title: Objectively-measured sedentary time and cardiometabolic health in adults with severe obesity.
abstract: It is unknown whether sedentary behavior is independently associated with the cardiometabolic health of adults with severe obesity. Additionally, there is debate regarding how best to derive meaningful indices of sedentary time (ST) from activity monitor data. A convenience sample of adults with severe obesity (N=927; 79% female, median age 45y, median body mass index (BMI) 46kg/m(2)) completed a research assessment at one of ten US hospitals in 2006-2009 prior to bariatric surgery. Cardiometabolic health was assessed via physical measures, fasting blood samples and medication use. Indices of ST were derived from StepWatch™ activity monitor data with minimum bout durations of 1min, 10min and 30min. Cross-sectional associations were examined. Median (25th, 75th percentile) ST was 9.3h/d (8.1, 10.5) in ≥1min bouts, 6.5h/d (5.2, 8.0) in ≥10min bouts, or 3.2h/d (2.1, 4.5) in ≥30min bouts. Associations with ST were generally strongest with the ≥10min bout duration. Independent of moderate-to-vigorous intensity physical activity, BMI and other potential confounders, 1h/day ST in ≥10min bouts was associated with higher odds of diabetes by 15% (95%CI: 1.05-1.26), metabolic syndrome by 12% (95%CI: 1.01-1.24) and elevated blood pressure by 14% (95%CI: 1.02-1.26), and was associated with 1.4cm (95%CI: 0.9-1.9) larger waist circumference. Findings indicate the importance of considering ST as a distinct health risk among adults with severe obesity, and suggest a 10min minimum duration may be preferable to 1min or 30min for establishing ST from activity monitor data.
authors.affiliation: University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, USA. Electronic address: kingw@edc.pitt.edu.
authors.forename: Wendy C
authors.initials: WC
authors.lastname: King
authors.affiliation: University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, USA. Electronic address: jic29@pitt.edu.
authors.forename: Jia-Yuh
authors.initials: JY
authors.lastname: Chen
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Electronic address: courcoulasap@upmc.edu.
authors.forename: Anita P
authors.initials: AP
authors.lastname: Courcoulas
authors.affiliation: Neuropsychiatric Research Institute, Fargo, ND, USA. Electronic address: jmitchell@nrifargo.com.
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.affiliation: Oregon Health and Science University, Portland, OR, USA. Electronic address: wolfeb@ohsu.edu.
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Wolfe
authors.affiliation: Legacy Good Samaritan Weight Management Institute, Portland, OR, USA. Electronic address: epatterson@oregonweightlosssurgery.com.
authors.forename: Emma J
authors.initials: EJ
authors.lastname: Patterson
authors.affiliation: Mount Sinai Hospital, New York, NY, USA. Electronic address: william.inabnet@mountsinai.org.
authors.forename: William B
authors.initials: WB
authors.lastname: Inabnet
authors.affiliation: Weill Cornell Medical Center, New York, NY, USA. Electronic address: grd9006@medcornell.edu.
authors.forename: Gregory F
authors.initials: GF
authors.lastname: Dakin
authors.affiliation: University of Washington, Seattle, WA, USA. Electronic address: daveflum@uw.edu.
authors.forename: David R
authors.initials: DR
authors.lastname: Flum
authors.affiliation: Neuropsychiatric Research Institute, Fargo, ND, USA. Electronic address: briancook@csumb.edu.
authors.forename: Brian
authors.initials: B
authors.lastname: Cook
authors.affiliation: University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, USA. Electronic address: belle@edc.pitt.edu.
authors.forename: Steven H
authors.initials: SH
authors.lastname: Belle
mesh_terms: D061725:Accelerometry / Q000379:methods; D000328:Adult; D050110:Bariatric Surgery; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D012307:Risk Factors; D057185:Sedentary Behavior
chemical_list: D015415:Biomarkers
keywords: Ambulatory monitoring; Diabetes mellitus, type 2; Metabolic syndrome X; Methods; Obesity; Physical activity; Risk factors; Sedentary bout length; Sedentary lifestyle