Lee Smith

How to reduce sitting time? A review of behaviour change strategies used in sedentary behaviour reduction interventions among adults

Sedentary behaviour – i.e., low energy-expending waking behaviour while seated or lying down – is a health risk factor, even when controlling for physical activity. This review sought to describe the behaviour change strategies used within interventions that have sought to reduce sedentary behaviour in adults. Studies were identified through existing literature reviews, a systematic database search, and hand-searches of eligible papers. Interventions were categorised as ‘very promising’, ‘quite promising’, or ‘non-promising’ according to observed behaviour changes. Intervention functions and behaviour change techniques were compared across promising and non-promising interventions. Twenty-six eligible studies reported thirty-eight interventions, of which twenty (53%) were worksite-based. Fifteen interventions (39%) were very promising, eight quite promising (21%), and fifteen non-promising (39%). Very or quite promising interventions tended to have targeted sedentary behaviour instead of physical activity. Interventions based on environmental restructuring, persuasion, or education were most promising. Self-monitoring, problem solving, and restructuring the social or physical environment were particularly promising behaviour change techniques. Future sedentary reduction interventions might most fruitfully incorporate environmental modification and self-regulatory skills training. The evidence base is, however, weakened by low-quality evaluation methods; more RCTs, employing no-treatment control groups, and collecting objective data are needed.

Childhood correlates of adult TV viewing time: a 32-year follow-up of the 1970 British Cohort Study

Background To identify, using a longitudinal data set, parental and childhood correlates of adult television (TV) viewing time at 32-year follow-up. Method Data were derived from the 1970 British Cohort Study, a longitudinal observational study of 17 248 British people born in a single week of 1970. The present analyses incorporated data from the age 10 and 42-year surveys. When participants were aged 10 years, their mothers provided information on how often participants watched TV and played sports (never/sometimes/often), and parents’ own occupation, as well as height and weight. A health visitor objectively assessed participants’ height and weight at age 10. Thirty-two years later, when participants were aged 42 years, they reported their daily TV viewing hours (none/0≤1/1<3/3<5/≥5), physical activity and health status. Associations between putative childhood and parental correlates and adult TV viewing time were investigated using logistic regression. Results Valid data at both time points were available for 6188 participants. Logistic regression models showed that those who reported ‘often’ watching TV at baseline were significantly more likely to watch >3 h/days of TV at follow-up (OR 1.42, 95% CI 1.21 to 1.65), as were those whose father was from a lower socio-occupational class (intermediate, routine/manual) compared with managerial (OR 1.55, 95% CI 1.14 to 2.11; OR 2.05, 95% CI 1.47 to 2.87). Body mass index (BMI) at age 10 was inversely associated with high TV in adulthood (per unit increase; OR 0.93, 95% CI 0.90 to 0.96) although fathers BMI when the child was aged 10 was positively associated with high TV in adulthood (per unit increase; OR 1.04, 95% CI 1.02 to 1.06). Conclusions Findings suggest that childhood TV viewing time tracks into adulthood. Parents’ health behaviours and social position appear to be associated with their childrens viewing habits, which may have important implications for the direction of future policy and practice. Specifically, findings support the case for early life interventions, particularly on socioeconomic inequalities, as a way of preventing sedentary behaviour in later life.

Patterns and correlates of physical activity behaviour over 10 years in older adults: prospective analyses from the English Longitudinal Study of Ageing

Objective Few studies have examined how levels of activity intensity fluctuate throughout later life in older adults and no study has identified correlates of sustained activity levels in this age group. The aim of the present analysis was to investigate stability of activity over a 10-year period and identify potential correlates of sustained activity levels in older adults. Design Analyses of data from the English Longitudinal Study of Ageing. Participant-reported physical activity data were collected in 2002 (baseline), 2004, 2006, 2008, 2010 and 2012. Participant age, sex, smoking, depressive symptoms, work status, wealth, and long-standing illness were recorded at baseline. Multiple logistic regression was used to examine associations between baseline exposure variables and persistent physical activity (reporting moderate and/or vigorous physical activity at least once a week at all 6 assessments over the 10-year time period). Results A total of 5022 participants (mean age 61 years; 2114 male) were included in the analyses. There was reasonable stability in the physical activity measure over the 6 time points (Cronbachs α 0.85). There was an overall trend for increasing levels of inactivity and a reduction in vigorous activity. Age, female sex, having ever smoked, long-standing illness, arthritis, obesity, and depressive symptoms were associated with a lower likelihood of being persistently active (defined as reporting moderate and/or vigorous physical activity at least once a week over all 6 assessment points). Those with greater wealth were 4 times more likely to be persistently active. Conclusions In the present analyses time spent in vigorous-intensity activity declined in later life. A range of sociodemographic and biomedical factors were associated with being persistently active in older adults.

Is active travel to non-school destinations associated with physical activity in primary school children?

OBJECTIVE To examine associations between mode of travel to non-school destinations and physical activity in schoolchildren. METHOD Analyses of data from SPEEDY, an observational study of 9-10 year old British children. In summer 2007, children reported their usual mode of travel to four destinations (to visit family, friends, the park or the shops) and wore accelerometers for at least three days. Time spent in moderate to vigorous physical activity (MVPA) was computed for the following time segments: daily, after school, weekend and out-of-school. Associations between mode of travel and physical activity were assessed using adjusted two-level multiple regression models stratified by sex. RESULTS 1859 pupils provided valid data. Boys who used active modes of travel spent significantly more time in MVPA in all time segments than boys who used passive modes. The median daily time spent in MVPA was 87 minutes (IQR 68-106) for active travellers and 76 minutes (IQR 60-93) for passive travellers. In girls, median time spent in MVPA after school was significantly higher in the active (34 minutes (IQR 27-44)) than the passive travellers (29 minutes (IQR 22-37)). CONCLUSION Active travel to non-school destinations is associated with higher overall physical activity levels in 9-10 year old schoolchildren.

Television viewing time and risk of incident diabetes mellitus: the English Longitudinal Study of Ageing

To investigate the longitudinal association between television viewing time and risk of incident diabetes mellitus in an elderly sample of adults in England.

The Potential Yield of Non-Exercise Physical Activity Energy Expenditure in Public Health

Previous work has shown prospective associations between total daily physical activity energy expenditure and various health outcomes including metabolic risk. Limited evidence is available on the health benefits of standing and light-intensity activity. Therefore, these behaviours are not supported in contemporary physical activity guidelines. Moreover, people may be more willing to replace sedentary activities with standing or light activities that can be incorporated into their daily lives, rather than activities of moderate intensity, as there are fewer potential barriers. With the rapid advancement of objective physical activity monitoring there is now potential to explore total daily physical activity energy expenditure in more depth. This article highlights the need for further research into all areas of total daily physical activity energy expenditure, in particular standing and light-intensity activities. Future physical activity guidelines may benefit from the inclusion of recommendations on physical activity energy expenditure rather than solely focusing on activities of a moderate or vigorous intensity.

Active buildings: modelling physical activity and movement in office buildings. An observational study protocol

Introduction Health benefits of regular participation in physical activity are well documented but population levels are low. Office layout, and in particular the number and location of office building destinations (eg, print and meeting rooms), may influence both walking time and characteristics of sitting time. No research to date has focused on the role that the layout of the indoor office environment plays in facilitating or inhibiting step counts and characteristics of sitting time. The primary aim of this study was to investigate associations between office layout and physical activity, as well as sitting time using objective measures. Methods and analysis Active buildings is a unique collaboration between public health, built environment and computer science researchers. The study involves objective monitoring complemented by a larger questionnaire arm. UK office buildings will be selected based on a variety of features, including office floor area and number of occupants. Questionnaires will include items on standard demographics, well-being, physical activity behaviour and putative socioecological correlates of workplace physical activity. Based on survey responses, approximately 30 participants will be recruited from each building into the objective monitoring arm. Participants will wear accelerometers (to monitor physical activity and sitting inside and outside the office) and a novel tracking device will be placed in the office (to record participant location) for five consecutive days. Data will be analysed using regression analyses, as well as novel agent-based modelling techniques. Ethics and dissemination The results of this study will be disseminated through peer-reviewed publications and scientific presentations. Ethical approval was obtained through the University College London Research Ethics Committee (Reference number 4400/001).

The association between objectively measured sitting and standing with body composition: a pilot study using MRI

Objective To investigate the association between objectively measured sitting and standing, using a postural allocation technique, with MRI-assessed body composition. Design The present study was a cross-sectional pilot study. Setting Participants were examined at one centre located in London, UK. Participants Normal weight Caucasian women (30.9±6.1 years; body mass index (BMI), 22.9±3.4 kg/m2) with desk-bound occupations were recruited to minimise variability in body composition outcomes. A convenience sample of 12 women was recruited in January 2014 from University College London. Outcome measures For each participant a number of body composition variables were attained from a single whole-body MRI session. Main outcome variables included: total and liver adiposity, visceral/subcutaneous fat ratio and BMI. Main exposure variables included: average sitting time, standing:sitting ratio and step count. Pearson correlations were carried out to examine associations between different activity categories and body composition variables. Results There were significant correlations between average daily sitting and liver adiposity and visceral/subcutaneous abdominal fat ratio (r=0.66 and 0.64, respectively); standing:sitting ratio was moderately correlated with liver adiposity and visceral/subcutaneous abdominal fat ratio (r=−0.53 and −0.45); average daily step count was moderately correlated with liver adiposity, total adiposity and visceral/subcutaneous abdominal fat ratio (r=−0.45, −0.46 and −0.51, respectively). Conclusions This pilot study has provided preliminary evidence of relationships between objectively measured sitting and standing and precise measures of body composition.

Association between participation in outdoor play and sport at 10 years old with physical activity in adulthood.

OBJECTIVE This study aimed to investigate whether active outdoor play and/or sports at age 10 is associated with sport/physical activity at 32 year follow-up using a birth cohort study. METHODS Data were from the 1970 British Cohort Study, a longitudinal observational study. The present paper included data from the age 10 years and age 42 years surveys. At age 10 the participants mother provided information regarding how often their child played sports, and played outside on streets, parks or playgrounds. At age 42 participants reported frequency of participation in physical activities and sports. Associations between participation in sport/active outdoor play at age 10 years and adult sport/physical activity were investigated using adjusted (gender, fathers socio-occupational class, childs BMI, fathers BMI, self-rated health at age 42, assessment of own weight at age 42, participants education) Cox regression. RESULTS Final adjusted Cox regression models showed that participants (n=6458) who often participated in sports at age 10 were significantly more likely to participate in sport/physical activity at age 42 (RR 1.10; 95% CI 1.01 to 1.19). Active outdoor play at age 10 was not associated with participation in sport/physical activity at age 42 (RR 0.99; 95% CI 0.91 to 1.07). CONCLUSION Childhood activity interventions might best achieve lasting change by promoting engagement in sport rather than active outdoor play.

A review of occupational physical activity and sedentary behaviour correlates

BACKGROUND Physical activity reduces the risk of morbidity and high sedentary time may be associated with negative health outcomes. The workplace offers an arena to promote physical activity and reduce sedentary time, but existing workplace-based interventions have typically yielded small effects. AIMS To collate the literature on correlates of occupational physical activity and sedentary behaviour and to inform future novel approaches to workplace-based intervention or policy. METHODS Systematic literature searches were conducted in December 2014 using multiple databases. Identified papers were screened against an inclusion criterion. Papers were deemed eligible for this review if they included occupational physical activity and sedentary behaviour as an outcome, were quantitative observational studies and included an adult working population. Identified correlates of occupational physical activity and sedentary behaviour were organized into levels of the socioecological model. RESULTS Forty studies met the inclusion criterion. A higher number of studies included only occupational physical activity, not sedentary time, as an outcome and were carried out in the USA and Australia. The review identified that white-collar workers are at greater risk of low occupational physical activity and high sedentary time. The majority of correlates found to be associated with occupational physical activity and sedentary time were intrapersonal and non-modifiable. CONCLUSIONS Intervention efforts to increase occupational physical activity and reduce sedentary time may be most effective when targeted at white-collar workers. Research is needed to identify additional modifiable correlates of occupational physical activity and sedentary behaviour, in white-collar workers.