The association of exercise and sedentary behaviours with incident end-stage renal disease: the Southern Community Cohort Study.
ABSTRACT: OBJECTIVE:To examine whether lifestyle factors, including sedentary time and physical activity, could independently contribute to risk of end-stage renal disease (ESRD). STUDY DESIGN:Case-cohort study. SETTING:South-eastern USA. PARTICIPANTS:The Southern Community Cohort Study recruited ~86?000 black and white participants from 2002 to 2009. We assembled a case cohort of 692 incident ESRD cases and a probability sample of 4113 participants. PREDICTORS:Sedentary time was calculated as hours/day from daily sitting activities. Physical activity was calculated as metabolic equivalent (MET)-hours/day from engagement in light, moderate and vigorous activities. OUTCOMES:Incident ESRD. RESULTS:At baseline, among the subcohort, mean (SD) age was 52 (8.6) years, and median (25th, 75th centile) estimated glomerular filtration rate (eGFR) was 102.8 (85.9-117.9) mL/min/1.73?m2. Medians (25th-75th centile) for sedentary time and physical activity were 8.0 (5.5-12.0) hours/day and 17.2 (8.7-31.9) MET-hours/day, respectively. Median follow-up was 9.4 years. We observed significant interactions between eGFR and both physical activity and sedentary behaviour (p<0.001). The partial effect plot of the association between physical activity and log relative hazard of ESRD suggests that ESRD risk decreases as physical activity increases when eGFR is 90?mL/min/1.73?m2. The inverse association is most pronounced at physical activity levels >27 MET-hours/day. High levels of sitting time were associated with increased ESRD risk only among those with reduced kidney function (eGFR ?30?mL/min/1.73?m2); this association was attenuated after excluding the first 2?years of follow-up. CONCLUSIONS:In a population with a high prevalence of chronic kidney disease risk factors such as hypertension and diabetes, physical activity appears to be associated with reduced risk of ESRD among those with preserved kidney function. A positive association between sitting time and ESRD observed among those with advanced kidney disease is likely due to reverse causation.
Project description:<h4>Background</h4>kidney function declines in older adults and physical activity levels are low. We investigated whether higher levels of physical activity and lower levels of sedentary behaviour were associated with lower odds of low kidney function in older men.<h4>Methods</h4>cross-sectional study of 1,352 men from the British Regional Heart Study, mean (standard deviation) age 78.5 (4.6) year. Physical activity and sedentary behaviour were measured using Actigraph GT3X accelerometers. Kidney function was measured by estimated Glomerular filtration rate (eGFR) using the chronic kidney disease-EPI creatinine-cystatin equation. Associations between physical (in)activity and kidney function were investigated using regression models.<h4>Results</h4>higher levels of physical activity and lower levels of sedentary behaviour were associated with reduced odds ratios (ORs) for lower eGFR (<45 versus ?45 ml/min per 1.73 m2) after adjustment for covariates. Each additional 1,000 steps, 30 min of light physical activity and 10 min of moderate/vigorous physical activity per day were associated with a lower odds (95% confidence interval (CI)) of a low eGFR; OR 0.81 (0.73, 0.91), OR 0.87 (0.78, 0.97) and OR 0.84 (0.76, 0.92), respectively. Each additional 30 min of sedentary behaviour per day was associated with a higher odds of a low eGFR (1.16 95% CI 1.06, 1.27). Associations between moderate/vigorous physical activity and lower kidney function persisted after adjustment for light physical activity or sedentary behaviour.<h4>Conclusion</h4>physical activity is associated with kidney function in older men and could be of public health importance in this group who are at increased risk of poor kidney function and low physical activity. More evidence is needed on whether the association is causal.
Project description:BACKGROUND: It remains unclear what people are attempting to communicate, in terms of objectively monitored behavior, when describing their physical activity and sedentary behavior through self-report. The purpose of this study was to examine various objectively monitored accelerometer variables (e.g., moderate-to-vigorous physical activity [MVPA], steps/day, sedentary time, etc.) across categories of self-reported MVPA (< 150 vs. ? 150 minutes/week), usual occupational/domestic activity (UODA; "mostly sitting" vs. "stand, walk, lift, or carry"), and leisure-time sedentary behavior (LTSB; ? 3 vs. < 3 hours/day) in a nationally representative sample of U.S. adults (? 20 years). METHODS: This is a secondary analysis of 3,725 participants from the 2005-2006 National Health and Nutrition Examination Survey (NHANES) who provided relevant questionnaire responses and???1 day of valid accelerometer data. Descriptive statistics were computed for various objectively monitored accelerometer variables across categories of self-reported MVPA, UODA, and LTSB. Pairwise comparisons were conducted to examine differences in objectively monitored behavior between categories of self-reported MVPA, UODA, and LTSB. RESULTS: On average, adults reporting compliance with physical activity guidelines (? 150 minutes/week of MVPA) accumulated more objectively measured physical activity and similar amounts of sedentary time relative to those reporting not achieving guidelines. Adults reporting their daily UODA as "mostly sitting" or accruing???3 hours/day of LTSB accumulated less objectively monitored physical activity and more sedentary time than those who described their UODA as "stand, walk, lift, or carry" or accrued?<?3 hours/day of LTSB. The most active cross-classified category (7,935 steps/day; ? 150 minutes/week of self-reported MVPA, "stand, walk, lift, or carry" UODA, and?<?3 hours/day of LTSB) accumulated more than twice as many daily steps as the least active cross-classified category (3,532 steps/day; < 150 minutes/week of self-reported MVPA, "mostly sitting" UODA, and???3 hours/day of LTSB). CONCLUSIONS: A number of objectively monitored physical activity indicators varied significantly between self-reported MVPA, UODA, and LTSB categories, while objectively monitored sedentary time only varied between UODA and LTSB categories. Cross-classifications of self-reported MVPA, UODA, and LTSB responses depict a greater range of physical activity than viewing dichotomous responses for these variables one-at-a-time.
Project description:OBJECTIVES:To examine patterns of sedentary behaviour and physical activity, among Japanese workers with differing occupational activity types. DESIGN:A cross-sectional observational study in 2013-2015. SETTING:Two local communities in Japan. PARTICIPANTS:Full-time workers aged 40-64 years (n=345; 55% men) and who lived in two cities. MAIN OUTCOME MEASURES:From accelerometer data for 7 days, mean overall sedentary time, prolonged bouts of sedentary time and light-and moderate-to vigorous-intensity of physical activity (LPA and MVPA) as a proportion of accelerometer wear time and number of breaks per sedentary hour were identified for four time periods: working hours, workdays, non-work hours and non-workdays. These sedentary behaviour and physical activity measures in the four time periods were examined among workers with four self-attributed occupational activity types (mainly sitting, standing, walking, and physical labour), adjusting for sociodemographic attributes. Diurnal patterns of sedentary behaviour, LPA, and MVPA were examined. RESULTS:In working hours, those with a sitting job had significantly more total and prolonged sedentary time (total: p<0.001; prolonged: p<0.01) along with less LPA (p<0.001) and MVPA (p<0.001) and less frequent breaks (p<0.01), compared with those with the three more active job type. Similar differences by job type were found for the whole working day, but not for prolonged sedentary time and breaks. On non-working hours and days, differences in sedentary and physically active patterns by job type were not apparent. CONCLUSIONS:Occupational activity type is related to overall sedentary time and patterns on working days, but not to leisure-time sitting and activity patterns, which were similar across the sitting, standing, walking, and physical labour occupational activity types.
Project description:Atrophy of the medial temporal lobe (MTL) occurs with aging, resulting in impaired episodic memory. Aerobic fitness is positively correlated with total hippocampal volume, a heavily studied memory-critical region within the MTL. However, research on associations between sedentary behavior and MTL subregion integrity is limited. Here we explore associations between thickness of the MTL and its subregions (namely CA1, CA23DG, fusiform gyrus, subiculum, parahippocampal, perirhinal and entorhinal cortex,), physical activity, and sedentary behavior. We assessed 35 non-demented middle-aged and older adults (25 women, 10 men; 45-75 years) using the International Physical Activity Questionnaire for older adults, which quantifies physical activity levels in MET-equivalent units and asks about the average number of hours spent sitting per day. All participants had high resolution MRI scans performed on a Siemens Allegra 3T MRI scanner, which allows for detailed investigation of the MTL. Controlling for age, total MTL thickness correlated inversely with hours of sitting/day (r = -0.37, p = 0.03). In MTL subregion analysis, parahippocampal (r = -0.45, p = 0.007), entorhinal (r = -0.33, p = 0.05) cortical and subiculum (r = -0.36, p = .04) thicknesses correlated inversely with hours of sitting/day. No significant correlations were observed between physical activity levels and MTL thickness. Though preliminary, our results suggest that more sedentary non-demented individuals have less MTL thickness. Future studies should include longitudinal analyses and explore mechanisms, as well as the efficacy of decreasing sedentary behaviors to reverse this association.
Project description:<h4>Objective</h4>Sedentary behaviour has long been associated with neck and low back pain, although relatively little is known about the thoracic spine. Contributing around 33% of functional neck movement, understanding the effect of sedentary behaviour and physical activity on thoracic spinal mobility may guide clinical practice and inform research of novel interventions.<h4>Design</h4>An assessor-blinded prospective observational study designed and reported in accordance with Strengthening the Reporting of Observational Studies in Epidemiology.<h4>Setting</h4>UK university (June-September 2016).<h4>Participants</h4>A convenience sample (18-30 years) was recruited and based on self-report behaviours, the participants were assigned to one of three groups: group 1, sitters-sitting >7?hours/day+physical?activity<150?min/week; group 2, physically active-moderate exercise >150?min/week+sitting <4?hours/day and group 3, low activity-sitting 2-7?hours/day+physical?activity <150?min/week.<h4>Outcome measures</h4>Thoracic spine mobility was assessed in the heel-sit position using Acumar digital goniometer; a validated measure. Descriptive and inferential analyses included analysis of variance and analysis of covariance for between group differences and Spearman's rank correlation for post hoc analysis of associations.<h4>Results</h4>The sample (n=92) comprised: sitters n=30, physically active n=32 and low activity n=30. Groups were comparable with respect to age and body mass index.Thoracic spine mobility (mean (SD)) was: group 1 sitters 64.75 (1.20), group 2 physically active 74.96 (1.18) and group 3 low activity 68.44 (1.22). Significant differences were detected between (1) sitters and low activity, (2) sitters and physically active (p<0.001). There was an overall effect size of 0.31. Correlations between thoracic rotation and exercise duration (r=0.67, p<0.001), sitting duration (r=-0.29, p<0.001) and days exercised (r=0.45, p<0.001) were observed.<h4>Conclusions</h4>Findings evidence reduced thoracic mobility in individuals who spend >7?hours/day sitting and <150?min/week of physical activity. Further research is required to explore possible causal relationships between activity behaviours and spinal musculoskeletal health.
Project description:Prolonged sitting time (ST) has negative consequences on health. Changing this behavior is paramount in overweight/obese individuals because they are more sedentary than those with normal weight. The aim of the study was to establish the pattern of sedentary behavior and its relationship to health, socio-demographics, occupation, and education level in Catalan overweight/obese individuals.A descriptive study was performed at 25 healthcare centers in Catalonia (Spain) with 464 overweight/moderately obese patients, aged25 to 65 years. Exclusion criteria were chronic diseases which contraindicated physical activity and language barriers. Face-to-face interviews were conducted to collect data on age, gender, educational level, social class, and marital status. Main outcome was 'sitting time' (collected by the Marshall questionnaire); chronic diseases and anthropometric measurements were registered.464 patients, 58.4% women, mean age 51.9 years (SD 10.1), 76.1% married, 60% manual workers, and 48.7% had finished secondary education. Daily sitting time was 6.2 hours on working days (374 minutes/day, SD: 190), and about 6 hours on non-working ones (357 minutes/day, SD: 170). 50% of participants were sedentary ?6 hours. The most frequent sedentary activities were: working/academic activities around 2 hours (128 minutes, SD: 183), followed by watching television, computer use, and commuting. Men sat longer than women (64 minutes more on working days and 54 minutes on non-working days), and individuals with office jobs (91 minutes),those with higher levels of education (42 minutes), and younger subjects (25 to 35 years) spent more time sitting.In our study performed in overweight/moderately obese patients the mean sitting time was around 6 hours which was mainly spent doing work/academic activities and watching television. Men, office workers, individuals with higher education, and younger subjects had longer sitting time. Our results may help design interventions targeted at these sedentary patients to decrease sitting time.
Project description:<b>Objective:</b> The study aims to investigate to what extent school- and leisure time-related factors are associated with sedentary behavior during school in German and Irish children and adolescents. <b>Methods:</b> The study based on a sample of 198 children and adolescents surveyed in 2015. Sedentary and activity behavior were measured using the activPAL physical activity monitor. Information on socio-economic status, school- and leisure-time related factors were provided by questionnaires. Associations between school- and leisure time-related factors and sedentary time during school were estimated using linear multi-level models. <b>Results:</b> Access to play equipment in school was associated with reduced sitting time (hours/day) of children (ß = 0.78; 95%CI = 0.06-1.48). Media devices in bedroom and assessing the neighborhood as activity friendly was associated with increased sitting time of children (ß = 0.92; 95%CI = 0.12-1.72 and ß = 0.30; 95%CI = 0.01-0.60, respectively). The permission to use media devices during breaks was associated with increased sitting time (hours/day) of adolescents (ß = 0.37; 95% CI = 0.06-0.69). A less safe traffic surrounding at school was associated with reduced sitting time of adolescents (ß = -0.42; 95% CI = -0.80 to -0.03). <b>Conclusion:</b> Results suggest that school- and leisure time-related factors are associated to the sedentary behavior during school. We suggest that future strategies to reduce sedentary time should consider both contexts.
Project description:Chronic kidney disease, which is defined as having a reduced kidney function (estimated glomerular filtration rate (eGFR)) and/or signs of kidney damage (albuminuria), is highly prevalent in Western society and is associated with adverse health outcomes, such as cardiovascular disease. This warrants a search for risk factors of lower eGFR and higher albuminuria. Physical activity and sedentary behavior may be such risk factors.To examine associations of physical activity (total, high, low), sedentary time and sedentary behavior patterns (breaks, prolonged bouts, average bout duration) with eGFR and albuminuria.We examined these associations in 2,258 participants of the Maastricht Study (average age 60.1±8.1 years; 51.3% men), who wore an accelerometer 24h/day on 7 consecutive days. Associations with continuous eGFR and categories of urinary albumin excretion (UAE; <15 [reference category], 15-<30, ?30 mg/24h) were evaluated with linear regression analyses and multinomial logistic regression analyses, respectively.After adjustment for potential confounders, each extra hour of total physical activity was associated with a more favorable kidney function (betaeGFR = 2.30 (95%CI = 1.46; 3.14)), whereas each extra hour of sedentary behavior was associated with a more adverse kidney function (betaeGFR = -0.71 (-1.08; -0.35)). Also, compared to individuals with the lowest levels of total physical activity, individuals with the highest levels had less kidney damage (OR15-<30mg/24h = 0.63 (0.41; 0.96), OR?30mg/24h = 0.84 (0.53; 1.35). An extra hour of sedentary behavior was associated with more kidney damage (OR15-<30 mg/24h = 1.11 (1.01; 1.22), OR?30 mg/24h = 1.10 (0.99; 1.22)). Further, a highly sedentary pattern was associated with a more adverse kidney function, but no association was seen with kidney damage.Physical activity and sedentary behavior were associated with kidney function and kidney damage. Additionally, sedentary behavior patterns were associated with kidney function. Causal studies are required to examine whether this indeed implicates that prevention strategies should focus not only on increasing physical activity, but on reducing sedentary behavior as well.
Project description:OBJECTIVES:To estimate the prevalence and influencing factors of physical activity (PA) and sedentary behaviour (SB) in rural areas of China. DESIGN:Cross-sectional study. SETTING:A multistage, stratified cluster sampling method was used to obtain samples in the general population of Henan province in China. PARTICIPANTS:38 515 participants aged 18-79 years were enrolled from the Henan Rural Cohort Study for the cross-sectional study. MAIN OUTCOME MEASURES:The International Physical Activity Questionnaire was used to assess the levels of PA and SB. Multiple logistic regression analysis was used to calculate ORs and 95% CIs of potential influencing factors with physical inactivity. RESULTS:The age-standardised prevalence of light PA and sitting >7.5 hours per day were 32.74% and 26.88% in the general Chinese rural adults, respectively. Gender differences were: 34.91%, 29.76% for men and 31.75%, 25.16% for women, respectively. The prevalence of participants with both light PA and sitting >7.5 hours per day was 13.95%. Education at least junior middle school, divorced/widowed/unmarried, RMB1000> per capita monthly income ≥RMB500, sitting >7.5 hours per day were negatively associated with light PA. For sitting >7.5 hours per day, the negative factors were being men, divorced/widowed/unmarried, heavy smoking, Fishery products, vegetable and fruits intake . CONCLUSION:Physical inactivity and SB were high in rural China. There is an increased need to promote a healthy lifestyle to the rural population. CLINICAL TRIAL REGISTRATION:The Henan Rural Cohort Study has been registered with the Chinese Clinical Trial Register.Registration number: ChiCTR-OOC-15006699. http://www.chictr.org.cn/showproj.aspx?proj=11375.
Project description:Despite the high prevalence of chronic kidney disease (CKD), relatively few individuals with CKD progress to ESRD. A better understanding of the risk factors for progression could improve the classification system of CKD and strategies for screening. We analyzed data from 65,589 adults who participated in the Nord-Trøndelag Health (HUNT 2) Study (1995 to 1997) and found 124 patients who progressed to ESRD after 10.3 yr of follow-up. In multivariable survival analysis, estimated GFR (eGFR) and albuminuria were independently and strongly associated with progression to ESRD: Hazard ratios for eGFR 45 to 59, 30 to 44, and 15 to 29 ml/min per 1.73 m(2) were 6.7, 18.8, and 65.7, respectively (P < 0.001 for all), and for micro- and macroalbuminuria were 13.0 and 47.2 (P < 0.001 for both). Hypertension, diabetes, male gender, smoking, depression, obesity, cardiovascular disease, dyslipidemia, physical activity and education did not add predictive information. Time-dependent receiver operating characteristic analyses showed that considering both the urinary albumin/creatinine ratio and eGFR substantially improved diagnostic accuracy. Referral based on current stages 3 to 4 CKD (eGFR 15 to 59 ml/min per 1.73 m(2)) would include 4.7% of the general population and identify 69.4% of all individuals progressing to ESRD. Referral based on our classification system would include 1.4% of the general population without losing predictive power (i.e., it would detect 65.6% of all individuals progressing to ESRD). In conclusion, all levels of reduced eGFR should be complemented by quantification of urinary albumin to predict optimally progression to ESRD.