Sedentary bout durations and metabolic syndrome among working adults: a prospective cohort study

Joint Association of Change in Physical Activity and Sitting Time with Metabolic Syndrome Risk: A Prospective Cohort Study

Background and Aims: The purpose of this study was to investigate the combined impact of variations in physical activity (PA) and sitting time (ST) on the risk of developing metabolic syndrome (MetS). Methods: This study was conducted on a cohort of adults from the general population, aged 40-69 years, who participated in the KOGES community-based cohort study over a span of 10 years. Changes in PA and ST were assessed using the results from PA questionnaires completed during baseline and follow-up surveys. The diagnosis of MetS was determined according to the criteria established by the International Diabetes Federation. To evaluate the combined effect of PA and ST changes on the incidence of MetS, we calculated hazard ratios and 95% confidence intervals using a Cox proportional hazards regression model. Result: The incidence of MetS was reduced by 39% (HR = 0.61, 95% CI = 0.46-0.82) for increased ST/increased PA and 26% (HR = 0.74, 95% CI = 0.58-0.94) for decreased ST/increased PA, compared with increased ST/decreased PA, respectively. In addition, this study confirmed that the combined impact of changes in PA and ST, based on the domain of PA, on the incidence of MetS varied. Conclusion: Changes in ST and PA are associated with the risk of developing MetS. These findings lay the groundwork for further research on the relationship between changes in PA, ST, and the occurrence of diseases.

A Scoping Review of Acute Sedentary Behaviour Studies of People with Spinal Cord Injury

People with a spinal cord injury (SCI) report less physical activity than other populations and may engage in more sedentary behaviour (SB), especially sitting time. SB negatively impacts physiological and psychosocial outcomes in the general population, yet minimal research has explored the effects in people with SCI. The goal of this scoping review was to catalogue and describe the effects of acute SB among people with SCI. We searched four databases before February 2024 for studies in which people with any SCI sat, laid, or reclined for more than one hour in a day, and any physiological, psychological, or behavioural (i.e., SB time) outcome was measured. In total, 2021 abstracts were screened, and eight studies were included (n = 172 participants). The studies were characterized by varied definitions, manipulations, and measures of SB. Most measured outcomes were physiological (e.g., metabolic, blood pressure), followed by behavioural (e.g., SB time) and psychological (e.g., well-being, affect). When SB was interrupted, only postprandial glucose and affect improved. Based on two studies, participants engaged in 1.6 to 12.2 h of SB per day. Average uninterrupted wheelchair sitting bouts lasted 2.3 h. Based on the very limited body of research, it is impossible to draw any conclusions regarding the nature, extent, or impact of SB in people with SCI. There is much work to carry out to define SB, test its effects, and determine if and how people with SCI should reduce and interrupt SB.

Characteristics of physical activity and sedentary behavior in patients undergoing outpatient cardiac rehabilitation

Cardiac rehabilitation is crucial for the secondary prevention of cardiovascular disease, the leading cause of death worldwide. In Japan, as hospitalization periods have been shortened due to advances in medical technology and government policies, outpatient rehabilitation focused on lifestyle and physical activity (PA) is becoming increasingly important as hospital stays shorten. This study was aimed to identify patient characteristics that define the different types of PA and sedentary behaviors, and patient factors in 92 Japanese outpatients by using accelerometers. The patients were found to spend considerable time being sedentary (663.7 ± 118.1 min/day) and very little time engaging in moderate-to-vigorous PA (MVPA, 25.6 (10.6-43.4) min/day). Regression analysis revealed that the daily duration of sedentary behavior was 64 min longer in men than in women (β = 64.2, 95% CI[12.9, 115], p = 0.015); furthermore, men engaged in 22% less light PA (β = -0.245, 95% CI[-0.388, -0.102], p = 0.001). Additionally, MVPA increased by 43% for every 1 metabolic equivalent (MET) task increase in the anaerobic threshold (AT) (β = 0.367, 95% CI[0.035, 0.698], p = 0.031) but decreased by 3% per year of age(β = -0.035, 95% CI[-0.056, -0.015], p < 0.001). The study also found that body mass index (BMI) was negatively correlated with walking time (β = -0.039, 95% CI[-0.075, -0.003], p = 0.036), while AT was positively correlated with MVPA (β = 0.367, 95% CI[0.035, 0.698], p = 0.031) but negatively correlated with time above the AT (β = -2.06, 95% CI[-2.53, -1.59], p < 0.001). These results emphasize the importance of customizing rehabilitation programs according to sex, age, BMI, and AT differences. Furthermore, monitoring home activities and providing individualized prescriptions may enhance the effectiveness of rehabilitation programs.

The effects of laser acupuncture on metabolic syndrome in obese postmenopausal women: a randomized controlled study

To study the laser acupuncture (LA) effects on postmenopausal obese women's metabolic syndrome. Randomized controlled trial. Benha university hospital. Thirty postmenopausal women were randomized into two equal groups. Group A received a diet regimen and Group B received LA treatment for 30 min three times a week for two months beside the diet regimen. Included weight (W), body mass index (BMI), waist (WC), hip (HC), waist-hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum level of total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), fasting blood glucose (FBG), fasting blood insulin (FBI), homeostatic model assessment-insulin resistance (HOMA-IR) before and after the end of treatment. The study's findings showed that both groups experienced a highly statistically significant decrease in the post-testing mean value of W, BMI, WC, HC, WHR, SBP, DBP, TC, TG, LDL, FBG, FBI, and HOMA-IR, while both groups experienced a significant increase in the post-treatment mean value of HDL (p 0.0001). The posttreatment SBP, DBP, TC, TG, LDL, FBS, FBI and insulin resistance were significantly lower while HDL was significantly higher in women who received combined LA and diet regimen compared to those who received dietary regimen only. LA beside the nutritional intervention is a physical therapy technique that may be used safely, easily, and effectively to minimize metabolic syndrome features during menopause.

Comparison of step-count outcomes across seven different activity trackers: a free-living experiment with young and older adults

BACKGROUND

There are now many different types of activity trackers, including pedometers and accelerometers, to estimate step counts per day. Previous research has extensively examined step-count measurements using activity trackers across various settings while simultaneously wearing different devices.; however, older adults frequently display distinct walking patterns and gait speeds compared to younger adults. This study aimed to compare the step-count between older and younger adults by having them simultaneously wear seven different activity trackers in free-living experiments.

METHODS

This study included 35 younger adults (21-43 yrs) and 57 physically independent older adults (65-91 yrs). All participants simultaneously wore one pedometer and six activity trackers: ActiGraph GT3X + Wrist and Hip, Omron Active Style Pro HJA-350IT, Panasonic Actimarker, TANITA EZ-064, Yamasa TH-300, and Yamasa AS-200 for seven days. A regression equation was also used to assess inter-device compatibility.

RESULTS

When comparing wrist-worn ActiGraph to the six hip-worn activity trackers, the wrist-worn ActiGraph consistently recorded step counts over 4,000 steps higher than hip-worn activity trackers in both groups (range, 3000-5000 steps). Moreover, when comparing the ActiGraph worn on the wrist to that worn on the hip, the proportion was higher among older adults compared to younger ones (younger: 131%, older: 180%). The Actimarker recorded the highest average step counts among six hip-worn devices, with 8,569 ± 4,881 overall, 9,624 ± 5,177 for younger adults, and 7,890 ± 4,562 for older adults. The difference between the hip-worn ActiGraph and Active Style Pro was just about 70 steps/day overall. The correlation among all devices demonstrated a very high consistency, except for the wrist-worn ActiGraph (r = 0.874-0.978).

CONCLUSIONS

Step counts recorded from seven selected consumer-based and research-grade activity trackers and one pedometer, except for the wrist-worn ActiGraph. showed a variation of approximately 1700 steps (range, 1265-2275 steps) steps for both groups, yet maintained a high correlation with each other. These findings will be valuable for researchers and clinicians as they compare step counts across different studies or representative surveys conducted globally.

Relationship between quantitative physical activity and deterioration of locomotive function: a cross-sectional study using baseline data from a cohort

BACKGROUND

In aged society, health policies aimed at extending healthy life expectancy are critical. Maintaining physical activity is essential to prevent the deterioration of body functions. Therefore, it is important to understand the physical activity levels of the target age group and to know the content and intensity of the required physical activity quantitatively. Especially we focused the role of non-exercise activity thermogenesis and sedentary time, which are emphasized more than the introduction of exercise in cases of obesity or diabetes.

METHODS

A total of 193 patients from 25 institutions were included. Participants underwent a locomotive syndrome risk test (stand-up test, 2-step test, and Geriatric Locomotive Function Scale-25 questionnaire) and were classified into three stages. Physical activity was quantitatively monitored for one week with 3-axial accelerometer. Physical activity was classified into three categories; (1) Sedentary behavior (0 ∼ ≤ 1.5 metabolic equivalents (METs)), (2) Light physical activity (LPA:1.6 ∼ 2.9 METs), and (3) Moderate to vigorous physical activity (MVPA: ≥3 METs). We investigated the relationship between physical activity, including the number of steps, and the stages after gender- and age- adjustment. We also investigated the relationship between social isolation using Lubben's Social Network Scale (LSNS), as social isolation would lead to fewer opportunities to go out and less outdoor walking.

RESULTS

Comparison among the three stages showed significant difference for age (p = 0.007) and Body Mass Index (p < 0.001). After gender-and age-adjustment, there was a significant relation with a decrease in the number of steps (p = 0.002) and with MVPA. However, no relation was observed in sedentary time and LPA. LSNS did not show any statistically significant difference. Moderate to high-intensity physical activity and the number of steps is required for musculoskeletal disorders. The walking, not sedentary time, was associated to the locomotive stages, and this finding indicated the importance of lower extremity exercise.

CONCLUSIONS

Adjusting for age and gender, the number of steps and moderate to vigorous activity levels were necessary to prevent worsening, and there was no effect of sedentary behavior. Merely reducing sedentary time may be inadequate for locomotive disorders. It is necessary to engage in work or exercise that moves lower extremities more actively.

Acceptability of Performing Resistance Exercise Breaks in the Workplace to Break Up Prolonged Sedentary Time: A Randomized Control Trial in U.S. Office Workers and Students

We investigated the acceptability of bodyweight resistance exercise breaks (REB) to disrupt prolonged sedentary behavior in the workplace. Twenty-nine individuals completed a REB, where they performed 3-min REB 4, 8, and 16 times on days 1-2, 3-4, and 5 of the workweek, respectively, and a control condition (i.e., SIT). Productivity was assessed on days 1 and 5 each week. The acceptability of each REB frequency was assessed. When asked to complete 4, 8, and 16 REB, participants completed (mean values) 3.2, 6.2, and 9.2 REB/day, respectively. Moreover, 88%, 40%, and 9% of participants expressed that the 4-, 8-, and 16-REB frequencies were acceptable, respectively. Decision-making ability and concentration levels increased from day 1-5 of the REB week (p=0.048) but were stable during SIT. REB (4/day) are highly acceptable and could be a promising intervention strategy for reducing occupational sitting, thus decreasing sedentary-behavior-induced risk.

Comparison of Physical Activity and Sedentary Behavior between Work in Office and Work From Home: A Self-controlled Study

OBJECTIVE

To compare physical activity levels and sedentary behavior between individuals working in the office and those working from home, with the aim of elucidating the potential implications on employees' health.

METHODS

We used triaxial accelerometers to assess the physical activity levels of 94 white-collar employees from a large-scale manufacturing company in Japan. They were instructed to wear the accelerometers during their working hours, which included the commuting time on work-in-office days.

RESULTS

The mean energy expenditure on work in office was 426 kcal for individuals, while it was 228 kcal on work from home (P < 0.01). In addition, not including commuting, the time spent sedentary on work-from-home days was higher than that on work-in-office days by 20 minutes.

CONCLUSIONS

Work from home decreases physical activity and increases sedentary time compared with work in office.

Analysis of sedentary behaviour levels and patterns in adults with Down syndrome

BACKGROUND

Sedentary behaviour (SB) among adults with Down syndrome (DS) may differ based on personal or environmental factors.

OBJECTIVE

Investigate differences in SB levels and patterns of adults with DS based on sex, age, and residence-type across weekdays and weekends.

METHODS

Thirty-four adults with DS (15 men; 37 ± 12 years) underwent accelerometry-based measurements of sedentary time, bouts, and breaks for 7 days. We evaluated differences with 2 × 2 mixed-model (group-by-day) ANOVA.

RESULTS

Younger (19-36 years) individuals had less sedentary time (p = .042), and shorter (p = .048) and fewer (p = .012) bouts than older (37-60 years) individuals. Group home residents had more bouts on weekends than adults living with parent/guardians (p = .015).

CONCLUSIONS

Adults with DS spent half their waking hours in SB of short bouts. Age and residence may influence SB.

Sedentary behavior patterns and the risk of non-communicable diseases and all-cause mortality: A systematic review and meta-analysis

BACKGROUND

The association between sedentary behavior and health-related outcomes has been well established, whereas it is inconclusive whether a sedentary behavior pattern is an additional risk factor for health-related outcomes independent of total sedentary time and physical activity.

OBJECTIVES

To determine sedentary behavior patterns and their association with risks of noncommunicable diseases and all-cause mortality and to assess whether this association is independent of total sedentary time and physical activity.

DESIGN

This was a systematic review and meta-analysis.

METHODS

Studies were obtained by searching the Web of Science Core Collection, PubMed/Medline, the Cochrane Library, Embase, CINAHL, and SPORTDiscus up to April 2023. All observational studies published in English or Chinese were included if they explored sedentary behavior patterns and their association with risks of abdominal obesity, metabolic syndrome, diabetes, cardiovascular disease, cancer, and all-cause mortality among individuals who had never experienced the outcome event before the baseline assessment. Data extraction using a standardized form and quality appraisal using two authoritative tools were then performed. All these steps were completed by two independent reviewers from December 2022 to May 2023. If data were sufficiently homogenous, meta-analyses were performed; otherwise, narrative syntheses were employed. Harvest plots were also used to visually represent the distribution of evidence.

RESULTS

Eighteen studies comprising 11 prospective cohort studies and seven cross-sectional studies were included. The findings suggested that prolonged sedentary time and usual sedentary bout duration were two metrics that reflected the nonlinear dose-response effect of prolonged sedentary behavior patterns. Only extremely high levels of prolonged sedentary behavior patterns significantly increased the risk of adverse health outcomes, independent of physical activity. Whether prolonged sitting was an additional risk factor for adverse health outcomes, independent of total sedentary time, was inconclusive due to an insufficient number of primary studies that included total sedentary time as one of the potential covariates. There was some evidence that supported a sedentary bout that significantly increased the risk of adverse health outcomes was 30-60 min. The threshold of prolonged sedentary time differed with outcomes, and future studies are needed to make this threshold more precise.

CONCLUSION

A prolonged sedentary behavior pattern was associated with increased risks of several major noncommunicable diseases and all-cause mortality. People, especially those who do not reach the recommended level of moderate-to-vigorous physical activity, are encouraged to interrupt sedentary bouts every 30 to 60 min and limit prolonged sedentary time per day as much as possible.

TWEETABLE ABSTRACT

Breaking up consecutive sedentary bouts >30 to 60 min and substituting them with brief bouts of physical activity.

Longitudinal Changes in Moderate to Vigorous Physical Activity in Community-Dwelling Older Men and Women: A 2-Year Prospective Cohort Study in Japan

BACKGROUND

To examine longitudinal changes in accelerometer-measured moderate to vigorous physical activity (MVPA) and associated factors of changes in MVPA among community-dwelling older Japanese men and women over 2 years of follow-up.

METHODS

In total, 601 participants (72.2 [5.4] y, 40.6% men) were included. MVPA was assessed at baseline (2011) and follow-up (2013) using triaxial accelerometers. Sex-stratified multiple linear regression models were used to identify associated factors of changes in MVPA.

RESULTS

On average, a significant decrease in MVPA over 2 years was observed only in women (P < .001). Higher baseline MVPA levels and older age were significantly associated with a decrease in MVPA over 2 years in both men and women. Men who were currently drinking (vs no) and had faster maximum gait speed showed statistically significant increases in MVPA. Women who had very poor/poor economic status (vs fair/good) and were socially isolated (vs no) showed statistically significant increases in MVPA over 2 years, while those who had fear of falling (vs no) and poor/fair self-rated health (vs good/very good) showed statistically significant decreases in MVPA over 2 years.

CONCLUSIONS

Our findings showed different associated factors of changes in MVPA by sex, suggesting the importance of accounting for sex differences in terms of developing specific intervention strategies for promoting MVPA among older men and women.

Objective assessment of the association between frailty and sedentary behavior in older adults: a cross-sectional study

BACKGROUND

Given the inconsistent findings of the association between frailty and sedentary behavior in older adults, this cross-sectional study investigated the aforementioned association using four different frailty criteria and two sedentary behavior indices in older adults.

METHODS

Data from older adults (age ≥ 65 y) who participated in health examinations or attended outpatient integrated clinics at a medical center in Taipei, Taiwan, were collected. Frailty was measured using the modified Fried Frailty Phenotype (mFFP), Clinical Frailty Scale in Chinese Translation (CFS-C), Study of Osteoporotic Fractures (SOF) index, and Clinical Frailty-Deficit Count (CF-DC) index; sedentary behavior was assessed with a waist-worn accelerometer. Adjusted linear regression ascertained the association between frailty and both sedentary behavior outcomes.

RESULTS

Among the 214 participants (mean age 80.82 ± 7.14 y), 116 were women. The average total sedentary time and number of sedentary bouts were 609.74 ± 79.29 min and 5.51 ± 2.09 times per day, respectively. Frail participants had a longer total sedentary time (odds ratio [OR]: 30.13, P = .01 and 39.43, P < .001) and more sedentary bouts (OR: 3.50 and 5.86, both P < .001) on mFFP and CFS-C assessments, respectively. The SOF index revealed more sedentary bouts among frail than in robust participants (OR: 2.06, P = .009), without a significant difference in the total sedentary time. Frail participants defined by the CF-DC index were more likely to have frequent sedentary bouts (OR: 2.03, P = .016), but did not have a longer total sedentary time.

CONCLUSIONS

Regardless of the frailty criteria adopted, frailty was positively associated with the number of sedentary bouts per day in older adults. A significant correlation between frailty and total sedentary time was detected only with mFFP and CFS-C indices. Further research may target decreasing the sedentary bouts in older adults as a strategy to improve frailty.

Accelerometer-measured sedentary behavior and risk of functional disability in older Japanese adults: a 9-year prospective cohort study

BACKGROUND

The associations of sedentary time and patterns with functional disability among older adults remain unclear, and few studies have accounted for the co-dependency of sedentary behavior and physical activities when modeling sedentary behavior with risk of functional disability. We aimed to examine the associations between sedentary time and patterns and risk of incident functional disability, and assess whether replacing sedentary time with light physical activity (LPA) or moderate-to-vigorous intensity physical activity (MVPA) is associated with reduced risk of functional disability in community-dwelling older adults.

METHODS

A total of 1,687 Japanese adults aged ≥ 65 years without functional disability at baseline were prospectively followed-up for 9 years (2011-2020). Functional disability was ascertained using the national database of Japan's Long-term Care Insurance System. Sedentary time and patterns, LPA, and MVPA were measured using a tri-axial accelerometer secured to participants' waists.

RESULTS

During follow-up, 466 participants developed functional disability. Compared with the lowest quartile of total sedentary time, the multivariable-adjusted hazard ratios (95% confidence intervals) of functional disability for the second, third, and top quartiles were 1.21 (0.91‒1.62), 1.45 (1.10‒1.92), and 1.40 (1.05‒1.88) (p for trend = 0.01). After further adjusting for MVPA, total sedentary time was no longer significantly associated with the risk of functional disability (p for trend = 0.41). Replacing 10 min/day of sedentary time with the same amount of MVPA (but not LPA) was significantly associated with a 12% reduced risk of functional disability (hazard ratio [95% confidence interval]: 0.88 [0.84‒0.92]). No significant association was observed between sedentary bout length and functional disability.

CONCLUSION

Higher levels of total sedentary time were associated with an increased risk of incident functional disability. However, this association was not independent of MVPA. Replacing sedentary time with MVPA, but not LPA, was associated with reduced risk of functional disability in older adults.

Accelerometer-Measured Physical Activity Data Sets (Global Physical Activity Data Set Catalogue) That Include Markers of Cardiometabolic Health: Systematic Scoping Review

BACKGROUND

Cardiovascular disease accounts for 17.9 million deaths globally each year. Many research study data sets have been collected to answer questions regarding the relationship between cardiometabolic health and accelerometer-measured physical activity. This scoping review aimed to map the available data sets that have collected accelerometer-measured physical activity and cardiometabolic health markers. These data were then used to inform the development of a publicly available resource, the Global Physical Activity Data set (GPAD) catalogue.

OBJECTIVE

This review aimed to systematically identify data sets that have measured physical activity using accelerometers and cardiometabolic health markers using either an observational or interventional study design.

METHODS

Databases, trial registries, and gray literature (inception until February 2021; updated search from February 2021 to September 2022) were systematically searched to identify studies that analyzed data sets of physical activity and cardiometabolic health outcomes. To be eligible for inclusion, data sets must have measured physical activity using an accelerometric device in adults aged ≥18 years; a sample size >400 participants (unless recruited participants in a low- and middle-income country where a sample size threshold was reduced to 100); used an observational, longitudinal, or trial-based study design; and collected at least 1 cardiometabolic health marker (unless only body mass was measured). Two reviewers screened the search results to identify eligible studies, and from these, the unique names of each data set were recorded, and characteristics about each data set were extracted from several sources.

RESULTS

A total of 17,391 study reports were identified, and after screening, 319 were eligible, with 122 unique data sets in these study reports meeting the review inclusion criteria. Data sets were found in 49 countries across 5 continents, with the most developed in Europe (n=53) and the least in Africa and Oceania (n=4 and n=3, respectively). The most common accelerometric brand and device wear location was Actigraph and the waist, respectively. Height and body mass were the most frequently measured cardiometabolic health markers in the data sets (119/122, 97.5% data sets), followed by blood pressure (82/122, 67.2% data sets). The number of participants in the included data sets ranged from 103,712 to 120. Once the review processes had been completed, the GPAD catalogue was developed to house all the identified data sets.

CONCLUSIONS

This review identified and mapped the contents of data sets from around the world that have collected potentially harmonizable accelerometer-measured physical activity and cardiometabolic health markers. The GPAD catalogue is a web-based open-source resource developed from the results of this review, which aims to facilitate the harmonization of data sets to produce evidence that will reduce the burden of disease from physical inactivity.

Patterns and correlates of sedentary behavior among university students

Objective: To characterize the context, patterns, and correlates of sedentary behavior (SB) in university students. Participants: A total of 95 adults (41% men) enrolled in 34 different undergraduate majors. Methods: SB was assessed by questionnaire and accelerometer. Results: Objective SB and moderate-to-vigorous physical activity (MVPA) accounted for 8.4 ± 1.5 and 1.2 ± 0.5 h·day-1, respectively. Most SB was spent in occupational, leisure, and screen time behaviors, and was accumulated in short bouts of 10 min or longer. Women were more sedentary than men (522.0 ± 80.3 vs. 486.1 ± 91.3 min·day-1, p = 0.03) and engaged in more prolonged bouts of SB. Correlates of SB included female sex, smoking, light activity, MVPA, and markers of obesity, with higher levels of light activity and current smoking the strongest and most consistent correlates of reduced SB. Conclusions: University students engage in high amounts of SB and accumulate most of their SB in short bouts, with differences in patterns of SB between men and women.

Daily physical activity measured by a wearable activity monitoring device in patients with rheumatoid arthritis

INTRODUCTION

Activities of daily living in patients with rheumatoid arthritis (RA) have been evaluated by patient-reported outcomes. However, it has been difficult to measure activity intensity quantitively. Calories expended, exercise, and steps were measured quantitively by a wearable activity meter, and their associations with patients' background characteristics were examined.

METHODS

Data from a prospective, observational study (CHIKARA study) were used. Eighty-five of 100 RA patients were entered and wore a wearable activity meter for 7 days. The daily calories expended and exercise for both walking and housework and steps were evaluated. Total daily calories expended and exercise was defined as the sum of walking and housework. The relationships of DAS28-ESR, mHAQ, body composition, muscle function, and general status were analyzed.

RESULTS

The median age was 66.0 years, and the disease duration was 5.3 years. DAS28-ESR was 3.11, and mHAQ was 0.125. Total daily calories expended, exercise, and number of steps were 461.7 kcal, 3.97 METs h, and 4,788, respectively. MHAQ, walking speed, power, locomotive syndrome, and frailty were independently related to exercise. Total daily exercise and steps of the moderate and high disease activity group were significantly lower than those of the remission group. When the number of steps was < 3,333 and < 2,468, the odds ratios for locomotive syndrome and frailty increased 14.4-fold and 8.7-fold, respectively, using Fisher's exact test (P < 0.001).

CONCLUSIONS

Daily physical activity and number of steps were significantly decreased in RA patients with moderate and high disease activity as measured by a wearable activity meter. Key Points • Total daily calories expended and exercise for both walking and housework and steps in patients with rheumatoid arthritis were 461.7 kcal, 3.97 METs h, and 4,788, respectively, using a wearable activity meter. • Daily physical activity, especially total daily exercise and number of steps, was significantly decreased in RA patients with moderate and high disease activity. • When total daily steps were < 3,333 and < 2,468, the odds ratios for locomotive syndrome and frailty increased 14.4-fold and 8.7-fold, respectively.

A new measure to quantify sedentary behavior using accelerometer data: Application to the Hispanic Community Health Study/Study of Latinos

Availability of accelerometer data has made it possible to objectively and continuously monitor sedentary behavior. Various summaries of the extensive accelerometer data have been used to understand the relationship between sedentary behavior and health. However, the widely used summary measures on sedentary bouts, average bout length or its derivatives, fail to reveal patterns of accumulated sedentary behavior over time. Studies have suggested that prolonged uninterrupted sedentary behavior can be an important metric that is related to health states. Yet existing measures to capture the prolonged sedentary patterns either rely on parametric assumptions on the underlying distribution of sedentary bout length or have to categorize sedentary bout length into somewhat arbitrary categories. Gini index was also used; however, it only measures the variability in bout lengths but not the actual length. To overcome these limitations, we proposed a non-parametric weighted survival function to characterize uninterrupted sedentary behavior over time in a continuous fashion and used the area under the survival curve as a new summary measure to quantify sedentary behavior. We showed that this measure is a weighted average of bout length and contains the information on both the mean and variability of bout lengths. We demonstrated in the simulation studies that the proposed measure could better identify prolonged uninterrupted sedentary behavior and predict health outcomes. We applied this new measure and existing sedentary measures to data from the Hispanic Community Health Study/Study of Latinos to examine the association between sedentary behavior and overweight/obesity.

Associations of Objectively-Measured Sedentary Time and Patterns with Cognitive Function in Non-Demented Japanese Older Adults: A Cross-Sectional Study

This study aimed to investigate the cross-sectional associations of objectively-measured sedentary time and patterns with cognitive function in Japanese older adults. A total of 1681 non-demented community-dwelling older adults (aged 73 ± 6, 62.1% women) were included. Total sedentary time, prolonged sedentary time (accumulated in ≥30 min bouts) and mean sedentary bout length were assessed using a tri-axial accelerometer. Global and domain-specific cognitive functions were measured using the Montreal Cognitive Assessment. The average of total sedentary time and prolonged sedentary time were 462 ± 125 and 186 ± 111 min/day, respectively. Greater prolonged sedentary time, but not total sedentary time, was significantly associated with poorer performance in the orientation domain even after controlling for moderate-to-vigorous physical activity (p for trend = 0.002). A significant inverse association was also observed between mean sedentary bout length and the orientation domain (p for trend = 0.009). No significant associations were observed for global cognitive function or other cognitive domains. Sedentary time accumulated in prolonged bouts, but not total sedentary time, was inversely associated with orientation ability among older adults. Our results encourage further researches to confirm the role of prolonged sedentary time in changes to cognitive domains over time among older adults.

Differences of Sedentary Behavior, Physical Activity, and Metabolic Syndrome Severity Among Metabolic Syndrome Clusters

Background: Sedentary behavior (SB), physical activity (PA), and metabolic syndrome (MetS) are risk indicators for cardiometabolic diseases. Novel methods for researching MetS by the 16 unique clusters (i.e., WC+FBG+BP) and as a continuous severity z-score (MetS-Z) have emerged. This study examined how SB, PA, and MetS-Z differed among MetS clusters and SB and PA differences by MetS-Z tertiles. Methods: Using 2015-2016 National Health and Nutritional Examination Survey (NHANES) data, participants with MetS (N = 792) were identified. Subsequently, sex-, race-, and ethnicity-specific MetS-Z were calculated. SB and PA differences were compared between MetS clusters and MetS-Z tertiles. Additionally, MetS-Z was compared between MetS clusters. Results: The WC+FBG+BP MetS cluster was prevalent among 23.80% of participants (95% CIs, 18.41-30.18) and the overall mean MetS-Z was 1.16 (1.08-1.24). Participants reported over 6 daily hours of SB (393.41 minutes⋅day-1 [370.07-416.75]). The TRI+FBG+BP+HDL MetS cluster had less SB than the WC+TRI+FBG+HDL, WC+TRI+HDL, and WC+FBG+BP MetS clusters. PA did not differ between MetS clusters and no differences in SB or PA between MetS-Z tertiles. Conclusions: Limited differences in SB and PA were observed. Participants with 4 or more MetS criteria had worse MetS-Z. Efforts should support replacing SB with PA to improve cardiometabolic health.

Sedentary Behavior and Associated Factors Among Working Adults in Eastern Ethiopia

Background: Sedentary behavior is a major risk factor for non-communicable diseases. Due to changes in lifestyle, sedentary behavior is increasing in sub-Saharan Africa. However, information on the extent of sedentarism among various segments of the population is scant in low-income countries. The objective of this study was to assess the extent of high sedentary behavior and associated factors among working adults in eastern Ethiopia.

Methods: A crosssectional study was conducted among 1,164 working adults at Haramaya University from December 2018 to February 2019. Data were collected through face-to-face interviews using the WHO STEPS and sedentary behavior questionnaire. All reported sedentary activities were added to calculate the total number of hours spent on sedentary behavior, which was then dichotomized into two categories. Those who had ≥8 sedentary hours per day were categorized as having high sedentary behavior. The prevalence ratio (PR) with 95% confidence intervals (CIs) was calculated. Factors associated with outcome variables were identified using Poisson regression with a robust variance statistical model.

Results: The prevalence of high sedentary behavior was 20.3% (95% CI, 18.0–22.7%) among the study participants. The prevalence of high sedentary behavior was associated with age 45–54 years adjusted PR (APR: 2.00; 95% CI = 1.01–3.97) and 55–64 years (APR: 2.16; 95% CI = 1.03–4.57), being a non-manual worker (APR: 2.11; 95% CI = 1.46–3.05), frequent khat chewers (APR: 1.57; 95% CI = 1.22–2.01), with body mass index of ≥25 kg/m² (APR: 1.93; 95% CI = 1.53–2.44), and regular alcohol drinker (APR: 1.39; 95% CI = 1.11–1.76).

Conclusion: One-fifth of working adults had high sedentary behavior. Factors associated with high sedentary behaviors were older age, being a non-manual worker, substance-use behaviors, and having a high body mass index.

Assessment of Physical Activity in Adults using Wrist Accelerometers

The health benefits of physical activity have been widely recognized, yet traditional measures of physical activity including questionnaires and category-based assessments of volume and intensity provide only broad estimates of daily activities. Accelerometers have advanced epidemiologic research on physical activity by providing objective and continuous measurement of physical activity in free-living conditions. Wrist-worn accelerometers have become especially popular due to low participant burden. However, the validity and reliability of wrist-worn devices for adults have yet to be summarized. Moreover, accelerometer data provide rich information on how physical activity is accumulated throughout the day, but only a small portion of these rich data have been utilized by researchers. Lastly, new methodological developments that aim to overcome some of the limitations of accelerometers are emerging. The purpose of this review is to provide an overview of accelerometry research, with a special focus on wrist-worn accelerometers. We describe briefly how accelerometers work, summarize the validity and reliability of wrist-worn accelerometers, discuss the benefits of accelerometers including measuring light-intensity physical activity, and discuss pattern metrics of daily physical activity recently introduced in the literature. A summary of large-scale cohort studies and randomized trials that implemented wrist-worn accelerometry is provided. We conclude the review by discussing new developments and future directions of research using accelerometers, with a focus on wrist-worn accelerometers.

Relationship between Psychological Distress and Prolonged Sedentary Bouts in the Elderly: Four Period Analysis

Background: Too much sitting is associated with low mental health in elderly individuals. We clarified the relationship between psychological distress and the rate of prolonged sedentary bouts (PSBs) among the elderly over four periods. Methods: In a secondary analysis, a sample population of 68 adults aged 65 years or older in Japan was used. The following proxy variables were used: PSB (mental health) and the Kessler 6 scale; K6 scores (psychological distress). Results: Using the cross-lagged effects models, from “2016 K6” to “2017 PSB” (p = 0.004), from “2017 K6” to “2018 PSB” (p < 0.001), and from “2018 K6” to “2019 PSB” (p = 0.021) were all significant; however, the reverse were not all significant in one period. In four periods, from “2016 PSB” to “2019 K6” (p = 0.025) was significant; however, the reverse was not significant. Fit indices were obtained: χ² = 7.641 (p = 0.182), goodness of fit index (GFI) = 0.891, comparative fit index (CFI) = 0.901, and root mean square error of approximation (RMSEA) = 0.121 in structural equation modelling. Conclusions: Psychological distress may affect the rate of PSB after one year, and the rate of PSB may affect the rate of psychological distress after three years in elderly individuals.

Association between walking energetics and fragmented physical activity in mid-to-late life

BACKGROUND

Physical activity becomes increasingly fragmented with age, which may be an early marker of functional decline. Energetic cost of walking and energy capacity are also linked with functional decline, but their associations with activity fragmentation, and the potential modifying roles of total daily physical activity and age, remains unclear.

METHODS

493 participants (50-93 years) from the Baltimore Longitudinal Study of Aging underwent measures of: energetic cost of usual-paced overground walking (ml/kg/m), energy demand during slow walking (ml/kg/min) on a treadmill (0.67 m/s, 0% grade),m/s, 0% grade), and average peak walking energy expenditure (ml/kg/min) during a fast-paced 400-m walk. A ratio of slow walking to peak walking energy expenditure ("cost-to-capacity ratio") was calculated. Activity fragmentation was quantified as an active-to-sedentary transition probability (ASTP) using Actiheart accelerometer data. Linear regression models with ASTP as the dependent variable were used to test whether poorer energy cost and capacity were associated with higher ASTP and whether the associations differed by daily physical activity or age.

RESULTS

After adjusting for demographics, body composition, comorbidities and daily physical activity, every 10% higher cost-to-capacity ratio was associated with 0.4% greater ASTP (p=0.005). This association was primarily driven by the least active participants (pinteraction=0.023). Peak walking energy expenditure was only associated with ASTP among participants aged ≥70 years.

CONCLUSIONS

Higher cost-to-capacity ratio and lower energy capacity may manifest as more fragmented physical activity, especially among those less active or aged ≥70 years. Future studies should examine whether an increasing cost-to-capacity ratio or declining energy capacity predicts subsequent activity fragmentation.

Objectively measured physical activity is associated with frailty in community-dwelling older adults: A systematic review

OBJECTIVE

The later-age shift towards physical inactivity and sedentary behaviour is associated with comorbidity and reduced function: markers of frailty. Whether these behaviours relate to frailty has yet to be thoroughly studied using objective measurements. This study aimed to summarise the associations of objectively measured habitual physical activity and sedentary behaviour with frailty in community-dwelling older adults.

STUDY DESIGN AND SETTING

Six databases were searched from inception to July 21st 2020. Articles analyzing objectively measured physical activity and/or sedentary behaviour with frailty in community-dwelling adults ≥60 years old were included. Synthesis of included articles was performed using effect direction heat maps and albatross plots.

RESULTS

The search identified 23 articles across 18 cohorts, including 7,696 total participants with a mean age of 69.3±8.1 years, and 56.9% female. All but one article were cross-sectional. Lower moderate-to-vigorous and total physical activity, steps, postural transitions, and energy expenditure were associated with frailty. The use of multifactorial or physical frailty definitions did not alter associations. Median effect sizes for the associations of all physical activity and sedentary behaviour measures with frailty were β = -0.272 [-0.381, -0.107] and β = 0.100 [0.001, 0.249], respectively.

CONCLUSION

Objective measures of physical activity are associated with frailty, regardless of frailty definition.

Prevalence of metabolic syndrome and associated factors among patients with chronic Chagas disease

The increase in life expectancy and the migration of individuals with Chagas disease (ChD) from rural to urban centers exposes them to the development of chronic-degenerative abnormalities that may increase the prevalence of metabolic syndrome (MetS). The present study aimed to identify the prevalence of MetS and its components in individuals with chronic ChD. This is a cross-sectional study with 361 patients of both sexes, aging >18 years, followed at a national reference center (Rio de Janeiro, Brazil). MetS diagnosis followed the International Diabetes Federation 2005 criteria. The association between the variables was determined through logistic regression models. The mean age was and 60.7±10.8 years. About half (56.2%) were female and the majority self-reported their race as mulatto (59.8%). The percentage of individuals with MetS was 40.4%. The variables independently associated with MetS were age (OR 1.06; 95%CI 1.04-1.09), high education levels (OR 0.36; 95%CI 0.17-0.79) and cardiac form with heart failure (OR 0.34; 95%CI 0.17-0.68). Therefore, a high prevalence of MetS was found in this Brazilian chronic ChD cohort. The identification of the associated factors can facilitate the development of effective approaches for preventing and managing MetS in ChD patients.

Criterion validity of a single-item question for assessment of daily breaks in sedentary time in adults

BACKGROUND

As the implementation of sensor-based assessment for sedentary time (ST) and physical activity (PA) has practical limitations when applied on a large-scale, most studies rely on subjective data. We aimed to examine the criterion validity of a single-item question to assess daily breaks in ST and other PA-related outcomes for the first time using sensor-based data as the criterion.

METHODS

In a sample of 858 adults, breaks in ST and other PA-related parameters were assessed through sensor-based accelerometry and subjective data, which included a comprehensive questionnaire with a specific question ('During the day, do you usually sit for a long time in a row or interrupt frequently?') with a three-level closed answer. The Spearman's rank correlation coefficient was used to determine the agreement between the single-item question and sensor-based data.

RESULTS

Positive correlations were found for self-reported breaks in ST with sensor-based breaks in ST in both women (ρ=0.37; 95% CI=0.29-0.44) and men (ρ=0.15; 95% CI=0.04-0.26). Self-reported breaks in ST were inversely correlated with ST in women (ρ =-0.33; 95% CI=-0.40 to 0.25). For both sexes, self-reported breaks in ST showed a positive correlation with light-intensity PA (ρ=0.39; 95% CI=0.31-0.46 women; ρ=0.13; 95% CI=0.02-0.24 men), however, positive correlations between self-reported breaks in ST and moderate-to-vigorous PA (ρ=0.13; 95% CI=0.02-0.24) were found only in men.

CONCLUSIONS

Our single-item question can be used as an indication for ranking people's breaks in ST during the waking day, although acknowledging that some misclassification will occur, especially in men. There must be an effort to include this question in future national and international surveys to replicate these findings.

Empirical study of the 30-s chair-stand test as an indicator for musculoskeletal disorder risk of sedentary behaviour in Japanese office workers: a cross-sectional empirical study

Objectives

Sedentary behaviour among office workers and the risk of adverse health outcomes are public health problems. However, risk indicators for these outcomes require invasive biochemical examination. A proactive screening tool using a non-invasive, easy-to-use method is required to assess the risk focused on musculoskeletal health for primary prevention. However, middle-aged adults have insufficient awareness of musculoskeletal disorders. This study examined to determine whether the 30-s chair-stand test (CS-30) can be used as a proactive screening index for musculoskeletal disorder risk of sedentary behaviour in office workers.

Design

Cross-sectional study using self-administered questionnaires and physical measurements.

Setting

Four workplaces located in a metropolitan area of Japan.

Participants

431 Japanese office workers aged 20–64 years. 406 valid sets of results remained (valid response rate: 94.2%).

Primary and secondary outcome measures

Musculoskeletal function was measured using the CS-30, quadriceps muscle strength. Receiver operating characteristic curve analysis was used to determine the sensitivity, specificity and optimal cut-off value for the CS-30. The risk of future incidence of musculoskeletal disorders was calculated using current quadriceps muscle strength.

Results

In total participants, 47.0% were male and the mean sitting time in work duration was 455.6 min/day (SD=111.2 min). The mean lower limb quadriceps muscle strength was 444.8 N (SD=131.3 N). For the optimum cut-off value of 23 on the CS-30 for all participants, sensitivity was 0.809 and specificity was 0.231. For men, the optimum cut-off was 25, with a sensitivity of 0.855 and a specificity 0.172. For women, the optimum cut-off was 21, with a sensitivity of 0.854 and a specificity 0.275.

Conclusions

Sensitivity was high, but specificity was insufficient. The CS-30 may be a potential proactive screening index for musculoskeletal disorder risk of sedentary behaviour, in combination with other indicators.

Association Between Self-Reported Sedentary Behavior and Health-Related Quality of Life Among Multimorbidity Patients in Singapore

BACKGROUND

The study examined the association between sedentary behavior and self-rated health-related quality of life (HRQoL) in a sample of patients with multimorbidity in Singapore recruited from a primary care clinic.

METHODS

Sedentary behavior and physical activity were assessed with the International Physical Activity Questionnaire short form (IPAQ-SF). HRQoL was assessed with EuroQol-5 Dimension (EQ-5D) utility index, visual analogue scale (EQ-VAS) and its 5 subscales (Mobility, Self-care, Usual Activities, Pain/Discomfort, and Anxiety/Depression). Depression was assessed via Patient Health Questionnaire (PHQ-9). Logistic and linear regression analyses adjusting for the effect of physical activity, depression, and sociodemographic variables (i.e., age, gender, ethnicity, education) were conducted.

RESULTS

932 patients participated in the study (mean age:64.5±8.5 years, range: 35-80) and 55% were men. Results indicated that women were less likely to have sedentary behavior (≥7 hrs/day) than men. Results indicated sedentary behavior was associated with lower EQ-5D index scores, but not EQ-VAS scores. Participants who were sedentary for ≥7 hrs/day were more likely to endorse having problems with mobility, self-care, and usual activities, but not with pain/discomfort, nor anxiety/depression.

CONCLUSION

Sedentary behavior was associated with poorer HRQoL. There is a need for interventions and health promotions to reduce sedentary behavior in patients with multimorbidity.

The association between job stress and metabolic syndrome among medical university staff

Background

The relationship between job stress and each component of metabolic syndrome has been previously suggested; however, this association is not consistent. The present study was conducted to assess the association between job stress and metabolic syndrome and its components in a group of Iranian workers affiliated with Tehran University of Medical Sciences.

Methodology

This cross-sectional study was performed on 3,537 randomly selected staff in Tehran University of Medical Sciences including the staff of clinical, administrative, and service departments with at least one year of working experience. The overall frequency of metabolic syndrome was assessed based on the international diabetes federation (IDF) criteria. The Persian version of the Copenhagen Psychosocial Questionnaire (COPSOQ) was used to measure major domains of psychosocial factors in the workplace.

Results

The overall frequency of metabolic syndrome in the assessed personnel was estimated to be 22.1 % and there was a significantly higher rate of metabolic syndrome in office workers and service personnel compared to clinical staff (OR: 1.51, CI 95 %: 1.25-1.82 and OR: 1.74, CI 95 %: 1.41-2.14, respectively). Health and well-being as a major domain of COPSOQ was found to be significantly impaired by the presence of metabolic syndrome. According to the results of multiple logistic regression modeling, the relationship between metabolic syndrome and impaired health and well-being domain remained significant after adjusting for age, gender, marital status, educational level, and employment category.

Conclusions

Our findings revealed a close association between job-related stress and the impaired well-being in the presence of metabolic syndrome among the medical university staff.

Comparison of dapagliflozin and teneligliptin in nonalcoholic fatty liver disease patients without type 2 diabetes mellitus: a prospective randomized study

There are no reports regarding the efficacy of sodium-glucose cotransporter 2 inhibitor (SGLT2i) and dipeptidyl peptidase 4 inhibitor (DPP4i) administrations in nonalcoholic fatty liver disease (NAFLD) patients without type 2 diabetes mellitus. The purpose of this study was to evaluate the efficacy of those drugs in such patients. NAFLD patients without type 2 diabetes mellitus were enrolled in this single center double-blind randomized prospective study, and allocated to receive either dapagliflozin (SGLT2i) or teneligliptin (DPP4i) for 12 weeks. Laboratory variables and body compositions were assessed at the baseline and end of treatment. The primary endpoint was alanine aminotransferase (ALT) reduction level at the end of treatment. Twenty-two eligible patients (dapagliflozin group, n = 12; teneligliptin group, n = 10) were analyzed. In both groups, the serum concentration of ALT was significantly decreased after treatment (p<0.05). Multiple regression analysis results showed that decreased body weight of patients with dapagliflozin administration was significantly related to changes in total body water and body fat mass. Administration of dapagliflozin or teneligliptin decreased the serum concentration of ALT in NAFLD patients without type 2 diabetes mellitus. With dapagliflozin, body weight decreased, which was related to changes in total body water and body fat mass (UMIN000027304).

Dose-Response Association Between Accelerometer-Assessed Physical Activity and Incidence of Functional Disability in Older Japanese Adults: A 6-Year Prospective Study

BACKGROUND

It is unknown whether moderate-to-vigorous physical activity (MVPA) in bouts of <10 minutes protects against disability risks or if only 10 minutes bouts of MVPA is critical. Additionally, it is unclear whether light physical activity (LPA) or its accumulation patterns is associated with functional disability.

METHODS

A total of 1,687 adults aged ≥65 years and without functional disability at baseline were followed up for 6 years. Functional disability was identified using the database of Japan's Long-term Care Insurance System. Physical activity was measured using a tri-axial accelerometer secured to the waist.

RESULTS

Functional disability was identified in 274 participants (16.2%). When examined as quartiles, higher levels of all MVPA measures were dose-dependently associated with lower risk of functional disability. Associations of MVPA in ≥10 and <10 minutes bouts remained significant in a mutually adjusted model. Neither total LPA nor LPA in bout of ≥10 minutes, but LPA in bouts of <10 minutes was associated with functional disability. Analyses using restricted cubic spline functions showed that associations of all MVPA measures and LPA in bouts of <10 minutes with functional disability were linear (p for nonlinear >.05). The hazard ratios (HRs; 95% confidence interval [CI]) for functional disability per 10 minutes increment of total MVPA and LPA in bout of <10 minutes were 0.86 (0.81-0.92) and 0.96 (0.93-0.99), respectively.

CONCLUSIONS

Higher MVPA, regardless accumulation patterns, or LPA in bouts of <10 minutes was associated with lower risk of functional disability in a linear dose-response manner in older adults.

Sedentary Behavior, Physical Inactivity, and Metabolic Syndrome: Pilot Findings From the Rapid Assessment Disuse Index Study

BACKGROUND

The Rapid Assessment Disuse Index (RADI) is a brief tool aimed to promptly assess primary care patients' overall physical inactivity and sedentary behavior. This study examines the relation between physical inactivity and sitting time (RADI) to cardiometabolic risk among primary care patients.

METHODS

Survey data and electronic medical record information were collated to explore the association between RADI scores (cumulative and sitting) to metabolic syndrome (and components) among women and men, using multivariable logistic regression.

RESULTS

Among women, the cumulative RADI score was not significantly associated with metabolic syndrome. However, the RADI sitting score was related to low high-density lipoprotein cholesterol and metabolic syndrome. That is, a transition to a higher RADI sitting score by 1 unit (vs remaining in the score) was related with a 1.4 and 1.3 times higher odds for having low high-density lipoprotein cholesterol (95% confidence interval, 1.05-1.87) and metabolic syndrome (95% confidence interval, 1.02-1.64), respectively. Among men, no significant relations were found.

CONCLUSIONS

The RADI sitting score is positively and significantly related to high-density lipoprotein and metabolic syndrome among women, yet not men. Due to the RADI's potential clinical utility, future research should attempt to examine these relations in larger, more robust samples and adjudicated outcomes using a prospective design.

Seasonal Changes in Continuous Sedentary Behavior in Community-Dwelling Japanese Adults: A Pilot Study

Background: Sedentary behavior (SB) is associated with adverse health outcomes. The aim of this study was to clarify seasonal changes in SB including continuous SB (CSB) in community-dwelling Japanese adults. Methods: In this secondary analysis, a total of 65 community-dwelling Japanese adults (7 men and 58 women, 69 (50-78) years) were enrolled. SB (%), including CSB (≥30 min) as well as physical activity, were evaluated using a tri-accelerometer. The differences in these parameters between baseline (summer) and follow-up (winter) were examined. Results: %CSB and %SB at baseline were 20.5 (4.0-60.9) and 54.0 ± 11.5, respectively. CSB was significantly increased (6.6%), and SB was also increased (5.1%) at follow-up compared with baseline. In addition, there were positive relationships between changes in CSB and SB, and body weight and body mass index. Conclusions: These results suggest that there were significant seasonal changes in CSB and SB in community-dwelling Japanese adults.

Device-assessed physical activity and sedentary behavior in a community-based cohort of older adults

BACKGROUND

Few studies characterize older adult physical activity and sitting patterns using accurate accelerometer and concurrent posture measures. In this descriptive paper, we report accelerometer data collection protocols, consent rates, and physical behavior measures from a population-based cohort study (Adult Changes in Thought, ACT).

METHODS

The ACT study holds enrollment steady at approximately 2000 members of Kaiser Permanente Washington aged 65+ without dementia undergoing detailed biennial assessments. In 2016 the ACT-Activity Monitor (ACT-AM) sub-study was initiated to obtain data from wearing activPAL and ActiGraph devices for 7 days following regular biennial visits. We describe the methods protocol of ACT-AM and present characteristics of people who did and did not consent to wear devices. We compute inverse probability of response weights and incorporate these weights in linear regression models to estimate means and 95% confidence intervals (CI) of device-based pattern metrics, adjusted for wear time and demographic factors, and weighted to account for potential selection bias due to device-wear consent.

RESULTS

Among 1885 eligible ACT participants, 56% agreed to wear both devices (mean age 77 years, 56% female, 89% non-Hispanic white, 91% with post-secondary education). On average, those who agreed to wear devices were younger and healthier. Estimated mean (95% CI) activPAL-derived sitting, standing, and stepping times were 10.2 h/day (603-618 min/day), 3.9 h/day (226-239 min/day), and 1.4 h/day (79-84 min/day), respectively. Estimated mean ActiGraph derived sedentary (Vector Magnitude [VM] < =18 counts/15 s), light intensity (VM 19-518 counts/15 s), and moderate-to-vigorous intensity (VM > 518 counts/15 s) physical activity durations were 9.5 h/day (565-577 min/day), 4.5 h/day (267-276 min/day), and 1.0 h/day (59-64 min/day). Participants who were older, had chronic conditions, and were unable to walk a half-mile had higher sedentary time and less physical activity.

CONCLUSIONS

Our recruitment rate demonstrates the feasibility of cohort participants to wear two devices that measure sedentary time and physical activity. Data indicate high levels of sitting time in older adults but also high levels of physical activity using cut-points developed for older adults. These data will help researchers test hypotheses related to physical behavior and health in older adults in the future.

Current and 1-Year Psychological and Physical Effects of Replacing Sedentary Time With Time in Other Behaviors

INTRODUCTION

Sedentary time is inversely associated with health. Capturing 24 hours of behavior (i.e., sleep, sedentary, light physical activity, and moderate-to-vigorous physical activity) is necessary to understand behavior-health associations.

METHODS

Healthy young adults aged 20-35 years (n=423) completed the Profile of Mood States, the Perceived Stress Scale, and dual-energy x-ray absorptiometry and anthropometric measures at baseline and 12 months. Time spent sedentary (total, in prolonged [>30 minutes] and short [≤30 minutes] bouts), in light physical activity (1.5-3.0 METs), moderate-to-vigorous physical activity (>3.0 METs), and asleep, were assessed through SenseWear armband worn 24 hours/day for 10 days at baseline. Isotemporal substitution modeling evaluated cross-sectional and longitudinal psychological and physical health associations of substituting sedentary time with sleep, light physical activity, or moderate-to-vigorous physical activity. Data were collected from 2010 to 2015 and analyzed in 2019.

RESULTS

Cross-sectional analyses revealed substituting prolonged sedentary time for sleep was associated with lower stress (standardized β= -0.11), better mood (-0.12), and lower BMI (-0.10). Substituting total or prolonged sedentary for moderate-to-vigorous physical activity was associated with lower body fat percentage (total, -0.22; prolonged, -0.23) and BMI (-0.40; -0.42). Higher BMI was associated with substituting total or prolonged sedentary for light physical activity (0.15; 0.17); lower BMI with substituting prolonged sedentary for short bouts (-0.09). Prospective analyses indicated substituting total or prolonged sedentary with light physical activity was associated with improved mood (-0.16; -0.14) and lower BMI (-0.15; -0.16); substituting with moderate-to-vigorous physical activity was associated with improved mood (-0.15; -0.15).

CONCLUSIONS

Short- and long-term psychological benefits may result from transitioning sedentary time to light physical activity or sleep, whereas increasing moderate-to-vigorous physical activity may be required to influence physical health.

TRIAL REGISTRATION

This study is registered at www.clinicaltrials.gov NCT01746186.

Temporal dynamics of sitting behavior at work

Sitting for prolonged periods of time impairs people's health. Prior research has mainly investigated sitting behavior on an aggregate level, for example, by analyzing total sitting time per day. By contrast, taking a dynamic approach, here we conceptualize sitting behavior as a continuous chain of sit-to-stand and stand-to-sit transitions. We use multilevel time-to-event analysis to analyze the timing of these transitions. We analyze ∼30,000 objectively measured posture transitions from 156 people during work time. Results indicate that the temporal dynamics of sit-to-stand transitions differ from stand-to-sit transitions, and that people are quicker to switch postures later in the workday, and quicker to stand up after having been more active in the recent hours. We found no evidence for associations with physical fitness. Altogether, these findings provide insights into the origins of people's stand-up and sit-down decisions, show that sitting behavior is fundamentally different from exercise behavior, and provide pointers for the development of interventions.

Incidence of Metabolic Syndrome in Young Japanese Adults in a 6-Year Cohort Study: The Uguisudani Preventive Health Large-Scale Cohort Study (UPHLS)

INTRODUCTION

To clarify the incidences of metabolic syndrome (MS) and risks in young Japanese adults by gender.

METHODS

A total of 58,901 adults who had undergone annual health check-ups in 2010 without a diagnosis of MS or missing data were divided into three age groups (20s through 40s) by gender. Participants were followed up for 6 years for new-onset MS according to Japanese criteria. The incidences of MS and risks were analyzed using the Cox proportional hazards model to adjust for confounding factors.

RESULTS

The incidences of MS per 1,000 person-years were 2.2, 5.5, and 10.2 for women aged in their 20s, 30s, and 40s, respectively, and 26.3, 40.5, and 57.4 in the respective men groups. Compared with the group aged in their 40s, the hazard ratios of new MS were 0.19 (95% confidence interval [CI], 0.13-0.29) for women in their 20s and 0.50 (95% CI, 0.41-0.61) for women in their 30s, and 0.46 (95% CI, 0.42-0.50) and 0.70 (95% CI, 0.66-0.73) for men in their 20s and 30s, respectively, after adjustment for lifestyle factors. For women, MS was associated with smoking in their 20s and 30s, and eating speed in their 30s, and for men, was associated with physical activity, eating speed, alcohol intake in their 20s and 30s, and smoking in their 30s.

CONCLUSION

Our findings suggest that the incidences of MS in the 20s and 30s are lower, but account for about 20-50% of women with MS and 50-70% of men with MS in their 40s. However, the data are not negligible and early lifestyle intervention for MS is necessary in young adults.

Factors that Decrease Sedentary Behavior in Community-Dwelling Elderly People: A Longitudinal Study

Background and objectives: This study was to clarify how the frequency of participation in a health class affected the reduction in sedentary behavior after two years, and whether decreases in sedentary behavior in elderly people who participated in a health class persisted two years after the end of an intervention. Materials and Methods: This study was longitudinal, and the results of a previous study conducted in 2017 were added to the findings of a different year. The participants were elderly health class members at a community dwelling in Japan who participated between 2016 and 2018. Of the 86 participants that were enrolled, the data of 80 were collected in 2016. A year later, in a 2017 follow-up, the number of participants was 80, and two years later, in a 2018 follow-up, there were 71 participants. Results: There was a significant difference with regards to the reduction of the sedentary behavior rate between two different groups (a health class participation rate of more than 75% and the other with less than 75%) two years later. However, no difference in sedentary behavior rate was found between the two groups (intervention group and control group) at a two-year follow-up, despite observing differences after one year. Conclusions: Continuous participation in a health class may help reduce sedentary behavior. After two years, “Active Guide” brochures and documents may not help in reducing sedentary behavior, despite seeing improvements after one year. Persistent social participation may have a more lasting effect than one-off interventions in reducing the sedentary behavior ratio.

Editorial “Biomechanical Spectrum of Human Sport Performance”

Several parameters can influence our health capital today and can have a negative impact on our performance, whether physiological or mechanical. Indeed, our health and wellbeing are influenced by a range of social, cultural, economic, psychological, and environmental factors across our lives. These change as we progress through the key transition points in life—from infancy and childhood through our teenage years to adulthood, working life, retirement and the end of life. Sport can be a vector that links many of these factors. Whether it is high-performance sport or sedentary practice, sport is very important for the improvement of psychological wellbeing and physical health. Our overarching aim was to increase quality of life. Sedentary practice can increase mobility and reduce the risk of disease, so changing adults’ behavior through sedentary practice could reduce illness and decrease costs to society concerning health problems. Furthermore, a higher frequency of practice can lead to improvements in technique and optimized performance. Our objective is to summarize the latest research in sport science and to quantify the most important parameters influencing human performance related to the health sciences for all age groups, throughout their lives.

Associations of Objectively Measured Patterns of Sedentary Behavior and Physical Activity with Frailty Status Screened by The Frail Scale in Japanese Community-Dwelling Older Adults

The objective of this study was to investigate the association between objectively measured patterns of sedentary behavior (SB) and physical activity (PA) and frailty status in Japanese community-dwelling older adults. Data was from 65-75 years older adults from the baseline of Itoshima Frail Study were used. Frailty was assessed using a Japanese version of the FRAIL scale. SB and PA were measured using an accelerometer. Multinomial logistic regression and receiver operating characteristic curve analyses were used to investigate the associations of SB and PA patterns with frailty status. Of the total 819 older adults, half were female (51.8%). The prevalence of robust, pre-frailty and frailty was 60.2%, 27.8%, and 12.0%, respectively. SB variables including total sedentary time, sedentary time in bouts of ≥ 10 min and ≥ 30 min, and mean sedentary bout duration were not associated with frailty status. Except LPA and moderate-to-vigorous physical activity (MVPA) in bouts of < 10 min, PA variables including total MVPA time, MVPA in bouts of ≥ 10 min (bouted MVPA), and steps were significantly associated with lower prevalence of frailty. Area under the curves (AUCs) of total MVPA time, bouted MVPA, and steps were 0.64 (P < 0.001), 0.67 (P < 0.001), and 0.66 (P < 0.001), respectively. The optimal cut-off value of total MVPA time, bouted MVPA, and steps to discriminate between frailty and non-frailty were 43.25 min/day, 9.13 min/day, and 3841 steps/day, respectively. Higher levels of total MVPA time, bouted MVPA, and daily steps were negatively associated with frailty. Lower amounts of bouted MVPA (70 min/week) or steps (4000 steps/day) may be achievable initial targets in older adults for frailty management.

activPAL-measured sitting levels and patterns in 9-10 years old children from a UK city

BACKGROUND

There is insufficient evidence of sitting time in UK children from validated objective measures. This study explored sitting patterns in primary school children from Bradford, UK, using the validated activPAL inclinometer.

METHODS

Overall, 79 children (9.8 (SD 0.3) years old, 52% boys; 70% South Asian) wore activPALs for 7 days. Total sitting time, sitting time accumulated in different bout lengths, and the proportion of wear time spent in these variables were explored and compared across different periods of the week.

RESULTS

Children spent 614 ± 112 (median ± IQR) min/day on school days and 690 ± 150 min/day on weekend days sitting. The proportion of time spent sitting was significantly higher on weekend days compared to school days (mean±SD: 74 ± 10% versus 68 ± 8%,P < 0.001), as was the proportion of time accumulated in >30 min sitting bouts (mean±CI: 28 ± 27-33% versus 20 ± 20-22%, P < 0.001). The proportion of time spent sitting after school was significantly higher than during school time (mean±SD: 70 ± 8.4% versus 63 ± 8.3%,P < 0.001), as was the proportion of time spent in prolonged (>30 min) sitting bouts (mean±CI: 19 ± 16-22% versus 11 ± 10-14%, P < 0.001).

CONCLUSIONS

Children spent large proportions of their waking day sitting, often accumulated in prolonged uninterrupted bouts and particularly after school and on weekends. Interventions to reduce sitting time in children are urgently needed.

Physical Activity and Sedentary Time: Association with Metabolic Health and Liver Fat

Introduction/Purpose

To investigate whether (a) lower levels of daily physical activity (PA) and greater sedentary time accounted for contrasting metabolic phenotypes (higher liver fat/presence of metabolic syndrome [METS+] vs lower liver fat/absence of metabolic syndrome [METS−]) in individuals of similar body mass index and (b) the association of sedentary time on metabolic health and liver fat.

Methods

Ninety-eight habitually active participants (53 female, 45 male; age, 39 ± 13 yr; body mass index 26.9 ± 5.1 kg·m⁻²), underwent assessments of PA (SenseWear armband; wear time ~98%), cardiorespiratory fitness (V˙O₂ peak), body composition (magnetic resonance imaging and magnetic resonance spectroscopy) and multiorgan insulin sensitivity (oral glucose tolerance test). We undertook a) cross-sectional analysis comparing four groups: nonobese or obese, with and without metabolic syndrome (METS+ vs METS−) and b) univariate and multivariate regression for sedentary time and other levels of PA in relation to liver fat.

Results

Light, moderate, and vigorous PA did not account for differences in metabolic health between individuals, whether nonobese or obese, although METS+ individuals were more sedentary, with a higher number, and prolonged bouts (~1–2 h). Overall, sedentary time, average daily METS and V˙O₂ peak were each independently associated with liver fat percentage. Each additional hour of daily sedentary time was associated with a 1.15% (95% confidence interval, 1.14%–1.50%) higher liver fat content.

Conclusions

Greater sedentary time, independent of other levels of PA, is associated with being metabolically unhealthy; even in habitually active people, lesser sedentary time, and higher cardiorespiratory fitness and average daily METS is associated with lower liver fat.

The Impact Of Structured Exercise Programs On Metabolic Syndrome And Its Components: A Systematic Review

BACKGROUND

The metabolic syndrome (MetS) is highly prevalent and associated with higher risk of diabetes and cardiovascular events. Exercise programs have been shown to improve components of MetS, but the optimal design of a structured exercise program for treatment of the MetS remains unclear.

PURPOSE

To assess the impact of different exercise programs on the MetS and its components.

METHODS

MEDLINE via PubMed and Embase was searched. Randomized controlled trials of supervised exercise alone and in combination with nutrition programs compared with usual care in adults with the MetS were selected. Two authors independently reviewed articles to select eligible studies and performed data abstraction. Eight studies representing 1218 patients were included. The participants had a median age of 51, median BMI of 29 kg/m2, and were 55% male. Mean weight loss increased with program duration. For combination programs, the mean weight loss was -2.6 kg, -3.7 kg, and -6.5 kg for 3, 6, and 12 months, respectively. The components of the MetS most frequently statistically significantly improved were waist circumference (6/6 studies), blood pressure (4/6 studies), and high-density lipoprotein cholesterol (3/6 studies).

LIMITATIONS

Studies did not include long-term follow-up post program completion to evaluate persistence of benefit. It is unknown whether the same results would be found in an older, more obese population.

CONCLUSION

Supervised exercise programs yield significant resolution of components of the MetS, particularly in reducing waist circumference. Longer program duration and frequent interval sessions appear to have highest benefit and thus may help reduce cardiovascular risk and diabetes associated with the MetS.

Sex-differences in relation to the association between patterns of physical activity and sedentary behavior with frailty

OBJECTIVE

To investigate the sex-difference in relation to the association between moderate-vigorous physical activity (MVPA) and sedentary time (ST) patterns with frailty.

METHOD

Accelerometry from ≥50 year olds from the National Health and Nutrition Examination Survey (2003-04/2005-06 cycles) were included. Bouted and sporadic MVPA were defined as MVPA in ≥10 min or <10 min durations, respectively. MVPA was analyzed based on meeting 0 %, 1-49 %, 50-99 %, and ≥100 % of the physical activity guidelines of 150 min/week. A duration of ≥30 minutes defined prolonged ST. The frequency (≥1 min interruption in ST), intensity and duration of breaks from ST were calculated. A 46-item frailty index (FI) quantified frailty. Multivariable linear regression models adjusted for demographics, total sedentary time, and accelerometer wear time.

RESULTS

There were 1143 females and 1174 males available for analysis. Bouted MVPA was associated with lower frailty levels; the association peaked at meeting 50-99 % of the guidelines in females and ≥1.0 % in males (p = NS for sex-interaction). Meeting a higher proportion of the guidelines through sporadic MVPA was significantly associated with a lower FI in males only (p = NS for sex-interaction). Prolonged ST bouts were associated with worse frailty in females but not males (p < 0.05 sex-interaction). Average break intensity was associated with a lower FI in both sexes, whereas, total sedentary breaks were not (p = NS for sex-interaction). Average break duration was associated with frailty in males (p = NS for sex-interaction).

CONCLUSION

Prolonged ST was more detrimentally associated with frailty in females than males, which could influence tailored movement prescriptions and guidelines.

The trajectory of patterns of light and sedentary physical activity among females, ages 14-23

PURPOSE

Light physical activity (LPA) and patterns of sedentary behavior influence cardio-metabolic health independently of moderate-to-vigorous physical activity. Understanding the trajectory and determinants of these activity levels over time may provide insights relevant to public health practice.

METHODS

We measured a cohort of young women recruited in middle school (age 14) using accelerometry for 1 week and remeasured them in high school (age 17) and again at age 23 (n = 385). We assessed changes in LPA and patterns of sedentary behavior by hours in a day. We examined the association of social and contextual factors, including employment status, screen time, and neighborhood context with LPA and sedentary behavior patterns.

RESULTS

The amount of LPA decreased over time, while the length of LPA bouts tended to increase. Sedentary bout durations increased over time and sedentary breaks decreased. Sedentary time and bout length were correlated with internet use, rather than with TV or videogaming. Employment was associated with less sedentary time; being a student was associated with longer sedentary time and bouts.

CONCLUSIONS

Because LPA and sedentary breaks can be protective for cardio-metabolic health, and the duration of sedentary bouts increase as women age from adolescence to young adulthood, worksites and college campuses should remind employees and students to take frequent activity breaks when they use computers and the internet for long stretches.

Identifying characteristics of indicators of sedentary behavior using objective measurements

Objective

Recent attention has been focused on sedentary behavior (SB) affecting health outcomes, but the characteristics of indicators reflecting SB remain to be identified. This cross‐sectional study aims to identify the characteristics of indicators of SB, focusing on the examination of correlations, reliability, and validity of sedentary variables assessed by the smartphone app.

Method

Objectively measured data of SB of eligible 46 Japanese workers obtained from smartphones were used. We assessed the characteristics of current indicators being used with a 10‐minute or 30‐minute thresholds, in addition to the conventional indicators of total sedentary time, mean sedentary bout duration, and total number of sedentary bouts. They were evaluated from three perspectives: (a) association among the indicators, (b) reliability of the indicators, and (c) criterion validity.

Results

Total sedentary time under 10 minutes (U10) and U30 had negative associations with Total sedentary time (r = −.47 and −.21 respectively). The correlation between Mean sedentary bout duration and Total number of sedentary bouts was −.84, whereas between Mean sedentary bout duration 10, 30 and Total number of sedentary bouts were −.54 and −.21, respectively. The intraclass correlation coefficients of almost all indicators were around .80. Mean sedentary bout duration, Mean sedentary bout duration 10, Total number of sedentary bouts, Total sedentary time 30, U30 and U10 have significant differences between three BMI groups.

Conclusion

This study comprehensively revealed the rationale of advantage in the current indicator being used with a 10‐minute or 30‐minute threshold, rather than the conventional total amount of SB.

Long-Term Relationship between Psychological Distress and Continuous Sedentary Behavior in Healthy Older Adults: A Three Panel Study

Background and objectives: Psychological distress (PD) is associated with continuous sedentary behaviors (CSB; based on the ratio of 1.5 metabolic equivalents (METs) sessions or more continuing for over 30 min) in older adults, but the long-term relation is not sufficiently clarified. This study aims to clarify the long-term relationship between PD and the rate of CSB. Materials and Methods: In this secondary analysis, a sample population of 72 healthy elderly people aged 65 years or older participated in a health club of college A from 2016 to 2018. We conducted structural equation modeling (SEM) using the cross-lagged and synchronous effects models. We adopted the following as proxy variables: CSB and PD (based on the Kessler 6 scale (K6) scores). Results: "2016 K6" to"2017 CSB" (standardization factor (β = 0.141, p = 0.025), "2017 K6" to "2018 CSB" (β = 0.187, p < 0.001) and "2016 CSB" to "2018 CSB" (β = 0.188, p < 0.001) were all statistically significant using the cross-lagged effects models. Fit indices were adjusted goodness of fit index (AGFI) = 0.961, comparative fit index (CFI) = 1.000, and root mean square error of approximation (RMSEA) = 0.000. Conclusion: The results suggest that PD may affect the ratio of CSB one year later, and CSB may affect the ratio of PD two year later.

[Validity and reliability of the Work-related Physical Activity Questionnaire for assessing intensity-specific physical activity and sedentary behavior in the workplace]

OBJECTIVE

We developed the Work-related Physical Activity Questionnaire (WPAQ) to measure occupational physical activity, including sedentary behavior and sedentary breaks (interruptions of prolonged sedentary behavior), during work. This study aimed to examine the WPAQ's reliability and criterion validity using an accelerometer.

METHODS

To examine criterion validity, 97 full-time factory workers (male: 89.7%) wore a triaxial accelerometer while working and completed the WPAQ. The questionnaire inquired about participants' normal work activities and the proportion of sitting, standing, walking, and heavy labor engaged in during work. In calculating time spent in each behavior, the proportion of each occupational activity was multiplied by the total minutes of work. Duration of uninterrupted sitting time was also measured. For reliability, the same questionnaire was administered twice (median test-retest interval: 9 days) to another convenient sample of 54 participants. Spearman's ρ was used to assess validity and intraclass correlation coefficients (ICCs) and Cohen's kappa with quadratic weighing were used to assess reliability.

RESULTS

The criterion validity of occupational sitting time measured by the WPAQ was moderate (Spearman's ρ for sedentary behavior: 0.69) based on comparison with accelerometer data. Significant positive correlations were found for standing (ρ = 0.66) and walking (ρ = 0.39) between the WPAQ and accelerometer data, though not for heavy labor. A moderate but significant correlation (ρ = 0.27) was found for sedentary breaks. Test-retest reliability for all items was adequate (ICC = 0.59-0.79 for occupational sedentary behavior and physical activities, and Cohen's kappa with quadratic weighting = 0.84 for sedentary breaks).

CONCLUSIONS

The WPAQ has acceptable properties for measuring workers' activities, including sedentary breaks. Reduced physical activity, increased time spent in sedentary behaviors, and fewer sedentary breaks during working time are all associated with adverse health outcomes. Though some occupational exposure to these activities might be unavoidable, the WPAQ may be a practical tool for assessing them.

Which cancer survivors are at risk for a physically inactive and sedentary lifestyle? Results from pooled accelerometer data of 1447 cancer survivors

Background

Physical activity has beneficial effects on the health of cancer survivors. We aimed to investigate accelerometer-assessed physical activity and sedentary time in cancer survivors, and describe activity profiles. Additionally, we identify demographic and clinical correlates of physical activity, sedentary time and activity profiles.

Methods

Accelerometer, questionnaire and clinical data from eight studies conducted in four countries (n = 1447) were pooled. We calculated sedentary time and time spent in physical activity at various intensities using Freedson cut-points. We used latent profile analysis to identify activity profiles, and multilevel linear regression analyses to identify demographic and clinical variables associated with accelerometer-assessed moderate to vigorous physical activity (MVPA), sedentary time, the highly active and highly sedentary profile, adjusting for confounders identified using a directed acyclic graph.

Results

Participants spent on average 26 min (3%) in MVPA and 568 min (66%) sedentary per day. We identified six activity profiles. Older participants, smokers and participants with obesity had significantly lower MVPA and higher sedentary time. Furthermore, men had significantly higher MVPA and sedentary time than women and participants who reported less fatigue had higher MVPA time. The highly active profile included survivors with high education level and normal body mass index. Haematological cancer survivors were less likely to have a highly active profile compared to breast cancer survivors. The highly sedentary profile included older participants, males, participants who were not married, obese, smokers, and those < 12 months after diagnosis.

Conclusions

Cancer survivors engage in few minutes of MVPA and spend a large proportion of their day sedentary. Correlates of MVPA, sedentary time and activity profiles can be used to identify cancer survivors at risk for a sedentary and inactive lifestyle.

Electronic supplementary material

The online version of this article (10.1186/s12966-019-0820-7) contains supplementary material, which is available to authorized users.