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      Effects of isotemporal substitution of sedentary behavior with light-intensity or moderate-to-vigorous physical activity on cardiometabolic markers in male adolescents

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          Abstract

          Increasing prevalence of sedentary behavior (SB) combined with low levels of physical activity (PA) in children and adolescents has become a growing public health concern. Therefore, this study aimed to identify the daily behavioral pattern of adolescents and examine the isotemporal substitution effects of SB with light-intensity PA (LIPA) or moderate-to-vigorous PA (MVPA) on cardiometabolic markers. In this cross-sectional study, the daily behavioral pattern of Brazilian male adolescents was objectively measured for 7 days. Vector magnitude activity counts were used to estimate SB, LIPA, and MVPA with cut-points specifically validated for youth. The isotemporal substitution model was used to assess the effects of replacing different SB bouts (5, 10, 30, and 60 min) with LIPA or MVPA on cardiometabolic markers [body mass index, waist circumference, body fat percentage (BF%), total cholesterol, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, low-density lipoprotein cholesterol, triglyceride (TG), glucose, insulin, homeostatic model assessment of insulin resistance (HOMA2-IR), insulin sensitivity (HOMA2-S), beta cell function (HOMA2-β), systolic-blood pressure (SBP), diastolic-blood pressure, and cardiometabolic risk score]. Male adolescents (n = 84; age, 16.7 ± 0.9 years) wore the GT3X+ for 6.7 ± 0.6 days, during 15.2 ± 2.3 h, and spent 72.9% of the time in SB, 17.3% in LIPA, and 9.8% in MVPA. SB replacement with LIPA was associated with increased HDL-C, TG, HOMA2-IR, and HOMA2-S and decreased SBP. In contrast, SB replacement with MVPA was associated with decreased BF%. Therefore, our findings suggest that replacing SB with LIPA showed positive results on HDL-C, HOMA2-S and SBP, while replacing SB with MVPA was associated with only one obesity indicator (BF%). Moreover, participants met the daily MVPA recommendations, but they still had a daily behavioral pattern with high SB. In this context, LIPAs can be considered an effective alternative to reduce SB and improve the health indicators of this population.

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          Health outcomes associated with reallocations of time between sleep, sedentary behaviour, and physical activity: a systematic scoping review of isotemporal substitution studies

          Background During a 24-h day, each given period is spent in either sedentary behaviour, sleeping, light physical activity (LPA), or moderate-to-vigorous physical activity (MVPA). In epidemiological research most studies have traditionally analysed the associations of these behaviours in isolation from each other; that is, without taking into account the displacement of time spent in the remaining behaviours. In recent years, there has been a growing interest in exploring how all the behaviours across the energy expenditure spectrum influence health outcomes. A statistical model used to investigate these associations is termed an isotemporal substitution model (ISM). Considering the increasing number of ISM-based studies conducted in all age groups, the present paper aimed to: (i) review and summarise findings from studies that employed ISM in sleep, sedentary behaviour, and physical activity research; (ii) appraise the methodological quality of the studies; and (iii) suggest future research directions in this area. Methods A systematic search of ten databases was performed. The Newcastle–Ottawa scale was used to assess the methodological quality of the included studies. Results Fifty-six studies met the inclusion criteria, all being of moderate or high methodological quality. Associations were reported for exchanged time varying from one minute to 120 min/day across the studies, with 30 min/day being the most common amount of time reallocated. In total, three different ISM methodologies were used. The most commonly studied health outcomes in relation to isotemporal substitutions were mortality, general health, mental health, adiposity, fitness, and cardiometabolic biomarkers. It seems that reallocations of sedentary time to LPA or MVPA are associated with significant reduction in mortality risk. Current evidence appears to consistently suggest that reductions in mortality risk are greater when time spent sedentary is replaced with higher intensities of physical activity. For adiposity, it seems that reallocating sedentary time to physical activity may be associated with reduced body mass index, body fat percentage, and waist circumference in all age groups, with the magnitude of associations being greater for higher intensities of physical activity. While there is a relatively large body of evidence reporting beneficial associations between the reallocation of time from sedentary behaviour to LPA or MVPA and cardiometabolic biomarkers among adults, there is a lack of studies among children, adolescents, and older adults. Although some studies investigated general health, mental health, and fitness outcomes, further investigation of these topics is warranted. In general, it seems that the strongest association with health outcomes is observed when time is reallocated from sedentary behaviour to MVPA. Most studies did not account for sleep time, which is a major limitation of the current evidence. Conclusions The current evidence indicates that time reallocation between sleep, sedentary behaviour, LPA, and MVPA may be associated with a number of health outcomes. Future studies should employ longitudinal designs, take into account all movement behaviours, and examine a wider range of health, psychological, social, economic, and environmental outcomes. Electronic supplementary material The online version of this article (10.1186/s12966-018-0691-3) contains supplementary material, which is available to authorized users.
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            Is objectively measured light-intensity physical activity associated with health outcomes after adjustment for moderate-to-vigorous physical activity in adults? A systematic review

            Background An increasing number of studies have demonstrated that light-intensity physical activity (LPA) confers health benefits after adjustment for moderate-to-vigorous physical activity (MVPA). The purpose of this systematic review was to summarize existing epidemiological evidence on associations of objectively measured LPA with health outcomes in adults. Methods This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched on PubMed, Web of Science, CINAL, and Cochrane Library for articles analyzing the association between objectively determined LPA and health outcomes that were published up to January 2017. Data were extracted regarding authors, publication year, country of survey, study setting, number of participants, study design, physical activity (PA) assessment (type of accelerometer and intensity), health outcomes, confounders, and results (summary measures and association). A coding system was used to summarize the results. Results Of the 3254 studies identified, 24 cross-sectional and 6 longitudinal studies were included in this review. Most of the studies targeted the Western population. LPA was inversely associated with all-cause mortality risk and associated favorably with some cardiometabolic risk factors including waist circumference, triglyceride levels, insulin, and presence of metabolic syndrome. Only a small amount of data were available on mental health and cognitive function. Conclusions LPA appears to be beneficially associated with important health outcomes after adjustment for MVPA in the adult population. Although current global PA guidelines recommend only MVPA, promoting LPA may confer additional health benefits. Electronic supplementary material The online version of this article (10.1186/s12966-018-0695-z) contains supplementary material, which is available to authorized users.
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              Calibration of ActiGraph GT3X, Actical and RT3 accelerometers in adolescents.

              The objective of this study was to develop count cut-points for three different accelerometer models: ActiGraph GT3X, RT3 and Actical to accurately classify physical activity intensity levels in adolescents. Seventy-nine adolescents (10-15 years) participated in this study. Accelerometers and oxygen consumption ([Formula: see text]) data were collected at rest and during 11 physical activities of different intensities. Accelerometers were worn on the waist and [Formula: see text] was measured by a portable metabolic system: Cosmed K4b2. Receiver operating characteristic (ROC) curves were used to determine cut-points. Cut-points for sedentary (SED), moderate-to-vigorous (MVPA) and vigorous-intensity physical activity (VPA) were 46, 607 and 818 counts·15s(-1) to the vertical axis of ActiGraph; 180, 757 and 1112 counts·15s(-1) to the vector magnitude of ActiGraph; 17, 441 and 873 counts·15s(-1) for Actical; and 5.6, 20.4 and 32.2 counts·s(-1) for RT3, respectively. For all three accelerometer models, there was an almost perfect discrimination of SED and MVPA (ROC >0.97) and an excellent discrimination of VPA (ROC>0.90) observed. Areas under the ROC curves indicated better discrimination of MVPA by ActiGraph (AUC=0.994) and Actical (AUC=0.993) when compared to RT3 (AUC=0.983). The cut-points developed in this study for the ActiGraph (vector magnitude), RT3 and Actical accelerometer models can be used to monitor physical activity level of adolescents.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                26 November 2019
                2019
                : 14
                : 11
                : e0225856
                Affiliations
                [1 ] Medical Science Graduate Program, Medical Sciences Faculty, Rio de Janeiro State University, Rio de Janeiro, Rio de Janeiro, Brazil
                [2 ] Department of Physical Education, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil
                University of New Brunswick, CANADA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0002-8439-4523
                Article
                PONE-D-19-16560
                10.1371/journal.pone.0225856
                6879145
                31770423
                1fa64a1d-f118-4dda-a458-73e5cadacafd
                © 2019 Moura et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 11 June 2019
                : 13 November 2019
                Page count
                Figures: 2, Tables: 1, Pages: 13
                Funding
                The authors received no specific funding for this work.
                Categories
                Research Article
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Physical Fitness
                Exercise
                Medicine and Health Sciences
                Sports and Exercise Medicine
                Exercise
                Biology and Life Sciences
                Sports Science
                Sports and Exercise Medicine
                Exercise
                Engineering and Technology
                Electronics
                Accelerometers
                People and Places
                Population Groupings
                Age Groups
                Children
                Adolescents
                People and Places
                Population Groupings
                Families
                Children
                Adolescents
                Biology and Life Sciences
                Psychology
                Behavior
                Social Sciences
                Psychology
                Behavior
                Medicine and Health Sciences
                Endocrinology
                Diabetic Endocrinology
                Insulin
                Biology and Life Sciences
                Biochemistry
                Hormones
                Insulin
                Medicine and Health Sciences
                Public and Occupational Health
                Behavioral and Social Aspects of Health
                Biology and Life Sciences
                Biochemistry
                Lipids
                Cholesterol
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Custom metadata
                The datasets generated and/or analyzed during the current study are available in the Mendeley Data repository, http://dx.doi.org/10.17632/cpy375t3cp.1.

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