Food consumption, physical activity and aerobic capacity in systemic lupus erythematosus patients with high cardiovascular risk

Systemic Lupus Erythematosus (SLE) is a chronic, autoimmune and multisystemic rheumatic disease. Patients with SLE have decreased functional and aerobic capacity, as well as increased prevalence of Cardiovascular Diseases (CVD), which are the primary causes of morbimortality in this condition. Dietary intake and physical activity are well-known modifiable cardiovascular risk factors. The aim of this study is to describe food consumption, sedentary behavior, physical activity level, and functional and aerobic capacity in a sample of SLE patients with high cardiovascular risk. This was a cross-sectional study in which patients were assessed for (i) Demographic, anthropometric, and disease-related parameters; (ii) Food consumption; (iii) Physical activity level and sedentary behavior; (iv) Functional and aerobic capacity. Patients averaged 41.7 ± 9 years, and most were classified as overweight/obese (87%). Average macronutrient intake was within recommendations; however, fiber (16 ± 9g) and calcium (391 ± 217 mg) intakes were below, and sodium intake (2.9 ± 1.3 mg) was above recommendations. Besides, food consumption assessed by the Nova system showed a predominance of unprocessed foods (43.8 ± 14.0%TEI), although ultraprocessed food intake (20.0 ± 13.9%TEI) was slightly higher than that seen in the Brazilian population. Patients also exhibited high sedentary behavior (8.2 ± 2.2h) and only eighteen participants reached the minimum recommended amount of moderate-to-vigorous physical activity. Overall, patients had a low functional and aerobic capacity compared to the general population. Data from this study may help design dedicated clinical trials aiming to investigate the effects of lifestyle intervention to mitigate CVD in SLE.

Transitioning to Working from Home Due to the COVID-19 Pandemic Significantly Increased Sedentary Behavior and Decreased Physical Activity: A Meta-Analysis

At the start of the COVID-19 pandemic, many workplaces transitioned to remote work, which altered lifestyle behaviors. We conducted a meta-analysis to understand if the transition to working from home due to the pandemic affected workers' physical activity and sedentary behavior worldwide. We reviewed articles published between November 2019 and May 2022. Of an initial 3485 articles, a total of 17 were included, 15 of 17 were included for their physical activity (PA) comparisons (n = 36,650), and 12 of 17 (n = 57,254) were included for their sedentary behavior (SB) comparisons (10 studies have data for both PA and SB). This work is registered through PROSPERO (CRD42022356000). Working from home resulted in a significant decrease in PA (Hedge's g = -0.29, 95% CI [-0.41, -0.18]) and an increase in SB (Hedge's g = +0.36, 95% CI [0.20, 0.52]). Working from home impaired preventative activity behaviors, and these results are relevant to worker health as the future of work evolves beyond the pandemic.

Examining reactivity to the measurement of physical activity and sedentary behavior among women in midlife with elevated risk for cardiovascular disease

OBJECTIVES

To estimate the extent of reactivity to measurement of physical activity (PA) and sedentary behavior among women in midlife with elevated risk for cardiovascular disease (CVD).

DESIGN

Secondary analysis of a 10-day observational study of PA and sedentary behavior.

MAIN OUTCOME MEASURES

PA (steps, minutes of light PA, total minutes of moderate-to- vigorous PA [MVPA]) and percent time in sedentary behavior per day were assessed using ActiGraph GT3X tri-axial accelerometers in 75 women in midlife with elevated CVD risk (e.g. hypertension; MAge = 51.61, MBMI = 34.02 kg/m2). Two-level multilevel models were used to test for evidence of reactivity, with the addition of random effects to test for evidence of individual differences in observed trends.

RESULTS

All outcomes showed linear trends across days (ps < 0.001), though this masked what appeared to be meaningful dropoff after Day 1 or Day 2 (with little difference between subsequent days; srs ranging from 0.15 to 0.32). The random effect was significant only for percent time in sedentary behavior (χ2[1] = 10.40, p = 0.02).

CONCLUSIONS

Consistent small to medium effects were found for all PA and sedentary behavior outcomes, underscoring the importance of considering measurement reactivity in populations with elevated CVD risk.

Adolescent screen time and unhealthy food consumption in the context of the digital development in New Caledonia

OBJECTIVE

For several years, the Pacific Island Countries and Territories (PICTs) have been undergoing digital developments that have had an impact on the time adolescents spend in front of screens. The association between screen time and the overconsumption of unhealthy foods has been observed but little studied in New Caledonia. The twofold aim of this research was to analyze adolescent screen time based on the number of screens at home, gender, place of living, ethnic community and family socio-professional category and determine the link with the consumption of unhealthy food and drinks.

METHODS

Self-report questionnaires on time spent in front of tablets, computers and mobile phones, as well as the consumption of unhealthy food and drinks, were administered between July 2018 and April 2019 to 867 adolescents from 11 to 15 years old during school hours in eight schools across the three provinces of New Caledonia.

RESULTS

Adolescents in rural areas had fewer screens than their urban counterparts, and the number of screens determined the amount of screen time, which was significantly higher among the adolescents living in urban areas (3.05 h/day weekdays vs rural 2.33 h/day). Screen time was not related to gender, socio-professional category or ethnic community, but correlations were found between screen time and consumption of unhealthy food and drinks. Those who consumed less than 1 u/day of unhealthy drinks watched screens for 3.30 h/day, whereas those who consumed more than 1 u/day watched screens for 4.13 h/day. Also, those who consumed less than 1 u/day of unhealthy food watched screens for 2.82 h/day and those consuming more than 1 u/day did so for 3.62 h/day. Melanesians and Polynesians consumed greater quantities of unhealthy food and drinks than Europeans. As the consumption of unhealthy products is linked to screen time in the context of digital development, there is an urgent need to address the excessive consumption of unhealthy foods in Oceanian populations, particularly among young people.

Physical Inactivity and Sedentariness: Languorous Behavior Among Adolescents in 80 Countries

PURPOSE

High rates of adolescent physical inactivity and sedentary behavior have been reported worldwide, but the combined prevalence of languorous behavior (physical inactivity and/or sedentary behavior) may more accurately reflect just how few adolescents meet World Health Organization recommendations.

METHODS

We analyzed nationally representative data from 325,219 students in 80 countries that participated in the Global School-based Student Health Survey between 2009 and 2018. Students were classified as physically inactive if they reported engaging in moderate or vigorous physical activity less than 60 minutes daily. Students were classified as being sedentary if they sat for three or more hours per day outside of school, such as when having screen time not related to studying. Statistics for each country were generated using complex samples analysis, then the results from all countries were synthesized.

RESULTS

In total, 84% of students were physically inactive, 37% were sedentary, and 91% met the definition for the concept we are calling languorous behavior.

DISCUSSION

Establishing specific evidence-based guidelines for increasing physical activity and decreasing sitting time will enable progress toward reducing languorous behavior among adolescents.

Quantitative assessment of sitting time in ambulant adults with Muscular Dystrophy

BACKGROUND

Current investigations into physical behaviour in Muscular Dystrophy (MD) have focussed largely on physical activity (PA). Negative health behaviours such as sedentary behaviour (Physical Behaviour) and sitting time (Posture Classification) are widely recognised to negatively influence health, but by contrast are poorly reported, yet could be easier behaviours to modify.

METHODS

14 ambulant men with MD and 12 healthy controls (CTRL) subjects completed 7-days of free-living with wrist-worn accelerometry, assessing physical behaviour (SB or PA) and Posture Classification (Sitting or Standing), presented at absolute (minutes) or relative (% Waking Hours). Participant body composition (Fat Mass and Fat Free Mass) were assessed by Bioelectrical Impedance, while functional status was assessed by 10 m walk test and a functional scale (Swinyard Scale).

RESULTS

Absolute Sedentary Behaviour (2.2 Hours, p = 0.025) and Sitting Time (1.9 Hours, p = 0.030 was greater in adults with MD compared to CTRL and Absolute Physical Activity (3.4 Hours, p < 0.001) and Standing Time (3.2 Hours, p < 0.001) was lower in adults with MD compared to CTRL. Absolute hours of SB was associated with Fat Mass (Kg) (R = 0.643, p < 0.05) in ambulatory adults with MD.

DISCUSSION

This study has demonstrated increased Sedentary Behaviour (2.2 hours) and Sitting time (1.9 Hours) in adults with MD compared to healthy controls. Extended waking hours in sitting and SB raises concerns with regards to progression of potential cardio-metabolic diseases and co-morbidities in MD.

Chronic stress experience, sleep, and physical activity: Relations with change in negative affect and acute stress response to a naturalistic stressor

OBJECTIVES

Prior research indicates that chronic stress increases allostatic load and alters individuals' affective response to stress. Recent studies have linked health-related behaviours including poor sleep and physical inactivity with elevated negative affect responses to stress. This study extends prior work to investigate chronic stress experience, sleep, and physical activity as predictors of negative affect and acute stress experience during acute, sustained naturalistic stress.

DESIGN

Students (N = 637) were assessed during an academic semester and end-of-term final exam period.

METHODS

Self-report ratings of chronic stress experience, negative affect, acute stress experience, sleep, physical activity, demographics, and health were obtained. Hierarchical multiple regression analyses examined the extent to which chronic stress experience, sleep duration and sleep quality, habitual physical activity, and their interactions, predicted changes in negative affect and acute stress experience during final exams. Health-related behaviours were also examined as mediators between chronic stress experience and changes in negative affect and acute stress experience.

RESULTS

Greater chronic stress experience and shorter exam period sleep duration, but not habitual sleep duration or physical activity, predicted greater increases in negative affect and acute stress experience. Poorer overall sleep quality was a significant predictor in these models and partially mediated the relation between chronic stress experience and negative affect and acute stress experience.

CONCLUSIONS

Findings highlight the importance of chronic stress experience and sleep in predicting individuals' affective health during naturalistic stress. Interventions that reduce chronic stress experience and improve sleep may help individuals' buffer against impairments to affective health during these episodes.

Associations Between Household Socioeconomic Status, Car Ownership, Physical Activity, and Cardiorespiratory Fitness in South African Primary Schoolchildren Living in Marginalized Communities

BACKGROUND

Little is known whether physical activity (PA)-promoting environments are equally accessible to children with divergent socioeconomic status (SES) in low-/middle-income countries. The authors, therefore, examined whether South African children from poorer versus wealthier families living in marginalized communities differed in moderate to vigorous PA and cardiorespiratory fitness. We also tested associations between family car ownership and PA/cardiorespiratory fitness.

METHODS

Parents/guardians of 908 children (49% girls, mean age = 8.3 [1.4] y) completed a survey on household SES. PA was assessed via 7-day accelerometry, parental and child self-reports, and cardiorespiratory fitness with the 20-m shuttle run test.

RESULTS

Based on accelerometry, most children met current moderate to vigorous PA recommendations (≥60 min/d). About 73% of the children did not engage in structured physical education lessons. Whereas children of the lowest SES quintile accumulated higher levels of device-based moderate to vigorous PA, peers from the highest SES quintile engaged in more sedentary behaviors, but self-reported higher engagement in sports, dance, and moving games after school. Families' car ownership was associated with higher parent/self-reported leisure-time PA.

CONCLUSIONS

A deeper understanding is needed about why wealthier children are more sedentary, but simultaneously engage in more leisure-time PA. The fact that access to structural physical education is denied to most children is critical and needs to be addressed.

The effectiveness of two levels of active office interventions to reduce sedentary behavior in office workers: a mixed-method approach

Sedentary behavior (SB) rates are rising globally, especially during working hours. This research focused on the effectiveness of two levels of active office interventions to reduce SB in office workers. Participants were 78 nonacademic university employees divided into a control (CON) group and an intervention (INT) group. At the organizational level, it was found that the organizational health culture, the physical and social environment, and the organizational health behavior were dramatically changed. At the individual level, compared with the CON group, the INT group was significantly higher in the METs rate; light-intensity physical activity (LPA); and moderate-to-vigorous-intensity physical activity, and was lower in SB (CON, 397.30 ± 39.33 minutes vs. INT, 389.09 ± 37.59 minutes), all p < .05. The intervention was effective in changing health behavior related to SB of office workers in both organization and individual levels.

"It Feels Unhealthy to be Sitting for 40 hours a Week": A Qualitative Analysis of Employee Perceptions of Standing Desk Use in the Workplace

OBJECTIVE

Reducing sedentary behavior (SB) is an important public health concern. The purpose of this study was to explore motivation to acquire a standing desk and strategies for using a standing desk through one-on-one interviews.

METHODS

Thirty-seven university employees (89% staff; 51% women) participated in the study. Data were collected using a semi-structured interview guide and brief demographic questionnaire.

RESULTS

Data analysis yielded five themes about motivation to acquire a standing desk: (1) pain management; (2) health risk; (3) movement opportunity; (4) workspace flexibility; and (5) productivity and three themes about typical use strategy: (1) task-dependent; (2) time-dependent; and (3) threshold.

CONCLUSIONS

Motivating factors for using a standing desk should be considered when encouraging standing desk use. Interventions should provide realistic strategies to establish a sit-stand routine that address employees' unique job demands and preferences.

Disentangling individual, school, and neighborhood effects on screen time among adolescents and young adults in the United States

OBJECTIVES

To examine the association between individual, neighborhood, and school-level influences on individual screen time among adolescents and young adults (AYAs) in the National Longitudinal Study of Adolescent to Adult Health.

METHODS

We classified screen time continuously as self-reported total hours per week of television, videos, and video/computer games at baseline and categorical as extended screen time (≥14 h per week). We fit cross-classified multilevel models (CCMM) to examine to examine the individual-, school- and neighborhood-level demographic and socioeconomic factors associated with screen time. Models were fit using MLwiN with Bayesian estimation procedures.

RESULTS

AYAs reported an average of 22.8 (SD = 19.4) and 21.9 (SD = 20.3) hours of screen time, respectively. At the individual level, younger age, male sex, Black/multiracial race, receipt of public assistance, and lower parental education were associated with higher screen time. At the school level, being out of session (i.e., school and national holidays including summer), having a higher proportion of non-White students, and having a lower proportion of parents with a college education were associated with higher individual screen time.

CONCLUSIONS

We found that individual-level factors most influence youth screen time, with smaller contributions from school factors.

Cognitive impairment and sedentary behavior predict health-related attrition in a prospective longitudinal Parkinson's disease study

INTRODUCTION

In Parkinson's disease (PD), the high burden of motor and non-motor symptoms, such as cognitive impairment or falls, is associated with rapid disease progression and mortality. This is often reflected by an increased drop-out rate of PD patients in longitudinal studies. Active physical behavior can impact the disease course beneficially and has an overall positive effect on health. Contrarily, sedentary behavior is associated with cognitive impairment in PD. The aim of this study was to investigate whether sedentary physical behavior assessed in the home environment and cognitive impairment can predict health-related study attrition due to sickness and death in PD.

METHODS

Data of 45 PD patients, longitudinally assessed, were analyzed. Of those, 20 patients completed six yearly visits, 16 dropped out due to sickness or death, and nine for other reasons. All patients wore a mobile device to assess physical behavior and completed cognitive testing.

RESULTS

Logistic regression revealed global cognition was the primary predictor for health-related drop-out in varying models (p ≤ .04). In the survival analysis, cognitive impairment (p = .005) and longer sedentary mean bout length (p = .02) were associated with drop-out due to sickness and death. The occurrence of health-related study drop-out or death was highest in patients with both impaired cognition and longer sedentary bouts.

CONCLUSIONS

Cognition was the primary predictor for study drop-out due to sickness and death. However, it seems that sedentary behavior might have a potential negative influence on PD patients' health, especially those with cognitive impairment.

Comparison of Physical Activity, TV/Video Watching/Gaming, and Usage of a Portable Electronic Devices by Children With and Without Autism Spectrum Disorder

OBJECTIVE

Individuals with autism spectrum disorder (ASD) participate in less physical activity (PA) and more sedentary behavior than their peers without ASD.

METHODS

The study employed Chi-square analyses of the NSCH 2016-2017 data to compare PA, TV/video watching/gaming, and usage of portable electronic devices by children with and without ASD by age and ASD severity.

RESULTS

Results suggest more than two and a half times as many children 6-11 and 12-17 years old with ASD failed to engage in 60 min of PA during the past week compared to peers without ASD. As children aged, their PA time decreased, with a larger percentage drop for children with ASD. For children ages 6-11 years, an inverse relationship was found between PA and ASD severity that was not found for older children. As the children got older, children with ASD spent more time watching TV/video watching/gaming than peers without ASD, with differing results by ASD severity. More children Birth to 5 years ASD used portable electronic devices than their peers without ASD and more young children with ASD used devices for 3 or more hours a day. Roughly the same proportions of children 12-17 years old used devices for more than 3 h a day but differential results were found between children with and without ASD for less than 1 h of device use.

CONCLUSIONS FOR PRACTICE

These data can be used to advocate for individualized PA interventions and services to increase PA and decrease sedentary behaviors of children with ASD.

Planning for active office intervention in Thailand: survey and in-depth interview of university employees

Purpose

This study aimed to explore knowledge, attitude, behavior and causes of sedentary behavior (SB) among office workers and guidelines for active office intervention.

Design/methodology/approach

The study was comprised of a survey and an interview. In total, 39 nonacademic office workers responded to the Past-day Adults Sedentary Time-University (PAST-U) and workplace sitting break (SITBRQ) questionnaire to measure SB level, sitting bout, frequency and duration of sitting interrupted in 1 h and in whole working hours. Eleven executives and staffs participated in in-depth interviews to understand knowledge, attitude, behavior and cause of SB and guidelines for active office intervention.

Findings

Participants commonly spend most of their working time in SB (383.85 ± 93.03 min or 6 h 23 min). The interview indicated that at an individual level, participants lack knowledge and understanding of SB. The most common causes of SB are huge workload, personal characteristics and the weather. At the organizational level, there is no policy, no support from colleagues or organizations, while the physical environment is not conducive to reducing SB.

Originality/value

The outcomes of the study are used as basic information and guidelines for establishing an active office intervention in accordance with the culture and context of Thai society. There have been studies in Thailand that examine SB but no studies that have been conducted to study basic information on knowledge, attitudes, behaviors and causes of SB to be used in planning active office intervention to reduce SB.

Physical Activity, Sedentary Behavior, and Sleep Quality in Adults with Primary Hypertension and Obesity before and after an Aerobic Exercise Program: EXERDIET-HTA Study

Background: The purposes of the study were to: analyze, by objective (accelerometry) and subjective (International Physical Activity Questionnaire, IPAQ) methodologies, the physical activity (PA) and sedentary behavior (SB) in healthy adults (HEALTHY, n = 30) and individuals with primary hypertension (HTN) and overweight/obesity (n = 218); assess the effects of an aerobic exercise intervention on physical activity (PA), sedentary behavior (SB), and sleep quality in the HTN group; and evaluate the relationship between objectively measured and subjectively reported PA and SB. Methods: The measurements were performed before a 16-week exercise intervention period in both HEALTHY and HTN groups and after the intervention period only in the HTN group, randomized to attention control or exercise training (ExT) subgroups. Results: The HEALTHY group showed more moderate-to-vigorous PA (p < 0.05) and better sleep quality (p < 0.05) than the HTN group, but no difference in SB. After the intervention, HTN participants’ PA and SB, objectively measured by accelerometry, were unchanged, but increased PA and decreased SB (p < 0.05) were observed through IPAQ in ExT. The intervention was effective in improving sleep quality in HTN participants. Conclusions: The differences in moderate-to-vigorous PA and SB may be useful in defining the health profile of a population. The supervised aerobic exercise program was effective in increasing PA, reducing SB, and improving sleep quality in overweight/obese adults with HTN. Accelerometer-measured and self-reported data were not comparable, but complementary.

Validity of long-term and short-term recall of occupational sitting time in Finnish and Chinese office workers

BACKGROUND

As sedentary behavior is a global health issue, there is a need for methods of self-reported sitting assessment. The accuracy and reliability of these methods should also be tested in various populations and different cultural contexts. This study examined the validity of long-term and short-term recall of occupational sitting time in Finnish and Chinese subgroups.

METHODS

Two cohort groups of office-based workers (58.6% female, age range 22-67 years) participated: a Finnish group (FIN, n = 34) and a Chinese group (CHI, n = 36). Long-term (past 3-month sitting) and short-term (daily sitting assessed on 5 consecutive days) single-item measures were used to assess self-reported occupational sitting time. Values from each participant were compared to objectively measured occupational sitting time assessed via thigh-mounted accelerometers, with Spearman's rho (ρ) used to assess validity and the Bland-Altman method used to evaluate agreement. Coefficients of variation depicted day-to-day variability of time spent on sitting at work.

RESULTS

In the total study sample, the results showed that both long-term and short-term recall correlated with accelerometer-derived sitting time (ρ = 0.532, 95% confidence intervals (CI): 0.336-0.684, p< 0.001; ρ = 0.533, 95%CI: 0.449-0.607, p< 0.001, respectively). Compared to objectively measured sitting time, self-reported occupational sitting time was 2.4% (95%CI: -0.5% to 5.3%, p = 0.091) and 2.2% (95%CI: 0.7%-3.6%, p = 0.005) greater for long-term and short-term recall, respectively. The agreement level was within the range -21.2% to 25.9% for long-term recall, and -24.2% to 28.5% for short-term recall. During a 5-day work week, day-to-day variation of sitting time was 9.4% ± 11.4% according to short-term recall and 10.4% ± 8.4% according to accelerometry-derived occupational sitting time.

CONCLUSION

Overall, both long-term and short-term self-reported instruments provide acceptable measures of occupational sitting time in an office-based workplace, but their utility at the individual level is limited due to large variability.

Associations of accelerometer-measured sedentary time, sedentary bouts, and physical activity with adiposity and fitness in children

Sedentary time (ST) has been inconsistently associated with adiposity and cardiorespiratory fitness in children in previous studies. We studied cross-sectional associations of ST, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) with fat mass index (FMI) and cardiorespiratory fitness (estimated VO₂max). Associations were evaluated with and without considering pattern of ST by bout length. We measured ST and activity by a wrist-worn accelerometer, FMI by bioelectrical impedance, and VO₂max by Pacer test in 443 children (51.2% girls, 10.2 ± 0.6 years). Isotemporal substitution regression models estimated the effects of substituting ST, LPA, and MVPA on FMI and VO₂max. Further models repeated analyses separating ST into short (<10 min) and long (≥10 min) bouts. Only replacing ST or LPA with MVPA was consistently associated with lower FMI and greater VO₂max. When separated by bout length, only one unique association was found where replacing long ST bouts with short ST bouts was associated with lower FMI in girls only. In conclusion, activity pattern is associated with adiposity in girls and fitness in boys and girls. Separating ST into long and short ST bouts may be of minimal importance when assessing associations with adiposity and fitness using wrist-worn accelerometry in children.

Sitting time among adolescents across 26 Asia-Pacific countries: a population-based study

OBJECTIVES

To assess the prevalence of sitting time (ST) and examine sex and age disparities in the prevalence among adolescents from Asia-Pacific countries.

METHODS

We used the Global School-based Student Health Survey data (n = 101,785) from 26 Asia-Pacific countries and computed the pooled prevalence of high ST (≥ 3 h/day) using random effect meta-analysis. We used logistic regression to examine sex and age disparities in the prevalence, and meta-regression to assess whether the prevalence was associated with common global indices.

RESULTS

The overall prevalence of ST was 29.9% (95% CI 24.1-35.8) with 29.8% (24.4-35.2) among male and 29.9% (23.4-36.3) female adolescents. Males had higher odds of high ST than females in seven countries, while females had higher odds in six countries. Older adolescents had higher prevalence than their younger counterparts. High ST was more common in high-income countries and was positively associated with country Human Development Index (β = 1.28, 95% CI 0.88-1.68).

CONCLUSION

Continued monitoring of adolescents' ST is warranted in this region to generate consistent and comparable surveillance data that can inform policies and actions for the health and well-being of the regional adolescents.

Accelerometer and self-reported measures of sedentary behaviour and associations with adiposity in UK youth

This study used accelerometer and self-report measures of overall sedentary time (ST) and screen time behaviours to examine their respective associations with adiposity among UK youth. Participants (Year groups 5, 8, and 10; n=292, 148 girls) wore the SenseWear Armband Mini accelerometer for eight days and completed the Youth Activity Profile, an online report tool designed to estimate physical activity and ST.Stature, body mass and waist circumference were measured to classify adiposity outcomes (overweight/obese and central obesity). One-way between groups ANOVA and adjusted linear, logistic and multinomial logistic regression analyses were conducted. There was a significant main effect of age on total ST across the whole week (F(2, 289)=41.64, p≤0.001). ST increased monotonically across Year 5 (581.09±107.81 min·d-¹), 8 (671.96±112.59 min·d-¹) and 10 (725.80±115.20 min·d-¹), and all pairwise comparisons were significant at p≤0.001. A steep age-related gradient to mobile phone use was present (p≤0.001). ST was positively associated with adiposity outcomes independent of moderate-to-vigorous intensity physical activity (MVPA; p≤0.001). Engaging in >3 hours of video gaming daily was positively associated with central obesity (OR=2.12, p≤0.05) but not after adjustment for MVPA. Results further demonstrate the importance of reducing overall ST to maintain healthy weight status among UK youth.

Barriers from Multiple Perspectives Towards Physical Activity, Sedentary Behaviour, Physical Activity and Dietary Habits When Living in Low Socio-Economic Areas in Europe. The Feel4Diabetes Study

This study investigated barriers towards health behaviours (physical activity, limiting sedentary behaviour and healthy dietary habits) experienced by young European families living in vulnerable areas, from multiple perspectives (parents, teachers, local community workers). Focus groups were conducted in six European countries (Belgium, Bulgaria, Finland, Hungary, Greece and Spain). In each country, three focus groups were conducted with parents, one with teachers and one with local community workers. Data were analysed using a deductive framework approach with a manifest content analysis using the software NVivo. The present study identified barriers on four levels (individual, interpersonal, organisational and macro level) of a socio-ecological model of health behaviour. From parents’ perspectives, both general barriers (e.g., financial limitations and lack of time) and country-specific barriers (e.g., organisational difficulties and inappropriate work environment) were identified. Additional barriers (e.g., lack of parental knowledge and lack of parental skills) were provided by other stakeholders (i.e., teachers and local community workers). The results of this study demonstrate the additional value of including multiple perspectives when developing a lifestyle intervention aiming to prevent type 2 diabetes in vulnerable groups. Future lifestyle interventions are recommended to include multiple components (family, school, and community) and could be implemented across European countries if country-specific adaptations are allowed.

Are Self-Efficacy and Weight Perception Associated With Physical Activity and Sedentary Behavior in Hispanic Adolescents?

Little is known about the correlates of physical activity and sedentary behavior in Hispanic adolescents. This study examined at baseline and 2-year follow-up: (1) the relationship between self-efficacy for physical activity and physical activity, (2) the association of weight perception with physical activity and sedentary behavior, and (3) whether sex moderated these associations. Hispanic adolescents ( N = 483 at baseline; age 15-17 years; 55.1% girls) completed questionnaires that assessed their self-efficacy for physical activity, weight perception, and time spent in physical activity and sedentary behavior. Multiple-group path analyses were conducted to examine the proposed relationships and determine whether they were moderated by sex. Models controlled for body mass index, weight loss intention, participation on a sports team, language spoken at home, parental education, and country of birth. Self-efficacy was related to time spent in physical activity in boys ( b = .35, p < .001) and girls ( b = .41, p < .001) at baseline, but not 2 years later. No association was found for weight perception and time spent in physical activity and sedentary behavior. Post hoc analyses for overweight participants at baseline showed that weight perception was associated with time spent watching television. Overall, the findings suggest that self-efficacy is an important correlate, but not a predictor, of physical activity among Hispanic adolescents. Including strategies to address and enhance self-efficacy for physical activity in lifestyle interventions may increase adherence to physical activity recommendations and help reduce the high prevalence of obesity in this population.

Changes in Physical Activity Behaviour and Health Risk Factors Following a Randomised Controlled Pilot Workplace Exercise Intervention

Background

Declining physical activity (PA) and associated health risk factors are well established. Workplace strategies to increase PA may be beneficial to ameliorate extensive sedentary behavior. This study assessed the effectiveness of two PA interventions in workplace settings.

Methods

Interventions were conducted over 40 days targeting insufficiently active (<150 min/wk PA) and/or obese (BMI ≥ 30 kg/m²) adults; participants were randomly allocated to instructor-led exercise sessions either after-work (n = 25) or in-work (n = 23) with a 60 minPA/day common goal, or a wait-listed control group (n = 23). The programme commenced with low-moderate physical activities and progressed to high intensity game style activities by week six. Adherence and compliance were determined using both objective measures of daily PA time from HR monitors and self-report responses to PA questionnaires. Cardiovascular and metabolic risk factors were measured pre- and post-intervention. Changes across the study were analysed using Chi square and repeat-measures ANOVA.

Results

Adherence rates (completed pre and post-testing) were not different between groups (76.0 vs 65.2%). Compliance for the instructor-led sessions was higher for the after-work group (70.4% vs 26.4%, respectively). Increased total PA and aerobic fitness, and decreased weight in both intervention groups were found relative to controls. The after-work group undertook more vigorous PA, and had greater weight loss and fasting blood glucose improvement, relative to in-work participants and controls.

Conclusions

These workplace interventions resulted in rapid and dramatic increases in PA behaviour and important health benefits. Short, in-work PA sessions were less efficacious than longer after-work sessions.

Systems and WBANs for Controlling Obesity

According to World Health Organization (WHO) estimations, one out of five adults worldwide will be obese by 2025. Worldwide obesity has doubled since 1980. In fact, more than 1.9 billion adults (39%) of 18 years and older were overweight and over 600 million (13%) of these were obese in 2014. 42 million children under the age of five were overweight or obese in 2014. Obesity is a top public health problem due to its associated morbidity and mortality. This paper reviews the main techniques to measure the level of obesity and body fat percentage, and explains the complications that can carry to the individual's quality of life, longevity and the significant cost of healthcare systems. Researchers and developers are adapting the existing technology, as intelligent phones or some wearable gadgets to be used for controlling obesity. They include the promoting of healthy eating culture and adopting the physical activity lifestyle. The paper also shows a comprehensive study of the most used mobile applications and Wireless Body Area Networks focused on controlling the obesity and overweight. Finally, this paper proposes an intelligent architecture that takes into account both, physiological and cognitive aspects to reduce the degree of obesity and overweight.

Reliability and validity of the Youth Leisure-time Sedentary Behavior Questionnaire (YLSBQ)

OBJECTIVES

To develop a questionnaire able to assess time spent by youth in a wide range of leisure-time sedentary behaviors (SB) and evaluate its test-retest reliability and criterion validity.

DESIGN

Cross-sectional observational.

METHODS

The reliability sample included 194 youth, aged 10-18 years, who completed the questionnaire twice, separated by one-week interval. The validity study comprised 1207 participants aged 8-18 years. Participants wore an accelerometer for 7 consecutive days. The questionnaire was designed to assess the amount of time spent in twelve different SB during weekdays and weekends, separately. In order to avoid usual phenomenon of time over reporting, values were adjusted to real available leisure-time (LT) for each participant. Reliability was assessed by using Intraclass Correlation Coefficients (ICC) and weighted (quadratic) kappa (k), and validity was assessed by using Pearson correlation and Bland-Altman plots.

RESULTS

The reliability of questionnaire showed a moderate-to-substantial agreement for the most (91%) of items (k=0.43-0.74; ICC=0.41-0.79) with three items (4%) reaching an almost perfect agreement (ICC=0.82-0.83). Only 'sitting and talking' evidenced fair-to-moderate reliability (k=0.27-0.39; ICC=0.34-0.46). The relationship between average sedentary time assessed by the questionnaire and accelerometry was moderate (r=0.36; p<0.001). Systematic biases were not found between questionnaire and accelerometer sedentary time for average day (r=0.05; p=0.11) but Bland-Altman plots suggest moderate discrepancies between both methods of SB measurement (mean=19.86; limits of agreement=-280.04 to 319.76).

CONCLUSIONS

The questionnaire showed moderate to good test-retest reliability and a moderate level of validity for assessing SB in youth, similar or slightly better to previously published in this population.

Daily Life Satisfaction in Older Adults as a Function of (In)Activity

Objectives

This 14-day daily diary study tested the between-person and within-person associations between sedentary behavior, physical activity, and life satisfaction in community-dwelling older adults.

Method

Older adults (n = 100) wore ActivPAL3 activity monitors for 14 days and, at the end of each day, answered questions regarding their health behaviors and life satisfaction.

Results

Separate multilevel models were tested for self-reported and objectively measured behavioral data. In the model using objectively measured behavioral data, life satisfaction was (a) negatively associated with sedentary behavior at the within-person level and unassociated with sedentary behavior at the between-person level and (b) unassociated with physical activity at either the between-person or within-person level. In the model using self-reported behavioral data, life satisfaction was (a) unassociated with sedentary behavior at either the between-person or within-person level and (2) positively associated with physical activity at the within-person, but not at the between-person, level.

Discussion

Results indicated that daily deviations in objectively measured sedentary behavior and self-reported physical activity have implications for older adults' well-being. Interventions designed to enhance well-being and quality of life in older adults should consider targeting daily changes in total sedentary behavior and daily changes in the volume or frequency of physical activity.

Promoting Physical Activity and Nutrition in People With Stroke

The prevalence of cardiovascular disease, diabetes, and obesity is high in people with stroke. Risk factors for these conditions include hypertension, high cholesterol, and physical inactivity. These risk factors are common in people with stroke and often go unmanaged. Engagement in healthy behaviors is important for managing and preventing these risk factors and comorbid conditions. More specifically, physical activity and nutrition are key health behaviors for the management and maintenance of health in people with stroke. These health behaviors, by their very nature, are also occupations; thus, they are influenced by client factors, performance skills and patterns, and environments and contexts. This article discusses physical activity and nutrition within the context of the Occupational Therapy Practice Framework: Domain and Process and proposes potential roles for occupational therapy practitioners and researchers in developing, testing, and providing physical activity and nutrition interventions for people with stroke.

Effect and process evaluation of a kindergarten-based, family-involved intervention with a randomized cluster design on sedentary behaviour in 4- to 6- year old European preschool children: The ToyBox-study

Background

The aim of the present study evaluated the effect and process of the ToyBox-intervention on proxy-reported sedentary behaviours in 4- to 6-year-old preschoolers from six European countries.

Methods

In total, 2434 preschoolers’ parents/primary caregivers (mean age: 4.7±0.4 years, 52.2% boys) filled out a questionnaire, assessing preschoolers’ sedentary behaviours (TV/DVD/video viewing, computer/video games use and quiet play) on weekdays and weekend days. Multilevel repeated measures analyses were conducted to measure the intervention effects. Additionally, process evaluation data were included to better understand the intervention effects.

Results

Positive intervention effects were found for computer/video games use. In the total sample, the intervention group showed a smaller increase in computer/video games use on weekdays (ß = -3.40, p = 0.06; intervention: +5.48 min/day, control: +8.89 min/day) and on weekend days (ß = -5.97, p = 0.05; intervention: +9.46 min/day, control: +15.43 min/day) from baseline to follow-up, compared to the control group. Country-specific analyses showed similar effects in Belgium and Bulgaria, while no significant intervention effects were found in the other countries. Process evaluation data showed relatively low teachers’ and low parents’ process evaluation scores for the sedentary behaviour component of the intervention (mean: 15.6/24, range: 2.5–23.5 and mean: 8.7/17, range: 0–17, respectively). Higher parents’ process evaluation scores were related to a larger intervention effect, but higher teachers’ process evaluation scores were not.

Conclusions

The ToyBox-intervention had a small, positive effect on European preschoolers’ computer/video games use on both weekdays and weekend days, but not on TV/DVD/video viewing or quiet play. The lack of larger effects can possibly be due to the fact that parents were only passively involved in the intervention and to the fact that the intervention was too demanding for the teachers. Future interventions targeting preschoolers' behaviours should involve parents more actively in both the development and the implementation of the intervention and, when involving schools, less demanding activities for teachers should be developed.

Trial registration

clinicaltrials.gov NCT02116296

The potential of bike desks to reduce sedentary time in the office: a mixed-method study

OBJECTIVES

To investigate the use of bike desks in an office setting and office workers' experiences of bike desks.

STUDY DESIGN

Mixed-method study; quantitative data of cycling desk use in combination with qualitative data of users' experience were obtained via questionnaires.

METHODS

Bike desks were provided in an office setting during a five-month period. The amount of cycled time, distance and the cycling intensity were registered. At the end of the intervention period, participants filled out a questionnaire about their experiences of cycling desks in the office.

RESULTS

Participants cycled for approximately 98 min/week. Most participants were very positive about their bike desk experience and almost all of them would continue using them. About one third of the participants experienced a positive effect on attention and work performance and for about two thirds it positively influenced their motivation during work. Furthermore, about half of the participants felt more energetic, more self-confident and perceived a positive effect on their health and lifestyle.

CONCLUSIONS

Providing bike desks in an office reduces office workers sedentary time. Furthermore, people experienced positive effects on several personal and work-related parameters. Therefore, providing bike desks in office settings seems to be a promising means to reduce sedentary time.

Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth

Moderate-to-vigorous physical activity (MVPA) is essential for disease prevention and health promotion. Emerging evidence suggests other intensities of physical activity (PA), including light-intensity activity (LPA), may also be important, but there has been no rigorous evaluation of the evidence. The purpose of this systematic review was to examine the relationships between objectively measured PA (total and all intensities) and health indicators in school-aged children and youth. Online databases were searched for peer-reviewed studies that met the a priori inclusion criteria: population (apparently healthy, aged 5-17 years), intervention/exposure/comparator (volumes, durations, frequencies, intensities, and patterns of objectively measured PA), and outcome (body composition, cardiometabolic biomarkers, physical fitness, behavioural conduct/pro-social behaviour, cognition/academic achievement, quality of life/well-being, harms, bone health, motor skill development, psychological distress, self-esteem). Heterogeneity among studies precluded meta-analyses; narrative synthesis was conducted. A total of 162 studies were included (204 171 participants from 31 countries). Overall, total PA was favourably associated with physical, psychological/social, and cognitive health indicators. Relationships were more consistent and robust for higher (e.g., MVPA) versus lower (e.g., LPA) intensity PA. All patterns of activity (sporadic, bouts, continuous) provided benefit. LPA was favourably associated with cardiometabolic biomarkers; data were scarce for other outcomes. These findings continue to support the importance of at least 60 min/day of MVPA for disease prevention and health promotion in children and youth, but also highlight the potential benefits of LPA and total PA. All intensities of PA should be considered in future work aimed at better elucidating the health benefits of PA in children and youth.

Sedentary behaviour across the primary-secondary school transition: A systematic review

The transition from primary/middle school to secondary/high school is likely to be a key period in children's development, characterised by significant changes in their social and physical environment. However, little is known about the changes in sedentary behaviour that accompany this transition. This review aimed to identify, critically appraise and summarise the evidence on changes in sedentary behaviour across the primary - secondary school transition. Published English language studies were located from computerised and manual searches in 2015. Inclusion criteria specified a longitudinal design, baseline assessment when children were in primary/middle school with at least one follow-up during secondary/high school and a measure of sedentary behaviour at both (or all) points of assessment. Based on data from 11 articles (19 independent samples), tracking coefficients were typically in the range of 0.3 to 0.5 and relatively consistent across the different sedentary behaviours examined and durations of follow-up. Both screen-based sedentary behaviour and overall sedentary time increased during the school transition. Overall there was an increase of approximately 10-20min per day per year in accelerometer-assessed sedentary time. Consistent with the broader age-related changes in behaviour observed during this period, sedentary behaviour increases during the transition from primary/middle to secondary/high school. Investigating features of the social and physical environment that might exacerbate or attenuate this trend would be a valuable next step.

Work Site-Based Environmental Interventions to Reduce Sedentary Behavior: A Systematic Review

OBJECTIVE

The purpose of this investigation was to systematically review work site-based, environmental interventions to reduce sedentary behavior following preferred reporting items for systematic reviews and meta-analyses guidelines.

DATA SOURCE

Data were extracted from Medical Literature Analysis and Retrieval System Online, Cochrane Central Register of Controlled Trials, and Web of Science between January 2005 and December 2015.

STUDY INCLUSION AND EXCLUSION CRITERIA

Inclusion criteria were work site interventions, published in peer-reviewed journals, employing environmental modalities, targeting sedentary behavior, and using any quantitative design. Exclusion criteria were noninterventions and non-English publications.

DATA EXTRACTION

Data extracted included study design, population, intervention dosage, intervention activities, evaluation measures, and intervention effects.

DATA SYNTHESIS

Data were tabulated quantitatively and synthesized qualitatively.

RESULTS

A total of 15 articles were identified for review and 14 reported statistically significant decreases in sedentary behavior. The majority of studies employed a randomized controlled trial design (n = 7), used inclinometers to measure sedentary behavior (n = 9), recruited predominantly female samples (n = 15), and utilized sit-to-stand desks as the primary intervention modality (n = 10). The mean methodological quality score was 6.2 out of 10.

CONCLUSION

Environmental work site interventions to reduce sedentary behavior show promise because work sites often have more control over environmental factors. Limitations of this intervention stream include inconsistent measurement of sedentary behavior, absence of theoretical frameworks to guide program development, and absence of long-term evaluation. Future studies should include clear reporting of intervention strategies and explicit operationalization of theoretical constructs.

Cardiorespiratory fitness estimation in free-living using wearable sensors

OBJECTIVE

In this paper we propose artificial intelligence methods to estimate cardiorespiratory fitness (CRF) in free-living using wearable sensor data.

METHODS

Our methods rely on a computational framework able to contextualize heart rate (HR) in free-living, and use context-specific HR as predictor of CRF without need for laboratory tests. In particular, we propose three estimation steps. Initially, we recognize activity primitives using accelerometer and location data. Using topic models, we group activity primitives and derive activities composites. We subsequently rank activity composites, and analyze the relation between ranked activity composites and CRF across individuals. Finally, HR data in specific activity primitives and composites is used as predictor in a hierarchical Bayesian regression model to estimate CRF level from the participant's habitual behavior in free-living.

RESULTS

We show that by combining activity primitives and activity composites the proposed framework can adapt to the user and context, and outperforms other CRF estimation models, reducing estimation error between 10.3% and 22.6% on a study population of 46 participants.

CONCLUSIONS

Our investigation showed that HR can be contextualized in free-living using activity primitives and activity composites and robust CRF estimation in free-living is feasible.

Acceptability and feasibility of a low-cost, theory-based and co-produced intervention to reduce workplace sitting time in desk-based university employees

BACKGROUND

Prolonged sedentary time is linked with poor health, independent of physical activity levels. Workplace sitting significantly contributes to sedentary time, but there is limited research evaluating low-cost interventions targeting reductions in workplace sitting. Current evidence supports the use of multi-modal interventions developed using participative approaches. This study aimed to explore the acceptability and feasibility of a low-cost, co-produced, multi-modal intervention to reduce workplace sitting.

METHODS

The intervention was developed with eleven volunteers from a large university department in the UK using participative approaches and "brainstorming" techniques. Main components of the intervention included: emails suggesting ways to "sit less" e.g. walking and standing meetings; free reminder software to install onto computers; social media to increase awareness; workplace champions; management support; and point-of-decision prompts e.g. by lifts encouraging stair use. All staff (n = 317) were invited to take part. Seventeen participated in all aspects of the evaluation, completing pre- and post-intervention sitting logs and questionnaires. The intervention was delivered over four weeks from 7th July to 3rd August 2014. Pre- and post-intervention difference in daily workplace sitting time was presented as a mean ± standard deviation. Questionnaires were used to establish awareness of the intervention and its various elements, and to collect qualitative data regarding intervention acceptability and feasibility.

RESULTS

Mean baseline sitting time of 440 min/workday was reported with a mean reduction of 26 ± 54 min/workday post-intervention (n = 17, 95 % CI = -2 to 53). All participants were aware of the intervention as a whole, although there was a range of awareness for individual elements of the intervention. The intervention was generally felt to be both acceptable and feasible. Management support was perceived to be a strength, whilst specific strategies that were encouraged, including walking and standing meetings, received mixed feedback.

CONCLUSIONS

This small-scale pilot provides encouragement for the acceptability and feasibility of low-cost, multi-modal interventions to reduce workplace sitting in UK settings. Evaluation of this intervention provides useful information to support participatory approaches during intervention development and the potential for more sustainable low-cost interventions. Findings may be limited in terms of generalisability as this pilot was carried out within a health-related academic setting.

Assessing the Physiological Cost of Active Videogames (Xbox Kinect) Versus Sedentary Videogames in Young Healthy Males

OBJECTIVES

The aims of this study were twofold: (1) to compare the physiological costs of active videogames (AVGs) and sedentary videogames (SVGs) and (2) to compare the exercise intensities attained during AVGs with the exercise intensity criteria for moderate and vigorous physical activity, as stated in current physical activity recommendations for improving public health.

MATERIALS AND METHODS

Nineteen young males participated in the study (age, 23 ± 3 years; height, 178 ± 6 cm; weight, 78 ± 15 kg). Participants completed a maximum oxygen uptake ([Formula: see text]) test and a gaming session, including AVGs ("Reflex Ridge," "River Rush," and "Boxing" for the Microsoft [Redmond, WA] Kinect™) and SVGs ("FIFA 14" [Electronic Arts, Burnaby, BC, Canada] and "Call of Duty" [Activision, Santa Monica, CA]). Heart rate (HR) and oxygen uptake [Formula: see text]) were recorded continuously during all videogames. Rating of perceived exertion (RPE) was taken every 3 minutes during AVGs and SVGs. Energy expenditure (EE), expressed as metabolic equivalents (METs), was calculated. One MET was defined as the volume of oxygen consumed at rest in a seated position and is equal to 3.5 mL of O2/kg of body mass/minute. The exercise intensity for each game was expressed as a percentage of [Formula: see text] and percentage of age-predicted maximum HR (HRmax).

RESULTS

Exercise intensity (percentage HRmax, percentage [Formula: see text], and RPE) and EE (METs) were significantly higher during active gaming compared with sedentary gameplay (P < 0.01). AVGs elicited moderate levels of exercise intensity (64-72 percent HRmax) in line with current recommended physical activity guidelines.

CONCLUSIONS

Our results indicate AVGs provoke physiological responses equivalent to a moderate-intensity physical activity.

Light-intensity physical activity is associated with adiposity in adolescent females

INTRODUCTION

Sedentary behavior (SB) research has relied on accelerometer thresholds to distinguish between sitting/lying time (SLT) and light-intensity physical activity (LIPA). Such methods may misclassify SLT, standing time (StT), and LIPA. This study examines the association between directly measured SB, physical activity (PA), and adiposity in an adolescent female sample.

METHODS

Female adolescents (n = 195; mean age, 15.7 yr (SD, 0.9)) had body mass index (BMI) (median, 21.7 kg·m (interquartile range, 5.2 kg·m)) and four-site sum of skinfolds (median, 62.0 mm; interquartile range, 37.1 mm) measured and wore an activPAL™ activity monitor for 7 d. SLT, StT, breaks in SLT, and bouts of SLT <30 and ≥30 min were determined from activPAL outputs. A threshold of 2997 counts per 15 s determined moderate-to-vigorous PA. All remaining time was quantified as LIPA. Mixed linear regression models examined associations between PA variables, SB variables, and adiposity.

RESULTS

Participants spent a mean of 65.3% (SD, 7.1) of the waking day in SLT, 23.0% (SD, 5.3) in StT, 5.6% (SD, 1.5) in LIPA, and 6.1% (SD, 2.4) in moderate-to-vigorous PA. Significant effects for the percentage of LIPA (which excluded StT) with both BMI (β = -4.38, P = 0.0006) and sum of skinfolds (β = -4.05, P = 0.006) were identified. Significant effects for breaks in SLT with BMI (β = -0.30, P = 0.04) were also observed. No additional significant associations were found between activity measures and adiposity.

CONCLUSIONS

Increased LIPA (excluding StT) and breaks in SLT were negatively associated with adiposity in this sample, independent of age. Interventional work should examine whether reducing SLT through breaks and increasing LIPA may prevent increases in adiposity in adolescent females.

All-cause mortality effects of replacing sedentary time with physical activity and sleeping using an isotemporal substitution model: a prospective study of 201,129 mid-aged and older adults

Background

Sedentary behaviour, sleeping, and physical activity are thought to be independently associated with health outcomes but it is unclear whether these associations are due to the direct physiological effects of each behaviour or because, across a finite 24-hour day, engagement in one behavior requires displacement of another. The aim of this study was to examine the replacement effects of sedentary behaviour (total sitting, television/computer screen time combined), sleeping, standing, walking, and moderate-to-vigorous physical activity on all-cause mortality using isotemporal substitution modelling.

Methods

Longitudinal analysis (4.22 ± 0 · 9 years follow-up/849,369 person-years) of 201,129 participants of the 45 and Up study aged ≥45 years from New South Wales, Australia.

Results

Seven thousand four hundred and sixty deaths occurred over follow-up. There were beneficial associations for replacing total sitting time with standing (per-hour HR: 95 % CI: 0.95, 0.94–0.96), walking (0.86, 0.81–0.90), moderate-to-vigorous physical activity (0.88, 0.85–0.90), and sleeping in those sleeping ≤ 7 h/day (0.94, 0.90–0.98). Similar associations were noted for replacing screen time. Replacing one hour of walking or moderate-to-vigorous physical activity with any other activity class was associated with an increased mortality risk by 7–18 %. Excluding deaths in the first 24 months of the follow up and restricting analyses to those who were healthy at baseline did not materially change the above observations.

Conclusion

Although replacing sedentary behaviour with walking and moderate-to-vigorous physical activity are associated with the lowest mortality risk, replacements with equal amounts of standing and sleeping (in low sleepers only) are also linked to substantial mortality risk reductions.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-015-0280-7) contains supplementary material, which is available to authorized users.

Technologies That Assess the Location of Physical Activity and Sedentary Behavior: A Systematic Review

Background

The location in which physical activity and sedentary behavior are performed can provide valuable behavioral information, both in isolation and synergistically with other areas of physical activity and sedentary behavior research. Global positioning systems (GPS) have been used in physical activity research to identify outdoor location; however, while GPS can receive signals in certain indoor environments, it is not able to provide room- or subroom-level location. On average, adults spend a high proportion of their time indoors. A measure of indoor location would, therefore, provide valuable behavioral information.

Objective

This systematic review sought to identify and critique technology which has been or could be used to assess the location of physical activity and sedentary behavior.

Methods

To identify published research papers, four electronic databases were searched using key terms built around behavior, technology, and location. To be eligible for inclusion, papers were required to be published in English and describe a wearable or portable technology or device capable of measuring location. Searches were performed up to February 4, 2015. This was supplemented by backward and forward reference searching. In an attempt to include novel devices which may not yet have made their way into the published research, searches were also performed using three Internet search engines. Specialized software was used to download search results and thus mitigate the potential pitfalls of changing search algorithms.

Results

A total of 188 research papers met the inclusion criteria. Global positioning systems were the most widely used location technology in the published research, followed by wearable cameras, and radio-frequency identification. Internet search engines identified 81 global positioning systems, 35 real-time locating systems, and 21 wearable cameras. Real-time locating systems determine the indoor location of a wearable tag via the known location of reference nodes. Although the type of reference node and location determination method varies between manufacturers, Wi-Fi appears to be the most popular method.

Conclusions

The addition of location information to existing measures of physical activity and sedentary behavior will provide important behavioral information.

The use of cycling workstations in public places - an observational study

OBJECTIVES

To determine the use of cycling workstations in public places; how long are they used, who uses them, and why do people use them.

STUDY DESIGN

Mixed methods study; observations in combination with questionnaires.

METHODS

Cycling desks with a charging feature (We-bike) at Brussels National Airport and Brussels South railway station were observed. Data about the number of users, time spent using the workstation, cycling and charging behaviour, were collected by observation. Data about sex, age, body mass index (BMI) and the reason of the use, were obtained via a survey.

RESULTS

Approximately three people per hour cycled on the workstation. Mean (SD) cycling time was 15.2 (11.9) minutes and mean (SD) cycling intensity was 2.11 (1.16) on the modified Borg scale. 88% of the users charged a device. About two-thirds of the observed people were male and the majority was between 26 and 45 years old (44%). The average BMI (SD) of the surveyed participants was 24.0 (3.1) kg/m(2), with 26.1% of the participants being overweight. People used the desks because they thought it was fun, relaxing, a good distraction, healthy, good for maintaining shape and/or eco-friendly. However, the majority of the participants (83%) used it because of the charging feature and only one-third of the people would also use the desk if a charging feature was not available.

CONCLUSIONS

Cycling desks at public places are used by approximately three people per hour. The charging feature is an important motivating factor as only one-third of the people would use the cycling workstation if there would not be a charging feature. As this easy-to-use machine brings about a decrease in sedentary behaviour and an increase in energy expenditure, the availability at places accessible to everyone, could contribute to a less sedentary society and could thus contribute to the prevention of diseases and mental problems related to prolonged sitting.

Prevalence of physical activity and sedentary behavior among adults with cardiovascular disease in the United States

BACKGROUND

Physical activity (PA) is recommended for primary and secondary prevention of cardiovascular disease (CVD). This study described the prevalence of self-reported and accelerometer-measured PA and sedentary behavior, using a nationally representative sample from the United States, a subset of whom had CVD, including angina, coronary heart disease (CHD), congestive heart failure (CHF), and myocardial infarction (MI).

METHODS

Using the most recently available accelerometer data (combined 2003-2006) from the National Health and Nutrition Examination Survey, the study sample included 680 adults with CVD, who completed a questionnaire and wore an ActiGraph accelerometer for 1 week. A group without CVD (n = 1000) was also selected as the referent, with similar age, gender, and race/ethnic distributions as those with CVD (angina, CHD, CHF, MI) to compare PA and sedentary behavior estimates. Percentages and means were weighted to reflect the US population from 2003 to 2006.

RESULTS

Among those with CVD, the proportion of individuals who engaged in self-reported past-month, moderate-intensity leisure activity ranged from 39.7% (CHF) to 53.8% (CHD) and vigorous-intensity leisure activity from 12.9% (CHF) to 18.4% (CHD), with walking being the most commonly reported activity. Television watching ≥4 h/d ranged from 36.2% (MI) to 44.8% (CHF). Using accelerometry, moderate- to vigorous-intensity PA ranged from 8.6 (CHF) to 11.4 min/d (angina). Sedentary behavior ranged from 9.6 (angina) to 10.1 h/d (CHF). All 4 CVD groups had lower leisure activity and moderate- to vigorous-intensity PA, and higher television watching and sedentary behavior, when compared with the referent group.

CONCLUSIONS

Further efforts are needed to encourage PA and reduce sedentary behavior for secondary prevention of CVD.

Active play opportunities at child care

BACKGROUND AND OBJECTIVES

Physical activity (PA) is important for children's health and development, yet preschoolers are not meeting PA recommendations. The objective of this study was to examine different PA opportunities at child care and how variation in indoor versus outdoor and free versus teacher-led opportunities relate to children's PA.

METHODS

An observational study of 98 children (mean age 4.5 years, 49% girls) from 10 child care centers. Classrooms were observed for at least 4 full days per center (total 50 days) to categorize time into (1) not an active play opportunity (APO); (2) naptime; (3) APO, outdoor free play; (4) APO, outdoor teacher-led; (5) APO, indoor free play; and (6) APO, indoor teacher-led. Children wore accelerometers during observations. Linear regression models examined the influence of APO categories on moderate-vigorous physical activity (MVPA) and sedentary time.

RESULTS

Children's activity was 73% sedentary, 13% light, and 14% MVPA. For 88% of time children did not have APOs, including 26% time as naptime. On average, 48 minutes per day were APOs (41% sedentary, 18% light, and 41% MVPA), 33 minutes per day were outdoors. The most frequent APO was outdoor free play (8% of time); outdoor teacher-led time was <1%. Children were more active and less sedentary outdoors versus indoors and during the child-initiated APOs (indoors and outdoors) versus teacher-led APOs.

CONCLUSIONS

Preschoolers were presented with significantly fewer than recommended opportunities for PA at child care. More APOs are needed for children to meet recommendations, particularly those that encourage more outdoor time, more teacher-led and child-initiated active play, and flexibility in naptime for preschoolers.

Hierarchical approaches to estimate energy expenditure using phone-based accelerometers

Physical inactivity is linked with increase in risk of cancer, heart disease, stroke, and diabetes. Walking is an easily available activity to reduce sedentary time. Objective methods to accurately assess energy expenditure from walking that is normalized to an individual would allow tailored interventions. Current techniques rely on normalization by weight scaling or fitting a polynomial function of weight and speed. Using the example of steady-state treadmill walking, we present a set of algorithms that extend previous work to include an arbitrary number of anthropometric descriptors. We specifically focus on predicting energy expenditure using movement measured by mobile phone-based accelerometers. The models tested include nearest neighbor models, weight-scaled models, a set of hierarchical linear models, multivariate models, and speed-based approaches. These are compared for prediction accuracy as measured by normalized average root mean-squared error across all participants. Nearest neighbor models showed highest errors. Feature combinations corresponding to sedentary energy expenditure, sedentary heart rate, and sex alone resulted in errors that were higher than speed-based models and nearest-neighbor models. Size-based features such as BMI, weight, and height produced lower errors. Hierarchical models performed better than multivariate models when size-based features were used. We used the hierarchical linear model to determine the best individual feature to describe a person. Weight was the best individual descriptor followed by height. We also test models for their ability to predict energy expenditure with limited training data. Hierarchical models outperformed personal models when a low amount of training data were available. Speed-based models showed poor interpolation capability, whereas hierarchical models showed uniform interpolation capabilities across speeds.

Canadian Society for Exercise Physiology position stand: Benefit and risk for promoting childhood physical activity

Current guidelines recommend children accumulate 60 min of daily physical activity; however, highly publicized sudden-death events among young athletes raise questions regarding activity safety. An expert group convened (June 2012) to consider the safety of promoting increased physical activity for children, and recommended the publication of an evidence-based statement of current knowledge regarding the benefits and risks of physical activity for children. Recommendations for encouraging physical activity while maximizing the opportunity to identify children who have been prescribed a physical activity restriction include (1) professionals and (or) researchers that encourage children to change the type of physical activity or to increase the frequency, intensity, or duration of their activity should inquire whether a child has primary healthcare provider-prescribed activity limitations before the child’s activity participation changes; (2) physical activity researchers should prioritize the development of evidence regarding the benefits and risks of childhood physical activity and inactivity, particularly data on the risks of sedentary lifestyles and physical activity-associated injury risks that accounts for the amount of activity performed, and the effectiveness of current risk-management strategies and screening approaches; (3) professionals and researchers should prioritize the dissemination of information regarding the benefits of physical activity and the risks of sedentary behaviour in children; and (4) parents and professionals should encourage all children to accumulate at least 60 min of physical activity daily. The recommendations are established as a minimum acceptable standard that is applicable to all physical activity opportunities organized for children, whether those opportunities occur in a community, school, or research setting.