Sedentary Behavior and Body Weight and Composition in Adults: A Systematic Review and Meta-analysis of Prospective Studies

The role of obesity and adipose tissue dysfunction in osteoarthritis pain

Obesity has a pivotal and multifaceted role in pain associated with osteoarthritis (OA), extending beyond the mechanistic influence of BMI. It exerts its effects both directly and indirectly through various modifiable risk factors associated with OA-related pain. Adipose tissue dysfunction is highly involved in OA-related pain through local and systemic inflammation, immune dysfunction, and the production of pro-inflammatory cytokines and adipokines. Adipose tissue dysfunction is intricately connected with metabolic syndrome, which independently exerts specific effects on OA-related pain, distinct from its association with BMI. The interplay among obesity, adipose tissue dysfunction and metabolic syndrome influences OA-related pain through diverse pain mechanisms, including nociceptive pain, peripheral sensitization and central sensitization. These complex interactions contribute to the heightened pain experience observed in individuals with OA and obesity. In addition, pain management strategies are less efficient in individuals with obesity. Importantly, therapeutic interventions targeting obesity and metabolic syndrome hold promise in managing OA-related pain. A deeper understanding of the intricate relationship between obesity, metabolic syndrome and OA-related pain is crucial and could have important implications for improving pain management and developing innovative therapeutic options in OA.

Relationship of work-related and leisure-based screen time with obesity: a cross-sectional study on adults including older adults

PURPOSE

The relationship between screen time (ST) and obesity has been demonstrated; however, few studies have differentiated between work-related and leisure-based use in Japanese adults, including older adults. This study aimed to examine the relationship between both work-related and leisure-based ST and obesity in adults.

METHODS

This cross-sectional study was based on a questionnaire survey conducted in 2018. Overall, 9947 adults were invited; 3161 participants (31.8%) returned the questionnaire. Finally, 2488 participants (597 younger men (YM), 792 younger women (YW), 542 older men (OM), 557 older women (OW)) were included. The main exposures were work-related, leisure-based, and total ST. The outcome was obesity (body mass index ≥ 25 kg/m2). Log-binomial regression analysis was used to calculate prevalence ratios (PRs) and confidence intervals (CIs) for obesity with 1-h increments of each ST. Analyses were conducted in all participants and subgroups comprising YM, YW, OM, and OW.

RESULTS

Total ST was significantly associated with obesity in all participants (PR (95% CI) 1.07 (1.04-1.10), YM (1.05 (1.01-1.10)), OM (1.13 (1.05-1.22)), and OW (1.13 (1.02-1.26)). Work-related ST was significantly associated with obesity in all participants (1.08 (1.04-1.12)), YM (1.06 (1.00-1.12)), and OM (1.24 (1.08-1.42)). Leisure-based ST was significantly associated with obesity in all participants (1.09 (1.04-1.14)), YM (1.09 (1.00-1.18)), and YW (1.10 (1.01-1.20)).

CONCLUSION

ST is associated with obesity in Japanese adults including older adults; particularly, work-related ST is associated with obesity in men, and leisure-based ST, in younger individuals.

Association of daily sitting time and leisure-time physical activity with body fat among U.S. adults

BACKGROUND

Prolonged sitting and reduced physical activity lead to low energy expenditures. However, little is known about the joint impact of daily sitting time and physical activity on body fat distribution. We investigated the independent and joint associations of daily sitting time and physical activity with body fat among adults.

METHODS

This was a cross-sectional analysis of U.S. nationally representative data from the National Health and Nutrition Examination Survey 2011-2018 among adults aged 20 years or older. Daily sitting time and leisure-time physical activity (LTPA) were self-reported using the Global Physical Activity Questionnaire. Body fat (total and trunk fat percentage) was determined via dual X-ray absorptiometry.

RESULTS

Among 10,808 adults, about 54.6% spent 6 h/day or more sitting; more than one-half reported no LTPA (inactive) or less than 150 min/week LTPA (insufficiently active) with only 43.3% reported 150 min/week or more LTPA (active) in the past week. After fully adjusting for sociodemographic data, lifestyle behaviors, and chronic conditions, prolonged sitting time and low levels of LTPA were associated with higher total and trunk fat percentages in both sexes. When stratifying by LTPA, the association between daily sitting time and body fat appeared to be stronger in those who were inactive/insufficiently active. In the joint analyses, inactive/insufficiently active adults who reported sitting more than 8 h/day had the highest total (female: 3.99% (95% confidence interval (95%CI): 3.09%-4.88%); male: 3.79% (95%CI: 2.75%-4.82%)) and trunk body fat percentages (female: 4.21% (95%CI: 3.09%-5.32%); male: 4.07% (95%CI: 2.95%-5.19%)) when compared with those who were active and sitting less than 4 h/day.

CONCLUSION

Prolonged daily sitting time was associated with increased body fat among U.S. adults. The higher body fat associated with 6 h/day sitting may not be offset by achieving recommended levels of physical activity.

Smartphone-based educational and counseling interventions for women with high body mass index at Urmia's health centers

BACKGROUND AND PURPOSE

Overweight and obesity in women of reproductive age not only contribute to chronic diseases but also lead to fertility issues, adverse pregnancy outcomes, and psychological challenges. Among the detrimental behaviors associated with obesity, the consumption of fast foods and sedentary lifestyles have the most significant impact on weight gain and require effective interventions. This study aims to examine the effectiveness of an educational and counseling smartphone intervention in raising awareness and modifying behaviors related to sedentary behavior and fast food consumption in women with high body mass index.

MATERIALS AND METHODS

This randomized controlled trial was conducted with two parallel groups comprising 106 women of reproductive age who sought assistance at Urmia health centers in 2022. Participants with diverse social and economic backgrounds were included. They were randomly assigned to either a control group or an intervention group. Valid and reliable questionnaires were administered to assess awareness regarding sedentary behaviors and fast foods consumption, as well as engagement in sedentary behaviors and consumption of fast foods. In addition to standard care, the intervention group received educational and counseling sessions through a dedicated smartphone application. Data analysis was performed using SPSS 20 software at a significance level of P < 0.05.

FINDINGS

The results of a statistical t-test indicated a noteworthy disparity between the control and intervention groups concerning the average awareness scores related to fast foods consumption (P < 0.001) and sedentary behaviors (P < 0.001) before and 3 months after the intervention. Additionally, a substantial statistical difference was observed in the mean consumption of fast foods (P < 0.001) and hours of sedentary behaviors (P < 0.001) before and 3 months after the intervention when comparing the two groups.

CONCLUSION

Educational and counseling programs, when applied effectively, can serve the dual purpose of enhancing awareness concerning sedentary behaviors and fast foods consumption while concurrently fostering a reduction in the prevalence of these behaviors. The study was registered in the Iranian Registry of Clinical Trials (IRCT Id: IRCT20210722051953N1) at 04/08/2021.

Adolescent sedentary behavior and body composition in early adulthood: results from a cohort study

BACKGROUND

This study investigates the cross-sectional and prospective associations between accelerometer-measured sedentary behavior and body composition from adolescence to early adulthood.

METHODS

Data from the Santiago Longitudinal Study were analyzed (n = 212). Sedentary time was measured at age 16 years, and body composition (body mass index [BMI], waist circumference, waist-to-height ratio [WHtR], fat mass percentage, and lean mass percentage) was examined at both age 16 and 23 years. Adjusted linear regression models estimated associations between sedentary time, sedentary bout duration, and body composition, overall and by sex.

RESULTS

In all analyses, mean sedentary bout duration was not associated with body composition. In cross-sectional analyses, more sedentary time during adolescence was significantly associated with lower BMI, waist circumference, WHtR, fat mass percentage, and higher lean mass percentage (p < 0.05). One standard deviation increase in daily sedentary time was prospectively associated with lower body mass index (β = -1.22 kg/m2, 95% CI: -2.02, -0.42), waist circumference (β = -2.39 cm, 95% CI: -4.03, -0.75), and WHtR (β = -0.014, 95% CI: -0.024, -0.004). Sedentary time at 16 years was not associated with changes in body composition from 16 to 23 years.

CONCLUSIONS

Sedentary behavior in adolescence is not adversely associated with body composition profiles in early adulthood.

IMPACT

Little is known about the effect of device-measured sedentary behavior on body composition during the transition from adolescence to early adulthood. Among participants in the Santiago Longitudinal Study, more accelerometer-measured sedentary time during adolescence was associated with lower BMI, waist circumference, and waist-to-height ratio in early adulthood though point estimates were generally small in magnitude. Sedentary behavior in adolescence was not detrimentally associated with healthy body composition profiles in early adulthood. Public health interventions aimed at reducing obesity rates could consider other behaviors, such as physical activity and healthy diet, instead of sitting time.

Weight Changes in Young Service Members After Lower Limb Amputation: Insights From Group-Based Trajectory Modeling

INTRODUCTION

Weight gain can contribute to osteoarthritis, cardiovascular disease, low back pain, and poor health-related quality of life. Weight trajectory patterns have been described in older veterans with limb loss; however, there is limited evidence of changes in weight in younger veterans with limb loss.

MATERIALS AND METHODS

Service members with unilateral or bilateral lower limb amputations (LLAs) (and without an upper limb amputation) were included in this retrospective cohort analysis (n = 931). The mean postamputation baseline weight was 78.0 ± 14.1 kg. Bodyweight and sociodemographic data were extracted from clinical encounters within electronic health records. Group-based trajectory modeling assessed weight change patterns 2 years postamputation.

RESULTS

Three weight change trajectory groups were identified: 58% (542 of 931) of the cohort had stable weight, 38% (352 of 931) had weight gain (mean gain = 19.1 kg), and 4% (31 of 931) had weight loss (mean loss = 14.5 kg). Individuals with bilateral amputations were more frequently noted in the weight loss group compared with those with unilateral amputations. Individuals with LLAs because of trauma other than blasts were more frequently found in the stable weight group compared with those with amputations because of disease or a blast. Younger individuals (<20 years old) with amputations were more likely to be in the weight gain group compared with older individuals.

CONCLUSIONS

More than half the cohort maintained a stable weight for two years after amputation, and more than a third experienced weight gain during the same time frame. Knowledge of underlying factors that were associated with weight gain could inform preventative strategies for young individuals with LLAs.

Association between Sedentary Time and Falls among Middle-Aged Women in Japan

There are many reports on the risk of falls in older adults but none regarding the risk among middle-aged people. We aimed to determine fall risk factors among middle-aged women. The participants comprised 1421 women aged 40 to 64 years; anthropometric and other measurements were obtained, and lifestyle factors were examined using a self-administered questionnaire. The participants were categorized into two groups (No-fall and Fall/Almost-fall) based on their questionnaire responses. The No-fall and Fall/Almost-fall groups comprised 1114 and 307 participants, respectively. Body mass index, abdominal circumference measurements, and prevalence of dyslipidemia were significantly higher in the Fall/Almost-fall group. Additionally, those in the Fall/Almost-fall group had a shorter two-step test, experienced difficulty performing the 40 cm single-leg sit-to-stand test, and had higher 25-question Geriatric Locomotive Function Scale (GLFS-25) scores than those in the No-fall group. The results of the adjusted logistic regression analysis indicated that physical activity, higher GLFS-25 scores, and sedentary time of more than seven hours were all risk factors for falling or almost falling. Longer sedentary time is a new risk factor for falls among middle-aged women. It is necessary for people to be concerned with their sedentary behavior, such as by reducing or interrupting continuous sedentary time.

Effect of the e-health supported INTER-ACT lifestyle intervention on postpartum weight retention and body composition, and associations with lifestyle behavior: A randomized controlled trial

We investigated whether a postpartum lifestyle intervention reduced postpartum weight retention (PPWR) and improved body composition, and whether improved lifestyle was associated with less PPWR and improved body composition. A total of 1075 women with excessive gestational weight gain were randomized into the intervention (N = 551) or control (N = 524) group. A completion rate of 76% was reached. Anthropometrics and lifestyle data were collected at 6 weeks and 6 months postpartum. The e-health supported intervention consisted of 4 face-to-face coaching's, focusing on nutrition, exercise and mental wellbeing and using motivational interviewing and behavior change techniques. In the intervention group we observed; larger decrease in weight in women who reduced their energy intake (mean ± SD: 3.1 ± 4.2 kg vs. 2.2 ± 3.8 kg, P = 0.05) and decreased uncontrolled eating (3.5 ± 4.2 kg vs. 1.9 ± 3.7 kg, P ≤0.001) by the end of the intervention; larger decrease in fat percentage in women who reduced energy intake (2.3% ± 2.9 vs. 1.4% ± 2.7, P = 0.01), enhanced restrained eating (2.2% ± 3 vs. 1.4% ± 2.6, P = 0.02) and decreased uncontrolled eating (2.3% ± 2.9 vs. 1.5% ± 2.7, P = 0.01) and larger decrease in waist circumference in women who reduced energy intake (4.6 cm ± 4.8 vs. 3.3 cm ± 4.7, P = 0.01), enhanced restrained eating (4.5 cm ± 4.8 vs. 3.4 cm ± 4.8, P = 0.05) and decreased uncontrolled eating (4.7 cm ± 4.8 vs. 3.3 cm ± 4.8, P = 0.006), compared to those who did not. Improved energy intake, restrained eating and uncontrolled eating behavior were associated with more favorable outcomes in weight and body composition. ClinicalTrials.gov identifier:NCT02989142.

Health and well-being benefits of e-bike commuting for inactive, overweight people living in regional Australia

INTRODUCTION

Pedal-assisted electric-bikes (e-bikes) are bicycles fitted with electric motors. Motorised functions on e-bikes only operate when the user pedals, allowing riders a moderate amount of physical activity. This study aimed to explore the mental and physical health and well-being impacts related to ebike usage for inactive overweight or obese individuals living in regional Australia.

METHODS

Twenty inactive, overweight/obese people who seldom cycled were provided with an ebike over a 12-week period. Individual semi-structured interviews conducted at the end of the trial generated data about participants' experiences of using ebikes. Inductive thematic analysis of interview data using Thomas (2006) data analysis framework and NVivo 12 software was undertaken.

RESULTS

Data analysis revealed that e-cycling improved participants' mental and physical well-being and that they felt happier when riding an e-bike.

CONCLUSIONS

Riding an e-bike can improve mental and physical health, happiness and overall sense of well-being. Greater uptake of e-bikes would have positive health implications for the wider community. Results from this study can be used to inform active transport policy. SO WHAT?: Our study demonstrated that encouraging active transport in the form of e-cycling can improve the overall health and well-being of overweight and obese Australians. More specifically, e-cycling demonstrated a positive impact on mental health well-being.

Prospective Association Between Problematic Mobile Phone Use and Eating Disorder Symptoms and the Mediating Effect of Resilience in Chinese College Students: A 1-Year Longitudinal Study

A previous cross-sectional study found that problematic mobile phone use (PMPU) was associated with students' eating disorder symptoms. However, since the cross-sectional study cannot infer the causality and the direction of effect, the longitudinal relationship between the two and the mechanism behind this relationship are unclear. Therefore, the present study explores the prospective association between PMPU and eating disorder symptoms and related mediation mechanisms using a 1-year longitudinal study of 1,181 college students (from December 2019 [T1] to December 2020 [T2]). Survey tools used include the Mobile Phone Addiction Tendency Scale, the 10-item Connor-Davidson resilience scale, and the 12 item Short Form of the Eating Disorder Examination Questionnaire. The longitudinal relationship between PMPU and eating disorder symptoms and the mediating effect of resilience was analyzed using a cross-lagged model. The results showed that PMPU (β = 0.086, P < 0.01) and resilience (β = -0.145, P < 0.01) at T1 predicted eating disorder symptoms at T2, but not vice versa. PMPU was bidirectionally associated with resilience, and the prediction effect of PMPU at T1 to resilience at T2 (β = -0.151, P < 0.001) was higher than the prediction effect of resilience at T1 to PMPU at T2 (β = -0.134, P < 0.001). The standardized indirect effect of PMPU at T1 on eating disorder symptoms at T2 via resilience was significant (β = 0.022, 95% CI = 0.010~0.040, P < 0.001). Therefore, PMPU and resilience were predictive for eating disorder symptoms in college students, and resilience may play a mediating role in the prospective association between PMPU and eating disorder symptoms. This study provides new ideas and higher-level evidence for the development of prevention and intervention measures for college students' eating disorder symptoms.

Associations of changes in physical activity and discretionary screen time with incident obesity and adiposity changes: longitudinal findings from the UK Biobank

BACKGROUND

Physical activity (PA) and discretionary screen time (DST; television and computer use during leisure) are both associated with obesity risk, but little longitudinal evidence exists on their combined influence. This study examined the independent and joint associations of changes in PA and DST with incident obesity, body mass index (BMI) and waist circumference (WC).

METHODS

We analysed the data of individuals aged 40-69 years from the UK Biobank, a large-scale, population-based prospective cohort study. PA was measured using the International Physical Activity Questionnaire and DST was defined as the total of daily TV viewing and non-occupational computer use. Changes in PA and DST over time were defined using departure from sex-specific baseline tertiles and categorised as worsened (PA decreased/DST increased), maintained, and improved (PA increased/DST decreased). We then used each exposure change to define a joint PA-DST change variable with nine mutually exclusive groups. We used multivariable adjusted mixed-effects linear and Poisson models to examine the independent and joint associations between PA and DST changes with BMI and WC and incident obesity, respectively. Development of a BMI ≥ 30 kg/m² was defined as incident obesity.

RESULTS

Among 30,735 participants, 1,628 (5.3%) developed incident obesity over a mean follow-up of 6.9 (2.2) years. In the independent association analyses, improving PA (Incident Rate Ratio (IRR) 0.46 (0.38-0.56)) was associated with a lower risk of incident obesity than maintaining PA, maintaining DST, or improving DST. Compared to the referent group (both PA and DST worsened), all other combinations of PA and DST changes were associated with lower incident obesity risk in the joint association analyses. We observed substantial beneficial associations in the improved PA groups, regardless of DST change [e.g., DST worsened (IRR 0.31 (0.21-0.44)), maintained (IRR 0.34 (0.25-0.46)), or improved (IRR 0.35 (0.22-0.56)]. The most pronounced decline in BMI and WC was observed when PA was maintained or improved and DST was maintained.

CONCLUSION

We found that improved PA had the most pronounced beneficial associations with incident obesity, irrespective of DST changes. Improvements in PA or DST mutually attenuated the deleterious effects of the other behaviour's deterioration.

Contributions of changes in physical activity, sedentary time, diet and body weight to changes in cardiometabolic risk

Background

Increased physical activity (PA), reduced time spent sedentary (SED), healthier diet and reduced body weight may all have a positive impact on cardiometabolic risk. The relative importance of change in each of these variables on cardiometabolic risk, however, is unclear. We therefore sought to investigate the relative contributions of changes in PA, SED, diet and body weight on cardiometabolic risk.

Methods

This is a secondary analysis of data collected from the EuroFIT randomised controlled trial, which was a 12-week group-based lifestyle intervention for overweight middle-aged men delivered by coaches in football club stadia aiming to improve PA, SED, diet, and body weight. PA and SED were assessed by accelerometry, diet using the Dietary Instrument for Nutrition Education (DINE). An overall cardiometabolic risk score was derived from combining z-scores for glucose, HbA1c, insulin, lipids and blood pressure. In total, 707 men (from the overall cohort of 1113) with complete data for these variables at baseline and 12-month follow-up were included in the multivariable linear regression analyses.

Results

In multivariable analyses, change in number of steps (explaining 5.1% of R²) and dietary factors (less alcohol, fatty and sugary food, and more fruit and vegetables) (together explaining 4.5% of R²), but not changes in standing time or SED, were significantly associated with change in body weight. Changes in number of steps (R² = 1.7%), fatty food score (R² = 2.4%), and sugary food score (R² = 0.4%) were significantly associated with change in cardiometabolic risk score in univariable models. However, in multivariable models which included changes in weight as well as changes in steps and dietary variables, change in weight explained a substantially larger proportion of the change in cardiometabolic risk score, explaining 14.1% of R² (out of an overall model R² of 19.0%). When baseline (as well as change) values were also included in the model, 38.8% of R² for change in cardiometabolic risk score was explained overall, with 14.1% of R² still explained by change in weight.

Conclusion

Change in body weight, together with baseline cardiometabolic risk explained most of the change in cardiometabolic risk. Thus, the benefits of increasing physical activity and improving diet on cardiometabolic risk appear to act largely via an effect on changes in body weight.

Trial registration

International Standard Randomised Controlled Trials, ISRCTN-81935608. Registered 06052015. https://www.isrctn.com/ISRCTN81935608?q=&filters=recruitmentCountry:Portugal&sort=&offset=7&totalResults=92&page=1&pageSize=10&searchType=basic-search

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-021-01237-1.

Effects of Substituting Sedentary Behavior with Light-Intensity or Moderate-to-Vigorous Physical Activity on Obesity Indices in Adults: A Prospective Short-Term Follow-Up Study

BACKGROUND

Sedentary behavior (SB) is an independent risk factor for cardiovascular diseases. We hypothesized that there may be benefits of replacing SB with light-intensity (LIPA) and moderate-to-vigorous (MVPA) physical activity. Substituting SB with LIPA and MVPA might be associated with body composition changes.

METHODS

We assessed body weight, body mass index (BMI), fat body mass (FBM), and physical activity level, as well as one-year changes, in 780 adults (EPIMOV Study).

RESULTS

We analyzed into 10-min blocks SB, LIPA, MVPA, and total wear time. After 14 ± 3 months of follow-up, there were 242 completed procedures. We reallocated time spent in SB to LIPA or MVPA and assessed cross-sectional and prospective associations with the outcomes using isotemporal substitution models. In cross-sectional analysis, substituting 10-min blocks of SB with MVPA led to significant decreases of 1.23 kg in body weight, 0.30 kg/m² in BMI, and 0.38% in FBM. 10-min blocks substituting SB with LIPA produced significantly lower body weight (1 kg) and BMI (0.1 kg/m²) values. In longitudinal analysis, reallocating SB to MVPA was only associated with FBM decline (-0.31%).

CONCLUSIONS

Substituting SB with MVPA is associated with significant improvement in obesity indices in both cross-sectional and follow-up. Replacing SB with LIPA produced a less consistent impact.

Moderate-To-Vigorous Intensity Physical Activity and Sedentary Behaviour across Childhood and Adolescence, and Their Combined Relationship with Obesity Risk: A Multi-Trajectory Analysis

The combined role of objectively assessed moderate-vigorous intensity physical activity (MVPA) and sedentary behaviour (SB) is unclear in obesity prevention. This study aimed to identify latent groups for MVPA and SB trajectories from childhood to adolescence and examine their relationship with obesity risk at adolescence. From the Gateshead Millennium Study, accelerometer-based trajectories of time spent in MVPA and SB at ages 7, 9, 12, and 15 were derived as assigned as the predictor variable. Fat mass index (FMI), using bioelectrical impedance at age 15, was the outcome variable. From 672 children recruited, we identified three distinct multiple trajectory groups for time spent in MVPA and SB. The group with majority membership (54% of the cohort) had high MVPA and low SB at childhood, but MVPA declined and SB increased by age 15. One third of the cohort (31%) belonged to the trajectory with low MVPA and high time spent sedentary throughout. The third trajectory group (15% of the cohort) that had relatively high MVPA and relatively low SB throughout had lower FMI (-1.7, 95% CI (-3.4 to -1.0) kg/m2, p = 0.034) at age 15 compared to the inactive throughout group. High MVPA and low SB trajectories when combined are protective against obesity.

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

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

Effectiveness of Workplace Exercise Interventions on Body Composition: A Systematic Review and Meta-Analysis

OBJECTIVE

The aim of this review was to analyze the effectiveness of workplace exercise interventions on body composition (BC).

DATA SOURCE

Studies published in PubMed, Scopus, SPORTDiscus, Web of Science, CINAHL and PsycINFO, from the earliest time point until 8 July 2020.

STUDY INCLUSION AND EXCLUSION CRITERIA

Inclusion criteria were worksite interventions, in adults, Randomized Controlled Trials (RCTs), real exercise practice, and measuring BC outcomes. Exclusion criteria were full-text non-available, abstract not in English, and exercise protocol missing.

DATA EXTRACTION

157 studies were retrieved and assessed for inclusion by 2 independent reviewers, who also used the Cochrane's Collaboration Tool to assess study quality and risk of bias.

DATA SYNTHESIS

We performed a meta-analysis to determine the effect size of the interventions on BC outcomes reported in at least 5 studies.

RESULTS

Twelve RCTs were included (n = 1270, 66% women), quality of studies being low to high (25% moderate, 67% high). Interventions achieved a statistically significant decrease in waist circumference (SMD = 0.24; 95% confidence interval (CI): 0.06 to 0.41; p = 0.008), total mass fat (SMD = 0.21; 95%CI: 0.00 to 0.41; p = 0.047), and body adiposity index (SMD = 0.20; 95%CI: 0.00 to 0.41; p = 0.049). No changes were observed in body weight (SMD = 0.08 95%CI: -0.02 to 0.18; p = 0.128). Additionally, muscle mass increased in interventions that included strength training. There were no adverse events reported.

CONCLUSION

The most effective workplace exercise interventions to improve BC combined supervised, moderate-intensity aerobic and strength training, for at least 4 months.

Momentary emotions and salivary cortisol: A systematic review and meta-analysis of ecological momentary assessment studies

An integrated view of the stress response requires consideration of both the emotional and hormonal sequelae of stress, which are regulated by the hypothalamic-pituitary-adrenal (HPA) axis. Understanding the extent of the association between emotions and cortisol at the momentary level can shed light on the biopsychological pathways linking stress to health. Research in this area has adopted heterogeneous approaches and produced mixed findings; thus, it is critical to conduct a systematic review and meta-analysis. Systematic searches in major databases identified 22 studies (negative emotions [k = 19; 38,418 momentary observations]; positive emotions [k = 15; 31,721 momentary observations]). Meta-analysis found a significant positive association between momentary negative emotions and cortisol (r = .06, p < .001) and a significant negative association between momentary positive emotions and cortisol (r = -.05, p = .003). No methodological differences moderated these associations. Our findings suggest that emotional states correlate with cortisol levels at the momentary level. We discuss the health implications of our findings and provide recommendations for advancing this area of research.

Cross-sectional associations of device-measured sedentary behaviour and physical activity with cardio-metabolic health in the 1970 British Cohort Study

AIMS

This study aimed to examine the cross-sectional associations of thigh accelerometry-assessed sedentary behaviour and moderate-to-vigorous physical activity (MVPA) with cardio-metabolic health markers and prevalent diabetes in a population sample of middle-aged British adults.

METHODS

Participants (n = 4892) from the age-46-to-48 wave of the 1970 British Cohort Study were fitted with a waterproofed activPAL3 micro device. Total/prolonged sedentary time, breaks and MVPA were the main exposures. We dichotomized prolonged sedentary time and MVPA based on the corresponding median, generating four combinations as categorical exposures. Outcomes comprised of diabetes and seven cardio-metabolic health markers. We used logistic regression and generalized linear models to examine independent/joint associations, conducting a minimally adjusted model including demographics and contextual covariates, and further adjusted for total sedentary time and/or MVPA as applicable.

RESULTS

Each set of 10 sedentary breaks and 1 h of prolonged sedentary time were associated with HbA_1c (mmol/mol) [B = -0.18 (-0.33, -0.03) and 2.35 (1.01, 3.69), respectively]. Each set of 10 sedentary breaks and 1 h of MVPA were favourably associated with diabetes [adjusted odds ratio (AOR): 0.80 (0.71, 0.99) and 0.42 (0.26, 0.67), respectively]. Joint analyses showed that only the low MVPA × long sedentary time combination had significantly higher odds for diabetes than the referent high MVPA × short sedentary time combination [AOR: 1.89 (1.17, 3.03)].

CONCLUSIONS

Each set of additional 10 sedentary breaks per day was associated with 20% lower odds for diabetes. A low physical activity level combined with long sedentary time might synergistically deteriorate cardio-metabolic health.

Relationship of the Pro12Ala Polymorphism on the PPARy2 Gene With the Body Composition of Practitioners of Cyclic Exercises

This study aimed to verify the association between the genotypic of the receptor gene activated by peroxisome proliferators gamma 2 (PPARy2) and the body composition and the specific indicators of adiposity in practitioners physical exercises, considering nutritional intake, age, and training load as influencing factors. It was conducted a cross-sectional study with 335 adults (47.9 ± 12.7 years, 138 men, body mass index/BMI = 27.0 ± 4.9 kg/m²), practitioners of aerobic exercises in cyclical modalities (running, walking and/or cycling, who spent 328.3 ± 193.6 kcal/day on physical training). The genotyping of the Pro12Ala polymorphism was performed using the PCR-RFLP technique and the body composition measured by bioimpedance (InBody 720). Energy expenditure was based on the compendium of physical activities and caloric intake was measured by 24 h recall questionnaire. The higher prevalence was for the Pro/Pro genotype (76.1% vs. 23.9% of Pro/Ala). Pro/Pro genotypic group showed significant higher mean values for body mass (BM) (p < 0.03 for men and p < 0.02 for women) and BMI (p < 0.00 for men and p < 0.02 for women) and %FAT (p < 0.00), waist-hip ratio (WHR) (p < 0.04), and visceral fat (VF) (p < 0.00) only in men compared to Pro/Ala. Higher frequency of Pro/Pro was observed in the category indicating BMI (p < 0.00 for men and p < 0.03 for women), WRH (p < 0.03 for men and p < 0.00 for women), and %FAT (p < 0.03) (in the latter case, only among men. It was also observed that the frequency of distribution of Pro/Ala in the eutrophic category of the BMI remained independent of all influencers, while WHR and %FAT were independent of the training load, but influenced by nutritional intake and age. In women, the frequency of Pro/Ala distribution at the lowest BMI and WHR values remained independent of all confounding variables. It is concluded that the Pro12Ala polymorphism in the PPARy2 gene consistently influences indicators of body composition and adiposity, regardless of the practitioners of physical training, but the relationship needs to be considered according to age and nutritional intake.

Association between obesity and sedentary behavior in adults

Abstract Although sedentary behavior (SB) is related to the development of metabolic diseases, there is still no consensus in literature about the association between accelerometer-based SB and obesity, especially adjusted for cardiovascular risk factors and level of daily physical activities. The aim was to evaluate the association between obesity and SB adjusted for potential confounders in adults. Data from 780 participants of the Epidemiology and Human Movement (EPIMOV) Study were analyzed. Body weight, body mass index (BMI), and fat body mass as percentage (%FBM) (bioelectrical impedance) were obtained and, then, used to stratify participants. SB was objectively measured using triaxial waist-worn accelerometers placed above the dominant hip during waking hours for at least four consecutive days (4-7 days). SB and its pattern were not significantly different between obesity groups. Although SB presented some significant correlations with obesity, the correlation and determination coefficient indicated weak association between SB and obesity (e.g., BMI and %FBM). Obesity presented little or no association with SB and its pattern after adjustment for potential confounders, especially when SB is measured through accelerometry.

Childhood Obesity and Device-Measured Sedentary Behavior: An Instrumental Variable Analysis of 3,864 Mother-Offspring Pairs

OBJECTIVE

Intergenerational data on mother-offspring pairs were utilized in an instrumental variable analysis to examine the longitudinal association between BMI and sedentary behavior.

METHODS

The sample included 3,864 mother-offspring pairs from the 1970 British Cohort Study. Height and weight were recorded in mothers (age 31 [5.4] years) and offspring (age 10 years) and repeated in offspring during adulthood. Offspring provided objective data on sedentary behavior (7-day thigh-worn activPAL) in adulthood at age 46 to 47 years.

RESULTS

Maternal BMI, the instrumental variable, was associated with offspring BMI at age 10 (change per kg/m² , β = 0.11; 95% CI: 0.09 to 0.12), satisfying a key assumption of instrumental variable analyses. Offspring (change per kg/m² , β = 0.010; 95% CI: -0.02 to 0.03 h/d) and maternal BMI (β = 0.017; 95% CI: 0.001 to 0.03 h/d) was related to offspring sedentary time, suggestive of a causal impact of BMI on sedentary behavior (two-stage least squares analysis, β = 0.18 [SE 0.08], P = 0.015). For moderate-vigorous physical activity, there were associations with offspring BMI (β = -0.010; 95% CI: -0.017 to -0.004) and maternal BMI (β = -0.007; 95% CI: -0.010 to -0.003), with evidence for causality (two-stage least squares analysis, β = -0.060 [SE 0.02], P = 0.001).

CONCLUSIONS

There is strong evidence for a causal pathway linking childhood obesity to greater sedentary behavior.

Obesity Trends and Associations with Types of Physical Activity and Sedentary Behavior in US Adults: National Health and Nutrition Examination Survey, 2007-2016

OBJECTIVE

Physical activity (PA) and sedentary behavior (SB) have been linked to adult adiposity. This research aims to explore 10-year (2007-2016) trends in obesity and abdominal obesity prevalence and associations with different types of PA and SB among US adults.

METHODS

National Health and Nutrition Examination Survey (NHANES) data were used with 20- to 64-year-old adults (n = 20,360; mean age: 41.9 years; male: 50.5%; non-Hispanic White: 64.3%). Sex- and sex- and race-specific linear trends in the prevalence of obesity, abdominal obesity, and moderate and vigorous work- and recreation-related PA and SB were estimated. Weighted logistic models explored the association between risk of obesity or abdominal obesity with each type of PA and SB by sex, adjusted for relevant confounders.

RESULTS

There were significant increasing trends in obesity and abdominal obesity in both sexes and in Hispanic adults. Men at higher vigorous work-related PA levels (P = 0.045) and women at higher moderate recreational-related PA (P = 0.005) levels had decreased risk of abdominal obesity. Women at the highest versus the lowest level of SB had increased risk of abdominal obesity (P = 0.017).

CONCLUSIONS

There was a significantly reduced risk for abdominal obesity with a few types of PA among both sexes and an increased risk with SB among women only.

Leisure Sedentary Behavior Levels and Meeting Program Goals in a Community Lifestyle Intervention for Diabetes Prevention

BACKGROUND

The importance of leisure sedentary behavior (LSB) change in diabetes prevention efforts is not well known. This study examines the relationships between changes in self-reported LSB and the primary intervention goals (weight and moderate-intensity to vigorous-intensity physical activity [MVPA]) during a community-based translation of the Diabetes Prevention Program (the Group Lifestyle Balance Program).

METHODS

A total of 322 adults at risk for type 2 diabetes were recruited from 3 community centers, a worksite, and military site. Community and worksite participants were randomized to immediate or delayed-delivery (control) intervention. All military site participants (n = 99) received immediate intervention. Logistic and linear generalized estimating equations were used to determine associations between LSB changes and weight-related outcomes and MVPA.

RESULTS

Results were obtained for 259 (80.4%) participants. The LSB decreased after 6 and 12 months (mean [95% confidence interval]: -25.7 [-38.6 to -12.8] and -16.1 [-28.2 to -3.9] min/d; both P < .05). Each 20-minute reduction in LSB was associated with a 5% increase in odds of meeting the weight-loss goal (6 mo: odds ratio = 1.05 [1.002 to 1.102]; P = .042; adjusted model including MVPA), but LSB was not related to changes in reported MVPA minutes or MVPA goal achievement.

CONCLUSION

Within the context of existing lifestyle intervention programs, reducing sedentary behavior has the potential to contribute to weight loss separately from reported MVPA improvement.

Device-Based Measures of Sedentary Time and Physical Activity Are Associated With Physical Fitness and Body Fat Content

Introduction/Purpose: Physical activity and sedentary time may associate with physical fitness and body composition. Yet, there exists some observational studies that have investigated the associations of device-based measures of sedentary time and physical activity (PA) with cardiorespiratory fitness (CRF) and body composition but associations with muscular fitness (MF) are less studied.

Methods: Objective sedentary time and physical activity was measured by a hip worn accelerometer from 415 young adult men (age: mean 26, standard deviation 7 years). Cardiorespiratory fitness (VO₂max) (CRF) was determined using a graded cycle ergometer test until exhaustion. Maximal force of lower extremities was measured isometrically and lower body power was assessed using standing long jump (MF). Body composition was determined with bioimpedance method. Single and compositional approach was used in regression analysis.

Results: Mean sedentary time was 707 (standard deviation 133) minutes per day (77 ± 8% of the wear time). Volumes of all PA intensities were positively associated with CRF and associations showed linearly increasing magnitudes with higher intensities in single regression models adjusted for age and smoking (p < 0.001). Similarly, PA intensities were positively associated with lower body MF, however, with weaker associations (p < 0.005). After further adjustment for resistance training, the associations remained significant. The associations of the relative distribution of time within sedentary behavior (SB), light intensity PA (LPA) and moderate-to-vigorous PA (MVPA) behaviors as a whole with using compositional analysis further revealed that within the composition MVPA and SB were positively associated with CRF and MF (p < 0.001), while LPA was not. In addition, within the composition, accumulated PA bouts lasting more than 3 min were consistently associated with CRF and MF, and with all body composition variables (p < 0.001), while sedentary time was associated with body fat percentage (p < 0.001).

Conclusion: Promoting physical activity and reducing sedentary time may have positive influence on physical fitness and body fat content, and thereby may offer positive health effects. Physical activity of higher intensities may offer greater benefits.

Effects of interrupting sitting with different activity bouts on postprandial lipemia: A randomized crossover trial

To determine whether interrupting prolonged sitting with three different activity breaks has both acute and chronic effects on postprandial lipid metabolism immediately after the activity-break period and on the following day, this study is a secondary analysis of an experimental research, which included 16 sedentary healthy adults (7 men, 24 ± 3 years, BMI 22.2 ± 2.3 kg/m² ) who completed four 26-h laboratory trials. Participants spent 22.5 hours in a whole room calorimeter for testing energy expenditure (EE), including a 9-h activity-break period: (a) 9-h prolonged sitting (SIT); (b) 3 minutes of brisk walking (60% VO_2max ) in between every 30-min sitting bout (WALK3), (c) 5 minutes every 45-min (WALK5), and (d) 8 minutes every 60-min (WALK8). Total area under the curve (tAUC) and incremental AUC (iAUC) for 2-h postprandial serum triglyceride (TG) levels and non-esterified fatty acid (NEFA) levels were examined immediately after the 9-h trial (post-dinner) and the next morning (post-breakfast). WALK8 reduced the post-breakfast TG tAUC by 11% (P = .041) relative to SIT, and the effect was attenuated after adjustment for EE. The tAUC and iAUC indicated no significant treatment effects on post-dinner TG and NEFA, and post-breakfast NEFA in any of the activity-break trials. EE was positively associated with the post-breakfast NEFA iAUC (unstandardized β = 0.17 µmol/L/MJ [0.05-0.28], P = .006). There was a chronic effect of interrupting sitting with short bouts (8 minutes) of brisk walking every 60 minutes on postprandial lipemia the following morning after intervention, and higher activity bout-induced EE may be more effective in sedentary, healthy adults.

Objectively Measured Sedentary Behavior and Physical Fitness in Adults: A Systematic Review and Meta-Analysis

Background: Sedentary behavior has been considered an independent risk factor to health. The aim of this systematic review and meta-analysis was to examine associations between objectively measured sedentary time and physical fitness components in healthy adults. Methods: Four electronic databases (Web of Science, Scopus, Pubmed and Sport Discus) were searched (up to 20 September 2020) to retrieve studies on healthy adults which used observational, cohort and cross-sectional designs. Studies were included if sedentary time was measured objectively and examined associations with the health- or skill-related attributes of physical fitness (e.g., muscular strength, cardiorespiratory fitness, balance). After applying additional search criteria, 21 papers (11,101 participants) were selected from an initial pool of 5192 identified papers. Results: Significant negative associations were found between total sedentary time with cardiorespiratory fitness (r = −0.164, 95%CI: −0.240, −0.086, p < 0.001), muscular strength (r = −0.147, 95%CI: −0.266, −0.024, p = 0.020) and balance (r = −0.133, 95%CI: −0.255, −0.006, p = 0.040). Conclusions: The evidence found suggests that sedentary time can be associated with poor physical fitness in adults (i.e., muscular strength, cardiorespiratory fitness and balance), so strategies should be created to encourage behavioral changes.

The role of the Mediterranean diet on weight loss and obesity-related diseases

Pandemic obesity is a major public health problem because of its association with non-communicable diseases and all-cause mortality, which can be improved/delayed with weight loss. Thus, several scientific societies and governments have launched guidelines to reduce body weight and adiposity or, at least, to avoid weight gain. In spite of the abundant literature on the topic, there is still controversy on the relative roles of fat and carbohydrate in the diet on weight gain. Present recommendations to avoid weight gain and obesity are directed to reduce intake of total energy variably and of total fat to <30% of energy, in spite on the lack of evidence of protection against cardiovascular disease (CVD) and mortality. By contrast, both high and low carbohydrate diets are associated with CVD and all-cause mortality in prospective studies, with a safe intake level at ≈50% of energy. Many popular diets with widely different macronutrient composition, including the Mediterranean diet, have been used in obesity; when energy-restricted, all result in similar modest weight loss at 6 months, but the effects are largely lost at 12 months. The Mediterranean diet is a plant-based, high-fat, high-unsaturated fat dietary pattern that has been consistently associated with lower rates on non-communicable diseases and total mortality in prospective studies and with reduced CVD in the PREDIMED trial. For this merits above other diets, this dietary pattern might also be used advantageously for weight loss. The results of the PREDIMED and PREDIMED-Plus randomized controlled trials on adiposity variables in high-risk populations are discussed.

Lifestyle Changes and Weight Gain: A 2-Year Follow-up Study of Japanese Workers

OBJECTIVE

To examine age-dependent trends in weight and lifestyle changes in Japanese workers.

METHODS

Using annual health examination data, 60,143 eligible Japanese workers aged 20 to 59 years were examined for their 2-year changes in weight and smoking, eating, exercise, drinking, and sleep habits.

RESULTS

Young male workers aged 20 to 24 years showed the greatest weight gain and the highest incidence of unhealthy lifestyle habits. Multivariate analyses indicated that quitting "exercise less than two times/week," "walking less than 60 min/d," and "smoking everyday" contributed to weight gain to a considerable extent except in young female workers aged 20 to 24 years.

CONCLUSIONS

Greater weight gain associated with unhealthy lifestyle changes tended to occur in early rather than middle-to-old adulthood. It is important to deliver health promotion programs targeting young male workers.

Do physical activity and sedentary time mediate the association of the perceived environment with BMI? The IPEN adult study

The study's main aim was to examine whether adults' accelerometer-based physical activity and sedentary time mediated the associations of neighbourhood physical environmental perceptions with body mass index (BMI) and weight status across 10 high- and middle-income countries. Data from the IPEN Adult study, an observational multi-country study (n = 5712) were used. Results showed that sedentary time was a non-significant or inconsistent mediator in all models. MVPA mediated the associations of street connectivity, land use mix-diversity, infrastructure/safety for walking and aesthetics with BMI in single models. In the multiple model, MVPA only fully mediated the relation between land use mix-diversity and BMI. This finding was replicated in the models with weight status as outcome. MVPA partially mediated associations of composite environmental variables with weight status. So, although MVPA mediated some associations, future comprehensive studies are needed to determine other mechanisms that could explain the relation between the physical environment and weight outcomes. Food intake, food accessibility and the home environment may be important variables to consider. Based on the consistency of results across study sites, global advocacy for policies supporting more walkable neighbourhoods should seek to optimize land-use-mix when designing and re-designing cities or towns.

Sedentary behavior, physical activity and body composition in adults

OBJECTIVE

We investigated the associations between objectively assessed sedentary behavior (SB) and moderate-to-vigorous physical activity (MVPA) and body composition variables among a representative sample of Brazilian adults.

METHODS

Using an accelerometer, SB and MVPA were monitored for at least 5 days in 524 participants (261 men; age, 18-65 years). Each minute epoch was classified as sedentary or spent in light, moderate, or vigorous physical activity (LPA, MPA, and VPA, respectively). The measured body composition variables included abdominal perimeter (AP) and neck circumference (NC).

RESULTS

Men accumulated significantly more min/day of MPA (37.82 versus 27.28), VPA (1.10 versus 0.31), MVPA (39.02 versus 27.61), and steps/day (14,978 versus 13,443) than women (p<.001). In men, MPA, VPA, MVPA, and steps/day were negatively associated with AP (p<.05) independently of SB. Only VPA was significantly associated with NC (β= 0.113; p=.002). In women, only SB was significantly associated with AP (β= 0.003; p=.031). There were no significant associations between physical activity intensities and body composition in women.

CONCLUSIONS

Our findings on the unequal association of physical activity with body composition variables between sexes can help inform future intervention strategies in Brasil.

Bidirectional 10-year associations of accelerometer-measured sedentary behavior and activity categories with weight among middle-aged adults

BACKGROUND

Although higher sedentary behavior (SB) with low light intensity (LPA) and moderate-to-vigorous intensity physical activity (MVPA) are thought to increase risk for obesity, other data suggest excess weight may precede these behaviors in the causal pathway. We aimed to investigate 10-year bidirectional associations between SB and activity with weight.

METHODS

Analysis included 886 CARDIA participants (aged 38-50 years, 62% female, 38% black) with weight and accelerometry ( ≥ 4 days with ≥ 10 h/day) collected in 2005-6 (ActiGraph 7164) and 2015-6 (ActiGraph wGT3X-BT). Accelerometer data were calibrated, harmonized, and expressed as counts per minute (cpm) and time-dependent intensity categories (min/day of SB, LPA, and MVPA; SB and MVPA were also separated into long-bout and short-bout categories). Linear regression models were constructed to estimate adjusted associations of baseline activity with 10-year change in weight and vice versa. When activity categories were the independent variables, standardized regression coefficients (βstd.) estimated associations of replacing SB with a one SD increase in other categories, adjusted for accelerometer wear time.

RESULTS

Over 10-years, weight increased by a mean 2.55 ± 8.05 kg and mean total activity decreased by 50 ± 153 cpm. In adjusted models, one SD higher baseline mean total activity (βstd. = -1.4 kg, p < 0.001), LPA (βstd. = -0.80 kg, p = 0.013), total MVPA (βstd. = -1.07 kg, p = 0.001), and long-bout MVPA (βstd. = -1.20 kg, p < 0.001) were associated with attenuated 10-year weight gain. Conversely, a one SD higher baseline weight was associated with unfavorable 10-year changes in daily activity profile including increases in SB (βstd. = 12.0 min, p < 0.001) and decreases in mean total activity (βstd. = 14.9 cpm, p = 0.004), LPA (βstd. = 8.9, p = 0.002), and MVPA (βstd. = 3.5 min, p = 0.001). Associations varied by race and gender.

CONCLUSIONS

Higher SB with lower activity and body weight were bidirectionally related. Interventions that work simultaneously to replace SB with LPA and long-bout MVPA while also using other methods to address excess weight may be optimal.

Association of total sedentary behaviour and television viewing with risk of overweight/obesity, type 2 diabetes and hypertension: A dose-response meta-analysis

AIMS

To explore the quantitative dose-response association of total sedentary behaviour and television viewing with overweight/obesity, type 2 diabetes and hypertension in a meta-analysis.

MATERIALS AND METHODS

We searched three databases to identify English-language reports that assessed the association of total sedentary behaviour or television viewing with the aforementioned health outcomes. Restricted cubic splines were used to evaluate possible linear or non-linear associations of total sedentary behaviour and television viewing with these health outcomes.

RESULTS

We included 48 articles (58 studies) with a total of 1 071 967 participants in the meta-analysis; 21 (six cohort and 15 cross-sectional) studies examined the association of total sedentary behaviour with overweight/obesity, 23 (13 cohort and 10 cross-sectional) studies examined the association with type 2 diabetes and 14 (one cohort and 13 cross-sectional) studies examined the association with hypertension. We found linear associations between total sedentary behaviour and type 2 diabetes (P_{non-linearity} = 0.190) and hypertension (P_{non-linearity} = 0.225) and a non-linear association between total sedentary behaviour and overweight/obesity (P_{non-linearity} = 0.003). For each 1-h/d increase in total sedentary behaviour, the risk increased by 5% for type 2 diabetes and 4% for hypertension. We also found linear associations between television viewing and type 2 diabetes (P_{non-linearity} = 0.948) and hypertension (P_{non-linearity} = 0.679) and a non-linear association for overweight/obesity (P_{non-linearity} = 0.007). For each 1-h/d increase in television viewing, the risk increased by 8% for type 2 diabetes and 6% for hypertension.

CONCLUSIONS

High levels of total sedentary behaviour and television viewing were associated with overweight/obesity, type 2 diabetes and hypertension.

Association of changes in commute mode with body mass index and visceral adiposity: a longitudinal study

BACKGROUND

Prospective data are sparse for active commuting to work and body weight in Asia. We assessed the association of 5-year changes in commuting mode with body mass index (BMI) and the indicators of abdominal obesity in Japanese working adults.

METHODS

In this longitudinal study, we studied 29,758 participants (25,808 men and 3950 women) in Japan aged 30 to 64 years at baseline who underwent further health examination 5 years after the baseline examination. Changes in BMI were calculated from objectively measured body height and weight at baseline and follow-up examination. Visceral and subcutaneous fat areas and waist circumference measured by computed tomography scans were used as indicators for abdominal adiposity. Linear regression was applied to estimate the association of changes in commuting mode with the obesity outcomes.

RESULTS

Within the 5-year study period, adults who maintained inactive commuting gained weight, and compared with this group, adults who switched to inactive commuting had higher weight gain; conversely, adults who switched to active or public transportation commuting and especially those who maintained active or public transportation commuting experienced less weight gain. Subgroup analysis showed similar tendency across the different transitions of leisure-time exercise or occupational physical activity. For example, among adults who maintained no exercise (n = 16,087), the adjusted mean (95% confidence intervals) of the BMI change over 5 years in kg/m² were 0.27 (0.24 to 0.30) for maintained inactive commuting group (reference), 0.34 (0.30 to 0.38) for switching to inactive commuting group (P = 0.046), 0.20 (0.18 to 0.22) for switching to active commuting or public transportation group (P = 0.001), and 0.09 (0.06 to 0.13) for maintained active commuting or public transportation group (P < 0.001). Maintained inactive commuting tended to be associated with larger gain in abdominal adiposity indicators.

CONCLUSION

Switching from inactive commuting mode to more physically active commuting mode and maintaining active commuting can promote body weight control among working adults across different levels of occupational or leisure-time physical activity.

Promotion of Pre- and Post-Transplant Physical Exercise in the Emilia-Romagna Region: The Network of the Program "Transplantation, Physical Activity, and Sport"

BACKGROUND

Following the positive experience of the national project "A transplant...and now it's time for sport," the Transplant Reference Center of the Emilia-Romagna Region has pursued the promotion of pre- and post-transplant physical exercise by developing a network.

METHODS

The path involved the transplant centers and operative units (UU.OO) who wanted to target transplant and waiting list patients, who are clinically stable, to perform personalized exercise through a program (supervised or not) prescribed by a specialist in sports medicine. With the collaboration of the Collective Prevention and Public Health Service, the network was established, consisting of the sports medicine centers and the gyms that promote health for adapted physical activity (PS-AMA). To implement the network, training courses for all the professionals involved (doctors, nurses, exercise specialists) and operational meetings in the transplant centers-nephrology units with patients' associations have been organized.

RESULTS

To date, there are 14 transplant centers and UU.OO, 9 sports medicine centers, and 45 PS-AMA involved in this network. Seven training courses were organized with the participation of 193 health professionals. Since January 2016, there have been 65 transplanted patients and 5 patients on the waiting list who practice the prescribed exercise. Of these, 45 carry out supervised exercise in PS-AMA; 25 perform autonomous exercise. Each patient is monitored every 6 months. No problems related to the exercise performance were recorded.

CONCLUSIONS

The development of a network of professionals and associations is the key element to raise awareness of physical activity among transplanted and waiting-for-transplant patients, reducing the pathologies associated with a sedentary lifestyle.

Healthy Weight and Obesity Prevention: JACC Health Promotion Series

Overweight and obesity have reached epidemic levels in the United States and worldwide, and this has contributed to substantial cardiovascular and other health risks. However, controversy exists concerning the causes of obesity and effective modalities for its prevention and treatment. There is also controversy related to the concept of metabolically healthy obesity phenotype, the "obesity paradox," and on the importance of fitness to protect individuals who are overweight or obese from cardiovascular diseases. In this state-of-the-art review, the authors focus on "healthy weight" with the emphasis on the pathophysiologic effects of weight gain on the cardiovascular system; mechanistic/triggering factors; and the role of preventive actions through personal, education/environment, and societal/authoritative factors, as well as factors to provide guidance for caregivers of health promotion. Additionally, the authors briefly review metabolically healthy obesity, the obesity paradox, and issues beyond lifestyle consideration for weight loss with medications and bariatric surgery.

Sedentary Time, Physical Activity, and Sleep Duration: Associations with Body Composition in Fibromyalgia. The Al-Andalus Project

To explore the individual–independent relationships of sedentary time (ST) and physical activity (PA) (light and moderate-to-vigorous intensity (MVPA)), with sleep duration and body composition (waist circumference, body mass index (BMI), body fat percentage, and muscle mass index) in women with fibromyalgia, and to determine whether these associations are independent of physical fitness. This cross-sectional study involved 385 women with fibromyalgia. ST and PA were assessed by triaxial accelerometry, sleep duration was self-reported. Waist circumference was measured using an anthropometric tape, and body weight, body fat percentage, and muscle mass were estimated using a bio-impedance analyzer. In individual regression models, ST and sleep were directly associated with waist circumference, BMI, and body fat percentage (β between 0.10 and 0.25; all p < 0.05). Light PA and MVPA were inversely associated with waist circumference, BMI, and body fat percentage (β between −0.23 and −0.12; all p < 0.05). In multiple linear regression models, ST (β between 0.17 and 0.23), light PA (β between −0.16 and −0.21), and sleep duration (β between 0.11 and 0.14) were independently associated with waist circumference, BMI, and body fat percentage (all p < 0.05). MVPA was associated with waist circumference independent of light physical activity (LPA) and sleep duration (β = −0.11; p < 0.05). Except for MVPA, these associations were independent of physical fitness. These results suggest that longer ST and sleep duration, and lower PA levels (especially light intensity PA), are independently associated with greater adiposity, but not muscle mass, in women with fibromyalgia. These associations are, overall, independent of physical fitness.

Frequent sit-to-stand transitions and several short standing periods measured by hip-worn accelerometer are associated with smaller waist circumference among adults

This cross-sectional study analysed the association of sedentary behaviour (SB) and standing with waist circumference. Finnish adults aged 30-75 years from a sub-sample of population-based Health 2011 Study used a hip-worn tri-axial accelerometer (Hookie AM20, Traxmeet, Ltd, Espoo, Finland) for seven days. Those 1405 participants (57% women) who used accelerometer at least four days, minimum of 10 hours/day, were included. SB and standing were analysed in 6s epochs using validated algorithm. Daily total time, daily number and accumulated time from bouts (30s-5min,30s-10min,30s-15min,30s 30min,>5min,>10min,>15min, >30min) as well as daily number of sit-to-stand transitions were determined. Waist circumference (cm) was measured in standardized way. Participants' mean age was 52 years (SD 12.2). Mean waist circumference was 97cm (SD 12.3) in men and 87cm (SD 12.7) in women. According to multivariable stepwise linear regression analysis, sit-to-stand transitions [standardised regression coefficient (β)= -0.14, 95%CI -0.20 to -0.09], standing bouts of 30s-5min (β= -0.21, 95%CI -0.26 to -0.15) and number of 30s-30min SB bouts (β=0.12, 95%CI 0.06 to 0.17) were most strongly associated with waist circumference. Besides assessing total SB time, future studies should assess also different bout lengths of SB and sit-to-stand transitions and standing times should be assessed separately.

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

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

Differences in Context-Specific Sedentary Behaviors According to Weight Status in Adolescents, Adults and Seniors: A Compositional Data Analysis

To develop effective sedentary behavior interventions aimed at people who are overweight/obese, detailed insight is needed into the contexts of sedentary behavior of these people. Therefore, the aims of this study were to describe the composition of sedentary behavior and to compare context-specific sedentary behaviors between different weight groups. Cross-sectional data were used from a study conducted in 2013⁻2014 among a Flemish sample of adolescents (n = 513), adults (n = 301), and seniors (n = 258). Sixteen context-specific sedentary behaviors were assessed using a validated questionnaire during the week and weekend. Compositional descriptive statistics were performed to determine the relative contribution of context-specific sedentary behaviors in the three age groups. Compositional multivariate analysis of covariance and pairwise comparisons were conducted to examine weight group differences in context-specific sedentary behaviors. The compositional means indicated that the highest proportion of sedentary time was spent at school, at work, and while watching television. Statistically significant differences were found in the composition of sedentary behaviors between healthy weight and overweight/obese participants. In all age groups, socially engaging sedentary behaviors were more prevalent in healthy weight people, whereas socially disengaging behaviors were more prevalent in overweight/obese people. Consequently, the findings of this study suggest that future overweight/obesity interventions should no longer focus on total sedentary time, as not all context-specific sedentary behaviors are associated with overweight/obesity. Instead, it might be better to target specific contexts of sedentary behaviors-preferably those less socially engaging-when aiming to reduce overweight/obesity.

Energy utilization associated with regular activity breaks and continuous physical activity: A randomized crossover trial

AIMS

To quantify and compare energy utilization associated with prolonged sitting alone, or interrupted with regular activity breaks and/or an additional bout of continuous physical activity.

METHODS AND RESULTS

Thirty six adults (11 males, BMI 24.1 ± 4.6) completed four interventions: (1) prolonged sitting (SIT), (2) sitting with 2-min of walking every 30 min (RAB), (3) prolonged sitting with 30-min of continuous walking at the end of the day (SIT + PA), (4) a combination of the activities in (2) and (3) above (RAB + PA). All walking was at a speed and incline corresponding to 60% V̇O_2max. Energy utilization over 7 h for each intervention was estimated using indirect calorimetry. Compared to SIT, SIT + PA increased total energy utilization by 709 kJ (95% CI 485-933 kJ), RAB by 863 kJ (95% CI 638-1088 kJ), and RAB + PA by 1752 kJ (95% CI 1527-1927 kJ) (all p < 0.001). There was no difference in total energy utilization between SIT + PA and RAB, however, post-physical activity energy utilization in RAB was 632 kJ greater than SIT + PA (95% CI 561-704 kJ; p < 0.001).

CONCLUSIONS

Short frequent activity, results in greater accumulation of elevated post-physical activity energy utilization compared to a single bout of continuous activity; however the total energy utilization is similar. Combining activity breaks with a longer continuous bout of activity will further enhance energy utilization, and in the longer term, may positively affect weight management of a greater magnitude than either activity pattern performed alone.

TRIAL REGISTRATION

ANZCTR12614000624684.

Interrupting Prolonged Sitting with Regular Activity Breaks does not Acutely Influence Appetite: A Randomised Controlled Trial

Regular activity breaks increase energy expenditure; however, this may promote compensatory eating behaviour. The present study compared the effects of regular activity breaks and prolonged sitting on appetite. In a randomised, cross-over trial, 36 healthy adults (BMI (Body Mass Index) 23.9 kg/m² (S.D. = 3.9)) completed four, two-day interventions: two with prolonged sitting (SIT), and two with sitting and 2 min of walking every 30 min (RAB). Standardized meals were provided throughout the intervention, with an ad libitum meal at the end of Day 2. Appetite and satiety were assessed throughout both days of each intervention using five visual analogue scales. The five responses were combined into a single appetite response at each time point. The area under the appetite response curve (AUC) was calculated for each day. Intervention effects for appetite response AUC and ad libitum meal intake were tested using linear mixed models. Appetite AUC did not differ between interventions (standardised effect of RAB compared to SIT: Day 1: 0.11; 95% CI: -0.28, 0.06; p = 0.212; Day 2: 0.04; 95% CI: -0.15, 0.24; p = 0.648). There was no significant difference in energy consumed at the ad libitum lunch meal on Day 2 between RAB and SIT. Interrupting prolonged sitting with regular activity breaks does not acutely influence appetite or volume of food consumed, despite inferred increases in energy expenditure. Longer-term investigation into the effects of regular activity breaks on energy balance is warranted.