When it comes to sedentary behaviour modification, should people be told what to do? A randomized comparison trial among home-based office workers living in Ontario, Canada

The effects of adding choice architecture to a theory-based (Health Action Process Approach; HAPA) sedentary intervention remain unknown. To investigate whether choice architecture enhances a theory-based sedentary behaviour reduction intervention in home-based office workers. A 4-week HAPA-based intervention was conducted in London, Canada. Choice architecture was tested as an enhancement via a two (group: 'Choice of Intervention' vs. 'No Choice Intervention') by two (time: Baseline vs. Week 4) factorial repeated measure randomized comparison design. Sedentary behaviour reduction strategies focussed on obtaining a sedentary break frequency (BF) of every 30-45 min with break durations (BD) of 2-3 min. BF, BD, sitting, standing, and moving time were objectively measured (activPAL4™) at both time points. Participants (n = 148) were 44.9 ± 11.4 years old and 72.3% female. BF and total sitting time showed a time effect (P < .001), where both groups improved over the 4 weeks; there were no significant differences between groups across time. BD, standing, and moving time had a significant group by time effect where the 'No Choice' group showed significant increases in BD (P < .001), standing (P = .006), and moving time (P < .001) over the 4 weeks. Augmenting a theory-based intervention with choice architecture resulted in change in some sedentary behaviours in at home office workers. Specifically, while BF increased for all participants, the 'No Choice' group exhibited greater changes for BD, standing, and moving time compared with the 'Choice' group. Overall, these changes exceeded the intervention BF and BD goals.

School-related sedentary behaviours and indicators of health and well-being among children and youth: a systematic review

BACKGROUND

The purpose of this systematic review was to examine the associations between school-related sedentary behaviours and indicators of health and well-being in children and youth (~ 5-18 years) attending school.

METHODS

This review was conducted to inform the development of School-Related Sedentary Behaviour Recommendations. Peer-reviewed, published, or in-press articles in English were included. Reviews, meta-analyses, and case studies were excluded; all other study designs were eligible. Further, articles had to meet the a priori study criteria for population, intervention, comparator (PROSPERO ID: CRD42021227600). Embase, MEDLINE® ALL, and PsycINFO were searched. Risk of bias was assessed for individual experimental studies using the Cochrane risk of bias assessment tool, and in observational studies based on the GRADE framework and in line with previous systematic reviews examining sedentary behaviours in children. Overall quality of evidence was assessed using the GRADE framework for each outcome category and study design. Results were synthesized narratively, grouped by study design and outcome category. Further, several high-level summaries were conducted to help interpret results.

RESULTS

Evidence was synthesized from 116 reports, including 1,385,038 participants and 1173 extracted associations. More school-related sedentary behaviour was favourably associated with nearly one-third of extracted associations for cognitive (33%) and social-emotional (32%) indicators (e.g., less anxiety), but unfavourably associated with other movement behaviours (e.g., less physical activity) (35%). Active lessons were favourable (72%), compared to more school-related sedentary behaviours, when examining associations for all health and well-being indicators. More homework was favourable across all health and well-being indicators in 4% of extracted associations for primary school children, and 25% of extracted associations for secondary school children. However, ≥2 h/day of homework appeared to be unfavourable for health and well-being. Limitations for synthesized studies included generally low quality of evidence and a lack of studies in South American, African, or low-middle income countries.

CONCLUSIONS

Findings can help inform policy makers, schools, and teachers, regarding the amount of homework assigned and the introduction of active lessons into the classroom to enhance health and well-being of children. More research is needed examining school-related sedentary behaviours and indicators of health and well-being in low- and middle-income countries.

International school-related sedentary behaviour recommendations for children and youth

BACKGROUND

Existing sedentary behaviour guidelines for children and youth target overall sedentary behaviour and recreational screen time, without any specific recommendations regarding school-related sedentary behaviours (i.e., sedentary behaviours performed during the school day, or within the influence of school). The purpose of this paper is to describe the development of international evidence-based recommendations for school-related sedentary behaviours for children and youth, led by the Sedentary Behaviour Research Network (SBRN).

METHODS

A panel of international experts was convened by SBRN in November 2020 to guide the development of these recommendations for children and youth aged ~ 5-18 years. The recommendations were informed by 1) age-relevant existing sedentary behaviour guidelines, 2) published research on the relationship between overall sedentary behaviour and health, 3) a de novo systematic review on the relationship between school-related sedentary behaviours and health and/or academic outcomes, and 4) a de novo environmental scan of the grey literature to identify existing recommendations for school-related sedentary behaviours. Draft recommendations were presented to the Expert Panel in June 2021. Following thorough discussion and modifications, updated recommendations were distributed for stakeholder feedback from July 9-26. Feedback was received from 148 stakeholders across 23 countries, leading to additional updates to the recommendations. Following further rounds of discussion and updates with the Expert Panel in August and September 2021, consensus was achieved on the final recommendations.

RESULTS

A healthy day includes breaking up extended periods of sedentary behaviour and incorporating different types of movement into homework whenever possible, while limiting sedentary homework. School-related screen time should be meaningful, mentally or physically active, and serve a specific pedagogical purpose that enhances learning. Replacing sedentary learning activities with movement-based learning activities, and replacing screen-based learning activities with non-screen-based learning activities, can further support students' health and wellbeing.

DISCUSSION

This paper presents the first evidence-based recommendations for school-related sedentary behaviours for children and youth. These recommendations will support the work of parents, caregivers, educators, school system administrators, policy makers, researchers and healthcare providers interested in promoting student health and academic success.

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.

Health associations with meeting the Canadian 24-hour movement guidelines for adults: Results from the Canadian Health Measures Survey

BACKGROUND

The Canadian 24-Hour Movement Guidelines for Adults (18-64 years and 65 years or older) were launched in October 2020 and provide evidence-based recommendations for physical activity, sedentary behaviour and sleep. The purpose of this study was to examine whether meeting the 24-Hour Movement Guidelines overall, and different combinations of recommendations within the guidelines, was associated with health indicators in a representative sample of Canadian adults.

DATA AND METHODS

Participants were 8,297 adults aged 18 to 79 from cycles 1 to 3 of the Canadian Health Measures Survey. They were classified as meeting or not meeting each of the recommendations required for overall guideline adherence: moderate-to-vigorous physical activity (150 minutes or more per week), sedentary behaviour (8 hours or less per day or 9 hours or less per day of sedentary time, including 3 hours or less per day of recreational screen time) and sleep duration (7 to 9 hours per day for adults 18 to 64 years old, 7 to 8 hours per day for adults aged 65 years or older). A combination of self-reported and device-based measures were used. Indicators of adiposity (n=2), aerobic fitness (n=1) and cardiometabolic health (n=7) were measured.

RESULTS

A total of 19.1% of the sample met none of the recommendations, 43.9% met one of them, 29.8% met two and 7.1% met all three. Compared with meeting no recommendations, meeting one, two and all three recommendations was associated with better health for one, six and seven health indicators, respectively (p < 0.05). Compared with adults meeting two or fewer recommendations, those who met all three recommendations had more favourable body mass index; waist circumference; aerobic fitness scores; and triglyceride, insulin, C-reactive protein and serum glucose levels (p < 0.05).

INTERPRETATION

These findings provide support for the 24-Hour Movement Guidelines and show that less than 1 in 10 Canadian adults are meeting all three of the healthy movement behaviour guidelines.

Validity of the occupational sitting and physical activity questionnaire (OSPAQ) for home-based office workers during the COVID-19 global pandemic: A secondary analysis

High levels of occupational sitting is an emerging health concern. As working from home has become a common practice as a result of COVID-19, it is imperative to validate an appropriate self-report measure to assess sitting in this setting. This secondary analysis study aimed to validate the occupational sitting and physical activity questionnaire (OSPAQ) against an activPAL4™ in full-time home-based 'office' workers (n = 148; mean age = 44.90). Participants completed a modified version of the OSPAQ and wore an activPAL4™ for a full work week. The findings suggest that the modified OSPAQ has fair levels of validity in terms of correlation for sitting and standing (ρ = 0.35-0.43, all p < 0.05) and agreement (bias = 2-12%) at the group level; however, estimates were poor at an individual level, as suggested by wide limits of agreement (±22-30%). Overall, the OSPAQ showed to be an easily administered and valid questionnaire to measure group level sitting and standing in this sample of adults.

Health-Related Criterion-Referenced Cut-Points for Cardiorespiratory Fitness Among Youth: A Systematic Review

BACKGROUND

Cardiorespiratory fitness (CRF), which reflects the overall aerobic capacity of the cardiovascular, respiratory, and muscular systems, is significantly related to health among youth.

OBJECTIVE

The aim of this systematic review was to identify health-related criterion-referenced cut-points for CRF among youth aged 5-17 years.

METHODS

A systematic search of two electronic databases (MEDLINE and SPORTDiscus) was conducted in September 2020. Only peer-reviewed studies that developed health-related criterion-referenced cut-points for CRF among youth were eligible provided they included (1) youth aged 5-17 years from the general population; (2) at least one quantitative assessment of CRF (e.g., peak oxygen uptake [[Formula: see text]O_2peak]); (3) at least one quantitative assessment of health (e.g., cardiometabolic risk); (4) a criterion for health; and (5) a quantitative analysis (e.g., receiver operating characteristic [ROC] curve) of at least one health-related cut-point for CRF. A narrative synthesis was used to describe the results of the included studies.

RESULTS

Collectively, 29 included studies developed health-related criterion-referenced cut-points for CRF among 193,311 youth from 23 countries. CRF cut-points, expressed as [Formula: see text]O_2peak, estimated using the 20-m shuttle run test, demonstrated high discriminatory ability (median area under the curve [AUC] ≥ 0.71) for both cardiometabolic and obesity risk. Cut-points derived from maximal cycle-ergometer tests demonstrated moderate discriminatory ability (median AUC 0.64-0.70) for cardiometabolic risk, and low discriminatory ability for early subclinical atherosclerosis (median AUC 0.56-0.63). Cut-points for CRF using submaximal treadmill exercise testing demonstrated high discriminatory ability for cardiometabolic risk, but only moderate discriminatory ability for obesity risk. CRF cut-points estimated using submaximal step testing demonstrated high discriminatory ability for cardiometabolic risk and moderate discriminatory ability for high blood pressure, while those for the 9-min walk/run test demonstrated moderate-to-high discriminatory ability for obesity risk. Collectively, CRF cut-points, expressed as [Formula: see text]O_2peak, demonstrated moderate-to-high discriminatory ability (median AUC ≥ 0.64) for cardiometabolic risk, obesity risk, and high blood pressure.

CONCLUSIONS

Currently, there is too wide a range of health-related criterion-referenced cut-points for CRF among youth to suggest universal age- and sex-specific thresholds. To further inform the development of universal cut-points, there is a need for additional research, using standardized testing protocols and health-risk definitions, that examines health-related criterion-referenced cut-points for CRF that are age, sex, and culturally diverse.

CLINICAL TRIALS REGISTRATION

PROSPERO registration number: CRD42020207458.

Meeting Canadian 24-Hour Movement Guideline recommendations and risk of all-cause mortality

This study determined if meeting the Canadian 24-Hour Movement Guidelines recommendations are associated with all-cause mortality. Participants were 3,471 adults from the 2005-2006 U.S. National Health and Nutrition Examination Survey followed for mortality over 11 years. They were classified as meeting or not meeting recommendations for sleep duration, sedentary behaviour, and moderate-to-vigorous physical activity (MVPA). A total of 63.8%, 35.3%, and 41.5% of participants met recommendations for sleep, sedentary behavior, and physical activity while 12.3% met all three recommendations. The hazard ratio (HR) for all-cause mortality in participants meeting the recommendations relative to those not meeting the recommendations were 0.91 (0.72, 1.16) for sleep, 0.92 (0.61, 1.40) for sedentary behavior, and 0.42 (0.24, 0.74) for MVPA. The HR for meeting none, any one, any two, and all three recommendations were 1.00, 0.86 (0.65, 1.14), 0.49 (0.28, 0.86), and 0.72 (0.34, 1.50). When the cut-point used to denote acceptable sedentary time was changed from ≤8 to ≤10 hours/day, the HR for meeting none, any one, any two, and all three recommendations were 1.00, 0.83 (0.59, 1.15), 0.57 (0.34, 0.96), and 0.43 (0.20, 0.93). These findings provide some support for the ability of the 24-hour movement guidelines to predict mortality risk. NOVELTY - The 24-Hour Movement Guidelines provide recommendations for sleep, sedentary behavior, and physical activity. - The findings of this study provide some support of the ability of these new guidelines to predict mortality risk.

A Comparison of Associations Between Self-Reported and Device-Based Sedentary Behavior and Obesity Markers in Adults: A Multi-National Cross-Sectional Study

The purpose of this study was to examine the associations between self-reported and device-based measures of sedentary behavior (SB) with obesity markers in adults from Latin American countries. Sitting time and total time spent in different SBs were self-reported using two different questionnaires. Accelerometers were used to assess total sedentary time. Body mass index, waist, and neck circumferences were assessed. The highest self-reported sitting time was in Argentina, the highest total time spent in different SBs was in Brazil and Costa Rica, and the highest device-based sedentary time was observed in Peru. Neither self-reported sitting time, total time spent in different SBs or device-based sedentary time were associated with body mass index. Device-based sedentary time was positively associated with waist circumference and self-reported sitting time was positively associated with neck circumference. Caution is warranted when comparing the associations of self-reported and device-based assessments of SB with anthropometric variables.

A combined health action process approach and mHealth intervention to reduce sedentary behaviour in university students - a randomized controlled trial

Objective: This investigation evaluated the effectiveness of a Health Action Process Approach (HAPA) based planning intervention augmented with text messages to reduce student-related sitting time (primary outcome) and increase specific non-sedentary behaviours. Relationships between the HAPA volitional constructs and sedentary and non-sedentary behaviours were also explored. Design: University students (M_age = 21.13 y; SD = 4.81) were randomized into either a HAPA intervention (n = 28) or control (n = 33) condition. Main Outcome Measures: School-related sitting time, time spent in specific non-sedentary behaviours and HAPA volitional constructs were assessed at baseline, weeks 2, 4, 6 (post-intervention) and 8 (follow-up). Results: Significant group by time interaction effects favouring the intervention group were found for sitting time (p = 0.004, ɳ_p² = 0.10), walking time (p = 0.021, ɳ_p² = 0.06) and stretching time (p = 0.023, ɳ_p² = 0.08), as well as for action planning (p < 0.001, ɳ_p² = 0.17), coping planning (p < 0.001, ɳ_p² = 0.20) and action control (p < 0.001, ɳ_p² = 0.20). Significant correlations (p < 0.05) were also found between the HAPA constructs and sitting-related outcomes. Conclusions: Combining a HAPA-based planning intervention with text messages can reduce student-related sitting time in university students.

Supplemental data for this article is available online at https://doi.org/10.1080/08870446.2021.1900574 .

Agreement Between Self-Reported and Device-Based Sedentary Time among Eight Countries: Findings from the ELANS

The purpose of this study was to analyze the agreement between self-reported and device-based sedentary time among eight countries in Latin America. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants (18-65 years) across eight countries. Participants reported time spent sedentary in different activities (computer use at home, videogame use, reading, sitting down to chat with friends/relatives or listening to music, speaking on the phone, watching TV, and riding in a car). Overall sitting time was assessed using a single item from the International Physical Activity Questionnaire (IPAQ). Device-based sedentary time was assessed using Actigraph GT3X accelerometers. Self-reported overall sitting time (227.1 min/day) produced the lowest values of the three assessment methods, followed by self-reported sum of different types of sedentary behavior (364.1 min/day) and device-based sedentary time (568.6 min/day). Overall, correlation coefficients and ICC varied from weak to moderate (rho: 0.25-0.39; ICC: 0.21:0.39) between self-reported sum of different types of sedentary behavior, self-reported overall sitting time, and device-based sedentary time. The Bland-Altman plots indicated low to moderate agreement between self-reported overall sitting time and device-based sedentary time by sex. Self-report measures underestimate sedentary behavior and overall sitting time when compared with device-based measures. The weak and moderate level of agreement between methods indicates that caution is required when comparing associations between different self-report and device-based measures of sedentary behavior with health outcomes.

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.

A combined health action process approach and mHealth intervention to reduce workplace sitting time in office-working adults: a secondary analysis examining health-related quality of life and work performance outcomes

OBJECTIVE

This secondary analysis study examined the effects of a 6-week theory-based planning and mHealth text message intervention targeting workplace sitting time on health-related quality of life and work performance in office workers.

DESIGN

Office-working adults (M_age=45.18 ± 11.33 years) were randomised into either a planning + text message intervention (n = 29) or control (n = 31) condition.

OUTCOME MEASURES

Workplace sitting time, time spent in specific non-sedentary behaviours (e.g. standing), health-related outcomes (i.e. emotional well-being, energy/fatigue, perceived role limitations), and work performance were assessed at baseline and week 6.

RESULTS

Significant group by time interaction effects, that favoured the intervention group, were found for perceived role limitations due to emotional health problems and emotional well-being. No significant interaction effects emerged for energy/fatigue, role limitations due to physical health problems or work performance. Significant correlations in the expected direction were found between sedentary/non-sedentary behaviours and health-related outcomes. No significant mediation effects were found to suggest the intervention affected health-related outcomes through reductions in sedentary behaviour.

CONCLUSION

Reducing workplace sitting improves emotional well-being and contributes to fewer perceived role limitations due to emotional health problems among office workers.

Socio-Demographic Correlates of Total and Domain-Specific Sedentary Behavior in Latin America: A Population-Based Study

Purpose: The aim of this study was to identify socio-demographic correlates of total and domain-specific sedentary behavior (SB). Methods: Cross-sectional findings are based on 9218 participants (15–65 years) from the Latin American Study of Nutrition and Health. Data were collected between September 2014 and February 2015. Participants reported time spent in SB across specific domains. Sex, age, ethnicity, socioeconomic (SEL), and education level were used as sociodemographic indicators. Results: Participants spent a total of 373.3 min/day engaged in total SB. Men, younger adults, other ethnicities, higher SEL and educational level presented higher total SB when compared with women, older adults, white/Caucasian, and low SEL and educational level. Men spent more time on the playing videogames (b: 32.8: 95% CI: 14.6;51.1) and riding in an automobile (40.5: 31.3; 49.8). Computer time, reading, socializing or listening to music was higher in younger participants (<30 years) compared with those ≥50 years in the total sample. Compared to the low SEL and educational level groups, middle (11.7: 5.7; 17.6) and higher (15.1: 5.3; 24.9) SEL groups as well as middle (9.8: 3.6; 15.9) and higher (16.6: 6.5; 26.8) education level groups reported more time spent reading. Conclusion: Socio-demographic characteristics are associated with SB patterns (total and specific) across Latin American countries.

The effects of sedentary behaviour interventions on work-related productivity and performance outcomes in real and simulated office work: A systematic review

This review examined the impact of environmental, behavioral, and combined interventions to reduce occupational sedentary behaviour on work performance and productivity outcomes. Productivity outcomes were defined as variables assessing work-related tasks (e.g., typing, mouse), whereas performance outcomes were categorized as any variables assessing cognition that did not mimic work-related tasks. Nine databases were searched for articles published up to January 2018. Sixty-three studies were identified that met the inclusion criteria: 45 examined a productivity outcome (i.e., typing, mouse, work-related tasks, and absenteeism), 38 examined a performance outcome (i.e., memory, reading comprehension, mathematics, executive function, creativity, psychomotor function, and psychobiological factors), and 30 examined a self-reported productivity/performance outcome (i.e., presenteeism or other self-reported outcome). Overall, standing interventions do not appear to impact productivity/performance outcomes, whereas walking and cycling interventions demonstrate mixed null/negative associations for productivity outcomes. Hence, standing interventions to reduce occupational sedentary behaviour could be implemented without negatively impacting productivity/performance outcomes.

Anthropometric and body composition changes in smokers vs abstainers following an exercise-aided pharmacotherapy smoking cessation trial for women

INTRODUCTION

Post-cessation weight gain contributes to smoking relapse, especially for women. Furthermore, excess weight in the form of android or visceral fat is associated with metabolic health problems. For this study, a secondary analysis was conducted in 2015 to determine whether quitting status, achieved through a 14 week supervised exercise-aided nicotine replacement therapy (NRT) cessation program [Getting Physical on Cigarette Trial-2009 to 2013; Prapavessis, et al., 2016], affects anthropometric and body composition parameters in female smokers (N = 413, M age = 42.39 years).

METHODS

Anthropometric (weight and BMI) and body composition (% total body fat, % android fat, lean mass and visceral fat) indices were assessed at baseline and end of treatment. Smoking status was confirmed weekly from expired breath carbon monoxide. Adherence to exercise and NRT patch was calculated from the number of exercise sessions attended and patches worn to the number of exercise sessions offered and patches supplied, respectively.

RESULTS

Factorial (smoking status) ANCOVAs controlling for baseline anthropometric and body composition parameters as well as adherence to exercise and NRT revealed significant differences in weight (p = .033; ɳ_p² = 0.017) and BMI (p = .020; ɳ_p² = 0.020) at week 14. This equated to abstainers weighing 1.26 kg more and having a 0.52 higher BMI than smokers. No significant differences were found for any of the body composition parameters at week 14 (ɳ_p² range from 0.001-0.007).

CONCLUSIONS

Abstainers gain modest weight compared to smokers. This weight gain is related to increases in lean mass and not total, android, or visceral fat.

Cognitive and Motivational Factors Associated with Sedentary Behavior: A Systematic Review

Excessive time spent in sedentary behavior (SB) is associated with numerous health risks. These associations remain even after controlling for moderate-to-vigorous physical activity (PA) and body mass index, indicating that efforts to promote leisure time physical activity alone are insufficient. Cognitive and motivation variables represent potentially modifiable factors and have the potential of furthering our understanding of sedentary behavior. Hence, a systematic review was conducted to synthesize and critique the literature on the relationship between cognitive and motivational factors and sedentary behaviors. In April 2016, four electronic databases (Psych info, Pub Med, SPORTDiscus, Web of Science) were searched and a total of 4866 titles and abstracts were reviewed. After meeting inclusion criteria, study characteristics were extracted and the methodological quality of each study was assessed according to the Downs and Black Checklist. PRISMA guidelines for reporting of systematic reviews were followed. Twenty-five studies (16 cross-sectional, 8 longitudinal and one examining two populations and employing both a cross-sectional and prospective design) assessed 23 different cognitive and motivational factors. Seventeen studies were theory-based and 8 did not employ a theoretical model. Results showed that among SB-related cognitions, risk factors for greater sedentary time included having a more positive attitude towards SB, perceiving greater social support/norms for SB, reporting greater SB habits, having greater intentions to be sedentary, and having higher intrinsic, introjected, and external motivation towards SB. Protective factors associated with lower sedentary time included having greater feelings of self-efficacy/control over SB and greater intentions to reduce SB. Among PA-related cognitions, protective factors for lower SB included a more positive attitude towards PA, having greater social support/norms for PA, greater self-efficacy/control for PA, higher PA intentions, and higher intrinsic and identified motivation towards PA. In addition, feeling more supported and empowered in general was related with lower levels of SB. The average methodological quality score for included studies was 69% (SD = 9.15%; range 35–80%). In conclusion, a number of cognitive and motivational factors were identified that were associated with sedentarism. These findings have come from reasonably high quality studies. To further extend our understanding of the relation between cognitive and motivational factors and SB, more longitudinal, theory-driven studies examining cognitions and motivation from a sedentary perspective are required.

[Rupture of the diaphragm caused by closed thoraco-abdominal trauma. Case contribution and anatomo-clinical considerations]

Diaphragmatic rupture is a potentially severe complication of blunt trauma which can easily be overlooked during initial emergency department evaluation. Delayed diagnosis is due to severe concurrent injuries and lack of specific clinical features and instrumental procedures. Clinical features of diaphragmatic herniation, in the early presentation, include respiratory symptoms, while abdominal symptoms and signs are late. Plain chest radiography repeated, if negative, is the main help in the diagnosis: especially in patients managed with intermittent positive-pressure ventilation. Experience in five cases of diaphragmatic hernia is reported.

[Congenital duodenal stenosis. A case treated in adulthood]

The authors report their experience the diagnosis and management of congenital duodenal malformation in adults. They emphasize problems and difficulties in this disease of pediatric age and the physiopathological adaptation in these years. They point out that surgery can modify important metabolic functions and sub-clinical pathological conditions that the malformation made up.

[Surgical treatment of liver metastases of colorectal carcinoma. Our experience and review of the literature]

The authors describe their personal experience of the surgical treatment of hepatic MTS caused by colon-rectum ca. Following a review of the literature, including therapeutic protocols which do not always agreed, the problems inherent to the number, site, size and appearance of MTS themselves are discussed. Different approaches are compared in an attempt to clarify this pathology about which still very little is known. There is often uncertainty regarding the cases which should be treated surgically, and there is certainly a need for a greater number of case studies so as to avoid relying on the sensitivity and experience of the individual surgeon.

[Reimplantation of the inferior mesenteric artery during surgery of abdominal aortic aneurysm. Current trends]

After a review of world literature and on the basis of personal experience, the problem of ischaemic colitis following abdominal aortic aneurysmectomy is examined. After remarks on the aetiopathogenesis and clinical picture of the condition the paper stresses the need for early detection of patients at high risk, to prevent a clinical picture that is insidious but serious and tends to develop rapidly. The use of preoperative angiography to study the SMA and IMA as well as intraoperative stump-pressure measurement is considered essential. The paper concludes that ischaemic colitis following abdominal aortic reconstruction can be avoided in a large percentage of cases by IMA implantation on the Dacron prosthesis, a surgical technique that is easy and not time-consuming.

[Surgical therapy of the kinking of the internal carotid artery. Indications and limitations]

Surgical treatment of a case of symptomatic kinking of the internal carotid suggested a review of the problem on the basis of the national and international literature. Opinions are not only extremely distant but not infrequently antithetical. In such a heterogeneous subjects that is often difficult to interpret, the most interesting approaches are examined in the light of new experimental and clinical findings.

[Role of serum pepsinogen I values in primary duodenal ulcer in childhood]

Serum pepsinogen I (PGI) was measured by radioimmunoassay in the fasting state in three homogeneous family groups composed of parents and their children. Group 1, families, did not suffer from primary duodenal ulcer (PDU). Group 2, 10 families had at least one parent with PDU diagnosed endoscopically. Group 3, 6 families, had at least one child with PDU and one parent with PDU diagnosed endoscopically. The analysis of variance (ANOVA) of PGI in the examined children, showed a significant difference between the three groups (F = 22.83; p = 0.005). In all 3 groups the ANOVA of serum PGI of the fathers and the mothers were significantly different: fathers (F = 4.4; p = 0.241); mothers (F = 3.4; p = 0.05). A correlation was noted between PGI of the fathers and PGI of the children (r = 0.31; p = 0.05); but a more significant correlation was observed between PGI of the mothers and PGI of the children (r = 0.48; p = 0.001). In group 3, the correlation between PGI of the mothers and PGI of the children was striking (r = 0.89; p = 0.025). However, the PGI of the fathers and the PGI of the children were not different in this group (r = 0.27; p = n.s.). The multiple correlation between PGI of the children and PGI of both parents was significant (r2 = 0.316). In group 3, the correlation was very high between the mothers and the children (r2 = 0.81).