Sedentary behaviour in office workers: correlates and interventions

Background: The concept of sedentary behaviour has emerged since the turn of the millennium and research into this area is rapidly developing. Sedentary behaviours are activities that require very little energy expenditure whilst in a sitting or reclining posture thus are distinct from physical inactivity. Previous observational studies have demonstrated that high amounts of sedentary behaviour are associated with an increased risk of obesity, type 2 diabetes, metabolic syndrome, cardiovascular disease, cancer, depression and all-cause, cardiovascular and cancer mortality. Experimental studies suggest that prolonged sedentary time causes metabolic dysregulation and could be the explanation for the associated negative health effects. Breaks in prolonged sedentary time where standing or stepping occurs have shown beneficial effects on metabolic risk markers but the threshold for these effects is ambivalent and may depend on the population. The increasing prevalence of sedentary behaviours due to advances in technology are concerning but there is a lack of large-scale studies from the UK identifying the extent of sedentary behaviour prevalence and where the majority of sedentary time is accumulated in working-aged adults. A number of correlates are associated with sedentary behaviour including individual, social and environmental factors but the extent to which multiple other health behaviours correlate with specific sedentary behaviours is unknown. Interventions to reduce sedentary time have focused on the workplace where office workers spend large amounts of time sedentary. Multicomponent workplace interventions have reported reductions in sedentary time but there is limited research in the UK investigating the long-term effects of these interventions on working and non-working hours sedentary time. Additionally, the use of persuasive technology in the form of a wearable device to reduce sedentary time has rarely been explored as an intervention strategy.Aims: Study One aimed to assess the prevalence of domain-specific sedentary behaviour in a large sample of office workers from the UK and links with multiple other health behaviours. Study Two aimed to investigate the effectiveness of a pilot multicomponent workplace intervention to reduce sedentary time over the short (3 months) and long-term (12 months). Study Three aimed to explore the feasibility of a self-monitoring and prompting device to reduce sedentary time in a sample of office workers who have sit-stand desks.Methods: Study One performed a secondary data analysis on a large sample of office workers (n=7,170) who self-reported their domain-specific sitting time, physical activity level, smoking status, alcohol consumption, and fruit and vegetable intake in a 2012 and/or 2014 survey. Multiple logistic regression models explored the association between sedentary behaviours and multiple other health behaviours. A separate analysis was performed to investigate how these associations tracked over time (n=806). Study Two implemented a multicomponent workplace intervention in a sample of office workers (baseline n=30) and measured the effects 3 and 12-months post-baseline compared to a control group (baseline n=30). activPAL sedentary time was the primary outcome with accelerometer-determined physical activity and markers of health measured as secondary outcomes. Study Three provided a sample of office workers who had sit-stand desks (n=19 baseline, n=17 follow-up) with a wearable device to self-monitor their sedentary time through an application and prompt reductions in prolonged sedentary time through haptic feedback (LUMO). Feasibility and acceptability of the 4-week intervention were measured through wear time, engagement with application, questionnaire and interview feedback. The effect on sedentary time was measured with the LUMO and activPAL in addition to health and work-related measures.Results: Study One found that 643±160 minutes on a workday and 491±210 minutes on a non-workday were spent sitting. The majority of workday sitting took place at work (383±95 minutes/day) and whilst TV viewing on a non-workday (173±101 minutes/day). ≥7 hours sitting at work and ≥2 hours TV viewing on a workday both more than doubled the odds of partaking in ≥3 unhealthy behaviours [Odds ratio, OR=2.03, 95% CI, (1.59-2.61); OR=2.19 (1.71-2.80)] and ≥3 hours of TV viewing on a non-workday nearly tripled the odds [OR= 2.96 (2.32-3.77)]. No associations between domain-specific sitting time at baseline and change in unhealthy behaviour score were found over two years with the majority of participants maintaining baseline levels of all behaviours. Study Two found a trend towards reduced sedentary time at work by -7.9±25.1% and -18.4±12.4% per day at 3- (n=25 intervention, n=18 control group) and 12-months (n=11 intervention, n=7 control group) post-baseline in addition to overall workday by -4.6±13.8% and -8.0±8.3%. The intervention group showed an increase in sedentary time outside of work on a workday (4.2±9.5%) and overall on a non-workday (3.5±10.8%) after 12 months compared to baseline. However, the results found at the 3-month follow-up were not statistically significant and no significant differences in physical activity or health measures between groups were observed. Furthermore, due to the reduced sample size at the 12-month follow-up, no statistical testing was performed. Study Three found that the LUMO was a feasible intervention device in the short-term demonstrating high wear time (mean=60.6% of measurement days) and application engagement (mean=26.2±33.2 sessions, 30.3±26.5 minutes per week) with sedentary time being the most engaged with aspect of the application. The acceptability of the LUMO depended on the task undertaken, experience of problems with the device and preference towards the application or the prompt but overall, it increased awareness of behaviour. A trend towards reductions in sedentary time (-4%) and prolonged bouts of sedentary time >60 mins (-3%) on a workday were observed. Improvements were found in fat percentage and mass, blood pressure, job performance, work engagement, need for recovery and job satisfaction. Non-workday sedentary time >60 min bouts increased (4.8%) and increases in non-working hours sedentary time were apparent in weeks 3 and 4.Conclusions: Office workers are highly sedentary at work and whilst TV viewing which is associated with partaking in other multiple unhealthy behaviours. Multicomponent workplace interventions result in a trend towards reductions in occupational sedentary behaviour over the short and long-term. However, compensation during non-working hours could attenuate overall sedentary behaviour reductions resulting from workplace interventions. Wearable technology as an intervention strategy to reduce sedentary time shows promise and further research is needed in fully-powered studies. Future interventions should target multiple unhealthy behaviours in addition to sedentary time during work and non-working hours.</div

Effectiveness of interventions to increase device-measured physical activity in pregnant women: systematic review and meta-analysis of randomised controlled trials

Background:  Interventions that provide pregnant women with opportunities to access and participate in physical activity have been shown to be beneficial to their health. Much of this evidence however has been based on self-reported physical activity data, which may be prone to inflated effects due to recall bias and social desirability bias. No previous synthesis of randomised controlled trials has assessed the effectiveness of these interventions using only device measured data, to assess their health benefits more accurately in pregnant women. This systematic review and meta-analysis aimed to address this evidence gap.  Data sources:  Cochrane Central Register of Controlled Trials, Medline, SportDiscus, APA PsycINFO, Embase and Web of Science databases were queried from inception up to December 2, 2021. An updated search of PubMed was conducted on May 16, 2022.  Study eligibility criteria:  Randomised controlled trials that recruited pregnant women, participating in any physical activity intervention (excluding interventions aimed entirely at body conditioning), compared with standard antenatal care (comparators), using device-measured total physical activity as an outcome were eligible for inclusion.  Methods:  3144 titles and abstracts were screened for eligibility, and 18 met the inclusion criteria. Data were analysed using random effect models, (standardised mean difference and mean difference), using data from baseline to last available follow-up (primary end point), and until between 24 to 30 weeks gestation. Gestational weight gain was also assessed at these timepoints in the included trials.  Results:  No significant differences between the groups were found for total physical activity at last available follow-up or 24 to 30 weeks gestation (95% CI 0.03 to 0.27, p = 0.10: 95% CI -0.05 to 0.33, p = 0.15) respectively. On average, pregnant women randomised to a physical activity intervention completed 435 and 449 more steps per day than comparators at last available follow-up and at 24 to 30 weeks gestation (95% CI -0.5-870.6, p = 0.05: 95% CI 5.5-892.7, p = 0.05) respectively. Intervention participants also gained 0.69 kg less (95% CI -1.30 to -0.08, p = 0.03) weight than comparators.  Conclusion:  Based on device-measured data, interventions to promote physical activity during pregnancy have small but important effects on increasing physical activity and managing excessive gestational weight gain.</p

Effectiveness of weight management interventions for adults delivered in primary care: systematic review and meta-analysis of randomised controlled trials

Objective  To examine the effectiveness of behavioural weight management interventions for adults with obesity delivered in primary care.  Design  Systematic review and meta-analysis of randomised controlled trials.  Eligibility criteria for selection of studies  Randomised controlled trials of behavioural weight management interventions for adults with a body mass index ≥25 delivered in primary care compared with no treatment, attention control, or minimal intervention and weight change at ≥12 months follow-up.  Data sources  Trials from a previous systematic review were extracted and the search completed using the Cochrane Central Register of Controlled Trials, Medline, PubMed, and PsychINFO from 1 January 2018 to 19 August 2021.  Data extraction and synthesis  Two reviewers independently identified eligible studies, extracted data, and assessed risk of bias using the Cochrane risk of bias tool. Meta-analyses were conducted with random effects models, and a pooled mean difference for both weight (kg) and waist circumference (cm) were calculated.  Main outcome measures  Primary outcome was weight change from baseline to 12 months. Secondary outcome was weight change from baseline to ≥24 months. Change in waist circumference was assessed at 12 months. Results 34 trials were included: 14 were additional, from a previous review. 27 trials (n=8000) were included in the primary outcome of weight change at 12 month follow-up. The mean difference between the intervention and comparator groups at 12 months was −2.3 kg (95% confidence interval −3.0 to −1.6 kg, I 2 =88%, P Conclusions  Behavioural weight management interventions for adults with obesity delivered in primary care are effective for weight loss and could be offered to members of the public.  Systematic review registration PROSPERO CRD42021275529.</p

Supplementary Information Files for: Cross-sectional associations between domain-specific sitting time and other lifestyle health behaviours: the Stormont study

Supplementary Information Files for: Cross-sectional associations between domain-specific sitting time and other lifestyle health behaviours: the Stormont studyAbstract Background There is a dearth of literature on how different domains of sitting time relate to other health behaviours. Therefore, this study aimed to explore these associations in a sample of office workers.Methods 7170 Northern Irish Civil Servants completed an online survey which included information on workday and non-workday sitting time in five domains (travel, work, TV, computer-use, leisure-time), physical activity, fruit and vegetable intake, alcohol consumption and cigarette smoking. An unhealthy behaviour score was calculated by summing the number of health behaviours which did not meet the current guidelines. Multinomial regressions examined associations between unhealthy behaviour score and each domain of sitting time.Results ≥7 hours sitting at work and ≥2 hours TV viewing on a workday both more than doubled the odds of partaking in ≥3 unhealthy behaviours [Odds ratio, OR = 2.03, 95% CI, (1.59–2.61); OR = 2.19 (1.71–2.80)] and ≥3 hours of TV viewing on a non-workday nearly tripled the odds [OR = 2.96 (2.32–3.77)].Conclusions High sitting time at work and TV viewing on a workday and non-workday are associated with increased odds of partaking in multiple unhealthy behaviours. Interventions need to focus on these domains and public health policy should consider sitting time as an important health behaviour.</div

Cross-sectional associations between domain-specific sitting time and other lifestyle health behaviours: the Stormont study

Abstract Background There is a dearth of literature on how different domains of sitting time relate to other health behaviours. Therefore, this study aimed to explore these associations in a sample of office workers. Methods 7170 Northern Irish Civil Servants completed an online survey which included information on workday and non-workday sitting time in five domains (travel, work, TV, computer-use, leisure-time), physical activity, fruit and vegetable intake, alcohol consumption and cigarette smoking. An unhealthy behaviour score was calculated by summing the number of health behaviours which did not meet the current guidelines. Multinomial regressions examined associations between unhealthy behaviour score and each domain of sitting time. Results ≥7 hours sitting at work and ≥2 hours TV viewing on a workday both more than doubled the odds of partaking in ≥3 unhealthy behaviours [Odds ratio, OR = 2.03, 95% CI, (1.59–2.61); OR = 2.19 (1.71–2.80)] and ≥3 hours of TV viewing on a non-workday nearly tripled the odds [OR = 2.96 (2.32–3.77)]. Conclusions High sitting time at work and TV viewing on a workday and non-workday are associated with increased odds of partaking in multiple unhealthy behaviours. Interventions need to focus on these domains and public health policy should consider sitting time as an important health behaviour