Sedentary Time is Associated with Cardiometabolic Diseases in A Large Japanese Population: A Cross-Sectional Study

Association between leisure sedentary behaviors and hypertension risk: A prospective cohort study and two-sample Mendelian randomization analysis in Europeans

OBJECTIVE

This study aimed to investigate the potential causal relationship between domain-specific sedentary behaviors (including television watching, computer use, and driving) and hypertension risk in European populations.

METHODS

Initially, we conducted a multivariable Cox regression analysis to evaluate the associations between domain-specific sedentary behaviors and the risk of developing hypertension using data from 261,829 hypertension-free participants in the UK Biobank. To validate the findings of observational analysis, we employed two-sample univariable mendelian randomization (UVMR) analysis utilizing summary statistics from genome-wide association study conducted on European populations. We then performed multivariable mendelian randomization (MVMR) analysis to account for the influence of the risk factors for hypertension.

RESULTS

In this prospective observational analysis, individuals who spent >3 h per day watching television had significantly higher risk of developing hypertension (HR = 1.24, 95% CI: 1.20-1.29, P < 0.001) compared to those who watched television for 0-1 h per day. The mendelian randomization analysis provided consistent evidence for a causal relationship between prolonged television watching time and hypertension risk (OR = 1.45, 95% CI: 1.25-1.69, P < 0.001; all PMVMR < 0.05) in both UVMR and MVMR results. No significant associations were found between computer use, driving behaviors and the risk of hypertension in either the observational or UVMR/MVMR analyses.

CONCLUSIONS

These findings provide evidence for a causal effect specifically linking higher television watching time to an increased risk of hypertension and indicate the potential effectiveness of reducing television viewing time as a preventive measure to mitigate the risk of hypertension.

Seven-plus hours of daily sedentary time and the subsequent risk of breast cancer: Japan Multi-Institutional Collaborative Cohort Study

This study aimed to investigate the association between daily sedentary time and the risk of breast cancer (BC) in a large Japanese population. The participants were 36,023 women aged 35-69 years from the Japan Multi-Institutional Collaborative Cohort Study. Cox proportional hazards analysis was used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for BC incidence in relation to time spent sedentarily (categorical variables: <7 and ≥7 hours/day [h/d]). Additionally, the associations of BC incidence to the joint effect of sedentary time with each component of physical activity, such as leisure-time metabolic equivalents (METs), frequency of leisure-time physical activity, and daily walking time, were examined. During 315,189 person-years of follow-up, 554 incident cases of BC were identified. When compared to participants who spent <7 h/d sedentary, those who spent ≥7 h/d sedentary have a significantly higher risk of BC (HR, 1.36; 95% CI, 1.07-1.71). The corresponding HRs among participants who spent ≥7 h/d sedentary with more physical activity, such as ≥1 h/d for leisure-time METs, ≥3 days/week of leisure-time physical activity, and ≥1 h/d of daily walking were 1.58 (95% CI, 1.11-2.25), 1.77 (95% CI, 1.20-2.61), and 1.42 (95% CI, 1.10-1.83), respectively, compared with those who spent <7 h/d sedentary. This study found that spending ≥7 h/d of sedentary time is associated with the risk of BC. Neither leisure-time physical activity nor walking had a BC-preventive effect in those with ≥7 h/d of sedentary time.

Relationship between physical activity and locomotive syndrome among young and middle-aged Japanese workers

OBJECTIVES

This study aimed to examine the relationship between physical activity (PA) and locomotive syndrome (LS) among young and middle-aged Japanese workers.

METHODS

This cross-sectional study included 335 participants from a company in Kumamoto, Japan. LS was evaluated using the 25-question Geriatric Locomotive Function Scale (GLFS-25); a GLFS-25 score ≥7 was defined as LS. Weekly PA was measured using the International Physical Activity Questionnaire. Work-related PA (time spent sitting, standing, walking, and strenuous work per day) and sedentary breaks were measured using a Work-related Physical Activity Questionnaire. Screen usage (television [TV], smartphones, tablets, and personal computers) during leisure time was recorded. The association between PA and LS was examined using a multivariate logistic regression analysis adjusted for age, sex, body mass index, history of musculoskeletal disorders, cancer, stroke, occupation, employment type, work time, shift system, employment status, and body pain.

RESULTS

A total of 149 participants had LS. Fewer sedentary breaks during work (>70-minute intervals, odds ratio [OR] = 2.96; prolonged sitting, OR = 4.12) and longer TV viewing time (≥180 minutes, OR = 3.02) were significantly associated with LS. In contrast, moderate PA (OR = 0.75) was significantly associated with a lower risk of LS.

CONCLUSIONS

Fewer sedentary breaks during work and longer TV viewing time could increase the risk of LS in young and middle-aged Japanese workers.

Identifying the causal relationship between sedentary behavior and heart failure: Insights from a Mendelian randomization study and mediation analysis

BACKGROUND

Observational studies have revealed that a lack of physical exercise may be linked to a higher risk of heart failure (HF). Here, the causal relationship between sedentary behavior (SB) and HF was investigated using Mendelian randomization (MR).

HYPOTHESIS

SB was considered as an important risk factor of HF.

METHODS

Single nucleotide polymorphisms with a genome-wide statistical significance threshold of <5 × 10-8 among the SB-proxied phenotypes (TV screen time, computer use, and driving) from genome-wide association study (GWAS) datasets were identified as instrumental variables (IVs). The MR study was performed using the inverse-variance weighting (IVW) model as a primary standard to evaluate causal relationships. Simultaneously, MR-Egger regression, weighted median, and maximum likelihood models were used as supplements. Sensitivity analysis, consisting of a heterogeneity and horizontal pleiotropy test, was performed using Cochran's Q, MR-Egger intercept, and MR-PRESSO tests to ensure the reliability of conclusions.

RESULTS

The IVW model results showed that increased TV screen time correlated with a higher genetic susceptibility for HF in both HF-associated GWAS datasets, which was also supported by weighted median and maximum likelihood model results. The odds ratios with 95% confidence intervals were 1.418 (1.182-1.700) and 1.486 (1.136-1.943), respectively. Although the results of Cochran's Q test indicated certain heterogeneity among the IVs. The MR-Egger intercept and MR-PRESSO tests suggested no horizontal pleiotropy and verified the reliability of the conclusion.

CONCLUSIONS

This MR study identified that increased TV screen time may predispose individuals to the development of HF.

Healthy lifestyles in relation to cardiometabolic diseases among schoolteachers: A cross-sectional study

Background

We aimed to explore the associations of adherence to an overall healthy lifestyle with cardiometabolic diseases (CMDs) among schoolteachers in China.

Methods

We conducted a cross-sectional analysis among 2983 teachers (aged 39.8 ± 9.3 years, 73.8% women) in Zhejiang Province, China. A healthy lifestyle score (0-7) was constructed based on seven low-risk factors: healthy diet, noncurrent smoking, noncurrent drinking, regular exercise, normal body mass index (BMI), adequate sleep duration, and limited sedentary behavior. CMDs included self-reported hyperlipidemia, hypertension, diabetes, coronary heart disease, and stroke. Multivariable-adjusted logistic regression models were used to evaluate the associations between healthy lifestyle and CMD.

Results

A total of 493 (16.5%) participants had at least one CMD, with hyperlipidemia, hypertension, and diabetes being the three leading CMDs. Each point increment in a healthy lifestyle score was associated with 20% lower odds of having CMD (p-trend < 0.001). Compared with 0-3 low-risk factors, the odds ratios (ORs) and 95% confidence intervals (CIs) were 0.66 (0.50-0.88) for 4 low-risk factors and 0.51 (0.39-0.67) for 5-7 low-risk factors. We observed independent associations for normal BMI (OR = 0.50, 95% CI = 0.40-0.63), noncurrent drinking (OR = 0.53, 95% CI = 0.36-0.77), and limited sedentary behavior (OR = 0.77, 95% CI = 0.62-0.96) in relation to CMD. Healthy diet (OR = 0.75, 95% CI = 0.55-1.01) exhibited marginally significant association with CMD.

Conclusions

Our findings suggest that adherence to an overall healthy lifestyle is associated with lower odds of CMD among schoolteachers.

Sedentary Behavioral Studies of Young and Middle-Aged Adults with Hypertension in the Framework of Behavioral Epidemiology: A Scoping Review

(1) Background: As times change, the detection rate of hypertension is increasing in the young and middle-aged population due to prevalent sedentary behaviors. The purpose of this study was to conduct a scoping review to identify and summarize the research on sedentary behavior in this population by separating it into five stages: the relationship between sedentary behavior and health; measurement modalities; influencing factors; interventions; and translational research in young and middle-aged adults with hypertension. (2) Methods: Using a scoping review research approach, the PubMed, Web of Science Core Collection, and MEDLINE databases were used to search for the literature on this subject from the date of the database's creation to 14 June 2022, and the behavioral epidemiology framework was used to classify the retrieved articles. (3) Results: A total of eight articles were included. Among them, there were six articles on the relationship between behavior and health, which includes blood pressure, insulin resistance, and the cardiovascular system; one article on the study of measurement methods, which was used for clinical decision making through decision trees; one article on influencing factors, which was divided into intrinsic and extrinsic factors; and no articles on intervention program development or the translation of intervention programs to further practice in this population. (4) Conclusions: Sedentary behavioral studies of young and middle-aged adults with hypertension are scarce and are generally carried out in the early stages of the condition. In the future, in-depth studies can be conducted on the dose-response relationship between sedentary behavior and health in this population; the development of easier and targeted measurement tools; the exploration of more influencing factors; and the effectiveness and translation of intervention programs.

Association between Sedentary Time and Falls among Middle-Aged Women in Japan

There are many reports on the risk of falls in older adults but none regarding the risk among middle-aged people. We aimed to determine fall risk factors among middle-aged women. The participants comprised 1421 women aged 40 to 64 years; anthropometric and other measurements were obtained, and lifestyle factors were examined using a self-administered questionnaire. The participants were categorized into two groups (No-fall and Fall/Almost-fall) based on their questionnaire responses. The No-fall and Fall/Almost-fall groups comprised 1114 and 307 participants, respectively. Body mass index, abdominal circumference measurements, and prevalence of dyslipidemia were significantly higher in the Fall/Almost-fall group. Additionally, those in the Fall/Almost-fall group had a shorter two-step test, experienced difficulty performing the 40 cm single-leg sit-to-stand test, and had higher 25-question Geriatric Locomotive Function Scale (GLFS-25) scores than those in the No-fall group. The results of the adjusted logistic regression analysis indicated that physical activity, higher GLFS-25 scores, and sedentary time of more than seven hours were all risk factors for falling or almost falling. Longer sedentary time is a new risk factor for falls among middle-aged women. It is necessary for people to be concerned with their sedentary behavior, such as by reducing or interrupting continuous sedentary time.

Domain-Specific Sedentary Behaviour and Health-Related Quality of Life by Age among Japanese Living in Malaysia

BACKGROUND

Recently, the number of Japanese people living in Asia has increased. A previous study suggested that obesity and overweight are growing health problems both in Malaysia and worldwide that result from lifestyle changes such as a decrease in physical activity, an increase in sedentary behaviour, and poor eating habits.

OBJECTIVE

The purpose of the present study was to investigate the effects of differences in social demographic factors and domain-specific sedentary behaviour and health-related quality of life by age in Japanese living overseas.

METHODS

We surveyed 109 participants by self-entry questionnaire for social demographic factors and domain-specific sedentary behaviour by life scenario and by Short Form-36 (SF-36) for healthrelated quality of life. The subjects were divided into the ≥65 years group and <65 years group.

RESULTS

Significant differences were noted in age, employment, alcohol intake, and marital status between the groups, whereas none were noted for transportation, driving, television viewing, and smartphone/personal computer use. Work time and total sitting time of sedentary behaviour were higher, and leisure-time activity and SF-36 Mental Component Score for health-related quality of life were lower in the <65 years group.

CONCLUSION

By assessing differences in social demographic factors and discouraging sedentary behaviour, sitting time in overseas-dwelling Japanese residents may be reduced, and effective strategies to improve health-related quality of life can be developed to combat such behaviour.

The effect of triglycerides in the associations between physical activity, sedentary behavior and depression: An interaction and mediation analysis

BACKGROUND

Previous studies reported that there were associations between physical activity (PA), sedentary behavior (SB), triglycerides (TG) and depression. However, it is unclear whether there is an interaction and/or mediation effect of TG in the associations between PA, SB and depression. This study was to explore the effects of TG in the associations between PA, SB and depression, respectively.

METHODS

Our study included 7,728 adults (aged ≥20 years) participating in the 2009-2018 National Health and Nutrition Examination Survey (NHANES), which was a nationally representative survey. With higher TG as a mediator, a four-way decomposition method was used to decompose the total effects of insufficient PA and prolonged SB on depression, respectively.

RESULTS

There were statistically significant associations between moderate-to-vigorous recreational activity (MVRA), SB, TG and depression (all P < 0.05), respectively. With higher TG as a mediator, there were interaction and mediation effects in the association between SB and depression, and the excess relative risk (95% CI) of reference interaction effect (INT_ref) and the total mediation effect were 0.15(0.01,0.29) and 0.03(0.00,0.06), respectively. While insufficient MVRA attributed a proportion of 80.42% for the controlled direct effect (CDE) and 6.28% for total mediation effect. In addition, similar findings were observed in those with hypertension, overweight/obesity, dyslipidemia, and metabolic syndromes.

LIMITATION

This was a cross-sectional study, and the ability to make causal inference was limited.

CONCLUSION

The controlled direct effect of MVRA, the mediation of TG, and the interaction between SB and TG played the vital roles in increasing the risk of depression.

Design and Evaluation of an Online Squat Fitness System: Lessons Learned During the Early COVID-19 Pandemic in Japan

COVID-19 has changed our lives and limited our ability to have adequate physical activity (PA). It is necessary to replace outdoor PA with home-based fitness. However, people lack access, skills, and even motivation for home-based fitness. To address these issues, we designed a free access self-monitoring and coaching and music-based interactive online squat fitness system. Body weight squat was utilized for fitness exercise and evaluated based on three indices: knee width, hip depth, and rhythm. An online survey on changes in exercise due to the COVID-19 pandemic and exercise habits was conducted to investigate the effect of the COVID-19 pandemic on PA. We collected data from 557 respondents 5 months after the system first released and analyzed 200 visitors' performance on squat exercise and the other relevant parameters. Visitors were divided into three groups according to their age: younger, middle, and older groups. Results showed that the younger group had better squat performance than the middle and older groups in terms of hip depth and rhythm. We highlighted the lessons learned about the system design, fitness performance evaluation, and social aspects, for future study of the design and development of similar home-based fitness systems. We provided first-hand results on the relation between the COVID-19 pandemic and physical exercise among different age groups in Japan, which was valuable for policy making in the post-COVID-19 era.

Association between Lifestyle Changes and at-Home Hours during and after the State of Emergency Due to the COVID-19 Pandemic in Japan

Lifestyle changes during the coronavirus disease (COVID-19) lockdown have been previously examined, but there is limited understanding about changes after such restrictions were lifted. This study examines changes in lifestyle habits and body weight among the Japanese population with regard to the length of at-home hours both during (April to May) and after (September) the nationwide stay-at-home request compared to those before the COVID-19 pandemic (January 2020). An online survey was conducted in September 2020 involving 10,000 Japanese survey monitors, selected according to population distribution. During the stay-at-home request, 34% participants extended their at-home hours. More respondents in the group with extended at-home hours experienced an increase or decrease in total physical activity, snacking, food intake, alcohol drinking, and body weight than those in the group with nonextended at-home hours. Some of these changes had a trend according to age. The prevalence of most of these changes decreased when at-home hours returned to normal after the stay-at-home request period; however, increased alcohol consumption and increased or decreased body weight persisted. Our findings suggest that close monitoring for further health outcomes and age-appropriate measures to encourage favorable health behaviors is needed.

Effect of Underlying Cardiometabolic Diseases on the Association Between Sedentary Time and All-Cause Mortality in a Large Japanese Population: A Cohort Analysis Based on the J-MICC Study

Background This study aimed to determine the association between sedentary time and mortality with regard to leisure-time physical activity with or without cardiometabolic diseases such as hypertension, dyslipidemia, and diabetes mellitus. Methods and Results Using data from the J-MICC (Japan Multi-Institutional Collaborative Cohort) Study, 64 456 participants (29 022 men, 35 434 women) were analyzed. Hazard ratios (HRs) and 95% CIs were used to characterize the relative risk of all-cause mortality to evaluate its association with sedentary time (categorical variables: <5, 5 to <7, 7 to <9, ≥9 h/d and 2-hour increments in exposure) according to the self-reported hypertension, dyslipidemia, and diabetes mellitus using a Cox proportional hazards model. A total of 2257 participants died during 7.7 years of follow-up. The corresponding HRs for each 2-hour increment in sedentary time among participants with all factors, no factors, hypertension, dyslipidemia, and diabetes mellitus were 1.153 (95% CI, 1.114-1.194), 1.125 (95% CI, 1.074-1.179), 1.202 (95% CI, 1.129-1.279), 1.176 (95% CI, 1.087-1.273), and 1.272 (95% CI, 1.159-1.396), respectively. Furthermore, when analyzed according to the combined different factors (hypertension, dyslipidemia, and diabetes mellitus), HRs increased with each additional factor, and participants reporting all 3 conditions had the highest HR of 1.417 (95% CI, 1.162-1.728) independently of leisure-time metabolic equivalents. Conclusions The association between sedentary time and increased mortality is stronger among patients with hypertension, dyslipidemia, and diabetes mellitus regardless of leisure-time physical activity in a large Japanese population.

Prolonged sedentary time under the state of emergency during the first wave of coronavirus disease 2019: Assessing the impact of work environment in Japan

OBJECTIVES

The coronavirus disease 2019 (COVID-19) outbreak and the resulting state of emergency have restricted work environments, which may contribute to increased duration of sedentary behaviors. This study investigated the self-reported sedentary time of Japanese workers during and after the first state of emergency (April 7 to May 25, 2020) and examined differences in sedentary time after starting work from home and according to job type.

METHODS

We used cross-sectional data from the Japan COVID-19 and Society Internet Survey, a web-based questionnaire survey conducted from August to September 2020 (n = 11,623; age range 15-79 years; 63.6% male). Prolonged sedentary time was calculated by subtracting the sedentary time after the state of emergency (defined as the normal sedentary time) from that during the emergency, with adjustments using inverse probability weighting for being a respondent in an internet survey.

RESULTS

An increase in sedentary time of at least 2 hours was reported by 12.8% of respondents who started working from home during the state of emergency, including 9.7% of salespersons and 7.7% of desk workers. After adjusting for potential confounders, the multivariate-adjusted odds ratios (ORs) for a prolonged sedentary time ≥2 hours was significantly higher in respondents who started to work from home (OR: 2.14, 95% confidence interval: 1.78-2.57), and certain job types (desk workers; OR: 1.56, 95% CI: 1.27-1.91, salespersons; OR: 2.03, 95% CI: 1.64-2.51).

CONCLUSIONS

Working from home and non-physical work environments might be important predictors of prolonged sedentary time.

The Association of Daily Physical Activity Behaviors with Visceral Fat

The association between health benefits and physical activity has received increasing attention among researchers working on the prevention of noncommunicable disease. However, the number of studies on the association between daytime activities and visceral fat is limited. In this study, we evaluated how daily physical activity behaviors impact the visceral adipose tissue (VAT) and body mass index (BMI). A total of 3543 participants (1240 men, 2303 women) were included in this cross-sectional study. The duration of daily physical activities (sedentary time, standing time, and walking time) was classified into the six categories. Multiple regression analysis was carried out to compare continuous variables. VAT and BMI were used as dependent variables, and the daily physical activities were used as independent variables. All results were expressed after adjusting for confounders, including sex, age, Brinkman index, daily alcohol consumption, sleeping time, and medication for hypertension, dyslipidemia, and diabetes. The multiple regression analysis showed that sedentary time was significantly associated with VAT (beta = 1.145, p value = 0.002), whereas standing time was negatively associated with VAT (beta = -0.763, p value = 0.043). Walking time was negatively and robustly associated with all depending variables as follows: BMI (beta = -0.172, p value = 0.001) and VAT (beta = -2.023, p value <0.001). This study showed that a daily behavior time affects the accumulation of VAT and BMI. A shift from sedentary time to standing or walking time might be a key population approach to prevent cardiometabolic diseases.