Abstract
Our first aim was to examine the main and interacting effects of accelerometer-based sedentary time (ST) and moderate-to-vigorous physical activity (MVPA) with BMI and the likelihood of being overweight/obese in Hong Kong and Ghent (Belgium) older adults. Second, we examined whether these main associations and interactions between MVPA and ST were moderated by socio-demographics (gender, education) and objective neighbourhood attributes supposed to be associated with healthy food intake (food outlet density, neighbourhood-level SES). Finally, we determined whether the associations and interactions were generalisable across study sites. Data from the ALECS (Hong Kong) and BEPAS Seniors studies (Ghent), two comparable observational studies, were used. Older adults (n = 829, 65+) provided self-reported socio-demographic information and objective MVPA and ST data using Actigraph accelerometers. Annual household income data and GIS software were used to assess neighbourhood-level SES and food outlet density. Generalised additive mixed models were conducted in R. ST was linearly and positively related to both weight outcomes in the overall sample, while MVPA was not. The overall-sample analyses including the two-way interaction between MVPA and ST showed no interactions between these behaviours on weight outcomes. Three site-specific findings were identified, showing distinct associations in Hong Kong compared to Ghent. Study site moderated the interaction between ST and MVPA on both weight outcomes, the interaction between education and ST on both weight outcomes and the interaction between the number of food outlets and ST on being overweight/obese. The country-specific effects confirm the cultural dependency and complexity of the associations between PA, ST and weight outcomes. Future longitudinal international studies including older adults from multiple regions assessing PA, ST, weight outcomes and dietary intake should be encouraged. Such studies are needed to refine the recommendations regarding ST and PA in older adults in light of preventing overweight and obesity.
Highlights
In the last decades, the prevalence of overweight and obesity has increased dramatically in developed and most developing countries worldwide [1,2]
The overall-sample analyses including the two-way interaction between moderate-to-vigorous PA (MVPA) and sedentary time (ST) showed no interactions between these behaviours on weight outcomes
A large body of literature shows that achieving recommended levels of moderate-to-vigorous PA (MVPA) is negatively associated with markers of overweight and obesity (e.g. BMI, waist circumference) in older adults [10,11]
Summary
The prevalence of overweight and obesity has increased dramatically in developed and most developing countries worldwide [1,2]. Evidence is clear that the global prevalence of overweight and obesity is alarmingly high in older adults [3,4]. Growing evidence documents a positive association between sedentary behaviours (mainly TV viewing) and the odds of overweight and obesity [12,13,14]. Based on this evidence, it seems that interventions targeting PA and ST in older adults are key to prevent overweight, obesity and their related health consequences. The currently available studies have some shortcomings and specific research questions remain to be answered
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