Economic burden of low physical activity and high sedentary behaviour in Finland

Large-scale greenway exposure reduces sedentary behavior: A natural experiment in China

As a global public health problem, sedentary behavior has attracted more and more attention. Although numerous studies have demonstrated many benefits of green spaces to health, causal evidence on how green spaces affect people's sedentary behavior is scarce. This study used a natural experiment to evaluate the impact of greenway intervention on sedentary behavior. Two waves of data were collected in 2016 and 2019 (before and after the intervention) at East Lake Greenway (102-km-long) in Wuhan, China, with 1020 participants in 52 neighborhoods. We adopted three major methods to evaluate the impact of greenway intervention on sedentary behavior, including Propensity Score Matching and difference-in-difference (PSM-DID) method (with both individual and neighborhood variables to match samples), continuous treatment DID method (with distance to the greenway as the continuous treatment), and mediation analysis (with moderate to vigorous physical activity or MVPA, and walking time as the mediator). The results revealed that the greenway intervention significantly reduced participants' sedentary time and the intervention has a distance decay effect. The closer to the greenway, the greater decrease in sedentary time after the greenway opening. Furthermore, we found that MVPA and walking time mediate the impact of the greenway intervention on the change in sedentary behavior. The effect of greenway intervention was more beneficial for those under the age of 60, those who were employed, or those who were married. Our findings provided robust evidence that exposure to urban greenways affects sedentary behavior and such green infrastructures help protect public health in high-density urban areas.

Profiling the patient with inflammatory bowel disease in the relationship between physical activity and partner/social network status: A post hoc patient-tailored analysis of the "BE-FIT-IBD" study

INTRODUCTION

Normal quality of life is an ultimate target in the therapeutic approach to inflammatory bowel diseases (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC) in the context of which regular physical activity (PA) is often a chimeric parameter that is not standardized in terms of quality/quantity. The study aimed to profile a sample of IBD patients about the relationship between PA-partner status and social network support.

PATIENTS AND METHODS

A post hoc analysis of the "BE-FIT-IBD" study was set up by stratifying the data of PA with that of partner status and the support that the patient's social network (i.e., relatives, friends) provided in inciting the patient to practice regular PA.

RESULTS

In the 219 patients included, there was a greater tendency for patients with stable partners to view the risk of reactivation/worsening of IBD as a barrier to conducting regular PA (p<0.0001). Single patients considered PA more as a protective factor (p=0.045). Patients without a PA-supporting social network retained IBD-related treatment as a PA barrier (p=0.016) and PA as a risk for IBD complications (p=0.01), with less confidence that PA could improve the course of IBD (p<0.001). Rectal syndrome was an IBD-related barrier more represented in patients with PA-deterring social network (p<0.0001).

CONCLUSIONS

These factors are potential targets for recovering the IBD patient's adherence to regular PA.

Sedentary behavior, abdominal obesity and healthcare costs in Brazilian adults with cardiovascular diseases: a cross-sectional study

BACKGROUND

Research on the economic burden of sedentary behavior and abdominal obesity on health expenses associated with cardiovascular diseases is scarce.

OBJECTIVE

The objective of this study was to verify whether sedentary behavior, isolated and combined with abdominal obesity, influences the medication expenditure among adults with cardiovascular diseases.

DESIGN AND SETTING

This cross-sectional study was conducted in the city of President Prudente, State of São Paulo, Brazil in 2018.

METHODS

The study included adults with cardiovascular diseases, aged 30-65 years, who were treated by the Brazilian National Health Services. Sedentary behavior was assessed using a questionnaire. Abdominal obesity was defined by waist circumference. Medication expenditures were verified using the medical records of each patient.

RESULTS

The study included a total of 307 adults. Individuals classified in the group with risk factor obesity combined (median [IQ] USD$ 29.39 [45.77]) or isolated (median [IQ] USD$ 27.17 [59.76]) to sedentary behavior had higher medication expenditures than those belonging to the non-obese with low sedentary behavior group (median [IQ] USD$ 13.51 [31.42]) (P = 0.01). The group with combined obesity and sedentary behavior was 2.4 (95%CI = 1.00; 5.79) times more likely to be hypertensive.

CONCLUSION

Abdominal obesity was a determining factor for medication expenses, regardless of sedentary behavior, among adults with cardiovascular diseases.

Use of electronic devices in leisure time modifies the prevalence and factors associated with sedentary behavior derived exclusively from excessive television viewing among Brazilian adults

The growing interest in the study of sedentary behavior is justified by its increasing presence in people's daily lives, particularly in leisure time. The aim of this study was to compare the prevalence and factors associated with sedentary behavior derived exclusively from TV time and from its combination with the time spent using other electronic devices among Brazilian adults (n = 52,443). This cross-sectional study used data from the Vigitel survey (2019), which included subjects ≥ 18 years old who resided in the capitals of the 26 Brazilian states and Federal District. High TV time (≥ 4 h/day), and its combination with computer, tablet, or cell phone use (≥ 4 h/day), as well as sociodemographic, behavioral, and health characteristics were self-reported. Adjusted logistic regression was used to estimate odds ratios and 95% confidence intervals (95%CI). The prevalence of high sedentary behavior almost tripled when TV viewing was added to the time spent using other electronic devices (from 12.2%; 95%CI: 11.6; 12.8, to 34.7%; 95%CI: 33.8; 35.6), notably among the youngest (32.0 percentage points). Individuals living without a partner, who smoked, consumed alcohol and processed foods excessively, were physically inactive, and had hypertension were more likely to have both outcomes than their counterparts. Older and less educated individuals were more likely to spend excessive time watching TV and less likely to have high use of other electronic devices in addition to TV viewing than their peers. Including computer, tablet, or cell phone led to an increase in the prevalence of high sedentary behavior. The magnitude and direction of the associations of age and education with high sedentary behavior varied according to the method how high sedentary behavior was defined. Projects, programs, and policies must consider the different indicators of sedentary behavior in monitoring and promoting a healthier lifestyle.

Detecting informal green, blue, and street physical activity spaces in the city using geotagged sports-related Twitter tweets

Introduction

Finland's natural physical environment and climate support a wide variety of informal outdoor sports, thereby motivating the population to do physical exercise in scenic environments. The vast majority of Finns enjoys outdoor recreational activities, and could thus be encouraged to post accounts of their year-round activities on social media. Our aim was to find out in what kind of areas and spaces, spatially, users are tweeting about sporting activities.

Methods

We use geotagged Twitter tweets filtering for 16 sporting activity keywords in both English and Finnish. The case study was conducted in the Helsinki Metropolitan Area, Finland, with an emphasis on cross-country skiing as a sports activity when there is snow. In a secondary analysis we concentrated on the sports people were practicing in these locations when there was no snow. The location spaces are split in to three land cover types: green, blue, and street spaces.

Results

We found that approximately half of the 150 skiing-related tweets were geotagged in green spaces, and half in street spaces. This finding related to street space was attributable to a spatial scale error: when we checked the results manually we noticed that they referenced the sporting location in the green space. Hence, then over 90% of the 745 non-ski-related tweets were geotagged in a street space.

Discussion

We conclude that Twitter is a beneficial tool for detecting spaces used for informal physical activity. A shortcoming in current Finnish national sporting policies is that spaces for informal physical activity are not explicitly mentioned- we use the term informal with reference both to the space and to the sporting activity, whereby public spaces are used for physical activity. This new knowledge of sporting locations will help city planners and sports planners to improve informal sports facilities, which in turn will promote healthy exercise in cities.

Economic burden of excessive sedentary behaviour in Canada

OBJECTIVE

To estimate health care and health-related productivity costs associated with excessive sedentary behaviour (> 8 h/day and > 9 h/day) in Canadian adults.

METHODS

Three pieces of information were used to estimate costs: (1) the pooled relative risk estimates of adverse health outcomes consistently shown to be associated with excessive sedentary behaviour, gathered from meta-analyses of prospective cohort studies; (2) the prevalence of excessive sedentary behaviour in Canadian men and women, obtained using waist-worn accelerometry in a nationally representative sample of adults (Canadian Health Measures Survey 2018-2019); and (3) the direct (health care) and indirect (lost productivity due to premature mortality) costs of the adverse health outcomes, selected using the Economic Burden of Illness in Canada 2010 data. The 2010 costs were then adjusted to 2021 costs to account for inflation, population growth, and higher average earnings. A Monte Carlo simulation was conducted to account for uncertainty in the model.

RESULTS

The total costs of excessive sedentary behaviour in Canada were $2.2 billion (8 h/day cut-point) and $1.8 billion (9 h/day cut-point) in 2021, representing 1.6% and 1.3% of the overall burden of illness costs, respectively. The two most expensive chronic diseases attributable to excessive sedentary behaviour were cardiovascular disease and type 2 diabetes. A 10% decrease in excessive sedentary behaviour (from 87.7% to 77.7%) would save an estimated $219 million per year in costs.

CONCLUSION

Excessive sedentary behaviour significantly contributes to the economic burden of illness in Canada. There is a need for evidence-based and cost-effective strategies that reduce excessive sedentary behaviour in the population.

Valuing preventable deaths from major non-communicable diseases and all causes associated with sedentary behavior in Argentina

OBJECTIVE

This study estimated the population attributable fractions, preventable deaths, and indirect economic costs from major non-communicable diseases (NCDs) and all causes associated with excessive sitting time in Argentina in 2019.

METHODS

Population attributable fractions were used to calculate preventable deaths from NCDs and all causes associated with prolonged sitting time (≥6 h/d). Then, the human capital approach was used to quantify the present value of lifetime earnings, which was subsequently used to calculate indirect costs due to lost productivity. A Monte Carlo simulation was performed in three counterfactual scenarios to evaluate the sensitivity of the results.

RESULTS

In Argentinian men and women, respectively, approximately 11.3% (381) [10% (290)] of deaths from colon cancer, 4.4% (250) from breast cancer (women only), 4.6% (588) [4.4% (402)] from coronary heart disease, 30.5% (1390) [27% (1047)] from diabetes, and 14.9% (24,686) [13.7% (21,418)] from all causes could have been avoided annually by eliminating excessive sitting time. The indirect economic costs of excessive sitting time reached 0.025% (0.019%-0.032%) and 0.37% (0.25-0.58%) of gross domestic product (GDP) for major NCDs and all causes, respectively. High levels of heterogeneity were found at the regional level.

CONCLUSION

Prolonged sitting time generates substantial societal costs. Public policies aimed at reducing excessive sedentary behavior in the overall population, especially in the most affected regions, would represent considerable savings for society as a whole. Such initiatives should address the complex and multifactorial causes of sedentary behavior, the clear gender and age differences in this behavior, and the factors underlying these differences.

Physical Activity Tracker Application in Promoting Physical Activity Behavior among Older Adults: A 24-month Follow-Up Study

Objectives

To investigate whether and how PA tracker application use supports PA behavior among older adults during the first 24 months of use. Methods: The changes in PA levels (i.e., time spent in different PA intensities) and between PA categories (i.e., low, moderate, or high based on total PA) were examined between three different time points: before taking the application into use (t0), after 12 months of use (t1), and after 24 months of use (t2). The data was collected by using the International Physical Activity Questionnaire modified for the elderly (IPAQ-E). Results: A statistically significant increase was observed in walking (χ2 (2) = 29.741, p < .001), moderate PA (χ2 (2) = 6.327, p = .042), and total PA levels (χ2 (2) = 11.489, p = .003). The increase was observed between t0 and t1 as well as between t0 and t2. The overall changes between PA categories were statistically significant between t0 and t1 (χ2 (3) = 15.789, p = .001) as well as between t0 and t2 (χ2 (3) = 14.745, p = .002). There were more increasingly active (moved to a higher PA category) than decreasingly active (moved to a lower PA category) participants. Discussion: Overall, the results indicate that PA tracker application use can promote PA behavior among older adults. Stakeholders that work with PA programs and PA promotion, as well as individual users, can utilize digital wellness technologies in supporting PA promotion, especially in exceptional times, like the COVID-19 pandemic, when health care restrictions prevent general gatherings.