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Sedentary Behavior and Prevalent Diabetes in 6,166 Older Women: The Objective Physical Activity and Cardiovascular Health Study.

ABSTRACT: BACKGROUND:We examined associations of sedentary time and sedentary accumulation patterns (ie, how sedentary time is accumulated) with prevalent diabetes in an ethnically diverse cohort of older women. METHODS:Community-dwelling women aged 63-99 (n = 6,116; median age = 79) wore ActiGraph GT3X+ accelerometers 24 h/day for up to 7 days from which we derived average daily sedentary time and three measures of sedentary accumulation patterns: breaks in sedentary time, usual sedentary bout duration, and alpha. Odds ratios (ORs) and 95% confidence intervals (CIs) for prevalent diabetes were estimated using multivariable logistic regression. RESULTS:Twenty-one percent (n = 1,282) of participants had diabetes. Women in the highest quartile of sedentary time (≥10.3 h/day) had higher odds of diabetes (OR = 2.18; 95% CI = 1.77-2.70) than women in the lowest quartile (≤8.3 h/day). Prolonged accumulation patterns (ie, accumulating sedentary time in longer sedentary bouts) was associated with higher odds of diabetes than regularly interrupted patterns (comparing quartiles with the most vs least prolonged patterns: usual bout duration OR = 1.57, 95% CI = 1.28-1.92; alpha OR = 1.61, 95% CI = 1.32-1.97); however, there was no significant association for breaks in sedentary time (OR = 1.00, 95% CI = 0.82-1.20). CONCLUSIONS:High levels of sedentary time and accumulating it in prolonged patterns were associated with increased odds of diabetes among older women.

SUBMITTER: Bellettiere J

PROVIDER: S-EPMC6376101 | biostudies-other | 2019 Feb

REPOSITORIES: biostudies-other

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Sedentary Behavior and Prevalent Diabetes in 6,166 Older Women: The Objective Physical Activity and Cardiovascular Health Study.

Bellettiere John J Healy Genevieve N GN LaMonte Michael J MJ Kerr Jacqueline J Evenson Kelly R KR Rillamas-Sun Eileen E Di Chongzhi C Buchner David M DM Hovell Melbourne F MF LaCroix Andrea Z AZ

The journals of gerontology. Series A, Biological sciences and medical sciences 20190201 3

<h4>Background</h4>We examined associations of sedentary time and sedentary accumulation patterns (ie, how sedentary time is accumulated) with prevalent diabetes in an ethnically diverse cohort of older women.<h4>Methods</h4>Community-dwelling women aged 63-99 (n = 6,116; median age = 79) wore ActiGraph GT3X+ accelerometers 24 h/day for up to 7 days from which we derived average daily sedentary time and three measures of sedentary accumulation patterns: breaks in sedentary time, usual sedentary ...[more]

PMID: 29726906

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Project description:BackgroundEvidence that higher sedentary time is associated with higher risk for cardiovascular disease (CVD) is based mainly on self-reported measures. Few studies have examined whether patterns of sedentary time are associated with higher risk for CVD.MethodsWomen from the Objective Physical Activity and Cardiovascular Health (OPACH) Study (n=5638, aged 63-97, mean age=79±7) with no history of myocardial infarction (MI) or stroke wore accelerometers for 4-to-7 days and were followed for up to 4.9 years for CVD events. Average daily sedentary time and mean sedentary bout duration were the exposures of interest. Cox regression models estimated hazard ratios (HR) and 95% confidence intervals (CI) for CVD using models adjusted for covariates and subsequently adjusted for potential mediators (body mass index (BMI), diabetes, hypertension, and CVD-risk biomarkers [fasting glucose, high-density lipoprotein, triglycerides, and systolic blood pressure]). Restricted cubic spline regression characterized dose-response relationships.ResultsThere were 545 CVD events during 19,350 person-years. Adjusting for covariates, women in the highest (≥ ~11 hr/day) vs. the lowest (≤ ~9 hr/day) quartile of sedentary time had higher risk for CVD (HR=1.62; CI=1.21-2.17; p-trend <0.001). Further adjustment for potential mediators attenuated but did not eliminate significance of these associations (p-trend<.05, each). Longer vs. shorter mean bout duration was associated with higher risks for CVD (HR=1.54; CI=1.27-2.02; p-trend=0.003) after adjustment for covariates. Additional adjustment for CVD-risk biomarkers attenuated associations resulting in a quartile 4 vs. quartile 1 HR=1.36; CI=1.01-1.83; p-trend=0.10). Dose-response associations of sedentary time and bout duration with CVD were linear (P-nonlinear >0.05, each). Women jointly classified as having high sedentary time and long bout durations had significantly higher risk for CVD (HR=1.34; CI=1.08-1.65) than women with both low sedentary time and short bout duration. All analyses were repeated for incident coronary heart disease (MI or CVD death) and associations were similar with notably stronger hazard ratios.ConclusionsBoth high sedentary time and long mean bout durations were associated in a dose-response manner with increased CVD risk in older women, suggesting that efforts to reduce CVD burden may benefit from addressing either or both component(s) of sedentary behavior.

Project description:Limited evidence exists to inform physical activity (PA) and sedentary behavior guidelines for older people, especially women. Rigorous evidence on the amounts, intensities, and movement patterns associated with better health in later life is needed.The Objective PA and Cardiovascular Health (OPACH) Study is an ancillary study to the Women's Health Initiative (WHI) Program that examines associations of accelerometer-assessed PA and sedentary behavior with cardiovascular and fall events. Between 2012 and 2014, 7048 women aged 63-99 were provided with an ActiGraph GT3X+ (Pensacola, Florida) triaxial accelerometer, a sleep log, and an OPACH PA Questionnaire; 6489 have accelerometer data. Most women were in their 70s (40%) or 80s (46%), while approximately 10% were in their 60s and 4% were age 90 years or older. Non-Hispanic Black or Hispanic/Latina women comprise half of the cohort. Follow-up includes 1-year of falls surveillance with monthly calendars and telephone interviews of fallers, and annual follow-up for outcomes with adjudication of incident cardiovascular disease (CVD) events through 2020. Over 63,600 months of calendar pages were returned by 5,776 women, who reported 5,980 falls. Telephone interviews were completed for 1,492 women to ascertain the circumstances, injuries and medical care associated with falling. The dataset contains extensive information on phenotypes related to healthy aging, including inflammatory and CVD biomarkers, breast and colon cancer, hip and other fractures, diabetes, and physical disability.This paper describes the study design, methods, and baseline data for a diverse cohort of postmenopausal women who wore accelerometers under free-living conditions as part of the OPACH Study. By using accelerometers to collect more precise and complete data on PA and sedentary behavior in a large cohort of older women, this study will contribute crucial new evidence about how much, how vigorous, and what patterns of PA are necessary to maintain optimal cardiovascular health and to avoid falls in later life.ClinicalTrials.gov identifier NCT00000611 . Registered 27 October 1999.

Project description:INTRODUCTION:The purpose of this study was to examine the association between sedentary behavior (SB), cardiometabolic risk factors, and self-reported physical function by level of moderate-vigorous physical activity (MVPA). METHODS:Cross-sectional analysis was completed on 1914 older adults age ? 65 yr from the 2003-2006 U.S. National Health and Nutrition Examination Survey. MVPA and SB were derived from ActiGraph accelerometers worn for 1 wk. MVPA was categorized as sufficient to meet the current U.S. guidelines (? 150 min · wk(-1)) or not; SB was split into quartiles. Various biomarkers were examined in laboratory analyses and physical exams, and the number of functional limitations was self-reported. Statistical interaction between SB and MVPA on the biomarker associations was the primary analysis, followed by an examination of their independent associations with relevant covariate adjustment. RESULTS:Average SB was 9.4 ± 2.3 h · d(-1) (mean ± SD), and approximately 35% were classified as sufficiently active. Overall, no significant meaningful statistical interactions were found between SB and MVPA for any of the outcomes; however, strong independent positive associations were found between SB and weight (P < 0.01), body mass index (P < 0.01), waist circumference (P < 0.01), C-reactive protein (P < 0.01), plasma glucose (P = 0.04), and number of functional limitations (P < 0.01) after adjustment for MVPA. Similarly, MVPA was negatively associated with weight (P = 0.01), body mass index (P < 0.01), waist circumference (P < 0.01), diastolic blood pressure (P = 0.04), C-reactive protein (P < 0.01), and number of functional limitations (P < 0.01) after adjustment for SB. CONCLUSIONS:The results suggest that sufficient MVPA did not ameliorate the negative associations between SB and cardiometabolic risk factors or functional limitations in the current sample and that there was independence on a multiplicative scale in their associations with the outcomes examined. Thus, older adults may benefit from the joint prescription to accumulate adequate MVPA and avoid prolonged sitting.

Project description:Background:Dialysis patients have reduced moderate to vigorous physical activity, and light physical activity. This has been shown in self-reported surveys and objective accelerometer studies. Less attention has been directed toward sedentary behavior, which is characterized by low energy expenditure (?1.5 metabolic equivalents). Furthermore, locations where physical activity and sedentary behavior occur are largely unknown for dialysis patients. Objectives:The objectives of this study were (1) to determine the minutes per day of moderate to vigorous physical activity, light physical activity, and sedentary behavior for hemodialysis patients; (2) to describe differences in moderate to vigorous physical activity, light physical activity, and sedentary behavior comparing dialysis versus nondialysis days; and (3) to describe the locations where moderate to vigorous physical activity, light physical activity, and sedentary behavior occur using global positioning system (GPS) data. Design:Cross-sectional study. Setting:The study was performed at a tertiary care hospital in Nova Scotia, Canada. Patients:A total of 50 adult in-center hemodialysis patients consented to the study. Measurements:Physical activity and sedentary behavior were measured with an Actigraph-GT3X accelerometer. Location was determined using a Qstarz BT-Q1000X GPS receiver. Methods:Minutes of daily activity were described as was percentage of wear time for each activity level across different locations during waking hours. Physical activity intensity, quantity, and location were also analyzed according to dialysis vs nondialysis days. Results:Forty-three patients met requirements for accelerometer analysis, of whom 42 had GPS data. Median wear time was 836.5 min/day (interquartile range [IQR]: 788.3-918.3). Median minutes of daily wear time spent in sedentary behavior, light physical activity, and moderate to vigorous physical activity was 636 minutes (IQR: 594.1-730.1), 178 minutes (IQR: 144-222.1), and 1.6 minutes (IQR: 0.6-7.7), respectively. Proportion of daily wear time spent in sedentary behavior, light physical activity, and moderate to vigorous physical activity was 78.4% (IQR: 70.7-84.0), 21.5% (IQR: 16.0-26.9), and 0.2% (IQR: 0.1-1.1), respectively. Home was the dominant location for total linked accelerometer-GPS time (59.4%, IQR: 46.9-69.5) as well as for each prespecified level of activity. Significantly more sedentary behavior and less light physical activity occurred on dialysis days compared with nondialysis days (P ? .01, respectively). Moderate to vigorous physical activity did not differ significantly between dialysis and nondialysis days. Limitations:Small sample size from a single academic center may limit generalizability. Difficult to engage population as less than half of eligible dialysis patients provided consent. Physical activity may have been underestimated as devices were not worn for all waking hours or aquatic activities, and hip-based accelerometers may not capture stationary exercise. Conclusions:Ambulatory, in-center hemodialysis patients exhibit substantial sedentary behavior and minimal physical activity across a limited range of locations. Given the sedentary tendencies of this population, focus should be directed on increasing physical activity at any location frequented. Home-based exercise programs may serve as a potential adjunct to established intradialytic-based therapies given the amount of time spent in the home environment.

Dataset Information

Sedentary Behavior and Prevalent Diabetes in 6,166 Older Women: The Objective Physical Activity and Cardiovascular Health Study.

Publications

Sedentary Behavior and Prevalent Diabetes in 6,166 Older Women: The Objective Physical Activity and Cardiovascular Health Study.

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