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3 Interactions among sleep, sedentary behaviour, physical activity and overall health Jean-Philippe Chaput, PhD

4 Research over the past years has been conducted in movement behaviour silos MVPA Sedentary behaviour Sleep Health outcomes Health outcomes Health outcomes An integrated approach is needed to understand the interactions and clustering of these behaviours

5 Looking for the trees and not the forest I ll have plenty of time to sleep when I m dead As long as the furnace is hot I can eat whatever I want I exercise every day so I don t need to care about my amount of screen time

6 Int J Environ Res Public Health (2014)

7 RESEARCH INSTITUTE The Movement Continuum Sedentary Physiology Exercise Physiology sleep sedentary behaviour NEAT moderate activity intense exercise METS - + Sleep Physiology

8 Sleep

9 Are Canadian kids sleep deprived? N=24,896 participants (HBSC) Chaput and Janssen. J Sleep Res (2016)

10 What about Canadian adults? N=10,976 adults and older adults Cycles 1-3 of CHMS Adults (18-64 years): - 65% sleep the recommended amount - 32% are short sleepers - 3% are long sleepers Older adults ( 65 years): - 54% sleep the recommended amount - 31% are short sleepers - 15% are long sleepers Sleep quality: 43% of men and 55% of women reported trouble going to sleep or staying asleep sometimes/most of the time/all of the time Chaput JP et al. Health Reports (2017)

11 Factors explaining sleep loss. And we don t take sleep seriously!!!

12 Screens and sleep hygiene - Bright light of screens suppresses melatonin secretion, which may delay sleep onset - Screen exposure before bedtime decreases sleep quality

13 Insufficient sleep is associated with: - Obesity, T2D, CVD, mortality - Unhealthy behaviours (inactivity, screen time, unhealthy eating behaviours, alcohol consumption, ) - Anxiety and depression - Irritability - Suicidality - Risky behaviours and injuries - Weaker immune system - Poorer academic achievement - Lower quality of life/well-being -

14 Mechanisms by which sleep deprivation may lead to weight gain and obesity Chaput JP. Eat Weight Disord (2016)

15 Influence of sleep timing (bedtime) on obesity risk Lark vs. night owl

16 Int J Obes (2013) Sleep (2011) Later bedtimes and later wake-up times are associated with poorer diet quality, lower MVPA, greater screen time and a higher risk of obesity independent of sleep duration

17 Sleep recommendations Age Recommendation Newborns (0-3 months) Infants (4-11 months) Toddlers (1-2 years) Preschoolers (3-5 years) School-aged children (6-13 years) Teenagers (14-17 years) Adults (18-64 years) Older adults (65 and over) h h h h 9-11 h 8-10 h 7-9 h 7-8 h

18 One of the best strategies to improve your sleep is to be active Bioenergetics (2013)

19 Sedentary Behaviour

20 Convenience seduction

21 Sedentary behaviour refers to any waking activity characterized by an energy expenditure 1.5 metabolic equivalents and a sitting, reclining or lying posture. In general this means that any time a person is sitting or lying down, they are engaging in sedentary behaviour. Common sedentary behaviours include TV viewing, video game playing, computer use, driving automobiles, and reading. Tremblay MS et al. Int J Behav Nutr Phys Act (2017)

22 Is sitting the new smoking?

23 Are you an active couch potato? Saunders TJ, Chaput JP, Tremblay MS. Can J Diabetes (2014)

24 Are all sedentary activities equal? Do they all promote weight gain?

25 Screen time increases food intake in the absence of hunger Chaput JP et al. Obes Rev (2011)

26 Energy expenditure (kcal/45 min) Energy intake (kcal) Intellectual work increases food intake * kj kj Rest Computing Rest 0 Computing Balance: +946 kj Chaput JP and Tremblay A. Physiol Behav (2007)

27 Energy intake (kj) Video game playing increases food intake = 335 kj 5000 * Control Video Game 1 2 Chaput JP et al. Am J Clin Nutr (2011)

28 What about reading? 2013

29 Breaks in sedentary time Dunstan et al. Touch Briefings (2010)

30 Conclusion: Greater time spent standing is associated with a lower risk of mortality

31 Lancet (2016)

32 FITT vs SITT Frequency Intensity Time Type Sedentary Interruptions Time Type

33 Physical Activity

34

35 PLoS One (2015)

36 Appl Physiol Nutr Metab (2016) The composition of movement behaviours matters for optimal health Replacing MVPA with any other movement behaviour has the biggest negative effect on health Maintaining MVPA seems to be more important than increasing it

37 Adopting a full-day approach

38 Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep

39 8 combinations of movement behaviours that can occur over 24 hours

40 Roman-Vinas B et al. Int J Behav Nutr Phys Act (2016)

41 The whole day matters! Roman-Vinas B et al. Int J Behav Nutr Phys Act (2016)

42 Some is good, more is better, everything counts When it comes to weight and health, you can t outrun a bad diet Exercise

43 Chaput JP and Sharma AM A substantial proportion of the variance in the contribution of exercise on body weight may well be explained by positive effects of exercise on ingestive behaviour in individuals in whom overeating is primarily driven by stress, depression, poor self-esteem or unrestorative sleep, all of which can be improved by regular exercise

44 We need a healthy balance of physical activity, sedentary behaviour, and sleep each day. We also need a good diet. Most importantly, we need to sustain good behaviours over time Sit less Move more Sleep well Eat better

45 Conclusion A broader, more integrated approach is needed to address current public health crises Sleep, sedentary behaviour, physical activity and diet all interact together to impact health Screen time is worse than non-screen sedentary behaviour for promoting weight gain Sedentary behaviour and MVPA do not directly displace one another You can t outrun a bad diet

46 we spend the first two years of life teaching kids to walk and talk and then the next 16 years telling them to sit down and shut up anonymous