The aim of the study was to investigate if (a) substituting total sedentary time or long sedentary bouts with standing or various types of physical activity and (b) substituting long sedentary bouts ...with brief sedentary bouts; is associated with obesity indicators using a cross sectional isotemporal substitution approach among blue-collar workers.
A total of 692 workers from transportation, manufacturing and cleaning sectors wore an Actigraph GT3X+ accelerometer on the thigh for 1-4 working days. The sedentary (sit and lie), standing, walking, and moderate to vigorous physical activity (MVPA) time on working days was computed using validated Acti4 software. The total sedentary time and uninterrupted sedentary time spent in brief (≤5 mins), moderate (>5 and ≤30 mins), and long (>30mins) bouts, were determined for the whole day and during work and non-work time separately. The obesity indicators, BMI (kg/m2), waist circumference (cm) and fat percentage were objectively measured. Isotemporal substitution modelling was utilized to determine the linear association with obesity indicators of replacing 30 min of total sedentary time or long sedentary bouts with standing, walking or MVPA and separately replacing 30 min of long sedentary bouts with brief sedentary bouts.
Workers mean (standard deviation, SD); age = 45.1 (9.9) years, BMI = 27.5 (4.9) kg/m2, %BF = 29.6 (9.5), waist circumference = 94.4 (13.0) cm sat for 2.4 hours (~32% of the measured time, SD = 1.8 hours) across the day during work period and 5.5 hours (~62% of the measured time, SD = 1.5 hours) during non-work period. Most of the sedentary time was accrued in moderate bouts work = 1.40 (SD = 1.09) hours during work and in long bouts during non-work 2.7 (SD = 1.4) hours, while least in long sedentary bouts during work work = 0.5 (SD = 0.9) and in brief sedentary bouts 0.5 hours (SD = 0.3) during non-work. Significant associations with all obesity indicators were found when 30 min of total sedentary time or long sedentary bouts were replaced with standing time (~1-2% lower) or MVPA (~4-9% lower) during whole day, work, and non-work periods. The exception was that a statistically significant association was not observed with any obesity indicator when replacing total sedentary time or long sedentary bouts with standing time during the work period. Significant beneficial associations were found when replacing the long sedentary bouts with brief sedentary bouts (~3-5% lower) during all domains.
Replacing total sedentary time and long sedentary bouts, respectively, not only with MVPA but also standing time appears to be beneficially associated with obesity indicators among blue-collar workers. Additionally, replacing long sedentary bouts with brief sedentary bouts was also beneficially associated with obesity indicators. Studies using prospective design are needed to confirm the findings.
Development and validation of a physical activity scale for measuring physical activity in 24 h of sports, work, and leisure time on an average weekday.
For development of the physical activity ...scale, 2500 randomly selected Danish men and women between the age of 20 and 60 were contacted by mail and asked to select frequent and relevant physical activities from a number of activities of known MET intensity. The activities were included in the physical activity scale, organized in nine different MET levels ranging from sleep/rest (0.9 METs) to high-intensity physical activities (>6 METs). Face validity of the physical activity scale was explored through interviews with 10 volunteer men and women. Concurrent validity was assessed against 4 d of accelerometry (CSA 7164) and physical activity diary in 40 volunteer men and women between 20 and 60 yr of age.
The correlation between the activity scale and the diary was high (r = 0.74, P = 0.000), whereas correlation between the activity scale and accelerometer measurements was poor (r = 0.20, NS). The physical activity scale MET-time was systematically higher than average MET-time estimated from the diary, and the difference increased with increasing total MET-time.
The physical activity scale appears to be a simple and valid alternative to measuring physical activity by diary in adult sedentary to moderately active Danes. The scale encompasses work, leisure time, and sports activity in one measure; it is easy to administer, and it provides detailed information on different activity levels as well as a single measure of the total amount of physical activity on an average weekday.
Pooling data from thigh-worn accelerometers across multiple studies has great potential to advance evidence on the health benefits of physical activity. This requires harmonization of information on ...body postures, physical activity types, volumes and time patterns across different brands of devices. The aim of this study is to compare the physical behavior estimates provided by three different brands of thigh-worn accelerometers.
Twenty participants volunteered for a 7-day free-living measurement. Three accelerometers - ActiGraph GT3X+, Axivity AX3 and ActivPAL Micro4 - were randomly placed in a vertical line on the midsection of the right thigh. Raw data from each accelerometer was processed and classified into 8 physical activities and postures using the Acti4 software. Absolute differences between estimates and the respective coefficient of variation (CV) were calculated.
We observed very minor differences between physical behavior estimates from three different accelerometer brands. When averaged over 24 h (1,440 min), the absolute difference (CV) between accelerometers were: 1.2 mins (0.001) for lying/sitting, 3.4 mins (0.02) for standing, 3.5 mins (0.06) for moving, 1.9 mins (0.03) for walking, 0.1 mins (0.19) for running, 1.2 mins (0.19) for stair climbing, 1.9 mins (0.07) for cycling. Moreover, there was an average absolute difference of 282 steps (0.03) per 24 h.
Physical behaviors were classified with negligible difference between the accelerometer brands. These results support harmonization of data from different thigh-worn accelerometers across multiple cohorts when analyzed in an identical manner.
Globally, unhealthy diet is one of the leading global risks to health, thus it is central to consider aspects of the food environment that are modifiable and may enable healthy eating. Food retail ...data can be used to present and facilitate analyses of food environments that in turn may direct strategies towards improving dietary patterns among populations. Though food retail data are available in many countries, their completeness and accuracy differ. We applied a systematically name-based procedure combined with a manual procedure on Danish administrative food retailer data (i.e. the Smiley register) to identify, locate and classify food outlets. Food outlets were classified into the most commonly used classifications (i.e. fast food, restaurants, convenience stores, supermarkets, fruit and vegetable stores and miscellaneous) each divided into three commonly used definitions; narrow, moderate and broad. Classifications were based on branch code, name, and/or information on the internal and external appearance of the food outlet. From ground-truthing we validated the information in the register for its sensitivity and positive predictive value. In 361 randomly selected areas of the Capital region of Denmark we identified a total of 1887 food outlets compared with 1861 identified in the register. We obtained a sensitivity of 0.75 and a positive predictive value of 0.76. Across classifications, the positive predictive values varied with highest values for the moderate and broad definitions of fast food, convenience stores and supermarkets (ranging from 0.89 to 0.97). Information from the Smiley Register is considered to be representative to the Danish food environment and may be used for future research.
Objectives Prolonged sitting at work has been found to increase risk for musculoskeletal pain. The office-based intervention ＂Take a Stand!＂ was effective in reducing sitting time at work. We aimed ...to study the effect of the intervention on a secondary outcome: musculoskeletal pain. Methods Take a Stand! included 19 offices (317 workers) at four workplaces cluster randomized to intervention or control. The multicomponent intervention lasted three months and included management support, environmental changes, and local adaptation. Control participants behaved as usual. Musculoskeletal pain was measured by self-report questionnaire assessing pain in neck-shoulders, back and extremities in three categories at baseline, and one and three months follow-up. Results At one month, there was no difference in odds ratio (OR) for pain in neck-shoulders between the two groups. However, after three months, the OR was 0.52 95% confidence interval (95% CI) 0.30-0.92 for pain in neck-shoulders in the intervention compared to the control group. No differences were found between the intervention and control group for pain in back and extremities over the three months. For total pain score a slight reduction was found in the intervention compared to the control group at one and three months -0.13 (95% CI -0.23- -0.03) and -0.17 (95% CI -0.32- -0.01). Conclusions The secondary analyses showed that the office-based intervention Take a Stand! reduced neck-shoulder pain after three months and total pain score after one and three months among office workers, but not neck-shoulder pain after one month or pain in the back and extremities.
School dropout rates and risky health behavior is common among students in vocational education and training (VET) schools. Students with poor physical and mental health are more likely to drop out, ...and as such VET schools may be an important setting for health promotion initiatives, not only to support a healthy lifestyle, but also to assure completion of education. A common feature of successful health promotion at VET schools is a high health promotion capacity at the school level. This study aimed to investigate the association between VET school's health promotion capacity and later student dropout rates. Secondary, we explored other school characteristics associated with student dropout rates.
This prospective study comprised 58 Danish VET schools offering basic programs. Health promotion capacity was assessed using questionnaire data from 2017 from school managers and teachers, and this was combined with register-based data on student dropouts the following year. Health promotion capacity was assessed using six scales, representing six underlying domains, and managers and teachers' ratings of these were compared using t-test. Associations between health promotion capacity and student dropout rates as well as associations between school characteristics and student dropout rates were analyzed using multiple linear regression.
No associations between VET schools' health promotion capacity and student dropout rates were observed, neither for the schools' overall health promotion capacity or for any of the six underlying domains (p = 0.17-0.84). School managers assessed health promotion capacity significantly higher than teachers overall and within all domains (p < 0.05). Moreover, student dropout rates were significantly lower at schools with a higher proportion of ethnic Danish students, VET-students at higher educational level and schools located in the Western part of Denmark (p < 0.05).
No associations between VET schools' health promotion capacity and student dropout rates were observed. This may be due to a relatively short follow-up time in our study and future research may reveal if VET school health promotion capacity may affect dropout rates over a longer time period. Moreover, more work is needed to further develop instruments for measuring health promotion capacity in a VET school context as well as other contexts.
Abstract Objective To investigate motives, strategies and experiences to quit smoking and reasons to relapse as a function of socioeconomic status. Methods A population-based study, Inter99, Denmark. ...Two thousand six hundred twenty-one daily smokers with a previous quit attempt completed questionnaires at baseline. Cross-sectional baseline-data (1999–2001) were analysed in adjusted regression analyses. Results. Consistent findings across the three indicators of socioeconomic status (employment, school education, higher education/vocational training): smokers with low socioeconomic status were significantly more likely than smokers with high socioeconomic status to report that they wanted to quit because smoking was too expensive (OR: 1.85 (1.4–2.4), for school education) or because they had health related problems (OR: 1.75 (1.4–2.2)). When looking at previous quit attempts, smokers with low socioeconomic status were significantly more likely to report that it had been a bad experience (OR: 1.41 (1.1–1.8)) and that they had relapsed because they were more nervous/restless/depressed (OR: 1.43 (1.1–1.8)). Conclusions. This study shows that smokers with low socioeconomic status have other motives to quit and other reasons to relapse than smokers with high socioeconomic status. Future tobacco prevention efforts aimed at smokers with low socioeconomic status should maybe focus on current advantages of quitting smoking, using high cost of smoking and health advantages of quitting as motivating factors and by including components of mental health as relapse prevention.
Aims: This study aimed to test the hypotheses that a high total sitting time and vigorous physical activity in leisure time increase the risk of low back pain and herniated lumbar disc disease. ...Methods: A total of 76,438 adults answered questions regarding their total sitting time and physical activity during leisure time in the Danish Health Examination Survey 2007–2008. Information on low back pain diagnoses up to 10 September 2015 was obtained from The National Patient Register. The mean follow-up time was 7.4 years. Data were analysed using Cox regression analysis with adjustment for potential confounders. Multiple imputations were performed for missing values. Results: During the follow-up period, 1796 individuals were diagnosed with low back pain, of whom 479 were diagnosed with herniated lumbar disc disease. Total sitting time was not associated with low back pain or herniated lumbar disc disease. However, moderate or vigorous physical activity, as compared to light physical activity, was associated with increased risk of low back pain (HR = 1.16, 95% CI: 1.03–1.30 and HR = 1.45, 95% CI: 1.15–1.83). Moderate, but not vigorous physical activity was associated with increased risk of herniated lumbar disc disease. Conclusions: The results suggest that total sitting time is not associated with low back pain, but moderate and vigorous physical activity is associated with increased risk of low back pain compared with light physical activity.
Body mass index (BMI) is a highly heritable polygenic trait. It is also affected by various environmental and behavioral risk factors. We used a BMI polygenic risk score (PRS) to study the interplay ...between the genetic and environmental factors defining BMI. First, we generated a BMI PRS that explained more variance than a BMI genetic risk score (GRS), which was using only genome-wide significant BMI-associated variants (R.sup.2 = 13.1% compared to 6.1%). Second, we analyzed interactions between BMI PRS and seven environmental factors. We found a significant interaction between physical activity and BMI PRS, even when the well-known effect of the FTO region was excluded from the PRS, using a small dataset of 6,179 samples. Third, we stratified the study population into two risk groups using BMI PRS. The top 22% of the studied populations were included in a high PRS risk group. Engagement in self-reported physical activity was associated with a 1.66 kg/m.sup.2 decrease in BMI in this group, compared to a 0.84 kg/m.sup.2 decrease in BMI in the rest of the population. Our results (i) confirm that genetic background strongly affects adult BMI in the general population, (ii) show a non-linear interaction between BMI genetics and physical activity, and (iii) provide a standardized framework for future gene-environment interaction analyses.
Frail elderly are at higher risk of negative outcomes such as disability, low quality of life, and hospital admissions. Furthermore, a peak in readmission of acutely admitted elderly patients is seen ...shortly after discharge. An investigation into the daily life experiences of the frail elderly shortly after discharge seems important to address these issues. The aim of this study was to explore how frail elderly patients experience daily life 1 week after discharge from an acute admission.
The qualitative methodological approach was interpretive description. Data were gathered using individual interviews. The participants were frail elderly patients over 65 years of age, who were interviewed at their home 1 week after discharge from an acute admission to a medical ward.
Four main categories were identified: "The system," "Keeping a social life," "Being in everyday life," and "Handling everyday life." These categories affected the way the frail elderly experienced daily life and these elements resulted in a general feeling of well-being or non-well-being. The transition to home was experienced as unsafe and troublesome especially for the more frail participants, whereas the less frail experienced this less.
Several elements and stressors were affecting the well-being of the participants in daily life 1 week after discharge. In particular, contact with the health care system created frustrations and worries, but also physical disability, loneliness, and inactivity were issues of concern. These elements should be addressed by health professionals in relation to the transition phase. Future interventions should incorporate a multidimensional and bio-psycho-social perspective when acutely admitted frail elderly are discharged. Stakeholders should evaluate present practice to seek to improve care across health care sectors.
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