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Hermansen R, Jacobsen BK, Løchen ML, Morseth B. Leisure time and occupational physical activity, resting heart rate and mortality in the Arctic region of Norway: The Finnmark Study. Eur J Prev Cardiol 2019; 26:1636-1644. [DOI: 10.1177/2047487319848205] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Aims This study examined the association of leisure time physical activity, occupational physical activity, and resting heart rate with all-cause and cardiovascular disease mortality in Sami and non-Sami populations. Study design This was a longitudinal, observational population-based study. Methods The Finnmark 3 study cohort was examined in 1987–1988 and followed for all-cause and cardiovascular disease mortality for 26 years. The cohort included 17,697 men and women with a mean age of 47.2 years at baseline. Leisure time physical activity and occupational physical activity were assessed with a validated questionnaire at baseline, whereas cause of death was obtained from the Norwegian Cause of Death Registry. Results A total of 1983 women and 3147 men died during follow-up. Leisure time physical activity was linearly and inversely associated with all-cause mortality, but not coronary heart disease mortality. Compared to inactive subjects, all-cause mortality was significantly reduced by 16% in the active leisure time physical activity group (hazard ratio 0.84; 95% confidence interval 0.76–0.92). Both for all-cause and cardiovascular disease mortality, we observed a U-shaped relationship with occupational physical activity, as participants in the walking and lifting group had significantly lower mortality than both the mostly sedentary and the heavy manual labour group ( p < 0.05). An increase in resting heart rate by one beat per minute was associated with a 1.1% increase in all-cause mortality (hazard ratio 1.011; 95% confidence interval 1.009–1.013). The associations were similar in Sami and non-Sami subjects. Conclusion In this population-based study, leisure time physical activity was inversely associated with all-cause mortality, whereas resting heart rate was positively associated with all-cause and cardiovascular disease mortality. There was a U-shaped association between occupational physical activity and cardiovascular disease and all-cause mortality.
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Affiliation(s)
- Rune Hermansen
- Department of Community Medicine, UiT The Arctic University of Norway, Norway
- Finnmark Hospital Health Trust, Kirkenes Hospital, Norway
| | - Bjarne K Jacobsen
- Department of Community Medicine, UiT The Arctic University of Norway, Norway
- Centre for Sámi Health Research, UiT The Arctic University of Norway, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Norway
| | - Bente Morseth
- Department of Community Medicine, UiT The Arctic University of Norway, Norway
- School of Sport Sciences, UiT The Arctic University of Norway, Norway
- Centre for Clinical Research and Education, University Hospital of North Norway Trust, Norway
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Wichmann F, Sill J, Hassenstein MJ, Zeeb H, Pischke CR. Apps zur Förderung von körperlicher Aktivität. PRÄVENTION UND GESUNDHEITSFÖRDERUNG 2019. [DOI: 10.1007/s11553-018-0678-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Alves DGL, Rocha SG, Andrade EV, Mendes AZ, Cunha ÂGJ. The positive impact of physical activity on the reduction of anxiety scores: a pilot study. ACTA ACUST UNITED AC 2019; 65:434-440. [PMID: 30994844 DOI: 10.1590/1806-9282.65.3.434] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 06/20/2018] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To compare anxiety scores between physical activity practitioners and sedentary, men and women and to relate them to physical activity frequency and age. METHODS In this cross-sectional study, a sample of 256 regular aerobic physical activity practitioners was compared to a sample of 256 sedentary individuals (control group). Anxiety scores were quantified by Anxiety Inventory Spielberger State-Trait (STAI). The scores of the groups were compared using the Student t-test and chi-square test for parametric and non-parametric data, respectively. The correlation between scores of different variables was performed using the Pearson test. RESULTS There was a significant difference between the average anxiety scores (p <0.001) and the chi-square test proved there is a higher prevalence of severe anxiety (p <0.001) in the sedentary group. Age did not correlate with worse anxiety scores (p <0.05). Comparing by gender, women had a higher prevalence of intense anxiety. CONCLUSIONS Individuals who engage in regular physical activity have lower levels of anxiety, and both sexes are benefited with the anxiolytic potential of physical activity. Therefore, this study proved that the Roman poet Juvenal was right, and his expression "Mens sana in corpore sano," could also be interpreted in the opposite direction, i.e., a healthy body correlates with a healthy mind.
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Affiliation(s)
- Dalton Gonçalves Lima Alves
- Academics in the Medical Program of the Metropolitan Institute of Higher Education/IMES - Univaço, Ipatinga, Minas Gerais, Brasil
| | - Sílvia Gabrielli Rocha
- Academics in the Medical Program of the Metropolitan Institute of Higher Education/IMES - Univaço, Ipatinga, Minas Gerais, Brasil
| | - Evandro Vitor Andrade
- Academics in the Medical Program of the Metropolitan Institute of Higher Education/IMES - Univaço, Ipatinga, Minas Gerais, Brasil
| | - Augusto Zbonik Mendes
- Academics in the Medical Program of the Metropolitan Institute of Higher Education/IMES - Univaço, Ipatinga, Minas Gerais, Brasil
| | - Ângelo Geraldo José Cunha
- Professor of the Medical Program of the Metropolitan Institute of Higher Education/IMES - Univaço, Ipatinga, Minas Gerais, Brasil
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Bock BC, Dunsiger SI, Ciccolo JT, Serber ER, Wu WC, Tilkemeier P, Walaska KA, Marcus BH. Exercise Videogames, Physical Activity, and Health: Wii Heart Fitness: A Randomized Clinical Trial. Am J Prev Med 2019; 56:501-511. [PMID: 30777705 PMCID: PMC7100962 DOI: 10.1016/j.amepre.2018.11.026] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Adults who engage in regular physical activity have lower rates of morbidity and mortality than those who do not. Exercise videogames may offer an attractive, sustainable alternative or supplement to traditional modes of exercise. This study compared exercise videogames with standard exercise modalities for improving uptake and maintenance of moderate to vigorous physical activity, and health risk indices. STUDY DESIGN A three-arm clinical RCT including 12 weeks of supervised laboratory-based moderate to vigorous physical activity followed by 6 months follow-up. SETTING/PARTICIPANTS This study was conducted at a university affiliated hospital research lab. Healthy, sedentary adults were eligible. INTERVENTIONS This study compared a 12-week program of supervised exercise videogames versus standard exercise (e.g., treadmill) versus control. Data were collected from January 2012 to September 2017 and analyzed in 2018. MAIN OUTCOME MEASURES The primary outcome was weekly minutes of moderate to vigorous physical activity at end of treatment, assessed at 3 and 6 months post-intervention by using self-report and accelerometer data. Health risk indices (e.g., HbA1c, lipids) were also assessed. RESULTS Participants (N=283) had an average age of 46.2 ±13.5 years; 79% were female. At end of treatment, those in the exercise videogame arm engaged in 30 minutes/week more moderate to vigorous physical activity compared with standard exercise and 85 more minutes/week than controls (all p<0.05). Exercise videogame participants had greater reductions in cholesterol, HbA1c, and body fat versus other groups. Reductions in cholesterol were twice as large in exercise videogame versus standard participants. CONCLUSIONS Exercise videogames produced greater uptake and maintenance of moderate to vigorous physical activity compared with standard exercise and improvements in multiple health risk indices. Exercise videogames may promote sustainable physical activity with significant health benefits. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov NCT03298919.
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Affiliation(s)
- Beth C Bock
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, Rhode Island; Department of Behavioral and Social Science, Brown School of Public Health, Providence, Rhode Island; The Miriam Hospital, Centers for Behavioral and Preventive Medicine, Providence, Rhode Island.
| | - Shira I Dunsiger
- Department of Behavioral and Social Science, Brown School of Public Health, Providence, Rhode Island; The Miriam Hospital, Centers for Behavioral and Preventive Medicine, Providence, Rhode Island
| | - Joseph T Ciccolo
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York
| | - Eva R Serber
- Department of Psychiatry and Behavioral Science, Medical University of South Carolina, Charleston, South Carolina
| | - Wen-Chih Wu
- Department of Medicine, Brown Medical School, Providence, Rhode Island; Department of Cardiology, Providence VA Medical Center, Providence, Rhode Island
| | - Peter Tilkemeier
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, Rhode Island; Department of Internal Medicine, Greenville Health System, Greenville, South Carolina
| | - Kristen A Walaska
- The Miriam Hospital, Centers for Behavioral and Preventive Medicine, Providence, Rhode Island
| | - Bess H Marcus
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, Rhode Island; Department of Behavioral and Social Science, Brown School of Public Health, Providence, Rhode Island
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Patterson R, Webb E, Hone T, Millett C, Laverty AA. Associations of Public Transportation Use With Cardiometabolic Health: A Systematic Review and Meta-Analysis. Am J Epidemiol 2019; 188:785-795. [PMID: 30689686 PMCID: PMC6438807 DOI: 10.1093/aje/kwz012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 01/21/2023] Open
Abstract
Public transportation provides an opportunity to incorporate physical activity into journeys, but potential health impacts have not been systematically examined. We searched the literature for articles on public transportation and health published through December 2017 using Google (Google Inc., Mountain View, California), 5 medical databases, and 1 transportation-related database. We identified longitudinal studies which examined associations between public transportation and cardiometabolic health (including adiposity, type 2 diabetes mellitus, and cardiovascular disease). We assessed study quality using the Newcastle-Ottawa Scale for cohort studies and performed meta-analyses where possible. Ten studies were identified, 7 investigating use of public transportation and 3 examining proximity to public transportation. Seven studies used individual-level data on changes in body mass index (BMI; weight (kg)/height (m)2), with objective outcomes being measured in 6 studies. Study follow-up ranged from 1 year to 10 years, and 3 studies adjusted for nontransportation physical activity. We found a consistent association between use of public transportation and lower BMI. Meta-analysis of data from 5 comparable studies found that switching from automobile use to public transportation was associated with lower BMI (−0.30 units, 95% confidence interval: −0.47, −0.14). Few studies have investigated associations between public transportation use and nonadiposity outcomes. These findings suggest that sustainable urban design which promotes public transportation use may produce modest reductions in population BMI.
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Affiliation(s)
- Richard Patterson
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Elizabeth Webb
- Economic and Social Research Council International Centre for Lifecourse Studies, Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Thomas Hone
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Christopher Millett
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
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Health Benefits of Physical Activity Related to an Urban Riverside Regeneration. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030462. [PMID: 30764538 PMCID: PMC6388232 DOI: 10.3390/ijerph16030462] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/25/2019] [Accepted: 02/01/2019] [Indexed: 12/20/2022]
Abstract
The promotion of physical activity through better urban design is one pathway by which health and well-being improvements can be achieved. This study aimed to quantify health and health-related economic impacts associated with physical activity in an urban riverside park regeneration project in Barcelona, Spain. We used data from Barcelona local authorities and meta-analysis assessing physical activity and health outcomes to develop and apply the “Blue Active Tool”. We estimated park user health impacts in terms of all-cause mortality, morbidity (ischemic heart disease; ischemic stroke; type 2 diabetes; cancers of the colon and breast; and dementia), disability-adjusted life years (DALYs) and health-related economic impacts. We estimated that 5753 adult users visited the riverside park daily and performed different types of physical activity (walking for leisure or to/from work, cycling, and running). Related to the physical activity conducted on the riverside park, we estimated an annual reduction of 7.3 deaths (95% CI: 5.4; 10.2), and 6.2 cases of diseases (95% CI: 2.0; 11.6). This corresponds to 11.9 DALYs (95% CI: 3.4; 20.5) and an annual health-economic impact of 23.4 million euros (95% CI: 17.2 million; 32.8 million). The urban regeneration intervention of this riverside park provides health and health-related economic benefits to the population using the infrastructure.
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Kestens Y, Winters M, Fuller D, Bell S, Berscheid J, Brondeel R, Cantinotti M, Datta G, Gauvin L, Gough M, Laberee K, Lewis P, Lord S, Luan H(H, McKay H, Morency C, Muhajarine N, Nelson T, Ottoni C, Stephens ZP, Pugh C, Rancourt G, Shareck M, Sims-Gould J, Sones M, Stanley K, Thierry B, Thigpen C, Wasfi R. INTERACT: A comprehensive approach to assess urban form interventions through natural experiments. BMC Public Health 2019; 19:51. [PMID: 30630441 PMCID: PMC6327503 DOI: 10.1186/s12889-018-6339-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 12/18/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Urban form interventions can result in positive and negative impacts on physical activity, social participation, and well-being, and inequities in these outcomes. Natural experiment studies can advance our understanding of causal effects and processes related to urban form interventions. The INTErventions, Research, and Action in Cities Team (INTERACT) is a pan-Canadian collaboration of interdisciplinary scientists, urban planners, and public health decision makers advancing research on the design of healthy and sustainable cities for all. Our objectives are to use natural experiment studies to deliver timely evidence about how urban form interventions influence health, and to develop methods and tools to facilitate such studies going forward. METHODS INTERACT will evaluate natural experiments in four Canadian cities: the Arbutus Greenway in Vancouver, British Columbia; the All Ages and Abilities Cycling Network in Victoria, BC; a new Bus Rapid Transit system in Saskatoon, Saskatchewan; and components of the Sustainable Development Plan 2016-2020 in Montreal, Quebec, a plan that includes urban form changes initiated by the city and approximately 230 partnering organizations. We will recruit a cohort of between 300 and 3000 adult participants, age 18 or older, in each city and collect data at three time points. Participants will complete health and activity space surveys and provide sensor-based location and physical activity data. We will conduct qualitative interviews with a subsample of participants in each city. Our analysis methods will combine machine learning methods for detecting transportation mode use and physical activity, use temporal Geographic Information Systems to quantify changes to urban intervention exposure, and apply analytic methods for natural experiment studies including interrupted time series analysis. DISCUSSION INTERACT aims to advance the evidence base on population health intervention research and address challenges related to big data, knowledge mobilization and engagement, ethics, and causality. We will collect ~ 100 TB of sensor data from participants over 5 years. We will address these challenges using interdisciplinary partnerships, training of highly qualified personnel, and modern methodologies for using sensor-based data.
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Affiliation(s)
- Yan Kestens
- École de Santé Publique de l’Université de Montréal / Centre de recherche du CHUM, Pavillon S, Tour St–Antoine – 850 St–Denis – S03–280 –, Montreal, QC H2X 0A9 Canada
| | - Meghan Winters
- Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6 Canada
| | - Daniel Fuller
- Memorial University of Newfoundland, 230 Elizabeth Avenue, St. John’s, NF A1C 5S7 Canada
| | - Scott Bell
- University of Saskatchewan, 105 Administration Place, Saskatoon, SK S7N 5A2 Canada
| | - Janelle Berscheid
- University of Saskatchewan, 105 Administration Place, Saskatoon, SK S7N 5A2 Canada
| | - Ruben Brondeel
- École de Santé Publique de l’Université de Montréal / Centre de recherche du CHUM, Pavillon S, Tour St–Antoine – 850 St–Denis – S03–280 –, Montreal, QC H2X 0A9 Canada
| | - Michael Cantinotti
- Université du Québec à Trois-Rivières, 3351 Boulevard des Forges, Trois-Rivières, QC G9A 5H7 Canada
| | - Geetanjali Datta
- École de Santé Publique de l’Université de Montréal / Centre de recherche du CHUM, Pavillon S, Tour St–Antoine – 850 St–Denis – S03–280 –, Montreal, QC H2X 0A9 Canada
| | - Lise Gauvin
- École de Santé Publique de l’Université de Montréal / Centre de recherche du CHUM, Pavillon S, Tour St–Antoine – 850 St–Denis – S03–280 –, Montreal, QC H2X 0A9 Canada
| | - Margot Gough
- University of Saskatchewan, 105 Administration Place, Saskatoon, SK S7N 5A2 Canada
| | - Karen Laberee
- Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6 Canada
| | - Paul Lewis
- École de Santé Publique de l’Université de Montréal / Centre de recherche du CHUM, Pavillon S, Tour St–Antoine – 850 St–Denis – S03–280 –, Montreal, QC H2X 0A9 Canada
| | - Sébastien Lord
- École de Santé Publique de l’Université de Montréal / Centre de recherche du CHUM, Pavillon S, Tour St–Antoine – 850 St–Denis – S03–280 –, Montreal, QC H2X 0A9 Canada
| | - Hui ( Henry) Luan
- Memorial University of Newfoundland, 230 Elizabeth Avenue, St. John’s, NF A1C 5S7 Canada
| | - Heather McKay
- University of British Columbia, 2329 West Mall, Vancouver, BC V6T 1Z4 Canada
| | - Catherine Morency
- Polytechnique Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4 Canada
| | - Nazeem Muhajarine
- University of Saskatchewan, 105 Administration Place, Saskatoon, SK S7N 5A2 Canada
| | - Trisalyn Nelson
- Arizona State University, PO Box 875302, Tempe, AZ 85287-5302 USA
| | - Callista Ottoni
- Université du Québec à Trois-Rivières, 3351 Boulevard des Forges, Trois-Rivières, QC G9A 5H7 Canada
| | - Zoe Poirier Stephens
- École de Santé Publique de l’Université de Montréal / Centre de recherche du CHUM, Pavillon S, Tour St–Antoine – 850 St–Denis – S03–280 –, Montreal, QC H2X 0A9 Canada
| | - Caitlin Pugh
- Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6 Canada
| | - Gabrielle Rancourt
- École de Santé Publique de l’Université de Montréal / Centre de recherche du CHUM, Pavillon S, Tour St–Antoine – 850 St–Denis – S03–280 –, Montreal, QC H2X 0A9 Canada
| | - Martin Shareck
- University of Toronto, 155 College Street, Toronto, ON M5T 1P8 Canada
| | - Joanie Sims-Gould
- Université du Québec à Trois-Rivières, 3351 Boulevard des Forges, Trois-Rivières, QC G9A 5H7 Canada
| | - Meridith Sones
- Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6 Canada
| | - Kevin Stanley
- University of Saskatchewan, 105 Administration Place, Saskatoon, SK S7N 5A2 Canada
| | - Benoit Thierry
- École de Santé Publique de l’Université de Montréal / Centre de recherche du CHUM, Pavillon S, Tour St–Antoine – 850 St–Denis – S03–280 –, Montreal, QC H2X 0A9 Canada
| | - Calvin Thigpen
- Polytechnique Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4 Canada
| | - Rania Wasfi
- École de Santé Publique de l’Université de Montréal / Centre de recherche du CHUM, Pavillon S, Tour St–Antoine – 850 St–Denis – S03–280 –, Montreal, QC H2X 0A9 Canada
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Mueller N, Rojas-Rueda D, Khreis H, Cirach M, Milà C, Espinosa A, Foraster M, McEachan RRC, Kelly B, Wright J, Nieuwenhuijsen M. Socioeconomic inequalities in urban and transport planning related exposures and mortality: A health impact assessment study for Bradford, UK. ENVIRONMENT INTERNATIONAL 2018; 121:931-941. [PMID: 30347375 DOI: 10.1016/j.envint.2018.10.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 10/10/2018] [Accepted: 10/10/2018] [Indexed: 05/12/2023]
Abstract
BACKGROUND Cities have unique geographic, environmental and sociocultural characteristics that influence the health status of their citizens. Identification and modification of these characteristics may help to promote healthier cities. OBJECTIVE We estimated premature mortality impacts of breaching international exposure guidelines for physical activity (PA), air pollution, noise and access to green space for Bradford (UK) adult residents (n = 393,091). METHODS We applied the Urban and TranspOrt Planning Health Impact Assessment (UTOPHIA) methodology and estimated mortality, life expectancy (LE) and economic impacts of non-compliance with recommended exposure levels. We also investigated the distribution of the mortality burden among the population, focusing on socioeconomic position (SEP) as defined by deprivation status and ethnicity. RESULTS We estimated that annually almost 10% of premature mortality (i.e. 375 deaths, 95% CI: 276-474) in Bradford is attributable to non-compliance with recommended exposure levels. Non-compliance was also estimated to result in over 300 days of LE lost (95% CI: 238-432), which translated in economic losses of over £50,000 per person (95% CI: 38,518-69,991). 90% of the premature mortality impact resulted from insufficient PA performance. Air and noise pollution and the lack of green space had smaller impacts (i.e. 48 deaths). Residents of lower SEP neighborhoods had the highest risks for adverse exposure and premature death. A larger number of deaths (i.e. 253 and 145, respectively) could be prevented by reducing air and noise pollution levels well below the guidelines. DISCUSSION Current urban and transport planning related exposures result in a considerable health burden that is unequally distributed among the Bradford population. Improvements in urban and transport planning practices including the reduction of motor traffic and the promotion of active transport together with greening of the district, particularly in areas of lower SEP, are promising strategies to increase PA performance and reduce harmful environmental exposures.
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Affiliation(s)
- Natalie Mueller
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - David Rojas-Rueda
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Haneen Khreis
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Center for Advancing Research in Transportation Emissions, Energy, and Health (CARTEEH), Texas A&M Transportation Institute (TTI), College Station, TX, USA
| | - Marta Cirach
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carles Milà
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ana Espinosa
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Maria Foraster
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Blanquerna School of Health Sciences, Universitat Ramon Llul, Barcelona, Spain
| | | | - Brian Kelly
- Bradford Institute for Health Research, Bradford, United Kingdom
| | - John Wright
- Bradford Institute for Health Research, Bradford, United Kingdom
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Mediano MFF, Leifer ES, Cooper LS, Keteyian SJ, Kraus WE, Mentz RJ, Fleg JL. Influence of Baseline Physical Activity Level on Exercise Training Response and Clinical Outcomes in Heart Failure: The HF-ACTION Trial. JACC. HEART FAILURE 2018; 6:1011-1019. [PMID: 30497641 PMCID: PMC6317714 DOI: 10.1016/j.jchf.2018.09.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 09/11/2018] [Accepted: 09/20/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study sought to evaluate the influence of baseline physical activity (PA) on responses to aerobic exercise training and clinical events in outpatients with chronic systolic heart failure (HF) from the multicenter HF-ACTION (Exercise Training Program to Improve Clinical Outcomes in Individuals With Congestive Heart Failure) trial. BACKGROUND The influence of baseline PA on exercise capacity, responses to exercise training and clinical outcomes in patients with chronic HF is unclear. METHODS Of 2,130 participants who provided consent for this analysis, 1,494 patients (64%) had complete baseline PA data, using a modified version of the International Physical Activity Questionnaire-Short Form questionnaire and were included in the analysis; 742 received usual care and 752 were allocated to the exercise training group. Changes in exercise capacity, all-cause mortality and hospitalization, cardiovascular (CV) mortality and hospitalization, and CV mortality and HF hospitalization were evaluated as a function of baseline PA tertile. RESULTS At baseline, the highest PA tertile showed greater peak oxygen uptake, cardiopulmonary exercise test duration, and 6-min walk test distance than the other 2 PA tertiles, as well as lower New York Heart Association functional class, lower Beck depression score, and lower atrial fibrillation prevalence than the lowest PA tertile. Compared to the lowest PA tertile, the middle tertile had 18% lower risk of CV death/CV hospitalizations, and the upper tertile showed 23% lower risk of CV death/HF hospitalizations. Exercise capacity and clinical outcome responses to training were similar and largely nonsignificant across baseline PA tertiles with significant benefit of training on exercise test duration for all tertiles. CONCLUSIONS In patients with chronic systolic HF, aerobic exercise training significantly improves exercise test duration to a similar extent across baseline PA tertiles. Although higher baseline PA was associated with lower risk of clinical events, no significant differences in event rates within each PA tertile were seen between subgroups randomized to exercise training versus usual care. (Exercise Training Program to Improve Clinical Outcomes in Individuals With Congestive Heart Failure [HF-ACTION]; NCT00047437).
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Affiliation(s)
- Mauro F F Mediano
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Manguinhos, Rio de Janeiro, Brazil
| | - Eric S Leifer
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Lawton S Cooper
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | | | | | | | - Jerome L Fleg
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
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Panter J, Mytton O, Sharp S, Brage S, Cummins S, Laverty AA, Wijndaele K, Ogilvie D. Using alternatives to the car and risk of all-cause, cardiovascular and cancer mortality. Heart 2018; 104:1749-1755. [PMID: 29785956 PMCID: PMC6241630 DOI: 10.1136/heartjnl-2017-312699] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/14/2018] [Accepted: 02/25/2018] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To investigate the associations between using alternatives to the car which are more active for commuting and non-commuting purposes, and morbidity and mortality. METHODS We conducted a prospective study using data from 3 58 799 participants, aged 37-73 years, from UK Biobank. Commute and non-commute travel were assessed at baseline in 2006-2010. We classified participants according to whether they relied exclusively on the car or used alternative modes of transport that were more active at least some of the time. The main outcome measures were incident cardiovascular disease (CVD) and cancer, and CVD, cancer and all-cause mortality. We excluded events in the first 2 years and conducted analyses separately for those who regularly commuted and those who did not. RESULTS In maximally adjusted models, regular commuters with more active patterns of travel on the commute had a lower risk of incident (HR 0.89, 95% CI 0.79 to 1.00) and fatal (HR 0.70, 95% CI 0.51 to 0.95) CVD. Those regular commuters who also had more active patterns of non-commute travel had an even lower risk of fatal CVD (HR 0.57, 95% CI 0.39 to 0.85). Among those who were not regular commuters, more active patterns of travel were associated with a lower risk of all-cause mortality (HR 0.92, 95% CI 0.86 to 0.99). CONCLUSIONS More active patterns of travel were associated with a reduced risk of incident and fatal CVD and all-cause mortality in adults. This is an important message for clinicians advising people about how to be physically active and reduce their risk of disease.
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Affiliation(s)
- Jenna Panter
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | - Oliver Mytton
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | - Stephen Sharp
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Søren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Steven Cummins
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | | | - David Ogilvie
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
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Jung D, An KO, Kim J. Association between Meeting the Physical Activity Guidelines and Participation in ‘Sports for All’ and the Risk of Hypertension in Community-dwelling Korean Adults. THE ASIAN JOURNAL OF KINESIOLOGY 2018. [DOI: 10.15758/ajk.2018.20.4.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Abstract
PURPOSE OF REVIEW The purpose of this review paper is to provide an overview of the recent research using physical activity monitors in rheumatic populations including those with osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, and fibromyalgia. RECENT FINDINGS Recent research demonstrates increased use of physical activity monitors in these populations, especially in those with osteoarthritis. Results from cross-sectional, longitudinal, and intervention studies highlight that physical activity levels are below recommended guidelines, yet evidence suggests benefits such as improving pain, fatigue, function, and overall well-being. While the use of physical activity monitors in rheumatic populations is increasing, more research is needed to better understand physical activity levels in these populations, the effects of activity on relevant clinical outcomes, and how monitors can be used to help more individuals reach physical activity guidelines.
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113
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Wilke J, Kaiser S, Niederer D, Kalo K, Engeroff T, Morath C, Vogt L, Banzer W. Effects of high-intensity functional circuit training on motor function and sport motivation in healthy, inactive adults. Scand J Med Sci Sports 2018; 29:144-153. [PMID: 30276916 DOI: 10.1111/sms.13313] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/29/2018] [Accepted: 09/25/2018] [Indexed: 01/30/2023]
Abstract
PURPOSE A small share of the world's population meets current physical activity guidelines, which recommend regular engagement in endurance, strength, and neuromotor exercise. As lack of time represents a major cause of inactivity, multidimensional training methods with short durations may provide a promising alternative to classical, volume-oriented approaches focusing on one biomotor ability. This trial examined the effects of a high-intensity functional circuit training (HIFCT) on motor performance and exercise motivation in untrained adults. METHODS Thirty-three inactive participants were randomly allocated to two groups exercising for six weeks. The intervention group (HIFCT, n = 20) 3×/week performed functional whole-body exercises in a circuit. Each 15-minute workout included repetitive 20s all-out bouts with 10s breaks. In the comparison group (moderate aerobic exercise, MAE, n = 13), the participants walked 3×/week for 50 minutes at moderate intensity. Measured motor outcomes were cycling endurance capacity (respiratory threshold, maximum workload), maximum strength (leg and chest press), postural control (force plate), and jump capacity (counter-movement jump, single leg hop for distance); exercise motivation was assessed using the self-concordance index. RESULTS In comparison with MAE, HIFCT enhanced maximum leg strength (between-group difference of relative pre- to post-changes of 5.0%), shoulder strength (7.6%), and endurance workload (5.0%; P < 0.05), while increasing motivation to exercise (+5.5 points, P < 0.05). No between-group differences occurred for postural control and jump capacity (P > 0.05). CONCLUSION Despite considerably shorter training duration, HIFCT enhances motor function and motivation to exercise more effectively than MAE. Further research should investigate the long-term adherence to the program and its effectiveness in other settings.
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Affiliation(s)
- Jan Wilke
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Stefanie Kaiser
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Daniel Niederer
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Kristin Kalo
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Tobias Engeroff
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Christian Morath
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Lutz Vogt
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Winfried Banzer
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
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Alosaimi FD, Abalhasan MF, Alhabbad AA, Fallata EO, Haddad BA, AlQattan NI, Alassiry MZ. Prevalence and determinants of physical activity in a mixed sample of psychiatric patients in Saudi Arabia. Saudi Med J 2018; 39:401-411. [PMID: 29619493 PMCID: PMC5938655 DOI: 10.15537/smj.2018.4.21796] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To estimate prevalence of physical activity and its associations with various psychiatric disorders and the use of psychotropic medications. METHODS A cross-sectional observational study was carried out between July 2012 and June 2014. Patients were enrolled from a number of hospitals located in 5 regions of the Kingdom of Saudi Arabia. RESULTS A total of 1185 patients were included in current analysis: 796 were outpatients, and 389 were inpatients. Out of 1,185 patients, 153 (12.9%) were physically active. Much higher rates of physical activity were reported among males than females (15.9% versus 9.6%, p less than 0.001). According to the univariate analysis, higher rates of physical activity were positively correlated with primary bipolar disorders, the use of antianxiety medications and, to a lesser extent, use of antipsychotic medications, but they were negatively correlated with primary anxiety disorders, use of antidepressant medications, and use of multiple psychotropic medications. The associations between physical activity and primary bipolar disorders (odds ratio [OR]=2.47, p=0.002), use of antianxiety medications (OR=3.58, p=0.003), and use of multiple psychotropic medications (OR=0.33, p less than 0.001) remained significant after adjusting for demographic and clinical characteristics. CONCLUSION We report a variable but generally low prevalence of physical activity among a large, mixed sample of psychiatric patients in Saudi Arabia. These findings may highlight the importance of assessing physical activity status of psychiatric patients and the critical need for physical activity promotion programs among this group of disadvantaged patients.
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Affiliation(s)
- Fahad D Alosaimi
- Department of Psychiatry, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Harrison AS, Doherty P. Does the mode of delivery in routine cardiac rehabilitation have an association with cardiovascular risk factor outcomes? Eur J Prev Cardiol 2018; 25:1925-1933. [DOI: 10.1177/2047487318798923] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Aims Cardiac rehabilitation is one of the most cost-effective interventions for patients with cardiovascular disease. Worldwide supervised group-based cardiac rehabilitation is the dominant mode of delivery followed by facilitated self-managed (FSM), which is emerging as part of a cardiac rehabilitation menu. Modern research evidence, using trials and well-resourced interventions, suggests FSM is comparable to supervised rehabilitation in its outcomes for patients; however, this is yet to be established using routine clinical practice data. Methods Including 81,626 patients from routine clinical data in the National Audit of Cardiac Rehabilitation, this observational study investigated whether mode of delivery, supervised or FSM, was associated with similar cardiac rehabilitation outcomes. Hierarchical regression models included patient and service covariates such as age, gender, cardiac rehabilitation duration and programme staff type. Results The results showed 85% of the population received supervised cardiac rehabilitation. The FSM group were significantly older, female and predominantly in lower socioeconomic groups. The results showed that all patients on average benefit from cardiac rehabilitation, independently of mode of delivery, across all risk factors. Additional benefit of 13% and 11.4% increased likelihood of achieving the target state for physical activity and body mass index respectively when using FSM approaches. Conclusion This is the first study to investigate traditional cardiovascular risk factors with cardiac rehabilitation mode of delivery using routine clinical data. Both modes of delivery were associated with comparable statistically significant positive outcomes. Despite having equivalent outcomes, FSM cardiac rehabilitation continues to be underutilised, with less than 20% of patients receiving this mode of delivery in the UK.
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Clarke AL, Zaccardi F, Gould DW, Hull KL, Smith AC, Burton JO, Yates T. Association of self-reported physical function with survival in patients with chronic kidney disease. Clin Kidney J 2018; 12:122-128. [PMID: 30746139 PMCID: PMC6366129 DOI: 10.1093/ckj/sfy080] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Indexed: 12/27/2022] Open
Abstract
Background Reduced physical function is associated with an increased risk of mortality among patients with chronic kidney disease (CKD) not requiring renal replacement therapy (RRT). Assessments of physical performance can help to identify those at risk for adverse events. However, objective measures are not always feasible and self-reported measures may provide a suitable surrogate. Methods We performed a cohort study examining associations between self-reported physical function and walking behaviour with survival in patients with CKD not requiring RRT. Data were analysed from the QCKD study (Physical activity opinions in kidney disease) (ISRCTN 87066351), a prospective observational mixed methods study of physical activity in patients with CKD. A total of 450 patients with CKD not requiring RRT, ages 17–93 years, were followed up for a median of 43 months. Upon enrolment, participants completed two questionnaires: Duke Activity Status Index (DASI) (physical function) and General Practice Physical Activity Questionnaire (GPPAQ) (habitual activity). Mortality data were collected from electronic records in September 2016; RRT was considered a competing event. Results A total of 74 deaths occurred during follow-up and 101 participants were started on RRT. The adjusted subdistribution hazard ratio (SHR) of mortality in participants scoring >19.2 on the DASI was 0.51 [95% confidence interval (CI) 0.30–0.88] while a one-unit increase in the DASI was associated with an SHR of 0.97 (95% CI 0.95–0.99). The adjusted SHRs of mortality were 0.48 (95% CI 0.26–0.90), 0.25 (0.11–0.57) and 0.48 (0.23–0.80) for participants walking <1, 1–3 and ≥3 h/week, respectively, compared with no walking. A walking pace >3 mph was associated with a reduced risk of mortality [SHR 0.37 (95% CI 0.20–0.71)] compared with a walking pace <3 mph. Conclusions Physical function and walking behaviours were independently associated with survival in CKD and may help to identify patients at risk for adverse events.
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Affiliation(s)
- Amy L Clarke
- Department of Infection Immunity and Inflammation, College of Life Sciences, University of Leicester, Leicester, UK
- Correspondence and offprint requests to: Amy L. Clarke; E-mail: ; Twitter handle: @aimes89
| | - Francesco Zaccardi
- Diabetes Research Centre, College of Life Sciences and Psychology, University of Leicester, Leicester, UK
| | - Douglas W Gould
- Department of Infection Immunity and Inflammation, College of Life Sciences, University of Leicester, Leicester, UK
| | - Katherine L Hull
- Department of Infection Immunity and Inflammation, College of Life Sciences, University of Leicester, Leicester, UK
- John Walls Renal Unit, University Hospitals Leicester NHS Trust, Leicester, UK
| | - Alice C Smith
- Department of Infection Immunity and Inflammation, College of Life Sciences, University of Leicester, Leicester, UK
- John Walls Renal Unit, University Hospitals Leicester NHS Trust, Leicester, UK
| | - James O Burton
- Department of Infection Immunity and Inflammation, College of Life Sciences, University of Leicester, Leicester, UK
- John Walls Renal Unit, University Hospitals Leicester NHS Trust, Leicester, UK
- Department of Cardiovascular Sciences, University of Leicester, UK
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, College of Life Sciences and Psychology, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
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Bayán-Bravo A, Pérez-Tasigchana RF, López-García E, Martínez-Gómez D, Rodríguez-Artalejo F, Guallar-Castillón P. The association of major patterns of physical activity, sedentary behavior and sleeping with mortality in older adults. J Sports Sci 2018; 37:424-433. [PMID: 30067477 DOI: 10.1080/02640414.2018.1504617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objective: To identify major patterns of physical activity (PA), sedentary behavior (SB) and sleeping (all self-reported), and their association with long-term mortality. Methods: Cohort of 2,851 individuals aged ≥ 60 from Spain. Mortality was ascertain from 2003 up to July 2013. Patterns of PA, SB and sleeping were identified by factor analysis. Results: During follow-up, 1,145 deaths occurred. The first pattern, named "sedentary and non-active pattern", was characterized by long sleeping or lying time, and not doing even light PA (household chores or walking). The second pattern was named "active and non-sedentary pattern", and was characterized long time devoted to vigorous activities, long walking time, and short seating time. Compared to those in the first quartile of the "sedentary and non-active pattern", those in the highest quartile showed a 71% higher mortality (HR: 1.71; 95%CI: 1.42-2.07; p-trend:<0.001); it corresponds to being 6-year older. By contrast, being in the highest versus the lowest quartile of the "active and non-sedentary pattern" was associated with a 32% lower mortality (HR: 0.68: 0.57-0.82; p-trend:<0.001); it corresponds to being 4-year younger. Conclusion: The "sedentary and non-active" pattern had a large impact on mortality. The "active and non-sedentary" pattern showed an opposite and slightly lower association.
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Affiliation(s)
- Ana Bayán-Bravo
- a Department of Preventive Medicine and Public Health, School of Medicine , Universidad Autónoma de Madrid/IdiPaz, CIBER of Epidemiology and Public Health (CIBERESP) , Madrid , Spain.,b Nefrology Department , Hospital "12 de Octubre" , Madrid , Spain
| | - Raúl F Pérez-Tasigchana
- a Department of Preventive Medicine and Public Health, School of Medicine , Universidad Autónoma de Madrid/IdiPaz, CIBER of Epidemiology and Public Health (CIBERESP) , Madrid , Spain.,c School of Medicine , Universidad San Francisco de Quito , Quito , Ecuador
| | - Esther López-García
- a Department of Preventive Medicine and Public Health, School of Medicine , Universidad Autónoma de Madrid/IdiPaz, CIBER of Epidemiology and Public Health (CIBERESP) , Madrid , Spain.,d IMDEA-Food Institute , CEI UAM+CSIC , Madrid , Spain
| | - David Martínez-Gómez
- d IMDEA-Food Institute , CEI UAM+CSIC , Madrid , Spain.,e Department of Physical Education, Sports and Human Movement , Universidad Autónoma de Madrid , Madrid , Spain
| | - Fernando Rodríguez-Artalejo
- a Department of Preventive Medicine and Public Health, School of Medicine , Universidad Autónoma de Madrid/IdiPaz, CIBER of Epidemiology and Public Health (CIBERESP) , Madrid , Spain.,d IMDEA-Food Institute , CEI UAM+CSIC , Madrid , Spain
| | - Pilar Guallar-Castillón
- a Department of Preventive Medicine and Public Health, School of Medicine , Universidad Autónoma de Madrid/IdiPaz, CIBER of Epidemiology and Public Health (CIBERESP) , Madrid , Spain.,d IMDEA-Food Institute , CEI UAM+CSIC , Madrid , Spain.,f Welch Center for Prevention, Epidemiology, and Clinical Research , Johns Hopkins University , Baltimore , MD , USA
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Lynch EA, Jones TM, Simpson DB, Fini NA, Kuys SS, Borschmann K, Kramer S, Johnson L, Callisaya ML, Mahendran N, Janssen H, English C. Activity monitors for increasing physical activity in adult stroke survivors. Cochrane Database Syst Rev 2018; 7:CD012543. [PMID: 30051462 PMCID: PMC6513611 DOI: 10.1002/14651858.cd012543.pub2] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Stroke is the third leading cause of disability worldwide. Physical activity is important for secondary stroke prevention and for promoting functional recovery. However, people with stroke are more inactive than healthy age-matched controls. Therefore, interventions to increase activity after stroke are vital to reduce stroke-related disability. OBJECTIVES To summarise the available evidence regarding the effectiveness of commercially available, wearable activity monitors and smartphone applications for increasing physical activity levels in people with stroke. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, Embase, CINAHL, SPORTDiscus, and the following clinical trial registers: WHO International Clinical Trials Registry Platform, Clinical Trials, EU Clinical Trial Register, ISRCTN Registry, Australian and New Zealand Clinical Trial Registry, and Stroke Trials Registry to 3 March 2018. We also searched reference lists, Web of Science forward tracking, and Google Scholar, and contacted trial authors to obtain further data if required. We did not restrict the search on language or publication status. SELECTION CRITERIA We included all randomised controlled trials (RCTs) and randomised cross-over trials that included use of activity monitors versus no intervention, another type of intervention, or other activity monitor. Participants were aged 18 years or older with a diagnosis of stroke, in hospital or living in the community. Primary outcome measures were steps per day and time in moderate-to-vigorous intensity activity. Secondary outcomes were sedentary time, time spent in light intensity physical activity, walking duration, fatigue, mood, quality of life, community participation and adverse events. We excluded upper limb monitors that only measured upper limb activity. DATA COLLECTION AND ANALYSIS We followed standard Cochrane methodology to analyse and interpret the data. At least two authors independently screened titles and abstracts for inclusion. We resolved disagreements by consulting a third review author. We extracted the following data from included studies into a standardised template: type of study, participant population, study setting, intervention and co-interventions, time-frame, and outcomes. We graded levels of bias as high, low, or unclear, and assessed the quality of evidence for each outcome using the GRADE approach. MAIN RESULTS We retrieved 28,098 references, from which we identified 29 potential articles. Four RCTs (in 11 reports) met the inclusion criteria.The sample sizes ranged from 27 to 135 (total 245 participants). Time poststroke varied from less than one week (n = 1), to one to three months (n = 2), or a median of 51 months (n = 1). Stroke severity ranged from a median of one to six on the National Institutes of Health Stroke Scale (NIHSS). Three studies were conducted in inpatient rehabilitation, and one was in a university laboratory. All studies compared use of activity monitor plus another intervention (e.g. a walking retraining programme or an inpatient rehabilitation programme) versus the other intervention alone. Three studies reported on the primary outcome of daily step counts.There was no clear effect for the use of activity monitors in conjunction with other interventions on step count in a community setting (mean difference (MD) -1930 steps, 95% confidence interval (CI) -4410 to 550; 1 RCT, 27 participants; very low-quality evidence), or in an inpatient rehabilitation setting (MD 1400 steps, 95% CI -40 to 2840; 2 RCTs, 83 participants; very low-quality evidence). No studies reported the primary outcome moderate-to-vigorous physical activity, but one did report time spent in moderate and vigorous intensity activity separately: this study reported that an activity monitor in addition to usual inpatient rehabilitation increased the time spent on moderate intensity physical activity by 4.4 minutes per day (95% CI 0.28 to 8.52; 1 RCT, 48 participants; low-quality evidence) compared with usual rehabilitation alone, but there was no clear effect for the use of an activity monitor plus usual rehabilitation for increasing time spent in vigorous intensity physical activity compared to usual rehabilitation (MD 2.6 minutes per day, 95% CI -0.8 to 6; 1 RCT, 48 participants; low-quality evidence). The overall risk of bias was low, apart from high-risk for blinding of participants and study personnel. None of the included studies reported any information relating to adverse effects. AUTHORS' CONCLUSIONS Only four small RCTs with 274 participants (three in inpatient rehabilitation and one in the community) have examined the efficacy of activity monitors for increasing physical activity after stroke. Although these studies showed activity monitors could be incorporated into practice, there is currently not enough evidence to support the use of activity monitors to increase physical activity after stroke.
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Affiliation(s)
- Elizabeth A Lynch
- The University of AdelaideAdelaide Nursing SchoolAdelaideSouth AustraliaAustralia
- University of MelbourneThe Florey Institute of Neuroscience and Mental HealthHeidelbergVICAustralia
- NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Florey Institute of Neuroscience and Mental Health & Hunter Medical Research InstituteMelbourne and NewcastleAustralia
| | - Taryn M Jones
- Macquarie UniversityFaculty of Medicine and Health SciencesSydneyAustralia2109
| | - Dawn B Simpson
- University of TasmaniaMenzies Institute for Medical ResearchHobartAustralia
| | - Natalie A Fini
- The University of MelbournePhysiotherapy DepartmentLevel 7, Alan Gilbert BuildingMelbourneVICAustralia3010
- La Trobe UniversitySchool of Allied HealthMelbourneAustralia
| | - Suzanne S Kuys
- Australian Catholic UniversitySchool of PhysiotherapyBrisbaneQLDAustralia4114
| | - Karen Borschmann
- University of MelbourneThe Florey Institute of Neuroscience and Mental HealthHeidelbergVICAustralia
- NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Florey Institute of Neuroscience and Mental Health & Hunter Medical Research InstituteMelbourne and NewcastleAustralia
| | - Sharon Kramer
- University of MelbourneThe Florey Institute of Neuroscience and Mental HealthHeidelbergVICAustralia
| | - Liam Johnson
- University of MelbourneThe Florey Institute of Neuroscience and Mental HealthHeidelbergVICAustralia
- NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Florey Institute of Neuroscience and Mental Health & Hunter Medical Research InstituteMelbourne and NewcastleAustralia
| | | | - Niruthikha Mahendran
- University of CanberraDiscipline of Physiotherapy, Faculty of HealthCanberraAustralia2617
| | - Heidi Janssen
- NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Florey Institute of Neuroscience and Mental Health & Hunter Medical Research InstituteMelbourne and NewcastleAustralia
- University of NewcastlePriority Research Centre for Stroke and Brain InjuryNewcastleAustralia
- Hunter New England HealthCommunity Aged Care and Hunter Stroke ServiceNew Lambton HeightsNSWAustralia2305
| | - Coralie English
- NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Florey Institute of Neuroscience and Mental Health & Hunter Medical Research InstituteMelbourne and NewcastleAustralia
- University of NewcastlePriority Research Centre for Stroke and Brain InjuryNewcastleAustralia
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Iwińska K, Blicharska M, Pierotti L, Tainio M, de Nazelle A. Cycling in Warsaw, Poland - Perceived enablers and barriers according to cyclists and non-cyclists. TRANSPORTATION RESEARCH. PART A, POLICY AND PRACTICE 2018; 113:291-301. [PMID: 30008521 PMCID: PMC6039858 DOI: 10.1016/j.tra.2018.04.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 01/31/2018] [Accepted: 04/18/2018] [Indexed: 06/08/2023]
Abstract
Cycling in urban environments provides many benefits to people. However, planning of cycling infrastructures in large cities faces numerous challenges and requires better understanding of both the factors enabling cycling as well as barriers to it, determined by particular local context. While there is a growing body of research that tackle the bike transport related questions in Western Europe and the USA, there is relatively little research on that in Central Eastern Europe (CEE), in post-communist countries. In this study we used qualitative and quantitative methods to explore urban cyclists and non-cyclists opinions about the cycling, the perceived problems and obstacles, and perception of the on-going changes in bicycle transportation system in Warsaw, Poland. Although many people see potential advantages of cycling, it is mostly perceived as a leisure time activity. Those who do utilitarian cycling are more acutely aware of the benefits, such as rapidity and flexibility of this mean of transport. The main perceived barriers are linked to lack of good cycling infrastructure in the city, the feeling of insecurity linked to the behaviour of drivers, and to maintenance during winter. In conclusion, our research highlights both the opportunities and challenges linked to the development of improved cycle transportation system, suggesting the need for a range of policies, from the infrastructure improvements and comprehensive planning of the whole transportation system, to improving the driving culture that would support feeling of security of the cyclists.
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Affiliation(s)
| | - Malgorzata Blicharska
- Natural Resources and Sustainable Development, Department of Earth Sciences, Uppsala University, Villavägen 16, 75 236 Uppsala, Sweden
| | - Livia Pierotti
- Centre for Environmental Policy, Imperial College London, 13 G7 Princes Gardens, London SW7 1NA, UK
| | - Marko Tainio
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Systems Research Institute, Polish Academy of Sciences, ul. Newelska 6, 01-447 Warsaw, Poland
| | - Audrey de Nazelle
- Centre for Environmental Policy, Imperial College London, 13 G7 Princes Gardens, London SW7 1NA, UK
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Stamatakis E, Kelly P, Strain T, Murtagh EM, Ding D, Murphy MH. Self-rated walking pace and all-cause, cardiovascular disease and cancer mortality: individual participant pooled analysis of 50 225 walkers from 11 population British cohorts. Br J Sports Med 2018; 52:761-768. [PMID: 29858463 DOI: 10.1136/bjsports-2017-098677] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 01/24/2018] [Accepted: 02/08/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND/OBJECTIVES Walking pace is associated with risk of premature mortality. However, whether this relationship is independent of total volume of physical activity and highest physical activity intensity remains unclear. We examined the associations between walking pace and cause-specific mortality, investigating the potential modifying effect of factors such as total physical activity volume, highest physical activity intensity, age, sex and body mass index (BMI). METHODS Prospective pooled analysis of 11 population-based baseline surveys in England and Scotland between 1994 and2008 that were linked with mortality records. Multivariate-adjusted Cox proportional hazards models examined associations between walking pace (slow, average, brisk/fast) and all-cause, cancer and cardiovascular disease (CVD) mortality. RESULTS 50 225 walkers were entered in the core analyses. Among participants who did not experience an event in the first 2 years of follow-up (n=49 731), walking at an average or brisk/fast pace was associated with a reduced risk of all-cause (20% (95% CI 12% to 28%) and 24% (95% CI 13% to 33%), respectively) and CVD mortality (24% (95% CI 9% to 36%) and 21% (95% CI 1% to 38%), respectively), compared with reporting walking at a slow pace. In stratified analyses, such associations were evident among those over 50 years, those not meeting the physical activity recommendations and those who did not undertake vigorous-intensity activity. There were no interactions by sex or BMI. No associations were seen between pace and cancer mortality. CONCLUSION Walking benefits health. Assuming causality, these analyses suggest that increasing walking pace could reduce risk for all-cause and CVD mortality. Walking pace could be emphasised in public health messages, especially in situations when increase in walking volume or frequency is less feasible.
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Affiliation(s)
- Emmanuel Stamatakis
- Epidemiology Unit, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.,Prevention Research Collaboration, Faculty of Medicine and Health, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Paul Kelly
- Physical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Tessa Strain
- Physical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, UK.,MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Elaine M Murtagh
- Mary Immaculate College, University of Limerick, Limerick, Ireland
| | - Ding Ding
- Epidemiology Unit, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.,Prevention Research Collaboration, Faculty of Medicine and Health, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Marie H Murphy
- Sport and Exercise Sciences Research Institute, University of Ulster, Coleraine, Northern Ireland
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Sirico F, Bianco A, D'Alicandro G, Castaldo C, Montagnani S, Spera R, Di Meglio F, Nurzynska D. Effects of Physical Exercise on Adiponectin, Leptin, and Inflammatory Markers in Childhood Obesity: Systematic Review and Meta-Analysis. Child Obes 2018; 14:207-217. [PMID: 29762052 PMCID: PMC5994661 DOI: 10.1089/chi.2017.0269] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND New findings on adipose tissue physiology and obesity-associated inflammation status suggest that modification of the adipokine level can be relevant for the long-term prevention of obesity-associated chronic disease. OBJECTIVES The scope of the present study was to investigate the effectiveness of physical exercise in reducing the systemic inflammation related to obesity in children. METHODS We conducted a systematic review with meta-analysis of controlled randomized trials, identified through electronic database search, which investigated the effect of physical exercise, without concomitant dietary intervention, on adiponectin, leptin, and/or other inflammatory markers in children up to age 18 years with a body mass index greater than the 95th percentile for age and sex. RESULTS Seven trials were included in the meta-analysis, with a total of 250 participants. Compared with the control group without any lifestyle modification, the physical exercise resulted in a reduction in leptin [standardized mean difference (SMD) -1.13; 95% confidence interval (95%CI): -1.89 to -0.37; I2 = 79.9%] and interleukin-6 (SMD -0.84; 95%CI: -1.45 to -0.23, I2 = 0.9%) and an increase in adiponectin plasma concentration (SMD 0.69; 95%CI: 0.02-1.35; I2 = 74.3%). CONCLUSIONS These results indicate that physical exercise improved the inflammatory state in children with obesity. It is unclear whether this effect can reduce the risk of cardiovascular and metabolic disease in adulthood. Clinical trials with a uniform intervention protocol and outcome measurements are required to put our knowledge on adipose tissue biology into a clinical perspective.
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Affiliation(s)
- Felice Sirico
- Department of Public Health, Human Anatomy, and Sports Medicine Section, University of Naples “Federico II,” Naples, Italy
| | - Antonio Bianco
- Department of Public Health, Human Anatomy, and Sports Medicine Section, University of Naples “Federico II,” Naples, Italy
| | - Giovanni D'Alicandro
- Department of Neuroscience and Rehabilitation, Centre for Sports Medicine and Disability, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Clotilde Castaldo
- Department of Public Health, Human Anatomy, and Sports Medicine Section, University of Naples “Federico II,” Naples, Italy
| | - Stefania Montagnani
- Department of Public Health, Human Anatomy, and Sports Medicine Section, University of Naples “Federico II,” Naples, Italy
| | - Rocco Spera
- Department of Public Health, Human Anatomy, and Sports Medicine Section, University of Naples “Federico II,” Naples, Italy
| | - Franca Di Meglio
- Department of Public Health, Human Anatomy, and Sports Medicine Section, University of Naples “Federico II,” Naples, Italy
| | - Daria Nurzynska
- Department of Public Health, Human Anatomy, and Sports Medicine Section, University of Naples “Federico II,” Naples, Italy
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Otero I, Nieuwenhuijsen MJ, Rojas-Rueda D. Health impacts of bike sharing systems in Europe. ENVIRONMENT INTERNATIONAL 2018; 115:387-394. [PMID: 29669687 DOI: 10.1016/j.envint.2018.04.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 04/02/2018] [Accepted: 04/07/2018] [Indexed: 05/19/2023]
Abstract
BACKGROUND Bike-sharing systems (BSS) have been implemented in several cities around the world as policies to mitigate climate change, reduce traffic congestion, and promote physical activity. This study aims to assess the health impacts (risks and benefits) of major BSS in Europe. METHODS We performed a health impact assessment study to quantify the health risks and benefits of car trips substitution by bikes trips (regular-bikes and/or electric-bikes) from European BSS with >2000 bikes. Four scenarios were created to estimate the annual expected number of deaths (increasing or reduced) due to physical activity, road traffic fatalities, and air pollution. A quantitative model was built using data from transport and health surveys and environmental and traffic safety records. The study population was BSS users between 18 and 64 years old. RESULTS Twelve BSS were included in the analysis. In all scenarios and cities, the health benefits of physical activity outweighed the health risk of traffic fatalities and air pollution. It was estimated that 5.17 (95%CI: 3.11-7.01) annual deaths are avoided in the twelve BSS, with the actual level of car trip substitution, corresponding to an annual saving of 18 million of Euros. If all BSS trips replaced car trips, 73.25 deaths could be avoided each year (225 million Euros saving) in the twelve cities. CONCLUSIONS The twelve major Bike-sharing systems in Europe provide health and economic benefits. The promotion of shifting car drivers to use BSS can significantly increase the health benefits. BSS in Europe can be used as a tool for health promotion and prevention.
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Affiliation(s)
- I Otero
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Unidad Docente de Medicina Preventiva y Salud Pública H. Mar- UPF- ASPB, Barcelona, Spain; Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - M J Nieuwenhuijsen
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - D Rojas-Rueda
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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de Rezende LFM, Rey-López JP, de Sá TH, Chartres N, Fabbri A, Powell L, Stamatakis E, Bero L. Reporting bias in the literature on the associations of health-related behaviors and statins with cardiovascular disease and all-cause mortality. PLoS Biol 2018; 16:e2005761. [PMID: 29912869 PMCID: PMC6023226 DOI: 10.1371/journal.pbio.2005761] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 06/28/2018] [Accepted: 06/07/2018] [Indexed: 12/16/2022] Open
Abstract
Reporting bias in the literature occurs when there is selective revealing or suppression of results, influenced by the direction of findings. We assessed the risk of reporting bias in the epidemiological literature on health-related behavior (tobacco, alcohol, diet, physical activity, and sedentary behavior) and cardiovascular disease mortality and all-cause mortality and provided a comparative assessment of reporting bias between health-related behavior and statin (in primary prevention) meta-analyses. We searched Medline, Embase, Cochrane Methodology Register Database, and Web of Science for systematic reviews synthesizing the associations of health-related behavior and statins with cardiovascular disease mortality and all-cause mortality published between 2010 and 2016. Risk of bias in systematic reviews was assessed using the ROBIS tool. Reporting bias in the literature was evaluated via small-study effect and excess significance tests. We included 49 systematic reviews in our study. The majority of these reviews exhibited a high overall risk of bias, with a higher extent in health-related behavior reviews, relative to statins. We reperformed 111 meta-analyses conducted across these reviews, of which 65% had statistically significant results (P < 0.05). Around 22% of health-related behavior meta-analyses showed small-study effect, as compared to none of statin meta-analyses. Physical activity and the smoking research areas had more than 40% of meta-analyses with small-study effect. We found evidence of excess significance in 26% of health-related behavior meta-analyses, as compared to none of statin meta-analyses. Half of the meta-analyses from physical activity, 26% from diet, 18% from sedentary behavior, 14% for smoking, and 12% from alcohol showed evidence of excess significance bias. These biases may be distorting the body of evidence available by providing inaccurate estimates of preventive effects on cardiovascular and all-cause mortality.
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Affiliation(s)
| | - Juan Pablo Rey-López
- Prevention Research Collaboration, School of Public Health, The University of Sydney, Sydney, Australia
| | - Thiago Hérick de Sá
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, São Paulo, São Paulo, Brasil
| | - Nicholas Chartres
- Charles Perkins Centre, Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
| | - Alice Fabbri
- Charles Perkins Centre, Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
| | - Lauren Powell
- Prevention Research Collaboration, School of Public Health, The University of Sydney, Sydney, Australia
| | - Emmanuel Stamatakis
- Prevention Research Collaboration, School of Public Health, The University of Sydney, Sydney, Australia
- Charles Perkins Centre, Epidemiology Unit, The University of Sydney, Sydney, Australia
| | - Lisa Bero
- Charles Perkins Centre, Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
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Liu Y, Shu XO, Wen W, Saito E, Rahman MS, Tsugane S, Tamakoshi A, Xiang YB, Yuan JM, Gao YT, Tsuji I, Kanemura S, Nagata C, Shin MH, Pan WH, Koh WP, Sawada N, Cai H, Li HL, Tomata Y, Sugawara Y, Wada K, Ahn YO, Yoo KY, Ashan H, Chia KS, Boffetta P, Inoue M, Kang D, Potter JD, Zheng W. Association of leisure-time physical activity with total and cause-specific mortality: a pooled analysis of nearly a half million adults in the Asia Cohort Consortium. Int J Epidemiol 2018; 47:771-779. [PMID: 29490039 PMCID: PMC6005114 DOI: 10.1093/ije/dyy024] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/22/2018] [Accepted: 01/30/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Most previous studies evaluating the association between leisure-time physical activity (LTPA) and risk of death were conducted among generally healthy individuals of European ancestry. We investigated the association of LTPA with all-cause and cause-specific mortality among East Asian populations, including healthy individuals and those with existing chronic diseases, which has been less well characterized. METHODS We performed pooled analyses among 467 729 East Asian individuals recruited in nine prospective cohorts included in the Asia Cohort Consortium. Cox proportional hazards regressions were used to derive hazard ratios (HRs) and 95% confidence intervals (CIs) associated with LTPA after adjusting for age, sex, education and marital and smoking status. RESULTS During a mean follow-up period of 13.6 years, 65 858 deaths were identified. Compared with those who reported no or less than 1 h of LTPA per week, an inverse association was observed between the amount of LTPA and all-cause and cause-specific mortality (P for trend < 0.001). The strength of the inverse association was stronger for death due to cardiovascular diseases and causes other than cancer deaths. An inverse association of LTPA with total mortality was observed among individuals with a severe and often life-threatening disease: cancer, stroke or coronary heart disease [hazard ratio (HR) = 0.81, 95% CI = 0.73-0.89 for high vs low LTPA) and those with other chronic diseases such as diabetes or hypertension (HR = 0.86, 95% CI = 0.80-0.93 for high vs low LTPA). No clear modifying effects by sex, body mass index or smoking status were identified. CONCLUSIONS Regular participation in LTPA is associated with reduced mortality in middle-aged and elder Asians regardless pre-existing health conditions.
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Affiliation(s)
- Ying Liu
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Nashville, TN, USA
| | - Xiao-Ou Shu
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Nashville, TN, USA
| | - Wanqing Wen
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Nashville, TN, USA
| | - Eiko Saito
- Division of Cancer Statistics Integration, National Cancer Center, Tokyo, Japan
| | - M Shafiur Rahman
- Department of Global Health Policy, University of Tokyo, Tokyo, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, National Cancer Center, Tokyo, Japan
| | - Akiko Tamakoshi
- Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yong-Bing Xiang
- Shanghai Cancer Institute, Shanghai Jiaotong University, Shanghai, PR China
| | - Jian-Min Yuan
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
- Division of Cancer Control and Population Science, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Yu-Tang Gao
- Shanghai Cancer Institute, Shanghai Jiaotong University, Shanghai, PR China
| | - Ichiro Tsuji
- Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan
| | - Seiki Kanemura
- Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan
| | - Chisato Nagata
- Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Myung-Hee Shin
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Wen-Harn Pan
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Woon-Puay Koh
- Duke-NUS Medical School Singapore
- Saw Swee Hock School of Public Health, Singapore, Republic of Singapore
| | - Norie Sawada
- Epidemiology and Prevention Group, National Cancer Center, Tokyo, Japan
| | - Hui Cai
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Nashville, TN, USA
| | - Hong-Lan Li
- Shanghai Cancer Institute, Shanghai Jiaotong University, Shanghai, PR China
| | - Yasutake Tomata
- Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan
| | - Yumi Sugawara
- Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan
| | - Keiko Wada
- Graduate School of Medicine, Gifu University, Gifu, Japan
| | | | - Keun-Young Yoo
- Armed Forces Capital Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Habibul Ashan
- Departments of Health Studies, Medicine and Human Genetics and Cancer Research Center, University of Chicago, Chicago, IL, USA
| | - Kee Seng Chia
- Saw Swee Hock School of Public Health, Singapore, Republic of Singapore
| | - Paolo Boffetta
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Manami Inoue
- Epidemiology and Prevention Group, National Cancer Center, Tokyo, Japan
| | - Daehee Kang
- Department of Preventive Medicine
- Department of Biomedical Sciences
- Cancer Research Institute, Seoul National University, Seoul, South Korea
| | - John D Potter
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Centre for Public Health Research, Massey University, Wellington, New Zealand
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Wei Zheng
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Nashville, TN, USA
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Using Devices to Assess Physical Activity and Sedentary Behavior in a Large Cohort Study, the Women's Health Study. ACTA ACUST UNITED AC 2018; 1:60-69. [PMID: 30666321 DOI: 10.1123/jmpb.2018-0005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In recent years, it has become feasible to use devices for assessing physical activity and sedentary behavior among large numbers of participants in epidemiologic studies, allowing for more precise assessments of these behaviors and quantification of their associations with health outcomes. Between 2011 and 2015, the Women's Health Study (WHS) used the Actigraph GT3X+ device to measure physical activity and sedentary behavior over 7 days, during waking hours, among 17,708 women (mean age, 72 years) living throughout the United States. Devices were sent to and returned by participants via mail. We describe here the methods used to collect and process the accelerometer data for epidemiologic data analyses. We also provide metrics that describe the quality of the accelerometer data collected, as well as expanded findings regarding previously published associations of physical activity or sedentary behavior with all-cause mortality during an average follow-up of 2.3 years (207 deaths). The WHS is one of the earliest "next generation" epidemiologic studies of physical activity, utilizing wearable devices, in which long-term follow-up of participants for various health outcomes is anticipated. It therefore serves as a useful case study in which to discuss unique challenges and issues faced.
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Abstract
PURPOSE OF REVIEW While many levels of government recognize that walking and cycling (active travel) are critical to healthy cities, a continued challenge is to identify and prioritize strategies that will increase walking and cycling for transportation. We review evidence on policies that can increase active travel. RECENT FINDINGS The reviews included here conclude that policies related to active travel may operate at various levels of the socio-ecological framework, including society, cities, routes or individuals. The provision of convenient, safe and connected walking and cycling infrastructure is at the core of promoting active travel, but policies may work best when implemented in comprehensive packages. There is strong evidence that active travel can result in substantial health benefits. However, there remains considerable uncertainty about the exact effects of specific policies on walking or cycling rates or safety. Further research is needed to quantify the impact of specific policies or packages of policies, especially across different settings or for different population segments.
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127
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Vetrovsky T, Cupka J, Dudek M, Kuthanova B, Vetrovska K, Capek V, Bunc V. A pedometer-based walking intervention with and without email counseling in general practice: a pilot randomized controlled trial. BMC Public Health 2018; 18:635. [PMID: 29769107 PMCID: PMC5956962 DOI: 10.1186/s12889-018-5520-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 04/26/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND General practitioners play a fundamental role in combatting the current epidemic of physical inactivity, and pedometer-based walking interventions are able to increase physical activity levels of their patients. Supplementing these interventions with email counseling driven by feedback from the pedometer has the potential to further improve their effectiveness but it has to be yet confirmed in clinical trials. Therefore, the aim of our pilot randomized controlled trial is to evaluate the feasibility and potential efficacy of future trials designed to assess the additional benefit of email counseling added to a pedometer-based intervention in a primary care setting. METHODS Physically inactive patients were opportunistically recruited from four general practices and randomized to a 12-week pedometer-based intervention with or without email counseling. To explore the feasibility of future trials, we assessed the speed and efficiency of recruitment, adherence to wearing the pedometer, and engagement with email counseling. To evaluate the potential efficacy, daily step-count was the primary outcome and blood pressure, waist and hip circumference, and body mass were the secondary outcomes. Additionally, we conducted a qualitative analysis of structured interviews with the participating general practitioners. RESULTS The opportunistic recruitment has been shown to be feasible and acceptable, but relatively slow and inefficient; moreover, general practitioners selectively recruited overweight and obese patients. Patients manifested high adherence, wearing the pedometer on 83% (± 20) of days. All patients from the counseling group actively participated in email communication and responded to 46% (± 22) of the emails they received. Both groups significantly increased their daily step-count (pedometer-plus-email, + 2119, p = 0.002; pedometer-alone, + 1336, p = 0.03), but the difference between groups was not significant (p = 0.18). When analyzing both groups combined, there was a significant decrease in body mass (- 0.68 kg, p = 0.04), waist circumference (- 1.73 cm, p = 0.03), and systolic blood pressure (- 3.48 mmHg, p = 0.045). CONCLUSIONS This study demonstrates that adding email counseling to a pedometer-based intervention in a primary care setting is feasible and might have the potential to increase the efficacy of such an intervention in increasing physical activity levels. TRIAL REGISTRATION The trial was retrospectively registered at ClinicalTrials.gov (ID: NCT03135561 , date: April 26, 2017).
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Affiliation(s)
- Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Jose Martiho 31, 162 52, Prague 6, Czech Republic.
| | - Jozef Cupka
- Mediciman s.r.o, Maxovska 1019/6, 155 00, Prague 5, Czech Republic
| | - Martin Dudek
- Laureus s.r.o, Palackeho 541, 252 29, Dobrichovice, Czech Republic
| | - Blanka Kuthanova
- Praktici Praha 6, s.r.o, Vitezne namesti 817/9, 160 00, Prague 6, Czech Republic
| | | | - Vaclav Capek
- Second Faculty of Medicine, Charles University, V Uvalu 84, 150 06, Prague 5, Czech Republic
| | - Vaclav Bunc
- Faculty of Physical Education and Sport, Charles University, Jose Martiho 31, 162 52, Prague 6, Czech Republic
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Wolkinger B, Haas W, Bachner G, Weisz U, Steininger K, Hutter HP, Delcour J, Griebler R, Mittelbach B, Maier P, Reifeltshammer R. Evaluating Health Co-Benefits of Climate Change Mitigation in Urban Mobility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050880. [PMID: 29710784 PMCID: PMC5981919 DOI: 10.3390/ijerph15050880] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/10/2018] [Accepted: 04/23/2018] [Indexed: 11/16/2022]
Abstract
There is growing recognition that implementation of low-carbon policies in urban passenger transport has near-term health co-benefits through increased physical activity and improved air quality. Nevertheless, co-benefits and related cost reductions are often not taken into account in decision processes, likely because they are not easy to capture. In an interdisciplinary multi-model approach we address this gap, investigating the co-benefits resulting from increased physical activity and improved air quality due to climate mitigation policies for three urban areas. Additionally we take a (macro-)economic perspective, since that is the ultimate interest of policy-makers. Methodologically, we link a transport modelling tool, a transport emission model, an emission dispersion model, a health model and a macroeconomic Computable General Equilibrium (CGE) model to analyze three climate change mitigation scenarios. We show that higher levels of physical exercise and reduced exposure to pollutants due to mitigation measures substantially decrease morbidity and mortality. Expenditures are mainly born by the public sector but are mostly offset by the emerging co-benefits. Our macroeconomic results indicate a strong positive welfare effect, yet with slightly negative GDP and employment effects. We conclude that considering economic co-benefits of climate change mitigation policies in urban mobility can be put forward as a forceful argument for policy makers to take action.
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Affiliation(s)
- Brigitte Wolkinger
- Wegener Center for Climate and Global Change, University of Graz, Brandhofgasse 5, A-8010 Graz, Austria.
| | - Willi Haas
- Institute of Social Ecology, Alpen-Adria University Klagenfurt, Schottenfeldgasse 29, A-1070 Vienna, Austria.
- Institute of Social Ecology, University of Natural Resources and Life Sciences, Vienna, Schottenfeldgasse 29, A-1070 Vienna, Austria.
| | - Gabriel Bachner
- Wegener Center for Climate and Global Change, University of Graz, Brandhofgasse 5, A-8010 Graz, Austria.
| | - Ulli Weisz
- Institute of Social Ecology, Alpen-Adria University Klagenfurt, Schottenfeldgasse 29, A-1070 Vienna, Austria.
- Institute of Social Ecology, University of Natural Resources and Life Sciences, Vienna, Schottenfeldgasse 29, A-1070 Vienna, Austria.
| | - Karl Steininger
- Wegener Center for Climate and Global Change, University of Graz, Brandhofgasse 5, A-8010 Graz, Austria.
- Department of Economics, University of Graz, Universitaetsstrasse 15, A-8010 Graz, Austria.
| | - Hans-Peter Hutter
- Department of Environmental Health, Center for Public Health, Medical University of Vienna, Spitalgasse 23, A-1090 Vienna, Austria.
| | - Jennifer Delcour
- Austrian Public Health Institute (Gesundheit Österreich GmbH), Stubenring 6, A-1010 Vienna, Austria.
| | - Robert Griebler
- Austrian Public Health Institute (Gesundheit Österreich GmbH), Stubenring 6, A-1010 Vienna, Austria.
| | - Bernhard Mittelbach
- Wegener Center for Climate and Global Change, University of Graz, Brandhofgasse 5, A-8010 Graz, Austria.
| | - Philipp Maier
- Institute of Social Ecology, Alpen-Adria University Klagenfurt, Schottenfeldgasse 29, A-1070 Vienna, Austria.
| | - Raphael Reifeltshammer
- Institute of Internal Combustion Engines and Thermodynamics, Graz University of Technology, Inffeldgasse 19, A-8010 Graz, Austria.
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Stepping volume and intensity patterns in a multi-ethnic urban Asian population. BMC Public Health 2018; 18:539. [PMID: 29685111 PMCID: PMC5914050 DOI: 10.1186/s12889-018-5457-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 04/12/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Accelerometer measured physical activity (PA) studies particularly in non-western populations are lacking. Therefore, this study investigated stepping activity in a multi-ethnic urban Asian population. METHODS Adult participants from the Singapore Health Study 2 consented to accelerometer activity monitoring for 7-consecutive days. Mean daily step count, peak stepping intensity (i.e. cadence) over 1-min, 30-min and 60-min and time spent in each cadence band: 0 (non-movement), 1-19, 20-39, 40-59, 60-79, 80-99 and ≥ 100 steps/minute (moderate to vigorous PA) were calculated. RESULTS A total of 713 participants (42% male, mean age 47.8 years) were included. Overall, the mean daily step count was 7549. Mean daily step count was significantly lower in Indians (7083 adjusted p = 0.02) but not Malays 7140 (adjusted p = 0.052) compared to Chinese (7745 steps). The proportion of Malays, Indians, and Chinese achieving < 5000 daily steps was 26%, 23% and 14%, respectively (p < 0.01). Regardless of ethnicity, approximately half of the recorded time was spent undertaking 0-steps/minute (7.9 h). CONCLUSIONS Greater promotion of brisk walking is required in light of the low step volume and pace observed in this multi-ethnic Asian population. Ethnic differences in stepping activity were also identified which indicates a need for targeted ethnic specific health promotion interventions.
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Laverty AA, Webb E, Vamos EP, Millett C. Associations of increases in public transport use with physical activity and adiposity in older adults. Int J Behav Nutr Phys Act 2018; 15:31. [PMID: 29609657 PMCID: PMC5879764 DOI: 10.1186/s12966-018-0660-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 03/12/2018] [Indexed: 12/28/2022] Open
Abstract
Background We investigated predictors of two increases in older people’s public transport use: initiating public transport use among non-users; and increasing public transport use amongst users. We also investigated associations of these changes with physical activity, Body Mass Index (BMI) and waist circumference. Methods Data come from the 2008 and 2012 English Longitudinal Study of Ageing (ELSA). Logistic regression assessed predictors of increases in public transport use among adults aged ≥50 years. Gender-stratified logistic and linear models assessed associations of increases in public transport use with changes in physical activity and adiposity. Results Those becoming eligible for a free older person’s bus pass were more likely to both initiate and increase public transport use (e.g. for initiating public transport use Adjusted Odds Ratio (AORs) 1.77, 95% Confidence Interval 1.35; 2.33). Retiring from paid work was also associated with both initiating and increasing public transport use e.g. AOR 1.57 (1.29; 1.91) for initiating use. Women who increased public transport use had mean BMI 2.03 kg/m2 lower (− 2.84, − 1.21) at follow up than those who did not, although this was attenuated after adjusting for BMI at baseline (− 0.40 kg/m2, − 0.82, 0.01). After adjustment for baseline physical activity those initiating public transport use were more likely to undertake at least some physical activity in 2012 (e.g. AOR for women 1.67, 1.03; 2.72). Conclusions Both initiating and increasing public transport use were associated with increased physical activity and may be associated with lower adiposity among women. These findings strengthen the case for considering public transport provision as an effective means of promoting healthier ageing.
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Affiliation(s)
- Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK.
| | - Elizabeth Webb
- ESRC International Centre for Lifecourse Studies in Society and Health, London, UK
| | - Eszter P Vamos
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
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131
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Mueller N, Rojas-Rueda D, Salmon M, Martinez D, Ambros A, Brand C, de Nazelle A, Dons E, Gaupp-Berghausen M, Gerike R, Götschi T, Iacorossi F, Int Panis L, Kahlmeier S, Raser E, Nieuwenhuijsen M. Health impact assessment of cycling network expansions in European cities. Prev Med 2018; 109:62-70. [PMID: 29330030 DOI: 10.1016/j.ypmed.2017.12.011] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 12/07/2017] [Accepted: 12/13/2017] [Indexed: 01/21/2023]
Abstract
We conducted a health impact assessment (HIA) of cycling network expansions in seven European cities. We modeled the association between cycling network length and cycling mode share and estimated health impacts of the expansion of cycling networks. First, we performed a non-linear least square regression to assess the relationship between cycling network length and cycling mode share for 167 European cities. Second, we conducted a quantitative HIA for the seven cities of different scenarios (S) assessing how an expansion of the cycling network [i.e. 10% (S1); 50% (S2); 100% (S3), and all-streets (S4)] would lead to an increase in cycling mode share and estimated mortality impacts thereof. We quantified mortality impacts for changes in physical activity, air pollution and traffic incidents. Third, we conducted a cost-benefit analysis. The cycling network length was associated with a cycling mode share of up to 24.7% in European cities. The all-streets scenario (S4) produced greatest benefits through increases in cycling for London with 1,210 premature deaths (95% CI: 447-1,972) avoidable annually, followed by Rome (433; 95% CI: 170-695), Barcelona (248; 95% CI: 86-410), Vienna (146; 95% CI: 40-252), Zurich (58; 95% CI: 16-100) and Antwerp (7; 95% CI: 3-11). The largest cost-benefit ratios were found for the 10% increase in cycling networks (S1). If all 167 European cities achieved a cycling mode share of 24.7% over 10,000 premature deaths could be avoided annually. In European cities, expansions of cycling networks were associated with increases in cycling and estimated to provide health and economic benefits.
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Affiliation(s)
- Natalie Mueller
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - David Rojas-Rueda
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Maëlle Salmon
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - David Martinez
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Albert Ambros
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Christian Brand
- University of Oxford (UOXF), Transport Studies Unit, Oxford, United Kingdom
| | - Audrey de Nazelle
- Centre for Environmental Policy, Imperial College London, London, United Kingdom
| | - Evi Dons
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Mailin Gaupp-Berghausen
- University of Natural Resources and Life Sciences Vienna, Institute for Transport Studies, Vienna, Austria
| | - Regine Gerike
- Dresden University of Technology, Chair of Integrated Transport Planning and Traffic Engineering, Dresden, Germany
| | - Thomas Götschi
- Physical Activity and Health Unit, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | | | - Luc Int Panis
- Flemish Institute for Technological Research (VITO), Mol, Belgium; Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
| | - Sonja Kahlmeier
- Physical Activity and Health Unit, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Elisabeth Raser
- University of Natural Resources and Life Sciences Vienna, Institute for Transport Studies, Vienna, Austria
| | - Mark Nieuwenhuijsen
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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132
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Williams DM, Lee HH, Connell L, Boyle H, Emerson J, Strohacker K, Galárraga O. Small sustainable monetary incentives versus charitable donations to promote exercise: Rationale, design, and baseline data from a randomized pilot study. Contemp Clin Trials 2018; 66:80-85. [PMID: 29374526 PMCID: PMC6022749 DOI: 10.1016/j.cct.2018.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 01/08/2018] [Accepted: 01/18/2018] [Indexed: 11/26/2022]
Abstract
Regular physical activity (PA) enhances weight-loss and reduces risk of chronic disease. However, as few as 10% of U.S. adults engage in regular PA. Incentive programs to promote PA have shown some promise, but have typically used incentives that are too large to sustain over time and have not demonstrated habit formation or been tested in community settings. This report presents the rationale and design of a randomized pilot study testing the feasibility and preliminary efficacy of small monetary incentives for PA (n=25) versus charitable donations in the same amount (n=25) versus control (n=25) over 12months among 75 low-active but otherwise healthy adults at a local YMCA. Incentives are based on YMCA attendance, which is verified by electronic swipe card data and is the primary study outcome, with self-reported minutes/week of PA assessed as a secondary outcome. Incentives are intentionally small enough-$1/session, maximum of $5/week-such that they could be indefinitely sustained by community organizations, privately-owned health clubs, healthcare organizations, or employers (e.g., employer fitness facilities). Costs of the incentive program for the sponsoring organization may be partially offset by increases in membership resulting from the appeal of the program. Moreover, if efficacious, the charitable donation incentive program may have the added benefit of building social capital for the sponsoring organization and potentially serving as a tax write-off, thus further offsetting the cost of the incentives. Findings will also have implications for the use of financially sustainable community-based incentive programs for other health-related behaviors (e.g., weight loss, smoking).
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Affiliation(s)
| | | | | | - Holly Boyle
- Brown University School of Public Health, USA
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133
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Safdar A, Tarnopolsky MA. Exosomes as Mediators of the Systemic Adaptations to Endurance Exercise. Cold Spring Harb Perspect Med 2018; 8:a029827. [PMID: 28490541 PMCID: PMC5830902 DOI: 10.1101/cshperspect.a029827] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Habitual endurance exercise training is associated with multisystemic metabolic adaptations that lower the risk of inactivity-associated disorders such as obesity and type 2 diabetes mellitus (T2DM). Identification of complex systemic signaling networks responsible for these benefits are of great interest because of their therapeutic potential in metabolic diseases; however, specific signals that modulate the multisystemic benefits of exercise in multiple tissues and organs are only recently being discovered. Accumulated evidence suggests that muscle and other tissues have an endocrine function and release peptides and nucleic acids into the circulation in response to acute endurance exercise to mediate the multisystemic adaptations. Factors released from skeletal muscle have been termed myokines and we propose that the total of all factors released in response to endurance exercise (including peptides, nucleic acids, and metabolites) be termed, "exerkines." We propose that many of the exerkines are released within extracellular vesicles called exosomes, which regulate peripheral organ cross talk. Exosomes (30-140 nm) and larger microvesicles [MVs] (100-1000 nm) are subcategories of extracellular vesicles that are released into the circulation. Exosomes contain peptides and several nucleic acids (microRNA [miRNA], messenger RNA [mRNA], mitochondrial DNA [mtDNA]) and are involved in intercellular/tissue exchange of their contents. An acute bout of endurance exercise increases circulating exosomes that are hypothesized to mediate organ cross talk to promote systemic adaptation to endurance exercise. Further support for the role of exosomes (and possibly MVs) in mediating the systemic benefits of exercise comes from the fact that the majority of the previously reported myokines/exerkines are found in extracellular vesicles databases (Vesiclepedia and ExoCarta). We propose that exosomes isolated from athletes following exercise or exosomes bioengineered to incorporate one or many of known exerkines will be therapeutically useful in the treatment of obesity, T2DM, and other aging-associated metabolic disorders.
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Affiliation(s)
- Adeel Safdar
- Department of Pediatrics, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
| | - Mark A Tarnopolsky
- Department of Pediatrics, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
- Department of Pediatrics & Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, Canada
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134
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Hardcastle SJ, Cohen PA. Reply to S.C. Adams et al, C. Lopez et al, and R.U. Newton et al. J Clin Oncol 2018; 36:928-930. [PMID: 29373095 DOI: 10.1200/jco.2017.76.8218] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Sarah J Hardcastle
- Sarah J. Hardcastle, Curtin University, Perth; and University of Western Australia, Crawley, Western Australia, Australia; and Paul A. Cohen, St John of God Hospital, Subiaco, Perth; University of Western Australia, Crawley; and University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Paul A Cohen
- Sarah J. Hardcastle, Curtin University, Perth; and University of Western Australia, Crawley, Western Australia, Australia; and Paul A. Cohen, St John of God Hospital, Subiaco, Perth; University of Western Australia, Crawley; and University of Notre Dame Australia, Fremantle, Western Australia, Australia
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135
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Heard CL, Rakow T, Spiegelhalter D. Comparing comprehension and perception for alternative speed-of-ageing and standard hazard ratio formats. APPLIED COGNITIVE PSYCHOLOGY 2018. [DOI: 10.1002/acp.3381] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - Tim Rakow
- Department of Psychology; King's College London; London UK
| | - David Spiegelhalter
- Statistical Laboratory, Centre for Mathematical Sciences; University of Cambridge; Cambridge UK
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136
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Patel AV, Hildebrand JS, Leach CR, Campbell PT, Doyle C, Shuval K, Wang Y, Gapstur SM. Walking in Relation to Mortality in a Large Prospective Cohort of Older U.S. Adults. Am J Prev Med 2018; 54:10-19. [PMID: 29056372 DOI: 10.1016/j.amepre.2017.08.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 08/12/2017] [Accepted: 08/14/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Engaging in >150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity weekly is recommended for optimal health. The relationship between walking, the most common activity especially for older adults, and total mortality is not well documented. METHODS Data from a large U.S. prospective cohort study including 62,178 men (mean age 70.7 years) and 77,077 women (mean age 68.9 years), among whom 24,688 men and 18,933 women died during 13 years of follow-up (1999-2012), were used to compute multivariable-adjusted hazard rate ratios and 95% CIs for walking as the sole form of activity or adjusted for other moderate- or vigorous-intensity physical activity in relation to total and cause-specific mortality (data analysis 2015-2016). RESULTS Inactivity compared with walking only at less than recommended levels was associated with higher all-cause mortality (hazard rate ratio=1.26, 95% CI=1.21, 1.31). Meeting one to two times the recommendations through walking only was associated with lower all-cause mortality (hazard rate ratio=0.80, 95% CI=0.78, 0.83). Associations with walking adjusted for other moderate- or vigorous-intensity physical activity were similar to walking only. Walking was most strongly associated with respiratory disease mortality followed by cardiovascular disease mortality and then cancer mortality. CONCLUSIONS In older adults, walking below minimum recommended levels is associated with lower all-cause mortality compared with inactivity. Walking at or above physical activity recommendations is associated with even greater decreased risk. Walking is simple, free, and does not require any training, and thus is an ideal activity for most Americans, especially as they age.
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Affiliation(s)
- Alpa V Patel
- Intramural Research Department, American Cancer Society, Atlanta, Georgia.
| | - Janet S Hildebrand
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Corinne R Leach
- Intramural Research Department, American Cancer Society, Atlanta, Georgia
| | - Peter T Campbell
- Intramural Research Department, American Cancer Society, Atlanta, Georgia
| | - Colleen Doyle
- Cancer Control Department, American Cancer Society, Atlanta, Georgia
| | - Kerem Shuval
- Intramural Research Department, American Cancer Society, Atlanta, Georgia
| | - Ying Wang
- Intramural Research Department, American Cancer Society, Atlanta, Georgia
| | - Susan M Gapstur
- Intramural Research Department, American Cancer Society, Atlanta, Georgia
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137
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Keats MR, Cui Y, DeClercq V, Dummer TJB, Forbes C, Grandy SA, Hicks J, Sweeney E, Yu ZM, Parker L. Multimorbidity in Atlantic Canada and association with low levels of physical activity. Prev Med 2017; 105:326-331. [PMID: 28987335 DOI: 10.1016/j.ypmed.2017.10.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/12/2017] [Accepted: 10/04/2017] [Indexed: 11/27/2022]
Abstract
Owing to an aging population and medical advances, the anticipated growth and prevalence of multimorbidity has been recognized as a significant challenge and priority in health care settings. Although physical activity has been shown to play a vital role in the primary and secondary prevention of chronic disease, much less is known about the relationship between physical activity and multimorbidity. The objective of the present study was to examine the relationship between physical activity levels and multimorbidity in male and female adults after adjusting for key demographic, geographical, and lifestyle factors. The study drew data from a prospective cohort in Atlantic Canada (2009-2015). The sample included 18,709 participants between the ages of 35-69. Eighteen chronic diseases were identified. Physical activity levels were estimated based on the long form of the International Physical Activity Questionnaire. Using logistic regression analysis, we found that multimorbid individuals were significantly more likely to be physically inactive (OR=1.26; 95% CI 1.10, 1.44) after adjusting for key sociodemographic and lifestyle characteristics. Additional stratified analyses suggest that the magnitude of the effect between multimorbidity and physical activity was stronger for men (OR=1.41; 95% CI 1.12, 1.79) than women (OR=1.18; CI 1.00, 1.39) and those living in rural (OR=1.43; CI 1.10, 1.85) versus urban (OR=1.20; CI 1.02, 141) areas. Given the generally low levels of physical activity across populations and a growing prevalence of multimorbidity, there is a need for a prospective study to explore causal associations between physical activity, multimorbidity, and health outcomes.
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Affiliation(s)
- Melanie R Keats
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada.
| | - Yunsong Cui
- Atlantic PATH, Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada
| | - Vanessa DeClercq
- Atlantic PATH, Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada
| | - Trevor J B Dummer
- Centre of Excellence in Cancer Prevention, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Cynthia Forbes
- Atlantic PATH, Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada
| | - Scott A Grandy
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Jason Hicks
- Atlantic PATH, Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada
| | - Ellen Sweeney
- Atlantic PATH, Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada
| | - Zhijie Michael Yu
- Atlantic PATH, Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada
| | - Louise Parker
- Atlantic PATH, Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada
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138
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Dohrn IM, Sjöström M, Kwak L, Oja P, Hagströmer M. Accelerometer-measured sedentary time and physical activity-A 15 year follow-up of mortality in a Swedish population-based cohort. J Sci Med Sport 2017; 21:702-707. [PMID: 29128418 DOI: 10.1016/j.jsams.2017.10.035] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 09/19/2017] [Accepted: 10/31/2017] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To investigate the associations of objectively assessed sedentary time, light intensity physical activity (PA), moderate to vigorous intensity PA (MVPA), and total PA with all-cause mortality and mortality from cardiovascular disease (CVD) or cancer in a Swedish population-based cohort with 15 years follow-up time. DESIGN Longitudinal prospective cohort study. METHODS Data from 851 persons (56% women) ≥35 years at baseline were included. Primary exposure variables were time (min/day) spent sedentary, in light intensity PA and in MVPA, and total counts from an Actigraph 7164 accelerometer. Data on all-cause mortality and mortality from CVD or cancer were obtained from Swedish registers. Cox proportional hazards models estimated hazard ratios (HR) of mortality with 95% confidence intervals (CI). RESULTS Compared with the least sedentary participants, those in the most sedentary tertile had an increased risk of all-cause mortality, HR: 2.7 (1.4, 5.3), CVD mortality, HR: 5.5 (1.4, 21.2) and cancer mortality, HR: 4.3 (1.2, 16.0). For all-cause mortality, those in the highest light intensity PA tertile had a HR 0.34 (0.17, 0.67) compared with the lowest tertile. A similar pattern was found for CVD and cancer mortality. More time spent in MVPA was associated with the largest risk reduction for CVD mortality, with an almost 90% lower risk in the tertile with the most time in MVPA. CONCLUSIONS This study confirms a strong inverse relationship between MVPA and mortality, and adds new insight for the understanding of the associations between sedentary time and light intensity PA and mortality.
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Affiliation(s)
- Ing-Mari Dohrn
- Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Sweden.
| | - Michael Sjöström
- Department of Biosciences and Nutrition (BioNut), Karolinska Institutet, Sweden
| | - Lydia Kwak
- Institute of Environmental Medicine (IMM), Karolinska Institutet, Sweden
| | | | - Maria Hagströmer
- Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Sweden; Functional Area Occupational Therapy and Physiotherapy, Karolinska University Hospital, Sweden
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139
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Sá THD, Tainio M, Goodman A, Edwards P, Haines A, Gouveia N, Monteiro C, Woodcock J. Health impact modelling of different travel patterns on physical activity, air pollution and road injuries for São Paulo, Brazil. ENVIRONMENT INTERNATIONAL 2017; 108:22-31. [PMID: 28780491 PMCID: PMC5632958 DOI: 10.1016/j.envint.2017.07.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/18/2017] [Accepted: 07/13/2017] [Indexed: 05/29/2023]
Abstract
BACKGROUND São Paulo city, Brazil, faces challenges caused by rapid urbanization. We illustrate how future travel patterns could lead to different health consequences in the city. METHODS We evaluated the health impacts of different travel pattern scenarios for the São Paulo adult population by comparing the travel patterns of São Paulo in 2012 with counterfactual scenarios in which the city adopted travel patterns of i) those living in the city's expanded centre; ii) London (2012); iii) a highly motorized São Paulo (SP California); and iv) a visionary São Paulo (SP 2040), with high levels of walking and cycling and low levels of car and motorcycle use. For each scenario we estimated changes in exposure to air pollution, road injury risk, and physical activity. Health outcomes were estimated using disability adjusted life years (DALYs) and premature deaths averted. Sensitivity analyses were performed to identify the main sources of uncertainty. RESULTS We found considerable health gains in the SP 2040 scenario (total 63.6k DALYs avoided), with 4.7% of premature deaths from ischemic heart disease avoided from increases in physical activity alone. Conversely, we found substantial health losses in the scenario favouring private transport (SP California, total increase of 54.9k DALYs), with an increase in road traffic deaths and injuries among pedestrians and motorized vehicles. Parameters related to air pollution had the largest impact on uncertainty. CONCLUSIONS Shifting travel patterns towards more sustainable transport can provide major health benefits in São Paulo. Reducing the uncertainties in the findings should be a priority for empirical and modelling research on the health impacts of such shifts.
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Affiliation(s)
- Thiago Hérick de Sá
- Centre for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, SP, Brazil.
| | - Marko Tainio
- UKCRC Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK
| | - Anna Goodman
- London School of Hygiene and Tropical Medicine, London, UK
| | - Phil Edwards
- London School of Hygiene and Tropical Medicine, London, UK
| | - Andy Haines
- London School of Hygiene and Tropical Medicine, London, UK
| | - Nelson Gouveia
- Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Carlos Monteiro
- Centre for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, SP, Brazil
| | - James Woodcock
- UKCRC Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK
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140
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Watanabe K, Kawakami N. Effects of a multicomponent workplace intervention programme with environmental changes on physical activity among Japanese white collar employees: a protocol for a cluster randomised controlled trial. BMJ Open 2017; 7:e017688. [PMID: 29070639 PMCID: PMC5665227 DOI: 10.1136/bmjopen-2017-017688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Physical activity is one of the most important health behaviours as a determinant of physical and mental health. Although intervention strategies for promoting physical activity among workers are needed, evidence for the effectiveness of multilevel workplace interventions with environmental changes on the promotion of physical activity are still limited due to lack of cluster randomised controlled trials (RCTs). The aim of this study is to investigate effects of a 3-month workplace intervention programme with environmental changes on the improvement in physical activity among Japanese white collar employees. METHODS AND ANALYSIS This study will be a two-arm and parallel-group cluster (worksite) RCT. Japanese worksites and employees who are employed by the worksites will be recruited through health insurance associations and chambers of commerce. Worksites that meet the inclusion criteria will be randomly allocated to intervention or control groups. The intervention worksites will be offered the original intervention programme that consists of 13 contents with environmental changes. The control worksites will be able to get three times feedback of the assessment of the amount of physical activity and basic occupational health service in each worksite. The primary outcome will be the total amount of physical activity measured by the Global Physical Activity Questionnaire at baseline, 3 months and 6 months. Multilevel latent growth modelling will be conducted to examine the effectiveness of the intervention programme. ETHICS AND DISSEMINATION This study was ethically approved by the research ethics committee of the Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Japan (No. 11230). Results will be submitted and published in a scientific peer-reviewed journal. TRIAL REGISTRATION NUMBER UMIN000024069; Pre-results.
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Affiliation(s)
- Kazuhiro Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- The Japan Society for the Promotion of Science, Tokyo, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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141
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Parretti HM, Bartington SE, Badcock T, Hughes L, Duda JL, Jolly K. Impact of primary care exercise referral schemes on the health of patients with obesity. Pragmat Obs Res 2017; 8:189-201. [PMID: 29033627 PMCID: PMC5614768 DOI: 10.2147/por.s118648] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Primary care exercise referral schemes (ERSs) are a potentially useful setting to promote physical activity (PA). It is not established, however, whether interventions to increase PA, such as ERSs, have differing health outcomes according to the participants’ body mass index (BMI). This paper summarizes evidence for the impact of primary care ERSs on the health of people with obesity and reports findings of a reanalysis of the EMPOWER study, providing the first data to report differential outcomes of ERSs by BMI category. Our literature review revealed a paucity of published data. A 2011 Health Technology Assessment review and 2015 update were identified, but normal-weight participants were neither excluded nor were results stratified by weight in the included studies. A study of the effect of exercise referral in overweight women reported a significantly greater increase in PA levels in the ERS group than the control group at 3 months. Reanalysis of the EMPOWER study data showed a significant improvement in PA at 3 months in both obese and overweight/normal BMI groups, with the effect size attenuated to 6 months. There was no significant difference from baseline to 6 months in blood pressure for either BMI category. At 6 months, there was a significant decrease in weight from baseline for the obese category. Comparison of crude mean differences between BMI groups revealed a significant mean difference in PA at 3 months favoring the overweight/normal BMI group, but not at 6 months. There were no further significant differences in unadjusted or adjusted mean differences for other outcomes at follow-up. We report some evidence of a differential impact of ERS on PA by BMI category. However, the effect of ERSs in primary care for patients with obesity remains unclear due to the small number of published studies that have reported outcomes by BMI category. Further research is needed.
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Affiliation(s)
| | | | | | | | - Joan L Duda
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, West Midlands, UK
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142
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Hsu B, Merom D, Blyth FM, Naganathan V, Hirani V, Le Couteur DG, Seibel MJ, Waite LM, Handelsman DJ, Cumming RG. Total Physical Activity, Exercise Intensity, and Walking Speed as Predictors of All-Cause and Cause-Specific Mortality Over 7 Years in Older Men: The Concord Health and Aging in Men Project. J Am Med Dir Assoc 2017; 19:216-222. [PMID: 28993048 DOI: 10.1016/j.jamda.2017.08.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 08/25/2017] [Accepted: 08/25/2017] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The study aimed to examine the contemporaneous temporal association between changes in total physical activity, sports intensity, muscle strengthening exercise, and walking speed as predictors of all-cause, cardiovascular, cancer and other cause-specific mortality in older men. DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS Community-dwelling men aged 70 years and older from Concord Health and Aging in Men Project were assessed at baseline (2005-2007, n = 1705), 2 years (n = 1367), and 5 years follow-up (n = 958). At all time points, Physical Activity Scale for the Elderly questionnaire, walking speed over a 6-m walk, and potential confounders were assessed. Mortality was ascertained through the state death registry with a median follow-up of 7 years. RESULTS As the Physical Activity Scale for the Elderly score increased by 1 standard deviation over the follow-up period, the relative risk (RR) for mortality was 0.78 [95% confidence interval (CI) 0.69-0.88] for all-cause, 0.66 (95% CI 0.55-0.79) for cardiovascular and 0.75 (95% CI 0.61-0.94) for other cause-specific mortality, but no association was observed in cancer mortality. The RR for undertaking strenuous sports during follow-up was 0.44 (95% CI 0.26-0.72) for all-cause mortality and 0.31 (95% CI 0.13-0.70) for cancer mortality when compared with no sports participation. Increases in walking speed per standard deviation over time were also associated with a decrease in all-cause mortality (RR 0.69, 95% CI 0.61-0.78), with similar associations for cardiovascular (RR 0.60, 95% CI 0.48-0.74), but not cancer mortality. CONCLUSIONS Older men who engage in strenuous sports and those who increase their walking speed over time may have lower risk of all-cause and some cause-specific mortality.
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Affiliation(s)
- Benjumin Hsu
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia; Center of Education and Research on Aging, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia; ARC Center of Excellence in Population Aging Research, University of Sydney, Sydney, New South Wales, Australia.
| | - Dafna Merom
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
| | - Fiona M Blyth
- Center of Education and Research on Aging, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Center of Education and Research on Aging, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia
| | - Vasant Hirani
- Center of Education and Research on Aging, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia
| | - David G Le Couteur
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia; Center of Education and Research on Aging, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia
| | - Markus J Seibel
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia
| | - Louise M Waite
- Center of Education and Research on Aging, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia
| | - Robert G Cumming
- ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia; Center of Education and Research on Aging, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia; ARC Center of Excellence in Population Aging Research, University of Sydney, Sydney, New South Wales, Australia; School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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143
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Bauman AE, Grunseit AC, Rangul V, Heitmann BL. Physical activity, obesity and mortality: does pattern of physical activity have stronger epidemiological associations? BMC Public Health 2017; 17:788. [PMID: 28982371 PMCID: PMC5629749 DOI: 10.1186/s12889-017-4806-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 09/28/2017] [Indexed: 02/08/2023] Open
Abstract
Background Most studies of physical activity (PA) epidemiology use behaviour measured at a single time-point. We examined whether ‘PA patterns’ (consistently low, consistently high or inconsistent PA levels over time) showed different epidemiological relationships for anthropometric and mortality outcomes, compared to single time-point measure of PA. Methods Data were the Danish MONICA (MONItoring Trends and Determinants in CArdiovascular Disease) study over three waves 1982–3 (time 1), 1987–8 (time 2) and 1993–4 (time 3). Associations between leisure time single time-point PA levels at time 1 and time 3, and sport and active travel at times 1 and 2 with BMI, waist, hip circumference and mortality (death from coronary heart disease (CHD) and cardiovascular disease (CVD)) were compared to ‘PA patterns’ spanning multiple time points. PA pattern classified participants’ PA as either 1) inactive or low PA at both time points; 2) moderate level PA at time 1 and high activity at time 3; or 3) a ‘mixed PA pattern’ indicating a varying levels of activity over time. Similarly, sport and active travel were also classified as indicating stable low, stable high and mixed patterns. Results The moderately and highly active groups for PA at times 1 and 3 had up to 1.7 cm lower increase in waist circumference compared with the inactive/low active group. Across ‘PA patterns’, ‘active maintainers’ had a 2.0 cm lower waist circumference than ‘inactive/low maintainers’. Waist circumference was inversely related to sport but not active travel. CHD risk did not vary by activity levels at time 1, but was reduced significantly by 43% for high PA at time 3 (vs ‘inactive’ group) and among ‘active maintainers’ (vs ‘inactive/low maintainers’) by 62%. ‘Sport pattern’ showed stronger reductions in mortality for cardiovascular disease and CHD deaths among sport maintainers, than the single time point measures. Conclusions PA patterns demonstrated a stronger association with a number of anthropometric and mortality outcomes than the single time-point measures. Operationalising PA as a sustained behavioural pattern may address some of the known under-estimation of risk for poor health in PA self-report measurements and better reflect exposure for epidemiological analysis of risk of health outcomes. Electronic supplementary material The online version of this article (10.1186/s12889-017-4806-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Adrian E Bauman
- Prevention Research Collaboration, School of Public Health, University of Sydney, Level 6, Charles Perkins Centre, Johns Hopkins Drive, Sydney, NSW, 2006, Australia
| | - Anne C Grunseit
- Prevention Research Collaboration, School of Public Health, University of Sydney, Level 6, Charles Perkins Centre, Johns Hopkins Drive, Sydney, NSW, 2006, Australia.
| | - Vegar Rangul
- HUNT Research Centre, Faculty of Medicine, Department of Public health and General practice, NTNU - Norwegian University of Science and Technology, Levanger, Norway
| | - Berit L Heitmann
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of Sydney, Sydney, NSW, 2006, Australia.,Research Unit for Dietary Studies at the Parker Institute and Institute of Preventive Medicine, Frederiksberg and Bispebjerg Hospital, Copenhagen, Denmark.,Institute of Public Health, University of Southern Denmark, Odense, Denmark.,Copenhagen Center for Preventive Medicine, Glostrup Hospital, Copenhagen Capital Region, Denmark
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144
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Mueller N, Rojas-Rueda D, Basagaña X, Cirach M, Cole-Hunter T, Dadvand P, Donaire-Gonzalez D, Foraster M, Gascon M, Martinez D, Tonne C, Triguero-Mas M, Valentín A, Nieuwenhuijsen M. Health impacts related to urban and transport planning: A burden of disease assessment. ENVIRONMENT INTERNATIONAL 2017; 107:243-257. [PMID: 28778040 DOI: 10.1016/j.envint.2017.07.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 07/20/2017] [Accepted: 07/21/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Until now, estimates of the Global Burden of Disease (GBD) have mainly been produced on national or regional levels. These general estimates, however, are less useful for city governments who have to take decisions on local scales. To address this gap, we focused on the city-level burden of disease (BD) due to exposures affected by urban and transport planning. We conducted a BD assessment using the Urban and Transport Planning Health Impact Assessment (UTOPHIA) tool to estimate annual preventable morbidity and disability-adjusted life-years (DALYs) under compliance with international exposure recommendations for physical activity (PA), exposure to air pollution, noise, heat, and access to green spaces in Barcelona, Spain. METHODS Exposure estimates and morbidity data were available for 1,357,361 Barcelona residents ≥20years (2012). We compared recommended with current exposure levels to estimate the associated BD. We quantified associations between exposures and morbidities and calculated population attributable fractions to estimate the number of attributable cases. We calculated DALYs using GBD Study 2015 background DALY estimates for Spain, which were scaled to Barcelona considering differences in population size, age and sex structures. We also estimated annual health costs that could be avoided under compliance with exposure recommendations. RESULTS Not complying with recommended levels for PA, air pollution, noise, heat and access to green spaces was estimated to generate a large morbidity burden and resulted in 52,001 DALYs (95% CI: 42,866-61,136) in Barcelona each year (13% of all annual DALYs). From this BD 36% (i.e. 18,951 DALYs) was due to traffic noise with sleep disturbance and annoyance contributing largely (i.e. 10,548 DALYs). Non-compliance was estimated to result in direct health costs of 20.10 million € (95% CI: 15.36-24.83) annually. CONCLUSIONS Non-compliance of international exposure recommendations was estimated to result in a considerable BD and in substantial economic expenditure each year in Barcelona. Our findings suggest that (1) the reduction of motor traffic together with the promotion of active transport and (2) the provision of green infrastructure would result in a considerable BD avoided and substantial savings to the public health care system, as these measures can provide mitigation of noise, air pollution and heat as well as opportunities for PA promotion.
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Affiliation(s)
- Natalie Mueller
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - David Rojas-Rueda
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Xavier Basagaña
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Marta Cirach
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Tom Cole-Hunter
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Payam Dadvand
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - David Donaire-Gonzalez
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Physical Activity and Sports Sciences Department, Fundació Blanquerna, Barcelona, Spain
| | - Maria Foraster
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Mireia Gascon
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - David Martinez
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Cathryn Tonne
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Margarita Triguero-Mas
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Antònia Valentín
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mark Nieuwenhuijsen
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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145
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A Novel Physical Activity and Sedentary Behavior Classification and Its Relationship With Physical Fitness in Spanish Older Adults: The PHYSMED Study. J Phys Act Health 2017; 14:815-822. [PMID: 28556668 DOI: 10.1123/jpah.2016-0263] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND As there is no gold-standard methodology to classify older people in relation to physical activity (PA) and sedentary behavior (SB), this paper aimed to propose a classification combining PA and SB. METHODS Within a broader study, 433 subjects, aged 55 years and older (57% females) from Madrid and Majorca, were evaluated for PA and SB by means of validated questionnaires. Physical fitness was analyzed objectively using the EXERNET test battery. Cluster analyses were used to establish behavioral patterns, combining PA and SB. RESULTS Males spent more time doing regular PA but less time walking and working at home than females (P < .001). Comparing the groups (inactive and high sedentary, inactive and low sedentary, active and high sedentary, and active and low sedentary), the worst aerobic endurance (P < .001) and lower body strength (P < .05) were obtained in males from both inactive groups. Agility was highest in the active and low sedentary group (P < .05). No significant differences were observed in females. CONCLUSIONS The proposed classification is valid, as it classifies subjects according to their PA and SB, and outcomes are related to objectively measured fitness. It could facilitate the work of public health authorities, researchers, and physicians.
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146
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Fishman EI, Steeves JA, Zipunnikov V, Koster A, Berrigan D, Harris TA, Murphy R. Association between Objectively Measured Physical Activity and Mortality in NHANES. Med Sci Sports Exerc 2017; 48:1303-11. [PMID: 26848889 DOI: 10.1249/mss.0000000000000885] [Citation(s) in RCA: 127] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE We examined total activity, light activity, and moderate-to-vigorous physical activity (MVPA) as predictors of mortality in a nationally representative sample of older adults. Then we explored the theoretical consequences of replacing sedentary time with the same duration of light activity or MVPA. METHODS Using accelerometer-measured activity, the associations between total activity, light activity (100-2019 counts per minute), and MVPA (>2019 counts per minute) counts and mortality were examined in adults age 50 to 79 yr in the National Health and Nutrition Examination Survey, 2003-2006 (n = 3029), with mortality follow-up through December 2011. Cox proportional hazard models were fitted to estimate mortality risks. An isotemporal substitution model was used to examine the theoretical consequences of replacing sedentary time with light activity or MVPA on mortality. RESULTS After adjusting for potential confounders, including age, sex, race/ethnicity, education, BMI, and the presence of comorbid conditions, those in the highest tertile of total activity counts had one fifth the risk of death of those in the lowest tertile (hazard ratio [HR] = 0.21, 95% confidence interval [CI] = 0.12-0.38), and those in the middle tertile had one third the risk of death (HR = 0.36, 95% CI = 0.30-0.44). In addition, replacing 30 min of sedentary time with light activity was associated with significant reduction in mortality risk (after 5 yr of follow-up: HR = 0.80, 95% CI = 0.75-0.85). Replacing 30 min of sedentary time with MVPA was also associated with reduction in mortality risk (HR = 0.49, 95% CI = 0.25-0.97). CONCLUSIONS Greater total activity is associated with lower all-cause mortality risk. Replacing sedentary time with light activity or MVPA may reduce mortality risk for older adults.
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Affiliation(s)
- Ezra I Fishman
- 1Population Studies Center, University of Pennsylvania, Philadelphia, PA; 2Division of Education, Maryville College, Maryville, TN; 3Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; 4Department of Social Medicine, Maastricht University, Maastricht, THE NETHERLANDS; 5Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD; 6Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD; 7Faculty of Medicine, University of British Columbia, Vancouver, BC, CANADA
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147
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Herzig KH, Leppäluoto J, Jokelainen J, Meugnier E, Pesenti S, Selänne H, Mäkelä KA, Ahola R, Jämsä T, Vidal H, Keinänen-Kiukaanniemi S. Low level activity thresholds for changes in NMR biomarkers and genes in high risk subjects for Type 2 Diabetes. Sci Rep 2017; 7:11267. [PMID: 28924247 PMCID: PMC5603534 DOI: 10.1038/s41598-017-09753-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 07/28/2017] [Indexed: 01/26/2023] Open
Abstract
Our objectives were to determine if there are quantitative associations between amounts and intensities of physical activities (PA) on NMR biomarkers and changes in skeletal muscle gene expressions in subjects with high risk for type 2 diabetes (T2D) performing a 3-month PA intervention. We found that PA was associated with beneficial biomarker changes in a factor containing several VLDL and HDL subclasses and lipids in principal component analysis (P = <0.01). Division of PA into quartiles demonstrated significant changes in NMR biomarkers in the 2nd - 4th quartiles compared to the 1st quartile representing PA of less than 2850 daily steps (P = 0.0036). Mediation analysis of PA-related reductions in lipoproteins showed that the effects of PA was 4-15 times greater than those of body weight or fat mass reductions. In a subset study in highly active subjects' gene expressions of oxidative fiber markers, Apo D, and G0/G1 Switch Gene 2, controlling insulin signaling and glucose metabolism were significantly increased. Slow walking at speeds of 2-3 km/h exceeding 2895 steps/day attenuated several circulating lipoprotein lipids. The effects were mediated rather by PA than body weight or fat loss. Thus, lower thresholds for PA may exist for long term prevention of cardio-metabolic diseases in sedentary overweight subjects.
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Affiliation(s)
- Karl-Heinz Herzig
- Research Unit of Biomedicine, and Biocenter of Oulu, Oulu University, 90014, Oulu, Finland. .,Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland. .,Medical Research Center and Oulu University Hospital, University of Oulu and Oulu University Hospital, Oulu, Finland.
| | - Juhani Leppäluoto
- Research Unit of Biomedicine, and Biocenter of Oulu, Oulu University, 90014, Oulu, Finland
| | - Jari Jokelainen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, 90014, Oulu, Finland.,Oulu University Hospital, Unit of General Practice, and Health Center of Oulu, Oulu, Finland
| | - Emmanuelle Meugnier
- CarMeN Laboratory, INSERM U1060, INRA U1397, University of Lyon, 69600, Oullins, France
| | - Sandra Pesenti
- CarMeN Laboratory, INSERM U1060, INRA U1397, University of Lyon, 69600, Oullins, France
| | - Harri Selänne
- Department of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Kari A Mäkelä
- Research Unit of Biomedicine, and Biocenter of Oulu, Oulu University, 90014, Oulu, Finland
| | - Riikka Ahola
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, 90014, Oulu, Finland
| | - Timo Jämsä
- Medical Research Center and Oulu University Hospital, University of Oulu and Oulu University Hospital, Oulu, Finland.,Research Unit of Medical Imaging, Physics and Technology, University of Oulu, 90014, Oulu, Finland.,Department of Diagnostic Imaging, Oulu University Hospital, Oulu, Finland
| | - Hubert Vidal
- CarMeN Laboratory, INSERM U1060, INRA U1397, University of Lyon, 69600, Oullins, France
| | - Sirkka Keinänen-Kiukaanniemi
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, 90014, Oulu, Finland.,Oulu University Hospital, Unit of General Practice, and Health Center of Oulu, Oulu, Finland
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148
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Turi BC, Codogno JS, Fernandes RA, Monteiro HL. Walking and health care expenditures among adult users of the Brazilian public healthcare system: retrospective cross-sectional study. CIENCIA & SAUDE COLETIVA 2017; 20:3561-8. [PMID: 26602733 DOI: 10.1590/1413-812320152011.00092015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Accepted: 03/09/2015] [Indexed: 11/21/2022] Open
Abstract
Physical inactivity is a major public health challenge due to its association with chronic diseases and the resulting economic impact on the public healthcare system. However, walking can help alleviate these problems. Aim To verify associations between walking during leisure-time, risk factors and health care expenditure among users of the Brazilian public health care system. Methods The sample consisted of 963 adults. Walking was evaluated using the Baecke questionnaire. The total expenditure per year was evaluated through the demand for health care services, verified in the medical records of each participant. Results Walking was reported as a physical activity during leisure-time by 64.4% of the participants. The group with the highest engagement in walking was younger and presented lower values for BMI, WC and expenditure on medication. Participants inserted in the category of higher involvement in walking were 41% less likely to be inserted into the group with higher total expenditure (OR = 0:59; 95% CI 0.39-0.89). Conclusion It was found that walking was the most frequent leisure-time physical activity reported by users of the Brazilian health care system and was associated with lower total and medication expenditure.
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Affiliation(s)
- Bruna Camilo Turi
- Universidade Estadual Paulista Júlio de Mesquita Filho, Rio Claro, SP, Brasil,
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149
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Hong YA, Forjuoh SN, Ory MG, Reis MD, Sang H. A Multi-Level, Mobile-Enabled Intervention to Promote Physical Activity in Older Adults in the Primary Care Setting (iCanFit 2.0): Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc 2017; 6:e183. [PMID: 28899848 PMCID: PMC5615219 DOI: 10.2196/resprot.8220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 07/13/2017] [Accepted: 07/22/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Most older adults do not adhere to the US Centers for Disease Control physical activity guidelines; their physical inactivity contributes to overweight and multiple chronic conditions. An urgent need exists for effective physical activity-promotion programs for the large number of older adults in the United States. OBJECTIVE This study presents the development of the intervention and trial protocol of iCanFit 2.0, a multi-level, mobile-enabled, physical activity-promotion program developed for overweight older adults in primary care settings. METHODS The iCanFit 2.0 program was developed based on our prior mHealth intervention programs, qualitative interviews with older patients in a primary care clinic, and iterative discussions with key stakeholders. We will test the efficacy of iCanFit 2.0 through a cluster randomized controlled trial in six pairs of primary care clinics. RESULTS The proposed protocol received a high score in a National Institutes of Health review, but was not funded due to limited funding sources. We are seeking other funding sources to conduct the project. CONCLUSIONS The iCanFit 2.0 program is one of the first multi-level, mobile-enabled, physical activity-promotion programs for older adults in a primary care setting. The development process has actively involved older patients and other key stakeholders. The patients, primary care providers, health coaches, and family and friends were engaged in the program using a low-cost, off-the-shelf mobile tool. Such low-cost, multi-level programs can potentially address the high prevalence of physical inactivity in older adults.
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Affiliation(s)
- Y Alicia Hong
- School of Public Health, Texas A&M University, College Station, TX, United States
| | - Samuel N Forjuoh
- Department of Family Medicine, Baylor Scott and White Health, Temple, TX, United States
| | - Marcia G Ory
- School of Public Health, Texas A&M University, College Station, TX, United States
| | - Michael D Reis
- Department of Family Medicine, Baylor Scott and White Health, Temple, TX, United States
| | - Huiyan Sang
- Department of Statistics, Texas A&M University, College Station, TX, United States
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150
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Miragall M, Domínguez-Rodríguez A, Navarro J, Cebolla A, Baños RM. Increasing physical activity through an Internet-based motivational intervention supported by pedometers in a sample of sedentary students: A randomised controlled trial. Psychol Health 2017; 33:465-482. [PMID: 28880576 DOI: 10.1080/08870446.2017.1368511] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The aim of this study was to analyse the effect of an Internet-based motivational intervention (IMI) supported by pedometers (in comparison with IMI alone and non-intervention) on increasing daily steps and changing constructs related to physical activity (PA) in a sample of sedentary students. DESIGN A randomised-controlled trial was conducted with 76 sedentary or low-active college students. The purpose of the IMI was to deliver information to increase motivation and set individualised PA goals. It involved a 3-week intervention and a 3-months follow-up. OUTCOME MEASURES Objective measures were used to measure daily steps, and self-report questionnaires to assess different constructs related to PA. RESULTS Results revealed that IMI supported by pedometers condition increased significantly more the daily steps (post-intervention: M = 2069; SD = 1827; follow-up: M = 2227; SD = 2477) and enjoyment than non-intervention condition at both points in time. Moreover, results showed that IMI alone condition increased more the scores in variables involved in PA behaviour than non-intervention condition. CONCLUSIONS This study shows the effectiveness of a self-administered IMI using pedometers in increasing PA and enjoyment, and the effectiveness of the IMI alone in changing different theoretical constructs related to the PA behaviour.
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Affiliation(s)
- Marta Miragall
- a Department of Personality, Evaluation and Psychological Treatment , University of Valencia , Spain.,b PROMOSAM Excellence in Research Program (PSI2014-56303-REDT), MINECO , Spain
| | - Alejandro Domínguez-Rodríguez
- a Department of Personality, Evaluation and Psychological Treatment , University of Valencia , Spain.,b PROMOSAM Excellence in Research Program (PSI2014-56303-REDT), MINECO , Spain
| | - Jessica Navarro
- a Department of Personality, Evaluation and Psychological Treatment , University of Valencia , Spain.,b PROMOSAM Excellence in Research Program (PSI2014-56303-REDT), MINECO , Spain
| | - Ausiàs Cebolla
- a Department of Personality, Evaluation and Psychological Treatment , University of Valencia , Spain.,b PROMOSAM Excellence in Research Program (PSI2014-56303-REDT), MINECO , Spain.,c CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto Carlos III , Spain
| | - Rosa M Baños
- a Department of Personality, Evaluation and Psychological Treatment , University of Valencia , Spain.,b PROMOSAM Excellence in Research Program (PSI2014-56303-REDT), MINECO , Spain.,c CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto Carlos III , Spain
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