals. PWV was significantly lower in the two highest quartiles of overall PA (0.26 m/s) compared with the lowest quartile. Participants in the highest quartile of sedentary time had 0.39 m/s higher PWV (95%CI: 0.20; 0.57) than those in the lowest quartile. Individuals achieving ≥30 min/day in MVPA had lower PWV (β = -0.35; 95%CI: -0.56; -0.14). Mutually adjusted analyses between MVPA and sedentary time and PWV changed the coefficients, although results from sedentary time remained more consistent. WC captured 44% of the association between MVPA and PWV. DBP explained 46% of the association between acceleration and PWV. CONCLUSIONS Physical activity was inversely related to PWV in young adults, whereas sedentary time was positively associated. Such associations were only partially mediated by WC and DBP.
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Affiliation(s)
| | - Beatriz D Schaan
- EndocrineDivision, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Department of Internal Medicine, Facultyof Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Renata Moraes Bielemann
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil; Department of Nutrition, Federal University of Pelotas, Brazil
| | | | | | - Fernando C Barros
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | - Ulf Ekelund
- Medical Research Council, Epidemiology Unit, University of Cambridge, United Kingdom; Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Pedro Curi Hallal
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil
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1620
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Farah BQ, Ritti-Dias RM, Montgomery PS, Casanegra AI, Silva-Palacios F, Gardner AW. Sedentary behavior is associated with impaired biomarkers in claudicants. J Vasc Surg 2015; 63:657-63. [PMID: 26518099 DOI: 10.1016/j.jvs.2015.09.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 09/08/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Time spent in sedentary behavior has been associated with worse inflammation and cardiometabolic biomarkers in various populations. However, the association between time spent in sedentary behavior and biomarkers remains unknown in patients with intermittent claudication. The aim of the current study was to analyze the relationship between sedentary behavior and inflammatory and cardiometabolic biomarkers in patients with symptomatic peripheral arterial disease (PAD). METHODS The sample included 297 patients with intermittent claudication. Sedentary behavior was assessed using a step activity monitor. Biomarkers of inflammation, oxidative stress, lipid profile, insulin resistance, and endogenous fibrinolysis were assessed. Demographic data, body mass index, physical activity status, and measures of severity of PAD (ankle-brachial index, peak walking time, and ischemic window) also were obtained. RESULTS Time spent in sedentary behavior was related with high-sensitivity C-reactive protein (b = 0.187; P = .005), glucose (b = 0.238; P < .001), fibrinogen (b = 0.167; P = .017), plasminogen activator inhibitor 1 activity (b = 0.143; P = .036), and high-density lipoprotein cholesterol (b = -0.133; P = .029). After adjustment for sex, age, physical activity status, body mass index, and severity of PAD, sedentary behavior remained related with high-sensitivity C-reactive protein (b = 0.170; P = .015), glucose (b = 0.178; P = .004), fibrinogen (b = 0.189; P = .010), and high-density lipoprotein cholesterol (b = -0.128; P = .032). CONCLUSIONS Time spent in sedentary activities was associated with worse inflammatory and cardiometabolic profile in patients with intermittent claudication.
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Affiliation(s)
- Breno Q Farah
- Graduate Program in Physical Education, University of Pernambuco, Recife, Brazil
| | - Raphael M Ritti-Dias
- Graduate Program in Physical Education, University of Pernambuco, Recife, Brazil; Albert Einstein Hospital, São Paulo, Brazil
| | - Polly S Montgomery
- Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, Okla
| | - Ana I Casanegra
- Cardiovascular Section, Department of Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, Okla
| | - Federico Silva-Palacios
- Cardiovascular Section, Department of Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, Okla
| | - Andrew W Gardner
- Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, Okla.
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1621
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Burns RD, Brusseau TA, Fang Y, Myrer RS, Fu Y, Hannon JC. Predictors and grade level trends of school day physical activity achievement in low-income children from the U.S. Prev Med Rep 2015; 2:868-73. [PMID: 26844162 PMCID: PMC4721362 DOI: 10.1016/j.pmedr.2015.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The achievement of recommended levels (≥ 30 min/day) of school moderate-to-vigorous physical activity (MVPA) is paramount to decrease risk of chronic disease in children from low-income families. The purpose of this study was to examine the predictors and grade-level trends of school day MVPA achievement in low-income children. Data were collected during the Fall of 2014 on 1232 children (Mean age = 8.8 ± 1.6 years; 625 girls, 607 boys) recruited from three low-income schools from the state of Utah in the U.S. Children wore pedometers for one school week and a stratified random subsample (n = 533) also wore accelerometers to record sedentary time and MVPA. Generalized linear mixed models were employed to calculate odds ratios for achieving school MVPA standards (≥ 30 min/day) from various predictors and to determine odds of achievement across grade levels, accounting for school and classroom clustering. Odds of meeting MVPA standards were 3 times greater if a student achieved at least 6000 steps during the school day (p < 0.01), and were 55% lower for every 1% increase in sedentary time (p < 0.001). Older children had 26% lower odds of meeting the recommended levels of MVPA compared to children in an immediately younger grade level (p < 0.05). A significant proportion of MVPA variance was explained by classroom and school affiliation (Rho = 0.09 to 0.54, p < 0.001). Daily steps, sedentary times, grade level, and classroom and school affiliation associate with school MVPA achievement in low-income children.
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Affiliation(s)
- Ryan D. Burns
- University of Utah, Department of Exercise and Sport Science, 250 S. 1850 E., HPER North, RM 241, Salt Lake City, UT 84112, USA
| | - Timothy A. Brusseau
- University of Utah, Department of Exercise and Sport Science, 250 S. 1850 E., HPER North, RM 241, Salt Lake City, UT 84112, USA
| | - Yi Fang
- University of Utah, Department of Exercise and Sport Science, 250 S. 1850 E., HPER North, RM 241, Salt Lake City, UT 84112, USA
| | - Rachel S. Myrer
- Salt Lake City School District, 440 East 100 South Salt Lake City, UT 84111, USA
| | - You Fu
- University of Nebraska Kearney, Kinesiology and Sports Sciences Department, 905 West 25th Street, Kearney, NE 68849, USA
| | - James C. Hannon
- West Virginia University, College of Physical Activity and Sport Sciences, P.O. Box 6116, 375 Birch St., Morgantown, WV 26505-6116, USA
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1622
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Affiliation(s)
- Francisco Lopez-Jimenez
- Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic and Mayo College of Medicine, Rochester, MN, USA
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1623
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Silverberg JI. Association between adult atopic dermatitis, cardiovascular disease, and increased heart attacks in three population-based studies. Allergy 2015; 70:1300-8. [PMID: 26148129 DOI: 10.1111/all.12685] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2015] [Indexed: 01/25/2023]
Abstract
BACKGROUND Adults with eczema are more likely to smoke cigarettes, consume alcohol, and have sedentary lifestyle. We sought to determine whether adult eczema is associated with increased cardiovascular and cerebrovascular disease. METHODS Data from the 2005-2006 National Health and Nutrition Examination Survey (NHANES) (n = 4970) and 2010 (n = 27 157) and 2012 (n = 34 525) National Health Interview Survey (NHIS). History of coronary artery disease (CAD), angina, heart attack, stroke, and peripheral vascular disease (PVD) were determined. RESULTS In NHANES, flexural eczema in the past year was associated with significantly higher odds of CAD (P ≤ 0.04), heart attack (P ≤ 0.01), and congestive heart failure (P ≤ 0.02), but not with stroke (P ≥ 0.37), in survey-weighted multivariate logistic regression models that controlled for socio-demographics, comorbid asthma, and hay fever. Similarly, in NHIS 2010 and 2012, 1-year history of eczema was associated with significantly higher odds of CAD (P ≤ 0.02), angina (P ≤ 0.02), heart attack (P ≤ 0.047), other heart disease (P < 0.0001), stroke (P ≤ 0.02), and PVD (<0.0001) in multivariate models. CONCLUSIONS Adults with atopic dermatitis may have increased cardiovascular disease, heart attack, and stroke.
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Affiliation(s)
- J. I. Silverberg
- Departments of Dermatology, Preventive Medicine and Medical Social Sciences; Northwestern University Feinberg School of Medicine; Chicago IL USA
- Northwestern Medicine Multidisciplinary Eczema Center; Chicago IL USA
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1624
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Qi Q, Strizich G, Merchant G, Sotres-Alvarez D, Buelna C, Castañeda SF, Gallo LC, Cai J, Gellman MD, Isasi CR, Moncrieft AE, Sanchez-Johnsen L, Schneiderman N, Kaplan RC. Objectively Measured Sedentary Time and Cardiometabolic Biomarkers in US Hispanic/Latino Adults: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Circulation 2015; 132:1560-9. [PMID: 26416808 DOI: 10.1161/circulationaha.115.016938] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 08/03/2015] [Indexed: 01/17/2023]
Abstract
BACKGROUND Sedentary behavior is recognized as a distinct construct from lack of moderate-vigorous physical activity and is associated with deleterious health outcomes. Previous studies have primarily relied on self-reported data, whereas data on the relationship between objectively measured sedentary time and cardiometabolic biomarkers are sparse, especially among US Hispanics/Latinos. METHODS AND RESULTS We examined associations of objectively measured sedentary time (via Actical accelerometers for 7 days) and multiple cardiometabolic biomarkers among 12 083 participants, aged 18 to 74 years, from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Hispanics/Latinos of diverse backgrounds (Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American) were recruited from 4 US cities between 2008 and 2011. Sedentary time (<100 counts/min) was standardized to 16 hours/d of wear time. The mean sedentary time was 11.9 hours/d (74% of accelerometer wear time). After adjustment for moderate-vigorous physical activity and confounding variables, prolonged sedentary time was associated with decreased high-density lipoprotein cholesterol (P=0.04), and increased triglycerides, 2-hour glucose, fasting insulin, and homeostatic model assessment of insulin resistance (all P<0.0001). These associations were generally consistent across age, sex, Hispanic/Latino backgrounds, and physical activity levels. Even among individuals meeting physical activity guidelines, sedentary time was detrimentally associated with several cardiometabolic biomarkers (diastolic blood pressure, high-density lipoprotein cholesterol, fasting and 2-hour glucose, fasting insulin and homeostatic model assessment of insulin resistance; all P<0.05). CONCLUSIONS Our large population-based, objectively derived data showed deleterious associations between sedentary time and cardiometabolic biomarkers, independent of physical activity, in US Hispanics/Latinos. Our findings emphasize the importance of reducing sedentary behavior for the prevention of cardiometabolic diseases, even in those who meet physical activity recommendations.
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Affiliation(s)
- Qibin Qi
- From Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (Q.Q., G.S., C.R.I., R.C.K.); San Diego State University, Graduate School of Public Health, San Diego, CA (G.M., C.B., S.F.C.); University of North Carolina, Collaborative Studies Coordinating Center, Department of Biostatistics, Chapel Hill, NC (D.S.-A., J.C.); San Diego State University, Department of Psychology, San Diego, CA (L.C.G.); University of Miami, Department of Psychology, Miami, FL (M.D.G., A.E.M., N.S.); and University of Illinois at Chicago, Department of Psychiatry, Chicago, IL (L.S.-J.).
| | - Garrett Strizich
- From Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (Q.Q., G.S., C.R.I., R.C.K.); San Diego State University, Graduate School of Public Health, San Diego, CA (G.M., C.B., S.F.C.); University of North Carolina, Collaborative Studies Coordinating Center, Department of Biostatistics, Chapel Hill, NC (D.S.-A., J.C.); San Diego State University, Department of Psychology, San Diego, CA (L.C.G.); University of Miami, Department of Psychology, Miami, FL (M.D.G., A.E.M., N.S.); and University of Illinois at Chicago, Department of Psychiatry, Chicago, IL (L.S.-J.)
| | - Gina Merchant
- From Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (Q.Q., G.S., C.R.I., R.C.K.); San Diego State University, Graduate School of Public Health, San Diego, CA (G.M., C.B., S.F.C.); University of North Carolina, Collaborative Studies Coordinating Center, Department of Biostatistics, Chapel Hill, NC (D.S.-A., J.C.); San Diego State University, Department of Psychology, San Diego, CA (L.C.G.); University of Miami, Department of Psychology, Miami, FL (M.D.G., A.E.M., N.S.); and University of Illinois at Chicago, Department of Psychiatry, Chicago, IL (L.S.-J.)
| | - Daniela Sotres-Alvarez
- From Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (Q.Q., G.S., C.R.I., R.C.K.); San Diego State University, Graduate School of Public Health, San Diego, CA (G.M., C.B., S.F.C.); University of North Carolina, Collaborative Studies Coordinating Center, Department of Biostatistics, Chapel Hill, NC (D.S.-A., J.C.); San Diego State University, Department of Psychology, San Diego, CA (L.C.G.); University of Miami, Department of Psychology, Miami, FL (M.D.G., A.E.M., N.S.); and University of Illinois at Chicago, Department of Psychiatry, Chicago, IL (L.S.-J.)
| | - Christina Buelna
- From Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (Q.Q., G.S., C.R.I., R.C.K.); San Diego State University, Graduate School of Public Health, San Diego, CA (G.M., C.B., S.F.C.); University of North Carolina, Collaborative Studies Coordinating Center, Department of Biostatistics, Chapel Hill, NC (D.S.-A., J.C.); San Diego State University, Department of Psychology, San Diego, CA (L.C.G.); University of Miami, Department of Psychology, Miami, FL (M.D.G., A.E.M., N.S.); and University of Illinois at Chicago, Department of Psychiatry, Chicago, IL (L.S.-J.)
| | - Sheila F Castañeda
- From Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (Q.Q., G.S., C.R.I., R.C.K.); San Diego State University, Graduate School of Public Health, San Diego, CA (G.M., C.B., S.F.C.); University of North Carolina, Collaborative Studies Coordinating Center, Department of Biostatistics, Chapel Hill, NC (D.S.-A., J.C.); San Diego State University, Department of Psychology, San Diego, CA (L.C.G.); University of Miami, Department of Psychology, Miami, FL (M.D.G., A.E.M., N.S.); and University of Illinois at Chicago, Department of Psychiatry, Chicago, IL (L.S.-J.)
| | - Linda C Gallo
- From Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (Q.Q., G.S., C.R.I., R.C.K.); San Diego State University, Graduate School of Public Health, San Diego, CA (G.M., C.B., S.F.C.); University of North Carolina, Collaborative Studies Coordinating Center, Department of Biostatistics, Chapel Hill, NC (D.S.-A., J.C.); San Diego State University, Department of Psychology, San Diego, CA (L.C.G.); University of Miami, Department of Psychology, Miami, FL (M.D.G., A.E.M., N.S.); and University of Illinois at Chicago, Department of Psychiatry, Chicago, IL (L.S.-J.)
| | - Jianwen Cai
- From Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (Q.Q., G.S., C.R.I., R.C.K.); San Diego State University, Graduate School of Public Health, San Diego, CA (G.M., C.B., S.F.C.); University of North Carolina, Collaborative Studies Coordinating Center, Department of Biostatistics, Chapel Hill, NC (D.S.-A., J.C.); San Diego State University, Department of Psychology, San Diego, CA (L.C.G.); University of Miami, Department of Psychology, Miami, FL (M.D.G., A.E.M., N.S.); and University of Illinois at Chicago, Department of Psychiatry, Chicago, IL (L.S.-J.)
| | - Marc D Gellman
- From Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (Q.Q., G.S., C.R.I., R.C.K.); San Diego State University, Graduate School of Public Health, San Diego, CA (G.M., C.B., S.F.C.); University of North Carolina, Collaborative Studies Coordinating Center, Department of Biostatistics, Chapel Hill, NC (D.S.-A., J.C.); San Diego State University, Department of Psychology, San Diego, CA (L.C.G.); University of Miami, Department of Psychology, Miami, FL (M.D.G., A.E.M., N.S.); and University of Illinois at Chicago, Department of Psychiatry, Chicago, IL (L.S.-J.)
| | - Carmen R Isasi
- From Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (Q.Q., G.S., C.R.I., R.C.K.); San Diego State University, Graduate School of Public Health, San Diego, CA (G.M., C.B., S.F.C.); University of North Carolina, Collaborative Studies Coordinating Center, Department of Biostatistics, Chapel Hill, NC (D.S.-A., J.C.); San Diego State University, Department of Psychology, San Diego, CA (L.C.G.); University of Miami, Department of Psychology, Miami, FL (M.D.G., A.E.M., N.S.); and University of Illinois at Chicago, Department of Psychiatry, Chicago, IL (L.S.-J.)
| | - Ashley E Moncrieft
- From Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (Q.Q., G.S., C.R.I., R.C.K.); San Diego State University, Graduate School of Public Health, San Diego, CA (G.M., C.B., S.F.C.); University of North Carolina, Collaborative Studies Coordinating Center, Department of Biostatistics, Chapel Hill, NC (D.S.-A., J.C.); San Diego State University, Department of Psychology, San Diego, CA (L.C.G.); University of Miami, Department of Psychology, Miami, FL (M.D.G., A.E.M., N.S.); and University of Illinois at Chicago, Department of Psychiatry, Chicago, IL (L.S.-J.)
| | - Lisa Sanchez-Johnsen
- From Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (Q.Q., G.S., C.R.I., R.C.K.); San Diego State University, Graduate School of Public Health, San Diego, CA (G.M., C.B., S.F.C.); University of North Carolina, Collaborative Studies Coordinating Center, Department of Biostatistics, Chapel Hill, NC (D.S.-A., J.C.); San Diego State University, Department of Psychology, San Diego, CA (L.C.G.); University of Miami, Department of Psychology, Miami, FL (M.D.G., A.E.M., N.S.); and University of Illinois at Chicago, Department of Psychiatry, Chicago, IL (L.S.-J.)
| | - Neil Schneiderman
- From Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (Q.Q., G.S., C.R.I., R.C.K.); San Diego State University, Graduate School of Public Health, San Diego, CA (G.M., C.B., S.F.C.); University of North Carolina, Collaborative Studies Coordinating Center, Department of Biostatistics, Chapel Hill, NC (D.S.-A., J.C.); San Diego State University, Department of Psychology, San Diego, CA (L.C.G.); University of Miami, Department of Psychology, Miami, FL (M.D.G., A.E.M., N.S.); and University of Illinois at Chicago, Department of Psychiatry, Chicago, IL (L.S.-J.)
| | - Robert C Kaplan
- From Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (Q.Q., G.S., C.R.I., R.C.K.); San Diego State University, Graduate School of Public Health, San Diego, CA (G.M., C.B., S.F.C.); University of North Carolina, Collaborative Studies Coordinating Center, Department of Biostatistics, Chapel Hill, NC (D.S.-A., J.C.); San Diego State University, Department of Psychology, San Diego, CA (L.C.G.); University of Miami, Department of Psychology, Miami, FL (M.D.G., A.E.M., N.S.); and University of Illinois at Chicago, Department of Psychiatry, Chicago, IL (L.S.-J.)
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1625
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Hallman DM, Mathiassen SE, Gupta N, Korshøj M, Holtermann A. Differences between work and leisure in temporal patterns of objectively measured physical activity among blue-collar workers. BMC Public Health 2015; 15:976. [PMID: 26415931 PMCID: PMC4587719 DOI: 10.1186/s12889-015-2339-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 09/23/2015] [Indexed: 12/03/2022] Open
Abstract
Background Leisure time physical activity (LTPA) is generally associated with favorable cardiovascular health outcomes, while occupational physical activity (OPA) shows less clear, or even opposite, cardiovascular effects. This apparent paradox is not sufficiently understood, but differences in temporal patterns of OPA and LTPA have been suggested as one explanation. Our aim was to investigate the extent to which work and leisure (non-occupational time) differ in temporal activity patterns among blue-collar workers, and to assess the modification of these patterns by age and gender. Methods This study was conducted on a cross-sectional sample of male (n = 108) and female (n = 83) blue-collar workers, aged between 21 and 65 years. Physical activity and sedentary behavior were assessed using accelerometers (Actigraph GT3X+) worn on the thigh and trunk for four consecutive days. Temporal patterns of OPA and LTPA were retrieved using Exposure Variation Analysis (EVA), and expressed in terms of percentage of work and leisure time spent in uninterrupted periods of different durations (<1 min, 1–5 min, 5–10 min, 10–30 min, 30–60 min and > 60 min) of sitting, standing, and walking. Repeated measures ANOVA and linear regression analyses were used to test a) possible differences between OPA and LTPA in selected EVA derivatives, and b) the modification of these differences by age and gender. Results OPA showed a larger percentage time walking in brief (<5 min) periods [mean (SD): 33.4 % (12.2)], and less time in prolonged (>30 min) sitting [7.0 % (9.3)] than LTPA [walking 15.4 % (5.0); sitting 31.9 % (15.3)], even after adjustment for the difference between work and leisure in total time spent in each activity type. These marked differences in the temporal pattern of OPA and LTPA were modified by gender, but not age. Conclusion We found that the temporal patterns of OPA and LTPA among blue-collar workers were markedly different even after adjustment for total physical activity time, and that this difference was modified by gender. We recommend using EVA derivatives in future studies striving to disentangle the apparent paradoxical cardiovascular effect of physical activity at work and during leisure.
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Affiliation(s)
- David M Hallman
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Kungsbäcksvägen 47, SE 801 76, Gävle, Sweden.
| | - Svend Erik Mathiassen
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Kungsbäcksvägen 47, SE 801 76, Gävle, Sweden.
| | - Nidhi Gupta
- National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - Mette Korshøj
- National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark.
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1626
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Epigenetics and Colorectal Neoplasia: the Evidence for Physical Activity and Sedentary Behavior. CURRENT COLORECTAL CANCER REPORTS 2015; 11:388-396. [PMID: 27212896 DOI: 10.1007/s11888-015-0296-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Studies demonstrate that regular physical activity and, more recently, limited sedentary behavior are associated with reduced risk of colorectal neoplasia. However, the biological mechanisms of action for physical activity versus sedentary behavior are not clear. Epigenetic variation is suggested as a potential mechanism that would allow for independent, or possibly even synergistic, effects of activity and inactivity on colorectal epithelium. We describe the evidence for epigenetic variation as a link between physical activity and sedentary behavior in colorectal neoplasia risk. There are few studies that directly evaluate this relationship. However, the growing literature describes a variety of gene targets influenced by activity that are also important to colorectal neoplasia etiology. Future studies may identify epigenetic markers with translational significance in identifying high-risk individuals or those for whom a personalized activity regimen could significantly alter the methylation signature in colon epithelial cells, and thus future risk of colorectal cancer.
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1627
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Van Houten JM, Wessells RJ, Lujan HL, DiCarlo SE. My gut feeling says rest: Increased intestinal permeability contributes to chronic diseases in high-intensity exercisers. Med Hypotheses 2015; 85:882-6. [PMID: 26415977 DOI: 10.1016/j.mehy.2015.09.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 09/12/2015] [Indexed: 12/28/2022]
Abstract
Chronic diseases are the leading cause of death and disability worldwide, and many of these conditions are linked to chronic inflammation. One potential cause of chronic inflammation is an increased intestinal epithelial permeability. Recent studies have demonstrated that parasympathetic stimulation via the efferent abdominal vagus nerve increases the expression and proper localization of tight junction proteins and decreases intestinal epithelial permeability. This finding may provide a novel approach for treating and preventing many chronic conditions. Importantly, physical activity is associated with increased resting parasympathetic (vagal) activity and lower risk of chronic diseases. However, high intensity long duration exercise can be harmful to overall health. Specifically, individuals who frequently exercise strenuously and for longer time intervals have the same mortality rates as sedentary individuals. This may be explained, in part, by longer periods of reduced vagal activity as vagal activity is markedly reduced both during and after intense exercise. We hypothesize that one mechanism by which exercise provides its health benefits is by increasing resting vagal activity and decreasing intestinal epithelial permeability, thus decreasing chronic inflammation. Additionally, we hypothesize that long periods of reduced vagal activity in individuals who exercise at high intensities and for longer durations, decrease the integrity of the intestinal barrier, putting them at greater risk of chronic inflammation and a host of chronic diseases. Thus, this hypothesis provides a conceptual link between the well-established benefits of frequent exercise and the paradoxical deleterious effects of prolonged, high-intensity exercise without adequate rest.
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Affiliation(s)
- Jason M Van Houten
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI 48201, United States
| | - Robert J Wessells
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI 48201, United States
| | - Heidi L Lujan
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI 48201, United States
| | - Stephen E DiCarlo
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI 48201, United States.
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1628
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Excessive sitting at work and at home: Correlates of occupational sitting and TV viewing time in working adults. BMC Public Health 2015; 15:899. [PMID: 26374514 PMCID: PMC4571074 DOI: 10.1186/s12889-015-2243-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 09/07/2015] [Indexed: 11/30/2022] Open
Abstract
Background Recent evidence links sedentary behaviour (or too much sitting) with poorer health outcomes; many adults accumulate the majority of their daily sitting time through occupational sitting and TV viewing. To further the development and targeting of evidence-based strategies there is a need for identification of the factors associated with higher levels of these behaviours. This study examined socio-demographic and health-related correlates of occupational sitting and of combined high levels of occupational sitting/TV viewing time amongst working adults. Methods Participants were attendees of the third wave (2011/12) of the Australian Diabetes, Obesity and Lifestyle (AusDiab) study who worked full-time (≥35 h/week; n = 1,235; 38 % women; mean ± SD age 53 ± 7 years). Logistic and multinomial logistic regression analyses were conducted (separately for women and men) to assess cross-sectional associations of self-reported occupational sitting time (categorised as high/low based on the median) and also the combination of occupational sitting time/TV viewing time (high/low for each outcome), with a number of potential socio-demographic and health-related correlates. Results Higher levels of occupational sitting (>6 h/day) were associated with higher household income for both genders. Lower levels of occupational sitting were associated with being older (women only); and, for men only, having a blue collar occupation, having a technical/vocational educational attainment, and undertaking more leisure-time physical activity (LTPA). Attributes associated with high levels of both occupational sitting and TV viewing time included white collar occupation (men only), lower levels of LTPA (both genders), higher BMI (men), and higher energy consumption (women). Conclusions Higher household income (both genders) and professional/managerial occupations (men only) were correlates of high occupational sitting time, relative to low occupational sitting time, while health-related factors (lower LTPA, higher BMI – men, and higher energy consumption – women) were associated with high levels of both occupational sitting and TV viewing time, relative to low occupational sitting and low TV viewing time. These findings suggest possible high-risk groups that may benefit from targeted interventions. Further research is needed on potentially modifiable environmental and social correlates of occupational sitting time, in order to inform workplace initiatives.
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1629
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1630
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Correction: Sedentary Time and Its Association With Risk for Disease Incidence, Mortality, and Hospitalization in Adults. Ann Intern Med 2015; 163:400. [PMID: 26322710 DOI: 10.7326/l15-5134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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1631
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Qiu S, Cai X, Ju C, Sun Z, Yin H, Zügel M, Otto S, Steinacker JM, Schumann U. Step Counter Use and Sedentary Time in Adults: A Meta-Analysis. Medicine (Baltimore) 2015; 94:e1412. [PMID: 26334900 PMCID: PMC4616497 DOI: 10.1097/md.0000000000001412] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Although step counters are increasingly being used in walking programmes to promote sedentary behavior changes in adults, their effectiveness remains unknown. The aim of this meta-analysis of randomized controlled trials (RCTs) was to assess the effectiveness of step counter use in reducing sedentary time among adults.English-language RCTs from 3 databases were searched up to December 2014. Studies were included if they evaluated the effects of step counter use in adult populations and reported outcomes in sedentary time. Summary estimates (Cohen d with 95% confidence intervals [CIs]) were pooled using a random-effects model. Subgroup analyses and random-effects meta-regression analyses based on the characteristics of participants or interventions were conducted to explore their associations with sedentary time changes.Fifteen RCTs with a total sample size of 3262 adults were included. Step counter use was associated with a small but significant overall effect in reducing sedentary time (d = -0.20, 95% CI -0.33 to -0.07), equating to a reduction in sedentary time of ~23 min/d compared with controls. Subgroup analyses showed that step counter use with a step goal was associated with significantly reduced sedentary time (d =- 0.32, 95% CI -0.53 to -0.11), whereas without, it had only a trend. A greater reduction in sedentary time was observed among step counter users employing objective methods than those employing subjective methods for measurement (P = 0.03). Effects of covariates on sedentary time changes were generally unclear.Step counter use is associated with reduced sedentary time among adults. Future studies are required to specify the step goal use and to employ objective as well as subjective methods for measuring both total and domain-specific sedentary time.
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Affiliation(s)
- Shanhu Qiu
- From the Department of Endocrinology (SQ, XC, CJ, ZS, HY), Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, P.R. China; and Department of Internal Medicine II (HY, MZ, SO, JMS, US), Division of Sports and Rehabilitation Medicine, Ulm University, Ulm, Germany
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1632
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Phillips SM, Awick EA, Conroy DE, Pellegrini CA, Mailey EL, McAuley E. Objectively measured physical activity and sedentary behavior and quality of life indicators in survivors of breast cancer. Cancer 2015; 121:4044-52. [PMID: 26308157 DOI: 10.1002/cncr.29620] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 06/20/2015] [Accepted: 07/10/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND The primary purpose of the current study was to determine prospective associations of accelerometer-assessed physical activity intensity and sedentary time with health-related quality of life (HRQOL) indicators among survivors of breast cancer. METHODS A total of 358 survivors of breast cancer wore an accelerometer for 7 days at baseline to assess different activity intensities (light, lifestyle, and moderate to vigorous) and sedentary behavior. Six months later, survivors completed online questionnaires that assessed HRQOL indicators (disease-specific HRQOL, fatigue, depression, and anxiety) and relevant covariates. Relationships between activity and sedentary behavior quartiles and HRQOL indicator scores were examined using generalized liner models with Bonferroni multiple comparison adjustment. RESULTS After adjustment for covariates and sedentary time, each increasing lifestyle activity quartile was associated with reduced fatigue duration (P for trend, .03). Each increasing baseline moderate-to-vigorous physical activity (MVPA) quartile was found to be significantly associated with higher Physical Well-Being, Functional Assessment of Cancer Therapy-Breast (FACT-B) total, and trial outcome index scores; fewer breast cancer-specific concerns; and lower fatigue interference, and these differences were statistically and clinically significant between survivors in quartile 1 and quartile 4. After controlling for covariates and MVPA, relationships between sedentary time and HRQOL were mostly null with the exception of lower fatigue duration. CONCLUSIONS Objectively measured MVPA was found to be positively associated with many HRQOL indicators. Lifestyle activity was found to be only inversely associated with fatigue duration whereas sedentary time was found to be positively associated with fatigue duration. Future research is warranted to explore these relationships further.
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Affiliation(s)
- Siobhan M Phillips
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Elizabeth A Awick
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana-Champaign, Illinois
| | - David E Conroy
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Christine A Pellegrini
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Emily L Mailey
- Department of Kinesiology, Kansas State University, Manhattan, Kansas
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana-Champaign, Illinois
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1633
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Bellettiere J, Carlson JA, Rosenberg D, Singhania A, Natarajan L, Berardi V, LaCroix AZ, Sears DD, Moran K, Crist K, Kerr J. Gender and Age Differences in Hourly and Daily Patterns of Sedentary Time in Older Adults Living in Retirement Communities. PLoS One 2015; 10:e0136161. [PMID: 26296095 PMCID: PMC4546658 DOI: 10.1371/journal.pone.0136161] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 07/31/2015] [Indexed: 11/27/2022] Open
Abstract
Background Total sedentary time varies across population groups with important health consequences. Patterns of sedentary time accumulation may vary and have differential health risks. The purpose of this study is to describe sedentary patterns of older adults living in retirement communities and illustrate gender and age differences in those patterns. Methods Baseline accelerometer data from 307 men and women (mean age = 84±6 years) who wore ActiGraph GT3X+ accelerometers for ≥ 4 days as part of a physical activity intervention were classified into bouts of sedentary time (<100 counts per minute). Linear mixed models were used to account for intra-person and site-level clustering. Daily and hourly summaries were examined in mutually non-exclusive bouts of sedentary time that were 1+, 5+, 10+, 20+, 30+, 40+, 50+, 60+, 90+ and 120+ minutes in duration. Variations by time of day, age and gender were explored. Results Men accumulated more sedentary time than women in 1+, 5+, 10+, 20+, 30+, 40+, 50+ and 60+ minute bouts; the largest gender-differences were observed in 10+ and 20+ minute bouts. Age was positively associated with sedentary time, but only in bouts of 10+, 20+, 30+, and 40+ minutes. Women had more daily 1+ minute sedentary bouts than men (71.8 vs. 65.2), indicating they break up sedentary time more often. For men and women, a greater proportion of time was spent being sedentary during later hours of the day than earlier. Gender differences in intra-day sedentary time were observed during morning hours with women accumulating less sedentary time overall and having more 1+ minute bouts. Conclusions Patterns identified using bouts of sedentary time revealed gender and age differences in the way in which sedentary time was accumulated by older adults in retirement communities. Awareness of these patterns can help interventionists better target sedentary time and may aid in the identification of health risks associated with sedentary behavior. Future studies should investigate the impact of patterns of sedentary time on healthy aging, disease, and mortality.
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Affiliation(s)
- John Bellettiere
- San Diego State University/University of California, San Diego Joint Doctoral Program in Public Health (Epidemiology), University of California San Diego, La Jolla, California, United States of America
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California, United States of America
- * E-mail:
| | - Jordan A. Carlson
- Center for Children's Healthy Lifestyles and Nutrition, Children’s Mercy Hospital, Kansas City, Missouri, United States of America
| | - Dori Rosenberg
- Department of Health Services, University of Washington School of Public Health, Seattle, Washington, United States of America
| | - Anant Singhania
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Loki Natarajan
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Vincent Berardi
- Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California, United States of America
- Computational Science Research Center, San Diego State University, San Diego, California
| | - Andrea Z. LaCroix
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Dorothy D. Sears
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Kevin Moran
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Katie Crist
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
| | - Jacqueline Kerr
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, United States of America
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1634
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Weisser B. Lack of physical activity. DEUTSCHES ARZTEBLATT INTERNATIONAL 2015; 112:563. [PMID: 26356558 PMCID: PMC4570966 DOI: 10.3238/arztebl.2015.0563b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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1635
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Messing K. Pain and Prejudice: Does Collecting Information From the Standpoint of Exposed Workers Improve Scientific Examination of Work-Related Musculoskeletal Disorders? INTERNATIONAL JOURNAL OF HEALTH SERVICES 2015; 46:465-82. [PMID: 26272913 DOI: 10.1177/0020731415595337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The meaning, feasibility, and importance of scientific objectivity have been debated among public health scientists. The debate is particularly relevant to occupational health, because of frequent opposition between employer and worker interests. This article suggests that the concept of standpoint (J. Eakin) may be more useful than that of objectivity in framing discussion of work-related musculoskeletal disorders. Studies done from a "worker" standpoint can, for example, investigate and characterize environmental risk factors for work-related musculoskeletal disorders, while studies from an "employer" standpoint may concentrate on identifying individual workers likely to report work-related musculoskeletal disorders or those for whom consequences of work-related musculoskeletal disorders are more severe. Within "worker" standpoints, a distinction between "high-prestige worker" and "lower-prestige worker" standpoints can be identified in the current scientific debate about the health costs and benefits of prolonged standing vs prolonged sitting at work. Contact with workers, particularly lower-prestige workers, is critical to developing and sustaining a worker-based standpoint among researchers in occupational health. This contact can be facilitated by formal collaborations between universities and unions or other community groups.
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Affiliation(s)
- Karen Messing
- CINBIOSE, Université du Québec à Montréal, Montréal, Quebec, Canada
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1636
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Yang CH, Maher JP, Conroy DE. Acceptability of mobile health interventions to reduce inactivity-related health risk in central Pennsylvania adults. Prev Med Rep 2015; 2:669-72. [PMID: 26844135 PMCID: PMC4721363 DOI: 10.1016/j.pmedr.2015.08.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Insufficient physical activity and excessive sedentary behavior elevate health risk. Mobile applications (apps) provide one mode for delivering interventions to modify these behaviors and reduce health risk. The purpose of this study was to characterize the need for and acceptability of health behavior interventions among rural adults and evaluate the interest in and the value of app-based interventions in this population. Central Pennsylvania adults with smartphones (N = 258) completed a brief web survey in October-November 2012. Most adults report one or both inactivity-related behavioral risk factors, would use a free app to modify those risk behaviors, and would pay a small amount for that app. Low-cost, efficacious apps to increase physical activity or reduce sedentary behavior should be promoted in public health practice. User experience should be at the forefront of this process to increase value and minimize burden in the service of long-term engagement, behavior change, and health risk reduction.
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Affiliation(s)
- Chih-Hsiang Yang
- Department of Kinesiology, The Pennsylvania State University, 266 Rec Hall, University Park, PA 16802, USA
| | - Jaclyn P. Maher
- Department of Kinesiology, The Pennsylvania State University, 266 Rec Hall, University Park, PA 16802, USA
| | - David E. Conroy
- Department of Kinesiology, The Pennsylvania State University, 266 Rec Hall, University Park, PA 16802, USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Dr., Suite 1400, Chicago, IL 60611, USA
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1637
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Decreased physical activity and cardiorespiratory fitness in adults with ankylosing spondylitis: a cross-sectional controlled study. Rheumatol Int 2015; 35:1863-72. [DOI: 10.1007/s00296-015-3339-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 07/30/2015] [Indexed: 01/28/2023]
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1638
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Abstract
Sitting too much kills. Epidemiological, physiological and molecular data suggest that sedentary lifestyle can explain, in part, how modernity is associated with obesity, more than 30 chronic diseases and conditions and high healthcare costs. Excessive sitting--sitting disease--is not innate to the human condition. People were designed to be bipedal and, before the industrial revolution, people moved substantially more throughout the day than they do presently. It is encouraging that solutions exist to reverse sitting disease. Work environments, schools, communities and cities can be re-imagined and re-invented as walking spaces, and people thereby offered more active, happier, healthier and more productive lives.
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Affiliation(s)
- James A Levine
- Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ, 85259, USA,
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1639
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Moore S, Shiers D, Daly B, Mitchell AJ, Gaughran F. Promoting physical health for people with schizophrenia by reducing disparities in medical and dental care. Acta Psychiatr Scand 2015; 132:109-21. [PMID: 25958971 DOI: 10.1111/acps.12431] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/14/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Acquiring a diagnosis of schizophrenia reduces life expectancy for many reasons including poverty, difficulties in communication, side-effects of medication and access to care. This mortality gap is driven by natural deaths; cardiovascular disease is a major cause, but outcomes for people with severe mental illness are worse for many physical health conditions, including cancer, fractures and complications of surgery. We set out to examine the literature on disparities in medical and dental care experienced by people with schizophrenia and suggest possible approaches to improving health. METHOD This narrative review used a targeted literature search to identify the literature on physical health disparities in schizophrenia. RESULTS There is evidence of inequitable access to and/or uptake of physical and dental health care by those with schizophrenia. CONCLUSION The goal was to reduce the mortality gap through equity of access to all levels of health care, including acute care, long-term condition management, preventative medicine and health promotion. We suggest solutions to promote health, wellbeing and longevity in this population, prioritising identification of and intervention for risk factors for premature morbidity and mortality. Shared approaches are vital, while joint education of clinicians will help break down the artificial mind-body divide.
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Affiliation(s)
- S Moore
- Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - D Shiers
- Royal College of Psychiatrists, Centre for Quality Improvement, London, UK
| | - B Daly
- King's College Hospital, Dental Public Health, London, UK
| | - A J Mitchell
- Department of Psycho-oncology, Leicestershire Partnership Trust and Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester, UK
| | - F Gaughran
- Institute of Psychiatry, Psychology and Neuroscience, London and South London and Maudsley NHS Foundation Trust, National Psychosis Service, London, UK
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1640
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Bergman F, Boraxbekk CJ, Wennberg P, Sörlin A, Olsson T. Increasing physical activity in office workers--the Inphact Treadmill study; a study protocol for a 13-month randomized controlled trial of treadmill workstations. BMC Public Health 2015; 15:632. [PMID: 26160221 PMCID: PMC4497371 DOI: 10.1186/s12889-015-2017-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 07/06/2015] [Indexed: 12/17/2022] Open
Abstract
Background Sedentary behaviour is an independent risk factor for mortality and morbidity, especially for type 2 diabetes. Since office work is related to long periods that are largely sedentary, it is of major importance to find ways for office workers to engage in light intensity physical activity (LPA). The Inphact Treadmill study aims to investigate the effects of installing treadmill workstations in offices compared to conventional workstations. Methods/Design A two-arm, 13-month, randomized controlled trial (RCT) will be conducted. Healthy overweight and obese office workers (n = 80) with mainly sedentary tasks will be recruited from office workplaces in Umeå, Sweden. The intervention group will receive a health consultation and a treadmill desk, which they will use for at least one hour per day for 13 months. The control group will receive the same health consultation, but continue to work at their regular workstations. Physical activity and sedentary time during workdays and non-workdays as well as during working and non-working hours on workdays will be measured objectively using accelerometers (Actigraph and activPAL) at baseline and after 2, 6, 10, and 13 months of follow-up. Food intake will be recorded and metabolic and anthropometric variables, body composition, stress, pain, depression, anxiety, cognitive function, and functional magnetic resonance imaging will be measured at 3–5 time points during the study period. Interviews with participants from the intervention group will be performed at the end of the study. Discussion This will be the first long-term RCT on the effects of treadmill workstations on objectively measured physical activity and sedentary time as well as other body functions and structures/morphology during working and non-working hours among office workers. This will provide further insight on the effects of active workstations on our health and could fill in some of the knowledge gaps regarding how we can reduce sedentary time in office environments. Trial registration ClinicalTrials.gov Identifier NCT01997970, 2nd Nov 2013.
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Affiliation(s)
- Frida Bergman
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden.
| | - Carl-Johan Boraxbekk
- CEDAR, Center for Demographic and Aging Research, Umeå University, Umeå, Sweden. .,UFBI, Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden.
| | - Patrik Wennberg
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden.
| | - Ann Sörlin
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
| | - Tommy Olsson
- Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden.
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1641
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Matei R, Thuné-Boyle I, Hamer M, Iliffe S, Fox KR, Jefferis BJ, Gardner B. Acceptability of a theory-based sedentary behaviour reduction intervention for older adults ('On Your Feet to Earn Your Seat'). BMC Public Health 2015; 15:606. [PMID: 26135402 PMCID: PMC4489366 DOI: 10.1186/s12889-015-1921-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 06/09/2015] [Indexed: 01/16/2023] Open
Abstract
Background Adults aged 60 years and over spend most time sedentary and are the least physically active of all age groups. This early-phase study explored acceptability of a theory-based intervention to reduce sitting time and increase activity in older adults, as part of the intervention development process. Methods An 8-week uncontrolled trial was run among two independent samples of UK adults aged 60–75 years. Sample 1, recruited from sheltered housing on the assumption that they were sedentary and insufficiently active, participated between December 2013 and March 2014. Sample 2, recruited through community and faith centres and a newsletter, on the basis of self-reported inactivity (<150 weekly minutes of moderate-to-vigorous activity) and sedentary behaviour (≥6 h mean daily sitting), participated between March and August 2014. Participants received a booklet offering 16 tips for displacing sitting with light-intensity activity and forming activity habits, and self-monitoring ‘tick-sheets’. At baseline, 4-week, and 8-week follow-ups, quantitative measures were taken of physical activity, sedentary behaviour, and habit. At 8 weeks, tick-sheets were collected and a semi-structured interview conducted. Acceptability was assessed for each sample separately, through attrition and adherence to tips, ANOVAs for behaviour and habit changes, and, for both samples combined, thematic analysis of interviews. Results In Sample 1, 12 of 16 intervention recipients completed the study (25 % attrition), mean adherence was 40 % (per-tip range: 15–61 %), and there were no clear patterns of changes in sedentary or physical activity behaviour or habit. In Sample 2, 23 of 27 intervention recipients completed (15 % attrition), and mean adherence was 58 % (per-tip range: 39–82 %). Sample 2 decreased mean sitting time and sitting habit, and increased walking, moderate activity, and activity habit. Qualitative data indicated that both samples viewed the intervention positively, found the tips easy to follow, and reported health and wellbeing gains. Conclusions Low attrition, moderate adherence, and favourability in both samples, and positive changes in Sample 2, indicate the intervention was acceptable. Higher attrition, lower adherence, and no apparent behavioural impact among Sample 1 could perhaps be attributable to seasonal influences. The intervention has been refined to address emergent acceptability problems. An exploratory controlled trial is underway. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1921-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Raluca Matei
- Health Behaviour Research Centre, University College London, London, UK.
| | - Ingela Thuné-Boyle
- Health Behaviour Research Centre, University College London, London, UK.
| | - Mark Hamer
- Population Health Domain Physical Activity Research Group, Department of Epidemiology and Public Health, University College London, London, UK.
| | - Steve Iliffe
- Research Department of Primary Care & Population Health, University College London, London, UK.
| | - Kenneth R Fox
- Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK.
| | - Barbara J Jefferis
- Population Health Domain Physical Activity Research Group, Department of Epidemiology and Public Health, University College London, London, UK. .,Research Department of Primary Care & Population Health, University College London, London, UK.
| | - Benjamin Gardner
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 9th Floor, Capital House, 42 Weston Street, London, SE1 3QD, UK. .,UCL Centre for Behaviour Change, University College London, London, UK.
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1642
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Robertson C, Avenell A, Stewart F, Archibald D, Douglas F, Hoddinott P, van Teijlingen E, Boyers D. Clinical Effectiveness of Weight Loss and Weight Maintenance Interventions for Men: A Systematic Review of Men-Only Randomized Controlled Trials (The ROMEO Project). Am J Mens Health 2015; 11:1096-1123. [PMID: 26130729 DOI: 10.1177/1557988315587550] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Men are underrepresented in obesity services, suggesting current weight loss service provision is suboptimal. This systematic review evaluated evidence-based strategies for treating obesity in men. Eight bibliographic databases and four clinical trials' registers were searched to identify randomized controlled trials (RCTs) of weight loss interventions in men only, with mean/median body mass index of ≥30 kg/m2 (or ≥28 kg/m2 with cardiac risk factors), with a minimum mean/median duration of ≥52 weeks. Interventions included diet, physical activity, behavior change techniques, orlistat, or combinations of these; compared against each other, placebo, or a no intervention control group; in any setting. Twenty-one reports from 14 RCTs were identified. Reducing diets produced more favorable weight loss than physical activity alone (mean weight change after 1 year from a reducing diet compared with an exercise program -3.2 kg, 95% confidence interval -4.8 to -1.6 kg, reported p < .01). The most effective interventions combined reducing diets, exercise, and behavior change techniques (mean difference in weight at 1 year compared with no intervention was -4.9 kg, 95% confidence interval -5.9 to -4.0, reported p < .0001). Group interventions produced favorable weight loss results. The average reported participant retention rate was 78.2%, ranging from 44% to 100% retention, indicating that, once engaged, men remained committed to a weight loss intervention. Weight loss for men is best achieved and maintained with the combination of a reducing diet, increased physical activity, and behavior change techniques. Strategies to increase engagement of men with weight loss services to improve the reach of interventions are needed.
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1643
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Patel AV, Hildebrand JS, Campbell PT, Teras LR, Craft LL, McCullough ML, Gapstur SM. Leisure-Time Spent Sitting and Site-Specific Cancer Incidence in a Large U.S. Cohort. Cancer Epidemiol Biomarkers Prev 2015; 24:1350-9. [DOI: 10.1158/1055-9965.epi-15-0237] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 06/21/2015] [Indexed: 11/16/2022] Open
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1644
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Urushidani S, Kuriyama A. Sedentary Time and Risk for Mortality. Ann Intern Med 2015; 162:875. [PMID: 26075765 DOI: 10.7326/l15-0180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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1645
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Tremblay MS, Gray C, Babcock S, Barnes J, Costas Bradstreet C, Carr D, Chabot G, Choquette L, Chorney D, Collyer C, Herrington S, Janson K, Janssen I, Larouche R, Pickett W, Power M, Sandseter EBH, Simon B, Brussoni M. Position Statement on Active Outdoor Play. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:6475-505. [PMID: 26062040 PMCID: PMC4483712 DOI: 10.3390/ijerph120606475] [Citation(s) in RCA: 167] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 05/22/2015] [Accepted: 05/29/2015] [Indexed: 11/16/2022]
Abstract
A diverse, cross-sectorial group of partners, stakeholders and researchers, collaborated to develop an evidence-informed Position Statement on active outdoor play for children aged 3–12 years. The Position Statement was created in response to practitioner, academic, legal, insurance and public debate, dialogue and disagreement on the relative benefits and harms of active (including risky) outdoor play. The Position Statement development process was informed by two systematic reviews, a critical appraisal of the current literature and existing position statements, engagement of research experts (N = 9) and cross-sectorial individuals/organizations (N = 17), and an extensive stakeholder consultation process (N = 1908). More than 95% of the stakeholders consulted strongly agreed or somewhat agreed with the Position Statement; 14/17 participating individuals/organizations endorsed it; and over 1000 additional individuals and organizations requested their name be listed as a supporter. The final Position Statement on Active Outdoor Play states: “Access to active play in nature and outdoors—with its risks— is essential for healthy child development. We recommend increasing children’s opportunities for self-directed play outdoors in all settings—at home, at school, in child care, the community and nature.” The full Position Statement provides context for the statement, evidence supporting it, and a series of recommendations to increase active outdoor play opportunities to promote healthy child development.
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Affiliation(s)
- Mark S. Tremblay
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada; E-Mails: casgray@cheo,on.ca (C.G.); (J.B.); (R.L.)
- Department of Pediatrics, Children’s Hospital of Eastern Ontario, University of Ottawa, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada
- School of Human Kinetics, University of Ottawa, 125 University Private, Ottawa, Ontario, K1N 1A2, Canada
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-613-737-7600; Fax: +1-613-738-4800
| | - Casey Gray
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada; E-Mails: casgray@cheo,on.ca (C.G.); (J.B.); (R.L.)
| | - Shawna Babcock
- KidActive, 559A, Burtron Lane, Combermere, Ontario, K0J 1L0, Canada; E-Mail:
| | - Joel Barnes
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada; E-Mails: casgray@cheo,on.ca (C.G.); (J.B.); (R.L.)
| | | | - Dawn Carr
- Canadian Parks Council, 455 Hunter Street West, Peterborough, Ontario, K9H 2M7, Canada; E-Mail:
| | - Guylaine Chabot
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Research Institute, Laval University, 2725 Chemin Ste-Foy, Québec City, Québec, G1V 4G5, Canada; E-Mail:
| | - Louise Choquette
- Best Start Resource Centre—Health Nexus, 180 Dundas Street West, Toronto, Ontario, M5G 1Z8, Canada; E-Mail:
| | - David Chorney
- PHE Canada, 301-2197 Riverside Drive, Ottawa, Ontario, K1H 7X3, Canada; E-Mail:
| | - Cam Collyer
- Evergreen, 550 Bayview Avenue, Toronto, Ontario, M4W 3X8, Canada; E-Mail:
| | - Susan Herrington
- School of Architecture and Landscape Architecture, University of British Columbia, 379-2357 Main Mall, Vancouver, British Columbia, B6T 1Z4, Canada; E-Mail:
| | - Katherine Janson
- ParticipACTION, 77 Bloor Street West, Toronto, Ontario, M5S 1M2, Canada; E-Mails: (C.C.B.); (K.J.)
| | - Ian Janssen
- Department of Public Health Sciences, School of Kinesiology and Health Studies, Queen’s University, 99 University Avenue, Kingston, Ontario, K7L 2P5, Canada; E-Mail:
| | - Richard Larouche
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada; E-Mails: casgray@cheo,on.ca (C.G.); (J.B.); (R.L.)
| | - William Pickett
- Department of Public Health Sciences, Carruthers Hall, Queen’s University, Kingston, Ontario, K7L 2P5, Canada; E-Mail:
| | - Marlene Power
- Forest School Canada, Child and Nature Alliance of Canada, 411 Corkstown Road, Ottawa, Ontario, K2K 2Y1, Canada; E-Mail:
| | - Ellen Beate Hansen Sandseter
- Department of Physical Education and Health, College of Early Childhood Education, Queen Maud University, Thrond Nergaardsvei 7, NO-7044 Trondheim, Norway; E-Mail:
| | - Brenda Simon
- PLAYbynature, 226 Albany Avenue, Toronto, Ontario, M5R 3C6, Canada; E-Mail:
| | - Mariana Brussoni
- British Columbia Injury Research & Prevention Unit, Department of Pediatrics, School of Population & Public Health, Child & Family Research Institute, British Columbia Children’s Hospital, University of British Columbia, , F511-4480 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada; E-Mail:
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1646
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Buckley JP, Hedge A, Yates T, Copeland RJ, Loosemore M, Hamer M, Bradley G, Dunstan DW. The sedentary office: an expert statement on the growing case for change towards better health and productivity. Br J Sports Med 2015; 49:1357-62. [PMID: 26034192 DOI: 10.1136/bjsports-2015-094618] [Citation(s) in RCA: 239] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 03/26/2015] [Indexed: 01/06/2023]
Abstract
An international group of experts convened to provide guidance for employers to promote the avoidance of prolonged periods of sedentary work. The set of recommendations was developed from the totality of the current evidence, including long-term epidemiological studies and interventional studies of getting workers to stand and/or move more frequently. The evidence was ranked in quality using the four levels of the American College of Sports Medicine. The derived guidance is as follows: for those occupations which are predominantly desk based, workers should aim to initially progress towards accumulating 2 h/day of standing and light activity (light walking) during working hours, eventually progressing to a total accumulation of 4 h/day (prorated to part-time hours). To achieve this, seated-based work should be regularly broken up with standing-based work, the use of sit-stand desks, or the taking of short active standing breaks. Along with other health promotion goals (improved nutrition, reducing alcohol, smoking and stress), companies should also promote among their staff that prolonged sitting, aggregated from work and in leisure time, may significantly and independently increase the risk of cardiometabolic diseases and premature mortality. It is appreciated that these recommendations should be interpreted in relation to the evidence from which they were derived, largely observational and retrospective studies, or short-term interventional studies showing acute cardiometabolic changes. While longer term intervention studies are required, the level of consistent evidence accumulated to date, and the public health context of rising chronic diseases, suggest initial guidelines are justified. We hope these guidelines stimulate future research, and that greater precision will be possible within future iterations.
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Affiliation(s)
- John P Buckley
- Institute of Medicine, University Centre Shrewsbury and University of Chester, Chester, UK
| | - Alan Hedge
- Department of Design and Environment Analysis, Cornell University, Ithaca, New York, USA
| | - Thomas Yates
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester Diabetes Centre, Leicester, UK Diabetes Research Centre, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK
| | - Robert J Copeland
- The National Centre for Sport & Exercise Medicine and, The Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, UK
| | - Michael Loosemore
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Mark Hamer
- Department of Epidemiology and Public Health, University College London, London, UK
| | | | - David W Dunstan
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
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1647
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Mansoubi M, Pearson N, Clemes SA, Biddle SJ, Bodicoat DH, Tolfrey K, Edwardson CL, Yates T. Energy expenditure during common sitting and standing tasks: examining the 1.5 MET definition of sedentary behaviour. BMC Public Health 2015; 15:516. [PMID: 26021449 PMCID: PMC4448542 DOI: 10.1186/s12889-015-1851-x] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 05/19/2015] [Indexed: 02/01/2023] Open
Abstract
Background Sedentary behavior is defined as any waking behavior characterized by an energy expenditure of 1.5 METS or less while in a sitting or reclining posture. This study examines this definition by assessing the energy cost (METs) of common sitting, standing and walking tasks. Methods Fifty one adults spent 10 min during each activity in a variety of sitting tasks (watching TV, Playing on the Wii, Playing on the PlayStation Portable (PSP) and typing) and non-sedentary tasks (standing still, walking at 0.2, 0.4, 0.6, 0.8, 1.0, 1.2, 1.4, and 1.6 mph). Activities were completed on the same day in a random order following an assessment of resting metabolic rate (RMR). A portable gas analyzer was used to measure oxygen uptake, and data were converted to units of energy expenditure (METs). Results Average of standardized MET values for screen-based sitting tasks were: 1.33 (SD: 0.24) METS (TV), 1.41 (SD: 0.28) (PSP), and 1.45 (SD: 0.32) (Typing). The more active, yet still seated, games on the Wii yielded an average of 2.06 (SD: 0.5) METS. Standing still yielded an average of 1.59 (SD: 0.37) METs. Walking MET values increased incrementally with speed from 2.17 to 2.99 (SD: 0.5 - 0.69) METs. Conclusions The suggested 1.5 MET threshold for sedentary behaviors seems reasonable however some sitting based activities may be classified as non-sedentary. The effect of this on the definition of sedentary behavior and associations with metabolic health needs further investigation.
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Affiliation(s)
- Maedeh Mansoubi
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK.
| | - Natalie Pearson
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK.
| | - Stacy A Clemes
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK. .,The NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester-Loughborough, Leicestershire, UK.
| | - Stuart Jh Biddle
- Institute of Sport, Exercise & Active Living, Victoria University, Melbourne, Australia.
| | - Danielle H Bodicoat
- Leicester Diabetes Centre, Leicester General Hospital, University of Leicester, Leicester, Leicestershire, UK.
| | - Keith Tolfrey
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK.
| | - Charlotte L Edwardson
- The NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester-Loughborough, Leicestershire, UK. .,Leicester Diabetes Centre, Leicester General Hospital, University of Leicester, Leicester, Leicestershire, UK.
| | - Thomas Yates
- The NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester-Loughborough, Leicestershire, UK. .,Leicester Diabetes Centre, Leicester General Hospital, University of Leicester, Leicester, Leicestershire, UK.
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1648
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Win AM, Yen LW, Tan KHX, Lim RBT, Chia KS, Mueller-Riemenschneider F. Patterns of physical activity and sedentary behavior in a representative sample of a multi-ethnic South-East Asian population: a cross-sectional study. BMC Public Health 2015; 15:318. [PMID: 25884916 PMCID: PMC4391474 DOI: 10.1186/s12889-015-1668-7] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 03/19/2015] [Indexed: 12/03/2022] Open
Abstract
Background Few studies have investigated patterns of physical activity in a multi-ethnic Asian urban population. Even less is known about sedentary behaviors in these populations. The present study examined the prevalence of physical activity, exercise and sedentary behavior. In addition, it investigated socio-demographic correlates and the contribution of different domains towards overall physical activity. Methods Data of 2319 participants from the population-based cross-sectional Singapore Health 2012 study were analyzed. Physical activity, exercise and sedentary behavior were assessed using the Global Physical Activity Questionnaires. A modified Cox regression model was used to estimate the relative prevalence rates (PR) for overall physical activity, leisure-time exercise and high level of sedentary behavior by socio-demographic factors. Results Overall, 73.8% of participants met physical activity guidelines, 24.3% did regular leisure-time exercise and 37.0% reported high levels of sedentary behavior. Travel-related activities contributed about half of the total physical activity. There was a consistent association between age of participants with physical activity and exercise. Older participants were less likely to meet the guidelines (PR = 0.74, 95% C I = 0.61 – 0.91) than younger participants. The prevalence of regular exercise was lowest among 30 to 39 years aged participants (PR = 0.62, 95% CI = 0.45 – 0.86). Females exercised less regularly (PR = 0.63, 95% C I = 0.51 – 0.76) than males. Participants with higher education exercised regularly (PR = 2.08, 95% CI = 1.45 – 2.99) than participants with lower education. Employment status was consistently associated with exercise and high levels of sedentary behavior. Participants who were not in full-time employment exercised more regularly (PR = 1.45, 95% CI = 1.1 – 1.92) and were less likely to report high levels of sedentary behavior (PR = 0.65, 95% CI = 0.44 – 0.97) than those in full-time employment. Conclusions Our population-based study suggests a need to encourage overall physical activity but, particularly regular leisure-time exercise, especially among middle-aged, females and those with lower levels of education and full-time employment. Strategies targeting workplaces may be important to reduce high levels of sedentary behavior.
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Affiliation(s)
- Aye Mya Win
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
| | - Lim Wei Yen
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
| | - Kristin H X Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
| | - Raymond Boon Tar Lim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
| | - Kee Seng Chia
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
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1649
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Katz DL. Raising kids, in a cultural blind spot. Child Obes 2015; 11:109-10. [PMID: 25692866 DOI: 10.1089/chi.2015.1121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- David L Katz
- Editor-in-Chief, Childhood Obesity; Director, Yale University Prevention Research Center , Griffin Hospital, Derby, CT
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1650
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Parnell D, Pringle A, McKenna J, Zwolinsky S, Rutherford Z, Hargreaves J, Trotter L, Rigby M, Richardson D. Reaching older people with PA delivered in football clubs: the reach, adoption and implementation characteristics of the Extra Time Programme. BMC Public Health 2015; 15:220. [PMID: 25884183 PMCID: PMC4397882 DOI: 10.1186/s12889-015-1560-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 02/17/2015] [Indexed: 11/10/2022] Open
Abstract
Background Older adults (OA) represent a core priority group for physical activity and Public Health policy. As a result, significant interest is placed on how to optimise adherence to interventions promoting these approaches. Extra Time (ET) is an example of a national programme of physical activity interventions delivered in professional football clubs for OA aged 55+ years. This paper aims to examine the outcomes from ET, and unpick the processes by which these outcomes were achieved. Methods This paper represents a secondary analysis of data collected during the evaluation of ET. From the 985 OA reached by ET, n=486 adopted the programme and completed post-intervention surveys (typically 12 weeks). We also draw on interview data with 18 ET participants, and 7 staff who delivered the programme. Data were subject to thematic analysis to generate overarching and sub themes. Results Of the 486 participants, the majority 95%, (n= 462) were White British and 59.7% (n=290) were female. Most adopters (65.4%/n=318) had not participated in previous interventions in the host clubs. Social interaction was the most frequently reported benefit of participation (77.2%, n=375). While the reach of the club badge was important in letting people know about the programme, further work enhanced adoption and satisfaction. These factors included (i) listening to participants, (ii) delivering a flexible age-appropriate programme of diverse physical and social activities, (iii) offering activities which satisfy energy drives and needs for learning and (iv) extensive opportunities for social engagement. Conclusions Findings emerging from this study indicate that physical activity and health interventions delivered through professional football clubs can be effective for engaging OA.
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Affiliation(s)
- Daniel Parnell
- Centre for Active Lifestyles, Institute of Sport, PA and Leisure, Leeds Beckett University, Leeds, UK.
| | - Andy Pringle
- Centre for Active Lifestyles, Institute of Sport, PA and Leisure, Leeds Beckett University, Leeds, UK.
| | - Jim McKenna
- Centre for Active Lifestyles, Institute of Sport, PA and Leisure, Leeds Beckett University, Leeds, UK.
| | - Stephen Zwolinsky
- Centre for Active Lifestyles, Institute of Sport, PA and Leisure, Leeds Beckett University, Leeds, UK.
| | - Zoe Rutherford
- Centre for Active Lifestyles, Institute of Sport, PA and Leisure, Leeds Beckett University, Leeds, UK.
| | - Jackie Hargreaves
- Centre for Active Lifestyles, Institute of Sport, PA and Leisure, Leeds Beckett University, Leeds, UK.
| | - Lizzie Trotter
- Independent Researcher, Football Foundation, Whittington House, 19-30 Alfred Place, London, UK.
| | - Michael Rigby
- Football Foundation, Whittington House, 19-30 Alfred Place, London, UK.
| | - David Richardson
- The Football Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
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