Sedentary Behavior Outcomes Research Articles

Sedentary behavior and health outcomes among older adults: a systematic review

BackgroundIn the last decade, sedentary behavior has emerged as a new risk factor for health. The elderly spend most of their awake time in sedentary activities. Despite this high exposure, the impact of this sedentary behavior on the health of this population has not yet been reviewed. We systematically reviewed evidence for associations between sedentary behavior and multiple health outcomes in adults over 60 years of age.MethodsWe searched the Medline, Embase, Web of Science, SPORTDiscus, PsycINFO, CINAHL, LILLACS, and Sedentary Research Database for observational studies published up to May 2013. Additionally, we contacted members of the Sedentary Behaviour Research Network to identify articles that were potentially eligible. After inclusion, the methodological quality of the evidence was assessed in each study.ResultsWe included 24 eligible articles in our systematic review, of which only 2 (8%) provided high-quality evidence. Greater sedentary time was related to an increased risk of all-cause mortality in the older adults. Some studies with a moderate quality of evidence indicated a relationship between sedentary behavior and metabolic syndrome, waist circumference, and overweightness/obesity. The findings for other outcomes such as mental health, renal cancer cells, and falls remain insufficient to draw conclusions.ConclusionThis systematic review supports the relationship between sedentary behavior and mortality in older adults. Additional studies with high methodological quality are still needed to develop informed guidelines for addressing sedentary behavior in older adults.

The effectiveness of interventions to promote healthy weight gain in infants and young children from socioeconomically disadvantaged and indigenous families: A systematic review

Background and aims: Early childhood is an important period for establishing behaviours that will affect weight gain and health across the life course. Children from disadvantaged families including those from low socio-economic backgrounds and indigenous families have significantly higher rates of obesity, making early intervention particularly important in these groups. Little is known however, about the most effective intervention approaches in these populations. This study will report the findings of a systematic review of the effectiveness of interventions to promote healthy weight gain in children 0—5 years from socioeconomically disadvantaged and indigenous families. Methods: Searches of major electronic databases were undertaken to identify intervention studies promoting healthy weight gain in children aged 0—5 years from low socio-economic and indigenous families. Articles published in the last 20 years reporting on feeding practices, anthropometric, diet, physical activity or sedentary behaviour outcomes were included. A total of 4144 unique citations were identified and a screening of titles, abstracts resulted in 83 papers to be reviewed to identify studies meeting the eligibility criteria. Data on included studies are to be extracted by one reviewer and verified by a second reviewer. Internal and external validity will also be assessed using standard quality rating tools. Results: The review will assess overall effectiveness of the interventions using meta-analysis (if possible) and narrative synthesis. The review will also report on the reach of the interventions, the most important intervention targets, the effectiveness of various intervention strategies and delivery modes as well as the generalizability of the studies. Significance: This review will provide important new information about the best bets in obesity prevention interventions for socioeconomically disadvantaged and indigenous families, as well as identifying key gaps in knowledge to guide future research. To be considered for ‘late breaking abstracts’ with results to be updated.

Satiety responsiveness in toddlerhood predicts energy intake and weight status at 4 years of age

Background and aims: Early childhood is an important period for establishing behaviours that will affect weight gain and health across the life course. Children from disadvantaged families including those from low socio-economic backgrounds and indigenous families have significantly higher rates of obesity, making early intervention particularly important in these groups. Little is known however, about the most effective intervention approaches in these populations. This study will report the findings of a systematic review of the effectiveness of interventions to promote healthy weight gain in children 0—5 years from socioeconomically disadvantaged and indigenous families. Methods: Searches of major electronic databases were undertaken to identify intervention studies promoting healthy weight gain in children aged 0—5 years from low socio-economic and indigenous families. Articles published in the last 20 years reporting on feeding practices, anthropometric, diet, physical activity or sedentary behaviour outcomes were included. A total of 4144 unique citations were identified and a screening of titles, abstracts resulted in 83 papers to be reviewed to identify studies meeting the eligibility criteria. Data on included studies are to be extracted by one reviewer and verified by a second reviewer. Internal and external validity will also be assessed using standard quality rating tools. Results: The review will assess overall effectiveness of the interventions using meta-analysis (if possible) and narrative synthesis. The review will also report on the reach of the interventions, the most important intervention targets, the effectiveness of various intervention strategies and delivery modes as well as the generalizability of the studies. Significance: This review will provide important new information about the best bets in obesity prevention interventions for socioeconomically disadvantaged and indigenous families, as well as identifying key gaps in knowledge to guide future research. To be considered for ‘late breaking abstracts’ with results to be updated.

Objectively measured sedentary behaviour and self-esteem among children

BackgroundExisting research suggests consistent negative mental health associations (e.g., self-esteem) with sedentary behaviour (primarily screen viewing) among children. Sedentary behaviour has typically been measured using self-report or by objective measures of time spent sedentary. ObjectiveThe objective of this study was to examine the association between self-esteem and patterns of objectively measured sedentary behaviour in terms of frequency of sedentary bouts and frequency of breaks in sedentary time. MethodsParticipants were 787 boys and girls [mean age (standard deviation) = 11 years (0.6)] from 16 secondary schools in Toronto, Canada. Height, weight, physical activity and sedentary behaviour (accelerometers), global self-esteem and physical self-worth were assessed. ResultsAfter adjusting for sex, age, weight status, parental socioeconomic status, physical activity, and accelerometer daily wear time, global self-esteem and physical self-worth were not associated with any of the sedentary behaviour outcomes. There was a significant positive association between physical self-worth and minutes spent in moderate to vigorous physical activity (MVPA; b = 1.514, p = 0.002). The association between global self-esteem and MVPA was not statistically significant. ConclusionsWhat children are actually doing when sedentary is likely more important in terms of associations with mental health outcomes like self-esteem. The development of objective measures of specific sedentary behaviours and the context that they occur in is likely needed to advance understanding of the relationship between sedentary behaviour and mental health.

The association between retirement and age on physical activity in older adults

retirement is a major life change that is likely to affect lifestyles and yet little is still known about its influence on physical activity (PA). This study objectively quantified sedentary behaviour and ambulatory activity outcomes in retired and non-retired older, community-dwelling adults. PA was quantified in 98 community-dwelling older adults (69.1 ± 7.6 years) who wore an activPAL PA monitor (accelerometer) for seven consecutive days. Outcomes representing the volume, pattern and variability of sedentary behaviour and ambulatory activity were derived from the cross-sectional accelerometer data. The association between retirement, ageing and their interaction on sedentary and ambulatory outcomes were examined. being retired was associated with a reduced percentage of sedentary behaviour; reduced long bouts of sitting (>55 min) and increased the percentage of ambulatory activity. The volume of sedentary behaviour increased with age, whereas ambulatory activity reduced with age. Measures of pattern and variability did not change with retirement or age. With respect to recommended amounts of PA, there was no difference between retired and employed adults and only 21% achieved the recommended 150 min/week (accumulated in ≥10 min bouts of walking). while retirement was associated with a greater volume of PA, most older adults do not meet current recommended PA guidelines. Interventions are needed to increase PA in older adults in the years leading to and after the transition to retirement.

Effectiveness of parent-centred interventions for the prevention and treatment of childhood overweight and obesity in community settings: a systematic review

Review Question/ Objective The objective of this review is to identify the effectiveness of parent-centred interventions implemented in the community setting, in modifying eating and physical activity behaviours or weight-related outcomes of children. Criteria for inclusion Types of Participants This review will consider studies that include children of pre-school, primary and secondary school age and/or their parents aged >18 years. Types of interventions Interventions of interest are implemented in a community setting including, but not limited to; pre-schools (outside of curriculum), schools (non-curricular, before- and after-school), home based community centres and community camps, with an aim of improving eating and physical activity behaviours and/ or overweight/obesity outcome measures. Interventions conducted at pre-schools and schools must be conducted outside of those school curriculums and must be resourced separately. Types of Outcomes This review will consider studies that include the following outcome measures for children and / or their parents: i) Overweight/obesity related outcomes: weight (kg), % body weight lost, BMI, waist circumference (cm) ii) Eating behaviour outcomes: fruit and vegetable intake, macronutrient composition (eg fat intake per day), core food groups, diet quality iii) Physical activity behaviour outcomes: steps per day, time spent in activity, energy expenditure iv) Sedentary behaviour outcomes and constructs: Time spent in non-educational, small screen recreation (eg TV, computer, hand held electronic games.)

Sedentary Behavior and Health Outcomes in Children and Adolescents

The purpose of this review was to summarize findings from epidemiological studies that determined if sedentary behavior was associated with obesity, metabolic risk factors, and cardiorespiratory fitness in children and adolescents. We noted if studies adjusted for moderate-to-vigorous physical activity (MVPA), dietary intakes, and/or sleep duration. Articles were identified through PubMed using the search terms: (sedentary OR sitting OR television) AND (adiposity OR blood pressure OR body mass index OR cardiometabolic OR metabolic risk OR waist circumference). The search was limited to ages 6 to 18 years, humans, and published between January 1, 2008 and September 26, 2012. Cross-sectional and longitudinal studies observed associations between more sedentary behavior, especially screen-based sedentary behavior, and measures of obesity; and most associations were independent of MVPA and dietary intake. Cross-sectional and longitudinal studies reported associations between screen-based sedentary behavior and lower cardiorespiratory fitness, and most associations were independent of MVPA and obesity. Cross-sectional studies observed associations between more screen-based and objectively measured sedentary behavior and lower insulin sensitivity; and most associations were independent of MVPA and obesity. There was little-to-no evidence that sedentary behavior was associated with increased blood pressure and increased blood lipids.

Tracking Physical Activity and Sedentary Behavior in Childhood

To date, no reviews have investigated the evidence of tracking of physical activity and sedentary behavior specifically during early childhood (aged 0-5.9 years) or from early childhood to middle childhood (aged 6-12 years). It is important to review the evidence of tracking of these behaviors to determine their stability during the foundational early years of life. A literature search of studies was conducted in seven electronic databases (January 1980 to April 2012). Studies were compared on methodologic quality and evidence of tracking of physical activity or sedentary behavior. Tracking was defined as the stability (or relative ranking within a cohort) of behaviors, such as physical activity and sedentary behavior, over time. Eleven studies met the inclusion criteria. All studies reporting physical activity outcomes had high methodologic quality; 71% of studies reporting sedentary behavior outcomes had high methodologic quality. Of the tracking coefficients for physical activity, 4% were large, 60% were moderate, and 36% were small. Of the tracking coefficients for sedentary behavior, 33% were large, 50% were moderate, and 17% were small. Overall, there was evidence of moderate tracking of physical activity during early childhood, and from early childhood to middle childhood, and of moderate-to-large tracking of sedentary behavior during early childhood and from early childhood to middle childhood. This review highlights the importance of establishing recommended levels of physical activity and sedentary behavior during the early years of life. Based on this review, the following recommendations are made: (1) early childhood should be targeted as a critical time to promote healthy lifestyle behaviors through methodologically sound prevention studies; and (2) future tracking studies should assess a broad range of sedentary behaviors using objective measures.

Sedentary behavior: target for change, challenge to assess.

Sedentary behavior is not a new topic, but trying to examine the direct links between sedentary behavior and health outcomes, independent of time spent in moderate- and vigorous-intensity physical activity, is a relatively new addition to the relationships between physical activity and health. Defining sedentary behavior as a risk factor and target for intervention opens up novel avenues for disease prevention and health promotion. The relationship between sedentary behavior and obesity is complex and not well understood, but the increased risk of disease due to sedentary behavior may be even greater in obese patients. Objective measurement of sedentary behavior is an important link in being able to understand the real effects of being sedentary, and a few measurement devices are described. Interventions targeting sedentary behavior should reduce total sedentary time, break long bouts of sitting with intermittent activity and encourage light-intensity activity throughout the day. New technologies can both measure and deliver an intervention aimed at reducing sitting time, the most common category of sedentary behavior. An optimal activity profile will include minimal amounts of sedentary behavior, in addition to regular physical activity and healthy sleep patterns.

Association of Sedentary Behaviour with Metabolic Syndrome: A Meta-Analysis

BackgroundIn recent years there has been a growing interest in the relationship between sedentary behaviour (sitting) and health outcomes. Only recently have there been studies assessing the association between time spent in sedentary behaviour and the metabolic syndrome. The aim of this study is to quantify the association between sedentary behaviour and the metabolic syndrome in adults using meta-analysis.Methodology/Principal FindingsMedline, Embase and the Cochrane Library were searched using medical subject headings and key words related to sedentary behaviours and the metabolic syndrome. Reference lists of relevant articles and personal databases were hand searched. Inclusion criteria were: (1) cross sectional or prospective design; (2) include adults ≥18 years of age; (3) self-reported or objectively measured sedentary time; and (4) an outcome measure of metabolic syndrome. Odds Ratio (OR) and 95% confidence intervals for metabolic syndrome comparing the highest level of sedentary behaviour to the lowest were extracted for each study. Data were pooled using random effects models to take into account heterogeneity between studies. Ten cross-sectional studies (n = 21393 participants), one high, four moderate and five poor quality, were identified. Greater time spent sedentary increased the odds of metabolic syndrome by 73% (OR 1.73, 95% CI 1.55–1.94, p<0.0001). There were no differences for subgroups of sex, sedentary behaviour measure, metabolic syndrome definition, study quality or country income. There was no evidence of statistical heterogeneity (I2 = 0.0%, p = 0.61) or publication bias (Eggers test t = 1.05, p = 0.32).ConclusionsPeople who spend higher amounts of time in sedentary behaviours have greater odds of having metabolic syndrome. Reducing sedentary behaviours is potentially important for the prevention of metabolic syndrome.

Self‐report use‐of‐time tools for the assessment of physical activity and sedentary behaviour in young people: systematic review

Regular physical activity and limiting extended periods of sitting are two behaviours critical for the prevention of obesity in young people. The purpose of the systematic review was to synthesize the psychometric evidence for self-report use-of-time tools that assess these behaviours. Articles were retrieved that reported reliability and/or validity for use-of-time tools in participants aged 18 years or under. Outcome variables were physical activity, sedentary behaviour and energy expenditure. Study quality was appraised, and the results summarized narratively. Sixteen studies and six different tools were identified. The tools were the Previous Day Physical Activity Recall, the Three-Day Physical Activity Recall, the Physical Activity Interview, the Computerized Activity Recall, the Activitygram, and the Multimedia Activity Recall for Children and Adolescents. Overall, tools indicated moderate validity compared with objective and criterion comparison methods. Generally, validity correlation coefficients were in the range of 0.30-0.40. Correlation coefficients for test-retest reliability ranged widely from 0.24 to 0.98. Use-of-time tools have indicated moderate reliability and validity for the assessment of physical activity and energy expenditure. Future research should focus on using criterion methods and on validating specifically for sedentary behaviour outcomes. Implementation of these tools for population surveillance should be considered.

Validation of Wearable Monitors for Assessing Sedentary Behavior

A primary barrier to elucidating the association between sedentary behavior (SB) and health outcomes is the lack of valid monitors to assess SB in a free-living environment. The purpose of this study was to examine the validity of commercially available monitors to assess SB. Twenty overweight (mean ± SD: body mass index = 33.7 ± 5.7 kg·m(-2)) inactive, office workers age 46.5 ± 10.7 yr were directly observed for two 6-h periods while wearing an activPAL (AP) and an ActiGraph GT3X (AG). During the second observation, participants were instructed to reduce sitting time. We assessed the validity of the commonly used cut point of 100 counts per minute (AG100) and several additional AG cut points for defining SB. We used direct observation (DO) using focal sampling with duration coding to record either sedentary (sitting/lying) or nonsedentary behavior. The accuracy and precision of the monitors and the sensitivity of the monitors to detect reductions in sitting time were assessed using mixed-model repeated-measures analyses. On average, the AP and the AG100 underestimated sitting time by 2.8% and 4.9%, respectively. The correlation between the AP and DO was R2 = 0.94, and the AG100 and DO sedentary minutes was R2 = 0.39. Only the AP was able to detect reductions in sitting time. The AG 150-counts-per-minute threshold demonstrated the lowest bias (1.8%) of the AG cut points. The AP was more precise and more sensitive to reductions in sitting time than the AG, and thus, studies designed to assess SB should consider using the AP. When the AG monitor is used, 150 counts per minute may be the most appropriate cut point to define SB.

Reducing Sedentary Behavior

There is growing interest in the role of sedentary behavior as a risk factor for poor health, independent of physical activity (PA). To guide the spectrum of descriptive, analytic, and intervention studies on sedentary behavior, the authors advocate a behavioral epidemiology framework. This 5-phase framework is useful because it outlines a series of sequential stages important for developing, evaluating, and diffusing interventions to reduce sedentary behavior and improve population health. Studies of sedentary behavior and health outcomes (phase I) have found consistent evidence that excessive use of screen-based media is linked to overweight and obesity in children, and there is some evidence among adults that overall sedentary time is associated with risk factors for cardiometabolic disease, some cancers, and mortality. Biological mechanisms to explain possible relationships have started to emerge but are mostly based on animal models. Obtaining valid and reliable measurements of sedentary behavior (phase II) remains a research priority because self-reports are prone to recall bias, and it appears that sedentary habits do not appear to be well represented by measures of individual behaviors such as TV viewing. Studies have identified few modifiable correlates of sedentary behavior (phase III), although research appears to be limited to studies of TV viewing or to scenarios in which sedentary behavior is defined as an absence of PA. Rigorous intervention research (phase IV) has focused almost exclusively on reducing self-reported TV viewing among children and adolescents, and there is consistent evidence that these interventions are efficacious. There appear to be no interventions focused exclusively on reducing sedentary behavior of adults. Translation studies (phase V) are absent because the underlying evidence is still emerging. Future research should focus on examining causal associations between sedentary behavior and health, developing objective measures of domain-specific sitting time, and identifying modifiable correlates of sedentary behavior that can be used as leverage points for behavioral interventions.

Systematic review of sedentary behaviour and health indicators in school-aged children and youth

Accumulating evidence suggests that, independent of physical activity levels, sedentary behaviours are associated with increased risk of cardio-metabolic disease, all-cause mortality, and a variety of physiological and psychological problems. Therefore, the purpose of this systematic review is to determine the relationship between sedentary behaviour and health indicators in school-aged children and youth aged 5-17 years. Online databases (MEDLINE, EMBASE and PsycINFO), personal libraries and government documents were searched for relevant studies examining time spent engaging in sedentary behaviours and six specific health indicators (body composition, fitness, metabolic syndrome and cardiovascular disease, self-esteem, pro-social behaviour and academic achievement). 232 studies including 983,840 participants met inclusion criteria and were included in the review. Television (TV) watching was the most common measure of sedentary behaviour and body composition was the most common outcome measure. Qualitative analysis of all studies revealed a dose-response relation between increased sedentary behaviour and unfavourable health outcomes. Watching TV for more than 2 hours per day was associated with unfavourable body composition, decreased fitness, lowered scores for self-esteem and pro-social behaviour and decreased academic achievement. Meta-analysis was completed for randomized controlled studies that aimed to reduce sedentary time and reported change in body mass index (BMI) as their primary outcome. In this regard, a meta-analysis revealed an overall significant effect of -0.81 (95% CI of -1.44 to -0.17, p = 0.01) indicating an overall decrease in mean BMI associated with the interventions. There is a large body of evidence from all study designs which suggests that decreasing any type of sedentary time is associated with lower health risk in youth aged 5-17 years. In particular, the evidence suggests that daily TV viewing in excess of 2 hours is associated with reduced physical and psychosocial health, and that lowering sedentary time leads to reductions in BMI.

Sedentary Behavior and Cancer: A Systematic Review of the Literature and Proposed Biological Mechanisms

Sedentary behavior (prolonged sitting or reclining characterized by low energy expenditure) is associated with adverse cardiometabolic profiles and premature cardiovascular mortality. Less is known for cancer risk. The purpose of this review is to evaluate the research on sedentary behavior and cancer, to summarize possible biological pathways that may underlie these associations, and to propose an agenda for future research. Articles pertaining to sedentary behavior and (a) cancer outcomes and (b) mechanisms that may underlie the associations between sedentary behavior and cancer were retrieved using Ovid and Web of Science databases. The literature review identified 18 articles pertaining to sedentary behavior and cancer risk, or to sedentary behavior and health outcomes in cancer survivors. Ten of these studies found statistically significant, positive associations between sedentary behavior and cancer outcomes. Sedentary behavior was associated with increased colorectal, endometrial, ovarian, and prostate cancer risk; cancer mortality in women; and weight gain in colorectal cancer survivors. The review of the literature on sedentary behavior and biological pathways supported the hypothesized role of adiposity and metabolic dysfunction as mechanisms operant in the association between sedentary behavior and cancer. Sedentary behavior is ubiquitous in contemporary society; its role in relation to cancer risk should be a research priority. Improving conceptualization and measurement of sedentary behavior is necessary to enhance validity of future work. Reducing sedentary behavior may be a viable new cancer control strategy.

Medical Hazards of Prolonged Sitting

Medical Hazards of Prolonged Sitting

Interventions to Prevent Obesity in 0–5 Year Olds: An Updated Systematic Review of the Literature

The small number and recency of the early childhood obesity-prevention literature identified in a previous review of interventions to prevent obesity, promote healthy eating, physical activity, and/or reduce sedentary behaviors in 0-5 year olds suggests this is a new and developing research area. The current review was conducted to provide an update of the rapidly emerging evidence in this area and to assess the quality of studies reported. Ten electronic databases were searched to identify literature published from January 1995 to August 2008. interventions reporting child anthropometric, diet, physical activity, or sedentary behavior outcomes and focusing on children aged 0-5 years of age. focusing on breastfeeding, eating disorders, obesity treatment, malnutrition, or school-based interventions. Two reviewers independently extracted data and assessed study quality. Twenty-three studies met all criteria. Most were conducted in preschool/childcare (n = 9) or home settings (n = 8). Approximately half targeted socioeconomically disadvantaged children (n = 12) and three quarters were published from 2003 onward (n = 17). The interventions varied widely although most were multifaceted in their approach. While study design and quality varied most studies reported their interventions were feasible and acceptable, although impact on behaviors that contribute to obesity were not achieved by all. Early childhood obesity-prevention interventions represent a rapidly growing research area. Current evidence suggests that behaviors that contribute to obesity can be positively impacted in a range of settings and provides important insights into the most effective strategies for promoting healthy weight from early childhood.

Effectiveness of parent-centred interventions for the prevention and treatment of childhood overweight and obesity in community settings: A Systematic Review.

Review Question/ Objective The objective of this review is to identify the effectiveness of parent-centred interventions implemented in the community setting, in modifying eating and physical activity behaviours or weight-related outcomes of children. Criteria for inclusion Types of Participants This review will consider studies that include children of pre-school, primary and secondary school age and/or their parents aged >18 years. Types of interventions Interventions of interest are implemented in a community setting including, but not limited to; pre-schools (outside of curriculum), schools (non-curricular, before- and after-school), home based community centres and community camps, with an aim of improving eating and physical activity behaviours and/ or overweight/obesity outcome measures. Interventions conducted at pre-schools and schools must be conducted outside of those school curriculums and must be resourced separately. Types of Outcomes This review will consider studies that include the following outcome measures for children and / or their parents: i) Overweight/obesity related outcomes: weight (kg), % body weight lost, BMI, waist circumference (cm) ii) Eating behaviour outcomes: fruit and vegetable intake, macronutrient composition (eg fat intake per day), core food groups, diet quality iii) Physical activity behaviour outcomes: steps per day, time spent in activity, energy expenditure iv) Sedentary behaviour outcomes and constructs: Time spent in non-educational, small screen recreation (eg TV, computer, hand held electronic games.)