Sedentariness at work: how much do we really sit?

The Prevalence of Weight Gain After Obtaining Employment: A Cross-Sectional Survey of Employees at the Ministry of National Guard Health Affairs, Eastern Region, Saudi Arabia

Background and objective Even though obesity is a major global health concern, few studies in the literature have discussed obesity in the workplace. In light of this, we aimed to explore obesity in the workplace and its contributing factors. Methodology An online survey was distributed via official work emails. The survey assessed demographic variables and work environment-related factors, such as physical and mental well-being, lack of time, and social and personal habits. The total sample included 380 full-time employees, of which 16.67% were excluded for not meeting the inclusion criteria. Data were analyzed by using descriptive and inferential statistics. Results Of note, 79.87% of the participants reported an increase in weight after getting employed. The average weight gain was 10.4 kg for 8.2 years of experience. The physical and mental items and time-related items had the highest average scores of 3.24 and 3.44, respectively. The multivariable logistic regression showed a significant association between work experience (p = 0.0259) and time (p = 0.0363), as well as physical and mental domains (p = 0.0007). Conclusions Based on our findings, greater work experience, a lack of time, and negative mental and physical well-being are risk factors for weight gain among employees.

Gender, Sex and Desk-Based Postural Behaviour: A systematic review re-interpreting biomechanical evidence from a social perspective

BACKGROUND

Biomechanical and pain prevalence differences between sex/gender groups are frequently attributed to biological differences between sexes without considering the influence of socially-constructed gender. This may lead to interventions which are insufficient and culturally unresponsive. This review reinterprets the evidence regarding differences in desk-based postural behaviour between sex/gender groups from a gender-based perspective.

METHODS

Four prominent databases were searched using terms such as 'desk based', 'posture', and 'position'. Articles were included if they objectively investigated desk-based positional variability, postural variability and/or habitual alignment in healthy adults.

RESULTS

Nine studies were included. Differences were found in postural variability and habitual alignment between sex/gender groups and were not explored from a gender-based perspective.

CONCLUSION

Gender-based expectations regarding 'acceptable' posture and movement likely contribute to biomechanical and pain differences between genders. This should be considered by clinicians intending to affect patients' movement and postural patterns and by researchers working in this space.

Effects of cognitive load and different exercise intensities on perceived effort in sedentary university students: a follow up of the Cubo Fitness Test validation

Work and intellectually fatiguing environments can significantly influence the health of individuals, which is strictly bound to motor efficiency. In particular, desk workers and university students may have a sedentary lifestyle and a condition of mental fatigue caused by daily routine, which could impair motor efficiency. The assessment is a starting point for enhancing awareness of the individual's psychophysical condition through the perception of one's body motor efficiency, motivating to move towards improvement. This way, a submaximal test based on perceived exertion was developed (Cubo Fitness Test, CFT) and validated in previous studies. Hence, two further studies were employed to enhance the consistency and accuracy of this instrument in different conditions. The first study investigated the internal responsiveness of CFT, evaluating if mental fatigue could affect motor efficiency. The second study investigated which perceived intensity (weak, moderate, strong, or absolute maximum) could be more reliable for applying the CFT (as previous research focused the investigation only on moderate intensity). In the first investigation, participants assessed two stimuli (mental fatigue induced with a Stroop color-word task and a neutral condition based on the vision of a documentary) lasting 60 min each. The quality of psychophysical recovery (total quality recovery) and the mood state (Italian Mood State questionnaire) were evaluated before the stimuli. After the fatiguing or the neutral task, the mood state was newly assessed, together with the evaluation of the workload's characteristics (Nasa TLX) and the CFT motor efficiency. In the second investigation, participants had to perform CFT twice for each at different intensities of Borg's Scale of perceived exertion. Researchers successfully requested to fill out the NASA TLX questionnaire regarding the perceived workload characteristics of CFT, and the reliability of each intensity was assessed. Results seem to enhance the consistency and the accuracy of the instrument. Indeed, findings evidenced that CFT is not influenced by mental fatigue conditions typical of the intellectual work of desk workers and university students for which this test was specifically conceived. Moreover, moderate and strong perceived intensity are the most adequate conditions to assess motor efficiency in these populations.

Correlation analysis between physical activity and depressive tendencies among occupational groups: an isotemporal substitution approach

OBJECTIVES

Sedentary behaviour (SB) and physical activity (PA) have been shown to be associated with depression. However, behaviours, such as PA, occupy a portion of an individual's 24-h day. Thus, an increase in time for one behaviour takes away time from another. Previous evidence suggests that it would be more appropriate to shift the focus to the importance of reallocating time spent in sedentary behaviour to time spent in physical activity. The aim of this study was to analyse the mutual replacement effect of different health behaviours on depressive tendencies by isotemporal substitution modelling (ISM) under the objective condition of considering a limited 24-h day. Second, we aimed to further explore the potential association between excessive or insufficient sleep duration and depressive symptoms.

METHODS

A total of 10656 employees from 79 companies in four provinces of China participated in this survey. The Center for Epidemiological Studies Depression Scale (CES-D) was used to measure workers' depressive tendencies. The duration of various types of physical activity was self-reported by workers based on the International Physical Activity Questionnaire (IPAQ). ISM was used to assess the associations of time spent in different activities on displacement of equivalent time spent on other activities with depression risk.

RESULTS

A total of 10656 participants (89.5% of the sample) were included in the analysis. The ISM found that a 30-min unit of SB replaced with walking (OR, 95% CI: 0.83, 0.77-0.88), sleep (≤ 8 h) (OR, 95% CI: 0.77, 0.74-0.79), moderate physical activity (MPA) (OR, 95% CI: 0.87, 0.81-0.93) and vigorous physical activity (VPA) (OR, 95% CI: 0.91, 0.84-0.99) was significantly and negatively associated with the risk of depressive tendencies. When sleep duration was less than 8 h, each additional half hour of sleep time was significantly associated with a lower risk of depressive tendencies, and this association was no longer significant after 8 h.

CONCLUSION

Prolonged SB is common in the current workplace in China. Replacing an average of 30 min per day of SB with VPA and MPA, even walking is associated with less depression among workers. In addition, insufficient daily sleep is also an important risk factor for workers' depressive tendencies. These findings provide valuable evidence to promote mental health among occupational groups and support the development of healthy workplaces.

The Fidget Factor and the obesity paradox. How small movements have big impact

The hypothesis is that the Fidget Factor is the innate neurological pulse that propels humans and other species to move to support their health. Fidgets, previously thought to be spontaneous, are neurologically regulated and highly ordered (non-random). Modern societies being chair-based overwhelm Fidget Factor pulses and consequently inflict chair-based living for transportation, labor, and leisure. Despite impulses firing through the nervous system, people sit because environmental design overwhelms the biology. Urbanization and chair-based societies were designed after the industrial revolution to promote productivity; however, the consequence has been opposite. Crushing the natural urge to move—the Fidget Factor—is a public health calamity. Excess sitting is associated with a myriad of detrimental health consequences and impairs productivity. Fidgeting may reduce all-cause mortality associated with excessive sitting. The Fidget Factor offers hope; data demonstrate that workplaces and schools can be designed to promote activity and free people's Fidget Factors. Evidence shows that people are happier, healthier, wealthier, and more successful if their Fidget Factors are freed.

Increasing physical activity in the vehicle with an interactive seating system in a male sample

An interactive seating system (IASS) was compared to a state-of-the-art massage seating system (MS) regarding the potential of reducing health risks from prolonged sitting in the vehicle. The study investigated if the systems (1) increase heart rate, which is associated with reduced metabolic and cardiovascular risks; (2) activate muscles with the potential to reduce musculoskeletal pain; (3) influence seating comfort and discomfort. The systems were compared in a passenger scenario in a laboratory study (30 male subjects). Only the use of the IASS significantly elevated the heart rate. Muscle activity showed tendencies to increase in the lower back only while using the MS. In comparison, the IASS activated all six captured muscles. Significantly less discomfort was found for the IASS compared to the MS. In comparison to the MS, the IASS showed a substantially higher potential for reducing health risks from static sitting in the vehicle.Practitioner summary: This laboratory study compared the effects of a novel automotive interactive seating system with those of a state-of-the-art massage seating system. Muscle activity, heart rate and discomfort indicated that the IASS has a significantly higher potential to reduce health risks associated with static seating in a vehicle.Abbreviations: AB: air bladder; AC: active condition; ADSS: active dynamic seating system; CLBP: chronic lumbar back pain; ECG: electrocardiography; EMG: electromyography; IASS: interactive seating system; MS: massage seating system; PC: passive condition; PDSS: passive dynamic seating system; RMS: rootmean-square; TI: time interval.

Feasibility and Effectiveness of a Worksite-Weight-Loss Program for Cancer Prevention among School-District Employees with Overweight and Obesity

The effects of Vibrant Lives, a 6-month worksite-weight-loss program, were examined in a cohort of school-district employees with overweight or obesity. The VL Basic (VLB) participants received materials and tailored text messages, the VL Plus (VLP) participants additionally received WIFI-enabled activity monitors and scales and participated in health challenges throughout the school year, and the VL Plus with Support (VLP + S) participants additionally received coaching support. The levels of program satisfaction and retention and changes in weight, physical activity (PA), and diet were compared across groups using Pearson chi-square tests, repeated-measure mixed models, and logistic regression. After the program, the VLB (n = 131), VLP (n = 87), and VLP + S (n = 88) groups had average weight losses of 2.5, 2.5, and 3.4 kg, respectively, and average increases in weekly PA of 40.4, 35.8, and 65.7 min, respectively. The VLP + S participants were more likely than the other participants to have clinically significant weight loss (≥3%; p = 0.026). Compared with the VLB participants, the VLP participants were less likely to meet the recommendations for consuming fast food (p = 0.022) and sugar-sweetened beverages (p = 0.010). The VLP and VLP + S participants reported higher program satisfaction than the VLB participants. The VL program facilitates weight loss among school-district employees with overweight and obesity by increasing their PA and healthy diet.

An investigation of the flexion relaxation ratio in adults with and without a history of self-reported low back pain and transient sitting-induced pain

It is unknown whether the presence of sitting-induced pain or a clinical history of low back pain (LBP) changes spine function outcomes such as the flexion relaxation ratio (FRR). The purpose of this investigation was to determine whether sitting-induced pain or a history of non-specific LBP results in a different FRR. Forty-seven participants were instrumented with surface electromyography over erector spinae at L1, and accelerometers at L1 and S2. Standing maximum lumbar flexion trials were taken preceding and following a 1-hour sitting trial. Pain ratings during sitting and history of LBP were used to group participants for analysis. FRR values taken after the sitting exposures were compared between those that did and did not develop pain during sitting. Baseline FRR values were compared participants with and without a history of LBP. No significant differences in FRR were found for either pain groups (p = 0.11) or clinical history (p = 0.85). Lack of differences may be due to participants not currently experiencing a clinical episode of pain when the ratio was measured and/or because 1-hour sitting exposure was not long enough to induce pain modulation. The findings suggest that neither sitting-induced pain development or clinical history need to be controlled to prevent confounding of FRR.

Qualitative comparative analysis of the implementation fidelity of a workplace sedentary reduction intervention

BACKGROUND

Stand and Move at Work was a 12-month, multicomponent, peer-led (intervention delivery personnel) worksite intervention to reduce sedentary time. Although successful, the magnitude of reduced sedentary time varied by intervention worksite. The purpose of this study was to use a qualitative comparative analysis approach to examine potential explanatory factors that could distinguish higher from lower performing worksites based on reduced sedentary time.

METHODS

We assessed 12-month changes in employee sedentary time objectively using accelerometers at 12 worksites. We ranked worksites based on the magnitude of change in sedentary time and categorized sites as higher vs. lower performing. Guided by the integrated-Promoting Action on Research Implementation in Health Services framework, we created an indicator of intervention fidelity related to adherence to the protocol and competence of intervention delivery personnel (i.e., implementer). We then gathered information from employee interviews and surveys as well as delivery personnel surveys. These data were aggregated, entered into a truth table (i.e., a table containing implementation construct presence or absence), and used to examine differences between higher and lower performing worksites.

RESULTS

There were substantive differences in the magnitude of change in sedentary time between higher (-75.2 min/8 h workday, CI₉₅: -93.7, -56.7) and lower (-30.3 min/8 h workday, CI₉₅: -38.3, -22.7) performing worksites. Conditions that were present in all higher performing sites included implementation of indoor/outdoor walking route accessibility, completion of delivery personnel surveys, and worksite culture supporting breaks (i.e., adherence to protocol). A similar pattern was found for implementer willingness to continue role and employees using face-to-face interaction/stair strategies (i.e., delivery personnel competence). However, each of these factors were also present in some of the lower performing sites suggesting we were unable to identify sufficient conditions to predict program success.

CONCLUSIONS

Higher intervention adherence and implementer competence is necessary for greater program success. These findings illustrate the need for future research to identify what factors may influence intervention fidelity, and in turn, effectiveness.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02566317 . Registered 2 October 2015, first participant enrolled 11 January 2016.

Association between Physical Activity Guidelines and Sedentary Time with Workers' Health-Related Quality of Life in a Spanish Multinational Company

Workers spend a large amount of time working, limiting the possibility of meeting physical activity (PA) guidelines. A better health-related quality of life (HRQoL) provides benefits for the employee and company. The aim of this study was to analyse the associations of four behavioural categories between compliance with PA guidelines (aerobic and strength training) and sedentary time with workers’ HRQoL. We classified the sample into four categories: (1) “Physically active & low sedentary”, (2) “Physically active & high sedentary”, (3) “Physically inactive & low sedentary”, and (4) “Physically inactive & high sedentary”. Student’s t-tests for two independent samples and a multiple linear regression adjusted for covariates were performed. A total of 1004 employees of the multinational company Grupo Red Eléctrica participated. Compliance with PA guidelines and a low level of sedentarism were associated with higher HRQoL (p < 0.001). Compared to “physically inactive & high sedentary”, “physically active & low sedentary” and “physically active & high sedentary” workers obtained a better HRQoL (B = 5.47; p = 0.006 and B = 4.10; p = 0.003; respectively). In this sample of Spanish workers, being physically active was associated with a better HRQoL, even in those with high sedentary time. Experimental studies are needed to confirm our results.

Leisure-time physical activity, sedentary behavior, and risk of breast cancer: Results from the SUN ('Seguimiento Universidad De Navarra') project

Evidence is still limited on the influence of sedentary lifestyles on breast cancer (BC) risk. Also, prospective information on the combined effects of both sedentariness and leisure-time physical activity (LTPA) is scarce. We aimed to assess the association of higher sedentary behavior and LTPA (separately and in combination) with the risk of BC in a middle-aged cohort of university graduates. The SUN Project is a follow-up study initiated in 1999 with recruitment permanently open. Baseline assessments included a validated questionnaire on LTPA and sedentary habits. Subsequently, participants completed biennial follow-up questionnaires. Multivariable adjusted Cox models were used to estimate the hazard ratios (HR) for incident BC according to LTPA, TV-watching, the joint classification of both, and a combined 8-item multidimensional active lifestyle score. We included 10,812 women, with 11.8 years of median follow-up of. Among 115,802 women-years of follow-up, we confirmed 101 incident cases of BC. Women in the highest category of LTPA (>16.5 MET-h/week) showed a significantly lower risk of BC (HR = 0.55; 95% CI: 0.34-0.90) compared to women in the lowest category (≤6 MET/h-week). Women watching >2 h/d of TV sh owed a higher risk (HR = 1.67; 95% CI:1.03-2.72) than those who watched TV <1 h/d. Women in the highest category (6-8 points) of the multidimensional combined 8-item score showed a lower BC risk (HR = 0.35; 95% CI: 0.15-0.79) than those in the lowest category (<2 points) group. There was no significant supra-multiplicative interaction between TV-watching and LTPA. Both low LTPA and TV-watching >2 h/d may substantially increase BC risk, independently of each other.

Exploration of individualized goals and ergonomic modifications to address sedentary behaviors and perceived health and well-being among office workers

BACKGROUND

Office workers spend significant time in sedentary behaviors. Exploration of interventions to address this concern is warranted.

OBJECTIVE

This study explored the impact of individualized goals and ergonomic modifications on sedentary behaviors and perceived health and well-being among office workers.

METHODS

A six-week, one-group, pre- and post-test design was utilized to assess sedentary behaviors and perceptions of health and well-being among office workers using the RAND 36-Item Short Form Survey (SF-36), Numerical Pain Rating Scale (NPRS), Pittsburgh Sleep Quality Index (PSQI), Sedentary Behavior Questionnaire (SBQ), actigraphy, and a workstation assessment.

RESULTS

Statistically significant improvements were noted from pre- to post-test on the RAND SF-36 for energy/fatigue (p = 0.000) and emotional well-being (p = 0.049) and subjective sleep quality using the PSQI (p = 0.005). Participants (n = 17) could set up to two goals related to health and well-being. A majority of the 31 established goals were met: increase physical activity (n = 11/16), reduce sedentary behavior (n = 8/11), and improve personal health (n = 3/4).

CONCLUSIONS

The use of individualized goals and ergonomic modifications is effective for addressing perceived health and well-being among office workers. However, limited statistical significance was found regarding the impact of these interventions on sedentary behaviors or activity levels.

UK university staff experience high levels of sedentary behaviour during work and leisure time

Objective. Reducing sedentary behaviours at work is imperative. Before effective strategies can be developed there is a need to understand profiles of activity within particular roles and organizations. This study aimed to determine activity profiles of staff by job title at a UK university. Methods. Three-hundred and seventeen participants completed the international physical activity questionnaire - short form to determine physical activity profiles. Fifty-one participants also wore a wrist-worn GENEActiv accelerometer for 7 days and completed a self-report diary denoting work and leisure hours. Results. Twenty-one per cent of respondents were categorized as inactive and achieved 298 ± 178 metabolic equivalent minutes (MET-min)/week. Those in administrative roles were most sedentary (501 ± 161 min/day). Accelerometer data highlighted that sedentary time was identical between job roles (pooled mean 8746 ± 823 counts) and equated to 84 ± 9% of total time. During working hours, management, professional and specialist job roles had the highest level of sedentary time (2066 ± 416 counts). Conclusion. Time spent undertaking sedentary activities during working hours contributes to reduced overall activity and can impede productivity, performance and health. Interventions encouraging regular movement and preventing sedentary behaviours at work are therefore required.

Acute Impact of the Use of a Standing Desk on Appetite Sensations and Energy Intake

BACKGROUND

Sedentariness has been shown to increase energy intake and is associated with increased obesity prevalence. Active workstations are used to implement physical activity interventions in workplaces, but it is unclear if they can lead to reductions in body weight. This study aims to observe the acute impact of a standing desk on energy intake and appetite sensations.

METHODS

Participants came to the laboratory, where they were randomly assigned to a seated or a standing desk. They completed a work session (∼75 min) during which they performed cognitive tasks and reported their levels of stress. Following this, they had a 15-minute break during which buffet-type snacks were served. Subjects were asked to rate their appetite sensations on visual analog scales.

RESULTS

Thirty-six normal-weight men and women aged 24.3 (4.3) years participated in this study. Energy intake from snacks was similar (P = .472) between participants who sat (427.8 [286.9] kcal) and the ones who stood (461.2 [272.8] kcal) during the work session. There was no difference in satiety quotients around the snack and no significant interaction time × condition for appetite sensations.

CONCLUSION

The use of a standing desk for 75 minutes did not increase food consumption following a meal.

Effect of Cycling on a Stationary Bike While Performing Assembly Tasks on Human Physiology and Performance Parameters

Objective: This study evaluated participants’ ability to assemble a computer keyboard while at a cycling workstation. Depending on task completion time, error percentage, and workload based on subjective workload ratings, subjective body discomfort, electroencephalography (EEG) and electrocardiographic (ECG) signals, human performances were compared at four different cycling conditions: no cycling, low level cycling (15 km/h), preferred level cycling, and high level cycling (25 km/h). Method: The experiment consisted of 16 participants. Each participant performed the test four times (each cycling condition) on different days. Results: The repeated measure test showed that the alpha and beta EEG signals were high during session times (post) when compared with session times (pre). Moreover, the mean interbeat (R-R) interval decreased after the participants performed the assembly while pedaling, possibly due to the physical effort of cycling. Conclusions: Pedaling had no significant effect on body discomfort ratings, task errors, or completion time.

Sedentary behaviour at work increases muscle stiffness of the back: Why roller massage has potential as an active break intervention

There is increasing evidence that subjects who are exposed to long sitting periods suffer from musculoskeletal discomfort and back pain. The underlying mechanism and effective prevention strategies are still largely unknown. In this study, muscle stiffness of the back was measured in 59 office workers who followed their usual desk work regime for 4.5 h in a sitting posture. The sitting period was either followed by an 8-min roller massage intervention or a controlled standing task. Results showed that muscle stiffness increased significantly after the 4.5 h sitting period. When the sitting period was followed by roller massage, the stiffness values dropped slightly below baseline stiffness. In contrast, the stiffness values remained increased when the sitting period was followed by controlled standing. This study indicates that short-duration tissue manipulation can be an effective active break between prolonged sitting periods to prevent musculoskeletal issues, such as musculoskeletal discomfort and back pain.

Breaking barriers: using the behavior change wheel to develop a tailored intervention to overcome workplace inhibitors to breaking up sitting time

BACKGROUND

The workplace is a prominent domain for excessive sitting. The consequences of increased sitting time include adverse health outcomes such as cardiovascular disease and poor mental wellbeing. There is evidence that breaking up sitting could improve health, however, any such intervention in the workplace would need to be informed by a theoretical evidence-based framework. The aim of this study was to use the Behaviour Change Wheel (BCW) to develop a tailored intervention to break up and reduce workplace sitting in desk-based workers.

METHODS

The BCW guide was followed for this qualitative, pre-intervention development study. Semi-structured interviews were conducted with 25 office workers (26-59 years, mean age 40.9 [SD = 10.8] years; 68% female) who were purposively recruited from local council offices and a university in the East of England region. The interview questions were developed using the Theoretical Domains Framework (TDF). Transcripts were deductively analysed using the COM-B (Capability, Opportunity, Motivation - Behaviour) model of behaviour. The Behaviour Change Technique Taxonomy Version 1 (BCTv1) was thereafter used to identify possible strategies that could be used to facilitate change in sitting behaviour of office workers in a future intervention.

RESULTS

Qualitative analysis using COM-B identified that participants felt that they had the physical Capability to break up their sitting time, however, some lacked the psychological Capability in relation to the knowledge of both guidelines for sitting time and the consequences of excess sitting. Social and physical Opportunity was identified as important, such as a supportive organisational culture (social) and the need for environmental resources (physical). Motivation was highlighted as a core target for intervention, both reflective Motivation, such as beliefs about capability and intention and automatic in terms of overcoming habit through reinforcement. Seven intervention functions and three policy categories from the BCW were identified as relevant. Finally, 39 behaviour change techniques (BCTs) were identified as potential active components for an intervention to break up sitting time in the workplace.

CONCLUSIONS

The TDF, COM-B model and BCW can be successfully applied through a systematic process to understand the drivers of behaviour of office workers to develop a co-created intervention that can be used to break up and decrease sitting in the workplace. Intervention designers should consider the identified BCW factors and BCTs when developing interventions to reduce and break up workplace sitting.

Sit-Stand Desk Software Can Now Monitor and Prompt Office Workers to Change Health Behaviors

OBJECTIVE

To determine the effectiveness of a computer-based intervention designed to increase sit-stand desk usage and help reverse workplace physical inactivity.

BACKGROUND

Sit-stand desks have been successful in reducing workplace sedentary behavior, but the challenge remains for an effective method to increase the usage in order to experience the health and productivity benefits.

METHOD

Data collection (1-year field study with 194 workers) used a novel method of computer software that continuously recorded objective electric sit-stand desk usage, while taking into account the time a worker spends away from their desk (breaks, meetings). During the baseline period, all workers' desk usage was recorded by the software, and the intervention period consisted of software reminders and real-time feedback to all workers to change desk positions. Pooled means were calculated to determine desk usage patterns, and effect sizes and pairwise mean differences were analyzed to test for intervention significance.

RESULTS

The intervention doubled desk usage by increasing ~1 change to ~2 changes per work day. There was a 76% reduction in workers who never used the sit-stand function of the desk. Medium to large effect sizes from the intervention were observed in all three primary outcome measures (desk in sitting/standing position and desk position changes per work day).

CONCLUSION

These findings demonstrate an effective intervention that increased postural transitioning and interrupted prolonged inactivity while remaining at the workstation.

APPLICATION

The methods and results in this research study show that we can quantify an increase in desk usage and collect aggregate data continuously.

Device-measured physical activity, sedentary behaviour and cardiometabolic health and fitness across occupational groups: a systematic review and meta-analysis

BACKGROUND

With approximately 8 hours of one's waking day spent at work, occupational tasks and environments are important influencers on an individual's physical activity (PA) and sedentary behaviours. Little research has compared device-measured physical activity, sedentary behaviour and cardiometabolic outcomes between occupational groups.

OBJECTIVE

To compare device-measured movement (sedentary time [ST], light intensity physical activity [LPA], moderate-to-vigorous intensity physical activity [MVPA], and steps) across occupations. The secondary objective was to examine whether cardiometabolic and fitness outcomes differed by occupation.

METHODS

Five bibliographic databases were searched to identify all studies which included working age, employed adults from high-income countries, and reported on device-measured movement within occupations. Risk of bias within and across studies was assessed. Results were synthesized using meta-analyses and narrative syntheses.

RESULTS

The review includes 132 unique studies with data from 15,619 participants. Working adults spent ~ 60% of their working and waking time engaged in sedentary behaviour; a very small proportion (~ 4%) of the day included MVPA. On average, workers accumulated 8124 steps/day. Office and call center workers' steps/day were among the lowest, while those of postal delivery workers were highest. Office workers had the greatest ST and the lowest time in LPA both at work and during wakeful time. However, office workers had the greatest minutes sent in MVPA during wakeful hours. Laborers had the lowest ST and spent a significantly greater proportion of their work time in LPA and MVPA. Healthcare and protective services workers had higher levels of LPA at work compared to other occupations. Workers in driving-based occupations tended to have a higher body mass index and blood pressure.

CONCLUSION

This review identifies that occupational and wakeful time PA and ST differed between occupations. Future studies are needed to assess whether patterns differ by age and sex, describe leisure-time movement and movement patterns, and the relationship with cardiometabolic health.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42017070448 .

Enrollment Strategies, Barriers to Participation, and Reach of a Workplace Intervention Targeting Sedentary Behavior

PURPOSE

To review enrollment strategies, participation barriers, and program reach of a large, 2-year workplace intervention targeting sedentary behavior.

APPROACH

Cross-sectional, retrospective review.

SETTING

Twenty-four worksites balanced across academic, industry, and government sectors in Minneapolis/Saint Paul (Minnesota) and Phoenix (Arizona) regions.

PARTICIPANTS

Full-time (≥30+ h/wk), sedentary office workers.

METHODS

Reach was calculated as the proportion of eligible employees who enrolled in the intervention ([N enrolled/(proportion of eligible employees × N total employees)] × 100). Mean (1 standard deviation) and median worksite sizes were calculated at each enrollment step. Participation barriers and modifications were recorded by the research team. A survey was sent to a subset of nonparticipants (N = 57), and thematic analyses were conducted to examine reasons for nonparticipation, positive impacts, and negative experiences.

RESULTS

Employer reach was 65% (56 worksites invited to participate; 66% eligible of 56 responses; 24 enrolled). Employee reach was 58% (1317 invited to participate, 83% eligible of 906 responses; 632 enrolled). Postrandomization, on average, 59% (15%) of the worksites participated. Eighteen modifications were developed to overcome participant-, context-, and research-related participation barriers.

CONCLUSION

A high proportion of worksites and employees approached to participate in a sedentary behavior reduction intervention engaged in the study. Interventions that provide flexible enrollment, graded participant engagement options, and adopt a participant-centered approach may facilitate workplace intervention success.

The effects of introducing electric adjustable height desks in an office setting on workplace physical activity levels: A randomised control field trial

BACKGROUND

Electric adjustable height desks (EAHD) have been promoted as an opportunity for desk based workers to stand at work but there is limited evidence that they have an effect on light physical activity.

OBJECTIVE

The main objective was to determine if there would be a change in light physical activity with the introduction of EAHD. The secondary objective was to assess if there was an associated change in leisure time activity.

METHODS

Activity levels were measured by step counts, self-reported activity levels and pre- and post-trial recall levels. Statistical analysis of the data was performed with the software R. Generalised linear models were fitted to the data. A Poisson regression was used for count data. Statistical hypotheses were deemed significant if their p values were less than 0.05.

RESULTS

There was a significant (p < 0.001) effect on step counts associated with allocation of EAHD and a significant (p < 0.001) increase in self-reported activity for the Intervention (EAHD) group. Having an EAHD was associated with increased activity during leisure (p = 0.039).

CONCLUSIONS

Activity levels, especially light physical activity, were significantly increased with the allocation of an electric adjustable height desk. This pilot study showed that the environmental change of introduction of electric adjustable height desks into an office workplace can increase physical activity and reduce sitting durations. There is limited evidence that the increase in work activity has a positive impact on leisure time activity.

Workplace interventions for reducing sitting at work

BACKGROUND

A large number of people are employed in sedentary occupations. Physical inactivity and excessive sitting at workplaces have been linked to increased risk of cardiovascular disease, obesity, and all-cause mortality.

OBJECTIVES

To evaluate the effectiveness of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, OSH UPDATE, PsycINFO, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal up to 9 August 2017. We also screened reference lists of articles and contacted authors to find more studies.

SELECTION CRITERIA

We included randomised controlled trials (RCTs), cross-over RCTs, cluster-randomised controlled trials (cluster-RCTs), and quasi-RCTs of interventions to reduce sitting at work. For changes of workplace arrangements, we also included controlled before-and-after studies. The primary outcome was time spent sitting at work per day, either self-reported or measured using devices such as an accelerometer-inclinometer and duration and number of sitting bouts lasting 30 minutes or more. We considered energy expenditure, total time spent sitting (including sitting at and outside work), time spent standing at work, work productivity and adverse events as secondary outcomes.

DATA COLLECTION AND ANALYSIS

Two review authors independently screened titles, abstracts and full-text articles for study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required.

MAIN RESULTS

We found 34 studies - including two cross-over RCTs, 17 RCTs, seven cluster-RCTs, and eight controlled before-and-after studies - with a total of 3,397 participants, all from high-income countries. The studies evaluated physical workplace changes (16 studies), workplace policy changes (four studies), information and counselling (11 studies), and multi-component interventions (four studies). One study included both physical workplace changes and information and counselling components. We did not find any studies that specifically investigated the effects of standing meetings or walking meetings on sitting time.Physical workplace changesInterventions using sit-stand desks, either alone or in combination with information and counselling, reduced sitting time at work on average by 100 minutes per workday at short-term follow-up (up to three months) compared to sit-desks (95% confidence interval (CI) -116 to -84, 10 studies, low-quality evidence). The pooled effect of two studies showed sit-stand desks reduced sitting time at medium-term follow-up (3 to 12 months) by an average of 57 minutes per day (95% CI -99 to -15) compared to sit-desks. Total sitting time (including sitting at and outside work) also decreased with sit-stand desks compared to sit-desks (mean difference (MD) -82 minutes/day, 95% CI -124 to -39, two studies) as did the duration of sitting bouts lasting 30 minutes or more (MD -53 minutes/day, 95% CI -79 to -26, two studies, very low-quality evidence).We found no significant difference between the effects of standing desks and sit-stand desks on reducing sitting at work. Active workstations, such as treadmill desks or cycling desks, had unclear or inconsistent effects on sitting time.Workplace policy changesWe found no significant effects for implementing walking strategies on workplace sitting time at short-term (MD -15 minutes per day, 95% CI -50 to 19, low-quality evidence, one study) and medium-term (MD -17 minutes/day, 95% CI -61 to 28, one study) follow-up. Short breaks (one to two minutes every half hour) reduced time spent sitting at work on average by 40 minutes per day (95% CI -66 to -15, one study, low-quality evidence) compared to long breaks (two 15-minute breaks per workday) at short-term follow-up.Information and counsellingProviding information, feedback, counselling, or all of these resulted in no significant change in time spent sitting at work at short-term follow-up (MD -19 minutes per day, 95% CI -57 to 19, two studies, low-quality evidence). However, the reduction was significant at medium-term follow-up (MD -28 minutes per day, 95% CI -51 to -5, two studies, low-quality evidence).Computer prompts combined with information resulted in no significant change in sitting time at work at short-term follow-up (MD -14 minutes per day, 95% CI -39 to 10, three studies, low-quality evidence), but at medium-term follow-up they produced a significant reduction (MD -55 minutes per day, 95% CI -96 to -14, one study). Furthermore, computer prompting resulted in a significant decrease in the average number (MD -1.1, 95% CI -1.9 to -0.3, one study) and duration (MD -74 minutes per day, 95% CI -124 to -24, one study) of sitting bouts lasting 30 minutes or more.Computer prompts with instruction to stand reduced sitting at work on average by 14 minutes per day (95% CI 10 to 19, one study) more than computer prompts with instruction to walk at least 100 steps at short-term follow-up.We found no significant reduction in workplace sitting time at medium-term follow-up following mindfulness training (MD -23 minutes per day, 95% CI -63 to 17, one study, low-quality evidence). Similarly a single study reported no change in sitting time at work following provision of highly personalised or contextualised information and less personalised or contextualised information. One study found no significant effects of activity trackers on sitting time at work.Multi-component interventions Combining multiple interventions had significant but heterogeneous effects on sitting time at work (573 participants, three studies, very low-quality evidence) and on time spent in prolonged sitting bouts (two studies, very low-quality evidence) at short-term follow-up.

AUTHORS' CONCLUSIONS

At present there is low-quality evidence that the use of sit-stand desks reduce workplace sitting at short-term and medium-term follow-ups. However, there is no evidence on their effects on sitting over longer follow-up periods. Effects of other types of interventions, including workplace policy changes, provision of information and counselling, and multi-component interventions, are mostly inconsistent. The quality of evidence is low to very low for most interventions, mainly because of limitations in study protocols and small sample sizes. There is a need for larger cluster-RCTs with longer-term follow-ups to determine the effectiveness of different types of interventions to reduce sitting time at work.

Association of self-reported sedentary time with insulin resistance among Korean adults without diabetes mellitus: a cross-sectional study

Background

A more sedentary lifestyle can result in insulin resistance. However, few research studies have assessed the association between insulin resistance and sedentary lifestyle in Asian populations. Therefore, this study aimed to investigate the association of sedentary time with insulin resistance. In addition, we also investigate the moderate effect of employment status, moderate-to-vigorous physical activity (MVPA), and body mass index (BMI) in this association.

Methods

Data from 2573 individuals who participated in the 2015 Korean National Health and Nutrition Examination Survey were analyzed. Sedentary time was measured using self-administered questionnaires, and IR data were estimated using the homeostasis model assessment–insulin resistance index (HOMA-IR). Adjusted odds ratio (OR) and 95% confidence intervals (CIs) from a multivariable logistic regression model were generated for all participants. Subgroup analysis was only performed between sedentary time and HOMA-IR stratified by employment status, because moderate effects were not significant in the tests for interaction for MVPA and BMI. For all analyses, the individuals were categorized as having high or normal HOMA-IR values (> 1.6 and ≤ 1.6, respectively).

Results

A HOMA-IR > 1.6 was observed in 40.3% of the sedentary time Q1 (low) group (< 5.0 h/day), 41.4% of the sedentary time Q2 (middle-low) group, 44.2% of the sedentary time Q3 (middle-high) group, and 48.4% of the sedentary time Q4 (high) group (≥10.0 h/day). When the low level sedentary time group was used as the reference group, the high level sedentary time group was significantly associated with high IR value (HOMA-IR > 1.6) (OR = 1.40, 95% CI: 1.060–1.838). However, this association was not significant across the other sedentary time groups. Moreover, participants reporting a high sedentary time and were employed had 1.67 times the odds of having a high IR value (HOMA-IR > 1.6) compared to those who reported having a low sedentary time and were employed (OR = 1.67, 95% CI: 1.184–2.344). In the unemployed participants, sedentary time was not associated with IR.

Conclusions

High sedentary time (≥10.0 h/day) was associated with elevated HOMA-IR among Korean adults without diabetes mellitus. Furthermore, the association between high sedentary time and HOMA-IR values was more pronounced in the employed population.

Physical activity and the human body in the (increasingly smart) built environment

Physical activity in the built environment of high income countries may be changing faster than at any time prior to the 2000s, with the engagement of social media, smart devices and increasing urban smartness that has come with the Internet of Things. This article describes the most salient features of built environments that have facilitated physical activity between the 1980s and 2000s (most importantly walkability and active transport with bicycles). It goes on to use the anthropological three bodies framework in association with that of forms of capital, to explore how the use of smart devices and increasing incorporation of smartness and performativity into architecture and urban planning since the 2000s might influence physical activity. Smartness and use of smart devices in the built environment should favour increased physical activity through new types of sociality that they facilitate. In turn, engagement with such technologies offers an important opportunity for the empowerment of the individual body-self and the social body towards increased physical activity.

Using Point-of-Choice Prompts to Reduce Sedentary Behavior in Sit-Stand Workstation Users

Introduction: Desk-based office workers are at occupational risk for poor health outcomes from excessive time spent sitting. Sit-stand workstations are used to mitigate sitting, but lack of workstation usage has been observed. Point-of-choice (PoC) prompts offer a complementary strategy for office workers to break up their sitting time. Study purpose: The purpose of this study was to examine the preliminary efficacy, preference, and acceptability of a theory-driven (i.e., 40 unique prompts encompassing social cognitive theory; TD-PoC) and an atheoretical basic reminder PoC prompt intervention (R-PoC) on reducing sedentary behavior in office workers with self-reported low sit-stand workstation usage (≤4 h per day). Methods: In a cross-over design, participants (N = 19, 78.9% female, 39.4 ± 10.7 years of age) completed a 5-days no-prompt control condition followed by a random and counterbalanced assignment to one of the TD-PoC and R-PoC active conditions with a 1-week washout period between. Preliminary efficacy was assessed during work hours with the activPAL micro accelerometer. Preference was assessed prior to each active condition and acceptability was assessed following each active condition via questionnaire. Results: The R-PoC prompt condition significantly decreased sitting time (b[se] = -49.0 [20.8], p = 0.03) and increased standing time (b[se] = 49.8 [19.7], p = 0.02) and displayed a significant increase in sit-stand transitions (b[se] = 2.3 [1.1], p = 0.04), relative to no-prompt control. Both the R-PoC and TD-PoC prompt conditions significantly decreased time spent in prolonged sitting bouts at b[se] = -68.1 [27.8], (p = 0.02), (b[se] = -76.7 [27.1], p = 0.008) relative to no-prompt control. Overall, the TD-PoC prompt condition displayed higher preference and acceptability ratings; however, these differences were not significant (p's > 0.05). Conclusion: While the R-PoC prompt condition was slightly more efficacious than the TD-PoC prompt condition, the TD-PoC prompt condition was rated with higher preference and acceptability scores. Large variations between participants in preference, acceptability, and intervention feedback may indicate need for tailored messaging which may facilitate sustained use in the long-term.

Breaking up Sedentary Time in Overweight/Obese Adults on Work Days and Non-Work Days: Results from a Feasibility Study

Office workers are vulnerable to the adverse health effects of sedentary behavior (i.e., sitting time). Increasing physical activity and preventing time spent sitting is an occupational health priority. This randomized crossover design study compared the short-term (3-days) effects of hourly interruptions of sedentary time with 5-min micrrobouts of activity for 9 hours (MICRO) to a sedentary control condition (SED) and a duration-matched continuous single bout of physical activity (45-min/d, ONE) condition on inclinometer-derived sitting-time on work and non-work days in sedentary overweight/obese adults. Differences in sitting/lying, standing, stepping, number of sit/stand transitions, time spent in moderate and vigorous activity (MVPA), energy expenditure, self-perceived vigor and fatigue, and insulin sensitivity were also examined. Twenty-two participants (10M/12F; 31.7 ± 1.3 year old BMI 30.4 ± 0.5 kg/m²) completed all conditions. No between-condition effects were observed in sitting-time and sit/stand transitions. Both interventions increased daily steps, MVPA and energy expenditure with increases being greater in ONE than MICRO. Feelings of vigor and fasting insulin sensitivity were also improved. Participants reported less fatigue with MICRO than SED and ONE. Both interventions increase physical activity and energy expenditure in occupational and leisure-time contexts. The sustainability of these effects over the long term and on health outcomes will need to be tested in future studies.

A "NEAT" Approach to Obesity Prevention in the Modern Work Environment

Increased prevalence of obesity may be due to an increase of being sedentary at work. Increasing non-exercise activity thermogenesis (NEAT) using walking workstations may increase total physical activity and promote a leaner physical body composition (or phenotype). The purpose of this study was to test whether walking slowly during work was sufficient to promote a leaner phenotype by increasing physical activity in sedentary desk workers without inducing compensation or a decrease in activity or energy expenditure during the nonworking hours. We conducted a prospective cohort study using a within-subjects crossover design. The design involved two phases each lasting 2 weeks: a treadmill exercise phase in which subjects used a walking workstation for 2.5 hours a day 5 days/week and a control phase in which subjects maintained their normal work activity. Twenty-five sedentary adults working at the Minneapolis VA Health Care System. We measured body weight, body composition, food intake, 24-hour physical activity, and self-reported physical activity with the International Physical Activity Questionnaire (IPAQ). Treadmill exercise caused a leaner phenotype (lean mass gain and fat mass loss) and significantly increased their 24-hour physical activity. Walking workstation use had favorable effects on physical well-being and mental focus and did not adversely affect productivity. Light treadmill exercise during work can increase physical activity and result in a leaner body composition. This is a potentially useful intervention to increase NEAT in the modern sedentary work environment.

Impact of Wearing Graduated Compression Stockings on Psychological and Physiological Responses during Prolonged Sitting

We investigated the impact of wearing vs. not wearing graduated compression stockings on psychological and physiological responses in 18 healthy young people (12 men and six women) during 3 h prolonged sitting. Profiled of Mood States (POMS) scores did not show marked differences between with and without stockings. A 3 h sit significantly decreased saliva cortisol in both conditions; with no differences between conditions. Wearing stockings suppressed a subjective uncomfortable sensation (e.g., pain; fatigue; swelling) in the lower limbs, as assessed by visual analogue scale (VAS). Increase in heart rate at 1 h and 3 h was significantly greater without than with stockings. In addition, high-frequency oscillations (HF: 0.15–0.4 Hz), used as an indicator of parasympathetic nerve activity, showed higher values with than without stockings throughout the 3 h sitting period—significantly higher at 1 h. When data for both conditions were pooled pre-to-post changes in saliva cortisol were positively associated with higher uncomfortable sensations of VAS in the lower limbs and negatively associated with changes in the Vigor subscale of POMS. Collectively, these findings suggest that wearing graduated compression stockings may benefit from subjective comfort and increased parasympathetic nerve activity.

Workplace interventions for reducing sitting at work

BACKGROUND

A large number of people are employed in sedentary occupations. Physical inactivity and excessive sitting at workplaces have been linked to increased risk of cardiovascular disease, obesity, and all-cause mortality.

OBJECTIVES

To evaluate the effectiveness of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, OSH UPDATE, PsycINFO, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal up to 9 August 2017. We also screened reference lists of articles and contacted authors to find more studies.

SELECTION CRITERIA

We included randomised controlled trials (RCTs), cross-over RCTs, cluster-randomised controlled trials (cluster-RCTs), and quasi-RCTs of interventions to reduce sitting at work. For changes of workplace arrangements, we also included controlled before-and-after studies. The primary outcome was time spent sitting at work per day, either self-reported or measured using devices such as an accelerometer-inclinometer and duration and number of sitting bouts lasting 30 minutes or more. We considered energy expenditure, total time spent sitting (including sitting at and outside work), time spent standing at work, work productivity and adverse events as secondary outcomes.

DATA COLLECTION AND ANALYSIS

Two review authors independently screened titles, abstracts and full-text articles for study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required.

MAIN RESULTS

We found 34 studies - including two cross-over RCTs, 17 RCTs, seven cluster-RCTs, and eight controlled before-and-after studies - with a total of 3,397 participants, all from high-income countries. The studies evaluated physical workplace changes (16 studies), workplace policy changes (four studies), information and counselling (11 studies), and multi-component interventions (four studies). One study included both physical workplace changes and information and counselling components. We did not find any studies that specifically investigated the effects of standing meetings or walking meetings on sitting time.Physical workplace changesInterventions using sit-stand desks, either alone or in combination with information and counselling, reduced sitting time at work on average by 100 minutes per workday at short-term follow-up (up to three months) compared to sit-desks (95% confidence interval (CI) -116 to -84, 10 studies, low-quality evidence). The pooled effect of two studies showed sit-stand desks reduced sitting time at medium-term follow-up (3 to 12 months) by an average of 57 minutes per day (95% CI -99 to -15) compared to sit-desks. Total sitting time (including sitting at and outside work) also decreased with sit-stand desks compared to sit-desks (mean difference (MD) -82 minutes/day, 95% CI -124 to -39, two studies) as did the duration of sitting bouts lasting 30 minutes or more (MD -53 minutes/day, 95% CI -79 to -26, two studies, very low-quality evidence).We found no significant difference between the effects of standing desks and sit-stand desks on reducing sitting at work. Active workstations, such as treadmill desks or cycling desks, had unclear or inconsistent effects on sitting time.Workplace policy changesWe found no significant effects for implementing walking strategies on workplace sitting time at short-term (MD -15 minutes per day, 95% CI -50 to 19, low-quality evidence, one study) and medium-term (MD -17 minutes/day, 95% CI -61 to 28, one study) follow-up. Short breaks (one to two minutes every half hour) reduced time spent sitting at work on average by 40 minutes per day (95% CI -66 to -15, one study, low-quality evidence) compared to long breaks (two 15-minute breaks per workday) at short-term follow-up.Information and counsellingProviding information, feedback, counselling, or all of these resulted in no significant change in time spent sitting at work at short-term follow-up (MD -19 minutes per day, 95% CI -57 to 19, two studies, low-quality evidence). However, the reduction was significant at medium-term follow-up (MD -28 minutes per day, 95% CI -51 to -5, two studies, low-quality evidence).Computer prompts combined with information resulted in no significant change in sitting time at work at short-term follow-up (MD -10 minutes per day, 95% CI -45 to 24, two studies, low-quality evidence), but at medium-term follow-up they produced a significant reduction (MD -55 minutes per day, 95% CI -96 to -14, one study). Furthermore, computer prompting resulted in a significant decrease in the average number (MD -1.1, 95% CI -1.9 to -0.3, one study) and duration (MD -74 minutes per day, 95% CI -124 to -24, one study) of sitting bouts lasting 30 minutes or more.Computer prompts with instruction to stand reduced sitting at work on average by 14 minutes per day (95% CI 10 to 19, one study) more than computer prompts with instruction to walk at least 100 steps at short-term follow-up.We found no significant reduction in workplace sitting time at medium-term follow-up following mindfulness training (MD -23 minutes per day, 95% CI -63 to 17, one study, low-quality evidence). Similarly a single study reported no change in sitting time at work following provision of highly personalised or contextualised information and less personalised or contextualised information. One study found no significant effects of activity trackers on sitting time at work.Multi-component interventions Combining multiple interventions had significant but heterogeneous effects on sitting time at work (573 participants, three studies, very low-quality evidence) and on time spent in prolonged sitting bouts (two studies, very low-quality evidence) at short-term follow-up.

AUTHORS' CONCLUSIONS

At present there is low-quality evidence that the use of sit-stand desks reduce workplace sitting at short-term and medium-term follow-ups. However, there is no evidence on their effects on sitting over longer follow-up periods. Effects of other types of interventions, including workplace policy changes, provision of information and counselling, and multi-component interventions, are mostly inconsistent. The quality of evidence is low to very low for most interventions, mainly because of limitations in study protocols and small sample sizes. There is a need for larger cluster-RCTs with longer-term follow-ups to determine the effectiveness of different types of interventions to reduce sitting time at work.

Effects of Sedentary Behavior, Physical Activity, Frequency of Protein Consumption, Lower Extremity Strength and Lean Mass on All-Cause Mortality

Background

No study has evaluated the potential independent and cumulative effects of physical activity, sedentary behavior, daily frequency of protein consumption, lean mass and muscular strength on mortality risk.

Methods

Data from the 1999–2002 NHANES were utilized (N = 1,079 adults 50–85 yr), with follow-up through 2011. Leg lean mass was estimated from DXA scans. Knee extensor strength was assessed using the Kin Com MP dynamometer. Physical activity and sedentary behavior were assessed via questionnaire, with the number of meals/day of ≥30 g of protein/meal assessed via a “multiple pass” 24-hour dietary interview. An index score was created (range = 0–5) indicating the number of these health characteristics each participant had.

Results

Only less sedentary behavior was independently associated with reduced mortality risk (HR_adjustment = 0.46; 0.32–0.66). After adjustments, and compared to those with an index score of 0, those with an index score of 1, 2 and 3+, respectively, had a 34%, 49%, and 57% reduced risk of all-cause mortality.

Conclusion

While considering physical activity, sedentary behavior, daily protein frequency consumption, lean mass and muscular strength, only sedentary behavior was independently associated with mortality risk among older adults.

Dietary Supplement Use among Australian Adults: Findings from the 2011-2012 National Nutrition and Physical Activity Survey

(1) Background: Supplement use is prevalent worldwide; however, there are limited studies examining the characteristics of people who take supplements in Australia. This study aimed to investigate the demographics, lifestyle habits and health status of supplement users; (2) Methods: Adults aged >19 years (n = 4895) were included from the 2011-2012 National Nutrition and Physical Activity Survey (NNPAS). A supplement user was defined as anyone who took one or more supplements on either of two 24-h dietary recalls. Poisson regression was used to estimate the prevalence ratio (PR) of supplement use, according to demographics, lifestyle characteristics and health status of participants; (3) Results: Supplement use was reported by 47% of women and 34% of men, and supplement use was higher among older age groups, among those with higher education levels and from areas reflecting the least socioeconomic disadvantaged. An association was found between blood pressure and supplement use; (4) Conclusions: A substantial proportion of Australians take supplements. Further investigation into the social, psychological and economic determinants that motivate the use of supplements is required, to ensure appropriate use of supplements among Australian adults.

Energy Expenditure of Standing Compared to Sitting While Conducting Office Tasks

Objectives This study aimed to investigate the energy expenditure of common office-based tasks. The objectives were to: (a) test the classification of tasks as sedentary or light-intensity physical activity and (b) compare the energy expenditure of tasks under two postural conditions (sitting and standing). Background The sedentary nature of office work has been highlighted as a health risk, and strategies to reduce sedentary behavior at work have been developed. However, there is limited evidence to guide the utilization of sit-stand workstations in the workplace for metabolic health benefits. Method A repeated measures laboratory-based study compared the energy expenditure of common office tasks in sitting and standing using indirect calorimetry ( n = 22). Four standardized tasks (sitting/standing quietly, reading, typing, sorting paper) under two postural conditions (sitting, standing) were performed in a randomized order. Results The mean energy expenditure for all tasks in sitting and standing was <1.5 METs. There were no significant differences in the energy expenditure of doing the same task in sitting compared to standing. In a repeated measures ANOVA, task ( p < .001) had a greater influence on METs expended than posture ( p = .030). Conclusion The study confirmed that the difference in energy expenditure of tasks carried out in sitting compared to standing is negligible. Application The ubiquitous use and utility of sit-stand workstations in the workplace needs to be reviewed. Notwithstanding the potential benefits of movement that may occur naturally, this study confirmed that standing as opposed to sitting does not produce a clinically important increase in energy expenditure.

Social ecological correlates of workplace sedentary behavior

Background

To identify social ecological correlates of objectively measured workplace sedentary behavior.

Methods

Participants from 24 worksites - across academic, industrial, and government sectors - wore an activPAL-micro accelerometer for 7-days (Jan-Nov 2016). Work time was segmented using daily logs. Sedentary behavior outcomes included time spent sitting, standing, in light intensity physical activity (LPA, stepping cadence <100 steps/min), and in prolonged sitting bouts (>30 min). Outcomes were standardized to an 8 h work day. Two electronic surveys were completed to derive individual (job type and work engagement), cultural (lunch away from the desk, walking at lunch and face-to-face interaction), physical (personal printer and office type) and organizational (sector) factors. Mixed-model analyses with worksite-level clustering were performed to examine multi-level associations. Secondary analyses examined job type and sector as moderators of these associations. All models were adjusted for age, race/ethnicity and gender.

Results

Participants (N = 478; 72% female; age: 45.0 ± 11.3 years; 77.8% non-Hispanic white) wore the activPAL-micro for 90.2 ± 15.5% of the reported workday. Walking at lunch was positively associated with LPA (5.0 ± 0.5 min/8 h, P < 0.001). Regular face-to-face interaction was negatively associated with prolonged sitting (−11.3 ± 4.8 min/8 h, P < 0.05). Individuals in private offices sat more (20.1 ± 9.1 min/8 h, P < 0.05), stood less (−21.5 ± 8.8 min/8 h, P < 0.05), and engaged in more prolonged sitting (40.9 ± 11.2 min/8 h, P < 0.001) than those in public office space. These associations were further modified by job type and sector.

Conclusions

Work-specific individual, cultural, physical and organizational factors are associated with workplace sedentary behavior. Associations vary by job type and sector and should be considered in the design of workplace interventions to reduce sedentary behavior.

Trial registration

Clinical trial No. NCT02566317; Registered Sept 22nd 2015.

An Under-the-Table Leg-Movement Apparatus and Changes in Energy Expenditure

Introduction: Deskwork contributes substantially to sedentariness. Here, we evaluated an under-the-table apparatus that was designed to promote leg movement (fidgeting) while seated. Our hypothesis was that the under-the-table apparatus would increase energy expenditure. Methods: We measured energy expenditure and heart rate in 26 people while they sat and worked using a standard chair, walked on a treadmill, and sat and worked using an under-the-desk apparatus that encouraged leg movement. Results: Energy expenditure increased significantly while using the under-the-table apparatus when compared to the standard office chair (standard chair, 81 ± 18 kcal/h; under-the-table apparatus, 96 ± 23 kcal/h) (P < 0.001); representing an 18 ± 16% increase. The changes in energy expenditure were not as great as walking (1 mph, 168 ± 46 kcal/h, P < 0.001; 2 mph, 205 ± 51 kcal/, P < 0.001), representing 107 ± 37% and 155 ± 48% increases over baseline, respectively. Conclusions: An under-the-table apparatus that promotes leg movement can increase energy expenditure by approximately 20%. Dynamic sitting is promoted by this apparatus and may be among a lexicon of options to help people move more while seated at work.

Translating Physical Activity Evidence to Hospital Settings: A Call for Culture Change

Extensive evidence exists on the multiple physical and psychological benefits of physical activity (PA) across the lifespan. Yet, the vast majority of Americans engage in highly sedentary lifestyles, and most do not meet recommended PA levels that can achieve health benefits. Moreover, nurses and other healthcare providers are highly inconsistent in their PA recommendations to patients in all settings, as well as in achieving their own levels of PA. The consequences are growing obesity and health-related conditions, disability, and mortality. A culture change is sorely needed that reimagines and reintegrates PA into the course of daily life activities. In this article, we present the research on PA benefits, declining PA levels, and healthcare practice deficits and propose designing an inpatient unit of the future with a mission of PA for all that is integrated into the fabric and operations of the unit. Malcolm Gladwell's Tipping Point ideas are used as a change framework to guide strategies recommended in this futuristic unit. These strategies include leadership by clinical nurse specialists, engagement of other key people, resources, and structures. The entire process will require bold leadership and a willingness to think outside existing models of hospital care, which are costly and outdated.

Planning for sedentary behaviour interventions: office workers’ survey and focus group responses

Aims:

As sedentary behaviour is becoming more prominent in office-based work environments, this study aimed to explore office workers’ perceptions of sedentary behaviour, explore potential behavioural strategies to reduce sedentary behaviour in the workplace and identify barriers which may hamper behaviour change.

Methods:

A total of 140 office workers were recruited and surveyed from the same workplace. The survey included questions regarding perceptions of the relationship between sitting time and health. Following the survey, 12 employees also participated in focus groups to identify potential sedentary behaviour intervention strategies and barriers. The responses from the survey and focus groups were thematically analysed.

Results:

In total, 88% of all participants surveyed agreed that there was a relationship between sitting time and their health. The most prominent theme identified was musculoskeletal complaints followed by general health and weight gain or obesity. The focus groups identified that interventions targeting reducing sitting time should include education, supportive and knowledgeable managers, and a variety of behaviour change strategies to address individual preferences and barriers.

Conclusion:

Multiple behavioural strategies were identified, which appear to be appropriate for sedentary behaviour change.

Future directions in physical activity intervention research: expanding our focus to sedentary behaviors, technology, and dissemination

Despite the increased health risks of a sedentary lifestyle, only 49 % of American adults participate in physical activity (PA) at the recommended levels. In an effort to move the PA field forward, we briefly review three emerging areas of PA intervention research. First, new intervention research has focused on not only increasing PA but also on decreasing sedentary behavior. Researchers should utilize randomized controlled trials, common terminology, investigate which behaviors should replace sedentary behaviors, evaluate long-term outcomes, and focus across the lifespan. Second, technology has contributed to an increase in sedentary behavior but has also led to innovative PA interventions. PA technology research should focus on large randomized trials with evidence-based components, explore social networking and innovative apps, improve PA monitoring, consider the lifespan, and be grounded in theory. Finally, in an effort to maximize public health impact, dissemination efforts should address the RE-AIM model, health disparities, and intervention costs.

An intervention to reduce sitting and increase light-intensity physical activity at work: Design and rationale of the 'Stand & Move at Work' group randomized trial

BACKGROUND

American workers spend 70-80% of their time at work being sedentary. Traditional approaches to increase moderate-vigorous physical activity (MVPA) may be perceived to be harmful to productivity. Approaches that target reductions in sedentary behavior and/or increases in standing or light-intensity physical activity [LPA] may not interfere with productivity and may be more feasible to achieve through small changes accumulated throughout the workday METHODS/DESIGN: This group randomized trial (i.e., cluster randomized trial) will test the relative efficacy of two sedentary behavior focused interventions in 24 worksites across two states (N=720 workers). The MOVE+ intervention is a multilevel individual, social, environmental, and organizational intervention targeting increases in light-intensity physical activity in the workplace. The STAND+ intervention is the MOVE+ intervention with the addition of the installation and use of sit-stand workstations to reduce sedentary behavior and enhance light-intensity physical activity opportunities. Our primary outcome will be objectively-measured changes in sedentary behavior and light-intensity physical activity over 12months, with additional process measures at 3months and longer-term sustainability outcomes at 24months. Our secondary outcomes will be a clustered cardiometabolic risk score (comprised of fasting glucose, insulin, triglycerides, HDL-cholesterol, and blood pressure), workplace productivity, and job satisfaction DISCUSSION: This study will determine the efficacy of a multi-level workplace intervention (including the use of a sit-stand workstation) to reduce sedentary behavior and increase LPA and concomitant impact on cardiometabolic health, workplace productivity, and satisfaction.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02566317 (date of registration: 10/1/2015).

Effects of Sitting and Standing Work Postures on Short-Term Typing Performance and Discomfort

The study evaluated effects of sitting and standing work postures on objective short-term computer typing performance and perceived discomfort. A randomized, repeated measures, study design was used to assess typing performance and perceived discomfort for 12 participants on a 15-minute computer-typing task. Typing performance was measured by number of characters typed and number of errors. Perceived discomfort was measured for the whole body, as well as for upper body and lower body, using a visual analog scale. Results suggest that for a short-term computer typing task, compared to a sitting work posture a standing work posture leads to fewer typing errors without impacting typing speed. Overall levels of perceived discomfort for the whole body are similar for sitting and standing work postures. However, for perceived discomfort there is an interaction of work posture and body region - upper body discomfort is higher in the sitting work posture while lower body discomfort is higher in the standing work posture.

Chair-based fidgeting and energy expenditure

Introduction

Sedentariness is associated with chronic health conditions, impaired cognitive function and obesity. Work contributes significantly to sedentariness because many work tasks necessitate sitting. Few sustained solutions exist to reverse workplace sedentariness. Here, we evaluated a chair and an under-table device that were designed to promote fidgeting while seated. Our hypothesis was that an under-table leg-fidget bar and/or a fidget-promoting chair significantly increased energy expenditure. We compared these devices with chair-based exercise and walking.

Materials and methods

We measured energy expenditure and heart rate in 16 people while they sat and worked using a standard chair, an under-desk device that encourages leg fidgeting and a fidget-promoting chair. We compared outcomes with chair-based exercise and walking.

Results

Energy expenditure increased significantly while using either an under-table leg-fidget bar or a fidget-promoting chair, when compared to the standard office chair (standard chair, 76±31 kcal/hour; leg-fidget bar, 98±42 kcal/hour (p<0.001); fidget chair, 89±40 kcal/hour (p=0.03)). However, heart rate did not increase significantly in either case. Bouts of exercise performed while seated provided energetic and heart rate equivalency to walking at 2 mph.

Conclusions

Chairs and devices that promote fidgeting can increase energy expenditure by ∼20–30% but not increase heart rate. Dynamic sitting may be among a lexicon of options to help people move more while at work.

Within-Day Time-Varying Associations Between Behavioral Cognitions and Physical Activity in Adults

This study used time-varying effect modeling to examine time-of-day differences in how behavioral cognitions predict subsequent physical activity (PA). Adults (N = 116) participated in three 4-day "bursts" of ecological momentary assessment (EMA). Participants were prompted with eight EMA questionnaires per day assessing behavioral cognitions (i.e., intentions, self-efficacy, outcome expectations) and wore an accelerometer during waking hours. Subsequent PA was operationalized as accelerometer-derived minutes of moderate- or vigorousintensity PA in the 2 hr following the EMA prompt. On weekdays, intentions positively predicted subsequent PA in the morning (9:25 a.m.-11:45 a.m.) and in the evening (8:15 p.m.-10:00 p.m.). Self-efficacy positively predicted subsequent PA on weekday evenings (7:35 p.m.-10:00 p.m.). Outcome expectations were unrelated to subsequent PA on weekdays. On weekend days, behavior cognitions and subsequent PA were unrelated regardless of time of day. This study identifies windows of opportunity and vulnerability for motivation-based PA interventions aiming to deliver intervention content within the context of adults' daily lives.

Effects of a dynamic chair on pelvic mobility, fatigue, and work efficiency during work performed while sitting: a comparison of dynamic sitting and static sitting

[Purpose] Working while sitting for long periods can cause lumbar pain, fatigue, and reduced work efficiency. How a dynamic chair with a seat that moves three-dimensionally affects pelvic mobility before and after work, work efficiency, and post-work fatigue were examined. [Subjects and Methods] Subjects were 17 healthy adults (10 males, 7 females, mean age 21.8 ± 2.7 years). Subjects performed a 30-min Kraepelin test under two conditions: sitting in a standard office chair and sitting in a dynamic sitting balance chair. Root mean square (RMS) values of pelvic movement measured by a triaxial accelerometer during 30 minutes of work, finger-floor distance before and after work, lumbar fatigue, and pelvic movement RMS values during finger-floor distance measurement were used as outcome measures. [Results] Pelvic movement RMS values collected every 5 minutes during 30 minutes of work were significantly higher while sitting in the dynamic balance chair. Changes in pelvic movement RMS values during finger-floor distance measurement after work and amount of work performed during 30 minutes were significantly higher and lumbar fatigue was significantly lower for the dynamic balance chair. [Conclusion] Dynamic sitting maintained or increased pelvic flexibility. The dynamic balance chair may effectively help workers work continuously in seated postures with little fatigue.

Worksite Physical Activity Intervention for Ambulatory Clinic Nursing Staff

Health behaviors, including physical activity (PA), of registered nurses (RNs) and medical assistants (MAs) are suboptimal but may improve with worksite programs. Using a repeated-measures crossover design, the authors explored if integrating a 6-month worksite non-exercise activity thermogenesis (NEAT) intervention, with and without personalized health coaching via text messaging into workflow could positively affect sedentary time, PA, and body composition of nursing staff without jeopardizing work productivity. Two ambulatory clinics were randomly assigned to an environmental NEAT intervention plus a mobile text message coaching for either the first 3 months (early texting group, n = 27) or the last 3 months (delayed texting group, n = 13), with baseline 3-month and 6-month measurements. Sedentary and PA levels, fat mass, and weight improved for both groups, significantly only for the early text group. Productivity did not decline for either group. This worksite intervention is feasible and may benefit nursing staff.

Active workstation allows office workers to work efficiently while sitting and exercising moderately

OBJECTIVE

To determine the effects of a moderate-intensity active workstation on time and error during simulated office work.

METHODS

The aim of the study was to analyse simultaneous work and exercise for non-sedentary office workers. We monitored oxygen uptake, heart rate, sweating stains area, self-perceived effort, typing test time with typing error count and cognitive performance during 30 min of exercise with no cycling or cycling at 40 and 80 W.

RESULTS

Compared baseline, we found increased physiological responses at 40 and 80 W, which corresponds to moderate physical activity (PA). Typing time significantly increased by 7.3% (p = 0.002) in C40W and also by 8.9% (p = 0.011) in C80W. Typing error count and cognitive performance were unchanged.

CONCLUSIONS

Although moderate intensity exercise performed on cycling workstation during simulated office tasks increases working task execution time with, it has moderate effect size; however, it does not increase the error rate. Participants confirmed that such a working design is suitable for achieving the minimum standards for daily PA during work hours.

Workplace interventions for reducing sitting at work

BACKGROUND

Office work has changed considerably over the previous couple of decades and has become sedentary in nature. Physical inactivity at workplaces and particularly increased sitting has been linked to increase in cardiovascular disease, obesity and overall mortality.

OBJECTIVES

To evaluate the effects of workplace interventions to reduce sitting at work compared to no intervention or alternative interventions.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, OSH UPDATE, PsycINFO, Clinical trials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal up to 2 June, 2015. We also screened reference lists of articles and contacted authors to find more studies to include.

SELECTION CRITERIA

We included randomised controlled trials (RCTs), cluster-randomised controlled trials (cRCTs), and quasi-randomised controlled trials of interventions to reduce sitting at work. For changes of workplace arrangements, we also included controlled before-and-after studies (CBAs) with a concurrent control group. The primary outcome was time spent sitting at work per day, either self-reported or objectively measured by means of an accelerometer-inclinometer. We considered energy expenditure, duration and number of sitting episodes lasting 30 minutes or more, work productivity and adverse events as secondary outcomes.

DATA COLLECTION AND ANALYSIS

Two review authors independently screened titles, abstracts and full-text articles for study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted authors for additional data where required.

MAIN RESULTS

We included 20 studies, two cross-over RCTs, 11 RCTs, three cRCTs and four CBAs, with a total of 2180 participants from high income nations. The studies evaluated physical workplace changes (nine studies), policy changes (two studies), information and counselling (seven studies) and interventions from multiple categories (two studies). One study had both physical workplace changes and information and counselling components. We did not find any studies that had investigated the effect of periodic breaks or standing or walking meetings. Physical workplace changesA sit-stand desk alone compared to no intervention reduced sitting time at work per workday with between thirty minutes to two hours at short term (up to three months) follow-up (six studies, 218 participants, very low quality evidence). In two studies, sit-stand desks with additional counselling reduced sitting time at work in the same range at short-term follow-up (61 participants, very low quality evidence). One study found a reduction at six months' follow-up of -56 minutes (95% CI -101 to -12, very low quality evidence) compared to no intervention. Also total sitting time at work and outside work decreased with sit-stand desks compared to no intervention (MD -78 minutes, 95% CI -125 to -31, one study) as did the duration of sitting episodes lasting 30 minutes or more (MD -52 minutes, 95% CI -79 to -26, two studies). This is considerably less than the two to four hours recommended by experts. Sit-stand desks did not have a considerable effect on work performance, musculoskeletal symptoms or sick leave. It remains unclear if standing can repair the harms of sitting because there is hardly any extra energy expenditure.The effects of active workstations were inconsistent. Treadmill desks combined with counselling reduced sitting time at work (MD -29 minutes, 95% CI -55 to -2, one study) compared to no intervention at 12 weeks' follow-up. Pedalling workstations combined with information did not reduce inactive sitting at work considerably (MD -12 minutes, 95% CI -24 to 1, one study) compared to information alone at 16 weeks' follow-up. The quality of evidence was low for active workstations. Policy changesTwo studies with 443 participants provided low quality evidence that walking strategies did not have a considerable effect on workplace sitting time at 10 weeks' (MD -16 minutes, 95% CI -54 to 23) or 21 weeks' (MD -17 minutes, 95% CI -58 to 25) follow-up respectively. Information and counsellingCounselling reduced sitting time at work (MD -28 minutes, 95% CI -52 to -5, two studies, low quality evidence) at medium term (three months to 12 months) follow-up. Mindfulness training did not considerably reduce workplace sitting time (MD -2 minutes, 95% CI -22 to 18) at six months' follow-up and at 12 months' follow-up (MD -16 minutes, 95% CI -45 to 12, one study, low quality evidence). There was no considerable increase in work engagement with counselling.There was an inconsistent effect of computer prompting on sitting time at work. One study found no considerable effect on sitting at work (MD -17 minutes, 95% CI -48 to 14, low quality evidence) at 10 days' follow-up, while another study reported a significant reduction in sitting at work (MD -55 minutes, 95% CI -96 to -14, low quality evidence) at 13 weeks' follow-up. Computer prompts to stand reduced sitting at work by 14 minutes more (95% CI 10 to 19, one study) compared to computer prompts to step at six days' follow-up. Computer prompts did not change the number of sitting episodes that last 30 minutes or longer. Interventions from multiple categories Interventions combining multiple categories had an inconsistent effect on sitting time at work, with a reduction in sitting time at 12 weeks' (25 participants, very low quality evidence) and six months' (294 participants, low quality evidence) follow-up in two studies but no considerable effect at 12 months' follow-up in one study (MD -47.98, 95% CI -103 to 7, 294 participants, low quality evidence).

AUTHORS' CONCLUSIONS

At present there is very low to low quality evidence that sit-stand desks may decrease workplace sitting between thirty minutes to two hours per day without having adverse effects at the short or medium term. There is no evidence on the effects in the long term. There were no considerable or inconsistent effects of other interventions such as changing work organisation or information and counselling. There is a need for cluster-randomised trials with a sufficient sample size and long term follow-up to determine the effectiveness of different types of interventions to reduce objectively measured sitting time at work.