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Background: Sedentary behavior is an increasingly recognized health risk factor, independent of physical activity. Although several correlates of sedentary behavior are known, little research has identified them among U.S. veterans, a population that faces disproportionate chronic disease burden. Methods: A survey was mailed to 1997 randomly selected veterans at a large urban Veterans Affairs medical center in 2012 and remailed in 2013 to nonresponders, resulting in a 40% response rate. We examined individual-, social-, and neighborhood-level factors in association with self-reported sitting time. Factors correlated with sitting time at P < .05 were included in a multiple linear regression model. Results: In the multivariate model, higher depression (B = 7.8), body mass index (B = 5.1), functional impairment (B = 4.2), and self-rated health (B = 68.5) were significantly associated with higher sitting time, and leisure time physical activity (B = -0.10) and being employed (B = -71.3) were significantly associated with lower sitting time. Conclusions: Individual-level, but not social- and neighborhood-level, variables were associated with sitting time in this population. This study identified individual-level targets for reducing sitting time and improving overall health among veterans. [ABSTRACT FROM AUTHOR]

The article discusses issues published in the journal. It highlights the research regarding the benefits of decreasing the time of being sedentary and spent sitting to improve health and reduce risk of cardiovascular disease. It also emphasizes the efficiency of health action process approach (HAPA) model to physical activity in several populations including multiple sclerosis, cardiac rehabilitation and type 2 diabetes.

Background: Physical inactivity is an established risk factor for diabetes; however, little is known about this association across ethnic groups with different diabetes risk. Therefore, we evaluated the association between physical activity and diabetes and potential effect modification by ethnicity in the Hawaii component of the Multiethnic Cohort. Methods: Participants, aged 45 to 75 years, were enrolled by completing a questionnaire on demographics, diet, and self-reported weekly hours of strenuous sports, vigorous work, and moderate activity. Among the 74,913 participants (39% Caucasian, 14% Native Hawaiian, 47% Japanese American), 8561 incident diabetes cases were identified by self-report, a medication questionnaire, and through health plan linkages. Cox regression was applied to estimate hazard ratios (HR) and 95% confidence intervals (95%CI) while adjusting for known confounders. Results: Engaging in strenuous sports was inversely related to diabetes risk with HRs (4+ hours/week vs. never) of 0.67 (95%CI: 0.57-0.79) in women and 0.80 (95%CI: 0.72-0.88) in men. In stratified analyses, the inverse association was consistent across ethnic groups. The inverse association of vigorous work with diabetes was limited to men, while beneficial effects of moderate activity were observed only in Caucasians. Conclusions: These findings support a role of high-intensity physical activity and ethnic-specific guidelines in diabetes prevention. [ABSTRACT FROM AUTHOR]

Background: While there is emerging evidence that sedentary behavior is negatively associated with health risk, research on the correlates of sitting time in adults is scarce. Methods: Self-report data from 7724 women born between 1973-1978 and 8198 women born between 1946-1951 were collected as part of the Australian Longitudinal Study on Women's Health. Linear regression models were computed to examine whether demographic, family and caring duties, time use, health, and health behavior variables were associated with weekday sitting time. Results: Mean sitting time (SD) was 6.60 (3.32) hours/day for the 1973-1978 cohort and 5.70 (3.04) hours/day for the 1946-1951 cohort. Indicators of socioeconomic advantage, such as full-time work and skilled occupations in both cohorts and university education in the mid-age cohort, were associated with high sitting time. A cluster of 'healthy behaviors' was associated with lower sitting time in the mid-aged women (moderate/high physical activity levels, nonsmoking, nondrinking). For both cohorts, sitting time was highest in women in full-time work, in skilled occupations, and in those who spent the most time in passive leisure. Conclusions: The results suggest that, in young and mid-aged women, interventions for reducing sitting time should focus on both occupational and leisure-time sitting. [ABSTRACT FROM AUTHOR]

Context: Numerous instruments to measure self-reported physical activity (PA) exist, but there is little guidance for determining the most appropriate choice. Objective: To provide a systematic framework for researchers and practitioners to select a self-reported PA instrument. Process: The framework consists of 2 components:a series of questions and a database of instruments. The questions encourage users to think critically about their specific needs and to appreciate the strengths and limitations of the available options. Instruments for the database were identified through existing literature and expert opinion. Findings: Ten questions, ranging from study aim and study design to target population and logistical consideration, guide the researcher or practitioner in defining the criteria for an appropriate PA instruments for a given situation. No one question on its own determines the optimal choice, but taken together, they narrow the potential field. The database currently includes 38 different self-reported PA instruments, characterized by 18 different parameters. Conclusions: The series of questions presented here, in conjunction with a searchable database of self-report PA instruments, provides a needed step toward the development of guiding principles and good practices for researchers and practitioners to follow in making an informed selection of a self-reported PA instrument. [ABSTRACT FROM AUTHOR]

Context: The selection of the most psychometrically appropriate self-report tool(s) to measure specific physical activity constructs has been a challenge for researchers, public health practitioners, and clinicians, alike. The lack of a reasonable gold standard measure and inconsistent use of established and evolving terminology have contributed to these challenges. The variation of self-report measures and quality of the derived summary estimates could be attributed to the absence of a standardized conceptual framework for physical activity. Objective: To present a conceptual framework for physical activity as a complex and multidimensional behavior that differentiates behavioral and physiological constructs of human movement. Process: The development of a conceptual framework can provide the basic foundation from which to standardize definitions, guide design and development of self-report measures, and provide consistency during instrument selection. Conclusions: Based on our proposed conceptual framework for physical activity, we suggest that physical activity is more clearly defined as the behavior that involves human movement, resulting in physiological attributes including increased energy expenditure and improved physical fitness. Utilization of the proposed conceptual framework can result in better instrument choices and consistency in methods used to assess physical activity and sedentary behaviors across research and public health practice. [ABSTRACT FROM AUTHOR]

For the scientific domain of physical activity and public health research to advance its agenda of health promotion and disease prevention continued development of measurement methodologies is essential. Over the past 50 years most data supporting a favorable relationship between habitual physical activity and chronic disease morbidity and mortality have been obtained using self-report methods, including questionnaires, logs, recalls, and diaries. Many of these instruments have been shown to have reasonable validity and reliability for determining general type, amount, intensity, and bout duration, but typically do better for groups than individuals with some instruments lacking the sensitivity to detect change in activity. During the past decade the objective assessment of physical activity using accelerometer-based devices has demonstrated substantial potential, especially in documenting the pattern of light-, moderate-, and vigorous-intensity activity throughout the day. However, these devices do not provide information on activity type, location or context. Research that combines the strengths of both self-report and objective measures has the potential to provide new insights into the benefits of physical activity and how to implement successful interventions. [ABSTRACT FROM AUTHOR]

Background: Individual, home social and physical environment correlates of electronic media (EM) use among children were examined and pattern of differences on school and weekend days. Methods: Youth (n = 298) aged 11 to 12 years self-reported time spent using EM (TV, video/DVD, computer use, and electronic games) on a typical school and a weekend day, each dichotomized at the median to indicate heavy and light EM users. Anthropometric measurements were taken. Logistic regression examined correlates of EM use. Results: In total, 87% of participants exceeded electronic media use recommendations of = 2 hrs/day. Watching TV during breakfast (OR = 3.17) and after school (OR = 2.07), watching TV with mother (OR = 1.96), no rule(s) limiting time for computer game usage (OR = 2.30), having multiple (OR = 2.99) EM devices in the bedroom and BMI (OR = 1.15) were associated with higher odds of being heavy EM user on a school day. Boys (OR = 2.35) and participants who usually watched TV at midday (OR = 2.91) and late at night (OR = 2.04) had higher odds of being a heavy EM user on the weekend. Conclusions: Efforts to modify children's EM use should focus on a mix of intervention strategies that address patterns and reinforcement of TV viewing, household rules limiting screen time, and the presence of EM devices in the child's bedroom. [ABSTRACT FROM AUTHOR]

Physical activity and sedentary behavior (performed primarily while sitting) play a key role in the current and future health of young people. Most health evidence and intervention strategies targeting reductions in children's sedentary behavior have focused on television viewing, with mixed evidence as to the effectiveness of these strategies and of the importance of television viewing for children's health. Evidence from studies with adults using objective measures of sedentary behavior suggests that accumulated sedentary time is independently associated with metabolic health; importantly, emerging evidence suggests that the manner in which the sedentary behavior is accrued (ie, frequency of interruptions to time spent sedentary) may also have independent effects on health. Potential novel intervention approaches to reduce children's sedentary time include activity breaks during class time at school, delivery of active lessons and homework, and changes to the: classroom environment. Further evidence of the importance of sedentary time (both total accumulation and frequency of interruptions) on children's health is required. Future studies should assess the effectiveness of interventions targeting organizational and pedagogical changes in schools as well as using homework to engage with families in more active ways. [ABSTRACT FROM AUTHOR]

Sedentary behavior (SB) has been proved to be an important risk factor for poor health, such as blood pressure and even cancer. However, existing sensor- and vision-based SB detection approaches have limitations on practical usage and privacy concerns, respectively. In this paper, we take the first attempt to develop a device-free SB monitoring and recommendation system namely CareFi, which leverages tremendous information behind WiFi signals to monitor the indoor environment and identify series of activities in SB. We deeply investigate the properties of channel state information and various activities in SB. According to different characteristics of static and dynamic activities, we design a foreground detection method to separate two categories and then adopt discriminative features of wireless signals in the frequency and time domains to recognize them. Besides, we propose an updated strategy to overcome the mutability of environment. We implement CareFi on commercial off-the-shelf WiFi routers and evaluate its performance in both office and home environments. Experimental results demonstrate the robustness and accuracy of our method. [ABSTRACT FROM AUTHOR]

Prolonged uninterrupted sitting is related adversely to cardiometabolic risk markers and postprandial hyperglycaemia, relative to sitting interrupted by regular brief activity breaks. However, whether the magnitude of hyperglycaemic responses to prolonged sitting is dependent upon the underlying degree of insulin resistance remains unclear. Data were pooled from 3 randomized cross‐over laboratory‐based trials (n = 62) that examined the postprandial blood glucose‐ and insulin‐lowering effects of prolonged sitting vs sitting interrupted by regular brief activity breaks in overweight/obese adults who had normal or impaired glucose metabolism (2 trials) or type 2 diabetes not treated by insulin (1 trial). Corrected for study effects, the magnitude of differences in postprandial glucose and insulin responses between the 2 conditions was significantly exacerbated with poorer baseline levels of fasting glucose, insulin and/or surrogate markers of β‐cell function and insulin resistance. This suggests that those with higher underlying levels of insulin resistance may derive greater metabolic benefits from regularly interrupting prolonged sitting than their healthier counterparts. If these findings can be replicated, they may have implications for future targeting and optimization of physical activity/sedentary behaviour interventions in the prevention and management of type 2 diabetes. [ABSTRACT FROM AUTHOR]

Objective The objective of this study was to compare patterns of objectively measured moderate-to-vigorous physical activity (MVPA, ≥ 3.00 metabolic equivalents [METs]), light-intensity physical activity (LPA, 1.50-2.99 METs), and sedentary behavior (SB, < 1.50 METs) in successful weight loss maintainers (WLMs), normal weight controls (NC), and controls with overweight/obesity (OC). Methods Participants (18-65 y) were recruited in three groups: WLM (maintaining ≥ 13.6-kg weight loss for ≥ 1 year, n = 30), NC (BMI matched to current BMI of WLM, n = 33), and OC (BMI matched to pre-weight loss BMI of WLM, n = 27). All participants wore the activPAL for 1 week. Results Compared with OC and NC, WLM spent more awake time in total MVPA (WLM: 9.6 ± 3.9%, NC: 7.1 ± 2.1%, OC: 5.9 ± 2.0%; P < 0.01) and more time in sustained (≥ 10 min) bouts of MVPA (WLM: 39 ± 33, NC: 17 ± 14, OC: 9 ± 11 min/d; P < 0.01). Compared with OC, WLM and NC spent more awake time in LPA (WLM: 29.6 ± 7.9%, NC: 29.1 ± 8.3%, OC: 24.8 ± 6.7%; P = 0.04) and less awake time sedentary (WLM: 60.8 ± 9.3%, NC: 63.8 ± 9.5%, OC: 69.3 ± 7.5%; P < 0.01). Conclusions Results provide additional data supporting the important role of MVPA in weight loss maintenance and suggest notable differences in LPA and SB between normal weight individuals and those with overweight/obesity. Increasing LPA and/or decreasing SB may be additional potential targets for weight management interventions. [ABSTRACT FROM AUTHOR]

Objectives: To identify the prevalence and predictors of physical exercise among nurses. Methods: This study was conducted at 2 hospitals selected randomly from tertiary hospitals in King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia (KSA) and Makassed General Hospital, Beirut, Lebanon in 2014. The study included nurses with at least one year of nursing experience. Data were collected using a self-administered questionnaire. The questionnaire was divided into 2 sections, one covering the respondents’ demographics, and the other one assessing the prevalence and the characteristics of physical exercise. Results: A total of 412 participants responded, of whom 248 (60.2%) are engaged in physical exercise. On multivariate analysis, normal weight and smoking were independently associated with physical exercise. Most 66.1% of respondents reported practicing walking as the most common type of physical activity. One hundred eighty (72.6%) respondents relied on their own motivation to perform physical activity and 64.6% reported the lack of availability of physical activity facilities. Conclusion: Smoking and obesity were the significant predictors associated with physical inactivity. Encouraging nurses to adopt a healthy lifestyle for their role modeling to patients as health promoters is recommended. [ABSTRACT FROM AUTHOR]

Background: Regular physical activity (PA) confers many positive effects on health and well-being. Sedentary behavior (SB), in turn, is a risk factor for health, regardless of the level of moderate to vigorous PA. The present study describes the levels of objectively measured SB, breaks in SB, standing still and PA among Finnish adults.Methods: This cross-sectional analysis is based on the sub-sample of the population-based Health 2011 Study of Finnish adults. The study population consisted of 18-to-85-year old men and women who wore a waist-worn triaxial accelerometer (Hookie AM 20) for at least 4 days, for at least 10 h per day (n = 1587) during a week. PA and SB were objectively assessed from the raw accelerometric data using novel processing and analysis algorithms with mean amplitude deviation as the processing method. The data was statistically analyzed using cross-tabulations, analysis of variance and analysis of covariance.Results: The participants were on average 52 years old, 57 % being women. Participants were sedentary 59 % of their waking wear time, mainly sitting. They spent 17 % of the time standing still, 15 % in light intensity PA, 9 % in moderate PA and less than 1 % in vigorous PA. Participants aged 30-39 years had the highest number of breaks in SB per day. Younger participants (<30 years of age) had more moderate and vigorous PA than older ones (≥60 years of age), and 30-60-year-olds had the greatest amount of light PA.Conclusions: Participants spent nearly 60 % of their waking time sedentary, and the majority of their daily PA was light. From a public health perspective it is important to find effective ways to decrease SB as well as to increase the level of PA. Our analysis method of raw accelerometer data may allow more precise assessment of dose-response relationships between objectively measured PA and SB and various indicators of health and well-being. [ABSTRACT FROM AUTHOR]

Purpose: To describe sedentary behaviors (duration, bouts and context) in people with and without a chronic health condition. Methods: Design: Secondary analysis of two cross-sectional studies. Participants: People with stable chronic obstructive pulmonary disease (COPD) (n = 24, male:female 18:6) and their spousal carers (n = 24, 6:18); stroke survivors (n = 24, 16:8) and age- and sex-matched healthy adults (n = 19, 11:8). Level of physiological impairment was measured with post-bronchodilator spirometry (FEV1 %predicted) for people with COPD, and walking speed for people with stroke. Outcomes: Participants were monitored over seven days (triaxial accelerometer, Sensewear armband) to obtain objective data on daily sedentary time, and prolonged sedentary bouts (≥ 30 min). During the monitoring period, a 24-hour use of time recall instrument was administered by telephone interview to explore the context of sedentary activities (e.g. television, computer or reading). Sedentary time was quantified using accelerometry and recall data, and group differences were explored. Linear regression examined associations between physiological impairment and sedentary time. Results: Participant groups were similar in terms of age (COPD 75 ± 8, carers 70 ± 11, stroke 69 ± 10, healthy 73 ± 7 years) and body mass index (COPD 28 ± 4, carers 27 ± 4, stroke 31 ± 4, healthy 26 ± 4 kg.m–2). The healthy group had the lowest sedentary time (45% of waking hours), followed by the carer (54%), stroke (60%) and COPD (62%) groups (p < 0.0001). Level of physiological impairment was an independent predictor of waking sedentary time (p = 0.001). Conclusions: People with a chronic health condition spent more time sedentary than those without a chronic condition, and there were small but clear differences between groups in the types of activities undertaken during sedentary periods. The study findings may aid in the design of targeted interventions to decrease sedentary time in people with chronic health conditions. [ABSTRACT FROM AUTHOR]

Purpose: Less time spent in sedentary behaviors is associated with improved health and disease outcomes in breast cancer survivors. However, little is known about survivors’ interest in sedentary behavior reduction interventions and how to effectively reduce this risk behavior. The purpose of this study was to explore breast cancer survivors’ interest in and preferences for technology-supported sedentary behavior reduction interventions. Methods: Breast cancer survivors (n = 279; Mage = 60.7 (SD = 9.7)) completed a battery of online questionnaires. Descriptive statistics were calculated for all data. To examine potential relationships between demographic, disease and behavioral factors, and survivors’ interest in a technology-supported sedentary behavior reduction intervention, we conducted logistic regression analyses. These same factors were examined in relation to the perceptions of the effectiveness of such intervention using multiple regression analyses. Results: On average, survivors spent 10.1 (SD = 4.3) hours/day in sedentary activity. They believed prolonged periods of sedentary behavior were harmful to their health (87.0%) and that reducing sedentary behavior could improve their health (88.4%). Survivors believed they should move around after 30–60 (56.7%) or ≥ 60 (29.9%) minutes of sedentary behavior and indicated they were most likely to replace sedentary behaviors with walking around (97.1%) or walking in place (73.4%). The majority of survivors (79.9%) was interested in participating in a technology-supported sedentary behavior reduction intervention and indicated they would use a smartphone application (61.3%) 2–3 times/day (48.0%), 6 to 7 days/week (52.0%). Most survivors (73.5%) believed reminders would help them decrease sedentary behavior and preferred they be delivered after sitting for 60 minutes (60.5%) via vibrations on a wrist worn activity tracker (77.3%) or text messages (54.4%). Conclusions: Technology-supported sedentary behavior reduction interventions may be feasible and acceptable to breast cancer survivors. Data regarding user preferences for content, features, delivery mode and design will aid researchers in developing sedentary interventions that are potentially more relevant and effective from the outset. [ABSTRACT FROM AUTHOR]

Background: Current evidence on associations of type-specific sedentary behavior with cardiovascular disease (CVD) is limited to mainly screen-time sedentary behavior (SB). We aimed to study the associations of type-specific and total time spent sitting with the Framingham 10-year cardiovascular disease risk score (Framingham score) in Finnish adults. Methods: Data comprise the National FINRISK 2007 and 2012 health examination surveys with 10,185 participants aged 25–74 years, apparently free of CVD. Participants reported average daily time spent sitting in different locations: work-related sitting, at home in front of television (TV), at home in front of computer, in a vehicle, and elsewhere. Total SB time was calculated from these context-specific self-reports. Accelerometer-based sedentary time was assessed in 988 FINRISK 2012 participants. Framingham score was calculated using information on blood pressure and its medication, cholesterol levels, age, diabetes status, and smoking. Analyses were adjusted for age, study year, education, employment status, leisure time physical activity, and body mass index. Results: Out of several type-specific sitting behaviors, only TV sitting showed systematic associations with the Framingham score in both genders. The lowest Framingham risk was found for TV sitting from 6 minutes to less than 1 hour daily. Of other types of sitting, computer sitting was inversely associated with the Framingham risk in men only. Total self-reported sitting time did not show significant associations with the Framingham score, but instead higher objectively assessed sedentary time showed higher Framingham risk in men. Conclusions: TV sitting showed most systematic associations with CVD risk score. This suggests that of all types of SB, reducing TV sitting should be targeted for reducing CVD risk. [ABSTRACT FROM AUTHOR]

Aim: Type 2 diabetes mellitus (T2D) is associated with gray matter atrophy. Adiposity and physical inactivity are risk factors for T2D and brain atrophy. We studied whether the associations of T2D with total gray matter volume (GMV) and hippocampal volume (HV) are dependent on obesity and physical activity. Materials and Methods: In this cross-sectional study, we measured waist-hip ratio (WHR), body mass index (BMI), mean steps/day and brain volumes in a community dwelling cohort of people with and without T2D. Using multivariable linear regression, we examined whether WHR, BMI and physical activity mediated or modified the association between T2D, GMV and HV. Results: There were 258 participants with (mean age 67±7 years) and 302 without (mean age 72±7 years) T2D. Adjusting for age, sex and intracranial volume, T2D was independently associated with lower total GMV (p = 0.001) and HV (p<0.001), greater WHR (p<0.001) and BMI (p<0.001), and lower mean steps/day (p = 0.002). After adjusting for covariates, the inclusion of BMI and mean steps/day did not significantly affect the T2D-GMV association, but WHR attenuated it by 32% while remaining independently associated with lower GMV (p<0.01). The T2D-HV association was minimally changed by the addition of BMI, steps/day or WHR in the model. No statistical interactions were observed between T2D and measures of obesity and physical activity in explaining brain volumes. Conclusions: Abdominal obesity or its downstream effects may partially mediate the adverse effect of T2D on brain atrophy. This requires confirmation in longitudinal studies. [ABSTRACT FROM AUTHOR]

Background: There has been increasing interest in neighbourhoods’ influence on individuals’ health-risk behaviours, such as smoking, alcohol consumption, physical activity and diet. The aim of this review was to systematically review recent studies on health-risk behaviour among adults who live in deprived neighbourhoods compared with those who live in non-deprived neighbourhoods and to summarise what kind of operationalisations of neighbourhood deprivation that were used in the studies. Methods: PRISMA guidelines for systematic reviews were followed. Systematic searches were performed in PubMed, Embase, Web of Science and Sociological Abstracts using relevant search terms, Boolean operators, and truncation, and reference lists were scanned. Quantitative observational studies that examined health-risk behaviour in deprived neighbourhoods compared with non-deprived neighbourhoods were eligible for inclusion. Results: The inclusion criteria were met by 22 studies. The available literature showed a positive association between smoking and physical inactivity and living in deprived neighbourhoods compared with non-deprived neighbourhoods. In regard to low fruit and vegetable consumption and alcohol consumption, the results were ambiguous, and no clear differences were found. Numerous different operationalisations of neighbourhood deprivation were used in the studies. Conclusion: Substantial evidence indicates that future health interventions in deprived neighbourhoods should focus on smoking and physical inactivity. We suggest that alcohol interventions should be population based rather than based on the specific needs of deprived neighbourhoods. More research is needed on fruit and vegetable consumption. In future studies, the lack of a uniform operationalisation of neighbourhood deprivation must be addressed. [ABSTRACT FROM AUTHOR]

Background: Recently attention has been drawn to the health impacts of time spent engaging in sedentary behaviors. While many studies have investigated general physical activity (PA) in relation to blood lipid levels, the current study aimed to examine the intensity of activity, including sedentary behavior time, and time spent engaging in moderate and intense PA, with concentrations of HDL and LDL-cholesterol, total cholesterol, and triglycerides. Methods: Participants comprised 1331 individuals, aged 18 to 70 years, from the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) study, who underwent objective cardiovascular health assessments and completed the International Physical Activity Questionnaire (IPAQ). Time spent engaging in sedentary behaviors (screen time on a workday and a day off, and total sitting time on a work day), and moderate and intense PA, were related to levels of HDL and LDL-cholesterol, total cholesterol, and triglycerides. Analyses were conducted in the whole sample, and then with stratification according to BMI (normal weight versus overweight/obese). Results: Both lower screen time during days off and higher intense PA time were significantly associated with higher HDL-cholesterol after full adjustment for socio-demographic factors, dietary factors and smoking (both p < 0.05). In normal weight individuals, consistent positive relations between triglycerides, LDL, and total cholesterol with all sedentary behavior time variables were observed (all p < 0.05; adjusted for age, education, gender). There were no statistically significant associations between any intensity level of PA or sedentary behavior time variable and lipid levels in those overweight or obese. Conclusions: Spending less time in sedentary behaviors, and engaging in medium levels of intense physical activity may be associated with a more favorable blood lipid profile, particularly with regard to levels of HDL and triglycerides. [ABSTRACT FROM AUTHOR]

Objectives. We examined whether the interactions between primarily speaking English at home and community-level measures (median household income and immigrant composition) are associated with physical inactivity and obesity. Methods. We pooled the 2005 and 2007 Los Angeles County Health Survey data to construct a multilevel data set, with community-level median household income and immigrant density as predictors at the community level. After controlling for individual-level demographic variables, we included the respondent's perceived community safety as a covariate to test the hypothesis that perceived public safety mediates the association between acculturation and health outcomes. Results. The interaction between community median household income and primarily speaking English at home was associated with lower likelihoods of physical inactivity (odds ratio [OR] = 0.644; 95% confidence interval [CI] = 0.502, 0.825) and obesity (OR = 0.674; 95% CI = 0.514, 0.882). These odds remained significant after we controlled for perceived community safety. Conclusions. Resources in higher-income areas may be beneficial only to residents fully integrated into the community. Future research could focus on understanding how linguistic isolation affects community-level social learning and access to resources and whether this differs by family-level acculturation. [ABSTRACT FROM AUTHOR]

Purpose. Sedentary behavior has been identified as a risk factor for chronic non-communicable diseases. This study identified the prevalence of excessive TV viewing time during the week and weekend and associated factors in adolescents living in a small urban and rural area. Methods. A cross-sectional study involving 283 students (aged 10-19 years) from Brazil was conducted in 2010. Data on TV viewing time and sociodemographic information were collected by questionnaires, cardiorespiratory fitness was evaluated by the 20-m shuttle run test, and anthropometric characteristics were obtained by measuring waist circumference and skinfold thickness. Statistical analysis involved binary logistic regression. Results. The prevalence of excessive TV viewing time ( 2 h) was 76.7% during on weekdays and 78.4% on the weekend. Adolescents aged 10-12 years (OR = 6.20; 95% CI = 2.91, 13.19; p < 0.001) and 13-15 years (OR = 2.57; 95% CI = 1.28, 5.18; p = 0.008) were more exposed to excessive TV viewing time during the week. No associations were found for excessive TV viewing time on the weekend. Conclusions. Approximately 8 in 10 adolescents presented excessive TV viewing time; excessive TV viewing time during the week was associated with age. [ABSTRACT FROM AUTHOR]

Physical inactivity and a sedentary lifestyle are risk factors for the development of type 2 diabetes. Here, we identified the effects 8 weeks of voluntary physical activity had on the prevention of insulin resistance in mouse skeletal muscles and liver (a hallmark of T2D). To do this, 8 week old C57 BL/6J mice with ( RUN) and without ( SED) voluntary access to running wheels were fed a standard rodent chow ad libitum for 8 weeks. In the liver, there was a 2.5-fold increase in insulin stimulated Akt SER473 phosphorylation, and a threefold increase in insulin-stimulated (0.5 U/kg) GSK3β SER9 phosphorylation in RUN compared to SED mice. Although not induced in skeletal muscles, there was a twofold increase in SOCS3 expression in SED compared to RUN mice in the liver. There was no difference in the glucose tolerance test between groups. This study was the first to show differences in liver insulin sensitivity after 8 weeks of voluntary physical activity, and increased SOCS3 expression in the liver of sedentary mice compared to active mice. These findings demonstrate that even in young mice that would normally be considered healthy, the lack of physical activity leads to insulin resistance representing the initial pathogenesis of impaired glucose metabolism leading to type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background: To promote and maintain health, all adults are recommended to do moderate-intensity aerobic activity a minimum of 30 min on 5 days, or vigorous-intensity activity of 20 min on 3 days, each week. Whether these levels prevent long-term weight gain is uncertain. Objective: To assess the relationship between physical activity and long-term weight gain. Study design: An observational prospective cohort study. Methods: Weight and physical activity were measured in the Nord-Trøndelag Health Study in 1984–1986, 1995–1997 and 2006–2008. Participants (n=19 127) were classified based on physical activity into inactive, below recommended level, recommended level or above recommended level. We carried out adjusted mixed model regression analyses with weight as outcome. Results: Men maintaining physical activity above the recommendations for 33 years increased 5.6 kg, while inactive men increased 9.1 kg. For women, corresponding numbers were 3.8 kg in those above recommended physical activity levels, and 9.5 kg in inactive. In adjusted analyses, physical activity above the recommendations was associated with 2.1 kg (95% CI 1.8 to 2.4) less weight gain in men over any 11-year period, compared with inactive. Women exceeding the recommendations gained 1.8 kg (CI 1.5 to 2.2) less than inactive. Compared with inactive, the ORs of gaining meaningful weight of ≥2.3 kg were 0.79 (CI 0.69 to 0.91) and 0.70 (CI 0.60 to 0.81) if exceeding the recommendations in men and women, respectively. Conclusions: Physical activity above the current recommendations for health benefits was associated with significantly lower risk of weight gain. [ABSTRACT FROM AUTHOR]

Background: To assess the Knowledge, Attitudes and Practice (KAP) amongst the general community regarding type 2 diabetes mellitus (DM) in rural Bangladesh. Methods: Data was collected using cluster random sampling from 3104 adults residing in a rural district in Bangladesh. Participants underwent a KAP questionnaire survey regarding assessing diabetes, socio-demographic and medical history. Descriptive, Chi-square and regression analyses were performed. Results: Participants were aged between 30 and 89 years (M  = 51, SD  = 11.8) and 65.5% were female. The prevalence of diabetes was found to be 8.3%. The majority (93%) reported to have heard of diabetes, yet only 4% knew what a glucose tolerance test was. Only 50% reported that they knew physical inactivity was a risk factor. Age, gender, level of education and socio-economic status (SES) were significantly associated with KAP. A lower proportion (41%) of older participants (aged ≥65 years) reported that they knew that dietary modifications assist in diabetes control compared to those aged less than 35 years (69%), p<0.001. Males (β  = 0.393, 95% CI = 0.142–0.643), and any level of education compared to no schooling (β  = 0.726, 95% CI = 0.596, 0.857) reported significantly more knowledge, after multivariate adjustments for covariates. Participants aged under 35 years, (odds ratio (OR)  = 1.73, 95% CI  = 1.22–2.43) had significantly higher positive attitudes towards treatments of diabetes compared to those aged ≥65 years. Of the 99 people with known diabetes, more than 50% (n = 52) never had their blood sugar levels checked since diagnosis. Conclusions: Knowledge of diabetes and its risk factors is very limited in rural Bangladesh, even in persons diagnosed with type 2 DM. The development of public health programmes to increase knowledge of diabetes and its complications is required to assist people living in rural Bangladesh to control and management of diabetes. [ABSTRACT FROM AUTHOR]

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BACKGROUND Sedentary behavior may independently contribute to morbidity and mortality among survivors of colorectal cancer. In the current study, the authors assessed whether a telephone-delivered multiple health behavior change intervention had an effect on the sedentary behavior of recently diagnosed colorectal cancer survivors. METHODS A total of 410 participants were recruited through the Queensland Cancer Registry and randomized to the health coaching (intervention) or usual-care (control) group. Eleven health coaching sessions addressing multiple health behaviors, including sedentary behavior, were delivered over a period of 6 months. Data were collected at baseline (before randomization), at 6 months, and at 12 months via a telephone interview. RESULTS At 12 months, there was a significant decrease noted in the hours per day of sedentary time in both the health coaching (−1.21; 95% confidence interval [95% CI], −1.71 to −0.70) and usual-care groups (−0.55; 95% CI, −1.06 to −0.05), but the between-group difference was not found to be statistically significant (−0.65; 95% CI, −1.37 to 0.06 [ P = .07]). In stratified subgroup analyses, the multiple health behavior change intervention was found to have a significant effect on total sedentary time (hours/day) at 12 months in survivors of colorectal cancer who were aged > 60 years (−0.90; 95% CI, −1.80 to −0.01 [ P = .05]), male (−1.33; 95% CI, −2.44 to −0.21 [ P = .02]), and nonobese (−1.10; 95% CI, −1.96 to −0.25; [ P = .01]). CONCLUSIONS Incorporating simple messages about limiting sedentary behaviors into a multiple health behavior change intervention was found to have modest effects on sedentary behavior. A sedentary behavior-specific intervention strategy may be required to achieve substantial changes in sedentary behavior among colorectal cancer survivors. Cancer 2014;120:2665-2672. © 2014 American Cancer Society. [ABSTRACT FROM AUTHOR]

Background: Health professionals are encouraged to play a part in reducing the health risks of physical inactivity. Little is known of the physical activity promotion practice behaviours of podiatrists. Methods: We performed 20 semi-structured interviews with purposefully selected podiatrists to explore their physical activity promotion attitudes, beliefs, knowledge and practice. Transcribed interviews were coded using an iterative thematic approach to identify major themes and salient beliefs. Results: Overall, the participants had a positive attitude to physical activity promotion, considering it a normal part of their role. They saw their role as giving information, encouraging activity and making recommendations, however in practice they were less inclined to follow up on recommendations, monitor activity levels or document the process. Their approach was generally opportunistic, informal and unstructured and the content of assessment and promotion dependent upon the presenting patient's condition. Advice tended to be tailored to the patient's capabilities and interests. They considered there are opportunities to promote physical activity during regular consultations, however, were more likely to do so in patients with chronic diseases such as diabetes. Main barriers to physical activity promotion included unreceptive and unmotivated patients as well as a lack of time, skills and resources. Conclusions: Physical activity promotion appears feasible in podiatry practice in terms of opportunity and acceptability to practitioners, but there is scope for improvement. Strategies to improve promotion need to consider the major issues, barriers and opportunities as well as provide a more structured approach to physical activity promotion by podiatrists. [ABSTRACT FROM AUTHOR]

Objective Research conducted on school-based interventions suggests that school connectedness protects against a variety of risk behaviors, including substance abuse, delinquency and sedentary behavior. The line of research is extended by examining the link between college expectations and early adult weight gain using nationally representative panel data from thirty cohorts of American high school seniors followed prospectively to age 30 in the Monitoring the Future Study (1986-2009). Design and Methods Growth mixture models identified two latent classes of trajectories of body mass index (BMI) from age 19 to 30: a persistently overweight class (BMI ≥ 25) and a second class exhibiting more moderate growth in BMI to age 30. Results Compared to those who did not expect to graduate from college, students fully expecting to graduate from college had 34% lower odds of being in the persistently overweight class (adjusted odds ratio = 0.66, 95% confidence interval = 0.54, 0.81), controlling for academic performance and socioeconomic status. Conclusions Successful prevention of obesity early in the life course is based on a multifactorial approach incorporating strategies that address the contexts in which adolescents are embedded. The school setting may be one avenue where successful educational attachment could have positive consequences for subsequent weight gain in early adulthood. [ABSTRACT FROM AUTHOR]

Background. Inactivity during hospitalization in older medical patients may lead to functional decline. This study quantified 24-hour mobility, validated the accelerometers used, and assessed the daily level of basic mobility in acutely admitted older medical patients during their hospitalization. Methods. This is a prospective cohort study in older medical patients able to walk independently (ambulatory patients) and those not able to walk independently (nonambulatory patients) on admission. The 24-hour mobility level during hospitalization was assessed by measuring the time in lying, sitting, and standing and/or walking, by two accelerometers. Basic mobility was quantified within 48 hours of admission and repeated daily throughout hospitalization. Results. Forty-three ambulatory patients and six nonambulatory patients were included. The ambulatory patients tended to be hospitalized for fewer days than the nonambulatory patients (7 vs 16, p = .13). The ambulatory patients were lying median 17 hours, (interquartile range [IQR]: 14.4–19.1), sitting 5.1 hours (IQR: 2.9–7.1), and standing and/or walking 1.1 hours (IQR: 0.6–1.7) per day. On days with independency in basic mobility, the ambulatory patients were lying 4.1 hours less compared with days with dependency in basic mobility (p < .0001), sitting 2.4 hours more (p = .0004), and standing 0.9 hours more (p < .0001). The algorithm identification for lying, sitting, and standing and/or walking of the accelerometers, corresponded by 89%–100% with positions performed by older medical patients. Conclusions. Older acutely hospitalized medical patients with walking ability spent 17h/d of their in-hospital time in bed, and the level of in-hospital mobility seemed to depend on the patients’ level of basic mobility. The accelerometers were valid in assessing mobility in older medical patients. [ABSTRACT FROM PUBLISHER]

Sedentary behaviour is becoming a popular area of health research, but most studies report data on samples from Australia, the UK and USA, and on a narrow range of behaviours. The present study reports on the prevalence of multiple sedentary behaviours in a sample of secondary school students (n = 635; mean age 16.0 years) from Romania and Slovakia. Ecological Momentary Assessment diaries were used to record multiple behaviours across weekdays and weekend days. Results showed high levels of many sedentary behaviours, particularly for screen time at weekends. Other behaviours included homework, sedentary socializing and motorized transport. Gender, age and country differences were evident for some behaviours. Interventions may need to account for socio-demographic moderators, and studies need to assess multiple sedentary behaviours. [ABSTRACT FROM PUBLISHER]

Our first aim was to investigate whether the ingestion of a single high-fat meal impairs glucose tolerance. Our second aim was to investigate whether improvements in glucose tolerance that are seen after resistance exercise remain when exercise is performed after ingestion of a high-fat meal. Eight young males consumed either a high fat (HF) or an isocaloric control (CON) meal in the morning and underwent an oral glucose tolerance test (OGTT) 6 h later. On two other occasions, a single 1 h bout of resistance exercise was completed 2 h after consumption of each meal (HFE and CONE). There were no significant differences in plasma glucose and plasma insulin areas under the curve (AUC) or estimates of insulin sensitivity between the HF and CON trials (P > 0.05). The HFE and CONE trials elicited a ~20% lower plasma glucose AUC (P < 0.05) compared to their respective control trials. The HFE also elicited a ~25% lower plasma insulin AUC (P < 0.05) in comparison to the HF trial. The HFE trial also significantly improved estimates of insulin sensitivity in comparison to the HF condition (P < 0.05). In conclusion, this study demonstrates that consumption of a single HF meal does not impair glucose tolerance in the resting state in lean individuals and that an acute bout of resistance exercise remains effective in enhancing glucose tolerance following the ingestion of a single high-fat meal. [ABSTRACT FROM AUTHOR]

School -based health education programmes are important in focussing on risk factors for chronic disease of lifestyle (CDL) among young people. The school as a setting can be used to assist learners to make informed decisions regarding health risk behaviours. In this article, research relating to school based interventions was reviewed by addressing physical inactivity as a risk factor for chronic diseases of lifestyle among young people. The literature search included data bases such as Pubmed, CINAHL, Ebscohost for the period of 1998-2008. Articles were assessed for methodological quality and according to the RE-AIM framework. Two assessors favourably rated the quality of the articles reviewed. Of the total number of articles identified, 60 were selected for further investigation but 26 were excluded after the first review and a further 21 following evaluation of the methodological quality and considering the REAIM framework. Thus, 13 articles were eventually reviewed and included as they had a moderate to high score in both methodological assessment and REAIM framework. Results were presented according to the RE-AIM framework and a narrative summary is provided. It was concluded that currently very few interventions were having the desired impact on behavioural change over a period of time and the targeted populations could not sustain the interventions. Thus, as health educators and promoters of behavioural change, it is important that the impact and sustainability of intervention programmes are prioritised. [ABSTRACT FROM AUTHOR]

Introduction. This cross-sectional study aimed to describe parents' views regarding self-efficacy to influence children's eating and sedentary behaviours at two time points in early childhood, and to examine associations between these views and children's eating and sedentary behaviours. Methods. Mothers of 1-year (n=60) and 5-year-old children (n=80) were recruited through Maternal and Child Health Centres and kindergartens in Victoria, Australia. Mothers reported children's dietary intake, television viewing and perceptions of their self-efficacy regarding children's eating and sedentary behaviours. Results. Overall, 5-year-old children consumed significantly more energy-dense food and drink and spent significantly more time viewing TV/DVD and video. Mothers of 1-year-olds were significantly more likely to report they felt confident to limit child's consumption of non-core foods/drinks, and to limit screen access (p<0.001). Measures of maternal self-efficacy were directly associated with 5-year-old children's water (p<0.05), and fruit and vegetable consumption (p<0.005), and with 1-year-old children's vegetable consumption (p<0.05), and were inversely associated with cordial and cake consumption (p<0.05). Maternal self-efficacy to limit viewing time was inversely associated with screen-time exposure in both age groups (p<0.01). Conclusion. This study suggests that mother's self-efficacy regarding limiting non-core foods/drinks and limiting screen-time exposures may decline during the first few years of a child's life. Higher maternal self-efficacy was associated with children having more obesity protective eating and sedentary behaviours at both ages. Interventions to support the development of healthy lifestyle behaviours may be most effective if they target mothers' self-efficacy in these domains early in their child's life. [ABSTRACT FROM AUTHOR]

Objectives. We prospectively examined nonrecreational physical activity and sedentary behavior in relation to breast cancer risk among 97039 postmenopausal women in the National Institutes of Health--AARP Diet and Health Study. Methods. We identified 2866 invasive and 570 in situ breast cancer cases recorded between 1996 and 2003 and used Cox proportional hazards regression to estimate multivariate relative risks (RRs) and 95% confidence intervals (CIs). Results. Routine activity during the day at work or at home that included heavy lifting or carrying versus mostly sitting was associated with reduced risk of invasive breast cancer (RR=0.62; 95% CI=0.42, 0.91; Ptrend=.024). Conclusions. Routine activity during the day at work or home may be related to reduced invasive breast cancer risk. Domains outside of recreation time may be attractive targets for increasing physical activity and reducing sedentary behavior among postmenopausal women. [ABSTRACT FROM AUTHOR]

Lifestyles are increasingly characterised by sedentary behaviour, obesity problems, stress, mental ill-health and disconnection from nature. However, contact with nature has been shown to improve psychological health by reducing stress, enhancing mood and replenishing mental fatigue. In addition to providing a range of environmental services, greenspaces provide opportunities and incentives for 'green exercise' such as walking, cycling or horse riding. Visitor numbers indicate that many people already benefit from spending time in greenspaces, but little is known about the immediate impact of an acute exposure on their health and wellbeing. This study focuses on evaluating changes in self-esteem and mood after walking in four different National Trust sites of natural and heritage value in the East of England. The standardised measures of both self-esteem and mood were administered immediately pre- and post-activity. Self-esteem scores for visitors leaving the sites were significantly higher than those just arriving and overall mood also significantly improved. Feelings of anger, depression, tension and confusion all significantly reduced and vigour increased. Thus, the environment plays an important role in facilitating physical activities and helping to address sedentary behaviours. Walking, in particular, can serve many purposes including exercise, recreation, travel, companionship, relaxation and restoration. However, walking in greenspaces may offer a more sustainable option, as the primary reward is enhanced emotional wellbeing through both exposure to nature and participation in exercise. [ABSTRACT FROM AUTHOR]

Future reductions in the overall burden of ill-health and premature death from cardiovascular disease are likely to follow from reductions in the proportions of the population who are physically inactive. More benefit is likely to be gained from activating the sedentary than from persuading those who are already active to become more active. Population studies of exercise behaviour from New Zealand, North America and Australia have found that 25–30% of adults are sedentary in their leisure time. Australia's National Health Goals and Targets are described as an example of recent initiatives in industrialised countries to increase physical activity levels on a population-wide basis. Evaluations of recent nationwide campaigns in Australia suggest the need for a realistic awareness of what can and cannot be achieved by mass-media information and persuasion to encourage sedentary people to be more active. Primary-health-care practitioners (particularly general practitioners and those educated in the exercise and sport sciences) have a key role to play in advising and encouraging sedentary people to be more active, particularly by focusing on each of the different stages of change in physical activity (precontemplation, contemplation, preparation, action and maintenance). Health-care practitioners should also be contributing to informed public debate not only by disseminating information on the benefits of a physically active lifestyle, but also by advocating for appropriate environmental and social changes which would encourage inactive people to be more active. [ABSTRACT FROM PUBLISHER]

The article offers information on study methods for assessing sedentary behavior as a risk factor for chronic disease and death in patients with cardiovascular disease, cancer, and type 2 diabetes. Topics discussed include the use of the isotemporal substitution modeling for analyzing the health effects of sedentary behavior, homeostasis model assessment of B-cell function, and the significance of biomarkers.

The author reflects on the risks of sedenterism or habitual physical inactivity in the U.S. He says that much of the risk of sedenterim has been ascribed to the onset of obesity, which is a well known risk factor for the development of insulin resistance and has been connected to endothelial dysfunction. He mentions the studies which used model protocols that impose strict, acute bed rest on healthy people to find out the sedenterism's hemodynamic, metabolic, and vascular effects.

Introduction: Physical inactivity is the fourth leading cause of death worldwide. South Africans have low physical activity (PA) levels which increase the morbidity and mortality associated with various chronic diseases. General Practitioners (GPs) play a key role in motivating a large proportion of the sedentary population to become physically active. Very little is known about the exercise prescription practices of South African GPs. This study aimed to determine the practices, attitudes toward and knowledge on exercise prescription among GPs in SA and identify possible barriers why they do not prescribe exercise. Methods: A self-administered, anonymous electronic questionnaire was circulated to a database of GPs via email on three separate occasions, two weeks apart and was completed by a total of 349 GPs. Exercise prescription practices, attitudes towards exercise prescription and the importance thereof as preventative modality for chronic diseases were assessed. Knowledge on benefits, risk factors, contraindications and compilations of exercise prescriptions were also assessed. Results: Substantially higher prescription rates were reported compared to international literature. A minority (18.0%) of the participants felt that exercise prescription will be too time consuming, while almost half (46.0%) of the non-prescribing doctors reported a lack of confidence in their knowledge to be able to prescribe exercise. Approximately 98% of the GPs believed that it should be part of their practice to prescribe exercise to their patients, despite the fact that their knowledge regarding recommendations for physical activity and the formulation of an exercise prescription was poor. Conclusion: Although GPs reported a high prevalence of exercise prescription, insufficient knowledge about exercise prescription and appropriate lifestyle modifications were noticed. Barriers to exercise prescription differ from international literature and should be investigated further. A lack in confidence and knowledge to enable safe and effective exercise prescription highlights a need to rethink the undergraduate medical curricula. [ABSTRACT FROM AUTHOR]

In this article, the author focuses on the importance of physical activity citing a research paper published in the periodical "Lancet." The study found that the population attributable fraction (PAF) for physical inactivity and all-cause mortality was about 9.4 percent, ranging from 5.1 percent in Southeast Asia to 12.5 percent in the eastern Mediterranean. He opines that the encouragement of physical activity or exercise is as important as discouragement of smoking for the public health.