The descriptive epidemiology of sitting in Chilean adults: Results from the National Health Survey 2009-2010
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摘要
Background: Although evidence on the health effects of sedentary behavior(SB) has grown systematically in recent years, few developing countries have reported population levels of SB, especially in South America. Our objective was to describe time spent sitting in a representative sample from Chile categorized by age, gender, educational level, and body mass index(BMI).Methods: A national health survey was conducted in Chile in a nationally representative sample(n = 5411) in 2009-2010. Sitting time(ST) was measured with the Global Physical Activity Questionnaire Version 2.Results: Data were from 5031 participants(43.26±0.41 years, mean±SE; 40.3% male). Overall, there were no gender differences in mean ST(men: 158.10±5.80 min/day, women 143.45±4.77 min/day; p = 0.05). ST was lower in those who lived in rural areas compared with urban areas(99.4 min/day vs. 160.0 min/day; p = 0.001). ST increased significantly with increasing BMI, but only in men(p = 0.009), and was positively related to years of education in both men and women(p < 0.0001).Conclusion: The findings were different from those reported in other countries and contexts, reinforcing the need for international surveillance and monitoring over time to inform policy makers. Differences in ST across different groups emphasize the need to develop tailored messages and interventions for reducing ST in different population subgroups.
Background: Although evidence on the health effects of sedentary behavior(SB) has grown systematically in recent years, few developing countries have reported population levels of SB, especially in South America. Our objective was to describe time spent sitting in a representative sample from Chile categorized by age, gender, educational level, and body mass index(BMI).Methods: A national health survey was conducted in Chile in a nationally representative sample(n = 5411) in 2009-2010. Sitting time(ST) was measured with the Global Physical Activity Questionnaire Version 2.Results: Data were from 5031 participants(43.26±0.41 years, mean±SE; 40.3% male). Overall, there were no gender differences in mean ST(men: 158.10±5.80 min/day, women 143.45±4.77 min/day; p = 0.05). ST was lower in those who lived in rural areas compared with urban areas(99.4 min/day vs. 160.0 min/day; p = 0.001). ST increased significantly with increasing BMI, but only in men(p = 0.009), and was positively related to years of education in both men and women(p < 0.0001).Conclusion: The findings were different from those reported in other countries and contexts, reinforcing the need for international surveillance and monitoring over time to inform policy makers. Differences in ST across different groups emphasize the need to develop tailored messages and interventions for reducing ST in different population subgroups.
Background: Although evidence on the health effects of sedentary behavior(SB) has grown systematically in recent years, few developing countries have reported population levels of SB, especially in South America. Our objective was to describe time spent sitting in a representative sample from Chile categorized by age, gender, educational level, and body mass index(BMI).Methods: A national health survey was conducted in Chile in a nationally representative sample(n = 5411) in 2009-2010. Sitting time(ST) was measured with the Global Physical Activity Questionnaire Version 2.Results: Data were from 5031 participants(43.26±0.41 years, mean±SE; 40.3% male). Overall, there were no gender differences in mean ST(men: 158.10±5.80 min/day, women 143.45±4.77 min/day; p = 0.05). ST was lower in those who lived in rural areas compared with urban areas(99.4 min/day vs. 160.0 min/day; p = 0.001). ST increased significantly with increasing BMI, but only in men(p = 0.009), and was positively related to years of education in both men and women(p < 0.0001).Conclusion: The findings were different from those reported in other countries and contexts, reinforcing the need for international surveillance and monitoring over time to inform policy makers. Differences in ST across different groups emphasize the need to develop tailored messages and interventions for reducing ST in different population subgroups.
引文
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3.Howard BJ,Balkau B,Thorp AA,Magliano DJ,Shaw JE,Owen N,et al.Associations of overall sitting time and TV viewing time with fibrinogen and C reactive protein:the AusDiab study.Br J Sports Med 2015;49:255-8.
4.Beunza JJ,Martinez-Gonzalez MA,Ebrahim S,Bes-Rastrollo M,Nunez J,Martinez JA,et al.Sedentary behaviors and the risk of incident hypertension:the SUN Cohort.Am J Hypertens 2007;20:1156-62.
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6.Kim Y,Wilkens LR,Park SY,Goodman MT,Monroe KR,Kolonel LN.Association between various sedentary behaviours and all-cause,cardiovascular disease and cancer mortality:the multiethnic cohort study.Int JEpidemiol 2013;42:1040-56.
7.Holtermann A,Mork PJ,Nilsen TI.Hours lying down per day and mortality from all-causes and cardiovascular disease:the HUNT study,Norway.Eur J Epidemiol 2014;29:559-65.
8.Pavey TG,Peeters GG,Brown WJ.Sitting-time and 9-year all-cause mortality in older women.Br J Sports Med 2015;49:95-9.
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10.Rosenberg DE,Bull FC,Marshall AL,Sallis JF,Bauman AE.Assessment of sedentary behavior with the International Physical Activity Questionnaire.J Phys Act Health 2008;5:(Suppl.1):S30-44.
11.Bull FC,Maslin TS,Armstrong T.Global Physical Activity Questionnaire(GPAQ):nine country reliability and validity study.J Phys Act Health2009;6:790-804.
12.Armstrong T,Bull F.Development of the World Health Organization Global Physical Activity Questionnaire(GPAQ).J Public Health(Bangkok)2006;14:66-70.
13.Gradidge PJ,Crowther NJ,Chirwa ED,Norris SA,Micklesfield LK.Patterns,levels and correlates of self-reported physical activity in urban black Soweto women.BMC Public Health 2014;14:934.
14.Hamrik Z,Sigmundova D,Kalman M,Pavelka J,Sigmund E.Physical activity and sedentary behaviour in Czech adults:results from the GPAQstudy.Eur J Sport Sci 2014;14:193-8.
15.Bauman A,Bull F,Chey T,Craig CL,Ainsworth BE,Sallis JF,et al.The international prevalence study on physical activity:results from 20 countries.Int J Behav Nutr Phys Act 2009;6:21.
16.Secretary of health of Santander and public health observatory of Santander.Risk factors for chronic diseases in Santander.STEPwise method;2011.
17.Ministry of Public Health and Social Welfare of Paraguay.First national survey of risk factors for noncommunicable diseases in general population.Washington DC:World Bank;2012.
18.Ministry of Health Uruguay.2nd National survey of risk factors for noncommunicable diseases.Presidency of the Eastern Republic of Uruguay.Montevideo;2013.
19.Barreto SM,Miranda JJ,Figueroa JP,Schmidt MI,Munoz S,KuriMorales PP,et al.Epidemiology in Latin America and the Caribbean:current situation and challenges.Int J Epidemiol 2012;41:557-71.
20.NHLBI obesity education initiative expert panel on the identification evaluation and treatment of obesity in adults.Clinical guidelines on the identification,evaluation,and treatment of overweight and obesity in adults:the evidence report:National heart,lung,and blood institute.Bethesda,MD:National Institutes of Health;1998.
21.Lloyd-Jones DM,Wilson PW,Larson MG,Beiser A,Leip EP,D’Agostino RB,et al.Framingham risk score and prediction of lifetime risk for coronary heart disease.Am J Cardiol 2004;94:20-4.
22.World Health Organization(WHO).Global Physical Activity Questionnaire(GPAQ).Analysis guide.Geneva:WHO;2012.
23.Aguilar-Farias N,Leppe Zamora J.Is a single question of the Global Physical Activity Questionnaire(GPAQ)valid for measuring sedentary behaviour in the Chilean population?J Sports Sci 2017;35:1652-7.
24.Cleland CL,Hunter RF,Kee F,Cupples ME,Sallis JF,Tully MA.Validity of the Global Physical Activity Questionnaire(GPAQ)in assessing levels and change in moderate-vigorous physical activity and sedentary behaviour.BMC Public Health 2014;14:1255.
25.Centers for Disease Control and Prevention.Continuous NHANES Web Tutorial Sample Code&Datasets;Available at:http://www.cdc.gov/nchs/tutorials/NHANES/NHANESAnalyses/Hypothesis Testing/Task2c.htm ;2014.[accessed 26.05.2015].
26.Harrington DM,Barreira TV,Staiano AE,Katzmarzyk PT.The descriptive epidemiology of sitting among US adults,NHANES 2009/2010.J Sci Med Sport 2014;17:371-5.
27.Soo KL,Wan Abdul Manan WM,Wan Suriati WN.The Bahasa Melayu version of the Global Physical Activity Questionnaire:reliability and validity study in Malaysia.Asia Pac J Public Health 2015;27:NP184-93.
28.Sigmundova D,Sigmund E,Hamrik Z,Kalman M,Pavelka J,Fromel K.Sedentary behaviour and physical activity of randomised sample of Czech adults aged 20à64 years:IPAQ and GPAQ studies between 2002 and2011.Cent Eur J Public Health 2015;23(Suppl.1):S91-6.
29.Bennie JA,Chau JY,van der Ploeg HP,Stamatakis E,Do A,Bauman A.The prevalence and correlates of sitting in European adults-a comparison of 32Eurobarometer-participating countries.Int J Behav Nutr Phys Act 2013;10:107.
30.Healy GN,Clark BK,Winkler EA,Gardiner PA,Brown WJ,Matthews CE.Measurement of adults’sedentary time in population-based studies.Am J Prev Med 2011;41:216-27.
31.Hermosillo-Gallardo ME,Jago R,Sebire SJ.The associations between urbanicity and physical activity and sitting time in Mexico.J Phys Act Health 2017;14:189-94.
32.Bulmer-Thomas V.The economic history of Latin America since independence.Cambridge:Cambridge University Press;2003.
33.Ffrench-Davis R.Economic reforms in Chile:from dictatorship to democracy.London:Palgrave Macmillan UK;2010.
34.Hagstromer M,Oja P,Sjostrom M.Physical activity and inactivity in an adult population assessed by accelerometry.Med Sci Sports Exerc2007;39:1502-8.
35.Milton K,Gale J,Stamatakis E,Bauman A.Trends in prolonged sitting time among European adults:27 country analysis.Prev Med 2015;77:11-6.
36.Proper KI,Cerin E,Brown WJ,Owen N.Sitting time and socio-economic differences in overweight and obesity.Int J Obes(Lond)2007;31:169-76.
37.Loyen A,Verloigne M,Van Hecke L,Hendriksen I,Lakerveld J,SteeneJohannessen J,et al.Variation in population levels of sedentary time in European adults according to cross-European studies:a systematic literature review within DEDIPAC.Int J Behav Nutr Phys Act 2016;13:71.
38.Church TS,Thomas DM,Tudor-Locke C,Katzmarzyk PT,Earnest CP,Rodarte RQ,et al.Trends over 5 decades in U.S.occupation-related physical activity and their associations with obesity.PLoS One 2011;6.doi:10.1371/journal.pone.0019657.
39.Chen M,Wu Y,Narimatsu H,Li X,Wang C,Luo J,etal.Socioeconomicstatus and physical activity in Chinese adults:a report from a community-based survey in Jiaxing,China.PLo S One 2015;10:doi:10.1371/journal.pone.0132918.
40.Cannobio L,Jeri T.Statistics about older adults:a gender analysis.Geneva:Chile’s National Service for older people.Santiago;2008.
41.Ainsworth BE,Caspersen CJ,Matthews CE,Masse LC,Baranowski T,Zhu W.Recommendations to improve the accuracy of estimates of physical activity derived from self report.J Phys Act Health 2012;9(Suppl.1):S76-84.
42.Aguilar-Farias N,Brown WJ,Olds TS,Geeske Peeters GM.Validity of self-report methods for measuring sedentary behaviour in older adults.JSci Med Sport 2015;18:662-6.
43.Clemes SA,David BM,Zhao Y,Han X,Brown W.Validity of two selfreport measures of sitting time.J Phys Act Health 2012;9:533-9.
2.Wilmot EG,Edwardson CL,Achana FA,Davies MJ,Gorely T,Gray LJ,et al.Sedentary time in adults and the association with diabetes,cardiovascular disease and death:systematic review and meta-analysis.Diabetologia 2012;55:2895-905.
3.Howard BJ,Balkau B,Thorp AA,Magliano DJ,Shaw JE,Owen N,et al.Associations of overall sitting time and TV viewing time with fibrinogen and C reactive protein:the AusDiab study.Br J Sports Med 2015;49:255-8.
4.Beunza JJ,Martinez-Gonzalez MA,Ebrahim S,Bes-Rastrollo M,Nunez J,Martinez JA,et al.Sedentary behaviors and the risk of incident hypertension:the SUN Cohort.Am J Hypertens 2007;20:1156-62.
5.Buman MP,Kline CE,Youngstedt SD,Phillips B,Tulio de Mello M,Hirshkowitz M.Sitting and television viewing:novel risk factors for sleep disturbance and apnea risk?Results from the 2013 National Sleep Foundation Sleep in America Poll.Chest 2015;147:728-34.
6.Kim Y,Wilkens LR,Park SY,Goodman MT,Monroe KR,Kolonel LN.Association between various sedentary behaviours and all-cause,cardiovascular disease and cancer mortality:the multiethnic cohort study.Int JEpidemiol 2013;42:1040-56.
7.Holtermann A,Mork PJ,Nilsen TI.Hours lying down per day and mortality from all-causes and cardiovascular disease:the HUNT study,Norway.Eur J Epidemiol 2014;29:559-65.
8.Pavey TG,Peeters GG,Brown WJ.Sitting-time and 9-year all-cause mortality in older women.Br J Sports Med 2015;49:95-9.
9.Bauman A,Ainsworth BE,Sallis JF,Hagstromer M,Craig CL,Bull FC,et al.The descriptive epidemiology of sitting.A 20-country comparison using the International Physical Activity Questionnaire(IPAQ).Am JPrev Med 2011;41:228-35.
10.Rosenberg DE,Bull FC,Marshall AL,Sallis JF,Bauman AE.Assessment of sedentary behavior with the International Physical Activity Questionnaire.J Phys Act Health 2008;5:(Suppl.1):S30-44.
11.Bull FC,Maslin TS,Armstrong T.Global Physical Activity Questionnaire(GPAQ):nine country reliability and validity study.J Phys Act Health2009;6:790-804.
12.Armstrong T,Bull F.Development of the World Health Organization Global Physical Activity Questionnaire(GPAQ).J Public Health(Bangkok)2006;14:66-70.
13.Gradidge PJ,Crowther NJ,Chirwa ED,Norris SA,Micklesfield LK.Patterns,levels and correlates of self-reported physical activity in urban black Soweto women.BMC Public Health 2014;14:934.
14.Hamrik Z,Sigmundova D,Kalman M,Pavelka J,Sigmund E.Physical activity and sedentary behaviour in Czech adults:results from the GPAQstudy.Eur J Sport Sci 2014;14:193-8.
15.Bauman A,Bull F,Chey T,Craig CL,Ainsworth BE,Sallis JF,et al.The international prevalence study on physical activity:results from 20 countries.Int J Behav Nutr Phys Act 2009;6:21.
16.Secretary of health of Santander and public health observatory of Santander.Risk factors for chronic diseases in Santander.STEPwise method;2011.
17.Ministry of Public Health and Social Welfare of Paraguay.First national survey of risk factors for noncommunicable diseases in general population.Washington DC:World Bank;2012.
18.Ministry of Health Uruguay.2nd National survey of risk factors for noncommunicable diseases.Presidency of the Eastern Republic of Uruguay.Montevideo;2013.
19.Barreto SM,Miranda JJ,Figueroa JP,Schmidt MI,Munoz S,KuriMorales PP,et al.Epidemiology in Latin America and the Caribbean:current situation and challenges.Int J Epidemiol 2012;41:557-71.
20.NHLBI obesity education initiative expert panel on the identification evaluation and treatment of obesity in adults.Clinical guidelines on the identification,evaluation,and treatment of overweight and obesity in adults:the evidence report:National heart,lung,and blood institute.Bethesda,MD:National Institutes of Health;1998.
21.Lloyd-Jones DM,Wilson PW,Larson MG,Beiser A,Leip EP,D’Agostino RB,et al.Framingham risk score and prediction of lifetime risk for coronary heart disease.Am J Cardiol 2004;94:20-4.
22.World Health Organization(WHO).Global Physical Activity Questionnaire(GPAQ).Analysis guide.Geneva:WHO;2012.
23.Aguilar-Farias N,Leppe Zamora J.Is a single question of the Global Physical Activity Questionnaire(GPAQ)valid for measuring sedentary behaviour in the Chilean population?J Sports Sci 2017;35:1652-7.
24.Cleland CL,Hunter RF,Kee F,Cupples ME,Sallis JF,Tully MA.Validity of the Global Physical Activity Questionnaire(GPAQ)in assessing levels and change in moderate-vigorous physical activity and sedentary behaviour.BMC Public Health 2014;14:1255.
25.Centers for Disease Control and Prevention.Continuous NHANES Web Tutorial Sample Code&Datasets;Available at:http://www.cdc.gov/nchs/tutorials/NHANES/NHANESAnalyses/Hypothesis Testing/Task2c.htm ;2014.[accessed 26.05.2015].
26.Harrington DM,Barreira TV,Staiano AE,Katzmarzyk PT.The descriptive epidemiology of sitting among US adults,NHANES 2009/2010.J Sci Med Sport 2014;17:371-5.
27.Soo KL,Wan Abdul Manan WM,Wan Suriati WN.The Bahasa Melayu version of the Global Physical Activity Questionnaire:reliability and validity study in Malaysia.Asia Pac J Public Health 2015;27:NP184-93.
28.Sigmundova D,Sigmund E,Hamrik Z,Kalman M,Pavelka J,Fromel K.Sedentary behaviour and physical activity of randomised sample of Czech adults aged 20à64 years:IPAQ and GPAQ studies between 2002 and2011.Cent Eur J Public Health 2015;23(Suppl.1):S91-6.
29.Bennie JA,Chau JY,van der Ploeg HP,Stamatakis E,Do A,Bauman A.The prevalence and correlates of sitting in European adults-a comparison of 32Eurobarometer-participating countries.Int J Behav Nutr Phys Act 2013;10:107.
30.Healy GN,Clark BK,Winkler EA,Gardiner PA,Brown WJ,Matthews CE.Measurement of adults’sedentary time in population-based studies.Am J Prev Med 2011;41:216-27.
31.Hermosillo-Gallardo ME,Jago R,Sebire SJ.The associations between urbanicity and physical activity and sitting time in Mexico.J Phys Act Health 2017;14:189-94.
32.Bulmer-Thomas V.The economic history of Latin America since independence.Cambridge:Cambridge University Press;2003.
33.Ffrench-Davis R.Economic reforms in Chile:from dictatorship to democracy.London:Palgrave Macmillan UK;2010.
34.Hagstromer M,Oja P,Sjostrom M.Physical activity and inactivity in an adult population assessed by accelerometry.Med Sci Sports Exerc2007;39:1502-8.
35.Milton K,Gale J,Stamatakis E,Bauman A.Trends in prolonged sitting time among European adults:27 country analysis.Prev Med 2015;77:11-6.
36.Proper KI,Cerin E,Brown WJ,Owen N.Sitting time and socio-economic differences in overweight and obesity.Int J Obes(Lond)2007;31:169-76.
37.Loyen A,Verloigne M,Van Hecke L,Hendriksen I,Lakerveld J,SteeneJohannessen J,et al.Variation in population levels of sedentary time in European adults according to cross-European studies:a systematic literature review within DEDIPAC.Int J Behav Nutr Phys Act 2016;13:71.
38.Church TS,Thomas DM,Tudor-Locke C,Katzmarzyk PT,Earnest CP,Rodarte RQ,et al.Trends over 5 decades in U.S.occupation-related physical activity and their associations with obesity.PLoS One 2011;6.doi:10.1371/journal.pone.0019657.
39.Chen M,Wu Y,Narimatsu H,Li X,Wang C,Luo J,etal.Socioeconomicstatus and physical activity in Chinese adults:a report from a community-based survey in Jiaxing,China.PLo S One 2015;10:doi:10.1371/journal.pone.0132918.
40.Cannobio L,Jeri T.Statistics about older adults:a gender analysis.Geneva:Chile’s National Service for older people.Santiago;2008.
41.Ainsworth BE,Caspersen CJ,Matthews CE,Masse LC,Baranowski T,Zhu W.Recommendations to improve the accuracy of estimates of physical activity derived from self report.J Phys Act Health 2012;9(Suppl.1):S76-84.
42.Aguilar-Farias N,Brown WJ,Olds TS,Geeske Peeters GM.Validity of self-report methods for measuring sedentary behaviour in older adults.JSci Med Sport 2015;18:662-6.
43.Clemes SA,David BM,Zhao Y,Han X,Brown W.Validity of two selfreport measures of sitting time.J Phys Act Health 2012;9:533-9.