Korean Journal of Health Promotion

Oh, Moon, Kong, Oh, and Kim: The Association between Sitting Time and Health-Related Quality of Life According to Body Mass Index in Elderly Korean

Original Article

Published online: December 28, 2017

DOI: https://doi.org/10.15384/kjhp.2017.17.4.209

The Association between Sitting Time and Health-Related Quality of Life According to Body Mass Index in Elderly Korean

Yun Hwan Oh^1,², Ji Hyun Moon^1,², Mi Hee Kong^1,³, Bumjo Oh⁴, Hyeon Ju Kim^1,³

¹Department of Family Medicine, Jeju Nation University Hospital, Jeju, Korea.

²Department of Medicine, Graduate School, Jeju National University, Jeju, Korea.

³Department of Family Medicine, Jeju National University School of Medicine, Jeju, Korea.

⁴Department of Family Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea.

Corresponding author: Hyeon Ju Kim, MD, PhD. Department of Family Medicine, Jeju National University Hospital, 15 Aran 13-gil, Jeju 63241, Korea.
Tel: +82-64-717-1830, Fax: +82-64-717-1581, fmhjukim@hanmail.net

Received October 19, 2017 Accepted November 30, 2017

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background: Although obesity and health-related quality of life (HRQOL) in elderly are well known to be associated with obesity and sitting time, it is unclear whether effect of sedentary lifestyle on HRQOL is affected by body mass index (BMI) or not. So we analyzed the relationship between sitting time and HRQOL according to BMI groups in elderly Korean.

Methods: Participants aged over 60 from the 6th Korea National Health and Nutrition Examination Survey (2014 and 2015) were included. Participants were classified as normal weight and overweight/obese groups. Mean sitting times were compared between groups according to the EuroQol 5 dimension (EQ-5D) And logistic regression analyses were performed.

Results: Men with mobility, usual activity, or pain/discomfort domain problem had longer sitting time. Women with a problem in every domain had longer sitting time. Overweight/obese women with problem showed longer sitting time. Odds ratios (ORs) of mobility, usual activity, pain or discomfort, and low EQ-5D score domain were increased regardless of BMI groups in men. But, ORs of all domains were increased only in overweight/obese group in women.

Conclusions: In elderly Korean, prolonged sitting time associated with decreased HRQOL. Impaired HRQOL is associated with increased sitting time regardless of BMI in men. But only overweight/obese group showed association between prolonged sitting time and impaired HRQOL in women. These results represents that decrease in quality of life according to the increase of the sitting time differs according to the BMI in elderly Korean women.

Key words: Aged; Sedentary lifestyle; Body mass index; Obesity; Quality of life

REFERENCES

REFERENCES: 1. World Health Organization. Good health adds life to years: global brief for World Health Day 2012. In Good health adds life to years: Global brief for World Health Day 2012 [Internet]. Geneva: World Health Organization; 2012;Accessed Sept 26, 2017]. Available from: http://www.who.int/ageing/publications/hd2012_global_brief/en/

2. Oldridge NB. Economic burden of physical inactivity: healthcare costs associated with cardiovascular disease. Eur J Cardiovasc Prev Rehabil 2008;15(2):130-139.
[Article] [PubMed]

3. Martínez-Gómez D, Guallar-Castillón P, León-Muñoz LM, López-García E, Rodríguez-Artalejo F. Combined impact of traditional and non-traditional health behaviors on mortality: a national prospective cohort study in Spanish older adults. BMC Med 2013;11:47.
[PubMed] [PMC]

4. Scarborough P, Bhatnagar P, Wickramasinghe KK, Allender S, Foster C, Rayner M. The economic burden of ill health due to diet, physical inactivity, smoking, alcohol and obesity in the UK: an update to 2006–07 NHS costs. J Public Health (Oxf) 2011;33(4):527-535.
[Article] [PubMed]

5. Health UDo. Services H. 2008 Physical Activity Guidelines for Americans. Be Active, Healthy and Happy! [Internet]. Washington: US Department of Health and Human Services; 2008;Accessed Sept 26, 2017]. Available from: https://health.gov/paguidelines/df/paguide.pdf

6. Owen N, Healy GN, Matthews CE, Dunstan DW. Too much sitting: the population health science of sedentary behavior. Exerc Sport Sci Rev 2010;38(3):105-113.
[PubMed] [PMC]

7. Katzmarzyk PT, Church TS, Craig CL, Bouchard C. Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med Sci Sports Exerc 2009;41(5):998-1005.
[Article] [PubMed]

8. Rowe JW, Kahn RL. Successful aging. Gerontologist 1997;37:433-440.
[Article] [PubMed]

9. Spilker B. Quality of life and pharmacoeconomics in clinical rials. 2nd ed. Philadelphia Pennsylvania: Lippincott-Raven Publishers; 1996. p. 11-24.

10. Goulart AC, Rexrode KM. Health consequences of obesity in the elderly: a review. Curr Cardiovasc Risk Rep 2007;1(4):340-347.
[Article]

11. Banegas JR, López-García E, Graciani A, Guallar-Castillón P, Gutierrez-Fisac JL, Alonso J, et al. Relationship between obesity, hypertension and diabetes, and health-related quality of life among the elderly. Eur J Cardiovasc Prev Rehabil 2007;14(3):456-462.
[Article] [PubMed]

12. Pedisic Z, Grunseit A, Ding D, Chau JY, Banks E, Stamatakis E, et al. High sitting time or obesity which came first? Bidirectional association in a longitudinal study of 31,787 Australian adults. Obesity (Silver Spring) 2014;22(10):2126-2130.
[Article] [PubMed] [PMC]

13. van Uffelen JG, Watson MJ, Dobson AJ, Brown WJ. Sitting time is associated with weight, but not with weight gain in mid-aged Australian women. Obesity (Silver Spring) 2010;18(9):1788-1794.
[Article] [PubMed]

14. Vallance JK, Eurich D, Marshall AL, Lavallee CM, Johnson ST. Associations between sitting time and health-related quality of life among older men. Ment Health Phys Act 2013;6(1):49-54.
[Article]

15. Lim JW, Gonzalez P, Wang-Letzkus MF, Ashing-Giwa KT. Understanding the cultural health belief model influencing health behaviors and health-related quality of life between Latina and Asian-American breast cancer survivors. Support Care Cancer 2009;17(9):1137-1147.
[Article] [PubMed]

16. World Health Organization. Global physical activity questionnaire (GPAQ) analysis guide [Internet]. Geneva: World Health Organization; 2012;Accessed Sept 26, 2017]. Available from: http://www.who.int/ageing/publications/whd2012_global_rief/en/

17. Weisell RC. Body mass index as an indicator of obesity. Asia Pac J Clin Nutr 2002;11:Suppl 8. S667-S751.
[Article]

18. Rabin R, de Charro F. EQ-SD: a measure of health status from the EuroQol Group. Ann Med 2001;33(5):337-343.
[Article] [PubMed]

19. Kim MH, Cho YS, Uhm WS, Kim S, Bae SC. Cross-cultural adaptation and validation of the Korean version of the EQ-5D in patients with rheumatic diseases. Qual Life Res 2005;14(5):1401-1406.
[Article] [PubMed]

20. Lee YK, Nam HS, Chuang LH, Kim KY, Yang HK, Kwon IS, et al. South Korean time trade-off values for EQ-5D health states: modeling with observed values for 101 health states. Value Health 2009;12(8):1187-1193.
[Article] [PubMed]

21. World Health Organization. International guide for monitoring alcohol consumption and related harm [Internet]. Geneva: World Health Organization; 2000;Accessed Sept 26, 2017]. Available from: http://apps.who.int/iris/bitstream/10665/66529//WHO_MSD_MSB_00.4.pdf

22. Herrmann SD, Heumann KJ, Der Ananian CA, Ainsworth BE. Validity and reliability of the global physical activity questionnaire (GPAQ). Meas Phys Educ Exerc Sci 2013;17(3):221-235.
[Article]

23. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112(17):2735-2752.
[Article] [PubMed]

24. Rosenkranz RR, Duncan MJ, Rosenkranz SK, Kolt GS. Active lifestyles related to excellent self-rated health and quality of life: cross sectional findings from 194,545 participants in The 45 and Up Study. BMC Public Health 2013;13:1071.
[Article] [PubMed] [PMC]

25. Jia H, Lubetkin EI. The impact of obesity on health-related quality-of-life in the general adult US population. J Public Health (Oxf) 2005;27(2):156-164.
[Article] [PubMed]

26. Hu F, Kim D, Kawachi I. Obesity epidemiology. 1th ed. New York: Oxford University Press; 2008. p. 234-226.

27. Olivares PR, Gusi N, Prieto J, Hernandez-Mocholi MA. Fitness and health-related quality of life dimensions in community-dwelling middle aged and older adults. Health Qual Life Outcomes 2011;9:117.
[Article] [PubMed] [PMC]

28. Salmon J, Owen N, Crawford D, Bauman A, Sallis JF. Physical activity and sedentary behavior: a population-based study of barriers, enjoyment, and preference. Health Psychol 2003;22(2):178-188.
[Article] [PubMed]

29. Hamer M, Stamatakis E. Prospective study of sedentary behavior, risk of depression, and cognitive impairment. Med Sci Sports Exerc 2014;46(4):718-723.
[Article] [PubMed] [PMC]

30. de Wit L, van Straten A, Lamers F, Cuijpers P, Penninx B. Are sedentary television watching and computer use behaviors associated with anxiety and depressive disorders? Psychiatry Res 2011;186(2-3):239-243.
[Article] [PubMed]

31. Kulinski JP, Khera A, Ayers CR, Das SR, De Lemos JA, Blair SN, et al. Association between cardiorespiratory fitness and accelerometer-derived physical activity and sedentary time in the general population. Mayo Clin Proc 2014;89(8):1063-1071.
[Article] [PubMed] [PMC]

32. Murtagh KN, Hubert HB. Gender differences in physical disability among an elderly cohort. Am J Public Health 2004;94(8):1406-1411.
[Article] [PubMed] [PMC]

33. Nolen-Hoeksema S. Gender differences in depression. Curr Dir Psychol Sci 2001;10(5):173-176.
[Article]

34. Vasan RS. Cardiac function and obesity. Heart 2003;89(10):1127-1129.
[Article] [PubMed] [PMC]

35. Lang IA, Llewellyn DJ, Alexander K, Melzer D. Obesity, physical function, and mortality in older adults. J Am Geriatr Soc 2008;56(8):1474-1478.
[Article] [PubMed]

36. Storch EA, Milsom VA, Debraganza N, Lewin AB, Geffken GR, Silverstein JH. Peer victimization, psychosocial adjustment, and physical activity in overweight and at-risk-for-overweight youth. J Pediatr Psychol 2006;32(1):80-89.
[Article] [PubMed]

37. Strine TW, Mokdad AH, Dube SR, Balluz LS, Gonzalez O, Berry JT, et al. The association of depression and anxiety with obesity and unhealthy behaviors among community-dwelling US adults. Gen Hosp Psychiatry 2008;30(2):127-137.
[Article] [PubMed]

Figure 1

Mean sitting time according to EQ-5D domain problem by sex. Shown are comparisons of adjusted mean sitting times between subjects with or without problem within each EQ-5D domain. P-values were calculated by t-test. Sitting time were adjusted for age, alcohol, smoking, physical activity, residential area, income, education, marital status, and comorbidities (hypertension, hypercholesterolemia, diabetes, coronary heart disease, stroke, COPD, arthritis, and cancer).

Abbreviations: EQ-5D, EuroQol comprising five dimensions; COPD, chronic obstructive pulmonary disease.

^aP<0.01.

Figure 2

Mean sitting time according to EQ-5D domain problem by sex and BMI categories. Shown are comparisons of adjusted mean sitting times between subjects with or without problem within each EQ-5D domain. P-values were calculated by t-test. Sitting time were adjusted for age, alcohol, smoking, physical activity, residential area, income, education, marital status, comorbidities (hypertension, hypercholesterolemia, diabetes, coronary heart disease, stroke, COPD, arthritis, cancer).

Abbreviations: EQ-5D, EuroQol comprising five dimensions; BMI, body mass index; COPD, chronic obstructive pulmonary disease.

^aP<0.01.

^bP<0.05.

Table 1

Baseline characteristic according to sex and BMI categories^a

Abbreviations: BMI, body mass index; LPA, low physical activity; MPA, moderate physical activity; HPA, high physical activity; COPD. chronic obstructive pulmonary disease; EQ-5D, EuroQol comprising five dimensions.

^aValues are represented as number (%) or mean±standard error unless otherwise indicated.

^bP-value by independent t-test (conticuous variables) or χ² test (categorical variavles).

^cDefined as consuming more than 7/5 (man/woman) standard alcoholic drinks at one time more than twice a week.

Table 2

ORs and 95% CI for impaired status of health related quality of life^a per hour increase in sitting time by sex and BMI categories

Abbreviations: OR, odds ratio; CI, confidence interval; BMI, body mass index; EQ-5D, EuroQol comprising five dimensions; COPD, chronic obstructive pulmonary disease.

Values are presented as OR (95% CI); OR (95% CI) by logistic regression analyses.

^aImpaired status of health related quality of life: some or extreme problems in EQ-5D domains and the lowest 20% in EQ-5D index score.

^bModel 1: adjusted for age

^cP<0.05.

^dP<0.01.

^eModel 2: adjusted for age, alcohol, smoking, physical activity, residential area, income, education, and marital status.

^fModel 3: adjusted for age, alcohol, smoking, physical activity, residential area, income, education, marital status, and comorbidities (hypertension, hypercholesterolemia, diabetes, coronary heart disease, stroke, COPD, arthritis, and cancer).