Total Sedentary Behavior Research Articles

Accelerometer-measured physical activity, sedentary behavior, and incidence of macrovascular and microvascular events in individuals with type 2 diabetes mellitus and prediabetes

BackgroundPhysical activity (PA) is considered beneficial for lowering cardiovascular risks following type 2 diabetes mellitus (T2DM) and prediabetes, but existing evidence relies mainly on self-reported measurements. We aimed to describe the intensity-specific dose-response associations of PA and sedentary behavior (SB) with macrovascular and microvascular events among individuals with T2DM and prediabetes. MethodsThis study included 11,474 individuals with T2DM and prediabetes from the UK Biobank. PA, including total PA, moderate-to-vigorous intensity PA (MVPA), light intensity PA (LPA), and SB, were measured by accelerometers over 7 days. MVPA was categorized according to the American Diabetes Association guideline-recommended level (at least 150 min/week), and total PA, LPA, and SB were grouped by tertiles. The outcomes were incidences of macrovascular events, microvascular events, heart failure (HF), and their combination (composite events). The events were ascertained using the ICD-10 codes on the hospital or death records. ResultsDuring a median follow-up of 6.8 years, 1680 cases were documented, including 969 macrovascular events, 839 microvascular events, and 284 incidents of HF. Accelerometer-measured PA, irrespective of intensity, was inversely associated with the risk of composite events and each outcome in the dose–response patterns. Regarding categorized PA, engagement in total PA (high vs. low) was associated with decreased risk of macrovascular events (hazard ratio (HR) = 0.80; 95% confidence interval (95%CI): 0.67–0.95), microvascular events (HR = 0.76; 95%CI: 0.63–0.93), and HF (HR = 0.46; 95%CI: 0.32–0.66). Adherence to MVPA, but not LPA, above the guideline-recommended level (at least 150 min/week) was associated with reduced risk of macrovascular events (HR = 0.80; 95%CI: 0.68–0.95), microvascular events (HR = 0.76; 95%CI: 0.63–0.92), and HF (HR = 0.65; 95%CI: 0.46–0.92). The minimum dose of MVPA for lowering the risk of composite events was approximately 59.0 min/week. More time spent in SB was associated with an increased risk of composite events (high vs. low, HR = 1.17; 95%CI: 1.02–1.35) and HF (high vs. low, HR = 1.54; 95%CI: 1.09–2.20). Replacement of 30 min of SB (HR = 0.73; 95%CI: 0.65–0.81) and LPA (HR = 0.74; 95%CI: 0.66–0.83) with MVPA dramatically reduced the risk of composite events. ConclusionAdherence to a higher amount of accelerometer-measured PA, especially MVPA at least 59 min/week, is associated with reduced risks of macrovascular and microvascular events among individuals with T2DM and prediabetes. Replacement of SB and LPA with MVPA helped lower the risk of diabetic vascular events.

Do physical activity intensity and sedentary behaviour relate to burnout among medical students? Insight from two Canadian medical schools

Background: Medical school involves high expectations of medical students, which may increase their risk for burnout. Physical activity (PA) and sedentary behaviour (SB) are modifiable risk factors for burnout. However, medical students are insufficiently taught about PA and SB and may therefore be less likely to meet guideline-recommended levels of these two movement behaviours or promote them in practice. Few studies have examined the relationships between medical students’ PA intensity, SB, and burnout; such examination could help clarify educational needs for improving levels of movement behaviours and their promotion. Purpose: This study investigated (1) the relationships between light, moderate, vigorous, and total PA, SB, and burnout among medical students, and (2) moderate-to-vigorous PA as a moderator of the relationship between SB and burnout, to guide future curriculum renewal. Methods: Medical students (N = 129) at two Canadian institutions completed online validated questionnaires assessing light, moderate, vigorous, and total PA, SB, and burnout. Results: Regression analyses indicated that light PA (β = -.191, p = .039) and SB (β=-.230, p = .013) were negatively associated with burnout. Moderate-to-vigorous PA did not significantly moderate the relationship between SB and burnout. Conclusions: Engaging in lighter forms of PA and SB within guideline recommendations may help mitigate medical student burnout. Competencies to promote movement behaviours may dually target medical student burnout and curriculum gaps.

The association between objectively-measured sedentary behavior patterns and predicted 10-year ASCVD risk

This study aims to investigated the association between sedentary behavior (SB) and predicted 10-year atherosclerotic cardiovascular disease (ASCVD) risk and determine whether the associations differ by how the behavior is accumulated, in US middle-aged and older adults. Cross-sectional data were derived from national health and nutrition examination survey (NHANES) 2003–2006. Seven-day wearing of accelerometer was used to assess SB pattern, exported as total SB, bouts of 1–9, 10–29, 30–59 and ≥ 60 min SB. Predicted 10-year ASCVD risk was calculated using validated pooled cohort equations. Linear regression was used to estimate adjusted coefficients. A total of 2327 participants were enrolled with mean age of 56.9 and mean predicted 10-year ASCVD risk of 10.7%. We observed significant associations of total SB and its longer accumulated patterns with higher 10-year predicted ASCVD risk, in a linear fashion and independent of a list of covariates. A 30 min increment per day of total SB, bouts in 10–29, bouts in 30–59 and bouts in ≥ 60 min were associated with 0.14, 0.14, 0.23 and 0.12% higher multivariable-adjusted 10-year predicted ASCVD risk. There are significant associations of total SB as well as its longer accumulated patterns with higher 10-year predicted ASCVD risk, independent of a list of covariates and in a linear fashion. The result indicates that reducing total sedentary time and interrupting long duration of prolonged SB, could be meaningful to for public guideline to lessen the personal and public health burden of cardiovascular health.

Replacement of sedentary behavior with various physical activities and the risk of incident depression: a prospective analysis of accelerator-measured and self-reported UK Biobank data.

To examine the dose‒response relationships of sedentary behavior (SB) and physical activities (PAs) with depression, and to explore the effects of replacing SB with PAs on depression risk. The study used data from UK Biobank aged 37 to 73 years. Light physical activity (LPA), moderate-to-vigorous activity (MVPA), sleep duration, and total sedentary behavior (TSB) were measured by accelerometers. Self-reported SB was also adopted when daily screen-sedentary behavior time (SSB) and leisure-sedentary behavior time (LSB) were the focus. Incident depression was obtained from the part of mental and behavioral disorders in the "first occurrence fields" of UK Biobank. A Cox proportional hazard model and isotemporal substitution model were performed to explore the associations of LPA, MVPA, TSB, LSB, SSB, and sleep on depression and the effects of replacing SB time with equal PA time. Highest levels of MVPA (HR = 0.58, 95%CI: 0.50-0.68) were associated with decreased depression risk compared with the lowest level (Q1). Longer SSB time (HR = 1.18, 95%CI: 1.06-1.32), LSB time (HR = 1.19, 95%CI: 1.07-1.32), and TSB time (HR = 1.17, 95%CI: 1.00-1.38) could increase depression risk significantly. Replacing 1h/day TSB, SSB, and LSB with MVPA brought the greatest risk reductions [31% (HR = 0.69, 95%CI: 0.62-0.77), 30% (HR = 0.70, 95%CI: 0.65-0.77), and 29% (HR = 0.71, 95%CI: 0.65-0.77)]. Under the same conditions, the effects of LPA replacement were also significant, but weaker than those of MVPA. Subgroup analyses showed that replacing 1h/d TSB with LPA could significantly decrease the depression risk for the females, but not for the males. Large benefits for reducing the risk of incident depression could be attained by replacing a period of TSB, SSB, or LSB with equal PA time, especially for MVPA. Regular PA and less SB were recommended for improving mental health.

Associations between accelerometer-measured physical activity and sedentary behaviour with physical function among older women: a cross-sectional study

BackgroundThis study aimed to investigate the relationships between accelerometer-measured physical activity (PA) and sedentary behaviour (SB) with physical function (PF) among older Chinese women in the community.MethodsThe present study comprised 1,113 community-dwelling older females, with an average age of 65 ± 2 years. We employed a linear regression analysis to investigate the relationship between patterns of PA and SB with PF. PA variables consisted of total PA time, bouted PA time (a continuous PA that lasts equal to or more than 10 min), and sporadic PA time (a continuous PA that lasts less than 10 min). SB variables included total SB time, 30-min bout of SB (a continuous SB that lasts equal to or more than 30 min), and 60-min bout of SB (a continuous SB that lasts equal to or more than 60 min). PF variables comprised handgrip strength (HGS), one-legged stance test with eyes closed (OLSTEC), usual walking speed (UWS), maximum walking speed (MWS) and chair-stand time (CT). To explore the joint effects of moderate-to-vigorous-intensity PA (MVPA) and SB on PF, we divided the duration of SB and MVPA participation in older women into different combinations: low MVPA & high SB, low MVPA & low SB, high MVPA & high SB, high MVPA & low SB.ResultsThe study revealed a significant association between 30-min bout of SB and CT, which remained after adjusting for total MVPA time (P = 0.021). Both total MVPA and bouted MVPA were found to be positively associated with better UWS, MWS, CT, and PF Z-score. When the combination of low MVPA & high SB was used as a reference, the regression coefficients for PF ascended by 1.32 (P < 0.001) in the high MVPA & high SB group and by 1.13 (P < 0.001) in the high MVPA & low SB group.ConclusionsA significant association was observed between poorer lower limb function and prolonged, uninterrupted SB in older women, rather than with the total SB time. Concurrently, the insufficient engagement in MVPA may also be a crucial factor contributing to poorer PF in older women. Engaging in longer durations and higher intensity of PA, such as bouts of MVPA lasting a minimum of 10 min or longer, may contribute to better PF.

Protocol for a Study Investigating Context-Specific Sedentary Behaviors and Cardiometabolic Health in College-Based Young Adults (CONTEXT-SB).

Sedentary behavior (SB) is detrimental to cardiometabolic disease (CMD) risk, which can begin in young adulthood. To devise effective SB-CMD interventions in young adults, it is important to understand which context-specific sedentary behaviors (CS-SB) are most detrimental for CMD risk, the lifestyle behaviors that co-exist with CS-SBs, and the socioecological predictors of CS-SB. This longitudinal observational study will recruit 500 college-aged (18-24 years) individuals. Two laboratory visits will occur, spaced 12 months apart, where a composite CMD risk score (e.g., arterial stiffness, metabolic and inflammatory biomarkers, heart rate variability, and body composition) will be calculated, and questionnaires to measure lifestyle behaviors and different levels of the socioecological model will be administered. After each visit, total SB (activPAL) and CS-SB (television, transportation, academic/ occupational, leisure computer, "other"; ecological momentary assessment) will be measured across seven days. It is hypothesized that certain CS-SB will show stronger associations with CMD risk, compared to T-SB, even after accounting for coexisting lifestyle behaviors. It is expected that a range of intra-individual, inter-individual, and physical environment socioecological factors will predict CS-SB. The findings from this study will support the development of an evidence-based, multi-level intervention to target SB reduction and mitigate CMD risk in CBYA.

The impact of COVID-19 lockdown on physical activity and sedentary behaviour in secondary school teachers: a prospective cohort study

BackgroundMid-March 2020, Belgium went in lockdown to combat the COVID-19-pandemic. Having to provide school-based day care and adapt to online teaching, while all social, cultural and sports events and activities were cancelled, secondary school teachers’ physical activity (PA) and sedentary behaviour (SB) may have been affected considerably. This study investigates the impact of the first Belgian lockdown on PA and SB in Flemish secondary school teachers.MethodsThis prospective cohort study was conducted throughout the 2019–2020 school year. PA and SB measured in March/April 2020 were compared with a pre-lockdown measurement in January/February 2020. Other pre-lockdown measurements (September/October 2019 and November/December 2019) and one other during-lockdown measurement (May/June 2020) allowed us to control for confounding. Validated questionnaires were used to assess participants’ PA and SB. Generalized linear mixed models were applied in R.ResultsAmong 624 participants (77·2% females, 43·3 ± 10·3 years), increases were observed for total PA (+ 108 min/week; p = 0·047), moderate PA (+ 217 min/week; p = 0·001), domestic and garden PA (+ 308 min/week; p < 0·0001) and leisure-time PA (+ 131 min/week; p < 0·0001), whereas work-related PA (-289 min/week; p < 0·0001) and active transportation (-38 min/week; p =0·005) decreased. No differences were observed for walking (p = 1·0) and vigorous PA (p = 0·570). Increases were found for total SB (+ 972 min/week; p < 0·0001), work-related SB (+ 662 min/week; p < 0·0001) and leisure-time SB (+ 592 min/week; p = 0·0004), whereas transport-related SB (-290 min/week; p < 0·0001) decreased.ConclusionDuring the lockdown, we found in our sample that Flemish secondary school teachers showed an increase in SB that was 9 times as high as their PA increase. As a government, education network or school, it is crucial to sensitize, promote, and facilitate sufficient MVPA and/or walking, but likewise to discourage SB during pandemic-induced lockdowns.

Associations of sedentary behavior and screen time with biomarkers of inflammation and insulin resistance.

Sedentary behavior (SB) has been linked to risk factors of cardiometabolic disease, with inconsistent findings reported in the literature. We aimed to assess the associations of SB with multiple biomarkers of inflammation and insulin resistance in adults. Domain-specific SB, sitting time and moderate-to-vigorous physical activity (MVPA) were measured in 78 adults (mean ± SD 52.0 ± 10.8 y). Body fat percentage (BF%) was assessed using multi-frequency bioelectrical impedance. A blood draw assessed glucose, insulin, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), leptin, and adiponectin. Adiponectin-leptin ratio (ALR), homeostasis model assessment of insulin resistance (HOMA-IR) and beta-cell function (HOMA-β) were calculated. Multivariable linear regression analyses, controlling for age, sex, MVPA, and BF%, were used to assess associations. After adjustment for age, sex and MVPA, total SB (7.5 ± 2.5h/day) was positively associated with leptin, insulin, HOMA-IR, HOMA-β (Standardized Beta (β) range 0.21-0.32) and negatively associated with ALR (β = -0.24, p < 0.05 for all). Similarly, total sitting time (7.2 ± 2.9h/day) was associated with TNF-α (β = 0.22) and ALR (β = -0.26). These associations were attenuated to non-significance after adjustment for BF%. Leisure screen time was detrimentally associated with IL-6 (β = 0.24), leptin (β = 0.21), insulin (β = 0.37), HOMA-IR (β = 0.37), and HOMA-β (β = 0.34), independent of age, sex and MVPA (p < 0.05 for all). Only the associations with insulin (β = 0.26), HOMA-IR (β = 0.26), and HOMA-β (β = 0.23) remained significant after further controlling BF% (p < 0.05). Self-reported SB is associated with biomarkers of inflammation and insulin resistance, independent of MVPA, and in some cases BF%.

The impact of the world’s first regulatory, multi-setting intervention on sedentary behaviour among children and adolescents (ENERGISE): a natural experiment evaluation

BackgroundRegulatory actions are increasingly used to tackle issues such as excessive alcohol or sugar intake, but such actions to reduce sedentary behaviour remain scarce. World Health Organization (WHO) guidelines on sedentary behaviour call for system-wide policies. The Chinese government introduced the world’s first nation-wide multi-setting regulation on multiple types of sedentary behaviour in children and adolescents in July 2021. This regulation restricts when (and for how long) online gaming businesses can provide access to pupils; the amount of homework teachers can assign to pupils according to their year groups; and when tutoring businesses can provide lessons to pupils. We evaluated the effect of this regulation on sedentary behaviour safeguarding pupils.MethodsWith a natural experiment evaluation design, we used representative surveillance data from 9- to 18-year-old pupils before and after the introduction of the regulation, for longitudinal (n = 7,054, matched individuals, primary analysis) and repeated cross-sectional (n = 99,947, exploratory analysis) analyses. We analysed pre-post differences for self-reported sedentary behaviour outcomes (total sedentary behaviour time, screen viewing time, electronic device use time, homework time, and out-of-campus learning time) using multilevel models, and explored differences by sex, education stage, residency, and baseline weight status.ResultsLongitudinal analyses indicated that pupils had reduced their mean total daily sedentary behaviour time by 13.8% (95% confidence interval [CI]: -15.9 to -11.7%, approximately 46 min) and were 1.20 times as likely to meet international daily screen time recommendations (95% CI: 1.01 to 1.32) one month after the introduction of the regulation compared to the reference group (before its introduction). They were on average 2.79 times as likely to meet the regulatory requirement on homework time (95% CI: 2.47 to 3.14) than the reference group and reduced their daily total screen-viewing time by 6.4% (95% CI: -9.6 to -3.3%, approximately 10 min). The positive effects were more pronounced among high-risk groups (secondary school and urban pupils who generally spend more time in sedentary behaviour) than in low-risk groups (primary school and rural pupils who generally spend less time in sedentary behaviour). The exploratory analyses showed comparable findings.ConclusionsThis regulatory intervention has been effective in reducing total and specific types of sedentary behaviour among Chinese children and adolescents, with the potential to reduce health inequalities. International researchers and policy makers may explore the feasibility and acceptability of implementing regulatory interventions on sedentary behaviour elsewhere.

Effectiveness of workplace interventions with digital elements to reduce sedentary behaviours in office employees: a systematic review and meta-analysis.

Digital interventions are potential tools for reducing and limiting occupational sedentary behaviour (SB) in sedentary desk-based jobs. Given the harmful effects of sitting too much and sitting for too long while working, the aim of this systematic review and meta-analysis was to examine the effectiveness of workplace interventions, that incorporated digital elements, to reduce the time spent in SB in office workers. Randomised control trials that evaluated the implementation of workplace interventions that incorporated digital elements for breaking and limiting SB among desk-based jobs were identified by literature searches in six electronic databases (PubMed, Web of Science, Scopus, CINAHL, PsycINFO and PEDro) published up to 2023. Studies were included if total and/or occupational SB were assessed. Only studies that reported pre- and postintervention mean differences and standard deviations or standard errors for both intervention arms were used for the meta-analysis. The meta-analysis was conducted using Review Manager 5 (RevMan 5; Cochrane Collaboration, Oxford, UK). Risk of bias was assessed using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields QUALSYST tool. Nineteen studies were included in the systematic review. The most employed digital elements were information delivery and mediated organisational support and social influences. Multicomponent, information, and counselling interventions measuring total and/or occupational/nonoccupational SB time by self-report or via device-based measures were reported. Multicomponent interventions were the most represented. Eleven studies were included in the meta-analysis, which presented a reduction of 29.9 (95% CI: -45.2, -14.5) min/8h workday in SB (overall effect: Z = 3.81). Multicomponent interventions, using a wide range of digital features, have demonstrated effectiveness in reducing time spent in SB at the workplace among desk-based employees. However, due to hybrid work (i.e., work in the office and home) being a customary mode of work for many employees, it is important for future studies to assess the feasibility and effectiveness of these interventions in the evolving work landscape. The review protocol was registered in the Prospero database (CRD42022377366).

Abstract 16: County-Level Racial Residential Segregation and Sedentary Behavior in US Adults

Introduction: Sedentary behavior (SB) is highly prevalent and shows an increasing trend in United States (US) adults, resulting in adverse health outcomes, such as cardiovascular disease, cancer, and diabetes. Yet, potential environmental determinants of SB, including racial residential segregation, remain understudied. Hypothesis: County-level segregation will be associated with sedentary time in a nationwide sample of US adults, and this relationship will be moderated by sex. Methods: We analyzed data from 2637 US adults aged 20-75 years (mean age [45.1 years], female [50.6%] from the population-based AmeriSpeak panel in 2019. Participants completed the Activities Completed over Time in 24-hours (ACT24) previous-day recall, a validated population-level measure of total daily SB (hours/day). County segregation was expressed as the isolation index at the county level for non-Hispanic (NH) White, NH Black, and Hispanic adults (vs all other races/ethnicities). The isolation index ranges from 0 to 1, with a higher value indicating higher segregation and therefore, a higher average probability of contact among residents of the minority group and, thus, a lower probability of contact among residents of the minority group and all other races/ethnicities. We used survey-weighted linear regression models to assess the relationships of race-specific isolation index with time spent in SB, adjusting for age, sex, marital status, education, occupation, household income, body mass index, census region, and county-level poverty. Additionally, we stratified these relationships by sex. Results: Overall, US adults reported a mean of 9.5 hours/day of sedentary time. Counties with higher NH White isolation showed a significant inverse relationship with sedentary time (β = -1.52, 95% confidence interval [-2.75, -0.29], p = 0.017). Counties with higher NH Black isolation showed a non-significant inverse relationship with sedentary time (β = -0.30 [-2.53, 1.94], p = 0.790), and counties with higher Hispanic isolation showed a non-significant positive relationship (β = 0.32, [-1.64, 2.28], p = 0.743). In sex-stratified analysis, only NH White isolation among White females showed a significant inverse relationship with sedentary time (β = -2.14 [-4.19, -0.09], p = 0.041). Conclusions: NH White adults, particularly females, residing in more segregated counties reported less sedentary time in this population-based nationwide sample of US adults. SB was not strongly associated with isolation for NH Black and Hispanic adults. Future studies could aim to replicate (or not) our findings with larger samples of underrepresented minority populations and further explore potential mechanisms for sex related variation in the association between residential segregation and sedentary behavior.

The Role of the Perceived Neighborhood Social Environment on Adolescent Sedentary Behavior and Physical Activity: Findings from Add Health.

Few studies have examined the role of perceived neighborhood characteristics such as neighborhood safety, social cohesion, and contentedness on sedentary behavior (SB) and physical activity (PA) among adolescents. Furthermore, no studies have investigated how these associations are moderated by gender and race. This study aimed to examine the associations of the perceived neighborhood social environment with (SB) and moderate-to-vigorous physical activity (MVPA). Data from 6504 adolescents (aged 15.4 ± 0.03 years) who participated in the National Longitudinal Study of Adolescent Health was used. SB and PA were considered continuously and dichotomously. PNSE variables include safety, social cohesion, and contentedness, where higher values of PNSE indicate a more favorable neighborhood perception. Weighted linear and logistic regression models were used to examine the association of PNSE with continuous total SB (hours/week) and MVPA (bouts/week), and binary excessive SB (14h/week) and meeting MVPA guidelines (≥ 5 bouts/week), respectively. Associations were stratified by gender and race to test moderation effects. Models were adjusted for demographic, health, parental, and neighborhood covariates. This study found that neighborhood safety and contentedness were negatively associated with SB, whereas neighborhood social cohesion and contentedness were positively associated with PA. Gender-specific and race-specific results remained somewhat consistent with overall findings; however, neighborhood safety was not associated with SB among female and non-White adolescents, respectively. Similarly, neighborhood safety and contentedness were not associated with MVPA for non-White adolescents. Findings suggest that an adolescent's neighborhood environment, gender, and race should be considered when implementing strategies to reduce SB and increase PA.

Active Learning Through Video Conferencing to Maintain Physical Activity Among Older Adults: A Pilot Randomized Controlled Trial.

This randomized pilot trial investigated the feasibility of an active learning physical activity intervention through video conferencing and its preliminary effects. Participants comprised community-dwelling older adults who could use e-mail. The intervention group underwent a 12-week active learning intervention via video conferencing to promote a healthy lifestyle, particularly physical activity. The control group received information via e-mail once per week. The amount of physical activity and sedentary behavior was measured using an accelerometer at baseline, postintervention, and 24-week postintervention (36weeks). Of the 31 participants, 29 were eligible and randomized into two groups (15 for the intervention and 14 for the control). Adherence to the intervention was 83%-100% (mean, 97%). Compared with the control group, the intervention group showed moderate maintenance effects on total physical activity and sedentary behavior at 36weeks. Active learning physical activity intervention through video conferencing was found to be feasible and contributed to the prevention of physical activity decline in older adults.

Sedentary Behavior and Phase Angle: An Objective Assessment in Physically Active and Inactive Older Adults.

The purpose of the present study was to investigate the associations of the objectively assessed total sedentary behavior (SB) amount and SB patterns with phase angle (PhA) in older populations and to conduct a comparison analysis for those who are physically active (meet 150 min/week) and inactive (less than 150 min/week). During May to August 2023, a convenience sampling was used to recruit older adults (aged ≥ 65 years) living in a community in Taiwan. The total SB amount (minutes/day), SB patterns (including SB bouts and breaks), and physical activity were assessed by a triaxial accelerometer. A multifrequency bioelectrical impedance analyzer (BIA) was used to measure PhA. Multiple linear regression analysis was employed to examine the associations between SB and PhA in the total number of participants and stratified in the physically active and inactive groups. For the whole sample (n = 166; mean age: 72.1 ± 5.5 years), the total SB amount and patterns of SB were not associated with PhA. For those physically active, the total SB amount and SB patterns were not associated with PhA. Among those physically inactive, the total SB amount was negatively related to PhA (B: -0.059, 95% CI: -0.118, 0.000). This study underscores the importance of minimizing the total SB amount in physically inactive older adults, providing evidence for future interventions targeting SB and PhA in this population.

Development of a behavior change intervention to improve physical activity in patients with COPD using the behavior change wheel: a non-randomized trial

The aim of this study was to evaluate whether a theory-based behavior change intervention could promote changes in physical activity (PA) and sedentary behavior (SB) among patients with chronic obstructive pulmonary disease (COPD), as well as its effects on symptoms of dyspnea, lung function, exercise capacity, self-efficacy, and health-related quality of life (HRQoL). A quasi-experimental design and convenience sampling were adopted. A total of 92 patients with stable COPD were recruited from outpatient and inpatient centers of two hospitals in Zhejiang Province, China. Both the experimental and control groups received standard medical care provided in the hospital. The experimental group performed a PA program based on the behavior change wheel theory. Outcomes were measured at baseline (T0) and after 4 weeks (T1), 8 weeks (T2), and 12 weeks of the intervention (T3). The primary outcome was PA measured by the International Physical Activity Questionnaire (IPAQ). Secondary outcomes included SB measured by the IPAQ, dyspnea measured by the modified Medical Research Council (mMRC) questionnaire, exercise capacity assessed by 6-min walk distance (6MWD), self-efficacy measured by the Exercise Self-Regulatory Efficacy Scale (EX-SRES), and HRQoL measured by the COPD Assessment Test (CAT). In addition, we measured lung function using a spirometer at baseline and 12 weeks. Of the 89 patients included in this study, 64 were male (71.91%), with a mean age of 67.03 ± 6.15 years. At 12 weeks, the improvements in PA, SB, mMRC, 6MWD, EX-SRES and CAT were all statistically significant (P < 0.05) in the experimental group compared to the control group. Repeated measures analysis of variance showed that there were group effects and time effects on total PA, SB, mMRC, 6MWD, EX-SRES, and CAT in both groups (P < 0.001). However, there was no significant difference in pulmonary function between the two groups before and after intervention (P < 0.05). The PA program based on theory significantly increased PA levels, reduced sedentary time, enhanced exercise capacity and self-efficacy as well as HRQoL in patients with stable COPD. Due to the limited intervention time in this study, the pulmonary function of COPD patients may not be reversed in a short time, and the long-term effect of this program on the pulmonary function of patients needs to be further explored.Trial registration: Clinical Trials.gov (ChiCTR2200060590). Registered 05/06/2022.

Sedentary behaviour in Australian university students: The contribution of study-related sedentary behaviour to total sedentary behaviour.

Seated activities are attributed to increased sedentary behaviour (SB) and adverse health effects, but little is currently known about university students' SB, particularly study-related SB. This study describes the sociodemographic variations of domain-specific SB in regional Australian university students and the contribution of study-related SB to total SB. Self-reported daily SBs from a cross-sectional survey of 451 students were used. Domain-specific and total SB were described within sub-groups, and differences examined using independent t-tests. Multinomial regression was used to examine the association of tertiles of duration in study-related SB with total and other domain-specific SBs. Study participants were a median age of 21 (19-25 years), mostly female (76%) and represented different years of study. On average, students spent 882 ± 292 min/day in total SB, with most SB occurring in the study, screen time and 'other activity' domains. No sociodemographic variations were found in total SB, but significantly higher study-related SB were reported by students studying full time (p < .001) and who moved from their family home to study (p < .022). Study-related SB contributed 36% of total SB, with students most sedentary during study having the highest total SB. This study suggests university students have high levels of SB, primarily in the domains of study, screen time and other activities. SB reduction strategies in universities and targeting screen time, across various sociodemographic groups (e.g., gender, university enrolment status, and living arrangements), may be important in reducing SB in university students. SO WHAT?: University students are highly sedentary and should be included in SB programs especially students studying full time and those who moved from their family home in the study domain.

Organized physical activity and sedentary behaviors in children and adolescents with autism spectrum disorder, cerebral palsy, and intellectual disability.

There is little data on physical activity (PA), organized PA (OPA), and sedentary behaviors in autism spectrum disorders (ASD) and other neurodevelopmental disorders in developing countries. To examine OPA, non-OPA, and sedentary behaviors and their associated factors in children and adolescents with ASD, cerebral palsy (CP), and intellectual disability (ID). A total of 1020 children and adolescents with ASD, CP, and ID were assessed regarding the child and family information as well as the Children's Leisure Activities Study Survey. The results showed that the OPA level was significantly lower than non-OPA in all groups. Furthermore, the OPA level was significantly lower in the CP group compared to ASD and ID groups (P < 0.001). Also, moderate (P < 0.001), vigorous (P < 0.05), and total (P < 0.001) physical activity levels were significantly different between all three groups, with the values being higher in the ASD group compared to the other two. The mean of the total sedentary behavior duration in the ASD group (1819.4 min/week, SD: 1680) was significantly lower than in the CP group (2687 min/week, SD: 2673) (P = 0.007) but not ID group (2176 min/week, SD: 2168.9) (P = 0.525). Our findings remark on the participation rate of PA, OPA, and sedentary behaviors of children and adolescents with ASD, CP, and ID in a developing country. In contrast, the need for developing standards of PA/OPA participation in neurodevelopmental disorders is discussed.

Post-COVID-19 Total and Domain-specific Sedentary Behaviors in Saudi Adults

Objectives: Although previous research reported prevalence of sedentary behavior (SB) during the COVID-19 pandemic, the prevalence of SB in the post-COVID-19 era remains unexplored. Prevalence, patterns, and determinants of post-COVID-19 total SB, and domain-specific SB in Saudi adults was examined. Methods: Participants (N=1,255; 55% females; 50% aged 20 to 29 years old) completed a Web-based survey (December 2, 2022 ‐ January 25, 2023). The Arabic version of the Sedentary Behavior Questionnaire estimated SBs (hours/day) during weekdays and weekend days. Respondents self-reported personal, anthropometric, and socioeconomical variables. Wilcoxon signed-rank tests assessed patterns of total and domain-specific SB and Kruskal-Wallis tests evaluated its determinants. Results: Most participants (54.7%) spent excessive time (≥8 hours/day) in total SB especially during weekdays (p&lt;.001). Leisure-time SB was higher compared to other domain-specific SB (p&lt;.001). Occupational-time SB was higher on weekdays while leisure-time SB was higher during weekends days (p&lt;.001). No statistically significant differences were found for transportational-time SB. Age and occupation were the main determinants of SB (p&lt;.005) while other correlates had more complex associations. Conclusions: Current efforts to reduce SB and suggest that Saudi policymakers, physicians, and researchers target not only daily total SB, but also domain-specific SB, especially in the post-COVID-19 era.

Correlations in Siblings' Physical Activity and Sedentary Behavior: Results from the Hispanic Community Children's Health Study/Study of Latino Youth.

Background: Family is an important determinant of youth's health behaviors, yet research on the importance of intragenerational relationships for determining physical activity (PA) and sedentary behaviors (SBs) is limited. This study examined correlations in siblings' total PA, moderate-to-vigorous physical activity (MVPA), and SB and explored potential determinants of differences in Hispanic/Latino siblings' activity. Methods: Hispanic/Latino 8-16-year olds from the cross-sectional Hispanic Community Children's Health Study/Study of Latino Youth with ≥1 sibling enrolled were examined (n = 535). Activity was assessed using the Actical accelerometer. Linear mixed models were used with total PA, MVPA, or SB as the outcome; correlations among siblings' PA and SB were assessed with intraclass correlation coefficients (ICCs). Results: ICCs for siblings' total PA, MVPA, and SB were 0.26 (95% confidence interval: 0.16-0.36), 0.29 (0.21-0.38), and 0.42 (0.34-0.51), respectively. There were no differences in correlations between siblings who were all brothers compared to all sisters. However, compared to siblings of differing sexes, siblings who were all brothers had the strongest correlations in total PA (0.61 [0.46-0.76]) and MVPA (0.64 [0.49-0.78]), and siblings who were all sisters had the weakest correlations in SB (0.14 [-0.10 to 0.37]). Correlations did not differ according to age, and social and environmental measures did not explain differences in siblings' PA or SB. Conclusions: Correlations in Hispanic/Latino siblings' PA and SB ranged from slight to fair, with siblings who were all brothers generally having the strongest correlations. Future research should examine determinants of sex-specific differences in siblings' PA and SB correlations.

Low movement, deep-learned sitting patterns, and sedentary behavior in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE).

Sedentary behavior (SB) has both movement and postural components, but most SB research has only assessed low movement, especially in children. The purpose of this study was to compare estimates and health associations of SB when derived from a standard accelerometer cut-point, a novel sitting detection technique (CNN Hip Accelerometer Posture for Children; CHAP-Child), and both combined. Data were from the International Study of Childhood Obesity, Lifestyle, and the Environment (ISCOLE). Participants were 6103 children (mean ± SD age 10.4 ± 0.56 years) from 12 countries who wore an ActiGraph GT3X+ accelerometer on the right hip for approximately one week. We calculated SB time, mean SB bout duration, and SB breaks using a cut-point (SBmovement), CHAP-Child (SBposture), and both methods combined (SBcombined). Mixed effects regression was used to test associations of SB variables with pediatric obesity variables (waist circumference, body fat percentage, and body mass index z-score). After adjusting for MVPA, SBposture showed several significant obesity associations favoring lower mean SB bout duration (b = 0.251-0.449; all p < 0.001) and higher SB breaks (b = -0.005--0.052; all p < 0.001). Lower total SB was unexpectedly related to greater obesity (b = -0.077--0.649; p from <0.001-0.02). For mean SB bout duration and SB breaks, more associations were observed for SBposture (n = 5) than for SBmovement (n = 3) or SBcombined (n = 1), and tended to have larger magnitude as well. Using traditional measures of low movement as a surrogate for SB may lead to underestimated or undetected adverse associations between SB and obesity. CHAP-Child allows assessment of sitting posture using hip-worn accelerometers. Ongoing work is needed to understand how low movement and posture are related to one another, as well as their potential health implications.