Abstract
Background
There is insufficient evidence of sitting time in UK children from validated objective measures. This study explored sitting patterns in primary school children from Bradford, UK, ...using the validated activPAL inclinometer.
Methods
Overall, 79 children (9.8 (SD 0.3) years old, 52% boys; 70% South Asian) wore activPALs for 7 days. Total sitting time, sitting time accumulated in different bout lengths, and the proportion of wear time spent in these variables were explored and compared across different periods of the week.
Results
Children spent 614 ± 112 (median ± IQR) min/day on school days and 690 ± 150 min/day on weekend days sitting. The proportion of time spent sitting was significantly higher on weekend days compared to school days (mean±SD: 74 ± 10% versus 68 ± 8%,P < 0.001), as was the proportion of time accumulated in >30 min sitting bouts (mean±CI: 28 ± 27–33% versus 20 ± 20–22%, P < 0.001). The proportion of time spent sitting after school was significantly higher than during school time (mean±SD: 70 ± 8.4% versus 63 ± 8.3%,P < 0.001), as was the proportion of time spent in prolonged (>30 min) sitting bouts (mean±CI: 19 ± 16–22% versus 11 ± 10–14%, P < 0.001).
Conclusions
Children spent large proportions of their waking day sitting, often accumulated in prolonged uninterrupted bouts and particularly after school and on weekends. Interventions to reduce sitting time in children are urgently needed.
Sedentary behaviour (sitting) is a risk factor for adverse health outcomes. The classroom environment has traditionally been associated with prolonged periods of sitting in children. The aim of this ...study was to examine the potential impact of an environmental intervention, the addition of sit-stand desks in the classroom, on school children's sitting and physical activity during class time and after school. The 'Stand Out in Class' pilot trial was a two-arm cluster randomised controlled trial conducted in eight primary schools with children from a mixed socioeconomic background. The 4.5 month environmental intervention modified the physical (six sit-stand desks replaced standard desks) and social (e.g., teachers' support) environment. All children wore activPAL and ActiGraph accelerometers for 7 days at baseline and follow-up. In total 176 children (mean age = 9.3 years) took part in the trial. At baseline, control and intervention groups spent more than 65% of class time sitting, this changed to 71.7% and 59.1% at follow-up, respectively (group effect
< 0.001). The proportion of class time spent standing and stepping, along with the proportion of time in light activity increased in the intervention group and decreased in the control group. There was no evidence of any compensatory effects from the intervention after school. Incorporating sit-stand desks to change the classroom environment at primary school appears to be an acceptable strategy for reducing children's sedentary behaviour and increasing light activity especially during class time. Trial registration: ISRCTN12915848 (registered: 09/11/16).
To determine how many days of pedometer monitoring are necessary to estimate monthly ambulatory activity in adults.
Two hundred and twelve adults (64% female; age = 38.3 +/- 13.3 yr; body mass index ...= 27.9 +/- 5.3 kg x m(-2)) wore a pedometer (SW-200) for 28 consecutive days. About 76.4% were randomly allocated to a reliability group, whereas the remainder (n = 50) comprised a confirmation group. Mean step counts calculated over the 28-d period served as the criterion. Using the reliability group, intraclass correlations (ICC) were computed for the entire 4-wk period, for 3, 2, and 1 wk, and for different combinations of any 6, 5, 4, 3, and 2 d. The reliability of the recommended time frame was tested in the confirmation group using regression analysis.
In the reliability group, the ICC for any single given day was 0.41. All combinations including 6 d or more had ICC above 0.80. The inclusion of participant characteristics into a regression, alongside mean steps reported during 1 wk of monitoring, failed to strengthen the prediction. When tested in the confirmation group, there was a significant relationship between mean step counts calculated from the first week of monitoring and the criterion (adjusted R2 = 0.91, P< 0.001).
It is recommended that researchers collect pedometer data over a 7-d period for a reliable estimate of monthly activity in adults. A 7-d period is recommended, as opposed to 6 d (where ICC > 0.80) because: 1) step counts are characteristically lower on a Sunday; thus, for a reliable estimate of habitual activity, Sunday activity should always be included; and 2) in the event of missing data (1 d), data collected on 6 d will remain sufficiently reliable to estimate mean monthly activity.
Occupational sitting is associated with negative health outcomes. Sit-stand workstations have been shown to reduce sitting time in office workers, although there is no evidence on whether this change ...to practice would be acceptable to GPs.
To investigate GPs views about the use of sit-stand desks within general practice and the potential impact they may have on the nature and quality of consultations with adult patients.
Observational study involving GPs located across the UK.
An online survey was emailed to members of the Royal College of General Practitioners (RCGP) and shared on social media. Only GPs working in the UK were eligible. The survey included questions on socio-demographics, GPs views about the use of sit-stand desks within their work, their levels of physical activity, total time spent sitting at work each day, and time spent at work.
14 142 surveys were sent by the RCGP to their members with 810 GPs responding, with a further 33 responding via social media. 60.6% of GPs would like a sit-stand desks in their consultation room, while 19.2% already had one. Most GPs thought sit-stand desks could be used for telephone consultations (91.9%) and administration tasks (92.3%). There was less agreement about whether they could be used during face-to-face consultations (35.0% agreed), with the potential impact on the doctor-patient relationship raised as the primary concern.
The implementation of sit-stand desks had support from GPs, but their possible impact on the doctor-patient relationship should be considered in future research.
OBJECTIVE:The aim of this study was to examine the effects of implementing a lifestyle health behavior intervention on cardiovascular risk markers in a sample of lorry drivers.
METHODS:Fifty-seven ...males participated in the pre-post evaluation of a multicomponent 12-week intervention.
RESULTS:Favorable changes in several cardiovascular health indicators were observed, including fasting blood glucose (−0.6 mmol/L), LDL-Cholesterol (−0.7 mmol/L), total cholesterol (−0.7 mmol/L), waist-hip ratio (−0.10), and waist circumference (−2.5 cm) (P < 0.01). The proportion of participants with a more than 10% risk of a cardiovascular event in the next 10 years was reduced by 12% (P < 0.05). A 21%, 12%, and 7.5% reduction in drivers with pre-diabetes (P < 0.001), undiagnosed diabetes (P < 0.05), and the metabolic syndrome (P < 0.05), respectively, was observed.
CONCLUSION:This study highlights the feasibility of implementing a multicomponent health intervention within the transport setting and provides preliminary evidence of its beneficial effects on some markers of health.
Physical inactivity and obesity are widely prevalent in Heavy Goods Vehicle (HGV) drivers. We analysed whether obesity classification influenced the effectiveness of a bespoke structured lifestyle ...intervention ('SHIFT') for HGV drivers. The SHIFT programme was evaluated within a cluster randomised controlled trial, across 25 transport depots in the UK. After baseline assessments, participants within intervention sites received a 6-month multi-component health behaviour change intervention. Intervention responses (verses control) were stratified by obesity status (BMI < 30 kg/m
, n = 131; BMI ≥ 30 kg/m
, n = 113) and compared using generalised estimating equations. At 6-months, favourable differences were found in daily steps (adjusted mean difference 1827 steps/day,
< 0.001) and sedentary time (adjusted mean difference -57 min/day,
< 0.001) in drivers with obesity undertaking the intervention, relative to controls with obesity. Similarly, in drivers with obesity, the intervention reduced body weight (adjusted mean difference -2.37 kg,
= 0.002) and led to other favourable anthropometric outcomes, verses controls with obesity. Intervention effects were absent for drivers without obesity, and for all drivers at 16-18-months follow-up. Obesity classification influenced HGV drivers' behavioural responses to a multi-component health-behaviour change intervention. Therefore, the most at-risk commercial drivers appear receptive to a health promotion programme.
Abstract Objectives To calibrate and validate the ActiGraph GT3X+ to measure sedentary behaviour and physical activity in 2–3 year olds, using 5-s epochs; and to compare the predictive validity of ...the resulting cut-points with that of NHANES’, Trost's, and Pate's 15-s cut-points. Design Cross-sectional study. Methods Eighteen children (2.86 ± 0.60 years) wore an ActiGraph GT3X+ during video-recorded semi-structured calibration activity sessions. Activity was coded following Children's Activity Rating Scale. Receiver Operating Characteristic analysis was used to derive Axis1 and vector magnitude cut-points for sedentary behaviour and moderate–to-vigorous physical activity at 5-s epochs. Agreement with Children's Activity Rating Scale was assessed with Cohen's kappa, Lin's concordance, and Bland–Altman plots. Predictive validity of all cut-points was assessed in an independent sample of 20 children (2.99 ± 0.48 years) video-recorded during free-play, using the same procedures as the calibration phase. Results During calibration, vector magnitude cut-points (sedentary behaviour ≤ 96.12 counts; moderate–to-vigorous physical activity ≥ 361.94 counts) showed slightly better classification agreement with Children's Activity Rating Scale than Axis1 cut-points (sedentary behaviour ≤ 5 counts; moderate–to-vigorous physical activity ≥ 165 counts), but the latter showed the lowest bias in estimated sedentary behaviour and moderate–to-vigorous physical activity time. In the validation sample, 5-s Axis1 cut-points showed the best predictive validity and lowest mean differences of all cut-points between predicted and observed sedentary behaviour (−2.31%), light physical activity (−24.40%), and total physical activity time (−0.95%). Moderate–to-vigorous physical activity time was significantly overestimated by all cut-points (128.33–184.17%). Conclusions Because moderate–to-vigorous physical activity was highly overestimated, using only the 5-s Axis1 sedentary behaviour cut-point to distinguish sedentary behaviour from total physical activity is advised. The high accuracy indicates that these cut-points are useful for epidemiological studies involving the sedentary behaviour and physical activity of 2–3 year olds.
Sedentary behaviours continue to increase and are associated with heightened risks of morbidity and mortality. We assessed the cost-effectiveness of SMART Work & Life (SWAL), an intervention designed ...to reduce sitting time inside and outside of work, both with (SWAL-desk) and without (SWAL-only) a height-adjustable workstation compared to usual practice (control) for UK office workers. Health outcomes were assessed in quality-adjusted life-years (QALY) and costs in pound sterling (2019-2020). Discounted costs and QALYs were estimated using regression methods with multiply imputed data from the SMART Work & Life trial. Absenteeism, productivity and wellbeing measures were also evaluated. The average cost of SWAL-desk was £228.31 and SWAL-only £80.59 per office worker. Within the trial, SWAL-only was more effective and costly compared to control (incremental cost-effectiveness ratio (ICER): £12,091 per QALY) while SWAL-desk was dominated (least effective and most costly). However, over a lifetime horizon, both SWAL-only and SWAL-desk were more effective and more costly than control. Comparing SWAL-only to control generated an ICER of £4985 per QALY. SWAL-desk was more effective and costly than SWAL-only, generating an ICER of £13,378 per QALY. Findings were sensitive to various worker, intervention, and extrapolation-related factors. Based on a lifetime horizon, SWAL interventions appear cost-effective for office-workers conditional on worker characteristics, intervention cost and longer-term maintenance in sitting time reductions.
In the British Army, fitness is assessed by a load carriage test (Annual Fitness Test, AFT) and by a three event Personal Fitness Assessment (PFA). Body composition based on body mass index (BMI) and ...abdominal circumference (AC) is also part of a mandatory annual assessment. This study examined the influence of BMI and AC on fitness test results within a comprehensive sample of British Army personnel.
Secondary analyse were carried out on data obtained from the 2011 Defence Analytical Services and Advice (DASA) database for 50,635 soldiers (47,173 men and 3,462 women).
Comparisons using loglinear analysis were made between groups of individuals classified by body mass index as obese (≥30kg/m2) and not obese (<30kg/m2), and further classified using combined BMI and AC for obesity-related health risks to compare “no risk” with “increased risk.”
Not obese or “no risk” soldiers had a significant relationship with success in the AFT (p<0.01) and PFA (p<0.01). Of those soldiers who attempted the AFT, 99% of men and 92% of women passed; for the PFA, 92% of men and 91% of women passed. Obese or “at risk” soldiers were more likely to fail and far less likely to take both tests (p<0.05). Compared to older obese soldiers, young obese soldiers were more likely to attempt the tests.
We conclude that BMI and AC are useful indicators of fitness test outcome in the British Army.
Heavy goods vehicle (HGV) driving is recognised as a highly hazardous occupation due to the long periods of sedentary behaviour, low levels of physical activity and unhealthy food options when ...working. These risk factors combine with shift work and concomitant irregular sleep patterns to increase the prevalence of fatigue. Fatigue is closely linked with stress and, subsequently, poor physiological and psychological health. In parallel, a wealth of evidence has demonstrated the health and wellbeing benefits of spending time in nature. Here, we sought to examine whether spending time in nature was associated with lower levels of fatigue, anxiety and depression in HGV drivers. 89 long-distance drivers (98.9% male, mean ± SD age: 51.0 ± 9 years, body mass index: 29.8 ± 4.7 kg/m
) participating in a wider health promotion programme reported time spent in nature (during and before the Covid-19 pandemic) and symptoms of occupational fatigue, depression and anxiety. After controlling for covariates, truck drivers who visited nature at least once a week exhibited 16% less chronic fatigue prior to the pandemic, and 23% less chronic fatigue and 20% less acute fatigue during the pandemic. No significant differences were observed for either anxiety or depression. As fatigue has a range of physical and mental health sequelae, we propose that increased exposure to natural settings may make a valuable contribution to interventions to promote the health and wellbeing of this underserved group.
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