Compositional Analysis of the Associations between 24-h Movement Behaviours and Health Indicators among Adults and Older Adults from the Canadian Health Measure Survey

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 Association of the 24-Hour Activity Cycle Profiles With Cognition in Older Adults With Mild Cognitive Impairment: A Cross-Sectional Study

BACKGROUND

The relationship of cognition and the 24-h activity cycle (24-HAC), encompassing physical activity, sedentary behavior, and sleep, in older adults with mild cognitive impairment (MCI) remains uncertain. Distinct combinations of 24-HAC behaviors can characterize unique activity profiles and influence cognition. We aimed to characterize 24-HAC activity profiles in older adults with MCI and assess whether differences in cognition exist across profiles.

METHODS

We conducted a cross-sectional analysis utilizing baseline data from 3 randomized controlled trials involving 253 community-dwelling older adults (55 + years) with MCI (no functional impairment, dementia diagnosis, and Montreal Cognitive Assessment score <26/30). Using MotionWatch8© wrist-worn actigraphy (+5 days), we captured the 24-HAC. Cognition was indexed by the Alzheimer's Disease Assessment Scale Cognitive Plus (ADAS-Cog-Plus). Compositional data and latent profile analyses identified distinct 24-HAC activity profiles. Analysis of covariance examined whether 24-HAC activity profiles differed in cognition.

RESULTS

Four distinct activity profiles were identified. Profile 1 ("Average 24-HAC," n = 103) engaged in all 24-HAC behaviors around the sample average. Profile 2 ("Active Chillers," n = 70) depicted lower-than-average engagement in physical activity and higher-than-average sedentary behavior. Profile 3 ("Physical Activity Masters," n = 54) were the most active and the least sedentary. Profile 4 ("Sedentary Savants," n = 26) were the least active and the most sedentary. Sleep was similar across profiles. There were no significant differences in ADAS-Cog-Plus scores between 24-HAC activity profiles (p > .05).

CONCLUSIONS

Older adults with MCI exhibited four 24-HAC activity profiles conforming to recommended physical activity and sleep guidelines. Nonetheless, cognition was similar across these profiles.

Longitudinal Associations between 24-h Movement Behaviors and Cardiometabolic Biomarkers: A Natural Experiment over Retirement

INTRODUCTION

Physical activity, sedentary behavior, and sleep, that is, 24-h movement behaviors, often change in the transition from work to retirement, which may affect cardiometabolic health. This study investigates the longitudinal associations between changes in 24-h movement behaviors and cardiometabolic biomarkers during the retirement transition.

METHODS

Retiring public sector workers ( n = 212; mean (SD) age, 63.5 (1.1) yr) from the Finnish Retirement and Aging study used a thigh-worn Axivity accelerometer and filled out a diary to obtain data on daily time spent in sedentary behavior (SED), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA), and sleep before and after retirement (1 yr in-between). Cardiometabolic biomarkers, including LDL-cholesterol, HDL-cholesterol, total/HDL-cholesterol ratio, triglycerides, C-reactive protein, fasting glucose, and insulin, were measured. Associations between changes in 24-h movement behaviors and cardiometabolic biomarkers were analyzed using compositional robust regression and isotemporal substitution analysis.

RESULTS

Increasing LPA in relation to remaining behaviors was associated with an increase in HDL-cholesterol and decrease in total/HDL-cholesterol ratio ( P < 0.05 for both). For instance, reallocation of 30 min from sleep/SED to LPA was associated with an increase in HDL-cholesterol by 0.02 mmol·L -1 . Moreover, increasing MVPA in relation to remaining behaviors was associated with a decrease in triglycerides ( P = 0.02). Reallocation of 30 min from SED/sleep to MVPA was associated with 0.07-0.08 mmol·L -1 decrease in triglycerides. Findings related to LDL-cholesterol, C-reactive protein, fasting glucose, and insulin were less conclusive.

CONCLUSIONS

During the transition from work to retirement, increasing physical activity at the expense of passive behaviors was associated with a better lipid profile. Our findings suggest that life transitions like retirement could be utilized more as an optimal time window for promoting physical activity and health.

24-hour movement behaviors time allocation and depression among Chinese community-dwelling older adults: A latent profile analysis

This study explored the combination characteristics of physical activity, sedentary behavior, and sleep among older adults during a 24-hour time allocation and analyzed the correlations between different combinations and depression. We recruited 648 older adults (mean age 72.65±7.03) from three communities in urban areas of central China and measured their physical activity, sedentary behavior, sleep quality, and depression. We used latent profile analysis to classify the time allocation of 24 h of movement behavior and binary logistic regression to analyze associations between different subgroups and depression. We found four classes of 24-hour movement behavior: moderately active-moderate sleepers (32.9 %), active-sedentary-short sleepers (17.8 %), sedentary-long sleepers (8.6 %), and active-short sleepers (40.7 %). Compared with moderately active-moderate sleepers, active-sedentary-short and sedentary-long sleepers were 2.953 and 4.813 times more likely to have depression, respectively. There was no statistically significant difference between active-short and moderately active-moderate sleepers. The results can inform preventive measures for depression in older adults.

Replacing sedentary time for physical activity: Does intensity matter for body composition in oldest-old adults?

To assess the independent and combined relationships among objectively measured sedentary time (ST), light intensity PA (LPA), and moderate-to-vigorous intensity PA (MVPA) with muscle mass and fat mass (FM) and how theoretical displacement of these inter-dependent behaviours relates to body composition in oldest-old men. A total of 1046 men participating in the year 14 visit of the prospective Osteoporotic Fractures in Men (MrOS) cohort study with complete data for accelerometry, dual x-ray absorptiometry, and deuterated creatine dilution (D3Cr) muscle mass were included in the analysis (84.0 ± 3.8 yrs.). Single, partition, and isotemporal substitution models were used to assess the interrelationships between PA intensities and ST with body composition measures, while controlling for relevant confounders. Replacing 30-min of ST with 30-min of MVPA was associated with lower FM (β =-0.17, p < 0.001) and higher D3Cr muscle mass, although this was of borderline significance (β = 0.07, p = 0.05). Replacing 30-min of ST for LPA was associated with lower FM (β =-0.15, p < 0.001), but there was no effect on D3Cr muscle mass (p > 0.05). Exchanging ST with any intensity of PA is associated with benefits for FM in oldest-old adult men, although substitution with MVPA may be more beneficial than LPA for maintaining/improving skeletal muscle mass.

Comparative effectiveness of interventions on promoting physical activity in older adults: A systematic review and network meta-analysis

Background

Despite the well-established health benefits of physical activity, a large population of older adults still maintain sedentary life style or physical inactivity. This network meta-analysis (NMA) aimed to compare the effectiveness of wearable activity tracker-based intervention (WAT), electronic and mobile health intervention (E&MH), structured exercise program intervention (SEP), financial incentive intervention (FI) on promoting physical activity and reducing sedentary time in older adults.

Methods

The systematic review based on PRISMA guidelines, a systematic literature search of PubMed, Web of Science, Google Scholar, EMbase, Cochrane Library, Scopus were searched from inception to December 10th 2022. The randomized controlled trials (RCT) were included. Two reviewers independently conducted study selection, data extraction, risk of bias and certainty of evidence assessment. The effect measures were standard mean differences (SMD) and 95% confidence interval (CI) in daily steps, moderate-to-vigorous physical activity (MVPA) and sedentary time.

Results

A total of 69 studies with 14,120 participants were included in the NMA. Among these included studies, the results of daily steps, MVPA and sedentary time was reported by 55, 25 and 15 studies, respectively. The NMA consistency model analysis suggested that the following interventions had the highest probability (surface under the cumulative ranking, SUCRA) of being the best when compared with control: FI + WAT for daily steps (SUCRA = 96.6%; SMD = 1.32, 95% CI:0.77, 1.86), WAT + E&MH + SEP for MVPA (SUCRA = 91.2%; SMD = 0.94, 95% CI: 0.36, 1.52) and WAT + E&MH + SEP for sedentary time (SUCRA = 80.3%; SMD = -0.50, 95% CI: -0.87, -0.14). The quality of the evidences of daily steps, MVPA and sedentary time was evaluated by very low, very low and low, respectively.

Conclusions

In this NMA, there's low quality evidence that financial incentive combined with wearable activity tracker is the most effective intervention for increasing daily steps of older adults, wearable activity tracker combined with electronic and mobile health and structured exercise program is the most effective intervention to help older adults to increase MVPA and reduce sedentary time.

Use of Electronic Ecological Momentary Assessment Methodologies in Physical Activity, Sedentary Behavior, and Sleep Research in Young Adults: Systematic Review

BACKGROUND

Recent technological advances allow for the repeated sampling of real-time data in natural settings using electronic ecological momentary assessment (eEMA). These advances are particularly meaningful for investigating physical activity, sedentary behavior, and sleep in young adults who are in a critical life stage for the development of healthy lifestyle behaviors.

OBJECTIVE

This study aims to describe the use of eEMA methodologies in physical activity, sedentary behavior, and sleep research in young adults.

METHODS

The PubMed, CINAHL, PsycINFO, Embase, and Web of Science electronic databases were searched through August 2022. Inclusion criteria were use of eEMA; sample of young adults aged 18 to 25 years; at least 1 measurement of physical activity, sedentary behavior, or sleep; English language; and a peer-reviewed report of original research. Study reports were excluded if they were abstracts, protocols, or reviews. The risk of bias assessment was conducted using the National Heart, Lung, and Blood Institute's Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Screening, data extraction, and risk of bias assessments were conducted by independent authors, with discrepancies resolved by consensus. Descriptive statistics and narrative synthesis were used to identify overarching patterns within the following categories guided by the Checklist for Reporting Ecological Momentary Assessments Studies: study characteristics, outcomes and measures, eEMA procedures, and compliance.

RESULTS

The search resulted in 1221 citations with a final sample of 37 reports describing 35 unique studies. Most reports (28/37, 76%) were published in the last 5 years (2017-2022), used observational designs (35/37, 95%), consisted of samples of college students or apprentices (28/35, 80%), and were conducted in the United States (22/37, 60%). The sample sizes ranged from 14 to 1584 young adults. Physical activity was measured more frequently (28/37, 76%) than sleep (16/37, 43%) or sedentary behavior (4/37, 11%). Of the 37 studies, 11 (30%) reports included 2 movement behaviors and no reports included 3 movement behaviors. eEMA was frequently used to measure potential correlates of movement behaviors, such as emotional states or feelings (25/37, 68%), cognitive processes (7/37, 19%), and contextual factors (9/37, 24%). There was wide variability in the implementation and reporting of eEMA procedures, measures, missing data, analysis, and compliance.

CONCLUSIONS

The use of eEMA methodologies in physical activity, sedentary behavior, and sleep research in young adults has greatly increased in recent years; however, reports continue to lack standardized reporting of features unique to the eEMA methodology. Additional areas in need of future research include the use of eEMA with more diverse populations and the incorporation of all 3 movement behaviors within a 24-hour period. The findings are intended to assist investigators in the design, implementation, and reporting of physical activity, sedentary behavior, and sleep research using eEMA in young adults.

TRIAL REGISTRATION

PROSPERO CRD42021279156; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021279156.

The relationship between psychology practice and complementary medicine in Australia: Psychologists' demographics and practice characteristics regarding type of engagement across a range of complementary medicine modalities

INTRODUCTION

Many people with mental health problems utilise a range of complementary medicine (CM) practitioners, products, and practices. Psychologists are likely to consult with clients who are seeking and using CM, in some form, as part of their wider mental health treatment. The aim of this research is to determine how much, and in what ways, Australian psychologists recommend CM products and/or practices, and/or initiate referrals to CM practitioners as part of their clinical practice and to explore if these behaviours have any association with the characteristics of the psychologist or their wider practice.

METHODS

Survey data was collected from psychologists in clinical practice who self-selected to participate between February and April 2021. Participation in the study was via an online 79-item questionnaire exploring core aspects of CM engagement in psychology clinical practice.

RESULTS

Amongst the 202 psychologists who completed the survey, mind/body approaches (90.5%) were the most recommended CM and cultural/spiritual approaches the least recommended CM (7.5%). Participants also reported referring to CM practitioners with naturopaths the most common focus of their referrals (57.9%) and cultural and spiritual practitioners the least common focus of their referrals (6.69%). Our analysis shows the demographic and practice characteristics of a psychologist are generally not predictors of a psychologist's engagement with CM in their clinical practice.

CONCLUSIONS

Substantial numbers of psychologists recommend CM products and practices and/or refer clients to CM practitioners. Alongside subjecting CM interventions for mental health to an evidence-base assessment, the broader discipline of psychology needs to also consider psychologist engagement with CM in clinical practice in order to help ensure cultural-sensitivity, client safety and client choice.

Physical activity, sedentary behaviour, and sleep in the Thai population: A compositional data analysis including 135,824 participants from two national time-use surveys

PURPOSE

To determine the amounts of time spent in physical activity (PA), sedentary behaviour (SB), and sleep in the Thai population, as well as their sociodemographic correlates and changes over time.

METHODS

We analysed cross-sectional data collected in a population-representative, stratified random sample of 135,824 Thais aged 10 years and over as part of the two most recent Thai National time-use surveys (2009 and 2015). Daily activities reported by the participants were coded using the International Classification of Activities for Time-Use Statistics (ICATUS) and categorised as PA, SB, or sleep.

RESULTS

In the latest survey, participants spent on average the largest amount of time sleeping (geometric mean [g] = 9.44 h/day; 95% confidence interval [CI]: 9.42, 9.47), followed by PA (g = 8.60 h/day; 95% CI: 8.55, 8.64) and SB (g = 5.96 h/day; 95% CI: 5.93, 6.00). The time spent in PA was higher on weekdays, while the amounts of SB and sleep were higher on weekends (p < 0.05). Males, older age groups, and unemployed people spent less time in PA and more time in SB, compared with other population groups (p < 0.05). We found a relatively large increase in SB (mean difference [d] = 39.64 min/day; 95% CI: 36.18, 42.98) and decrease in PA (d = 54.33 min/day; 95% CI: -58.88, -49.30) over time. These findings were consistent across most sociodemographic groups, with the most concerning shifts from active to sedentary lifestyle found among people with a higher education degree and on weekends.

CONCLUSIONS

Our findings revealed a shift to a more sedentary lifestyle in the Thai population. Public health interventions should focus on improving time use among males, older age groups, and unemployed people, while preventing the rapid decrease in PA and increase in SB among those with a higher education degree and on weekends.

Substituting sedentary time with physical activity in youngest-old to oldest-old community-dwelling older adults: Associations with body composition

Introduction

Several studies have suggested that physical activity and sedentary behavior are strongly and independently associated with body composition and obesity. However, few studies have investigated whether substituting sedentary time with moderate-to-vigorous physical activity is associated with body composition in older adults, especially among those older than 75 years.

Methods

This study examined the associations between replacing sedentary time with physical activity and obesity indices in a sample of 199 community-dwelling older Taiwanese adults (52.3% women; 80.6 ± 7.0 years). Physical activity and sedentary behavior were measured using the triaxial accelerometer (GT3X+, ActiGraph). Body composition indices were computed through a bioelectrical impedance analysis of body fat percentage and appendicular skeletal muscle mass index. Waist circumference and body mass index were measured by trained personnel. Isotemporal substitution analyses estimated these associations after adjusting for sociodemographic characteristics and nutritional status.

Results

The study showed that substituting 30 min of sedentary behavior per day with moderate-to-vigorous physical activity was associated with lower body fat percentage (B = -1.408, 95% CI = -2.55, -0.264), body mass index (B = -0.681, 95% CI = -1.300, -0.061), and waist circumference (B = -2.301, 95% CI = -4.062, -0.539) after adjusting for covariates. Substituting 30 min of light physical activity per day with moderate-to-vigorous physical activity was associated with lower waist circumference (B = -2.230, 95% CI = -4.173, -0.287) after adjusting for covariates. Stratified analyses indicated that associations were stronger in youngest-old older adults, and in older adults with a normal nutritional status (vs. underweight status).

Discussion

These findings confirm the importance of reducing sedentary behavior and increasing moderate-to-vigorous physical activity among older adults to improve their physical health, as well as highlighting the importance of taking into account nutritional status and age group.

Trajectories of 24-h movement guidelines from middle adolescence to adulthood on depression and suicidal ideation: a 22-year follow-up study

Background:

The 24-h movement guidelines for youth and adults recommend the specific duration of physical activity, sedentary time, and sleep duration to ensure optimal health, but little is known about its relationship to mental health indicators. The aim of the study was to explore the association between 24-h movement guidelines in adolescence and its trajectories from middle adolescence (12–17 years old) to adulthood (33–39 years old) with depression and suicidal ideation in adulthood.

Methods:

This prospective cohort study included individuals who participated in Waves I (1994–1995) and V (2016–2018) of the National Longitudinal Study of Adolescent Health (Add Health) in the United States. Physical activity, screen time and sleep duration were measured using questionnaires. Adults were categorized as having depression if they had a self-reported history of depression and/or prescription medication-use for depression in the previous four weeks. Suicidal ideation was assessed by a self-reported single question in both waves. Poisson regression analyses were used to estimate the incidence rate ratio (IRR) of depression and suicidal ideation at adulthood, according to meeting specific and combinations of 24-h movement guidelines at Wave I and its trajectories from adolescence to adulthood.

Results:

The study included 7,069 individuals (56.8% women). Adolescents who met physical activity guidelines and all three guidelines at middle adolescence had lower risk of depression (IRR = 0.84, 95%CI 0.72 to 0.98) and suicidal ideation (IRR = 0.74, 95%CI 0.55 to 0.99) at adulthood than those who did not meet any of these guidelines, respectively. Individuals who met the guidelines for screen time and all three guidelines in both adolescence and adulthood had lower risk of depression (screen time, IRR = 0.87, 95% CI 0.72 to 0.98; all three, IRR = 0.37, 95% CI 0.15 to 0.92) and suicidal ideation (screen time, IRR = 0.74, 95% CI 0.51 to 0.97; all three, IRR = 0.12, 95% CI 0.06 to 0.33) than those who never met the guidelines. Additionally, individuals who did not meet all three guidelines in adolescence but met the guidelines in adulthood had lower risk of suicidal ideation than those who never met the guidelines (IRR = 0.81, 95%CI 0.45 to 0.89).

Conclusion:

Our findings highlight the importance of promoting and maintaining adherence to the 24-h movement guidelines from middle adolescence to adulthood to prevent mental health problems. However, our findings must be interpreted carefully due to declared limitations, e.g., the self-reported assessments which are subject to sources of error and bias or that the dataset used to gauge meeting a guidelines (1994–1996) was made later (2016).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-022-01367-0.

Isotemporal Associations of Device-Measured Sedentary Time and Physical Activity with Cardiac-Autonomic Regulation in Previously Pregnant Women

BACKGROUND

High sedentary time (ST) and low physical activity may increase cardiovascular risk, potentially though cardiac-autonomic dysregulation. This study investigated associations of statistically exchanging device-measured ST and physical activity with measures of cardiac-autonomic regulation in previously pregnant women.

METHOD

This cross-sectional, secondary analysis included 286 women (age = 32.6 ± 5.7 years; 68% white) measured 7-15 years after delivery. ST and light (LPA), moderate (MPA), vigorous (VPA), and moderate-to-vigorous (MVPA) intensity physical activity were measured by ActiGraph GT3X. ST was further partitioned into long (≥ 30 min) and short (< 30 min) bouts. MVPA was also partitioned into long (≥ 10 min) and short (< 10 min) bouts. Cardiac-autonomic regulation was assessed by heart rate variability (HRV) (resting heart rate, natural log transformed standard deviation of normal R-R intervals [lnSDNN], natural log-transformed root mean square of successive differences [lnRMSSD]) from a 5-min seated ECG. Progressive isotemporal substitution models adjusted for confounders. Sensitivity analyses removed women with related underlying medical conditions and who did not meet respiration rate criteria.

RESULTS

Initial analyses found no significant associations with HRV when exchanging 30 min of ST and physical activity (p > 0.05). Yet, replacing long- and short-bout ST with 30 min of long-bout MVPA yielded significantly higher (healthier) lnRMSSD (B = 0.063 ± 0.030 and B = 0.056 ± 0.027, respectively; both p < 0.05). Sensitivity analyses strengthened these associations and yielded further associations of higher lnSDNN and lnRMSSD when replacing 30 min of short-bout MVPA with equivalent amounts of long-bout MVPA (B = 0.074 ± 0.037 and B = 0.091 ± 0.046, respectively).

CONCLUSION

Replacing ST with long-bout MVPA is a potential strategy to improve cardiac-autonomic function in previously pregnant women.

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.

The association between sedentary behaviour, physical activity and type 2 diabetes markers: A systematic review of mixed analytic approaches

The negative effect of sedentary behaviour on type 2 diabetes markers is established, but the interaction with measures of physical activity is still largely unknown. Previous studies have analysed associations with single-activity models, which ignore the interaction with other behaviours. By including results from various analytical approaches, this review critically summarises the effects of sedentary behaviour on diabetes markers and the benefits of substitutions and compositions of physical activity. Ovid Medline, Embase and Cochrane Library databases were systematically searched. Studies were selected if sedentary behaviour and physical activity were measured by accelerometer in the general population, and if associations were reported with glucose, insulin, HOMA-IR, insulin sensitivity, HbA1c, diabetes incidence, CRP and IL-6. Forty-five studies were included in the review. Conclusive detrimental associations with sedentary behaviour were determined for 2-h insulin (6/12 studies found associations), fasting insulin (15/19 studies), insulin sensitivity (4/6 studies), diabetes (3/4 studies) and IL-6 (2/3 studies). Reallocating sedentary behaviour to light or moderate-to-vigorous activity has a beneficial effect for 2-h glucose (1/1 studies), fasting insulin (3/3 studies), HOMA-IR (1/1 studies) and insulin sensitivity (1/1 studies). Compositional measures of sedentary behaviour were found to affect 2-h glucose (1/1 studies), fasting insulin (2/3 studies), 2-h insulin (1/1 studies), HOMA-IR (2/2 studies) and CRP (1/1 studies). Different analytical methods produced conflicting results for fasting glucose, 2-h glucose, 2-h insulin, insulin sensitivity, HOMA-IR, diabetes, hbA1c, CRP and IL-6. Studies analysing data by quartiles report independent associations between sedentary behaviour and fasting insulin, HOMA-IR and diabetes only for high duration of sedentary time (7-9 hours/day). However, this review could not provide sufficient evidence for a time-specific cut-off of sedentary behaviour for diabetes biomarkers. While substituting sedentary behaviour with moderate-to-vigorous activity brings greater improvements for health, light activity also benefits metabolic health. Future research should elucidate the effects of substituting and combining different activity durations and modalities.

24-Hour Movement Behaviors Among US Adults With Functional Disabilities

This study aimed to quantify and compare physical activity, sitting time, and sleep behaviors among US adults with and without disabilities using the 2020 Canadian 24-hour movement framework. The weighted prevalence of 24-hour movement guideline adherence was estimated among a nationally representative sample from the 2017 to 2018 National Health and Nutrition Examination Survey of US adults (18-65 years old) with (n = 1070) and without (n = 33,370) functional disabilities in vision, hearing, mobility, cognitive, and self-care domains. The adjusted odds of single and combination guideline compliance were estimated by disability type, in reference to adults without disabilities, using separate multivariable logistic regressions. After adjusting for age, sex, and income, adults with disabilities in mobility, cognitive, or self-care domains had approximately half the odds of meeting all 3 guidelines, compared with adults without disabilities (adjusted odds range: 0.49-0.77). Significantly lower adherence was observed among adults with functional disabilities, compared with no disabilities, for sleep, and moderate to vigorous physical activity, but not sedentary guidelines. This report establishes baseline prevalence estimates for guidelines compliance among US adults with functional disabilities ages 18-65 years old. Low guideline adherence, and evidence for significant differences in physical activity and sleep, signals a need to further explore combination health behaviors among adults with disabilities.

Movement behavior patterns composition remains stable, but individuals change their movement behavior pattern over time in people with a first-ever stroke

BACKGROUND

Movement behaviors (i.e., physical activity levels, sedentary behavior) in people with stroke are not self-contained but cluster in patterns. Recent research identified three commonly distinct movement behavior patterns in people with stroke. However, it remains unknown if movement behavior patterns remain stable and if individuals change in movement behavior pattern over time.

OBJECTIVES

1) To investigate the stability of the composition of movement behavior patterns over time, and 2) determine if individuals change their movement behavior resulting in allocation to another movement behavior pattern within the first two years after discharge to home in people with a first-ever stroke.

METHODS

Accelerometer data of 200 people with stroke of the RISE-cohort study were analyzed. Ten movement behavior variables were compressed using Principal Componence Analysis and K-means clustering was used to identify movement behavior patterns at three weeks, six months, one year, and two years after home discharge. The stability of the components within movement behavior patterns was investigated. Frequencies of individuals' movement behavior pattern and changes in movement behavior pattern allocation were objectified.

RESULTS

The composition of the movement behavior patterns at discharge did not change over time. At baseline, there were 22% sedentary exercisers (active/sedentary), 45% sedentary movers (inactive/sedentary) and 33% sedentary prolongers (inactive/highly sedentary). Thirty-five percent of the stroke survivors allocated to another movement behavior pattern within the first two years, of whom 63% deteriorated to a movement behavior pattern with higher health risks. After two years there were, 19% sedentary exercisers, 42% sedentary movers, and 39% sedentary prolongers.

CONCLUSIONS

The composition of movement behavior patterns remains stable over time. However, individuals change their movement behavior. Significantly more people allocated to a movement behavior pattern with higher health risks. The increase of people allocated to sedentary movers and sedentary prolongers is of great concern. It underlines the importance of improving or maintaining healthy movement behavior to prevent future health risks after stroke.

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

OBJECTIVE

Previous studies have reported opposite effects of occupational or non-occupational physical activity (PA) and sedentary behavior (SB) on health outcomes. However, no study has investigated the relationship between domain-specific movement behaviors and cardiometabolic health (CMH) among office workers, considering the compositional nature of time-use data. We investigated the associations of accelerometer-measured PA and SB for each domain (working time, non-working time on workday, and non-workday) with CMH indicators among office workers, using compositional data analysis.

METHODS

This cross-sectional study included 1258 Japanese office workers. The time spent on SB, light-intensity PA (LPA), and moderate- to vigorous-intensity PA (MVPA) were assessed using an accelerometer. CMH indicators were retrieved from the annual health check-up data.

RESULTS

Compositional multiple linear regression indicated that PA and SB during non-working time on workdays, but not working time or non-workdays, were significantly associated with CMH. In particular, during non-working time, time reallocations from SB to LPA and from SB to MVPA were associated with favorable changes in cardiometabolic risk score and lipid metabolism, respectively. Paradoxically, a greater proportion of LPA during non-working time was associated with favorable diastolic blood pressure (β = 1.61; 95% confidence interval [CI] = 0.02, 3.19), whereas occupational LPA was detrimental (β = -2.48; 95% CI = -4.87, -0.09).

CONCLUSION

Our results suggested that reducing SB and increasing PA during non-working time on workdays may be effective for managing CMH among office workers. Future longitudinal studies using compositional data analysis are required to confirm our results.

Association between 24-h movement guidelines and cardiometabolic health in Chilean adults

This study aimed to examine the association between meeting 24-h movement guidelines and cardiometabolic health in Chilean adults. We used cross-sectional data of 2618 adults from the Chilean National Health Survey 2016–2017. Meeting the 24-h movement guidelines was defined as ≥ 600 MET-min/week of physical activity; ≤ 8 h/day of sitting time; and 7 to 9 h/day of sleep duration. Cardiometabolic health indicators were body mass index, waist circumference, high triglycerides, high blood pressure, type 2 diabetes, metabolic syndrome, and risk of cardiovascular disease in a 10-year period. Meeting none out of three 24-h movement guidelines (vs all three) was associated with higher odds of overweight/obesity (OR 1.67; 95%CI 1.45 to 1.89), high waist circumference (1.65; 1.40 to 1.90), hypertension (2.88; 2.23 to 3.53), type 2 diabetes (1.60; 1.26 to 1.94), metabolic syndrome (1.97; 1.54 to 2.40) and risk of cardiovascular disease (1.50; 1.20, 1.80). Meeting one guideline (vs three) was associated with higher odds of five of out seven cardiometabolic indicators. Our study found that the composition of movement behaviors within a 24-h period may have important implications for cardiometabolic health.

Prevalence and sociodemographic correlates of meeting the Canadian 24-hour movement guidelines among latin american adults: a multi-national cross-sectional study

BACKGROUND

24-hour movement behaviors, including moderate-to-vigorous physical activity (MVPA), sedentary time (ST), and sleep duration, have important implications for health across the lifespan. However, no studies exist that have examined the integration of these 24-hour movement behaviors in Latin America. The purpose of this study was to examine the prevalence of meeting the Canadian 24-Hour Movement Guideline recommendations and sociodemographic correlates of meeting the guidelines in adults from eight Latin American countries.

METHODS

This was a multi-national cross-sectional study of 2338 adults aged 18 to 64 years from the Latin American Study of Nutrition and Health. MVPA and ST data were collected using accelerometers. Sleep duration was self-reported using a daily log. Socio-demographic correlates included sex, age, education level, and marital status. Meeting the 24-hour movement guidelines was defined as: ≥150 min/week of MVPA; ≤8 h/day of ST; and between 7 and 9 h/day of sleep. Logistic regression models were estimated on pooled data.

RESULTS

The prevalence of adults who met the MVPA, ST, sleep duration, and integrated recommendations was 48.3, 22.0, 19.4, and 1.6%, respectively. Overall, being a woman (OR: 0.72; 95%CI: 0.55,0.93) and having a middle (0.63; 0.47,0.85) or high education level (0.31; 0.17,0.56) was associated with lower odds of meeting all three of the 24-hour movement guideline recommendations. Being married (1.70; 1.25,2.29) was associated with greater odds of meeting all three recommendations. Being a woman (0.46; 0.39,0.55), aged 50-64 years (0.77; 0.60,0.97), and married (0.79; 0.65,0.96) were associated with lower odds of meeting the MVPA recommendation. Having a middle (0.64; 0.50,0.80) or high (0.36; 0.23,0.55) education level was associated with lower odds and being married (1.86; 1.46,2.36) was associated with greater odds of meeting the ST recommendation. Being a woman (0.63; 0.51,0.78) was associated with lower odds; whereas being aged 50-64 years (1.40; 1.04,1.88) and having a middle education level (1.37; 1.09,1.73) were associated with greater odds of meeting the sleep duration recommendation.

CONCLUSIONS

Overall, the proportion of Latin American adults achieving healthy levels of 24-hour movement behaviors was low. Further efforts are needed to promote more MVPA, less ST, and sufficient sleep in Latin American adults.

TRIAL REGISTRATION

Clinical Trials NCT02226627 . Retrospectively registered on August 27, 2014.

Cross-sectional and prospective associations of sleep, sedentary and active behaviors with mental health in older people: a compositional data analysis from the Seniors-ENRICA-2 study

BACKGROUND

Most studies on the effects of sleep, sedentary behavior (SB), and physical activity (PA) on mental health did not account for the intrinsically compositional nature of the time spent in several behaviors. Thus, we examined the cross-sectional and prospective associations of device-measured compositional time in sleep, SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) with depression symptoms, loneliness, happiness, and global mental health in older people (≥ 65 years).

METHODS

Data were taken from the Seniors-ENRICA-2 study, with assessments in 2015-2017 (wave 0) and 2018-2019 (wave 1). Time spent in sleep, SB, LPA and MVPA was assessed by wrist-worn accelerometers. Depression symptoms, loneliness, happiness, and global mental health were self-reported using validated questionnaires. Analyses were performed using a compositional data analysis (CoDA) paradigm and adjusted for potential confounders.

RESULTS

In cross-sectional analyses at wave 0 (n = 2489), time-use composition as a whole was associated with depression and happiness (all p < 0.01). The time spent in MVPA relative to other behaviors was beneficially associated with depression (γ = -0.397, p < 0.001), loneliness (γ = -0.124, p = 0.017) and happiness (γ = 0.243, p < 0.001). Hypothetically, replacing 30-min of Sleep, SB or LPA with MVPA was beneficially cross-sectionally related with depression (effect size [ES] ranged -0.326 to -0.246), loneliness (ES ranged -0.118 to -0.073), and happiness (ES ranged 0.152 to 0.172). In prospective analyses (n = 1679), MVPA relative to other behaviors at baseline, was associated with favorable changes in global mental health (γ = 0.892, p = 0.049). We observed a beneficial prospective effect on global mental health when 30-min of sleep (ES = 0.521), SB (ES = 0.479) or LPA (ES = 0.755) were theoretically replaced for MVPA.

CONCLUSIONS

MVPA was cross-sectionally related with reduced depression symptoms and loneliness and elevated level of happiness, and prospectively related with enhanced global mental health. Compositional isotemporal analyses showed that hypothetically replacing sleep, SB or LPA with MVPA could result in modest but significantly improvements on mental health indicators. Our findings add evidence to the emerging body of research on 24-h time-use and health using CoDA and suggest an integrated role of daily behaviors on mental health in older people.

Better health indicators of FitSpirit participants meeting 24-h movement guidelines for Canadian children and youth

This study aims to determine the proportion of girls who meet the recommendations for moderate-to-vigorous physical activity (MVPA), screen time and sleep duration among FitSpirit participants and evaluate the associations of these recommendations with perceived health-related quality of life (QOL), perceived health, physical activity (PA), self-efficacy and body mass index. Cross-sectional analyses of FitSpirit data were performed. All variables were collected through an online questionnaire. The proportion of girls meeting all recommendations was 2.2%, while 72.5% met either one or two and 25.4% met none. A greater percentage of girls with ≥3 years in FitSpirit met MVPA and sleep recommendations combined when compared with fewer years (12.9% vs. 1.7% with 1 year; vs. 10.1% with 2 years; p < 0.05). Meeting the combinations of MVPA and screen time (β = 0.19, 95% CI = 0.40, 1.68), MVPA and sleep (β = 0.20, 95% CI = 0.27, 1.04) and all three combined (β = 0.17, 95% CI = 0.33, 1.71) was the most significant predictors of better perceived QOL. Respecting MVPA recommendations predicted a better perceived health (β = 0.18, 95% CI = 0.18, 0.87) while girls who slept as recommended had a better PA-related self-efficacy (β = 0.23, 95% CI = 0.51, 2.11). Not meeting any recommendation was associated with inferior PA-related self-efficacy (β = -0.32, 95% CI = -3.03, -1.21). Lastly, meeting MVPA and sleep recommendations was significantly associated with lower body mass index z-scores (β = -0.14, 95% CI = -1.16, -0.11). There was a small percentage of girls following all of the recommendations. Furthermore, meeting individual and combined recommendations was associated with better perceived QOL and health, PA self-efficacy as well as healthier body mass index z-score.

Associations of Sedentary Time with Heart Rate and Heart Rate Variability in Adults: A Systematic Review and Meta-Analysis of Observational Studies

PURPOSE

To evaluate if sedentary time (ST) is associated with heart rate (HR) and variability (HRV) in adults.

METHODS

We systematically searched PubMed and Google Scholar through June 2020. Inclusion criteria were observational design, humans, adults, English language, ST as the exposure, resting HR/HRV as the outcome, and (meta-analysis only) availability of the quantitative association with variability. After qualitative synthesis, meta-analysis used inverse variance heterogeneity models to estimate pooled associations.

RESULTS

Thirteen and eight articles met the criteria for the systematic review and meta-analysis, respectively. All studies were cross-sectional and few used gold standard ST or HRV assessment methodology. The qualitative synthesis suggested no associations between ST and HR/HRV. The meta-analysis found a significant association between ST and HR (β = 0.24 bpm per hour ST; CI: 0.10, 0.37) that was stronger in males (β = 0.36 bpm per hour ST; CI: 0.19, 0.53). Pooled associations between ST and HRV indices were non-significant (p > 0.05). Substantial heterogeneity was detected.

CONCLUSIONS

The limited available evidence suggests an unfavorable but not clinically meaningful association between ST and HR, but no association with HRV. Future longitudinal studies assessing ST with thigh-based monitoring and HRV with electrocardiogram are needed.

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.

Impact of replacing sedentary behaviour with other movement behaviours on depression and anxiety symptoms: a prospective cohort study in the UK Biobank

BACKGROUND

Sedentary behaviour is potentially a modifiable risk factor for depression and anxiety disorders, but findings have been inconsistent. To assess the associations of sedentary behaviour with depression and anxiety symptoms and estimate the impact of replacing daily time spent in sedentary behaviours with sleep, light, or moderate to vigorous physical activity, using compositional data analysis methods.

METHODS

We conducted a prospective cohort study in 60,235 UK Biobank participants (mean age: 56; 56% female). Exposure was baseline daily movement behaviours (accelerometer-assessed sedentary behaviour and physical activity, and self-reported total sleep). Outcomes were depression and anxiety symptoms (Patient Health Questionnaire-9 and Generalised Anxiety Disorders-7) at follow-up.

RESULTS

Replacing 60 min of sedentary behaviour with light activity, moderate-to-vigorous activity, and sleep was associated with lower depression symptom scores by 1.3% (95% CI, 0.4-2.1%), 12.5% (95% CI, 11.4-13.5%), and 7.6% (95% CI, 6.9-8.4%), and lower odds of possible depression by 0.95 (95% CI, 0.94-0.96), 0.75 (95% CI, 0.74-0.76), and 0.90 (95% CI, 0.90-0.91) at follow-up. Replacing 60 min of sedentary behaviour with moderate-to-vigorous activity and sleep was associated with lower anxiety symptom scores by 6.6% (95% CI, 5.5-7.6%) and 4.5% (95% CI, 3.7-5.2%), and lower odds of meeting the threshold for a possible anxiety disorder by 0.90 (95% CI, 0.89-0.90) and 0.97 (95%CI, 0.96-0.97) at follow-up. However, replacing 60 min of sedentary behaviour with light activity was associated with higher anxiety symptom scores by 4.5% (95% CI, 3.7-5.3%) and higher odds of a possible anxiety disorder by 1.07 (95% CI, 1.06-1.08).

CONCLUSIONS

Sedentary behaviour is a risk factor for increased depression and anxiety symptoms in adults. Replacing sedentary behaviour with moderate-to-vigorous activity may reduce mental health risks, but more work is necessary to clarify the role of light activity.

The impact of sitting time and physical activity on mental health during COVID-19 lockdown

Objective

The primary aim of this study was to investigate the association between physical activity (PA) and sitting time on adults’ mental health (i.e., depression, anxiety and wellbeing) and the influence of mediators and confounders.

Methods

An online survey was disseminated in the UK between May and June 2020. A total of 284 participants (33.5 ± 12.4 years) self-reported their PA, sitting time and mental health through validated questionnaires.

Results

Multiple stepwise regression analysis revealed that being of younger age, female, on a lower income, with one or more comorbid health conditions, with a previous diagnosis of mood disorder and increased sitting time independently correlated with higher depression scores (F (13,219) = 12.31, p < 0.001), and explained 42% of the variance. Similar results were found for wellbeing where socio-demographic, health outcomes and sitting time influenced the subjective wellbeing (F (14,218) = 5.77, p < 0.001, 27% variance), although only socio-demographic and health outcomes contributed to the variation in anxiety score (F (13,219) = 7.84, p < 0.001, 32% variance). PA did not explain variation when sitting time was taken into account in any of the models. Combined analysis revealed that participants with lower sedentary time (< 8 h) and with both low or moderate and high PA presented a significantly lower depression score [low PA: (B = −2.7, 95% CI −4.88, −0.52); moderate and high PA (B = −2.7, −4.88, −0.52)].

Conclusion

Sitting time was strongly associated with adverse mental health during COVID-19 lockdown and should be considered in future public health recommendations.

Associations of meeting 24-h movement guidelines with stress and self-rated health among adults: is meeting more guidelines associated with greater benefits?

Background

Several countries have recently issued 24-h movement guidelines that include quantitative recommendations for moderate-to-vigorous physical activity (MVPA), sedentary behaviour (SB), and sleep. This study explored the associations of meeting the 24-h movement guidelines with stress and self-rated health among adults, and whether the likelihood of favourable outcomes increases with the number of guidelines met.

Methods

A total of 2476 adults aged 18 years and over completed a questionnaire on their time spent in MVPA, SB and sleep, frequency of stress (never, very rarely, occasionally, often, every day), self-rated health (very good, good, fair, bad, very bad), sociodemographic characteristics, and lifestyle variables.

Results

In an ordinal logistic regression analysis adjusted for age, sex, body mass index, education, socio-economic status, employment, place of residence, living with or without partner, and smoking, lower odds of higher frequency of stress were found for those meeting the combined 24-h movement guidelines (adjusted odds ratio [OR] = 0.45; 95% confidence interval [CI]: 0.32, 0.63; p <  0.001), any combination of two guidelines (OR range: 0.48–0.63; p <  0.05 for all), and sleep guideline only (OR = 0.51; 95% CI: 0.35, 0.75; p = 0.001). Higher odds of better self-rated health were found for those meeting the combined 24-h movement guidelines (OR = 2.94; 95% CI: 2.07, 4.19; p <  0.001), combination of MVPA and SB guidelines (OR = 2.33; 95% CI: 1.57, 3.44; p <  0.001), combination of MVPA and sleep guidelines (OR = 1.78; 95% CI: 1.23, 2.59; p = 0.002), and MVPA guideline only (OR = 2.24; 95% CI: 1.50, 3.36; p <  0.001). Meeting more guidelines was associated with greater odds of favourable outcomes (p for linear trend < 0.001).

Conclusion

Adults who meet the sleep guideline, any combination of two guidelines, or all three guidelines experience stress less frequently. Meeting the MVPA guideline alone or in combination with any other movement behaviour guideline was associated with better self-rated health. The likelihood of less frequent stress and better self-rated health increases with the number of guidelines met. Adults should be encouraged to meet as many movement behaviour guidelines as possible.

Compositional Associations of Sleep and Activities within the 24-h Cycle with Cardiometabolic Health Markers in Adults

PURPOSE

This study aimed to examine how compositions of 24-h time use and time reallocations between movement behaviors are associated with cardiometabolic health in a population-based sample of middle-age Finnish adults.

METHODS

Participants were 3443 adults 46 yr of age from the Northern Finland Birth Cohort 1966 study. Participants wore a hip-worn accelerometer for 14 d from which time spent in sedentary behavior (SB), light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (MVPA) were determined. These data were combined with self-reported sleep to obtain the 24-h time-use composition. Cardiometabolic outcomes included adiposity markers, blood lipid levels, and markers of glucose control and insulin sensitivity. Multivariable-adjusted regression analysis, using a compositional data analysis approach based on isometric log-ratio transformation, was used to examine associations between movement behaviors with cardiometabolic outcomes.

RESULTS

More daily time in MVPA and LPA, relative to other movement behaviors, was consistently favorably associated with all cardiometabolic outcomes. For example, relative to time spent in other behaviors, 30 min·d-1 more MVPA and LPA were both associated with lower 2-h post-glucose load insulin level (-11.8% and -2.7%, respectively). Relative to other movement behaviors, more daily time in SB was adversely associated with adiposity measures, lipid levels, and markers of insulin sensitivity, and more daily time asleep was adversely associated with adiposity measures, blood lipid, fasting plasma glucose, and 2-h insulin. For example, 60 min·d-1 more SB and sleep relative to the remaining behaviors were both associated with higher 2-h insulin (3.5% and 5.7%, respectively).

CONCLUSIONS

Altering daily movement behavior compositions to incorporate more MVPA at the expense of any other movement behavior, or more LPA at the expense of SB or sleep, could help to improve cardiometabolic health in midadulthood.

Associations between multiple positive health behaviors and cardiometabolic risk using 3 alternative measures of physical activity: NHANES 2005-2006

The study aimed to investigate the association between clustered cardiometabolic risk (CCMR) and health-behavior indices comprising 3 different measures of physical activity, screen time, diet and sleep in NHANES 2005-2006. CCMR was calculated by standardizing and summarizing measures of blood pressure, fasting glucose, triglycerides, insulin, high-density lipoprotein and waist circumference to create a z score. Three health behavior indices were constructed with a single point allocated to each of the following lower risk behaviors: muscle strengthening activity, healthy eating score, sleep disorder/disruption, sleep duration, screen time and physical activity (self-reported moderate-to-vigorous physical activity [MVPA] (Index Score-SR), accelerometer-measured MVPA (Index Score-MVPA) or accelerometer-measured steps Index Score-Steps). Linear regression models explored associations between index scores and CCMR. In the sample (n = 1537, 52% male, aged 45.5 [SE: 0.9] years), reporting 0-5 vs. 6 health behaviors using Index Score-SR and Index Score-MVPA, and 0-4 vs. 6 health behaviors using Index Score-Steps, were associated with a significantly higher CCMR. The beta (β [95% CI]) for zero vs. 6 behaviors were Index Score-SR (2.86 [2.02, 3.69], Index Score-MVPA (2.41 [1.49, 3.33] and Index Score-Steps (2.41 [1.68, 3.15]). Irrespective of the measure of physical activity, engaging in fewer positive health behaviors was associated with greater CCMR. Novelty: Physical activity, screen time, diet and sleep may exert synergistic/cumulative effects on clustered cardiometabolic risk. A greater number of positive health behaviors was associated with a lower clustered cardiometabolic risk factor score. The reduction in cardiometabolic risk was similar irrespective of which physical activity measure was used.

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.

Compositional data analysis of 24-hour movement behaviors and mental health in workers

•

Time in sleep was favorably associated with mental distress and work engagement.

•

Sedentary behavior (SB) was negatively correlated with distress and work engagement.

•

Light-intensity physical activity (LPA) was negatively correlated with distress.

•

Reallocating time in SB or LPA to sleep was associated with better mental health.

This cross-sectional study investigated the relationship between 24-hour movement behaviors and mental health among Japanese workers, accounting for the co-dependence of time spent in different behaviors during a single day. This research is part of a prospective cohort study called the Meiji Yasuda LifeStyle study. Participants were 1095 workers in Tokyo, Japan, who underwent annual health check-ups between 2017 and 2018. Time use during workdays and non-workdays was separately evaluated. Behaviors included sleep (self-reported duration), sedentary behavior (SB), light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (assessed with a tri-axial accelerometer). We used the six-item Kessler Psychological Distress scale to evaluate psychological distress and the Utrecht Work Engagement Scale to assess work engagement as indicators for negative and positive mental health, respectively. We performed compositional logistic regression and compositional isotemporal substitution to examine associations between 24-hour movement behaviors and mental health. After controlling for potential confounders, time spent in workdays was significantly associated with higher psychological distress and lower work engagement (p < 0.05), respectively. Time spent sleeping was positively correlated with both mental health indicators, whereas time spent in SB or LPA was negatively correlated (p < 0.05). During workdays, higher psychological distress and lower work engagement were predicted to be 11.4–26.6% lower when 60 min/day of time spent sleeping were reallocated to SB or LPA. Reallocating time spent on SB or LPA to sleep during workdays may minimize psychological distress and optimize work engagement. Thus, proper time management focused on encouraging sleep may help improve workers’ mental health.

Sleep Duration, Sleep Quality and Physical Activity, but Not Sedentary Behaviour, Are Associated with Positive Mental Health in a Multi-Ethnic Asian Population: A Cross-Sectional Evaluation

BACKGROUND

We assessed the associations of sleep, physical activity and sedentary behaviour with positive mental health (PMH) in the multi-ethnic population of Singapore.

METHODS

The Singapore Health 2 study is a nationally representative cross-sectional survey among residents aged 18-79 years. A PMH instrument was administered to 1925 participants to obtain total PMH and six sub-component scores. Self-rated sleep duration, sleep quality, sedentary behaviour and physical activity were assessed. Multivariable linear regression analyses were conducted.

RESULTS

The mean age of the participants was 40.1 (SD 14.3) years. Sleep duration (≥8 h/night: β = 0.17,95% CI: 0.02-0.32; 7-< 8 h/night: β = 0.17,95% CI: 0.03-0.30 versus <6 h/night, p = 0.002), sleep quality (very good: β = 0.45,95% CI: 0.29-0.60; fairly good: β = 0.20,95% CI: 0.06-0.33 versus very/fairly bad; ptrend < 0.001) and physical activity (high: β = 0.19,95% CI: 0.05-0.32; moderate: β = 0.15, 95% CI: 0.03-0.27 versus low; ptrend < 0.001) were directly associated with total PMH. Sedentary behaviour was not significantly associated with PMH. Sleep duration, sleep quality and physical activity were directly associated with the PMH sub-components 'emotional support' and 'personal growth and autonomy'.

CONCLUSIONS

Duration and quality of sleep and physical activity were directly associated with PMH in an urban Asian population. These findings support incorporating sleep and physical activity interventions to improve population mental health.

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

Association between muscle strength and sleep quality and duration among middle-aged and older adults: a systematic review

PURPOSE

To examine the relationship between sleep quality and duration and muscle strength among community-dwelling middle-aged and older adults.

METHODS

A systematic review was conducted from March 2020 until May 2020. Searches were done for peer-reviewed and English-written articles reporting results of studies in PubMed, Embase, Scopus, Cochrane Library, and in article references lists. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used as well as the Newcastle-Ottawa Scale (NOS) to appraise the methodological quality.

RESULTS

Twenty-one cross-sectional, three prospective studies and a total of 92,363 subjects were included. The majority of the included studies are classified as "high quality". Handgrip strength is the main method of muscle strength assessment. Sleep assessment is usually conducted using subjective measures, such as validated sleep scales or self-reported questionnaires. Actigraphy, as an objective measure, is used less often. Most studies support strong evidence on the association between weak muscle strength and poor sleep quality and duration among middle-aged and older adults; whereas the results for the gender-specific association and the impact of short or long sleep duration were inconclusive.

CONCLUSION

This review has identified strong evidence on the relationship between sleep quality and duration and muscle strength among middle-aged and older adults. Health professionals should consider this relationship as a component of geriatric assessment in community practice and geriatric settings. Future rigorous research with a combination of subjective and objective measurements is needed to explore whether gender and specific sleep duration are related to muscle strength.

Associations between 24 h Movement Behavior and Mental Health in Office Workers

The associations between 24 h movement behavior, i.e., the way people distribute their time in different movement-related behaviors, on mental health are not well understood. This study applied a compositional data analysis approach to explore cross-sectional associations between device-measured moderate to vigorous physical activity (MVPA), light intensity physical activity (LIPA), sedentary behavior (SED), self-reported time in bed and mental health outcomes, i.e., depression or anxiety symptoms, burnout, mental wellbeing and stress, in office workers. ActiGraph accelerometers were worn for 24 h for at least 4 days to assess MVPA, LIPA, and SED. Sleep diaries were used in addition to identify time in bed. Analytic sample sizes for the different outcomes ranged from N = 345-370 participants. In this population of office workers with high levels of MVPA, the entire movement behavior composition was not associated to any of the mental health outcomes, but MVPA relative to all other behaviors was positively associated with mental wellbeing. This confirms the importance of MVPA for health relative to other movement-related behaviors.

Trends and correlates of meeting 24-hour movement guidelines: a 15-year study among 167,577 Thai adults

Background

Time spent in physical activity (PA), sedentary behaviour (SB), and sleep always takes up the whole day. New public health guidelines combining recommendations for PA, SB, and sleep have been issued in several countries. Thailand was the first country to release the 24-h guidelines for adults. Currently, there is no evidence on the population prevalence of meeting 24-h movement guidelines in Thailand. This study, therefore, aimed to determine 15-year trends and associations of meeting 24-h movement guidelines among Thai adults.

Method

We analysed cross-sectional data from 2001, 2004, 2009, and 2015 Thai Time-Use Surveys, coded using the International Classification of Activities for Time-Use Statistics (ICATUS). All ICATUS-based activities were categorised into moderate-to-vigorous PA (MVPA), light PA (LPA), SB, and sleep based on a previously developed classification system. A total of 167,577 adult participants were included. The participants were classified according to the Thai 24-h movement guidelines into meeting or not meeting the following criteria: 1) ≥150 min/week of MVPA; 2) interrupting SB every 2 h; 3) sleeping 7–9 h per day; and 4) adhering to all three guidelines.

Results

In 2015, the prevalence of adults who met the MVPA, SB, sleep, and overall recommendations was 81.7, 44.6, 56.4, and 21.3%, respectively. A significant linear increase was found for the prevalence of meeting the SB recommendation, while the prevalence meeting the MVPA, sleep, and overall recommendations was lowest in 2001, peaked in 2004 or 2009, and declined in 2015. The lowest odds for meeting the 24-h guidelines were found among males, those living in urban areas, inhabitants of Bangkok and South Thailand, unemployed, and those with low education level.

Conclusions

Despite promising trends in the prevalence of meeting PA, SB, and sleep recommendations, a majority of Thai adults still do not meet the overall 24-h movement guidelines. Further actions are needed to promote more MVPA, less SB, and adequate sleep in Thai adults, particularly among males, those living in urban areas, inhabitants of Bangkok and South Thailand, unemployed, and those with low education level.

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.

Sedentary behaviour is associated with depression symptoms: Compositional data analysis from a representative sample of 3233 US adults and older adults assessed with accelerometers

BACKGROUND

Evidence supporting the individual associations of sedentary behaviours with depression symptoms commonly ignores the inherent co-dependency between physical activity, sedentary behaviours and sleep in a given 24-hour period. Data analysis based on compositional methods effectively deals with this issue.

AIM

To investigate the association between sedentary behaviour and depression symptoms synergistically using compositional analysis methods.

METHODS

Participants were a representative sample of 3233 US adults and older adults from the 2005-2006 cycle of the NHANES with valid 24-hour lifestyle behaviours data (i.e., accelerometer-derived physical activity and sedentary behaviour and self-reported sleep) and available self-reported depression symptoms (PHQ-9). The association between sedentary behaviour and depression symptoms scoring was investigated using a compositional zero-inflated Poisson regression analysis. Subsequently, the model estimates were used to evaluate the effects on depression symptoms of replacing time spent in sitting activities with physical activity of different intensities and sleep.

LIMITATIONS

The current study is limited by its cross-sectional design. Also, sleep time was self-reported, which could bias our estimations.

RESULTS

Increased sedentary behaviour relative to other behaviours was statistically significantly associated with increased depression symptoms (p < 0.001). Reallocating 60 min time from sedentary behaviours to moderate-to-vigorous physical activity (MVPA) and sleep was associated with small reductions in depression symptoms.

CONCLUSIONS

A synergistic compositional analysis of accelerometer data uncovered a detrimental association between sedentary behaviour and depression symptoms. These results add to evidence from previous studies. The observed association seems to be principally driven by corresponding reductions in MVPA and sleep duration.

Introducing 24-Hour Movement Guidelines for the Early Years: A New Paradigm Gaining Momentum

Background: Emerging research shows that the composition of movement behaviors throughout the day (physical activities, sedentary behaviors, sleep) is related to indicators of health, suggesting previous research that isolated single movement behaviors maybe incomplete, misleading, and/or unnecessarily constrained. Methods: This brief report summarizes evidence to support a 24-hour movement behavior paradigm and efforts to date by a variety of jurisdictions to consult, develop, release, promote, and study 24-hour movement guidelines. It also introduces and summarizes the accompanying series of articles related specifically to 24-hour movement guidelines for the early years. Results: Using robust and transparent processes, Canada, Australia, New Zealand, South Africa, and the World Health Organization have developed and released 24-hour movement guidelines for the early years: an integration of physical activity, sedentary behavior, and sleep. Other countries are exploring a similar approach and related research is expanding rapidly. Articles related to guideline development in South Africa, the United Kingdom, Australia, and by the World Health Organization are a part of this special series. Conclusions: A new paradigm employing 24-hour movement guidelines for the early years that combines recommendations for movement behaviors across the whole day is gaining momentum across the globe.

Adiposity and changes in movement-related behaviors in older adult women in the context of the built environment: a protocol for a prospective cohort study

Background

In older adults, sedentary behaviors increase while physical activity decreases over time following the compositional nature of 24-h behaviors. These changes in movement-related behaviors (MRBs) might be associated with unhealthy weight gain and several health comorbidities. However, information is lacking on how obesity influences longitudinal changes in the composition of MRBs in older adults. Furthermore, the moderating effect of the built environment on prospective associations between obesity and MRBs in older adults is not fully understood. Therefore, using an integrated time-use approach, this study aims to identify prospective associations between obesity and MRBs together with an assessment of the moderating effect of the built environment in elderly women.

Methods

The study was designed as a prospective 7-year follow-up study. It is based on two previous cross-sectional studies that enable the use of participant data (women aged 60+ years, n = 409) as a baseline dataset in the current study. All methods designed for 7-year follow-up are based on previous studies. The data collection comprises device-based measurement of MRBs (ActiGraph GT1M accelerometer), objective assessment of body adiposity (multi-frequency bioelectrical impedance analysis), subjective assessment of the built environment (NEWS-A questionnaire), and other possible confounding factors. Time spent in sedentary behavior, light physical activity, and moderate-to-vigorous physical activity will be used as three components in a composition reflecting individual MRBs. In linear multiple compositional regression analysis assessing the prospective association between obesity and MRBs, the 7-year follow-up composition of the three mentioned components represents the dependent variable. The 7-year changes in the percentage of body fat (body adiposity), baseline composition of MRBs, and parameters of the built environment represent regressors.

Discussion

This study will use an integrated time-use approach to explore causality from obesity to device-measured behaviors in older women. The design and respective analysis consider the compositional nature of MRBs data and the potential moderating effects of various factors. A comprehensive assessment of causality may help to develop multilevel interventional models that enhance physical activity in older adults.

Valence and Motivation as Predictors of Student Time Use in Everyday Life: An Experience Sampling Study

Popular descriptions of studying frequency show remarkable discrepancies: students complain about their workload, and alumni describe freedom and pleasure. Unfortunately, empirical evidence on student time use is sparse. To investigate time use and reveal contributing psychological factors, we conducted an e-diary study. One hundred fifty-four students reported their time use and valence hourly over 7 days, both at the start of the semester and during their examination period. Motivational problems, social support and self-control were assessed once via questionnaires. Whereas the mean academic time use was in the expected range, the between-subject differences were substantial. We used multilevel modeling to separately analyze the within- and between-subject associations of valence as within factor and time use and social support, self-control, and motivation as between factors and time use. The analyses revealed the importance of affective factors on a within-subject level. Before studying, valence was already low, and it deteriorated further during studying. As expected at the between-subject level, motivational problems were related to less time studying, whereas surprisingly, self-control had no effect. The findings at the start of the semester were replicated in the examination period.

The Effect of Exercise on Glucoregulatory Hormones: A Countermeasure to Human Aging: Insights from a Comprehensive Review of the Literature

Hormones are secreted in a circadian rhythm, but also follow larger-scale timetables, such as monthly (hormones of the menstrual cycle), seasonal (i.e., winter, summer), and, ultimately, lifespan-related patterns. Several contexts modulate their secretion, such as genetics, lifestyle, environment, diet, and exercise. They play significant roles in human physiology, influencing growth of muscle, bone, and regulating metabolism. Exercise training alters hormone secretion, depending on the frequency, duration, intensity, and mode of training which has an impact on the magnitude of the secretion. However, there remains ambiguity over the effects of exercise training on certain hormones such as glucoregulatory hormones in aging adults. With advancing age, there are many alterations with the endocrine system, which may ultimately alter human physiology. Some recent studies have reported an anti-aging effect of exercise training on the endocrine system and especially cortisol, growth hormone and insulin. As such, this review examines the effects of endurance, interval, resistance and combined training on hormones (i.e., at rest and after) exercise in older individuals. We summarize the influence of age on glucoregulatory hormones, the influence of exercise training, and where possible, examine masters' athletes' endocrinological profile.

Can Off-Training Physical Behaviors Influence Recovery in Athletes? A Scoping Review

Recently, the attention on recovery in sport increased enormously although there is lack of scientific evidence on the role of lifestyle in terms of movement [i.e., physical behaviors (PBs)], apart from sleep. Few studies assessed physical activity (PA) and sedentary behavior (SB) in athletes. The aims of this scoping review were to answer to the following scientific questions: (1) How active/inactive are competitive athletes out of training? (2) Do off-training PBs affect recovery, performance, and health? (3) What strategies can be implemented to improve recovery using off-training PBs, apart from sleep? From 1,116 potentially relevant articles, nine were eligible for inclusion in this review. The main issues identified were related to the heterogeneity concerning the types of sports, age category, gender, competitive level, sample size, and instruments/devices adopted, the paucity of studies investigating the effects of PBs while awake on recovery, and the lack of experimental designs manipulating PBs while awake to accelerate recovery. Furthermore, PA and SB domains were rarely investigated, while no research articles focused on the combined effect of 24-h PBs. Eight out of nine studies measured PA, seven SB, and two included sleep. Three studies included training practice into PA measurement by the means of accelerometry. Overall, almost the totality of the athletes achieved recommended PA levels although they sustained prolonged SB. In conclusion, more descriptive researches are needed in different athletic populations and settings. Furthermore, experimental designs aimed at investigating the effects of PBs manipulation on recovery and the putative mechanisms are encouraged.