Dataset Information

Physical Activity and Sedentary Behavior in Cardiac Rehabilitation: Does Body Mass Index Matter?

ABSTRACT:

Objective

The purpose of this study was to investigate the relationship between body mass index (BMI) class and physical activity and sedentary behavior in patients with acute coronary syndrome (ACS) during cardiac rehabilitation (CR).

Methods

This study was a secondary analysis of the OPTICARE trial. Physical activity and sedentary behavior were measured in participants with ACS (n = 359) using actigraphy at baseline, directly after completion of a multidisciplinary 12-week exercise-based CR program and 9 months thereafter. Outcome measures were step count and duration of time (percentage of wear time) spent in light physical activity, moderate-to-vigorous physical activity, and sedentary behavior. Participants were classified as normal weight (BMI = 18.5-24.99 kg/m2; n = 82), overweight (BMI = 25.0-29.99 kg/m2; n = 182), or obese (BMI ≥ 30.0 kg/m2; n = 95). Linear mixed-effects models were applied to study the relationship between BMI class and physical activity and sedentary behavior.

Results

At the start of CR, compared with participants with normal weight, participants with obesity made on average 1.11 steps fewer per minute (952 steps/d), spent 2.9% (25 min/d) less time in light physical activity, and spent 3.31% (28 min/d) more time in sedentary behavior. Participants of all BMI classes improved their physical activity and sedentary behavior levels similarly during CR, and these improvements were maintained after completion of CR.

Conclusion

Participants with ACS who had obesity started CR with a less favorable physical activity and sedentary behavior profile than that of participants with normal weight. Because all BMI classes showed similar improvement during CR, this deficit was preserved.

Impact

This study indicates that reconsideration of the CR program in the Netherlands for patients with ACS and obesity is warranted, and development of more inclusive interventions for specific populations is needed. A new program for people with obesity should include added counseling on increasing physical activity and preventing sedentary behavior to facilitate weight loss and reduce mortality risk.

Lay summary

People with ACS who have obesity are less active and sit more than individuals with normal weight, both during and after CR. This study suggests that CR needs to be changed to help individuals increase their physical activity to help them lose weight and reduce their risk of death.

SUBMITTER: den Uijl I

PROVIDER: S-EPMC8459883 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND:Physical activity, sedentary behavior, and sleep are all movement behaviors that range on a continuum from no or low movement, to high movement. Consistent associations between movement behaviors and adiposity indicators have been observed in school-age children. However, limited information exists in younger children. Since approximately 50 % of Canadian children ?5 years of age attend non-parental care, movement behaviors within and outside of the child care setting are important to consider. Therefore, this study examined the association between movement behaviors (physical activity, sedentary behavior and sleep) inside and outside of child care, with body mass index (BMI) z-scores, among a sample of toddlers and preschoolers. METHODS:Children aged 19-60 months (n?=?100) from eight participating child care centers throughout Alberta, Canada participated. Movement behaviors inside child care were accelerometer-derived (light physical activity, moderate to vigorous physical activity (MVPA), sedentary time, and time spent in sedentary bouts lasting 1-4, 5-9, 10-14 and ?15 min) and questionnaire-derived (daytime sleep). Movement behaviors outside of child care were questionnaire-derived (MVPA, screen and non-screen sedentary behavior, and nighttime sleep). Demographic information (child age, child sex, and parental education) was also questionnaire-derived. Height and weight were measured, and age- and sex-specific BMI z-scores were calculated using World Health Organization growth standards. The association between movement behaviors and BMI z-scores were examined using linear regression models. RESULTS:Hours/day of sedentary bouts lasting 1-4 min (??=-0.8, 95 % CI:-1.5,-0.1) and nighttime sleep (??=?0.2, 95 % CI: 0.1, 0.4) were associated with BMI z-scores. However, after adjusting for demographics variables, sedentary bouts lasting 1-4 min (??=-0.7; 95 % CI:-1.5, 0.0) became borderline non-significant, while nighttime sleep (??=?0.2, 95 % CI: 0.1, 0.4) remained significant. No other movement behaviors inside/outside of child care were associated with BMI z-scores. CONCLUSIONS:All children must engage in some sedentary behavior in a day, but promoting the sedentary behavior in short bouts during child care may be important for the primary prevention of overweight and obesity. Future research is needed to understand the mechanisms between sleep and adiposity in this age group and to confirm these findings in large representative samples.