Duration and breaks in sedentary behaviour: Accelerometer data from 1566 community-dwelling older men (British Regional Heart Study)

Background: Sedentary behaviours are increasingly recognised as raising risk of CVD events, diabetes and mortality, independently of physical activity (PA) levels. However, little is known about patterns of sedentary behaviour in older adults. Methods: Cross sectional study of 1566/3137 (50% response) men aged 71-91 years from a UK population-based cohort study. Men wore a GT3x accelerometer over the hip for one week in 2010-11. Mean daily minutes of SB, % of day in sedentary behaviours, sedentary bouts and breaks were calculated and summarized by health and demographic characteristics. Results: 1403 ambulatory men aged 78.4 years (SD 4.6 years) with ≥600 minutes of accelerometer wear on ≥3 days had complete data on covariables. Men spent on average 618 minutes (SD=83), or 72% of their day in sedentary behaviours (<100 counts/minute). On average men accumulated 72 spells of sedentary behaviours per day, with 7 breaks in each sedentary hour. Men had on average 5.1 sedentary bouts of ≥30 minutes, which accounted for 43% of sedentary time, and 1.4 bouts of ≥60 minutes, which accounted for 19% of daily sedentary time. Men who were over 80 years old, obese, depressed and had multiple chronic conditions accumulated more sedentary time and spent more time in longer sedentary bouts. Conclusions: Older men spend nearly three quarters of their day in sedentary behaviours, mostly accumulated in short bouts, although bouts lasting ≥30 minutes accounted for nearly half of the sedentary time each day. Men with medical risk factors were more likely to also display sedentary behaviour

The role of forensic anthropological techniques in identifying America\u27s war dead from past conflicts

The Scientific Analysis Directorate of the U.S. Department of Defense\u27s (DoD) Defense POW/MIA Accounting Agency (DPAA) is a unique entity within the U.S. Government. This agency currently houses the world\u27s largest, accredited skeletal identification laboratory in the world, in terms of the size of the scientific staff, global mission, and number of annual identifications. Traditional forensic anthropology is used for the formation of a biological profile (biological sex, stature, population affinity/ancestry, and age) as well as trauma and pathologies that may be compared with historical records and personnel files. Since World War II, various scientists associated with DoD have conducted base-line research in support of the identification of U.S. war dead, including, but not limited to, histology, the use of chest radiography and clavicle comparison, and statistical models to deal with commingling issues. The primary goal of the identification process of the Scientific Analysis Directorate is to use all available historical, field, and forensic methods to establish the most robust and defendable identification as scientifically and legally possible

The Role of Forensic Anthropological Techniques in Identifying America\u27s War Dead from Past Conflicts

The Scientific Analysis Directorate of the U.S. Department of Defense\u27s (DoD) Defense POW/MIA Accounting Agency (DPAA) is a unique entity within the U.S. Government. This agency currently houses the world\u27s largest, accredited skeletal identification laboratory in the world, in terms of the size of the scientific staff, global mission, and number of annual identifications. Traditional forensic anthropology is used for the formation of a biological profile (biological sex, stature, population affinity/ancestry, and age) as well as trauma and pathologies that may be compared with historical records and personnel files. Since World War II, various scientists associated with DoD have conducted base-line research in support of the identification of U.S. war dead, including, but not limited to, histology, the use of chest radiography and clavicle comparison, and statistical models to deal with commingling issues. The primary goal of the identification process of the Scientific Analysis Directorate is to use all available historical, field, and forensic methods to establish the most robust and defendable identification as scientifically and legally possible

Revisiting the association of sedentary behavior and physical activity with all-cause mortality using a compositional approach: the Women's Health Study

This research was supported by grants from the National Institutes of Health (CA154647, CA047988, CA182913, HL043851, HL080467, and HL099355). EJS was supported by the Intramural Research Program at the National Institute on Aging. JHM was supported by a Grant from the Spanish Ministry of Education, Culture and Sport (FPU15/02645). CC-S was supported by a grant from the Spanish Ministry of Science and Innovation (FJC2018-037925-I). Additional funding was provided by the University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence; Scientific Excellence Unit on Exercise and Health (UCEES) to FBO. The funders had no role in preparing and conducting this manuscript, in interpreting and deciding to publish the results, or in drafting the manuscript. drafting this manuscript. Open Access funding provided by the National Institutes of Health (NIH).Background: While physical activity has consistently been associated with decreased mortality rates, it remains unknown if there is a single “ideal” combination of time in physical activities of different intensities and sedentary behavior (SB) associated with the lowest rate. This study examined the associations of combinations of time in moderate-to-vigorous intensity (MVPA), higher-light intensity (HLPA), lower-light intensity activities (LLPA), and SB with mortality rates in older women. Methods: This prospective cohort study included 16,676 older women from throughout the United States enrolled in the Women’s Health Study. Women wore accelerometers on their hip from 2011 to 2015 and were followed through 2017 (mean (SD) of 4.3 (1.1) years). Deaths were confirmed with medical records, death certificates, or the National Death Index. Compositional Cox regression models were used. Results: The mean (SD) age was 72 (5.7) years at accelerometer wear; 503 women died. Compared to the least active women (mean, 3 min/day MVPA, 27 min/day HLPA, 162 min/day LLPA, and 701 min/day SB): compositional models showed an inverse L-shaped dose-response association of MVPA replacing other behaviors with mortality rates mortality rates (P = .02); SB relative to LLPA, HLPA, and MVPA was directly associated with mortality rates in a curvilinear dose-response manner (P < .001); replacing 10 min of SB for MVPA (HR (95% CI) = .86 (.73–.98)) or for HLPA (HR (95% CI.94 (.88–1.00)) associated with 14 and 6% lower mortality rates, respectively; a 47% risk reduction (HR [95% CI] = .53 [.42–.64]) was observed among women meeting physical activity guidelines (mean, 36 min/day MVPA, 79 min/day HLPA, 227 min/day LLPA and 549 min/day SB); and similar mortality rate reductions of 43% (HR (95% CI) = .57 (.41–.73)) were observed with increases in HLPA and LLPA without increasing MVPA, e.g., reallocating SB to 90 min/day of HLPA plus 120 min/day of LLPA. Conclusions: There was no “ideal” combination of physical activities of different intensities and SB associated with the lowest mortality rates. Of particular relevance to older women, replacing SB with light intensity activity was associated with lower mortality rates, and “mixing and matching” times in different intensities yielded equivalent mortality risk reductions.United States Department of Health & Human Services National Institutes of Health (NIH) - USA CA154647 CA047988 CA182913 HL043851 HL080467 HL099355Intramural Research Program at the National Institute on AgingSpanish Ministry of Education, Culture and Sport FPU15/02645Spanish Government FJC2018-037925-IUniversity of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of ExcellenceScientific Excellence Unit on Exercise and Health (UCEES)United States Department of Health & Human ServicesNational Institutes of Health (NIH) - US

Do Moderate‐Intensity and Vigorous‐Intensity Physical Activities Reduce Mortality Rates to the Same Extent?

Background: Limited data exist directly comparing the relative benefits of moderate‐ and vigorous‐intensity activities with all‐cause and cardiovascular (CV) disease mortality rates when controlling for physical activity volume. Methods and Results: We followed 7979 men (Harvard Alumni Health Study, 1988–2008) and 38 671 women (Women's Health Study, 1992–2012), assessing their physical activity and health habits through repeated questionnaires. Over a mean follow‐up of 17.3 years in men and 16.4 years in women, there were 3551 deaths (1077 from CV disease) among men and 3170 deaths (620 from CV disease) among women. Those who met or exceeded an equivalent of the federal guidelines recommendation of at least 150 minutes of moderate‐intensity activity, 75 minutes of vigorous‐intensity activity, or a combination of the 2 that expended similar energy experienced significantly lower all‐cause and CV disease–related mortality rates (men, 28% to 36% and 31% to 34%, respectively; women: 38% to 55% and 22% to 44%, respectively). When comparing different combinations of moderate‐ and vigorous‐intensity activity and all‐cause mortality rates, we observed sex‐related differences. Holding constant the volume of moderate‐ to vigorous‐intensity physical activity, men experienced a modest additional benefit when expending a greater proportion of moderate‐ to vigorous‐intensity physical activity in vigorous‐intensity activities (Ptrend=0.04), but women did not (Ptrend<0.001). Moderate‐ to vigorous‐intensity physical activity composition was not associated with further cardiovascular mortality rate reductions in either men or women. Conclusions: The present data support guidelines recommending 150 minutes of moderate‐intensity activity per week, 75 minutes of vigorous‐intensity activity per week, or an equivalent combination for mortality benefits. Among men, but not women, additional modest reductions in all‐cause mortality rates are associated with a greater proportion of moderate‐ to vigorous‐intensity physical activity performed at a vigorous intensity

Using Devices to Assess Physical Activity and Sedentary Behavior in a Large Cohort Study: The Women’s Health Study

In recent years, it has become feasible to use devices for assessing physical activity and sedentary behavior among large numbers of participants in epidemiologic studies, allowing for more precise assessments of these behaviors and quantification of their associations with health outcomes. Between 2011–2015, the Women’s Health Study (WHS) used the Actigraph GT3X+ device to measure physical activity and sedentary behavior over seven days, during waking hours, among 17,708 women (Mage, 72 years) living throughout the United States. Devices were sent to and returned by participants via mail. We describe here the methods used to collect and process the accelerometer data for epidemiologic data analyses. We also provide metrics that describe the quality of the accelerometer data collected, as well as expanded findings regarding previously published associations of physical activity or sedentary behavior with all-cause mortality during an average follow-up of 2.3 years (207 deaths). The WHS is one of the earliest “next generation” epidemiologic studies of physical activity, utilizing wearable devices, in which long-term follow-up of participants for various health outcomes is anticipated. It therefore serves as a useful case study in which to discuss unique challenges and issues faced

Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis

Objective To examine the dose-response associations between accelerometer assessed total physical activity, different intensities of physical activity, and sedentary time and all cause mortality. Design Systematic review and harmonised meta-analysis. Data sources PubMed, PsycINFO, Embase, Web of Science, Sport Discus from inception to 31 July 2018. Eligibility criteria Prospective cohort studies assessing physical activity and sedentary time by accelerometry and associations with all cause mortality and reported effect estimates as hazard ratios, odds ratios, or relative risks with 95% confidence intervals. Data extraction and analysis Guidelines for meta-analyses and systematic reviews for observational studies and PRISMA guidelines were followed. Two authors independently screened the titles and abstracts. One author performed a full text review and another extracted the data. Two authors independently assessed the risk of bias. Individual level participant data were harmonised and analysed at study level. Data on physical activity were categorised by quarters at study level, and study specific associations with all cause mortality were analysed using Cox proportional hazards regression analyses. Study specific results were summarised using random effects meta-analysis. Main outcome measure All cause mortality. Results 39 studies were retrieved for full text review; 10 were eligible for inclusion, three were excluded owing to harmonisation challenges (eg, wrist placement of the accelerometer), and one study did not participate. Two additional studies with unpublished mortality data were also included. Thus, individual level data from eight studies (n=36 383; mean age 62.6 years; 72.8% women), with median follow-up of 5.8 years (range 3.0-14.5 years) and 2149 (5.9%) deaths were analysed. Any physical activity, regardless of intensity, was associated with lower risk of mortality, with a non-linear dose-response. Hazards ratios for mortality were 1.00 (referent) in the first quarter (least active), 0.48 (95% confidence interval 0.43 to 0.54) in the second quarter, 0.34 (0.26 to 0.45) in the third quarter, and 0.27 (0.23 to 0.32) in the fourth quarter (most active). Corresponding hazards ratios for light physical activity were 1.00, 0.60 (0.54 to 0.68), 0.44 (0.38 to 0.51), and 0.38 (0.28 to 0.51), and for moderate-to-vigorous physical activity were 1.00, 0.64 (0.55 to 0.74), 0.55 (0.40 to 0.74), and 0.52 (0.43 to 0.61). For sedentary time, hazards ratios were 1.00 (referent; least sedentary), 1.28 (1.09 to 1.51), 1.71 (1.36 to 2.15), and 2.63 (1.94 to 3.56). Conclusion Higher levels of total physical activity, at any intensity, and less time spent sedentary, are associated with substantially reduced risk for premature mortality, with evidence of a non-linear dose-response pattern in middle aged and older adults. Systematic review registration PROSPERO CRD42018091808

Systematic literature review of determinants of sedentary behaviour in older adults:a DEDIPAC study

BACKGROUND: Older adults are the most sedentary segment of society and high sedentary time is associated with poor health and wellbeing outcomes in this population. Identifying determinants of sedentary behaviour is a necessary step to develop interventions to reduce sedentary time. METHODS: A systematic literature review was conducted to identify factors associated with sedentary behaviour in older adults. Pubmed, Embase, CINAHL, PsycINFO and Web of Science were searched for articles published between 2000 and May 2014. The search strategy was based on four key elements: (a) sedentary behaviour and its synonyms; (b) determinants and its synonyms (e.g. correlates, factors); (c) types of sedentary behaviour (e.g. TV viewing, sitting, gaming) and (d) types of determinants (e.g. environmental, behavioural). Articles were included in the review if specific information about sedentary behaviour in older adults was reported. Studies on samples identified by disease were excluded. Study quality was rated by means of QUALSYST. The full review protocol is available from PROSPERO (PROSPERO 2014: CRD42014009823). The analysis was guided by the socio-ecological model framework. RESULTS: Twenty-two original studies were identified out of 4472 returned by the systematic search. These included 19 cross-sectional, 2 longitudinal and 1 qualitative studies, all published after 2011. Half of the studies were European. The study quality was generally high with a median of 82 % (IQR 69-96 %) using Qualsyst tool. Personal factors were the most frequently investigated with consistent positive association for age, negative for retirement, obesity and health status. Only four studies considered environmental determinants suggesting possible association with mode of transport, type of housing, cultural opportunities and neighbourhood safety and availability of places to rest. Only two studies investigated mediating factors. Very limited information was available on contexts and sub-domains of sedentary behaviours. CONCLUSION: Few studies have investigated determinants of sedentary behaviour in older adults and these have to date mostly focussed on personal factors, and qualitative studies were mostly lacking. More longitudinal studies are needed as well as inclusion of a broader range of personal and contextual potential determinants towards a systems-based approach, and future studies should be more informed by qualitative work

Objectively measured physical activity and sedentary behaviour and ankle brachial index: Cross-sectional and longitudinal associations in older men

AbstractBackgroundAssociations between bouts of physical activity (PA), sedentary behaviour (SB) and cardiovascular disease, and their mutual independence are not well defined. A low ankle brachial index (ABI ≤0.9) indicates peripheral arterial disease (PAD) and is predictive of cardiovascular events and functional impairment. We investigated the independence of PA and SB and the importance of bout duration in relation to ABI using objective measures.Methods945 men from the British Regional Heart Study, mean age 78.4 y, had concurrent measurements of ABI (Vicorder) and physical activity (Actigraph GT3X accelerometer); 427 men also had accelerometer measurements one year previously and contributed data to longitudinal analyses.Results and conclusionIn cross-sectional analyses, after adjusting for covariates each extra 10 min of moderate and vigorous PA per day was associated with an OR of 0.81 (95% CI 0.72, 0.91) for a low ABI, a stronger association than for light PA (OR 0.85, 95% CI 0.75, 0.98). Each extra 30 min of SB was associated with an OR of 1.19 (95% CI 1.07, 1.33) for a low ABI. Associations between moderate and vigorous PA and ABI persisted after adjustment for light PA or SB. Bout lengths for PA and SB were not associated with a low ABI. One year changes in PA or SB were not associated with low ABI.All physical activity and lower levels of SB, regardless of bout duration were inversely associated with ABI; more intense PA showed a stronger association. No associations between changes in PA and ABI were observed, but power may have been limited