Abstract
BackgroundToo much prolonged sitting is a prevalent health risk among adults. Interventions have focused mainly on the workplace, with limited attention to non-work settings. The effectiveness of a short-term intervention to reduce and break-up sitting-time in overweight/obese adults was examined. This pilot study sought to determine the feasibility of interrupting sitting to stand/ambulate objectively with ActivPAL devices which provide a valid measurement of sit/stand transitions.MethodsThis is a cross-over randomized controlled pilot that included 10 participants (aged 37–65 years) and although a small and short-term intervention (1-week intervention; no washout) further informs on the feasibility of interventions on a larger scale. At the workplace, screen-delivered hourly alerts prompted participants to break-up sitting-time through adopting walking behaviors (approximately 30–60 minutes day−1). During transportation/home/leisure-time individual goals for steps day−1 were set and sitting-reduction strategies (including behavioral self-monitoring) were delivered through daily text messages. Change in inclinometer-derived sitting-time is the main outcome. Standing, stepping, number of sit/stand transitions and participant satisfaction were also examined.ResultsFor the intervention compared to the control-week (mean difference (95 % confidence interval); p value), participants had less sitting-time (1.85 hours (0.96–2.75); p = 0.001), more standing (0.77 hours (0.06–1.48); p = 0.036), and more stepping (1.09 hours (0.79– 1.38); p < 0.001). Importantly, there was no change in the total number of sit/stand transitions (3.28 (−2.33–8.89); p = 0.218) despite successfully reducing sitting-time and increasing time spent standing and walking.ConclusionsSitting-time in overweight/obese adults can be reduced following a brief multi-component intervention based on prompts, telephone support, goal setting and behavioral self-monitoring. However, the results from this pilot study provide new insight that when overweight/obese adults attempted to reduce sedentary-time by walking and standing for approximately 2 hour day−1 more than usual, they did not actually get up from sitting more often (i.e. increasing the number of sit/stand transitions), but instead remained on their feet for longer during each non-sitting bout. This behavioral resistance to make more sit/stand transitions (i.e. get-up from sitting more often) may have important implications for future modification programs and supports the concept that when overweight/obese people are sitting, people seem to prefer not to interrupt the sedentary behavior to get-up from sitting.Trial registration26 November 2013, ClinicalTrials.govID:NCT02007681 (first participant was randomized on 2 September 2013).Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-015-1015-4) contains supplementary material, which is available to authorized users.
Highlights
Too much prolonged sitting is a prevalent health risk among adults
Prolonged sitting is associated with obesity [2], metabolic disorders [3] and all-cause mortality [4] and observational [5] and experimental evidence [6, 7] suggest that interrupting sitting-time may be associated with better health outcomes
Adults spend most of their time in sedentary behaviors, some 65 % of waking- hours; 8 to 11 hour day−1 [8] and one of the features of modern life is that work has become less physically active and more sedentary [9] and has more leisure-time engaged in sittingrelated pursuits [10]
Summary
Too much prolonged sitting is a prevalent health risk among adults. Interventions have focused mainly on the workplace, with limited attention to non-work settings. Recent trials have shown significant reductions in workplace sedentary-time, using sit/stand workstations [11], educational sessions [12] and multicomponent interventions [13]. These multi-component interventions are likely to provide the most effective approach to reduce workplace sedentary-time [14, 15]. Distinct prompt frequencies have been previously used [16,17,18] but regardless of a generalized increase in the number of breaks, shorter prompt frequencies (1 prompt every 30 minutes) seemed not to reduce overall sitting-time [16] In this pilot study we considered hourly prompts to enhance overall sitting-time reduction while at work
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