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      A systematic review of correlates of sedentary behaviour in adults aged 18–65 years: a socio-ecological approach

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          Abstract

          Background

          Recent research shows that sedentary behaviour is associated with adverse cardio-metabolic consequences even among those considered sufficiently physically active. In order to successfully develop interventions to address this unhealthy behaviour, factors that influence sedentariness need to be identified and fully understood. The aim of this review is to identify individual, social, environmental, and policy-related determinants or correlates of sedentary behaviours among adults aged 18–65 years.

          Methods

          PubMed, Embase, CINAHL, PsycINFO and Web of Science were searched for articles published between January 2000 and September 2015. The search strategy was based on four key elements and their synonyms: (a) sedentary behaviour (b) correlates (c) types of sedentary behaviours (d) types of correlates. Articles were included if information relating to sedentary behaviour in adults (18–65 years) was reported. Studies on samples selected by disease were excluded. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42014009823).

          Results

          74 original studies were identified out of 4041: 71 observational, two qualitative and one experimental study. Sedentary behaviour was primarily measured as self-reported screen leisure time and total sitting time. In 15 studies, objectively measured total sedentary time was reported: accelerometry ( n = 14) and heart rate ( n = 1). Individual level factors such as age, physical activity levels, body mass index, socio-economic status and mood were all significantly correlated with sedentariness. A trend towards increased amounts of leisure screen time was identified in those married or cohabiting while having children resulted in less total sitting time. Several environmental correlates were identified including proximity of green space, neighbourhood walkability and safety and weather.

          Conclusions

          Results provide further evidence relating to several already recognised individual level factors and preliminary evidence relating to social and environmental factors that should be further investigated. Most studies relied upon cross-sectional design limiting causal inference and the heterogeneity of the sedentary measures prevented direct comparison of findings. Future research necessitates longitudinal study designs, exploration of policy-related factors, further exploration of environmental factors, analysis of inter-relationships between identified factors and better classification of sedentary behaviour domains.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12889-016-2841-3) contains supplementary material, which is available to authorized users.

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          Most cited references67

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          Sedentary behaviors and subsequent health outcomes in adults a systematic review of longitudinal studies, 1996-2011.

          To systematically review and provide an informative synthesis of findings from longitudinal studies published since 1996 reporting on relationships between self-reported sedentary behavior and device-based measures of sedentary time with health-related outcomes in adults. Studies published between 1996 and January 2011 were identified by examining existing literature reviews and by systematic searches in Web of Science, MEDLINE, PubMed, and PsycINFO. English-written articles were selected according to study design, targeted behavior, and health outcome. Forty-eight articles met the inclusion criteria; of these, 46 incorporated self-reported measures including total sitting time; TV viewing time only; TV viewing time and other screen-time behaviors; and TV viewing time plus other sedentary behaviors. Findings indicate a consistent relationship of self-reported sedentary behavior with mortality and with weight gain from childhood to the adult years. However, findings were mixed for associations with disease incidence, weight gain during adulthood, and cardiometabolic risk. Of the three studies that used device-based measures of sedentary time, one showed that markers of obesity predicted sedentary time, whereas inconclusive findings have been observed for markers of insulin resistance. There is a growing body of evidence that sedentary behavior may be a distinct risk factor, independent of physical activity, for multiple adverse health outcomes in adults. Prospective studies using device-based measures are required to provide a clearer understanding of the impact of sedentary time on health outcomes. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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            The influence of geographic life environments on cardiometabolic risk factors: a systematic review, a methodological assessment and a research agenda.

            C Leal, B Chaix (2011)
            Recent environmental changes play a role in the dramatic increase in the prevalence of cardiometabolic risk factors (CMRFs) such as obesity, hypertension, type 2 diabetes, dyslipidemias and the metabolic syndrome in industrialized countries. Therefore, identifying environmental characteristics that are associated with risk factors is critical to develop more effective public health interventions. We conducted a systematic review of the literature investigating relationships between characteristics of geographic life environments and CMRFs (131 articles). Most studies were published after 2006, relied on cross-sectional designs, and examined whether sociodemographic and physical environmental characteristics, and more recently service environment characteristics, were associated with obesity or, to a lesser extent, hypertension. Only 14 longitudinal studies were retrieved; diabetes, dyslipidemias and the metabolic syndrome were rarely analysed; and aspects of social interactions in the neighbourhood were critically underinvestigated. Environmental characteristics that were consistently associated with either obesity or hypertension include low area socioeconomic position; low urbanization degree; low street intersection, service availability and residential density; high noise pollution; low accessibility to supermarkets and high density of convenience stores; and low social cohesion. Intermediate mechanisms between environmental characteristics and CMRFs have received little attention. We propose a research agenda based on the assessment of underinvestigated areas of research and methodological limitations of current literature. © 2010 The Authors. obesity reviews © 2010 International Association for the Study of Obesity.
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              Conceptualization and measurement of environmental exposure in epidemiology: accounting for activity space related to daily mobility.

              A considerable body of literature has investigated how environmental exposures affect health through various pathways. These studies have generally adopted a common approach to define environmental exposures, focusing on the local residential environment, using census tracts or postcodes to delimit exposures. However, use of such administrative units may not be appropriate to evaluate contextual effets on health because they are generally not a 'true' representation of the environments to which individuals are exposed. Recent work has suggested that advances may be made if an activity-space approach is adopted. The present paper investigates how various disciplines may contribute to the refinement of the concept of activity space for use in health research. In particular we draw on seminal work in time geography, which provides a framework to describe individual behavior in space and time, and can help the conceptualization of activity space. In addition we review work in environmental psychology and social networks research, which provides insights on how people and places interact and offers new theories for improving the spatial definition of contextual exposures. Copyright © 2013 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                grainne.odonoghue@dcu.ie
                camille.perchoux@gmail.com
                keitly.mensah@chu-lyon.fr
                je.lakerveld@vumc.nl
                hp.vanderploeg@vumc.nl
                claire.bernaards@tno.nl
                Sebastien.chastin@gcu.ac.uk
                chantal.simon@univ-lyon1.fr
                donal.ogorman@dcu.ie
                julie-anne.nazare@cens-nutrition.com
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                17 February 2016
                17 February 2016
                2016
                : 16
                : 163
                Affiliations
                [ ]Centre for Preventive Medicine, School of Health & Human Performance, Dublin City University, Dublin 9, Republic of Ireland
                [ ]CarMeN Laboratory, INSERM U1060, Lyon 1 University, CRNH-Rhône-Alpes, CENS, Lyon, France
                [ ]EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, Netherlands
                [ ]TNO, Leiden, The Netherlands
                [ ]Institute of Applied Health Research, School of Health and Life Science, Glasgow Caledonian University, Glasgow, UK
                Article
                2841
                10.1186/s12889-016-2841-3
                4756464
                26887323
                1ed3b775-258a-4f3f-9fbc-9ec776c8f6b1
                © O’Donoghue et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 29 July 2015
                : 5 February 2016
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001590, Health Research Board (IE);
                Award ID: DEDIPAC/2013/1
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Public health
                sitting,sedentary behaviour,determinants,correlates,adults,ecological model,intrapersonal,interpersonal,environment,policy-related

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