451
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Franco I, Bianco A, Bonfiglio C, Sorino P, Mirizzi A, Campanella A, Buongiorno C, Liuzzi R, Osella AR. Decreased levels of physical activity: results from a cross-sectional study in southern Italy during the COVID-19 lockdown. J Sports Med Phys Fitness 2021; 61:294-300. [PMID: 33570347 DOI: 10.23736/s0022-4707.20.11536-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, the Italian government took security measures to try to limit infections. Restrictive measures included social distancing, home confinement and the closure of all public structures like gyms and swimming pools. The impact of these limitations on health and lifestyle was inevitably negative. The purpose of this study was to establish the level of physical activity (PA), expressed as energy expenditure (MET-minute/week) in a Southern Italian population before and during the COVID-19 lockdown. METHODS An adapted version of the International Physical Activity Questionnaire-short form (IPAQ-SF) was published on the official website of the National Institute of Gastroenterology IRCCS S. de Bellis, Castellana Grotte, Bari, Italy and on several social media in May 2020. RESULTS Three hundred ten replies (72% women) from Apulia (60%), Calabria (28%), Campania (11%) and Sicily (1%) were included in the study. The COVID-19 lockdown had a negative effect on the vigorous PA intensity level and on walking, but not on the moderate PA intensity level. Additionally, daily time spent sitting down increased by more than 12% during the COVID-19 lockdown. CONCLUSIONS Isolation changed PA behaviors. The decreased energy expenditure (MET-minute/week) during the lockdown had a negative impact in both genders, especially on the young adults and adults' groups.
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Affiliation(s)
- Isabella Franco
- Laboratory of Epidemiology and Biostatistics, IRCCS S. de Bellis, Castellana Grotte, Bari, Italy
| | - Antonella Bianco
- Laboratory of Epidemiology and Biostatistics, IRCCS S. de Bellis, Castellana Grotte, Bari, Italy
| | - Caterina Bonfiglio
- Laboratory of Epidemiology and Biostatistics, IRCCS S. de Bellis, Castellana Grotte, Bari, Italy
| | - Paolo Sorino
- Laboratory of Epidemiology and Biostatistics, IRCCS S. de Bellis, Castellana Grotte, Bari, Italy
| | - Antonella Mirizzi
- Laboratory of Epidemiology and Biostatistics, IRCCS S. de Bellis, Castellana Grotte, Bari, Italy
| | - Angelo Campanella
- Laboratory of Epidemiology and Biostatistics, IRCCS S. de Bellis, Castellana Grotte, Bari, Italy
| | - Claudia Buongiorno
- Laboratory of Epidemiology and Biostatistics, IRCCS S. de Bellis, Castellana Grotte, Bari, Italy
| | - Rosalba Liuzzi
- Laboratory of Epidemiology and Biostatistics, IRCCS S. de Bellis, Castellana Grotte, Bari, Italy
| | - Alberto R Osella
- Laboratory of Epidemiology and Biostatistics, IRCCS S. de Bellis, Castellana Grotte, Bari, Italy -
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452
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Tamura K, Orstad SL, Cromley EK, Neally SJ, Claudel SE, Andrews MR, Ceasar J, Sims M, Powell-Wiley TM. The Mediating role of perceived discrimination and stress in the associations between neighborhood social environment and TV Viewing among Jackson Heart Study participants. SSM Popul Health 2021; 13:100760. [PMID: 33681448 PMCID: PMC7930346 DOI: 10.1016/j.ssmph.2021.100760] [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] [Received: 10/07/2020] [Revised: 02/08/2021] [Accepted: 02/17/2021] [Indexed: 12/25/2022] Open
Abstract
Objectives The aim of this study was to test the mediating role of perceived discrimination and stress on associations between perceived neighborhood social environment (PNSE) and TV viewing. Methods Baseline data were used for 4716 participants (mean age = 55.1 y; 63.4% female) in the Jackson Heart Study (JHS), a large prospective cohort study of African Americans in Jackson, Mississippi. One binary TV viewing outcome was created: ≥4 h/day versus <4 h/day. PNSE variables included neighborhood violence, problems (higher value = more violence/problems), and social cohesion (higher value = more cohesion). Mediators included perceived lifetime discrimination, daily discrimination, and chronic stress (higher value = greater discrimination/stress). Multivariable regression was used with bootstrap-generated 95% bias-corrected confidence intervals (BC CIs) to test for mediation adjusting for demographics, health-related and psychosocial factors, and population density. Results Neighborhood violence, problems, and social cohesion were indirectly associated with TV viewing through lifetime discrimination (OR = 1.03, 95%BC CI = 1.00, 1.07; OR = 1.03, 95%BC CI = 0.99, 1.06 [marginal]; OR = 0.98, 95%BC CI = 0.94, 0.99, respectively) and chronic stress (OR = 0.95, 95%BC CI = 0.90, 0.99; OR = 0.96, 95%BC CI = 0.92, 0.99; OR = 1.05, 95%BC CI = 1.01, 1.10, respectively). Daily discrimination was neither directly nor indirectly associated with TV viewing. Conclusions Each PNSE variable was indirectly associated with TV viewing via lifetime discrimination and perceived stress, but not with daily discrimination among JHS participants. Unexpected directionality of mediating effects of lifetime discrimination and chronic stress should be replicated in future studies. Further research is also needed to pinpoint effective community efforts and physical environmental policies (e.g., installing bright street lights, community policing) to reduce adverse neighborhood conditions and psychosocial factors, and decrease TV viewing and subsequent cardiovascular disease risk.
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Affiliation(s)
- Kosuke Tamura
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Stephanie L Orstad
- Department of Medicine, Division of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, 550 Avenue, New York, NY, 10016, USA
| | - Ellen K Cromley
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, 2006 Hillside Road, Unit 1248, Storrs, CT, 06269-1248, USA
| | - Sam J Neally
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Sophie E Claudel
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Marcus R Andrews
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Joniqua Ceasar
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, 2500 N State St, Jackson, MS, 39216, USA
| | - Tiffany M Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892, USA.,Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, 6707 Democracy Boulevard, Bethesda, MD, 20892, USA
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453
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AlQuaiz AM, Kazi A, Almigbal TH, AlHazmi AM, Qureshi R, AlHabeeb KM. Factors Associated with an Unhealthy Lifestyle among Adults in Riyadh City, Saudi Arabia. Healthcare (Basel) 2021; 9:221. [PMID: 33671352 PMCID: PMC7922185 DOI: 10.3390/healthcare9020221] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/13/2021] [Accepted: 02/15/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Unhealthy lifestyles are a global concern. This study measured the prevalence and factors associated with an unhealthy lifestyle in Riyadh city, Saudi Arabia. METHODS An interview-based, cross-sectional study was conducted with 968 males and 2029 females, aged 30-75 years, covering 18 primary health care centers in Riyadh. Multivariate logistic regression analyses were conducted to identify the significant determinants associated with an unhealthy lifestyle. RESULTS Overall, men were 1.49 (1.28, 1.74) times at higher risk of an unhealthy lifestyle compared to women. Men reporting unhealthy lifestyle were 2.1 (1.3, 3.4) and 1.5 (1.0, 2.6) times more likely than men with healthy lifestyle to cite not enjoying physical activity, lack of social support, and not having enough information about a healthy diet [1.5 (1.0, 2.0)], whereas those ≥ 45 years age group were 30 times less likely to report unhealthy lifestyle [0.7 (0.5, 0.9)]. In contrast, in women aged ≥ 45 years [1.3 (1.1, 1.7)], lack of motivation [1.3 (1.1, 1.7)], feeling conscious while exercising [2.0 (1.4, 2.9)], not enjoying healthy food [1.6 (1.3, 2.1)], and no family support to prepare healthy food [1.4 (1.1, 1.8)] were significantly associated with an unhealthy lifestyle. CONCLUSIONS In a Saudi sample, younger men and older women are at higher risk of an unhealthy lifestyle. In addition to self-motivation, combined strategies to promote physical activity and healthy eating are required to improve lifestyle.
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Affiliation(s)
- AlJohara M. AlQuaiz
- Princess Nora Bent Abdullah Research Chair for Women’s Health Research, King Saud University, Riyadh 11321, Saudi Arabia; (A.M.A.); (R.Q.); (K.M.A.)
- Department of Family & Community Medicine, College of Medicine, King Saud Medical City, King Saud University, Riyadh 11321, Saudi Arabia; (T.H.A.); (A.M.A.)
| | - Ambreen Kazi
- Princess Nora Bent Abdullah Research Chair for Women’s Health Research, King Saud University, Riyadh 11321, Saudi Arabia; (A.M.A.); (R.Q.); (K.M.A.)
- Department of Family & Community Medicine, College of Medicine, King Saud Medical City, King Saud University, Riyadh 11321, Saudi Arabia; (T.H.A.); (A.M.A.)
| | - Turky H. Almigbal
- Department of Family & Community Medicine, College of Medicine, King Saud Medical City, King Saud University, Riyadh 11321, Saudi Arabia; (T.H.A.); (A.M.A.)
| | - Ali M. AlHazmi
- Department of Family & Community Medicine, College of Medicine, King Saud Medical City, King Saud University, Riyadh 11321, Saudi Arabia; (T.H.A.); (A.M.A.)
| | - Riaz Qureshi
- Princess Nora Bent Abdullah Research Chair for Women’s Health Research, King Saud University, Riyadh 11321, Saudi Arabia; (A.M.A.); (R.Q.); (K.M.A.)
- Department of Family & Community Medicine, College of Medicine, King Saud Medical City, King Saud University, Riyadh 11321, Saudi Arabia; (T.H.A.); (A.M.A.)
| | - Khaled M. AlHabeeb
- Princess Nora Bent Abdullah Research Chair for Women’s Health Research, King Saud University, Riyadh 11321, Saudi Arabia; (A.M.A.); (R.Q.); (K.M.A.)
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454
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Wshah A, Selzler AM, Ellerton L, Hill K, Brooks D, Goldstein R. Reducing sedentary behavior in individuals with COPD: healthcare professionals' perspectives. Physiother Theory Pract 2021; 38:1693-1704. [PMID: 33586622 DOI: 10.1080/09593985.2021.1885088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Reducing sedentary behavior (SB) in individuals with chronic obstructive pulmonary disease (COPD) is being increasingly recognized as a novel health target. Understanding healthcare professionals (HCPs) behavior that influences a reduction in SB in this population could facilitate achieving this target. Objective: To explore the determinants of behavior related to HCPs targeting a reduction in SB in people with COPD. Methods: We used a qualitative semi-structured interview approach informed by the Theoretical Domains Framework (TDF). Sixteen HCPs were interviewed. Interview transcripts were mapped against the relevant TDF domain(s) and then higher order themes were generated. Results: Directed content analysis resulted in mapping 949 quotes to the TDF domains with environmental context and resources being the most coded domain. Three higher order themes were identified: 1) HCPs need more knowledge on reducing SB; 2) Strategies suggested to include in pulmonary rehabilitation (PR) to reduce SB; and 3) Barriers to adding SB to PR. Domains of environmental context and resources, knowledge, social/professional role and identity, reinforcement, social influences, skills and beliefs about capabilities were relevant to the study population to reduce SB in people with COPD. Conclusion: Knowledge of SB varied across participants. This study provided information on potential behavioral targets for future interventions that involve HCPs and aim to reduce SB among people with COPD.
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Affiliation(s)
- Adnan Wshah
- Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Anne-Marie Selzler
- Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Lauren Ellerton
- Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Kylie Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Dina Brooks
- Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Roger Goldstein
- Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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455
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Pinidiyapathirage J, Kasthuriratne A, Bennie JA, Pathmeswaran A, Biddle SJH, De Silva HJ, Chackrewarthy S, Dassanayake AS, Ranawaka U, Kato N, Wickremasinghe AR. Physical Activity Tracking Among Sri Lankan Adults: Findings From a 7-Year Follow-up of the Ragama Health Study. Asia Pac J Public Health 2021; 33:205-212. [PMID: 33577353 DOI: 10.1177/1010539520971179] [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] [Indexed: 11/16/2022]
Abstract
Limited data are available on physical activity tracking among adults in low- and middle-income countries. Using a longitudinal design, we assessed trends and correlates of physical activity among Sri Lankan adults. Individuals selected through age-stratified random sampling, were screened initially in 2007 (n = 2986) and reevaluated in 2014 (n = 2148). On both occasions, structured interviews and clinical measurements were completed. Approximately 40% of the participants engaged in recommended levels of physical activity both at baseline and follow-up. One-fifth reported increased physical activity at follow-up, a similar proportion reported being persistently inactive or a reduction in physical activity. In the adjusted analysis, being persistently active was associated with male sex, a lower educational level and income, being free of any chronic disease conditions, better self-rated health, and sitting time <8 hours. Our findings support public health interventions to help maintain recommended physical activity levels over time, particularly for subgroups at high-risk of physical inactivity.
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Affiliation(s)
- Janani Pinidiyapathirage
- University of Southern Queensland, Toowoomba, Queensland, Australia.,University of Kelaniya, Ragama, Sri Lanka.,Griffith University, Gold Coast, Queensland, Australia
| | | | - Jason A Bennie
- University of Southern Queensland, Toowoomba, Queensland, Australia
| | | | | | | | | | | | | | - Norihiro Kato
- National Centre for Global Health and Medicine Research Institute, Shinjuku-ku, Tokyo, Japan
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456
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Koblinsky ND, Meusel LAC, Greenwood CE, Anderson ND. Household physical activity is positively associated with gray matter volume in older adults. BMC Geriatr 2021; 21:104. [PMID: 33546613 PMCID: PMC7863483 DOI: 10.1186/s12877-021-02054-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/22/2021] [Indexed: 01/13/2023] Open
Abstract
Background Total physical activity is positively associated with brain volume and cognition in older adults. While we have ample evidence that recreational physical activity influences brain health, the contributions of other daily activities are less understood. In particular, the associations between household physical activity and brain health in older adults is underexplored. The purpose of this study was to identify associations between household physical activity, brain volume, and cognition in a sample of cognitively unimpaired older adults. Methods We report data from 66 cognitively unimpaired older adults (71 ± 4 years) who participated in a health evaluation, cognitive assessment, and structural brain imaging. Physical activity was assessed using the Phone-FITT questionnaire and separated into household and recreational physical activity. We quantified whole brain volume, gray matter volume, and white matter volume, and assessed cognitive performance in four domains: memory, working memory/attention, processing speed, and executive function. Associations between physical activity, brain volume, and cognition were investigated in an omnibus approach using two multivariate analysis of variance (MANOVA) models. The first model assessed the associations between physical activity and brain volume adjusting for age, sex, Framingham Risk score (FRS) and intracranial volume. The second model assessed the associations between physical activity and overall cognitive performance adjusting for age, sex, FRS and education. Post hoc regression analyses were conducted to investigate significant MANOVA results. We also conducted further regression analyses to investigate associations with hippocampal and frontal lobe volume. Results Household, but not recreational, physical activity was positively associated with brain volume measurements (F = 3.07, p = .035), specifically gray matter volume (t = 2.51, p = .015). Further exploratory analyses identified that household physical activity was associated with hippocampal (p = .015) and frontal lobe (p = .010) volume. No significant relationships were observed between household or recreational physical activity and cognition. Conclusion Time spent engaging in household physical activity was positively associated with brain volume, specifically gray matter volume, in older adults. Highlighting the benefits associated with household chores may motivate older adults to be more active by providing a more attainable, low risk form of physical activity.
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Affiliation(s)
- Noah D Koblinsky
- Rotman Research Institute, Baycrest Hospital, Toronto, ON, Canada.
| | - Liesel-Ann C Meusel
- Rotman Research Institute, Baycrest Hospital, Toronto, ON, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Carol E Greenwood
- Rotman Research Institute, Baycrest Hospital, Toronto, ON, Canada.,Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nicole D Anderson
- Rotman Research Institute, Baycrest Hospital, Toronto, ON, Canada.,Departments of Psychology and Psychiatry, University of Toronto, Toronto, ON, Canada
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457
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O'Gorman P, Monaghan A, McGrath M, Naimimohasses S, Gormley J, Norris S. Determinants of Physical Activity Engagement in Patients With Nonalcoholic Fatty Liver Disease: The Need for an Individualized Approach to Lifestyle Interventions. Phys Ther 2021; 101:5940149. [PMID: 33104787 DOI: 10.1093/ptj/pzaa195] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/23/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Physical activity (PA) is an important non-pharmacological treatment for non-alcoholic fatty liver disease (NAFLD). This study investigated the determinants of PA engagement and awareness of the World Health Organization (WHO) PA guidelines in patients with NAFLD. METHODS Study participants were 101 patients with NAFLD (median age: 54 [IQR = 15] y; 53 men and 48 women) who completed 4 questionnaires: (1) a PA guideline awareness questionnaire; (2) a PA questionnaire assessing PA levels; and (3) 2 questionnaires assessing perceived barriers and motivators for engaging in PA. Binary logistic regression was performed to assess predictors of PA levels. RESULTS Twenty-four percent of participants correctly identified the recommended WHO weekly PA guidelines, and 39% adhered to the guidelines. Lack of willpower, time, and energy were the most frequently cited barrier domains. Scores for lack of willpower (odds ratio [OR] = 1.445, 95% CI = 1.088-1.919) and lack of resources (OR = 1.378, 95% CI = 1.003-1.893), and reporting 3 or more "significant" barrier domains (OR = 5.348, 95% CI = 1.792-15.873) were significant predictors of PA levels. Maintaining health and fitness was the most cited motivator domain and was a significant predictor (OR = 2.551, 95% CI = 1.253-5.208) of PA levels. CONCLUSIONS This study highlights the lack of awareness of the WHO PA guidelines and the key determinants of PA participation in patients with NAFLD. Determinants of PA should be identified at the individual level to create a personalized approach for PA maintenance for people with NAFLD to promote lifelong participation in PA. IMPACT This study closes a gap in the published data on the determinants of PA engagement in patients with NAFLD. LAY SUMMARY Physical inactivity is the fourth leading cause of global mortality and contributes to many chronic inflammatory diseases, including obesity, type 2 diabetes, cardiovascular disease, and nonalcoholic fatty liver disease (NAFLD). People with NAFLD engage in less physical activity compared with people who are healthy, and this study provides new information that clinicians can use to help these patients increase their physical activity participation.
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Affiliation(s)
- Philip O'Gorman
- Discipline of Physiotherapy, University of Dublin, Trinity College, Dublin, Ireland
| | - Ann Monaghan
- Discipline of Physiotherapy, University of Dublin, Trinity College, Dublin, Ireland
| | - Marie McGrath
- Department of Hepatology, St James's Hospital, Dublin, Ireland
| | - Sara Naimimohasses
- Department of Hepatology, St James's Hospital, Dublin, Ireland.,Department of Clinical Medicine, University of Dublin, Trinity College, Dublin, Ireland
| | - John Gormley
- Discipline of Physiotherapy, University of Dublin, Trinity College, Dublin, Ireland
| | - Suzanne Norris
- Department of Hepatology, St James's Hospital, Dublin, Ireland.,Department of Clinical Medicine, University of Dublin, Trinity College, Dublin, Ireland
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458
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Fernández-Matarrubia M, Goni L, Rognoni T, Razquin C, Fernández-Lázaro CI, Bes-Rastrollo M, Martínez-González MÁ, Toledo E. An Active Lifestyle Is Associated with Better Cognitive Function Over Time in APOE ɛ4 Non-Carriers. J Alzheimers Dis 2021; 79:1257-1268. [DOI: 10.3233/jad-201090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background: Available evidence on the association of physical activity (PA) or sedentary behavior with cognitive decline is inconclusive. Objective: To assess the association between an active lifestyle score and leisure-time physical activity (LTPA) and changes in cognitive function in the Seguimiento Universidad de Navarra (SUN) prospective cohort. Methods: Cognitive function was evaluated in a subsample of 806 participants of the SUN cohort study using the validated Telephone Interview for Cognitive Status-modified (STICS-m) questionnaire at baseline and after 6 years. LTPA was evaluated with a previously validated 17-item self-administered questionnaire and with information on sedentary lifestyles. We also calculated a multidimensional 8-item PA score. Multivariable linear regression analysis evaluated the association between PA and changes in cognitive function and its interaction by APOE genotype. Results: Mean age of participants was 66 (SD 5.3) years and 69.7% were male. When stratifying by APOE variants, no significant associations between the active lifestyle score or LTPA and changes in cognitive performance over time were found among APOE ɛ4 carriers. However, we observed that a higher adherence to an active lifestyle (high versus low PA score β= 0.76 95% CI 0.15,1.36; p trend = 0.011) and a high LTPA (Q4 versus Q1 β= 0.63; 95% CI –0.01,1.26; p trend = 0.030) were associated with more favorable changes in cognitive function over time among APOE ɛ4 non-carriers with statistically significant interactions in both cases (p for interaction = 0.042 for PA score, and p = 0.039 for LTPA). Conclusion: The results of the present study suggest that an active lifestyle is associated with a better status of cognitive function over time only among APOE ɛ4 non-carriers.
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Affiliation(s)
- Marta Fernández-Matarrubia
- Department of Neurology, Clínica Universidad de Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Leticia Goni
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Teresa Rognoni
- Department of Neurology, Clínica Universidad de Navarra, Madrid, Spain
| | - Cristina Razquin
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
| | - César Ignacio Fernández-Lázaro
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
| | - Maira Bes-Rastrollo
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Miguel Ángel Martínez-González
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Estefanía Toledo
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
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459
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Júdice PB, Hetherington-Rauth M, Magalhães JP, Correia IR, Sardinha LB. Sedentary behaviours and their relationship with body composition of athletes. Eur J Sport Sci 2021; 22:474-480. [PMID: 33416024 DOI: 10.1080/17461391.2021.1874060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
During the recovery period, athletes present high sedentary behaviour (SB). In non-athletes, there is a direct relationship between SB and obesity. However, little is known about this relationship in athletes. We hypothesized that different types of SB entail different associations with body composition outcomes.We examined the associations between different types of SB and body composition outcomes in 135 athletes (70 males) aged 21.3 ± 3.9 years old. Dual-energy X-ray absorptiometry was performed to assess fat mass (FM), fat-free mass (FFM) and trunk fat mass (TFM). A validated SB questionnaire (PACE) was used to estimate total SB and specific sedentary pursuits on an average day. Multiple linear regression analyses were performed, adjusting for age, sex, weekly training time, years of sport practice, and sport type.A positive association was found for total SB and total screen time with %TFM (β = 0.220, p = 0.038 and β = 0.319, p = 0.040, respectively), while an inverse association was found for %FFM (β = -0.214, p = 0.042 and β = -0.310, p = 0.026). A higher total screen time was related with a higher %FM (β = 0.283, p = 0.035). With a much stronger effect size, cell phone screen time was positively related with %FM (β = 1.447, p = 0.001).There is still debate whether high levels of physical activity can fully counteract the harms of SB. These findings suggest that SB, particularly cell phone screen time, can compromise athletes' body composition, regardless of weekly training time. Sport federations and coaches may improve athletes' body composition by targeting specific sedentary pursuits, i.e. total screen time and cell phone screen time, during athletes' recovery time.Highlights Even in athletes, SB can compromise total and regional body composition regardless of high training time.Screen time, specifically cell phone screen time seems to be the sedentary pursuit to target in athletes.Sport federations and coaches must control SB during athletes' recovery time.
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Affiliation(s)
- Pedro B Júdice
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal.,CIDEFES - Centro de Investigação em Desporto, Educação Física e Exercício e Saúde; Faculty of Physical Education and Sport, Lusofona University, Lisbon, Portugal
| | - Megan Hetherington-Rauth
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal
| | - João P Magalhães
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal
| | - Inês R Correia
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal
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Huang BH, Hamer M, Chastin S, Pearson N, Koster A, Stamatakis E. Cross-sectional associations of device-measured sedentary behaviour and physical activity with cardio-metabolic health in the 1970 British Cohort Study. Diabet Med 2021; 38:e14392. [PMID: 32852105 DOI: 10.1111/dme.14392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/27/2020] [Accepted: 08/18/2020] [Indexed: 11/28/2022]
Abstract
AIMS This study aimed to examine the cross-sectional associations of thigh accelerometry-assessed sedentary behaviour and moderate-to-vigorous physical activity (MVPA) with cardio-metabolic health markers and prevalent diabetes in a population sample of middle-aged British adults. METHODS Participants (n = 4892) from the age-46-to-48 wave of the 1970 British Cohort Study were fitted with a waterproofed activPAL3 micro device. Total/prolonged sedentary time, breaks and MVPA were the main exposures. We dichotomized prolonged sedentary time and MVPA based on the corresponding median, generating four combinations as categorical exposures. Outcomes comprised of diabetes and seven cardio-metabolic health markers. We used logistic regression and generalized linear models to examine independent/joint associations, conducting a minimally adjusted model including demographics and contextual covariates, and further adjusted for total sedentary time and/or MVPA as applicable. RESULTS Each set of 10 sedentary breaks and 1 h of prolonged sedentary time were associated with HbA1c (mmol/mol) [B = -0.18 (-0.33, -0.03) and 2.35 (1.01, 3.69), respectively]. Each set of 10 sedentary breaks and 1 h of MVPA were favourably associated with diabetes [adjusted odds ratio (AOR): 0.80 (0.71, 0.99) and 0.42 (0.26, 0.67), respectively]. Joint analyses showed that only the low MVPA × long sedentary time combination had significantly higher odds for diabetes than the referent high MVPA × short sedentary time combination [AOR: 1.89 (1.17, 3.03)]. CONCLUSIONS Each set of additional 10 sedentary breaks per day was associated with 20% lower odds for diabetes. A low physical activity level combined with long sedentary time might synergistically deteriorate cardio-metabolic health.
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Affiliation(s)
- B H Huang
- Charles Perkins Centre, School of Health Sciences, the University of Sydney, New South Wales, Australia
| | - M Hamer
- Institute Sport Exercise & Health, Division of Surgery & Interventional Science, University College London, London, United Kingdom
| | - S Chastin
- School of Health and Life Science, Glasgow Caledonian University, Glasgow
- Department of Movement and Sports Sciences, Universiteit Gent, Gent, Belgium
| | - N Pearson
- School of Sport Exercise & Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - A Koster
- Department of Social Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, Limburg, Netherlands
| | - E Stamatakis
- Charles Perkins Centre, School of Health Sciences, the University of Sydney, New South Wales, Australia
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Ferrari G, Werneck AO, Silva DR, Kovalskys I, Gómez G, Rigotti A, Cortés LY, García MY, Liria M, Herrera-Cuenca M, Zimberg IZ, Guajardo V, Pratt M, Cristi-Montero C, Marques A, Peralta M, Bolados CC, Leme ACB, Rollo S, Fisberg M. Agreement Between Self-Reported and Device-Based Sedentary Time among Eight Countries: Findings from the ELANS. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 22:1036-1047. [PMID: 33502675 DOI: 10.1007/s11121-021-01206-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to analyze the agreement between self-reported and device-based sedentary time among eight countries in Latin America. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants (18-65 years) across eight countries. Participants reported time spent sedentary in different activities (computer use at home, videogame use, reading, sitting down to chat with friends/relatives or listening to music, speaking on the phone, watching TV, and riding in a car). Overall sitting time was assessed using a single item from the International Physical Activity Questionnaire (IPAQ). Device-based sedentary time was assessed using Actigraph GT3X accelerometers. Self-reported overall sitting time (227.1 min/day) produced the lowest values of the three assessment methods, followed by self-reported sum of different types of sedentary behavior (364.1 min/day) and device-based sedentary time (568.6 min/day). Overall, correlation coefficients and ICC varied from weak to moderate (rho: 0.25-0.39; ICC: 0.21:0.39) between self-reported sum of different types of sedentary behavior, self-reported overall sitting time, and device-based sedentary time. The Bland-Altman plots indicated low to moderate agreement between self-reported overall sitting time and device-based sedentary time by sex. Self-report measures underestimate sedentary behavior and overall sitting time when compared with device-based measures. The weak and moderate level of agreement between methods indicates that caution is required when comparing associations between different self-report and device-based measures of sedentary behavior with health outcomes.
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Affiliation(s)
- Gerson Ferrari
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Las Sophoras 175, Estación Central, Santiago, Chile.
| | - André O Werneck
- Department of Nutrition, School of Public Health, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Danilo R Silva
- Department of Physical Education, Federal University of Sergipe - UFS, São Cristóvão, Brazil
| | - Irina Kovalskys
- Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Georgina Gómez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Lilia Yadira Cortés
- Departamento de Nutrición y Bioquímica, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Martha Yépez García
- Colégio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | - María Liria
- Instituto de Investigación Nutricional, La Molina, Lima, Peru
| | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas, Venezuela
| | - Ioná Zalcman Zimberg
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Viviana Guajardo
- Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Michael Pratt
- Institute for Public Health, University of California San Diego, La Jolla, CA, USA
| | - Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Adilson Marques
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,ISAMB, University of Lisbon, Lisbon, Portugal
| | - Miguel Peralta
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,ISAMB, University of Lisbon, Lisbon, Portugal
| | - Cristian Cofre Bolados
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Las Sophoras 175, Estación Central, Santiago, Chile
| | - Ana Carolina B Leme
- Department of Nutrition, School of Public Health, Universidade de São Paulo (USP), São Paulo, Brazil.,Family Relations and Applied Nutrition, University of Guelph, Guelph, Canada.,Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo, Brazil
| | - Scott Rollo
- Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Mauro Fisberg
- Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo, Brazil.,Departamento de Pediatria da Universidade Federal de São Paulo, São Paulo, Brazil
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462
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COVID-19 Awareness, Adoption of COVID-19 Preventive Measures, and Effects of COVID-19 Lockdown Among Adolescent Boys and Young Men in Kampala, Uganda. J Community Health 2021; 46:842-853. [PMID: 33481156 PMCID: PMC7820821 DOI: 10.1007/s10900-021-00961-w] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 12/16/2022]
Abstract
There is growing evidence of the challenges with adherence to COVID-19 prevention measures and the effect of the prevention measures on the health of populations in various parts of the world but with limited documentation in sub-Saharan Africa. We assessed COVID-19 awareness, adoption of COVID-19 prevention measures, and the effects of COVID-19 lockdown on the mental health status, socio-economic disruptions and engagement in unhealthy behaviours among 2500 in- and out-of-school adolescent boys and young men (ABYM) aged 10–24 years in Kampala, Uganda. 74.8% (n = 1869) were in-school; nearly half (47.3%, n = 1182) were aged 15–19 years. Although > 80% were aware of at least two COVID-19 prevention measures, only 22.2% (n = 555) reported that they always wore a face mask while in a public place; 40.9% (n = 1023) always washed their hands with soap and running water while 17.6% (n = 440) always avoided gatherings of more than five people. COVID-19 lockdown led to: (a) increased mental health challenges (e.g. 1.2% [n = 31] contemplated committing suicide); (b) limited ability to meet basic needs (e.g. 62.0% [n = 1549] found it difficult to afford a diverse/balanced diet); (c) socio-economic disruptions (e.g. 30.3% [n = 756] experienced a reduction in income) and (d) engagement in unhealthy behaviours (e.g. 62% [n = 1554] reported a sedentary life style such as excessive watching of TV). These effects were more pronounced among older adolescent boys (15–19 years) and young men (20–24 years) and out-of-school compared to in-school ABYM. Our findings suggest a need for appropriate health promotion, mental health and socio-economic interventions targeting ABYM in Kampala, Uganda.
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SARS-CoV-2 and Obesity: "CoVesity"-a Pandemic Within a Pandemic. Obes Surg 2021; 31:1745-1754. [PMID: 33479921 PMCID: PMC7819768 DOI: 10.1007/s11695-020-04919-0] [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: 06/25/2020] [Revised: 08/09/2020] [Accepted: 08/11/2020] [Indexed: 12/19/2022]
Abstract
Individuals who are overweight or suffering from obesity are in a chronic state of low-grade inflammation, making them particularly susceptible to developing severe forms of respiratory failure. Studies conducted in past pandemics link obesity with worse health outcomes. This population is thus of particular concern within the context of the COVID-19 pandemic, considering the cessation of obesity management services. This systematic review highlights [1] the reciprocal link between the obesity and COVID-19 pandemics, [2] obesity as a risk factor for more severe disease in past pandemics, [3] potential mechanisms that make individual’s suffering from obesity more susceptible to severe disease and higher viral load, and [4] the need to safely resume bariatric services as recommended by expert guidelines, in order to mitigate the health outcomes of an already vulnerable population.
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464
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Fast walking is a preventive factor against new-onset diabetes mellitus in a large cohort from a Japanese general population. Sci Rep 2021; 11:716. [PMID: 33436978 PMCID: PMC7804125 DOI: 10.1038/s41598-020-80572-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 11/23/2020] [Indexed: 12/23/2022] Open
Abstract
Based on questionnaires from 197,825 non-diabetic participants in a large Japanese cohort, we determined impact of (1) habit of exercise, (2) habit of active physical activity (PA) and (3) walking pace on new-onset of type 2 diabetes mellitus. Unadjusted and multivariable-adjusted logistic regression models were used to determine the odds ratio of new-onset diabetes mellitus incidence in a 3-year follow-up. There were two major findings. First, habits of exercise and active PA were positively associated with incidence of diabetes mellitus. Second, fast walking, even after adjusting for multiple covariates, was associated with low incidence of diabetes mellitus. In the subgroup analysis, the association was also observed in participants aged ≥ 65 years, in men, and in those with a body mass index ≥ 25. Results suggest that fast walking is a simple and independent preventive factor for new-onset of diabetes mellitus in the health check-up and guidance system in Japan. Future studies may be warranted to verify whether interventions involving walking pace can reduce the onset of diabetes in a nation-wide scale.
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465
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Yerrakalva D, Hajna S, Wijndaele K, Westgate K, Khaw KT, Wareham N, Griffin SJ, Brage S. Correlates of change in accelerometer-assessed total sedentary time and prolonged sedentary bouts among older English adults: results from five-year follow-up in the EPIC-Norfolk cohort. Aging (Albany NY) 2021; 13:134-149. [PMID: 33431710 PMCID: PMC7835006 DOI: 10.18632/aging.202497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 12/18/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Development of effective strategies to reduce sedentary time among older adults necessitates understanding of its determinants but longitudinal studies of this utilising objective measures are scarce. METHODS Among 1536 older adults (≥60 years) in the EPIC-Norfolk study, sedentary time was assessed for seven days at two time-points using accelerometers. We assessed associations of change in total and prolonged bouts of sedentary time (≥ 30 minutes) with change in demographic and behavioural factors using multi-level regression. RESULTS Over follow-up (5.3±1.9 years), greater increases in total sedentary time were associated with older age, being male, higher rate of increase in BMI, lower rate of increase in gardening (0.5 min/day/yr greater sedentary time per hour/week/yr less gardening, 95% CI 0.1, 1.0), a lower rate of increase in walking (0.2 min/day/yr greater sedentary time per hour/week/yr less walking, 95% CI 0.1, 0.3) and a higher rate of increase in television viewing. Correlates of change in prolonged sedentary bouts were similar. CONCLUSION Individuals in specific sub-groups (older, male, higher BMI) and who differentially participate in certain behaviours (less gardening, less walking and more television viewing) but not others increase their sedentary time at a higher rate than others; utilising this information could inform successful intervention content and targeting.
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Affiliation(s)
- Dharani Yerrakalva
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Samantha Hajna
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Katrien Wijndaele
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Kate Westgate
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Nick Wareham
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Simon J Griffin
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
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466
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Zhu J, Chen M, Pang Y, Li S. Impact of lifestyle education for type 2 diabetes mellitus: Protocol for a randomized controlled trial. Medicine (Baltimore) 2021; 100:e24208. [PMID: 33429812 PMCID: PMC7793339 DOI: 10.1097/md.0000000000024208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 12/15/2020] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To explore the influence of the education of lifestyle in the type 2 diabetes mellitus (T2DM) patients with microalbuminuria as a part of the enhanced multifactorial intervention. METHODS This study will be conducted from May 2021 to August 2022 at Ningbo No.6 hospital. The experiment was granted through the Research Ethics Committee of Ningbo No.6 hospital (539D035). The patients will be included if they are between 18 and 65 years old and are diagnosed with T2DM with microalbuminuria and the patients who have signed the written informed consent. While the patients will be excluded if they have serious physical comorbidities and patients who are unwilling to offer the informed consent to take part in this experiment. We measure the clinical examination (fasting blood-glucose, glycosylated hemoglobin and routine urine test) timely. Detail of daily dietary intake and lifestyle factors are also recorded. RESULTS Table 1 reflects the comparison of the biochemical and clinical variables and the lifestyle factors. CONCLUSION Lifestyle education is effective in facilitating the control of T2DM and reducing microalbuminuria. TRIAL REGISTRATION NUMBER researchregistry6348.
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467
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Hannan M, Kringle E, Hwang CL, Laddu D. Behavioral Medicine for Sedentary Behavior, Daily Physical Activity, and Exercise to Prevent Cardiovascular Disease: A Review. Curr Atheroscler Rep 2021; 23:48. [PMID: 34226989 PMCID: PMC8257263 DOI: 10.1007/s11883-021-00948-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Behavioral medicine is a multidisciplinary field that has a key role in reducing risk factors for cardiovascular disease (CVD). The purpose of this review is to describe the role of behavioral medicine for CVD prevention, using physical activity behaviors (e.g., sedentary behavior, daily physical activity, or exercise) as an exemplar. Application of behavioral medicine to improve dietary behaviors is also briefly discussed. RECENT FINDINGS Behavioral medicine interventions that address physical activity behaviors are associated with improved cardiovascular risk factors. Interventions framed in behavior change theory that integrate behavior change techniques to reduce sedentary behavior and promote daily physical activity and exercise have similarly been applied to improve certain dietary behaviors and show promise for reducing CVD risk factors. Behavioral medicine has an important role in improving various physical activity behaviors for all populations, which is essential for preventing or managing CVD. Further investigation into behavioral medicine interventions that address personal, environmental, and social factors that influence participation in physical activity behaviors, as well as the adoption of a more optimal dietary pattern, is warranted.
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Affiliation(s)
- Mary Hannan
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL USA
| | - Emily Kringle
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL USA
| | - Cheuh-Lung Hwang
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor Street (MC 898), Chicago, IL USA
| | - Deepika Laddu
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor Street (MC 898), Chicago, IL USA
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468
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Fukushima N, Machida M, Kikuchi H, Amagasa S, Hayashi T, Odagiri Y, Takamiya T, Inoue S. Associations of working from home with occupational physical activity and sedentary behavior under the COVID-19 pandemic. J Occup Health 2021; 63:e12212. [PMID: 33683779 PMCID: PMC7938758 DOI: 10.1002/1348-9585.12212] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/10/2021] [Accepted: 02/15/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES To compare physical activity (PA) and sedentary behavior (SB) levels during work time between those who work from home (WFH) and at workplaces (no WFH), and by WFH subgroups. METHODS This cross-sectional internet-based survey included 1239 workers (mean age [standard deviation], 44.7 [13.7] years; 59.2% men) living in the Tokyo Metropolitan Area. Time spent sitting (SB), standing (light-intensity PA; LPA), walking, and engaging in heavy labor (moderate-to-vigorous PA; MVPA) during work time was measured using the Work-related Physical Activity Questionnaire. Workers reported weekly WFH percentages (eg, 0% implies no WFH and 100% implies full WFH), and WFH percentages were categorized into no WFH (0% WFH) and WFH (1%-100% WFH) groups. The WFH group was further subcategorized into 1%-25%, 26%-50%, 51%-75%, and 76%-100% subgroups. RESULTS Overall, 494 workers (39.9%) worked from home. During working hours, SB time was longer in the WFH group than in the no WFH group (mean minutes [% working-time SB]: 335.7 vs 224.7 min [74% vs 50%]). Significantly shorter LPA and MVPA times (%) were reported in the WFH group than in the no WFH group (LPA, 59.6 vs 122.9 min [14% vs 29%]; MVPA, 55.3 vs 91.9 min [13% vs 22%], all P < .001). Among the WFH subgroups, longer SB time and shorter LPA and MVPA times were observed in the highest WFH group (WFH 76%-100%) than in the WFH 1%-25% and 26%-50% subgroups. CONCLUSIONS Workers who telecommuted were less physically active and had longer sedentary during work time than those who worked at the workplaces.
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Affiliation(s)
- Noritoshi Fukushima
- Department of Preventive Medicine and Public HealthTokyo Medical UniversityTokyoJapan
| | - Masaki Machida
- Department of Preventive Medicine and Public HealthTokyo Medical UniversityTokyoJapan
| | - Hiroyuki Kikuchi
- Department of Preventive Medicine and Public HealthTokyo Medical UniversityTokyoJapan
| | - Shiho Amagasa
- Department of Preventive Medicine and Public HealthTokyo Medical UniversityTokyoJapan
| | - Toshio Hayashi
- Department of Preventive Medicine and Public HealthTokyo Medical UniversityTokyoJapan
| | - Yuko Odagiri
- Department of Preventive Medicine and Public HealthTokyo Medical UniversityTokyoJapan
| | - Tomoko Takamiya
- Department of Preventive Medicine and Public HealthTokyo Medical UniversityTokyoJapan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public HealthTokyo Medical UniversityTokyoJapan
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Dranebois S, Lalanne-Mistrih ML, Nacher M, Thelusme L, Deungoue S, Demar M, Dueymes M, Drak Alsibai K, Sabbah N. Prescription of Physical Activity by General Practitioners in Type 2 Diabetes: Practice and Barriers in French Guiana. Front Endocrinol (Lausanne) 2021; 12:790326. [PMID: 35082754 PMCID: PMC8784518 DOI: 10.3389/fendo.2021.790326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/29/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND General practitioners (GPs) are the major primary healthcare players in the management of type 2 diabetes. In addition to a well-balanced diet, physical activity (PA) appears as a necessary non-medicinal therapy in the management of diabetic patients. However, GPs emphasize several obstacles to its prescription. The aim of this study is to evaluate the practices, barriers, and factors favoring the prescription of PA in type 2 diabetic patients by GPs in French Guiana. METHOD We conducted a cross-sectional descriptive study using a questionnaire, designed to interview 152 French Guiana GPs and describe their practice in prescribing PA in type 2 diabetic patients. RESULTS Our results revealed that the prescription of PA as a non-medicinal therapeutic choice in the management of type 2 diabetes was practiced by 74% of the French Guiana GPs. However, only 37% of GPs responded that they implemented the recommendations; indeed, only one-third knew about them. The majority of GPs were interested in PA training, but only 11% were actually trained in this practice. The lack of structure adapted to the practice of PA and the lack of awareness of the benefits of PA in metabolic pathology appeared as the main obstacles to PA prescription. CONCLUSION This study highlights the importance of improving the training of GPs in the prescription of PA, the development of adapted PA structures, and collaboration between the different actors within the framework of the sport-health system in type 2 diabetes in French Guiana.
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Affiliation(s)
- Stephanie Dranebois
- Department of General Medicine, Cayenne Hospital Center, Cayenne, French Guiana
| | - Marie Laure Lalanne-Mistrih
- Department of Nutrition (UTDN-CSO), University Hospital of Guadeloupe, Pointe à Pitre, France
- Clinical Investigation Center Antilles, Guadeloupe (INSERM CIC 1424), University Hospital of Guadeloupe, Pointe à Pitre, France
| | - Mathieu Nacher
- Clinical Investigation Center Antilles French Guiana (INSERM CIC 1424) Cayenne Hospital Center, Cayenne, French Guiana
| | - Liliane Thelusme
- Department of Endocrinology and Metabolic Diseases, Cayenne Hospital Center, Cayenne, French Guiana
| | - Sandra Deungoue
- Clinical Investigation Center Antilles French Guiana (INSERM CIC 1424) Cayenne Hospital Center, Cayenne, French Guiana
| | - Magalie Demar
- EA3593, Amazon Ecosystems and Tropical Diseases, University of Guiana, Cayenne, French Guiana
- Department of Biology, Immunology and Parasitology, Cayenne Hospital Center, Cayenne, French Guiana
| | - Maryvonne Dueymes
- EA3593, Amazon Ecosystems and Tropical Diseases, University of Guiana, Cayenne, French Guiana
- Department of Biology, Immunology and Parasitology, Cayenne Hospital Center, Cayenne, French Guiana
| | - Kinan Drak Alsibai
- Center of Biological Resources (CRB Amazonie), Cayenne Hospital Center, Cayenne, French Guiana
- Department of Pathology, Cayenne Hospital Center, Cayenne, French Guiana
| | - Nadia Sabbah
- Clinical Investigation Center Antilles French Guiana (INSERM CIC 1424) Cayenne Hospital Center, Cayenne, French Guiana
- Department of Endocrinology and Metabolic Diseases, Cayenne Hospital Center, Cayenne, French Guiana
- EA3593, Amazon Ecosystems and Tropical Diseases, University of Guiana, Cayenne, French Guiana
- *Correspondence: Nadia Sabbah,
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470
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Machado MV. Aerobic Exercise in the Management of Metabolic Dysfunction Associated Fatty Liver Disease. Diabetes Metab Syndr Obes 2021; 14:3627-3645. [PMID: 34408459 PMCID: PMC8364841 DOI: 10.2147/dmso.s304357] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/29/2021] [Indexed: 12/17/2022] Open
Abstract
Sedentarism is the pandemic of modern times. It is associated with several medical conditions including obesity, type 2 diabetes mellitus, cardiovascular diseases and also liver disease, particularly metabolic dysfunction associated fatty liver disease (MAFLD). In an era when MAFLD is the most prevalent chronic liver disease worldwide, whilst no pharmacological therapy has been approved for it, exercise has proved to be effective in improving liver steatosis. Interestingly, exercise decreases liver fat even in the absence of weight loss. The challenge for the clinician is to motivate the obese patient with MAFLD, and associated co-morbidities, who has crystallized a sedentary behavior, at times when every need is at the distance of a click on the Internet, and the entire world can be visited behind a screen. In this review, the aggregate evidence on the mechanisms and effects of exercise in the management of MAFLD is summarized, with simple recommendations for everyday clinical practice.
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Affiliation(s)
- Mariana Verdelho Machado
- Serviço de Gastrenterologia, Hospital de Vila Franca de Xira, Vila Franca de Xira, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Correspondence: Mariana Verdelho Machado Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, 1649-035, PortugalTel +35 1912620306 Email
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471
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Ferreira MJ, Irigoyen MC, Angelis KD. Physically active routine during COVID-19 pandemic: do not fail to comply with the recommendations for cardiovascular health. MOTRIZ: REVISTA DE EDUCACAO FISICA 2021. [DOI: 10.1590/s1980-657420210000212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Affiliation(s)
| | | | - Kátia De Angelis
- Universidade Federal de São Paulo, Brazil; Universidade Nove de Julho, Brazil
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472
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Arocha Rodulfo JI. Approach to the cardiometabolic continuum. Narrative description. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2020; 33:158-167. [PMID: 33309070 DOI: 10.1016/j.arteri.2020.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/14/2020] [Accepted: 10/05/2020] [Indexed: 10/22/2022]
Abstract
Atherosclerotic cardiovascular disease (ACVD) is the major adverse outcome in the evolution of several metabolic conditions. For around several decades, the cardiovascular continuum has been used as a fantastic tool to explain the evolution of ACVD from the onset of risk factor, to clinical outcomes, and to death. Nowadays, metabolic diseases such as obesity, prediabetes, and type2 diabetes have been increasing enough to become serious public health problems and notorious contributors to the morbidity and mortality rates due to ACVD, including arterial hypertension. Other conditions seem to increase the list, such as: physical inactivity with its metabolic cluster, sarcopenia, and non-alcoholic fatty liver disease (NAFLD). Moreover, obesity in childhood has been growing at an exponential rate so the excess of adiposity in children and adolescents will translate into an excess of cardiometabolic risk in adults. Several longitudinal studies confirm the strong association of paediatric obesity with the persistence of adult obesity, as well as the future development of cardiometabolic conditions, such as prediabetes, diabetes, obesity, increased risk of arterial hypertension, and ACVD. Therefore, it is time to conceptualise the cardiometabolic continuum as a tool of an early, wider and preventive intervention in order to reduce the morbidity and mortality due to ACVD.
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Affiliation(s)
- J Ildefonzo Arocha Rodulfo
- Sociedad Venezolana de Cardiología, Fundación Venezolana de Cardiología Preventiva, Chacao, Caracas, Venezuela.
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473
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Werneck AO, Sadarangani KP, Ramírez-Vélez R, Baldew SS, Gomes TN, Ferrari G, Szwarcwald CL, Miranda JJ, Silva DR. Macroeconomic, demographic and human developmental correlates of physical activity and sitting time among South American adults. Int J Behav Nutr Phys Act 2020; 17:163. [PMID: 33317548 PMCID: PMC7737374 DOI: 10.1186/s12966-020-01068-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 12/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Our aim was to investigate the association of macroeconomic, human development, and demographic factors with different domains of physical activity and sitting time among South American adults. METHODS We used data from nationally representative samples in Argentina (n = 26,932), Brazil (n = 52,490), Chile (n = 3866), Colombia (n = 14,208), Ecuador (n = 19,883), Peru (n = 8820), and Uruguay (n = 2403). Our outcomes included leisure time (≥150 min/week), transport (≥10 min/week), occupational (≥10 min/week), and total (≥150 min/week) physical activity, as well as sitting time (≥4 h/day), which were collected through self-reported questionnaires. As exposures, gross domestic product, total population, population density, and human development index indicators from the most updated national census of each country were used. Age and education were used as covariates. Multilevel logistic regressions with harmonized random effect meta-analyses were conducted, comparing highest vs. lowest (reference) tertiles. RESULTS Higher odds for transport physical activity were observed among the highest tertiles of total population (ORmen: 1.41; 95% CI: 1.23-1.62), ORwomen: 1.51; 95% CI:1.32-1.73), population density (ORmen: 1.36; 95% CI: 1.18-1.57, ORwomen: 1.49; 95% CI: 1.30-1.70), and gross domestic product (ORmen: 1.16; 95% CI: 1.00-1.35, ORwomen: 1.39; 95% CI: 1.20-1.61). For leisure physical activity, women living in departments with higher human development index presented 18% higher odds for being active, and for total physical activity a similar estimate in both sexes was observed among those who live in more populated areas. No consistent associations were found for occupational physical activity and sitting time. CONCLUSION Macroeconomic, demographic and human development indicators are associated with different domains of physical activity in the South American context, which can in turn guide policies to promote physical activity in the region.
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Affiliation(s)
- André O Werneck
- Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, School of Public Health, Universidade de São Paulo (USP), Av. Dr. Arnaldo, 715 - Cerqueira César, São Paulo, SP, 01246-904, Brazil.
| | - Kabir P Sadarangani
- Escuela de Kinesiología, Universidad Autónoma de Chile, Santiago, Chile
- Escuela de Kinesiología, Facultad de Salud y Odontología, Universidad Diego Portales, Santiago, Chile
| | - Robinson Ramírez-Vélez
- Department of Health Sciences, Public University of Navarra, Navarrabiomed-Biomedical Research Centre, IDISNA-Navarra's Health Research Institute, Complejo Hospitalario de Navarra, C/irunlarrea 3, 31,008, 31008, Pamplona, Navarra, Spain
| | - Se-Sergio Baldew
- Department of Physical Therapy, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - Thayse N Gomes
- Department of Physical Education, Federal University of Sergipe - UFS, São Cristóvão, Brazil
| | - Gerson Ferrari
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, USACH, Santiago, Chile
| | | | - J Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Danilo R Silva
- Department of Physical Education, Federal University of Sergipe - UFS, São Cristóvão, Brazil
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474
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Morris AS, Mackintosh KA, Dunstan D, Owen N, Dempsey P, Pennington T, McNarry MA. Rise and Recharge: Effects on Activity Outcomes of an e-Health Smartphone Intervention to Reduce Office Workers' Sitting Time. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9300. [PMID: 33322678 PMCID: PMC7764765 DOI: 10.3390/ijerph17249300] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 12/15/2022]
Abstract
This feasibility study evaluated the effects of an individual-level intervention to target office workers total and prolonged sedentary behaviour during working hours, using an e-health smartphone application. A three-arm (Prompt-30 or 60 min Intervention arm and a No-Prompt Comparison arm), quasi-randomised intervention was conducted over 12 weeks. Behavioural outcomes (worktime sitting, standing, stepping, prolonged sitting, and physical activity) were monitored using accelerometers and anthropometrics measured at baseline, 6 weeks and 12 weeks. Cardiometabolic measures were taken at baseline and 12 weeks. Fifty-six office workers (64% female) completed baseline assessments. The Prompt-60 arm was associated with a reduction in occupational sitting time at 6 (-46.8 min/8 h workday [95% confidence interval = -86.4, -6.6], p < 0.05) and 12 weeks (-69.6 min/8 h workday [-111.0, -28.2], p < 0.05) relative to the No-Prompt Comparison arm. Sitting was primarily replaced with standing in both arms (p > 0.05). Both Intervention arms reduced time in prolonged sitting bouts at 12 weeks (Prompt-30: -27.0 [-99.0, 45.0]; Prompt-60: -25.8 [-98.4, 47.4] min/8 h workday; both p > 0.05). There were no changes in steps or cardiometabolic risk. Findings highlight the potential of a smartphone e-health application, suggesting 60 min prompts may present an optimal frequency to reduce total occupational sedentary behaviour.
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Affiliation(s)
- Abigail S. Morris
- School of Sport and Exercise Sciences, Swansea University, Swansea SA1 8EN, Wales, UK; (A.S.M.); (K.A.M.); (T.P.)
- Department of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YW, UK
| | - Kelly A. Mackintosh
- School of Sport and Exercise Sciences, Swansea University, Swansea SA1 8EN, Wales, UK; (A.S.M.); (K.A.M.); (T.P.)
| | - David Dunstan
- Baker Heart & Diabetes Institute, Melbourne, VIC 3004, Australia; (D.D.); (N.O.); (P.D.)
| | - Neville Owen
- Baker Heart & Diabetes Institute, Melbourne, VIC 3004, Australia; (D.D.); (N.O.); (P.D.)
| | - Paddy Dempsey
- Baker Heart & Diabetes Institute, Melbourne, VIC 3004, Australia; (D.D.); (N.O.); (P.D.)
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0SL, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK
| | - Thomas Pennington
- School of Sport and Exercise Sciences, Swansea University, Swansea SA1 8EN, Wales, UK; (A.S.M.); (K.A.M.); (T.P.)
| | - Melitta A. McNarry
- School of Sport and Exercise Sciences, Swansea University, Swansea SA1 8EN, Wales, UK; (A.S.M.); (K.A.M.); (T.P.)
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475
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Aunger J, Wagnild J. Objective and subjective measurement of sedentary behavior in human adults: A toolkit. Am J Hum Biol 2020; 34:e23546. [PMID: 33277954 PMCID: PMC9286366 DOI: 10.1002/ajhb.23546] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/11/2020] [Accepted: 11/19/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Objectives: Human biologists are increasingly interested in measuring and comparing physical activities in different societies. Sedentary behavior, which refers to time spent sitting or lying down while awake, is a large component of daily 24 hours movement patterns in humans and has been linked to poor health outcomes such as risk of all-cause and cardiovascular mortality, independently of physical activity. As such, it is important for researchers, with the aim of measuring human movement patterns, to most effectively use resources available to them to capture sedentary behavior. METHODS This toolkit outlines objective (device-based) and subjective (self-report) methods for measuring sedentary behavior in free-living contexts, the benefits and drawbacks to each, as well as novel options for combined use to maximize scientific rigor. Throughout this toolkit, emphasis is placed on considerations for the use of these methods in various field conditions and in varying cultural contexts. RESULTS Objective measures such as inclinometers are the gold-standard for measuring total sedentary time but they typically cannot capture contextual information or determine which specific behaviors are taking place. Subjective measures such as questionnaires and 24 hours-recall methods can provide measurements of time spent in specific sedentary behaviors but are subject to measurement error and response bias. CONCLUSIONS We recommend that researchers use the method(s) that suit the research question; inclinometers are recommended for the measurement of total sedentary time, while self-report methods are recommended for measuring time spent in particular contexts of sedentary behavior.
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Affiliation(s)
- Justin Aunger
- Health Services Management Centre, Park House, University of Birmingham, England, UK
| | - Janelle Wagnild
- Department of Anthropology, Durham University, Durham, England, UK
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476
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Dieterich AV, Müller AM, Akksilp K, K C S, Dabak SV, Rouyard T. Reducing sedentary behaviour and physical inactivity in the workplace: protocol for a review of systematic reviews. BMJ Open Sport Exerc Med 2020; 6:e000909. [PMID: 33324487 PMCID: PMC7722375 DOI: 10.1136/bmjsem-2020-000909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Increasing rates of urbanisation have been accompanied by higher levels of sedentary behaviour (SB) and reduced physical activity (PA) worldwide. While physical inactivity has long been identified as a major risk factor for morbidity and mortality, increased concerns about the detrimental associations between SB and health has led to the development of many interventions aimed at reducing SB and/or promoting PA. Due to the prominence of sedentary time spent at work, the workplace has been identified as a key setting to implement such interventions. Building an evidence base of effective strategies to reduce SB and/or promote PA at work is needed to help reduce the health risks faced by many employees. METHODS AND ANALYSIS We aim to conduct a review of reviews (RoR) to identify, evaluate and synthesise all systematic reviews (SRs) of workplace interventions aimed at reducing SB and/or promoting PA among adults. Systematic searches for relevant SRs will be conducted in six databases: Cochrane Systematic Review Database, Cumulative Index to Nursing & Allied Health Literature through EBSCOhost, EMBASE, PubMed including MEDLINE, Scopus and Web of Science. Selection for final inclusion and data extraction will be performed by two independent reviewers. SRs will be included if they assessed interventions aimed at reducing SB or promoting PA in the workplace, and if they report on changes in the respective behavioural outcomes in the occupational domain. DISCUSSION This RoR will be valuable to policy-makers and employers who are looking for strategies to promote health at work. This will also allow potential research gaps to be identified, so that the design of future studies can be better informed. TRIAL REGISTERATION This study has been registered with the PROSPERO International Prospective Register of Systematic Reviews (registration number CRD42020171774).
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Affiliation(s)
| | - Andre Matthias Müller
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Centre for Sport & Exercise Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | - Katika Akksilp
- Health Intervention and Technology Assessment Program, Mueang Nonthaburi, Thailand
| | - Sarin K C
- Health Intervention and Technology Assessment Program, Mueang Nonthaburi, Thailand
| | | | - Thomas Rouyard
- Research Center for Health Policy and Economics, Hitotsubashi University, Kunitachi, Japan
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477
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Intervention Effects of the Health Promotion Programme "Join the Healthy Boat" on Objectively Assessed Sedentary Time in Primary School Children in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239029. [PMID: 33287418 PMCID: PMC7730991 DOI: 10.3390/ijerph17239029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/16/2020] [Accepted: 11/26/2020] [Indexed: 12/11/2022]
Abstract
Sedentary behaviour (SB) in children is related to negative health consequences that can track into adulthood. The programme "Join the Healthy Boat" promotes reduced screen time and a less sedentary lifestyle in schoolchildren. This study investigated the effects of the programme on children's SB. For one year, teachers delivered the programme. A total of 231 children (7.0 ± 0.6 years) participated in the cluster-randomised study; there were 154 one year later at follow-up. Children's SB was assessed using multi-sensor accelerometery, screen time via parental questionnaire. Effects were analysed using (linear) mixed effects regression models. At baseline, children spent 211 (±89) min daily in SB, at follow-up 259 (±109) min/day with no significant difference between the intervention (IG) and control group (CG). SB was higher during weekends (p < 0.01, for CG and IG). However, at follow-up, daily screen time decreased in IG (screen time of >1 h/day: baseline: 33.3% vs. 27.4%; follow-up: 41.2% vs. 27.5%, for CG and IG, respectively). This multi-dimensional, low-threshold intervention for one year does not seem to achieve a significant reduction in children's SB, although screen time decreased in IG. Therefore, it should be considered that screen time cannot be the key contributor to SB and should not solely be used for changing children's SB. However, if screen time is targeted, interventions should promote the replacement of screen time with active alternatives.
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478
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Lerma NL, Cho CC, Swartz AM, Maeda H, Cho Y, Strath SJ. Acceptance and Feasibility of Seated Elliptical Pedaling to Replace Sedentary Behavior in Older Adults. J Aging Phys Act 2020; 28:844-853. [PMID: 32485664 DOI: 10.1123/japa.2019-0388] [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: 10/22/2019] [Revised: 03/04/2020] [Accepted: 03/17/2020] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to explore the feasibility and acceptability of a seated pedaling device to reduce sedentary behavior (SB) in the homes of older adults. METHODS Each participant (N = 20) was outfitted with an activity monitor and seated pedaling device in the home for 7 days and randomly assigned to one of four light-intensity pedaling groups (15, 30, 45, and 60 min/day). RESULTS There was 100% adherence in all groups and significant group differences in the minutes pedaled per day (p < .001), with no significant difference in the total pedaling days completed (p = .241). The 15-, 30-, 45-, and 60-min groups experienced a 4.0%, 5.4%, 10.6%, and 11.3% reduction in SB on the days pedaled, respectively. CONCLUSION Clinically relevant reductions in SB time were achievable in this 1-week trial. Long-term adherence and the impact of replacing SB with seated light activities on geriatric-relevant health outcomes should be investigated.
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479
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Ekelund U, Tarp J, Fagerland MW, Johannessen JS, Hansen BH, Jefferis BJ, Whincup PH, Diaz KM, Hooker S, Howard VJ, Chernofsky A, Larson MG, Spartano N, Vasan RS, Dohrn IM, Hagströmer M, Edwardson C, Yates T, Shiroma EJ, Dempsey P, Wijndaele K, Anderssen SA, Lee IM. Joint associations of accelero-meter measured physical activity and sedentary time with all-cause mortality: a harmonised meta-analysis in more than 44 000 middle-aged and older individuals. Br J Sports Med 2020; 54:1499-1506. [PMID: 33239356 PMCID: PMC7719907 DOI: 10.1136/bjsports-2020-103270] [Citation(s) in RCA: 137] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To examine the joint associations of accelerometer-measured physical activity and sedentary time with all-cause mortality. METHODS We conducted a harmonised meta-analysis including nine prospective cohort studies from four countries. 44 370 men and women were followed for 4.0 to 14.5 years during which 3451 participants died (7.8% mortality rate). Associations between different combinations of moderate-to-vigorous intensity physical activity (MVPA) and sedentary time were analysed at study level using Cox proportional hazards regression analysis and summarised using random effects meta-analysis. RESULTS Across cohorts, the average time spent sedentary ranged from 8.5 hours/day to 10.5 hours/day and 8 min/day to 35 min/day for MVPA. Compared with the referent group (highest physical activity/lowest sedentary time), the risk of death increased with lower levels of MVPA and greater amounts of sedentary time. Among those in the highest third of MVPA, the risk of death was not statistically different from the referent for those in the middle (16%; 95% CI 0.87% to 1.54%) and highest (40%; 95% CI 0.87% to 2.26%) thirds of sedentary time. Those in the lowest third of MVPA had a greater risk of death in all combinations with sedentary time; 65% (95% CI 1.25% to 2.19%), 65% (95% CI 1.24% to 2.21%) and 263% (95% CI 1.93% to 3.57%), respectively. CONCLUSION Higher sedentary time is associated with higher mortality in less active individuals when measured by accelerometry. About 30-40 min of MVPA per day attenuate the association between sedentary time and risk of death, which is lower than previous estimates from self-reported data.
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Affiliation(s)
- Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Department of chronic diseases and ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Jakob Tarp
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Morten W Fagerland
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Bjørge H Hansen
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Vest-Agder, Norway
| | - Barbara J Jefferis
- Primary Care & Population Health, Institute of Epidemiology & Health care, University College London, London, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's, University of London, London, UK
| | - Keith M Diaz
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, New York, USA
| | - Steven Hooker
- College of Health and Human Services, San Diego State University, San Diego, California, USA
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ariel Chernofsky
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Martin G Larson
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Nicole Spartano
- Department of Endocrinology, Diabetes, Nutrition and Weight Management, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Ramachandran S Vasan
- Departments of Medicine and Epidemiology, Boston University School of Medicine and Boston University School of Public Health, Boston, Massachusetts, USA
| | - Ing-Mari Dohrn
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
| | - Maria Hagströmer
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
- Function area Occupational Therapy and Physiotherapy, Allied Health Professionals, Karolinska Institutet, Huddinge, Sweden
| | - Charlotte Edwardson
- NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
| | - Thomas Yates
- NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
| | - Eric J Shiroma
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, Maryland, USA
| | - Paddy Dempsey
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, Cambridgeshire, UK
- Physical Activity & Behavioural Epidemiology Laboratories, Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia
| | - Katrien Wijndaele
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Sigmund A Anderssen
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - I-Min Lee
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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480
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Tremblay MS, Rollo S, Saunders TJ. Sedentary Behavior Research Network members support new Canadian 24-Hour Movement Guideline recommendations. JOURNAL OF SPORT AND HEALTH SCIENCE 2020; 9:479-481. [PMID: 33071162 PMCID: PMC7749241 DOI: 10.1016/j.jshs.2020.09.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/12/2020] [Indexed: 05/02/2023]
Affiliation(s)
- Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 8L1, Canada; Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON, K1H 8M5, Canada; Department of Health Sciences, Carleton University, Ottawa, ON, K1S 5B6, Canada.
| | - Scott Rollo
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 8L1, Canada; Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON, K1H 8M5, Canada
| | - Travis J Saunders
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PEI, C1A 4P3, Canada
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481
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Kirwan R, McCullough D, Butler T, Perez de Heredia F, Davies IG, Stewart C. Sarcopenia during COVID-19 lockdown restrictions: long-term health effects of short-term muscle loss. GeroScience 2020; 42:1547-1578. [PMID: 33001410 PMCID: PMC7528158 DOI: 10.1007/s11357-020-00272-3] [Citation(s) in RCA: 176] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/16/2020] [Indexed: 12/16/2022] Open
Abstract
The COVID-19 pandemic is an extraordinary global emergency that has led to the implementation of unprecedented measures in order to stem the spread of the infection. Internationally, governments are enforcing measures such as travel bans, quarantine, isolation, and social distancing leading to an extended period of time at home. This has resulted in reductions in physical activity and changes in dietary intakes that have the potential to accelerate sarcopenia, a deterioration of muscle mass and function (more likely in older populations), as well as increases in body fat. These changes in body composition are associated with a number of chronic, lifestyle diseases including cardiovascular disease (CVD), diabetes, osteoporosis, frailty, cognitive decline, and depression. Furthermore, CVD, diabetes, and elevated body fat are associated with greater risk of COVID-19 infection and more severe symptomology, underscoring the importance of avoiding the development of such morbidities. Here we review mechanisms of sarcopenia and their relation to the current data on the effects of COVID-19 confinement on physical activity, dietary habits, sleep, and stress as well as extended bed rest due to COVID-19 hospitalization. The potential of these factors to lead to an increased likelihood of muscle loss and chronic disease will be discussed. By offering a number of home-based strategies including resistance exercise, higher protein intakes and supplementation, we can potentially guide public health authorities to avoid a lifestyle disease and rehabilitation crisis post-COVID-19. Such strategies may also serve as useful preventative measures for reducing the likelihood of sarcopenia in general and in the event of future periods of isolation.
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Affiliation(s)
- Richard Kirwan
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK.
| | - Deaglan McCullough
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Tom Butler
- Department of Clinical Sciences and Nutrition, University of Chester, Chester, UK.
| | - Fatima Perez de Heredia
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | - Ian G Davies
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Claire Stewart
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
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482
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Mougharbel F, Goldfield GS. Psychological Correlates of Sedentary Screen Time Behaviour Among Children and Adolescents: a Narrative Review. Curr Obes Rep 2020; 9:493-511. [PMID: 32870464 DOI: 10.1007/s13679-020-00401-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW The aims of this narrative review were to (1) synthesise the literature on the relationship between screen time and important mental health outcomes and (2) examine the underpinning factors that can influence this association. RECENT FINDINGS Paralleling the rise of mental health issues in children and adolescents is the ubiquitous overuse of screens, but it is unclear how screen time is related to important mental health outcomes and whether this association differs by gender, age and screen type. METHODS Medline/PubMed, PsychINFO and Google Scholar databases were searched on December 2019 for articles published mainly in the last 5 years. The search focused on two main concepts: (i) screen time and (ii) mental health outcomes including anxiety, depression, psychological and psychosocial well-being and body image concerns. RESULTS Sixty studies were included in the review. Higher levels of screen time were associated with more severe depressive symptoms. We found moderate evidence for an association between screen time and poor psychological well-being and body dissatisfaction especially among females. Relationships between screen time and anxiety were inconsistent and somewhat gender specific. Social media use was consistently associated with poorer mental health. Higher levels of screen time are generally associated with poorer mental health outcomes, but associations are influenced by screen type, gender and age. Practitioners, parents, policy makers and researchers should collectively identify and evaluate strategies to reduce screen time, or to use screens more adaptively, as a means of promoting better mental health among children and adolescents.
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Affiliation(s)
- Fatima Mougharbel
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Gary S Goldfield
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada.
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483
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Stamatakis E, Bauman AE. The bold sedentary behavior recommendations in the new Canadian guidelines: are they evidence-based? Response to "Sedentary Behavior Research Network members support new Canadian 24-Hour Movement Guideline recommendations". JOURNAL OF SPORT AND HEALTH SCIENCE 2020; 9:482-484. [PMID: 33071163 PMCID: PMC7749232 DOI: 10.1016/j.jshs.2020.09.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 09/19/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Emmanuel Stamatakis
- Charles Perkins Centre, Faculty of Medicine and Health, School of Health Sciences, University of Sydney, Sydney, NSW 2006, Australia.
| | - Adrian E Bauman
- Charles Perkins Centre, Faculty of Medicine and Health, School of Public Health, Prevention Research Collaboration, University of Sydney, Sydney, NSW 2006, Australia
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484
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Meisinger C, Linseisen J, Leitzmann M, Baurecht H, Baumeister SE. Association of physical activity and sedentary behavior with type 2 diabetes and glycemic traits: a two-sample Mendelian randomization study. BMJ Open Diabetes Res Care 2020; 8:8/2/e001896. [PMID: 33293297 PMCID: PMC7725078 DOI: 10.1136/bmjdrc-2020-001896] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/19/2020] [Accepted: 11/11/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Observational studies suggest that physical activity lowers and sedentary behavior increases the risk of type 2 diabetes. Despite of some supportive trial data for physical activity, it is largely unresolved whether these relations are causal or due to bias. OBJECTIVE We investigated the associations between accelerometer-based physical activity and sedentary behavior with type 2 diabetes and several glycemic traits using two-sample Mendelian randomization analysis. RESEARCH DESIGN AND METHODS Single nucleotide polymorphisms (SNPs) associated at p<5×10-8 with accelerometer-based physical activity average accelerations, vigorous physical activity (fraction of accelerations >425 milligravities), and sedentary behavior (metabolic equivalent task ≤1.5) in a genome-wide analysis of the UK Biobank served as instrumental variables. OUTCOMES Type 2 diabetes, hemoglobin A1c (HbA1c), fasting glucose, homeostasis model assessment of beta-cell function (HOMA-B), and homeostasis model assessment of insulin resistance (HOMA-IR). RESULTS Physical activity and sedentary behavior were unrelated to type 2 diabetes, HbA1c, fasting glucose, HOMA-B, and HOMA-IR. The inverse variance weighted ORs per SD increment for the association between average accelerations and vigorous physical activity with type 2 diabetes were 1.00 (95% CI 0.94 to 1.07, p=0.948) and 0.83 (95% CI 0.56 to 1.23, p=0.357), respectively. These results were confirmed by sensitivity analyses using alternative MR-methods to test the robustness of our findings. CONCLUSIONS Based on these results, genetically predicted objectively measured average or vigorous physical activity and sedentary behavior is not associated with type 2 diabetes risk or with glycemic traits in the general population. Further research is required to deepen the understanding of the biological pathways of physical activity.
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Affiliation(s)
- Christa Meisinger
- Chair of Epidemiology at UNIKA-T Augsburg, Ludwig-Maximilians-Universitat Munchen, Munchen, Germany
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Jakob Linseisen
- Chair of Epidemiology at UNIKA-T Augsburg, Ludwig-Maximilians-Universitat Munchen, Munchen, Germany
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Hansjoerg Baurecht
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Sebastian Edgar Baumeister
- Chair of Epidemiology at UNIKA-T Augsburg, Ludwig-Maximilians-Universitat Munchen, Munchen, Germany
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
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485
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Huntington J, Dwyer JJM, Shama S, Brauer P. Registered dietitians' beliefs and behaviours related to counselling patients on physical activity and sedentary behaviour from a theory of planned behaviour perspective. BMC Nutr 2020; 6:66. [PMID: 33292838 PMCID: PMC7702673 DOI: 10.1186/s40795-020-00392-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 10/26/2020] [Indexed: 11/18/2022] Open
Abstract
Background Registered dietitians working in team-based primary care settings (e.g., family health teams [FHTs]) are positioned to counsel on physical activity and sedentary behaviour when providing nutrition-related services to promote health and prevent disease. This qualitative study explored FHT registered dietitians’ beliefs and behaviours related to counselling patients on physical activity and sedentary behaviour. Methods Twenty registered dietitians in FHTs in Ontario, Canada were interviewed in person. Theory of planned behaviour guided the development of this cross-sectional, descriptive study. Thematic analysis was used to identify themes within each of the following theoretical constructs (topics): registered dietitians’ behaviour (practice), behavioural intention, attitude, subjective norm, and perceived behavioural control related to physical activity and sedentary behaviour counselling. Results All participants counselled patients on physical activity, using some motivational interviewing strategies, and most counselled on sedentary behaviour. Many participants intended to continue their current physical activity counselling practices and increase sedentary behaviour counselling. Some participants had a positive attitude about the effectiveness of counselling on physical activity and sedentary behaviour, but their belief about effectiveness was dependent on factors such as time frame for behaviour change. Many participants felt that other health care professionals expected them to counsel on physical activity and they believed that other registered dietitians counsel on physical activity and sedentary behaviour. Facilitators to counselling included FHT dynamics and time with patients. In terms of barriers, almost all participants were confident in basic PA counselling only and contended that only this is within their scope of practice. Many participants posited that exercise prescription is outside their scope of practice. Other barriers included registered dietitians’ lack of knowledge and not having a physical activity expert on the team. Conclusions The results suggest that strategies are warranted to improve FHT registered dietitians’ knowledge, attitude, and counselling skills related to physical activity and sedentary behaviour. This study provides a strong foundation to develop a theory-based, quantitative measure to assess physical activity and sedentary behaviour counselling practices and determinants among registered dietitians. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-020-00392-1.
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Affiliation(s)
- Jessica Huntington
- Department of Family Relations and Applied Nutrition, University of Guelph, Macdonald Institute Building, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
| | - John J M Dwyer
- Department of Family Relations and Applied Nutrition, University of Guelph, Macdonald Institute Building, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada.
| | - Sara Shama
- Department of Family Relations and Applied Nutrition, University of Guelph, Macdonald Institute Building, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
| | - Paula Brauer
- Department of Family Relations and Applied Nutrition, University of Guelph, Macdonald Institute Building, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
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486
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El Khoudary SR, Aggarwal B, Beckie TM, Hodis HN, Johnson AE, Langer RD, Limacher MC, Manson JE, Stefanick ML, Allison MA. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation 2020; 142:e506-e532. [PMID: 33251828 DOI: 10.1161/cir.0000000000000912] [Citation(s) in RCA: 334] [Impact Index Per Article: 83.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of death in women, who have a notable increase in the risk for this disease after menopause and typically develop coronary heart disease several years later than men. This observation led to the hypothesis that the menopause transition (MT) contributes to the increase in coronary heart disease risk. Over the past 20 years, longitudinal studies of women traversing menopause have contributed significantly to our understanding of the relationship between the MT and CVD risk. By following women over this period, researchers have been able to disentangle chronological and ovarian aging with respect to CVD risk. These studies have documented distinct patterns of sex hormone changes, as well as adverse alterations in body composition, lipids and lipoproteins, and measures of vascular health over the MT, which can increase a woman's risk of developing CVD postmenopausally. The reported findings underline the significance of the MT as a time of accelerating CVD risk, thereby emphasizing the importance of monitoring women's health during midlife, a critical window for implementing early intervention strategies to reduce CVD risk. Notably, the 2011 American Heart Association guidelines for CVD prevention in women (the latest sex-specific guidelines to date) did not include information now available about the contribution of the MT to increased CVD in women. Therefore, there is a crucial need to discuss the contemporary literature on menopause and CVD risk with the intent of increasing awareness of the significant adverse cardiometabolic health-related changes accompanying midlife and the MT. This scientific statement provides an up-to-date synthesis of the existing data on the MT and how it relates to CVD.
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487
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Dempsey PC, Biddle SJH, Buman MP, Chastin S, Ekelund U, Friedenreich CM, Katzmarzyk PT, Leitzmann MF, Stamatakis E, van der Ploeg HP, Willumsen J, Bull F. New global guidelines on sedentary behaviour and health for adults: broadening the behavioural targets. Int J Behav Nutr Phys Act 2020; 17:151. [PMID: 33239026 PMCID: PMC7691115 DOI: 10.1186/s12966-020-01044-0] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/23/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND In 2018, the World Health Organisation (WHO) commenced a program of work to update the 2010 Global Recommendations on Physical Activity for Health, for the first-time providing population-based guidelines on sedentary behaviour. This paper briefly summarizes and highlights the scientific evidence behind the new sedentary behaviour guidelines for all adults and discusses its strengths and limitations, including evidence gaps/research needs and potential implications for public health practice. METHODS An overview of the scope and methods used to update the evidence is provided, along with quality assessment and grading methods for the eligible new systematic reviews. The literature search update was conducted for WHO by an external team and reviewers used the AMSTAR 2 (Assessment of Multiple Systematic Reviews) tool for critical appraisal of the systematic reviews under consideration for inclusion. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to rate the certainty (i.e. very low to high) of the evidence. RESULTS The updated systematic review identified 22 new reviews published from 2017 up to August 2019, 14 of which were incorporated into the final evidence profiles. Overall, there was moderate certainty evidence that higher amounts of sedentary behaviour increase the risk for all-cause, cardiovascular disease (CVD) and cancer mortality, as well as incidence of CVD, cancer, and type 2 diabetes. However, evidence was deemed insufficient at present to set quantified (time-based) recommendations for sedentary time. Moderate certainty evidence also showed that associations between sedentary behaviour and all-cause, CVD and cancer mortality vary by level of moderate-to-vigorous physical activity (MVPA), which underpinned additional guidance around MVPA in the context of high sedentary time. Finally, there was insufficient or low-certainty systematic review evidence on the type or domain of sedentary behaviour, or the frequency and/or duration of bouts or breaks in sedentary behaviour, to make specific recommendations for the health outcomes examined. CONCLUSIONS The WHO 2020 guidelines are based on the latest evidence on sedentary behaviour and health, along with interactions between sedentary behaviour and MVPA, and support implementing public health programmes and policies aimed at increasing MVPA and limiting sedentary behaviour. Important evidence gaps and research opportunities are identified.
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Affiliation(s)
- Paddy C Dempsey
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
- Baker Heart and Diabetes Institute, Melbourne, Australia.
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.
| | - Stuart J H Biddle
- Centre for Health Research, University of Southern Queensland, Springfield Central, Australia
| | - Matthew P Buman
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Sebastien Chastin
- Department of Movement and Sports Sciences, University of Ghent, Ghent, Belgium
- School of Health and Life Sciences, Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Science, Oslo, Norway
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | - Michael F Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Juana Willumsen
- Physical Activity Unit, Department of Health Promotion, World Health Organization, Geneva, Switzerland
| | - Fiona Bull
- Physical Activity Unit, Department of Health Promotion, World Health Organization, Geneva, Switzerland
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488
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Lysen TS, Ikram MA, Ghanbari M, Luik AI. Sleep, 24-h activity rhythms, and plasma markers of neurodegenerative disease. Sci Rep 2020; 10:20691. [PMID: 33244083 PMCID: PMC7692474 DOI: 10.1038/s41598-020-77830-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 11/18/2020] [Indexed: 11/23/2022] Open
Abstract
Sleep and 24-h activity rhythm disturbances are associated with development of neurodegenerative diseases and related pathophysiological processes in the brain. We determined the cross-sectional relation of sleep and 24-h activity rhythm disturbances with plasma-based biomarkers that might signal neurodegenerative disease, in 4712 middle-aged and elderly non-demented persons. Sleep and activity rhythms were measured using the Pittsburgh Sleep Quality Index and actigraphy. Simoa assays were used to measure plasma levels of neurofilament light chain, and additionally β-amyloid 40, β-amyloid 42, and total-tau. We used linear regression, adjusting for relevant confounders, and corrected for multiple testing. We found no associations of self-rated sleep, actigraphy-estimated sleep and 24-h activity rhythms with neurofilament light chain after confounder adjustment and correction for multiple testing, except for a non-linear association of self-rated time in bed with neurofilament light chain (P = 2.5*10−4). Similarly, we observed no significant associations with β-amyloid 40, β-amyloid 42, and total-tau after multiple testing correction. We conclude that sleep and 24-h activity rhythm disturbances were not consistently associated with neuronal damage as indicated by plasma neurofilament light chain in this population-based sample middle-aged and elderly non-demented persons. Further studies are needed to determine the associations of sleep and 24-h activity rhythm disturbances with NfL-related neuronal damage.
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Affiliation(s)
- Thom S Lysen
- Department of Epidemiology, Erasmus MC, University Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus MC, University Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus MC, University Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
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489
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Both sedentary time and physical activity are associated with cardiometabolic health in overweight adults in a 1 month accelerometer measurement. Sci Rep 2020; 10:20578. [PMID: 33239818 PMCID: PMC7688927 DOI: 10.1038/s41598-020-77637-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/09/2020] [Indexed: 12/31/2022] Open
Abstract
The aim of this study was to examine the associations of cardiometabolic health markers with device-measured sedentary behavior (SB) duration and different intensities of physical activity (PA) among overweight working-aged adults with low self-reported PA levels. This cross-sectional analysis included 144 subjects (42 men) with mean age of 57 (SD 6.5) years and mean BMI of 31.7 (SD 4) kg/m2. SB and standing time, breaks in sedentary time, light PA (LPA) and moderate-to-vigorous PA (MVPA) were measured for 4 consecutive weeks (mean 25 days, SD 4) with hip-worn accelerometers. Fasting plasma glucose, insulin, HbA1c, triglycerides and total cholesterol, HDL and LDL were measured from venous blood samples. HOMA-IR index was calculated as a surrogate of insulin resistance. The associations were examined using linear models. LPA, MVPA, and daily steps associated with better insulin sensitivity and favorable plasma lipid profile, when adjusted for age, sex and BMI, whereas greater proportion of SB associated with insulin resistance and unfavorable lipid profile. As all PA intensities associated with better cardiometabolic health, the total daily duration of PA may be more relevant than intensity in maintaining metabolic health in overweight adults, if the current guidelines for PA are not met. Trial Registration: ClinicalTrials.gov NCT03101228, registered 05/04/2017, https://clinicaltrials.gov/show/NCT03101228.
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490
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Scartoni FR, Sant'Ana LDO, Murillo-Rodriguez E, Yamamoto T, Imperatori C, Budde H, Vianna JM, Machado S. Physical Exercise and Immune System in the Elderly: Implications and Importance in COVID-19 Pandemic Period. Front Psychol 2020; 11:593903. [PMID: 33329256 PMCID: PMC7711129 DOI: 10.3389/fpsyg.2020.593903] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/27/2020] [Indexed: 12/19/2022] Open
Abstract
Physical exercise is seen as the main ally for health promotion, preventing and protecting the organism from several diseases. According to WHO, there is a tendency of constant growth in the elderly population in the coming years. The regular practice of exercises by the elderly becomes relevant to minimize the deleterious effects of the aging process and to increase the fitness index. Recently, the world population started a confrontation against Corona Virus Disease (COVID-19), which is the most significant public health challenge globally. Although social isolation is a reasonable measure in an attempt to stop contamination by COVID-19, this measure has limited the ability of individuals to exercise outdoors or in gyms and health clubs, which increased the risk of developing chronic illnesses related to a sedentary lifestyle. The critical point is that the recent recommendations on exercise prescription to combat the potentially harmful effects of COVID-19 failure to adequately address resistance exercise interventions as home-based exercise strategy. Thus, in this paper, we discussed the physical exercise as medicine if the training status is enough to protect the elderly against COVID-19 infection, about the role of physical activity on immunosuppression. Possible risks for COVID-19 infection, and the old training methods, such as no-load resistance training as possible resistance exercise strategies and high-intensity interval training, as new proposals of home-based exercise interventions, could perform during the current COVID-19 pandemic.
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Affiliation(s)
- Fabiana Rodrigues Scartoni
- Department of Physical Education, Catholic University of Petrópolis, Petrópolis, Brazil.,Sport and Exercise Sciences Laboratory, Catholic University of Petrópolis, Petrópolis, Brazil
| | - Leandro de Oliveira Sant'Ana
- Sport and Exercise Sciences Laboratory, Catholic University of Petrópolis, Petrópolis, Brazil.,Postgraduate Program in Physical Education, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Eric Murillo-Rodriguez
- Molecular and Integrative Neuroscience Laboratory, Escuela de Medicina, División Ciencias de la Salud, Universidad Anáhuac Mayab, Mérida, Mexico.,Intercontinental Neuroscience Research Group, Mérida, México
| | - Tetsuya Yamamoto
- Intercontinental Neuroscience Research Group, Mérida, México.,Graduate School of Technology, Industrial and Social Sciences, Tokushima University, Tokushima, Japan
| | - Claudio Imperatori
- Intercontinental Neuroscience Research Group, Mérida, México.,Department of Human Sciences, European University of Rome, Rome, Italy
| | - Henning Budde
- Intercontinental Neuroscience Research Group, Mérida, México.,MSH Medical School Hamburg, Hamburg, Germany
| | - Jeferson Macedo Vianna
- Postgraduate Program in Physical Education, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Sergio Machado
- Intercontinental Neuroscience Research Group, Mérida, México.,Laboratory of Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program, Salgado de Oliveira University, São Gonçalo, Brazil.,Laboratory of Physical Activity Neuroscience, Neurodiversity Institute, Queimados, Brazil
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491
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Riera-Sampol A, Bennasar-Veny M, Tauler P, Aguilo A. Effectiveness of physical activity prescription by primary care nurses using health assets: A randomized controlled trial. J Adv Nurs 2020; 77:1518-1532. [PMID: 33210773 DOI: 10.1111/jan.14649] [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: 02/23/2020] [Revised: 09/07/2020] [Accepted: 10/20/2020] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the effectiveness of a 12-month multifactorial intervention by primary care nurses using health assets in increasing adherence to physical activity prescription (150 min/week) in patients with two or more cardiovascular risk factors. BACKGROUND Physical activity promotion is a priority and helps to decrease mortality risk due to cardiovascular diseases. However, adherence to the habitual physical activity prescription in primary healthcare settings is low. DESIGN Multicentre, single-blind, parallel randomized (in two different branches) clinical trial. METHODS In total, 263 participants from 20 primary healthcare centres in Mallorca completed the randomized controlled trial study (intervention group N = 128, control group N = 135). The intervention consisted in four visits and included a motivational interview and an individualized prescription of physical activity using health assets. Primary outcome measure was the number of participants performing at least 150 min of weekly physical activity. Secondary outcomes included physical activity level and physical fitness, Sense of Coherence, cardiovascular risk, sociodemographic data, trans-theoretical stage of change, sleep quality, and depression. RESULTS Adherence to the recommendation of at least 150 min of physical activity was higher in the intervention than in the control group (χ2 = 3.951, p = .047). However, this higher adherence did not suppose higher physical activity levels because no differences between groups were found in the total physical activity performed after intervention (t=-0.915, p = .361). At the end of the intervention participants randomized to the intervention group spent more time walking than participants in the control group (t = 2.260, p = .025). CONCLUSION The multifactorial intervention performed by primary care nurses induced a higher adherence to the 150-min of weekly physical activity recommendation. IMPACT Adherence to the usual physical activity prescription in primary care is low. Physical activity prescription performed by primary care nurses and based on health assets and motivational interview can help to increase physical activity levels of patients. The main finding of the present study was that prescription using this approach was shown to be effective, leading to a higher adherence in the intervention group. This intervention is feasible in the nurse's primary healthcare setting, thus it could be implemented as the main tool when exercise is prescribed. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number: ISRCTN76069254.
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Affiliation(s)
- Aina Riera-Sampol
- Research Group on Evidence, Lifestyles and Health, University of the Balearic Islands, Palma, Spain.,Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain.,Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Miquel Bennasar-Veny
- Research Group on Evidence, Lifestyles and Health, University of the Balearic Islands, Palma, Spain.,Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain.,Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Pedro Tauler
- Research Group on Evidence, Lifestyles and Health, University of the Balearic Islands, Palma, Spain.,Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain.,Department of Fundamental Biology and Health Sciences, University of the Balearic Islands, Palma, Spain
| | - Antoni Aguilo
- Research Group on Evidence, Lifestyles and Health, University of the Balearic Islands, Palma, Spain.,Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain.,Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
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492
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Suorsa K, Pulakka A, Leskinen T, Pentti J, Vahtera J, Stenholm S. Changes in prolonged sedentary behaviour across the transition to retirement. Occup Environ Med 2020; 78:oemed-2020-106532. [PMID: 33203649 PMCID: PMC8142433 DOI: 10.1136/oemed-2020-106532] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 09/10/2020] [Accepted: 09/24/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Prolonged sedentary behaviour is associated with a higher risk of cardiometabolic diseases. This longitudinal study examined changes in daily total, prolonged (≥30 min) and highly prolonged (≥60 min) sedentary time across the transition to retirement by gender and occupational status. METHODS We included 689 aging workers (mean (SD) age before retirement 63.2 (1.6) years, 85% women) from the Finnish Retirement and Aging Study (FIREA). Sedentary time was measured annually using a wrist-worn triaxial ActiGraph accelerometer before and after retirement with on average 3.4 (range 2-4) measurement points. RESULTS Women increased daily total sedentary time by 22 min (95% CI 13 to 31), prolonged sedentary time by 34 min (95% CI 27 to 42) and highly prolonged sedentary time by 15 min (95% CI 11 to 20) in the transition to retirement, and remained at the higher level of sedentary time years after retirement. The highest increase in total and prolonged sedentary time was observed among women retiring from manual occupations. Men had more total and prolonged sedentary time compared with women before and after retirement. Although no changes in men's sedentary time were observed during the retirement transition, there was a gradual increase of 33 min (95% CI 6 to 60) in prolonged sedentary time from pre-retirement years to post-retirement years. CONCLUSION The transition to retirement was accompanied by an abrupt increase in prolonged sedentary time in women but a more gradual increase in men. The retirement transition may be a suitable time period for interventions aiming to decrease sedentary behaviour.
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Affiliation(s)
- Kristin Suorsa
- Department of Public Health, University of Turku, and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku, and Turku University Hospital, Turku, Finland
| | - Anna Pulakka
- Department of Public Health Solutions, Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Uusimaa, Finland
| | - Tuija Leskinen
- Department of Public Health, University of Turku, and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku, and Turku University Hospital, Turku, Finland
| | - Jaana Pentti
- Department of Public Health, University of Turku, and Turku University Hospital, Turku, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku, and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku, and Turku University Hospital, Turku, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku, and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku, and Turku University Hospital, Turku, Finland
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493
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Ee C, Lake J, Firth J, Hargraves F, de Manincor M, Meade T, Marx W, Sarris J. An integrative collaborative care model for people with mental illness and physical comorbidities. Int J Ment Health Syst 2020; 14:83. [PMID: 33292354 PMCID: PMC7659089 DOI: 10.1186/s13033-020-00410-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 10/28/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Many individuals with mental health problems have comorbid physical conditions, or may present with substance/alcohol misuse or abuse issues. This results in complex treatment challenges that may not be adequately addressed by a model of care that is solely delivered by an individual clinician using a sole intervention. Mainstream pharmacotherapeutic treatment of mental health problems often have limited effectiveness in completely resolving symptoms, and may cause adverse side effects. Adjunctive treatment approaches, including nutraceuticals, lifestyle and behaviour change interventions, are widely used to assist with treatment of mental health problems. However, whilst these can be generally safer with fewer side effects, they have varying levels of evidentiary support. These circumstances warrant reframing the current treatment approach towards a more evidence-based integrative model which may better address the real-world challenges of psychiatric disorders and comorbid physical conditions. In essence, this means developing an integrative model of care which embodies an evidence-informed, personalized stepwise approach using both conventional pharmacological treatments alongside novel adjunctive treatments (where applicable) via the application of a collaborative care approach. DISCUSSION In order to inform this position, a brief review of findings on common patterns of comorbidity in mental illness is presented, followed by identification of limitations of conventional treatments, and potential applications of integrative medicine interventions. Advantages and challenges of integrative mental health care, collaborative models of care, review of research highlights of select integrative approaches, and comment on potential cost advantages are then discussed. We propose that a collaborative care model incorporating evidence-based integrative medicine interventions may more adequately address mental health problems with comorbid medical conditions. Robust research is now required of such a model, potentially within an integrative clinical practice.
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Affiliation(s)
- C. Ee
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751 Australia
| | - J. Lake
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751 Australia
| | - J. Firth
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751 Australia
| | - F. Hargraves
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751 Australia
| | - M. de Manincor
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751 Australia
| | - T. Meade
- School of Psychology and Translational Health Research Institute, Western Sydney University, Penrith, Australia
| | - W. Marx
- IMPACT, Food & Mood Centre, Deakin University, Barwon Health, Geelong, Australia
| | - J. Sarris
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751 Australia
- Professorial Unit, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
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494
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Foster HME, Ho FK, Sattar N, Welsh P, Pell JP, Gill JMR, Gray SR, Celis-Morales CA. Understanding How Much TV is Too Much: A Nonlinear Analysis of the Association Between Television Viewing Time and Adverse Health Outcomes. Mayo Clin Proc 2020; 95:2429-2441. [PMID: 32713607 DOI: 10.1016/j.mayocp.2020.04.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To inform potential guideline development, we investigated nonlinear associations between television viewing time (TV time) and adverse health outcomes. METHODS From 2006 to 2010, 490,966 UK Biobank participants, aged 37 to 73 years, were recruited. They were followed from 2006 to 2018. Nonlinear associations between self-reported TV time (hours per day) and outcomes explored using penalized cubic splines in Cox proportional hazards adjusted for demographics and lifestyle. Population-attributable and potential impact fractions were calculated to contextualize population-level health outcomes associated with different TV time levels. Nonlinear isotemporal substitution analyses were used to investigate substituting TV time with alternative activities. Primary outcomes were mortality: all-cause, cardiovascular disease (CVD) and cancer; incidence: CVD and cancer; secondary outcomes were incident myocardial infarction, stroke, and heart failure and colon, lung, breast, and prostate cancer. RESULTS Those with noncommunicable disease (109,867 [22.4%]), CVD (32,243 [6.6%]), and cancer (37,81 [7.7%]) at baseline were excluded from all-cause mortality, CVD, and cancer analyses, respectively. After 7.0 years (mortality) and 6.2 years (disease incidence) mean follow-up, there were 10,306 (2.7%) deaths, 24,388 (5.3%) CVD events, and 39,121 (8.7%) cancer events. Associations between TV time and all-cause and CVD mortality were curvilinear (Pnon-linear ≤.003), with lowest risk observed <2 hours per day. Theoretically, 8.64% (95% confidence interval [CI], 6.60-10.73) of CVD mortality is attributable to TV time. Limiting TV time to 2 hours per day might have prevented, or at least delayed, 7.97% (95% CI, 5.54-10.70) of CVD deaths. Substituting TV time with sleeping, walking, or moderate or vigorous physical activity was associated with reduced risk for all outcomes when baseline levels of substitute activities were low. CONCLUSION TV time is associated with numerous adverse health outcomes. Future guidelines could suggest limiting TV time to less than 2 hours per day to reduce most of the associated adverse health events.
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Affiliation(s)
| | - Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, UK
| | - Naveed Sattar
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | - Paul Welsh
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, UK
| | - Jason M R Gill
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | - Stuart R Gray
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | - Carlos A Celis-Morales
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK; Research Centre on Exercise Physiology (CIFE), Universidad Mayor, Santiago, Chile; Research Centre on Education, Physical Activity and Health (GEEAFyS), Universidad Católica del Maule, Talca, Chile.
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495
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Albitres-Flores L, Bernabe-Ortiz A. Diagnostic accuracy of ADA 2020 criteria for undiagnosed diabetes in a Peruvian population. Diabetes Res Clin Pract 2020; 169:108475. [PMID: 33002547 DOI: 10.1016/j.diabres.2020.108475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/26/2020] [Accepted: 09/21/2020] [Indexed: 11/26/2022]
Abstract
AIMS To assess the prevalence of undiagnosed diabetes (UDD) and the diagnostic accuracy of the American Diabetes Association (ADA) criteria to detect UDD cases in a Peruvian population. METHODS Population-based cross-sectional study. UDD was defined using fasting plasma glucose (FPG), 2-hour post-prandial plasma glucose (2 h-PPG), and glycated hemoglobin (HbA1c) traditional cut-offs. Diagnostic accuracy was estimated using areas under the receiver-operating characteristic (ROC) curve, compared with the combination of oral glucose tolerance test (FPG plus 2 h-PPG) plus HbA1c as gold standard. RESULTS 1609 subjects were evaluated; mean age 48.2 (SD: 10.6) years, 50.3% were women. A total of 179 (11.3%) subjects were classified as having diabetes, 41.3% of them had UDD. Area under the curve for FPG, 2 h-PPG and HbA1c was 86.5% (95% CI: 81.4-91.6%); 87.2% (95% CI: 82.2-92.2%) and 80.4% (95% CI: 74.8-86.0%), respectively. FPG sensitivity was 73.0%, whereas this value was 74.3% for 2 h-PPG and 60.8% for HbA1c. Of 74 UDD cases, 45 were positive for HbA1c, 54 for FPG and 55 for 2 h-PPG. CONCLUSIONS 41.3% of people with diabetes do not know their diagnosis. Diagnostic accuracy of FPG and 2 h-PPG was higher than HbA1c. The most sensitive combination of two tests to detect UDD cases was FPG plus 2 h-PPG.
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Affiliation(s)
- Leonardo Albitres-Flores
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Facultad de Medicina, Universidad Nacional de Trujillo, Trujillo, Peru. https://orcid.org/0000-0002-0077-3615
| | - Antonio Bernabe-Ortiz
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Universidad Científica del Sur, Lima, Peru. https://orcid.org/0000-0002-6834-1376
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496
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Park JH, Moon JH, Kim HJ, Kong MH, Oh YH. Sedentary Lifestyle: Overview of Updated Evidence of Potential Health Risks. Korean J Fam Med 2020; 41:365-373. [PMID: 33242381 PMCID: PMC7700832 DOI: 10.4082/kjfm.20.0165] [Citation(s) in RCA: 216] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 08/04/2020] [Indexed: 12/20/2022] Open
Abstract
One-third of the global population aged 15 years and older engages in insufficient physical activities, which affects health. However, the health risks posed by sedentary behaviors are not well known. The mean daily duration of sedentary behavior is 8.3 hours among the Korean population and 7.7 hours among the American adult population. Sedentary lifestyles are spreading worldwide because of a lack of available spaces for exercise, increased occupational sedentary behaviors such as office work, and the increased penetration of television and video devices. Consequently, the associated health problems are on the rise. A sedentary lifestyle affects the human body through various mechanisms. Sedentary behaviors reduce lipoprotein lipase activity, muscle glucose, protein transporter activities, impair lipid metabolism, and diminish carbohydrate metabolism. Furthermore, it decreases cardiac output and systemic blood flow while activating the sympathetic nervous system, ultimately reducing insulin sensitivity and vascular function. It also alters the insulin-like growth factor axis and the circulation levels of sex hormones, which elevates the incidence of hormone-related cancers. Increased sedentary time impairs the gravitostat, the body's weight homeostat, and weight gain, adiposity, and elevated chronic inflammation caused by sedentary behavior are risk factors for cancer. Sedentary behaviors have wide-ranging adverse impacts on the human body including increased all-cause mortality, cardiovascular disease mortality, cancer risk, and risks of metabolic disorders such as diabetes mellitus, hypertension, and dyslipidemia; musculoskeletal disorders such as arthralgia and osteoporosis; depression; and, cognitive impairment. Therefore, reducing sedentary behaviors and increasing physical activity are both important to promote public health.
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Affiliation(s)
- Jung Ha Park
- Department of Family Medicine, Jeju National University Hospital, Jeju, Korea
| | - Ji Hyun Moon
- Department of Family Medicine, Jeju National University Hospital, Jeju, Korea
- Department of Family Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Hyeon Ju Kim
- Department of Family Medicine, Jeju National University Hospital, Jeju, Korea
- Department of Family Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Mi Hee Kong
- Department of Family Medicine, Jeju National University Hospital, Jeju, Korea
- Department of Family Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Yun Hwan Oh
- Department of Family Medicine, Jeju National University Hospital, Jeju, Korea
- Department of Family Medicine, Jeju National University School of Medicine, Jeju, Korea
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497
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Liu Q, Liu F, Li J, Huang K, Yang X, Chen J, Liu X, Cao J, Shen C, Yu L, Zhao Y, Wu X, Zhao L, Li Y, Hu D, Lu X, Huang J, Gu D. Sedentary behavior and risk of incident cardiovascular disease among Chinese adults. Sci Bull (Beijing) 2020; 65:1760-1766. [PMID: 36659249 DOI: 10.1016/j.scib.2020.05.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/23/2020] [Accepted: 03/26/2020] [Indexed: 01/21/2023]
Abstract
Although emerging studies from high-income countries investigated the relationship between sedentary behavior (SB) and cardiovascular risk, little evidence came from developing countries. Moreover, the benefits of reallocating time from SB to physical activity (PA) on incident cardiovascular disease (CVD) are unknown. Using three cohorts from the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project, we included 93 110 adults who were free from CVD at baseline. Cox proportional hazards models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD, including stroke, coronary heart disease, and CVD death. Isotemporal substitution models were applied to estimate the per-hour effects of replacing SB with PA. After 5.8 years follow-up, 3799 CVD cases were identified. A gradient positive association between sedentary time and incident CVD was observed. Relative to those with < 5 h/d sedentary time, the multivariable-adjusted HRs (95% CIs) of CVD incidence were 1.07(0.96-1.20), 1.27(1.13-1.43) and 1.51(1.34-1.70) for those having 5-<8, 8-<10, and ≥ 10 h/d sedentary time, respectively. When participants were cross-classified by SB and moderate to vigorous physical activity (MVPA) level, the CVD risk was highest in those with ≥ 10 h/d SB and < 150 min/week MVPA. Among those who reported ≥ 5 h/d sedentary time, per-hour substitution of SB with light, moderate, and vigorous PA reduced incident CVD risk by 5%, 6%, and 8%, respectively. The study first found that sedentary time was associated with increased incident CVD risk among Chinese adults and that substitution of SB with PA of any intensity could convey cardiovascular benefits among those with ≥ 5 h/d SB.
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Affiliation(s)
- Qiong Liu
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Fangchao Liu
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Jianxin Li
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Keyong Huang
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xueli Yang
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Jichun Chen
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xiaoqing Liu
- Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou 510080, China
| | - Jie Cao
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Chong Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Ling Yu
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou 350014, China
| | - Yingxin Zhao
- Shandong First Medical University, Jinan 271099, China
| | - Xianping Wu
- Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - Liancheng Zhao
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Ying Li
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Dongsheng Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518071, China; Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Xiangfeng Lu
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Jianfeng Huang
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Dongfeng Gu
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China.
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498
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Minakata Y, Sasaki S. Data Reproducibility and Effectiveness of Bronchodilators for Improving Physical Activity in COPD Patients. J Clin Med 2020; 9:jcm9113497. [PMID: 33138116 PMCID: PMC7692282 DOI: 10.3390/jcm9113497] [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] [Received: 09/07/2020] [Revised: 10/24/2020] [Accepted: 10/27/2020] [Indexed: 11/16/2022] Open
Abstract
Increasing physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD) is an important issue, however, the effect of bronchodilators on PA is still controversial. The indicators of PA, as measured by an accelerometer, can easily fluctuate based on several factors, which might cause inconsistent results. In this review, we listed the indicators of PA and the factors influencing the reproducibility of indicators of PA, and reviewed reports in which the effects of bronchodilators on PA were evaluated by an accelerometer. Then, we investigated the association between the processing of influencing factors and the effectiveness of bronchodilators for improving the PA of COPD patients. Fifteen reports were extracted using the PubMed database. In all seven reports in which adjustment was performed for at least two of four influencing factors (non-wear time, data from days with special behavior, environmental factors, and number of valid days required to obtain reproducible data), bronchodilators showed beneficial effects on PA. No adjustment was made for any of these factors in any of the four bronchodilator-ineffective reports. This suggests that the processing of influencing factors to secure reproducibility might affect the results regarding the effectiveness of bronchodilators for improving PA in COPD patients.
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499
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Rollo S, Prapavessis H. A combined health action process approach and mHealth intervention to reduce workplace sitting time in office-working adults: a secondary analysis examining health-related quality of life and work performance outcomes. Psychol Health 2020; 36:1200-1216. [PMID: 33108910 DOI: 10.1080/08870446.2020.1838522] [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] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This secondary analysis study examined the effects of a 6-week theory-based planning and mHealth text message intervention targeting workplace sitting time on health-related quality of life and work performance in office workers. DESIGN Office-working adults (Mage=45.18 ± 11.33 years) were randomised into either a planning + text message intervention (n = 29) or control (n = 31) condition. OUTCOME MEASURES Workplace sitting time, time spent in specific non-sedentary behaviours (e.g. standing), health-related outcomes (i.e. emotional well-being, energy/fatigue, perceived role limitations), and work performance were assessed at baseline and week 6. RESULTS Significant group by time interaction effects, that favoured the intervention group, were found for perceived role limitations due to emotional health problems and emotional well-being. No significant interaction effects emerged for energy/fatigue, role limitations due to physical health problems or work performance. Significant correlations in the expected direction were found between sedentary/non-sedentary behaviours and health-related outcomes. No significant mediation effects were found to suggest the intervention affected health-related outcomes through reductions in sedentary behaviour. CONCLUSION Reducing workplace sitting improves emotional well-being and contributes to fewer perceived role limitations due to emotional health problems among office workers.
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Affiliation(s)
- Scott Rollo
- Exercise and Health Psychology Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
| | - Harry Prapavessis
- Exercise and Health Psychology Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
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500
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Physical Activity and Sedentary Behavior among Young Adolescents in 68 LMICs, and Their Relationships with National Economic Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217752. [PMID: 33114035 PMCID: PMC7660305 DOI: 10.3390/ijerph17217752] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/11/2020] [Accepted: 10/13/2020] [Indexed: 12/25/2022]
Abstract
It is unclear whether physical activity and sedentary behavior are associated with economic development in low- and middle-income countries (LMICs). We aimed to assess the association between these two behaviors and country economic development among young adolescents in LMICs. Data came from the Global School-based Student Health Survey (GSHS) conducted between 2009 and 2016 in 68 LMICs. A total of 180,298 adolescents aged 12–15 years were included; 15.3% of young adolescents achieved the recommended level for sufficient physical activity (≥60 min/day of physical activity of any kind per week according to WHO) and 64.6% achieved a low sedentary behavior (≤2 h of sitting activities/day according to some guidelines, not accounting for sitting time at school or for doing homework). However, only 9.1% of young adolescents met the recommended levels of both behaviors. Comparing the lowest to the highest quintiles of a country’s purchasing power parity per capita (PPP), mean values of both physical activity (boys: 2.55 to 2.96 days/week; girls: 2.10 to 2.31 days/week) and sedentary behavior(boys: 1.86 to 3.13 h/day; girls: 1.83 to 3.53 h/day) increased. The prevalence of having both recommended behaviors decreased among boys (12.0% to 10.0%) and girls (9.6% to 4.9%) (p < 0.001). Although there might be an ecological fallacy, the findings emphasize the need for interventions to increase physical activity and reduce sedentary behavior among children and young adolescents.
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