The relationship between sedentary behaviour and physical activity and their role in the development of health conditions is an ongoing topic of research. This debate paper presents arguments in ...favour and against the statement: "Is sedentary behaviour just physical inactivity by another name?" The paper finishes with recommendations for future research in the field of sedentary behaviour, physical activity and public health.
This study examines the association between objectively measured access to green space, frequency of green space use, physical activity, and the probability of being overweight or obese in the city ...of Bristol, England. Data from the 2005 Bristol Quality of Life in your Neighbourhood survey for 6821 adults were combined with a comprehensive GIS database of neighbourhood and green space characteristics. A range of green space accessibility measures were computed. Associations between accessibility and the odds of respondents achieving a recommended 30min or more of moderate activity five times a week, or being overweight or obese, were examined using logistic regression. Results showed that the reported frequency of green space use declined with increasing distance. The study also found that respondents living closest to the type of green space classified as a Formal park were more likely to achieve the physical activity recommendation and less likely to be overweight or obese. The association with physical activity, but not with overweight or obesity, remained after adjustment for respondent characteristics, area deprivation, and a range of characteristics of the neighbourhood environment. The findings suggest that the provision of good access to green spaces in urban areas may help promote population physical activity.
To undertake a systematic review and meta-analysis to assess the impact of cardiac rehabilitation (CR) on physical activity (PA) levels of patients with heart disease and the methodological quality ...of these studies.
Databases (MEDLINE, EMBASE, CENTRAL, CINAHL, PsychINFO and SportDiscus) were searched without language restriction from inception to January 2017 for randomised controlled trials (RCTs) comparing CR to usual care control in adults with heart failure (HF) or coronary heart disease (CHD) and measuring PA subjectively or objectively. The direction of PA difference between CR and control was summarised using vote counting (ie, counting the positive, negative and non-significant results) and meta-analysis.
Forty RCTs, (6480 patients: 5825 CHD, 655 HF) were included with 26% (38/145) PA results showing a statistically significant improvement in PA levels with CR compared with control. This pattern of results appeared consistent regardless of type of CR intervention (comprehensive vs exercise-only) or PA measurement (objective vs subjective). Meta-analysis showed PA increases in the metrics of steps/day (1423, 95% CI 757.07 to 2089.43, p<0.0001) and proportion of patients categorised as physically active (relative risk 1.55, 95% CI 1.19 to 2.02, p=0.001). The included trials were at high risk of bias, and the quality of the PA assessment and reporting was relatively poor.
Overall, there is moderate evidence of an increase in PA with CR participation compared with control. High-quality trials are required, with robust PA measurement and data analysis methods, to assess if CR definitely leads to important improvements in PA.
Continued proliferation of accelerometers in physical activity research has opened new avenues for understanding activity behaviours beyond simple aggregate measures of frequency and duration. This ...study explores the standing and stepping composition, and the temporal distribution, of upright events, and investigates their associations with sociodemographic and health factors.
Participants from the 1970 British Cohort Study wore activPAL3 accelerometers for seven days. Event-based analysis was used to extract a time series of upright, standing, and stepping events. Derived metrics included daily number of upright and stepping events, total upright and stepping time, the burstiness of upright events and burstiness of sedentary events (burstiness refers to the pattern of how physical activity and sedentary behaviour are distributed throughout a given time period), within-event stepping proportion, within-event step count, and stepping cadence. Generalized linear regression models, adjusted for total step count, were employed to explore associations between derived metrics and sociodemographic and health-related factors.
A total of 4527 participants, provided 30992 valid days (≥ 10 h of waking wear) and 1.64 million upright events. Upright event composition and temporal distribution varied across a range of sociodemographic and health-related factors. Females had more upright events than males (4.39 3.41,5.38 n), spent more time upright, and exhibited burstier patterns of upright events (0.05 0.04,0.05 B
). Individuals with higher BMI had fewer upright events and a lower daily step count, but their temporal distribution of upright events was less bursty (overweight -0.02 -0.02,-0.01 B
; obese -0.03 -0.04,-0.02 B
), and upright events had a higher step count. People in active occupations were upright for longer, displayed burstier patterns of upright events (standing 0.04 0.03,0.05 B
; physical work 0.05 0.04,0.05 B
; heavy manual 0.06 0.04,0.07 B
), with more variable durations and shorter, slower paced stepping events compared with sedentary occupations.
This study has revealed novel phenotypes of standing and sitting that go beyond simple aggregate measures of total steps, step event duration or time between events. People with the same volume of stepping and frequency of gaps between upright events can accumulate their steps in very different ways. These differences and associations with population sub-groups, which persisted after adjustment for total stepping volume, may have important relations with functional and health outcomes. The findings lay the groundwork for future studies to investigate how different sitting and standing phenotypes can add to our understanding of the relationship between physical activity and health.
Abstract Objectives To understand the patterning of greenspace provision and use by area deprivation, and determine how deprivation moderates relationships with physical activity. Methods The ...responses obtained from 6821 respondents to the 2005 ‘The Quality of Life in your Neighbourhood Survey’ undertaken in Bristol, England, were combined with objective measures of access to greenspaces. Area deprivation was determined using the Index of Multiple Deprivation. Descriptive analyses examined how mean distance, perceived greenspace access and safety, visit frequency, and physical activity varied by deprivation quartile. Logistic regression models examined how relationships were moderated by deprivation. Results Respondents in more deprived areas lived closer to greenspaces, but reported poorer perceived accessibility, poorer safety, and less frequent use. Frequency of use declined with distance but only in the most affluent areas. Relationships between physical activity and perceived accessibility, safety, and visit frequency were moderated by deprivation. Conclusions The accessibility of greenspaces was better in more deprived areas but those residents had more negative perceptions and were less likely to use the greenspaces. Interventions may be most effective if they target the perceptions and needs of residents of deprived neighbourhoods.
BACKGROUND: Walking for physical activity is associated with substantial health benefits for adults. Increasingly research has focused on associations between walking behaviours and neighbourhood ...environments including street characteristics such as pavement availability and aesthetics. Nevertheless, objective assessment of street-level data is challenging. This research investigates the reliability of a new street characteristic audit tool designed for use with Google Street View, and assesses levels of agreement between computer-based and on-site auditing. METHODS: The Forty Area STudy street VIEW (FASTVIEW) tool, a Google Street View based audit tool, was developed incorporating nine categories of street characteristics. Using the tool, desk-based audits were conducted by trained researchers across one large UK town during 2011. Both inter and intra-rater reliability were assessed. On-site street audits were also completed to test the criterion validity of the method. All reliability scores were assessed by percentage agreement and the kappa statistic. RESULTS: Within-rater agreement was high for each category of street characteristic (range: 66.7%-90.0%) and good to high between raters (range: 51.3%-89.1%). A high level of agreement was found between the Google Street View audits and those conducted in-person across the nine categories examined (range: 75.0%-96.7%). CONCLUSION: The audit tool was found to provide a reliable and valid measure of street characteristics. The use of Google Street View to capture street characteristic data is recommended as an efficient method that could substantially increase potential for large-scale objective data collection.
The aim of this review was to understand the association between habitual physical activity (hPA) and carotid-femoral pulse wave velocity (cfPWV) in an ostensibly healthy adult population. Searches ...were performed in MEDLINE Web of Science, SPORTDiscus and CINAHL databases published up to 01/01/2022 (PROSPERO, Registration No: CRD42017067159). Observational English-language studies assessing the relationship between cfPWV and hPA (measured via self-report or device-based measures) were considered for inclusion in a narrative synthesis. Studies were excluded if studying specific disease. Studies were further included in pooled analyses where a standardised association statistic for continuous hPA and cfPWV was available. 29 studies were included in narrative synthesis, of which 18 studies provided sufficient data for pooled analyses, totalling 15,573 participants. A weak, significant, negative correlation between hPA and cfPWV was observed; partial r = -0.08 95%CI -0.15, -0.01; P = 0.045. Heterogeneity was high (I2 = 94.5% P<0.001). Results did not differ across sub-group analyses, however the high heterogeneity within pooled analyses was largely explained by studies utilizing self-reports of PA exposures, being of poor methodological quality or providing only univariate analyses. Overall this systematic review identified a weak negative beneficial association between hPA and cfPWV suggesting that higher levels of hPA benefit vascular health even amongst an asymptomatic population. However, the variation in PA metrics reported (restricting ability to complete meta-analysis), and the heterogeneity within pooled analyses suggests that findings should be interpreted with a degree of caution. The development of methods to precisely quantify day-to-day movement behaviours should support future high-quality research in this field.
Observational studies have shown a positive association between time outdoors and physical activity in children. Time outdoors may be a feasible intervention target to increase the physical activity ...of youth, but methods are required to accurately measure time spent outdoors in a range of locations and over a sustained period. The Global Positioning System (GPS) provides precise location data and can be used to identify when an individual is outdoors. The aim of this study was to investigate whether GPS data recorded outdoors were associated with objectively measured physical activity.
Participants were 1010 children (11.0 +/- 0.4 years) recruited from 23 urban primary schools in South West England, measured between September 2006 and July 2008. Physical activity was measured by accelerometry (Actigraph GT1M) and children wore a GPS receiver (Garmin Foretrex 201) after school on four weekdays to record time outdoors. Accelerometer and GPS data were recorded at 10 second epochs and were combined to describe patterns of physical activity when both a GPS and accelerometer record were present (outdoors) and when there was accelerometer data only (indoors). ANOVA was used to investigate gender and seasonal differences in the patterns of outdoor and indoor physical activity, and linear regression was used to examine the cross-sectional associations between GPS-measured time outdoors and physical activity.
GPS-measured time outdoors was a significant independent predictor of children's physical activity after adjustment for potential confounding factors. Physical activity was more than 2.5 fold higher outdoors than indoors (1345.8 +/- 907.3 vs 508.9 +/- 282.9 counts per minute; F = 783.2, p < .001). Overall, children recorded 41.7 +/- 46.1 minutes outdoors between 3.30 pm and 8.30 pm, with more time spent outdoors in the summer months (p < .001). There was no gender difference in time spent outdoors. Physical activity outdoors was higher in the summer than the winter (p < .001), whilst there was no seasonal variation in physical activity indoors.
Duration of GPS recording is positively associated with objectively measured physical activity and is sensitive to seasonal differences. Minute by minute patterning of GPS and physical activity data is feasible and may be a useful tool to investigate environmental influences on children's physical activity and to identify opportunities for intervention.
Prospective studies report associations between indicators of time spent sitting and obesity risk. Most studies use a single indicator of sedentary behavior and are unable to clearly identify whether ...sedentary behavior is a cause or a consequence of obesity.
To investigate cross-sectional and prospective associations between multiple sitting time indicators and obesity and examine the possibility of reverse causality.
Using data from the Whitehall II cohort, multiple logistic models were fitted to examine associations between prevalent obesity (BMI ≥30) at Phase 5 (1997-1999), and incident obesity between Phases 5 and 7 (2003-2004) across four levels of five sitting exposures (work sitting, TV viewing, non-TV leisure-time sitting, leisure-time sitting, and total sitting). Using obesity data from three prior phases (1985-1988, 1991-1993; and recalled weight at age 25 years), linear regression models were fitted to examine the association between prior obesity and sitting time at Phase 5. Analyses were conducted in 2012.
None of the sitting exposures were associated with obesity either cross-sectionally or prospectively. Obesity at one previous measurement phase was associated with a 2.43-hour/week (95% CI=0.07, 4.78) increase in TV viewing; obesity at three previous phases was associated with a 7.42-hour/week (95% CI=2.7, 12.46) increase in TV-viewing hours/week at Phase 5.
Sitting time was not associated with obesity cross-sectionally or prospectively. Prior obesity was prospectively associated with time spent watching TV per week but not other types of sitting.
Measures of stepping volume and rate are common outputs from wearable devices, such as accelerometers. It has been proposed that biomedical technologies, including accelerometers and their ...algorithms, should undergo rigorous verification as well as analytical and clinical validation to demonstrate that they are fit for purpose. The aim of this study was to use the V3 framework to assess the analytical and clinical validity of a wrist-worn measurement system of stepping volume and rate, formed by the GENEActiv accelerometer and GENEAcount step counting algorithm. The analytical validity was assessed by measuring the level of agreement between the wrist-worn system and a thigh-worn system (activPAL), the reference measure. The clinical validity was assessed by establishing the prospective association between the changes in stepping volume and rate with changes in physical function (SPPB score). The agreement of the thigh-worn reference system and the wrist-worn system was excellent for total daily steps (CCC = 0.88, 95% CI 0.83-0.91) and moderate for walking steps and faster-paced walking steps (CCC = 0.61, 95% CI 0.53-0.68 and 0.55, 95% CI 0.46-0.64, respectively). A higher number of total steps and faster paced-walking steps was consistently associated with better physical function. After 24 months, an increase of 1000 daily faster-paced walking steps was associated with a clinically meaningful increase in physical function (0.53 SPPB score, 95% CI 0.32-0.74). We have validated a digital susceptibility/risk biomarker-pfSTEP-that identifies an associated risk of low physical function in community-dwelling older adults using a wrist-worn accelerometer and its accompanying open-source step counting algorithm.