COMMENTARY

Sedentary Behavior: Emerging Evidence for a New Health Risk

El sedentarismo es un factor predictivo para numerosas enfermedades. El objetivo de este estudio fue valorar la evolución de la prevalencia de sedentarismo en la población española adulta entre los años 1987-2020.

Las fuentes de datos fueron las Encuestas Nacionales y Europeas de Salud. La prevalencia de sedentarismo se valoró en 3 escenarios (actividad principal, tiempo libre y todos los escenarios). Se estimaron prevalencias de sedentarismo global, por sexo y grupo de edad. En todos los escenarios la prevalencia también se estimó por comunidad autónoma. La tendencia de las prevalencias se analizó con los porcentajes de cambio anual (PCA) obtenidos a través de modelos joinpoint.

La prevalencia de sedentarismo en la actividad principal varió entre el 31,2% en 1987 y el 38,4% en 2020 (PCA: 0,7 [0,5 a 1,0]), siendo mayor en los varones que en las mujeres, y más elevada en los más jóvenes y en los más mayores. La prevalencia de sedentarismo en el tiempo libre varió entre el 55,1% en 1993 y el 36,4% en 2020 (PCA: −1,4 [−1,9 a −0,9]), siendo siempre superior en las mujeres, más alta en los mayores de 64 años y menor en los de 16-24 años. Cantabria y Canarias fueron las comunidades autónomas con la prevalencia de sedentarismo más baja en todos los escenarios.

La prevalencia de sedentarismo en la actividad principal está aumentando en España, mientras que durante el tiempo libre está descendiendo. Es importante aplicar medidas de prevención y promoción de la salud dirigidas a disminuir el sedentarismo en la población.

Sedentary behavior is a predictive factor for numerous diseases. The objective of this study was to assess the evolution of the prevalence of sedentary behavior in the Spanish adult population between 1987 and 2020.

The data sources were the National and European Health Surveys. The prevalence of sedentary behavior was assessed in three scenarios (main activity, leisure time and all scenarios). Prevalence of sedentary behavior was estimated overall, by sex and age group. In all scenarios, prevalence was also estimated by Autonomous Community. The prevalence trend was analyzed with the annual percent change (APC) obtained through joinpoint models.

The prevalence of sedentary in the main activity ranged from 31.2% in 1987 to 38.4% in 2020 [PCA: 0.7 (0.5-1.0)], being higher in men than in women and higher in younger and older people. The prevalence of sedentary in the leisure time varied between 55.1% in 1993 and 36.4% in 2020 [PCA: −1.4 (−1.9 to −0.9)], being always higher in women, higher in those over 64 years of age and lower in those aged 16–24 years. Cantabria and the Canary Islands were the Autonomous Communities with the lowest prevalence of sedentary behavior in all scenarios.

The prevalence of sedentary behavior in the main activity is increasing in Spain, whereas during leisure time it is decreasing. It is important to implement prevention and health promotion measures aimed at reducing sedentary behavior in the population.

Metabolic syndrome (MetS) is a precursor to cardiovascular diseases and type 2 diabetes. Existing MetS prediction models relied heavily on biochemical measures and those based on non-invasive predictors such as lifestyle behaviours were limited. We aim to (1) develop a weighted lifestyle risk index for MetS and (2) externally validate this index using two Asian-based cohorts in Singapore.

Using data from the Multi-Ethnic Cohort (MEC) 1 (n = 2873, 41% male), multiple logistic regression was used to identify predictors associated with MetS. A weighted lifestyle risk index was generated using coefficients of the selected predictors in the development cohort (MEC1). Subsequently, the performance of the lifestyle risk index in predicting the occurrence of MetS within 10 years was assessed by discrimination and calibration in an external validation cohort (MEC2) (n = 6070, 43% male).

A lifestyle risk index for MetS with nine predictors was developed (age, sex, ethnicity, having a family history of diabetes, BMI, diet, physical activity, smoking status, and screen time). This index demonstrated acceptable discrimination in the development cohort [AUC (95% CI) = 0.74 (0.71, 0.76)] and the validation cohort [AUC (95% CI) = 0.79 (0.77, 0.81)].

This lifestyle risk index exhibits potential for risk stratification in population-based screening programmes. Future research could apply a similar methodology to develop disease-specific lifestyle risk indices using nationwide registry-based data.

Hypertension is closely associated with an inactive lifestyle. Physical activity and/or exercise have been shown to delay the development of hypertension. This study aimed to assess the level of physical activity and sedentary time, and its determinants among Moroccan Hypertensive patients.

A cross-sectional study was conducted between March and July 2019 including 680 hypertensive patients. We administered international physical activity questionnaire in face-to-face interview to assess the level of physical activity and sedentary time.

The results showed that only 43.4% of participants met recommended physical activity levels (≥ 600 MET min/week). Adherence to physical activity recommendations was observed more in male participants (p = 0.035), in participants aged less than 40 years (p = 0.040) and those aged between 41 and 50 years (p = 0.047). The average sedentary time was 37.19 ± 18.92 hours per week. This time was significantly longer in people aged 51 and over, in married, divorced, and widowed people, and in those with low levels of physical activity.

The level of physical inactivity and the sedentary time was high. In addition, participants with a high-level sedentary lifestyle had a low level of physical activity. Educational actions should be undertaken among this group of participants to prevent the risks associated with inactivity and sedentary behavior.

L'hypertension artérielle est étroitement associée à un mode de vie inactif. Il a été démontré que l'activité et/ou l'exercice physique, retardent le développement de l'hypertension. Cette étude visait à évaluer le niveau d'activité physique et le temps de sédentarité, et ses déterminants chez les patients hypertendus marocains.

Une étude transversale a été menée entre mars et juillet 2019 incluant 680 patients hypertendus. Nous avons administré le questionnaire international sur l'activité physique lors d'un entretien en face à face pour évaluer le niveau d'activité physique et le temps de sédentarité.

Les résultats ont montré que seulement 43,4 % des participants respectaient les niveaux d'activité physique recommandés (≥ 600 MET min/semaine). L'adhésion aux recommandations d'activité physique a été observée davantage chez les participants masculins (p = 0,035), chez les participants âgés de moins de 40 ans (p = 0,040) et ceux âgés entre 41 et 50 ans (p = 0,047). Le temps sédentaire moyen était de 37,19 ± 18,92 heures par semaine. Ce temps était significativement plus long chez les personnes âgées de 51 ans et plus, chez les personnes mariées, divorcées et veuves, et chez celles ayant un faible niveau d'activité physique.

Le niveau d'inactivité physique et le temps de sédentarité étaient élevés. En outre, les participants ayant un mode de vie sédentaire élevé avaient un faible niveau d'activité physique. Des actions éducatives devraient être entreprises auprès de ce groupe de participants pour prévenir les risques liés à l'inactivité et aux comportements sédentaires.

High sedentary behaviour is associated with adverse effects on central vascular function and cognitive function. Although interventions to mitigate the adverse effects of workplace sitting are intriguing, evidence of the efficacy of such interventions remains lacking. This randomised cross-over trial was aimed at exploring the effectiveness of prolonged sitting, with or without physical activity breaks, on central, peripheral vascular and cognitive function in adults.

Twenty one healthy adults completed 4 h of simulated work conditions in three experimental visits: (1) uninterrupted sitting (SIT); (2) sitting interrupted by 3 min of walking every hour (LIT); and (3) sitting interrupted by 3 min of stair climbing every hour (MIT). Carotid (CA) and superficial femoral artery (SFA) diameter, velocity, shear rate and blood flow were measured with Duplex ultrasound at 50 MHz at three time points (hours 0, 2 and 4), and executive function was assessed with the computer based Eriksen Flanker task every hour.

The decreases in reaction time (−30.59%) and accuracy (−10.56%) during SIT conditions were statistically significant, and less of a decrease was observed under LIT and MIT conditions. No significant differences in CA and SFA function were observed with LIT and MIT interventions.

Physical activity breaks of varying intensity during prolonged sitting improve reaction time. However, the vascular benefits of physical activity breaks should be confirmed in the future through long term studies in natural environment.

The prevalent sedentary lifestyle of adults has led to decreased physical activity and increased health risks. We aimed to investigate the effects of Ishige okamurae extract (IO) and its active compound diphlorethohydroxycarmalol (DPHC) on muscle characteristics of physically inactive adult male mice. IO and DPHC supplementation did not lead to significant male hormonal imbalance in adult sedentary mice. However, they significantly increased muscle strength and hypertrophy in four major muscle groups. Furthermore, IO and DPHC treatment upregulated the expression of oxidative phosphorylation chain enzyme complexes in the muscle tissue, indicating enhanced mitochondrial activity. Thus, IO and DPHC exert positive effects on muscle health and function by improving mitochondrial function in physically inactive adult mice. Algal consumption can improve muscle-related indicators and prevent muscle deterioration in sedentary individuals. Understanding the mechanisms underlying these effects could provide valuable insights for developing interventions to enhance muscle health in individuals with limited physical activity.

Non-operative management is common for low-impact pelvic fractures. In this study, we characterize the epidemiology of those treated nonoperatively following low-energy pelvic fracture, while identifying recent management trends.

Data from the Nationwide Inpatient Sample (NIS) database from 2011 to 2018 were analyzed. We identified adult patients diagnosed with pelvic fracture based on International Classification of Diseases (ICD) codes, excluding fractures of the acetabulum, femur, polytrauma, and open fractures to isolate cases caused by low-impact mechanisms. Codes indicating operative management were excluded. Demographic information and outcomes (length of stay, in-hospital mortality, hospital discharge status) were collected. Sub-analyses were performed to identify trends.

123,936 eligible patients were identified. The average age was 68.7 years. 70% were female, showing a decline from 75% to 66% over the study period. Pubic bone involvement was observed in 59% of fractures. The mean Charlson Comorbidity Index (CCI) was 3.83, corresponding to a 10-year survival rate of 58.5%, which remained relatively stable throughout the study period. 62.4% of patients received treatment at urban teaching hospitals. Average length of hospital stay was 6.3 days. Discharge to a skilled nursing facility (SNF) was the most common outcome, ranging from 62.1% to 65.0% during the study period, while 20.0% of patients were discharged home (18.4%–21.1%). Mean in-hospital mortality was 3.28%, showing no significant change, with higher rates among male patients (5.1%) and patients of Asian descent (3.8%).

The majority of patients receiving nonoperative treatment for low-energy pelvic fractures were females in their mid-60s with moderate comorbidity. The study reveals a relatively high in-hospital mortality rate of 3.28%, particularly among male patients and those of Asian descent, indicating the need for increased surveillance for further injury in these groups. Most patients were discharged to a SNF, highlighting the necessity for extended rehabilitation in this population. This persistent trend is noteworthy considering the growing emphasis on the cost of inpatient admissions and advancements in outpatient management of orthopedic injuries.