ContextTime spent in sedentary behaviours (SB) is associated with poor health, irrespective of the level of physical activity. The aim of this study was to evaluate the effect of interventions which included SB as an outcome measure in adults.MethodsThirteen databases, including The Cochrane Library, MEDLINE and SPORTDiscus, trial registers and reference lists, were searched for randomised controlled trials until January 2014. Study selection, data extraction and quality assessment were performed independently. Primary outcomes included SB, proxy measures of SB and patterns of accumulation of SB. Secondary outcomes were cardiometabolic health, mental health and body composition. Intervention types were categorised as SB only, physical activity (PA) only, PA and SB or lifestyle interventions (PA/SB and diet).ResultsOf 8087 records, 51 studies met the inclusion criteria. Meta-analysis of 34/51 studies showed a reduction of 22 min/day in sedentary time in favour of the intervention group (95% CI −35 to −9 min/day, n=5868). Lifestyle interventions reduced SB by 24 min/day (95% CI −41 to −8 min/day, n=3981, moderate quality) and interventions focusing on SB only by 42 min/day (95% CI −79 to −5 min/day, n=62, low quality). There was no evidence of an effect of PA and combined PA/SB interventions on reducing sedentary time.ConclusionsThere was evidence that it is possible to intervene to reduce SB in adults. Lifestyle and SB only interventions may be promising approaches. More high quality research is needed to determine if SB interventions are sufficient to produce clinically meaningful and sustainable reductions in sedentary time.

Exercise training for ambulatory stroke patients was feasible and led to significantly greater benefits in aspects of physical function and perceived effect of physical health on daily life.

The high mortality from diet-related diseases among African Americans strongly suggests a need to adopt diets lower in total fat, saturated fat and salt and higher in fiber. However, such changes would be contrary to some traditional African American cultural practices. Focus group interviews were used to explore cultural aspects of eating patterns among low- and middle-income African Americans recruited from an urban community in Pennsylvania. In total, 21 males and 32 females, aged 13-65+ years were recruited using a networking technique. Participants identified eating practices commonly attributed to African Americans and felt that these were largely independent of socioeconomic status. They were uncertain about links between African American eating patterns and African origins but clear about influences of slavery and economic disadvantage. The perception that African American food patterns were characteristically adaptive to external conditions, suggest that, for effective dietary change in African American communities, changes in the food availability will need to precede or take place in parallel with changes recommended to individuals. Cultural attitudes about where and with whom food is eaten emerged as being equivalent in importance to attitudes about specific foods. These findings emphasize the importance of continued efforts to identify ways to increase the relevance of cultural context and meanings in dietary counseling so that health and nutrition interventions are anchored in values as perceived, in this case, by African Americans.