A comparison of standard and compositional data analysis in studies addressing group differences in sedentary behavior and physical activity

Socioeconomic gradients in 24-hour movement patterns across weekends and weekdays in a working-age sample: evidence from the 1970 British Cohort Study

BACKGROUND

Socioeconomic differences in movement behaviours may contribute to health inequalities. The aim of this descriptive study was to investigate socioeconomic patterns in device-measured 24-hour movement and assess whether patterns differ between weekdays and weekends.

METHODS

4894 individuals aged 46 years from the 1970 British Cohort Study were included. Participants wore thigh-worn accelerometers for 7 days. Movement behaviours were classified in two 24-hour compositions based on intensity and posture, respectively: (1) sleep, sedentary behaviour, light-intensity activity and moderate-vigorous activity; and (2) sleep, lying, sitting, standing, light movement, walking and combined exercise-like activity. Four socioeconomic measures were explored: education, occupation, income and deprivation index. Movement behaviours were considered compositional means on a 24-hour scale; isometric log ratios expressed per cent differences in daily time in each activity compared with the sample mean.

RESULTS

Associations were consistent across all socioeconomic measures. For example, those with a degree spent more time in exercise-like activities across weekdays (10.8%, 95% CI 7.3 to 14.7; ref: sample mean) and weekends (21.9%, 95% CI 17.2 to 26.9). Other patterns differed markedly by the day of the week. Those with no formal qualifications spent more time standing (5.1%, 95% CI 2.3 to 7.1), moving (10.8%, 95% CI 8.6 to 13.1) and walking(4.0%, 95% CI 2.2 to 6.1) during weekdays, with no differences on weekends. Conversely, those with no formal qualifications spent less time sitting during weekdays (-6.6%, 95% CI -7.8 to -4.8), yet more time lying on both weekends (8.8%, 95% CI 4.9 to 12.2) and weekdays (7.5%, 95% CI 4.0 to 11.5).

CONCLUSIONS

There were strong socioeconomic gradients in 24-hour movement behaviours, with notable differences between weekdays/weekends and behaviour type/posture. These findings emphasise the need to consider socioeconomic position, behaviour type/posture and the day of the week when researching or designing interventions targeting working-age adults.

Protocol for an observational study of working conditions and musculoskeletal health in Swedish online retail warehousing from the perspective of sex/gender and place of birth

European and International sustainable development agendas aim to reduce inequalities in working conditions and work-related health, yet disparate occupational health outcomes are evident between both men and women and domestic- and foreign-born workers. In Sweden, major growth in online retail warehousing has increased occupational opportunities for foreign-born workers. The rapid change has left research lagging on working conditions, i.e., employment conditions, facility design, work organisation, physical and psychosocial work environment conditions, and their effects on worker health. Further, no known studies have considered patterns of inequality related to these factors. The overall aim of this study is to describe working conditions and musculoskeletal health in online retail warehousing, determine the extent to which differences exist related to sex/gender and place of birth (as a proxy for race/ethnicity), and examine factors at the organisational and individual levels to understand why any differences exist. Three online retail warehouses, each employing 50-150 operations workers performing receiving, order picking, order packing and dispatching tasks will be recruited. Warehouses will, to the extent possible, differ in their extent of digital technology use. Employment conditions, facility design (including digital tool use), work organisation, physical and psychosocial work environment conditions and worker health will be assessed by survey, interview and technical measurements. Analysis of quantitative data stratified by sex and place of birth will consider the extent to which inequalities exist. Focus group interviews with operations employees and in-depth interviews with managers, union and health and safety representatives will be conducted to assess how employee working conditions and musculoskeletal health are related to inequality regimes of sex/gender and/or race/ethnicity in organisational processes and practices in online retail warehousing. The study is pre-registered with the Open Science Framework. This study will describe working conditions and health in online retail warehouse workers and consider the extent to which patterns of inequality exist based on sex/gender and place of birth.

Replacing device-measured sedentary time with physical activity is associated with lower risk of coronary heart disease regardless of genetic risk

BACKGROUND

Excess sedentary time (ST) is recognized as an important modifiable risk factor for coronary heart disease (CHD). However, whether the associations of genetic susceptibility with CHD incidence can be modified by replacing wearable-device-measured ST with physical activity (PA) is unknown.

OBJECTIVES

To examine the associations of wearable-device-measured ST replaced by PA with incident CHD across strata of genetic susceptibility.

METHODS

This study included 77,500 White British (57% female) with valid wrist-worn accelerometry and without prevalent CHD/stroke from UK Biobank. Genetic susceptibility to CHD was quantified through weighted polygenic risk scores for CHD based on 300 single-nucleotide polymorphisms. Wrist-worn accelerometer data were used to derive ST, light PA, and moderate-to-vigorous PA (MVPA).

RESULTS

Reallocation of 60 min/day of ST into the same amount of MVPA was associated with approximately 9% lower relative risk of CHD for all participants and across strata of genetic risk: replacement of 1 min/day of ST associated with <1% lower relative risk of CHD. No evidence of interaction (p: 0.784) was found between genetic risk and ST for CHD risk. Reallocating 60 min/day of ST into the same MVPA time was associated with greater absolute CHD risk reductions at high genetic risk (0.27%) versus low genetic risk (0.15%).

CONCLUSIONS

Replacing any amount of ST with an equal amount of MVPA time is associated with a lower relative risk of CHD, irrespective of genetic susceptibility to CHD. Reductions in CHD absolute risk for replacing ST with MVPA are greater at high genetic risk versus low genetic risk.

Association of physical activity with loss of knee joint space width over two years: a compositional data analysis in the Osteoarthritis Initiative

OBJECTIVE

There is continued debate as to how engaging in physical activity (PA), including moderate-to-vigorous PA (MVPA), light PA (LPA), and sedentary time (SED), affects one's risk for knee osteoarthritis (OA). Traditional regression methods do not account for the codependence of these categories of PA, whereby when one category increases, the others must decrease. Thus, we used compositional data analysis (CoDA) to examine time spent in each category of PA, or PA composition, and its association with loss of knee joint space width (JSW), a common indicator of knee OA progression.

METHODS

We performed a secondary analysis of data from a subset of participants in the Osteoarthritis Initiative. These participants had minute-by-minute activity data collected over 7 days at baseline; we then categorized each minute as MVPA, LPA, or SED. Our exposure, PA composition, represented min/day spent in each category. Our outcome, medial JSW loss, was the difference in medial tibiofemoral JSW from baseline to 2 years later. We employed CoDA, using an isometric log-ratio transformation, to examine the association of PA composition with medial JSW loss over 2 years, adjusting for potential confounders.

RESULTS

We included 969 participants (age: 64.5 years, 56% female, body mass index [BMI]: 28.8 kg/m2). Mean PA composition was: MVPA 9.1 min/day, LPA 278 min/day, SED 690 min/day. Per adjusted regression models, higher MVPA was not associated with greater medial JSW loss (β = -0.0005, P = 0.97), nor was LPA (β = 0.06, P = 0.27) or SED (β = -0.06, P = 0.21).

CONCLUSION

Using CoDA, PA composition was not associated with medial JSW loss over 2 years.

The visual control of locomotion when stepping onto moving surfaces: A comparison of younger and older adults

Stepping between static and moving surfaces presents a locomotor challenge associated with increased injury frequency and severity in older adults. The current study evaluates younger and older adults' behaviours when overcoming challenges sampling moving walkway and escalator environments. Twelve younger adults (18-40 years, Male = 8) and 15 older adults (60-81 years, Male = 5) were examined using an integration of optoelectronic motion capture and mobile eye-tracking. Participants were investigated approaching and stepping onto a flat conveyor belt (static or moving; with or without surface (demarcation) lines). Specifically, the four conditions were: (i) static surface without demarcation lines; (ii) static surface with demarcation lines; (iii) moving surface without demarcation lines; and (iv) moving surface with demarcation lines. A two (age group) x two (surface-condition) x two (demarcation-condition) linear mixed-model revealed no main or interaction effects (p > .05) for perturbation magnitude, indicating participants maintained successful locomotion. However, different adaptive behaviours were identified between conditions with moving and accuracy demands (e.g., moving surfaces increased step length, demarcations reduced step length). Between subject effects identified differences between age groups. Older adults utilised different behaviours, such as earlier gaze transfer from the final approach walkway step location. Overall, the current study suggests that adaptive behaviours emerge relative to the environment's specific demands and the individual's action capabilities.

Physical activity, sedentary behaviour, and sleep in the Thai population: A compositional data analysis including 135,824 participants from two national time-use surveys

PURPOSE

To determine the amounts of time spent in physical activity (PA), sedentary behaviour (SB), and sleep in the Thai population, as well as their sociodemographic correlates and changes over time.

METHODS

We analysed cross-sectional data collected in a population-representative, stratified random sample of 135,824 Thais aged 10 years and over as part of the two most recent Thai National time-use surveys (2009 and 2015). Daily activities reported by the participants were coded using the International Classification of Activities for Time-Use Statistics (ICATUS) and categorised as PA, SB, or sleep.

RESULTS

In the latest survey, participants spent on average the largest amount of time sleeping (geometric mean [g] = 9.44 h/day; 95% confidence interval [CI]: 9.42, 9.47), followed by PA (g = 8.60 h/day; 95% CI: 8.55, 8.64) and SB (g = 5.96 h/day; 95% CI: 5.93, 6.00). The time spent in PA was higher on weekdays, while the amounts of SB and sleep were higher on weekends (p < 0.05). Males, older age groups, and unemployed people spent less time in PA and more time in SB, compared with other population groups (p < 0.05). We found a relatively large increase in SB (mean difference [d] = 39.64 min/day; 95% CI: 36.18, 42.98) and decrease in PA (d = 54.33 min/day; 95% CI: -58.88, -49.30) over time. These findings were consistent across most sociodemographic groups, with the most concerning shifts from active to sedentary lifestyle found among people with a higher education degree and on weekends.

CONCLUSIONS

Our findings revealed a shift to a more sedentary lifestyle in the Thai population. Public health interventions should focus on improving time use among males, older age groups, and unemployed people, while preventing the rapid decrease in PA and increase in SB among those with a higher education degree and on weekends.

Sedentary behaviour, physical activity, and sleep among office workers during the COVID-19 pandemic: a comparison of Brazil and Sweden

Background

The COVID-19 pandemic has affected the physical behaviours of office workers worldwide, but studies comparing physical behaviours between countries with similar restrictions policies are rare. This study aimed to document and compare the 24-hour time-use compositions of physical behaviours among Brazilian and Swedish office workers on working and non-working days during the pandemic.

Methods

Physical behaviours were monitored over 7 days using thigh-worn accelerometers in 73 Brazilian and 202 Swedish workers. Daily time-use compositions were exhaustively described in terms of sedentary behaviour (SED) in short (< 30 min) and long (≥30 min) bouts, light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and time-in-bed. We examined differences between countries using MANOVA on data processed according to compositional data analysis. As Swedish workers had the possibility to do hybrid work, we conducted a set of sensitivity analyses including only data from days when Swedish workers worked from home.

Results

During working days, Brazilian office workers spent more time SED in short (294 min) and long (478 min) bouts and less time in LPA (156 min) and MVPA (50 min) than Swedish workers (274, 367, 256 and 85 min, respectively). Time spent in bed was similar in both groups. Similar differences between Brazilians and Swedes were observed on non-working days, while workers were, in general, less sedentary, more active and spent more time-in-bed than during working days. The MANOVA showed that Brazilians and Swedes differed significantly in behaviours during working (p <  0.001, ηp2 = 0.36) and non-working days (p <  0.001, ηp2 = 0.20). Brazilian workers spent significantly more time in SED relative to being active, less time in short relative to long bouts in SED, and more time in LPA relative to MVPA, both during workdays and non-workdays. Sensitivity analyses only on data from days when participants worked from home showed similar results.

Conclusions

During the COVID-19 pandemic Brazilian office workers were more sedentary and less active than Swedish workers, both during working and non-working days. Whether this relates to the perception or interpretation of restrictions being different or to differences present even before the pandemic is not clear, and we encourage further research to resolve this important issue.

Movement behaviours and anxiety symptoms in Chinese college students: A compositional data analysis

In the current research, sleep duration, sedentary behaviour, physical activity, and their relationship with several anxiety symptoms among college students were examined. This study was a cross-sectional study, and study respondents were recruited from college students. A total of 1,475 of college students were included for analysis. Sedentary behaviours and physical activity were assessed by the International Physical Activity Questionnaire Short Form, while sleep duration was assessed by the Chinese version Pittsburgh Sleep Quality Index. To assess the anxiety symptoms of study respondents, the Generalised Anxiety Disorder-7 was used. The compositional data was analysed in R to estimate the associations between replacements among physical activities, sedentary behaviours, and sleep and anxiety symptoms. Results indicated a greater impact was imposed on the alleviation of anxiety symptoms by substituting sedentary behaviours with physical activity at moderate to vigorous intensity. In the current research, the significance of moderate to vigorous physical activity should be highlighted in preventing anxiety among Chinese college students.

Longitudinal Changes in Physical Activity during Pregnancy: National Institute of Child Health and Human Development Fetal Growth Studies

INTRODUCTION

Exercise in pregnancy is associated with many perinatal benefits, but patterns of home, work, and commuting activity are not well described. We investigated longitudinal activity in singleton and twin pregnancy by activity domain and maternal characteristics.

METHODS

In the National Institute of Child Health and Human Development Fetal Growth Studies cohorts, 2778 women with singleton and 169 women with twin gestations reported activity using the Pregnancy Physical Activity Questionnaire at up to six or seven study visits, respectively. Metabolic equivalent of task-hours per week (MET-h·wk -1 ) was calculated from reported activity. Baseline measurements (obtained between 10 and 13 wk) reflected past year activity. Linear mixed models estimated MET-h·wk -1 by domain (household/childcare, occupational, inactive, transportation, sports/exercise), self-reported race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, Asian/Pacific Islander), prepregnancy body mass index (<25, 25 to < 30, ≥30 kg·m -2 ), parity (0, ≥1), baseline activity (quartiles), and plurality (singleton, twin).

RESULTS

Household/caregiving activity made up the largest fraction of reported MET-h·wk -1 at baseline (42%), followed by occupational activity (28%). Median summed activity declined 47%, from 297 to 157 MET-h·wk -1 , between 10 and 40 wk, largely driven by changes in household/caregiving (44% decline), and occupational activity (63% decline). Sports/exercise activity declined 55% but constituted only 5% of reported MET-h·wk -1 at baseline. At baseline, non-Hispanic Black women reported significantly higher activity than non-Hispanic White or Hispanic women, but differences did not persist across pregnancy. Across gestation nulliparous women reported significantly lower activity than parous women. Women with singleton gestations reported significantly more activity than women with twins from weeks 26 to 38. Baseline activity level was strongly associated with later activity levels.

CONCLUSIONS

Measuring domains of activity beyond exercise, and collecting longitudinal measurements, is necessary to fully describe activity in diverse populations of pregnant women.

Within-Person Associations Between Physical and Social Contexts With Movement Behavior Compositions in Adolescents: An Ecological Momentary Assessment Study Using a Compositional Data Analysis Approach

BACKGROUND

External contexts, including the social and physical contexts, are independent predictors of momentary physical activity and sedentary behaviors. However, no studies to date have examined how external contexts are related to overall momentary movement behavior compositions using compositional data analysis. Therefore, this study aimed to determine differences in momentary movement behavior compositions between different social and physical contexts in adolescents.

METHODS

Overall, 119 adolescents (mean age 14.7 y, SD = 1.44) provided details about their momentary physical and social contexts over 4 days using ecological momentary assessment. Sedentary behaviors, light-intensity physical activity, and moderate to vigorous physical activity were assessed using ActiGraph GT3X+ accelerometers. Compositional multivariate multilevel models were estimated to determine if movement behavior compositions differed between contexts.

RESULTS

Participants engaged in significantly less sedentary behaviors when outdoors compared with indoors and replaced it with moderate to vigorous physical activity. Participants also engaged in significantly less sedentary behaviors when with friends or friends and family and replaced it with light-intensity physical activity.

CONCLUSION

These results highlight the potential of targeting external contexts to increase physical activity and to reduce sedentary behavior in adolescents' daily lives. These factors could be targeted in mobile health and just-in-time adaptive interventions to improve young people's movement behavior compositions.

Lack of avoidance of the fungal entomopathogen, Metarhizium brunneum, by male Agriotes obscurus beetles

Fungal entomopathogens can greatly reduce the fitness of their hosts, and it is therefore expected that susceptible insects will be selected to avoid exposure to pathogens. Metarhizium brunneum is a fungal pathogen that can infect Agriotes obscurus, which in its larval form is a destructive agricultural pest and is repelled by the presence of M. brunneum conidia. Due to the subterranean nature of larval A. obscurus, recent research has focused on targeting adult A. obscurus with M. brunneum. No-choice and choice behavioural assays were conducted to determine if male adult A. obscurus avoid M. brunneum mycosed cadavers, or conidia applied to either food or soil. To further investigate the response of A. obscurus beetles to conspecific cadavers, the movement and behaviour of beetles placed at the centre of a semi-circular arrangement of mycosed or control cadavers was examined using motion tracking software. We found little evidence to suggest that A. obscurus male beetles avoid M. brunneum conidia or mycosed conspecific cadavers or alter their behaviour in their presence.

Differences in Accelerometer-Measured Physical Activity and Sedentary Behavior Between Middle-Aged Men and Women in Japan: A Compositional Data Analysis

BACKGROUND

Differences in accelerometer-measured sedentary behavior and different physical activity (PA) intensities between men and women have been poorly described. The authors examined gender differences in time-use activity composition and total volume of PA.

METHODS

A cross-sectional mail survey was conducted from 2013 to 2015 with a randomized sample of 6000 middle-aged (40-64 y) community-dwelling Japanese adults living in urban and regional cities. Participants wore Active style Pro HJA-350IT on their waist for 7 consecutive days. Gender differences in activity time use was examined using compositional data analysis to control for time spent in all activity measures.

RESULTS

In total, 757 participants (303 men, 52.3 [7.1] y) with valid data were included in the analysis. Women spent on average 12.6% less time in sedentary behavior and 23.4% more time in light-intensity PA than men, whereas no significant difference was found for moderate to vigorous PA. Women accumulated a significantly greater volume of PA than men (17.8 vs 15.0 metabolic equivalent of task h/d).

CONCLUSIONS

Japanese middle-aged women showed higher levels of PA than men because they spent more time in light-intensity PA. Given the health benefits of light-intensity PA, evaluating only moderate to vigorous PA may lead to an underestimation of women's participation in PA.

The impact of ActiGraph's low-frequency extension filter on measurement of children's physical activity

This study examines differences in accelerometer-based measurements of children's movement with and without applying ActiGraph's low-frequency extension (LFE) filter. Thirty children wore ActiGraph GT9X devices during structured physical activity (PA) periods. Raw accelerometry data for each activity period were processed with and without the LFE filter applied. For each activity period, paired t-tests were used to compare vector magnitude counts and minutes spent in moderate-to-vigorous physical activity (MVPA) with and without the LFE filter applied. Repeated measures MANOVA models were used for compositional data analysis of the percentage of time spent in sedentary behaviour and light, moderate, and vigorous PA with and without the LFE filter applied. Applying the LFE filter significantly increased vector magnitude counts and estimated minutes spent in MVPA for all activity periods when compared to the normal filter. For brisk walking, the LFE filter had a significant impact on the composition of time spent in sedentary behaviour and PA intensities. Children's activity data processed with the LFE filter may not be compatible with cut-points for activity levels developed with the normal filter, and caution should be taken when comparing children's activity levels or movement data between studies that do and do not use the LFE filter.

Physical Activity Advice for Prevention and Rehabilitation of Low Back Pain- Same or Different? A Study on Device-Measured Physical Activity and Register-Based Sickness Absence

Purpose We lack knowledge on whether the advice of "being physically active" should be the same for prevention and rehabilitation of low back pain (LBP). Sickness absence is a key outcome for LBP prevention and rehabilitation. We investigated the associations between physical activity and long-term sickness absence (LTSA) among employees with and without LBP. Methods Between 2011 and 2013, 925 Danish employees wore a Actigraph GTX3 accelerometer for 1-5 workdays to measure physical activity and reported LBP in past 7 days. Employees were followed for 4 years to determine their first register-based LTSA event (≥ 6 consecutive weeks). Results Among employees with LBP, increasing moderate-to-vigorous-intensity physical activity at work by 20 min and decreasing the remaining behaviors at work (ie., sitting, standing and light-intensity activity) by 20 min was associated with 38% (95% CI 17%; 63%) higher LTSA risk. Increasing light-intensity activity at work by 20 min and decreasing 20 min from the remaining behaviors was associated with 18% (95% CI 4%; 30%) lower risk. During leisure, increasing moderate-to-vigorous-intensity activity by 20 min or standing by 40 min was associated with 26% (95% CI 3%; 43%) lower and 37% (95% CI 0%; 87%) higher risk, respectively. Among employees without LBP, we found no such associations. Conclusions The physical activity advice ought to be different for LBP prevention and rehabilitation to reduce LTSA risk, and specified by domain and activity intensity. At work, employees with LBP should be advised to spend time on light-intensity physical activity and limit their time on moderate-to-vigorous-intensity physical activity. During leisure, employees should spend time on moderate-to-vigorous-intensity physical activity.

Effects of physical activity intervention on 24-h movement behaviors: a compositional data analysis

We utilized compositional data analysis (CoDA) to study changes in the composition of the 24-h movement behaviors during an activity tracker based physical activity intervention. A total of 231 recently retired Finnish retirees were randomized into intervention and control groups. The intervention participants were requested to use a commercial activity tracker bracelet with daily activity goal and inactivity alerts for 12 months. The controls received no intervention. The 24-h movement behaviors, i.e., sleep, sedentary time (SED), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) were estimated from wrist-worn ActiGraph data using the GGIR R-package. Three balance coordinates describing the composition of movement behaviors were applied: ratio of active vs. passive behaviors, LPA vs. MVPA, and sleep vs. SED. A linear mixed model was used to study changes between the baseline and 6-month time point. Overall, the changes in the 24-h movement behaviors were small and did not differ between the groups. Only the ratio of LPA to MVPA tended to change differently between the groups (group*time interaction p = 0.08) as the intervention group increased LPA similarly to controls but decreased their MVPA. In conclusion, the use of a commercial activity tracker may not be enough to induce changes in the 24-h movement behaviors among retirees.

The Impact of Online-Schooling during COVID-19 on Device-Measured 24-Hour Movement Behaviours among High School Students: A Compositional Data Analysis

The COVID-19 measures have unfavourably affected the movement behaviours of youth. The aim of this study was to explore the impact of online-schooling during COVID-19 on device-measured sleep (SL), sedentary behaviour (SB), light physical activity (LPA), and moderate–vigorous physical activity (MVPA) among high school students. A total of 51 students (26 female) from Slovenia wore an activity monitor activPAL4 during the weekdays of onsite-schooling and during the weekdays of online-schooling. Data on movement behaviours were analysed using compositional data analysis. During the onsite-schooling (and online-schooling), students spent on average 432 min/day (469 min/day) in SL, 731 (755) in SB, 253 (202) in LPA, and 25 (15) in MVPA. Repeated measures multivariate analysis of variance confirmed significantly more time was spent in SL (log ratio 0.29; 95% CI 0.20, 0.37)) and SB (log ratio 0.23; 95% CI 0.13, 0.32) and less time in MVPA (log ratio −0.44; 95% CI −0.66, −0.23) during the online-schooling weekdays. Students spent significantly more time in SB during leisure (log ratio 0.20; 95% CI 0.06, 0.35) as well as during lecture time (log ratio 0.45; 95% CI 0.32, 0.58). Our results indicate that online-schooling significantly contributed to the unfavourable changes in students’ movement behaviours during COVID-19. Future studies should focus on developing physical activity interventions suitable for the circumstances of the epidemic.

Improving Practices of Mental Health Professionals in Recommending More Physical Activity and Less Sedentary Behaviour to Their Clients: An Intervention Trial

We investigated the effects of increasing physical activity (PA) and reducing sedentary behaviour (SB) of mental health professionals on their attitudes towards and practices in recommending more PA and less SB to their clients. A 4-week pre-post intervention trial was conducted involving 17 mental health professionals. The participants who increased their own physical activity during the intervention increased the frequency of recommending more PA (p = 0.009) and less SB (p = 0.005) to their clients. A relatively simple, low-cost intervention, consisting of group behaviour change counselling, goal setting and positive feedback, may improve the practices of mental health professionals.Supplemental data for this article is available online at https://doi.org/10.1080/01612840.2021.1972189 .

An Exploratory Study on the Physical Activity Health Paradox-Musculoskeletal Pain and Cardiovascular Load during Work and Leisure in Construction and Healthcare Workers

Using a novel approach, this exploratory study investigated whether the physical activity (PA) paradox extends to cardiovascular load and musculoskeletal pain. At baseline, 1–2 days of 24 h heart rate was assessed in 72 workers from construction and healthcare. Workers then reported pain intensity in 9 body regions (scale 0–3) every 6 months for two years. The 2 year average of musculoskeletal pain (sum of 9 pain scores; scale 0–27) was regressed on time spent during work and leisure above three thresholds of percentage heart rate reserve (%HRR), i.e., ≥20 %HRR, ≥30 %HRR, and ≥40 %HRR, using a novel ilr structure in compositional data analysis. Analyses were stratified for several important variables. Workers spending more time in physical activity at work had higher pain, while workers with more time in physical activity during leisure had less pain (i.e., the PA paradox), but none of the associations were statistically significant. Higher aerobic capacity and lower body mass index lowered the pain score among those with higher physical activity at work. This exploratory study suggests that the PA paradox may apply to musculoskeletal pain and future studies with larger sample sizes and additional exposure analyses are needed to explain why this occurs.

Contrasting compositions of sitting, standing, stepping, and sleeping time: associations with glycaemic outcome by diabetes risk

BACKGROUND

Recent evidence suggests that prolonged sitting and its adverse impact on glycaemic indicators appear to be proportional to the degree of insulin resistance. To investigate this finding in a free-living context, we aimed to examine associations of device-measured 24-h time-use compositions of sitting, standing, stepping, and sleeping with fasting glucose (FPG) and 2 h post-load glucose (2hPLG) levels, and to examine separately the associations with time-use compositions among those at lower and at higher risk of developing type 2 diabetes.

METHODS

Cross-sectional analyses examined thigh-worn inclinometer data (activPAL, 7 day, 24 h/day protocol) from 648 participants (aged 36-80 years) at either lower (< 39 mmol/mol; < 5.7% HbA1c) or higher (≥39 mmol/mol; ≥5.7% HbA1c) diabetes risk from the 2011-2012 Australian Diabetes, Obesity and Lifestyle study. Multiple linear regression models were used to examine associations of differing compositions with FPG and 2hPLG, with time spent in each behaviour allowed to vary up to 60 min.

RESULTS

In general, the associations with the FPG within the time-use compositions were small, with statistically significant associations observed for sitting and sleeping (in the lower diabetes risk group) and standing (in higher diabetes risk group) only. For 2hPLG, statistically significant associations were observed for stepping only, with findings similar between lower (β = - 0.12 95%CI:-0.22, - 0.02) and higher (β = - 0.13 95%CI:-0.26, - 0.01) risk groups. Varying the composition had minimal impact on FPG; however 1 h less sitting time and equivalent increase in standing time was associated with attenuated FPG levels in higher risk only (Δ FPG% = - 1.5 95%CI: - 2.4, - 0.5). Large differences in 2hPLG were observed for both groups when varying the composition. One hour less sitting with equivalent increase in stepping was associated with attenuated 2hPLG, with estimations similar in lower (Δ 2hPLG% = - 3.8 95%CI: - 7.3, - 0.2) and higher (Δ 2hPLG% = - 5.0 95%CI: - 9.7, - 0.0) risk for diabetes.

CONCLUSIONS

In middle-aged and older adults, glycaemic control could be improved by reducing daily sitting time and replacing it with stepping. Standing could also be beneficial for those at higher risk of developing type 2 diabetes.

Are Japanese Women Less Physically Active Than Men? Findings From the DOSANCO Health Study

BACKGROUND

Previous research has established that women accumulate less moderate-to-vigorous physical activity (MVPA) than men. To date, however, little is known about the gender differences in device-based activity patterns of sedentary behavior (SB) and light-intensity physical activity (LPA). We aimed to compare time spent in SB and different intensities of physical activity taking into account of co-dependence of time use domains.

METHODS

This cross-sectional study was conducted in Suttu town, Hokkaido, Japan. Data were analyzed from 634 Japanese adults (278 men, aged 19-92 years) who provided valid accelerometer (HJA-750C) data. Gender differences in activity behavior patterns were tested using multivariate analysis of covariance (MANCOVA) based on isometric log-ratio transformations of time use, adjusting for age. We also developed bootstrap percentile confidence intervals (CI) to support the interpretation of which behavior differed between genders.

RESULTS

Overall, participants had percent time spent in SB, LPA, MVPA during wearing time (mean, 14.8 hours) corresponding to 53.9%, 41.7%, and 4.4% of wearing time, respectively. Activity behavior patterns differed significantly between genders after controlling for time spent in all activities. Women spent relatively 13.3% (95% CI, 9.9-15.9%) less time in SB and 19.8% (95% CI, 14.9-24.6%) more time in LPA compared to men. The difference of time spent in MVPA was not statistically significant.

CONCLUSIONS

In contrast with previous studies, our findings suggest that Japanese women are more physically active than men when all intensities of activities are considered. Given the health benefits of LPA, evaluating only MVPA may disproportionately underestimate the level of physical activity of women.

Psychophysiological Reactivity, Postures and Movements among Academic Staff: A Comparison between Teleworking Days and Office Days

The aim of this study was to determine if psychophysiological activity, postures and movements differ during telework (i.e., work performed at home) and work performed at the conventional office. We performed twenty-four-hour pulse recordings and accelerometry measurements on 23 academic teaching and research staff during five consecutive workdays, with at least one day of telework. Additionally, we conducted salivary sampling during one day of telework, and one day of office work. Heart rate and heart rate variability indices, postural exposure and cortisol concentration were analyzed using repeated measures analysis of variance with Workplace and Time (i.e., before, during and after workhours) as within-subject effects. We found a significant interaction effect of Workplace and Time in heart rate variability indices and in the number of transitions between seated and standing postures. This shows more parasympathetic activity among academic teleworkers during telework than office work, which may indicate more relaxation during telework. They had an overall sedentary behavior at both workplaces but switched between sitting and standing more often during telework, which may be beneficial for their health.

Association between animal source foods consumption and risk of hypertension: a cohort study

PURPOSE

This study assessed the association between animal source foods (ASF) consumption and hypertension, a recognised risk factor for cardiovascular disease. Adverse effects of red and processed meat (RPM) consumption and beneficial effects of the consumption of dairy products and other ASF have been discovered separately; however, the constrained nature of food intake has been typically ignored. We assessed the effects of substituting RPM and other ASF.

METHODS

We followed-up 5394 Chinese adults (age 18-60 years) at baseline using the China Health and Nutrition Survey from 2004 to 2011. Food consumption was assessed using individual-based consecutive 24-h recall and household-based food weighing approaches. Both traditional substitution analysis and substitution analysis based on compositional transformation were used to assess substitution effects.

RESULTS

In total, 1267 participants were newly diagnosed with hypertension during the median follow-up time of 6.81 years (range, 2.97-6.99 years). The traditional substitution analysis found that substituting eggs for RPM was associated with a lower risk of hypertension. The compositional transformation substitution analysis revealed that replacing RPM with any other ASF was associated with a lower risk of hypertension; it implemented substitutions of one or many ASF for RPM; it also revealed different substitution effects of RPM and dairy products, and substituting dairy products for RPM was associated with reduced hypertension risks.

CONCLUSION

The compositional transformation substitution analysis considers the constrained and relative nature of food consumption. It is a flexible approach to estimating substitution effects using different patterns to obtain personalised estimation effects and provide individualised dietary recommendations.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Physical Behaviours in Brazilian Office Workers Working from Home during the COVID-19 Pandemic, Compared to before the Pandemic: A Compositional Data Analysis

Work from home has increased greatly during the COVID-19 pandemic, and concerns have been raised that this would change physical behaviours. In the present study, 11 Brazilian office workers (five women, six men; mean [SD] age 39.3 [9.6] years) wore two triaxial accelerometers fixed on the upper back and right thigh continuously for five days, including a weekend, before COVID-19 (September 2019), and again while working at home during COVID-19 (July 2020). We determined time used in five behaviours: sedentary, standing, light physical activity (LPA), moderate-to-vigorous activity (MVPA), and time-in-bed. Data on these behaviours were processed using Compositional Data Analysis, and behaviours observed pre-COVID19 and during-COVID19 were compared using repeated-measures MANOVA. On workdays during-COVID19, participants spent 667 min sedentary, 176 standing, 74 LPA, 51 MVPA and 472 time-in-bed; corresponding numbers pre-COVID were 689, 180, 81, 72 and 418 min. Tests confirmed that less time was spent in bed pre-COVID19 (log-ratio −0.12 [95% CI −0.19; −0.08]) and more time in MVPA (log-ratio 0.35, [95% CI 0.08; 0.70]). Behaviours during the weekend changed only marginally. While small, this study is the first to report objectively measured physical behaviours during workdays as well as weekends in the same subjects before and during the COVID-19 pandemic.

Intensity Matters for Musculoskeletal Health: A Cross-Sectional Study on Movement Behaviors of Older Adults from High-Income Scottish and Low-Income South African Communities

This study aimed to investigate differences in physical activity (PA) patterns and the associations between objectively measured 24-h movement behaviors and musculoskeletal measures (muscle strength, muscle mass, physical performance, and bone mineral density) in a high-income and a low-income community. This cross-sectional study recruited independent living older adults aged 60-85 years from high-income Scottish (n = 150) and low-income South African (n = 138) settings. Participants completed demographic and health questionnaires, and testing included body composition and bone mineral density (dual energy X-ray absorptiometry), physical performance (grip strength, gait speed), and PA (accelerometry). Participants accumulated similar amounts of weekly total PA, however, the Scottish cohort engaged in more moderate-to-vigorous intensity PA (MVPA) and sedentary behavior (SB), while the South African cohort spent more time sleeping and in light intensity PA (LPA). From compositional data analysis, more time spent in MVPA relative to the other movement behaviors was positively associated with higher muscle mass (p < 0.001) and strength (p = 0.001) in the Scottish cohort. Conversely, more time spent in MVPA was associated with faster gait speed (p < 0.001) and greater hip bone mineral density (p = 0.011) in the South African cohort. Our findings confirm the beneficial role of MVPA in both high- and low-income cohorts, however, the relationship MVPA had with components of musculoskeletal health in older adults differed between settings.

Effects of Two Randomized and Controlled Multi-Component Interventions Focusing On 24-Hour Movement Behavior among Office Workers: A Compositional Data Analysis

Intervention studies aiming at changing movement behavior have usually not accounted for the compositional nature of time-use data. Compositional data analysis (CoDA) has been suggested as a useful strategy for analyzing such data. The aim of this study was to examine the effects of two multi-component interventions on 24-h movement behavior (using CoDA) and on cardiorespiratory fitness among office workers; one focusing on reducing sedentariness and the other on increasing physical activity. Office workers (n = 263) were cluster randomized into one of two 6-month intervention groups, or a control group. Time spent in sedentary behavior, light-intensity, moderate and vigorous physical activity, and time in bed were assessed using accelerometers and diaries, both for 24 h in total, and for work and leisure time separately. Cardiorespiratory fitness was estimated using a sub-maximal cycle ergometer test. Intervention effects were analyzed using linear mixed models. No intervention effects were found, either for 24-h behaviors in total, or for work and leisure time behaviors separately. Cardiorespiratory fitness did not change significantly. Despite a thorough analysis of 24-h behaviors using CoDA, no intervention effects were found, neither for behaviors in total, nor for work and leisure time behaviors separately. Cardiorespiratory fitness did not change significantly. Although the design of the multi-component interventions was based on theoretical frameworks, and included cognitive behavioral therapy counselling, which has been proven effective in other populations, issues related to implementation of and compliance with some intervention components may have led to the observed lack of intervention effect.

A study on prospective associations between adiposity and 7-year changes in movement behaviors among older women based on compositional data analysis

INTRODUCTION

It is unclear whether adiposity leads to changes in movement behaviors, and there is a lack of compositional analyses of longitudinal data which focus on these associations. Using a compositional approach, this study aimed to examine the associations between baseline adiposity and 7-year changes in physical activity (PA) and sedentary behavior (SB) among elderly women. We also explored the longitudinal associations between change in adiposity and change in movement-behavior composition.

METHODS

This longitudinal study included 176 older women (mean baseline age 62.8 (4.1) years) from Central Europe. Movement behavior was assessed by accelerometers and adiposity was measured by bioelectrical impedance analysis at baseline and follow-up. A set of multivariate least-squares regression analyses was used to examine the associations of baseline adiposity and longitudinal changes in adiposity as explanatory variables with longitudinal changes in a 3-part movement-behavior composition consisting of SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) as outcome variables.

RESULTS

No significant associations were found between baseline adiposity and longitudinal changes in the movement-behavior composition (p > 0.05). We found significant associations of changes in body mass index (BMI) and fat mass percentage (FM%) with changes in the movement-behavior composition. An increase in BMI was associated with an increase of SB at the expense of LPA and MVPA (β = 0.042, p = 0.009) and with a decrease of MVPA in favor of SB and LPA (β = - 0.059, p = 0.037). An increase in FM% was significantly associated only with an increase of SB at the expense of LPA and MVPA (β = 0.019, p = 0.031).

CONCLUSIONS

This study did not support the assumption that baseline adiposity is associated with longitudinal changes in movement behaviors among elderly women, but we found evidence for change-to-change associations, suggesting that a 7-year increase in adiposity is associated with a concurrent increase of SB at the expense of LPA and MVPA and with a concurrent decrease of MVPA in favor of LPA and SB. Public health interventions are needed to simultaneously prevent weight gain and promote physically active lifestyle among elderly women.

Time-Based Data in Occupational Studies: The Whys, the Hows, and Some Remaining Challenges in Compositional Data Analysis (CoDA)

Data on the use of time in different exposures, behaviors, and work tasks are common in occupational research. Such data are most often expressed in hours, minutes, or percentage of work time. Thus, they are constrained or ‘compositional’, in that they add up to a finite sum (e.g. 8 h of work or 100% work time). Due to their properties, compositional data need to be processed and analyzed using specifically adapted methods. Compositional data analysis (CoDA) has become a particularly established framework to handle such data in various scientific fields such as nutritional epidemiology, geology, and chemistry, but has only recently gained attention in public and occupational health sciences. In this paper, we introduce the reader to CoDA by explaining why CoDA should be used when dealing with compositional time-use data, showing how to perform CoDA, including a worked example, and pointing at some remaining challenges in CoDA. The paper concludes by emphasizing that CoDA in occupational research is still in its infancy, and stresses the need for further development and experience in the use of CoDA for time-based occupational exposures. We hope that the paper will encourage researchers to adopt and apply CoDA in studies of work exposures and health.

Sedentary Time and Metabolic Risk in Extremely Active Older Adults

OBJECTIVE

Increasing evidence suggests that time spent sedentary predicts increasing cardiometabolic risk independent of other physical activity. We objectively measured activity levels in active older adults and examined the association between sedentary behavior and the continuous metabolic syndrome risk score (cMSy).

RESEARCH DESIGN AND METHODS

Older adults (age ≥65 years) were recruited from the Whistler Masters ski team, a group of active older adults who undergo organized group training. Daily activity levels were recorded with accelerometers (SenseWear) worn for 7 days. A compositional approach was used to determine proportion of the time spent sedentary as compared with all other nonsedentary behaviors (isometric log-ratio transformation for time spent sedentary [ILR1]). Waist circumference, triglycerides, HDL, systolic blood pressure, and fasting glucose were measured, and cMSy was calculated using principal component analysis (sum of eigenvalues ≥1.0).

RESULTS

Fifty-four subjects (30 women and 24 men, mean ± SE age 71.4 ± 0.6 years) were recruited. Subjects demonstrated high levels of physical activity (2.6 ± 0.2 h light activity and 3.9 ± 0.2 h moderate/vigorous activity). In our final parsimonious model, ILR1 showed a significant positive association with increasing cMSy (standardized β = 0.368 ± 0.110, R ² = 0.40, P = 0.002), independent of age and biological sex.

CONCLUSIONS

Despite high levels of activity, ILR1 demonstrated a strong association with cMSy. This suggests that even in active older adults, sedentary behavior is associated with increasing cardiometabolic risk.

Associations of movement behaviors and body mass index: comparison between a report-based and monitor-based method using Compositional Data Analysis

BACKGROUND/OBJECTIVES

Evidence on the associations between lifestyle movement behaviors and obesity has been established without taking into account the time-constrained nature of categorized, time-based lifestyle behaviors. We examined the associations of sleep, sedentary behavior (SED), light-intensity physical activity (LPA), and moderate-to-vigorous PA (MVPA) with body mass index (BMI) using Compositional Data Analysis (CoDA), and compared the associations between a report-based method (24-h Physical Activity Recall; 24PAR) and a monitor-based method (SenseWear Armband; SWA).

SUBJECTS/METHODS

Replicate data from a representative sample of 1247 adults from the Physical Activity Measurement Survey (PAMS) were used in the study. Participants completed activity monitoring on two randomly selected days, each of which required wearing a SWA for a full day, and then completing a telephone-administered 24PAR the following day. Relationships among behavioral compositional parts and BMI were analyzed using CoDA via multiple linear regression models with both 24PAR and SWA data.

RESULTS

Using 24PAR, time spent in sleep (γ = -3.58, p = 0.011), SED (γ = 3.70, p = 0.002), and MVPA (γ = -0.53, p = 0.018) was associated with BMI. Using SWA, time spent in sleep (γ = -5.10, p < 0.001), SED (γ = 8.93, p < 0.001), LPA (γ = -3.12, p < 0.001), and MVPA (γ = -1.43, p < 0.001) was associated with BMI. The SWA models explained more variance in BMI (R2 = 0.28) compared with the 24PAR models (R2 = 0.07). The compositional isotemporal substitution models revealed reductions in BMI when replacing SED by MVPA, LPA (not with 24PAR) or sleep for both 24PAR and SWA, but the effect estimates were larger with SWA.

CONCLUSIONS

Favorable levels of relative time spent in lifestyle movement behaviors were, in general, associated with decreased BMI. The observed associations were stronger using the monitor-based SWA method compared with the report-based 24PAR method.

Associations of older adults' physical activity and bout-specific sedentary time with frailty status: Compositional analyses from the NEIGE study

AIM

To examine associations of intensity-specific physical activity and bout-specific sedentary time with frailty status among Japanese community-dwelling older adults, taking into account the interrelationships of these behaviors.

METHODS

Participants were 511 community-dwelling older adults. Physical activity and sedentary time were assessed using a tri-axial accelerometer. Frailty status (frail, pre-frail, or robust) was determined, based on the phenotypic model and used established criteria for Japanese older adults. Associations with frailty status of intensity-specific physical activity and bout-specific sedentary behavior (SB) time were examined using compositional data analysis, adjusted for potential confounders.

RESULTS

Participants included 13 (2.6%) who were frail, 234 (45.8%) pre-frail, and 264 (51.6%) who were robust. For the frail and pre-frail, the proportion of time spent in moderate-to-vigorous physical activity (MVPA) was less than for those who were robust. Frail older adults has larger proportion of time spent in prolonged (≥30 min/bouts) sedentary behavior (SB), and less in short-bout (<30 min/bout) SB, compared to the robust. No statistically-significant differences in the proportion of time spent in light-intensity physical activity was found across frailty levels.

CONCLUSION

Pre-frail and frail older adults spend proportionally less time in MVPA and more time in prolonged SB, compared with those who were robust. These findings need to be confirmed by evidence from larger and more-diverse study samples and by evidence from prospective studies, in order to better understand whether or not avoiding prolonged periods of sitting could be a potential strategy for preventing frailty among community-dwelling older adults.

Modeling and visualizing two-way contingency tables using compositional data analysis: A case-study on individual self-prediction of migraine days

Two-way contingency tables arise in many fields, such as in medical studies, where the relation between two discrete random variables or responses is to be assessed. We propose to analyze and visualize a sample of 2 × 2 tables in the context of single-subject repeated measurements design by means of compositional data (CoDa) methods. First, we propose to visualize the tables in a quaternary diagram. Second, we show how to represent these tables by means of logratios indicating the relationship between the two variables as well as their strength and direction of dependency. Finally, we describe a technique to model those tables with a simplicial regression model. Data from a real-world study of self-prediction of migraine attack onset is used to illustrate this methodology. For each individual, the 2 × 2 table of their migraine expectation vs next day migraine occurrence is computed, generating a sample of tables. Then we visualize and interpret the prediction ability of individuals both in the simplex and in terms of logratios of components. Finally, we model the self-prediction ability with respect to demographic variables, days tracked and disease characteristics. Our application demonstrates that CoDa can be a useful tool for visualizing, modeling, and interpreting the components of 2 × 2 tables.

Use of Compositional Data Analysis to Show Estimated Changes in Cardiometabolic Health by Reallocating Time to Light-Intensity Physical Activity in Older Adults

BACKGROUND

All physical activity (PA) behaviours undertaken over the day, including sleep, sedentary time, standing time, light-intensity PA (LIPA) and moderate-to-vigorous PA (MVPA) have the potential to influence cardiometabolic health. Since these behaviours are mutually exclusive, standard statistical approaches are unable to account for the impact on time spent in other behaviours.

OBJECTIVE

By employing a compositional data analysis (CoDA) approach, this study examined the associations of objectively measured time spent in sleep, sedentary time, standing time, LIPA and MVPA over a 24-h day on markers of cardiometabolic health in older adults.

METHODS

Participants (n =366; 64.6 years [5.3]; 46% female) from the Mitchelstown Cohort Rescreen Study provided measures of body composition, blood lipid and markers of glucose control. An activPAL3 Micro was used to obtain objective measures of sleep, sedentary time, standing time, LIPA and MVPA, using a 7-day continuous wear protocol. Regression analysis, using geometric means derived from CoDA (based on isometric log-ratio transformed data), was used to examine the relationship between the aforementioned behaviours and markers of cardiometabolic health.

RESULTS

Standing time and LIPA showed diverging associations with markers of body composition. Body mass index (BMI), body mass and fat mass were negatively associated with LIPA (all p <0.05) and positively associated with standing time (all p <0.05). Sedentary time was also associated with higher BMI (p <0.05). No associations between blood markers and any PA behaviours were observed, except for triglycerides, which were negatively associated with standing time (p < 0.05). Reallocating 30 min from sleep, sedentary time or standing time, to LIPA, was associated with significant decreases in BMI, body fat and fat mass.

CONCLUSION

This is the first study to employ CoDA in older adults that has accounted for sleep, sedentary time, standing time, LIPA and MVPA in a 24-h cycle. The findings support engagement in LIPA to improve body composition in older adults. Increased standing time was associated with higher levels of adiposity, with increased LIPA associated with reduced adiposity; therefore, these findings indicate that replacing standing time with LIPA is a strategy to lower adiposity.

The physical activity paradox revisited: a prospective study on compositional accelerometer data and long-term sickness absence

Background

The ‘physical activity paradox’ advocates that leisure physical activity (PA) promotes health while high occupational PA impairs health. However, this paradox can be explained by methodological limitations of the previous studies—self-reported PA measures, insufficient adjustment for socioeconomic confounding or not addressing the compositional nature of PA. Therefore, this study investigated if we still observe the PA paradox in relation to long-term sick absence (LTSA) after adjusting for the abovementioned limitations.

Methods

Time spent on moderate-to-vigorous physical activity (MVPA) and remaining physical behaviors (sedentary behavior, standing, light PA and time in bed) at work and in leisure was measured for 929 workers using thigh accelerometry and expressed as isometric log-ratios (ilrs). LTSA was register-based first event of ≥6 consecutive weeks of sickness absence during 4-year follow-up. The association between ilrs and LTSA was analyzed using a Cox proportional hazards model adjusted for remaining physical behaviors and potential confounders, then separately adjusting for and stratifying by education and type of work.

Results

During the follow-up, 21% of the workers experienced LTSA. In leisure, more relative MVPA time was negatively associated with LTSA (20% lower risk with 20 min more MVPA, p = 0.02). At work, more relative MVPA time was positively associated with LTSA (15% higher risk with 20 min more MVPA, p = 0.02). Results remained unchanged when further adjusted for or stratified by education and type of work.

Conclusion

These findings provide further support to the ‘PA paradox’.

Prospective Changes in the Distribution of Movement Behaviors Are Associated With Bone Health in the Elderly According to Variations in their Frailty Levels

Frailty is associated with poor bone health and osteoporosis, and physical activity (PA) is one of the best treatments for both pathologies in older adults. Nonetheless, because daily time is limited, how the time is distributed during the waking hours is critical. The waking hours are spent according to different movement behaviors: sedentary behaviors (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). The aim of this study was to use compositional data analyses to examine the effects of the change in movement behaviors on bone health during aging in older people, related to the changes in their frailty levels. We analyzed 227 older people aged 65 to 94 (125 women and 102 men) over a 4-year period. Movement behaviors were assessed using accelerometry. Both bone mineral density (BMD) and bone mineral content (BMC) were determined using bone densitometry. The Frailty Trait Scale was used to divide the sample by frailty level evolution during aging. The R statistical system was used for the compositional data analysis and, in addition, all models were adjusted for several covariates. The changes in the distribution of all movement behaviors within a waking hour period were significantly associated with spine and femoral neck BMD changes in the subgroup with a positive change in frailty level and spine BMC in the subgroup with no change in frailty level (p ≤ .05). Likewise, MVPA relative to the change in other movement behaviors was also associated in both subgroups with higher BMD and BMC, respectively, in the same body areas (p ≤ .05). No significant associations were found in the negative change in frailty level subgroup. Older people who achieved a positive change in frailty level during a 4-year period showed higher BMD changes compared to those with no changes or increases in their frailty level. Therefore, increasing MVPA relative to the change in the other movement behaviors during a 4-year period could perhaps produce bone health improvements in the elderly that do not worsen their frailty level. © 2020 American Society for Bone and Mineral Research.

Natural Patterns of Sitting, Standing and Stepping During and Outside Work-Differences between Habitual Users and Non-Users of Sit-Stand Workstations

Sit-stand workstations have shown to reduce sitting time in office workers on a group level. However, movement behaviour patterns might differ between subgroups of workers. Therefore, the objective of this study was to examine sitting, standing and stepping outcomes between habitual users and non-users of sit-stand workstations. From an international office population based in the Netherlands, 24 users and 25 non-users of sit-stand workstations were included (all had long-term access to these workstations). Using the ActivPAL, sitting, standing and stepping were objectively measured during and outside working hours. Differences in outcomes between users and non-users were analysed using linear regression. During working hours, users sat less (-1.64; 95% IC= -2.27--1.01 hour/8 hour workday) and stood more (1.51; 95% IC= 0.92-2.10 hour/8 hour workday) than non-users. Attenuated but similar differences were also found for total sitting time over the whole week. Furthermore, time in static standing bouts was relatively high for users during working hours (median= 0.56; IQR = 0.19-1.08 hour/8 hour workday). During non-working hours on workdays and during non-working days, no differences were found between users and non-users. During working hours, habitual users of their sit-stand workstation sat substantially less and stood proportionally more than non-users. No differences were observed outside working hours, leading to attenuated but similar differences in total sitting and standing time between users and non-users for total days. This indicated that the users of sit-stand workstations reduced their sitting time at work, but this seemed not to be accompanied by major carry-over or compensatory effects outside working hours.

Sitting, standing and moving during work and leisure among male and female office workers of different age: a compositional data analysis

Background

Gendered patterns of physical activity behaviours may help explaining health inequalities between men and women. However, evidence on such patterns in the working population is sparse. This study aimed at documenting and comparing compositions of sitting, standing and moving at work and during leisure among male and female office workers of different age.

Methods

Sitting (including lying), standing and moving were measured using accelerometry for, on average, four working days in 55 male and 57 female Swedish office workers. Behaviours were described in terms of time spent in four exhaustive categories: sitting in short (< 30 min) and long (≥30 min) bouts, standing, and moving. In a compositional data analysis approach, isometric log-ratios (ilr) were calculated for time sitting relative to non-sitting, time in short relative to long sitting bouts, and time in standing relative to moving. Differences between genders (men vs. women), domains (work vs. leisure), and according to age were examined for each ilr using ANOVA.

Results

At work, time spent sitting in short bouts, sitting in long bouts, standing, and moving was, on average, 29, 43, 21 and 7% among men, and 28, 38, 26 and 7% among women. Corresponding proportions during leisure were 34, 27, 27 and 13% among men and 28, 27, 32 and 13% among women. Men spent more time sitting relative to non-sitting (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\eta}_p^2 $$\end{document}ηp2 =0.04, p = 0.03) than women, and less time standing relative to moving (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\eta}_p^2 $$\end{document}ηp2 =0.07, p = 0.01). At work compared to during leisure, both genders spent more time sitting relative to non-sitting (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\eta}_p^2 $$\end{document}ηp2 =0.47, p < 0.01); within sitting more time was spent in long relative to short sitting bouts (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\eta}_p^2 $$\end{document}ηp2 =0.26, p < 0.01), and within non-sitting, more time was spent standing than moving (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\eta}_p^2 $$\end{document}ηp2 =0.12, p < 0.01). Older workers spent less of their non-sitting time moving than younger workers (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\eta}_p^2 $$\end{document}ηp2 =0.07, p = 0.01).

Conclusion

Male office workers spent more time sitting relative to non-sitting than female workers, and more time moving relative to standing. Both genders were sitting more at work than during leisure. Older workers moved less than younger. These workers could likely benefit from interventions to reduce or break up prolonged sitting time, preferably by moving more.

Association between objectively measured physical behaviour and neck- and/or low back pain: A systematic review

BACKGROUND AND OBJECTIVE

Clinical guidelines recommend physical activity to manage neck pain (NP) and low back pain (LBP). However, studies used to support these guidelines are based on self-reports of physical behaviour, which are prone to bias and misclassification. This systematic review aimed to investigate associations between objectively measured physical behaviour and the risk or prognosis of NP and/or LBP.

DATABASES AND DATA TREATMENT

Literature searches were performed in MEDLINE, Embase and Scopus from their inception until 18 January 2019. We considered prospective cohort studies for eligibility. Article selection, data extraction and critical appraisal were carried out by independent reviewers. Results were stratified on activity/sedentariness.

RESULTS

Ten articles out of 897 unique records identified met the inclusion criteria, of which eight studied working populations with mainly blue-collar workers. The overall results indicate that increased sitting time at work reduces the risk of NP and LBP while increased physical activity during work and/or leisure increases the risk of these conditions among blue-collar workers; however, associations were weak. Physical activity was not associated with prognosis of LBP (no studies investigated prognosis of NP). Most of the included articles have methodological shortcomings.

CONCLUSIONS

This review indicates that, among blue-collar workers, increased sitting at work may protect against NP and LBP while increased physical activity during work and/or leisure may increase this risk. There was no evidence supporting physical activity as a prognostic factor for LBP. Findings should be interpreted with caution due to the weak associations and few available studies with methodological shortcomings.

SIGNIFICANCE

Based on prospective cohort studies with objectively measured physical behaviour, this review questions the common notion that increased physical activity is associated with reduced risk or better prognosis of NP and/or LBP. We found that, among blue-collar workers, increased sitting time at work reduces the risk of NP and LBP, whereas physical activity somewhat increases the risk. Despite methodological shortcomings, there was consistency in the direction of the results, although high-quality articles reported the weakest associations. Systematic review registration: PROSPERO CRD42018100765.

Can childcare work be designed to promote moderate and vigorous physical activity, cardiorespiratory fitness and health? Study protocol for the Goldilocks-childcare randomised controlled trial

BACKGROUND

Despite extensive efforts, issues like obesity and poor physical capacity remain challenges for a healthy work life in several occupations. The Goldilocks work principle offers a new approach, encouraging design of productive work to promote physical capacity and health. This paper presents the protocol for the Goldilocks-childcare study, a randomised controlled intervention trial aiming to evaluate the effectiveness of implementing the Goldilocks work principle in childcare. The primary aim of the intervention is to increase time in moderate to vigorous physical activity (MVPA) by having the childcare workers act as active role models for children in daily playful physical activities, and thereby improve cardiorespiratory fitness and health of the workers.

METHODS

The study is a cluster-randomised trial with a usual-practice wait-list control group. The 10-week intervention consists of two phases. In the first, the childcare workers will participate in two participatory workshops aiming to a) develop playful physical activities ('Goldilocks-games') for children in which childcare workers participate as active role models at MVPA intensity, and b) develop action plans for implementation of the Goldilocks-games in daily work routines. In the second phase, childcare institutions will implement the Goldilocks-games. The primary outcome is working time spent in MVPA, and secondary outcomes are cardiorespiratory fitness, sleeping heart rate, perceived need for recovery, and productivity. Primary outcome and process evaluation will be based on direct measurements of physical activity and heart rate, determination of cardiorespiratory fitness, and questionnaires.

DISCUSSION

If proven effective, the Goldilocks work principle has a large potential for promoting sustainable health and working lives of childcare workers.

TRIAL REGISTRATION

ISRCTN, ISRCTN15644757, Registered 25th December 2019.

Equal health at work? Protocol for an observational study of work organisation, workload and musculoskeletal complaints among women and men in grocery retail

INTRODUCTION

Women generally report more work-related musculoskeletal complaints than men and have higher rates of sickness absence, even within occupations. One likely reason is that work tasks within the occupation are gendered, that is, women and men have different tasks, even when sharing the same job title. Retail is an appealing sector for studying working conditions and work environment in a gender context. The prevalence of work-related complaints is high, physical loads may differ considerably between tasks and the distribution of tasks is likely gendered. The overall aim of this study in retail is to examine factors at the organisational and individual level that may, in a gender perspective, explain working conditions, work tasks, workloads and musculoskeletal health.

METHODS AND ANALYSES

Data will be collected in two grocery stores, each with 50-70 workers, at two occasions interspersed by about 1 year. In each of these four waves, data collection will include a web-based questionnaire to all workers addressing, for example, work tasks, psychosocial factors, fatigue and pain; semistructured interviews with managers and approximately 10 workers addressing, for example, competences and decision levels; and technical measurements of postures, movements and heart rate in about 30 workers. The study is novel in combining an organisational gender perspective addressed through qualitative methods with a quantitative analysis of tasks, workload and health. The design allows an examination of both how genders may differ, and why they may differ, as well as analyses of the extent to which gendered working conditions change over time in the two participating stores.

ETHICS AND DISSEMINATION

Approval of the study by the Swedish Ethical Review Authority (reference number 2017/404) has been obtained. This work will be disseminated by publication of peer-reviewed papers in scientific journals, presentations at scientific conferences and in meetings with representatives from Swedish retail, including unions and employers' organisations.

The difference in sleep, sedentary behaviour, and physical activity between older adults with 'healthy' and 'unhealthy' cardiometabolic profiles: a cross-sectional compositional data analysis approach

Background

Studies have seldom used Compositional Data Analysis (CoDA) to map the effects of sleep, sedentary behaviour, and physical activity on older adults' cardio-metabolic profiles. This study therefore aimed to illustrate how sleep, sedentary behaviour, and physical activity profiles differ between older adult groups (60-89 years), with 'low' compared to those with 'high' concentrations of endocrine cardio-metabolic disease risk markers, using CoDA.

Method

Ninety-three participants (55% female) wore a thigh-mounted triaxial accelerometer for seven consecutive free-living days. Accelerometer estimates of daily average hours of engagement in sedentary behaviour (SB), standing, light-intensity physical activity (LIPA), sporadic moderate-vigorous physical activity (sMVPA, accumulated with bouts between 1 and 10 min), 10-min moderate-vigorous physical activity (₁₀MVPA, accumulated with bouts ≥10 min), in addition to self-reported sleeping hours were reported. Fasted whole blood concentrations of total cholesterol, triglyceride, glucose, and glycated haemoglobin, and serum lipoprotein lipase (LPL), interleukin-6 (IL-6), and procollagen III N-terminal propeptide were determined.

Results

Triglyceride concentration appeared to be highly dependent on ₁₀MVPA engagement as the 'low' and 'high' concentration groups engaged in 48% more and 32% less ₁₀MVPA, respectively, relative to the geometric mean of the entire study sample. Time-use composition of the 'low' LPL group's engagement in ₁₀MVPA was 26% less, while the 'high' LPL group was 7.9% more, than the entire study sample. Time-use composition of the 'high' glucose and glycated haemoglobin groups appeared to be similar as both engaged in more Sleep and SB, and less ₁₀MVPA compared to the study sample. Participants with a 'low' IL-6 concentration engaged in 4.8% more Sleep and 2.7% less ₁₀MVPA than the entire study sample. Time-use composition of the Total Cholesterol groups was mixed with the 'low' concentration group engaging in more Standing and ₁₀MVPA but less Sleep, SB, LIPA, and sMVPA than the entire study sample.

Conclusion

Older adults should aim to increase 10MVPA engagement to improve lipid profile and decrease SB engagement to improve glucose profile.

Parent Engagement and Support, Physical Activity, and Academic Performance (PESPAAP): A Proposed Theoretical Model

An emerging area of research within public health is the interaction between parents and their children for the promotion of physical activity. Higher levels of daily physical activity may not only improve physical health but also yield better academic performance by improving cognitive skills, classroom behavior, and academic achievement within the pediatric population. However, no theoretical model has yet been proposed to interrelate constructs of parental engagement and support, physical activity, and academic performance within the pediatric population. Here, we: 1) summarize salient research related to pediatric physical activity and academic performance, parents' physical activity engagement with their children, and the role of parental support in child academic performance; 2) propose a theoretical model interrelating parent physical activity engagement and support, physical activity, and academic performance (PESPAAP); 3) identify features of the proposed model that support its potential merit; and 4) provide potential future research directions and potential analyses that can be undertaken to support, modify, or disprove the proposed theoretical model. The proposed PESPAAP model provides a logically sound model that can be modified or expanded upon to improve applicability and generalizability and can be used as a framework to help align testable hypotheses for studies examining these interrelationships.

Associations of Sedentary and Physically-Active Behaviors With Cognitive-Function Decline in Community-Dwelling Older Adults: Compositional Data Analysis From the NEIGE Study

Background

Physical activity can help to protect against cognitive decline in older adults. However, little is known about the potential combined relationships of time spent in sedentary behavior (SB), light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) with indices of cognitive health. We examined the cross-sectional associations of objectively-determined sedentary and physically-active behaviors with an indicator of cognitive function decline (CFD) in older adults.

Methods

A randomly-recruited sample of 511 Japanese older adults (47% male; aged 65–84 years) wore a tri-axial accelerometer for 7 consecutive days in 2017. Cognitive function was assessed by interviewers using the Japanese version of Mini-Mental State Examination, with a score of ≤23 indicating CFD. Associations of sedentary and physically-active behaviors with CFD were examined using a compositional logistic regression analysis based on isometric log-ratio transformations of time use, adjusting for potential confounders.

Results

Forty one (9.4%) of the participants had an indication of CFD. Activity compositions differed significantly between CFD and normal cognitive function (NCF); the proportion of time spent in MVPA was 39.1% lower, relative to the overall mean composition in those with CFD, and was 5.3% higher in those with NCF. There was a significant beneficial association of having a higher proportion of MVPA relative to other activities with CFD. LPA and SB were not associated with CFD when models were corrected for time spent in all activity behaviors.

Conclusions

Larger relative contribution of MVPA was favorably associated with an indicator of CFD in older adults.

Calibration of Self-Reported Time Spent Sitting, Standing and Walking among Office Workers: A Compositional Data Analysis

We developed and evaluated calibration models predicting objectively measured sitting, standing and walking time from self-reported data using a compositional data analysis (CoDA) approach. A total of 98 office workers (48 women) at the Swedish Transport Administration participated. At baseline and three-months follow-up, time spent sitting, standing and walking at work was assessed for five working days using a thigh-worn accelerometer (Actigraph), as well as by self-report (IPAQ). Individual compositions of time spent in the three behaviors were expressed by isometric log-ratios (ILR). Calibration models predicting objectively measured ILRs from self-reported ILRs were constructed using baseline data, and then validated using follow-up data. Un-calibrated self-reports were inaccurate; root-mean-square (RMS) errors of ILRs for sitting, standing and walking were 1.21, 1.24 and 1.03, respectively. Calibration reduced these errors to 36% (sitting), 40% (standing), and 24% (walking) of those prior to calibration. Calibration models remained effective for follow-up data, reducing RMS errors to 33% (sitting), 51% (standing), and 31% (walking). Thus, compositional calibration models were effective in reducing errors in self-reported physical behaviors during office work. Calibration of self-reports may present a cost-effective method for obtaining physical behavior data with satisfying accuracy in large-scale cohort and intervention studies.

Associations of School Day Sedentary Behavior and Physical Activity With Gross Motor Skills: Use of Compositional Data Analysis

Background

To examine the relationships among school day sedentary times (SED), light physical activity (LPA), and moderate to vigorous physical activity (MVPA) with gross motor skills in children using Compositional Data Analysis.

Methods

Participants were 409 children (mean age = 8.4 [1.8] y) recruited across 5 low-income schools. Gross motor skills were assessed using the test for gross motor development—third edition (TGMD-3), and physical activity was assessed using accelerometers. Isometric log-ratio coordinates were calculated by quantifying the relative proportion of percentage of the school day spent in SED, LPA, and MVPA. The associations of the isometric log-ratio coordinates with the TGMD-3 scores were estimated using general linear mixed-effects models adjusted for age, body mass index, estimated aerobic capacity, and school affiliation.

Results

A higher proportion of the school day spent in %MVPA relative to %SED and %LPA was significantly associated with higher TGMD-3 total scores (γMVPA = 14.44, P = .01). This relationship was also observed for the ball skills subtest scores (γMVPA = 16.12, P = .003).

Conclusion

Replacing %SED and %LPA with %MVPA during school hours may be an effective strategy for improving gross motor skills, specifically ball skills, in low-income elementary school-aged children.

International Comparison of the Levels and Potential Correlates of Objectively Measured Sedentary Time and Physical Activity among Three-to-Four-Year-Old Children

Physical activity (PA) patterns track from childhood through to adulthood. The study aimed to determine the levels and correlates of sedentary time (ST), total PA (TPA), and moderate-to-vigorous PA (MVPA) in preschool-aged children. We conducted cross-sectional analyses of 1052 children aged three-to-four-years-old from six studies included in the International Children’s Accelerometry Database. Multilevel linear regression models adjusting for age, gender, season, minutes of wear time, and study clustering effects were used to estimate associations between age, gender, country, season, ethnicity, parental education, day of the week, time of sunrise, time of sunset, and hours of daylight and the daily minutes spent in ST, TPA, and MVPA. Across the UK, Switzerland, Belgium, and the USA, children in our analysis sample spent 490 min in ST per day and 30.0% and 21.2% of children did not engage in recommended daily TPA (≥180 min) and MVPA (≥60 min) guidelines. There was evidence for an association between all 10 potential correlates analyzed and at least one of the outcome variables; average daily minutes spent in ST, TPA and/or MVPA. These correlates can inform the design of public health interventions internationally to decrease ST and increase PA in preschoolers.

Consistency of Sedentary Behavior Patterns among Office Workers with Long-Term Access to Sit-Stand Workstations

INTRODUCTION

Sit-stand workstations are a popular intervention to reduce sedentary behavior (SB) in office settings. However, the extent and distribution of SB in office workers long-term accustomed to using sit-stand workstations as a natural part of their work environment are largely unknown. In the present study, we aimed to describe patterns of SB in office workers with long-term access to sit-stand workstations and to determine the extent to which these patterns vary between days and workers.

METHODS

SB was objectively monitored using thigh-worn accelerometers for a full week in 24 office workers who had been equipped with a sit-stand workstation for at least 10 months. A comprehensive set of variables describing SB was calculated for each workday and worker, and distributions of these variables between days and workers were examined.

RESULTS

On average, workers spent 68% work time sitting [standard deviation (SD) between workers and between days (within worker): 10.4 and 18.2%]; workers changed from sitting to standing/walking 3.2 times per hour (SDs 0.6 and 1.2 h-1); with bouts of sitting being 14.9 min long (SDs 4.2 and 8.5 min). About one-third of the workers spent >75% of their workday sitting. Between-workers variability was significantly different from zero only for percent work time sitting, while between-days (within-worker) variability was substantial for all SB variables.

CONCLUSIONS

Office workers accustomed to using sit-stand workstations showed homogeneous patterns of SB when averaged across several days, except for percent work time seated. However, SB differed substantially between days for any individual worker. The finding that many workers were extensively sedentary suggests that just access to sit-stand workstations may not be a sufficient remedy against SB; additional personalized interventions reinforcing use may be needed. To this end, differences in SB between days should be acknowledged as a potentially valuable source of variation.

Active Transport, Not Device Use, Associates with Self-Reported School Week Physical Activity in Adolescents

The purpose of this study was to examine the relationships among active transport, electronic device-use, and self-reported school week moderate-to-vigorous physical activity (MVPA) in a sample of adolescents. The sample consisted of 1445 adolescents enrolled in the Family Life, Activity, Sun, Health, and Eating study. A panel research organization invited panel members balanced to the US population on sex, census division, household income and size, and race/ethnicity. Web-based surveys were administered to each selected adolescent. Adolescents answered questions pertaining to out-of-school electronic device-use and active transport to and from school. Predicted weekly minutes of MVPA were calculated from the Youth Activity Profile. The outcome variable was predicted school week MVPA (in minutes). The predictive utility of device-use and active transport variables on self-reported school week MVPA were examined using weighted multiple linear regression models. After adjusting for age, sex, and BMI, active transport to school (b = 12.32, 95% CI [9.72–14.93], p < 0.001) and from school (b = 7.18, 95% CI [4.79–5.57], p < 0.001) were significantly associated with self-reported school week MVPA. No device-use variables were significantly associated with school week MVPA. Active transport to and from school may have an impact on school week MVPA in adolescents.

Technically measured compositional physical work demands and prospective register-based sickness absence (PODESA): a study protocol

Background

Various physical work demands are shown to be associated with sickness absence. However, these studies have: (a) predominantly used self-reported data on physical work demands that have been shown to be inaccurate compared with technical measurements, (b) principally focused on various physical work demands in ‘isolation’, i.e. ignoring their co-dependency – compositional nature –, and (c) mainly used register data on long-term sickness absence. The present article describes the protocol of a study with the objective of investigating the association between technically measured compositional data on physical work demands and prospective long- and short-term register-based data on sickness absence.

Methods

‘The technically measured compositional Physical wOrk DEmands and prospective association with register-based Sickness Absence study (PODESA)’ comprises data from two Danish cohorts (NOMAD and DPhacto) primarily on blue-collar workers. In the PODESA cohort, data on 1108 workers were collected at baseline (between 2011 and 2014). The cohort data comprise, e.g., self-reported information on descriptives, lifestyle, workday, and health, as well as accelerometer-based measurements of physical work demands (physical activity, movements, and postures). These baseline measurements are linked with prospective register-based data on sickness absence for up to four years after baseline. The prospective association between physical work demands and sickness absence will be analysed using a Compositional Data Analysis approach.

Discussion

PODESA provides a unique possibility of unravelling which combinations of physical work demands are associated with prospective sickness absence. PODESA employs technically measured information on physical work demands (taking into account the compositionality of physical work demand data) and prospective sickness absence data. The findings from PODESA can be used to develop strengthened preventive interventions for sickness absence. Results are expected in 2019–2021.