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      Sedentary time in older men and women: an international consensus statement and research priorities

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          Abstract

          Sedentary time is a modifiable determinant of poor health, and in older adults, reducing sedentary time may be an important first step in adopting and maintaining a more active lifestyle. The primary purpose of this consensus statement is to provide an integrated perspective on current knowledge and expert opinion pertaining to sedentary behaviour in older adults on the topics of measurement, associations with health outcomes, and interventions. A secondary yet equally important purpose is to suggest priorities for future research and knowledge translation based on gaps identified. A five-step Delphi consensus process was used. Experts in the area of sedentary behaviour and older adults (n=15) participated in three surveys, an in-person consensus meeting, and a validation process. The surveys specifically probed measurement, health outcomes, interventions, and research priorities. The meeting was informed by a literature review and conference symposium, and it was used to create statements on each of the areas addressed in this document. Knowledge users (n=3) also participated in the consensus meeting. Statements were then sent to the experts for validation. It was agreed that self-report tools need to be developed for understanding the context in which sedentary time is accumulated. For health outcomes, it was agreed that the focus of sedentary time research in older adults needs to include geriatric-relevant health outcomes, that there is insufficient evidence to quantify the dose–response relationship, that there is a lack of evidence on sedentary time from older adults in assisted facilities, and that evidence on the association between sedentary time and sleep is lacking. For interventions, research is needed to assess the impact that reducing sedentary time, or breaking up prolonged bouts of sedentary time has on geriatric-relevant health outcomes. Research priorities listed for each of these areas should be considered by researchers and funding agencies.

          This consensus statement has been endorsed by the following societies: Academy of Geriatric Physical Therapy, Exercise & Sports Science Australia, Canadian Centre for Activity and Aging, Society of Behavioral Medicine, and the National Centre for Sport and Exercise Medicine.

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          Most cited references53

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          Physical activity of Canadian adults: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey.

          Rising obesity rates and declining fitness levels have increased interest in understanding what underlies these trends. This article presents the first directly measured data on physical activity and sedentary behaviour on a nationally representative sample of Canadians aged 20 to 79 years. Data are from the 2007 to 2009 Canadian Health Measures Survey (CHMS). Physical activity was measured using accelerometry. Data are presented as time spent in sedentary, light, moderate and vigorous intensity movement as well as steps accumulated per day. An estimated 15% of Canadian adults accumulate 150 minutes of moderate-to-vigorous physical activity (MVPA) per week; 5% accumulate 150 minutes per week as at least 30 minutes of MVPA on 5 or more days a week. Men are more active than women and MVPA declines with increasing age and adiposity. Canadian adults are sedentary for approximately 9.5 hours per day (69% of waking hours). Men accumulate an average of 9,500 steps per day and women, 8,400 steps per day. The 10,000-steps-per-day target is achieved by 35% of adults. Before the CHMS, objective measures of physical activity and sedentary behaviour were not available for a representative sample of Canadians. The findings indicate that 85% of adults are not active enough to meet Canada's new physical activity recommendation.
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            Protecting muscle mass and function in older adults during bed rest.

            To highlight the losses in muscle mass, strength, power, and functional capacity incurred in older adults during bed rest-mediated inactivity and to provide practical recommendations for both the prevention and rehabilitation of these losses. In addition to sarcopenic muscle loss, older adults lose lean tissue more rapidly than the young during prolonged periods of physical inactivity. Amino acid or protein supplementation has the potential to maintain muscle protein synthesis and may reduce inactivity-induced muscle loss, but should ideally be part of an integrated countermeasure regimen consisting of nutrition, exercise, and, when appropriate, pharmacologic interventions. In accordance with recent mechanistic advances, we recommend an applied, broad-based two-phase approach to limit inactivity-mediated losses of muscle mass and function in older adults: (i) Lifestyle: consume a moderate amount (25-30 g) of high-quality protein with each meal and incorporate habitual exercise in close temporal proximity to protein-containing meals; (ii) Crises: react aggressively to combat the accelerated loss of muscle mass and function during acute catabolic crises and periods of reduced physical activity. As a base strategy, this should include nutritional support such as targeted protein or amino acid supplementation and integrated physical therapy.
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              Amount of time spent in sedentary behaviors and cause-specific mortality in US adults.

              Sedentary behaviors predominate modern life, yet we do not fully understand the adverse effects of these behaviors on mortality after considering the benefits of moderate-vigorous physical activity (MVPA). We tested the hypotheses that higher amounts of overall sitting time and television viewing are positively associated with mortality and described the independent and combined effects of these sedentary behaviors and MVPA on mortality. In the NIH-AARP Diet and Health Study, we examined 240,819 adults (aged 50-71 y) who did not report any cancer, cardiovascular disease, or respiratory disease at baseline. Mortality was ascertained over 8.5 y. Sedentary behaviors were positively associated with mortality after adjustment for age, sex, education, smoking, diet, race, and MVPA. Participants who reported the most television viewing (≥7 h compared with 7 h/wk), high amounts of television viewing (≥7 h/d) remained associated with increased risk of all-cause (HR: 1.47; 95% CI: 1.20, 1.79) and cardiovascular (HR: 2.00; 95% CI: 1.33, 3.00) mortality compared with those reporting the least television viewing (<1 h/d). Time spent in sedentary behaviors was positively associated with mortality, and participation in high levels of MVPA did not fully mitigate health risks associated with prolonged time watching television. Adults should be encouraged to reduce time spent in sedentary behaviors, when possible, and to participate in MVPA at recommended levels. The NIH-AARP Diet and Health Study was registered at clinicaltrials.gov as NCT00340015.
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                Author and article information

                Journal
                Br J Sports Med
                Br J Sports Med
                bjsports
                bjsm
                British Journal of Sports Medicine
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0306-3674
                1473-0480
                November 2017
                19 July 2017
                : 51
                : 21
                : 1526-1532
                Affiliations
                [1 ]University of Ontario Institute of Technology , Oshawa, Ontario, Canada
                [2 ]University of British Columbia , Vancouver, British Columbia, Canada
                [3 ]Victoria University , Melbourne, Australia
                [4 ]University of Southern Queensland , Springfield, Australia
                [5 ]University of Queensland , Brisbane, Australia
                [6 ]Arizona State University , Phoenix, Arizona, USA
                [7 ]Glasgow Caledonian University , Glasgow, UK
                [8 ]Ghent University , Ghent, Belgium
                [9 ]Waseda University , Saitama, Japan
                [10 ]University College London , London, UK
                [11 ]Waseda University , Tokyo, Japan
                [12 ]Baker Heart and Diabetes Institute , Melbourne, Australia
                [13 ]Swinburne University of Technology , Melbourne, Australia
                [14 ]departmentCIPER , Faculdade de Motricidade Humana, Universidade de Lisboa , Lisboa, Portugal
                [15 ]Australian Catholic University , Melbourne, Australia
                [16 ]University of Lethbridge , Lethbridge, Canada
                Author notes
                [Correspondence to ] Dr Shilpa Dogra, Faculty of Health Sciences (Kinesiology), University of Ontario Institute of Technology, Oshawa L1H 7K4, Canada; shilpa.dogra@ 123456uoit.ca
                Article
                bjsports-2016-097209
                10.1136/bjsports-2016-097209
                5738599
                28724710
                ded3f795-3a30-439d-b61d-e67e06d6bb7e
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 28 June 2017
                Funding
                Funded by: Canadian Society for Exercise Physiology;
                Funded by: FundRef http://dx.doi.org/10.13039/501100000029, Institute of Gender and Health;
                Categories
                Consensus Statement
                1506
                2314
                Custom metadata
                unlocked

                Sports medicine
                sitting,ageing,physical activity,consensus
                Sports medicine
                sitting, ageing, physical activity, consensus

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