Association of domain-specific physical activity and sedentary behavior with cardiometabolic health among office workers

Development of Digital Strategies for Reducing Sedentary Behavior in a Hybrid Office Environment: Modified Delphi Study

BACKGROUND

Hybrid work is the new modus operandi for many office workers, leading to more sedentary behavior than office-only working. Given the potential of digital interventions to reduce sedentary behavior and the current lack of studies evaluating these interventions for home office settings, it is crucial to develop digital interventions for such contexts involving all stakeholders.

OBJECTIVE

This study aimed to reach expert consensus on the most feasible work strategies and the most usable digital elements as a delivery method to reduce sedentary behavior in the home office context.

METHODS

A modified Delphi study including 3 survey rounds and focus groups was conducted to achieve consensus. The first Delphi round consisted of two 9-point Likert scales for assessing the feasibility of work strategies and the potential usefulness of digital elements to deliver the strategies. The work strategies were identified and selected from a scoping review, a systematic review, and 2 qualitative studies involving managers and employees. The median and mean absolute deviation from the median for each item are reported. The second round involved 2 ranking lists with the highly feasible strategies and highly useful digital elements based on round 1 responses to order the list according to experts' preferences. The weighted average ranking for each item was calculated to determine the most highly ranked work strategies and digital elements. The third round encompassed work strategies with a weight above the median from round 2 to be matched with the most useful digital elements to implement each strategy. In total, 4 focus groups were additionally conducted to gain a greater understanding of the findings from the Delphi phase. Focus groups were analyzed using the principles of reflexive thematic analysis.

RESULTS

A total of 27 international experts in the field of occupational health participated in the first round, with response rates of 86% (25/29) and 66% (19/29) in rounds 2 and 3, respectively, and 52% (15/29) in the focus groups. Consensus was achieved on 18 work strategies and 16 digital elements. Feedback on activity progress and goal achievement; creating an action plan; and standing while reading, answering phone calls, or conducting videoconferences were the most feasible work strategies, whereas wrist-based activity trackers, a combination of media, and app interfaces in smartphones were the most useful digital elements. Moreover, experts highlighted the requirement of combining multiple levels of strategies, such as social support, physical environment, and individual strategies, to enhance their implementation and effectiveness in reducing sedentary behavior when working from home.

CONCLUSIONS

This expert consensus provided a foundation for developing digital interventions for sedentary behavior in home office workers. Ongoing interventions should enable the evaluation of feasible strategies delivered via useful digital elements in home office or hybrid contexts.

Sedentary Behavior, Physical Activity, and Health of Workers in Chile According to the National Health Survey-2017

BACKGROUND/OBJECTIVES

Sedentary behavior (SB) and physical activity (PA) are key determinants of health in occupational settings. This study aimed to analyze the levels of SB, PA, and their associations with health outcomes among Chilean workers using data from the National Health Survey-2017.

METHODS

A secondary analysis of 2042 workers aged ≥18 years was conducted. Occupations were classified using ISCO-08, and SB/PA were assessed using the Global Physical Activity Questionnaire (GPAQ). Health outcomes included musculoskeletal symptoms, hypertension, diabetes mellitus, metabolic syndrome, and cardiovascular risk.

RESULTS

Of the participants, 49.8% were women, and the mean age was 45 years (±13.7). The median SB was 120 min/day, with 32.6% accumulating ≥4 h/day. "Managers" exhibited the highest SB (median: 270 min/day). The median total PA was 123 min/day, and "Skilled agricultural, forestry, and fishery workers" reported the highest PA (median: 330 min/day). The SB (≥4 h/day) was significantly associated with musculoskeletal symptoms (OR: 1.61, 95% CI: 1.21-2.14) and hypertension (OR: 1.53, 95% CI: 1.07-2.18). PA showed no significant protective effect.

CONCLUSIONS

SB and PA vary significantly across occupational groups. SB is associated with musculoskeletal symptoms. Health promotion programs should be tailored to specific occupational groups.

Association of watching sports games with subsequent health and well-being among adults in Japan: An outcome-wide longitudinal approach

OBJECTIVE

Although the health benefits of playing sports are well-known, the association between watching sports and health is not well understood. We examined the longitudinal association of watching sports with 20 different health and well-being outcomes.

METHODS

Three-wave cohort data from 6327 adults (4851 workers) in the Meiji Yasuda LifeStyle study were used to draw causal inferences. We assessed the frequency of watching sports games on media or in-person using a self-reported questionnaire in 2018. Outcomes, including health behaviors, physical, mental, and work-related outcomes, were evaluated in 2019. In 2017, sociodemographic factors, prior exposure, and outcome values were evaluated and used as covariates. Three different statistical models (logistic, modified Poisson, or linear regression) were used according to the nature of the outcome variable.

RESULTS

Watching sports on media had a favorable dose-response association with a lower risk of becoming physically inactive and skipping breakfast, as well as higher happiness (p for trend < 0.05). Conversely, watching sports on media had an adverse dose-response association with higher body mass index and increased risks of developing hypertension and diabetes (p for trend < 0.05). Watching sports in-person had a dose-response association with lower risks of exhibiting the precontemplation stage of health behavior change, moderate/severe psychological distress, and dyslipidemia (p for trend < 0.05).

CONCLUSIONS

Despite the observed detrimental association between watching sports and cardiometabolic health, which should be interpreted cautiously and studied further, the study findings suggest that watching sports could be a new modifiable protective factor for developing healthy lifestyles and improving mental well-being.

Associations of Working From Home Frequency With Accelerometer-Measured Physical Activity and Sedentary Behavior in Japanese White-Collar Workers: A Cross-Sectional Analysis of the Meiji Yasuda LifeStyle Study

BACKGROUND

The association of working from home (WFH) with physical activity (PA) and sedentary behavior (SB) has been explored; however, this association during periods without stringent measures to combat coronavirus disease 2019 is undercharacterized. Particularly, few studies have evaluated the potential effect modification on its associations. Therefore, this study aimed to investigate the associations of WFH frequency with accelerometer-measured PA and SB, along with its effect modifiers, among Japanese white-collar workers during the later pandemic period.

METHODS

A cross-sectional study involving 1133 white-collar workers residing in the Tokyo metropolitan area was conducted between April 2022 and March 2023. WFH frequency was evaluated through a self-report questionnaire, while SB and PA during weekdays were measured using a triaxial accelerometer. Linear regression models adjusting for potential confounders were used to examine the association of WFH frequency with PA and SB.

RESULTS

Regardless of activity intensity, individuals who worked at home, even for 1 to 2 days per week, demonstrated lower levels of PA and higher levels of SB as compared with those who did not (P < .05). For example, difference between never and ≥5 days per week WFH was approximately 70 minutes/day for total PA and about 4000 steps/day for step counts. Associations between WFH and decreased PA were more pronounced in workers who were older, female, less educated, in sales and service work, nonregular staff, and precontemplating changes in exercise and eating habits.

CONCLUSIONS

We report that WFH was associated with decreased PA and increased SB in Japanese white-collar workers with pronounced associated in several subgroups.

Association of Occupational and Leisure-Time Physical Activity With Allostatic Load

INTRODUCTION

Leisure-time physical activity decreases allostatic load, a measure of burden of chronic stress. However, the role of occupational physical activity is unknown. This study examined associations of occupational physical activity and leisure-time physical activity with allostatic load among workers in the U.S.

METHODS

This cross-sectional study included 6,944 U.S. workers aged 20-64 years from the National Health and Nutrition Examination Survey (2007-2018). Physical activity was assessed using the Global Physical Activity Questionnaire. Allostatic load was calculated using biomarkers of cardiovascular, metabolic, and immune systems. Associations of occupational physical activity and leisure-time physical activity with allostatic load were examined using negative binomial regressions. Analyses were conducted between August 2022 and March 2023.

RESULTS

Vigorous leisure-time physical activity inversely associated with allostatic load among all workers (count ratio=0.68, 95% CI=0.62, 0.76) and in each sex- and age-stratified group as well as in each race/ethnicity-stratified group. Vigorous occupational physical activity positively associated with allostatic load only among females aged 20-44 years (1.38, 95% CI=1.10, 1.73). Inverse associations of vigorous leisure-time physical activity with allostatic load were similar in young females with high or low vigorous occupational physical activity.

CONCLUSIONS

Increasing vigorous leisure-time physical activity associates with a lower allostatic load for all workers, whereas increasing vigorous occupational physical activity associates with a higher allostatic load only in young females. Promoting vigorous leisure-time physical activity reduces allostatic load among young females with either low or high vigorous occupational physical activity.

Sedentary behaviors and physical activity of the working population measured by accelerometry: a systematic review and meta-analysis

BACKGROUND

Too much sedentary behavior (SB) and too little physical activity (PA) place adult workers at risk for chronic illness. It remains unclear which occupations and subgroups within occupations have the highest and lowest SB and PA, and little is known about the effects of organizational factors on these behaviors and metrics. Thus, our main aims were to review and summarize evidence describing daily SB and PA collected using accelerometry across various occupations and to identify organizational factors influencing SB and PA.

METHODS

A literature search of six databases was performed for relevant studies published through March 2023. Eligible studies were in English, targeted working populations, had a sample size > 75, and objectively measured both SB and PA for seven consecutive days using accelerometers. Following PRISMA guidelines, 5,197 studies were identified, and 19 articles met our inclusion criteria. Five of these studies were included in a meta-analysis comparing time spent in SB, light PA (LPA), and moderate to vigorous PA (MVPA) across occupations. Methodological quality was assessed using a Joanna Briggs Institute tool.

RESULTS

We found that 63% of the studies reported daily time spent in SB and in MVPA, but fewer reported LPA, moderate PA, and vigorous PA. The average time spent in SB was 553.34 min/day, in LPA was 299.77 min/day, and in MVPA was 33.87 min/day. In occupational subgroup analysis, we observed that office workers had 2.3 h more SB, 2.4 less hours LPA, and 14 min less MVPA per day than nurses. However, most studies either did not specify workers' occupations or grouped occupations. Shift work and workplace facilities significantly influenced SB and PA, but organizational factors affecting these behaviors were not sufficiently investigated (e.g., occupation type, work environment and workplace facilities, and shift work).

CONCLUSIONS

More research is needed to explore SB and PA patterns within occupational subgroups. Additionally, it is important to explore work-related individual (e.g., job task), interpersonal (e.g., social support from colleagues), organizational (e.g., work policy), and environmental factors influencing SB and PA. Future studies should also investigate the association of these factors with SB and PA.

Effective management of sedentary behavior among Indian university students: An empirical exploration into health-related behavior

BACKGROUND

The past few years have witnessed a notable rise in sedentary tendencies, unveiling a modern era of prolonged stillness and diminished physical engagement. This study sought to assess the feasibility of a digital health intervention (DHI) to reduce overall sedentary behavior among university students. The study also identifies distinct subgroups within Indian universities that exhibit a heightened propensity for engaging in unhealthy behaviors.

MATERIALS AND METHODS

The research design used was a quasi-experimental (pre-post) design. A total of 500 participants were selected using a simple randomized sampling method (250 belonging to the control group and 250 belonging to the experimental group). These participants actively engaged in the study for 2 weeks. The participants completed the Sedentary Behavior Questionnaire (SBQ) before the intervention to evaluate their level of sedentary behavior. To evaluate the impact of the intervention on subjectively measured sedentary behavior, statistical analyses were conducted using the paired-samples t-test and analysis of covariance (ANCOVA) with the post hoc Bonferroni test.

RESULTS

The findings demonstrated a significant t-value of sedentary behavior for the entire group, with t(249) = 4.88, P < .05. Furthermore, the F-value of 28.787 indicated a statistically significant difference in the sedentary behavior between the experimental and control groups. When considering female university students specifically, the t-value for sedentary behavior was significant at t(105) = 3.22, P < .05, and for male university students, the t-value for sedentary behavior was found to be significant at t(143) = 3.69, P < .05.

CONCLUSION

Smartphone-based health interventions targeting sedentary behavior reduction demonstrated promising outcomes in facilitating health behavior change among university students.

The Effect of a Program to Improve Adherence to the Mediterranean Diet on Cardiometabolic Parameters in 7034 Spanish Workers

BACKGROUND

Cardiovascular and metabolic diseases include a large group of pathologies and constitute one of the most serious chronic health problems facing the 21st century, with high rates of morbidity and mortality worldwide. Unhealthy diets influence the development of these pathologies. The Mediterranean diet can be an important part in the treatment of these diseases. The objective of this study was to assess the effect of a program that aims to increase adherence to the Mediterranean diet on the improvement of different cardiometabolic risk parameters.

METHODS

A prospective intervention study was carried out on 7034 Spanish workers. Prior to the intervention, 22 cardiometabolic risk scales were evaluated. Participants in this study were informed both orally and in writing of the characteristics and benefits of the Mediterranean diet and were given the website of the Ministry of Health, Consumption and Social Welfare of Spain, which provides advice on nutrition. Adherence to the Mediterranean diet was reinforced by sending a monthly SMS to their mobile phones. After six months of follow-up, the 22 risk scales were re-evaluated to assess changes. Means and standard deviations were calculated using Student's t test to analyse quantitative variables. Prevalence was calculated using the Chi-square test when the variables were qualitative.

RESULTS

All the cardiometabolic risk scales studied decreased after implementing a program to improve and enhance adherence to the Mediterranean diet. The number of losses in the sample was very low, standing at 4.31%.

CONCLUSIONS

The Mediterranean diet is effective in reducing all cardiovascular risk scales evaluated. The mean values and prevalence of high values of the different cardiometabolic risk scales analysed led to lower values after the implementation of the program to increase adherence to the Mediterranean diet. We observed a significant positive difference in metabolic age in both sexes. We have obtained a significant improvement in the insulin resistance index, especially in the SPISE-IR index, data that we have not found in previous publications. Easy access to the Internet and new information and communication technologies facilitate adherence to a diet and can reduce the number of losses.

Measurement of Sedentary Behavior-The Outcomes of the Angle for Posture Estimation (APE) Method

Hip-worn accelerometers are commonly used to assess habitual physical activity, but their accuracy in precisely measuring sedentary behavior (SB) is generally considered low. The angle for postural estimation (APE) method has shown promising accuracy in SB measurement. This method relies on the constant nature of Earth's gravity and the assumption that walking posture is typically upright. This study investigated how cardiorespiratory fitness (CRF) and body mass index (BMI) are related to APE output. A total of 3475 participants with adequate accelerometer wear time were categorized into three groups according to CRF or BMI. Participants in low CRF and high BMI groups spent more time in reclining and lying postures (APE ≥ 30°) and less time in sitting and standing postures (APE < 30°) than the other groups. Furthermore, the strongest partial Spearman correlation with CRF (r = 0.284) and BMI (r = -0.320) was observed for APE values typical for standing. The findings underscore the utility of the APE method in studying associations between SB and health outcomes. Importantly, this study emphasizes the necessity of reserving the term "sedentary behavior" for studies wherein the classification of SB is based on both intensity and posture.

Relationship between rest-activity rhythms and cardiorespiratory fitness in middle-aged workers: a cross-sectional study with non-parametric analysis using accelerometers worn on the thigh

BACKGROUND

Rest-activity rhythms are directly related to health risks, but there are limited objective methods to assess them. This study aimed to investigate the relationship between rest-activity rhythms and cardiorespiratory fitness (CRF) in middle-aged workers.

METHODS

Peak oxygen uptake was measured on a treadmill to assess CRF in 254 middle-aged workers who were divided into low, medium, and high-CRF groups based on tertiles. Participants were asked to wear an accelerometer (activPAL) on their thighs for 1 week, and the logarithmically transformed acceleration data were used for the analysis of a 24-hour rest-activity rhythm. Sex, age, body mass index, occupation, smoking status, and alcohol consumption were used as covariates in Model 1, with Model 2 also including walking count on non-workdays. Repeated measures analysis of variance was used to compare time course of rest-activity rhythms changes on workdays between groups, and post-hoc tests were conducted using Bonferroni's correlation.

RESULTS

Higher CRF correlated with increased physical activity. In model 1, higher CRF showed improved interdaily stability, but the significant difference disappeared in model 2 after adjusting for non-workday walking counts. A time-course group comparison showed that the high group had significantly higher activity levels than those of the low group from 6:00 to 8:59 and 17:00 to 17:59 and the medium group from 6:00 to 7:59 and 19:00 to 19:59.

CONCLUSIONS

Workers who have better rest-activity rhythms and engage in higher levels of physical activity on workdays tend to have higher CRF levels. Regular daily routines, influenced by physical activity during holidays, can positively impact cardiopulmonary endurance.

Association of Physical Activity and Exercise with Physical Performance and Muscle Mass in Older Adults: Results from the Longevity Check-Up (Lookup) 7+ Project

Regular engagement in physical activity (PA) or physical exercise (PE) is effective at improving physical performance and body composition in older adults. Less is known about the benefits that may be obtained through combining PA with PE and whether the effects of activity habits differ between men and women. This study cross-sectionally investigated the association of PA and/or PE with physical performance and anthropometric measures in a large and relatively unselected sample of older adults enrolled in the Longevity Check-up (Lookup) 7+ project. Participants were individuals 65 years and older living in the community who were recruited in unconventional settings across Italy. Adherence to PA or PE was operationalized as involvement in light walking or various types of exercise, respectively, at least twice weekly for a minimum of 30 min per session throughout the last 12 months. Physical performance measures included handgrip strength and five-time sit-to-stand (5STS) tests. Lower-limb muscle power and appendicular skeletal muscle mass (ASM) were estimated through validated equations. We analyzed data of 4119 participants, of whom 2222 (53.4%) were women. The mean age was 72.8 ± 5.8 years in men and 72.1 ± 5.4 years in women. Regular engagement in PA + PE was reported by 139 (7.3%) men and 100 (4.5%) women. Results indicated that regular walking activity and/or PE were significantly associated with better physical performance and greater ASM with sex-specific patterns. Associations were also influenced by the type of activity, physical performance assessment tool, and anthropometric parameters. Men engaged in PA + PE performed better on the 5STS test and had greater handgrip strength, ASM, and relative and specific muscle power than those practicing either PA or PE. In women, the combination of PA and PE was associated with greater handgrip strength. The findings of this study indicate that older adults regularly practicing PA + PE had better physical performance than those who only engaged in either modality. In men, the combination of PA and PE was also associated with greater ASM.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Association Between Domain-Specific Physical Activity and Cardiometabolic Factors in a Multiethnic Asian Population: A Longitudinal Study

AIMS

To examine the association between domain-specific physical activity (PA) and cardiometabolic factors with longitudinal data, which is limited in current literature.

METHODS

Participants who attended the Singapore Multi-Ethnic Cohort and follow-up surveys were included in this study (N = 3950, mean age: 44.7 y, female: 57.9%). Self-reported moderate- to vigorous-intensity PA (MVPA) for each domain (leisure-time, transportation, occupation, and household) was categorized into 4 levels: no, low, middle, and high MVPA. The longitudinal associations of domain-specific MVPA with cardiometabolic factors including systolic and diastolic blood pressures, low-density and high-density lipoprotein cholesterols, triglycerides, and body mass index were examined using Generalized Estimating Equations, accounting for confounding factors and repeated measurements.

RESULTS

There were 5.2% participants who had no MVPA. For each domain, this rate ranged from 22.6% (household) to 83.3% (occupation). Leisure-time and occupation MVPAs had positive and linear associations with high-density lipoprotein cholesterols, corresponding to 0.030 (95% confidence interval, 0.015 to 0.045) mmol/L (leisure-time) and 0.063 (95% confidence interval, 0.043 to 0.083) mmol/L (occupation), when compared high with no respective MVPA. Occupation and household MVPAs were associated with low-density lipoprotein cholesterol. Transportation and occupation exhibited a positive and linear relationship with diastolic blood pressure. None of the domains were associated with body mass index, systolic blood pressures, or triglycerides.

CONCLUSIONS

This study showed that each domain had differential association with individual cardiometabolic risk factors. As occupation, transportation, or household PA had unfavorable associations with low-density lipoprotein cholesterol or diastolic blood pressure, the overall beneficial impact of higher PA levels may not necessarily hold in the context of domain-specific PA and cardiovascular health. Further investigation is needed to corroborate our findings.