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Background: Hip-worn accelerometer cut-points have poor validity for assessing children's sedentary time, which may partly explain the equivocal health associations shown in prior research. Improved processing/classification methods for these monitors would enrich the evidence base and inform the development of more effective public health guidelines. The present study aimed to develop and evaluate a novel computational method (CHAP-child) for classifying sedentary time from hip-worn accelerometer data. Methods: Participants were 278, 8–11-year-olds recruited from nine primary schools in Melbourne, Australia with differing socioeconomic status. Participants concurrently wore a thigh-worn activPAL (ground truth) and hip-worn ActiGraph (test measure) during up to 4 seasonal assessment periods, each lasting up to 8 days. activPAL data were used to train and evaluate the CHAP-child deep learning model to classify each 10-s epoch of raw ActiGraph acceleration data as sitting or non-sitting, creating comparable information from the two monitors. CHAP-child was evaluated alongside the current practice 100 counts per minute (cpm) method for hip-worn ActiGraph monitors. Performance was tested for each 10-s epoch and for participant-season level sedentary time and bout variables (e.g., mean bout duration). Results: Across participant-seasons, CHAP-child correctly classified each epoch as sitting or non-sitting relative to activPAL, with mean balanced accuracy of 87.6% (SD = 5.3%). Sit-to-stand transitions were correctly classified with mean sensitivity of 76.3% (SD = 8.3). For most participant-season level variables, CHAP-child estimates were within ± 11% (mean absolute percent error [MAPE]) of activPAL, and correlations between CHAP-child and activPAL were generally very large (> 0.80). For the current practice 100 cpm method, most MAPEs were greater than ± 30% and most correlations were small or moderate (≤ 0.60) relative to activPAL. Conclusions: There was strong support for the concurrent validity of the CHAP-child classification method, which allows researchers to derive activPAL-equivalent measures of sedentary time, sit-to-stand transitions, and sedentary bout patterns from hip-worn triaxial ActiGraph data. Applying CHAP-child to existing datasets may provide greater insights into the potential impacts and influences of sedentary time in children. [ABSTRACT FROM AUTHOR]

The health effects of sedentary behavior (SB) may be moderated by SB accumulation patterns (e.g., in prolonged bouts). These patterns are challenging to assess thoroughly and interpretably. Purpose: The purpose of this study is to introduce SB profiles (i.e., groups of similar SB accumulation patterns) as a new approach to pattern-focused SB research. Methods: Data came from the National Health and Nutrition Examination Survey (2003–2006). The SB bouts were determined from hip-worn accelerometer data, and k-medoid clustering was used to define three SB profiles (interrupted, intermediate, and prolonged). These were used as the exposure in logistic regression models to examine odds ratios (OR) of having high (>20%) predicted-10-yr risk of cardiovascular disease (CVD). For comparison, the models were also fitted using standard metrics (i.e., tertiles of mean SB bout duration and daily total SB time). Results: Those with interrupted profile (n = 1740) were typically sedentary ~32% of the time, in bouts ≤15 min. Those with intermediate profile (n = 2453) were typically sedentary ~47% of the time, in bouts ≤20 min. Those with prolonged profile (n = 1302) were typically sedentary ~61% of the time, frequently in bouts >20 min. The fully adjusted model showed that high CVD risk was more common for the intermediate (OR, 1.87) and prolonged (OR, 4.65) profiles than the interrupted profile (all P < 0.001). For standard metrics, OR ranged from 1.46 (middle tertile of daily total SB time) to 4.11 (upper tertile of mean bout duration) with all P < 0.002. Conclusions: The SB profiles represent a promising new avenue for understanding and combating adverse SB trends. The value of the approach was highlighted by the strong associations with CVD risk. [ABSTRACT FROM AUTHOR]

Background: Recent evidence suggests that prolonged sitting and its adverse impact on glycaemic indicators appear to be proportional to the degree of insulin resistance. To investigate this finding in a free-living context, we aimed to examine associations of device-measured 24-h time-use compositions of sitting, standing, stepping, and sleeping with fasting glucose (FPG) and 2 h post-load glucose (2hPLG) levels, and to examine separately the associations with time-use compositions among those at lower and at higher risk of developing type 2 diabetes. Methods: Cross-sectional analyses examined thigh-worn inclinometer data (activPAL, 7 day, 24 h/day protocol) from 648 participants (aged 36-80 years) at either lower (< 39 mmol/mol; < 5.7% HbA1c) or higher (≥39 mmol/mol; ≥5.7% HbA1c) diabetes risk from the 2011-2012 Australian Diabetes, Obesity and Lifestyle study. Multiple linear regression models were used to examine associations of differing compositions with FPG and 2hPLG, with time spent in each behaviour allowed to vary up to 60 min. Results: In general, the associations with the FPG within the time-use compositions were small, with statistically significant associations observed for sitting and sleeping (in the lower diabetes risk group) and standing (in higher diabetes risk group) only. For 2hPLG, statistically significant associations were observed for stepping only, with findings similar between lower (β = − 0.12 95%CI:−0.22, − 0.02) and higher (β = − 0.13 95%CI:−0.26, − 0.01) risk groups. Varying the composition had minimal impact on FPG; however 1 h less sitting time and equivalent increase in standing time was associated with attenuated FPG levels in higher risk only (Δ FPG% = − 1.5 95%CI: − 2.4, − 0.5). Large differences in 2hPLG were observed for both groups when varying the composition. One hour less sitting with equivalent increase in stepping was associated with attenuated 2hPLG, with estimations similar in lower (Δ 2hPLG% = − 3.8 95%CI: − 7.3, − 0.2) and higher (Δ 2hPLG% = − 5.0 95%CI: − 9.7, − 0.0) risk for diabetes. Conclusions: In middle-aged and older adults, glycaemic control could be improved by reducing daily sitting time and replacing it with stepping. Standing could also be beneficial for those at higher risk of developing type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background: Sedentary behavior (SB) is linked to negative health outcomes in older adults. Most studies use summary values, e.g., total sedentary minutes/day. Diurnal timing of SB accumulation may further elucidate SB-health associations. Methods: Six thousand two hundred four US women (mean age = 79 ± 7; 50% White, 34% African-American) wore accelerometers for 7-days at baseline, yielding 41,356 person-days with > 600 min/day of data. Annual follow-up assessments of health, including physical functioning, were collected from participants for 6 years. A novel two-phase clustering procedure discriminated participants' diurnal SB patterns: phase I grouped day-level SB trajectories using longitudinal k-means; phase II determined diurnal SB patterns based on proportion of phase I trajectories using hierarchical clustering. Mixed models tested associations between SB patterns and longitudinal physical functioning, adjusted for covariates including total sedentary time. Effect modification by moderate-vigorous-physical activity (MVPA) was tested. Results: Four diurnal SB patterns were identified: p1 = high-SB-throughout-the-day; p2 = moderate-SB-with-lower-morning-SB; p3 = moderate-SB-with-higher-morning-SB; p4 = low-SB-throughout-the-day. High MVPA mitigated physical functioning decline and correlated with better baseline and 6-year trajectory of physical functioning across patterns. In low MVPA, p2 had worse 6-year physical functioning decline compared to p1 and p4. In high MVPA, p2 had similar 6-year physical functioning decline compared to p1, p3, and p4. Conclusions: In a large cohort of older women, diurnal SB patterns were associated with rates of physical functioning decline, independent of total sedentary time. In particular, we identified a specific diurnal SB subtype defined by less SB earlier and more SB later in the day, which had the steepest decline in physical functioning among participants with low baseline MVPA. Thus, diurnal timing of SB, complementary to total sedentary time and MVPA, may offer additional insights into associations between SB and physical health, and provide physicians with early warning of patients at high-risk of physical function decline. [ABSTRACT FROM AUTHOR]

National guidelines recommend physically active interruptions to sitting time; however, the characteristics of these interruptions are broadly stated and ill-defined. A robust methodology for population surveillance for such interruptions is needed. Purpose: To describe the frequency and characteristics (i.e. duration, stepping time, and estimated intensity) of all interruptions and physically active interruptions to adults' free-living sitting time (i.e. transitions from sitting to upright posture) across segments of the population. Methods : Australian Diabetes, Obesity and Lifestyle study participants (321 men; 406 women; mean +/- standard deviation, 58.0 +/- 10.3 yr) wore the activPAL3(TM) for >=1 valid day. The characteristics of interruptions from laboratory studies demonstrating health benefits were selected to define active interruptions (>=5 min upright and/or >=2 min stepping) and ambulatory interruptions (>=2 min stepping). The frequency and characteristics of all, active, and ambulatory interruptions were described and compared by age, sex, diabetes status, and body mass index. Results : Adults averaged 55.0 +/- 21.8 interruptions per day, but only 20.3 +/- 6.7 were active and 14.0 +/- 5.4 were ambulatory. Median (25th, 75th percentile) duration was 2.6 min (0.9, 7.8 min), stepping time was 0.8 min (0.3, 2.0 min), and estimated energy expenditure was 4.3 metabolic equivalents (MET)[middle dot]min-1 (1.4, 12.5 MET[middle dot]min-1). Those who were older, had obesity, or had diabetes had significantly (P < 0.05) fewer interruptions of all types and less stepping time during active interruptions than their counterparts (Cohen's d < 0.2). Conclusions : Free-living interruptions were often less active than interruptions performed in effective acute laboratory studies and their content varied widely between population groups. Monitoring all interruptions, as well as those that are more active, is advisable to provide a comprehensive understanding of free-living sedentary behavior. [ABSTRACT FROM AUTHOR]