Total Worker Health Intervention Increases Activity of Sedentary Workers. Breaking up Sedentary Time in Overweight/Obese Adults on Work Days and Non-Work Days: Results from a Feasibility Study Increasing physical activity in office workers – the Inphact Treadmill study; a study protocol for a 13-month randomized controlled trial of treadmill workstations Sit-Stand Desks To Reduce Workplace Sitting Time In Office Workers With Abdominal Obesity: A Randomized Controlled Trial. Impact of objectively measured sedentary behaviour on changes in insulin resistance and secretion over 3 years in the RISC study: interaction with weight gain. Participatory Workplace Interventions Can Reduce Sedentary Time for Office Workers—A Randomised Controlled Trial A “NEAT” Approach to Obesity Prevention in the Modern Work Environment Multicomponent intervention to reduce daily sedentary time: a randomised controlled trial Comparing the effects of two different break strategies on occupational sedentary behavior in a real world setting: A randomized trial Patterns of Sedentary Behavior and Mortality in U.S. Middle-Aged and Older Adults Using Sit-Stand Workstations to Decrease Sedentary Time in Office Workers: A Randomized Crossover Trial A Randomised Controlled Trial to Reduce Sedentary Time in Young Adults at Risk of Type 2 Diabetes Mellitus: Project STAND (Sedentary Time ANd Diabetes) An intervention to reduce sitting and increase light-intensity physical activity at work: Design and rationale of the 'Stand & Move at Work' group randomized trial. Accelerometer-measured sedentary time and physical activity-A 15 year follow-up of mortality in a Swedish population-based cohort. A randomised feasibility study to investigate the impact of education and the addition of prompts on the sedentary behaviour of office workers Reducing office workers’ sitting time: rationale and study design for the Stand Up Victoria cluster randomized trial The application of an occupational health guideline reduces sedentary behaviour and increases fruit intake at work: results from an RCT
INTRODUCTION Office employees are exposed to hazardous levels of sedentary work . Interventions that integrate health promotion and health protection elements are needed to advance the health of sedentary workers . This study tested an integrated intervention on occupational sedentary/physical activity behaviors , cardiometabolic disease biomarkers , musculoskeletal discomfort , and work productivity . DESIGN Two-group , RCT . Data were collected between January and August 2014 . SETTING / PARTICIPANTS Overweight/obese adults working in sedentary desk jobs were r and omized to : ( 1 ) a health protection-only group ( HPO , n=27 ) ; or ( 2 ) an integrated health protection/health promotion group ( HP/HP , n=27 ) . INTERVENTION HPO participants received an ergonomic workstation optimization intervention and three e-mails/week promoting rest breaks and posture variation . HP/HP participants received the HPO intervention plus access to a seated activity permissive workstation . MAIN OUTCOME MEASURES Occupational sedentary and physical activity behaviors ( primary outcomes ) , cardiometabolic health outcomes , musculoskeletal discomfort , and work productivity ( secondary outcomes ) were measured at baseline and post-intervention ( 16 weeks ) . RESULTS The HP/HP group increased occupational light intensity physical activity over the HPO group and used the activity permissive workstations 50 minutes/work day . Significant associations were observed between activity permissive workstation adherence and improvements in several cardiometabolic biomarkers ( weight , total fat mass , resting heart rate , body fat percentage ) and work productivity outcomes ( concentration at work , days missed because of health problems ) . CONCLUSIONS The HP/HP group increased occupational physical activity and greater activity permissive workstation adherence was associated with improved health and work productivity outcomes . These findings are important for employers interested in advancing the well-being of sedentary office workers . TRIAL REGISTRATION This study is registered at www . clinical trials.gov NCT02071420 Office workers are vulnerable to the adverse health effects of sedentary behavior ( i.e. , sitting time ) . Increasing physical activity and preventing time spent sitting is an occupational health priority . This r and omized crossover design study compared the short-term ( 3-days ) effects of hourly interruptions of sedentary time with 5-min micrrobouts of activity for 9 hours ( MICRO ) to a sedentary control condition ( SED ) and a duration -matched continuous single bout of physical activity ( 45-min/d , ONE ) condition on inclinometer-derived sitting-time on work and non-work days in sedentary overweight/obese adults . Differences in sitting/lying , st and ing , stepping , number of sit/st and transitions , time spent in moderate and vigorous activity ( MVPA ) , energy expenditure , self-perceived vigor and fatigue , and insulin sensitivity were also examined . Twenty-two participants ( 10M/12F ; 31.7 ± 1.3 year old BMI 30.4 ± 0.5 kg/m2 ) completed all conditions . No between-condition effects were observed in sitting-time and sit/st and transitions . Both interventions increased daily steps , MVPA and energy expenditure with increases being greater in ONE than MICRO . Feelings of vigor and fasting insulin sensitivity were also improved . Participants reported less fatigue with MICRO than SED and ONE . Both interventions increase physical activity and energy expenditure in occupational and leisure-time context s. The sustainability of these effects over the long term and on health outcomes will need to be tested in future studies Background Sedentary behaviour is an independent risk factor for mortality and morbidity , especially for type 2 diabetes . Since office work is related to long periods that are largely sedentary , it is of major importance to find ways for office workers to engage in light intensity physical activity ( LPA ) . The Inphact Treadmill study aims to investigate the effects of installing treadmill workstations in offices compared to conventional workstations . Methods / Design A two-arm , 13-month , r and omized controlled trial ( RCT ) will be conducted . Healthy overweight and obese office workers ( n = 80 ) with mainly sedentary tasks will be recruited from office workplaces in Umeå , Sweden . The intervention group will receive a health consultation and a treadmill desk , which they will use for at least one hour per day for 13 months . The control group will receive the same health consultation , but continue to work at their regular workstations .  Physical activity and sedentary time during workdays and non-workdays as well as during working and non-working hours on workdays will be measured objective ly using accelerometers ( Actigraph and activPAL ) at baseline and after 2 , 6 , 10 , and 13 months of follow-up . Food intake will be recorded and metabolic and anthropometric variables , body composition , stress , pain , depression , anxiety , cognitive function , and functional magnetic resonance imaging will be measured at 3–5 time points during the study period . Interviews with participants from the intervention group will be performed at the end of the study . Discussion This will be the first long-term RCT on the effects of treadmill workstations on objective ly measured physical activity and sedentary time as well as other body functions and structures/morphology during working and non-working hours among office workers . This will provide further insight on the effects of active workstations on our health and could fill in some of the knowledge gaps regarding how we can reduce sedentary time in office environments . Trial registration Clinical Trials.gov Identifier NCT01997970 , 2nd Nov 2013 BACKGROUND Sit-st and desks reduce workplace sitting time among healthy office workers ; however , their metabolic and behavioral impact in higher risk population s remains unknown . METHODS 25 office workers with abdominal obesity were r and omized to an intervention ( sit-st and workstation ) or control group ( seated desk ) for 12 weeks . Physical activity , sedentary behavior , and cardiometabolic risk factors were assessed before and after the intervention period in both groups . RESULTS In comparison with the control group , which did not change , the intervention group experienced significant reductions in workday ( 344 ± 107 to 186 ± 101 min/day ) and total ( 645 ± 140 to 528 ± 91 min/day ) sitting time , as well as increases in workday st and ing time ( 154 ± 108 to 301 ± 101 min/day , P < .05 ) . There were no changes in sitting or st and ing time outside of work hours , steps taken each day , or any marker of cardiometabolic risk in either group ( all P > .05 ) . CONCLUSION Sit-st and desks were effective in reducing workplace sedentary behavior in an at-risk population , with no change in sedentary behavior or physical activity outside of work hours . However , these changes were not sufficient to improve markers of cardiometabolic risk in this population AIMS The importance of reducing sedentary time is increasingly being recognized in the prevention of diabetes and cardiovascular disease . Despite this , the prospect i ve association between sedentary time and physical activity with insulin sensitivity and cardiometabolic risk factors has been little studied . METHODS In an analysis of data from the European RISC study , sedentary time and time spent in activity of moderate or vigorous intensity were assessed by accelerometry at baseline in 313 men and 414 women , aged 30 - 60 years , with insulin sensitivity as measured by euglycaemic-hyperinsulinaemic clamp . Three years later , cardiometabolic risk factors ( anthropometry , glucose , insulin , lipids ) were available for 549 participants . RESULTS In cross-sectional analyses using baseline data , after adjusting for age , gender , recruitment centre and time spent in activity of moderate or vigorous intensity , significant unfavourable associations were observed between higher sedentary time with body weight , HDL cholesterol , triglycerides , clamp-measured insulin sensitivity and insulin secretion ( all P(trend)<0.002 ) .  Sedentary time  remained significantly associated with insulin secretion after adjusting for insulin sensitivity ( P(trend)=0.02 ) . In longitudinal analyses , higher baseline sedentary time  was associated with 3-year increases in fasting glucose , fasting insulin and the HOMA insulin-resistance index score for the 50 % of the study population who increased their BMI by at least 0.3 kg/m(2 ) ( all P(trend)<0.01 ) ; these relationships remained significant after adjusting for time spent in activity of moderate or vigorous intensity . The 3-year increase in insulin secretion was lower in those spending more time doing activity of moderate or vigorous intensity ( P(trend)=0.03 ) . CONCLUSION These prospect i ve data suggest that less sedentary behaviour may partly counteract some of the negative effects of increasing body weight on glucose-insulin homoeostasis Background Occupational sedentary behaviour is an important contributor to overall sedentary risk . There is limited evidence for effective workplace interventions to reduce occupational sedentary time and increase light activity during work hours . The purpose of the study was to determine if participatory workplace interventions could reduce total sedentary time , sustained sedentary time ( bouts > 30 minutes ) , increase the frequency of breaks in sedentary time and promote light intensity activity and moderate/vigorous activity ( MVPA ) during work hours . Methods A r and omised controlled trial ( ANZCTR number : ACTN12612000743864 ) was conducted using clerical , call centre and data processing workers ( n = 62 , aged 25–59 years ) in 3 large government organisations in Perth , Australia . Three groups developed interventions with a participatory approach : ‘ Active office ’ ( n = 19 ) , ‘ Active Workstation ’ and promotion of incidental office activity ; ‘ Traditional physical activity ’ ( n = 14 ) , pedometer challenge to increase activity between productive work time and ‘ Office ergonomics ’ ( n = 29 ) , computer workstation design and breaking up computer tasks . Accelerometer ( ActiGraph GT3X , 7 days ) determined sedentary time , sustained sedentary time , breaks in sedentary time , light intensity activity and MVPA on work days and during work hours were measured before and following a 12 week intervention period . Results For all participants there was a significant reduction in sedentary time on work days ( −1.6 % , p = 0.006 ) and during work hours ( −1.7 % , p = 0.014 ) and a significant increase in number of breaks/sedentary hour on work days ( 0.64 , p = 0.005 ) and during work hours ( 0.72 , p = 0.015 ) ; there was a concurrent significant increase in light activity during work hours ( 1.5 % , p = 0.012 ) and MVPA on work days ( 0.6 % , p = 0.012 ) . Conclusions This study explored novel ways to modify work practice s to reduce occupational sedentary behaviour . Participatory workplace interventions can reduce sedentary time , increase the frequency of breaks and improve light activity and MVPA of office workers by using a variety of interventions . Trial Registration Australian New Zeal and Clinical Trials Registry ACTN12612000743864 Increased prevalence of obesity may be due to an increase of being sedentary at work . Increasing non-exercise activity thermogenesis ( NEAT ) using walking workstations may increase total physical activity and promote a leaner physical body composition ( or phenotype ) . The purpose of this study was to test whether walking slowly during work was sufficient to promote a leaner phenotype by increasing physical activity in sedentary desk workers without inducing compensation or a decrease in activity or energy expenditure during the nonworking hours . We conducted a prospect i ve cohort study using a within-subjects crossover design . The design involved two phases each lasting 2 weeks : a treadmill exercise phase in which subjects used a walking workstation for 2.5 hours a day 5 days/week and a control phase in which subjects maintained their normal work activity .  Twenty-five sedentary adults working at the Minneapolis VA Health Care System . We measured body weight , body composition , food intake , 24-hour physical activity , and self-reported physical activity with the International Physical Activity Question naire ( IPAQ ) . Treadmill exercise caused a leaner phenotype ( lean mass gain and fat mass loss ) and significantly increased their 24-hour physical activity .  Walking workstation use had favorable effects on physical well-being and mental focus and did not adversely affect productivity .  Light treadmill exercise during work can increase physical activity and result in a leaner body composition . This is a potentially useful intervention to increase NEAT in the modern sedentary work environment Objectives To test the efficacy of a multicomponent technology intervention for reducing daily sedentary time and improving cardiometabolic disease risk among sedentary , overweight university employees . Design Blinded , r and omised controlled trial . Setting A large south-eastern university in the USA . Participants 49 middle-aged , primarily female , sedentary and overweight adults working in sedentary jobs enrolled in the study . A total of 40 participants completed the study . Interventions Participants were r and omised to either : ( 1 ) an intervention group ( N=23 ; 47.6 + 9.9 years ; 94.1 % female ; 33.2 + 4.5 kg/m2 ) ; ( 2 ) or wait-list control group ( N=17 ; 42.6 + 8.9 years ; 86.9 % female ; 31.7 + 4.9 kg/m2 ) . The intervention group received a theory-based , internet-delivered programme , a portable pedal machine at work and a pedometer for 12 weeks . The wait-list control group maintained their behaviours for 12 weeks . Outcome measures Primary ( sedentary and physical activity behaviour measured objective ly through StepWatch ) and secondary ( heart rate , blood pressure , height , weight , waist circumference , per cent body fat , cardiorespiratory fitness , fasting lipids ) outcomes were measured at baseline and postintervention ( 12 weeks ) . Exploratory outcomes including intervention compliance and process evaluation measures were also assessed postintervention . Results Compared to controls , the intervention group reduced daily sedentary time ( mean change ( 95%CI ) : −58.7 min/day ( −118.4 to 0.99 ; p<0.01 ) ) after adjusting for baseline values and monitor wear time . Intervention participants logged on to the website 71.3 % of all intervention days , used the pedal machine 37.7 % of all working intervention days and pedalled an average of 31.1 min/day . Conclusions These findings suggest that the intervention was engaging and result ed in reductions in daily sedentary time among full-time sedentary employees . These findings hold public health significance due to the growing number of sedentary jobs and the potential of these technologies in large-scale worksite programmes . Trial Registration Clinical Trials.gov # NCT01371084 Developing interventions to reduce sedentary behavior in the workplace is an important public health priority . Furthermore , research is needed to determine whether different approaches to breaking up prolonged sitting during the workday are equally feasible and effective . Thus , the purpose of this study was to determine whether varying the frequency and duration of activity breaks during the workday would differentially impact sedentary behavior and health outcomes . Inactive females ( N = 49 ) working full-time sedentary jobs were recruited for this parallel-group r and omized trial . Participants were r and omly assigned to take short , frequent breaks from sitting ( 1–2 min every half hour ; SB ) or longer , planned breaks from sitting ( two 15-minute breaks per workday ; LB ) during each workday across an 8-week  intervention . Sedentary time and health outcomes were assessed at baseline and post-intervention . The study ran from March 2014–June 2015 . Results showed sedentary time during the workday decreased significantly in the SB group ( − 35.6 min ; d = − 0.75 ; p = 0.03 ) , but did not change in the LB group ( + 4.5 min ; d = 0.12 ) . Participants in the SB group also demonstrated small-to-moderate declines in total cholesterol ( d = − 0.33 ; p = 0.10 ) , triglycerides ( d = − 0.38 ; p = 0.06 ) and fasting blood glucose ( d = − 0.29 ; p = 0.01 ) from pre to post-intervention . Health outcomes did not change in the LB group . This study demonstrated that taking short , frequent breaks from sitting during the workday is a feasible and effective approach for reducing sedentary time at work . These results have implication s for the development of public health messages addressing sedentary behavior , and inform future interventions to reduce sedentary time in the workplace . Trial registration This study is registered at www . clinical trials.gov : NCT02609438 Adults are sedentary for an alarming 9 to 10 hours per day ( 1 ) . Accordingly , the popular press has coined the phrase sitting is the new smoking to describe a current epidemic of developed nations ( 24 ) . Evidence indicates that sedentary time is associated with incident cardiovascular disease , incidence of cardiovascular diseaserelated risk factors , and mortality ( 5 , 6 ) . Of note , the risk conferred by prolonged sedentariness is eliminated only by high levels of moderate- to vigorous-intensity physical activity ( MVPA ) ( about 60 to 75 min/d ) , which exceed physical activity recommendations ( 7 , 8) . As such , sedentary behavior is now believed to represent a clinical ly important aspect of a person 's physical activity profile and is no longer considered simply the extreme low end of the physical activity continuum ( 5 ) . Studies linking sedentary behavior to health outcomes have relied almost exclusively on self-reported  sedentary time  , which is subject to reporting bias and measurement error ( 9 ) . A 2015 systematic review ( 5 ) identified only 1 study ( NHANES [ National Health and Nutrition Examination Survey ] ) that examined the association between objective ly measured sedentary time and health outcomes , a study limited by a small event rate ( 10 ) . New studies using NHANES data have since been published , with longer follow-up and higher event rates ( 1115 ) . However , some of these studies have reported an association between objective ly measured sedentary time and mortality ( 11 , 14 , 15 ) , but others have not ( 12 , 13 ) . Additional cohort studies are thus needed to rectify evidence gaps . Furthermore , studies using accelerometers to objective ly measure sedentary behavior conventionally operationalize sedentary time as the total number of sedentary minutes per day . This approach ignores patterns of accumulated sedentary behavior over time . For example , accumulation of sedentary time in a few long bouts or many short bouts represents 2 distinct patterns of sedentary time accrual . Experimental studies have shown that acute periods of prolonged , uninterrupted sedentary behavior cause greater detrimental cardiometabolic effects than sedentary behavior that is periodically interrupted ( 1618 ) , suggestive that it is not just total sedentary time that is relevant to health outcomes , but also the manner in which it is accumulated . Few longitudinal studies , however , have explored the association between prolonged , uninterrupted sedentary behavior and mortality to corroborate these findings . To inform guidelines on reducing sedentary behavior ( target reductions in overall sedentary time or target interruption of prolonged sedentary bouts ) , evidence from prospect i ve studies is needed to 1 ) confirm the association between total sedentary time and mortality using objective measures , 2 ) determine whether prolonged sedentary bouts confer risk for death , and 3 ) eluci date whether the total volume of sedentary time and its pattern of accumulation individually or jointly contribute to risk for death . The purpose of this study , therefore , was to examine the association between objective ly measured sedentary time ( both total volume and accrual in prolonged bouts ) and all-cause mortality in a national cohort of U.S. middle-aged and older adults enrolled in the REGARDS ( Reasons for Geographic and Racial Differences in Stroke ) study . Methods Study Population REGARDS is a population -based study design ed to examine racial and regional disparities in stroke . It comprises 30239 white and black adults aged 45 years or older enrolled between 2003 and 2007 from across the contiguous United States ( 19 , 20 ) . Detailed design and methods for REGARDS are described elsewhere ( 21 ) . Briefly , demographic and cardiovascular risk factor data were collected by telephone interview and an in-home physical assessment on enrollment . A detailed summary of baseline measures is provided in the Supplement . Participants ( or their proxies ) were then followed for 6-month intervals to ascertain vital status . Objective measurements of sedentary behavior were collected from active REGARDS participants from 2009 to 2013 ( mean time from study enrollment , 5.7 years [ SD , 1.5 ] ; range , 1.9 to 9.5 years ) ( 22 ) . A total of 7985 participants adhered to accelerometer wear requirements ( 4 days with accelerometer wear 10 hours ) , provided follow-up data , and were available for the current analyses ( Supplement Figure 1 ) . Supplement Table 1 shows the characteristics of included versus excluded REGARDS participants . The REGARDS study protocol was approved by the institutional review boards of participating institutions . All participants provided informed consent . Supplement . Supplementary Material Accelerometer Data Collection Methods for accelerometer data collection are described elsewhere ( 22 ) . Briefly , participants were fitted with an Actical ( Philips Respironics ) accelerometer secured to their right hip using a nylon belt and were instructed to wear the device during waking hours for 7 consecutive days . The Actical had been vali date d formeasurement of physical activity and sedentary behavior and was shown to have acceptable reliability ( 2325 ) . Activity counts were summed over 1-minute epochs . Nonwear periods were defined as at least 150 consecutive minutes of 0 activity counts . This nonwear algorithm was previously vali date d against daily log sheets in REGARDS participants ( 26 ) . Measurements of 0 to 49 , 50 to 1064 , and at least 1065 counts per minute were defined as sedentary behavior , light-intensity physical activity , and MVPA , respectively , as determined in a laboratory-based calibration study ( 27 ) . A sedentary bout was defined as consecutive minutes in which the accelerometer registered fewer than 50 counts per minute . A sedentary break was defined as at least 1 minute in which 50 or more counts per minute were registered after a sedentary bout . Both sedentary bouts and breaks were exclusively continuous periods , with no interruptions or nonwear intervals allowed in the definition . Outcome Ascertainment All-cause mortality was the primary outcome , defined as any death after completion of the accelerometer protocol regardless of cause . Date s of death were confirmed through review of death certificates , medical records , and administrative data bases . Deaths through 4 September 2015 were included in the current analysis . Statistical Analysis Sedentary and physical activity variables were averaged across compliant days ( 10 hours of wear ) . Because of a high correlation between total sedentary time and wear time ( Supplement Figure 2 ) , we corrected for the influence of wear time by st and ardizing total sedentary time to 16 hours of wear time per day using the residuals obtained when regressing total sedentary time on wear time ( see Methods section of the Supplement ) ( 2830 ) . Participants were stratified into quartiles according to total sedentary time and , separately , mean sedentary bout duration ( a measure of overall prolonged , uninterrupted sedentary behavior ) . Cox proportional hazards regression modeling was used to calculate the hazard ratio ( HR ) for all-cause mortality associated with quartiles of total sedentary time ( and separately , mean sedentary bout length ) . Crude HRs were initially calculated . Subsequent HRs were calculated after adjustment for age , race , sex , region of residence , education , and season the accelerometer was worn ( model 1 ) , with further adjustment for current smoking , alcohol use , body mass index ( BMI ) , diabetes , hypertension , dyslipidemia , estimated glomerular filtration rate less than 60 mL/min/1.73 m2 , atrial fibrillation , history of coronary heart disease , and history of stroke ( model 2 ) . Models were additionally adjusted for MVPA expressed continuously ( model 3 ) . Tests for linear trend across quartiles were conducted by including the quartile for each participant as an ordinal variable in regression models . Proportional hazards assumptions were confirmed with a Kolmogorov-type supremum test ( 31 ) . The above analyses were then repeated in a fully adjusted model , testing interactions for age ( < 65 and 65 years ) , sex ( male and female ) , race ( black and white ) , BMI category ( normal weight and overweight or obese ) , and MVPA category ( < 150 min/wk and 150 min/wk ) . As a secondary analysis , we examined the continuous doseresponse relationship between each sedentary characteristic and all-cause mortality in a fully adjusted model ( model 3 ) using restricted cubic splines ( 32 ) . Cubic polynomials were fitted with the mean of each sedentary characteristic set as the reference and knots placed at the 5th , 35th , 65th , and 95th percentiles ( 33 ) . Nonlinear associations were evaluated using the likelihood ratio test . For nonlinear associations , spline models were used to describe the associations and when the association was determined to be linear , a linear model was used . Because of multicollinearity between total sedentary time and mean sedentary bout duration ( r= 0.61 ) , both variables were not included in the same model . Alternatively , to examine the individual and joint associations of total sedentary time and prolonged , uninterrupted sedentary behavior with mortality , participants were classified into 4 categories : low total sedentary time ( < 750 min/d ) and low prolonged sedentary bout time ( < 10 min/bout ) , low total sedentary time  and high prolonged sedentary bout time  ( 10 min/bout ) , high total sedentary time  ( 750 min/d ) and low prolonged sedentary bout time , and high total sedentary time and high prolonged sedentary bout time . Hazard ratios for all-cause mortality were calculated for each joint category in comparison with the lowlow group in a fully adjusted model ( model 3 ) . Thresholds for total sedentary time ( 750 min/d ) and mean sedentary bout duration ( 10 min/bout ) were selected on the basis of the restricted cubic splines and were confirmed using a method described by Contal and O'Quigley ( see Methods section of the Supplement ) ( 34 ) . To allow for the possibility that sedentary bouts Objective : This study was conducted to determine whether installation of sit-st and desks ( SSDs ) could lead to decreased sitting time during the workday among sedentary office workers . Methods : A r and omized cross-over trial was conducted from January to April , 2012 at a business in Minneapolis . 28 ( nine men , 26 full-time ) sedentary office workers took part in a 4 week intervention period which included the use of SSDs to gradually replace 50 % of sitting time with st and ing during the workday .  Physical activity was the primary outcome . Mood , energy level , fatigue , appetite , dietary intake , and productivity were explored as secondary outcomes . Results : The intervention reduced sitting time at work by 21 % ( 95 % CI 18%–25 % ) and sedentary time by 4.8 min/work-hr ( 95 % CI 4.1–5.4 min/work-hr ) . For a 40 h work-week , this translates into replacement of 8 h of sitting time with st and ing and sedentary time being reduced by 3.2 h. Activity level during non-work hours did not change . The intervention also increased overall sense of well-being , energy , decreased fatigue , had no impact on productivity , and reduced appetite and dietary intake . The workstations were popular with the participants . Conclusion : The SSD intervention was successful in increasing work-time activity level , without changing activity level during non-work hours Aims Type 2 diabetes mellitus ( T2DM ) , a serious and prevalent chronic disease , is traditionally associated with older age . However , due to the rising rates of obesity and sedentary lifestyles , it is increasingly being diagnosed in the younger population . Sedentary ( sitting ) behaviour has been shown to be associated with greater risk of cardio-metabolic health outcomes , including T2DM . Little is known about effective interventions to reduce sedentary behaviour in younger adults at risk of T2DM . We aim ed to investigate , through a r and omised controlled trial ( RCT ) design , whether a group-based structured education workshop focused on sitting reduction , with self-monitoring , reduced sitting time . Methods Adults aged 18–40 years who were either overweight ( with an additional risk factor for T2DM ) or obese were recruited for the Sedentary Time ANd Diabetes ( ST AND ) RCT . The intervention programme comprised of a 3-hour group-based structured education workshop , use of a self-monitoring tool , and follow-up motivational phone call . Data were collected at three time points : baseline , 3 and 12 months after baseline . The primary outcome measure was accelerometer-assessed sedentary behaviour after 12 months . Secondary outcomes included other objective ( activPAL ) and self-reported measures of sedentary behaviour and physical activity , and biochemical , anthropometric , and psycho-social variables . Results 187 individuals ( 69 % female ; mean age 33 years ; mean BMI 35 kg/m2 ) were r and omised to intervention and control groups . 12 month data , when analysed using intention-to-treat analysis ( ITT ) and per- protocol analyses , showed no significant difference in the primary outcome variable , nor in the majority of the secondary outcome measures . Conclusions A structured education intervention design ed to reduce sitting in young adults at risk of T2DM was not successful in changing behaviour at 12 months . Lack of change may be due to the brief nature of such an intervention and lack of focus on environmental change . Moreover , some participants reported a focus on physical activity rather than reductions in sitting per se . The habitual nature of sedentary behaviour means that behaviour change is challenging . Trial Registration Controlled-Trials.com IS RCT BACKGROUND American workers spend 70 - 80 % of their time at work being sedentary . Traditional approaches to increase moderate-vigorous physical activity ( MVPA ) may be perceived to be harmful to productivity . Approaches that target reductions in sedentary behavior and /or increases in st and ing or light-intensity physical activity [ LPA ] may not interfere with productivity and may be more feasible to achieve through small changes accumulated throughout the workday METHODS / DESIGN : This group r and omized trial ( i.e. , cluster r and omized trial ) will test the relative efficacy of two sedentary behavior focused interventions in 24 worksites across two states ( N=720 workers ) . The MOVE+ intervention is a multilevel individual , social , environmental , and organizational intervention targeting increases in light-intensity physical activity in the workplace . The ST AND + intervention is the MOVE+ intervention with the addition of the installation and use of sit-st and workstations to reduce sedentary behavior and enhance light-intensity physical activity opportunities . Our primary outcome will be objective ly-measured changes in sedentary behavior and light-intensity physical activity over 12months , with additional process measures at 3months and longer-term sustainability outcomes at 24months . Our secondary outcomes will be a clustered cardiometabolic risk score ( comprised of fasting glucose , insulin , triglycerides , HDL-cholesterol , and blood pressure ) , workplace productivity , and job satisfaction DISCUSSION : This study will determine the efficacy of a multi-level workplace intervention ( including the use of a sit-st and workstation ) to reduce sedentary behavior and increase LPA and concomitant impact on cardiometabolic health , workplace productivity , and satisfaction . TRIAL REGISTRATION Clinical Trials.gov Identifier : NCT02566317 ( date of registration : 10/1/2015 ) OBJECTIVES To investigate the associations of objective ly assessed sedentary time , light intensity physical activity ( PA ) , moderate to vigorous intensity PA ( MVPA ) , and total PA with all-cause mortality and mortality from cardiovascular disease ( CVD ) or cancer in a Swedish population -based cohort with 15 years follow-up time . DESIGN Longitudinal prospect i ve cohort study . METHODS Data from 851 persons ( 56 % women ) ≥35 years at baseline were included . Primary exposure variables were  time ( min/day ) spent sedentary , in light intensity PA and in MVPA , and total counts from an Actigraph 7164 accelerometer . Data on all-cause mortality and mortality from CVD or cancer were obtained from Swedish registers . Cox proportional hazards models estimated hazard ratios ( HR ) of mortality with 95 % confidence intervals ( CI ) . RESULTS Compared with the least sedentary participants , those in the most sedentary tertile had an increased risk of all-cause mortality , HR : 2.7 ( 1.4 , 5.3 ) , CVD mortality , HR : 5.5 ( 1.4 , 21.2 ) and cancer mortality , HR : 4.3 ( 1.2 , 16.0 ) . For all-cause mortality , those in the highest light intensity PA tertile had a HR 0.34 ( 0.17 , 0.67 ) compared with the lowest tertile . A similar pattern was found for CVD and cancer mortality . More time spent in MVPA was associated with the largest risk reduction for CVD mortality , with an almost 90 % lower risk in the tertile with the most time in MVPA . CONCLUSIONS This study confirms a strong inverse relationship between MVPA and mortality , and adds new insight for the underst and ing of the associations between sedentary time  and light intensity PA  and mortality Background Office workers have been identified as being at risk of accumulating high amounts of sedentary time in prolonged events during work hours , which has been associated with increased risk of a number of long-term health conditions . There is some evidence that providing advice to st and at regular intervals during the working day , and using computer-based prompts , can reduce sedentary behaviour  in office workers . However , evidence of effectiveness , feasibility and acceptability for these types of intervention is currently limited . Methods A 2-arm , parallel group , cluster-r and omised feasibility trial to assess the acceptability of prompts to break up sedentary behaviour was conducted with office workers in a commercial bank ( n = 21 ) . Participants were assigned to an  education only group ( EG ) or prompt and education group  ( PG  ) . Both groups received education on reducing and breaking up sitting at work , and the PG also received hourly prompts , delivered by Microsoft Outlook over 10 weeks , reminding them to st and . Objective measurements of sedentary behaviour were made using activPAL monitors worn at three time points : baseline , in the last 2 weeks of the intervention period and 12 weeks after the intervention . Focus groups were conducted to explore the acceptability of the intervention and the motivations and barriers to changing sedentary behaviour . Results R and omly generated , customised prompts , delivered by Microsoft Outlook , with messages about breaking up sitting , proved to be a feasible and acceptable way of delivering prompts to office workers . Participants in both groups reduced their sitting , but changes were not maintained at follow-up . The education session seemed to increase outcome expectations of the benefits of changing sedentary behaviour and promote self-regulation of behaviour in some participants . However , low self-efficacy and a desire to conform to cultural norms were barriers to changing behaviour . Conclusions Prompts delivered by Microsoft Outlook were a feasible , low-cost way of prompting office workers to break up their sedentary behaviour , although further research is needed to determine whether this has an additional impact on sedentary behaviour , to education alone . The role of cultural norms , and promoting self-efficacy , should be considered in the design of future interventions .Trial registration This study was registered retrospectively as a clinical trial on Clinical Trials.gov ( ID no. NCT02609282 ) on 23 March 2015 Background Excessive time spent in sedentary behaviours ( sitting or lying with low energy expenditure ) is associated with an increased risk for type 2 diabetes , cardiovascular disease and some cancers . Desk-based office workers typically accumulate high amounts of daily sitting time , often in prolonged unbroken bouts . The St and Up Victoria study aims to determine whether a 3-month multi-component intervention in the office setting reduces workplace sitting , particularly prolonged , unbroken sitting time , and results in improvements in cardio-metabolic biomarkers and work-related outcomes , compared to usual practice . Methods / Design A two-arm cluster-r and omized controlled trial ( RCT ) , with worksites as the unit of r and omization , will be conducted in 16 worksites located in Victoria , Australia . Work units from one organisation ( Department of Human Services , Australian Government ) will be allocated to either the multi-component intervention ( organisational , environmental [ height-adjustable workstations ] , and individual behavioural strategies ) or to a usual practice control group . The recruitment target is 160 participants ( office-based workers aged 18–65 years and working at least 0.6 full time equivalent ) per arm . At each assessment ( 0- [ baseline ] , 3- [ post intervention ] , and 12-months [ follow-up ] ) , objective measurement via the activPAL3 activity monitor will be used to assess workplace : sitting time ( primary outcome ) ; prolonged sitting time ( sitting time accrued in bouts of ≥30 minutes ) ; st and ing time ; sit-to-st and transitions ; and , moving time . Additional outcomes assessed will include : non-workplace activity ; cardio-metabolic biomarkers and health indicators ( including fasting glucose , lipids and insulin ; anthropometric measures ; blood pressure ; and , musculoskeletal symptoms ) ; and , work-related outcomes ( presenteeism , absenteeism , productivity , work performance ) . Incremental cost-effectiveness and identification of both workplace and individual-level mediators and moderators of change will also be evaluated . Discussion St and Up Victoria will be the first cluster- RCT to evaluate the effectiveness of a multi-component intervention aim ed at reducing prolonged workplace sitting in office workers . Strengths include the objective measurement of activity and assessment of the intervention on markers of cardio-metabolic health . Health- and work-related benefits , as well as the cost-effectiveness of the intervention , will help to inform future occupational practice .Trial registration Objective To evaluate the effectiveness of a draft occupational health practice guideline aim ed at preventing weight gain on employees ' physical activity , sedentary behaviour and dietary behaviour and on body weight-related outcomes . Methods A r and omised controlled trial was performed comparing guideline -based care to usual care among 16 occupational physicians and 523 employees in the Netherl and s between 2009 and 2011 . Occupational physicians in the intervention group followed the draft guideline by providing advice to employers on how to assess and intervene on the obesogenic work environment and conducted five face-to-face behavioural change counselling sessions with employees to improve their lifestyle . Data of employees were collected by question naire and physical measurements at baseline and 6-months follow-up . Linear and logistic regression analyses were performed to determine effects . Results The intervention showed significant effects on sedentary behaviour at work ( β −28 min/day , 95 % CI −2 to −54 ) and on fruit intake ( β 2.1 pieces/week ; 95 % CI 0.6 to 3.6 ) . No significant intervention effects were found for physical activity , sedentary behaviour in leisure time or during weekend days , snack intake and body weight-related outcomes . Conclusion Guideline -based care result ed in a more favourable sedentary behaviour at work and increased fruit intake but did not improve employees '  physical activity , snack intake or body weight-related outcomes . Trial registration number IS RCT N/73545254 and NTR/1190
Non-significant changes were reported for most health- and work-related outcomes .
Findings suggest that activity-permissive workstations can be effective to reduce occupational sedentary time , without compromising work performance .
Excessive sedentary time is detrimentally linked to obesity , type 2 diabetes , cardiovascular disease and premature mortality .
Studies have been investigating the use of activity-permissive workstations to reduce sedentary time in office workers , a highly sedentary target group .
This review systematic ally summarizes the evidence for activity-permissive workstations on sedentary time , health-risk biomarkers , work performance and feasibility indicators in office workplaces .