What is sedentary behaviour?

Any waking activity characterized by an energy expenditure ≤ 1.5 METs, and a sitting or reclining

posture.

sleep sedentary behaviour LPA moderate physical activity intense exercise METS - +

Sedentary Physiology

Exercise Physiology

The Movement Continuum

Well researched NOT Well researched

Why focus on Sedentary Behaviour?

• Physical inactivity is the fourth leading cause of death worldwide

• 2011 CMO guidelines for physical activity and older people to improve public health recommend breaking up prolonged periods of sitting

• “All Older adults should minimise the amount of time spent being sedentary (sitting) for extended periods”

CMO, Start Active Stay Active, 2011

An Active Day?

6 hours

30 min

30 min

30 min

4 hours

YES ! But 12 hours

sitting! 30 min

1 hour

• Sedentary Behaviour has been linked to frailty, mortality and chronic health problems.

• Also, likely to effect: – Function – Quality of Life – Social Inclusion and Engagement

• Older adults are the most sedentary sector of the population.

What does this mean?

0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

1.8

25% 50% 75% 100%

36% 54%

Katzmarzyk et al., 2009. MSSE

Risk

of D

eath

% Time Spent Sitting

11%

SB as an independent risk factor

Sedentary Behaviour & Chronic Disease

Wilmot et al., 2012 (Diabetologia)

Bone Health & Sedentary behaviour • Longer time spent sitting (objectively measured) is associated

with lower femoral bone mineral density (BMD) in post-menopausal women.

– longer duration of sitting bouts, as opposed to sitting bout frequency.

• This effect is distinct from lack of engagement in physical activity and independent of total level of moderate and vigorous physical activity (MVPA) in women.

• Men, however, can reduce the effect of sitting by spending more time in MVPA.

Chastin, Mandrichenko, Skelton, Bone, 2014, in press

Sedentary Behaviour Active bone and strength loss

● No standing activity leads to active loss of

bone and muscle

● 1 wk bed rest ⇓ leg strength by ~ 20%

● 1 wk bed rest ⇓ spine BMD by ~1%

● Avoid bed rest!

● Nursing home residents spend 80-90% of

their time seated or lying down

Krolner 1983; Tinetti 1988; Skelton 2001; Beyer 2002

Are we doing harm to older patients?

Older people on wards Community Dwelling older people

Grant PM et al. J Aging Phys Act 2010

How long do older people sit for?

0

2

4

6

8

10

12

Self Report:Sitting

Self Report: TV Self Report:Screen

Accelerometry

Hou

rs P

er D

ay

MaleFemale

No significant difference ♀♂

Significant difference between subjective report of “sitting”

and objective report by accelerometry.

Harvey, Chastin, Skelton, In press

2014

Sedentary Behaviour and Increasing Age

0

2

4

6

8

10

12

14

60-64 65-69 70-74 75-79 80-84 85-89 90-94 > 95

Hou

rs D

aily

Age Group

TV

Sitting

Accelerometry

Harvey, Chastin, Skelton, In press

2014

Prevalence of Sitting in Older Adults

0

20

40

60

80

100

> 3 >4 >5 >6 >7 >8 >9 >11

% P

opul

atio

n

Hours

N = 661,125

Harvey, Chastin, Skelton, IJERPH, 2013

TV viewing by Time Sections

55%

45%

TV Watching by OA Over/Under 2hrs

TV Watching Over 2hrs

TV Watching Under 2hrs

N = 350,419

21%

79%

TV Watched by OA Over/Under 4hrs

TV Watching Over 4 Hrs

TV Watching Under 4 Hrs

N = 257, 321

compared to < 2hrs, > 4hrs TV viewing = 46% risk of all cause mortality

and 80% increased risk with CVD mortality.

This is independent to traditional risk factors

(Dunstan, et al., 2010).

Harvey, Chastin, Skelton, In press

2014

Cost of Sedentary Behaviour • High levels of sedentary behaviour are associated

with poor health, regardless of how physically active a person is at other points in the day.

• In the UK, the estimated direct cost of physical inactivity to the NHS is £10 billion.

• The draft Scottish Charter for Physical Activity reports an economic benefit of £85.2 million if the number of inactive Scots was reduced by 1% each year for the next five years.

CMO, Start Active Stay Active, 2011

Seniors USP: Seniors - Understanding Sedentary Patterns

PI: Dawn Skelton £ 817,140 01 May 2014 – 36 months MRC Reference: MR/K025023/1

Multidisciplinary Co-Investigators Who Where What

Dr Sebastien Chastin Dr Philippa Dall

Glasgow Caledonian University Statistician/Physiotherapist Bioengineer

Prof Ian Deary Prof Nanette Mutrie Dr Catharine Gale Dr Claire Fitzsimons Dr Gillian Mead Prof John Starr

University of Edinburgh Psychiatrist Exercise Science / Psychologist Epidemiologist Physiologist Geriatrician / Stoke Geriatrician / Dementia & LD

Dr Geoff Der MRC Social and Public Health Sciences

Statistician

Prof Sally Wyke Dr Jason Gill Prof Naveed Sattar Dr Cindy Gray

University of Glasgow

Health Care Researcher / GP Sports Sciences Endocrinologist / Biochemist Psychologist

Dr Carolyn Greig University of Birmingham Physiologist

Prof Malcolm Granat University of Salford Bioengineer

Aim (s) of Seniors USP To better understand the determinants and effects of activity behaviour, especially sedentary behaviour, in older people in order to inform future interventions

Which questions are best to measure sedentary behaviour in older people?

How do past individual, social and environmental factors affect sedentary behaviour now?

What do older people think about sedentary behaviour and how might we intervene?

Objectives: WP1

to provide recommendations for the development and tailoring of guidelines and interventions to reduce sedentary behaviour and increase physical activity in older people

to disseminate information on the determinants and effects of sedentary behaviour to older people, professionals and organisations working with older people and policy makers

to increase research capacity and interdisciplinary working in the field of sedentary behaviour

You will hear from WP2, WP3 and WP4 separately

The Cohorts

• Lothian Birth Cohort 1936 (LBC1936) – From age 11, now 77 years – From 2004, regular

monitoring – Subjective Physical Activity – Brain Scans – IQ – Cognition – .....

• West of Scotland Twenty-07 study (Twenty-07) – In their 60s and 80s – From 1987, regular

monitoring – Subjective Physical Activity – Medical Examinations – Blood Tests – Deprivation – .....

Recruit 750 cohort members

Impact

• Tailoring interventions and who to target those interventions at: – Recommendations – Manuals – Workshops – Leaflets

• For professionals and organisations

• For policy makers • For National Health Surveys and

Research

• Dissemination Advisory Group with user engagement at the hub – Internet (Website,

Networks, Social Media, You Tube, Webinars)

– Publications (Peer review and professional)

– Conferences (with strong older people engagement and attendance)

– Academic Curriculum

Beneficiaries

Older People

Education (HEIs and NHS)

Public Health Surveys

NGO s/ Charities

Policy Makers Health & Social

Care Professionals

Fitness and Physical Activity

Professionals

Service providers: Hospitals,

Residential Settings,

Community Care

Researchers

Surveillance/Monitoring Determinants Intervention Diet Physical activity Sedentary behaviour

Diet Physical activity Sedentary behaviour

Best Practice Policy Development

260 researchers 35 institutions 12 countries 35 million Euros Set EU research and policy

Working towards achieving the guidelines

Moving

Moving More Often

Moving regularly and

frequently

Sedentary

Meeting the guidelines

Increased physical activity

Increased benefits