Reducing office workers' sitting time: rationale and study design for the Stand Up Victoria cluster randomized trial

Background: Excessive time spent in sedentary behaviours (sitting or lying with low energy expenditure) is associated with an increased risk for type 2 diabetes, cardiovascular disease and some cancers. Desk-based office workers typically accumulate high amounts of daily sitting time, often in prolonged unbroken bouts. The Stand Up Victoria study aims to determine whether a 3-month multi-component intervention in the office setting reduces workplace sitting, particularly prolonged, unbroken sitting time, and results in improvements in cardio-metabolic biomarkers and work-related outcomes, compared to usual practice

The epidemiology of muscle-strengthening exercise in Europe: a 28-country comparison including 280,605 adults

Objective: Muscle-strengthening exercise (use of weight machines, free weights, push-ups, sit-ups), has multiple independent health benefits, and is a component of the Global physical activity guidelines. However, there is currently a lack of multi-country muscle-strengthening exercise prevalence studies. This study describes the prevalence and correlates of muscle-strengthening exercise across multiple European countries. Methods: Data were drawn from the European Health Interview Survey Wave 2 (2013-14), which included nationally representative samples (n = 3,774-24,016) from 28 European countries. Muscle-strengthening exercise was assessed using the European Health Interview Survey Physical Activity Questionnaire. Population-weighted proportions were calculated for (1) 'insufficient' (0-1 days/week) or (2) 'sufficient' muscle-strengthening exercise (>= 2 days/week). Prevalence ratios were calculated using multivariate Poisson regression for those reporting sufficient muscle-strengthening by country and by sociodemographic/lifestyle characteristics (sex, age, education, income, self-rated health etc.). Results: Data were available for 280,605 European adults aged >= 18 years. Overall, 17.3% (95% CI = 17.1%-17.5%) reported sufficient muscle-strengthening exercise (>= 2 days/week). Muscle-strengthening exercise was geographically patterned with the lowest prevalence reported in South-eastern European countries (Romania, Malta and Cyprus: range: 0.7%-7.4%), and the highest prevalence in the Nordic countries (Iceland, Sweden, and Denmark: range: 34.1%-51.6%). Older age, insufficient aerobic activity, poorer self-rated health, lower income/education, being female, and being overweight/obese were significantly associated with lower likelihood of reporting sufficient muscle-strengthening exercise, independently of other characteristics. Conclusions: Most European adults do not report sufficient muscle-strengthening exercise, and prevalence estimates varied considerably across countries. Low participation in muscle-strengthening exercise is widespread across Europe, and warrants public health attention

Equity of a government subsidised exercise referral scheme: a population study

Background: Health inequities could increase if utilisation of physical activity interventions is lower among socioeconomically disadvantaged groups. We examined associations between area level socioeconomic disadvantage and utilisation of Australian government-subsidised, general practitioner (GP)-referred, accredited exercise physiologist (AEPs) services. Methods: We conducted a cross-sectional analysis of Australian Medical Benefits Scheme (MBS) data (N=228,771 AEP services) for the 2015–2016 financial year and aggregated publicly available data from several sources. Spearman's correlations examined associations between utilisation of AEP services and arealevel socioeconomic disadvantage, indicated by Index of Relative Socioeconomic Disadvantage (IRSD) decile scores. Lower IRSD scores indicate greater levels of socioeconomic disadvantage. Results: Significant correlations between IRSD score and study variables were as follows: Out-of-pocket expenses/service (rs=0.52); number of patients/AEP provider (rs=−0.42); number of patients/1000 population (rs=−0.24); AEP services/1000 population (rs=−0.18); average services/patient (rs=0.24); and AEP provider/1000 population (rs=0.14). Conclusion: Patients living in areas of greater disadvantage utilised government-subsidised, GP-referred AEP services at a higher rate and paid lower out-of-pocket fees than those living in more affluent areas. Thus, AEP services are equitably distributed, from a utilisation perspective, and acceptable to patients living in areas of disadvantage. However, the higher caseloads and lower fees that characterise AEP services in areas of greater disadvantage may result in shorter consultation times. Further research on exercise referral schemes is warranted, particularly whether socioeconomic disadvantage is associated with adherence to exercise sessions and health outcomes

Sources of practice knowledge among Australian fitness trainers

Few studies have examined the sources of practice knowledge fitness trainers use to inform their training methods and update knowledge. This study aims to describe sources of practice knowledge among Australian fitness trainers. In July 2014, 9100 Australian fitness trainers were invited to complete an online survey. Respondents reported the frequency of use of eight sources of practice knowledge (e.g. fitness magazines, academic texts). In a separate survey, exercise science experts (n = 27) ranked each source as either (1) ‘high-quality’ or (2) ‘low-quality’. Proportions of users of ‘high-quality’ sources were calculated across demographic (age, sex) and fitness industry-related characteristics (qualification, setting, role). A multivariate logistic regression analysis assessed the odds of being classified as a user of high-quality sources, adjusting for demographic and fitness industry-related factors. Out of 1185 fitness trainers (response rate = 13.0%), aged 17–72 years, 47.6% (95% CI, 44.7–50.4%) were classified as frequent users of high-quality sources of practice knowledge. In the adjusted analysis, compared to trainers aged 17–26 years, those aged ≥61 years (OR, 2.15; 95% CI, 1.05–4.38) and 40–50 years (OR, 1.54; 95% CI, 1.02–2.31) were more likely to be classified as a user of high-quality sources. When compared to trainers working in large centres, those working in outdoor settings (OR, 1.81; 95% CI, 1.23–2.65) and medium centres (OR, 1.59; 95% CI, 1.12–2.29) were more likely to be classified as users of high-quality sources. Our findings suggest that efforts should be made to improve the quality of knowledge acquisition among Australian fitness trainers

Muscle-strengthening exercise among 397,423 U.S. adults: prevalence, correlates, and associations with health conditions

INTRODUCTION: Although muscle-strengthening exercise has multiple independent health benefits, little is known about muscle-strengthening exercise participation and associations with adverse health conditions among U.S. adults. METHODS: In 2017, data were analyzed from the U.S. 2015 Behavioral Risk Factor Surveillance System. During telephone surveys, respondents reported how many times during the past week they engaged in muscle-strengthening exercise. Weighted weekly muscle-strengthening exercise frequencies were calculated for the total sample and across sociodemographic and lifestyle characteristics. A multivariable logistic regression assessed the odds of having self-reported adverse health conditions (e.g., diabetes, coronary heart disease) according to weekly muscle-strengthening exercise frequency. RESULTS: Data were available on 397,423 adults (aged 18-80 years). Overall, 30.2% (95% CI=29.9, 30.5) met the muscle-strengthening exercise recommendations (two or more times/week) and 57.8% (95% CI=57.5, 58.2) reported no muscle-strengthening exercise. Older age, insufficient aerobic activity, lower income, lower education, poorer self-rated health, being female, and being overweight/obese were significantly associated with lower odds of meeting the muscle-strengthening exercise recommendations independently of other characteristics. After adjusting for confounders (e.g., age, sex, income, smoking, aerobic activity), when compared with those who did none, muscle-strengthening exercise was associated with lower odds for several adverse health conditions, including prevalent diabetes, cancer (non-skin), poor self-rated health, and obesity. CONCLUSIONS: Three in five U.S. adults do not engage in any muscle-strengthening exercise, despite an association for muscle-strengthening exercise with better health conditions. Future muscle-strengthening exercise promotion strategies should target older adults, females, those with low education/income, and those with a poor health status

Feasibility for the use of a standardized fitness testing protocol among Australian fitness industry professionals

Purpose: There is currently no standardized testing protocol for assessing clients’ fitness/health within the Australian fitness industry. This study examined the perceptions of the feasibility of using a standardized testing protocol among Australian fitness industry professionals. Method: In 2014, 1,206 registered fitness industry professionals (aged 17–69 years) completed an online survey. Perceived feasibility for using a standardized testing protocol was assessed based on responses to 6 items. Respondents were classified as having a high level of perceived feasibility if they reported all 6 items to be 'definitely feasible'. A multivariate logistic regression analysis, adjusting for demographic and fitness industry-related factors (e.g., qualification/years of experience), assessed the likelihood of having a high level of perceived feasibility. Results: Overall, 25.5% (95% CI [23.1%, 28.0%]) of the sample perceived the use of a standardized testing protocol as highly feasible. Items ranked most often as 'definitely feasible' were 'undertaking training to use the protocol' (55%) and 'conducting follow-up testing every 6 to 12 weeks' (52%). After adjustment for the effect of confounding factors, casually employed professionals (OR = 0.63; 95% CI [0.45, 0.90]) and group instructors (OR = 0.58; 95% CI [0.41, 0.82]) were less likely to perceive standardized testing protocols as highly feasible. Conclusions: Among a large sample of Australian fitness industry professionals, slightly more than a quarter perceived using a standardized testing protocol to be highly feasible. Group instructors and casual employees perceived lower feasibility. Further research should determine the barriers to implementing a standardized testing protocol across the fitness industry

Effectiveness of interventions for reducing non-occupational sedentary behaviour in adults and older adults: a systematic review and meta-analysis

BACKGROUND: No systematic reviews of the effectiveness of interventions for reducing non-occupational sedentary behaviour are available. Therefore, the aim of this systematic review was to assess the effectiveness of interventions for reducing non-occupational sedentary behaviour in adults and older adults. METHODS: An electronic search of nine databases was performed. Randomised controlled trials (RCT) and cluster RCTs among adults testing the effectiveness of interventions aimed to reduce non-occupational sedentary behaviour were considered for inclusion. Two review authors independently screened studies for eligibility, completed data extraction and assessed the risk of bias. RESULTS: Nineteen studies that evaluated multicomponent lifestyle interventions, counselling or education, television (TV) control devices and workplace interventions were included. Evidence from the meta-analyses suggested that interventions can reduce leisure sitting time in adults in the medium term (-30 min/day; 95% CI -58 to -2), and TV viewing in the short term (-61 min/day; 95% CI -79 to -43) and medium term (-11 min/day; 95% CI -20 to -2). No significant pooled effects were found for transport sitting time, leisure-time computer use and longer term outcomes. No evidence was available on the effectiveness of interventions for reducing non-occupational sedentary time in older adults. CONCLUSIONS: The findings of this systematic review suggest the interventions may be effective in reducing non-occupational sedentary behaviour in the short to medium term in adults. However, no significant effect was found on longer term outcomes. The quality of evidence was, however, low to very low. No evidence was available on the effectiveness of non-occupational interventions on reducing sedentary time in older adults. Further high-quality research with larger samples is warranted