Socio-demographic, clinical and health behavior correlates of sitting time in older adults

Sedentary behaviour and related factors in people with multiple sclerosis

BACKGROUND

Sedentary behaviour is a major problem in persons with multiple sclerosis (pwMS). However, little is known about the related factors of sedentary behaviour in MS. Our study aimed to examine the association between sedentary behaviour and physical activity level, fear of falling, and fatigue.

METHOD

Demographic and clinical data have been recorded. Sedentary behaviour was assessed with the Marshall Sitting Questionnaire, physical activity level was evaluated with the Godin Leisure Time Exercise Questionnaire, fear of falling was evaluated with the Fall Efficacy Scale International, and fatigue was evaluated with the modified fatigue impact scale (MFIS). The Timed 25-Foot Walk, 6-Minute Walk Test, Timed Up and Go Test, and 12-Item Multiple Sclerosis Walking Scale were also used to assess walking and perceived walking disability.

RESULTS

We recruited 71 pwMS [49 were female (69 %), mean age:38.08 years, median EDSS:1.5]. The mean daily sitting time was 593.54 min (∼10 h). No significant correlation was found between sitting times and demographics, leisure time physical activity, fear of falling, walking, perceived walking disability, and neurological disability level (p > 0.05). Logistic regression analysis indicated that being male increased the risk of sedentary behaviour by 3.08 times, being employed increased the risk of sitting by 4.65 times, and each point increase in MFIS scores resulted in a 1.03-fold elevation in the odds of prolonged sitting.

CONCLUSION

The fact that pwMS, even with a mild disability spend almost 10 h sitting highlights the significance of sedentary behaviour in this population. Developing strategies to address modifiable factors, such as fatigue, may be effective in reducing sedentary behaviour.

The Frail-LESS (LEss Sitting and Sarcopenia in Frail older adults) intervention to improve sarcopenia and maintain independent living via reductions in prolonged sitting: a randomised controlled feasibility trial protocol

BACKGROUND

Sarcopenia is a progressive and generalised loss of muscle mass and function with advancing age and is a major contributor to frailty. These conditions lead to functional disability, loss of independence, and lower quality of life. Sedentary behaviour is adversely associated with sarcopenia and frailty. Reducing and breaking up sitting should thus be explored as an intervention target for their management. The primary aim of this study, therefore, is to examine the feasibility, safety, and acceptability of conducting a randomised controlled trial (RCT) that evaluates a remotely delivered intervention to improve sarcopenia and independent living via reducing and breaking up sitting in frail older adults.

METHODS

This mixed-methods randomised controlled feasibility trial will recruit 60 community-dwelling older adults aged ≥ 65 years with very mild or mild frailty. After baseline measures, participants will be randomised to receive the Frail-LESS (LEss Sitting and Sarcopenia in Frail older adults) intervention or serve as controls (usual care) for 6 months. Frail-LESS is a remotely delivered intervention comprising of tailored feedback on sitting, information on the health risks of excess sitting, supported goal setting and action planning, a wearable device that tracks inactive time and provides alerts to move, health coaching, and peer support. Feasibility will be assessed in terms of recruitment, retention and data completion rates. A process evaluation will assess intervention acceptability, safety, and fidelity of the trial. The following measures will be taken at baseline, 3 months, and 6 months: sitting, standing, and stepping using a thigh-worn activPAL4 device, sarcopenia (via hand grip strength, muscle mass, and physical function), mood, wellbeing, and quality of life.

DISCUSSION

This study will determine the feasibility, safety, and acceptability of evaluating a remote intervention to reduce and break up sitting to support improvements in sarcopenia and independent living in frail older adults. A future definitive RCT to determine intervention effectiveness will be informed by the study findings.

TRIAL REGISTRATION

ISRCTN, ISRCTN17158017; Registered 6 August 2021, https://www.isrctn.com/ISRCTN17158017.

The Effect of Equipment-Based Pilates (Reformer) Exercises on Body Composition, Some Physical Parameters, and Body Blood Parameters of Medical Interns

BACKGROUND

Pilates is a type of exercise that exerts positive effects on body composition and general health. This study set out to investigate the effects of equipment-based Pilates (reformer) exercise on body composition, some physical parameters, and blood parameters of medical interns showing a tendency toward sedentary life.

MATERIALS AND METHODS

The experimental group (EG) comprising 22 healthy internship students in the medical faculty performed Pilates reformer exercises for nine weeks. The control group (CG) consisted of 18 students who did not engage in any exercise program. The baseline and final parameters of all the participants were measured.

RESULTS

The mean age of the experimental group (EG) was 23.68±1.29 years, while that of the control group (CG) was 24.78±3.44 (p=0.089). A significant difference was evident between the performance pre-test and post-test scores of the EG (p<0.05). However, a significant positive difference was noted only between the waist pre-test and post-test results in the body composition measurements (p<0.05). A significant rise in HDL and fasting blood sugar levels and a decrease in insulin levels was observed in the post-exercise biochemical parameters measured in the EG (p=0.05). When the EG and CG were compared, a significant difference was found only in HDL cholesterol values in relation to the differences between the pre-test and the post-test groups (p=0.024).

CONCLUSION

The positive data from performance tests, especially with its HDL-increasing and insulin-lowering effects in the EG, implicate that Pilates reformer exercises can produce a favorable effect on the healthy living standards of medical interns.

An intervention to increase physical activity in care home residents: results of a cluster-randomised, controlled feasibility trial (the REACH trial)

BACKGROUND

Care home (CH) residents are mainly inactive, leading to increased dependency and low mood. Strategies to improve activity are required.

DESIGN AND SETTING

Cluster randomised controlled feasibility trial with embedded process and health economic evaluations. Twelve residential CHs in Yorkshire, United Kingdom, were randomised to the MoveMore intervention plus usual care (UC) (n = 5) or UC only (n = 7).

PARTICIPANTS

Permanent residents aged ≥65 years.

INTERVENTION

MoveMore: a whole home intervention involving all CH staff designed to encourage and support increase in movement of residents.

OBJECTIVES AND MEASUREMENTS

Feasibility objectives relating to recruitment, intervention delivery, data collection and follow-up and safety concerns informed the feasibility of progression to a definitive trial. Data collection at baseline, 3, 6 and 9 months included: participants' physical function and mobility, perceived health, mood, quality of life, cognitive impairment questionnaires; accelerometry; safety data; intervention implementation.

RESULTS

300 residents were screened; 153 were registered (62 MoveMore; 91 UC). Average cluster size: MoveMore: 12.4 CHs; UC: 13.0 CHs. There were no CH/resident withdrawals. Forty (26.1%) participants were unavailable for follow-up: 28 died (12 MoveMore; 16 UC); 12 moved from the CH. Staff informant/proxy data collection for participants was >80%; data collection from participants was <75%; at 9 months, 65.6% of residents provided valid accelerometer data; two CHs fully, two partially and one failed to implement the intervention. There were no safety concerns.

CONCLUSIONS

Recruiting CHs and residents was feasible. Intervention implementation and data collection methods need refinement before a definitive trial. There were no safety concerns.

Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) participant's profile regarding self-rated health: a multiple correspondence analysis

BACKGROUND

Self-rated health (SRH) - one of the most common health indicators used to verify health conditions - can be influenced by several types of socioeconomic conditions, thereby reflecting health inequalities. This study aimed to evaluate the participant profiles regarding the association between self-rated health and social and occupational characteristics of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

METHODS

Cross-sectional design, including 11,305 individuals. Self-rated health was categorized as good, fair, and poor. The relationship between socio-demographic, psychosocial work environment, health-related variables, and self-rated health was analyzed by multiple correspondence analysis (stratified by age: up to 49 years old and 50 years old or more).

RESULTS

For both age strata, group composition was influenced by socioeconomic conditions. Poor SRH was related to lower socioeconomic conditions, being women, black self-declared race/ethnicity, being non-married/non-united, low decision authority, low skill discretion, and obesity.

CONCLUSION

To promote health, interventions should focus on reducing existing socioeconomic, race, and gender inequalities in Brazil.

Approaches to Promote Reduction in Sedentary Behavior in Patients With Minor Ischemic Stroke: A Randomized Controlled Trial

OBJECTIVE

The purpose of this study was to determine whether an approach that promotes reduction in sedentary behavior (SB) during hospitalization and after hospital discharge reduces SB in patients with minor ischemic stroke (MIS) compared with an approach that promotes an increase in physical activity levels.

DESIGN

Randomized controlled trial design.

SETTING

During hospitalization and after hospital discharge.

PARTICIPANTS

We randomly assigned patients (N=61) with MIS (average age, 71.3±8.3y; 65.6% men) admitted to an acute hospital to either the intervention group (reduced SB, n=31) or the control group (increased physical activity levels, n=30).

INTERVENTIONS

During hospitalization, the intervention group received education on reducing SB, goal setting for SB after hospital discharge, and self-monitoring of SB and step count. In contrast, the control group received education on increasing physical activity levels and self-monitoring of step count. Patients in both groups wore an accelerometer during hospitalization until 3 months after hospital discharge. The intervention group received self-monitoring of SB and step count, stickers including information about reducing their SB, and phone calls once every 2 weeks for encouragement and feedback. The control group only wore the accelerometer.

MAIN OUTCOME MEASURES

The primary outcome was SB (in percentage) at 3 months after hospital discharge.

RESULTS

There was an interaction between the 2 groups for SB. Compared with the control group, the intervention group showed a significantly reduced SB (intervention group: baseline, 70.5%; 3 months after hospital discharge, 48.6%; control group: baseline, 71.5%; 3 months after hospital discharge, 57.5%; F value=5.981; P=.018).

CONCLUSIONS

The results suggested that an approach that promotes SB reduction during hospitalization and after hospital discharge is effective in reducing SB in patients with MIS 3 months after hospital discharge.

Strategies to enhance routine physical activity in care home residents: the REACH research programme including a cluster feasibility RCT

Background

Care home residents are mainly inactive, leading to increased dependency and low mood. Although exercise classes may increase activity, a more sustainable model is to engage staff and residents in increasing routine activity.

Objectives

The objectives were to develop and preliminarily test strategies to enhance the routine physical activity of care home residents to improve their physical, psychological and social well-being through five overlapping workstreams.

Design

This trial had a mixed-methods research design to develop and test the feasibility of undertaking an evaluative study consisting of gaining an understanding of the opportunities for and barriers to enhancing physical activity in care homes (workstream 1); testing physical activity assessment instruments (workstream 2); developing an intervention through a process of intervention mapping (workstream 3); refining the provisional intervention in the care home setting and clarifying outcome measurement (workstream 4); and undertaking a cluster randomised feasibility trial of the intervention [introduced via three facilitated workshops at baseline (with physiotherapist input), 2 weeks (with artist input) and 2 months], with embedded process and health economic evaluations (workstream 5).

Setting

The trial was set in 12 residential care homes differing in size, location, ownership and provision in Yorkshire, UK.

Participants

The participants were elderly residents, carers, managers and staff of care homes.

Intervention

The intervention was MoveMore, designed for the whole home, to encourage and support the movement of residents in their daily routines.

Main outcome measures

The main outcome measures related to the feasibility and acceptability of implementing a full-scale trial in terms of recruitment and retention of care homes and residents, intervention delivery, completion and reporting of baseline data and outcomes (including hours of accelerometer wear, hours of sedentary behaviour and hours and type of physical activity), and safety and cost data (workstream 5).

Results

Workstream 1 – through a detailed understanding of life in a care home, a needs assessment was produced, and barriers to and facilitators of activity were identified. Key factors included ethos of care; organisation, management and delivery of care; use of space; and the residents’ daily routines. Workstream 2 – 22 (73.3%) out of 30 residents who wore a hip accelerometer had valid data (≥ 8 hours on ≥ 4 days of the week). Workstream 3 – practical mechanisms for increasing physical activity were developed, informed by an advisory group of stakeholders and outputs from workstreams 1 and 2, framed by the process of intervention mapping. Workstream 4 – action groups were convened in four care homes to refine the intervention, leading to further development of implementation strategies. The intervention, MoveMore, is a whole-home intervention involving engagement with a stakeholder group to implement a cyclical process of change to encourage and support the movement of residents in their daily routines. Workstream 5 – 12 care homes and 153 residents were recruited to the cluster randomised feasibility trial. Recruitment in the care homes varied (40–89%). Five care homes were randomised to the intervention and seven were randomised to usual care. Predetermined progression criteria were recruitment of care homes and residents (green); intervention delivery (amber); and data collection and follow-up – 52% of residents provided usable accelerometer data at 9 months (red), > 75% of residents had reported outcomes at 9 months (green, but self-reported resident outcomes were red), 26% loss of residents to follow-up at 9 months [just missing green criterion (no greater than 25%)] and safety concerns (green).

Limitations

Observations of residents’ movements were not conducted in private spaces. Working with care home residents to identify appropriate outcome measures was challenging. Take-up of the intervention was suboptimal in some sites. It was not possible to make a reliably informed decision on the most appropriate physical activity end point(s) for future use in a definitive trial.

Conclusions

A whole-home intervention was developed that was owned and delivered by staff and was informed by residents and staff. The feasibility of conducting a cluster randomised controlled trial was successfully tested: the target numbers of care homes and residents were recruited, demonstrating that it is possible to recruit care home residents to a cluster randomised trial, although this process was time-consuming and resource heavy. A large data set was collected, which provided a comprehensive picture of the environment, residents and staff in care homes. Extensive quantitative and qualitative work comprehensively explored a neglected area of health and social care research. Completion of ethnographic work in a range of settings enabled the production of an in-depth picture of life in care homes that will be helpful for other researchers considering organisational change in this setting.

Future work

The content and delivery of the intervention requires optimisation and the outcome measurement requires further refinement prior to undertaking a full trial evaluation. Consideration could be given to a recommended, simplified, core outcome set, which would facilitate data collection in this population.

Trial registration

Current Controlled Trials ISRCTN16076575.

Funding

This project was funded by the National Institute for Health Research (NIHR) Programme Grant for Applied Research programme and will be published in full in Programme Grant for Applied Research; Vol. 9, No. 9. See the NIHR Journals Library website for further project information.

The Impact of Sedentary Behavior and Self-Rated Health on Cardiovascular Disease and Cancer among South Korean Elderly Persons Using the Korea National Health and Nutrition Examination Survey (KNHANES) 2014-2018 Data

Cardiovascular disease and cancer have increased the risk of mortality and morbidity in elderly persons worldwide. The aim of this study was to investigate the association of sedentary behavior and self-rated health with cardiovascular disease or cancer in elderly people. The data of 6785 elderly persons aged above 65 years from the Korea National Health and Nutrition Examination Survey 2014-2018 were examined. Binary logistic regression analyses assessed the association of sedentary behavior, self-rated health, and other risk factors with cardiovascular disease or cancer. Prolonged sedentary behavior in elderly people was associated with a high risk for cardiovascular disease (odds ratio (OR): 1.28, 95% confidence interval (CI): 1.08-1.52). There was a high risk for cardiovascular disease (OR: 2.36, 95% CI: 1.85-3.01) or cancer (OR: 1.48, 95% CI: 1.17-1.88) in elderly people who had poor self-rated health. This study identified the association between prolonged sedentary behavior and cardiovascular disease, and between poor self-rated health and cancer. Since prolonged sedentary behavior is related to cardiovascular disease, efforts are needed to reduce sedentary behavior hours and maintain good self-rated health.

Does adult recreational screen-time sedentary behavior have an effect on self-perceived health?

Objectives

Sedentary behavior is a risk factor for comorbidities independently of physical activity. Some studies have reported screen time as an unhealthier form of sedentary behavior. This study assessed the association between recreational screen-time behavior and self-perceived health.

Study design

This is a cross-sectional study.

Methods

As part of the Salut als Carrers Project, in 2018 a survey was conducted in a representative sample (n ​= ​795) of residents aged ​≥ ​18 years living in the borough of Horta, in Barcelona. The survey assessed self-perceived health, recreational screen-time behavior on working and non-working days (Marshall questionnaire), leisure time physical activity (International Physical Activity Questionnaire [IPAQ] long form), socioeconomic status, and age. We analyzed associations between self-perceived health and recreational screen-time sedentary behavior, with adjustment of robust Poisson models for social class, age, and leisure physical activity. All analyses were stratified by gender.

Results

A total of 82.7% of men and 82.5% of women reported sedentary behavior during recreational screen time of ≥3 ​h/day on working days, and 63.9% of men and 65.8% of women on non-working days. Spending ≥3 ​h/day sitting in front of a screen for leisure was associated with poor self-perceived health only on working days for men [PR ​= ​1.87 (1.13–3.09)] but not for women [PR ​= ​1.32 (0.82–2.11)] regardless of leisure physical activity, age, and social class.

Conclusions

In adults, sedentary behavior during recreational screen time on working days is adversely associated with perceived ill health in men, irrespective of leisure time physical activity. Public health interventions could benefit from promoting a reduction in leisure screen sitting time after working hours.

•

Recreational screen-time sedentary behavior in the adult population is adversely associated with poor perceived health.

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Exists gender differences in the association of recreational screen-time sedentary behaviour and self-perceived health.

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We highlight the challenges to generate more about recreational screen-time sedentary behavior at the population level.

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Public health should consider addressing interventions that help reduce sedentary behavior and the use of screens.

Transition and factors associated with the level of physical activity combined with sedentary behavior of the elderly: A longitudinal study

Introduction:

Physical activity and sedentary behavior are emerging issues in public health, especially in developing countries.

Objective:

To verify transition and factors related to physical activity combined with sedentary behavior among the elderly followed for 24 months.

Materials and methods:

We conducted a longitudinal observational study with people aged 60 years or over living in the urban area of Uberaba, Brazil. We collected the data from sociodemographic, health, and physical tests in 2014 and 2016 using the Mini-Mental State Examination (MMSE), the Katz Index, the Lawton and Brody Scale, the Short Physical Performance Battery (SPPB), and the International Physical Activity Questionnaire (IPAQ). For the combined evaluation we considered a cutoff point of 150 minutes of physical activity per week and the percentile 75 (420 minutes/day) for sedentary behavior constituting the groups: Unsatisfactory (insufficient sum of physical activity and sedentary behavior), intermediate (loss of only one of the two components) and satisfactory (sufficient sum of physical activity and sedentary behavior). The statistical descriptive and inferential analysis was performed using the Statistical Package for Social Sciences^™, version 21.0, considering p<0.05.

Results:

Of the 374 elderly, 61 (16.3%) improved their physical activity and sedentary behavior condition, 226 (60.4%) remained in the same category and 87 (23.3%) got worse. Unsatisfactory levels of physical activity and sedentary behavior were related to the eldest group (p=0.031), the absence of professional activity (p<0.001), the dependence for instrumental activities of daily living (p=0.013), and a worse physical performance (p<0.001).

Conclusion:

Our results showed a relationship between sociodemographic and health factors with physical activity and sedentary behavior, reiterating the need for further research on the subject.

Quality of Life in Older Adults with Benign Prostatic Hyperplasia

The purpose of this study is to identify factors that affect health-related quality of life (HRQOL) of older patients with Benign Prostatic Hyperplasia (BPH) and suggest ways to improve the same. Through this, we will improve the self-management practice of patients and promote the treatment of BPH in older patients. The 2015 Korea Health Panel Survey data were used in this study. A total of 422 BPH patients aged 65 or older were included. Logistic regression analysis was conducted to identify factors affecting the HRQOL of older patients with BPH. General characteristics of factors affecting older patients with BPH included income level and type of insurance. In addition, among medical-related characteristics and health behavior factors, subjective health status, unmet medical care needs, moderate physical activity, sitting time, and drinking influenced the HRQOL. Therefore, in order to improve the HRQOL of adult patients with BPH, it is necessary to improve medical accessibility by strengthening primary care. In addition, it is necessary to increase the amount of activity in daily life through healthcare medical devices.

The Social Context of Sedentary Behaviors and Their Relationships With Health in Later Life

This study examined sedentary behaviors among older adults and explored associations with social context and health measures using cross-sectional data from the National Health and Aging Trends Study (N = 1,687). Multivariate models were estimated to explore associations of time in six sedentary behaviors (i.e., television watching, sitting and talking, hobbies, computer use, driving, and resting) with sociodemographic characteristics and level of social engagement and with health status. Results indicated substantial variability in sedentary behaviors, with television watching being the most frequent and resting the least frequent activities. Sedentary behaviors varied by sociodemographic characteristics, including age, race/ethnicity, and education, as well as by level of social engagement. Television watching and resting, but not other behaviors, were associated with poorer health. These findings help to unpack the role of social context in sedentary behaviors and could inform public health interventions aimed at reducing time spent in behaviors that are adversely associated with health.

Sociodemographic and clinical correlates of device-measured sedentary behaviour in multiple sclerosis

PURPOSE

This study examined sociodemographic and clinical variables as correlates of device-measured volume and pattern of sedentary behaviour in persons with multiple sclerosis (MS).

MATERIALS AND METHODS

Participants were recruited through a standardised invitation letter distributed among 1000 persons randomly selected from the North American Research Committee on MS registry. Those who volunteered wore an accelerometer for 7 d and provided sociodemographic and clinical information.

RESULTS

There were 233 persons with MS who were included in the analyses. Linear regression analyses indicated that age and MS type explained significant variance in total sedentary time per day as well as number of breaks in sedentary time. Only disability status explained significant variance in sedentary bout length, whereas age explained significant variance in both number of long sedentary bouts per day. Both age and disability status explained significant variance total time spent in long sedentary bouts per day.

CONCLUSIONS

Persons of older age, progressive MS, and higher disability status spend prolonged, uninterrupted periods of time sedentary. Such results highlight the need for targeted interventions in sub-populations of MS that reduce time spent sedentary and break up the pattern of sedentary behaviour. Implications for Rehabilitation Sedentary behaviour is highly prevalent in multiple sclerosis and may be associated with comorbid conditions. The majority of research on sedentary behaviour in multiple sclerosis has been derived from self-report instruments that only measure the volume of sitting time per day. This study indicates that persons with multiple sclerosis spend a significant amount of time sedentary, and those who are older, have progressive multiple sclerosis, and have higher disability status spend prolonged, uninterrupted periods of time sedentary. Such results highlight the need for targeted behavioural interventions in these sub-populations of multiple sclerosis to reduce time spent sedentary and break the pattern of sedentary behaviour to manage its consequences.

Arriba por la Vida Estudio (AVE): Study protocol for a standing intervention targeting postmenopausal Latinas

BACKGROUND

Postmenopausal Latinas are a growing population group in the US who are at high risk for cardiovascular disease. Epidemiological studies have shown that excessive sitting is related to cardiovascular disease risk. Older women sit for prolonged periods and most individuals do not meet physical activity guidelines. Reducing sitting through increased standing may improve cardiovascular risk. More research is needed on how to intervene to increase standing in older Latinas.

OBJECTIVE

To describe the protocol for a randomized controlled trial to increase standing in postmenopausal Latinas: the Arriba por la Vida Estudio (AVE).

DESIGN/METHODS

Postmenopausal Latinas will be randomized to one of two study arms: an increase standing intervention or a heart healthy attention-comparison condition. A total of 250 overweight postmenopausal Latinas will be recruited and followed for 12weeks. AVE is based on various models of behavior change including strategies such as self-monitoring, goal setting, and habit formation. Participants will receive three in-personhealth-counseling sessions (including one in-home visit) and five follow-up telephone calls using motivational interviewing techniques. Those in the attention-comparison condition will receive an equal number of contacts as the standing intervention with topics focused on healthy aging. The primary outcome is objectively-measured sitting time over three months measured via thigh-worn inclinometers and secondary outcomes include blood pressure, physical functioning and glucoregulatory and lipid biomarkers.

CONCLUSIONS

The findings from this study will provide valuable information about effective approaches to increase standing time in postmenopausal Latinas and its impact on cardiovascular disease risk.

TRIAL REGISTRATION

This study is registered at clincialtrials.gov Identifier: NCT02905929.

Combined effect of different factors on weight status and cardiometabolic risk in Italian adolescents

Background

The observed increase in body weight and cardiometabolic risk (CR) in youth from developed countries contributes to the global burden of chronic diseases in adult age. The aim of this work is to provide a patterning of the associations between different factors and the weight status and CR of the subjects involved in the Italian ministerial ASSO project.

Methods

This study involved 919 students from high schools in Palermo. Weight, height and waist circumference were collected by trained teachers; weight status was estimated by the BMI cut-offs for adolescents and CR through the waist-to-height ratio. Questionnaires were administered through the web-based ASSO-NutFit software. Chi-square test investigated the variables significantly associated with the outcomes, which were then included in a Multiple Correspondence Analysis (MCA), to explore their dimensional relationship to weight status and CR. Poisson regressions were conducted separately for the two outcomes, reporting raw and adjusted prevalence ratios (PRs) and Bootstrap Method was used to determine confidence intervals (CIs), to assessing the degree of effect of the explanatory variables over the outcomes.

Results

Two main dimensions were evidenced, with the overweight/obese group and the group at CR characterized by the following strongly associated factors: male gender, overweight/obese parents, following a slimming regime, caesarean birth, sedentariness, being under/overweight at birth, presence of metabolic risk, going to school by car/scooter, not using supplements.

Conclusions

This study contributed to identifying those adolescents that should be prioritized in interventions aiming at reducing overweight/obesity and CR in this age group.

Electronic supplementary material

The online version of this article (10.1186/s13052-019-0619-9) contains supplementary material, which is available to authorized users.

Association of objective sedentary behaviour and self-rated health in English older adults

Objective

Reducing sedentary behaviour (SB) might improve the health of older adults. However, we know little about how objectively measured SB impacts on self-rated health in older adults. We aimed to explore the associations between objectively measured SB and self-rated health in English older adults.

Results

A random sub-sample of older adults (≥ 65 years old) from the 2008 Health Survey for England wore an ActiGraph GT1M accelerometer for 7 days. Self-rated health was measured using an item from the General Health Questionnaire. Linear regression and analysis of covariance were used to test the associations between percentage time spent in SB and mean daily minutes in SB and self-rated health (very good/good; fair; bad/very bad), adjusting for covariates. Valid accelerometry datasets were returned by 578 individuals. Significant negative associations between percentage time and mean daily minutes in SB and self-rated health were found. In particular, individuals spending reduced percentages of time being sedentary had higher self-rated health. In conclusion, SB appears to be associated with self-rated health in older people independently from MVPA. If longitudinal research could determine how changes in SB influence self-rated health as individuals’ age, this might be an important lifestyle variable to target for health improvement.

Sedentary behaviour is associated with diabetes mellitus in adults: findings of a cross-sectional analysis from the Brazilian National Health System

Background

Sedentary behaviour (SB) may contribute to the development of several chronic diseases, such as hypertension, diabetes mellitus (DM) and all-cause mortality. The aim of this study is to investigate the association between different domains of SB with diabetes among adult users of the Brazilian National Health System (NHS).

Methods

Cross-sectional study from the primary care system of the Brazilian NHS in the city of Bauru, Brazil. SB, physical activity (PA), DM and other chronic diseases were assessed by face-to-face interviews and medical records. As potential confounders in the adjusted model, we used gender, age, economic status, smoking status, hypertension, hypercholesterolaemia and PA.

Results

The study was composed of 147 men and 410 women. The fully adjusted model showed that Brazilian adults spending ≥3 h per day in television viewing (OR = 1.61 [95% CI: 1.11–2.33]) and overall SB (OR = 1.60 [95% CI: 1.09–2.36]) had increased prevalence of DM compared to those spending &lt;3 h per day.

Conclusions

TV viewing and overall SB was associated with higher prevalence of DM in Brazilian adults from the NHS, even after controlling for potential confounders including PA.

SEDENTARY BEHAVIOR AND NUTRITIONAL STATUS AMONG OLDER ADULTS: A META-ANALYSIS

ABSTRACT The accelerated modernization process has entailed changes in the lifestyle of people, such as exposure to sedentary behavior, and this in turn may affect the nutritional status. The aim of this systematic review with meta-analysis was to analyze observational studies that assessed the association between exposure time to sedentary behavior and nutritional status (overweight/malnutrition) in individuals aged ≥60 years. BVS, PubMed and Web of Science were the databases used in the search for observational studies, published until November 28, 2017, which have examined the association between exposure time to sedentary behavior and nutritional status. Two authors undertook the reading of titles and abstracts and applied the STROBE checklist independently. The Odds Ratio was calculated using the random effects model. Eight studies were included in this meta-analysis and involved 21415 individuals. All the studies covered most of the items suggested by the STROBE checklist. Of the total, four studies showed association between sedentary behavior and nutritional status. Longer exposure to sedentary behavior did not increase the odds of overweight and/or obesity (OR 1.32; 95%; CI 0.95-1.84). It is suggested that further studies with standardized criteria for measuring sedentary behavior and nutritional status are undertaken. Level of Evidence II; Systematic review of level II studies.

National estimates of self-reported sitting time in adults with multiple sclerosis

BACKGROUND

Limited data exist on the prevalence and distribution of sedentary behavior (SB) in multiple sclerosis (MS).

OBJECTIVE

The objective of this paper is to describe sitting time as a metric of SB in a large national sample of people with MS.

METHODS

A total of 8004 individuals from the North American Research Committee on MS (NARCOMS) Registry completed the sitting time question from the International Physical Activity Questionnaire in spring 2015. We present descriptive data on sitting time for the total sample and across sociodemographic, clinical, and behavioral characteristics.

RESULTS

The final sample included 6483 individuals. Of these, 36.7% were classified with mild disability, 24.7% with moderate disability, and 38.6% with severe disability. Median sitting time for the total sample was 480 min/day (P25 = 310 min/day, P75 = 720 min/day). Sitting time was highest for individuals with MS who were male (540 min/day), not married (540 min/day), had a disease duration >30 years (540 min/day), were underweight (540.5 min/day), had an annual income of < $15,000 (585 min/day), presented with a progressive form of MS (600 min/day), were classified as insufficiently active (600 min/day), or presented with severe disability (661 min/day).

CONCLUSION

Sitting time is twice as high in individuals with MS compared to the general population (240 min/day).

Sedentary time in older adults: a critical review of measurement, associations with health, and interventions

Sedentary time (ST) is an important risk factor for a variety of health outcomes in older adults. Consensus is needed on future research directions so that collaborative and timely efforts can be made globally to address this modifiable risk factor. In this review, we examined current literature to identify gaps and inform future research priorities on ST and healthy ageing. We reviewed three primary topics:(1) the validity/reliability of self-report measurement tools, (2) the consequences of prolonged ST on geriatric-relevant health outcomes (physical function, cognitive function, mental health, incontinence and quality of life) and(3) the effectiveness of interventions to reduce ST in older adults.

METHODS

A trained librarian created a search strategy that was peer reviewed for completeness.

RESULTS

Self-report assessment of the context and type of ST is important but the tools tend to underestimate total ST. There appears to be an association between ST and geriatric-relevant health outcomes, although there is insufficient longitudinal evidence to determine a dose-response relationship or a threshold for clinically relevant risk. The type of ST may also affect health; some cognitively engaging sedentary behaviours appear to benefit health, while time spent in more passive activities may be detrimental. Short-term feasibility studies of individual-level ST interventions have been conducted; however, few studies have appropriately assessed the impact of these interventions on geriatric-relevant health outcomes, nor have they addressed organisation or environment level changes. Research is specifically needed to inform evidence-based interventions that help maintain functional autonomy among older adults.This consensus statement has been endorsed by the following societies: Academy of Geriatric Physical Therapy, Exercise & Sports Science Australia, Canadian Centre for Activity and Aging, Society of Behavioral Medicine, and the National Centre for Sport and Exercise Medicine.

Is questionnaire-based sitting time inaccurate and can it be improved? A cross-sectional investigation using accelerometer-based sitting time

OBJECTIVES

To investigate the differences between a questionnaire-based and accelerometer-based sitting time, and develop a model for improving the accuracy of questionnaire-based sitting time for predicting accelerometer-based sitting time.

METHODS

183 workers in a cross-sectional study reported sitting time per day using a single question during the measurement period, and wore 2 Actigraph GT3X+ accelerometers on the thigh and trunk for 1-4 working days to determine their actual sitting time per day using the validated Acti4 software. Least squares regression models were fitted with questionnaire-based siting time and other self-reported predictors to predict accelerometer-based sitting time.

RESULTS

Questionnaire-based and accelerometer-based average sitting times were ≈272 and ≈476 min/day, respectively. A low Pearson correlation (r=0.32), high mean bias (204.1 min) and wide limits of agreement (549.8 to -139.7 min) between questionnaire-based and accelerometer-based sitting time were found. The prediction model based on questionnaire-based sitting explained 10% of the variance in accelerometer-based sitting time. Inclusion of 9 self-reported predictors in the model increased the explained variance to 41%, with 10% optimism using a resampling bootstrap validation. Based on a split validation analysis, the developed prediction model on ≈75% of the workers (n=132) reduced the mean and the SD of the difference between questionnaire-based and accelerometer-based sitting time by 64% and 42%, respectively, in the remaining 25% of the workers.

CONCLUSIONS

This study indicates that questionnaire-based sitting time has low validity and that a prediction model can be one solution to materially improve the precision of questionnaire-based sitting time.

Socio-Ecological Variables Associated with Context-Specific Sitting Time in Belgian Older Adults: A One-Year Follow-Up Study

INTRODUCTION

Knowledge about variables associated with context-specific sitting time in older adults is limited. Therefore, this study explored cross-sectional and longitudinal associations of socio-demographic, social-cognitive, physical-environmental and health-related variables with sitting during TV viewing, computer use and motorized transport in older adults.

METHODS

A sample of Belgian older adults completed structured interviews on context-specific sitting time and associated variables using a longitudinal study design. Objective measurements of grip strength and physical performance were also completed. Complete baseline data were available of 258 participants (73.98±6.16 years) of which 229 participants remained in the study at one year follow-up (retention rate: 91.60%). Cross-sectional correlates (baseline data) and longitudinal predictors (change-scores in relation with change in sitting time) were explored through multiple linear regression analyses.

RESULTS

Per context-specific sitting time, most of the cross-sectional correlates differed from the longitudinal predictors. Increases over time in enjoyment of watching TV (+one unit), encouragement of partner to watch less TV (+one unit) and TV time of partner (+30.0 min/day) were associated with respectively 9.1 min/day (p<0.001), 16.0 min/day (p<0.001) and 12.0 min/day (p<0.001) more sitting during TV viewing at follow-up. Increases over time in enjoyment of using a computer (+one unit), the number of smartphones and tablets (+1) and computer use of the partner (+30.0 min/day) were associated with respectively 5.5 min/day (p < .01), 10.4 min/day (p < .05) and 3.0 min/day (p < .05) more sitting during computer use at follow-up. An increase over time in self-efficacy regarding taking a bicycle or walking was associated with 2.9 min/day (p < .05) less sitting during motorized transport at follow-up.

CONCLUSIONS

The results stressed the importance of looking at separate contexts of sitting. Further, the results highlighted the importance of longitudinal research in order to reveal which changes in particular variables predicted changes in context-specific sitting time. Variables at the social-cognitive level were most frequently related to context-specific sitting.

A review of the assessment and prevalence of sedentarism in older adults, its physiology/health impact and non-exercise mobility counter-measures

This literature review focuses on aspects of sedentary behaviour (SB) in elderly. Since it has been identified as a distinct health risk, independent of physical activity, SB is a significant issue. This is particularly true for an ageing population as evidence shows that older adults (aged ≥65 years) are the most sedentary age group (on average 8.5–9.6 h daily sitting time). Accurate SB assessment is important for understanding this habitual behaviour and its impact. However, SB measurement is challenging, regardless of the method used. Although negative associations of SB in elderly have been reported for several health outcomes, evidence is inconclusive, apart from the evidence on the adverse SB effect on the all-cause mortality rate. Generally, strategies have been proposed to counteract SB, of which breaking prolonged sedentary bouts with at least light-intensity physical activity seems to be the most promising. Overall, further research in elderly is required to increase the evidence and to either support or refute the current findings. Moreover, further research will help to develop informed SB guidelines for an optimal strategy to counteract SB and its health effects in older adults.