Sitting too much: a hierarchy of socio-demographic correlates

Too much sitting (extended sedentary time) is recognized as a public health concern in Europe and beyond. Time spent sedentary is influenced and conditioned by clusters of individual-level and contextual (upstream) factors. Identifying population subgroups that sit too much could help to develop targeted interventions to reduce sedentary time. We explored the relative importance of socio-demographic correlates of sedentary time in adults across Europe. We used data from 26,617 adults who participated in the 2013 Special Eurobarometer 412 "Sport and physical activity". Participants from all 28 EU Member States were randomly selected and interviewed face-to-face. Self-reported sedentary time was dichotomized into sitting less or >7.5h/day. A Chi-squared Automatic Interaction Detection (CHAID) algorithm was used to create a tree that hierarchically partitions the data on the basis of the independent variables (i.e., socio-demographic factors) into homogeneous (sub)groups with regard to sedentary time. This allows for the tentative identification of population segments at risk for unhealthy sedentary behaviour. Overall, 18.5% of the respondents reported sitting >7.5h/day. Occupation was the primary discriminator. The subgroup most likely to engage in extensive sitting were higher educated, had white-collar jobs, reported no difficulties with paying bills, and used the internet frequently. Clear socio-demographic profiles were identified for adults across Europe who engage in extended sedentary time. Furthermore, physically active participants were consistently less likely to engage in longer daily sitting times. In general, those with more indicators of higher wealth were more likely to spend more time sitting

Educational differences in the validity of self-reported physical activity

BACKGROUND: The assessment of physical activity for surveillance or population based studies is usually done with self-report questionnaires. However, bias in self-reported physical activity may be greater in lower educated than in higher educated populations. The aim of the present study is to describe educational differences in the validity of self-reported physical activity. METHODS: We included 196 healthy adults (age 57 ± 15.4, of whom 17 % low, 24 % medium and 59 % high educated). Criterion validity of an adapted International Physical Activity Questionnaire was assessed against the ActiGraph GT3X+ accelerometer. RESULTS: While criterion validity of self-reported physical activity was low to moderate in the total sample (Spearman rho ranged from 0.16 to 0.27, depending on the variables used), the validity in lower educated respondents was poor (-0.07 to 0.05). CONCLUSIONS: The results confirm the hypothesis that self-report physical activity questionnaires are less valid in lower educated populations

European Sitting Championship: Prevalence and Correlates of Self-Reported Sitting Time in the 28 European Union Member States

Objective: Sedentary behaviour is increasingly recognized as an important health risk, but comparable data across Europe are scarce. The objective of this study was to explore the prevalence and correlates of self-reported sitting time in adults across and within the 28 European Union Member States. Methods: This study reports data from the Special Eurobarometer 412. In 2013, 27,919 randomly selected Europeans (approximately 1000 per Member State) were interviewed face-to-face. Sitting time on a usual day was self-reported and dichotomised into sitting less- and more than 7.5 hours per day. Uni- and multivariate odds ratios of sitting more than 7.5 hours per day were assessed by country and socio-demographic variables using binary logistic regression analyses. The analyses were stratified by country to study the socio-demographic correlates of sitting time within the different countries. Results: A total of 26,617 respondents were included in the analyses. Median sitting time was five hours per day. Across Europe, 18.5 percent of the respondents reported to sit more than 7.5 hours per day, with substantial variation between countries (ranging from 8.9 to 32.1 percent). In general, northern European countries reported more sitting than countries in the south of Europe. ‘Current occupation’ and ‘age when stopped education’ were found to be the strongest correlates of sitting time, both across Europe and within most Member States. Compared to manual workers, the odds ratio of sitting more than 7.5 hours per day was 5.00 for people with white collar occupations, 3.84 for students, and 3.65 for managers. Conclusions: There is substantial variation in self-reported sitting time among European adults across countries as well as socio-demographic groups. While regular surveillance of (objectively measured) sedentary behaviour is needed, the results of this study provide entry points for developing targeted interventions aimed at highly sedentary populations, such as people with sedentary occupations

Objectively measured physical environmental neighbourhood factors are not associated with accelerometer-determined total sedentary time in adults

Background: The physical neighbourhood environment may influence adults' sedentary behaviour. Yet, most studies examining the association between the physical neighbourhood environment and sedentary behaviour rely on self-reported data of either the physical neighbourhood environment and/or sedentary behaviour. The aim of this study was to investigate the associations between objectively measured physical environmental neighbourhood factors and accelerometer-determined total sedentary time in adults. Methods: In total, 219 Dutch and 128 Belgian adults (mean age +/- SD: 55.8 +/- 15.4 years) were recruited between March and August 2014 as part of the European SPOTLIGHT project. Physical environmental neighbourhood factors, grouped into eight domains, i.e. walking, cycling, public transport, aesthetics, land use mix, grocery stores, food outlets and recreational facilities, were assessed using the SPOTLIGHT Virtual Audit Tool. Sedentary time was collected using ActiGraph GT3X+ accelerometers. General linear mixed models were conducted to examine associations between physical environmental neighbourhood factors and total sedentary time. Results: Participants were sedentary, on average, for 542.9 min/day (SD: 84.3), or 9.1 h/day. None of the examined physical environmental neighbourhood factors were significantly related to total sedentary time. Conclusions: Our findings do not support associations of objectively measured physical environmental neighbourhood factors with adults' objectively sedentary time in Dutch and Belgian adults. More research on sedentary behaviours in settings such as the home and work setting is needed to examine the influence of more specific physical environmental factors on these context-specific sedentary behaviours

Individual and environmental correlates of objectively measured sedentary time in Dutch and Belgian adults

As the detrimental health effects of sedentary behaviour are well established, insight into the individual and environmental factors that influence adults' sedentary behaviour is needed. Most studies to date rely on self-reported measures of sedentary time. Therefore, the aim of the current study was to examine individual and environmental correlates of objectively measured sedentary time in Dutch and Belgian adults. Between March and August 2014, Belgian (n = 133) and Dutch (n = 223) adults, recruited as sub-sample of the SPOTLIGHT survey, wore an ActiGraph accelerometer to provide objectively measured sedentary and moderate to vigorous physical activity time. Participants completed a questionnaire assessing sociodemographic (country of residence, age, gender and educational level), lifestyle (sleep, smoking, sugar-containing beverage consumption, alcohol intake), health (body mass index, self-rated health), work (employment status and type of work), happiness, physical environmental (owning a car, number of screens, socioeconomic status and residential density) and social environmental factors (social network, social cohesion). Univariate and multivariable regression analyses showed that Belgian participants had a lower odds of being sedentary for at least 9 hours per day compared to Dutch participants. Women, older participants and those meeting the WHO recommendation for physical activity were also less likely to sit for 9 hours or more per day. Participants doing (heavy) manual work or being in education, homemaker, unemployed had lower odds of being sedentary for at least 9 hours per day compared to participants with a sitting job. Those with a higher self-reported social network also had lower odds for sedentary time. No associations between physical and other social environmental characteristics and sedentary time were found. Our findings add to the growing evidence of factors associated with prolonged sedentary time in adults. These findings may be used to inform the development of strategies and interventions aimed at reducing sedentary time, and to identify high risk groups

Moderators and mediators of the association between the obesogenicity of neighbourhoods and weight status in Dutch adults

This study aimed to assess sociodemographic, personality, and psychological moderators, and lifestyle behavioural mediators, of the association between obesogenicity of neighbourhoods and weight status in Dutch adults. This cross-sectional study used baseline data of 150,506 adult participants of the Lifelines study. To quantify obesogenicity of Dutch neighbourhoods, the Obesogenic Built Environment CharacterisTics (OBCT) index was used, calculated for 1000 m circular buffers around participant's residencies. Z-scores of components across food and physical activity (PA) environments were averaged, and rescaled from 0 to 100. Weight status was operationalised as objectively measured waist circumference. Stratified linear regression analyses by (self-reported) sociodemographic factors, perceived stress, impulsivity, self-discipline, and deliberation were conducted when interaction terms were significant (P <. 01). Mediation by adherence to the Dutch PA guidelines and dietary behaviour was examined using the difference-in-coefficients approach. Every 10% increase in OBCT index was associated with a 0.65 (P <. 001, 95%CI [0.59, 0.71]) centimetre larger waist circumference. The association was largest for respondents who were younger, had the lowest income, the highest educational level, the least self-discipline, the highest impulsivity scores and the most perceived stress. Adherence to PA guidelines and dietary behaviour mediated 13.3% of this association; however, the difference in coefficients was not statistically significant. Our findings enable to better target lifestyle interventions to individuals most vulnerable to obesogenic environments. Furthermore, they provide guidance for policymakers and urban planners in promoting health-enhancing environments

Motives for (not) participating in a lifestyle intervention trial

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Successful behavior change in obesity interventions in adults: a systematic review of self-regulation mediators

International audienceBackground: Relapse is high in lifestyle obesity interventions involving behavior and weight change. Identifying mediators of successful outcomes in these interventions is critical to improve effectiveness and to guide approaches to obesity treatment, including resource allocation. This article reviews the most consistent self-regulation mediators of medium-and long-term weight control, physical activity, and dietary intake in clinical and community behavior change interventions targeting overweight/obese adults. Methods: A comprehensive search of peer-reviewed articles, published since 2000, was conducted on electronic databases (for example, MEDLINE) and journal reference lists. Experimental studies were eligible if they reported intervention effects on hypothesized mediators (self-regulatory and psychological mechanisms) and the association between these and the outcomes of interest (weight change, physical activity, and dietary intake). Quality and content of selected studies were analyzed and findings summarized. Studies with formal mediation analyses were reported separately. Results: Thirty-five studies were included testing 42 putative mediators. Ten studies used formal mediation analyses. Twenty-eight studies were randomized controlled trials, mainly aiming at weight loss or maintenance (n = 21). Targeted participants were obese (n = 26) or overweight individuals, aged between 25 to 44 years (n = 23), and 13 studies targeted women only. In terms of study quality, 13 trials were rated as " strong " , 15 as " moderate " , and 7 studies as " weak ". In addition, methodological quality of formal mediation analyses was " medium ". Identified mediators for medium-/long-term weight control were higher levels of autonomous motivation, self-efficacy/barriers, self-regulation skills (such as self-monitoring), flexible eating restraint, and positive body image. For physical activity, significant putative mediators were high autonomous motivation, self-efficacy, and use of self-regulation skills. For dietary intake, the evidence was much less clear, and no consistent mediators were identified. Conclusions: This is the first systematic review of mediational psychological mechanisms of successful outcomes in obesity-related lifestyle change interventions. Despite limited evidence, higher autonomous motivation, self-efficacy, and self-regulation skills emerged as the best predictors of beneficial weight and physical activity outcomes; for weight control, positive body image and flexible eating restraint may additionally improve outcomes. These variables represent possible targets for future lifestyle interventions in overweight/obese populations

Obesogenic environments: a systematic review of the association between the physical environment and adult weight status, the SPOTLIGHT project.

BACKGROUND: Understanding which physical environmental factors affect adult obesity, and how best to influence them, is important for public health and urban planning. Previous attempts to summarise the literature have not systematically assessed the methodological quality of included studies, or accounted for environmental differences between continents or the ways in which environmental characteristics were measured. METHODS: We have conducted an updated review of the scientific literature on associations of physical environmental factors with adult weight status, stratified by continent and mode of measurement, accompanied by a detailed risk-of-bias assessment. Five databases were systematically searched for studies published between 1995 and 2013. RESULTS: Two factors, urban sprawl and land use mix, were found consistently associated with weight status, although only in North America. CONCLUSIONS: With the exception of urban sprawl and land use mix in the US the results of the current review confirm that the available research does not allow robust identification of ways in which that physical environment influences adult weight status, even after taking into account methodological quality

Exploring the mediating role of energy balance-related behaviours in the association between sleep duration and obesity in European adults. The SPOTLIGHT project.

Sleep restriction is a risk factor for weight gain and obesity. Few studies have formally investigated the mediating role of energy balance-related behaviours in the sleep - obesity association. The aim of this study was to explore the mediating role of physical activity, sedentary behaviours and dietary habits in the association of sleep duration with obesity in adults in five European urban regions. Data on self-reported sleep duration, energy balance-related behaviours, height and weight and other covariates were collected between February and September 2014 from participants to the SPOTLIGHT survey (N=5900, mean age 52years). Participants were recruited from 60 urban neighbourhoods in Belgium, France, Hungary, the Netherlands and the United Kingdom. Multilevel logistic regression analyses were used to assess the associations of sleep duration, energy balance-related behaviours and obesity and mediating effects were calculated using MacKinnon's product-of-coefficients method. Results indicated that a 1h increase in sleeping time was associated with a 14% lower likelihood of being obese (OR=0.86, 95%CI=0.80; 0.93). Only work-related sedentary behaviour was identified as a statistically significant mediator in the association between sleep duration and obesity for the total sample, and youngest and oldest age group. We did not find evidence for a mediating role of dietary habits and physical activities