ORCID Profile
0000-0001-6485-9330
Current Organisation
University of Leicester
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Publisher: Public Library of Science (PLoS)
Date: 13-04-2012
Publisher: MDPI AG
Date: 12-08-2019
Abstract: Firstly, we would like to thank the authors for taking the time to review and comment on our paper [...]
Publisher: MDPI AG
Date: 08-06-2021
Abstract: Isotemporal substitution modelling (ISM) and compositional isotemporal modelling (CISM) are statistical approaches used in epidemiology to model the associations of replacing time in one physical behaviour with time in another. This study’s aim was to use both ISM and CISM to examine and compare associations of reallocating 60 min of sitting into standing or stepping with markers of cardiometabolic health. Cross-sectional data collected during three randomised control trials (RCTs) were utilised. All participants (n = 1554) were identified as being at high risk of developing type 2 diabetes. Reallocating 60 min from sitting to standing and to stepping was associated with a lower BMI, waist circumference, and triglycerides and higher high-density lipoprotein cholesterol using both ISM and CISM (p 0.05). The direction and magnitude of significant associations were consistent across methods. No associations were observed for hemoglobin A1c, total cholesterol, or low-density lipoprotein cholesterol for either method. Results of both ISM and CISM were broadly similar, allowing for the interpretation of previous research, and should enable future research in order to make informed methodological, data-driven decisions.
Publisher: Springer Science and Business Media LLC
Date: 12-03-2019
DOI: 10.1186/S12889-019-6615-6
Abstract: Call agents spend ~ 90% of their working day seated, which may negatively impact health, productivity, and wellbeing. This study aimed to explore the acceptability and feasibility of a multi-component workplace intervention targeting increased activity and decreased prolonged sitting in the contact centre setting prior to a full-scale effectiveness trial. An 8-week non-randomised pre-post feasibility study was conducted. Using a mixed methods approach, focus groups and interviews were thematically analysed to explore the acceptability and feasibility of key study phases, and provide context to agents’ process evaluation and survey responses. The multi-component intervention, conducted in a single call centre, included height-adjustable workstations, emails, education and training sessions, and support from team leaders and a workplace ch ion. Six (of 20) team leaders were recruited, with 17 of 84 call agents ( 78% female, 39.3 ± 11.9 years) completing baseline assessments and 13 completing follow-up. High workload influenced recruitment. Call agents perceived assessments as acceptable, though strategies are needed to enhance fidelity. Education sessions, height-adjustable workstations and emails were perceived as the most effective components however, height-adjustable hot-desks were not perceived as feasible in this setting. This study has identified unique, pragmatic considerations for conducting a multi-level, multi-component PA and SB intervention and associated evaluation in highly sedentary call agents in the challenging contact centre setting. The intervention was largely perceived positively, with call agents and team leaders describing numerous perceived positive effects on behavioural, health and work-related outcomes. Findings will be of value to researchers attempting to intervene in contact centres and will be used by the current authors to design a subsequent trial.
Publisher: National Institute for Health and Care Research
Date: 02-2019
DOI: 10.3310/PHR07050
Abstract: Physical activity (PA) levels among adolescent girls in the UK are low. ‘Girls Active’, developed by the Youth Sport Trust (YST), has been designed to increase girls’ PA levels. To understand the effectiveness and cost-effectiveness of the Girls Active programme. A two-arm cluster randomised controlled trial. State secondary schools in the Midlands, UK. Girls aged between 11 and 14 years. Girls Active involves teachers reviewing PA, sport and physical education provision, culture and practices in their school attending training creating action plans and effectively working with girls as peer leaders to influence decision-making and to promote PA to their peers. Support from a hub school and the YST is offered. The change in objectively measured moderate to vigorous intensity PA (MVPA) levels at 14 months. Secondary outcomes included changes in overall PA level (mean acceleration), light PA levels, sedentary time, body composition and psychosocial outcomes. Cost-effectiveness and process evaluation (qualitative and quantitative) data were collected. Twenty schools and 1752 pupils were recruited 1211 participants provided complete primary outcome data at 14 months. No difference was found in mean MVPA level between groups at 14 months [1.7 minutes/day, 95% confidence interval (CI) –0.8 to 4.3 minutes/day], but there was a small difference in mean MVPA level at 7 months (2.4 minutes/day, 95% CI 0.1 to 4.7 minutes/day). Significant differences between groups were found at 7 months, but not at 14 months, in some of the objective secondary outcomes: overall PA level represented by average acceleration (1.39 m g , 95% CI 0.1 to 2.2 m g ), after-school sedentary time (–4.7 minutes/day, 95% CI –8.9 to –0.6 minutes/day), overall light PA level (5.7 minutes/day, 95% CI 1.0 to 10.5 minutes/day) and light PA level on school days (4.5 minutes/day, 95% CI 0.25 to 8.75 minutes/day). Minor, yet statistically significant, differences in psychosocial measures at 7 months were found in favour of control schools. Significant differences in self-esteem and identified motivation in favour of intervention schools were found at 7 and 14 months, respectively. Subgroup analyses showed a significant effect of the intervention for those schools with higher numbers of pupils at 14 months. Girls Active was well received by teachers, and they reported that implemented strategies and activities were having a positive impact in schools. Barriers to implementation progress included lack of time, competing priorities and the programme flexibility. Implementation costs ranged from £2054 (£23 upil) to £8545 (£95 upil) per school. No differences were found between groups for health-related quality-of-life scores or frequencies, or for costs associated with general practitioner, school nurse and school counsellor use. Girls Active may not have had an effect on the random 90 girls per school included in the evaluation. Although we included a erse s le of schools, the results may not be generalisable to all schools. Girls Active was viewed positively but teachers did not implement as many aspects of the programme as they wanted. The intervention was unlikely to have a wide impact and did not have an impact on MVPA level at 14 months. Capitalising on the opportunities of a flexible programme like this, while also learning from the stated barriers to and challenges of long-term implementation that teachers face, is a priority for research and practice. Current Controlled Trials ISRCTN10688342. This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research Vol. 7, No. 5. See the NIHR Journals Library website for further project information. The YST funded the intervention. This study was undertaken in collaboration with the Leicester Clinical Trials Unit, a UK Clinical Research Collaboration-registered clinical trials unit in receipt of NIHR Clinical Trials Unit support funding. Neither the YST nor the NIHR Clinical Trials Unit had any involvement in the Trial Steering Committee, data analysis, data interpretation, data collection or writing of the report. The University of Leicester authors are supported by the NIHR Leicester–Loughborough Biomedical Research Unit (2012–17), the NIHR Leicester Biomedical Research Centre (2017–22) and the Collaboration for Leadership in Applied Health Research and Care East Midlands. These funders had no involvement in the Trial Steering Committee, the data analysis, data interpretation, data collection or writing of the report.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2017
Publisher: Elsevier BV
Date: 06-2017
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2015
Publisher: BMJ
Date: 25-11-2020
DOI: 10.1136/BJSPORTS-2020-103270
Abstract: To examine the joint associations of accelerometer-measured physical activity and sedentary time with all-cause mortality. We conducted a harmonised meta-analysis including nine prospective cohort studies from four countries. 44 370 men and women were followed for 4.0 to 14.5 years during which 3451 participants died (7.8% mortality rate). Associations between different combinations of moderate-to-vigorous intensity physical activity (MVPA) and sedentary time were analysed at study level using Cox proportional hazards regression analysis and summarised using random effects meta-analysis. Across cohorts, the average time spent sedentary ranged from 8.5 hours/day to 10.5 hours/day and 8 min/day to 35 min/day for MVPA. Compared with the referent group (highest physical activity/lowest sedentary time), the risk of death increased with lower levels of MVPA and greater amounts of sedentary time. Among those in the highest third of MVPA, the risk of death was not statistically different from the referent for those in the middle (16% 95% CI 0.87% to 1.54%) and highest (40% 95% CI 0.87% to 2.26%) thirds of sedentary time. Those in the lowest third of MVPA had a greater risk of death in all combinations with sedentary time 65% (95% CI 1.25% to 2.19%), 65% (95% CI 1.24% to 2.21%) and 263% (95% CI 1.93% to 3.57%), respectively. Higher sedentary time is associated with higher mortality in less active in iduals when measured by accelerometry. About 30–40 min of MVPA per day attenuate the association between sedentary time and risk of death, which is lower than previous estimates from self-reported data.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2018
DOI: 10.1249/MSS.0000000000001588
Abstract: This study aimed to determine the cross-sectional and cumulative compliance of adolescent girls to accelerometer wear at three deployment points and to identify variables associated with compliance. Girls from 20 secondary schools were recruited: 10 schools were participating in the “Girls Active” intervention and 10 were control schools. Physical activity was measured using the GENEActiv accelerometer worn on the nondominant wrist 24 h·d −1 for up to 7 d at baseline, 7 months, and 14 months. Demographic and anthropometric characteristics were recorded. Seven valid days (≥16 h) of accelerometer wear was obtained from 83%, 77%, and 68% of girls at baseline ( n = 1734), 7 months ( n = 1381), and 14 months ( n = 1326), respectively. Sixty-eight percent provided 7 valid days for both baseline and 7 months, 59% for baseline and 14 months, and 52% for all three deployment points. Estimates of physical activity level from 3 d of measurement could be considered equivalent to a 7-d measure (i.e., they fell within a ±5% equivalence zone). Cross sectionally, 3 valid days was obtained from at least 91% of girls cumulatively, this was obtained from ≥88% of girls across any two deployment points and 84% of girls across all three deployment points. When controlling for clustering at school level and other potential predictors, physical activity level, being South Asian, being in the intervention group, and prior compliance were positively associated with monitor wear. Compliance reduced across deployment points, with the reduction increasing as the deployment points got further apart. High prior compliance and high physical activity level were associated with the most additional wear time.
Publisher: BMJ
Date: 10-10-2018
DOI: 10.1136/BMJ.K3870
Abstract: To evaluate the impact of a multicomponent intervention (Stand More AT (SMArT) Work) designed to reduce sitting time on short (three months), medium (six months), and longer term (12 months) changes in occupational, daily, and prolonged sitting, standing, and physical activity, and physical, psychological, and work related health. Cluster two arm randomised controlled trial. National Health Service trust, England. 37 office clusters (146 participants) of desk based workers: 19 clusters (77 participants) were randomised to the intervention and 18 (69 participants) to control. The intervention group received a height adjustable workstation, a brief seminar with supporting leaflet, workstation instructions with sitting and standing targets, feedback on sitting and physical activity at three time points, posters, action planning and goal setting booklet, self monitoring and prompt tool, and coaching sessions (month 1 and every three months thereafter). The control group continued with usual practice. The primary outcome was occupational sitting time (thigh worn accelerometer). Secondary outcomes were objectively measured daily sitting, prolonged sitting (≥30 minutes), and standing time, physical activity, musculoskeletal problems, self reported work related health (job performance, job satisfaction, work engagement, occupational fatigue, sickness presenteeism, and sickness absenteeism), cognitive function, and self reported psychological measures (mood and affective states, quality of life) assessed at 3, 6, and 12 months. Data were analysed using generalised estimating equation models, accounting for clustering. A significant difference between groups (in favour of the intervention group) was found in occupational sitting time at 12 months (−83.28 min/workday, 95% confidence interval −116.57 to −49.98, P=0.001). Differences between groups (in favour of the intervention group compared with control) were observed for occupational sitting time at three months (−50.62 min/workday, −78.71 to −22.54, P .001) and six months (−64.40 min/workday, −97.31 to −31.50, P .001) and daily sitting time at six months (−59.32 min/day, −88.40 to −30.25, P .001) and 12 months (−82.39 min/day, −114.54 to −50.26, P=0.001). Group differences (in favour of the intervention group compared with control) were found for prolonged sitting time, standing time, job performance, work engagement, occupational fatigue, sickness presenteeism, daily anxiety, and quality of life. No differences were seen for sickness absenteeism. SMArT Work successfully reduced sitting time over the short, medium, and longer term, and positive changes were observed in work related and psychological health. Current Controlled Trials ISRCTN10967042 .
Publisher: MDPI AG
Date: 17-10-2019
DOI: 10.3390/S19204504
Abstract: Few methods for classifying physical activity from accelerometer data have been tested using an independent dataset for cross-validation, and even fewer using multiple independent datasets. The aim of this study was to evaluate whether unsupervised machine learning was a viable approach for the development of a reusable clustering model that was generalisable to independent datasets. We used two labelled adult laboratory datasets to generate a k-means clustering model. To assess its generalised application, we applied the stored clustering model to three independent labelled datasets: two laboratory and one free-living. Based on the development labelled data, the ten clusters were collapsed into four activity categories: sedentary, standing/mixed/slow ambulatory, brisk ambulatory, and running. The percentages of each activity type contained in these categories were 89%, 83%, 78%, and 96%, respectively. In the laboratory independent datasets, the consistency of activity types within the clusters dropped, but remained above 70% for the sedentary clusters, and 85% for the running and ambulatory clusters. Acceleration features were similar within each cluster across s les. The clusters created reflected activity types known to be associated with health and were reasonably robust when applied to erse independent datasets. This suggests that an unsupervised approach is potentially useful for analysing free-living accelerometer data.
Publisher: Wiley
Date: 20-07-2017
DOI: 10.1111/DOM.13016
Abstract: To investigate the impact of performing short bouts of seated upper body activity on postprandial blood glucose and insulin levels during prolonged sitting. Participants undertook two 7.5-hour experimental conditions in randomized order: (1) prolonged sitting only and (2) sitting, interspersed with 5 minutes of seated arm ergometry every 30 minutes. Blood s les were obtained while fasting and throughout the postprandial period after ingestion of two standardized meals. The incremental area under the curve (iAUC) was calculated for glucose and insulin throughout each experimental condition. A paired s les t-test was used to assess the difference in iAUC data between conditions for glucose (primary outcome) and insulin (secondary outcome). Thirteen obese adults (7 women, 6 men mean ± standard deviation [s.d.] age: 66 ± 6 years body mass index 33.8 ± 3.8 kg/m Performing short bouts of arm ergometry during prolonged sitting attenuated postprandial glycaemia despite maintaining a seated posture. This may have clinical significance for those with weight-bearing difficulty who may struggle with postural change.
Publisher: Springer Science and Business Media LLC
Date: 2009
Publisher: Elsevier BV
Date: 06-2011
Publisher: Elsevier BV
Date: 10-2020
Publisher: BMJ
Date: 14-09-2020
Publisher: Elsevier BV
Date: 11-2021
Publisher: Springer Science and Business Media LLC
Date: 29-05-2015
Publisher: Informa UK Limited
Date: 02-10-2022
DOI: 10.1080/02640414.2022.2147134
Abstract: The Verisense Step Count Algorithm facilitates generation of steps from wrist-worn accelerometers. Based on preliminary evidence suggesting a proportional bias with overestimation at low steps/day, but underestimation at high steps/day, the algorithm parameters have been revised. We aimed to establish validity of the original and revised algorithms relative to waist-worn ActiGraph step cadence. We also assessed whether step cadence was similar across accelerometer brand and wrist. Ninety-eight participants (age: 58.6±11.1 y) undertook six walks (~500 m hard path) at different speeds (cadence: 92.9±9.5-127.9±8.7 steps/min) while wearing three accelerometers on each wrist (Axivity, GENEActiv, ActiGraph) and an ActiGraph on the waist. Of these, 24 participants also undertook one run (~1000 m). Mean bias for the original algorithm was -21 to -26.1 steps/min (95% limits of agreement (LoA) ~±65 steps/min) and mean absolute percentage error (MAPE) 17-22%. This was unevenly distributed with increasing error as speed increased. Mean bias and 95%LoA were halved with the revised algorithm parameters (~-10 to -12 steps/min, 95%LoA ~30 steps/min, MAPE ~10-12%). Performance was similar across brand and wrist. The revised step algorithm provides a more valid measure of step cadence than the original, with MAPE similar to recently reported wrist-wear summary MAPE (7-11%).
Publisher: Oxford University Press (OUP)
Date: 27-10-2022
DOI: 10.1093/EURHEARTJ/EHAC613
Abstract: The interplay between physical activity (PA) volume and intensity is poorly understood in relation to cardiovascular disease (CVD) risk. This study aimed to investigate the role of PA intensity, over and above volume, in relation to incident CVD. Data were from 88 412 UK Biobank middle-aged adults (58% women) without prevalent CVD who wore accelerometers on their dominant wrist for 7 days, from which we estimated total PA energy expenditure (PAEE) using population-specific validation. Cox proportional hazards regressions modelled associations between PAEE (kJ/kg/day) and PA intensity (%MVPA the fraction of PAEE accumulated from moderate-to-vigorous-intensity PA) with incident CVD (ischaemic heart disease or cerebrovascular disease), adjusted for potential confounders. There were 4068 CVD events during 584 568 person-years of follow-up (median 6.8 years). Higher PAEE and higher %MVPA (adjusted for PAEE) were associated with lower rates of incident CVD. In interaction analyses, CVD rates were 14% (95% confidence interval: 5–23%) lower when MVPA accounted for 20% rather than 10% of 15 kJ/kg/d PAEE equivalent to converting a 14 min stroll into a brisk 7 min walk. CVD rates did not differ significantly between values of PAEE when the %MVPA was fixed at 10%. However, the lowest CVD rates were observed for combinations of both higher PAEE and %MVPA. Reductions in CVD risk may be achievable through higher PA volume and intensity, with the role of moderately intense PA appearing particularly important. This supports multiple approaches or strategies to PA participation, some of which may be more practical or appealing to different in iduals.
Publisher: IOP Publishing
Date: 21-09-2016
DOI: 10.1088/0967-3334/37/10/1653
Abstract: The activPAL monitor, often worn 24 h d
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 22-05-2020
DOI: 10.1249/MSS.0000000000002380
Abstract: High-impact physical activity is associated with bone health, but higher volumes of lower-intensity activity may also be important. The aims of this study were to: 1) investigate the relative importance of volume and intensity of physical activity accumulated during late adolescence for bone health at age 23 yr and 2) illustrate interpretation of the results. This is a secondary analysis of data from the Iowa Bone Development Study, a longitudinal study of bone health from childhood through to young adulthood. The volume (average acceleration) and intensity distribution (intensity gradient) of activity at age 17, 19, 21, and 23 yr were calculated from raw acceleration ActiGraph data and averaged across ages. Hip areal bone mineral density (aBMD), total body bone mineral content (BMC), spine aBMD, and hip structural geometry (dual-energy X-ray absorptiometry, Hologic QDR4500A) were assessed at age 23 yr. Valid data, available for 220 participants (124 girls), were analyzed with multiple regression. To elucidate significant effects, we predicted bone outcomes when activity volume and intensity were high (+1SD), medium (mean), and low (−1SD). There were additive associations of volume and intensity with hip aBMD and total body BMC (low-intensity/low-volume cf. high-intensity/high-volume = ∆0.082 g·cm −2 and ∆169.8 g, respectively). For males only, spine aBMD intensity was associated independently of volume (low-intensity cf. high-intensity = ∆0.049 g·cm −2 ). For hip structural geometry, volume was associated independently of intensity (low-volume cf. high-volume = ∆4.8–6.6%). The activity profile associated with optimal bone outcomes was high in intensity and volume. The variation in bone health across the activity volume and intensity distribution suggests intensity is key for aBMD and BMC, whereas high volumes of lower intensity activity may be beneficial for hip structural geometry.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 28-10-2020
DOI: 10.1097/JOM.0000000000002066
Abstract: To pilot a multicomponent intervention to sit less and move more, with (SLAMM+) and without (SLAMM) height-adjustable workstations, in contact center call agents. Agents were in idually randomized to SLAMM or SLAMM+ in this 10-month, parallel, open-label, pilot trial. Mixed-methods assessed response, recruitment, retention, attrition and completion rates, adverse effects, trial feasibility and acceptability, preliminary effectiveness on worktime sitting, and described secondary outcomes. The participant recruitment rate, and randomization, data collection, and interventions were mostly acceptable. Refinements to organization recruitment were identified. High staff turnover negatively impacted retention and completion rates. The multicomponent intervention with height-adjustable workstations has potential to reduce sitting time at work. The demonstrated findings will help prepare for a future randomized controlled trial designed to assess the effect of the interventions.
Publisher: MDPI AG
Date: 17-10-2018
Abstract: Standard statistical modelling has shown that the reallocation of sitting time to either standing or stepping may be beneficial for metabolic health. However, this overlooks the inherent dependency of time spent in all behaviours. The aim is to examine the associations between physical behaviours and markers of metabolic health (fasting glucose, fasting insulin, 2-h glucose, 2-h insulin, Homeostasis Model Assessment of Insulin Sensitivity (HOMA-IS), Matsuda Insulin Sensitivity Index (Matsuda-ISI) while quantifying the associations of reallocating time from one physical behaviour to another using compositional analysis. Objectively measured physical behaviour data were analysed (n = 435) using compositional analysis and compositional isotemporal substitutions to estimate the association of reallocating time from one behaviour to another in a population at high risk of type 2 diabetes mellitus (T2DM). Stepping time was associated with all markers of metabolic health relative to all other behaviours. Reallocating 30 min from sleep, sitting, or standing to stepping was associated with 5–6 fold lower 2-h glucose, 15–17 fold lower 2-h insulin, and higher insulin sensitivity (10–11 fold via HOMA-IS, 12–15 fold via Matsuda-ISI). Associations of reallocating time from any behaviour to stepping were maintained for 2-h glucose, 2-h insulin, and Matsuda-ISI after further adjusting for body mass index (BMI). Relocating time from stepping into sleep, sitting, or standing was associated with lower insulin sensitivity. Stepping time may be the most important behavioural composition when promoting improved metabolic health in adults at risk of T2DM.
Publisher: IOP Publishing
Date: 21-09-2016
Publisher: BMJ
Date: 17-08-2022
Abstract: To evaluate the effectiveness of an intervention, with and without a height adjustable desk, on daily sitting time, and to investigate the relative effectiveness of the two interventions, and the effectiveness of both interventions on physical behaviours and physical, biochemical, psychological, and work related health and performance outcomes. Cluster three arm randomised controlled trial with follow-up at three and 12 months. Local government councils in Leicester, Liverpool, and Greater Manchester, UK. 78 clusters including 756 desk based employees in defined offices, departments, or teams from two councils in Leicester, three in Greater Manchester, and one in Liverpool. Clusters were randomised to one of three conditions: the SMART Work and Life (SWAL) intervention, the SWAL intervention with a height adjustable desk (SWAL plus desk), or control (usual practice). The primary outcome measure was daily sitting time, assessed by accelerometry, at 12 month follow-up. Secondary outcomes were accelerometer assessed sitting, prolonged sitting, standing and stepping time, and physical activity calculated over any valid day, work hours, workdays, and non-workdays, self-reported lifestyle behaviours, musculoskeletal problems, cardiometabolic health markers, work related health and performance, fatigue, and psychological measures. Mean age of participants was 44.7 years, 72.4% (n=547) were women, and 74.9% (n=566) were white. Daily sitting time at 12 months was significantly lower in the intervention groups (SWAL −22.2 min/day, 95% confidence interval −38.8 to −5.7 min/day, P=0.003 SWAL plus desk −63.7 min/day, −80.1 to −47.4 min/day, P .001) compared with the control group. The SWAL plus desk intervention was found to be more effective than SWAL at changing sitting time (−41.7 min/day, −56.3 to −27.0 min/day, P .001). Favourable differences in sitting and prolonged sitting time at three and 12 month follow-ups for both intervention groups and for standing time for the SWAL plus desk group were observed during work hours and on workdays. Both intervention groups were associated with small improvements in stress, wellbeing, and vigour, and the SWAL plus desk group was associated with improvements in pain in the lower extremity, social norms for sitting and standing at work, and support. Both SWAL and SWAL plus desk were associated with a reduction in sitting time, although the addition of a height adjustable desk was found to be threefold more effective. ISRCTN Registry ISRCTN11618007 .
Publisher: Springer Science and Business Media LLC
Date: 09-08-2019
DOI: 10.1038/S41587-019-0252-6
Abstract: An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Publisher: Wiley
Date: 03-03-2021
DOI: 10.1111/APA.15806
Abstract: To describe concurrent screen use and any relationships with lifestyle behaviours and psychosocial health. Participants wore an accelerometer for seven days to calculate physical activity sleep and sedentary time. Screen ownership and use and psychosocial variables were self‐reported. Body mass index (BMI) was measured. Relationships were explored using mixed models accounting for school clustering and confounders. In 816 adolescent females (age: 12.8 SD 0.8 years 20.4% non‐white European) use of ≥2 screens concurrently was: 59% after school, 65% in evenings, 36% in bed and 68% at weekends. Compared to no screens those using: ≥1 screens at weekends had lower physical activity ≥2 screens at the weekend or one/two screen at bed had lower weekend moderate‐to‐vigorous physical activity one screen in the evening had lower moderate‐to‐vigorous physical activity in the after‐school and evening period ≥1 screens after school had higher BMI and ≥3 screens at the weekend had higher weekend sedentary time. Compared to no screens those using: 1–3 after‐school screens had shorter weekday sleep ≥1 screens after‐school had lower time in bed. Screen use is linked to lower physical activity, higher BMI and less sleep. These results can inform screen use guidelines.
Publisher: Informa UK Limited
Date: 25-08-2020
Publisher: BMJ
Date: 11-2019
DOI: 10.1136/BMJOPEN-2018-027773
Abstract: A person’s chronotype is their entrained preference for sleep time within the 24 hours clock. It is described by the well-known concept of the ‘lark’ (early riser) and ‘owl’ (late sleeper). Evidence suggests that the ‘owl’ is metabolically disadvantaged due to the standard organisation of our society which favours the ‘lark’ and places physiological stresses on this chronotype. The aim of this study is to explore cardiometabolic health between the lark and owl in a population with an established metabolic condition - type 2 diabetes. This cross-sectional, multisite study aims to recruit 2247 participants from both secondary and primary care settings. The primary objective is to compare glycaemic control between late and early chronotypes. Secondary objectives include determining if late-chronotype is associated with poorer cardiometabolic health and other lifestyle factors, including well-being, compared with early-chronotype describing the prevalence of the five different chronotypes in this cohort and examining the trends in glycaemic control, cardiometabolic health, well-being and lifestyle factors across chronotype. The primary outcome (glycated haemoglobin (HbA1c)), linear regression analysis will compare HbA1c between early and late chronotypes, with and without adjustment for confounding variables. Chronotype will be modelled as a categorical variable with all five levels (from extreme-morning to extreme-late type), and as a continuous variable to calculate p for trend across the five categories. A number of models will be created unadjusted through to adjusted with age, sex, ethnicity, body mass index, duration of diabetes, family history of diabetes, current medication and dietary habits. All secondary outcomes will be analysed using the same method. Ethical approval from the West Midlands - Black Country Research Ethics Committee (16/WM/0457). The results will be disseminated through publication in peer-reviewed medical journal, relevant medical/health conferences and a summary report sent to patients. NCT02973412 (Pre-Results).
Publisher: Informa UK Limited
Date: 18-05-2020
Publisher: Cold Spring Harbor Laboratory
Date: 24-02-2022
DOI: 10.1101/2022.02.23.22271386
Abstract: Although the cardiovascular disease (CVD) benefits of both overall volume and intensity of physical activity (PA) are known, the role of PA intensity, over and above volume, is poorly understood. We aimed to investigate the interplay between PA volume and intensity in relation to incident CVD. Data were from 88,412 UK Biobank participants without prevalent CVD (58% women) who wore an accelerometer on their dominant wrist for 7 days, from which we estimated total physical activity energy expenditure (PAEE) using population-specific validation. Cox proportional hazards regressions modelled associations between PAEE (kJ/kg/day)] and PA intensity [%MVPA the fraction of PAEE accumulated from moderate-to-vigorous-intensity PA] with incident CVD, adjusted for potential confounders. There were 4,068 CVD events during 584,568 person-years of follow-up (median 6.8 years). Higher PAEE and higher %MVPA (adjusted for PAEE) were associated with lower rates of incident CVD. In interaction analyses, CVD rates were 17% (95%CI: 8-26%) lower when MVPA accounted for 20% rather than 10% of 15 kJ/kg/d PAEE equivalent to the difference between a 12-min stroll into a brisk 7-min walk. CVD rates did not differ significantly between values of PAEE when the %MVPA was fixed at 10%. However, the combination of higher PAEE and %MVPA was associated with lower CVD rates. Rates were 24% (10-35%) lower for 20 kJ/kg/d PAEE with 20% from MVPA, and 49% (23-66%) lower for 30 kJ/kg/d with 40% from MVPA (compared to 15 kJ/kg/d PAEE with 10% MVPA). Reductions in CVD risk may be achievable through higher levels of PA volume and intensity, with the role of moderately intense PA appearing particularly important for future CVD risk. Our findings support multiple approaches or strategies to PA participation, some of which may be more practical or appealing to different in iduals.
Publisher: Oxford University Press (OUP)
Date: 07-11-2018
Abstract: Prolonged sitting is common in older adults and is associated with insulin resistance and poor cardiometabolic health. We investigate whether breaking prolonged sitting with regular short bouts of standing or light walking improves postprandial metabolism in older white European and South Asian adults and whether effects are modified by ethnic group. Thirty South Asian (15 women) and 30 white European (14 women) older adults (aged 65–79 years) undertook three experimental conditions in random order. (a) Prolonged sitting: continuous sitting during an observation period if 7.5 hours consuming two standardized mixed meals. (b) Standing breaks: sitting interrupted with 5 minutes of standing every 30 minutes (accumulating 60 minutes of standing over the observation period). (c) Walking breaks: sitting interrupted with 5 minutes of self-paced light walking every 30 minutes (accumulating 60 minutes of walking). Blood s les (glucose, insulin, triglycerides) and blood pressure were s led regularly throughout each condition. Compared with prolonged sitting, walking breaks lowered postprandial insulin by 16.3 mU/L, (95% CI: 19.7, 22.0) with greater reductions (p = .029) seen in South Asians (22.4 mU/L 12.4, 32.4) than white Europeans (10.3 mU/L 5.9, 14.7). Glucose (0.3 mmol/L 0.1, 0.5) and blood pressure (4 mm Hg 2, 6), but not triglycerides, were lower with walking breaks, with no ethnic differences. Standing breaks did not improve any outcome. Breaking prolonged sitting with short bouts of light walking, but not standing, resulted in clinically meaningful improvements in markers of metabolic health in older adults, with South Asians gaining a greater reduction in postprandial insulin. NCT02453204
Publisher: Canadian Science Publishing
Date: 06-2021
Abstract: This study examined the effect of exercise training on sleep duration and quality and bidirectional day-to-day relationships between physical activity (PA) and sleep. Fourteen inactive men with obesity (age: 49.2 ± 7.9 years, body mass index: 34.9 ± 2.8 kg/m 2 ) completed a baseline visit, 8-week aerobic exercise intervention, and 1-month post-intervention follow-up. PA and sleep were assessed continuously throughout the study duration using wrist-worn accelerometry. Generalised estimating equations were used to examine associations between PA and sleep. Sleep duration increased from 5.2 h at baseline to 6.6 h during the intervention period and 6.5 h at 1-month post-intervention follow-up (p 0.001). Bi-directional associations showed that higher overall activity volume and moderate-to-vigorous physical activity (MVPA) were associated with earlier sleep onset time (p 0.05). Later timing of sleep onset was associated with lower overall volume of activity, most active continuous 30 min (M30 CONT ), and MVPA (p 0.05). Higher overall activity volume, M30 CONT , and MVPA predicted more wake after sleep onset (WASO) (p 0.001), whereas greater WASO was associated with higher overall volume of activity, M30 CONT , and MVPA (p 0.001). An aerobic exercise intervention increased usual sleep duration. Day-to-day, more PA predicted earlier sleep onset, but worse sleep quality and vice versa. Novelty: Greater levels of physical activity in the day were associated with an earlier sleep onset time that night, whereas a later timing of sleep onset was associated with lower physical activity the next day in men with obesity. Higher physical activity levels were associated with worse sleep quality, and vice versa.
Publisher: National Institute for Health and Care Research
Date: 09-2023
DOI: 10.3310/DNYC2141
Publisher: Springer Science and Business Media LLC
Date: 14-09-2018
Publisher: BMJ
Date: 11-2017
DOI: 10.1136/BMJOPEN-2017-019428
Abstract: Children engage in a high volume of sitting in school, particularly in the classroom. A number of strategies, such as physically active lessons (termed movement integration (MI)), have been developed to integrate physical activity into this learning environment however, no single approach is likely to meet the needs of all pupils and teachers. This protocol outlines an implementation study of a primary school-based MI intervention: CLASS PAL (Physically Active Learning) programme. This study aims to (A) determine the degree of implementation of CLASS PAL, (B) identify processes by which teachers and schools implement CLASS PAL and (C) investigate in idual (pupil and teacher) level and school-level characteristics associated with implementation of CLASS PAL. The intervention will provide teachers with a professional development workshop and a bespoke teaching resources website. The study will use a single group before-and-after design, strengthened by multiple interim measurements. Six state-funded primary schools will be recruited within Leicestershire, UK. Evaluation data will be collected prior to implementation and at four discrete time points during implementation: At measurement 0 (October 2016), school, teacher and pupil characteristics will be collected. At measurements 0 and 3 (June–July 2017), accelerometry, cognitive functioning, self-reported sitting and classroom engagement data will be collected. At measurements 1(December 2016–March 2017) and 3 , teacher interviews (also at measurement 4 September–October 2017) and pupil focus groups will be conducted, and at measurements 1 and 2 (April–May 2017), classroom observations. Implementation will be captured through website analytics and ongoing teacher completed logs. Ethical approval was obtained through the Loughborough University Human Participants Ethics Sub-Committee (Reference number: R16-P115). Findings will be disseminated via practitioner and/or research journals and to relevant regional and national stakeholders through print and online media and dissemination event(s).
Publisher: Elsevier BV
Date: 05-2021
DOI: 10.1016/J.JAD.2021.03.037
Abstract: Assessment of sitting has been challenging and nuances in the length of sitting are often missed. The present study assessed total, short and prolonged sitting time, and number of breaks from sitting, and their association with anxiety, depression, and health-related quality of life (HRQoL). Adults (M=59.1 years) in three studies (n=1,574) wore the activPAL accelerometer (thigh) to obtain a measure of sitting, and the Actigraph accelerometer (hip) for estimating moderate-to-vigorous physical activity (MVPA). Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale, and HRQoL using the EQ-5D-5L (for health state and utility scores). Generalised linear modelling tested associations. Total and prolonged sitting were associated with higher depression [total: β = 0.132 (0.010, 0.254) prolonged: β = 0.178 (0.053, 0.304)] and worse HRQoL health state scores [(total: β = -0.985 (-1.471, -0.499) prolonged: β = -0.834 (-1.301, -0.367)] and utility scores [(total: β = -0.008 (-0.012, -0.003) prolonged: β = -0.008 (-0.012, -0.004)], after controlling for covariates. MVPA was associated with better HRQoL health state and utility scores [health state: β =0.554 (0.187, 0.922) utility: β = 0.001 (0.001, 0.002)]. Total and prolonged sitting were associated with a 14% increased odds of being in the borderline/abnormal category for depression. No interactions were observed between MVPA status (active vs. inactive) and total or prolonged sitting. Anxiety was unrelated to any sitting variable. Device-based measures of both total and prolonged sitting time were associated with depression and health-related quality of life, but not anxiety.
Publisher: Elsevier BV
Date: 07-2015
DOI: 10.1016/J.YPMED.2015.04.005
Abstract: The aim of this study is to quantify associations between objectively measured sedentary time and markers of insulin sensitivity by considering allocation into light-intensity physical activity or moderate- to vigorous-intensity physical activity (MVPA). Participants with an increased risk of impaired glucose regulation (IGR) were recruited (Leicestershire, United Kingdom, 2010-2011). Sedentary, light-intensity physical activity and MVPA time were measured using accelerometers. Fasting and 2-hour post-challenge insulin and glucose were assessed insulin sensitivity was calculated by HOMA-IS and Matsuda-ISI. Isotemporal substitution regression models were used. Data were analysed in 2014. 508 participants were included (average age=65years, female=34%). Reallocating 30min of sedentary time into light-intensity physical activity was associated a 5% (95% CI 1, 9% p=0.024) difference in Matsuda-ISI after adjustment for measured confounding variables. Reallocation into MVPA was associated with a 15% (7, 25% p<0.001) difference in HOMA-IS and 18% (8, 28% p<0.001) difference in Matsuda-ISI. Results for light-intensity physical activity were modified by IGR status with stronger associations seen in those with IGR. Reallocating sedentary time into light-intensity physical activity or MVPA was associated with differences in insulin sensitivity, with stronger and more consistent associations seen for MVPA.
Publisher: Informa UK Limited
Date: 06-2013
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2018
DOI: 10.1249/MSS.0000000000001561
Abstract: Commonly used physical activity metrics tell us little about the intensity distribution across the activity profile. The purpose of this paper is to introduce a metric, the intensity gradient, which can be used in combination with average acceleration (overall activity level) to fully describe the activity profile. A total of 1669 adolescent girls (s le 1) and 295 adults with type 2 diabetes (s le 2) wore a GENEActiv accelerometer on their nondominant wrist for up to 7 d. Body mass index and percent body fat were assessed in both s les and physical function (grip strength, Short Physical Performance Battery, and sit-to-stand repetitions) in s le 2. Physical activity metrics were as follows: average acceleration (Accel AV ) the intensity gradient (Intensity GRAD from the log–log regression line: 25-m g intensity bins [ x ]/time accumulated in each bin [ y ]) total moderate-to-vigorous physical activity (MVPA) and bouted MVPA (s le 2 only). Correlations between Accel AV and Intensity GRAD ( r = 0.39–0.51) were similar to correlations between Accel AV and bouted MVPA ( r = 0.48) and substantially lower than between Accel AV and total MVPA ( r ≥ 0.93). Intensity GRAD was negatively associated with body fatness in s le 1 ( P 0.05) and positively associated with physical function in s le 2 ( P 0.05) associations were independent of Accel AV and potential covariates. By contrast, MVPA was not independently associated with body fatness or physical function. Accel AV and Intensity GRAD provide a complementary description of a person’s activity profile, each explaining unique variance, and independently associated with body fatness and/or physical function. Both metrics are appropriate for reporting as standardized measures and suitable for comparison across studies using raw acceleration accelerometers. Concurrent use will facilitate investigation of the relative importance of intensity and volume of activity for a given outcome.
Publisher: Elsevier BV
Date: 10-2019
DOI: 10.1016/J.JSAMS.2019.06.016
Abstract: Our aim is to demonstrate how a data-driven accelerometer metric, the acceleration above which a person's most active minutes are accumulated, can (a) quantify the prevalence of meeting current physical activity guidelines for global surveillance and (b) moving forward, could inform accelerometer-driven physical activity guidelines. Unlike cut-point methods, the metric is population-independent (e.g. age) and potentially comparable across datasets. Cross-sectional, secondary data analysis. Analyses were carried out on five datasets using wrist-worn accelerometers: children (N=145), adolescent girls (N=1669), office workers (N=114), pre- (N=1218) and post- (N=1316) menopausal women, and adults with type 2 diabetes (N=475). Open-source software (GGIR) was used to generate the magnitude of acceleration above which a person's most active 60, 30 and 2min are accumulated: M60 The proportion of participants with M60 These metrics can be used for global surveillance of physical activity, including assessing prevalence of meeting current physical activity guidelines. As accelerometer and corresponding health data accumulate it will be possible to interpret the metrics relative to age- and sex- specific norms and derive evidence-based physical activity guidelines directly from accelerometer data for use in future global surveillance. This is where the potential advantages of these metrics lie.
Publisher: Wiley
Date: 25-09-2020
DOI: 10.1111/DME.14393
Abstract: To quantify how differences in metrics characterizing physical activity and sedentary behaviour in type 2 diabetes are associated with physical function. This analysis included participants’ data from the Chronotype of Patients with Type 2 Diabetes and Effect on Glycaemic Control (CODEC) cross‐sectional study. Data were stratified into two groups according to their short physical performance battery (SPPB) score (impaired physical function = SPPB 10 and normal physical function = SPPB ≥ 10). Hand‐grip strength, sit‐to‐stand 60 (STS‐60) and the Duke Activity Status Index (DASI) score were used to assess functional capacity, while physical activity metrics were measured with a wrist‐worn accelerometer. The associations between physical activity metrics and measures of functional capacity were analysed using generalized linear modelling. Some 635 adults (median age 66 years, 34% female) were included in this analysis. Overall, 29% of the cohort scored 10 in the SPPB test indicating impaired physical function. This group spent more time in prolonged sedentary behaviour (600.7 vs. 572.5 min) and undertook less‐intense physical activity. Each sd increase in physical activity volume and intensity gradients for those with impaired physical function was associated with 17% more repetitions for STS‐60 with similar associations seen for DASI score. Each sd in sedentary time was associated with 15% fewer repetitions in STS‐60 and 16% lower DASI score in those with impaired physical function, whereas in normal physical function group it was 2% and 1%, respectively. The strength of the associations for physical activity measures and functional capacity were modified by physical function status, with the strongest association seen in those with impaired physical function.
Publisher: MDPI AG
Date: 13-02-2020
Abstract: This study conducted a cost and cost-benefit analysis of the Stand More AT (SMArT) Work workplace intervention, designed to reduce sitting time. The study was a cluster two-armed randomised controlled trial involving 37 office clusters (146 desk-based workers) in a National Health Service Trust. The intervention group received a height-adjustable workstation with supporting behaviour change strategies. The control group continued with usual practice. Self-report absenteeism, presenteeism and work productivity were assessed at baseline, 3, 6 and 12 months and organisational sickness absence records 12 months prior to, and 12 months of the intervention. Mean per employee costs associated with SMArT Work were calculated. Absenteeism, presenteeism and work productivity were estimated, and employer-recorded absence data and employee wage-banding were used to provide a human-capital-based estimate of costs to the organisation. The return-on-investment (ROI) and incremental cost-efficacy ratios (ICER) were calculated. Intervention cost was £692.40 per employee. Cost-benefit estimates show a net saving of £1770.32 (95%CI £-354.40, £3895.04) per employee as a result of productivity increase. There were no significant differences in absence data compared to the control group. SMArT Work provides supporting evidence for policy-makers and employers on the cost benefits of reducing sitting time at work.
Publisher: Springer Science and Business Media LLC
Date: 12-2019
DOI: 10.1186/S40798-019-0225-9
Abstract: The lack of consensus on meaningful and interpretable physical activity outcomes from accelerometer data h ers comparison across studies. Cut-point analyses are simple to apply and easy to interpret but can lead to results that are not comparable. We propose that the optimal accelerometer metrics for data analysis are not the same as the optimal metrics for translation. Ideally, analytical metrics are precise continuous variables that cover the intensity spectrum, while translational metrics facilitate meaningful, public-health messages and can be described in terms of activities (e.g. brisk walking) or intensity (e.g. moderate-to-vigorous physical activity). Two analytical metrics that capture the volume and intensity of the 24-h activity profile are average acceleration (volume) and intensity gradient (intensity distribution). These allow investigation of independent, additive and interactive associations of volume and intensity of activity with health however, they are not immediately interpretable. The MX metrics, the acceleration above which the most active X minutes are accumulated, are translational metrics that can be interpreted in terms of indicative activities. Using a range of MX metrics illustrates the intensity gradient and average acceleration (i.e. 24-h activity profile). The M120, M60, M30, M15 and M5 illustrate the most active accumulated minutes of the day, the M 1 / 3DAY the most active accumulated 8 h of the day. We demonstrate how radar plots of MX metrics can be used to interpret and translate results from between- and within-group comparisons, provide information on meeting guidelines, assess in idual activity profiles relative to percentiles and compare activity profiles between domains and/or time periods.
Publisher: Oxford University Press (OUP)
Date: 10-2012
DOI: 10.1093/IJE/DYS118
Publisher: Cold Spring Harbor Laboratory
Date: 14-12-2022
DOI: 10.1101/2022.12.13.22283391
Abstract: Sleep disturbance is common following hospitalisation both for COVID-19 and other causes. The clinical associations are poorly understood, despite it altering pathophysiology in other scenarios. We, therefore, investigated whether sleep disturbance is associated with dyspnoea along with relevant mediation pathways. Sleep parameters were assessed in a prospective cohort of patients (n=2,468) hospitalised for COVID-19 in the United Kingdom in 39 centres using both subjective and device-based measures. Results were compared to a matched UK biobank cohort and associations were evaluated using multivariable linear regression. 64% (456/714) of participants reported poor sleep quality 56% felt their sleep quality had deteriorated for at least 1-year following hospitalisation. Compared to the matched cohort, both sleep regularity (44.5 vs 59.2, p .001) and sleep efficiency (85.4% vs 88.5%, p .001) were lower whilst sleep period duration was longer (8.25h vs 7.32h, p .001). Overall sleep quality (effect estimate 4.2 (3.0–5.5)), deterioration in sleep quality following hospitalisation (effect estimate 3.2 (2.0–4.5)), and sleep regularity (effect estimate 5.9 (3.7–8.1)) were associated with both dyspnoea and impaired lung function (FEV 1 and FVC). Depending on the sleep metric, anxiety mediated 13–42% of the effect of sleep disturbance on dyspnoea and muscle weakness mediated 29-43% of this effect. Sleep disturbance is associated with dyspnoea, anxiety and muscle weakness following COVID-19 hospitalisation. It could have similar effects for other causes of hospitalisation where sleep disturbance is prevalent. UK Research and Innovation, National Institute for Health Research, and Engineering and Physical Sciences Research Council.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2018
Publisher: Wiley
Date: 23-03-2021
DOI: 10.1111/DME.14549
Abstract: Restrictions during the COVID‐19 crisis will have impacted on opportunities to be active. We aimed to (a) quantify the impact of COVID‐19 restrictions on accelerometer‐assessed physical activity and sleep in people with type 2 diabetes and (b) identify predictors of physical activity during COVID‐19 restrictions. Participants were from the UK Chronotype of Patients with type 2 diabetes and Effect on Glycaemic Control (CODEC) observational study. Participants wore an accelerometer on their wrist for 8 days before and during COVID‐19 restrictions. Accelerometer outcomes included the following: overall physical activity, moderate‐to‐vigorous physical activity (MVPA), time spent inactive, days/week with ≥30‐minute continuous MVPA and sleep. Predictors of change in physical activity taken pre‐COVID included the following: age, sex, ethnicity, body mass index (BMI), socio‐economic status and medical history. In all, 165 participants (age (mean±S.D = 64.2 ± 8.3 years, BMI=31.4 ± 5.4 kg/m 2 , 45% women) were included. During restrictions, overall physical activity was lower by 1.7 m g (~800 steps/day) and inactive time 21.9 minutes/day higher, but time in MVPA and sleep did not statistically significantly change. In contrast, the percentage of people with ≥1 day/week with ≥30‐minute continuous MVPA was higher (34% cf. 24%). Consistent predictors of lower physical activity and/or higher inactive time were higher BMI and/or being a woman. Being older and/or from ethnic minorities groups was associated with higher inactive time. Overall physical activity, but not MVPA, was lower in adults with type 2 diabetes during COVID‐19 restrictions. Women and in iduals who were heavier, older, inactive and/or from ethnic minority groups were most at risk of lower physical activity during restrictions.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2016
Publisher: American Diabetes Association
Date: 06-11-2020
DOI: 10.2337/DC20-1393
Abstract: To examine whether circulating metabolic responses to low-volume high-intensity interval exercise (LV-HIIE) or continuous moderate-intensity aerobic exercise (CME) differ between white Europeans and South Asians with nondiabetic hyperglycemia (NDH). Thirteen white Europeans and 10 South Asians (combined median [interquartile range] age 67 [60–68] years, HbA1c 5.9% [5.8–6.1%] [41.0 (39.9–43.2) mmol ⋅ mol−1]) completed three 6-h conditions (sedentary control [CON], LV-HIIE, and CME) in a randomized order. Exercise conditions contained a single bout of LV-HIIE and CME, respectively (each ending at 2 h), with meals provided at 0 and 3 h. Circulating glucose (primary outcome), insulin, insulin resistance index (IRI), triglycerides, and nonesterified fatty acids were measured at 0, 0.5, 1, 2, 3, 3.5, 4, 5, and 6 h. Data were analyzed as postexercise time-averaged area under the curve (AUC) adjusted for age, sex, and preexercise AUC. Glucose was similar in each condition and with ethnicity, with no condition-by-ethnicity interaction (P ≥ 0.28). However, insulin was lower in LV-HIIE (mean [95% CI] −44.4 [−23.7, −65.1] mU ⋅ L−1) and CME (−33.8 [−13.7, −53.9] mU ⋅ L−1) compared with CON. Insulin responses were greater in South Asians (interaction P = 0.03) such that values were similar in each ethnicity during exercise conditions, despite being 33% higher in South Asians during CON. IRI followed a similar pattern to insulin. Lipids were unaffected by exercise. Reductions in insulin and insulin resistance after acute LV-HIIE and CME are greater in South Asians than in white Europeans with NDH. Further trials are required to examine the longer-term impact of LV-HIIE and CME on cardiometabolic health.
Publisher: BMJ
Date: 07-2020
DOI: 10.1136/BMJDRC-2020-001375
Abstract: Previous investigations have suggested that evening chronotypes may be more susceptible to obesity-related metabolic alterations. However, whether device-measured physical behaviors differ by chronotype in those with type 2 diabetes (T2DM) remains unknown. This analysis reports data from the ongoing Chronotype of Patients with Type 2 Diabetes and Effect on Glycaemic Control (CODEC) observational study. Eligible participants were recruited from both primary and secondary care settings in the Midlands area, UK. Participants were asked to wear an accelerometer (GENEActiv, ActivInsights, Kimbolton, UK) on their non-dominant wrist for 7 days to quantify different physical behaviors (sleep, sedentary, light, moderate-to-vigorous physical activity (MVPA), intensity gradient, average acceleration and the acceleration above which the most active continuous 2, 10, 30 and 60 min are accumulated). Chronotype preference (morning, intermediate or evening) was assessed using the Morningness-Eveningness Questionnaire. Multiple linear regression analyses assessed whether chronotype preference was associated with physical behaviors and their timing. Evening chronotypes were considered as the reference group. 635 participants were included (age=63.8±8.4 years, 34.6% female, body mass index=30.9±5.1 kg/m 2 ). 25% (n=159) of the cohort were morning chronotypes, 52% (n=330) intermediate and 23% (n=146) evening chronotypes. Evening chronotypes had higher sedentary time (28.7 min/day, 95% CI 8.6 to 48.3) and lower MVPA levels (–9.7 min/day, –14.9 to –4.6) compared to morning chronotypes. The intensity of the most active continuous 2-60 min of the day, average acceleration and intensity gradient were lower in evening chronotypes. The timing of physical behaviors also differed across chronotypes, with evening chronotypes displaying a later sleep onset and consistently later physical activity time. People with T2DM lead a lifestyle characterized by sedentary behaviors and insufficient MVPA. This may be exacerbated in those with a preference for ‘eveningness’ (ie, go to bed late and get up late).
Publisher: Elsevier BV
Date: 2021
Publisher: Informa UK Limited
Date: 20-09-2021
DOI: 10.1080/02640414.2021.1976491
Abstract: This study aimed to a) determine whether wrist acceleration varies by accelerometer brand, wear location, and age for self-paced "slow", "normal" and "brisk" walking b) develop normative acceleration values for self-paced walking and running for adults. One-hundred-and-three adults (40-79 years) completed self-paced "slow", "normal" and "brisk" walks, while wearing three accelerometers (GENEActiv, Axivity, ActiGraph) on each wrist. A sub-s le (n = 22) completed a self-paced run. Generalized estimating equations established differences by accelerometer brand, wrist, and age-group (walking only, 40-49, 50-59, 60-69, 70-79 years) for self-paced walking and running. Brand*wrist interactions showed ActiGraph dominant wrist values were ~10% lower than GENEActiv/Axivity values for walking and running, and non-dominant ActiGraph values were ~5% lower for running only (p < 0.001). Acceleration during brisk walking was lower in those aged 70-79 (p < 0.05). Normative acceleration values (non-dominant wrist, all brands dominant wrist GENEActiv/Axivity) for slow and normal walking were 140 m
Publisher: JMIR Publications Inc.
Date: 04-05-2016
DOI: 10.2196/JMIR.5373
Publisher: Informa UK Limited
Date: 04-2022
Publisher: Elsevier BV
Date: 03-2021
Publisher: Springer Science and Business Media LLC
Date: 24-07-2019
Publisher: Springer Science and Business Media LLC
Date: 14-01-2017
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2014
Publisher: Public Library of Science (PLoS)
Date: 05-10-2016
Publisher: Springer Science and Business Media LLC
Date: 06-03-2018
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Publisher: Cold Spring Harbor Laboratory
Date: 12-04-2019
DOI: 10.1101/604694
Abstract: Accelerometer-driven physical activity guidelines are not available, likely due to the lack of consensus on meaningful and interpretable accelerometer outcomes. The aim of this paper is to demonstrate how a data-driven accelerometer metric, the acceleration above which a person’s most active minutes are accumulated, can a) quantify the prevalence of meeting current physical activity guidelines for global surveillance and b) moving forward, could inform accelerometer-driven physical activity guidelines. Unlike cut-point methods, the metric is population-independent (e.g. age) and comparable across datasets. Secondary data analyses were carried out on five datasets using wrist-worn accelerometers: children (N=145), adolescent girls (N=1669), office workers (N=114), pre- (N=1218) and post- (N=1316) menopausal women, and adults with type 2 diabetes (N=475). Open-source software (GGIR) was used to generate the magnitude of acceleration above which a person’s most active 60, 30 and 2 minutes are accumulated: M60 ACC M30 ACC and M2 ACC , respectively. The proportion of participants with M60 ACC (children) and M30 ACC (adults) values higher than accelerations indicative of brisk walking (i.e., moderate-to-vigorous physical activity) ranged from 17-68% in children and 15%-81% in adults, tending to decline with age. The proportion of pre-and post-menopausal women with M2 ACC values indicative of running and thus meeting recently presented thresholds for bone health ranged from 6-13%. These metrics can be used for global surveillance of physical activity, including assessing prevalence of meeting the current physical activity guidelines, across the lifespan. Translation of acceleration magnitudes into indicative activities provides a public health friendly interpretation of results. As accelerometer and corresponding health data accumulate it will be possible to interpret the metrics relative to age- and sex-specific norms and derive evidence-based physical activity guidelines directly from accelerometer data for use in future global surveillance. This is where the key advantages of these metrics lie.
Publisher: Cambridge University Press (CUP)
Date: 03-12-2009
DOI: 10.1017/S1368980009992217
Abstract: To examine associations between parenting styles, family structure and aspects of adolescent dietary behaviour. Cross-sectional study. Secondary schools in the East Midlands, UK. Adolescents aged 12–16 years ( n 328, 57 % boys) completed an FFQ assessing their consumption of fruit, vegetables, unhealthy snacks and breakfast. Adolescents provided information on parental and sibling status and completed a seventeen-item instrument measuring the general parenting style dimensions of involvement and strictness, from which four styles were derived: indulgent, neglectful, authoritarian, authoritative. After controlling for adolescent gender and age, analysis of covariance revealed no significant interactions between parenting style and family structure variables for any of the dietary behaviours assessed. Significant main effects for family structure were observed only for breakfast consumption, with adolescents from dual-parent families ( P 0·01) and those with no brothers ( P 0·05) eating breakfast on more days per week than those from single-parent families and those with one or more brother, respectively. Significant main effects for parenting style were observed for all dietary behaviours apart from vegetable consumption. Adolescents who described their parents as authoritative ate more fruit per day, fewer unhealthy snacks per day, and ate breakfast on more days per week than those who described their parents as neglectful. The positive associations between authoritative parenting style and adolescent dietary behaviour transcend family structure. Future research should be food-specific and assess the efficacy of strategies promoting the central attributes of an authoritative parenting style on the dietary behaviours of adolescents from a variety of family structures.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 17-07-2019
DOI: 10.1249/MSS.0000000000002047
Abstract: The physical activity profile can be described from accelerometer data using two population-independent metrics: average acceleration (ACC, volume) and intensity gradient (IG, intensity). This article aims 1) to demonstrate how these metrics can be used to investigate the relative contributions of volume and intensity of physical activity for a range of health markers across data sets and 2) to illustrate the future potential of the metrics for generation of age and sex-specific percentile norms. Secondary data analyses were conducted on five erse data sets using wrist-worn accelerometers (ActiGraph/GENEActiv/Axivity): children ( n = 145), adolescent girls ( n = 1669), office workers ( n = 114), premenopausal ( n = 1218) and postmenopausal ( n = 1316) women, and adults with type 2 diabetes ( n = 475). Open-source software (GGIR) was used to generate ACC and IG. Health markers were (a) zBMI (children), (b) %fat (adolescent girls and adults), (c) bone health (pre- and postmenopausal women), and (d) physical function (adults with type 2 diabetes). Multiple regression analyses showed that IG, but not ACC, was independently associated with zBMI/%fat in children and adolescents. In adults, associations were stronger and the effects of ACC and IG were additive. For bone health and physical function, interactions showed associations were strongest if IG was high, largely irrespective of ACC. Exemplar illustrative percentile “norms” showed the expected age-related decline in physical activity, with greater drops in IG across age than ACC. The ACC and the IG accelerometer metrics facilitate the investigation of whether volume and intensity of physical activity have independent, additive, or interactive effects on health markers. In future studies, the adoption of data-driven metrics would facilitate the generation of age- and sex-specific norms that would be beneficial to researchers.
Publisher: BMJ
Date: 04-2017
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2016
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2016
Publisher: Public Library of Science (PLoS)
Date: 12-2015
Publisher: Springer Science and Business Media LLC
Date: 25-04-2018
Publisher: BMJ
Date: 07-12-2021
DOI: 10.1136/BJSPORTS-2021-104827
Abstract: The joint associations of total and intensity-specific physical activity with obesity in relation to all-cause mortality risk are unclear. We included 34 492 adults (72% women, median age 62.1 years, 2034 deaths during follow-up) in a harmonised meta-analysis of eight population-based prospective cohort studies with mean follow-up ranging from 6.0 to 14.5 years. Standard body mass index categories were cross-classified with s le tertiles of device-measured total, light-to-vigorous and moderate-to-vigorous physical activity and sedentary time. In five cohorts with waist circumference available, high and low waist circumference was combined with tertiles of moderate-to-vigorous physical activity. There was an inverse dose–response relationship between higher levels of total and intensity-specific physical activity and mortality risk in those who were normal weight and overweight. In in iduals with obesity, the inverse dose–response relationship was only observed for total physical activity. Similarly, lower levels of sedentary time were associated with lower mortality risk in normal weight and overweight in iduals but there was no association between sedentary time and risk of mortality in those who were obese. Compared with the obese-low total physical activity reference, the HRs were 0.59 (95% CI 0.44 to 0.79) for normal weight-high total activity and 0.67 (95% CI 0.48 to 0.94) for obese-high total activity. In contrast, normal weight-low total physical activity was associated with a higher risk of mortality compared with the obese-low total physical activity reference (1.28 95% CI 0.99 to 1.67). Higher levels of physical activity were associated with lower risk of mortality irrespective of weight status. Compared with obesity-low physical activity, there was no survival benefit of being normal weight if physical activity levels were low.
Publisher: Springer Science and Business Media LLC
Date: 14-08-2012
DOI: 10.1007/S00125-012-2677-Z
Abstract: Sedentary (sitting) behaviours are ubiquitous in modern society. We conducted a systematic review and meta-analysis to examine the association of sedentary time with diabetes, cardiovascular disease and cardiovascular and all-cause mortality. Medline, Embase and the Cochrane Library databases were searched for terms related to sedentary time and health outcomes. Cross-sectional and prospective studies were included. RR/HR and 95% CIs were extracted by two independent reviewers. Data were adjusted for baseline event rate and pooled using a random-effects model. Bayesian predictive effects and intervals were calculated to indicate the variance in outcomes that would be expected if new studies were conducted in the future. Eighteen studies (16 prospective, two cross-sectional) were included, with 794,577 participants. Fifteen of these studies were moderate to high quality. The greatest sedentary time compared with the lowest was associated with a 112% increase in the RR of diabetes (RR 2.12 95% credible interval [CrI] 1.61, 2.78), a 147% increase in the RR of cardiovascular events (RR 2.47 95% CI 1.44, 4.24), a 90% increase in the risk of cardiovascular mortality (HR 1.90 95% CrI 1.36, 2.66) and a 49% increase in the risk of all-cause mortality (HR 1.49 95% CrI 1.14, 2.03). The predictive effects and intervals were only significant for diabetes. Sedentary time is associated with an increased risk of diabetes, cardiovascular disease and cardiovascular and all-cause mortality the strength of the association is most consistent for diabetes.
Publisher: PeerJ
Date: 03-12-2018
DOI: 10.7287/PEERJ.PREPRINTS.27295V2
Abstract: We present QIIME 2, an open-source microbiome data science platform accessible to users spanning the microbiome research ecosystem, from scientists and engineers to clinicians and policy makers. QIIME 2 provides new features that will drive the next generation of microbiome research. These include interactive spatial and temporal analysis and visualization tools, support for metabolomics and shotgun metagenomics analysis, and automated data provenance tracking to ensure reproducible, transparent microbiome data science.
Publisher: Springer Science and Business Media LLC
Date: 21-01-2019
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: Start date not available
End Date: End date not available
Funder: National Institute for Health Research
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