Search

Background: Regular physical activity reduces the risk of depression onset and is an effective treatment for mood disorders. Recent studies have reported that sedentary behavior (SB) increases the risk of depression in adults, but relationships of different types of SBs with depression have not been examined systematically. We explored longitudinal relationships of passive (e.g. watching TV) and mentally-active (e.g. office-work) SBs with incident major depressive disorder (MDD). Methods: Self-report questionnaires were completed by 40,569 Swedish adults in 1997; responses were linked to clinician-diagnosed MDD obtained from medical registers until 2010. Relationships between passive, mentally-active and total SBs with incident MDD were explored using survival analysis with Cox proportional hazards regression. Models controlled for leisure time moderate-vigorous physical activity and occupational physical activity. Moderating effects of gender were examined. Results: In fully-adjusted models, including only non-depressed adults at baseline, those reporting ≥ 3 h of mentally-active SBs on a typical day (versus < 3 h) had significant lower hazards of incident MDD at follow-up (HR = 0.74, 95% CI = 0.58–0.94, p = 0.018). There was a non-significant positive relationship of passive SBs with incident MDD (HR = 1.20, 95% CI = 0.96–1.52, p = 0.106). The association between total SBs (passive and mentally-active combined) was not significant (HR = 0.91, 95% CI = 0.75–1.10, p = 0.36). Gender did not moderate these associations. Limitations: Physical activity and SBs were self-reported. Conclusion: Mentally-active SBs may have beneficial effects on adults’ mental well-being. These effects are largely independent of habitual physical activity levels

Paired associative stimulation (PAS) can induce plasticity in the motor cortex, as measured by changes in corticospinal excitability (CSE). This effect is attenuated in older and less active individuals. Although a single bout of exercise enhances PAS-induced plasticity in young, physically inactive adults, it is not yet known if physical activity interventions affect PAS-induced neuroplasticity in middle-aged inactive individuals. Sixteen inactive middle-aged office workers participated in a randomized cross-over design investigating how CSE and short-interval intracortical inhibition (SICI) were affected by PAS preceded by 3 h of sitting (SIT), 3 h of sitting interrupted every 30 min by 3 min of frequent short bouts of physical activity (FPA) and 2.5 h of sitting followed by 25 min of moderate-intensity exercise (EXE). Transcranial magnetic stimulation was applied over the primary motor cortex (M1) of the dominant abductor pollicis brevis to induce recruitment curves before and 5 min and 30 min post-PAS. Linear mixed models were used to compare changes in CSE using time and condition as fixed effects and subjects as random effects. There was a main effect of time on CSE and planned within-condition comparisons showed that CSE was significantly increased from baseline to 5 min and 30 min post-PAS, in the FPA condition, with no significant changes in the SIT or EXE conditions. SICI decreased from baseline to 5 min post-PAS, but this was not related to changes in CSE. Our findings suggest that in middle-aged inactive adults, FPAs may promote corticospinal neuroplasticity. Possible mechanisms are discussed., Fysisk aktivitet och hälsosamma hjärnfunktioner bland kontorsarbetare. Delprojekt 2 Akuta interventioner

Background: As distinct from mentally-active sedentary behaviors (e.g. reading), passive sedentary behaviors (e.g. TV-viewing) have been linked to a higher risk of depression, but the underlying mechanisms are unclear. We examined the potential mediating role of sleep problems in prospective relationships of passive sedentary behaviors with major depressive disorder (MDD). Method: In 1997, 43 863 adults were surveyed and responses linked to clinician diagnoses of MDD until 2010. The questionnaire included items on sedentary behavior and sleep problems (Karolinska Sleep Questionnaire). Cox proportional hazard models and the ‘counterfactual approach’ were used to identify potential mediating effects of sleep problems in the association of passive sedentary behavior and MDD. Results: Of the total sample, 3,065 (7.6%) were excluded for having indications of depression at baseline. Of 33,116 participants with complete data (mean age = 51.3 years, SD = 15.7, 64% female); 472 (1.4%) incident cases of MDD were identified during the 13-year follow-up. In Cox regression analyses, higher durations of passive sedentary behavior (≥3 h/day versus <3 h/day) were associated with greater hazards of developing MDD (HR = 1.27; 95% CI = 1.01, 1.58). This relationship remained after adjusting for confounders (HR = 1.29; 95% CI = 1.03, 1.63). Adding sleep problems into the analysis significantly attenuated these relationships (HR = 1.25; 95% CI = 0.99, 1.57). The excess MDD relative risk of passive sedentary behaviors due to sleep problems was statistically significant. Limitations: Measures of sedentary behavior, physical activity and sleep were self-reported. Conclusion: Sleep problems appear to mediate detrimental associations of passive sedentary behavior with depression. Findings require further confirmation using objective measures.

Background Sedentary behaviour can be associated with poor mental health, but it remains unclear whether all types of sedentary behaviour have equivalent detrimental effects.Aims To model the potential impact on depression of replacing passive with mentally active sedentary behaviours and with light and moderate-to-vigorous physical activity. An additional aim was to explore these relationships by self-report data and clinician diagnoses of depression.Method In 1997, 43 863 Swedish adults were initially surveyed and their responses linked to patient registers until 2010. The isotemporal substitution method was used to model the potential impact on depression of replacing 30 min of passive sedentary behaviour with equivalent durations of mentally active sedentary behaviour, light physical activity or moderate-to-vigorous physical activity. Outcomes were self-reported depression symptoms (cross-sectional analyses) and clinician-diagnosed incident major depressive disorder (MDD) (prospective analyses).Results Of 24 060 participants with complete data (mean age 49.2 years, s.d. 15.8, 66% female), 1526 (6.3%) reported depression symptoms at baseline. There were 416 (1.7%) incident cases of MDD during the 13-year follow-up. Modelled cross-sectionally, replacing 30 min/day of passive sedentary behaviour with 30 min/day of mentally active sedentary behaviour, light physical activity and moderate-to-vigorous activity reduced the odds of depression symptoms by 5% (odds ratio 0.95, 95% CI 0.94-0.97), 13% (odds ratio 0.87, 95% CI 0.76-1.00) and 19% (odds ratio 0.81, 95% CI 0.93-0.90), respectively. Modelled prospectively, substituting 30 min/day of passive with 30 min/day of mentally active sedentary behaviour reduced MDD risk by 5% (hazard ratio 0.95, 95% CI 0.91-0.99); no other prospective associations were statistically significant.Conclusions Substituting passive with mentally active sedentary behaviours, light activity or moderate-to-vigorous activity may reduce depression

The development in research concerning sedentary behaviour has been rapid over the past two decades. This has led to the development of evidence and views that have become more advanced, diverse and, possibly, contentious. These include the effects of standing, the breaking up of prolonged sitting and the role of moderate-to-vigorous physical activity (MVPA) in the association between sedentary behaviour and health outcomes. The present aim is to report the views of experts (n = 21) brought together (one-day face-to-face meeting in 2018) to consider these issues and provide conclusions and recommendations for future work. Each topic was reviewed and presented by one expert followed by full group discussion, which was recorded, transcribed and analysed. The experts concluded that (a). standing may bring benefits that accrue from postural shifts. Prolonged (mainly static) standing and prolonged sitting are both bad for health; (b). 'the best posture is the next posture'. Regularly breaking up of sitting with postural shifts and movement is vital; (c). health effects of prolonged sitting are evident even after controlling for MVPA, but high levels of MVPA can attenuate the deleterious effects of prolonged sitting depending on the health outcome of interest. Expert discussion addressed measurement, messaging and future directions.

BACKGROUND: Living in walkable neighborhoods may provide long-term cardio-metabolic health benefits to residents. Little empirical research has examined the behavioral mechanisms in this relationship. In this longitudinal study, we examined the potential mediating role of physical activity (baseline and 12-year change) in the relationships of neighborhood walkability with 12-year changes in cardio-metabolic risk markers. METHODS: The Australian Diabetes, Obesity and Lifestyle study collected data from adults, initially aged 25+ years, in 1999-2000, 2004-05, and 2011-12. We used 12-year follow-up data from 2023 participants who did not change their address during the study period. Outcomes were 12-year changes in waist circumference, weight, systolic and diastolic blood pressure, fasting and 2-h postload plasma glucose, high-density lipoprotein cholesterol, and triglycerides. A walkability index was calculated, using dwelling density, intersection density, and destination density, within 1 km street-network buffers around participants' homes. Spatial data for calculating these measures were sourced around the second follow-up period. Physical activity was assessed by self-reported time spent in moderate-to-vigorous physical activity (including walking). Multilevel models, adjusting for potential confounders, were used to examine the total and indirect relationships. The joint-significance test was used to assess mediation. RESULTS: There was evidence for relationships of higher walkability with smaller increases in weight (P = 0.020), systolic blood pressure (P < 0.001), and high-density lipoprotein cholesterol (P = 0.002); and, for relationships of higher walkability with higher baseline physical activity (P = 0.020), which, in turn, related to smaller increases in waist circumference (P = 0.006), weight (P = 0.020), and a greater increase in high-density lipoprotein cholesterol (P = 0.005). There was no evidence for a relationship of a higher walkability with a cha

© 2018, The Author(s) 2018. A large amount of time spent sitting is a newly identified health risk. Although desk-based workers spend much of their time at work sitting, little is known about how office spaces may be related to workplace sitting time. This study examined cross-sectional associations of the perceived availability of office shared spaces with workers’ sitting time, and the potential role of workplace normative-social factors in the relationship. Participants (N = 221) wore an activity monitor (activPAL3) and reported availability of shared spaces (for formal meetings, informal discussion, collaborative working), organizational norms, and workplace behavioral autonomy. No shared-space variables were associated with workplace sitting time. However, the perceived availability of sufficient informal discussion space was associated with lower levels of sitting among those who reported more-supportive organizational norms and greater behavioral autonomy. These findings highlight environmental, organizational, and psychosocial factors that will be important to address in future initiatives to reduce work place sitting time.

© 2018, Nordic Association of Occupational Safety and Health. All rights reserved. Objectives This study aimed to assess the economic credentials of a workplace-delivered intervention to reduce sitting time among desk-based workers. Methods We performed within-trial cost-efficacy analysis and long-term cost-effectiveness analysis (CEA) and recruited 231 desk-based workers, aged 24–65 years, across 14 worksites of one organization. Multicomponent workplace-delivered intervention was compared to usual practice. Main outcome measures including total device-measured workplace sitting time, body mass index (BMI), self-reported health-related quality of life (Assessment of Quality of Life-8D, AQoL-8D), and absenteeism measured at 12 months. Results Compared to usual practice, the intervention was associated with greater cost (AU$431/person), benefits in terms of reduced workplace sitting time [-46.8 minutes/8-hour workday, 95% confidence interval (CI):-69.9–-23.7] and increased workplace standing time (42.2 minutes/8-hour workday, 95% CI 23.8–60.6). However, there were no significant benefits for BMI [0.148 kg/m2 (95% CI-1.407–1.703)], QoL-8D [-0.006 (95% CI-0.074–0.063)] and absenteeism [2.12 days (95% CI-2.01–6.26)]. The incremental cost-efficacy ratios (ICER) ranged from AU$9.94 cost/minute reduction in workplace sitting time to AU$13.37/minute reduction in overall sitting time. CEA showed the intervention contributed to higher life year (LY) gains [0.01 (95% CI 0.009–0.011)], higher health-adjusted life year (HALY) gains [0.012 (95% CI 0.0105 – 0.0135)], and higher net costs [AU$344 (95% CI $331–358)], with corresponding ICER of AU$34 443/LY and AU$28 703/HALY if the intervention effects were to be sustained for five-years. CEA results were sensitive to assumptions surrounding intervention-effect decay rate and discount rate. Conclusions The intervention was cost-effective over the lifetime of the cohort when scaled up to the national workforce and provides important

© Genevieve Nissa Healy, Elizabeth G Eakin, Elisabeth AH Winkler, Nyssa Hadgraft, David W Dunstan, Nicholas D Gilson, Ana D Goode. Originally published in JMIR Formative Research (http://formative.jmir.org), 28.08.2018. This is an open-access article distributed under the terms of the Creative Commons Attribution License. Background: The Web-based, evidence-informed BeUpstanding Champion Toolkit was developed to provide employers (via a “train-the-champion approach”) with resources and support to help in reducing prolonged sitting in their own desk-based workplace. As part of a five-phase research-to-dissemination process, this study reports on the evaluation of the beta (test) version of this toolkit (Phase 2). Objective: The objective of our study was to evaluate (1) the implementation of the toolkit by workplace champions and (2) the impact of the toolkit on sitting (primary outcome), standing, and moving; use of activity-promoting strategies; knowledge and attitudes; and indicators of health and work performance. Methods: An implementation study using a pre-post design was conducted in 7 desk-based workplaces in Australia (September 2015 to May 2016), with work teams (one per workplace) purposively recruited to ensure representation across a range of sectors (white- or blue-collar), organizational sizes (small or medium or large), and locations (metropolitan or regional). All staff within participating teams were invited to participate in the relevant toolkit activities. Implementation outcomes (time commitment required by champions and toolkit activities completed) were collected from each champion via telephone interviews. Changes in impact outcomes, measured via a Web-based questionnaire completed by employees at baseline and 3 months postimplementation, were assessed using mixed models, correcting for clustering. Results: Champions reported a 30-60 minutes per week time commitment to the toolkit activities. All teams

© 2018 The Author(s). Background: Reducing workplace sedentary behaviour (sitting) is a topic of contemporary public health and occupational health interest. Understanding workers' perspectives on the feasibility and acceptability of strategies, and barriers and facilitators to reducing workplace sitting time, can help inform the design and implementation of targeted interventions. The aim of this qualitative synthesis was to identify and synthesise the evidence on factors perceived to influence the acceptability and feasibility of reducing sitting at work, without, and with, an associated intervention component. Methods: A systematic search of the peer-reviewed literature was conducted across multiple databases in October 2017 to identify studies with a qualitative component relating to reducing workplace sitting time. Relevant data were extracted and imported into NVivo, and analysed by three of the authors by coding the results sections of papers line-by-line, with codes organised into sub-themes and then into overarching themes. Studies with and without an associated intervention were analysed separately. Results: Thirty-two studies met the inclusion criteria, 22 of which had collected qualitative data during and/or following a workplace intervention. Sample sizes ranged from five through to 71 participants. Studies predominately involved desk-based workers (28/32) and were most frequently conducted in Australia, USA or the United Kingdom (26/32). Similar themes were identified across non-intervention and intervention studies, particularly relating to barriers and facilitators to reducing workplace sitting. Predominately, work and social environment attributes were identified as barriers/facilitators, with desk-based work and work pressures influencing the perceived feasibility of reducing sitting, particularly for low-cost interventions. Support from co-workers and managers was considered a key facilitator to reducing sitting, while social norms that discourage

© 2018 The Author(s). Background: Large amounts of sitting at work have been identified as an emerging occupational health risk, and findings from intervention trials have been reported. However, few such reports have examined participant-selected strategies and their relationships with behaviour change. Methods: The Stand Up Victoria cluster-randomised controlled trial was a workplace-delivered intervention comprising organisational, environmental and individual level behaviour change strategies aimed at reducing sitting time in desk-based workers. Sit-stand workstations were provided, and participants (n = 134; intervention group only) were guided by health coaches to identify strategies for the 'Stand Up', 'Sit Less', and 'Move More' intervention targets, including how long they would stand using the workstation. Three-month workplace sitting and activity changes (activPAL3-assessed total sitting, prolonged sitting (i.e., sitting =30 min continuously) and purposeful walking) were evaluated in relation to the number (regression analysis) and types of strategies (decision-tree analysis). Results: Over 80 different strategies were nominated by participants. Each additional strategy nominated for the 'Stand Up' intervention target (i.e. number of strategies) was associated with a reduction in prolonged sitting of 27.6 min/8-h workday (95% CI: -53.1, - 2.1, p = 0.034). Types of strategies were categorised into 13 distinct categories. Strategies that were task-based and phone-based were common across all three targets. The decision tree models did not select any specific strategy category as predicting changes in prolonged sitting ('Stand Up'), however four strategy categories were identified as important for total sitting time ('Sit Less') and three strategy categories for purposeful walking ('Moving More'). The uppermost nodes (foremost predictors) were nominating > 3 h/day of workstation standing (reducing total workplace sitting) and choosing a 'Move More' task

© 2018 The Author(s). Background: Office-based workers typically spend 70-85% of working hours, and a large proportion of leisure time, sitting. High levels of sitting have been linked to poor health. There is a need for fully powered randomised controlled trials (RCTs) with long-term follow-up to test the effectiveness of interventions to reduce sitting. This paper describes the methodology of a three-arm cluster RCT designed to determine the effectiveness and cost-effectiveness of the SMART Work & Life intervention, delivered with and without a height-adjustable desk, for reducing daily sitting. Methods/design: A three-arm cluster RCT of 33 clusters (660 council workers) will be conducted in three areas in England (Leicester; Manchester; Liverpool). Office groups (clusters) will be randomised to the SMART Work & Life intervention delivered with (group 1) or without (group 2) a height-adjustable desk or a control group (group 3). SMART Work & Life includes organisational (e.g., management buy-in, provision/support for standing meetings), environmental (e.g., relocating waste bins, printers), and group/individual (education, action planning, goal setting, addressing barriers, coaching, self-monitoring, social support) level behaviour change strategies, with strategies driven by workplace champions. Baseline, 3, 12 and 24 month measures will be taken. Primary outcome: Objectively measured daily sitting time (activPAL3). Secondary outcomes: objectively measured sitting, standing, stepping, prolonged sitting and moderate-to-vigorous physical activity time and number of steps at work and daily; objectively measured sleep (wrist accelerometry). Adiposity, blood pressure, fasting glucose, glycated haemoglobin, cholesterol (total, HDL, LDL) and triglycerides will be assessed from capillary blood samples. Questionnaires will examine dietary intake, fatigue, musculoskeletal issues, job performance and satisfaction, work engagement, occupational and general fatigue, stress, p

Background: According to cross-sectional and acute experimental evidence, reducing sitting time should improve cardiometabolic health risk biomarkers. Furthermore, the improvements obtained may depend on whether sitting is replaced with standing or ambulatory activities. Based on data from the Stand Up Victoria multicomponent workplace intervention, we examined this issue using compositional data analysis—a method that can examine and compare all activity changes simultaneously. Methods: Participants receiving the intervention (n = 136 Q 0.6 full-time equivalent desk-based workers, 65% women, mean T SD age = 44.6 T 9.1 yr from seven worksites) were asked to improve whole-of-day activity by standing up, sitting less, and moving more. Their changes in the composition of daily waking hours (activPAL-assessed sitting, standing, and stepping) were quantified then tested for associations with concurrent changes in cardiometabolic risk (CMR) scores and 14 biomarkers concerning body composition, glucose, insulin, and lipid metabolism. Analyses were by mixed models, accounting for clustering (3 months, n = 105–120; 12 months, n = 80–97). Results: Sitting reduction was significantly (P G 0.05) associated only with lower systolic blood pressure at 3 months, and with CMR scores, weight, body fat, waist circumference, diastolic blood pressure, and fasting triglycerides, total/HDL cholesterol, and insulin at 12 months. Significant differences between standing and stepping were only observed for systolic blood pressure and insulin; both favored stepping. However, replacing sitting with standing was significantly associated only with improvements in CMR scores, whereas replacing sitting with stepping was significantly associated with CMR scores and six biomarkers. Conclusions: Improvements in several cardiometabolic health risk biomarkers were significantly associated with sitting reductions that occurred in a workplace intervention. The greatest degree and/or widest range of cardi

We examined the association of musculoskeletal symptoms (MSS) with workplace sitting, standing and stepping time, as well as sitting and standing time accumulation (i.e. usual bout duration of these activities), measured objectively with the activPAL3 monitor. Using baseline data from the Stand Up Victoria trial (216 office workers, 14 workplaces), cross-sectional associations of occupational activities with self-reported MSS (low-back, upper and lower extremity symptoms in the last three months) were examined using probit regression, correcting for clustering and adjusting for confounders. Sitting bout duration was significantly (p < 0.05) associated, non-linearly, with MSS, such that those in the middle tertile displayed the highest prevalence of upper extremity symptoms. Other associations were non-significant but sometimes involved large differences in symptom prevalence (e.g. 38%) by activity. Though causation is unclear, these non-linear associations suggest that sitting and its alternatives (i.e. standing and stepping) interact with MSS and this should be considered when designing safe work systems. Practitioner summary: We studied associations of objectively assessed occupational activities with musculoskeletal symptoms in office workers. Workers who accumulated longer sitting bouts reported fewer upper extremity symptoms. Total activity duration was not significantly associated with musculoskeletal symptoms. We underline the importance of considering total volumes and patterns of activity time in musculoskeletal research.