20th Apr 2024

Introduction: Integrating movement behaviours into the 24-hour recommendations is a holistic approach of leading a healthy lifestyle. However, research on how complying with each behaviour influences the others is still scarce. Therefore, this study aimed to explore the interconnectedness between attaining each of the 24-hour movement behaviour recommendations among Portuguese youth.
Methods: A total of 282 students (138 girls), aged 11 to 17 years old (mean=12.9±1.0), participated in this study. Young people’s movement behaviours, such as physical activity, sedentary behaviour (screen time) and sleep, were measured by accelerometery and self-reported. Logistic regression models were carried out to investigate the relationship between each of the movement behaviours, adjusting the analysis for gender and age.
Results: Sleep recommendations were attained by 64% (95% confidence interval [CI]: 58.2, 69.4) of youths. On the other hand, only 25% (95%CI: 20.1, 30.2) and 29% (95%CI: 23.8, 34.4) complied with physical activity and sedentary behaviour recommendations, respectively. Attaining the sedentary behaviour recommendations increases twofold the chances of complying with both the physical activity (odds ratio [OR]=2.03; 95%CI: 1.04, 3.97) and sleep recommendations (OR=2.33; 95%CI: 1.27, 4.26). Complying with the physical activity and sleep recommendations were not related to each other.
Conclusions: Compliance with the 24-hour movement behaviours recommendations among Portuguese youth is still far from ideal. Notwithstanding, attaining the sedentary behaviour recommendations was interconnected with physical activity and sleep recommendations. Public health strategies targeting youth’s screen time may also be effective for promoting physical activity and sleep.

19th Apr 2024

Introduction: Health-related fitness is an important biomarker of health in youth. However, information on the association between 24-hour movement behaviour compliance and the different health-related fitness parameters is still uncertain. Thus, the aim was to analyse the association between complying with the 24-hour movement behaviours and health-related fitness in Portuguese youth.
Methods: Participants were 263 Portuguese youths, 51.3% boys, with a mean age of 12.9±1.0. Movement behaviours (moderate-to-vigorous physical activity [MVPA], screen time and sleep) were assessed by accelerometers and self-reported. Health-related fitness was assessed using the FITescola battery, including body mass index (BMI), waist circumference (WC), aerobic fitness (PACER), upper-body strength (push-ups), lower-body strength (standing broad jump), agility (4x10m shuttle-run) and speed (40m dash). Linear regression models, adjusted for sex and age, were performed for each fitness parameter.
Results: Only 24.7% (95% confidence interval [CI]: 19.5, 29.9) and 28.5% (95%CI: 23.0, 34.0) of children and adolescents followed the MVPA and screen-time recommendations, while 64.6% (95%CI: 58.8, 70.4) attained enough sleep. Complying with MVPA was associated with better aerobic fitness (B=14.5 laps; 95%CI: 9.8, 19.1) and upper- (B=2.1 push-ups; 95%CI: 0.4, 3.7) and lower-body strength (B=10.9 cm; 95%CI: 3.8, 18.2). Whereas, attaining screen-time recommendations was related to lower BMI (B=-1.1; 95%CI: -2.1, -0.1). Sleep was not associated with any fitness parameter. Following all three movement behaviours was associated with better aerobic fitness (B=10.7 laps; 95%CI: 2.7, 18.7) and upper-body strength (B=2.8 cm; 95%CI: 0.1, 5.6) and thinner WC (B=-5.0 cm; 95%CI: -9.8, -0.2).
Conclusions: Movement behaviour compliance is associated with health-related fitness but with different patterns. While engaging in 60 daily minutes of MVPA seems key for muscular and aerobic fitness, having less than 2 hours/day of screen time may positively impact weight. Promoting the 24-hour movement behaviours could be a gateway for improving health-related fitness in future generations.

Introduction: Optimal 24-hour movement behavior compositions (i.e., high levels of physical activity (PA), low levels of sedentary behavior (SB) and sufficient sleep) induce positive effects on for example insulin sensitivity, glucose control and triglyceride levels in adults with Type 2 Diabetes (T2D) showing/emphasizing the importance of intervening on these behaviors. The aim of this systematic review and meta-analysis was to identify effective intervention components that can positively change PA, SB and/or sleep in this population.

Methods: Three electronic databases (PubMed, Web of Science and Embase) were searched using keywords of the following concepts: pathology (T2D), PA, SB, sleep, and study design (randomized controlled trials). ASReview (which uses Artificial Intelligence) was used for title and abstract screening, followed by Covidence for full text screening. Risk of bias was evaluated using the Cochrane Risk of Bias tool 2 (PROSPERO ID CRD42023494007).

Results: The search strategy resulted in 9,437 original references. After screening title and abstract, 595 references were screened for full text resulting in a total of 99 included articles. Preliminary results show a total of 10,531 participants in the intervention group (mean age: 56.7; 50.1% female) and 11,061 participants in the control group (mean age: 57.4; 52.4% female) across all included studies. Goal-setting, action planning, monitoring, social support, and reinforcement and feedback seem commonly used behavior change techniques. The use of a pedometer, face-to-face sessions, group sessions and using the mobile phone are commonly used delivery methods for interventions. The results of the meta-analysis, which will be presented during the conference, will provide more detailed information about effective intervention components and behavior change techniques.

Conclusion: The results of this systematic review and meta-analysis will identify effective intervention components and behavior change techniques that will contribute to future single or multicomponent interventions targeting 24-hour movement behaviors in people with T2D.

10th Apr 2024

Introduction: Type 2 diabetes (T2D) is a prevalent condition associated with cardiometabolic risk in which an unhealthy lifestyle (e.g. low physical activity (PA), high sedentary behavior (SB), insufficient sleep i.e., 24h-movement behaviors (24h-MBs)) plays an important role in disease management. However, it remains unclear whether 24h-MBs are associated with cardiometabolic health in people with T2D (PwT2D) and whether this association differs from that of healthy peers.
Purpose: To compare 24h-MB compositions and associations with cardiometabolic variables between PwT2D and healthy controls.
Methods: Cardiometabolic variables (i.e. Body Mass Index, waist-to-hip ratio, systolic- and diastolic blood pressure, advanced glycation end products) and accelerometer-derived 24-h MBs were collected in 75 healthy controls and 52 PwT2D. Blood parameters (i.e. HbA1c, cholesterol, triglycerides, glucose) were exclusively measured in PwT2D. A MANOVA, using compositional data analysis, was used to explore the differences in compositions between groups. Linear regression models analysed the associations between cardiometabolic variables and 24h-MB composition as the independent variable.
Results: Significant differences (p<0.01) in 24h-MB compositions were observed between both groups with PwT2D spending less time in LPA (-34.13 min) and MVPA (-20.45 min) and more time in SB (+52.38 min) compared to healthy controls while sleep time did not differ. The composition of PwT2D was significantly associated with HDL-cholesterol (p<0.05), reallocating 20 minutes proportional from the other behaviors into MVPA was associated with a 3.53 mg/dl increase in HDL cholesterol. Preliminary results in a subsample of PwT2D (n=36) showed significant changes in 24h-MB compositions (more SB and less PA) after one year follow up.
Conclusions: These findings underscore the importance of considering 24h-MBs in. Further longitudinal research is necessary to explore the potential benefits of optimizing 24h-MB compositions to achieve more optimal cardiometabolic health.
Practical implications: These findings could be a first step towards an integrated approach in T2D management.
Funding: Research foundation Flanders

04th Apr 2024

Introduction: Questionnaires and device-based measures are used for understanding daily behaviors (sleep, sedentary behavior (SB), physical activity (PA)). The recently developed Daily Activity Behavior Questionnaire (DABQ) showed a good agreement for sleep but poor agreements for SB, light-intensity PA (LPA), and moderate-to-vigorous PA (MVPA) compared to ActivPAL. While the thigh-worn ActivPAL is best known for classifying posture-related behaviors, hip-worn devices like Actigraph-GT3x+ are preferred to classify activity intensities. Therefore, the aim of this study is to compare the DABQ with Actigraph-GT3X+, and to explore associations of sociodemographic factors with measurement differences.

Methods: Adults (n=105, 54% female, ±46 y/o) wore an Actigraph-GT3X+ for seven consecutive days (hip/day; wrist/night). Afterwards, participants filled in the DABQ considering the past seven days. Raw accelerometer data were processed by the R-package GGIR comparing different metrics (ENMO, MAD). Single movement analysis (intraclass correlation coefficient (ICC), interclass correlations (r), Bland Altman plots) and compositional analyses (multilevel regression models) were used to compare the measurement techniques.

Results: There was moderate agreement between DABQ and Actigraph for sleep (ICC 0.55; r=0.55) across different metrics. Poor agreements were found for SB, LPA and MVPA, however with varying results across metrics (SBenmo: ICC=0.01, r=0.06; SBmad: ICC=0.24, r=0.42; LPAenmo: ICC=0.01, r=0.11; LPAmad: ICC=0.17, r=0.5; MVPAenmo: ICC=0.22, r=0.28; MVPAmad: ICC=0.24, r=0.38). Using ENMO, Actigraph estimated +400 minutes SB/day, -350 minutes LPA/day and +15 minutes MVPA/day vs DABQ. Using MAD, Actigraph estimated +100 minutes SB/day, -150 minutes LPA/day and +40 minutes MVPA/day vs DABQ. Compositional models found that age, sedentary job and education were associated with differences between DABQ/Actigraph (p<0.001).

Conclusions:. Compared to Actigraph, the DABQ underestimates SB and MVPA, but overestimates LPA. Differences between Actigraph and DABQ measurement differ by metric, age, job and education. Understanding the validity of the DABQ questionnaire is helpful to improve assessments of 24-hour movement behaviors.

Introduction: Optimal levels 24-hour movement behaviors (24h-MB), encompassing sufficient physical activity (PA), limited sedentary behavior (SB) and sufficient sleep duration are crucial for cardiometabolic health. Despite the importance of these 24h-MBs, many adults have difficulties with consistently adopting optimal levels of these behaviors. Understanding factors that underpin adults’ 24h-MB is the fundament for intervention development to optimize these behaviors. The aim of this study is to explore associations between 24h-MBs and cardiometabolic health and to identify the correlates explaining adults’ 24h-MBs.

Methods: The 24h-MBs were objectively collected by Actigraph GT3X accelerometers. The following cardiometabolic variables were measured: HbA1c, fasting glucose, triglycerides, cholesterol, blood pressure, Body Mass Index (BMI), waist circumference (WC) and fat%. Explanatory variables were collected by an online questionnaire, i.e. attitude, facilitators, barriers, self-efficacy, subjective norm, subjective modelling, and social support. Regression analyses were used to explore associations between cardiometabolic variables or explanatory variables on the one hand and 24h-MB time use estimates on the other hand (Compositional Data Analysis).

Results: Data of 191 adults (45 y/o, 68% female) showed associations between the 24h-MB composition with adults’ BMI, WC, and fat% (p<0.001). Different correlates showed significant associations with a more active 24h-MB composition such as male sex (p=0.01), waking up early (p=0.001), being younger (p=0.001), higher self-efficacy regarding PA (p=0.05), less perceived barriers regarding PA (p=0.005), less perceived modelling regarding SB (p=0.04), less perceived barriers regarding interrupting SB (p=0.003), and less perceived facilitators of being sedentary (p=0.008).

Conclusions: These preliminary results highlight the association with 24h-MBs and adiposity and will advance the current understanding of correlates of 24h-MB compositions among Flemish adults which in turn may provide key points for the development of healthy lifestyle interventions.

29th Mar 2024

Background: A healthy active lifestyle (i.e. regular physical activity (PA), limited sedentary behavior (SB) and adequate sleep duration) is an important but challenging part of type 1 diabetes (T1D) management.
Aims: This systematic review aimed to summarize knowledge on explanatory variables of PA, SB and sleep in adults with T1D which is the first step toward developing interventions to achieve a healthy lifestyle.
Methods: A systematic search of four databases (PubMed, Web of Science, Scopus and Embase) was performed. Only objective measurements of PA, SB and sleep were included and all explanatory variables were classified according to the socio-ecological model (i.e. intrapersonal, interpersonal, environmental and policy level). Risk of bias (Joanna Briggs Institute appraisal checklists) and level of evidence (Evidence-Base Guideline Development) were assessed.
Results: All but one studied explanatory variables were situated at the intrapersonal level. A favorable body composition was associated with more time spent in total PA and moderate to vigorous PA (MVPA). Men with T1D spent more time in MVPA than women and a younger age was associated with increased MVPA. Barriers for PA showed an indeterminate association with MVPA.
Conclusion: This review underscores the focus on the individual level to identify explanatory variables of 24h-MBs in adults with T1D, despite the necessity for a socio-ecological approach to develop effective interventions. Based on the investigated variables, future interventions may be tailored to sex and age. More evidence on psychological, interpersonal and environmental variables is needed as these variables are (more) modifiable than health-related and socio-demographic variables.

28th Mar 2024

Rationale: Dementia is a condition that affects an increasing number of older people around the world. Currently, in Portugal, more than 200,000 people are suffering from dementia, and with a substantial financial impact. Investigating risk factors, early diagnosis, and symptoms of age-related diseases and cognitive impairments are crucial. Gait is not a simple motor task; it requires complex cognitive functions, such as attention; it presupposes overcoming obstacles and adapting to the environment so that the individual can walk successfully in complex environments, especially when performing other tasks. Recent evidence suggests that early changes in cognitive abilities are associated with slower, more unsteady gait during dual tasking.
Aim: This study compares the characteristics of cognitive function and gait in elderly people with and without dementia.
Methods: A minimum of 40 institutionalized elderly will be included in the study, all without neurological and/or psychiatric history previous to the current disease, 20 obtain a diagnosis of cognitive impairment or dementia, and another 20 do not score for mild cognitive decline (MCI) nor dementia in the neuropsychological screening tests.
This research, led by the University of Évora, received ethical approval (GD/24725/2023). Participants’ gait will be assessed with the Berg Balance Scale (BBS) and the Time Up and Go Test (TUG) in a single-task and dual-task situation. During these tests, participants will wear Movesense sensors to collect kinematic data associated with gait.
Results: Data are still being collected. Preliminary findings will be presented at the conference.
Conclusion: This study aims to contribute to a more in-depth knowledge of this subject, which will assist professionals in the potential (and future) early detection of this condition.

25th Mar 2024

Introduction: Meeting moderate-to-vigorous physical activity (MVPA) guidelines may not enough to counteract the negative cardiometabolic effects of prolonged sitting time. Athletes involved in diverse sports often comply with 60 minutes per day in MVPA guidelines proposed by World Health Organization, benefiting physical fitness (PF) levels. However, they also often engage in more sedentary activities. We aimed to investigate the impact of practicing at least a second sport (SP2) and sitting time (ST) on PF levels in female volleyball players.
Methods: This study comprises 89 female volleyball players aged 12 to 30 years (15.7±2.6 years). PF was assessed considering three components: muscular (the counter-movement jump, handgrip-strength test, standing-broad jump and step-approach jump), cardiorespiratory fitness (three-minute-step test) and motor component (T-test, shuttle run, and 30-meter run). Individual z-scores, adjusted for age, were computed for each test. Subsequently, aggregated z-scores for motor, muscular, cardiorespiratory fitness and overall PF were derived by summing the scores from the corresponding tests. Body fat percentage (BF%) was evaluated using a bioelectrical impedance analysis. Sports participation and ST were obtained through questionnaire. Linear regression models were using to analyse the links between SP2 and ST and each PF component as well as overall PF. All models were adjusting for BF%.
Results: The prevalence of players exclusively playing volleyball is 90% (N=80) and the mean time spent sitting is 11.22±0.37 hours. Athletes who participate at least two sports tend to have higher overall PF levels (β=3.448±1.405, p=0.016) and higher motor fitness (β=1.874±0.725, p=0.012) compared to those who practice only volleyball. No association was found between ST and overall PF or PF components (p>0.05).
Conclusions: Engaging in at least a second sport might enhance the intensity of PA which could potentially contribute to improved overall PF and motor fitness. Sitting time does not impact physical fitness levels in Volleyball Players.

22nd Mar 2024

Introduction
In the tropical island of Mauritius, the rise of type 2 diabetes has accelerated in the past decades to reach a current prevalence that exceed 20%, and could be contributed by low physical activity and increased sedentary behaviour. The study objectives were to generate the first dataset of objectively determined free-living total energy expenditure (TEE), to estimate physical activity in Mauritian children, and to explore differences due to gender and ethnicity.

Methods
The doubly-labeled water (DLW) technique was used to evaluate TEE over 14 days in 56 Mauritian school children (aged 7-11 years) belonging to the two main ethnic groups: Indian (South Asian descent) and Creole (African/Malagasy descent). Physical activity level (PAL) was calculated as the ratio of TEE and resting energy expenditure (using Schofield equations), and daily step counts were measured by accelerometry. Anthropometry and body composition (by BIA validated against deuterium dilution technique) were also assessed.

Results
TEE was lower in Mauritian children (by ~155 kcal/d) than that predicted using FAO/WHO/UNU equations for children of the same sex, age and body size. Furthermore, TEE, as well as PAL and step counts, also differed according to gender (lower in girls than in boys) and to ethnicity (lower in Indians than in Creoles) even after adjusting for differences in body weight and body composition. On average, Mauritian children fall in the category of countries or subpopulations of countries with low PAL values; this being particularly low in Mauritian Indian girls.

Conclusions
These results in Mauritian children provide the first dataset of objectively measured TEE, from which physical activity is estimated as PAL, and complemented by step counts measurements. They suggest potential gender and ethnic differences in TEE and physical activity that need consideration in developing strategies to counter sedentary behavior and obesity in this diabetes-prone population.