Association between leisure sedentary behaviors and hypertension risk: A prospective cohort study and two-sample Mendelian randomization analysis in Europeans.

OBJECTIVE: This study aimed to investigate the potential causal relationship between domain-specific sedentary behaviors (including television watching, computer use, and driving) and hypertension risk in European populations. METHODS: Initially, we conducted a multivariable Cox regression analysis to evaluate the associations between domain-specific sedentary behaviors and the risk of developing hypertension using data from 261,829 hypertension-free participants in the UK Biobank. To validate the findings of observational analysis, we employed two-sample univariable mendelian randomization (UVMR) analysis utilizing summary statistics from genome-wide association study conducted on European populations. We then performed multivariable mendelian randomization (MVMR) analysis to account for the influence of the risk factors for hypertension. RESULTS: In this prospective observational analysis, individuals who spent >3 h per day watching television had significantly higher risk of developing hypertension (HR = 1.24, 95% CI: 1.20-1.29, P < 0.001) compared to those who watched television for 0-1 h per day. The mendelian randomization analysis provided consistent evidence for a causal relationship between prolonged television watching time and hypertension risk (OR = 1.45, 95% CI: 1.25-1.69, P < 0.001; all PMVMR < 0.05) in both UVMR and MVMR results. No significant associations were found between computer use, driving behaviors and the risk of hypertension in either the observational or UVMR/MVMR analyses. CONCLUSIONS: These findings provide evidence for a causal effect specifically linking higher television watching time to an increased risk of hypertension and indicate the potential effectiveness of reducing television viewing time as a preventive measure to mitigate the risk of hypertension.

Neighborhood Social and Physical Environments and Sedentary Behaviors: Importance of Early Childhood in Shaping Health Behaviors.

This study aims to investigate the persistence of sedentary behaviors from early childhood to adolescence and the longitudinal association between neighborhood social and physical environments and childhood sedentary behaviors. Using the Future of Families & Child Wellbeing Study (N = 2716), we conducted a cross-lagged path analysis to examine the longitudinal association between neighborhood social and physical environments (neighborhood socioeconomic status, observed physical disorder, and crime rates) and sedentary behaviors at subsequent measurement points, after controlling for demographic factors and family socioeconomic status. We observed the continuity of sedentary behaviors in early childhood, extending throughout adolescence. Neighborhood socioeconomic status was significantly associated with sedentary behaviors at subsequent measurement points from early childhood to adolescence. Observation-based physical disorder and crime rates were associated with engagement in greater sedentary behaviors in adolescence but not in early and middle childhood. We also observed a partial mediation effect of neighborhood physical disorder and crime rates in the association between neighborhood socioeconomic status and sedentary behaviors in adolescence. Our results demonstrated the importance of early childhood in shaping healthy behaviors and highlighted the contribution of unfavorable environments to sedentary behaviors. These findings call for the need to support disadvantaged neighborhoods, particularly by addressing safety concerns and physical disorder, for promoting physical activity and reducing sedentary behaviors among adolescents.

Different sedentary behaviors, genetic susceptibility of hypertension, and new-onset hypertension: Mediating effects of body mass index and grip strength.

BACKGROUND: The association between different sedentary behaviors and hypertension risk remains unclear. We aimed to explore the relationship between different domains of sedentary behaviors and new-onset hypertension, investigate whether genetic susceptibility to hypertension modifies the relationship, and examine the extent to which the relationship is mediated by body mass index (BMI) and grip strength. METHODS: 212 714 participants without baseline hypertension in the UK Biobank were enrolled. The three major sedentary behaviors (TV-watching, nonoccupational computer use, and driving) were measured using touch screen questionnaires. The primary outcome was new-onset hypertension. RESULTS: During a median follow-up of 11.9 years, 13 983 participants developed hypertension. There was a linear positive association between TV-watching time and new-onset hypertension (p for nonlinearity =0.868). A J-shaped association was found for nonoccupational computer use time and driving time with new-onset hypertension, with an inflection point of 0.5 h/day for both (both p for nonlinearity <0.001). Polygenetic risk scores for hypertension (based on 118 related single-nucleotide polymorphisms) did not significantly modify these associations (all p-interactions >0.05). Furthermore, the detrimental effects of long-term sedentary behaviors on hypertension were mediated by BMI by 21%-30%, and the beneficial effects of limited sitting time (within 0.5 h/day) for driving and nonoccupational computer use were mediated by grip strength by 6-25%. CONCLUSIONS: There was a positive association for hands-independence sedentary behavior (TV-watching), and a J-shaped association for hands-dependence sedentary behaviors (nonoccupational computer use and driving) with new-onset hypertension, regardless of genetic risks of hypertension. These relationships were partly mediated by BMI and grip strength.

Potential causal associations between leisure sedentary behaviors, physical activity, sleep traits, and myopia: a Mendelian randomization study.

BACKGROUND: Myopia is the most prevalent refractive error and a growing global health concern that significantly affects visual function. Researchers have recently emphasized considerably on the influence of lifestyle on myopia incidence and development. This study investigates the relationship between leisure sedentary behaviors (LSB)/physical activity (PA)/sleep traits and myopia. METHODS: LSB, PA, and sleep trait-associated genetic variants were used as instrument variables in a Mendelian randomization (MR) study to examine their causal effects on myopia. Summary genome-wide association studies (GWASs) statistical data for LSB and PA were obtained from UK Biobank, and the data of sleep traits was obtained from UK Biobank, UK Biobank and 23andMe, and FinnGen. We used summary statistics data for myopia from MRC IEU. The MR analyses was performed using the inverse variance-weighted (IVW), MR-Egger, weighted median, and MR Pleiotropy RESidual Sum and Outlier methods. RESULTS: Computer use was genetically predicted to increase the myopia risk [IVW odds ratio (OR) = 1.057; 95% confidence interval (CI), 1.038-1.078; P = 7.04 × 10- 9]. The self-reported moderate-to-vigorous physical activity (MVPA) (IVW OR = 0.962; 95% CI, 0.932-0.993; P = 1.57 × 10- 2) and television watching (IVW OR = 0.973; 95% CI, 0.961-0.985, P = 1.93 × 10- 5) were significantly associated with a lower myopia risk. However, genetically predicted sleep traits or accelerometer-measured physical activity had no significant associations with myopia. CONCLUSION: Our results indicated that computer use is a risk factor for myopia, whereas television watching and MVPA may protect against myopia. These findings shed new light on possible strategies for reducing the prevalence of myopia.

Exploring the link between walking and lung cancer risk: a two-stage Mendelian randomization analysis.

BACKGROUND: Previous observational research showed a potential link between physical activities such as walking and the risk of lung cancer. However, Mendelian randomization (MR) studies suggested there was no association between moderate to vigorous physical activity and lung cancer risk. We speculated that specific physical activities may be associated with lung cancer risk. Consequently, we conducted an MR study to examine the potential relationship between walking and the risk of lung cancer. METHODS: We collected genetic summary data from UK Biobank. After excluding SNPs with F values less than 10 and those associated with confounding factors, we conducted a MR analysis to assess the causal effects between different types of walk and lung cancer. We also performed sensitivity analysis to validate the robustness of our findings. Finally, we analyzed the possible mediators. RESULTS: MR analysis showed number of days/week walked for 10 + minutes was associated with a reduced risk of lung cancer risk (OR = 0.993, 95% CI = 0.987-0.998, P = 0.009). Additionally, usual walking pace was identified as a potentially significant factor in lowering the risk (OR = 0.989, 95% CI = 0.980-0.998, P = 0.015). However, duration of walks alone did not show a significant association with lung cancer risk (OR = 0.991, 95%CI = 0.977-1.005, P = 0.216). The sensitivity analysis confirmed the robustness of these findings. And number of days/week walked for 10 + minutes could affect fed-up feelings and then lung cancer risk. There was a bidirectional relationship between usual walking pace and sedentary behaviors (time spent watching TV). CONCLUSION: The study unveiled a genetically predicted causal relationship between number of days/week walked for 10 + minutes, usual walking pace, and the risk of lung cancer. The exploration of potential mediators of walking phenotypes and their impact on lung cancer risk suggests that specific physical activities may reduce the risk of lung cancer.

Feasibility and acceptability of a cohort study baseline data collection of device-measured physical behaviors and cardiometabolic health in Saudi Arabia: expanding the Prospective Physical Activity, Sitting and Sleep consortium (ProPASS) in the Middle East.

BACKGROUND: Physical behaviors such physical activity, sedentary behavior, and sleep are associated with mortality, but there is a lack of epidemiological data and knowledge using device-measured physical behaviors. PURPOSE: To assess the feasibility of baseline data collection using the Prospective Physical Activity, Sitting, and Sleep consortium (ProPASS) protocols in the specific context of Saudi Arabia. ProPASS is a recently developed global platform for collaborative research that aims to harmonize retrospective and prospective data on device-measured behaviors and health. Using ProPASS methods for collecting data to perform such studies in Saudi Arabia will provide standardized data from underrepresented countries. METHOD: This study explored the feasibility of baseline data collection in Saudi Arabia between November and December 2022 with a target recruitment of 50 participants aged ≥ 30 years. Established ProPASS methods were used to measure anthropometrics, measure blood pressure, collect blood samples, carry out physical function test, and measure health status and context of physical behaviors using questionnaires. The ActivPal™ device was used to assess physical behaviors and the participants were asked to attend two sessions at (LHRC). The feasibility of the current study was assessed by evaluating recruitment capability, acceptability, suitability of study procedures, and resources and abilities to manage and implement the study. Exit interviews were conducted with all participants. RESULT: A total of 75 participants expressed an interest in the study, out of whom 54 initially agreed to participate. Ultimately, 48 participants were recruited in the study (recruitment rate: 64%). The study completion rate was 87.5% of the recruited participants; 95% participants were satisfied with their participation in the study and 90% reported no negative feelings related to participating in the study. One participant reported experiencing moderate skin irritation related to placement of the accelerometer. Additionally, 96% of participants expressed their willingness to participate in the study again. CONCLUSION: Based on successful methodology, data collection results, and participants' acceptability, the ProPASS protocols are feasible to administer in Saudi Arabia. These findings are promising for establishing a prospective cohort in Saudi Arabia.

The Role of the Perceived Neighborhood Social Environment on Adolescent Sedentary Behavior and Physical Activity: Findings from Add Health.

Few studies have examined the role of perceived neighborhood characteristics such as neighborhood safety, social cohesion, and contentedness on sedentary behavior (SB) and physical activity (PA) among adolescents. Furthermore, no studies have investigated how these associations are moderated by gender and race. This study aimed to examine the associations of the perceived neighborhood social environment with (SB) and moderate-to-vigorous physical activity (MVPA). Data from 6504 adolescents (aged 15.4 ± 0.03 years) who participated in the National Longitudinal Study of Adolescent Health was used. SB and PA were considered continuously and dichotomously. PNSE variables include safety, social cohesion, and contentedness, where higher values of PNSE indicate a more favorable neighborhood perception. Weighted linear and logistic regression models were used to examine the association of PNSE with continuous total SB (hours/week) and MVPA (bouts/week), and binary excessive SB (14 h/week) and meeting MVPA guidelines (≥ 5 bouts/week), respectively. Associations were stratified by gender and race to test moderation effects. Models were adjusted for demographic, health, parental, and neighborhood covariates. This study found that neighborhood safety and contentedness were negatively associated with SB, whereas neighborhood social cohesion and contentedness were positively associated with PA. Gender-specific and race-specific results remained somewhat consistent with overall findings; however, neighborhood safety was not associated with SB among female and non-White adolescents, respectively. Similarly, neighborhood safety and contentedness were not associated with MVPA for non-White adolescents. Findings suggest that an adolescent's neighborhood environment, gender, and race should be considered when implementing strategies to reduce SB and increase PA.

Effectiveness of eHealth Interventions Promoting Physical Activity in Children and Adolescents: Systematic Review and Meta-Analysis.

BACKGROUND: eHealth interventions have been postulated as a feasible, acceptable, and possibly effective tool to promote physical activity (PA) among children and adolescents; however, a comprehensive quantitative analysis of the effects of eHealth interventions promoting PA is lacking. OBJECTIVE: This study aims to conduct a systematic review and meta-analysis on experimental studies reporting the effects of eHealth interventions aimed at promoting PA on PA parameters and sedentary behavior parameters in children and adolescents. METHODS: The CENTRAL, MEDLINE, Embase, and Web of Science databases were searched from inception to February 2022 for randomized controlled trials that analyzed the effects of eHealth interventions aimed at promoting PA on PA and sedentary parameters in children and adolescents. The Hartung-Knapp-Sidik-Jonkman random effects method was used to determine the mean differences (MDs) with their respective 95% CIs. The risk of bias was assessed using the Risk of Bias 2 (RoB2; Cochrane) tool and its extension for cluster randomized controlled trials. The certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool. RESULTS: A total of 20 trials reporting the effects of different eHealth interventions aimed at promoting PA were included. Results for each parameter were as follows: counts per minute (MD -16.11 counts, 95% CI -122.76 to 90.53; k=3; n=402; I2=69%; favoring control), steps per day (MD 593.46 steps, 95% CI -2102.27 to 3289.19; k=2; n=152; I2=0%; favoring intervention [FI]), moderate to vigorous PA (MD -1.99 min/d, 95% CI -8.95 to 4.96; k=14; n=2336; I2=86%; favoring control), light PA (MD 3.28 min/d, 95% CI -15.48 to 22.04; k=5; n=355; I2=67%; FI), screen time (MD -31.48 min/d, 95% CI -68.62 to 5.65; k=5; n=904; I2=0%; FI), and sedentary time (MD -33.12 min/d, 95% CI -57.27 to -8.97; k=8; n=819; I2=75%; FI). Our results should be interpreted cautiously because of important limitations such as the scarcity of evidence, overall risk of bias, and low to very low certainty of evidence. CONCLUSIONS: We did not find conclusive evidence regarding the impact of PA-targeted eHealth interventions on PA parameters, but the very low certainty of evidence suggests that eHealth interventions may reduce sedentary time in children and adolescents. Our results may have important scientific implications as they highlight that the rapid development of eHealth interventions to promote PA lacks robust supporting evidence. TRIAL REGISTRATION: PROSPERO CRD42020211020; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=211020.

Examining the Long-term Association Between Neighborhood Socioeconomic Status and Obesity and Obesity-related Unhealthy Behaviors Among Children: Results From the Fragile Families and Child Wellbeing Study.

BACKGROUND: Literature has focused on neighborhood environments and their possible impacts on obesity and obesity-related behaviors. However, few longitudinal studies have examined the effect of neighborhood socioeconomic status (nSES) on childhood obesity. PURPOSE: Investigate the longitudinal association between nSES and obesity and obesity-related unhealthy behaviors. METHODS: We obtained data from the Fragile Families and Child Wellbeing Study (N = 2,072). The main exposure was nSES (measured using an index of five variables representing wealth, income, education, and occupation from the Decennial Census 2000) at ages 3, 5, and 9. The outcome was children's body mass index z-score (BMIz) at ages 5, 9, and 15. Three measures of obesity-related behaviors (i.e., child- or caregiver-reported soda/snack food intake, fast-food intake, and sedentary behaviors) at ages 5, 9, and 15 were included as mediators and outcomes. Cross-lagged path analyses were conducted. RESULTS: Higher nSES at a previous wave was associated with consuming less soda/snack foods (ßs = -0.15 to -0.11 [varying by ages], p < .05) and fast-food intake (ßs = -0.21 to -0.14 [varying by ages], p < .01), and less frequent sedentary behaviors (ßs = -0.14 to -0.06 [varying by ages], p < .01), but not with BMIz (ßs = -0.08 to 0.05 [varying by ages], p > .05). Unhealthy behaviors did not mediate the nSES-BMIz association at alpha .05. CONCLUSION: Health policies need to target low-socioeconomic neighborhoods to shape healthy lifestyles in children. To develop effective interventions, future research needs to examine comprehensive potential mediators like obesity-related parenting skills, home environments, and built and social environments on the risk of childhood obesity and obesity-related behaviors.

Neighborhood environments where children live and grow up have been shown to impact obesity and obesity-related behaviors. However, few longitudinal studies have examined the effect of neighborhood socioeconomic status on childhood obesity risk. We investigated the longitudinal association between neighborhood socioeconomic status and obesity and obesity-related unhealthy behaviors from early childhood to adolescence. Using data from the Fragile Families and Child Wellbeing Study, we conducted a statistical analysis to examine a mechanism by which neighborhood socioeconomic status at ages 3, 5, and 9 impacts childhood obesity and obesity-related unhealthy behaviors (i.e., soda/snack food intake, fast-food intake, and sedentary behaviors) at ages 5, 9, and 15. We observed that living in higher socioeconomic neighborhoods was associated with consuming less soda/snack foods and fast-food intake and engaging in sedentary behaviors less frequently. Neighborhood socioeconomic status was not significantly associated with childhood obesity. Our results indicate that community health policies targeting low socioeconomic neighborhoods are warranted to shape children's healthy lifestyle.

A prospective analysis of physical activity and mental health in children: the GECKO Drenthe cohort.

BACKGROUND: Mental health problems in young people have become a global health burden. The positive effects of physical activity on mental health in adults are well known but still not clear in children. The aim of this study was to investigate to what extent physical activity in early childhood would affect mental health in middle childhood. METHODS: From the Dutch GECKO Drenthe birth cohort, 850 children (51.5% boys) were enrolled in this analysis. Physical activity and sedentary time were measured at age 5-6 using ActiGraph GT3X. Mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ) at age 5-6 and age 10-11. Multiple linear regression models were used to estimate the associations between physical activity, sedentary time and SDQ subscales, stratified by gender, adjusting for age, BMI, maternal education level, family size, accelerometer wear time and season, and additionally adjusting for SDQ scores at age 5-6 to take tracking of mental health over time into account. RESULTS: Greater physical activity volume at age 5-6 was associated with lower peer problems scores at age 10-11 in boys and girls. An increase in MVPA was associated with lower peer problems scores in boys (b = -0.445, -0.713 to -0.176) and girls (b = -0.354, -0.601 to -0.107), however, increased sedentary time was linked to higher peer problems scores in boys (b = 1.18, 0.455 to 1.906) and girls (b = 0.870, 0.191 to 1.550). For hyperactivity, higher levels of physical activity volume and MVPA were associated with higher hyperactivity scores in boys. Increased sedentary time was related to lower hyperactivity scores in boys. Further adjustment for SDQ scores at age 5-6 attenuated associations between physical activity and hyperactivity in boys but hardly changed the relationships with peer problems. No significant associations between physical activity and other SDQ subscales or total difficulties scores were observed, neither in boys nor in girls. CONCLUSIONS: Children who are more physically active at age 5-6 have fewer peer problems at age 10-11, and for boys, greater activity levels at age 5-6 could be an indicator of hyperactivity at age 10-11.

Inverse association of glucosamine use and risk of new-onset kidney stones in UK adults with less sedentary time.

OBJECTIVE: To assess the association of different sedentary behaviors and glucosamine use with the risk of kidney stones and examine the modification of genetic risk of kidney stones on this association. METHODS: 473,225 participants free of kidney stones at baseline from the UK Biobank were included. Total sedentary time was calculated as the sum of the duration of TV-watching, driving, and non-occupational computer using. The primary outcome was new-onset kidney stones. RESULTS: During a median follow-up of 12.0 years, 5528 cases of kidney stones were documented. All major sedentary behaviors and total sedentary time were significantly positively related to the risk of kidney stones (All P for trend<0.05). Participants with total sedentary time ≥ 3.5 h/day had a significantly higher risk of new-onset kidney stones (vs. <3.5 h/day [tertile 1]; HR, 1.18; 95%CI,1.10-1.27). Compared with non-users, participants who regularly used glucosamine had a significantly lower risk of new-onset kidney stones in those with total sedentary time < 3.5 h/day (HR, 0.72; 95%CI,0.59-0.86), but not in those with total sedentary time ≥ 3.5 h/day (HR, 0.99; 95%CI,0.91-1.08; P-interaction = 0.001). Among participants with total sedentary time < 3.5 h/day, there was a dose-response relationship of glucosamine use with new-onset kidney stones (P for trend<0.001). Genetic risks of kidney stones did not significantly modify the association. CONCLUSIONS: TV-watching, driving and non-occupational computer using were all positively associated with the risk of new-onset kidney stones. Glucosamine use was associated with a lower risk of new-onset kidney stones in participants with total sedentary time < 3.5 h/day, following a dose-response relationship.

A time compositional analysis of the association between movement behaviors and indicators of mental health in young adults.

BACKGROUND: Movement behaviors (i.e., physical activity [PA], sedentary behaviors [SB], sleep) relate to mental health. Although movement behaviors are often analyzed as distinct entities, they are in fact highly inter-dependent (e.g., if an individual increases sleep, then PA and/or SB must be reduced) and these dependencies should be accounted for in the analysis. We tested whether perceptions of time spent in movement behaviors (i.e., moderate-to-vigorous intensity PA [MVPA], light physical activity [LPA], SB, and sleep) related to depressive symptoms and self-report mental health in young adults using a compositional analysis. We then estimated change in depressive symptoms with reallocation of time across movement behaviors using compositional time-reallocation models. METHODS: Data were drawn from the longitudinal NDIT dataset. Complete data were available for 770 young adults (Mage = 20.3, 55% females). RESULTS: The proportion of time spent in MVPA relative to other movement behaviors related to depressive symptoms non-significantly and to mental health significantly. Reallocating 15 min from MVPA to SB resulted in a significant (0.46 unit) increase in depressive symptoms, and reallocating 15 min of MVPA to LPA was associated with a (0.57) increase in depressive symptoms. CONCLUSION: These results indicate the importance of relative time spent in each movement behavior to mental health. Further research should examine these associations over time.

Work from home and the association with sedentary behaviors, leisure-time and domestic physical activity in the ELSA-Brasil study.

BACKGROUND: Work from home (WFH) can impact workers´ sedentary behaviors and levels of physical activity. The aim of this study was to estimate the association between WFH and workers´ sedentary behaviors, leisure-time and domestic physical activities during the COVID-19 pandemic and verify whether age and sex may act as effect modifiers. METHODS: We conducted a cross-sectional study of 2544 participants in the supplementary study on COVID-19 in the Longitudinal Study of Adult Health (ELSA-Brasil) from July 2020 to February 2021. We assessed screen time (≤ 8 h/day versus > 8 h/day), accumulated sitting time (≤ 8 h/day versus > 8 h/day) as sedentary behaviors on a typical day, and leisure-time (active versus inactive, according to World Health Organization recommendations) and domestic (low versus high, according to median) physical activity, using the International Physical Activity Questionnaire (IPAQ), before and during social distancing. Logistic regression models were used. RESULTS: Participants that were working from home during social distancing showed increased odds of screen time and sitting time greater than 8 h/day (OR = 3.12; 95%CI: 2.32-4.20 and OR = 2.68; 95%CI: 2.02-3.56, respectively) and higher odds of high domestic physical activity (OR = 1.29; 95%CI: 0.99-1.67) when compared to those not working from home. There was no association between WFH and leisure-time physical activity (OR = 0.99, 95%CI: 0.75,1.31). Age was an effect modifier in the association between WFH and leisure-time physical activity and domestic activity. Older people working from home showed higher odds of physical inactivity (OR = 1.84, 95%CI: 1.07,3.16) and high domestic physical activity (OR = 1.92, 95%CI: 1.12,3.27) compared to older people not working from home. CONCLUSION: WFH was associated with sedentary behavior > 8 h/day and high domestic physical activity. In the older people, WFH was associated with physical inactivity and high domestic physical activity. As sedentary behavior and physical inactivity are consistently negatively associated with health, it is important to discuss policies to manage WFH that allow pauses from physical activities and performance of hours of work within preestablished limits to reduce sedentary behavior. In addition, individuals working from home, especially the older people, should be encouraged to engage in leisure-time physical activity as a form of health promotion.

Interventions to promote healthy lifestyle behaviors in children and adolescents in summer day camps: a scoping review.

BACKGROUND: Children and adolescents have suboptimal physical activity and eating habits during summer breaks. Unlike the school setting, there is little evidence on interventions to promote healthy lifestyle behaviors in Summer Day Camps (SDCs). METHODS: The aim of this scoping review was to examine physical activity, healthy eating, and sedentary behavior interventions in the SDCs. A systematic search on four platforms (EBSCOhost, MEDLINE, EMBASE, and Web of Science) was performed in May 2021 and was updated in June 2022. Studies related to promoting healthy behaviors, physical activity, sedentary behaviors and/or healthy eating among campers aged 6 to 16 in Summer Day Camps were retained. The protocol and writing of the scoping review were done according to the guidelines of the "Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR)". RESULTS: Most interventions had a positive effect on the behavioral determinants or the behaviors themselves (i.e., physical activity, sedentary behaviors, or healthy eating). Involving counsellors and parents, setting camp goals, gardening, and education are all relevant strategies in promoting healthy lifestyle behaviors in SDCs. CONCLUSIONS: Since only one intervention directly targeted sedentary behaviors, it should strongly be considered for inclusion in future studies. In addition, more long-term and experimental studies are needed to establish cause-and-effect relationships between healthy behavior interventions in SDCs and behaviors of children and young adolescents.

Causal relationship between leisure sedentary behaviors and low back pain risk: a Mendelian randomization study.

PURPOSE: This study aims to assess the causal associations of leisure sedentary behaviors with low back pain (LBP). METHODS: A Mendelian randomization (MR) study was carried out utilizing genetic instruments to determine whether leisure sedentary behaviors (including leisure television watching, leisure computer use, and driving) are causally associated with LBP. All instrumental variables were selected from publicly available genetic summary data. The inverse variance weighted (IVW) was used as the main method to conduct univariable MR analyses. Further sensitivity analyses were utilized to test the stability of the results. Moreover, multivariable MR was performed to evaluate the independent causal relationship between leisure sedentary behaviors and LBP when body mass index (BMI), waist circumference, smoking initiation, and vigorous physical activity were taken into account. RESULTS: The MR analyses showed evidence that television watching increased the risk for LBP (OR: 1.97, 95% CI 1.45, 2.66; P = 1.19 × 10-5). Genetically determined computer use is causally associated with a decreased risk of LBP (OR: 0.53, 95% CI 0.41, 0.68; P = 4.79 × 10-7). However, no evidence was found of a causal relationship between driving and LBP (OR: 2.27, 95% CI 0.75, 6.81; P = 0.145). After adjusting for BMI, waist circumference, smoking initiation, and vigorous physical activity, only television maintained its causal effect on LBP. CONCLUSIONS: This study indicated that genetically predicted television watching was a risk factor for LBP independent of BMI, waist circumference, smoking initiation, and vigorous physical activity. This finding may be helpful for the diagnosis and management of LBP.

The Effects of Using a Cycling Desk at School on Executive Function, Physical Fitness, and Body Composition in Primary School Children: Impact of Socioeconomic Status.

CONTEXT: Physical inactivity and sedentary behaviors are associated with adverse health outcomes in both adults and children. The purpose of this study was to investigate the effects of a 9-week program using a Cycle Desk during school time in French primary school children from high or low socioeconomic status (SES) on body composition, physical fitness (PF), and executive function. METHODS: Seventy-five (n = 75) children completed a test battery before and after 9 weeks of use of Cycle Desk to evaluate anthropometric characteristics, body composition, PF, and executive function. RESULTS: Body mass index increased significantly (P = .0095), while body fat decreased after the use of Cycle Desks (P < .0001). Specifically, lean mass increased in the high-SES group while it decreased in the low-SES group (P < .0001). After 9 weeks, there was an improvement in motor skills (P < .0001), upper and lower limbs' strength (P < .0001), and executive function performance (P < .0001). More specifically, the low-SES group had a greater improvement in motor skills and maximal aerobic speed between T0 and T1, compared to the high-SES group (P = .001, P = .023, respectively). In contrast, the high-SES group had a greater improvement in executive function at 9 weeks of use of Cycle Desk compared with the low-SES group (P = .0084). CONCLUSIONS: The promotion of low-intensity physical activity with the use of a Cycle Desk at school may help offset some adverse effects of excess sedentary behavior among children. Moreover, this strategy appears to be particularly effective in children from low-SES backgrounds. What's New: The use of a Cycle Desk during school time has no deleterious effects on PF as well as cognitive executive functions in primary children. Modifications are more beneficial in children from low SES.

Association of Sitting Time With All-Cause and Cardiovascular Mortality: How Does Frailty Modify This Association?

To investigate how frailty modifies the association of sitting time with all-cause and cardiovascular mortality in Chilean adults. This prospective study included 2,604 participants aged ≥35 from the Chilean National Health Survey 2009-2010. Sitting time was self-reported, while frailty was assessed using a 36-item Frailty Index. Sitting time was categorized as low, medium, and high. Cox proportional hazard models were used to estimate the risk of mortality stratified for the sitting time categories. Over a median follow-up of 8.9 years, 311 participants died, 28% of them due to cardiovascular events. Frail people with prolonged sitting time were at higher risk of all-cause and cardiovascular mortality (hazard ratio 3.13; 95% confidence interval [2.06, 4.71] and hazard ratio 2.41; 95% confidence interval [1.50, 3.64], respectively). The observed risk was higher in women than men. Public health and individual strategies should be implemented to decrease sitting time across the population, with special attention on frail people.

The pillars of health: influence of multiple lifestyle behaviors on body mass index and depressive symptoms in adult twins.

BACKGROUND: Guidelines promoting healthy lifestyles are cornerstones of chronic disease prevention and treatment. The purpose of this study is to investigate independent and joint associations of five key health behaviors with health outcomes (body mass index (BMI kg/m2) and depressive symptoms) in adult twins. METHODS: We included 6,048 twin pairs from a community-based registry. Five key health behaviors were: (1) ≥ 8 h of sleep per night, (2) ≥ 5 servings of fruits and vegetables daily, (3) ≤ 2 h sedentary time per day, (4) ≥ 150 min of moderate-to-vigorous physical activity (MVPA) per week, and (5) no smoking. We analyzed phenotypic associations between behaviors and outcomes; whether phenotypic associations were confounded by additive genetic and shared environmental factors within twin pairs ("quasi-causal" associations); and which behaviors, considered simultaneously, had the largest associations with outcomes. RESULTS: We found negative phenotypic associations between number of behaviors achieved with BMI and depressive symptoms score (ps < 0.05). Associations remained significant, though attenuated, when controlling for genetic and shared environmental factors, and demographics, for depressive symptoms score but not BMI (p < 0.05). Quantitative variable importance measures derived from regression tree models showed sedentary time and MVPA were the most important variables in partitioning twins with different BMI, and smoking and sedentary time for partitioning twins with different depressive symptoms score. CONCLUSIONS: Achievement of commonly endorsed health behaviors is associated with lower BMI (especially sedentary and MVPA targets) and depressive symptoms score (especially sedentary and smoking targets). This provides further support of health behavior promotion to improve health outcomes.

Independent and combined influences of physical activity, screen time, and sleep quality on adiposity indicators in Indian adolescents.

BACKGROUND: Inadequate physical activity (PA), excess screen time (ST), and sub-optimal sleep quality tend to co-occur during adolescence. Yet, little is known about the associations of these behaviors as a cluster with adiposity indicators in Indian adolescents. This study aimed to evaluate the independent and combined influences of PA, ST, and sleep quality on body mass index (BMI) and waist to height ratio (WHtR) in 10-15 years old adolescents in Mumbai, India. A secondary aim was to explore if these influences vary between sexes. METHODS: Cross-sectional study. Adolescents (n = 772, mean age 13.2 (1.4) years) reported frequency and duration of moderate to vigorous PA (MVPA) and time spent using screens on a previously validated instrument. Sleep quality was estimated using the Pittsburg Sleep Quality Index (PSQI). Weight, height, and waist circumference were measured. Mixed effect logistic regression analyses were performed to explore associations between adiposity indicators (BMI z scores > +1SD and WHtR > 0.5) and unhealthy behaviors (PA < 60 min/d, ST > 120 min/d and PSQI scores > 5), stratified by sex. RESULTS: The combined prevalence of overweight and obesity was 38.3%. Overall, 62.0 and 85.0% reported MVPA< 60 min/d and ST > 120 min/d respectively. Girls reported higher ST (218.21 (69.01) min/d) as compared to boys (165.3 (101.22) min/d, p < 0.001). Clustering of low PA and excess ST was observed in 69.2% and of all three unhealthy behaviors in 18.8%. Among girls, MVPA < 60 min/d (OR = 1.78, 95% CI 1.54-1.92, p < 0.001) and PSQI scores > 5 (OR = 2.01, 95% CI 1.78-2.25, p < 0.001) predicted increased BMI. The odds of overweight/obesity were 2.10 times higher in boys reporting low PA and 4.13 times higher in those with low PA+ ST > 120 min/d. Clustering of all three unhealthy behaviors increased prevalence of obesity in both sexes. CONCLUSIONS: The results indicated a co-existence of multiple unhealthy lifestyle factors of obesity and that clustering of these behaviors can further aggravate obesity risk as compared to their independent effects. Integrated interventions that leverage the cumulative benefits of being active, less sedentary and sufficient sleep are warranted to facilitate greater improvements in obesity risk behaviors.

A cross-sectional, exploratory survey on health-relevant free-time activities and body mass index in preschool children in urban and rural settings of Austria.

BACKGROUND: The increasing prevalence of obesity is among the most relevant healthcare issues in Europe. The number of overweight people rises due to lifestyle changes, increased sitting activities, and less physical activity. Prevention in early childhood is paramount to stop this alarming trend. AIM: This study primarily aimed to evaluate the average time children (3-5 years) from rural and urban Austrian regions spent engaging in physical activity and sedentary behaviors in their free-time. Additionally, we investigated the potential correlation between duration and habits of free-time activity or place of residence and age- and sex-specific body mass index (BMI). The potential impact of socio-economic factors on BMI was examined. METHODS: Urban (Vienna) and rural (Carinthia) regions of Austria were chosen for this observational cross-sectional study. Preschool children (n=130) attending nurseries in these regions were included. Weight and height were measured and BMI calculated. Free-time activity and socio-economic data were asked using a self-administered questionnaire. Data on sedentary behavior time (sedentary activity and media consumption) and physical activity time (defined as organized or spontaneous exercise) were analyzed using non-parametric tests. RESULTS: Preschool children spent approximately as many hours of their free-time engaged in physical activity as in sedentary behaviors. Time trend in media consumption amounts to one-third of the cumulative time spent engaging in sedentary behaviors. Preschoolers from the urban area spent fewer hours practicing organized exercise and more in sedentary behaviors than peers in the rural area. In the selected areas, 7 % of preschoolers were overweight, 3.9 % were obese. BMI was not associated with free-time activities but showed a trendwise negative correlation with organized exercise. A positive correlation of age and organized exercise was observed but not with physical activity per se. CONCLUSIONS: Our results confirm the necessity of preventive interventions among Austrian preschoolers and lead to a better understanding of their free-time activities. Further investigations with larger study populations are needed to promote effective childhood obesity prevention and examine the differences regarding obesity prevalence and leisure-time activity between rural and urban areas.