Sit less and move more for cardiovascular health: emerging insights and opportunities

Workplace physical activity, sitting time, and menopause symptoms

OBJECTIVE

Increasing numbers of women are in employment during the menopause; however, menopause symptoms can negatively impact capacity to work. Aspects of the work environment, such as the amount of time spent in physical activity (PA) and sitting, may influence symptoms, yet this is unexplored. This study aimed to explore relationships between workplace PA and sitting, and menopause symptom severity.

METHODS

Using a cross-sectional study design, 264 perimenopausal or postmenopausal women were recruited to complete an online questionnaire assessing their self-reported workplace PA and sitting time, and their menopause symptom severity (menopause quality of life, hot flash interference, symptom severity). Multiple linear regression analyses examined the associations between menopause symptom severity and the time spent in PA (standing, walking, and physically demanding tasks) and sitting during work hours. Binomial logistical regression was used to assess if menopause symptom severity predicts whether women meet workplace activity guidelines.

RESULTS

No significant associations were observed between the time spent in PA or sitting while at work and menopause symptom severity (P > 0.05). Menopause symptom severity did not significantly predict whether women met workplace activity guidelines (P > 0.05).

CONCLUSIONS

In a cohort of perimenopausal and postmenopausal women, self-reported time spent in PA and sitting while at work is not associated with menopause symptom severity. Further research is needed using device-based methods to assess PA and sitting time, to explore in more detail the influence of the time spent in these behaviors while at work on menopause symptoms.

Exercise intensity of virtual reality exergaming modulates the responses to executive function and affective response in sedentary young adults: A randomized, controlled crossover feasibility study

Virtual reality (VR) exergaming is a novel strategy to encourage physical activity and boost emotional well-being. However, its effects on executive function (EF) are not fully understood. This study assessed the immediate and retention effects of immersive VR exergaming, at varying exercise intensities, on EF and affect among sedentary college students. Thirty participants (mean age = 22.2 ± 2.5 years; 18 females) underwent 15-minute sessions of moderate-intensity (MI), high-intensity (HI), and active-control intensity (AC) VR exergaming in a counterbalanced order. EF was evaluated using the Flanker, Task-switching, and N-back tasks before, immediately after, and 30 min post-intervention. Emotional valence and arousal were measured by the Feeling Scale and Felt Arousal Scale, respectively. The inverse efficiency score (IES) results indicated that inhibitory control was higher following both MI and HI exergaming compared to AC (p < 0.05), with improvements sustained for 30 minutes HI VR exergaming showed the greatest improvement (p = 0.048). Both HI and MI also exhibited higher working memory capacity than AC (p < 0.05), with HI performing better (p = 0.039). No significant differences in task-switching performance were observed among the groups (p > 0.05). Emotional valence and arousal were significantly elevated immediately after and sustained for 30 minutes following MI and HI exergaming (p < 0.05). This study demonstrates the cognitive and affective benefits of MI and HI VR exergaming in young adults, with HI VR exergaming showing longer-lasting improvements. These findings suggest that immersive VR exergaming can enhance both physical and cognitive health, potentially improving academic performance and daily functionality in collegiate populations.

Correlation and predictive value of novel anthropometric indicators with adult sarcopenia and sarcopenia obesity

The present study leverages the comprehensive data from the National Health and Nutrition Examination Survey (NHANES) to examine the Influencing factors of sarcopenia (SA) and sarcopenic obesity (SO). The investigation is designed to a non-invasive, cost-effective, and convenient method that is applicable to the adult population, enabling the accurate and simultaneous detection of risks associated with SA and SO. Furthermore, this research will evaluate the critical values of effective anthropometric indicators, providing early warning for risk management in self-health care and offering valuable insights for subsequent research and clinical practice. The data pertaining to NHANES participants were meticulously selected from the databases of six cycles, spanning from 2001 to 2004 and 2011 to 2018. Utilizing the diagnostic criteria established by the American Foundation for the National Institutes of Health (FNIH), anthropometric measurement data were extracted to construct composite indices. These indices were then cross-referenced with diagnostic assessments from dual-energy X-ray absorptiometry and bioelectrical impedance analysis to examine the correlations between various metrics and the incidence of diseases. R software (version 4.3.3) was used for analysis, and the primary analytical methods employed included logistic regression, restricted cubic splines (RCS), and the Receiver Operating Characteristic (ROC) curve analysis (AUC). Sarcopenia and sarcopenic obesity are commonly observed in individuals within the middle-aged and elderly demographics. The prevalence of these conditions is higher among middle-aged men of a given age when contrasted with women at the age of 40. All anthropometric indexes demonstrated a positive correlation with the onset of SA and SO, with the association with waist-to-height ratio (WHtR) showcasing a heightened strength subsequent to the adjustment for all covariates. The predictive models of all ROC curves performed commendably, particularly with the body roundness index and WHtR forecasting models exhibiting superior performance, the area under the AUC curve is 0.87 (95 CI% 0.85, 0.88) and 0.86 (95 CI% 0.85, 0.88), respectively. The RCS curve delineated a distinctive J-shaped distribution for each physical index in concurrence with SA and SO, signifying an optimal value at which the incidence of these conditions is minimal; conversely, deviations from this optimal value entailed an escalated risk of disease. Diverse anthropometric index metrics bear a strong correlation with adult onset of sarcopenia and sarcopenic obesity, each displaying commendable predictive capability. Notably, the body roundness index and waist-to-height ratio may harbor heightened potential as indicative anthropometric indexes. Furthermore, the dose-effect relationship analysis inferred that the lowest disease risk is manifested among individuals with specific index profiles, thereby advocating for autonomous health monitoring to promote physical activity and bolster nutrient intake, thus mitigating the risk of sarcopenia and sarcopenic obesity.

Interventions for reducing sedentary behaviour in patients with coronary heart disease: a systematic review and meta-analysis protocol

INTRODUCTION

Sedentary behaviour is associated with numerous adverse health outcomes in patients with cardiovascular disease, independent of physical activity. Related interventions have improved sedentary behaviour in patients with coronary heart disease (CHD). However, their effectiveness has remained inconclusive. This systematic review and meta-analysis aim to comprehensively examine the efficacy of interventions for patients with CHD, thereby contributing to future implementation decisions to improve sedentary behaviour.

METHODS AND ANALYSIS

This protocol follows the guidelines for the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Searches will be conducted in English and Chinese electronic databases from inception to 31 December 2024. All published randomised controlled trials and quasi-experimental studies that report on reducing sedentary behaviour in patients with CHD will be included. Two authors will independently conduct study selection, data extraction and quality assessment. Study quality will be assessed using validated tools appropriate for each study design. The overall meta-analyses for sedentary behaviour outcomes will be performed if the outcome data are sufficient and provide similar effect measures and subgroup analyses based on demographic characteristics, intervention duration, intervention types, intervention content and measurement tools. We will conduct a qualitative synthesis for studies that could not be quantitatively synthesised.

ETHICS AND DISSEMINATION

Ethical approval is not required for this review as no human participants will be involved. The results will be disseminated through a peer-reviewed journal publication or academic conference.

PROSPERO REGISTRATION NUMBER

CRD42023466985.

The Relationship Between Daily Activity Level, Posture Distribution, Stepping Patterns, and Cadence in the BCS70 Cohort

This study investigated the relationship between stepping-defined daily activity levels, time spent in different postures, and the patterns and intensities of stepping behaviour. Using a thigh-mounted triaxial accelerometer, physical activity data from 3547 participants with seven days of valid data were analysed. We classified days based on step count and quantified posture and stepping behaviour, distinguishing between indoor, community, and recreation stepping. The results indicated significant differences in time spent in upright (2.5 to 8.9 h, p < 0.05), lying (8.0 to 9.1 h, p < 0.05), and sedentary (7.0 to 13.0 h, p < 0.05) postures across activity levels. At higher daily activity levels (10,000-15,000 steps), individuals tended to spend approximately equal time in each posture (8 h lying, 8 h sitting, and 8 h upright). The study found that at lower stepping-defined activity levels, step volumes were driven primarily by indoor stepping, while at higher activity levels, outdoor and recreation stepping were larger contributors. Additionally, stepping classified as indoor had significantly slower cadences compared to outdoor stepping. These findings suggest that the composition and intensity of stepping behaviours vary significantly with daily activity volumes, providing insights that could enhance public health messaging and interventions aimed at promoting physical activity.

Association of sedentary behaviour with gout and the interaction effect of hyperuricemia: a cross-sectional study from 2007 to 2018

BACKGROUND

The increasing prevalence of sedentary lifestyles has raised concerns about its health impacts. This study sought to explore the association between sedentary behaviour and gout, a condition historically linked with affluent lifestyles but now increasingly prevalent in the general population.

METHODS

Utilizing data from the National Health and Nutrition Examination Survey database, this cross-sectional study analysed 34,526 participants from 2007 to 2018. The study focused on identifying any potential relationships between sedentary behaviour and the incidence of gout while adjusting for various confounders.

RESULTS

The study found a significant increase in the prevalence of gout from 2017 to 2018 and identified a reversed L-shaped relationship between sedentary behaviour and gout (OR = 1.03; 95% CI 1.00, 1.06; P = 0.0198), especially among individuals without hyperuricemia. Body Mass Index (BMI) may act as a key mediator in the relationship between sedentary behaviour and gout. In those with hyperuricemia, more than 12 h per day of sedentary behaviour substantially increased the prevalence of gout.

CONCLUSION

Prolonged sedentary behaviour emerged as an independent risk factor for gout. This association was particularly pronounced in individuals without hyperuricemia, suggesting the need for lifestyle modifications in this group. However, further research using prospective cohort studies is necessary to establish causality.

Socioeconomic Status and Patterns of Physical Activity and Sedentary Behavior: A Cross-Sectional Analysis of the J-SHINE

BACKGROUND

This study aimed to examine the association between socioeconomic status (SES) and optimal movement behaviors including sufficient moderate-to-vigorous physical activity (PA), regular leisure-time PA, and less sedentary behavior.

METHODS

We used data from the Japanese Study on Stratification, Health, Income, and Neighborhood conducted in 2012. Activity patterns and SES were measured using International Physical Activity Questionnaire Short-Version and other self-administered questionnaires. Activity pattern outcomes assessed were sufficient total volume of moderate-to-vigorous PA (≥150 min/wk), regular leisure-time PA (≥1 d/wk), less sedentary time (≤4 h/d), and optimal movement behaviors (meeting all criteria). SES variables were equivalized annual income, educational attainment, and occupation. Logistic regression analysis adjusted for confounders.

RESULTS

We included 731 men and 852 women. Lower income levels were associated with less leisure-time PA among men and women (men, odds ratio [OR]: 0.60 and 0.65 for Q2 and Q1 [lowest], respectively; women, OR: 0.53 and 0.56 for Q2 and Q1 [lowest]). Lower SES groups associated with less sedentary time (men, OR: 1.82 for blue-collar; women, OR: 1.44 for Q1 income level, 1.61 and 1.53 for junior college, technical school, and high school/junior high school, respectively; 1.89 for unemployed). SES was not significantly associated with optimal movement behavior in both sexes (in men, OR for those with high school or junior high school education vs those with university or graduate school education = 0.81 [0.43-1.53]).

CONCLUSION

Activity patterns varied by SES, with lower income associated with less leisure-time PA and white-collar workers associated with more prevalent sedentary behavior among both sexes.

A Physical Activity and Sitting Time Balance Index and All-Cause Mortality Risk

INTRODUCTION

Achieving a healthier balance of more time spent in physical activity (PA) and less time in sedentary behavior is now widely advocated for achieving multiple health benefits. This study introduces a Physical Activity and Sitting Time Balance Index (PASTBI), a potential risk identification tool addressing the interplay between PA and sedentary behavior; and aims to explore its association with the risk of all-cause mortality in Australian adults.

METHODS

This prospective cohort study analyzed the Australian Diabetes, Obesity and Lifestyle Study (AusDiab) data on 5,836 Australian adults. The PASTBI was calculated by dividing the total duration of PA (minutes/day) by the duration of sitting time (ST) (hours/day), both self-reported at baseline (2004-2005). The PASTBI was expressed in quartiles ranging from Q1 - low PA/high ST to Q4 - high PA/low ST. The association between PASTBI and all-cause mortality was explored (in 2022) using the Cox proportional hazards regression models adjusted for socio-demographics, lifestyle factors, waist circumference, and the number of comorbidities.

RESULTS

During 78,406 person-years of follow-up (median follow-up of 14.3 years), there were 885 deaths (15%). In the fully adjusted model, compared to those in the highest PASTBI category (Quartile 4 - high PA/low ST), participants from the lowest PASTBI category (Quartile 1 - low PA/high ST) were at a higher risk of all-cause mortality [HR (95% CI) = 1.47 (1.21-1.79)].

CONCLUSIONS

A less favorable balance of time spent in PA and ST (as characterized by a parsimonious PASTBI index approach) was associated with a higher risk of all-cause mortality.

Exercise Mediates Noncoding RNAs in Cardiovascular Diseases: Pathophysiological Roles and Clinical Application

Exercise-based cardiac rehabilitation is effective in improving cardiovascular disease risk factor management, cardiopulmonary function, and quality of life. However, the precise mechanisms underlying exercise-induced cardioprotection remain elusive. Recent studies have shed light on the beneficial functions of noncoding RNAs in either exercise or illness models, but only a limited number of noncoding RNAs have been studied in both contexts. Hence, the present study aimed to elucidate the pathophysiological implications and molecular mechanisms underlying the association among exercise, noncoding RNAs, and cardiovascular diseases. Additionally, the present study analysed the most effective and personalized exercise prescription, serving as a valuable reference for guiding the clinical implementation of cardiac rehabilitation in patients with cardiovascular diseases.

Sitting less and moving more: the impact of physical activity on mortality in the population of Spain

BACKGROUND

Sitting time (ST) constitutes a significant aspect of sedentary behavior, and its worldwide escalation raises concerns regarding public health. International guidelines recommend limiting sedentary time and replacing it with physical activity (PA) to reduce the risk of diseases and mortality. This study examines the impact of replacing ST with PA on all-cause, cardiovascular disease (CVD), and cancer mortality in a representative cohort of the population of Spain.

METHODS

We included 30 955 participants aged 15-69 years from two National Health Surveys performed in 2011 and 2017. Data were linked to mortality records as of December 2022. Data on ST, light PA (LPA), and moderate-vigorous PA (MVPA) were collected as part of the International Physical Activity Questionnaire at baseline. Isotemporal substitution analysis from Poisson regression models was used to estimate the relative risk ratio (RR) of replacing ST with LPA or MVPA.

RESULTS

During a median follow-up of 5.7 years, 957 deaths were reported. The replacement of 1 h per week of ST with 1 h per week of MVPA was significantly associated with a lower risk of all-cause (3.3%), CVD (6.7%), and cancer mortality (3.1%). Similarly, replacing 1 h per week of ST with 1 h per week of LPA was significantly associated with a lower risk of all-cause (1.6%) and cancer mortality (2.1%). Finally, substituting 1 h per week of LPA with 1 h per week of MVPA was significantly associated with a 7.6% lower risk of CVD mortality.

CONCLUSIONS

Substituting one hour per week of ST with an equivalent amount of PA was associated with a lower risk of all-cause, CVD, and cancer mortality.

Accelerometer-Measured Sedentary Behavior and Risk of Future Cardiovascular Disease

BACKGROUND

Beyond serving as a marker for insufficient physical activity, sedentary behavior may directly affect future cardiovascular (CV) disease risk.

OBJECTIVES

This study sought to examine associations between accelerometer-measured sedentary behavior with risk of specific CV outcomes, including potential relations with moderate to vigorous physical activity (MVPA).

METHODS

Among participants of the UK Biobank prospective cohort study, we fit Cox models adjusted for demographic and lifestyle factors to assess associations between accelerometer-measured daily sedentary time with incident atrial fibrillation (AF), myocardial infarction (MI), heart failure (HF), and CV mortality. We assessed the potential effect of MVPA on associations between sedentary time and CV disease by including MVPA as an adjustment variable, as well as performing subgroup analyses stratified at the guideline-recommended MVPA threshold (ie, ≥150 min/wk). We then performed compositional analyses to estimate the effects of reallocating sedentary time to other activities.

RESULTS

Among 89,530 individuals (age 62 ± 8 years, 56.4% women) undergoing 1 week of accelerometry, median sedentary time was 9.4 h/d (Q1-Q3: 8.2-10.6). In multivariable models, using the second quartile (8.2-9.4 h/d) as a referent, sedentary time in the top quartile (>10.6 h/d) was associated with greater risks of HF (HR: 1.45; 95% CI: 1.28-1.65) and CV mortality (HR: 1.62; 95% CI: 1.34-1.96), with an inflection of risk at 10.6 h/d. Higher sedentary time was also associated with greater risks of incident AF (HR: 1.11; 95% CI: 1.01-1.21) and MI (HR: 1.15; 95% CI: 1.00-1.32), with an approximately linear relation. Associations with HF and CV mortality persisted among individuals meeting guideline-recommended MVPA levels. Among individuals with >10.6 h/d of sedentary time, reallocating sedentary behavior to other activities substantially reduced the excess CV risk conferred by sedentary behavior (eg, 30-minute decrease in sedentary time for HF: HR: 0.93; 95% CI: 0.90-0.96), even among individuals meeting guideline-recommended MVPA (HR: 0.93; 95% CI: 0.87-0.99).

CONCLUSIONS

Sedentary behavior is broadly associated with future adverse CV outcomes, with particularly prominent effects on HF and CV mortality, where risk inflected at approximately 10.6 h/d. Although guideline-adherent MVPA partially mitigates excess risk, optimizing sedentary behavior appears to be important even among physically active individuals.

Focusing on Sedentary Behavior in Comprehensive Cardiac Rehabilitation

In recent years, the adverse effects of prolonged sedentary behavior in daily life, so-called 'sitting too much', on health have been pointed out. Sedentary behavior is defined as 'all waking behavior in which the energy expenditure in a sitting, semi-recumbent, or recumbent position is 1.5 metabolic equivalents or less'. Even if a person engages in the level of physical activity recommended in the guidelines, sitting for too long at other times may increase the risk of developing various diseases and death. For patients with cardiovascular disease, a comprehensive cardiac rehabilitation program that systematically includes not only medical treatment but also exercise therapy, patient education, and disease management is extremely important. Also, differences in sedentary behavior during the acute and recovery phases are known to affect physical function and activities of daily living at the time of hospital discharge. Here, we discuss cardiac rehabilitation that addresses sedentary behavior and review the previous related research.

Effect of Interrupting Prolonged Sitting with Frequent Activity Breaks on Postprandial Glycemia and Insulin Sensitivity in Adults with Type 1 Diabetes on Continuous Subcutaneous Insulin Infusion Therapy: A Randomized Crossover Pilot Trial

Objective: This study examined acute effects of interrupting prolonged sitting with short activity breaks on postprandial glucose/insulin responses and estimations of insulin sensitivity in adults with type 1 diabetes (T1D). Method: In a randomized crossover trial, eight adults (age = 46 ± 14 years [mean ± SD], body mass index [BMI] = 27.2 ± 3.8 kg/m2) receiving continuous subcutaneous insulin infusion (CSII) therapy completed two 6-h conditions as follows: uninterrupted sitting (SIT) and sitting interrupted with 3-min bouts of simple resistance activities (SRAs) every 30 min. Basal and bolus insulin were standardized across conditions except in cases of hypoglycemia. Postprandial responses were assessed using incremental area-under-the-curve (iAUC) and total AUC (tAUC) from half-hourly venous sampling. Meal-based insulin sensitivity determined from glucose sensor and insulin pump (SiSP) was assessed from flash continuous glucose monitor and insulin pump data. Outcomes were analyzed using mixed models adjusted for sex, BMI, treatment order, and preprandial values. Results: Glucose iAUC did not differ by condition (SIT: 19.8 ± 3.0 [estimated marginal means ± standard error] vs. SRA: 14.4 ± 3.0 mmol.6 h.L-1; P = 0.086). Despite CSII being standardized between conditions, insulin iAUC was higher in SRA compared to SIT (137.1 ± 22.7 vs. 170.9 ± 22.7 mU.6 h.L-1; P < 0.001). This resulted in a lower glucose response relative to the change in plasma insulin in SRA (tAUCglu/tAUCins: 0.32 ± 0.02 vs. 0.40 ± 0.02 mmol.mU-1; P = 0.03). SiSP was also higher at dinner following the SRA condition, with no between-condition differences at breakfast or lunch. Conclusion: Regularly interrupting prolonged sitting in T1D may increase plasma insulin and improve insulin sensitivity when meals and CSII are standardized. Future studies should explore underlying mechanistic determinants and the applicability of findings to those on multiple daily injections. Trial Registration: Australian and New Zealand Clinical Trial Registry Identifier-ACTRN12618000126213 (www.anzctr.org.au).

Dose-Response Independent and Joint Associations of Physical Activity and Sedentary Behavior With Mortality Risk in 40 156 Australian Adults With Coronary Heart Disease

BACKGROUND

Little is known about the relationship between physical activity (PA) and sedentary behavior (SB) with death in people with coronary heart disease. The aim was to examine the independent and joint associations of PA and SB with death.

METHODS AND RESULTS

This is a prospective cohort study including Australian participants aged ≥45 years with self-reported coronary heart disease (2006-2020). Self-reported PA (min/wk) and SB (h/d) were the exposures. Cardiac and all-cause death were the main outcomes. The cohort included 40 156 participants (mean age, 70.3 (SD, 10.3) years; 15 278 women [38%]). During a median follow-up of 11.1 (interquartile range, 6.2-14.4) years, 2497 cardiac and 12 240 all-cause deaths were recorded. Compared with no PA, a 20% to 30% lower risk of cardiac and all-cause death was associated with any level of PA. Walking and moderate to vigorous PA at 150 to 300 min/wk was associated with a 43% to 44% lower risk of cardiac death and 35% to 40% lower risk of all-cause death. Compared with ≥10.5 h/d of SB, participants who were sedentary for 7 to 10.4 h/d experienced an ≈25% reduced associated risk of cardiac and all-cause death. A 56% associated reduction in all-cause mortality risk was found if SB was limited to <3.4 h/d. If participants completed >150 min/wk moderate to vigorous PA and spent <7 h/d in SB, the associated risk of cardiac and all-cause death was reduced by ≈70%.

CONCLUSIONS

All people with coronary heart disease should be encouraged to meet the PA guidelines and limit SB to <7 h/d, noting any increase in physical activity and decrease in SB is better than none to prevent premature death.

Characteristics of physical activity and sedentary behavior in patients undergoing outpatient cardiac rehabilitation

Cardiac rehabilitation is crucial for the secondary prevention of cardiovascular disease, the leading cause of death worldwide. In Japan, as hospitalization periods have been shortened due to advances in medical technology and government policies, outpatient rehabilitation focused on lifestyle and physical activity (PA) is becoming increasingly important as hospital stays shorten. This study was aimed to identify patient characteristics that define the different types of PA and sedentary behaviors, and patient factors in 92 Japanese outpatients by using accelerometers. The patients were found to spend considerable time being sedentary (663.7 ± 118.1 min/day) and very little time engaging in moderate-to-vigorous PA (MVPA, 25.6 (10.6-43.4) min/day). Regression analysis revealed that the daily duration of sedentary behavior was 64 min longer in men than in women (β = 64.2, 95% CI[12.9, 115], p = 0.015); furthermore, men engaged in 22% less light PA (β = -0.245, 95% CI[-0.388, -0.102], p = 0.001). Additionally, MVPA increased by 43% for every 1 metabolic equivalent (MET) task increase in the anaerobic threshold (AT) (β = 0.367, 95% CI[0.035, 0.698], p = 0.031) but decreased by 3% per year of age(β = -0.035, 95% CI[-0.056, -0.015], p < 0.001). The study also found that body mass index (BMI) was negatively correlated with walking time (β = -0.039, 95% CI[-0.075, -0.003], p = 0.036), while AT was positively correlated with MVPA (β = 0.367, 95% CI[0.035, 0.698], p = 0.031) but negatively correlated with time above the AT (β = -2.06, 95% CI[-2.53, -1.59], p < 0.001). These results emphasize the importance of customizing rehabilitation programs according to sex, age, BMI, and AT differences. Furthermore, monitoring home activities and providing individualized prescriptions may enhance the effectiveness of rehabilitation programs.

Effects of Breaking Up Sitting on Gut Hormone Responses and Subsequent Compensatory Behaviors in Physically Inactive Adults

INTRODUCTION

The effects of breaking up sitting on gut hormone responses and free-living energy compensatory behaviors are still unclear in people of Asian ethnicity.

METHODS

Twenty-six Asians including 13 lean individuals (Lean) and 13 individuals with centrally overweight/obesity (OW), aged between 20 and 45 yr, completed a randomized crossover study with either 5.5-h uninterrupted sitting (SIT) or 5.5-h sitting with 2-min walking at 6.4 km·h -1 every 20 min (ACTIVE) in the laboratory. Blood samples were collected at regular time points to examine postprandial glucagon-like peptide 1 (GLP-1), peptide YY (PYY), and glucose-dependent insulinotropic polypeptide (GIP) concentrations. Free-living physical activity and energy intake were recorded using wearable devices and weighed food diaries outside the laboratory until midnight. Paired t -tests were conducted to compare responses between trials.

RESULTS

Postprandial GLP-1 and PYY incremental area under the curve values were higher in the ACTIVE trial versus SIT in both Lean and OW groups (all, P < 0.05), but there was no difference in GIP in either group (both, P > 0.05). There were no differences in free-living physical activity (volume and intensity) or energy intake (total and macronutrients) between trials in either group (all, P > 0.05), resulting in greater total physical activity over the 24-h monitoring period in ACTIVE trial versus SIT trial (both, P < 0.05).

CONCLUSIONS

Breaking up sitting increases postprandial GLP-1 and PYY concentrations in Asians, but does not induce subsequent behavioral compensation, resulting in greater 24-h physical activity levels and lower relative energy intake, in inactive individuals irrespective of bodyweight status.

Association of sedentary behavior and physical activity with occurrence of signs and symptoms in participants of a cardiac rehabilitation program

Sedentary behavior (SB) is associated with health impairments, while physical activity (PA) has been a protective factor. It is unclear whether SB and PA are associated with occurrence of signs and/or symptoms (SS) during cardiac rehabilitation program (CRP) exercise sessions. The objective was to evaluate the association between SB and PA with occurrence of SS. Was included 48 patients from a CRP program (64.7 ± 10.4 years-old). Daily time and % of time of SB and weekly time in moderate-to-vigorous-intensity [MVPA], % of MVPA time, steps/day, and steps/minute were accelerometer-measured. Patients were followed-up during 24 CRP sessions, for accompaniment of SS. Age, sex, and comorbidities (hypertension, diabetes, dyslipidemia, obesity) were covariates. Log-transformed values of SB, MVPA and steps/day were also analyzed. As results, 43.7% (n = 21) of participants presented occurrence of signs, 62.5% (n = 30) presented occurrence of symptoms, and 81.2% (n = 39) present occurrence of SS. In fully adjusted model, % of time in MVPA (β: -0.449,p = 0.045) and steps/minute (β: -0.244,p = 0.026) were inversely associated with occurrence of symptoms. No association was observed between SB and PA and occurrence of signs. The occurrence of symptoms and SS among CRP participants was directly associated with SB and inversely associated with variables of PA.

Detection of sedentary time and bouts using consumer-grade wrist-worn devices: a hidden semi-Markov model

BACKGROUND

Wrist-worn data from commercially available devices has potential to characterize sedentary time for research and for clinical and public health applications. We propose a model that utilizes heart rate in addition to step count data to estimate the proportion of time spent being sedentary and the usual length of sedentary bouts.

METHODS

We developed and trained two Hidden semi-Markov models, STEPHEN (STEP and Heart ENcoder) and STEPCODE (STEP enCODEr; a steps-only based model) using consumer-grade Fitbit device data from participants under free living conditions, and validated model performance using two external datasets. We used the median absolute percentage error (MDAPE) to measure the accuracy of the proposed models against research-grade activPAL device data as the referent. Bland-Altman plots summarized the individual-level agreement with activPAL.

RESULTS

In OPTIMISE cohort, STEPHEN's estimates of the proportion of time spent sedentary had significantly (p < 0.001) better accuracy (MDAPE [IQR] = 0.15 [0.06-0.25] vs. 0.23 [0.13-0.53)]) and agreement (Bias Mean [SD]=-0.03[0.11] vs. 0.14 [0.11]) than the proprietary software, estimated the usual sedentary bout duration more accurately (MDAPE[IQR] = 0.11[0.06-0.26] vs. 0.42[0.32-0.48]), and had better agreement (Bias Mean [SD] = 3.91[5.67] minutes vs. -11.93[5.07] minutes). With the ALLO-Active dataset, STEPHEN and STEPCODE did not improve the estimation of proportion of time spent sedentary, but STEPHEN estimated usual sedentary bout duration more accurately than the proprietary software (MDAPE[IQR] = 0.19[0.03-0.25] vs. 0.36[0.15-0.48]) and had smaller bias (Bias Mean[SD] = 0.70[8.89] minutes vs. -11.35[9.17] minutes).

CONCLUSIONS

STEPHEN can characterize the proportion of time spent being sedentary and usual sedentary bout length. The methodology is available as an open access R package available from https://github.com/limfuxing/stephen/ . The package includes trained models, but users have the flexibility to train their own models.

Assessing and Enhancing Movement Quality Using Wearables and Consumer Technologies: Thematic Analysis of Expert Perspectives

BACKGROUND

Improvements in movement quality (ie, how well an individual moves) facilitate increases in movement quantity, subsequently improving general health and quality of life. Wearable technology offers a convenient, affordable means of measuring and assessing movement quality for the general population, while technology more broadly can provide constructive feedback through various modalities. Considering the perspectives of professionals involved in the development and implementation of technology helps translate user needs into effective strategies for the optimal application of consumer technologies to enhance movement quality.

OBJECTIVE

This study aimed to obtain the opinions of wearable technology experts regarding the use of wearable devices to measure movement quality and provide feedback. A secondary objective was to determine potential strategies for integrating preferred assessment and feedback characteristics into a technology-based movement quality intervention for the general, recreationally active population.

METHODS

Semistructured interviews were conducted with 12 participants (age: mean 42, SD 9 years; 5 males) between August and September 2022 using a predetermined interview schedule. Participants were categorized based on their professional roles: commercial (n=4) and research and development (R&D; n=8). All participants had experience in the development or application of wearable technology for sports, exercise, and wellness. The verbatim interview transcripts were analyzed using reflexive thematic analysis in QSR NVivo (release 1.7), resulting in the identification of overarching themes and subthemes.

RESULTS

Three main themes were generated as follows: (1) "Grab and Go," (2) "Adjust and Adapt," and (3) "Visualize and Feedback." Participants emphasized the importance of convenience to enhance user engagement when using wearables to collect movement data. However, it was suggested that users would tolerate minor inconveniences if the benefits were perceived as valuable. Simple, easily interpretable feedback was recommended to accommodate diverse audiences and aid understanding of their movement quality, while avoiding excessive detail was advised to prevent overload, which could deter users. Adaptability was endorsed to accommodate progressions in user movement quality, and customizable systems were advocated to offer variety, thereby increasing user interest and engagement. The findings indicate that visual feedback representative of the user (ie, an avatar) should be used, supplemented with concise text or audible instructions to form a comprehensive, multimodal feedback system.

CONCLUSIONS

The study provides insights from wearable technology experts on the use of consumer technologies for enhancing movement quality. The findings recommend the prioritization of user convenience and simplistic, multimodal feedback centered around visualizations, and an adaptable system suitable for a diverse audience. Emphasizing individualized feedback and user-centric design, this study provides valuable findings around the use of wearables and other consumer technologies to enhance movement quality among the general population. These findings, in conjunction with those of future research into user perspectives, should be applied in practical settings to evaluate their effectiveness in enhancing movement quality.

Composite activity type and stride-specific energy expenditure estimation model for thigh-worn accelerometry

BACKGROUND

Accurately measuring energy expenditure during physical activity outside of the laboratory is challenging, especially on a large scale. Thigh-worn accelerometers have gained popularity due to the possibility to accurately detect physical activity types. The use of machine learning techniques for activity classification and energy expenditure prediction may improve accuracy over current methods. Here, we developed a novel composite energy expenditure estimation model by combining an activity classification model with a stride specific energy expenditure model for walking, running, and cycling.

METHODS

We first trained a supervised deep learning activity classification model using pooled data from available adult accelerometer datasets. The composite energy expenditure model was then developed and validated using additional data based on a sample of 69 healthy adult participants (49% female; age = 25.2 ± 5.8 years) who completed a standardised activity protocol with indirect calorimetry as the reference measure.

RESULTS

The activity classification model showed an overall accuracy of 99.7% across all five activity types during validation. The composite model for estimating energy expenditure achieved a mean absolute percentage error of 10.9%. For running, walking, and cycling, the composite model achieved a mean absolute percentage error of 6.6%, 7.9% and 16.1%, respectively.

CONCLUSIONS

The integration of thigh-worn accelerometers with machine learning models provides a highly accurate method for classifying physical activity types and estimating energy expenditure. Our novel composite model approach improves the accuracy of energy expenditure measurements and supports better monitoring and assessment methods in non-laboratory settings.

Effects of light-intensity physical activity on cardiometabolic parameters in young adults with overweight and obesity: The SED-ACT randomized controlled crossover trial

AIMS

To investigate how a change in body position with light-intensity physical activity (PA) 'snacks' (LIPAS, alternate sitting and standing, walking or standing continuously) compared with uninterrupted prolonged sitting affects glucose metabolism and heart rate variability (HRV) parameters in young adults with overweight and obesity.

MATERIALS AND METHODS

We conducted a four-arm randomized controlled crossover trial. The following conditions were tested during an 8-h simulated workday: uninterrupted prolonged sitting (SIT), alternate sitting and standing (SIT-STAND; 2.5 h total), continuous standing (STAND), and continuous walking (1.0 mph; WALK). The primary outcome was to investigate how a change in body position (alternate sitting and standing, walking or standing continuously) compared with uninterrupted sitting affects mean 8-h glucose metabolism. Secondary outcomes included the effects on 2-h postprandial glucose concentrations, as well as on 8-h/24-h heart rate and HRV parameters, in the respective study arms. Capillary blood samples were drawn from an hyperemised earlobe in the fasted state and once every hour during each trial intervention by puncturing the earlobe with a lancet and collecting 20 μL of blood (Biosen S-Line Lab+; EKF diagnostics, Barleben, Germany). HRV was assessed for 24 h including the 8-h intervention phase, and a home phase by means of a Holter electrocardiogram. All participants received the same standardized non-relativised breakfast and lunch during the four trial visits.

RESULTS

Seventeen individuals (eight women, mean age 23.4 ± 3.3 years, body mass index 29.7 ± 3.8 kg/m2, glycated haemoglobin level 34.8 ± 3.1 mmol/mol [5.4 ± 0.3%], body fat 31.8 ± 8.2%) completed all four trial arms. Compared with SIT (89.4 ± 6.8 mg/dL), 8-h mean glucose was lower in all other conditions (p < 0.05) and this was statistically significant compared with WALK (86.3 ± 5.2 mg/dL; p = 0.034). Two-hour postprandial glucose after breakfast was approximately 7% lower for WALK compared with SIT (p = 0.002). Furthermore, significant time × condition effects on HRV parameters favouring light-intensity walking were observed (p < 0.001).

CONCLUSIONS

Replacement and interruption of prolonged sitting with light-intensity walking showed a significant blood glucose-lowering effect and improved HRV during an 8-h work environment in young adults with overweight and obesity.

Can step count be used to identify older adults with high sedentary time and low moderate-to-vigorous physical activity?

INTRODUCTION

Combined high sedentary time (ST) and low moderate-to-vigorous physical activity (MVPA) has been associated with adverse cardiovascular events. However, accurately assessing ST and MVPA in older adults is challenging in clinical practice.

PURPOSE

To investigate whether step count can identify older adults with unhealthier movement behavior (high ST/low MVPA) and poorer cardiometabolic profile.

METHODS

Cross-sectional study (n = 258; 66 ± 5 years). Step count, ST, and MVPA were assessed by hip accelerometry during 7 days. The cardiometabolic profile was assessed using a continuous metabolic syndrome score (cMetS), including blood pressure, HDL-cholesterol, triglycerides, fasting glucose, and waist circumference. Receiving operating curve analysis was used to test the performance of step count in identifying older adults with unhealthier movement behavior (highest tertile of ST/lowest tertile of MVPA). Healthier movement behavior was defined as lowest tertile of ST/highest tertile of MVPA, with neutral representing the remaining combinations of ST/MVPA.

RESULTS

A total of 40 participants (15.5%) were identified with unhealthier movement behavior (ST ≥ 11.4 h/day and MVPA ≤ 10 min/day). They spent ~73% and 0.4% of waking hours in ST and MVPA, respectively. Step count identified those with unhealthier movement behavior (area under the curve 0.892, 0.850-0.934; cutoff: ≤5263 steps/day; sensitivity/specificity: 83%/81%). This group showed a higher cMetS compared with neutral (β = .25, p = .028) and healthier movement behavior groups (β = .41, p = .008).

CONCLUSION

Daily step count appears to be a practical, simple metric for identifying community-dwelling older adults with concomitant high ST and low MVPA, indicative of unhealthier movement behavior, who have a poorer cardiometabolic profile.

Association of Daily Physical Activity With Motivation in Prefrail and Frail Older Adults Living in Retirement Communities

Older adults living in retirement communities are an understudied population, and the association between their motivation and daily physical activity is unknown. We recruited participants (n = 173) living in a retirement community who completed the Behavioral Regulation in Exercise Questionnaire-2 and wore an activPAL accelerometer to evaluate this relationship. Participants had a median age of 81 years and demonstrated low levels of daily activity with an average step count of 3,637 (±1,965) steps per day and 52 (±25) min of daily stepping time. External motivation was negatively associated with the square root of daily step count (β = -4.57; p < .001) and square root of daily stepping time (β = -0.49; p < .001). Older adults living in retirement communities demonstrated low levels of daily activity, with a negative association between external motivation and daily activity. Strategies are needed to make an active lifestyle supportive and enticing for older adults in these communities.

Effects of Interrupting Prolonged Sitting with Light-Intensity Physical Activity on Inflammatory and Cardiometabolic Risk Markers in Young Adults with Overweight and Obesity: Secondary Outcome Analyses of the SED-ACT Randomized Controlled Crossover Trial

Sedentary behavior (SB) is an essential risk factor for obesity, cardiovascular disease, and type 2 diabetes. Though certain levels of physical activity (PA) may attenuate the detrimental effects of SB, the inflammatory and cardiometabolic responses involved are still not fully understood. The focus of this secondary outcome analysis was to describe how light-intensity PA snacks (LIPASs, alternate sitting and standing, walking or standing continuously) compared with uninterrupted prolonged sitting affect inflammatory and cardiometabolic risk markers. Seventeen young adults with overweight and obesity participated in this study (eight females, 23.4 ± 3.3 years, body mass index (BMI) 29.7 ± 3.8 kg/m2, glycated hemoglobin A1C (HbA1c) 5.4 ± 0.3%, body fat 31.8 ± 8.2%). Participants were randomly assigned to the following conditions which were tested during an 8 h simulated workday: uninterrupted prolonged sitting (SIT), alternate sitting and standing (SIT-STAND, 2.5 h total standing time), continuous standing (STAND), and continuous walking (1.6 km/h; WALK). Each condition also included a standardized non-relativized breakfast and lunch. Venous blood samples were obtained in a fasted state at baseline (T0), 1 h after lunch (T1) and 8 h after baseline (T2). Inflammatory and cardiometabolic risk markers included interleukin-6 (IL-6), c-reactive protein (CRP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), visceral fat area (VFA), triglyceride-glucose (TyG) index, two lipid ratio measures, TG/HDL-C and TC/HDL-C, albumin, amylase (pancreatic), total protein, uric acid, and urea. We found significant changes in a broad range of certain inflammatory and cardiometabolic risk markers during the intervention phase for IL-6 (p = 0.014), TG (p = 0.012), TC (p = 0.017), HDL-C (p = 0.020), LDL-C (p = 0.021), albumin (p = 0.003), total protein (p = 0.021), and uric acid (p = 0.040) in favor of light-intensity walking compared with uninterrupted prolonged sitting, alternate sitting and standing, and continuous standing. We found no significant changes in CRP (p = 0.529), creatinine (p = 0.199), TyG (p = 0.331), and the lipid ratios TG/HDL-C (p = 0.793) and TC/HDL-C (p = 0.221) in response to the PA snack. During a simulated 8 h work environment replacement and interruption of prolonged sitting with light-intensity walking, significant positive effects on certain inflammatory and cardiometabolic risk markers were found in young adults with overweight and obesity.

Association between daily sitting time and kidney stones based on the National Health and Nutrition Examination Survey (NHANES) 2007-2016: a cross-sectional study

BACKGROUND

Kidney stones are among the most common urological conditions affecting ~9% of the world population. Although some unhealthy diets and unhealthy lifestyles are reportedly risk factors for kidney stone, the association between daily sitting time and kidney stone has not been explored.

MATERIALS AND METHODS

This large-scale, cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) database 2007-2016. Kidney stone history and daily sitting time were retrieved from the questionnaire and 24 hour (h) recall interviews. Logistic regression and subgroup analysis were conducted to investigate the association. The analysis was further stratified by vigorous recreational activity.

RESULTS

A total of 19 188 participants aged ≥20 years with complete information were included in this study. The overall prevalence of kidney stone was 9.6%. Among participants without vigorous recreational activity, a trend towards an increasing prevalence of kidney stone was observed with increased daily sitting time. However, the trend was not observed in individuals who participated in vigorous recreational activity, as they experienced a decreased risk of kidney stone despite having a daily sitting time of 6-8 h (crude model OR=0.659, 95% CI: 0.457-0.950, P =0.028), indicating that vigorous recreational activity may partially attenuate the detrimental effect of prolonged sitting time.

CONCLUSION

Our study revealed an increasing trend of prevalence of kidney stone with increased daily sitting time among the population not performing vigorous recreational activity despite the difference was nonsignificant. Vigorous recreational activity may modify the association between daily sitting time and kidney stone. More prospective cohort studies are warranted to further examine this association.

A 7-Month Multidisciplinary Healthy Lifestyle Intervention Effectively Improved Cardiometabolic Risk Profile of Firefighters

OBJECTIVE

We investigated the effect of a 7-month healthy lifestyle intervention on cardiometabolic risk factors (CMRF) among male career military firefighters (FFs).

METHODS

Forty-nine FFs participated in a 7-month workplace multiddisciplinary healthy lifestyle intervention designed to reduce CMRF through exercise, diet, and improved sleep. Medical assessments, accelerometry, and surveys at the beginning and end determined program effectiveness.

RESULTS

At the end of the intervention period, there was a significant improvement in measures of body composition and blood glucose. The prevalence of hypertension also decreased significantly ( P < 0.01). The 57% of participants who fully adhered to the program had significantly greater improvements across multiple CMRF. Participants increased their physical activity and improved their diet following the intervention.

CONCLUSIONS

This healthy lifestyle intervention was effective in changing behavior and lowering cardiometabolic risk among FFs.

Thigh-worn accelerometry: a comparative study of two no-code classification methods for identifying physical activity types

BACKGROUND

The more accurate we can assess human physical behaviour in free-living conditions the better we can understand its relationship with health and wellbeing. Thigh-worn accelerometry can be used to identify basic activity types as well as different postures with high accuracy. User-friendly software without the need for specialized programming may support the adoption of this method. This study aims to evaluate the classification accuracy of two novel no-code classification methods, namely SENS motion and ActiPASS.

METHODS

A sample of 38 healthy adults (30.8 ± 9.6 years; 53% female) wore the SENS motion accelerometer (12.5 Hz; ±4 g) on their thigh during various physical activities. Participants completed standardized activities with varying intensities in the laboratory. Activities included walking, running, cycling, sitting, standing, and lying down. Subsequently, participants performed unrestricted free-living activities outside of the laboratory while being video-recorded with a chest-mounted camera. Videos were annotated using a predefined labelling scheme and annotations served as a reference for the free-living condition. Classification output from the SENS motion software and ActiPASS software was compared to reference labels.

RESULTS

A total of 63.6 h of activity data were analysed. We observed a high level of agreement between the two classification algorithms and their respective references in both conditions. In the free-living condition, Cohen's kappa coefficients were 0.86 for SENS and 0.92 for ActiPASS. The mean balanced accuracy ranged from 0.81 (cycling) to 0.99 (running) for SENS and from 0.92 (walking) to 0.99 (sedentary) for ActiPASS across all activity types.

CONCLUSIONS

The study shows that two available no-code classification methods can be used to accurately identify basic physical activity types and postures. Our results highlight the accuracy of both methods based on relatively low sampling frequency data. The classification methods showed differences in performance, with lower sensitivity observed in free-living cycling (SENS) and slow treadmill walking (ActiPASS). Both methods use different sets of activity classes with varying definitions, which may explain the observed differences. Our results support the use of the SENS motion system and both no-code classification methods.

Joint association of sedentary time and physical activity with abnormal heart rate recovery in young and middle-aged adults

BACKGROUND

Abnormal heart rate recovery (HRR), representing cardiac autonomic dysfunction, is an important predictor of cardiovascular disease. Prolonged sedentary time (ST) is associated with a slower HRR. However, it is not clear how much moderate-to-vigorous physical activity (MVPA) is required to mitigate the adverse effects of sedentary behavior on HRR in young and middle-aged adults. This study aimed to examine the joint association of ST and MVPA with abnormal HRR in this population.

METHODS

A cross-sectional analysis was conducted on 1253 participants (aged 20-50 years, 67.8% male) from an observational study assessing cardiopulmonary fitness in Fujian Province, China. HRR measured via cardiopulmonary exercise tests on a treadmill was calculated as the difference between heart rate at peak exercise and 2 min after exercise. When the HRR was ≤ 42 beats·minute-1 within this time, it was considered abnormal. ST and MVPA were assessed by the IPAQ-LF. Individuals were classified as having a low sedentary time (LST [< 6 h·day-1]) or high sedentary time (HST [≥ 6 h·day-1]) and according to their MVPA level (low MVPA [0-149 min·week-1], medium MVPA [150-299 min·week-1], high MVPA [≥ 300 min·week-1]). Finally, six ST-MVPA groups were derived. Associations between ST-MVPA groups with abnormal HRR incidence were examined using logistic regression models.

RESULTS

53.1% of the young and middle-aged adults had less than 300 min of MVPA per week. In model 2, adjusted for possible confounders (e.g. age, sex, current smoking status, current alcohol consumption, sleep status, body mass index), HST was associated with higher odds of an abnormal HRR compared to LST (odds ratio (OR) = 1.473, 95% confidence interval (CI) = 1.172-1.852). Compared with the reference group (HST and low MVPA), the HST and high MVPA groups have a lower chance of abnormal HRR (OR, 95% CI = 0.553, 0.385-0.795). Compared with individuals with HST and low MVPA, regardless of whether MVPA is low, medium, or high, the odds of abnormal HRR in individuals with LST is significantly reduced (OR, 95% CI = 0.515, 0.308-0.857 for LST and low MVPA; OR, 95% CI = 0.558, 0.345-0.902 for LST and medium MVPA; OR, 95% CI = 0.476, 0.326-0.668 for LST and high MVPA).

CONCLUSION

Higher amounts of MVPA appears to mitigate the increased odds of an abnormal HRR associated with HST for healthy young and middle-aged adults.

Inertial Measurement Unit and Heart Rate Monitoring to Assess Cardiovascular Fitness of Manual Wheelchair Users during the Six-Minute Push Test

Manual wheelchair users (MWUs) are prone to a sedentary life that can negatively affect their physical and cardiovascular health, making regular assessment important to identify appropriate interventions and lifestyle modifications. One mean of assessing MWUs' physical health is the 6 min push test (6MPT), where the user propels themselves as far as they can in six minutes. However, reliance on observer input introduces subjectivity, while limited quantitative data inhibit comprehensive assessment. Incorporating sensors into the 6MPT can address these limitations. Here, ten MWUs performed the 6MPT with additional sensors: two inertial measurement units (IMUs)-one on the wheelchair and one on the wrist together with a heart rate wristwatch. The conventional measurements of distance and laps were recorded by the observer, and the IMU data were used to calculate laps, distance, speed, and cadence. The results demonstrated that the IMU can provide the metrics of the traditional 6MPT with strong significant correlations between calculated laps and observer lap counts (r = 0.947, p < 0.001) and distances (r = 0.970, p < 0.001). Moreover, heart rate during the final minute was significantly correlated with calculated distance (r = 0.762, p = 0.017). Enhanced 6MPT assessment can provide objective, quantitative, and comprehensive data for clinicians to effectively inform interventions in rehabilitation.

Assessing the association between a sedentary lifestyle and prevalence of primary osteoporosis: a community-based cross-sectional study among Chinese population

OBJECTIVES

To reveal the association between a sedentary lifestyle and the prevalence of primary osteoporosis (POP).

DESIGN

A community-based cross-sectional study was conducted.

SETTING

This study was conducted in communities in Hefei city, Anhui province, China.

PARTICIPANTS

A total of 1346 residents aged 40 and above underwent POP screening via calcaneus ultrasound bone mineral density (BMD) testing and completed a questionnaire survey.

OUTCOME MEASURES

The average daily sitting time was included in the study variable and used to assess sedentary behaviour. The 15 control variables included general information, dietary information and life behaviour information. Logistic regression was used to analyse the association between the POP prevalence and study or control variables in different models.

RESULTS

1346 participants were finally included in the study. According to the 15 control variables, the crude model and 4 models were established. The analysis revealed that the average daily sitting time showed a significant correlation with the prevalence of POP in the crude model (OR=2.02, 95% CI=1.74 to 2.36, p<0.001), Model 1 (OR=2.65, 95% CI=2.21 to 3.17, p<0.001), Model 2 (OR=2.63, 95% CI=2.19 to 3.15, p<0.001), Model 3 (OR=2.62, 95% CI=2.18 to 3.15, p<0.001) and Model 4 (OR=2.58, 95% CI=2.14 to 3.11, p<0.001). Besides, gender, age and body mass index showed a significant correlation with the POP prevalence in all models.

CONCLUSIONS

This study suggests a potential association between a sedentary lifestyle and the prevalence of POP within the Chinese population. Modifying sedentary behaviours could contribute to a reduction in POP risk. However, longitudinal cohort studies are necessary to confirm this hypothesis in the future.

Arterial Smooth Muscle Cell AKAP150 Mediates Exercise-Induced Repression of CaV1.2 Channel Function in Cerebral Arteries of Hypertensive Rats

BACKGROUND

Hypertension is a major, prevalent risk factor for the development and progression of cerebrovascular disease. Regular exercise has been recommended as an excellent choice for the large population of individuals with mild-to-moderate elevations in blood pressure, but the mechanisms that underlie its vascular-protective and antihypertensive effects remain unknown. Here, we describe a mechanism by which myocyte AKAP150 (A-kinase anchoring protein 150) inhibition induced by exercise training alleviates voltage-dependent L-type Ca2+ channel (CaV1.2) activity and restores cerebral arterial function in hypertension.

METHODS

Spontaneously hypertensive rats and newly generated smooth muscle-specific AKAP150 knockin mice were used to assess the role of myocyte AKAP150/CaV1.2 channel in regulating cerebral artery function after exercise intervention.

RESULTS

Activation of the AKAP150/PKCα (protein kinase Cα) signaling increased CaV1.2 activity and Ca2+ influx of cerebral arterial myocyte, thus enhancing vascular tone in spontaneously hypertensive rats. Smooth muscle-specific AKAP150 knockin mice were hypertensive with higher CaV1.2 channel activity and increased vascular tone. Furthermore, treatment of Ang II (angiotensin II) resulted in a more pronounced increase in blood pressure in smooth muscle-specific AKAP150 knockin mice. Exercise training significantly reduced arterial myocyte AKAP150 expression and alleviated CaV1.2 channel activity, thus restoring cerebral arterial function in spontaneously hypertensive rats and smooth muscle-specific AKAP150 knockin mice. AT1R (AT1 receptor) and AKAP150 were interacted closely in arterial myocytes. Exercise decreased the circulating Ang II and Ang II-involved AT1R-AKAP150 association in myocytes of hypertension.

CONCLUSIONS

The current study demonstrates that aerobic exercise ameliorates CaV1.2 channel function via inhibiting myocyte AKAP150, which contributes to reduced cerebral arterial tone in hypertension.

[Healthier at work for longer? Trends in life years free of cardiovascular and musculoskeletal diseases in the employed and general population based on health insurance claims data]

BACKGROUND

Our study focuses on the development of disease-free life years of two disease groups with high public health relevance: musculoskeletal diseases (MSD) and cardiovascular diseases (CVD). Against the backdrop of prolonged working lives, the development of disease-free life years in the working-age population is compared with the trend in the employed population. Differences between occupational groups are also examined.

METHODS

The study is based on data from the statutory health insurance provider AOK Lower Saxony (N = 2,001,225). Incident cases were identified based on the diagnosis data. The expected years free of MSD and CVD were calculated using multistate life table analysis for three periods between 2006 and 2018. The occupational group is identified via the occupational key. Three groups are distinguished: unskilled and semi-skilled workers, skilled workers and specialists, and highly skilled workers.

RESULTS

Life years free of MSD clearly decreased in the general population and among the employed population. The decrease was strongest in the higher-skilled occupational groups. Life years free of CVD increased in the general population. The increase was weaker among the employed population. The only occupational group showing increases were men in unskilled and semi-skilled occupations.

DISCUSSION

The study shows that disease-free life years among employed persons developed in some cases worse than in the general population. For the analysed disease groups MSD and CVD, there are clear inequalities between occupational groups, which decreased somewhat over time. The inequalities and the decrease in years free of MSD highlight the high public health relevance and the need for effective prevention strategies to prevent CVD and MSD in working age.

Association of 'Tortoise' and 'Hare' movement behavior patterns with cardiometabolic health, body composition, and functional fitness in older adults

We investigated the association of movement behavior patterns with cardiometabolic health, body composition, and functional fitness in older adults. A total of 242 older adults participated of this cross-sectional study. Sedentary time, light physical activity (LPA) and moderate-vigorous physical activity (MVPA), steps/day, and step cadence were assessed by accelerometry. The movement behavior patterns were derived by principal component analysis. Cardiometabolic health was defined by a metabolic syndrome score (cMetS). Body composition was determined by appendicular lean mass/body mass index (ALM/BMI). Functional fitness was assessed by a composite z-score from the Senior Fitness Test battery. Two patterns were identified: 'Tortoise' (low sedentary time, high LPA and steps/day) and 'Hare' (high MVPA, steps/day, and step cadence). 'Tortoise' and 'Hare' were associated with better cMetS. 'Hare' was positively associated with ALM/BMI and Functional Fitness. While 'Tortoise' and 'Hare' were associated with better cMetS, only 'Hare' was associated with better ALM/BMI and functional fitness.

Effective management of sedentary behavior among Indian university students: An empirical exploration into health-related behavior

BACKGROUND

The past few years have witnessed a notable rise in sedentary tendencies, unveiling a modern era of prolonged stillness and diminished physical engagement. This study sought to assess the feasibility of a digital health intervention (DHI) to reduce overall sedentary behavior among university students. The study also identifies distinct subgroups within Indian universities that exhibit a heightened propensity for engaging in unhealthy behaviors.

MATERIALS AND METHODS

The research design used was a quasi-experimental (pre-post) design. A total of 500 participants were selected using a simple randomized sampling method (250 belonging to the control group and 250 belonging to the experimental group). These participants actively engaged in the study for 2 weeks. The participants completed the Sedentary Behavior Questionnaire (SBQ) before the intervention to evaluate their level of sedentary behavior. To evaluate the impact of the intervention on subjectively measured sedentary behavior, statistical analyses were conducted using the paired-samples t-test and analysis of covariance (ANCOVA) with the post hoc Bonferroni test.

RESULTS

The findings demonstrated a significant t-value of sedentary behavior for the entire group, with t(249) = 4.88, P < .05. Furthermore, the F-value of 28.787 indicated a statistically significant difference in the sedentary behavior between the experimental and control groups. When considering female university students specifically, the t-value for sedentary behavior was significant at t(105) = 3.22, P < .05, and for male university students, the t-value for sedentary behavior was found to be significant at t(143) = 3.69, P < .05.

CONCLUSION

Smartphone-based health interventions targeting sedentary behavior reduction demonstrated promising outcomes in facilitating health behavior change among university students.

Physical activity and sedentary behavior levels among individuals with mental illness: A cross-sectional study from 23 countries

People with mental illness tend to present low levels of physical activity and high levels of sedentary behavior. The study aims to compare these levels in mental illness patients, exploring the role of socioeconomic development and treatment setting. This cross-sectional study used accelerometers and the Simple Physical Activity Questionnaire (SIMPAQ) to assess physical activity and sedentary behavior in mental illness individuals living in 23 countries. Two-way ANOVAs were used to evaluate the interaction between socioeconomic development and the treatment settings on physical activity and sedentary behavior. A total of 884 (men = 55.3%) participants, mean age of 39.3 (SD = 12.8), were evaluated. A significant interaction between socioeconomic development and treatment settings was found in sedentary behavior (F = 5.525; p = 0.019; η2p = 0.009; small effect size). Main effects were observed on socioeconomic development (F = 43.004; p < 0.001; η2p = 0.066; medium effect size) and treatment setting (F = 23.001; p < 0.001; η2p = 0.036; small effect size) for sedentary behavior and physical activity: socioeconomic development (F = 20.888; p < 0.001; η2p = 0.033; small effect size) and treatment setting (F = 30.358; p < 0.001; η2p = 0.047; small effect size), showing that HIC patients were more active, while MIC patients were more sedentary. Moreover, despite of inpatients had presented higher levels of physical activity than outpatients, they also spent more time sitting. Socioeconomic development plays an important role in sedentary behavior in patients with mental disorders, warning the need to develop new strategies to reduce these levels in this population.

Using functional principal component analysis (FPCA) to quantify sitting patterns derived from wearable sensors

BACKGROUND

Sedentary behavior (SB) is a recognized risk factor for many chronic diseases. ActiGraph and activPAL are two commonly used wearable accelerometers in SB research. The former measures body movement and the latter measures body posture. The goal of the current study is to quantify the pattern and variation of movement (by ActiGraph activity counts) during activPAL-identified sitting events, and examine associations between patterns and health-related outcomes, such as systolic and diastolic blood pressure (SBP and DBP).

METHODS

The current study included 314 overweight postmenopausal women, who were instructed to wear an activPAL (at thigh) and ActiGraph (at waist) simultaneously for 24 hours a day for a week under free-living conditions. ActiGraph and activPAL data were processed to obtain minute-level time-series outputs. Multilevel functional principal component analysis (MFPCA) was applied to minute-level ActiGraph activity counts within activPAL-identified sitting bouts to investigate variation in movement while sitting across subjects and days. The multilevel approach accounted for the nesting of days within subjects.

RESULTS

At least 90% of the overall variation of activity counts was explained by two subject-level principal components (PC) and six day-level PCs, hence dramatically reducing the dimensions from the original minute-level scale. The first subject-level PC captured patterns of fluctuation in movement during sitting, whereas the second subject-level PC delineated variation in movement during different lengths of sitting bouts: shorter (< 30 minutes), medium (30 -39 minutes) or longer (> 39 minute). The first subject-level PC scores showed positive association with DBP (standardized β ^ : 2.041, standard error: 0.607, adjusted p = 0.007), which implied that lower activity counts (during sitting) were associated with higher DBP.

CONCLUSION

In this work we implemented MFPCA to identify variation in movement patterns during sitting bouts, and showed that these patterns were associated with cardiovascular health. Unlike existing methods, MFPCA does not require pre-specified cut-points to define activity intensity, and thus offers a novel powerful statistical tool to elucidate variation in SB patterns and health.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03473145; Registered 22 March 2018; https://clinicaltrials.gov/ct2/show/NCT03473145 ; International Registered Report Identifier (IRRID): DERR1-10.2196/28684.

Effects on physical activity, physical fitness and well-being in a 36-months randomized controlled study, comparing a multimodal hospital-based intervention programme for primary cardiovascular prevention with usual care

BACKGROUND

Cardiovascular disease is a major cause of mortality and morbidity worldwide, and primary prevention efforts are poorly developed in people at high cardiovascular risk. On this background, we performed the Hjerteløftet Study and demonstrated that participation over 36 months in a multimodal primary prevention programme, significantly reduced validated cardiovascular risk scores. In the current substudy we aimed to further explore several elements and effects following the intervention programme.

METHODS

A random sample from the original Hjerteløftet Study was included for further examinations (n = 255, 40% women), and these patients were already randomized to an intervention group (IG) (n = 127), or a control group (CG) (n = 128). We compared changes from baseline to 36-months follow-up in physical activity, cardiorespiratory fitness, psychological well-being (WHO-5), cardiovascular medication use, smoking habits, and cardiometabolic risk factors (blood pressure, lipids, blood glucose, HbA1c, Apolipoprotein A-I, Apolipoprotein B and high-sensitive C-reactive protein).

RESULTS

Self-reported physical activity increased significantly with absolute difference in mean delta Physical Activity Index score in the IG compared to the CG: 0.90, 95% CI: 0.10 to 1.70, p = 0.028 (ANCOVA). There were no corresponding differences in cardiorespiratory fitness. The participation resulted in psychological well-being improvement in both groups with a larger increase in the IG compared to the CG. The mean difference in delta WHO-5 score was 5.06, 95% CI: 0.68 to 9.45, p = 0.024, and 3.28, 95% CI: -0.69 to 5.25, p = 0.104 when controlled for baseline values (ANCOVA). The use of antihypertensive medication increased significantly more in the CG (p = 0.044). Only minor, nonsignificant changes were observed for traditional risk factors and cardiometabolic variables.

CONCLUSIONS

Participation in the Hjerteløftet Study intervention programme resulted in an improved physical activity level, but without changing cardiorespiratory fitness. Participation in the programme also tended to improve psychological well-being, possibly related to increased physical activity, less smoking and less use of cardiovascular medication. Concerning the metabolic status, no major differences were observed, but minor changes may have been concealed by a larger increase in cardiovascular medication use in the control group.

TRIAL REGISTRATION

ClinicalTrials.gov (NCT01741428), 04/12/2012.

The effect of different high-intensity interval training protocols on cardiometabolic and inflammatory markers in sedentary young women: A randomized controlled trial

Few studies have reported the cardiovascular health effects of different high-intensity interval training (HIIT) protocols among sedentary young women. We investigated the impact of a traditional HIIT programme and a high-intensity circuit training (HICT) programme on lipid profiles and inflammatory cytokine levels in sedentary young women. Forty-two women were randomly assigned to HICT (body weight-based training), HIIT (cycling-based training), or control groups (n = 14 each). HICT and HIIT participants completed an 8-week training programme of three sessions per week. Total cholesterol (TC), triglyceride, high- and low-density lipoprotein, leptin, resistin, tumour necrosis factor-alpha (TNF-α), interleukin-8, and interferon-gamma levels were measured before and after the intervention. Post-intervention, TC and leptin were decreased in the HICT group. The HICT group also demonstrated increased lean mass, upper and lower limb strength, and balance, while the HIIT group displayed improved lower limb strength. Additionally, the control group showed significant increases in triglyceride levels, weight, body mass index, and fat mass. In conclusion, although both HICT and HIIT interventions showed improvements in cardiovascular health and physical fitness, participants in the HICT group experienced more health benefits.

Sedentary behavior and lifespan brain health

Higher levels of physical activity are known to benefit aspects of brain health across the lifespan. However, the role of sedentary behavior (SB) is less well understood. In this review we summarize and discuss evidence on the role of SB on brain health (including cognitive performance, structural or functional brain measures, and dementia risk) for different age groups, critically compare assessment approaches to capture SB, and offer insights into emerging opportunities to assess SB via digital technologies. Across the lifespan, specific characteristics of SB (particularly whether they are cognitively active or cognitively passive) potentially act as moderators influencing the associations between SB and specific brain health outcomes. We outline challenges and opportunities for future research aiming to provide more robust empirical evidence on these observations.

Association between leisure sedentary behaviors and hypertension risk: A prospective cohort study and two-sample Mendelian randomization analysis in Europeans

OBJECTIVE

This study aimed to investigate the potential causal relationship between domain-specific sedentary behaviors (including television watching, computer use, and driving) and hypertension risk in European populations.

METHODS

Initially, we conducted a multivariable Cox regression analysis to evaluate the associations between domain-specific sedentary behaviors and the risk of developing hypertension using data from 261,829 hypertension-free participants in the UK Biobank. To validate the findings of observational analysis, we employed two-sample univariable mendelian randomization (UVMR) analysis utilizing summary statistics from genome-wide association study conducted on European populations. We then performed multivariable mendelian randomization (MVMR) analysis to account for the influence of the risk factors for hypertension.

RESULTS

In this prospective observational analysis, individuals who spent >3 h per day watching television had significantly higher risk of developing hypertension (HR = 1.24, 95% CI: 1.20-1.29, P < 0.001) compared to those who watched television for 0-1 h per day. The mendelian randomization analysis provided consistent evidence for a causal relationship between prolonged television watching time and hypertension risk (OR = 1.45, 95% CI: 1.25-1.69, P < 0.001; all PMVMR < 0.05) in both UVMR and MVMR results. No significant associations were found between computer use, driving behaviors and the risk of hypertension in either the observational or UVMR/MVMR analyses.

CONCLUSIONS

These findings provide evidence for a causal effect specifically linking higher television watching time to an increased risk of hypertension and indicate the potential effectiveness of reducing television viewing time as a preventive measure to mitigate the risk of hypertension.

Association Between Typologies of Sedentary Behavior and Muscle Strength, Gait Speed, and Balance in Community-Dwelling Older Adults

Knowledge of how the different types of sedentary behaviors (SB) are associated with functional limitations can guide professionals who work with older adults on better recommendations about the amount of daily time that should be encouraged in each type of SB. The objective was to estimate the associations between two SB typologies (SB television [TV] and SB computer/internet) and the presence of handgrip strength, lower limb strength, gait speed, and balance limitations in Brazilian community-dwelling older adults. This is a cross-sectional study with 1,298 community-dwelling older adults (≥60 years). SB was assessed by self-reporting daily time spent watching TV or using computer/internet (categorized into <2, 3-4, and ≥5 hr/day). Outcomes were handgrip strength, lower limb strength, gait speed, and balance limitations considering referenced cutoff points. Older adults in SB TV ≥5 hr/day had 1.75 (95% confidence interval [CI] [1.07, 2.86]) and 1.88 (95% CI [1.02, 3.46]) times more chances of handgrip strength and gait speed limitations, respectively. On the other hand, those who spent 3-4 and ≥5 hr/day in SB computer/internet had 0.45 (95% CI [0.20, 0.99]) and 0.37 (95% CI [0.15, 0.93]) had less chances of lower limb strength and balance limitations, respectively. In conclusion, functional limitations would be associated differently depending on the type of SB in the older adults sampled.

Association between Sitting Time and Urinary Incontinence in the US population: Data from the National Health and Nutrition Examination Survey (NHANES) 2007 to 2018

Background

Urinary incontinence (UI) is a common health problem that affects the quality of life and health of millions of people in the United States (US). We aimed to investigate the association between sitting time and UI symptoms in the US population.

Methods

A cross-sectional survey of participants aged 20 and above from the National Health and Nutrition Examination Survey 2007-2018 was performed. A self-report questionnaire that reported complete data on UI, sitting time and covariates was included. Weighted multivariable logistic and regression models were used to assess the association between sitting time and UI symptoms.

Results

A total of 22,916 participants were enrolled. Prolonged sitting time was associated with urgency UI (UUI, odds ratio [OR] = 1.2, 95% confidence interval [CI] = 1.1 to 1.3, p = 0.001). Compared with patients with sitting a time shorter than 7 hours (h), moderate recreational activity modified the association between sitting time and mixed UI in males in the fully adjusted model (OR = 2.5, 95% CI = 1.4 to 4.5, p = 0.002). A sitting time over 7 h was related to mixed UI (MUI, OR = 1.6, 95% CI = 1.1 to 2.2, p = 0.01) in males, and stress UI (SUI, OR = 0.9, 95% CI = 0.8 to 0.98, p = 0.03) in females. However, no significant difference was found among the UI, SUI, and MUI groups in fully adjusted model.

Conclusions

A prolonged sitting time (≥7 h) was associated with UUI symptoms in all populations, SUI symptoms in females and MUI symptoms in males compared with sitting time lower than 7 h. Compared with those sit shorter than 7 h, moderate recreational activity may be a modifier between prolonged sitting and MUI symptoms in male participants, which warrants further studies for confirmation.

Accumulating Sedentary Time and Physical Activity From Childhood to Adolescence and Cardiac Function in Adolescence

BACKGROUND

Increased physical activity (PA) may mitigate the negative cardiovascular health effects of sedentary behavior in adolescents. However, the relationship of PA and sedentary time from childhood with cardiac function in adolescence remains underexplored. Therefore, we investigated the associations of cumulative sedentary time and PA from childhood to adolescence with cardiac function in adolescence.

METHODS AND RESULTS

Participants were 153 adolescents (69 girls) who were aged 6 to 8 years at baseline, 8 to 10 years at 2-year follow-up, and 15 to 17 years at 8-year follow-up. Cumulative sedentary time and PA exposure between baseline and 2-year follow-up and between baseline and 8-year follow-up were measured using a combined accelerometer and heart rate monitor. Cardiac function was assessed using impedance cardiography at 8-year follow-up. The data were analyzed using linear regression analyses adjusted for age and sex. Cumulative moderate to vigorous PA (standardized regression coefficient [β]=-0.323 [95% CI, -0.527 to -0.119]) and vigorous PA (β=-0.295 [95% CI, -0.508 to -0.083]) from baseline to 8-year follow-up were inversely associated with cardiac work at 8-year follow-up. Conversely, cumulative sedentary time had a positive association (β=0.245 [95% CI, 0.092-0.398]). Cumulative vigorous PA from baseline to 8-year follow-up was inversely associated with cardiac work index at 8-year follow-up (β=-0.218 [95% CI, -0.436 to 0.000]).

CONCLUSIONS

Higher levels of sedentary time and lower levels of PA during childhood were associated with higher cardiac work in adolescence, highlighting the importance of increasing PA and reducing sedentary time from childhood.

Associations Between Patterns of Daily Stepping Behavior, Health-Related Quality of Life, and Pain Symptoms Among Older Adults with Chronic Pain: A Secondary Analysis of Two Randomized Controlled Trials

Purpose

One's amount, intensity, and distribution of physical activity may have implications for whether it has positive or negative effects on pain and quality of life for older adults living with chronic pain. Thus, we investigated baseline patterns of stepping related to pain symptoms and health-related quality of life at baseline and over a 12-week follow-up period.

Patients and Methods

Participants were low-active older adults (69.54±6.74 years) with obesity and chronic pain who enrolled in one of two randomized controlled trials. Participants completed measures of pain intensity, interference, and health-related quality of life and wore an accelerometer for 7 days at baseline and week 12. Functional principal components analysis identified patterns of within-day stepping behavior at baseline, and linear regressions were used to investigate how these component scores related to pain and health-related quality of life at baseline and over 12 weeks.

Results

Two patterns were extracted; one describing more vs less stepping and the second capturing movement later vs earlier in the day. More baseline stepping was associated with better physical functioning (B=0.148, p<0.001) and energy (B=0.073, p=0.033), while a later start in the day was associated with worse social functioning (B=-0.193, p=0.031). More stepping at baseline predicted positive changes in physical functioning (B=0.094, p=0.019), emotional role limitations (B=0.132, p=0.049), energy (B=0.112, p<0.001), social functioning (B=0.086, p=0.043), pain (B=0.086, p=0.009), general health (B=0.081, p=0.003) and pain intensity (B=-0.039, p=0.003). A later start to the day was associated with worsening physical functioning (B=-0.229, p<0.001), physical (B=-0.282, p=0.047) and emotional role limitations (B=-0.254, p=0.048), general health (B=-0.108, p=0.041), and pain interference (B=0.055, p=0.043).

Conclusion

Findings suggest there is value in activity patterns as an indicator for additional behavioral intervention, as those who move little and/or delay daily movement are likely to experience subsequent decrements in quality of life and pain symptoms.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Sitting leg vasculopathy: potential adaptations beyond the endothelium

Increased sitting time, the most common form of sedentary behavior, is an independent risk factor for all-cause and cardiovascular disease mortality; however, the mechanisms linking sitting to cardiovascular risk remain largely elusive. Studies over the last decade have led to the concept that excessive time spent in the sitting position and the ensuing reduction in leg blood flow-induced shear stress cause endothelial dysfunction. This conclusion has been mainly supported by studies using flow-mediated dilation in the lower extremities as the measured outcome. In this review, we summarize evidence from classic studies and more recent ones that collectively support the notion that prolonged sitting-induced leg vascular dysfunction is likely also attributable to changes occurring in vascular smooth muscle cells (VSMCs). Indeed, we provide evidence that prolonged constriction of resistance arteries can lead to modifications in the structural characteristics of the vascular wall, including polymerization of actin filaments in VSMCs and inward remodeling, and that these changes manifest in a time frame that is consistent with the vascular changes observed with prolonged sitting. We expect this review will stimulate future studies with a focus on VSMC cytoskeletal remodeling as a potential target to prevent the detrimental vascular ramifications of too much sitting.

Is low-volume high-intensity interval training a time-efficient strategy to improve cardiometabolic health and body composition? A meta-analysis

The present meta-analysis aimed to assess the effects of low-volume high-intensity interval training (LV-HIIT; i.e., ≤5 min high-intensity exercise within a ≤15 min session) on cardiometabolic health and body composition. A systematic search was performed in accordance with PRISMA guidelines to assess the effect of LV-HIIT on cardiometabolic health and body composition. Twenty-one studies (moderate to high quality) with a total of 849 participants were included in this meta-analysis. LV-HIIT increased cardiorespiratory fitness (CRF, SMD = 1.19 [0.87, 1.50]) while lowering systolic blood pressure (SMD = -1.44 [-1.68, -1.20]), diastolic blood pressure (SMD = -1.51 [-1.75, -1.27]), mean arterial pressure (SMD = -1.55 [-1.80, -1.30]), MetS z-score (SMD = -0.76 [-1.02, -0.49]), fat mass (kg) (SMD = -0.22 [-0.44, 0.00]), fat mass (%) (SMD = -0.22 [-0.41, -0.02]), and waist circumference (SMD = -0.53 [-0.75, -0.31]) compared to untrained control (CONTROL). Despite a total time-commitment of LV-HIIT of only 14%-47% and 45%-94% compared to moderate-intensity continuous training and HV-HIIT, respectively, there were no statistically significant differences observed for any outcomes in comparisons between LV-HIIT and moderate-intensity continuous training (MICT) or high-volume HIIT. Significant inverse dose-responses were observed between the change in CRF with LV-HIIT and sprint repetitions (β = -0.52 [-0.76, -0.28]), high-intensity duration (β = -0.21 [-0.39, -0.02]), and total duration (β = -0.19 [-0.36, -0.02]), while higher intensity significantly improved CRF gains. LV-HIIT can improve cardiometabolic health and body composition and represent a time-efficient alternative to MICT and HV-HIIT. Performing LV-HIIT at a higher intensity drives higher CRF gains. More repetitions, longer time at high intensity, and total session duration did not augment gains in CRF.

Behavioural patterns of university students during the COVID-19 pandemic: A cross-sectional study of the effects of active transportation, uninterrupted sitting time, and screen use on physical activity and sitting time

Background

The closure of universities due to the coronavirus disease 2019 (COVID-19) pandemic may alter the behaviour of students. This study aimed to determine the effect of active transportation duration, uninterrupted sitting time, and screen time to study on physical activity and sitting time during the lockdown.

Methods

This was a cross-sectional study based on data collected via an online questionnaire for university students during the second confinement in France (between October and December 2020). Participants (N=2873) completed the International Physical Activity Questionnaire, which assessed physical activity and sedentary behaviour, and contained questions about modes of transport, and perception of uninterrupted sitting time and screen time to study prior to confinement and during confinement. Multiple regression models assessed how time duration of active transportation, uninterrupted sitting time, and screen time studying increased or reduced confinement effects on physical activity and sitting time.

Results

The regression models showed that physical activity decreased during confinement for students who engaged in more prolonged periods of active transportation prior to confinement. Moreover, the perception of long, uninterrupted sitting time and high screen time prior to confinement significantly increased sitting time during confinement. Students who adopted the most active transport time prior to confinement were the least likely to increase their screen time during confinement.

Conclusions

Confinement reduced physical activity levels and increased sitting time, mainly among students who adopted active transport and accumulated longer uninterrupted sitting time prior to confinement. Students who combined-long periods of uninterrupted sitting time with high screen use could be a riskier profile for health. Analysis of physical activity time and sitting position should include its accumulation patterns.

Effects of physical activity and sedentary behaviors on cardiovascular disease and the risk of all-cause mortality in overweight or obese middle-aged and older adults

Aim

The aim of this study was to respectively explore the relationships between physical activity and sedentary behaviors and cardiovascular disease (CVD) and all-cause mortality risk in overweight/obese middle-aged and older patients, and also assess the interaction between physical activity and sedentary behaviors.

Methods

Data of middle-aged and older adults with body mass index (BMI) ≥25 kg/m2 were extracted from the National Health and Nutrition Examination Surveys (NHANES) database in 2007-2018 in this retrospective cohort study. Weighted univariate and multivariate logistic regression analyses were used to explore the associations between physical activity and sedentary behaviors and CVDs; weighted univariate and multivariate Cox regression analyses were used to explore the relationships between physical activity and sedentary behaviors with the risk of all-cause mortality. The interaction effect between physical activity and sedentary behaviors on CVD and all-cause mortality was also assessed. We further explored this interaction effect in subgroups of age and BMI. The evaluation indexes were odds ratios (ORs), hazard ratios (HRs), and 95% confidence intervals (CIs).

Results

Among 13,699 eligible patients, 1,947 had CVD, and 1,560 died from all-cause mortality. After adjusting for covariates, patients who had high sedentary time seemed to have both high odds of CVD [OR = 1.24, 95% CI: (1.06-1.44)] and a high risk of all-cause mortality [HR = 1.20, 95% CI: (1.06-1.37)]. Furthermore, being insufficiently active was linked to high odds of CVD [OR = 1.24, 95% CI: (1.05-1.46)] as well as a high risk of all-cause mortality [HR = 1.32, 95% CI: (1.15-1.51)]. High sedentary time and being insufficiently active had an interaction effect on both high odds of CVD [OR = 1.44, 95% CI: (1.20-1.73)] and high risk of all-cause mortality [HR = 1.48, 95% CI: (1.24-1.76)]. Individuals of different ages with/without obesity need to focus on the potential CVD/mortality risk of high sedentary time and low physical activity (all P < 0.05).

Conclusion

Reducing sedentary time combined with increasing physical activity may benefit health by reducing both the risk of CVD and all-cause mortality in overweight or obese middle-aged and older adults.