Too Much Sitting and Cardio-Metabolic Risk: An Update of Epidemiological Evidence

Research on dynamic comfort maintenance by measuring lower limb edema and seat pressure during simulated seated sleep in flight

Objectives. Seated sleep during flight can bring significant discomfort to passengers. The objective of this research was to study passengers' dynamic comfort maintenance strategies in lower limb postural shifting during seated sleep in flight. Methods. Studies on seated sleep postures and sitting comfort were conducted. First, 40 participants were recruited to the observational research for collecting typical leg postures during seated sleep. Then, an experiment was conducted with the participants simulating seated sleep in the aircraft seat. The changes in lower limb edema and seat pressure in different postures were measured with a bioelectrical impedance device, near-infrared spectroscopy device and pressure mapping device. Results. Six postures were selected through the observational research. The experiment showed that tissues of the thighs and buttocks suffer alternate higher compression by shifting between the six postures. Lower limb edema is higher when the shanks are forward, while the tissue under the ischial tuberosity suffers higher compression when the shanks are neutral. Conclusion. Six motivations for passengers to shift each sitting posture to achieve dynamic comfort were summarized, which helps obtain alternating rest in different body parts. The suggestion of a leg position adjustment system was also proposed.

The Impact of Age and Body Composition on Bone Density among Office Worker Women in Hungary

The study's aim was to investigate bone condition and see its associations with body composition and age among office worker women in Hungary. In total, 316 individuals participated in this study from Csongrad-Csanad county in 2019. Participants' ages ranged from 18 to 62, with a mean of 41 years. A questionnaire was used to gather sociodemographic information, whereas body composition was measured using the Inbody 230, and bone density and bone quality were measured with the SONOST 3000 ultrasound device. Results were analyzed using descriptive statistics, ANOVA with Tukey's post hoc test, correlation analysis, and an independent sample t-test. The results show that Body Fat Mass, Body Mass Index, Obesity Degree, and Percent Body Fat increase significantly as age increases, and Bone Quality Index and t-score decrease substantially. Furthermore, Bone Density and Bone Quality Index were positively influenced by most components of body composition. The differences between normal and osteopenia bone quality showed that Basal Metabolic Rate, Bone Mineral Content, Fat-Free Mass, Mineral Mass, Skeletal Lean Mass, and Skeletal Muscle Mass were lower in participants with osteopenia. Our results provide more evidence of the effects of body composition and age on bone density and quality. It was the first study in Hungary investigating this phenomenon, which could be useful for professionals and researchers who intend to understand the associations of bone density.

The relationship between objectively measured sitting time, posture, and low back pain in sedentary employees during COVID-19

Purpose

The purpose of this study was to examine the relationship between objectively measured sitting time, posture, and low back pain (LBP) in adults with full-time (≥ 40 h/week) sedentary "desk" jobs. Physical activity (PA) and sedentary behavior (SB) between work environments (home vs. office) were also compared during COVID-19.

Methods

Participants (N = 53; M _age = 41 ± 12years) were full-time employees in sedentary jobs during COVID-19. A survey with demographic, work environment, and LBP questions was completed; Thomas Test assessed poor hip posture. ActivPAL devices were worn for ≥ 4 valid days (≥ 10 h/d) to assess waking sitting time (min/d). Binomial logistic regressions examined sitting as a predictor of poor posture and LBP; ANOVAs compared PA and SB between work environments.

Results

Objectively measured sitting (min/day) predicted poor hip posture (β = - 0.01, p < 0.046) but was not significant for LBP (β = 0.002, p < 0.43). Participants who worked from home had significantly higher sitting time (569 ± 111 vs. 477 ± 46 min/d; p < 0.04), higher muscle strengthening PA (2.2 ± 2 vs. 0.5 ± 1.2d/week p < 0.02), but no difference in aerobic PA (p < 0.15), than those who worked from an office.

Conclusion

Given the shift to remote work during COVID-19, employees are at high risk for postural compensations that lead to LBP due to high SB and poor work ergonomics at home. There is a need to develop home-based behavioral and exercise interventions to reduce sitting, help improve posture, and invest in proper ergonomic homework equipment.

An Arabic Sedentary Behaviors Questionnaire (ASBQ): Development, Content Validation, and Pre-Testing Findings

Background: Sedentary behaviors (SB) are very prevalent nowadays. Prolonged sitting associates with chronic disease risks and increased mortality even while controlling for physical activity. Objective measurement of SB is costly, requires technical expertise, and is challenging in terms of time and management. Currently, there is no validated self-reported instrument in the Arabic language that assesses SB among individuals and relates sedentary time to social, environmental, and health outcomes. The aim of this research was to develop a multi-item Arabic SB questionnaire (ASBQ). Methods: The ASBQ was developed through an extensive literature review and discussion by the research team (n = 5), then went through content validation (n = 10 experts) and pre-testing using cognitive interviewing procedures (n = 51 respondents, mean (SD) age was 38.3 (18.2) years, and with 49% females). Results: The ASBQ included 13 questions comprising a wide range of sedentary activities. The Arabic SB instrument showed excellent content validity for assessing sedentary time in adolescents and adults with a very high item-level and scale-level content validity index. A kappa statistic, a measure of interrater reliability, was 0.95. The pre-testing showed that the instrument was highly rated by a diverse sample of Saudi adolescents and adults. Conclusion: The ASBQ received excellent acceptance by a panel of experts with promising pre-test results. Further testing of psychometric properties, including test-retest reliability and criterion validity is required.

Association of occupation with the daily physical activity and sedentary behaviour of middle-aged workers in Korea: a cross-sectional study based on data from the Korea National Health and Nutrition Examination Survey

OBJECTIVES

The WHO recommends that adults engage in regular moderate-to-vigorous physical activities (MVPAs) and muscle-strengthening activities (MSA), and minimise sedentary behaviour. This study aimed to determine the association of occupation with MVPA, MSA and sedentary behaviour in middle-aged Korean workers.

DESIGN AND SETTING

A cross-sectional study using data from the seventh Korea National Health and Nutrition Examination Survey (2016-2018).

PARTICIPANTS

Workers aged between 40 and 69 years in Korea (n=6359).

OUTCOME MEASURES

Population-weighted proportions not meeting the MVPA (＜150 min/week) and MSA (＜2 days/week) guidelines, and with high sedentary behaviour (＞7 hours/day) were calculated, and their associations with sociodemographic and work-related variables were assessed using multiple logistic regression analyses. Additionally, the estimated time spent on MVPA, MSA and sedentary behaviour according to the occupation categories (white-collar, pink-collar and blue-collar) was calculated using analysis of covariance (ANCOVA).

RESULTS

The MVPA level did not show a significant difference across the occupation categories. Blue-collar workers showed significantly lower MSA participation than white-collar and pink-collar workers (male, p=0.006; female, p=0.004; by ANCOVA). High sedentary behaviour was significantly associated with white-collar occupations (p<0.001 by ANCOVA). Longer working hours were negatively associated with MVPA (OR=1.01, 95% CI 1.01 to 1.02) and MSA (OR=1.01, 95% CI 1.00 to 1.02). Workers with higher stress were less likely to participate in MSA (male: OR=1.43, 95% CI 1.10 to 1.86; female: OR=1.39, 95% CI 1.08 to 1.80). Self-employed workers showed lower MVPA levels than employees (male: OR=1.26, 95% CI 1.09 to 1.47; female: OR=1.36, 95% CI 1.13 to 1.64). Daily workers compared with full-time workers (OR=0.38, 95% CI 0.24 to 0.59) and temporary workers compared with regular workers (OR=0.75, 95% CI 0.59 to 0.95) were associated with less sedentary behaviour in men.

CONCLUSION

A number of work-related factors were associated with PA levels and sedentary behaviour in middle-aged workers. The workplace is one of the critical elements to intervene in health promotion strategies.

A Call to Clarify the Intensity and Classification of Standing Behavior

Public health guidelines for physical activity now include recommendations to break up prolonged sitting with light-intensity activities. Concurrently, interventions to increase standing have emerged, especially within the workplace in the form of sit–stand or standing workstations. Moreover, in short-duration studies, breaking up prolonged sitting with standing has been associated improved cardiometabolic outcomes. Publicly available estimates of the intensity of standing range from 1.5 to 2.3 metabolic equivalents (METs), neatly classifying standing as a light-intensity activity (>1.5 to <3.0 METs). Further delineation between ‘active’ and ‘passive’ standing has been proposed, with corresponding METs of >2.0 METs and ≤2.0 METs, respectively. However, this study reviews data suggesting that some standing (e.g., while performing deskwork) is substantially below the minimum light intensity activity threshold of 1.5 METs. These data bring into question whether standing should be universally classified as a light-intensity behavior. The objectives of this study are to (i) highlight discrepancies in classifying standing behavior in the human movement spectrum continuum, and (ii) to propose a realignment of the ‘active’ vs. ‘passive’ standing threshold to match the light intensity threshold to help provide a clearer research framework and subsequent public health messaging for the expected health benefits from standing.

An Exploration of Sedentary Behavior Patterns in Community-Dwelling People With Stroke: A Cluster-Based Analysis

BACKGROUND AND PURPOSE

Long periods of daily sedentary time, particularly accumulated in long uninterrupted bouts, are a risk factor for cardiovascular disease. People with stroke are at high risk of recurrent events and prolonged sedentary time may increase this risk. We aimed to explore how people with stroke distribute their periods of sedentary behavior, which factors influence this distribution, and whether sedentary behavior clusters can be distinguished?

METHODS

This was a secondary analysis of original accelerometry data from adults with stroke living in the community. We conducted data-driven clustering analyses to identify unique accumulation patterns of sedentary time across participants, followed by multinomial logistical regression to determine the association between the clusters, and the total amount of sedentary time, age, gender, body mass index (BMI), walking speed, and wake time.

RESULTS

Participants in the highest quartile of total sedentary time accumulated a significantly higher proportion of their sedentary time in prolonged bouts (P < 0.001). Six unique accumulation patterns were identified, all of which were characterized by high sedentary time. Total sedentary time, age, gender, BMI, and walking speed were significantly associated with the probability of a person being in a specific accumulation pattern cluster, P < 0.001 - P = 0.002.

DISCUSSION AND CONCLUSIONS

Although unique accumulation patterns were identified, there is not just one accumulation pattern for high sedentary time. This suggests that interventions to reduce sedentary time must be individually tailored.Video Abstract available for more insight from the authors (see the Video Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A343).

Development and implementation of a logic model: Occupational stress, physical activity, and sedentary behavior in the workplace

BACKGROUND

An increasing level of occupational stress is a major problem in the workplace that requires innovative approaches and strategies. An understudied research area pertains to the effects that physical activity performed during the workday have on occupational stress.

OBJECTIVE

To determine if and how an intervention that increases physical activity and reduces sedentary behavior affects workplace stress. The population of interest are employees at a large university medical center including supportive staff, healthcare professionals, physicians, and faculty members; the study design is longitudinal; the approach is the implementation of an innovative workplace program (i.e., the Booster Break).

METHODS

We present a logic model promoting physical activity and reducing sitting time during the workday as a feasible and practical strategy to cope with occupational stress.

RESULTS

The logic model approach emphasizes that funding, partnerships, and incentives are inputs to implementing program activities such as Booster Break sessions, weekly meetings, social support, and personal self-monitoring. Short-term outcomes were categorized as psychosocial, goal setting, organizational, and social; intermediate outcomes were behavioral and psychosocial; and long-term outcomes were health status and physiological status.

CONCLUSIONS

This study is the first known effort to outline a comprehensive intervention based on changing physical activity and sedentary behavior during the workday and the concomitant effects on occupational stress. The findings of this study can be used to develop and implement interventions at workplaces to target increases in physical activity, decreases in sedentary time, and improvements in overall employee health.

Examining sex differences in sitting-induced microvascular dysfunction: Insight from acute vitamin C supplementation

PURPOSE

Lower limb microvascular dysfunction resulting from prolonged sitting (PS) bouts has been revealed to occur independent of sex. Although acute antioxidant supplementation has been reported to blunt conduit artery dysfunction following PS in young males, it is unknown if this protective effect extends to the microvasculature or is relevant in young females, who possess intrinsic vascular protective mechanisms specific to antioxidant defense. Therefore, this study employed an acute antioxidant supplementation to further examine sex differences during PS with a specific focus on microvascular function.

METHODS

On two separate visits, 14 females (23 ± 3 years) and 12 males (25 ± 4 years) had leg microvascular function (LMVF) assessed (via the passive leg movement technique) before and after 1.5 h of sitting. Prior to each visit, one gram of vitamin C (VC) or placebo (PL) was consumed.

RESULTS

PS significantly reduced LMVF [PL: (M: -34 ± 20; F: -23 ± 18%; p < 0.01) independent of sex (p = 0.7)], but the VC condition only blunted this reduction in males (VC: -3 ± 20%; p < 0.01), but not females (VC: -18 ± 25%; p = 0.5).

CONCLUSION

Young males and females reported similar reductions LMVF following PS, but only the young males reported a preservation of LMVF following the VC supplementation. This finding in young females was highlighted by substantial variability in LMVF measures in response to the VC condition that was unrelated to changes in the potential contributors to sitting-induced reductions in LMVF (e.g. lower limb venous pooling, reduced arterial shear rate).

NEW AND NOTEWORTHY

In this study, we employed an acute Vitamin C (VC) supplementation to examine sex differences in leg microvascular function (LMVF) following a bout of prolonged sitting. This study revealed that prolonged sitting reduced LMVF independent of sex, but only young males reported an attenuation to this lowered LMVF following VC supplementation. The young females revealed substantial variability in sitting-induced changes to LMVF that could not be explained by the potential contributors to sitting-induced reductions in LMVF (e.g. lower limb venous pooling, reduced arterial shear rate).

Sex-specific typologies of older adults' sedentary behaviors and their associations with health-related and socio-demographic factors: a latent profile analysis

BACKGROUND

Some types of sedentary behaviors tend to cluster in individuals or groups of older adults. Insight into how these different types of sedentary behavior cluster is needed, as recent research suggests that not all types of sedentary behavior may have the same negative effects on physical and mental health. Therefore, the aim of this study was to identify sex-specific typologies of older adults' sedentary behavior, and to examine their associations with health-related and socio-demographic factors.

METHODS

Cross-sectional data were collected as part of the BEPAS Seniors, and the Busschaert study among 696 Flemish older adults (60+). Typologies of self-reported sedentary behavior were identified using latent profile analysis, and associations with health-related and sociodemographic factors were examined using analyses of variances.

RESULTS

Five distinct typologies were identified from seven sedentary behaviors (television time, computer time, transport-related sitting time, sitting for reading, sitting for hobbies, sitting for socializing and sitting for meals) in men, and three typologies were identified from six sedentary behaviors (television time, transport-related sitting time, sitting for reading, sitting for hobbies, sitting for socializing and sitting for meals) in women. Typologies that are characterized by high television time seem to be related to more negative health outcomes, like a higher BMI, less grip strength, and a lower physical and mental health-related quality-of-life. Typologies that are represented by high computer time and motorized transport seem to be related to more positive health outcomes, such as a lower body mass index, more grip strength and a higher physical and mental health-related quality-of-life.

CONCLUSIONS

Although causal direction between identified typologies and health outcomes remains uncertain, our results suggests that future interventions should better focus on specific types of sedentary behavior (e.g. television time), or patterns of sedentary behavior, rather than on total sedentary behavior.

Does Active Design Influence Activity, Sitting, Wellbeing and Productivity in the Workplace? A Systematic Review

Active design is an emerging concept to incorporate physical activity into daily life through thoughtful design, and is often implemented in new building designs. It is, however, not known what evidence base there is to support the claims. Through this systematic review, the current evidence for active design was investigated. Seven databases were searched. A range of search terms relating to active design, physical activity, sitting, performance and wellbeing were used. After title and abstract screening of 1174 papers and full-text screening, 17 were selected for inclusion. The papers provided promising evidence of active design aiding a reduction in sitting and increase in standing time. Limited evidence was found for physical activity; a few studies reported an increase in step counts. Musculoskeletal effects were investigated in few studies, but there is some evidence of benefits to lower back pain. There was consistent evidence for better light and air quality, but no evidence for other features of the workplace environment. No conclusive evidence was found on associations between active design features and work performance. There is hence some evidence to support the benefit of active design on physical health; however, the dearth and heterogeneity of the study designs, measures and findings warrant further research.

Effects of Vibrotactile Feedback on Sedentary Behaviors in Adults: A Pilot Randomized Controlled Trial

No effective and easily implemented intervention strategies for reducing sedentary behavior have been established. This pilot trial (UMIN000024372) investigated whether vibrotactile feedback reduces sedentary behavior. Twenty-six adults aged 30–69 years who were sedentary ≥8 h/day were randomly assigned to control (n = 13) or vibration (n = 13) groups. Participants wore a monitor 9 h daily for seven-day periods at baseline (week zero), during the intervention (weeks one, three, five, and seven), and after the intervention (week eight). During the eight-week intervention, vibration-group participants were notified by a vibration through the monitor whenever continuous sedentary time reached ≥30 min; they also received weekly reports of their sedentary patterns. Control-group participants did not receive feedback. The primary outcome was change in total sedentary time. Changes in longer bouts of sedentary time (≥35 min) were also assessed. No significant difference was found in the change in total sedentary time (control: −17.5 min/9 h, vibration: −9.1 min/9 h; p = 0.42). Although no significant differences were observed in sedentary time in longer bouts, vibration-group participants exhibited significantly lower sedentary time (–21.6 min/9 h, p = 0.045). Thus, vibration feedback does not appear to offer any advantages in reducing total sedentary time.

Time trends between 2002 and 2017 in correlates of self-reported sitting time in European adults

BACKGROUND

This study explores trends in the prevalence of high sitting time and its correlates among "high sitting" and "high sitting-least active" European adults from 2002 to 2017. Both groups have merit for future public health interventions to prevent development of a range of prevalent non-communicable diseases.

METHODS

Data collected in the 2002 (15 countries), 2005 (30 countries), 2013 (28 countries) and 2017 (28 countries) Eurobarometer surveys were used, including around 15,000 respondents in 2002 and >26,000 respondents in the other years. Sitting time and moderate to vigorous intensity physical activity were measured with the validated International Physical Activity Questionnaire-short. High sitting was defined as >7.5 hours per day. Respondents in the lowest quartile of total reported days of physical activity (i.e. days walking, days in moderate activity, and days in vigorous activity) were defined as least active. Multivariate odds ratios of high sitting, and high sitting-least active were assessed by country and socio-demographic characteristics for each survey year using binary logistic regression analyses.

RESULTS

Trends in sitting time were relatively stable over a 15-year period, although this time trend was limited by a change in the sitting question between 2005 and 2013. Men, higher educated people, students, retired people, white collar workers, people living in urban areas, people with lower physical activity levels, and people living in the Czech Republic, Denmark or the Netherlands were consistently more likely to be in the high sitting group across all four survey years. Similarly, men, students, retired people, unemployed people, white collar workers, and people living in the Czech Republic or Denmark were consistently more likely to be in the high sitting-least active group across all four surveys.

CONCLUSION

This study identified population sub-groups that need special attention in public health interventions to lower total sitting time.

Excellent Self-Rated Health Associated With Activities of Higher Intensities: A Compositional Data Analysis Approach

BACKGROUND

This study investigates the association between self-rated health and the time spent in sedentary behavior (SB), low light-intensity physical activity (LLPA), high light-intensity physical activity (HLPA), and moderate to vigorous physical activity (MVPA), by controlling for demographics, socioeconomic status, and chronic diseases.

METHODS

A total of 1665 participants (55% women) completed a questionnaire about demographics, chronic diseases, and anthropometric characteristics and provided objective physical activity data on time in SB, LLPA, HLPA, and MVPA, using an ActiGraph 7164 accelerometer. Association between self-rated health and activity data was explored in a compositional data analysis.

RESULTS

The multinomial logistic regression analysis showed a significantly lower time spent in MVPA in proportion to time in other movement behaviors (SB, LLPA, and HLPA) for participants who rated their health as alright or poor compared with excellent (P < .001). Participants with poor, compared with excellent health, spent about a third of the time in MVPA (17 vs 50 min), marginally higher time in HLPA (134 vs 125 min), more time in LLPA (324 vs 300 min), and similar time in SB (383 vs 383 min), accounting for confounders and time in other movement behaviors.

CONCLUSIONS

Promoting MVPA, as opposed to time in other movement behaviors, is suggested to be beneficial for excellent self-rated health.

Classifying Diverse Physical Activities Using "Smart Garments"

Physical activities can have important impacts on human health. For example, a physically active lifestyle, which is one of the most important goals for overall health promotion, can diminish the risk for a range of physical disorders, as well as reducing health-related expenditures. Thus, a long-term goal is to detect different physical activities, and an important initial step toward this goal is the ability to classify such activities. A recent and promising technology to discriminate among diverse physical activities is the smart textile system (STS), which is becoming increasingly accepted as a low-cost activity monitoring tool for health promotion. Accordingly, our primary aim was to assess the feasibility and accuracy of using a novel STS to classify physical activities. Eleven participants completed a lab-based experiment to evaluate the accuracy of an STS that featured a smart undershirt (SUS) and commercially available smart socks (SSs) in discriminating several basic postures (sitting, standing, and lying down), as well as diverse activities requiring participants to walk and run at different speeds. We trained three classification methods—K-nearest neighbor, linear discriminant analysis, and artificial neural network—using data from each smart garment separately and in combination. Overall classification performance (global accuracy) was ~98%, which suggests that the STS was effective for discriminating diverse physical activities. We conclude that, overall, smart garments represent a promising area of research and a potential alternative for discriminating a range of physical activities, which can have positive implications for health promotion.

Occupational health risks and intervention strategies for US taxi drivers

Research has shown that taxi drivers are at risk for numerous health concerns, such as low back and leg pain, linked to their highly sedentary occupation, long work hours and stressors related to the job (e.g. low income, safety threats). The goal of this study was to explore occupational health risks and opportunities for health interventions with taxi drivers using community-based participatory research (CBPR) methods. A mixed methods approach included first a convenience sample of 19 East African taxi drivers participating in focus group discussions. Second, a convenience sample of 75 current taxi drivers (M age = 45.7 years) and 25 non-driver comparison participants (M age = 40.3 years) were recruited to complete a structured self-reported questionnaire and objective measures of health. Health education was provided alongside the research to address common health concerns and to ensure mutual benefit and an action orientation. The focus groups described numerous health concerns that drivers attributed to their occupation, including chronic pain, sleep deprivation, cardiovascular disease, diabetes, kidney disease and eye problems, as the most common. Participants offered ideas for health interventions that include workplace reform and driver education. Quantitative data indicate that 44% of drivers reported their health as 'fair' or 'poor'. Drivers were more likely to report musculoskeletal pain, less sleep, more fatigue and less physical activity as compared to non-drivers. The majority of drivers reported financial and job dissatisfaction. The research provides data to inform targeted health interventions that support the health and safety of taxi drivers.

Identifying factors associated with sedentary time after stroke. Secondary analysis of pooled data from nine primary studies

Background: High levels of sedentary time increases the risk of cardiovascular disease, including recurrent stroke. Objective: This study aimed to identify factors associated with high sedentary time in community-dwelling people with stroke. Methods: For this data pooling study, authors of published and ongoing trials that collected sedentary time data, using the activPAL monitor, in community-dwelling people with stroke were invited to contribute their raw data. The data was reprocessed, algorithms were created to identify sleep-wake time and determine the percentage of waking hours spent sedentary. We explored demographic and stroke-related factors associated with total sedentary time and time in uninterrupted sedentary bouts using unique, both univariable and multivariable, regression analyses. Results: The 274 included participants were from Australia, Canada, and the United Kingdom, and spent, on average, 69% (SD 12.4) of their waking hours sedentary. Of the demographic and stroke-related factors, slower walking speeds were significantly and independently associated with a higher percentage of waking hours spent sedentary (p = 0.001) and uninterrupted sedentary bouts of >30 and >60 min (p = 0.001 and p = 0.004, respectively). Regression models explained 11-19% of the variance in total sedentary time and time in prolonged sedentary bouts. Conclusion: We found that variability in sedentary time of people with stroke was largely unaccounted for by demographic and stroke-related variables. Behavioral and environmental factors are likely to play an important role in sedentary behavior after stroke. Further work is required to develop and test effective interventions to address sedentary behavior after stroke.

Sitting ducks face chronic disease: an analysis of newspaper coverage of sedentary behaviour as a health issue in Australia 2000-2012

Issue addressed This study examines how sedentary behaviour (too much sitting) was covered as a health issue by Australian newspapers and how physical activity was framed within this newspaper coverage. Methods Articles featuring sedentary behaviour published in Australian newspapers between 2000 and 2012 were analysed for content and framing. Main outcome measures were volume, number and content of newspaper articles; framing and types of sedentary behaviour; responsibility for the problem of and solutions to high levels of sedentary behaviour; and physical activity mentions and how it was framed within sedentary behaviour coverage. Results Out of 48 articles, prolonged sitting was framed as bad for health (52%) and specifically as health compromising for office workers (25%). Adults who sat a lot were framed as 'easy targets' for ill health (21% of headlines led with 'sitting ducks' or 'sitting targets'). Prolonged sitting was framed as an issue of individual responsibility (>90%) with less mention of environmental and sociocultural contributors. Thirty-six of 48 articles mentioned physical activity; 39% stated that being physically active does not matter if a person sits for prolonged periods of time or that the benefits of physical activity are undone by too much sitting. Conclusions News coverage should reflect the full socio-ecological model of sedentary behaviour and continually reinforce the independent and well-established benefits of health-enhancing physical activity alongside the need to limit prolonged sitting. So what? It is important that the entire 'move more, sit less, every day!' message is communicated by news media.

Physical activity may compensate for prolonged TV time regarding pulse rate-a cross-sectional study

BACKGROUND

Regular exercise reduces pulse rate, but it is less clear how prolonged sitting time affects pulse rate. Our hypothesis was that high physical activity could compensate for prolonged sitting time regarding the pulse rate.

METHODS

Regression analysis was performed on cross-sectional data including 47,457 men and women based on two Swedish cohort studies, EpiHealth (18-45 years) and LifeGene (45-75 years). Self-reported leisure time physical activity was given in five levels, from low (level 1) to vigorous (level 5), and television time was used as a proxy of sitting time.

RESULTS

A higher physical activity (level 4 compared to level 1) was associated with a lower pulse rate in middle-aged females (-2.7 beats per minute [bpm]; 95% CI -3.3 to -2.2) and males (-4.0 bpm; 95% CI -4.7 to -3.4). The relationship between physical activity and pulse rate was strongest in the young. A prolonged television time (3 h compared to 1 h per day) was associated with a slightly higher pulse rate in middle-aged females (+0.6 bpm; 95% CI +0.3 to +0.8) and males (+0.9 bpm; 95% CI +0.7 to +1.2). Among participants with a prolonged television time (3 h), those with a high physical activity (level 4) had a lower pulse rate compared to those with a low physical activity (level 1).

CONCLUSIONS

A prolonged television time was associated with a high pulse rate, while high physical activity was associated with a low pulse rate. The results suggest that a high physical activity could compensate for a prolonged television time regarding pulse rate.

Overselling Sit-Stand Desks: News Coverage of Workplace Sitting Guidelines

The first quantitative, specific recommendations for sitting time at work were released in June 2015. This paper examines the implications of news coverage received by this position statement. Media reports about statement published May, 31-June, 29, 2015 were analyzed according to five recommendations and three caveats extracted from the guidelines' press release. Information about how physical activity was framed and mentions of conflicts of interest were recorded. Of 58 news reports, nine reported all five recommendations in the position paper. The topline recommendation (two hours daily of standing and light activity) was reported in all articles. Alleviating musculoskeletal discomfort by sitting less was not reported by 72% of reports. Physical activity was mentioned in 32 reports: 69% said physical activity did not attenuate the risks of prolonged sitting. No reports mentioned any potential conflicts of interest despite co-author links to sit-stand desk industry. These results demonstrate the need to balance public and market demands for public health guidance around sitting; and could encourage more accurate communication of research outcomes. The physical activity component of the "move more and sit less" message requires greater efforts to raise its public salience.

Breaking up Sedentary Time in Overweight/Obese Adults on Work Days and Non-Work Days: Results from a Feasibility Study

Office workers are vulnerable to the adverse health effects of sedentary behavior (i.e., sitting time). Increasing physical activity and preventing time spent sitting is an occupational health priority. This randomized crossover design study compared the short-term (3-days) effects of hourly interruptions of sedentary time with 5-min micrrobouts of activity for 9 hours (MICRO) to a sedentary control condition (SED) and a duration-matched continuous single bout of physical activity (45-min/d, ONE) condition on inclinometer-derived sitting-time on work and non-work days in sedentary overweight/obese adults. Differences in sitting/lying, standing, stepping, number of sit/stand transitions, time spent in moderate and vigorous activity (MVPA), energy expenditure, self-perceived vigor and fatigue, and insulin sensitivity were also examined. Twenty-two participants (10M/12F; 31.7 ± 1.3 year old BMI 30.4 ± 0.5 kg/m²) completed all conditions. No between-condition effects were observed in sitting-time and sit/stand transitions. Both interventions increased daily steps, MVPA and energy expenditure with increases being greater in ONE than MICRO. Feelings of vigor and fasting insulin sensitivity were also improved. Participants reported less fatigue with MICRO than SED and ONE. Both interventions increase physical activity and energy expenditure in occupational and leisure-time contexts. The sustainability of these effects over the long term and on health outcomes will need to be tested in future studies.

Interaction between physical activity and television time on blood pressure level: cross-sectional data from 45 000 individuals

OBJECTIVES

The aim was to investigate if there is an interaction between sitting time and leisure time physical activity on blood pressure and if there are age differences and sex differences in this respect.

METHODS

Linear regression analysis on cross-sectional data was performed in more than 45 000 men and women from two Swedish cohort studies, EpiHealth (45-75 years) and LifeGene (18-45 years). Self-reported leisure time physical activity was given in five levels from low (level 1) to vigorous physical activity (level 5) and television time was used as a proxy measure of sitting time.

RESULTS

High physical activity was associated with lower DBP (P = 0.001), but not SBP. Active middle-aged men had lower DBP (-1.1 mmHg; 95% CI -1.7 to -0.4) compared with inactive participants. Prolonged television time was associated with higher SBP (P < 0.001) and DBP (P = 0.011) in both sexes and in most age groups. Watching 3 h instead of 1 h television per day was associated with higher SBP in middle-aged women (SBP: 1.1 mmHg; 95% CI 0.7-1.4) and men (SBP: 1.2 mmHg; 95% CI 0.8-1.6). Only in young men, a high physical activity (level 4 instead of level 1) could compensate for a prolonged television time (3 h per day) in terms of DBP.

CONCLUSION

Prolonged television time was associated with higher SBP and DBP in both sexes and at most ages, whereas an increased physical activity was mainly associated with a lower DBP. Only in young men, a high physical activity could compensate for prolonged television time regarding DBP.

Breaking up sedentary time with seated upper body activity can regulate metabolic health in obese high-risk adults: A randomized crossover trial

AIMS

To investigate the impact of performing short bouts of seated upper body activity on postprandial blood glucose and insulin levels during prolonged sitting.

METHODS

Participants undertook two 7.5-hour experimental conditions in randomized order: (1) prolonged sitting only and (2) sitting, interspersed with 5 minutes of seated arm ergometry every 30 minutes. Blood samples were obtained while fasting and throughout the postprandial period after ingestion of two standardized meals. The incremental area under the curve (iAUC) was calculated for glucose and insulin throughout each experimental condition. A paired samples t-test was used to assess the difference in iAUC data between conditions for glucose (primary outcome) and insulin (secondary outcome).

RESULTS

Thirteen obese adults (7 women, 6 men; mean ± standard deviation [s.d.] age: 66 ± 6 years; body mass index 33.8 ± 3.8 kg/m² ) completed this investigation. Compared with the prolonged sitting-only condition, the implementation of seated arm ergometry every 30 minutes significantly reduced mean blood glucose iAUC (from 7.4 mmol/L/h [95% confidence interval {CI} 5.2, 9.5] to 3.1 mmol/L/h [95% CI 1.3, 5.0]; P = .001). Significant reductions in mean insulin iAUC (from 696 mU/L/h [95% CI 359, 1032] to 554 mU/L/h [95% CI 298, 811]; P = .047) were also observed.

CONCLUSION

Performing short bouts of arm ergometry during prolonged sitting attenuated postprandial glycaemia despite maintaining a seated posture. This may have clinical significance for those with weight-bearing difficulty who may struggle with postural change.

Improving Cardiometabolic Health with Diet, Physical Activity, and Breaking Up Sitting: What about Sleep?

Cardiometabolic disease poses a serious health and economic burden worldwide and its prevalence is predicted to increase. Prolonged sitting, lack of physical activity, poor diet, and short sleep duration are ubiquitous behaviors in modern society, and all are independent risk factors in the development of cardiometabolic disease. Existing evidence demonstrates that breaking up prolonged periods of sitting is beneficial for cardiometabolic health, however, studies have not controlled for prior sleep duration. This article examines how prolonged sitting and short sleep duration independently contribute to cardiometabolic risk, and how breaking up sitting and obtaining adequate sleep may reduce this risk. We suggest that as prolonged sitting and short sleep duration influence the same cardiometabolic parameters, there is potential for short sleep to attenuate the positive impact of breaking up prolonged sitting with physical activity. Likewise, breaking up prolonged sitting and obtaining adequate sleep together could improve predictors of cardiometabolic disease, i.e., the combined effect may be stronger than either alone. To explore these perspectives, we propose a research agenda to investigate the relationship between breaking up prolonged sitting with physical activity and short sleep duration. This will provide an evidence-base for informing the design of interventions to reduce the burden of cardiometabolic disease on communities worldwide.

Breaking Up Sitting with Light-Intensity Physical Activity: Implications for Shift-Workers

Prolonged sitting, restricted sleep, and circadian disruption are all independent risk factors for non-communicable diseases. Previous research has demonstrated that breaking up sitting with light-intensity physical activity has clear benefits for the health of day workers, but these findings may not apply in the presence of sleep restriction and/or circadian disruption-both of which are commonly experienced by shift-workers. Specifically, sleep restriction, and circadian disruption result in acute physiological changes that may offset the benefits of breaking up sitting. This commentary will explore the potential benefits of breaking up sitting for health, work performance, and subsequent sleep in shift-workers. Future areas of research designed to understand the mechanisms by which prolonged sitting and shift work impact worker health and safety and to support the design of effective occupational health and safety interventions are proposed.

The acute physiological stress response to driving: A systematic review

BACKGROUND

The experience of driving has been suggested to be detrimental to health. One hypothesis is that each exposure elicits an acute stress response, and that repeated exposures may act as a chronic stressor.

OBJECTIVE

The aim of this review is to evaluate and synthesise the evidence on whether driving elicits an acute physiological stress response.

METHODS

Electronic databases, including CINAHL, PsycINFO and Medline, were searched for original articles written in English from database inception until March 2016. The inclusion criteria of this review included a quantitative examination of an acute physiological stress response to driving, in either on-road or simulated settings, compared to a comparison or control condition. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting criteria.

RESULTS

A total of 27,295 abstracts were screened and 28 full-text manuscripts retrieved. Of these, seven articles met the inclusion criteria including four simulator studies and three on-road studies. All suggested a significant change in at least one physiological outcome, but the strongest evidence was for increases in urine catecholamine and cortisol after driving for long hours on-road; results on other outcomes are limited by the small number of studies or inconsistent findings.

CONCLUSIONS

Overall, these studies provided moderate evidence to suggest that driving for long hours elicits a stress response over an extended period of time. There is insufficient evidence that driving for a shorter period of time elicits an acute stress response, especially in real, on-road tasks. However, the limited number of studies, small sample sizes, heterogeneity in study objectives, methodologies and physiological outcomes limit conclusions. Future studies could be improved by recruiting a larger sample, utilizing modern stress markers such as heart rate variability, and primarily focusing on the acute physiological stress response to on-road driving.

Effects of prior aerobic exercise on sitting-induced vascular dysfunction in healthy men

INTRODUCTION

Acute aerobic exercise prevents sitting-induced impairment of flow-mediated dilation (FMD). Further, evidence suggests that sitting-induced impairment of FMD occurs via an oxidative stress-dependent mechanism that disrupts endothelial function.

PURPOSE

We hypothesized that acute aerobic exercise would prevent impairment of femoral artery FMD by limiting oxidative stress responses that increase endothelin-1 (ET-1) levels and disrupt nitric oxide (NO) status.

METHODS

In a randomized, cross-over study, healthy men (n = 11; 21.2 ± 1.9 years) completed two 3 h sitting trials that were preceded by 45 min of either quiet rest (REST) or a single bout of continuous treadmill exercise (65% maximal oxygen consumption) (EX). Superficial femoral artery FMD, plasma glucose, malondialdehyde (MDA), ET-1, arginine (ARG) and its related metabolites [homoarginine (HA), asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA)] were assessed at baseline, 1 h following EX (or REST) (0 h), and at 1 h intervals during 3 h of uninterrupted sitting. Data were analyzed using repeated measures ANOVA.

RESULTS

During REST, femoral artery FMD declined from baseline (2.6 ± 1.8%) at 1, 2, and 3 h of sitting and resting shear rate decreased at 3 h. In contrast, when sitting was preceded by EX, femoral artery FMD (2.7 ± 2.0%) and resting shear rate responses were unaffected. No between trial differences were detected for plasma glucose, MDA, ET-1, ARG, HA, ADMA, or SDMA.

CONCLUSION

Prior aerobic exercise prevented the decline in femoral artery FMD that is otherwise induced by prolonged sitting independent of changes in oxidative stress, ET-1, and NO status.

The impact of breaking up prolonged sitting on glucose metabolism and cognitive function when sleep is restricted

Objectives

To investigate the acute benefits of breaking up prolonged sitting with light-intensity physical activity on (i) glucose metabolism under conditions of sleep restriction, and (ii) cognitive deficits associated with sleep restriction.

Methods

This counterbalanced, crossover trial consisted of two five-day (5 night) experimental conditions separated by a two-week washout period. On the first night, participants were given a 9-h sleep opportunity to allow the collection of steady-state baseline measures the following day. This was followed by three consecutive nights of sleep restriction (5-h sleep opportunity). In the sitting condition (SIT), participants remained seated between 1000 and 1800 h. In the physical activity condition (ACT), participants completed 3-min bouts of light-intensity walking every 30 min on a motorised treadmill between 1000 and 1800 h. At all other times, in both conditions, participants remained seated, except when walking to the dining room or to use the bathroom (max distance = 32 m). Six physically inactive, healthy males were randomised to one of two trial orders, 1) SIT then ACT, or 2) ACT then SIT. Continuous measures of interstitial glucose were measured at 5-min intervals. A cognitive and subjective test battery was administered every two hours during wake periods. Analyses were conducted using a series of linear mixed-effect ANOVAs.

Results

No differences in interstitial glucose concentration or cognitive performance were observed between the SIT condition and the ACT condition. Participants reported higher levels of sleepiness, and felt less alert in the SIT condition compared with the ACT condition.

Conclusions

There were no observable benefits of breaking up prolonged sitting on glucose metabolism under conditions of sleep restriction. These findings have implications for behaviour change interventions. Future studies will need to include larger, less homogenous study populations and appropriate control conditions (i.e., 8–9 h sleep opportunities).

Is Active Design changing the workplace? - A natural pre-post experiment looking at health behaviour and workplace perceptions

BACKGROUND

Active Design is a relatively new concept and evaluation on its effects on healthy behaviour is lacking.

OBJECTIVE

To investigate Active Design influence on workplace physical activity, sedentary behaviour, musculoskeletal complaints, and perceptions of the workplace and productivity.

METHODS

Participants (n = 118 adults) moving from 14 workplaces into a new building completed an online questionnaire pre- and post-move. The questions related to health behaviours (physical activity, sitting time and sleep); musculoskeletal issues; perceptions of the office environment; productivity; and engagement.

RESULTS

After the move, 68% of participants were located in an open plan building (21% before the move). In the new workplace participants tended to sit less during their work time (72% - 66%; p < 0.05) and stand more (15% - 19%; p < 0.05) while walking remained unchanged. Participants reported less lower-back pain. The new work environment was perceived as more motivating and providing better light, air quality and temperature, but less storage space. Participants reported looking forward to going to work more than before. No difference was reported in productivity related measures.

CONCLUSIONS

Moving to a new Active Design building can have some physical health-promoting effects on occupants. Satisfaction with environmental characteristics tended to improve in the new building though perceptions of productivity measures were variable.

Effects of urban motorways on physical activity and sedentary behaviour in local residents: a natural experimental study

BACKGROUND

There is little evidence on how changing the physical environment changes health-related behaviours. We studied the effects of the new M74 motorway (freeway) - opened in 2011 - and the existing M8 motorway in Glasgow, Scotland, on physical activity and sedentary behaviour among local residents.

METHODS

This natural experimental study used baseline (T1; 2005) and follow-up data (T2; 2013) from a longitudinal cohort (N = 365) and two cross-sectional samples (T1 N = 980; T2 N = 978). Adult participants were recruited from three study areas: one surrounding the new motorway, one surrounding the existing motorway, and a third, control, area without a motorway. The outcomes were self-reported time spent sitting, walking, and in moderate-to-vigorous physical activity (MVPA). Motorway exposure was defined in terms of (1) study area and (2) distance from home to the nearest motorway junction. Outcomes were regressed on exposures in two-part (walking and MVPA) or linear (sedentary behaviour) cohort and repeat cross-sectional models, adjusted for baseline behaviour and sociodemographic covariates.

RESULTS

Cohort participants living in the M8 area were less likely to participate in MVPA at follow-up than those living in the area without a motorway (OR 0.37; 95%CI 0.15, 0.91). Within the M8 area, those living closer to the motorway were also less likely to do so (OR 0.30; 95%CI 0.09, 0.97). No other statistically significant results were found.

CONCLUSIONS

We found some evidence of a negative association between exposure to an existing urban motorway and MVPA. However, the behavioural impacts of motorways are likely to be complex and evolve over time.

Energy expenditure and muscular activation patterns through active sitting on compliant surfaces

PURPOSE

To test the effectiveness of sitting surfaces with varied amounts of stability on muscle activity and energy expenditure.

METHODS

Using a within-participants repeated measures design, 11 healthy young-adult females (age = 20.0 ± 1.8 years) were measured using indirect calorimetry to assess energy expenditure, and electromyography to assess muscular activation in trunk and leg musculature under 3 different sitting surfaces: flat-firm surface, air-filled cushion, and a stability ball. Data were analyzed using repeated measures analysis of variance with follow-up pairwise contrasts used to determine the specific effects of sitting surface on muscle activation and energy expenditure.

RESULTS

Significantly greater energy expenditure was recorded for the stability ball (p = 0.01) and the cushion (p = 0.03) over the flat surface (10.4% and 9.6% greater, respectively), with no differences between the ball and the cushion. Both the ball and the cushion produced higher tibialis anterior activation over the flat surface (1.09 and 0.63 root-mean-square millivolts (RMSmv), respectively), while the stability ball produced higher soleus activity over both cushion and flat surfaces (3.97 and 4.24 RMSmv, respectively). Additionally, the cushion elicited higher adductor longus activity over the ball and flat surfaces (1.76 and 1.81 RMSmv, respectively), but no trunk musculature differences were revealed.

CONCLUSION

Compliant surfaces resulted in higher levels of muscular activation in the lower extremities facilitating increased caloric expenditure. Given the increasing trends in sedentary careers and the increases in obesity, this is an important finding to validate the merits of active sitting facilitating increased caloric expenditure and muscle activation.

Low physical activity, high television viewing and poor sleep duration cluster in overweight and obese adults; a cross-sectional study of 398,984 participants from the UK Biobank

BACKGROUND

An unhealthy lifestyle is one of the greatest contributors to obesity. A number of behaviours are linked with obesity, but are often measured separately. The UK Biobank cohort of >500,000 participants allows us to explore these behaviours simultaneously. We therefore aimed to compare physical activity, television (TV) viewing and sleep duration across body mass index (BMI) categories in a large sample of UK adults.

METHODS

UK Biobank participants were recruited and baseline measures were taken between 2007 and 2010 and data analysis was performed in 2015. BMI was measured objectively using trained staff. Self-report questionnaires were used to measure lifestyle behaviours including the international physical activity questionnaire (IPAQ-short form) for physical activity. During data analysis, six groups were defined based on BMI; 'Underweight' (n = 2026), 'Normal weight' (n = 132,372), 'Overweight (n = 171,030), 'Obese I' (n = 67,903), 'Obese II' (n = 18,653) and 'Obese III' (n = 7000). The odds of reporting unhealthy lifestyle behaviours (low physical activity, high TV viewing or poor sleep duration) were compared across BMI groups using logistic regression analysis.

RESULTS

Overweight and obese adults were more likely to report low levels of physical activity (≤967.5 MET.mins/wk) ('Overweight'-OR [95% CI]: 1.23 [1.20 to 1.26], 'Obese I' 1.66 [1.61-1.71], 'Obese II' 2.21 [2.12-2.30], and 'Obese III' 3.13 [2.95 to 3.23]) compared to 'Normal weight' adults. The odds of reporting high TV viewing (3 h/day) was greater in 'Overweight' (1.52 [1.48 to 1.55]) and obese adults ('Obese I' 2.06 [2.00-2.12], 'Obese II' 2.69 [2.58-2.80], 'Obese III' 3.26 [3.07 to 3.47]), and poor sleep duration (<7, >8 h/night) was higher in 'Overweight' (1.09 [1.07 to 1.12]) and obese adults ('Obese I' 1.31 [1.27-1.34], 'Obese II' 1.50 [1.44-1.56], 'Obese III' (1.78 [1.68 to 1.89]) compared to the 'Normal weight' group. These lifestyle behaviours were clustered, the odds of reporting simultaneous low physical activity, high TV viewing and poor sleep (unhealthy behavioural phenotype) was higher than reporting these behaviours independently, in overweight and obese groups. 'Obese III' adults were almost six times more likely (5.47 [4.96 to 6.05]) to report an unhealthy behavioural phenotype compared to the 'Normal weight' group.

CONCLUSIONS

Overweight and obese adults report low levels of physical activity, high TV viewing and poor sleep duration. These behaviours seem to cluster and collectively expose individuals to greater risk of obesity. Multiple lifestyle behaviours should be targeted in future interventions.

Health impacts of the M74 urban motorway extension: a mixed-method natural experimental study

Background

Making travel easier can improve people’s access to opportunities, but motor transport also incurs substantial undesirable health and social impacts.

Aims

To assess how a new urban motorway affected travel and activity patterns, road accidents and well-being in local communities, and how these impacts were experienced and brought about.

Design

The Traffic and Health in Glasgow study, a mixed-method controlled before-and-after study.

Setting

Glasgow, UK.

Participants

Repeat cross-sectional survey samples of 1345 and 1343 adults, recruited in 2005 and 2013, respectively. Of these, 365 formed a longitudinal cohort, 196 took part in a quantitative substudy using accelerometers and global positioning system receivers and 30, living within 400 m of the new motorway, took part in a qualitative substudy along with 12 other informants. Complementary analyses used police STATS19 road traffic accident data (1997–2014) and Scottish Household Survey travel diaries (2009–13).

Intervention

A new 5-mile, six-lane section of the M74 motorway, opened in 2011 and running through predominantly deprived neighbourhoods in south-east Glasgow, with associated changes to the urban landscape.

Main outcome measures

Differences in self-reported travel behaviour (1-day travel record), physical activity (short International Physical Activity Questionnaire) and well-being [Short Form 8 Health Survey (SF-8) and a short version of the Warwick–Edinburgh Mental Well-being Scale], and in the incidence of road traffic accidents.

Methods

A combination of multivariable cohort, cross-sectional, repeat cross-sectional and interrupted time series regression analyses comparing residents of the ‘M74 corridor’ intervention area and two matched control areas, complemented by novel qualitative spatial methods. Graded measures of the proximity of the motorway to each participant’s home served as a further basis for controlled comparisons.

Results

Both benefits and harms were identified. Cohort participants living closer to the new motorway experienced significantly reduced mental well-being (mental component summary of the SF-8 scale) over time compared with those living further away [linear regression coefficient –3.6, 95% confidence interval (CI) –6.6 to –0.7]. In the area surrounding an existing motorway, this association was concentrated among those with chronic conditions. In repeat cross-sectional analyses, participants living closer to a new motorway junction were more likely to report using a car at follow-up than those living further away (odds ratio 3.4, 95% CI 1.1 to 10.7). We found weaker quantitative evidence of a decline in physical activity participation and no quantitative evidence of an overall change in either active travel or accidents associated with motorway exposure. Qualitative evidence suggested that, although the new motorway improved connectivity for those with dispersed social networks and access to motor vehicles, the impacts were more complex for others, some of whom found the motorway to be a cause of severance. Changes in community composition and cohesion, and perceptions of personal safety, were widely perceived as more important to local people.

Limitations

A key limitation of natural experimental studies is that the risk of residual confounding cannot be eliminated.

Conclusions

Overall, these findings highlight the potential for urban infrastructural projects of this kind to add further burdens to already disadvantaged communities, exacerbating inequalities and contributing to poorer health outcomes. The health and social impacts of such initiatives should be more fully taken into account in planning and research.

Funding

The National Institute for Health Research Public Health Research programme.

Is More Area-Level Crime Associated With More Sitting and Less Physical Activity? Longitudinal Evidence From 37,162 Australians

Does a rise in crime result in increased sitting time and a reduction in physical activity? We used unobserved ("fixed")-effects models to examine associations between change in objectively measured crime (nondomestic violence, malicious damage, breaking and entering, and stealing, theft, and robbery) in Australia and measures of sitting time, walking, and moderate-to-vigorous physical activity (MVPA) in a residentially stable sample of 17,474 men and 19,688 women at baseline (2006-2008) and follow-up (2009-2010). Possible sources of time-varying confounding included age, income, economic status, relationship (couple) status, and physical functioning. In adjusted models, an increase in all crimes of 10 counts per 1,000 residents was associated with an increase in sitting time (hours/day) among men (β = 0.21, 95% confidence interval (CI): 0.17, 0.25) and women (β = 0.18, 95% CI: 0.15, 0.22). Counterintuitively, the same increase in crime was also associated with an increase in the weekly number of ≥10-minute walking sessions (men: rate ratio (RR) = 1.01 (95% CI: 1.01, 1.02); women: RR = 1.00 (95% CI: 0.99, 1.01)) and MVPA sessions (men: RR = 1.02 (95% CI: 1.02, 1.03); women: RR = 1.01 (95% CI: 1.00, 1.02)). Similar associations were found for the other area-level crime indicators. While area-level crime prevention may be considered a lever for promoting more active lifestyles, these results suggest that the association is not unequivocal.

Nurse Educators' Occupational and Leisure Sitting Time

Prolonged sitting time (ST) is a risk factor for all-cause mortality, independent of physical activity. Nurse educators are particularly at risk due to limited physical activity, older age, and the increasing use of computers. This descriptive correlational study was designed to explore the ST of nurse educators in relation to their self-reported health status and general health indicators. A convenience sample of 56 nurse educators was recruited, and participants completed demographic items, general health questions, and the Workforce Sitting Questionnaire (WSQ; Chau, van der Ploeg, Dunn, Kurko, & Bauman, 2011). More than one half of the participants were either overweight or obese based on their body mass index (BMI). Sitting time domains for "watching TV" on a non-working day ( r = 1.00) and during "other leisure activities" on a non-working day ( r = 1.00) were associated with a current diagnosis of diabetes. These findings add to an understanding of the effects of ST on health risks for nurse educators.

Retirement-A Transition to a Healthier Lifestyle?: Evidence From a Large Australian Study

INTRODUCTION

Population aging is associated with a rising burden of non-communicable disease, profoundly impacting health policy and practice. Adopting and adhering to healthy lifestyles in middle or older age can protect against morbidity and mortality. Retirement brings opportunities to reconfigure habitual lifestyles and establish new routines. This study examines the longitudinal association between retirement and a range of lifestyle risk behaviors among a large population-based sample of Australian adults.

METHODS

Study sample included working adults aged ≥45 years at baseline (2006-2009, N=23,478-26,895). Lifestyle behaviors, including smoking, alcohol use, physical activity, diet, sedentary behavior, and sleep, were measured at both baseline and follow-up (2010). Logistic regression models estimated the odds of having each risk factor at follow-up and multiple linear regression models calculated the change in the total number of risk factors, adjusted for baseline risk and other covariates. Sociodemographic characteristics and reasons for retirement were tested as potential effect modifiers.

RESULTS

During the 3.3-year follow-up, about 11% of respondents retired. Retirement was associated significantly with reduced odds of smoking (AOR=0.74); physical inactivity (AOR=0.73); excessive sitting (AOR=0.34); and at-risk sleep patterns (AOR=0.82). There was no significant association between retirement and alcohol use or fruit and vegetable consumption. Change in the total number of lifestyle risk factors differed significantly by reason for retirement.

CONCLUSIONS

In a large population-based Australian cohort, retirement was associated with positive lifestyle changes. Health professionals and policymakers should consider developing special programs for retirees to capitalize on the healthy transitions through retirement.

Too much sitting and all-cause mortality: is there a causal link?

Background

Sedentary behaviours (time spent sitting, with low energy expenditure) are associated with deleterious health outcomes, including all-cause mortality. Whether this association can be considered causal has yet to be established.

Using systematic reviews and primary studies from those reviews, we drew upon Bradford Hill’s criteria to consider the likelihood that sedentary behaviour in epidemiological studies is likely to be causally related to all-cause (premature) mortality.

Methods

Searches for systematic reviews on sedentary behaviours and all-cause mortality yielded 386 records which, when judged against eligibility criteria, left eight reviews (addressing 17 primary studies) for analysis. Exposure measures included self-reported total sitting time, TV viewing time, and screen time. Studies included comparisons of a low-sedentary reference group with several higher sedentary categories, or compared the highest versus lowest sedentary behaviour groups. We employed four Bradford Hill criteria: strength of association, consistency, temporality, and dose–response. Evidence supporting causality at the level of each systematic review and primary study was judged using a traffic light system depicting green for causal evidence, amber for mixed or inconclusive evidence, and red for no evidence for causality (either evidence of no effect or no evidence reported).

Results

The eight systematic reviews showed evidence for consistency (7 green) and temporality (6 green), and some evidence for strength of association (4 green). There was no evidence for a dose–response relationship (5 red). Five reviews were rated green overall. Twelve (67 %) of the primary studies were rated green, with evidence for strength and temporality.

Conclusions

There is reasonable evidence for a likely causal relationship between sedentary behaviour and all-cause mortality based on the epidemiological criteria of strength of association, consistency of effect, and temporality.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-3307-3) contains supplementary material, which is available to authorized users.

Reducing Sedentary Behavior Versus Increasing Moderate-to-Vigorous Intensity Physical Activity in Older Adults

OBJECTIVE

To compare the effects of behavioral interventions targeting decreased sedentary behavior versus increased moderate-to-vigorous intensity physical activity (MVPA) in older adults.

METHOD

Inactive older adults ( N = 38, 68 ± 7 years old, 71% female) were randomized to 12-week interventions targeting decreased sedentary behavior ( Sit Less) or increased MVPA ( Get Active). The SenseWear armband was used to objectively assess activity in real time. Assessments included a blinded armband, the Community Health Activites Model Program for Senior (CHAMPS) questionnaire, 400-meter walk, and the Short Physical Performance Battery (SPPB).

RESULTS

Objectively measured MVPA increased in Get Active (75 ± 22 min/week, p < .001); self-reported MVPA increased in both groups ( p < .05). Sedentary behavior did not change in either group (all p > .05). Only the Sit Less group improved the SPPB score (0.5 ± 0.3, p = .046).

DISCUSSION

Targeting reduced sedentary behavior had a greater effect on physical function among inactive but high functioning older adults over 12 weeks. Future studies of longer duration and combining increased MVPA with reduced sedentary behavior are needed.

European Sitting Championship: Prevalence and Correlates of Self-Reported Sitting Time in the 28 European Union Member States

Objective

Sedentary behaviour is increasingly recognized as an important health risk, but comparable data across Europe are scarce. The objective of this study was to explore the prevalence and correlates of self-reported sitting time in adults across and within the 28 European Union Member States.

Methods

This study reports data from the Special Eurobarometer 412. In 2013, 27,919 randomly selected Europeans (approximately 1000 per Member State) were interviewed face-to-face. Sitting time on a usual day was self-reported and dichotomised into sitting less- and more than 7.5 hours per day. Uni- and multivariate odds ratios of sitting more than 7.5 hours per day were assessed by country and socio-demographic variables using binary logistic regression analyses. The analyses were stratified by country to study the socio-demographic correlates of sitting time within the different countries.

Results

A total of 26,617 respondents were included in the analyses. Median sitting time was five hours per day. Across Europe, 18.5 percent of the respondents reported to sit more than 7.5 hours per day, with substantial variation between countries (ranging from 8.9 to 32.1 percent). In general, northern European countries reported more sitting than countries in the south of Europe. ‘Current occupation’ and ‘age when stopped education’ were found to be the strongest correlates of sitting time, both across Europe and within most Member States. Compared to manual workers, the odds ratio of sitting more than 7.5 hours per day was 5.00 for people with white collar occupations, 3.84 for students, and 3.65 for managers.

Conclusions

There is substantial variation in self-reported sitting time among European adults across countries as well as socio-demographic groups. While regular surveillance of (objectively measured) sedentary behaviour is needed, the results of this study provide entry points for developing targeted interventions aimed at highly sedentary populations, such as people with sedentary occupations.

Total sitting time and the risk of incident diabetes in Danish adults (the DANHES cohort) over 5 years: a prospective study

AIMS

To test the hypothesis that total sitting time is associated with incident diabetes, after adjustment for physical activity and obesity.

METHODS

72 608 Danish adults from the DANHES cohort reported their total sitting time in 2007-2008 and were followed-up for 5 years, in relation to register-based incident diabetes mellitus. Cox regression analyses were used, and the effect-modifying influence of obesity and physical activity assessed.

RESULTS

The age-sex adjusted HR for developing diabetes among those who sat 10+ h/day as compared to <6 h/day was 1.35 (95% CI 1.17 to 1.57). The relative risks were similar by gender, but were largely attenuated by adjustment for potential confounding factors including physical activity, and statistically non-significant for all categories of body mass index except the obese.

CONCLUSIONS

The association between total sitting time and incident diabetes is substantially moderated by physical activity and obesity. Total sitting time remains a risk factor for diabetes only in inactive and obese populations.

The descriptive epidemiology of total physical activity, muscle-strengthening exercises and sedentary behaviour among Australian adults--results from the National Nutrition and Physical Activity Survey

BACKGROUND

The current Australia's Physical Activity and Sedentary Behaviour Guidelines recommend that adults engage in regular moderate-to-vigorous-intensity physical activity (MVPA) and strength training (ST), and minimise time spent in sedentary behaviours (SB). However, evidence about the specific individual and concurrent distribution of these behaviours in Australia is scarce. Therefore, the aim of this study was to determine the prevalence and sociodemographic correlates of MVPA, ST and SB in a national-representative sample of Australian adults.

METHODS

Data were collected using face-to-face interviews, as part of the National Nutrition and Physical Activity Survey 2011-12. The population-weighted proportions meeting the MVPA (≥ 150 min/week), ST (≥ 2 sessions/week) and combined MVPA-ST guidelines, and proportions classified as having 'low levels of SB' (< 480 min/day) were calculated, and their associations with selected sociodemographic and health-related variables were assessed using multiple logistic regression analyses. This was also done for those at potentially 'high-risk', defined as insufficient MVPA-ST and 'high-sedentary' behaviour.

RESULTS

Out of 9345 participants (response rate = 77.0 %), aged 18-85 years, 52.6 % (95 % CI: 51.2 %-54.0 %), 18.6 % (95 % CI: 17.5 %-19.7 %) and 15.0 % (95 % CI: 13.9 %-16.1 %) met the MVPA, ST and combined MVPA-ST guidelines, respectively. Female gender, older age, low/medium education, poorer self-rated health, being classified as underweight or obese, and being a current smoker were independently associated with lower odds of meeting the MVPA, ST and combined MVPA-ST guidelines. A total of 78.9 % (95 % CI: 77.9 %-80.0 %) were classified as having low levels of SB. Females, older adults and those with lower education were more likely to report lower levels of SB, whilst those with poor self-rated health and obese individuals were less likely to report lower levels of SB (i.e. SB = ≥ 480 min/day). A total of 8.9 % (95 % CI: 8.1 %-9.6 %) were categorised as individuals at potentially 'high-risk'. Those with poorer self-rated health, obese individuals, those aged 25-44, and current smokers were more likely to be in the 'high risk' group.

CONCLUSIONS

The large majority of Australian adults do not meet the full physical activity guidelines and/or report excessive SB. Our results call for public health interventions to reduce physical inactivity and SB in Australia, particularly among the subgroups at the highest risk of these unhealthy behaviours.

Cardiorespiratory fitness in 16 025 adults aged 18-91 years and associations with physical activity and sitting time

Our aim was to provide up-to-date cardiorespiratory fitness reference data for adults of all ages and to investigate associations between cardiores-piratory fitness and leisure time physical activity as well as sitting time. In the Danish Health Examination Survey 2007-2008, cardiorespiratory fitness was estimated in 16 025 individuals aged 18-91 years from validated cycle ergometer exercise tests. Level of leisure time physical activity (sedentary, light, moderate, and vigorous) and daily sitting time in hours was obtained from a self-administered questionnaire. Men had 20-33% higher cardiorespiratory fitness than women, depending on age, and cardiorespiratory fitness decreased by 0.26 and 0.23 mL/min/kg per year in men and women, respectively. Cardiorespiratory fitness was higher among participants who reported a high level of physical activity in leisure time compared with participants who were sedentary. Among sedentary or lightly physically active participants, inverse associations between total daily sitting time and cardiorespiratory fitness were found, while there was no association between sitting time and cardiorespiratory fitness among moderately or vigorously physically active participants. These data on cardiorespiratory fitness can serve as useful reference material. Although reluctant to conclude on causality, sitting time might impact cardiorespiratory fitness among individuals with low levels of leisure time physical activity.

Profiles of sedentary and non-sedentary young men - a population-based MOPO study

BACKGROUND

Sedentary behavior is associated with poor well-being in youth with adverse trajectories spanning to adulthood. Still, its determinants are poorly known. Our aim was to profile sedentary and non-sedentary young men and to clarify their differences in a population-based setting.

METHODS

A total of 616 men (mean age 17.9, SD 0.6) attending compulsory conscription for military service completed a questionnaire on health, health behavior, socioeconomic situation and media use. They underwent a physical (body composition, muscle and aerobic fitness) and medical examination. Profiles were formed by principal component analysis (PCA).

RESULTS

A total of 30.1 % men were sedentary (daily leisure-time sitting ≥5 h) and 28.9 % non-sedentary (sitting ≤2 h). The sedentary men had more body fat, more depressive symptoms, but lower fitness and life satisfaction than non-sedentary men. However, according to PCA, profiles of unhealthy eating, life-dissatisfaction, and gaming were detected both among sedentary and non-sedentary men, as well as high self-rated PA and motives to exercise.

CONCLUSION

Determinants of sedentary and non-sedentary lifestyles were multiple and partially overlapping. Recognizing individual patterns and underlying factors of the sedentary lifestyle is essential for tailored health promotion and interventions.

Effect of prolonged sitting and breaks in sitting time on endothelial function

Sitting time (ST) is associated with cardiovascular disease risk factors, whereas breaking ST has been reported to be beneficial for reducing cardiovascular risk.

PURPOSE

The objective of this study is to examine the effects of breaking ST on superficial femoral artery (SFA) endothelial function.

HYPOTHESES

1) Prolonged sitting would induce endothelial dysfunction and changes in shear forces, and 2) breaking ST with brief periods of activity would prevent attenuation in endothelial function.

METHODS

Twelve nonobese men (24.2 ± 4.2 yr) participated in two randomized 3-h sitting trials. In the sitting (SIT) trial, subjects were seated on a firmly cushioned chair for 3 h without moving their lower extremities. In the breaking ST trial (ACT), subjects sat similar to the SIT trial but walked on a treadmill for 5 min at 2 mph at 30 min, 1 h 30 min, and 2 h 30 min during the sitting interval. SFA flow-mediated dilation (FMD) was assessed at baseline, 1 h, 2 h, and 3 h in each trial. Statistical analyses were performed using dependent variables SFA FMD and shear rates. Significance was set at P ≤ 0.05.

RESULTS

In the SIT trial, there was a significant decline in SFA FMD from baseline to 3 h (baseline, 4.72% ± 3.78%; 1 h, 0.52% ± 0.85%; 2 h, 1.66% ± 1.11%; 3 h, 2.2% ± 2.15; P < 0.05 by ANOVA) accompanied by a decline in mean shear rate and antegrade shear rate but no difference in shear rate (area under the curve). By two-way repeated-measures ANOVA, ACT prevented the sitting-induced decline in FMD (baseline, 4.5% ± 2.3%; 1 h, 5.04% ± 2.85%; 2 h, 5.28% ± 5.05%; 3 h, 6.9% ± 4.5%) along with no decline in shear rates.

CONCLUSION

Three hours of sitting resulted in a significant impairment in shear rate and SFA FMD. When light activity breaks were introduced hourly during sitting, the decline in FMD was prevented.

Workplace building design and office-based workers' activity: a study of a natural experiment

Objective: This opportunistic natural study investigated the effects of relocation of office workers from a 30‐year‐old building to a new purpose‐built building. The new building included an attractive central staircase that was easily accessed and negotiated, as well as breakout spaces and a centralised facilities area. The researchers aimed to determine the impact of the purpose‐built office building on the office workers' sedentariness and level of physical activity.

Method: In 2013, a natural pre‐post study was undertaken with office‐based workers in their old conventional 1970s building and on relocating to a new purpose‐built ‘activity permissive’ building. Objective movement data was measured using accelerometers. Anthropometric and demographic data was also collected.

Results: Forty‐two office‐based workers significantly decreased their percentage of daily sitting time (T1 = 84.9% to T2=79.7%; p<0.001) and increased their percentage of daily standing time (T1=11.2% to T2 17.0%; p<0.001) in the new building. Moderate activity significantly declined (T1=3.9% to 3.2%=T2; p=0.038). There was a significant decrease in mean minutes of sitting time (19.62 minutes; p<0.001) and increase in standing time (22.03 minutes; p<0.001).

Conclusions: The design of a building can influence activity. This opportunistic study on the impact of workplace relocation on office‐based workers' activity showed modest positive outcomes in sitting and standing. Evidence is required to inform building design policy and practice that supports physical activity and reduces levels of sedentariness in the workplace.

Trends in prolonged sitting time among European adults: 27 country analysis

OBJECTIVE

To examine trends in adult sitting time across 27 European countries.

METHOD

Data were from the Eurobarometer surveys collected in 2002, 2005, and 2013. Sitting time data were used to categorise respondents into 'low' (0 to 4h30min), 'middle' (4h31min to 7h30min), and 'high' levels of sitting (>7h30min). We modelled the likelihood of being in the high sitting group within a given country and overall across the three time points, controlling for age, gender, education, employment status, and physical activity.

RESULTS

In total 17 countries had sitting data at all three time points; among these countries the prevalence of 'high sitting' decreased steadily from 23.1% (95% CI=22.2-24.1) in 2002 to 21.8% (95% CI=20.8-22.8) in 2005, and 17.8% (95% CI=16.9-18.7) in 2013. A further 10 countries had data only over the latter two time points; among these countries the prevalence of high sitting decreased from 27.7% (95% CI=26.0-29.4) in 2005 to 19.0% (95% CI=17.6-20.5) in 2013.

CONCLUSION

Time spent in sedentary behaviour may not be increasing in the European region, and prolonged sitting may, in fact, be decreasing. This finding has important implications for the sedentary behaviour debate and the policy response.

Definition, measurement, and health risks associated with sedentary behavior

PURPOSE AND METHODS

Although evidence is accumulating that sedentary behavior (SB), independent of moderate-to-vigorous intensity physical activity (MVPA), is associated with cardiometabolic and aging outcomes in adults, several gaps present opportunities for future research. This article reports on the "Research Evidence on Sedentary Behavior" session of the Sedentary Behavior: Identifying Research Priorities workshop, sponsored by the National Heart, Lung, and Blood Institute and the National Institute on Aging, which aimed to identify priorities in SB research.

RESULTS AND CONCLUSIONS

A consensus definition of SB has not yet been established, although agreement exists that SB is not simply all behaviors other than MVPA. The two most common definitions are as follows: one based solely on intensity (<1.5 metabolic equivalents [METs]) and another which combines low intensity (≤1.5 METs) with a seated or reclining posture. Thus, for the definition of SB, evaluation of whether or not to include a postural component is a research priority. SB assessment methodologies include self-report and objective measurement, each offering distinct information. Therefore, evaluation, standardization, and comparison across self-report and objective assessment methods are needed. Specific priorities include the development and validation of novel devices capable of assessing posture and standardization of research practices for SB assessment by accelerometry. The prospective evidence that SB relates to health outcomes is limited in that SB is almost exclusively measured by self-report. The lack of longitudinal studies with objectively measured SB was recognized as a major research gap, making examination of the association between objectively measured SB and adverse health outcomes in longitudinal studies a research priority. Specifically, studies with repeated measures of SB, evaluating dose-response relationships, with inclusion of more diverse populations are needed.