Objective measurement of physical activity and sedentary behavior among South Asian adults: A systematic review

Abstract

Background South Asians are one of the fastest growing ethnic groups in western countries with a high incidence of chronic diseases like metabolic syndrome and cardiovascular disease occurring at younger ages and lower body weight compared with white Europeans. Physically active lifestyle and reduced sedentary time are modifiable risk factors that can decrease burden of chronic diseases. Population-level surveys based on self-report show South Asians engage in low levels of physical activity. Because of known limitations with self-report data, we aimed to synthesize available evidence to generate a physical activity /sedentary time profile of South Asians from studies using accelerometry. Methods We systematically searched Medline, EMBASE, CINAHL, PsycINFO, and SportDiscus. We included studies applying accelerometry to measure physical activity /sedentary time under free-living. Studies with an exclusive focus on drugs or including participants with health conditions/physical disability, and special populations (athletes/pregnant women) were excluded. Two authors independently adjudicated inclusion of citations at title/abstract and full text. We applied a standardized data abstraction form to extract relevant data. We evaluated methodological quality using Newcastle Ottawa Quality Assessment Scale. Due to variability and inconsistencies in measurement and reporting of physical activity /sedentary time, we only provide a narrative synthesis. Findings We identified only 14 studies(n = 1,338). Despite using similar accelerometry assumptions, we noted variability in reported outcomes for physical activity and sedentary time. Sedentary time ranged from 482(98) to 587 min/day. Mean light physical activity ranged from 211.69 (67. 38) to 574(227) min/day. Moderate to vigorous physical activity among South Asian women ranged from 17-41 min/day and among men, 32-43 min/day.

The Prevalence of Daily Sedentary Time in South Asian Adults: A Systematic Review

“…The review's main findings are that South Asian adults engage in a mean daily sedentary time of approximately 7 h (424 ± 8 min), although sedentary time varies widely between self-reported and objective measures. The daily sedentary time of South Asians in the present review is lower than the 482 to 587 min/day reported by Mahmood et al [26]. This discrepancy may be due to Mahmood et al [26] reporting total mean sedentary time based on accelerometer data only (i.e., ActiGraph and ActiHeart), whereas the current review reports total sedentary time in South Asians based on both objective and subjective measurement methods.…”

“…The daily sedentary time of South Asians in the present review is lower than the 482 to 587 min/day reported by Mahmood et al [26]. This discrepancy may be due to Mahmood et al [26] reporting total mean sedentary time based on accelerometer data only (i.e., ActiGraph and ActiHeart), whereas the current review reports total sedentary time in South Asians based on both objective and subjective measurement methods. However, based on the weighted sedentary time of the studies that used objective methods in the present review, daily sedentary time was 527 min/day, which is similar to the range reported in the systematic review by Mahmood et al [26].…”

“…Inclinometers are devices that measure posture and are worn on the thigh to distinguish between sitting, standing, and lying [25]. A previous systematic review examining physical activity and sedentary time profiles in South Asians reported that objectively measured sedentary time ranged from 482 to 587 min/day [26]. However, this review included only accelerometer-derived data.…”

“…Accelerometers cannot detect posture and, therefore, may misclassify standing as sedentary time, thus leading to overestimations [27]. Furthermore, Mahmood et al [26] pooled data from South Asians and African Surinamese adults from more than 10 countries (i.e., Bangladesh, Indian, Pakistan, Nepal, Sri Lanka, Maldives, Bhutan, Afghanistan, the Netherlands, and African countries) rather than focusing exclusively on South Asians, who may have distinct sedentary time profiles. The review by Mahmood et al [26] also did not quantitatively synthesise sedentary time across the reported studies, so it is not clear what the mean sedentary time of South Asians is across the literature.…”

Device-worn measures of sedentary time and physical activity in South Asian adults at high risk for type 2 diabetes in Metro-Vancouver, Canada

“…Accelerometers are particularly useful to measure PA and sedentary time in diverse ethnic groups where English proficiency may be limited and where conceptualization of PA and sedentary time may be heavily influenced by cultural factors [ 11 , 19 ]. While there has been a rapid increase in the use of accelerometers in the past decade, our recent systematic review concluded that up until March 2019, just 14 studies (with only three of those based in North America) used this technology to measure PA levels and/or sedentary time in South Asians [ 20 ].…”