Associations between sleep duration, sedentary time, physical activity, and health indicators among Canadian children and youth using compositional analyses

The purpose of this study was to examine the relationships between movement behaviours (sleep duration, sedentary time, physical activity) and health indicators in a representative sample of children and youth using compositional analyses. Cross-sectional findings are based on 4169 children and youth (aged 6–17 years) from cycles 1 to 3 of the Canadian Health Measures Survey. Sedentary time (SB), light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (MVPA) were accelerometer-derived. Sleep duration was subjectively measured. Body mass index z scores, waist circumference, blood pressure, behavioural strengths and difficulties, and aerobic fitness were measured in the full sample. Triglycerides, high-density lipoprotein-cholesterol, C-reactive protein, and insulin were measured in a fasting subsample. The composition of movement behaviours was entered into linear regression models via an isometric log ratio transformation and was found to be associated with all health indicators (p &lt; 0.01). Relative to other movement behaviours, time spent in SB or LPA was positively associated (p &lt; 0.04) and time spent in MVPA or sleep was negatively associated (p &lt; 0.02) with obesity risk markers. Similarly, LPA was positively associated (p &lt; 0.005) and sleep was negatively associated (p &lt; 0.03) with unfavourable behavioural strengths and difficulties scores and systolic blood pressure. Relative to other movement behaviours, time spent in SB was negatively associated (p &lt; 0.001) and time spent in MVPA (p &lt; 0.001) was positively associated with aerobic fitness. Likewise, MVPA was also negatively associated with several cardiometabolic risk markers (p &lt; 0.008). Compositional data analyses provide novel insights into collective health implications of 24-h movement behaviours and can facilitate interesting avenues for future investigations. </jats:p

Compositional analyses of the associations between sedentary time, different intensities of physical activity, and cardiometabolic biomarkers among children and youth from the United States

Introduction : Compositional data analysis is one appropriate method for co-dependent data, even when data are collected for a subdivision of the 24-hour period, such as the waking day. Objectives were to use compositional analyses to examine the combined and relative associations of sedentary time (ST), light-intensity physical activity (LPA), moderate-intensity physical activity (MPA), and vigorous-intensity physical activity (VPA) with cardiometabolic biomarkers in a representative sample of children and youth. Methods : This cross-sectional study included 2544 participants aged 6-17 years from the 2003-2006 United States National Health and Nutrition Examination Survey. ST (= 7 METs) were accelerometer-derived. Cardiometabolic biomarkers included waist circumference, body mass index (BMI) z-score, HDL-cholesterol, C-reactive protein, and blood pressure. Triglycerides, glucose, insulin, and LDL-cholesterol were measured in a fasting sub-sample of adolescents (n = 670). Compositional linear regression models were conducted. Results : The composition of ST, LPA, MPA, and VPA was significantly associated with BMI z-score, log waist circumference, systolic and diastolic blood pressure, HDL-cholesterol, and log plasma glucose (variance explained: 1-29%). Relative to the other three behaviors, VPA was negatively associated with BMI z-score (gamma VPA = -0.206, p = 0.005) and waist circumference (gamma VPA = -0.03, p = 0.001). Conversely, ST was positively associated with waist circumference (gamma ST = 0.029, p = 0.013). ST and VPA were also positively associated with diastolic blood pressure (gamma ST = 2.700, p = 0.018; gamma VPA = 1.246, p = 0.038), relative to the other behaviors, whereas negative associations were observed for LPA (gamma LPA = -2.892, p = 0.026). Finally, VPA was positively associated with HDL-cholesterol, relative to other behaviors (gamma VPA = 0.058, p<0.001). Conclusions : The ST and physical activity composition appears important for many aspects of cardiometabolic health in children and youth. Compositions with more time in higher-intensity activities may be better for some aspects of cardiometabolic health

Childhood obesity and device-measured sedentary behaviour: an instrumental variable analysis of 3,864 mother–offspring pairs

Objective: Intergenerational data on mother–offspring pairs were utilized in an instrumental variable analysis to examine the longitudinal association between BMI and sedentary behavior. Methods: The sample included 3,864 mother–offspring pairs from the 1970 British Cohort Study. Height and weight were recorded in mothers (age 31 [5.4] years) and offspring (age 10 years) and repeated in offspring during adulthood. Offspring provided objective data on sedentary behavior (7‐day thigh‐worn activPAL) in adulthood at age 46 to 47 years. Results: Maternal BMI, the instrumental variable, was associated with offspring BMI at age 10 (change per kg/m2, β = 0.11; 95% CI: 0.09 to 0.12), satisfying a key assumption of instrumental variable analyses. Offspring (change per kg/m2, β = 0.010; 95% CI: −0.02 to 0.03 h/d) and maternal BMI (β = 0.017; 95% CI: 0.001 to 0.03 h/d) was related to offspring sedentary time, suggestive of a causal impact of BMI on sedentary behavior (two‐stage least squares analysis, β = 0.18 [SE 0.08], P = 0.015). For moderate‐vigorous physical activity, there were associations with offspring BMI (β = −0.010; 95% CI: −0.017 to −0.004) and maternal BMI (β = −0.007; 95% CI: −0.010 to −0.003), with evidence for causality (two‐stage least squares analysis, β = −0.060 [SE 0.02], P = 0.001). Conclusions: There is strong evidence for a causal pathway linking childhood obesity to greater sedentary behavior

Planning, implementing and governing systems-based co-creation: the DISCOVER framework

Background: Increasingly, public health faces challenges requiring complex, multifaceted and multi-sectoral responses. This calls for systems-based approaches that facilitate the kind of collective and collaborative thinking and working required to address complexity. While the literature on systems thinking, system dynamics and the associated methodologies is extensive, there remains little clear guidance on how to plan, govern and implement participatory systems approaches within a co-creation process. Methods: We used a three-step process to develop DISCOVER, a framework for implementing, and governing systems-based co-creation: Stage 1: We conducted a literature analysis of key texts to identify well-documented methods and phases for co-creation using a systems approach, as well as areas where gaps existed.Stage 2: We looked for the most appropriate methods and approaches to fill the gaps in the knowledge production chain.Stage 3: We developed the framework, identifying how the different tools and approaches fit together end-to-end, from sampling and recruiting participants all the way through to responding with an action plan. Results: We devised DISCOVER to help guide researchers and stakeholders to collectively respond to complex social, health and wider problems. DISCOVER is a strategic research planning and governance framework that provides an actionable, systematic way to conceptualise complex problems and move from evidence to action, using systems approaches and co-creation. In this article, we introduce the eight-step framework and provide an illustrative case study showcasing its potential. The framework integrates complementary approaches and methods from social network analysis, systems thinking and co-creation literature. The eight steps are followed sequentially but can overlap. Conclusions: DISCOVER increases rigour and transparency in system approaches to tackling complex issues going from planning to action. It is being piloted in environmental health research but may be suitable to address other complex challenges and could be incorporated into research proposals and protocols for future projects.</p

Exploring the context of sedentary behaviour in older adults (what, where, why, when and with whom)

BACKGROUND: Older adults are the most sedentary segment of the population. Little information is available about the context of sedentary behaviour to inform guidelines and intervention. There is a dearth of information about when, where to intervene and which specific behaviours intervention should target. The aim of this exploratory study was to obtain objective information about what older adults do when sedentary, where and when they are sedentary and in what social context. METHODS: The study was a cross-sectional data collection. Older adults (Mean age = 73.25, SD ± 5.48, median = 72, IQR = 11) volunteers wore activPAL monitors and a Vicon Revue timelapse camera between 1 and 7 days. Periods of sedentary behaviour were identified using the activPAL and the context extracted from the pictures taken during these periods. Analysis of context was conducted using the Sedentary Behaviour International Taxonomy classification system. RESULTS: In total, 52 days from 36 participants were available for analysis. Participants spent 70.1 % of sedentary time at home, 56.9 % of sedentary time on their own and 46.8 % occurred in the afternoon. Seated social activities were infrequent (6.9 % of sedentary bouts) but prolonged (18 % of sedentary time). Participants appeared to frequently have vacant sitting time (41 % of non-screen sedentary time) and screen sitting was prevalent (36 % of total sedentary time). CONCLUSIONS: This study provides valuable information to inform future interventions to reduce sedentary behaviour. Interventions should consider targeting the home environment and focus on the afternoon sitting time, though this needs confirmation in a larger study. Tackling social isolation may also be a target to reduce sedentary time

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

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Associations between the composition of daily time spent in physical activity, sedentary behaviour and sleep and risk of depression: compositional data analyses of the 1970 British cohort study

Background The benefits of moderate to vigorous physical activity(MVPA) in lowering depression risk are well established, but there is mixed evidence on sleep, sedentary behaviour(SB), and light-intensity physical activity(LIPA). These behaviours are often considered in isolation, neglecting their behavioural and biological interdependences. We investigated how time spent in one behaviour relative to others was associated with depression risk. Methods We included 4738 individuals from the 1970 British Cohort study (age 46 wave). Depression status was ascertained using self-reported doctor visits and prescribed anti-depressant use. MVPA, LIPA, SB and sleep were ascertained using thigh-worn accelerometers worn consecutively for 7 days. Compositional logistic regression was used to examine associations between different compositions of time spent in movement behaviours and depression. Results More time spent in MVPA, relative to SB, sleep or LIPA, was associated with a lower risk of depression. When modelling reallocation of time (e.g. replacing time in one behaviour with another), replacing sleep, SB or LIPA with MVPA time was strongly associated with lower depression risk. Reallocating time between SB, sleep or LIPA had minimal to no effect. Limitations Data was cross-sectional, therefore causality cannot be inferred. Accelerometers do not capture SB context (e.g. TV watching, reading) nor separate biological sleep from time spent in bed. Conclusions Displacing any behaviour with MVPA was associated with a lower risk of depression. This study provides promising support that increasing MVPA, even in small doses, can have a positive impact on prevention, mitigation and treatment of depression

Reliability and validity of three questionnaires measuring context-specific sedentary behaviour and associated correlates in adolescents, adults and older adults

BACKGROUND: Reliable and valid measures of total sedentary time, context-specific sedentary behaviour (SB) and its potential correlates are useful for the development of future interventions. The purpose was to examine test-retest reliability and criterion validity of three newly developed questionnaires on total sedentary time, context-specific SB and its potential correlates in adolescents, adults and older adults. METHODS: Reliability and validity was tested in six different samples of Flemish (Belgium) residents. For the reliability study, 20 adolescents, 22 adults and 20 older adults filled out the age-specific SB questionnaire twice. Test-retest reliability was analysed using Kappa coefficients, Intraclass Correlation Coefficients and/or percentage agreement, separately for the three age groups. For the validity study, data were retrieved from 62 adolescents, 33 adults and 33 older adults, with activPAL as criterion measure. Spearman correlations and Bland-Altman plots (or non-parametric approach) were used to analyse criterion validity, separately for the three age groups and for weekday, weekend day and average day. RESULTS: The test-retest reliability for self-reported total sedentary time indicated following values: ICC = 0.37-0.67 in adolescents; ICC = 0.73-0.77 in adults; ICC = 0.68-0.80 in older adults. Item-specific reliability results (e.g. context-specific SB and its potential correlates) showed good-to-excellent reliability in 67.94%, 68.90% and 66.38% of the items in adolescents, adults and older adults respectively. All items belonging to sedentary-related equipment and simultaneous SB showed good reliability. The sections of the questionnaire with lowest reliability were: context-specific SB (adolescents), potential correlates of computer use (adults) and potential correlates of motorized transport (older adults). Spearman correlations between self-reported total sedentary time and the activPAL were different for each age group: rho = 0.02-0.42 (adolescents), rho = 0.06-0.52 (adults), rho = 0.38-0.50 (older adults). Participants over-reported total sedentary time (except for weekend day in older adults) compared to the activPAL, for weekday, weekend day and average day respectively by +57.05%, +46.29%, +53.34% in adolescents; +40.40%, +19.15%, +32.89% in adults; +10.10%, -6.24%, +4.11% in older adults. CONCLUSIONS: The questionnaires showed acceptable test-retest reliability and criterion validity. However, over-reporting of total SB was noticeable in adolescents and adults. Nevertheless, these questionnaires will be useful in getting context-specific information on SB

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

Feasibility of measuring sedentary time with thigh worn accelerometry and sociodemographic correlates: the 1970 British Cohort Study

In large scale cohort studies sedentary behaviour has been routinely measured using self-report or devices that apply count-based threshold. We employed a gold standard postural allocation technique using thigh inclination and acceleration to capture free-living sedentary behaviour . Participants (n=5,346, aged 46.8 ± 0.7 yrs) from the 1970 British Cohort study (U.K.) were fitted with a water-proofed thigh mounted accelerometer device (activPAL3 micro) worn continuously over 7 days, collected 2016 – 2018. Useable data were retrieved in 83.0% of the devices fitted, with 79.6% of the sample recording at least 6 full days of wear (at least 10 waking hours). Total daily sitting time (average 9.5±2.0 hr/d men and 9.0±2.0 hr/d women) accounted for 59.4% and 57.3% of waking hours in men and women respectively; 73.8% of the sample recorded ≥8hr/d of sitting. Sitting in prolonged bouts of more than 60 continuous minutes accounted for 25.3 % and 24.4% of total daily sitting in men and women respectively. In mutually adjusted models, male sex, underweight and obesity, education, poor self-rated health, TV-viewing time and a sitting occupation were associated with higher device measured sitting times. Thigh worn accelerometry was feasibly deployed and should be considered for larger scale national surveys