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OBJECTIVES: Both high and low levels of occupational physical activity are associated with back pain. Thus, there might be a “sweet- and sour-spot” of occupational physical activity for back pain. Our aim was to investigate if there exists an occupational physical activity “sweet- (lowest risk) and sour-spot” (highest risk) for back pain. METHODS: A total of 396 eldercare workers from 20 Danish nursing homes participated. Occupational physical activity was measured between 1–4 working days using thigh-worn accelerometry. Back pain intensity was reported monthly on a scale from 0–10 over 1-year. A zero-inflated mixed-effects model was developed regressing occupational physical activity against back pain, adjusted for confounders. The “sweet- and sour-spot” were defined as the occupational physical activity compositions (sitting, standing, light, and moderate-to-vigorous) associated with the 5% lowest and highest risk for back pain, respectively. RESULTS: The composition associated with the lowest risk of back pain – the “sweet-spot”– consisted of 71% worktime spent sitting, 18% spent standing, 5% spent on light physical activity and 6% spent on moderate-to-vigorous physical activity. The composition associated with highest risk for back pain –the “sour-spot”– consisted of 8% worktime spent sitting, 66% spent standing, 4% spent on light physical activity, and 21% spent on moderate-to-vigorous physical activity. CONCLUSIONS: The “sweet-spot” of occupational physical activity for back pain among eldercare workers involves more sitting and light physical activity time, while the “sour-spot” involves more standing and moderate-to-vigorous physical activity time. Research on the occupational physical activity “sweet- and sour-spot” is needed.

Background Time spent in sleep, sedentary behaviour (SB), and physical activity are exhaustive and mutually exclusive parts of a 24-h day that need to be considered in a combination. The aim of this study was to identify validated self-reported tools for assessment of movement behaviours across the whole 24-h day, and to review their attributes and measurement properties. Methods The databases PubMed, Scopus, and SPORTDiscus were searched until September 2023. Inclusion criteria were: (i) published in English language, (ii) per-reviewed paper, (iii) assessment of self-reported time spent in sleep, SB, and physical activity, (iv) evaluation of measurement properties of all estimates across the full 24-h day, and (v) inclusion of adolescents, adults, or older adults. The methodological quality of included studies was assessed using the Consensus-based Standards for the selection of health Measurement Instruments checklist. Results Our search returned 2064 records. After studies selection, we included 16 articles that reported construct validity and/or test-retest reliability of 12 unique self-reported tools – eight questionnaires, three time-use recalls, and one time-use diary. Most tools enable assessment of time spent in sleep, and domain-specific SB and physical activity, and account that sum of behaviours should be 24 h. Validity (and reliability) correlation coefficients for sleep ranged between 0.22 and 0.69 (0.41 and 0.92), for SB between 0.06 and 0.57 (0.33 and 0.91), for light-intensity physical activity between 0.18 and 0.46 (0.55 and 0.94), and for moderate- to vigorous-intensity physical activity between 0.38 and 0.56 (0.59 and 0.94). The quality of included studies being mostly fair-to-good. Conclusions This review found that only a limited number of validated self-reported tools for assessment of 24-h movement behaviours are currently available. Validity and reliability of most tools are generally adequate to be used in epidemiological studies and population surveillance, while little is known about adequacy for individual level assessments and responsiveness to behavioural change. To further support research, policy, and practice, there is a need to develop new tools that resonate with the emerging 24-h movement paradigm and to evaluate measurement properties by using compositional data analysis. Systematic review registration PROSPERO CRD42022330868.

Background The ‘physical activity paradox’ advocates that leisure physical activity (PA) promotes health while high occupational PA impairs health. However, this paradox can be explained by methodological limitations of the previous studies—self-reported PA measures, insufficient adjustment for socioeconomic confounding or not addressing the compositional nature of PA. Therefore, this study investigated if we still observe the PA paradox in relation to long-term sick absence (LTSA) after adjusting for the abovementioned limitations. Methods Time spent on moderate-to-vigorous physical activity (MVPA) and remaining physical behaviors (sedentary behavior, standing, light PA and time in bed) at work and in leisure was measured for 929 workers using thigh accelerometry and expressed as isometric log-ratios ( ilrs ). LTSA was register-based first event of ≥6 consecutive weeks of sickness absence during 4-year follow-up. The association between ilrs and LTSA was analyzed using a Cox proportional hazards model adjusted for remaining physical behaviors and potential confounders, then separately adjusting for and stratifying by education and type of work. Results During the follow-up, 21% of the workers experienced LTSA. In leisure, more relative MVPA time was negatively associated with LTSA (20% lower risk with 20 min more MVPA, p  = 0.02). At work, more relative MVPA time was positively associated with LTSA (15% higher risk with 20 min more MVPA, p  = 0.02). Results remained unchanged when further adjusted for or stratified by education and type of work. Conclusion These findings provide further support to the ‘PA paradox’.

Sleep, sedentary behaviour (SB), and physical activity are among key behavioural determinants of health. There is a need to evaluate questionnaires that capture movement behaviours across the full 24-h day. The aim of this study was to examine the measurement properties of the Daily Activity Behaviours Questionnaire (DABQ), a novel questionnaire (with a past seven-day recall period) for estimating the time spent in sleep, SB, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) among adults. A sample of 126 adults was recruited. DABQ was administered to the participants on two occasions seven days apart to examine its test-retest reliability. The convergent validity of DABQ estimates was explored against activPAL4 accelerometer/inclinometer estimates. Intraclass correlation coefficients for absolute agreement and consistency between the times spent in sleep, SB, LPA, and MVPA estimated by DABQ in the test and re-test ranged from 0.59 to 0.69. Spearman’s correlations between the times spent in sleep, SB, LPA, and MVPA estimated by DABQ and activPAL4 ranged from 0.38 to 0.66. In terms of reliability and validity, DABQ is comparable with existing questionnaires; however, it has an important advantage of enabling a comprehensive assessment of all four 24-h movement behaviours. The measurement properties of DABQ make it suitable for large-scale epidemiological studies on 24-h movement behaviours.

Background Time spent in physical activity (PA), sedentary behaviour (SB), and sleep always takes up the whole day. New public health guidelines combining recommendations for PA, SB, and sleep have been issued in several countries. Thailand was the first country to release the 24-h guidelines for adults. Currently, there is no evidence on the population prevalence of meeting 24-h movement guidelines in Thailand. This study, therefore, aimed to determine 15-year trends and associations of meeting 24-h movement guidelines among Thai adults. Method We analysed cross-sectional data from 2001, 2004, 2009, and 2015 Thai Time-Use Surveys, coded using the International Classification of Activities for Time-Use Statistics (ICATUS). All ICATUS-based activities were categorised into moderate-to-vigorous PA (MVPA), light PA (LPA), SB, and sleep based on a previously developed classification system. A total of 167,577 adult participants were included. The participants were classified according to the Thai 24-h movement guidelines into meeting or not meeting the following criteria: 1) ≥150 min/week of MVPA; 2) interrupting SB every 2 h; 3) sleeping 7–9 h per day; and 4) adhering to all three guidelines. Results In 2015, the prevalence of adults who met the MVPA, SB, sleep, and overall recommendations was 81.7, 44.6, 56.4, and 21.3%, respectively. A significant linear increase was found for the prevalence of meeting the SB recommendation, while the prevalence meeting the MVPA, sleep, and overall recommendations was lowest in 2001, peaked in 2004 or 2009, and declined in 2015. The lowest odds for meeting the 24-h guidelines were found among males, those living in urban areas, inhabitants of Bangkok and South Thailand, unemployed, and those with low education level. Conclusions Despite promising trends in the prevalence of meeting PA, SB, and sleep recommendations, a majority of Thai adults still do not meet the overall 24-h movement guidelines. Further actions are needed to promote more MVPA, less SB, and adequate sleep in Thai adults, particularly among males, those living in urban areas, inhabitants of Bangkok and South Thailand, unemployed, and those with low education level.

Background To examine compositional associations between short sleep duration and sedentary behavior (SB), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) among children and adolescents. Methods Multi-day 24-h data on sleep, SB, LPA and MVPA were collected using accelerometers among 343 children (8–13 years old) and 316 adolescents (14–18 years old). Children and adolescents with sleep duration of < 9 and < 8 h, respectively, were classified as short sleepers. Robust compositional regression analysis was used to examine the associations between short sleep duration and the waking-time composition. Results Seventy-one percent of children and 75.3% of adolescents were classified as short sleepers. In children, being a short sleeper was associated with higher SB by 95 min/day ( p  < 0.001) and lower MVPA by 16 min/day ( p  = 0.002). Specifically, it was associated with a higher amount of time spent in long sedentary bouts (β ilr1  = 0.46, 95% confidence interval [CI] = 0.29 to 0.62) and lower amounts of time spent in sporadic SB (β ilr1  = − 0.17, 95% CI = –0.24 to − 0.10), sporadic LPA (β ilr1  = − 0.09, 95% CI = –0.14 to − 0.04) and sporadic MVPA (β ilr1  = − 0.17, 95% CI = –0.25 to − 0.10, p  < 0.001 for all), relative to the remaining behaviours. In adolescents, being a short sleeper was associated with a higher amount of time spent in SB by 67 min/day ( p  = 0.001) and lower LPA by 2 min/day ( p  = 0.035). Specifically, it was associated with more time spent in sedentary bouts of 1–9 min (β ilr1  = 0.08, 95% CI = 0.02 to 0.14, p  = 0.007) and 10–29 min (β ilr1  = 0.10, 95% CI = 0.02 to 0.18, p  = 0.015), relative to the remaining behaviours. Conclusions Among children and adolescents, short sleep duration seems to be highly prevalent and associated with less healthy waking time. Public health interventions and strategies to tackle the high prevalence of short sleep duration among children and adolescents are warranted.

Background Several countries have recently issued 24-h movement guidelines that include quantitative recommendations for moderate-to-vigorous physical activity (MVPA), sedentary behaviour (SB), and sleep. This study explored the associations of meeting the 24-h movement guidelines with stress and self-rated health among adults, and whether the likelihood of favourable outcomes increases with the number of guidelines met. Methods A total of 2476 adults aged 18 years and over completed a questionnaire on their time spent in MVPA, SB and sleep, frequency of stress ( never , very rarely , occasionally , often , every day ), self-rated health ( very good , good , fair , bad , very bad ), sociodemographic characteristics, and lifestyle variables. Results In an ordinal logistic regression analysis adjusted for age, sex, body mass index, education, socio-economic status, employment, place of residence, living with or without partner, and smoking, lower odds of higher frequency of stress were found for those meeting the combined 24-h movement guidelines (adjusted odds ratio [OR] = 0.45; 95% confidence interval [CI]: 0.32, 0.63; p  <  0.001), any combination of two guidelines (OR range: 0.48–0.63; p  <  0.05 for all), and sleep guideline only (OR = 0.51; 95% CI: 0.35, 0.75; p  = 0.001). Higher odds of better self-rated health were found for those meeting the combined 24-h movement guidelines (OR = 2.94; 95% CI: 2.07, 4.19; p  <  0.001), combination of MVPA and SB guidelines (OR = 2.33; 95% CI: 1.57, 3.44; p  <  0.001), combination of MVPA and sleep guidelines (OR = 1.78; 95% CI: 1.23, 2.59; p  = 0.002), and MVPA guideline only (OR = 2.24; 95% CI: 1.50, 3.36; p  <  0.001). Meeting more guidelines was associated with greater odds of favourable outcomes ( p for linear trend < 0.001). Conclusion Adults who meet the sleep guideline, any combination of two guidelines, or all three guidelines experience stress less frequently. Meeting the MVPA guideline alone or in combination with any other movement behaviour guideline was associated with better self-rated health. The likelihood of less frequent stress and better self-rated health increases with the number of guidelines met. Adults should be encouraged to meet as many movement behaviour guidelines as possible.

Background Understanding how older adults spend time in moderate- to vigorous-intensity physical activity (MVPA) is crucial to understanding healthy ageing. This study connects 24-h time-use diary records of the daily activities of a sample of Swedish older adults to energy intensities. The aim was to: i) estimate the prevalence of Swedish older adults (aged 65–84 years) who achieved recommended daily levels of physical activity; ii) identify what domains of everyday life contribute to MVPA; and iii) explore socio-demographic factors affecting rates of active living. Methods We draw on two Swedish nationally representative samples of time-use diary data from 2000/2001 and 2010/2011. Data covering the duration of all activities performed over two days were combined with activity-intensity information (metabolic equivalent of task [MET] values) to estimate the energy expenditure (MET min) originating from MVPA. Results Results indicate that 94.1% of Swedish older adults achieved the WHO-recommended minimum level of daily MVPA in 2010/2011; the share remained unchanged over the period. MVPA performed in natural environments (24.2%), during housework (22.8%), and on everyday walks in one’s local area (18.1%) were dominant domains contributing to energy expenditure. Home maintenance and repairs (8.8%), active transport (9.9%), and physical exercise (8.2%) contributed to a lesser extent. In 2000/2001, total MVPA energy expenditure was associated with gender, housing, living region, and disability; in 2010/2011, except for disability, these associations were no longer significant. Conclusions The high proportion of older adults who achieved the recommended level of MVPA, their allocation of MVPA time to diverse domains, and the reduced social distribution over time suggest that elderly people increasingly find their own paths to everyday physical activity. This indicates a need to promote MVPA not only in established ways, such as prescribed training programmes. The importance of active physical activities in natural environments, and of regular walks in the vicinity of home, indicates a need to incorporate healthy ageing considerations in wider urban and regional planning, for example, to increase access to natural environments and urban walkability. Also, older adults’ involvement in household chores, maintenance and repairs, and active transport extends responsibility to new policy areas.

Background The composition of daily time-use physical behaviours—such as sedentary behaviour (SB), light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and sleep may be crucial for overall health and wellbeing. This study examined the associations between these time-use behaviours and both evaluative wellbeing (life satisfaction) and experienced wellbeing (momentary happiness, anxiousness, and tiredness). Evaluative wellbeing reflects an individual's overall life assessment, while experienced wellbeing captures real-time affective states. We investigated these associations by reallocating time among behaviours and assessing the predicted impact on wellbeing outcomes. Methods Time-use behaviours were obtained from 211 adults who wore Axivity AX3 accelerometers on their wrists for seven days. Participants also completed a survey to assess demographics and life satisfaction, before using a custom smartphone app to report their real-time happiness, anxiousness, and tiredness levels over seven days (at three random times each day). Time-use data were processed using UK Biobank machine learning algorithms. We employed Bayesian multilevel compositional analysis to investigate how time-use behaviours, and reallocating time between behaviours, were associated with both life satisfaction and momentary affective states. Results Increasing sedentary time (relative to other behaviours) over the week of observation was negatively associated with happiness and positively associated with anxiousness aggregated at the day level. Conversely, increasing the proportion of MVPA (relative to other behaviours) was associated with reduced anxiousness and tiredness. Substitution analysis showed that reallocating 20 min of SB to MVPA increased happiness by 0.12 units, 95% CI [0.01, 0.22] and reduced anxiousness by 0.20 units, 95% CI [-0.34, -0.07]. Additionally, reallocating 20 min of time spent in LPA to MVPA reduced tiredness by 0.16 units, 95% CI [-0.28, -0.03]. All affective states are reported on a 0–10 scale. No associations were found between time-use behaviours and life satisfaction. Conclusion Our study shows that time-use behaviours, particularly reducing sedentary time and increasing physical activity, were more strongly linked to experienced wellbeing. Studies that focus solely on examining time-use behaviours and long-term wellbeing outcomes, such as life satisfaction (common in population studies), may overlook the dynamic interplay and immediate impacts of behaviours on wellbeing. While some associations were present, most of the tested relationships were weak or non-significant, suggesting that contextual factors like social and environmental conditions may play a greater role in shaping wellbeing. The next step is to explore sequential associations, such as behaviours occurring immediately before or after a momentary affect response is recorded.

Purpose An accurate assessment of time spent in 24-hour movement behaviors (24 h-MBs) is crucial in exploring health related associations. This study aims to evaluate the concurrent validity of the Daily Activity Behavior Questionnaire (DABQ) compared to the ActiGraph using absolute and relative indicators of validity. Methods This cross-sectional observational study included 105 adults (45 ± 13 y/o, 54% female). Participants wore an ActiGraph during seven consecutive days followed by filling in the DABQ recalling the past seven days. Intraclass correlations (95% confidence intervals), Bland-Altman plots, Spearman’s correlations and the magnitude of error were calculated to estimate the absolute agreement and validity. Interaction effects between sociodemographic variables and the measurement methods were explored in mixed models. All analyses were compared by four commonly used data processing methods for ActiGraph data (cut-points and data reduction method-specific). Results Moderate absolute agreement (ICC = 0.56) and validity (rho sleep =0.58) was found for sleep comparing the DABQ with the ActiGraph. Time spent in sedentary behavior (SB), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) showed poor absolute agreement (ICC SB : 0.01–0.38, ICC LPA : 0.00-0.31; ICC MVPA : 0.23–0.30) and validity (rho SB : 0.01–0.43, rho LPA : 0.10–0.46; rho MVPA : 0.38–0.44) comparing the DABQ with the ActiGraph. The Ranges in ICC and Spearmans’ rho include the comparison between the four data processing methods. A significant interaction was found between the measurement method and educational level ( p  < 0.001), in specific for sleep, SB and LPA. Conclusion Compared to the ActiGraph, the DABQ showed accurate time-use estimates for sleep but presented poor to moderate evidence of validity regarding SB, LPA and MVPA. This was shown in underestimations regarding SB and MVPA, and overestimations regarding LPA. However, educational level and data processing methods contributed to these variations.