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Qiao YS, Blackwell TL, Cawthon PM, Coen PM, Cummings SR, Distefano G, Farsijani S, Forman DE, Goodpaster BH, Kritchevsky SB, Mau T, Toledo FGS, Newman AB, Glynn NW. Associations of accelerometry-measured and self-reported physical activity and sedentary behavior with skeletal muscle energetics: The Study of Muscle, Mobility and Aging (SOMMA). JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:621-630. [PMID: 38341136 DOI: 10.1016/j.jshs.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/25/2023] [Accepted: 01/08/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Skeletal muscle energetics decline with age, and physical activity (PA) has been shown to offset these declines in older adults. Yet, many studies reporting these effects were based on self-reported PA or structured exercise interventions. Therefore, we examined the associations of accelerometry-measured and self-reported PA and sedentary behavior (SB) with skeletal muscle energetics and explored the extent to which PA and sedentary behavior would attenuate the associations of age with muscle energetics. METHODS As part of the Study of Muscle, Mobility and Aging, enrolled older adults (n = 879), 810 (age = 76.4 ± 5.0 years old, mean ± SD; 58% women) had maximal muscle oxidative capacity measured ex vivo via high-resolution respirometry of permeabilized myofibers (maximal oxidative phosphorylation (maxOXPHOS)) and in vivo by 31phosphorus magnetic resonance spectroscopy (maximal adenosine triphosphate (ATPmax)). Accelerometry-measured sedentary behavior, light activity, and moderate-to-vigorous PA (MVPA) were assessed using a wrist-worn ActiGraph GT9X over 7 days. Self-reported sedentary behavior, MVPA, and all PA were assessed with the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire. Linear regression models with progressive covariate adjustments evaluated the associations of sedentary behavior and PA with muscle energetics, as well as the attenuation of the age/muscle energetics association by MVPA and sedentary behavior. As a sensitivity analysis, we also examined activPAL-measured daily step count and time spent in sedentary behavior and their associations with muscle energetics. RESULTS Every 30 min/day more of ActiGraph-measured MVPA was associated with 0.65 pmol/(s × mg) higher maxOXPHOS and 0.012 mM/s higher ATPmax after adjusting for age, site/technician, and sex (p < 0.05). Light activity was not associated with maxOXPHOS or ATPmax. Meanwhile, every 30 min/day spent in ActiGraph-measured sedentary behavior was associated with 0.39 pmol/s × mg lower maxOXPHOS and 0.006 mM/s lower ATPmax (p < 0.05). Only associations with ATPmax held after further adjusting for socioeconomic status, body mass index, lifestyle factors, and multimorbidity. CHAMPS MVPA and all PA yielded similar associations with maxOXPHOS and ATPmax (p < 0.05), but sedentary behavior did not. Higher activPAL step count was associated with higher maxOXHPOS and ATPmax (p < 0.05), but time spent in sedentary behavior was not. Additionally, age was significantly associated with muscle energetics for men only (p < 0.05); adjusting for time spent in ActiGraph-measured MVPA attenuated the age association with ATPmax by 58% in men. CONCLUSION More time spent in accelerometry-measured or self-reported daily PA, especially MVPA, was associated with higher skeletal muscle energetics. Interventions aimed specifically at increasing higher intensity activity might offer potential therapeutic interventions to slow age-related decline in muscle energetics. Our work also emphasizes the importance of taking PA into consideration when evaluating associations related to skeletal muscle energetics.
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Affiliation(s)
- Yujia Susanna Qiao
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA; San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA 94143, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94143, USA
| | - Terri L Blackwell
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA 94143, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94143, USA
| | - Peggy M Cawthon
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA 94143, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94143, USA
| | - Paul M Coen
- Translational Research Institute, AdventHealth, Orlando, FL 32804, USA
| | - Steven R Cummings
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA 94143, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94143, USA
| | | | - Samaneh Farsijani
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Daniel E Forman
- Department of Medicine (Geriatrics and Cardiology), University of Pittsburgh; and Geriatrics, Research, Education, and Clinical Center (GRECC), VA Pittsburgh Healthcare System, Pittsburgh, PA 15261, USA
| | - Bret H Goodpaster
- Translational Research Institute, AdventHealth, Orlando, FL 32804, USA
| | - Stephen B Kritchevsky
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27109, USA
| | - Theresa Mau
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA 94143, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94143, USA
| | - Frederico G S Toledo
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Anne B Newman
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Nancy W Glynn
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA.
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Yang CH, Lee J, Wilcox S, Rudisill AC, Friedman DB, Hakun JG, Neils-Strunjas J, Wei J, Miller MC, Byers MD. Implementation and evaluation of a community-based mindful walking randomized controlled trial to sustain cognitive health in older African Americans at risk for dementia. BMC Geriatr 2024; 24:579. [PMID: 38965464 PMCID: PMC11225163 DOI: 10.1186/s12877-024-05090-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 05/17/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND With an increasing proportion of older adults and the associated risk of Alzheimer's Disease and Related Dementias (ADRD) around the globe, there is an urgent need to engage in ADRD risk reduction efforts. African American (AA) older adults in the U.S. are disproportionally impacted by ADRD compared to other races and ethnicities. Mindful walking integrates two potentially protective factors of ADRD by elevating mindfulness and physical activity (i.e., walking), resulting in a synergistic behavioral strategy that is feasible and safe for older adults. However, the efficacy of applying this intervention for cognitive health outcomes has not been evaluated using experimental designs. METHODS This paper documents the goal and protocol of a community-based, mindful walking randomized controlled trial to examine the short- and longer-term efficacy on cognitive and other health-related outcomes in ADRD at-risk AA older adults. The study outcomes include various brain health determinants, including cognitive function, quality of life, psychological well-being, physical activity, mindfulness, sleep, and overall health status. In addition, the estimated costs of program implementation are also collected throughout the study period. This study will recruit 114 older adults (ages 60+ years) with elevated ADRD risk from the Midlands region of South Carolina. Older adults are randomly assigned to participate in 24 sessions of outdoor mindful walking over three months or a delayed mindful walking group (n=57 in each group). Participants in both groups follow identical measurement protocols at baseline, after 12 weeks, after 18 weeks, and after 24 weeks from baseline. The outcome measures are administered in the lab and in everyday settings. Costs per participant are calculated using micro-costing methods. The eliciting participant costs for mindful walking engagement with expected results are reported using the payer and the societal perspectives. DISCUSSION This study will generate evidence regarding the efficacy of mindful walking on sustaining cognitive health in vulnerable older adults. The results can inform future large-scale effectiveness trials to support our study findings. If successful, this mindful walking program can be scaled up as a low-cost and viable lifestyle strategy to promote healthy cognitive aging in diverse older adult populations, including those at greatest risk. TRIAL REGISTRATION ClinicalTrials.gov number NCT06085196 (retrospectively registered on 10/08/2023).
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Affiliation(s)
- Chih-Hsiang Yang
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Jongwon Lee
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sara Wilcox
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - A Caroline Rudisill
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Daniela B Friedman
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jonathan G Hakun
- Department of Neurology, The Pennsylvania State University, College of Medicine, Hershey, PA, 17033, USA
- Department of Psychology, The Pennsylvania State University, University Park, PA, 16802, USA
- Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, 17033, USA
| | - Jean Neils-Strunjas
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jingkai Wei
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Margaret C Miller
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Megan D Byers
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Skiba MB, Miller D, Stratton DB, Hall CA, McKenna S, Blair CK, Demark-Wahnefried W. Adaptation and study protocol for harvest for health together Arizona: A mentored community garden intervention for survivors of cancer. Contemp Clin Trials Commun 2024; 39:101290. [PMID: 38595771 PMCID: PMC11002544 DOI: 10.1016/j.conctc.2024.101290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 02/16/2024] [Accepted: 03/26/2024] [Indexed: 04/11/2024] Open
Abstract
Background Current health behavior recommendations for skin cancer prevention, treatment, and survivorship are the same for survivors of other cancers; they include eating a healthy diet, being physically active, maintaining a healthy weight, and minimizing ultraviolet (U.V.) exposure. Few interventions exist to support health behaviors beyond U.V. exposure. We adapted Harvest for Health, a home-based mentored gardening intervention for cancer survivors, for implementation in Arizona as a community-based intervention. Methods Stakeholder-informed adaptations for Harvest for Health Together Arizona (H4H2-AZ) included updating intervention materials to be relevant to the arid desert environment, emphasizing the importance of sun safety in cancer survivorship, and shifting from a home-based to a community-based delivery model. Participants will be enrolled in cohorts aligned with growing seasons (e.g., spring, monsoon, fall) and matched to an individual 30 ft2 community garden plot for two growing seasons (6 months). Original intervention components retained are: 1) Master Gardeners deliver the intervention providing one-to-one mentorship and 2) gardening materials and supplies provided. This pilot six-month single-arm intervention will determine feasibility, acceptability, and appropriateness of an evidence-based adapted mentored community gardening intervention for survivors of skin cancer as primary outcomes. Secondary outcomes are to explore the effects on cancer preventive health behaviors and health-related quality of life. Discussion This pilot single-arm intervention will determine feasibility, acceptability, and appropriateness of an evidence-based adapted mentored community gardening intervention for survivors of skin cancer. If successful, the intervention could be widely implemented throughout existing Master Gardener programs and community garden networks for survivors of other cancers. Trial registration ClinicalTrials.gov identifier: NCT05648604. Trial registered on December 13, 2022.
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Affiliation(s)
- Meghan B. Skiba
- Advanced Nursing Practice and Science Division, College of Nursing, University of Arizona, Tucson, AZ, USA
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
| | - Dylan Miller
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
- Department of Epidemiology, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Delaney B. Stratton
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
- Dermatology, Banner University Health, Tucson, AZ, USA
| | - Caitlyn A. Hall
- W.A. Franke Honors College, University of Arizona, Tucson, AZ, USA
- Department of Biosystems Engineering, College of Agricultural and Life Sciences, University of Arizona, Tucson, AZ, USA
| | - Sharon McKenna
- Melanoma Task Force, Arizona Department of Health Services, Phoenix, AZ, USA
| | - Cindy K. Blair
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Wendy Demark-Wahnefried
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
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Mao Z, Cawthon PM, Kritchevsky SB, Toledo FGS, Esser KA, Erickson ML, Newman AB, Farsijani S. The association between chrononutrition behaviors and muscle health among older adults: The study of muscle, mobility and aging. Aging Cell 2024; 23:e14059. [PMID: 38059319 PMCID: PMC11166361 DOI: 10.1111/acel.14059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/16/2023] [Accepted: 11/20/2023] [Indexed: 12/08/2023] Open
Abstract
Emerging studies highlight chrononutrition's impact on body composition through circadian clock entrainment, but its effect on older adults' muscle health remains largely overlooked. To determine the associations between chrononutrition behaviors and muscle health in older adults. Dietary data from 828 older adults (76 ± 5 years) recorded food/beverage amounts and their clock time over the past 24 h. Studied chrononutrition behaviors included: (1) The clock time of the first and last food/beverage intake; (2) Eating window (the time elapsed between the first and last intake); and (3) Eating frequency (Number of self-identified eating events logged with changed meal occasion and clock time). Muscle mass (D3-creatine), leg muscle volume (MRI), grip strength (hand-held dynamometer), and leg power (Keiser) were used as outcomes. We used linear regression to assess the relationships between chrononutrition and muscle health, adjusting for age, sex, race, marital status, education, study site, self-reported health, energy, protein, fiber intake, weight, height, and moderate-to-vigorous physical activity. Average eating window was 11 ± 2 h/day; first and last intake times were at 8:22 and 19:22, respectively. After multivariable adjustment, a longer eating window and a later last intake time were associated with greater muscle mass (β ± SE: 0.18 ± 0.09; 0.27 ± 0.11, respectively, p < 0.05). The longer eating window was also marginally associated with higher leg power (p = 0.058). An earlier intake time was associated with higher grip strength (-0.38 ± 0.15; p = 0.012). Chrononutrition behaviors, including longer eating window, later last intake time, and earlier first intake time were associated with better muscle mass and function in older adults.
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Affiliation(s)
- Ziling Mao
- Department of EpidemiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
- Center for Aging and Population HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Peggy M. Cawthon
- California Pacific Medical Center Research InstituteUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Stephen B. Kritchevsky
- Department of Internal Medicine, Section on Gerontology & Geriatric Medicine and the Sticht Center for Healthy Aging and Alzheimer's PreventionWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Frederico G. S. Toledo
- Department of Medicine, Division of Endocrinology and MetabolismUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Karyn A. Esser
- Department of Physiology and AgingUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | | | - Anne B. Newman
- Department of EpidemiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
- Center for Aging and Population HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Samaneh Farsijani
- Department of EpidemiologyUniversity of PittsburghPittsburghPennsylvaniaUSA
- Center for Aging and Population HealthUniversity of PittsburghPittsburghPennsylvaniaUSA
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Malik J, Główka N, Jelonek W, Stemplewski R, Maciaszek J. Effect of a juggling-based physical activity on postural stability, reaction time, and attention focus in older adults: a randomized crossover study. Eur Rev Aging Phys Act 2024; 21:15. [PMID: 38822245 PMCID: PMC11143604 DOI: 10.1186/s11556-024-00351-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 05/22/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND In the aging society, more attention is paid to the promotion of forms of physical activity that can improve postural stability and cognitive functioning. In this context, the importance of combined exercises, requiring simultaneous physical and cognitive involvement, is emphasized. Juggling seems to be a form of activity that is both cognitively and physically demanding. The purpose of this study was to determine the effect of additional juggling exercise on postural stability and cognitive abilities in healthy, physically active older adults. METHODS Twenty-six healthy and physically active older adults (70.08±4.40 years old) were included in a randomized crossover study. The addition of juggling three times a week during four weeks was the main intervention (one period), while the control phase included four weeks with no addition of juggling (second period). Measurements of postural stability and cognitive abilities were performed before and after each period. For the purpose of postural stability assessment, a velocity of center of pressure with root mean square, area 95 percentile, medio-lateral and anterior-posterior range of motion were measured. Center of pressure signals were obtained using an AccuGait™ System force plate in three conditions: free standing, dual-task and limits of stability. The Vienna Test System was used for the assessment of selected cognitive abilities. A battery of reaction time tests and Cognitrone test were used for this purpose. RESULTS A significant interaction effect of intervention and time was observed in the postural stability dual-task condition in the root mean square of the center of pressure velocity in the advantage of the juggling period (medio-lateral: F=14.83, p<.01, ƞp2=.37; anterior-posterior: F=26.30, p<.01, ƞp2=.51). Additionally, moderate effect sizes were observed in the velocity of the center of pressure and variability of simple reaction time measurements, but without statistical significance. CONCLUSIONS The results of this study indicate that the implementation of juggling activity in everyday life may have positive effects on cognitive abilities and postural stability in healthy, physically active older adults, but the true effect may be low to moderate. TRIAL REGISTRATION The study was registered retrospectively (30.10.2023) at ClinicalTrials.gov (NCT06108713).
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Affiliation(s)
- Jakub Malik
- Department of Physical Activity and Health Promotion Science, Poznan University of Physical Education, Królowej Jadwigi 27/39, 61-871, Poznan, Poland.
| | - Natalia Główka
- Department of Sports Dietetics, Poznan University of Physical Education, Królowej Jadwigi 27/39, 61-871, Poznan, Poland
| | - Wojciech Jelonek
- Department of Neuromuscular Physiotherapy, Poznan University of Physical Education, Królowej Jadwigi 27/39, 61-871, Poznan, Poland
| | - Rafał Stemplewski
- Department of Digital Technologies in Physical Activity, Poznan University of Physical Education, Królowej Jadwigi 27/39, 61-871, Poznan, Poland
| | - Janusz Maciaszek
- Department of Physical Activity and Health Promotion Science, Poznan University of Physical Education, Królowej Jadwigi 27/39, 61-871, Poznan, Poland
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Bullock SL, Winthrop HM, Hales D, Lin FC, Yang Y, Ammerman AS, Viera AJ. Who chooses "healthy" meals? An analysis of lunchtime meal quality in a workplace cafeteria. BMC Public Health 2024; 24:921. [PMID: 38553694 PMCID: PMC10979548 DOI: 10.1186/s12889-024-18284-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/05/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND The workplace can play an important role in shaping the eating behaviors of U.S. adults. Unfortunately, foods obtained in the workplace tend to be low in nutritional quality. Questions remain about the best way to approach the promotion of healthy food purchases among employees and to what extent health promotion activities should be tailored to the demographic characteristics of the employees. The purpose of this study was to (1) assess the nutritional quality of lunchtime meal purchases by employees in cafeterias of a large organization, (2) examine associations between lunchtime meal quality selection and the demographic characteristics of employees, and (3) determine the healthfulness of foods and beverages offered in the cafeterias of this organization. METHODS A cross-sectional analysis was conducted using secondary data from a food labeling study implemented in three worksite cafeterias. Demographic data was collected via surveys and meal data was collected using a photo capture system for 378 participants. The Healthy Eating Index 2015 (HEI-2015) was used to determine meal quality and a total score for the menu of options available in the cafeterias during the study period. Summary statistics were generated, and the analysis of variance (ANOVA) was used to compare the HEI-2015 scores between groups. RESULTS The mean HEI-2015 total score for the menu items offered (n = 1,229) in the cafeteria during the study period was 63.1 (SD = 1.83). The mean HEI-2015 score for individual lunchtime meal observations (n = 378) was 47.1 (SD = 6.8). In general, HEI-2015 total scores were higher for non-smokers, individuals who self-identified as Asian, had higher physical activity levels, scored higher on numeracy and literacy assessments, and reported higher education levels, incomes, and health status. CONCLUSIONS The overall HEI-2015 scores indicate that the menu of options offered in the cafeterias and individual meal selections did not align with the Dietary Guidelines for Americans, and there were significant associations between average lunchtime meal quality scores and several demographic characteristics. These results suggest that healthy eating promotion activities in workplaces may need to be tailored to the demographic characteristics of the employees, and efforts to improve the food environment in the workplace could improve meal quality for all employees.
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Affiliation(s)
- Sally L Bullock
- Davidson College, PO Box 5000, 209 Ridge Road, Davidson, NC, 28035, USA.
| | - Hilary M Winthrop
- Duke University School of Medicine, 2200 W Main St, Durham, NC, 27705, USA
| | - Derek Hales
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 MLK Jr. Blvd, CB#7426,, Chapel Hill, NC, 27599, USA
| | - Feng-Chang Lin
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 3101 McGavran-Greenberg Hall, CB #7420,, Chapel Hill, NC, 27599, USA
| | - Yumei Yang
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 3101 McGavran-Greenberg Hall, CB #7420,, Chapel Hill, NC, 27599, USA
| | - Alice S Ammerman
- Department of Nutrition, Gillings School of Global Public Health, Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, CB# 7426, 1700 MLK Jr. Blvd, Room 239,, Chapel Hill, 27599, USA
| | - Anthony J Viera
- Department of Family Medicine and Community Health, Duke University School of Medicine, 2200 W Main St, Suite 400, Durham, NC, 27705, USA
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Mao Z, Cawthon PM, Kritchevsky SB, Toledo FGS, Esser KA, Erickson ML, Newman AB, Farsijani S. The association between chrononutrition behaviors and muscle health among older adults: The Study of Muscle, Mobility and Aging (SOMMA). MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.13.23298454. [PMID: 38014276 PMCID: PMC10680884 DOI: 10.1101/2023.11.13.23298454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Background Emerging studies highlight chrononutrition's impact on body composition through circadian clock entrainment, but its effect on older adults' muscle health remains largely overlooked. Objective To determine the associations between chrononutrition behaviors and muscle health in older adults. Methods Dietary data from 828 older adults (76±5y) recorded food/beverage amounts and their clock time over the past 24 hours. Studied chrononutrition behaviors included: 1) The clock time of the first and last food/beverage intake; 2) Eating window (the time elapsed between the first and last intake); and 3) Eating frequency (Number of self-identified eating events logged with changed meal occasion and clock time). Muscle mass (D 3 -creatine), leg muscle volume (MRI), grip strength (hand-held dynamometer), and leg power (Keiser) were used as outcomes. We used linear regression to assess the relationships between chrononutrition and muscle health, adjusting for age, sex, race, marital status, education, study site, self-reported health, energy, protein, fiber intake, weight, height, and moderate-to-vigorous physical activity. Results Average eating window was 11±2 h/d; first and last intake times were at 8:22 and 19:22, respectively. After multivariable adjustment, a longer eating window and a later last intake time were associated with greater muscle mass (β±SE: 0.18±0.09; 0.27±0.11, respectively, P <0.05). The longer eating window was also marginally associated with higher leg power ( P =0.058). An earlier intake time was associated with higher grip strength (-0.38±0.15; P =0.012). Conclusions Chrononutrition behaviors, including longer eating window, later last intake time, and earlier first intake time were associated with better muscle mass and function in older adults. GRAPHICAL ABSTRACT Key findings Chrononutrition behaviors, including longer eating window, later last intake time, and earlier first intake time were associated with better muscle mass and function in older adults.
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Cawthon PM, Blackwell TL, Kritchevsky SB, Newman AB, Hepple RT, Coen PM, Goodpaster BH, Duchowny K, Hetherington-Rauth M, Mau T, Shankaran M, Hellerstein M, Evans WJ, Cummings SR. Associations between D 3Cr muscle mass and MR thigh muscle volume with strength, power, physical performance, fitness, and limitations in older adults in the SOMMA study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.09.23298303. [PMID: 37986809 PMCID: PMC10659521 DOI: 10.1101/2023.11.09.23298303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Background Different measures to assess muscle size - magnetic resonance (MR) derived thigh muscle volume and d3-creatine dilution derived muscle mass (D3Cr muscle mass) - may have similar associations with strength, power, physical performance, fitness, and functional limitations in older adults. Methods Men (N=345) and women (N=482) aged ≥70 years from the Study of Muscle, Mobility and Aging completed exams including leg extension strength (1-repetition max) and cardiopulmonary exercise testing to assess fitness (VO2peak). Correlations and adjusted regression models stratified by sex were used to assess the association between muscle size measures and study outcomes; we tested for sex interactions. Results D3Cr muscle mass and MR thigh muscle volume were correlated (men: r=0.62, women: r=0.51, p<.001). Lower D3Cr muscle mass and lower MR thigh muscle volume were associated with lower strength and lower VO2peak in both men and women; D3Cr muscle mass was more strongly associated with strength in men than in women (p-int<0.05). There were correlations, though less consistent, between muscle size or mass with physical performance and function. Associations between the muscle size measures and the study outcomes occasionally varied by sex, and associations of MR thigh muscle volume were, at times, slightly more strongly associated with the study outcomes than was D3Cr muscle mass. Conclusions Less muscle -measured by either D3Cr muscle mass or MR thigh muscle volume - was associated with lower strength and worse performance. Varied associations by sex and assessment method suggest consideration be given to which measurement to use in future studies.
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Affiliation(s)
- Peggy M Cawthon
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Terri L Blackwell
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA
| | - Stephen B Kritchevsky
- Department of Internal Medicine: Gerontology & Geriatric Medicine and The Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Anne B Newman
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA USA
| | - Russell T Hepple
- Department of Physical Therapy, University of Florida, Gainesville, FL USA
| | - Paul M Coen
- Translational Research Institute, AdventHealth, Orlando, FL, USA
| | | | - Kate Duchowny
- University of Michigan, Institute for Social Research, Ann Arbor, MI, USA
| | | | - Theresa Mau
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA
| | - Mahalakshmi Shankaran
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| | - Marc Hellerstein
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| | - William J Evans
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| | - Steven R Cummings
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
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9
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Qiao YS, Blackwell TL, Cawthon PM, Coen PM, Cummings SR, Distefano G, Farsijani S, Forman DE, Goodpaster BH, Kritchevsky SB, Mau T, Toledo FGS, Newman AB, Glynn NW. Associations of Objective and Self-Reported Physical Activity and Sedentary Behavior with Skeletal Muscle Energetics: The Study of Muscle, Mobility and Aging (SOMMA). MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.05.23298134. [PMID: 37986749 PMCID: PMC10659463 DOI: 10.1101/2023.11.05.23298134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Background Skeletal muscle energetics decline with age, and physical activity (PA) has been shown to counteract these declines in older adults. Yet, many studies were based on self-reported PA or structured exercise interventions. We examined the associations of objective daily PA and sedentary behavior (SB) with skeletal muscle energetics and also compared with self-reported PA and SB. We also explored the extent to which PA would attenuate the associations of age with muscle energetics. Methods Among the Study of Muscle, Mobility and Aging (SOMMA) enrolled older adults, 810 (mean age=76±5, 58% women) had maximal muscle oxidative capacity measured ex vivo via high-resolution respirometry of permeabilized myofibers (maxOXPHOS) and in vivo by 31 Phosphorus magnetic resonance spectroscopy (ATP max ). Objective PA was measured using the wrist-worn ActiGraph GT9X over 7-days to capture sedentary behavior (SB), light, and moderate-to-vigorous PA (MVPA). Self-reported SB, MVPA, and all exercise-related PA were assessed with The Community Healthy Activities Model Program for Seniors questionnaire. Linear regression models with progressive covariate adjustments evaluated the associations between SB, PA and muscle energetics, and the attenuation of the age / muscle energetic association by PA. Results Every 30 minutes more objective MVPA was associated with 0.65 pmol/s*mg higher maxOXPHOS and 0.012 mM/sec higher ATP max , after adjustment for age, site/technician and sex. More time spent in objective light+MVPA was significantly associated with higher ATP max , but not maxOXPHOS. In contrast, every 30 minutes spent in objective SB was associated with 0.43 pmol/s*mg lower maxOXPHOS and 0.004 mM/sec lower ATP max . Only associations with ATP max held after further adjusting for socioeconomic status, body mass index, lifestyle factors and multimorbidities. Self-reported MVPA and all exercise-related activities, but not SB, yielded similar associations with maxOXPHOS and ATP max . Lastly, age was only significantly associated with muscle energetics in men. Adjusting for objective time spent in MVPA attenuated the age association with ATP max by nearly 60% in men. Conclusion More time spent in daily PA, especially MVPA, were associated with higher muscle energetics. Interventions that increase higher intensity activity might offer potential therapeutic interventions to slow the age-related decline in muscle energetics. Our work also emphasizes the importance of taking PA into consideration when evaluating associations related to skeletal muscle energetics.
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10
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Gocer O, Wei Y, Ozbil Torun A, Alvanides S, Candido C. Multidimensional attributes of neighbourhood quality: A systematic review. Heliyon 2023; 9:e22636. [PMID: 38034601 PMCID: PMC10687291 DOI: 10.1016/j.heliyon.2023.e22636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 10/28/2023] [Accepted: 11/15/2023] [Indexed: 12/02/2023] Open
Affiliation(s)
- Ozgur Gocer
- School of Architecture, Design and Planning, The University of Sydney, Sydney, NSW, Australia
| | - Yuan Wei
- School of Architecture, Design and Planning, The University of Sydney, Sydney, NSW, Australia
| | - Ayse Ozbil Torun
- Department of Architecture and Built Environment, Northumbria University, Newcastle Upon Tyne, UK
| | - Seraphim Alvanides
- Department of Architecture and Built Environment, Northumbria University, Newcastle Upon Tyne, UK
| | - Christhina Candido
- Melbourne School of Design, Faculty of Architecture, Building and Planning, The University of Melbourne, Melbourne, VIC, Australia
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11
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Petnehazy N, Barnes HN, Newman AB, Kritchevsky SB, Cummings SR, Hepple RT, Cawthon PM. Muscle mass, strength, power and physical performance and their association with quality of life in older adults, the Study of Muscle, Mobility and Aging (SOMMA). MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.31.23297845. [PMID: 37961491 PMCID: PMC10635249 DOI: 10.1101/2023.10.31.23297845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Background Sarcopenia negatively impacts quality of life. It is unclear whether different measures of muscle size, strength, physical performance, and fitness have similar associations with quality of life. Objective To describe associations of sarcopenia metrics with quality of life outcomes. Participants Community-dwelling adults aged 70+ years participating in the SOMMA (Study of Muscle, Mobility and Aging) study. Design and settings Two academic medical centers. Measurements Measures included muscle size (MRI- muscle volume. D3Cr muscle mass); strength and power (grip strength, leg extension power and strength); walking and physical performance (4m and 400m walk, SPPB (Short Physical Performance Battery), stair climb, chair stand); fitness (VO2 peak); health related quality of life (EQ-5D); and anthropometrics (weight, height, and body mass index).Results were stratified by sex. Correlations, scatterplots and linear regression models described the association between various measures of sarcopenia and fitness with overall quality of life score (EQ5D VAS) as a continuous variable. We also quantified differences between sarcopenia and fitness measures by overall QOL (Quality of Life) as a categorical variable (low, medium, high) and by QOL subcomponents (pain and discomfort, problems with usual activities, mobility, anxiety and depression, and problems with self-care) using distributionally appropriate methods. Results Walking tests and physical performance were most consistently (but modestly) associated with overall quality of life (r~0.2, p<.001) and its subcomponents. Both men and women several sarcopenia and fitness measures were more strongly associated with pain and usual activity than other QOL components. Conclusions Poor performance, lower fitness and lower strength are related to worse quality of life, particularly pain, in older adults. Future studies should quantify these relationships longitudinally.
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Affiliation(s)
- Nora Petnehazy
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Haley N Barnes
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Anne B Newman
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Stephen B Kritchevsky
- Department of Internal Medicine-Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Steven R Cummings
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Russel T Hepple
- Department of Physical Therapy, University of Florida, Gainesville, Florida, USA
| | - Peggy M Cawthon
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
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12
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Cummings SR, Newman AB, Coen PM, Hepple RT, Collins R, Kennedy, MS K, Danielson M, Peters K, Blackwell T, Johnson E, Mau T, Shankland EG, Lui LY, Patel S, Young D, Glynn NW, Strotmeyer ES, Esser KA, Marcinek DJ, Goodpaster BH, Kritchevsky S, Cawthon PM. The Study of Muscle, Mobility and Aging (SOMMA): A Unique Cohort Study About the Cellular Biology of Aging and Age-related Loss of Mobility. J Gerontol A Biol Sci Med Sci 2023; 78:2083-2093. [PMID: 36754371 PMCID: PMC10613002 DOI: 10.1093/gerona/glad052] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND The Study of Muscle, Mobility and Aging (SOMMA) aims to understand the biological basis of many facets of human aging, with a focus on mobility decline, by creating a unique platform of data, tissues, and images. METHODS The multidisciplinary SOMMA team includes 2 clinical centers (University of Pittsburgh and Wake Forest University), a biorepository (Translational Research Institute at Advent Health), and the San Francisco Coordinating Center (California Pacific Medical Center Research Institute). Enrollees were age ≥70 years, able to walk ≥0.6 m/s (4 m); able to complete 400 m walk, free of life-threatening disease, and had no contraindications to magnetic resonance or tissue collection. Participants are followed with 6-month phone contacts and annual in-person exams. At baseline, SOMMA collected biospecimens (muscle and adipose tissue, blood, urine, fecal samples); a variety of questionnaires; physical and cognitive assessments; whole-body imaging (magnetic resonance and computed tomography); accelerometry; and cardiopulmonary exercise testing. Primary outcomes include change in walking speed, change in fitness, and objective mobility disability (able to walk 400 m in 15 minutes and change in 400 m speed). Incident events, including hospitalizations, cancer diagnoses, fractures, and mortality are collected and centrally adjudicated by study physicians. RESULTS SOMMA exceeded its goals by enrolling 879 participants, despite being slowed by the COVID-19 pandemic: 59.2% women; mean age 76.3 ± 5.0 years (range 70-94); mean walking speed 1.04 ± 0.20 m/s; 15.8% identify as other than Non-Hispanic White. Over 97% had data for key measurements. CONCLUSIONS SOMMA will provide the foundation for discoveries in the biology of human aging and mobility.
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Affiliation(s)
- Steven R Cummings
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Anne B Newman
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Paul M Coen
- Translational Research Institute, AdventHealth, Orlando, Florida, USA
| | - Russell T Hepple
- Department of Physical Therapy, University of Florida, Gainesville, Florida, USA
| | - Robin Collins
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Kimberly Kennedy, MS
- Department of Internal Medicine, Section on Gerontology & Geriatric Medicine and the Sticht Center for Healthy aging and Alzheimer’s Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Michelle Danielson
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kathy Peters
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Terri Blackwell
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Eileen Johnson
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Theresa Mau
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Eric G Shankland
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Li-Yung Lui
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Sheena Patel
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Dani Young
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Nancy W Glynn
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Elsa S Strotmeyer
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Karyn A Esser
- Department of Physiology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - David J Marcinek
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Bret H Goodpaster
- Translational Research Institute, AdventHealth, Orlando, Florida, USA
| | - Stephen Kritchevsky
- Department of Internal Medicine, Section on Gerontology & Geriatric Medicine and the Sticht Center for Healthy aging and Alzheimer’s Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Peggy M Cawthon
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
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13
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Uhlig-Reche H, Ontiveros D, Syzdek R, Mathews P, Dalal L, Amaro A, Wunnava N, Housammy Z, Schmitt B, Sharrief A, Gonzales NR. Description of Baseline Nutrition and Physical Activity Knowledge and Behavior in Acute Stroke/TIA Patients Enrolled in the Health Education on Information Retention and Behavior Change in Stroke (HERBS) Pilot Trial. Nutrients 2023; 15:3761. [PMID: 37686793 PMCID: PMC10490333 DOI: 10.3390/nu15173761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/24/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Lifestyle modifications after stroke are associated with better risk factor control and lower mortality. The primary objective of this study was to describe the knowledge of American Heart Association (AHA) recommendations for diet and exercise in survivors of stroke and transient ischemic attack (TIA). The secondary objectives were to describe their diet and exercise behaviors, self-efficacy (SE), behavioral intent (BI), stage of change, and barriers to change. Data are described from participants enrolled in a prospective educational intervention in mild stroke/TIA survivors. A multiple-choice questionnaire ascertained knowledge of AHA recommendations for diet and exercise, nutrition and physical activity behavior, SE, BI, stage of change, and barriers to change. Twenty-eight stroke/TIA survivors, with a mean age of 61.7 ± 11.8 years, completed questionnaires during their acute hospitalization. Participants underestimated the recommended intake of fruits, vegetables, whole grains, and participation in aerobic exercise and overestimated the recommended intake of sugar and salt. SE demonstrated a significant positive association with combined behavior scores (rs = 0.36, p = 0.043). Greater knowledge of the AHA recommendations was not associated with healthier behavior, greater SE, higher BI, or more advanced stage of change. The gaps between AHA recommendations and stroke/TIA patient knowledge identifies an area for potential intervention in stroke prevention and recovery.
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Affiliation(s)
- Hannah Uhlig-Reche
- Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Diana Ontiveros
- Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, NC 27514, USA
| | - Riley Syzdek
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA (L.D.); (Z.H.)
| | - Patenne Mathews
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Leanne Dalal
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA (L.D.); (Z.H.)
| | - Andrea Amaro
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX 75235, USA
| | - Nidhi Wunnava
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Zina Housammy
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA (L.D.); (Z.H.)
| | - Barrie Schmitt
- Department of Neurology, Neurohospitalist & Stroke Section, University of Colorado School of Medicine, Aurora, CO 80045, USA (N.R.G.)
| | - Anjail Sharrief
- Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Nicole R. Gonzales
- Department of Neurology, Neurohospitalist & Stroke Section, University of Colorado School of Medicine, Aurora, CO 80045, USA (N.R.G.)
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14
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Mau T, Lui LY, Distefano G, Kramer PA, Ramos SV, Toledo FGS, Santanasto AJ, Shankland EG, Marcinek DJ, Jurczak MJ, Sipula I, Bello FM, Duchowny KA, Molina AJA, Sparks LM, Goodpaster BH, Hepple RT, Kritchevsky SB, Newman AB, Cawthon PM, Cummings SR, Coen PM. Mitochondrial Energetics in Skeletal Muscle Are Associated With Leg Power and Cardiorespiratory Fitness in the Study of Muscle, Mobility and Aging. J Gerontol A Biol Sci Med Sci 2023; 78:1367-1375. [PMID: 36462195 PMCID: PMC10395564 DOI: 10.1093/gerona/glac238] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Mitochondrial energetics are an important property of aging muscle, as generation of energy is pivotal to the execution of muscle contraction. However, its association with functional outcomes, including leg power and cardiorespiratory fitness, is largely understudied. METHODS In the Study of Muscle, Mobility, and Aging, we collected vastus lateralis biopsies from older adults (n = 879, 70-94 years, 59.2% women). Maximal State 3 respiration (Max OXPHOS) was assessed in permeabilized fiber bundles by high-resolution respirometry. Capacity for maximal adenosine triphosphate production (ATPmax) was measured in vivo by 31P magnetic resonance spectroscopy. Leg extension power was measured with a Keiser press system, and VO2 peak was determined using a standardized cardiopulmonary exercise test. Gender-stratified multivariate linear regression models were adjusted for age, race, technician/site, adiposity, and physical activity with beta coefficients expressed per 1-SD increment in the independent variable. RESULTS Max OXPHOS was associated with leg power for both women (β = 0.12 Watts/kg, p < .001) and men (β = 0.11 Watts/kg, p < .050). ATPmax was associated with leg power for men (β = 0.09 Watts/kg, p < .05) but was not significant for women (β = 0.03 Watts/kg, p = .11). Max OXPHOS and ATPmax were associated with VO2 peak in women and men (Max OXPHOS, β women = 1.03 mL/kg/min, β men = 1.32 mL/kg/min; ATPmax β women = 0.87 mL/kg/min, β men = 1.50 mL/kg/min; all p < .001). CONCLUSIONS Higher muscle mitochondrial energetics measures were associated with both better cardiorespiratory fitness and greater leg power in older adults. Muscle mitochondrial energetics explained a greater degree of variance in VO2 peak compared to leg power.
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Affiliation(s)
- Theresa Mau
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Li-Yung Lui
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | | | - Philip A Kramer
- Department of Internal Medicine-Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Sofhia V Ramos
- AdventHealth, Translational Research Institute, Orlando, Florida, USA
| | - Frederico G S Toledo
- Department of Medicine-Division of Endocrinology and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Adam J Santanasto
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Eric G Shankland
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - David J Marcinek
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Michael J Jurczak
- Department of Medicine-Division of Endocrinology and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Center for Metabolism and Mitochondrial Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Ian Sipula
- Department of Medicine-Division of Endocrinology and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Center for Metabolism and Mitochondrial Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Fiona M Bello
- Department of Medicine-Division of Endocrinology and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Center for Metabolism and Mitochondrial Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Kate A Duchowny
- Social Environment and Health, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Anthony J A Molina
- Department of Internal Medicine-Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Department of Medicine-Division of Geriatrics, Gerontology, and Palliative Care, University of California San Diego School of Medicine, La Jolla, California, USA
| | - Lauren M Sparks
- AdventHealth, Translational Research Institute, Orlando, Florida, USA
| | - Bret H Goodpaster
- AdventHealth, Translational Research Institute, Orlando, Florida, USA
| | - Russell T Hepple
- Department of Physical Therapy, University of Florida, Gainesville, Florida, USA
| | - Stephen B Kritchevsky
- Department of Internal Medicine-Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Anne B Newman
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Peggy M Cawthon
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Steven R Cummings
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Paul M Coen
- AdventHealth, Translational Research Institute, Orlando, Florida, USA
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15
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Lim SER, Meredith SJ, Agnew S, Clift E, Ibrahim K, Roberts HC. Volunteer-led online group exercise for community-dwelling older people: a feasibility and acceptability study. BMC Geriatr 2023; 23:461. [PMID: 37507667 PMCID: PMC10375749 DOI: 10.1186/s12877-023-04184-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Despite the clear benefits of physical activity in healthy ageing, engagement in regular physical activity among community-dwelling older adults remains low, with common barriers including exertional discomfort, concerns with falling, and access difficulties. The recent rise of the use of technology and the internet among older adults presents an opportunity to engage with older people online to promote increased physical activity. This study aims to determine the feasibility and acceptability of training volunteers to deliver online group exercises for older adults attending community social clubs. METHODS This was a pre-post mixed-methods study. Older adults aged ≥ 65 years attending community social clubs who provided written consent and were not actively participating in exercise classes took part in the feasibility study. Older adults, volunteers, and staff were interviewed to determine the acceptability of the intervention. The intervention was a once weekly volunteer-led online group seated strength exercises using resistance bands. The duration of the intervention was 6 months. The primary outcome measures were the feasibility of the intervention (determined by the number of volunteers recruited, trained, and retained, participant recruitment and intervention adherence) and its acceptability to key stakeholders. Secondary outcome measures included physical activity levels (Community Health Model Activities Programme for Seniors (CHAMPS) questionnaire), modified Barthel Index, Health-related quality of life (EQ-5D-5L), frailty (PRISMA-7) and sarcopenia (SARC-F), at baseline and 6 months. RESULTS Nineteen volunteers were recruited, 15 (78.9%) completed training and 9 (47.3%) were retained after 1 year (mean age 68 years). Thirty older adults (mean age 77 years, 27 female) participated, attending 54% (IQR 37-67) of exercise sessions. Participants had no significant changes in secondary outcome measures, with a trend towards improvement in physical activity levels (physical activity in minutes per week at baseline was 1770 min, and 1909 min at six months, p = 0.13). Twenty volunteers, older adults, and staff were interviewed and found the intervention acceptable. The seated exercises were perceived as safe, manageable, and enjoyable. CONCLUSIONS Trained volunteers can safely deliver online group exercise for community-dwelling older adults which was acceptable to older adults, volunteers, and club staff. TRIALS REGISTRATION NCT04672200.
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Affiliation(s)
- S E R Lim
- Academic Geriatric Medicine, Southampton General Hospital, Mailpoint 807, Southampton, SO16 6YD, UK.
- NIHR Applied Research Collaboration Wessex, University of Southampton, Southampton, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK.
| | - S J Meredith
- Academic Geriatric Medicine, Southampton General Hospital, Mailpoint 807, Southampton, SO16 6YD, UK
- NIHR Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
| | - S Agnew
- The Brendoncare Foundation, Winchester, UK
| | - E Clift
- Southern Health NHS Foundation Trust, Southampton, UK
| | - K Ibrahim
- Academic Geriatric Medicine, Southampton General Hospital, Mailpoint 807, Southampton, SO16 6YD, UK
- NIHR Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
| | - H C Roberts
- Academic Geriatric Medicine, Southampton General Hospital, Mailpoint 807, Southampton, SO16 6YD, UK
- NIHR Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
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16
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Minto LR, Ellis R, Cherry KE, Wood RH, Barber SJ, Carter S, Dotson VM. Impact of cardiovascular risk factors on the relationships of physical activity with mood and cognitive function in a diverse sample. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2023; 30:654-667. [PMID: 35510295 PMCID: PMC10461536 DOI: 10.1080/13825585.2022.2071414] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 04/22/2022] [Indexed: 05/10/2023]
Abstract
Physical activity has well-known benefits for older adults' mood and cognitive functioning; however, it is not clear whether risk factors for cardiovascular disease (CVD) affect the relationships of physical activity with these health outcomes among diverse older adults. This study investigated the impact of CVD risk burden on the relationships among self-reported physical activity, mood, and cognitive functioning in a diverse sample of 62 adults age 45 and older. We found that higher physical activity was associated with better attention and verbal working memory at lower CVD risk, but with worse attention and verbal working memory at higher CVD risk levels. Thus, higher CVD risk might limit the effectiveness of exercise interventions for mood and cognitive functioning. Future studies are needed to further clarify individual differences that impact the relationships among physical activity, CVD risk, and cognitive outcomes.
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Affiliation(s)
- Lex R. Minto
- Department of Psychology, Georgia State University
| | - Rebecca Ellis
- Department of Kinesiology & Health, Georgia State University
| | | | | | - Sarah J. Barber
- Department of Psychology, Georgia State University
- Gerontology Institute, Georgia State University
| | | | - Vonetta M. Dotson
- Department of Psychology, Georgia State University
- Gerontology Institute, Georgia State University
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17
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Maasen K, Eussen SJ, Dagnelie PC, Stehouwer CDA, Opperhuizen A, van Greevenbroek MM, Schalkwijk CG. Habitual intake of dietary dicarbonyls is associated with greater insulin sensitivity and lower prevalence of type 2 diabetes: The Maastricht Study. Am J Clin Nutr 2023:S0002-9165(23)46840-2. [PMID: 37054886 DOI: 10.1016/j.ajcnut.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/11/2023] [Accepted: 04/10/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND Dicarbonyls are reactive precursors of advanced glycation endproducts (AGEs). Dicarbonyls are formed endogenously, but also during food processing. Circulating dicarbonyls are positively associated with insulin resistance and type 2 diabetes, but consequences of dietary dicarbonyls are unknown. OBJECTIVE To examine the associations of dietary intake of dicarbonyls with insulin sensitivity, β-cell function, and prevalence of prediabetes or type 2 diabetes. METHODS In 6282 participants (60±9 years, 50% men, 23% type 2 diabetes (oversampled)) of the population-based cohort The Maastricht Study, we estimated habitual intake of the dicarbonyls methylglyoxal (MGO), glyoxal (GO), and 3-deoxyglucosone (3-DG) using Food Frequency Questionnaires. Insulin sensitivity (n=2390), β-cell function (n=2336) and glucose metabolism status (n=6282) were measured by a seven-point oral glucose tolerance test. Insulin sensitivity was assessed as the Matsuda index. Additionally, insulin sensitivity was measured as HOMA2-IR (n=2611). β-cell function was assessed as C-peptidogenic index, overall insulin secretion, glucose sensitivity, potentiation factor, and rate sensitivity. Cross-sectional associations of dietary dicarbonyls with these outcomes were investigated using linear or logistic regression adjusting for age, sex, cardio-metabolic risk-factors, lifestyle, and dietary factors. RESULTS Higher dietary MGO and 3-DG intakes were associated with greater insulin sensitivity after full adjustment, indicated by both a higher Matsuda index (MGO: Std. β [95% CI]=0.08 [0.04, 0.12] and 3-DG: 0.09 [0.05, 0.13]) and a lower HOMA2-IR (MGO: Std. β=-0.05 [-0.09, -0.01] and 3-DG: -0.04 [-0.08, -0.01]). Moreover, higher MGO and 3-DG intakes were associated with lower prevalence of newly diagnosed type 2 diabetes (OR [95%CI]=0.78 [0.65, 0.93] and 0.81 [0.66, 0.99]). There were no consistent associations of MGO, GO, and 3-DG intakes with β-cell function. CONCLUSIONS Higher habitual consumption of the dicarbonyls MGO and 3-DG was associated with better insulin sensitivity and with lower prevalence of type 2 diabetes, after excluding individuals with known diabetes. These novel observations warrant further exploration in prospective cohorts and intervention studies.
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Affiliation(s)
- Kim Maasen
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Simone Jpm Eussen
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute/CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Pieter C Dagnelie
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Coen DA Stehouwer
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Antoon Opperhuizen
- Department of Pharmacology and Toxicology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, the Netherlands; Office for Risk Assessment and Research, Netherlands Food and Consumer Product Safety Authority, Utrecht, the Netherlands
| | - Marleen Mj van Greevenbroek
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Casper G Schalkwijk
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, the Netherlands.
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Intervention Fidelity of Telephone Motivational Interviewing On Physical Activity, Fruit Intake, and Vegetable Consumption in Dutch Outpatients With and Without Hypertension. Int J Behav Med 2023; 30:108-121. [PMID: 35347643 PMCID: PMC9879808 DOI: 10.1007/s12529-022-10076-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND In theory, Motivational Interviewing (MI) fidelity should be associated with client outcomes. Nevertheless, this fidelity-effectiveness association is rarely investigated. This study evaluated the extent to which Telephone Motivational Interviewing (TMI) fidelity is associated with change in self-reported physical activity (PA), fruit intake, and vegetable consumption. METHOD Adults in primary care (45-70 years) participated in a study that compared the effect of tailor print communication, telephone motivational interviewing (TMI), and a combination of the two on PA, fruit intake, and vegetable consumption. MI fidelity was assessed using the behavioral coding method "Motivational Interviewing Treatment Integrity Code (MITI)" in 409 randomly selected audio-recorded sessions, representing 232 participants of the TMI group. The associations between MI fidelity scores and the behavioral changes from baseline to 47-week follow-up were examined using backward multiple linear regression analyses (adjusted for covariates). RESULTS A significant and positive association between the percentage of MI adherent responses and improvements in PA and fruit consumption was found with respectively a small and medium effect size. The global rating "Spirit" (which resembles an all-at-once appraisal of the interviewer's MI competence) was significantly, but inversely associated with progress in vegetable intake with a medium effect size. CONCLUSION The finding that relatively lower MI competency was associated with higher vegetable consumption went against our expectations. Findings suggest that practicing MI-consistent skills was beneficial in promoting PA and fruit consumption, but moderated vegetable intake. This study contributes to the scientific confidence that TMI enables change in PA and fruit intake.
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Maasen K, Eussen SJPM, Dagnelie PC, Houben AJHM, Webers CAB, Schram MT, Berendschot TTJM, Stehouwer CDA, Opperhuizen A, van Greevenbroek MMJ, Schalkwijk CG. Habitual intake of dietary methylglyoxal is associated with less low-grade inflammation: the Maastricht Study. Am J Clin Nutr 2022; 116:1715-1728. [PMID: 36055771 PMCID: PMC9761753 DOI: 10.1093/ajcn/nqac195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 07/08/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Dicarbonyls are major reactive precursors of advanced glycation endproducts (AGEs). Dicarbonyls are formed endogenously and also during food processing. Circulating dicarbonyls and AGEs are associated with inflammation and microvascular complications of diabetes, but for dicarbonyls from the diet these associations are currently unknown. OBJECTIVES We sought to examine the associations of dietary dicarbonyl intake with low-grade inflammation and microvascular function. METHODS In 2792 participants (mean ± SD age: 60 ± 8 y; 50% men; 26% type 2 diabetes) of the population-based cohort the Maastricht Study, we estimated the habitual intake of the dicarbonyls methylglyoxal (MGO), glyoxal (GO), and 3-deoxyglucosone (3-DG) by linking FFQ outcome data to our food composition database of the MGO, GO, and 3-DG content of >200 foods. Low-grade inflammation was assessed as six plasma biomarkers, which were compiled in a z score. Microvascular function was assessed as four plasma biomarkers, compiled in a zscore; as diameters and flicker light-induced dilation in retinal microvessels; as heat-induced skin hyperemic response; and as urinary albumin excretion. Cross-sectional associations of dietary dicarbonyls with low-grade inflammation and microvascular function were investigated using linear regression with adjustments for age, sex, potential confounders related to cardiometabolic risk factors, and lifestyle and dietary factors. RESULTS Fully adjusted analyses revealed that higher intake of MGO was associated with a lower z score for inflammation [standardized β coefficient (STD β): -0.05; 95% CI: -0.09 to -0.01, with strongest inverse associations for hsCRP and TNF-α: both -0.05; -0.10 to -0.01]. In contrast, higher dietary MGO intake was associated with impaired retinal venular dilation after full adjustment (STD β: -0.07; 95% CI: -0.12 to -0.01), but not with the other features of microvascular function. GO and 3-DG intakes were not consistently associated with any of the outcomes. CONCLUSION Higher habitual intake of MGO was associated with less low-grade inflammation. This novel, presumably beneficial, association is the first observation of an association between MGO intake and health outcomes in humans and warrants further investigation.
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Affiliation(s)
- Kim Maasen
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Simone J P M Eussen
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute/CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Pieter C Dagnelie
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute/CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Alfons J H M Houben
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Carroll A B Webers
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Miranda T Schram
- Department of Internal Medicine, Heart and Vascular Center, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Tos T J M Berendschot
- University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Antoon Opperhuizen
- Department of Pharmacology and Toxicology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
- Office for Risk Assessment and Research, Netherlands Food and Consumer Product Safety Authority, Utrecht, The Netherlands
| | - Marleen M J van Greevenbroek
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Casper G Schalkwijk
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
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Tønning LU, Mechlenburg I, Christiansen DH, Andersen NBV, Stabel HH, Pedersen AR, Nielsen JF, Grimm B, Næss-Schmidt E. Disability and physical activity in people with chronic disease receiving physiotherapy. A prospective cohort study. Front Sports Act Living 2022; 4:1006422. [PMID: 36213452 PMCID: PMC9537493 DOI: 10.3389/fspor.2022.1006422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/30/2022] [Indexed: 11/25/2022] Open
Abstract
Chronic disease affects patients' disability and participation in activities of daily living. Longitudinal information on disability and physical activity is generally scarce in patients with chronic disease. The current study aimed to investigate if self-reported disability and physical activity changed in patients with chronic disease receiving physiotherapy. Furthermore, the aim was to assess if an improvement in self-reported disability was related to an increase in objectively measured physical activity and if an aggravation in self-reported disability was related to a decrease in physical activity. Seventy patients with either multiple sclerosis, Parkinson's disease, rheumatoid arthritis or stroke receiving free of charge physiotherapy were tested at baseline and 1 year later. Disability was measured with the self-reported modified Ranking Scale-9 Questionnaire and physical activity was objectively measured using tri-axial accelerometry. Neither self-reported disability nor physical activity changed among patients receiving 1 year of free of charge physiotherapy at group level. Furthermore, self-reported change of disability was not expressed with changes in objectively measured physical activity, indicating that the two measures represent two different constructs.
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Affiliation(s)
- Lisa U. Tønning
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- *Correspondence: Lisa U. Tønning
| | - Inger Mechlenburg
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - David H. Christiansen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, Herning, Denmark
| | - Nils-Bo V. Andersen
- Primary Health Care and Quality Improvement, Central Denmark Region, Viborg, Denmark
| | - Henriette H. Stabel
- Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark
| | - Asger R. Pedersen
- Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark
| | - Jørgen F. Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark
| | - Bernd Grimm
- Luxembourg Institute of Health, Human Motion, Orthopaedics, Sports Medicine, Digital Methods (HOSD) Platform, Strassen, Luxembourg
| | - Erhard Næss-Schmidt
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark
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21
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VandeBunte A, Gontrum E, Goldberger L, Fonseca C, Djukic N, You M, Kramer JH, Casaletto KB. Physical activity measurement in older adults: Wearables versus self-report. Front Digit Health 2022; 4:869790. [PMID: 36120711 PMCID: PMC9470756 DOI: 10.3389/fdgth.2022.869790] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 08/08/2022] [Indexed: 02/02/2023] Open
Abstract
Physical activity (PA) is associated with preserved age-related body and brain health. However, PA quantification can vary. Commercial-grade wearable monitors are objective, low burden tools to capture PA but are less well validated in older adults. Self-report PA questionnaires are widely accepted and more frequently used but carry inherent limitations. We aimed to compare these commonly used PA measures against one another and examine their convergent validity with a host of relevant outcomes. We also examined the factors that drive differences in PA self-reporting styles in older adults. 179 older adults completed 30-day Fitbit Flex2™ monitoring and reported PA levels via two widely used PA questionnaires: PASE and CHAMPS-METs (metabolic expenditure calories burned). Participants also completed measures of cardiometabolic (hypertension diagnosis, resting heart rate, A1C levels), cognitive (memory, processing speed, executive functioning), and brain MRI (medial temporal lobe volume) outcomes. The discrepancy between objective Fitbit monitoring and self-reported PA was evaluated using a sample-based z difference score. There were only modest relationships across all PA metrics. Fitbit step count demonstrated a stronger association with the PASE, whereas Fitbit calories burned was more strongly associated with CHAMPS-MET. Fitbit outcomes had more consistent convergence with relevant outcomes of interest (e.g., cardiometabolic and brain health indices) when compared to subjective measures; however, considerable heterogeneity within these associations was observed. A higher degree of overreporting was associated with worse memory and executive performances, as well as hypertension diagnoses. We build on prior findings that wearable, digital health indicators of PA demonstrate greater construct validity than self-report in older adults. We further show important clinical features (e.g., poorer cognitive status) of older adults that could contribute to a higher level of overreporting on self-report measures. Characterization of what PA measures truly operationalize will help elucidate relationships between most relevant facets of PA and outcomes of interest.
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Affiliation(s)
- Anna VandeBunte
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychology, Palo Alto University, Palo Alto, CA, United States
| | - Eva Gontrum
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Lauren Goldberger
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Corrina Fonseca
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Nina Djukic
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Michelle You
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Joel H. Kramer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Kaitlin B. Casaletto
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
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22
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Teh R, Barnett D, Edlin R, Kerse N, Waters DL, Hale L, Tay E, Leilua E, Pillai A. Effectiveness of a complex intervention of group-based nutrition and physical activity to prevent frailty in pre-frail older adults (SUPER): a randomised controlled trial. THE LANCET. HEALTHY LONGEVITY 2022; 3:e519-e530. [PMID: 36102762 DOI: 10.1016/s2666-7568(22)00124-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/11/2022] [Accepted: 05/16/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The increasing prevalence of frailty with age is becoming a public health priority in countries with ageing populations. Pre-frailty presents a window of opportunity to prevent the development of frailty in community-dwelling older adults. This study aimed to examine the effectiveness of a complex intervention that combined a nutrition-based intervention and a physical activity intervention, along with the effectiveness of each intervention individually, to reduce physical frailty in pre-frail older adults over 2 years. METHODS In this single-blind, 2 x 2 factorial, randomised, controlled trial, we recruited pre-frail community-dwelling older adults in Aotearoa New Zealand via mail through general medical practices. To be eligible, participants had to be pre-frail according to self-reported FRAIL scores of 1 or 2, aged 75 years or older (or 60 years or older for Māori and Pacific Peoples), not terminally ill or with advanced dementia as judged by a general practitioner, able to stand, medically safe to participate in low-intensity exercise, and able to use kitchen utensils safely. Participants were randomly allocated to receive an 8-week Senior Chef programme (SC group), a 10-week Steady As You Go programme (SAYGO group), a 10-week combined SC and SAYGO intervention (combined group), or a 10-week social programme (control group), using computer-generated block randomisation administered through an electronic data capture system by local study coordinators. Assessors were masked to group allocation for all assessments. SC is a group-based nutrition education and cooking class programme (3 h weekly), SAYGO is a group-based strength and balance exercise programme (1 h weekly), and the social control programme was a seated, group socialising activity (once a week). Masked assessors ascertained Fried frailty scores at baseline, end of intervention, and at 6, 12, and 24 months after the programme. The primary outcome was change in Fried frailty score at 2 years. Intention-to-treat analyses were completed for all randomised participants, and all participants who had a high (≥75%) adherence were analysed per protocol. This study is registered at ANZCTR, ACTRN12614000827639. FINDINGS Between May 12, 2016 and April 9, 2018, we assessed 2678 older adults for eligibility, of whom 468 (17%) consented and completed baseline assessment, with a mean age of 80·3 years (SD 5·1) and a mean Fried score of 1·9 (1·2); 59% were women. We randomly allocated these participants into the four groups: 117 in the SC group, 118 in the SAYGO group, 118 in the combined group, and 115 in the control group; 318 participants attended the 24-month follow-up: 89 in the SC group, 78 in the SAYGO group, 73 in the combined group, and 78 in the control group. At the 24-month follow-up, there were no differences in mean Fried scores between the intervention groups and the control group. No adverse events were reported. INTERPRETATION The study did not find that the combined SC and SAYGO programme was effective in reducing frailty in pre-frail older adults. Although some short-term benefits were observed in each individual programme, there was no clear evidence of long-term impact. Further research is needed to evaluate combinations of group-based programmes for community-dwelling older adults to optimise their physical function. FUNDING Health Research Council New Zealand and Ageing Well Challenge (Ministry of Business Innovation and Employment).
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Affiliation(s)
- Ruth Teh
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand.
| | - Daniel Barnett
- Department of Statistics, University of Auckland, Auckland, New Zealand
| | - Richard Edlin
- Department of Health Systems, University of Auckland, Auckland, New Zealand
| | - Ngaire Kerse
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Debra L Waters
- Department of Medicine, University of Otago, Otago, New Zealand; School of Physiotherapy, University of Otago, Otago, New Zealand
| | - Leigh Hale
- School of Physiotherapy, University of Otago, Otago, New Zealand
| | - Esther Tay
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Evelingi Leilua
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Avinesh Pillai
- Department of Statistics, University of Auckland, Auckland, New Zealand
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Questionnaires measuring movement behaviours in adults and older adults: Content description and measurement properties. A systematic review. PLoS One 2022; 17:e0265100. [PMID: 35275936 PMCID: PMC8916622 DOI: 10.1371/journal.pone.0265100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/22/2022] [Indexed: 01/14/2023] Open
Abstract
Background Sleep, sedentary behaviour and physical activity are constituent parts of a 24h period and there are several questionnaires to measure these movement behaviours, the objective was to systematically review the literature on content and measurement properties of self- and proxy-reported questionnaires measuring movement behaviours in adults and older adults. Methods The databases PubMed, CINAHL, PsycINFO and SPORTDiscus were systematically searched until April 2021. Articles were included if: the questionnaires were design for adults and older adults; the sample size for validity studies had at least 50 participants; at least, both validity and test-retest reliability results of questionnaire that were developed specifically to measure the amount of sleep, sedentary behaviour or physical activity, or their combination were reported; and articles had to be written in English, Spanish, French, Portuguese, German, Italian or Chinese. Findings and conclusions Data extraction, results, studies’ quality, and risk of bias were evaluated using the Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Fifty-five articles were included in this review, describing 60 questionnaires. None of the questionnaires showed adequate criterion validity and adequate reliability, simultaneously; 68.3% showed adequate content validity. The risk of bias for criterion validity and reliability were very low in 72.2% and 23.6% of the studies, respectively. Existing questionnaires have insufficient measurement properties and frequent methodologic limitations, and none was developed considering the 24h movement behaviour paradigm. The lack of valid and reliable questionnaires assessing 24h movement behaviours in an integrated way, precludes accurate monitoring and surveillance systems of 24h movement behaviours.
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Kurita S, Doi T, Tsutsumimoto K, Nakakubo S, Ishii H, Shimada H. Development of a Questionnaire to Evaluate Older Adults' Total Sedentary Time and Sedentary Time With Cognitive Activity. J Geriatr Psychiatry Neurol 2022; 35:392-399. [PMID: 33840291 PMCID: PMC9003769 DOI: 10.1177/08919887211006468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to develop a questionnaire for evaluating total sedentary time (ST) and ST with cognitive activity, and to examine the association between ST and cognitive function among Japanese older adults. The questionnaire to evaluate ST comprised 12 items regarding behavior in specific settings, including 8 items on ST with cognitive activity, in a usual week. Older adults aged ≥75 years who participated in a health check-up assessing cognitive function completed the developed questionnaire and subsequently wore an accelerometer and recorded a diary of ST with cognitive activity for a week as validity measures. Cognitive function was assessed with neuropsychological tests covering 4 domains: memory, attention, executive function, and processing speed. Fifty-two participants were included in the validity analysis. Spearman's correlation coefficient indicated fair-to-good agreement between the questionnaire-measured and the diary-measured time for ST with cognitive activity (r = 0.59, p < 0.001), but this was not the case for total ST. Bland-Altman plots showed that the questionnaire-measured total ST contained proportional bias (r = 0.51, p < 0.001). Multiple regression analysis (n = 49) showed longer questionnaire-measured ST with cognitive activity was significantly associated with better neuropsychological test scores (attention: β = -0.38, p = 0.025; executive function: β = -0.46, p = 0.003; and processing speed: β = 0.31, p = 0.041), while total ST was not associated with better cognitive performance. The developed questionnaire showed acceptable validity to measure ST with cognitive activity, which was found to be protectively associated with cognitive function.
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Affiliation(s)
- Satoshi Kurita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan,Satoshi Kurita, Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi Prefecture, 474-8511, Japan.
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Sho Nakakubo
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Hideaki Ishii
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Japan
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The Evaluation of Biomarkers of Physical Activity on Stress Resistance and Wellness. Appl Psychophysiol Biofeedback 2022; 47:121-129. [PMID: 35296973 PMCID: PMC9098580 DOI: 10.1007/s10484-022-09538-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 12/02/2022]
Abstract
Physical activity can improve health as well as reduce stress and the risk of developing several widespread diseases. However, there exists no accepted standard biomedical examination-method for stress evaluation. The purpose of this study was to investigate the effect of regular physical activity on stress and wellness as well as the evaluation of potential biomarkers in this field. This study included 105 people (mean age = 36.57 ± 1.4 years) who were randomly assigned into the exercise group 1 (EG-1) (n = 41), the exercise group 2 (EG-2) (n = 30), and the control group (CG) (n = 34). Measurements of stress and wellness were obtained by Multiscan BC-OXI before and after experimental period. This device presents a multifrequency segmental body composition 3D analyser with digital pulse oximeter. The key indicators of stress as well as for wellness were significantly improved in the EG-1. Parasympathetic activity showed significant changes as potential stress biomarker. Statistically significant gender differences were not observed in the comparable groups. The results suggest that the stress resistance and well-being significantly improved in the EG-1 due to regular physical activity. However, further research is necessary to determine effects of physical activity on integral health indicators.
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Lim SER, Meredith S, Agnew S, Clift E, Ibrahim K, Roberts H. Evaluating the feasibility and acceptability of virtual group exercise for older adults delivered by trained volunteers: the ImPACt study protocol. BMJ Open 2022; 12:e052631. [PMID: 35105576 PMCID: PMC8808406 DOI: 10.1136/bmjopen-2021-052631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Physical activity is important for healthy ageing. Despite strong evidence on the benefits of physical activity for health and well-being, physical inactivity remains a significant problem among older adults. This study aims to determine the feasibility and acceptability of implementing an online volunteer-led group exercise for older adults. METHODS A quasi-experimental mixed-methods approach will be used in this study. A training programme will be developed to train volunteers to deliver online group exercises to older adults aged >65 years (n=30). The primary outcome is the feasibility of implementing the intervention. This will be assessed by the number of volunteers recruited, trained, and retained at the end of the study, and the number of exercise sessions delivered and completed by participants. Secondary outcomes include physical activity levels measured using the Community Health Model Activities Programme for Seniors questionnaire, Barthel Index, EQ-5D-5L as a measure of health-related quality of life, SARC-F to determine sarcopenia status, and PRIMSA-7 to determine frailty status. Outcomes will be measured at baseline and at 6 months.Qualitative interviews will be conducted with volunteers(n=5), older adults (n=10) and family members (n=5) to explore their views on the intervention. ANALYSIS Simple descriptive statistics will be used to describe participant characteristics, the feasibility of the study and the impact of the intervention on health outcomes. Parametric(t-test) or non-parametric(Mann-Whitney U test) statistics will be used to analyse continuous variables. χ2 test will be used for categorical variables. Qualitative data will be analysed using an inductive thematic analysis approach. ETHICS AND DISSEMINATION This study received ethical approval from the University of Southampton Faculty of Medicine Ethics Committee and Research Integrity and Governance committee (ID: 52 967 .A1). Study findings will be made available to service users, voluntary organisations and other researchers who may be interested in implementing the intervention. TRIAL REGISTRATION NUMBER NCT04672200.
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Affiliation(s)
- Stephen Eu Ruen Lim
- Academic Geriatric Medicine, University of Southampton, Southampton, UK
- NIHR Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
| | - Samantha Meredith
- Academic Geriatric Medicine, University of Southampton, Southampton, UK
- NIHR Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
| | | | - Esther Clift
- Southern Health NHS Foundation Trust, Southampton, UK
| | - Kinda Ibrahim
- Academic Geriatric Medicine, University of Southampton, Southampton, UK
- NIHR Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
| | - Helen Roberts
- Academic Geriatric Medicine, University of Southampton, Southampton, UK
- NIHR Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
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Maasen K, Eussen SJPM, Scheijen JLJM, van der Kallen CJH, Dagnelie PC, Opperhuizen A, Stehouwer CDA, van Greevenbroek MMJ, Schalkwijk CG. Higher habitual intake of dietary dicarbonyls is associated with higher corresponding plasma dicarbonyl concentrations and skin autofluorescence: the Maastricht Study. Am J Clin Nutr 2022; 115:34-44. [PMID: 34625788 DOI: 10.1093/ajcn/nqab329] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 09/27/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Dicarbonyls are highly reactive compounds and major precursors of advanced glycation end products (AGEs). Both dicarbonyls and AGEs are associated with development of age-related diseases. Dicarbonyls are formed endogenously but also during food processing. To what extent dicarbonyls from the diet contribute to circulating dicarbonyls and AGEs in tissues is unknown. OBJECTIVES To examine cross-sectional associations of dietary dicarbonyl intake with plasma dicarbonyl concentrations and skin AGEs. METHODS In 2566 individuals of the population-based Maastricht Study (age: 60 ± 8 y, 50% males, 26% with type 2 diabetes), we estimated habitual intake of the dicarbonyls methylglyoxal (MGO), glyoxal (GO), and 3-deoxyglucosone (3-DG) by combining FFQs with our dietary dicarbonyl database of MGO, GO, and 3-DG concentrations in > 200 commonly consumed food products. Fasting plasma concentrations of MGO, GO, and 3-DG were measured by ultra-performance liquid chromatography-tandem mass spectrometry. Skin AGEs were measured as skin autofluorescence (SAF), using the AGE Reader. Associations of dietary dicarbonyl intake with their respective plasma concentrations and SAF (all standardized) were examined using linear regression models, adjusted for age, sex, potential confounders related to cardiometabolic risk factors, and lifestyle. RESULTS Median intake of MGO, GO, and 3-DG was 3.6, 3.5, and 17 mg/d, respectively. Coffee was the main dietary source of MGO, whereas this was bread for GO and 3-DG. In the fully adjusted models, dietary MGO was associated with plasma MGO (β: 0.08; 95% CI: 0.02, 0.13) and SAF (β: 0.12; 95% CI: 0.07, 0.17). Dietary GO was associated with plasma GO (β: 0.10; 95% CI: 0.04, 0.16) but not with SAF. 3-DG was not significantly associated with either plasma 3-DG or SAF. CONCLUSIONS Higher habitual intake of dietary MGO and GO, but not 3-DG, was associated with higher corresponding plasma concentrations. Higher intake of MGO was also associated with higher SAF. These results suggest dietary absorption of MGO and GO. Biological implications of dietary absorption of MGO and GO need to be determined. The study has been approved by the institutional medical ethical committee (NL31329.068.10) and the Minister of Health, Welfare and Sports of the Netherlands (Permit 131088-105234-PG).
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Affiliation(s)
- Kim Maasen
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Simone J P M Eussen
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute/CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jean L J M Scheijen
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Carla J H van der Kallen
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Pieter C Dagnelie
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute/CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Antoon Opperhuizen
- Department of Pharmacology and Toxicology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands.,Office for Risk Assessment and Research, Netherlands Food and Consumer Product Safety Authority, Utrecht, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marleen M J van Greevenbroek
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Casper G Schalkwijk
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, The Netherlands
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28
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Tough D, Dunning J, Robinson J, Dixon J, Ferguson J, Paul I, Harrison SL. Investigating balance, gait, and physical function in people who have undergone thoracic surgery for a diagnosis of lung cancer: A mixed-methods study. Chron Respir Dis 2021; 18:14799731211052299. [PMID: 34715760 PMCID: PMC8558594 DOI: 10.1177/14799731211052299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objectives Symptoms associated with lung cancer and thoracic surgery might increase fall risk. We aimed to investigate: 1) balance, gait and functional status in people post-thoracic surgery compared to healthy controls; 2) perceptions of balance, gait and functional status. Methods Recruitment targeted older adults (≥50 years) who had undergone thoracic surgery for a diagnosis of lung cancer in the previous 3 months, and healthy age-matched controls. Dynamic and static balance, gait velocity, knee-extension strength and physical activity levels were assessed using the BESTest, Kistler force plate, GAITRite system, Biodex System 3 and CHAMPS questionnaire, respectively. Two-part semi-structured interviews were conducted post-surgery. Results Individuals post-surgery (n = 15) had worse dynamic balance and gait, and lower levels of moderate/vigorous physical activity (MVPA) (all p<0.05) versus healthy controls (n = 15). Strength did not differ between groups (p > 0.05). No associations between BESTest and strength or physical activity existed post-surgery (p > 0.05). Three themes were identified: 1) Symptoms affect daily activities; 2) Functional assessments alter perceptions of balance ability and 3) Open to supervised rehabilitation. Conclusion Balance, gait and MVPA are impaired post-thoracic surgery, yet balance was not viewed to be important in enabling activities of daily living. However, supervised rehabilitation was considered acceptable.
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Affiliation(s)
- Daniel Tough
- School of Health and Life Sciences, 5462Teesside University, Middlesbrough, UK
| | - Joel Dunning
- Department of Cardiothoracic Surgery, 156705James Cook University Hospital, Middlesbrough, UK
| | - Jonathan Robinson
- School of Health and Life Sciences, 5462Teesside University, Middlesbrough, UK
| | - John Dixon
- School of Health and Life Sciences, 5462Teesside University, Middlesbrough, UK
| | - Jonathan Ferguson
- Department of Cardiothoracic Surgery, 156705James Cook University Hospital, Middlesbrough, UK
| | - Ian Paul
- Department of Cardiothoracic Surgery, 156705James Cook University Hospital, Middlesbrough, UK
| | - Samantha L Harrison
- School of Health and Life Sciences, 5462Teesside University, Middlesbrough, UK
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Community-Dwelling Older Adults and Physical Activity Recommendations: Patterns of Aerobic, Strengthening, and Balance Activities. J Aging Phys Act 2021; 30:653-665. [PMID: 34653962 DOI: 10.1123/japa.2021-0194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/18/2022]
Abstract
Though it is known that most older adults do not meet the recommended physical activity (PA) guidelines, little is known regarding their participation in balance activities or the full guidelines. Therefore, we sought to describe PA patterns among 1,352 community-dwelling older adult participants of the Adult Changes in Thought study, a longitudinal cohort study exploring dementia-related risk factors. We used a modified version of the Community Healthy Activities Model Program for Seniors questionnaire to explore PA performed and classify participants as meeting or not meeting the full guidelines or any component of the guidelines. Logistic regression was used to identify factors associated with meeting PA guidelines. Despite performing 10 hr of weekly PA, only 11% of participants met the full guidelines. Older age, greater body mass index, needing assistance with instrumental daily activities, and heart disease were associated with decreased odds of meeting PA guidelines. These results can guide interventions that address PA among older adults.
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King AC, Campero MI, Garcia D, Blanco-Velazquez I, Banchoff A, Fierros F, Escobar M, Cortes AL, Sheats JL, Hua J, Chazaro A, Done M, Espinosa PR, Vuong D, Ahn DK. Testing the effectiveness of community-engaged citizen science to promote physical activity, foster healthier neighborhood environments, and advance health equity in vulnerable communities: The Steps for Change randomized controlled trial design and methods. Contemp Clin Trials 2021; 108:106526. [PMID: 34371162 PMCID: PMC8453124 DOI: 10.1016/j.cct.2021.106526] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 12/18/2022]
Abstract
While low-income midlife and older adults are disproportionately affected by non-communicable diseases that can be alleviated by regular physical activity, few physical activity programs have been developed specifically with their needs in mind. Those programs that are available typically do not address the recognized local environmental factors that can impact physical activity. The specific aim of the Steps for Change cluster-randomized controlled trial is to compare systematically the initial (one-year) and sustained (two-year) multi-level impacts of an evidence-based person-level physical activity intervention (Active Living Every Day [ALED] and age-relevant health education information), versus the ALED program in combination with a novel neighborhood-level citizen science intervention called Our Voice. The study sample (N = 300) consists of insufficiently active adults ages 40 years and over living in or around affordable senior public housing settings. Major study assessments occur at baseline, 12, and 24 months. The primary outcome is 12-month change in walking, and secondary outcomes include other forms of physical activity, assessed via validated self-report measures supported by accelerometry, and physical function and well-being variables. Additional intervention impacts are assessed at 24 months. Potential mediators and moderators of intervention success will be explored to better determine which subgroups do best with which type of intervention. Here we present the study design and methods, including recruitment strategies and yields. TRIAL REGISTRATION: clinicaltrial.gov Identifier = NCT03041415.
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Affiliation(s)
- Abby C King
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA 94305, United States of America; Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Maria I Campero
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Dulce Garcia
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Isela Blanco-Velazquez
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Ann Banchoff
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Fernando Fierros
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Michele Escobar
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Ana L Cortes
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Jylana L Sheats
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Jenna Hua
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Aldo Chazaro
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Monica Done
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America
| | - Patricia Rodriguez Espinosa
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA 94305, United States of America; Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Daniel Vuong
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - David K Ahn
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
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31
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Pragmatic Evaluation of Older Adults' Physical Activity in Scale-Up Studies: Is the Single-Item Measure a Reasonable Option? J Aging Phys Act 2021; 30:25-32. [PMID: 34348228 DOI: 10.1123/japa.2020-0412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/18/2020] [Accepted: 02/01/2021] [Indexed: 11/18/2022]
Abstract
Convergent validity and responsiveness to change of the single-item physical activity measure were assessed in adults aged 60 years and older, at baseline (n = 205) and 6 months (n = 177) of a health promotion program, Choose to Move. Spearman correlations were used to examine associations between physical activity as measured by the single-item measure and the Community Health Activities Model Program for Seniors (CHAMPS) questionnaire at baseline and for 6-month change in all participants and for sex and age (60-74 years, and ≥75 years) subgroups. Effect size assessed responsiveness to change in physical activity for both tools. Baseline physical activity by the single-item measure correlated moderately with physical activity by the CHAMPS questionnaire in all participants and subgroups. Correlations were weaker for change in physical activity. Effect size for physical activity change was larger for the single-item measure than for the CHAMPS questionnaire. The single-item measure is a valid, pragmatic tool for use in intervention and scale-up studies with older adults.
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32
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Fanning J, Brooks AK, Hsieh KL, Kershner K, Furlipa J, Nicklas BJ, Rejeski WJ. Building on Lessons Learned in a Mobile Intervention to Reduce Pain and Improve Health (MORPH): Protocol for the MORPH-II Trial. JMIR Res Protoc 2021; 10:e29013. [PMID: 34279241 PMCID: PMC8329761 DOI: 10.2196/29013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Engaging in sufficient levels of physical activity, guarding against sustained sitting, and maintaining a healthy body weight represent important lifestyle strategies for managing older adults' chronic pain. Our first Mobile Health Intervention to Reduce Pain and Improve Health (MORPH) randomized pilot study demonstrated that a partially remote group-mediated diet and daylong activity intervention (ie, a focus on moving often throughout the day) can lead to improved physical function, weight loss, less pain intensity, and fewer minutes of sedentary time. We also identified unique delivery challenges that limited the program's scalability and potential efficacy. OBJECTIVE The purpose of the MORPH-II randomized pilot study is to refine the MORPH intervention package based on feedback from MORPH and evaluate the feasibility, acceptability, and preliminary efficacy of this revised package prior to conducting a larger clinical trial. METHODS The MORPH-II study is an iteration on MORPH designed to pilot a refined framework, enhance scalability through fully remote delivery, and increase uptake of the daylong movement protocol through revised education content and additional personalized remote coaching. Older, obese, and low-active adults with chronic multisite pain (n=30) will be randomly assigned to receive a 12-week remote group-mediated physical activity and dietary weight loss intervention followed by a 12-week maintenance period or a control condition. Those in the intervention condition will partake in weekly social cognitive theory-based group meetings via teleconference software plus one-on-one support calls on a tapered schedule. They will also engage with a tablet application paired with a wearable activity monitor and smart scale designed to provide ongoing social and behavioral support throughout the week. Those in the control group will receive only the self-monitoring tools. RESULTS Recruitment is ongoing as of January 2021. CONCLUSIONS Findings from MORPH-II will help guide other researchers working to intervene on sedentary behavior through frequent movement in older adults with chronic pain. TRIAL REGISTRATION ClinicalTrials.gov NCT04655001; https://clinicaltrials.gov/ct2/show/NCT04655001. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/29013.
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Affiliation(s)
- Jason Fanning
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States
| | - Amber K Brooks
- Wake Forest School of Medicine, Winston-Salem, NC, United States
| | | | - Kyle Kershner
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States
| | - Joy Furlipa
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States
| | | | - W Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States
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33
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Falck RS, Davis JC, Best JR, Chan PCY, Li LC, Wyrough AB, Bennett KJ, Backhouse D, Liu-Ambrose T. Effect of a Multimodal Lifestyle Intervention on Sleep and Cognitive Function in Older Adults with Probable Mild Cognitive Impairment and Poor Sleep: A Randomized Clinical Trial. J Alzheimers Dis 2021; 76:179-193. [PMID: 32444553 DOI: 10.3233/jad-200383] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Poor sleep is common among older adults with mild cognitive impairment (MCI) and may contribute to further cognitive decline. Whether multimodal lifestyle intervention that combines bright light therapy (BLT), physical activity (PA), and good sleep hygiene can improve sleep in older adults with MCI and poor sleep is unknown. OBJECTIVE To assess the effect of a multimodal lifestyle intervention on sleep in older adults with probable MCI and poor sleep. METHODS This was a 24-week proof-of-concept randomized trial of 96 community-dwelling older adults aged 65-85 years with probable MCI (<26/30 on the Montreal Cognitive Assessment) and poor sleep (>5 on the Pittsburgh Sleep Quality Index [PSQI]). Participants were allocated to either a multimodal lifestyle intervention (INT); or 2) education + attentional control (CON). INT participants received four once-weekly general sleep hygiene education classes, followed by 20-weeks of: 1) individually-timed BLT; and 2) individually-tailored PA promotion. Our primary outcome was sleep efficiency measured using the MotionWatch8© (MW8). Secondary outcomes were MW8-measured sleep duration, fragmentation index, wake-after-sleep-onset, latency, and PSQI-measured subjective sleep quality. RESULTS There were no significant between-group differences in MW8 measured sleep efficiency at 24-weeks (estimated mean difference [INT -CON]: 1.18%; 95% CI [-0.99, 3.34]), or any other objective-estimate of sleep. However, INT participants reported significantly better subjective sleep quality at 24-weeks (estimated mean difference: -1.39; 95% CI [-2.72, -0.06]) compared to CON. CONCLUSION Among individuals with probable MCI and poor sleep, a multimodal lifestyle intervention improves subjective sleep quality, but not objectively estimated sleep.
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Affiliation(s)
- Ryan S Falck
- Aging, Mobility, and Cognitive Neuroscience Lab, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute. University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer C Davis
- Faculty of Management, University of British Columbia-Okanagan Campus, Kelowna, British Columbia, Canada
| | - John R Best
- Aging, Mobility, and Cognitive Neuroscience Lab, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute. University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Patrick C Y Chan
- Aging, Mobility, and Cognitive Neuroscience Lab, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute. University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Linda C Li
- Arthritis Research Canada, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anne B Wyrough
- Aging, Mobility, and Cognitive Neuroscience Lab, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute. University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kimberly J Bennett
- Aging, Mobility, and Cognitive Neuroscience Lab, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute. University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Daniel Backhouse
- Aging, Mobility, and Cognitive Neuroscience Lab, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute. University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Lab, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute. University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
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34
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Validation of an Adapted Questionnaire for Outdoor Walking Among Older Adults: The CHAMPS-OUTDOORS. J Aging Phys Act 2021; 29:843-851. [PMID: 33831840 DOI: 10.1123/japa.2020-0350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/22/2020] [Accepted: 11/26/2020] [Indexed: 11/18/2022]
Abstract
The aim of this study was to examine the construct and known-groups validity of the total score of five items adapted from the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire to measure outdoor walking (CHAMPS-OUTDOORS) in older adults. Data from the baseline assessment of the Getting Older Adult OUTdoors (GO-OUT) trial were used. Construct validity of the CHAMPS-OUTDOORS used objective measures of outdoor walking (accelerometry-GPS), Ambulatory Self-Confidence Questionnaire, RAND-36, 6-min walk test, 10-m walk test, and Mini-Balance Evaluation System Test. For known-groups validity, we compared the CHAMPS-OUTDOORS of those who walked < or ≥1.2 m/s. Sixty-five participants had an average age of 76.5 ± 7.8 years. The CHAMPS-OUTDOORS was moderately correlated with total outdoor walking time (r = .33) and outdoor steps (r = .33) per week measured by accelerometry-GPS, and weakly correlated with Mini-Balance Evaluation System Test score (r = .27). The CHAMPS-OUTDOORS did not distinguish known groups based on crosswalk speed (p = .33). The CHAMPS-OUTDOORS may be used to assess outdoor walking in the absence of accelerometry GPS. Further research examining reliability is needed.
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35
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Weaver AN, Jaeggi SM. Activity Engagement and Cognitive Performance Amongst Older Adults. Front Psychol 2021; 12:620867. [PMID: 33776844 PMCID: PMC7990770 DOI: 10.3389/fpsyg.2021.620867] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/17/2021] [Indexed: 12/30/2022] Open
Abstract
Research supporting cognitive reserve theory suggests that engaging in a variety of cognitive, social, and physical activities may serve as protective factors against age-related changes in mental functioning, especially if the activities are cognitively engaging. Individuals who participate in a variety of cognitive activities have been found to be more likely to maintain a higher level of cognitive functioning and be less likely to develop dementia. In this study, we explore the relationship between engaging in a variety of activities and cognitive performance amongst 206 healthy older adults between the ages of 65–85. Age and years of education were found to be the most significant predictors of a global composite representing cognitive performance, consistent with previous work linking these variables to age-related changes in cognition and the cognitive reserve. We interpret these results to suggest that age and education are better predictors of global cognitive performance in older adults than self-reported activity engagement.
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Affiliation(s)
- Alexandria N Weaver
- School of Education, University of California, Irvine, Irvine, CA, United States
| | - Susanne M Jaeggi
- School of Education, University of California, Irvine, Irvine, CA, United States
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36
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Current Evidence of Measurement Properties of Physical Activity Questionnaires for Older Adults: An Updated Systematic Review. Sports Med 2021; 50:1271-1315. [PMID: 32125670 PMCID: PMC7305082 DOI: 10.1007/s40279-020-01268-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Questionnaires provide valuable information about physical activity (PA) behaviors in older adults. Until now, no firm recommendations for the most qualified questionnaires for older adults have been provided. OBJECTIVES This review is an update of a previous systematic review, published in 2010, and aims to summarize, appraise and compare the measurement properties of all available self-administered questionnaires assessing PA in older adults. METHODS We included the articles evaluated in the previous review and conducted a new search in PubMed, Embase, and SPORTDiscus from September 2008 to December 2019, using the following inclusion criteria (1) the purpose of the study was to evaluate at least one measurement property (reliability, measurement error, hypothesis testing for construct validity, responsiveness) of a self-administered questionnaire; (2) the questionnaire intended to measure PA; (3) the questionnaire covered at least one domain of PA; (4) the study was performed in the general, healthy population of older adults; (5) the mean age of the study population was > 55 years; and (6) the article was published in English. Based on the Quality Assessment of Physical Activity Questionnaires (QAPAQ) checklist, we evaluated the quality and results of the studies. The content validity of all included questionnaires was also evaluated using the reviewers' rating. The quality of the body of evidence was evaluated for the overall construct of each questionnaire (e.g., total PA), moderate-to-vigorous physical activity (MVPA) and walking using a modified Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. RESULTS In total, 56 articles on 40 different questionnaires (14 from the previous review and 26 from the update) were included. Reliability was assessed for 22, measurement error for four and hypotheses testing for construct validity for 38 different questionnaires. Evidence for responsiveness was available for one questionnaire. For many questionnaires, only one measurement property was assessed in only a single study. Sufficient content validity was considered for 22 questionnaires. All questionnaires displayed large measurement errors. Only versions of two questionnaires showed both sufficient reliability and hypotheses testing for construct validity, namely the Physical Activity Scale for the Elderly (PASE; English version, Turkish version) for the assessment of total PA, and the Physical Activity and Sedentary Behavior Questionnaire (PASB-Q; English version) for the assessment of MVPA. The quality of evidence for these results ranged from very low to high. CONCLUSIONS Until more high-quality evidence is available, we recommend the PASE for measuring total PA and the PASB-Q for measuring MVPA in older adults. However, they are not equally qualified among different languages. Future studies on the most promising questionnaires should cover all relevant measurement properties. We recommend using and improving existing PA questionnaires-instead of developing new ones-and considering the strengths and weaknesses of each PA measurement instrument for a particular purpose.
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Tanaka R, Fujita K, Makimoto K, Yakushiji K, Tanaka S, Motomura G, Fujii M, Ikemura S, Nakashima Y. Development and evaluation of the sedentary behavior and light-intensity physical activity questionnaire. J Phys Ther Sci 2021; 33:125-131. [PMID: 33642686 PMCID: PMC7897535 DOI: 10.1589/jpts.33.125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 11/02/2020] [Indexed: 11/29/2022] Open
Abstract
[Purpose] To describe our newly developed Sedentary Behavior and Light-Intensity Physical Activity Questionnaire and examine its reliability and validity. [Participants and Methods] We identified and selected self-reported items through a literature review and interviews with 11 inactive individuals. Thirty-one individuals with lower limb prostheses and an expert panel assessed the content validity of the integrated items and identified 17 items. Patients who had undergone lower limb surgeries were regarded as inactive individuals, and 112 patients completed the questionnaire twice for test-retest reliability and wore an accelerometer for criterion validity. The ethics committee of Kyushu University approved this study (2019-126 and 2019-273). [Results] Item analysis was revised to the Sedentary Behavior and Light-Intensity Physical Activity Questionnaire-10 (six light-intensity physical activity and four sedentary behavior items) because of the floor effect. The test-retest correlation coefficient showed high reliability. Moderate to weak correlation coefficient was observed between the questionnaire and accelerometer (light-intensity physical activity: 0.43 and sedentary behavior: 0.20), and the Bland-Altman plots indicated no bias. [Conclusion] The Sedentary Behavior and Light-Intensity Physical Activity Questionnaire-10 had acceptable validity and reliability among inactive individuals and it could be used for studying light-intensity physical activity.
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Affiliation(s)
- Rumi Tanaka
- Department of Health Sciences, Graduate School of Medical
Sciences, Kyushu University: 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan
| | - Kimie Fujita
- Division of Health Sciences, Graduate School of Medicine,
Kyushu University, Japan
| | - Kiyoko Makimoto
- Department of Nursing, School of Nursing and
Rehabilitation, Konan Women’s University, Japan
| | - Kanako Yakushiji
- Division of Health Sciences, Graduate School of Medicine,
Kyushu University, Japan
| | - Satomi Tanaka
- Department of Health Sciences, Graduate School of Medical
Sciences, Kyushu University: 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan
| | - Goro Motomura
- Department of Orthopedic Surgery, Graduate School of
Medical Sciences, Kyushu University, Japan
| | - Masanori Fujii
- Department of Orthopedic Surgery, Graduate School of
Medical Sciences, Kyushu University, Japan
| | - Satoshi Ikemura
- Department of Orthopedic Surgery, Graduate School of
Medical Sciences, Kyushu University, Japan
| | - Yasuharu Nakashima
- Department of Orthopedic Surgery, Graduate School of
Medical Sciences, Kyushu University, Japan
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Seguin-Fowler RA, Grocke M, Graham ML, Tarabochia D, Sriram U, Eldridge GD. Effects of StrongPeople Strong Bodies on Functional Fitness: A Community-Based Randomized Trial. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2021. [DOI: 10.1249/tjx.0000000000000178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Validity of Tools to Measure Physical Activity in Older Adults Following Total Knee Arthroplasty. J Aging Phys Act 2020; 29:651-658. [PMID: 33378742 DOI: 10.1123/japa.2020-0240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/03/2020] [Accepted: 09/29/2020] [Indexed: 11/18/2022]
Abstract
Few validated tools exist for measuring physical activity following total knee arthroplasty (TKA) despite the importance of returning to sufficient levels of physical activity post-TKA to achieve health benefits. This study examined the validity of two clinical measures-the Fitbit, a commercially available personal activity monitor, and the Community Healthy Activities Model Program for Seniors (CHAMPS), a self-report questionnaire-compared with a reference standard accelerometer, the SenseWearTM Armband (SWA). At 6-month post-TKA, 47 participants wore the Fitbit and SWA for 4 days and then completed the CHAMPS. Moderate-to-good correlation was observed between the Fitbit and SWA for steps (intraclass correlation coefficient [ICC] = .79), energy expenditure (ICC = .78), and energy expenditure <3 METS (ICC = .79). Poor-to-moderate correlation was observed between the CHAMPS and SWA (ICC = .43) with the questionnaire reporting lower daily energy expenditures than the SWA. Results showed that Fitbit may be a reasonable measurement tool to measure steps and energy expenditures in older adults following TKA.
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Shi X, Wang Y, Huang X, Gao S, Wan Q, Shang S. Cross-Cultural Adaptation and Psychometric Evaluation of the Community Healthy Activities Model Program for Seniors Physical Activity Questionnaire in Chinese Older Adults. J Aging Phys Act 2020; 28:952-961. [PMID: 32702663 DOI: 10.1123/japa.2019-0464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 02/21/2020] [Accepted: 04/20/2020] [Indexed: 11/18/2022]
Abstract
The study's aims were to translate the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire to Chinese and examine its psychometric properties. Adapting it for use in China involved forward translation, synthesis, back translation, expert review, and pretesting. A convenience sample of 201 Chinese older adults completed the Chinese version (CHAMPS-C) to evaluate its construct validity index and associations with physiological, psychosocial, and energy expenditure measures. The construct validity index of the CHAMPS-C was 0.95, and it had fair to moderate associations with physiological and psychosocial measures, other scales of physical activity, and accelerometer measurements. Our structured, stepwise process of cross-cultural adaptation produced a scale (i.e., CHAMPS-C), with items equivalent in meaning to the English version, for use with Chinese older adults. The findings of this study indicate that the CHAMPS-C has acceptable reliability and validity to assess the physical activity of older Chinese adults.
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Yeh GY, Litrownik D, Wayne PM, Beach D, Klings ES, Reyes Nieva H, Pinheiro A, Davis RB, Moy ML. BEAM study (Breathing, Education, Awareness, Movement): a randomised controlled feasibility trial of tai chi exercise in patients with COPD. BMJ Open Respir Res 2020; 7:7/1/e000697. [PMID: 33219007 PMCID: PMC7682460 DOI: 10.1136/bmjresp-2020-000697] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 10/20/2020] [Accepted: 10/28/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Despite therapeutic advances, the management of chronic obstructive pulmonary disease (COPD) remains complex. There is growing interest in multidimensional, mind-body exercises to improve both physical and psychosocial aspects of COPD burden. Few US data are available in this population on tai chi (TC) a mind-body exercise incorporating physical activity, breathing and mindful awareness. We explored feasibility and preliminary efficacy of TC in COPD in an US academic medical setting. METHODS Patients with COPD Global Obstructive Lung Disease (GOLD) stages 2-4 were randomised to a 12-week TC programme or education control. At 12 weeks, those in TC were randomised again to continue in maintenance classes or not to further explore optimal duration. All groups were followed to 24 weeks. Feasibility/safety parameters were analysed descriptively. Preliminary between-group differences were estimated in symptoms (dyspnoea, fatigue), health-related quality-of-life (Chronic Respiratory Questionnaire CRQ), cognitive-emotional measures (mood, COPD self-efficacy) and functional status (6 min walk test, lower body strength, flexibility, physical activity). RESULTS Ninety-two subjects were randomised (N=61 TC, N=31 education). Mean age was 68±8 years, 66% male, mean forced expiratory volume in 1 s % predicted 57±13, 28% were GOLD stage 3-4. Overall retention was 85%. Nineteen adverse events occurred, most being study-unrelated COPD exacerbations. From baseline to 12 weeks, there were between-group improvements favouring TC, in CRQ-total (Cohen's d effect size (ES)=0.46; adj mean diff (AMD)=0.31), CRQ-emotion (ES=0.54; AMD=0.49), Centre for Epidemiologic Studies Depression (ES=-0.37; AMD=2.39) and Patient-Reported Outcome Measurement Information System (PROMIS)-fatigue (ES=-0.34; AMD=-0.17). From baseline to 24 weeks, there was an improvement favouring TC in CRQ-dyspnoea (ES=0.41; AMD=0.46). Among TC participants, there was a positive effect of maintenance classes on self-efficacy (ES=-0.69; AMD=-0.40), 6 min walk (ES=0.56; AMD=49.26 feet), PROMIS-fatigue (ES=-0.41; AMD=-0.28) and chair stand (0.43; AMD=0.56). CONCLUSION TC in patients with COPD is feasible and safe. Preliminary analyses support a potential modest role in improving quality-of-life, cognitive-emotional health and function that should be further studied. TRIAL REGISTRATION NUMBER NCT01551953. IRB REFERENCE BIDMC 2010P-000412; VA 2540.
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Affiliation(s)
- Gloria Y Yeh
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA .,Osher Center for Integrative Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel Litrownik
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Peter M Wayne
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Douglas Beach
- Division of Pulmonary and Critical Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Elizabeth S Klings
- Pulmonary and Critical Care Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | | | - Adlin Pinheiro
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Roger B Davis
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Marilyn L Moy
- Harvard Medical School, Boston, Massachusetts, USA.,Pulmonary and Critical Care Section, Department of Medicine, Veterans Administration Boston Healthcare System, Boston, Massachusetts, USA
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King AC, Campero MI, Sheats JL, Castro Sweet CM, Hauser ME, Garcia D, Chazaro A, Blanco G, Banda J, Ahn DK, Fernandez J, Bickmore T. Effects of Counseling by Peer Human Advisors vs Computers to Increase Walking in Underserved Populations: The COMPASS Randomized Clinical Trial. JAMA Intern Med 2020; 180:1481-1490. [PMID: 32986075 PMCID: PMC7522781 DOI: 10.1001/jamainternmed.2020.4143] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
IMPORTANCE Effective and practical treatments are needed to increase physical activity among those at heightened risk from inactivity. Walking represents a popular physical activity that can produce a range of desirable health effects, particularly as people age. OBJECTIVE To test the hypothesis that counseling by a computer-based virtual advisor is no worse than (ie, noninferior to) counseling by trained human advisors for increasing 12-month walking levels among inactive adults. DESIGN, SETTING, AND PARTICIPANTS A cluster-randomized, noninferiority parallel trial enrolled 245 adults between July 21, 2014, and July 29, 2016, with follow-up through September 15, 2017. Data analysis was performed from March 15 to December 20, 2018. The evidence-derived noninferiority margin was 30 minutes of walking per week. Participants included inactive adults aged 50 years and older, primarily of Latin American descent and capable of walking without significant limitations, from 10 community centers in Santa Clara and San Mateo counties, California. INTERVENTIONS All participants received similar evidence-based, 12-month physical activity counseling at their local community center, with the 10 centers randomized to a computerized virtual advisor program (virtual) or a previously validated peer advisor program (human). MAIN OUTCOMES AND MEASURES The primary outcome was change in walking minutes per week over 12 months using validated interview assessment corroborated with accelerometry. Both per-protocol and intention-to-treat analysis was performed. RESULTS Among the 245 participants randomized, 193 were women (78.8%) and 241 participants (98.4%) were Latino. Mean (SD) age was 62.3 (8.4) years (range, 50-87 years), 107 individuals (43.7%) had high school or less educational level, mean BMI was 32.8 (6.8), and mean years residence in the US was 47.4 (17.0) years. A total of 231 participants (94.3%) completed the study. Mean 12-month change in walking was 153.9 min/wk (95% CI, 126.3 min/wk to infinity) for the virtual cohort (n = 123) and 131.9 min/wk (95% CI, 101.4 min/wk to infinity) for the human cohort (n = 122) (difference, 22.0, with lower limit of 1-sided 95% CI, -20.6 to infinity; P = .02); this finding supports noninferiority. Improvements emerged in both arms for relevant clinical risk factors, sedentary behavior, and well-being measures. CONCLUSIONS AND RELEVANCE The findings of this study indicate that a virtual advisor using evidence-based strategies produces significant 12-month walking increases for older, lower-income Latino adults that are no worse than the significant improvements achieved by human advisors. Changes produced by both programs are commensurate with those reported in previous investigations of these behavioral interventions and provide support for broadening the range of light-touch physical activity programs that can be offered to a diverse population. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02111213.
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Affiliation(s)
- Abby C King
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, California.,Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Maria Ines Campero
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Jylana L Sheats
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California.,Now with Global Community Health and Behavioral Science Department, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Cynthia M Castro Sweet
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California.,Now with Omada Health, Inc, San Francisco, California
| | - Michelle E Hauser
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California.,Now with Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, California.,Now with Primary Care, Veterans Affairs Palo Alto Health Care System, Livermore, California.,Now with Fair Oaks Health Center, San Mateo County Health System, Redwood City, California
| | - Dulce Garcia
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Aldo Chazaro
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - German Blanco
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Jorge Banda
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California.,Now with Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - David K Ahn
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Juan Fernandez
- Khoury College of Computer Sciences, Northeastern University, Boston, Massachusetts
| | - Timothy Bickmore
- Khoury College of Computer Sciences, Northeastern University, Boston, Massachusetts
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Zhao Y, Wang Q, Chung PK, Cai K. Cross-cultural modifications and measurement properties of the CHAMPS questionnaire among Chinese older adults. J Exerc Sci Fit 2020; 19:13-18. [PMID: 32904054 PMCID: PMC7452187 DOI: 10.1016/j.jesf.2020.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 06/27/2020] [Accepted: 07/01/2020] [Indexed: 12/03/2022] Open
Abstract
Background/objective The Community Health Activities Model Program for Seniors questionnaires (CHAMPS-Q) is one of the most extensively used instruments in assessing physical activity among older adults. However, no study had translated the CHAMPS-Q into Chinese, and no evaluations were made on the psychometric properties of the CHAMPS-Q among the Chinese population. Considering cultural differences in perceptions of language, cultural context and living habits, this study was of necessary to 1) translate and cross-culturally adapt the original CHAMPS-Q, and 2) examine the test-retest reliability and construct/predictive validity of the Chinese version of the CHAMPS-Q. Methods The English CHAMPS-Q was first translated into Chinese, synthesized, back-translated, and revised by an expert committee according to the pre-test results. The Chinese CHAMPS-Q was then assessed in a cross-sectional study consisting of 101 apparently healthy older adults. Test-retest reliability test was conducted with 7 days apart. The construct validity of the Chinese CHAMPS-Q was tested against accelerometer data, and the predictive validity was assessed against physical fitness as measured by the Senior Fitness Test. Results The Chinese CHAMPS-Q has moderate to excellent test-retest reliability (ICC = 0.72-.96, p < .05). Energy expenditure and duration in PA significantly correlated with all accelerometry outcomes (ρ = 0.22-.31, p < .05). All the outcomes from the CHAMPS-Q showed significant correlations with upper body muscle strength (ρ = 0.22-.34, p < .05). Conclusion The Chinese CHAMPS-Q has excellent test-retest reliability and acceptable construct and predictive validity in assessing the physical activity of Chinese older adults. Cultural differences exist in physical activity habits between western and oriental older adults. Cultural adaptions are necessary for the popularization of physical activity measurements. Not only frequency and duration but also energy expenditures have significant meaning to physical activity evaluation. The Chinese CHAMPS-Q is a reliable and valid instrument for assessing the physical activity of older adults.
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Affiliation(s)
- Yanan Zhao
- School of Sports Science and Physical Education, Nanjing Normal University, Nanjing, Jiangsu, 210097, China
| | - Qianwen Wang
- School of Sports Science and Physical Education, Nanjing Normal University, Nanjing, Jiangsu, 210097, China
| | - Pak-Kwong Chung
- Department of Sport and Physical Education, Hong Kong Baptist University, Hong Kong, China
| | - Keshu Cai
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210046, China
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Sedentary Behavior, Physical Inactivity, and Metabolic Syndrome: Pilot Findings From the Rapid Assessment Disuse Index Study. J Phys Act Health 2020; 17:1042-1046. [PMID: 32908021 DOI: 10.1123/jpah.2019-0645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 06/17/2020] [Accepted: 07/31/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The Rapid Assessment Disuse Index (RADI) is a brief tool aimed to promptly assess primary care patients' overall physical inactivity and sedentary behavior. This study examines the relation between physical inactivity and sitting time (RADI) to cardiometabolic risk among primary care patients. METHODS Survey data and electronic medical record information were collated to explore the association between RADI scores (cumulative and sitting) to metabolic syndrome (and components) among women and men, using multivariable logistic regression. RESULTS Among women, the cumulative RADI score was not significantly associated with metabolic syndrome. However, the RADI sitting score was related to low high-density lipoprotein cholesterol and metabolic syndrome. That is, a transition to a higher RADI sitting score by 1 unit (vs remaining in the score) was related with a 1.4 and 1.3 times higher odds for having low high-density lipoprotein cholesterol (95% confidence interval, 1.05-1.87) and metabolic syndrome (95% confidence interval, 1.02-1.64), respectively. Among men, no significant relations were found. CONCLUSIONS The RADI sitting score is positively and significantly related to high-density lipoprotein and metabolic syndrome among women, yet not men. Due to the RADI's potential clinical utility, future research should attempt to examine these relations in larger, more robust samples and adjudicated outcomes using a prospective design.
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Maldonado-Contreras A, Noel SE, Ward DV, Velez M, Mangano KM. Associations between Diet, the Gut Microbiome, and Short-Chain Fatty Acid Production among Older Caribbean Latino Adults. J Acad Nutr Diet 2020; 120:2047-2060.e6. [PMID: 32798072 DOI: 10.1016/j.jand.2020.04.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 04/16/2020] [Accepted: 04/22/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Caribbean Latino adults have disproportionately high prevalence of chronic disease; however, underlying mechanisms are unknown. Unique gut microbiome profiles and relation to dietary quality may underlie health disparities. OBJECTIVES To examine the dietary quality of an underrepresented group of Caribbean Latino older adults with high prevalence of chronic disease; characterize gut microbiome profiles in this cohort; determine associations between dietary quality, gut microbiome composition, and short-chain fatty acid (SCFA) production; examine associations of clinical factors (body mass index, type 2 diabetes [T2D] status, and laxative use) with gut microbiome composition. DESIGN The study design was cross-sectional. PARTICIPANTS/SETTING Recruitment and interviews occurred at the Senior Center in Lawrence, MA, from September 2016-September 2017. A total of 20 adults aged ≥50 years, self-identified of Caribbean Latino origin, without use of antibiotics in 6 months or intestinal surgery were included in the study. EXPOSURE AND OUTCOME MEASURES Diet was assessed by two, 24-hour recalls and dietary quality was calculated using the Healthy Eating Index 2015 and the Mediterranean Diet Score. The gut microbiome was assessed by 16S rRNA sequencing and fecal SCFA content. Anthropometrics (ie, weight and height) were measured by a trained interviewer, and self-reported laxative use, and other self-report health outcomes (ie, T2D status) were assessed by questionnaire. STATISTICAL ANALYSES Faith Phylogenetic Diversity (alpha diversity) and unique fraction metric, or UniFrac (beta diversity) and nonphylogenetic metrics, including Shannon diversity index (alpha diversity) were calculated. Spearman correlations and group comparisons using Kruskal-Wallis test between alpha diversity indexes and nutrient intakes were calculated. Patterns in the microbiome were estimated using a partitioning around medoids with estimation of number of clusters, with optimum average silhouette width. Log odds were calculated to compare predefined nutrients and diet score components between microbiome clusters using multivariable logistic regression, controlling for age and sex. Pearson correlation was used to relate SCFA fecal content to individual nutrients and diet indexes. Final models were additionally adjusted for laxative use. Differences in lifestyle factors by gut microbiome cluster were tested by Fisher's exact test. RESULTS Generally, there was poor alignment of participant's diets to either the Mediterranean Diet score or Healthy Eating Index 2015. Range in the Healthy Eating Index 2015 was 36 to 90, where only 5% (n=1) of the sample showed high adherence to the Dietary Guidelines for Americans. Mediterranean Diet scores suggested low conformance with a Mediterranean eating pattern (score range=2 to 8, where 45% scored ≤3 [poor adherence]). The gut microbiome separated into two clusters by difference in a single bacterial taxon: Prevotella copri (P copri) (permutational multivariate analysis of variance [PERMANOVA] R2=0.576, ADONIS function P=0.001). Significantly lower P copri abundance was observed in cluster 1 compared with cluster 2 (Mann-Whitney P<0.0001). Samples in the P copri dominated cluster 2 showed significantly lower alpha diversity compared with P copri depleted cluster 1 (Shannon diversity index P=0.01). Individuals in the P copri dominated cluster showed a trend toward higher 18:3 α-linolenic fatty acid intakes (P=0.09). Percentage of energy from total fat intake was significantly, positively correlated with fecal acetate (r=0.46; P=0.04), butyrate (r=0.50; P=0.03) and propionate (r=0.52; P=0.02). Associations between dietary intake and composition of the gut microbiome were attenuated by self-report recent laxative use. Individuals with T2D exhibited a significantly greater abundance of the Enterobacteriales (P=0.01) and a trend toward lower fecal content of butyric acid compared to subjects without T2D (P=0.08). Significant beta diversity differences were observed by weight (Mantel P<0.003) and body mass index (Mantel P<0.07). CONCLUSIONS Two unique microbiome profiles, identified by abundance of P copri, were identified among Caribbean Latino adults. Microbiome profiles and SCFA content were associated with diet, T2D, and lifestyle. Further research is needed to determine the role of P copri and SCFA production in the risk for chronic disease and associated lifestyle predictors.
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An Optimal Self-Report Physical Activity Measure for Older Adults: Does Physical Function Matter? J Aging Phys Act 2020; 29:193-199. [PMID: 32788419 DOI: 10.1123/japa.2019-0380] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 11/18/2022]
Abstract
The authors compared two self-report measures of physical activity, the Physical Activity Scale for the Elderly (PASE) and the Community Healthy Activities Model Program for Seniors (CHAMPS), against the device-derived SenseWear Armband (SWA), to identify a recommended self-report tool to measure physical activity in older adults across physical function levels. A total of 65 community-dwelling older adults completed the PASE, CHAMPS, and seven full days of SWA wear. The authors measured physical function using the modified short physical performance battery (SPPB) and a usual-paced 6-m walk. Age- and sex-adjusted Spearman correlations showed that CHAMPS and SWA were correlated in higher functioning participants (SPPB: ρ = .33, p = .03; gait speed: ρ = .40, p = .006) and also correlated in lower functioning participants for SPPB (ρ = .70, p = .003) only. PASE and SWA were not significantly correlated across physical function. When an objective measure of physical activity is not practical, the CHAMPS questionnaire appears to capture physical activity for older adults across physical function levels.
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King AC, Campero I, Sheats JL, Castro Sweet CM, Espinosa PR, Garcia D, Hauser M, Done M, Patel ML, Parikh NM, Corral C, Ahn DK. Testing the effectiveness of physical activity advice delivered via text messaging vs. human phone advisors in a Latino population: The On The Move randomized controlled trial design and methods. Contemp Clin Trials 2020; 95:106084. [PMID: 32659437 PMCID: PMC7351675 DOI: 10.1016/j.cct.2020.106084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/02/2020] [Accepted: 07/07/2020] [Indexed: 12/25/2022]
Abstract
Physical inactivity is a key risk factor for a range of chronic diseases and conditions, yet, approximately 50% of U.S. adults fall below recommended levels of regular aerobic physical activity (PA). This is particularly true for ethnic minority populations such as Latino adults for whom few culturally adapted programs have been developed and tested. Text messaging (SMS) represents a convenient and accessible communication channel for delivering targeted PA information and support, but has not been rigorously evaluated against standard telehealth advising programs. The objective of the On The Move randomized controlled trial is to test the effectiveness of a linguistically and culturally targeted SMS PA intervention (SMS PA Advisor) versus two comparison conditions: a) a standard, staff-delivered phone PA intervention (Telephone PA Advisor) and b) an attention-control arm consisting of a culturally targeted SMS intervention to promote a healthy diet (SMS Nutrition Advisor). The study sample (N = 350) consists of generally healthy, insufficiently active Latino adults ages 35 years and older living in five northern California counties. Study assessments occur at baseline, 6, and 12 months, with a subset of participants completing 18-month assessments. The primary outcome is 12-month change in walking, and secondary outcomes include other forms of PA, assessed via validated self-report measures and supported by accelerometry, and physical function and well-being variables. Potential mediators and moderators of intervention success will be explored to better determine which subgroups do best with which type of intervention. Here we present the study design and methods, including recruitment strategies and yields. Trial Registration: clinicaltrial.gov Identifier = NCT02385591.
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Affiliation(s)
- Abby C King
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA 94305, United States of America; Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Ines Campero
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Jylana L Sheats
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Cynthia M Castro Sweet
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Patricia Rodriguez Espinosa
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Dulce Garcia
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Michelle Hauser
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Monica Done
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Michele L Patel
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
| | - Nina M Parikh
- CareMessage, Inc., San Francisco, California 94115, United States of America.
| | - Cecilia Corral
- CareMessage, Inc., San Francisco, California 94115, United States of America.
| | - David K Ahn
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States of America.
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48
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Bakker EA, Hartman YAW, Hopman MTE, Hopkins ND, Graves LEF, Dunstan DW, Healy GN, Eijsvogels TMH, Thijssen DHJ. Validity and reliability of subjective methods to assess sedentary behaviour in adults: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2020; 17:75. [PMID: 32539720 PMCID: PMC7294635 DOI: 10.1186/s12966-020-00972-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 05/12/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Subjective measures of sedentary behaviour (SB) (i.e. questionnaires and diaries/logs) are widely implemented, and can be useful for capturing type and context of SBs. However, little is known about comparative validity and reliability. The aim of this systematic review and meta-analysis was to: 1) identify subjective methods to assess overall, domain- and behaviour-specific SB, and 2) examine the validity and reliability of these methods. METHODS The databases MEDLINE, EMBASE and SPORTDiscus were searched up to March 2020. Inclusion criteria were: 1) assessment of SB, 2) evaluation of subjective measurement tools, 3) being performed in healthy adults, 4) manuscript written in English, and 5) paper was peer-reviewed. Data of validity and/or reliability measurements was extracted from included studies and a meta-analysis using random effects was performed to assess the pooled correlation coefficients of the validity. RESULTS The systematic search resulted in 2423 hits. After excluding duplicates and screening on title and abstract, 82 studies were included with 75 self-reported measurement tools. There was wide variability in the measurement properties and quality of the studies. The criterion validity varied between poor-to-excellent (correlation coefficient [R] range - 0.01- 0.90) with logs/diaries (R = 0.63 [95%CI 0.48-0.78]) showing higher criterion validity compared to questionnaires (R = 0.35 [95%CI 0.32-0.39]). Furthermore, correlation coefficients of single- and multiple-item questionnaires were comparable (1-item R = 0.34; 2-to-9-items R = 0.35; ≥10-items R = 0.37). The reliability of SB measures was moderate-to-good, with the quality of these studies being mostly fair-to-good. CONCLUSION Logs and diaries are recommended to validly and reliably assess self-reported SB. However, due to time and resources constraints, 1-item questionnaires may be preferred to subjectively assess SB in large-scale observations when showing similar validity and reliability compared to longer questionnaires. REGISTRATION NUMBER CRD42018105994.
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Affiliation(s)
- Esmée A Bakker
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Yvonne A W Hartman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Maria T E Hopman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Nicola D Hopkins
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Lee E F Graves
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - David W Dunstan
- Baker Heart & Diabetes Institute, Melbourne, Australia
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Genevieve N Healy
- The University of Queensland, School of Public Health, Brisbane, Australia
| | - Thijs M H Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Dick H J Thijssen
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
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49
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Lynch TG. Doctor meets world. J Vasc Surg 2020; 71:2107. [PMID: 32446514 DOI: 10.1016/j.jvs.2019.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 09/26/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Thomas G Lynch
- Department of Surgery, George Washington University School of Medicine, Washington, D.C..
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50
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Kennedy G, Meyer D, Hardman RJ, Macpherson H, Scholey AB, Pipingas A. Modelling Modifiable Predictors of Age-Related Cognitive Decline: Exercise, Aortic Stiffness, and the Importance of Physical Fitness. J Alzheimers Dis Rep 2020; 4:79-89. [PMID: 32467878 PMCID: PMC7242822 DOI: 10.3233/adr-190164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Previous modelling found that fitness and aortic stiffness both independently predicted spatial working memory (SWM) performance in older people. There is also evidence that greater engagement in moderate intensity exercise contributes to better cognitive performance, potentially working through improving fitness and aortic stiffness. OBJECTIVE To investigate the effect of exercise on the previously established relationships between fitness, aortic stiffness, and SWM, and whether these associations differ between older adults of higher and lower fitness. METHODS One hundred and two residents of independent living facilities, aged 60-90 (M = 77.5, SD = 6.9) participated in the study. Measures included computerized cognitive assessment, the Six-Minute Walk fitness test, the CHAMPS physical activity questionnaire, and aortic pulse wave analysis. Multiple structural equation models were used to test hypotheses. RESULTS Overall, exercise levels had a small additional effect in predicting SWM, working exclusively through fitness, although this was only true for those of lower than average fitness. Additionally, it was found that while fitness was the most important factor in predicting SWM in those of lower fitness, aortic stiffness was the strongest predictor in those of higher fitness. CONCLUSION Fitness and aortic stiffness are strong predictors of cognition in older people, and greater engagement in exercise predicted better cognition in those who were of lower fitness. Fitter older people may benefit more from interventions which target aortic stiffness in order to preserve cognitive performance as they age, while those who are less fit may benefit most from improving fitness first, including through increased physical activity.
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Affiliation(s)
- Greg Kennedy
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia
| | - Denny Meyer
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia
| | - Roy J. Hardman
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia
| | - Helen Macpherson
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Andrew B. Scholey
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia
| | - Andrew Pipingas
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia
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