Do Intervention Studies to Promote Physical Activity and Reduce Sedentary Behavior in Children and Adolescents Take Sex/Gender Into Account? A Systematic Review

Background: Physical inactivity is often reported in youth and differs among boys and girls. The aim of this study is to assess sex/gender considerations in intervention studies promoting physical activity and reducing sedentary behavior in youth using a sex/gender checklist. Methods: A systematic search was conducted in August 2018 to identify all relevant controlled trials. Studies screened must have reported a quantified measure of physical activity and/or sedentary behavior, and identified participants by sex/gender at baseline. For evaluation of the sex/gender consideration, the authors used a sex/gender checklist developed by expert consensus. Results: The authors reviewed sex/gender considerations in all aspects of intervention development, implementation, and evaluation in 217 studies. Sex/gender aspects were only rudimentarily taken into account, most frequently during statistical analyses, such as stratification or interaction analysis. Conclusions: Sex/gender effects are not sufficiently reported. To develop guidelines that are more inclusive of all girls and boys, future interventions need to document sex/gender differences and similarities, and explore whether sex/gender influences different phases of intervention programs. The newly developed sex/gender checklist can hereby be used as a tool and guidance to adequately consider sex/gender in the several steps of intervention planning, implementation, and evaluation.

Download Full-text

Trends in Self-Reported Sitting Time by Physical Activity Levels Among US Adults, NHANES 2007/2008–2017/2018

Journal of Physical Activity and Health ◽

10.1123/jpah.2021-0221 ◽

2021 ◽

Vol 18 (S1) ◽

pp. S74-S83

Author(s):

Emily N. Ussery ◽

Geoffrey P. Whitfield ◽

Janet E. Fulton ◽

Deborah A. Galuska ◽

Charles E. Matthews ◽

...

Keyword(s):

Physical Activity ◽

Sedentary Behavior ◽

Physical Inactivity ◽

Premature Mortality ◽

Linear Increase ◽

Sitting Time ◽

Point Estimate ◽

Activity Levels ◽

Physical Activity Levels ◽

Active Adults

Background: High levels of sedentary behavior and physical inactivity increase the risk of premature mortality and several chronic diseases. Monitoring national trends and correlates of sedentary behavior and physical inactivity can help identify patterns of risk in the population over time. Methods: The authors used self-reported data from the National Health and Nutrition Examination Surveys (2007/2008–2017/2018) to estimate trends in US adults’ mean daily sitting time, overall, and stratified by levels of leisure-time and multidomain physical activity, and in the joint prevalence of high sitting time (>8 h/d) and physical inactivity. Trends were tested using orthogonal polynomial contrasts. Results: Overall, mean daily sitting time increased by 19 minutes from 2007/2008 (332 min/d) to 2017/2018 (351 min/d) (Plinear < .05; Pquadratic < .05). The highest point estimate occurred in 2013/2014 (426 min/d), with a decreasing trend observed after this point (Plinear < .05). Similar trends were observed across physical activity levels and domains, with one exception: an overall linear increase was not observed among sufficiently active adults. The mean daily sitting time was lowest among highly active adults compared with less active adults when using the multidomain physical activity measure. Conclusions: Sitting time among adults increased over the study period but decreased in recent years.

Download Full-text

Temporal Trends of Physical Activity and Sedentary Behavior Simultaneity in Brazilian Students

Journal of Physical Activity and Health ◽

10.1123/jpah.2016-0700 ◽

2018 ◽

Vol 15 (5) ◽

pp. 331-337

Author(s):

Rafaela Costa Martins ◽

Luiza Isnardi Cardoso Ricardo ◽

Gerfeson Mendonça ◽

Daiana Lopes de Rosa ◽

Letícia Lemos Ayres da Gama Bastos ◽

...

Keyword(s):

Physical Activity ◽

Confidence Interval ◽

Sedentary Behavior ◽

Private Schools ◽

Physical Inactivity ◽

Temporal Trends ◽

Cross Sectional ◽

Public And Private ◽

Independent Variables ◽

Brazilian Students

Objective: To evaluate trends in physical activity and sedentary behavior simultaneity among Brazilian students from 2009 to 2015 and its association with independent variables. Methods: This study presents a panel of 3 cross-sectional studies carried out in 2009, 2012, and 2015 (Pesquisa Nacional de Saúde do Escolar—PeNSE). The population was comprised of ninth-grade public and private schools students from Brazilian capitals. Physical activity and sedentary behavior variables were combined to create the outcome of simultaneity of these risk factors. Results: A large proportion of students were simultaneously inactive and sedentary in the 3 surveys. However, it was possible to observe a downward trend (2009: 56.4%; 95% confidence interval, 55.7–57.1; 2012: 53.7%; 95% confidence interval, 53.0–54.4; 2015: 51.9%; 95% confidence interval, 51.2–52.7). In 2015, estimates of physical inactivity and sedentary behavior simultaneity were greater than 48% for 20 out of 27 of the Brazilian states. Significant declining trends were observed among mideast residents, females, nonwhite, and those attending private schools. Only around 5%–7% of the adolescents were both active and nonsedentary in the 3 surveys. Conclusion: Despite of a slight decreasing trend in the proportion of Brazilian students simultaneously inactive and sedentary throughout the period, the prevalence remained elevated across the surveys.

Download Full-text

Physical Activity and Sitting Time Are Specifically Associated With Multiple Chronic Diseases and Medicine Intake in Brazilian Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.2017-0271 ◽

2018 ◽

Vol 26 (4) ◽

pp. 608-613 ◽

Cited By ~ 1

Author(s):

Alex S. Ribeiro ◽

Luiz C. Pereira ◽

Danilo R.P. Silva ◽

Leandro dos Santos ◽

Brad J. Schoenfeld ◽

...

Keyword(s):

Physical Activity ◽

Sedentary Behavior ◽

Chronic Diseases ◽

Physical Inactivity ◽

Prevalence Ratio ◽

Sitting Time ◽

Older Individuals ◽

Independent Association ◽

Older Men And Women ◽

Multiple Chronic Diseases

The purpose of the study was to clarify the independent association between sedentary behavior and physical activity with multiple chronic diseases and medicine intake in older individuals. Sedentary behavior and physical activity were measured by questionnaires. Diseases and medication use were self-reported. Poisson’s regression was adopted for main analysis, through crude and adjusted prevalence ratio and confidence interval of 95%. For men, sedentary time >4 hr/day presented a 76% higher prevalence of ≥2 chronic diseases, while physical inactivity increases the likelihood of using ≥2 medicines in 95%. For women, sedentary behavior >4 hr/day presented an 82% and 43% greater prevalence for ≥2 chronic diseases and the intake of ≥2 medicines, respectively. Sedentary behavior represents an independent associated factor of multiple chronic diseases in older men and women. In addition, inactivity for men and sedentarism for women are associated with the amount of medicine intake.

Download Full-text

Assessment of Sedentary Behavior With the International Physical Activity Questionnaire

Journal of Physical Activity and Health ◽

10.1123/jpah.5.s1.s30 ◽

2008 ◽

Vol 5 (s1) ◽

pp. S30-S44 ◽

Cited By ~ 173

Author(s):

Dori E. Rosenberg ◽

Fiona C. Bull ◽

Alison L. Marshall ◽

James F. Sallis ◽

Adrian E. Bauman

Keyword(s):

Physical Activity ◽

Sedentary Behavior ◽

Physical Inactivity ◽

International Physical Activity Questionnaire ◽

Population Surveillance ◽

Sitting Time ◽

Time Activity ◽

Physical Activity Questionnaire ◽

The Relationship ◽

Activity Questionnaire

Purpose:This study explored definitions of sedentary behavior and examined the relationship between sitting time and physical inactivity using the sitting items from the International Physical Activity Questionnaire (IPAQ).Methods:Participants (N = 289, 44.6% male, mean age = 35.93) from 3 countries completed self-administered long- and short-IPAQ sitting items. Participants wore accelero-meters; were classified as inactive (no leisure-time activity), insufficiently active, or meeting recommendations; and were classified into tertiles of sitting behavior.Results:Reliability of sitting time was acceptable for men and women. Correlations between total sitting and accelerometer counts/min <100 were significant for both long (r = .33) and short (r = .34) forms. There was no agreement between tertiles of sitting and the inactivity category (kappa = .02, P = .68).Conclusion:Sedentary behavior should be explicitly measured in population surveillance and research instead of being defined by lack of physical activity.

Download Full-text

Social isolation during the COVID-19 pandemic can increase physical inactivity and the global burden of cardiovascular disease

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00268.2020 ◽

2020 ◽

Vol 318 (6) ◽

pp. H1441-H1446 ◽

Cited By ~ 33

Author(s):

Tiago Peçanha ◽

Karla Fabiana Goessler ◽

Hamilton Roschel ◽

Bruno Gualano

Keyword(s):

Physical Activity ◽

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Sedentary Behavior ◽

Social Isolation ◽

Physical Inactivity ◽

Global Burden ◽

Activity Levels ◽

Home Based ◽

Physical Activity Levels

Emerging data indicate a substantial decrease in global physical activity levels during the period of social isolation adopted worldwide to contain the spread of the coronavirus disease 2019 (COVID-19). Confinement-induced decreases in physical activity levels and increases in sedentary behavior may provoke a rapid deterioration of cardiovascular health and premature deaths among populations with increased cardiovascular risk. Even short-term (1–4 wk) inactivity has been linked with detrimental effects in cardiovascular function and structure and increased cardiovascular risk factors. In this unprecedented and critical scenario, home-based physical activity programs arise as a clinically relevant intervention to promote health benefits to cardiac patients. Many studies have demonstrated the feasibility, safety, and efficacy of different models of home-based exercise programs in the primary and secondary prevention of cardiovascular diseases and major cardiovascular events among different populations. This body of knowledge can inform evidence-based policies to be urgently implemented to counteract the impact of increased physical inactivity and sedentary behavior during the COVID-19 outbreak, thereby alleviating the global burden of cardiovascular disease.

Download Full-text

A Sex/Gender Perspective on Interventions to Reduce Sedentary Behaviour in Girls and Boys: Results of the genEffects Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17145231 ◽

2020 ◽

Vol 17 (14) ◽

pp. 5231

Author(s):

Catherina Vondung ◽

Yolanda Demetriou ◽

Anne K. Reimers ◽

Annegret Schlund ◽

Jens Bucksch

Keyword(s):

Systematic Review ◽

Sedentary Behaviour ◽

Interaction Analysis ◽

Gender Effects ◽

Gender Analysis ◽

Intervention Effect ◽

Gender Interaction ◽

Gender Information ◽

Intervention Planning ◽

Randomised Controlled

This systematic review aims to evaluate the extent of sex/gender consideration and effectiveness of interventions designed to reduce sedentary behaviour (SB). We searched for randomised or non-randomised controlled trials with the outcome SB and a sex/gender analysis in eleven electronic databases. Sixty-seven studies were included. Sex/gender considerations were qualitatively rated. Sex/gender was reported separately in 44.8% of studies, 14.9% of studies conducted a sex/gender interaction analysis, and 19.4% enrolled either girls or boys. SB was significantly reduced for girls in 16.4%, for boys in 11.9% and for both in 13.4%. No sex/gender intervention effect was found in 38.8%. According to the qualitative rating, studies without significant sex/gender effects reached “detailed” rating twice as often as studies finding a significant intervention effect for either girls or boys, or both. Overall, no clear pattern according to the qualitative rating and in terms of intervention effectiveness can be drawn. The results reveal a lack of sufficient sex/gender information in intervention planning and delivery. Further research should consider analysing sex/gender intervention effects as well as consider sex/gender inclusive intervention planning and delivery.

Download Full-text

Leisure-Time Physical Activity Does not Attenuate the Association Between Occupational Sedentary Behavior and Obesity: Results From Alberta’s Tomorrow Project

Journal of Physical Activity and Health ◽

10.1123/jpah.2014-0370 ◽

2015 ◽

Vol 12 (12) ◽

pp. 1589-1600 ◽

Cited By ~ 11

Author(s):

Joshua A. Nicholas ◽

Geraldine Lo Siou ◽

Brigid M. Lynch ◽

Paula J. Robson ◽

Christine M. Friedenreich ◽

...

Keyword(s):

Physical Activity ◽

Sedentary Behavior ◽

Physical Inactivity ◽

Leisure Time ◽

Leisure Time Physical Activity ◽

Positive Association ◽

Obesity Risk ◽

Waist To Hip Ratio ◽

Logistic Regressions ◽

Vigorous Intensity

Background:Sedentary behavior has been proposed as a risk factor for obesity that is distinct from physical inactivity. This study aimed to examine the association between occupational sedentary behavior and obesity, and to determine if this association is independent of leisure-time physical activity (LTPA).Methods:Fully employed participants enrolled between 2001 and 2008 to Alberta’s Tomorrow Project, a prospective cohort study in Alberta, Canada, were studied (n = 12,409). Associations between occupational sedentary behavior and waist circumference (WC), waist-to-hip ratio (WHR), and body mass index (BMI) were examined using multiple binary and multinomial logistic regressions.Results:In men, a positive association was observed between daily occupational sedentary hours and WC, WHR, BMI, and with high risk profiles that incorporated both BMI and WC (P < .01). Controlling for vigorous-intensity LTPA in all models strengthened associations between sedentary behavior and measures of obesity. In contrast, inverse associations were observed for occupational sedentary hours and WHR for women (P < .05).Conclusions:In fully employed men, occupational sedentary behavior was positively associated with obesity risk that was not attenuated by physical activity. In women, an increase in obesity risk was not observed with sedentary behavior. Gender differences in the health effects of sedentary behavior require further study.

Download Full-text

Prevalence of Physical Inactivity and Sedentary Behaviors and Associations with Obesity among Saudi Adults

10.21203/rs.3.rs-40306/v1 ◽

2020 ◽

Author(s):

Nora A Althumiri ◽

Nasser F BinDhim ◽

Saleh A. Alqahtani4

Keyword(s):

Physical Activity ◽

Saudi Arabia ◽

Sedentary Behavior ◽

Physical Inactivity ◽

National Level ◽

World Health ◽

Moderate Activity ◽

Age And Gender ◽

National Implementation ◽

And Gender

Abstract Background: Worldwide, physical inactivity is ranked as the fourth leading risk factor for mortality. This study aimed to provide an update on the prevalence of physical inactivity and sedentary behavior among adults in Saudi Arabia and to examine associations with obesity.Methods: This study was conducted as secondary analysis of a national survey that was conducted in Saudi Arabia in 2018. In this study, a proportional quota-sampling technique was used to obtain equal distributions of participants, stratified by age and gender, across the 13 regions of Saudi Arabia. Participants (n = 3,699) were recruited mainly via random phone interviews. The World Health Organization (WHO) recommendations (150 minutes of moderate activity/week or 75 minutes of intensive activity/week) were used to classify physical activity. Logistic regression was used for multivariate analysis.Results: The prevalence of physical inactivity (not meeting the WHO recommendations) ranged between 66.8% and 81.2%. Females and males did not differ in their frequency of physical activity. Participants spent an average of 275 minutes/day watching TV or using phone apps and 267 minutes/day doing office work. Physical inactivity was associated with increased likelihood of obesity (BMI ≥ 30), as compared to those who met the WHO intensive physical activity criteria (odds ratio [OR]: 1.62; 95% CI: 1.23–2.13) and to those who met WHO mixed intensive/moderate physical activity criteria (OR: 1.49; 95% CI: 1.24–1.81), adjusted for age and gender. However, sitting long hours for work or leisure was not significantly associated with obesity.Conclusions: Future research is needed to identify public health interventions that would be most feasible and suitable for physical inactivity and sedentary behavior reduction at the national level for national implementation; and health policies are needed to facilitate sustainability.

Download Full-text

Factors associated with physical inactivity and sedentary behavior among women living in the urban area of Santos City, Brazil

Revista Brasileira de Atividade Física & Saúde ◽

10.12820/rbafs.v.21n2p162-171 ◽

2016 ◽

Vol 21 (2) ◽

pp. 162 ◽

Cited By ~ 1

Author(s):

Angela Trude ◽

Gabriela Vedovato ◽

Yeeli Mui ◽

Maria Oliveira ◽

Paula Martins

Keyword(s):

Physical Activity ◽

Sedentary Behavior ◽

Urban Areas ◽

Physical Inactivity ◽

Economic Status ◽

Sitting Time ◽

World Health ◽

Environmental Perceptions ◽

Cross Sectional ◽

Home Based

We aimed to assess the association between individual, socioeconomic, and environmental variables and sedentary behavior and physical inactivity (PI) among urban Brazilian women of varying economic status in Santos. Through a cross-sectional design in a home-based study, we interviewed 538 women with children under 10 years. We assessed PI through two different indices: the International Physical Activity Questionnaire (IPAQ) and the physical activity time/week as recommended by the World Health Organization (WHO). Sedentary behavior was assessed by sitting-time (>360min/week). Using adjusted logistic regression, walking and driving remained significantly correlated to IPAQ’s score (OR 0.24 95% CI 0.11; 0.50; OR 1.87 95% IC 1.25; 2.81) and to WHO’s guideline (OR 0.20 95% CI 0.08; 0.48; OR 1.77 95% CI 1.16; 2.70). Sedentary behavior was associated with having housekeeper in the household (OR 2.14 95% IC 1.31; 3.50) and perceiving as a barrier for physical activity not having money (OR 0.29 95% CI 0.12; 0.65). Physical inactivity and sedentary behavior were associated with individual, psychosocial and environmental perceptions factors among women with children. Therefore, environmental and policy interventions with multilevel approach may be considered in urban areas to promote health and to prevent obesity among maternal-infant group.

Download Full-text

Abstract 006: Relationship of Sedentary Behavior and Physical Inactivity to Incident Coronary Heart Disease: Results from the Women's Health Initiative

Circulation ◽

10.1161/circ.125.suppl_10.a006 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Andrea K Chomistek ◽

Bing Lu ◽

Megan Sands ◽

Scott B Going ◽

Lorena Garcia ◽

...

Keyword(s):

Physical Activity ◽

Coronary Heart Disease ◽

Heart Disease ◽

Sedentary Behavior ◽

Physical Inactivity ◽

Sedentary Time ◽

Incident Coronary Heart Disease ◽

Health Initiative ◽

Chd Risk ◽

History Of

Background: Sedentary behavior, such as prolonged sitting, is becoming recognized as a distinct construct that may not merely reflect lack of leisure-time physical activity (PA), usually defined as physical inactivity. Our objective was to examine the independent and joint associations of sedentary time and physical inactivity with risk of incident coronary heart disease (CHD) in women. Methods: This study included 84,798 post-menopausal women, aged 50-79 and free of CHD at baseline, participating in the Women's Health Initiative Observational Study. At baseline, participants reported information on sedentary behavior, defined as hours of sitting and lying per day, and usual PA, defined as energy expenditure from recreational activity including walking, mild, moderate and strenuous PA. Participants were followed from the baseline visit through September 2010 for first occurrence of CHD (MI and CHD death). Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for incident CHD according to tertiles of sedentary time (hrs/day) and physical activity (MET-hrs/wk). Results: Sedentary time ≥10 hrs/day was associated with increased CHD risk (HR=1.13, 95% CI 1.04,1.23) in age-adjusted models, but was non-significant in multivariable-adjusted models (HR=1.08, 95% CI 0.99,1.17). In multivariable-adjusted models, the HR of CHD comparing moderate (5.1 - 16.25 MET-hrs/wk) and low (≤ 5 MET-hrs/wk) levels of PA to high (>16.25 MET-hrs/wk) levels were 1.10 (95%CI 1.01,1.21) and 1.21 (95%CI 1.11,1.32), respectively (P for trend <.0001). When we cross-classified women by sedentary time and PA (P for interaction = 0.91), CHD risk was significantly increased only in women with low PA regardless of their sedentary behavior, with the greatest risk seen in women reporting low PA and ≥10 hrs/day of sedentary time. Conclusion: Physical inactivity is associated with increased CHD risk in a dose-response manner, whereas sedentary behavior was only modestly associated with CHD risk in this analysis. Physical Activity (MET-hours/week) Sedentary Time (hours/day) High (> 16.25) Moderate (5.1 - 16.25) Low (≤ 5) ≤6 1.00 (Referent) 1.12 (0.96, 1.30) 1.17 (1.01, 1.36) 6.1-9.9 0.96 (0.82, 1.13) 1.09 (0.94, 1.27) 1.18 (1.02, 1.38) ≥10 1.08 (0.92, 1.27) 1.14 (0.99, 1.32) 1.32(1.15, 1.51) The multivariable model includes age, race, education, income, marital status, smoking, family history of MI, depression, alcohol intake, and history of diabetes, hypertension, or hypercholesterolemia

Download Full-text