Compositional analysis of the association between mortality and 24-hour movement behaviour from NHANES

The effects of a web-based 24-hour movement behavior lifestyle education program on mental health and psychological well-being in parents of children with autism spectrum disorder: A randomized controlled trial

BACKGROUND AND PURPOSE

Compared with parents of neurotypical children or children diagnosed with other disabilities, parents of children with autism spectrum disorder (ASD) often experience poorer mental health, greater stress, and more depression and anxiety symptoms. This study aimed to assess the effects of a web-based 24-h movement behavior lifestyle education program on mental health and psychological well-being in parents of children with ASD.

METHODS

This study employed a randomized controlled trial utilizing the Health Action Process Approach (HAPA) as a theoretical framework. A total of 318 parents of children with ASD were enrolled and randomly assigned to the experimental or control group. The experimental group received an 8-week web-based 24-h movement behavior lifestyle education program, while the control group followed their usual routine. Two instruments, the Depression Anxiety and Stress Scale (DASS-21) and the Satisfaction With Life Scale (SWLS), were used to measure mental health and psychological well-being, respectively. The data were collected at two time points-at the beginning and the end of the intervention.

RESULTS

Compared with the baseline and control groups, the experimental group demonstrated significant improvements in all outcome measures (p < 0.01). There were significant differences in the DASS-21 and SWLS scores between the two groups before and after the intervention (p ≤ 0.01).

CONCLUSION

This study represents the first randomized controlled trial involving a web-based 24-h movement behavior lifestyle education program specifically designed to address the mental health and psychological well-being of parents of children with ASD. The findings confirm the potential impact of 24-h movement behavior lifestyle education as a functional and effective strategy for parents of children with ASD.

The role of education attainment on 24-hour movement behavior in emerging adults: evidence from a population-based study

Purpose

The purpose of this study was to explore the relationship between education level and health behavior including sleep, work activity, exercise activity, and sedentary behavior among emerging adults.

Methods

This study utilized data from the National Health and Nutrition Examination Survey (NHANES) collected between 2007 and 2018. The study sample included 4,484 emerging adults aged 18-25 years and the weighted participants were 30,057,813. Weighted multivariable regression analysis was performed to investigate the association between education level and the aforementioned health behavior, adjusting for age, gender, race/ethnicity, marital status, poverty-income ratio, BMI, smoking, and alcohol drinking status.

Results

This study revealed that higher education level was associated with shorter sleep duration [Fully adjusted model, β (95% CI): -0.588 (-0.929, -0.246), p < 0.001]. Additionally, those with higher education levels were more likely to allocate time in sedentary behavior [β (95% CI): 90.162 (41.087, 139.238), p < 0.001]. Moreover, higher education level was related to less work activity [β (95% CI): -806.991 (-1,500.280, -113.703), p = 0.023] and more exercise activity time [β (95% CI): 118.196 (-21.992, 258.385), p = 0.097]. Subgroup analysis further verified this trend and detected that males with higher education level tended to participate in less work activity [β (95% CI): -1,139.972 (-2,136.707, -143.237), p = 0.026] while females with higher education level tended to engage in more exercise activity [Fully adjusted model, β (95% CI): 141.709 (45.468, 237.950), p = 0.004].

Conclusion

This study highlighted the importance of education level as a significant factor in promoting healthy behavior among emerging adults. The findings underscored the need for the Ministry of Education to prioritize educating this demographic about the significance of maintaining adequate sleep patterns and reducing sedentary habits. Encouraging them to allocate more time for work and physical activities can significantly contribute to their overall wellbeing and success, ultimately fostering a healthier next generation.

A time compositional analysis of the association between movement behaviors and indicators of mental health in young adults

BACKGROUND

Movement behaviors (i.e., physical activity [PA], sedentary behaviors [SB], sleep) relate to mental health. Although movement behaviors are often analyzed as distinct entities, they are in fact highly inter-dependent (e.g., if an individual increases sleep, then PA and/or SB must be reduced) and these dependencies should be accounted for in the analysis. We tested whether perceptions of time spent in movement behaviors (i.e., moderate-to-vigorous intensity PA [MVPA], light physical activity [LPA], SB, and sleep) related to depressive symptoms and self-report mental health in young adults using a compositional analysis. We then estimated change in depressive symptoms with reallocation of time across movement behaviors using compositional time-reallocation models.

METHODS

Data were drawn from the longitudinal NDIT dataset. Complete data were available for 770 young adults (Mage  = 20.3, 55% females).

RESULTS

The proportion of time spent in MVPA relative to other movement behaviors related to depressive symptoms non-significantly and to mental health significantly. Reallocating 15 min from MVPA to SB resulted in a significant (0.46 unit) increase in depressive symptoms, and reallocating 15 min of MVPA to LPA was associated with a (0.57) increase in depressive symptoms.

CONCLUSION

These results indicate the importance of relative time spent in each movement behavior to mental health. Further research should examine these associations over time.

Adherence to 24-Hour Movement Guidelines in Relation to the Risk of Overweight and Obesity Among Children and Adolescents

PURPOSE

Adherence to overall 24-hour Movement Guidelines (24HGs) has been associated with childhood obesity in cross-sectional studies. However, few longitudinal studies have examined such associations, especially in China. We aimed to explore prospective associations between adherence to recommendations of 24HGs and risks of developing overweight and obesity among children and adolescents.

METHODS

We included participants (aged 6-17 years) without overweight and obesity at enrollment from the China Health and Nutrition Survey in 2004-2011 surveys and followed them till 2015. We assigned one point each to the adherence of guidelines for moderate-to-vigorous physical activity, recreational screen time and sleep, and summed them up to indicate the overall level of adherence to 24HGs (range: 0-3 points). The primary outcome was the first occurrence of overweight or obesity. Multivariable cox proportional hazard models were used to evaluate the corresponding associations.

RESULTS

Among 1,382 participants (mean age: 10.3 ± 3.2 years; 48.4% girls), a total of 152 (11%) individuals were identified as incident overweight and obesity during an average of 4.7 years of follow-up. Compared with participants nonadherent to any of the guidelines, those adhering to one (hazard ratio [HR] = 0.38, 95% confidence interval [CI]: 0.21-0.71, p < .01), two (HR = 0.49, 95% CI: 0.28-0.88, p = .02), and three (HR = 0.40, 95% CI: 0.17-0.91, p = .03) recommendations had significantly lower risks of developing overweight and obesity.

DISCUSSION

Children and adolescents who met any recommendations of 24HGs had significantly lower risks of developing subsequent overweight and obesity. Setting achievable goals such as adopting at least one recommendation could be considered in future public health recommendations to accelerate progress in childhood obesity prevention.

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.

Modifications of 24-h movement behaviors to prevent obesity in retirement: a natural experiment using compositional data analysis

BACKGROUND

Retirement often leads to a more passive lifestyle and may therefore lead to weight gain. This study aims to investigate longitudinal associations between changes in 24-h movement behaviors and BMI and waist circumference in relation to the transition from work to retirement.

METHODS

The study population included 213 retiring public sector workers (mean age 63.5 years, standard deviation 1.1) from the Finnish Retirement and Aging study. Before and after retirement participants wore an Axivity accelerometer on their thigh and filled in a daily log for at least four days to measure daily time spent sleeping, in sedentary behavior (SED), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA). Also, their body mass index (BMI) and waist circumference were measured repeatedly. Compositional linear regression analysis and isotemporal substitution analysis were used to study associations between one-year changes in 24-h movement behaviors and concurrent changes in BMI and waist circumference.

RESULTS

An increase in MVPA in relation to sleep, SED and LPA was associated with a decreasing BMI (β = -0.60, p = 0.04) and waist circumference (β = -2.14, p = 0.05) over one year from before retirement to after retirement. In contrast, increasing sleep in relation to SED, LPA and MVPA was associated with an increasing BMI (β = 1.34, p = 0.02). Reallocating 60 min from MVPA to SED or sleep was estimated to increase BMI by on average 0.8-0.9 kg/m2 and waist circumference by 3.0 cm during one year.

CONCLUSIONS

During the transition from work to retirement, increasing MVPA was associated with a slight decrease in BMI and waist circumference, whereas increasing sleep was associated with an increasing BMI. Common life transitions, like retirement, should be considered when giving recommendations and guidance for physical activity and sleep.

Gender difference in the effects of chronic diseases on daily physical activity patterns in older adults: analysis of objectively measured physical activity in NHATS 2021

PURPOSE

Many chronic diseases have detrimental impact on the physical activity (PA) patterns of older adults. Often such diseases have different degrees of severity in males and females. Quantifying this gender difference would not only enhance our understanding of diseases but would also help design individual-specific PA interventions, thereby improving health outcomes for both genders.

METHODS

PA data for 747 participants from round 11 (2021) of the National Health and Aging Trends Study were analyzed. Multilevel functional regression models were used to study gender difference in the effects of chronic diseases on daily PA patterns while adjusting for confounders.

RESULTS

Females with dementia (or Alzheimer's disease), hypertension, heart and lung disease had lower PA at different times of day compared to females without these diseases, whereas males with and without these diseases had comparable daily PA. Males with diabetes had higher midnight PA and lower noon PA compared to males without diabetes, while females' PA with and without diabetes were similar.

CONCLUSIONS

Our analysis demonstrates that although for most diseases, the daily PA patterns of individuals with the disease are negatively altered compared to healthy individuals, the extent of decline varies by gender and time of day. Designing personalized physical activity interventions considering gender and diurnal PA pattern can potentially improve quality of life across both genders.

How do People Spend their Day? Sociodemographic Disparities in 24-hour Movement Guideline Adherence among US Adults Using 2017-2020 NHANES Data

INTRODUCTION

The 24-hour movement guidelines recommend that adults be physically active every day, get good sleep quality, and limit sedentary behavior to lower disease risk and improve quality of life. Adherence to these guidelines have not been evaluated among racially and ethnically diverse adults in the United States. The objectives were to: 1) estimate and compare the prevalence of guideline adherence among all adults and separated by age recommendations (ages 18-64; 65 + years); and 2) determine whether the odds of movement adherence differ by sociodemographics.

METHODS

Self-reported data from 2017-2020 National Health and Nutrition Examination Survey (NHANES) were analyzed (n = 9,627) using multivariate logistic regression for all adults and age stratified. Sedentary behavior was measured by minutes of sedentary activity per day (< 480 minutes adherent). Sleep was measured by hours per night (7-9 hours adherent ages 18-64; 7-8 hours adherent ages >  = 65). Physical activity was measured by minutes of recreational activity per week (150 + minutes adherent).

RESULTS

Guideline adherence among all adults was 23.7% (ages 18-64 = 26%: ages 65 +  = 14.7%). Guideline adherence was highest among non-Hispanic Asians (28.1%) and lowest among non-Hispanic Blacks (19.2%) (p = .0070). Males (25.8%) were more likely to meet movement guidelines than females (21.8%; p = .0009). In adjusted models, the odds of meeting movement guidelines were lower among non-Hispanic Blacks (OR = 0.81; 95%CI = 0.66-0.98) compared to Whites, females (OR = 0.84; 95%CI = 0.72-0.97) compared to males, and lower education (OR = 0.22; 95%CI = 0.14- 0.35) compared to adults with a college degree or higher.

RECOMMENDATION

Future interventions should be developed to improve guideline adherence tailored to particular at-risk groups.

Association Between 24-Hour Movement Behavior and Cognitive Function in Brazilian Middle-Aged and Older Adults: Findings From the ELSA-Brasil

Background and Objectives

The relationship between 24-hr movement behavior and specific domains of cognitive function is unclear. The purpose of this study was to identify the joint association of daily time spent in light (light-intensity physical activity [LPA]) and moderate-to-vigorous physical activity (MVPA), sedentary behavior (SB), and sleep with cognitive function in middle-aged and older adults.

Research Design and Methods

Cross-sectional data from Wave 3 (2017-2019) of the Brazilian Longitudinal Study of Adult Health were analyzed. The study included adults aged 41-84 years old. Physical activity was assessed using a waist-worn accelerometer. Cognitive function was examined using standardized tests to assess memory, language, and Trail-Making test. Global cognitive function score was calculated by averaging domain-specific scores. Compositional isotemporal substitution models were performed to identify the association between the reallocation of time spent in LPA, MVPA, sleep, and SB with cognitive function.

Results

Participants (n = 8,608) were 55.9% female (mean age 58.9 [8.6] years). Reallocating time from SB to MVPA was associated with higher cognitive function: Reallocating 15 min to MVPA by reducing 5 min from each other behavior was associated with increased odds of better cognitive function in both insufficient (<7 hr/day; odds ratio [OR]: 0.64; 95% confidence interval [CI]: 0.54-0.77) and sufficient (≥7 hr/day; OR: 0.62; 95% CI: 0.58-0.67) sleep groups. Among those with insufficient sleep, reallocating time to MVPA and sleep from SB was associated with higher global cognitive performance.

Discussion and Implications

Small reductions in SB and increments in MVPA were associated with higher cognitive function in middle-aged and older adults.

Analysis of the 24-h activity cycle: An illustration examining the association with cognitive function in the Adult Changes in Thought study

The 24-h activity cycle (24HAC) is a new paradigm for studying activity behaviors in relation to health outcomes. This approach inherently captures the interrelatedness of the daily time spent in physical activity (PA), sedentary behavior (SB), and sleep. We describe three popular approaches for modeling outcome associations with the 24HAC exposure. We apply these approaches to assess an association with a cognitive outcome in a cohort of older adults, discuss statistical challenges, and provide guidance on interpretation and selecting an appropriate approach. We compare the use of the isotemporal substitution model (ISM), compositional data analysis (CoDA), and latent profile analysis (LPA) to analyze 24HAC. We illustrate each method by exploring cross-sectional associations with cognition in 1,034 older adults (Mean age = 77; Age range = 65-100; 55.8% female; 90% White) who were part of the Adult Changes in Thought (ACT) Activity Monitoring (ACT-AM) sub-study. PA and SB were assessed with thigh-worn activPAL accelerometers for 7-days. For each method, we fit a multivariable regression model to examine the cross-sectional association between the 24HAC and Cognitive Abilities Screening Instrument item response theory (CASI-IRT) score, adjusting for baseline characteristics. We highlight differences in assumptions and the scientific questions addressable by each approach. ISM is easiest to apply and interpret; however, the typical ISM assumes a linear association. CoDA uses an isometric log-ratio transformation to directly model the compositional exposure but can be more challenging to apply and interpret. LPA can serve as an exploratory analysis tool to classify individuals into groups with similar time-use patterns. Inference on associations of latent profiles with health outcomes need to account for the uncertainty of the LPA classifications, which is often ignored. Analyses using the three methods did not suggest that less time spent on SB and more in PA was associated with better cognitive function. The three standard analytical approaches for 24HAC each have advantages and limitations, and selection of the most appropriate method should be guided by the scientific questions of interest and applicability of each model's assumptions. Further research is needed into the health implications of the distinct 24HAC patterns identified in this cohort.

Time reallocation of physical behaviors induced by endurance exercise in physically active individuals

ABSTRACT

Increasing moderate-vigorous physical activity (MVPA) through exercise requires reallocating time from other physical behavior(s). We aimed to determine the reallocations induced by endurance exercise in physically active individuals. We also searched for behavioral compensatory responses, and explored the effect of exercise on daily energy expenditure. Fourteen participants (8 women; median age 37.8 [IQR 29.9–48.5] yr) exercised on Monday, Wednesday, and Friday mornings (cycling MVPA, 65 min/session; "exercise days"), and avoided exercising on Tuesday and Thursday ("rest days"). Time spent on sleep, sedentary behavior, light-intensity physical activity, and MVPA was determined each day by accelerometers and logs. An energy expenditure index was computed considering minutes spent on each behavior and fixed metabolic equivalents. We found that all participants had lower sleep and higher total (including exercise) MVPA on exercise days compared to rest days. Thus, on exercise vs. rest days, sleep was lower (490 [453–553] vs. 553 [497–599] min/day, respectively, P<0.001), and total MVPA was higher (86 [80–101] vs. 23 [15–45] min/day, respectively; P<0.001). No differences in other physical behaviors were detected. Notably, exercise not only induced reallocations (i.e. less time in other behaviors) but also behavioral compensatory responses in some participants (e.g. increased sedentary behavior). This rearrangement of physical behaviors manifested in exercise-induced increases in energy expenditure from 96 to 232 MET×min/day. In conclusion, active individuals reallocated time from sleep to accommodate morning exercise. Yet exercise induced variable rearrangements of behaviors, with some individuals manifesting compensatory responses. Understanding individual rearrangements may help improve exercise interventions.

Cognitive Performance in Short Sleep Young Adults with Different Physical Activity Levels: A Cross-Sectional fNIRS Study

Short sleep is a common issue nowadays. The purpose of this study was to investigate prefrontal cortical hemodynamics by evaluating changes in concentrations of oxygenated hemoglobin (HbO) in cognitive tests among short-sleep young adults and to explore the relationship between sleep duration, physical activity level, and cognitive function in this specific population. A total of 46 participants (25 males and 21 females) were included in our study, and among them, the average sleep duration was 358 min/day. Stroop performance in the short sleep population was linked to higher levels cortical activation in distinct parts of the left middle frontal gyrus. This study found that moderate-to-vigorous physical activity (MVPA) was significantly associated with lower accuracy of incongruent Stroop test. The dose-response relationship between sleep duration and Stroop performance under different levels of light-intensity physical activity (LPA) and MVPA was further explored, and increasing sleep time for different PA level was associated with better Stroop performance. In summary, this present study provided neurobehavioral evidence between cortical hemodynamics and cognitive function in the short sleep population. Furthermore, our findings indicated that, in younger adults with short sleep, more MVPA was associated with worse cognitive performance. Short sleep young adults should increase sleep time, rather than more MVPA, to achieve better cognitive function.

Predictive equations for energy expenditure in adult humans: From resting to free-living conditions

Humans acquire energy from the environment for survival. A central question for nutritional sciences is how much energy is required to sustain cellular work while maintaining an adequate body mass. Because human energy balance is not exempt from thermodynamic principles, the energy requirement can be approached from the energy expenditure. Conceptual and technological advances have allowed understanding of the physiological determinants of energy expenditure. Body mass, sex, and age are the main factors determining energy expenditure. These factors constitute the basis for predictive equations for resting (REE) and total (TEE) energy expenditure in healthy adults. These equations yield predictions that differ up to ~400 kcal/d for REE and ~550 kcal/d for TEE. Identifying additional factors accounting for such variability and the most valid equations appears relevant. This review used novel approaches based on mathematical modeling of REE and analyses of the data from which REE predictive equations were generated. As for TEE, R² and SE were considered because only a few predictive equations are available. From these analyses, Oxford's and Plucker's equations appear valid for predicting REE and TEE in adults, respectively.

A compositional analysis study of body composition and cardiometabolic risk factors

OBJECTIVE

This cross-sectional study used compositional data analysis (CoDA) to do the following: 1) analyze the relative associations between fat and lean tissues with cardiometabolic risk factors; and 2) estimate how these risk factors would change if equivalent mass was displaced from one tissue to another. Differences between CoDA and traditional regression were explored.

METHODS

A total of 397 adults with overweight or obesity were studied. Body composition consisted of visceral fat, abdominal subcutaneous fat, peripheral subcutaneous fat, other fat depots, skeletal muscle, and other lean tissues. The outcomes were a continuous metabolic syndrome score (primary outcome) and eight other cardiometabolic risk factors (secondary outcomes). Associations were examined using CoDA and traditional linear regression.

RESULTS

Visceral fat mass, relative to the mass of the remaining tissues, was significantly associated with the metabolic syndrome score and five of eight remaining risk factors (p < 0.05). The relative contribution of the remaining tissues was not consistently associated with the study outcomes. Displacing equivalent mass from visceral fat into the remaining tissues was associated with meaningful decreases in the metabolic syndrome score. Regression estimates for CoDA and traditional regression differed in size and statistical significance.

CONCLUSIONS

These CoDA findings reinforce that excess visceral fat contributes to less-favorable cardiometabolic risk factors.

Effects of Low-Volume High-Intensity Interval Exercise on 24 h Movement Behaviors in Inactive Female University Students

The purpose of this study was to examine if low-volume, high-intensity interval exercise (HIIE) was associated with changes in 24-h movement behaviors. A quasi-experimental study design was used. We collected accelerometry data from 21 eligible participants who consistently wore an ActiGraph for a period of two-weeks. Differences in behaviors were analyzed using a paired t-test and repeated measures analysis of variance. Regression analysis was used to explore relationships with factors that impacted changes. The results indicated a compensatory increase in sedentary time (ST) (4.4 ± 6.0%, p < 0.01) and a decrease in light-intensity physical activity (LPA) (−7.3 ± 16.7%, p < 0.05). Meanwhile, moderate-intensity physical activity (MPA), vigorous-intensity physical activity (VPA), and total physical activity (TPA) increased following exercise (p < 0.001). Sleep duration and prolonged sedentary time were reduced (p < 0.05). Exercise intensity and aerobic capacity were associated with changes in ST. The results from the study indicate that participating in a low-volume HIIE encouraged participants who were previously inactive to become more active. The observations of increases in ST may have displaced a prolonged sitting time. The decrease in sleeping time observed may be reflecting an increased sleep quality in connection with increased higher-intensity PA.

Effects of physical activity intervention on 24-h movement behaviors: a compositional data analysis

We utilized compositional data analysis (CoDA) to study changes in the composition of the 24-h movement behaviors during an activity tracker based physical activity intervention. A total of 231 recently retired Finnish retirees were randomized into intervention and control groups. The intervention participants were requested to use a commercial activity tracker bracelet with daily activity goal and inactivity alerts for 12 months. The controls received no intervention. The 24-h movement behaviors, i.e., sleep, sedentary time (SED), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) were estimated from wrist-worn ActiGraph data using the GGIR R-package. Three balance coordinates describing the composition of movement behaviors were applied: ratio of active vs. passive behaviors, LPA vs. MVPA, and sleep vs. SED. A linear mixed model was used to study changes between the baseline and 6-month time point. Overall, the changes in the 24-h movement behaviors were small and did not differ between the groups. Only the ratio of LPA to MVPA tended to change differently between the groups (group*time interaction p = 0.08) as the intervention group increased LPA similarly to controls but decreased their MVPA. In conclusion, the use of a commercial activity tracker may not be enough to induce changes in the 24-h movement behaviors among retirees.

Associations of neighborhood walkability with moderate to vigorous physical activity: an application of compositional data analysis comparing compositional and non-compositional approaches

Background

We compared the relation between neighborhood features and moderate to vigorous physical activity (MVPA) using linear regression analysis and the more novel compositional data analysis (CoDA). Compositional data analysis allows us to take the time children allocate to different movement behaviours during a 24-hour time period into account.

Methodology

Data from youth participants (n = 409) in the QUALITY (QUebec Adipose and Lifestyle InvesTigation in Youth) cohort were included. Time spent in MVPA, light physical activity, sedentary behavior, and sleep (“24-hour movement behaviours”) was measured using accelerometers. Neighborhood data were collected using a geographic information system and through direct observation. In CoDA models, we used orthogonal logratio coordinates, which allows for the association of neighbourhood walkability with MVPA to be estimated with respect to the average composition of all other behaviours within a 24-hour time frame. In baseline linear regression models, MVPA was regressed cross-sectionally on neighborhood walkability. All models were stratified by sex, and controlled for BMI z-scores, pubertal development, seasonal variation, parental education, and neighbourhood safety.

Results

Based on CoDA, girls who lived in more walkable neighborhoods had 10% higher daily MVPA (95% CI: 2%, 19%), taking into account all other movement behaviours. Based on linear regression, girls who resided in more walkable neighborhoods engaged in 4.2 (95% confidence interval [CI]: 1.2, 6.6) more minutes of MVPA per day on average than girls residing in less walkable neighborhoods.

Conclusions

Unlike with traditional linear models, all movement behaviours were included in a single model using CoDA, allowing for a more complete picture of the strength and direction of the association between neighbourhood Walkability and MVPA. Application of CoDA to investigate determinants of physical activity provides additional insight into potential mechanisms and the ways in which people allocate their time.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-022-01256-6.

A Compositional Analysis of Physical Activity, Sedentary Time, and Sleep and Associated Health Outcomes in Children and Adults with Cystic Fibrosis

This study sought to investigate the association of light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), sedentary time (SED), and sleep with lung function in children and adults with CF. In total, 86 children (41 females; 13.6 ± 2.8 years; FEV₁%_predicted: 86 ± 1%) and 43 adults (21 females; 24.6 ± 4.7 years; FEV₁%_predicted: 63 ± 21%) with CF participated in this study. Wrist-worn accelerometery was used to assess PA, SED and sleep. Compositional linear regression models were conducted following normalisation via isometric log-ratio transformations. Sequential binary partitioning was applied to investigate the impact of reallocating 10 to 30 min between each behaviour on FEV₁%_predicted. A decline in FEV₁%_predicted was predicted with the reallocation of 30 min from MVPA to SED or LPA or sleep to any other behaviour in children (−3.04–−0.005%) and adults (−3.58–−0.005%). Conversely, improvements in FEV₁%_predicted were predicted when 30 min was reallocated to MVPA from LPA or SED in children (0.12–1.59%) and adults (0.77–2.10%), or when 30 min was reallocated to sleep from any other behaviour in both children (0.23–2.56%) and adults (1.08–3.58%). This study supports the importance of MVPA and sleep for maintaining and promoting lung function in people with CF.

Comparison of Outcomes Derived from the ActiGraph GT3X+ and the Axivity AX3 Accelerometer to Objectively Measure 24-Hour Movement Behaviors in Adults: A Cross-Sectional Study

The aim of this cross-sectional study is to investigate convergent validity of outcomes derived from the ActiGraph GT3X and Axivity accelerometer and to investigate feasibility and acceptability of using outcomes derived from these devices to measure 24-h movement behaviors (i.e., sleep, sedentary behavior, and physical activity) in adults during free-living conditions. Twenty-four adults (33.3% male; 39.79 ± 13.09 years old) simultaneously wore a hip-mounted ActiGraph and thigh-mounted Axivity during 48 consecutive hours. The ActiGraph was switched from hip to wrist during the night. To assess convergent validity between the two devices, Paired sample t-tests, linear regressions, Bland-Altman plots and κ statistic were conducted. Feasibility and acceptability of the devices was self-reported on a five-point scale. Daily time spent in 24-h movement behaviors differed between both devices. Except for sleep, the mean differences in daily time spent in the behaviors were clinically relevant and the limits of agreement were wide. For all 24-h movement behaviors, except for sleep and vigorous physical activity, proportional errors were observed. κ statistic showed substantial agreement for total physical activity and outstanding agreement for sedentary behavior and sleep. Adults perceived the Axivity as more practical than the ActiGraph to wear it for more than two days whereas the feasibility to wear it for two days was comparable. Depending on the measure, the observed biases were clinically relevant, proportional to the size of the measure and/or erratically variable. When taking into account the data processing approaches applied in this study, the ActiGraph and the Axivity cannot be used interchangeably to measure 24-h movement behaviors since the bias between both devices is clinically relevant and unpredictable.

Dose-response relationships of accelerometer-measured sedentary behaviour and physical activity with non-alcoholic fatty liver disease

BACKGROUND

Although a few studies have confirmed the association of accelerometer-measured sedentary behaviour (SB) and physical activity (PA) with non-alcoholic fatty liver disease (NAFLD), PA intensity and co-dependent daily time-use of movement behaviours are yet to be studied.

AIMS

To cross-sectionally examine the dose-response relationship between accelerometer-measured SB or PA and NAFLD using cubic spline analysis and the interdependence of movement behaviours over 24 hours with compositional data analysis.

METHODS

Data were obtained between May 2017 and February 2020 from 1914 people who were not heavy alcohol drinkers using health check-ups at the Meiji Yasuda Shinjuku Medical Center, Tokyo. SB, light-intensity PA (LPA) and moderate- to vigorous-intensity PA (MVPA) were evaluated using a triaxial accelerometer. Fatty liver was diagnosed by ultrasonography.

RESULTS

A multivariable-adjusted logistic model showed an inverse association between MVPA and NAFLD (odds ratio [OR] per 600 metabolic equivalents [MET]-min/week = 0.85, 95% confidence interval [CI] = 0.76-0.96). MVPA showed rapidly decreasing odds of NAFLD to approximately 1800 MET-min/week in cubic spline analysis and then a moderate decline. Although SB was significantly associated with NAFLD in a body mass index (BMI)-unadjusted model, it was not significant in a BMI-adjusted model. In the compositional isotemporal substitution, reallocating 60 min/day of SB to MVPA decreased the odds of NAFLD by 22% (OR = 0.78, 95% CI: 0.65-0.93), whereas reallocating 60 min/day of MVPA to SB increased it by 69% (OR = 1.69, 95% CI: 1.12-2.38).

CONCLUSIONS

The inverse dose-response association between MVPA and NAFLD confirms increased MVPA as a target for the prevention of NAFLD.

Revisiting the association of sedentary behavior and physical activity with all-cause mortality using a compositional approach: the Women's Health Study

BACKGROUND

While physical activity has consistently been associated with decreased mortality rates, it remains unknown if there is a single "ideal" combination of time in physical activities of different intensities and sedentary behavior (SB) associated with the lowest rate. This study examined the associations of combinations of time in moderate-to-vigorous intensity (MVPA), higher-light intensity (HLPA), lower-light intensity activities (LLPA), and SB with mortality rates in older women.

METHODS

This prospective cohort study included 16,676 older women from throughout the United States enrolled in the Women's Health Study. Women wore accelerometers on their hip from 2011 to 2015 and were followed through 2017 (mean (SD) of 4.3 (1.1) years). Deaths were confirmed with medical records, death certificates, or the National Death Index. Compositional Cox regression models were used.

RESULTS

The mean (SD) age was 72 (5.7) years at accelerometer wear; 503 women died. Compared to the least active women (mean, 3 min/day MVPA, 27 min/day HLPA, 162 min/day LLPA, and 701 min/day SB): compositional models showed an inverse L-shaped dose-response association of MVPA replacing other behaviors with mortality rates mortality rates (P = .02); SB relative to LLPA, HLPA, and MVPA was directly associated with mortality rates in a curvilinear dose-response manner (P < .001); replacing 10 min of SB for MVPA (HR (95% CI) = .86 (.73-.98)) or for HLPA (HR (95% CI.94 (.88-1.00)) associated with 14 and 6% lower mortality rates, respectively; a 47% risk reduction (HR [95% CI] = .53 [.42-.64]) was observed among women meeting physical activity guidelines (mean, 36 min/day MVPA, 79 min/day HLPA, 227 min/day LLPA and 549 min/day SB); and similar mortality rate reductions of 43% (HR (95% CI) = .57 (.41-.73)) were observed with increases in HLPA and LLPA without increasing MVPA, e.g., reallocating SB to 90 min/day of HLPA plus 120 min/day of LLPA.

CONCLUSIONS

There was no "ideal" combination of physical activities of different intensities and SB associated with the lowest mortality rates. Of particular relevance to older women, replacing SB with light intensity activity was associated with lower mortality rates, and "mixing and matching" times in different intensities yielded equivalent mortality risk reductions.

A systematic review of compositional data analysis studies examining associations between sleep, sedentary behaviour, and physical activity with health outcomes in adults

This systematic review determined if the composition of time spent in movement behaviours (i.e., sleep, sedentary behaviour (SED), light physical activity, and moderate-to-vigorous physical activity (MVPA)) is associated with health in adults. Five electronic databases were searched in August 2019. Studies were eligible for inclusion if they were peer-reviewed, examined community-dwelling adults, and used compositional data analysis to examine the associations between the composition of time spent in movement behaviours and health outcomes. Eight studies (7 cross-sectional, 1 prospective cohort) of >12 000 unique participants were included. Findings indicated that the 24-h movement behaviour composition was associated with all-cause mortality (1 of 1 analyses), adiposity (4 of 4 analyses), and cardiometabolic biomarkers (8 of 15 analyses). Reallocating time into MVPA from other movement behaviours was associated with favourable changes to most health outcomes and taking time out of SED and reallocating it into other movement behaviours was associated with favourable changes to all-cause mortality. The quality of evidence was very low for all health outcomes. In conclusion, these findings support the notion that the composition of movement across the entire 24-h day matters, and that recommendations for sleep, SED, and physical activity should be combined into a single public health guideline. (PROSPERO registration no.: CRD42019121641.) Novelty The 24-h movement behaviour composition is associated with a variety of health outcomes. Reallocating time into MVPA is favourably associated with health. Reallocating time out of SED is associated with favourable changes to mortality risk.

GRANADA consensus on analytical approaches to assess associations with accelerometer-determined physical behaviours (physical activity, sedentary behaviour and sleep) in epidemiological studies

The inter-relationship between physical activity, sedentary behaviour and sleep (collectively defined as physical behaviours) is of interest to researchers from different fields. Each of these physical behaviours has been investigated in epidemiological studies, yet their codependency and interactions need to be further explored and accounted for in data analysis. Modern accelerometers capture continuous movement through the day, which presents the challenge of how to best use the richness of these data. In recent years, analytical approaches first applied in other scientific fields have been applied to physical behaviour epidemiology (eg, isotemporal substitution models, compositional data analysis, multivariate pattern analysis, functional data analysis and machine learning). A comprehensive description, discussion, and consensus on the strengths and limitations of these analytical approaches will help researchers decide which approach to use in different situations. In this context, a scientific workshop and meeting were held in Granada to discuss: (1) analytical approaches currently used in the scientific literature on physical behaviour, highlighting strengths and limitations, providing practical recommendations on their use and including a decision tree for assisting researchers’ decision-making; and (2) current gaps and future research directions around the analysis and use of accelerometer data. Advances in analytical approaches to accelerometer-determined physical behaviours in epidemiological studies are expected to influence the interpretation of current and future evidence, and ultimately impact on future physical behaviour guidelines.

A compositional analysis of time spent in sleep, sedentary behaviour and physical activity with all-cause mortality risk

BACKGROUND

Daily time spent in sleep, sedentary behaviour (SED), light intensity physical activity (LIPA), and moderate-to-vigorous intensity physical activity (MVPA) are compositional, co-dependent variables. The objectives of this study were to use compositional data analysis to: (1) examine the relationship between the movement behaviour composition (daily time spent in sleep, SED, LIPA and MVPA) and all-cause mortality risk, and (2) estimate the extent to which changing time spent in any given movement behaviour (sleep, SED, LIPA, or MVPA) within the movement behaviour composition was associated with changes in risk of all-cause mortality.

METHODS

2838 adult participants from the 2005-2006 cycle of the U.S. National Health and Nutrition Examination Survey were studied using a prospective cohort design. Daily time spent in SED, LIPA and MVPA were determined by accelerometer. Nightly time spent sleeping was self-reported. Survey data were linked with mortality data through to the end of December 2015. Compositional data analysis was used to investigate relationships between the movement behaviour composition and mortality.

RESULTS

The movement behaviour composition was significantly associated with mortality risk. Time spent in MVPA relative to other movement behaviours was negatively associated with mortality risk (HR = .74; 95% CI [.67, .83]) while relative time spent in SED was positively associated with mortality risk (HR = 1.75; 95% CI [1.10, 2.79]). Time displacement estimates revealed that the greatest estimated changes in mortality risk occurred when time spent in MVPA was decreased and replaced with sleep, SED, LIPA or a combination of these behaviours (HRs of 1.76 to 1.80 for 15 min/day displacements).

CONCLUSIONS

The daily movement behaviour composition was related to mortality. Replacing time in MVPA or SED with equivalent time from any other movement behaviour was associated with an increase and decrease in mortality risk, respectively.

Association of Physical Activity Intensity With Mortality: A National Cohort Study of 403 681 US Adults

IMPORTANCE

It is unclear whether, for the same amount of total physical activity, a higher proportion of vigorous physical activity (VPA) to total physical activity is associated with a greater reduction in mortality.

OBJECTIVE

To examine the association of the proportion of VPA to total physical activity (defined as moderate to vigorous physical activity [MVPA]) with all-cause mortality, cardiovascular disease mortality, and cancer mortality.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study included 403 681 adults from the National Health Interview Survey 1997-2013 who provided data on self-reported physical activity and were linked to the National Death Index records through December 31, 2015. Statistical analysis was performed from May 15, 2018, to August 15, 2020.

EXPOSURES

Proportion of VPA to total physical activity among participants performing any MVPA.

MAIN OUTCOMES AND MEASURES

All-cause mortality, cardiovascular disease mortality, and cancer mortality. Cox proportional hazards regression models were performed to estimate hazard ratios (HRs) and 95% CIs, adjusted for sociodemographic characteristics, lifestyle risk factors, and total physical activity.

RESULT

Among the 403 681 individuals (225 569 women [51.7%]; mean [SD] age, 42.8 [16.3] years) in the study, during a median 10.1 years (interquartile range, 5.4-14.6 years) of follow-up (407.3 million person-years), 36 861 deaths occurred. Mutually adjusted models considering the recommendations of moderate physical activity (MPA; 150-299 vs 0 minutes per week) and VPA (≥75-149 vs 0 minutes per week) showed similar associations for all-cause mortality (MPA: HR, 0.83; 95% CI, 0.80-0.87; and VPA: HR, 0.80; 95% CI, 0.76-0.84) and cardiovascular disease mortality (MPA: HR, 0.75; 95% CI, 0.68-0.83; and VPA: HR, 0.79; 95% CI, 0.70-0.91). For the same contrasts, VPA (HR, 0.89; 95% CI, 0.80-0.99) showed a stronger inverse association with cancer mortality compared with MPA (HR, 0.94; 95% CI, 0.86-1.02). Among participants performing any MVPA, a higher proportion of VPA to total physical activity was associated with lower all-cause mortality but not with cardiovascular disease and cancer mortality. For instance, compared with participants with 0% of VPA (no vigorous activity), participants performing greater than 50% to 75% of VPA to total physical activity had a 17% lower all-cause mortality (hazard ratio, 0.83; 95% CI, 0.78-0.88), independent of total MVPA. The inverse association between proportion of VPA to total physical activity and all-cause mortality was consistent across sociodemographic characteristics, lifestyle risk factors, and chronic conditions at baseline.

CONCLUSIONS AND RELEVANCE

This study suggests that, for the same volume of MVPA, a higher proportion of VPA to total physical activity was associated with lower all-cause mortality. Clinicians and public health interventions should recommend 150 minutes or more per week of MVPA but also advise on the potential benefits associated with VPA to maximize population health.

The whole day matters: Understanding 24-hour movement guideline adherence and relationships with health indicators across the lifespan

BACKGROUND

New research suggests that the composition (mix) of movement behaviors within a 24-h period may have important implications for health across the lifespan. Consistent with this integrated movement behavior paradigm, a number of countries across the world have developed and released 24-h movement guidelines for specific age groups. The purpose of this systematic review was to examine the associations between the 24-h time-use composition of movement behaviors, or adherence to 24-h movement guidelines, and multiple health indicators across the lifespan.

METHODS

Five online databases (PsycINFO, PubMed, SPORTDiscus, Web of Science, and Ovid MEDLINE) were searched for relevant peer-reviewed studies published between January 2015 and January 2020 that met the a priori inclusion criteria, with no study design limits. The methodological quality of research evidence for each individual study and for each health indicator was assessed by using a modified version of the Downs and Black checklist.

RESULTS

A total of 51 studies from 20 different countries met the inclusion criteria. A total of 31 studies examined adherence (meeting vs. not meeting) to 24-h movement guidelines, and 20 studies used compositional analyses to explore the 24-h time-use composition of movement behaviors. Findings indicated that meeting the 24-h movement guidelines were (1) not associated with adiposity among toddlers, (2) favorably associated with health-related quality of life, social-cognitive development, and behavioral and emotional problems among preschoolers, (3) favorably associated with global cognition, health-related quality of life, and healthy dietary patterns in children, and (4) favorably associated with adiposity, fitness, and cardiometabolic, mental, social, and emotional health among children and youth. Significant associations were also found between the composition of 24-h movement behaviors and indicators of (1) adiposity and bone and skeletal health among preschoolers, (2) health-related quality of life among children, (3) adiposity, fitness, and cardiometabolic, social, and emotional health among children and youth, (4) cardiometabolic health in adults, (5) adiposity and fitness among adults and older adults, and (6) mental health and risk of mortality among older adults. The quality of the available evidence ranged from poor to good.

CONCLUSION

The current evidence indicates that the composition of movement behaviors within a 24-h period may have important implications for health at all ages and that meeting the current 24-h movement guidelines is associated with a number of desirable health indicators in children and youth. Future studies should employ longitudinal and experimental designs, include valid and reliable measures of 24-h movement behaviors, and examine a wide array of health indicators across all age groups. Such studies would confirm the results from the primarily cross-sectional evidence drawn from studies included in our review and further advance our understanding of the relationships between 24-h movement behaviors and health.

Twenty-Four Hour Activity and Sleep Profiles for Adults Living with Arthritis: Habits Matter

OBJECTIVE

To identify 24-hour activity-sleep profiles in adults with arthritis and explore factors associated with profile membership.

METHODS

Our study comprised a cross-sectional cohort and used baseline data from 2 randomized trials studying activity counseling for people with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), or knee osteoarthritis (OA). Participants wore activity monitors for 1 week and completed surveys for demographic information, mood (Patient Health Questionnaire 9), and sitting and walking habits (Self-Reported Habit Index). A total of 1,440 minutes/day were stratified into minutes off body (activity unknown), sleeping, resting, nonambulatory, and intermittent or purposeful ambulation. Latent class analysis determined cluster numbers; baseline-category multinomial logit regression identified factors associated with cluster membership.

RESULTS

Our cohort included 172 individuals, including 51% with RA, 30% with OA, and 19% with SLE. We identified 4 activity-sleep profiles (clusters) that were characterized primarily by differences in time in nonambulatory activity: high sitters (6.9 hours sleep, 1.6 hours rest, 13.2 hours nonambulatory activity, and 1.6 hours intermittent and 0.3 hours purposeful walking), low sleepers (6.5 hours sleep, 1.2 hours rest, 12.2 hours nonambulatory activity, and 3.3 hours intermittent and 0.6 hours purposeful walking), high sleepers (8.4 hours sleep, 1.9 hours rest, 10.4 hours nonambulatory activity, and 2.5 hours intermittent and 0.3 hours purposeful walking), and balanced activity (7.4 hours sleep, 1.5 hours sleep, 9.4 hours nonambulatory activity, and 4.4 hours intermittent and 0.8 hours purposeful walking). Younger age (odds ratio [OR] 0.95 [95% confidence interval (95% CI) 0.91-0.99]), weaker occupational sitting habit (OR 0.55 [95% CI 0.41-0.76]), and stronger walking outside habit (OR 1.43 [95% CI 1.06-1.91]) were each associated with balanced activity relative to high sitters.

CONCLUSION

Meaningful subgroups were identified based on 24-hour activity-sleep patterns. Tailoring interventions based on 24-hour activity-sleep profiles may be indicated, particularly in adults with stronger habitual sitting or weaker walking behaviors.

Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep

The Canadian Society for Exercise Physiology assembled a Consensus Panel representing national organizations, content experts, methodologists, stakeholders, and end-users and followed an established guideline development procedure to create the Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. These guidelines underscore the importance of movement behaviours across the whole 24-h day. The development process followed the strategy outlined in the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. A large body of evidence was used to inform the guidelines including 2 de novo systematic reviews and 4 overviews of reviews examining the relationships among movement behaviours (physical activity, sedentary behaviour, sleep, and all behaviours together) and several health outcomes. Draft guideline recommendations were discussed at a 4-day in-person Consensus Panel meeting. Feedback from stakeholders was obtained by survey (n = 877) and the draft guidelines were revised accordingly. The final guidelines provide evidence-based recommendations for a healthy day (24-h), comprising a combination of sleep, sedentary behaviours, and light-intensity and moderate-to-vigorous-intensity physical activity. Dissemination and implementation efforts with corresponding evaluation plans are in place to help ensure that guideline awareness and use are optimized.

Novelty First ever 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older with consideration of a balanced approach to physical activity, sedentary behaviour, and sleep Finalizes the suite of 24-Hour Movement Guidelines for Canadians across the lifespan

Validating Accelerometers for the Assessment of Body Position and Sedentary Behavior

There is growing evidence that sedentary behavior is a risk factor for somatic and mental health. However, there is still a lack of objective field methods, which can assess both components of sedentary behavior: the postural (sitting/lying) and the movement intensity part. The purpose of the study was to compare the validity of different accelerometers (ActivPAL [thigh], ActiGraph [hip], move [hip], and move [thigh]). 20 adults (10 females; age 25.68 ± 4.55 years) participated in a structured protocol with a series of full- and semistandardized sessions under laboratory conditions. Direct observation via video recording was used as a criterion measure of body positions (sitting/lying vs. nonsitting/lying). By combining direct observation with metabolic equivalent tables, protocol activities were also categorized as sedentary or nonsedentary. Cohen’s kappa was calculated as an overall validity measure to compare accelerometer and video recordings. Across all conditions, for the measurement of sitting/lying body positions, the ActivPAL ([thigh], ĸ = .85) and Move 4 ([thigh], ĸ = .97) showed almost perfect agreement, whereas the Move 4 ([hip], ĸ = .78) and ActiGraph ([hip], ĸ = .67) showed substantial agreement. For the sedentary behavior part, across all conditions, the ActivPAL ([thigh], ĸ = .90), Move 4 ([thigh], ĸ = .95) and Move 4 ([hip], ĸ = .84) revealed almost perfect agreement, whereas the ActiGraph ([hip], ĸ = .69) showed substantial agreement. In particular, thigh-worn devices, namely the Move and the ActivPAL, achieved up to excellent validity in measuring sitting/lying body positions and sedentary behavior and are recommended for future studies.

The physical activity paradox revisited: a prospective study on compositional accelerometer data and long-term sickness absence

Background

The ‘physical activity paradox’ advocates that leisure physical activity (PA) promotes health while high occupational PA impairs health. However, this paradox can be explained by methodological limitations of the previous studies—self-reported PA measures, insufficient adjustment for socioeconomic confounding or not addressing the compositional nature of PA. Therefore, this study investigated if we still observe the PA paradox in relation to long-term sick absence (LTSA) after adjusting for the abovementioned limitations.

Methods

Time spent on moderate-to-vigorous physical activity (MVPA) and remaining physical behaviors (sedentary behavior, standing, light PA and time in bed) at work and in leisure was measured for 929 workers using thigh accelerometry and expressed as isometric log-ratios (ilrs). LTSA was register-based first event of ≥6 consecutive weeks of sickness absence during 4-year follow-up. The association between ilrs and LTSA was analyzed using a Cox proportional hazards model adjusted for remaining physical behaviors and potential confounders, then separately adjusting for and stratifying by education and type of work.

Results

During the follow-up, 21% of the workers experienced LTSA. In leisure, more relative MVPA time was negatively associated with LTSA (20% lower risk with 20 min more MVPA, p = 0.02). At work, more relative MVPA time was positively associated with LTSA (15% higher risk with 20 min more MVPA, p = 0.02). Results remained unchanged when further adjusted for or stratified by education and type of work.

Conclusion

These findings provide further support to the ‘PA paradox’.

Natural Patterns of Sitting, Standing and Stepping During and Outside Work-Differences between Habitual Users and Non-Users of Sit-Stand Workstations

Sit-stand workstations have shown to reduce sitting time in office workers on a group level. However, movement behaviour patterns might differ between subgroups of workers. Therefore, the objective of this study was to examine sitting, standing and stepping outcomes between habitual users and non-users of sit-stand workstations. From an international office population based in the Netherlands, 24 users and 25 non-users of sit-stand workstations were included (all had long-term access to these workstations). Using the ActivPAL, sitting, standing and stepping were objectively measured during and outside working hours. Differences in outcomes between users and non-users were analysed using linear regression. During working hours, users sat less (-1.64; 95% IC= -2.27--1.01 hour/8 hour workday) and stood more (1.51; 95% IC= 0.92-2.10 hour/8 hour workday) than non-users. Attenuated but similar differences were also found for total sitting time over the whole week. Furthermore, time in static standing bouts was relatively high for users during working hours (median= 0.56; IQR = 0.19-1.08 hour/8 hour workday). During non-working hours on workdays and during non-working days, no differences were found between users and non-users. During working hours, habitual users of their sit-stand workstation sat substantially less and stood proportionally more than non-users. No differences were observed outside working hours, leading to attenuated but similar differences in total sitting and standing time between users and non-users for total days. This indicated that the users of sit-stand workstations reduced their sitting time at work, but this seemed not to be accompanied by major carry-over or compensatory effects outside working hours.

Compositional Data Analysis in Time-Use Epidemiology: What, Why, How

In recent years, the focus of activity behavior research has shifted away from univariate paradigms (e.g., physical activity, sedentary behavior and sleep) to a 24-h time-use paradigm that integrates all daily activity behaviors. Behaviors are analyzed relative to each other, rather than as individual entities. Compositional data analysis (CoDA) is increasingly used for the analysis of time-use data because it is intended for data that convey relative information. While CoDA has brought new understanding of how time use is associated with health, it has also raised challenges in how this methodology is applied, and how the findings are interpreted. In this paper we provide a brief overview of CoDA for time-use data, summarize current CoDA research in time-use epidemiology and discuss challenges and future directions. We use 24-h time-use diary data from Wave 6 of the Longitudinal Study of Australian Children (birth cohort, n = 3228, aged 10.9 ± 0.3 years) to demonstrate descriptive analyses of time-use compositions and how to explore the relationship between daily time use (sleep, sedentary behavior and physical activity) and a health outcome (in this example, adiposity). We illustrate how to comprehensively interpret the CoDA findings in a meaningful way.