Combined Effects of Time Spent in Physical Activity, Sedentary Behaviors and Sleep on Obesity and Cardio-Metabolic Health Markers: A Novel Compositional Data Analysis Approach

Abstract

The associations between time spent in sleep, sedentary behaviors (SB) and physical activity with health are usually studied without taking into account that time is finite during the day, so time spent in each of these behaviors are codependent. Therefore, little is known about the combined effect of time spent in sleep, SB and physical activity, that together constitute a composite whole, on obesity and cardio-metabolic health markers. Cross-sectional analysis of NHANES 2005–6 cycle on N = 1937 adults, was undertaken using a compositional analysis paradigm, which accounts for this intrinsic codependence. Time spent in SB, light intensity (LIPA) and moderate to vigorous activity (MVPA) was determined from accelerometry and combined with self-reported sleep time to obtain the 24 hour time budget composition. The distribution of time spent in sleep, SB, LIPA and MVPA is significantly associated with BMI, waist circumference, triglycerides, plasma glucose, plasma insulin (all p<0.001), and systolic (p<0.001) and diastolic blood pressure (p<0.003), but not HDL or LDL. Within the composition, the strongest positive effect is found for the proportion of time spent in MVPA. Strikingly, the effects of MVPA replacing another behavior and of MVPA being displaced by another behavior are asymmetric. For example, re-allocating 10 minutes of SB to MVPA was associated with a lower waist circumference by 0.001% but if 10 minutes of MVPA is displaced by SB this was associated with a 0.84% higher waist circumference. The proportion of time spent in LIPA and SB were detrimentally associated with obesity and cardiovascular disease markers, but the association with SB was stronger. For diabetes risk markers, replacing SB with LIPA was associated with more favorable outcomes. Time spent in MVPA is an important target for intervention and preventing transfer of time from LIPA to SB might lessen the negative effects of physical inactivity.

Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth

“…An increase in LPA at the expense of MVPA may indeed have a negative impact on health outcomes, while a displacement of sedentary time to increase LPA is likely beneficial. This distinction is difficult to capture empirically, but is supported by recent compositional analyses in adults that identified that replacing sedentary time with LPA had some health benefits (Chastin et al 2015). This reinforces the assertion that some activity is better than no activity, but that "more is better" ).…”

Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update

“…For example, 6 out of 9 longitudinal studies and 8 out of 18 cross-sectional studies that examined the association between accelerometer-derived total sedentary time and body composition adjusted for physical activity. However, recent work suggests that adjusting for physical activity when examining the association between sedentary behaviour and health indicators may produce inaccurate results (Chastin et al 2015;Pedisic 2014). More specifically, adjusting for physical activity in a regression model assumes independence with sedentary behaviour.…”

“…More specifically, adjusting for physical activity in a regression model assumes independence with sedentary behaviour. However, time spent in movement behaviours, including physical activity, sedentary behaviour, and sleep are collinear and interdependent (Chastin et al 2015). Consequently, findings based on studies that adjusted for physical activity, including a number of studies that used accelerometermeasures of sedentary time, need to be interpreted with caution.…”

Refining a Church-Based Lifestyle Intervention Targeting African-American Adults at Risk for Cardiometabolic Diseases: A Pilot Study

“…Obesity has been associated with a substantial increase in risk of type 2 diabetes [3] [4] [5], and cardiovascular disease and mortality [6] [7] [8] [9]. Physical inactivity was an independent risk factor for type 2 diabetes [10] [11] [12] and for cardio-metabolic markers related to risk of cardiovascular diseases [13] [14]. The age-adjusted prevalence of hypertension and diabetes was 42% and 15% respectively among African American adults, compared to 31% and 10% among the total population from 1999-2006 [15].…”