Abstract
Little is known about the relationship between socioeconomic position (SEP) and duration and patterning of objectively measured sedentary time (ST) among adults, especially adults at high risk of diabetes. The aim of this study was to examine cross-sectional associations of SEP with ST (total, prolonged ST, breaks in ST) and self-reported TV time among pregnant women at risk of gestational diabetes in the UK. At 20 weeks' gestation, pregnant women (n=174) wore an activPAL accelerometer and reported their usual TV time. Generalized linear mixed models were used to test associations of education, household income and area-level deprivation (separately and with mutual adjustment) with total ST, prolonged ST and breaks in ST. Logistic regression models were used to test associations between SEP indicators and high (≥2h/day) TV time. Those with the lowest education, lowest household income and highest area-level deprivation had the lowest ST and lowest prolonged ST. After mutual adjustment, area-level deprivation remained associated with total ST (β=0.10 [0.01, 0.20]). There was an inverse association between area-level deprivation and breaks in sedentary time (exp(b)=1.11 [1.01, 1.22]). Education was the only SEP correlate of high TV time, with more of those with least education reporting high TV time; this association persisted after adjustment for household income and area-level deprivation. The association between SEP and total and prolonged ST (positive) was the opposite of the association between education and high TV time (negative) in this sample of high-risk pregnant women. These findings should inform interventions to reduce sedentary time.
Highlights
Sedentary time, defined as time spent in a sitting or reclining posture with low energy expenditure during waking hours (Sedentary Behaviour Research Network, 2012), has been linked to the development of poor health outcomes, including all-cause mortality and incident type 2 diabetes, after adjustment for physical activity (Patterson et al, 2018)
The way in which Sedentary time (ST) is accumulated throughout the day may be important, as evidence suggests that prolonged ST is more strongly associated with higher glucose levels than total ST (Wagnild et al, 2019), while breaks in ST have been linked to lower glucose levels (Healy et al, 2008; Carson et al, 2014)
There was a moderate correlation between total ST and prolonged ST (Spearman’s ρ=0.46, p
Summary
Sedentary time, defined as time spent in a sitting or reclining posture with low energy expenditure during waking hours (Sedentary Behaviour Research Network, 2012), has been linked to the development of poor health outcomes, including all-cause mortality and incident type 2 diabetes, after adjustment for physical activity (Patterson et al, 2018). Sedentary time (ST) is associated with biomarkers indicative of cardiometabolic risk, including higher levels of plasma glucose, insulin and triglycerides (Powell et al, 2018). Socioeconomic position (SEP), which refers to the ‘social and economic factors that influence what positions individuals or groups hold within the structure of a society’ (Galobardes et al, 2006a), is strongly linked to health outcomes (Braveman et al, 2011). At the individual level, educational attainment may reflect childhood SEP and potential employment and income, while household income is an indicator of material living standards (Galobardes et al, 2006a). Area-level SEP reflects the socioeconomic conditions of the neighbourhoods in which people live, which may have an impact on health beyond individual and household SEP (Galobardes et al, 2006b)
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