Anne Loyen

Variation in population levels of sedentary time in European adults according to cross-European studies: a systematic literature review within DEDIPAC

BackgroundSedentary behaviour is increasingly recognized as a public health risk that needs to be monitored at the population level. Across Europe, there is increasing interest in assessing population levels of sedentary time. This systematic literature review aims to provide an overview of all existing cross-European studies that measure sedentary time in adults, to describe the variation in population levels across these studies and to discuss the impact of assessment methods.MethodsSix literature databases (PubMed, EMBASE, CINAHL, PsycINFO, SportDiscus and OpenGrey) were searched, supplemented with backward- and forward tracking and searching authors’ and experts’ literature databases. Articles were included if they reported on observational studies measuring any form of sedentary time in the general population in two or more European countries. Each record was reviewed, extracted and assessed by two independent researchers, and disagreements were resolved by a third researcher. The review protocol of this review is registered in the PROSPERO database under registration number CRD42014010335.ResultsOf the 9,756 unique articles that were identified in the search, twelve articles were eligible for inclusion in this review, reporting on six individual studies and three Eurobarometer surveys. These studies represented 2 to 29 countries, and 321 to 65,790 participants. Eleven studies focused on total sedentary time, while one studied screen time. The majority of studies used questionnaires to assess sedentary time, while two studies used accelerometers. Total sedentary time was reported most frequently and varied from 150 (median) to 620 (mean) minutes per day across studies and countries.ConclusionsOne third of European countries were not included in any of the studies. Objective measures of European adults are currently limited, and most studies used single-item self-reported questions without assessing sedentary behaviour types or domains. Findings varied substantially between studies, meaning that population levels of sedentary time in European adults are currently unknown. In general, people living in northern Europe countries appear to report more sedentary time than southern Europeans. The findings of this review highlight the need for standardisation of the measurement methods and the added value of cross-European surveillance of sedentary behaviour.

European Sitting Championship: Prevalence and Correlates of Self-Reported Sitting Time in the 28 European Union Member States

Objective Sedentary behaviour is increasingly recognized as an important health risk, but comparable data across Europe are scarce. The objective of this study was to explore the prevalence and correlates of self-reported sitting time in adults across and within the 28 European Union Member States. Methods This study reports data from the Special Eurobarometer 412. In 2013, 27,919 randomly selected Europeans (approximately 1000 per Member State) were interviewed face-to-face. Sitting time on a usual day was self-reported and dichotomised into sitting less- and more than 7.5 hours per day. Uni- and multivariate odds ratios of sitting more than 7.5 hours per day were assessed by country and socio-demographic variables using binary logistic regression analyses. The analyses were stratified by country to study the socio-demographic correlates of sitting time within the different countries. Results A total of 26,617 respondents were included in the analyses. Median sitting time was five hours per day. Across Europe, 18.5 percent of the respondents reported to sit more than 7.5 hours per day, with substantial variation between countries (ranging from 8.9 to 32.1 percent). In general, northern European countries reported more sitting than countries in the south of Europe. ‘Current occupation’ and ‘age when stopped education’ were found to be the strongest correlates of sitting time, both across Europe and within most Member States. Compared to manual workers, the odds ratio of sitting more than 7.5 hours per day was 5.00 for people with white collar occupations, 3.84 for students, and 3.65 for managers. Conclusions There is substantial variation in self-reported sitting time among European adults across countries as well as socio-demographic groups. While regular surveillance of (objectively measured) sedentary behaviour is needed, the results of this study provide entry points for developing targeted interventions aimed at highly sedentary populations, such as people with sedentary occupations.

Determinants of diet and physical activity (DEDIPAC): a summary of findings

The establishment of the Determinants of Diet and Physical Activity (DEDIPAC) Knowledge Hub, 2013–2016, was the first action taken by the ‘Healthy Diet for a Healthy Life’ European Joint Programming Initiative. DEDIPAC aimed to provide better insight into the determinants of diet, physical activity and sedentary behaviour across the life course, i.e. insight into the causes of the causes of important, non-communicable diseases across Europe and beyond. DEDIPAC was launched in late 2013, and delivered its final report in late 2016. In this paper we give an overview of what was achieved in terms of furthering measurement and monitoring, providing overviews of the state-of-the-art in the field, and building toolboxes for further research and practice. Additionally, we propose some of the next steps that are now required to move forward in this field, arguing in favour of 1) sustaining the Knowledge Hub and developing it into a European virtual research institute and knowledge centre for determinants of behavioural nutrition and physical activity with close links to other parts of the world; 2) establishing a cohort study of families across all regions of Europe focusing specifically on the individual and contextual determinants of major, non-communicable disease; and 3) furthering DEDIPAC’s work on nutrition, physical activity, and sedentary behaviour policy evaluation and benchmarking across Europe by aligning with other international initiatives and by supporting harmonisation of pan-European surveillance.

Identifying and sharing data for secondary data analysis of physical activity, sedentary behaviour and their determinants across the life course in Europe: general principles and an example from DEDIPAC

Background The utilisation of available cross-European data for secondary data analyses on physical activity, sedentary behaviours and their underlying determinants may benefit from the wide variation that exists across Europe in terms of these behaviours and their determinants. Such reuse of existing data for further research requires Findable; Accessible; Interoperable; Reusable (FAIR) data management and stewardship. We here describe the inventory and development of a comprehensive European dataset compendium and the process towards cross-European secondary data analyses of pooled data on physical activity, sedentary behaviour and their correlates across the life course. Methods A five-step methodology was followed by the European Determinants of Diet and Physical Activity (DEDIPAC) Knowledge Hub, covering the (1) identification of relevant datasets across Europe, (2) development of a compendium including details on the design, study population, measures and level of accessibility of data from each study, (3) definition of key topics and approaches for secondary analyses, (4) process of gaining access to datasets and (5) pooling and harmonisation of the data and the development of a data harmonisation platform. Results A total of 114 unique datasets were found for inclusion within the DEDIPAC compendium. Of these datasets, 14 were eventually obtained and reused to address 10 exemplar research questions. The DEDIPAC data harmonisation platform proved to be useful for pooling, but in general, harmonisation was often restricted to just a few core (crude) outcome variables and some individual-level sociodemographic correlates of these behaviours. Conclusions Obtaining, pooling and harmonising data for secondary data analyses proved to be difficult and sometimes even impossible. Compliance to FAIR data management and stewardship principles currently appears to be limited for research in the field of physical activity and sedentary behaviour. We discuss some of the reasons why this might be the case and present recommendations based on our experience.

Data on Determinants Are Needed to Curb the Sedentary Epidemic in Europe. Lessons Learnt from the DEDIPAC European Knowledge Hub

Societal and technological changes have resulted in sitting being the dominant posture during most activities of daily living, such as learning, working, travelling and leisure time. Too much time spent in seated activities, referred to as sedentary behaviour, is a novel concern for public health as it is one of the key lifestyle causes of poor health. The European DEDIPAC (Determinants of Diet and Physical Activity) Knowledge Hub coordinated the work of 35 institutions across 12 European member states to investigate the determinants of sedentary behaviour. DEDIPAC reviewed current evidence, set a theoretical framework and harmonised the available epidemiological data. The main results are summarised. The conclusion is that there is a dire lack of data that is exploitable across Europe to inform policy and intervention. There is an urgent need to develop international data collection compliant with FAIR (Findable, Accessible, Interoperable, Re-usable) and standardised surveillance systems for sedentary behaviour.

Associations of self-reported physical activity and depression in 10,000 Irish adults across harmonised datasets: a DEDIPAC-study

BackgroundDepression is a prevalent, debilitating, and often recurrent mood disorder for which successful first-line treatments remains limited. The purpose of this study was to investigate the cross-sectional associations between self-reported physical activity (PA) and depressive symptoms and status among Irish adults, using two existing datasets, The Irish Longitudinal Study on Ageing (TILDA) and The Mitchelstown Cohort Study.MethodsThe two selected databases were pooled (n = 10,122), and relevant variables were harmonized. PA was measured using the short form International Physical Activity Questionnaire. Depressive symptoms were measured by the Center for Epidemiologic Studies Depression (CES-D) questionnaire. Participants were classified as meeting World Health Organization moderate-to-vigorous PA (MVPA) guidelines or not, and divided into tertiles based on weekly minutes of MVPA. A CES-D score of ≥16 indicated elevated depressive symptoms. Data collection were conducted in 2010–2011.ResultsSignificantly higher depressive symptoms were reported by females (7.11 ± 7.87) than males (5.74 ± 6.86; p < 0.001). Following adjustment for age, sex, BMI, and dataset, meeting the PA guidelines was associated with 44.7% (95%CI: 35.0 to 52.9; p < 0.001) lower odds of elevated depressive symptoms. Compared to the low PA tertile, the middle and high PA tertiles were associated with 25.2% (95%CI: 8.7 to 38.6; p < 0.01) and 50.8% (95%CI: 40.7 to 59.2; p < 0.001) lower odds of elevated depressive symptoms, respectively.ConclusionMeeting the PA guidelines is associated with lower odds of elevated depressive symptoms, and increased volumes of MVPA are associated with lower odds of elevated depressive symptoms.

Objectively measured sedentary time among five ethnic groups in Amsterdam: The HELIUS study

Introduction Sedentary behaviour is increasingly recognised as a health risk. While differences in this behaviour might help explain ethnic differences in disease profiles, studies on sedentary behaviour in ethnic minorities are scarce. The aim of this study was to compare the levels and the socio-demographic and lifestyle-related correlates of objectively measured sedentary time among five ethnic groups in Amsterdam, the Netherlands. Methods Data were collected as part of the HELIUS study. The sample consisted of adults from a Dutch, Moroccan, African Surinamese, South-Asian Surinamese and Turkish ethnic origin. Data were collected by questionnaire, physical examination, and a combined heart rate and accelerometry monitor (Actiheart). Sedentary time was defined as waking time spent on activities of <1.5 metabolic equivalents. Ethnic differences in the levels of sedentary time were tested using ANOVA and ANCOVA analyses, while ethnic differences in the correlates of sedentary time were tested with interactions between ethnicity and potential correlates using general linear models. Associations between these correlates and sedentary time were explored using linear regression analyses stratified by ethnicity (pre-determined). All analyses were adjusted for gender and age. Results 447 participants were included in the analyses, ranging from 73 to 109 participants per ethnic group. Adjusted levels of sedentary time ranged from 569 minutes/day (9.5 hours/day) for participants with a Moroccan and Turkish origin to 621 minutes/day (10.3 hours/day) in African Surinamese participants. There were no statistically significant differences in the levels or correlates of sedentary time between the ethnic groups. Meeting the physical activity recommendations (150 minutes/week) was consistently inversely associated with sedentary time across all ethnic groups, while age was positively associated with sedentary time in most groups. Conclusions No statistically significant differences in the levels of objectively measured sedentary time or its socio-demographic and lifestyle-related correlates were observed among five ethnic groups in Amsterdam, the Netherlands.

Recent trends in population levels and correlates of occupational and leisure sitting time in full-time employed Australian adults

This study aimed to explore the trend in population levels, as well as the correlates, of occupational and leisure sitting time in full-time employed Australian adults between 2007 and 2015. We used data from the 2007/08, 2011/12 and 2014/15 Australian Health Surveys, in which nationally representative samples of the Australian population were interviewed. Full-time (≥35 hours/week) employed respondents reported sitting time at work and during leisure on a usual workday. Trends over time and associations between socio-demographic and health-related characteristics and sitting time were analysed in the combined dataset using multivariable logistic regression models. Over 21,000 observations were included in the analyses. Across the three surveys, approximately 51% of the respondents reported ≥4 hours/workday occupational sitting time, 40% reported ≥4 hours/workday leisure sitting time, and 55% reported ≥7 hours/workday combined occupational and leisure sitting time. There were no clear trends over time. All potential correlates were associated with occupational sitting time and all but educational level were associated with leisure sitting time. The directions of the associations with gender, age and leisure-time physical activity were reversed for occupational sitting time and leisure sitting time. These findings show that the average levels of occupational and leisure sitting time on workdays were high but stable over the past decade. The observed differences in correlates of occupational and leisure sitting time demonstrate the need to assess and address sedentary behaviour domains separately in research and policy.

Changes in children's television and computer time according to parental education, parental income and ethnicity: A 6-year longitudinal EYHS study

Objectives To investigate changes in children’s television and computer time according to three socio-economic status (SES) indicators. Design Prospective cohort study. Methods Data were drawn from the European Youth Heart Study and included longitudinal data collected in 1997 and 2003 in Denmark. Television and computer time were self-reported by children. Parental education, income and ethnicity were parent-reported. Baseline data were available for 549 children (47.0% boys, 9.6 years). Generalized linear mixed models analyzed whether changes in television and computer time from baseline to follow-up differed according to the SES-indicators. Result TV viewing time increased with 25% over time (ExpB = 1.25, 95% CI = 1.04–1.50). At both time points, children with two higher educated parents viewed 25% less hours of television than children with no higher educated parents (ExpB = 0.75, 95% CI = 0.60–0.94) and one higher educated parent (ExpB = 0.75, 95%CI = 0.59–0.97). Among children with no higher educated parents the odds of being in a higher category of computer time increased with 80% over time (OR = 1.80, 95% CI = 1.24–2.60). Among children with two higher educated parents the odds of being in a higher category of computer time decreased with 45% over time (OR = 0.55, 95% CI = 0.32–0.94). The association with ethnicity showed that white children had 42% lower odds (OR = 0.58; 95% CI = 0.34–1.00) of being in a higher category of computer time than non-white children. No significant associations were found for parental income. Conclusions The most important SES measure of screen-based behaviors in children was parental education. Ethnicity was only associated with computer time. Financial resources were less relevant for changes in television viewing and computer use.