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Table 7 Summary of the findings from studies that assessed chronic diseases and conditions

From: Health outcomes associated with reallocations of time between sleep, sedentary behaviour, and physical activity: a systematic scoping review of isotemporal substitution studies

Study Sample Measures of sleep, SB, LPA, MVPA Outcome measures Data analysis method / reallocated time Adjustments for confounding Results
Boeke et al. [46] Women (n = 75,669) from the Nurses’ Health Study II, USA; prospective cohort LPA, MPA, VPA – self-report; sleep, SB – not assessed Breast cancer Mekary et al. [12] / not presented Age, height, age at menarche, oral contraceptive history, reproductive history, alcohol intake, body size at ages 10 and 20 years, weight, new pregnancies, breastfeeding duration, oral contraceptive and postmenopausal hormone use, menopausal status, age at menopause, and benign breast disease diagnosis. No individual values were reported.
Ekblom-Bak et al. [51] Adults (n = 836) from the Swedish Cardio Pulmonary bioImage Study, Sweden; cross-sectional SB, LPA, MPA, VPA – waist-worn accelerometers; sleep – not assessed Metabolic syndrome prevalence Mekary et al. [12] / 1, 5, 10, 15, 20, 25, 30, 60, 90 and 120 min Age, sex, education level, smoking habits, perceived psychological stress, energy intake and wear time. OR (95% CI)
10-min reallocation
Metabolic syndrome
SB → LPA: 0.96 (0.93, 0.98)
SB → MPA: 0.89 (0.82, 0.97)
SB → VPA: 0.42 (0.26, 0.67)
Reallocating 1 to 120 min from SB to LPA or MPA was associated with a decrease in metabolic syndrome prevalence.
Reallocating 1 to 60 min from SB to VPA was associated with a decrease in metabolic syndrome prevalence.
Pinto et al. [30] Adults with an increased risk for developing knee osteoarthritis (n = 1794) from the sub-cohort of the Osteoarthritis Initiative, USA; prospective cohort SB, LPA, MVPA – waist-worn accelerometers; sleep – not assessed Quality-adjusted life year Mekary et al. [12] / 60 min Age, sex, race/ethnicity, education, marriage status, income and BMI. Reallocating 60 min from SB to MVPA was associated with an improvement in the quality-adjusted life year. Reallocating 60 min from SB to LPA did not result in any significant changes.
Rosique-Esteban et al. [32] Adults (n = 5776) from the PREDIMED-PLUS trial, Spain; prospective cohort Sleep, SB, LPA, MVPA – self report Prevalence of type 2 diabetes Mekary et al. [12] / 60 min Age, sex, education, marital and employment status, smoking habits, personal and family history of illness, medical conditions, medication use, and adherence to an energy-restricted Mediterranean diet. RR (95% CI)
Type 2 diabetes
MVPA → sleep: 0.95 (0.89, 1.01)
MVPA → TV-viewing: 0.91 (0.86, 0.96)
MVPA → LPA: 0.92 (0.85, 0.99)
LPA → sleep: 1.03 (0.96, 1.10)
LPA → TV-viewing: 1.00 (0.93, 1.07)
Sleep → TV-viewing: 0.96 (0.93, 0.99)
Ryan et al. [33] Adults (n = 2313) from the 2008 Health Survey for England, UK; prospective cohort SB, LPA, MVPA – waist-worn accelerometers; sleep – not assessed Chronic musculoskeletal pain Mekary et al. [12] / 10, 30 min Age, sex, BMI, socioeconomic status, diet, smoking history, alcohol intake, anxiety/depression, and presence of a non-musculoskeletal long-standing illness. PR (95% CI)
SB → LPA: 1.01 (0.99, 1.02)
SB → MVPA: 0.90 (0.82, 0.98)
In the secondary analysis reallocating 30 min of SB to MVPA resulted in relative risk reduction of 29%.
Wellburn et al. [75] Adults (n = 1327) from the 2008 Health Survey for England, UK; prospective cohort SB, LPA, MVPA – waist-worn accelerometers; sleep – not assessed Prevalence of cardiovascular disease Mekary et al. [12] / 10, 20 min Age, sex, smoking status, socioeconomic status, diet, alcohol intake, anxiety/depression, musculoskeletal medication. Model 1 was adjusted for age alone, model 2 for age and sex and model 3 for all covariates. RR (95% CI)
10 min
Model 1
SB → LPA: 0.97 (0.95, 0.98)
SB → MVPA: 0.89 (0.82, 0.96)
Model 2
SB → LPA: 0.97 (0.96, 0.99)
SB → MVPA: 0.87 (0.81, 0.94)
Model 3
SB → LPA: 0.97 (0.96, 0.99)
SB → MVPA: 0.88 (0.81, 0.96)
20 min
SB → LPA: 0.95 (0.92, 0.98)
  1. SB sedentary behaviour, LPA light intensity physical activity, MVPA moderate-to-vigorous intensity physical activity, MPA moderate intensity physical activity, VPA vigorous intensity physical activity, BMI body mass index, OR odds ratio, CI confidence interval, RI relative risk, PR prevalence ratio