Compositional Data Analysis in Time-Use Epidemiology: What, Why, How

Associations between 24-h movement behaviors and health-related quality of life(HRQoL) in preschool children: a cross-sectional study

PURPOSE

To investigate the association between preschool children's 24-h movement behaviors and health-related quality of life (HRQoL), exploring the impact of time reallocation among these behaviors and examining gender differences.

METHODS

This study analysed HRQoL and 24-h movement behaviors of 349 preschool children in three kindergartens in Beijing, China, selected through convenience sampling using a cross-sectional study design. A t-test and multivariate analysis of variance methods were used to investigate gender differences. The study examined the relationship between 24-h movement behaviors and HRQoL using component data analysis and component isochronic substitution model methods, with an investigation into gender differences in the overall association.

RESULTS

The study found a negative correlation between sedentary behavior (SB) and overall HRQoL score (γ = - 11.92, p < 0.05) in the entire sample, particularly affecting physical health score (γ = - 14.39, p < 0.01). Among boys, SB was negatively correlated with the HRQoL total score (γ = - 15.83, p < 0.05), while sleep was positively correlated with psychosocial health scores (γ = 17.814, p = 0.01). However, there was no significant association found between 24-h movement behaviors and HRQoL in girls. When using the component isochronic substitution model, reallocating 30 min from sedentary behavior to sleep increased the total HRQoL score of preschool children by 0.865 points (95% CI 0.071, 1.658). In contrast, reallocating 30 min from sleep to sedentary behavior resulted in a decrease of 0.850 points (95% CI - 1.638, - 0.062) in the total HRQoL score.

CONCLUSIONS

To improve preschool children's HRQoL, it is recommended to reduce their sedentary behavior time and increase their sleep time. Public health policymakers should consider this when developing 24-h movement behavior guidelines for preschoolers.

Reallocations of Time Between Sleep, Sedentary Behavior, and Physical Activity and Their Associations With 24-Hour Blood Pressure

BACKGROUND

The 24-h activity cycle (24H-ACT) (sleep, sedentary behavior, light physical activity, and moderate to vigorous physical activity) may have deleterious or beneficial associations with 24-h blood pressure (24H-BP).

PURPOSE

Estimate the short-term associated changes in 24H-BP with acutely replacing 30 min/d from one behavior of the 24H-ACT to other behaviors in employed adults.

METHODS

Participants (N = 659) wore an ambulatory blood pressure monitor and two accelerometers (waist and wrist) to measure 24H-BP and the 24H-ACT.

RESULTS

Replacing 30 min of sedentary behavior with 30 min of sleep was associated with lower 24-h mean systolic [ß = -0.32 mm Hg per 0.5 h (95% CI: -0.58, 0.06)] and diastolic [ß = -0.31 mm Hg per 0.5 h (95% CI: -0.50, -0.12)] blood pressure. Replacing 30 min of light physical activity with 30 min of sleep was associated with lower 24-h mean systolic [ß = -0.30 mm Hg per 0.5 h (95% CI: -0.62, 0.03,)] and diastolic blood pressure [ß = -0.34 mm Hg per 0.5 h (95% CI: -0.58, -0.11)]. No other time reallocations between 24H-ACT behaviors were associated with changes in 24H-BP.

CONCLUSION

Replacing time in sedentary behavior or light physical activity with sleep may provide small short-term reductions in that day's 24H-BP.

Theoretical Behavior Substitutions during the 24-h Day in Pregnancy and Infant Growth Outcomes

PURPOSE

The purpose of this study is to assess associations of theoretically reallocating time from sleep, sedentary behavior, or light-intensity physical activity (LPA) to moderate/vigorous-intensity physical activity (MVPA) during pregnancy with infant growth outcomes.

METHODS

We used data from a cohort of pregnant individuals with overweight or obesity ( n = 116). At 9 to 15 and 30 to 36 wk of gestation, waking movement was measured using wrist-worn accelerometers and sleep duration was self-reported. Outcomes were obtained from delivery electronic health records (birth) and study visits (12 months). We used compositional isotemporal substitution models.

RESULTS

In early pregnancy, reallocating 10 min of sleep, sedentary behavior, or LPA to MVPA was associated with 20% (relative risk [RR] = 0.80; 95% CI, 0.75-0.85), 21% (RR = 0.79; 95% CI, 0.75-0.84), and 25% (RR = 0.75; 95% CI, 0.70-0.81) lower risk of large-for-gestational age (LGA) birthweight, respectively, and 17% (RR = 0.83; 95% CI, 0.75-0.91), 18% (RR = 0.82; 95% CI, 0.75-0.91), and 22% (RR = 0.78; 95% CI, 0.70-0.88) lower risk of rapid infant growth (birth to 12 months), respectively. In late pregnancy, reallocating 10 min to MVPA was associated with 18% to 22% lower risk of LGA birthweight, but was not associated with rapid infant growth. Reallocating time to MVPA in early or late pregnancy was not associated with high newborn body fat percentage.

CONCLUSIONS

Our findings suggest beneficial associations of theoretically reallocating time from sleep, sedentary behavior, or LPA to MVPA, especially during early pregnancy, for reducing LGA birthweight and rapid infant growth.

Associations of 24-h Movement Behaviors With Incidence of Cardiovascular Risk Factors: The Finnish Retirement and Aging Study

Low physical activity, high sedentary time (SED), and inadequate sleep increase cardiovascular disease risk, but the codependency between these 24-h movement behaviors has often been neglected. This study examined associations between 24-h movement behaviors and incidence of cardiovascular risk factors. The study included 866 adults (mean age 62.4 years, SD 1.1) from the Finnish Retirement and Aging study who participated in wrist-accelerometry measurements between 2014 and 2018. Incident register-based cardiovascular risk factors including hypertension, dyslipidemia, type 2 diabetes, and questionnaire-based obesity were followed up over on average 3-year follow-up. Compositional Cox regression models were adjusted for age, sex, occupation, smoking, and heavy alcohol consumption. We recorded 84 (17%) new cases of hypertension, 66 (9%) dyslipidemia, 28 (3%) type 2 diabetes, 43 (6%) obesity, and 94 (26%) any of these cardiovascular risk factors. Compared to mean composition (7.8 h sleep, 11.0 h SED, 4.2 h light physical activity [LPA], 60 min moderate-to-vigorous physical activity [MVPA]), having 10 min more MVPA at the cost of other behaviors was associated with 5%-7% risk reduction in hypertension, 10%-13% in obesity, and 6%-7% in any cardiovascular risk factor. Among the least active (sleep 7.9 h, SED 12.1 h, LPA 3.6 h, MVPA 24 min), the risk reductions were nearly twofold. In conclusion, when accounting the interdependence of movement behaviors, MVPA associated with highest risk reduction in hypertension and obesity, especially among the least active participants. This suggests that even a small increase in daily MVPA could help prevent development of cardiovascular risk factors.

Association between moderate-to-vigorous physical activity trajectories and academic achievement in Chinese primary school children: a 3-year longitudinal study

BACKGROUND

Past cross-sectional studies have reported a positive association between moderate-to-vigorous physical activity (MVPA) and academic achievement in children and adolescents. Despite this, the influence of variations in MVPA over time on academic achievement remains yet to be definitively understood. Therefore, this study aims to track the patterns of MVPA and examine how they are associated with academic achievement over a three-year period among Chinese primary school students.

METHODS

The longitudinal study examined the MVPA and academic achievement of a cohort of 202 primary school children over a three-year period. MVPA was assessed via accelerometers and analysed using Compositional Data Analysis (CoDA). Academic achievement was quantified using standardised test scores in reading, mathematics, and language. Group-Based Trajectory Models (GBTMs) were used to identify patterns of MVPA. Covariates such as demographics, sleep duration, and attitudes towards sports were adjusted in the Generalized Estimating Equations (GEEs) used to examine associations with academic achievement. All statistical analyses were conducted using R and SAS 9.4 software.

RESULTS

This study identified three distinct MVPA trajectories: Low (74.8%), Decline (13.2%), and High (12.0%). At baseline, the High MVPA group had better academic achievement with mean scores of 89.8 in reading, 94.5 in mathematics, and 94.7 in language, compared to the Low MVPA group with mean scores of 80.4, 83.0, and 84.9, respectively. After adjustment for confounders, GEE models showed significant associations between MVPA trajectories and improved academic achievement. Compared to the Low MVPA group, the Decline MVPA group exhibited significant score increases in reading (β = 4.11, 95% CI: 1-7.21) and mathematics (β = 2.79, 95% CI: 0.09-5.5). The High MVPA group exhibited significant score increases in reading (β = 11.3, 95% CI: 7.93-14.67), mathematics (β = 12.32, 95% CI: 9.61-15.02), and language (β = 11.53, 95% CI: 8.99-14.06). Additionally, notable gender differences in MVPA trajectories were observed, and a positive association was found between favorable sports attitudes and improved academic achievement.

CONCLUSIONS

This study reveals three distinct MVPA trajectories among Chinese primary school children and demonstrates that those with high MVPA trajectories showcase superior academic achievements, particularly in reading, mathematics, and language. This highlights the vital role of MVPA in supporting academic excellence.

Can home care work be organized to promote musculoskeletal health for workers? Results from the GoldiCare cluster randomized controlled trial

BACKGROUND

Workers in home care have high sick leave rates, predominantly because of musculoskeletal pain. The Goldilocks Work Principle proposes that health should be promoted by a "just right" composition of work tasks. Weekly workloads differ substantially between home care workers, suggesting that certain workers may have workloads that are too high, impacting their musculoskeletal health. The aim of this study was to evaluate the effectiveness of a "GoldiCare" intervention redistributing weekly workloads to become more equal among the homecare workers. Outcomes were pain in the neck/shoulder and lower back, and the implementation of the intervention was also evaluated.

METHODS

A 16-week cluster randomized controlled trial was conducted with 125 workers from 11 home care units, divided into six intervention units and five control units. The operation coordinators of each intervention unit were educated in the Goldilocks Work Principle and provided with a planning tool to facilitate an even distribution of high care need clients. The control group continued their usual work. Primary outcomes were pain intensity in the neck/shoulder and lower back (0 to 10). Secondary outcomes included fatigue (0 to 10), composition of physical behaviors and postures (accelerometers), adherence to the intervention (weekly usage rates of the planning tool), and performance of the intervention (percentage of workers with an even distribution of workload).

RESULTS

The analysis showed no difference between the intervention and control groups in change in lower back pain (0.07, 95%CI[-0.29;0.43]), neck/shoulder pain (-0.06, 95%CI[-0.49;0.36]) or fatigue (0.04, 95%CI[-0.52;0.61]. No significant changes were observed in the composition of physical behaviors (p = 0.067) or postures (p = 0.080-0.131) between the two groups. The intervention was succesfully implemented in three units of the six, with adherence ranging from 82-100% across the intervention period. The remaining three units had an adherence of 0-47%. No improvement in performance was observed.

CONCLUSION

No significant intervention effects were observed on musculoskeletal pain, fatigue, or the composition of physical behaviors and postures. The findings suggest that the intervention was not adequately implemented within the organization. Consequently, we cannot discern whether the lack of positive results were due to poor implementation or an ineffective intervention. Results thus highlight the need for a more comprehensive understanding of organizational structures within home care to facilitate more effective implementations. The hypothetical effectiveness of a fully implemented intervention remains unknown.

TRIAL REGISTRATION

Clinicaltrials.gov ID: NCT05487027, submitted: 03/08/2022.

Association Between 24-Hour Movement Behaviors and Adiposity in Malaysian Schoolchildren: A Compositional Isotemporal Substitution Analysis

BACKGROUND

Physical activity (PA), sedentary behavior (SB), and sleep are interrelated 24-hour movement behaviors that are important for the growth and well-being of children. This cross-sectional study examined the relationship between 24-hour movement behaviors and adiposity, and predicted changes in adiposity following compositional time reallocations in 7- to 12.9-year-old Malaysian children from the South East Asian Nutrition Surveys II Malaysia.

METHODS

A total of 381 children (mean age 9.7 [1.6] y, 57% girls) provided 24-hour wrist-worn GENEActiv accelerometry data which captured time spent for sleep, SB, light PA and moderate to vigorous PA (MVPA). Indicators of adiposity were derived from anthropometry and bioelectrical impedance analysis: body-mass-index-for-age, waist circumference, waist-to-height ratio, percent body fat, and body mass index. The composition of 4-part movement behaviors was expressed as isometric log-ratio coordinates which were entered into regression models. Isotemporal substitution analysis was used to assess changes in adiposity indicators when reallocating time between movement behaviors.

RESULTS

Relative to other movement behaviors, time spent on MVPA was significantly associated with waist circumference, waist-to-height ratio, percent body fat, and fat mass index. A 15-minute one-to-one reallocation from other movement behaviors to MVPA predicted lower body-mass-index-for-age (-0.03 to -0.11), smaller waist circumference (-0.67 to -1.28 cm), lower waist-to-height ratio (-0.004 to -0.008), percent body fat (-0.87% to -1.47%), and fat mass index (-0.23 to -0.42). Replacing SB and light PA with sleep or MVPA was associated with lower adiposity.

CONCLUSIONS

The overall composition of movement behavior was significantly associated with the adiposity of Malaysian schoolchildren. Promoting MVPA and sleep and reducing SB and light PA are important for prevention of childhood obesity.

24-hour activity composition is associated with lower fall and fracture risk in older men

Physical activity (PA), sedentary behavior (SB), and sleep are each individually associated with falls and fractures, but often are not examined simultaneously. Compositional data analysis examined the combined prospective associations between the proportion of time in PA, SB, and sleep relative to the remaining behaviors with recurrent falls (2+ falls in any yr), any fractures, and major osteoporotic fracture (MOF) from tri-annual questionnaires, with adjudication for fractures, in 2918 older men aged 78.9 ± 5.1 yr in the Osteoporotic Fractures in Men (MrOS) Study. Accelerometers were worn on the right tricep for seven consecutive 24-h periods and measured PA (>1.5 METs), SB (≤1.5 METs), and sleep. Generalized estimating equations evaluated associations with recurrent falls. Cox proportional hazards regression estimated any incident fracture and MOF risk separately. Over 4 yr of follow-up, 1025 (35.2%) experienced recurrent falls; over 10 ± 4 yr of follow-up, 669 (22.9%) experienced incident fractures, and 370 (12.7%) experienced a MOF. Higher proportions of PA relative to SB and sleep were associated with lower odds of recurrent falls [odds ratio (OR): 0.87, 95% CI: 0.76-0.99]. Higher proportions of SB relative to PA and sleep were associated with a higher odds of recurrent falls (OR: 1.38, 95% CI: 1.06-1.81) and a higher risk of any fracture [hazard ratio (HR): 1.42, 95% CI: 1.05-1.92]. Higher proportions of sleep relative to PA and SB were associated with a lower risk of fracture (HR: 0.74, 95% CI: 0.54-0.99). No associations of activity composition with MOF were observed. When accounting for the co-dependence of daily activities, higher proportions of SB relative to the proportion of PA and sleep were associated with higher odds of recurrent falls and fracture risk. Results suggest reducing SB (and increasing PA) may lower fall and fracture risk in older men, which could inform future interventions.

The interplay between lying, sitting, standing, moving, and walking on obesity risk in older adults: a compositional and isotemporal substitution analysis

INTRODUCTION

Obesity in older adults is linked to various chronic conditions and decreased quality of life. Traditional physical activity guidelines often overlook the specific postures and movements that older adults engage in daily. This study aims to explore the compositional associations between posture-specific behaviours and obesity risk in younger (M = 67.35 ± 2.03 years) and older (M = 75.73 ± 4.17 years) groups of older adults and investigate the differences in body mass index (BMI) associated with replacing time spent in lying, sitting and standing with moving or walking.

METHODS

This cross-sectional study involved 309 older adults aged 65 and above from Czech Republic. Participants' movement behaviours, including lying, sitting, standing, moving, and walking, were measured using accelerometers. The data were analysed using compositional data analysis (CoDA) and isotemporal substitution models to assess the impact of reallocating time between different activities on self-reported (BMI).

RESULTS

The younger group engaged in more overall movement (193.84 min/day vs. 172.41 min/day) and walking (92.15 min/day vs. 76.62 min/day) than the older group. Significant estimated increases in BMI were associated with reallocating 30 min from movement to lying, sitting, or standing (up to + 3.31 kg/m²), while reallocating the same amount of time from lying, sitting, or standing to movement was associated with estimated reductions in BMI (up to - 2.54 kg/m²). In the older group, reallocating time from slow walking to lying or sitting was associated with estimated increases in BMI (up to + 1.86 kg/m²), while increasing time spent slow walking at the expense of lying or sitting theoretically reduced BMI (up to - 0.95 kg/m²).

CONCLUSIONS

The findings suggest that promoting movement and walking, including both slow and fast walking, may play a role in managing obesity risk in older adults. This study highlights the potential benefits of reducing sedentary time and encouraging low-intensity physical activity tailored to the capabilities of seniors, especially those aged 70+, as a possible strategy to mitigate obesity risk. However, further longitudinal studies are needed to confirm these associations and explore causal relationships.

Causal effects of sedentary breaks on affective and cognitive parameters in daily life: a within-person encouragement design

Understanding the complex relationship between sedentary breaks, affective well-being and cognition in daily life is critical as modern lifestyles are increasingly characterized by sedentary behavior. Consequently, the World Health Organization, with its slogan "every move counts", emphasizes a central public health goal: reducing daily time spent in sedentary behavior. Previous studies have provided evidence that short sedentary breaks are feasible to integrate into daily life and can improve affective and cognitive parameters. However, observational studies do not allow for causal interpretation. To overcome this limitation, we conducted the first empirical study that integrated the within-person encouragement approach to test the causal effects of short 3-min sedentary breaks on affective and cognitive parameters in daily life. The results suggest that brief sedentary breaks may have a beneficial impact on valence and energetic arousal. Moreover, our methodological approach powerfully demonstrated the possibility of moving towards causal effects in everyday life.

24-hour movement behaviors and changes in quality of life over time among community-dwelling older adults: a compositional data analysis

BACKGROUND

Favorable movement behavior patterns, comprising more physical activity, less sedentary behavior, and sufficient sleep, may promote the maintenance of good quality of life (QoL) with advancing age. The aim of the present study was to investigate whether movement behaviors predict future changes in QoL among community-dwelling older adults over a four-year follow-up.

METHODS

Participants were 75-, 80- and 85-year-old community-dwelling older adults (n = 203) followed up for 4 years. Participants wore thigh- and trunk-mounted accelerometers for 3-7 days at baseline. Proportion of time-use in physical activity, standing and sedentary behavior were assessed based on body posture and movement intensity. Time in bed was determined using an automated algorithm. QoL was assessed during a home interview using the short Older People's Quality of Life Questionnaire at baseline and follow-up (range 13-65, higher scores indicate higher QoL). Compositional linear regression analysis was used to study whether baseline time-use composition predicts changes in QoL.

RESULTS

Over the 4-year follow-up, QoL scores decreased by 5% on average. Higher physical activity in relation to the other movement behaviors was associated with increase in QoL over time (βilr 0.94, p = 0.013), but this association attenuated after adding baseline physical function into the model. Sedentary behavior, standing, and time in bed were not associated with changes in QoL. Theoretical reallocation of 30 min of physical activity into sedentary behavior, standing or time in bed was estimated to decrease QoL by 0.5 (CI 95% -0.6 to -0.4), 0.6 (-0.7 to -0.5) and 0.4 (-0.5 to -0.3) points, respectively.

CONCLUSIONS

Theoretical reallocation of physical activity into sedentary behavior, standing, and time in bed was found to be associated with prospective decline in QoL among older adults. Engaging more in physical activity and less in more passive activities may promote better QoL with advancing age.

Sitting, Standing, and Physical Activity in Australian Passenger Rail Drivers: On the Right Track for Better Health?

BACKGROUND

Poor health in passenger rail drivers, resulting from perceived highly sedentary work and leisure time, has implications for public safety. To date, no studies have described the physical behaviors of passenger rail drivers. This study aimed to characterize the physical behaviors of passenger rail drivers by investigating the volume, pattern, variation, and composition of behaviors at and outside of work.

METHODS

A convenience sample of 31 rail drivers (77% male, median age 51.0 [12.5] y) in South Australia wore an activity monitor on their right thigh for 8 days and completed a work logbook. Physical behaviors (sitting, standing, light-intensity physical activity, moderate- to vigorous-intensity physical activity [MVPA], and steps) were recorded for workdays and nonworkdays, and work and nonwork time on workdays. The volume, bouts, between-participants variation, and 3-way composition were compared across the 4 time periods.

RESULTS

Drivers sat for 10.6 (1.5) hours, did 76.3 (38.8) minutes of MVPA, and took 9727.3 (4088.4) steps daily. At work, drivers were sitting 369.3 (41.8) minutes (187.1 [54.2] min in prolonged bouts) and doing MVPA 31.7 (10.0) minutes. Between-participants variation in sitting time during work (11%) was lower than both nonwork on a workday (19%) and on a nonworkday (24%; P < .001). Compositions at work differed from nonwork on workdays (F = 27.7, P < .001), as did compositions on workdays compared with nonworkdays (F = 6.8, P = .002).

CONCLUSIONS

Passenger rail drivers were highly sedentary, but also surprisingly active. At work, drivers were more sedentary and had lower variation in behaviors, suggesting work constraints play an important role. Therefore, work may be the most appropriate domain to intervene for promoting healthy physical behavior profiles among these passenger rail drivers.

Associations Between Childcare Physical Activity and Sedentary Time and Early Childhood Developmental Outcomes: A Compositional and Isotemporal Substitution Analysis

BACKGROUND

Physical activity and sedentary time are independently associated with health and developmental outcomes in preschool children. However, the integrated nature of these behaviours on early life outcomes, particularly during childcare hours, is currently understudied. As such, the aim of this study was to examine the association between preschool children's physical activity and sedentary time during childcare and various developmental outcomes (psychosocial, cognitive and fundamental movement skills).

METHODS

A total of 107 preschool children (Mage: 41 ± 6 months) recruited from London, Canada, wore ActiGraph wGT3X-BT accelerometers during childcare hours to measure their sedentary time, light intensity physical activity (LPA) and moderate-to-vigorous intensity physical activity (MVPA). Developmental outcomes, including psychosocial health (internalising, externalising, prosocial behaviour), indicators of cognitive development (memory, inhibitory control) and fundamental movement skills (locomotor control, object control, total fundamental movement), were assessed using validated tools. Compositional regression and isotemporal substitution models were estimated to examine how movement compositions in childcare were associated with developmental outcomes.

RESULTS

Engaging in more MVPA relative to LPA and sedentary time was associated with fewer internalising symptoms and better total fundamental movement skills and object control skills, whilst spending more time in LPA relative to MVPA and sedentary time was associated with more internalising symptoms and worse object control skills. Isotemporal substitution models suggested that theoretically increasing sedentary time or engaging in MVPA at the expense of time engaging in LPA during childcare is associated with lower internalising symptoms.

CONCLUSION

The findings of this study provide preliminary evidence that engaging in MVPA during childcare, at the expense of time in LPA or sedentary time, is associated with children's fundamental movement skills and psychosocial development. Further longitudinal research is required, with larger samples of young children, to assess the mechanisms through which childcare movement behaviour compositions may interact with developmental outcomes, including contextualising both sedentary time and LPA.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT05359536.

Changes in 24-h Movement Behaviors During Relationship and Parenthood Transitions: A Compositional Data Analysis

There is scarcity of studies using device-based measures to examine how relationship and parenthood transitions modify 24-h movement behaviors. This study examined how the composition of 24-h movement behaviors changes during these life transitions. Young adults (n = 170, mean age 25.6 years, SD 0.6) from the Special Turku Coronary Risk Factor Intervention Project (STRIP) wore wrist-worn accelerometers for 1 week and completed questionnaire at ages 26 and 31 years. Participants were categorized by relationship status into single (16%), those transitioning from single to partnered (31%), partnered (47%), and separated (7%), and by parenthood status into non-parents (73%), new parents (19%), and parents (8%). Changes in daily movement behaviors, including sleep, sedentary behavior (SED), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA), were examined using compositional linear mixed models. In general, LPA and MVPA decreased relative to sleep and SED (p = 0.007). Differences emerged between LPA and MVPA in relationship and parenthood groups (p for group × time interaction 0.008 and 0.001). Those transitioning to partnership decreased MVPA by 17 min/day, while partnered and separated individuals showed no notable MVPA change but decreased LPA by 14 and 43 min/day. Single individuals and non-parents decreased LPA and MVPA in similar proportions. New parents decreased MVPA by 20 min/day, while parents increased it by 19 min/day. Becoming first-time parent and starting relationship was associated with decline of MVPA. Our results suggest the importance of considering these life transitions and providing guidance for maintaining physical activity despite changes in life situations.

The pleasure of moving: A compositional data analysis of the association between replacing sedentary time with physical activity on affective valence in daily life

Although the independent within-person association between physical activity and sedentary behaviour with valence in daily life has been extensively studied, few studies have used compositional data analysis to examine how different movement behaviour compositions are related to valence in daily life. This study aimed to examine the within-person association between wake-time movement behaviour compositions with affective valence and the extent to which replacing time spent sedentary with physical activity was associated with valence within individuals in daily life. A 7-day ecological momentary study design was used whereby 94 Canadian university students (Mage = 19.45, SD = 2.21, 78.7 % female) reported on affective valence using an adapted version of the Feeling Scale at 7 randomly timed prompts each day. In addition, activPAL accelerometers were worn continuously by participants on their right thigh for the duration of the study to determine time spent engaging in sedentary behaviours and physical activity. Compositional data analysis with isotemporal substitution models were used to examine the within-person association between movement behaviour compositions and affective valence. The within-person association between movement behaviours and affective valence was weak (r2 = 0.013). Nevertheless, engaging in less sedentary time than usual and instead engaging in physical activity was significantly related to more positive affective valence. Considering light intensity physical activity (LPA) and moderate-to-vigorous intensity physical activity (MVPA) separately, replacing time spent sedentary with time engaged in MVPA and LPA both had a significant positive association on affective valence, although the association with MVPA was stronger than the association with LPA. The results provide unique insights into how replacing sedentary time with physical activity in daily life, especially MVPA, may be associated with more feelings of pleasure. These results may be useful to help inform the development of just-in-time adaptive interventions.

Exploring the Relationship Between Play During School Recess and Motor Performance in 6- to 8-Year-Old Children

BACKGROUND

Playing with others, which in school occurs mainly during recess, might be an enabling factor to improve children's motor performance, as behaviour is shaped by observing and imitating others.

OBJECTIVE

The aim of the current study was to examine whether children's play activities and with whom 6- to 8-year-old children play during recess are related to their motor performance.

METHODS

The study sample consisted of 86 Dutch participants (mean age 6.92 ± 0.62 years, 58.1% boys). A modified version of the System for Observing Children's Activity and Relationships during Play was used to observe the following play variables: sedentary or active behaviour, group size, activity type, and type of interaction. The Movement Assessment Battery for Children 2 was used to measure three components of motor performance: Manual Dexterity, Aiming and Catching, and Balance. Associations between the play variables and the motor components were investigated using compositional data analysis and logistic regressions.

RESULTS

The results showed that children who spent more time in sedentary behaviour rather than in active behaviour were less likely to have motor difficulties in the Aiming and Catching component. None of the other play variables were related to motor performance.

CONCLUSIONS

One explanation might be that these play variables in itself are not related to motor performance, but that these variables should be investigated as an integrated whole rather than in isolation. Therefore, future research should investigate whether interactions between the play variables are related to motor performance.

A systematic review of research reporting practices in observational studies examining associations between 24-h movement behaviors and indicators of health using compositional data analysis

Background

Compositional data analysis (CoDA) techniques are well suited for examining associations between 24-h movement behaviors (i.e., sleep, sedentary behavior, physical activity) and indicators of health given they recognize these behaviors are co-dependent, representing relative parts that make up a whole day. Accordingly, CoDA techniques have seen increased adoption in the past decade, however, heterogeneity in research reporting practices may hinder efforts to synthesize and quantify these relationships via meta-analysis. This systematic review described reporting practices in studies that used CoDA techniques to investigate associations between 24-h movement behaviors and indicators of health.

Methods

A systematic search of eight databases was conducted, in addition to supplementary searches (e.g., forward/backward citations, expert consultation). Observational studies that used CoDA techniques involving log-ratio transformation of behavioral data to examine associations between time-based estimates of 24-h movement behaviors and indicators of health were included. Reporting practices were extracted and classified into seven areas: (1) methodological justification, (2) behavioral measurement and data handling strategies, (3) composition construction, (4) analytic plan, (5) composition-specific descriptive statistics, (6) model results, and (7) auxiliary information. Study quality and risk of bias were assessed by the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies.

Results

102 studies met our inclusion criteria. Reporting practices varied considerably across areas, with most achieving high standards in methodological justification, but inconsistent reporting across all other domains. Some items were reported in all studies (e.g., how many parts the daily composition was partitioned into), whereas others seldom reported (e.g., definition of a day: midnight-to-midnight versus wake-to-wake). Study quality and risk of bias was fair in most studies (85%).

Conclusions

Current studies generally demonstrate inconsistent reporting practices. Consistent, clear and detailed reporting practices are evidently needed moving forward as the field of time-use epidemiology aims to accurately capture and analyze movement behavior data in relation to health outcomes, facilitate comparisons across studies, and inform public health interventions and policy decisions. Achieving consensus regarding reporting recommendations is a key next step.

Supplementary Information

The online version contains supplementary material available at 10.1186/s44167-024-00062-8.

A Compensatory Role of Physical Activity in the Association Between Sleep and Cognition

We synthesize evidence investigating the hypothesis that greater engagement in physical activity (PA) may compensate for some of the negative cognitive consequences associated with poor sleep in older adults. Potential mechanistic pathways include glymphatic clearance, influences on depression, and other comorbidities. The evidence base is largely cross-sectional and observational, and further experimental studies are required.

A comparative analysis of 24-hour movement behaviors features using different accelerometer metrics in adults: Implications for guideline compliance and associations with cardiometabolic health

BACKGROUND

Movement behavior features such as time use estimates, average acceleration and intensity gradient are crucial in understanding associations with cardiometabolic health. The aim of this study was to 1) compare movement behavior features processed by commonly used accelerometer metrics among adults (i.e. Euclidian Norm Minus One (ENMO), Mean Amplitude Deviation (MAD) and counts per minute (CPM)), 2) investigate the impact of accelerometer metrics on compliance with movement behavior guidelines, and 3) explore potential variations in the association between movement behavior features and cardiometabolic variables depending on the chosen metric.

METHODS

This cross-sectional study collected movement behavior features (Actigraph GT3X+) and cardiometabolic variables. Accelerometer data were analyzed by four metrics, i.e. ENMO, MAD, and CPM vertical axis and CPM vector magnitude (GGIR). Intraclass correlations and Bland‒Altman plots identified metric differences for time use in single movement behaviors (physical activity, sedentary behavior), average acceleration and intensity gradient. Regression models across the four metrics were used to explore differences in 24-hour movement behaviors (24h-MBs; compositional variable) as for exploration of associations with cardiometabolic variables.

RESULTS

Movement behavior data from 213 Belgian adults (mean age 45.8±10.8 years, 68.5% female) differed according to the metric used, with ENMO representing the most sedentary movement behavior profile and CPM vector magnitude representing the most active profile. Compliance rates for meeting integrated 24h-MBs guidelines varied from 0-25% depending on the metric used. Furthermore, the strength and direction of associations between movement behavior features and cardiometabolic variables (body mass index, waist circumference, fat% and HbA1c) differed by the choice of metric.

CONCLUSION

The metric used during data processing markedly influenced cut-point dependent time use estimates and cut-point independent average acceleration and intensity gradient, impacting guideline compliance and associations with cardiometabolic variables. Consideration is necessary when comparing findings from accelerometry studies to inform public health guidelines.

Measuring 24-h use of time in people with a diabetes-related foot ulcer: A feasibility study

BACKGROUND

Physical activity (PA), sleep and sedentary time are now recognised as mutually exclusive and exhaustive parts of the 24-h day-if PA decreases, time spent sleeping, being sedentary or both must increase so that all components equate to 24 h. Recent advances in time-use epidemiology suggest that we should not consider time-use domains (PA, sleep and sedentary time) in isolation from each other, but in terms of a composition-the mix of time-use domains across the 24-h day. While interrelated daily activities are known to be important in the management of diabetes mellitus, few studies have investigated the interrelated daily activities in people with an active diabetes-related foot ulcer (DFU) and their impact on important outcomes such as wound severity, blood glucose control and health-related quality of life (HRQoL). This feasibility study aims to determine the acceptability and practicality of measuring 24-h use of time data in people with a DFU and its associations on important outcome measures for this population.

METHODS

Participants wore a wrist-worn accelerometer for two weeks and completed demographic and HRQoL questionnaires. Outcomes were participant engagement, reported levels of study burden and value and compositional data analysis as a methodological approach for evaluating 24-h use of time data.

RESULTS

Twenty-six participants reported low levels of study burden and rated the study value highly. The protocol appears feasible in terms of recruitment (81%) and retention rate (86%). On average, participants were relatively sedentary spending 747, 172 and 18 min in sedentary time, light physical activity and moderate-to-vigorous activity, respectively. Sleep appeared adequate with participants obtaining an average of 485 min, but quality of sleep was notably poor with average sleep efficiency of 75%. Compositional data analysis was able to quantify the integrated associations of 24-h use of time with HRQoL.

CONCLUSION

The protocol provides an acceptable method to collect 24-h use of time data in people with a DFU. Efforts to consider and analyse PA as part of a 24-h activity composition may provide holistic and realistic understandings of PA in this clinical population.

Analytic Methods for Understanding the Temporal Patterning of Dietary and 24-H Movement Behaviors: A Scoping Review

Dietary and movement behaviors [physical activity (PA), sedentary behavior (SED), and sleep] occur throughout a 24-h day and involve multiple contexts. Understanding the temporal patterning of these 24-h behaviors and their contextual determinants is key to determining their combined effect on health. A scoping review was conducted to identify novel analytic methods for determining temporal behavior patterns and their contextual correlates. We searched Embase, ProQuest, and EBSCOhost databases in July 2022 to identify studies published between 1997 and 2022 on temporal patterns and their contextual correlates (e.g., locational, social, environmental, personal). We included 14 studies after title and abstract (n = 33,292) and full-text (n = 135) screening, of which 11 were published after 2018. Most studies (n = 4 in adults; n = 5 in children and adolescents), examined waking behavior patterns (i.e., both PA and SED) of which 3 also included sleep and 6 included contextual correlates. PA and diet were examined together in only 1 study of adults. Contextual correlates of dietary, PA, and sleep temporal behavior patterns were also examined. Machine learning with various clustering algorithms and model-based clustering techniques were most used to determine 24-h temporal behavior patterns. Although the included studies used a diverse range of methods, behavioral variables, and assessment periods, results showed that temporal patterns characterized by high SED and low PA were linked to poorer health outcomes, than those with low SED and high PA. This review identified temporal behavior patterns, and their contextual correlates, which were associated with adiposity and cardiometabolic disease risk, suggesting these methods hold promise for the discovery of holistic lifestyle exposures important to health. Standardized reporting of methods and patterns and multidisciplinary collaboration among nutrition, PA, and sleep researchers; statisticians; and computer scientists were identified as key pathways to advance future research on temporal behavior patterns in relation to health.

Exploring Associations Between Device-Based Occupational Sedentary Behavior and Need for Recovery in White Collar Workers: A Compositional Data-Analysis

Objectives

White collar workers spend an increasing amount of time in occupational sedentary behavior (OSB) and are thereby at risk for adverse health outcomes. Nevertheless, the association between OSB and the need for recovery (NFR), an important indicator of wellbeing, is unknown and therefore examined.

Methods

Baseline data from a cluster randomized controlled trial was used. A subgroup of 89 white collar workers wore a triaxial accelerometer for 7 days. NFR was measured using the Questionnaire on the Experience and Evaluation of Work. Compositional data analysis was applied to determine the composition of different OSB bouts (short, medium and long) and occupational physical activity (OPA) (light, moderate and vigorous and standing). Linear regression analyses were performed to explore the associations between occupational compositions and NFR.

Results

Relatively more time spent in long OSB bouts was associated with a lower NFR (β: -11.30, 95% CI: -20.2 to -2.4). Short and medium OSB bouts and OPA were not associated with NFR.

Conclusion

Associations between OSB bouts, OPA and NFR hinted at contrasting trends, suggesting the need to consider different bout lengths of OSB in future studies.

The associations of chronic pain and 24-h movement behaviors with incident mental disorders: evidence from a large-scale cohort study

BACKGROUND

Chronic pain was associated with a higher risk of mental disorders (e.g., depression and anxiety). However, the role of 24-h movement behaviors in the association remains unclear.

METHODS

A total of 72,800 participants with accelerometer data and free of mental disorders from the UK Biobank were analyzed. The compositional mediation model and isotemporal substitution model were used to explore the associations between chronic pain, 24-h movement behaviors, and the incidence of overall mental disorders, depression, and anxiety.

RESULTS

With a median follow-up of 13.36 years, participants with chronic pain had a higher rate of incident overall mental disorders (hazard ratio (HR): 1.281, 95% confidence interval (CI): 1.219 to 1.344), anxiety (HR: 1.391, 95% CI: 1.280 to 1.536), and depression (HR: 1.703, 95% CI: 1.551 to 1.871). Increased sedentary behavior (SB) and reduced moderate-to-vigorous physical activity (MVPA) caused by chronic pain both increased the risk of mental disorders. Twenty-four-hour movement behaviors explained the relationship between chronic pain and overall mental disorders, depression, and anxiety by 10.77%, 5.70%, and 6.86%, respectively. Interaction effects were found between MVPA and chronic pain when predicting the incidence of depression and between MVPA, sleep (SLP), and chronic pain when predicting the incidence of mental disorders. People with chronic pain would recommend at least 0.5 h per day of MVPA and 7 h per day of SLP and restricting SB below 11.5 h per day.

CONCLUSIONS

Twenty-four-hour movement behaviors played a significant mediating role in the association between chronic pain and mental disorders. Individuals with chronic pain should engage in more MVPA, less sedentary behavior, and have 7-h sleep per day.

Longitudinal Associations between 24-h Movement Behaviors and Cardiometabolic Biomarkers: A Natural Experiment over Retirement

INTRODUCTION

Physical activity, sedentary behavior, and sleep, that is, 24-h movement behaviors, often change in the transition from work to retirement, which may affect cardiometabolic health. This study investigates the longitudinal associations between changes in 24-h movement behaviors and cardiometabolic biomarkers during the retirement transition.

METHODS

Retiring public sector workers ( n = 212; mean (SD) age, 63.5 (1.1) yr) from the Finnish Retirement and Aging study used a thigh-worn Axivity accelerometer and filled out a diary to obtain data on daily time spent in sedentary behavior (SED), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA), and sleep before and after retirement (1 yr in-between). Cardiometabolic biomarkers, including LDL-cholesterol, HDL-cholesterol, total/HDL-cholesterol ratio, triglycerides, C-reactive protein, fasting glucose, and insulin, were measured. Associations between changes in 24-h movement behaviors and cardiometabolic biomarkers were analyzed using compositional robust regression and isotemporal substitution analysis.

RESULTS

Increasing LPA in relation to remaining behaviors was associated with an increase in HDL-cholesterol and decrease in total/HDL-cholesterol ratio ( P < 0.05 for both). For instance, reallocation of 30 min from sleep/SED to LPA was associated with an increase in HDL-cholesterol by 0.02 mmol·L -1 . Moreover, increasing MVPA in relation to remaining behaviors was associated with a decrease in triglycerides ( P = 0.02). Reallocation of 30 min from SED/sleep to MVPA was associated with 0.07-0.08 mmol·L -1 decrease in triglycerides. Findings related to LDL-cholesterol, C-reactive protein, fasting glucose, and insulin were less conclusive.

CONCLUSIONS

During the transition from work to retirement, increasing physical activity at the expense of passive behaviors was associated with a better lipid profile. Our findings suggest that life transitions like retirement could be utilized more as an optimal time window for promoting physical activity and health.

Movement behaviour typologies and their associations with adiposity indicators in children and adolescents: a latent profile analysis of 24-h compositional data

OBJECTIVES

Growing evidence supports the important role of 24-hour movement behaviours (MB) in preventing childhood obesity. However, research to understand the heterogeneity and variability of MB among individuals and what kind of typologies of individuals are at risk of developing obesity is lacking. To bridge this gap, this study identified typologies of 24-hour MB in children and adolescents and investigated their associations with adiposity indicators.

METHODS

In this cross-sectional study, 374 children and 317 adolescents from the Czech Republic wore wrist-worn accelerometers for seven consecutive days. Time spent in moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behaviour (SB), and sleep was quantified using raw accelerometery data. Adiposity indicators included body mass index (BMI) z-score, fat mass percentage (FM%), fat mass index (FMI), and visceral adipose tissue (VAT). Bias-adjusted latent profile analysis was used on the 24-hour MB data to identify MB typologies and their associations with adiposity indicators. The models were adjusted for potential confounders. The identified typologies were labelled to reflect the behavioural profiles of bees to aid interpretability for the general public.

RESULTS

Two typologies were identified in children: highly active Workers characterised by high levels of MVPA and LPA, and inactive Queens characterised by low levels of MVPA and LPA, high levels of SB and longer sleep duration compared to Workers. In adolescents, an additional typology labelled as Drones was characterised by median levels of MVPA, LPA, SB and longest sleep duration. After controlling for covariates, we found that children labelled as Queens were associated with 1.38 times higher FM%, 1.43 times higher FMI, and 1.67 times higher VAT than Workers. In adolescents, Drones had 1.14 times higher FM% and Queens had 1.36 higher VAT in comparison with Workers, respectively.

CONCLUSION

Our study highlights the importance of promoting active lifestyles in children and adolescents to potentially reduce adiposity. These findings can provide insights for interventions aimed at promoting healthy MB and preventing childhood obesity.

Time use and dimensions of healthy sleep: A cross-sectional study of Australian children and adults

BACKGROUND

Sleep is increasingly recognized as a multidimensional construct that occurs within the 24-hour day. Despite advances in our understanding, studies continue to consider the relationship between sleep, sedentary time and physical activity separately, and not as part of the 24-hour day.

AIMS

To determine the association between the 24-hour activity composition and dimensions of healthy sleep.

METHODS

This study examined data on 1168 children (mean age 12years; 49% female) and 1360 adults (mean age 44years; 87% female) collected as part of the Child Health CheckPoint study. Participants were asked to wear a GENEActiv monitor (Activinsights, Cambs, UK) on their nondominant wrist for eight consecutive days to measure 24-hour time-use. Compositional data analysis was used to examine the association between time use (actigraphy-derived sleep duration, sedentary time, light physical activity and moderate-vigorous physical activity) and dimensions of healthy sleep. Healthy sleep was conceptualized in terms of continuity/efficiency, timing, alertness/sleepiness, satisfaction/quality, and regularity. Time allocations were also examined.

RESULTS

The 24-hour activity composition was significantly associated with all objectively measured and self-report dimensions of healthy sleep in both children and adults. Allocating more time to sleep was associated with earlier sleep onsets, later sleep offsets, less efficient and more consistent sleep patterns for both children and adults.

CONCLUSION

This study highlights the integral relationship between daily activities and dimensions of sleep. Considering sleep within the 24-hour day activity composition framework may help inform lifestyle decisions to improve sleep health.

Is patients' activities of daily living self-care score in Norwegian home care a proxy for workers standing at work?

BACKGROUND

Prolonged standing at work may contribute to increased risk of musculoskeletal pain in home care workers. Patients' activities of daily living (ADL) score may be a proxy for home care workers' standing time at work. The objective of the present study was to investigate the association between patients' ADL self-care score, and workers standing time.

METHODS

This cross-sectional study measured time spent standing, sitting and in physical activity for seven days using thigh-worn accelerometers, among 14 home care workers. Patients' ADL self-care scores are routinely adjusted by home care nurses, and time intervals of home care visits are stored in home care services electronic patient journal. We collected ADL self-care scores and start and end time points of visits, and categorized ADL self-care scores as low (ADL ≤ 2.0), medium (ADL > 2.0 to 3.0) or high (ADL > 3.0). Physical behavior data were transformed to isometric log-ratios and a mixed-effect model was used to investigate differences in physical behavior between the three ADL self-care score categories.

RESULTS

We analyzed 931 patient visits and found that high ADL self-care scores were associated with longer standing times relative to sitting and physical activity, compared to low ADL score (0.457, p = 0.001). However, no significant differences in time spent standing were found between high and medium ADL patient visits (0.259, p = 0.260), nor medium and low (0.204, p = 0.288). High ADL score patients made up 33.4% of the total care time, despite only making up 7.8% of the number of patients.

CONCLUSION

Our findings suggest that caring for patients with high ADL self-care score requires workers to stand for longer durations and that this group of patients constitute a significant proportion of home care workers' total work time. The findings of this study can inform interventions to improve musculoskeletal health among home care workers by appropriate planning of patient visits.

Cross-sectional association between 24-hour movement guidelines and depressive symptoms in Chinese university students

Background

The world's first 24-h movement guidelines for adults were released on 15 October 2020 in Canada, though evidence of their associations with health indicators in young adults is sparse. This study aimed to report the prevalence of meeting the 24-h movement guidelines and associations with depressive symptoms in a sample of Chinese university students.

Methods

Cross-sectional data from 1,793 Chinese university students (mean age = 20.7 years, 63.6% female) were used. Sociodemographic information, movement behaviors (physical activity, sedentary behavior, and sleep duration), and depressive symptoms were collected using a self-reported questionnaire.

Results

The prevalence of meeting the 24-h movement guidelines was 27.8% in Chinese university students. Logistic regression results show that compared to those who met the 24-h movement guidelines, odds ratio (OR) for depressive symptoms in those who met fewer recommendations contained in the 24-h movement guidelines were significantly higher (OR for none = 3.4, 95% CI [2.1-5.5], p < 0.001; OR for one = 2.7, 95% CI [2.0-3.8], p < 0.001; OR for two = 1.5, 95% CI [1.1-2.1], p = 0.013).

Conclusion

The prevalence of meeting the 24-h movement guidelines in Chinese university students was relatively low and should be enhanced through multiple strategies. Meeting the 24-h movement guidelines was associated with lower risk for depression in Chinese young adults. It is suggested that moving more, sitting less and sleeping well in this population may reduce the occurrence of depression.

Meeting 24-h movement behavior guidelines is linked to academic engagement, psychological functioning, and cognitive difficulties in youth with internalizing problems

BACKGROUND

This study aimed to investigate associations of meeting 24-h movement behavior (24-HMB: physical activity [PA], screen time [ST] in the school-aged youth, and sleep) guidelines with indicators of academic engagement, psychological functioning, and cognitive function in a national representative sample of U.S. youth.

METHODS

In this cross-sectional study, 1794 participants aged 6 to 17 years old were included for multivariable logistic regression to determine the above-mentioned associations, while adjusting for sociodemographic and health covariates.

RESULTS

The proportion of participants who met 24-HMB guideline(s) varied greatly (PA+ ST+ sleep = 34 [weighted 1.17 %], PA + ST = 23 [weighted 1.72 %], PA + sleep = 52 [weighted 2.15 %], PA = 34 [weighted 2.88 %], ST = 142 [weighted 7.5 %], ST+ sleep = 209 [weighted 11.86 %], sleep = 725 [weighted 35.5 %], none = 575 [weighted 37.22 %]). Participants who met ST guideline alone and integrated (ST + Sleep and ST + sleep + PA) guidelines demonstrated the consistently beneficial associations with learning interest/curiosity, caring for school performance, completing required homework, resilience, cognitive difficulties, self-regulation (ps < 0.05).

CONCLUSION

Meeting 24-HMB guidelines in an isolated or integrative manner was associated with improved academic engagement, psychological functioning, and reduced cognitive difficulties. These findings highlight the importance of the promotion of 24-HMB guidelines in youth with internalizing problems. Future longitudinal studies are needed to investigate whether changes or modifications of meeting specific 24-HMB guidelines (especially ST) is beneficial for youth with internalizing problems.

Behavior reallocations within 24-h movement profiles and change in cardiometabolic biomarkers during pregnancy

OBJECTIVE

The goal of this study was to investigate associations of reallocations within 24-h movement profiles and changes in cardiometabolic biomarkers from early to late pregnancy.

METHODS

In 137 individuals with prepregnancy overweight/obesity, waking movement was measured using wrist-worn accelerometers, sleep was self-reported, and biomarkers were measured in fasting serum samples at 12 and 32 weeks' gestation. We used compositional isotemporal substitution models.

RESULTS

On average, biomarkers increased 21%-83% across pregnancy. For those with guideline-recommended moderate/vigorous-intensity physical activity (MVPA) in early pregnancy, reallocating 30 min from MVPA to sleep, sedentary behavior, or light-intensity physical activity (LPA) was associated with a 0.6 mmol/L greater increase in total cholesterol (95% CI: -0.1 to 1.2) and a 0.7 mmol/L greater increase in low-density lipoprotein (LDL) cholesterol (95% CI: 0.1 to 1.3) from early to late pregnancy. For those with low MVPA in early pregnancy, reallocating 30 min from sleep, sedentary behavior, or LPA to MVPA was associated with a 0.6 mmol/L lower increase in total cholesterol (95% CI: -1.3 to 0.1) and a 0.8 mmol/L lower increase in LDL cholesterol (95% CI: -1.4 to -0.1) from early to late pregnancy. There were no associations with change in glucose, insulin, homeostatic model assessment for insulin resistance, very low-density lipoprotein, or high-density lipoprotein cholesterol, triglycerides, or free fatty acids.

CONCLUSIONS

Maintaining or achieving a 24-h movement profile with guideline-recommended amounts of MVPA may be beneficial for reducing pregnancy-induced increases in total and LDL cholesterol.

Cross-sectional associations between 24-hour movement behaviors and cardiometabolic health among adults with type 2 diabetes mellitus: A comparison according to weight status

OBJECTIVES

Type 2 diabetes mellitus (T2DM) is a chronic disease associated with overweight and obesity. Evidence suggests that 24-hour movement behaviors (24 h-MBs) play a crucial role in cardiometabolic health. However, it is not yet known if 24 h-MBs differ between weight status groups among people with T2DM (PwT2DM) and how 24 h-MBs are associated with their cardiometabolic health.

DESIGN

Cross-sectional study.

METHODS

Cardiometabolic variables (i.e. Body Mass Index (BMI), waist circumference (WC), HbA1c, fasting glucose, triglycerides, total-cholesterol, HDL-cholesterol, LDL-cholesterol, blood pressure) and 24 h-MBs (accelerometry and sleep-diary) of 1001 PwT2DM were collected. Regression models using compositional data analysis explored differences in 24 h-MBs between weight status groups and analyzed associations with cardiometabolic variables.

RESULTS

The 24 h-MBs of PwT2DM being obese consisted of less sleep, light physical activity (LPA) and moderate to vigorous physical activity (MVPA) and more sedentary time (ST) per day as compared to PwT2DM being overweight or normal weight (p < 0.001). Regardless of weight status, the largest associations were found when reallocating 20 min a day from ST into MVPA for BMI (-0.32 kg/m2; [-0.55; -0.09], -1.09 %), WC (-1.44 cm, [-2.26; -0.62], -1.35 %) and HDL-cholesterol (0.02 mmol/l, [0.01, 0.02], +1.59 %), as well as from ST into LPA for triglycerides (-0.04 mmol/l, [-0.05; -0.03], -2.3 %). Moreover, these associations were different when stratifying people by short-to-average (7.7 h/night) versus long sleep (9.3 h/night) period.

CONCLUSIONS

This study highlights the importance of 24 h-MBs in the cardiometabolic health of PwT2DM. Shifting time from ST and/or sleep toward LPA or MVPA might theoretically benefit cardiometabolic health among relatively inactive PwT2DM, irrespective of weight status.

Associations between Parental Educational Attainment, Children's 24-h Behaviors and Children's Hyperactivity Behavior in the COVID-19 Pandemic

BACKGROUND

Parental Educational Attainment and children's 24-h behaviors significantly influenced children's hyperactivity symptoms. This study aimed to examine the mediating role of children's 24-h behavior changes due to the COVID-19 pandemic between Parental Educational Attainment and children's hyperactivity index. It also aimed to investigate the associations between Children's Physical Activity, digital media use, sleep, and hyperactivity index between two clusters of Parental Educational Attainments. The goal was to provide targeted behavioral optimization recommendations for caregivers to reduce the risk of children's hyperactivity.

METHODS

The study was a collaborative extension of the International iPreschooler Surveillance Study Among Asians and otheRs project and the Chinese Children and Adolescent Sports Health Promotion Action Project. The Parent-Surveillance of Digital Media in Childhood Questionnaire® and the Abbreviated Rating Scales from the Conners Parent Symptom Questionnaire were used to measure Parental Educational Attainment, children's behavior changes during the COVID-19 pandemic, and hyperactivity indexes. A total of 11,190 parents of 6-to-12-year-old children completed the online surveys in mainland China. A structural equation model was established by using Smart-PLS, and the linear regression model, and isotemporal substitution models were established by using a Compositional Data Analysis package with R program to achieve the research objectives.

RESULTS

Changes in children's 24-h behaviors due to the COVID-19 pandemic had a significant mediation effect on the negative associations between Parental Educational Attainment and children's hyperactivity index (β = 0.018, T = 4.521, p < 0.001) with a total effect (β = -0.046, T = 4.521, p < 0.001) and a direct effect (β = -0.064, T = 6.330, p < 0.001). Children's Digital Media use was significantly and negatively associated with hyperactivity index among all children. Reallocated time from digital media use to both sleep and physical activity decreased the hyperactivity index, and vice-versa. For parents without tertiary education (R2 = 0.09, p < 0.001), sleep was significantly and negatively associated with the hyperactivity index (βilr-CSL = -0.06, p < 0.001); for parents with tertiary education (R2 = 0.07, p < 0.001), physical activity was significantly and negatively associated with the hyperactivity index (βilr-CPA = -0.05, p < 0.001), and sleep was significantly and positively associated with the hyperactivity index (βilr-CSL = 0.03, p < 0.001). A significant increase in the hyperactivity index was detected when physical activity time was reallocated to sleep, with a significant decrease in the opposite direction.

CONCLUSIONS

Parental Educational Attainment and children's 24-h behaviors directly influenced children's hyperactivity index. However, a purposeful and targeted optimization of children's 24-h behaviors-namely, physical activity, digital media use, and sleep-could assist parents with different educational attainments to reduce their children's hyperactivity index and mitigate the risk of hyperactivity.

Reallocating desk workers' sitting time to standing or stepping: associations with work performance

BACKGROUND

Studies have suggested that sitting time at work may lead to underperformance but they may underestimate the benefits to desk workers' performance of reducing occupational sitting time without considering the relative effects of the specific activities replaced.

AIMS

To estimate differences in work performance (presenteeism, absenteeism and engagement) when occupational sitting time is reallocated to standing/stepping in desk workers.

METHODS

Data for middle-aged desk workers were from a Japan-wide online survey (n = 2228). Self-report proportion of occupational sitting and standing/stepping, work hours and work performance indicators, including absolute (ratings relating only to self) and relative (ratings of self, compared to others) presenteeism and absenteeism, and dimensions of work engagement, were collected. Partition and isotemporal substitution models were used to investigate the associations of occupational sitting and standing/stepping time with work performance, including their reallocation effects.

RESULTS

In partition models, longer occupational sitting time was associated with a lower absolute presenteeism score (i.e. less productivity), lower absolute absenteeism (i.e. longer-than-expected work hours), and lower engagement. Longer occupational standing/stepping time was associated with lower absolute absenteeism and more engagement. Isotemporal substitution models showed that each hour of occupational sitting reallocated to standing/stepping was favourably associated with overall work engagement (B = 0.087; 95% confidence interval 0.051, 0.122) and its dimensions (B ranged from 0.078 to 0.092), but was not associated with presenteeism or absenteeism.

CONCLUSIONS

These findings suggest that management support and practical initiatives to encourage desk workers to replace portions of their sitting time with standing/stepping may contribute to enhanced work engagement.

The whole day matters after stroke: Study protocol for a randomized controlled trial investigating the effect of a 'sit less, move more, sleep better' program early after stroke

BACKGROUND

Movement-related behaviours, including prolonged sedentary behaviour, physical inactivity, and poor sleep, are associated with worse functional outcomes poststroke. Addressing these co-dependent behaviours early after stroke may help to optimize recovery and improve overall quality of life for individuals with stroke.

OBJECTIVE

This study aims to determine the feasibility and effect of a 'sit less, move more, sleep better' program early after stroke on functional mobility and global disability outcomes, while also exploring imaging and behavioural markers that may influence walking recovery.

METHODS

The study is an assessor-blinded, single-center, parallel-group, randomized controlled trial to be completed within 24 months from July 12, 2023 to June 30, 2025. We will enroll 50 patients with acute ischemic stroke within 7 days from symptom onset, aged 18 years or older, and with ongoing walking goals. Demographic and stroke characteristics, including stroke risk factors, neuroimaging, and acute stroke treatments, will be determined and documented. All participants will wear an accelerometer for one week at three different time-points (baseline, 6, and 12 weeks) to assess movement-related behaviours. Following randomization, participants in the intervention arm will receive a 'sit less, move more, sleep better' program for up to 1 hour/day, 5 days/week, for 6 weeks to enhance self-efficacy for change. Participants in the control arm will receive usual inpatient and early supported stroke discharge care. The feasibility outcomes will include reach (enrolled/eligible), retention (completed/enrolled), adverse events, and program adherence. Other outcomes at 6 and 12 weeks include the modified Rankin Scale, Timed-Up and Go, movement-related behaviours, walking endurance, gait speed, cognition, stroke severity and quality of life. Mixed-effects models will assess changes in outcomes over time. Compositional associations between movement-related behaviours and outcomes will consider covariates such as imaging markers.

DISCUSSION

Adopting a whole-day approach to poststroke rehabilitation will provide valuable insights into the relationship between optimizing movement-related behaviours early after stroke and their impact on functional outcomes. Through exploring person-specific behavioural and imaging markers, this study may inform precision rehabilitation strategies, and guide clinical decision making for more tailored interventions.

TRIAL REGISTRATION

Clinical Trial registration (ClinicalTrials.gov Identifier: NCT05753761, March 3, 2023).

The Association Between Socioeconomic Status and Use of Time in Australian Children and Adolescents

PURPOSE

There are well-known socioeconomic status (SES) gradients in children and adolescents' health which may be associated with time use. Our aim was to evaluate the association between Australian children's 24-hour time use and SES using four separate surveys from 2005 to 2021.

METHODS

Time use was assessed in 4526 8-19-year-olds from the 2005 Health of Young Victorians, 2007 National Children's Nutrition and Physical Activity, 2015 Child Health CheckPoint, and 2019-21 Life on Holidays study. Each survey used the same reliable, valid, 24-hour recall instrument. SES was quantified using tertiles of household income, education, and postcode-level measures. Compositional data analysis was used to compare 24-hour time use between SES categories, adjusting for age, sex, and puberty.

RESULTS

Time-use compositions differed significantly by SES in each survey. Relative to the lowest SES, children from the highest SES accumulated on average 31 min/day more School-related time, 6 min/day more Passive Transport and 6 min/day more Self-care. Conversely, they accumulated 30 min/day less Screen Time (which included computer time), 11 min/day less sleep, and spent 7 min/day less in Domestic/Social activities. There were only small differences in Quiet Time and Physical Activity.

DISCUSSION

SES-related differences in time use were robust across ages 8-19, a 16-year timespan, diverse Australian geographical regions, and using different SES metrics. The exchange of about 30 min/day between School-related activities and Screen Time amounts to >180 hours extra exposure to School-related activities annually in the highest SES category relative to the lowest, equivalent to >6 weeks of school time per year.

Cross-sectional and prospective associations between children's 24-h time use and their health-related quality of life: a compositional isotemporal substitution approach

Background

Promoting active, balanced lifestyles among children may be an important approach to optimising their health-related quality of life (HRQoL). However, the relationships between children's movement behaviours and HRQoL remain unclear.

Methods

We examined the associations between movement behaviours (sleep, inactivity, light and moderate-to-vigorous intensity physical activity) assessed using accelerometers at ages 8 and 10 years and self-reported HRQoL scores (overall, and physical and emotional well-being, self-esteem, relationship with family and friends, and school functioning domains) at age 10 years among 370 children in a local birth cohort using compositional isotemporal substitution techniques.

Findings

Cross-sectionally, light and moderate-to-vigorous intensity physical activities were associated with better self-esteem (β = 15.94 [2.71, 29.18]) and relationship with friends (β = 10.28 [3.81, 16.74]) scores respectively. Prospectively, inactivity was associated with lower overall HRQoL (β = -10.00 [-19.13, -0.87]), relationship with friends (β = -16.41 [-31.60, -1.23]) and school functioning (β = -15.30 [-29.16, -1.44]) scores, while sleep showed a positive trend with overall HRQoL (β = 10.76 [-1.09, 22.61]) and school functioning (β = 17.12 [-0.87, 35.10]) scores. Children's movement behaviours were not associated with their physical and emotional well-being, or relationship with family scores. The isotemporal substitution analyses suggest that increasing time spent in physical activity and/or sleep at the expense of inactivity may benefit children's HRQoL.

Interpretation

Our findings suggest that sleep and physical activity may be associated with better HRQoL, with the inverse for inactivity. However, the relationship between children's movement behaviours and HRQoL is complex and warrants further research.

Funding

Singapore National Research Foundation, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research.

Changes in Desk-Based Workers' Sitting, Standing, and Stepping Time: Short- and Longer-Term Effects on Musculoskeletal Pain

PURPOSE

Sitting at work can be associated with musculoskeletal pain, but the effect of reductions in sitting is not well understood. We examined relationships with musculoskeletal pain of changes in sitting, standing, stepping, and short and long bouts of these behaviors.

METHODS

Analyses pooled data from 224 desk workers (68.4% women; mean ± SD age = 45.5 ± 9.4 yr; body mass index = 28.1 ± 6.1 kg⋅m -2 ) in intervention trial. Device-assessed (activPAL3) sitting, standing, and stepping time and multisite musculoskeletal pain (Nordic Questionnaire; 12 body areas) were assessed at baseline, 3 months, and 12 months. Compositional data analyses in linear mixed-effects regressions examined relationships within 16 waking hours of the behaviors and their short and long bouts, with changes from baseline in acute and chronic multisite musculoskeletal pain at 3 and 12 months. Analyses were adjusted for initial group randomization and relevant covariates.

RESULTS

At 3 months, increased standing relative to changes in other compositions was significantly associated with increased multisite musculoskeletal pain (acute: β = 1.54, 95% confidence interval [CI] = 0.10 to 2.98; chronic: β = 1.49, 95% CI = 0.12 to 2.83). By contrast, increased stepping relative to changes in other compositions was significantly associated with reduced multisite musculoskeletal pain (acute: β = -1.49, 95% CI = -2.97 to -0.02; chronic: β = -1.87, 95% CI = -3.75 to -0.01). Neither sitting reduction relative to changes in other compositions nor changes in short bouts relative to long bouts of the behaviors were significantly associated with multisite musculoskeletal pain changes. At 12 months, there were no significant associations for any of the compositional changes.

CONCLUSIONS

In the short term, while increasing standing with reduced sitting time can be unfavorable, concurrently increasing stepping could potentially reduce musculoskeletal pain. In the longer term, musculoskeletal pain may not be increased by moderate reductions in sitting time through spending more time standing or stepping.

Are reallocations of time between physical activity, sedentary behaviour and sleep associated with low back pain? A compositional data analysis

Objectives

The aim of this cross-sectional study was to explore the associations of reallocating time between moderate- to vigorous-intensity physical activity (MVPA), light-intensity physical activity (LPA), sedentary behaviour (SB) and sleep with occurrence, frequency and intensity of low back pain (LBP) among adults using compositional isotemporal substitution analysis.

Methods

A total of 2333 participants from the general adult population completed the Daily Activity Behaviours Questionnaire asking about their time-use composition consisting of sleep, SB, LPA and MVPA, and they self-reported their frequency and intensity of LBP in the past year.

Results

Regression analyses adjusted for age, sex, body mass index, smoking, stress, education and socioeconomic status found that the time-use composition is associated with the frequency (p=0.009) and intensity of LBP (p<0.001). Reallocating time from SB or LPA to sleep was associated with lower frequency and intensity of LBP (p<0.05). Reallocating time from MVPA to sleep, SB or LPA and from SB to LPA was associated with a lower intensity of LBP (p<0.05). For example, reallocating 30 min/day from SB to sleep was associated with 5% lower odds (95% CI: 2% to 8%, p=0.001) of experiencing LBP more frequently, and 2% lower LBP intensity (95% CI: 1% to 3%, p<0.001).

Conclusion

LBP sufferers may benefit from getting additional sleep and spending more time in LPA, while engaging less in SB and MVPA. These reallocations of time may be meaningful from clinical and public health perspectives.

Association of meeting 24-hour movement guidelines with low back pain among adults

Background

According to recently published 24-hour movement guidelines, adults should spend: ≥150 minutes/week in moderate-to-vigorous physical activity (MVPA); <8 hours/day in sedentary behaviour (SB); and 7-9 hours/day sleeping.

Objective

We explored the association between meeting these recommendations and low back pain (LBP)-the most common musculoskeletal disorder.

Methods

We collected self-reported data from 2333 adults about: MVPA, SB and sleep duration; frequency and intensity of LBP; and sociodemographic and lifestyle characteristics.

Results

Meeting a combination of SB and sleep recommendations was associated with lower odds of LBP in the past week and past month (adjusted odds ratio [OR]: 0.64 and 0.52, respectively; p < 0.05 for both). Among LBP sufferers, meeting any combination of recommendations that includes sleep was associated with lower odds of frequent (OR range: 0.49-0.61; p < 0.05 for all) and intense (OR range: 0.39-0.66; p < 0.05 for all) LBP in the past week, while meeting a combination of SB and sleep recommendations or all three recommendations was associated with lower odds of intense LBP in the past month and past year (OR range: 0.50-0.68; p < 0.05 for all). The likelihood of experiencing higher frequency and intensity of LBP decreased with the number of recommendations met (p for linear trend < 0.05).

Conclusion

Meeting the SB and sleep recommendations in combination is associated with a lower likelihood of LBP, while adhering to the overall 24-hour movement guidelines or any combination of recommendations that includes sleep is associated with lower frequency and intensity of LBP among LBP sufferers.

The association between reallocations of time and health using compositional data analysis: a systematic scoping review with an interactive data exploration interface

BACKGROUND

How time is allocated influences health. However, any increase in time allocated to one behaviour must be offset by a decrease in others. Recently, studies have used compositional data analysis (CoDA) to estimate the associations with health when reallocating time between different behaviours. The aim of this scoping review was to provide an overview of studies that have used CoDA to model how reallocating time between different time-use components is associated with health.

METHODS

A systematic search of four electronic databases (MEDLINE, Embase, Scopus, SPORTDiscus) was conducted in October 2022. Studies were eligible if they used CoDA to examine the associations of time reallocations and health. Reallocations were considered between movement behaviours (sedentary behaviour (SB), light physical activity (LPA), moderate-to-vigorous physical activity (MVPA)) or various activities of daily living (screen time, work, household chores etc.). The review considered all populations, including clinical populations, as well as all health-related outcomes.

RESULTS

One hundred and three studies were included. Adiposity was the most commonly studied health outcome (n = 41). Most studies (n = 75) reported reallocations amongst daily sleep, SB, LPA and MVPA. While other studies reported reallocations amongst sub-compositions of these (work MVPA vs. leisure MVPA), activity types determined by recall (screen time, household chores, passive transport etc.) or bouted behaviours (short vs. long bouts of SB). In general, when considering cross-sectional results, reallocating time to MVPA from any behaviour(s) was favourably associated with health and reallocating time away from MVPA to any behaviour(s) was unfavourably associated with health. Some beneficial associations were seen when reallocating time from SB to both LPA and sleep; however, the strength of the association was much lower than for any reallocations involving MVPA. However, there were many null findings. Notably, most of the longitudinal studies found no associations between reallocations of time and health. Some evidence also suggested the context of behaviours was important, with reallocations of leisure time toward MVPA having a stronger favourable association for health than reallocating work time towards MVPA.

CONCLUSIONS

Evidence suggests that reallocating time towards MVPA from any behaviour(s) has the strongest favourable association with health, and reallocating time away from MVPA toward any behaviour(s) has the strongest unfavourable association with health. Future studies should use longitudinal and experimental study designs, and for a wider range of outcomes.

Modifications of 24-h movement behaviors to prevent obesity in retirement: a natural experiment using compositional data analysis

BACKGROUND

Retirement often leads to a more passive lifestyle and may therefore lead to weight gain. This study aims to investigate longitudinal associations between changes in 24-h movement behaviors and BMI and waist circumference in relation to the transition from work to retirement.

METHODS

The study population included 213 retiring public sector workers (mean age 63.5 years, standard deviation 1.1) from the Finnish Retirement and Aging study. Before and after retirement participants wore an Axivity accelerometer on their thigh and filled in a daily log for at least four days to measure daily time spent sleeping, in sedentary behavior (SED), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA). Also, their body mass index (BMI) and waist circumference were measured repeatedly. Compositional linear regression analysis and isotemporal substitution analysis were used to study associations between one-year changes in 24-h movement behaviors and concurrent changes in BMI and waist circumference.

RESULTS

An increase in MVPA in relation to sleep, SED and LPA was associated with a decreasing BMI (β = -0.60, p = 0.04) and waist circumference (β = -2.14, p = 0.05) over one year from before retirement to after retirement. In contrast, increasing sleep in relation to SED, LPA and MVPA was associated with an increasing BMI (β = 1.34, p = 0.02). Reallocating 60 min from MVPA to SED or sleep was estimated to increase BMI by on average 0.8-0.9 kg/m2 and waist circumference by 3.0 cm during one year.

CONCLUSIONS

During the transition from work to retirement, increasing MVPA was associated with a slight decrease in BMI and waist circumference, whereas increasing sleep was associated with an increasing BMI. Common life transitions, like retirement, should be considered when giving recommendations and guidance for physical activity and sleep.

Distributional data analysis via quantile functions and its application to modeling digital biomarkers of gait in Alzheimer's Disease

With the advent of continuous health monitoring with wearable devices, users now generate their unique streams of continuous data such as minute-level step counts or heartbeats. Summarizing these streams via scalar summaries often ignores the distributional nature of wearable data and almost unavoidably leads to the loss of critical information. We propose to capture the distributional nature of wearable data via user-specific quantile functions (QF) and use these QFs as predictors in scalar-on-quantile-function-regression (SOQFR). As an alternative approach, we also propose to represent QFs via user-specific L-moments, robust rank-based analogs of traditional moments, and use L-moments as predictors in SOQFR (SOQFR-L). These two approaches provide two mutually consistent interpretations: in terms of quantile levels by SOQFR and in terms of L-moments by SOQFR-L. We also demonstrate how to deal with multi-modal distributional data via Joint and Individual Variation Explained using L-moments. The proposed methods are illustrated in a study of association of digital gait biomarkers with cognitive function in Alzheimers disease. Our analysis shows that the proposed methods demonstrate higher predictive performance and attain much stronger associations with clinical cognitive scales compared to simple distributional summaries.

Do Sit-Stand Tables Affect Physical Behavior and Body Composition Similarly in Normal-Weight and Overweight Office Workers? A Pilot Study

OCCUPATIONAL APPLICATIONSSedentary behavior is a significant health concern among office workers. We completed the same 6-month sit-stand table intervention at work for groups of normal-weight and overweight workers, and compared it to not having sit-stand tables. The intervention caused the intended decrease in sitting time in both groups and a corresponding increase in standing. We did not find compensation effects on physical behavior outside of work. Furthermore, the intervention did not change the composition of fat, lean, and bone mass in either group. Thus, strategies including initiatives to increase physical activity are likely needed to have effects on body composition; and an intervention needs to be sustained for longer than six months for any changes in body composition to be observed.

Longitudinal Associations Between Timing of Physical Activity Accumulation and Health: Application of Functional Data Methods

Accelerometers are widely used for tracking human movement and provide minute-level (or even 30 Hz level) physical activity (PA) records for detailed analysis. Instead of using day-level summary statistics to assess these densely sampled inputs, we implement functional principal component analysis (FPCA) approaches to study the temporal patterns of PA data from 245 overweight/obese women at three visits over a 1-year period. We apply longitudinal FPCA to decompose PA inputs, incorporating subject-specific variability, and then test the association between these patterns and obesity-related health outcomes by multiple mixed effect regression models. With the proposed methods, the longitudinal patterns in both densely sampled inputs and scalar outcomes are investigated and connected. The results show that the health outcomes are strongly associated with PA variation, in both subject and visit-level. In addition, we reveal that timing of PA during the day can impact changes in outcomes, a finding that would not be possible with day-level PA summaries. Thus, our findings imply that the use of longitudinal FPCA can elucidate temporal patterns of multiple levels of PA inputs. Furthermore, the exploration of the relationship between PA patterns and health outcomes can be useful for establishing weight-loss guidelines.

Characteristics of 24-hour movement behaviours and their associations with mental health in children and adolescents

Background

Time-use estimates are typically used to describe 24-hour movement behaviours. However, these behaviours can additionally be characterised by other easily measured metrics. These include sleep quality (e.g., sleep efficiency), 24-hour rest-activity rhythmicity (e.g., between-day rhythm variability), and directly measured acceleration metrics (e.g., intensity gradient). Associations between these characteristics and youth mental health are unclear. This study aimed to [1] compare 24-hour movement behaviour characteristics by sex and age groups, [2] determine which movement behaviour characteristics were most strongly associated with mental health outcomes, and [3] investigate the optimal time-use behaviour compositions for different mental health outcomes.

Methods

Three-hundred-and-one children and adolescents (age 9-13 y; 60% girls) wore accelerometers for 24-hours/day over 7-days. Overall mental health, externalising, and internalising problems were self-reported using the Strengths and Difficulties Questionnaire. 24-hour movement behaviour characteristics were categorised as time-use estimates, sleep quality, 24-hour activity rhythmicity, and directly measured acceleration. Linear mixed models and compositional data analysis were used to analyse the data in alignment with the study aims.

Results

Time-use estimates, directly measured accelerations, and 24-hour rest-activity rhythm metrics indicated that children were significantly more physically active (p = .01-<0.001) than adolescents. Children were also less sedentary (p < .01), slept longer (p = .02-0.01), and had lower sleep efficiency. Boys were significantly more active than girls (p < .001) who in turn accrued more time in sleep (p = .02). The timing of peak activity was significantly later among adolescents (p = .047). Overall mental health and externalising problems were significantly associated with sleep, sedentary time, sleep efficiency, amplitude, and inter-daily stability (p = .04-0.01). The optimal time-use compositions were specific to overall mental health and externalising problems and were characterised by more sleep, light and vigorous physical activity, and less sedentary time and moderate physical activity than the sample's mean time-use composition.

Conclusions

Extracting and examining multiple movement behaviour characteristics from 24-hour accelerometer data can provide a more rounded picture of the interplay between different elements of movement behaviours and their relationships with mental health than single characteristics alone, such as time-use estimates. Applying multiple movement behaviour characteristics to the translation of research findings may enhance the impact of the data for research users.

Supplementary Information

The online version contains supplementary material available at 10.1186/s44167-023-00021-9.

Association Between 24-Hour Movement Behavior and Cognitive Function in Brazilian Middle-Aged and Older Adults: Findings From the ELSA-Brasil

Background and Objectives

The relationship between 24-hr movement behavior and specific domains of cognitive function is unclear. The purpose of this study was to identify the joint association of daily time spent in light (light-intensity physical activity [LPA]) and moderate-to-vigorous physical activity (MVPA), sedentary behavior (SB), and sleep with cognitive function in middle-aged and older adults.

Research Design and Methods

Cross-sectional data from Wave 3 (2017-2019) of the Brazilian Longitudinal Study of Adult Health were analyzed. The study included adults aged 41-84 years old. Physical activity was assessed using a waist-worn accelerometer. Cognitive function was examined using standardized tests to assess memory, language, and Trail-Making test. Global cognitive function score was calculated by averaging domain-specific scores. Compositional isotemporal substitution models were performed to identify the association between the reallocation of time spent in LPA, MVPA, sleep, and SB with cognitive function.

Results

Participants (n = 8,608) were 55.9% female (mean age 58.9 [8.6] years). Reallocating time from SB to MVPA was associated with higher cognitive function: Reallocating 15 min to MVPA by reducing 5 min from each other behavior was associated with increased odds of better cognitive function in both insufficient (<7 hr/day; odds ratio [OR]: 0.64; 95% confidence interval [CI]: 0.54-0.77) and sufficient (≥7 hr/day; OR: 0.62; 95% CI: 0.58-0.67) sleep groups. Among those with insufficient sleep, reallocating time to MVPA and sleep from SB was associated with higher global cognitive performance.

Discussion and Implications

Small reductions in SB and increments in MVPA were associated with higher cognitive function in middle-aged and older adults.

Method for Activity Sleep Harmonization (MASH): a novel method for harmonizing data from two wearable devices to estimate 24-h sleep-wake cycles

Background

Daily 24-h sleep-wake cycles have important implications for health, however researcher preferences in choice and location of wearable devices for behavior measurement can make 24-h cycles difficult to estimate. Further, missing data due to device malfunction, improper initialization, and/or the participant forgetting to wear one or both devices can complicate construction of daily behavioral compositions. The Method for Activity Sleep Harmonization (MASH) is a process that harmonizes data from two different devices using data from women who concurrently wore hip (waking) and wrist (sleep) devices for ≥ 4 days.

Methods

MASH was developed using data from 1285 older community-dwelling women (ages: 60-72 years) who concurrently wore a hip-worn ActiGraph GT3X + accelerometer (waking activity) and a wrist-worn Actiwatch 2 device (sleep) for ≥ 4 days (N = 10,123 days) at the same time. MASH is a two-tiered process using (1) scored sleep data (from Actiwatch) or (2) one-dimensional convolutional neural networks (1D CNN) to create predicted wake intervals, reconcile sleep and activity data disagreement, and create day-level night-day-night pairings. MASH chooses between two different 1D CNN models based on data availability (ActiGraph + Actiwatch or ActiGraph-only). MASH was evaluated using Receiver Operating Characteristic (ROC) and Precision-Recall curves and sleep-wake intervals are compared before (pre-harmonization) and after MASH application.

Results

MASH 1D CNNs had excellent performance (ActiGraph + Actiwatch ROC-AUC = 0.991 and ActiGraph-only ROC-AUC = 0.983). After exclusions (partial wear [n = 1285], missing sleep data proceeding activity data [n = 269], and < 60 min sleep [n = 9]), 8560 days were used to show the utility of MASH. Of the 8560 days, 46.0% had ≥ 1-min disagreement between the devices or used the 1D CNN for sleep estimates. The MASH waking intervals were corrected (median minutes [IQR]: -27.0 [-115.0, 8.0]) relative to their pre-harmonization estimates. Most correction (-18.0 [-93.0, 2.0] minutes) was due to reducing sedentary behavior. The other waking behaviors were reduced a median (IQR) of -1.0 (-4.0, 1.0) minutes.

Conclusions

Implementing MASH to harmonize concurrently worn hip and wrist devices can minimizes data loss and correct for disagreement between devices, ultimately improving accuracy of 24-h compositions necessary for time-use epidemiology.

Substituting device-measured sedentary time with alternative 24-hour movement behaviours: compositional associations with adiposity and cardiometabolic risk in the ORISCAV-LUX 2 study

BACKGROUND

There is a considerable burden of sedentary time in European adults. We aimed to quantify the differences in adiposity and cardiometabolic health associated with theoretically exchanging sedentary time for alternative 24 h movement behaviours.

METHODS

This observational cross-sectional study included Luxembourg residents aged 18-79 years who each provided  ≥ 4 valid days of triaxial accelerometry (n = 1046). Covariable adjusted compositional isotemporal substitution models were used to examine if statistically replacing device-measured sedentary time with more time in the sleep period, light physical activity (PA), or moderate-to-vigorous PA (MVPA) was associated with adiposity and cardiometabolic health markers. We further investigated the cardiometabolic properties of replacing sedentary time which was accumulated in prolonged (≥ 30 min) with non-prolonged (< 30 min) bouts.

RESULTS

Replacing sedentary time with MVPA was favourably associated with adiposity, high-density lipoprotein cholesterol, fasting glucose, insulin, and clustered cardiometabolic risk. Substituting sedentary time with light PA was associated with lower total body fat, fasting insulin, and was the only time-exchange to predict lower triglycerides and a lower apolipoprotein B/A1 ratio. Exchanging sedentary time with more time in the sleep period was associated with lower fasting insulin, and with lower adiposity in short sleepers. There was no significant evidence that replacing prolonged with non-prolonged sedentary time was related to outcomes.

CONCLUSIONS

Artificial time-use substitutions indicate that replacing sedentary time with MVPA is beneficially associated with the widest range of cardiometabolic risk factors. Light PA confers some additional and unique metabolic benefit. Extending sleep, by substituting sedentary time with more time in the sleep period, may lower obesity risk in short sleepers.

Associations of activity, sedentary, and sleep behaviors with cognitive and social-emotional health in early childhood

Background

Early childhood is important for cognitive and social-emotional development, and a time in which to promote healthy movement behaviors (sedentary behavior, physical activity, and sleep). Movement behaviors may have interactive influences on cognition and social-emotional factors in young children, but most previous research has explored them independently. The purpose of this study was to determine if movement behaviors are associated with measures of cognitive and social-emotional health in young children and if so, to describe optimal compositions of movement behaviors of a daily cycle for such outcomes.

Methods

Children (n = 388, 33 to 70 months, 44.6% female) from a clinical trial (ClinicalTrials.gov ID: NCT03285880, first posted September 18, 2017) wore accelerometers on their wrists for 24-h for 9.56 ± 3.3 days. Movement behavior compositions consisted of time spent in sedentary behaviors, light intensity physical activity, moderate to vigorous intensity physical activity (MVPA), and sleep. Outcomes were cognitive (receptive vocabulary, declarative and procedural memory, and executive attention) and social-emotional measures (temperament and behavioral problems). Compositional linear regression models with isometric log ratios were used to investigate the relations between the movement behavior composition and the cognitive and social-emotional health measures. If a significant association was found between the composition and an outcome, we further explored the "optimal" 24-h time-use for said outcome.

Results

Movement behavior compositions were associated with receptive vocabulary. The composition associated with the predicted top five percent of vocabulary scores consisted of 12.1 h of sleep, 4.7 h of sedentary time, 5.6 h of light physical activity, and 1.7 h of MVPA.

Conclusions

While behavior compositions are related to vocabulary ability in early childhood, our findings align with the inconclusiveness of the current evidence regarding other developmental outcomes. Future research exploring activities within these four movement behaviors, that are meaningful to cognitive and social-emotional development, may be warranted.

Supplementary Information

The online version contains supplementary material available at 10.1186/s44167-023-00016-6.