Isotemporal Substitution of Sedentary Behavior and Physical Activity on Function

Lerma, Nicholas L.; Cho, Chi C.; Swartz, Ann M.; Miller, Nora E.; Keenan, Kevin G.; Strath, Scott J.

doi:10.1249/mss.0000000000001491

Cited by 31 publications

(31 citation statements)

References 39 publications

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“…Reallocating 30 min/week from SB to MVPA and from LPA to MVPA had beneficial effects on subjective health in older adults, in line with previous research showing that spending 30 min/day on LPA instead of SB improved walking ability in older adults [32]. Our results increased current understanding on the role of reallocating PA in elderly South Koreans.…”

Section: Discussionsupporting

confidence: 89%

Association between Reallocation Behaviors and Subjective Health and Stress in South Korean Adults: An Isotemporal Substitution Model

Park

et al. 2020

IJERPH

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This study used an isotemporal substitution (IS) model to determine the potential reallocation effects of sedentary behavior (SB) and physical activity (PA) on subjective health and stress in South Koreans with data from the Sixth Korean National Health and Nutrition Examination Survey 2015. The analysis included 791 participants whose accelerometer-measured PA was available, divided into three age groups (young adults = 151; mid-age adults = 334; older adults = 306). We adopted SB, light PA (LPA), and moderate-to-vigorous PA (MVPA) to determine how time was allocated to each activity level, then examined the effects of reallocation on subjective health and stress across age groups. The analyses were performed in three steps: single-activity, partition, and IS model. An additional ANCOVA was conducted on statistically significant outcomes (i.e., subjective health of young and older adults). We found that among young adults, reallocating 30 min/week of SB to LPA and to MVPA was linked to high levels of subjective health. In older adults, reallocating 30 min/week of SB and LPA to MVPA was associated with high subjective health. However, this relationship was not observed in mid-age adults. None of the age groups showed a relationship between any activity reallocation and stress. Our findings provide the first insight on the development of interventions aimed at promoting active, healthier lifestyles on the basis of behavior reallocation in South Koreans.

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Section: Discussionsupporting

confidence: 89%

Association between Reallocation Behaviors and Subjective Health and Stress in South Korean Adults: An Isotemporal Substitution Model

Park

et al. 2020

IJERPH

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“…Thus, efforts that target SB as a means to increase LPA is a new behavioral leverage-point that could help us increase overall PA and induce health benefits within the population ( 45 ). A recent study using isotemporal substitution regression modeling to assess the relationship of replacing the amount of time spent in one activity for another showed that replacing 60 min/d of SB with 10 min/d of MVPA and 50 min/d of LPA was associated with significant improvements in physical function ( 49 ). However, there is little evidence to guide SB limiting strategies or LPA promotion activities for older adults ( 50 ).…”

Section: Discussionmentioning

confidence: 99%

Accelerometer-Measured Sedentary and Physical Activity Time and Their Correlates in European Older Adults: The SITLESS Study

Giné-Garriga

Sansano-Nadal

Tully

et al. 2020

The Journals of Gerontology: Series A

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Background Sedentary behavior (SB) and physical activity (PA) are important determinants of health in older adults. This study aimed to describe the composition of accelerometer-measured SB and PA in older adults, to explore self-reported context-specific SB, and to assess sociodemographic and functional correlates of engaging in higher levels of SB in participants of a multicenter study including four European countries. Method One thousand three hundred and sixty community-dwelling older adults from the SITLESS study (61.8% women; 75.3 ± 6.3 years) completed a self-reported SB questionnaire and wore an ActiGraph accelerometer for 7 days. Accelerometer-determined compositional descriptive statistics were calculated. A fixed-effects regression analysis was conducted to assess the sociodemographic (country, age, sex, civil status, education, and medications) and functional (body mass index and gait speed) correlates. Results Older adults spent 78.8% of waking time in SB, 18.6% in light-intensity PA, and 2.6% in moderate-to-vigorous PA. Accelerometry showed that women engaged in more light-intensity PA and walking and men engaged in higher amounts of moderate-to-vigorous PA. Watching television and reading accounted for 47.2% of waking time. Older age, being a man, single, taking more medications, being obese and overweight, and having a slower gait speed were statistically significant correlates of more sedentary time. Conclusions The high amount of SB of our participants justifies the need to develop and evaluate interventions to reduce sitting time. A clinically relevant change in gait speed can decrease almost 0.45 percentage points of sedentary time. The distribution of context-specific sedentary activities by country and sex showed minor differences, albeit worth noting.

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“…It should also be noted that step counts are a lightintensity activity and do not capture the full spectrum of physical activity. Therefore another possibility is that though walking regressed from 3 to 6 months, patients engaged in isotemporal substitution with other forms of activity, and so some portion of the continued increase in muscle mass and decrease in fat mass in the intervention group was from reduction in overall sedentary time rather than walking [47]. However, walking is the most common form of physical activity for most dialysis patients [48], and it is not evident that patients would switch their focus to other activities so readily.…”

Section: Discussionmentioning

confidence: 99%

Effect of a pedometer-based walking intervention on body composition in patients with ESRD: a randomized controlled trial

et al. 2020

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Background: A randomized trial of a pedometer-based intervention with weekly activity goals led to a modest increase in step count among dialysis patients. In a secondary analysis, we investigated the effect of this intervention on body composition.Methods: Sixty dialysis patients were randomized to standard care or a 6-month program consisting of 3 months of pedometers and weekly step count targets and 3 months of post-intervention follow-up. We obtained bioelectrical impedance spectroscopy (BIS) data on 54 of these patients (28 control, 26 intervention) and used linear mixedmodeling (adjusted for sex and dialysis modality) to estimate differences in change in total-body muscle mass (TBMM) adjusted for height 2 , fat mass (kg), and body mass index (BMI) (kg/m 2 ) between control and intervention groups.Results: The median age of participants was 57.5 years (53-66), and 76% were men. At baseline, there was no significant difference between groups in age, BMI, race, or body composition, but there were more men in the intervention group. After 3 months, patients in the intervention group increased their average daily steps by 2414 (95% CI 1047, 3782) more than controls (p < 0.001), but there were no significant differences in body composition. However, at 6 months, participants in the intervention had a significantly greater increase from baseline in TBMM of 0.7 kg/m 2 (95% CI 0.3, 1.13), decrease in fat mass (− 4.3 kg [95% CI -7.1, − 1.5]) and decrease in BMI (− 1.0 kg/m 2 [95% CI -1.8, − 0.2]) relative to controls. In post-hoc analysis, each increase of 1000 steps from 0 to 3 months was associated with a 0.3 kg decrease in fat mass (95% CI 0.05, 0.5) from 0 to 6 months, but there was no dose-response relationship with TBMM/ht 2 or BMI. Conclusion: A pedometer-based intervention resulted in greater decreases in fat mass with relative preservation of muscle mass, leading to a greater decrease in BMI over time compared with patients not in the intervention. These differences were driven as much by worsening in the control group as by improvement in the intervention group.Step counts had a doseresponse relationship with decrease in fat mass.Trial registration: ClinicalTrials.gov (NCT02623348). 02 December 2015.

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Isotemporal Substitution of Sedentary Behavior and Physical Activity on Function

Abstract: Replacing SB with LPA was linked to a significant improvement in the 400W, but not the other brief functional measures. Mixed doses of LPA and MVPA may add flexibility to interventions targeting reductions of SB in older adults for clinically relevant improvements in physical function.

Cited by 31 publications

References 39 publications

Association between Reallocation Behaviors and Subjective Health and Stress in South Korean Adults: An Isotemporal Substitution Model

Association between Reallocation Behaviors and Subjective Health and Stress in South Korean Adults: An Isotemporal Substitution Model

Accelerometer-Measured Sedentary and Physical Activity Time and Their Correlates in European Older Adults: The SITLESS Study

Effect of a pedometer-based walking intervention on body composition in patients with ESRD: a randomized controlled trial

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