Energy balance-related behaviours associated with overweight and obesity in preschool children: a systematic review of prospective studies. What are the most effective behaviour change techniques to promote physical activity and/or reduce sedentary behaviour in inactive adults? A systematic review protocol A behaviour change intervention to reduce sedentary time in people with chronic obstructive pulmonary disease: protocol for a randomised controlled trial. The application of an occupational health guideline reduces sedentary behaviour and increases fruit intake at work: results from an RCT Role of dietary patterns, sedentary behaviour and overweight on the longitudinal development of childhood constipation: the Generation R study. A family-centered lifestyle intervention to improve body composition and bone mass in overweight and obese children 6 through 8 years: a randomized controlled trial study protocol Effectiveness of parent‐centred interventions for the prevention and treatment of childhood overweight and obesity in community settings: a systematic review A Randomised Controlled Trial to Reduce Sedentary Time in Young Adults at Risk of Type 2 Diabetes Mellitus: Project STAND (Sedentary Time ANd Diabetes)
The current review aim ed to systematic ally identify dietary , physical activity and sedentary behaviours in preschool children ( 4 - 6 years of age ) that are prospect ively related to overweight or obesity later in childhood . Prospect i ve studies published between January 1990 and June 2010 were selected from search es in PubMed , EMBASE , PsycINFO , CINAHL and Cochrane Library . Studies examining the prospect i ve association between at least one relevant behaviour measured during preschool period ( children aged 4 - 6 years at baseline ) in relation to at least one anthropometric measurement at follow-up ( age < 18 years ) were included . Harvest plots were used to summarize the results and draw conclusions from the evidence . Of the 8,718 retrieved papers , 23 papers reporting on 15 different study sample s were included in this review . Strong evidence was found for an inverse association between total physical activity and overweight . Moderate evidence was observed for a positive association between television viewing and overweight . Because of the heterogeneity in the assessed dietary behaviours , insufficient evidence was found for an association between  dietary intake or specific dietary behaviours and overweight . These results suggest that interventions aim ing to prevent overweight among preschool children should focus on promotion of total physical activity and limitation of screen time and that further research is needed to establish whether and which dietary behaviours are important for obesity prevention in this age group . However , despite the lack of evidence for dietary behaviours from the present review , future interventions may already target specific dietary behaviours that are highly prevalent and for which there a clear rationale as well as preliminary evidence that these behaviours are associated with overweight Introduction Large proportions of the population are not meeting recommended levels of physical activity and have increasingly sedentary lifestyles . Low levels of physical activity are predictive of poor health outcomes and time spent sedentary is related to a host of risk factors independently of physical activity levels . Building an evidence base of the best approaches to intervene in the lifestyles of inactive individuals is crucial in preventing long-term disease , disability and higher mortality rates . Methods and analysis Systematic search es will be conducted on all relevant data bases ( eg , PubMed , Scopus , CINAHL , PsycINFO ) . Studies will be included if they assess interventions aim ed at changing physical activity or sedentary behaviour levels in adults ( over 18 ) who are inactive and do not suffer from chronic conditions . Studies must also be r and omised controlled trials ( RCTs ) , have a primary outcome of physical activity or sedentary behaviour , and measure outcomes at least 6 months after intervention completion . Studies will be coded using the Behaviour Change Technique ( BCT ) taxonomy v1 and Template for Intervention Description and Replication ( TIDieR ) guidelines . 2 review ers will independently screen full-text articles and extract data on study characteristics , participants , BCTs , intervention features and outcome measures . Study quality will also be assessed independently by 2 review ers using the Cochrane risk of bias tool . A meta- analysis will be considered if there is sufficient homogeneity across outcomes . GRADE criteria will be used to assess quality of evidence . Dissemination This will be the first review to systematic ally appraise interventions aim ed at changing the physical activity or sedentary behaviour of inactive individuals using RCT design s with a 6-month follow-up post-intervention . This review will better inform intervention design ers targeting inactive population s and inform the design of a future complex intervention . Review registration number This protocol was registered with the International Prospect i ve Register of Systematic Review s ( PROSPERO ) on 17 October 2014 ( registration number : CRD42014014321 ) INTRODUCTION Replacing sedentary behaviour with light intensity physical activity ( ie , activities classified as less than three metabolic equivalents , such as slow-paced walking ) may be a more realistic strategy for reducing cardiometabolic risk in people with chronic obstructive pulmonary disease than only aim ing to increase levels of moderate-vigorous intensity physical activity . Behaviour change interventions to reduce sedentary behaviour in people with chronic obstructive pulmonary disease have not yet been developed or tested . RESEARCH QUESTIONS Is a 6-week behaviour change intervention effective and feasible in reducing sedentary time in people with chronic obstructive pulmonary disease ? DESIGN This study will be a multi-centre , r and omised , controlled trial with concealed allocation , assessor blinding , and intention-to-treat analysis , comparing a 6-week behaviour change intervention aim ed at reducing sedentary time with a sham intervention in people with chronic obstructive pulmonary disease . PARTICIPANTS AND SETTING Seventy participants will be recruited from the waiting lists for pulmonary rehabilitation programs at Royal Prince Alfred Hospital and Prince of Wales Hospital , Sydney , Australia . INTERVENTION The behaviour change intervention aims to reduce sedentary time through a process of guided goal setting with participants to achieve two target behaviours : ( 1 ) replace sitting and lying down with light-intensity physical activity where possible , and ( 2 ) st and up and move for 2minutes after 30minutes of continuous sedentary time . Three face-to-face sessions and three phone sessions will be held with a physiotherapist over the 6-week intervention period . The ' capability ' , ' opportunity ' , ' motivation ' and ' behaviour ' ( COM-B ) model will be applied to each participant to determine which components of behaviour ( capability , opportunity or motivation ) need to change in order to reduce sedentary time . Based on this ' behavioural diagnosis ' , the Behaviour Change Wheel will be used to systematic ally select appropriate behaviour change techniques to assist participants in achieving their weekly goals . Behaviour change techniques will include providing information about the health consequences of sedentary behaviour , self-monitoring and review of weekly goals , problem-solving of barriers to achieving weekly goals , and providing feedback on sedentary time using the Jawbone UP3 activity monitor . CONTROL The sham intervention will consist of weekly phone calls for 6 weeks , to enquire whether the participants ' health status has changed over the intervention period ( eg , hospitalised for an acute exacerbation ) . No instructions regarding physical activity or exercise will be given . MEASUREMENTS Outcomes will be assessed at baseline , at the end of the 6-week intervention period , and at the 3-month follow-up . Primary outcome measures will be : ( 1 ) total sedentary time , including the pattern of accumulation of sedentary time , assessed by the activPAL3 activity monitor , and ( 2 ) feasibility of the intervention assessed by uptake and retention of participants , participant compliance , self-reported achievement of weekly goals , and adverse events . Secondary outcome measures will include functional exercise capacity , health-related quality of life , domain-specific and behaviour-specific sedentary time , patient activation , and anxiety and depression .  Semi-structured interviews will be conducted with participants who receive the behaviour change intervention to explore acceptability and satisfaction with the different components of the intervention . ANALYSIS Analysis of covariance ( ANCOVA ) will be used to calculate between-group comparisons of total sedentary time and the number of bouts of sedentary time>30minutes after adjusting baseline values . Uncertainty about the size of the mean between-group differences will be quantified with 95 % CI . Within-group comparisons will be examined using paired t-tests and described as mean differences with 95 % CIs . Secondary outcome measures will be analysed similarly . The feasibility measures will be analysed descriptively . Semi-structured interviews will be conducted until data saturation is achieved and there are no new emerging themes . De-identified interview transcripts will be coded independently by two research ers and analysed alongside data collection using the COM-B model as a thematic framework . DISCUSSION / SIGNIFICANCE If behaviour change interventions are found to be an effective and feasible method for reducing sedentary time , such interventions may be used to reduce cardiometabolic risk in people with chronic obstructive pulmonary disease . An approach that emphasises participation in light-intensity physical activity may increase the confidence and willingness of people with chronic obstructive pulmonary disease to engage in more intense physical activity , and may serve as an intermediate goal to increase uptake of pulmonary rehabilitation Objective To evaluate the effectiveness of a draft occupational health practice guideline aim ed at preventing weight gain on employees ' physical activity , sedentary behaviour and dietary behaviour and on body weight-related outcomes . Methods A r and omised controlled trial was performed comparing guideline -based care to usual care among 16 occupational physicians and 523 employees in the Netherl and s between 2009 and 2011 . Occupational physicians in the intervention group followed the draft guideline by providing advice to employers on how to assess and intervene on the obesogenic work environment and conducted five face-to-face behavioural change counselling sessions with employees to improve their lifestyle . Data of employees were collected by question naire and physical measurements at baseline and 6-months follow-up . Linear and logistic regression analyses were performed to determine effects . Results The intervention showed significant effects on sedentary behaviour at work ( β −28 min/day , 95 % CI −2 to −54 ) and on fruit intake ( β 2.1 pieces/week ; 95 % CI 0.6 to 3.6 ) . No significant intervention effects were found for physical activity , sedentary behaviour in leisure time or during weekend days , snack intake and body weight-related outcomes . Conclusion Guideline -based care result ed in a more favourable sedentary behaviour at work and increased fruit intake but did not improve employees '  physical activity , snack intake or body weight-related outcomes . Trial registration number IS RCT N/73545254 and NTR/1190 The influence of childhood nutrition on the development of constipation beyond the period of weaning and breastfeeding is relatively understudied . In addition , eating patterns in childhood can be highly correlated with overweight and sedentary behaviour , which may also have an influence on constipation . The aim of this study was to assess whether common dietary patterns , sedentary behaviour and childhood overweight are associated with  constipation in childhood . The study was embedded in a population -based prospect i ve birth cohort . Information on dietary intake was obtained by a food frequency question naire  at the child 's age of 14 months ( n = 2420 ) . The adherence scores on a ' Health conscious ' and ' Western-like ' diet were extracted from principal component analysis . At the age of 24 , 36 and 48 months , information on constipation and sedentary behaviour , and weight and height was obtained by parental-derived question naires and from the child health centres , respectively . Adherence to a ' Western-like ' dietary pattern was associated with a higher prevalence of constipation up to 48 months [ adjusted odds ratio ( aOR ) ; 95 % confidence interval ( CI ) : 1.39 ; 1.02 - 1.87 ] , which was not mediated by overweight or sedentary behaviour . Adherence to a ' Health Conscious ' dietary pattern was only associated at short term , with a lower prevalence of constipation at 24 months ( aOR ; 95%CI : 0.65 ; 0.44 - 0.96 ) . No association was found between overweight , sedentary behaviour and constipation . Our results suggest that specific dietary patterns in early childhood could be associated with higher or lower risks for constipation , but these effects are time-dependent . Overweight and sedentary behaviour seem to not have a major role on constipation in childhood Background Childhood obesity gives rise to health complications including impaired musculoskeletal development that associates with increased risk of fractures . Prevention and treatment programs should focus on nutrition education , increasing physical activity ( PA ) , reducing sedentary behaviours , and should monitor bone mass as a component of body composition . To ensure lifestyle changes are sustained in the home environment , programs need to be family-centered . To date , no study has reported on a family-centered lifestyle intervention for obese children that aims to not only ameliorate adiposity , but also support increases in bone and lean muscle mass . Furthermore , it is unknown if programs of such nature can also favorably change eating and activity behaviors . The aim of this study is to determine the effects of a 1 y family-centered lifestyle intervention , focused on both nutrient dense foods including increased intakes of milk and alternatives , plus total and weight-bearing PA , on body composition and bone mass in overweight or obese children . Methods / design The study design is a r and omized controlled trial for overweight or obese children ( 6–8 y ) . Participants are r and omized to control , st and ard treatment ( StTx ) or modified treatment ( ModTx ) . This study is family-centred and includes individualized counselling sessions on nutrition , PA and sedentary behaviors occurring 4 weeks after baseline for 5 months , then at the end of month 8 . The  control group receives counselling at the end of the study . All groups are measured at baseline and every 3 months for the primary outcome of changes in body mass index Z-scores . At each visit blood is drawn and children complete a research er-administered behavior question naire and muscle function testing . Changes from baseline to 12 months in body fat ( % and mass ) , waist circumference , lean body mass , bone ( mineral content , mineral density , size and volumetric density ) , dietary intake , self-reported PA and sedentary behaviour are examined . Discussion This family-centered theory-based study permits for biochemical and physiological assessment s. This trial will assess the effectiveness of the intervention at changing lifestyle behaviours by decreasing adiposity while enhancing lean and bone mass . If successful , the intervention proposed offers new insights for the management or treatment of childhood obesity . Trial registration Clinical Trials.gov , NCT01290016 Background Worldwide in 2000 , 10 % of children aged five to 17 years were reported as being overweight with an additional 2‐3 % being obese . Overweight and obesity in childhood can adversely impact on both physical and psychological health . The rise in the prevalence of childhood obesity is a complex issue but widely recognised contributors include increased energy intake , decreased levels of physical activity and greater time spent in sedentary pursuits . A large number of environmental and cultural factors have also been identified as contributing to the problem . Evidence to support an optimal approach to treating childhood obesity is limited with many studies showing only modest results at best in the long‐term . However , the importance of family‐based treatment that combines diet , physical activity and behavioral components has been acknowledged in a recent Cochrane Systematic Review . It has also been suggested that interventions offered in the community setting may help overcome barriers to participation , by making programs more accessible and allowing the targeting of specific sub‐groups of the population . Objectives The objective of this review was to identify the effectiveness of parent‐centred interventions implemented in the community setting in modifying eating and physical activity behaviors or weight‐related outcomes of children . Inclusion criteria Types of participants This review considered studies that included free‐living children of pre‐school , primary and secondary school age and /or their parents/guardians aged > 18 years . Types of intervention(s)/phenomena of interest Intervention programs were required to have a parental component , to target eating and /or exercise behaviors for the prevention or treatment of obesity , and child weight status reported . Types of studies All intervention studies were included in the review including : r and omized controlled trials ( RCTs ) ; non‐r and omized controlled trials , longitudinal studies , cohort ( both retrospective and prospect i ve ) , case control and time series studies which had been conducted in a community setting . Types of outcomes This review considered studies that included overweight/obesity related outcomes , eating behavior outcomes , physical activity behaviour outcomes , and sedentary behavior outcomes and constructs . Search strategy A literature search of community‐based parent‐centred intervention studies to promote nutrition and physical activity for the prevention and treatment and of childhood overweight and obesity was performed in eight electronic data bases dating from 1975 to April 2009 . Method ological quality Studies were critically appraised for method ological quality using st and ardized tools . Data collection Data was extracted by one review er using a st and ardized data extraction form developed by the research ers and checked for accuracy and consistency by a second review er . Data synthesis Data in relation to setting , methodology , intervention components and effect on weight , dietary intake and physical activity was extracted , and described in a narrative synthesis . Where possible a meta‐ analysis was undertaken . Results Of the home‐based interventions , five of nine studies reported statistically significant changes in anthropometric outcomes post intervention . Of the 10 studies in the before and after school care setting , seven reported a significant decrease in a weight‐related outcome post intervention , with only one reporting an increase . Conclusions Results from the review support the after‐school setting as the most promising for community intervention setting for targeting parents as agents of change within child obesity prevention and treatment programs . Implication s for practice At this stage , interventions to support parents should target the after‐school environment as opposed to being conducted in the home , summer camps , leisure centers or churches . Targeting a decrease in energy intake and sweetened beverages in parallel with increasing number of daily steps and decreasing screen time use . Implication s for research Future studies of high quality are needed across the full range of community setting s. Given that currently most of the higher quality RCTs and the studies showing positive impacts of weight change are in the after‐school setting , further studies in this area using similar method ologies to those already published will facilitate future meta‐analyses in this area Aims Type 2 diabetes mellitus ( T2DM ) , a serious and prevalent chronic disease , is traditionally associated with older age . However , due to the rising rates of obesity and sedentary lifestyles , it is increasingly being diagnosed in the younger population . Sedentary ( sitting ) behaviour has been shown to be associated with greater risk of cardio-metabolic health outcomes , including T2DM . Little is known about effective interventions to reduce sedentary behaviour in younger adults at risk of T2DM . We aim ed to investigate , through a r and omised controlled trial ( RCT ) design , whether a group-based structured education workshop focused on sitting reduction , with self-monitoring , reduced sitting time . Methods Adults aged 18–40 years who were either overweight ( with an additional risk factor for T2DM ) or obese were recruited for the Sedentary Time ANd Diabetes ( ST AND ) RCT . The intervention programme comprised of a 3-hour group-based structured education workshop , use of a self-monitoring tool , and follow-up motivational phone call . Data were collected at three time points : baseline , 3 and 12 months after baseline . The primary outcome measure was accelerometer-assessed sedentary behaviour after 12 months . Secondary outcomes included other objective ( activPAL ) and self-reported measures of sedentary behaviour and physical activity , and biochemical , anthropometric , and psycho-social variables . Results 187 individuals ( 69 % female ; mean age 33 years ; mean BMI 35 kg/m2 ) were r and omised to intervention and control groups . 12 month data , when analysed using intention-to-treat analysis ( ITT ) and per- protocol analyses , showed no significant difference in the primary outcome variable , nor in the majority of the secondary outcome measures . Conclusions A structured education intervention design ed to reduce sitting in young adults at risk of T2DM was not successful in changing behaviour at 12 months . Lack of change may be due to the brief nature of such an intervention and lack of focus on environmental change . Moreover , some participants reported a focus on physical activity rather than reductions in sitting per se . The habitual nature of sedentary behaviour means that behaviour change is challenging . Trial Registration Controlled-Trials.com IS RCT
Sedentary behaviour continues to be associated with unhealthy diet in young people in mostly cross-sectional studies .
BACKGROUND Sedentary behaviour and its association with dietary intake in young people and adults are important topics and were systematic ally review ed in 2011 .
There is a need to up date this evidence given the changing nature of sedentary behaviour and continued interest in this field .
This review aims to assist research ers in better interpreting the diversity of findings concerning sedentary behaviour and weight status .
OBJECTIVE To provide an up date of the associations between sedentary behaviour and dietary intake across the lifespan .