Habitual sedentary time and stationary time are inversely related to aerobic fitness

Abstract

A one metabolic-equivalent-of-task increase in peak aerobic fitness (peak MET) is associated with a clinically relevant improvement in survival risk and all-cause mortality. The co-dependent impact of free-living physical behaviours on aerobic fitness are poorly understood. The purpose of this study was to investigate the impact of theoretically re-allocating time spent in physical behaviours on aerobic fitness. We hypothesized that substituting sedentary time with any physical activity (at any intensity) would be associated with a predicted improvement in aerobic fitness. Peak volume rate of oxygen uptake (V˙O₂peak) was assessed via indirect calorimetry during a progressive, maximal cycle ergometer protocol in 103 adults (52 females; [38 ± 21] years; [25.0 ± 3.8] kg/m²; V˙O₂peak: [35.4 ± 11.5] ml·kg⁻¹·min⁻¹). Habitual sedentary time, standing time, light- (LPA), moderate- (MPA), and vigorous-physical activity (VPA) were assessed 24-h/day via thigh-worn inclinometry for up to one week (average: [6.3 ± 0.9] days). Isotemporal substitution modelling examined the impact of replacing one physical behaviour with another. Sedentary time (β = −0.8, 95% CI: [-1.3, −0.2]) and standing time (β = −0.9, 95%CI: [−1.6, −0.2]) were negatively associated with V˙O₂peak, whereas VPA was positively associated with relative V˙O₂peak (β = 9.2, 95%CI: [0.9, 17.6]). Substituting 30-min/day of VPA with any other behaviour was associated with a 2.4-3.4 higher peak MET. Higher standing time was associated with a lower aerobic fitness. As little as 10-min/day of VPA predicted a clinically relevant 0.8-1.1 peak MET increase. Theoretically, replacing any time with relatively small amounts of VPA is associated with improvements in aerobic fitness.

Keywords

Physical activity intensity / Cardiorespiratory fitness / Objective activity monitoring / Sedentary activity / Isotemporal substitution modelling

Funding

Support provided by: Canadian Foundation for Innovation: Leader's Opportunity Fund (DSK) and Faculty of Health Research Development (DSK). MWO and MES were supported by a Heart and Stroke Foundation of Nova Scotia BrightRed Scholarship. MWO and JLP were supported by a Canadian Institutes of Health Research Fredrick Banting and Charles Best Masters (JLP) and Doctoral (MWO) Award. MWO and MES were supported by a Nova Scotia Graduate Scholarship. MWO was also supported by a Research Nova Scotia - Scotia Scholars Award, and a Killam PreDoctoral Scholarship.

Ethical approval statement

Participants were informed of the methods and procedures of determining aerobic fitness and habitual activity verbally and in writing before providing written informed consent. All protocols and procedures conformed to the Declaration of Helsinki and were approved by the Dalhousie University Health Sciences Research Ethics Board.

Authors’ contributions

MWO drafted the manuscript. All authors contributed to the collection and/or analysis of data. All authors edited the manuscript and approved the final version for submission.

Conflict of interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Submission statement

The work has not been published and is not under the consideration for publication elsewhere. The article has been approved by all authors and if accepted, will not be published elsewhere including electronically (regardless of language) without consent of the copyright-holder.

References

[1] T.C. Hoffmann, C.G. Maher, T. Briffa, et al.. Prescribing exercise interventions for patients with chronic conditions. Can Med Assoc J, 188 (7) ( 2016), pp. 510-518, DOI: 10.1503/cmaj.150684

[2] S. Blair, Y. Cheng, J. Holder. Is physical activity or physical fitness more important in defining health benefits?. Med Sci Sports Exerc, 33 (6) ( 2001), pp. S379-S399, DOI: 10.1097/00005768-200106001-00007

[3] R. Ross, S.N. Blair, R. Arena, et al.. Importance of assessing cardiorespiratory fitness in clinical practice: a case for fitness as a clinical vital sign: a scientific statement from the American Heart Association. Circulation, 134 (24) ( 2016), pp. e653-e699, DOI: 10.1161/CIR.0000000000000461

[4] A.M. Costa, L. Breitenfeld, A.J. Silva, A. Pereira, M. Izquierdo, M.C. Marques. Genetic inheritance effects on endurance and muscle strength. Sports Med, 42 (6) ( 2012), pp. 449-458, DOI: 10.2165/11650560-000000000-00000

[5] J. Zeiher, K.J. Ombrellaro, N. Perumal, T. Keil, G.B.M. Mensink, J.D. Finger.Correlates and determinants of cardiorespiratory fitness in adults: a systematic review. Sport Med - Open, 5 (1) ( 2019), p. 39, DOI: 10.1186/s40798-019-0211-2

[6] M. Nayor, A. Chernofsky, N.L. Spartano, et al.. Physical activity and fitness in the community: the Framingham Heart Study. Eur Heart J, 42 (44) ( 2021), pp. 4565-4575, DOI: 10.1093/eurheartj/ehab580

[7] S.A. Prince, C.M. Blanchard, S.L. Grace, R.D. Reid. Objectively-measured sedentary time and its association with markers of cardiometabolic health and fitness among cardiac rehabilitation graduates. Eur J Prev Cardiol, 23 (8) ( 2016), pp. 818-825, DOI: 10.1177/2047487315617101

[8] R.A. Mekary, W.C. Willett, F.B. Hu, E.L. Ding. Isotemporal substitution paradigm for physical activity epidemiology and weight change. Am J Epidemiol, 170 (4) ( 2009), pp. 519-527, DOI: 10.1093/aje/kwp163

[9] J. Grgic, D. Dumuid, E.G. Bengoechea, et al.. Health outcomes associated with reallocations of time between sleep, sedentary behaviour, and physical activity: a systematic scoping review of isotemporal substitution studies. Int J Behav Nutr Phys Activ, 15 (1) ( 2018), p. 69, DOI: 10.1186/s12966-018-0691-3

[10] C. Edwardson, E. Winkler, D. Bodicoat, et al.. Considerations when using the activPAL monitor in field-based research with adult populations. J Sport Heal Sci, 6 (2) ( 2017), pp. 162-178, DOI: 10.1016/j.jshs.2016.02.002

[11] J.H.P.M. Van Der Velde, A. Koster, J.D. Van Der Berg, et al.. Sedentary behavior, physical activity, and fitness - the Maastricht study. Med Sci Sports Exerc, 49 (8) ( 2017), pp. 1583-1591, DOI: 10.1249/MSS.0000000000001262

[12] M.W. O'Brien, M.J. Kivell, W.R. Wojcik, G. D’entremont, D.S. Kimmerly, J.R. Fowles.Step rate thresholds associated with moderate and vigorous physical activity in adults. Int J Environ Res Publ Health, 15 (11) ( 2018), p. 2454, DOI: 10.3390/ijerph15112454

[13] M.W. O'Brien, M.J. Kivell, W.R. Wojcik, G.R. D'Entremont, D.S. Kimmerly, J.R. Fowles. Influence of anthropometrics on step-rate thresholds for moderate and vigorous physical activity in older adults: scientific modeling study. JMIR Aging, 1 (2) ( 2018), Article 12363, DOI: 10.2196/12363

[14] M.E. Shivgulam, M.W. O'Brien, J.A. Johns, et al.. Impact of habitual sedentary patterns on popliteal artery endothelial-dependent vasodilation in healthy adults. Vasc Med, 27 (2) ( 2022), pp. 120-126, DOI: 10.1177/1358863X211065494

[15] M.W. O'Brien, A. Al-Hinnawi, Y. Wu, et al.. The influence of habitual breaks in sedentary time on cardiovagal baroreflex function. Appl Physiol Nutr Metabol, 46 (9) ( 2021), pp. 1143-1146, DOI: 10.1139/apnm-2021-0246

[16] F. Faul, E. Erdfelder, A. Buchner, A.G. Lang. Statistical power analyses using G∗Power 3.1: tests for correlation and regression analyses. Behav Res Methods, 41 (4) ( 2009), pp. 1149-1160, DOI: 10.3758/BRM.41.4.1149

[17] Y. Wu, J.A. Johns, J. Poitras, D.S. Kimmerly, M.W. O'Brien. Improving the criterion validity of the activPAL in determining physical activity intensity during laboratory and free-living conditions. J Sports Sci, 39 (7) ( 2021), pp. 826-834, DOI: 10.1080/02640414.2020.1847503

[18] P. Grant, C. Ryan, W. Tigbe, M. Granat. The validation of a novel activity monitor in the measurement of posture and motion during everyday activities. Br J Sports Med, 40 (12) ( 2006), pp. 992-997, DOI: 10.1136/bjsm.2006.030262

[19] T.L. Hart, A.M. Swartz, S.E. Cashin, S.J. Strath.How many days of monitoring predict physical activity and sedentary behaviour in older adults?. Int J Behav Nutr Phys Activ, 8 ( 2011), p. 62, DOI: 10.1186/1479-5868-8-62

[20] M.W. O'Brien, J.A. Johns, J.R. Fowles, D.S. Kimmerly. Validity of the activPAL and height-adjusted curvilinear cadence-METs equations in healthy adults. Meas Phys Educ Exerc Sci, 24 (2) ( 2020), pp. 147-156, DOI: 10.1080/1091367X.2020.1724112

[21] J.A. Johns, R.J. Frayne, J.A. Goreham, D.S. Kimmerly, M.W. O'Brien. The bout cadence method improves the quantification of stepping cadence in free-living conditions. Gait Posture, 79 ( 2020), pp. 96-101, DOI: 10.1016/j.gaitpost.2020.04.014

[22] E. Vittinghoff, D. Glidden, S. Shiboski, C. McCulloch. Regression Methods in Biostatistics: Linear, Logistic, Survival, and RepeatedMeasures Models. (second ed.ed.), Springer ( 2012)

[23] F.C. Bull, S.S. Al-Ansari, S. Biddle, et al.. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med, 54 (24) ( 2020), pp. 1451-1462, DOI: 10.1136/bjsports-2020-102955

[24] U. Ekelund, J. Steene-Johannessen, W.J. Brown, et al.. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet, 388 (10051) ( 2016), pp. 1302-1310, DOI: 10.1016/S0140-6736(16)30370-1

[25] F. Saeidifard, J.R. Medina-Inojosa, M. Supervia, et al.. The effect of replacing sitting with standing on cardiovascular risk factors: a systematic review and meta-analysis. Mayo Clin Proc Innov Qual Outcomes, 4 (6) ( 2020), pp. 611-626, DOI: 10.1016/j.mayocpiqo.2020.07.017

[26] P.T. Katzmarzyk. Standing and mortality in a prospective cohort of canadian Adults. Med Sci Sports Exerc, 46 (5) ( 2014), pp. 940-946, DOI: 10.1249/MSS.0000000000000198

[27] A.R. Caldwell, K.M. Gallagher, B.T. Harris, et al.. Prolonged standing increases lower limb arterial stiffness. Eur J Appl Physiol, 118 (10) ( 2018), pp. 2249-2258, DOI: 10.1007/s00421-018-3956-2

[28] I.M. Greenlund, P.E. Suriano, S.J. Elmer, J.R. Carter, J.J. Durocher. Chronic standing desk use and arterial stiffness. J Phys Activ Health, 16 (11) ( 2019), pp. 1022-1028, DOI: 10.1123/jpah.2018-0668

[29] N.T. Kruse, W.E. Hughes, R.M. Benzo, L.J. Carr, D.P. Casey. Workplace strategies to prevent sitting-induced endothelial dysfunction. Med Sci Sports Exerc, 50 (4) ( 2018), pp. 801-808, DOI: 10.1249/MSS.0000000000001484

[30] R. Ross, J.P. Chaput, L.M. Giangregorio, et al.. Canadian 24-Hour Movement Guidelines for Adults aged 18-64 years and Adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep. Appl Physiol Nutr Metabol, 45 ( Suppl. 2) ( 2020), pp. S57-S102, DOI: 10.1139/apnm-2020-0467. 10

[31] B.B. Gibbs, K.M. Diaz, R.J. Kowalsky, P.M. Smith, L. Stoner. Association of standing with cardiovascular disease and mortality in adults. Curr Epidemiol Reports, 8 (4) ( 2021), pp. 200-211, DOI: 10.1007/s40471-021-00276-3

[32] R.J. Kowalsky, L. Stoner, M.A. Faghy, B.B. Gibbs.A call to clarify the intensity and classification of standing behavior. Int J Environ Res Publ Health, 18 (16) ( 2021), p. 8460, DOI: 10.3390/ijerph18168460

[33] E. Stamatakis, N.A. Johnson, L. Powell, M. Hamer, V. Rangul, A. Holtermann. Short and sporadic bouts in the 2018 US physical activity guidelines: is high-intensity incidental physical activity the new HIIT?. Br J Sports Med, 53 (18) ( 2019), pp. 1137-1139, DOI: 10.1136/bjsports-2018-100397