Objectively measured sedentary behavior and quality of life among survivors of early stage breast cancer.

PurposeThis study examined relationships between sedentary behavior accumulated in different bout durations and quality of life (QoL) among breast cancer survivors.MethodsPostmenopausal breast cancer survivors completed the Short Form Health Survey to assess QoL and wore an accelerometer to measure sedentary behavior and physical activity between August 2011 and May 2013.ResultsParticipants (n = 134) averaged 509.7 min/day in sedentary time with 285.2 min/day in short bouts (<20 min) and 224.5 min/day long bouts (≥20 min). Linear regression models indicated that greater total sedentary time was significantly associated with worse physical QoL (b = -0.70, p = 0.02) but not mental QoL (p = 0.92). Models that examined the accumulation of sedentary time in short bouts and long bouts together showed that time in long sedentary bouts was significantly related to physical QoL (b = -0.72, p = 0.02), while time in short bouts was not (p = 0.63). Moderate-to-vigorous intensity physical activity (MVPA) was a significant effect modifier of the relation between time spent in long sedentary bouts and physical QoL (p = 0.028) such that greater time in long bouts was associated with worse physical QoL only among women with lower levels of MVPA.ConclusionsFindings indicate that time spent in long sedentary bouts is associated with worse physical QoL among breast cancer survivors who do not engage in high levels of MVPA. Future research should examine reducing sedentary time as a potential strategy to improve physical QoL

Contrasting compositions of sitting, standing, stepping, and sleeping time: associations with glycaemic outcome by diabetes risk

BACKGROUND: Recent evidence suggests that prolonged sitting and its adverse impact on glycaemic indicators appear to be proportional to the degree of insulin resistance. To investigate this finding in a free-living context, we aimed to examine associations of device-measured 24-h time-use compositions of sitting, standing, stepping, and sleeping with fasting glucose (FPG) and 2 h post-load glucose (2hPLG) levels, and to examine separately the associations with time-use compositions among those at lower and at higher risk of developing type 2 diabetes. METHODS: Cross-sectional analyses examined thigh-worn inclinometer data (activPAL, 7 day, 24 h/day protocol) from 648 participants (aged 36-80 years) at either lower (< 39 mmol/mol; < 5.7% HbA1c) or higher (≥39 mmol/mol; ≥5.7% HbA1c) diabetes risk from the 2011-2012 Australian Diabetes, Obesity and Lifestyle study. Multiple linear regression models were used to examine associations of differing compositions with FPG and 2hPLG, with time spent in each behaviour allowed to vary up to 60 min. RESULTS: In general, the associations with the FPG within the time-use compositions were small, with statistically significant associations observed for sitting and sleeping (in the lower diabetes risk group) and standing (in higher diabetes risk group) only. For 2hPLG, statistically significant associations were observed for stepping only, with findings similar between lower (β = - 0.12 95%CI:-0.22, - 0.02) and higher (β = - 0.13 95%CI:-0.26, - 0.01) risk groups. Varying the composition had minimal impact on FPG; however 1 h less sitting time and equivalent increase in standing time was associated with attenuated FPG levels in higher risk only (Δ FPG% = - 1.5 95%CI: - 2.4, - 0.5). Large differences in 2hPLG were observed for both groups when varying the composition. One hour less sitting with equivalent increase in stepping was associated with attenuated 2hPLG, with estimations similar in lower (Δ 2hPLG% = - 3.8 95%CI: - 7.3, - 0.2) and higher (Δ 2hPLG% = - 5.0 95%CI: - 9.7, - 0.0) risk for diabetes. CONCLUSIONS: In middle-aged and older adults, glycaemic control could be improved by reducing daily sitting time and replacing it with stepping. Standing could also be beneficial for those at higher risk of developing type 2 diabetes

Associations of accelerometer-measured physical activity and physical activity-related cancer incidence in older women: results from the WHI OPACH Study

Background: We examined the associations between accelerometry-measured physical activity (PA) and incidence of 13 cancers among a cohort of postmenopausal women. Methods: In this prospective study, 6382 women wore ActiGraph GT3X+ accelerometers at the hip for up to 7 days during 2012–2013, and were followed over a median of 4.7 years for diagnosis of 13 invasive cancers. Calibrated intensity cut points were used to define minutes per day of total, light and moderate-to-vigorous PA. We used multivariable Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for tertiles, and one-standard deviation (SD) unit increments of PA exposures in relation to cancer incidence. We examined effect measure modification by age, race/ethnicity, body mass index and smoking history. Results: The highest (vs. lowest) tertiles of total, light and moderate-to-vigorous PA were associated with covariate-adjusted HRs of 0.72 (95% CI = 0.53–0.97), 0.81 (95% CI = 0.60–1.09) and 0.66 (95% CI = 0.48–0.91), respectively. In age-stratified analyses, HRs for total PA were lower among women &lt;80 years (HRper one-SD = 0.75, 95% CI = 0.63–0.90) than among women ≥80 years (HRper one-SD = 0.99, 95% CI = 0.82–1.18) (PInteraction = 0.03). Race/ethnicity, BMI and smoking did not strongly modify these associations. Conclusions: Engaging in physical activity may play a beneficial role in the prevention of certain cancers in older women

The relationship of accelerometer-assessed standing time with and without ambulation and mortality: The WHI OPACH study

Background: Self-reported time spent standing has been associated with lower risk of mortality. No previous studies have examined this association using device-measured standing. Method: This was a prospective cohort study of 5878 older (median age = 80 years), racial/ethnically diverse, community-dwelling women in the WHI Objective Physical Activity and Cardiovascular Health Study (OPACH). Women wore accelerometers for 1 week and were followed for mortality. The study applied previously validated machine learning algorithms to ActiGraph GT3X+ accelerometer data to separately measure time spent standing with and without ambulation. Cox proportional hazards models were used to estimate mortality risk adjusting for potential confounders. Effect modification by age, body mass index, moderate-to-vigorous physical activity, sedentary time, physical functioning, and race/ethnicity was evaluated. Results: There were 691 deaths during 26 649 person-years of follow-up through March 31, 2018 (mean follow-up = 4.8 years). In fully adjusted models, all-cause mortality risk was lower among those with more standing without ambulation (quartile [Q] 4 vs Q1 HR = 0.63; 95% CI = 0.49-0.81, p-trend =.003) and more standing with ambulation (Q4 vs Q1 HR = 0.50; 95% CI = 0.35-0.71, p-trend <.001). Associations of standing with ambulation and mortality were stronger among women with above-median sedentary time (HR = 0.51; 95% CI = 0.38-0.68) compared to women with below-median sedentary time (HR = 0.80; 95% CI = 0.59-1.07; p-interaction =.02). Conclusions: In this prospective study among older women, higher levels of accelerometer-measured standing were associated with lower risks of all-cause mortality. Standing is an achievable approach to interrupting prolonged sedentary time, and if not contraindicated, is a safe and feasible behavior that appears to benefit health in older ages

Association of Light Physical Activity Measured by Accelerometry and Incidence of Coronary Heart Disease and Cardiovascular Disease in Older Women

IMPORTANCE To our knowledge, no studies have examined light physical activity (PA) measured by accelerometry and heart disease in older women. OBJECTIVE To investigate whether higher levels of light PA were associated with reduced risks of coronary heart disease (CHD) or cardiovascular disease (CVD) in older women. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study of older women from baseline (March 2012 to April 2014) through February 28, 2017, for up to 4.91 years. The setting was community-dwelling participants from the Women's Health Initiative. Participants were ambulatory women with no history of myocardial infarction or stroke. EXPOSURES Data from accelerometers worn for a requested 7 days were used to measure light PA. MAIN OUTCOMES AND MEASURES Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% CIs for physician-adjudicated CHD and CVD events across light PA quartiles adjusting for possible confounders. Light PA was also analyzed as a continuous variable with and without adjustment for moderate to vigorous PA (MVPA). RESULTS Among 5861 women (mean [SD] age, 78.5 [6.7] years), 143 CHD events and 570 CVD events were observed. The HRs for CHD in the highest vs lowest quartiles of light PA were 0.42 (95% CI, 0.25-0.70; P for trend <. 001) adjusted for age and race/ethnicity and 0.58 (95% CI, 0.34-0.99; P for trend = .004) after additional adjustment for education, current smoking, alcohol consumption, physical functioning, comorbidity, and self-rated health. Corresponding HRs for CVD in the highest vs lowest quartiles of light PA were 0.63 (95% CI, 0.49-0.81; P for trend <. 001) and 0.78 (95% CI, 0.60-1.00; P for trend = .004). The HRs for a 1-hour/day increment in light PA after additional adjustment for MVPA were 0.86 (95% CI, 0.73-1.00; P for trend = .05) for CHD and 0.92 (95% CI, 0.85-0.99; P for trend = .03) for CVD. CONCLUSIONS AND RELEVANCE The present findings support the conclusion that all movement counts for the prevention of CHD and CVD in older women. Large, pragmatic randomized trials are needed to test whether increasing light PA among older women reduces cardiovascular risk.National Heart, Lung, and Blood Institute (NHLBI) [R01 HL105065]; NHLBI [T32HL079891-11]; National Institutes of Health; US Department of Health and Human Services [HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, HHSN268201600004C]Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Associations of sitting accumulation patterns with cardio-metabolic risk biomarkers in Australian adults

Backgroun

Accelerometer-Measured Sedentary Patterns are Associated with Incident Falls in Older Women

Background/Objective: Falls cause significant problems for older adults. Sedentary time is associated with lower physical function and could increase the risk for falls. Design: Prospective study. Setting: Sites across the United States. Participants: Older women (N = 5,545, mean age 79 years) from the Women's Health Initiative Objective Physical Activity and Cardiovascular Health study. Measurements: Accelerometers worn at the hip for up to 1 week collected measures of daily sedentary time and the mean sedentary bout duration, a commonly used metric for sedentary accumulation patterns. For up to 13 months after accelerometer wear, women reported daily whether they had fallen on monthly calendars. Results: In fully adjusted models, the incident rate ratios (95% confidence interval) for quartiles 1 (lowest), 2, 3, and 4 of sedentary time respectively were 1.0 (ref.), 1.07 (0.93–1.24), 1.07 (0.91–1.25), and 1.14 (0.96–1.35; P-trend =.65) and for mean sedentary bout duration was 1.0 (ref.), 1.05 (0.92–1.21), 1.02 (0.88–1.17), and 1.17 (1.01–1.37; P-trend =.01), respectively. Women with a history of two or more falls had stronger associations between sedentary time and falls incidence compared with women with a history of no or one fall (P for interaction =.046). Conclusions: Older women in the highest quartile of mean sedentary bout duration had a significantly increased risk of falling. Women with a history of frequent falling may be at higher risk for falling if they have high sedentary time. Interventions testing whether shortening total sedentary time and/or sedentary bouts lowers fall risk are needed to confirm these observational findings

Sedentary Behavior and Diabetes Risk Among Women Over the Age of 65 Years: The OPACH Study

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 (n = 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); Ptrend = 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); Ptrend = 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]; P = 0.01); the HR for replacing 30 min of light PA with MVPA was 0.85 (95% CI 0.73-0.98); P = 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

Sedentary Behavior and Cardiovascular Disease in Older Women: The OPACH Study

Background: Evidence that higher sedentary time is associated with higher risk for cardiovascular disease (CVD) is based mainly on self-reported measures. Few studies have examined whether patterns of sedentary time are associated with higher risk for CVD. Methods: Women from the OPACH Study (Objective Physical Activity and Cardiovascular Health; n=5638, aged 63-97 years, mean age 79±7 years) with no history of myocardial infarction or stroke wore accelerometers for 4 to 7 days and were followed up for up to 4.9 years for CVD events. Average daily sedentary time and mean sedentary bout duration were the exposures of interest. Cox regression models were used to estimate hazard ratios (HRs) and 95% CIs for CVD using models adjusted for covariates and subsequently adjusted for potential mediators (body mass index, diabetes mellitus, hypertension, and CVD risk biomarkers [fasting glucose, high-density lipoprotein, triglycerides, and systolic blood pressure]). Restricted cubic spline regression characterized dose-response relationships. Results: There were 545 CVD events during 19 350 person-years. With adjustment for covariates, women in the highest (≈11 h/d or more) versus the lowest (≈9 h/d or less) quartile of sedentary time had higher risk for CVD (HR, 1.62; 95% CI, 1.21-2.17; P trend 0.05, each). Women jointly classified as having both high sedentary time and long bout durations had significantly higher risk for CVD (HR, 1.34; 95% CI, 1.08-1.65) than women with low sedentary time and short bout duration. All analyses were repeated for incident coronary heart disease (myocardial infarction or CVD death), and associations were similar, with notably stronger HRs. Conclusions: Both high sedentary time and long mean bout durations were associated in a dose-response manner with increased CVD risk in older women, which suggests that efforts to reduce CVD burden might benefit from addressing either or both components of sedentary behavior

Randomised Controlled Trial of Real-Time Feedback and Brief Coaching to Reduce Indoor Smoking

Background: Previous secondhand smoke (SHS) reduction interventions have provided only delayed feedback on reported smoking behaviour, such as coaching, or presenting results from child cotinine assays or air particle counters. Design: This SHS reduction trial assigned families at random to brief coaching and continuous real-time feedback (intervention) or measurement-only (control) groups. Participants: We enrolled 298 families with a resident tobacco smoker and a child under age 14. Intervention: We installed air particle monitors in all homes. For the intervention homes, immediate light and sound feedback was contingent on elevated indoor particle levels, and up to four coaching sessions used prompts and praise contingent on smoking outdoors. Mean intervention duration was 64 days. Measures: The primary outcome was \u27particle events\u27 (PEs) which were patterns of air particle concentrations indicative of the occurrence of particle-generating behaviours such as smoking cigarettes or burning candles. Other measures included indoor air nicotine concentrations and participant reports of particle-generating behaviour. Results: PEs were significantly correlated with air nicotine levels (r=0.60) and reported indoor cigarette smoking (r=0.51). Interrupted time-series analyses showed an immediate intervention effect, with reduced PEs the day following intervention initiation. The trajectory of daily PEs over the intervention period declined significantly faster in intervention homes than in control homes. Pretest to post-test, air nicotine levels, cigarette smoking and e-cigarette use decreased more in intervention homes than in control homes. Conclusions: Results suggest that real-time particle feedback and coaching contingencies reduced PEs generated by cigarette smoking and other sources