Galileo Galilei’s quote ‘measure what is measurable, and make measurable what is not so’ has particular relevance to health behaviours, such as physical activity (PA), sitting and sleep, whose measurement during free living is notoriously difficult. To date, much of what we know about how these behaviours affect our health is based on self-report by questionnaires which have limited validity, are prone to bias and inquire about selective aspects of these behaviours. Although self-reported evidence has made great contributions to shaping public health and exercise medicine policy and guidelines until now,1 the ongoing advancements of accelerometry-based measurement and evidence synthesis methods are set to change the landscape. The aim of this editorial is to outline new directions in PA and sleep-related epidemiology that open new horizons for guideline development and improvement; and to describe a new research collaboration platform: the Prospective Physical Activity, Sitting, and Sleep consortium (ProPASS

Aadahl, M

Arvidsson, D

Askie, L

Atkin, AJ

Bauman, AE

Chastin, S

Cistulli, P

Crowley, PJ

Ekelund, U

Granat, M

Gupta, N

Hamer, M

Holtermann, A

Koster, A

Lee, I-M

Matthews, CE

Mishra, G

Mork, PJ

Palm, P

Pulakka, A

Rangul, V

Stamatakis, E

Stenholm, S

Stevens, M

Wennberg, P

UCL Discovery

   1Stamatakis E, et al. Br J Sports Med Month 2019 Vol 0 No 0Emerging collaborative research platforms for the next generation of physical activity, sleep and exercise medicine guidelines: the Prospective Physical Activity, Sitting, and Sleep consortium (ProPASS)Galileo Galilei’s quote ‘measure what is measurable, and make measurable what is not so’ has particular relevance to health behaviours, such as physical activity (PA), sitting and sleep, whose measurement during free living is notoriously difficult. To date, much of what we know about how these behaviours affect our health is based on self-report by questionnaires which have limited validity, are prone to bias and inquire about selective aspects of these behaviours. Although self-re-ported evidence has made great contri-butions to shaping public health and exercise medicine policy and guidelines until now,1 the ongoing advancements of accelerometry-based measurement and evidence synthesis methods are set to change the landscape. The aim of this editorial is to outline new directions in PA and sleep-related epidemiology that open new horizons for guideline develop-ment and improvement; and to describe a new research collaboration platform: the Prospective Physical Activity, Sitting, and Sleep consortium (ProPASS) (figure 1).FEASiblE rESEArch tEchnology At ScAlE, big conSortiAMeasurement technology used in epide-miology has made measurable what was not so until recently. Several popula-tion-based studies use accelerometers that are worn by participants for 24 hours a day for a whole week, offering unprecedented insights into the health attributes of PA, sitting and sleep. One of the most exciting aspects of accelerome-ters is that they show great promise for capturing nearly complete accounts of movement behaviour, including posture and activity type detection.2However, advanced measurement methods and optimal evidence synthesis are not synonymous. Individual accel-erometry studies have limited gener-alisability beyond the specific country, population and setting, and usually have low statistical power to address detailed research questions. For example, none of the National Health and Nutrition Examination Survey (NHANES) acceler-ometry studies3 have been able to study potentially metabolic health-enhancing sporadic short (<2–3 min) bursts of higher intensity incidental PA,4 likely because of the sparsity of such data. Like any other field, classic systematic reviews of accelerometry inherit the problems of source studies and their conclusions may not be robust.5 We need to think differ-ently when it comes to consolidating, analysing and interpreting new formats of accelerometry data. As John Ioan-nidis’ BJSM editorial succinctly put it, the next generation of evidence in exercise medicine and PA involves large consortia of individual participant data that are harmonised retrospectively or prospec-tively.5 Prospective harmonisation (ie, agree on same or similar measurements across different studies prior to data collection), in particular, is an extremely powerful tool as it can overcome hetero-geneity, which is one of the largest obsta-cles for rigorous evidence synthesis.5 The value of consortia goes beyond producing more robust and generalisable knowl-edge, there is also a strong economic argument. The value of every dollar, pound or euro tax payers and research funders invested in the original studies is multiplied through further use of the data resources to inform better public health and clinical practice guidelines.A nEw conSortiumThe momentum generated by successful accelerometry consortia (eg, Interna-tional Children’s Accelerometry Data-base6) and large epidemiological studies like NHANES3 and the UK Biobank6 that used waist or wrist mounted accelerome-ters inspired the genesis of the ProPASS.7 ProPASS is a research collaboration plat-form that aims to bring together existing and future observational studies of thigh-worn accelerometry. Although each accelerometer placement site has both strengths and challenges, the ProPASS choice of site was far from accidental: the unique appeal of the thigh-worn method is that it provides information on multiple dimentions of movement behaviour, including movement intensity (eg, light, moderate and vigorous PA) and posture (eg, sitting/lying, standing). Activity types such as cycling, running and stair climbing can also be extrapo-lated by thigh-attached sensors2 and inte-gration with other important behaviours such as duration and timing of sleep can provide unique insights on lifestyle and health.8 Information about such tangible aspects of human behaviour has imme-diate relevance to people’s daily lives; and is easier for clinicians, policymakers and the public alike to understand, ‘digest’ and hopefully seek to improve.The ultimate scientific objective of ProPASS is to produce evidence on the associations of PA, sitting, and sleep and long-term health outcomes and longevity. As of February 2019, ProPASS is supported by 12 international cohorts totalling over 70 000 participants (table 1). To safeguard consortium feasibility, longevity and faster growth, ProPASS is not restricted to one specific model of accelerometer; any triaxial device that outputs raw acceleration and is worn on the thigh is suitable—an approach we have validated empirically.9 The ProPASS cohorts are rich in health outcome data, many contain genotypic information, and most can be linked to administrative health and mortality records, opening up a huge variety of possibilities to generate new knowledge.EditorialFigure 1  on 21 May 2019 by guest. Protected by copyright.http://bjsm.bmj.com/Br J Sports Med: first published as 10.1136/bjsports-2019-100786 on 10 May 2019. Downloaded from 2 Stamatakis E, et al. Br J Sports Med Month 2019 Vol 0 No 0EditorialcAll For collAborAtionNew research collaboration platforms have paved the way for the next genera-tion of evidence on PA-related behaviours and health. Recording detailed and accu-rate objective accounts of daily move-ment behaviour and posture is now feasible in large epidemiological studies. To fully capitalise on the opportunities offered by such methodological progress at least two essential conditions need to be met: breaking down silos to integrate research paradigms across PA domains, and tight interdisciplinary collaboration. Meeting ProPASS’ objectives is depen-dent on these conditions.In this editorial we invite researchers from any discipline who have collected or are considering to collect thigh-worn accelerometry data in observational studies to contact us. We also invite scientists with an interest in health-re-lated data consortia, as well as health professionals and policymakers to help us form a ProPASS research agenda with maximal relevance to patients, the public and health policy. There is no question in our mind that such a research agenda is a prerequisite for the success of ProPASS and any other effort aimed at shaping the next generation of PA, sitting, sleep and exercise medicine guidelines.Get in touch to discuss opportunities for your existing or future studies to join ProPASS (email:  propass. consor-tium@ sydney. edu. au). Join our mailing list ( www. propassconsortium. org) to stay updated about future events and activities.Emmanuel Stamatakis,  1 Annemarie Koster,  2 mark hamer,  3,4 Vegar rangul,  5 i-min lee,  6 Adrian E bauman,  1,7 Andrew J Atkin,  8 mette Aadahl,  9 charles E matthews,  10 Paul Jarle mork,  11 lisa Askie,  12 Peter cistulli,  13 malcolm granat,  14 Peter Palm,  15 Patrick Joseph crowley,  16 matthew Stevens,  16 nidhi gupta,  16 Anna Pulakka,  17 Sari Stenholm,  17 Daniel Arvidsson,  18 gita mishra,  19 Patrik wennberg, table 1 Accelerometry studies supporting the Prospective Physical Activity, Sitting, and Sleep consortium (ProPASS)main study name/country leading institutiongeographical coverage of the study Participants (n) SexPopulation/age range (accelerometry measurement)Accelerometry deviceyears (accelerometry measurement)Australian Longitudinal Study on Women’s Health/ AustraliaThe University of Queensland and The University of SydneyAustralia (target) ≈3250 Women General population/45–50 yearsActivPAL3 and ActivPAL4 micro2019–20201970 British Birth Cohort Study/UKLoughborough University and University College LondonUK ≈5500 Both General population/47–49 yearsActivPAL3 micro 2016–2018Copenhagen City Heart Study/Denmark10Frederiksberg Hospital, CopenhagenTwo districts of Copenhagen≈2000 Both General population/18 years or olderActigraph GT3X 2011–2015Danish PHysical ACTivity cohort with Objective measurements (DPHACTO) Study11/DenmarkNational Research Centre for the Working Environment, CopenhagenDenmark ≈1000 Both Workers in manufacturing, cleaning and transportation companies/18–67 yearsActigraph GT3X 2012–2014Danish Observational Study of Eldercare work and musculoskeletal disorderS (DOSES)12 Study/DenmarkNational Research Centre for the Working Environment, CopenhagenGreater Copenhagen region≈500 Both Eldercare workers/18–67 yearsActigraph GT3X 2013–2014Finnish Retirement and Aging Study (FIREA)/Finland13University of Turku Southwest Finland ≈280 Both General population/occupational cohort/59–65 years, 60–64 yearsActivPAL3 2015–2020Health 2016 Study/Denmark Centre for Clinical Research and Prevention, FrederiksbergWestern part of Greater Copenhagen≈800 Both General population/18–69 yearsAxivity 2016–2017The Nord-Trøndelag Health Study (HUNT 4)14/NorwayNorwegian University of Science and TechnologyNorthern part of Trøndelag region≈40 000 Both General population/18 years or olderAxivity 3 2017–2019The Maastricht Study15/The NetherlandsMaastricht UniversitySouth of The Netherlands≈9000 Both General population (oversampling of people with type 2 diabetes)/40–75 yearsActivPAL3 2010–2019Swedish CArdioPulmonary bioImage Study (SCAPIS)16 Ad-On Gothenburg/SwedenUniversity of GothenburgGothenburg region ≈500 Both General population/50–64 yearsAxivity AX3 2017Swedish CArdioPulmonary bioImage Study (SCAPIS)16 Ad-On Umeå/SwedenUmeå University Umeå region ≈2500 Both General population/50–64 yearsActivPAL3 2016–2018Swedish CArdioPulmonary bioImage Study (SCAPIS) Ad-On Uppsala16/SwedenUppsala University Uppsala region ≈5000 Both General population/50–64 yearsAxivity AX3 2015–2018 on 21 May 2019 by guest. Protected by copyright.http://bjsm.bmj.com/Br J Sports Med: first published as 10.1136/bjsports-2019-100786 on 10 May 2019. Downloaded from 3Stamatakis E, et al. Br J Sports Med Month 2019 Vol 0 No 0Editorial 20 Sebastien chastin,  21,22 ulf Ekelund,  23 Andreas holtermann  161Prevention Research Collaboration, Charles Perkins Centre, Faculty of Medicine and Health, School of Public Health, University of Sydney, Sydney, New South Wales, Australia2Department of Social Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, , The Netherlands3Department of Epidemiology and Public Health, University College London, London, UK4School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, UK5Department of Public Health and Nursing, HUNT Research Centre, Norwegian University of Science and Technology, Trondheim, Norway6Division of Preventive Medicine, Brigham and Women’s Hospital and Harvard Medical School, Harvard University, Cambridge, Massachusetts, USA7Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia8Faculty of Medicine and Health Sciences, School of Health Sciences, University of East Anglia, Norwich, UK9Research Centre for Prevention and Health, Copenhagen, Denmark10Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA11Department of Public Health and Nursing, The Norwegian University of Science and Technology, Trondheim, Norway12NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia13Sleep Research Group, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia14School of Health Sciences, University of Salford, Salford, UK15Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala Universitet, Uppsala, Sweden16National Research Centre for the Working Environment, Copenhagen, Denmark17Department of Public Health, University of Turku, Turku, Finland18Department of Food and Nutrition and Sport Science, Centre for Health and Performance, University of Gothenburg, Gothenburg, Sweden19School of Public Health, University of Queensland, Brisbane, Queensland, Australia20Family Medicine, Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden21School of Health and Life Science, Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK22Department of Movement and Sports Sciences, Universiteit Gent, Gent, Belgium23Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norwaycontributors ES conceived the idea and drafted the first draft of the manuscript and carried out all revisions. AH, AK, MH and VR contributed to the idea. All authors reviewed critically the manuscript and provided detailed suggestions for revisions. AP, VR, AH, MA, PP, PW, DA, AK, GM and ES provided the data presented in table 1.Funding The ProPASS consortium has received financial support from the following organisations: an unrestricted grant by PAL Technologies, Scotland, UK; a grant by the Worldwide Universities Network–Research Development Fund 2018; an internal seed grant by the University of Sydney; a National Health and Medical Research Council (Australia) equipment grant; in-kind support by the National Research Centre for the Working Environment, Copenhagen; and financial support by Loughborough University.competing interests None declared.Patient consent for publication Not required.Provenance and peer review Not commissioned; externally peer reviewed.open access This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http:// creativecommons. org/ licenses/ by- nc/ 4. 0/.© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.to cite Stamatakis E, Koster A, Hamer M, et al. Br J Sports Med Epub ahead of print: [please include Day Month Year]. doi:10.1136/bjsports-2019-100786Received 5 March 2019Revised 6 April 2019Accepted 9 April 2019Br J Sports Med 2019;0:1–3.doi:10.1136/bjsports-2019-100786RefeRences 1 2018 Physical Activity Guidelines Advisory Committee. 2018 physical activity guidelines Advisory Committee scientific report. Washington, DC U.S. Department of Health and Human Services; 2018. 2 Skotte J, Korshøj M, Kristiansen J, et al. Detection of physical activity types using triaxial accelerometers. J Phys Act Health 2014;11:76–84. 3 Füzéki E, Engeroff T, Banzer W. Health benefits of Light-intensity physical activity: a systematic review of Accelerometer data of the National Health and Nutrition Examination Survey (NHANES). Sports Med 2017;47:1769–93. 4 Stamatakis E, Johnson NA, Powell L, et al. Short and sporadic bouts in the 2018 us physical activity guidelines: is high-intensity incidental physical activity the new HIIT? Br J Sports Med 2019. 5 Ioannidis J. Next-generation systematic reviews: prospective meta-analysis, individual-level data, networks and umbrella reviews. Br J Sports Med 2017;51:1456–8. 6 Doherty A, Smith-Byrne K, Ferreira T, et al. GWAS identifies 14 loci for device-measured physical activity and sleep duration. Nat Commun 2018;9. 7 ProPASS consortium. Prospective physical activity, sitting, and sleep cosnsortium, 2019. Available: www. propassconsortium. org 8 van der Berg JD, Willems PJB, van der Velde JHPM, et al. Identifying waking time in 24-h accelerometry data in adults using an automated algorithm. Journal of Sports Sciences 2016;34:1867–73. 9 Crowley P, Skotte J, Stamatakis E, et al. A comparison of movement behavior estimates from three different thigh-worn accelerometer models: a proof-of-concept for the ProspectivePhysical Activity, Sitting, and Sleep consortium (ProPASS). Under review. 10 Aguib Y, Al Suwaidi J. The Copenhagen City Heart study (Østerbroundersøgelsen). Global Cardiology Science and Practice 2015;2015. 11 Jørgensen MB, Gupta N, Korshøj M, et al. The DPhacto cohort: an overview of technically measured physical activity at work and leisure in blue-collar sectors for practitioners and researchers. Appl Ergon 2019;77:29–39. 12 Karstad K, Jørgensen AFB, Greiner BA, et al. Danish observational study of eldercare work and musculoskeletal disorderS (doses): a prospective study at 20 nursing homes in Denmark. BMJ Open 2018;8:e019670. 13 Pulakka A, Leskinen T, Koster A, et al. Daily physical activity patterns among aging workers: the Finnish retirement and aging study (FIREA). Occup Environ Med 2019;76:33–9. 14 Krokstad S, Langhammer A, Hveem K, et al. Cohort profile: the HUNT study, Norway. Int J Epidemiol 2013;42:968–77. 15 Schram MT, Sep SJS, van der Kallen CJ, et al. The Maastricht study: an extensive phenotyping study on determinants of type 2 diabetes, its complications and its comorbidities. Eur J Epidemiol 2014;29:439–51. 19 Bergström G,Berglund G, Blomberg G, , , , et al. The Swedish cardiopulmonary BioImage study: objectives and design. Journal of Internal Medicine2015;278:645–59. 17 Sherar LB, Griew P, Esliger DW, et al. International children’s accelerometry database (ICAD): design and methods. BMC Public Health 2011;11. 18 Dobson AJ, Hockey R, Brown WJ, McLaughlin D, et al. Cohort profile update: Australian longitudinal study on women’s health. Int J Epidemiol 2015;44:1547–1547f. 19 Elliott J, Shepherd P. Cohort profile: 1970 British birth cohort (BCS70). Int J Epidemiol 2006;35:836–43. on 21 May 2019 by guest. Protected by copyright.http://bjsm.bmj.com/Br J Sports Med: first published as 10.1136/bjsports-2019-100786 on 10 May 2019. Downloaded from 

Emerging collaborative research platforms for the next generation of physical activity, sleep and exercise medicine guidelines: the Prospective Physical Activity, Sitting, and Sleep consortium (ProPASS)

http://discovery.ucl.ac.uk/10074654/1/ProPASSbjsports-2019-100786.full.pdf

Emerging collaborative research platforms for the next generation of physical activity, sleep and exercise medicine guidelines: the Prospective Physical Activity, Sitting, and Sleep consortium (ProPASS)

Abstract

Similar works

Full text

Available Versions

UCL Discovery