The Relationship of Objectively Measured Physical Activity and Sedentary Behaviour with Gestational Weight Gain and Birth Weight A Randomised Controlled Trial to Reduce Sedentary Time in Young Adults at Risk of Type 2 Diabetes Mellitus: Project STAND (Sedentary Time ANd Diabetes) Impact of objectively measured sedentary behaviour on changes in insulin resistance and secretion over 3 years in the RISC study: interaction with weight gain. What are the most effective behaviour change techniques to promote physical activity and/or reduce sedentary behaviour in inactive adults? A systematic review protocol Objective vs. Self-Reported Physical Activity and Sedentary Time: Effects of Measurement Method on Relationships with Risk Biomarkers A prospective study of pregravid physical activity and sedentary behaviors in relation to the risk for gestational diabetes mellitus. Sedentary behaviors and abnormal glucose tolerance among pregnant Latina women. Association between Physical Activity in Obese Pregnant Women and Pregnancy Outcomes: The UPBEAT Pilot Study Reducing office workers’ sitting time: rationale and study design for the Stand Up Victoria cluster randomized trial On Your Feet to Earn Your Seat: pilot RCT of a theory-based sedentary behaviour reduction intervention for older adults A behaviour change intervention to reduce sedentary time in people with chronic obstructive pulmonary disease: protocol for a randomised controlled trial. ‘On Your Feet to Earn Your Seat’, a habit-based intervention to reduce sedentary behaviour in older adults: study protocol for a randomized controlled trial A randomised feasibility study to investigate the impact of education and the addition of prompts on the sedentary behaviour of office workers Results of the Sedentary Intervention Trial in Cardiac Rehabilitation (SIT-CR Study): A pilot randomized controlled trial. Objective measures of activity level and mortality in older men. Effectiveness of a walking programme to support adults with intellectual disabilities to increase physical activity: walk well cluster-randomised controlled trial Exercise Training in Pregnancy for obese women (ETIP): study protocol for a randomised controlled trial Acute effects of advertisements on children's choices, preferences, and ratings of liking for physical activities and sedentary behaviours: a randomised controlled pilot study. Energy expenditure during common sitting and standing tasks: examining the 1.5 MET definition of sedentary behaviour Intra-individual variability in day-to-day and month-to-month measurements of physical activity and sedentary behaviour at work and in leisure-time among Danish adults Physical activity, sedentary behaviors and risk of gestational diabetes mellitus: a population-based cross-sectional study in Tianjin, China. Efficacy of a theory-based behavioural intervention to increase physical activity in an at-risk group in primary care (ProActive UK): a randomised trial Balanced: a randomised trial examining the efficacy of two self-monitoring methods for an app-based multi-behaviour intervention to improve physical activity, sitting and sleep in adults
Objective . To evaluate the relationship of physical activity ( PA ) and sedentary behaviour with  gestational weight gain ( GWG ) and birth weight . Design . Combined data from two prospect i ve studies : ( 1 ) nulliparous pregnant women without BMI restrictions and ( 2 ) overweight and obese pregnant women at risk for gestational diabetes . Methods . Daily PA and sedentary behaviour were measured with an accelerometer around 15 and at 32–35 weeks of gestation . The association between time spent in moderate-to-vigorous PA ( MVPA ) and in  sedentary activities  with GWG and birth weight was determined . Main outcome measures were GWG between 15 and 32 weeks of gestation , average GWG per week , and birth weight . Results . We studied 111 women . Early in pregnancy , 32 % of women spent ≥30 minutes/day in at least moderate PA versus 12 % in late pregnancy . No significant associations were found between time spent in MVPA or sedentary behaviour with GWG or birth weight . Conclusions . We found no relation  between MVPA and sedentary behaviour with GWG or birth weight . The small percentage of women meeting the recommended levels of PA indicates the need to inform and support pregnant women to maintain regular PA , as there seems to be no adverse effect on birth weight and maintaining PA increases overall health Aims Type 2 diabetes mellitus ( T2DM ) , a serious and prevalent chronic disease , is traditionally associated with older age . However , due to the rising rates of obesity and sedentary lifestyles , it is increasingly being diagnosed in the younger population . Sedentary ( sitting ) behaviour has been shown to be associated with greater risk of cardio-metabolic health outcomes , including T2DM . Little is known about effective interventions to reduce sedentary behaviour in younger adults at risk of T2DM . We aim ed to investigate , through a r and omised controlled trial ( RCT ) design , whether a group-based structured education workshop focused on sitting reduction , with self-monitoring , reduced sitting time . Methods Adults aged 18–40 years who were either overweight ( with an additional risk factor for T2DM ) or obese were recruited for the Sedentary Time ANd Diabetes ( ST AND ) RCT . The intervention programme comprised of a 3-hour group-based structured education workshop , use of a self-monitoring tool , and follow-up motivational phone call . Data were collected at three time points : baseline , 3 and 12 months after baseline . The primary outcome measure was accelerometer-assessed sedentary behaviour after 12 months . Secondary outcomes included other objective ( activPAL ) and self-reported measures of sedentary behaviour and physical activity , and biochemical , anthropometric , and psycho-social variables . Results 187 individuals ( 69 % female ; mean age 33 years ; mean BMI 35 kg/m2 ) were r and omised to intervention and control groups . 12 month data , when analysed using intention-to-treat analysis ( ITT ) and per- protocol analyses , showed no significant difference in the primary outcome variable , nor in the majority of the secondary outcome measures . Conclusions A structured education intervention design ed to reduce sitting in young adults at risk of T2DM was not successful in changing behaviour at 12 months . Lack of change may be due to the brief nature of such an intervention and lack of focus on environmental change . Moreover , some participants reported a focus on physical activity rather than reductions in sitting per se . The habitual nature of sedentary behaviour means that behaviour change is challenging . Trial Registration Controlled-Trials.com IS RCT AIMS The importance of reducing sedentary time is increasingly being recognized in the prevention of diabetes and cardiovascular disease . Despite this , the prospect i ve association between sedentary time and physical activity with insulin sensitivity and cardiometabolic risk factors has been little studied . METHODS In an analysis of data from the European RISC study , sedentary time and time spent in activity of moderate or vigorous intensity were assessed by accelerometry at baseline in 313 men and 414 women , aged 30 - 60 years , with insulin sensitivity as measured by euglycaemic-hyperinsulinaemic clamp . Three years later , cardiometabolic risk factors ( anthropometry , glucose , insulin , lipids ) were available for 549 participants . RESULTS In cross-sectional analyses using baseline data , after adjusting for age , gender , recruitment centre and time spent in activity of moderate or vigorous intensity , significant unfavourable associations were observed between higher sedentary time with body weight , HDL cholesterol , triglycerides , clamp-measured insulin sensitivity and insulin secretion ( all P(trend)<0.002 ) .  Sedentary time  remained significantly associated with insulin secretion after adjusting for insulin sensitivity ( P(trend)=0.02 ) . In longitudinal analyses , higher baseline sedentary time  was associated with 3-year increases in fasting glucose , fasting insulin and the HOMA insulin-resistance index score for the 50 % of the study population who increased their BMI by at least 0.3 kg/m(2 ) ( all P(trend)<0.01 ) ; these relationships remained significant after adjusting for time spent in activity of moderate or vigorous intensity . The 3-year increase in insulin secretion was lower in those spending more time doing activity of moderate or vigorous intensity ( P(trend)=0.03 ) . CONCLUSION These prospect i ve data suggest that less sedentary behaviour may partly counteract some of the negative effects of increasing body weight on glucose-insulin homoeostasis Introduction Large proportions of the population are not meeting recommended levels of physical activity and have increasingly sedentary lifestyles . Low levels of physical activity are predictive of poor health outcomes and time spent sedentary is related to a host of risk factors independently of physical activity levels . Building an evidence base of the best approaches to intervene in the lifestyles of inactive individuals is crucial in preventing long-term disease , disability and higher mortality rates . Methods and analysis Systematic search es will be conducted on all relevant data bases ( eg , PubMed , Scopus , CINAHL , PsycINFO ) . Studies will be included if they assess interventions aim ed at changing physical activity or sedentary behaviour levels in adults ( over 18 ) who are inactive and do not suffer from chronic conditions . Studies must also be r and omised controlled trials ( RCTs ) , have a primary outcome of physical activity or sedentary behaviour , and measure outcomes at least 6 months after intervention completion . Studies will be coded using the Behaviour Change Technique ( BCT ) taxonomy v1 and Template for Intervention Description and Replication ( TIDieR ) guidelines . 2 review ers will independently screen full-text articles and extract data on study characteristics , participants , BCTs , intervention features and outcome measures . Study quality will also be assessed independently by 2 review ers using the Cochrane risk of bias tool . A meta- analysis will be considered if there is sufficient homogeneity across outcomes . GRADE criteria will be used to assess quality of evidence . Dissemination This will be the first review to systematic ally appraise interventions aim ed at changing the physical activity or sedentary behaviour of inactive individuals using RCT design s with a 6-month follow-up post-intervention . This review will better inform intervention design ers targeting inactive population s and inform the design of a future complex intervention . Review registration number This protocol was registered with the International Prospect i ve Register of Systematic Review s ( PROSPERO ) on 17 October 2014 ( registration number : CRD42014014321 ) Purpose Imprecise measurement of physical activity variables might attenuate estimates of the beneficial effects of activity on health-related outcomes . We aim ed to compare the cardiometabolic risk factor dose-response relationships for physical activity and sedentary behaviour between accelerometer- and question naire-based activity measures . Methods  Physical activity and sedentary behaviour  were assessed in 317 adults by 7-day accelerometry and International Physical Activity Question naire ( IPAQ ) . Fasting blood was taken to determine insulin , glucose , triglyceride and total , LDL and HDL cholesterol concentrations and homeostasis model-estimated insulin resistance ( HOMAIR ) . Waist circumference , BMI , body fat percentage and blood pressure were also measured . Results For both accelerometer-derived sedentary time ( < 100 counts.min−1 ) and IPAQ-reported sitting time significant positive ( negative for HDL cholesterol ) relationships were observed with all measured risk factors – i.e. increased sedentary behaviour was associated with increased risk ( all p≤0.01 ) . However , for HOMAIR and insulin the regression coefficients were > 50 % lower for the IPAQ-reported compared to the accelerometer-derived measure ( p<0.0001 for both interactions ) . The relationships for moderate-to-vigorous physical activity ( MVPA ) and risk factors were less strong than those observed for sedentary behaviours , but significant negative relationships were observed for both accelerometer and IPAQ MVPA measures with glucose , and insulin and HOMAIR values ( all p<0.05 ) . For accelerometer-derived MVPA only , additional negative relationships were seen with triglyceride , total cholesterol and LDL cholesterol concentrations , BMI , waist circumference and percentage body fat , and a positive relationship was evident with HDL cholesterol ( p = 0.0002 ) . Regression coefficients for HOMAIR , insulin and triglyceride were 43–50 % lower for the IPAQ-reported compared to the accelerometer-derived MVPA measure ( all p≤0.01 ) . Conclusion Using the IPAQ to determine sitting time and MVPA reveals some , but not all , relationships between these activity measures and metabolic and vascular disease risk factors . Using this self-report method to quantify activity can therefore underestimate the strength of some relationships with risk factors BACKGROUND Although gestational diabetes mellitus ( GDM ) has been associated with substantial adverse health outcomes for both mothers and offspring , few modifiable risk factors for GDM have been identified . METHODS We conducted a prospect i ve cohort study among women in the Nurses ' Health Study II to assess whether the amount , type , and intensity of pregravid physical activity and sedentary behaviors are associated with GDM risk . The analysis included 21,765 women who reported at least 1 singleton pregnancy between 1990 and 1998 .  Physical activity and sedentary behaviors  were assessed through vali date d question naire . RESULTS We documented 1428 incident GDM cases . After controlling for body mass index , dietary factors , and other covariates , there was a significant inverse association between vigorous activity and the risk of GDM . The multivariate relative risk ( RR ) comparing the highest with the lowest quintile of vigorous activity was 0.77 ( 95 % confidence interval [ CI ] , 0.69 - 0.94 ) ( P = .002 for trend ) . Among women who did not perform vigorous activity , brisk walking pace was associated with significantly lower GDM risk ( RR , 0.66 ; 95 % CI , 0.46 - 0.95 ) compared with an easy pace . Women who spent 20 h/wk or more watching television but did not perform vigorous activity had a significantly higher GDM risk than women who spent less than 2 h/wk watching television and were physically active ( multivariate RR , 2.30 ; 95 % CI , 1.06 - 4.97 ) . CONCLUSION Our prospect i ve study provides strong evidence that regular physical activity before pregnancy is associated with lower GDM risk UNLABELLED Studies conducted among nonpregnant population s have observed an association between sedentary behavior and glucose intolerance . Few studies have investigated this association during pregnancy , particularly among Latina women , a population with higher rates of sedentary behavior and abnormal glucose tolerance ( AGT ) as compared with non-Latina white women . OBJECTIVE The purpose of this study was to estimate the association between sedentary behavior and AGT . RESEARCH DESIGN AND METHODS We used data from the Latina gestational diabetes mellitus study , a prospect i ve cohort of 1231 Latina prenatal care patients in western Massachusetts .  Sedentary behavior  was assessed by bilingual interviewers using a modified version of the  Kaiser Physical Activity Survey  in prepregnancy , early pregnancy , and midpregnancy and defined as hours spent TV watching , frequency of sitting at work , and participation in sports or exercise activity as well as a derived composite of total sedentary activity . AGT was measured at 24 - 28 wk of gestation and abstract ed from medical records after delivery . Multivariate logistic regression was used to calculate odds ratios and 95 % confidence intervals . RESULTS A total of 12 % ( n = 119 ) of participants were classified as having AGT . After adjusting for AGT risk factors , sedentary behaviors in prepregnancy or in early pregnancy were not associated with AGT . However , in midpregnancy , low levels of participation in sports or exercise ( odds ratio = 2.01 , 95 % CI = 1.01 - 4.02 ) and increasing total sedentary activity ( Ptrend = 0.003 ) were associated with increased risk for AGT . CONCLUSIONS Findings suggest an association between sedentary activity in midpregnancy and risk of AGT in this understudied population Background : Obesity in pregnancy is associated with fetal macrosomia , a raised neonatal fat mass and an increased risk of obesity and poor metabolic health in childhood which persists into adulthood . The offspring of obese women are more likely to be obese than the offspring of lean women when they become pregnant themselves , perpetuating a cycle of obesity and its associated negative metabolic consequences . Increasing physical activity during pregnancy could improve insulin sensitivity and reduce the risk of maternal and offspring adverse outcomes . The UK Pregnancy Better Eating and Activity Trial ( UPBEAT ) is a trial of a complex intervention design ed to improve pregnancy outcomes through dietary changes and physical activity .  Data from the pilot trial of 183 women were available for analysis . The relationship between the time spent at different physical activity levels and maternal and infant pregnancy outcomes was examined . Key Messages : Strong evidence exists that physical activity improves insulin sensitivity in non-pregnant population s , and lifestyle interventions of proven effectiveness in non-pregnant population s have been developed . Women who are active in pregnancy demonstrate better glucose control and favourable pregnancy outcomes . There is a lack of effective interventions to support obese pregnant women to be physically active . Conclusions : No difference was detected in objective ly measured physical activity between women r and omised to the intervention and control arms of the UPBEAT pilot trial . Light-intensity physical activity was lower in early pregnancy in women who delivered macrosomic infants . Maternal sedentary time at 35 - 36 weeks ' gestation was positively associated and moderate-intensity physical activity was inversely associated with neonatal abdominal circumference . Maternal physical activity is associated with infant birth weight and abdominal circumference and is an appropriate target for intervention to improve infant outcomes . The challenge remains to develop an effective intervention to support obese pregnant women to be physically active Background Excessive time spent in sedentary behaviours ( sitting or lying with low energy expenditure ) is associated with an increased risk for type 2 diabetes , cardiovascular disease and some cancers . Desk-based office workers typically accumulate high amounts of daily sitting time , often in prolonged unbroken bouts . The St and Up Victoria study aims to determine whether a 3-month multi-component intervention in the office setting reduces workplace sitting , particularly prolonged , unbroken sitting time , and results in improvements in cardio-metabolic biomarkers and work-related outcomes , compared to usual practice . Methods / Design A two-arm cluster-r and omized controlled trial ( RCT ) , with worksites as the unit of r and omization , will be conducted in 16 worksites located in Victoria , Australia . Work units from one organisation ( Department of Human Services , Australian Government ) will be allocated to either the multi-component intervention ( organisational , environmental [ height-adjustable workstations ] , and individual behavioural strategies ) or to a usual practice control group . The recruitment target is 160 participants ( office-based workers aged 18–65 years and working at least 0.6 full time equivalent ) per arm . At each assessment ( 0- [ baseline ] , 3- [ post intervention ] , and 12-months [ follow-up ] ) , objective measurement via the activPAL3 activity monitor will be used to assess workplace : sitting time ( primary outcome ) ; prolonged sitting time ( sitting time accrued in bouts of ≥30 minutes ) ; st and ing time ; sit-to-st and transitions ; and , moving time . Additional outcomes assessed will include : non-workplace activity ; cardio-metabolic biomarkers and health indicators ( including fasting glucose , lipids and insulin ; anthropometric measures ; blood pressure ; and , musculoskeletal symptoms ) ; and , work-related outcomes ( presenteeism , absenteeism , productivity , work performance ) . Incremental cost-effectiveness and identification of both workplace and individual-level mediators and moderators of change will also be evaluated . Discussion St and Up Victoria will be the first cluster- RCT to evaluate the effectiveness of a multi-component intervention aim ed at reducing prolonged workplace sitting in office workers . Strengths include the objective measurement of activity and assessment of the intervention on markers of cardio-metabolic health . Health- and work-related benefits , as well as the cost-effectiveness of the intervention , will help to inform future occupational practice .Trial registration Background Of all age groups , older adults spend most of the time sitting and are least physically active . This sequential , mixed- methods feasibility study used a r and omised controlled trial design to assess methods for trialling a habit-based intervention to displace older adults ’ sedentary behaviour with light activity and explore impact on behavioural outcomes . Methods Eligibility criteria were age 60–74 years , retired , and ≥6 h/day leisure sitting . Data were collected across four sites in Engl and . The intervention comprised a booklet outlining 15 ‘ tips ’ for disrupting sedentary habits and integrating activity habits into normally inactive setting s , and eight weekly self-monitoring sheets . The control was a non-habit-based factsheet promoting activity and sedentary reduction . A computer-generated 1:1 block-r and omisation schedule was used , with participants blinded to allocation . Participants self-reported sedentary behaviour ( two indices ) , sedentary habit , physical activity ( walking , moderate , vigorous activity ) and activity habit , at pre-treatment baseline , 8- and 12-week follow-ups and were interviewed at 12 weeks . Primary feasibility outcomes were attrition , adverse events and intervention adherence . The secondary outcome was behavioural change . Results Of 104 participants consented , 103 were r and omised ( intervention N = 52 , control N = 51 ) . Of 98 receiving allocated treatment , 91 ( 93 % ; intervention N = 45 ; control N = 46 ) completed the trial . One related adverse event was reported in the intervention group . Mean per-tip adherence across 7 weeks was ≥50 % for 9/15 tips . Qualitative data suggested acceptability of procedures , and , particularly among intervention recipients , the allocated treatment . Both groups appeared to reduce sedentary behaviour and increase their physical activity , but there were no apparent differences between groups in the extent of change . Conclusions Trial methods were acceptable and feasible , but the intervention conferred no apparent advantage over control , though it was not trialled among the most sedentary and inactive population for whom it was developed . Further development of the intervention may be necessary prior to a large-scale definitive trial . One possible refinement would combine elements of the intervention with an informational approach to enhance effectiveness . Trial registration IS RCT N47901994 ( registration date : 16th January 2014 ; trial end date 30th April 2015 INTRODUCTION Replacing sedentary behaviour with light intensity physical activity ( ie , activities classified as less than three metabolic equivalents , such as slow-paced walking ) may be a more realistic strategy for reducing cardiometabolic risk in people with chronic obstructive pulmonary disease than only aim ing to increase levels of moderate-vigorous intensity physical activity . Behaviour change interventions to reduce sedentary behaviour in people with chronic obstructive pulmonary disease have not yet been developed or tested . RESEARCH QUESTIONS Is a 6-week behaviour change intervention effective and feasible in reducing sedentary time in people with chronic obstructive pulmonary disease ? DESIGN This study will be a multi-centre , r and omised , controlled trial with concealed allocation , assessor blinding , and intention-to-treat analysis , comparing a 6-week behaviour change intervention aim ed at reducing sedentary time with a sham intervention in people with chronic obstructive pulmonary disease . PARTICIPANTS AND SETTING Seventy participants will be recruited from the waiting lists for pulmonary rehabilitation programs at Royal Prince Alfred Hospital and Prince of Wales Hospital , Sydney , Australia . INTERVENTION The behaviour change intervention aims to reduce sedentary time through a process of guided goal setting with participants to achieve two target behaviours : ( 1 ) replace sitting and lying down with light-intensity physical activity where possible , and ( 2 ) st and up and move for 2minutes after 30minutes of continuous sedentary time . Three face-to-face sessions and three phone sessions will be held with a physiotherapist over the 6-week intervention period . The ' capability ' , ' opportunity ' , ' motivation ' and ' behaviour ' ( COM-B ) model will be applied to each participant to determine which components of behaviour ( capability , opportunity or motivation ) need to change in order to reduce sedentary time . Based on this ' behavioural diagnosis ' , the Behaviour Change Wheel will be used to systematic ally select appropriate behaviour change techniques to assist participants in achieving their weekly goals . Behaviour change techniques will include providing information about the health consequences of sedentary behaviour , self-monitoring and review of weekly goals , problem-solving of barriers to achieving weekly goals , and providing feedback on sedentary time using the Jawbone UP3 activity monitor . CONTROL The sham intervention will consist of weekly phone calls for 6 weeks , to enquire whether the participants ' health status has changed over the intervention period ( eg , hospitalised for an acute exacerbation ) . No instructions regarding physical activity or exercise will be given . MEASUREMENTS Outcomes will be assessed at baseline , at the end of the 6-week intervention period , and at the 3-month follow-up . Primary outcome measures will be : ( 1 ) total sedentary time , including the pattern of accumulation of sedentary time , assessed by the activPAL3 activity monitor , and ( 2 ) feasibility of the intervention assessed by uptake and retention of participants , participant compliance , self-reported achievement of weekly goals , and adverse events . Secondary outcome measures will include functional exercise capacity , health-related quality of life , domain-specific and behaviour-specific sedentary time , patient activation , and anxiety and depression .  Semi-structured interviews will be conducted with participants who receive the behaviour change intervention to explore acceptability and satisfaction with the different components of the intervention . ANALYSIS Analysis of covariance ( ANCOVA ) will be used to calculate between-group comparisons of total sedentary time and the number of bouts of sedentary time>30minutes after adjusting baseline values . Uncertainty about the size of the mean between-group differences will be quantified with 95 % CI . Within-group comparisons will be examined using paired t-tests and described as mean differences with 95 % CIs . Secondary outcome measures will be analysed similarly . The feasibility measures will be analysed descriptively . Semi-structured interviews will be conducted until data saturation is achieved and there are no new emerging themes . De-identified interview transcripts will be coded independently by two research ers and analysed alongside data collection using the COM-B model as a thematic framework . DISCUSSION / SIGNIFICANCE If behaviour change interventions are found to be an effective and feasible method for reducing sedentary time , such interventions may be used to reduce cardiometabolic risk in people with chronic obstructive pulmonary disease . An approach that emphasises participation in light-intensity physical activity may increase the confidence and willingness of people with chronic obstructive pulmonary disease to engage in more intense physical activity , and may serve as an intermediate goal to increase uptake of pulmonary rehabilitation Background Many older adults are both highly sedentary ( that is , spend considerable amounts of time sitting ) and physically inactive ( that is , do little physical activity ) . This protocol describes an exploratory trial of a theory-based behaviour change intervention in the form of a booklet outlining simple activities ( ‘ tips ’ ) design ed both to reduce sedentary behaviour and to increase physical activity in older adults . The intervention is based on the ‘ habit formation ’ model , which proposes that consistent repetition leads to behaviour becoming automatic , sustaining activity gains over time . Methods The intervention is being developed iteratively , in line with Medical Research Council complex intervention guidelines . Selection of activity tips was informed by semi-structured interviews and focus groups with older adults , and input from a multidisciplinary expert panel . An ongoing preliminary field test of acceptability among 25 older adults will inform further refinement . An exploratory r and omized controlled trial will be conducted within a primary care setting , comparing the tips booklet with a control fact sheet . Retired , inactive and sedentary adults ( n = 120 ) aged 60 to 74 years , with no physical impairments precluding light physical activity , will be recruited from general practice s in north London , UK . The primary outcomes are recruitment and attrition rates . Secondary outcomes are changes in behaviour , habit , health and wellbeing over 12 weeks . Discussion Data will be used to inform study procedures for a future , larger-scale definitive r and omized controlled trial . Trial registration Current Controlled Trials IS RCT N47901994 Background Office workers have been identified as being at risk of accumulating high amounts of sedentary time in prolonged events during work hours , which has been associated with increased risk of a number of long-term health conditions . There is some evidence that providing advice to st and at regular intervals during the working day , and using computer-based prompts , can reduce sedentary behaviour  in office workers . However , evidence of effectiveness , feasibility and acceptability for these types of intervention is currently limited . Methods A 2-arm , parallel group , cluster-r and omised feasibility trial to assess the acceptability of prompts to break up sedentary behaviour was conducted with office workers in a commercial bank ( n = 21 ) . Participants were assigned to an  education only group ( EG ) or prompt and education group  ( PG  ) . Both groups received education on reducing and breaking up sitting at work , and the PG also received hourly prompts , delivered by Microsoft Outlook over 10 weeks , reminding them to st and . Objective measurements of sedentary behaviour were made using activPAL monitors worn at three time points : baseline , in the last 2 weeks of the intervention period and 12 weeks after the intervention . Focus groups were conducted to explore the acceptability of the intervention and the motivations and barriers to changing sedentary behaviour . Results R and omly generated , customised prompts , delivered by Microsoft Outlook , with messages about breaking up sitting , proved to be a feasible and acceptable way of delivering prompts to office workers . Participants in both groups reduced their sitting , but changes were not maintained at follow-up . The education session seemed to increase outcome expectations of the benefits of changing sedentary behaviour and promote self-regulation of behaviour in some participants . However , low self-efficacy and a desire to conform to cultural norms were barriers to changing behaviour . Conclusions Prompts delivered by Microsoft Outlook were a feasible , low-cost way of prompting office workers to break up their sedentary behaviour , although further research is needed to determine whether this has an additional impact on sedentary behaviour , to education alone . The role of cultural norms , and promoting self-efficacy , should be considered in the design of future interventions .Trial registration This study was registered retrospectively as a clinical trial on Clinical Trials.gov ( ID no. NCT02609282 ) on 23 March 2015 BACKGROUND Sedentary time ( ST ) is negatively associated with cardiometabolic health and fitness . Traditional cardiac rehabilitation ( CR ) programming may not significantly reduce ST . The objectives of the study were to assess the feasibility and practicality of activPAL devices for measuring ST in CR , and whether prompting cues to interrupt sedentary behaviour can decrease ST and improve clinical outcomes . METHODS An 8-week , two-arm pilot r and omized controlled trial allocated coronary artery disease patients to either a control ( usual care CR ) or intervention ( CR + sedentary prompts from an activPAL3-VT ) group . Primary outcomes included : recruitment ; acceptability ; completion ; and , adherence rates . Secondary outcomes included changes in : ST ; physical activity ( PA ) ; cardiometabolic health ; psychosocial health ; and , fitness . RESULTS Forty participants ( 16 females ; 19 intervention ; 62 ± 10 years ) were r and omized . Outcome data were available for 95 % of participants . All but one participant completed the full intervention . Most ( 73 % ) intervention participants felt the prompts had somewhat changed their sedentary behaviour . At baseline , participants spent 47 % of their day sedentary . No significant group differences in changes for any of the ST , PA or fitness outcomes were observed . The mean group difference for post-intervention ST ( controlling for baseline ) was 30.3 min/day ( 95 % CI : -51.7 , 112.2 ) in favour of the intervention . The intervention group reported significantly better physical health and had a lower ratio of total cholesterol-to-high density lipoprotein when compared to controls . CONCLUSIONS It is feasible to use activPAL devices to measure ST in a CR setting . Further studies are needed to assess the effectiveness of multi-component sedentary behaviour interventions OBJECTIVES To examine associations between objective measures of activity level and mortality risk in older men . DESIGN Prospect i ve cohort study . SETTING Six U.S. sites . PARTICIPANTS Men aged 71 and older followed an average of 4.5 years ( N = 2,918 ) .  MEASUREMENTS Time awake spent in sedentary behavior  ( metabolic equivalent ( MET ) level ≤1.50 ) , light activity  ( MET level 1.51 - 2.99 ) , and at least moderate activity  ( MET level ≥3.00 ) measured using an activity monitor worn for 5 days or longer and expressed as quartiles . Deaths were confirmed with death certificates ; cause of death was adjudicated by review of certificates and records . RESULTS During follow-up , 409 ( 14 % ) men died . After multivariable adjustment , comparing Q4 with Q1 , more time spent in sedentary behavior ( Q4 vs Q1 , hazard ratio ( HR ) = 1.51 , 95 % confidence interval ( CI ) = 1.10 - 2.08 ) , less time spent in light activity ( Q1 vs Q4 , HR = 1.54 , 95 % CI = 1.06 - 2.24 ) , and less time spent in at least moderate activity ( Q1 vs Q4 , HR = 1.56 , 95 % CI = 1.09 - 2.25 ) were similarly associated with greater mortality risk primarily due to higher risks of cardiovascular and noncardiovascular , noncancer death . The association between time spent in sedentary behavior and mortality varied according to time spent at higher activity level . More time spent in sedentary behavior was associated with greater risk of death in men spending 1.2 ( median ) h/d or more in at least moderate activity ( Q4 vs Q1 , HR = 2.09 , 95 % CI = 1.26 - 3.49 ) but not in those spending less time ( Q4 vs Q1 , HR = 1.02 , 95 % CI = 0.62 - 1.66 ) ( P = .005 for interaction ) . CONCLUSION In older men exceeding current guidelines on physical activity , more time spent in sedentary behavior is associated with greater mortality risk Background Programs to change health behaviours have been identified as one way to reduce health inequalities experienced by disadvantaged groups . The objective of this study was to examine the effectiveness of a behaviour change programme to increase walking and reduce sedentary behaviour of adults with intellectual disabilities . Methods We used a cluster r and omised controlled design and recruited participants over 18 years old and not regularly involved in physical activity from intellectual disabilities community-based organisations . Assessment s were carried out blind to allocation . Clusters of participants were r and omly allocated to the Walk Well program or a 12-week waiting list control . Walk Well consisted of three face-to-face physical activity consultations incorporating behaviour change techniques , written re sources for participants and carers , and an individualised , structured walking programme . The primary outcome measured with accelerometers was change in mean step count per day between baseline and 12 weeks . Secondary outcomes included percentage time per day sedentary and in moderate-vigorous physical activity ( MVPA ) , body mass index ( BMI ) , and subjective well being . Results One hundred two participants in 50 clusters were r and omised . 82 ( 80.4 % ) participants completed the primary outcome . 66.7 % of participants lived in the most deprived quintile on the Scottish Index of Multiple Deprivation . At baseline , participants walked 4780 ( st and ard deviation 2432 ) steps per day , spent 65.5 % ( st and ard deviation 10.9 ) of time sedentary and 59 % percent had a body mass in the obesity range . After the walking programme , the difference between mean counts of the Walk Well and control group was 69.5 steps per day [ 95 % confidence interval ( CI ) -1054 to 1193.3 ] . There were no significant between group differences in percentage time sedentary 1.6 % ( 95 % CI −2.984 to 6.102 ) , percentage time in MVPA 0.3 % ( 95 % CI −0.7 to 1.3 ) , BMI −0.2 kg/m2 ( 95 % CI −0.8 to 0.4 ) or subjective well-being 0.3 ( 95 % CI −0.9 to 1.5 ) . Conclusions This is the first published trial of a walking program for adults with intellectual disabilities . Positively changing physical activity and sedentary behaviours may require more intensive programmes or upstream approaches to address the multiple social disadvantages experienced by adults with intellectual disabilities . Since participants spent the majority of their time sedentary , home-based programmes to reduce sitting time may be a viable health improvement approach . Trial registration Current Controlled Trials IS RCT Background Both maternal pre-pregnancy obesity and excessive gestational weight gain are increasing in prevalence and associated with a number of adverse pregnancy outcomes for both mother and child . Observational studies regarding physical activity in pregnancy have found reduced weight gain in active mothers , as well as reduced risk of adverse pregnancy outcomes . There is however a lack of high quality , r and omized controlled trials on the effects of regular exercise training in pregnancy , especially those with a pre-pregnancy body mass index ( BMI ) at or above 30 kg/m2 . Methods We are conducting a r and omised , controlled trial in Norway with two parallel arms ; one intervention group and one control group . We will enroll 150 previously sedentary , pregnant women with a pre-pregnancy BMI at or above 30 kg/m2 . The intervention group will meet for organized exercise training three times per week , starting in gestation week 14 ( range 12 - 16 ) . The control group will get st and ard antenatal care . The main outcome measure will be weight gain from baseline to delivery . Among the secondary outcome measures are changes in exercise capacity , endothelial function , physical activity level , body composition , serum markers of cardiovascular risk , incontinence , lumbopelvic pain and cardiac function from baseline to gestation week 37 ( range 36 - 38 ) . Offspring outcome measures include anthropometric variables at birth , Apgar score , as well as serum markers of inflammation and metabolism in cord blood . Discussion The results of this trial will provide knowledge about effects of regular exercise training in previously sedentary , obese pregnant women . If the program proves effective in reducing gestational weight gain and adverse pregnancy outcomes , such programs should be considered as part of routine pregnancy care for obese women . Trial Registration Clinical Trials.gov : The acute decision prompting effects of social marketing via television ( TV ) advertisements promoting physical activity  to children are unknown . This pilot study aim ed to determine the acute effects of an Australian government-sponsored TV advertisement ( called ' Get Moving ' ) , promoting more physical activity and less sedentary behaviour , on children 's choices , preferences , and ratings of liking for physical activities and sedentary behaviours . Thirty-one children aged 10 - 12 years were recruited from a single public school , and r and omised to one of two treatment groups or two control groups ( Solomon four-group design ) . Treatment participants watched an episode of The Simpsons embedded every 10min with three 30s Get Moving advertisements plus st and ard advertisements . Control participants watched the same episode plus st and ard advertisements , but without the Get Moving advertisements . The following dependent variables were assessed immediately before and /or after exposure : activity preference ( participants selected either verbally or by pointing to one of eight picture cards depicting four physical activities and four sedentary behaviours ) ; ratings of liking ( participants rated how much they liked or disliked each of these activities/behaviours either verbally or by pointing to one of nine values with an adjacent smile or frown on a Likert-type scale ) ; and time spent in physical activities was assessed by direct observation during a 10min free-time session . No significant effects or trends were seen for any of the dependent variables . Further research is needed to determine whether different content and /or higher doses of exposure to physical activity promoting advertisements are needed to influence children 's activity choices Background Sedentary behavior is defined as any waking behavior characterized by an energy expenditure of 1.5 METS or less while in a sitting or reclining posture . This study examines this definition by assessing the energy cost ( METs ) of common sitting , st and ing and walking tasks . Methods Fifty one adults spent 10 min during each activity in a variety of sitting tasks ( watching TV , Playing on the Wii , Playing on the PlayStation Portable ( PSP ) and typing ) and non-sedentary tasks ( st and ing still , walking at 0.2 , 0.4 , 0.6 , 0.8 , 1.0 , 1.2 , 1.4 , and 1.6 mph ) . Activities were completed on the same day in a r and om order following an assessment of resting metabolic rate ( RMR ) . A portable gas analyzer was used to measure oxygen uptake , and data were converted to units of energy expenditure ( METs ) . Results Average of st and ardized MET values for screen-based sitting tasks were : 1.33 ( SD : 0.24 ) METS ( TV ) , 1.41 ( SD : 0.28 ) ( PSP ) , and 1.45 ( SD : 0.32 ) ( Typing ) . The more active , yet still seated , games on the Wii yielded an average of 2.06 ( SD : 0.5 ) METS . St and ing still yielded an average of 1.59 ( SD : 0.37 ) METs . Walking MET values increased incrementally with speed from 2.17 to 2.99 ( SD : 0.5 - 0.69 ) METs . Conclusions The suggested 1.5 MET threshold for sedentary behaviors seems reasonable however some sitting based activities may be classified as non-sedentary . The effect of this on the definition of sedentary behavior and associations with metabolic health needs further investigation Background Accelerometers can obtain precise measurements of movements during the day . However , the individual activity pattern varies from day-to-day and there is limited evidence on measurement days needed to obtain sufficient reliability . The aim of this study was to examine variability in accelerometer derived data on sedentary behaviour and physical activity at work and in leisure-time during week days among Danish office employees . Methods We included control participants ( n = 135 ) from the Take a St and ! Intervention ; a cluster r and omized controlled trial conducted in 19 offices .  Sitting time and physical activity were measured using an ActiGraph GT3X+ fixed on the thigh and data were processed using Acti4 software . Variability was examined for sitting time , st and ing time , steps and time spent in moderate-to-vigorous physical activity ( MVPA ) per day by multilevel mixed linear regression modelling . Results Results of this study showed that the number of days needed to obtain a reliability of 80 % when measuring sitting time was 4.7 days for work and 5.5 days for leisure time . For physical activity at work , 4.0 days and 4.2 days were required to measure steps and MVPA , respectively . During leisure time , more monitoring time was needed to reliably estimate physical activity ( 6.8 days for steps and 5.8 days for MVPA ) . Conclusions The number of measurement days needed to reliably estimate activity patterns was greater for leisure time than for work time . The domain specific variability is of great importance to research ers and health promotion workers planning to use objective measures of sedentary behaviour and physical activity . Trial registration Clinical trials NCT01996176 OBJECTIVE Physical activity in a nonpregnant state or before pregnancy reduces the risk of  type 2 diabetes  and is also associated with reduced risk of gestational diabetes mellitus ( GDM ) . However , it is uncertain whether physical activity during pregnancy reduces the risk of GDM . DESIGN AND METHODS Using an established universal screening system in Tianjin , China , we prospect ively recruited 11 450 pregnant women within the 12th gestational week from 2010 to 2012 . These women underwent a 50-g 1-h glucose challenge test ( GCT ) at 24 - 28 weeks of gestation and a 75-g 2-h oral glucose tolerance test if GCT glucose ≥7.8mmol/L. GDM was defined according to the International Association of Diabetes and Pregnancy Study Group 's criteria .  Self-reported physical activity  in the last month was collected at GCT time using a vali date d question naire . RESULTS GDM developed in 7.3 % ( n=840 ) of the women . Women with GDM were less likely to be engaged in moderate-to-high physical activity during pregnancy than those without ( 79.8 % vs 81.6 % , P=0.191 ) .  Moderate-to-high physical  activity during pregnancy was associated with decreased risk of GDM ( multivariable odds ratio ( OR ) : 0.81 , 95 % confidence interval ( CI ) : 0.67 - 0.97 ) . Sitting at home for 2 - 4h per day and > 4h per day were associated with significantly increased risk of GDM ( multivariable OR of sitting time for 2 - 4h vs < 2h : 1.59 , 95 % CI : 1.18 - 2.15 ; OR of sitting time for > 4h vs < 2h : 1.73 , 95 % CI : 1.22 - 2.43 ) . CONCLUSIONS Increased physical activity during pregnancy was associated with reduced GDM risk , whereas sedentary lifestyle was associated with increased GDM risk among Chinese pregnant women BACKGROUND Declining physical activity is associated with a rising burden of global disease . Efforts to reverse this trend have not been successful . We aim ed to assess the efficacy of a facilitated behavioural intervention to increase the physical activity of sedentary individuals at familial risk of diabetes . METHODS We enrolled 365 sedentary adults who had a parental history of type 2 diabetes . They were recruited from either diabetes or family history registers at 20 general practice clinics in the UK . Eligible participants were r and omly assigned to one of two intervention groups , or to a comparison group . All participants were posted a brief advice leaflet . One intervention group was offered a 1-year behaviour-change programme , to be delivered by trained facilitators in participants ' homes , and the other the same programme by telephone . The programme was design ed to alter behavioural determinants , as defined by the theory of planned behaviour , and to teach behaviour-change strategies . The principal outcome at 1 year was daytime physical activity , which was objective ly measured as a ratio to resting energy expenditure . Analysis was by intention to treat . This study is registered as IS RCT N61323766 . FINDINGS Of 365 patients , we analysed primary endpoints for 321 ( 88 % ) for whom we had data after 1 year of follow-up . At 1 year , the physical-activity ratio of participants who received the intervention , by either delivery route , did not differ from the ratio in those who were given a brief advice leaflet . The mean difference in daytime physical-activity ratio , adjusted for baseline , was -0.04 ( 95 % CI -0.16 to 0.08 ) . The physical-activity ratio did not differ between participants who were delivered the intervention face-to-face or by telephone ( mean difference -0.05 ; 95 % CI -0.19 to 0.10 ) . INTERPRETATION A facilitated theory-based behavioural intervention was no more effective than an advice leaflet for promotion of physical activity in an at-risk group ; therefore health-care providers should remain cautious about commissioning behavioural programmes into individual preventive health-care services Background Many adults are insufficiently physically active , have prolonged sedentary behaviour and report poor sleep . These behaviours can be improved by interventions that include education , goal setting , self-monitoring , and feedback strategies . Few interventions have explicitly targeted these behaviours simultaneously or examined the relative efficacy of different self-monitoring methods . Methods / Design This study aims to compare the efficacy of two self-monitoring methods in an app-based multi-behaviour intervention to improve objective ly measured physical activity , sedentary , and sleep behaviours , in a 9 week 2–arm r and omised trial . Participants will be adults ( n = 64 ) who report being physically inactive , sitting > 8 h/day and frequent insufficient sleep ( ≥14 days out of last 30 ) . The “ Balanced ” intervention is delivered via a smartphone ‘ app ’ , and includes education material s ( guidelines , strategies to promote change in behaviour ) , goal setting , self-monitoring and feedback support . Participants will be r and omly allocated to either a device-entered or user-entered self-monitoring method . The device-entered group will be provided with a activity tracker to self-monitor behaviours . The user-entered group will recall and manually record behaviours . Assessment s will be conducted at 0 , 3 , 6 , and 9 weeks . Physical activity , sedentary behaviour and sleep-wake behaviours will be measured using the wrist worn Geneactiv accelerometer . Linear mixed models will be used to examine differences between groups and over time using an alpha of 0.01 . Discussion This study will evaluate an app-based multi-behavioural intervention to improve physical activity , sedentary behaviour and sleep ; and the relative efficacy of two different approaches to self-monitoring these behaviours . Outcomes will provide information to inform future interventions and self-monitoring targeting these behaviours . Trial registration ACTRN12615000182594 ( Australian New Zeal and Clinical Trials Registry . Registry URL : www.anzctr.org.au ; registered prospect ively on 25 February 2015 )
Increased time in sedentary behaviour was significantly associated with higher levels of C Reactive Protein and LDL Cholesterol , and a larger newborn abdominal circumference .
Discrepancies were found in associations of sedentary behaviour with gestational weight gain , hypertensive disorders , and birth weight .
No consistent associations were found between sedentary behaviour and other variables such as gestational diabetes .
Conclusions Our review highlights the significant time spent in sedentary behaviour during pregnancy , and that sedentary behaviour may impact on pregnancy outcomes for both mother and child .
Background In the general population , at least 50 % of time awake is spent in sedentary behaviours .
Sedentary behaviours are activities that expend less energy than 1.5 metabolic equivalents , such as sitting .
The amount of time spent in sedentary behaviours is a risk factor for diseases such as type 2 diabetes , cardiovascular disease , and death from all causes .
Even individuals meeting physical activity guidelines are at a higher risk of premature death and adverse metabolic outcomes if they sit for extended intervals .
The associations between sedentary behaviour with type 2 diabetes and with impaired glucose tolerance are stronger for women than for men .
It is not known whether sedentary behaviour in pregnancy influences pregnancy outcomes , but if those negative outcomes observed in general adult population also occur in pregnancy , this could have implication s for adverse outcomes for mothers and offspring .
We aim ed to determine the proportion of time spent in sedentary behaviours among pregnant women , and the association of sedentary behaviour with pregnancy outcomes in mothers and offspring .