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Background: Experimental research has established the benefits of interrupting prolonged periods of sedentary behaviour in the evening with regular activity breaks. Research should now focus on how people can be encouraged and supported to engage in this behaviour. This study explores the barriers and facilitators unique to performing regular activity breaks in the evening mapped to the Capability Opportunity and Motivation model of Behaviour (COM-B), to inform future free-living intervention development., Methods: Individual, face-to-face, semi-structured interviews were conducted with 28 participants (female n = 20, mean (SD) age 25.4 (5.5) years) who had participated in a laboratory-based, evening regular activity breaks intervention. Questions explored barriers and facilitators to incorporating regular activity breaks into their everyday lives at home in the evening. The interview transcripts were analyzed inductively first using thematic analysis, and then mapped, where relevant, to the COM-B model to link the themes to theoretical factors influencing behaviour change., Results: 'Awareness of the benefits' of performing regular activity breaks, along with having the 'Memory and attention required to change behaviour' (e.g., reminders to overcome forgetfulness) influenced participant's psychological capability to perform this behaviour in the evening at home. 'Characteristics of the regular activity break exercises' enhanced physical capability as the exercises were easy and simple. The theme 'Social influences on behaviour' was mapped to social opportunity and described that others present in their home environment could support or hinder the behaviour, dependent on whether they were also taking regular activity breaks or not. 'Motivation' such as working towards a goal (facilitator) or not wanting to interrupt current sedentary behaviours (barrier) explained how reflective motivation, could influence taking regular activity breaks. Additionally, this theme explained how laziness, tiredness and reinforcement of sedentary behaviour via the nature of streaming services could hinder individuals' automatic motivation to perform regular activity breaks in their habitual evening routines., Conclusions: Capability, opportunity and motivation were all perceived to influence individuals' ability to interrupt habitual evening sedentary behaviour by performing regular activity breaks. To encourage people to perform this behaviour, a multicomponent intervention is required to improve capability by understanding the benefits, opportunity by utilizing social support and motivation by creating goals and action planning., Competing Interests: Declarations Ethics Approval This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the University of Otago Ethics Committee (Health; H20/161, December 2020). Informed Consent Informed consent was obtained from all individual participants included in the study. Conflict of Interest The authors declare no conflict of interest., (© 2024. International Society of Behavioral Medicine.)

Objective: To determine if performing regular 3-min bouts of resistance exercise spread over 4 hours in an evening will impact subsequent sleep quantity and quality, sedentary time and physical activity compared with prolonged uninterrupted sitting., Methods: In this randomised crossover trial, participants each completed two 4-hour interventions commencing at approximately 17:00 hours: (1) prolonged sitting and (2) sitting interrupted with 3 min of bodyweight resistance exercise activity breaks every 30 min. On completion, participants returned to a free-living setting. This paper reports secondary outcomes relating to sleep quality and quantity, physical activity and sedentary time which were assessed using wrist-worn ActiGraph GT3+ accelerometers paired with a sleep and wear time diary., Results: A total of 28 participants (women, n=20), age 25.6±5.6 years, body mass index 29.5±6.7 kg/m 2 (mean±SD) provided data for this analysis. Compared with prolonged sitting, regular activity breaks increased mean sleep period time and time spent asleep by 29.3 min (95% CI: 1.3 to 57.2, p=0.040) and 27.7 min (95% CI: 2.3 to 52.4, p=0.033), respectively, on the night of the intervention. There was no significant effect on mean sleep efficiency (mean: 0.2%, 95% CI: -2.0 to 2.4, p=0.857), wake after sleep onset (1.0 min, 95% CI: -9.6 to 11.7, p=0.849) and number of awakenings (0.8, 95% CI: -1.8 to 3.3, p=0.550). Subsequent 24-hour and 48-hour physical activity patterns were not significantly different., Conclusions: Performing bodyweight resistance exercise activity breaks in the evening has the potential to improve sleep period and total sleep time and does not disrupt other aspects of sleep quality or subsequent 24-hour physical activity. Future research should explore the longer-term impact of evening activity breaks on sleep., Trial Registration Number: Australian New Zealand Clinical Trials Registry (ACTRN12621000250831)., Competing Interests: Competing interests: None declared., (© 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.)

Aims: To compare the effects of 4 hours of laboratory-based regular activity breaks (RABs) and prolonged sitting (SIT) on subsequent 48-h free-living interstitial glucose levels in a group of healthy adults., Materials and Methods: In this randomized crossover trial, participants completed two 4-h laboratory-based interventions commencing at ~5:00 pm: (1) SIT and (2) SIT interrupted with 3 min of body weight resistance exercise activity breaks every 30 min (RABs). Continuous glucose monitoring was performed during the intervention and for 48-h after, during which time participants returned to a free-living setting., Results: Twenty-eight adults (female n = 20, mean ± SD age 25.5 ± 5.6 years, body mass index 29.2 ± 6.9 kg/m 2 ) provided data for this analysis. During the intervention period, RABs lowered mean interstitial glucose by 8.3% (-0.47 mmol/L/4 h, 95% confidence interval [CI] -0.74 to -0.20; p = 0.001) and area under the curve (AUC) by 8.9% (-2.01 mmol/L/4 h, 95% CI -3.05 to -0.97; p < 0.001) compared to SIT. Measures of glycaemic variability were not significantly different during the intervention. There were no significant differences in mean glucose and AUC between conditions during the first nocturnal period and 24-h post intervention. When compared to SIT, RABs increased continuous overall net action of glucose at 1 h and SD glucose by 22% (0.18 mmol/L, 95% CI 0.03 to 0.29; p = 0.018) and 26% (95% CI 4.9 to 42.7; p = 0.019) in the first nocturnal period and by 10% (0.09 mmol/L, 95% CI 0.01, 0.17; p = 0.025) and 15% (95% CI 6.6 to 22.4; p = 0.001) in the 24-h post intervention period, respectively., Conclusion: Performing activity breaks in the evening results in acute reductions in interstitial glucose concentrations; however, the magnitude of these changes is not maintained overnight or into the following 48 hours., (© 2024 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.)

Background and Objectives: Globally, there appears to be an ever-increasing interest in adopting a vegetarian diet. However, there are concerns that avoiding meat may increase the risk of anaemia and micronutrient deficiencies, especially for vulnerable populations, such as adolescent women. The objective of this study was to compare the micronutrient status of vegetarian and non-vegetarian adolescent women in New Zealand., Methods and Study Design: Adolescent women aged 15-18 y were recruited from eight locations across New Zealand. Blood samples were analysed for: haemoglobin, serum ferritin, soluble transferrin receptor, zinc, selenium, retinol binding protein, folate, vitamin B-12, vitamin D and parathyroid hormone., Results: Of the 182 participants who provided a blood sample, 15% self-identified as vegetarian (n=27). On average, vegetarians had 3.1% (95% CI -5.8 to -0.4, p=0.025) lower haemoglobin, and 8.3% (95%CI -14.1 to -2.1, p=0.004) lower selenium. In contrast, serum folate was 80.5% (95% CI 45.7 to 123.7, p<0.001) higher. The prevalence of zinc and selenium deficiency was higher among vegetarians (50% and 12%, respectively) than non-vegetarians (21%, and 2%, respectively)., Conclusions: Adolescent vegetarian women may be at increased risk of deficiency of micronutrients commonly found in animal products, including zinc and selenium, and may benefit from following dietary practices that enhance micronutrient intake and absorption., Competing Interests: The authors declare no conflict of interest

Objective: The aim of the study is to evaluate the feasibility of a workplace intervention supporting employees to interrupt sitting time with short bouts of activity (termed an opportunity to move [OTM])., Methods: Using an interrupted time series design, 58 sedentary employees provided baseline assessments of physical activity, health, and work-related outcomes and completed the 12-week intervention. Assessments were repeated immediately and 12 weeks after intervention. Focus groups explored intervention acceptability., Results: Accelerometer data showed no change in the number of OTMs taken before to after intervention, while participants self-reported 62-69% intervention adherence. Physical activity at work, productivity, and musculoskeletal health improved but cardiometabolic health and psychological well-being did not. Intervention components were viewed favorably (pending amendments), but taking an OTM every 30 minutes was not feasible., Conclusions: The Move More @ Work intervention has potential, but adaptations are required to increase adherence., Competing Interests: Hargreaves, Shaw, Scott, Calverley, and Peddie have no relationships/conditions/circumstances that present potential conflict of interest., (Copyright © 2023 American College of Occupational and Environmental Medicine.)

Introduction: Interrupting sedentary time during the day reduces postprandial glycemia (a risk factor for cardiometabolic disease). However, it is not known if benefits exist for postprandial glucose, insulin and triglyceride responses in the evening, and if these benefits differ by body mass index (BMI) category., Methods: In a randomized crossover study, 30 participants (25.4 ± 5.4 yr old; BMI 18.5-24.9: n = 10, BMI 25-29.9: n = 10, BMI ≥30: n = 10) completed two intervention arms, beginning at ~1700 h: prolonged sitting for 4 h, and sitting with regular activity breaks of 3 min of resistance exercises every 30 min. Plasma glucose, insulin, and triglyceride concentrations were measured in response to two meals fed at baseline and 120 min. Four-hour incremental area under the curve was compared between interventions. Moderation by BMI status was explored., Results: Overall, when compared with prolonged sitting, regular activity breaks lowered plasma glucose and insulin incremental area under the curve by 31.5% (95% confidence interval = -49.3% to -13.8%) and 26.6% (-39.6% to -9.9%), respectively. No significant differences were found for plasma triglyceride area under the curve. Interactions between BMI status and intervention was not statistically significant., Conclusions: Interventions that interrupt sedentary time in the evening may improve cardiometabolic health by some magnitude in all participants regardless of bodyweight., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Sports Medicine.)

Objective: This study aimed to describe meat consumption rationalisation and relationships with meat consumption patterns and food choice motivations in New Zealand adolescents., Design: This was a cross-sectional study of adolescents from high schools across New Zealand. Demographics, dietary habits, and motivations and attitudes towards food were assessed by online questionnaire and anthropometric measurements taken by researchers. The 4Ns questionnaire assessed meat consumption rationalisation with four subscales: 'Nice', 'Normal', 'Necessary' and 'Natural'., Setting: Nineteen secondary schools from eight regions in New Zealand, with some purposive sampling of adolescent vegetarians in Otago, New Zealand., Participants: Questionnaires were completed by 385 non-vegetarian and vegetarian (self-identified) adolescents., Results: A majority of non-vegetarian adolescents agreed that consuming meat was 'nice' (65 %), but fewer agreed that meat consumption was 'necessary' (51 %). Males agreed more strongly than females with all 4N subscales. High meat consumers were more likely to agree than to disagree that meat consumption was nice, normal, necessary and natural, and vegetarians tended to disagree with all rationalisations. Adolescent non-vegetarians whose food choice was motivated more by convenience, sensory appeal, price and familiarity tended to agree more with all 4N subscales, whereas adolescents motivated by animal welfare and environmental concerns were less likely to agree., Conclusions: To promote a reduction in meat consumption in adolescents, approaches will need to overcome beliefs that meat consumption is nice, normal, necessary and natural.

Background: The measurement of height is crucial for weight status assessment. When standing height is difficult to measure, ulna length may offer a convenient and accurate surrogate of height measure. Adolescence is a period of accelerated linear growth; hence, the validation of age-specific equations that predict height from ulna length in adolescents is warranted. The present study aimed to develop and validate age- and sex-specific equations for predicting height from ulna length in New Zealand adolescents., Methods: Height, weight and ulna length were measured in 364 adolescents (n = 110 males, n = 254 females) aged 15.0-18.8 years, who were enrolled in the SuNDiAL (Survey of Nutrition Dietary Assessment and Lifestyle) project, a cross-sectional survey performed in 2019 and 2020. Regression models were used to determine equations to predict height from ulna length. Agreement between measured and predicted height, body mass index (BMI) and BMI z-score was assessed with intra-class correlation coefficients (ICC) and Bland-Altman plots. Sensitivity and specificity were calculated for classifying obesity., Results: Strong agreement was found between predicted and measured height (ICC = 0.78; mean difference = 0; 95% confidence interval = -0.5 to 0.5 cm) and BMI (ICC = 0.95; mean difference = 0; 95% confidence interval = -0.1 to 0.1 kg m -2 ). Predicted height was 88.1% accurate when classifiying weight status, showing high sensitivity (93.8%) and specificity (99.4%) for classifying obesity., Conclusions: Ulna length measurement can accurately estimate height and subsequently weight status in New Zealand adolescents aged 15-18 years., (© 2021 The British Dietetic Association Ltd.)

Background: Prolonged sitting increases the risk of cardio-metabolic disease. Office-based employees are particularly susceptible to high rates of this sedentary behaviour during work hours. Laboratory studies indicate that regularly interrupting periods of prolonged sitting with short bouts (2 min) of physical activity can improve markers of cardio-metabolic health. This method of interrupting sitting time is yet to be tested in an occupational setting and may provide an alternative to providing sit-to-stand desks. Drawing on the Behaviour Change Wheel and evidence on the barriers and motivators to performing regular activity breaks, the Move More @ Work intervention was developed. The objectives of this pilot study are to examine the feasibility, and preliminary outcomes, of this intervention designed to encourage participants to perform 1-2 min of activity after every 30 min of continuous sitting throughout the work day. The study will inform if progress to a full effectiveness trial is warranted., Methods: An interrupted time series design consisting of a 4-week baseline (control period), a 12-week intervention, and a 12-week follow-up will be utilised. At least 57 university employees who self-report spending > 5 h per day sitting at work on at least 3 days per week will be recruited to participate. The intervention consists of (1) a structured consultation with a Move More @ Work coach, containing a number of behaviour change techniques to create an individualised plan of how to incorporate the activity breaks into the working day, and (2) strategies to create a supportive workplace culture for performing the activity breaks. Feasibility will be assessed by recruitment and retention rates, and acceptability of the intervention. Pilot outcomes are the number of regular activity breaks taken during the workday, cardio-metabolic risk score and self-reported health, and work-related productivity outcomes., Discussion: If the Move More @ Work intervention is shown to be feasible, acceptable, and shows evidence of effectiveness, this will provide justification for the progression to a full scale evaluation of the intervention. In the longer-term, this intervention may provide an alternative means of improving health outcomes through interrupting sedentary time than that offered by current sedentary behaviour interventions., Trial Registration: Australian New Zealand Clinical Trials Registry, ACTRN12620000354987 . Registered on 12 March 2020., (© 2021. The Author(s).)

Background: The majority of adolescents do less physical activity than is recommended by the World Health Organization. Active commuting and participation in organised sport and/or physical education individually have been shown to increase physical activity in adolescents. However, how these domains impact physical activity both individually and in combination has yet to be investigated in a sample of New Zealand female adolescents from around the country., Methods: Adolescent females aged 15-18 y ( n = 111) were recruited from 13 schools across eight locations throughout New Zealand to participate in this cross-sectional study. Participants completed questions about active commuting, and participation in organised sport and physical education, before wearing an Actigraph GT3X (Actigraph, Pensacola, FL, USA) +24 h a day for seven consecutive days to determine time spent in total, MVPA and light physical activity., Results: Active commuters accumulated 17 min/d (95% CI 8 to 26 min/d) more MVPA compared to those who did not. Those who participated in sport accumulated 45 min/d (95% CI 20 to 71 min/d) more light physical activity and 14 min/d (95% CI 5 to 23 min/d) more MVPA compared to those who did not. Participation in physical education did not seem to have a large impact on any component of physical activity. Participation in multiple domains of activity, e.g., active commuting and organised sport, was associated with higher accumulation of MVPA but not light activity. Conclusion Active commuting and sport both contribute a meaningful amount of daily MVPA. Sport participation has the potential to increase overall activity and displace sedentary behaviour. A combination of physical activity domains may be an important consideration when targeting ways to increase physical activity in adolescent females.

Background: Tools that assess all three components of 24 h movement guidelines (sleep, physical activity, and screen use) are scarce. Our objective was to use a newly developed Screen Time and Activity Recall (STAR-24) to demonstrate how this tool could be used to illustrate differences in time-use across the day between two independent samples of male adolescents collected before and during the COVID-19 lockdown., Methods: Adolescent boys aged 15-18 years ( n = 109) each completed the STAR-24 twice, n = 74 before lockdown and n = 35 during lockdown., Results: During lockdown more than 50% of the sample reported gaming between 10 a.m. and 12 noon, transport was not reported as an activity, and activities of daily living spiked at mealtimes. Gaming and screen time were more prevalent in weekends than weekdays, with the highest prevalence of weekday screen use (before lockdown) occurring between 8 and 9 p.m. Differences in estimates of moderate-to-vigorous physical activity prior to and during lockdown (mean difference (95% CI); 21 (-9 to 51) min) and sleep (0.5 (-0.2 to 1.2) h) were small. Total and recreational screen time were higher during lockdown (2 h (0.7 to 3.3 h) and 48 min (-36 to 132 min), respectively)., Conclusions: The STAR-24 holds promise as a single tool that assesses compliance with 24 h movement guidelines. This tool also allows clear illustration of how adolescent boys are using their time (instead of only providing summary measures), providing richer data to inform public health initiatives.

Diet is one of the strongest modifiable risk factors for hypertension. In this study, we described the associations between dietary factors and blood pressure; and explored how weight status moderated these associations in a sample of New Zealand male adolescents. We collected demographics information, anthropometric, blood pressure, and dietary data from 108 male adolescents (15-17 years old). Mixed effects and logistic regression models were used to estimate relationships between dietary variables, blood pressure, and hypertension. Moderation effects of overweight status on the relationship between hypertension and diet were explored through forest plots. One-third (36%) of the sample was classified as hypertensive. Fruit intake was related to significantly lower systolic (-2.4 mmHg, p = 0.005) and diastolic blood pressure (-3.9 mmHg, p = 0.001). Vegetable and milk intake was related to significantly lower diastolic blood pressure (-1.4 mmHg, p = 0.047) and (-2.2 mmHg, p = 0.003), respectively. In overweight participants, greater vegetable and milk, and lower meat intake appeared to reduce the odds of hypertension. Certain dietary factors may have more prominent effects on blood pressure depending on weight status.

The objective of this study was to compare acute effects of prolonged sitting, prolonged standing and sitting interrupted with regular activity breaks on vascular function and postprandial glucose metabolism. In a randomized cross-over trial, 18 adults completed: 1. Prolonged Sitting; 2. Prolonged Standing and 3. Sitting with 2-min walking (5 km/h, 10% incline) every 30 min (Regular Activity Breaks). Flow mediated dilation (FMD) was measured in the popliteal artery at baseline and 6 h. Popliteal artery hemodynamics, and postprandial plasma glucose and insulin were measured over 6 h. Neither raw nor allometrically-scaled FMD showed an intervention effect (p = 0.285 and 0.159 respectively). Compared to Prolonged Sitting, Regular Activity Breaks increased blood flow (overall effect of intervention p<0.001; difference = 80%; 95% CI 34 to 125%; p = 0.001) and net shear rate (overall effect of intervention p<0.001; difference = 72%; 95% CI 30 to 114%; p = 0.001) at 60 min. These differences were then maintained for the entire 6 h. Prolonged Standing increased blood flow at 60 min only (overall effect of intervention p<0.001; difference = 62%; 95% CI 28 to 97%; p = 0.001). Regular Activity Breaks decreased insulin incremental area under the curve (iAUC) when compared to both Prolonged Sitting (overall effect of intervention P = 0.001; difference = 28%; 95% CI 14 to 38%; p<0.01) and Prolonged Standing (difference = 19%; 95% CI 4 to 32%, p = 0.015). There was no intervention effect on glucose iAUC or total AUC (p = 0.254 and 0.450, respectively). In normal-weight participants, Regular Activity Breaks induce increases in blood flow, shear stress and improvements in postprandial metabolism that are associated with beneficial adaptations. Physical activity and sedentary behaviour messages should perhaps focus more on the importance of frequent movement rather than simply replacing sitting with standing., Competing Interests: The authors have declared that no competing interests exist.

Background: Insulin-like growth factor-I (IGF-1) is an anabolic hormone that stimulates cell growth and division. The effects of IGF-1 may be beneficial (muscle growth/repair) or detrimental (increased risk of several types of cancer and mortality) for health. Dietary protein and physical activity are thought to be factors that modulate IGF-1., Objective: This study analysed the relationships dietary protein vs IGF-1 and physical activity vs IGF-1 independently with a large sample size, and determined if/how physical activity affected the association between dietary protein and IGF-1 in healthy adults., Methods: Regression models were used to assess the association between dietary protein and/or physical activity on serum IGF-1 in a cross-sectional sample of 60,677 healthy adults that were enrolled in the UK Biobank project., Results: Dietary protein was positively associated with IGF-1 (0.030 nmol/L;95%CI 0.027-0.033;p < 0.001). Individuals undertaking 10-50 excess MET h/week of physical activity had 0.129 nmol/L greater IGF-1 than participants completing less than 10 excess MET h/week (95%CI 0.028-0.230). The "high" category of physical activity (>50 excess MET h/week) was not correlated with IGF-1 (-0.055 nmol/L;95%CI -0.185-0.076). When dietary protein and physical activity were included in the same model, physical activity did not change the relationship between dietary protein and IGF-1, nor visa-versa., Conclusions: The positive association between dietary protein and IGF-1 was not influenced by physical activity. The former association was stronger than the latter. Thus, when seeking to adjust IGF-1 for possible health concerns, regulating dietary protein may be more pertinent than physical activity as a primary intervention., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Interrupting sedentary behaviour with regular activity breaks benefits glycaemic control; however, the influence of the energy utilised during these activity breaks on postprandial metabolic response is relatively unknown. Therefore, the aim of this study was to investigate whether the energy utilisation of regular (every 30 min) short (1 min 40 s or 2 min) activity breaks was associated with the lowering of postprandial glycaemia, insulinemia and lipidemia., Using separate data from two previously performed studies (ALPhA Study n = 65, age 25.7 (5.2) y, 40% male, BMI 23.6 (4.1) kg · m -2 . ABPA study n = 35, age 25.1 (3.7) y, 31% male, BMI 23.4 (3.2) kg · m -2 ) we investigated the association between energy utilisation (measured by indirect calorimetry) and postprandial glucose, insulin and triglycerides during prolonged sitting, and regular activity breaks.Results., Mixed effects regression models indicated that energy utilisation was not consistently associated with postprandial glucose, insulin or triglyceride responses (p > 0.05 for all). Additionally, there was some indication that energy utilisation was obscuring (mildly suppressing) the effects of regular activity breaks on glucose, insulin and triglyceride iAUC.Conclusions., If energy utilisation does not mediate the association between regular activity breaks and postprandial glycaemic response, it is possible that it is the frequency of the activity breaks that is beneficial.

Insulin-like growth factor 1 (IGF-1) is a dichotomous hormone. While beneficial for growth/repair, and regulating muscle hypertrophy, high concentrations of IGF-1 are associated with increased risk of cancer and mortality. Factors thought to mediate IGF-1 include dietary protein and exercise. The purpose of this study was to analyze acute effects of dietary protein and/or exercise on plasma free IGF-1 and the time-course thereof to inform individuals who may benefit from increased IGF-1 (muscle growth/repair) or reduced IGF-1 (risk/diagnosis of cancer). Twenty-four participants (11 females, 24.9±4.6y) completed the three-way crossover study consisting of: (1)a high protein (42g) meal; (2)exercise (20min with four 30sec sprints); and (3)exercise followed by a high protein meal. Blood samples were collected fasted at rest, immediately after rest (or 5min after exercise), and at regular intervals throughout a 5h recovery. An additional fasted venipuncture was performed the morning following each condition (24h after baseline). Free IGF-1 was higher at immediately after exercise in the exercise condition (p=0.04). In the protein condition the 24h IGF-1 was 17.5% higher (p=0.02) than baseline. IGF-1 did not change over time in response to exercise with protein. The data gleaned from this study can enhance the knowledge of the time-course effects from protein and/or exercise on IGF-1. This study can provide a foundation for future research to investigate optimal timing and dosage to enhance muscle protein synthesis for athletes, as well as investigate whether consistent high protein meals may chronically elevate IGF-1 and increase the risk of deleterious health outcomes., Competing Interests: Conflict of Interest The authors declare no conflicts of interest arising from the conclusions of this work. Declaration of Interest Statement We, the authors, declare this manuscript is original, has not been published before and is not currently being considered for publication elsewhere. The manuscript and order of authors has been read/approved by all authors. There are no other personas who satisfied the authorship criteria. There are no impediments to publication. Our institutions intellectual property regulations have been followed. The involvement of human patients has met ethical approval (acknowledged in manuscript). We understand the Corresponding Author is the sole contact for the Editorial process and is responsible for communicating with the other authors.

Despite activity guidelines moving towards a 24-h focus, we have a poor understanding of the 24-h activity patterns of adolescents. Therefore, this study aims to describe the 24-h activity patterns of a sample of adolescent females and investigate the association with body mass index (BMI). Adolescent females aged 15-18 years ( n = 119) were recruited across 13 schools in 8 locations throughout New Zealand. Actigraph GT3X+ accelerometers were worn 24-h a day for seven days and the output was used to identify time spent in each 24-h component (sleep, sedentary, light-intensity physical activity and moderate-to-vigorous intensity physical activity). In a 24-h period, adolescent females spent approximately half their time sedentary, one third sleeping and the remainder in light-intensity physical activity (15%) and moderate-to-vigorous intensity physical activity (5%). Higher BMI z-scores were associated with 16 min more time spent in light-intensity physical activity. Additionally, those with higher BMI were less likely to meet the sleep and physical activity guidelines for this age group. Compliance with the moderate-to-vigorous intensity physical activity guidelines, sleep guidelines, or both, was low, especially in those classified as overweight or obese. The association between BMI and light activity warrants further investigation.

Objective: The aim of this study was to describe device-measured patterns of sedentary behavior in self-identified sedentary university employees., Methods: Participants (n = 78) wore the ActiGraph GT3X+ and the activPAL3 for 7 days. Data from the ActiGraph were used to identify time in sedentary behavior, light-intensity, and moderate-to-vigorous physical activity. Data from the activPAL identified time sitting/lying, standing, and stepping. Breaks in sedentary time and prolonged sedentary bouts were described., Results: During workdays, participants spent 65% to 79% of time sedentary, 16% in light-intensity physical activity, and 4% in moderate-to-vigorous physical activity, 76% of time was spent sitting/lying, 16% standing, and 8% stepping. Between 10 and 12 breaks in sedentary time were accumulated., Conclusion: Office-based university employees spend a high proportion of their time sedentary, but accumulate a high number of breaks. Whether these breaks are appropriate in timing, duration, and intensity to elicit health benefits seen in laboratory studies requires further investigation.

Objective: The aim was to conduct a systematic review and meta-analysis analyzing the impact of up to 24 h of prolonged sitting on postprandial glucose, insulin and triglyceride responses, blood pressure and vascular function, in comparison to sitting interrupted with light- to moderate-intensity physical activity., Methods: To be included, studies had to examine the impact of prolonged sitting lasting < 24 h in apparently healthy males or females of any age. Studies were identified from searches of the MEDLINE, CINAHL and SportDISCUS databases on July 6, 2016. Study quality was assessed using the Downs and Black Checklist; publication bias was assessed via funnel plot., Results: Forty-four studies met the inclusion criteria for the systematic review; of these, 20 were included in the meta-analysis, which compared prolonged sitting to the effects of interrupting sitting with regular activity breaks on postprandial glucose, insulin and triglycerides. When compared to prolonged sitting, regular activity breaks lowered postprandial glucose (d = - 0.36, 95% confidence interval [CI] - 0.50 to - 0.21) and insulin (d = - 0.37, 95% CI - 0.53 to - 0.20), but not triglyceride responses (d = 0.06, 95% CI - 0.15 to 0.26). Subgroup analyses indicated reductions in postprandial triglyceride responses only occurred 12-16 h after the intervention. The magnitude of the reductions in glucose, insulin or triglyceride response was not modified by the intensity of the activity breaks, the macronutrient composition of the test meal, or the age or body mass index of participants., Conclusion: Prolonged sitting results in moderate elevations in postprandial glucose and insulin responses when compared to sitting interrupted with activity breaks., Prospero Id: CRD42015020907.

Aims: To quantify and compare energy utilization associated with prolonged sitting alone, or interrupted with regular activity breaks and/or an additional bout of continuous physical activity., Methods and Results: Thirty six adults (11 males, BMI 24.1 ± 4.6) completed four interventions: (1) prolonged sitting (SIT), (2) sitting with 2-min of walking every 30 min (RAB), (3) prolonged sitting with 30-min of continuous walking at the end of the day (SIT + PA), (4) a combination of the activities in (2) and (3) above (RAB + PA). All walking was at a speed and incline corresponding to 60% V̇O 2max . Energy utilization over 7 h for each intervention was estimated using indirect calorimetry. Compared to SIT, SIT + PA increased total energy utilization by 709 kJ (95% CI 485-933 kJ), RAB by 863 kJ (95% CI 638-1088 kJ), and RAB + PA by 1752 kJ (95% CI 1527-1927 kJ) (all p < 0.001). There was no difference in total energy utilization between SIT + PA and RAB, however, post-physical activity energy utilization in RAB was 632 kJ greater than SIT + PA (95% CI 561-704 kJ; p < 0.001)., Conclusions: Short frequent activity, results in greater accumulation of elevated post-physical activity energy utilization compared to a single bout of continuous activity; however the total energy utilization is similar. Combining activity breaks with a longer continuous bout of activity will further enhance energy utilization, and in the longer term, may positively affect weight management of a greater magnitude than either activity pattern performed alone., Trial Registration: ANZCTR12614000624684., (Copyright © 2018 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Background: The cumulative effect of too much sedentary behavior may contribute to weight gain and obesity., Objective: The aim of this study was to conduct a systematic review and meta-analysis of prospective cohorts and randomized controlled studies to determine the association between sedentary behavior and body weight and obesity in adults., Data Sources and Study Selection: Relevant studies were identified from searches of the MEDLINE, Embase, AMED and PubMed databases up to May 2017, and by manual searches of in-text citations. Studies that evaluated the association in adults between sedentary behavior and body weight or obesity, while controlling for physical activity, were included. Overall, 31 publications met the eligibility criteria, including 23 prospective cohort studies with data that could be extracted for a quantitative meta-analysis, and a single randomized controlled trial., Results: There were no significant associations between sedentary behavior and any measure of body weight or obesity, with the exception of waist circumference. For the latter outcome, over a 5-year follow-up period, each 1 h per day increase-from baseline to follow-up-in sedentary behavior was associated with a 0.02 mm [95% confidence interval (CI) 0.01-0.04; p = 0.001) increase in waist circumference. The odds ratio of becoming overweight or obese was 1.33 (95% CI 1.11-1.60; p = 0.001) in the highest compared with lowest categories of sedentary behavior., Conclusions: Meta-analysis of data from prospective cohort studies showed small, inconsistent and non-significant associations between sedentary behavior and body weight.

Regular activity breaks increase energy expenditure; however, this may promote compensatory eating behaviour. The present study compared the effects of regular activity breaks and prolonged sitting on appetite. In a randomised, cross-over trial, 36 healthy adults (BMI (Body Mass Index) 23.9 kg/m² (S.D. = 3.9)) completed four, two-day interventions: two with prolonged sitting (SIT), and two with sitting and 2 min of walking every 30 min (RAB). Standardized meals were provided throughout the intervention, with an ad libitum meal at the end of Day 2. Appetite and satiety were assessed throughout both days of each intervention using five visual analogue scales. The five responses were combined into a single appetite response at each time point. The area under the appetite response curve (AUC) was calculated for each day. Intervention effects for appetite response AUC and ad libitum meal intake were tested using linear mixed models. Appetite AUC did not differ between interventions (standardised effect of RAB compared to SIT: Day 1: 0.11; 95% CI: -0.28, 0.06; p = 0.212; Day 2: 0.04; 95% CI: -0.15, 0.24; p = 0.648). There was no significant difference in energy consumed at the ad libitum lunch meal on Day 2 between RAB and SIT. Interrupting prolonged sitting with regular activity breaks does not acutely influence appetite or volume of food consumed, despite inferred increases in energy expenditure. Longer-term investigation into the effects of regular activity breaks on energy balance is warranted., Competing Interests: The authors declare no conflict of interest.

Background: Compared with prolonged sitting, regular activity breaks immediately lower postprandial glucose and insulin, but not triglyceride responses. Postprandial triglycerides can be lowered by physical activity but the effect is often delayed by ∼12 to 24 hours., Objective: The objective of the study was to determine whether regular activity breaks affect postprandial triglyceride response in a delayed manner similar to physical activity., Methods: In a randomized crossover trial, 36 adults (body mass index 23.9 kg/m 2 [standard deviation 3.9]) completed four 2-day interventions: (1) prolonged sitting (SIT); (2) prolonged sitting with 30 minutes of continuous walking (60% VO 2max ), at the end of Day 1 (SIT + PA D1 ); (3) Sitting with 2 minutes of walking (60% VO 2max ) every 30 minutes (RAB); (4) A combination of the continuous walking and regular activity breaks in 2 and 3 above (RAB + PA D1 ). Postprandial plasma triglyceride, nonesterified fatty acids, glucose, and insulin responses were measured in venous blood over 5 hours on Day 2., Results: Compared with SIT, both RAB (difference: -43.61 mg/dL·5 hours; 95% confidence interval [CI] -83.66 to -2.67; P = .035) and RAB + PA D1 (-65.86 mg/dL·5 hours; 95% CI -112.14 to -19.58; P = .005) attenuated triglyceride total area under the curve (tAUC). RAB + PA D1 produced the greatest reductions in insulin tAUC (-23%; 95% CI -12% to -31%; P < .001), whereas RAB resulted in the largest increase in nonesterified fatty acids (tAUC, 10.08 mg/dL·5 hours; 95% CI 5.60-14.84; P < .001). There was no effect on glucose tAUC (P = .290)., Conclusions: Postprandial triglyceride response is attenuated by regular activity breaks, when measured ∼24 hours after breaks begin. Combining regular activity breaks with 30 minutes of continuous walking further improves insulinemic and lipidemic responses., (Copyright © 2017 National Lipid Association. Published by Elsevier Inc. All rights reserved.)

Background: Interrupting sedentary time induces improvements in glucose metabolism; however, it is unclear how much activity is required to reduce the negative effects of prolonged sitting., Methods: Sixty-six participants sat continuously for 9 hours except for required bathroom breaks. Participants were fed meal replacement beverages at 60, 240 and 420 min. Blood samples were obtained hourly for 9 hours, with additional samples collected 30 and 45 min after each feeding. Responses were calculated as incremental area under the curve (iAUC) for plasma glucose, insulin and triglyceride. Participants wore a triaxial accelerometer and a heart rate monitor. Energy expenditure was estimated using indirect calorimetry., Results: After controlling for age, sex and BMI, every 100 count increase in accelerometer derived total movement was associated with a 0.06 mmol·L-1·9 hours decrease in glucose iAUC (95% CI 0.004-0.1; P = .035), but not associated with changes in insulin or triglyceride iAUC. Every 1 bpm increase in mean heart rate was associated with a 0.76 mmol·L-1·9 hours increase in triglyceride iAUC (95% CI 0.13-1.38)., Conclusion: Accelerometer measured movement during periods of prolonged sitting can result in minor improvements in postprandial glucose metabolism, but not lipid metabolism.

Objective: Mandatory folic acid fortification of breads in New Zealand was put on hold in 2009. At this time, bread manufacturers were requested to adopt greater voluntary fortification and agreed to add folic acid to approximately one-third of their bread range. We sought to evaluate the impact of increased voluntary fortification of bread and the proposed mandatory fortification programme on folate intake adequacy of reproductive-age women., Design: Cross-sectional study conducted in 2008. Dietary data were collected using 3 d weighed food records and usual folate intakes were generated by modifying the food composition table as follows: (i) voluntary fortification of bread as of 2008 (six breads); (ii) increased voluntary fortification of bread as of 2011 (thirty-four breads); and (iii) mandatory fortification of all breads. The prevalence of inadequate folate intake was calculated for all three scenarios using the Estimated Average Requirement (320 μg dietary folate equivalents/d) cut-point method., Setting: New Zealand., Subjects: Healthy non-pregnant women (n 125) aged 18-40 years., Results: Usual folate intake in 2008 was 362 μg dietary folate equivalents/d. Increased voluntary bread fortification led to a marginal increase in folate intakes (394 μg dietary folate equivalents/d) and a decline in inadequacy from 37 % to 29 %. Mandatory fortification resulted in an increase of 89 μg folic acid/d, which substantially shifted both the proportion of women with folic acid intakes above 100 μg/d and the distribution of overall folate intakes, producing a marked reduction in inadequacy to 5 %., Conclusions: Increased voluntary bread fortification efforts are far inferior to mandatory fortification as a reliable public health intervention.

Background: Sedentary behavior is a risk factor for cardiometabolic disease. Regularly interrupting sedentary behavior with activity breaks may lower this risk., Objective: We compared the effects of prolonged sitting, continuous physical activity combined with prolonged sitting, and regular activity breaks on postprandial metabolism., Design: Seventy adults participated in a randomized crossover study. The prolonged sitting intervention involved sitting for 9 h, the physical activity intervention involved walking for 30 min and then sitting, and the regular-activity-break intervention involved walking for 1 min 40 s every 30 min. Participants consumed a meal-replacement beverage at 60, 240, and 420 min., Results: The plasma incremental area under the curve (iAUC) for insulin differed between interventions (overall P < 0.001). Regular activity breaks lowered values by 866.7 IU · L(-1) · 9 h(-1) (95% CI: 506.0, 1227.5 IU · L(-1) · 9 h(-1); P < 0.001) when compared with prolonged sitting and by 542.0 IU · L(-1) · 9 h(-1) (95% CI: 179.9, 904.2 IU · L(-1) · 9 h(-1); P = 0.003) when compared with physical activity. Plasma glucose iAUC also differed between interventions (overall P < 0.001). Regular activity breaks lowered values by 18.9 mmol · L(-1) · 9 h(-1) (95% CI: 10.0, 28.0 mmol · L(-1) · 9 h(-1); P < 0.001) when compared with prolonged sitting and by 17.4 mmol · L(-1) · 9 h(-1) (95% CI: 8.4, 26.3 mmol · L(-1) · 9 h(-1); P < 0.001) when compared with physical activity. Plasma triglyceride iAUC differed between interventions (overall P = 0.023). Physical activity lowered values by 6.3 mmol · L(-1) · 9 h(-1) (95% CI: 1.8, 10.7 mmol · L(-1) · 9 h(-1); P = 0.006) when compared with regular activity breaks., Conclusion: Regular activity breaks were more effective than continuous physical activity at decreasing postprandial glycemia and insulinemia in healthy, normal-weight adults. This trial was registered with the Australian New Zealand Clinical Trials registry as ACTRN12610000953033.

Public health recommendations do not distinguish between vitamin D2 and vitamin D3, yet disagreement exists on whether these two forms should be considered equivalent. The objective of the present study was to evaluate the effect of a daily physiological dose of vitamin D2 or vitamin D3 on 25-hydroxyvitamin D (25(OH)D) status over the winter months in healthy adults living in Dunedin, New Zealand (latitude 46°S). Participants aged 18-50 years were randomly assigned to 25 μg (1000 IU) vitamin D3 (n 32), 25 μg (1000 IU) vitamin D2 (n 31) or placebo (n 32) daily for 25 weeks beginning at the end of summer. A per-protocol approach, which included ≥ 90 % supplement compliance, was used for all analyses. Serum 25-hydroxyvitamin D3 (25(OH)D3), 25-hydroxyvitamin D2 (25(OH)D2) and parathyroid hormone (PTH) were measured at baseline and at 4, 8, 13 and 25 weeks. Geometric mean total serum 25(OH)D concentrations (sum of 25(OH)D2 and 25(OH)D3) at baseline was 80 nmol/l. After 25 weeks, participants randomised to D2 and placebo had a significant reduction in serum 25(OH)D3 concentrations over the winter months compared with vitamin D3-supplemented participants (both P< 0.001). Supplementation with vitamin D2 increased serum 25(OH)D2 but produced a 9 (95 % CI 1, 17) nmol/l greater decline in the 25(OH)D3 metabolite compared with placebo (P< 0.036). Overall, total serum 25(OH)D concentrations were 21 (95 % CI 14, 30) nmol/l lower in participants receiving vitamin D2 compared with those receiving D3 (P< 0.001), among whom total serum 25(OH)D concentrations remained unchanged. No intervention-related changes in PTH were observed. Daily supplementation of vitamin D3 was more effective than D2; however, the functional consequence of the differing metabolic response warrants further investigation.

Recently, choline has been associated with neurodevelopment, cognitive function and neural tube defect incidence. However, data on usual intakes are limited, and estimates of dietary intakes of choline and its metabolite betaine, are not available for New Zealanders. The objective of the present study was to determine usual intake and food sources of choline and betaine in a group of New Zealand reproductive age women. Dietary intake data were collected from a sample of 125 women, aged 18-40 years, by means of a 3-day weighed food record, and usual choline and betaine intake distributions were determined. The mean (SD) daily intakes of choline and betaine were 316 (66) mg and 178 (66) mg, respectively. The total choline intake relative to energy intake and body weight was 0.18 mg/kcal and 5.1 mg/kg, respectively. Only 16% of participants met or exceeded the Adequate Intake (AI) for adult women of 425 mg of choline. The top five major food contributors of choline were eggs, red meat, milk, bread and chicken; and of betaine were bread, breakfast cereal, pasta, grains and root vegetables (carrots, parsnips, beetroot, swedes). Our findings contribute towards the recent emergence of published reports on the range of dietary choline and betaine intakes consumed by free-living populations. In our sample of New Zealand women, few participants were meeting or exceeding the AI level. Given recent epidemiological evidence suggesting health benefits of increased choline and betaine intakes, recommendations should be made to encourage the consumption of choline and betaine-rich foods.

Historically, the link between elevated cholesterol and increased risk of cardiovascular disease has been based on fasting measurements. This is appropriate for total, low-density lipoprotein and high-density lipoprotein cholesterol. However, triglyceride concentrations vary considerably throughout the day in response to the regular consumption of food and drink. Recent findings indicate that postprandial triglyceride concentrations independently predict future cardiovascular risk. Potential modulators of postprandial lipidemia include meal composition and physical activity. Early cross sectional studies indicated that physically active individuals had a lower postprandial lipidemic response compared to inactive individuals. However, the effect of physical activity on postprandial lipidemia is an acute phenomenon, which dissipates within 60 h of a single bout of exercise. Total exercise induced energy expenditure, rather than duration or intensity of the physical activity is commonly reported to be a potent modulator of postprandial lipidemia. However, the pooled results of studies in this area suggest that energy expenditure exerts most of its influence on fasting triglyceride concentrations rather than on the incremental change in triglyceride concentrations seen following meal consumption. It seems more likely that energy expenditure is one component of a multifactorial list of mediators that may include local muscle contractile activity, and other yet to be elucidated mechanisms., (Copyright © 2011 Elsevier Ltd. All rights reserved.)