Twenty-four-hour movement patterns relate with cardiometabolic health in adults with obesity

Accelerometer-derived Step Metrics and Quality of Life in Individuals with and without Cardiovascular Diseases

Background and Aims: Steps are increasingly used to prescribe physical activity, but their impact on quality of life (QoL) remains unclear. We examined the dose-response association between step metrics and QoL, and whether cardiovascular disease (CVD) status moderates this association. Methods: Individual-level data of five studies were pooled. Physical activity was measured with thigh-worn accelerometry. We assessed steps/day, daily minutes of fast stepping ([≥]100 steps/min), peak 1- and 30-min cadence. We investigated the association of step metrics and QoL (questionnaire-based; standardized) with multivariable (non-)linear regression, and the interaction with CVD status. Results: We included 9,371 participants (62 [54-68] years; 47% female), comprising 1,977 individuals with and 7,394 without CVD. Significant, curvilinear dose-response associations between step metrics and QoL were found. The optimal step volume was 6,561 steps/day which associated with a 0.35 SD (95%CI: 0.28-0.42) higher QoL compared to the referent 4,000 steps/day. The optimal doses for peak 1-min and peak 30-min cadence were 107 steps/minute (+0.34 SD; 95%CI: 0.28-0.41) and 74 steps/minute (+0.29 SD; 95%CI: 0.24-0.34) respectively, compared to references of 90 and 60 steps/minute. Only fast stepping interacted with CVD status, with a lower optimum in those with versus without CVD (4 minutes/day, +0.20 SD, 95%CI: 0.12-0.28 versus 9 minutes/day, +0.19 SD, 95%CI: 0.12-0.25), compared to the referent 2 minutes/day. Conclusions: Step metrics were curvilinearly associated with QoL with optimal benefits at ~6,500 steps/day. Optimal QoL benefits can be reached at feasible stepping targets, and at slightly fewer daily minutes of fast stepping in CVD versus non-CVD.

Compositional analyses of accelerometer-measured 24-h movement behaviors among adults with normoglycemia, pre-diabetes phenotypes, and diabetes: a population-based study.

Movement Behaviors and Quality of Life in Cardiac Rehabilitation Programs: A Study Based on the Canadian 24‐Hour Movement Guidelines

ABSTRACT Background and Purpose The Canadian 24‐Hour Movement Guidelines integrate recommendations on physical activity (PA), sedentary behavior (SB), and sleep. Individuals in cardiac rehabilitation programs (CRPs) have specific characteristics that may influence adherence to these 24‐Hour Movement Guidelines and their relationship with quality of life. This study aimed to investigate the proportion of CRP participants who meet the recommendations of the Canadian 24‐Hour Movement Guidelines and to evaluate the association between levels of PA, SB, and sleep duration with the quality‐of‐life domains of these individuals. Methods This was a cross‐sectional observational study including CRP participants (mean age: 68.46 ± 10.15 years; 58.1% with coronary artery disease). Quality of life was assessed using the 36‐Item Short‐Form Health Survey (SF‐36). Movement behaviors (PA, SB, and sleep) were measured by accelerometers. Compliance with the guidelines was described using percentage values. Associations between PA, SB, and sleep with quality‐of‐life domains were analyzed using quantile regression. The significance level was set at 5%. Results Among the 105 participants analyzed, only 2.9% simultaneously met all three recommendations. Individual adherence was 29.5% (PA), 9.5% (SB), and 34.3% (sleep). A negative association was identified between SB and functional capacity, and positive associations were found between PA and the domains of functional capacity, vitality, and social aspects. Sleep duration was not associated with quality‐of‐life domains. Discussion Few CRP participants simultaneously meet all three recommendations of the Canadian 24‐Hour Movement Guidelines, with partial adherence being more frequent. Higher levels of PA and lower time spent in SB were associated with better quality of life, whereas sleep duration showed no significant association.

Beyond MVPA minutes: physical activity phenotypes are associated with metabolic profiles in children with obesity

Pediatric obesity is associated with early cardiometabolic risk, yet MVPA alone may not capture meaningful variation in movement behavior. We applied DDRTree to accelerometry data to identify multidimensional physical activity phenotypes in children and adolescents with obesity and assessed their associations with body composition and cardiometabolic. This cross-sectional study included 91 children and adolescents with obesity (43% girls), aged 6–17 years, who wore a thigh-mounted accelerometer for 7 days. Multidimensional accelerometry features were extracted and PA phenotypes identified using DDRTree, an unsupervised reversed graph-embedding method that maps high-dimensional data onto a low-dimensional branching manifold. DDRTree identified 3-PA phenotypes. Anthropometry, metabolic outcomes, and a continuous metabolic syndrome risk score were compared across phenotypes using ANCOVA adjusted for age and sex. DDRTree identified three PA phenotypes: Sedentary (24%), Light Activity (55%), and Higher Activity (21%); only three participants met MVPA recommendations. Compared with the Sedentary Pattern, the Higher Activity Pattern accumulated 122 min/day less sedentary time and 16.5 min/day more MVPA (p < 0.001) and showed lower fat mass percentage, higher fat-free mass percentage, higher insulin sensitivity (SPISE), and a lower metabolic risk score (p ≤ 0.05). Conclusion: Multidimensional PA phenotypes derived from accelerometry identify clinically meaningful differences in body composition and metabolic risk beyond MVPA duration, supporting phenotype-based approaches for pediatric obesity risk stratification and intervention design. What is Known? • Most children and adolescents with obesity do not meet moderate-to-vigorous physical activity recommendations and are at increased risk of adverse cardiometabolic outcomes. • Physical activity volume alone may not fully capture health-relevant movement behaviour; sedentary accumulation, light activity, activity fragmentation, and transitions between activity states may also be associated with metabolic health. What is New? • Multidimensional analysis of thigh-worn accelerometry data identified three distinct physical activity phenotypes, Sedentary, Light Activity, and Higher Activity, even though only three participants met recommended moderate-to-vigorous physical activity levels. • The Higher Activity phenotype was associated with lower fat mass percentage, higher fat-free mass percentage, greater insulin sensitivity, and a lower metabolic risk score than the Sedentary phenotype, supporting assessment beyond moderate-to-vigorous physical activity duration alone.

Association Between Meeting 24-Hour Movement Behavior Guidelines and Adiposity Among Portuguese Children.

PURPOSE To determine the association between meeting 24-hour movement guidelines and markers of adiposity in children, including body mass index, waist circumference, waist-to-height ratio, and percentage body fat. METHODS The sample included 910 children aged 6-10 years from Northern Portugal. Meeting the 24-hour movement guidelines was defined as (1) moderate-to-vigorous physical activity (MVPA): ≥60 minutes per day, (2) sleep: 9 to 11 hours/night, and (3) screen time: ≤2 hours per day. Moderate-to-vigorous physical activity and sleep duration were assessed with wrist-worn accelerometry over 7 days, and screen time was assessed by parental report. RESULTS A total of 5.4% of the sample met none of the guidelines, whereas 23% met all 3 guidelines. Children who met individual guidelines (MVPA, screen time, and sleep) had significantly lower levels of body mass index z-scores and waist circumference, whereas those who met the MVPA and sleep guidelines had lower waist-to-height ratio. Those who met the MVPA guideline had lower percentage body fat than those who did not. There were significant linear trends (all P < .01) between the number of guidelines met (0, 1, 2, and 3) and lower levels of all markers of adiposity. CONCLUSIONS We found significant associations between meeting 24-hour guidelines and lower levels of adiposity among Portuguese children.

Sleep Health: Journal of the National Sleep Foundation