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    The Potential Impact of Displacing Sedentary Time in Adults with Type 2 Diabetes. Falconer Catherine L,Page Angie S,Andrews Rob C,Cooper Ashley R Medicine and science in sports and exercise PURPOSE:Sedentary time, in particular, prolonged unbroken sedentary time, is detrimental to health and displaces time spent in either light or moderate intensity physical activity. This cross-sectional study aimed to identify the potential impact of reallocating time from sedentary behaviors to more active behaviors on measures of body composition and metabolic health in people with type 2 diabetes. METHODS:Participants were 519 adults with newly diagnosed type 2 diabetes who had been recruited to the Early Activity in Diabetes (Early ACTID) randomized controlled trial. Waist-worn accelerometers were used to obtain objective measurement of sedentary time, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) at baseline alongside clinical measurements and fasting blood samples to determine cholesterol, triglycerides, HOMA-IR, and glucose. Isotemporal substitution modeling was performed to determine the potential impact of reallocating 30 min of sedentary time accumulated in a single bout (long bout) with 30 min of interrupted sedentary time, LPA, or MVPA. RESULTS:Sedentary time accounted for 65% of the waking day, of which 45% was accumulated in prolonged (≥30 min) bouts. Reallocation of 30 min of long-bout sedentary time with 30 min of short-bout sedentary time was associated with lower body mass index (BMI) (adjusted β, -0.60; 95% confidence interval [CI], -1.00, -0.21) and waist circumference (WC) (adjusted β, -1.16; 95% CI, -2.08, -0.25). Stronger effects were seen for LPA and MVPA. Reallocation of 30 min of long-bout sedentary time with LPA was associated with higher HDL-cholesterol (adjusted β, 0.02; 95% CI, 0.00-0.03 mmol·L). CONCLUSIONS:Encouraging adults with newly diagnosed type 2 diabetes to break up prolonged periods of sedentary time may be an effective strategy for improving body composition and metabolic health. 10.1249/MSS.0000000000000651
    Association between Objectively Measured Physical Activity and Mortality in NHANES. Fishman Ezra I,Steeves Jeremy A,Zipunnikov Vadim,Koster Annemarie,Berrigan David,Harris Tamara A,Murphy Rachel Medicine and science in sports and exercise PURPOSE:We examined total activity, light activity, and moderate-to-vigorous physical activity (MVPA) as predictors of mortality in a nationally representative sample of older adults. Then we explored the theoretical consequences of replacing sedentary time with the same duration of light activity or MVPA. METHODS:Using accelerometer-measured activity, the associations between total activity, light activity (100-2019 counts per minute), and MVPA (>2019 counts per minute) counts and mortality were examined in adults age 50 to 79 yr in the National Health and Nutrition Examination Survey, 2003-2006 (n = 3029), with mortality follow-up through December 2011. Cox proportional hazard models were fitted to estimate mortality risks. An isotemporal substitution model was used to examine the theoretical consequences of replacing sedentary time with light activity or MVPA on mortality. RESULTS:After adjusting for potential confounders, including age, sex, race/ethnicity, education, BMI, and the presence of comorbid conditions, those in the highest tertile of total activity counts had one fifth the risk of death of those in the lowest tertile (hazard ratio [HR] = 0.21, 95% confidence interval [CI] = 0.12-0.38), and those in the middle tertile had one third the risk of death (HR = 0.36, 95% CI = 0.30-0.44). In addition, replacing 30 min of sedentary time with light activity was associated with significant reduction in mortality risk (after 5 yr of follow-up: HR = 0.80, 95% CI = 0.75-0.85). Replacing 30 min of sedentary time with MVPA was also associated with reduction in mortality risk (HR = 0.49, 95% CI = 0.25-0.97). CONCLUSIONS:Greater total activity is associated with lower all-cause mortality risk. Replacing sedentary time with light activity or MVPA may reduce mortality risk for older adults. 10.1249/MSS.0000000000000885
    Does replacing sedentary behaviour with light or moderate to vigorous physical activity modulate inflammatory status in adults? Phillips Catherine M,Dillon Christina B,Perry Ivan J The international journal of behavioral nutrition and physical activity BACKGROUND:Sedentary behaviour, obesity and insulin resistance are associated with pro-inflammatory status. Limited data on whether physical activity modulates inflammatory status and counteracts obesity and insulin resistance associated low-grade inflammation exist. Our objective was to investigate associations between objectively measured physical activity and inflammatory status, and specifically whether substituting daily sedentary behaviour with light activity or moderate to vigorous physical activity (MVPA), is associated with beneficial alterations to the inflammatory profile among middle-aged adults and those at increased cardiometabolic risk (obese and insulin resistant subjects). METHODS:Data are from a sub-sample of the Mitchelstown cohort; a population-based cross-sectional sample of 2047 Irish adults. Physical activity intensity and duration were measured in 396 participants for 7-consecutive days using the GENEActiv accelerometer. Isotemporal regression analysis examined the associations between replacing 30 min per day of sedentary behaviour with equal amounts of light activity and MVPA on inflammatory factors (serum acute-phase reactants, adipocytokines, pro-inflammatory cytokines and white blood cells (WBC)). RESULTS:Reallocating 30 min of sedentary time with MVPA was associated with a more favourable inflammatory profile characterized by higher adiponectin and lower complement component C3 (C3), leptin, interleukin 6 (IL-6) and WBC concentrations (P < 0.05). No significant effects were noted with substitution of sedentary time with light activity. Among the obese subjects replacing sedentary behaviour with an equivalent amount of MVPA was associated with lower WBC counts (P < 0.05); no associations were detected among the insulin resistant (HOMA-IR >75th percentile) subjects. Among the non-obese and non-insulin resistant subjects substituting 30 min of sedentary behaviour with MVPA was associated with decreased C3, IL-6 and WBC concentrations. CONCLUSIONS:Replacing sedentary behaviour with MVPA modulates pro-inflammatory status. These findings, which highlight the need for the developing randomized trials aimed at lowering cardiometabolic risk, warrant further investigation. 10.1186/s12966-017-0594-8
    Screen Time and Health Indicators Among Children and Youth: Current Evidence, Limitations and Future Directions. Saunders Travis J,Vallance Jeff K Applied health economics and health policy Despite accumulating evidence linking screen-based sedentary behaviours (i.e. screen time) with poorer health outcomes among children and youth <18 years of age, the prevalence of these behaviours continues to increase, with roughly half of children and youth exceeding the public health screen time recommendation of 2 h per day or less. The purpose of this article is to provide an overview of key research initiatives aimed at understanding the associations between screen time and health indicators including physical health, quality of life and psychosocial health. Available evidence suggests that screen time is deleteriously associated with numerous health indicators in child and youth populations, including adiposity, aerobic fitness, quality of life, self-esteem, pro-social behaviour, academic achievement, depression and anxiety. However, few longitudinal or intervention studies have been conducted, with most of these studies focusing on physical health indicators. While most studies have used self-reported assessments of screen time, the availability of more objective assessment methods presents important opportunities (e.g. more accurate and precise assessment of sedentary time and screen time) and challenges (e.g. privacy and participant burden). Novel statistical approaches such as isotemporal substitution modelling and compositional analysis, as well as studies using longitudinal and experimental methodologies, are needed to better understand the health impact of excessive screen time, and to develop strategies to minimise or reverse the negative impacts of these behaviours. The evidence to date suggests a clear need for policy aimed at minimising the hazardous health consequences associated with screen time among children and youth. 10.1007/s40258-016-0289-3
    Longitudinal Physical Activity, Body Composition, and Physical Fitness in Preschoolers. Leppänen Marja H,Henriksson Pontus,Delisle Nyström Christine,Henriksson Hanna,Ortega Francisco B,Pomeroy Jeremy,Ruiz Jonatan R,Cadenas-Sanchez Cristina,Löf Marie Medicine and science in sports and exercise PURPOSE:This study aimed to investigate longitudinal associations of objectively measured physical activity (PA) and sedentary behavior (SB) with body composition and physical fitness at a 12-month follow-up in healthy Swedish 4-yr-old children. METHODS:The data from the population-based MINISTOP trial were collected between 2014 and 2016, and this study included the 138 children who were in the control group. PA and SB were assessed using the wrist-worn ActiGraph (wGT3x-BT) accelerometer during seven 24-h periods and, subsequently, defined as SB, light-intensity PA, moderate-intensity PA, vigorous-intensity PA (VPA), and moderate-to-vigorous PA (MVPA). Body composition was measured using air-displacement plethysmography and physical fitness (cardiorespiratory fitness, lower and upper muscular strength as well as motor fitness) by the PREFIT fitness battery. Linear regression and isotemporal substitution models were applied. RESULTS:Greater VPA and MVPA at the age of 4.5 yr were associated with higher fat-free mass index (FFMI) at 5.5 yr (P < 0.001 and P = 0.044, respectively). Furthermore, greater VPA and MVPA at the age of 4.5 yr were associated with higher scores for cardiorespiratory fitness, lower body muscular strength, and motor fitness at 12-month follow-up (P = 0.001 to P = 0.031). Substituting 5 min·d of SB, light-intensity PA, or moderate-intensity PA for VPA at the age of 4.5 yr were associated with higher FFMI, and with greater upper and lower muscular strength at 12-month follow-up (P < 0.001 to P = 0.046). CONCLUSION:Higher VPA and MVPA at the age of 4.5 yr were significantly associated with higher FFMI and better physical fitness at 12-month follow-up. Our results indicate that promoting high-intensity PA at young ages may have long-term beneficial effects on childhood body composition and physical fitness, in particular muscular strength. 10.1249/MSS.0000000000001313
    Does Physically Demanding Work Hinder a Physically Active Lifestyle in Low Socioeconomic Workers? A Compositional Data Analysis Based on Accelerometer Data. Rasmussen Charlotte Lund,Palarea-Albaladejo Javier,Bauman Adrian,Gupta Nidhi,Nabe-Nielsen Kirsten,Jørgensen Marie Birk,Holtermann Andreas International journal of environmental research and public health Leisure time physical activity (LTPA) is strongly associated with socioeconomic position (SEP). Few studies have investigated if demanding occupational physical activity (OPA) could impede a physically active lifestyle in low SEP groups. The aim of this study was to investigate the association between OPA and LTPA among low SEP men and women. We used cross-sectional data from 895 low SEP workers who wore accelerometers for 1⁻5 consecutive workdays. The associations between the relative importance of activities performed during work and leisure time were assessed using compositional regression models stratified on sex. Compositional isotemporal substitution models were used to assess the implication of increasing occupational walking, standing, or sitting on LTPA. We found dissimilarity in LTPA between the sexes, with men spending more waking leisure time sedentary than women (men ~67%, women ~61%), suggesting women performed more household tasks. In men, the associations between OPA and LTPA were weak. In women, the strongest association was observed between the relative importance of occupational walking and leisure time standing (β = -0.16; = 0.01), where reallocating 15 min work time to occupational walking showed an expected decrease in leisure time standing of 7 min. If this time was spent on additional sedentary leisure time, it could have adverse health consequences. 10.3390/ijerph15071306
    One day you'll wake up and won't have to go to work: The impact of changes in time use on mental health following retirement. Olds Tim,Burton Nicola W,Sprod Judy,Maher Carol,Ferrar Katia,Brown Wendy J,van Uffelen Jannique,Dumuid Dorothea PloS one BACKGROUND:Retirement is a life transition involving an obligatory change in how people use their time. Because there are strong associations between use of time and health, different changes in time use following retirement may have different impacts on mental health. METHODS:105 participants were followed from 6 months before retirement to 12 months after retirement. At each time-point, use of time was quantified using a validated computerised 24-hour recall. Depression, anxiety and stress were assessed using the Depression, Anxiety and Stress Scales (DASS21), well-being with the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS), life satisfaction with the Australian Unity Personal Well-being Index (AUPWI), and self-esteem with the Rosenberg Self-Esteem Scale. Time-use data were analysed using compositional data analysis, which treats the 24-h day as a holistic "activity composition" rather than as individual activity domains. Time flow analytics were used to map patterns of change in time use from pre-retirement to post-retirement. Regression analysis was used to determine whether changes in the activity composition were significantly associated with changes in mental health. Compositional isotemporal substitution models were used to illustrate dose-response relationships between changes in time use and conditional changes in mental health for individual activity domains, such as sleep, screen time and physical activity. RESULTS:Following retirement, time no longer spent in work flowed mainly to household chores, sleep, screen time and quiet time (e.g. reading). Mental health improved overall. Changes in the activity composition were significantly related to conditional changes in DASS21 total score, depression, stress, and self-esteem, but not to anxiety, well-being or life satisfaction. Replacing work time with physical activity or sleep was associated with positive changes in mental health. Effect sizes for 60-minute substitutions ranged from -0.15 to +0.31. CONCLUSION:Following retirement, replacing work with physical activity, and to a lesser extent sleep, is associated with better mental health. 10.1371/journal.pone.0199605
    Potential Effects on Mortality of Replacing Sedentary Time With Short Sedentary Bouts or Physical Activity: A National Cohort Study. Diaz Keith M,Duran Andrea T,Colabianchi Natalie,Judd Suzanne E,Howard Virginia J,Hooker Steven P American journal of epidemiology Little is known concerning the type of activity that should be substituted for sedentary time and its potentially most hazardous form (prolonged sedentary bouts) to impart health benefit. We used isotemporal substitution techniques to examine whether 1) replacing total sedentary time with light-intensity or moderate to vigorous physical activity (LIPA or MVPA) or 2) replacing prolonged sedentary bouts with shorter sedentary bouts is associated with reductions in all-cause mortality risk. Participants (n = 7,999) from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a national cohort of US adults aged ≥45 years, were studied. Sedentary time was measured by accelerometry between 2009 and 2013. There was a beneficial association with mortality risk for replacing total sedentary time with both LIPA (per 30 minutes, hazard ratio (HR) = 0.83; 95% confidence interval (CI): 0.80, 0.87) and MVPA (per 30 minutes, HR = 0.65; 95% CI: 0.50, 0.85). Similarly, there was a beneficial association for replacing prolonged sedentary-bout time with LIPA and MVPA but not for replacement with shorter sedentary bouts (per 30 minutes, HR = 1.00; 95% CI: 0.96, 1.03). These findings suggest short sedentary bouts still carry mortality risk and are not a healthful alternative to prolonged sedentary bouts. Instead, physical activity of any intensity is needed to mitigate the mortality risks incurred by sedentary time. 10.1093/aje/kwy271
    Effects of replacing sitting time with physical activity on lung function: An analysis of the Canadian Longitudinal Study on Aging. Dogra Shilpa,Good Joshua,Gardiner Paul A,Copeland Jennifer L,Stickland Michael K,Rudoler David,Buman Matthew P Health reports BACKGROUND:Sitting time and physical activity may be modifiable determinants of lung function. The purpose of this study was to assess the effect that replacing various movement behaviours has on lung function among individuals with and without obstructive lung disease. DATA AND METHODS:For analysis, data were used from participants of the Canadian Longitudinal Study on Aging, recruited between 2012 and 2015. Lung function was assessed using spirometry. A modified version of the Physical Activity Scale for the Elderly was used to assess sitting time and physical activity levels. Isotemporal substitution analysis was performed to analyze the effects of replacing 30 minutes per day of one movement behaviour with another, keeping the total time constant. Analyses were run separately for individuals with an obstructive lung disease (asthma, chronic obstructive pulmonary disease, or forced expiratory volume in 1 second [FEV₁] ⟨ 5th percentile lower limit of normal; n=3,398), and healthy adults (n=14,707). RESULTS:When sitting time was replaced with 30 minutes per day of any type of physical activity or sleep, an increase in percent (%) of predicted FEV₁ (i.e., β=0.65, confidence interval [CI]: 0.43, 0.88 for replacing sitting time with strenuous or strengthening activity) was observed among healthy adults. Among adults with obstructive lung disease, replacing 30 minutes per day of sitting time or sleep duration with strenuous or strengthening activity was associated with an improvement in the percent of predicted FEV₁ (i.e., β=0.98, CI: 0.13, 1.82 for replacing sleep duration with strenuous or strengthening activity). DISCUSSION:Replacing sitting time with physical activity leads to significant improvements in lung function among adults with an obstructive lung disease, as well as among adults without a respiratory disease. 10.25318/82-003-x201900300002-eng
    Is high aerobic workload at work associated with leisure time physical activity and sedentary behaviour among blue-collar workers? A compositional data analysis based on accelerometer data. Lund Rasmussen Charlotte,Palarea-Albaladejo Javier,Korshøj Mette,Gupta Nidhi,Nabe-Nielsen Kirsten,Holtermann Andreas,Jørgensen Marie Birk PloS one OBJECTIVE:This study aimed to investigate the hypothesized negative association between duration of work time spent at a high relative aerobic workload and leisure time movement behaviours among blue-collar workers. METHODS:This was a cross-sectional study based on heart rate and accelerometer data from 803 blue-collar workers (447 men and 356 women). Relative aerobic workload was measured as percentage of heart rate reserve during work (%HRR). Leisure time movement behaviours were expressed in terms of leisure time spent in sedentary and active behaviours in uninterrupted bouts (i.e. <10 min, ≥10-30 min and >30 min). Compositional regression and isotemporal substitution models were used to assess the association between the predominance of work time spent at ≥40%HRR and leisure time spent in sedentary and active bouts. All analyses were stratified by sex. RESULTS:For men, there was no statistically significant association between the predominance of work time spent at ≥40%HRR and leisure time movement behaviours. Among women, the predominance of ≥40%HRR at work was negatively associated with relative leisure time spent in ≥10 min bouts of active behaviour ([Formula: see text] = -0.21, p = 0.02) and a theoretical 15 min reallocation of work time from <40%HRR to ≥40%HRR was estimated to decrease active behaviour by 6 min during leisure time. CONCLUSION:Our result highlights the need for considering work-related barriers for an active leisure time in high-risk populations. Longitudinal studies are warranted to disentangle the relationship between physically demanding work characteristics and leisure time movement behaviours in such populations. 10.1371/journal.pone.0217024
    Physical activity and depression in men: Increased activity duration and intensity associated with lower likelihood of current depression. Currier Dianne,Lindner Remy,Spittal Matthew J,Cvetkovski Stefan,Pirkis Jane,English Dallas R Journal of affective disorders OBJECTIVES:Depression is a significant public health issue for men, however men are less likely to use mental health services. Alternative interventions, such as physical activity, may be of value for this population. This study sought to determine what levels and intensity of physical activity are associated with lower depression prevalence in Australian men. METHODS:Using baseline data from 13,884 participants in the Australian Longitudinal Study on Male Health we compared current depression in men who completed the recommended 150 min of physical activity in the past week with men who did not. Duration of activity was examined using logistic regression with restricted cubic splines. Intensity of physical activity was examined by isotemporal substitution of hours of moderate activity with hours of vigorous activity. RESULTS:Men who completed at least 150 min/week of activity had lower odds of moderate/severe depression symptoms. Duration of activity was inversely associated with moderate/severe depression symptoms. Among physically active men, each additional hour of moderate activity replaced with vigorous activity was associated with lower odds of depression. LIMITATIONS:This is a cross-sectional study and so cannot determine causal direction in the relationship between physical activity and depression symptoms observed. Self-report measures of physical activity are widely used but are not as accurate as biometric measurement. CONCLUSIONS:In adult men, meeting minimum recommendations is associated with lower current depression. Increased duration and greater intensity of activity were both associated with further reduction in prevalence. Promoting higher levels of physical activity is potentially an intervention for improving men's mental wellbeing. 10.1016/j.jad.2019.09.061
    Understanding How Much TV is Too Much: A Nonlinear Analysis of the Association Between Television Viewing Time and Adverse Health Outcomes. Foster Hamish M E,Ho Frederick K,Sattar Naveed,Welsh Paul,Pell Jill P,Gill Jason M R,Gray Stuart R,Celis-Morales Carlos A Mayo Clinic proceedings OBJECTIVE:To inform potential guideline development, we investigated nonlinear associations between television viewing time (TV time) and adverse health outcomes. METHODS:From 2006 to 2010, 490,966 UK Biobank participants, aged 37 to 73 years, were recruited. They were followed from 2006 to 2018. Nonlinear associations between self-reported TV time (hours per day) and outcomes explored using penalized cubic splines in Cox proportional hazards adjusted for demographics and lifestyle. Population-attributable and potential impact fractions were calculated to contextualize population-level health outcomes associated with different TV time levels. Nonlinear isotemporal substitution analyses were used to investigate substituting TV time with alternative activities. Primary outcomes were mortality: all-cause, cardiovascular disease (CVD) and cancer; incidence: CVD and cancer; secondary outcomes were incident myocardial infarction, stroke, and heart failure and colon, lung, breast, and prostate cancer. RESULTS:Those with noncommunicable disease (109,867 [22.4%]), CVD (32,243 [6.6%]), and cancer (37,81 [7.7%]) at baseline were excluded from all-cause mortality, CVD, and cancer analyses, respectively. After 7.0 years (mortality) and 6.2 years (disease incidence) mean follow-up, there were 10,306 (2.7%) deaths, 24,388 (5.3%) CVD events, and 39,121 (8.7%) cancer events. Associations between TV time and all-cause and CVD mortality were curvilinear (P ≤.003), with lowest risk observed <2 hours per day. Theoretically, 8.64% (95% confidence interval [CI], 6.60-10.73) of CVD mortality is attributable to TV time. Limiting TV time to 2 hours per day might have prevented, or at least delayed, 7.97% (95% CI, 5.54-10.70) of CVD deaths. Substituting TV time with sleeping, walking, or moderate or vigorous physical activity was associated with reduced risk for all outcomes when baseline levels of substitute activities were low. CONCLUSION:TV time is associated with numerous adverse health outcomes. Future guidelines could suggest limiting TV time to less than 2 hours per day to reduce most of the associated adverse health events. 10.1016/j.mayocp.2020.04.035
    Associations of Activity and Sleep With Quality of Life: A Compositional Data Analysis. Verhoog Sanne,Braun Kim V E,Bano Arjola,van Rooij Frank J A,Franco Oscar H,Koolhaas Chantal M,Voortman Trudy American journal of preventive medicine INTRODUCTION:Associations between time spent on physical activity, sedentary behavior, and sleep and quality of life are usually studied without considering that their combined time is fixed. This study investigates the reallocation of time spent on physical activity, sedentary behavior, and sleep during the 24-hour day and their associations with quality of life. METHODS:Data from the 2011-2016 Rotterdam Study were used to perform this cross-sectional analysis among 1,934 participants aged 51-94 years. Time spent in activity levels (sedentary, light-intensity physical activity, moderate-to-vigorous physical activity, and sleep) were objectively measured with a wrist-worn accelerometer combined with a sleep diary. Quality of life was measured using the EuroQoL 5D-3L questionnaire. The compositional isotemporal substitution method was used in 2018 to examine the association between the distribution of time spent in different activity behaviors and quality of life. RESULTS:Reallocation of 30 minutes from sedentary behavior, light-intensity physical activity, or sleep to moderate-to-vigorous physical activity was associated with a higher quality of life, whereas reallocation from moderate-to-vigorous physical activity to sedentary behavior, light-intensity physical activity, or sleep was associated with lower quality of life. To illustrate this, a reallocation of 30 minutes from sedentary behavior to moderate-to-vigorous physical activity was associated with a 3% (95% CI=2, 4) higher quality of life score. By contrast, a reallocation of 30 minutes from moderate-to-vigorous physical activity to sedentary behavior was associated with a 4% (95% CI=2, 6) lower quality of life score. CONCLUSIONS:Moderate-to-vigorous physical activity is important with regard to the quality of life of middle-aged and elderly individuals. The benefits of preventing less time spent in moderate-to-vigorous physical activity were greater than the benefits of more time spent in moderate-to-vigorous physical activity. These results could shift the attention to interventions focused on preventing reductions in moderate-to-vigorous physical activity levels. Further longitudinal studies are needed to confirm these findings and explore causality. 10.1016/j.amepre.2020.03.029
    Reallocating time spent in physical activity intensities: Longitudinal associations with physical fitness (DADOS study). Beltran-Valls Maria Reyes,Adelantado-Renau Mireia,Moliner-Urdiales Diego Journal of science and medicine in sport OBJECTIVES:Firstly, to investigate the longitudinal associations between accelerometer-derived physical activity (PA) intensities and physical fitness (PF) at 24-month follow-up in adolescents. Secondly, to examine how substituting time spent in low or moderate PA intensities with vigorous PA at baseline was related to PF at 24-month follow-up. DESIGN:Longitudinal observational study METHOD: The DADOS (Deporte, ADOlescencia y Salud) study is a 3-year longitudinal research project carried out between years 2015-2017. The analyses included 189 adolescents (91girls) aged 13.9±0.3 years at baseline. PA was assessed by a wrist-worn GENEActiv triaxial accelerometer and expressed as minutes/day of light, moderate and vigorous PA. Cardiorespiratory, musculoskeletal and motor fitness were assessed by field tests and a global fitness z-score was calculated as the mean of the z-scores values of each fitness test. Association between PA intensities and PF were determined using linear regression. Isotemporal analyses estimating the association of reallocating PA intensities with PF were performed. RESULTS:Baseline vigorous PA was positively associated with cardiorespiratory fitness and global fitness score at follow-up in boys (β=0.234;p=0.002, β=0.340;p<0.001) and girls (β=0.184;p=0.043, β=0.213;p=0.004). In boys, baseline vigorous PA was also positively associated with musculoskeletal and motor fitness (β=0.139;p=0.035, β=0.195;p=0.021). The substitution of 10min/day of light PA or moderate PA with 10min/day of vigorous PA at baseline was positively associated with all PF components and global fitness score in boys (p<0.001), and with global fitness score girls (p<0.05). CONCLUSION:These findings highlight the need of promoting vigorous PA due to its specific influence on adolescent's PF. 10.1016/j.jsams.2020.04.012
    Associations of movement behaviors and body mass index: comparison between a report-based and monitor-based method using Compositional Data Analysis. Kim Youngwon,Burns Ryan D,Lee Duck-Chul,Welk Gregory J International journal of obesity (2005) BACKGROUND/OBJECTIVES:Evidence on the associations between lifestyle movement behaviors and obesity has been established without taking into account the time-constrained nature of categorized, time-based lifestyle behaviors. We examined the associations of sleep, sedentary behavior (SED), light-intensity physical activity (LPA), and moderate-to-vigorous PA (MVPA) with body mass index (BMI) using Compositional Data Analysis (CoDA), and compared the associations between a report-based method (24-h Physical Activity Recall; 24PAR) and a monitor-based method (SenseWear Armband; SWA). SUBJECTS/METHODS:Replicate data from a representative sample of 1247 adults from the Physical Activity Measurement Survey (PAMS) were used in the study. Participants completed activity monitoring on two randomly selected days, each of which required wearing a SWA for a full day, and then completing a telephone-administered 24PAR the following day. Relationships among behavioral compositional parts and BMI were analyzed using CoDA via multiple linear regression models with both 24PAR and SWA data. RESULTS:Using 24PAR, time spent in sleep (γ = -3.58, p = 0.011), SED (γ = 3.70, p = 0.002), and MVPA (γ = -0.53, p = 0.018) was associated with BMI. Using SWA, time spent in sleep (γ = -5.10, p < 0.001), SED (γ = 8.93, p < 0.001), LPA (γ = -3.12, p < 0.001), and MVPA (γ = -1.43, p < 0.001) was associated with BMI. The SWA models explained more variance in BMI (R = 0.28) compared with the 24PAR models (R = 0.07). The compositional isotemporal substitution models revealed reductions in BMI when replacing SED by MVPA, LPA (not with 24PAR) or sleep for both 24PAR and SWA, but the effect estimates were larger with SWA. CONCLUSIONS:Favorable levels of relative time spent in lifestyle movement behaviors were, in general, associated with decreased BMI. The observed associations were stronger using the monitor-based SWA method compared with the report-based 24PAR method. 10.1038/s41366-020-0638-z
    The 24-h Movement Compositions in Weekday, Weekend Day or Four-Day Periods Differentially Associate with Fundamental Movement Skills. Roscoe Clare M P,Duncan Michael J,Clark Cain C T Children (Basel, Switzerland) The aim of this study was to investigate the relationship between weekday, weekend day and four-day physical activity (PA) behaviours and fundamental movement skills (FMS) in British preschool children from a low socio-economic status background using compositional data analysis (CoDA). One hundred and eighty-five preschool children aged 3-4 years provided objectively assessed PA and sedentary behaviour (SB) data (GENEActiv accelerometer) and FMS (TGMD-2). The association of 24-h movement behaviours with FMS was explored using CoDA and isotemporal substitution (R Core Team, 3.6.1). When data were considered compositionally (SB, light PA (LPA), moderate and vigorous PA (MVPA)) and adjusted for age, BMI and sex, the weekday-derived composition predicted total motor competence (r = 0.07), locomotor (r = 0.08) and object control skills (r = 0.09); the weekend day-derived composition predicted total motor competence (r = 0.03) and object control skills (r = 0.03), the 4-day-derived composition predicted total motor competence (r = 0.07), locomotor (r = 0.07) and object control skills (r = 0.06) (all < 0.05). Reallocation of 5 min of LPA at the expense of any behaviour was associated with significant improvements in total motor competence, locomotor and object control skills; for weekend-derived behaviours, MVPA was preferential. Considering movement behaviours over different time periods is required to better understand the effect of the 24-h movement composition on FMS in preschool children. 10.3390/children8100828
    Day-to-day pattern of work and leisure time physical behaviours: are low socioeconomic status adults couch potatoes or work warriors? Rasmussen Charlotte Lund,Dumuid Dorothea,Hron Karel,Gupta Nidhi,Jørgensen Marie Birk,Nabe-Nielsen Kirsten,Holtermann Andreas BMC public health BACKGROUND:Most studies on day-to-day patterns of physical behaviours (i.e. physical activities and sedentary behaviour) are based on adults with high socioeconomic status (SES) and without differentiating between work and leisure time. Thus, we aimed to characterise the day-to-day leisure time physical behaviours patterns among low SES adults and investigate the influence of work physical behaviours. METHODS:This cross-sectional study included 963 adults from low SES occupations (e.g. manufacturing, cleaning and transportation). The participants wore accelerometers for 1-7 days to measure physical behaviours during work and leisure time, expressed as time-use compositions consisting of time spent sedentary, standing or being active (walking, running, stair climbing, or cycling). Compositional multivariate multilevel models were used to regress daily leisure time-use composition against work time-use compositions. Interaction between weekday and (1) type of day, (i.e., work/non-work) and (2) the work time-use composition were tested. Compositional isotemporal substitution was used to interpret the estimates from the models. RESULTS:Each weekday, workers consistently spent most leisure time being sedentary and most work time standing. Leisure time physical behaviours were associated with type of day (p < 0.005, more sedentary on workdays vs. non-workdays), weekday (p < 0.005, more sedentary on Friday, Saturday and Sunday), standing work (p < 0.005, more sedentary and less standing and active leisure time on Sunday), and active work (p < 0.005, less sedentary and more standing and active leisure time on Sunday). Sedentary leisure time increased by 18 min, while standing and active leisure time decreased by 11 and 7 min, respectively, when 30 min were reallocated to standing at work on Sunday. Conversely, sedentary leisure time decreased by 25 min, and standing and active leisure time increased by 15 and 10 min, respectively, when 30 min were reallocated to active time at work on Sunday. CONCLUSIONS:While low SES adults' leisure time was mostly sedentary, their work time was predominantly standing. Work physical behaviours differently influenced day-to-day leisure time behaviours. Thus, public health initiatives aiming to change leisure time behaviours among low SES adults should consider the influence of work physical behaviours. 10.1186/s12889-021-11409-0
    Association between 24-Hour Movement Behaviors and Smartphone Addiction among Adolescents in Foshan City, Southern China: Compositional Data Analysis. International journal of environmental research and public health Smartphone addiction has become a public health issue. To help reduce smartphone addiction, we assessed the combined effect of 24-Hour Movement Behaviors on smartphone addiction during Corona Virus Disease 2019 (COVID-19) home confinement in Foshan, China. Data were collected in a sample of 1323 senior middle school students ((mean age ± standard deviation): 16.4 ± 0.9 years; 43.46% males) during the COVID-19 lockdown. Their 24-Hour movement behaviors were assessed by a self-reported questionnaire, The Smartphone Addiction Scale-Short Version (SAS-SV). The compositional multiple linear regression model and compositional isotemporal substitution model were used to examine the association between the time budget composition of the day and smartphone addiction. Smartphone addiction occurred in 671 (50.72%) of the 1323 students. Compared with smartphone-addicted adolescents, non-smartphone-addicted adolescents had more moderate-to-vigorous physical activity (MVPA) and sleep duration (SLP), and less sedentary behavior (SB). The distribution of time spent in 24-Hour movement behaviors was significantly associated with smartphone addiction. The negative effect was found for the proportion of time spent in MVPA or SLP ( = -0.453, &lt; 0.001. = -3.641, &lt; 0.001, respectively) relative to the other three behaviors. Conversely, SB was positively associated with the score of smartphone addiction ( = 2.641, &lt; 0.001). Reallocating one behavior to remaining behaviors was associated with smartphone addiction. Noticeably, the effects of one behavior replacing another behavior and of one behavior being displaced by another behavior were asymmetric. The 24-Hour movement behaviors of adolescents are closely related to smartphone addiction, and future intervention studies should focus on the compositional attribute of 24-Hour movement behaviors. 10.3390/ijerph19169942
    GRANADA consensus on analytical approaches to assess associations with accelerometer-determined physical behaviours (physical activity, sedentary behaviour and sleep) in epidemiological studies. British journal of sports medicine The inter-relationship between physical activity, sedentary behaviour and sleep (collectively defined as physical behaviours) is of interest to researchers from different fields. Each of these physical behaviours has been investigated in epidemiological studies, yet their codependency and interactions need to be further explored and accounted for in data analysis. Modern accelerometers capture continuous movement through the day, which presents the challenge of how to best use the richness of these data. In recent years, analytical approaches first applied in other scientific fields have been applied to physical behaviour epidemiology (eg, isotemporal substitution models, compositional data analysis, multivariate pattern analysis, functional data analysis and machine learning). A comprehensive description, discussion, and consensus on the strengths and limitations of these analytical approaches will help researchers decide which approach to use in different situations. In this context, a scientific workshop and meeting were held in Granada to discuss: (1) analytical approaches currently used in the scientific literature on physical behaviour, highlighting strengths and limitations, providing practical recommendations on their use and including a decision tree for assisting researchers' decision-making; and (2) current gaps and future research directions around the analysis and use of accelerometer data. Advances in analytical approaches to accelerometer-determined physical behaviours in epidemiological studies are expected to influence the interpretation of current and future evidence, and ultimately impact on future physical behaviour guidelines. 10.1136/bjsports-2020-103604
    Reallocating sedentary time to moderate-to-vigorous physical activity but not to light-intensity physical activity is effective to reduce adiposity among youths: a systematic review and meta-analysis. García-Hermoso A,Saavedra J M,Ramírez-Vélez R,Ekelund U,Del Pozo-Cruz B Obesity reviews : an official journal of the International Association for the Study of Obesity The aim of the study was to summarize the evidence of the effects of reallocating time spent in sedentary behaviours in different activity intensities on youth's adiposity. Five databases were searched. Studies that reported the effects of replacing sedentary behaviour with light-intensity physical activity (LIPA) and/or moderate-to-vigorous physical activity (MVPA) on at least one adiposity parameter. The estimated regression coefficients (β) and 95% CIs were combined and meta-analysed. Data from 7,351 youths and five studies were analysed. Pooled analysis from cross-sectional studies shows that replacing sedentary time with LIPA showed no significant associations with any adiposity-related outcomes. Replacing sedentary time with MVPA was statistically associated with total body fat percentage (β = -2.512; p = 0.003), but not with body mass index or waist circumference. In subgroup analysis, the greatest magnitude of association was observed from studies where 60 min of sedentary behaviour was reallocated to 60 min of MVPA (β = -4.535; p < 0.001). Our results highlight the importance of promoting MVPA, which may improve body composition phenotypes in young people. This information can be used to develop more effective lifestyle interventions. 10.1111/obr.12552
    Effects of Replacing Sedentary Time With Physical Activity on Mortality Among Patients With Heart Failure: National Health and Nutrition Examination Survey Follow-Up Study. Mayo Clinic proceedings A sedentary lifestyle is prevalent among patients with heart failure (HF) and is associated with poor prognosis and survival, possibly owing to the displacement of health-enhancing behaviors, such as physical activity (PA). However, there is limited evidence examining the displacement effects of reducing duration of sedentary time (ST) on clinical outcomes in patients with HF. The current study examined the theoretical effects of relocating ST with PA on all-cause and cardiovascular disease (CVD)-specific mortality risks in patients with HF. We analyzed 265 patients with HF who participated in the National Health and Nutrition Examination Survey from 2003 to 2006. Cox proportional hazards regression model was fitted to estimate mortality risks based on objectively measured ST well as time spent in light-intensity PA (LPA) and moderate- and vigorous-intensity PA (MVPA). The theoretical changes in the hazard ratio (HR) by replacing ST with LPA or MVPA were examined using isotemporal substitutional modeling. On average, patients with HF spent 70% of waking hours per day in ST (9.01 hours), followed by LPA (29%; 3.75 hours) and MVPA (1%; 0.13 hours). Ten-minute substitution of ST with LPA was associated with significantly lower all-cause and CVD-specific mortality risks (hazard ratio [HR]=0.93 for both). The mortality risks progressively decreased as more ST was relocated to LPA. The relocation effects of ST with MVPA were not statistically significant, possibly because of limited MVPA accrued in this clinical population. The current study provides empirical evidence about the potential health benefits of replacing a modest amount of ST with LPA among patients with HF. 10.1016/j.mayocp.2022.05.009
    Sleep, sedentary activity, physical activity, and cognitive function among older adults: The National Health and Nutrition Examination Survey, 2011-2014. Wei Jingkai,Hou Ruixue,Xie Liyang,Chandrasekar Eeshwar K,Lu Haidong,Wang Tiansheng,Li Changwei,Xu Hanzhang Journal of science and medicine in sport OBJECTIVES:We aimed to estimate the association of sleep, sedentary activity and physical activity with cognitive function among older adults, with consideration of the competing nature between variables of activity status. DESIGN:Cross-sectional study. METHODS:A total of 3086 older adults (60 years or older) in the 2011-2014 National Health and Nutrition Examination Survey were included. The Global Physical Activity Questionnaire was used to measure self-reported time for sedentary activity, walking/bicycling and moderate-to-vigorous physical activity (MVPA). Cognitive function was examined using the CERAD Word Learning subtest (memory), Digit Symbol Substitution Test (executive function/processing speed), and Animal Fluency Test (language). Sleep duration was obtained via interview. Isotemporal substitution models using multivariable linear regression were applied to examine the associations of replacing sleep, sedentary activity, walking/bicycling, MVPA with each other and cognitive function, stratified by sleep duration per night (≤7h, >7h). RESULTS:Among participants with sleep duration ≤7h/night, replacing 30min/day of sedentary activity with 30min/day of MVPA or 30min/day was associated with better cognition. Among participants with sleep duration >7h/night, replacing 30min/day of sleep with 30min/day of sedentary activity, walking/bicycling, or MVPA was associated with better cognition. CONCLUSIONS:Replacing sedentary activities with MVPA was associated with favorable cognitive function among older adults sleeping no longer than 7h/night, and replacing excessive sleep with sedentary or physical activities was associated with favorable cognition. Future research is expected to examine the associations of replacing different activity status on long-term cognitive outcomes in longitudinal studies. 10.1016/j.jsams.2020.09.013
    Managing free-living hyperglycemia with exercise or interrupted sitting in type 2 diabetes. Blankenship Jennifer M,Chipkin Stuart R,Freedson Patty S,Staudenmayer John,Lyden Kate,Braun Barry Journal of applied physiology (Bethesda, Md. : 1985) Breaking up sitting with light physical activity (PA) is effective in reducing hyperglycemia in the laboratory. Whether the same effects are observed in the free-living environment remains unknown. We evaluated how daily and postprandial glycemia is impacted by 20, 40, or 60 min of activity performed as either breaks from sitting after each meal (BR) or as one continuous walk after breakfast (WALK). Thirty individuals with type 2 diabetes completed three experimental conditions [BR, WALK, and control (CON)] in a randomized crossover design. Conditions were performed in a free-living environment with strict dietary control over 7 days. Participants increased PA in BR and WALK by 20, 40, or 60 min ( n = 10 in each group) and maintained habitual levels of PA during CON. A continuous glucose monitor (iPro2) and activPAL activity monitor were worn to quantify glycemic control and PA. Using linear mixed models with repeated measures, we 1) compared postprandial glucose (PPG) across conditions and 2) assessed the relationship between activity volume and glucose responses. Whereas WALK tended to shorten the daily duration of hyperglycemia compared with CON ( P = 0.0875), BR was not different from CON. BR and WALK significantly attenuated the breakfast PPG versus CON ( P ≤ 0.05), but lunch and dinner PPG were unaffected by BR and WALK. In conclusion, continuous walking was more effective than breaks from sitting in lowering daily hyperglycemia for the group, but both conditions lowered breakfast PPG. In contrast to tightly controlled laboratory studies, breaks from sitting did not lower hyperglycemia in the free-living environment. NEW & NOTEWORTHY Our "ecolabical" approach is new and noteworthy. This approach combines the external validity of the free-living environment (ecological) with the control of key confounding variables in the laboratory and allows for highly translatable findings by minimizing confounding variables. We found that both postmeal continuous walking and short breaks from sitting similarly attenuated the postprandial glucose (PPG) response to breakfast. Unlike previous laboratory studies, neither condition (walk after breakfast or postmeal breaks) significantly impacted PPG at lunch or dinner. 10.1152/japplphysiol.00389.2018
    Modeling the cardiometabolic benefits of sleep in older women: exploring the 24-hour day. Full Kelsie M,Gallo Linda C,Malhotra Atul,Bellettiere John,Kerr Jacqueline,Arredondo Elva,Stone Katie L,Zaslavsky Oleg,Lewis Cora E,Lin Xiaochen,Lacroix Andrea Z Sleep STUDY OBJECTIVES:Activities throughout the day, including sleep, sedentary behavior (SB), light-intensity physical activity (LIPA), and moderate to vigorous physical activity (MVPA) are independently associated with cardiometabolic health. Few studies have examined interrelationships between sleep and 24-hour activity and associations with cardiometabolic risk. The objective of this study is to understand how replacing time in SB, LIPA, or MVPA with sleep impacts cardiometabolic risk. METHODS:Women's Health Initiative OPACH Study participants (N = 3329; mean age = 78.5 ± 6) wore ActiGraph GT3X+ accelerometers 24 hours/7 days. Adjusted linear regression estimated the relationship between sleep duration and cardiometabolic markers. Separately for shorter (<8 hours) and longer (≥8 hours) sleepers, isotemporal substitution models estimated the cross-sectional associations with cardiometabolic markers with reallocating time in daytime activities to or from sleep. RESULTS:Longer sleep duration was associated with higher insulin, HOMA-IR, glucose, total cholesterol, and triglycerides (all p < 0.05). The associations between sleep duration and C-reactive protein, waist circumference, and body mass index (BMI) were U-shaped (both p < 0.05). For shorter sleepers, reallocating 33 minutes of MVPA to sleep was associated with higher values of insulin, HOMA-IR, glucose, triglycerides, waist circumference, and BMI (0.7%-11.5%). Replacing 91 minutes of SB time with sleep was associated with lower waist circumference and BMI (-1.3%, -1.8%). For long sleepers, shifting 91 minutes of sleep to SB was associated with higher waist circumference and BMI (1.3%, 1.4%). CONCLUSIONS:This is one of the first isotemporal analyses to include objectively measured sleep duration. Results illuminate possible cardiometabolic risks and benefits of reallocating time to or from sleep. 10.1093/sleep/zsz205
    Cross-sectional and prospective relationships of passive and mentally active sedentary behaviours and physical activity with depression - CORRIGENDUM. Hallgren Mats,Nguyen Thi-Thuy-Dung,Owen Neville,Stubbs Brendon,Vancampfort Davy,Lundin Andreas,Dunstan David,Bellocco Rino,Lagerros Ylva Trolle The British journal of psychiatry : the journal of mental science 10.1192/bjp.2019.87
    Use of time in chronic obstructive pulmonary disease: Longitudinal associations with symptoms and quality of life using a compositional analysis approach. Lewthwaite Hayley,Olds Tim,Williams Marie T,Effing Tanja W,Dumuid Dorothea PloS one BACKGROUND AND OBJECTIVES:This study explored whether, for people with chronic obstructive pulmonary disease (COPD), changes to the 24-hour composition of physical activity (PA), sedentary behaviour (SB) and sleep were associated with changes in symptoms and health-related quality of life (HRQoL); and how time re-allocations between these behaviours were associated with changes in outcomes. METHODS:This study pools data on people with COPD drawn from two previous studies: a randomised controlled trial of cognitive behavioural therapy and pulmonary rehabilitation and a usual care cohort. Participants recalled behaviours and completed symptom and HRQoL assessments at baseline (T0) and four months (T1). Linear mixed-effects models (pooled control/intervention samples) predicted changes in outcomes from T0 to T1 with a change to the 24-hour behaviour composition; compositional isotemporal substitution predicted change in outcomes when re-allocating time between behaviours. RESULTS:Valid data were obtained for 95 participants (forced expiratory volume in one second %predicted = 49.6±15.3) at T0 and T1. A change in the 24-hour behaviour composition was associated with a change in anxiety (p<0.01) and mastery (p<0.01), but not breathlessness, depression or fatigue. When modelling time re-allocation with compositional isotemporal substitution, more time re-allocated to higher intensity PA or sleep was associated with favourable changes in outcomes; re-allocating time to SB or light PA was associated with unfavourable changes in outcomes. The direction of association, however, could not be determined. CONCLUSION:To improve the overall health and wellbeing of people with COPD, intervention approaches that optimise the composition of PA, SB and sleep may be beneficial. 10.1371/journal.pone.0214058
    Mortality Risk Reductions from Substituting Screen Time by Discretionary Activities. Wijndaele Katrien,Sharp Stephen J,Wareham Nicholas J,Brage Søren Medicine and science in sports and exercise PURPOSE:Leisure screen time, including TV viewing, is associated with increased mortality risk. We estimated the all-cause mortality risk reductions associated with substituting leisure screen time with different discretionary physical activity types, and the change in mortality incidence associated with different substitution scenarios. METHODS:A total of 423,659 UK Biobank participants, without stroke, myocardial infarction, or cancer history, were followed for 7.6 (1.4) yr, median (interquartile range [IQR]). They reported leisure screen time (TV watching and home computer use) and leisure/home activities, categorized as daily life activities (walking for pleasure, light do-it-yourself [DIY], and heavy DIY) and structured exercise (strenuous sports and other exercises). Isotemporal substitution modeling in Cox regression provided hazard ratios (95% confidence intervals) for all-cause mortality when substituting screen time (30 min·d) with different discretionary activity types of the same duration. Potential impact fractions estimated the proportional change in mortality incidence associated with different substitution scenarios. RESULTS:During 3,202,105 person-years of follow-up, 8928 participants died. Each 30-min·d difference in screen time was associated with lower mortality hazard when modeling substitution of screen time by an equal amount of daily life activities (0.95, 0.94-0.97), as well as structured exercise (0.87, 0.84-0.90). Reallocations from screen time into specific activity subtypes suggested different reductions in mortality hazard: walking for pleasure (0.95, 0.92-0.98), light DIY (0.97, 0.94-1.00), heavy DIY (0.93, 0.90-0.96), strenuous sports (0.87, 0.79-0.95), and other exercises (0.88, 0.84-0.91). The lowest hazard estimates were found when modeling replacement of TV viewing. Potential impact fractions ranged from 4.3% (30-min·d substitution of screen time into light DIY) to 14.9% (TV viewing into strenuous sports). CONCLUSION:Substantial public health benefits could be gained by replacing small amounts of screen time with daily life activities and structured exercise. Daily life activities may provide feasible screen time alternatives, if structured exercise is initially too ambitious. 10.1249/MSS.0000000000001206
    The association between recreational screen time and cancer risk: findings from the UK Biobank, a large prospective cohort study. Hunter Ruth F,Murray Jennifer M,Coleman Helen G The international journal of behavioral nutrition and physical activity BACKGROUND:Evidence is suggestive of sedentary behaviour being associated with an increased risk of endometrial cancer, but the evidence base is too limited to draw any conclusions for other cancers. The aim of the study was to investigate the association between recreational screen time and site-specific cancer risk. METHODS:We analysed data from the prospective UK Biobank cohort study. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between daily recreational screen time (including television (TV) viewing time, computer use time and total screen time) and site-specific cancer risk. Partition models and isotemporal substitution models investigated the impact of substituting recreational screen time with physical activity. RESULTS:During a mean follow-up of 7.6 years, 28,992 incident cancers were identified among 470,578 adults. A 1-h increase in daily TV viewing time was associated with higher risks of oropharyngeal, oesophago-gastric and colon cancer in fully adjusted models. Participants who reported ≤1, compared with 1- ≤ 3, hours/day of TV viewing time had lower risks of lung, breast, and oesophago-gastric cancer. Findings were inconsistent for daily recreational computer use and daily total recreational screen time. The majority of observed associations were small, and were attenuated after excluding cancers diagnosed within the first two years of follow-up, except for oesophago-gastric and colon cancers (HR 1.05, 95% CI: 1.01, 1.10; and HR 1.04, 95% CI: 1.01, 1.07 per 1-h increase in daily TV viewing time, respectively). However, isotemporal substitution models showed reduced risk of some site-specific (oropharyngeal, lung, breast and colorectal) cancers when replacing 1-h/day of TV viewing with 1-h of moderate-intensity physical activity or walking. CONCLUSIONS:Our findings show that daily recreational screen time, particularly TV viewing, was associated with small increased risks of oesophago-gastric and colon cancer. Replacing 1-h/day of TV viewing with 1-h of moderate-intensity physical activity or walking was associated with lower risk of oropharyngeal, lung, breast and colorectal cancers. Further research from other large prospective cohort studies is required, while mechanistic research is warranted to enhance the biological plausibility of these findings. 10.1186/s12966-020-00997-6
    Sedentary Behavior and Diabetes Risk Among Women Over the Age of 65 Years: The OPACH Study. Diabetes care OBJECTIVE:To evaluate whether sedentary time (ST) and/or sedentary behavior patterns are related to incident diabetes in the U.S.'s oldest age-groups. RESEARCH DESIGN AND METHODS:Women without physician-diagnosed diabetes ( = 4,839, mean ± SD age = 79 ± 7 years) wore accelerometers for ≥4 days and were followed up to 6 years for self-reported newly diagnosed diabetes requiring treatment with medications. Hazard ratios (HRs) for incident diabetes were estimated across quartiles of accelerometer-measured ST and mean bout duration with use of Cox proportional hazards models. We conducted isotemporal substitution analyses using Cox regression and tested associations with risk for diabetes after statistically replacing ST with light physical activity (PA) or moderate-to-vigorous PA (MVPA) and after replacing light PA with MVPA. RESULTS:During 20,949 person-years, 342 diabetes cases were identified. Women in ST quartile (Q)2, Q3, and Q4 (vs. Q1) had incident diabetes HR 1.20 (95% CI 0.87-1.65), 1.33 (0.97-1.82), and 1.21 (0.86-1.70); = 0.04. Respective HRs following additional adjustment for BMI and MVPA were 1.04 (95% CI 0.74-1.47), 1.04 (0.72-1.50), and 0.85 (0.56-1.29); = 0.90. Fully adjusted isotemporal substitution results indicated that each 30 min of ST replaced with MVPA (but not light PA) was associated with 15% lower risk for diabetes (HR 0.85 [95% CI 0.75-0.96]; = 0.01); the HR for replacing 30 min of light PA with MVPA was 0.85 (95% CI 0.73-0.98); = 0.03. Mean bout duration was not associated with incident diabetes. CONCLUSIONS:Statistically replacing ST or light PA with MVPA was associated with lower diabetes risk in older women. While reducing ST is important for several health outcomes, results indicate that to reduce diabetes risk among older adults, the primary public health focus should be on increasing MVPA. 10.2337/dc20-0709
    Longitudinal association between movement behaviours and depressive symptoms among adolescents using compositional data analysis. Sampasa-Kanyinga Hugues,Colman Ian,Dumuid Dorothea,Janssen Ian,Goldfield Gary S,Wang Jian Li,Patte Karen A,Leatherdale Scott T,Chaput Jean-Philippe PloS one BACKGROUND:Research examining the associations between movement behaviours and mental health indicators within a compositional framework are sparse and limited by their cross-sectional study design. This study has three objectives. First, to describe the change in movement behaviour composition over time. Second, to explore the association between change in movement behaviour composition and change in depressive symptoms. Third, to explore how reallocations of time between movement behaviours are associated with changes in depressive symptoms. METHODS:Longitudinal data of 14,620 students in grades 9-12 (mean age: 14.9 years) attending secondary schools in Canada (Ontario, British Columbia, Alberta, Quebec) were obtained from two waves (2017/18, 2018/19) of the COMPASS study. Moderate-to-vigorous physical activity (MVPA), recreational screen time, and sleep duration were self-reported. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (Revised)-10 (CESD-R-10). Compositional data analyses using pivot coordinates and compositional isotemporal substitution for longitudinal data were used to analyse the data. Analyses accounted for school clustering, were stratified by gender and age (< or ≥ 15 years), and were adjusted for race/ethnicity, body mass index z-score, baseline movement behaviour composition, and baseline depressive symptoms. RESULTS:There were significant differences in movement behaviour composition over time across all subgroups. For example, the relative contributions of MVPA and sleep duration to the movement behaviour composition decreased over time while screen time increased among younger boys and girls and older girls. Increasing sleep duration relative to the remaining behaviours (i.e. screen time and MVPA) was associated with lower depressive symptoms among all subgroups. Increasing screen time relative to the remaining behaviours (i.e. MVPA and sleep duration) was associated with higher depressive symptoms among all subgroups. Increasing MVPA relative to the remaining behaviours (i.e. screen time and sleep duration) was associated with lower depressive symptoms in older girls only. Isotemporal substitution estimates indicated that decreasing screen time by 60 minutes/day and replacing that time with 60 minutes of additional sleep is associated with the largest change in depressive symptoms across all subgroups. CONCLUSIONS:Findings from this prospective analysis suggest that increased sleep duration and reduced screen time are important determinants of lower depressive symptoms among adolescents. 10.1371/journal.pone.0256867
    Replacing sedentary time with physical activity: a 15-year follow-up of mortality in a national cohort. Dohrn Ing-Mari,Kwak Lydia,Oja Pekka,Sjöström Michael,Hagströmer Maria Clinical epidemiology BACKGROUND:Sedentary behavior is associated with health risks in adults. The potential benefits of reducing sedentary time may be dependent not only on decrease per se, but also on the type of activity it replaces. Few longitudinal studies have investigated the effects on mortality when replacing objectively assessed sedentary time with another physical activity (PA) behavior. OBJECTIVE:To investigate the effects of replacing objectively assessed sedentary time with time in light-intensity PA or moderate-vigorous PA (MVPA) on all-cause mortality, cardiovascular disease (CVD) mortality or cancer mortality in a cohort with 15 years follow-up time. METHODS:In total, 851 women and men from the population-based Sweden Attitude Behaviour and Change study were included. Time spent sedentary, in light-intensity PA and in MVPA were assessed using an Actigraph 7164 accelerometer. Mortality data were obtained from Swedish registers. Cox proportional hazards models estimated hazard ratios (HR) of mortality with 95% confidence intervals (CI) and isotemporal substitution models were used to estimate the effect of replacing sedentary behavior with PA for the same amount of time. RESULTS:Over a follow-up of 14.2 years (SD 1.9) with 12,117 person-years at risk, 79 deaths occurred, 24 deaths from CVD, 27 from cancer, and 28 from other causes. Replacing 30 minutes/day of sedentary time with light-intensity PA was associated with significant reduction in all-cause mortality risk (HR: 0.89, 95% CI: 0.81-0.98) and CVD mortality risk (HR: 0.76, 95% CI: 0.63-0.92). Replacing 10 minutes of sedentary time with MVPA was associated with reduction in CVD mortality risk (HR: 0.62, 95% CI: 0.42-0.91). No statistically significant reductions were found for cancer mortality. CONCLUSION:This statistical modelling study suggests that replacing sedentary time with light-intensity PA could have beneficial effect on both all-cause mortality and CVD mortality. Replacing sedentary time with MVPA could reduce CVD mortality. 10.2147/CLEP.S151613
    Replacing sedentary time with physical activity and sleep: associations with quality of life in kidney cancer survivors. Tabaczynski Allyson,Courneya Kerry S,Trinh Linda Cancer causes & control : CCC PURPOSE:Kidney cancer survivors spend large quantities of time sedentary and little time physically active, which negatively impacts quality of life (QoL). This study examined (1) the association of reallocating sedentary time to sleep, light physical activity (PA), or moderate-to-vigorous PA (MVPA) on QoL in kidney cancer survivors and (2) the threshold at which results are clinically meaningful. METHODS:Kidney cancer survivors (N = 463) completed a survey including the Godin Leisure-Time Exercise Questionnaire, sitting time, sleep duration, and Functional Assessment of Cancer Therapy (FACT) scales. Isotemporal substitution analyses estimated associations of reallocating sedentary time to PA and sleep on QoL. RESULTS:Reallocating 10 min/day of sedentary time to MVPA was significantly associated with higher scores on the Trial Outcome Index-Fatigue (B = 0.60, SE = 0.25, p = 0.02), FACT-Fatigue (B = 0.71, SE = 0.32, p = 0.03), functional well-being (B = 0.18, SE = 0.08, p = 0.02), and fatigue subscales (B = 0.35, SE = 0.15, p = 0.02). Reallocating sedentary time to sleep was significantly associated with higher FACT-General (B = 0.15, SE = 0.08, p = 0.04) and functional well-being subscale (B = 0.06, SE = 0.03, p = 0.049) scores. Reallocating sedentary time to light PA was significantly associated with higher fatigue subscale scores (B = 0.46, SE = 0.23, p = 0.045). Kidney cancer survivors would need to reallocate a minimum of about 83, 200, and 65 min/day of MVPA, sleep, and light PA, respectively, for associations to be clinically meaningful. CONCLUSIONS:Reallocating sedentary time to MVPA, light PA, or sleep at higher doses is associated with better fatigue and physical aspects of QoL. Interventions should consider replacing sedentary time with MVPA or light PA in a gradual manner, and improve sleep quality for kidney cancer survivors. 10.1007/s10552-020-01308-x
    Targeting body composition in an older population: do changes in movement behaviours matter? Longitudinal analyses in the PREDIMED-Plus trial. Galmes-Panades Aina M,Konieczna Jadwiga,Varela-Mato Veronica,Abete Itziar,Babio Nancy,Fiol Miquel,Antonio de Paz José,Casas Rosa,Olbeyra Romina,Ruiz-Canela Miguel,Palau-Galindo Antoni,Castañer Olga,Martín-García Arturo,Estruch Ramón,Vidal Josep,Buil-Cosiales Pilar,Wärnberg Julia,Salas-Salvadó Jordi,Martínez J Alfredo,Romaguera Dora, BMC medicine BACKGROUND:The optimal distribution between physical activity (PA) levels and sedentary behaviour (SB) for the greatest benefits for body composition among older adults with overweight/obesity and chronic health conditions remains unclear. We aimed to determine the prospective association between changes in PA and in SB with concurrent changes in body composition and to examine whether reallocating inactive time into different physical activity levels was associated with 12-month change to body composition in older adults. METHODS:Longitudinal assessment nested in the PREDIMED-Plus trial. A subsample (n = 1564) of men and women (age 55-75 years) with overweight/obesity and metabolic syndrome from both arms of the PREDIMED-Plus trial was included in the present analysis. Participants were followed up at 6 and 12 months. Physical activity and SB were assessed using validated questionnaires. Out of 1564 participants, 388 wore an accelerometer to objectively measure inactive time and PA over a 7-day period. At each time point, participants' body composition was measured using dual-energy X-ray absorptiometry (DXA). Standard covariate-adjusted and isotemporal substitution modelling were applied to linear mixed-effects models. RESULTS:Increasing 30 min of total PA and moderate-to-vigorous physical activity (MVPA) was associated with significant reductions in body fat (β - 0.07% and - 0.08%) and visceral adipose tissue (VAT) (- 13.9 g, and - 15.6 g) at 12 months (all p values < 0.001). Reallocating 30 min of inactive time to MVPA was associated with reductions in body fat and VAT and with an increase in muscle mass and muscle-to-fat mass ratio (all p values < 0.001). CONCLUSIONS:At 12 months, increasing total PA and MVPA and reducing total SB and TV-viewing SB were associated with improved body composition in participants with overweight or obesity, and metabolic syndrome. This was also observed when substituting 30 min of inactive time with total PA, LPA and MVPA, with the greatest benefits observed with MVPA. TRIAL REGISTRATION:International Standard Randomized Controlled Trial (ISRCTN), 89898870 . Retrospectively registered on 24 July 2014. 10.1186/s12916-020-01847-9
    Substituting bouts of sedentary behavior with physical activity: adopting positive lifestyle choices in people with a history of cancer. Cancer causes & control : CCC PURPOSE:To determine in people with a history of cancer, whether substituting sitting time with other daily activities (i.e., sleeping, walking, moderate and vigorous physical activity) was associated with changes in waist circumference (WC), an important surrogate marker of cardiometabolic risk. METHODS:Cross-sectional analyses from the Atlantic Partnership for Tomorrow's Health (Atlantic PATH) cohort was conducted using isotemporal substitution models to explore the associations of substituting sedentary time, physical activity behavior (International Physical Activity Questionnaire), or sleep (Pittsburgh Sleep Quality Index) with changes in WC. Analyses were conducted using sex-specific WC classifications. RESULTS:In 3,684 people with a history of cancer [mean age (SD) 58.2 (7.3) years; BMI 28.9 (5.2) kg m; 71% female], reallocating 10 min of sleep or sedentary time for 10 min of walking was associated with lower WC in women (p < 0.01). In men, PA intensity appeared to be more strongly associated with a reduced WC. Replacing 10 min of sedentary time with 10 min of moderate or vigorous PA and replacing 10 min of sleep with moderate PA were associated with a significantly reduced WC (p < 0.001). The largest effect was when 10 min of moderate PA was replaced with vigorous PA, a reduction in WC (p < 0.01) was evident. CONCLUSION:For people with a history of cancer, adopting small but positive changes in lifestyle behaviors could help reduce WC and potentially offset negative health-related outcomes associated with higher WC. Further research is required to examine whether such an intervention may be acceptable and manageable among this population. 10.1007/s10552-022-01592-9
    Increasing light physical activity helps to maintain cognitive function among the community-dwelling oldest old population: a cross-sectional study using actigraph from the Arakawa 85+ study. Suzuki Kouta,Niimura Hidehito,Kida Hisashi,Eguchi Yoko,Kitashima Chiho,Takayama Midori,Mimura Masaru Geriatrics & gerontology international AIM:To investigate the influence of replacing sedentary time with physical activity on cognitive function using an isotemporal substitution model in a population of community-dwelling oldest old. METHODS:This cross-sectional study included residents of the Arakawa ward, Tokyo, who were part of a prospective cohort from the Arakawa 85+ study. We measured physical activity in 136 participants using a triaxial actigraph. Cognitive function was measured using the Addenbrooke's Cognitive Examination-III and participants were divided into a "cognitive decline group" (Addenbrooke's Cognitive Examination-III ≤88) and "cognitive maintain group" (Addenbrooke's Cognitive Examination-III ≥89). Physical activity was divided into three categories: sedentary behavior (≤1.5 metabolic equivalents), light physical activity (>1.5 to <3.0 metabolic equivalents), and moderate-to-vigorous physical activity (≥3 metabolic equivalents). Using an isotemporal substitution approach, we applied multiple logistic regression analysis to demonstrate the association between cognitive function and replacing 30 min/day of sedentary behavior with an equal period of light physical activity. Covariates included age, education and the Center for Epidemiologic Studies Depression Scale. RESULTS:Our findings showed that in men, replacing 30 min of sedentary behavior per day with light physical activity was associated with a 1.47-fold increase in the odds of maintaining cognitive function. An association between physical activity and cognitive function was not observed in female participants. CONCLUSIONS:Our results indicate that substituting sedentary behavior with light physical activity could be helpful in maintaining cognitive function in community-dwelling oldest old men. These results highlight the importance of behavioral changes to promote cognition. Geriatr Gerontol Int 2020; 20: 773-778. 10.1111/ggi.13967
    24-hour movement behaviour and executive function in preschoolers: A compositional and isotemporal reallocation analysis. Bezerra Thaynã Alves,Clark Cain Craig Truman,Souza Filho Anastácio Neco De,Fortes Leonardo De Souza,Mota Jorge Augusto Pinto Silva,Duncan Michael Joseph,Martins Clarice Maria De Lucena European journal of sport science Adherence to healthy behaviours promotes several health benefits in preschool children, including executive function (EF). Recently, the predictive power of the 24-hour movement behaviour (24 h MB) composition on health outcomes has been evidenced; however, its relationship with EF in preschoolers is unknown. Thus, the present study had two objectives: (1) to analyse the associations between the 24 h MB composition and EF of preschoolers; and (2) to investigate the theoretical changes in EF when time in different movement behaviours is reallocated. This cross-sectional study was carried out with 123 preschoolers (3-5 years old) of low socioeconomic status. Physical activity (PA) and sedentary behaviour were assessed using an accelerometer for 7 days, sleep time was obtained through interviews with parents, and EF was measured using the Early Tool Box battery. To verify the association between 24 h MB and EF, compositional data analysis was used, and for time reallocation, compositional isotemporal substitution analysis was utilized. It was observed that the 24 h MB composition was positively associated with EF ( < .0001; ² = 0.34), and that reallocating 5, 10, 15 or 20 min of the time spent on sleep and light PA to moderate-to-vigorous PA, respectively, was associated with significant improvements in EF ( < .05). These findings provide hitherto unseen insight into the relationship between 24 h MB and EF in preschool children, and warrants consideration for researchers and practitioners seeking to improve EF and PA in preschool children. 10.1080/17461391.2020.1795274
    Isotemporal Substitution as the Gold Standard Model for Physical Activity Epidemiology: Why It Is the Most Appropriate for Activity Time Research. Mekary Rania A,Ding Eric L International journal of environmental research and public health Isotemporal substitution model was first developed in 2009 [...]. 10.3390/ijerph16050797
    Isotemporal substitution analysis for physical activity, television watching, and risk of depression. Mekary Rania A,Lucas Michel,Pan An,Okereke Olivia I,Willett Walter C,Hu Frank B,Ding Eric L American journal of epidemiology The isotemporal substitution model (ISM) was previously developed as a methodology to study the time-substitution effects of 1 type of activity for another in a data setting with continuous outcomes. To demonstrate the application of ISM with a dichotomous outcome, we prospectively examined the associations of different activities with various activity displacements with depression risk among 32,900 US women from the Nurses' Health Study who were free from depressive symptoms at baseline (in 1996). During a 10-year follow-up, 5,730 incident depression cases were documented. Results from the ISMs indicated that for each physical activity, differences in magnitude of effects of each activity type were observed, dependent on the activity being displaced/substituted. Notably, an isotemporal substitution gradient was found for television watching, in which its association with depression risk varied by its substitution for slow-, average-, or brisk-paced walking in a gradient toward high depression risk when television watching replaced a faster walking pace (relative risk = 1.18, 95% confidence interval: 1.05, 1.31). Conversely, no association with depression was found for replacement of television watching with 60 minutes/day of slow walking, whereas a lower depression risk (relative risk = 0.85, 95% confidence interval: 0.76, 0.95) was found when 60 minutes/day of brisk walking replaced 60 minutes/day of television watching. Thus, the ISM could offer a more meaningful alternative to the standard nonsubstitution models to support public health recommendations. 10.1093/aje/kws590
    Association between Reallocation Behaviors and Subjective Health and Stress in South Korean Adults: An Isotemporal Substitution Model. Park Saengryeol,Park So-Youn,Oh Gapjin,Yoon Eun Jung,Oh In-Hwan International journal of environmental research and public health This study used an isotemporal substitution (IS) model to determine the potential reallocation effects of sedentary behavior (SB) and physical activity (PA) on subjective health and stress in South Koreans with data from the Sixth Korean National Health and Nutrition Examination Survey 2015. The analysis included 791 participants whose accelerometer-measured PA was available, divided into three age groups (young adults = 151; mid-age adults = 334; older adults = 306). We adopted SB, light PA (LPA), and moderate-to-vigorous PA (MVPA) to determine how time was allocated to each activity level, then examined the effects of reallocation on subjective health and stress across age groups. The analyses were performed in three steps: single-activity, partition, and IS model. An additional ANCOVA was conducted on statistically significant outcomes (i.e., subjective health of young and older adults). We found that among young adults, reallocating 30 min/week of SB to LPA and to MVPA was linked to high levels of subjective health. In older adults, reallocating 30 min/week of SB and LPA to MVPA was associated with high subjective health. However, this relationship was not observed in mid-age adults. None of the age groups showed a relationship between any activity reallocation and stress. Our findings provide the first insight on the development of interventions aimed at promoting active, healthier lifestyles on the basis of behavior reallocation in South Koreans. 10.3390/ijerph17072488
    Replacement of Sedentary Behavior by Various Daily-Life Physical Activities and Structured Exercises: Genetic Risk and Incident Type 2 Diabetes. Li Xiang,Zhou Tao,Ma Hao,Liang Zhaoxia,Fonseca Vivian A,Qi Lu Diabetes care OBJECTIVE:To prospectively analyze the association of sedentary behavior time with type 2 diabetes (T2D) risk and perform the isotemporal substitution analyses to estimate the effect of substitution of sedentary behaviors by equal time of different types of daily-life physical activities and structured exercise. We also examined modifications by the genetic predisposition to T2D. RESEARCH DESIGN AND METHODS:We included 475,502 participants free of T2D in the UK Biobank. Sedentary time was quantified by summing up the time spent on television watching, computer use, and driving. RESULTS:During a median follow-up of 11 years, we documented 18,169 incident T2D cases. In comparison of the extreme categories (≥6 vs. <2 h/day), the hazard ratio for T2D was 1.58 (95% CI 1.47, 1.71) after adjustment for age, race, sex, lifestyle factors, and other covariates. Replacing 30 min of sedentary behavior per day with an equal amount of time of different types of daily-life activities and structured exercise was significantly associated with a 6-31% risk reduction of T2D, with strenuous sports showing the strongest (31%, 95% CI 24, 37) benefit. Moreover, we found a significant interaction between sedentary behavior and genetic predisposition for the risk of T2D ( = 0.0008). The association was more profound among participants with a lower genetic risk of T2D. CONCLUSIONS:Our study indicates that sedentary behavior time is associated with an increased risk of T2D; replacing sedentary behavior with a short duration (30 min/day) of daily-life physical activities or structured exercise is related to a significant reduction in T2D risk. Furthermore, such association was stronger among those with a lower genetic risk of T2D. 10.2337/dc21-0455