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Cited by 1,034Physical Activity and HealthObesity, Physical Activity, DietSleep and related disorders

Combined Effects of Time Spent in Physical Activity, Sedentary Behaviors and Sleep on Obesity and Cardio-Metabolic Health Markers: A Novel Compositional Data Analysis Approach

Open access
Chastin, Sebastien F. M., Palarea-Albaladejo, Javier, Dontje, Manon L., Skelton, Dawn A.·2015·PLOS ONE
DOI 10.1371/journal.pone.0139984PMC PMC4604082
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Abstract

The associations between time spent in sleep, sedentary behaviors (SB) and physical activity with health are usually studied without taking into account that time is finite during the day, so time spent in each of these behaviors are codependent. Therefore, little is known about the combined effect of time spent in sleep, SB and physical activity, that together constitute a composite whole, on obesity and cardio-metabolic health markers. Cross-sectional analysis of NHANES 2005-6 cycle on N = 1937 adults, was undertaken using a compositional analysis paradigm, which accounts for this intrinsic codependence. Time spent in SB, light intensity (LIPA) and moderate to vigorous activity (MVPA) was determined from accelerometry and combined with self-reported sleep time to obtain the 24 hour time budget composition. The distribution of time spent in sleep, SB, LIPA and MVPA is significantly associated with BMI, waist circumference, triglycerides, plasma glucose, plasma insulin (all p<0.001), and systolic (p<0.001) and diastolic blood pressure (p<0.003), but not HDL or LDL. Within the composition, the strongest positive effect is found for the proportion of time spent in MVPA. Strikingly, the effects of MVPA replacing another behavior and of MVPA being displaced by another behavior are asymmetric. For example, re-allocating 10 minutes of SB to MVPA was associated with a lower waist circumference by 0.001% but if 10 minutes of MVPA is displaced by SB this was associated with a 0.84% higher waist circumference. The proportion of time spent in LIPA and SB were detrimentally associated with obesity and cardiovascular disease markers, but the association with SB was stronger. For diabetes risk markers, replacing SB with LIPA was associated with more favorable outcomes. Time spent in MVPA is an important target for intervention and preventing transfer of time from LIPA to SB might lessen the negative effects of physical inactivity.

AI snapshot

Written from the paper’s full text.

TL;DR

Using NHANES 2005–6 data on 1,937 adults, this study applies compositional data analysis to the 24-hour time budget of sleep, sedentary behavior (SB), light activity (LIPA), and moderate-to-vigorous activity (MVPA). The overall composition is associated with most obesity and cardiometabolic markers, with MVPA generally favorable, SB detrimental, and effects of reallocating time being asymmetric.

Key findings

  • The 24-hour composition of sleep, SB, LIPA, and MVPA was significantly associated with BMI, waist circumference, triglycerides, plasma glucose, plasma insulin, HOMA, systolic blood pressure (all p<0.001), and diastolic blood pressure (p=0.003), but not HDL (p=0.121) or LDL (p=0.434).
  • Within the composition, MVPA showed the strongest favorable associations; for example, MVPA was associated with lower waist circumference (B = -2.96, p<0.001) and lower BMI (B = -0.98, p<0.001), while SB was associated with higher waist circumference (B = 2.41, p=0.023) and higher BMI (B = 1.40, p=0.002).
  • Reallocating 10 minutes was asymmetric: replacing 10 minutes of SB with MVPA was associated with 0.001% lower waist circumference, whereas displacing 10 minutes of MVPA with SB was associated with 0.84% higher waist circumference. For BMI, displacing 10 minutes of MVPA with SB changed BMI by 1.21%, while the opposite change was -0.001%.
  • For diabetes risk markers, replacing SB with LIPA was associated with more favorable outcomes; LIPA contrasted favorably with other behaviors for triglycerides (B = -0.21, p<0.001), plasma insulin (B = -0.13, p=0.033), and HOMA (B = -0.15, p=0.020).

Methods

  • Secondary cross-sectional analysis of NHANES 2005–6, including adults aged 21–64 with at least 5 valid days of accelerometry data; N=1,937 were available for analysis.
  • Sleep was self-reported; SB, LIPA, and MVPA were measured with an Actigraph 7164 accelerometer and classified using count thresholds (<100, 100–1951, and ≥1952 counts/min, respectively), then expressed as proportions of 24 hours and normalized to sum to one.
  • Compositional data analysis used isometric log-ratio transformations in linear regression models (CODA), compared with single-behavior models (SINGLE), and estimated effects of 10-minute time reallocations; confounders were retained by backward elimination if p<0.2, with analyses in R 3.1.1.

Limitations

  • The paper states that objective sleep data were unavailable, sleep was self-reported only for week/workdays while accelerometry was averaged over the whole week, and this likely introduced random error.
  • The paper states that accelerometer thresholds are less accurate for distinguishing SB from LIPA, that different thresholds might lead to different results, and that data loss from the full NHANES sample was around 50%, affecting representativity.
  • The paper states that cross-sectional analysis limits causal inference and that estimated effects reflect population shifts in time distribution rather than actual individual effects; it also notes that absolute estimates depend on confounding-variable values, though trends remained similar.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1371/journal.pone.0139984

Cites

69 of 69 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 50 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Within the composition, the strongest positive effect is found for the proportion of time spent in MVPA.

    “Within the composition, the strongest positive effect is found for the proportion of time spent in MVPA.”
    Quote in the paperSubstantial claim
  • Findingown data

    The distribution of time spent in sleep, SB, LIPA and MVPA is not significantly associated with HDL or LDL cholesterol.

    “The distribution of time spent in sleep, SB, LIPA and MVPA is significantly associated with BMI, waist circumference, triglycerides, plasma glucose, plasma insulin (all p<0.001), and systolic (p<0.001) and diastolic blood pressure (p<0.003), but not HDL or LDL.”
    • Also stated in: § Linear regression models · plain
      “The CODA models show that the relative distribution of time amongst the four behaviors as a whole is statistically significantly associated with all outcomes (BMI p<0.001, waist circumference p<0.001, systolic blood pressure p<0.001, diastolic blood pressure p = 0.003, triglycerides p<0.001, plasma glucose p<0.001, plasma insulin p<0.001, HOMA p<0.001) except cholesterol levels (HDL p = 0.121 and”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Self-reported sleep duration accurately reflects actual sleep time.
  • Findingown data

    The effects of MVPA replacing another behavior and of MVPA being displaced by another behavior are asymmetric.

    “Strikingly, the effects of MVPA replacing another behavior and of MVPA being displaced by another behavior are asymmetric.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The absolute values of the time re-allocation estimates will vary if computed around a different starting composition, but the direction and relative size of the effects should be the same.
  • Findingown data

    The distribution of time spent in sleep, SB, LIPA and MVPA is significantly associated with BMI, waist circumference, triglycerides, plasma glucose, plasma insulin, systolic blood pressure, and diastolic blood pressure.

    “The distribution of time spent in sleep, SB, LIPA and MVPA is significantly associated with BMI, waist circumference, triglycerides, plasma glucose, plasma insulin (all p<0.001), and systolic (p<0.001) and diastolic blood pressure (p<0.003), but not HDL or LDL.”
    • Also stated in: § Linear regression models · plain
      “The CODA models show that the relative distribution of time amongst the four behaviors as a whole is statistically significantly associated with all outcomes (BMI p<0.001, waist circumference p<0.001, systolic blood pressure p<0.001, diastolic blood pressure p = 0.003, triglycerides p<0.001, plasma glucose p<0.001, plasma insulin p<0.001, HOMA p<0.001) except cholesterol levels (HDL p = 0.121 and”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Self-reported sleep duration accurately reflects actual sleep time.
  • Findingown data

    The mean relative amount of time spent in MVPA is over-estimated by the arithmetic mean with respect to the compositional alternative by almost 0.7% of a day, roughly 10 minutes.

    “The most obvious difference is found with the mean relative amount of time spent in MVPA, which is over-estimated by the arithmetic mean with respect to the compositional alternative by almost 0.7% of a day, roughly 10 minutes.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 51
  • Classified as probably not a substantial claim. 13

  • May combine two claims.

    Findingown data

    The proportion of time spent in LIPA and SB were detrimentally associated with obesity and cardiovascular disease markers, but the association with SB was stronger.

    “The proportion of time spent in LIPA and SB were detrimentally associated with obesity and cardiovascular disease markers, but the association with SB was stronger.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The absolute values of the time re-allocation estimates will vary if computed around a different starting composition, but the direction and relative size of the effects should be the same.

  • May combine two claims.

    Findingown data

    In the SINGLE models, both proportion of time spent in LIPA and MVPA were associated with better outcomes for waist circumference, triglycerides, plasma insulin and HOMA, with MVPA showing much higher effect sizes.

    “Both proportion of time spent in LIPA and MVPA were associated with better outcomes for waist circumference, triglycerides, plasma insulin and HOMA, with MVPA showing much higher effect sizes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Sleep was deleteriously associated with triglycerides (B=0.17, p=0.018), CRP (B=0.23, p=0.024) and plasma glucose (B=0.04, p=0.044).

    “and sleep deleteriously associated with triglycerides (B = 0.17, p = 0.018), CRP (B = 0.23, p = 0.024) and plasma glucose (B = 0.04, p = 0.044).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Self-reported sleep duration accurately reflects actual sleep time.

  • May combine two claims.

    Findingown data

    Less variance was explained by the models for BMI (R2 adj = 0.10), waist circumference (R2 adj = 0.12), diastolic blood pressure (R2 adj = 0.12), triglycerides (R2 adj = 0.12) and very little for LDL (R2 adj = 0.04).

    “Less variance was explained by the models for BMI (R2 adj = 0.10), waist circumference (R2 adj = 0.12), diastolic blood pressure (R2 adj = 0.12), triglycerides (R2 adj = 0.12) and very little for LDL (R2 adj = 0.04).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In the CODA models, for BMI, the proportion of time spent in each behavior compared to the other three was statistically significantly detrimentally associated with SB (B=1.40, p=0.002) and LIPA (B=0.98, p=0.029) but favorably with sleep (B=-1.40, p=0.009) and MVPA (B=-0.098, p<0.001).

    “For BMI, the proportion of time spent in each behavior compared to the other three was statistically significantly detrimentally associated with SB (B = 1.40, p = 0.002) and LIPA (B = 0.98 and p = 0.029) but favorably with sleep (B = -1.40, p = 0.009) and MVPA (B = -0.098, p<0.001).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Self-reported sleep duration accurately reflects actual sleep time.

  • May combine two claims.

    Findingown data

    The variance of log(sleep/SB) is 0.148, which reflects the highest proportional relationship or co-dependence between two behaviors.

    “For example, the variance of log(sleep/SB) is 0.148, which reflects the highest (proportional) relationship or co-dependence (not correlation in the usual sense) between two behaviors.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    The models' fit to the data was in line with previous reports, with moderate amount of variance explained for systolic blood pressure (R2 adj = 0.21), HDL (R2 adj = 0.22), CRP (R2 adj = 0.26), plasma glucose (R2 adj = 0.33), insulin (R2 adj = 0.40) and HOMA (R2 adj = 0.42).

    “The models’ fit to the data was in line with previous reports [1,6,10,14–17], with moderate amount of variance explained for systolic blood pressure (R2 adj = 0.21), HDL (R2 adj = 0.22), CRP (R2 adj = 0.26), plasma glucose (R2 adj = 0.33), insulin (R2 adj = 0.40) and HOMA (R2 adj = 0.42).”
    Quote in the paperNot a substantial claim0 of 7 sources checked
    • cites [1] P Bansil, 2011, Associations between sleep disorders, sleep duration, quality of sleep, and hypertension: results from the National Health and Nutrition Examination Survey, 2005 to 2008, J Clin Hypertens source

      Not checked in the free run.

    • cites [6] GN Healy, 2011, Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003–06, Eur Heart J source

      Not checked in the free run.

    • cites [10] C Maher, 2014, Reconsidering the Sedentary Behaviour Paradigm. Johannsen D, editor, PLoS One source

      Not checked in the free run.

    • cites [14] MP Buman, 2014, Reallocating time to sleep, sedentary behaviors, or active behaviors: associations with cardiovascular disease risk biomarkers, NHANES 2005–2006, Am J Epidemiol source

      Not checked in the free run.

    • cites [15] CE Matthews, 2008, Amount of time spent in sedentary behaviors in the United States, 2003–2004, Am J Epidemiol source

      Not checked in the free run.

    • cites [16] PD Loprinzi, 2014, Daily movement patterns and biological markers among adults in the United States, Prev Med (Baltim) source

      Not checked in the free run.

    • cites [17] RP Troiano, 2008, Physical activity in the United States measured by accelerometer, Med Sci Sports Exerc source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    In the SINGLE models, the proportion of time spent sleeping was statistically significantly associated with higher triglycerides and CRP levels, but associated with lower BMI and diastolic blood pressure.

    “In the SINGLE models, the proportion of time spent sleeping was statistically significantly associated with higher triglycerides and CRP levels, but associated with lower BMI and diastolic blood pressure.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Self-reported sleep duration accurately reflects actual sleep time.

  • May combine two claims.

    Findingown data

    The contrast between LIPA and the other behaviors was favorably associated with triglycerides (B=-0.21, p<0.001), plasma insulin (B=-0.13, p=0.033), and HOMA (B=-0.15, p=0.020).

    “Statistical support was obtained to conclude that the contrast between LIPA and the other behaviors was favorably associated with triglycerides (B = -0.21, p<0.001), plasma insulin (B = -0.13, p = 0.033), and HOMA (B = -0.15,p = 0.020)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Displacing LIPA and MVPA with sleep had small positive effects on systolic and diastolic blood pressure, with larger effects when sleep replaces MVPA.

    “Small positive effects were also observed on systolic and diastolic blood pressure when displacing LIPA and MVPA with sleep, with larger effects observed when sleep replaces MVPA.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The highest log-ratio variances all involve MVPA, which shows that time spent in MVPA is the least co-dependent on the other behaviors.

    “On the other end, it can be observed that the highest log-ratio variances all involve MVPA, which shows that time spent in MVPA is the least co-dependent on the other behaviors.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The proportion of time spent in MVPA was associated beneficially with HDL levels (B=0.02, p=0.012) and this was the only part of the composition statistically significantly associated with this outcome.

    “The proportion of time spent in MVPA was associated beneficially with HDL levels (B = 0.02, p = 0.012) and this was the only part of the composition statistically significantly associated with this outcome.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The effect of re-allocating time from one behavior to another while the other two are kept stable was small and not symmetric.

    “The effect of re-allocating time from one behavior to another one whilst the other two are kept stable was found to be small and not symmetric.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The relative times spent in SB and LIPA were both detrimentally associated with obesity markers, HDL, CRP and blood pressure, while MVPA showed a health enhancing relationship.

    “In our results, the relative times spent in SB and LIPA were both detrimentally associated with obesity markers, HDL, CRP and blood pressure, while MVPA showed a health enhancing relationship.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Replacing MVPA with sleep changed log(HDL) positively by 0.09%, while replacing LIPA and SB with sleep changed log(HDL) by 0.004% and 0.003% respectively.

    “Replacing MVPA with sleep changed positively log(HDL) by 0.09%, but only 0.004% and 0.003% changes were observed when sleep replaces LIPA and SB respectively.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    LIPA had favorable effects on LDL, triglycerides, glucose, insulin and HOMA, substantially more pronounced when replacing sleep than when replacing SB.

    “On the contrary, LIPA had favorable effects on LDL, triglycerides, glucose, insulin and HOMA, substantially more pronounced when replacing sleep than when replacing SB.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    SB led to higher obesity markers if it displaced any of the other behaviors, but only by sizeable amounts if it replaced MVPA.

    “SB was found to lead to higher obesity markers if it displaced any of the other behaviors, but only by sizeable amounts if it replaced MVPA.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    The effect was relatively stronger at lower proportions of MVPA and weakened as the proportion of time spent on MVPA was higher.

    “The effect was relatively stronger at lower proportions of MVPA and weakened as the proportion of time spent on MVPA was higher, which is consistent with current evidence on dose-response [3].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [3] WL Haskell, 2007, Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association, Med Sci Sports Exerc source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Detrimental effects were observed when replacing MVPA and sleep with LIPA for both obesity markers, with stronger magnitude when LIPA replaced MVPA.

    “Detrimental effects were observed when replacing MVPA and sleep with LIPA for both obesity markers, with stronger magnitude when LIPA replaced MVPA.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The strength of the negative relationship was higher with SB than with LIPA, and the effect of replacing MVPA with SB was stronger than with LIPA.

    “However the strength of the negative relationship was higher with SB than with LIPA, and in Table 4 the effect of replacing MVPA with SB was stronger than with LIPA.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    These results are for 8 hours of time spent sleeping; the magnitude of the effect varied when other proportions of sleep time were considered but the trends and observed co-dependences between waking day behaviors remained unchanged.

    “These results are for 8 hours of time spent sleeping. The magnitude of the effect varied when other proportions of sleep time were considered but the trends and observed co-dependences between waking day behaviors remained unchanged.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The positive effects of LIPA on insulin and HOMA depended on the proportion of MVPA and were strongest when LIPA replaced SB.

    “However these effects depended on the proportion of MVPA and were strongest when LIPA replaced SB (Figs 25F and 26F).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Re-allocating time to MVPA from the other behaviors only had very small effect, most noticeable on lipids.

    “Re-allocating time to MVPA from the other behaviors only had very small effect, most noticeable on lipids.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Sleep reduced log(CRP) by 2.1% when replacing MVPA, but only by 0.004% and 0.002% when displacing LIPA and SB respectively.

    “A similar, but more pronounced, pattern was observed for CRP, with sleep reducing the log(CRP) by 2.1% when replacing MVPA, but only by 0.004% and 0.002% when displacing LIPA and SB in that order.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Replacing 10 minutes of MVPA with 10 minutes of SB corresponded to a 1.2% higher BMI, while the opposite, replacing 10 minutes of SB with 10 minutes of MVPA, had a 1000 fold lower effect.

    “For example, replacing 10 minutes of MVPA with 10 minutes of SB corresponded to a 1.2% higher BMI, while the opposite, replacing 10 minutes of SB with 10 minutes of MVPA, had a 1000 fold lower effect.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Taken together, the plots show that MVPA positively affects all outcomes, except glucose, when replacing either LIPA or SB time.

    “Taken together, these plots show that MVPA positively affects all outcomes, except glucose (Figs 15 and 24) when replacing either LIPA or SB time.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Sleep showed detrimental effects on LDL, triglycerides, glucose, insulin level and HOMA, which were much stronger when sleep displaced MVPA.

    “Finally, sleep showed detrimental effects on LDL, triglycerides, glucose and insulin level and HOMA, which were much stronger when sleep displaced MVPA.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    We found that a small decrease in MVPA time has a large effect while an increase in MVPA has more moderate effects.

    “Indeed, we found that a small decrease in MVPA time has a large effect while an increase in MVPA has more moderate effects.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Sedentary time is detrimental to health.

    “and that sedentary time is detrimental to health [5].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [5] N Owen, 2009, Too much sitting: a novel and important predictor of chronic disease risk?, Br J Sports Med source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    The influence of SB might be independent of time spent in MVPA.

    “There is some evidence that the influence of SB might be independent of time spent in MVPA [6]”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [6] GN Healy, 2011, Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 2003–06, Eur Heart J source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisenone given

    Time is finite, in a circadian or diurnal cycle, and time spent in one behavior necessarily displaces time spent in at least another one.

    “Indeed time is finite, in a circadian or diurnal cycle, and time spent in one behavior necessarily displaces time spent in, at least, another one.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Compositional data analysis is a mature and well-established field of statistics.

    “Compositional data analysis is currently a mature and well-established field of statistics which has been used in diverse fields of research concerned with multivariate proportion-type data such as nutrition (e.g. fatty acid composition in meat) [19], geochemistry (e.g. sedimentary composition of rocks or chemistry of groundwaters) [20, 21], politics (e.g. multiparty electoral data) [22], and”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [19] R Ros-Freixedes, 2013, On the Compositional Analysis of Fatty Acids in Pork, J Agric Biol Environ Stat source

      Not checked in the free run.

    • cites [20] A Buccianti, 2014, Methods to investigate the geochemistry of groundwaters with values for nitrogen compounds below the detection limit, J Geochemical Explor source

      Not checked in the free run.

    • cites [21] JC Montero-Serrano, 2010, Sedimentary chemofacies characterization by means of multivariate analysis, Sediment Geol source

      Not checked in the free run.

    • cites [22] J Honaker, 2002, A Fast, Easy, and Efficient Estimator for Multiparty Electoral Data, Polit Anal source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    In accordance with STROBE guidelines, a sensitivity analysis was conducted for each model by removing 10% of cases at random and checking for a statistically significant change in the results.

    “In accordance with STROBE guidelines, a sensitivity analysis [26] was conducted for each model by removing 10% of cases at random and checking for a statistically significant change in the results.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] E Von Elm, 2007, Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies, BMJ source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Time spent in LIPA might have effects independent of time spent on MVPA.

    “Similarly, time spent in LIPA might have effects independent of time spent on MVPA [7]”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7] GN Healy, 2007, Objectively measured light-intensity physical activity is independently associated with 2-h plasma glucose, Diabetes Care source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    There is good evidence that 5 to 7 hours of sleep and over 30 minutes of MVPA per day are associated with better health outcomes.

    “For example, there is good evidence that 5 to 7 hours of sleep [1], and over 30 minutes of MVPA per day [2,3] are associated with better health outcomes.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [1] P Bansil, 2011, Associations between sleep disorders, sleep duration, quality of sleep, and hypertension: results from the National Health and Nutrition Examination Survey, 2005 to 2008, J Clin Hypertens source

      Not checked in the free run.

    • cites [2] Department of Health. Start active, stay active: a report on physical activity from the four home countries’ Chief Medical Officers. 2011.

      Not checked in the free run.

    • cites [3] WL Haskell, 2007, Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association, Med Sci Sports Exerc source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Time spent in LIPA might play a positive role in preventing obesity.

    “More recently, it has emerged that time spent in LIPA might play a positive role in preventing obesity [4]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] CM Kotz, 2005, Role of nonexercise activity thermogenesis (NEAT) in obesity, Minn Med

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisereasoning

    We know very little about the combined effect of allocating time to these different behaviors that together constitutes a composite whole.

    “However, we know very little about the combined effect of allocating time to these different behaviors that together constitutes a composite whole.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    10 minutes is the smallest unit of change in activity recognized to have beneficial health effect.

    “We chose 10 minutes as this is the smallest unit of change in activity recognized to have beneficial health effect [2,3].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [2] Department of Health. Start active, stay active: a report on physical activity from the four home countries’ Chief Medical Officers. 2011.

      Not checked in the free run.

    • cites [3] WL Haskell, 2007, Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association, Med Sci Sports Exerc source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    For diabetes risk markers (insulin and HOMA), time spent in SB and LIPA had the opposite relationship, suggesting that replacing sitting time with light activity might be beneficial.

    “For diabetes risk markers (insulin and HOMA) time spent in SB and LIPA had the opposite relationship, suggesting that replacing sitting time with light activity might be beneficial (Table 3, Figs 15B, 15C, 25F and 26F).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The study addresses two important gaps in the literature: the dearth of information about the combined effect of sleep, SB, LIPA and MVPA on health, and the need for a solution to study the relationship between health and time budgets without spurious correlations and collinearity.

    “In our view, this study addresses two important gaps in the literature. First, it contributes to mitigate the dearth of information about the combined effect of sleep, SB, LIPA and MVPA on health [14,27]. Second, it provides a solution to study the relationship between health and time budgets without encountering issues of spurious correlations and collinearity [8].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [14] MP Buman, 2014, Reallocating time to sleep, sedentary behaviors, or active behaviors: associations with cardiovascular disease risk biomarkers, NHANES 2005–2006, Am J Epidemiol source

      Not checked in the free run.

    • cites [27] M Hamer, 2014, Effects of Substituting Sedentary Time with Physical Activity on Metabolic Risk, Med Sci Sports Exerc source

      Not checked in the free run.

    • cites [8] Zeljko Pedisic, 2014, Measurement issues and poor adjustments for physical activity and sleep undermine sedentary behaviour research, Kinesiology

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Time is finite during the day, so the debate on whether the effect of a single behavior is independent of another might be conceptually wrong.

    “The fact that time is finite during the day strongly suggests that the debate on whether or not the effect of a single behavior is independent of another one might be conceptually wrong.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Time spent in one behavior is naturally co-dependent on the time spent in others, and the effect of time spent in one behavior should naturally depend on the composition of the rest of the day.

    “Time spent in one behavior is naturally co-dependent of the time spent in others and the effect of time spent in one behavior should naturally depend on the composition of the rest of the day.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    The absolute values of the estimates varied depending on the value of the confounding variables, but the trends observed remained similar.

    “The absolute values of these estimates varied depending on the value of the confounding variables. The trends observed however remained similar.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    When the compositional model is compared to the single behavior models, the strength of association is greatly attenuated, in particular for MVPA, which suggests that the effect of MVPA is not entirely independent of SB, LIPA and sleep.

    “In addition, when the compositional model is compared to the single behavior models we found that the strength of association is greatly attenuated. This is in particular for MVPA, which suggests that the effect of MVPA is not entirely independent of SB, LIPA and sleep.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Our results do not disagree with the overwhelming evidence that MVPA is beneficial to health, but the analysis shows that this relationship depends on the composition of the rest of the day.

    “Our results do not disagree with the overwhelming evidence that MVPA is beneficial to health, but the analysis shows that this relationship depends on the composition of the rest of the day.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    At equal proportion of MVPA, if SB replaces LIPA the detrimental effect of inactivity could be higher, explaining the added mortality for active people who sit for a long time.

    “But, at equal proportion of MVPA, if SB replaces LIPA the detrimental effect of inactivity could be higher, then explaining the added mortality for active people who sit for a long time (Fig 27).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Each behavior might affect health both directly and also indirectly because it displaces the others.

    “Our analysis shows that each behavior might affect health both directly and also indirectly because it displaces the others.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductcitation

    The accelerometer data were classified every minute of the day as MVPA, SB or LIPA depending on a threshold; this method is less accurate than postural allocation at distinguishing between SB and LIPA, so these two components might not be entirely accurate and different thresholds might lead to different results.

    “The accelerometer data were classified every minute of the day as MVPA, SB or LIPA depending on a threshold. This method is less accurate than postural allocation at distinguishing between SB and LIPA [57], therefore it is possible that these two components of the composition might not be entirely accurate and that different thresholds might lead to different results.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [57] SFM Chastin, 2010, Methods for objective measure, quantification and analysis of sedentary behaviour and inactivity, Gait Posture source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Although replacing SB by MVPA has a stronger positive health effect, our results show that replacing SB by LIPA could have beneficial health effects as well.

    “Although replacing SB by MVPA has a stronger positive health effect, our results show that replacing SB by LIPA could have beneficial health effects as well.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    As with all cross-sectional analysis, causal inference is limited and the estimated effects reflects more a population shift in distribution of time rather than actual effects for individuals.

    “Finally, as with all cross-sectional analysis, causal inference is limited and the estimated effects reflects more a population shift in distribution of time rather than actual effects for individuals.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationcitation

    This was not reported previously by analysis of this wave of NHANES but is consistent with evidence that long sleep duration are generally associated with worse health outcomes.

    “This was not reported previously by analysis of this wave of NHANES [14] but it is consistent with evidence that long sleep duration are generally associated with worse health outcomes [50–53].”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [14] MP Buman, 2014, Reallocating time to sleep, sedentary behaviors, or active behaviors: associations with cardiovascular disease risk biomarkers, NHANES 2005–2006, Am J Epidemiol source

      Not checked in the free run.

    • cites [50] FP Cappuccio, 2010, Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies, Sleep source

      Not checked in the free run.

    • cites [51] FP Cappuccio, 2010, Quantity and quality of sleep and incidence of type 2 diabetes: A systematic review and meta-analysis, Diabetes Care source

      Not checked in the free run.

    • cites [52] FP Cappuccio, 2011, Sleep duration predicts cardiovascular outcomes: A systematic review and meta-analysis of prospective studies, European Heart Journal

      Not checked in the free run.

    • cites [53] MA Grandner, 2013, Sleep duration, cardiovascular disease, and proinflammatory biomarkers, Nat Sci Sleep source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Our analysis adds to the current evidence that decreasing inactivity, in particular sedentary time, and maintaining or increasing time spent in moderate to vigorous physical activity, contributes toward a more favorable cardiometabolic risk profile.

    “Our analysis adds to the current evidence that decreasing inactivity, in particular sedentary time, and maintaining or increasing time spent in moderate to vigorous physical activity, contributes toward a more favorable cardiometabolic risk profile.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    Sleep was only evaluated over week or working days, while the accelerometry was averaged over the whole week, which likely introduced some random error.

    “In addition, sleep was only evaluated over week or working days, while the accelerometry was averaged over the whole week. It is likely that this introduced some random error.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Activity patterns can be different at weekends or non-working days.
    • Rests on an assumption: Sleep duration varies at weekends or non-working days depending on chronotypes.

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationnone given

    Time spent on a physical behavior is co-dependent on the other ones and, therefore, it should be analysed and conceptualised within a compositional paradigm to obtain meaningful and accurate inferences.

    “In summary, time spent on a physical behavior is co-dependent on the other ones and, therefore, it should be analysed and conceptualised within a compositional paradigm to obtain meaningful and accurate inferences.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Deconditioning or weight gain occurs rapidly when activity levels are dropped, and it takes a larger amount of exercise overload to return to the same weight or fitness.

    “Secondly, it is also well known that deconditioning or weight gain occurs rapidly when activity levels are dropped, and that it takes a larger amount of exercise overload to return to the same weight or fitness [46–48].”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [46] MJ Carvalho, 2009, Training and detraining effects on functional fitness after a multicomponent training in older women, Gerontology source

      Not checked in the free run.

    • cites [47] A Lobo, 2010, Effects of Training and Detraining on Physical Fitness, Physical Activity Patterns, Cardiovascular Variables, and HRQoL after 3 Health-Promotion Interventions in Institutionalized Elders, Int J Family Med

      Not checked in the free run.

    • cites [48] R Mora-Rodriguez, 2014, Time-course effects of aerobic interval training and detraining in patients with metabolic syndrome, Nutr Metab Cardiovasc Dis source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    Objective measurements are less prone to error, especially for quantifying time spent in MVPA, but this is less true for SB and LIPA time.

    “Objective measurements are less prone to error [56], especially for quantifying time spent in MVPA. This is however less true for SB and LIPA time.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [56] KR Westerterp, 2009, Assessment of physical activity: A critical appraisal, European Journal of Applied Physiology

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Removing 10 minutes from MVPA is a large amount of MVPA equal to one third of the recommended guidelines, while decreasing SB time by 10 minutes only accounts for a 2 to 5% change in total SB time.

    “Firstly, removing 10 minutes from MVPA is actually a large amount of MVPA equal to one third of the recommended guidelines [2], while decreasing SB time by 10 minutes only accounts for a 2 to 5% change in total SB time.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [2] Department of Health. Start active, stay active: a report on physical activity from the four home countries’ Chief Medical Officers. 2011.

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    The data loss from the full NHANES sample is relatively high (around 50%) due to compliance with objective monitoring and this selection bias affects the representativity of the sample analyzed.

    “The data loss from the full NHANES sample is relatively high (around 50% see S1 File) due to compliance with objective monitoring and this selection bias affects the representativity of the sample analyzed.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites S1 File

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Sleep in our analysis was directly beneficially associated with obesity and blood pressure markers but could have negative effects if it displaced MVPA.

    “Sleep in our analysis was directly beneficially associated with obesity and blood pressure markers but could have negative effects if it displaced MVPA.”
    Quote in the paperSubstantial claim
59 of 59

  • The paper relies on this without support.

    The absolute values of the time re-allocation estimates will vary if computed around a different starting composition, but the direction and relative size of the effects should be the same.

    “The absolute values of these estimates will vary if the time re-allocation is computed around a different starting composition, but the direction and relative size of the effects should be the same.”

  • The paper relies on this without support.

    Self-reported sleep duration accurately reflects actual sleep time.

    “Sleep duration was self-reported as an integer from 1 to 24 hours in response to the question “How much sleep do you actually get at night on weekdays or workdays”.”

  • The paper relies on this without support.

    This study is the first to use compositional analysis to investigate associations between the relative distribution of time in physical behaviors and cardiometabolic health markers.

    “This study is the first to our knowledge to use a compositional analysis to provide a statistically sound and comprehensive investigation of the associations between the relative distribution of time spent in different physical behaviors that make up the day and cardio-metabolic health markers.”

  • The paper relies on this without support.

    Humans cannot perform MVPA all day.

    “Humans cannot perform MVPA all day, therefore, although LIPA might be detrimental, spending the rest of the day in LIPA might be better than sitting (SB).”

  • The paper relies on this without support.

    Activity patterns can be different at weekends or non-working days.

    “It is known that activity patterns can be different at weekends or non-working days.”

  • The paper relies on this without support.

    Sleep duration varies at weekends or non-working days depending on chronotypes.

    “Similarly sleep duration varies at weekends or non-working days depending on chronotypes.”
6 of 6

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Claimed detrimental SB effect on CRP reverses the table's direction

    Major

    The text describes a negative health effect on CRP when SB replaces MVPA. In Table 4, that replacement changes Log(CRP) by -0.950, indicating lower CRP.

  • BMI plot is cited as Fig 6B instead of Fig 16B

    Minor

    The cited reciprocal BMI plot is described as panel B of Fig 16. Fig 6 concerns LDL concentration groups.

  • BMI coefficient for MVPA differs from Table 3

    Minor

    The results text gives the CODA coefficient for MVPA as -0.098, while Table 3 reports -0.98-a tenfold difference.

3 of 3

Cites

Flagged first, then by citations

1 of the 70 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Zeljko Pedisic, 2014, Measurement issues and poor adjustments for physical activity and sleep undermine sedentary behaviour research, Kinesiology, 46, 135

Cited by

Sorted by citations

Related

Authors
Chastin, S. F. M., Palarea-Albaladejo, J., Dontje, M. L., & Skelton, D. A.
Affiliations
Glasgow Caledonian University (GB)
Corresponding author
Chastin, Sebastien F. M.
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2015-10-13
Volume
10
Issue
10
Pages
e0139984
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0139984
PMC
PMC4604082
OpenAlex
W1818552750
Semantic Scholar
26e3231050045c392eb982c52747c0cf1c3a90ec
Cited by
1,034
References
70
Citations by year
2026: 81 · 2025: 115 · 2024: 124 · 2023: 108 · 2022: 90 · 2021: 109 · 2020: 140 · 2019: 90 · 2018: 72 · 2017: 67 · 2016: 36
FWCI
42.99
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • ResearchOnline (Glasgow Caledonian University) (acceptedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
Funders
  • Rural and Environment Science and Analytical Services Division
  • Scottish Government
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords
physical activity, sedentary behavior, sleep, time budget, compositional data analysis, obesity, cardiometabolic health, waist circumference, blood pressure, insulin, triglycerides, light physical activity, moderate-to-vigorous physical activity, time displacement, diabetes risk, NHANES
MeSH terms
Adult, Behavior, Blood Glucose, Blood Pressure, C-Reactive Protein, Diastole, Fasting, Humans, Insulin, Lipids, Middle Aged, Motor Activity, Obesity, Sleep, Statistics as Topic, Systole, Time Factors, Body Mass Index, Linear Models, Waist Circumference, Young Adult, Sedentary Behavior

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

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