Objectively measured patterns of sedentary time and physical activity in young adults of the Raine study cohort

Protocol for a Study Investigating Context-Specific Sedentary Behaviors and Cardiometabolic Health in College-Based Young Adults (CONTEXT-SB)

Background

Sedentary behavior (SB) is detrimental to cardiometabolic disease (CMD) risk, which can begin in young adulthood. To devise effective SB-CMD interventions in young adults, it is important to understand which context-specific sedentary behaviors (CS-SB) are most detrimental for CMD risk, the lifestyle behaviors that co-exist with CS-SBs, and the socioecological predictors of CS-SB.

Methods

This longitudinal observational study will recruit 500 college-aged (18-24 years) individuals. Two laboratory visits will occur, spaced 12 months apart, where a composite CMD risk score (e.g., arterial stiffness, metabolic and inflammatory biomarkers, heart rate variability, and body composition) will be calculated, and questionnaires to measure lifestyle behaviors and different levels of the socioecological model will be administered. After each visit, total SB (activPAL) and CS-SB (television, transportation, academic/ occupational, leisure computer, "other"; ecological momentary assessment) will be measured across seven days.

Discussion

It is hypothesized that certain CS-SB will show stronger associations with CMD risk, compared to T-SB, even after accounting for coexisting lifestyle behaviors. It is expected that a range of intra-individual, inter-individual, and physical environment socioecological factors will predict CS-SB. The findings from this study will support the development of an evidence-based, multi-level intervention to target SB reduction and mitigate CMD risk in CBYA.

The Annual Rhythms in Sleep, Sedentary Behavior, and Physical Activity of Australian Adults: A Prospective Cohort Study

BACKGROUND

Sleep, sedentary behavior, and physical activity have fundamental impacts on health and well-being. Little is known about how these behaviors vary across the year.

PURPOSE

To investigate how movement-related behaviors change across days of the week and seasons, and describe movement patterns across a full year and around specific temporal events.

METHODS

This cohort study included 368 adults (mean age = 40.2 years [SD = 5.9]) who wore Fitbit activity trackers for 12 months to collect minute-by-minute data on sleep, sedentary behavior, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). Data were analyzed descriptively, as well as through multilevel mixed-effects linear regression to explore associations with specific temporal cycles (day-of-the-week, season) and events.

RESULTS

Movement patterns varied significantly by day-of-the-week and season, as well as during annual events like Christmas-New Year and daylight saving time (DST) transitions. For example, sleep was longer on weekends (+32 min/day), during autumn and winter relative to summer (+4 and +11 min/day), and over Christmas-New Year (+24 min/day). Sedentary behavior was longer on weekdays, during winter, after Christmas-New Year, and after DST ended (+45, +7, +12, and +8 min/day, respectively). LPA was shorter in autumn, winter, and during and after Christmas-New Year (-6, -15, -17, and -31 min/day, respectively). Finally, there was less MVPA on weekdays and during winter (-5 min/day and -2 min/day, respectively).

CONCLUSIONS

Across the year, there were notable variations in movement behaviors. Identifying high-risk periods for unfavorable behavior changes may inform time-targeted interventions and health messaging.

Circulating Levels of IL-8 and MCP-1 in Healthy Adults: Changes after an Acute Aerobic Exercise and Association with Body Composition and Energy Metabolism

The most recent WHO recommendations about physical activity emphasise the importance of total exercise volume above the significance of the duration of each bout. This study examined whether acute aerobic exercise changes circulating levels of IL-8 and MCP-1 and if these changes are associated with body composition and energy metabolism. Healthy adult volunteers completed a 10 min walking-running exercise on a treadmill. Indirect calorimetry was used to determine their resting metabolic rate (RMR) and energy expenditure (EE) during the exercise. Pre-exercise levels of IL-8 and MCP-1 were similar in both sexes. There were positive correlations of pre-exercise IL-8 with body mass, waist circumference, and lean body mass in men and pre-exercise MCP-1 with RMR in women. The exercise led to an increase in IL-8 of 68% and a decrease in MCP-1 of 74% of participants. An increase in post-exercise IL-8 in men was associated with greater walking EE and a greater increase in walking EE. The increase in post-exercise MCP-1 was associated with a lower RMR and running EE in women. There are both sex and individual variations in changes in chemokine secretion in response to the same exercise situation and their associations with values of metabolic parameters.

Predictive Equation for Basal Metabolic Rate in Normal-Weight Chinese Adults

This study aimed to develop a predictive equation for basal metabolic rate (BMR) in normal-weight Chinese adults and provide a reference for establishing the national recommended dietary energy intake. A new equation for BMR was derived from a sample of 516 normal-weight Chinese adults (men = 253, women = 263), and this sample was collected from two previous studies. Furthermore, the accuracy of this new equation and eight other previous predictive equations was reviewed. The agreement and reliability were compared in terms of bias, accuracy, the intraclass correlation coefficient, and Bland-Altman plots between predictive equations. In addition, the newly developed equation was further verified using a small independent sample, which contained 41 healthy Chinese adults (men = 21, women = 20). The measured BMR (mBMR) of all participants, measured using indirect calorimetry, was 1346.2 ± 358.0 kcal/d. Thirty participants were excluded based on Cook's distance criteria (Cook's distance of ≥0.008). Previous equations developed by Henry, Schofield, Harris-Benedict (H-B), Yang, and Hong overestimated the BMR of healthy Chinese adults. The present equation displayed the smallest average bias (0.2 kcal/d) between the mBMR and predicted basal metabolic rate (pBMR). The limits of agreement of the present equation from Bland-Altman plots were -514.3 kcal/d and 513.9 kcal/d, which is the most narrow and balanced limit of agreement. Moreover, in the verification of the testing database, the pBMR of the new equation was not significantly different from the mBMR, and the accuracy was 75.6%. Compared with pre-existing equations, the present equation is more applicable to the prediction of BMR in healthy Chinese adults. However, further studies are required to verify the accuracy of this new equation.

Musculoskeletal pain latent classes and biopsychosocial characteristics among emerging adults

BACKGROUND

Emerging adults (aged 18-29) report high levels of musculoskeletal pain; however, it is unknown if body location and intensity patterns are related to different biopsychosocial characteristics. This study identified patterns of self-reported musculoskeletal pain among emerging adults and assessed if there were differences in their lifestyle and psychological characteristics.

METHODS

Data from survey responses from a large public university and a large medical university in the United States were used (n = 1,318). Self-reported pain location and intensity at five body regions were assessed, and latent class analysis identified classes separately for men and women. Mental health, physical activity, and sleep outcomes were compared between the classes.

RESULTS

Four classes were identified for men and women. Three of the classes were consistent between genders - "no pain," (women = 28% of their sample; men = 40% of their sample) "mild multisite pain," (women = 50%; men = 39%) and "moderate-severe multisite pain" (women = 9%; men = 7%). The fourth class for women was "moderate spine pain," (13%) and for men was "mild extremity pain" (13%). For both men and women, the "moderate-severe multisite" pain classes reported the highest levels of depression, anxiety, and stress, poorer sleep, and higher work physical activity than the "no pain" class. The "mild multisite" and "moderate spine" (women only) pain classes fell between the "no pain" and "moderate-severe" pain classes. The characteristics of the "mild upper extremity pain" class for men was similar to the "no pain" class.

CONCLUSIONS

The identified classes provide unique information on pain location and intensity in emerging adults. The high prevalence of "mild multisite pain" (n = 593; 45% of the total sample) demonstrates an intervention opportunity during this age range to prevent further increases in musculoskeletal pain later in life. Future work should assess the longitudinal outcomes of these pain classes, the impact of interventions for this age group, and the balance between leisure and occupational physical activity when addressing musculoskeletal health.

Patterns and correlates of sedentary behavior among university students

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

Device assessed activity behaviours in patients with indwelling pleural catheter: A sub-study of the Australasian Malignant PLeural Effusion (AMPLE)-2 randomized trial

BACKGROUND AND OBJECTIVE

Device-assessed activity behaviours are a novel measure for comparing intervention outcomes in patients with malignant pleural effusion (MPE). Australasian Malignant PLeural Effusion (AMPLE)-2 was a multi-centre clinical trial where participants with MPE treated with an indwelling pleural catheter were randomized to daily (DD) or symptom-guided (SGD) drainage for 60-days. Our aim was to describe activity behaviour patterns in MPE patients, explore the impact of drainage regimen on activity behaviours and examine associations between activity behaviours and quality of life (QoL).

METHODS

Following randomization to DD or SGD, participants enrolled at the lead site (Perth) completed accelerometry assessment. This was repeated monthly for 5-months. Activity behaviour outcomes were calculated as percent of daily waking-wear time and compared between groups (Mann-Whitney U test; Median [IQR]). Correlations between activity behaviour outcomes and QoL were examined.

RESULTS

Forty-one (91%) participants provided ≥1 valid accelerometry assessment (DDn = 20, SGD n = 21). Participants spent a large proportion of waking hours sedentary (72%-74% across timepoints), and very little time in moderate-to-vigorous physical activity (<1% across timepoints). Compared to SGD group, DD group had a more favourable sedentary-to-light ratio in the week following randomization (2.4 [2.0-3.4] vs. 3.2 [2.4-6.1]; p = 0.047) and at 60-days (2.0 [1.9-2.9] vs. 2.9 [2.8-6.0]; p = 0.016). Sedentary-to-light ratio was correlated with multiple QoL domains at multiple timepoints.

CONCLUSION

Patients with MPE are largely sedentary. Preliminary results suggest that even modest differences in activity behaviours favouring the DD group could be meaningful for this clinical population. Accelerometry reflects QoL and is a useful outcome measure in MPE populations.

Measuring posture change to detect emotional conditions for workers: A scoping review

BACKGROUND: The emotional management of workers can not only increase the efficiency of work, but also contribute to the improvement of the productivity of a company. OBJECTIVE: This scoping review surveyed the literature to identify the relationship between postural expression and emotion during sedentary tasks. METHODS: We searched relevant literature published up to December 1, 2019 using seven electronic databases (PubMed, CINAHL, Embase, Web of science, PsycINFO, IEEE Xplore, and Medline complete). RESULTS: A total of 14 publications were included in this scoping review. It was found that the application of pressure sensor and camera-based measurement equipment was effective. Additionally, it was proposed to predict the emotional state of the worker by using forward and backward movements as the main variable as opposed to left and right movements. The information-based analysis technique was able to further increase the accuracy of workers’ emotion prediction. CONCLUSIONS: The emotion prediction of workers based on sitting posture could be confirmed for certain movements, and the information-based technical method could further increase the accuracy of prediction. Expansion of information-based technical research will further increase the possibility of predicting the emotions of workers based on posture, and this will in turn promote safer and more efficient work performance.

Skip the wait and take a walk home! The suitability of point-of-choice prompts to promote active transportation among undergraduate students

Objectives: The objectives were to: determine undergraduate students' awareness of active transportation-promoting point-of-choice prompts; explore perceptions of the impact of the prompts on students' transportation choices; and obtain feedback regarding the suitability of the prompts. Participants: This cross-sectional study included a convenience sample of 346 undergraduate students. Methods: Prompts were displayed in March 2018 on one Canadian university campus. Thereafter, students completed a 20-question and study-specific online questionnaire containing a mix of closed- and open-ended questions. Results: Approximately 41% of respondents were aware of the prompts, with awareness levels being associated with the distribution and the design of the displays. Although students assessed them as suitable, the prompts did not impact the transportation choices of the majority of respondents who saw them. Conclusions: Findings contribute to the understanding of students' awareness levels of tailored and strategically-placed prompts, and the impact of this intervention on decisions to engage in active transportation.

Associations between health-related skills and young adults' work ability within a structural health literacy model

Young adults have a high societal relevance but are still an under-represented target group in health promotion. Health literacy is widely acknowledged as one of the strongest predictors and key determinant of health, so its influence on work ability is of great interest. The purpose of the study was to examine the associations between health-related skills and work ability within the structural model of health literacy of Lenartz, Soellner and colleagues, which explains health behaviour and health through the indirect and direct influence of six 'advanced skills' ('self-perception', 'proactive approach to health', 'dealing with health information', 'self-control', 'self-regulation' and 'communication and cooperation'). The cross-sectional study was based on baseline data of a health literacy promotion intervention (495 vocational school students, 59.0% female, age span 18-25 years). Structural equation modelling with partial least squares was used to examine the associations between the six constructs of the model and the Work Ability Index (WAI). Mean WAI score was 39.7 ± 4.5 (51.1% categorized 'moderate'/'poor'). Five out of six constructs of the model showed a statistically significant indirect or direct effect, respectively, on work ability. The model explained 24.8% of the WAI score variance. Our findings show associations between the health literacy model and the work ability among young employees. In view of demographic change, it is crucial to develop and analyse target group-specific health literacy interventions. The model offers new facets in the modelling of health literacy.

The context matters - not all prolonged sitting bouts are equally related to momentary affective states: an ambulatory assessment with sedentary-triggered E-diaries

Background

Sedentary behaviors (SB) and especially prolonged sitting bouts are highly prevalent in daily life and studies indicated an association with an increased risk for several non-communicable diseases. Consequently, guidelines to reduce SB were developed. At the same time, an in-depth knowledge regarding SB such as where, what and with whom people spend time sedentary as well as correlates such as affective states of prolonged sitting bouts, is still lacking. A more differentiated view on SB is necessary to identify detrimental and modifiable sedentary bouts. We addressed this gap by conducting an ambulatory assessment study including accelerometer and sedentary-triggered e-diaries that captures data during prolonged sitting bouts (> 20 min). We investigated how contextual factors of prolonged sitting bouts are associated with momentary affective states.

Method

Four studies were combined with a final sample of 308 participants (50.3% female, M_age, 27.4, range, 17–66). SB was assessed objectively with thigh-worn accelerometers for four to five days. Whenever a participant was sitting for 20 or 30 min the accelerometer triggered questions assessing social (not alone vs. alone) and environmental (leisure vs. working) factors as well as momentary affective states (valence, energetic arousal and calmness). Multilevel analyses were used to examine within-person associations between different contexts and mood during prolonged sitting.

Results

Momentary affective states varied significantly due to different social and environmental contexts (p_s < 0.001): Sitting together with others was associated with higher levels of valence and energetic arousal. Furthermore, sitting during leisure time was associated with higher levels of valence and calmness and lower levels of energetic arousal. Significant interaction analyses revealed that participants had the highest ratings while sitting during leisure episodes together with others.

Conclusion

Findings showed that prolonged sitting bouts differ regarding their association with affect. Sitting with others, sitting during leisure time and especially sitting during leisure time and with others, was associated with higher levels of momentary affective states, respectively. Thus, SB guidelines should focus on reducing those SB episodes that are associated with lower levels of affect, for example during working episodes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-021-01170-3.

Six-week behaviour change intervention to reduce sedentary behaviour in people with chronic obstructive pulmonary disease: a randomised controlled trial

INTRODUCTION

This study aimed to determine whether a 6-week behaviour change intervention was more effective than a sham intervention for reducing sedentary behaviour (SB) in people with chronic obstructive pulmonary disease (COPD).

METHODS

People with stable COPD on the waitlist for entry into pulmonary rehabilitation were recruited to this multicentre trial with randomisation (independent, concealed allocation) to either an intervention group or sham group, assessor blinding and intention-to-treat (ITT) analysis. The behaviour change intervention consisted of once weekly sessions for 6 weeks with a physiotherapist to reduce SB through education, guided goals setting and real-time feedback on SB. The sham intervention consisted of once weekly phone calls for 6 weeks to monitor health status. SB was measured continuously over 7 days using thigh-worn accelerometry (activPAL3 micro). The primary outcome was time spent in SB. Participants with at least 4 days of ≥10 hours waking wear time were included in the ITT analysis and those who reported achieving ≥70% of goals to reduce SB or who completed all sham calls were included in a per-protocol analysis.

RESULTS

70 participants were recruited and 65 completed the study (mean±SD age 74±9 years, mean FEV₁ 55%±19% predicted, 49% male). At 6 weeks, no between-group differences in time spent in SB were observed in the ITT analysis (mean difference 5 min/day, 95% CI -38 to 48) or per-protocol analysis (-16 min/day, 95% CI -80 to 48).

DISCUSSION

A 6-week behaviour change intervention did not reduce time in SB compared with a sham intervention in people with stable moderate-to-severe COPD prior to pulmonary rehabilitation.

Capability, opportunity, and motivation: an across contexts empirical examination of the COM-B model

BACKGROUND

There is limited evidence for successful weight gain prevention interventions targeting young adults. Developing effective interventions necessitates a theoretical model that can identify barriers and enablers for healthy eating and physical activity among young adults to support weight management. This study empirically examines the utility of the COM-B model as a framework for intervention planning across two behavioural contexts: eating and physical activity.

METHODS

A cross-sectional survey research design was employed to empirically test the COM-B model in the contexts of young adult's eating and physical activity behaviours. Informed by the Theoretical Domains Framework, pre-validated measures appropriate for capturing the latency of the COM (Capability, Opportunity, and Motivation) constructs were sourced. Both surveys (eating and physical activity) were administered online to two independent samples of young adults aged 18-35 years. Models were specified and tested using structural equation modelling.

RESULTS

A total of 582 (mean age = 22.8 years; 80.3% female) and 455 (mean age = 24.9 years; 80.8% female) participants were included in the physical activity and eating analyses, respectively. The COM-B model explained 31% of variance in physical activity behaviour and 23% of variance in eating behaviour. In the physical activity model (N = 582), capability and opportunity were found to be associated with behaviour through the mediating effect of motivation. In the eating model (N = 455), capability was found to be associated with behaviour through the mediating effect of motivation. Capability was also found to mediate the association between opportunity and motivation. Consistencies and variations were observed across both models in terms of COM indicators.

CONCLUSIONS

Findings support the COM-B model's explanatory potential in the context of young adult's physical activity and eating behaviours. Barriers and enablers underlying young adult's physical activity and eating behaviours were identified that represent potential targets for future intervention design. Further research is needed to validate present study findings across different populations and settings.

Weight status and health behaviors of adolescents and young adults with sickle cell disease: The emerging risk for obesity

Historically, youth with sickle cell disease (SCD) were at risk for being underweight, but recent data suggests this population is replicating obesity trends of youth in the United States. The current observational study assessed the weight status and health behaviors of 44 adolescents and young adults with SCD via a self-report survey and chart review. Using height and weight data closest to survey completion date, 27% of participants were either overweight or obese. With respect to obesogenic risk behaviors, 77% ate fast food 1-3 times per week, 25% had no fruits/vegetables with any of their meals, 11% drank no water, and 57% watched 4 or more hours of television per day. Though more research is needed, this preliminary study adds to the SCD literature suggesting an emerging shift toward obesity in this population. As such, adolescents with SCD may benefit from interventions to decrease obesity risk factors as being overweight or obese has the potential to worsen SCD-related symptoms and complications.

Understanding Vocational Students' Motivation for Dietary and Physical Activity Behaviors

Unhealthy eating behaviors and low levels of physical activity are major problems in adolescents and young adults in vocational education. To develop effective intervention programs, more research is needed to understand how different types of motivation contribute to health behaviors. In the present study, Self-Determination Theory is used to examine how motivation contributes to dietary and physical activity behaviors in vocational students. This cross-sectional study included 809 students (mean age 17.8 ± 1.9 years) attending vocational education in the Netherlands. Linear multilevel regression analyses were used to investigate the association between types of motivation and dietary and physical activity behaviors. Amotivation was negatively associated with breakfast frequency and positively associated with diet soda consumption and high-calorie between-meal snacks. A positive association was found between autonomous motivation and water intake, breakfast frequency, fruit intake, and moderate-to-vigorous physical activity. Autonomous motivation was negatively associated with the consumption of unhealthy products. Controlled motivation was not associated with physical activity or dietary behaviors. Different types of motivation seem to explain either healthy or unhealthy dietary behaviors in vocational students. Autonomous motivation, in particular, was shown to be associated with healthy behaviors and could therefore be a valuable intervention target.

Measurement Reactivity of Accelerometer-Based Sedentary Behavior and Physical Activity in 2 Assessment Periods

BACKGROUND

The purposes of this study were to examine accelerometer measurement reactivity (AMR) in sedentary behavior (SB), physical activity (PA), and accelerometer wear time in 2 measurement periods and to quantify AMR as a human-related source of bias for the reproducibility of SB and PA estimates.

METHODS

In total, 136 participants (65% women, mean age = 54.6 y) received 7-day accelerometry at the baseline and after 12 months. Latent growth models were used to identify AMR. Intraclass correlations were calculated to examine the reproducibility using 2-level mixed-effects linear regression analyses.

RESULTS

Within each 7-day accelerometry assessment, the participants increased their time spent in SB (b = 2.4 min/d; b = 3.8 min/d) and reduced their time spent in light PA (b = -2.0 min/d; b = -3.2 min/d), but did not change moderate to vigorous PA. The participants reduced their wear time (b = -5.2 min/d) only at the baseline. The intraclass correlations ranged from .42 for accelerometer wear time to .74 for SB. The AMR was not identified as a source of bias in any regression model.

CONCLUSIONS

AMR may influence SB and PA estimates differentially. Although 7-day accelerometry seems to be a reproducible measure, our findings highlight accelerometer wear time as a crucial confounder in analyzing SB and PA data.

Physical activity trajectories from childhood to late adolescence and their implications for health in young adulthood

Physical activity has been associated with physical and mental health across the life course, yet few studies have used group-based trajectory modeling to examine the effect of longitudinal patterns of physical activity during childhood and adolescence on adult health outcomes. The Raine Study data from Gen2 follow-ups at 8, 10, 14, 17, 20, and 22 years collected between 1998 and 2014 were used. Latent class analysis identified trajectories using parent-reported physical activity for ages 8 to 17. Associations between trajectories and physical and mental health outcomes at ages 20 and 22 were explored, adjusting for current physical activity and considering sex interactions. Analysis in 2019 identified three trajectories: low (13%), mid (65%) and high (22%) physical activity (n = 1628). Compared to the low-activity trajectory, those in the high-activity trajectory had lower adiposity, insulin, HOMA-IR and fewer diagnosed disorders, higher HDL-cholesterol, and faster cognitive processing. For example, those in the high-activity trajectory had lower percent body fat at age 20 compared to those in the mid-activity (-4.2%, 95%CI: -5.8, -2.7) and low-activity (-9.5%, 95%CI: -11.7, -7.2) trajectories. Physical activity trajectories showed different associations between sexes for self-reported physical and mental health, BMI, systolic blood pressure, and depression symptoms. Being in the high- or mid-activity trajectory was associated with a more favorable cardiometabolic and mental health profile in young adulthood. Strategies are needed to help less active children to increase physical activity throughout childhood and adolescence to improve young adult health outcomes.

Active design of built environments for increasing levels of physical activity in adults: the ENABLE London natural experiment study

Background

Low physical activity is widespread and poses a serious public health challenge both globally and in the UK. The need to increase population levels of physical activity is recognised in current health policy recommendations. There is considerable interest in whether or not the built environment influences health behaviours, particularly physical activity levels, but longitudinal evidence is limited.

Objectives

The effect of moving into East Village (the former London 2012 Olympic and Paralympic Games Athletes’ Village, repurposed on active design principles) on the levels of physical activity and adiposity, as well as other health-related and well-being outcomes among adults, was examined.

Design

The Examining Neighbourhood Activities in Built Environments in London (ENABLE London) study was a longitudinal cohort study based on a natural experiment.

Setting

East Village, London, UK.

Participants

A cohort of 1278 adults (aged ≥ 16 years) and 219 children seeking to move into social, intermediate and market-rent East Village accommodation were recruited in 2013–15 and followed up after 2 years.

Intervention

The East Village neighbourhood, the former London 2012 Olympic and Paralympic Games Athletes’ Village, is a purpose-built, mixed-use residential development specifically designed to encourage healthy active living by improving walkability and access to public transport.

Main outcome measure

Change in objectively measured daily steps from baseline to follow-up.

Methods

Change in environmental exposures associated with physical activity was assessed using Geographic Information System-derived measures. Individual objective measures of physical activity using accelerometry, body mass index and bioelectrical impedance (per cent of fat mass) were obtained, as were perceptions of change in crime and quality of the built environment. We examined changes in levels of physical activity and adiposity using multilevel models adjusting for sex, age group, ethnic group, housing sector (fixed effects) and baseline household (random effect), comparing the change in those who moved to East Village (intervention group) with the change in those who did not move to East Village (control group). Effects of housing sector (i.e. social, intermediate/affordable, market-rent) as an effect modifier were also examined. Qualitative work was carried out to provide contextual information about the perceived effects of moving to East Village.

Results

A total of 877 adults (69%) were followed up after 2 years (mean 24 months, range 19–34 months, postponed from 1 year owing to the delayed opening of East Village), of whom 50% had moved to East Village; insufficient numbers of children moved to East Village to be considered further. In adults, moving to East Village was associated with only a small, non-significant, increase in mean daily steps (154 steps, 95% confidence interval –231 to 539 steps), more so in the intermediate sector (433 steps, 95% confidence interval –175 to 1042 steps) than in the social and market-rent sectors (although differences between housing sectors were not statistically significant), despite sizeable improvements in walkability, access to public transport and neighbourhood perceptions of crime and quality of the built environment. There were no appreciable effects on time spent in moderate to vigorous physical activity or sedentary time, body mass index or percentage fat mass, either overall or by housing sector. Qualitative findings indicated that, although participants enjoyed their new homes, certain design features might actually serve to reduce levels of activity.

Conclusions

Despite strong evidence of large positive changes in neighbourhood perceptions and walkability, there was only weak evidence that moving to East Village was associated with increased physical activity. There was no evidence of an effect on markers of adiposity. Hence, improving the physical activity environment on its own may not be sufficient to increase population physical activity or other health behaviours.

Funding

This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 12. See the NIHR Journals Library website for further project information. This research was also supported by project grants from the Medical Research Council National Prevention Research Initiative (MR/J000345/1).

Mediating role of body-related shame and guilt in the relationship between weight perceptions and lifestyle behaviours

INTRODUCTION

A substantial proportion of individuals with overweight or obesity perceive themselves as 'too heavy' relative to 'about right'. Perceiving one's weight as 'too heavy' is associated with lower levels of physical activity and higher levels of sedentary behaviour. However, the mechanisms underpinning the associations between weight perception and lifestyle behaviours have not been identified. Based on theoretical tenets and empirical evidence, the self-conscious emotions of shame and guilt may mediate these associations.

METHODS

Participants were young adults (n = 618, Mage = 24.0 ± .6 years) who provided data on weight, weight perception, body-related shame and guilt, physical activity and screen time.

RESULTS

Mediation analyses using the PROCESS macro indicated that shame and guilt significantly mediated the relationships between weight perception and physical activity and shame significantly mediated the relationship between weight perception and screen time.

CONCLUSIONS

These findings provide preliminary evidence that self-conscious emotions may be mechanisms by which weight perception influences physical activity and sedentary behaviour in young adults. However, longitudinal investigations of this mechanism are needed.

Diurnal patterns of sedentary behavior and changes in physical function over time among older women: a prospective cohort study

BACKGROUND

Sedentary behavior (SB) is linked to negative health outcomes in older adults. Most studies use summary values, e.g., total sedentary minutes/day. Diurnal timing of SB accumulation may further elucidate SB-health associations.

METHODS

Six thousand two hundred four US women (mean age = 79 ± 7; 50% White, 34% African-American) wore accelerometers for 7-days at baseline, yielding 41,356 person-days with > 600 min/day of data. Annual follow-up assessments of health, including physical functioning, were collected from participants for 6 years. A novel two-phase clustering procedure discriminated participants' diurnal SB patterns: phase I grouped day-level SB trajectories using longitudinal k-means; phase II determined diurnal SB patterns based on proportion of phase I trajectories using hierarchical clustering. Mixed models tested associations between SB patterns and longitudinal physical functioning, adjusted for covariates including total sedentary time. Effect modification by moderate-vigorous-physical activity (MVPA) was tested.

RESULTS

Four diurnal SB patterns were identified: p1 = high-SB-throughout-the-day; p2 = moderate-SB-with-lower-morning-SB; p3 = moderate-SB-with-higher-morning-SB; p4 = low-SB-throughout-the-day. High MVPA mitigated physical functioning decline and correlated with better baseline and 6-year trajectory of physical functioning across patterns. In low MVPA, p2 had worse 6-year physical functioning decline compared to p1 and p4. In high MVPA, p2 had similar 6-year physical functioning decline compared to p1, p3, and p4.

CONCLUSIONS

In a large cohort of older women, diurnal SB patterns were associated with rates of physical functioning decline, independent of total sedentary time. In particular, we identified a specific diurnal SB subtype defined by less SB earlier and more SB later in the day, which had the steepest decline in physical functioning among participants with low baseline MVPA. Thus, diurnal timing of SB, complementary to total sedentary time and MVPA, may offer additional insights into associations between SB and physical health, and provide physicians with early warning of patients at high-risk of physical function decline.

Health literacy promotion among young adults: a web-based intervention in German vocational schools

Against the background of an ageing population, the target group of young adults holds strong societal relevance as the future workforce. At the same time, young adults find themselves in a critical phase of life regarding the manifestation of a healthy lifestyle. In this context, young adults' health literacy gains importance. Web-based interventions implemented in educational settings offer the potential for promoting health literacy, although longitudinal studies remain scarce. Within a pre-post cluster randomized controlled trial with 6-month follow-up, this study investigated whether an 8-week web-based intervention in vocational schools (with or without an additional initial face-to-face measure) improves individual competencies within a structural model of health literacy ('self-perception', 'proactive approach to health', 'dealing with health information', 'self-control', 'self-regulation' and 'communication and cooperation'). The control condition was regular school lessons following the curriculum only. A multi-level regression analysis was performed using the control group as reference. None of the interventions showed a significant improvement in any of the dimensions. Significant differences between the intervention and control were obtained for some dimensions, albeit showing reductions. Future research must examine how to build impactful health literacy promotion in educational settings. Investigations into linking digital and face-to-face measures should continue.

A good beginning: study protocol for a group-randomized trial to investigate the effects of sit-to-stand desks on academic performance and sedentary time in primary education

BACKGROUND

Sedentary behavior is associated with health risks and academic under-achievement in children. Still, children spend a large part of their waking hours sitting at a desk at school. Recent short-term studies demonstrated the potential of sit-to-stand desks to reduce sitting time in primary education. The program of "A Good Beginning" was conceived to assess the long-term effects of sit-to-stand desks on sitting time in primary education, and to examine how sit-to-stand desks versus regular desks relate to academic performance, and measures of executive functioning, health and wellbeing. The present paper describes the design of this group-randomized trial, which started in 2017 and will be completed in 2019.

METHODS

Children of two grade-three groups (age 8-9) following regular primary education in Leiden, The Netherlands, were recruited. A coin toss determined which group is the experimental group; the other group is the control group. All children in the experimental group received sit-to-stand desks. They are invited and motivated to reduce sedentary time at school, however, it is their own choice to sit or stand. Children in the control group use regular desks. Otherwise, both groups receive regular treatment. Outcomes are assessed at baseline (T0) and at five follow-up sessions (T1-T5) alternately in winter and summer seasons over three academic years. Primary outcome measures are academic performance, and the proportion of sitting time at school, measured with a 3D accelerometer. Secondary outcome measures are a number of measures related to executive functioning (e.g., N-back task for working memory), health (e.g., height and weight for BMI), and wellbeing (e.g., KIDSCREEN-52 for Quality of Life).

DISCUSSION

A Good Beginning is a two-and-a-half-year research program, which aims to provide a better understanding of the long-term effects of sit-to-stand desks on sedentary time at school and the relation between sitting time reduction and academic performance, executive functioning, health and wellbeing. The findings may serve as useful information for policy making and practical decision making for school and classroom environments.

TRIAL REGISTRATION

The program of "A Good Beginning" is registered at the Netherlands Trial Register (NTR, https://www.trialregister.nl), number NL6166, registration date 24 November 2016.

Perceived Stress among Different Occupational Groups and the Interaction with Sedentary Behaviour

Sedentary lifestyle and low physical activity are associated with health issues, including both physical and mental health, non-communicable diseases, overweight, obesity and reduced quality of life. This study investigated differences in physical activity and other individual factors among different occupational groups, highlighting the impact of sedentary behaviour on perceived stress by occupation. Cross-sectional study included 571 full-time workers of Kaunas city, Lithuania. The outcome of this study was assessment of perceived stress. Time spent sedentary per day, occupation and other individual characteristics were self-reported using questionnaires. Two main occupational groups were analysed: white-collar and blue-collar workers. Multivariate logistic regression was used to assess the impact of sedentary behaviour on perceived stress among different occupational groups. The prevalence of high sedentary behaviour was 21.7 and 16.8 % among white-collar and blue-collar workers, respectively. Blue-collar workers had a higher risk of high perceived stress (OR 1.55, 95% CI 1.05-2.29) compared to white-collar workers; however, sedentary time did not have any impact on high perceived stress level. Meanwhile, white-collar male (OR 4.34, 95% CI 1.46-12.95) and white-collar female (OR 3.26, 95% CI 1.23-8.65) workers who spend more than three hours per day sedentary had a greater risk of high levels of perceived stress. These findings indicate sedentary behaviour effect on perceived stress among two occupational groups-white-collar and blue-collar workers-and other important factors associated with perceived stress.

Tracking of Physical Activity and Sedentary Behavior From Adolescence to Young Adulthood: A Systematic Literature Review

PURPOSE

The transition from adolescence to young adulthood is categorized by substantial changes in one's activity behaviors, which may have important implications for health. To date, no reviews have systematically investigated the evidence of tracking for both physical activity (PA) and sedentary behavior (SB) specifically during this transition period.

METHODS

Web of Science, PubMed, SPORTDiscus, PsycINFO, and CINAHL were searched for articles that examined the tracking of PA and SB in adolescents (aged 9-18 years) through young adulthood (aged 19-25 years) published between the years of 2000 and 2018. Studies were also compared on methodologic quality.

RESULTS

Sixteen studies met the inclusion criteria. The tracking correlations for both the frequency and duration of PA were low-to-moderate. Gender differences were observed in the tracking of PA frequency and duration. Studies that examined the tracking of SB were less frequent, making it difficult to determine how SB tracks from adolescence to young adulthood.

CONCLUSIONS

Generally, PA was shown to track moderately from adolescence through young adulthood. The lack of studies reporting on the tracking of SB indicates that this area should be a target for future research. Future tracking studies should consider appropriate gold-standard objective methodologies and statistical analysis techniques that report fixed outcomes.

Physical Activity and Sedentary Behaviour Patterns in 326 Persons with COPD before Starting a Pulmonary Rehabilitation: A Cluster Analysis

This study applies a cluster analysis to identify typical physical activity (PA) and sedentary behaviour (SB) patterns in people with chronic obstructive pulmonary disease (COPD) before starting pulmonary rehabilitation (PR). We implemented an observational design which assessed baseline data of objectively measured PA and SB from the STAR (Stay Active after Rehabilitation) study. A total of 355 persons wore an accelerometer (Actigraph wGT3X) for seven days before the start of their PR. Sociodemographic and disease-related parameters were assessed at the start of PR. We applied cluster analysis and compared clusters applying univariate variance analyses. Data was available for 326 persons (31.6% women; age ø = 58 years). Cluster analysis revealed four movement clusters with distinct PA and SB patterns: Sedentary non-movers (28.5%), sedentary occasional movers (41.7%), sedentary movers (19.6%), and sedentary exercisers (10.1%). The four clusters displayed varying levels of moderate PA before rehabilitation (Ø daily min: 9; 28; 38; 70). Notably, all four clusters displayed considerably long average sedentary time per day (Ø daily minutes: 644; 561; 490; 446). The clusters differed significantly in disease-related parameters of GOLD severity, FEV1, CAT, and 6-Min-Walk-Test. In addition to PA promotion, PR programs should consider the reduction of sedentary behaviour as a valuable goal.

Parameterizing and validating existing algorithms for identifying out-of-bed time using hip-worn accelerometer data from older women

OBJECTIVE

To parameterize and validate two existing algorithms for identifying out-of-bed time using 24 h hip-worn accelerometer data from older women.

APPROACH

Overall, 628 women (80  ±  6 years old) wore ActiGraph GT3X+  accelerometers 24 h d-1 for up to 7 d and concurrently completed sleep-logs. Trained staff used a validated visual analysis protocol to measure in-bed periods on accelerometer tracings (criterion). The Tracy and McVeigh algorithms were adapted for optimal use in older adults. A training set of 314 women was used to choose two key thresholds by maximizing the sum of sensitivity and specificity for each algorithm and data (vertical axis, VA, and vector magnitude [VM]) combination. Data from the remaining 314 women were then used to test agreement in waking wear time (i.e. out-of-bed time while wearing the accelerometer) by computing sensitivity, specificity, and kappa comparing the algorithm output with the criterion. Waking wear time-adjusted means of sedentary time, light-intensity physical activity (light PA) and moderate-to-vigorous-intensity physical activity (MVPA) were then estimated and compared.

MAIN RESULTS

Waking wear time agreement with the criterion was high for Tracy_VA, Tracy_VM, McVeigh_VA, and highest for McVeigh_VM. Compared to the criterion, McVeigh_VM had mean sensitivity  =  0.92, specificity  =  0.87, kappa  =  0.80, and overall mean difference (±SD) of  -0.04  ±  2.5 h d-1. Minutes of sedentary time, light PA, and MVPA adjusted for waking wear time using the criterion measure and McVeigh_VM were not statistically different (p   >  0.43|all).

SIGNIFICANCE

The McVeigh algorithm with optimal parameters using VM performed best compared to criterion sleep-log assisted visual analysis and is suitable for automated identification of waking wear time in older women when visual analysis is not feasible.

Associations of physical activity or sedentary behaviour with pain sensitivity in young adults of the Raine Study

Background and aims

There is high level evidence for physical activity (PA) improving outcomes in persistent pain disorders and one of the mechanisms proposed is the effect of exercise on central nociceptive modulation. Although laboratory studies and small field intervention studies suggest associations between physical activity and pain sensitivity, the association of objectively measured, habitual PA and sedentary behaviour (SB) with pain sensitivity requires further investigation. Current evidence suggests PA typically lowers pain sensitivity in people without pain or with single-site pain, whereas PA is frequently associated with an increase in pain sensitivity for those with multisite pain. The aim of this study was to explore the relationships of PA and SB with pain sensitivity measured by pressure pain thresholds and cold pain thresholds, considering the presence of single-site and multisite pain and controlling for potential confounders.

Methods

Participants from the Western Australian Pregnancy Cohort (Raine) Study (n = 714) provided data at age 22-years. PA and SB were measured via accelerometry over a 7-day period. Pain sensitivity was measured using pressure pain threshold (4 sites) and cold pain threshold (wrist). Participants were grouped by number of pain areas into “No pain areas” (n = 438), “Single-site pain” (n = 113) and “Multisite pain” (n = 163) groups. The association of PA and SB variables with pain sensitivity was tested separately within each pain group by multivariable regression, adjusting for potential confounders.

Results

For those with “Single-site pain”, higher levels (>13 min/day) of moderate-vigorous PA in ≥10 min bouts was associated with more pressure pain sensitivity (p = 0.035). Those with “Multisite pain” displayed increased cold pain sensitivity with greater amounts of vigorous PA (p = 0.011). Those with “No pain areas” displayed increased cold pain sensitivity with decreasing breaks from sedentary time (p = 0.046).

Conclusions

This study was a comprehensive investigation of a community-based sample of young adults with “No pain areas”, “Single-site pain” and “Multisite pain” and suggests some associations of measures of PA and SB with pain sensitivity.

Implications

The findings suggest that the pattern of accumulation of PA and SB may be important to inform improved clinical management of musculoskeletal pain disorders. This study provides a baseline for follow-up studies using the Raine Study cohort. Future research should consider temporal influences of PA and SB on pain sensitivity, pain experience and consider using a broader range of pain sensitivity measures.

Methodology Used in Ecological Momentary Assessment Studies About Sedentary Behavior in Children, Adolescents, and Adults: Systematic Review Using the Checklist for Reporting Ecological Momentary Assessment Studies

Background

The use of ecological momentary assessment (EMA) to measure sedentary behavior (SB) in children, adolescents, and adults can increase the understanding of the role of the context of SB in health outcomes.

Objective

The aim of this study was to systematically review literature to describe EMA methodology used in studies on SB in youth and adults, verify how many studies adhere to the Methods aspect of the Checklist for Reporting EMA Studies (CREMAS), and detail measures used to assess SB and this associated context.

Methods

A systematic literature review was conducted in the PubMed, Scopus, Web of Science, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and SPORTDiscus databases, covering the entire period of existence of the databases until January 2018.

Results

This review presented information about the characteristics and methodology used in 21 articles that utilized EMA to measure SB in youth and adults. There were more studies conducted among youth compared with adults, and studies of youth included more waves and more participants (n=696) than studies with adults (n=97). Most studies (85.7%) adhered to the Methods aspect of the CREMAS. The main criteria used to measure SB in EMA were self-report (81%) with only 19% measuring SB using objective methods (eg, accelerometer). The main equipment to collect objective SB was the ActiGraph, and the cutoff point to define SB was <100 counts/min. Studies most commonly used a 15-min window to compare EMA and accelerometer data.

Conclusions

The majority of studies in this review met minimum CREMAS criteria for studies conducted with EMA. Most studies measured SB with EMA self-report (n=17; 81.0%), and a few studies also used objective methods (n=4; 19%). The standardization of the 15-min window criteria to compare EMA and accelerometer data would lead to a comparison between these and new studies. New studies using EMA with mobile phones should be conducted as they can be considered an attractive method for capturing information about the specific context of SB activities of young people and adults in real time or very close to it.

Associations of sedentary time and self-reported television time during pregnancy with incident gestational diabetes and plasma glucose levels in women at risk of gestational diabetes in the UK

BACKGROUND

Sedentary time is associated with increased risk of type 2 diabetes, but the association between objectively measured sedentary time and incident gestational diabetes mellitus (GDM) has not been tested. The purpose of this paper is to test associations between objectively measured sedentary time and self-reported television time during pregnancy with incident GDM and plasma glucose levels among women at high risk for GDM.

METHODS

At 20 weeks' gestation, pregnant women (n = 188) in the North East of England with a risk factor for GDM wore an activPAL accelerometer and reported their usual television time. Participants underwent a standard oral glucose tolerance test at 24-28 weeks' gestation. Regression analyses were used to test for associations of total and prolonged sedentary time, breaks in sedentary time, and television time with GDM and fasting and 2-h glucose levels. Interaction terms were applied to examine whether the association between each indicator of sedentary time and glucose levels differed by GDM status.

RESULTS

Total sedentary time (hours/day) was not associated with incident GDM (OR 1.00 (95%CI 1.00, 1.01)). The association between total sedentary time and glucose levels depended on GDM status: sedentary time was associated with fasting (β = 0.16 (95%CI 0.01, 0.31)) and 2-h (β = 0.15 (95%CI 0.01, 0.30)) glucose levels for those without GDM, while breaks in sedentary time were associated with lower fasting (β = - 0.55 (95%CI - 0.92, - 0.17)) and 2-h (β = - 0.40 (95%CI - 0.77, - 0.03)) glucose levels for those with GDM. Prolonged sedentary time was associated with higher fasting glucose levels regardless of GDM status (β 0.15 (0.01, 0.30)). Television time was associated with development of GDM (OR 3.03 (95%CI 1.21, 7.96)) but not with plasma glucose levels.

CONCLUSIONS

This is the first study to test associations between posture-based measures of sedentary time during pregnancy and GDM and glucose levels. The findings presented here suggest the possible importance of minimizing or breaking up sedentary time for the management of glucose levels during pregnancy, at least among women at high risk of GDM. Further research is needed to understand the different roles of total sedentary time and television time in the development of GDM.

Designing effective point-of-choice prompts to promote active transportation and staircase use at a Canadian University

OBJECTIVE

The purpose of this study was to determine the most suitable health messages and designs to create point-of-choice prompts for promoting active transportation and staircase use that would appeal to undergraduate students.

PARTICIPANTS

Undergraduate students (N = 21; 71% women) were recruited during Fall (2016) and Winter (2017) semesters.

METHODS

Focus groups (50-80 minutes each) were organized to obtain students' feedback on the kind of messages and poster designs they found motivational. Inductive content analysis was performed on verbatim transcripts. Descriptive statistics were calculated to summarize demographic characteristics of participants.

RESULTS

The major themes revealed that participants: preferred simple designs with tailored messages; had diverse lifestyle-based values associated with physical activity; and participation in activities were affected by uncontrollable factors (eg, time, built environment, and weather).

CONCLUSIONS

This study provides insights for designing suitable point-of-choice prompts that are tailored for university students in terms of future interventions that aim to improve their activity levels.

Accelerometer-Derived Activity Phenotypes in Young Adults: a Latent Class Analysis

PURPOSE

To identify "activity phenotypes" from accelerometer-derived activity characteristics among young adults.

METHODS

Participants were young adults (n = 628, mean age, 22.1, SD 0.6) in the Raine Study in Western Australia. Sex-specific latent class analyses identified sub-groups using eight indicators derived from 7-day hip-worn Actigraph GT3X+ accelerometers: daily steps, total daily moderate-to-vigorous physical activity (MVPA), MVPA variation, MVPA intensity, MVPA bout duration, sedentary-to-light ratio, sedentary-to-light ratio variation, and sedentary bout duration.

RESULTS

Five activity phenotypes were identified for women (n = 324) and men (n = 304). Activity phenotype 1 for both women (35%) and men (30%) represented average activity characteristics. Phenotype 2 for women (17%) and men (16%) was characterized by below average total activity and MVPA (10.6 and 16.7 min of MVPA/day, women and men respectively). Phenotype 3 for women (15%) and men (23%) was characterized by below average total physical activity, average MVPA (32.6 and 36.5 min/day), high sedentary-light ratio and long sedentary bouts. Phenotype 4 differed between women (29%) and men (18%) but both had low sedentary-to-light ratios and shorter sedentary bouts. Finally, phenotype 5 in both women (4%) and men (12%) was characterized by extreme MVPA metrics (81.3 and 96.1 min/day).

CONCLUSIONS

Five activity phenotypes were identified for each gender in this population of young adults which can help design targeted interventions to enhance or modulate activity phenotypes.

Associations of Accumulated Time in Bouts of Sedentary Behavior and Moderate-to-Vigorous Physical Activity With Cardiometabolic Health in 10- to 13-Year-Old Boys

BACKGROUND

Little is known about the impact of sedentary and moderate-to-vigorous physical activity (MVPA) bouts on cardiometabolic health. The aim was to examine how the accumulation of bouts of sedentary time and MVPA associates to cardiometabolic health in children independently of total sedentary and MVPA time.

METHODS

In a cross-sectional study with 123 boys (10-13 y), sedentary and MVPA bouts were determined using 7-day accelerometry. Each bout was compared with cardiometabolic risk factors and with the risk score that was calculated using standardized values of body mass index, waist circumference, homeostasis model assessment for insulin resistance, triglycerides, and total cholesterol/high-density cholesterol ratio.

RESULTS

Time in 10- to 14-minute sedentary bouts was negatively associated with continuous cardiometabolic risk score in weekdays and weekend days and with triglycerides in a weekend (P < .05). Time accumulated in ≥30-minute sedentary bouts was associated with higher insulin and homeostasis model assessment for insulin resistance values in weekend (P < .05). Weekday total MVPA and time accumulated in ≥10-minute MVPA bouts were negatively associated with continuous cardiometabolic risk score and body mass index in weekdays (P < .05). No associations were found between total sedentary time and metabolic health.

CONCLUSION

Significant associations between sedentary and MVPA bouts with cardiometabolic risk factors suggest the need of the more detailed analysis for sedentary behavior and its effects on health risks.

Sedentary Behavior in Patients With Knee Osteoarthritis Before and After Total Knee Arthroplasty: A Systematic Review

Objective:The objective of this systematic review is to integrate the available evidence on changes in sedentary behavior (SB) in patients with knee osteoarthritis after total knee arthroplasty (TKA).Methods:A systematic literature search from January 2002 to October 31, 2017, was performed for studies assessing objectively and/or subjectively measured SB following TKA. The Scottish Intercollegiate Guidelines Network Methodology appraisal tool was used to critically appraise the methodological quality of the included studies.Results:Ten studies reporting on SB with a total of 1,028 participants were included in the review. Three studies reported changes in SB with two showing a reduction in SB and one (with high risk of bias) an increase in SB after TKA. Seven studies showed no change in SB following TKA.Conclusion:Currently, there is insufficient evidence which suggests that SB time improves following TKA. Detailed assessments of SB after TKA are needed.

Housing, neighbourhood and sociodemographic associations with adult levels of physical activity and adiposity: baseline findings from the ENABLE London study

OBJECTIVES

The neighbourhood environment is increasingly shown to be an important correlate of health. We assessed associations between housing tenure, neighbourhood perceptions, sociodemographic factors and levels of physical activity (PA) and adiposity among adults seeking housing in East Village (formerly London 2012 Olympic/Paralympic Games Athletes' Village).

SETTING

Cross-sectional analysis of adults seeking social, intermediate and market-rent housing in East Village.

PARTICIPANTS

1278 participants took part in the study (58% female). Complete data on adiposity (body mass index (BMI) and fat mass %) were available for 1240 participants (97%); of these, a subset of 1107 participants (89%) met the inclusion criteria for analyses of accelerometer-based measurements of PA. We examined associations between housing sector sought, neighbourhood perceptions (covariates) and PA and adiposity (dependent variables) adjusted for household clustering, sex, age group, ethnic group and limiting long-standing illness.

RESULTS

Participants seeking social housing had the fewest daily steps (8304, 95% CI 7959 to 8648) and highest BMI (26.0 kg/m², 95% CI 25.5kg/m² to 26.5 kg/m²) compared with those seeking intermediate (daily steps 9417, 95% CI 9106 to 9731; BMI 24.8 kg/m², 95% CI 24.4 kg/m² to 25.2 kg/m²) or market-rent housing (daily steps 9313, 95% CI 8858 to 9768; BMI 24.6 kg/m², 95% CI 24.0 kg/m² to 25.2 kg/m²). Those seeking social housing had lower levels of PA (by 19%-42%) at weekends versus weekdays, compared with other housing groups. Positive perceptions of neighbourhood quality were associated with higher steps and lower BMI, with differences between social and intermediate groups reduced by ~10% following adjustment, equivalent to a reduction of 111 for steps and 0.5 kg/m² for BMI.

CONCLUSIONS

The social housing group undertook less PA than other housing sectors, with weekend PA offering the greatest scope for increasing PA and tackling adiposity in this group. Perceptions of neighbourhood quality were associated with PA and adiposity and reduced differences in steps and BMI between housing sectors. Interventions to encourage PA at weekends and improve neighbourhood quality, especially among the most disadvantaged, may provide scope to reduce inequalities in health behaviour.

Association of Physical Activity With Income, Race/Ethnicity, and Sex Among Adolescents and Young Adults in the United States: Findings From the National Health and Nutrition Examination Survey, 2007-2016

IMPORTANCE

Physical activity in youth is associated with adult health. Understanding the prevalence and factors of moderate to vigorous physical activity among adolescents and young adults will guide public health and policy efforts.

OBJECTIVES

To describe the current patterns of physical activity and duration among adolescents and young adults and to identify the direction and magnitude of associations between physical activity and income, race/ethnicity, and sex.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional secondary data analysis used the self-reported physical activity data of adolescents and young adults from the National Health and Nutrition Examination Survey from 2007 through 2016. This data set is a multistage probability sample of the noninstitutionalized US population and allows estimates that represent the US population. The years 2007 through 2016 were selected because of the consistent physical activity questions during this period. Adolescents and young adults aged 12 to 29 years who responded to the survey were included. Individuals who were underweight were excluded. Data analysis was performed from October 17, 2017, to April 27, 2018.

MAIN OUTCOMES AND MEASURES

Self-reported physical activity duration and intensity.

RESULTS

Of the 9472 participants, 4771 (50.4%) were males, and the weighted mean age (range) was 20.6 (12-19) years. Across all demographic categories, females reported less physical activity than did their male counterparts. White adolescent males were most likely (89.3%; 95% CI, 86.5%-92.1%) and black females aged 18 to 24 years were least likely (45%; 95% CI, 39.0%-51.0%) to report any physical activity. Among those who were active, black males aged 18 to 24 years reported the longest duration of activity (77.9 minutes per day; 95% CI, 66.4-89.3 minutes per day), and black females aged 25 to 29 years reported the shortest duration of activity (33.2 minutes per day; 95% CI, 28.1-38.2 minutes per day). In adjusted models, younger age, white race, and higher income were associated with greater physical activity.

CONCLUSIONS AND RELEVANCE

Female adolescents and young adults were not meeting the recommended guidelines for physical activity, and substantial disparities by race and income levels were noted. These data highlight opportunities for targeted physical activity programming and policy efforts.

Correlates of physical activity and sedentary time in young adults: the Western Australian Pregnancy Cohort (Raine) Study

Background

The socioecological model proposes a wide array of factors that influence behaviours. There is a need to understand salient correlates of these activity behaviours in a specific population. However, few studies identified socio-demographic, behavioural, physical, and psychological correlates of objectively-assessed physical activity and sedentary time in young adults.

Methods

This was a cross-sectional analysis of participants in the Raine Study (a pregnancy cohort started in 1989). Australian young adults (mean 22.1 years ± SD 0.6) wore Actigraph GT3X+ accelerometers on the hip 24 h/day for seven days to assess moderate-to-vigorous physical activity (MVPA) and sedentary time (n = 256 women, n = 219 men). Potential correlates were assessed via clinical assessment and questionnaire and included socio-demographic variables (ethnicity, relationship status, work/study status, education, mothers education), health behaviours (food intake, alcohol consumption, smoking status, sleep quality), and physical and psychological health aspects (anthropometrics, diagnosed disorders, mental health, cognitive performance). Backwards elimination (p < 0.2 for retention) with mixed model regressions were used and the gender-stratified analyses were adjusted for demographic variables, waking wear time and number of valid days.

Results

Increased time spent in MVPA was associated with: being single (IRR 1.44 vs in a relationship living together, 95%CI: 1.17, 1.77, p = .001) in women; and better sleep quality in men (lower scores better IRR 0.97, 95%CI: 0.93, 1.00). Less time spent sedentary was associated with: lower mother’s education (− 32.1 min/day, 95%CI -52.9, 11.3, p = 0.002 for having mother with no university degree vs at least a baccalaureate degree) and smoking (− 44.3 min/day, 95%CI: - 72.8, − 15.9, p = .0002) for women; lower education status (− 32.1 min/day, 95%CI: -59.5, − 4.8, p = 0.021 for having no university degree vs at least a baccalaureate degree) and lower depression scores in men (− 2.0, 95%CI: - 3.5, − 0.4, p = 0.014); more alcoholic drinks per week for women (− 1.9 min/day, 95%CI: -3.1, − 0.6, p = 0.003) and men (− 1.0, 95%CI: -1.8, − 0.3, p = 0.007).

Conclusions

Less desirable correlates were associated with positive levels of activity in young Australian adult women and men. Interventions to increase MVPA and decrease sedentary activity in young adults need to specifically consider the life stage of young adults.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5705-1) contains supplementary material, which is available to authorized users.

Correlates of objectively measured sedentary time in adults with intellectual disabilities

Sedentary behaviour is an independent risk factor for adverse health conditions. Adults with intellectual disabilities spend a high proportion of their day engaged in sedentary behaviour, however, there is limited evidence on potential correlates of objectively measured sedentary behaviour in this population group. In Glasgow, UK from July to September 2017, a secondary analysis of pooled baseline accelerometer data from two randomised controlled trials of lifestyle behaviour change programmes was conducted. Backwards linear regression was used to investigate the associations between demographic, biological, and environmental correlates and objective measure of sedentary behaviour (percentage of time spent sedentary). One-hundred and forty-three participants provided valid accelerometer data. Mean percentage time spent sedentary (adjusted for wear time) was 72.9% [Standard Deviation (SD) = 8.7] per day. In the final model, physical and mental health problems were significantly (p < 0.05) associated with increased percentage time spent sedentary. This is the first study to provide evidence on multi-level, demographic, biological, and environmental correlates of objectively measured sedentary behaviour in adults with intellectual disabilities. To inform the development of interventions to modify sedentary behaviours in adults with intellectual disabilities, further research is required including a wide range of socio-ecological correlates.

Are habitual runners physically inactive?

The World Health Organisation's (WHO) physical activity guidelines recommend 150min/week of moderate- to vigorous-intensity physical activity (MVPA) accumulated in 10 min bouts. To see whether people performing habitual exercise for recreation meet these guidelines, 25 long-distance runners [mean 67 km/wk], 25 joggers [mean 28 km/wk], and 20 sedentary adults wore an ActiGraph GT3X+ accelerometer for 7 days. Sedentary time and bouts were similar in runners and sedentary adults (p > 0.46). Sedentary adults performed 20 ± 16 min/day of MVPA (usual bout duration (W50%): 9.53 ± 3.45min), with joggers and runners performing 45 ± 31min (W50%: 16.92 ± 9.53min) and 83 ± 58min (W50%: 20.35 ± 8.85min), respectively (p ≤ 0.001 versus sedentary group). Data showed that 65% of the sedentary group, 32% of joggers and 4% of long-distance runners did not meet the WHO guideline for MVPA. Failure to meet the guideline was most prominent in, but not restricted to, runners who reported ≤50km running per week. Self-reported running does not ensure adults meet physical activity guidelines or offset daily sedentary behaviours. On the other hand, the sedentary group was very close in accumulating recommended bouts of MVPA in incidental activities. Future studies should assess whether modification of work and leisure physical activity would be more fruitful than encouraging recreational exercise per se in meeting physical activity guidelines.

Device-Measured Physical Activity As a Predictor of Disability in Mobility-Limited Older Adults

OBJECTIVES

To examine associations between objectively measured physical activity (PA) and incidence of major mobility disability (MMD) and persistent MMD (PMMD) in older adults in the Lifestyle Interventions and Independence for Elders (LIFE) Study.

DESIGN

Prospective cohort of individuals aged 65 and older undergoing structured PA intervention or health education.

SETTING

The LIFE Study was a multicenter (eight sites) randomized controlled trial designed to compare the efficacy of a long-term structured PA intervention with that of a health education (HE) program in reducing the incidence of MMD in mobility-limited older adults.

PARTICIPANTS

LIFE Study participants (n = 1,590) had a mean age±standard deviation of 78.9 ± 5.2, low levels of PA, and measured mobility-relevant functional impairment at baseline.

MEASUREMENTS

Activity data were collected using hip-worn 7-day accelerometers at baseline and 6, 12, and 24 months after randomization to test for associations with incident MMD and PMMD (≥2 consecutive instances of MMD).

RESULTS

At baseline, every 30 minutes spent being sedentary (<100 accelerometry counts per minute) was associated with higher rate of subsequent MMD (10%) and PMMD (11%) events. Every 500 steps taken was associated with lower rate of MMD (15%) and PMMD (18%). Similar associations were observed when fitting accelerometry-based PA as a time-dependent variable.

CONCLUSION

Accelerometry-based PA levels were strongly associated with MMD and PMMD events in older adults with limited mobility. These results support the importance of daily PA and lower amounts of sedentary time levels in this population and suggest that accelerometry may be a useful tool for assessing risk of mobility disability.

Correlates of sedentary behaviour in adults: a systematic review

OBJECTIVE

The objective of this study was to systematically review evidence to identify intrapersonal, social environmental, physical environmental and policy correlates of sedentary behaviour (SB) among adults.

METHODS

Six databases were searched to identify studies that reported on intrapersonal, social, physical environmental and/or policy correlates of SB across domains (i.e. occupational, leisure and transportation) in adults (mean ≥ 18 years old). Subgroup differences (sex, age, disease status, publication status and date, weekdays vs. weekend) were examined. Risk of bias was assessed, and a qualitative synthesis completed.

PROSPERO

CRD42014009814 RESULTS: Searching identified 22,779 articles; 257 were used in the analysis. Most studies used self-reported SB and were cross-sectional. The most studied domain of SB and correlate was leisure and intrapersonal, respectively. Consistent evidence found positive relationships between full-time employment and higher transportation and lower leisure SB; higher income/socioeconomic status and greater transportation and occupation SB; living in more urban areas and greater sitting time and total SB; ownership of televisions and greater leisure SB; and, active workstations and lower occupational SB.

CONCLUSIONS

The review identifies the need for longitudinal studies, as well as further research on factors in the physical, social and policy environments. The review also recognizes the need to standardize methodology for collecting, defining and reporting SB and correlates.

Targeting Reductions in Sitting Time to Increase Physical Activity and Improve Health

: New evidence suggests that reductions in sedentary behavior may increase physical activity and improve health. These findings point to new behavioral targets for intervention and new ways to think about intervening to increase overall physical activity in the population. This report provides a knowledge update reflecting the rapid accumulation of new evidence related to sedentary behavior and health among adults. Recent observational studies suggest that leveraging the time-inverse relationship between sedentary and active behaviors by replacing sitting with standing, light- or moderate-intensity activity can have important health benefits, particularly among less active adults. Clinical studies are providing evidence of the probable physiologic mechanisms underlying these associations, as well as insights into the cardiometabolic impact of breaking up and reducing sedentary behavior. In contrast to the well-established behavioral theories that guide the development and dissemination of evidence-based interventions to increase moderate- to vigorous-intensity physical activity, much less is known about how to reduce sedentary time to increase daily activities. It has become clear that the environmental, social, and individual level determinants for sedentary time are distinct from those linked to the adoption and maintenance of moderate- to vigorous-intensity physical activity. As a result, novel intervention strategies that focus on sitting and lower-intensity activities by leveraging the surrounding environment (e.g., workplace, school, and home) as well as individual-level cues and habits of sedentary behavior are being tested to increase the potency of interventions designed to increase overall physical activity. Herein we summarize the solutions-oriented research across the behavioral research framework, with a focus on highlighting areas of synergy across disciplines and identifying gaps for future research.

Patterns of objectively measured sedentary time in 10- to 12-year-old Belgian children: an observational study within the ENERGY-project

BACKGROUND

This study examined the frequency of and differences in sedentary bouts of different durations and the total time spent in sedentary bouts on a weekday, a weekend day, during school hours, during after-school hours and in the evening period in a sample of 10- to 12-year-old Belgian children.

METHODS

Accelerometer data were collected as part of the ENERGY-project in Belgium (n = 577, 10.9 ± 0.7 years, 53% girls) in 2011. Differences in total sedentary time, sedentary bouts of 2-5, 5-10, 10-20, 20-30 and ≥30 min and total time accumulated in those bouts were examined on a weekday, a weekend day, during school hours, during after-school hours and in the evening period, using multilevel analyses in MLwiN 2.22.

RESULTS

More than 60% of the participants' waking time was spent sedentary. Children typically engaged in short sedentary bouts of 2-5 and 5-10 min, which contributed almost 50% towards their total daily sedentary time. Although the differences were very small, children engaged in significantly fewer sedentary bouts of nearly all durations during after-school hours compared to during school hours and in the evening period. Children also engaged in significantly fewer sedentary bouts of 5-10, 10-20, and 20-30 min per hour on a weekend day than on a weekday.

CONCLUSIONS

Although primary school children spend more than 60% of their waking time sedentary, they generally engaged in short sedentary bouts. Children's sedentary bouts were slightly longer on weekdays, particularly during school hours and in the evening period, although the differences were very small. These results suggest that in this age group, interventions focusing on reducing total sedentary time rather than interrupting prolonged sedentary time are needed.

Sedentary behavior patterns in non-pregnant and pregnant women

Sedentary behavior has been associated with adverse health outcomes among pregnant women; however, few studies have characterized sedentary behavior patterns in this population. We described patterns of accelerometer-determined indicators of sedentary behavior among a national sample of US pregnant (n = 234) women and non-pregnant (n = 1146) women participating in the NHANES 2003-06 cycles. We included women with ≥ 4 days of accelerometer wear of ≥ 10 h/day. A count threshold of < 100 cpm was used to describe sedentary behavior as: 1) total accumulated sedentary time by bout length categories; 2) accumulated sedentary time within discrete bout length categories; 3) mean, median, and usual bout length; and 4) and bout frequency. Both non-pregnant and pregnant women spent up to 60% of their accelerometer wear time in sedentary behavior depending on the minimum bout threshold applied. Sedentary time was higher among pregnant women compared to non-pregnant women when lower bout thresholds (i.e. 10 min or less) were applied. The majority of total sedentary time was accumulated in bouts lasting < 10 min. The women averaged less than two prolonged sedentary bouts (i.e., ≥ 30 min) per day, which accounted for nearly 20% of total accumulated sedentary time. When applying a minimum threshold of at least 15 min, sedentary time increased across pregnancy trimesters, while sedentary time was similar across trimesters when using lower thresholds. These findings provide the first characterization of accelerometer-determined indicators of sedentary behavior in pregnant women. The minimum bout threshold applied influenced estimates of sedentary time and patterns sedentary time accumulation across pregnancy trimesters.

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How we operationalized sedentary behavior affects estimates of sedentary time.

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How women accumulate their sedentary time, changes over trimesters of pregnancy.

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Most sedentary bouts are short in duration (i.e. < 10 min).

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Long sedentary bouts (i.e. ≥ 30 min) account for ~ 20% of total sedentary time.