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Abstract: Purpose: The associations between work time, leisure-time, and non-workday physical activity (PA) and sedentary behavior (SED) and 24 h ambulatory blood pressure (BP) are not well known. Therefore, the aim of this study was to evaluate the associations between domain-specific activity behavior and 24 h blood pressure.Methods: A hundred and fifty-six aging workers (mean age 62.4 [SD 1.0] years, BMI 26.2 [4.5] kg/m2, 84 % women, 75 % non-manual occupation) from the Finnish Retirement and Aging study (FIREA) were included. Standing, light and moderate-to-vigorous PA (LPA and MVPA, respectively), and SED were measured using thigh-worn accelerometers and work time, leisure-time, and non-workdays were distinguished using a diary. Ambulatory 24 h BP was analyzed as mean daytime and nighttime systolic and diastolic BP, and the nocturnal BP dipping percentage was calculated. Associations were examined with linear regression analysis adjusting for age, sex, occupation, work time mode, job strain, BMI, BP medication, and accelerometer wear time.Results: Higher work time SED associated with lower nighttime diastolic BP (B = -0.92, 95% CI -1.83, -0.01). In addition, higher work time standing associated with higher daytime diastolic BP (B = 1.34, 95% CI 0.03, 2.65) and higher work time LPA with less diastolic BP dipping (B = -3.57, 95% CI -6.80, -0.34). MVPA in any domain was not associated with ambulatory BP.Conclusions: Higher work time SED associated with a more favorable diastolic BP, and higher work time PA associated with more adverse diastolic BP among aging workers. In conclusion, work time, rather than leisure time or non-workday, activity behavior seems to associate with 24 h ambulatory BP., Competing Interests: Conflict of Interest and Funding Source: This work was supported by funding granted by the Research Council of Finland (286294, 319246, 294154 and 332030 to SS, and 324243 to IH), Finnish Ministry of Education and Culture (to SS), Juho Vainio Foundation (to SS, KS), the State Research Funding (Turku University Hospital) (to SS, JN), Finnish Foundation for Cardiovascular Research (to SS), Päivikki and Sakari Sohlberg foundation (to JN), and Tyks Foundation (to JN). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors report no conflicts of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Sports Medicine.)

The aim of this study was to investigate whether a reduction in accelerometer-measured sedentary behavior (SB) improves blood lipids in inactive adults with metabolic syndrome (MetS). Sixty-four participants were randomly assigned into intervention (INT, n = 33) and control (CONT, n = 31) groups. The INT group was instructed to reduce SB by 1 h/day without increasing formal exercise, whereas the CONT group was advised to maintain usual SB habits. SB and physical activity (PA) were measured with accelerometers throughout the intervention. Plasma lipid concentrations and dietary intake by food diaries were assessed at baseline and at the end of the intervention. High-density lipoprotein percentage of total cholesterol decreased during the intervention similarly in both groups (p = 0.047). Other blood lipids did not change from baseline to six months in either group. The CONT group had a statistically significant reduction in the intake of saturated fatty acids compared to the INT group (p = 0.03). Intervention resulting in a 40-minute reduction in daily SB and 20-minute increase in habitual MVPA seems to not be effective in improving blood lipids in adults with MetS. Reducing SB together with a higher volume and/or intensity of PA and proper nutrition may be needed to reduce the risk of cardiometabolic diseases.Trial registration. This study is registered at ClinicalTrials.gov (NCT03101228, 05/04/2017). https://www.clinicaltrials.gov/ct2/show/NCT03101228?term=NCT03101228&draw=2&rank=1 ., (© 2024. The Author(s).)

Objectives: Sedentary behaviour (SB) is a plausible intervention target for back pain mitigation. Therefore, this study aimed to investigate the effects of a 6-month SB reduction intervention on back pain and related disability outcomes, and paraspinal muscle (ie, erector spinae and transversospinales separately) insulin sensitivity (glucose uptake, GU) and muscle fat fraction (FF)., Methods: Sixty-four adults with overweight or obesity and metabolic syndrome were randomised into intervention (n=33) and control (n=31) groups. The intervention group aimed to reduce SB by 1 hour/day (measured with accelerometers) and the control group continued as usual. Back pain intensity and pain-related disability were assessed using 10 cm Visual Analogue Scales and the Oswestry Disability Index (ODI) questionnaire. Paraspinal muscle GU was measured using 18-fluorodeoxyglucose positron emission tomography during hyperinsulinaemic-euglycaemic clamp. FF was measured using MRI., Results: Pain-related disability increased during the intervention in both groups. Back pain intensity increased significantly more in the control group than in the intervention group in which back pain intensity remained unchanged (group×time p=0.030). No statistically significant between-group changes in pain-related disability, ODI or paraspinal GU and FF were observed. In the whole study group, the change in daily steps was associated positively with the change in paraspinal muscle GU., Conclusion: An intervention focusing on SB reduction may be feasible for preventing back pain worsening regardless of paraspinal muscle GU or FF., Trial Registration Number: NCT03101228., Competing Interests: Competing interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: TS received a speaker fee from Pihlajalinna Plc, Tampere, Finland. The other authors report no conflicts of interest. The results are presented clearly and honestly without fabrication, falsification or inappropriate data manipulation., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Mobilization of certain immune cells may improve the ability of the immune system to combat tumor cells, but the effect of acute exercise on mobilizing immune cells has been sparsely investigated in cancer patients. Therefore, we examined how acute exercise influences circulating immune cells in breast cancer patients., Methods: Nineteen newly diagnosed breast cancer patients aged 36-68 performed 30 minutes of moderate-intensity exercise with a cycle ergometer. Blood samples were collected at various time points: at rest, at 15 (E15) and 30 minutes (E30) after onset of the exercise, and at 30 and 60 minutes post-exercise. We analyzed several immune cell subsets using flow cytometry., Results: Acute exercise increased the number of total leukocytes, neutrophils, lymphocytes, monocytes, basophils, total T-cells, CD4 + T-cells, T helper (Th) 2-cells, Th 17-cells, CD8 + T-cells, CD4 - CD8 - T-cells, CD56 + natural killer (NK) cells, and CD14 - CD16 + monocytes. Many of the changes were transient. Proportions of NK-cells and CD8 + T-cells increased, while the proportion of myeloid derived suppressor cells (MDSCs) reduced, and proportion of regulatory T-cells remained unchanged by exercise. Several associations were detected between cell mobilizations and disease state. For instance, tumor size correlated negatively with NK cell mobilization at E15, and progesterone receptor positivity correlated negatively with CD8 + T-cell mobilization., Conclusion: The findings show that the proportions of CD8 + T-cells and NK cells increased and the proportion of MDSCs proportion decreased in breast cancer patients after 30-minute exercise, suggesting a change in the profile of circulating immune cells towards more cytotoxic/anti-tumorigenic. The mobilization of some immune cells also appears to be related to the disease state., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Koivula, Lempiäinen, Neuvonen, Norha, Hollmén, Sundberg, Rundqvist, Minn, Rinne and Heinonen.)

Physical activities and sedentary behaviors take place in different contexts. This study aimed to determine if the context, total score, and leisure-time MET-index assessed by the Baecke questionnaire associate with each other or with sedentary behavior and physical activity outcomes from a 4-week accelerometer measurement in physically inactive adults with overweight. The item "After working I am tired" correlated negatively with items related to leisure-time physical activity and sports participation. The total Baecke Score showed weak but significant correlations with accelerometer-measured sedentary behavior, physical activity, daily steps, and mean activity intensity of the day (r = - 0.33, 0.41, 0.35, and 0.41, respectively). The associations strengthened when the Sport Index was omitted from the Score. The leisure-time MET-Index did not correlate with accelerometer-measured sedentary behavior or physical activity. Tiredness after working associated with less self-reported physical activity during leisure time. This suggests that better recovery from work-related stress could increase leisure-time physical activity, or increasing leisure-time physical activity could reduce tiredness after working. Moreover, among self-reportedly inactive adults with overweight, focusing the questionnaire on work and non-sport leisure time instead of total time might give more accurate estimates of sedentary behavior and physical activity when compared to accelerometry.The study is registered at ClinicalTrials.gov (NCT03101228, 05/04/2017)., (© 2024. The Author(s).)

Evidence on the long-term effects of reducing sedentary behaviour (SB) on blood pressure (BP) is scarce. Therefore, we performed a sub-analysis of the BP effects of a six-month intervention that aimed at reducing SB by 1 h/day and replacing it with non-exercise activities. Sixty-four physically inactive and sedentary adults with metabolic syndrome (58% female, 58 [SD 7] years, BP 143/88 [16/9] mmHg, SB 10 [1] h/day) were randomised into intervention (INT, n = 33) and control (CON, n = 31) groups. Resting BP and BP at each stage during and after a graded maximal bicycle ergometer test were measured before and after the intervention. SB, standing, moderate-to-vigorous physical activity (MVPA), and light physical activity (LPA) were measured in six-second intervals at baseline and during the whole six-month intervention using hip-worn accelerometers. The analyses were adjusted for BP medication status. The intervention resulted in a 40 min/day reduction in SB and concomitant 20 min/day increase in MVPA. Resting systolic BP was lower in the CON group before and after the intervention. No group x time interactions were observed in resting BP or BP during exercise at submaximal or maximal intensities, or during recovery. The changes in LPA and MVPA were inversely correlated with the changes in BP during light-to-moderate intensity exercise. An intervention that resulted in a 40 min/day reduction in SB for six months was not sufficient at influencing BP at rest, during or after exercise in adults with metabolic syndrome. However, successfully increasing LPA or MVPA might lower BP during light-to-moderate-intensity activities., (© 2024. The Author(s).)

Metabolic flexibility (MetFlex) describes the ability to respond and adapt to changes in metabolic demand and substrate availability. The relationship between physical (in)activity and MetFlex is unclear. This study aimed to determine whether sedentary time, physical activity (PA), and cardiorespiratory fitness associate with MetFlex. Sedentary time, standing, and PA were measured with accelerometers for 4 weeks in 64 sedentary adults with metabolic syndrome [37 women, 27 men; 58.3 (SD 6.8) years]. Fitness (V̇o 2max ; mL·kg -1 ·min -1 ) was measured with graded maximal cycle ergometry. MetFlex was assessed with indirect calorimetry as the change in respiratory exchange ratio (ΔRER) from fasting to insulin stimulation with hyperinsulinemic-euglycemic clamp and from low-intensity to maximal exercise. Carbohydrate (CHOox) and fat oxidation (FATox) were calculated from respiratory gases. High sedentary time associated with higher fasting RER [β = 0.35 (95% confidence interval: 0.04, 0.67)], impaired insulin-stimulated MetFlex (ΔRER) [β=-0.41 (-0.72, -0.09)], and lower fasting FATox [β=-0.36 (-0.67, -0.04)]. Standing associated with lower fasting RER [β=-0.32 (-0.62, -0.02)]. Higher standing time and steps/day associated with higher fasting FATox [β = 0.31 (0.01, 0.61), and β = 0.26 (0.00, 0.53)]. Light-intensity and total PA associated with better insulin-stimulated MetFlex [β = 0.33 (0.05, 0.61)], and β = 0.33 (0.05, 0.60)]. Higher V̇o 2max associated with higher CHOox during maximal exercise [β = 0.81 (0.62, 1.00)], as well as during insulin stimulation [β = 0.43 (0.13, 0.73)]. P values are less than 0.05 for all associations. Sedentary time and PA associate with MetFlex. Reducing sitting and increasing PA of even light intensity might aid in the prevention of metabolic diseases in risk populations through their potential effects on energy metabolism. NEW & NOTEWORTHY High accelerometer-assessed sedentary time associates with metabolic inflexibility measured during hyperinsulinemic-euglycemic clamp in adults with metabolic syndrome, and more light-intensity and total physical activity associate with more metabolic flexibility. Physical activity behaviors may thus play an important role in the regulation of fuel metabolism. This highlights the potential of reduced sedentary time and increased physical activity of any intensity to induce metabolic health benefits and help in disease prevention in risk populations.

Introduction: Poor cardiorespiratory fitness (CRF) is associated with adverse health outcomes. Previous observational and cross-sectional studies have suggested that reducing sedentary behavior (SB) might improve CRF. Therefore, we investigated the effects of a 6-month intervention of reducing SB on CRF in 64 sedentary inactive adults with metabolic syndrome in a non-blind randomized controlled trial., Materials and Methods: In the intervention group (INT, n = 33), the aim was to reduce SB by 1 h/day for 6 months without increasing exercise training. Control group (CON, n = 31) was instructed to maintain their habitual SB and physical activity. Maximal oxygen uptake (VO 2max ) was measured by maximal graded bicycle ergometer test with respiratory gas measurements. Physical activity and SB were measured during the whole intervention using accelerometers., Results: Reduction in SB did not improve VO 2max statistically significantly (group × time p > 0.05). Maximal absolute power output (W max ) did not improve significantly but increased in INT compared to CON when scaled to fat free mass (FFM) (at 6 months INT 1.54 [95% CI: 1.41, 1.67] vs. CON 1.45 [1.32, 1.59] W max /kg FFM , p = 0.036). Finally, the changes in daily step count correlated positively with the changes in VO 2max scaled to body mass and FFM (r = 0.31 and 0.30, respectively, p < 0.05)., Discussion: Reducing SB without adding exercise training does not seem to improve VO 2max in adults with metabolic syndrome. However, succeeding in increasing daily step count may increase VO 2max ., (© 2023 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.)

Objectives: The association between the subjective experience of pain-related disability (PRD) and device-measured physical activity (PA) and sedentary behavior (SB) in overweight and obese adults is not well known. The aim of this study was to investigate the associations of pain markers with accelerometer-measured SB duration and different intensities of PA among physically inactive middle-aged adults with overweight or obesity., Methods: This cross-sectional analysis included 72 subjects (27 men) with mean age of 57.9 (SD 6.7) years and mean BMI of 31.6 (SD 4.1) kg/m 2 . SB and standing time (ST), breaks in sedentary time, light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) were measured for four consecutive weeks (mean 25 days, SD 4) with a hip-worn triaxial accelerometer. Headache, musculoskeletal pain, back pain, and PRD were assessed by visual analog scales (VAS) and using the Oswestry disability index (ODI). RAND-36 questionnaire was applied to assess health-related quality of life. The associations were studied by linear models., Results: ST was positively and SB proportion was negatively associated with PRD when adjusted for age, sex, BMI, accelerometry duration, MVPA, pain medication use, and general health perceptions assessed by RAND-36. No associations were found between ST and back pain. SB or different PA intensities were not associated with pain experience at specific sites., Conclusions: Longer daily ST, but not LPA or MVPA is associated with higher level of PRD. Correspondingly, higher proportion of SB is associated with lower level of PRD. This suggests that individuals with PRD prefer to stand, possibly to cope with pain. These results may highlight the importance of habitual standing behaviors in coping with experienced PRD in adults with overweight or obesity., (© 2021 Walter de Gruyter GmbH, Berlin/Boston.)