Correction: Sedentary Time and Its Association With Risk for Disease Incidence, Mortality, and Hospitalization in Adults

A multiple technology-based and individually-tailored Sit Less program for people with cardiovascular disease: A randomized controlled trial study protocol

Sedentary behavior, a key modifiable risk factor for cardiovascular disease, is prevalent among cardiovascular disease patients. However, few interventions target sedentary behavior in this group. This paper describes the protocol of a parallel two-group randomized controlled trial for a novel multi-technology sedentary behavior reduction intervention for cardiovascular disease patients (registered at Clinicaltrial.gov, NCT05534256). The pilot trial (n = 70) will test a 12-week "Sit Less" program, based on Habit Formation theory. The 35 participants in the intervention group will receive an instructional goal-setting session, a Fitbit for movement prompts, a smart water bottle (HidrateSpark) to promote hydration and encourage restroom breaks, and weekly personalized text messages. A control group of 35 will receive the American Heart Association's "Answers by Heart" fact sheets. This trial will assess the feasibility and acceptability of implementing the "Sit Less" program with cardiovascular disease patients and the program's primary efficacy in changing sedentary behavior, measured by the activPAL activity tracker. Secondary outcomes include physical activity levels, cardiometabolic biomarkers, and patient-centered outcomes (i.e. sedentary behavior self-efficacy, habit strength, and fear of movement). This study leverages commonly used mobile and wearable technologies to address sedentary behavior in cardiovascular disease patients, a high-risk group. Its findings on the feasibility, acceptability and primary efficacy of the intervention hold promise for broad dissemination.

The eMouveRecherche application competes with research devices to evaluate energy expenditure, physical activity and still time in free-living conditions

The proliferation of smartphones is creating new opportunities to monitor and interact with human subjects in free-living conditions since smartphones are familiar to large segments of the population and facilitate data collection, transmission and analysis. From accelerometry data collected by smartphones, the present work aims to estimate time spent in different activity categories and the energy expenditure in free-living conditions. Our research encompasses the definition of an energy-saving function (Pred^EE) considering four physical categories of activities (still, light, moderate and vigorous), their duration and metabolic cost (MET). To create an efficient discrimination function, the method consists of classifying accelerometry-transformed signals into categories and of associating each category with corresponding Metabolic Equivalent Tasks. The performance of the Pred^EE function was compared with two previously published functions (f(η,d)aedes,f(η,d)nrjsi), and with two dedicated sensors (Armband® and Actiheart®) in free-living conditions over a 12-h monitoring period using 30 volunteers. Compared to the two previous functions, Pred^EE was the only one able to provide estimations of time spent in each activity category. In relative value, all the activity categories were evaluated similarly to those given by Armband®. Compared to Actiheart®, the function underestimated still activities by 10.1% and overestimated light- and moderate-intensity activities by 7.9% and 4.2%, respectively. The total energy expenditure error produced by Pred^EE compared to Armband® was lower than those given by the two previous functions (5.7% vs. 14.1% and 17.0%). Pred^EE provides the user with an accurate physical activity feedback which should help self-monitoring in free-living conditions.

Impact of changes in television viewing time and physical activity on longevity: a prospective cohort study

BACKGROUND

Television viewing is a highly prevalent sedentary behavior among older adults, yet the mortality risks associated with hours of daily viewing over many years and whether increasing or decreasing viewing time affects mortality is unclear. This study examined: 1) the long-term association between mortality and daily viewing time; 2) the influence of reducing and increasing in television viewing time on longevity and 3) combined effects of television viewing and moderate-to-vigorous physical activity (MVPA) on longevity.

METHODS

Participants included 165,087 adults in the NIH-AARP Diet and Health (aged 50-71 yrs) who completed questionnaires at two-time-points (Time 1: 1994-1996, and Time 2: 2004-2006) and were followed until death or December 31, 2011. Multivariable-adjusted Cox proportional hazards regression was used to estimate Hazard Ratios and 95% confidence intervals (CI) with self-reported television viewing and MVPA and all-cause mortality.

RESULTS

Over 6.6 years of follow-up, there were 20,104 deaths. Compared to adults who watched < 3 h/day of television at both time points, mortality risk was 28% greater (CI:1.21,1.34) those who watched 5+ h/day at both time-points. Decreasing television viewing from 5 + h/day to 3-4 h/d was associated with a 15% reduction in mortality risk (CI:0.80, 0.91) and decreasing to <3 h/day resulted in an 12% lower risk (CI:0.79, 0.97). Conversely, adults who increased their viewing time to 3-4 h/day had an 17% greater mortality risk (CI:1.10, 1.24) and those who increased to 5+ h/day had a 45% greater risk (CI:1.32, 1.58), compared to those who consistently watched <3 h/day. The lowest mortality risk was observed in those who were consistently active and watched < 3 h/day of television.

CONCLUSIONS

We confirm that prolonged television viewing time was associated with greater mortality in older adults and demonstrate for the first time that individuals who reduced the amount of time they spent watching television had lower mortality. Our findings provide new evidence to support behavioral interventions that seek to reduce sedentary television viewing in favor of more physically active pursuits, preferably MVPA. Given the high prevalence of physical inactivity and prolonged television viewing in older adults, favorable changes in these two modifiable behaviors could have substantial public health impact.

TRIAL REGISTRATION

ClinicalTrials.gov number, NCT00340015.