Associations of physical activity and sleep with cardiometabolic risk in older women

Reallocating just 10 min to moderate-to-vigorous physical activity from other components of 24-hour movement behaviors improves cardiovascular health in adults

BACKGROUND

As components of a 24-hour day, sedentary behavior (SB), physical activity (PA), and sleep are all independently linked to cardiovascular health (CVH). However, insufficient understanding of components' mutual exclusion limits the exploration of the associations between all movement behaviors and health outcomes. The aim of this study was to employ compositional data analysis (CoDA) approach to investigate the associations between 24-hour movement behaviors and overall CVH.

METHODS

Data from 581 participants, including 230 women, were collected from the 2005-2006 wave of the US National Health and Nutrition Examination Survey (NHANES). This dataset included information on the duration of SB and PA, derived from ActiGraph accelerometers, as well as self-reported sleep duration. The assessment of CVH was conducted in accordance with the criteria outlined in Life's Simple 7, encompassing the evaluation of both health behaviors and health factors. Compositional linear regression was utilized to examine the cross-sectional associations of 24-hour movement behaviors and each component with CVH score. Furthermore, the study predicted the potential differences in CVH score that would occur by reallocating 10 to 60 min among different movement behaviors.

RESULTS

A significant association was observed between 24-hour movement behaviors and overall CVH (p < 0.001) after adjusting for potential confounders. Substituting moderate-to-vigorous physical activity (MVPA) for other components was strongly associated with favorable differences in CVH score (p < 0.05), whether in one-for-one reallocations or one-for-remaining reallocations. Allocating time away from MVPA consistently resulted in larger negative differences in CVH score (p < 0.05). For instance, replacing 10 min of light physical activity (LPA) with MVPA was related to an increase of 0.21 in CVH score (95% confidence interval (95% CI) 0.11 to 0.31). Conversely, when the same duration of MVPA was replaced with LPA, CVH score decreased by 0.67 (95% CI -0.99 to -0.35). No such significance was discovered for all duration reallocations involving only LPA, SB, and sleep (p > 0.05).

CONCLUSIONS

MVPA seems to be as a pivotal determinant for enhancing CVH among general adult population, relative to other movement behaviors. Consequently, optimization of MVPA duration is an essential element in promoting overall health and well-being.

The association between reallocations of time and health using compositional data analysis: a systematic scoping review with an interactive data exploration interface

BACKGROUND

How time is allocated influences health. However, any increase in time allocated to one behaviour must be offset by a decrease in others. Recently, studies have used compositional data analysis (CoDA) to estimate the associations with health when reallocating time between different behaviours. The aim of this scoping review was to provide an overview of studies that have used CoDA to model how reallocating time between different time-use components is associated with health.

METHODS

A systematic search of four electronic databases (MEDLINE, Embase, Scopus, SPORTDiscus) was conducted in October 2022. Studies were eligible if they used CoDA to examine the associations of time reallocations and health. Reallocations were considered between movement behaviours (sedentary behaviour (SB), light physical activity (LPA), moderate-to-vigorous physical activity (MVPA)) or various activities of daily living (screen time, work, household chores etc.). The review considered all populations, including clinical populations, as well as all health-related outcomes.

RESULTS

One hundred and three studies were included. Adiposity was the most commonly studied health outcome (n = 41). Most studies (n = 75) reported reallocations amongst daily sleep, SB, LPA and MVPA. While other studies reported reallocations amongst sub-compositions of these (work MVPA vs. leisure MVPA), activity types determined by recall (screen time, household chores, passive transport etc.) or bouted behaviours (short vs. long bouts of SB). In general, when considering cross-sectional results, reallocating time to MVPA from any behaviour(s) was favourably associated with health and reallocating time away from MVPA to any behaviour(s) was unfavourably associated with health. Some beneficial associations were seen when reallocating time from SB to both LPA and sleep; however, the strength of the association was much lower than for any reallocations involving MVPA. However, there were many null findings. Notably, most of the longitudinal studies found no associations between reallocations of time and health. Some evidence also suggested the context of behaviours was important, with reallocations of leisure time toward MVPA having a stronger favourable association for health than reallocating work time towards MVPA.

CONCLUSIONS

Evidence suggests that reallocating time towards MVPA from any behaviour(s) has the strongest favourable association with health, and reallocating time away from MVPA toward any behaviour(s) has the strongest unfavourable association with health. Future studies should use longitudinal and experimental study designs, and for a wider range of outcomes.

A compositional analysis of time spent in sleep, sedentary behaviour and physical activity with all-cause mortality risk

BACKGROUND

Daily time spent in sleep, sedentary behaviour (SED), light intensity physical activity (LIPA), and moderate-to-vigorous intensity physical activity (MVPA) are compositional, co-dependent variables. The objectives of this study were to use compositional data analysis to: (1) examine the relationship between the movement behaviour composition (daily time spent in sleep, SED, LIPA and MVPA) and all-cause mortality risk, and (2) estimate the extent to which changing time spent in any given movement behaviour (sleep, SED, LIPA, or MVPA) within the movement behaviour composition was associated with changes in risk of all-cause mortality.

METHODS

2838 adult participants from the 2005-2006 cycle of the U.S. National Health and Nutrition Examination Survey were studied using a prospective cohort design. Daily time spent in SED, LIPA and MVPA were determined by accelerometer. Nightly time spent sleeping was self-reported. Survey data were linked with mortality data through to the end of December 2015. Compositional data analysis was used to investigate relationships between the movement behaviour composition and mortality.

RESULTS

The movement behaviour composition was significantly associated with mortality risk. Time spent in MVPA relative to other movement behaviours was negatively associated with mortality risk (HR = .74; 95% CI [.67, .83]) while relative time spent in SED was positively associated with mortality risk (HR = 1.75; 95% CI [1.10, 2.79]). Time displacement estimates revealed that the greatest estimated changes in mortality risk occurred when time spent in MVPA was decreased and replaced with sleep, SED, LIPA or a combination of these behaviours (HRs of 1.76 to 1.80 for 15 min/day displacements).

CONCLUSIONS

The daily movement behaviour composition was related to mortality. Replacing time in MVPA or SED with equivalent time from any other movement behaviour was associated with an increase and decrease in mortality risk, respectively.