Physical Activity and Sedentary Behavior at the End of the Human Lifespan

To objectively assess physical activity levels and sedentary behavior in a cohort of Spanish centenarians and their nonagenarian peers. Physical activity and sedentary behavior patterns were objectively measured by an ActiGraph GT3X accelerometer in centenarians (n = 18; 83% women; 100.8 ± 0.8 [100-103] years) and nonagenarians (n = 11; 91% women; 93.3 ± 2.5 [90-98] years). Centenarians showed less counts per minute (17.6 ± 7.1 vs. 46.1 ± 23.7, p = .003, d = 1.851) and steps per day (455 ± 237 vs. 1,249 ± 776, p = .007, d = 1.587) than nonagenarians. The daily number of sedentary breaks was also lower in the former (5.0 ± 1.5 vs. 6.7 ± 2.0, p = .019, d = 0.971). When observing time distribution, the most active day period in both groups was the morning, with a peak between 10:00 and 11:59. This data suggest that the decline in physical activity levels continues to worsen until the end of the human lifespan.

Associations of Sedentary Behavior with Physical Fitness and Academic Performance among Chinese Students Aged 8-19 Years

Background: Existing evidence regarding how time spent on various types of sedentary behavior (SB) in relation to physical fitness (PF) and academic performance (AP) in children and adolescents is limited. This cross-sectional study aimed to explore the associations of SB types with PF and AP among 8–19-year-old Chinese students. Methods: A total of 1164 students were recruited from five schools in Zhejiang province, China. Children’s SB was assessed by a valid questionnaire and AP was represented by scores on four courses. PF was measured by Chinese National Student PF Standard battery. The associations were assessed using linear mixed-effects models adjusted for age, school, grade, and class. Results: Students’ screen-based SB was observed to be negatively associated with PF in girls (p < 0.05). Screen-based SB was inversely associated with AP in both girls and boys (p < 0.001). The significant interaction between weekdays and weekends, and SB on AP was observed in girls (p < 0.001). On weekends, screen-based SB ≥ 6 h/day (<3 h/day as reference group) was significantly and negatively associated with AP (p < 0.01 for both sex). Conclusions: Longer screen-based SB, especially on weekends, was related to poorer AP in 8–19-year-old Chinese students. Our findings suggest that restrictions on any type of screen-based SB for leisure on weekends are beneficial to AP in Chinese students.

A Walking Intervention to Increase Weekly Steps in Dialysis Patients: A Pilot Randomized Controlled Trial

RATIONALE & OBJECTIVE

Patients receiving dialysis report very low physical activity. We implemented a pilot trial to assess the feasibility of a pedometer-based intervention to gather preliminary evidence about its impact on physical activity, symptoms, and surrogates of cardiovascular risk.

STUDY DESIGN

Pilot randomized controlled trial.

SETTING & PARTICIPANTS

60 dialysis patients from San Francisco dialysis clinics.

INTERVENTION

Participants were randomly assigned 1:1 to receiving pedometers with weekly step goals or usual care for 3 months.

OUTCOMES

The primary outcome was step counts, measured using pedometers. Secondary outcomes included physical performance using the Short Physical Performance Battery, the Physical Function and Vitality scales of the 36-Item Short Form Health Survey, the Dialysis Symptoms Index, and the Center for Epidemiologic Studies-Depression Scale, with endothelial function as a secondary and heart rate variability as an exploratory surrogate measure of cardiovascular risk. Targeted enrollment was 50% and targeted completion was 85%.

RESULTS

49% of approached patients were enrolled, and 92% completed the study. After 3 months, patients randomly assigned to the intervention (n=30) increased their average daily steps by 2,256 (95% CI, 978-3,537) more than the 30 controls (P<0.001). Heart rate variability (standard deviation of N-N intervals) increased by 14.94 (95% CI, 0.31-33.56) millisecondsin the intervention group as compared with controls (P = 0.05). There were no statistically significant differences across intervention groups in symptoms, physical performance, or endothelial function. Participants in the intervention group reverted to baseline steps during the postintervention follow-up.

LIMITATIONS

The Northern California study setting may limit generalizability. Walking does not capture the full spectrum of physical activity.

CONCLUSIONS

A short-term pedometer-based intervention led to increased step counts in dialysis patients, but the increase was not sustained. Pedometer-based interventions are feasible for dialysis patients, but future studies are needed to address whether more prolonged interventions can improve physical function or symptoms.

FUNDING

Supported by grants from the American Kidney Fund, National Institutes of Health-National Institute of Diabetes and Digestive and Kidney Diseases, and International Society of Nephrology.

TRIAL REGISTRATION

Registered at ClinicalTrials.gov with study identifier NCT02623348.

Associations of Sedentary and Physically-Active Behaviors With Cognitive-Function Decline in Community-Dwelling Older Adults: Compositional Data Analysis From the NEIGE Study

Background

Physical activity can help to protect against cognitive decline in older adults. However, little is known about the potential combined relationships of time spent in sedentary behavior (SB), light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) with indices of cognitive health. We examined the cross-sectional associations of objectively-determined sedentary and physically-active behaviors with an indicator of cognitive function decline (CFD) in older adults.

Methods

A randomly-recruited sample of 511 Japanese older adults (47% male; aged 65–84 years) wore a tri-axial accelerometer for 7 consecutive days in 2017. Cognitive function was assessed by interviewers using the Japanese version of Mini-Mental State Examination, with a score of ≤23 indicating CFD. Associations of sedentary and physically-active behaviors with CFD were examined using a compositional logistic regression analysis based on isometric log-ratio transformations of time use, adjusting for potential confounders.

Results

Forty one (9.4%) of the participants had an indication of CFD. Activity compositions differed significantly between CFD and normal cognitive function (NCF); the proportion of time spent in MVPA was 39.1% lower, relative to the overall mean composition in those with CFD, and was 5.3% higher in those with NCF. There was a significant beneficial association of having a higher proportion of MVPA relative to other activities with CFD. LPA and SB were not associated with CFD when models were corrected for time spent in all activity behaviors.

Conclusions

Larger relative contribution of MVPA was favorably associated with an indicator of CFD in older adults.

Detection of hypertension and its relation to other cardiovascular risk factors in adolescents who request a medical fitness certificate for school

Arterial hypertension (HTN) may begin in childhood and is related to other risk factors, such as obesity and a sedentary lifestyle. In this study, the prevalence of HTN was estimated and the factors associated with it were assessed in adolescents aged 15- 19 years who attended the Center for Health and Community Action no. 12 to request their medical fitness certificate for school. The following data were collected: age, sex, family history of HTN, current smoking, physical activity, weight, height, waist circumference, and blood pressure. A total of 289 adolescents were assessed; their mean age was 16.6 years. Among them, 48.6 % were males; 6.6 % had HTN; 10.9 % were obese; and 13.4 % had a larger waist circumference. The presence of HTN was significantly associated with obesity and a larger waist circumference, but no significant association was observed with the other studied outcome measures.

Sedentary Behaviors in Today's Youth: Approaches to the Prevention and Management of Childhood Obesity: A Scientific Statement From the American Heart Association

This scientific statement is about sedentary behavior and its relationship to obesity and other cardiometabolic outcomes in youth. A deleterious effect of sedentary behavior on cardiometabolic health is most notable for screen-based behaviors and adiposity; however, this relation is less apparent for other cardiometabolic outcomes or when sedentary time is measured with objective movement counters or position monitors. Increasing trends of screen time are concerning; the portability of screen-based devices and abundant access to unlimited programming and online content may be leading to new patterns of consumption that are exposing youth to multiple pathways harmful to cardiometabolic health. This American Heart Association scientific statement provides an updated perspective on sedentary behaviors specific to modern youth and their impact on cardiometabolic health and obesity. As we reflect on implications for practice, research, and policy, what emerges is the importance of understanding the context in which sedentary behaviors occur. There is also a need to capture the nature of sedentary behavior more accurately, both quantitatively and qualitatively, especially with respect to recreational screen-based devices. Further evidence is required to better inform public health interventions and to establish detailed quantitative guidelines on specific sedentary behaviors in youth. In the meantime, we suggest that televisions and other recreational screen-based devices be removed from bedrooms and absent during meal times. Daily device-free social interactions and outdoor play should be encouraged. In addition, parents/guardians should be supported to devise and enforce appropriate screen time regulations and to model healthy screen-based behaviors.

What Players of Virtual Reality Exercise Games Want: Thematic Analysis of Web-Based Reviews

Background

Physical activity (PA) is associated with a variety of physical and psychosocial health benefits, but levels of moderate-to-vigorous intensity PA remain low worldwide. Virtual reality (VR) gaming systems involving movement (VR exergames) could be used to engage people in more PA.

Objective

This study aimed to synthesize public reviews of popular VR exergames to identify common features that players liked or disliked to inform future VR exergame design.

Methods

We conducted a thematic analysis of 498 reviews of the 29 most popular exergames sold in the top 3 VR marketplaces: Steam (Valve Corporation), Viveport (Valve Corporation), and Oculus (Oculus VR). We categorized reviews as positive and negative as they appeared in the marketplaces and identified the most common themes using an inductive thematic analysis.

Results

The reviews were often mixed, reporting a wide variety of expectations, preferences, and gaming experiences. Players preferred highly realistic games (eg, closely simulated real-world sport), games that were intuitive (in terms of body movement and controls), and games that provided gradual increases in skill acquisition. Players reported feeling that they reached a high level of exertion when playing and that the immersion distracted them from the intensity of the exercise. Some preferred features included music and social aspects of the games, with multiplayer options to include friends or receive help from experienced players. There were 3 main themes in negative reviews. The first concerned bugs that rendered games frustrating. Second, the quality of graphics had a particularly strong impact on perceived enjoyment. Finally, reviewers disliked when games had overly complex controls and display functions that evoked motion sickness.

Conclusions

Exergames prove to be a stimulating avenue for players to engage in PA and distract themselves from the negative perceptions of performing exercise. The common negative aspects of VR exergames should be addressed for increased uptake and continued engagement.

Effects of High-Intensity Interval and Moderate-Intensity Continuous Exercise on Physical Activity and Sedentary Behavior Levels in Inactive Obese Males: A Crossover Trial

A total of 17 participants (30.2 ± 4.8 years; 35.4 ± 4 kg/m²; 38.2 ± 3.6 % body fat) were enrolled in this randomized crossover trial to analyze the effects of a single session of high-intensity interval (HIIE) and moderate-intensity continuous exercise (MICE) on the physical activity and sedentary behavior levels in inactive obese males. The participants performed two exercise sessions and one control session (no exercise): i) low-volume HIIE (10 x 60 s at 90% of maximal aerobic velocity [MAV] interspaced by 60 s at 30% of MAV); ii) MICE (20 min at 70% of maximum heart rate); and iii) control (25 min in a seated position). After all sessions, the physical activity and sedentary behavior levels were monitored by accelerometer over seven consecutive days. No differences in the physical activity (activity counts, and time spent at light, moderate, and vigorous intensities) and sedentary behavior (time spent at sedentary behavior, breaks, and bouts) levels were found among the sessions (HIIE, MICE and control) (p > 0.05). In summary, a single session of HIIE and MICE does not change the physical activity and sedentary behavior levels in inactive obese males. Therefore, low-volume of both high- and moderate-intensity exercise should be considered for inactive obese males given that it does not reduce the physical activity level or increase the time spent at sedentary behavior.

The South American Physical Activity and Sedentary Behavior Network (SAPASEN)

The present article describes the South American Physical Activity and Sedentary Behavior Network, which was designed to provide ongoing transnational empirical evidence about physical activity and sedentary behavior in South America. The first goal of this initiative was to form a representative body of researchers and policy makers from all South American countries (Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Guyana, Paraguay, Peru, Suriname, Uruguay and Venezuela) to establish priorities and targets for the short, medium and long term. Examples are given of connecting physical activity and sedentary data from existing surveys in several of the partner countries. The main objective of the South American Physical Activity and Sedentary Behavior Network will be to impact policies on physical activity and sedentary behavior in South America according to the singularities of each country or region. By encouraging an inclusive and collaborative effort, we expect that the South American Physical Activity and Sedentary Behavior Network will support the connection between researchers from South America as well as provide a better comprehension of the epidemiology of physical activity and sedentary behavior regionally.

How to Measure Sedentary Behavior at Work?

Background: Prolonged sedentary behavior (SB) is associated with increased risk for chronic conditions. A growing number of the workforce is employed in office setting with high occupational exposure to SB. There is a new focus in assessing, understanding and reducing SB in the workplace. There are many subjective (questionnaires) and objective methods (monitoring with wearable devices) available to determine SB. Therefore, we aimed to provide a global understanding on methods currently used for SB assessment at work.

Methods: We carried out a systematic review on methods to measure SB at work. Pubmed, Cochrane, Embase, and Web of Science were searched for peer-reviewed English-language articles published between 1st January 2000 and 17th March 2019.

Results: We included 154 articles: 89 were cross-sectional and 65 were longitudinal studies, for a total of 474,091 participants. SB was assessed by self-reported questionnaires in 91 studies, by wearables devices in also 91 studies, and simultaneously by a questionnaire and wearables devices in 30 studies. Among the 91 studies using wearable devices, 73 studies used only one device, 15 studies used several devices, and three studies used complex physiological systems. Studies exploring SB on a large sample used significantly more only questionnaires and/or one wearable device.

Conclusions: Available questionnaires are the most accessible method for studies on large population with a limited budget. For smaller groups, SB at work can be objectively measured with wearable devices (accelerometers, heart-rate monitors, pressure meters, goniometers, electromyography meters, gas-meters) and the results can be associated and compared with a subjective measure (questionnaire). The number of devices worn can increase the accuracy but make the analysis more complex and time consuming.

Effect of skipping breakfast for 6 days on energy metabolism and diurnal rhythm of blood glucose in young healthy Japanese males

BACKGROUND

Skipping breakfast has become a common trend that may lead to obesity and type 2 diabetes. Previous studies, which imposed a single incidence of breakfast skipping, did not observe any decrease in 24-h energy expenditure. Furthermore, the effects of breakfast skipping on diurnal blood glucose profiles over 24 h are contradictory.

OBJECTIVE

The aim of this study was to clarify the influence of 6 consecutive days of breakfast skipping and sedentary behavior on energy metabolism and glycemic control.

METHODS

Ten young men participated in 2 trials (with or without breakfast) that lasted for 6 consecutive days, and the 2 trials were conducted 1 wk apart with a repeated-measures design. During the meal intervention, each subject's blood glucose was measured using the continuous glucose monitoring system. If breakfast was skipped, subjects ate large meals at lunch and dinner such that the 24-h energy intake was identical to that of the 3-meal condition. At 2200 on the fifth day, the subjects entered a room-sized respiratory chamber, where they remained for 33 h, and were instructed to carry out sedentary behavior.

RESULTS

The glucose levels were similar between the 2 meal conditions during the first 5 d of meal intervention, but the blood glucose at 2300 was higher in the breakfast-skipping condition than in the 3-meal condition. Breakfast skipping elevated postprandial glycemic response after lunch on the first day of meal intervention. On the sixth day, there were no significant differences in 24-h energy expenditure and substrate oxidation. When subjects remained in a metabolic chamber, the level of physical activity significantly decreased, glycemic stability slightly deteriorated, and mean blood glucose over 24 h was higher in the breakfast-skipping trial than in the 3-meal trial.

CONCLUSIONS

Sedentary lifestyle and repeated breakfast skipping caused abnormal glucose fluctuations, whereas 24-h energy metabolism remained unaffected. Clinical Trial Registry: This trial was registered at http://www.umin.ac.jp/english/ as UMIN000032346.

Physical Activity and Sedentary Time in Active and Non-Active Adults with Intellectual Disability: A Comparative Study

This study describes and compares physical activity (PA) levels and sedentary time (ST) of active (AG) and a non-active (NAG) groups of adults with intellectual disability (ID) versus a group of adults without ID. Thirty-seven participants from the AG, 29 from the NAG, and 31 adults without ID participated in this study. Height and weight were obtained to calculate body mass index (BMI). PA levels and ST were assessed with GT3X Actigraph accelerometers for 7 days. Results revealed that the AG engaged in higher values of moderate to vigorous PA compared with the NAG (all p < 0.05), but were similar to adults without ID. Adults without ID performed less ST and more light PA than the ID groups (all p < 0.05). The participants of the AG did not demonstrate less ST than the NAG. It is concerning that adults with ID (AG or NAG) are spending a higher time in ST and less time in light PA than adults without ID. Our results suggest that integrated, well-designed PA programmes into the ID population workdays can lead to increased PA levels. Nevertheless, these interventions and exercise programmes implemented for adults with ID should be tailored to also reduce ST.

Maintenance of physical activity and sedentary behavior change, and physical activity and sedentary behavior change after an abridged intervention: Secondary outcomes from the ACTIVATE Trial

BACKGROUND

This brief report examines the maintenance of moderate to vigorous physical activity (MVPA) and sedentary behavior changes approximately 12 weeks after the delivery of the ACTIVATE Trial primary intervention (use of the Garmin Vivofit 2 activity tracker coupled with a behavioral feedback and goal-setting session and 5 telephone-delivered health coaching sessions). We also examine the efficacy of an abridged intervention (use of the Garmin Vivofit 2 only) in the waitlist control group.

METHODS

A pre-post design was employed to examine the secondary aims of the ACTIVATE Trial (n = 80; mean age = 62 years). MVPA and sedentary behavior were measured using Actigraph and activPAL accelerometers after delivery of the primary intervention (T2), and again 12 weeks later (T3). Linear mixed models with random effects were used to examine within-group changes in MVPA and sitting time variables.

RESULTS

After the 12-week follow-up period, women in the primary intervention group had maintained their higher levels of MVPA (change from T2 to T3 = 14 min/wk; 95% CI = -18 to 46; P = .37). However, their sitting time increased slightly, by 7 min/d (95% CI = -20 to 34; P = .58), but it did not return to its preintervention level. After receiving the Garmin Vivofit 2, the waitlist control group increased their MVPA by 33 min/wk (95% CI = 3-64; P = .03) and reduced their sitting time by 38 min/d (95% CI = -69 to -7; P = .02) over the same 12-week period.

CONCLUSION

The secondary outcomes from the ACTIVATE Trial suggest that wearable technology may generate sustainable changes in MVPA and sitting time. Wearable technology alone may be sufficient to change behavior, at least in the short term.

A randomized controlled trial of a wearable technology-based intervention for increasing moderate to vigorous physical activity and reducing sedentary behavior in breast cancer survivors: The ACTIVATE Trial

BACKGROUND

The benefits of an active lifestyle after a breast cancer diagnosis are well recognized, but the majority of survivors are insufficiently active. The ACTIVATE Trial examined the efficacy of an intervention (use of the Garmin Vivofit 2 activity monitor coupled with a behavioral feedback and goal-setting session and 5 telephone-delivered health coaching sessions) to increase moderate to vigorous physical activity (MVPA) and reduce sedentary behavior in breast cancer survivors.

METHODS

This randomized controlled trial recruited 83 inactive, postmenopausal women diagnosed with stage I-III breast cancer who had completed primary treatment. Participants were randomly assigned to the intervention group or to the control group, and the intervention was delivered over a 12-week period. MVPA and sedentary behavior were measured with Actigraph and activPAL accelerometers at baseline (T1) and at the end of the intervention (T2).

RESULTS

Retention in the trial was high, with 80 (96%) of participants completing T2 data collection. At T2, there was a significant between-group difference in MVPA (69 min/wk; 95% CI = 22-116) favoring the intervention group. The trial resulted in a statistically significant decrease in both total sitting time and prolonged bouts (≥20 min) of sitting, with between-group reductions of 37 min/d (95% CI = -72 to -2) and 42 min/d (95% CI = -83 to -2), respectively, favoring the intervention group.

CONCLUSION

Results from the ACTIVATE Trial suggest that the use of wearable technology presents an inexpensive and scalable opportunity to facilitate more active lifestyles for cancer survivors. Whether or not such wearable technology-based interventions can create sustainable behavioral change should be the subject of future research.

Phase angle is associated with the physical fitness of HIV-infected children and adolescents

The objective of this study was to identify the association of phase angle with physical fitness in children and adolescents infected with HIV. Sixty-four children and adolescents infected with HIV (8-15 years old) were tested for vertical transmission. The electrical bioimpedance was used to obtain the phase angle. Body fat (BF) and lean soft tissue mass (LSTM) were measured by x-ray absorptiometry, and the manual grip strength was evaluated by dynamometry. The peak oxygen consumption (VO₂ peak) was measured by respiratory change in a submaximal incremental test. Moderate-vigorous physical activity (MVP) and sedentary behavior were measured using accelerometers and were used as covariates. Multiple linear regression was used. The linear correlation analyses demonstrated that the phase angle was inversely proportional to relative BF (r = -0.26), but was not associated with absolute body fat (r = -0.02). The phase angle was directly associated with LSTM (r = 0.57), handgrip strength, and (r = 0.43) peak VO₂ (r = 0.55). The phase angle was not associated with absolute BF (β = -0.017, P = 0.413) and relative (β = -0.014, P = 0.175). The phase angle presented a direct association with LSTM (β = 0.041, P = 0.019) and peak VO₂ (β = 0.005; P = 0.019), regardless of age, sex, sexual maturation, MVPA, sedentary behavior, antiretroviral drugs, and viral load. No association was found between phase angle and handgrip strength (β = 0.153; P = 0.199). It was concluded that phase angle was associated with LSTM and the aerobic fitness in HIV-infected children and adolescents.

[Relationship between levels of physical activity and sedentarism with metabolic syndrome. ENS Chile 2009-2010.]

OBJECTIVE

.To use a new methodology to classify the level of physical activity (PA) by combining the levels of PA and sedentary time (SED) in order to establish its association with metabolic syndrome (MS).

MATERIALS AND METHODS

A representative sample of Chilean adults (≥18 years old) who participated in the National Health Survey (ENS 2009-2010) was included in this study (n=5 040). Four categories were created using a combination of PA and SED levels through the GPAQ questionnaire. MS was defined accord- ing to the norms established by NCEP ATP-III.

RESULTS

A lower probability of MS was observed only in the categories that comply with the international recommendations of PA, "active and low-SED" (OR=0.72 [0.57 to 0.91]) and "active and high-SED" (OR=0.63 [0.49 to 0.81]).While the level of SED (high/low) was not associated with a significant reduction of MS in any of the groups.

CONCLUSIONS

This type of classification demonstrates that the main strategy to reduce the risk of MS should be associated with compliance with the recommendations of PA.

Characterization and Agreement Between Application of Mobile Ecological Momentary Assessment (mEMA) and Accelerometry in the Identification of Prevalence of Sedentary Behavior (SB) in Young Adults

New technologies able to identify the sedentary behavior (SB), such as the Mobile Ecological Momentary Assessment (mEMA) still need to be investigated. The aim of this study was to describe SB in the physical, social, and environmental contexts and verify the agreement between the mEMA and accelerometry in the identification of SB in young adults. During 7 days, 123 young adults used concomitant mEMA and Actigraph wGT3xBT accelerometer. Data of 2262 mEMA prompts and respective count values in each minute (5 min previous to prompt) were included in the analyses. Descriptive and comparative statistics were used in analyses using the SPSS 20.0 software. The physical context (PC) at home was the highest occurrence of SB (46.3%) and the main activity was “watching TV/movies” (29.7%). The main social context (SC) related to SB was “staying alone” (49.6%). The main assertions related to the participants’ environmental context (EC) were: “I appreciate the comfort of electronic devices when I am at home” (86.2%). mEMA identified the presence of SB in 78.1% of prompts, while accelerometry identified 70.9% (PABAK = 0.42). High values for the presence of SB were observed (sensitivity = 84%) and lower in the absence of SB (specificity = 38%). The study demonstrates the viability of mEMA use to obtain information about the occurrence of SB in contextual factors and good sensitivity to identify the presence of SB in young adults. The combined use of these methods is suggested in future studies about SB in young adults.

Accelerometer and Survey Data on Patterns of Physical Inactivity in New York City and the United States

OBJECTIVE

Inactive lifestyles contribute to health problems and premature death and are influenced by the physical environment. The primary objective of this study was to quantify patterns of physical inactivity in New York City and the United States by combining data from surveys and accelerometers.

METHODS

We used Poisson regression models and self-reported survey data on physical activity and other demographic characteristics to predict accelerometer-measured inactivity in New York City and the United States among adults aged ≥18. National data came from the 2003-2004 and 2005-2006 National Health and Nutrition Examination Surveys. New York City data came from the 2010-2011 New York City Physical Activity and Transit survey.

RESULTS

Self-reported survey data indicated no significant differences in inactivity between New York City and the United States, but accelerometer data showed that 53.1% of persons nationally, compared with 23.4% in New York City, were inactive ( P < .001). New Yorkers reported a median of 139 weekly minutes of transportation activity, compared with 0 minutes nationally. Nationally, 50.0% of self-reported activity minutes came from recreation activity, compared with 17.5% in New York City. Regression models indicated differences in the association between self-reported minutes of transportation and recreation and accelerometer-measured inactivity in the 2 settings.

CONCLUSIONS

The prevalence of physical inactivity was higher nationally than in New York City. The largest difference was in walking behavior indicated by self-reported transportation activity. The study demonstrated the feasibility of combining accelerometer and survey measurement and that walkable environments promote an active lifestyle.

Sedentary Time and Cumulative Risk of Preserved and Reduced Ejection Fraction Heart Failure: From the Multi-Ethnic Study of Atherosclerosis

BACKGROUND

This study examined the relationship between self-reported sedentary time (ST) and the cumulative risk of heart failure with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF) in a diverse cohort of U.S. adults 45-84 years of age.

METHODS AND RESULTS

Using data from the Multi-Ethnic Study of Atherosclerosis (MESA), we identified 6,814 subjects, all free of baseline cardiovascular disease. Cox regression was used to calculate the hazard ratios (HR) associated with risk of HFpEF and HFrEF. Weekly ST was dichotomized based on the 75th percentile (1890 min/wk). During ∼11.2 years of follow-up there were 178 first incident HF diagnoses: 74 HFpEF and 69 HFrEF. Baseline ST >1890 min/wk was significantly associated with an increased risk of HFpEF (HR 1.87, 95% confidence interval [CI] 1.13-3.09, P = .01), but not of HFrEF. The relationship with HFpEF remained significant in fully adjusted models including physical activity and waist circumference (HR 2.16, 95% CI 1.23-3.78, P < .01). In addition, every 60-minute increase in weekly ST was associated with a 3% increased risk of HFpEF (HR 1.03, 95% CI 1.01-1.05, P < .01).

CONCLUSIONS

Sedentary time >1890 min/wk (∼4.5 h/d) is a significant predictor of HFpEF, independently from physical activity and adiposity.

Barriers to daily life physical activities for Brazilian children with asthma: a cross-sectional study

BackgroundObjective: To identify barriers to daily life physical activities (DLPA) and to evaluate physical activity levels for children with asthma and without asthma.Method: This is a cross-sectional study that enrolled 130 children with asthma and 54 non-asthma, from 7 to 12 years old. All of the children in both groups used an accelerometer for 6 consecutive days to assess DLPA and completed a questionnaire to evaluate barriers to physical activity. Accelerometer was used to measure each child's total number of steps, as well as the number of steps and the time spent in moderate-to-vigorous physical activity (MVPA). The barrier questionnaire to DLPA included 11 questions, divided into three domains: personal, social and environmental.Results: The most commonly described barrier to DLPA in the asthma and non-asthma groups was an unsafe environment (23.6% vs 28.5%, respectively). The asthma group reported having asthma (19%) and lack of parental encouragement (17.3%) as being other important barriers to DLPA. It was also observed that the asthma and non-asthma groups presented similar values for the total number of steps (13,379 ± 3,837 vs 14,055 ± 3,914, respectively, p > 0.05), number of steps in MVPA (5,654 ± 1,988 vs. 6,025 ± 2,058, p > 0.05), and time spent in MVPA (46 ± 16 min vs. 50.8 ± 14.7 min, p > 0.05).Conclusions: An unsafe environment is the main barrier to physical activity for Brazilian children. Moreover, a lack of parental encouragement and having asthma were considered to be barriers to physical activity. And lastly, children have similar levels of physical activity whether they have asthma or do not have asthma.

Levels of physical activity and associated factors between military policemen and firemen

BACKGROUND

Military Policemen and Firemen are professionals often involved in life-risking activities as well as duties demanding endurance and muscular strength. Nevertheless, their working conditions are rarely satisfactory.

OBJECTIVE

To compare levels of physical activity and social, demographic and occupational factors between military policemen and firemen; factors that may impact their ability to efficiently and effectively accomplish their jobs.

METHODS

This cross-sectional study was performed in Brazil with 127 local military personnel (67 policemen and 60 firemen). A sociodemographic questionnaire was applied together with the International Physical Activity Questionnaire (IPAQ), short version.

RESULTS

It was observed that the firemen participating in this study are 4 times more likely to be inactive than the policemen. However, policemen showed higher sociodemographic risk factors (less schooling and the higher number of children and workplaces) to work performance when compared to military firemen.

CONCLUSION

It could be inferred that in relation to the firemen, policemen suffer from less favorable sociodemographic conditions and face major risk situations more frequently once they are directly involved with the public security of the States; on the other hand, both populations should be incentivized and offered systematized physical activity programs in their workplaces.

Do Stand-Biased Desks in the Classroom Change School-Time Activity and Sedentary Behavior?

The purpose of this study was to determine the effect of stand-biased desks on the physical activity and sedentary behavior of third, fourth and sixth grade students across the school year. Methods: This within classroom crossover design study used teacher-determined allocation for seating within each classroom. Half of the students used a stand-biased desk and half used a sitting desk. Five-day hip-worn accelerometer assessments were completed at baseline and at the end of each nine-week intervention period. A mixed effects model was used to determine the differences in the percentage of time spent active and sedentary. Results: A total of 22, 36 and 41 students in 3rd, 4th and 6th grades, respectively, completed this study (57.1% male, 79.3% White). Regardless of the desk type, students became more sedentary (p < 0.001) and less active (p < 0.001) in the classroom as the school year progressed. After controlling for baseline activity, there was a significant interaction between the type of desk and time (p = 0.029). Students who spent a higher percentage of their classroom time sedentary engaged in less sedentary behavior when using a stand-biased desk compared to the traditional desk. Conclusion: The standing desk intervention was effective in mitigating the increase in sedentary behavior for those who started the school year more sedentary.

Can Physical Activity Offset the Detrimental Consequences of Sedentary Time on Frailty? A Moderation Analysis in 749 Older Adults Measured With Accelerometers

OBJECTIVES

To determine whether or not and to what extent the association between sedentary time and frailty was moderated by moderate-to-vigorous physical activity in older adults.

DESIGN

Cross-sectional.

SETTING

Community-dwelling individuals.

PARTICIPANTS

749 (403 females and 346 males) white older adults.

MEASUREMENTS

Sedentary time and moderate-to-vigorous physical activity were measured with accelerometers. Frailty was objectively measured using the Frailty Trait Scale. All models were adjusted for age, sex, education, income, marital status, body mass index, moderate-to-vigorous physical activity, and accelerometer wear time.

RESULTS

The regression model reported a significant effect of sedentary time on frailty (P < .05). Nevertheless, the results indicated that moderate-to-vigorous physical activity moderates the relationship between frailty status and sedentary time. The Johnson-Neyman technique determined that the estimated moderate-to-vigorous physical activity point was 27.25 minutes/d, from which sedentary time has no significant effect on frailty.

CONCLUSIONS

Moderate-to-vigorous physical activity is a moderator in the relationship between sedentary time and frailty in older adults, offsetting the harmful effects of sedentary behavior with 27 minutes/d of moderate-to-vigorous activity. Engaging in moderate-to-vigorous physical activities should be encouraged. Reducing sedentary behavior may also be beneficial, particularly among inactive older adults.

Dyslipidemia in Adolescents Seen in a University Hospital in the city of Rio de Janeiro/Brazil: Prevalence and Association

BACKGROUND

Early exposure to obesity favors greater risks of cardiovascular factors such as dyslipidemia.

OBJECTIVES

To establish the prevalence of dyslipidemia, and to evaluate its association with nutritional status of the adolescents attended at the ambulatory of the Adolescent Health Studies Center of the University Hospital Pedro Ernesto.

METHODS

This is a cross-sectional, observational study, the sample of which was of convenience, consisting of adolescents from 12 to 18 years old of both genders. The lipid profile was evaluated, along with its association with the anthropometric indicators: body mass index and waist circumference. For statistical analysis, a significance level of 5% was used.

RESULTS

A total of 239 adolescents, 104 boys (43.5%) and 135 girls (56.5%) were evaluated and, of these, 52 (21.8%) were eutrophic, 60 (25.1%) overweight, and 127 (53.1%) obese. Obeseadolescents had significantly lower mean values of HDL-cholesterol (44.7 mg/dl vs 53.9 mg/dl; p < 0.001) and higher triglycerides (109.6 mg/dl vs 87.3 mg/dl; p = 0.01). The changes with higher prevalence were low HDL-cholesterol (50.6%), hypercholesterolemia (35.1%), and hypertriglyceridemia (18.4%). A negative association of HDL-cholesterol with body mass index and a positive association of triglycerides with body mass index could be observed, even after adjustment for gender and skin color.

CONCLUSION

This study demonstrated high prevalence of dyslipidemia among adolescents. In view of the significant association between lower levels of HDL-cholesterol and increased triglycerides with overweight, the control of these factors should receive attention, with the precocious diagnosis of the dyslipidemia being important, mainly if it is associated with another cardiovascular risk, to develop effective intervention strategies.