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Raichlen DA, Ally M, Aslan DH, Sayre MK, Bharadwaj PK, Maltagliati S, Lai MHC, Wilcox RR, Habeck CG, Klimentidis YC, Alexander GE. Associations between accelerometer-derived sedentary behavior and physical activity with white matter hyperintensities in middle-aged to older adults. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e70001. [PMID: 39183745 PMCID: PMC11342350 DOI: 10.1002/dad2.70001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 07/30/2024] [Accepted: 08/02/2024] [Indexed: 08/27/2024]
Abstract
INTRODUCTION We examined the relationship between sedentary behavior (SB), moderate-to-vigorous physical activity (MVPA), and white matter hyperintensity (WMH) volumes, a common magnetic resonance imaging (MRI) marker associated with risk of neurodegenerative disease in middle-aged to older adults. METHODS We used data from the UK Biobank (n = 14,415; 45 to 81 years) that included accelerometer-derived measures of SB and MVPA, and WMH volumes from MRI. RESULTS Both MVPA and SB were associated with WMH volumes (βMVPA = -0.03 [-0.04, -0.01], p < 0.001; βSB = 0.02 [0.01, 0.03], p = 0.007). There was a significant interaction between SB and MVPA on WMH volumes (βSB×MVPA = -0.015 [-0.028, -0.001], p SB×MVPA = 0.03) where SB was positively associated with WMHs at low MVPA, and MVPA was negatively associated with WMHs at high SB. DISCUSSION While this study cannot establish causality, the results highlight the potential importance of considering both MVPA and SB in strategies aimed at reducing the accumulation of WMH volumes in middle-aged to older adults. Highlights SB is associated with greater WMH volumes and MVPA is associated with lower WMH volumes.Relationships between SB and WMH are strongest at low levels of MVPA.Associations between MVPA and WMH are strongest at high levels of SB.Considering both SB and MVPA may be effective strategies for reducing WMHs.
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Affiliation(s)
- David A. Raichlen
- Human and Evolutionary Biology SectionDepartment of Biological SciencesUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Department of AnthropologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Madeline Ally
- Department of PsychologyUniversity of ArizonaTucsonArizonaUSA
| | - Daniel H. Aslan
- Human and Evolutionary Biology SectionDepartment of Biological SciencesUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | | | | | - Silvio Maltagliati
- Human and Evolutionary Biology SectionDepartment of Biological SciencesUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Mark H. C. Lai
- Department of PsychologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Rand R. Wilcox
- Department of PsychologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Christian G. Habeck
- Cognitive Neuroscience DivisionDepartment of Neurology and Taub InstituteColumbia UniversityNew YorkNew YorkUSA
| | - Yann C. Klimentidis
- Department of Epidemiology and BiostatisticsMel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonArizonaUSA
- BIO5 InstituteUniversity of ArizonaTucsonArizonaUSA
| | - Gene E. Alexander
- Department of PsychologyUniversity of ArizonaTucsonArizonaUSA
- BIO5 InstituteUniversity of ArizonaTucsonArizonaUSA
- Evelyn F. McKnight Brain InstituteUniversity of ArizonaTucsonArizonaUSA
- Department of PsychiatryUniversity of ArizonaTucsonArizonaUSA
- Neuroscience Graduate Interdisciplinary ProgramUniversity of ArizonaTucsonArizonaUSA
- Physiological Sciences Graduate Interdisciplinary ProgramUniversity of ArizonaTucsonArizonaUSA
- Arizona Alzheimer's ConsortiumPhoenixArizonaUSA
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Bergum H, Grimsmo J, Anderssen SA, Klemsdal TO. Effects on physical activity, physical fitness and well-being in a 36-months randomized controlled study, comparing a multimodal hospital-based intervention programme for primary cardiovascular prevention with usual care. BMC Cardiovasc Disord 2024; 24:225. [PMID: 38664620 PMCID: PMC11044290 DOI: 10.1186/s12872-024-03892-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 04/15/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Cardiovascular disease is a major cause of mortality and morbidity worldwide, and primary prevention efforts are poorly developed in people at high cardiovascular risk. On this background, we performed the Hjerteløftet Study and demonstrated that participation over 36 months in a multimodal primary prevention programme, significantly reduced validated cardiovascular risk scores. In the current substudy we aimed to further explore several elements and effects following the intervention programme. METHODS A random sample from the original Hjerteløftet Study was included for further examinations (n = 255, 40% women), and these patients were already randomized to an intervention group (IG) (n = 127), or a control group (CG) (n = 128). We compared changes from baseline to 36-months follow-up in physical activity, cardiorespiratory fitness, psychological well-being (WHO-5), cardiovascular medication use, smoking habits, and cardiometabolic risk factors (blood pressure, lipids, blood glucose, HbA1c, Apolipoprotein A-I, Apolipoprotein B and high-sensitive C-reactive protein). RESULTS Self-reported physical activity increased significantly with absolute difference in mean delta Physical Activity Index score in the IG compared to the CG: 0.90, 95% CI: 0.10 to 1.70, p = 0.028 (ANCOVA). There were no corresponding differences in cardiorespiratory fitness. The participation resulted in psychological well-being improvement in both groups with a larger increase in the IG compared to the CG. The mean difference in delta WHO-5 score was 5.06, 95% CI: 0.68 to 9.45, p = 0.024, and 3.28, 95% CI: -0.69 to 5.25, p = 0.104 when controlled for baseline values (ANCOVA). The use of antihypertensive medication increased significantly more in the CG (p = 0.044). Only minor, nonsignificant changes were observed for traditional risk factors and cardiometabolic variables. CONCLUSIONS Participation in the Hjerteløftet Study intervention programme resulted in an improved physical activity level, but without changing cardiorespiratory fitness. Participation in the programme also tended to improve psychological well-being, possibly related to increased physical activity, less smoking and less use of cardiovascular medication. Concerning the metabolic status, no major differences were observed, but minor changes may have been concealed by a larger increase in cardiovascular medication use in the control group. TRIAL REGISTRATION ClinicalTrials.gov (NCT01741428), 04/12/2012.
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Affiliation(s)
- Hilde Bergum
- Department of Cardiac and Pulmonary Rehabilitation, Lovisenberg Rehabilitation, Cathinka Guldbergs Hospital, Jessheim, 2051, Norway.
- University of Oslo, Oslo, Norway.
| | - Jostein Grimsmo
- Department of Cardiac and Pulmonary Rehabilitation, Lovisenberg Rehabilitation, Cathinka Guldbergs Hospital, Jessheim, 2051, Norway
| | - Sigmund Alfred Anderssen
- Department of Sports Medicine, the Norwegian School of Sports Sciences, Sognsveien 220, 0806, Oslo, Norway
| | - Tor Ole Klemsdal
- Department of Preventive Cardiology, Oslo University Hospital Aker, Trondheimsveien 235, 0586, Oslo, Norway
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Zink J, O'Connor SG, Blachman-Demner DR, Wolff-Hughes DL, Berrigan D. Examining the Bidirectional Associations Between Sleep Duration, Screen Time, and Internalizing Symptoms in the ABCD Study. J Adolesc Health 2024; 74:496-503. [PMID: 37855753 PMCID: PMC10872986 DOI: 10.1016/j.jadohealth.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 08/10/2023] [Accepted: 09/06/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE The likelihood of meeting sleep duration and screen time guidelines decreases as children develop toward adolescence. Simultaneously, the prevalence of internalizing symptoms increases. The purpose of this paper was to examine the bidirectional associations between sleep duration and screen time with internalizing symptoms in a one-year longitudinal study starting in late childhood. METHODS Participants were 10,828 youth (47.8% female) enrolled in the Adolescent Brain Cognitive Development Study. At baseline (mean age 9.9 years) and one-year follow-up (mean age 10.9 years), youth self-reported screen time for weekdays and weekend days. Responses were separately dichotomized as >2 versus ≤2 hours/day (meeting behavioral guidelines). Caregiver-reported youth sleep duration was dichotomized as <9 versus 9-11 hours/night (meeting behavioral guidelines). Caregivers reported internalizing symptoms via the child behavior checklist. The withdrawn/depressed, anxious/depressed, and somatic symptom child behavior checklist subscale t-scores were separately dichotomized as ≥65 (borderline clinical levels of symptoms and above) versus <65. Analyses were gender-stratified. RESULTS In females, longer baseline sleep duration was protective against withdrawn/depressed symptoms (odds ratio [OR] 0.6, 95% confidence interval [CI] 0.4-0.8) and somatic complaints (OR 0.8, 95% CI 0.6-0.97) one year later. In females, greater baseline weekend screen time was associated with increased risk of withdrawn/depressed symptoms (OR 1.6, 95% CI 1.1-2.2) one year later. No other significant associations were observed. DISCUSSION Longitudinal associations between sleep duration, weekend screen time, and internalizing symptoms were unidirectional (behavior preceding internalizing symptoms), among females only, and specific to withdrawn/depressed and somatic symptoms. These prospective study findings warrant attention and inform future research in this cohort.
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Affiliation(s)
- Jennifer Zink
- Division of Cancer Control and Population Sciences, Health Behaviors Research Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Rockville, Maryland.
| | - Sydney G O'Connor
- Division of Cancer Control and Population Sciences, Health Behaviors Research Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Dara R Blachman-Demner
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland
| | - Dana L Wolff-Hughes
- Division of Cancer Control and Population Sciences, Risk Factor Assessment Branch, Epidemiology and Genomics Research Program, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - David Berrigan
- Division of Cancer Control and Population Sciences, Health Behaviors Research Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Rockville, Maryland
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So R, Murai F, Fujii M, Watanabe S, Matsuo T. Association of sitting time and cardiorespiratory fitness with cardiovascular disease risk and healthcare costs among office workers. INDUSTRIAL HEALTH 2023; 61:368-378. [PMID: 36273913 PMCID: PMC10542471 DOI: 10.2486/indhealth.2022-0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
Evidence of the impact of domain-specific sitting time (ST) and cardiorespiratory fitness (CRF) on cardiovascular disease (CVD) risk is currently limited. This study aimed to examine the associations between CRF and domain-specific STs in relation to CVD risk and annual healthcare costs among office workers. This cross-sectional study included 1,749 workers from an insurance company. The Worker's Living Activity-time Questionnaire was used to measure the domain-specific STs, including occupational ST and non-working day ST. Additionally, estimated maximal oxygen uptake as the CRF data was calculated using a validated equation: 59.96 - 0.23 × age + 7.39 × sex - 0.79 × body mass index + 0.33 × physical activity score. The company provided medical checkup results for CVD risk factors and healthcare costs. Multiple logistic regression analyses were used to calculate the odds ratios (ORs) for CVD risk. Significantly lower ORs for CVD risk were seen only with high CRF levels, and it was also associated with low annual healthcare costs. There were no associations between domain-specific STs and annual healthcare costs. Further explorations of domain-specific STs, physical activity, and health risks are warranted, and guidelines should focus on increasing CRF to prevent CVD risk among office workers.
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Affiliation(s)
- Rina So
- Ergonomics Research Group, National Institute of Occupational Safety and Health, Japan
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan
| | - Fumiko Murai
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan
| | | | | | - Tomoaki Matsuo
- Ergonomics Research Group, National Institute of Occupational Safety and Health, Japan
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan
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Edwardson CL, Maylor BD, Biddle SJ, Clemes SA, Cox E, Davies MJ, Dunstan DW, Eborall H, Granat MH, Gray LJ, Hadjiconstantinou M, Healy GN, Jaicim NB, Lawton S, Mandalia P, Munir F, Richardson G, Walker S, Yates T, Clarke-Cornwell AM. A multicomponent intervention to reduce daily sitting time in office workers: the SMART Work & Life three-arm cluster RCT. PUBLIC HEALTH RESEARCH 2023; 11:1-229. [PMID: 37786938 DOI: 10.3310/dnyc2141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023] Open
Abstract
Background Office workers spend 70-85% of their time at work sitting. High levels of sitting have been linked to poor physiological and psychological health. Evidence shows the need for fully powered randomised controlled trials, with long-term follow-up, to test the effectiveness of interventions to reduce sitting time. Objective Our objective was to test the clinical effectiveness and cost-effectiveness of the SMART Work & Life intervention, delivered with and without a height-adjustable workstation, compared with usual practice at 12-month follow-up. Design A three-arm cluster randomised controlled trial. Setting Councils in England. Participants Office workers. Intervention SMART Work & Life is a multicomponent intervention that includes behaviour change strategies, delivered by workplace champions. Clusters were randomised to (1) the SMART Work & Life intervention, (2) the SMART Work & Life intervention with a height-adjustable workstation (i.e. SMART Work & Life plus desk) or (3) a control group (i.e. usual practice). Outcome measures were assessed at baseline and at 3 and 12 months. Main outcome measures The primary outcome was device-assessed daily sitting time compared with usual practice at 12 months. Secondary outcomes included sitting, standing, stepping time, physical activity, adiposity, blood pressure, biochemical measures, musculoskeletal issues, psychosocial variables, work-related health, diet and sleep. Cost-effectiveness and process evaluation data were collected. Results A total of 78 clusters (756 participants) were randomised [control, 26 clusters (n = 267); SMART Work & Life only, 27 clusters (n = 249); SMART Work & Life plus desk, 25 clusters (n = 240)]. At 12 months, significant differences between groups were found in daily sitting time, with participants in the SMART Work & Life-only and SMART Work & Life plus desk arms sitting 22.2 minutes per day (97.5% confidence interval -38.8 to -5.7 minutes/day; p = 0.003) and 63.7 minutes per day (97.5% confidence interval -80.0 to -47.4 minutes/day; p < 0.001), respectively, less than the control group. Participants in the SMART Work & Life plus desk arm sat 41.7 minutes per day (95% confidence interval -56.3 to -27.0 minutes/day; p < 0.001) less than participants in the SMART Work & Life-only arm. Sitting time was largely replaced by standing time, and changes in daily behaviour were driven by changes during work hours on workdays. Behaviour changes observed at 12 months were similar to 3 months. At 12 months, small improvements were seen for stress, well-being and vigour in both intervention groups, and for pain in the lower extremity and social norms in the SMART Work & Life plus desk group. Results from the process evaluation supported these findings, with participants reporting feeling more energised, alert, focused and productive. The process evaluation also showed that participants viewed the intervention positively; however, the extent of engagement varied across clusters. The average cost of SMART Work & Life only and SMART Work & Life plus desk was £80.59 and £228.31 per participant, respectively. Within trial, SMART Work & Life only had an incremental cost-effectiveness ratio of £12,091 per quality-adjusted life-year, with SMART Work & Life plus desk being dominated. Over a lifetime, SMART Work & Life only and SMART Work & Life plus desk had incremental cost-effectiveness ratios of £4985 and £13,378 per quality-adjusted life-year, respectively. Limitations The study was carried out in one sector, limiting generalisability. Conclusions The SMART Work & Life intervention, provided with and without a height-adjustable workstation, was successful in changing sitting time. Future work There is a need for longer-term follow-up, as well as follow-up within different organisations. Trial registration Current Controlled Trials ISRCTN11618007.
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Affiliation(s)
| | | | - Stuart Jh Biddle
- Centre for Health Research, University of Southern Queensland, Springfield Central, QLD, Australia
| | - Stacy A Clemes
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Edward Cox
- Centre for Health Economics, University of York, York, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Helen Eborall
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - Laura J Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | | | | | - Sarah Lawton
- School of Health & Society, University of Salford, Salford, UK
| | - Panna Mandalia
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Simon Walker
- Centre for Health Economics, University of York, York, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK
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Lin CY, Chandrabose M, Hadgraft N, Selvakumaran S, Owen N, Oka K, Shibata A, Sugiyama T. Neighborhood socioeconomic status and cardiometabolic risk: mediating roles of domain-specific physical activities and sedentary behaviors. Ann Epidemiol 2023; 83:1-7. [PMID: 37094624 DOI: 10.1016/j.annepidem.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/03/2023] [Accepted: 04/19/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE We examined the potential mediating roles of domain-specific physical activities and sedentary behaviors in the relationship between area-level socioeconomic status (SES) and cardiometabolic risk. METHODS Data were from the 2011/2012 Australian Diabetes, Obesity and Lifestyle study (n = 3431). The outcome was a clustered cardiometabolic risk (CCR) score, and the exposure was suburb-level SES. Potential mediators were domain-specific physical activities and sedentary behaviors. Multilevel linear regression models examined associations between SES and potential mediators (α) and between mediators and CCR (β). Mediation was assessed using the joint-significance test. RESULTS Higher SES was associated with a lower CCR score. Lower SES was associated with less frequent walking for transport, lower vigorous-intensity recreational physical activity, and higher TV time, which were associated with higher CCR scores. However, higher SES was associated with longer transport-related sitting time (all modes and in cars), which were associated with higher CCR scores. CONCLUSIONS The SES-cardiometabolic risk relationship may be partially explained by walking for transport, vigorous-intensity recreational physical activity, and TV viewing. These findings, which require corroboration from prospective evidence and clarification of the roles of transport-related sitting and occupational physical activity, can inform initiatives addressing socioeconomic inequalities in cardiometabolic health.
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Affiliation(s)
- Chien-Yu Lin
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan; Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia.
| | - Manoj Chandrabose
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia; Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia
| | - Nyssa Hadgraft
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia; Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia
| | - Sungkavi Selvakumaran
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia; Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Ai Shibata
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Takemi Sugiyama
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia; Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia
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Dingle SE, Bowe SJ, Bujtor M, Milte CM, Daly RM, Anstey KJ, Shaw JE, Torres SJ. Associations between data-driven lifestyle profiles and cognitive function in the AusDiab study. BMC Public Health 2022; 22:1990. [DOI: 10.1186/s12889-022-14379-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/10/2022] [Indexed: 11/30/2022] Open
Abstract
Abstract
Background
Mounting evidence highlights the importance of combined modifiable lifestyle factors in reducing risk of cognitive decline and dementia. Several a priori additive scoring approaches have been established; however, limited research has employed advanced data-driven approaches to explore this association. This study aimed to examine the association between data-driven lifestyle profiles and cognitive function in community-dwelling Australian adults.
Methods
A cross-sectional study of 4561 Australian adults (55.3% female, mean age 60.9 ± 11.3 years) was conducted. Questionnaires were used to collect self-reported data on diet, physical activity, sedentary time, smoking status, and alcohol consumption. Cognitive testing was undertaken to assess memory, processing speed, and vocabulary and verbal knowledge. Latent Profile Analysis (LPA) was conducted to identify subgroups characterised by similar patterns of lifestyle behaviours. The resultant subgroups, or profiles, were then used to further explore associations with cognitive function using linear regression models and an automatic Bolck, Croon & Hagenaars (BCH) approach.
Results
Three profiles were identified: (1) “Inactive, poor diet” (76.3%); (2) “Moderate activity, non-smokers” (18.7%); and (3) “Highly active, unhealthy drinkers” (5.0%). Profile 2 “Moderate activity, non-smokers” exhibited better processing speed than Profile 1 “Inactive, poor diet”. There was also some evidence to suggest Profile 3 “Highly active, unhealthy drinkers” exhibited poorer vocabulary and verbal knowledge compared to Profile 1 and poorer processing speed and memory scores compared to Profile 2.
Conclusion
In this population of community-dwelling Australian adults, a sub-group characterised by moderate activity levels and higher rates of non-smoking had better cognitive function compared to two other identified sub-groups. This study demonstrates how LPA can be used to highlight sub-groups of a population that may be at increased risk of dementia and benefit most from lifestyle-based multidomain intervention strategies.
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Edwardson CL, Biddle SJH, Clemes SA, Davies MJ, Dunstan DW, Eborall H, Granat MH, Gray LJ, Healy GN, Jaicim NB, Lawton S, Maylor BD, Munir F, Richardson G, Yates T, Clarke-Cornwell AM. Effectiveness of an intervention for reducing sitting time and improving health in office workers: three arm cluster randomised controlled trial. BMJ 2022; 378:e069288. [PMID: 35977732 PMCID: PMC9382450 DOI: 10.1136/bmj-2021-069288] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of an intervention, with and without a height adjustable desk, on daily sitting time, and to investigate the relative effectiveness of the two interventions, and the effectiveness of both interventions on physical behaviours and physical, biochemical, psychological, and work related health and performance outcomes. DESIGN Cluster three arm randomised controlled trial with follow-up at three and 12 months. SETTING Local government councils in Leicester, Liverpool, and Greater Manchester, UK. PARTICIPANTS 78 clusters including 756 desk based employees in defined offices, departments, or teams from two councils in Leicester, three in Greater Manchester, and one in Liverpool. INTERVENTIONS Clusters were randomised to one of three conditions: the SMART Work and Life (SWAL) intervention, the SWAL intervention with a height adjustable desk (SWAL plus desk), or control (usual practice). MAIN OUTCOMES MEASURES The primary outcome measure was daily sitting time, assessed by accelerometry, at 12 month follow-up. Secondary outcomes were accelerometer assessed sitting, prolonged sitting, standing and stepping time, and physical activity calculated over any valid day, work hours, workdays, and non-workdays, self-reported lifestyle behaviours, musculoskeletal problems, cardiometabolic health markers, work related health and performance, fatigue, and psychological measures. RESULTS Mean age of participants was 44.7 years, 72.4% (n=547) were women, and 74.9% (n=566) were white. Daily sitting time at 12 months was significantly lower in the intervention groups (SWAL -22.2 min/day, 95% confidence interval -38.8 to -5.7 min/day, P=0.003; SWAL plus desk -63.7 min/day, -80.1 to -47.4 min/day, P<0.001) compared with the control group. The SWAL plus desk intervention was found to be more effective than SWAL at changing sitting time (-41.7 min/day, -56.3 to -27.0 min/day, P<0.001). Favourable differences in sitting and prolonged sitting time at three and 12 month follow-ups for both intervention groups and for standing time for the SWAL plus desk group were observed during work hours and on workdays. Both intervention groups were associated with small improvements in stress, wellbeing, and vigour, and the SWAL plus desk group was associated with improvements in pain in the lower extremity, social norms for sitting and standing at work, and support. CONCLUSIONS Both SWAL and SWAL plus desk were associated with a reduction in sitting time, although the addition of a height adjustable desk was found to be threefold more effective. TRIAL REGISTRATION ISRCTN Registry ISRCTN11618007.
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Affiliation(s)
- Charlotte L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Stuart J H Biddle
- Centre for Health Research, University of Southern Queensland, Springfield Central, QLD, Australia
| | - Stacy A Clemes
- NIHR Leicester Biomedical Research Centre, Leicester, UK
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicester, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Mary MacKillop Institute for Health Research, The Australian Catholic University, Melbourne, VIC, Australia
| | - Helen Eborall
- Department of Health Sciences, University of Leicester, Leicester, UK
- Deanery of Molecular, Genetic and Population Health Sciences, The University of Edinburgh, UK
| | - Malcolm H Granat
- School of Health and Society, University of Salford, Salford, Greater Manchester, UK
| | - Laura J Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Genevieve N Healy
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | | | - Sarah Lawton
- School of Health and Society, University of Salford, Salford, Greater Manchester, UK
| | - Benjamin D Maylor
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicester, UK
| | | | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, LE5 4PW, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
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Association between Physical Activity Guidelines and Sedentary Time with Workers' Health-Related Quality of Life in a Spanish Multinational Company. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116592. [PMID: 35682176 PMCID: PMC9180907 DOI: 10.3390/ijerph19116592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/25/2022] [Accepted: 05/25/2022] [Indexed: 02/04/2023]
Abstract
Workers spend a large amount of time working, limiting the possibility of meeting physical activity (PA) guidelines. A better health-related quality of life (HRQoL) provides benefits for the employee and company. The aim of this study was to analyse the associations of four behavioural categories between compliance with PA guidelines (aerobic and strength training) and sedentary time with workers’ HRQoL. We classified the sample into four categories: (1) “Physically active & low sedentary”, (2) “Physically active & high sedentary”, (3) “Physically inactive & low sedentary”, and (4) “Physically inactive & high sedentary”. Student’s t-tests for two independent samples and a multiple linear regression adjusted for covariates were performed. A total of 1004 employees of the multinational company Grupo Red Eléctrica participated. Compliance with PA guidelines and a low level of sedentarism were associated with higher HRQoL (p < 0.001). Compared to “physically inactive & high sedentary”, “physically active & low sedentary” and “physically active & high sedentary” workers obtained a better HRQoL (B = 5.47; p = 0.006 and B = 4.10; p = 0.003; respectively). In this sample of Spanish workers, being physically active was associated with a better HRQoL, even in those with high sedentary time. Experimental studies are needed to confirm our results.
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Kurita S, Doi T, Tsutsumimoto K, Nakakubo S, Ishii H, Shimada H. Development of a Questionnaire to Evaluate Older Adults' Total Sedentary Time and Sedentary Time With Cognitive Activity. J Geriatr Psychiatry Neurol 2022; 35:392-399. [PMID: 33840291 PMCID: PMC9003769 DOI: 10.1177/08919887211006468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to develop a questionnaire for evaluating total sedentary time (ST) and ST with cognitive activity, and to examine the association between ST and cognitive function among Japanese older adults. The questionnaire to evaluate ST comprised 12 items regarding behavior in specific settings, including 8 items on ST with cognitive activity, in a usual week. Older adults aged ≥75 years who participated in a health check-up assessing cognitive function completed the developed questionnaire and subsequently wore an accelerometer and recorded a diary of ST with cognitive activity for a week as validity measures. Cognitive function was assessed with neuropsychological tests covering 4 domains: memory, attention, executive function, and processing speed. Fifty-two participants were included in the validity analysis. Spearman's correlation coefficient indicated fair-to-good agreement between the questionnaire-measured and the diary-measured time for ST with cognitive activity (r = 0.59, p < 0.001), but this was not the case for total ST. Bland-Altman plots showed that the questionnaire-measured total ST contained proportional bias (r = 0.51, p < 0.001). Multiple regression analysis (n = 49) showed longer questionnaire-measured ST with cognitive activity was significantly associated with better neuropsychological test scores (attention: β = -0.38, p = 0.025; executive function: β = -0.46, p = 0.003; and processing speed: β = 0.31, p = 0.041), while total ST was not associated with better cognitive performance. The developed questionnaire showed acceptable validity to measure ST with cognitive activity, which was found to be protectively associated with cognitive function.
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Affiliation(s)
- Satoshi Kurita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan,Satoshi Kurita, Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi Prefecture, 474-8511, Japan.
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Sho Nakakubo
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Hideaki Ishii
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
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11
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Nguyen P, Ananthapavan J, Tan EJ, Crosland P, Bowe SJ, Gao L, Dunstan DW, Moodie M. Modelling the potential health and economic benefits of reducing population sitting time in Australia. Int J Behav Nutr Phys Act 2022; 19:28. [PMID: 35305678 PMCID: PMC8934131 DOI: 10.1186/s12966-022-01276-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 02/28/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Strong evidence indicates that excessive time spent sitting (sedentary behaviour) is detrimentally associated with multiple chronic diseases. Sedentary behaviour is prevalent among adults in Australia and has increased during the COVID-19 pandemic. Estimating the potential health benefits and healthcare cost saving associated with reductions in population sitting time could be useful for the development of public health initiatives. METHODS A sedentary behaviour model was developed and incorporated into an existing proportional, multi-state, life table Markov model (ACE-Obesity Policy model). This model simulates the 2019 Australian population (age 18 years and above) and estimates the incidence, prevalence and mortality of five diseases associated with sedentary behaviour (type 2 diabetes, stroke, endometrial, breast and colorectal cancer). Key model inputs included population sitting time estimates from the Australian National Health Survey 2014-2015, healthcare cost data from the Australian Institute of Health and Welfare (2015) and relative risk estimates assessed by conducting literature reviews and meta-analyses. Scenario analyses estimated the potential change in disease incidence as a result of changes in population sitting time. This, in turn, resulted in estimated improvements in long term health outcomes (Health-adjusted life years (HALYs)) and healthcare cost-savings. RESULTS According to the model, if all Australian adults sat no more than 4 h per day, the total HALYs gained would be approximately 17,211 with health care cost savings of approximately A$185 million over one year. Under a more feasible scenario, where sitting time was reduced in adults who sit 4 or more hours per day by approximately 36 min per person per day (based on the results of the Stand Up Victoria randomised controlled trial), potential HALYs gained were estimated to be 3,670 and healthcare cost saving could reach A$39 million over one year. CONCLUSIONS Excessive sedentary time results in considerable population health burden in Australia. This paper describes the development of the first Australian sedentary behaviour model that can be used to predict the long term consequences of interventions targeted at reducing sedentary behaviour through reductions in sitting time. These estimates may be used by decision makers when prioritising healthcare resources and investing in preventative public health initiatives.
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Affiliation(s)
- Phuong Nguyen
- Deakin Health Economics, Deakin University, Institute for Health Transformation, Geelong, VIC, Australia.
- Global Obesity Centre, Deakin University, Institute for Health Transformation, Geelong, VIC, Australia.
| | - Jaithri Ananthapavan
- Deakin Health Economics, Deakin University, Institute for Health Transformation, Geelong, VIC, Australia
- Global Obesity Centre, Deakin University, Institute for Health Transformation, Geelong, VIC, Australia
| | - Eng Joo Tan
- Deakin Health Economics, Deakin University, Institute for Health Transformation, Geelong, VIC, Australia
| | - Paul Crosland
- Deakin Health Economics, Deakin University, Institute for Health Transformation, Geelong, VIC, Australia
| | - Steve J Bowe
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Lan Gao
- Deakin Health Economics, Deakin University, Institute for Health Transformation, Geelong, VIC, Australia
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, Australia
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Marj Moodie
- Deakin Health Economics, Deakin University, Institute for Health Transformation, Geelong, VIC, Australia
- Global Obesity Centre, Deakin University, Institute for Health Transformation, Geelong, VIC, Australia
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12
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Greenwood-Hickman MA, Zhou J, Cook A, Mettert KD, Green B, McClure J, Arterburn D, Florez-Acevedo S, Rosenberg DE. Exploring Differences in Older Adult Accelerometer-Measured Sedentary Behavior and Resting Blood Pressure Before and During the COVID-19 Pandemic. Gerontol Geriatr Med 2022; 8:23337214221096007. [PMID: 35506125 PMCID: PMC9051995 DOI: 10.1177/23337214221096007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/16/2022] [Accepted: 04/05/2022] [Indexed: 11/30/2022] Open
Abstract
Older adults have higher sedentary behavior (SB), lower physical activity, and are particularly susceptible to negative impacts from the COVID-19 pandemic and associated public health restrictions. Pandemic impacts to SB and health, particularly via objective assessment, are not well documented in the literature. Here we described differences in SB, physical activity, and blood pressure (BP) for older adults before and during the pandemic. Baseline thigh-worn activPAL accelerometer and BP measurements from 95 participants enrolled in a SB intervention trial pre-pandemic were compared to 60 enrolled post-pandemic. We used linear regression models adjusted for demographic and health factors to estimate differences in sample means of SB measures and BP. The post-COVID sample was older (age 67 vs. 70), more female (60% vs. 72%), and included more individuals of color (21% vs. 32%). In fully adjusted models, systolic BP was statistically significantly higher in the post-COVID group (6.8, 95% CI: [0.3,13.3]). After adjustment, activPAL-measured and self-reported activity were non-significant but trended towards greater total sitting (0.4 hours [-0.3, 1.1]), fewer daily steps (-270 [-1078, 538]), and greater self-reported TV time (0.4 hours, [-0.3, 1.1]) post-COVID. Future analyses are warranted to better quantify these impacts and guide clinical care and future interventions.
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Affiliation(s)
| | - Jing Zhou
- Kaiser Permanente Washington Health
Research Institute, Seattle, WA, USA
| | - Andrea Cook
- Kaiser Permanente Washington Health
Research Institute, Seattle, WA, USA
| | - Kayne D. Mettert
- Kaiser Permanente Washington Health
Research Institute, Seattle, WA, USA
| | - Bev Green
- Kaiser Permanente Washington Health
Research Institute, Seattle, WA, USA
| | - Jennifer McClure
- Kaiser Permanente Washington Health
Research Institute, Seattle, WA, USA
| | - David Arterburn
- Kaiser Permanente Washington Health
Research Institute, Seattle, WA, USA
| | - Stefani Florez-Acevedo
- Kaiser Permanente Washington Health
Research Institute, Seattle, WA, USA
- Department of Health Services, University of
Washington, Seattle, WA, USA
| | - Dori E. Rosenberg
- Kaiser Permanente Washington Health
Research Institute, Seattle, WA, USA
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13
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Protocol for a randomized controlled trial of sitting reduction to improve cardiometabolic health in older adults. Contemp Clin Trials 2021; 111:106593. [PMID: 34666182 DOI: 10.1016/j.cct.2021.106593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/24/2021] [Accepted: 10/05/2021] [Indexed: 12/17/2022]
Abstract
Older adults with obesity spend the majority of their waking hours sedentary. Given substantial barriers to regular physical activity in this population, approaches to reduce sedentary time could be an effective health promotion strategy. We present the protocol of a randomized controlled trial to reduce sitting time in older adults with a body mass index of 30 kg/m2 or above. Participants (N = 284) will be randomized to receive a sitting reduction intervention (termed I-STAND) or a healthy living focused attention control condition. I-STAND includes 10 contacts with a health coach (10 sessions total) and participants receive a wrist-worn prompting device and portable standing desk. The healthy living condition includes 10 sessions with a health coach to set goals around various topics relating to healthy aging. Participants receive their assigned intervention for 6 months. After 6 months, those receiving the I-STAND condition are re-randomized to receive five booster health coaching sessions by 'phone or no further contact; healthy living participants receive no further contact and those in both conditions are followed for an additional 6 months. Measurements initially included wearing an activPAL device and completing several biometric tests (e.g., blood pressure, HbA1c), at baseline, 3 months, 6 months, and 12 months; however, during the COVID-19 pandemic we shifted to remote assessments and were unable to collect all of these measures. The primary outcomes remained activPAL-assessed sitting time and blood pressure. Recruitment is anticipated to be completed in 2022.
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14
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Sacre JW, Holmes‐Truscott E, Salim A, Anstey KJ, Drummond GR, Huxley RR, Magliano DJ, van Wijngaarden P, Zimmet PZ, Speight J, Shaw JE. Impact of the COVID-19 pandemic and lockdown restrictions on psychosocial and behavioural outcomes among Australian adults with type 2 diabetes: Findings from the PREDICT cohort study. Diabet Med 2021; 38:e14611. [PMID: 34053106 PMCID: PMC8237067 DOI: 10.1111/dme.14611] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/08/2021] [Accepted: 05/26/2021] [Indexed: 12/14/2022]
Abstract
AIM To examine psychosocial and behavioural impacts of the novel coronavirus disease 2019 (COVID-19) pandemic and lockdown restrictions among adults with type 2 diabetes. METHODS Participants enrolled in the PRogrEssion of DIabetic ComplicaTions (PREDICT) cohort study in Melbourne, Australia (n = 489 with a baseline assessment pre-2020) were invited to complete a phone/online follow-up assessment in mid-2020 (i.e., amidst COVID-19 lockdown restrictions). Repeated assessments that were compared with pre-COVID-19 baseline levels included anxiety symptoms (7-item Generalised Anxiety Disorder scale [GAD-7]), depressive symptoms (8-item Patient Health Questionnaire [PHQ-8]), diabetes distress (Problem Areas in Diabetes scale [PAID]), physical activity/sedentary behaviour, alcohol consumption and diabetes self-management behaviours. Additional once-off measures at follow-up included COVID-19-specific worry, quality of life (QoL), and healthcare appointment changes (telehealth engagement and appointment cancellations/avoidance). RESULTS Among 470 respondents (96%; aged 66 ± 9 years, 69% men), at least 'moderate' worry about COVID-19 infection was reported by 31%, and 29%-73% reported negative impacts on QoL dimensions (greatest for: leisure activities, feelings about the future, emotional well-being). Younger participants reported more negative impacts (p < 0.05). Overall, anxiety/depressive symptoms were similar at follow-up compared with pre-COVID-19, but diabetes distress reduced (p < 0.001). Worse trajectories of anxiety/depressive symptoms were observed among those who reported COVID-19-specific worry or negative QoL impacts (p < 0.05). Physical activity trended lower (~10%), but sitting time, alcohol consumption and glucose-monitoring frequency remained unchanged. 73% of participants used telehealth, but 43% cancelled a healthcare appointment and 39% avoided new appointments despite perceived need. CONCLUSIONS COVID-19 lockdown restrictions negatively impacted QoL, some behavioural risk factors and healthcare utilisation in adults with type 2 diabetes. However, generalised anxiety and depressive symptoms remained relatively stable.
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Affiliation(s)
| | - Elizabeth Holmes‐Truscott
- School of PsychologyDeakin UniversityGeelongVic.Australia
- The Australian Centre for Behavioural Research in DiabetesMelbourneVic.Australia
| | - Agus Salim
- Baker Heart and Diabetes InstituteMelbourneVic.Australia
- Department of Mathematics and StatisticsLa Trobe UniversityMelbourneVic.Australia
- Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global HealthThe University of MelbourneMelbourneVic.Australia
| | - Kaarin J. Anstey
- UNSW Ageing Futures InstituteUniversity of New South WalesSydneyNSWAustralia
- Neuroscience Research AustraliaSydneyNSWAustralia
| | - Grant R. Drummond
- Baker Heart and Diabetes InstituteMelbourneVic.Australia
- Centre for Cardiovascular Biology and Disease Research, Department of Physiology, Anatomy and Microbiology, School of Life SciencesLa Trobe UniversityMelbourneVic.Australia
| | | | - Dianna J. Magliano
- Baker Heart and Diabetes InstituteMelbourneVic.Australia
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVic.Australia
| | - Peter van Wijngaarden
- Centre for Eye Research AustraliaRoyal Victorian Eye and Ear HospitalMelbourneVic.Australia
- OphthalmologyDepartment of SurgeryUniversity of MelbourneMelbourneVic.Australia
| | - Paul Z. Zimmet
- Department of DiabetesCentral Clinical SchoolMonash UniversityMelbourneVic.Australia
| | - Jane Speight
- School of PsychologyDeakin UniversityGeelongVic.Australia
- The Australian Centre for Behavioural Research in DiabetesMelbourneVic.Australia
| | - Jonathan E. Shaw
- Baker Heart and Diabetes InstituteMelbourneVic.Australia
- School of Life SciencesLa Trobe UniversityMelbourneVic.Australia
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15
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Ferrari G, Werneck AO, Silva DR, Kovalskys I, Gómez G, Rigotti A, Cortés LY, García MY, Liria M, Herrera-Cuenca M, Zimberg IZ, Guajardo V, Pratt M, Cristi-Montero C, Marques A, Peralta M, Bolados CC, Leme ACB, Rollo S, Fisberg M. Agreement Between Self-Reported and Device-Based Sedentary Time among Eight Countries: Findings from the ELANS. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 22:1036-1047. [PMID: 33502675 DOI: 10.1007/s11121-021-01206-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to analyze the agreement between self-reported and device-based sedentary time among eight countries in Latin America. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants (18-65 years) across eight countries. Participants reported time spent sedentary in different activities (computer use at home, videogame use, reading, sitting down to chat with friends/relatives or listening to music, speaking on the phone, watching TV, and riding in a car). Overall sitting time was assessed using a single item from the International Physical Activity Questionnaire (IPAQ). Device-based sedentary time was assessed using Actigraph GT3X accelerometers. Self-reported overall sitting time (227.1 min/day) produced the lowest values of the three assessment methods, followed by self-reported sum of different types of sedentary behavior (364.1 min/day) and device-based sedentary time (568.6 min/day). Overall, correlation coefficients and ICC varied from weak to moderate (rho: 0.25-0.39; ICC: 0.21:0.39) between self-reported sum of different types of sedentary behavior, self-reported overall sitting time, and device-based sedentary time. The Bland-Altman plots indicated low to moderate agreement between self-reported overall sitting time and device-based sedentary time by sex. Self-report measures underestimate sedentary behavior and overall sitting time when compared with device-based measures. The weak and moderate level of agreement between methods indicates that caution is required when comparing associations between different self-report and device-based measures of sedentary behavior with health outcomes.
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Affiliation(s)
- Gerson Ferrari
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Las Sophoras 175, Estación Central, Santiago, Chile.
| | - André O Werneck
- Department of Nutrition, School of Public Health, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Danilo R Silva
- Department of Physical Education, Federal University of Sergipe - UFS, São Cristóvão, Brazil
| | - Irina Kovalskys
- Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Georgina Gómez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Lilia Yadira Cortés
- Departamento de Nutrición y Bioquímica, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Martha Yépez García
- Colégio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | - María Liria
- Instituto de Investigación Nutricional, La Molina, Lima, Peru
| | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas, Venezuela
| | - Ioná Zalcman Zimberg
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Viviana Guajardo
- Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Michael Pratt
- Institute for Public Health, University of California San Diego, La Jolla, CA, USA
| | - Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Adilson Marques
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,ISAMB, University of Lisbon, Lisbon, Portugal
| | - Miguel Peralta
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,ISAMB, University of Lisbon, Lisbon, Portugal
| | - Cristian Cofre Bolados
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Las Sophoras 175, Estación Central, Santiago, Chile
| | - Ana Carolina B Leme
- Department of Nutrition, School of Public Health, Universidade de São Paulo (USP), São Paulo, Brazil.,Family Relations and Applied Nutrition, University of Guelph, Guelph, Canada.,Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo, Brazil
| | - Scott Rollo
- Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Mauro Fisberg
- Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo, Brazil.,Departamento de Pediatria da Universidade Federal de São Paulo, São Paulo, Brazil
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16
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Aunger J, Wagnild J. Objective and subjective measurement of sedentary behavior in human adults: A toolkit. Am J Hum Biol 2020; 34:e23546. [PMID: 33277954 PMCID: PMC9286366 DOI: 10.1002/ajhb.23546] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/11/2020] [Accepted: 11/19/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Objectives: Human biologists are increasingly interested in measuring and comparing physical activities in different societies. Sedentary behavior, which refers to time spent sitting or lying down while awake, is a large component of daily 24 hours movement patterns in humans and has been linked to poor health outcomes such as risk of all-cause and cardiovascular mortality, independently of physical activity. As such, it is important for researchers, with the aim of measuring human movement patterns, to most effectively use resources available to them to capture sedentary behavior. METHODS This toolkit outlines objective (device-based) and subjective (self-report) methods for measuring sedentary behavior in free-living contexts, the benefits and drawbacks to each, as well as novel options for combined use to maximize scientific rigor. Throughout this toolkit, emphasis is placed on considerations for the use of these methods in various field conditions and in varying cultural contexts. RESULTS Objective measures such as inclinometers are the gold-standard for measuring total sedentary time but they typically cannot capture contextual information or determine which specific behaviors are taking place. Subjective measures such as questionnaires and 24 hours-recall methods can provide measurements of time spent in specific sedentary behaviors but are subject to measurement error and response bias. CONCLUSIONS We recommend that researchers use the method(s) that suit the research question; inclinometers are recommended for the measurement of total sedentary time, while self-report methods are recommended for measuring time spent in particular contexts of sedentary behavior.
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Affiliation(s)
- Justin Aunger
- Health Services Management Centre, Park House, University of Birmingham, England, UK
| | - Janelle Wagnild
- Department of Anthropology, Durham University, Durham, England, UK
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17
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Bakker EA, Hartman YAW, Hopman MTE, Hopkins ND, Graves LEF, Dunstan DW, Healy GN, Eijsvogels TMH, Thijssen DHJ. Validity and reliability of subjective methods to assess sedentary behaviour in adults: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2020; 17:75. [PMID: 32539720 PMCID: PMC7294635 DOI: 10.1186/s12966-020-00972-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 05/12/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Subjective measures of sedentary behaviour (SB) (i.e. questionnaires and diaries/logs) are widely implemented, and can be useful for capturing type and context of SBs. However, little is known about comparative validity and reliability. The aim of this systematic review and meta-analysis was to: 1) identify subjective methods to assess overall, domain- and behaviour-specific SB, and 2) examine the validity and reliability of these methods. METHODS The databases MEDLINE, EMBASE and SPORTDiscus were searched up to March 2020. Inclusion criteria were: 1) assessment of SB, 2) evaluation of subjective measurement tools, 3) being performed in healthy adults, 4) manuscript written in English, and 5) paper was peer-reviewed. Data of validity and/or reliability measurements was extracted from included studies and a meta-analysis using random effects was performed to assess the pooled correlation coefficients of the validity. RESULTS The systematic search resulted in 2423 hits. After excluding duplicates and screening on title and abstract, 82 studies were included with 75 self-reported measurement tools. There was wide variability in the measurement properties and quality of the studies. The criterion validity varied between poor-to-excellent (correlation coefficient [R] range - 0.01- 0.90) with logs/diaries (R = 0.63 [95%CI 0.48-0.78]) showing higher criterion validity compared to questionnaires (R = 0.35 [95%CI 0.32-0.39]). Furthermore, correlation coefficients of single- and multiple-item questionnaires were comparable (1-item R = 0.34; 2-to-9-items R = 0.35; ≥10-items R = 0.37). The reliability of SB measures was moderate-to-good, with the quality of these studies being mostly fair-to-good. CONCLUSION Logs and diaries are recommended to validly and reliably assess self-reported SB. However, due to time and resources constraints, 1-item questionnaires may be preferred to subjectively assess SB in large-scale observations when showing similar validity and reliability compared to longer questionnaires. REGISTRATION NUMBER CRD42018105994.
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Affiliation(s)
- Esmée A Bakker
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Yvonne A W Hartman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Maria T E Hopman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Nicola D Hopkins
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Lee E F Graves
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - David W Dunstan
- Baker Heart & Diabetes Institute, Melbourne, Australia
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Genevieve N Healy
- The University of Queensland, School of Public Health, Brisbane, Australia
| | - Thijs M H Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Dick H J Thijssen
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
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18
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The Length and Number of Sedentary Bouts Predict Fibrinogen Levels in Postmenopausal Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093051. [PMID: 32353951 PMCID: PMC7246768 DOI: 10.3390/ijerph17093051] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/21/2020] [Accepted: 04/26/2020] [Indexed: 11/17/2022]
Abstract
Menopause is associated with adverse changes in coagulation homeostasis. We aimed to investigate the association between objectively measured sedentary behavior (SB) and SB bouts (i.e., number and length of SB bouts) vs. fibrinogen levels in post-menopausal women. Fifty-three post-menopausal women (age 59.8 ± 6.2 years, BMI 27.3 ± 4.4) wore a multisensory device (Sensewear Mini Armband, BodyMedia, Inc., Pittsburgh, PA) for 5 days, to measure SB and physical activity (PA). Blood samples were collected to measure serum fibrinogen. Fibrinogen was directly correlated with SB (r = −0.48, p < 0.01), lying down during awake time (r = −0.50, p < 0.01), and both medium (11–30 mins) and very long bouts (>1 h) of SB (r = −0.59, p < 0.01; r = −0.51, p < 0.01, respectively), and inversely correlated with moderate to vigorous-intensity physical activity (r = −0.39, p < 0.01). Furthermore, fibrinogen was also directly correlated with BMI (r = −0.28, p < 0.05). In postmenopausal women without prevalent cardiovascular disease, the number of prolonged and uninterrupted sedentary bouts is directly correlated with increased fibrinogen levels, regardless of PA and BMI. This result suggests the importance of delivering new strategies to counteract the increase of sedentariness and inactivity of the postmenopausal population.
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Owen N, Healy GN, Dempsey PC, Salmon J, Timperio A, Clark BK, Goode AD, Koorts H, Ridgers ND, Hadgraft NT, Lambert G, Eakin EG, Kingwell BA, Dunstan DW. Sedentary Behavior and Public Health: Integrating the Evidence and Identifying Potential Solutions. Annu Rev Public Health 2020; 41:265-287. [DOI: 10.1146/annurev-publhealth-040119-094201] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In developed and developing countries, social, economic, and environmental transitions have led to physical inactivity and large amounts of time spent sitting. Research is now unraveling the adverse public health consequences of too much sitting. We describe improvements in device-based measurement that are providing new insights into sedentary behavior and health. We consider the implications of research linking evidence from epidemiology and behavioral science with mechanistic insights into the underlying biology of sitting time. Such evidence has led to new sedentary behavior guidelines and initiatives. We highlight ways that this emerging knowledge base can inform public health strategy: First, we consider epidemiologic and experimental evidence on the health consequences of sedentary behavior; second, we describe solutions-focused research from initiatives in workplaces and schools. To inform a broad public health strategy, researchers need to pursue evidence-informed collaborations with occupational health, education, and other sectors.
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Affiliation(s)
- Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia;,
- Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia
| | - Genevieve N. Healy
- School of Public Health, University of Queensland, Herston, Queensland 4006, Australia;, , ,
| | - Paddy C. Dempsey
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, United Kingdom
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia;,
| | - Jo Salmon
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria 3125, Australia;, , ,
| | - Anna Timperio
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria 3125, Australia;, , ,
| | - Bronwyn K. Clark
- School of Public Health, University of Queensland, Herston, Queensland 4006, Australia;, , ,
| | - Ana D. Goode
- School of Public Health, University of Queensland, Herston, Queensland 4006, Australia;, , ,
| | - Harriet Koorts
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria 3125, Australia;, , ,
| | - Nicola D. Ridgers
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria 3125, Australia;, , ,
| | - Nyssa T. Hadgraft
- Centre for Urban Transitions, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia;,
| | - Gavin Lambert
- Iverson Health Innovation Institute, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia
| | - Elizabeth G. Eakin
- School of Public Health, University of Queensland, Herston, Queensland 4006, Australia;, , ,
| | - Bronwyn A. Kingwell
- CSL Limited, Bio21 Institute, Melbourne, Victoria 3010, Australia
- Metabolic and Vascular Physiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia
| | - David W. Dunstan
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia;,
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria 3000, Australia
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20
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Wagnild JM, Pollard TM. Associations Between Television Time and activPAL-Measured Duration and Pattern of Sedentary Time Among Pregnant Women at Risk of Gestational Diabetes in the UK. J Phys Act Health 2020; 17:471-474. [PMID: 32035413 DOI: 10.1123/jpah.2019-0315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 10/18/2019] [Accepted: 12/31/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Television (TV) time is associated with poor cardiometabolic health outcomes. This finding is commonly attributed to duration of sitting or patterns of sitting associated with high TV time, but there is very little evidence on this link. METHODS Pregnant women (n = 167) at risk of gestational diabetes wore an activPAL accelerometer and self-reported their usual TV time in the second trimester. Generalized linear mixed models were used to compare objectively measured total sedentary time (ST), prolonged ST (bouts ≥30 min), and breaks in ST for all hours and evening hours (6 PM-11 PM) between those with high (≥2 h/d) and low TV time. RESULTS Over all waking hours, those with high TV time had fewer breaks in ST than those with low TV time, exp(b) 0.92; 95% confidence interval, 0.86 to 0.998; there were no differences in total ST or prolonged ST between the 2 groups. Those with high TV time had significantly higher evening ST (b = 9.9; 95% confidence interval, 0.5 to 19.2); there were no differences in prolonged ST or breaks in ST during evening hours. CONCLUSIONS These findings suggest that high TV time may be associated with higher evening ST and fewer breaks in ST. The link between TV time and sitting patterns requires further investigation.
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21
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Prince SA, Cardilli L, Reed JL, Saunders TJ, Kite C, Douillette K, Fournier K, Buckley JP. A comparison of self-reported and device measured sedentary behaviour in adults: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2020; 17:31. [PMID: 32131845 PMCID: PMC7055033 DOI: 10.1186/s12966-020-00938-3] [Citation(s) in RCA: 212] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 02/19/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Sedentary behaviour (SB) is a risk factor for chronic disease and premature mortality. While many individual studies have examined the reliability and validity of various self-report measures for assessing SB, it is not clear, in general, how self-reported SB (e.g., questionnaires, logs, ecological momentary assessments (EMAs)) compares to device measures (e.g., accelerometers, inclinometers). OBJECTIVE The primary objective of this systematic review was to compare self-report versus device measures of SB in adults. METHODS Six bibliographic databases were searched to identify all studies which included a comparable self-report and device measure of SB in adults. Risk of bias within and across studies was assessed. Results were synthesized using meta-analyses. RESULTS The review included 185 unique studies. A total of 123 studies comprising 173 comparisons and data from 55,199 participants were used to examine general criterion validity. The average mean difference was -105.19 minutes/day (95% CI: -127.21, -83.17); self-report underestimated sedentary time by ~1.74 hours/day compared to device measures. Self-reported time spent sedentary at work was ~40 minutes higher than when assessed by devices. Single item measures performed more poorly than multi-item questionnaires, EMAs and logs/diaries. On average, when compared to inclinometers, multi-item questionnaires, EMAs and logs/diaries were not significantly different, but had substantial amount of variability (up to 6 hours/day within individual studies) with approximately half over-reporting and half under-reporting. A total of 54 studies provided an assessment of reliability of a self-report measure, on average the reliability was good (ICC = 0.66). CONCLUSIONS Evidence from this review suggests that single-item self-report measures generally underestimate sedentary time when compared to device measures. For accuracy, multi-item questionnaires, EMAs and logs/diaries with a shorter recall period should be encouraged above single item questions and longer recall periods if sedentary time is a primary outcome of study. Users should also be aware of the high degree of variability between and within tools. Studies should exert caution when comparing associations between different self-report and device measures with health outcomes. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019118755.
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Affiliation(s)
- Stephanie A Prince
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada.
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, K1A 0K9, Canada.
| | - Luca Cardilli
- Birmingham Community Healthcare NHS Foundation Trust, Community Cardiac Services, Birmingham, United Kingdom
- Centre for Active Living, University Centre Shrewsbury, University of Chester, Guildhall, Frankwell Quay, Shrewsbury, United Kingdom
| | - Jennifer L Reed
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Travis J Saunders
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada
| | - Chris Kite
- Centre for Active Living, University Centre Shrewsbury, University of Chester, Guildhall, Frankwell Quay, Shrewsbury, United Kingdom
- School of Life and Health Sciences, Aston University, Birmingham, United Kingdom
| | - Kevin Douillette
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada
| | - Karine Fournier
- Health Sciences Library, University of Ottawa, Ottawa, Canada
| | - John P Buckley
- Centre for Active Living, University Centre Shrewsbury, University of Chester, Guildhall, Frankwell Quay, Shrewsbury, United Kingdom
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22
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Henschel B, Gorczyca AM, Chomistek AK. Time Spent Sitting as an Independent Risk Factor for Cardiovascular Disease. Am J Lifestyle Med 2020; 14:204-215. [PMID: 32231486 PMCID: PMC7092398 DOI: 10.1177/1559827617728482] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 07/31/2017] [Accepted: 08/07/2017] [Indexed: 12/15/2022] Open
Abstract
Sedentary behavior is highly prevalent despite growing evidence of adverse effects on the cardiovascular and metabolic system that are independent of the level of recreational physical activity (PA). We present results for the association between sitting time and cardiovascular disease (CVD) from selected cohort and cross-sectional studies published in or after the year 2010 according to the domains where sitting time is accumulated during the day. These include TV viewing, occupational sitting, and sitting during transportation as well as overall sitting. The outcomes considered in this review are total CVD, coronary heart disease, and stroke as well as CVD risk factors-namely, hypertension, hypercholesterolemia, and type 2 diabetes and their associated biomarkers. Finally, several current issues with regard to studying the effects of sitting time on CVD are discussed, including how sedentary behavior is assessed, isotemporal substitution modeling, examination of joint associations for sitting and PA, and benefits of breaks in sitting time. Overall, the scientific evidence supports public health recommendations that encourage adults to limit their sedentary time in order to improve their cardiovascular health.
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Affiliation(s)
- Beate Henschel
- Department of Epidemiology and
Biostatistics, School of Public Health, Indiana University,
Bloomington, Indiana (BH, AKC)
- Center for Physical Activity and Weight
Management, Cardiovascular Research Institute, University of Kansas
Medical Center, Kansas City, Kansas (AMG)
| | - Anna M. Gorczyca
- Department of Epidemiology and
Biostatistics, School of Public Health, Indiana University,
Bloomington, Indiana (BH, AKC)
- Center for Physical Activity and Weight
Management, Cardiovascular Research Institute, University of Kansas
Medical Center, Kansas City, Kansas (AMG)
| | - Andrea K. Chomistek
- Andrea K. Chomistek, MPH, ScD,
School of Public Health, Indiana University-Bloomington, 1025 E 7th
Street, Bloomington, IN 47405; e-mail:
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23
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Criterion Validity of the Sedentary Behavior Question From the Global Physical Activity Questionnaire in Older Adults. J Phys Act Health 2020; 17:2-12. [PMID: 31672924 DOI: 10.1123/jpah.2019-0145] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 07/12/2019] [Accepted: 08/27/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND To assess the validity of the single question to determine sedentary behavior (SB) by using the Global Physical Activity Questionnaire (GPAQ) in older adults. METHODS The sample included 163 participants (96 women) aged 65-92 years. Self-reported SB was obtained from the GPAQ. Objectively measured SB was assessed using the Intelligent Device for Energy Expenditure and Activity. Participants wore the Intelligent Device for Energy Expenditure and Activity continuously during 2 consecutive days while following their daily routine. The relative validity was assessed using the Spearman rank correlation coefficient (ρ), and the agreement was examined using mean bias and 95% limit of agreement with the Intelligent Device for Energy Expenditure and Activity as reference. RESULTS The results showed small correlations (ρ = .291, P < .001) between the SB from the GPAQ and the objective measures, and ranged from ρ = .217 to ρ = .491 depending on the potential moderator. Similarly, the GPAQ underestimates the SB for approximately 2 hours per day in older adults (limit of agreement = -7.3 to 3.4 h/d). CONCLUSION The GPAQ may not be the most suitable questionnaire for measuring SB in this population and should be used with caution because those studies that use this questionnaire in older adults may have an inaccurate measurement of SB levels.
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24
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Ekelund U, Tarp J, Steene-Johannessen J, Hansen BH, Jefferis B, Fagerland MW, Whincup P, Diaz KM, Hooker SP, Chernofsky A, Larson MG, Spartano N, Vasan RS, Dohrn IM, Hagströmer M, Edwardson C, Yates T, Shiroma E, Anderssen SA, Lee IM. Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis. BMJ 2019; 366:l4570. [PMID: 31434697 PMCID: PMC6699591 DOI: 10.1136/bmj.l4570] [Citation(s) in RCA: 786] [Impact Index Per Article: 157.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/27/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To examine the dose-response associations between accelerometer assessed total physical activity, different intensities of physical activity, and sedentary time and all cause mortality. DESIGN Systematic review and harmonised meta-analysis. DATA SOURCES PubMed, PsycINFO, Embase, Web of Science, Sport Discus from inception to 31 July 2018. ELIGIBILITY CRITERIA Prospective cohort studies assessing physical activity and sedentary time by accelerometry and associations with all cause mortality and reported effect estimates as hazard ratios, odds ratios, or relative risks with 95% confidence intervals. DATA EXTRACTION AND ANALYSIS Guidelines for meta-analyses and systematic reviews for observational studies and PRISMA guidelines were followed. Two authors independently screened the titles and abstracts. One author performed a full text review and another extracted the data. Two authors independently assessed the risk of bias. Individual level participant data were harmonised and analysed at study level. Data on physical activity were categorised by quarters at study level, and study specific associations with all cause mortality were analysed using Cox proportional hazards regression analyses. Study specific results were summarised using random effects meta-analysis. MAIN OUTCOME MEASURE All cause mortality. RESULTS 39 studies were retrieved for full text review; 10 were eligible for inclusion, three were excluded owing to harmonisation challenges (eg, wrist placement of the accelerometer), and one study did not participate. Two additional studies with unpublished mortality data were also included. Thus, individual level data from eight studies (n=36 383; mean age 62.6 years; 72.8% women), with median follow-up of 5.8 years (range 3.0-14.5 years) and 2149 (5.9%) deaths were analysed. Any physical activity, regardless of intensity, was associated with lower risk of mortality, with a non-linear dose-response. Hazards ratios for mortality were 1.00 (referent) in the first quarter (least active), 0.48 (95% confidence interval 0.43 to 0.54) in the second quarter, 0.34 (0.26 to 0.45) in the third quarter, and 0.27 (0.23 to 0.32) in the fourth quarter (most active). Corresponding hazards ratios for light physical activity were 1.00, 0.60 (0.54 to 0.68), 0.44 (0.38 to 0.51), and 0.38 (0.28 to 0.51), and for moderate-to-vigorous physical activity were 1.00, 0.64 (0.55 to 0.74), 0.55 (0.40 to 0.74), and 0.52 (0.43 to 0.61). For sedentary time, hazards ratios were 1.00 (referent; least sedentary), 1.28 (1.09 to 1.51), 1.71 (1.36 to 2.15), and 2.63 (1.94 to 3.56). CONCLUSION Higher levels of total physical activity, at any intensity, and less time spent sedentary, are associated with substantially reduced risk for premature mortality, with evidence of a non-linear dose-response pattern in middle aged and older adults. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018091808.
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Affiliation(s)
- Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, Ullevål Stadion, 0806 Oslo, Norway
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Jakob Tarp
- Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, Ullevål Stadion, 0806 Oslo, Norway
| | - Jostein Steene-Johannessen
- Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, Ullevål Stadion, 0806 Oslo, Norway
| | - Bjørge H Hansen
- Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, Ullevål Stadion, 0806 Oslo, Norway
| | - Barbara Jefferis
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London. London, UK
| | - Morten W Fagerland
- Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, Ullevål Stadion, 0806 Oslo, Norway
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Peter Whincup
- Population Health Research Institute, St George's, University of London, London, UK
| | - Keith M Diaz
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, New York, USA
| | - Steven P Hooker
- College of Health and Human Services, San Diego State University, San Diego, CA, USA
| | - Ariel Chernofsky
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Martin G Larson
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Nicole Spartano
- Department of Endocrinology, Diabetes, Nutrition and Weight Management, Boston University School of Medicine, Boston, MA, USA
| | - Ramachandran S Vasan
- Departments of Medicine and Epidemiology, Boston University School of Medicine and Boston University School of Public Health, Boston, MA, USA
| | - Ing-Mari Dohrn
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet, Stockholm, Sweden
| | - Maria Hagströmer
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet, Stockholm, Sweden
- Function area Occupational Therapy and Physiotherapy, Allied Health Professionals, Karolinska University Hospital, Stockholm, Sweden
| | - Charlotte Edwardson
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Eric Shiroma
- Neuro-epidemiology Section, National Institute of Ageing, National Institutes of Health, Bethesda, MD, USA
| | - Sigmund A Anderssen
- Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014, Ullevål Stadion, 0806 Oslo, Norway
| | - I-Min Lee
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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25
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Jefferis BJ, Parsons TJ, Sartini C, Ash S, Lennon LT, Papacosta O, Morris RW, Wannamethee SG, Lee IM, Whincup PH. Objectively measured physical activity, sedentary behaviour and all-cause mortality in older men: does volume of activity matter more than pattern of accumulation? Br J Sports Med 2019; 53:1013-1020. [PMID: 29440040 PMCID: PMC6691867 DOI: 10.1136/bjsports-2017-098733] [Citation(s) in RCA: 150] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2018] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To understand how device-measured sedentary behaviour and physical activity are related to all-cause mortality in older men, an age group with high levels of inactivity and sedentary behaviour. METHODS Prospective population-based cohort study of men recruited from 24 UK General Practices in 1978-1980. In 2010-2012, 3137 surviving men were invited to a follow-up, 1655 (aged 71-92 years) agreed. Nurses measured height and weight, men completed health and demographic questionnaires and wore an ActiGraph GT3x accelerometer. All-cause mortality was collected through National Health Service central registers up to 1 June 2016. RESULTS After median 5.0 years' follow-up, 194 deaths occurred in 1181 men without pre-existing cardiovascular disease. For each additional 30 min in sedentary behaviour, or light physical activity (LIPA), or 10 min in moderate to vigorous physical activity (MVPA), HRs for mortality were 1.17 (95% CI 1.10 to 1.25), 0.83 (95% CI 0.77 to 0.90) and 0.90 (95% CI 0.84 to 0.96), respectively. Adjustments for confounders did not meaningfully change estimates. Only LIPA remained significant on mutual adjustment for all intensities. The HR for accumulating 150 min MVPA/week in sporadic minutes (achieved by 66% of men) was 0.59 (95% CI 0.43 to 0.81) and 0.58 (95% CI 0.33 to 1.00) for accumulating 150 min MVPA/week in bouts lasting ≥10 min (achieved by 16% of men). Sedentary breaks were not associated with mortality. CONCLUSIONS In older men, all activities (of light intensity upwards) were beneficial and accumulation of activity in bouts ≥10 min did not appear important beyond total volume of activity. Findings can inform physical activity guidelines for older adults.
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Affiliation(s)
- Barbara J Jefferis
- Department of Primary Care and Population Health, University College London, London, UK
| | - Tessa J Parsons
- Department of Primary Care and Population Health, University College London, London, UK
| | - Claudio Sartini
- Department of Primary Care and Population Health, University College London, London, UK
| | - Sarah Ash
- Department of Primary Care and Population Health, University College London, London, UK
| | - Lucy T Lennon
- Department of Primary Care and Population Health, University College London, London, UK
| | - Olia Papacosta
- Department of Primary Care and Population Health, University College London, London, UK
| | - Richard W Morris
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - S Goya Wannamethee
- Department of Primary Care and Population Health, University College London, London, UK
| | - I-Min Lee
- Harvard Medical School, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Peter H Whincup
- Population Health Research Institute, St George’s University of London, London, UK
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26
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Stamatakis E, Ekelund U, Ding D, Hamer M, Bauman AE, Lee IM. Is the time right for quantitative public health guidelines on sitting? A narrative review of sedentary behaviour research paradigms and findings. Br J Sports Med 2019; 53:377-382. [PMID: 29891615 PMCID: PMC6579498 DOI: 10.1136/bjsports-2018-099131] [Citation(s) in RCA: 181] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2018] [Indexed: 12/19/2022]
Abstract
Sedentary behaviour (SB) has been proposed as an 'independent' risk factor for chronic disease risk, attracting much research and media attention. Many countries have included generic, non-quantitative reductions in SB in their public health guidelines and calls for quantitative SB targets are increasing. The aim of this narrative review is to critically evaluate key evidence areas relating to the development of guidance on sitting for adults. We carried out a non-systematic narrative evidence synthesis across seven key areas: (1) definition of SB, (2) independence of sitting from physical activity, (3) use of television viewing as a proxy of sitting, (4) interpretation of SB evidence, (5) evidence on 'sedentary breaks', (6) evidence on objectively measured sedentary SB and mortality and (7) dose response of sitting and mortality/cardiovascular disease. Despite research progress, we still know little about the independent detrimental health effects of sitting, and the possibility that sitting is mostly the inverse of physical activity remains. Unresolved issues include an unclear definition, inconsistencies between mechanistic and epidemiological studies, over-reliance on surrogate outcomes, a very weak epidemiological evidence base to support the inclusion of 'sedentary breaks' in guidelines, reliance on self-reported sitting measures, and misinterpretation of data whereby methodologically inconsistent associations are claimed to be strong evidence. In conclusion, public health guidance requires a consistent evidence base but this is lacking for SB. The development of quantitative SB guidance, using an underdeveloped evidence base, is premature; any further recommendations for sedentary behaviour require development of the evidence base and refinement of the research paradigms used in the field.
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Affiliation(s)
- Emmanuel Stamatakis
- Charles Perkins Centre, Epidemiology Unit, University of Sydney, Sydney, New South Wales, Australia
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | - Ding Ding
- Charles Perkins Centre, Epidemiology Unit, University of Sydney, Sydney, New South Wales, Australia
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Mark Hamer
- Department of Epidemiology and Public Health, University College London, London, UK
- National Centre for Sport and Exercise Medicine – East Midlands, Loughborough University, Loughborough, UK
| | - Adrian E Bauman
- Charles Perkins Centre, Epidemiology Unit, University of Sydney, Sydney, New South Wales, Australia
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - I-Min Lee
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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27
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Sasaki JE, Motl RW, McAuley E. Validity of the Marshall Sitting Questionnaire in people with multiple sclerosis. J Sports Sci 2018; 37:1250-1256. [PMID: 30543314 DOI: 10.1080/02640414.2018.1554614] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study examines the validity of the Marshall Sitting Questionnaire (MSQ) in people with multiple sclerosis (MS) and presents a prediction model to improve the accuracy of the MSQ estimates. Participants (n = 63 [15M and 48F], age: 56.6 ± 7.3 years) wore an accelerometer on the hip for a 7-day period and completed the MSQ. Sedentary behaviour (SB) estimates were computed as min/day for both the MSQ and accelerometer. Associations between the two methods were examined using the Pearson correlation and agreement was assessed using a Bland-Altman plot. A linear prediction model was developed to improve the accuracy of the MSQ estimates using a selection of predictor variables routinely collected in MS research. There was a moderate correlation between MSQ and accelerometer SB estimates (r = 0.34, p < 0.01). The Bland-Altman plot indicated that the MSQ overestimated SB (mean bias: 80.54 min/day, 95% limits of agreement: -410.5 to 571.5 min/day). The prediction model improved the MSQ estimates by 39% and virtually eliminated measurement bias (mean bias:-0.21 min/day; 95% limits of agreement:-109.8 to 109.4 min/day). The results indicate preliminary evidence for the validity of the MSQ in people with MS, and support the application of an alternative prediction model to improve the accuracy of the MSQ estimates. Abbreviations: SB = sedentary behaviour; MS = multiple sclerosis; MSQ = Marshall Sitting Questionnaire; PA = physical activity; EDSS = Expanded Disability Status Scale; LPA = light physical activity; MVPA = moderate-to-vigorous physical activity; GLTEQ = Godin Leisure Time Exercise Questionnaire; PDDS = Patient-Determined Disease Steps; RMSE = root mean square error.
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Affiliation(s)
- Jeffer Eidi Sasaki
- a Department of Physical Therapy , University of Alabama at Birmingham , Birmingham , AL , USA.,b Graduate Program in Physical Education , Federal University of Triangulo Mineiro , Uberaba , MG , Brazil
| | - Robert W Motl
- a Department of Physical Therapy , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Edward McAuley
- c Department of Kinesiology and Community Health and The Beckman Institute for Advanced Science and Technology , University of Illinois at Urbana-Champaign , Urbana , IL , USA
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Dempsey PC, Hadgraft NT, Winkler EAH, Clark BK, Buman MP, Gardiner PA, Owen N, Lynch BM, Dunstan DW. Associations of context-specific sitting time with markers of cardiometabolic risk in Australian adults. Int J Behav Nutr Phys Act 2018; 15:114. [PMID: 30458790 PMCID: PMC6245709 DOI: 10.1186/s12966-018-0748-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 11/05/2018] [Indexed: 12/25/2022] Open
Abstract
Background High volumes of sitting time are associated with an elevated risk of type 2 diabetes and cardiovascular disease, and with adverse cardiometabolic risk profiles. However, previous studies have predominately evaluated only total sitting or television (TV) viewing time, limiting inferences about the specific cardiometabolic health impacts of sitting accumulated in different contexts. We examined associations of sitting time in four contexts with cardiometabolic risk biomarkers in Australian adults. Methods Participants (n = 3429; mean ± SD age 58 ± 10 years) were adults without clinically diagnosed diabetes or cardiovascular disease from the 2011–2012 Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Multiple linear regressions examined associations of self-reported context-specific sitting time (occupational, transportation, TV-viewing and leisure-time computer use) with a clustered cardiometabolic risk score (CMR) and with individual cardiometabolic risk biomarkers (waist circumference, BMI, resting blood pressure, triglycerides, HDL- and LDL-cholesterol, and fasting and 2-h post-load plasma glucose). Results Higher CMR was significantly associated with greater TV-viewing and computer sitting time (b [95%CI] = 0.07 [0.04, 0.09] and 0.06 [0.03, 0.09]), and tended to be associated with higher occupational and transport sitting time (0.01 [− 0.01, 0.03] and 0.03 [− 0.00, 0.06]), after adjustment for potential confounders. Furthermore, keeping total sitting time constant, accruing sitting via TV-viewing and computer use was associated with significantly higher CMR (0.05 [0.02, 0.08] and 0.04 [0.01, 0.06]), accruing sitting in an occupational context was associated with significantly lower CMR (− 0.03 [− 0.05, − 0.01]), while no significant association was seen for transport sitting (0.00 [− 0.03, 0.04]). Results varied somewhat between the respective biomarkers; however, higher sitting time in each domain tended to be associated detrimentally with individual biomarkers except for fasting glucose (non-significant associations) and systolic blood pressure (a beneficial association was observed). Overall, associations were stronger for TV-viewing and computer use, and weaker for occupational sitting. Conclusions Higher context-specific sitting times tended to be detrimentally associated, albeit modestly, with CMR and several cardiometabolic risk biomarkers. There was some evidence suggesting that the context in which people sit is relevant above and beyond total sitting time. Methodological issues notwithstanding, these findings may assist in identifying priorities for sitting-reduction initiatives, in order to achieve optimal cardiometabolic health benefits. Electronic supplementary material The online version of this article (10.1186/s12966-018-0748-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Paddy C Dempsey
- Physical Activity, Metabolic & Vascular Physiology and Behavioural Epidemiology Laboratories, Baker Heart and Diabetes Institute, Level 4, 99 Commercial Rd, Melbourne, VIC, 3004, Australia. .,Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia. .,MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
| | - Nyssa T Hadgraft
- Physical Activity, Metabolic & Vascular Physiology and Behavioural Epidemiology Laboratories, Baker Heart and Diabetes Institute, Level 4, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.,Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia.,School of Public Health/Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia
| | - Elisabeth A H Winkler
- School of Public Health/Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia
| | - Bronwyn K Clark
- School of Public Health/Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia
| | - Matthew P Buman
- College of Health Solutions, Arizona State University, 550 N 3rd Street, Phoenix, AZ, 85004, USA
| | - Paul A Gardiner
- School of Public Health/Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia
| | - Neville Owen
- Physical Activity, Metabolic & Vascular Physiology and Behavioural Epidemiology Laboratories, Baker Heart and Diabetes Institute, Level 4, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.,Centre for Urban Transitions, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Brigid M Lynch
- Physical Activity, Metabolic & Vascular Physiology and Behavioural Epidemiology Laboratories, Baker Heart and Diabetes Institute, Level 4, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, 3004, Australia
| | - David W Dunstan
- Physical Activity, Metabolic & Vascular Physiology and Behavioural Epidemiology Laboratories, Baker Heart and Diabetes Institute, Level 4, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.,School of Public Health/Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia.,Central Clinical School/Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.,Institute of Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia.,Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, VIC, Australia.,School of Sport Science, Exercise and Health, The University of Western Australia, Perth, WA, Australia
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Susanto M, Hubbard RE, Gardiner PA. Association of 12-Year Trajectories of Sitting Time With Frailty in Middle-Aged Women. Am J Epidemiol 2018; 187:2387-2396. [PMID: 29868880 DOI: 10.1093/aje/kwy111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 05/14/2018] [Indexed: 12/29/2022] Open
Abstract
Prolonged sitting time is associated with several health outcomes; limited evidence indicates associations with frailty. Our aims in this study were to identify patterns of sitting time over 12 years in middle-aged (ages 50-55 years) women and examine associations of these patterns with frailty in older age. We examined 5,462 women born in 1946-1951 from the Australian Longitudinal Study on Women's Health who provided information on sociodemographic attributes, daily sitting time, and frailty in 2001 and then again every 3 years until 2013. Frailty was assessed using the FRAIL (fatigue, resistance, ambulation, illness, loss of weight) scale (0 = healthy; 1-2 = prefrail; 3-5 = frail), and group-based trajectory analyses identified trajectories of sitting time. We identified 5 sitting-time trajectories: low (26.9%), medium (43.1%; referent), increasing (6.9%), decreasing (18.1%), and high (4.8%). In adjusted models, the likelihoods of being frail were statistically higher for women in the increasing (odds ratio (OR) = 1.29, 95% confidence interval (CI): 1.03, 1.61) and high (OR = 1.42, 95% CI: 1.10, 1.84) trajectories. In contrast, women in the low trajectory group were less likely to be frail (OR = 0.86, 95% CI: 0.75, 0.98), and there was no difference in the likelihood of frailty in the decreasing trajectory group. Our study suggests that patterns of sitting time over 12 years in middle-aged women predict frailty in older age.
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Affiliation(s)
- Maja Susanto
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- The Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Ruth E Hubbard
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- The Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Paul A Gardiner
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
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Edwardson CL, Biddle SJH, Clarke-Cornwell A, Clemes S, Davies MJ, Dunstan DW, Eborall H, Granat MH, Gray LJ, Healy GN, Richardson G, Yates T, Munir F. A three arm cluster randomised controlled trial to test the effectiveness and cost-effectiveness of the SMART Work & Life intervention for reducing daily sitting time in office workers: study protocol. BMC Public Health 2018; 18:1120. [PMID: 30217233 PMCID: PMC6137871 DOI: 10.1186/s12889-018-6017-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 09/04/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Office-based workers typically spend 70-85% of working hours, and a large proportion of leisure time, sitting. High levels of sitting have been linked to poor health. There is a need for fully powered randomised controlled trials (RCTs) with long-term follow-up to test the effectiveness of interventions to reduce sitting. This paper describes the methodology of a three-arm cluster RCT designed to determine the effectiveness and cost-effectiveness of the SMART Work & Life intervention, delivered with and without a height-adjustable desk, for reducing daily sitting. METHODS/DESIGN A three-arm cluster RCT of 33 clusters (660 council workers) will be conducted in three areas in England (Leicester; Manchester; Liverpool). Office groups (clusters) will be randomised to the SMART Work & Life intervention delivered with (group 1) or without (group 2) a height-adjustable desk or a control group (group 3). SMART Work & Life includes organisational (e.g., management buy-in, provision/support for standing meetings), environmental (e.g., relocating waste bins, printers), and group/individual (education, action planning, goal setting, addressing barriers, coaching, self-monitoring, social support) level behaviour change strategies, with strategies driven by workplace champions. Baseline, 3, 12 and 24 month measures will be taken. PRIMARY OUTCOME Objectively measured daily sitting time (activPAL3). SECONDARY OUTCOMES objectively measured sitting, standing, stepping, prolonged sitting and moderate-to-vigorous physical activity time and number of steps at work and daily; objectively measured sleep (wrist accelerometry). Adiposity, blood pressure, fasting glucose, glycated haemoglobin, cholesterol (total, HDL, LDL) and triglycerides will be assessed from capillary blood samples. Questionnaires will examine dietary intake, fatigue, musculoskeletal issues, job performance and satisfaction, work engagement, occupational and general fatigue, stress, presenteeism, anxiety and depression and sickness absence (organisational records). Quality of life and resources used (e.g. GP visits, outpatient attendances) will also be assessed. We will conduct a full process evaluation and cost-effectiveness analysis. DISCUSSION The results of this RCT will 1) help to understand how effective an important simple, yet relatively expensive environmental change is for reducing sitting, 2) provide evidence on changing behaviour across all waking hours, and 3) provide evidence for policy guidelines around population and workplace health and well-being. TRIAL REGISTRATION ISRCTN11618007 . Registered on 21 January 2018.
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Affiliation(s)
- Charlotte L. Edwardson
- Diabetes Research Centre, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Stuart J. H. Biddle
- Institute for Resilient Regions, University of Southern Queensland, Springfield Central, QLD Australia
| | | | - Stacy Clemes
- NIHR Leicester Biomedical Research Centre, Leicester, UK
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
| | - Melanie J. Davies
- Diabetes Research Centre, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
| | - David W. Dunstan
- Baker Heart and Diabetes Institute, Melbourne, VIC Australia
- School of Public Health, The University of Queensland, Brisbane, QLD Australia
- Department of Medicine, Monash University, Melbourne, VIC Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC Australia
- School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC Australia
- School of Sport Science, Exercise and Health, The University of Western Australia, Perth, WA Australia
- Mary MacKillop Institute for Health Research, The Australian Catholic University, Melbourne, VIC Australia
| | - Helen Eborall
- Department of Health Sciences, University of Leicester, Leicester, UK
| | | | - Laura J. Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Genevieve N. Healy
- Baker Heart and Diabetes Institute, Melbourne, VIC Australia
- School of Public Health, The University of Queensland, Brisbane, QLD Australia
- Faculty of Health Sciences, School of Physiotherapy, Curtin University, Perth, WA Australia
| | | | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
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Stamatakis E, Gill JMR. Sitting behaviour and physical activity: two sides of the same cardiovascular health coin? Br J Sports Med 2018; 53:852-853. [DOI: 10.1136/bjsports-2018-099640] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2018] [Indexed: 01/11/2023]
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McKeough Z, Cheng SWM, Alison J, Jenkins C, Hamer M, Stamatakis E. Low leisure-based sitting time and being physically active were associated with reduced odds of death and diabetes in people with chronic obstructive pulmonary disease: a cohort study. J Physiother 2018; 64:114-120. [PMID: 29574168 DOI: 10.1016/j.jphys.2018.02.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/07/2017] [Accepted: 02/15/2018] [Indexed: 02/04/2023] Open
Abstract
QUESTIONS In people with chronic obstructive pulmonary disease (COPD), are activity phenotypes (based on physical activity and recreational screen time) associated with mortality and cardiometabolic risk factors? DESIGN Cohort study. PARTICIPANTS People with COPD aged≥40years and who were current or ex-smokers were identified from the 2003 Scottish Health Survey. OUTCOME MEASURES Data were collected regarding demographics, anthropometric measurements, medical history, physical activity, sedentary behaviour, health outcomes, and mortality. ANALYSIS Participants were categorised into one of the following activity phenotypes: 'couch potatoes' were those who were insufficiently active with high leisure-based sitting time and/or no domestic physical activity; 'light movers' were insufficiently active with some domestic physical activity; 'sedentary exercisers' were sufficiently active with high leisure-based sitting time; and 'busy bees' were sufficiently active with low leisure-based sitting time. 'Sufficiently active' was defined as adhering to physical activity (PA) recommendations of≥7.5 metabolic equivalent (MET) hours/week. 'Low leisure-based sitting time' was defined as≤200minutes of recreational screen time/day. RESULTS The 584 participants had a mean age of 64 years (SD 12) and 52% were male. Over 5.5 years (SD 1.3) of follow-up, there were 81 all-cause deaths from 433 COPD participants with available data. Compared to the 'couch potatoes', there was a reduced risk of all-cause mortality in the 'busy bees' (Hazard Ratio 0.26, 95% CI 0.11 to 0.65) with a trend towards a reduction in mortality risk in the other phenotypes. The odds of diabetes were lower in the 'busy bees' compared to the 'couch potatoes' (OR 0.14, 95% CI 0.03 to 0.67). CONCLUSIONS Adhering to physical activity guidelines and keeping leisure-based sitting time low had a mortality benefit and lowered the odds of diabetes in people with COPD. [McKeough Z, Cheng SWM, Alison J, Jenkins C, Hamer M, Stamatakis E (2018) Low leisure-based sitting time and being physically active were associated with reduced odds of death and diabetes in people with chronic obstructive pulmonary disease: a cohort study. Journal of Physiotherapy 64: 114-120].
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Affiliation(s)
- Zoe McKeough
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney
| | - Sonia Wing Mei Cheng
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney
| | - Jennifer Alison
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney; Allied Health Professorial Unit, Sydney Local Health District
| | - Christine Jenkins
- Department of Thoracic Medicine, Concord Hospital, Sydney, Australia
| | - Mark Hamer
- University of Loughborough, United Kingdom
| | - Emmanuel Stamatakis
- School of Public Health, Charles Perkins Centre, The University of Sydney, Sydney, Australia
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Rivière F, Aubert S, Omorou AY, Ainsworth BE, Vuillemin A. Taxonomy-based content analysis of sedentary behavior questionnaires: A systematic review. PLoS One 2018; 13:e0193812. [PMID: 29509791 PMCID: PMC5839579 DOI: 10.1371/journal.pone.0193812] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 02/19/2018] [Indexed: 11/18/2022] Open
Abstract
Background Health effects of sedentary behaviors (SB) may vary depending on their characteristics such as type, purpose, duration, and intensity of the behavior. While a growing number of questionnaires assess sedentary behaviors, it is unclear which characteristics of SB are measured. The aim of this review was to examine the content of self-report SB questionnaires. Methods Three databases were searched for sedentary behavior questionnaires published before January 1st, 2016. Based on the inclusion criteria, 82 articles out of 1369 were retrieved for a total of 60 questionnaires. For each questionnaire, the sedentary behavior characteristics identified were reported and analyzed. Results Most of the questionnaires assessed the time (n = 60), posture (n = 54), purpose (n = 46) and the types (n = 45) of SB performed. Fewer questionnaires assessed the environment (n = 20) social context (n = 11), status (n = 2), and associated behaviors (n = 2) related to sedentary behaviors. All the questionnaires except two assessed time spent in SB with 17 assessing frequency and 6 assessing breaks in SB. The most frequent characteristics identified in the questionnaires were the categories of sitting (90%), a day (95%), watching television (65%) and using a computer (55%). Many characteristics of SB were not measured. Conclusions By knowing the breadth of SB included in questionnaires, this review provides support to shape the design of new questionnaires designed to reduce the gaps in measuring sedentary behaviors.
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Affiliation(s)
- Fabien Rivière
- EA 4360 APEMAC, University of Lorraine, Paris Descartes University, Nancy, France
| | - Salomé Aubert
- Healthy Active Living and Obesity Research, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Abdou Yacoubou Omorou
- EA 4360 APEMAC, University of Lorraine, Paris Descartes University, Nancy, France
- INSERM, CIC-1433 Clinical Epidemiology, CHRU Nancy, France
| | - Barbara E. Ainsworth
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States of America
| | - Anne Vuillemin
- EA 4360 APEMAC, University of Lorraine, Paris Descartes University, Nancy, France
- Université Côte d’Azur, LAMHESS, Nice, France
- * E-mail:
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Uijtdewilligen L, Yin JDC, van der Ploeg HP, Müller-Riemenschneider F. Correlates of occupational, leisure and total sitting time in working adults: results from the Singapore multi-ethnic cohort. Int J Behav Nutr Phys Act 2017; 14:169. [PMID: 29237471 PMCID: PMC5729286 DOI: 10.1186/s12966-017-0626-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 12/03/2017] [Indexed: 11/21/2022] Open
Abstract
Background Evidence on the health risks of sitting is accumulating. However, research identifying factors influencing sitting time in adults is limited, especially in Asian populations. This study aimed to identify socio-demographic and lifestyle correlates of occupational, leisure and total sitting time in a sample of Singapore working adults. Methods Data were collected between 2004 and 2010 from participants of the Singapore Multi Ethnic Cohort (MEC). Medical exclusion criteria for cohort participation were cancer, heart disease, stroke, renal failure and serious mental illness. Participants who were not working over the past 12 months and without data on sitting time were excluded from the analyses. Multivariable regression analyses were used to examine cross-sectional associations of self-reported age, gender, ethnicity, marital status, education, smoking, caloric intake and moderate-to-vigorous leisure time physical activity (LTPA) with self-reported occupational, leisure and total sitting time. Correlates were also studied separately for Chinese, Malays and Indians. Results The final sample comprised 9384 participants (54.8% male): 50.5% were Chinese, 24.0% Malay, and 25.5% Indian. For the total sample, mean occupational sitting time was 2.71 h/day, mean leisure sitting time was 2.77 h/day and mean total sitting time was 5.48 h/day. Sitting time in all domains was highest among Chinese. Age, gender, education, and caloric intake were associated with higher occupational sitting time, while ethnicity, marital status and smoking were associated with lower occupational sitting time. Marital status, smoking, caloric intake and LTPA were associated with higher leisure sitting time, while age, gender and ethnicity were associated with lower leisure sitting time. Gender, marital status, education, caloric intake and LTPA were associated with higher total sitting time, while ethnicity was associated with lower total sitting time. Stratified analyses revealed different associations within sitting domains for Indians compared to Chinese and Malays. Conclusion Our findings highlight the need to focus on separate domains of sitting (occupational, leisure or total) when identifying which factors determine this behavior, and that the content of intervention programs should be tailored to domain-specific sitting rather than to sitting in general. Finally, our study showed ethnic differences and therefore we recommend to culturally target interventions.
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Affiliation(s)
- Léonie Uijtdewilligen
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Jason Dean-Chen Yin
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Hidde P van der Ploeg
- Department of Public & Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands.,Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore. .,Institute for Social Medicine, Epidemiology and Health Economics, Charite University Medical Centre Berlin, Berlin, Germany. .,Saw Swee Hock School of Public Health and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore.
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Prince SA, LeBlanc AG, Colley RC, Saunders TJ. Measurement of sedentary behaviour in population health surveys: a review and recommendations. PeerJ 2017; 5:e4130. [PMID: 29250468 PMCID: PMC5729819 DOI: 10.7717/peerj.4130] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 11/14/2017] [Indexed: 01/06/2023] Open
Abstract
Background The purpose of this review was to determine the most valid and reliable questions for targeting key modes of sedentary behaviour (SB) in a broad range of national and international health surveillance surveys. This was done by reviewing the SB modules currently used in population health surveys, as well as examining SB questionnaires that have performed well in psychometric testing. Methods Health surveillance surveys were identified via scoping review and contact with experts in the field. Previous systematic reviews provided psychometric information on pediatric questionnaires. A comprehensive search of four bibliographic databases was used to identify studies reporting psychometric information for adult questionnaires. Only surveys/studies published/used in English or French were included. Results The review identified a total of 16 pediatric and 18 adult national/international surveys assessing SB, few of which have undergone psychometric testing. Fourteen pediatric and 35 adult questionnaires with psychometric information were included. While reliability was generally good to excellent for questions targeting key modes of SB, validity was poor to moderate, and reported much less frequently. The most valid and reliable questions targeting specific modes of SB were combined to create a single questionnaire targeting key modes of SB. Discussion Our results highlight the importance of including SB questions in survey modules that are adaptable, able to assess various modes of SB, and that exhibit adequate reliability and validity. Future research could investigate the psychometric properties of the module we have proposed in this paper, as well as other questionnaires currently used in national and international population health surveys.
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Affiliation(s)
- Stephanie A Prince
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.,Current affiliation: Centre for Surveillance and Applied Research, Public Health Agency of Canada
| | - Allana G LeBlanc
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Rachel C Colley
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada
| | - Travis J Saunders
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
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Ishii K, Shibata A, Kurita S, Yano S, Inoue S, Sugiyama T, Owen N, Oka K. Validity and Reliability of Japanese-Language Self-reported Measures for Assessing Adults Domain-Specific Sedentary Time. J Epidemiol 2017; 28:149-155. [PMID: 29093359 PMCID: PMC5821692 DOI: 10.2188/jea.je20170002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Good quality measures of Japanese adults' sedentary behaviors are needed to accurately assess correlates of specific sedentary behaviors. The present study assessed criterion validity of total sedentary behavior and test-retest reliability of six domain-specific sedentary behaviors. METHODS We administered a questionnaire, based on previous studies, that measured domain-specific sedentary behaviors. To examine validity, agreement between self-reported time spent in sedentary behaviors from the questionnaire and objectively-measured sedentary time using accelerometers was compared among 392 adults (aged 40-64 years) in two Japanese cities. For reliability, a 2-week interval test-retest was administered to a convenience sample of 34 participants. RESULTS The correlation between total self-reported and objectively measured sedentary time was significant (all P < 0.001) and fair-to-good for workdays (ρ = 0.57) and whole week (ρ = 0.49), but was low for non-workdays (ρ = 0.23). The difference between the two measures was significant for whole week (z = -2.25, P = 0.03) and non-workdays (z = -5.50, P < 0.001), but was not significant for workdays (z = -0.60, P = 0.55). There was a significant positive association between the difference in the two measures and the average of these two measures (workdays: r = 0.53; non-workdays: r = 0.45; and whole week: r = 0.54, all P < 0.001). There was fair-to-good test-retest reliability of total sedentary time for each domain (workdays: interclass correlation coefficient [ICC] = 0.77, non-workdays: ICC = 0.53, and whole week: ICC = 0.7; all P < 0.01). CONCLUSIONS The scale of domain-specific sedentary behaviors is reliable for estimating where and for what purpose Japanese adults spend their sedentary time, and total sedentary time is valid for workdays and the whole week.
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Affiliation(s)
- Kaori Ishii
- Faculty of Sport Sciences, Waseda University
| | - Ai Shibata
- Faculty of Health and Sport Sciences, University of Tsukuba
| | | | - Shohei Yano
- Graduate School of Sport Sciences, Waseda University
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University
| | - Takemi Sugiyama
- Institute for Health & Ageing, Australian Catholic University
| | - Neville Owen
- Swinburne University of Technology.,Behavioural Epidemiology Laboratory, Baker IDI Heart and Diabetes Institute
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GRACE MEGANSTACEY, DILLON FRANCIS, BARR ELIZABETHLM, KEADLE SARAHK, OWEN NEVILLE, DUNSTAN DAVIDW. Television Viewing Time and Inflammatory-Related Mortality. Med Sci Sports Exerc 2017; 49:2040-2047. [DOI: 10.1249/mss.0000000000001317] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Copeland JL, Ashe MC, Biddle SJ, Brown WJ, Buman MP, Chastin S, Gardiner PA, Inoue S, Jefferis BJ, Oka K, Owen N, Sardinha LB, Skelton DA, Sugiyama T, Dogra S. Sedentary time in older adults: a critical review of measurement, associations with health, and interventions. Br J Sports Med 2017; 51:1539. [PMID: 28724714 DOI: 10.1136/bjsports-2016-097210] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 06/21/2017] [Accepted: 06/21/2017] [Indexed: 12/21/2022]
Abstract
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.
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Affiliation(s)
| | - Maureen C Ashe
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | | | | | | | | | | | - Neville Owen
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Swinburne University of Technology, Melbourne, Australia
| | - Luís B Sardinha
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal
| | | | | | - Shilpa Dogra
- University of Ontario Institute of Technology, Oshawa, Ontario, Canada
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Dogra S, Ashe MC, Biddle SJH, Brown WJ, Buman MP, Chastin S, Gardiner PA, Inoue S, Jefferis BJ, Oka K, Owen N, Sardinha LB, Skelton DA, Sugiyama T, Copeland JL. Sedentary time in older men and women: an international consensus statement and research priorities. Br J Sports Med 2017; 51:1526-1532. [PMID: 28724710 PMCID: PMC5738599 DOI: 10.1136/bjsports-2016-097209] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2017] [Indexed: 01/12/2023]
Abstract
Sedentary time is a modifiable determinant of poor health, and in older adults, reducing sedentary time may be an important first step in adopting and maintaining a more active lifestyle. The primary purpose of this consensus statement is to provide an integrated perspective on current knowledge and expert opinion pertaining to sedentary behaviour in older adults on the topics of measurement, associations with health outcomes, and interventions. A secondary yet equally important purpose is to suggest priorities for future research and knowledge translation based on gaps identified. A five-step Delphi consensus process was used. Experts in the area of sedentary behaviour and older adults (n=15) participated in three surveys, an in-person consensus meeting, and a validation process. The surveys specifically probed measurement, health outcomes, interventions, and research priorities. The meeting was informed by a literature review and conference symposium, and it was used to create statements on each of the areas addressed in this document. Knowledge users (n=3) also participated in the consensus meeting. Statements were then sent to the experts for validation. It was agreed that self-report tools need to be developed for understanding the context in which sedentary time is accumulated. For health outcomes, it was agreed that the focus of sedentary time research in older adults needs to include geriatric-relevant health outcomes, that there is insufficient evidence to quantify the dose–response relationship, that there is a lack of evidence on sedentary time from older adults in assisted facilities, and that evidence on the association between sedentary time and sleep is lacking. For interventions, research is needed to assess the impact that reducing sedentary time, or breaking up prolonged bouts of sedentary time has on geriatric-relevant health outcomes. Research priorities listed for each of these areas should be considered by researchers and funding agencies. 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.
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Affiliation(s)
- Shilpa Dogra
- University of Ontario Institute of Technology, Oshawa, Ontario, Canada
| | - Maureen C Ashe
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Stuart J H Biddle
- Victoria University, Melbourne, Australia.,University of Southern Queensland, Springfield, Australia
| | | | | | - Sebastien Chastin
- Glasgow Caledonian University, Glasgow, UK.,Ghent University, Ghent, Belgium
| | | | | | | | | | - Neville Owen
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Swinburne University of Technology, Melbourne, Australia
| | - Luís B Sardinha
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
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Stamatakis E, Pulsford RM, Brunner EJ, Britton AR, Bauman AE, Biddle SJ, Hillsdon M. Sitting behaviour is not associated with incident diabetes over 13 years: the Whitehall II cohort study. Br J Sports Med 2017; 51:818-823. [PMID: 28465446 DOI: 10.1136/bjsports-2016-096723] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although certain types of sedentary behaviour have been linked to metabolic risk, prospective studies describing the links between sitting with incident diabetes are scarce and often do not account for baseline adiposity. We investigate the associations between context-specific sitting and incident diabetes in a cohort of mid-aged to older British civil servants. METHODS Using data from the Whitehall II study (n=4811), Cox proportional hazards models (adjusted for age, sex, ethnicity, employment grade, smoking, alcohol intake, fruit and vegetable consumption, self-rated health, physical functioning, walking and moderate-to-vigorous physical activity, and body mass index (BMI)) were fitted to examine associations between total sitting and context-specific sitting time (work, television (TV), non-TV leisure time sitting at home) at phase 5 (1997-1999) and fasting glucose-defined incident diabetes up to 2011. RESULTS Total sitting (HR of the top compared with the bottom group: 1.26; 95% CI 1.00 to 1.62; p=0.01) and TV sitting (1.33; 95% CI 1.03 to 1.88; p=0.05) showed associations with incident diabetes; once BMI was included in the model these associations were attenuated for both total sitting (1.19; 95% CI 0.92 to 1.55; p=0.22) and TV sitting (1.31; 95% CI 0.96 to 1.76; p=0.14). CONCLUSION We found limited evidence linking sitting and incident diabetes over 13 years in this occupational cohort of civil servants.
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Affiliation(s)
- Emmanuel Stamatakis
- Charles Perkins Centre, School of Public Health, University of Sydney, Sydney, Australia.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Richard M Pulsford
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Eric J Brunner
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Annie R Britton
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Adrian E Bauman
- Charles Perkins Centre, School of Public Health, University of Sydney, Sydney, Australia
| | - Stuart Jh Biddle
- Institute of Sport, Exercise & Active Living (ISEAL), Victoria University, Melbourne, Australia
| | - Melvyn Hillsdon
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
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Aguilar-Farias N, Leppe Zamora J. Is a single question of the Global Physical Activity Questionnaire (GPAQ) valid for measuring sedentary behaviour in the Chilean population? J Sports Sci 2016; 35:1652-1657. [PMID: 27607078 DOI: 10.1080/02640414.2016.1229010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A study was conducted to assess the validity of the Global Physical Activity Questionnaire (GPAQ) for measuring sedentary behaviour (SB) in the Chilean adult population. About 217 adults (93/124 male/female, 43.8 ± 15.75 years) who were randomly selected during National Health Survey 2009-2010 completed the protocol. The participants wore an ActiGraph GT3X (AG) for 7 consecutive days and then completed the GPAQ (single-item question for measuring time spent sitting in a usual day). Validity was examined using Spearman's correlation, mean bias and limits of agreement (LoA), with AG (vertical axis <100 counts · min-1) as the reference standard for estimates of SB in bouts of 1 (AG1), 5 (AG5) and 10 (AG10) min. Agreement between the GPAQ and AG for classifying data into quartiles and tertiles was assessed with kappa method. The GPAQ showed fair correlation with AG1, AG5 and AG10 (range = 0.23-0.26), with large mean biases (range = -293.9, -76.12 min · day-1). Agreement between the GPAQ and AG1, AG5 and AG10 was poor for categorising time spent in SB into tertiles and quartiles. The single question from the GPAQ has shown fair validity for measuring SB and poor ability for correctly classifying individuals into tertiles or quartiles of SB in a Chilean population.
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Affiliation(s)
- Nicolas Aguilar-Farias
- a Departamento de Educacion Fisica, Deportes y Recreacion , Universidad de La Frontera , Temuco , Chile.,b School of Human Movement and Nutrition Sciences , The University of Queensland , Brisbane , Australia
| | - Jaime Leppe Zamora
- c Carrera de Kinesiologia, Facultad de Medicina Clinica Alemana Universidad del Desarrollo , Santiago , Chile
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Pedersen SJ, Kitic CM, Bird ML, Mainsbridge CP, Cooley PD. Is self-reporting workplace activity worthwhile? Validity and reliability of occupational sitting and physical activity questionnaire in desk-based workers. BMC Public Health 2016; 16:836. [PMID: 27542603 PMCID: PMC4992189 DOI: 10.1186/s12889-016-3537-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 08/17/2016] [Indexed: 12/20/2022] Open
Abstract
Background With the advent of workplace health and wellbeing programs designed to address prolonged occupational sitting, tools to measure behaviour change within this environment should derive from empirical evidence. In this study we measured aspects of validity and reliability for the Occupational Sitting and Physical Activity Questionnaire that asks employees to recount the percentage of work time they spend in the seated, standing, and walking postures during a typical workday. Methods Three separate cohort samples (N = 236) were drawn from a population of government desk-based employees across several departmental agencies. These volunteers were part of a larger state-wide intervention study. Workplace sitting and physical activity behaviour was measured both subjectively against the International Physical Activity Questionnaire, and objectively against ActivPal accelerometers before the intervention began. Criterion validity and concurrent validity for each of the three posture categories were assessed using Spearman’s rank correlation coefficients, and a bias comparison with 95 % limits of agreement. Test-retest reliability of the survey was reported with intraclass correlation coefficients. Results Criterion validity for this survey was strong for sitting and standing estimates, but weak for walking. Participants significantly overestimated the amount of walking they did at work. Concurrent validity was moderate for sitting and standing, but low for walking. Test-retest reliability of this survey proved to be questionable for our sample. Conclusions Based on our findings we must caution occupational health and safety professionals about the use of employee self-report data to estimate workplace physical activity. While the survey produced accurate measurements for time spent sitting at work it was more difficult for employees to estimate their workplace physical activity.
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Affiliation(s)
- Scott J Pedersen
- Active Work Laboratory, Faculty of Education, University of Tasmania, Newnham Dr., Launceston, TAS 7250, Australia.
| | - Cecilia M Kitic
- School of Health Sciences, Faculty of Health, University of Tasmania, Hobart, Australia
| | - Marie-Louise Bird
- School of Health Sciences, Faculty of Health, University of Tasmania, Hobart, Australia
| | - Casey P Mainsbridge
- Active Work Laboratory, Faculty of Education, University of Tasmania, Newnham Dr., Launceston, TAS 7250, Australia
| | - P Dean Cooley
- Active Work Laboratory, Faculty of Education, University of Tasmania, Newnham Dr., Launceston, TAS 7250, Australia
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Mensah K, Maire A, Oppert JM, Dugas J, Charreire H, Weber C, Simon C, Nazare JA. Assessment of sedentary behaviors and transport-related activities by questionnaire: a validation study. BMC Public Health 2016; 16:753. [PMID: 27506456 PMCID: PMC4977835 DOI: 10.1186/s12889-016-3412-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 07/29/2016] [Indexed: 12/03/2022] Open
Abstract
Background Comprehensive assessment of sedentary behavior (SB) and physical activity (PA), including transport-related activities (TRA), is required to design innovative PA promotion strategies. There are few validated instruments that simultaneously assess the different components of human movement according to their context of practice (e.g. work, transport, leisure). We examined test-retest reliability and validity of the Sedentary, Transportation and Activity Questionnaire (STAQ), a newly developed questionnaire dedicated to assessing context-specific SB, TRA and PA. Methods Ninety six subjects (51 women) kept a contextualized activity-logbook and wore a hip accelerometer (Actigraph GT3X + TM) for a 7-day or 14-day period, at the end of which they completed the STAQ. Activity-energy expenditure was measured in a subgroup of 45 subjects using the double labeled water (DLW) method. Test-retest reliability was assessed using intra-class-coefficients (ICC) in a subgroup of 32 subjects who filled the questionnaire twice one month apart. Accelerometry was annotated using the logbook to obtain total and context-specific objective estimates of SB. Spearman correlations, Bland-Altman plots and ICC were used to analyze validity with logbook, accelerometry and DLW data validity criteria. Results Test-retest reliability was fair for total sitting time (ICC = 0.52), good to excellent for work sitting time (ICC = 0.71), transport-related walking (ICC = 0.61) and car use (ICC = 0.67), and leisure screen-related SB (ICC = 0.64-0.79), but poor for total sitting time during leisure and transport-related contexts. For validity, compared to accelerometry, significant correlations were found for STAQ estimates of total (r = 0.54) and context-specific sitting times with stronger correlations for work sitting time (r = 0.88), and screen times (TV/DVD viewing: r = 0.46; other screens: r = 0.42) than for transport (r = 0.35) or leisure-related sitting-times (r = 0.19). Compared to contextualized logbook, STAQ estimates of TRA was higher for car (r = 0.65) than for active transport (r = 0.41). The questionnaire generally overestimated work- and leisure-related SB and sitting times, while it underestimated total and transport-related sitting times. Conclusions The STAQ showed acceptable reliability and a good ranking validity for assessment of context-specific SB and TRA. This instrument appears as a useful tool to study SB, TRA and PA in context in adults. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3412-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Keitly Mensah
- CRNH Rhône-Alpes/CENS, Hospices Civils de Lyon, Lyon, France
| | - Aurélia Maire
- CRNH Rhône-Alpes/CENS, Hospices Civils de Lyon, Lyon, France.,Univ-Lyon, CarMeN laboratory, Inserm U1060, INRA U1397, Université Claude Bernard Lyon 1, INSA Lyon, Charles Merieux Medical School, Fr-69600, Oullins, France, Lyon, France
| | - Jean-Michel Oppert
- Université Paris 13, Sorbonne Paris Cité - EREN (Equipe de Recherche en Epidémiologie Nutritionnelle), U1153 Inserm, Inra, Cnam, Centre de Recherche en Epidémiologie et, Biostatistiques, CRNH IdF, Bobigny, France.,Department of Nutrition Pitié-Salpêtrière Hospital (AP-HP), Université Pierre et Marie Curie-Paris 6, Paris, France
| | - Julien Dugas
- CRNH Rhône-Alpes/CENS, Hospices Civils de Lyon, Lyon, France.,Univ-Lyon, CarMeN laboratory, Inserm U1060, INRA U1397, Université Claude Bernard Lyon 1, INSA Lyon, Charles Merieux Medical School, Fr-69600, Oullins, France, Lyon, France
| | | | - Christiane Weber
- Laboratoire Image, Ville et Environnement, Université de Strasbourg, Strasbourg, France
| | - Chantal Simon
- CRNH Rhône-Alpes/CENS, Hospices Civils de Lyon, Lyon, France. .,Univ-Lyon, CarMeN laboratory, Inserm U1060, INRA U1397, Université Claude Bernard Lyon 1, INSA Lyon, Charles Merieux Medical School, Fr-69600, Oullins, France, Lyon, France. .,Service d'Endocrinologie, Diabète, Nutrition Centre Hospitalier Lyon Sud, 165 Chemin du Grand Revoyet, F69310, Pierre-Bénite, France.
| | - Julie-Anne Nazare
- CRNH Rhône-Alpes/CENS, Hospices Civils de Lyon, Lyon, France.,Univ-Lyon, CarMeN laboratory, Inserm U1060, INRA U1397, Université Claude Bernard Lyon 1, INSA Lyon, Charles Merieux Medical School, Fr-69600, Oullins, France, Lyon, France
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