Trends in Australian children traveling to school 1971–2003: Burning petrol or carbohydrates?

Objective. To determine how Australian children traveled to and from school between 1971 and 2003. Methods. The 1971 (n=4284), 1981 (n=4936), 1991 (n=662) and 1999–2003 (n=816) Household Travel Surveys from the New South Wales Government Department of Planning were used to determine the mode of transport kids (5–14 years) took to and from school in the area of Sydney (Australia). Results. The results showed that the percentage of children aged 5–9 that walked to school was 57.7, 44.5, 35.3 and 25.5 in 1971, 1981, 1991 and 1999–2003, respectively. The percentage of children aged 5–9 that were driven to school by car in the four surveys was 22.8, 37.3, 53.9 and 66.6, respectively. The results for children aged 10–14 were similar, walking decreased from 44.2% to 21.1% and car use increased from 12.2% to 47.8% over the study period. Similar results were found for travel from school and there were no major differences between boys and girls. Conclusion. Between 1971 and 2003, Australian children's mode of travel to and from school has markedly shifted from active (walking) to inactive (car) modes

The evolution of time use approaches for understanding activities of daily living in a public health context

This Supplement aims to raise awareness and knowledge of how time use surveys may be applied to studying health behaviours such as physical activity, sedentary behaviour, and eating. This commentary provides an overview and discussion of the papers in this Supplement about time use and health research, and considers possible future directions for the field

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

Effectiveness of interventions using self-monitoring to reduce sedentary behavior in adults : a systematic review and meta-analysis

Background: Sedentary behavior occurs largely subconsciously, and thus specific behavior change techniques are needed to increase conscious awareness of sedentary behavior. Chief amongst these behavior change techniques is self-monitoring of sedentary behavior. The aim of this systematic review and meta-analysis was to evaluate the short-term effectiveness of existing interventions using self-monitoring to reduce sedentary behavior in adults. Methods: Four electronic databases (PubMed, Embase, Web of Science, and The Cochrane Library) and grey literature (Google Scholar and the International Clinical Trials Registry Platform) were searched to identify appropriate intervention studies. Only (cluster-)randomized controlled trials that 1) assessed the short-term effectiveness of an intervention aimed at the reduction of sedentary behavior, 2) used self-monitoring as a behavior change technique, and 3) were conducted in a sample of adults with an average age >= 18 years, were eligible for inclusion. Relevant data were extracted, and Hedge's g was used as the measure of effect sizes. Random effects models were performed to conduct the meta-analysis. Results: Nineteen intervention studies with a total of 2800 participants met the inclusion criteria. Results of the meta-analyses showed that interventions using self-monitoring significantly reduced total sedentary time (Hedges g = 0,32; 95% CI = 0,14 - 0,50; p = 0,001) and occupational sedentary time (Hedge's g = 0,56; 95% CI = 0,07 - 0,90; p = 0,02) on the short term. Subgroup analyses showed that significant intervention effects were only found if objective self-monitoring tools were used (g = 0,40; 95% CI = 0,19 - 0,60; p < 0,001), and if the intervention only targeted sedentary behavior (g = 0,45; 95% CI = 0,15-0,75; p = 0,004). No significant intervention effects were found on the number of breaks in sedentary behavior. Conclusions: Despite the small sample sizes, and the large heterogeneity, results of the current meta-analysis suggested that interventions using self-monitoring as a behavior change technique have the potential to reduce sedentary behavior in adults. If future - preferably large-scale studies - can prove that the reductions in sedentary behavior are attributable to self-monitoring and can confirm the sustainability of this behavior change, multi-level interventions including self-monitoring may impact public health by reducing sedentary behavior

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

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

The prevalence and correlates of sitting in European adults - a comparison of 32 Eurobarometer-participating countries

Background Prolonged sitting is an emerging health risk. However, multi-country comparative sitting data are sparse. This paper reports the prevalence and correlates of sitting time in 32 European countries. Methods Data from the Eurobarometer 64.3 study were used, which included nationally representative samples (n = 304-1,102) from 32 European countries. Face-to-face interviews were conducted during November and December 2005. Usual weekday sitting time was assessed using the International Physical Activity Questionnaire (short-version). Sitting time was compared by country, age, gender, years of education, general health status, usual activity and physical activity. Multivariable-adjusted analyses assessed the odds of belonging to the highest sitting quartile. Results Data were available for 27,637 adults aged 15–98 years. Overall, mean reported weekday sitting time was 309 min/day (SD 184 min/day). There was a broad geographical pattern and some of the lowest amounts of daily sitting were reported in southern (Malta and Portugal means 194–236 min/day) and eastern (Romania and Hungary means 191–276 min/day) European countries; and some of the highest amounts of daily sitting were reported in northern European countries (Germany, Benelux and Scandinavian countries; means 407–335 min/day). Multivariable-adjusted analyses showed adults with low physical activity levels (OR = 5.10, CI95 = 4.60-5.66), those with high sitting in their main daily activity (OR = 2.99, CI95 = 2.74-3.25), those with a bad/very bad general health state (OR = 1.87, CI95 = 1.63-2.15) and higher education levels (OR = 1.48, CI95 = 1.38-1.59) were more likely to be in the highest quartile of daily sitting time. Adults within Greece (OR = 2.91, CI95 = 2.51-3.36) and Netherlands (OR = 2.56, CI95 = 2.22-2.94) were most likely to be in the highest quartile. High-sit/low-active participants comprised 10.1% of the sample. Adults self-reporting bad/very bad general health state (OR = 4.74, CI95 = 3.97-5.65), those within high sitting in their main daily activities (OR = 2.87, CI95 = 2.52-3.26) and adults aged ≥65 years (OR = 1.53, CI95 = 1.19-1.96) and were more likely to be in the high-sit/low-active group. Conclusions Weekday sitting time and its demographic correlates varied considerably across European countries, with adults in north-western European countries sitting the most. Sitting is prevalent across Europe and merits attention by preventive interventions

Validity and repeatability of the EPIC physical activity questionnaire: a validation study using accelerometers as an objective measure

<p>Abstract</p> <p>Background</p> <p>A primary aim of the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study is to examine the association between total physical activity levels (comprising occupational, household and recreational activity) and the incidence of cancer. We examined the validity and long-term repeatability of total physical activity measurements estimated from the past-year recall EPIC questionnaire, using accelerometers as an objective reference measure.</p> <p>Methods</p> <p>Participants included 100 men and 82 women aged 50–65 years. Criterion validity was assessed by comparing the physical activity estimates from the EPIC questionnaire with total activity estimated from the average of three separate 7-day accelerometer periods during the same (past-year) period. Long-term repeatability of the EPIC questionnaire was assessed by comparing the responses from the baseline and 10-month administrations. Past-year EPIC estimates were also compared with the Friedenreich Lifetime Total Physical Activity Questionnaire to examine whether recent activity reflected lifetime activity.</p> <p>Results</p> <p>Accelerometer total metabolic equivalent (MET)-hours/week were positively associated with a total physical activity index (Spearman rank correlation ρ = 0.29, 95% confidence interval (CI) 0.15, 0.42) and with non-occupational activity estimated in MET-hours/week (ρ = 0.21, 95% CI 0.07, 0.35). Stratified analyses suggested stronger correlations for non-occupational activity for participants who were male, had a lower BMI, were younger, or were not full-time workers, although the differences in correlations between groups were not statistically significant. The weighted kappa coefficient for repeatability of the total physical activity index was 0.62 (95% CI 0.53, 0.71). Spearman correlations for repeatability of components of activity were 0.65 (95% CI 0.55, 0.72) for total non-occupational, 0.58 (95% CI 0.48, 0.67) for recreational and 0.73 (95% CI 0.66, 0.79) for household activity. When past-year activity was compared to lifetime estimates of activity, there was fair agreement for non-occupational (ρ = 0.26) activity, which was greater for household activity (ρ = 0.46) than for recreational activity (ρ = 0.21).</p> <p>Conclusion</p> <p>Our findings suggest that the EPIC questionnaire has acceptable measurement characteristics for ranking participants according to their level of total physical activity. The questionnaire should be able to identify the presence or absence of reasonably strong aetiological associations when either recent or long-term activity is the responsible factor.</p

Interventions with potential to reduce sedentary time in adults:Systematic review and meta-analysis

Context: Time spent in sedentary behaviours (SB) is associated with poor health, irrespective of the level of physical activity. The aim of this study was to evaluate the effect of interventions which included SB as an outcome measure in adults. Methods: Thirteen databases, including The Cochrane Library, MEDLINE and SPORTDiscus, trial registers and reference lists, were searched for randomised controlled trials until January 2014. Study selection, data extraction and quality assessment were performed independently. Primary outcomes included SB, proxy measures of SB and patterns of accumulation of SB. Secondary outcomes were cardiometabolic health, mental health and body composition. Intervention types were categorised as SB only, physical activity (PA) only, PA and SB or lifestyle interventions (PA/SB and diet). Results: Of 8087 records, 51 studies met the inclusion criteria. Meta-analysis of 34/51 studies showed a reduction of 22 min/day in sedentary time in favour of the intervention group (95% CI −35 to −9 min/day, n=5868). Lifestyle interventions reduced SB by 24 min/day (95% CI −41 to −8 min/day, n=3981, moderate quality) and interventions focusing on SB only by 42 min/day (95% CI −79 to −5 min/day, n=62, low quality). There was no evidence of an effect of PA and combined PA/SB interventions on reducing sedentary time. Conclusions: There was evidence that it is possible to intervene to reduce SB in adults. Lifestyle and SB only interventions may be promising approaches. More high quality research is needed to determine if SB interventions are sufficient to produce clinically meaningful and sustainable reductions in sedentary time

Walking behaviours from the 1965–2003 American Heritage Time Use Study (AHTUS)

<p>Abstract</p> <p>Background</p> <p>The American Heritage Time Use Study (AHTUS) represents a harmonised historical data file of time use by adults, amalgamating surveys collected in 1965–66, 1975–76, 1985, 1992–94, and 2003. The objectives of time-use studies have ranged from evaluating household and other unpaid production of goods and services, to monitoring of media use, to comparing lifestyles of more and less privileged social groups, or to tracking broad shifts in social behaviour. The purpose of this paper is to describe the process and utility of identifying and compiling data from the AHTUS to describe a range of walking behaviours collected using time-use survey methods over almost 40 years in the USA.</p> <p>Methods</p> <p>This is a secondary data analysis of an existing amalgamated data set. Noting source survey-specific limitations in comparability of design, we determined age-standardized participation (and associated durations) in any walking, walking for exercise, walking for transport, walking the dog, sports/exercise (excluding walking), and all physical activity for those survey years for which sufficient relevant data details were available.</p> <p>Results</p> <p>Data processing revealed inconsistencies in instrument administration, coding various types of walking and in prompting other sport/exercise across surveys. Thus for the entire period, application of inferential statistics to determine trend for a range of walking behaviours could not be done with confidence. Focusing on the two most comparable survey years, 1985 and 2003, it appears that walking for exercise in America has increased in popularity on any given day (from 2.9 to 5.4% of adults) and accumulated duration amongst those who walk for exercise (from 30 to 45 mins/day). Dog walking has decreased in popularity over the same time period (from 9.4 to 2.6%). Associated duration amongst dog walkers was stable at 30 mins/day.</p> <p>Conclusion</p> <p>The noted and sometimes substantial differences in methods between the various survey administrations preclude stringent interpretation of these trends in walking behaviours and the use of conventional application of inferential statistics to evaluate significance of time trends. Although the AHTUS offers the most comprehensive attempt at harmonization yet undertaken with these individual time-use surveys, we found that any noted cross-time changes in walking and physical activity behaviour are not easily interpreted in terms of conventional epidemiological approaches and could be true changes, artefact related to instrument and method changes, or both. Public health utilization of the AHTUS, could be enhanced with greater attention to methodological issues known to influence estimation of physical activity behaviour in population. This could be achieved with cross-disciplinary collaboration between groups of experts in the various stages of these surveys.</p