Individual Barriers to an Active Lifestyle at Older Ages Among Whitehall II Study Participants After 20 Years of Follow-up

To describe active and sedentary time in children with spina bifida and to compare their physical activity on weekdays versus weekends. In this exploratory cross-sectional study, data from 13 Canadian and 22 Dutch children with spina bifida (14 females, 21 males; mean age 10y 11mo, standard deviation [SD] 3y 6mo, range 5y 6mo-18y; Hoffer classification distribution: community [n=28], household [n=3], non-functional [n=3], and non-ambulator [n=1]) were analysed. Objective measures of physical activity and sedentary behaviour were obtained by using ActiGraph or Actiheart activity monitors. Data for the participants wearing the ActiGraph were compared with age- and sex-matched controls that were developing typically using independent-samples t-tests. Activity data collected on weekdays was compared to those on weekends. ActiGraph data demonstrated children with spina bifida spent more time sedentary (mean [SD] 49.5min/h [5.78]) and less time in moderate to vigorous physical activity (mean [SD] 2.33min/h [1.61]) compared with the typically developing group (mean [SD] 41.0min/h [5.76] and 5.46min/h [2.13], p=0.001 and p<0.001 respectively). For both ActiGraph- and Actiheart-derived data, physical activity and sedentary time were not significantly different between weekdays and weekends. Children with spina bifida have reduced levels of physical activity and increased sedentary behaviour, with no statistical differences seen between weekdays and weekends. Several methodological issues related to activity monitoring warrant consideration when choosing the appropriate method to quantify physical activity and sedentary behaviour. Reduced levels of physical activity and sedentary time were quantified in children with spina bifida. Objective quantification of physical behaviour in ambulatory and non-ambulatory school-aged children with spina bifida is possible.

All physical activity (PA) behaviours undertaken over the day, including sleep, sedentary time, standing time, light-intensity PA (LIPA) and moderate-to-vigorous PA (MVPA) have the potential to influence cardiometabolic health. Since these behaviours are mutually exclusive, standard statistical approaches are unable to account for the impact on time spent in other behaviours. By employing a compositional data analysis (CoDA) approach, this study examined the associations of objectively measured time spent in sleep, sedentary time, standing time, LIPA and MVPA over a 24-hday on markers of cardiometabolic health in older adults. Participants (n =366; 64.6years [5.3]; 46% female) from the Mitchelstown Cohort Rescreen Study provided measures of body composition, blood lipid and markers of glucose control. An activPAL3 Micro was used to obtain objective measures of sleep, sedentary time, standing time, LIPA and MVPA, using a 7-day continuous wear protocol. Regression analysis, using geometric means derived from CoDA (based on isometric log-ratio transformed data), was used to examine the relationship between the aforementioned behaviours and markers of cardiometabolic health. Standing time and LIPA showed diverging associations with markers of body composition. Body mass index (BMI), body mass and fat mass were negatively associated with LIPA (all p <0.05) and positively associated with standing time (all p <0.05). Sedentary time was also associated with higher BMI (p <0.05). No associations between blood markers and any PA behaviours were observed, except for triglycerides, which were negatively associated with standing time (p < 0.05). Reallocating 30min from sleep, sedentary time or standing time, to LIPA, was associated with significant decreases in BMI, body fat and fat mass. This is the first study to employ CoDA in older adults that has accounted for sleep, sedentary time, standing time, LIPA and MVPA in a 24-h cycle. The findings support engagement in LIPA to improve body composition in older adults. Increased standing time was associated with higher levels of adiposity, with increased LIPA associated with reduced adiposity; therefore, these findings indicate that replacing standing time with LIPA is a strategy to lower adiposity.

BackgroundThe current international physical activity guidelines for health recommend children to engage in at least 60 minutes of moderate-to-vigorous physical activity (MVPA) daily. Yet, accurate prevalence estimates of physical activity levels of children are unavailable in many African countries due to the dearth of accelerometer-measured physical activity data. The aim of this study was to describe the prevalence and examine the socio-demographic correlates of accelerometer-measured physical activity among school-going children in Kampala city, Uganda.MethodsA cross-sectional study design was used to recruit a sample of 10–12 years old school-going children (n = 256) from 7 primary schools (3 public schools and 4 private schools) in Kampala city, Uganda. Sedentary time, light-intensity physical activity (LPA), moderate-intensity physical activity (MPA) and vigorous-intensity physical activity (VPA) were measured by accelerometers (ActiGraph GT3X+ [Pensacola, Florida, USA]) over a seven-day period. Socio-demographic factors were assessed by a parent/guardian questionnaire. Weight status was generated from objectively measured height and weight and computed as body mass index (BMI). Multi-level logistic regressions identified socio-demographic factors that were associated with meeting physical activity guidelines.ResultsChildren’s sedentary time was 9.8±2.1 hours/day and MVPA was 56±25.7 minutes/day. Only 36.3% of the children (38.9% boys, 34.3% girls) met the physical activity guidelines. Boys, thin/normal weight and public school children had significantly higher mean daily MVPA levels. Socio-demographic factors associated with odds of meeting physical activity guidelines were younger age (OR = 0.68; 95% CI = 0.55–0.84), thin/normal weight status (OR = 4.08; 95% CI = 1.42–11.76), and socioeconomic status (SES) indicators such as lower maternal level of education (OR = 2.43; 95% CI = 1.84–3.21) and no family car (OR = 0.31; 95% CI = 0.17–0.55).ConclusionChildren spent a substantial amount of time sedentary and in LPA and less time in MVPA. Few children met the physical activity guidelines. Lower weight status, lower maternal education level and no family car were associated with meeting physical activity guidelines. Effective interventions and policies to increase physical activity among school-going children in Kampala, are urgently needed.

The current international physical activity guidelines for health recommend children to engage in at least 60 minutes of moderate-to-vigorous physical activity (MVPA) daily. Yet, accurate prevalence estimates of physical activity levels of children are unavailable in many African countries due to the dearth of accelerometer-measured physical activity data. The aim of this study was to describe the prevalence and examine the socio-demographic correlates of accelerometer-measured physical activity among school-going children in Kampala city, Uganda. A cross-sectional study design was used to recruit a sample of 10-12 years old school-going children (n = 256) from 7 primary schools (3 public schools and 4 private schools) in Kampala city, Uganda. Sedentary time, light-intensity physical activity (LPA), moderate-intensity physical activity (MPA) and vigorous-intensity physical activity (VPA) were measured by accelerometers (ActiGraph GT3X+ [Pensacola, Florida, USA]) over a seven-day period. Socio-demographic factors were assessed by a parent/guardian questionnaire. Weight status was generated from objectively measured height and weight and computed as body mass index (BMI). Multi-level logistic regressions identified socio-demographic factors that were associated with meeting physical activity guidelines. Children's sedentary time was 9.8±2.1 hours/day and MVPA was 56±25.7 minutes/day. Only 36.3% of the children (38.9% boys, 34.3% girls) met the physical activity guidelines. Boys, thin/normal weight and public school children had significantly higher mean daily MVPA levels. Socio-demographic factors associated with odds of meeting physical activity guidelines were younger age (OR = 0.68; 95% CI = 0.55-0.84), thin/normal weight status (OR = 4.08; 95% CI = 1.42-11.76), and socioeconomic status (SES) indicators such as lower maternal level of education (OR = 2.43; 95% CI = 1.84-3.21) and no family car (OR = 0.31; 95% CI = 0.17-0.55). Children spent a substantial amount of time sedentary and in LPA and less time in MVPA. Few children met the physical activity guidelines. Lower weight status, lower maternal education level and no family car were associated with meeting physical activity guidelines. Effective interventions and policies to increase physical activity among school-going children in Kampala, are urgently needed.

Adolescents and young adults with intellectual and developmental disabilities (IDD) have high rates of obesity and low levels of physical activity. This analysis examined changes in light, moderate-to-vigorous physical activity (MVPA) and sedentary time, and the association between changes in MVPA and weight loss in adolescents and young adults with IDD and overweight and obesity participating in a 6-month multi-component weight loss intervention. Adolescents and young adults with IDD and overweight or obesity (body mass index≥85 percentile, n=110, age ~16years, 52.7% female) and a parent were randomised to one of three intervention groups: face-to-face delivery/conventional reduced energy diet (n=36), remote delivery (RD)/conventional reduced energy diet (n=39), or RD/reduced energy enhanced stop light diet (eSLD) (n=35.) Participants were asked to engage in 60min/day of MVPA on 5 or more days/wk. Participants and a parent attended twice monthly education/behavioural counselling sessions with a health educator to assist participants in complying with dietary and MVPA recommendations. Education/counselling in the RD arms was delivered remotely using video conferencing, and self-monitoring of MVPA and daily steps was completed using a wireless activity tracker. Education/counselling in the face-to-face arm was delivered during home-visits and self-monitoring of MVPA and daily steps was completed by self-report using paper tracking forms designed for individuals with IDD. MVPA, light activity, and sedentary time were assessed over 7days at baseline and 6months using a portable accelerometer (ActiGraph wGT3x-BT). Mixed modelling analysis completed using participants with valid accelerometer data (i.e. ≥4-10h days) at baseline (n=68) and 6months (n=30) revealed no significant changes in light, moderate- MVPA, or sedentary time across the 6-month intervention (all P>0.05). Participants obtained 15.2±21.5min/day of MVPA at baseline and 19.7±19.7min/day at 6months (P=0.119). Mixed modelling indicated no significant effects of group (P=0.79), time (P=0.10), or group-by-time interaction (P=0.21) on changes in MVPA from baseline to 6months. Correlational analysis conducted on participants with valid accelerometer data at both baseline and 6months (n=24) revealed no significant associations between baseline sedentary time (r=0.10, P=0.40) and baseline MVPA (r=-0.22, P=0.30) and change in MVPA across the 6-month intervention. Additionally, attendance at education/counselling sessions (r=0.26, P=0.22) and frequency of self-monitoring of MVPA were not significantly associated with change in MVPA from baseline to 6months (r=0.26, P=0.44). Baseline MVPA (r=0.02, P=0.92) and change in MVPA from baseline to 6months (r=0.13, P=0.30) were not associated with changes in body weight across the 6-month intervention. We observed a non-significant increase in MVPA (30%), which was not associated with the magnitude of weight loss in a sample of adolescents and young adults with IDD who participated in a 6-month multi-component weight loss intervention. Additional strategies to increase MVPA in adolescents and young adults with IDD participating in weight loss interventions need to be developed and evaluated.

Although correlates of physical activity (PA) have been extensively examined in both children and adolescents who are typically developing, little is known about correlates of moderate to vigorous physical activity (MVPA) and sedentary time in adolescents with intellectual and developmental disabilities (IDD). Therefore, we examined intrapersonal, interpersonal and environmental factors and their association with device-based MVPA and sedentary time in adolescents with IDD. MVPA and sedentary time was assessed using a hip-worn ActiGraph model wGT3x-BT tri-axial accelerometer across a 7-day period in adolescents with IDD and one of their parents. Pearson and point-biserial correlations were calculated to inspect the associations of PA (MVPA, sedentary time) with intrapersonal factors (demographic characteristic, BMI, waist circumference, motor ability, muscle strength, grip strength, cardiovascular fitness and self-efficacy for PA), interpersonal factors (parent demographics, parent BMI, parent MVPA and sedentary time, family social support for PA, parent barriers and support for PA, parent's beliefs/attitudes towards PA and number of siblings), and environmental factors (meteorologic season and COVID-19). Ordinary least squares regression was used to estimate the unique contributions of key factors to PA after controlling for participants' age, sex, race, waist circumference and total wear time. Ninety-two adolescents (15.5±3.0years old, 21.7% non-White, 6.5% Hispanic, 56.5% female) provided valid accelerometer data. Average sedentary time was 494.6±136.4min/day and average MVPA was 19.8±24.2min/day. Age (r=0.27, P=0.01), diagnosis of congenital heart disease (r=-0.26, P=0.01) and parent sedentary time (r=0.30, P=0.01) were correlated with sedentary time. BMI (r=-0.24, P=0.03), waist circumference (r=-0.28, P=0.01), identifying as White (r=-0.23, P=0.03) and parent MVPA (r=0.56, P<0.001) were correlated with MVPA. After adjusting for the adolescent's age, sex, race, waist circumference, and total wear time, the association between parent and adolescent MVPA remained significant (b=0.55, P<0.01, partial η2 =0.11). The results of this study provide evidence that race, waist circumference and parental MVPA may influence the amount of MVPA in adolescents with IDD. The limited available information and the potential health benefits of increased MVPA highlight the need to evaluate the effectiveness of multi-component interventions targeting both intrapersonal and interpersonal levels to promote increased PA in adolescents with IDD.

BackgroundOur aim was to describe and explore older adults’ device-measured sedentary behavior and physical activity (PA) pattern by sex, age, education, marital status, body mass index, and physical function; and to assess agreement regarding fulfillment of PA recommendations, i.e. 150 min/week of moderate-to-vigorous intensity PA (MVPA), between device-measured and self-reported PA.MethodWe included 656 older adults (64% women), aged 66, 81–87 or ≥ 90 years from a Swedish population-based cohort study. The activPAL3 accelerometer provided information on sedentary behavior (sedentary time, sedentary bouts, sit-to-stand transitions) and PA. Stepping ≥100 steps/min was considered MVPA; standing and stepping < 100 steps/min were considered light-intensity PA (LPA). Self-reported PA was compared with min/week in MVPA and steps/day.ResultsOn average, 60% of wear time was spent sedentary, 36% in LPA, and 4% in MVPA. Relative to men, women, had significantly (p < 0.05) more sit-to-stand transitions, spent 33 min/day less sedentary and 27 min/day more in LPA, and were more likely to report meeting PA recommendations, but showed no difference in steps/day, MVPA, or sedentary bout duration. Older age was associated with more sedentary time, lower MVPA and fewer steps/day. The prevalence of meeting PA recommendations was 59% device-measured and 88% by self-report with limited agreement between methods (Cohen’s Kappa = 0.21, Spearman’s rho = 0.28). Age differences were much more pronounced with objective measures than by self-report.ConclusionsWe found significant sex differences in sedentary behavior and time in LPA in older adults, but not in MVPA, in contrast to previous findings. Sedentary time increased with age, with small differences in accumulation pattern. MVPA time was lower with older age, obesity, and poor physical function. A majority of the participants > 80 years did not meet the PA recommendations. Given the strong relationships between sedentary behavior, PA and health in older adults, programs are needed to address these behaviors. Agreement between device-measured and self-reported fulfillment of PA recommendations was limited. Device-based measurement adds value to PA studies, providing richer and different data than self-report.

THE USE OF INDIVIDUALIZED EXERCISE PRESCRIPTION AND ACTIVITY TRACKERS TO PROMOTE PHYSICAL ACTIVITY IN CHILDREN WITH CONGENITAL HEART DISEASE

BackgroundIt is well established that all types of movement behaviors, including moderate-to-vigorous physical activity (MVPA), light-intensity physical activity (LIPA), sedentary behavior (SB), and sleep, are associated with the risk of incident dementia, all-cause mortality, and premature death. However, it remains unclear whether reallocating time from one type to another is associated with these outcomes. In addition, the extent to which genetic susceptibility modifies the association between physical activity and dementia risk still warrants further investigation.MethodsThis study included 94 086 dementia-free participants from the UK Biobank with valid accelerometer and genomic data. Time spent MVPA, LIPA, SB, and sleep were derived from wrist-worn accelerometers. Genetic susceptibility of dementia was assessed by polygenic risk score (PRS) consisting of 82 single nucleotide polymorphisms. The isotemporal substitution model was applied to explore how reallocating time between movement behaviors was associated with incident dementia, mortality, and premature death.ResultsOf 94 086 included participants, 52 853 (56.2%) were female, and the mean (standard deviation, SD) age was 62.3 (7.8) years. Reallocating 1 h/day to MVPA from LIPA, SB, and sleep was associated with a 19%, 26%, and 18% lower risk of incident dementia (adjusted hazard ratios [HRs] and 95% confidence intervals [CIs]: 0.81 [0.68, 0.95], 0.74 [0.63, 0.87], and 0.82 [0.69, 0.96], respectively). A 22%, 30%, and 29% reduced risk of mortality were observed when reallocating 1 h/day from LIPA, SB, and sleep to MVPA (0.78 [0.72, 0.84], 0.70 [0.65, 0.75], and 0.71 [0.66, 0.77], respectively). Replacing 1 h/day of SB with MVPA, LIPA, and sleep was associated with a 26%, 8%, and 9% lower risk of incident dementia (0.74 [0.63, 0.87], 0.92 [0.87, 0.97], and 0.91 [0.85, 0.97], respectively), and reallocating 1 h/day from SB to LIPA (0.89 [0.87–0.92]) or MVPA (0.70 [0.65–0.75]) was associated with reduced risk of mortality. Similar results could be seen in premature death. Participants with high levels of MVPA and low genetic risk showed 72% lower risk of dementia comparing to participants with low levels of MVPA and high PRS (0.28 [0.17–0.50]).ConclusionsReallocating time to MVPA from any behavior and substituting physical activity of any intensity for SB were associated with decreased risks of incident dementia, mortality, and premature death, suggesting the significance of maintaining a physically active lifestyle among old adults. Moreover, increasing MVPA level could partially attenuate the strength of association between genetic susceptibility and the risk of dementia.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12966-025-01814-8.

BackgroundSedentary behavior is associated with health risks in adults. The potential benefits of reducing sedentary time may be dependent not only on decrease per se, but also on the type of activity it replaces. Few longitudinal studies have investigated the effects on mortality when replacing objectively assessed sedentary time with another physical activity (PA) behavior.ObjectiveTo investigate the effects of replacing objectively assessed sedentary time with time in light-intensity PA or moderate-vigorous PA (MVPA) on all-cause mortality, cardiovascular disease (CVD) mortality or cancer mortality in a cohort with 15 years follow-up time.MethodsIn total, 851 women and men from the population-based Sweden Attitude Behaviour and Change study were included. Time spent sedentary, in light-intensity PA and in MVPA were assessed using an Actigraph 7164 accelerometer. Mortality data were obtained from Swedish registers. Cox proportional hazards models estimated hazard ratios (HR) of mortality with 95% confidence intervals (CI) and isotemporal substitution models were used to estimate the effect of replacing sedentary behavior with PA for the same amount of time.ResultsOver a follow-up of 14.2 years (SD 1.9) with 12,117 person-years at risk, 79 deaths occurred, 24 deaths from CVD, 27 from cancer, and 28 from other causes. Replacing 30 minutes/day of sedentary time with light-intensity PA was associated with significant reduction in all-cause mortality risk (HR: 0.89, 95% CI: 0.81–0.98) and CVD mortality risk (HR: 0.76, 95% CI: 0.63–0.92). Replacing 10 minutes of sedentary time with MVPA was associated with reduction in CVD mortality risk (HR: 0.62, 95% CI: 0.42–0.91). No statistically significant reductions were found for cancer mortality.ConclusionThis statistical modelling study suggests that replacing sedentary time with light-intensity PA could have beneficial effect on both all-cause mortality and CVD mortality. Replacing sedentary time with MVPA could reduce CVD mortality.

BackgroundCross-sectional investigation showed that Chinese children in Hong Kong were more physically active on weekends than weekdays, which is contrary to previous findings. However, little is known as to whether these time-segment-specific differences persist with age. This study aimed to compare the 2-year changes in accelerometer-assessed physical activity (PA) and sedentary time (ST) between weekdays and weekends among Chinese children in Hong Kong.MethodsChildren aged 6–8 years were recruited from primary schools in Hong Kong. Time spent in ST (<100 counts per minute [cpm]), moderate-to-vigorous PA (MVPA), and light-intensity PA (LPA) were measured by accelerometer at baseline and then at 1-year and 2-year follow-ups. Mean annual changes were determined using mixed-effects linear models for children who provided 3-day valid data (including 1 weekend day) for at least two time points (n = 412). Magnitude of changes between weekdays and weekends was compared using age × time-segment interactions.ResultsAt each assessment wave, the percentage of time spent in MVPA (% MVPA) and LPA (% LPA) was consistently high, whereas the percentage of time spent in ST (% ST) was lower on weekends than weekdays. A decrease in % MVPA was found for both weekdays (mean annual change: boys, −0.7, 95 % CI = −0.9 to −0.1; girls, −0.8, 95 % CI = −1.0 to −0.6) and weekends (boys, −1.2, 95 % CI = −1.5 to −0.9; girls, −1.4, 95 % CI = −1.6 to −1.1). An increase was found in % ST for both weekdays (boys, 1.3, 95 % CI = 0.7 to 1.9; girls, 2.4, 95 % CI = 1.9 to 3.3) and weekends (boys, 1.8, 95 % CI = 1.1 to 2.5; girls, 2.6, 95 % CI = 1.9 to 3.3). Mean annual change in MVPA time (min) was greater on weekends than weekdays (difference: boys, 3.0, 95 % CI = 0.3 to 5.7; girls, 3.5, 95 % CI = 1.1 to 5.8).ConclusionsAge-related decline in MVPA was more marked on weekends than weekdays. Interventions to hinder age-related changes in PA and ST should target both time segments, but weekends warrant particular attention for interventions targeting PA maintenance due to the greater declines.

Physical activity (PA) and sedentary behavior (SB) are key determinants of health outcomes in individuals living with type 1 diabetes (T1D). However, the influence of sociodemographic and clinical factors on engagement in these behaviors is not yet well understood. This study aimed to analyze the associations of sociodemographic factors, body mass index, and both the duration and age at diagnosis of diabetes with SB, light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) in Brazilian adults. A cross-sectional study was conducted at the Diabetes and Metabolism Service of a public secondary care unit in Rio de Janeiro. One hundred adults diagnosed with T1D had their daily awake time spent in SB, LPA, and MVPA measured using triaxial accelerometers. Sociodemographic and clinical factors were assessed using questionnaires. Generalized Linear Models were used to analyze the relationships of these factors with SB, LPA, and MVPA. Significant associations were found between age, education level, and employment status with SB and LPA, but not with MVPA. On average, each additional year of age was associated with decreased time in SB and increased time in LPA. Higher education levels and unemployment were linked to more SB and less time in LPA. Age, education level, and employment status emerged as key sociodemographic predictors of SB and LPA in Brazilian adults living with T1D. These findings contribute to a better understanding of the sociodemographic determinants associated with SB and PA in individuals diagnosed with T1D.

BackgroundAlthough current technological advancements have allowed for objective measurements of sedentary behavior via accelerometers, these devices do not provide the contextual information needed to identify targets for behavioral interventions and generate public health guidelines to reduce sedentary behavior. Thus, self-reports still remain an important method of measurement for physical activity and sedentary behaviors.ObjectiveThis study evaluated the reliability, validity, and sensitivity to change of a smartphone app in assessing sitting, light-intensity physical activity (LPA), and moderate-vigorous physical activity (MVPA).MethodsAdults (N=28; 49.0 years old, standard deviation [SD] 8.9; 85% men; 73% Caucasian; body mass index=35.0, SD 8.3 kg/m2) reported their sitting, LPA, and MVPA over an 11-week behavioral intervention. During three separate 7-day periods, participants wore the activPAL3c accelerometer/inclinometer as a criterion measure. Intraclass correlation (ICC; 95% CI) and bias estimates (mean difference [δ] and root of mean square error [RMSE]) were used to compare app-based reported behaviors to measured sitting time (lying/seated position), LPA (standing or stepping at <100 steps/minute), and MVPA (stepping at >100 steps/minute).ResultsTest-retest results suggested moderate agreement with the criterion for sedentary time, LPA, and MVPA (ICC=0.65 [0.43-0.82], 0.67 [0.44-0.83] and 0.69 [0.48-0.84], respectively). The agreement between the two measures was poor (ICC=0.05-0.40). The app underestimated sedentary time (δ=-45.9 [-67.6, -24.2] minutes/day, RMSE=201.6) and overestimated LPA and MVPA (δ=18.8 [-1.30 to 38.9] minutes/day, RMSE=183; and δ=29.3 [25.3 to 33.2] minutes/day, RMSE=71.6, respectively). The app underestimated change in time spent during LPA and MVPA but overestimated change in sedentary time. Both measures showed similar directions in changed scores on sedentary time and LPA.ConclusionsDespite its inaccuracy, the app may be useful as a self-monitoring tool in the context of a behavioral intervention. Future research may help to clarify reasons for under- or over-reporting of behaviors.

AimThe aim of this study was to investigate the potential associations of reallocating 30 minutes sedentary time in long bouts (>60 min) to sedentary time in non-bouts, light intensity physical activity (LPA) and moderate- to vigorous physical activity (MVPA) with cardiometabolic risk factors in a population diagnosed with prediabetes or type 2 diabetes.MethodsParticipants diagnosed with prediabetes and type 2 diabetes (n = 124, 50% men, mean [SD] age = 63.8 [7.5] years) were recruited to the physical activity intervention Sophia Step Study. For this study baseline data was used with a cross-sectional design. Time spent in sedentary behaviors in bouts (>60 min) and non-bouts (accrued in <60 min bouts) and physical activity was measured using the ActiGraph GT1M. Associations of reallocating bouted sedentary time to non-bouted sedentary time, LPA and MVPA with cardiometabolic risk factors were examined using an isotemporal substitution framework with linear regression models.ResultsReallocating 30 minutes sedentary time in bouts to MVPA was associated with lower waist circumference (b = -4.30 95% CI:-7.23, -1.38 cm), lower BMI (b = -1.46 95% CI:-2.60, -0.33 kg/m2) and higher HDL cholesterol levels (b = 0.11 95% CI: 0.02, 0.21 kg/m2. Similar associations were seen for reallocation of sedentary time in non-bouts to MVPA. Reallocating sedentary time in bouts to LPA was associated only with lower waist circumference.ConclusionReallocation of sedentary time in bouts as well as non-bouts to MVPA, but not to LPA, was beneficially associated with waist circumference, BMI and HDL cholesterol in individuals with prediabetes and type 2 diabetes. The results of this study confirm the importance of reallocation sedentary time to MVPA.

Association of objectively measured physical activity and sedentary time with health-related quality of life in women with fibromyalgia: The al-Ándalus project