High SED Research Articles

Rationale, Design, and Methods for the Sedentary Behavior Reduction in Pregnancy Intervention (SPRING): Protocol for a Pilot and Feasibility Randomized Controlled Trial.

Adverse pregnancy outcomes (APOs) identify cardiovascular disease risk, but few effective interventions are available. High sedentary behavior (SED) has recently been associated with APOs, but very few randomized controlled trials (RCTs) have tested SED reduction in pregnancy. The Sedentary Behavior Reduction in Pregnancy Intervention (SPRING) pilot and feasibility RCT addresses this gap by testing the feasibility, acceptability, and preliminary pregnancy health effects of an intervention to reduce SED in pregnant women. The objective of this manuscript is to describe the rationale and design of SPRING. Pregnant participants (n=53) in their first trimester, who are at risk for high SED and APO and without contraindications, are randomized in a 2:1 ratio to an intervention or control group. SED (primary outcome) and standing durations, and steps per day, are measured objectively in each trimester for 1 week with a thigh-mounted activPAL3 accelerometer. SPRING also seeks to demonstrate feasibility and acceptability while estimating preliminary effects on maternal-fetal health outcomes assessed during study visits and abstracted from medical records. The pregnancy-customized intervention promotes daily behavioral targets of less than 9 hours of SED and at least 7500 steps, achieved via increased standing and incorporating light-intensity movement breaks each hour. The multicomponent intervention provides a height-adjustable workstation, a wearable activity monitor, behavioral counseling every 2 weeks (through videoconference), and membership in a private social media group. Herein, we review the rationale, describe recruitment and screening processes, and detail the intervention, assessment protocols, and planned statistical analyses. This study was funded by the American Heart Association (20TPA3549099), with a funding period of January 1, 2021, and until December 31, 2023. Institutional review board approval was obtained on February 24, 2021. Participants were randomized between October 2021 and September 2022, with final data collection planned for May 2023. Analyses and submission of results are expected for winter of 2023. The SPRING RCT will provide initial evidence on the feasibility and acceptability of an SED-reduction intervention to decrease SED in pregnant women. These data will inform the design of a large clinical trial testing SED reduction as a strategy to reduce APO risk. ClincialTrials.gov NCT05093842; https://clinicaltrials.gov/ct2/show/NCT05093842. DERR1-10.2196/48228.

Patterns in Prenatal Physical Activity and Sedentary Behavior: Associations With Blood Pressure and Placental Features in the MoMHealth Cohort.

Moderate to vigorous physical activity (MVPA) and sedentary behavior (SED) are associated with blood pressure (BP) and adverse pregnancy outcomes. The authors investigated associations of prenatal MVPA and SED patterns with BP and with placental malperfusion features. Women enrolled in this prospective cohort study in the first trimester. MVPA, SED, and BP were measured objectively each trimester. MVPA and SED trajectories were constructed. Placental examinations were conducted in a subset. Associations of trajectories with BPs were assessed with linear regression adjusted for age, race, education, prepregnancy body mass index, and gestational age. Associations with placental malperfusion lesions and weight were adjusted for key covariates. One hundred eleven participants were included; placental exams were available in 50. Participants with high (vs low) SED were younger and more likely to have adverse pregnancy outcomes. High SED (vs low) was associated with higher first trimester systolic (β = 5.3; 95% confidence interval, 0.0 to 10.6) and diastolic (β = 5.0; 95% confidence interval, 1.4 to 8.6) and higher second trimester diastolic (β = 4.9; 95% confidence interval, 1.6 to 8.2) BP. Medium and high MVPA groups were associated with lower postpartum diastolic BP. Trajectories were not associated with placental malperfusion. MVPA and SED patterns were differentially associated with prenatal and postpartum BP. Encouraging favorable levels of both might help women achieve lower BP during and after pregnancy.

P05-04 Physical activity level and sedentary time prior to cardiac ward admission among patients with cardiovascular disease and its association to all-cause mortality

BackgroundLow physical activity (PA) level and high sedentary time (SED) have been associated to cardiovascular (CVD) morbidity and mortality. Routinely assessing the PA-level of patients being admitted to hospital has been proposed. The aim was to explore PA-level and SED among patients prior to cardiac ward admission and whether this can predict all-cause mortality.MethodsA longitudinal observational study of patients with ischemic heart disease, heart failure, cardiac arrhythmia, valvular heart disorder and inflammatory heart diseases treated on cardiac wards (2015-2016) in Stockholm, Sweden. Data on PA-levels and SED prior to admission were collected by validated questionnaires during inpatient care. PA level a regular week was calculated by an index (3-19 points) including everyday PA and exercise. The cut-off of insufficiently physically active was set to > 9 points. Individuals' reporting ≥7 hours of sitting a normal day were categorised as high SED. Differences in PA-level and SED between different diagnose groups were explored by Benjamini-Hochberg procedure. The associations between PA-level and SED with all-cause mortality were analysed using cox regressions, adjusting for age, sex, diagnosis group, education level, disposable income, smoking status, alcohol consumption and eating habits.ResultsAmong 1148 patients with CVD, approximately 56% were considered as insufficiently physically active (>9 points). In addition, approximately half the study population were categorized as high SED (≥7 hours per day). There were differences in PA-level and SED between the various cardiovascular diagnoses, with individuals with heart failure and valvular heart disorder being in general more inactive and having higher levels of SED. A total of 200 deaths occurred during a median follow-up time of 2.6 years. The mortality was higher among those categorised as insufficiently physically active (HR 1.49, 95% CI 1.08-2.07) or high SED (HR 1.79, 95% CI 1.32-2.43) compared to those reporting sufficient PA and low SED, respectively.ConclusionA high amount reported insufficient PA and a high amount of SED preceding hospitalisation. There was an association between PA (negatively) and SED (positively) with all-cause mortality among patients with CVD. This highlights the prognostic value of assessing patients' PA-level and SED in clinical practice.

Convergent validity of commonly used questions assessing physical activity and sedentary time in Swedish patients after myocardial infarction

BackgroundGuidelines recommend regular physical activity (PA) and decreased sedentary time (SED) for patients after myocardial infarction (MI). Therefore, valid self-assessment of PA is vital in clinical practice. The purpose of this study was to assess the convergent validity of commonly used PA and SED questions recommended by the National Board of Health and welfare (NBHW) and national SWEDEHEART-registry using accelerometers as the reference method in patients after MI.MethodsData were obtained 2017–2021 among Swedish men and women (180 assessments). Participants answered five commonly used PA and SED-questions (by NBHW and SWEDEHEART) and wore an accelerometer (Actigraph GT3X) for seven days. Convergent validity was assessed gradually by; Kruskall Wallis-, Sperman rho, Weighted Kappa- and ROC-analyses. Misclassification was explored by Chi-square analyses with Benjamini–Hochberg adjustment.ResultsThe strongest correlation (r = 0.37) was found for the SED-GIH question (NBHW). For PA, no specific question stood out, with correlations of r = 0.31 (NBWH), and r = 0.24–0.30 (SWEDEHEART). For all questions (NBHW and SWEDEHEART), there was a high degree of misclassification (congruency 12–30%) affecting the agreement (0.09–0.32) between self-report and accelerometer assessed time. The SED-GIH, PA-index and SWEDEHEART-VPA had the strongest sensitivity for identifying individuals with high SED (0.72) or low PA (0.77 and 0.75).ConclusionThe studied PA and SED questions may provide an indication of PA and SED level among patients with MI in clinical practice and could be used to form a basis for further dialogue and assessment. Further development is needed, since practical assessment tools of PA and SED are desirable.

Maternal Sedentary Behavior and Physical Activity across Pregnancy and Early Childhood Growth.

Background: Evidence suggests in utero exposures are related to lifespan health of the offspring. Whether maternal activity profile during pregnancy impacts offspring health remains unknown. Methods: This follow-up study recruited mothers with objectively measured sedentary behavior (SED) and moderate-to-vigorous intensity physical activity (MVPA) from a previous cohort study. Maternal activity was analyzed across pregnancy (trajectory groups) and continuously by trimester. Offspring anthropometrics up to 24 months were abstracted from medical records (n = 62). Outcomes included childhood growth rate (incremental rate of BMI z-score change up to 24 months) and rapid growth (increased BMI z-score >0.67 at 12 months). Associations of maternal activity with growth rate were examined using mixed linear models and rapid growth using generalized linear models. Results: Forty percent of participants were in the high SED and 20% in the high MVPA trajectories during pregnancy. Higher SED, across pregnancy [slope (95% confidence interval; CI): 0.080 (0.024-0.061) ΔBMI z-score/month] and in the first trimester [standardized beta; std β (95% CI): 0.017 (0.007-0.026)], was related to accelerated growth rate. Higher MVPA, in the second and third trimesters, was associated with accelerated growth rate [std β (95% CI): trimester 2: 0.013 (0.002-0.024) and trimester 3:0.011 (0.003-0.020)] and greater risk of rapid growth [risk ratio (95% CI): trimester 2: 1.25 (1.009-1.555) and trimester 3: 1.25 (1.056-1.475)]. Conclusions: These findings add to growing evidence on the deleterious effects of high SED during pregnancy. The increased risk for accelerated growth with higher MVPA elicits further investigation. Overall, maternal activity profile shows promise as a modifiable behavior to improve intergenerational health.

Physical activity and fitness in the community: the Framingham Heart Study.

While greater physical activity (PA) is associated with improved health outcomes, the direct links between distinct components of PA, their changes over time, and cardiorespiratory fitness are incompletely understood. Maximum effort cardiopulmonary exercise testing (CPET) and objective PA measures [sedentary time (SED), steps/day, and moderate-vigorous PA (MVPA)] via accelerometers worn for 1 week concurrent with CPET and 7.8 years prior were obtained in 2070 Framingham Heart Study participants [age 54 ± 9 years, 51% women, SED 810 ± 83 min/day, steps/day 7737 ± 3520, MVPA 22.3 ± 20.3 min/day, peak oxygen uptake (VO2) 23.6 ± 6.9 mL/kg/min]. Adjusted for clinical risk factors, increases in steps/day and MVPA and reduced SED between the two assessments were associated with distinct aspects of cardiorespiratory fitness (measured by VO2) during initiation, early-moderate level, peak exercise, and recovery, with the highest effect estimates for MVPA (false discovery rate <5% for all). Findings were largely consistent across categories of age, sex, obesity, and cardiovascular risk. Increases of 17 min of MVPA/day [95% confidence interval (CI) 14-21] or 4312 steps/day (95% CI 3439-5781; ≈54 min at 80 steps/min), or reductions of 249 min of SED per day (95% CI 149-777) between the two exam cycles corresponded to a 5% (1.2 mL/kg/min) higher peak VO2. Individuals with high (above-mean) steps or MVPA demonstrated above average peak VO2 values regardless of whether they had high or low SED. Our findings provide a detailed assessment of relations of different types of PA with multidimensional cardiorespiratory fitness measures and suggest favourable longitudinal changes in PA (and MVPA in particular) are associated with greater objective fitness.

Demographic, Socioeconomic, and Health-Related Predictors of Objectively Measured Sedentary Time and Physical Activity During Pregnancy.

Sedentary behavior (SED) and moderate-to-vigorous intensity physical activity (MVPA) have important implications for health; however, little is known about predictors of these behaviors during pregnancy. This cohort study measured SED (activPAL) and MVPA (GT3X) in each trimester of pregnancy. Univariate associations of demographic, socioeconomic, and pregnancy health-related factors with SED or MVPA were calculated. Associations with P < .10 were included in stepwise linear regression models to determine independent predictors in each trimester. Pregnant women (n = 127) were age 31.0 (4.9) years and 78% white. In regression models across trimesters, fewer children ≤ age 5 in the household (P < .04) and primarily sitting job activity (P < .008) were related to higher SED and use of assisted reproductive technology (P < .05) was associated with higher MVPA. In at least one trimester, younger age was related to higher SED (P = .014); no history of pregnancy loss (P < .04), being married (P = .003), employed (P < .004, full time or student), white race (P = .006), and higher education (P = .010) were associated with higher MVPA. Predictors of SED in pregnancy were more consistent, and differed from predictors of MVPA. These findings may help identify women at risk of high SED or low MVPA, though future research in larger samples is needed.

Relationship of Physical Activity and Sedentary Time with Metabolic Health in Children and Adolescents Measured by Accelerometer: A Narrative Review.

The purpose of this study was to summarize the associations of physical activity (PA) and sedentary time (SED) with metabolic health and examine the effects of time reallocation on metabolic health in adolescents using accelerometer data. A literature search was conducted using PubMed, ScienceDirect, Web of Science, Cochran Library, and Google Scholar, and 27 articles were reviewed. Recent research generally confirms the associations of PA and SED with metabolic health. High PA levels and low SED levels had a positive relationship with metabolic health. Moreover, reallocating 10 min of daily SED to PA was associated with better metabolic health indicators. These results were stronger for moderate-to-vigorous physical activity than for light intensity PA. Thus, efforts to convert SED into PA of at least moderate intensity appear to be an effective strategy to prevent metabolic disease development in children and adolescents. However, some of the associations between PA and metabolic health indicators were inconsistent, depending on age, obesity degree, and PA intensity. Additionally, various accelerometer data collection and processing criteria impact the interpretation of the results. Therefore, consistent accelerometer data collection and analysis methods are needed in future studies. Further, intervention studies are required to verify the causality and effectiveness of the isotemporal substitution model.

Sedentary behaviour and physical activity across pregnancy and birth outcomes.

Shorter gestation or smaller birth size are indicators of a suboptimal fetal environment and negatively impact short- and long-term offspring health. Understanding how modifiable maternal behaviours, such as moderate-to-vigorous intensity physical activity (MVPA) or sedentary behaviour (SED), improve fetal outcomes could inform strategies to improve health across the lifespan. The objective of this study was to examine the association of MVPA and SED across pregnancy trimesters on gestational age at delivery and newborn anthropometrics. The MoM Health Study measured SED (thigh-mounted activPAL3 micro) and MVPA (waist-worn Actigraph GTX3) in each trimester of pregnancy. Birth outcomes (gestational age at delivery, birthweight, birth length, and head circumference) were abstracted from medical records and used to calculate ponderal index (grams*100/cm3 ) and size-for-gestational age percentiles. Associations of group-based trajectories and trimester-specific SED and MVPA with birth outcomes were analysed using regression models. Low, medium, and high trajectory groups were generated SED and MVPA in 103 and 99 pregnant women, respectively. High vs low SED trajectory was associated with earlier gestational age at delivery (β -1.03weeks, 95% CI -2.01, -0.06), larger head circumference (β 0.83cm, 95% CI 0.24, 1.63), longer birth length (β 1.37cm, 95% CI 0.09, 2.64), and lower ponderal index (β -0.24g*100/cm3 , 95% CI -0.42, -0.06), after adjustment for demographics, pre-pregnancy BMI, and (for newborn anthropometric outcomes) gestational age. The association of high SED with lower ponderal index was the most robust across progressively adjusted models (β -0.25g*100/cm3 , 95% CI -0.44, -0.07). SED trajectory was not associated with birthweight or size-for-gestational age. High vs low MVPA trajectory was only associated with smaller head circumference (β -0.86cm, 95% CI -1.70, -0.02). Higher SED during pregnancy may result in shorter gestation and inhibited fetal growth. Further research evaluating the effect of reducing SED during pregnancy on birth outcomes is warranted.

Chronotypes and objectively measured physical activity and sedentary time at midlife.

Morning, day, or evening chronotypes differ by the circadian timing of alertness and the preferred timing of sleep. It has been suggested that evening chronotype is associated with low physical activity (PA) and high sedentary time (SED). Our aim was to investigate whether such an association is confirmed by objectively measured PA and SED. In 46-year follow-up of the Northern Finland Birth Cohort 1966 study, total PA (MET min/day) and SED (min/day) among 5156 participants were determined using wrist-worn accelerometers for 14days. We used the shortened Morningness-Eveningness Questionnaire to define participants' chronotypes. As covariates, we used self-reported physical strenuousness of work, health, and demographics, and clinical measures. We used adjusted general linear models (B coefficients with 95% confidence intervals, CI) to analyze how chronotype was related to total PA or SED. As compared to evening chronotype, men with day and morning chronotypes had higher total PA volumes (adjusted B 75.2, 95% CI [8.1, 142.4], P=.028, and 98.6, [30.2, 167.1], P=.005). Men with day and morning chronotypes had less SED (-35.8, [-53.8, 17.8], P<.0001, and-38.6, [-56.9, -20.2], P<.0001). Among women, morning chronotype was associated with higher total PA (57.8, [10.5, 105.0], P=.017), whereas no association between chronotype and SED emerged. Evening chronotype was associated with low objectively measured PA in both sexes and with high SED in men, even after adjustments for established potential confounders. Chronotype should be considered in PA promotion.

Abstract P231: Physical Activity and Sedentary Behavior Trajectories During Pregnancy and Postpartum Blood Pressure

Background: Pregnancy influences longer-term vascular health for women. Moderate-vigorous physical activity (MVPA) and sedentary behavior (SED) have been associated with blood pressure (BP) in non-pregnant adults. Self-reported pregnancy MVPA has been associated with less risk of hypertension during pregnancy, but associations of MVPA and SED patterns during pregnancy and postpartum BP have not been investigated. Methods: MVPA and SED were measured objectively in women in each trimester of a singleton pregnancy using triaxial and positional accelerometers and defined using established cut points. Systolic and diastolic BP obtained at the 6-week postpartum clinic visit were abstracted from medical charts. Latent class trajectory modeling was used to assign women to one of three MVPA and SED trajectory groups: low, medium, and high. Kruskal-Wallis tests were used to evaluate differences in systolic and diastolic BP between trajectory groups and linear regression was used to test for associations of MVPA and SED trajectory group assignment with BP. Adjustment variables included age, race, and postpartum BMI. Results: Of the 101 women in the study, 23 were African American, mean age = 31±0.5 years and mean postpartum BMI = 27.6±0.7 kg/m 2 . Mean postpartum systolic and diastolic BP were 114±1 and 71±1 mmHg. Systolic BP was similar among MVPA and SED trajectory groups. Diastolic BP differed between MVPA (low: 76±2, medium: 70±1, high: 70±2 mmHg, p&lt;0.05) and SED (low: 71±3, medium: 69±1, high: 74±1, p&lt;0.05) trajectory groups. In adjusted analyses, SED, but not MVPA, trajectory assignment was significantly associated with postpartum diastolic BP, b=3.1, 95% CI: 0.6, 5.6, p&lt;0.02. Compared to the low SED trajectory, assignment to the high SED trajectory was associated with 4.9 (95% CI: -0.2, 10.0) mmHg higher diastolic BP in the adjusted model. Conclusions: SED trajectory across three trimesters of pregnancy was associated with postpartum diastolic BP, even after accounting for biologic covariates and MVPA. Results suggest avoiding high SED during pregnancy might help improve diastolic BP after delivery.

Abstract MP13: Prospective Associations of Prenatal Sedentary Behavior and Physical Activity Trajectories With Adverse Pregnancy Outcomes

Background: Adverse pregnancy outcomes (APO) are risk factors for future cardiovascular disease. Though factors such as obesity increase the risk of APO, whether patterns of prenatal sedentary behavior (SED) or physical activity are associated with APO is unclear. Methods: This cohort study measured objective SED, steps, and moderate-vigorous intensity physical activity (MVPA) during each trimester of pregnancy. Women were instructed to wear two monitors for 7 d: a thigh-mounted activPAL3 micro to measure SED and steps, and an Actigraph GT3X on an elastic waist belt to measure MVPA. Women also completed a detailed wear log. Data were considered valid with ≥4 d of ≥10 hr of wear. Physician-diagnosed APO (gestational hypertension, preeclampsia, gestational diabetes, preterm birth, or intrauterine growth restriction) were abstracted from medical records by trained research personnel. Growth mixture modelling was used to construct separate SED, steps, and MVPA trajectories across pregnancy. Associations between trajectory groups and APO were evaluated using logistic regression with adjustment for prepregnancy BMI, race, education, and age. Results: Women (n=100) had mean (SD) age 31.2 (4.8) yr, pregnancy BMI 26.2 (6.8) kg/m 2 , and were 25% non-white. Trajectory analyses revealed three groups within each SED, steps, and MVPA (see Table). Nineteen women (19%) had at least one APO: gestational hypertension and/or preeclampsia (n=13), gestational diabetes (n=3), preterm birth (n=6), or intrauterine growth restriction (n=4). High vs. low SED trajectory was associated with more than 6-fold higher odds of APO. Medium and high vs. low steps trajectory was associated with lower odds of APO, but only medium vs. low trajectories were statistically different. MVPA trajectory was not associated with APO risk (see Table). Conclusion: Reducing SED and increasing daily steps, though not increasing MVPA, could be novel intervention targets for reducing APO and future cardiovascular risk in pregnant women.

Associations Between Habitual Sedentary Behavior and Endothelial Cell Health.

The purpose of this study was to examine the association of accelerometer-measured SED with markers of endothelial cell health. Healthy adult participants (n=83; 43.4% male; 25.5 ± 5.8 years old) were examined. SED was measured for 7-days by accelerometer. Endothelial function measures included endothelium-dependent vasodilation (EDV); endothelial microparticles (EMPs) [CD62E+ and CD31+/CD42- EMPs]; and endothelial progenitor cells (EPCs) [CD34+/CD133+/KDR+ and CD34+/KDR+EPCs]. Participants were classified as having low or high SED based on a median split. Participants in the low and high SED group spent a mean ± SD of 8.6 ± 1.1 and 11.1 ± 1.0 h/day in SED, respectively. No significant differences between the low and high SED groups were detected in mean [95% confidence interval (CI)] EDV (2.51 [2.21-2.81] vs. 2.36 [2.07-2.64], p=0.50), EMPs (CD62E+: 6.70 [6.55-6.84] vs. 6.56 [6.42-6.69], p=0.20; CD31+/CD42‒: 6.26 [6.10-6.42] vs. 6.18 [6.03-6.33], p=0.50), or EPCs (CD34+/KDR+: 11.91 [9.23-14.48]×10-2 vs. 14.87 [12.41-17.32]×10-2, p=0.13); CD34+/CD133+/KDR+: 1.84 [1.28-2.39]×10-2 vs. 2.17 [1.64-2.70]×10-2, p=0.43). Among healthy adults, habitual SED was not associated with markers of endothelial cell health.

The Impact of Socioeconomic Deprivation on Clinical Outcomes for Pancreatic Adenocarcinoma at a High-volume Cancer Center: A Retrospective Cohort Analysis.

To assess the impact of a granular measure of SED on pancreatic surgical and cancer-related outcomes at a high-volume cancer center that employs a standardized clinic pathway. Prior research has shown that low socioeconomic status leads to less treatment and worse outcomes for PDAC. However, these studies employed inconsistent definitions and categorizations of socioeconomic status, aggregated individual socioeconomic data using large geographic areas, and lacked detailed clinicopathologic variables. We conducted a retrospective cohort study of 1552 PDAC patients between 2008 and 2015. Patients were stratified using the area deprivation index, a validated dataset that ranks census block groups based on SED. Multivariable models were used in the curative surgery cohort to predict the impact of SED on (1) grade 3/4 Clavien-Dindo complications, (2) initiation of adjuvant therapy, (3) completion of adjuvant therapy, and (4) overall survival. Patients from high SED neighborhoods constituted 29.9% of the cohort. Median overall survival was 28 months. The rate of Clavien-Dindo grade 3/4 complications was 14.2% and completion of adjuvant therapy was 65.6%. There was no evidence that SED impacted surgical evaluation, receipt of curative-intent surgery, postoperative complications, receipt of adjuvant therapy or overall survival. Although nearly one-quarter of curative-intent surgery patients were from high SED neighborhoods, this factor was not associated with measures of treatment quality or survival. These observations suggest that treatment at a high-volume cancer center employing a standardized clinical pathway may in part address socioeconomic disparities in pancreatic cancer.

Predictors of sedentary behavior among colorectal survivors.

Colorectal cancer (CRC) survivors spend approximately 9h per day in sedentary behavior (SED), despite recommendations to reduce sitting time. The purpose of this study was to examine predictors of SED among CRC survivors over a 1-year duration. Male and female CRC survivors (< 5years since diagnosis) participated in a 12-week moderate-to-vigorous physical activity randomized controlled trial. To measure SED, participants were given a CSA monitor to wear for three consecutive days (including one weekend day). Additionally, fitness (Treadmill walk test), body composition (bioelectrical impedance analysis) and questionnaires (Profile of Mood States, Exercise Processes of Change and Self-Efficacy for Exercise) were administered. Follow-up assessments were completed at a 3-month, 6-month, and 12-month follow-up. Forty-six colorectal survivors (average age = 57.3 ± 9.7years) completed the 12-month study. Using latent class models, four classes of SED behavior over time were identified: class 1 (high and sustained SED over time), class 2 (low and sustain SED over time), class 3 (increasing SED over time), and class 4 (high SED through 6-months, followed be a marked decrease at 12-months). Males were more likely to be in class 1, while majority of females were in class 3. Those CRC survivors with a better mood at baseline were in class 2, while those with poor fitness, high body fat, and higher cognitive processes at baseline were in class 3. Identifying the characteristics of survivors who engage in high SED can help healthcare providers to target their efforts to reduce SED.

Profiling sedentary behavior in breast cancer survivors: Links with depression symptoms during the early survivorship period

Depression symptoms are prevalent among breast cancer survivors (BCS). Reducing sedentary behavior (SED) may be a non-pharmaceutical strategy for alleviating depression symptoms. However, little is known about SED among BCS. The present study aimed to: (i) describe SED behaviors among BCS and identify unique SED groups based on different SED dimensions; (ii) identify personal and cancer-specific factors that discriminate SED clusters; and (iii) examine the association between SED clusters and depression symptoms. Baseline self-report demographic and medical information was collected from 187 BCS. SED and physical activity were assessed over seven days using an accelerometer. Self-reported depression symptoms were reported three months later. Multiple dimensions of SED were identified and examined in cluster analysis. The clusters were examined for differences using multivariate analysis of variance and chi-square analyses. The difference in depression symptoms among SED groups was assessed using an analysis of covariance. High and low SED groups were identified. Survivors in the high SED cluster were significantly older, heavier, less physically active, reported less education, and were more likely to have undergone lymph/axial node dissection. Women in the high SED cluster reported significantly higher depression symptoms prospectively (M=9.50, SD=6.07) compared to women in the low SED group (M=6.89, SD=5.18), F(8,179)=4.97, p=0.03, R2 =0.34. The importance of understanding multiple dimensions of SED among BCS was highlighted. Reducing SED during the early survivorship period may alleviate depression symptoms.

Physical Activity, Not Sedentary Time, Predicts Dual-Energy X-ray Absorptiometry-measured Adiposity Age 5 to 19 Years.

To examine the associations among physical activity (PA), sedentary time (SED), and TV viewing (TV) with fat mass (FAT) and visceral adipose tissue mass (VAT) from childhood through adolescence (5-19 yr). Participants in the Iowa Bone Development Study (n = 230 males and 233 females) were examined at ages 5, 8, 11, 13, 15, 17, and 19 yr. Accelerometers measured moderate- or vigorous-intensity PA (MVPA; min·d), light-intensity PA (LPA; min·d), and SED (h·d). Parent-proxy report (5 and 8 yr) and child-report (11, 13, 15, 17, and 19 yr) measured TV (h·d). X-ray absorptiometry scans measured FAT (kg) and VAT (g). Sex-specific growth models were used to create FAT and VAT growth curves for individual participants (level 1), and to test the effect of MVPA, LPA, SED, and TV (level 2) after adjusting for weight, height, linear age, nonlinear age, and maturity. Growth models indicated that low levels of MVPA were associated with high levels of FAT and VAT for males and high levels of FAT for females. TV viewing was positively associated with FAT and VAT for males and females. LPA was positively associated with FAT in males. Sedentary time was not associated with FAT or VAT for males or females (P > 0.05). This study supports current PA guidelines focusing on MVPA rather than SED. The contribution of high TV, but not high SED, to high levels of adiposity suggests that TV's contribution to obesity is not just a function of low energy expenditure.

Patterns of Sedentary Behavior in The First Month After Acute Coronary Syndrome

Sedentary behavior (SED) is a key contributor to cardiovascular disease in the general population. Few data exist on objectively measured SED patterns in acute coronary syndrome (ACS) patients in the first month after an ACS event; a critical period when lifestyle behaviors are reformed. PURPOSE: To characterize SED patterns and their correlates in ACS patients over the first month post-discharge. METHODS: Participants (n = 177) with confirmed ACS (myocardial infarction or unstable angina) from a university hospital in Upper Manhattan were examined. SED was objectively measured for 28-days post-discharge via Actical wrist accelerometry. Group-based modeling at the day-level was used to characterize SED patterns (trajectories) over the 28-days. Logistic regression was used to determine correlates of SED trajectories. Correlates included sociodemographic, hospitalization, physical and psychosocial factors. Models were adjusted for age, sex, race and ethnicity. RESULTS: Participants spent a mean (SD) of 12.3±3.2 hrs/day in SED the first month post-discharge. Three distinct SED trajectory groups were identified (Fig 1). The high SED group (38%) spent a mean (SD) of 15.6±1.3 hrs/day in SED with no change in day-level SED. The moderate SED group (41%) spent a mean (SD) of 11.8±1.2 hrs/day in SED with little change in day-level SED. The low SED group (21%) spent a mean (SD) of 7.6±1.5 hrs/day in SED, with a gradual decline in SED from immediately post-discharge (∼ 9 hrs/day) to 28-days post-discharge (∼ 7 hrs/day). In multivariable models, left ventricular ejection fraction< 40, length of hospital stay and coronary artery bypass grafting were identified as significant correlates of the high SED group (p<0.05 for all). CONCLUSION: ACS survivors accrued alarmingly high volumes of SED during the first month post-discharge, with little to no change in day-level SED over time. ACS survivors with greater disease severity were more likely to accrue higher volumes of SED.Figure 1: Trajectories of sedentary time post-discharge in ACS patients.

Long-term monitoring of PKS 0537−441 with Fermi–LAT and multiwavelength observations

We report on multiwavelength observations of the blazar PKS 0537-441 (z = 0.896) obtained from microwaves through gamma rays by SMA, REM, ATOM, Swift and Fermi during 2008 August-2010 April. Strong variability has been observed in gamma rays, with two major flaring episodes (2009 July and 2010 March) and a harder-when-brighter behaviour, quite common for FSRQs and low-synchrotron-peaked BL Lacs, in 2010 March. In the same way the SED of the source cannot be modelled by a simple synchrotron self-Compton model, as opposed to many BL Lacs, but the addition of an external Compton component of seed photons from a dust torus is needed. The 230 GHz light curve showed an increase simultaneous with the gamma-ray one, indicating co-spatiality of the mm and gamma-ray emission region likely at large distance from the central engine. The low, average, and high activity SED of the source could be fit changing only the electron distribution parameters, but two breaks in the electron distribution are necessary. The ensuing extra spectral break, located at NIR-optical frequencies, together with that in gamma rays seem to indicate a common origin, most likely due to an intrinsic feature in the underlying electron distribution. An overall correlation between the gamma-ray band with the R-band and K-band has been observed with no significant time lag. On the other hand, when inspecting the light curves on short time scales some differences are evident. In particular, flaring activity has been detected in NIR and optical bands with no evident gamma-ray counterparts in 2009 September and November. Moderate variability has been observed in X-rays with no correlation between flux and photon index. An increase of the detected X-ray flux with no counter part at the other wavelengths has been observed in 2008 October, suggesting once more a complex correlation between the emission at different energy bands.

Comparison of 3 Different Analytic Approaches for Determining Risk-Related Active and Sedentary Behavioral Patterns in Adolescents

Much of the research conducted to date implies overweight youth exhibit uniform active and sedentary behavioral patterns. This approach negates the possibility that multiple co-occurring, and seemingly contrasting, behaviors may manifest within the same individual. We present a substantive dialogue on alternative analytical approaches to identifying risk-related active/sedentary behavioral patterns associated with overweight in adolescents. Comparisons were made among latent profile analysis (LPA), cluster analysis (CA), and multinomial logistic regression (MLR). A cross sectional sample of youth (N = 6603; 12-18 yrs) completed a questionnaire assessing: physical activity (PA); competing activities (COMP); and sedentary activities (SED). Demographics associated with PA (age, sex, BMI) were used as covariates/predictors. Comparisons among methods revealed that LPA and CA detected subgroupings of behavioral patterns associated with overweight, each unique in regards to behaviors and demographic characteristics, whereas MLR results followed established associations of low PA and high SED without subgroup separation. Use of LPA and CA provides a rich understanding of behavioral patterns and the related demographic characteristics. Decisions guiding the selection of analytical techniques are discussed.