The primary purpose of this study was to evaluate the variability of sedentary behavior (SB) throughout a 7-day measurement period and to compare SB between weekdays and weekend days. Second, this study aimed to determine the minimum number of days of SB measurement that is comparable to 7-days of measurement. Secondary to the primary purpose, this study aimed to determine the role demographic variables play in the variability of SB. METHODS: Accelerometry data was previously collected in the Clinical Exercise Physiology Program at Ball State University from 708 participants (260 males, aged 57±13 years, BMI = 30±6 kg/m2; 448 females, aged 52±12 years, BMI of 29±8 kg/m2) who wore an accelerometer at least 4 days. To determine if differences exist between individual days, SB data (<100 cpm) from 293 participants (99 males, 194 females) with 7-consecutive days of accelerometry data, were compared using a two-way repeated measures ANOVA. The larger 4-day cohort was used to compare SB on weekdays and weekend days using a univariate ANOVA. To determine the minimum number of SB measurement days compared to the typical 7-day period, a stepwise regression was performed with the 7-day sub-cohort. RESULTS: No differences in SB were found between individual days (p>0.05) when using the 7-day cohort. However, when using the 4-day cohort, weekdays were found to be more sedentary than weekend days (p<0.05). Using the 7-day cohort, 2 weekdays and 2 weekend days of SB measurement were found to be comparable to 7 days of measurement (R2 of 0.91). CONCLUSION: No differences in SB were found between individual days of the week, however more time, on average, was spent in weekdays (66%) compared to weekend days (64%). 4 days of SB measurement were found to be comparable to 7, meaning the typical 7-day measurement period may not be necessary. / School of Physical Education, Sport, and Exercise Science

A dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Science in Medicine Johannesburg, 2018. / There has been an increase in the percentage of individuals employed in sedentary occupations over the last 50 years. Prolonged sedentary time has been associated with poorer cardiometabolic health. Interrupting prolonged sedentary activity may attenuate the risk of developing cardiometabolic disease. This study aimed to determine whether prompts delivered via a mobile phone were effective in reducing sedentary behaviour (measured objectively using an Actigraph and activPAL accelerometer) in people with sedentary occupations. Twenty men and women were randomly assigned to either a control or intervention (PROMPT) group. Only participants in the PROMPT group were instructed to interrupt their sedentary behaviour. During the intervention participants in the PROMPT group spent less time in sedentary behaviour (5.5±0.5 hrs/day) during their working day, compared to the control group (6.7±0.6 hrs/day) as measured using the activPAL (p=0.04). There was no association between the intervention and cardiometabolic health variables. There were differences in the outputs of ActiGraph and activPAL accelerometers. Interrupting prolonged sedentary time via mobile phone messages may be an effective strategy in reducing total sedentary time in the workplace. / LG2018

Background: Adults with Intellectual Disability (ID) experience health disparities that may be attributable to high sedentary behavior (SB). The levels and patterns of SB among U.S. adults with ID have received little attention. Purpose: To examine levels and patterns of SB in adults with ID. Method: The sample included 52 adults with ID who wore an accelerometer on the hip for 7 days. We determined total sedentary time, percent of wear time spent sedentary, number and duration of sedentary bouts, and breaks in sedentary time. We used t-tests and 2×2 ANOVA to evaluate the effects of sex or age-group and day of the week. Result: Adults with ID spent about 8-8.5 hours per day in SB and they primarily accumulated sedentary time in bouts 1-30 min in duration. Conclusion: Apart from small differences in SB, people with ID appear to have near uniform SB levels and patterns throughout the week.

Master of Public Health / Department of Kinesiology / Mary A. McElroy / BACKGROUND: Rural Americans face significant barriers for meeting recommended physical activity guidelines (Trivedi et al., 2015). Although studies have demonstrated adults in rural communities participate in less physical activity than their urban counterparts (Martin et al., 2005; Reis et al., 2004), the differences in physical activity for children and adolescents are not so clear. The main goal of this study was to explore potential differences among school physical activity (SPA), outside of school time physical activity (OSTPA), and sedentary behavior (SB), among rural and non-rural fourth and fifth-grade students. It was hypothesized that rural schools participate in less physical activity and more sedentary behavior than non-rural schools. Additionally, factors such as student gender and school socio-economic status were considered. METHOD: Data from the Youth Activity Profile (YAP), collected as part of the NFL PLAY60 FITNESSGRAM Partnership, is utilized to assess physical activity. The YAP captures the three constructs of SPA, OSTPA, and SB with fifteen questions (five questions each). A two-level mixed-model using SAS Proc Mixed was used to test for significant differences among groups. RESULTS: An analysis of least square means resulted in the following. Rural schools of fifth-grade students reported significantly more minutes in SPA (MD=8.68, 95% CI=-17.38, 0.01) than non-rural schools of fifth-grade students. Fourth-grade girls reported significantly fewer minutes in SPA (MD=11.1, 95% CI=9.09, 13.11), OSTPA (MD=19.55, 95% CI=17.54, 21.57), and more minutes in SB (MD=16.82, 95% CI=-22.85, -10.80) than fourth-grade boys. Fifth-grade girls reported significantly fewer minutes in SPA (MD=8.41, 95% CI=7.15, 9.67), OSTPA (MD=18.99, 95% CI=17.28, 20.70), and significantly more minutes in SB (MD=21.66, 95% CI=-26.92, -16.40) than fifth grade boys. High SES schools of fourth-grade students reported significantly fewer minutes in SB (MD=7.18, 95% CI=-14.42, 0.04) compared to low SES schools of fourth-grade students. CONCLUSION: There were no significant differences among rural and non-rural schools of fourth and fifth-grade students with respect to outside of school time physical activity and sedentary behavior. Rural schools of fifth-grade students reported more minutes in school physical activity. Gender differences were observed as girls reported significantly lower school physical activity, out of school physical activity, and significantly higher sedentary behavior than boys. Future studies need to more closely examine definitions of rural and non-rural environments, the physical activity domains under question, as well as, to examine of socioeconomic status.

A dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfilment of the requirements for the degree of Master of Science in Medicine, Johannesburg, 2017 / Objective: Physical activity (PA) is recommended in the management of osteoarthritis (OA) to reduce pain and improve function. Total volumes of PA and sedentary behaviour (SB) have been described in people with knee OA, but detailed information about the patterns of accumulation of PA and SB in knee OA populations is lacking. The purpose of this study was to objectively assess the patterns of accumulation of PA and SB and to explore associations with subjectively measured functional outcomes and quality of life in patients with knee OA. Methods: End-stage knee OA patients (n = 87, 65 ± 8.8 (mean ± SD) years, body mass index 34.4 ± 7.8 kg/m2) with Kellgren-Lawrence-defined grade 3-4 radiographic OA, wore an Actigraph and an activPAL accelerometer for 24 hours a day for 7 consecutive days. Total volumes of SB, light physical activity (LPA), moderate to vigorous physical activity (MVPA), and different bouts of SB, LPA, and MVPA were assessed. Self-report questionnaires were used to assess patient-experienced pain, function, quality of life and activities of daily living were the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and the Knee Injury Osteoarthritis Outcome Score (KOOS). Results: Of the 87 knee OA patients only 76 and 65 had complete Actigraph and activPAL data respectively. The participants had a mean (SD) age of 65.0 (8.8) years, were mostly women and most were classified as being obese with an average BMI of 34.4 (7.8) kg/m2. The Actigraph mean (95% CI) of awake wear time was 15.6 (15.1-16) hours/day, SB 10.9 (10.5-11.4) hours/day, LPA 4.5 (4.1-5) hours/day and MVPA 8.2 (3.3-13) min/day. Approximately 7% of patients met the current recommended PA guidelines. The activPAL mean (95% CI) of sitting time, standing time, stepping time and number of steps were 9.3 (8.5 – 10.1) hours per day, 5.0 (4.4 – 5.6) hour per day, 76.5 (66.6 – 86.3) minutes per day and 2489 (2130 – 2848) minutes per day respectively. There were variations in the hourly patterns of movement behaviours. Participants were significantly less sedentary between 6 am and 9 am compared to the grand mean of sedentary time per hour over the day (p<0.01) and were significantly more sedentary per hour from 3 pm to 7 pm (p<0.05). Significant correlations were found between WOMAC pain scores and Actigraph measured SB (r=0.277, p=0.031), LPA (r=-0.240, p=0.043), MVPA (r=-0.242. p=0.042), number of steps (r=-0.282, p=0.020), number of breaks in bouts of SB greater than 20 minutes (r=-0.292, x p=0.016), average duration of breaks in SB (r=-0.277, p=0.024), average duration of MVPA bouts (r=-0.326, p=0.012). Significant correlations were also found between WOMAC activity of daily living scores and Actigraph measured LPA (r=-0.206, p=0.048), MVPA (r=-0.246, p=0.029), number of steps (r=-0.286, p=0.010) and average duration of MVPA bouts (r=-0.383, p=0.002). Significant correlations were found between WOMAC pain scores and activPAL sitting time (r=0.029, p=0.02), and stepping time (r=-0.029, p=0.01), between self-reported WOMAC activity of daily living score and stepping time (r=-0.309, p=0.02), between KOOS activity of daily living score and stepping time (r=-0.276, p=0.004), and between KOOS quality of life score and stepping time (r=-0.263, p=0.008). Conclusion: This study describes novel detail of the patterns of activity and sedentary behaviour in patients with knee OA. The use of two accelerometers gives a detailed account of daily activity and the variation throughout the day, highlighting when interventions to improve activity might be most effective. Therefore, interventions should target the long bouts of inactivity in this population. Since even healthy populations of older adults struggle to meet current recommended PA guidelines, it may be important to shift attention from meeting recommendations of MVPA to creating feasible suggestions of doing more light activity and breaking more sedentary time in knee OA patients. / XL2018

No description available.

The purpose of this dissertation series was to describe sedentary behavior and its associations with cardiovascular disease (CVD) biomarkers and outcomes, and to explore the potential that reducing sedentary behavior may be a secondary prevention target for Acute Coronary Syndrome (ACS) survivors. As such, the following series of research studies evaluate the mechanisms, patterns, and correlates of sedentary behavior in relation to CVD risk and examine whether sedentary behavior might be a risk factor for CVD outcomes among ACS survivors. In Chapter II, a cross-sectional study of young, healthy adults examined a set of biomarkers representing several aspects of endothelial cell health to elucidate the relationship between free-living, habitual sedentary time and endothelial dysfunction. Results showed that there were no differences in measures of endothelial cell injury, endothelial cell reparative capacity, or upper extremity endothelium-dependent vasodilatation in participants with high compared with low volumes of device-measured sedentary behavior in a sample of young, healthy adults. These findings suggest that physiological mechanisms other than endothelial dysfunction may need to be explored as a potential link between habitual prolonged sedentary time and CVD in young adults. Chapter III employed group-based trajectory modeling to identify distinct patterns of sedentary behavior, as measured by accelerometry, in ACS survivors over the 28 consecutive days following hospital discharge, and, secondly, to explore potential correlates of these patterns. Results demonstrated that ACS patients as a group engaged in high volumes of accelerometer-measured sedentary time. Three patterns of sedentary behavior over the first month post-discharge were identified; these involved either gradual or rapid reductions in sedentary behavior. Several measures of disease severity and physical health (e.g., GRACE CVD risk score, physical health-related quality of life), and partner status (i.e., married or partnered or without partner), were associated with the worst patterns of sedentary behavior (i.e., high volume of sedentary time with only a slight decline over time). These findings provide insight on the different patterns of sedentary behavior that emerge as patients resume their daily life over the first month post hospital discharge. Chapter IV, building upon the study presented in Chapter III, examined whether accelerometer-measured sedentary behavior of ACS survivors over the first month post hospital discharge was associated with 1-year health outcomes. The purpose of this study was to understand whether sedentary behavior in the early post hospital discharge period may be an important risk factor in ACS survivors, that might be targeted in secondary prevention strategies. Results demonstrated that the average sedentary behavior over the first month post hospital discharge was not significantly associated with increased risk of 1-year recurrent major adverse cardiovascular events or hospitalizations. These findings do not support sedentary behavior in the early post hospital discharge period as a prognostic risk factor that should be modified in ACS survivors as part of secondary heart disease prevention strategy. However, studies with larger sample sizes, and that evaluate sedentary behavior patterns beyond the first month are needed. Collectively, these studies show that high volumes of sedentary behavior are prevalent in ACS survivors over the first month immediately following hospital discharge. Future work is needed to further study the underlying mechanisms through which sedentary behavior may confer CVD risk and to determine whether sedentary behavior is an important modifiable risk factor in ACS survivors.

Background: Clinical and epidemiologic studies have investigated the effects of diet, physical activity, and inflammation on the risk of colorectal adenoma occurrence and recurrence. Inflammation has been proposed as a mechanism of action for the development of colorectal adenoma and cancer. Research indicates that fruit phenolic exposure may attenuate the inflammatory response and some data suggest that berries are effective in mitigating this process. Inflammatory cytokines such as interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor alpha (TNF-α) are of particular interest due to their role in adenoma development. Epidemiological investigations have studied the association between bioactive fruit phenolic compounds and colorectal neoplasia; however, epidemiological data for the association between consumption of berries, which contain high concentrations of these compounds, and colorectal adenoma recurrence are limited. In addition to a potential role of phenolics in reducing inflammation, physical activity has also been proposed as a mitigator of this process. Numerous studies have investigated the association between physical activity and colorectal neoplasia, yet data on sedentary behavior and colorectal adenoma recurrence are limited. This dissertation was designed to further elucidate the role of fruit phenolics and sedentary behavior on colorectal adenoma recurrence and to specifically highlight the potential role of black raspberries in mitigating the postprandial inflammatory response among overweight and obese individuals. Methods: Ten overweight or obese males (BMI>25 kg/m²), ages 55-72, participated in an open-label, randomized, 14-day, pilot crossover study. Subjects consumed a high- fat, high- calorie (HFHC) meal, with (Group 1) or without (Group 2) a 5 day regimen of 45 g of black raspberry powder in the form of a slurry. The study included a two-day washout period before Group 1 and Group 2 were crossed over. The two-day washout period was based on a pharmacokinetic study conducted with black raspberry powder (1); peak plasma concentrations of ellagic acid and anthocyanin metabolites peaked at 1 to 2 hours following consumption of 45 grams of black raspberry powder and by 12 hours, plasma concentrations of these metabolites were almost fully washed out, with plasma concentrations returning to near baseline levels. Blood samples were obtained prior to consumption of the HFHC breakfast and at 1, 2, 4, 8, and 12 hours afterwards, during two 14-hour clinic visits. The primary study outcomes were changes in areas under the curves (AUCs) of serum biomarkers of TNF-α, CRP, and IL-6. A secondary pooled analysis was conducted among participants from two randomized, double blind, placebo-controlled Phase III clinical trials to investigate the association between berry consumption and colorectal adenoma recurrence, and the association between sedentary behavior and colorectal adenoma recurrence. Analyses included 2,502 subjects who had completed the baseline Arizona Food Frequency Questionnaire to ascertain berry consumption history in the past year and 1,730 men and women who had completed the baseline Arizona Activity Frequency Questionnaire to ascertain sedentary behavior. All subjects had a follow-up colonoscopy during the trial. Logistic regression modeling was employed to estimate the effect of sedentary behavior or berry consumption on colorectal adenoma recurrence. Results: The mean AUC of serum IL-6 was significantly lower (p=0.03) with black raspberry (BRB) feeding (45.5±36.3 pg/mL; mean±SD), compared to high fat, high calorie meal alone (56.7±50.0 pg/mL). No statistically significant differences were observed in the mean AUC of serum TNF-α or CRP. In the pooled analysis, no significant associations were observed between berry consumption and adenoma recurrence in the pooled population or when stratified by sex. In the evaluation of association between sedentary behavior and adenoma recurrence, subjects in the second, third, and fourth quartiles of sedentary behavior experienced higher odds of adenoma recurrence; however, the difference was only statistically significant for the third quartile. Sex-stratified analyses revealed that in men, sedentary activity was statistically significantly associated with 45% higher odds of adenoma recurrence. Compared to the lowest quartile of sedentary activity, the ORs (95% CIs) for the second, third, and fourth quartiles among men were 1.31 (0.93, 1.84), 1.47 (1.04, 2.09), and 1.45 (1.02, 2.06) respectively (P trend=0.03). In contrast, no association with sedentary activity was observed in women. Conclusion: Polyphenol exposure in the form of a black raspberry slurry significantly decreased post-prandial IL-6 in a clinical trial among ten older overweight and obese men. These findings suggest short-term attenuation of an inflammatory maker may not translate to decreased adenoma recurrence, however, long term randomized clinical trials with black raspberries are needed to evaluate this further. However, in an epidemiological analysis, consumption of up to 1 cup per week of whole berries was not associated with lower odds for adenoma recurrence among a pooled population of participants in the Wheat Bran Fiber and Ursodeoxycholic Acid Phase III clinical trials. While the epidemiological results indicated that berry consumption are not associated with the development of early colorectal neoplasia, the effects on later stages of carcinogenesis are unknown. Higher levels of berry consumption may be required in order to reach a cancer inhibitory effect. Finally, results of the physical activity study suggest that sedentary behavior is associated with a higher risk of adenoma recurrence among men, providing evidence of detrimental effects of a sedentary lifestyle early in the carcinogenesis pathway. Efforts to further evaluate these findings in other cohorts or in an intervention trial should be considered.

Weight gain affects all living beings and excessive weight gain can lead to obesity and comorbidities linked to obesity. In order to better understand how the college student population gains weight and increase in BMI, data collected under the Council of Environment and Dietary Activity (CEDA) at Texas A&M University was examined and analyzed in order to understand how physical activity, sedentary behavior, and dietary activity affect weight gain or weight loss. The college population was divided into BMI categories, gender, and where they lived on campus at Texas A&M University. The data shows that physical activity was associated with loss of weight and BMI in females. Sedentary behavior was associated with weight gain in males but also weight loss in females. Meat consumption was associated with weight gain in males. Fish consumption was associated with weight loss in females. Pastries consumption was associated with weight gain in females. Physical activity appeared to have a stronger effect on weight than dietary behavior even though both can interact to affect weight for females. Speed of service and location have a significant effect on where students would eat. In conclusion, physical activity and sedentary activity have an effect on weight and BMI. Diet can also have an effect on weight and BMI. More specifically, sugar snacks affect weight in females and meat affects weight and BMI in males. However, physical activity appears to have a larger on weight and BMI than diet. Location also affects where a student will eat.

abstract: The purpose of this study was to examine the feasibility and preliminary efficacy of a theory-driven and a atheoretical reminder point-of-choice (PoC) prompt interventions on reducing workplace sedentary behavior in office workers with self-reported low usage (<4 hours per day) of their sit-stand workstations in the standing position. The design of this study was a cross-over trial including randomization into either the theory-driven or atheoertical reminder condition, after completion of a no prompt control condition. Participants (N=19) included full-time, primarily female, Caucasian, middle-aged office workers. The primary aim of this study was to assess the feasibility of these two PoC prompt conditions on reducing sedentary behaviors through the use of a Therapy Evaluation Questionnaire. The secondary aim of this study was to assess the preliminary efficacy of the two PoC prompt conditions on reducing sedentary behaviors relative to no-prompt control using the activPAL micro device. For the primary aim, descriptive means adjusted for ordering effect were computed. For the secondary aim, mixed-effects regression models were used to cluster for observations within-persons and were adjusted for age, gender, race, job-type, and ordering effects. During the no-prompt control, participants spent 267.90 ± 68.01 sitting and 170.20 ± 69.34 min/8hr workday standing. The reminder PoC prompt condition significantly increased sanding time (b[se] = 24.52 [11.09], p=0.034) while the theory-driven PoC condition significantly decreased time spent in long sitting bouts b[se] = -34.86 [16.20], p=0.036), both relative to no prompt control. No statistically significant reductions in sitting time were seen in either PoC prompt condition. Furthermore, no statistically significant differences between the two PoC prompt conditions were observed. This study provides feasibility insight in addition to objective measures of sedentary behaviors regarding the use of PoC prompt interventions in the workplace. / Dissertation/Thesis / Masters Thesis Exercise and Wellness 2018