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McAlister KL, Zink J, Huh J, Yang CH, Dunton GF, Dieli-Conwright CM, Page KA, Belcher BR. Perceived stress and associations between physical activity, sedentary time, and interstitial glucose in healthy adolescents. Physiol Behav 2024; 283:114617. [PMID: 38889810 PMCID: PMC11246823 DOI: 10.1016/j.physbeh.2024.114617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 05/09/2024] [Accepted: 06/15/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Less moderate to vigorous physical activity (MVPA), more sedentary time (ST), and higher perceived stress are related to type 2 diabetes mellitus (T2DM) occurrence, but observational evidence addressing the interaction of these factors is lacking in youth. This pilot study investigated momentary stress as a moderator in the acute associations of MVPA and ST with subsequent glucose in healthy adolescents. METHODS Participants (N=15, Mage=13.1±1.0 years, 10 girls, 5 with overweight/obesity) simultaneously wore a continuous glucose monitor (CGM), thigh-mounted accelerometer, and reported momentary stress via random ecological momentary assessments (EMA; Time T) for 7-14 days. MVPA and ST (min) were calculated for 60- and 120-minute time windows before each EMA prompt (Time T-1). Mean CGM-measured interstitial glucose (mg/dL) was calculated after each prompt (Mmin=120.0±25.4; Time T+1). Multilevel models assessed whether within-subject MVPA and ST (Time T-1) predicted mean glucose (Time T+1), with momentary stress as a moderator (Time T). RESULTS There were 513 time-matched EMA reports of stress, accelerometer, and CGM data. Momentary stress moderated the effects of MVPA 60 (β=-0.22, p=.001) and 120 min (β=-0.08, p=.02) before the prompt on subsequent glucose levels. When youth spent more time in MVPA than their average and when momentary stress was higher than their average, subsequent glucose was lower. Stress did not moderate associations of ST with glucose (p>.05). CONCLUSIONS Higher momentary stress may interact with higher MVPA to lower subsequent glucose in youth. Accelerometers, EMA, and CGMs can be integrated in future studies to further understand these associations in free-living environments.
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Affiliation(s)
- Kelsey L McAlister
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Jennifer Zink
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Jimi Huh
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Chih-Hsiang Yang
- Department of Exercise Science/TecHealth, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Psychology, Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, CA, USA
| | - Christina M Dieli-Conwright
- Department of Medical Oncology, Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Kathleen A Page
- Department of Medicine, Division of Endocrinology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Diabetes and Obesity Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Britni R Belcher
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Hopkins J, McVeigh JA, Hill KD, Burton E. Physical Activity Levels and Sedentary Behavior of People Living With Mild Cognitive Impairment: A Cross-Sectional Study Using Thigh-Worn Accelerometers. J Aging Phys Act 2024; 32:520-530. [PMID: 38684211 DOI: 10.1123/japa.2023-0176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 11/29/2023] [Accepted: 02/17/2024] [Indexed: 05/02/2024]
Abstract
Community-dwelling people with Mild Cognitive Impairment self-reporting not to be meeting recommended physical activity levels participated in this study to (a) determine compliance of wearing (thigh-worn) accelerometers, (b) describe physical activity levels and sedentary behavior, and (c) determine the validity of the Physical Activity Scale for the Elderly (PASE) compared with activPAL accelerometers. A total of 79 people had valid accelerometer data (median [interquartile range]: age, 71 [54-75] years). Compliance was 86.81%. Participants were sedentary for 10.6 hr per day and engaged in a median of 9 min per day of moderate-intensity physical activity. Fair correlations were found between the PASE and total stepping time per day (r = .35, p < .01), total number of steps per day (r = .36, p < .01), and number of steps in stepping activities completed for ≤1 min (r = .42, p < .01). The PASE and Standing time (r = .04, p = .724) and PASE and Sitting time (r = .04, p = .699) had little to no relationship. The use of thigh-worn accelerometers for this population is achievable. People with Mild Cognitive Impairment have high levels of sedentary behavior and minimal engagement in moderate-intensity physical activity. The PASE has fair, positive criterion validity with activity-based outcomes measured by activPAL accelerometers but not with sedentary behavior, which is high for this population.
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Affiliation(s)
- Jane Hopkins
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Joanne A McVeigh
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
- Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, Johannesburg, South Africa
- enAble Institute, Curtin University, Perth, WA, Australia
| | - Keith D Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research Center, Monash University, Frankston, VIC, Australia
- National Center for Healthy Ageing, Monash University and Peninsula Health, Frankston, VIC, Australia
| | - Elissa Burton
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
- enAble Institute, Curtin University, Perth, WA, Australia
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Lebuf E, Van Dyck D, Van de Velde L, Beeckman M, Van Cauwenberg J, Compernolle S. Sedentary patterns and health outcomes in the oldest-old: a latent profile analysis. PeerJ 2024; 12:e17505. [PMID: 38938606 PMCID: PMC11210487 DOI: 10.7717/peerj.17505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 05/13/2024] [Indexed: 06/29/2024] Open
Abstract
Background Sedentary behavior is most prevalent among those aged 80 years and above, referred to as the oldest-old. Current literature emphasizes the significance of sedentary behavior patterns, but further evidence is required to understand how these patterns relate to specific health outcomes and to identify at-risk profiles for tailored interventions in the oldest-old. Therefore, the aim of this study was to identify profiles of adults aged 80+ years based on their sedentary patterns and health outcomes, and to examine associations between profiles and socio-demographics. Methods A cross-sectional study was conducted in Flanders (Belgium) from February 2021 to December 2022 recruiting 90 older adults (80+) through convenience sampling, employing word of mouth, social media and local service centers. Latent profile analysis identified device-based sedentary patterns and assessed their associations with physical and cognitive functioning, mental health-related quality of life (QoL), and social isolation. Associations of these profiles with socio-demographic factors were analyzed. Results Three distinct profiles were identified: (1) the 'cognitively and physically frail' profile, (2) the 'healthy' profile and (3) the 'lower mental health-related QoL' profile. Those in the 'cognitively and physically frail' profile exhibited the least favorable sedentary pattern, and had a higher likelihood of residing in a nursing home. No significant differences were found for the other socio-demographic variables, being age, sex, educational degree and family situation. Conclusions Three distinct profiles in the oldest-old population, based on cognitive and physical functioning, mental health-related QoL, and sedentary behavior patterns, were identified. Lower physical and cognitive functioning was associated with unhealthy sedentary patterns. Further research with larger samples is crucial to uncover potential links between socio-demographics and at-risk subgroups, enhancing our understanding of sedentary behavior and geriatric health outcomes in this population.
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Affiliation(s)
- Elien Lebuf
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Laura Van de Velde
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Melanie Beeckman
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | | | - Sofie Compernolle
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
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Biddle GJH, Thomas N, Edwardson CL, Clemes SA, Daley AJ. Feasibility and acceptability of general practitioners using sit-stand desks: a feasibility trial. BMJ Open 2024; 14:e084085. [PMID: 38910005 DOI: 10.1136/bmjopen-2024-084085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/25/2024] Open
Abstract
OBJECTIVES The primary aim of this study was to investigate the feasibility and acceptability of general practitioners (GPs) using sit-stand desks to facilitate standing during consultations. A further aim was to examine the views of patients about GPs standing for their consultations. DESIGN A pre-post single-group experimental trial design. SETTING General practices in England, UK. PARTICIPANTS 42 GPs (working a minimum of five clinical sessions per week) and 301 patients (aged ≥18 years). INTERVENTIONS The intervention consisted of each GP having a sit-stand desk (Opløft Sit-Stand Platform) installed in their consultation room for 4 working weeks. Sit-stand desks allow users to switch, in a few seconds, between a sitting and standing position and vice versa, by adjusting the height of the desk. MAIN OUTCOME MEASURES To test feasibility and acceptability, GPs reported their views about using sit-stand desks at work at baseline and follow-up. Sitting time and physical activity were also measured via accelerometer at baseline and follow-up. Patients who attended a consultation where their GP was standing were asked to complete an exit questionnaire about the perceived impact on the consultation. RESULTS Most GPs reported using their sit-stand desk daily (n=28, 75.7%). 16 GPs (44.4%) used their sit-stand desk during face-to-face consultations every day. Most GPs and patients did not view that GPs standing during face-to-face consultations impacted the doctor-patient relationship (GPs; 73.5%, patients; 83.7%). GPs' sitting time during work was 121 min per day lower (95% CI: -165 to -77.58) at follow-up compared with baseline. CONCLUSIONS Use of sit-stand desks is acceptable within general practice and may reduce sitting time in GPs. This may benefit GPs and help reduce sitting time in patients. TRIAL REGISTRATION NUMBER ISRCTN76982860.
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Affiliation(s)
- Gregory James Hamilton Biddle
- Diabetes Research Centre, University of Leicester, Loughborough, UK
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
| | | | - Charlotte L Edwardson
- Diabetes Research Centre, University of Leicester, Loughborough, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
| | - Stacy A Clemes
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Amanda J Daley
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Koopmans L, Spoelder M, Bongers CCWG, Eijsvogels TMH, Hopman MTE. The effect of lesser mealworm protein on exercise-induced muscle damage in active older adults: a randomized controlled trial. J Nutr Health Aging 2024; 28:100204. [PMID: 38460318 DOI: 10.1016/j.jnha.2024.100204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/23/2024] [Accepted: 02/25/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVES We compared the effect of 12 weeks lesser mealworm-based (Alphitobius diaperinus) protein supplementation to whey protein and placebo supplementation on Exercise-Induced Muscle Damage (EIMD) after long-distance walking in older adults. METHODS in this randomized controlled trial, 70 physically active older adults (>60 years) were randomly allocated to the following groups: I) lesser mealworm protein, II) whey protein or III) iso-caloric placebo. Participants received supplements 11 weeks before and 1 week during a 3-day long-distance walking challenge (30-50 km per day). Blood concentrations of creatinine kinase (CK) and lactate dehydrogenase (LDH), handgrip strength and muscle soreness were measured pre-exercise and directly after each walking bout. RESULTS Significant elevations of CK concentrations (103 [76-161] U/l to 758 [342-1104] U/l, p < 0.001) and LDH concentrations (202 [175-220] to 283 [252-339] U/l, p < 0.001) were observed following 7h45 min ± 11 min of walking exercise per day, but the magnitude of this effect did not differ among suppletion groups. Hand grip strength decreased significantly (p < 0.001) while muscle soreness increased (p = 0.002) after the first walking day compared to pre-exercise, with no group differences. CONCLUSION 12-weeks of lesser mealworm-based protein supplementation (30 g/day) does not attenuate exercise induced muscle damage in older adults following three days of prolonged walking exercise in comparison to placebo or whey protein.
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Affiliation(s)
- Lotte Koopmans
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marcia Spoelder
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Primary and Community Care, Radboud University Medical Center, Radboud, The Netherlands
| | - Coen C W G Bongers
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands; School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Thijs M H Eijsvogels
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maria T E Hopman
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands.
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Brierley ML, Chater AM, Edwardson CL, Castle EM, Hunt ER, Biddle SJ, Sisodia R, Bailey DP. The Regulate your Sitting Time (RESIT) intervention for reducing sitting time in individuals with type 2 diabetes: findings from a randomised-controlled feasibility trial. Diabetol Metab Syndr 2024; 16:87. [PMID: 38659052 PMCID: PMC11040907 DOI: 10.1186/s13098-024-01336-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/15/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Reducing and breaking up sitting is recommended for optimal management of Type 2 diabetes mellitus (T2DM). Yet, there is limited evidence of interventions targeting these outcomes in individuals with this condition. The primary aim of this study was to assess the feasibility and acceptability of delivering and evaluating a tailored online intervention to reduce and break up sitting in adults with T2DM. METHODS A mixed-methods two-arm randomised controlled feasibility trial was conducted in ambulatory adults with T2DM who were randomised 1:1 to the REgulate your SItting Time (RESIT) intervention or usual care control group. The intervention included online education, self-monitoring and prompt tools (wearable devices, smartphone apps, computer apps) and health coaching. Feasibility outcomes were recruitment, attrition, data completion rates and intervention acceptability. Measurements of device-assessed sitting (intended primary outcome for definitive trial), standing and stepping, and physical function, psychosocial health and wellbeing were taken at baseline, 3 months and 6 months. Individual semi-structured interviews were conducted at six-months (post intervention) to explore acceptability, feasibility and experiences of the trial and intervention using the Framework Method. RESULTS Seventy participants aged 55 ± 11 years were recruited. Recruitment rate (proportion of eligible participants enrolled into the study) was 67% and participant retention rate at 6 months was 93% (n = 5 withdrawals). Data completion rates for daily sitting were 100% at baseline and ranged from 83 to 91% at 3 months and 6 months. Descriptive analysis demonstrated potential for the intervention to reduce device-measured sitting, which was 30.9 ± 87.2 and 22.2 ± 82.5 min/day lower in the intervention group at 3 and 6 months, respectively, compared with baseline. In the control group, sitting was 4.4 ± 99.5 and 23.7 ± 85.2 min/day lower at 3 and 6 months, respectively. Qualitative analysis identified three themes: reasons for participating in the trial, acceptability of study procedures, and the delivery and experience of taking part in the RESIT intervention. Overall, the measurement visits and intervention were acceptable to participants. CONCLUSIONS This study demonstrated the feasibility and acceptability of the RESIT intervention and evaluation methods, supporting a future definitive trial. If RESIT is found to be clinically effective, this could lead to changes in diabetes healthcare with a focus on reducing sitting. TRIAL REGISTRATION The trial was registered with ISRCTN (number ISRCTN14832389).
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Affiliation(s)
- Marsha L Brierley
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
| | - Angel M Chater
- Institute for Sport and Physical Activity Research, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Polhill Avenue, MK41 9EA, Bedford, UK
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, WC1E 7HB, London, UK
| | - Charlotte L Edwardson
- Leicester Lifestyle and Health Research Group, Diabetes Research Centre, University of Leicester, Leicester General Hospital, LE5 4PW, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester General Hospital, LE5 4PW, Leicester, UK
| | - Ellen M Castle
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
- Physiotherapy Division, Department of Health Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, UB8 4PH, Uxbridge, UK
- Curtin School of Allied Health, School of Health Sciences, Curtin University, Western Australia, 6845, Bentley, Australia
| | - Emily R Hunt
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
| | - Stuart Jh Biddle
- Centre for Health Research, University of Southern Queensland, Springfield Central, 4300, Springfield, QLD, Australia
- Faculty of Sport & Health Sciences, University of Jyväskylä, FI-40014, Jyväskylä, Finland
| | - Rupa Sisodia
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK
| | - Daniel P Bailey
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK.
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Kingston Lane, UB8 3PH, Uxbridge, UK.
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Lally P, Kennedy F, Smith S, Beeken RJ, Buck C, Thomas C, Counsell N, Wyld L, Martin C, Williams S, Roberts A, Greenfield DM, Gath J, Potts HWW, Latimer N, Smith L, Fisher A. The feasibility and acceptability of an app-based intervention with brief behavioural support (APPROACH) to promote brisk walking in people diagnosed with breast, prostate and colorectal cancer in the UK. Cancer Med 2024; 13:e7124. [PMID: 38529687 DOI: 10.1002/cam4.7124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 03/27/2024] Open
Abstract
INTRODUCTION Increased moderate to vigorous physical activity (MVPA) can improve clinical and psychosocial outcomes for people living with and beyond cancer (LWBC). This study aimed to assess the feasibility and acceptability of trial procedures in a pilot randomised controlled trial (RCT) of a theory-driven app-based intervention with behavioural support focused on promoting brisk walking (a form of MVPA) in people LWBC (APPROACH). METHODS Participants diagnosed with breast, prostate or colorectal cancer were recruited from a single UK hospital site. Assessments at baseline and 3 months included online questionnaires, device-measured brisk walking (activPAL accelerometer) and self-reported weight and height. Participants were randomised to intervention or control (care as usual). The intervention comprised a non-cancer-specific app to promote brisk walking (National Health Service 'Active 10') augmented with print information about habit formation, a walking planner and two behavioural support telephone calls. Feasibility and acceptability of trial procedures were explored. Initial estimates for physical activity informed a power calculation for a phase III RCT. A preliminary health economics analysis was conducted. RESULTS Of those medically eligible, 369/577 (64%) were willing to answer further eligibility questions and 90/148 (61%) of those eligible were enrolled. Feasibility outcomes, including retention (97%), assessment completion rates (>86%) and app download rates in the intervention group (96%), suggest that the trial procedures are acceptable and that the intervention is feasible. The phase III RCT will require 472 participants to be randomised. As expected, the preliminary health economic analyses indicate a high level of uncertainty around the cost-effectiveness of the intervention. CONCLUSIONS This pilot study demonstrates that a large trial of the brisk walking intervention with behavioural support is both feasible and acceptable to people LWBC. The results support progression onto a confirmatory phase III trial to determine the efficacy and cost-effectiveness of the intervention.
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Affiliation(s)
- Phillippa Lally
- Department of Psychological Sciences, University of Surrey, Guildford, Surrey, UK
| | - Fiona Kennedy
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Susan Smith
- Department of Behavioural Science and Health, University College London, London, UK
| | - Rebecca J Beeken
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Caroline Buck
- Department of Behavioural Science and Health, University College London, London, UK
| | - Chloe Thomas
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Nicholas Counsell
- Cancer Research UK & Cancer Trials Centre, Cancer Institute, University College London, London, UK
| | - Lynda Wyld
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Charlene Martin
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Sarah Williams
- Department of Behavioural Science and Health, University College London, London, UK
| | - Anna Roberts
- Department of Behavioural Science and Health, University College London, London, UK
| | - Diana M Greenfield
- Sheffield Teaching Hospitals NHS FT, Weston Park Hospital, Sheffield, UK
| | - Jacqui Gath
- Independent Cancer Patients' Voice (ICPV), London, UK
| | - Henry W W Potts
- Institute of Health Informatics, University College London, London, UK
| | - Nicholas Latimer
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Lee Smith
- The Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Abi Fisher
- Department of Behavioural Science and Health, University College London, London, UK
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Mayne RS, Biddle GJH, Edwardson CL, Hart ND, Daley AJ, Heron N. The relationship between general practitioner movement behaviours with burnout and fatigue. BMC PRIMARY CARE 2024; 25:60. [PMID: 38365606 PMCID: PMC10870505 DOI: 10.1186/s12875-024-02289-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/01/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Physical inactivity is associated with feelings of burnout and fatigue, which in turn are associated with reduced performance among healthcare practitioners. This study explored movement behaviours of general practitioners (GPs) and the association between these behaviours with burnout and fatigue. METHODS GPs in Northern Ireland were asked to wear a thigh-worn accelerometer for seven days and complete validated questionnaires to assess the association between daily number of steps, time spent sitting and standing with feelings of burnout and fatigue. RESULTS Valid accelerometer data were obtained from 47 (77.0%) participants. Average workday sitting time, standing time and number of steps were 10.6 h (SD 1.5), 3.8 h (SD 1.3), and 7796 steps (SD 3116) respectively. Participants were less sedentary (8.0 h (SD 1.6)) and more active (4.7 h (SD 1.4) standing time and 12,408 steps (SD 4496)) on non-workdays. Fourteen (30.4%) participants reported burnout and sixteen (34.8%) reported severe fatigue. There were no significant associations between sitting, standing and step counts with burnout or fatigue (p > 0.05). CONCLUSION GPs were less active on workdays compared to non-workdays and exhibited high levels of sitting. Feelings of burnout and fatigue were highly prevalent, however movement behaviours were not found to be associated with burnout and fatigue. Given the increased sedentariness among GPs on workdays compared to non-workdays, GPs should consider how they can improve their movement behaviours on workdays to help optimise their wellbeing.
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Affiliation(s)
- Richard S Mayne
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
| | - Gregory J H Biddle
- School of Sport, Exercise and Health Sciences, The Centre for Lifestyle Medicine and Behaviour, Loughborough University, Loughborough, UK
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
| | - Charlotte L Edwardson
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK
| | - Nigel D Hart
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Amanda J Daley
- School of Sport, Exercise and Health Sciences, The Centre for Lifestyle Medicine and Behaviour, Loughborough University, Loughborough, UK
| | - Neil Heron
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
- School of Medicine, Keele University, David Weatherall Building, Keele, UK
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Mast IH, Bongers CCWG, Gootjes EC, de Wilt JHW, Hopman MTE, Buffart LM. Potential mechanisms underlying the effect of walking exercise on cancer-related fatigue in cancer survivors. J Cancer Surviv 2024:10.1007/s11764-024-01537-y. [PMID: 38296934 DOI: 10.1007/s11764-024-01537-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/12/2024] [Indexed: 02/02/2024]
Abstract
PURPOSE Cancer-related fatigue (CRF) is a common and debilitating long-term side effect of cancer and its treatment. While exercise has been shown to effectively reduce CRF, the underlying mechanisms are not fully clear. Therefore, the aim of this study was to explore the effects of a 4-month walking exercise program on fatigue severity and to explore potential underlying physiological, behavioral, and psychological mechanisms of action. METHODS We included 27 cancer survivors (59 ± 15 years, 37% female) with variable cancer diagnoses who were at least moderately fatigued and finished treatment between 6 and 36 months ago. This study with a quasi-experimental interrupted time-series design compared a 4-month walking intervention period with a 4-month control period. Measurements of fatigue and physiological, behavioral, and psychological factors were performed, supplemented with participants' perceptions on how exercise influenced their fatigue. RESULTS A significant and clinically relevant decrease in fatigue severity was found over time (β = - 8.1, 95% CI = - 12.1; - 4.2), but could not be attributed directly to the walking exercise intervention. Increases in muscle strength (β = - 0.07, 95% CI = - 0.12; - 0.02), physical activity (β = - 0.1, 95% CI = - 0.2; - 0.04), and sleep quality (β = 1.1, 95% CI = 0.3; 1.9), as well as decreases in muscle relaxation times (β = 0.09, 95% CI = 0.02; 0.16) and psychological distress (β = 1.1, 95% CI = 0.8; 1.3) were associated with reductions in fatigue severity. Resilience and physical well-being were perceived as most important constructs explaining the walking exercise effects on fatigue. CONCLUSION Our findings reveal potential physiological, behavioral, and psychological mechanisms underlying the multidimensional effects of exercise on fatigue severity. IMPLICATIONS FOR CANCER SURVIVORS Incorporating resistance exercise and addressing resilience and physical well-being might improve the efficacy of exercise interventions for cancer survivors.
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Affiliation(s)
- Isa Hiske Mast
- Department of Medical BioSciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Coen C W G Bongers
- Department of Medical BioSciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - Elske C Gootjes
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Johannes H W de Wilt
- Department of Oncological Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Maria T E Hopman
- Department of Medical BioSciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Laurien M Buffart
- Department of Medical BioSciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, the Netherlands.
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Drenthen LCA, de Baaij JHF, Rodwell L, van Herwaarden AE, Tack CJ, de Galan BE. Oral magnesium supplementation does not affect insulin sensitivity in people with insulin-treated type 2 diabetes and a low serum magnesium: a randomised controlled trial. Diabetologia 2024; 67:52-61. [PMID: 37922013 PMCID: PMC10709477 DOI: 10.1007/s00125-023-06029-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/30/2023] [Indexed: 11/05/2023]
Abstract
AIMS/HYPOTHESIS Hypomagnesaemia has been associated with insulin resistance and an increased risk of type 2 diabetes. Whether magnesium supplementation improves insulin sensitivity in people with type 2 diabetes and a low serum magnesium level is unknown. METHODS Using a randomised, double-blind (both participants and investigators were blinded to the participants' treatment sequences), placebo-controlled, crossover study design, we compared the effect of oral magnesium supplementation (15 mmol/day) for 6 weeks with that of matched placebo in individuals with insulin-treated type 2 diabetes (age ≥18 years, BMI 18-40 kg/m2, HbA1c <100 mmol/mol [11.3%], serum magnesium ≤0.79 mmol/l). Participants were recruited from the outpatient clinic and through advertisements. Randomisation to a treatment sequence order was done using a randomisation list. We used block randomisation and the two possible treatment sequences were evenly distributed among the trial population. The primary outcome was the mean glucose infusion rate during the final 30 min of a hyperinsulinaemic-euglycaemic clamp (i.e. M value). Secondary outcomes included variables of glucose control, insulin need, BP, lipid profile and hypomagnesaemia-related symptoms during follow-up. RESULTS We recruited 14 participants (50% women, 100% White, mean ± SD age 67±6 years, BMI 31±5 kg/m2, HbA1c 58±9 mmol/mol [7.4±0.9%]) with insulin-treated type 2 diabetes. Magnesium supplementation increased both mean ± SEM serum magnesium level (0.75±0.02 vs 0.70±0.02 mmol/l, p=0.016) and urinary magnesium excretion (magnesium/creatinine ratio, 0.23±0.02 vs 0.15±0.02, p=0.005), as compared with placebo. The M value of the glucose clamp did not differ between the magnesium and placebo study arms (4.6±0.5 vs 4.4±0.6 mg kg-1 min-1, p=0.108). During the 6 weeks of treatment, continuous glucose monitoring outcomes, HbA1c, insulin dose, lipid profile and BP also did not differ, except for a lower HDL-cholesterol concentration after magnesium compared with placebo (1.14±0.08 vs 1.20±0.09 mmol/l, p=0.026). Symptoms potentially related to hypomagnesaemia were similar for both treatment arms. CONCLUSIONS/INTERPRETATION Despite an albeit modest increase in serum magnesium concentration, oral magnesium supplementation does not improve insulin sensitivity in people with insulin-treated type 2 diabetes and low magnesium levels. TRIAL REGISTRATION EudraCT number 2021-001243-27. FUNDING This study was supported by a grant from the Dutch Diabetes Research Foundation (2017-81-014).
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Affiliation(s)
| | | | - Laura Rodwell
- Department for Health Evidence, Section Biostatistics, Radboudumc, Nijmegen, the Netherlands
| | | | - Cees J Tack
- Department of Internal Medicine, Radboudumc, Nijmegen, the Netherlands
| | - Bastiaan E de Galan
- Department of Internal Medicine, Radboudumc, Nijmegen, the Netherlands
- Department of Internal Medicine, Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
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Sonesson S, Kuster RP, Kvist J. Accelerometer-assessed physical activity patterns during the first two years after a non-surgically treated ACL injury. Phys Ther Sport 2023; 64:123-132. [PMID: 37864852 DOI: 10.1016/j.ptsp.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVES To describe physical activity patterns and analyze changes during the first two years after a non-surgically treated ACL injury, and to assess correlations between accelerometer-assessed physical activity and self-reported knee function and knee-related quality of life. DESIGN Prospective cohort study. PARTICIPANTS 128 patients (61 females, 25.2 ± 7.1 years) with acute ACL injury. MAIN OUTCOME MEASURES Physical activity patterns were measured with accelerometry. Self-reported knee function was assessed using the International Knee Documentation Committee Subjective Knee Form, and knee-related quality of life was assessed using the Anterior Cruciate Ligament Quality of Life questionnaire. RESULTS Moderate to vigorous physical activity (MVPA) and steps per day increased from baseline to 3 months (p < .001), with no further increase from 3 to 24 months (p > .05). Time in MVPA did not correlate to patient-reported outcome measures at 3, 6, 12, or 24 months (p > .05). CONCLUSIONS Physical activity increased from acute phase to 3 months after non-surgically treated ACL injury, but almost one in four patients did not reach recommended levels of physical activity. Physical activity did not correlate with knee function or quality of life. Patients may need improved support to return to physical activity after ACL injury. LEVEL OF EVIDENCE Level II. TRIAL REGISTRATION NCT02931084.
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Affiliation(s)
- Sofi Sonesson
- Department of Health, Medicine and Caring Science, Division of Physiotherapy, Linköping University, Linköping, Sweden.
| | - Roman Peter Kuster
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Huddinge, Sweden
| | - Joanna Kvist
- Department of Health, Medicine and Caring Science, Division of Physiotherapy, Linköping University, Linköping, Sweden; Stockholm Sports Trauma Research Center, FIFA Medical Centre of Excellence, Department of Molecular Medicine & Surgery, Karolinska Institute, Sweden; Center for Medical Image Science and Visualization (CMIV), Department of Health, Medicine and Caring Sciences, Linköping University, Sweden
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12
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Donnelly S, Buchan DS, McLellan G, Roberts R, Arthur R. Exploring the feasibility of a cluster pilot randomised control trial to improve children's 24-hour movement behaviours and dietary intake: Happy homework. J Sports Sci 2023; 41:1787-1800. [PMID: 38219248 DOI: 10.1080/02640414.2023.2300562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 12/21/2023] [Indexed: 01/16/2024]
Abstract
We aimed to explore the feasibility, acceptability, and potential efficacy of Happy Homework (HH); an 8-week home-focussed intervention, with the purpose of encouraging children's positive dietary behaviours and engagement in positive physical activity (PA) and sleep behaviours. We randomised four Scottish schools (n = 71 participants; 5 classrooms) to either the HH intervention (n = 2) or usual curriculum control group (n = 2). HH consisted of movement and dietary-focused parent and child tasks. Primary outcome measures were intervention feasibility, acceptability, and potential efficacy. Secondary outcomes were objectively measured PA via ActiGraph GT3X+, sedentary behaviours (SBs) and sleep duration via activPAL4™ accelerometers and dietary behaviours, fruit and vegetable consumption and screen-time via questionnaires. After controlling for pre-test levels, post intervention stepping time and sleep duration were significantly greater for the HH group in comparison to the control group. The HH group reported eating more fruit and vegetables at post-test than the control group. Participants also reported the intervention to be enjoyable and motivating. These findings provide promising evidence that given a greater sample size, better retention and the prioritisation of health and wellbeing homework, HH could enhance children's health and wellbeing.
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Affiliation(s)
- Samantha Donnelly
- School of Health and Life Science, University of the West of Scotland, South Lanarkshire, UK
| | - Duncan S Buchan
- School of Health and Life Science, University of the West of Scotland, South Lanarkshire, UK
| | - Gillian McLellan
- School of Health and Life Science, University of the West of Scotland, South Lanarkshire, UK
| | - Ross Roberts
- Institute for the Psychology of Elite Performance, School of Human and Behavioural Sciences, Bangor University, Bangor, UK
| | - Rosie Arthur
- School of Health and Life Science, University of the West of Scotland, South Lanarkshire, UK
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Perks J, Mcbride P, Rayt H, Payne T, Edwardson C, Rowlands AV, Messeder SJ, Yates T, Sayers R. Efficacy of a personalised activity plan for BREAKing UP sitting time in patients with intermittent claudication (the BREAK UP study). Diabetes Res Clin Pract 2023; 204:110925. [PMID: 37774979 DOI: 10.1016/j.diabres.2023.110925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/11/2023] [Accepted: 09/27/2023] [Indexed: 10/01/2023]
Abstract
INTRODUCTION The aim of this study was to investigate the concept of an 8-week personalised activity plan, using short periods of physical activity to break up sitting time in people with Intermittent Claudication (IC), to improve walking ability, and reduce time spent sitting. METHODS The study was designed as a single centre, single arm, before and after study and is registered with clinicaltrials.gov (NCT04572737). The co-primary outcomes are time spent sitting and walking ability measured via the walking impairment questionnaire. Normally distributed data was analysed using paired samples T-tests; non-normally distributed data was analysed using related-samples Wilcoxon signed rank tests. RESULTS There was a significant improvement in both co-primary outcomes: walking ability and time spent sitting, as well as the following secondary outcomes: total bouts and time spent in prolonged sitting, time spent standing and stepping, anxiety, depression, and activity levels reported on the vascular quality of life questionnaire. CONCLUSION An 8-week personalised activity plan to break up sitting time shows promise as a treatment for people with IC, improving walking ability and reducing time spent sitting. This study supports the use of large randomised controlled trials to further develop this treatment in people with IC.
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Affiliation(s)
- Jemma Perks
- Department of Cardiovascular Sciences, University of Leicester, On-Call Suite OC9, Glenfield General Hospital, Groby Road, Leicester LE3 9QP, UK.
| | - Philip Mcbride
- Leicester Diabetes Centre, University of Leicester, Leicester LE5 4PW, UK
| | - Harjeet Rayt
- Department of Cardiovascular Sciences, University of Leicester, On-Call Suite OC9, Glenfield General Hospital, Groby Road, Leicester LE3 9QP, UK
| | - Tanya Payne
- Department of Cardiovascular Sciences, University of Leicester, On-Call Suite OC9, Glenfield General Hospital, Groby Road, Leicester LE3 9QP, UK
| | | | - Alex V Rowlands
- Leicester Diabetes Centre, University of Leicester, Leicester LE5 4PW, UK
| | - Sarah Jane Messeder
- Department of Cardiovascular Sciences, University of Leicester, On-Call Suite OC9, Glenfield General Hospital, Groby Road, Leicester LE3 9QP, UK
| | - Thomas Yates
- Leicester Diabetes Centre, University of Leicester, Leicester LE5 4PW, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, UK
| | - Robert Sayers
- Department of Cardiovascular Sciences, University of Leicester, On-Call Suite OC9, Glenfield General Hospital, Groby Road, Leicester LE3 9QP, UK
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14
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Albers JD, Meertens RM, Savelberg HHCM, Köhler S, Wesselius A, Schram MT, Stehouwer CDA, de Galan BE, van Greevenbroek MMJ, van der Kallen CJH, Eussen SJPM, Bosma H, Schaper NC, Koster A. Both short and long sleep durations are associated with type 2 diabetes, independent from traditional lifestyle risk factors-The Maastricht Study. Sleep Health 2023; 9:733-741. [PMID: 37573207 DOI: 10.1016/j.sleh.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/17/2023] [Accepted: 06/27/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVES This study examined the cross-sectional association between sleep duration, prediabetes, and type 2 diabetes, and its independence from the traditional lifestyle risk factors diet, physical activity, smoking behavior, and alcohol consumption. METHODS Cross-sectional data from 5561 people aged 40-75 years recruited into The Maastricht Study between 2010 and 2018 were used (1:1 female:male and mean age: 60.1 years [standard deviation: 8.6]). Sleep duration was operationalized as in-bed time, algorithmically derived from activPAL3 accelerometer data (median 7 nights, IQR 1). Glucose metabolism status was determined with an oral glucose tolerance test. Multinomial logistic regression was used to assess the association of sleep duration as restricted cubic spline with prediabetes and type 2 diabetes. We adjusted for sex, age, educational level, the use of sleep medication or antidepressants, and the following lifestyle risk factors: diet quality, physical activity, smoking behavior, and alcohol consumption. RESULTS A U-shaped association between sleep duration and type 2 diabetes was found. Compared to those with a sleep duration of 8 hours, participants with a sleep duration of 5 and 12 hours had higher odds of type 2 diabetes (OR: 2.9 [95% CI 1.9 to 4.4] and OR 3.2 [2.0 to 5.2], respectively). This association remained after further adjustment for the lifestyle risk factors (OR: 2.6 [1.7 to 4.1] and OR 1.8 [1.1 to 3.1]). No such association was observed between sleep duration and prediabetes. CONCLUSIONS Both short and long sleep durations are associated positively and independently of lifestyle and cardiovascular risk factors with type 2 diabetes, but not with prediabetes.
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Affiliation(s)
- Jeroen D Albers
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
| | - Ree M Meertens
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands; Department of Health Promotion, Maastricht University, Maastricht, the Netherlands
| | - Hans H C M Savelberg
- School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands; Department of Human Movement Sciences, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands
| | - Anke Wesselius
- School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands; Department of Genetics & Cell Biology, Complex Genetics, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Miranda T Schram
- School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Bastiaan E de Galan
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marleen M J van Greevenbroek
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Carla J H van der Kallen
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Simone J P M Eussen
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Hans Bosma
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Nicolaas C Schaper
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - Annemarie Koster
- Department of Social Medicine, Maastricht University, Maastricht, the Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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Edwardson CL, Maylor BD, Biddle SJ, Clemes SA, Cox E, Davies MJ, Dunstan DW, Eborall H, Granat MH, Gray LJ, Hadjiconstantinou M, Healy GN, Jaicim NB, Lawton S, Mandalia P, Munir F, Richardson G, Walker S, Yates T, Clarke-Cornwell AM. A multicomponent intervention to reduce daily sitting time in office workers: the SMART Work & Life three-arm cluster RCT. PUBLIC HEALTH RESEARCH 2023; 11:1-229. [PMID: 37786938 DOI: 10.3310/dnyc2141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023] Open
Abstract
Background Office workers spend 70-85% of their time at work sitting. High levels of sitting have been linked to poor physiological and psychological health. Evidence shows the need for fully powered randomised controlled trials, with long-term follow-up, to test the effectiveness of interventions to reduce sitting time. Objective Our objective was to test the clinical effectiveness and cost-effectiveness of the SMART Work & Life intervention, delivered with and without a height-adjustable workstation, compared with usual practice at 12-month follow-up. Design A three-arm cluster randomised controlled trial. Setting Councils in England. Participants Office workers. Intervention SMART Work & Life is a multicomponent intervention that includes behaviour change strategies, delivered by workplace champions. Clusters were randomised to (1) the SMART Work & Life intervention, (2) the SMART Work & Life intervention with a height-adjustable workstation (i.e. SMART Work & Life plus desk) or (3) a control group (i.e. usual practice). Outcome measures were assessed at baseline and at 3 and 12 months. Main outcome measures The primary outcome was device-assessed daily sitting time compared with usual practice at 12 months. Secondary outcomes included sitting, standing, stepping time, physical activity, adiposity, blood pressure, biochemical measures, musculoskeletal issues, psychosocial variables, work-related health, diet and sleep. Cost-effectiveness and process evaluation data were collected. Results A total of 78 clusters (756 participants) were randomised [control, 26 clusters (n = 267); SMART Work & Life only, 27 clusters (n = 249); SMART Work & Life plus desk, 25 clusters (n = 240)]. At 12 months, significant differences between groups were found in daily sitting time, with participants in the SMART Work & Life-only and SMART Work & Life plus desk arms sitting 22.2 minutes per day (97.5% confidence interval -38.8 to -5.7 minutes/day; p = 0.003) and 63.7 minutes per day (97.5% confidence interval -80.0 to -47.4 minutes/day; p < 0.001), respectively, less than the control group. Participants in the SMART Work & Life plus desk arm sat 41.7 minutes per day (95% confidence interval -56.3 to -27.0 minutes/day; p < 0.001) less than participants in the SMART Work & Life-only arm. Sitting time was largely replaced by standing time, and changes in daily behaviour were driven by changes during work hours on workdays. Behaviour changes observed at 12 months were similar to 3 months. At 12 months, small improvements were seen for stress, well-being and vigour in both intervention groups, and for pain in the lower extremity and social norms in the SMART Work & Life plus desk group. Results from the process evaluation supported these findings, with participants reporting feeling more energised, alert, focused and productive. The process evaluation also showed that participants viewed the intervention positively; however, the extent of engagement varied across clusters. The average cost of SMART Work & Life only and SMART Work & Life plus desk was £80.59 and £228.31 per participant, respectively. Within trial, SMART Work & Life only had an incremental cost-effectiveness ratio of £12,091 per quality-adjusted life-year, with SMART Work & Life plus desk being dominated. Over a lifetime, SMART Work & Life only and SMART Work & Life plus desk had incremental cost-effectiveness ratios of £4985 and £13,378 per quality-adjusted life-year, respectively. Limitations The study was carried out in one sector, limiting generalisability. Conclusions The SMART Work & Life intervention, provided with and without a height-adjustable workstation, was successful in changing sitting time. Future work There is a need for longer-term follow-up, as well as follow-up within different organisations. Trial registration Current Controlled Trials ISRCTN11618007.
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Affiliation(s)
| | | | - Stuart Jh Biddle
- Centre for Health Research, University of Southern Queensland, Springfield Central, QLD, Australia
| | - Stacy A Clemes
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Edward Cox
- Centre for Health Economics, University of York, York, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Helen Eborall
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - Laura J Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | | | | | - Sarah Lawton
- School of Health & Society, University of Salford, Salford, UK
| | - Panna Mandalia
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Simon Walker
- Centre for Health Economics, University of York, York, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK
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McBride P, Henson J, Edwardson CL, Maylor B, Dempsey PC, Rowlands AV, Davies MJ, Khunti K, Yates T. Four-Year Increase in Step Cadence Is Associated with Improved Cardiometabolic Health in People with a History of Prediabetes. Med Sci Sports Exerc 2023; 55:1601-1609. [PMID: 37005498 DOI: 10.1249/mss.0000000000003180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
PURPOSE To investigate associations between 4-yr change in step cadence and markers of cardiometabolic health in people with a history of prediabetes and to explore whether these associations are modified by demographic factors. METHODS In this prospective cohort study, adults, with a history of prediabetes, were assessed for markers of cardiometabolic health (body mass index, waist circumference, high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], triglycerides, and glycated hemoglobin A1c [HbA1c]), and free-living stepping activity (activPAL3™) at baseline, 1 yr, and 4 yr. Brisk steps per day were defined as the number of steps accumulated at ≥100 steps per minute and slow steps per day as those accumulated at <100 steps per minute; the mean peak stepping cadence during the most active 10 minutes of the day was also derived. Generalized estimating equations examined associations between 4-yr change in step cadence and change in cardiometabolic risk factors, with interactions by sex and ethnicity. RESULTS Seven hundred ninety-four participants were included (age, 59.8 ± 8.9 yr; 48.7% women; 27.1% ethnic minority; total steps per day, 8445 ± 3364; brisk steps per day, 4794 ± 2865; peak 10-min step cadence, 128 ± 10 steps per minute). Beneficial associations were observed between change in brisk steps per day and change in body mass index, waist circumference, HDL-C, and HbA1c. Similar associations were found between peak 10-min step cadence and HDL-C and waist circumference. Interactions by ethnicity revealed change in brisk steps per day and change in peak 10-min step cadence had a stronger association with HbA1c in White Europeans, whereas associations between change in 10-min peak step cadence with measures of adiposity were stronger in South Asians. CONCLUSIONS Change in the number of daily steps accumulated at a brisk pace was associated with beneficial change in adiposity, HDL-C, and HbA1c; however, potential benefits may be dependent on ethnicity for outcomes related to HbA1c and adiposity.
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Nuijten MAH, Eijsvogels TMH, Sanders B, Vriese LM, Monpellier VM, Hazebroek EJ, Janssen IMC, Hopman MTE. Changes in Fat-Free Mass, Protein Intake and Habitual Physical Activity Following Roux-en-Y Gastric Bypass Surgery: A Prospective Study. Obes Surg 2023; 33:2148-2157. [PMID: 37249699 PMCID: PMC10228447 DOI: 10.1007/s11695-023-06650-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/05/2023] [Accepted: 05/12/2023] [Indexed: 05/31/2023]
Abstract
PURPOSE Large inter-individual variations in post-bariatric fat-free mass loss (FFML) are observed, which might relate to differences in protein intake and physical activity across patients. We performed repetitive assessments of protein intake and physical activity before and after banded Roux-en-Y gastric bypass surgery, and examined its relations to FFML during 6 months of follow-up. MATERIALS AND METHODS FFML (bio-impedance analyses), protein intake (24-h dietary recalls) and moderate-to-vigorous physical activity (MVPA; activPAL) were assessed in 28 patients (4 males, age 42 ± 12 years) before surgery and at 1-, 3- and 6-months post-surgery. Changes in protein intake and MVPA were evaluated with mixed model analysis, whereas associations with FFML were assessed by univariate regression analysis. RESULTS Six-month FFML was -7.3 ± 3.6 kg. Protein intake decreased from 80 ± 29 g/day (pre-surgery) to 45 ± 26 g/day (1 month post-surgery (P < 0.001)) and did not improve thereafter (51 ± 21 g/day; P > 0.05). Seven participants (25%) consumed ≥ 60 g protein/day at 6 months post-surgery. Participants performed 7394 ± 2420 steps/day in 54 ± 20 min/day of MVPA, which did not change from pre- to post-surgery (P > 0.05). A higher step count (B = -0.002; 95%CI = [-0.004 - 0.000]; P = 0.048) and higher level of MVPA (B = -0.29; 95%CI = [-0.54 - -0.03]; P = 0.018) were related to a lower FFML. CONCLUSION A lower post-surgery FFML was attributable to higher MVPA levels but not protein intake. This may be due to the low total protein intake and the observation that only a minority of patients achieved a protein intake ≥ 60 g/day. Future studies should focus on interventions to increase post-bariatric protein intake and MVPA levels.
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Affiliation(s)
- Malou A H Nuijten
- Department of Medical BioSciences (Route 928), Radboud University Medical Center, P.O. Box 1901, 6500 HB, Nijmegen, The Netherlands
- Nederlandse Obesitas Kliniek, Huis Ter Heide, The Netherlands
| | - Thijs M H Eijsvogels
- Department of Medical BioSciences (Route 928), Radboud University Medical Center, P.O. Box 1901, 6500 HB, Nijmegen, The Netherlands
| | - Boy Sanders
- Nederlandse Obesitas Kliniek, Huis Ter Heide, The Netherlands
| | - Laura M Vriese
- Department of Medical BioSciences (Route 928), Radboud University Medical Center, P.O. Box 1901, 6500 HB, Nijmegen, The Netherlands
| | | | - Eric J Hazebroek
- Department of Surgery, Rijnstate Hospital/Vitalys Clinics, Arnhem, The Netherlands
| | | | - Maria T E Hopman
- Department of Medical BioSciences (Route 928), Radboud University Medical Center, P.O. Box 1901, 6500 HB, Nijmegen, The Netherlands.
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van Bakel BMA, de Koning IA, Bakker EA, Pop GAM, Cramer E, van Geuns RM, Thijssen DHJ, Eijsvogels TMH. Rapid Improvements in Physical Activity and Sedentary Behavior in Patients With Acute Myocardial Infarction Immediately Following Hospital Discharge. J Am Heart Assoc 2023; 12:e028700. [PMID: 37158085 PMCID: PMC10227295 DOI: 10.1161/jaha.122.028700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 03/28/2023] [Indexed: 05/10/2023]
Abstract
Background Little is known about changes in physical activity (PA) and sedentary behavior (SB) patterns in the acute phase of a myocardial infarction (MI). We objectively assessed PA and SB during hospitalization and the first week after discharge. Methods and Results Consecutively admitted patients hospitalized with an MI were approached to participate in this prospective cohort study. SB, light-intensity PA, and moderate-vigorous intensity PA were objectively assessed for 24 h/d during hospitalization and up to 7 days after discharge in 165 patients. Changes in PA and SB from the hospital to home phase were evaluated using mixed-model analyses, and outcomes were stratified for predefined subgroups based on patient characteristics. Patients (78% men) were aged 65±10 years and diagnosed with ST-segment-elevation MI (50%) or non-ST-segment-elevation MI (50%). Sedentary time was high during hospitalization (12.6 [95% CI, 11.8-13.7] h/d) but substantially decreased following transition to the home environment (-1.8 [95% CI, -2.4 to -1.3] h/d). Furthermore, the number of prolonged sedentary bouts (≥60 minutes) decreased between hospital and home (-1.6 [95% CI, -2.0 to -1.2] bouts/day). Light-intensity PA (1.1 [95% CI, 0.8-1.6] h/d) and moderate-vigorous intensity PA (0.2 [95% CI, 0.1-0.3] h/d) were low during hospitalization but significantly increased following transition to the home environment (light-intensity PA: 1.8 [95% CI, 1.4-2.3] h/d; moderate-vigorous intensity PA: 0.4 [95% CI, 0.3-0.5] h/d; both P<0.001). Improvements in PA and SB were similar across groups, except for patients who underwent coronary artery bypass grafting and who did not improve their PA patterns after discharge. Conclusions Patients with MI demonstrate high levels of SB and low PA volumes during hospitalization, which immediately improved following discharge at the patient's home environment. Registration URL: trialsearch.who.int/; Unique identifier: NTR7646.
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Affiliation(s)
- Bram M. A. van Bakel
- Department of PhysiologyRadboud University Medical Center, Radboud Institute for Health SciencesNijmegenthe Netherlands
| | - Iris A. de Koning
- Department of PhysiologyRadboud University Medical Center, Radboud Institute for Health SciencesNijmegenthe Netherlands
| | - Esmée A. Bakker
- Department of PhysiologyRadboud University Medical Center, Radboud Institute for Health SciencesNijmegenthe Netherlands
| | - Gheorghe A. M. Pop
- Department of Cardiology, Radboud University Medical CenterRadboud Institute for Health SciencesNijmegenthe Netherlands
| | - Etienne Cramer
- Department of Cardiology, Radboud University Medical CenterRadboud Institute for Health SciencesNijmegenthe Netherlands
| | - Robert‐Jan M. van Geuns
- Department of Cardiology, Radboud University Medical CenterRadboud Institute for Health SciencesNijmegenthe Netherlands
| | - Dick H. J. Thijssen
- Department of PhysiologyRadboud University Medical Center, Radboud Institute for Health SciencesNijmegenthe Netherlands
- Research Institute for Sports and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
| | - Thijs M. H. Eijsvogels
- Department of PhysiologyRadboud University Medical Center, Radboud Institute for Health SciencesNijmegenthe Netherlands
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19
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Johansson PJ, Crowley P, Axelsson J, Franklin K, Garde AH, Hettiarachchi P, Holtermann A, Kecklund G, Lindberg E, Ljunggren M, Stamatakis E, Theorell Haglöw J, Svartengren M. Development and performance of a sleep estimation algorithm using a single accelerometer placed on the thigh: an evaluation against polysomnography. J Sleep Res 2023; 32:e13725. [PMID: 36167935 PMCID: PMC10909528 DOI: 10.1111/jsr.13725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 01/04/2023]
Abstract
Accelerometers placed on the thigh provide accurate measures of daily physical activity types, postures and sedentary behaviours, over 24 h and across consecutive days. However, the ability to estimate sleep duration or quality from thigh-worn accelerometers is uncertain and has not been evaluated in comparison with the 'gold-standard' measurement of sleep polysomnography. This study aimed to develop an algorithm for sleep estimation using the raw data from a thigh-worn accelerometer and to evaluate it in comparison with polysomnography. The algorithm was developed and optimised on a dataset consisting of 23 single-night polysomnography recordings, collected in a laboratory, from 15 asymptomatic adults. This optimised algorithm was then applied to a separate evaluation dataset, in which, 71 adult males (mean [SD] age 57 [11] years, height 181 [6] cm, weight 82 [13] kg) wore ambulatory polysomnography equipment and a thigh-worn accelerometer, simultaneously, whilst sleeping at home. Compared with polysomnography, the algorithm had a sensitivity of 0.84 and a specificity of 0.55 when estimating sleep periods. Sleep intervals were underestimated by 21 min (130 min, Limits of Agreement Range [LoAR]). Total sleep time was underestimated by 32 min (233 min LoAR). Our results evaluate the performance of a new algorithm for estimating sleep and outline the limitations. Based on these results, we conclude that a single device can provide estimates of the sleep interval and total sleep time with sufficient accuracy for the measurement of daily physical activity, sedentary behaviour, and sleep, on a group level in free-living settings.
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Affiliation(s)
- Peter J. Johansson
- Department of Medical Sciences, Occupational and Environmental MedicineUppsala University, Uppsala University HospitalUppsalaSweden
| | - Patrick Crowley
- The National Research Centre for the Working EnvironmentCopenhagenDenmark
| | - John Axelsson
- Department of Psychology, Department of Clinical NeuroscienceStress Research Institute, Karolinska Institutet, Stockholm UniversityStockholmSweden
| | - Karl Franklin
- Department of Surgical and Perioperative Sciences, SurgeryUmeå UniversityUmeåSweden
| | - Anne Helene Garde
- The National Research Centre for the Working EnvironmentCopenhagenDenmark
| | - Pasan Hettiarachchi
- Department of Medical Sciences, Occupational and Environmental MedicineUppsala University, Uppsala University HospitalUppsalaSweden
| | - Andreas Holtermann
- The National Research Centre for the Working EnvironmentCopenhagenDenmark
| | - Göran Kecklund
- Department of Psychology, Department of Clinical NeuroscienceStress Research Institute, Karolinska Institutet, Stockholm UniversityStockholmSweden
| | - Eva Lindberg
- Department of Medical Sciences, Occupational and Environmental MedicineUppsala University, Uppsala University HospitalUppsalaSweden
| | - Mirjam Ljunggren
- Department of Medical Sciences, Occupational and Environmental MedicineUppsala University, Uppsala University HospitalUppsalaSweden
| | - Emmanuel Stamatakis
- Charles Perkins Centre, Faculty of Medicine and Health, School of Health SciencesUniversity of SydneySydneyAustralia
| | - Jenny Theorell Haglöw
- Department of Medical Sciences, Occupational and Environmental MedicineUppsala University, Uppsala University HospitalUppsalaSweden
| | - Magnus Svartengren
- Department of Medical Sciences, Occupational and Environmental MedicineUppsala University, Uppsala University HospitalUppsalaSweden
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20
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Wanders L, Gijbels A, Bakker EA, Trouwborst I, Jardon KM, Manusama KCM, Hul GB, Feskens EJM, Afman LA, Blaak EE, Hopman MTE, Goossens GH, Thijssen DHJ. Physical activity and sedentary behavior show distinct associations with tissue-specific insulin sensitivity in adults with overweight. Acta Physiol (Oxf) 2023; 237:e13945. [PMID: 36745002 DOI: 10.1111/apha.13945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 01/21/2023] [Accepted: 02/02/2023] [Indexed: 02/07/2023]
Abstract
AIM The aim of this study is to investigate associations between the physical activity (PA) spectrum (sedentary behavior to exercise) and tissue-specific insulin resistance (IR). METHODS We included 219 participants for analysis (median [IQR]: 61 [55; 67] years, BMI 29.6 [26.9; 32.0] kg/m2 ; 60% female) with predominant muscle or liver IR, as determined using a 7-point oral glucose tolerance test (OGTT). PA and sedentary behavior were measured objectively (ActivPAL) across 7 days. Context-specific PA was assessed with the Baecke questionnaire. Multiple linear regression models (adjustments include age, sex, BMI, site, season, retirement, and dietary intake) were used to determine associations between the PA spectrum and hepatic insulin resistance index (HIRI), muscle insulin sensitivity index (MISI) and whole-body IR (HOMA-IR, Matsuda index). RESULTS In fully adjusted models, objectively measured total PA (standardized regression coefficient β = 0.17, p = 0.020), light-intensity PA (β = 0.15, p = 0.045) and moderate-to-vigorous intensity PA (β = 0.13, p = 0.048) were independently associated with Matsuda index, but not HOMA-IR (p > 0.05). A higher questionnaire-derived sport index and leisure index were associated with significantly lower whole-body IR (Matsuda, HOMA-IR) in men but not in women. Results varied across tissues: more time spent sedentary (β = -0.24, p = 0.045) and a higher leisure index (β = 0.14, p = 0.034) were respectively negatively and positively associated with MISI, but not HIRI. A higher sport index was associated with lower HIRI (β = -0.30, p = 0.007, in men only). CONCLUSION While we confirm a beneficial association between PA and whole-body IR, our findings indicate that associations between the PA spectrum and IR seem distinct depending on the primary site of insulin resistance (muscle or liver).
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Affiliation(s)
- Lisa Wanders
- Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Nijmegen, the Netherlands
- TiFN, Wageningen, the Netherlands
| | - Anouk Gijbels
- TiFN, Wageningen, the Netherlands
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Esmée A Bakker
- Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Nijmegen, the Netherlands
| | - Inez Trouwborst
- TiFN, Wageningen, the Netherlands
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Kelly M Jardon
- TiFN, Wageningen, the Netherlands
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Koen C M Manusama
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Gabby B Hul
- TiFN, Wageningen, the Netherlands
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Edith J M Feskens
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Lydia A Afman
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Ellen E Blaak
- TiFN, Wageningen, the Netherlands
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Maria T E Hopman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Nijmegen, the Netherlands
| | - Gijs H Goossens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Dick H J Thijssen
- Radboud Institute for Health Sciences, Department of Physiology, Radboud university medical center, Nijmegen, the Netherlands
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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21
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Yates T, Henson J, McBride P, Maylor B, Herring LY, Sargeant JA, Davies MJ, Dempsey PC, Rowlands AV, Edwardson CL. Moderate-intensity stepping in older adults: insights from treadmill walking and daily living. Int J Behav Nutr Phys Act 2023; 20:31. [PMID: 36934275 PMCID: PMC10024004 DOI: 10.1186/s12966-023-01429-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 02/26/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND A step cadence of 100 steps/minute is widely used to define moderate-intensity walking. However, the generalizability of this threshold to different populations needs further research. We investigate moderate-intensity step cadence values during treadmill walking and daily living in older adults. METHODS Older adults (≥ 60 years) were recruited from urban community venues. Data collection included 7 days of physical activity measured by an activPAL3™ thigh worn device, followed by a laboratory visit involving a 60-min assessment of resting metabolic rate, then a treadmill assessment with expired gas measured using a breath-by-breath analyser and steps measured by an activPAL3™. Treadmill stages were undertaken in a random order and lasted 5 min each at speeds of 1, 2, 3, 4 and 5 km/h. Metabolic equivalent values were determined for each stage as standardised values (METSstandard) and as multiples of resting metabolic rate (METSrelative). A value of 3 METSstandard defined moderate-intensity stepping. Segmented generalised estimating equations modelled the association between step cadence and MET values. RESULTS The study included 53 participants (median age = 75, years, BMI = 28.0 kg/m2, 45.3% women). At 2 km/h, the median METSstandard and METSrelative values were above 3 with a median cadence of 81.00 (IQR 72.00, 88.67) steps/minute. The predicted cadence at 3 METSstandard was 70.3 (95% CI 61.4, 75.8) steps/minute. During free-living, participants undertook median (IQR) of 6988 (5933, 9211) steps/day, of which 2554 (1297, 4456) steps/day were undertaken in continuous stepping bouts lasting ≥ 1 min. For bouted daily steps, 96.4% (90.7%, 98.9%) were undertaken at ≥ 70 steps/minute. CONCLUSION A threshold as low as 70 steps/minute may be reflective of moderate-intensity stepping in older adults, with the vast majority of all bouted free-living stepping occurring above this threshold.
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Affiliation(s)
- T Yates
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK.
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, UK.
| | - J Henson
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, UK
| | - P McBride
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, UK
| | - B Maylor
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, UK
| | - L Y Herring
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, UK
- Leicester Diabetes Centre, University Hospitals of Leicester National Health Service Trust, Leicester, UK
| | - J A Sargeant
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, UK
- Leicester Diabetes Centre, University Hospitals of Leicester National Health Service Trust, Leicester, UK
| | - M J Davies
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, UK
| | - P C Dempsey
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, UK
| | - A V Rowlands
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, UK
| | - C L Edwardson
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, UK
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22
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van Bakel BMA, Kroesen SH, Bakker EA, van Miltenburg RV, Günal A, Scheepmaker A, Aengevaeren WRM, Willems FF, Wondergem R, Pisters MF, de Bruin M, Hopman MTE, Thijssen DHJ, Eijsvogels TMH. Effectiveness of an intervention to reduce sedentary behaviour as a personalised secondary prevention strategy for patients with coronary artery disease: main outcomes of the SIT LESS randomised clinical trial. Int J Behav Nutr Phys Act 2023; 20:17. [PMID: 36788615 PMCID: PMC9927064 DOI: 10.1186/s12966-023-01419-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/26/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND A high sedentary time is associated with increased mortality risk. Previous studies indicate that replacement of sedentary time with light- and moderate-to-vigorous physical activity attenuates the risk for adverse outcomes and improves cardiovascular risk factors. Patients with cardiovascular disease are more sedentary compared to the general population, while daily time spent sedentary remains high following contemporary cardiac rehabilitation programmes. This clinical trial investigated the effectiveness of a sedentary behaviour intervention as a personalised secondary prevention strategy (SIT LESS) on changes in sedentary time among patients with coronary artery disease participating in cardiac rehabilitation. METHODS Patients were randomised to usual care (n = 104) or SIT LESS (n = 108). Both groups received a comprehensive 12-week centre-based cardiac rehabilitation programme with face-to-face consultations and supervised exercise sessions, whereas SIT LESS participants additionally received a 12-week, nurse-delivered, hybrid behaviour change intervention in combination with a pocket-worn activity tracker connected to a smartphone application to continuously monitor sedentary time. Primary outcome was the change in device-based sedentary time between pre- to post-rehabilitation. Changes in sedentary time characteristics (prevalence of prolonged sedentary bouts and proportion of patients with sedentary time ≥ 9.5 h/day); time spent in light-intensity and moderate-to-vigorous physical activity; step count; quality of life; competencies for self-management; and cardiovascular risk score were assessed as secondary outcomes. RESULTS Patients (77% male) were 63 ± 10 years and primarily diagnosed with myocardial infarction (78%). Sedentary time decreased in SIT LESS (- 1.6 [- 2.1 to - 1.1] hours/day) and controls (- 1.2 [ ─1.7 to - 0.8]), but between group differences did not reach statistical significance (─0.4 [─1.0 to 0.3]) hours/day). The post-rehabilitation proportion of patients with a sedentary time above the upper limit of normal (≥ 9.5 h/day) was significantly lower in SIT LESS versus controls (48% versus 72%, baseline-adjusted odds-ratio 0.4 (0.2-0.8)). No differences were observed in the other predefined secondary outcomes. CONCLUSIONS Among patients with coronary artery disease participating in cardiac rehabilitation, SIT LESS did not induce significantly greater reductions in sedentary time compared to controls, but delivery was feasible and a reduced odds of a sedentary time ≥ 9.5 h/day was observed. TRIAL REGISTRATION Netherlands Trial Register: NL9263. Outcomes of the SIT LESS trial: changes in device-based sedentary time from pre-to post-cardiac rehabilitation (control group) and cardiac rehabilitation + SIT LESS (intervention group). SIT LESS reduced the odds of patients having a sedentary time >9.5 hours/day (upper limit of normal), although the absolute decrease in sedentary time did not significantly differ from controls. SIT LESS appears to be feasible, acceptable and potentially beneficial, but a larger cluster randomised trial is warranted to provide a more accurate estimate of its effects on sedentary time and clinical outcomes. CR: cardiac rehabilitation.
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Affiliation(s)
- B. M. A. van Bakel
- grid.10417.330000 0004 0444 9382Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - S. H. Kroesen
- grid.10417.330000 0004 0444 9382Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - E. A. Bakker
- grid.10417.330000 0004 0444 9382Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - R. V. van Miltenburg
- grid.10417.330000 0004 0444 9382Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - A. Günal
- grid.470077.30000 0004 0568 6582Department of Cardiology, Bernhoven Hospital, Uden, The Netherlands
| | - A. Scheepmaker
- grid.470077.30000 0004 0568 6582Department of Cardiology, Bernhoven Hospital, Uden, The Netherlands
| | - W. R. M. Aengevaeren
- grid.415930.aDepartment of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands
| | - F. F. Willems
- grid.415930.aDepartment of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands
| | - R. Wondergem
- grid.5477.10000000120346234Department of Rehabilitation, Physical Therapy Science and Sport, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands ,grid.448801.10000 0001 0669 4689Research Group Empowering Healthy Behaviour, Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, The Netherlands ,Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, the Netherlands
| | - M. F. Pisters
- grid.5477.10000000120346234Department of Rehabilitation, Physical Therapy Science and Sport, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands ,grid.448801.10000 0001 0669 4689Research Group Empowering Healthy Behaviour, Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, The Netherlands ,Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, the Netherlands
| | - M. de Bruin
- grid.10417.330000 0004 0444 9382Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M. T. E. Hopman
- grid.10417.330000 0004 0444 9382Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - D. H. J. Thijssen
- grid.10417.330000 0004 0444 9382Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands ,grid.4425.70000 0004 0368 0654Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - T. M. H. Eijsvogels
- grid.10417.330000 0004 0444 9382Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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23
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Sedentary behaviour, but not moderate-to-vigorous physical activity, is associated with respiratory responses to acute psychological stress. Biol Psychol 2023; 177:108510. [PMID: 36716988 DOI: 10.1016/j.biopsycho.2023.108510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND Acute psychological stress induces respiratory responses, and stress-induced respiratory changes can be used to non-invasively reflect metabolic regulation. Respiratory and cardiovascular responses to stress are both driven by sympathetic mechanisms. Higher volumes of sedentary behaviour and lower volumes of physical activity are associated with elevated sympathetic tone and larger cardiovascular responses to stress. The aim of this study was to test whether these associations translate to measures of respiratory stress reactivity. METHODS Daily hours of sedentary behaviour (thigh-mounted activPAL) and moderate-to-vigorous physical activity (MVPA; wrist-mounted ActiGraph) were assessed across seven days. Breath-by-breath respiratory (e.g., breathing frequency [BF], end-tidal carbon dioxide partial pressure [PetCO2], carbon dioxide output [V̇CO2] and respiratory exchange ratio [RER]) responses to an 8-min Paced Auditory Serial Addition Test were then measured using a Cortex MetaLyzer3B. RESULTS Healthy participants (N = 61, mean age ± SD = 25.7 ± 8.9 years) recorded high volumes of sedentary behaviour (9.96 ± 1.48 h/day) and MVPA (1.70 ± 0.71 h/day). In adjusted models (with the inclusion of sedentary behaviour, MVPA, and other a priori selected covariates) hours of daily sedentary behaviour were associated with baseline to stress changes in BF (Β = 0.695, 95% CI = 0.281 - 1.109, p = .014), VT (Β = -0.042, 95% CI = -0.058 - -0.026, p = .014), PetCO2 (Β = -0.537, 95% CI = -0.829 - -0.245, p = .014), V̇CO2 (Β = -0.008, 95% CI = -0.014 - -0.003, p = .030), and RER (Β = -0.013, 95% CI = -0.021 - -0.005, p = .022). Daily hours of MVPA were not linked with respiratory responses to stress. DISCUSSION Sedentary behaviour, but not MVPA, is associated with respiratory stress reactivity. Future work should untangle the underlying mechanisms of these findings and explore the consequences for cardiometabolic disease.
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Clusters of Activity-Related Social and Physical Home Environmental Factors and Their Association With Children's Home-Based Physical Activity and Sitting. Pediatr Exerc Sci 2023; 35:23-34. [PMID: 35940584 DOI: 10.1123/pes.2021-0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 04/19/2022] [Accepted: 05/30/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE Understanding which physical activity (PA) and sedentary behavior correlates cluster in children is important, particularly in the home, where children spend significant time. Therefore, this study aimed to assess clustering of physical and social activity-related factors at home, and whether these clusters are related to home-based sitting and PA in children. A secondary aim was to explore whether the clusters were associated with child, parent, and family characteristics. METHODS Altogether, 235 children (55% girls, mean age = 10.2 [0.7] y) and their parents took part. Physical (eg, PA and electronic media equipment, house and garden size, layout) and social (eg, activity preferences, priorities, parental rules) home environmental factors were obtained via the HomeSPACE-II audit and self-report, respectively. Principal component analysis was used to identify clusters of physical and social environmental factors. Backward regression analysis and partial correlations were used to examine relationships between clusters, children's device-measured home-based activity behaviors, and background characteristics. RESULTS The findings show that physical and social environment activity-related factors at home cluster. The clusters were associated with several background characteristics, with socioeconomic factors appearing to be particularly influential. The clusters were also associated with home-based activity behaviors in the hypothesized directions. CONCLUSION Interventions which target clusters of social and physical factors at home, especially among low-socioeconomic status families, are warranted.
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25
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Trouwborst I, Gijbels A, Jardon KM, Siebelink E, Hul GB, Wanders L, Erdos B, Péter S, Singh-Povel CM, de Vogel-van den Bosch J, Adriaens ME, Arts ICW, Thijssen DHJ, Feskens EJM, Goossens GH, Afman LA, Blaak EE. Cardiometabolic health improvements upon dietary intervention are driven by tissue-specific insulin resistance phenotype: A precision nutrition trial. Cell Metab 2023; 35:71-83.e5. [PMID: 36599304 DOI: 10.1016/j.cmet.2022.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/12/2022] [Accepted: 11/13/2022] [Indexed: 01/05/2023]
Abstract
Precision nutrition based on metabolic phenotype may increase the effectiveness of interventions. In this proof-of-concept study, we investigated the effect of modulating dietary macronutrient composition according to muscle insulin-resistant (MIR) or liver insulin-resistant (LIR) phenotypes on cardiometabolic health. Women and men with MIR or LIR (n = 242, body mass index [BMI] 25-40 kg/m2, 40-75 years) were randomized to phenotype diet (PhenoDiet) group A or B and followed a 12-week high-monounsaturated fatty acid (HMUFA) diet or low-fat, high-protein, and high-fiber diet (LFHP) (PhenoDiet group A, MIR/HMUFA and LIR/LFHP; PhenoDiet group B, MIR/LFHP and LIR/HMUFA). PhenoDiet group B showed no significant improvements in the primary outcome disposition index, but greater improvements in insulin sensitivity, glucose homeostasis, serum triacylglycerol, and C-reactive protein compared with PhenoDiet group A were observed. We demonstrate that modulating macronutrient composition within the dietary guidelines based on tissue-specific insulin resistance (IR) phenotype enhances cardiometabolic health improvements. Clinicaltrials.gov registration: NCT03708419, CCMO registration NL63768.068.17.
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Affiliation(s)
- Inez Trouwborst
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands; TI Food and Nutrition (TIFN), Wageningen, the Netherlands
| | - Anouk Gijbels
- TI Food and Nutrition (TIFN), Wageningen, the Netherlands; Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Kelly M Jardon
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands; TI Food and Nutrition (TIFN), Wageningen, the Netherlands
| | - Els Siebelink
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Gabby B Hul
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands; TI Food and Nutrition (TIFN), Wageningen, the Netherlands
| | - Lisa Wanders
- TI Food and Nutrition (TIFN), Wageningen, the Netherlands; Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Balázs Erdos
- TI Food and Nutrition (TIFN), Wageningen, the Netherlands; Maastricht Centre for Systems Biology, Maastricht University, Maastricht, the Netherlands
| | | | | | | | - Michiel E Adriaens
- TI Food and Nutrition (TIFN), Wageningen, the Netherlands; Maastricht Centre for Systems Biology, Maastricht University, Maastricht, the Netherlands
| | - Ilja C W Arts
- TI Food and Nutrition (TIFN), Wageningen, the Netherlands; Maastricht Centre for Systems Biology, Maastricht University, Maastricht, the Netherlands
| | - Dick H J Thijssen
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, the Netherlands; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Edith J M Feskens
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Gijs H Goossens
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Lydia A Afman
- TI Food and Nutrition (TIFN), Wageningen, the Netherlands; Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Ellen E Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands; TI Food and Nutrition (TIFN), Wageningen, the Netherlands.
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26
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Sleep Variability in UK Long Distance Heavy Goods Vehicle Drivers. J Occup Environ Med 2023; 65:67-73. [PMID: 36608152 DOI: 10.1097/jom.0000000000002687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Sleep variability levels are unknown in heavy goods vehicle (HGV) drivers yet are associated with adverse health outcomes and reduced driver vigilance when high. METHODS Two hundred and thirty-three HGV drivers recruited across 25 UK depots provided sleep variability, sleep duration, and sleep efficiency data via wrist-worn accelerometry (GENEActiv) over 8 days. Sleep variability indicators included social jetlag (the difference in midpoint of the sleep window between work and nonworkdays) and intraindividual variability of sleep window onset time, out-of-bed time, and sleep duration. RESULTS Fifty-three percent of drivers experienced social jetlag (≥1 hour), and 27% experienced high (>2 hours) social jetlag. Drivers with the highest sleep variability had the shortest sleep duration and lowest sleep efficiency during workdays. CONCLUSIONS Drivers with high sleep variability may experience more fatigue when driving given the poor sleep outcomes during workdays observed.
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van der Sluijs KM, Bakker EA, Schuijt TJ, Joseph J, Kavousi M, Geersing GJ, Rutten FH, Hartman YAW, Thijssen DHJ, Eijsvogels TMH. Long-term cardiovascular health status and physical functioning of nonhospitalized patients with COVID-19 compared with non-COVID-19 controls. Am J Physiol Heart Circ Physiol 2023; 324:H47-H56. [PMID: 36459448 PMCID: PMC9870581 DOI: 10.1152/ajpheart.00335.2022] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is reported to have long-term effects on cardiovascular health and physical functioning, even in the nonhospitalized population. The physiological mechanisms underlying these long-term consequences are however less well described. We compared cardiovascular risk factors, arterial stiffness, and physical functioning in nonhospitalized patients with COVID-19, at a median of 6 mo postinfection, versus age- and sex-matched controls. Cardiovascular risk was assessed using blood pressure and biomarker concentrations (amino-terminal pro-B-type-natriuretic-peptide, high-sensitive cardiac troponin I, C-reactive protein), and arterial stiffness was assessed using carotid-femoral pulse wave velocity. Physical functioning was evaluated using accelerometry, handgrip strength, gait speed and questionnaires on fatigue, perceived general health status, and health-related quality of life (hrQoL). We included 101 former patients with COVID-19 (aged 59 [interquartile range, 55-65] yr, 58% male) and 101 controls. At 175 [126-235] days postinfection, 32% of the COVID-19 group reported residual symptoms, notably fatigue, and 7% required post-COVID-19 care. We found no differences in blood pressure, biomarker concentrations, or arterial stiffness between both groups. Former patients with COVID-19 showed a higher handgrip strength (43 [33-52] vs. 38 [30-48] kg, P = 0.004) and less sleeping time (8.8 [7.7-9.4] vs. 9.8 [8.9-10.3] h/day, P < 0.001) and reported fatigue more often than controls. Accelerometry-based habitual physical activity levels, gait speed, perception of general health status, and hrQoL were not different between groups. In conclusion, one in three nonhospitalized patients with COVID-19 reports residual symptoms at a median of 6 mo postinfection, but we were unable to relate these symptoms to increases in cardiovascular risk factors, arterial stiffness, or physical dysfunction.NEW & NOTEWORTHY We examined cardiovascular and physical functioning outcomes in nonhospitalized patients with COVID-19, at a median of 6 mo postinfection. When compared with matched controls, minor differences in physical functioning were found, but objective measures of cardiovascular risk and arterial stiffness did not differ between groups. However, one in three former patients with COVID-19 reported residual symptoms, notably fatigue. Follow-up studies should investigate the origins of residual symptoms and their long-term consequences in former, nonhospitalized patients with COVID-19.
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Affiliation(s)
- Koen M. van der Sluijs
- 1Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Esmée A. Bakker
- 1Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tim J. Schuijt
- 2Clinical Chemistry and Hematology Laboratory, Hospital Gelderse Vallei Ede, Ede, The Netherlands
| | - Jayaraj Joseph
- 3Department of Electrical Engineering, Indian Institute of Technology Madras, Chennai, India
| | - Maryam Kavousi
- 4Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Geert-Jan Geersing
- 5Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Frans H. Rutten
- 5Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Yvonne A. W. Hartman
- 1Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dick H. J. Thijssen
- 1Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thijs M. H. Eijsvogels
- 1Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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Benzo RM, Farag A, Whitaker KM, Xiao Q, Carr LJ. Examining the impact of 12-hour day and night shifts on nurses' fatigue: A prospective cohort study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100076. [PMID: 38745643 PMCID: PMC11080398 DOI: 10.1016/j.ijnsa.2022.100076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 11/26/2022] Open
Abstract
Background: Fatigue is prevalent among hospital nurses and has been linked to medical errors and decreased patient safety. However, little is known regarding the relationship between occupational physical activity, sedentary behavior, and fatigue. Objective: To assess the impact of 12-hour shifts on nurses' fatigue and its relationship to occupational physical activity and sedentary behavior. Design: Prospective-cohort study design Setting(s): Midwestern trauma one academic medical center Participants: A total of 80 registered nurses working 12-hour day and night shifts participated in this study and completed momentary measures of fatigue (texting, aim one). Only 52 participants were included in aim two analyses (included activity monitoring, aim two). Methods: Occupational patterns of momentary fatigue was measured via ecological momentary assessments. Occupational physical activity and sedentary behaviors (e.g., step count, time spent sitting, standing, and walking) were measured for 14 continuous days using the ActivPAL3 micro activity monitor. Mixed models were used to examine the effects of shift type and time within a shift on occupational fatigue. General estimation equations were used to examine the relationship between time spent sitting, standing, and walking on fatigue. Results: Regardless of shift type, nurses exhibited a significant rise in fatigue; however, the rise was greater during night shifts compared to day shifts. Walking was positively associated with fatigue during day shifts, and negatively associated with fatigue during night shifts. Conclusions: The rise in fatigue was greater among nurses working night shifts compared to day shifts, which could place them at greater risk for fatigue-related consequences. The relationship between walking and fatigue was moderated by shift-type. Tweetable abstract: Nursing fatigue rises during 12-hour shifts, but the rise is greater for those working night shifts @DrRobertoBenzo.
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Affiliation(s)
- Roberto M. Benzo
- Department of Psychology, University of Miami, Miami, Florida 33136, United States of America
- Department of Health & Human Physiology, University of Iowa, E102 Field House, Iowa City, Iowa 52242, United States of America
| | - Amany Farag
- College of Nursing, University of Iowa, 101 College of Nursing Building; 50 Newton Road, Iowa City, Iowa 52242, United States of America
| | - Kara M. Whitaker
- Department of Health & Human Physiology, University of Iowa, E102 Field House, Iowa City, Iowa 52242, United States of America
- Department of Epidemiology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Qian Xiao
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, United States of America
| | - Lucas J. Carr
- Department of Health & Human Physiology, University of Iowa, E102 Field House, Iowa City, Iowa 52242, United States of America
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Ruettger K, Clemes SA, Chen YL, Edwardson CL, Guest A, Gilson ND, Gray LJ, Johnson V, Paine NJ, Sherry AP, Sayyah M, Troughton J, Varela-Mato V, Yates T, King JA. Drivers with and without Obesity Respond Differently to a Multi-Component Health Intervention in Heavy Goods Vehicle Drivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15546. [PMID: 36497618 PMCID: PMC9739045 DOI: 10.3390/ijerph192315546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
Physical inactivity and obesity are widely prevalent in Heavy Goods Vehicle (HGV) drivers. We analysed whether obesity classification influenced the effectiveness of a bespoke structured lifestyle intervention ('SHIFT') for HGV drivers. The SHIFT programme was evaluated within a cluster randomised controlled trial, across 25 transport depots in the UK. After baseline assessments, participants within intervention sites received a 6-month multi-component health behaviour change intervention. Intervention responses (verses control) were stratified by obesity status (BMI < 30 kg/m2, n = 131; BMI ≥ 30 kg/m2, n = 113) and compared using generalised estimating equations. At 6-months, favourable differences were found in daily steps (adjusted mean difference 1827 steps/day, p < 0.001) and sedentary time (adjusted mean difference -57 min/day, p < 0.001) in drivers with obesity undertaking the intervention, relative to controls with obesity. Similarly, in drivers with obesity, the intervention reduced body weight (adjusted mean difference -2.37 kg, p = 0.002) and led to other favourable anthropometric outcomes, verses controls with obesity. Intervention effects were absent for drivers without obesity, and for all drivers at 16-18-months follow-up. Obesity classification influenced HGV drivers' behavioural responses to a multi-component health-behaviour change intervention. Therefore, the most at-risk commercial drivers appear receptive to a health promotion programme.
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Affiliation(s)
- Katharina Ruettger
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Stacy A. Clemes
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
- NIHR Leicester Biomedical Research Centre, Leicester LE5 4PW, UK
| | - Yu-Ling Chen
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Charlotte L. Edwardson
- NIHR Leicester Biomedical Research Centre, Leicester LE5 4PW, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK
| | - Amber Guest
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Nicholas D. Gilson
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane 4072, Australia
| | - Laura J. Gray
- Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK
| | - Vicki Johnson
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester LE5 4PW, UK
| | - Nicola J. Paine
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
- NIHR Leicester Biomedical Research Centre, Leicester LE5 4PW, UK
| | - Aron P. Sherry
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
- NIHR Leicester Biomedical Research Centre, Leicester LE5 4PW, UK
| | - Mohsen Sayyah
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
| | - Jacqui Troughton
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester LE5 4PW, UK
| | - Veronica Varela-Mato
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
- NIHR Leicester Biomedical Research Centre, Leicester LE5 4PW, UK
| | - Thomas Yates
- NIHR Leicester Biomedical Research Centre, Leicester LE5 4PW, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK
| | - James A. King
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
- NIHR Leicester Biomedical Research Centre, Leicester LE5 4PW, UK
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30
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ten Broeke P, van Bakel BMA, Bakker EA, Beckers DGJ, Geurts SAE, Thijssen DHJ, Eijsvogels TMH, Bijleveld E. Sitting patterns in cardiovascular disease patients compared with healthy controls and impact of cardiac rehabilitation. Scand J Med Sci Sports 2022; 32:1639-1649. [PMID: 35689546 PMCID: PMC9796723 DOI: 10.1111/sms.14202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/15/2022] [Accepted: 06/06/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE To identify how and when to intervene in cardiovascular disease (CVD) patients' sedentary behavior, we moved beyond studying total volume of sitting and examined sitting patterns. By analyzing the timing of stand-to-sit and sit-to-stand transitions, we compared sitting patterns (a) between CVD patients and healthy controls, and (b) before and after cardiac rehabilitation (CR). METHODS One hundered twenty nine CVD patients and 117 age-matched healthy controls continuously wore a tri-axial thigh-worn accelerometer for 8 days (>120 000 posture transitions). CVD patients additionally wore the accelerometer directly and 2 months after CR. RESULTS With later time of the day, both CVD patients and healthy controls sat down sooner (i.e., shorter standing episode before sitting down; HR = 1.01, 95% CI [1.011, 1.015]) and remained seated longer (HR = 0.97, CI [0.966, 0.970]). After more previous physical activity, both groups sat down later (HR = 0.97, CI [0.959, 0.977]), and patients remained seated longer (HR = 0.96; CI [0.950, 0.974]). Immediately and 2-months following CR, patients sat down later (HRpost-CR = 0.96, CI [0.945, 0.974]; HRfollow-up = 0.96, CI [0.948, 0.977]) and stood up sooner (HRpost-CR = 1.04, CI [1.020, 1.051]; HRfollow-up = 1.03, CI [1.018, 1.050]). These effects were less pronounced with older age, higher BMI, lower sedentary behavior levels, and/or higher physical activity levels at baseline. CONCLUSION Cardiac rehabilitation programs could be optimized by targeting CVD patients' sit-to-stand transitions, by focusing on high-risk moments for prolonged sitting (i.e., in evenings and after higher-than-usual physical activity) and attending to the needs of specific patient subgroups.
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Affiliation(s)
- Pam ten Broeke
- Behavioural Science InstituteRadboud UniversityNijmegenThe Netherlands
| | - Bram M. A. van Bakel
- Radboud Institute for Health Sciences, Department of PhysiologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Esmée A. Bakker
- Radboud Institute for Health Sciences, Department of PhysiologyRadboud University Medical CenterNijmegenThe Netherlands
| | | | | | - Dick H. J. Thijssen
- Radboud Institute for Health Sciences, Department of PhysiologyRadboud University Medical CenterNijmegenThe Netherlands,Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUK
| | - Thijs M. H. Eijsvogels
- Radboud Institute for Health Sciences, Department of PhysiologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Erik Bijleveld
- Behavioural Science InstituteRadboud UniversityNijmegenThe Netherlands
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Clemes SA, Varela-Mato V, Bodicoat DH, Brookes CL, Chen YL, Cox E, Edwardson CL, Gray LJ, Guest A, Johnson V, Munir F, Paine NJ, Richardson G, Ruettger K, Sayyah M, Sherry A, Paola ASD, Troughton J, Walker S, Yates T, King J. A multicomponent structured health behaviour intervention to improve physical activity in long-distance HGV drivers: the SHIFT cluster RCT. PUBLIC HEALTH RESEARCH 2022. [DOI: 10.3310/pnoy9785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background
Long-distance heavy goods vehicle drivers are exposed to a multitude of risk factors associated with their occupation. The working environment of heavy goods vehicle drivers provides limited opportunities for a healthy lifestyle, and, consequently, heavy goods vehicle drivers exhibit higher than nationally representative rates of obesity and obesity-related comorbidities, and are underserved in terms of health promotion initiatives.
Objective
The aim of this trial was to test the effectiveness and cost-effectiveness of the multicomponent Structured Health Intervention For Truckers (SHIFT) programme, compared with usual care, at both 6 months and 16–18 months.
Design
A two-arm cluster randomised controlled trial, including a cost-effectiveness analysis and process evaluation.
Setting
Transport depots throughout the Midlands region of the UK.
Participants
Heavy goods vehicle drivers.
Intervention
The 6-month SHIFT programme included a group-based interactive 6-hour education session, health coach support and equipment provision [including a Fitbit® (Fitbit Inc., San Francisco, CA, US) and resistance bands/balls to facilitate a ‘cab workout’]. Clusters were randomised following baseline measurements to either the SHIFT arm or the control arm.
Main outcome measures
Outcome measures were assessed at baseline, with follow-up assessments occurring at both 6 months and 16–18 months. The primary outcome was device-measured physical activity, expressed as mean steps per day, at 6-month follow-up. Secondary outcomes included device-measured sitting, standing, stepping, physical activity and sleep time (on any day, workdays and non-workdays), along with adiposity, biochemical measures, diet, blood pressure, psychophysiological reactivity, cognitive function, functional fitness, mental well-being, musculoskeletal symptoms and work-related psychosocial variables. Cost-effectiveness and process evaluation data were collected.
Results
A total of 382 participants (mean ± standard deviation age: 48.4 ± 9.4 years; mean ± standard deviation body mass index: 30.4 kg/m2 ± 5.1 kg/m2; 99% male) were recruited across 25 clusters. Participants were randomised (at the cluster level) to either the SHIFT arm (12 clusters, n = 183) or the control arm (13 clusters, n = 199). At 6 months, 209 (54.7%) participants provided primary outcome data. Significant differences in mean daily steps were found between arms, with participants in the SHIFT arm accumulating 1008 more steps per day than participants in the control arm (95% confidence interval 145 to 1871 steps; p = 0.022), which was largely driven by the maintenance of physical activity levels in the SHIFT arm and a decline in physical activity levels in the control arm. Favourable differences at 6 months were also seen in the SHIFT arm, relative to the control arm, in time spent sitting, standing and stepping, and time in moderate or vigorous activity. No differences between arms were observed at 16–18 months’ follow-up. No differences were observed between arms in the other secondary outcomes at either follow-up (i.e. 6 months and 16–18 months). The process evaluation demonstrated that the intervention was well received by participants and that the intervention reportedly had a positive impact on their health behaviours. The average total cost of delivering the SHIFT programme was £369.57 per driver, and resulting quality-adjusted life-years were similar across trial arms (SHIFT arm: 1.22, 95% confidence interval 1.19 to 1.25; control arm: 1.25, 95% confidence interval 1.22 to 1.27).
Limitations
A higher (31.4%) than anticipated loss to follow-up was experienced at 6 months, with fewer (54.7%) participants providing valid primary outcome data at 6 months. The COVID-19 pandemic presents a major confounding factor, which limits our ability to draw firm conclusions regarding the sustainability of the SHIFT programme.
Conclusion
The SHIFT programme had a degree of success in positively impacting physical activity levels and reducing sitting time in heavy goods vehicle drivers at 6-months; however, these differences were not maintained at 16–18 months.
Future work
Further work involving stakeholder engagement is needed to refine the content of the programme, based on current findings, followed by the translation of the SHIFT programme into a scalable driver training resource.
Trial registration
This trial is registered as ISRCTN10483894.
Funding
This project was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 12. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Stacy A Clemes
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health and Care Research Leicester Biomedical Research Centre, Leicester, UK
| | - Veronica Varela-Mato
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health and Care Research Leicester Biomedical Research Centre, Leicester, UK
| | | | | | - Yu-Ling Chen
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health and Care Research Leicester Biomedical Research Centre, Leicester, UK
| | - Edward Cox
- Centre for Health Economics, University of York, York, UK
| | - Charlotte L Edwardson
- National Institute for Health and Care Research Leicester Biomedical Research Centre, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Laura J Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Amber Guest
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Vicki Johnson
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health and Care Research Leicester Biomedical Research Centre, Leicester, UK
| | - Nicola J Paine
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health and Care Research Leicester Biomedical Research Centre, Leicester, UK
| | | | - Katharina Ruettger
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Mohsen Sayyah
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Aron Sherry
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health and Care Research Leicester Biomedical Research Centre, Leicester, UK
| | | | - Jacqui Troughton
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Simon Walker
- Centre for Health Economics, University of York, York, UK
| | - Thomas Yates
- National Institute for Health and Care Research Leicester Biomedical Research Centre, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - James King
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- National Institute for Health and Care Research Leicester Biomedical Research Centre, Leicester, UK
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Sheldrick MPR, Swindell NJ, Richards AB, Fairclough SJ, Stratton G. Homes became the "everything space" during COVID-19: impact of changes to the home environment on children's physical activity and sitting. Int J Behav Nutr Phys Act 2022; 19:134. [PMID: 36271402 PMCID: PMC9587651 DOI: 10.1186/s12966-022-01346-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND During the 2020 UK COVID-19 lockdown restrictions, children spent almost all of their time at home, which had a significant influence on their physical activity (PA) and sedentary behaviour. This study aimed to: 1) determine changes to the social and physical environment at home and children's home-based sitting, PA, standing and sitting breaks as a result of the COVID-19 restrictions; and 2) examine associations between changes at home and children's movement behaviours. METHODS One hundred and two children had their PA and sitting, standing and sitting breaks at home objectively measured pre-COVID-19 and during the first COVID-19 lockdown (June-July 2020). Children's parents (n = 101) completed an audit of their home physical environment and a survey on the home social environment at both time points. Changes in the home physical and social environment and behavioural outcomes were assessed using Wilcoxon signed ranked tests, paired t-tests, or chi-square. Repeated linear regression analyses examined associations between changes in homes and changes in the home-based behavioural outcomes. RESULTS During COVID-19, households increased the amount of seated furniture and electronic media equipment at home. The number of books and PA equipment decreased and fewer parents enforced a screen-time rule. Children's preference for physical activities and socialising at home decreased. Time at home and sitting at home increased during COVID-19, whilst PA, standing and sitting breaks decreased. Both MVPA and TPA were positively associated with child preference for PA, and negatively associated with attending school. Sitting was negatively associated with child preference for PA and child preference for socialising at home. Media equipment was negatively associated with sitting breaks, whilst PA equipment was positively associated with standing. CONCLUSION The COVID-19 restrictions forced children to spend almost all their time at home. Children's PA, standing, and sitting breaks at home declined during the restrictions, while sitting increased. Mostly negative changes occurred in homes, some of which impacted children's behaviours at home. To avoid the changes persisting post-lockdown, interventions are needed to reset and promote children's PA and discourage prolonged sitting time.
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Affiliation(s)
- Michael P R Sheldrick
- Research Centre in Applied Sports, Technology, Exercise and Medicine (A-STEM), Swansea University, Swansea, SA1 8EN, UK.
| | - Nils J Swindell
- Research Centre in Applied Sports, Technology, Exercise and Medicine (A-STEM), Swansea University, Swansea, SA1 8EN, UK
| | - Amie B Richards
- Research Centre in Applied Sports, Technology, Exercise and Medicine (A-STEM), Swansea University, Swansea, SA1 8EN, UK
| | - Stuart J Fairclough
- Movement Behaviours, Health and Wellbeing Research Group, Department of Sport & Physical Activity, Edge Hill University, St Helens Road, Ormskirk, L39 4QP, Lancashire, UK
| | - Gareth Stratton
- Research Centre in Applied Sports, Technology, Exercise and Medicine (A-STEM), Swansea University, Swansea, SA1 8EN, UK
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Jelsma JGM, van der Ploeg HP, Renaud LR, Stijnman DPM, Loyen A, Huysmans MA, van der Beek AJ, van Nassau F. Mixed-methods process evaluation of the Dynamic Work study: A multicomponent intervention for office workers to reduce sitting time. APPLIED ERGONOMICS 2022; 104:103823. [PMID: 35724470 DOI: 10.1016/j.apergo.2022.103823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
Previously, we observed no significant reductions in sitting time of the multicomponent Dynamic Work (DW) intervention among office workers. In this study we used mixed-method data to understand context, implementation (i.e. recruitment and delivery) and mechanism of impact (i.e. experiences) of the DW intervention and to explore whether an higher implementation index score led to larger changes in participants' outcomes. We found considerable variation across departments regarding context (i.e. different size and work tasks) and implementation (i.e. delivery varied). Satisfaction with the DW intervention was high. An higher implementation index score was associated with lower overall sitting time, lower occupational sitting time, higher number of steps/day and steps/day at work at 4-months, which was maintained at 8-month for occupational sitting time. These findings provide an understanding that implementation was affected by a lack of availability of intervention components, department policy, work tasks, positioning and work location. TRIAL REGISTRATION: Clinicaltrials.gov, registration number:NCT03115645. Registered February 17, 2017 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03115645.
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Affiliation(s)
- Judith G M Jelsma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Hidde P van der Ploeg
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Lidewij R Renaud
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Dominique P M Stijnman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Anne Loyen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Maaike A Huysmans
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Allard J van der Beek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Femke van Nassau
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
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Leonard KS, de Brito JN, Larouche ML, Rydell SA, Mitchell NR, Pereira MA, Buman MP. Effect of Weight Goals on Sitting and Moving During a Worksite Sedentary Time Reduction Intervention. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2022; 7:e000210. [PMID: 36213514 PMCID: PMC9534174 DOI: 10.1249/tjx.0000000000000210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Introduction/Purpose Although many US adults report trying to lose weight, little research has examined weight loss goals as a motivator for reducing workplace sitting and increasing physical activity. This exploratory analysis examined weight goals and the association with changes in workplace sitting, physical activity, and weight. Methods Employees (N = 605) were drawn from worksites participating in Stand and Move at Work. Worksites (N = 24) were randomized to a multilevel behavioral intervention with (STAND+) or without (MOVE+) sit-stand workstations for 12 months; MOVE+ worksites received sit-stand workstations from 12 to 24 months. At each assessment (baseline and 3, 12, and 24 months), participants were weighed and wore activPAL monitors. Participants self-reported baseline weight goals and were categorized into the "Lose Weight Goal" (LWG) group if they reported trying to lose weight or into the "Other Weight Goal" (OWG) group if they did not. Results Generalized linear mixed models revealed that within STAND+, LWG and OWG had similar sitting time through 12 months. However, LWG sat significantly more than OWG at 24 months. Within MOVE+, sitting time decreased after introduction of sit-stand workstations for LWG and OWG, although LWG sat more than OWG. Change in physical activity was minimal and weight remained stable in all groups. Conclusions Patterns of change in workplace sitting were more favorable in OWG relative to LWG, even in the absence of notable weight change. Expectations of weight loss might be detrimental for reductions in workplace sitting. Interventionists may want to emphasize non-weight health benefits of reducing workplace sitting.
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Affiliation(s)
- Krista S. Leonard
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Junia N. de Brito
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | - Sarah A. Rydell
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | - Mark A. Pereira
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Matthew P. Buman
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
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Fox FAU, Diers K, Lee H, Mayr A, Reuter M, Breteler MMB, Aziz NA. Association Between Accelerometer-Derived Physical Activity Measurements and Brain Structure: A Population-Based Cohort Study. Neurology 2022; 99:e1202-e1215. [PMID: 35918154 PMCID: PMC9536740 DOI: 10.1212/wnl.0000000000200884] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 05/11/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES While there is growing evidence that physical activity promotes neuronal health, studies examining the relation between physical activity and brain morphology remain inconclusive. We therefore examined whether objectively quantified physical activity is related to brain volume, cortical thickness, and gray matter density in a large cohort study. In addition, we assessed molecular pathways that may underlie the effects of physical activity on brain morphology. METHODS We used cross-sectional baseline data from 2,550 eligible participants (57.6% women; mean age: 54.7 years, range: 30-94 years) of a prospective cohort study. Physical activity dose (metabolic equivalent hours and step counts) and intensity (sedentary and light-intensity and moderate-to-vigorous intensity activities) were recorded with accelerometers. Brain volumetric, gray matter density, and cortical thickness measures were obtained from 3T MRI scans using FreeSurfer and Statistical Parametric Mapping. The relation of physical activity (independent variable) and brain structure (outcome) was examined with polynomial multivariable regression, while adjusting for age, sex, intracranial volume, education, and smoking. Using gene expression profiles from the Allen Brain Atlas, we extracted molecular signatures associated with the effects of physical activity on brain morphology. RESULTS Physical activity dose and intensity were independently associated with larger brain volumes, gray matter density, and cortical thickness of several brain regions. The effects of physical activity on brain volume were most pronounced at low physical activity quantities and differed between men and women and across age. For example, more time spent in moderate-to-vigorous intensity activities was associated with greater total gray matter volume, but the relation leveled off with more activity (standardized β [95% CIs]: 1.37 [0.35-2.39] and -0.70 [-1.25 to -0.15] for the linear and quadratic terms, respectively). The strongest effects of physical activity were observed in motor regions and cortical regions enriched for genes involved in mitochondrial respiration. DISCUSSION Our findings suggest that physical activity benefits brain health, with the strongest effects in motor regions and regions with a high oxidative demand. While young adults may particularly profit from additional high-intensity activities, older adults may already benefit from light-intensity activities. Physical activity and reduced sedentary time may be critical in the prevention of age-associated brain atrophy and neurodegenerative diseases.
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Affiliation(s)
- Fabienne A U Fox
- From the Population Health Sciences (F.A.U.F., H.L., M.M.B.B., N.A.A.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Image Analysis (K.D., M.R.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Institute for Medical Biometry (A.M., M.M.B.B.), Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Germany; A.A. Martinos Center for Biomedical Imaging (M.R.), Massachusetts General Hospital, Boston; Department of Radiology (M.R.), Harvard Medical School, Boston, MA; and Department of Neurology (N.A.A.), Faculty of Medicine, University of Bonn, Germany
| | - Kersten Diers
- From the Population Health Sciences (F.A.U.F., H.L., M.M.B.B., N.A.A.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Image Analysis (K.D., M.R.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Institute for Medical Biometry (A.M., M.M.B.B.), Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Germany; A.A. Martinos Center for Biomedical Imaging (M.R.), Massachusetts General Hospital, Boston; Department of Radiology (M.R.), Harvard Medical School, Boston, MA; and Department of Neurology (N.A.A.), Faculty of Medicine, University of Bonn, Germany
| | - Hweeling Lee
- From the Population Health Sciences (F.A.U.F., H.L., M.M.B.B., N.A.A.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Image Analysis (K.D., M.R.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Institute for Medical Biometry (A.M., M.M.B.B.), Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Germany; A.A. Martinos Center for Biomedical Imaging (M.R.), Massachusetts General Hospital, Boston; Department of Radiology (M.R.), Harvard Medical School, Boston, MA; and Department of Neurology (N.A.A.), Faculty of Medicine, University of Bonn, Germany
| | - Andreas Mayr
- From the Population Health Sciences (F.A.U.F., H.L., M.M.B.B., N.A.A.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Image Analysis (K.D., M.R.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Institute for Medical Biometry (A.M., M.M.B.B.), Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Germany; A.A. Martinos Center for Biomedical Imaging (M.R.), Massachusetts General Hospital, Boston; Department of Radiology (M.R.), Harvard Medical School, Boston, MA; and Department of Neurology (N.A.A.), Faculty of Medicine, University of Bonn, Germany
| | - Martin Reuter
- From the Population Health Sciences (F.A.U.F., H.L., M.M.B.B., N.A.A.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Image Analysis (K.D., M.R.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Institute for Medical Biometry (A.M., M.M.B.B.), Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Germany; A.A. Martinos Center for Biomedical Imaging (M.R.), Massachusetts General Hospital, Boston; Department of Radiology (M.R.), Harvard Medical School, Boston, MA; and Department of Neurology (N.A.A.), Faculty of Medicine, University of Bonn, Germany
| | - Monique M B Breteler
- From the Population Health Sciences (F.A.U.F., H.L., M.M.B.B., N.A.A.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Image Analysis (K.D., M.R.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Institute for Medical Biometry (A.M., M.M.B.B.), Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Germany; A.A. Martinos Center for Biomedical Imaging (M.R.), Massachusetts General Hospital, Boston; Department of Radiology (M.R.), Harvard Medical School, Boston, MA; and Department of Neurology (N.A.A.), Faculty of Medicine, University of Bonn, Germany
| | - N Ahmad Aziz
- From the Population Health Sciences (F.A.U.F., H.L., M.M.B.B., N.A.A.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Image Analysis (K.D., M.R.), German Center for Neurodegenerative Diseases (DZNE), Bonn; Institute for Medical Biometry (A.M., M.M.B.B.), Informatics and Epidemiology (IMBIE), Faculty of Medicine, University of Bonn, Germany; A.A. Martinos Center for Biomedical Imaging (M.R.), Massachusetts General Hospital, Boston; Department of Radiology (M.R.), Harvard Medical School, Boston, MA; and Department of Neurology (N.A.A.), Faculty of Medicine, University of Bonn, Germany.
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Blodgett JM, Norris T, Stamatakis E, O'Donovan G, Pinto Pereira SM, Hamer M. Prenatal and postnatal correlates of moderate-to-vigorous physical activity in midlife: evidence from the 1970 British Cohort Study. J Epidemiol Community Health 2022. [PMCID: PMC9554029 DOI: 10.1136/jech-2022-219213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background It is hypothesised that lifelong physical activity behaviours are established in early life, however there is minimal, and contradictory, evidence examining prenatal and postnatal factors in relation to adulthood physical activity. We investigated associations between prospectively ascertained prenatal/postnatal factors and device-measured moderate-to-vigorous physical activity (MVPA) in midlife. Methods Analyses included 5011 participants from the 1970 British Cohort Study, a birth cohort study of individuals born within the same week. At birth, the following factors were ascertained: socioeconomic position (SEP), maternal age, number of previous pregnancies, maternal smoking, maternal diabetes, gestational age, birth weight, breastfeeding status and infant health concerns. MVPA was captured at age 46 with a thigh-worn accelerometer device following a 24-hour protocol over 7 days. Results In sex-adjusted models, lower SEP (−6.7 min/day (95% CI: −9.0 to –4.4) in those with a partly or unskilled paternal occupation), younger maternal age (0.4 min/day (0.2 to 0.5) per additional year of maternal age), maternal smoking during pregnancy (−2.5 min/day (−4.0 to –1.0)) and post-term gestational age (−7.4 min/day (−11.5 to –3.4); boys only) were associated with lower MVPA at age 46. In the mutually adjusted model, associations did not change but there was some evidence that birth weight may also be associated with MVPA levels. Conclusions SEP, maternal age, maternal smoking, post-term birth in boys and birth weight were associated with MVPA in midlife, indicating that midlife physical activity behaviours may be partially established at birth. Early interventions in disadvantaged environments may have a positive impact on physical activity throughout the life course.
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Affiliation(s)
- Joanna M Blodgett
- Institute of Sport Exercise & Health, Department of Targeted Intervention, Division of Surgery & Interventional Science, University College London, London, UK
| | - Thomas Norris
- Institute of Sport Exercise & Health, Department of Targeted Intervention, Division of Surgery & Interventional Science, University College London, London, UK
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Gary O'Donovan
- Facultad de Medicina, Universidad de Los Andes, Bogotá, Colombia
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Snehal M Pinto Pereira
- Institute of Sport Exercise & Health, Department of Targeted Intervention, Division of Surgery & Interventional Science, University College London, London, UK
| | - Mark Hamer
- Institute of Sport Exercise & Health, Department of Targeted Intervention, Division of Surgery & Interventional Science, University College London, London, UK
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Carlson JA, Ridgers ND, Nakandala S, Zablocki R, Tuz-Zahra F, Bellettiere J, Hibbing PR, Steel C, Jankowska MM, Rosenberg DE, Greenwood-Hickman MA, Zou J, LaCroix AZ, Kumar A, Natarajan L. CHAP-child: an open source method for estimating sit-to-stand transitions and sedentary bout patterns from hip accelerometers among children. Int J Behav Nutr Phys Act 2022; 19:109. [PMID: 36028890 PMCID: PMC9419346 DOI: 10.1186/s12966-022-01349-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 08/15/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Hip-worn accelerometer cut-points have poor validity for assessing children's sedentary time, which may partly explain the equivocal health associations shown in prior research. Improved processing/classification methods for these monitors would enrich the evidence base and inform the development of more effective public health guidelines. The present study aimed to develop and evaluate a novel computational method (CHAP-child) for classifying sedentary time from hip-worn accelerometer data. METHODS Participants were 278, 8-11-year-olds recruited from nine primary schools in Melbourne, Australia with differing socioeconomic status. Participants concurrently wore a thigh-worn activPAL (ground truth) and hip-worn ActiGraph (test measure) during up to 4 seasonal assessment periods, each lasting up to 8 days. activPAL data were used to train and evaluate the CHAP-child deep learning model to classify each 10-s epoch of raw ActiGraph acceleration data as sitting or non-sitting, creating comparable information from the two monitors. CHAP-child was evaluated alongside the current practice 100 counts per minute (cpm) method for hip-worn ActiGraph monitors. Performance was tested for each 10-s epoch and for participant-season level sedentary time and bout variables (e.g., mean bout duration). RESULTS Across participant-seasons, CHAP-child correctly classified each epoch as sitting or non-sitting relative to activPAL, with mean balanced accuracy of 87.6% (SD = 5.3%). Sit-to-stand transitions were correctly classified with mean sensitivity of 76.3% (SD = 8.3). For most participant-season level variables, CHAP-child estimates were within ± 11% (mean absolute percent error [MAPE]) of activPAL, and correlations between CHAP-child and activPAL were generally very large (> 0.80). For the current practice 100 cpm method, most MAPEs were greater than ± 30% and most correlations were small or moderate (≤ 0.60) relative to activPAL. CONCLUSIONS There was strong support for the concurrent validity of the CHAP-child classification method, which allows researchers to derive activPAL-equivalent measures of sedentary time, sit-to-stand transitions, and sedentary bout patterns from hip-worn triaxial ActiGraph data. Applying CHAP-child to existing datasets may provide greater insights into the potential impacts and influences of sedentary time in children.
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Affiliation(s)
- Jordan A Carlson
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, 610 E. 22ndSt., Kansas City, MO, 64108, USA.
- Department of Pediatrics, University of Missouri - Kansas City, Kansas City, MO, USA.
| | - Nicola D Ridgers
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Supun Nakandala
- Department of Computer Science and Engineering, University of California San Diego, La Jolla, CA, USA
| | - Rong Zablocki
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Fatima Tuz-Zahra
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - John Bellettiere
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Paul R Hibbing
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, 610 E. 22ndSt., Kansas City, MO, 64108, USA
| | - Chelsea Steel
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, 610 E. 22ndSt., Kansas City, MO, 64108, USA
| | - Marta M Jankowska
- Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | | | - Jingjing Zou
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Andrea Z LaCroix
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Arun Kumar
- Department of Computer Science and Engineering, University of California San Diego, La Jolla, CA, USA
| | - Loki Natarajan
- Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, La Jolla, CA, USA
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Edwardson CL, Biddle SJH, Clemes SA, Davies MJ, Dunstan DW, Eborall H, Granat MH, Gray LJ, Healy GN, Jaicim NB, Lawton S, Maylor BD, Munir F, Richardson G, Yates T, Clarke-Cornwell AM. Effectiveness of an intervention for reducing sitting time and improving health in office workers: three arm cluster randomised controlled trial. BMJ 2022; 378:e069288. [PMID: 35977732 PMCID: PMC9382450 DOI: 10.1136/bmj-2021-069288] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of an intervention, with and without a height adjustable desk, on daily sitting time, and to investigate the relative effectiveness of the two interventions, and the effectiveness of both interventions on physical behaviours and physical, biochemical, psychological, and work related health and performance outcomes. DESIGN Cluster three arm randomised controlled trial with follow-up at three and 12 months. SETTING Local government councils in Leicester, Liverpool, and Greater Manchester, UK. PARTICIPANTS 78 clusters including 756 desk based employees in defined offices, departments, or teams from two councils in Leicester, three in Greater Manchester, and one in Liverpool. INTERVENTIONS Clusters were randomised to one of three conditions: the SMART Work and Life (SWAL) intervention, the SWAL intervention with a height adjustable desk (SWAL plus desk), or control (usual practice). MAIN OUTCOMES MEASURES The primary outcome measure was daily sitting time, assessed by accelerometry, at 12 month follow-up. Secondary outcomes were accelerometer assessed sitting, prolonged sitting, standing and stepping time, and physical activity calculated over any valid day, work hours, workdays, and non-workdays, self-reported lifestyle behaviours, musculoskeletal problems, cardiometabolic health markers, work related health and performance, fatigue, and psychological measures. RESULTS Mean age of participants was 44.7 years, 72.4% (n=547) were women, and 74.9% (n=566) were white. Daily sitting time at 12 months was significantly lower in the intervention groups (SWAL -22.2 min/day, 95% confidence interval -38.8 to -5.7 min/day, P=0.003; SWAL plus desk -63.7 min/day, -80.1 to -47.4 min/day, P<0.001) compared with the control group. The SWAL plus desk intervention was found to be more effective than SWAL at changing sitting time (-41.7 min/day, -56.3 to -27.0 min/day, P<0.001). Favourable differences in sitting and prolonged sitting time at three and 12 month follow-ups for both intervention groups and for standing time for the SWAL plus desk group were observed during work hours and on workdays. Both intervention groups were associated with small improvements in stress, wellbeing, and vigour, and the SWAL plus desk group was associated with improvements in pain in the lower extremity, social norms for sitting and standing at work, and support. CONCLUSIONS Both SWAL and SWAL plus desk were associated with a reduction in sitting time, although the addition of a height adjustable desk was found to be threefold more effective. TRIAL REGISTRATION ISRCTN Registry ISRCTN11618007.
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Affiliation(s)
- Charlotte L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Stuart J H Biddle
- Centre for Health Research, University of Southern Queensland, Springfield Central, QLD, Australia
| | - Stacy A Clemes
- NIHR Leicester Biomedical Research Centre, Leicester, UK
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicester, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Mary MacKillop Institute for Health Research, The Australian Catholic University, Melbourne, VIC, Australia
| | - Helen Eborall
- Department of Health Sciences, University of Leicester, Leicester, UK
- Deanery of Molecular, Genetic and Population Health Sciences, The University of Edinburgh, UK
| | - Malcolm H Granat
- School of Health and Society, University of Salford, Salford, Greater Manchester, UK
| | - Laura J Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Genevieve N Healy
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | | | - Sarah Lawton
- School of Health and Society, University of Salford, Salford, Greater Manchester, UK
| | - Benjamin D Maylor
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicester, UK
| | | | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
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Brierley ML, Smith LR, Chater AM, Bailey DP. A-REST (Activity to Reduce Excessive Sitting Time): A Feasibility Trial to Reduce Prolonged Sitting in Police Staff. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159186. [PMID: 35954543 PMCID: PMC9368451 DOI: 10.3390/ijerph19159186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/12/2022] [Accepted: 07/23/2022] [Indexed: 11/16/2022]
Abstract
The aim of this study was to evaluate the acceptability and feasibility of a theory-derived sedentary workplace intervention for police office staff. Twenty-four staff participated in an 8-week intervention (single arm, pre-post design) incorporating an education session, team competition with quick response (QR) codes, team trophy, weekly leaderboard newsletters, a self-monitoring phone app, and electronic prompt tools. The intervention supported participants to reduce and break up their sitting time with three minutes of incidental movement every 30 min at work. Feasibility and acceptability were assessed using mixed methods via the RE-AIM QuEST and PRECIS-2 frameworks. The intervention was highly pragmatic in terms of eligibility, organisation, adherence, outcome, and analysis. It was slightly less pragmatic on recruitment and setting. Delivery and follow-up were more explanatory. Reach and adoption indicators demonstrated feasibility among police staff, across a range of departments, who were demographically similar to participants in previous office-based multi-component interventions. The intervention was delivered mostly as planned with minor deviations from protocol (implementation fidelity). Participants perceived the intervention components as highly acceptable. Results showed improvements in workplace sitting and standing, as well as small improvements in weight and positive affect. Evaluation of the intervention in a fully powered randomised controlled trial to assess behaviour and health outcomes is recommended.
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Affiliation(s)
- Marsha L. Brierley
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK; (M.L.B.); (L.R.S.); (A.M.C.)
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK
- Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UK
| | - Lindsey R. Smith
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK; (M.L.B.); (L.R.S.); (A.M.C.)
| | - Angel M. Chater
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK; (M.L.B.); (L.R.S.); (A.M.C.)
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Daniel P. Bailey
- Institute for Sport and Physical Activity Research, School of Sport Science and Physical Activity, University of Bedfordshire, Polhill Avenue, Bedford MK41 9EA, UK; (M.L.B.); (L.R.S.); (A.M.C.)
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK
- Centre for Physical Activity in Health and Disease, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UK
- Correspondence: ; Tel.: +44-(0)1895-266127
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Chauntry AJ, Bishop NC, Hamer M, Kingsnorth AP, Chen YL, Paine NJ. Sedentary behaviour is associated with heightened cardiovascular, inflammatory and cortisol reactivity to acute psychological stress. Psychoneuroendocrinology 2022; 141:105756. [PMID: 35483244 DOI: 10.1016/j.psyneuen.2022.105756] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Sedentary behaviour is a risk factor for cardiovascular disease (CVD), but the underlying mechanisms remain unclear. Exaggerated psychobiological responses to acute psychological stress increase CVD risk. Sedentary behaviour is associated with characteristics that can predict large psychobiological stress response patterns (e.g., elevated resting blood pressure and systemic inflammation), but it is currently unknown whether sedentary behaviour and stress reactivity are directly linked. The aim of this study was to examine associations between device-assessed sedentary behaviour and measures of stress reactivity. METHODS Sixty-one healthy adults wore an activPAL (thigh) and ActiGraph (wrist) for seven days to measure habitual levels of sedentary behaviour (mean ± SD = 9.96 ± 1.48 h/day) and moderate-to-vigorous physical activity (mean ± SD = 101.82 ± 42.92 min/day). Participants then underwent stress reactivity testing, where beat-to-beat cardiovascular (e.g., blood pressure, total peripheral resistance), inflammatory (plasma interleukin-6, leukocytes) and salivary cortisol measurements were taken in response to an 8-minute socially evaluative Paced Auditory Serial Addition Test. RESULTS Higher volumes of daily sedentary behaviour were associated with larger stress responses for diastolic blood pressure (Β=1.264, 95%CI=0.537-1.990, p = .005), total peripheral resistance (Β=40.563, 95%CI=19.310-61.812, p < .001), interleukin-6 (Β=0.219, 95%CI=0.109-0.329, p < .001) and cortisol (Β=1.844, 95%CI=1.139-2.549, p < .001). These findings emerged independent of a priori determined covariates, including daily levels of moderate-to-vigorous physical activity and adiposity. DISCUSSION Exaggerated stress reactivity is characteristic of high sedentary behaviour and could be a novel mechanism linking sedentary behaviour with CVD. Future work should examine the impact of reducing sedentary behaviour on measures of stress reactivity, as this may have clinical relevance for preventing CVD.
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Affiliation(s)
- Aiden J Chauntry
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, United Kingdom; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicestershire, United Kingdom
| | - Nicolette C Bishop
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, United Kingdom; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicestershire, United Kingdom
| | - Mark Hamer
- The Institute of Sport, Exercise and Health, Division of Surgery & Interventional Science, University College London, London, United Kingdom
| | - Andrew P Kingsnorth
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, United Kingdom; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicestershire, United Kingdom; Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
| | - Yu-Ling Chen
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, United Kingdom
| | - Nicola J Paine
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, United Kingdom; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicestershire, United Kingdom.
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41
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Hamer M, Blodgett JM, Stamatakis E. Dose-response association between step count and cardiovascular disease risk markers in middle-aged adults. Scand J Med Sci Sports 2022; 32:1161-1165. [PMID: 35460292 PMCID: PMC9428935 DOI: 10.1111/sms.14173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 04/05/2022] [Accepted: 04/21/2022] [Indexed: 11/27/2022]
Abstract
Several step-based daily targets have been widely circulated, but there is a lack of empirical population-based evidence to support such guidance. We examined dose-response associations between step count and classical CVD risk markers (glycated hemoglobin, high density lipoprotein cholesterol, triglycerides, and C-reactive protein) in 4665 adults (aged 46 years; 51.4% female) in a cross-sectional study. Step counts were measured from a thigh mounted accelerometer (activPAL) worn over 7 days. The shape of the dose-response curve for most risk markers was "L-shaped," with linear risk reduction up to around 10 000 steps a day. Controlling for stepping intensity did not materially alter our results.
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Affiliation(s)
- Mark Hamer
- Division Surgery Interventional Science, Institute of Sport Exercise and Health, University College London, London, UK
| | - Joanna M Blodgett
- Division Surgery Interventional Science, Institute of Sport Exercise and Health, University College London, London, UK
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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42
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Giurgiu M, Timm I, Becker M, Schmidt S, Wunsch K, Nissen R, Davidovski D, Bussmann JBJ, Nigg CR, Reichert M, Ebner-Priemer UW, Woll A, von Haaren-Mack B. Quality Evaluation of Free-living Validation Studies for the Assessment of 24-Hour Physical Behavior in Adults via Wearables: Systematic Review. JMIR Mhealth Uhealth 2022; 10:e36377. [PMID: 35679106 PMCID: PMC9227659 DOI: 10.2196/36377] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 12/13/2022] Open
Abstract
Background Wearable technology is a leading fitness trend in the growing commercial industry and an established method for collecting 24-hour physical behavior data in research studies. High-quality free-living validation studies are required to enable both researchers and consumers to make guided decisions on which study to rely on and which device to use. However, reviews focusing on the quality of free-living validation studies in adults are lacking. Objective This study aimed to raise researchers’ and consumers’ attention to the quality of published validation protocols while aiming to identify and compare specific consistencies or inconsistencies between protocols. We aimed to provide a comprehensive and historical overview of which wearable devices have been validated for which purpose and whether they show promise for use in further studies. Methods Peer-reviewed validation studies from electronic databases, as well as backward and forward citation searches (1970 to July 2021), with the following, required indicators were included: protocol must include real-life conditions, outcome must belong to one dimension of the 24-hour physical behavior construct (intensity, posture or activity type, and biological state), the protocol must include a criterion measure, and study results must be published in English-language journals. The risk of bias was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool with 9 questions separated into 4 domains (patient selection or study design, index measure, criterion measure, and flow and time). Results Of the 13,285 unique search results, 222 (1.67%) articles were included. Most studies (153/237, 64.6%) validated an intensity measure outcome such as energy expenditure. However, only 19.8% (47/237) validated biological state and 15.6% (37/237) validated posture or activity-type outcomes. Across all studies, 163 different wearables were identified. Of these, 58.9% (96/163) were validated only once. ActiGraph GT3X/GT3X+ (36/163, 22.1%), Fitbit Flex (20/163, 12.3%), and ActivPAL (12/163, 7.4%) were used most often in the included studies. The percentage of participants meeting the quality criteria ranged from 38.8% (92/237) to 92.4% (219/237). On the basis of our classification tree to evaluate the overall study quality, 4.6% (11/237) of studies were classified as low risk. Furthermore, 16% (38/237) of studies were classified as having some concerns, and 72.9% (173/237) of studies were classified as high risk. Conclusions Overall, free-living validation studies of wearables are characterized by low methodological quality, large variability in design, and focus on intensity. Future research should strongly aim at biological state and posture or activity outcomes and strive for standardized protocols embedded in a validation framework. Standardized protocols for free-living validation embedded in a framework are urgently needed to inform and guide stakeholders (eg, manufacturers, scientists, and consumers) in selecting wearables for self-tracking purposes, applying wearables in health studies, and fostering innovation to achieve improved validity.
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Affiliation(s)
- Marco Giurgiu
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Irina Timm
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Marlissa Becker
- Unit Physiotherapy, Department of Orthopedics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Steffen Schmidt
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Kathrin Wunsch
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Rebecca Nissen
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Denis Davidovski
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Johannes B J Bussmann
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Claudio R Nigg
- Health Science Department, Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Markus Reichert
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Department of eHealth and Sports Analytics, Faculty of Sport Science, Ruhr-University Bochum, Bochum, Germany
| | - Ulrich W Ebner-Priemer
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Alexander Woll
- Department of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Birte von Haaren-Mack
- Department of Health and Social Psychology, Institute of Psychology, German Sport University, Cologne, Germany
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Clemes SA, Varela-Mato V, Bodicoat DH, Brookes CL, Chen YL, Edwardson CL, Gray LJ, Guest AJ, Johnson V, Munir F, Paine NJ, Richardson G, Ruettger K, Sayyah M, Sherry A, Di Paola AS, Troughton J, Yates T, King JA. The effectiveness of the Structured Health Intervention For Truckers (SHIFT): a cluster randomised controlled trial (RCT). BMC Med 2022; 20:195. [PMID: 35606763 PMCID: PMC9126630 DOI: 10.1186/s12916-022-02372-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/11/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Long distance heavy goods vehicle (HGV) drivers exhibit higher than nationally representative rates of obesity, and obesity-related co-morbidities, and are underserved in terms of health promotion initiatives. The purpose of this study was to evaluate the effectiveness of the multicomponent 'Structured Health Intervention For Truckers' (SHIFT), compared to usual care, at 6- and 16-18-month follow-up. METHODS We conducted a two-arm cluster RCT in transport sites throughout the Midlands, UK. Outcome measures were assessed at baseline, at 6- and 16-18-month follow-up. Clusters were randomised (1:1) following baseline measurements to either the SHIFT arm or usual practice control arm. The 6-month SHIFT programme included a group-based interactive 6-h education and behaviour change session, health coach support and equipment provision (Fitbit® and resistance bands/balls to facilitate a 'cab workout'). The primary outcome was device-assessed physical activity (mean steps/day) at 6 months. Secondary outcomes included the following: device-assessed sitting, physical activity intensity and sleep; cardiometabolic health, diet, mental wellbeing and work-related psychosocial variables. Data were analysed using mixed-effect linear regression models using a complete-case population. RESULTS Three hundred eighty-two HGV drivers (mean ± SD age: 48.4 ± 9.4 years, BMI: 30.4 ± 5.1 kg/m2, 99% male) were recruited across 25 clusters (sites) and randomised into either the SHIFT (12 clusters, n = 183) or control (13 clusters, n = 199) arms. At 6 months, 209 (55%) participants provided primary outcome data. Significant differences in mean daily steps were found between groups, in favour of the SHIFT arm (adjusted mean difference: 1008 steps/day, 95% CI: 145-1871, p = 0.022). Favourable differences were also seen in the SHIFT group, relative to the control group, in time spent sitting (- 24 mins/day, 95% CI: - 43 to - 6), and moderate-to-vigorous physical activity (6 mins/day, 95% CI: 0.3-11). Differences were not maintained at 16-18 months. No differences were observed between groups in the other secondary outcomes at either follow-up. CONCLUSIONS The SHIFT programme led to a potentially clinically meaningful difference in daily steps, between trial arms, at 6 months. Whilst the longer-term impact is unclear, the programme offers potential to be incorporated into driver training courses to promote activity in this at-risk, underserved and hard-to-reach essential occupational group. TRIAL REGISTRATION ISRCTN10483894 (date registered: 01/03/2017).
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Affiliation(s)
- Stacy A Clemes
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK. .,NIHR Leicester Biomedical Research Centre, Leicester, LE5 4PW, UK.
| | - Veronica Varela-Mato
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK.,NIHR Leicester Biomedical Research Centre, Leicester, LE5 4PW, UK
| | | | - Cassandra L Brookes
- Leicester Clinical Trials Unit, University of Leicester, Leicester, LE1 7RH, UK
| | - Yu-Ling Chen
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK.,NIHR Leicester Biomedical Research Centre, Leicester, LE5 4PW, UK
| | - Charlotte L Edwardson
- NIHR Leicester Biomedical Research Centre, Leicester, LE5 4PW, UK.,Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - Laura J Gray
- Department of Health Sciences, University of Leicester, Leicester, LE1 7RH, UK
| | - Amber J Guest
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - Vicki Johnson
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, LE5 4PW, UK
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK.,NIHR Leicester Biomedical Research Centre, Leicester, LE5 4PW, UK
| | - Nicola J Paine
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK.,NIHR Leicester Biomedical Research Centre, Leicester, LE5 4PW, UK
| | - Gerry Richardson
- Centre for Health Economics, University of York, York, YO10 5DD, UK
| | - Katharina Ruettger
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - Mohsen Sayyah
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - Aron Sherry
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK.,NIHR Leicester Biomedical Research Centre, Leicester, LE5 4PW, UK
| | - Ana Suazo Di Paola
- Leicester Clinical Trials Unit, University of Leicester, Leicester, LE1 7RH, UK
| | - Jacqui Troughton
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, LE5 4PW, UK
| | - Thomas Yates
- NIHR Leicester Biomedical Research Centre, Leicester, LE5 4PW, UK.,Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - James A King
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK.,NIHR Leicester Biomedical Research Centre, Leicester, LE5 4PW, UK
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van Bakel BMA, Kroesen SH, Günal A, Scheepmaker A, Aengevaeren WRM, Willems FF, Wondergem R, Pisters MF, Dam J, Janssen AM, de Bruin M, Hopman MTE, Thijssen DHJ, Eijsvogels TMH. Sedentary Behaviour Intervention as a Personalised Secondary Prevention Strategy (SIT LESS) for patients with coronary artery disease participating in cardiac rehabilitation: rationale and design of the SIT LESS randomised clinical trial. BMJ Open Sport Exerc Med 2022; 8:e001364. [PMID: 35692440 PMCID: PMC9134157 DOI: 10.1136/bmjsem-2022-001364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/11/2022] Open
Abstract
Patients with coronary artery disease (CAD) are more sedentary compared with the general population, but contemporary cardiac rehabilitation (CR) programmes do not specifically target sedentary behaviour (SB). We developed a 12-week, hybrid (centre-based+home-based) Sedentary behaviour IntervenTion as a personaLisEd Secondary prevention Strategy (SIT LESS). The SIT LESS programme is tailored to the needs of patients with CAD, using evidence-based behavioural change methods and an activity tracker connected to an online dashboard to enable self-monitoring and remote coaching. Following the intervention mapping principles, we first identified determinants of SB from literature to adapt theory-based methods and practical applications to target SB and then evaluated the intervention in advisory board meetings with patients and nurse specialists. This resulted in four core components of SIT LESS: (1) patient education, (2) goal setting, (3) motivational interviewing with coping planning, and (4) (tele)monitoring using a pocket-worn activity tracker connected to a smartphone application and providing vibrotactile feedback after prolonged sedentary bouts. We hypothesise that adding SIT LESS to contemporary CR will reduce SB in patients with CAD to a greater extent compared with usual care. Therefore, 212 patients with CAD will be recruited from two Dutch hospitals and randomised to CR (control) or CR+SIT LESS (intervention). Patients will be assessed prior to, immediately after and 3 months after CR. The primary comparison relates to the pre-CR versus post-CR difference in SB (objectively assessed in min/day) between the control and intervention groups. Secondary outcomes include between-group differences in SB characteristics (eg, number of sedentary bouts); change in SB 3 months after CR; changes in light-intensity and moderate-to-vigorous-intensity physical activity; quality of life; and patients' competencies for self-management. Outcomes of the SIT LESS randomised clinical trial will provide novel insight into the effectiveness of a structured, hybrid and personalised behaviour change intervention to attenuate SB in patients with CAD participating in CR. Trial registration number NL9263.
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Affiliation(s)
- B M A van Bakel
- Department of Physiology, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - S H Kroesen
- Department of Physiology, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - A Günal
- Department of Cardiology, Bernhoven Hospital, Uden, The Netherlands
| | - A Scheepmaker
- Department of Cardiology, Bernhoven Hospital, Uden, The Netherlands
| | - W R M Aengevaeren
- Department of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands
| | - F F Willems
- Department of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands
| | - R Wondergem
- Department of Rehabilitation, Physical Therapy Science and Sport, University Medical Center Utrecht Brain Center, Utrecht, The Netherlands
- Research Group Empowering Healthy Behaviour, Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, The Netherlands
- Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, The Netherlands
| | - M F Pisters
- Department of Rehabilitation, Physical Therapy Science and Sport, University Medical Center Utrecht Brain Center, Utrecht, The Netherlands
- Research Group Empowering Healthy Behaviour, Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, The Netherlands
- Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, The Netherlands
| | - J Dam
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - A M Janssen
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - M de Bruin
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - M T E Hopman
- Department of Physiology, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - D H J Thijssen
- Department of Physiology, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
- Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - T M H Eijsvogels
- Department of Physiology, Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
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Detecting accelerometer non-wear periods using change in acceleration combined with rate-of-change in temperature. BMC Med Res Methodol 2022; 22:147. [PMID: 35596151 PMCID: PMC9123693 DOI: 10.1186/s12874-022-01633-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/03/2022] [Indexed: 11/22/2022] Open
Abstract
Background Accelerometery is commonly used to estimate physical activity, sleep, and sedentary behavior. In free-living conditions, periods of device removal (non-wear) can lead to misclassification of behavior with consequences for research outcomes and clinical decision making. Common methods for non-wear detection are limited by data transformations (e.g., activity counts) or algorithm parameters such as minimum durations or absolute temperature thresholds that risk over- or under-estimating non-wear time. This study aimed to advance non-wear detection methods by integrating a ‘rate-of-change’ criterion for temperature into a combined temperature-acceleration algorithm. Methods Data were from 39 participants with neurodegenerative disease (36% female; age: 45–83 years) who wore a tri-axial accelerometer (GENEActiv) on their wrist 24-h per day for 7-days as part of a multi-sensor protocol. The reference dataset was derived from visual inspection conducted by two expert analysts. Linear regression was used to establish temperature rate-of-change as a criterion for non-wear detection. A classification and regression tree (CART) decision tree classifier determined optimal parameters separately for non-wear start and end detection. Classifiers were trained using data from 15 participants (38.5%). Outputs from the CART analysis were supplemented based on edge cases and published parameters. Results The dataset included 186 non-wear periods (85.5% < 60 min). Temperature rate-of-change over the first five minutes of non-wear was − 0.40 ± 0.17 °C/minute and 0.36 ± 0.21 °C/minute for the first five minutes following device donning. Performance of the DETACH (DEvice Temperature and Accelerometer CHange) algorithm was improved compared to existing algorithms with recall of 0.942 (95% CI 0.883 to 1.0), precision of 0.942 (95% CI 0.844 to 1.0), F1-Score of 0.942 (95% CI 0.880 to 1.0) and accuracy of 0.996 (0.994–1.000). Conclusion The DETACH algorithm accurately detected non-wear intervals as short as five minutes; improving non-wear classification relative to current interval-based methods. Using temperature rate-of-change combined with acceleration results in a robust algorithm appropriate for use across different temperature ranges and settings. The ability to detect short non-wear periods is particularly relevant to free-living scenarios where brief but frequent removals occur, and for clinical application where misclassification of behavior may have important implications for healthcare decision-making. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-022-01633-6.
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Brakenridge CJ, Gardiner PA, Grigg RV, Winkler EAH, Fjeldsoe BS, Schaumberg MA, Owen N, Eakin EG, Biddle SJH, Moodie M, Daly RM, Green DJ, Cohen N, Gray L, Comans T, Buman MP, Goode AD, Nguyen P, Gao L, Healy GN, Dunstan DW. Sitting less and moving more for improved metabolic and brain health in type 2 diabetes: 'OPTIMISE your health' trial protocol. BMC Public Health 2022; 22:929. [PMID: 35538430 PMCID: PMC9086419 DOI: 10.1186/s12889-022-13123-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 01/21/2023] Open
Abstract
Background Clinical practice guidelines recommend that adults with type 2 diabetes (T2D) sit less and move more throughout the day. The 18-month OPTIMISE Your Health Clinical Trial was developed to support desk-based workers with T2D achieve these recommendations. The two-arm protocol consists of an intervention and control arms. The intervention arm receives 6 months health coaching, a sit-stand desktop workstation and an activity tracker, followed by 6 months of text message support, then 6 months maintenance. The control arm receives a delayed modified intervention after 12 months of usual care. This paper describes the methods of a randomised controlled trial (RCT) evaluating the effectiveness and cost-effectiveness of the intervention, compared to a delayed intervention control. Methods This is a two-arm RCT being conducted in Melbourne, Australia. Desk-based workers (≥0.8 full-time equivalent) aged 35–65 years, ambulatory, and with T2D and managed glycaemic control (6.5–10.0% HbA1c), are randomised to the multicomponent intervention (target n = 125) or delayed-intervention control (target n = 125) conditions. All intervention participants receive 6 months of tailored health coaching assisting them to “sit less” and “move more” at work and throughout the day, supported by a sit-stand desktop workstation and an activity tracker (Fitbit). Participants receive text message-based extended care for a further 6-months (6–12 months) followed by 6-months of non-contact (12–18 months: maintenance). Delayed intervention occurs at 12–18 months for the control arm. Assessments are undertaken at baseline, 3, 6, 12, 15 and 18-months. Primary outcomes are activPAL-measured sitting time (h/16 h day), glycosylated haemoglobin (HbA1c; %, mmol/mol) and, cognitive function measures (visual learning and new memory; Paired Associates Learning Total Errors [adjusted]). Secondary, exploratory, and process outcomes will also be collected throughout the trial. Discussion The OPTIMISE Your Health trial will provide unique insights into the benefits of an intervention aimed at sitting less and moving more in desk-bound office workers with T2D, with outcomes relevant to glycaemic control, and to cardiometabolic and brain health. Findings will contribute new insights to add to the evidence base on initiating and maintaining behaviour change with clinical populations and inform practice in diabetes management. Trial registration ANZCTRN12618001159246. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13123-x.
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Affiliation(s)
- Christian J Brakenridge
- Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia. .,Australian Catholic University, Mary Mackillop Institute of Health Research, Melbourne, Australia.
| | - Paul A Gardiner
- University of Southern Queensland, School of Health and Medical Sciences, Ipswich, Australia.,University of Southern Queensland, Centre for Health Research, Springfield, Australia.,The University of Queensland, Centre for Health Services Research, Brisbane, Australia
| | - Ruth V Grigg
- Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia
| | - Elisabeth A H Winkler
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Australia
| | - Brianna S Fjeldsoe
- The University of Queensland, School of Public Health, Brisbane, Australia
| | - Mia A Schaumberg
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Australia.,University of Sunshine Coast, School of Health and Behavioural Sciences, Sunshine Coast, Australia.,Sunshine Coast Health Institute, Sunshine Coast Hospital and Health Service, Birtinya, Australia
| | - Neville Owen
- Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.,Swinburne University, School of Health Sciences, Melbourne, Australia
| | - Elizabeth G Eakin
- The University of Queensland, School of Public Health, Brisbane, Australia
| | - Stuart J H Biddle
- University of Southern Queensland, Centre for Health Research, Springfield, Australia
| | - Marjory Moodie
- Deakin University, School of Health and Social Development, Melbourne, Australia
| | - Robin M Daly
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Melbourne, Australia
| | - Daniel J Green
- University of Western Australia, School of Sport Science, Exercise & Health, Perth, Australia
| | - Neale Cohen
- Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia
| | - Len Gray
- The University of Queensland, Centre for Health Services Research, Brisbane, Australia
| | - Tracy Comans
- The University of Queensland, Centre for Health Services Research, Brisbane, Australia
| | - Matthew P Buman
- Arizona State University, College of Health Solutions, Tempe, USA
| | - Ana D Goode
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Australia
| | - Phuong Nguyen
- Deakin University, School of Health and Social Development, Melbourne, Australia
| | - Lan Gao
- Deakin University, School of Health and Social Development, Melbourne, Australia
| | - Genevieve N Healy
- Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.,The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Australia
| | - David W Dunstan
- Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.,Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Melbourne, Australia.,School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
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47
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Ojo SO, Bailey DP, Chater AM, Hewson DJ. Workplace Intervention for Reducing Sitting Time in Sedentary Workers: Protocol for a Pilot Study Using the Behavior Change Wheel. Front Public Health 2022; 10:832374. [PMID: 35493386 PMCID: PMC9039234 DOI: 10.3389/fpubh.2022.832374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
The workplace is a major contributor to excessive sitting in office workers. There are a wide array of adverse effects of high volumes of sitting time, including an increased risk of type 2 diabetes and depression. Active workstations can be used in effective interventions to decrease workplace sitting. However, there are a lack of interventions that have been developed using a systematic process that is informed by participant needs and a framework for identifying the most appropriate content for the intervention. Applying these methods could increase adherence and potential effectiveness of the intervention. Therefore, the purpose of this pilot study is to examine the feasibility, acceptability, and efficacy of a tailored workplace intervention to reduce and break up sitting in office workers that has been developed using the Behavior Change Wheel and the APEASE (Acceptability, Practicability, Effectiveness/cost-effectiveness, Affordability, Safety/side-effects, Equity) criteria. This article reports the protocol for this study that is currently ongoing. Participants will be cluster-randomized (by offices) to control and intervention groups. The evaluation of the intervention includes determining feasibility by assessing participant recruitment, retention and data completion rates. Adherence to the intervention will be assessed based on daily sitting and standing time relative to guidelines provided to participants as part of the intervention. Outcome measures also include productivity measured using Ecological Momentary Assessment, absenteeism, presenteeism, cardiometabolic risk markers, and wellbeing. The findings of this study will inform the effective design and implementation of interventions for reducing and breaking up sitting in office workers.
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Affiliation(s)
- Samson O Ojo
- Institute for Health Research, University of Bedfordshire, Luton, United Kingdom.,Quality Improvement, Northampton General Hospital NHS Trust, Northampton, United Kingdom
| | - Daniel P Bailey
- Institute for Sport and Physical Activity Research, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, United Kingdom.,Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom.,Centre for Physical Activity in Health and Disease, Brunel University London, Uxbridge, United Kingdom
| | - Angel M Chater
- Institute for Sport and Physical Activity Research, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, United Kingdom.,Centre for Behaviour Change, University College London, London, United Kingdom
| | - David J Hewson
- Institute for Health Research, University of Bedfordshire, Luton, United Kingdom
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48
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McBride P, Yates T, Henson J, Davies M, Gill J, Celis-Morales C, Khunti K, Maylor B, Rowlands A, Edwardson C. Ethnic differences in the relationship between step cadence and physical function in older adults. J Sports Sci 2022; 40:1183-1190. [PMID: 35363123 PMCID: PMC9038174 DOI: 10.1080/02640414.2022.2057013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
This study investigated associations between step cadence and physical function in healthy South Asian (SA) and White European (WE) older adults, aged ≥60. Participants completed the 60-s Sit-to-Stand (STS-60) test of physical function. Free-living stepping was measured using the activPAL3™. Seventy-one WEs (age = 72 ± 5, 53% male) and 33 SAs (age = 71 ± 5, 55% male) were included. WEs scored higher than SAs in the STS-60 (23 vs 20 repetitions, p = 0.045). Compared to WEs, SAs had significantly lower total and brisk (≥100 steps/min) steps (total: 8971 vs 7780 steps/day, p = 0.041; brisk: 5515 vs 3723 steps/day, p = 0.001). In WEs, 1000 brisk steps and each decile higher proportion of steps spent brisk stepping were associated with STS-60 (β = 0.72 95% CI 0.05, 1.38 and β = 1.01 95% CI 0.19, 1.82, respectively), with associations persisting across mean peak 1 min (β = 1.42 95% CI 0.12, 2.71), 30 min (β = 1.71 95% CI 0.22, 3.20), and 60 min (β = 2.16 95% CI 0.62, 3.71) stepping periods. Associations were not observed in SAs. Ethnic differences in associations between ambulation and physical function may exist in older adults which warrant further investigationi.
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Affiliation(s)
- Philip McBride
- Diabetes Research Centre, Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester HHS Trust, Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester HHS Trust, Leicester, UK
| | - Joseph Henson
- Diabetes Research Centre, Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester HHS Trust, Leicester, UK
| | - Melanie Davies
- Diabetes Research Centre, Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester HHS Trust, Leicester, UK.,Leicester Diabetes Centre, Leicester General Hospital, University Hospitals Leicester, Leicester, UK
| | - Jason Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Carlos Celis-Morales
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK.,Leicester Diabetes Centre, Leicester General Hospital, University Hospitals Leicester, Leicester, UK.,NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands, University of Leicester and University Hospitals of Leicester Nhs Trust, Leicester, UK
| | - Benjamin Maylor
- Diabetes Research Centre, Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester HHS Trust, Leicester, UK
| | - Alex Rowlands
- Diabetes Research Centre, Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester HHS Trust, Leicester, UK
| | - Charlotte Edwardson
- Diabetes Research Centre, Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester HHS Trust, Leicester, UK
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49
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Kalisch T, Theil C, Gosheger G, Schwarze J, Voss K, Schoenhals I, Moellenbeck B. Validation of a Modified Version of the German Sedentary Behavior Questionnaire. Healthcare (Basel) 2022; 10:healthcare10050807. [PMID: 35627946 PMCID: PMC9141471 DOI: 10.3390/healthcare10050807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Physical inactivity and excessive sedentary behavior (SB) are growing public health issues that require surveillance, guidelines, and targeted interventions. In addition to a variety of sophisticated technical methods, questionnaires are still an attractive method for quick, easy, comprehensive, and cost-effective estimation of SB. The aim of this study was to validate a modified version of the widely used Sedentary Behavior Questionnaire (SBQ) compared to waist-worn accelerometers as an objective measurement. Contemporary explanations covering the use of smart devices have been added to the original instrument, and sitting while handwriting was explicated in more detail. Methods: Cross-sectional data from an adult sample (n = 64, 20−85 y, 25 m, 39 f) were used in this first validation study. Based on prior investigations of the SBQ, analyses were conducted in a gender-specific manner. Criterion validity was assessed using Spearman’s Rho coefficients. The Bland−Altman method was used to test the agreement between self-reported and accelerometer-measured SB time. Results: Using the modified SBQ (mSBQ), a significant gender difference in weekly sedentary time was found. Women estimated their sedentary time to be almost 50% higher than men (median 74.5 h vs. 51.0 h). No correlation was found between the questionnaire and accelerometer data for both subgroups (rho ≤ 0.281, p ≥ 0.174). Individual differences in daily SB estimation between both methods (in relation to accelerometry) were +3.82 h ± 4.36 h for women and +0.48 h ± 2.58 h for men (p < 0.001). Conclusion: The modifications to the SBQ did not improve the correlation between self-assessment of SB and objective determination. The reasons for the presented gender-specific overestimation of the participants’ own sedentary time, which contradicts the findings of other studies, remain unclear and need to be investigated further.
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Affiliation(s)
- Tobias Kalisch
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany; (C.T.); (G.G.); (J.S.); (I.S.); (B.M.)
- Correspondence:
| | - Christoph Theil
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany; (C.T.); (G.G.); (J.S.); (I.S.); (B.M.)
| | - Georg Gosheger
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany; (C.T.); (G.G.); (J.S.); (I.S.); (B.M.)
| | - Jan Schwarze
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany; (C.T.); (G.G.); (J.S.); (I.S.); (B.M.)
| | - Katharina Voss
- Biomechatronics Research Laboratory, Muenster University of Applied Sciences, Buergerkamp 3, 48565 Steinfurt, Germany;
| | - Isabell Schoenhals
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany; (C.T.); (G.G.); (J.S.); (I.S.); (B.M.)
| | - Burkhard Moellenbeck
- Department of Orthopedics and Tumor Orthopedics, Muenster University Hospital, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany; (C.T.); (G.G.); (J.S.); (I.S.); (B.M.)
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50
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Ruettger K, Varela-Mato V, Chen YL, Edwardson CL, Guest A, Gilson ND, Gray LJ, Paine NJ, Sherry AP, Sayyah M, Yates T, King JA, Clemes SA. Physical Activity, Sedentary Time, and Cardiometabolic Health in Heavy Goods Vehicle Drivers. J Occup Environ Med 2022; 64:e217-e223. [PMID: 35051962 DOI: 10.1097/jom.0000000000002484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Physical inactivity, prolonged sitting, and unhealthy dietary habits are common in Heavy Goods Vehicle (HGV) drivers. These factors increase risk of long-term health conditions. METHODS 329 HGV drivers across 25 UK depots completed a health assessment, including questionnaire completion, and objectively measured anthropometrics, blood biomarkers, physical activity (PA), and sedentary behavior. RESULTS The sample demonstrated a high-risk cardiometabolic health profile. 88.1% were overweight or had obesity, and 11.9% had pre-diabetes or diabetes. 28.3% had hypertension, 83.6% had clinically elevated circulating low-density lipoprotein-cholesterol concentrations (>2mmol/l), and 66.6% had high total cholesterol levels (>4mmol/l). On workdays drivers accumulated 12 hours/day of sitting, 1.7 hours/day of light PA, and 9.8 mins/day of moderate-to-vigorous PA. Associations between light PA and cardiometabolic markers were observed. CONCLUSION This sample presents high levels of inactivity, overweight, and obesity, and unhealthy cardiometabolic health profiles.
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Affiliation(s)
- Katharina Ruettger
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (Miss Ruettger, Dr Varela-Mato, Dr Chen, Miss Guest, Dr Paine, Dr Sherry, Dr Sayyah, Dr King, Dr Clemes), NIHR Leicester Biomedical Research Centre, United Kingdom (Dr Varela-Mato, Dr Edwardson, Dr Paine, Dr Sherry, Dr Yates, Dr King, Dr Clemes), Diabetes Research Centre, University of Leicester, United Kingdom (Dr Edwardson, Dr Yates), School of Human Movement and Nutrition Sciences, University of Queensland, Australia (Dr Gilson), Department of Health Sciences, University of Leicester, Leicester, United Kingdom (Dr Gray)
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