Most cited article - PubMed ID 32224966
Compositional Data Analysis in Time-Use Epidemiology: What, Why, How
This study introduces the concept of the "Goldilocks Day" - the optimal 24-hour time-use of intensity- or posture-specific composition specifically tailored for young-old (65-70 years) and old-old (> 70 years) adults. We aimed (1) to describe optimal 24-hour time-use of compositions for each health outcome, and (2) identify the 'Goldilock Day' for all outcomes together. This approach, involving backwards pivot coordinates (bpcs), we provide a clearer interpretation of physical behavior data, offering practical insights for healthy aging. Data were collected from 309 older adults (65 + years) in Czechia, using accelerometers worn on the non-dominant wrist to assess intensity-specific behaviors (sedentary behavior - SB, light physical activity - LPA, moderate-to-vigorous physical activity - MVPA, and sleep) and on the right thigh and waist to assess posture-specific behaviors (lying, sitting, standing, moving, and walking). Health outcomes included body mass index (BMI), fall risk, fear of falling, and overall physical performance as assessed by the Short Physical Performance Battery. Compositional regression models, based on the bpcs, were used to assess the relationships between time-use and these outcomes. In young-old adults, the time-use composition for optimal BMI included 7.5 h of sleep, 12.0 h of SB, 3.2 h of LPA, and 1.4 h of MVPA. Old-old adults displayed slightly lower MVPA (1.0 h) and increased SB (12.8 h). Generally, higher MVPA and lower SB were associated with better physical performance and reduced fear of falling. The optimal "Goldilocks Day" for both age groups highlighted the benefits of higher physical activity and reduced sedentary time, with significant implications for personalized health recommendations and improved health outcomes in Czech older adults.
- Keywords
- Accelerometry, Compositional data analysis, Physical behavior, Posture-specific behavior,
- MeSH
- Accelerometry MeSH
- Exercise physiology MeSH
- Body Mass Index MeSH
- Humans MeSH
- Obesity * prevention & control MeSH
- Posture MeSH
- Sedentary Behavior MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Fear * psychology MeSH
- Physical Functional Performance * MeSH
- Accidental Falls * prevention & control MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
BACKGROUND: Adolescents' movement behaviours (MB) vary between schooldays and weekends, potentially impacting health-related quality of life (HRQoL) and well-being. This study aimed to identify transitions between 24-h MB profiles on schooldays and weekends and examine their associations with HRQoL and well-being. METHODS: This is a cross-sectional study of 1070 Czech adolescents (average age: 13.8 years and standard deviation: 2.2 years; 56% girls). Participants wore accelerometers for 7 consecutive days to assess physical activity (PA) of different intensities, sedentary behaviour (SB) and sleep. A subsample of 451 participants provided data on HRQoL, which was measured using the Paediatric Quality of Life Inventory, and 484 provided valid well-being data measured with the 5-item World Health Organisation Well-Being Index. Latent transition analysis was used on the MB variables to identify transitions across MB profiles, and linear regression was used to examine associations between transitions and HRQoL or well-being. RESULTS: Four MB profiles were identified: Excellent (high PA, low SB and high sleep duration), Good (average MB values), Fair (below-average PA and sleep, above-average SB) and Poor (low PA and sleep, high SB). Most adolescents transitioned to less favourable profiles on weekends. Those remaining in the Excellent profile had higher HRQoL than those transitioning to less favourable profiles. Transitions to the Poor profile were associated with the lowest HRQoL and well-being scores. CONCLUSION: This study underscores the dynamic nature of adolescents' MB and the importance of consistent, healthy routines. Interventions optimizing 24-h MB throughout the week and especially on weekends may enhance adolescent HRQoL and well-being, but further evidence from longitudinal and intervention studies is needed. SUMMARY: We observed a contrast in 24-h MB between schooldays and weekends: 29.7% of adolescents were in the Excellent on schooldays, but only 5.8% did so on weekends, while the prevalence of the Poor profile rose from 1.6% on schooldays to 27.7% on weekends. Adolescents who maintained the Excellent profile across the whole week recorded the highest scores for HRQoL and well-being. Moving into the Poor profile on weekend was associated with about 9 points poorer HRQoL and 14 points lower well-being, compared with peers who remained in the Excellent profile. Behaviour change strategies should target the entire week to preserve PA, reduce SB and protect sleep.
- Keywords
- accelerometry, latent class analysis, physical activity, sedentary behaviour, sleep,
- MeSH
- Accelerometry MeSH
- Time Factors MeSH
- Adolescent Behavior * psychology physiology MeSH
- Exercise * psychology physiology MeSH
- Quality of Life * psychology MeSH
- Humans MeSH
- Adolescent MeSH
- Cross-Sectional Studies MeSH
- Sedentary Behavior MeSH
- Sleep physiology MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic epidemiology MeSH
INTRODUCTION: Obesity in older adults is linked to various chronic conditions and decreased quality of life. Traditional physical activity guidelines often overlook the specific postures and movements that older adults engage in daily. This study aims to explore the compositional associations between posture-specific behaviours and obesity risk in younger (M = 67.35 ± 2.03 years) and older (M = 75.73 ± 4.17 years) groups of older adults and investigate the differences in body mass index (BMI) associated with replacing time spent in lying, sitting and standing with moving or walking. METHODS: This cross-sectional study involved 309 older adults aged 65 and above from Czech Republic. Participants' movement behaviours, including lying, sitting, standing, moving, and walking, were measured using accelerometers. The data were analysed using compositional data analysis (CoDA) and isotemporal substitution models to assess the impact of reallocating time between different activities on self-reported (BMI). RESULTS: The younger group engaged in more overall movement (193.84 min/day vs. 172.41 min/day) and walking (92.15 min/day vs. 76.62 min/day) than the older group. Significant estimated increases in BMI were associated with reallocating 30 min from movement to lying, sitting, or standing (up to + 3.31 kg/m²), while reallocating the same amount of time from lying, sitting, or standing to movement was associated with estimated reductions in BMI (up to - 2.54 kg/m²). In the older group, reallocating time from slow walking to lying or sitting was associated with estimated increases in BMI (up to + 1.86 kg/m²), while increasing time spent slow walking at the expense of lying or sitting theoretically reduced BMI (up to - 0.95 kg/m²). CONCLUSIONS: The findings suggest that promoting movement and walking, including both slow and fast walking, may play a role in managing obesity risk in older adults. This study highlights the potential benefits of reducing sedentary time and encouraging low-intensity physical activity tailored to the capabilities of seniors, especially those aged 70+, as a possible strategy to mitigate obesity risk. However, further longitudinal studies are needed to confirm these associations and explore causal relationships.
- Keywords
- backwards pivot coordinates, body mass index, sitting, slow walking, standing,
- MeSH
- Accelerometry methods MeSH
- Walking * physiology MeSH
- Body Mass Index MeSH
- Humans MeSH
- Obesity * epidemiology physiopathology MeSH
- Posture physiology MeSH
- Sitting Position * MeSH
- Cross-Sectional Studies MeSH
- Risk Factors MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Standing Position * MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic epidemiology MeSH
OBJECTIVES: Growing evidence supports the important role of 24-hour movement behaviours (MB) in preventing childhood obesity. However, research to understand the heterogeneity and variability of MB among individuals and what kind of typologies of individuals are at risk of developing obesity is lacking. To bridge this gap, this study identified typologies of 24-hour MB in children and adolescents and investigated their associations with adiposity indicators. METHODS: In this cross-sectional study, 374 children and 317 adolescents from the Czech Republic wore wrist-worn accelerometers for seven consecutive days. Time spent in moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behaviour (SB), and sleep was quantified using raw accelerometery data. Adiposity indicators included body mass index (BMI) z-score, fat mass percentage (FM%), fat mass index (FMI), and visceral adipose tissue (VAT). Bias-adjusted latent profile analysis was used on the 24-hour MB data to identify MB typologies and their associations with adiposity indicators. The models were adjusted for potential confounders. The identified typologies were labelled to reflect the behavioural profiles of bees to aid interpretability for the general public. RESULTS: Two typologies were identified in children: highly active Workers characterised by high levels of MVPA and LPA, and inactive Queens characterised by low levels of MVPA and LPA, high levels of SB and longer sleep duration compared to Workers. In adolescents, an additional typology labelled as Drones was characterised by median levels of MVPA, LPA, SB and longest sleep duration. After controlling for covariates, we found that children labelled as Queens were associated with 1.38 times higher FM%, 1.43 times higher FMI, and 1.67 times higher VAT than Workers. In adolescents, Drones had 1.14 times higher FM% and Queens had 1.36 higher VAT in comparison with Workers, respectively. CONCLUSION: Our study highlights the importance of promoting active lifestyles in children and adolescents to potentially reduce adiposity. These findings can provide insights for interventions aimed at promoting healthy MB and preventing childhood obesity.
- Keywords
- Clusters, Obesity, Physical activity, Profiles, Sedentary behaviour, Sleep, Youth,
- MeSH
- Adiposity * physiology MeSH
- Accelerometry MeSH
- Exercise * MeSH
- Child MeSH
- Body Mass Index MeSH
- Humans MeSH
- Adolescent MeSH
- Pediatric Obesity * epidemiology MeSH
- Cross-Sectional Studies MeSH
- Sedentary Behavior * MeSH
- Sleep physiology MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic MeSH
BACKGROUND: Twenty-four-hour movement behaviours are gaining attention in the research community. However, no study has addressed how 24-h activity profiles vary between structured and less structured days and whether an unfavourable activity profile is associated with childhood obesity. We aimed to analyse differences between school day and weekend day 24-h activity profiles and their associations with adiposity indicators among children and adolescents. METHODS: Participants were 382 children and 338 adolescents who wore wrist accelerometers for 24 hours a day for seven consecutive days. The 24-h activity profile expressed by the average acceleration (AvAcc) and intensity gradient (IG) were estimated from multi-day raw accelerometer data. Adiposity indicators included body mass index (BMI) z-score, fat mass percentage (FM%), fat mass index (FMI), and visceral adipose tissue (VAT). Multiple linear regression of activity profile metrics and adiposity indicators was performed separately for school and weekend days. RESULTS: Weekend days AvAcc and IG were lower compared to school days in both age groups (p <0.001 for all). Specifically, AvAcc was lower by 9.4% and 11.3% in children and adolescents, respectively. IG on weekend days was lower (more negative) by 3.4% in children and 3.1% in adolescents. Among children, on school days AvAcc and IG were negatively associated with FM%, FMI, and VAT, whilst on weekend days AvAcc was positively associated with BMI z-score, FMI, and VAT (p < 0.05 for all). Among adolescents, negative associations were found between weekend day AvAcc and IG and FM% and FMI (p < 0.05 for all), respectively. CONCLUSIONS: This study confirms the importance of 24-h activity profile as a potentially protective factor against excess adiposity. The variability of movement behaviours during structured and less structured days should be considered when optimizing the 24-h movement behaviours to prevent childhood obesity.
- MeSH
- Adiposity MeSH
- Exercise MeSH
- Child MeSH
- Body Mass Index MeSH
- Humans MeSH
- Adolescent MeSH
- Pediatric Obesity * MeSH
- Sedentary Behavior MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND: Early childhood is important for cognitive and social-emotional development, and a time in which to promote healthy movement behaviors (sedentary behavior, physical activity, and sleep). Movement behaviors may have interactive influences on cognition and social-emotional factors in young children, but most previous research has explored them independently. The purpose of this study was to determine if movement behaviors are associated with measures of cognitive and social-emotional health in young children and if so, to describe optimal compositions of movement behaviors of a daily cycle for such outcomes. METHODS: Children (n = 388, 33 to 70 months, 44.6% female) from a clinical trial (ClinicalTrials.gov ID: NCT03285880, first posted September 18, 2017) wore accelerometers on their wrists for 24-h for 9.56 ± 3.3 days. Movement behavior compositions consisted of time spent in sedentary behaviors, light intensity physical activity, moderate to vigorous intensity physical activity (MVPA), and sleep. Outcomes were cognitive (receptive vocabulary, declarative and procedural memory, and executive attention) and social-emotional measures (temperament and behavioral problems). Compositional linear regression models with isometric log ratios were used to investigate the relations between the movement behavior composition and the cognitive and social-emotional health measures. If a significant association was found between the composition and an outcome, we further explored the "optimal" 24-h time-use for said outcome. RESULTS: Movement behavior compositions were associated with receptive vocabulary. The composition associated with the predicted top five percent of vocabulary scores consisted of 12.1 h of sleep, 4.7 h of sedentary time, 5.6 h of light physical activity, and 1.7 h of MVPA. CONCLUSIONS: While behavior compositions are related to vocabulary ability in early childhood, our findings align with the inconclusiveness of the current evidence regarding other developmental outcomes. Future research exploring activities within these four movement behaviors, that are meaningful to cognitive and social-emotional development, may be warranted. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s44167-023-00016-6.
- Keywords
- Children, Cognition, Physical activity, Sedentary behavior, Sleep, Social-emotional,
- Publication type
- Journal Article MeSH
BACKGROUND: How we spend our time and what we eat have important implications for our health. Evidence suggests that health-equivalent behaviour change options which result in the same benefit are available within both time use (physical activities, sedentary behaviours and sleep) and diet (e.g., fruit and vegetables, snack foods). However, it is not yet known if health-equivalent choices exist across both time-use and diet behaviours. This study aimed to explore if a variety of different time-use and dietary profiles were associated with equivalent physical functioning score among adolescents. METHODS: This study used cross-sectional data from 2123 adolescent participants from the Longitudinal Study of Australian Children (LSAC) (mean age = 14.4 ± 0.5 years), including time-use diaries (min/day of sleep, self-care, screen time, quiet time, physical activity, school-related and domestic/social), diet questionnaires (serves/day of fruit and vegetables, discretionary (snack) foods and sugar-sweetened beverages) and a measure of physical functioning (PedsQL™ 4.0 physical functioning scale for teens). Multiple linear regression models were used to find the association of 24-h time-use composition (expressed as isometric log ratios) and dietary variables with physical functioning score. The models were used to estimate which time-use and diet profiles (within a feasible range from the sample average) were associated with equivalent physical functioning scores. Finally, an interactive app was developed to make the results accessible to end users. RESULTS: Within 30 min and 1.5 servings of the average adolescent's time-use and dietary behaviours, 45 equivalent options were associated with a ~ 0.2 SD improvement in physical functioning scale. All options associated with this improvement in physical function involved increasing physical activity and increasing fruit and vegetable intake, whilst also reducing discretionary food intake and sugar-sweetened beverages. Most behavioural options also increased sleep and reduced time spent in self-care, screen time and quiet time activities. CONCLUSIONS: There are a range of time-use and diet profiles that may result in equivalent benefits in physical functioning among adolescents. Communicating these options using decision tools such as interactive apps may allow for tailored interventions across both time use and diet which are based on an individual's needs, preferences and constraints.
- Keywords
- Adolescent, Diet, Health, Non-communicable diseases, Time use,
- Publication type
- Journal Article MeSH
Reallocations of time between daily activities such as sleep, sedentary behavior and physical activity are differentially associated with markers of physical, mental and social health. An individual's most desirable allocation of time may differ depending on which outcomes they value most, with these outcomes potentially competing with each other for reallocations. We aimed to develop an interactive app that translates how self-selected time reallocations are associated with multiple health measures. We used data from the Australian Child Health CheckPoint study (n = 1685, 48% female, 11-12 y), with time spent in daily activities derived from a validated 24-h recall instrument, %body fat from bioelectric impedance, psychosocial health from the Pediatric Quality of Life Inventory and academic performance (writing) from national standardized tests. We created a user-interface to the compositional isotemporal substitution model with interactive sliders that can be manipulated to self-select time reallocations between activities. The time-use composition was significantly associated with body fat percentage (F = 2.66, P < .001), psychosocial health (F = 4.02, P < .001), and academic performance (F = 2.76, P < .001). Dragging the sliders on the app shows how self-selected time reallocations are associated with the health measures. For example, reallocating 60 minutes from screen time to physical activity was associated with -0.8 [95% CI -1.0 to -0.5] %body fat, +1.9 [1.4 to 2.5] psychosocial score and +4.5 [1.8 to 7.2] academic performance. Our app allows the health associations of time reallocations to be compared against each other. Interactive interfaces provide flexibility in selecting which time reallocations to investigate, and may transform how research findings are disseminated.
We examined the compositional associations between the intensity spectrum derived from incremental acceleration intensity bands and the body mass index (BMI) z-score in youth, and investigated the estimated differences in BMI z-score following time reallocations between intensity bands. School-aged youth from 63 schools wore wrist accelerometers, and data of 1453 participants (57.5% girls) were analysed. Nine acceleration intensity bands (range: 0−50 mg to ≥700 mg) were used to generate time-use compositions. Multivariate regression assessed the associations between intensity band compositions and BMI z-scores. Compositional isotemporal substitution estimated the differences in BMI z-score following time reallocations between intensity bands. The ≥700 mg intensity bandwas strongly and inversely associated with BMI z-score (p < 0.001). The estimated differences in BMI z-score when 5 min were reallocated to and from the ≥700 mg band and reallocated equally among the remaining bands were −0.28 and 0.44, respectively (boys), and −0.39 and 1.06, respectively (girls). The time in the ≥700 mg intensity band was significantly associated with BMI z-score, irrespective of sex. When even modest durations of time in this band were reallocated, the asymmetrical estimated differences in BMI z-score were clinically meaningful. The findings highlight the utility of the full physical activity intensity spectrum over a priori-determined absolute intensity cut-point approaches.
- Keywords
- CoDa, accelerometer, adiposity, adolescents, children, intensity spectrum, physical activity,
- MeSH
- Exercise * MeSH
- Child MeSH
- Body Mass Index MeSH
- Humans MeSH
- Adolescent MeSH
- Sedentary Behavior * MeSH
- Schools MeSH
- Acceleration MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND: This study aimed to map the available evidence related to physical activity (PA) and sedentary behaviour (SB) in Czech children and adolescents and suggest future directions and improvements to strengthen the surveillance of PA and SB in the Czech Republic. METHODS: The search of articles published between January 2000 and December 2020 included the Medline and Medvik databases and a manual search in eight Czech journals related to the topic. This review followed the "Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews". RESULTS: Out of 350 identified articles, 79 articles met the criteria for selection and referred to 27 studies. The majority of the articles were cross-sectional (89%), approximately two-thirds of the articles (61%) examined only PA, and half of the articles (51%) employed device-based assessments. Approximately 47% of the articles reported the prevalence of physical inactivity on the basis of inconsistently defined recommendations. Approximately 14%, 23%, and 10% of the articles focused on active transportation, organized PA (including physical education or leisure-time PA), and parent-child PA, respectively. CONCLUSIONS: Future studies need to focus on longitudinal design and interventions, randomly selected samples, a mix of device-based and self-reported methods, and the recognition of health-related 24-hour time use patterns. This review advocates the government-supported development of a national surveillance system that will help to reduce insufficient PA and excessive SB.
- Keywords
- Health, Insufficient physical activity, Prevalence, Youth,
- MeSH
- Exercise * MeSH
- Humans MeSH
- Adolescent MeSH
- Motor Activity MeSH
- Prevalence MeSH
- Sedentary Behavior * MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Scoping Review MeSH
- Geographicals
- Czech Republic MeSH