Sedentary Behavior Patterns Research Articles

Towards an In-Depth Understanding of Physical Activity and Eating Behaviours during COVID-19 Social Confinement: A Combined Approach from a Portuguese National Survey.

Rapid worldwide decreases in physical activity (PA), an increase in sedentary behaviour (SB) and poorer dietary patterns have been reported during COVID-19 confinement periods. However, as national variability has been observed, this study sought to describe PA, SB and eating patterns, and to explore their gender as well as other socio-demographic correlates and how they interrelate in a representative sample of Portuguese adults during the COVID-19 first mandatory social confinement. The survey was applied online and by telephone to 5856 adults (mean age = 45.8 years; 42.6% women). The majority reported high (46.0%) or moderate (20.5%) PA levels. Men, younger participants, those with higher education levels and a favourable perception of their financial situation reported higher PA levels, with the opposite pattern for SB. Physical fitness activities and household chores were more reported by women, with more strength training and running activities reported by men. Regarding eating behaviours, 45.1% reported changes, positive (58%) and negative (42%), with 18.2% reporting increases in consumption of fruit, vegetables, and fish and other seafood consumption, while 10.8% (most with lower educational level and less comfortable with their income) reported an increase in consumption of ready-to-eat meals, soft drinks, savoury snacks, and take-away and delivered meals. Two clusters—a health-enhancing vs. risky pattern—emerged through multiple correspondence analysis characterized by co-occurrence of high vs. low PA levels, positive vs. negative eating changes, awareness or not of the COVID-19 PA and dietary recommendations, perceived financial situation, higher vs. lower educational level and time in social confinement. In conclusion, while in social confinement, both positive and negative PA and eating behaviours and trends were displayed, highlighting the role of key sociodemographic correlates contributing to healthy vs. risky patterns. Results may inform future health interventions and policies to be more targeted to those at risk, and also advocate the promotion of PA and healthy eating in an integrated fashion.

Perceived anxiety and physical activity behaviour changes during the early stages of COVID-19 restrictions in community-dwelling adults in Canada: a cross-sectional study

ObjectivesThe COVID-19 pandemic changed daily routines, including physical activity, which could influence physical and mental health. In our study, we describe physical activity and sedentary behaviour patterns in relation to...

Association of Daily Physical Activity and Sedentary Behaviour with Protein Intake Patterns in Older Adults: A Multi-Study Analysis across Five Countries.

Physical activity and protein intake are associated with ageing-related outcomes, including loss of muscle strength and functional decline, so may contribute to strategies to improve healthy ageing. We investigated the cross-sectional associations between physical activity or sedentary behaviour and protein intake patterns in community-dwelling older adults across five countries. Self-reported physical activity and dietary intake data were obtained from two cohort studies (Newcastle 85+ Study, UK; LiLACS, New Zealand Māori and Non-Māori) and three national food consumption surveys (DNFCS, The Netherlands; FINDIET, Finland; INRAN-SCAI, Italy). Associations between physical activity and total protein intake, number of eating occasions providing protein, number of meals with specified protein thresholds, and protein intake distribution over the day (calculated as a coefficient of variance) were assessed by regression and repeated measures ANOVA models adjusting for covariates. Greater physical activity was associated with higher total protein intake and more eating occasions containing protein, although associations were mostly explained by higher energy intake. Comparable associations were observed for sedentary behaviour in older adults in Italy. Evidence for older people with higher physical activity or less sedentary behaviour achieving more meals with specified protein levels was mixed across the five countries. A skewed protein distribution was observed, with most protein consumed at midday and evening meals without significant differences between physical activity or sedentary behaviour levels. Findings from this multi-study analysis indicate there is little evidence that total protein and protein intake patterns, irrespective of energy intake, differ by physical activity or sedentary behaviour levels in older adults.

Segmented physical activity and sedentary behavior patterns among children in Maasai village and Nairobi city.

Urban-rural comparisons between those who maintain traditional lifestyles such as pastoralist Maasai children, and those who live in cities such as Nairobi, provide implications on how urbanization is associated with children's physical activity (PA) and sedentary behavior (SB) patterns. This study compares PA and SB volumes and patterns across different segments of the week among children in Maasai village and Nairobi city in Kenya. A total of 261 children (11.4 ± 1.3 years) from Maasai (n=118) and Nairobi (n=143) participated in this cross-sectional study. Moderate- to vigorous-intensity PA (MVPA) and SB on weekdays (before, during, and after school) and weekends (morning, afternoon, and evening) were calculated using accelerometers (ActiGraph). Screen time and sleep duration were assessed using questionnaires. Maasai children were more physically active than Nairobi children with MVPA (min/day) of 166.6 and 81.4 for Maasai and Nairobi boys and 116.4 and 77.4 for Maasai and Nairobi girls, respectively. Our week segments analyses suggested that Maasai children were more active both in and out of school than Nairobi children. Additionally, Nairobi children spent more time watching television and playing computer games than Maasai children. There was no significant difference in sleep duration between Maasai and Nairobi children. Our findings suggest that urbanization is negatively associated with activity patterns both in and out of school in Kenyan children. This is concerning given that Kenya is currently undergoing rapid urbanization, which may lead to further reductions in PA among Kenyan children.

Socioeconomic disparities in physical activity, sedentary behavior and sleep patterns among 6- to 9-year-old children from 24 countries in the WHO European region.

Physical activity, sedentary behavior, and sleep are important predictors of children's health. This paper aimed to investigate socioeconomic disparities in physical activity, sedentary behavior, and sleep across the WHO European region. This cross-sectional study used data on 124,700 children aged 6 to 9years from 24 countries participating in the WHO European Childhood Obesity Surveillance Initiative between 2015 and 2017. Socioeconomic status (SES) was measured through parental education, parental employment status, and family perceived wealth. Overall, results showed different patterns in socioeconomic disparities in children's movement behaviors across countries. In general, high SES children were more likely to use motorized transportation. Low SES children were less likely to participate in sports clubs and more likely to have more than 2h/day of screen time. Children with low parental education had a 2.24 [95% CI 1.94-2.58] times higher risk of practising sports for less than 2h/week. In the pooled analysis, SES was not significantly related to active play. The relationship between SES and sleep varied by the SES indicator used. Importantly, results showed that low SES is not always associated with a higher prevalence of "less healthy" behaviors. There is a great diversity in SES patterns across countries which supports the need for country-specific, targeted public health interventions.

Pattern of Physical Activity and Sedentary Behavior in Early Childhood

The research aimed to examine the prevalence and comparisons between physical activity and sedentary behavior of early-year children in preschool. The samples were 55 early-year children under five years old whose parents were willing to become participants voluntarily. Considering that the children have a plasticity characteristic, it is possible to form movement and healthy behavior from this early stage. Twenty-four-hour movement behaviors (physical activity, sedentary time, and sleep) were assessed using the ActiGraphTM accelerometer. Compared to early childhood children in a rural area, the results showed that early childhood children in urban areas were more physically active and spent less time on sedentary behavior (p 0.05). Meanwhile, male children in the rural area spent less physical activity and were more sedentary than male children in the urban area (p 0.05). These findings suggest that interventions aiming to improve physical activity and reduce sedentary behavior in early childhood may be more effective by considering the residential location.

Interventions for reducing sedentary behaviour in people with stroke.

Stroke survivors are often physically inactive as well as sedentary,and may sit for long periods of time each day. This increases cardiometabolic risk and has impacts on physical and other functions. Interventions to reduce or interrupt periods of sedentary time, as well as to increase physical activity after stroke, could reduce the risk of secondary cardiovascular events and mortality during life after stroke. To determine whether interventions designed to reduce sedentary behaviour after stroke, or interventions with the potential to do so, can reduce the risk of death or secondary vascular events, modify cardiovascular risk, and reduce sedentary behaviour. In December 2019, we searched the Cochrane Stroke Trials Register, CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, Conference Proceedings Citation Index, and PEDro. We also searched registers of ongoing trials, screened reference lists, and contacted experts in the field. Randomised trials comparing interventions to reduce sedentary time with usual care, no intervention, or waiting-list control, attention control, sham intervention or adjunct intervention. We also included interventions intended to fragment or interrupt periods of sedentary behaviour. Two review authors independently selected studies and performed 'Risk of bias' assessments. We analyzed data using random-effects meta-analyses and assessed the certainty of the evidence with the GRADE approach. We included 10 studies with 753 people with stroke. Five studies used physical activity interventions, four studies used a multicomponent lifestyle intervention, and one study used an intervention to reduce and interrupt sedentary behaviour. In all studies, the risk of bias was high or unclear in two or more domains. Nine studies had high risk of bias in at least one domain. The interventions did not increase or reduce deaths (risk difference (RD) 0.00, 95% confidence interval (CI) -0.02 to 0.03; 10 studies, 753 participants; low-certainty evidence), the incidence of recurrent cardiovascular or cerebrovascular events (RD -0.01, 95% CI -0.04 to 0.01;10 studies, 753 participants; low-certainty evidence), the incidence of falls (and injuries) (RD 0.00, 95% CI -0.02 to 0.02; 10 studies, 753 participants; low-certainty evidence), or incidence of other adverse events (moderate-certainty evidence). Interventions did not increase or reduce the amount of sedentary behaviour time (mean difference (MD) +0.13 hours/day, 95% CI -0.42 to 0.68; 7 studies, 300 participants; very low-certainty evidence). There were too few data to examine effects on patterns of sedentary behaviour. The effect of interventions on cardiometabolic risk factors allowed very limited meta-analysis. Sedentary behaviour research in stroke seems important, yet the evidence is currently incomplete, and we found no evidence for beneficial effects. Current World Health Organization (WHO) guidelines recommend reducing the amount of sedentary time in people with disabilities, in general. The evidence is currently not strong enough to guide practice on how best to reduce sedentariness specifically in people with stroke. More high-quality randomised trials are needed, particularly involving participants with mobility limitations. Trials should include longer-term interventions specifically targeted at reducing time spent sedentary, risk factor outcomes, objective measures of sedentary behaviour (and physical activity), and long-term follow-up.

Moderate‐to‐vigorous physical activity modifies the relationship between sedentary time and sarcopenia: the Tromsø Study 2015–2016

BackgroundSarcopenia is an age‐related muscle disease primarily characterized by reductions in muscle strength that increases the risk of falls, fractures, cognitive impairment, and mortality. Exercise is currently preferred in prevention and treatment, but it is unknown how different habitual physical activity and sedentary behaviour patterns associate with sarcopenia status. The purpose of the present study was to compare associations of these patterns with probable sarcopenia in older adults.MethodsIn 3653 community‐dwelling participants (51% women) aged 60–84 years from the seventh survey of the Tromsø Study, we assessed objective physical activity and sedentary behaviour collected over 8 days (ActiGraph wGT3X‐BT Accelerometer), grip strength (Jamar+ Digital Dynamometer), five‐repetition chair stands, and self‐reported disease. We combined tertiles of sedentary (SED) time and moderate‐to‐vigorous physical activity (MVPA) to create nine different activity profiles (SEDHIGH, SEDMOD, and SEDLOW combined with MVPAHIGH, MVPAMOD, or MVPALOW). Multiple logistic regression models were used to examine how these profiles associated with probable sarcopenia, defined by low handgrip strength and/or slow chair stands time according to the revised European Working Group on Sarcopenia in Older People criteria.ResultsProbable sarcopenia was present in 227 (6.2%) participants. Men with probable sarcopenia had on average 35.3 min more SED time and 20 min less MVPA compared with participants without sarcopenia (P < 0.01 for all), while women with probable sarcopenia only had 18 min less MVPA (P < 0.001). Compared with the SEDHIGH–MVPALOW reference activity profile (714.2 min SED/day and 10.4 min MVPA/day), the SEDHIGH–MVPAMOD profile (697.1 min SED/day and 31.5 min MVPA/day) had significantly lower odds ratio (OR) for probable sarcopenia (OR 0.17, 95% confidence interval [CI] 0.08–0.35), while the SEDLOW–MVPALOW profile (482.9 min SED/day and 11.0 min MVPA/day) did not (OR 0.72, 95% CI 0.47–1.11). These findings were not influenced by age, sex, smoking, or self‐reported diseases, and higher levels of MVPA did not further decrease ORs for probable sarcopenia.ConclusionsOlder adults who achieve moderate amounts of MVPA have reduced odds for probable sarcopenia, even when they have high sedentary time. Those with low sedentary time did not have reduced odds for probable sarcopenia when they also had low amounts of MVPA. These findings need confirmation in longitudinal studies but suggest that interventions for preventing sarcopenia should prioritize increasing MVPA over reducing sedentary behaviour.

Sedentary Behaviour Among Male Adolescents in Sagamu, Southwest Nigeria.

Sedentary behaviour (SB) is a leading risk factor for development of non-communicable diseases (NCDs) and associated morbidity worldwide. Several studies have reported a high prevalence of sedentary behaviour among adolescents in developing countries with a male preponderance. The Nigerian male adolescent is similarly faced with lifestyle challenges as his counterparts in other countries. This study determined the pattern, knowledge and factors associated with sedentary behaviour among male adolescents in Sagamu, Nigeria. A cross-sectional study was carried out among 330 in-school male adolescents in Sagamu, selected via multi-stage sampling technique. Data were collected using a semi-structured, self-administered questionnaire and analyzed using IBM SPSS version 20. Relevant descriptive and inferential statistics were calculated, with p < .05. Participation was fully voluntary and strict confidentiality was ensured. The mean age of respondents was 15.9 ± 1.4 years; 86.9% of respondents were aged 15-19years. About 94.8% of sedentary respondents had poor knowledge. Over 90% of respondents were sedentary. Screen-based behaviour (79%) contributed more to respondents' pattern of SB while using a tablet or a smart phone (23.6%) singularly contributed the largest to sedentariness. SB was associated with motorized transport (p = .038), smoking (p ≤ .001) and central obesity status (p = .040) but not with socio-demographic characteristics and alcohol intake. Knowledge of SB was poor among respondents. The prevalence of sedentary behaviour was high and associated with central obesity, smoking and motorized transport. School-based interventions including health education, should be initiated to reduce the risk of developing NCDs.

Physical Activity and Sedentary Behavior Patterns Across Weekdays and Weekend Days in Youth With Multiple Sclerosis and Controls.

This study quantified and compared weekday and weekend patterns of device-measured physical activity (PA) and sedentary behavior between youth with pediatric multiple sclerosis (MS) and controls for the purpose of informing future PA behavior change interventions. Participant data were obtained from 3 ongoing observational studies, and the sample included 40 participants with pediatric MS and 41 controls. Light PA (LPA), moderate to vigorous PA (MVPA), and sedentary behavior data were collected using activity monitors (ActiGraph LLC) over 1 week. The main analysis involved a 2-way mixed factor analysis of variance with group as a between-subjects factor (pediatric MS vs control) and day as a within-subjects factor (weekday vs weekend day). There was no group by day interaction from the analysis of variance for percentage of activity monitor wear time spent in LPA, MVPA, or sedentary behavior. There was no effect of group for LPA, MVPA, or sedentary behavior. There was an effect of day of week on percentage of day spent in LPA, MVPA, and sedentary behavior. These results suggest that youth with pediatric MS and controls were less physically active and more sedentary on weekends than on weekdays, but there were no differences between groups in PA and sedentary behavior overall or by day of the week. Physical activity interventions may be more successful by initially targeting weekend day activity.

Sedentary activity bout length was associated with BMI and waist circumference in Swedish children aged 5-7years.

This study examined the pattern of sedentary behaviour during the week and on weekends and associations with health outcomes among children aged 5-7years in Sweden. This cross-sectional study used data from 342 children, many of whom had at least one parent born outside the Nordic region. Physical activity and sedentary time were measured by accelerometry. A sedentary bout was defined as 1-4 and 5-9min. Diet, time in front of television or computer screen, sleep and physical activity behaviour were measured via parental reports, and anthropometric data by research staff. The number of sedentary bouts was higher on weekends than on weekdays. Compared to girls, boys had more 1-4min bouts on both weekdays and weekend days, and more 5-9min bouts on weekends. A higher number of 5-9min bouts was associated with a higher body mass index and waist circumference. This study showed an association between sedentary activity and weight status in children as young as 5-7years. Reducing time, especially longer bouts, spent in sedentary activities may encourage healthy weight development in children.

Weekday-Weekend Sedentary Behavior and Recreational Screen Time Patterns in Families with Preschoolers, Schoolchildren, and Adolescents: Cross-Sectional Three Cohort Study.

Background: Excessive recreational screen time (RST) has been associated with negative health consequences already being apparent in preschoolers. Therefore, the aim of this study was to reveal parent-child sedentary behavior, and RST patterns and associations with respect to the gender, age category of children, and days of the week. Methods: Our cross-sectional survey included 1175 parent-child dyads with proxy-reported RST data collected during a regular school week during the spring and fall between 2013 and 2019. The parent-child RST (age and RST) relationship was quantified using Pearson’s (rP) correlation coefficient. Results: Weekends were characterized by longer RST for all family members (daughters/sons: +34/+33 min/day, mothers/fathers: +43/+14 min/day) and closer parent-child RST associations than on weekdays. The increasing age of children was positively associated with an increase in RST on weekdays (+6.4/+7.2 min per year of age of the daughter/son) and weekends (+5.8/+7.5 min per year of age of the daughter/son). Conclusions: Weekends provide a suitable target for implementation of programs aimed at reducing excessive RST involving not only children, but preferably parent-child dyads.

Identifying typologies of diurnal patterns in desk-based workers' sedentary time.

The purpose of this study was to identify typologies of diurnal sedentary behavior patterns and sociodemographic characteristics of desk-based workers. The sedentary time of 229 desk-based workers was measured using accelerometer devices. The within individual diurnal variations in sedentary time was calculated for both workdays and non-workdays. Diurnal variations in sedentary time during each time period (morning, afternoon, and evening) was calculated as the percentage of sedentary time during each time period divided by the percentage of the total sedentary time. A hierarchical cluster analysis (Ward’s method) was used to identify the optimal number of clusters. To refine the initial clusters, a non-hierarchical cluster analysis (k-means method) was performed. Four clusters were identified: stable sedentary cluster (46.7%), off-morning break cluster (26.6%), off-afternoon break cluster (8.3%), and evening sedentary cluster (18.3%). The stable sedentary cluster had the lowest variations in sedentary time throughout the day and the highest amount of total sedentary time. Participants in the off-morning and off-afternoon break clusters had nearly the same sedentary patterns but took short-term breaks during non-workday mornings or afternoons. The evening sedentary cluster had a completely different pattern, with a longer sedentary time during the evening both on workdays and non-workdays. Sociodemographic attributes such as sex, household income, educational attainment, employment status, sleep duration, and residential area, differed significantly between groups. Initiatives to address desk-based workers’ sedentary behavior need to focus not only on the workplace but also on the appropriate timing for reducing excessive sedentary time in non-work contexts depending on the characteristics and diurnal patterns of target subgroups.

Associations between physical function and device-based measures of physical activity and sedentary behavior patterns in older adults: moving beyond moderate-to-vigorous intensity physical activity

BackgroundResearch supports that moderate-to-vigorous intensity physical activity (MVPA) is key to prolonged health and function. Among older adults, substantial changes to MVPA may be infeasible, thus a growing literature suggests a shift in focus to whole-day activity patterns.MethodsWith data from 795 older adults aged 65–100 in the Adult Changes in Thought Activity Monitoring study, we used linear regression to estimate associations between ActiGraph and activPAL measured activity patterns – including light intensity physical activity, steps, standing, and sedentary behaviors – and physical function as measured by a short Performance-based Physical Function (sPPF) score (range 0–12), a composite score based on three standardized physical performance tasks: gait speed, timed chair stands, and grip strength. We examined whether relationships persisted when controlling for MVPA or differed across age, gender, or quartiles of MVPA.ResultsIn models unadjusted for MVPA, a 1-standard deviation (SD) increment of daily sitting (1.9 h more), mean sitting bout duration (8 min longer average), or time spent in sedentary activity (1.6 h more) was associated with ~ 0.3–0.4 points lower mean sPPF score (all p < 0.05). A 1-SD increment in daily steps (~ 3500 more steps) was associated with ~ 0.5 points higher mean sPPF score (95% CI: 0.22 to 0.73). MVPA adjustment attenuated all relationships. The association between physical function and steps was strongest among adults aged 75+; associations of worse function with greater sedentary behavior were more pronounced in participants with the lowest levels of MVPA.ConclusionsWe found associations between function and activity metrics other than MVPA in key subgroups, findings that support research on broader activity patterns and may offer ideas regarding practical intervention opportunities for improving function in older adults.

Patterns of Daily Physical Activity and Sedentary Behaviors in Recent Lung Transplant Recipients

Purpose Greater physical activity (PA) and less time in sedentary behavior are associated with better recovery post lung transplantation and reduced all-cause mortality. The aim of this analysis was to describe and examine associations between participant characteristics and objectively measured activity among recent lung transplant recipients (LTRs). Methods In this descriptive study, actigraph accelerometers were used to measure baseline PA for 20 LTRs enrolled in an ongoing telerehabilitation intervention study. Participants were instructed to wear the accelerometer during waking hours for 7 days. Average time spent in sedentary and moderate-to-vigorous PA (MVPA) were calculated in minutes per day. Spearman correlations were used to examine the relationships between activity measures and baseline characteristics (age, sex, body mass index (BMI), underlying lung condition, length of stay (LOS) of transplant hospitalization, hypertension stage, Charlson Comorbidity Index Scores (CCI), and days post-transplantation). Results Baseline PA data were collected at a mean of 252±131 days post-transplantation. LTRs were mostly white (95%) and female (60%) with a mean age of 55.6±13.4 years. Most participants had a double lung transplant (90%), non-obstructive lung disease (60%), elevated blood pressure (55%), normal BMI (50%), and scored ≤3 on the CCI (80%). The mean LOS for transplant hospitalization was 25.8±11.4 days. Participants wore the actigraph accelerometers for an average of 6.8±0.6 days. Time spent in sedentary behavior and MVPA were 700±97 and 15±14 min/day, respectively. Time spent in sedentary behavior was significantly higher among males (757±112 vs. 662±67 p=.045). CCI (r=.482, p=.031), days post-transplantation (r=.597, p=.005), and sex (r=.460, p=.041) were significantly positively correlated with time spent in sedentary behavior. No other significant correlations were found between PA measures and baseline characteristics. Conclusion Participants spend the majority of the day in sedentary behavior and had less than desirable levels of MVPA. Comorbidity index, days post-transplantation, and sex were found to be moderately correlated with sedentary time. Further studies are planned to evaluate physical activity patterns of LTRs over time and examine the influence on lung transplantation recovery.

31 Physical Activity, Muscle Strength and Quantity: Preliminary Findings From the Mass_Lifecourse Cohort

Abstract Introduction We established the MASS_Lifecourse study to investigate changes in skeletal muscle between ages 45–85. Reduced physical activity (PA) is a key factor linked to the development of sarcopenia. Our aim was the describe the amount and patterns of PA and sedentary behaviour (SB), and relationships with muscle strength and quantity, among MASS_Lifecourse participants. Method Participants wore a triaxial accelerometer on their dominant wrist for seven days. Recordings were analysed to calculate time in moderate-vigorous PA (MVPA) with time not in MVPA classified as SB based on wrist position. Muscle strength was measured with a Jamar grip dynamometer and the 5 chair-stand test. Muscle quantity was assessed using appendicular lean muscle mass from dual-energy X-ray absorptiometry. Physical performance was assessed by gait speed. Results 68 participants (31 male) aged 47–84 (mean 65) participated in the present study. Median daily MVPA was 19.1 (IQR 7.1, 36.6) minutes and was lower with age. The mean sedentary time per day was 767.1 minutes per day and increased with age. The pattern of MVPA across the day changed with age: the oldest group (75–84 years) achieved a lower morning activity peak followed by an earlier decline whilst the younger groups were more consistently active throughout the day. Participants were more active than population reference data from the Active Lives Survey. Time spent in MVPA was positively associated with muscle strength and physical performance, whereas SB was negatively associated. Muscle quantity was not associated with PA or SB. Conclusions Participants in the MASS_Lifecourse study are more active than the general population but still show age-related declines in physical activity and strength. Future work in the cohort aims to elucidate mechanisms underlying the age-related loss of muscle strength and quantity.

An Exploration of Sedentary Behavior Patterns in Community-Dwelling People With Stroke: A Cluster-Based Analysis.

Long periods of daily sedentary time, particularly accumulated in long uninterrupted bouts, are a risk factor for cardiovascular disease. People with stroke are at high risk of recurrent events and prolonged sedentary time may increase this risk. We aimed to explore how people with stroke distribute their periods of sedentary behavior, which factors influence this distribution, and whether sedentary behavior clusters can be distinguished? This was a secondary analysis of original accelerometry data from adults with stroke living in the community. We conducted data-driven clustering analyses to identify unique accumulation patterns of sedentary time across participants, followed by multinomial logistical regression to determine the association between the clusters, and the total amount of sedentary time, age, gender, body mass index (BMI), walking speed, and wake time. Participants in the highest quartile of total sedentary time accumulated a significantly higher proportion of their sedentary time in prolonged bouts (P < 0.001). Six unique accumulation patterns were identified, all of which were characterized by high sedentary time. Total sedentary time, age, gender, BMI, and walking speed were significantly associated with the probability of a person being in a specific accumulation pattern cluster, P < 0.001 - P = 0.002. Although unique accumulation patterns were identified, there is not just one accumulation pattern for high sedentary time. This suggests that interventions to reduce sedentary time must be individually tailored.Video Abstract available for more insight from the authors (see the Video Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A343).

Associations of Sleep With Sedentary Behavior and Physical Activity Patterns Across Pregnancy Trimesters.

Sleep, sedentary behavior, and moderate-to-vigorous physical activity (MVPA) are altered in pregnancy and may affect pregnancy health; however, how these behaviors are associated with each other is unclear. Pregnant women (N=120) completed the Pittsburgh Sleep Quality Index and wore an activPAL3 micro and ActiGraph GT3X for 7days in each trimester to assess sleep, sedentary behavior, and MVPA, respectively. Latent trajectories described patterns of sleep duration, efficiency, and quality as well as sedentary behavior and MVPA. Multinomial logistic regression examined associations of sleep patterns with sedentary behavior and MVPA patterns and, in exploratory analyses, with adverse pregnancy outcomes. Trajectories were identified for sleep duration (consistently short, 20.7% of sample; consistently adequate, 79.3%), efficiency (consistently low, 17.5%; consistently high, 82.5%), and quality (consistently poor, 15.1%; worsening, 23.5%; and consistently good, 61.5%). Compared with those in more optimal sleep groups, women in the short duration, low efficiency, and worsening quality groups had lower odds of being in the moderate and/or high sedentary behavior group (odds ratio range, 0.21-0.31; 95% confidence interval range, 0.09-0.65). Women in the worsening quality group had greater odds of being in the low MVPA group (odds ratio, 2.51; 95% confidence interval, 1.18-5.38). Trends were observed with women in less optimal sleep groups having greater odds of adverse pregnancy outcomes and lower odds of excessive gestational weight gain. Less optimal sleep patterns in pregnancy are associated with less sedentary behavior and MVPA; additional research is needed to confirm associations between sleep and pregnancy outcomes.

Patterns of Sedentary Behavior among Older Adults in Care Facilities: A Scoping Review

Understanding the sedentary patterns can guide the design of strategies to engage older adults in physical activity. This scoping review aimed to synthesize available evidence on sedentary behaviors in care facilities. We searched PubMed/MEDLINE and Web of Science for studies published from inception through October 2020. Eighteen studies were included and reviewed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Data obtained were analyzed based on levels of care provided. Overall, daily sedentary time was higher among residents in high level care facilities (e.g., nursing homes) (11.6 h/day) than intermediate/mixed level care facilities (e.g., assisted living) (9.5 h/day). In intermediate/mixed level care facilities, television (TV) viewing was the most common sedentary activity (2.5–2.9 h/day; 26% of daily sedentary time), while napping was the most favorite sedentary activity (4.7 h/day; 36% of waking hours) in high level care facilities. Sex differences in daily patterns of sedentary behavior (sedentary time, uninterrupted bouts, and bout durations) were commonly observed in intermediate/mixed level care facilities, as exemplified by men being more sedentary by 0.7–1.1 h/day. In summary, this study highlights distinctive sedentary patterns among older adults residing in different levels of care facilities, addressing a pressing need for customized interventions to engage care facility residents in physical activity.

Agreement of sedentary behaviour metrics derived from hip-worn and thigh-worn accelerometers among older adults: with implications for studying physical and cognitive health.

Little is known about how sedentary behaviour (SB) metrics derived from hip-worn and thigh-worn accelerometers agree for older adults. Thigh-worn activPAL micro monitors were concurrently worn with hip-worn ActiGraph GT3X+ accelerometers (with SB measured using the 100 count-per-minute (cpm) cut-point; ActiGraph100cpm) by 953 older adults (age 77±6.6, 54% women) for 4-to-7 days. Device agreement for sedentary time and 5 SB pattern metrics was assessed using mean error and correlations. Logistic regression tested associations with 4 health outcomes using standardized (i.e., z-scores) and unstandardized SB metrics. Mean errors (activPAL-ActiGraph100cpm) and 95% limits of agreement were: sedentary time -54.7(-223.4,113.9) min/d; time in 30+ minute bouts 77.6(-74.8,230.1) min/d; mean bout duration 5.9(0.5,11.4) min; usual bout duration 15.2(0.4,30) min; breaks in sedentary time -35.4(-63.1,-7.6) breaks/d; and alpha -0.5(-0.6,-0.4). Respective Pearson correlations were: 0.66, 0.78, 0.73, 0.79, 0.51, 0.40. Concordance correlations were: 0.57, 0.67, 0.40, 0.50, 0.14, 0.02. The statistical significance and direction of associations was identical for ActiGraph100cpm and activPAL metrics in 46 of 48 tests, though significant differences in the magnitude of odds ratios were observed among 9 of 24 tests for unstandardized and 2 of 24 for standardized SB metrics. Caution is needed when interpreting SB metrics and associations with health from ActiGraph100cpm due to the tendency for it to overestimate breaks in sedentary time relative to activPAL. However, high correlations between activPAL and ActiGraph100cpm measures and similar standardized associations with health outcomes suggest that studies using ActiGraph100cpm are useful, though not ideal, for studying SB in older adults.