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Health Impact of 24-Hour Movement Behaviour and Time Use

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 July 2018) | Viewed by 55564

Special Issue Editors

1. School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK
2. Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium
Interests: physical activity; sedentary behavior; green and blue spaces; system based approach; blue spaces; compositional data analysis
Biomathematics and Statistics Scotland, JCMB, The King's Buildings, Peter Guthrie Tait Road, EDINBURGH, EH9 3FD, Scotland, UK
Interests: Applied data analysis and statistical modelling; Multivariate and compositional data analysis; missing and censored data; Statistical programming

Special Issue Information

Dear Colleagues,

Across the 24-hour day, time spent in sleep, sedentary behaviour and physical activity have distinct health consequences; however, as time is finite, the effect of time use in one behaviour also depends on the time it displaced from another behaviour. The new challenge is to understanding these interactions between time spent on different behaviours and to find the optimum composition of a day that is beneficial to health.

Advances in sensor technology and analytic methodologies now allow us to track and analyse the impact of 24-hour time-use and movement behaviour on health, and to rise to this challenge. This Special Issue welcomes cutting-edge articles on the relationship between 24-hour movement behaviour and health. Articles can report on significant methodological improvements and results of analysis of observational or experimental studies.

Dr. Sebastien Chastin
Dr. Javier Palarea-Albaladejo
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sleep
  • sedentary behavior
  • physical activity
  • movement behavior
  • time use
  • active transport
  • occupational activity
  • leisure time activity
  • exercise
  • sitting
  • metabolic health
  • cardiovascular health
  • 24-hour
  • circadian

Published Papers (11 papers)

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Research

14 pages, 746 KiB  
Article
Associations of Physical Behaviours and Behavioural Reallocations with Markers of Metabolic Health: A Compositional Data Analysis
by Gregory J. H. Biddle, Charlotte L. Edwardson, Joseph Henson, Melanie J. Davies, Kamlesh Khunti, Alex V. Rowlands and Thomas Yates
Int. J. Environ. Res. Public Health 2018, 15(10), 2280; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15102280 - 17 Oct 2018
Cited by 43 | Viewed by 4941
Abstract
Standard statistical modelling has shown that the reallocation of sitting time to either standing or stepping may be beneficial for metabolic health. However, this overlooks the inherent dependency of time spent in all behaviours. The aim is to examine the associations between physical [...] Read more.
Standard statistical modelling has shown that the reallocation of sitting time to either standing or stepping may be beneficial for metabolic health. However, this overlooks the inherent dependency of time spent in all behaviours. The aim is to examine the associations between physical behaviours and markers of metabolic health (fasting glucose, fasting insulin, 2-h glucose, 2-h insulin, Homeostasis Model Assessment of Insulin Sensitivity (HOMA-IS), Matsuda Insulin Sensitivity Index (Matsuda-ISI) while quantifying the associations of reallocating time from one physical behaviour to another using compositional analysis. Objectively measured physical behaviour data were analysed (n = 435) using compositional analysis and compositional isotemporal substitutions to estimate the association of reallocating time from one behaviour to another in a population at high risk of type 2 diabetes mellitus (T2DM). Stepping time was associated with all markers of metabolic health relative to all other behaviours. Reallocating 30 min from sleep, sitting, or standing to stepping was associated with 5–6 fold lower 2-h glucose, 15–17 fold lower 2-h insulin, and higher insulin sensitivity (10–11 fold via HOMA-IS, 12–15 fold via Matsuda-ISI). Associations of reallocating time from any behaviour to stepping were maintained for 2-h glucose, 2-h insulin, and Matsuda-ISI after further adjusting for body mass index (BMI). Relocating time from stepping into sleep, sitting, or standing was associated with lower insulin sensitivity. Stepping time may be the most important behavioural composition when promoting improved metabolic health in adults at risk of T2DM. Full article
(This article belongs to the Special Issue Health Impact of 24-Hour Movement Behaviour and Time Use)
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10 pages, 430 KiB  
Article
Compliance with 24-h Movement Behaviour Guidelines among Belgian Pre-School Children: The ToyBox-Study
by Marieke De Craemer, Duncan McGregor, Odysseas Androutsos, Yannis Manios and Greet Cardon
Int. J. Environ. Res. Public Health 2018, 15(10), 2171; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15102171 - 03 Oct 2018
Cited by 52 | Viewed by 4261
Abstract
The 24-h day—containing physical activity, sedentary behaviour and sleep—in pre-school children has not yet been extensively investigated. The aim of the current study was to investigate pre-schoolers’ compliance with the 24-h movement behaviour guidelines (i.e., three hours/day total physical activity, a maximum of [...] Read more.
The 24-h day—containing physical activity, sedentary behaviour and sleep—in pre-school children has not yet been extensively investigated. The aim of the current study was to investigate pre-schoolers’ compliance with the 24-h movement behaviour guidelines (i.e., three hours/day total physical activity, a maximum of one hour/day of screen time and 10–13 h sleep/night). In total, 595 pre-schoolers (53.3% boys, mean age: 4.2 years) provided complete data for the three behaviours. Physical activity was objectively measured with accelerometers, while screen time and sleep were parent-reported through questionnaires. The proportion of pre-schoolers complying with the 24-h movement behaviour guidelines was calculated on weekdays and on weekend days. Low compliance rates were found: 10.1% on weekdays and only 4.3% on weekend days. The majority of pre-schoolers complied with the sleep duration guidelines (>90% on weekdays and weekend days), followed by the screen time guidelines (61% on weekdays and 28% on weekend days). The lowest compliance rates were found for physical activity (<20% on weekdays and weekend days). Overall, low percentages of pre-schoolers complying with the 24-h movement behaviour guidelines were found, and the lowest compliance was found for physical activity. Full article
(This article belongs to the Special Issue Health Impact of 24-Hour Movement Behaviour and Time Use)
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14 pages, 722 KiB  
Article
The Association of the 24 Hour Distribution of Time Spent in Physical Activity, Work, and Sleep with Emotional Exhaustion
by Janina Janurek, Sascha Abdel Hadi, Andreas Mojzisch and Jan Alexander Häusser
Int. J. Environ. Res. Public Health 2018, 15(9), 1927; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15091927 - 05 Sep 2018
Cited by 17 | Viewed by 4736
Abstract
Previous research identified time spent in physical activity, sleeping, and working as predictors of emotional exhaustion. However, this research did not take into account the interdependence of these time-use components. Since daily time is limited to 24 h, time spent in one specific [...] Read more.
Previous research identified time spent in physical activity, sleeping, and working as predictors of emotional exhaustion. However, this research did not take into account the interdependence of these time-use components. Since daily time is limited to 24 h, time spent in one specific activity (e.g., sleep) cannot be used for any other activity (e.g., physical activity). We conducted a one-week daily sampling study to assess the compositional effects of physical activity, sleep, and work on emotional exhaustion. Since the sample consisted of 104 undergraduate students, work was operationalized as study time. Participants wore accelerometers for one week continuously to assess sleep and physical activity. Also, they filled in questionnaires on study time and emotional exhaustion every morning. Multilevel and compositional data analyses were conducted. The multilevel analysis revealed significant between- (p = 0.012) and within-level (p < 0.001) associations of study time with emotional exhaustion. The compositional approach showed that time spent in physical activity was negatively related to emotional exhaustion (p = 0.007), whereas time spent studying was positively related to emotional exhaustion (p = 0.003), relative to the remaining two time-use components. In conclusion, our results show that emotional exhaustion is not only associated with work-related factors, but also with off-job physical activity. Full article
(This article belongs to the Special Issue Health Impact of 24-Hour Movement Behaviour and Time Use)
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14 pages, 1034 KiB  
Article
Compositional Analysis of the Associations between 24-h Movement Behaviours and Health Indicators among Adults and Older Adults from the Canadian Health Measure Survey
by Duncan E. McGregor, Valerie Carson, Javier Palarea-Albaladejo, Philippa M. Dall, Mark S. Tremblay and Sebastien F. M. Chastin
Int. J. Environ. Res. Public Health 2018, 15(8), 1779; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15081779 - 18 Aug 2018
Cited by 48 | Viewed by 6296
Abstract
This study investigated the association between the allocation of time-use over the 24-h day between sleep, sedentary behaviour (SB), light-intensity physical activity (LPA) and moderate-to-vigorous-intensity physical activity (MVPA)) and health indicators. A cross-sectional analysis of Canadian Health Measures Survey data was undertaken using [...] Read more.
This study investigated the association between the allocation of time-use over the 24-h day between sleep, sedentary behaviour (SB), light-intensity physical activity (LPA) and moderate-to-vigorous-intensity physical activity (MVPA)) and health indicators. A cross-sectional analysis of Canadian Health Measures Survey data was undertaken using compositional data analysis. SB, LPA and MVPA were derived from Actical accelerometers, whilst sleep was self-reported by respondents. The analysis was stratified by age; adults (aged 18–64 years; n = 6322) and older adults (65–79 years; n = 1454). For adults, beneficial associations were observed between larger proportions of MVPA relative to time in other behaviours and body mass index (BMI), waist circumference, aerobic fitness, resting heart rate, high-density lipoprotein (HDL) cholesterol, triglycerides, blood glucose and insulin levels. More time spent in sleep relative to other movement behaviours was deleteriously associated with aerobic fitness, HDL cholesterol, insulin, C-reactive proteins and grip strength but beneficially with low-density lipoprotein cholesterol. Relative time spent in LPA was deleteriously associated with BMI and beneficially with triglycerides and grip strength. In older adults, these associations were blunted or disappeared but larger proportions of MVPA were associated with better mental health. The importance to health of MVPA when explicitly considered relative to other movement behaviours was confirmed. Full article
(This article belongs to the Special Issue Health Impact of 24-Hour Movement Behaviour and Time Use)
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11 pages, 327 KiB  
Article
Physical Activity and Physical Fitness of Adults with Intellectual Disabilities in Group Homes in Hong Kong
by Bik C. Chow, Peggy H. N. Choi and Wendy Y. J. Huang
Int. J. Environ. Res. Public Health 2018, 15(7), 1370; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15071370 - 29 Jun 2018
Cited by 19 | Viewed by 4851
Abstract
Adults with intellectual disabilities (ID) typically have a sedentary lifestyle and higher rates of overweight and obesity. This study describes the habitual daily physical activity (PA) and the health-related physical fitness (PF) of adults with mild and moderate ID who resided in four [...] Read more.
Adults with intellectual disabilities (ID) typically have a sedentary lifestyle and higher rates of overweight and obesity. This study describes the habitual daily physical activity (PA) and the health-related physical fitness (PF) of adults with mild and moderate ID who resided in four group homes and worked in sheltered workshops. We also assessed the contribution of PF variables towards PA levels and sedentary behavior of this population subgroup. Adults with mild and moderate ID (N = 114) were assessed on PF tests (percent body fat, waist and hip circumferences, 6-min walk (6MWT), arm curl, and sit and reach). PA and sedentary behavior on weekdays were determined using Actigraph accelerometers. Results showed these adults averaged 2% of their daily time (or 10 min) engaged in moderate-to-vigorous PA (MVPA) and 67% of the time (495 min) being sedentary. No significant differences between mild and moderate ID were found for any PA or PF variable. Linear multiple regression analyses showed 6MWT to be the only significant PF variable contributing to the variance of PA and sedentary behavior. In conclusion, adults with ID reside in group home have low PA and low fitness levels. Among fitness variables, the walking test (i.e., cardiovascular fitness) had the highest positive association with participants’ daily PA, MVPA, and negative association with sedentary behavior. Future intervention studies in promoting PA and fitness for adults with ID are warranted. Full article
(This article belongs to the Special Issue Health Impact of 24-Hour Movement Behaviour and Time Use)
23 pages, 641 KiB  
Article
Does Physically Demanding Work Hinder a Physically Active Lifestyle in Low Socioeconomic Workers? A Compositional Data Analysis Based on Accelerometer Data
by Charlotte Lund Rasmussen, Javier Palarea-Albaladejo, Adrian Bauman, Nidhi Gupta, Kirsten Nabe-Nielsen, Marie Birk Jørgensen and Andreas Holtermann
Int. J. Environ. Res. Public Health 2018, 15(7), 1306; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15071306 - 21 Jun 2018
Cited by 23 | Viewed by 4925
Abstract
Leisure time physical activity (LTPA) is strongly associated with socioeconomic position (SEP). Few studies have investigated if demanding occupational physical activity (OPA) could impede a physically active lifestyle in low SEP groups. The aim of this study was to investigate the association between [...] Read more.
Leisure time physical activity (LTPA) is strongly associated with socioeconomic position (SEP). Few studies have investigated if demanding occupational physical activity (OPA) could impede a physically active lifestyle in low SEP groups. The aim of this study was to investigate the association between OPA and LTPA among low SEP men and women. We used cross-sectional data from 895 low SEP workers who wore accelerometers for 1–5 consecutive workdays. The associations between the relative importance of activities performed during work and leisure time were assessed using compositional regression models stratified on sex. Compositional isotemporal substitution models were used to assess the implication of increasing occupational walking, standing, or sitting on LTPA. We found dissimilarity in LTPA between the sexes, with men spending more waking leisure time sedentary than women (men ~67%, women ~61%), suggesting women performed more household tasks. In men, the associations between OPA and LTPA were weak. In women, the strongest association was observed between the relative importance of occupational walking and leisure time standing (β^ = −0.16; p = 0.01), where reallocating 15 min work time to occupational walking showed an expected decrease in leisure time standing of 7 min. If this time was spent on additional sedentary leisure time, it could have adverse health consequences. Full article
(This article belongs to the Special Issue Health Impact of 24-Hour Movement Behaviour and Time Use)
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12 pages, 2311 KiB  
Article
Wear-Time Compliance with a Dual-Accelerometer System for Capturing 24-h Behavioural Profiles in Children and Adults
by Scott Duncan, Tom Stewart, Lisa Mackay, Jono Neville, Anantha Narayanan, Caroline Walker, Sarah Berry and Susan Morton
Int. J. Environ. Res. Public Health 2018, 15(7), 1296; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15071296 - 21 Jun 2018
Cited by 31 | Viewed by 6148
Abstract
To advance the field of time-use epidemiology, a tool capable of monitoring 24 h movement behaviours including sleep, physical activity, and sedentary behaviour is needed. This study explores compliance with a novel dual-accelerometer system for capturing 24 h movement patterns in two free-living [...] Read more.
To advance the field of time-use epidemiology, a tool capable of monitoring 24 h movement behaviours including sleep, physical activity, and sedentary behaviour is needed. This study explores compliance with a novel dual-accelerometer system for capturing 24 h movement patterns in two free-living samples of children and adults. A total of 103 children aged 8 years and 83 adults aged 20-60 years were recruited. Using a combination of medical dressing and purpose-built foam pouches, participants were fitted with two Axivity AX3 accelerometers—one to the thigh and the other to the lower back—for seven 24 h periods. AX3 accelerometers contain an inbuilt skin temperature sensor that facilitates wear time estimation. The median (IQR) wear time in children was 160 (67) h and 165 (79) h (out of a maximum of 168 h) for back and thigh placement, respectively. Wear time was significantly higher and less variable in adults, with a median (IQR) for back and thigh placement of 168 (1) and 168 (0) h. A greater proportion of adults (71.6%) achieved the maximum number of complete days when compared to children (41.7%). We conclude that a dual-accelerometer protocol using skin attachment methods holds considerable promise for monitoring 24-h movement behaviours in both children and adults. Full article
(This article belongs to the Special Issue Health Impact of 24-Hour Movement Behaviour and Time Use)
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10 pages, 301 KiB  
Article
Occupational Physical Activity Habits of UK Office Workers: Cross-Sectional Data from the Active Buildings Study
by Lee Smith, Alexia Sawyer, Benjamin Gardner, Katri Seppala, Marcella Ucci, Alexi Marmot, Pippa Lally and Abi Fisher
Int. J. Environ. Res. Public Health 2018, 15(6), 1214; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15061214 - 09 Jun 2018
Cited by 13 | Viewed by 5071
Abstract
Habitual behaviours are learned responses that are triggered automatically by associated environmental cues. The unvarying nature of most workplace settings makes workplace physical activity a prime candidate for a habitual behaviour, yet the role of habit strength in occupational physical activity has not [...] Read more.
Habitual behaviours are learned responses that are triggered automatically by associated environmental cues. The unvarying nature of most workplace settings makes workplace physical activity a prime candidate for a habitual behaviour, yet the role of habit strength in occupational physical activity has not been investigated. Aims of the present study were to: (i) document occupational physical activity habit strength; and (ii) investigate associations between occupational activity habit strength and occupational physical activity levels. A sample of UK office-based workers (n = 116; 53% female, median age 40 years, SD 10.52) was fitted with activPAL accelerometers worn for 24 h on five consecutive days, providing an objective measure of occupational step counts, stepping time, sitting time, standing time and sit-to-stand transitions. A self-report index measured the automaticity of two occupational physical activities (“being active” (e.g., walking to printers and coffee machines) and “stair climbing”). Adjusted linear regression models investigated the association between occupational activity habit strength and objectively-measured occupational step counts, stepping time, sitting time, standing time and sit-to-stand transitions. Eighty-one per cent of the sample reported habits for “being active”, and 62% reported habits for “stair climbing”. In adjusted models, reported habit strength for “being active” were positively associated with average occupational sit-to-stand transitions per hour (B = 0.340, 95% CI: 0.053 to 0.627, p = 0.021). “Stair climbing” habit strength was unexpectedly negatively associated with average hourly stepping time (B = −0.01, 95% CI: −0.01 to −0.00, p = 0.006) and average hourly occupational step count (B = −38.34, 95% CI: −72.81 to −3.88, p = 0.030), which may reflect that people with stronger stair-climbing habits compensate by walking fewer steps overall. Results suggest that stair-climbing and office-based occupational activity can be habitual. Interventions might fruitfully promote habitual workplace activity, although, in light of potential compensation effects, such interventions should perhaps focus on promoting moderate-intensity activity. Full article
(This article belongs to the Special Issue Health Impact of 24-Hour Movement Behaviour and Time Use)
11 pages, 568 KiB  
Article
Associations between the Objectively Measured Office Environment and Workplace Step Count and Sitting Time: Cross-Sectional Analyses from the Active Buildings Study
by Abi Fisher, Marcella Ucci, Lee Smith, Alexia Sawyer, Richard Spinney, Marina Konstantatou and Alexi Marmot
Int. J. Environ. Res. Public Health 2018, 15(6), 1135; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15061135 - 01 Jun 2018
Cited by 16 | Viewed by 4872
Abstract
Office-based workers spend a large proportion of the day sitting and tend to have low overall activity levels. Despite some evidence that features of the external physical environment are associated with physical activity, little is known about the influence of the spatial layout [...] Read more.
Office-based workers spend a large proportion of the day sitting and tend to have low overall activity levels. Despite some evidence that features of the external physical environment are associated with physical activity, little is known about the influence of the spatial layout of the internal environment on movement, and the majority of data use self-report. This study investigated associations between objectively-measured sitting time and activity levels and the spatial layout of office floors in a sample of UK office-based workers. Participants wore activPAL accelerometers for at least three consecutive workdays. Primary outcomes were steps and proportion of sitting time per working hour. Primary exposures were office spatial layout, which was objectively-measured by deriving key spatial variables: ‘distance from each workstation to key office destinations’, ‘distance from participant’s workstation to all other workstations’, ‘visibility of co-workers’, and workstation ‘closeness’. 131 participants from 10 organisations were included. Fifty-four per cent were female, 81% were white, and the majority had a managerial or professional role (72%) in their organisation. The average proportion of the working hour spent sitting was 0.7 (SD 0.15); participants took on average 444 (SD 210) steps per working hour. Models adjusted for confounders revealed significant negative associations between step count and distance from each workstation to all other office destinations (e.g., B = −4.66, 95% CI: −8.12, −1.12, p < 0.01) and nearest office destinations (e.g., B = −6.45, 95% CI: −11.88, −0.41, p < 0.05) and visibility of workstations when standing (B = −2.35, 95% CI: −3.53, −1.18, p < 0.001). The magnitude of these associations was small. There were no associations between spatial variables and sitting time per work hour. Contrary to our hypothesis, the further participants were from office destinations the less they walked, suggesting that changing the relative distance between workstations and other destinations on the same floor may not be the most fruitful target for promoting walking and reducing sitting in the workplace. However, reported effect sizes were very small and based on cross-sectional analyses. The approaches developed in this study could be applied to other office buildings to establish whether a specific office typology may yield more promising results. Full article
(This article belongs to the Special Issue Health Impact of 24-Hour Movement Behaviour and Time Use)
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14 pages, 500 KiB  
Article
Convergence in Sleep Time Accomplished? Gender Gap in Sleep Time for Middle-Aged Adults in Korea
by Seung-Eun Cha and Ki-Soo Eun
Int. J. Environ. Res. Public Health 2018, 15(4), 803; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15040803 - 19 Apr 2018
Cited by 6 | Viewed by 4210
Abstract
Although the gender gap in sleep time has narrowed significantly in the last decade, middle-aged women between ages 35 and 60 still sleep less than their male counterparts in Korea. This study examines and provides evidence for factors contributing to the gender gap [...] Read more.
Although the gender gap in sleep time has narrowed significantly in the last decade, middle-aged women between ages 35 and 60 still sleep less than their male counterparts in Korea. This study examines and provides evidence for factors contributing to the gender gap in this age group. Using Korean Time Use Survey (KTUS) data from 2004, 2009 and 2014, we find that middle-aged women’s difficulty in managing work-life balance and traditional role expectations placed upon women are the main causes of the gender gap in sleep time. The decomposition analysis reveals that the improved socioeconomic status and recent changes in familial expectations for women may have helped them sleep more than in the past. However, there remain fundamental differences in attitude and time use patterns between men and women that prevent middle-aged women from getting the same amount of sleep. Full article
(This article belongs to the Special Issue Health Impact of 24-Hour Movement Behaviour and Time Use)
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12 pages, 1584 KiB  
Article
Patterns of Time Use across the Chronic Obstructive Pulmonary Disease Severity Spectrum
by Toby Hunt, Marie T. Williams, Timothy S. Olds and Dorothea Dumuid
Int. J. Environ. Res. Public Health 2018, 15(3), 533; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph15030533 - 16 Mar 2018
Cited by 10 | Viewed by 3923
Abstract
Descriptions of time use patterns in people with chronic obstructive pulmonary disease (COPD) are scarce and the relationship between use-of-time and COPD severity remains unclear. This study aimed to describe a typical day for people with COPD and to explore the differences in [...] Read more.
Descriptions of time use patterns in people with chronic obstructive pulmonary disease (COPD) are scarce and the relationship between use-of-time and COPD severity remains unclear. This study aimed to describe a typical day for people with COPD and to explore the differences in time-use patterns across the Body Mass-Index, Airflow Obstruction, Dyspnoea and Exercise Capacity (BODE) index using compositional analyses. Using a cross-sectional design, 141 adults with clinically stable COPD had their demographics, objective measures of function (pulmonary, exercise capacity and physical activity), and self-reported COPD-related impairment recorded. Daily time-use compositions were derived from 24-h accelerometry and 24-h use-of-time recall interviews. Compositional multiple linear regression models were used to explore the relationship between the BODE index and 24-h time-use compositions. These models were used to predict daily time (min/d) that is spent in time-use components across the BODE index. The BODE index score was clearly associated with 24-h accelerometry (p < 0.0001) and 24-h use-of-time recall (p < 0.0001) compositions. Relative to the remaining time-use components, higher BODE index scores were associated with greater sedentary behaviour (p < 0.0001), Quiet time (p < 0.0001), Screen time (p = 0.001) and Self-care (p = 0.022), and less daily Chores (p < 0.0001) and Household administration (p = 0.015) time. As the BODE index scores increased, time-use predictions were strongly associated with decreases in Chores (up to 206 min/d), and increases in Screen (up to 156 min/d) and Quiet time (up to 131 min/d). Time–use patterns may provide a basis for planning interventions relative to the severity of COPD. Full article
(This article belongs to the Special Issue Health Impact of 24-Hour Movement Behaviour and Time Use)
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