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Epidemiology and Population Health

Low movement, deep-learned sitting patterns, and sedentary behavior in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE)

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Abstract

Background/Objectives

Sedentary behavior (SB) has both movement and postural components, but most SB research has only assessed low movement, especially in children. The purpose of this study was to compare estimates and health associations of SB when derived from a standard accelerometer cut-point, a novel sitting detection technique (CNN Hip Accelerometer Posture for Children; CHAP-Child), and both combined.

Methods

Data were from the International Study of Childhood Obesity, Lifestyle, and the Environment (ISCOLE). Participants were 6103 children (mean ± SD age 10.4 ± 0.56 years) from 12 countries who wore an ActiGraph GT3X+ accelerometer on the right hip for approximately one week. We calculated SB time, mean SB bout duration, and SB breaks using a cut-point (SBmovement), CHAP-Child (SBposture), and both methods combined (SBcombined). Mixed effects regression was used to test associations of SB variables with pediatric obesity variables (waist circumference, body fat percentage, and body mass index z-score).

Results

After adjusting for MVPA, SBposture showed several significant obesity associations favoring lower mean SB bout duration (b = 0.251–0.449; all p < 0.001) and higher SB breaks (b = −0.005–−0.052; all p < 0.001). Lower total SB was unexpectedly related to greater obesity (b = −0.077–−0.649; p from <0.001–0.02). For mean SB bout duration and SB breaks, more associations were observed for SBposture (n = 5) than for SBmovement (n = 3) or SBcombined (n = 1), and tended to have larger magnitude as well.

Conclusions

Using traditional measures of low movement as a surrogate for SB may lead to underestimated or undetected adverse associations between SB and obesity. CHAP-Child allows assessment of sitting posture using hip-worn accelerometers. Ongoing work is needed to understand how low movement and posture are related to one another, as well as their potential health implications.

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Fig. 1: Density plots comparing the distributions of sedentary behavior (SB) variables when assessed by the SBmovement, SBposture, and SBcombined methods.
Fig. 2: Two-dimensional density plots depicting joint distributions of sedentary behavior (SB) variables with moderate-to-vigorous physical activity (MVPA).

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Code availability

Code from the analysis is available on request.

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Acknowledgements

This study was funded by NIH R01DK114945. The parent study (ISCOLE) was funded by The Coca-Cola Company. With the exception of requiring that the study be global in nature, the parent study funder had no role in the design and conduct of the study.

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Authors and Affiliations

  1. Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, USA

    Paul R. Hibbing

  2. Center for Children’s Healthy Lifestyles & Nutrition, Children’s Mercy Kansas City, Kansas City, MO, USA

    Paul R. Hibbing, Jordan A. Carlson & Chelsea Steel

  3. Department of Pediatrics, University of Missouri Kansas City, Kansas City, MO, USA

    Jordan A. Carlson

  4. Kaiser Permanente Washington Health, Research Institute, Seattle, WA, USA

    Mikael Anne Greenwood-Hickman

  5. Databricks Inc, San Francisco, CA, USA

    Supun Nakandala

  6. Department of Computer Science and Engineering, University of California, San Diego, La Jolla, CA, USA

    Supun Nakandala & Arun Kumar

  7. Beckman Research Institute, Population Sciences, City of Hope, Duarte, CA, USA

    Marta M. Jankowska

  8. Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA

    John Bellettiere, Jingjing Zou, Andrea Z. LaCroix & Loki Natarajan

  9. Pennington Biomedical Research Center, Baton Rouge, LA, USA

    Peter T. Katzmarzyk

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Contributions

Designed and implemented parent study: PK. Acquired funding for present study: LN, JC, AL, MJ, AK. Developed the methods: JC, SN, JB, JZ, AK, LN, MAGH. Processed data: CS, PH, PK. Devised analysis: PH, JC, LN, MJ. Drafted manuscript: PH, JC, LN. Reviewed, revised, and approved manuscript: All authors.

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Correspondence to Paul R. Hibbing.

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Competing interests

This study was funded by NIH R01DK114945. The parent study (ISCOLE) was funded by The Coca-Cola Company. With the exception of requiring that the study be global in nature, the parent study funder had no role in the design and conduct of the study. The authors declare no conflicts of interest.

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Hibbing, P.R., Carlson, J.A., Steel, C. et al. Low movement, deep-learned sitting patterns, and sedentary behavior in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE). Int J Obes 47, 1100–1107 (2023). https://doi.org/10.1038/s41366-023-01364-8

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