Sedentary Behaviors and Health Outcomes among Young Adults: A Systematic Review of Longitudinal Studies

Impact of Sedentary Behaviors on Blood Pressure and Cardiovascular Disease: An Umbrella Review of Systematic Reviews and Meta-Analyses

BACKGROUND

Cardiovascular diseases (CVD) are among the leading causes of mortality in the western world, and high blood pressure is among the greatest risk factors for CVD. Given that most of a person's waking hours are spent in sedentary behaviors, understanding the cardiovascular impact of a sedentary lifestyle is imperative. Although limiting sedentary time is encouraged in public health messaging, individual reviews analyzing its impact on clinically relevant cardiovascular outcomes such as blood pressure and CVD exhibit conflicting results.

OBJECTIVE

We conducted an umbrella review of systematic reviews and meta-analyses synthesizing the effects of sedentary time/behaviors on blood pressure or CVD.

METHODS

To be included, studies had to be a systematic review and/or meta-analysis that studied the impact of sedentary time or a sedentary posture on blood pressure or CVD incidence/mortality. The review was preregistered in PROSPERO (CRD4202342568) and conducted in May 2023. The Joanna Briggs Institute and Risk of Bias in Systematic Reviews tools assessed study quality. PRISMA reporting was followed.

RESULTS

Our umbrella review screened 2215 citations with 40 review studies meeting our inclusion criteria (n = 22 meta-analyses) that included 234 unique individual studies of 3,769,755 unique participants. The average study quality was high (9.2 ± 1.7 out of 11). A minority of studies (n = 7/20) supported that less sedentary time was associated with lower blood pressure, with reviews of interventional studies typically not observing a consistent effect (n = 9/12), whereas reviews of cross-sectional studies observed a positive effect (n = 5/7). When hypertension rates were used as the outcome, most (n = 3/4) studies observed a deleterious impact of sedentary time. For CVD incidence/mortality, less sedentary time or screen time was consistently associated with a lower CVD incidence/mortality (n = 17/23), with studies exhibiting a null effect generally including small sample sizes and being of a lower study quality. Total sedentary time and specific behaviors (i.e., television and screen time) exhibited similar findings.

CONCLUSIONS

Based on a high quality of evidence and large sample size, existing systematic reviews and meta-analyses demonstrate the negative impact of sedentary behaviors on CVD incidence/mortality, with conflicting reports for blood pressure that vary based on the study design.

Sex Differences in the Association between Prolonged Sitting Time and Anxiety Prevalence among Korean Adults

Sex differences in the effect of prolonged sitting time on anxiety symptoms have not yet been explored. This study examined the sex-specific association between prolonged sitting time and anxiety prevalence in Korean adults. Community-dwelling adults aged >18 years who underwent a cross-sectional structured study survey of physical activity and mental health tests were enrolled as part of the Kangbuk Samsung Hospital Cohort Study from 2012 to 2019. The prevalence of anxiety was evaluated using the Clinically Useful Anxiety Outcome Scale (CUXOS) questionnaire. The mean daily sitting time was 7.9 ± 3.4 h in men and 6.8 ± 3.6 h in women. After adjustments for possible confounding factors, the adjusted mean CUXOS score was the highest in participants sitting for ≥10 h, followed by 5-9 h, and <5 h, in that order. In the post-hoc Bonferroni analysis, there were significant differences in the adjusted mean CUXOS scores in group comparisons. A multivariate logistic regression analysis was conducted after adjusting for potential confounding factors. A prolonged sitting time was positively associated with an increased prevalence of anxiety in both men and women, with stronger associations in women than in men. It is necessary to prevent anxiety by adjusting or reducing sitting time in adults, especially women.

Relationships between training load and body composition and physical fitness changes in sedentary individuals: A 4-month small-sided soccer games intervention

Purpose

This study aimed to: (i) analyze the changes in physical fitness and body composition following a 4-month intervention of small-sided games (SSG) training; and (ii) analyze the association between internal and external training loads and the observed changes in physical fitness and body composition among sedentary young adults.

Methods

Sixty sedentary individuals (males: 30; females: 30) participated in this randomized controlled trial study. Physical fitness and body composition parameters were assessed at the 1st, 8th weeks, and 16th weeks after a SSG intervention.

Results

Significant main effects of time and gender on overall physical fitness parameters, with a notable time-group interaction were observed. For body composition measures, we found significant main effects of time, group, and gender. Furthermore, we identified significant correlations between shuttle run, handgrip, and vertical jump performance, and the time spent at VO2max (TVO2max) during SSG (r = -0.779, p = 0.001; r = -0.788, p = 0.001; r = 0.692, p = 0.004, respectively). Handgrip strength exhibited significant correlations with heat exhaustion (HE) and total distance (TD) during SSG (r = -0.616, p = 0.014; r = -0.629, p = 0.012). Similarly, we observed significant correlations between hip perimeter (HP), skinfolds (SF), waist-to-hip ratio (W:H), and TVO2max (r = 0.624, p = 0.013; r = 0.663, p = 0.007; r = 0.535, p = 0.040, respectively).

Conclusion

This study indicates that the intensity achieved during SSG plays a crucial role in fostering positive adaptations in aerobic capacity, maximal strength, and jumping performance in recreational soccer. Therefore, practitioners should ensure that SSG formats generate the required stimulus to sustain prolonged periods within VO2max zones.

Effects of a 16-week recreational small-sided games soccer intervention on body composition and physical fitness in sedentary young adults: A randomized controlled study

Recreational small-sided games (SSGs) have demonstrated positive effects on body composition and physical fitness, while minimizing adverse outcomes. In this randomized controlled study, we aimed to investigate the impact of incorporating an additional 16-week intervention program involving recreational soccer SSGs on parameters related to body composition and physical fitness in sedentary young adult males and females. Sixty sedentary participants, with a mean age of 20.2 years, were randomly assigned to either the small-sided games group (SSG; n = 30) or the active control group, which participated in regular physical education classes (CG; n = 30). The SSG group engaged in the same activities as the control group but additionally participated in a recreational SSG football program. This program involved continuous and intermittent moderate-to high-intensity exercises conducted on 20 m × 30 m and 30 m × 50 m football fields. In contrast, the CG group received 1 h of physical education once a week. The interventions were administered for a duration of sixteen weeks. Baseline, 8-week, and post-intervention assessments were conducted to measure body mass (BM), body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), skinfold thickness (SFT), standing broad jump (SBJ), vertical jump (VJ), handgrip strength (HG) for both left and right hands, shuttle run distance (SRD), and shuttle run estimated VO2max. Results indicated that both male and female participants in the SSG group exhibited significant improvements in BM, BMI, SFT, WC, HC, and WHR following the intervention (p < 0.05), whereas the control group demonstrated no significant changes over the study period (p > 0.05). Additionally, SSG participants (regardless of sex) displayed significant enhancements in SBJ, VJ, HG, SRD, and VO2max (p < 0.05), while the control group did not exhibit any significant alterations (p > 0.05). The findings from this experimental study suggested that a 16-week recreational soccer SSG intervention effectively enhanced body composition and physical fitness among overweight sedentary young adults, offering a pleasurable alternative to conventional training approaches.

Return to Play after SARS-CoV-2 Infection: Focus on the Pediatric Population with Potential Heart Involvement

The COVID-19 pandemic has entailed consequences on any type of physical activities, mainly due to the social restriction measures applied to reduce the spreading of SARS-CoV-2. When public health policies progressively reduced limitations and resuming a normal life was possible, the return to previous physical activity and sports was not only requested by people who had deeply suffered from limitations, but was also recommended by experts as a means of reducing the physical and psychological consequences induced by the pandemic. The aim of this narrative review is to summarize the available evidence on the return to play in children after SARS-CoV-2 infection, suggesting an algorithm for clinical practice and highlighting priorities for future studies. Criteria to identify subjects requiring laboratory and radiological tests before returning to physical activity are severity of COVID-19 and existence of underlying disease. Children of any age with asymptomatic infection or mild disease severity, i.e., the great majority of children with previous COVID-19, do not need a cardiologic test before resumption of previous physical activity. Only a visit or a telephonic contact with the primary care pediatricians should be established. On the contrary, children with moderate COVID-19 should not exercise until they are cleared by a physician and evaluated for resting electrocardiogram, exercise testing, and echocardiogram. Finally, in those with severe COVID-19, return to play should be delayed for several months, should be gradual and should be performed only after a cardiologist's clearance. Further studies are needed to assess the risks of returning to sports activity in pediatric age, including careful age-adjusted risk stratification, in order to improve the cost-benefit ratio of specific screenings.

Relationship between Physical Activity and Sedentary Behavior, Spinal Curvatures, Endurance and Balance of the Trunk Muscles-Extended Physical Health Analysis in Young Adults

BACKGROUND

Physical inactivity and sedentary behavior are associated with poor well-being in young people with adverse effects extending into adulthood. To date, there are many studies investigating the relationship between physical activity (PA) and posture, but there are no data on the relationship between the type and intensity of PA and sedentary behavior, their association with thoracic and lumbar spine angles, and with endurance and balance of the trunk muscles, especially in healthy young adults aged 18-25 years. Moreover, there are no data on the relationship between PA and sedentary behavior and musculoskeletal and cardiopulmonary health, as well as quality of life (QoL) and sleep that would provide a more comprehensive picture of physical health status.

AIM

Therefore, the aim of this cross-sectional study was to investigate the extent to which PA and sedentary behavior are associated with each other and with changes in spinal curvatures, endurance and balance of trunk muscles in an extended analysis of physical health status in young adults aged 18-25 years by additionally including measures of body composition, cardiorespiratory capacity, and QoL and sleep.

METHODS

A total of 82 students (58% female, 42% male) aged 18-25 years completed all required tests. Primary outcome measures included the following: PA and sedentary behavior calculated from the long form of International PA Questionnaire (IPAQ-LF), spinal curvatures measured by a Spinal Mouse® device, endurance and balance of the trunk muscles measured using trunk endurance tests and their ratio.

RESULTS

Overall, 50% of students were classified as minimally active and 50% as health-enhancing PA (HEPA) active. The angles of thoracic kyphosis and lumbar lordosis showed no correlation with PA or time spent sitting. However, students with the lowest PA had significantly higher scores on the trunk extensor endurance test and trunk extensor/flexor endurance test ratio, indicating imbalanced trunk muscles. Moreover, these students spent the most their time sitting. Only PA of vigorous intensity and PA during recreation, leisure, and sports significantly correlated with QoL related to physical health. QoL related to physical and psychosocial health had significantly higher scores when students spent less time sitting. In addition, we found significantly better respiratory performance and SQ at higher PA values, i.e., PA during recreation, leisure, and sport.

CONCLUSIONS

Our results suggest that students with low PA levels and more time spent sitting have imbalanced trunk muscles, worse respiratory function, and poorer QoL and sleep. Moreover, these findings in college students may reflect their lifestyle and suggest that more PA needs to be promoted to prevent the development of chronic diseases including musculoskeletal disorders.

Associations between Physical Activity and Kyphosis and Lumbar Lordosis Abnormalities, Pain, and Quality of Life in Healthy Older Adults: A Cross-Sectional Study

Significant evidence suggests that regular physical activity (PA) leads to numerous physical and psychological outcomes in the elderly. This cross-sectional study was designed to further explore this issue by investigating the associations between PA (measured by accelerometer) and kyphosis and lumbar lordosis abnormalities, pain, and quality of life (QoL) in the elderly. In this cross-sectional study, 163 older adults (73 women) over 65 years of age (mean age: 68.70 ± 3.09) from Russia acted as participants. The following instruments were used to measure research variables: ActiGraph wGT3X-BT for measuring PA, spinal-mouse for measuring kyphosis and lumbar lordosis abnormalities, and the World Health Organization Quality of Life Scale (WHOQOL-BREF) questionnaire for measuring QoL. Pain was measured using two questions. The Independent t-test and a regression analysis were used to analyze data. The results showed that our sample participated on average in 15.8 min of moderate PA (MPA) per day, which is lower than the recommended guidelines. Men were significantly more physically active than women. In addition, MPA was significantly associated with lower kyphosis and lumbar lordosis abnormalities and pain in older adults. Finally, MPA was significantly associated with higher QoL. These findings indicate that PA is a critical concern for the elderly. Accordingly, physical educators and fitness instructors should adopt appropriate strategies to promote an active lifestyle among older adults.