Sitting time and socio-economic differences in overweight and obesity

From test to rest: evaluating socioeconomic differences along the COVID-19 care pathway in the Netherlands

INTRODUCTION

The COVID-19 pandemic exacerbated healthcare needs and caused excess mortality, especially among lower socioeconomic groups. This study describes the emergence of socioeconomic differences along the COVID-19 pathway of testing, healthcare use and mortality in the Netherlands.

METHODOLOGY

This retrospective observational Dutch population-based study combined individual-level registry data from June 2020 to December 2020 on personal socioeconomic characteristics, COVID-19 administered tests, test results, general practitioner (GP) consultations, hospital admissions, Intensive Care Unit (ICU) admissions and mortality. For each outcome measure, relative differences between income groups were estimated using log-link binomial regression models. Furthermore, regression models explained socioeconomic differences in COVID-19 mortality by differences in ICU/hospital admissions, test administration and test results.

RESULTS

Among the Dutch population, the lowest income group had a lower test probability (RR = 0.61) and lower risk of testing positive (RR = 0.77) compared to the highest income group. However, among individuals with at least one administered COVID-19 test, the lowest income group had a higher risk of testing positive (RR = 1.40). The likelihood of hospital admissions and ICU admissions were higher for low income groups (RR = 2.11 and RR = 2.46, respectively). The lowest income group had an almost four times higher risk of dying from COVID-19 (RR = 3.85), which could partly be explained by a higher risk of hospitalization and ICU admission, rather than differences in test administration or result.

DISCUSSION

Our findings indicated that socioeconomic differences became more pronounced at each step of the care pathway, culminating to a large gap in mortality. This underlines the need for enhancing social security and well-being policies and incorporation of health equity in pandemic preparedness plans.

Associations of the neighbourhood built and natural environment with cardiometabolic health indicators: A cross-sectional analysis of environmental moderators and behavioural mediators

BACKGROUND

Most studies examining the effects of neighbourhood urban design on cardiometabolic health focused solely on the built or natural environment. Also, they did not consider the roles of neighbourhood socio-economic status (SES) and ambient air pollution in the observed associations, and the extent to which these associations were mediated by physical activity and sedentary behaviours.

METHODS

We used data from the AusDiab3 study (N = 4141), a national cohort study of Australian adults to address the above-mentioned knowledge gaps. Spatial data were used to compute indices of neighbourhood walkability (population density, intersection density, non-commercial land use mix, commercial land use), natural environment (parkland and blue spaces) and air pollution (annual average concentrations of nitrogen dioxide (NO2) and fine particulate matter <2.5 μm in diameter (PM2.5)). Census indices were used to define neighbourhood SES. Clinical assessments collected data on adiposity, blood pressure, blood glucose and blood lipids. Generalised additive mixed models were used to estimate associations.

RESULTS

Neighbourhood walkability showed indirect beneficial associations with most indicators of cardiometabolic health via resistance training, walking and sitting for different purposes; indirect detrimental associations with the same indicators via vigorous gardening; and direct detrimental associations with blood pressure. The neighbourhood natural environment had beneficial indirect associations with most cardiometabolic health indicators via resistance training and leisure-time sitting, and beneficial direct associations with adiposity and blood lipids. Neighbourhood SES and air pollution moderated only a few associations of the neighbourhood environment with physical activity, blood lipids and blood pressure.

CONCLUSIONS

Within a low-density and low-pollution context, denser, walkable neighbourhoods with good access to nature may benefit residents' cardiometabolic health by facilitating the adoption of an active lifestyle. Possible disadvantages of living in denser neighbourhoods for older populations are having limited opportunities for gardening, higher levels of noise and less healthy dietary patterns associated with eating out.

Associations between sedentary behavior and health and the moderating role of physical activity in young people within a cross-sectional investigation

The purpose of this study was to determine the influence of sedentary behavior (SB) on the frequency of health complaints (fHC) as well as on self-rated health (SRH) and body mass index (BMI), and to determine whether physical activity (PA) moderated this influence. Data were obtained from the Youth Survey Luxembourg 2019 (N = 2,802), a nationally representative stratified random sample of all youths aged 16 to 29 years who were living in Luxembourg. fHC is a composite measure of eight common psychosomatic health complaints, SRH was measured on a five-point scale, and BMI was calculated by dividing participants' body weight by the square of their body height (kg/m2). PA and SB values were obtained from factor analyses of the relevant questionnaire items. SB was evaluated as both leisure-time SB and gaming-associated SB. Multiple regression analyses adjusted for age, sex, socioeconomic status, and migration status were used to determine the association between SB, fHC, BMI, and SRH. We found that leisure-time SB was positively associated with fHC, but not with SRH or BMI. Gaming-associated SB was positively associated with fHC and BMI but was negatively associated with SRH. PA was negatively associated with fHC, BMI and SRH. No statistically significant moderating effects were observed. We found that both leisure-time and gaming-associated SB showed statistically significant impacts on health. Although PA is known to be beneficial to health, we conclude that its potential to mitigate the negative effects of SB is limited in young people.

Factors Associated with Sedentary Behavior and Physical Activity Among People Living in Saudi Arabia - A Cross-Sectional Study

Background

A poor physical activity and sedentary behavior is common among individuals which can be detrimental to one's health. Furthermore, sedentary behavior is associated with metabolic disorders. Therefore, this study explored factors associated with sedentary behavior and physical activity among individuals in capital region of Saudi Arabia.

Methods

A cross-sectional web-based study was conducted over a period of 3 months in 2023 using prevalidated questionnaires, which address the sedentary behavior and physical activity and its factors. This study included among individuals aged from 19 to 50 years, living in Riyadh. Factors associated with outcome variables were identified using multiple linear regression analysis in SPSS.

Results

Of the 833 study participants, 569 (68.3%) and most were males aged between years 31-35 years old. Only 20.6% (n=172) of the activities that induced high levels of breathing or heart rate were vigorous-intensity activities among the respondents. The average number of sitting hours per day was 6.74 (SD=1.577). The regression model's findings showed a significant correlation between mean sitting time and education level (p=0.008), occupation (p=0.001), monthly income (p=0.029), and kind and status of physical activity (p=0.002). Similar to this, there was a significant correlation between age group (p=0.040) and physical activity status (p=0.001) and the amount of time spent engaging in vigorous-intensity activities at work on an average day.

Conclusion

The findings of this study confirmed that Saudi adults living in the Riyadh region spent a significant amount of time sedentary, and the most common factors associated with sedentary behavior were education, employment, monthly income, physical activity status, type of physical activity, and reasons for not practicing physical activity. The findings of this study can be used by healthcare providers and those associated with policymaking to improve health outcomes in healthcare settings.

The effect of time spent sitting and excessive gaming on the weight status, and perceived weight stigma among Taiwanese young adults

Background

During the COVID-19 pandemic, physical inactivity and sedentary behaviors (i.e., longer sitting time and excessive gaming) increased because governments across the globe adopted stringent mitigation strategies such as social distancing and lockdowns to curb the spread of the virus. Excessive gaming was one of the coping mechanisms used to deal with the pressure associated with the pandemic. Moreover, perceived weight stigma (PWS) and weight status became more salient concerns among young adults during the COVID-19 pandemic. The current study sought to investigate the relationship between time spent sitting, excessive gaming, weight status, and PWS of Taiwanese Young adults. Additionally, weight status and PWS were examined as mediators between both sedentary behaviors.

Methods

This cross-sectional study involved 600 participants who were recruited through Taiwan universities. All participants completed a demographic questionnaire (including weight and height) and self-report measures including the International Physical Activity Questionnaire short form (IPAQ-SF), the Perceived Weight Stigma Scale (PWSS), and the Internet Gaming Disorder Scale-short form (IGDS9-SF). PROCESS model was performed to test the potential mediation roles of weight status and PWS. Moreover, we categorized participants into two groups based on the sitting-time item in the IPAQ-SF: students whose sitting time was less than 8 h daily, and those more than 8 h daily.

Results

The group that had less than 8 h had significantly higher PWS and IGDS9-SF scores than the other group. Sitting time was negatively associated with weight status, PWS, and IGDS9-SF. Additionally, we found a significantly direct effect between time spent sitting and excessive gaming. Both weight status and PWS were significant mediators in the association between time spent sitting and excessive gaming.Conclusions: The present study demonstrated important negative correlates of excessive sedentary behaviors. Prevention efforts should focus on promoting physical activity and providing information to decrease sedentary behavior among university students.

Are the different cut-off points for sitting time associated with excess weight in adults? A population based study in Latin America

BACKGROUND

Excess weight is increasing worldwide, and in Latin America more than half of the population is excess weight. One of the reasons for this increase has been excessive sitting time. Still, it remains to be seen whether there is an excessive amount of that time in Latin American adults. This study aimed to associate different sitting time cut-off points with the excess weight.

METHODS

Data from the Latin American Study of Nutrition and Health (ELANS), a cross-sectional population-based survey conducted in eight Latin American countries, were used. The excess weight indicators used were body mass index, and waist and neck circumferences. Sitting time was obtained using questionnaires and categorized at different cut-off points. Differences between sitting time categories (< 4 or ≥ 4; < 6 or ≥ 6; and < 8 or ≥ 8 hours/day) and excess weight were obtained by Student's t test for independent samples and the association between sitting time categories and different indicators of excess weight were obtained by logistic regression.

RESULTS

The median of the sitting time was 420 min/day (IQR: 240-600). There were no significant differences between body mass index (kg/m²) and waist circumference (cm) with categories of sitting time. The mean values of neck circumference (cm) were significantly higher in ≥4, ≥6 and ≥ 8 hours/day than < 4, < 6, and < 8 hours/day of sitting time in the pooled sample. Some distinct differences by country were observed. There were significant differences among excess weight by body mass index (63.2% versus 60.8) with < 8 vs ≥8 hours/day of sitting time. The proportion of excess weight by neck circumference was higher in participants who reported ≥4, ≥6, and ≥ 8 hours/day compared to < 4, < 6, and < 8 hours/day of sitting time. Considering ≥8 hours/day of sitting time, higher odds of excess weight were found evaluated by body mass index (OR: 1.10; 95% CI: 1.01, 1.20) and neck circumference (OR: 1.13; CI 95%: 1.03, 1.24) overall.

CONCLUSIONS

Sitting time above 8 hours/day was associated with higher odds of excess weight, even though there were no differences in waist circumference between sitting time categories.

TRIAL REGISTRATION

Clinical Trials NCT02226627. (27/08/2014).

Lifestyle choices mediate the association between educational attainment and BMI in older adults in China: A cross-sectional study

As the Chinese population ages, unhealthfully high body mass index (BMI) levels in older adults are becoming a public health concern as an unhealthfully high BMI is an ill-being condition and can contribute to the risk of disease. Education and lifestyle choices affect BMI; however, the evidence on the relationships and interactions among these factors remains unclear. This study aimed to investigate the mediating effect of lifestyle choices on educational attainment and BMI among older adults in China. Using the Chinese Family Panel Studies (CFPS) 2018 panel data, this study integrated personal- and family-level economic data libraries, including 7,359 adults aged ≥60 years. Lifestyle parameters included smoking amount and screen time. Height and weight values were used to calculate BMI. The chi-square test, binary logistic regression analysis, stepwise regression analysis, and bootstrapping mediating effect tests were used for data analysis. Single-factor chi-square test revealed differences in BMI levels among groups defined by sex, age, residence, marital status, per capita annual household income, education years, and lifestyle choices. Binary logistic regression showed that age, residence, education years, smoking amount, and screen time influenced BMI. Stepwise regression results showed that education years, smoking amount, and screen time were associated with BMI (t = 3.907, -4.902, 7.491, P < 0.001). The lifestyle variables had partial mediating effects on BMI. The mediating effect of lifestyle on BMI was 0.009, while smoking amount was 0.003, and screen time was 0.006. Unhealthfully high BMI levels are increasing among older adults in China and are affected by many factors. Lifestyle factors and educational attainment can interact, affecting BMI. Interventions should consider lifestyle factors and education attainment to help maintain healthy BMI and reduce unhealthfully high BMI incidence.

Spatial location, temperature and rainfall diversity affect the double burden of malnutrition among women in Kenya

Studies have looked into how environmental and climate covariates affect under-and over-nutrition, but little is known about the spatial distribution of different forms of malnutrition in Kenya and whether there are locations that suffer from double-burden of malnutrition. This research quantifies spatial variations and estimates how climatic and environmental factors affect under-and over-nutrition among women in Kenya. This enables us to determine if the patterns in which these factors affect the malnutrition indicators are similar and whether there are overlaps in the spatial distributions. The study used data from the Demographic and Health Survey, which included cross-sectional data on malnutrition indicators as well as some climate and environmental variables. A multicategorical response variable that classified the women into one of four nutritional classes was generated from the body mass index (BMI) of the women, and a Bayesian geoadditive regression model with an estimate based on the Markov chain Monte Carlo simulation technique was adopted. Findings show that women in Turkana, Samburu, Isiolo, Baringo, Garissa, and West Pokot counties are more likely to be underweight than women in other counties while being overweight is prevalent in Kirinyag'a and Kitui counties. Obesity is prevalent in Kirinyag'a, Lamu, Kiambu, Murang'a, and Taita Taveta counties. The study further shows that as mean temperature and precipitation increase, the likelihood of being underweight reduces. The chances of being underweight are lower among literate women [OR: 0.614; 95% CrI: 0.513,0.739], married women [OR: 0.702; 95% CrI: 0.608,0.819] and those from rich households [OR: 0.617; 95% CrI: 0.489,0.772], which is not the case for overweight and obesity. The generated spatial maps identify hot spots of the double burden of malnutrition that can assist the government and donor agencies in channeling resources efficiently.

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Low- and middle-income countries have been experiencing double burden of malnutrition.

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The generated spatial maps identify hot spots of the double burden of malnutrition.

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Carefully thought-out policy plans are required to curb the challenges of the double burden of malnutrition.

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Burden of undernutrition has decreased but the cost of being overweight or obese is increasing among women.

The association between core job components, physical activity, and mental health in African academics in a post-COVID-19 context

This study examined the association between core job components (i.e. teaching, research, and student assessment), physical activity (PA), and mental health in a post-COVID-19 context. An online questionnaire administered via Google Forms was used to gather data from 1064 African academics in four countries. A sensitivity analysis was applied to adjust for covariates. Data were analyzed with the hierarchical linear regression analysis. The average age of participants was 44 years. The study found that PA was positively associated with research but negatively associated with student assessment. Mental health was positively associated with onsite teaching but negatively associated with online teaching and research. PA did not predict mental health and mediate the relationship between the job components and mental health. It is concluded that PA may not increase mental health in African academics in a post-COVID-19 situation that required the resumption of work while observing social distancing protocols.

Impact of lockdown COVID-19 on metabolic control in type 2 diabetes mellitus and healthy people

AIMS

The impact of prolonged COVID-19 lockdown on metabolic control in type 2 diabetes patients and healthy individuals has not exactly been known. We aimed to evaluate the change in body weight and metabolic control in type 2 diabetic and non-diabetic healthy subjects during the prolonged lockdown period.

METHODS

Diabetic (n = 85), and age-and sex-matched non-diabetic subjects (n = 55) were included in this prospective study. Body mass index and metabolic parameters were compared between before and 6th months of lockdown. Changes in values were evaluated using the difference before and after lockdown.

RESULTS

Age (54.81 ± 10.53 vs. 52.61 ± 4.88 years), gender (female, 68.2% vs. 56.4%) and, BMI (33.44 ± 6.48 vs. 31.63 ± 3.57 kg/m²) were similar between groups (p > 0.05). Before and after lockdown, BMI increased both in non-diabetic (0.54 ± 0.95 kg) and diabetic groups (1.91 ± 5.48 kg) (p > 0.05). Increase in HbA1c was more in diabetic than in non-diabetic groups (0.71 ± 1.35 vs. 0.02 ± 0.19%, p = 0.002). Glucose, LDL-C, and TG increased in diabetic (39.69 ± 74.69, 7.60 ± 34.33, and 58.21 ± 133.54 mg/dl, p < 0.05) whereas non significantly decreased in non-diabetic group (-0.51 ± 4.40, -3.52 ± 14.53, and -6.47 ± 41.77 mg/dl, respectively. After adjusting BMI, increase in blood glucose (p = 0.021), HbA1c (p = 0.018), and TG (p = 0.041) levels were more in diabetic than non-diabetic group. Duration of diabetes was an independent predictor of the change in HbA1c (OR: 1.2, 95% CI = 1.1-1.8, p = 0.032).

CONCLUSIONS

Body weight gain was observed in type 2 diabetic patients and healthy subjects. This is the first study to show that prolonged lockdown COVID-19 pandemic worsened glucose regulation and increased TG level in diabetes mellitus independent of weight gain.

Sitting dynamics during computer work are age-dependent

This laboratory study aimed to characterize the dynamics of sitting during a 40 min computer task in 20 younger (YG) and 18 older (OG) computer users. The position of the center of pressure (COP) in anterior-posterior (AP) and medial-lateral (ML) direction was computed. The range, velocity, area, standard deviation (SD) and sample entropy (SaEn) values were extracted. The range, velocity and area of the COP displacement were larger in the AP while the SD and SaEn were respectively larger and smaller in both AP and ML for the OG than the YG. The findings revealed altered dynamics of sitting among older computer users.

Patterns and Predictors of Sitting among Women from Disad-Vantaged Neighbourhoods over Time: A 5-Year Prospective Cohort Study

Background: Our aim was to describe patterns of sitting over time and determine the sociodemographic predictors of sitting over time among women living in socioeconomically disadvantaged neighbourhoods. Methods: Women age between 18 and 45 years (mean = 34.4 ±8.1, n = 4349) reported their sitting time, sociodemographic (e.g., age), and health (e.g., body mass index) three times over 5 years. Linear mixed modelling was used to determine the predictors of change in sitting over time, adjusting for covariates. Results: Mean baseline sitting time was 40.9 h/week, decreasing to 40.1 h/week over five years. Greater sitting time was reported in participants ≤25 years of age, living with obesity, living in urban areas, self-reported poor/fair health, working full-time, with higher education, never married and with no children. Annually, the average sitting time decreased by 0.4 h/week (95% CI; -0.7 to -0.05) in women working full-time but increased by 0.1 h/week (95% CI; -0.2 to 0.6) who were not working. Similarly, annual sitting time decreased by 0.6 h/week (95% CI; -0.2 to 1.3) in women with no children but increased by 0.4 h/week (95% CI; -0.2 to 0.5) and 0.9 h/week (95% CI; 0.3 to 1.3) among those with two and three/more children, respectively. Conclusion: Among disadvantaged women, those not working and with two or more children may be at particular risk for increased sitting time and warrant further attention.

Advancing health-enhancing physical activity at workplace: Sport4Heath 2020 scientific forum

Physical activity at workplace can positively impact various wellbeing outcomes yet developing and implementing exercise programs that are straightforward, time-efficient and widely applicable remains a notable public health challenge. Sport4Health Network (SPORT4H) project co-funded by the European Union Erasmus+ programme unites health and sport professionals in an effort to encourage participation in physical activity among working population and reduce health risk factors for lifestyle diseases. A two-day SPORT4H scientific forum on non-traditional types of work-place exercise interventions was organized from 14th to 15th September 2020, to critically evaluate evidence on stretching and resistance exercise programs targeted to working population in aim to identify knowledge gaps and future areas of research and application. Evidence on traditional interventions (e.g., walking initiatives, active travel) appears more robust while only few studies evaluated the applicability of non-traditional PA programs in working population. However, we identified a moderate-to-strong link between non-traditional PA programs at the workplace and several health-related physical fitness indices, with resistance exercise turned out to be superior to other exercise interventions analyzed. It appears that low-volume high-repetition resistance exercise favorably affects musculoskeletal disorders, work performance and health-related quality of life in employees who exercised at least 3 times per week for over 8 weeks. In terms of safety, screening protocols should employ health-related questionnaires, adopting a progressive training load, and prescribing training programs to individual participants' needs. Implementing non-traditional PA programs aimed to improve health-related physical fitness and counteract sedentary behavior at workplace might be therefore of utmost importance to contribute to health promotion in this sensible population.

The Effect of Domain-Specific Sitting Time and Exercise Habits on Metabolic Syndrome in Japanese Workers: A Cross-Sectional Study

The effects of domain-specific (i.e., occupational, leisure-time on workday, and holiday) sitting time (ST), and exercise on metabolic syndrome (MetS) development are insufficiently studied. The present study aimed to examine the single and combined effects of each domain-specific ST and exercise habits on MetS. The total and domain-specific STs of 5530 participants were collected using a validated questionnaire. The multiple logistic regression analyses determined the effects of each domain-specific ST and exercise habit on MetS. Of all participants, 7.8% had MetS. Odds ratios (ORs) for MetS were significant only in the group with the longest leisure-time ST on holidays (OR, 1.43; 95% confidence interval [CI], 1.12-1.83); we found no significant associations with any other domain-specific ST after statistical adjustment for confounders. The no-habitual-exercise group clearly had a higher risk for MetS (OR, 1.44; 95% CI, 1.15-1.80). The significantly higher ORs for MetS was shown in only the combined longer total ST (OR, 1.64; 95% CI, 1.12-2.39) and holiday ST (OR, 1.83; 95% CI, 1.30-2.59) with no habitual exercise. These findings suggested that accumulated daily total ST, particularly leisure-time ST on holidays with no-habitual exercise, can increase the risk of MetS and it could possibly be mitigated by habitual exercise.

Are long working hours associated with weight-related outcomes? A meta-analysis of observational studies

The relationship between long working hours and body weight outcomes remains inconclusive; thus, we conducted a meta-analysis to assess the effect of long working hours on weight-related outcomes. PubMed and Embase databases were searched from their inception to June 2019. A random-effects model was used to assess the pooled odds ratio (OR) and corresponding confidence interval (CI). Subgroup analyses and sensitivity analyses were conducted to explore sources of heterogeneity. Publication bias was evaluated by the Begg's and Egger's tests. A total of 29 articles involving 374 863 participants were included. The pooled OR of long working hours on weight-related outcomes was 1.13 (95% CI, 1.07-1.19). In subgroup analysis stratified by definition of outcomes, the pooled ORs of long working hours on "weight gain/BMI increase," "BMI ≥ 25 kg/m² ," and "BMI ≥ 30 kg/m² " were 1.19 (95% CI, 1.02-1.40), 1.07 (95% CI, 1.00-1.14), and 1.23 (95% CI, 1.09-1.39), respectively. We found evidence of publication bias, but correction for this bias using the trim-and-fill method did not alter the combined OR substantially. There was evidence to suggest that long working hours are associated with adverse weight-related outcomes. Preventative interventions such as improved flexibility and healthy working schedules should be established for employees.

Correlates of Total and domain-specific Sedentary behavior: a cross-sectional study in Dutch adults

Background

Sedentary behavior (SB) is associated with increased risks of detrimental health outcomes. Few studies have explored correlates of SB in physically active individuals. Furthermore, SB correlates may depend on settings of SB, such as occupation, transportation and leisure time sitting. This study aims to identify subject-, lifestyle- and health-related correlates for total SB and different SB domains: transportation, occupation, and leisure time.

Methods

Dutch participants were recruited between June, 2015 and December, 2016. Participant characteristics (i.e. age, sex, weight, height, marital status, education level, employment), lifestyle (sleep, smoking, alcohol consumption, physical activity) and medical history were collected via an online questionnaire. SB was assessed using the Sedentary Behavior Questionnaire and estimated for 9 different activities during weekdays and weekend days. Logistic regression was used to calculate odds ratios and 95% confidence intervals for the association between correlates and SB. Total SB was dichotomized at > 8 h/day and > 10 h/day, and being sedentary during transportation, occupation and leisure time at the 75th percentile (60 min/day, 275 min/day and 410 min/day, respectively).

Results

In total, 8471 participants (median age 55, 55% men) were included of whom 86% met the physical activity guidelines. Median SB was 9.1 h/day (Q₂₅ 6.3-Q₇₅ 12.0) during weekdays and 7.4 h/day (Q₂₅ 5.5-Q₇₅ 9.5) during weekend days. SB was most prevalent during leisure time (5.3 h/day; Q₂₅ 3.9-Q₇₅ 6.8), followed by occupation (2 h/day; Q₂₅ 0.1-Q₇₅ 4.6) and transportation (0.5 h/day; Q₂₅ 0.2-Q₇₅ 1.0). Younger age, male sex, being unmarried, higher education, employment and higher BMI were significantly related to higher levels of total SB. Younger age, male sex, employment, and higher BMI increased the odds for high SB volumes during occupation and transportation. Higher education, being unmarried and smoking status were positively associated with high volumes of occupational SB only, whereas older age, being unmarried, unemployment, higher BMI and poor health were positively linked to leisure time SB.

Conclusions

SB is highly prevalent in physically active individuals, with SB during leisure time as the most important contributor. Correlates for high volumes of SB vary substantially across SB domains, emphasizing the difficulty to target this unhealthy lifestyle.

The descriptive epidemiology of sitting in Chilean adults: Results from the National Health Survey 2009-2010

BACKGROUND

Although evidence on the health effects of sedentary behavior (SB) has grown systematically in recent years, few developing countries have reported population levels of SB, especially in South America. Our objective was to describe time spent sitting in a representative sample from Chile categorized by age, gender, educational level, and body mass index (BMI).

METHODS

A national health survey was conducted in Chile in a nationally representative sample (n = 5411) in 2009-2010. Sitting time (ST) was measured with the Global Physical Activity Questionnaire Version 2.

RESULTS

Data were from 5031 participants (43.26 ± 0.41 years, mean ± SE; 40.3% male). Overall, there were no gender differences in mean ST (men: 158.10 ± 5.80 min/day, women 143.45 ± 4.77 min/day; p = 0.05). ST was lower in those who lived in rural areas compared with urban areas (99.4 min/day vs. 160.0 min/day; p = 0.001). ST increased significantly with increasing BMI, but only in men (p = 0.009), and was positively related to years of education in both men and women (p < 0.0001).

CONCLUSION

The findings were different from those reported in other countries and contexts, reinforcing the need for international surveillance and monitoring over time to inform policy makers. Differences in ST across different groups emphasize the need to develop tailored messages and interventions for reducing ST in different population subgroups.

Roles of Sedentary Behaviors and Unhealthy Foods in Increasing the Obesity Risk in Adult Men and Women: A Cross-Sectional National Study

Sedentary behaviors and dietary intake are independently associated with obesity risk. In the literature, only a few studies have investigated gender differences for such associations. The present study aims to assess the association of sedentary behaviors and unhealthy foods intake with obesity in men and women in a comparative manner. The analysis presented in this study was based on the data from a population-based, cross-sectional, nationally representative survey (Indonesian Basic Health Research 2013/RISKESDAS 2013). In total, 222,650 men and 248,590 women aged 19–55 years were enrolled. A validated questionnaire, physical activity card, and food card were used for the assessments. The results showed that the prevalence of obesity (body mass index of ≥27.5 kg/m²) was higher in women (18.71%) than in men (8.67%). The mean body mass index in women tended to be higher than in men. After adjusting for age and education, the gender effect on obesity persisted in women and was more significant than in men. There was also a positive and significant effect on obesity of sedentary behaviors and unhealthy foods intake. Moreover, fatty and fried foods displayed a positive multiplicative interaction, increasing obesity risk in women more than in men and indicating a possible dietary risk in in women in relation to obesity. The study suggests that the implementation of educational programs on nutrition and physical activity is particularly important for promoting a healthy body weight among Indonesian women.

Diet and physical activity as possible mediators of the association between educational attainment and body mass index gain among Australian adults

OBJECTIVES

To quantify the mediating role of leisure time physical activity (LTPA) and five dietary behaviours on educational differences in 13-year body mass index (BMI) gain across adulthood.

METHODS

Participants from the Melbourne Collaborative Cohort Study (4791 women; 3103 men) who maintained or gained BMI over 1990-1994 to 2003-2007 and met our inclusion criteria were selected. Education, potential mediators and confounders (age, alcohol, and smoking) were measured at baseline. We conducted sex-specific multiple mediation analyses using MacKinnon's product of coefficients method.

RESULTS

A higher educational attainment was associated with a 0.27 kg m^-2 (95% CI 0.14, 0.39) lesser 13-year BMI gain among women only. We observed significant indirect effects of educational attainment on 13-year BMI gain through LTPA and nutrient-rich foods (each associated with a higher educational attainment and lesser 13-year BMI gain) and diet soft drink (associated with a lower educational attainment and greater 13-year BMI gain), which mediated 10, 15 and 20% of this relationship, respectively (45% in total).

CONCLUSIONS

Nutrient-rich foods, LTPA and diet soft drink may represent effective public health targets to reduce inequities in excess weight across adulthood.

Patterns of sedentary behavior in overweight and moderately obese users of the Catalan primary-health care system

Background and objectives

Prolonged sitting time (ST) has negative consequences on health. Changing this behavior is paramount in overweight/obese individuals because they are more sedentary than those with normal weight. The aim of the study was to establish the pattern of sedentary behavior and its relationship to health, socio-demographics, occupation, and education level in Catalan overweight/obese individuals.

Methods

A descriptive study was performed at 25 healthcare centers in Catalonia (Spain) with 464 overweight/moderately obese patients, aged25 to 65 years. Exclusion criteria were chronic diseases which contraindicated physical activity and language barriers. Face-to-face interviews were conducted to collect data on age, gender, educational level, social class, and marital status. Main outcome was ‘sitting time’ (collected by the Marshall questionnaire); chronic diseases and anthropometric measurements were registered.

Results

464 patients, 58.4% women, mean age 51.9 years (SD 10.1), 76.1% married, 60% manual workers, and 48.7% had finished secondary education. Daily sitting time was 6.2 hours on working days (374 minutes/day, SD: 190), and about 6 hours on non-working ones (357 minutes/day, SD: 170). 50% of participants were sedentary ≥6 hours. The most frequent sedentary activities were: working/academic activities around 2 hours (128 minutes, SD: 183), followed by watching television, computer use, and commuting. Men sat longer than women (64 minutes more on working days and 54 minutes on non-working days), and individuals with office jobs (91 minutes),those with higher levels of education (42 minutes), and younger subjects (25 to 35 years) spent more time sitting.

Conclusions

In our study performed in overweight/moderately obese patients the mean sitting time was around 6 hours which was mainly spent doing work/academic activities and watching television. Men, office workers, individuals with higher education, and younger subjects had longer sitting time. Our results may help design interventions targeted at these sedentary patients to decrease sitting time.

Sitting Time and Obesity or Abdominal Obesity in Older South Koreans: Korean National Health and Nutrition Examination Survey 2013

We examined relationships between sitting time and obesity or abdominal obesity according to sex and socioeconomic status in elderly people. We analyzed data from the Korean National Health and Nutrition Examination Survey 2013, and 1565 participants were included in the study. Multivariate logistic regression analysis was used to examine relationships between sitting time and obesity or abdominal obesity according to sex and socioeconomic status. Sitting time was positively correlated with body mass index in men and women and waist circumference in men. When considering socioeconomic factors, men who sat for 5 hours or longer and fell within the lowest income were more likely to have obesity and abdominal obesity relative to men who sat for 5 hours or shorter and earned higher incomes (odds ratio [95% confidence interval] = 1.80 [1.14-2.84] and 1.63 [1.02-2.61] respectively), and women who sat for 5 hours or longer and fell within the lowest educational level were more likely to have obesity relative to women who sat for 5 hours or less and were educated to a higher level (1.24 [1.01-1.85]). Strategies to reduce sedentary behavior would help to prevent obesity in older men who earn low incomes and women with lower levels of educational attainment.

Sedentariness and weight status related to SES and family characteristics in Italian adults: exploring geographic variability through multilevel models

AIM

In this study, our aim was to assess the prevalence of sedentariness and overweight/obesity, two modifiable risk factors for non-communicable diseases (NCDs), and to investigate the geographic variability in their association with socio-economic status (SES) and family characteristics in Italian adults.

METHODS

The Multipurpose Survey on Health Conditions and the Recourse to Health Services (MSHC), 2012/2013 edition, conducted by the National Institute of Statistics was used as data source. The sample for this study included 99,479 interviewed people aged 18 and over, which are representative of about 50 million persons. For the scope of this analysis, data were considered as individuals nested within families within regions and analysed through multilevel models.

RESULTS

It was estimated that 39.8% of Italian adults are sedentary, 38.1% are partially active and 22.1% are physically active; 11.3% of Italian adults are obese and the 34.5% are overweight. There was evidence of inverse socio-economic gradient for both sedentariness and body mass index (BMI). There was higher risk of sedentariness for one-parent (odds ratio (OR) = 1.10; 95% confidence interval (CI) = (1.02; 1.20)) and other family types (OR = 1.34; 95% CI = (1.20; 1.48 )) compared with couples with children. Also, the relative variation of BMI was statistically significant for one-parent, one-person and other families ( p < 0.05). An increasing north-south gradient was suggested for BMI, but not for sedentariness.

CONCLUSIONS

Policy interventions could be addressed to reduce BMI levels in the southern area and to encourage physical activity in regions with high sedentariness. The Italian family is the key driver to promote virtuous healthy behaviours.

Correlates of sedentary behaviour in adults: a systematic review

OBJECTIVE

The objective of this study was to systematically review evidence to identify intrapersonal, social environmental, physical environmental and policy correlates of sedentary behaviour (SB) among adults.

METHODS

Six databases were searched to identify studies that reported on intrapersonal, social, physical environmental and/or policy correlates of SB across domains (i.e. occupational, leisure and transportation) in adults (mean ≥ 18 years old). Subgroup differences (sex, age, disease status, publication status and date, weekdays vs. weekend) were examined. Risk of bias was assessed, and a qualitative synthesis completed.

PROSPERO

CRD42014009814 RESULTS: Searching identified 22,779 articles; 257 were used in the analysis. Most studies used self-reported SB and were cross-sectional. The most studied domain of SB and correlate was leisure and intrapersonal, respectively. Consistent evidence found positive relationships between full-time employment and higher transportation and lower leisure SB; higher income/socioeconomic status and greater transportation and occupation SB; living in more urban areas and greater sitting time and total SB; ownership of televisions and greater leisure SB; and, active workstations and lower occupational SB.

CONCLUSIONS

The review identifies the need for longitudinal studies, as well as further research on factors in the physical, social and policy environments. The review also recognizes the need to standardize methodology for collecting, defining and reporting SB and correlates.

The Effect of Changes in Physical Activity on Sedentary Behavior: Results From a Randomized Lifestyle Intervention Trial

PURPOSE

To investigate whether changes in physical activity (PA) have an impact on sedentary behavior (SB) during a lifestyle intervention.

DESIGN

Study design was a randomized trial.

SETTING/SUBJECTS

Participants (n = 204) were individuals with low PA and high sedentary leisure screen time from the Chicago area.

INTERVENTION

Participants were randomized to either increase PA (iPA) or decrease sedentary leisure (dSED). The intervention consisted of decision support, coaching, and financial incentives. For iPA participants, the goal was at least 60 min/d of self-reported moderate-tovigorous-intensity PA (MVPA). For dSED participants the goal was less than 90 min/d of sedentary leisure screen time.

MEASURES

Daily accelerometer-based measures of SB and bout-corrected MVPA were obtained.

ANALYSIS

Linear mixed-effects models were fit to estimate the effect of the intervention on MVPA and total SB and to estimate the effect of daily changes in MVPA on daily SB.

RESULTS

The iPA participants increased their bout-corrected MVPA by 14 min/d (p < .001) and decreased their total SB by 18 min/d (p < .001). The dSED participants did not significantly change their PA or their total SB. On days when participants exercised, each 10-minute bout of MVPA was associated with a 6-minute decrease in SB on the same day (p < .001).

CONCLUSION

In an intervention study designed to increase MVPA, participants who increase their time spent exercising will obtain much of this time by reducing their SB.

Level of Sedentary Behavior and Its Associated Factors among Saudi Women Working in Office-Based Jobs in Saudi Arabia

Research in Saudi Arabia has revealed a shocking level of insufficiently physically active adults, particularly women. The risk of sedentary behavior will likely increase as the number of women with office-based jobs increases. The aim of this study is to determine the level of sedentary behavior, and its associated factors, among Saudi women working office-based jobs in the city of Riyadh. A cross-sectional study of 420 Saudi female employees at 8 office-based worksites were measured to determine body mass index and were given a self-administered survey to evaluate their level of physical activity and sedentary behavior. Median sitting time on work days was 690 min per day (interquartile range, IQR 541–870), with nearly half accumulated during work hours, and 575 min per day (IQR 360–780) on non-work days. Predictors of work day sitting time were level of education, number of children, and working in the private sector. Number of children, whether they were single, and whether they lived in a small home were found to predict non-work day sitting time. This study identifies Saudi women in office-based jobs as a high-risk group for sedentary behavior. There is a need to promote physical activity at worksites and reduce prolonged sitting.

TAxonomy of Self-reported Sedentary behaviour Tools (TASST) framework for development, comparison and evaluation of self-report tools: content analysis and systematic review

OBJECTIVE

Sedentary behaviour (SB) has distinct deleterious health outcomes, yet there is no consensus on best practice for measurement. This study aimed to identify the optimal self-report tool for population surveillance of SB, using a systematic framework.

DESIGN

A framework, TAxonomy of Self-reported Sedentary behaviour Tools (TASST), consisting of four domains (type of assessment, recall period, temporal unit and assessment period), was developed based on a systematic inventory of existing tools. The inventory was achieved through a systematic review of studies reporting SB and tracing back to the original description. A systematic review of the accuracy and sensitivity to change of these tools was then mapped against TASST domains.

DATA SOURCES

Systematic searches were conducted via EBSCO, reference lists and expert opinion.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

The inventory included tools measuring SB in adults that could be self-completed at one sitting, and excluded tools measuring SB in specific populations or contexts. The systematic review included studies reporting on the accuracy against an objective measure of SB and/or sensitivity to change of a tool in the inventory.

RESULTS

The systematic review initially identified 32 distinct tools (141 questions), which were used to develop the TASST framework. Twenty-two studies evaluated accuracy and/or sensitivity to change representing only eight taxa. Assessing SB as a sum of behaviours and using a previous day recall were the most promising features of existing tools. Accuracy was poor for all existing tools, with underestimation and overestimation of SB. There was a lack of evidence about sensitivity to change.

CONCLUSIONS

Despite the limited evidence, mapping existing SB tools onto the TASST framework has enabled informed recommendations to be made about the most promising features for a surveillance tool, identified aspects on which future research and development of SB surveillance tools should focus.

TRIAL REGISTRATION NUMBER

International prospective register of systematic reviews (PROPSPERO)/CRD42014009851.

Empirically derived cut-points for sedentary behaviour: are we sitting differently?

Sedentary behaviour (SB) is associated with a number of adverse health outcomes. Studies that have used ActiGraph monitors to define sedentary time tend to use a threshold of  <100 counts per minute (cpm) for classifying SB; however, this cut-point was not empirically derived for adults. It is not known whether ActiGraph cut-points for SB differ depending on the context in which it occurs. We aimed to: (1) empirically derive an optimal threshold for classifying SB, using the cpm output from the ActiGraph GT3X+, compared to the sedentary classification from the activPAL3^™; and (2) ascertain whether this varied by day of the week and in working time versus non-working time. A convenience sample of 30 office-based university employees (females (66.67%); age 40.47  ±  10.95 years; BMI 23.93  ±  2.46 kg m^-2) wore the ActiGraph GT3X+ and activPAL3^™ devices simultaneously for seven days. Data were downloaded in 1 min epochs and non-wear time was removed. Generalised estimating equations were used to make minute by minute comparisons of sedentary time from the two devices, using sedentary minutes (when all 60 s were classified as sitting/lying) from the activPAL3^™ as the criterion measure. After data reduction participants provided on average 11 h 27 min of data per day. The derived cut-points from the models were significantly higher on a Saturday (97 cpm) compared to weekdays (60 cpm) and Sunday (57 cpm). Derived cpm for sedentary time during working time were significantly lower compared to non-working time (35 (95%CI 30-41) versus 73 (54-113)). Compared to the 100 cpm and 150 cpm thresholds, the empirically derived cut-points were not significantly different in terms of area-under-the-curve, but had lower mean bias for working and non-working times. Accelerometer cut-points for SB can depend on day and also domain, suggesting that the nature of sitting differs depending on the context in which sedentary time is accrued.

Socio-Economic, Demographic and Lifestyle Determinants of Overweight and Obesity among Adults of Northeast India

Background

Overweight and obesity are the accumulation of high body adiposity, which can have detrimental health effects and contribute to the development of numerous preventable non-communicable diseases. This study aims to evaluate the effect of socio-economic, demographic and lifestyle factors on the prevalence of overweight and obesity among adults belonging to the Rengma-Naga population of North-east India.

Methods

This cross-sectional study was conducted among 826 Rengma-Naga individuals (males: 422; females: 404) aged 20–49 years from the Karbi Anglong District of Assam, using a two-stage stratified random sampling. The socio-economic, demographic and lifestyle variables were recorded using structured schedules. Height and weight were recorded and the Body Mass Index (BMI) was calculated using standard procedures and equation. The WHO (2000) cut-off points were utilized to assess the prevalence of overweight (BMI ≥23.00–24.99 kg/m²) and obesity (BMI ≥25.00 kg/m²). The data were analysed using ANOVA, chi-square analysis and binary logistic regression analysis using SPSS (version 17.0).

Results

The prevalence of overweight and obesity were 32.57% (males: 39.34%; females: 25.50%) and 10.77% (males: 9.95%; females: 11.63%), respectively. The binary logistic regression analysis showed that age groups (e.g., 40–49 years), education (≥9^th standard), part-time occupation and monthly income (≥Rs.10000) were significantly associated with overweight and obesity (p<0.05).

Conclusions

Age, education occupation and income appear to have higher associations with overweight and obesity among adults. Suitable healthcare strategies and intervention programmes are needed for combating such prevalence in population.

Associations of sitting time and occupation with metabolic syndrome in South Korean adults: a cross-sectional study

BACKGROUND

Previous evidence suggests that there is a correlation between prolonged sitting time and cardio-metabolic disease, such as metabolic syndrome (MS). Cardiovascular disease is the second-leading cause of mortality in South Korea, a country with the longest working hours among all member states of the Organization for Economic Co-operation and Development. However, no previous study has investigated the relationships of overall sitting-time and occupation with MS in South Korea. Accordingly, the present study examined these relationships in a South Korean population.

METHODS

Data from the sixth Korean National Health and Nutrition Examination Survey (KNHANES), a nationally representative survey with a cross-sectional design, were used in the present study. MS diagnoses were evaluated using the International Diabetes Foundation (IDF) criteria. Participants self-reported their overall sitting times, and occupations were classified using the Korean version of the Standard Classification of Occupations (KSCO). A multiple logistic regression analysis was conducted to evaluate the associations of sitting time and occupation with MS.

RESULTS

The risk of MS was 1.21-fold higher among participants who sat for >7 h/day than among those who sat for ≤7 h/day (odds ratio [OR]: 1.21, 95 % confidence interval [CI]: 1.00-1.46). Regarding occupation, office workers had a two-fold higher risk of MS than did agriculture, forestry, and fishery (AFF) workers (OR: 2.01, 95 % CI: 1.26-3.22). In a combined analysis of sitting time and occupation, male participants who sat for >7 h/day and reported an occupation that involves office work (OW) or machine fitting (MF) were significantly more likely to have MS when compared to those who sat for ≤7 h/day and were employed as AFF workers (>7 h/day × OW, OR: 2.41, 95 % CI: 1.05-5.51; >7 h/day × MF, OR: 2.92, 95 % CI: 1.43-5.93).

CONCLUSIONS

Excessive sitting time and a sedentary occupation correlated positively with MS in South Korean adults. Accordingly, a reduction in the overall sitting time or inclusion of energy-expending activities in the workplace might improve the rate of MS.

Sedentary Behavior and Cardiovascular Morbidity and Mortality: A Science Advisory From the American Heart Association

Epidemiological evidence is accumulating that indicates greater time spent in sedentary behavior is associated with all-cause and cardiovascular morbidity and mortality in adults such that some countries have disseminated broad guidelines that recommend minimizing sedentary behaviors. Research examining the possible deleterious consequences of excess sedentary behavior is rapidly evolving, with the epidemiology-based literature ahead of potential biological mechanisms that might explain the observed associations. This American Heart Association science advisory reviews the current evidence on sedentary behavior in terms of assessment methods, population prevalence, determinants, associations with cardiovascular disease incidence and mortality, potential underlying mechanisms, and interventions. Recommendations for future research on this emerging cardiovascular health topic are included. Further evidence is required to better inform public health interventions and future quantitative guidelines on sedentary behavior and cardiovascular health outcomes.

Accelerometer-Measured Physical Activity and Sedentary Time Differ According to Education Level in Young Adults

This study examined the association of education level with objectively measured physical activity and sedentary time in young adults. Data from the Finnish ESTER study (2009–2011) (n = 538) was used to examine the association between educational attainment and different subcomponents of physical activity and sedentary time measured using hip-worn accelerometers (ActiGraph GT1M) for seven consecutive days. Overall physical activity, moderate-to-vigorous physical activity (MVPA), light-intensity physical activity and sedentary time were calculated separately for weekdays and weekend days. A latent profile analysis was conducted to identify the different profiles of sedentary time and the subcomponents of physical activity. The educational differences in accelerometer-measured physical activity and sedentary time varied according to the subcomponents of physical activity, and between weekdays and weekend days. A high education level was associated with high MVPA during weekdays and weekend days in both sexes, high sedentary time during weekdays in both sexes, and a low amount of light-intensity physical activity during weekdays in males and during weekdays and weekend days in females. The results indicate different challenges related to unhealthy behaviours in young adults with low and high education: low education is associated with a lack of MVPA, whereas high education is associated with a lack of light-intensity physical activity and high sedentary time especially during weekdays.

A systematic review of correlates of sedentary behaviour in adults aged 18-65 years: a socio-ecological approach

Background

Recent research shows that sedentary behaviour is associated with adverse cardio-metabolic consequences even among those considered sufficiently physically active. In order to successfully develop interventions to address this unhealthy behaviour, factors that influence sedentariness need to be identified and fully understood. The aim of this review is to identify individual, social, environmental, and policy-related determinants or correlates of sedentary behaviours among adults aged 18–65 years.

Methods

PubMed, Embase, CINAHL, PsycINFO and Web of Science were searched for articles published between January 2000 and September 2015. The search strategy was based on four key elements and their synonyms: (a) sedentary behaviour (b) correlates (c) types of sedentary behaviours (d) types of correlates. Articles were included if information relating to sedentary behaviour in adults (18–65 years) was reported. Studies on samples selected by disease were excluded. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42014009823).

Results

74 original studies were identified out of 4041: 71 observational, two qualitative and one experimental study. Sedentary behaviour was primarily measured as self-reported screen leisure time and total sitting time. In 15 studies, objectively measured total sedentary time was reported: accelerometry (n = 14) and heart rate (n = 1). Individual level factors such as age, physical activity levels, body mass index, socio-economic status and mood were all significantly correlated with sedentariness. A trend towards increased amounts of leisure screen time was identified in those married or cohabiting while having children resulted in less total sitting time. Several environmental correlates were identified including proximity of green space, neighbourhood walkability and safety and weather.

Conclusions

Results provide further evidence relating to several already recognised individual level factors and preliminary evidence relating to social and environmental factors that should be further investigated. Most studies relied upon cross-sectional design limiting causal inference and the heterogeneity of the sedentary measures prevented direct comparison of findings. Future research necessitates longitudinal study designs, exploration of policy-related factors, further exploration of environmental factors, analysis of inter-relationships between identified factors and better classification of sedentary behaviour domains.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-2841-3) contains supplementary material, which is available to authorized users.

Physical activity and sedentary behavior in bariatric patients long-term post-surgery

BACKGROUND

To measure sedentary behaviors and physical activity using accelerometry in participants who have undergone bariatric surgery 8.87 ± 3.78 years earlier and to compare these results with established guidelines.

METHODS

Participants' weight and height were measured, an ActivPAL™3 accelerometer and sleeping journal were used to determine day sedentary time, transitions from sitting to standing, as well as steps/day, and participants were asked to indicate if they felt that they were currently less, the same, or more active than before surgery.

RESULTS

Participants averaged 48 ± 15 transitions/day, 6375 ± 2690 steps/day, and 9.7 ± 2.3 h/day in sedentary positions. There was a negative correlation between steps/day and sedentary time (r = -.466, p ≤ .001), 11.27 % of participants achieved 10,000 steps/day. Participants who reported being more active prior to surgery averaged 6323.4 ± 2634.79 steps/day, which was not different from the other two groups of self-perceived change in level of physical activity (F (2, 68) = .941, p ≤ .05) from pre- to post-surgery.

CONCLUSIONS

Participants were inadequately active and overly sedentary compared to established guidelines and norms. Healthcare workers should be taking physical activity and sedentary time into account when creating post-surgical guidelines for this population to ensure the best long-term weight loss maintenance and health outcomes.

A prospective study of sedentary behavior and changes in the body mass index distribution

PURPOSE

We aimed to determine whether baseline sedentary behavior was associated with changes in body mass index (BMI) over 9 yr.

METHODS

Participants were enrolled into the National Institutes of Health American Association of Retired Persons (NIH-AARP) Diet and Health study in 1995-1996 (median age, 63 yr), and BMI was reported at baseline and 9 yr later (n = 158,436). Sitting time (<3 (referent), 3-4, 5-6, 7-8, or ≥9 h·d), television viewing (none, <1, 1-2, 3-4, 5-6, 7-8, or ≥9 h·d), and the covariates (age, sex, race, education, smoking, moderate-to-vigorous physical activity, caloric intake, and sleep duration) were reported at baseline. We used longitudinal quantile regression to model changes at the 10th, 25th, 50th, 75th, and 90th BMI percentiles.

RESULTS

More sitting at baseline was associated with additional increases in BMI over time, and the association was stronger at the upper BMI percentiles (e.g., <3 (referent) vs 5-6 h·d of sitting additional increases: 50th percentile = 0.41 kg·m and 95% confidence interval (CI) = 0.34-0.48; 90th percentile = 0.85 kg·m and 95% CI = 0.72-0.98). Similar associations were observed between more television viewing at baseline and additional increases in BMI over time (e.g., no television (referent) vs 3-4 h·d of television: 50th percentile = 1.96 kg·m and 95% CI = 1.77-2.15; 90th percentile = 2.11 kg·m and 95% CI = 1.49-2.73).

CONCLUSIONS

Reducing sedentary behavior could help prevent an increase in BMI in adulthood especially at the upper percentiles of the BMI distribution and thereby reduce the prevalence of obesity.

Maternal efficacy and sedentary behavior rules predict child obesity resilience

BACKGROUND

To identify longitudinal individual, social and environmental predictors of adiposity (BMI z-score), and of resilience to unhealthy weight gain, in healthy weight children and adolescents.

METHODS

Two hundred healthy weight children aged 5-12 years at baseline and their parents living in socio-economically disadvantaged neighborhoods were surveyed at baseline and three years later. Children's height and weight were objectively measured, parents completed a detailed questionnaire that examined the home, social and neighborhood environments, and objective measures of the neighborhood environment were assessed using geographic information system data. Children classified as healthy weight at baseline who had small or medium increases in their BMI z-score between baseline and three year follow up (those in the bottom and middle tertiles) were categorized as 'resilient to unhealthy weight gain'. Where applicable, fully adjusted multivariable regression models were employed to determine baseline intrapersonal, social and environmental predictors of child BMI z-scores at follow-up, and resilience to unhealthy weight gain at follow-up.

RESULTS

Maternal efficacy for preventing their child from engaging in sedentary behaviors (B = -0.03, 95 % CI: -0.06, 0.00) was associated with lower child BMI z-score at follow up. Rules to limit sedentary behaviors (OR = 1.14, 95 % CI: 1.03, 1.25) was a predictor of being resilient to unhealthy weight gain.

CONCLUSION

The findings suggest that strategies to support parents to limit their children's sedentary behavior may be important in preventing unhealthy weight gain in socioeconomically disadvantaged communities.

Impact of travel mode shift and trip distance on active and non-active transportation in the São Paulo Metropolitan Area in Brazil

Background

Changes in urban mobility play a major role in transforming metropolitan areas into healthier places. This study quantified the impact of changes in travel mode shift and trip distance on active and non-active transportation of working age adult population of São Paulo.

Methods and findings

Through different scenarios, we estimated the daily time spent in transportation per inhabitant (divided in active and non-active transportation time) and the proportion of inhabitants accumulating 30 min or more of daily active transportation. The replacement of individual for collective motorized modes in long distance trips (> 1000 m) in combination with the substitution of long for short trips positively impacted all outcomes. Compared to the current situation, there was an increase in the active transportation time (from 19.4 to 26.7 min/inhabitant), which also increased the proportion of adults active for transportation (from 27.6% to 35.4%). Additionally, the non-active transportation time decreased (from 67.0 to 26.2 min/inhabitant), which helped to reduce the total time spent in transportation (from 86.4 to 52.9 min/inhabitant).

Conclusion

Transport and urban planning policies to reduce individual motorized trips and the number of long trips might produce important health benefits, both by increasing population levels of active transportation and reducing the non-active and the total time of daily trips.

•

Changes in urban mobility could increase population levels of physical activity.

•

Shorter trip distances reduce total and non-active daily commuting time.

•

Less car based transportation reduces total and non-active daily commuting time.

•

Increasing connectivity and compactness of cities could reduce car-based trips.

Work engagement and its association with occupational sitting time: results from the Stormont study

Background

Evidence suggests that poor health outcomes and poor work-related health outcomes such as sickness presenteeism are associated with excessive sitting at work. Studies have yet to investigate the relationship between work engagement and occupational sitting. Work engagement is considered to be an important predictor of work-related well-being. We investigated the relationship between and self-reported work engagement and high occupational sitting time in Northern Ireland Civil Service (NICS) office-based workers.

Method

A cohort of 4436 NICS office-workers (1945 men and 2491 women) completed a questionnaire measuring work engagement and occupational sitting time. Logistic regression analyses were used to test the associations between work engagement and occupational sitting times.

Results

Compared to women, men reported lower mean occupational sitting time (385.7 minutes/day; s.d. = 1.9; versus 362.4 minutes/day; s.d. =2.5; p < .0001). After adjusting for confounding variables, men with high work engagement of vigor (OR = 0.49, 95% CI 0.34-0.98) and dedication (OR 0.68 95% CI 0.47-0.98) were less likely to have prolonged sitting time. Women with high work engagement of vigor (OR = 0.62, 95% CI 0.45-0.84) were also less likely to have prolonged occupational sitting times. In contrast, women with high absorption (OR = 1.29, 95% CI 1.01-1.65) were more likely to have prolonged sitting times.

Conclusions

Being actively engaged in one’s work is associated with lower occupational sitting times for men (vigor and dedication) and to a limited extent for women (vigor only). This suggests that interventions such as introducing sit-stand workstations to reduce sitting times, may be beneficial for work engagement.

Descriptive epidemiology of domain-specific sitting in working adults: the Stormont Study

BACKGROUND

Given links between sedentary behaviour and unfavourable health outcomes, there is a need to understand the influence of socio-demographic factors on sedentary behaviour to inform effective interventions. This study examined domain-specific sitting times reported across socio-demographic groups of office workers.

METHODS

The analyses are cross-sectional and based on a survey conducted within the Stormont Study, which is tracking employees in the Northern Ireland Civil Service. Participants self-reported their daily sitting times across multiple domains (work, TV, travel, PC use and leisure) on workdays and non-workdays, along with their physical activity and socio-demographic variables (sex, age, marital status, BMI, educational attainment and work pattern). Total and domain-specific sitting on workdays and non-workdays were compared across socio-demographic groups using multivariate analyses of covariance.

RESULTS

Completed responses were obtained from 4436 participants. For the whole sample, total daily sitting times were higher on workdays in comparison to non-workdays (625 ± 168 versus 469 ± 210 min/day, P < 0.001). On workdays and non-workdays, higher sitting times were reported by individuals aged 18-29 years, obese individuals, full-time workers and single/divorced/widowed individuals (P < 0.001).

CONCLUSIONS

Interventions are needed to combat the high levels of sedentary behaviour observed in office workers, particularly among the highlighted demographic groups. Interventions should target workplace and leisure-time sitting.

Educational mobility and weight gain over 13 years in a longitudinal study of young women

Background

Limited evidence exists about the role of education and own educational mobility on body weight trajectory. A better understanding of how education influences long term weight gain can help us to design more effective health policies.

Methods

Using random effects models, the association between i) highest education (n = 10 018) and ii) educational mobility over a 9 year period (n = 9 907) and weight gain was analysed using five waves of data (over 13 years) from the Australian Longitudinal Study on Women’s Health 1973–78 cohort (from 18–23 years to 31–36 years).

Results

Highest educational attainment was inversely associated with weight at baseline and weight gain over 13 years. Compared to high educated women, those with a low (12 years or less) or intermediate (trade/certificate/diploma) education, respectively, weighed an additional 2.6 kg (95% CI:1.9 to 3.1) and 2.5 kg (95% CI:1.9 to 3.3) at baseline and gained an additional 3.9 kg (95% CI:2.6 to 5.2) and 3.1 kg (95% CI:2.6 to 3.9) over 13 years. Compared to women who remained with a low education, women with the greatest educational mobility had similar baseline weight to the women who already had a high education at baseline (2.7 kg lighter (95% CI:-3.7 to -1.8) and 2.7 kg lighter (95% CI:-3.4 to -1.9), respectively) and similarly favourable weight gain (gaining 3.1 kg less (95% CI:-4.0 to -2.21) and 4.2 kg less (95% CI:-4.8 to -3.4) over the 13 years, respectively).

Conclusions

While educational attainment by mid-thirties was positively associated with better weight management, women’s weight was already different in young adult age, before their highest education was achieved. These findings highlight a potential role of early life factors and personality traits which may influence both education and weight outcomes.

Electronic supplementary material

The online version of this article (doi:10.1186/1471-2458-14-1219) contains supplementary material, which is available to authorized users.

Effectiveness of a worksite mindfulness-based multi-component intervention on lifestyle behaviors

Introduction

Overweight and obesity are associated with an increased risk of morbidity. Mindfulness training could be an effective strategy to optimize lifestyle behaviors related to body weight gain. The aim of this study was to evaluate the effectiveness of a worksite mindfulness-based multi-component intervention on vigorous physical activity in leisure time, sedentary behavior at work, fruit intake and determinants of these behaviors. The control group received information on existing lifestyle behavior- related facilities that were already available at the worksite.

Methods

In a randomized controlled trial design (n = 257), 129 workers received a mindfulness training, followed by e-coaching, lunch walking routes and fruit. Outcome measures were assessed at baseline and after 6 and 12 months using questionnaires. Physical activity was also measured using accelerometers. Effects were analyzed using linear mixed effect models according to the intention-to-treat principle. Linear regression models (complete case analyses) were used as sensitivity analyses.

Results

There were no significant differences in lifestyle behaviors and determinants of these behaviors between the intervention and control group after 6 or 12 months. The sensitivity analyses showed effect modification for gender in sedentary behavior at work at 6-month follow-up, although the main analyses did not.

Conclusions

This study did not show an effect of a worksite mindfulness-based multi-component intervention on lifestyle behaviors and behavioral determinants after 6 and 12 months. The effectiveness of a worksite mindfulness-based multi-component intervention as a health promotion intervention for all workers could not be established.

The mediating role of dietary factors and leisure time physical activity on socioeconomic inequalities in body mass index among Australian adults

BACKGROUND

The relationship between socioeconomic position and obesity has been clearly established, however, the extent to which specific behavioural factors mediate this relationship is less clear. This study aimed to ascertain the contribution of specific dietary elements and leisure-time physical activity (LTPA) to variations in obesity with education in the baseline (1990-1994) Melbourne Collaborative Cohort Study (MCCS).

METHODS

18, 489 women and 12, 141 men were included in this cross-sectional analysis. A series of linear regression models were used in accordance with the products of coefficients method to examine the mediating role of alcohol, soft drink (regular and diet), snacks (healthy and sweet), savoury items (healthy and unhealthy), meeting fruit and vegetable guidelines and LTPA on the relationship between education and body mass index (BMI).

RESULTS

Compared to those with lowest educational attainment, those with the highest educational attainment had a 1 kg/m2 lower BMI. Among men and women, 27% and 48%, respectively, of this disparity was attributable to differences in LTPA and diet. Unhealthy savoury item consumption and LTPA contributed most to the mediated effects for men and women. Alcohol and diet soft drink were additionally important mediators for women.

CONCLUSIONS

Diet and LTPA are potentially modifiable behavioural risk factors for the development of obesity that contribute substantially to inequalities in BMI. Our findings highlight the importance of specific behaviours which may be useful to the implementation of effective, targeted public policy to reduce socioeconomic inequalities in obesity.

Associations between occupational indicators and total, work-based and leisure-time sitting: a cross-sectional study

BACKGROUND

A better understanding of how occupational indicators (e.g. job type, doing shift-work, hours worked, physical demand) influence sitting time will aid in the design of more effective health behaviour interventions. The aim of the study was to examine the associations between several occupational indicators and total, occupational and leisure-time sitting.

METHODS

Cross-sectional self-report data was collected in November 2011 from 1194 participants through a telephone interview in regional Queensland, Australia (response rate was 51.9%). The Workforce Sitting Questionnaire was used to measure sitting time. Multiple logistic regression was applied to examine associations between sitting time and occupational indicators.

RESULTS

Of all participants 77.9% were employed full-time, 72.7% had white-collar jobs, 35.7% were engaged in shift-work, 39.5% had physically demanding jobs, and 53.2% had high total sitting time (>8 hours a day). Those in physically demanding and blue-collar occupations were less likely to report high total (physically demanding: OR = 0.41,95% CI = 0.29-0.58; blue-collar: OR = 0.55,95% CI = 0.37-0.82) and occupational (physically demanding: OR = 0.26,95% CI = 0.14-0.24; blue-collar: OR = 0.32,95% CI = 0.21-0.49) sitting time compared to those in physically undemanding and white-collar occupations respectively. Working more than 8 hours per day was inversely associated with high leisure-time sitting (OR = 0.44,95% CI = 0.29-0.68). No evidence for 'compensation' effects, where lower occupational sitting is compensated with higher leisure-time sitting, was found.

CONCLUSIONS

Behaviour change interventions are needed to reduce sitting time as a means to prevent chronic disease. Workplace initiatives to reduce sitting time may be particularly important among individuals employed in white-collar and physical undemanding occupations, although other intervention strategies targeting leisure-time sitting are also required.

Assessing sitting across contexts: development of the multicontext sitting time questionnaire

PURPOSE

To describe the development and preliminary evaluation of the Multicontext Sitting Time Questionnaire (MSTQ).

METHOD

During development of the MSTQ, contexts and domains of sitting behavior were utilized as recall cues to improve the accuracy of sitting assessment. The terms "workday" and "nonworkday" were used to disambiguate occupational and discretionary sitting. An expert panel evaluated content validity. Among 25 participants, test-retest reliability of the MSTQ items was assessed with intraclass correlation coefficients (ICCs). Convergent validity was assessed versus relative and absolute accelerometer-estimated sedentary time and activity log using Pearson (r) or Spearman (p) correlation coefficients where appropriate.

RESULTS

Pilot testing revealed Web-based MSTQ administration was rapid, scalable, and inexpensive. Most items in the MSTQ demonstrated acceptable reliability (ICCs > .70). Compared with accelerometer-estimated sedentary time relative to total wear time, the MSTQ exhibited a low correlation on workdays (r = .34) and a moderately high correlation on nonworkdays (r = .61).

CONCLUSIONS

The systematic development of the MSTQ resulted in several improvements over previous tools and may serve as a model for purpose-driven questionnaire design. Additional validation is needed to conclusively determine the utility of the MSTQ.

Sitting time and cardiometabolic risk in US adults: associations by sex, race, socioeconomic status and activity level

BACKGROUND

Sitting time is associated with adverse health outcomes including chronic disease and premature mortality. However, it is not known if the association of sitting time with cardiometabolic risk factors varies across sociodemographic or health factors.

METHODS

The sample included 4560 adults (≥20 years) who participated in the cross-sectional 2007-2010 US National Health and Nutrition Examination Survey. Participants self-reported typical daily sitting time. Weight, height, blood pressure, and fasting triglycerides, high-density lipoprotein-cholesterol (HDL-C), glucose and insulin were measured. Homeostatic model assessment-insulin resistance (HOMA-IR) and β cell function (HOMA-%B) were calculated. A subsample of 3727 participants underwent an oral glucose tolerance test to obtain 2 h postload glucose levels. Population-weighted linear regression analysis was used to examine the association between sitting time and each cardiometabolic risk factor, stratified by sex, race, socioeconomic status and activity level. Analyses were controlled for demographics, socioeconomic status, survey cycle, personal and family medical history, diet and physical activity.

RESULTS

Sitting time was significantly associated with adverse levels of waist circumference, body mass index, triglycerides, HDL-C, insulin, HOMA-IR, HOMA-%B and 2 h postload glucose, but not with blood pressure or glucose level. In stratified analyses, sitting time was most consistently related to cardiometabolic risk factors among low and middle socioeconomic groups and for those who reported no weekly physical activity, but there were few differences between sex or race groups.

CONCLUSIONS

Self-reported sitting time was associated with adverse cardiometabolic risk factors consistently across sex and race groups in a representative US sample, independent of other risk factors. Excessive sitting warrants a public health concern.

The descriptive epidemiology of sitting among US adults, NHANES 2009/2010

OBJECTIVES

Using NHANES 2009/2010, to describe the amount of time a representative sample of the U.S. population spends sitting by age, sex, ethnicity, education, and body mass index.

DESIGN

Cross-sectional analysis.

METHODS

Participants (n=5911, ≥20 years) self-reported demographic variables and the amount of time they spend sitting on a typical day. Body mass index was calculated from measured height and weight.

RESULTS

Mean self-reported sitting time was 285min/day for males and 281min/day for females. Mexican-Americans reported sitting less than both non-Hispanic Whites and non-Hispanic Blacks (all p<0.0001). Non-Hispanic White males reported sitting more than non-Hispanic Black males, while Non-Hispanic White females reported sitting more than Other Hispanic females (both p<0.0001). No significant differences were found between sexes in any age group. There was a trend for increased sitting time with increasing age for females (p for trend=0.0045), for all Mexican-American and Hispanic participants and non-Hispanic Black males (all p≤0.006) and with increasing education (p for trend <0.0001). At the College Graduate level, females reported sitting less than males (p<0.0001). Obese females reported sitting more than normal weight and overweight females (p=0.0008). There were no significant differences in sitting time by body mass index for males.

CONCLUSIONS

Self-reported sitting time differed by ethnicity, age group, education and body mass index but there was no overall difference by sex. These results represent the most up to date prevalence of self-reported sitting for the US adult population. Certain groups should be targeted to reduce sitting time, for example those with higher educational attainment and obese females.

Sociodemographic and anthropometric factors associated with screen-based sedentary behavior among Japanese adults: a population-based cross-sectional study

BACKGROUND

Concern over the health risks of sedentary behavior has highlighted the need to examine factors associated with screen-based (television/computer) sedentary behavior. The present study examined the association of screen-based sedentary behavior with body weight and sociodemographic attributes among Japanese adults.

METHODS

A population-based cross-sectional study enrolled 1034 Japanese adults aged 40 to 69 years who lived in 2 Japanese cities. Sociodemographic variables, height, weight, and time spent on screen-based sedentary behavior were collected by self-administered questionnaire. Differences in screen time in relation to body mass index and weight gain since age 20 years were assessed by the Mann-Whitney U test. Independent associations of each variable with screen time were examined by forced-entry logistic regression analyses.

RESULTS

Mean (SD) age and median (interquartile range) duration of screen time per week were 55.6 (8.4) years and 832.0 (368.8-1263.1) minutes, respectively, for men, and 55.3 (8.4) years and 852.6 (426.0-1307.5) minutes, respectively, for women. Screen time among participants with weight gain was longer than among those with a weight gain of less than 10 kg (P = 0.08). Unmarried and unemployed participants had longer screen times. Participants aged 40 to 49 years were less likely than older age groups to spend time on screen-based sedentary behavior during leisure hours.

CONCLUSIONS

The present findings imply that strategies are necessary to discourage screen-based sedentary behavior among all demographic groups, especially among adults who are elderly, unmarried, or unemployed.

Use of neighbourhood parks: does socio-economic status matter? A four-city study

OBJECTIVES

To determine if neighbourhood socio-economic status (SES) is associated with park use and park-based physical activity.

STUDY DESIGN

Cross-sectional study.

METHODS

The use and characteristics of 24 neighbourhood parks in Albuquerque, Chapel Hill/Durham, Columbus and Philadelphia were observed systematically in three seasons (spring, summer and autumn), with nearly 36,000 park users observed. Twelve parks were in high-poverty neighbourhoods and 12 parks were in low-poverty neighbourhoods. In total, 3559 park users and 3815 local residents were surveyed. Park incivilities were assessed and park administrators were interviewed about management practices.

RESULTS

The size and number of facilities in parks in high-poverty neighbourhoods were similar to those in parks in low-poverty neighbourhoods, but the former had more hours of programming. Neighbourhood poverty level, perception of safety and the presence of incivilities were not associated with the number of park users observed. However, programmed activities and the number of activity facilities were strongly correlated with park use and energy expended in the park.

CONCLUSIONS

The finding that park programming is the most important correlate of park use and park-based physical activity suggests that there are considerable opportunities for facilitating physical activity among populations of both high- and low-poverty areas.