Associations of nonoccupational sedentary behaviors with cardiometabolic outcomes: coronary artery risk development in young adults (CARDIA)

BACKGROUND

The association between sedentary behavior (SB) and cardiometabolic risk may differ by SB domain and context. Nonoccupational SB is particularly important because it is discretionary and more amenable to change. This study estimated associations of nonoccupational SB contexts with hypertension (HTN) and diabetes mellitus (DM).

METHODS

A total of 3370 middle-aged adults (50.1 ± 3.6 years; 56% F) from the Coronary Artery Risk Development in Young Adults (CARDIA) study were included. Cross-sectional and 5-year prospective associations between self-report total SB and 6 context-specific SBs (television-TV, computer, transportation, phone, music, and paperwork) with HTN and DM were tested using logistic regression. Fully adjusted models controlled for sociodemographic variables, body mass index, and self-report moderate-vigorous intensity physical activity.

RESULTS

Prevalences of HTN and DM at baseline were 48% (1618 cases) and 10% (320 cases), respectively. Each hour per day of total-SB was cross-sectionally associated with HTN (OR: 1.03, 95% CI, 1.01-1.05) but not DM, with nonsignificant prospective associations for HTN and DM. Of the context-specific SBs, only TV-SB was significantly associated with HTN or DM. Each hour of TV-SB was cross-sectionally associated with HTN (OR: 1.09, 95% CI, 1.03-1.15) and DM (OR: 1.18, 95% CI, 1.09-1.29), and prospectively with HTN (OR: 1.14, 95% CI, 1.04-1.26) but not DM.

CONCLUSION

When comparing total-SB and the 6 context-specific SBs, TV-SB was most robustly associated with HTN. The findings were less clear for DM. Behavior change strategies that target TV-SB reduction may be effective at reducing HTN risk in middle-aged adults.

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

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Accelerometer-Measured Sedentary Behavior and Risk of Future Cardiovascular Disease

BACKGROUND

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Effectiveness and Durability of a Workplace Sedentary Behavior Intervention Based on the Total Worker Health® Approach

We used the Total Worker Health® approach to develop a multi-component workplace sedentary behavior intervention and tested intervention effectiveness in a cluster randomized trial. Participants (n = 198; 75% female) were recruited from three call-centers (two intervention and one usual practice control). All worksites received pedal stand active workstations. The usual practice site received no additional support, while the intervention group completed a six-month program of activities including computer-based training, behavioral self-monitoring, health and safety discussions, and pedaling competitions. Data collection included a survey, a physical health assessment, and accelerometer measures of sedentary behavior, physical activity, and sitting/standing time. Primary analyses were generalized estimating equations comparing changes between intervention and usual practice conditions over time, along with analyses of changes in both groups combined over time. Six-month results revealed less prolonged sitting and reductions in musculoskeletal pain in both groups (all p < 0.05), while the intervention group showed additional improvements in moderate physical activity (p < 0.001) and use of pedal stands (p < 0.01). At 12-months, the additional physical activity and pedal stand use in the intervention group regressed to baseline levels, while reductions in prolonged sitting in both groups were durable (p < 0.01). This study adds to previous research showing the effectiveness of the Total Worker Health® approach for workplace health and safety. Results also show that, while providing employees with health and safety resources is beneficial, providing ongoing support for the adoption and use of resources is more effective.

Middle Childhood Sport Participation Predicts Timely Long-Term Chances of Academic Success in Boys and Girls by Late Adolescence

INTRODUCTION

School-aged children experience successive academic demands that increase over time. Extracurricular sport develops skills that involve physical movement, social rules, formal practice, and rational competition. This may facilitate success.

PURPOSE

Using a prospective-longitudinal birth cohort of 746 girls/721 boys, we examined prospective associations between middle childhood sport participation with subsequent indicators of academic success in adolescence. We hypothesized that persistent participation would promote long-term achievement indicators.

METHODS

Mothers reported on whether the child participated in sporting activities with a coach/instructor from ages 6 to 10 yr. Developmental trajectories of participation were generated using longitudinal latent class analysis and then used to predict outcomes. From ages 12 to 17 yr, youth self-reported on academic indicators of success over the last 6 months. These were linearly regressed on trajectories of participation in sport, while controlling for preexisting and concurrent child/family confounds.

RESULTS

Children's sport participation from kindergarten to fourth grade predicted long-term chances of academic success in boys and girls, above and beyond individual/family confounders. Consistent participation predicted increments indicators of future success and reductions in academic failure and dropout risk through to the senior year of secondary school, ranging from 9.1% to 21.3% for girls and 11.7% to 22.9% for boys.

CONCLUSIONS

We provide compelling and timely evidence of long-term associations between children's sport participation and subsequent indicators of academic success in typically developing boys and girls by late adolescence. Persistent sport involvement in sport increased educational prospects by late adolescence, potentially improving opportunities for success in emerging adulthood.

Sitting Time and Its Interaction With Physical Activity in Relation to All-Cause and Heart Disease Mortality in U.S. Adults With Diabetes

OBJECTIVE

To evaluate whether associations between sitting time and all-cause and heart disease mortality are modified by physical activity in adults with diabetes.

RESEARCH DESIGN AND METHODS

Data came from 6,335 U.S. adults with diabetes from National Health and Nutrition Examination Survey 2007-2018 (baseline), with mortality follow-up through 2019. Sitting time and moderate to vigorous physical activity (MVPA) were self-reported. Cox models were adjusted for sociodemographics, lifestyle factors, and medical conditions.

RESULTS

Over a median follow-up of 5.9 years, 1,278 all-cause and 354 heart disease deaths were documented (mean age, 59.6 years; 48.3% female). Longer sitting time was associated with greater all-cause and heart disease mortality risk in inactive (MVPA <10 min/week) or insufficiently active (MVPA 10 to <150 min/week) adults with diabetes, but not in active adults (MVPA ≥150 min/week) (all-cause mortality: P = 0.003 for interaction; heart disease mortality: P = 0.008 for interaction).

CONCLUSIONS

In adults with diabetes, meeting guideline-recommended physical activity may offset the elevated all-cause and heart disease mortality risk associated with excessive sitting time.

Thyroid function, physical activity and sedentary behaviour: A bidirectional two-sample Mendelian randomisation study

Background

The interinfluence of thyroid function and daily physical activity (PA) remains unclear. We examined the causal relationship between genetically proxied thyroid-related traits; hypothyroidism, hyperthyroidism, thyroid stimulating hormone (TSH) and free thyroxine (FT4), and daily PA measures; leisure screen time (LST) and moderate-to-vigorous physical activity (MVPA), using Mendelian randomisation (MR) analysis.

Methods

We used genome-wide association study (GWAS) data from the ThyroidOmics Consortium and the most comprehensive meta-analysis on PA, comprising data on hypothyroidism (n = 53 423), hyperthyroidism (n = 51 823), TSH within the reference range (n = 54 288), fT4 within the reference range (n = 49 269), LST (n = 526 725), and MVPA (n = 608 595) to conduct a bidirectional two-sample MR analysis. The inverse variance weighted (IVW) method was employed as the primary result. Sensitivity analyses included MR-Egger, weighted median, and MR pleiotropy residual sum and outlier (MR-PRESSO) regression. Similar investigations were conducted in the reverse direction. Finally, we analysed a multivariable MR using body mass index (BMI)-related traits GWAS data.

Results

In the primary IVW analysis, an increase in genetically proxied TSH levels significantly increased LST (correlation coefficient (β) = 0.040; 95% confidence interval (CI) = 0.020-0.061, P = 9.776 × 10-5). The multivariable MR analysis indicated that the positive causal effect still existed when considering the influence of BMI (MVMR-IVW: β = 0.042; 95% CI = 0.011-0.073, P = 0.007). Conversely, there was no evidence to suggest that PA impacts thyroid function.

Conclusions

The results of this MR analysis suggest that thyroid function influences daily PA. The positive association between TSH and LST is not confounded or mediated by BMI.

Sedentary Behavior, Obesity, and Disabilities in Community-Dwelling Older Adults: Analysis of the Brazilian National Health Survey 2019

Research suggests that sedentary behavior (SB) and obesity are associated with disabilities in basic activities (BADL) and instrumental (IADL) activities of daily living. However, there is a lack of studies investigating this association in community-dwelling older adults. Thus, the aim of this study was to investigate the association between different SB typologies, isolated and in conjunction with obesity, and their associations with BADL and IADL disabilities in community-dwelling Brazilian older adults. This was a cross-sectional study using data from older adults (≥60 years) who participated in the Brazilian National Health Survey (2019). The exposures were obesity (BMI > 27 kg/m2) and the amount of time spent daily on SB watching television (SB TV < 3 and ≥3 h/day) and engaging in leisure activities (SB leisure < 3 and ≥3 h/day), analyzed both separately and jointly. The outcomes were BADL and IADL disabilities. The main results showed that isolated SB TV ≥ 3 h/day (OR: 1.26; 95% CI: 1.14; 1.39) and SB TV ≥ 3 h/day combined with obesity (OR: 1.55; 95% CI: 1.37; 1.75) increased the odds of BADL and IADL disabilities. Obesity alone (OR: 1.21; 95% CI: 1.07; 1.36) increased only the odds of BADL disabilities. Moreover, SB leisure ≥ 3 h/day without obesity reduced the odds of IADL disabilities (OR: 0.56; 95% CI: 0.41; 0.76). Ideally, older adults should be encouraged to prevent obesity, reduce excessive periods spent in SB watching TV, and increase the daily periods spent in leisure activities, thus minimizing the likelihood of disabilities in functional activities.

Effect of Exercise Prior to Sedentary Behavior on Vascular Health Parameters: A Systematic Review and Meta-Analysis of Crossover Trials

BACKGROUND

Sedentary behavior has been shown to negatively affect parameters of endothelial function and central hemodynamics, both of which are closely associated with vascular health. Exercise prior to sedentary behavior has demonstrated potential as a preventive strategy to mitigate these detrimental effects. To evaluate the impact of exercise prior to sedentary behavior on vascular health parameters in the adult population, a systematic review and meta-analysis were conducted, synthesizing the available body of knowledge.

METHODS

A literature search was carried out in 6 databases. For each outcome, standard error and mean difference or standardized mean difference were calculated, as appropriate. An analysis was performed using a random effects model with a 95% confidence interval, using the inverse variance statistical method. Risk of bias assessment was performed using ROB2 and considerations for crossover trials. The quality of evidence was assessed using the GRADE system.

RESULTS

Exercise performed prior to prolonged sedentary behavior resulted in increased flow-mediated vasodilation at the first and third hours of sedentary time, compared with the control condition of sedentary behavior without prior exercise [MD: 1.51% (95% CI: 0.57 to 2.45) and MD: 1.36% (95% CI: 0.56 to 2.16), respectively]. Moreover, prior exercise led to increased shear rate at the first and third hours of sedentary time [MD: 7.70 s^-1 (95% CI: 0.79 to 14.61) and MD: 5.21 s^-1 (95% CI: 1.77 to 8.43), respectively]. Furthermore, it increased blood flow at the third hour [SMD: 0.40 (95%CI: 0.07 to 0.72)], compared with the control condition of prolonged sedentary behavior without prior exercise. Regarding hemodynamic parameters, exercise prior to prolonged sedentary behavior decreased mean arterial pressure during the first and third hours of sedentary behavior [MD: -1.94 mmHg (95% CI: -2.77 to -1.11) and MD: -1.90 mmHg (95% CI: -3.27 to -0.53), respectively], and an increase in heart rate during the first hour [MD: 4.38 beats per minute (95%CI: 2.78 to 5.98)] compared with the control condition of prolonged sedentary behavior without prior exercise.

CONCLUSIONS

The findings of this research suggest that prior exercise may prevent the impairment of vascular health parameters caused by sedentary behavior. However, the quality of the evidence was estimated as moderate. Therefore, further experimental studies and high-quality clinical trials are needed in this field to strengthen the results and conclusions drawn.

PROSPERO REGISTRATION NUMBER

CRD42023393686.

Reliability and Validity of Self-Reported Questionnaires Assessing Physical Activity and Sedentary Behavior in Finland

Reliable and valid data on physical activity (PA) and sedentary behavior (SB) are needed for implementing evidence-based interventions and policies. Monitoring of these behaviors is based on PA questionnaires (PAQs) and device-based measurements, but their comparability is challenging. The present study aimed to investigate the test-retest reliability and concurrent validity of Finnish versions of the widely used PAQs (IPAQ-SF, EHIS-PAQ, GPAQ, Eurobarometer) and to compare their data with accelerometer data. This study is based on the Finnish data of the European Union Physical Activity and Sport Monitoring project (EUPASMOS). Participants (n = 62 adults, 62% women) answered the PAQs twice, one week apart, and wore an accelerometer for these seven consecutive days. Intraclass correlations, Spearman's rank correlations, t-tests, and Cohen's kappa with bootstrap confidence intervals were used to analyze the data. The PAQs had typically moderate-to-good test-retest reliability (ICC 0.22-0.78), GPAQ, EHIS-PAQ, and Eurobarometer showing the highest reliability. The PAQs correlated with each other when assessing sitting and vigorous PA (R = 0.70-0.97) and had a fair-to-substantial agreement when analyzing adherence to the PA recommendations (74-97%, Cohen's kappa 0.25-0.73). All the PAQs had a poor criterion validity against the accelerometry data. The Finnish versions of the PAQs are moderately reliable and valid for assessing PA, adherence to PA recommendations and sitting among adult participants. However, the poor criterion validity against accelerometer data indicates that PAQs assess different aspects of PA constructs compared to accelerometry.

Co-construct, implement and evaluate a multi-level intervention to prevent a sedentary lifestyle in children-Study protocol of the CIPRES study

BACKGROUND

A sedentary lifestyle is commonly associated with a higher risk of chronic disease development. Among school-aged children from European countries, screen-time represents a significant portion of sedentary time with 39.8% of children spending more than 2h/day in front of a screen on average. Therefore, effective solutions to reduce sedentary behavior (SB) must be found. Multilevel interventions based on the socio-ecological model (SEM) are particularly relevant to take into account influences of the social environment on individuals' SB. Moreover, the trans-contextual model (TCM) can offer complementary levers for individuals' behavior change. The CIPRES study is a theory-based multilevel intervention designed to decrease the SB in French primary school children aged 8-10 years. The present paper describes the protocol of a randomized controlled study to evaluate the effectiveness of the CIPRES multilevel intervention on SB.

METHODS

The CIPRES study is a cluster-randomized controlled trial comparing intervention vs control groups. A total of 700 children are targeted for inclusion, distributed in four municipalities considered as clusters. The study consists of two successive phases: 1) co-building of a SB prevention intervention by using a participatory approach involving representatives of each level of the SEM (e.g., children, parents, staff from municipalities, teachers) and 2) implementation and evaluation of the intervention. The intervention will last for 6 weeks in each involved class. Primary outcome will be the sedentary time of children per week, assessed by accelerometry. In addition, children and their parents will be asked to fill out questionnaires concerning children's physical activity level, screen time, quality-of-life and variables of the TCM.

DISCUSSION

This study will give information on the effectiveness of a theory-based intervention, involving multiple levels of actors in the co-construction and the implementation of the intervention, that may interest schools and public health officers looking for innovative sedentary prevention programs.

Selenoprotein P in a Rodent Model of Exercise; Theorizing Its Interaction with Brain Reward Dysregulation, Addictive Behavior, and Aging

Exercise promotes health and wellness, including its operation as a protective factor against a variety of psychological, neurological, and chronic diseases. Selenium and its biomarker, selenoprotein P (SEPP1), have been implicated in health, including cancer prevention, neurological function, and dopamine signaling. SEPP1 blood serum levels were compared with a one-way ANOVA between sedentary (SED), moderately exercised (MOD) [10 m/min starting at 10 min, increasing to 60 min], and high-intensity interval training (HIIT) exercised rats [30 min in intervals of 2-min followed by a 1-min break, speed progressively increased from 10 to 21 m/min]. HIIT rats showed significantly higher serum SEPP1 concentrations compared to MOD and SED. More specifically, HIIT exercise showed an 84% increase in SEPP1 levels compared to sedentary controls. MOD rats had greater serum SEPP1 concentrations compared to SED, a 33% increase. The results indicated that increased exercise intensity increases SEPP1 levels. Exercise-induced increases in SEPP1 may indicate an adaptive response to the heightened oxidative stress. Previous studies found a significant increase in dopamine D2 receptor (D2R) binding in these same rats, suggesting a potential association between SEPP1 and dopamine signaling during exercise. Modulating antioxidants like SEPP1 through personalized therapies, including exercise, has broad implications for health, disease, and addiction.

Age Unplugged: A Brief Narrative Review on the Intersection of Digital Tools, Sedentary and Physical Activity Behaviors in Community-Dwelling Older Adults

This brief narrative review assesses how digital technologies-such as wearables, mobile health apps, and various digital tools such as computers, game consoles, tablets, smartphones, and extended reality systems-can influence sedentary and physical activity behaviors among community-dwelling older adults. Each section highlights the central role of these technologies in promoting active aging through increased motivation, engagement and customized experiences. It underlines the critical importance of functionality, usability and adaptability of devices and confirms the effectiveness of digital interventions in increasing physical activity and reducing sedentary behavior. The sustainable impact of these technologies needs to be further investigated, with a focus on adapting digital health strategies to the specific needs of older people. The research advocates an interdisciplinary approach and points out that such collaborations are essential for the development of accessible, effective and ethical solutions. This perspective emphasizes the potential of digital tools to improve the health and well-being of the aging population and recommends their strategic integration into health promotion and policy making.

Health Promotion and Chronic Disease Prevention at the Workplace

The concept of workplace safety and health has focused largely on preventing accidents and on minimizing hazardous exposures. However, because workers spend a substantial part of their waking hours at the workplace, the potential to influence the health of a large proportion of the world's population through the workplace is enormous. The opportunities to carry out health promotion and chronic disease prevention activities at the workplace are countless, including (a) health screening; (b) tobacco cessation activities; (c) the promotion of healthy food choices and weight loss; (d) active breaks with physical exercise in terms of microexercise, enhancement of infrastructure to stimulate physical activity, and organization of work tasks to facilitate incidental physical activity; and (e) routine vaccinations. This review discusses the key factors necessary to implement health promotion and chronic disease prevention programs at the workplace (SWOLE model) and discusses the different foci and possibilities with respect to the differing nature of work for the blue- versus white-collar workforce.

The causal relationship between physical activity, sedentary behavior and brain cortical structure: a Mendelian randomization study

Physical activity and sedentary behavior, both distinct lifestyle behaviors associated with brain health, have an unclear potential relationship with brain cortical structure. This study aimed to determine the causal link between physical activity, sedentary behavior, and brain cortical structure (cortical surface area and thickness) through Mendelian randomization analysis. The inverse-variance weighted method was primarily utilized, accompanied by sensitivity analyses, to confirm the results' robustness and accuracy. Analysis revealed nominally significant findings, indicating a potential positive influence of physical activity on cortical thickness in the bankssts (β = 0.002 mm, P = 0.043) and the fusiform (β = 0.002 mm, P = 0.018), and a potential negative association of sedentary behavior with cortical surface area in the caudal middle frontal (β = -34.181 mm2, P = 0.038) and the pars opercularis (β = -33.069 mm2, P = 0.002), alongside a nominally positive correlation with the cortical surface area of the inferior parietal (β = 58.332 mm2, P = 0.035). Additionally, a nominally significant negative correlation was observed between sedentary behavior and cortical thickness in the paracentral (β = -0.014 mm, P = 0.042). These findings offer insights into how lifestyle behaviors may influence brain cortical structures, advancing our understanding of their interaction with brain health.

Systems approaches to scaling up: a systematic review and narrative synthesis of evidence for physical activity and other behavioural non-communicable disease risk factors

BACKGROUND

Non-communicable diseases (NCDs) are the leading causes of death worldwide. Systems approaches have potential for creating sustainable outcomes at scale but have rarely been used to support scale up in physical activity/nutrition promotion or NCD prevention more generally. This review aimed to: (i) synthesise evidence on the use of systems approaches in scaling up interventions targeting four behavioural risk factors for NCDs; and (ii) to explore how systems approaches have been conceptualised and used in intervention implementation and scale up.

METHOD

Seven electronic databases were searched for studies published 2016-2021. Eligible studies targeted at least one of four NCD behavioural risk factors (physical inactivity, tobacco use, alcohol consumption, diet), or described evaluation of an intervention planned for or scaled up. Studies were categorised as having a (i) high, (ii) moderate, or (iii) no use of a systems approach. A narrative synthesis of how systems approaches had been operationalised in scale up, following PRISMA guidelines.

RESULTS

Twenty-one intervention studies were included. Only 19% (n = 4) of interventions explicitly used systems thinking to inform intervention design, implementation and scale up (targeting all four risk factors n = 2, diet n = 1, tobacco use n = 1). Five studies ('high use') planned and implemented scale up with an explicit focus on relations between system elements and used system changes to drive impact at scale. Seven studies ('moderate use') considered systems elements impacting scale-up processes or outcomes but did not require achieving system-level changes from the outset. Nine studies ('no use') were designed to work at multiple levels among multiple agencies in an intervention setting, but the complexity of the system and relations between system elements was not articulated. We synthesised reported barriers and facilitators to scaling up, and how studies within each group conceptualised and used systems approaches, and methods, frameworks and principles for scaling up.

CONCLUSION

In physical activity research, and NCD prevention more broadly, the use of systems approaches in scale up remains in its infancy. For researchers, practitioners and policymakers wishing to adopt systems approaches to intervention implementation at scale, guidance is needed on how to communicate and operationalise systems approaches in research and in practice.

TRIAL REGISTRATION

PROSPERO (CRD42021287265).

Prevalence and association of compliance with the Canadian 24-hour movement guidelines with sociodemographic aspects in Brazilian adults: a cross-sectional epidemiological study

BACKGROUND

The physical inactivity is a global health concern, so that recommendations on sufficient physical activity levels are elaborated worldwide, such as in Brazil. However, the Canadian 24-Hour Movement Guidelines were first in the world to consider time-specific recommendations for physical activity, sedentary behavior and sleep, which is still not developed for Latin-American population. The present study aimed to verify the adherence to Canadian 24-hour guidelines in a Brazilian inner city and to analyze its association with sociodemographic aspects.

METHODS

A cross-sectional epidemiological study, with a sample composed by 250 adults (140 women), with a median age of 41.0 years. Objective measures of moderate-to-vigorous physical activity (MVPA) and sedentary behavior were collected by accelerometry. Sleep duration and sociodemographic aspects (ethnicity, gender, age, educational attainment and socioeconomic level) were obtained through a face-to-face questionnaire. Canadian 24-hour guidelines considered ≥ 150 min/week of MVPA, <8 h/day of sedentary behavior and daily sleep time between 7 and 9 h, being analyzed separately and in combination. Poisson regression with robust variance estimator was used to analyze the prevalence ratio (PR) of meeting the 24-hour guidelines according to the categories of sociodemographic variables, being performed by the software IBM SPSS version 25.0.

RESULTS

The complete 24-hour guidelines were met only by 24.4% of sample (n = 61). Sedentary behavior was the most met guideline (88%), followed by MVPA (56.8%) and sleep (53.2%), without significant difference according to sex. When compared to elderly participants, those participants in younger groups (18-39 years and 40-59 years) were more likely to meet MVPA guideline (PR = 2.51 [95%CI = 1.47; 4.28] and PR = 2.60 [95%CI = 1.52; 4.45], respectively), as well as the combination of MVPA and sedentary behavior (PR = 1.98 [95%CI = 1.13; 3.44] and PR = 2.17 [95%CI = 1.25; 3.79], respectively) and MVPA with the sleep guideline (PR = 2.39 [95%CI = 1.09; 5.27] only for 18-39 years group). Men were more likely to meet MVPA guideline than women (PR = 1.29 [95%CI = 1.04; 1.59]).

CONCLUSION

Younger aged and male adults were more likely to meet the Canadian 24-hour guidelines in a small Brazilian city. However, further studies with larger and representative samples of sociodemographic stratum are still needed.

Reallocating desk workers' sitting time to standing or stepping: associations with work performance

BACKGROUND

Studies have suggested that sitting time at work may lead to underperformance but they may underestimate the benefits to desk workers' performance of reducing occupational sitting time without considering the relative effects of the specific activities replaced.

AIMS

To estimate differences in work performance (presenteeism, absenteeism and engagement) when occupational sitting time is reallocated to standing/stepping in desk workers.

METHODS

Data for middle-aged desk workers were from a Japan-wide online survey (n = 2228). Self-report proportion of occupational sitting and standing/stepping, work hours and work performance indicators, including absolute (ratings relating only to self) and relative (ratings of self, compared to others) presenteeism and absenteeism, and dimensions of work engagement, were collected. Partition and isotemporal substitution models were used to investigate the associations of occupational sitting and standing/stepping time with work performance, including their reallocation effects.

RESULTS

In partition models, longer occupational sitting time was associated with a lower absolute presenteeism score (i.e. less productivity), lower absolute absenteeism (i.e. longer-than-expected work hours), and lower engagement. Longer occupational standing/stepping time was associated with lower absolute absenteeism and more engagement. Isotemporal substitution models showed that each hour of occupational sitting reallocated to standing/stepping was favourably associated with overall work engagement (B = 0.087; 95% confidence interval 0.051, 0.122) and its dimensions (B ranged from 0.078 to 0.092), but was not associated with presenteeism or absenteeism.

CONCLUSIONS

These findings suggest that management support and practical initiatives to encourage desk workers to replace portions of their sitting time with standing/stepping may contribute to enhanced work engagement.

Ukumela impilo randomised trial: preliminary findings of height-adjustable sit-to-stand workstations on health outcomes of South African office workers

BACKGROUND

The prevalence of sedentary behaviour has concurrently risen with multiple cardiometabolic risk markers independent of physical activity levels. Office-based workers accumulate the highest levels of sitting time during occupational times. This study aims to investigate the short-term effects of using height-adjustable sit-to-stand workstations on cardiometabolic risk markers of office-based workers in South Africa.

RESULTS

Sixty-two office-based workers were randomized into intervention (n = 44), and the control group (n = 18). Small improvements were observed in BMI, blood pressure, and cholesterol levels in this cohort.

CONCLUSION

This preliminary investigation confirms that short-term height-adjustable sit-stand interventions are effective in reducing workplace sitting time and selected health outcomes. South Africa has been attributed with the highest burden of obesity in Sub-Saharan Africa, as a result, there is a need to implement long-term workplace intervention to reverse these implications.

TRIAL REGISTRATION

Pan African Clinical Trial Registry, PACTR201911656014962 on the 12th of November 2019.

Sitting vs. standing: an urgent need to rebalance our world

During their activities of daily living, humans run, walk, stand, sit and lie down. Recent changes in our environment have favored sedentary behavior over more physically active behavior to such a degree that our health is in danger. Here, we sought to address the problem of excessive time spent seated from various theoretical viewpoints, including postural control, human factors engineering, human history and health psychology. If nothing is done now, the high prevalence of sitting will continue to increase. We make a case for the standing position by demonstrating that spending more time upright can mitigate the physiological and psychological problems associated with excessive sitting without lowering task performance and productivity. The psychological literature even highlights potential benefits of performing certain tasks in the standing position. We propose a number of recommendations on spending more time (but not too much) in the standing position and on more active, nonambulatory behaviors. There is a need to inform people about (i) harmful consequences of excessive sitting and (ii) benefits of spending more time performing active, nonambulatory behaviors. One clear benefit is to reduce detrimental health consequences of excessive sitting and to provide potential additional benefits in terms of productivity and performance.

Changes in Desk-Based Workers' Sitting, Standing, and Stepping Time: Short- and Longer-Term Effects on Musculoskeletal Pain

PURPOSE

Sitting at work can be associated with musculoskeletal pain, but the effect of reductions in sitting is not well understood. We examined relationships with musculoskeletal pain of changes in sitting, standing, stepping, and short and long bouts of these behaviors.

METHODS

Analyses pooled data from 224 desk workers (68.4% women; mean ± SD age = 45.5 ± 9.4 yr; body mass index = 28.1 ± 6.1 kg⋅m -2 ) in intervention trial. Device-assessed (activPAL3) sitting, standing, and stepping time and multisite musculoskeletal pain (Nordic Questionnaire; 12 body areas) were assessed at baseline, 3 months, and 12 months. Compositional data analyses in linear mixed-effects regressions examined relationships within 16 waking hours of the behaviors and their short and long bouts, with changes from baseline in acute and chronic multisite musculoskeletal pain at 3 and 12 months. Analyses were adjusted for initial group randomization and relevant covariates.

RESULTS

At 3 months, increased standing relative to changes in other compositions was significantly associated with increased multisite musculoskeletal pain (acute: β = 1.54, 95% confidence interval [CI] = 0.10 to 2.98; chronic: β = 1.49, 95% CI = 0.12 to 2.83). By contrast, increased stepping relative to changes in other compositions was significantly associated with reduced multisite musculoskeletal pain (acute: β = -1.49, 95% CI = -2.97 to -0.02; chronic: β = -1.87, 95% CI = -3.75 to -0.01). Neither sitting reduction relative to changes in other compositions nor changes in short bouts relative to long bouts of the behaviors were significantly associated with multisite musculoskeletal pain changes. At 12 months, there were no significant associations for any of the compositional changes.

CONCLUSIONS

In the short term, while increasing standing with reduced sitting time can be unfavorable, concurrently increasing stepping could potentially reduce musculoskeletal pain. In the longer term, musculoskeletal pain may not be increased by moderate reductions in sitting time through spending more time standing or stepping.

Can the bias of self-reported sitting time be corrected? A statistical model validation study based on data from 23 993 adults in the Norwegian HUNT study

BACKGROUND

Despite apparent shortcomings such as measurement error and low precision, self-reported sedentary time is still widely used in surveillance and research. The aim of this study was threefold; (i) to examine the agreement between self-reported and device-measured sitting time in a general adult population; (ii), to examine to what extent demographics, lifestyle factors, long-term health conditions, physical work demands, and educational level is associated with measurement bias; and (iii), to explore whether correcting for factors associated with bias improves the prediction of device-measured sitting time based on self-reported sitting time.

METHODS

A statistical validation model study based on data from 23 993 adults in the Trøndelag Health Study (HUNT4), Norway. Participants reported usual sitting time on weekdays using a single-item questionnaire and wore two AX3 tri-axial accelerometers on the thigh and low back for an average of 3.8 (standard deviation [SD] 0.7, range 1-5) weekdays to determine their sitting time. Statistical validation was performed by iteratively adding all possible combinations of factors associated with bias between self-reported and device-measured sitting time in a multivariate linear regression. We randomly selected 2/3 of the data (n = 15 995) for model development and used the remaining 1/3 (n = 7 998) to evaluate the model.

RESULTS

Mean (SD) self-reported and device-measured sitting time were 6.8 (2.9) h/day and 8.6 (2.2) h/day, respectively, corresponding to a mean difference of 1.8 (3.1) h/day. Limits of agreement ranged from - 8.0 h/day to 4.4 h/day. The discrepancy between the measurements was characterized by a proportional bias with participants device-measured to sit less overestimating their sitting time and participants device-measured to sit more underestimating their sitting time. The crude explained variance of device-measured sitting time based on self-reported sitting time was 10%. This improved to 24% when adding age, body mass index and physical work demands to the model. Adding sex, lifestyle factors, educational level, and long-term health conditions to the model did not improve the explained variance.

CONCLUSIONS

Self-reported sitting time had low validity and including a range of factors associated with bias in self-reported sitting time only marginally improved the prediction of device-measured sitting time.

Low movement, deep-learned sitting patterns, and sedentary behavior in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE)

BACKGROUND/OBJECTIVES

Sedentary behavior (SB) has both movement and postural components, but most SB research has only assessed low movement, especially in children. The purpose of this study was to compare estimates and health associations of SB when derived from a standard accelerometer cut-point, a novel sitting detection technique (CNN Hip Accelerometer Posture for Children; CHAP-Child), and both combined.

METHODS

Data were from the International Study of Childhood Obesity, Lifestyle, and the Environment (ISCOLE). Participants were 6103 children (mean ± SD age 10.4 ± 0.56 years) from 12 countries who wore an ActiGraph GT3X+ accelerometer on the right hip for approximately one week. We calculated SB time, mean SB bout duration, and SB breaks using a cut-point (SBmovement), CHAP-Child (SBposture), and both methods combined (SBcombined). Mixed effects regression was used to test associations of SB variables with pediatric obesity variables (waist circumference, body fat percentage, and body mass index z-score).

RESULTS

After adjusting for MVPA, SBposture showed several significant obesity associations favoring lower mean SB bout duration (b = 0.251-0.449; all p < 0.001) and higher SB breaks (b = -0.005--0.052; all p < 0.001). Lower total SB was unexpectedly related to greater obesity (b = -0.077--0.649; p from <0.001-0.02). For mean SB bout duration and SB breaks, more associations were observed for SBposture (n = 5) than for SBmovement (n = 3) or SBcombined (n = 1), and tended to have larger magnitude as well.

CONCLUSIONS

Using traditional measures of low movement as a surrogate for SB may lead to underestimated or undetected adverse associations between SB and obesity. CHAP-Child allows assessment of sitting posture using hip-worn accelerometers. Ongoing work is needed to understand how low movement and posture are related to one another, as well as their potential health implications.

Determining minimum number of valid days for accurate estimation of sedentary behaviour and awake-time movement behaviours using the ActivPAL3 in nursing home residents

INTRODUCTION

Scarce evidence is available about the minimum number of valid days wearing the activPAL3 to obtain a precise estimate of sedentary behaviour (SB) and awake-time movement behaviours (ATMB) in nursing home (NH) residents. The study aimed to determine the minimum number of valid days required for accurately estimate SB and ATMB using the activPAL3 device in NH residents. It also investigated how the starting point of a day (the 24-h period) impacted reliability.

METHODS

Participants wore an activPAL3 for 7 consecutive days. The data was classified in two-time blocks (00:00 Ante Meridiem (AM)-00:00 AM midnight vs 12:00 Post Meridiam (PM) -12:00 PM midday) and the sample was stratified into two groups according to their capacity to stand and walk, to examine if timing of sampling or physical functioning affected minimum wear time. SB, ATMB, sociodemographic, and health-related variables were collected. Sensitivity of the time-blocks were tested through the dispersion frequencies and differences between blocks through Kolmogorov-Smirnov test for normality; parametric variables through two-related means T-test and Wilcoxon test for non-parametric data. Reliability was assessed with the Cronbach's Alpha and the intra-class correlation coefficient (ICC), using a one-factor model estimating the reliability for each measurement day loading in the same latent factor.

RESULTS

Ninety-five NH residents (81.1% women; age = 85.8 ± 7.2 years) were included. The midnight block had higher reliability, sensitivity and no statistically significant differences between days were found. At least three consecutive days of monitoring were necessary to achieve a reliability of ICC ≥ 0.8 for those NH residents able to stand and walk and six days for those unable.

CONCLUSIONS

NH residents who are able to stand and walk require a minimum of three consecutive days wearing the device, while those who are unable require at least six days due to their highly homogenous daily routines and sensitivity to PA events. Regardless of the activPAL3 recording start time, data processing should reference the midnight time block.

Are more physical education classes related to less time in leisure-time sedentary behavior? An analysis including adolescents from 73 countries

This study aimed to verify the association between the weekly frequency of physical education (PE) classes and leisure sitting time among adolescents. We analyzed data from 73 countries using the Global School-based Student Health Survey (283,233 adolescents between 11 and 18 years of age). Leisure sitting time and weekly frequency of PE classes were self-reported. Sex, age, and food insecurity were used as covariates and the analyses were stratified by world regions and country income level. Poisson regression models (random-effects meta-analysis) were used for the main analyses. In comparison with 1 PE class per week (reference group), those with no PE classes presented a lower prevalence of ≥ 3 h/d of leisure sitting time (PR [95%CI] = 0.94 [0.91; 0.98]). On the other hand, adolescents with 2 days (PR [95%CI] = 1.06 [1.02; 1.26]), 3-4 days (PR [95%CI] = 1.17 [1.12; 1.22]), and 5 days (PR [95%CI] = 1.08 [1.04; 1.11]) of PE classes presented a higher likelihood of ≥ 3 h/d of leisure sitting time. No clear differences were observed for the different world regions and country income levels. We conclude that a higher weekly frequency of PE classes is associated with increased leisure sitting time among adolescents worldwide.

Effects of acute moderate-intensity aerobic exercise on cognitive function in E-athletes: A randomized controlled trial

BACKGROUND

E-sports require athletes to have high-speed reflexes and excellent memory skills. Whereas a single session of aerobic exercise has been shown to improve cognitive function, this paper aims is to investigate the effects of acute moderate-intensity aerobic exercise on the cognitive function of e-sports players and its time-course characteristics.

METHODS

Thirty-four E-athletes were divided into 2 groups according to a random number table method, and 2 trials in a quiet physical fitness gym. The duration of each trial was approximately 1 hour. In the first trial: exercise group (64-76% of maximum heart rate for 30 minutes power cycling) and control group, cognitive function was tested, and results were automatically recorded before, immediately after, and 30 minutes after exercise using the human benchmark website (https://humanbenchmark.com). The second trial crossed and swapped the interventions of the 2 groups, and the other test protocols were the same as the first.

RESULTS

In both trials, the exercise intervention group showed significant improvements in speed accuracy (P < .001, Cohen's d = 1.406, 95% CI: 0.717-2.072; P = .005, Cohen's d = 0.782, 95% CI: 0.227-1.319), visual memory (P < .001, Cohen's d = 1.416, 95% CI: 0.725-2.086; P = .015, Cohen's d = 0.662, 95% CI: 0.127-1.181), and reaction time (P < .001, Cohen's d = 1.265, 95% CI: 0.610-1.898; P<.001, Cohen's d = 0.979, 95% CI: 0.386-1.551) immediately after exercise compared to baseline. The exercise intervention group also showed significant improvement in speed accuracy 30 minutes after exercise compared to baseline (P = .002 Cohen's d = 0.869, 95% CI: 0.298-1.421; P = .009, Cohen's d = 0.722, 95% CI: 0.177-1.249). In the first trial, the exercise intervention group showed significant improvements in visual memory and reaction time immediately after exercise compared to the control group (P = .013, Cohen's d = 0.904, 95% CI: 0.190-1.605; P = .027, Cohen's d = 0.796, 95% CI: 0.090-1.490). The exercise intervention group also showed significant improvement in reaction time 30 minutes after exercise compared to baseline (P = .009, Cohen's d = 0.719, 95% CI: 0.174-1.246). There was no effect of exercise on sequence memory or the chimp test in both trials (P > .05). Sequence effect analysis showed no influence on the order of the exercise intervention in both trials (P = .912; P = .111; P = .226).

CONCLUSION

Acute moderate-intensity aerobic exercise significantly enhanced the speed accuracy, visual reaction time, and instantaneous memory of eSports players, and the effect could be extended up to 30 minutes after exercise.

Sedentary Bout Patterns and Metabolic Health in the Hispanic Community Health Study/Study of Latino Youth (SOL Youth)

Background There is limited evidence on the potential negative metabolic health impacts of prolonged and uninterrupted sedentary bouts in structurally disadvantaged youth. This study investigated associations between sedentary bout variables and metabolic health markers in the Hispanic Community Health Study/SOL Youth (Study of Latino Youth). Methods and Results SOL Youth was a population-based cohort of 1466 youth (age range, 8-16 years; 48.5% female); 957 youth were included in the analytic sample based on complete data. Accelerometers measured moderate-to-vigorous physical activity (MVPA), total sedentary time, and sedentary bout patterns (daily time spent in sedentary bouts ≥30 minutes, median sedentary bout duration, and number of daily breaks from sedentary time). Clinical measures included body mass index, waist circumference, fasting glucose, glycated hemoglobin, fasting insulin, and the homeostasis model assessment of insulin resistance. After adjusting for sociodemographics, total sedentary time, and MVPA, longer median bout durations and fewer sedentary breaks were associated with a greater body mass index percentile (bbouts=0.09 and bbreaks=-0.18), waist circumference (bbouts=0.12 and bbreaks=-0.20), and fasting insulin (bbouts=0.09 and bbreaks=-0.21). Fewer breaks were also associated with a greater homeostasis model assessment of insulin resistance (b=-0.21). More time in bouts lasting ≥30 minutes was associated with a greater fasting glucose (b=0.18) and glycated hemoglobin (b=0.19). Conclusions Greater accumulation of sedentary time in prolonged and uninterrupted bouts had adverse associations with adiposity and glycemic control over and above total sedentary time and MVPA. Findings suggest interventions in Hispanic/Latino youth targeting both ends of the activity spectrum (more MVPA and less prolonged/uninterrupted sedentary patterns) may provide greater health benefits than those targeting only MVPA.

The Quiet Epidemic: An Overview of Emerging Qualitative Research Trends on Sedentary Behavior in Aging Populations

Sedentary behavior poses a significant health risk to older adults. The purpose of this scoping review is to summarize key findings from qualitative research (since 2012), with a focus on explaining prevailing research trends and patterns within the field. This review included 25 studies that met the strict inclusion criteria. Five key research themes have emerged: (1) defining and shaping perspectives of sedentary behavior, (2) understanding the dynamics of daily routines and contexts, (3) raising awareness of older adults' perceived advantages and disadvantages of sedentary behavior, (4) identifying its determinants and discouraging factors, and (5) exploring interventions to promote active behaviors and reduce sedentary behavior. These themes highlight the multifaceted nature of SB and underscore the importance of tailoring interventions to address individual, social, and environmental issues. A comprehensive understanding of SB is critical to developing effective strategies to promote active lifestyles and reduce SB in older adults. Further qualitative research is needed to deepen our understanding and develop targeted interventions and strategies.

Trends in Activity Limitations From an International Perspective: Differential Changes Between Age Groups Across 30 Countries

Objectives: Examine trends in limitations among young (15-39), middle-aged (40-64) and older age-groups (>=65) and their socioeconomic differences. Methods: Population-based European Social Survey data (N = 396,853) were used, covering 30 mostly European countries and spanning the time-period 2002-2018. Limitations were measured using a global activity limitations indicator. Results: Age-differential trends in limitations were found. Activity limitations generally decreased in older adults, whereas trends varied among younger and middle-aged participants, with decreasing limitations in some countries but increasing limitations in others. These age-differential trends were replicated across limitation severity and socioeconomic groups; however, stronger limitation increases occurred regarding less-severe limitations. Discussion: Functional health has improved in older adults. Contrarily, the increasing limitations in younger and middle-aged individuals seem concerning, which were mostly observed in Western and Northern European countries. Given its public health importance, future studies should investigate the reasons for this declining functional health in the young and middle-aged.

Combined association of physical activity and sitting time with cardiometabolic risk factors in Chilean adults

In this study we examined the combined association of physical activity and sitting time with cardiometabolic risk factors in adults in Chile. This is a cross-sectional study based on 3201 adults aged from 18 to 98 years from the Chilean National Health Survey (2016-2017) who responded to the GPAQ questionnaire. Participants were considered inactive if spent < 600 METs-min/wk^-1 in physical activity. High sitting time was defined as ≥ 8 h/day. We classified participants into the following 4 groups: active and low sitting time; active and high sitting time; inactive and low sitting time; inactive and high sitting time. The cardiometabolic risk factors considered were metabolic syndrome, body mass index, waist circumference, total cholesterol, and triglycerides. Multivariable logistic regression models were performed. Overall, 16.1% were classified as inactive and high sitting time. Compared to active participants with low sitting time, both inactive participants with low (OR: 1.51; 95% CI 1.10, 1.92) and high sitting time (1.66; 1.10, 2.22) had higher body mass index. Similar results were found for high waist circumference: inactive participants with low (1.57; 1.14, 2.00) and high sitting time (1.84; 1.25, 2.43). We found no combined association of physical activity and sitting time with metabolic syndrome, total cholesterol, and triglycerides. These findings may be useful to inform programs focused on obesity prevention in Chile.

Effectiveness of multilevel interventions based on socio-ecological model to decrease sedentary time in children: a systematic review of controlled studies

Objectives

Preventive actions of sedentary behavior (SB) based on the socio-ecological model are needed among children and young adolescents. The aim of this systematic review is to ascertain the effectiveness of multilevel interventions (i.e., involving consideration of at least two interventional levels) in reducing sedentary time (ST) in children aged 5-12 years.

Methods

Adhering to PRISMA guidelines, a systematic literature search was conducted in three databases (PsyInfo, PubMed and ERIC) until July 2021.

Results

30 trials met the eligibility criteria and were included. They showed acceptable (< 8, n = 18) and high (≥ 8, n = 12) methodological quality. Among studies targeting 2 (n = 2), 3 (n = 19) and 4 levels (n = 9), 1 (50%), 9 (47%) and 7 (78%) were effective and reported significant reduction of ST, respectively.

Conclusion

Interventions tend to be more effective when they involve 4 levels, using both agentic and structural strategies (targeting intrinsic determinants, in the organizational environment of the child). Findings underline the relevance of multilevel strategies to reduce ST in children, but also raise issues about operationalization of the socio-ecological perspective.

Systematic review registration

PROSPERO, identifier: CRD42020209653.

Device-measured movement behaviors and cardiac biomarkers in older adults without major cardiovascular disease: the Seniors-ENRICA-2 study

BACKGROUND

High-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) are biomarkers of myocardial infarction and heart failure, respectively, and indicate cardiovascular risk. Since low physical activity (PA) and sedentary behavior (SB) are also associated with higher cardiovascular risk, and this association could be a consequence of higher levels of cardiac biomarkers, we examined the association of device-measured movement behaviors with hs-cTnT and NT-proBNP in older men and women without major cardiovascular disease (CVD).

METHODS

We used data from 1939 older adults from the Seniors-ENRICA-2 study. Accelerometers were used to assess time spent in sleep, SB, light PA (LPA), and moderate-to-vigorous PA (MVPA). Linear regression models were fitted separately in eight strata defined by sex, by median total PA time, and by the presence of subclinical cardiac damage according to cardiac biomarkers levels.

RESULTS

In the less active men with subclinical cardiac damage, spending 30 min/day more of MVPA was associated with a mean percentage difference (MPD) (95% confidence interval) in hs-cTnT of - 13.1 (- 18.3, - 7.5); MPDs in NT-proBNP per 30 min/day increment were 5.8 (2.7, 8.9) for SB, - 19.3 (- 25.4, - 12.7) for LPA and - 23.1 (- 30.7, - 14.6) for MVPA. In women with subclinical cardiac damage who were less physically active, 30 min/day more of SB, LPA and MVPA were associated with MPDs in hs-cTnT of 2.1 (0.7, 3.6), - 5.1 (- 8.3, - 1.7) and - 17.5 (- 22.9, - 11.7), respectively, whereas in those more active, LPA and MVPA were associated with MPDs of 4.1 (1.2, 7.2) and - 5.4 (- 8.7, - 2.0), respectively. No associations were found with NT-proBNP in women.

CONCLUSIONS

The relationship between movement behaviors and cardiac biomarkers in older adults without major CVD depends on sex, subclinical cardiac damage and PA level. More PA and less SB were generally related to lower cardiac biomarkers levels among less active individuals with subclinical cardiac damage, with greater benefits for hs-cTnT in women than men and no benefits for NT-proBNP in women.

Movement Behavior and Health Outcomes among Sedentary Adults: A Cross-Sectional Study

BACKGROUND

Sedentary behavior, which is highly prevalent among office workers, is associated with multiple health disorders, including those of the musculoskeletal and cardiometabolic systems. Although prior studies looked at postures or physical activity during work or leisure time, few analyzed both posture and movement throughout the entire day.

OBJECTIVE

This cross-sectional pilot study examined the movement behavior of sedentary office workers during both work and leisure time to explore its association with musculoskeletal discomfort (MSD) and cardiometabolic health indicators.

METHODS

Twenty-six participants completed a survey and wore a thigh-based inertial measuring unit (IMU) to quantify the time spent in different postures, the number of transitions between postures, and the step count during work and leisure time. A heart rate monitor and ambulatory blood pressure cuff were worn to quantify cardiometabolic measures. The associations between movement behavior, MSD, and cardiometabolic health indicators were evaluated.

RESULTS

The number of transitions differed significantly between those with and without MSD. Correlations were found between MSD, time spent sitting, and posture transitions. Posture transitions had negative correlations with body mass index and heart rate.

CONCLUSIONS

Although no single behavior was highly correlated with health outcomes, these correlations suggest that a combination of increasing standing time, walking time, and the number of transitions between postures during both work and leisure time was associated with positive musculoskeletal and cardiometabolic health indicators among sedentary office workers and should be considered in future research.

Polysensoriality and Aesthetics: The Lived Sensory Experiences of Adults with Mental Illness

Background. Research in neuroscience shows that adults with schizophrenia or related psychotic disorders experience atypical sensory processing (e.g., deficits in sensory gating and mismatch negativity). Despite significant evidence proving these biomarkers are common among adults with serious mental illness, it is unclear how their sensory experiences impact their occupations in daily life (i.e., real-world implications of atypical sensory processing). Purpose. To explore how the lived sensory experiences of adults with psychotic disorders affect their occupations. Method. We used Walking with Video, photo-elicitation, and semi-structured interviews to study how the lived sensory experiences of adults with psychotic disorders (N  =  6) relate to their occupations. Informed by a phenomenological perspective, we analysed data from semistructured interviews, and undertook analyses through iterative rounds of coding to develop themes and two cycles of group reflective practices to identify researcher biases and assumptions. Findings. Analyses revealed the following themes: polysensoriality, embodied aesthetics of everyday life, habits of sensing and sensory anchors, and active sensory beings. Implications. In clinical contexts, occupational therapists should carefully consider the situatedness of sensory experiences while avoiding assumptions that sensory preferences and aversions mechanistically generalize across contexts and occupations.

The Dyadic Interplay Between Relationship Satisfaction, Perceived Positive and Negative Social Control, and a Reduction of Sedentary Behavior Time

BACKGROUND

Both the close relationship processes and health model and the dyadic health influence model posit that beliefs about the relationship (e.g., relationship satisfaction) and influence strategies (e.g., social control) serve as mediators of health behavior change. The evidence for such mediation is limited.

PURPOSE

This study investigated two competing hypotheses that arise from these models: (1) perceived use of positive and negative social control (attempts to influence the partner's behaviors) predict sedentary behavior (SB) indirectly, via relationship satisfaction; or (2) relationship satisfaction predicts SB indirectly, via positive and negative social control.

METHODS

Data from 320 dyads (target persons and their partners, aged 18-90 years), were analyzed using mediation models. SB time was measured with GT3X-BT accelerometers at Time 1 (T1; baseline) and Time 3 (T3; 8 months following baseline). Relationship satisfaction and social control were assessed at T1 and Time 2 (T2; 2 months following baseline).

RESULTS

Higher T1 relationship satisfaction among target persons predicted target persons' reporting of higher T2 negative control from partners, which in turn predicted lower T3 SB time among target persons. Lower T1 relationship satisfaction among partners predicted target persons' reporting of higher T2 perceived negative control from partners, which predicted lower T3 SB time among target persons. On average, both members of the dyad reported moderate-to-high relationship satisfaction and low-to-moderate negative control.

CONCLUSIONS

In contrast to very low levels of negative control, its low-to-moderate levels may be related to beneficial behavioral effects (lower SB time) among target persons reporting moderate-to-high relationship satisfaction.

Associations of physical activity levels, and attitudes towards physical activity with blood pressure among adults with high blood pressure in Bangladesh

BACKGROUND

Physical activity is important for the control of high blood pressure (hypertension). We aimed to investigate the associations of current physical activity levels, sedentary time, knowledge of and attitude towards physical activity with blood pressure in people with hypertension in a rural area in Bangladesh.

METHODS

A total of 307 adults aged 30 to 75 years with hypertension were recruited from the Banshgram Union of Narial district as part of a cluster-randomized control trial. Current blood pressure was measured as the outcome variable. Associated variables included physical activity at work, travel to and from places, recreational activity, metabolic equivalent task (MET)-min, sedentary time, and awareness of and attitudes towards physical activity. Rasch analysis was used to compute a combined score from the five awareness of and attitudes towards physical activity items and categorized into 0-40 (towards negative attitude), 41-60 score (mixed attitude) and 61-100 (positive attitude). We used a generalised linear model to analyze the data.

RESULTS

Participants (n = 68, 22.1%) who engaged in vigorous-intensity physical activity that causes large increases in breathing or heart rate like carrying or lifting heavy loads, digging or construction work for at least 10 minutes continuously had lower systolic blood pressure (SBP) (mean (95% confidence interval (CI)), 143.6 (140.1, 147.2)) compared to those who did not take part in a vigorous-intensity physical activity (mean (95% CI), 150 (147.6, 152.3)). MET-min less than 600 min/week was significantly associated with higher SBP 153.8 (148.1, 159.6) than MET-min 600-2999 min/week 148.0 (143.0, 152.9) and MET-min>3000 min/week 146.9 (144.5, 149.3), p = 0.001 for trend. Sitting time more than four hours a day was associated with higher DBP 91.4 (89.7, 93.0) compared to those who had sitting time less than fours a day 88.6 (87.1, 90.1). People with positive attitudes were associated with a reduced SBP of 10.6 (0.36, 20.8) mmHg and DBP 5.88 (0.47, 11.3) compared to the people who had a negative attitude towards taking part in physical activity.

CONCLUSIONS

Participating in high physical activity and positive attitudes towards physical activity were associated with lower blood pressure levels. Physical activity awareness programs should be implemented to increase awareness of health benefits and increase participation in high physical activity.

Association of low physical activity with higher respiratory tract infections frequency among pre-school children

BACKGROUND

There is no consensus on the benefits of physical activity (PA) regarding upper respiratory tract infections (URTIs) among children. This study aimed to determine an association between the PA level and URTIs in preschoolers.

METHODS

In 4-7-year-old participants, URTI symptoms were monitored using the Polish version of the Wisconsin Upper Respiratory System Survey for Kids. The daily number of steps, PA intensity, and sleep duration were measured with a Garmin-vivofit pedometer. The lag effect between the initial level of daily PA and the frequency of infections was evaluated.

RESULTS

The average daily step count from healthy days was a significant determinant of the total number of days with the URTI symptoms, and it accounted for 44% (p < 0.001) of this variable variance. A low level of baseline PA (initial 14-day "run-in" observation period) was associated with an increased risk of URTI. In the non-sport group, the severity of the URTI symptoms depended on the number of daily steps. No significant correlation was found between sleep duration and the number of URTI days.

CONCLUSION

Low levels of PA in preschoolers result in increased susceptibility to respiratory infections. Parents should encourage children to engage in PA to prevent URTIs.

IMPACT

In pre-school children, higher physical activity (PA) is associated with fewer days of upper respiratory tract infection symptoms (URTIS). Children with a higher average daily step count have fewer days with URTIS over a long-term observation period. A change in the average number of steps per day by 1000 changed the number of days with symptoms of URTI by 4 days. The severity of URTIS was inversely related to the degree of PA. Children who participate in sports 3 or more hours per week have fewer URTIS than those who do not engage in sports regularly.

Physical education, muscle strengthening exercise, sport participation and their associations with screen time in adolescents

Background/Objective

Physical activity (PA) has been suggested to reduce screen time. This study aimed to explore the associations of physical education (PE), muscle-strengthening exercise (MSE), and sport participation with screen time.

Methods

A multi-cluster sampling design was used to select 13,677 school-attending adolescents that participated in the Youth Risk Behavior Surveillance 2019 survey. Adolescents self-reported their frequency of PE attendance, participations in MSE, sport participation and hours for screen time. Additionally, participants provided demographic information including sex, age, race, grade, and weight status.

Results

Collectively, there were beneficial associations between participating in MSE for 4 (OR = 1.31, CI: 1.02-1.68), 5 (OR = 1.65, CI: 1.31-2.08), 6 (OR = 2.23, CI: 1.47-3.36), 7 (OR = 1.62, CI: 1.30-2.01) days and video or computer game hours. Similarly, beneficial associations between participating in 1 team sport (OR = 1.23, CI: 1.06-1.42), 2 team sports (OR = 1.61, CI: 1.33-1.95), 3 or more team sports (OR = 1.45, CI: 1.16-1.83) and video or computer game hours were observed. Participating in 1 team sport (OR = 1.27, CI: 1.08-1.48), 2 teams sport (OR = 1.41, CI: 1.09-1.82), 3 or more team sport (OR = 1.40, CI: 1.03-1.90) also increased the odds for meeting guidelines for television viewing hours. Only 2 days of PE attendance (OR = 1.44, CI: 1.14-1.81) was significantly associated with video or computer game hours.

Conclusion

The promotion of sports participation appears to be an important component for reducing excess screen time in adolescents. Further, MSE may have beneficial effects on reducing time spent on the computer and playing video games.

Long sedentary time is associated with worsened cardiometabolic risk factors among university employees in Eastern Ethiopia

Sedentary time is associated with increased risks of detrimental health outcomes. Prolonged sedentary time associates with cardiometabolic risk factors and increased mortality regardless of physical activity. Therefore, the purpose of this study was to examine the associations of sedentary time and cardiometabolic risk factors among university employees in Eastern Ethiopia. A cross-sectional study was conducted among 1200 participants. Data were collected using the World Health Organization STEPS survey instrument, and sedentary behavior questionnaire in hour per day. Sedentary time is the time spent for any duration (minutes per day or hours per day) by considering a local context. Study participants were asked how many minutes or hours they spent in sedentary time at work, their leisure time and in transportation. Finally, the total sedentary time was calculated by the sum of the individual spent in sedentary time at work, leisure, and transportation. Cardiometabolic risk factors were assessed with blood samples analysis and anthropometric measurements. The associations between sedentary time and cardiometabolic risk factors were examined using linear regression models. An adjusted coefficient (β) with the 95% confidence interval (CI) was used to report the results. p value < 0.05 was considered for statistical significance. The mean age of the study participants were (35 ± 9.4 years). Almost half of the study participants, 566 (48.6) were women and 598 (51.4%) were men. As the total sedentary time was increased by one unit, the body mass index increased by β = 0.61; (95% CI 0.49-0.71),waist circumference increased by β = 1.48; (95% CI 1.14-1.82), diastolic blood pressure increased by β = 0.87; (95% CI 0.56-1.18), systolic blood pressure increased by β = 0.95; (95% CI 0.45-1.48), triglycerides increased by β = 7.07; (95% CI 4.01-10.14), total cholesterol increased by β = 3.52; (95% CI 2.02-5.02), fasting plasma glucose increased by β = 4.15; (95% CI 5.31-4.98) and low-density lipoprotein cholesterol increased by β = 2.14; (95% CI 0.96-3.33) with the effects of other variables maintain constant. These findings depict the need for strategies that policymakers should promote physical activity and encouraging the breaking up of prolonged sedentary time to reduce cardiometabolic risk factors among university employees in Ethiopia.

Sedentary Behavioral Studies of Young and Middle-Aged Adults with Hypertension in the Framework of Behavioral Epidemiology: A Scoping Review

(1) Background: As times change, the detection rate of hypertension is increasing in the young and middle-aged population due to prevalent sedentary behaviors. The purpose of this study was to conduct a scoping review to identify and summarize the research on sedentary behavior in this population by separating it into five stages: the relationship between sedentary behavior and health; measurement modalities; influencing factors; interventions; and translational research in young and middle-aged adults with hypertension. (2) Methods: Using a scoping review research approach, the PubMed, Web of Science Core Collection, and MEDLINE databases were used to search for the literature on this subject from the date of the database's creation to 14 June 2022, and the behavioral epidemiology framework was used to classify the retrieved articles. (3) Results: A total of eight articles were included. Among them, there were six articles on the relationship between behavior and health, which includes blood pressure, insulin resistance, and the cardiovascular system; one article on the study of measurement methods, which was used for clinical decision making through decision trees; one article on influencing factors, which was divided into intrinsic and extrinsic factors; and no articles on intervention program development or the translation of intervention programs to further practice in this population. (4) Conclusions: Sedentary behavioral studies of young and middle-aged adults with hypertension are scarce and are generally carried out in the early stages of the condition. In the future, in-depth studies can be conducted on the dose-response relationship between sedentary behavior and health in this population; the development of easier and targeted measurement tools; the exploration of more influencing factors; and the effectiveness and translation of intervention programs.

CHAP-Adult: A Reliable and Valid Algorithm to Classify Sitting and Measure Sitting Patterns Using Data From Hip-Worn Accelerometers in Adults Aged 35

Background

Hip-worn accelerometers are commonly used, but data processed using the 100 counts per minute cut point do not accurately measure sitting patterns. We developed and validated a model to accurately classify sitting and sitting patterns using hip-worn accelerometer data from a wide age range of older adults.

Methods

Deep learning models were trained with 30-Hz triaxial hip-worn accelerometer data as inputs and activPAL sitting/nonsitting events as ground truth. Data from 981 adults aged 35-99 years from cohorts in two continents were used to train the model, which we call CHAP-Adult (Convolutional Neural Network Hip Accelerometer Posture-Adult). Validation was conducted among 419 randomly selected adults not included in model training.

Results

Mean errors (activPAL - CHAP-Adult) and 95% limits of agreement were: sedentary time -10.5 (-63.0, 42.0) min/day, breaks in sedentary time 1.9 (-9.2, 12.9) breaks/day, mean bout duration -0.6 (-4.0, 2.7) min, usual bout duration -1.4 (-8.3, 5.4) min, alpha .00 (-.04, .04), and time in ≥30-min bouts -15.1 (-84.3, 54.1) min/day. Respective mean (and absolute) percent errors were: -2.0% (4.0%), -4.7% (12.2%), 4.1% (11.6%), -4.4% (9.6%), 0.0% (1.4%), and 5.4% (9.6%). Pearson's correlations were: .96, .92, .86, .92, .78, and .96. Error was generally consistent across age, gender, and body mass index groups with the largest deviations observed for those with body mass index ≥30 kg/m2.

Conclusions

Overall, these strong validation results indicate CHAP-Adult represents a significant advancement in the ambulatory measurement of sitting and sitting patterns using hip-worn accelerometers. Pending external validation, it could be widely applied to data from around the world to extend understanding of the epidemiology and health consequences of sitting.

Compression and Expansion of Morbidity

BACKGROUND

Morbidity is said to be compressed when the interval from the onset of a disease or disability to death becomes shorter over time, or when the incidence of the disease or disability declines over time. In the reverse situation, morbidity is said to be expanded.

METHODS

This review is based on national and international studies retrieved by a selective literature search on secular trends in morbidity and mortality. The findings were derived from data from surveys and registries, and from the routine data of health insurance carriers.

RESULTS

Three different types of secular trends in morbidity were seen. For some diseases (e.g., lung cancer, stroke, and dementia), morbidity among the elderly was compressed over time. On the other hand, for multimorbidity and type 2 diabetes including comorbidities, morbidity expanded over time. Unexpectedly, a double development was seen in certain other conditions, with both compression among the elderly and expansion among the middle-aged: this was particularly so for myo - cardial infarction, grip strength, and indicators of general health.

CONCLUSION

The notion of morbidity being reduced by compression seems less tenable in view of the double development just mentioned. The findings suggest that the observed secular trend toward better health among the elderly has not persisted among the more recently born cohorts. This can have negative effects on social security systems, particularly with respect to retirement ages being deferred or made more flexible, as well as the cost of health care.

Desk based prompts to replace workplace sitting with stair climbing; a pilot study of acceptability, effects on behaviour and disease risk factors

Background

Prolonged sitting is associated with increased risk of obesity, type 2 diabetes and cardiovascular disease. Occupational sitting accounts for up to 50 h/week for employees. This pilot study assessed the acceptability of stair climbing as an interruption to sitting throughout working hours, and provided preliminary data of the effects on glucose and lipid profiles.

Methods

A quasi-experimental design was conducted involving 16 sedentary office workers (five females and 11 males) for intervention (n = 8) and control groups (n = 8) with mean age of 36.38 (5.58). For the eight-week intervention, a continuous four-floor stair climb and descent was performed eight times/day spread evenly over the working day. A prompt to climb was presented on the participant’s computer eight times/day. Participants in the experimental group recorded daily floors climbed and steps (measured using pedometers) in a weekly log sheet. Blood samples were collected pre and post intervention to test effects on fasting glucose and 2 h plasma glucose, triglycerides, and total (TC), LDL and HDL cholesterol. Experimental participants were interviewed at the end of the study. The Wilcoxon signed rank test was used to compare the median changes (pre-post) of the dependent variables.

Results

On average, the experimental group climbed 121 floors/week when prompted. There were significant reductions in fasting blood glucose, TC and LDL, as well as the derived measures of ‘bad’ cholesterol and the TC/HDL ratio in the experimental group. Post-experimental interviews indicated that the interruption to sitting was well tolerated.

Conclusion

Prompted stair climbing activity had impacts on health outcomes and was found acceptable to employees at work.

Trial registration

Ethics for this study was approved by Science, Technology, Engineering and Mathematics Ethical Review Committee, University of Birmingham with ethics reference number ERN_15_0491.

Supplementary information

The online version contains supplementary material available at 10.1186/s12889-022-14393-1.

Do energy expenditure differences across work postures influence cognitive processing speed? A counter-balanced randomised cross-over trial

BACKGROUND

Anecdotal evidence links occupational sedentary behaviour, low energy expenditure (EE) and cognitive dysfunction. Nevertheless, EE across different work postures including active workstations remains unclear and its influence on cognitive processing speed is yet to be established.

OBJECTIVE

We aimed to investigate differences in EE across various work postures and its influence on cognitive processing speed.

METHODS

Sixteen desk-based employees performed simulated work tasks (typing, reading and cognitive tasks) in three different work positions (sitting, standing, and walking) in three different days. EE was measured for three days consecutively for 30-minutes in three simulated working postures using indirect calorimetry. Cognitive processing speed was assessed through computer-based choice reaction times during each work posture. The outcome variables of interest (EE, reaction times and accuracy) were compared between three work postures using repeated measures ANOVA and Pearson correlation.

RESULTS

EE in walking posture was higher (5.57±0.45 Kcal) than sitting (1.07±0.12 Kcal) and standing (1.88±0.42 Kcal). Total EE was significantly higher in walking than standing (35.17±6.86 Kcal) and sitting postures (41.37±8.46 Kcal). We did not find any significant differences in cognitive processing speed between different work postures except within standing work condition (60.22±13.97 ms). Accuracy was found to be reduced in walking compared to sitting (0.76±0.83%) and standing (0.43±0.09%) but not reached significance.

CONCLUSION

Although significant differences in EE were observed between work postures, walking or standing at work did not affect the cognitive processing speed.

CHAP-child: an open source method for estimating sit-to-stand transitions and sedentary bout patterns from hip accelerometers among children

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.

The associations between specific-type sedentary behaviors and cognitive flexibility in adolescents

Background: The prevalence of sedentary behavior in adolescents has aroused social attention. The association between sedentary behavior and cognitive flexibility remains unclear, and it may vary depending on the type of sedentary behavior. This study aimed to investigate the associations between specific-type sedentary behaviors and cognitive flexibility in adolescents.

Method: A total of 700 Chinese adolescents aged 10–15 years were recruited. The self-report questionnaire was used to assess total sedentary time, recreational screen-based sedentary time, and educational sedentary time. The More-odd shifting task was used to assess cognitive flexibility.

Results: The correlation analysis showed that recreational screen-based sedentary time was negatively correlated with cognitive flexibility, whereas educational sedentary time was positively correlated with cognitive flexibility. The regression analysis also further revealed that a significantly negative association between recreational screen-based sedentary time and cognitive flexibility, while a significantly positive association existed between educational sedentary time and cognitive flexibility.

Conclusion: The findings shown that the association between recreational screen-based sedentary behavior and cognitive flexibility differs from educational sedentary behavior in adolescents, providing new ideas for a more comprehensive understanding of the association between sedentary behavior and cognitive flexibility in adolescents.

Sedentary Behaviors and Health Outcomes among Young Adults: A Systematic Review of Longitudinal Studies

Objective: This study aimed to review and provide an informative synthesis of the findings from longitudinal studies that describe the relationship between sedentary behavior and various health outcomes among young adults. Methods: A literature search was conducted in Web of Science, PubMed, APA PsycInfo, MEDLINE, Embase, and the Cochrane Library for articles that examined the association between sedentary behavior and health outcomes among young adults aged 18–34 years. Two reviewers independently examined the articles and performed data extraction and quality assessment. The level of evidence was determined using the best-evidence synthesis. Results: A total of 34 studies were included in the analysis, 18 of which were high-quality studies. On the basis of inconsistency in the findings among studies, insufficient evidence was concluded for sedentary behavior and adiposity indicators, physical fitness, metabolic syndrome/cardiovascular disease risk factors, cognitive function, and mood disorders. Based on one high-quality study, moderate evidence for a negative relationship between sedentary behavior and physical fitness was observed. Conclusions: Given the trend toward increased time in sedentary behaviors and the inconsistent current findings, additional longitudinal studies of high methodologic quality are recommended to clarify the relationships between sedentary behavior and health outcomes among young adults.

Cross-Sectional Associations of Sedentary Behavior and Sitting with Serum Lipid Biomarkers in Midlife

INTRODUCTION

Physical inactivity, excessive total time spent in sedentary behavior (SB) and prolonged sedentary bouts have been proposed to be risk factors for chronic disease morbidity and mortality worldwide. However, which patterns and postures of SB have the most negative impacts on health outcomes is still unclear. This population-based study aimed to investigate the independent associations of the patterns of accelerometer-based overall SB and sitting with serum lipid biomarkers at different moderate- to vigorous-intensity physical activity (MVPA) levels.

METHODS

Physical activity and SB were measured in a birth cohort sample ( N = 3272) at 46 yr using a triaxial hip-worn accelerometer in free-living conditions for 14 d. Raw acceleration data were classified into SB and PA using a machine learning-based model, and the bouts of overall SB and sitting were identified from the classified data. The participants also answered health-related questionnaires and participated in clinical examinations. Associations of overall SB (lying and sitting) and sitting patterns with serum lipid biomarkers were investigated using linear regression.

RESULTS

The overall SB patterns were more consistently associated with serum lipid biomarkers than the sitting patterns after adjustments. Among the participants with the least and the most MVPA, high total time spent in SB and SB bouts of 15-29.99 and ≥30 min were associated with impaired lipid metabolism. Among those with moderate amount of MVPA, higher time spent in SB and SB bouts of 15-29.99 min was unfavorably associated with serum lipid biomarkers.

CONCLUSIONS

The associations between SB patterns and serum lipid biomarkers were dependent on MVPA level, which should be considered when planning evidence-based interventions to decrease SB in midlife.

Awareness of initiative practice for health in the Chinese population: A questionnaire survey based on a network platform

BACKGROUND

In 2016, the Chinese government issued the Healthy China 2030 plan, which also produced the initiative practice for health (IPFH) concept. However, people’s knowledge and awareness of the IPFH are unclear.

AIM

To investigate awareness of IPFH in the Chinese population and explore the relevant influential factors.

METHODS

An internet-based self-designed questionnaire survey was used to collect respondents’ demographic characteristics and awareness of health and the IPFH from March 26 to April 18, 2020. IPFH consciousness was assessed by the scores for different related questions. The Student’s t test, the Chi-square test, and multiple logistic regression analysis were performed to analyze the differences and influencing factors.

RESULTS

A total of 2678 valid questionnaires were collected. Of the respondents, 973 (36.3%) had heard of the IPFH concept. In addition, 89.5% of participants agreed with the view that the IPFH is beneficial to improving quality of life, and over half thought that a regular schedule, a reasonable diet, tobacco and alcohol control, a cheerful mood, specific life goals and plans, taking the initiative to accept health-related education and implement health knowledge, good interpersonal relationships, and regular physical examinations were closely related to the IPFH. The majority of respondents paid attention to their health and usually obtained health-related knowledge via social media and were also willing to promote the IPFH. Most of the participants underestimated the role of hospitals, family doctors, and health managers in promoting the IPFH. Age, monthly income, and medical-related work experience were the influencing factors for IPFH awareness.

CONCLUSION

The Chinese population has limited knowledge of the IPFH. People with strong IPFH awareness are older, earn more, and have medical-related work experience.