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Substituting bouts of sedentary behavior with physical activity: adopting positive lifestyle choices in people with a history of cancer

Ingle, Lee; Ruilova, Samantha; Cui, Yunsung; DeClercq, Vanessa; Sweeney, Ellen; Yu, Zhijie Michael; Forbes, Cynthia C.


Samantha Ruilova

Yunsung Cui

Vanessa DeClercq

Ellen Sweeney

Zhijie Michael Yu


Purpose: To determine in people with a history of cancer, whether substituting sitting time with other daily activities (i.e., sleeping, walking, moderate and vigorous physical activity) was associated with changes in waist circumference (WC), an important surrogate marker of cardiometabolic risk. Methods: Cross-sectional analyses from the Atlantic Partnership for Tomorrow’s Health (Atlantic PATH) cohort was conducted using isotemporal substitution models to explore the associations of substituting sedentary time, physical activity behavior (International Physical Activity Questionnaire), or sleep (Pittsburgh Sleep Quality Index) with changes in WC. Analyses were conducted using sex-specific WC classifications. Results: In 3,684 people with a history of cancer [mean age (SD) 58.2 (7.3) years; BMI 28.9 (5.2) kgm−2; 71% female], reallocating 10min of sleep or sedentary time for 10min of walking was associated with lower WC in women (p < 0.01). In men, PA intensity appeared to be more strongly associated with a reduced WC. Replacing 10min of sedentary time with 10min of moderate or vigorous PA and replacing 10min of sleep with moderate PA were associated with a significantly reduced WC (p < 0.001). The largest effect was when 10min of moderate PA was replaced with vigorous PA, a reduction in WC (p < 0.01) was evident. Conclusion: For people with a history of cancer, adopting small but positive changes in lifestyle behaviors could help reduce WC and potentially offset negative health-related outcomes associated with higher WC. Further research is required to examine whether such an intervention may be acceptable and manageable among this population.


Ingle, L., Ruilova, S., Cui, Y., DeClercq, V., Sweeney, E., Yu, Z. M., & Forbes, C. C. (2022). Substituting bouts of sedentary behavior with physical activity: adopting positive lifestyle choices in people with a history of cancer. Cancer Causes and Control,

Journal Article Type Article
Acceptance Date May 23, 2022
Online Publication Date Jun 14, 2022
Publication Date 2022-08
Deposit Date May 23, 2022
Publicly Available Date Oct 27, 2022
Journal Cancer Causes and Control
Print ISSN 0957-5243
Electronic ISSN 1573-7225
Publisher Springer
Peer Reviewed Peer Reviewed
Keywords Isotemporal substitution; Physical activity; Sedentary behavior; Cardiometabolic risk; Oncology
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© The Author(s) 2022.<br /> Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit

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