Effect of a novel workstation device on promoting non-exercise activity thermogenesis (NEAT)

Abstract

BACKGROUND:

Strategies to increase non-exercise activity thermogenesis (NEAT) through promotion of movement and energy expenditure at desk stations are needed to help overcome ill effects of prolonged sitting.

OBJECTIVE:

Examine the metabolic rate during three stages of a workstation: sitting, standing, and use of a device (HOVR^®) that promotes leg movement while seated.

METHODS:

Participants (n = 16; mean ±standard deviation: age 26.1±6.0 years; BMI 24.7±4.3 kg/m²) were tested for VO₂ and VCO₂ for 15 min at each stage in this order: sitting only, sitting using the HOVR, and standing. Participants performed the same desk work to keep fine-motor activity consistent for the stages. Data collected during the final 5 min of a stage were averaged and analyzed as steady-state data. To evaluate the effect of each stage on cognitive function, the Stroop word-color test was administered after metabolic assessment as the stage continued. One-way ANOVA with repeated measures was used to compare stages for VO₂ (L/min), metabolic equivalents (METs), respiratory exchange ratio (RER), and heart rate (p < 0.05).

RESULTS:

The ANOVA revealed significant differences between the mean values for each stage for each dependent variable (p < 0.05). Post hoc tests indicated VO₂ differed for each stage (mean±SD in mL/kg/min: sitting, 4.13±0.56; sitting with HOVR, 4.82±0.74; standing, 4.50±0.53; p < 0.05). METs followed a similar pattern (sitting, 1.19±0.16; sitting with HOVR, 1.39±0.20; standing, 1.29±0.16; p < 0.05). An increase in Stroop Test scores was found as the stages progressed (p < 0.05).

CONCLUSION:

Modest movement while seated, i.e., use of HOVR, elevated metabolic rate by 17.6% compared to sitting and by 7% compared to standing and might be a reasonable strategy to help elevate NEAT during the workday.

Keywords

Very low-intensity activity METS sedentary sitting

1 Introduction

Sitting has been identified as a risk factor for early mortality independent of the presence of an existing disease [1 –4]. van der Ploeg et al. [4] reported that sitting accounted for 7% of deaths, and that achieving the recommended average of 30 minutes of moderate exercise per day offered no protection, i.e., the hazard ratio was >1, if an individual sat for 8 to 11 hours a day. Prolonged sitting is also linked to an increase in risk factors for Type 2 Diabetes, heart and vascular disease, and obesity [5, 6].

Advancements in technology and other changes in the work environment require prolonged periods at the desk with minimal movement; hence, the workday is a major contributor to sedentary behavior. The average duration of inactivity among people in the U.S. ages 20 to 60 years, i.e. those representing the workforce, is 7 to 8 hours daily [7]. Depending on the age and type of work, 20% of workers in the U.S. report spending >8 h a day being sedentary [8]. Consequently, efforts have been made to break up clerical work and encourage movement at desk jobs. It is unclear what underlies the health risks of sitting, whether it is the absence of muscle contraction per se or reduced daily energy expenditure to offset energy intake and curtail adiposity. Regardless, movement even at low intensity requires muscle contraction and will elevate energy expenditure. Therefore, movement is highly encouraged for those who engage in sedentary occupations.

Low-level activity that simply interrupts sitting for a brief period has been associated with lower risks for chronic disease including lower waist circumference, Body Mass Index (BMI), serum triglycerides, and plasma glucose concentration two hours after glucose ingestion [9]. The movement can be planned physical activity such as exercise or that which is spontaneous and unrelated to a routine for fitness; the latter has become known as non-exercise activity thermogenesis, or NEAT. NEAT is an often overlooked component of total 24-hour energy expenditure and may help counter the adverse effects of being sedentary [10]. Fidgeting, an example of NEAT, may account for as much as 800 calories per day [11]. This might help explain why some individuals seem resilient to weight change over the life span [11, 12].

In recent years, tactics that promote workstation physical activity and attenuate the ill effects of a sedentary lifestyle have emerged and include the standing workstation, and dynamic stations such as the seated pedal station, and the treadmill workstation [13 –17]. Standing workstations and treadmill workstations may elevate metabolism up to ∼25% [15] and ∼250% [18], respectively. Dynamic workstations, though, may carry limitations due to the mental distraction that could affect work productivity or safety. For example, Thompson and Levine reported that workers took longer to complete tasks when walking at a treadmill workstation even though accuracy for a transcription task was unaffected [19]. Commissaris et al. found mostly no differences in performance between standing and a variety of dynamic workstations except that computer mouse movement and accuracy worsened work, and workers’ perception of how they thought they would perform were lower compare to perceptions for a standing desk [20]. Alternate methods that increase spontaneous activity without being distractive mentally or physically could add mild to modest daily physical activity that accumulates over time for impact. Modest, sustained change that imposes minimal disruption to the day appears to be most promising, particularly for long-term success in addressing obesity and related health risks [6].

The purpose of this preliminary study was to compare metabolic rate elicited for activity during three versions of workstations: seated at a desk, standing at a desk, and seated using a new device that stimulates spontaneous movement of the legs while sitting. Our hypothesis was that metabolic rate would be raised during seated leg movement compared to merely sitting for desk work. Furthermore, we expected to see an increase in metabolic rate with the progression from seated to seated leg movement to standing. Finally, we hypothesized that cognitive function assessed using the Stroop Word Color Test [21] would not be different between the three simulated workstations.

2 Methods

A convenient sample of participants was recruited from the university faculty, staff, and student population. All participants indicated spending a good portion of the day seated at a desk for work or college studies. Fitness level varied as two participants trained for distance running events, two were off-season swimmers, one performed resistance training for exercise, and the remainder were recreationally active at most. The physical characteristics of the participants are presented in Table 1. Written informed consent was obtained after participants had the study explained. The protocol and consent form were reviewed and approved by the Institutional Review Board prior to recruitment and data collection.

Table 1
Mean (±SD) and range of participant physical characteristics (n = 16)

Mean±SD Minimum-Maximum

Age, years 26.1±6.0 20–39

Height, cm 168.8±7.4 158.5–185.2

Body mass, kg 70.5±13.3 52.5–102.6

BMI, kg/m² 24.7±4.3 18.8–34.7

	Mean±SD	Minimum-Maximum
Age, years	26.1±6.0	20–39
Height, cm	168.8±7.4	158.5–185.2
Body mass, kg	70.5±13.3	52.5–102.6
BMI, kg/m²	24.7±4.3	18.8–34.7

SD: standard deviation; cm: centimeters; kg: kilograms; m: meters.

The sample of 16 participants was composed of 3 males and 13 females. For this pilot study, there was no attempt to balance the number of males and females; participants were tested as they were recruited and available. It is recognized that hormone concentrations vary in females depending on the phase of the menstrual cycle and could alter metabolic rate and substrate oxidation. However, when measuring the acute metabolic response to activities done during the same test session, the hormone influence would not be a confounding factor. The sample size was based on an expected difference of ∼11% in VO₂ for sitting vs. standing, the standard deviation of 0.5 mL/kg/min determined in a prior study [22] and a statistical power level set at 80%. To account for the repeated measures approach, the sample size was then adjusted based on a correlation coefficient of r = 0.8, between seated and standing values.

2.1 Experimental protocol

Two sessions were scheduled one day to no more than one week apart for each participant. In the first session, the study was explained, and participants were familiarized with the lab environment, metabolic equipment, and use of the device to promote leg movement while seated. Briefly, the device called the HOVR^® (Active Ideas, LLC, Chicago, IL) is a metal brace that is suspended from the desk, hanging freely on a strap. The metal brace runs parallel to the floor and provides the anchor for a foot pedal at each end of the brace. Potential movements enabled by the device include swinging in multiple planes, twisting, teetering, or stepping. Movements would mainly rely on contractions of portions of the quadriceps and hamstrings; to a lesser extent, the hip abductors and adductors and calf muscles may be engaged. Participants also performed a complete practice trial of the Stroop Color and Word Test [21] to become accustomed to the challenge. Anthropometric measurements were taken including height (stadiometer, Health-o-Meter), and body mass (Toledo-Mettler, Toledo, OH).

At the second session, measurements of metabolic rate and heart rate were collected during three progressive stages in the same session: sitting still at a desk, sitting at a desk with feet on and using the HOVR, and standing. This order was fixed for all participants and not randomized for several reasons. First, as a pilot study, data were needed to simply understand the degree of change, if any, and variability in metabolism that might occur. It was reasonable to assume that metabolic rate would be progressively higher as the “physical effort” and amount of muscle recruited would increase for each subsequent stage, from sitting, to sitting with slight leg movement, to standing. It was also reasonable to assume that the prior stage would have relatively little carryover effect on the subsequent stage since the physical effort of each stage was low and unlikely to induce fatigue that would alter the metabolic response during the subsequent stage. Testing of the same participant for all three stages during the same session was done to minimize inter-day variability in the metabolic rate due to absence or presence of thermogenic effect of food, recent physical activity, or differences in plasma hormone concentrations (phase of menstrual cycle). For this reason, the participants were not restricted in their diet other than being asked to refrain from eating within an hour of the time of the test. Participants were tested during work hours of the day and the three stages were completed consistently for each participant, one after another, within an approximately 60 minute period.

For each stage, participants performed at a work station for 15 minutes to achieve steady state and allow respiratory gases to come into equilibrium with the mixing chamber of the metabolic cart. Pilot studies in our lab and observations by others [23] indicate five minutes is adequate to achieve steady state and obtain accurate metabolic rates for resting and very low level activity. Only the final five minutes of the data collected within a stage were averaged to represent the metabolic rate of that stage. This also helped to assure that the metabolic data represented participants in a consistent and normalized pattern of movement with the HOVR. Just prior to starting the stage of testing that involved the HOVR, participants were given instruction to keep the foot device moving during the entire stage and not given any further guidance or motivation after that. At the end of each stage while continuing with the position or movement, participants removed the mouthpiece and nose clips, and took the Stroop Color and Word test as index of cognitive function [21]. The Stroop test was selected as a relatively short test to determine whether the stage of workstation altered mental attentiveness. The test could be administered quickly before moving on to the next stage.

2.2 Measurement methods

The oxygen consumption (VO₂) and carbon dioxide production (VCO₂) were measured using a metabolic cart (Parvo Medics TrueOne 2400, Sandy, Utah). Continuous 15-sec measures were captured for 10 min per stage and the data for the final five minutes were averaged for the statistical analyses. Respiratory exchange ratio (RER) was calculated using the gas ratios. The TrueOne 2400 unit was calibrated before each session of testing using standard calibration gases and a 3-liter syringe for the flow meter. Participants also wore a heart rate monitor through the experimental sessions (Polar FT1, Kempele, Finland). The strap was placed such that contacts were on the ribcage at the level of the xiphoid process. Electrolyte gel was used to ensure complete contact for detection and transmission of the heartrate to the wristwatch monitor that investigator held. Heart rate was recorded at the end of each minute of each stage. The average was calculated for the final 5 min to coincide with the metabolic data.

The metabolic measurements were converted to rate of energy expenditure (kcal/min) using the following equation:

Energy Expenditure in kcal/min = (3.9×VO₂ in L/min)±(1.1×VCO₂ in L/min) [24].

2.3 Statistical analysis

The means±standard deviations were determined for the descriptive statistics. Dependent variables were volume of oxygen consumption (VO₂), heart rate (HR), respiratory exchange ratio (RER), MET level (based on 3.5 mL/kg/min), energy expenditure (kcal/min), and sum of the scores for the three sections of the Stroop test. One-way ANOVA adjusted for repeated measures was used to compare each variable for effects of the stage of the workstation (seated, seated with leg movement using HOVR, standing). When Mauchy’s test of sphericity was statistically significant (p < 0.05), the Greenhouse-Geisser correction was applied. If an ANOVA showed a statistically significant difference between the means, multiple comparison tests were done using least significant difference to compare specific means. A probability level of 0.05 was selected to establish statistical significance.

3 Results

Table 2 presents the descriptive statistics for the outcome variables in each stage. The ANOVA indicated significant differences between the means for the stages for each outcome variable. Post-hoc tests showed that the subtle movement of using the HOVR led to a 17.6% elevation in VO₂ compared to during sitting and 7.5% greater VO₂ than when standing (p < 0.05 for both). Standing elicited a 9.9% rise in VO₂ on average compared to sitting (p < 0.05). The consistency among the participants for the VO₂ response at each stage can be seen in absolute units (L/in) in Fig. 1. The MET level for the stages followed an identical pattern to VO₂ and differences between mean values occurred for all stages (p < 0.05). The METS level was 16.8% greater for HOVR use vs. sitting (p < 0.05) and 7.8% higher for use of HOVR vs. standing (p < 0.05).

Table 2
Mean (±SD) for outcome variables

Phase VO₂, mL/kg/min METs RER HR Stroop^‡

Sitting 4.13±0.56^a 1.19±0.16^a 0.81±0.06^a 73.5±9.9^a 248.0±30.7^a

HOVR 4.82±0.74^b 1.39±0.20^b 0.79±0.06^a 78.4±17.0^a 263.3±32.6^b

Standing 4.50±0.53^c 1.29±0.16^c 0.77±0.04^b 85.9±17.6^b 271.8±28.6^c

Phase	VO₂, mL/kg/min	METs	RER	HR	Stroop^‡
Sitting	4.13±0.56^a	1.19±0.16^a	0.81±0.06^a	73.5±9.9^a	248.0±30.7^a
HOVR	4.82±0.74^b	1.39±0.20^b	0.79±0.06^a	78.4±17.0^a	263.3±32.6^b
Standing	4.50±0.53^c	1.29±0.16^c	0.77±0.04^b	85.9±17.6^b	271.8±28.6^c

SD: standard deviation. VO₂: rate of oxygen consumption; METs: metabolic equivalents; RER: respiratory exchange ratio; HR: heart rate; Stroop: Stroop Word Color Test. p < 0.05 for mean values with different superscripts (multiple comparison post hoc to ANOVA). ^‡Mean value for sum on Word, Color, and Word Color portions of the test.

Fig.1

Oxygen consumption (L/min) of individual participants for the three workstations. Dotted line shows the pattern for the mean value at each station.

Converting the VO₂ and VCO₂ values to units of energy expenditure provided mean values for sitting, using HOVR, and standing of 1.43±0.24, 1.65±0.30, and 1.54±0.25 kcal/min, respectively. The post-hoc comparisons indicated that the rate of energy expenditure for the HOVR movement was 15.8% higher than sitting, standing was 7.9% higher than sitting, and HOVR movement was 7.3% higher than standing (p < 0.05 for all comparisons).

Mean values for the respiratory exchange ratio (RER) and heart rate did not differ between sitting and when using HOVR. However, during standing the mean RER was lower and the mean heart rate was significantly higher than corresponding values for the other two stages (p < 0.05).

The mean values for the total scores of the Stroop Word Color Test, provided in Table 2, were statistically different for each stage (p < 0.05 for ANOVA and post hoc tests). The percentage differences, though, were small and under 10%, with scores during the HOVR stage 6.2% higher than those during sitting, and scores during standing 8.5% higher than those during use of the HOVR.

As an index of consistency of measurement, the coefficient of variation for each participant during each stage of activity was examined. Using the primary outcome of oxygen consumption, the average coefficient of variation was calculated (range for individual participant CV) to be 23.4% (6.4 to 40.7%), 15.8% (6.1 to 29.7%), and 17.0% (9.4 to 32.8%), for sitting, using HOVR, and standing, respectively.

Anecdotally, it was observed that participants used a variety of movements with the HOVR. These included parallel-feet swinging, alternate leg half twists, pedaling-like motions, and teeter-tooter movements. The movement count or amount of work performed were not measured, and it was not possible to quantify how much it varied between participants.

4 Discussion

This study was designed to evaluate whether a workstation device could elevate metabolic rate by promoting spontaneous activity to elevate metabolism, a form of NEAT, with minimal mental distraction while participants sat and worked. When participants performed leg movements using the HOVR device, metabolic rate was elevated by ∼17% on average compared to when sitting, and by 7-8% compared to standing (p < 0.05). Standing elevated metabolic rate by approximately 10% above that of sitting (p < 0.05).

The VO₂ values were converted to units of energy expenditure (EE, in Calories/min) to compare with literature values as summarized in Table 3 for the effects of workstation designs and protocols used to increase NEAT. Absolute values for sitting and standing in the present study appear slightly higher but this could be due to differences in body size or that the participants in the present study were required to perform self-selected desk work, which would include additional movement during each of the three stages (kept constant per subject). More important are the percentages for the change within a study. The increase in EE ranged from zero to 25% for standing vs. sitting. The rise in EE when using the HOVR vs. sitting was comparable to literature values for standing [25] and for rising from a desk after 13 min to walk for 2 min and then return to sitting [26].

Table 3

Summary of literature on energy expenditure (EE) for various workstation comparisons

Study	EE Assessment Method^†	Workstations	Cal/min	% elevation vs. sitting
[27]	Estimated using Compendium	Sit	NA	0.0^*
		Sit interrupted	NA	21.7^*
[15]	Indirect calorimetry	Sit	1.02
		Stand	1.36	25
[16]	Indirect calorimetry	Sit	1.30
		Sit on Ball	1.34	3.1 (NSD)
		Stand	1.29	–0.8 (NSD)
[26]	Indirect calorimetry	Sit	1.46
		Sit + 1 min walking	1.57	7.4
		Sit + 2 min walking	1.72	17.3
		Sit + 5 min walking	2.02	37.7
[25]	Indirect calorimetry	Sit	0.79
		Stand	0.90	13.9
[22]	Indirect calorimetry	Sit	1.13
		Sit on Ball	1.20	5.9
		Stand	1.20	5.9
[28]	Estimated from Activity Monitor	Sit	1.07
		Stand	1.21	13.1
Current study	Indirect calorimetry	Sit	1.43
		Sitting movement	1.65	15.4
		Standing	1.54	7.7

^†Estimated using published compendium of energy expenditure rates for various activities [35]. Indirect calorimetry consistent of measurement of oxygen consumed and carbon dioxide produce. Activity monitor was worn by participants and used to estimate energy expenditure rate based on movement counts calibrated to oxygen consumption. ^*Derived from treatment study that compared energy expenditure before and after introducing interruptions requiring workers to rise from their desk and move during the work day (duration of day not defined). NSD: not statistically different from value for Sit.

Prior studies comparing sitting and standing workstations have used sequential testing of the same participants on the same day [26], randomizing the order of testing with a crossover design in the same participants [15 , 25], between-group comparisons [27, 28], or have not described the testing order [16]. For the current pilot study, randomization of the testing order was not done purposely. The participants were tested for all three stages during the same session in a progression from seated, to seated while using the leg-movement device, to standing. The level of activity during each stage was very low and unlikely to have a carry-over effect on the subsequent stages. Participants performed each stage for 10 min to establish steady state before data were collected. Because minimal control for the timing of the last meal before testing was implemented, it is possible that the thermogenic effect of food, i.e., a recent meal, could have elevated metabolic rate during the initial stage, i.e., sitting [29]. Consistent with this possibility, a small but statistically significant reduction in RER was detected during the last stage (standing) compared to the prior two stages (Table 2). This suggests a shift in substrate oxidation with more carbohydrate being oxidized in the early stages, perhaps due to the last meal influence [30]. In spite of this possibility, the data still revealed differences between all three stages for metabolic rate regardless of whether it was expressed as VO₂, MET, or calorie expenditure. Because the absolute values and percentage differences are consistent with those in the literature (Table 3), the seated movement when using the HOVR appeared to have a small but real effect on metabolic rate. Regardless, a comparison of the stages or work stations tested in this study with randomized order is warranted.

A concern exists that a workstation demanding physical effort and movement could be disruptive to accomplishing daily work objectives. A recent review showed that the data are mixed on this point and that stations requiring greater effort – walking and pedaling – may contribute to a decrement in specific deskwork activities such as typing and accuracy of using of a computer mouse [17]. In contrast, static workstations such as a standing desk or seated-ball appear to have few if any adverse effects on productivity of desk work [17]. However, those workstations raise metabolic rate to a lesser degree than those with some form of ergometry. In the present study, differences for the Stroop Word Color Test scores were found for each stage and a trend for progressively higher scores occurred. Because of the consistent order of testing, a definitive conclusion cannot be drawn regarding beneficial effects of the seated movement or standing. Learning or warm-up effects with repeated exposure to the test might have improved Stroop scores. Consistent with this is the observation of improved scores for the Stroop test when administered repeatedly during the course of an exercise protocol, albeit at a very vigorous intensity that would be expected to induce fatigue and otherwise adversely affect cognition [31]. There is also evidence of improvement in the Stroop test outcomes following 10 min of cycling at 50% VO₂ peak, which would be in the range of 3 to 5 MET [32]. It should also be noted that the Stroop Word Color Test required verbal responses from the participants, so the test was completed at the end of the metabolic measurements with the mouthpiece removed, but with the participant continuing the activity for that stage of assessment. Confirmation cannot be made that metabolic rate remained constant throughout the stage (e.g., participants could have moved less on the HOVR device when focusing on the Stroop test).

As a tactic to increase metabolism though chronic very-low intensity exercise, devices such as the one tested in this study might have value at a workstation. The basis for activity in body weight management is to promote energy expenditure for energy balance, if not create a negative balance for weight loss. Though the effects of this device are subtle compared to a routine exercise program or even a treadmill workstation, the cumulative effects of small but consistently applied movement for sustained periods may be a critical factor in successfully managing weight and risk factors of obesity as has been recommended by Hill [6]. When extrapolating the per-min difference between the use of HOVR and sitting to an 8-hour work day, approximately 100 additional calories would be expended for the seated leg movement compared to merely sitting. This figure coincides with the estimated daily surplus for the weight gain over a 20-year period in 90% of the population [33]. In further support of the benefits of workstations that may elevate NEAT, standing workstations reduced glycemic response to a standardized feeding of carbohydrate-fat [25] and oxidative stress compared to effects of sitting stations in short-term intervention studies [34]. In a year-long intervention study, high-density lipoprotein cholesterol increased with use of a standing workstation [10]. It remains to be seen whether workers could and would use a device such as the HOVR for the entire workday hours, day after day.

In summary, a workstation that allowed physical movement while seated at a desk raised metabolic rate above that measured during the sitting and standing at the workstation on average. While an order effect for the study design might exist, such an effect would expect to favor an elevated metabolic rate during the first stage (merely seated) compared to later stages if the assessment was biased by a thermogenic effect of the most recent meal and/or physical activity required to arrive at the lab. Regardless, metabolic rate was higher for the seated leg movement and standing, thereby supporting a desirable effect on NEAT. Ultimately, a longitudinal study is needed to determine whether seated leg movement could be sustained throughout the day and impact daily energy balance, body weight, and chronic-disease risk factors.

Conflict of interest

The authors attest that they do not have a conflict of interest to report. The results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation.

Footnotes

Acknowledgments

The study was funded in part by a grant from Active Ideas, LLC, Chicago, IL.

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35.

Ainsworth

, Haskell

, Whitt

, Irwin

, Swartz

, Strath

, O’Brien

, Bassett

Jr , Schmitz

, Emplaincourt

, Jacobs

Jr , Leon

. Compendium of physical activities: An update of activity codes and MET intensities. Medicine and Science in Sports and Exercise 2000;32(9 Suppl):S498–504.

Effect of a novel workstation device on promoting non-exercise activity thermogenesis (NEAT)

Abstract

BACKGROUND:

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Keywords

1 Introduction

2 Methods

Table 1 Mean (±SD) and range of participant physical characteristics (n = 16) Mean±SD Minimum-Maximum Age, years 26.1±6.0 20–39 Height, cm 168.8±7.4 158.5–185.2 Body mass, kg 70.5±13.3 52.5–102.6 BMI, kg/m2 24.7±4.3 18.8–34.7

2.2 Measurement methods

2.3 Statistical analysis

3 Results

Table 2 Mean (±SD) for outcome variables Phase VO2, mL/kg/min METs RER HR Stroop‡ Sitting 4.13±0.56a 1.19±0.16a 0.81±0.06a 73.5±9.9a 248.0±30.7a HOVR 4.82±0.74b 1.39±0.20b 0.79±0.06a 78.4±17.0a 263.3±32.6b Standing 4.50±0.53c 1.29±0.16c 0.77±0.04b 85.9±17.6b 271.8±28.6c

Conflict of interest

Footnotes

Acknowledgments

References

Table 1
Mean (±SD) and range of participant physical characteristics (n = 16)

Mean±SD Minimum-Maximum

Age, years 26.1±6.0 20–39

Height, cm 168.8±7.4 158.5–185.2

Body mass, kg 70.5±13.3 52.5–102.6

BMI, kg/m² 24.7±4.3 18.8–34.7