A Short, Multimodal Activity Break Incorporated Into the Learning Context During the Covid-19 Pandemic: Effects of Physical Activity and Positive Expressive Writing on University Students' Mental Health-Results and Recommendations From a Pilot Study

Physical inactivity, sedentary behavior and mental ill health, due to high levels of perceived stress or self-reported depressive symptoms, are highly prevalent among university students. There are concerns that these behaviors and mental symptoms have significantly increased during the current Covid-19 pandemic, partly because academic life has changed considerably from face-to-face communication to e-learning and studying at home. Self-regulation and physical activity are hard to maintain during pandemic lockdowns. Short activity breaks could be helpful to avoid physical inactivity and sustain mental health. The breaks should comprise short and easy-implementable physical activity exercises that can be integrated into the learning context. Moreover, cognitive interventions, such as writing about positive events and feelings might help as coping strategy for self-regulation during study breaks. This study investigated and compared the effects of a physical activity intervention and a cognitive intervention (positive expressive writing) on mental health among university students. Both interventions are particularly suitable for use at home. N = 20 university students, studying in Germany, were assigned to a physical activity group or a cognitive intervention group. The physical activity intervention consisted of a mix of physical exercises including endurance exercises, muscular strength, relaxation, and ballroom dance movements. The interventions were carried out guided, once a week, for 5-10 mins at the beginning of classes. The effects of group × time showed no significant interaction on self-reported perceived stress, mood, quality of life (QoL) assessed online and compared at the beginning of the term before the intervention (T0) and at the end of the term after the intervention (T3). However, the physical activity group reported a similar physical activity level per day over time, while the cognitive intervention group showed a decrease in physical activity from T0 to T3. Low-dose, short physical activity interventions as well as cognitive interventions consisting of positive expressive writing could buffer university students' perceived stress, mood, and QoL across the term. Moreover, both interventions seem to be promising in buffering the negative side effects of stress during the Covid-19 pandemic.

Muscle strength explains the protective effect of physical activity against COVID-19 hospitalization among adults aged 50 years and older

Physical activity has been proposed as a protective factor for COVID-19 hospitalisation. However, the mechanisms underlying this association are unclear. We examined the association between physical activity and COVID-19 hospitalisation and whether this relationship was explained by risk factors (chronic conditions, weak muscle strength). We used data from adults over 50 years from the Survey of Health, Ageing and Retirement in Europe. The outcome was self-reported hospitalisation due to COVID-19, before August 2020. The main exposure was physical activity, self-reported between 2004 and 2017. Among the 3139 participants included (69.3 ± 8.5 years, 1763 women), 266 were tested positive for COVID-19, 66 were hospitalised. Logistic regression models showed that individuals who engaged in physical activity more than once a week had lower odds of COVID-19 hospitalisation than individuals who hardly ever or never engaged in physical activity (odds ratios = 0.41, 95% confidence interval = 0.22-0.74, p = .004). This association between physical activity and COVID-19 hospitalisation was explained by muscle strength, but not by other risk factors. These findings suggest that, after 50 years, engaging in physical activity is associated with lower odds of COVID-19 hospitalisation. This protective effect of physical activity may be explained by muscle strength.

The impact of COVID-19 lockdown on physical activity and weight gain among active adult population in Israel: a cross-sectional study

BACKGROUND

The COVID-19 outbreak holds public health concerns. The stay-at-home increases sedentary behavior, with unintended adverse outcomes. Since organized recreation and sports facilities were closed, we aimed to study how the crisis of closure affected exercise habits and weight gain among the trainee population in Israel. We examined differences in weight gain among individuals with different PA activities and assessed their ability to adapt to digital media as an alternative training structure.

METHODS

A cross-sectional survey consisted of a multiple-choice questionnaire obtained using a web-based survey application. Trainees (1202) who exercised steadily anonymously answered the questionnaire sent by their coaches regarding their activity and weight gain during lockdown times.

RESULTS

Results confirmed that 70% of Israelis trained less than their usual routine, 60% used digital media for training, 55% gained weight. Half of the respondents gained more than 2 kg, with an average increase of 1.2 kg. However, those who exhibited a higher physical activity level gained less weight. Using digital media for training was associated with higher physical activity levels. The aged population was less likely to use digital media.

CONCLUSIONS

Since increased sedentary behavior could increase the risk for potential worsening of health conditions, health agencies should look for strategies, including digital remote media training to promote physical activity and subsequently, preventing the increased burden of future comorbidities worsening by a sedentary lifestyle. Approval: by the Helsinki ethics committee of Sheba Medical Center (6504-19-SMC).

Level of active lifestyle and exercise approach among students of the University of Novi Pazar during the COVID-19 pandemic

Introduction

Metabolic Remodeling in Skeletal Muscle Atrophy as a Therapeutic Target

Skeletal muscle is a highly responsive tissue, able to remodel its size and metabolism in response to external demand. Muscle fibers can vary from fast glycolytic to slow oxidative, and their frequency in a specific muscle is tightly regulated by fiber maturation, innervation, or external causes. Atrophic conditions, including aging, amyotrophic lateral sclerosis, and cancer-induced cachexia, differ in the causative factors and molecular signaling leading to muscle wasting; nevertheless, all of these conditions are characterized by metabolic remodeling, which contributes to the pathological progression of muscle atrophy. Here, we discuss how changes in muscle metabolism can be used as a therapeutic target and review the evidence in support of nutritional interventions and/or physical exercise as tools for counteracting muscle wasting in atrophic conditions.

Contemporary Lifestyle and Neutrophil Extracellular Traps: An Emerging Link in Atherosclerosis Disease

Neutrophil extracellular traps (NETs) are networks of extracellular genetic material decorated with proteins of nuclear, granular and cytosolic origin that activated neutrophils expel under pathogenic inflammatory conditions. NETs are part of the host's innate immune defense system against invading pathogens. Interestingly, these extracellular structures can also be released in response to sterile inflammatory stimuli (e.g., shear stress, lipidic molecules, pro-thrombotic factors, aggregated platelets, or pro-inflammatory cytokines), as in atherosclerosis disease. Indeed, NETs have been identified in the intimal surface of diseased arteries under cardiovascular disease conditions, where they sustain inflammation via NET-mediated cell-adhesion mechanisms and promote cellular dysfunction and tissue damage via NET-associated cytotoxicity. This review will focus on (1) the active role of neutrophils and NETs as underestimated players of the inflammatory process during atherogenesis and lesion progression; (2) how these extracellular structures communicate with the main cell types present in the atherosclerotic lesion in the arterial wall; and (3) how these neutrophil effector functions interplay with lifestyle-derived risk factors such as an unbalanced diet, physical inactivity, smoking or lack of sleep quality, which represent major elements in the development of cardiovascular disease.

Unfixed Movement Route Model, Non-Overcrowding and Social Distancing Reduce the Spread of COVID-19 in Sporting Facilities

Localized outbreaks of COVID-19 have been reported in sporting facilities. This study used the Agent-based Modeling (ABM) method to analyze the transmission rate of COVID-19 in different sporting models, sporting spaces per capita, and situations of gathering, which contributes to understanding how COVID-19 transmits in sports facilities. The simulation results show that the transmission rate of COVID-19 was higher under the Fixed Movement Route (FMR) than under the Unfixed Movement Route (UMR) in 10 different sporting spaces per capita (1, 2, 3, 4, 5, 6, 7, 8, 9, and 10 m2) (p = 0.000). For both FMR and UMR, the larger the sporting space per capita, the lower the virus transmission rate. Additionally, when the sporting space per capita increases from 4 m2 to 5 m2, the virus transmission rate decreases most significantly (p = 0.000). In the FMR model with a per capita sporting space of 5 m2, minimizing gathering (no more than three people) could significantly slow down the transmission rate of the COVID-19 virus (p < 0.05). This study concluded that: (1) The UMR model is suggested in training facilities or playing grounds; (2) The sporting space should be non-overcrowding, and it is recommended that the sporting space per capita in the sporting grounds should not be less than 5 m2; (3) It is important to maintain safe social distancing and minimize gathering (no more than three people) when exercising.

Towards an In-Depth Understanding of Physical Activity and Eating Behaviours during COVID-19 Social Confinement: A Combined Approach from a Portuguese National Survey

Rapid worldwide decreases in physical activity (PA), an increase in sedentary behaviour (SB) and poorer dietary patterns have been reported during COVID-19 confinement periods. However, as national variability has been observed, this study sought to describe PA, SB and eating patterns, and to explore their gender as well as other socio-demographic correlates and how they interrelate in a representative sample of Portuguese adults during the COVID-19 first mandatory social confinement. The survey was applied online and by telephone to 5856 adults (mean age = 45.8 years; 42.6% women). The majority reported high (46.0%) or moderate (20.5%) PA levels. Men, younger participants, those with higher education levels and a favourable perception of their financial situation reported higher PA levels, with the opposite pattern for SB. Physical fitness activities and household chores were more reported by women, with more strength training and running activities reported by men. Regarding eating behaviours, 45.1% reported changes, positive (58%) and negative (42%), with 18.2% reporting increases in consumption of fruit, vegetables, and fish and other seafood consumption, while 10.8% (most with lower educational level and less comfortable with their income) reported an increase in consumption of ready-to-eat meals, soft drinks, savoury snacks, and take-away and delivered meals. Two clusters-a health-enhancing vs. risky pattern-emerged through multiple correspondence analysis characterized by co-occurrence of high vs. low PA levels, positive vs. negative eating changes, awareness or not of the COVID-19 PA and dietary recommendations, perceived financial situation, higher vs. lower educational level and time in social confinement. In conclusion, while in social confinement, both positive and negative PA and eating behaviours and trends were displayed, highlighting the role of key sociodemographic correlates contributing to healthy vs. risky patterns. Results may inform future health interventions and policies to be more targeted to those at risk, and also advocate the promotion of PA and healthy eating in an integrated fashion.

Physical Activity as a Preventive Lifestyle Intervention Acts Through Specific Exosomal miRNA Species-Evidence From Human Short- and Long-Term Pilot Studies

Exercise initiates systemic adaptation to promote health and prevent various lifestyle-related chronic diseases. Emerging evidence suggests that circulating exosomes mediate some of the beneficial effects of exercise via the transfer of microRNAs between tissues. Yet to date, a comprehensive profile of the exosomal miRNA (exomiR) content released following short-term (0.5 year in this study) and long-term (25 + years in this study) regular bouts of exercise is still lacking. However, a better understanding of these miRNA species would assist in clarifying the role of regular exercise at the molecular level in the prevention of chronic diseases. In the present pilot studies we analyzed serum exomiR expression in healthy young, sedentary participants (n = 14; age: 23 ± 2 years) at baseline and following a half year-long moderate-intensity regular exercise training. We also analyzed serum exomiR expression in older, healthy trained participants (seniors, n = 11; age: 62 ± 6 years) who engaged in endurance activities for at least 25 years. Following the isolation and enrichment of serum exosomes using Total Exosome Isolation Reagent (TEI) their exomiR levels were determined using the amplification-free Nanostring platform. Hierarchical cluster analysis revealed that the majority of exomiRs overlap for short-term (0.5 year in this study) and long-term (25 + years in this study) regular bouts of exercise. The top 12 significantly altered exomiRs (let-7a-5p; let-7g-5p; miR-130a-3p; miR-142-3p; miR-150-5p; miR-15a-5p; miR-15b-5p; miR-199a-3p; miR-199b-3p; miR-223-3p; miR-23a-3p, and miR-451a-3p) were used for further evaluation. According to KEGG pathway analysis a large portion of the exomiRs target chronic diseases including cancer, neurodegenerative and metabolic diseases, and viral infections. Our results provide evidence that exosomal miRNA modulation is the molecular mechanism through which regular exercise prevents various chronic diseases. The possibility of using such exomiRs to target diseases is of great interest. While further validation is needed, our comprehensive exomiR study presents, for the first time, the disease-preventive molecular pattern of both short and long-term regular exercise.

The comparison of fatigue, sleep quality, physical activity, quality of life, and psychological status in multiple sclerosis patients with or without COVID-19

Purpose

The study was purposed to investigate the effect of COVID-19 disease on fatigue, sleep quality, physical activity, quality of life, and psychological status in people with MS.

Methods

A total of 104 people with MS, including 46 of them with COVID-19 disease history, were enrolled in the study. All patients were evaluated with the Expanded Disability Status Scale (EDSS), Fatigue Severity Scale (FSS), Pittsburgh Sleep Quality Index (PSQI), International Physical Activity Questionnaire Short Form (IPAQ-SF), the EuroQoL Instrument (EQ-5D-3L), the Fear of COVID-19 Scale (FCV-19S) and the Coronavirus Anxiety Scale (CAS).

Results

People with MS in the COVID-19 positive group had a significantly lower IPAQ-Total score (p = 0.014). Besides, the FCV-19S scores of COVID-19 positive patients were significantly higher (p = 0.006). EQ-5D-3L Index and EQ-5D-3L VAS scores were higher in the group with COVID-19 (p₁ = 0.021, p₂ = 0.014, respectively). FCV-19S had a moderate correlation with EDSS (r = -0.362). IPAQ-Total was moderately associated with MS duration, EDSS and FSS (r₁ = -0.471, r₂ = -0.389, r₃ = -0.388, respectively). The EQ-5D-3L Index was moderately correlated with FSS (r₁ = -0.404). There was a weakly significant relationship between EQ-5D-3L Index and BMI, MS duration, PSQI and CAS (r₁ = -0.471, r₂ =-0.389, r₃ = -0.388, r₄ = -0.326, respectively). On the other hand, EQ-5D-3L was moderately associated with VAS and EDSS and PSQI (r₁ = -0.393, r₂ = -0.357, respectively).

Conclusion

COVID-19 negatively affected the people with MS's physical activity and coronavirus related fear parameters. However, the causality of this influence should be investigated in detail.

The Effect of Mechanical Stretch on Myotube Growth Suppression by Colon-26 Tumor-Derived Factors

Preclinical models and in vitro experiments have provided valuable insight into the regulation of cancer-induced muscle wasting. Colon-26 (C26) tumor cells induce cachexia in mice, and conditioned media (CM) from these cells promotes myotube atrophy and catabolic signaling. While mechanical stimuli can prevent some effects of tumor-derived factors on myotubes, the impact of mechanical signaling on tumor-derived factor regulation of myosin heavy chain (MyHC) expression is not well understood. Therefore, we examined the effects of stretch-induced mechanical signaling on C2C12 myotube growth and MyHC expression after C26 CM exposure. C26 CM was administered to myotubes on day 5 of differentiation for 48 h. During the last 4 or 24 h of C26 CM exposure, 5% static uniaxial stretch was administered. C26 CM suppressed myotube growth and MyHC protein and mRNA expression. Stretch for 24 h increased myotube size and prevented the C26 CM suppression of MyHC-Fast protein expression. Stretch did not change suppressed MyHC mRNA expression. Stretch for 24 h reduced Atrogin-1/MAFbx, MuRF-1, and LC3B II/I ratio and increased integrin β1D protein expression and the myogenin-to-MyoD protein ratio. Stretch in the last 4 h of CM increased ERK1/2 phosphorylation but did not alter the CM induction of STAT3 or p38 phosphorylation. These results provide evidence that in myotubes pre-incubated with CM, the induction of mechanical signaling can still provide a growth stimulus and preserve MyHC-Fast protein expression independent of changes in mRNA expression.

Motivation and Intention Toward Physical Activity During the COVID-19 Pandemic: Perspectives From Integrated Model of Self-Determination and Planned Behavior Theories

Background: In attempts to hinder the spread of the Coronavirus disease 2019 (COVID-19), many countries have continued distancing, isolation, and quarantine measures, which has led to limited opportunity of physical activity. This study provides empirical support for a motivational process behind physical activity during the COVID-19 pandemic by testing the influence of psychosocial variables derived from the integrated model of self-determination theory (SDT) and the theory of planned behavior (TPB). Methods: A cross-sectional survey was conducted among Korean adults (N = 248). Participants completed the measures of SDT and TPB constructs modified to reflect their participation in physical activity during the COVID-19 pandemic. A sample size of 243 participants was employed, and the integrated model was tested using serial multiple mediation analysis to check the hypothesized relationships. Results: Findings indicated that in the COVID-19 context, the satisfaction of basic psychological needs positively predicts the level of self-determined motivations for physical activity, which is partially related to the level of social cognitive beliefs and intentions. The findings also demonstrated that attitude toward physical activity during COVID-19 was a major variable explaining the serial multiple relationships between the SDT and TPB constructs. The potential influence of demographics (gender, age, marital status, and past physical activity) was controlled as a covariate, and no significant effects were identified. Conclusion: The current study identified the psychosocial mechanisms of intention of South Koreans' physical activity during the COVID-19 pandemic, which could be used as an empirical basis for the development of interventions to maintain or strengthen physical activity in unprecedented situations.

Effects of Physical Activity and Mindfulness on Resilience and Depression During the First Wave of COVID-19 Pandemic

The first wave of the COVID-19 pandemic generated a significant number of stressors that the Swiss population had to deal with. In order to cope with and adapt to such adversity, it is essential to have protective factors that allow for resilience. The objective of this study was to investigate the effects of mindfulness and physical activity on depression and resilience during the first wave of the COVID-19 pandemic. A quantitative method was adopted asking participants who were engaged in physical activity or mindfulness to fill a battery of measures of depression and resilience and some demographic questions. The results showed that mindfulness practice strengthened the initial level of resilience of practitioners, suggesting that mindfulness meditation is a tool for coping with adversity during a potentially traumatic event. Conversely, physical activity practitioners maintained a stable resilience score over time, suggesting that exposure to adversity did not disrupt their state of biopsychospiritual homeostasis. Moreover, being physically active decreased the depression score over time. Regarding demographic variables, gender differences were observed in the average scores in the resilience scale and in the Depression Inventory.

Comparison of Health Awareness in South Korean Middle School Students According to Type of Online Physical Education Classes during the COVID-19 Pandemic

Coronavirus disease 2019 popularized online classes to prevent educational deficits affected by the pandemic. This study aimed to assess the differences in the importance and performance of health awareness in Korean middle school students according to the types of online physical education classes they attended during the coronavirus disease 2019 pandemic. Overall, 583 participants were selected using a convenience sampling method; the data were obtained through an online survey using Google forms. Frequency analysis, reliability analysis, independent sample t-test, and importance–performance analysis were performed. First, the differences between importance and performance were found to be the most for sleep and physical activity management, and the least for disease and hygiene management. In addition, both groups demonstrated higher importance and performance for hygiene and disease management. There were significant differences in the importance and performance of all the sub-factors. Second, hygiene, disease management, and mental health management were found in quadrant I in both groups, while physical activity, sleep, and dietary habit management were in quadrant III. No factors were in quadrants II and IV. Correspondingly, there was no significant difference in adolescents’ health awareness between the assignment-based online group and interactive online group.

Strategies for COVID-19 Epidemiological Surveillance in India: Overall Policies Till June 2021

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has gripped the entire world, almost paralysing the human race in its entirety. The virus rapidly transmits via human-to-human medium resulting in a massive increase of patients with COVID-19. In order to curb the spread of the disease, an immediate action of complete lockdown was implemented across the globe. India with a population of over 1.3 billion was not an exception and took the challenge to execute phase-wise lockdown, unlock and partial lockdown activities. In this study, we intend to summarise these different phases that the Government of India (GoI) imposed to fight against SARS-CoV-2 so that it can act as a reference guideline to help controlling future waves of COVID-19 and similar pandemic situations in India.

Structure-function analysis of purified proanthocyanidins reveals a role for polymer size in suppressing inflammatory responses

Proanthocyanidins (PAC) are dietary compounds that have been extensively studied for beneficial health effects due to their anti-inflammatory properties. However, the structure-function relationships of PAC and their mode-of-action remain obscure. Here, we isolated a wide range of diverse PAC polymer mixtures of high purity from plant material. Polymer size was a key factor in determining the ability of PAC to regulate inflammatory cytokine responses in murine macrophages. PAC polymers with a medium (9.1) mean degree of polymerization (mDP) induced substantial transcriptomic changes, whereas PAC with either low (2.6) or high (12.3) mDP were significantly less active. Short-term oral treatment of mice with PAC modulated gene pathways connected to nutrient metabolism and inflammation in ileal tissue in a polymerization-dependent manner. Mechanistically, the bioactive PAC polymers modulated autophagic flux and inhibited lipopolysaccharide-induced autophagy in macrophages. Collectively, our results highlight the importance of defined structural features in the health-promoting effects of PAC-rich foods.

Smart City and Crisis Management: Lessons for the COVID-19 Pandemic

COVID-19 shocked cities around the world and revealed the vulnerability of urban lives and functions. Most cities experienced a catastrophic disturbance that has lasted for a long time. Planning plays a critical role in responding efficiently to this crisis and enabling rapid functional recovery in the post-disaster era. Cities that have implemented digitalization initiatives and programs are likely to have more capacity to react appropriately. Specifically, digitalized cities could ensure the well-being of their residents and maintain continuity of urban functions. This research aims to analyze the role of technology in crisis management in the last two decades and provide appropriate policy recommendations for dealing with the COVID-19 pandemic. Systematic literature review and subjective content analysis are employed to investigate the effects of technology on community well-being and making cities more resilient in past crises. This study shows that different technology-driven policies and actions enable crisis management, enhance community well-being, and increase urban resilience. Technology has enhanced coping and recovery capacities by increasing participation and social connectedness, enhancing physical and mental health and maintaining the functionality of education and economic systems. These have been achieved through various solutions and technologies such as social media, telehealth, tracking and monitoring systems, sensors and locational applications, teleworking systems, etc. These solutions and technologies have also been used during the COVID-19 pandemic to enhance community well-being and sustain urban functions. However, technology deployment might have adverse effects such as social exclusion, digital divide, privacy and confidentiality violation, political bias and misinformation dissemination, and inefficient remote working and education. It is suggested that to mitigate these side effects, policymakers should liberate the process of digitalization, increase the accessibility to digital services, and enhance digital literacy.

Changes in Physical Activity during the COVID-19 Pandemic-An Analysis of Differences Based on Mitigation Policies and Incidence Values in the Federal States of Germany

Measures to slow down the spread of coronavirus SARS-CoV-2 have had an impact on the daily life and physical activity (PA) of many people. Nevertheless, in Germany, mitigation policies and incidence values vary widely across the federal states (Länder). Thus, the aim of the present study was to investigate regional differences in PA during the coronavirus pandemic. This study is based on the SPOVID project (Examining physical activity and sports behavior in the face of COVID-19 pandemic: a social inequality perspective) that incorporates a large-scale, representative cross-sectional survey representing the German population (≥14 years). Based on the survey that took place in October 2020 (N = 1477), we investigated the relationships between the COVID-19 incidence values as well as the mitigation policies across the federal states in Germany and changes in PA. Pearson correlations indicated a strong negative relationship between PA change and 7-day incidence values (r = -0.688 **, p = 0.009) and a moderate negative relationship between PA changes and an index of mitigation policies (r = -0.444, p = 0.112). Higher 7-day incidence values and stricter mitigation policies were associated with a stronger decline in PA levels. Therefore, it is important to support people to stay active even if there are restrictions. In particular, in federal states and regions with high incidences and stricter mitigation policies, measures to promote health-enhancing PA are necessary.

Physical activity patterns among adults population during the coronavirus pandemic: consideration of the role of resilience

BACKGROUND

This study aims to characterize patterns of physical activity (PA) and resilience levels, and to examine whether resilience contributes to PA participation among adults during COVID-19 pandemic.

METHODS

This cross-sectional study was conducted during the quarantine period. The International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Brief Resilience Scale (BRS) questionnaires were used to assess the study's outcomes. The Kruskal-Wallis test was used to examine the difference in PA across resilience levels. Spearman's correlation coefficient was used to assess the relationship between resilience and PA. Data were reported as medians and interquartile ranges.

RESULTS

A sample of 1859 were included in the study (40% aged 26-35 yrs). The findings show that 85% of the respondents engaged in PA and 15% were physically inactive. The majority participated in moderate-intensity PA (71%). The median score was 3.50(0.85), which indicates a medium level of resilience. The positive correlation coefficient was shown between the average score of resilience and both walking (rs =0.01, p<0.001) and vigorous- intensity PA (rs =0.08, p=.007). Data did not show a significant correlation between moderate-intensity PA and resilience score.

CONCLUSIONS

Greater emphasis on PA engagement after the period of quarantine is needed. Resilience may play an important role in buffering the deleterious impact of quarantine on PA. Key words: Exercise; Physical Activity; Rehabilitation; Mental Health; COVID-19.

The Effects of Royal Jelly Acid, 10-Hydroxy-trans-2-decenoic Acid, on Neuroinflammation and Oxidative Stress in Astrocytes Stimulated with Lipopolysaccharide and Hydrogen Peroxide

The increased prevalence of neurodegenerative diseases, especially during the COVID-19 outbreak, necessitates the search for natural immune- and cognitive-enhancing agents. 10-Hydroxy-trans-2-decenoic acid (10-H2DA), the main fatty acid of royal jelly, has several pharmacological activities. Given the fundamental role of astrocytes in regulating immune responses of the central nervous system, we used cortical astrocytes to examine the effect of 10-H2DA on the expression of genes associated with neuroinflammation and the production of neurotrophins, as well as cellular resistance to H2O2-induced cytotoxicity. Astrocytes, pretreated with a range of concentrations of 10-H2DA for 24 h, were exposed to lipopolysaccharide (LPS) for 3 h, after which the expression of proinflammatory cytokines (IL-1β, IL-6, and tumor necrosis factor-α (TNF-α)) and neurotrophic factors (BDNF, GDNF, and IGF-1) was evaluated. In the absence of LPS, 10-H2DA had no significant effect on the mRNA expression of neurotrophins or cytokines except for IL-1β, which significantly increased with low doses of 10-H2DA (3 µM). 10-H2DA (10 µM) pretreatment of LPS-stimulated cells did not significantly inhibit the expression of cytokine encoding genes; however, it significantly lowered the mRNA expression of GDNF and tended to decrease BDNF and IGF-1 expression compared with LPS alone. Additionally, 10-H2DA did not protect astrocytes against H2O2-induced oxidative stress. Our data indicate no anti-inflammatory, antioxidant, or neurotrophic effect of 10-H2DA in astrocytes undergoing inflammation or oxidative stress. The effect of IGF-1 inhibition by 10-H2DA on neuronal ketogenesis needs investigation.

Practical Solutions to Address COVID-19-Related Mental and Physical Health Challenges Among Low-Income Older Adults

Low-income older adults are disproportionately impacted by the COVID-19 pandemic. In this perspective article, we review the context in which low-income older people experience the pandemic and the mental and physical health consequences they have faced to date. Then, we offer practical solutions to help improve low-income older adults' sleep, physical activity, nutrition, and stress that require no or low financial commitment. We argue that governments, communities, and organizations should make greater efforts to promote healthy living for low-income older adults in times of health emergencies to ensure their ability to be universally adopted, regardless of income and resources.

Relationship Between Sarcopenia, Obesity, Osteoporosis, and Cardiometabolic Health Conditions and Physical Activity Levels in Korean Older Adults

This study aimed to analyze the status of sarcopenia, obesity, osteoporosis, and cardiometabolic disease according to the level of physical activity (PA) among elderly people in Korea. Among the data obtained from the National Health and Nutrition Survey (2008–2011), we analyzed the data of a total of 3,573 Korean elderly people over 65 years of age who were surveyed for dual X-ray absorptiometry (DXA) and PA. Higher levels of PA were associated with a lower prevalence of cardiometabolic disease (χ² = 33.865, p < 0.001), osteoporosis (χ² = 94.198, p < 0.001), sarcopenia, obesity, and sarcopenic obesity (χ² = 71.828, p < 0.001). Above moderate-active PA was associated with lower body weight (p < 0.001), body fat mass (p < 0.001), and percent body fat (p < 0.001), and higher free-fat mass (p < 0.001) and appendicular skeletal muscle mass (ASM) (p < 0.001) than in low-active PA. In addition, when high-active is the risk factors of cardiometabolic were lower in waist circumference (p = 0.001), total cholesterol (TC) (p = 0.015), and triglyceride (TG) (p < 0.001) than low- and moderate-active PA, and higher in high-density lipoprotein cholesterol (HDL-C) (p < 0.001). The prevalence of cardiometabolic diseases was significantly decreased in high-active PA (odds ratio (OR) 0.60, 95% confidence interval (CI) 0.50–0.71); waist circumference (OR 0.85, 95% CI, 0.73–0.99; OR 0.59, 95% CI, 0.50–0.70) and HDL-C (OR 0.76, 95% CI, 0.65–0.88; OR 0.56, 95% CI, 0.47–0.67) significantly improved in moderate- and high-active PA, respectively, and TG (0.67 95% CI, 0.55–0.80) significantly improved in high-active PA. Osteoporosis (OR 0.62, 95% CI, 0.53–0.74; OR 0.46, 95% CI, 0.38–0.55) and sarcopenia (OR 0.77, 95% CI, 0.60–0.98; OR 0.73, 95% CI, 0.57–0.93) were significantly improved in moderate- and high-active PA, respectively. The incidence of obesity (OR 0.47, 95% CI, 0.39–0.57) and sarcopenic obesity (OR 0.47, 95% CI, 0.30–0.75) were significantly decreased in high-active PA. Therefore, we verified a lower prevalence of sarcopenia, osteoporosis, obesity, and cardiac metabolic disease in Korean elderly with more active PA. This suggests that more active PA maybe reduce the prevalence of sarcopenia, osteoporosis, obesity, and cardiometabolic diseases in older adults.

The Influence of COVID-19-Induced Daily Activities on Health Parameters—A Case Study in Malaysia

Since December 2019, the COVID-19 epidemic has been spreading all over the world. This epidemic has brought a risk of death in the daily activity (physical and social) participation that influences travellers’ physical, social, and mental health. To analyze the impact of the COVID-19-induced daily activities on health parameters of higher education institutes, 150 students of the Universiti Teknologi PETRONAS, Perak, Malaysia, were surveyed through an online web survey using random sampling techniques. The data were analyzed through RStudio and SPSS using multilevel linear regression analysis and Hierarchical Structural Equation Modeling. The estimated results indicate that restricting individuals from doing out-of-home activities negatively influences physical and social health. A unit increase in the in-home maintenance activities during the COVID-19 pandemic introduced a daily increase of 0.5% in physical health. Moreover, a unit increase in the in-home activities at leisure time represents a 1% positive improvement in social health. Thus, physical activity has proven to be beneficial in improving physical and social health with severe COVID-19. In contrast, the coefficient of determination (R2) for all endogenous variables ranges from 0.148 to 0.227, which is incredibly acceptable in psychological research. For a healthier society with a better quality of life, this study adopted multidisciplinary approaches that are needed to be designed.

Motor Dysfunction in REM Sleep Behavior Disorder: A Rehabilitation Framework for Prodromal Synucleinopathy

Parkinson disease (PD) and other related diseases with α-synuclein pathology are associated with a long prodromal or preclinical stage of disease. Predictive models based on diagnosis of idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD) make it possible to identify people in the prodromal stage of synucleinopathy who have a high probability of future disease and provide an opportunity to implement neuroprotective therapies. However, rehabilitation providers may be unaware of iRBD and the motor abnormalities that indicate early motor system dysfunction related to α-synuclein pathology. Furthermore, there is no existing rehabilitation framework to guide early interventions for people with iRBD. The purpose of this work is to (1) review extrapyramidal signs of motor system dysfunction in people with iRBD and (2) propose a framework for early protective or preventive therapies in prodromal synucleinopathy using iRBD as a predictive marker. Longitudinal and cross-sectional studies indicate that the earliest emerging motor deficits in iRBD are bradykinesia, deficits performing activities of daily living, and abnormalities in speech, gait, and posture. These deficits may emerge up to 12 years before a diagnosis of synucleinopathy. The proposed rehabilitation framework for iRBD includes early exercise-based interventions of aerobic exercise, progressive resistance training, and multimodal exercise with rehabilitation consultations to address exercise prescription, progression, and monitoring. This rehabilitation framework may be used to implement neuroprotective, multidisciplinary, and proactive clinical care in people with a high likelihood of conversion to PD, dementia with Lewy bodies, or multiple systems atrophy.

Physical Activity among Adults Residing in 11 Countries during the COVID-19 Pandemic Lockdown

During the novel coronavirus (COVID-19) pandemic, physical activity (PA) behaviors were altered worldwide due to public health measures such as “lockdown.” This study described PA among adults residing in 11 countries during COVID-19 lockdown and examined factors associated with PA engagement. We conducted a cross-sectional anonymous survey among adults (≥18 years old) in 11 countries (Brazil, Bulgaria, China, India, Ireland, Malaysia, North Macedonia, Singapore, Spain, Turkey, United States). Of 11,775 participants, 63.7% were female and 52.8% were 18–34 years old. More than 40% of participants were insufficiently active (43.9%) and reported a decrease in their PA during lockdown (44.8%). Statistically significant differences were observed in (1) proportions of participants being insufficiently active, (2) level of PA, and (3) decrease in PA across the 11 countries. More stringent governmental policy responses were associated with greater likelihood of being insufficiently active during lockdown (adjusted odds ratio = 1.22, 95% confidence interval = 1.03, 1.45). Higher depression or anxiety scores were associated with greater likelihood of decreased level of PA during lockdown.We found substantial reductions in PA levels during COVID-19 lockdown across countries. Country-specific PA promotion interventions are needed during this and similar global emergencies.

Comparative analysis of reported physical activity from leisure centres' members versus the general population in Spain

OBJECTIVES

(1) To describe the physical activity (PA) levels of the members of a Spanish leisure centre operator according to age and gender; (2) to describe the differences in the three PA levels between the members of a Spanish leisure centre operator and the general Spanish population considering the PA Eurobarometer data according to their gender and age and (3) to explore the intensity origin of the PA either in Spanish members of leisure centres or the Spanish population considering their gender.

DESIGN

Descriptive epidemiology study.

PARTICIPANTS

Data from 16 Spanish leisure centres (n=3627) and from the 2017 Eurobarometer 472 for Spain (n=1002) were used for this research.

PRIMARY AND SECONDARY OUTCOMES MEASURES

The PA levels were analysed with the International Physical Activity Questionnaire short version, and respondents were grouped into physical inactivity (PIA), moderate-PA and high-PA. Moreover, gender (men or women) and age (18-29 years; 30-44 years; 45-59 years; 60-69 years; ≥70 years) were considered. Total metabolic equivalent (MET)-min/week, as well as total MET-min/week for walking intensity, moderate intensity and vigorous intensity were recorded.

RESULTS

Leisure centres showed a lower prevalence of PIA and a higher prevalence of high-PA than the general population (p<0.05). Women displayed a higher prevalence of PIA and lower prevalence of high-PA than men (p<0.05). The prevalence of PIA increases with age while the prevalence of high-PA decreases.

CONCLUSION

Leisure centres engage most of their members in regular PA, including women and older adults, and these members also perform a higher number of MET in vigorous PA, than the general population.

Bee honey and exercise for improving physical performance, reducing fatigue, and promoting an active lifestyle during COVID-19

Active lifestyle has enormous health benefits. However, physical activity has globally decreased since the beginning of the current coronavirus disease 2019 (COVID-19) outbreak because of social distancing measures. Older adults and people with age-related diseases (e.g., diabetes, obesity, cancer, cardiovascular disorders, etc.) are widely affected by COVID-19 and its grave adverse effects because of their baseline poor immune function. Although they are in intense need for the therapeutic benefits of exercise, they may express a low capacity for exercising due to skeletal muscle dysfunction and low motivation. Honey is a natural energy-rich, low glycemic index food with a variety of biological activities. It is reported to correct muscle pathology in diseased conditions. Because skeletal muscle is the key structure involved in exercise, we explored the literature for the exercise-promoting potential of natural honey. Bee honey improves physical performance at moderate levels of activity, and it reduces the production of inflammatory cytokines and biomarkers of fatigue following strenuous exercise among athletes. Supplementing ischemic heart disease patients with honey combined with floral pollen improved patients' tolerance for physical loads and corrected metabolism. Therefore, the therapeutic use of honey may have implications for to increasing the capacity for exercise in aged and diseased individuals. Soundly designed studies are needed to evaluate such possibility.

Spondyloarthritis and Strength Training: A 4-Year Report

Peripheral spondyloarthritis (SpA) has predominant peripheral (arthritis, enthesitis, or dactylitis) involvement. The severity of the symptoms can have a significant impact on the quality of life. There is no therapeutic gold standard, and physical exercise, with the opposition of resistance, remains controversial. Herein, we report the case of a woman who, at the age of 50, comes to our center with evident motor difficulties. She was previously diagnosed with SpA and was in therapy with a biological drug (adalimumab) for over one year. The training program and the nutritional intervention plan improved her condition, as pointed out by WOMAC, SQS, RAD-36 questionnaire, and BIA analysis, suspending biological therapy for almost two years. During this period, she achieved in sequence: (i) the Italian master deadlift championship, and (ii) the Italian master powerlifting championship, both for two consecutive years.

Identifying factors causing decline in physical functionality of geriatric population

The objective of the study was to find major correlates of decline in the physical functionality of the geriatric population. The main focus was the evaluation of demographic, social, economic, and health-related factors that have a potential impact on physical functionality. A sample of 423 elderly people were selected from district Faisalabad, Pakistan by using a snowball sampling approach. Statistical analysis was performed using frequency analysis and some tests for association like chi-square, Cramer’s V, and gamma coefficient. It was observed that 42.8% of the respondents were independent in doing their all-routine work and the physical functional status decline was observed partially in 35.2% and completely in 22.0% of the respondents. Using frequency analysis and association measures, age, education, marital status, living with family, having an independent source of income, level of social network and support, having exercise routine were found to be significantly associated with functional status of elders. The study concluded that besides age and other demographic factors that cannot be controlled, the socio-economic factors can be improved to substantially reduce the decline in the physical functionality of the geriatric population.

Perceived Neighborhood Environment Associated with Sarcopenia in Urban-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study (KFACS)

Sarcopenia is associated with adverse health outcomes among older individuals. However, little is known about its association with neighborhood environmental factors. We explored the relationship between sarcopenia and perceived neighborhood environmental factors among community-dwelling older adults aged 70-84 years. We analyzed 1778 participants (mean age of 75.9 ± 3.8 years; 54.0% women) who lived in urban areas and underwent dual-energy X-ray absorptiometry from the Korean Frailty and Aging Cohort Study. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 definition. Perceived neighborhood environmental factors were assessed using the Environmental Module of the International Physical Activity Questionnaire (IPAQ-E). In the multivariate analysis, compared to the fifth quintile of the IPAQ-E score, the odds ratios (ORs) and 95% confidence intervals (CIs) for sarcopenia in the first, second, third, and fourth quintiles were 2.13 (1.40-3.24), 1.72 (1.12-2.64), 1.75 (1.15-2.66), and 1.62 (1.06-2.47), respectively. These neighborhood environmental characteristics were linked with an increased likelihood of sarcopenia: no public transportation access (OR = 2.04; 95% CI = 1.19-3.48), poor recreational facilities access (OR = 1.39; 95% CI = 1.01-1.90), absence of destination (OR = 1.53; 95% CI = 1.06-2.20), many hill hazards (OR = 1.36; 95% CI = 1.03-1.78), and lack of traffic safety (OR = 1.35; 95% CI = 1.02-1.78). Thus, better neighborhood environmental strategies may help prevent sarcopenia among urban-dwelling older adults.

Impact of High Altitude on Cardiovascular Health: Current Perspectives

Globally, about 400 million people reside at terrestrial altitudes above 1500 m, and more than 100 million lowlanders visit mountainous areas above 2500 m annually. The interactions between the low barometric pressure and partial pressure of O2, climate, individual genetic, lifestyle and socio-economic factors, as well as adaptation and acclimatization processes at high elevations are extremely complex. It is challenging to decipher the effects of these myriad factors on the cardiovascular health in high altitude residents, and even more so in those ascending to high altitudes with or without preexisting diseases. This review aims to interpret epidemiological observations in high-altitude populations; present and discuss cardiovascular responses to acute and subacute high-altitude exposure in general and more specifically in people with preexisting cardiovascular diseases; the relations between cardiovascular pathologies and neurodegenerative diseases at altitude; the effects of high-altitude exercise; and the putative cardioprotective mechanisms of hypobaric hypoxia.

Evidencing the Influence of the COVID-19 Pandemic and Imposed Lockdown Measures on Fitness Status in Adolescents: A Preliminary Report

It was established that the COVID-19 pandemic resulted in decreased physical activity levels, potentially leading to reduced physical fitness. The aim of this research was to investigate the impact of the COVID-19 lockdown on fitness indices in adolescents. We observed high school adolescents (33% girls; aged 15–17 years) divided into two cohorts. The first cohort (control; n = 48) included adolescents who were in school during the 2018/2019 year, while the second cohort (lockdown; n = 66) was observed during the school year 2019/2020 when COVID-19 lockdown measures were imposed. Variables included body height, body mass, BMI, sit-ups, and the 600 m dash. Both cohorts were tested at the beginning and at the end of the observed school years. A factorial analysis of variance for repeated measurements evidenced an improvement in sit-ups and the 600 m dash in the control, and a decrease of the same capacities in the lockdown cohort. In the lockdown cohort, a decrease in muscular fitness was more evident in boys than in girls. No differential changes between cohorts were evidenced in anthropometrics. Results suggest that the COVID-19 lockdown negatively influenced muscular fitness status in adolescents, especially in boys.

Health behaviours of young adults during the outbreak of the Covid-19 pandemic - a longitudinal study

BACKGROUND

The outbreak of the Covid-19 pandemic has created a number of obstacles to daily functioning, which have led to a need for major changes in lifestyles. The aim of the study was to assess whether and to what extent the outbreak of the Covid-19 pandemic has affected the health behaviours of young adults.

METHODS

506 people aged 18 to 34 ([Formula: see text] =24.67 years ±4.23 years) who filled in an online survey were qualified for the study. Assessment was made of eating habits (a modified Food Frequency Questionnaire, FFQ), physical activity and sedentary behaviours (International Physical Activity Questionnaire, short form IPAQ-SF), sleep quality (The Pittsburgh Sleep Quality Index, PSQI), and generalized anxiety (Generalized anxiety Disorder, 7-item, GAD-7 scale).

RESULTS

During the pandemic, young adults changed their dietary preferences toward sweets and cereal products, increased alcohol (p < 0.001) and fat (p = 0.005) intake, significantly reduced their physical activity (from 8752.5 metabolic equivalents (MET) min/week vs. 6174.6 MET min/week, p < 0.001), increased the time spent sedentarily (Me = 240 min vs. Me = 360 min, p < 0.001) and had decreased sleep quality (PSQI score Me = 7.00 vs. Me = 9.00).

CONCLUSIONS

The Covid-19 pandemic worsened health behaviours and intensified the feeling of generalized anxiety in young adults. Generalized anxiety during obligatory lockdown had the greatest negative impact on sedentary behaviours and sleep quality.

Physical Activity and Self-Reported Metabolic Syndrome Risk Factors in the Aboriginal Population in Perth, Australia, Measured Using an Adaptation of the Global Physical Activity Questionnaire (GPAQ)

Background: Complex, ongoing social factors have led to a context where metabolic syndrome (MetS) is disproportionately high in Aboriginal Australians. MetS is characterised by insulin resistance, abdominal obesity, hypertension, hypertriglyceridemia, high blood-sugar and low HDL-C. This descriptive study aimed to document physical activity levels, including domains and intensity and sedentary behaviour, and MetS risk factors in the Perth Aboriginal (predominately Noongar) community. Methods: The Global Physical Activity Questionnaire (GPAQ), together with a questionnaire on self-reported MetS risk factors, was circulated to community members for completion during 2014 (n = 129). Results: Data were analysed using chi-squared tests. The average (SD) age was 37.8 years (14) and BMI of 31.4 (8.2) kg/m2. Occupational, transport-related and leisure-time physical activity (PA) and sedentary intensities were reported across age categories. The median (interquartile range) daily sedentary time was 200 (78, 435), 240 (120, 420) and 180 (60, 300) minutes for the 18-25, 26-44 and 45+ year-olds, respectively (p = 0.973). Conclusions: An in-depth understanding of the types, frequencies and intensities of PA reported for the Perth Aboriginal community is important to implementing targeted strategies to reduce the prevalence of chronic disease in this context. Future efforts collaborating with community should aim to reduce the risk factors associated with MetS and improve quality of life.

A deep analysis of the proteomic and phosphoproteomic alterations that occur in skeletal muscle after the onset of immobilization

KEY POINTS

A decrease in protein synthesis plays a major role in the loss of muscle mass that occurs in response to immobilization. In mice, immobilization leads to a rapid (within 6 h) and progressive decrease in the rate of protein synthesis and this effect is mediated by a decrease in translational efficiency. Deep proteomic and phosphoproteomic analyses of mouse skeletal muscles revealed that the rapid immobilization-induced decrease in protein synthesis cannot be explained by changes in the abundance or phosphorylation state of proteins that have been implicated in the regulation of translation.

ABSTRACT

The disuse of skeletal muscle, such as that which occurs during immobilization, can lead to the rapid loss of muscle mass, and a decrease in the rate of protein synthesis plays a major role in this process. Indeed, current dogma contends that the decrease in protein synthesis is mediated by changes in the activity of protein kinases (e.g. mTOR); however, the validity of this model has not been established. Therefore, to address this, we first subjected mice to 6, 24 or 72 h of unilateral immobilization and then used the SUnSET technique to measure changes in the relative rate of protein synthesis. The result of our initial experiments revealed that immobilization leads to a rapid (within 6 h) and progressive decrease in the rate of protein synthesis and that this effect is mediated by a decrease in translational efficiency. We then performed a deep mass spectrometry-based analysis to determine whether this effect could be explained by changes in the expression and/or phosphorylation state of proteins that regulate translation. From this analysis, we were able to quantify 4320 proteins and 15,020 unique phosphorylation sites, and surprisingly, the outcomes revealed that the rapid immobilization-induced decrease in protein synthesis could not be explained by changes in either the abundance, or phosphorylation state, of proteins. The results of our work not only challenge the current dogma in the field, but also provide an expansive resource of information for future studies that are aimed at defining how disuse leads to loss of muscle mass.

Role of nutritional care and general guidance for patients with advanced or metastatic gastric cancer

Patients with advanced or metastatic gastric cancer often suffer from malnutrition, which can have an impact on quality of life, increase the toxicity of chemotherapy and reduce overall survival. Options available to the clinician to manage a patient's nutritional status include screening and assessment of malnutrition at diagnosis, monitoring during the 'cancer journey', early detection of precachexia and the ongoing use of a multidisciplinary team (oncologists, other medical specialists and nutritionists). Because malnutrition is frequently overlooked and under treated in patients with advanced or metastatic gastric cancer, this narrative review focuses on the clinical meaning of nutritional status in gastric cancer and provides general guidance regarding nutritional care management for patients with advanced or metastatic gastric cancer.

Healthy Behaviors Associated with Changes in Mental and Physical Strength in Urban African American and White Adults

Over time, adherence to healthy behaviors may improve physical and mental strength which is essential for successful aging. A plausible mechanism is the reduction of inflammation. Research on the association of risky health behaviors on change in strength with age is limited. This study examined changes in the inflammatory potential of the diet, smoking, illicit drug use with changes in strength in a racially and socioeconomically diverse adult sample from the Healthy Aging in Neighborhoods of Diversity Across the Life Span study. The dietary inflammatory index (DII) was calculated from 35 food components derived from multiple 24-h dietary recalls. Strength was evaluated by handgrip strength (HGS), SF-12 PCS and SF-12 MCS (physical and mental component scores). Repeated measures analyses were used to examine associations. At baseline, mean age was 48.4 ± 0.25 years, 56% of the sample were women, and 58% African American. Significant 4-way interactions were found between age, race, socioeconomic status, and DII for women, on change in HGS (p < 0.05) and in SF-12 PCS (p < 0.05) and for men, in change in SF-12 PCS (p < 0.05). Improvements in SF-12 MCS were associated with all three health behaviors as main effects. This study provided evidence that changes towards improving healthy behaviors, diet with anti-inflammatory potential, not smoking cigarettes and not using illicit drugs, were associated with improved strength. Health professionals, especially registered dietitians and health coaches, should create lifestyle interventions to reduce inflammation targeting change in more than one risky health behavior.

Explaining socioeconomic disparities in health behaviours: A review of biopsychological pathways involving stress and inflammation

The purpose of this article was to explore how individuals' position in a socioeconomic hierarchy is related to health behaviours that are related to socioeconomic disparities in health. We identified research which shows that: (a) low socioeconomic status (SES) is associated with living in harsh environments, (b) harsh environments are related to increased levels of stress and inflammation, (c) stress and inflammation impact neural systems involved in self-control by sensitising the impulsive system and desensitising the reflective system, (d) the effects are inflated valuations of small immediate rewards and deflated valuations of larger delayed rewards, (e) these effects are observed as increased delay discounting, and (f) delay discounting is positively associated with practicing more unhealthy behaviours. The results are discussed within an adaptive evolutionary framework which lays out how the stress response system, and its interaction with the immune system and brain systems for decision-making and behaviours, provides the biopsychological mechanisms and regulatory shifts that make widespread conditional adaptability possible. Consequences for policy work, interventions, and future research are discussed.

The Impact of an 8-Weeks At-Home Physical Activity Plan on Academic Achievement at the Time of COVID-19 Lock-Down in Italian School

The purpose of this randomized controlled study was to investigate the efficacy of an 8-week exercise programme conducted in e-learning mode on high school students’ academic performance. The aim was to examine the changes in physical fitness and learning outcomes during the enforced period of lockdown caused by outbreak of the second wave of COVID-19 pandemic and the closure of schools in Italy. Thirty high-school students (14–15 years) were randomly assigned to an experimental group (n = 15) that performed an at-home workout programme (~60 min., twice a week), or a control group (n = 15) who received only a regular programme of theoretical lessons where no practice takes place. Both groups were synchronized in real-time with the physical education teacher. In order to assess students’ starting level and significant changes reached, at baseline and after training, a battery of standardized assessment motor tests (Standing long jump test, Harvard step test, sit and reach test, and butt kicks test), and an academic achievement test (Amos 8–15) were administered. In comparison to the control group at baseline and the end of the programme, the experimental group reported considerable improvements in motivation and concentration, significant anxiety reduction, and an increase in capacity to organize studying and to be more flexible. Moreover, it was possible to observe the efficacy of the workout to improve learning ability among practicing students (p < 0.001). No significant changes were found in the control group. The results suggest that a school-based exercise programme conducted online could be a powerful approach in order to achieve the best academic outcomes and for improving students’ physical fitness as well as their cognitive health.

Screening for Sarcopenia (Physical Frailty) in the COVID-19 Era

Although the numbers of aged populations have risen considerably in the last few decades, the current coronavirus disease 2019 (COVID-19) has revealed an extensive vulnerability among these populations. Sarcopenia is an age-related disorder that increases hospitalization, dependencies, and mortality in older adults. It starts to develop in midlife or even earlier as a result of unbalanced diet/poor nutrition and low levels of physical activity, in addition to chronic disorders such as obesity and diabetes mellitus. Given that social isolation is adopted as the most protective measure against COVID-19, the level of physical activity and the intake of adequate diet have considerably declined, especially among older adults-denoting an increased possibility for developing sarcopenia. Research also shows a higher vulnerability of sarcopenic people to COVID-19 as well as the development of wasting disorders such as sarcopenia and cachexia in a considerable proportion of symptomatic and recovering COVID-19 patients. Muscular wasting in COVID-19 is associated with poor prognosis. Accordingly, early detection and proper management of sarcopenia and wasting conditions in older adults and COVID-19 patients may minimize morbidity and mortality during the current COVID-19 crisis. This review explored different aspects of screening for sarcopenia, stressing their relevance to the detection of altered muscular structure and performance in patients with COVID-19. Current guidelines recommend prior evaluation of muscle strength by simple measures such as grip strength to identify individuals with proven weakness who then would be screened for muscle mass loss. The latter is best measured by MRI and CT. However, due to the high cost and radiation risk entailed by these techniques, other simpler and cheaper techniques such as DXA and ultrasound are given preference. Muscle loss in COVID-19 patients was measured during the acute phase by CT scanning of the pectoralis muscle simultaneously during a routine check for lung fibrosis, which seems to be an efficient evaluation of sarcopenia among those patients with no additional cost. In recovering patients, muscle strength and physical performance have been evaluated by electromyography and traditional tests such as the six-minute walk test. Effective preventive and therapeutic interventions are necessary in order to prevent muscle loss and associated physical decline in COVID-19 patients.

Home Confinement in Previously Active Older Adults: A Cross-Sectional Analysis of Physical Fitness and Physical Activity Behavior and Their Relationship With Depressive Symptoms

AIM

The aim of our study was to analyze physical activity levels, sitting time, physical fitness, and their relationship with depressive symptoms after home confinement in previously active older adults.

METHODS

This cross-sectional study sample comprised 68 older adults (74.24 ± 5.67 years) from a community-based exercise program conducted in Porto, Portugal. After home confinement, participants were assessed in person for lower-body strength (30-s chair stand test), cardiorespiratory fitness (6-min walking test), agility/dynamic balance (8-ft up-and-go test), handgrip strength, and anthropometry. Telephone interviews were performed to evaluate depressive symptoms with the Geriatric Depression Scale - 15 items (GDS-15) and physical activity levels through the International Physical Activity Questionnaire (IPAQ-SV). Individuals were also asked to self-report changes in their physical activity levels and time spent sitting.

RESULTS

Ninety percent of older adults self-reported a decrease in overall physical activity levels, and nearly 65% increased daily sitting time during the home confinement. However, previously active older adults still presented high levels of physical fitness (scores above 50th compared with Portuguese normative values) after 11 weeks of home confinement. Overall, 52.9% of participants scored 5 or more points on GDS-15, which is suggestive of depression. Higher levels of moderate-to-vigorous physical activity (MVPA) and cardiorespiratory fitness were found in the non-depressed group compared with the depressed group. Finally, results from multiple regression analysis revealed that MVPA was negatively associated with depression. This model explained 16.4% of the variability seen in depression score, controlled for age, gender, and education.

CONCLUSION

Even reporting a decline in physical activity, older adults who previously participated in a formal exercise program, still presented high levels of physical fitness after 11 weeks of home confinement. However, MVPA, but not physical fitness, seems to be an associated depression score in previously active older adults. These results reinforce the importance of older adults to remain physically active, since higher levels of MVPA may have a protective effect on depressive symptoms and, therefore, mitigate the negative impact of home confinement on mental health. Future longitudinal research studies are needed to ascertain these results.

Effects of early-life exposure to Western diet and voluntary exercise on adult activity levels, exercise physiology, and associated traits in selectively bred High Runner mice

Exercise behavior is under partial genetic control, but it is also affected by numerous environmental factors, potentially including early-life experiences whose effects persist into adulthood. We studied genetic and early-life environmental effects on wheel-running behavior in a mouse model that includes four replicate high runner (HR) lines selectively bred for increased voluntary wheel running as young adults and four non-selected control (C) lines. In a full factorial design, mice from each line were granted wheel access or not and administered either standard or Western diet (WD) from weaning (3 weeks old) to 6 weeks of age (sexual maturity). In addition to acute effects, after a washout period of 8 weeks (∼6 human years) in which all mice had standard diet and no wheel access, we found both beneficial and detrimental effects of these early-life exposures. During the first week of treatments, WD increased distance run by 29% in C mice and 48% in HR mice (significant Diet × Linetype interaction), but diet effects disappeared by the third week. Across the three weeks of juvenile treatment, WD significantly increased fat mass (with lean mass as a covariate). Tested as adults, early-life exercise increased wheel running of C mice but not HR mice in the first week. Early-life exercise also reduced adult anxiety-like behavior and increased adult fasted blood glucose levels, triceps surae mass, subdermal fat pad mass, and brain mass, but decreased heart ventricle mass. Using fat mass as a covariate, early-life exercise treatment increased adult leptin concentration. In contrast, early-life WD increased adult wheel running of HR mice but not C mice. Early-life WD also increased adult lean mass and adult preference for Western diet in all groups. Surprisingly, early-life treatment had no significant effect on adult body fat or maximal aerobic capacity (VO2max). No previous study has tested for combined or interactive effects of early-life WD and exercise. Our results demonstrate that both factors can have long-lasting effects on adult voluntary exercise and related phenotypes, and that these effects are modulated by genetic background. Overall, the long-lasting effects of early-life exercise were more pervasive than those of WD, suggesting critical opportunities for health intervention in childhood habits, as well as possible threats from modern challenges. These results may be relevant for understanding potential effects of activity reductions and dietary changes associated with the obesity epidemic and COVID-19 pandemic.

COVID-19: the relationship between perceptions of risk and behaviours during lockdown

AIM

Understanding COVID-19 risk perceptions and their impact on behaviour can improve the effectiveness of public health strategies. Prior evidence suggests that, when people perceive uncontrollable risks to their health, they are less likely to engage in healthful behaviour. This article aims to understand the extent to which COVID-19 is perceived as an uncontrollable risk, and to assess whether this perceived risk is associated with health behaviour.

SUBJECT AND METHODS

We surveyed a nationally representative sample of 496 participants during the first UK lockdown. We assessed perceptions of COVID-19-related risk, self-reported adherence to infection control measures recommended by the UK Government, and general health behaviours. We predicted that increased perceived extrinsic mortality risk (the portion of mortality risk perceived to be uncontrollable) would disincentivise healthy behaviour.

RESULTS

Perceived threat to life was the most consistent predictor of reported adherence to infection control measures. Perceived extrinsic mortality risk was found to have increased due to the pandemic, and was associated with lower reported adherence to Government advice on diet, physical activity, and smoking.

CONCLUSIONS

Our findings suggest that health messages that highlight threat to life may be effective in increasing adherence to infection control, but may also lead to a reduction in health-promoting behaviours. We suggest that messages that highlight threat to life should be accompanied by statements of efficacy. Further, messages evoking feelings of concern for others may be effective in promoting compliance with anti-infection measures, without the potential for the unwelcome side-effect of discouraging healthy behaviour.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10389-021-01543-9.

Impact of the COVID-19 Pandemic on Life Space Extent and Apathy: A Comparison of Competitive Japanese Swimmers with and without Disabilities

Changes in the daily lives and mental health of people with disabilities due to the coronavirus disease (COVID-19) pandemic have not been reported. The Japanese government closed public facilities, including swimming pools, during the first wave of COVID-19, and many competitive swimmers lost their places of activities. This study aimed to investigate the impact of the COVID-19 pandemic on life space and apathy among swimmers and investigated differences in the impact on swimmers with and without disabilities. A total of 39 competitive swimmers participated in this study, including 11 male and nine female swimmers with disabilities (swimmers with disabilities = para-swimmers), and e11 male and eight female swimmers without disabilities. Baseline and follow-up web-based questionnaire surveys were conducted, and changes in life space and apathy scale (AS) were assessed. Female para-swimmers showed significantly lower apathy than female able-bodied subjects (para, during; 16.0 ± 1.9; after, 12.8 ± 3.2; non-disabled; during, 10.5 ± 4.4; after, 10.6 ± 4.8; p < 0.05). Female swimmers with disabilities may be more likely to experience worsening mental health due to changes in their lifestyle.

A Cross-Sectional Comparison of Physical Activity during COVID-19 in a Sample of Rural and Non-Rural Participants in the US

Physical activity (PA) pre-COVID-19 was lower in rural areas compared to non-rural areas. The purpose of this study was to determine COVID-19's impact on PA in rural and non-rural residents. A cross-sectional study consisting of a convenience sample of 278 participants (50% rural, 50% non-rural) from 25 states completed an online survey describing their PA behaviors and perceptions during COVID-19. The global physical activity questionnaire was used to determine PA in various domains and summed to determine if the participant met the PA guidelines. Rural participants had a significantly higher body mass index, lower income, and a lower educational attainment. Conversely, non-rural participants reported more barriers to PA. There was no difference in the perception of COVID-19's impact on PA, specifically; however, rural participants were significantly less likely to meet cardiorespiratory PA recommendations compared to non-rural participants. Conclusions: This study demonstrates the continued disparity in PA between rural and non-rural residents, despite the supposition of COVID-19 being less impactful in rural areas due to sparse populations. Efforts should be pursued to close the PA gap between rural and non-rural residents.

The effectiveness of a 17-week lifestyle intervention on health behaviors among airline pilots during COVID-19

PURPOSE

The aim of this study was to evaluate the efficacy of a 17-week, 3-component lifestyle intervention for enhancing health behaviors during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

A parallel-group (intervention and control) study was conducted amongst 79 airline pilots over a 17-week period during the COVID-19 pandemic. The intervention group (n = 38) received a personalized sleep, dietary, and physical activity (PA) program. The control group (n = 41) received no intervention. Outcome measures for sleep, fruit and vegetable intake, PA, and subjective health were measured though an online survey before and after the 17-week period. The changes in outcome measures were used to determine the efficacy of the intervention.

RESULTS

Significant main effects for time × group were found for International Physical Activity Questionnaire-walk (p = 0.02) and for all other outcome measures (p < 0.01). The intervention group significantly improved in sleep duration (p < 0.01; d = 1.35), Pittsburgh Sleep Quality Index score (p < 0.01; d = 1.14), moderate-to-vigorous PA (p < 0.01; d = 1.44), fruit and vegetable intake (p < 0.01; d = 2.09), Short Form 12v2 physical score (p < 0.01; d = 1.52), and Short Form 12v2 mental score (p < 0.01; d = 2.09). The control group showed significant negative change for sleep duration, Pittsburgh Sleep Quality Index score, and Short Form 12v2 mental score (p < 0.01).

CONCLUSION

Results provide preliminary evidence that a 3-component healthy sleep, eating, and PA intervention elicit improvements in health behaviors and perceived subjective health in pilots and may improve quality of life during an unprecedented global pandemic.

Association between healthy lifestyle practices and life purpose among a highly health-literate cohort: a cross-sectional study

BACKGROUND

The national health promotion program in the twenty-first century Japan (HJ21) correlates life purpose with disease prevention, facilitating the adoption of healthy lifestyles. However, the influence of clustered healthy lifestyle practices on life purpose, within the context of this national health campaign remains uninvestigated. This study assessed the association between such practices and life purpose, in line with the HJ21.

METHODS

We performed a nationwide cross-sectional survey on certified specialists in health management. Participants' demographic information, lifestyle, and purpose in life were measured using a validated tool. The cohort was median-split into two groups based on their clustered health-related lifestyle score. The values for health-related lifestyle and purpose were compared between the two groups and the correlation between health-related lifestyle and purpose in life was measured.

RESULTS

Data from 4820 participants were analyzed. The higher-scoring health-related lifestyle group showed a significantly higher life purpose than the lower group (35.3 vs 31.4; t = 23.6, p < 0.001). There was a significant association between the scores of clustered healthy lifestyle practices and life purpose (r = 0.401, p < 0.001). The higher-scoring health-related lifestyle group achieved a higher life purpose than the lower-scoring group. This association between healthy lifestyle practices and life purpose denotes a positive and linear relationship.

CONCLUSIONS

Our results suggest that individuals who have a better health-related lifestyle gain a higher sense of life purpose. In other words, a healthy lifestyle predicts a purpose in life. Our findings posit that examining the causal relationship between healthy lifestyle and purpose in life may be a more efficient approach toward health promotion.

Change in eating habits and physical activities before and during the COVID-19 pandemic in Hong Kong: a cross-sectional study via random telephone survey

BACKGROUND

Hong Kong is a densely populated city with a low incidence and mortality of coronavirus disease 2019 (COVID-19). The city imposed different levels of social distancing including, the closure of sports venues and restrictions on eateries. This inevitably affects the eating behaviour and physical activities of the population. We examined the changes in eating behavior and physical activities before and during the COVID-19 pandemic, and identified sociodemographic factors associated with the behavioral changes.

METHODS

This was a cross-sectional study via a random telephone survey of Chinese adults conducted in Hong Kong from May to June, 2020 - a period in which social distancing measures were being imposed. We measured the physical activity habits from four aspects and dietary consumption patterns from seven aspects before and during the pandemic based on the World Health Organization's guidelines and previous publications.

RESULTS

In total, 724 participants were recruited. Individuals were found to cook more frequently at home (p < 0.001) and order take-out (p < 0.001) during the COVID-19 pandemic. While no significant change in the frequency of fast food consumption was observed, we found significant increases in the frequency of eating fruits (p < 0.001) and vegetables (p = 0.004). The frequencies of walking, moderate-intensive sports, and high-intensity sports were significantly reduced (p < 0.001). We found that healthy lifestyle behaviors during the pandemic were negatively associated with participants' economic status.

CONCLUSIONS

Social distancing measures likely provided an opportunity for individuals to stay home and thus eat healthier. However, in a prolonged period of social restrictions, a lower physical activity level poses a risk to public health. Public health officials are thus advised to monitor physical health on a population-wide basis. The findings highlighted the importance of interventions tailored to individuals who have prolonged home stays - particularly for individuals in the low economic group.