Main and interacting effects of physical activity and sedentary time on older adults’ BMI: The moderating roles of socio-demographic and environmental attributes

• Published in: PloS one Vol. 15; no. 7; p. e0235833
• Main Authors: Van Dyck, Delfien, Barnett, Anthony, Van Cauwenberg, Jelle, Zhang, Casper J. P., Sit, Cindy H. P., Cerin, Ester
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 09.07.2020; Public Library of Science (PLoS)
• Subjects: Accelerometers; Adults; Behavior; Biology and Life Sciences; Body fat; Body mass index; Body weight; Data collection; Demographics; Demography; Density; Diabetes; Diet; Dietary intake; Education; Elderly; Engineering and Technology; Ethics; Exercise; Food; Food additives; Food intake; Gender; Health aspects; Health care; Health sciences; International studies; Medical research; Medicine and Health Sciences; Obesity; Observational studies; Older people; Overweight; People and Places; Physical activity; Physiological aspects; Public health; Sedentary behavior; Social Sciences; Sociodemographics; Socioeconomic factors; Sport science; Studies; Womens health; Belgium; Hong Kong China; Melbourne Victoria Australia; Australia; China
• DOI: 10.1371/journal.pone.0235833
• ISSN: 1932-6203

Objectives Our first aim was to examine the main and interacting effects of accelerometer-based sedentary time (ST) and moderate-to-vigorous physical activity (MVPA) with BMI and the likelihood of being overweight/obese in Hong Kong and Ghent (Belgium) older adults. Second, we examined whether these main associations and interactions between MVPA and ST were moderated by socio-demographics (gender, education) and objective neighbourhood attributes supposed to be associated with healthy food intake (food outlet density, neighbourhood-level SES). Finally, we determined whether the associations and interactions were generalisable across study sites. Methods Data from the ALECS (Hong Kong) and BEPAS Seniors studies (Ghent), two comparable observational studies, were used. Older adults (n = 829, 65+) provided self-reported socio-demographic information and objective MVPA and ST data using Actigraph accelerometers. Annual household income data and GIS software were used to assess neighbourhood-level SES and food outlet density. Generalised additive mixed models were conducted in R. Results ST was linearly and positively related to both weight outcomes in the overall sample, while MVPA was not. The overall-sample analyses including the two-way interaction between MVPA and ST showed no interactions between these behaviours on weight outcomes. Three site-specific findings were identified, showing distinct associations in Hong Kong compared to Ghent. Study site moderated the interaction between ST and MVPA on both weight outcomes, the interaction between education and ST on both weight outcomes and the interaction between the number of food outlets and ST on being overweight/obese. Conclusions The country-specific effects confirm the cultural dependency and complexity of the associations between PA, ST and weight outcomes. Future longitudinal international studies including older adults from multiple regions assessing PA, ST, weight outcomes and dietary intake should be encouraged. Such studies are needed to refine the recommendations regarding ST and PA in older adults in light of preventing overweight and obesity.