Substituting prolonged sedentary time and cardiovascular risk in children and youth: a meta-analysis within the International Children's Accelerometry database (ICAD)

Katrien Wijndaele; Thomas White; Lars Bo Andersen; Anna Bugge; Elin Kolle; Kate Northstone; Niels Wedderkopp; Mathias Ried-Larsen; S. Kriemler; Angie S. Page; Jardena J. Puder; John J. Reilly; Luis B. Sardinha; E. M. F. van Sluijs; Stephen J. Sharp; Soren Brage; U. Ekelund; A. J. Atkin; G. Cardon; R. Davey; U. Ekelund; D. W. Esliger; P. Hallal; B. H. Hansen; K. F. Janz; S. Kriemler; N. Moller; A. Page; R. Pate; J. J. Puder; J. Salmon; L. B. Sherar; A. Timperio; E. M. F. van Sluijs

doi:10.1186/s12966-019-0858-6

Substituting prolonged sedentary time and cardiovascular risk in children and youth: a meta-analysis within the International Children's Accelerometry database (ICAD)

Katrien Wijndaele, Thomas White, Lars Bo Andersen, Anna Bugge, Elin Kolle, Kate Northstone, Niels Wedderkopp, Mathias Ried-Larsen, S. Kriemler, Angie S. Page, Jardena J. Puder, John J. Reilly, Luis B. Sardinha, E. M. F. van Sluijs, Stephen J. Sharp, Soren Brage, U. Ekelund, A. J. Atkin, G. Cardon, R. DaveyU. Ekelund, D. W. Esliger, P. Hallal, B. H. Hansen, K. F. Janz, S. Kriemler, N. Moller, A. Page, R. Pate, J. J. Puder, J. Salmon, L. B. Sherar, A. Timperio, E. M. F. van Sluijs

Health Research Institute

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Abstract

Background Evidence on the association between sitting for extended periods (i.e. prolonged sedentary time (PST)) and cardio-metabolic health is inconsistent in children. We aimed to estimate the differences in cardio-metabolic health associated with substituting PST with non-prolonged sedentary time (non-PST), light (LIPA) or moderate-to-vigorous physical activity (MVPA) in children. Methods Cross-sectional data from 14 studies (7 countries) in the International Children's Accelerometry Database (ICAD, 1998-2009) was included. Accelerometry in 19,502 participants aged 3-18 years, together with covariate and outcome data, was pooled and harmonized. Iso-temporal substitution in linear regression models provided beta coefficients (95%CI) for substitution of 1 h/day PST (sedentary time accumulated in bouts > 15 min) with non-PST, LIPA or MVPA, for each study, which were meta-analysed. Results Modelling substitution of 1 h/day of PST with non-PST suggested reductions in standardized BMI, but estimates were > 7-fold greater for substitution with MVPA (- 0.44 (- 0.62; - 0.26) SD units). Only reallocation by MVPA was beneficial for waist circumference (- 3.07 (- 4.47; - 1.68) cm), systolic blood pressure (- 1.53 (- 2.42; - 0.65) mmHg) and clustered cardio-metabolic risk (- 0.18 (- 0.3; - 0.1) SD units). For HDL-cholesterol and diastolic blood pressure, substitution with LIPA was beneficial; however, substitution with MVPA showed 5-fold stronger effect estimates (HDL-cholesterol: 0.05 (0.01; 0.10) mmol/l); diastolic blood pressure: - 0.81 (- 1.38; - 0.24) mmHg). Conclusions Replacement of PST with MVPA may be the preferred scenario for behaviour change, given beneficial associations with a wide range of cardio-metabolic risk factors (including adiposity, HDL-cholesterol, blood pressure and clustered cardio-metabolic risk). Effect estimates are clinically relevant (e.g. an estimated reduction in waist circumference of approximate to 1.5 cm for 30 min/day replacement). Replacement with LIPA could be beneficial for some of these risk factors, however with substantially lower effect estimates.

Original language	English
Article number	96
Pages (from-to)	1-10
Number of pages	10
Journal	International Journal of Behavioral Nutrition and Physical Activity
Volume	16
Issue number	1
DOIs	https://doi.org/10.1186/s12966-019-0858-6
Publication status	Published - 31 Oct 2019

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Wijndaele, K., White, T., Andersen, L. B., Bugge, A., Kolle, E., Northstone, K., Wedderkopp, N., Ried-Larsen, M., Kriemler, S., Page, A. S., Puder, J. J., Reilly, J. J., Sardinha, L. B., van Sluijs, E. M. F., Sharp, S. J., Brage, S., Ekelund, U., Atkin, A. J., Cardon, G., ... van Sluijs, E. M. F. (2019). Substituting prolonged sedentary time and cardiovascular risk in children and youth: a meta-analysis within the International Children's Accelerometry database (ICAD). International Journal of Behavioral Nutrition and Physical Activity, 16(1), 1-10. [96]. https://doi.org/10.1186/s12966-019-0858-6

@article{872ab57dc0ad4fb89725e8e86ae039b5,

title = "Substituting prolonged sedentary time and cardiovascular risk in children and youth: a meta-analysis within the International Children's Accelerometry database (ICAD)",

abstract = "Background Evidence on the association between sitting for extended periods (i.e. prolonged sedentary time (PST)) and cardio-metabolic health is inconsistent in children. We aimed to estimate the differences in cardio-metabolic health associated with substituting PST with non-prolonged sedentary time (non-PST), light (LIPA) or moderate-to-vigorous physical activity (MVPA) in children. Methods Cross-sectional data from 14 studies (7 countries) in the International Children's Accelerometry Database (ICAD, 1998-2009) was included. Accelerometry in 19,502 participants aged 3-18 years, together with covariate and outcome data, was pooled and harmonized. Iso-temporal substitution in linear regression models provided beta coefficients (95%CI) for substitution of 1 h/day PST (sedentary time accumulated in bouts > 15 min) with non-PST, LIPA or MVPA, for each study, which were meta-analysed. Results Modelling substitution of 1 h/day of PST with non-PST suggested reductions in standardized BMI, but estimates were > 7-fold greater for substitution with MVPA (- 0.44 (- 0.62; - 0.26) SD units). Only reallocation by MVPA was beneficial for waist circumference (- 3.07 (- 4.47; - 1.68) cm), systolic blood pressure (- 1.53 (- 2.42; - 0.65) mmHg) and clustered cardio-metabolic risk (- 0.18 (- 0.3; - 0.1) SD units). For HDL-cholesterol and diastolic blood pressure, substitution with LIPA was beneficial; however, substitution with MVPA showed 5-fold stronger effect estimates (HDL-cholesterol: 0.05 (0.01; 0.10) mmol/l); diastolic blood pressure: - 0.81 (- 1.38; - 0.24) mmHg). Conclusions Replacement of PST with MVPA may be the preferred scenario for behaviour change, given beneficial associations with a wide range of cardio-metabolic risk factors (including adiposity, HDL-cholesterol, blood pressure and clustered cardio-metabolic risk). Effect estimates are clinically relevant (e.g. an estimated reduction in waist circumference of approximate to 1.5 cm for 30 min/day replacement). Replacement with LIPA could be beneficial for some of these risk factors, however with substantially lower effect estimates.",

keywords = "ICAD, ALSPAC, Prolonged sitting, Cardio-metabolic, Iso-temporal, Physical activity",

author = "Katrien Wijndaele and Thomas White and Andersen, {Lars Bo} and Anna Bugge and Elin Kolle and Kate Northstone and Niels Wedderkopp and Mathias Ried-Larsen and S. Kriemler and Page, {Angie S.} and Puder, {Jardena J.} and Reilly, {John J.} and Sardinha, {Luis B.} and {van Sluijs}, {E. M. F.} and Sharp, {Stephen J.} and Soren Brage and U. Ekelund and Atkin, {A. J.} and G. Cardon and R. Davey and U. Ekelund and Esliger, {D. W.} and P. Hallal and Hansen, {B. H.} and Janz, {K. F.} and S. Kriemler and N. Moller and A. Page and R. Pate and Puder, {J. J.} and J. Salmon and Sherar, {L. B.} and A. Timperio and {van Sluijs}, {E. M. F.}",

note = "Funding Information: This work was supported by the National Prevention Research Initiative [grant number: G0701877] (http://www.mrc.ac.uk/research/initiatives/ national-prevention-research-initiative-npri/). The funding partners relevant to this award are: British Heart Foundation; Cancer Research UK; Department of Health; Diabetes UK; Economic and Social Research Council; Medical Research Council; Research and Development Office for the Northern Ireland Health and Social Services; Chief Scientist Office; Scottish Executive Health Department; The Stroke Association; Welsh Assembly Government and World Cancer Research Fund. This work was additionally supported by the Medical Research Council [grant numbers MC_UU_12015/3, MC_UU_12015/7], The Research Council of Norway [grant number 249932/F20], Bristol University, Loughborough University and Norwegian School of Sport Sciences. We also gratefully acknowledge the contribution of Prof Chris Riddoch, Prof Ken Judge, Prof Ashley Cooper and Dr. Pippa Griew to the development of ICAD. This work was further supported by a British Heart Foundation Intermediate Basic Science Research Fellowship [grant number FS/12/58/29709]. Publisher Copyright: {\textcopyright} 2019 The Author(s).",

year = "2019",

month = oct,

day = "31",

doi = "10.1186/s12966-019-0858-6",

language = "English",

volume = "16",

pages = "1--10",

journal = "International Journal of Behavioral Nutrition and Physical Activity",

issn = "1479-5868",

publisher = "BioMed Central",

number = "1",

}

Wijndaele, K, White, T, Andersen, LB, Bugge, A, Kolle, E, Northstone, K, Wedderkopp, N, Ried-Larsen, M, Kriemler, S, Page, AS, Puder, JJ, Reilly, JJ, Sardinha, LB, van Sluijs, EMF, Sharp, SJ, Brage, S, Ekelund, U, Atkin, AJ, Cardon, G, Davey, R, Ekelund, U, Esliger, DW, Hallal, P, Hansen, BH, Janz, KF, Kriemler, S, Moller, N, Page, A, Pate, R, Puder, JJ, Salmon, J, Sherar, LB, Timperio, A & van Sluijs, EMF 2019, 'Substituting prolonged sedentary time and cardiovascular risk in children and youth: a meta-analysis within the International Children's Accelerometry database (ICAD)', International Journal of Behavioral Nutrition and Physical Activity, vol. 16, no. 1, 96, pp. 1-10. https://doi.org/10.1186/s12966-019-0858-6

Substituting prolonged sedentary time and cardiovascular risk in children and youth: a meta-analysis within the International Children's Accelerometry database (ICAD). / Wijndaele, Katrien; White, Thomas; Andersen, Lars Bo et al.
In: International Journal of Behavioral Nutrition and Physical Activity, Vol. 16, No. 1, 96, 31.10.2019, p. 1-10.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Substituting prolonged sedentary time and cardiovascular risk in children and youth

T2 - a meta-analysis within the International Children's Accelerometry database (ICAD)

AU - Wijndaele, Katrien

AU - White, Thomas

AU - Andersen, Lars Bo

AU - Bugge, Anna

AU - Kolle, Elin

AU - Northstone, Kate

AU - Wedderkopp, Niels

AU - Ried-Larsen, Mathias

AU - Kriemler, S.

AU - Page, Angie S.

AU - Puder, Jardena J.

AU - Reilly, John J.

AU - Sardinha, Luis B.

AU - van Sluijs, E. M. F.

AU - Sharp, Stephen J.

AU - Brage, Soren

AU - Ekelund, U.

AU - Atkin, A. J.

AU - Cardon, G.

AU - Davey, R.

AU - Ekelund, U.

AU - Esliger, D. W.

AU - Hallal, P.

AU - Hansen, B. H.

AU - Janz, K. F.

AU - Kriemler, S.

AU - Moller, N.

AU - Page, A.

AU - Pate, R.

AU - Puder, J. J.

AU - Salmon, J.

AU - Sherar, L. B.

AU - Timperio, A.

AU - van Sluijs, E. M. F.

N1 - Funding Information: This work was supported by the National Prevention Research Initiative [grant number: G0701877] (http://www.mrc.ac.uk/research/initiatives/ national-prevention-research-initiative-npri/). The funding partners relevant to this award are: British Heart Foundation; Cancer Research UK; Department of Health; Diabetes UK; Economic and Social Research Council; Medical Research Council; Research and Development Office for the Northern Ireland Health and Social Services; Chief Scientist Office; Scottish Executive Health Department; The Stroke Association; Welsh Assembly Government and World Cancer Research Fund. This work was additionally supported by the Medical Research Council [grant numbers MC_UU_12015/3, MC_UU_12015/7], The Research Council of Norway [grant number 249932/F20], Bristol University, Loughborough University and Norwegian School of Sport Sciences. We also gratefully acknowledge the contribution of Prof Chris Riddoch, Prof Ken Judge, Prof Ashley Cooper and Dr. Pippa Griew to the development of ICAD. This work was further supported by a British Heart Foundation Intermediate Basic Science Research Fellowship [grant number FS/12/58/29709]. Publisher Copyright: © 2019 The Author(s).

PY - 2019/10/31

Y1 - 2019/10/31

N2 - Background Evidence on the association between sitting for extended periods (i.e. prolonged sedentary time (PST)) and cardio-metabolic health is inconsistent in children. We aimed to estimate the differences in cardio-metabolic health associated with substituting PST with non-prolonged sedentary time (non-PST), light (LIPA) or moderate-to-vigorous physical activity (MVPA) in children. Methods Cross-sectional data from 14 studies (7 countries) in the International Children's Accelerometry Database (ICAD, 1998-2009) was included. Accelerometry in 19,502 participants aged 3-18 years, together with covariate and outcome data, was pooled and harmonized. Iso-temporal substitution in linear regression models provided beta coefficients (95%CI) for substitution of 1 h/day PST (sedentary time accumulated in bouts > 15 min) with non-PST, LIPA or MVPA, for each study, which were meta-analysed. Results Modelling substitution of 1 h/day of PST with non-PST suggested reductions in standardized BMI, but estimates were > 7-fold greater for substitution with MVPA (- 0.44 (- 0.62; - 0.26) SD units). Only reallocation by MVPA was beneficial for waist circumference (- 3.07 (- 4.47; - 1.68) cm), systolic blood pressure (- 1.53 (- 2.42; - 0.65) mmHg) and clustered cardio-metabolic risk (- 0.18 (- 0.3; - 0.1) SD units). For HDL-cholesterol and diastolic blood pressure, substitution with LIPA was beneficial; however, substitution with MVPA showed 5-fold stronger effect estimates (HDL-cholesterol: 0.05 (0.01; 0.10) mmol/l); diastolic blood pressure: - 0.81 (- 1.38; - 0.24) mmHg). Conclusions Replacement of PST with MVPA may be the preferred scenario for behaviour change, given beneficial associations with a wide range of cardio-metabolic risk factors (including adiposity, HDL-cholesterol, blood pressure and clustered cardio-metabolic risk). Effect estimates are clinically relevant (e.g. an estimated reduction in waist circumference of approximate to 1.5 cm for 30 min/day replacement). Replacement with LIPA could be beneficial for some of these risk factors, however with substantially lower effect estimates.

AB - Background Evidence on the association between sitting for extended periods (i.e. prolonged sedentary time (PST)) and cardio-metabolic health is inconsistent in children. We aimed to estimate the differences in cardio-metabolic health associated with substituting PST with non-prolonged sedentary time (non-PST), light (LIPA) or moderate-to-vigorous physical activity (MVPA) in children. Methods Cross-sectional data from 14 studies (7 countries) in the International Children's Accelerometry Database (ICAD, 1998-2009) was included. Accelerometry in 19,502 participants aged 3-18 years, together with covariate and outcome data, was pooled and harmonized. Iso-temporal substitution in linear regression models provided beta coefficients (95%CI) for substitution of 1 h/day PST (sedentary time accumulated in bouts > 15 min) with non-PST, LIPA or MVPA, for each study, which were meta-analysed. Results Modelling substitution of 1 h/day of PST with non-PST suggested reductions in standardized BMI, but estimates were > 7-fold greater for substitution with MVPA (- 0.44 (- 0.62; - 0.26) SD units). Only reallocation by MVPA was beneficial for waist circumference (- 3.07 (- 4.47; - 1.68) cm), systolic blood pressure (- 1.53 (- 2.42; - 0.65) mmHg) and clustered cardio-metabolic risk (- 0.18 (- 0.3; - 0.1) SD units). For HDL-cholesterol and diastolic blood pressure, substitution with LIPA was beneficial; however, substitution with MVPA showed 5-fold stronger effect estimates (HDL-cholesterol: 0.05 (0.01; 0.10) mmol/l); diastolic blood pressure: - 0.81 (- 1.38; - 0.24) mmHg). Conclusions Replacement of PST with MVPA may be the preferred scenario for behaviour change, given beneficial associations with a wide range of cardio-metabolic risk factors (including adiposity, HDL-cholesterol, blood pressure and clustered cardio-metabolic risk). Effect estimates are clinically relevant (e.g. an estimated reduction in waist circumference of approximate to 1.5 cm for 30 min/day replacement). Replacement with LIPA could be beneficial for some of these risk factors, however with substantially lower effect estimates.

KW - ICAD

KW - ALSPAC

KW - Prolonged sitting

KW - Cardio-metabolic

KW - Iso-temporal

KW - Physical activity

UR - http://www.scopus.com/inward/record.url?scp=85074645497&partnerID=8YFLogxK

U2 - 10.1186/s12966-019-0858-6

DO - 10.1186/s12966-019-0858-6

M3 - Article

SN - 1479-5868

VL - 16

SP - 1

EP - 10

JO - International Journal of Behavioral Nutrition and Physical Activity

JF - International Journal of Behavioral Nutrition and Physical Activity

IS - 1

M1 - 96

ER -

Substituting prolonged sedentary time and cardiovascular risk in children and youth: a meta-analysis within the International Children's Accelerometry database (ICAD)

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