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Sun L, Xu C, Zhang Z, Tang L, Liu X. Physical activity lowers all-cause and cardio-cerebrovascular mortality in adults with coronary heart disease. Int J Cardiol 2024; 410:132225. [PMID: 38821122 DOI: 10.1016/j.ijcard.2024.132225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/08/2024] [Accepted: 05/28/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND The health outcomes and their adherence to guideline-based secondary prevention physical activity in US patients with coronary heart disease (CHD), together with the association between physical activity (PA) and mortality risk, were investigated. METHODS Data on CHD patients (aged 18 to 85 years) was acquired from the US National Health and Nutrition Examination Survey (NHANES) 1999-2018. The patients were divided into four groups according to the level and frequency of PA, namely, a) sedentary (n = 1178), b) moderate PA (moderate, n = 270), c) vigorous PA once or twice per week (vigorous ≤2×, n = 206), and d) vigorous PA three or more times per week (vigorous >2×, n = 598). Logistic analysis was used to determine the relationship between PA and all-cause or cardio-cerebrovascular mortality in CHD patients. RESULTS A total of 2252 patients with CHD were enrolled, of whom 47.69% reported adequate PA. During the investigation, there were 296 (13.14%) cardio-cerebrovascular and 724 (32.15%) all-cause deaths. The incidence of all-cause or cardio-cerebrovascular death was lowest in the vigorous ≤2× group. Patients who undertook vigorous PA ≤ 2× showed the lowest risk of all-cause (odds ratio 0.32; 95% confidence interval 0.22-0.47; P < 0.01) or cardio-cerebrovascular death (odds ratio 0.43; 95% confidence interval 0.25-0.73; P < 0.01) relative to those in the sedentary group. More frequent vigorous PA did not lead to improved benefits. CONCLUSIONS Vigorous PA once or twice per week was more effective for reducing all-cause and cardio-cerebrovascular mortality compared with patients performing no or a moderate level of PA in US adults with CHD.
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Affiliation(s)
- Lingling Sun
- Department of Geriatrics, Ningbo No.2 Hospital, Ningbo, Zhejiang 315000, PR China
| | - Cheng Xu
- Science and Education Department, Guangxi Zhuang Autonomous Region Jiangbin Hospital, Nanning, Guangxi 530021, PR China
| | - Zhi Zhang
- Department of Cardiology, First People's Hospital of Linping District, Hangzhou, Zhejiang 311199, PR China.
| | - Lijiang Tang
- Department of Cardiology, Zhejiang Hospital, Hangzhou, Zhejiang 310013, PR China.
| | - Xiaowei Liu
- Department of Cardiology, Zhejiang Hospital, Hangzhou, Zhejiang 310013, PR China.
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Mok Y, Lu Y, Ballew SH, Sang Y, Kucharska-Newton A, Mediano MF, Koton S, Schrack JA, Palta P, Coresh J, Rosamond W, Matsushita K. Premorbid physical activity and prognosis after incident myocardial infarction: The atherosclerosis risk in communities study. Am Heart J 2024; 274:75-83. [PMID: 38723879 PMCID: PMC11168863 DOI: 10.1016/j.ahj.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 04/19/2024] [Accepted: 05/05/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND High to moderate levels of physical activity (PA) are associated with low risk of incident cardiovascular disease. However, it is unclear whether the benefits of PA in midlife extend to cardiovascular health following myocardial infarction (MI) in later life. METHODS Among 1,111 Atherosclerosis Risk in Communities study participants with incident MI during Atherosclerosis Risk in Communities follow-up (mean age 73 [SD 9] years at MI, 54% men, 21% Black), PA on average 11.9 (SD 6.9) years prior to incident MI (premorbid PA) was evaluated as the average score of PA between visit 1 (1987-1989) and visit 3 (1993-1995) using a modified Baecke questionnaire. Total and domain-specific PA (sport, nonsport leisure, and work PA) was analyzed for associations with composite and individual outcomes of mortality, recurrent MI, and stroke after index MI using multivariable Cox models. RESULTS During a median follow-up of 4.6 (IQI 1.0-10.5) years after incident MI, 823 participants (74%) developed a composite outcome. The 10-year cumulative incidence of the composite outcome was lower in the highest, as compared to the lowest tertile of premorbid total PA (56% vs. 70%, respectively). This association remained statistically significant even after adjusting for potential confounders (adjusted hazard ratio [aHR] 0.80 [0.67-0.96] for the highest vs. lowest tertile). For individual outcomes, high premorbid total PA was associated with a low risk of recurrent MI (corresponding aHR 0.64 [0.44, 0.93]). When domain-specific PA was analyzed, similar results were seen for sport and work PA. The association was strongest in the first year following MI (e.g., aHR of composite outcome 0.66 [95% CI 0.47, 0.91] for the highest vs. lowest tertile of total PA). CONCLUSIONS Premorbid PA was associated positively with post-MI cardiovascular health. Our results demonstrate the additional prognostic advantages of PA beyond reducing the risk of incident MI.
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Affiliation(s)
- Yejin Mok
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Yifei Lu
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Shoshana H Ballew
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Optimal Aging Institute, New York University Grossman School of Medicine, New York, NY; Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Yingying Sang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Optimal Aging Institute, New York University Grossman School of Medicine, New York, NY; Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Anna Kucharska-Newton
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Mauro F Mediano
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil; Department of Research and Education, National Institute of Cardiology, Rio de Janeiro, Brazil
| | - Silvia Koton
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Stanley Steyer School of Health Professions, Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Priya Palta
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Optimal Aging Institute, New York University Grossman School of Medicine, New York, NY; Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Wayne Rosamond
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Stamatakis E, Ahmadi MN, Elphick TL, Huang BH, Paudel S, Teixeira-Pinto A, Chen LJ, Cruz BDP, Lai YJ, Holtermann A, Ku PW. Occupational physical activity, all-cause, cardiovascular disease, and cancer mortality in 349,248 adults: Prospective and longitudinal analyses of the MJ Cohort. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:579-589. [PMID: 38462173 PMCID: PMC11184299 DOI: 10.1016/j.jshs.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/19/2023] [Accepted: 01/10/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Evidence on the health benefits of occupational physical activity (OPA) is inconclusive. We examined the associations of baseline OPA and OPA changes with all-cause, cardiovascular disease (CVD), and cancer mortality and survival times. METHODS This study included prospective and longitudinal data from the MJ Cohort, comprising adults over 18 years recruited in 1998-2016, 349,248 adults (177,314 women) with baseline OPA, of whom 105,715 (52,503 women) had 2 OPA measures at 6.3 ± 4.2 years (mean ± SD) apart. Exposures were baseline OPA, OPA changes, and baseline leisure-time physical activity. RESULTS Over a mean mortality follow-up of 16.2 ± 5.5 years for men and 16.4 ± 5.4 years for women, 11,696 deaths (2033 of CVD and 4631 of cancer causes) in men and 8980 deaths (1475 of CVD and 3689 of cancer causes) in women occurred. Combined moderately heavy/heavy baseline OPA was beneficially associated with all-cause mortality in men (multivariable-adjusted hazard ratio (HR) = 0.93, 95% confidence interval (95%CI): 0.89-0.98 compared to light OPA) and women (HR = 0.86, 95%CI: 0.79-0.93). Over a mean mortality follow-up of 12.5 ± 4.6 years for men and 12.6 ± 4.6 years for women, OPA decreases in men were detrimentally associated (HR = 1.16, 95%CI: 1.01-1.33) with all-cause mortality, while OPA increases in women were beneficially (HR = 0.83, 95%CI: 0.70-0.97) associated with the same outcome. Baseline or changes in OPA showed no associations with CVD or cancer mortality. CONCLUSION Higher baseline OPA was beneficially associated with all-cause mortality risk in both men and women. Our longitudinal OPA analyses partly confirmed the prospective findings, with some discordance between sex groups.
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Affiliation(s)
- Emmanuel Stamatakis
- Sydney School of Health Sciences, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia.
| | - Matthew N Ahmadi
- Sydney School of Health Sciences, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
| | - Tiana-Lee Elphick
- Sydney School of Health Sciences, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
| | - Bo-Huei Huang
- Sydney School of Health Sciences, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
| | - Susan Paudel
- Sydney School of Health Sciences, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
| | - Armando Teixeira-Pinto
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Li-Jung Chen
- Department of Exercise Health Science, "National" Taiwan University of Sport, Taichung 40404, China
| | - Borja Del Pozo Cruz
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense 5230, Denmark
| | - Yun-Ju Lai
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou 54552, China
| | - Andreas Holtermann
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense 5230, Denmark; National Research Centre for the Working Environment, Copenhagen 2100, Denmark
| | - Po-Wen Ku
- Graduate Institute of Sports and Health Management, "National" Chung Hsing University, Taichung 40227, China
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Norris T, Mitchell JJ, Blodgett JM, Hamer M, Pinto Pereira SM. Does cardiorespiratory fitness mediate or moderate the association between mid-life physical activity frequency and cognitive function? findings from the 1958 British birth cohort study. PLoS One 2024; 19:e0295092. [PMID: 38848437 PMCID: PMC11161044 DOI: 10.1371/journal.pone.0295092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 05/23/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Physical activity (PA) is associated with a lower risk of cognitive decline and all-cause dementia in later life. Pathways underpinning this association are unclear but may involve either mediation and/or moderation by cardiorespiratory fitness (CRF). METHODS Data on PA frequency (exposure) at 42y, non-exercise testing CRF (NETCRF, mediator/moderator) at 45y and overall cognitive function (outcome) at 50y were obtained from 9,385 participants (50.8% female) in the 1958 British birth cohort study. We used a four-way decomposition approach to examine the relative contributions of mediation and moderation by NETCRF on the association between PA frequency at 42y and overall cognitive function at 50y. RESULTS In males, the estimated overall effect of 42y PA ≥once per week (vs. CONCLUSION We present the first evidence from a four-way decomposition analysis of the potential contribution that CRF plays in the relationship between mid-life PA frequency and subsequent cognitive function. Our lack of evidence in support of CRF mediating or moderating the PA frequency-cognitive function association suggests that other pathways underpin this association.
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Affiliation(s)
- Tom Norris
- Faculty of Medical Sciences, Institute of Sport, Division of Surgery and Interventional Science, Exercise and Health, UCL, London, United Kingdom
| | - John J. Mitchell
- Faculty of Medical Sciences, Institute of Sport, Division of Surgery and Interventional Science, Exercise and Health, UCL, London, United Kingdom
| | - Joanna M. Blodgett
- Faculty of Medical Sciences, Institute of Sport, Division of Surgery and Interventional Science, Exercise and Health, UCL, London, United Kingdom
| | - Mark Hamer
- Faculty of Medical Sciences, Institute of Sport, Division of Surgery and Interventional Science, Exercise and Health, UCL, London, United Kingdom
| | - Snehal M. Pinto Pereira
- Faculty of Medical Sciences, Institute of Sport, Division of Surgery and Interventional Science, Exercise and Health, UCL, London, United Kingdom
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Gunchick V, Wen W, Jia G, Roberts LR, Koshiol J, Shu XO, Zheng W. Dietary intake, obesity, and physical activity in association with biliary tract cancer risk: Results from meta-analyses of individual-level data from prospective cohort studies of 723,326 adults. Int J Cancer 2024. [PMID: 38847561 DOI: 10.1002/ijc.35048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/03/2024] [Accepted: 05/02/2024] [Indexed: 06/16/2024]
Abstract
Biliary tract cancer (BTC) is a rare and aggressive malignancy with increasing incidence. Most BTC cases are diagnosed with metastatic disease which carries a 5-year survival rate of <5%. Physical activity, diet, and obesity might be associated with BTC risk, but studies have been limited particularly in African descendants. We addressed this knowledge gap by evaluating associations of BTC risk with obesity, physical activity, and dietary intakes in 723,326 adult participants in four cohort studies conducted in China, the United Kingdom, and the United States. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) in each cohort; results were combined using meta-analysis. All cohorts had ≥11 median follow-up years with 839 incident BTC cases combined. BTC risk was positively associated with body mass index (BMI) and waist-to-hip ratio (WHR) whereas physical activity, fruit intake, and fish intake were inversely associated. HR and (95% CI) comparing BMI >35.0 to 18.5-24.9: 1.71 (1.26, 2.31), p-trend <.0001; comparing BMI-adjusted WHR top to bottom quartile: 1.20 (0.94, 1.53), p-trend = .05; comparing ≥15-0 metabolic equivalent task-hours/week 0.76 (0.61, 0.94), p-trend = .009; comparing highest to lowest intake tertile for fruit and fish 0.79 (0.66, 0.95), p-trend = .01; 0.82 (0.68, 0.98), p-trend = .04, respectively. Associations were, in general, similar across ancestry groups. Our study provides strong evidence for important roles of obesity, diet, and physical activity in BTC etiology and stresses the need for lifestyle modification to combat the rising incidence of this fatal malignancy.
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Affiliation(s)
- Valerie Gunchick
- Vanderbilt Epidemiology Center, Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Wanqing Wen
- Vanderbilt Epidemiology Center, Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Guochong Jia
- Vanderbilt Epidemiology Center, Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Lewis R Roberts
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jill Koshiol
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Xiao-Ou Shu
- Vanderbilt Epidemiology Center, Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Wei Zheng
- Vanderbilt Epidemiology Center, Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Langston PK, Mathis D. Immunological regulation of skeletal muscle adaptation to exercise. Cell Metab 2024; 36:1175-1183. [PMID: 38670108 DOI: 10.1016/j.cmet.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/29/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024]
Abstract
Exercise has long been acknowledged for its powerful disease-preventing, health-promoting effects. However, the cellular and molecular mechanisms responsible for the beneficial effects of exercise are not fully understood. Inflammation is a component of the stress response to exercise. Recent work has revealed that such inflammation is not merely a symptom of exertion; rather, it is a key regulator of exercise adaptations, particularly in skeletal muscle. The purpose of this piece is to provide a conceptual framework that we hope will integrate exercise immunology with exercise physiology, muscle biology, and cellular immunology. We start with an overview of early studies in the field of exercise immunology, followed by an exploration of the importance of stromal cells and immunocytes in the maintenance of muscle homeostasis based on studies of experimental muscle injury. Subsequently, we discuss recent advances in our understanding of the functions and physiological relevance of the immune system in exercised muscle. Finally, we highlight a potential immunological basis for the benefits of exercise in musculoskeletal diseases and aging.
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Affiliation(s)
- P Kent Langston
- Department of Immunology, Harvard Medical School, Boston, MA 02115, USA
| | - Diane Mathis
- Department of Immunology, Harvard Medical School, Boston, MA 02115, USA.
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Comer JK, Cueva J, McCafferty L, Silvestre J, Reyes M, Naicker B, Gottlieb M, Schnapp B. How to accomplish mission-driven work for emergency medicine educators. AEM EDUCATION AND TRAINING 2024; 8:e10966. [PMID: 38765711 PMCID: PMC11099796 DOI: 10.1002/aet2.10966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 05/22/2024]
Affiliation(s)
| | - Julie Cueva
- Department of Emergency MedicineMaimonides Medical CenterBrooklynNew YorkUSA
| | - Lauren McCafferty
- Department of Emergency MedicineUniversity Hospitals Cleveland Medical Center, Case Western Reserve UniversityClevelandOhioUSA
| | | | - Miguel Reyes
- Department of Emergency MedicineUniversity of South Carolina School of MedicineGreenvilleSouth CarolinaUSA
| | - Bavani Naicker
- Division of Emergency Medicine, School of Clinical MedicineUniversity of KwaZulu‐NatalDurbanSouth Africa
| | - Michael Gottlieb
- Department of Emergency MedicineRush University Medical CenterChicagoIllinoisUSA
| | - Benjamin Schnapp
- BerbeeWalsh Department of Emergency MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
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Pagès L, Gouin-Barré E, Bourgier C. [Onco'sport testing by patients: Lived experience of patients with cancer practicing adapted physical activity as part of the Onco'sport program, a qualitative study]. Bull Cancer 2024; 111:587-596. [PMID: 38631986 DOI: 10.1016/j.bulcan.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/14/2024] [Accepted: 02/21/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION Physical activity is a major determinant in the prevention of chronic diseases, equally on the side effects of treatments and the consequences of the disease. It improves quality of life, but also reduces morbidity and mortality, and therefore health expenses. A sedentary lifestyle is the fourth cause of premature death in the world, in the context of chronic non-communicable diseases. In France, the prescription for adapted physical activity (APA) has been included in the law since 2016. With the development of "Maisons Sport santé", the Onco'sport program was developed to enable people affected by cancer to participate in adapted physical activity. The objective of our work is to explore the lived experience of cancer patients practicing adapted physical activity as part of the Onco'sport program. METHODS This is a qualitative study of 10 semi-directed individual interviews with patients participating in the Onco'sport program, recruited from the "Maison Sport Santé" from Nîmes and the association "Les Roses du Gard". A phenomenological analysis was carried out with a semiopragmatic approach. RESULTS For all participants, the APA through a program provides professional supervision of Physical Activity, influences adherence and builds confidence. This program is at the origin of changes in lifestyle habits and improves the relationship with illness and their cancer thanks to the physical and psychological benefits felt. Thus, APA appears as a full-fledged supportive care which requires informing patients and promoting it so that access is facilitated and becomes a standard. Health professionals including general practitioners do not currently have an important place in the promotion of APA, and patients most often obtain documentation on their own or through associations of patient. CONCLUSION An APA program like Onco'sport is often the cause of a return to physical activity in patients, brings overall well-being and changes lifestyle habits. It seems important to promote physical activity to patients but also to the general population, given the benefits. This promotion involves easier access to this type of supervised program, financial support and better training of health professionals.
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Affiliation(s)
- Loïc Pagès
- Université de Montpellier, 38, rue Roussy, 30000 Nîmes, France.
| | | | - Céline Bourgier
- Institut régional du cancer Montpellier, 208, avenue des Apothicaires, Parc Euromédecine, 34298 Montpellier cedex 5, France
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Okamura T, Tsukamoto K, Arai H, Fujioka Y, Ishigaki Y, Koba S, Ohmura H, Shoji T, Yokote K, Yoshida H, Yoshida M, Deguchi J, Dobashi K, Fujiyoshi A, Hamaguchi H, Hara M, Harada-Shiba M, Hirata T, Iida M, Ikeda Y, Ishibashi S, Kanda H, Kihara S, Kitagawa K, Kodama S, Koseki M, Maezawa Y, Masuda D, Miida T, Miyamoto Y, Nishimura R, Node K, Noguchi M, Ohishi M, Saito I, Sawada S, Sone H, Takemoto M, Wakatsuki A, Yanai H. Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022. J Atheroscler Thromb 2024; 31:641-853. [PMID: 38123343 DOI: 10.5551/jat.gl2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- Tomonori Okamura
- Preventive Medicine and Public Health, Keio University School of Medicine
| | | | | | - Yoshio Fujioka
- Faculty of Nutrition, Division of Clinical Nutrition, Kobe Gakuin University
| | - Yasushi Ishigaki
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Hirotoshi Ohmura
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Tetsuo Shoji
- Department of Vascular Medicine, Osaka Metropolitan University Graduate school of Medicine
| | - Koutaro Yokote
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Hiroshi Yoshida
- Department of Laboratory Medicine, The Jikei University Kashiwa Hospital
| | | | - Juno Deguchi
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University
| | - Kazushige Dobashi
- Department of Pediatrics, School of Medicine, University of Yamanashi
| | | | | | - Masumi Hara
- Department of Internal Medicine, Mizonokuchi Hospital, Teikyo University School of Medicine
| | - Mariko Harada-Shiba
- Cardiovascular Center, Osaka Medical and Pharmaceutical University
- Department of Molecular Pathogenesis, National Cerebral and Cardiovascular Center Research Institute
| | - Takumi Hirata
- Institute for Clinical and Translational Science, Nara Medical University
| | - Mami Iida
- Department of Internal Medicine and Cardiology, Gifu Prefectural General Medical Center
| | - Yoshiyuki Ikeda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Shun Ishibashi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University, School of Medicine
- Current affiliation: Ishibashi Diabetes and Endocrine Clinic
| | - Hideyuki Kanda
- Department of Public Health, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
| | - Shinji Kihara
- Medical Laboratory Science and Technology, Division of Health Sciences, Osaka University graduate School of medicine
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University Hospital
| | - Satoru Kodama
- Department of Prevention of Noncommunicable Diseases and Promotion of Health Checkup, Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine
| | - Masahiro Koseki
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Yoshiro Maezawa
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Daisaku Masuda
- Department of Cardiology, Center for Innovative Medicine and Therapeutics, Dementia Care Center, Doctor's Support Center, Health Care Center, Rinku General Medical Center
| | - Takashi Miida
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine
| | | | - Rimei Nishimura
- Department of Diabetes, Metabolism and Endocrinology, The Jikei University School of Medicine
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Midori Noguchi
- Division of Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University
| | - Shojiro Sawada
- Division of Metabolism and Diabetes, Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Hirohito Sone
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine
| | - Minoru Takemoto
- Department of Diabetes, Metabolism and Endocrinology, International University of Health and Welfare
| | | | - Hidekatsu Yanai
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Kohnodai Hospital
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Wu P, Guo Q, Zhao Y, Bian M, Cao S, Zhang J(J, Duan X. Emerging concern on air pollution and health: Trade-off between air pollution exposure and physical activity. ECO-ENVIRONMENT & HEALTH 2024; 3:202-207. [PMID: 38655004 PMCID: PMC11035044 DOI: 10.1016/j.eehl.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 12/31/2023] [Accepted: 01/25/2024] [Indexed: 04/26/2024]
Abstract
Air pollution is a major contributor to the global disease burden, especially affecting respiratory and cardiovascular health. However, physical activity is associated with improved lung function, a slower decline in lung function, and lower mortality. The public is more likely to be exposed to air pollution during outdoor physical activity. However, studies on how long-term and short-term exposure to air pollution interacts with physical activity yield inconsistent results, and the thresholds for air pollution and physical activity remain unclear. Thus, more studies are needed to provide sufficient evidence to guide the public to safely engage in outdoor physical activity when exposed to air pollution.
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Affiliation(s)
- Pengpeng Wu
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Qian Guo
- China North Artificial Intelligence & Innovation Research Institute, Beiing 100072, China
- Collective Intelligence & Collaboration Laboratory, Beijing 100072, China
| | - Yuchen Zhao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Mengyao Bian
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Suzhen Cao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Junfeng (Jim) Zhang
- Nicholas School of the Environment and Global Health Institute, Duke University, Durham, NC 27708, USA
- Duke Kunshan University, Kunshan 215316, China
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
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11
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Bondar G, Mahapatra AD, Bao TM, Silacheva I, Hairapetian A, Vu T, Su S, Katappagari A, Galan L, Chandran J, Adamov R, Mancusi L, Lai I, Rahman A, Grogan T, Hsu JJ, Cappelletti M, Ping P, Elashoff D, Reed EF, Deng MC. An Exercise Immune Fitness Test to Unravel Disease Mechanisms-A Proof-of-Concept Heart Failure Study. J Clin Med 2024; 13:3200. [PMID: 38892912 PMCID: PMC11172881 DOI: 10.3390/jcm13113200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Background: Cardiorespiratory fitness positively correlates with longevity and immune health. Regular exercise may provide health benefits by reducing systemic inflammation. In chronic disease conditions, such as chronic heart failure and chronic fatigue syndrome, mechanistic links have been postulated between inflammation, muscle weakness, frailty, catabolic/anabolic imbalance, and aberrant chronic activation of immunity with monocyte upregulation. We hypothesize that (1) temporal changes in transcriptome profiles of peripheral blood mononuclear cells during strenuous acute bouts of exercise using cardiopulmonary exercise testing are present in adult subjects, (2) these temporal dynamic changes are different between healthy persons and heart failure patients and correlate with clinical exercise-parameters and (3) they portend prognostic information. Methods: In total, 16 Heart Failure (HF) patients and 4 healthy volunteers (HV) were included in our proof-of-concept study. All participants underwent upright bicycle cardiopulmonary exercise testing. Blood samples were collected at three time points (TP) (TP1: 30 min before, TP2: peak exercise, TP3: 1 h after peak exercise). We divided 20 participants into 3 clinically relevant groups of cardiorespiratory fitness, defined by peak VO2: HV (n = 4, VO2 ≥ 22 mL/kg/min), mild HF (HF1) (n = 7, 14 < VO2 < 22 mL/kg/min), and severe HF (HF2) (n = 9, VO2 ≤ 14 mL/kg/min). Results: Based on the statistical analysis with 20-100% restriction, FDR correction (p-value 0.05) and 2.0-fold change across the three time points (TP1, TP2, TP3) criteria, we obtained 11 differentially expressed genes (DEG). Out of these 11 genes, the median Gene Expression Profile value decreased from TP1 to TP2 in 10 genes. The only gene that did not follow this pattern was CCDC181. By performing 1-way ANOVA, we identified 8/11 genes in each of the two groups (HV versus HF) while 5 of the genes (TTC34, TMEM119, C19orf33, ID1, TKTL2) overlapped between the two groups. We found 265 genes which are differentially expressed between those who survived and those who died. Conclusions: From our proof-of-concept heart failure study, we conclude that gene expression correlates with VO2 peak in both healthy individuals and HF patients, potentially by regulating various physiological processes involved in oxygen uptake and utilization during exercise. Multi-omics profiling may help identify novel biomarkers for assessing exercise capacity and prognosis in HF patients, as well as potential targets for therapeutic intervention to improve VO2 peak and quality of life. We anticipate that our results will provide a novel metric for classifying immune health.
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Affiliation(s)
- Galyna Bondar
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | | | - Tra-Mi Bao
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | - Irina Silacheva
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | - Adrian Hairapetian
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | - Thomas Vu
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | - Stephanie Su
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | - Ananya Katappagari
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | - Liana Galan
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | - Joshua Chandran
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | - Ruben Adamov
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | - Lorenzo Mancusi
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | - Isabel Lai
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | - Anca Rahman
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | - Tristan Grogan
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | - Jeffrey J. Hsu
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | - Monica Cappelletti
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | - Peipei Ping
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | - David Elashoff
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | - Elaine F. Reed
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
| | - Mario C. Deng
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, CA 90095, USA; (G.B.); (T.-M.B.); (I.S.); (A.H.); (T.V.); (S.S.); (A.K.); (L.G.); (J.C.); (R.A.); (L.M.); (I.L.); (A.R.); (T.G.); (J.J.H.); (M.C.); (P.P.); (D.E.); (E.F.R.)
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12
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Hetland RA, Wilsgaard T, Hopstock LA, Ariansen I, Johansson J, Jacobsen BK, Grimsgaard S. Social inequality in prevalence of NCD risk factors: a cross-sectional analysis from the population-based Tromsø Study 2015-2016. BMJ Open 2024; 14:e080611. [PMID: 38688673 PMCID: PMC11086291 DOI: 10.1136/bmjopen-2023-080611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 03/22/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVE We aimed to examine associations between educational level, serving as an indicator of socioeconomic position, and prevalence of WHO-established leading behavioural and biological risk factors for non-communicable diseases (NCDs), in middle-aged to older women and men. DESIGN Population-based cross-sectional study. SETTING All inhabitants of the municipality of Tromsø, Norway, aged ≥40 years, were invited to the seventh survey (2015-2016) of the Tromsø Study; an ongoing population-based cohort study. PARTICIPANTS Of the 32 591 invited; 65% attended, and a total of 21 069 women (53%) and men aged 40-99 years were included in our study. OUTCOME MEASURES We assessed associations between educational level and NCD behavioural and biological risk factors: daily smoking, physical inactivity (sedentary in leisure time), insufficient fruit/vegetable intake (<5 units/day), harmful alcohol use (>10 g/day in women, >20 g/day in men), hypertension, obesity, intermediate hyperglycaemia and hypercholesterolaemia. These were expressed as odds ratios (OR) per unit decrease in educational level, with 95% CIs, in women and men. RESULTS In women (results were not significantly different in men), we observed statistically significant associations between lower educational levels and higher odds of daily smoking (OR 1.69; 95% CI 1.60 to 1.78), physical inactivity (OR 1.38; 95% CI 1.31 to 1.46), insufficient fruit/vegetable intake (OR 1.54, 95% CI 1.43 to 1.66), hypertension (OR 1.25; 95% CI 1.20 to 1.30), obesity (OR 1.23; 95% CI 1.18 to 1.29), intermediate hyperglycaemia (OR 1.12; 95% CI 1.06 to 1.19), and hypercholesterolaemia (OR 1.07; 95% CI 1.03 to 1.12), and lower odds of harmful alcohol use (OR 0.75; 95% CI 0.72 to 0.78). CONCLUSION We found statistically significant educational gradients in women and men for all WHO-established leading NCD risk factors within a Nordic middle-aged to older general population. The prevalence of all risk factors increased at lower educational levels, except for harmful alcohol use, which increased at higher educational levels.
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Affiliation(s)
- Rebecca A Hetland
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Inger Ariansen
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Jonas Johansson
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bjarne K Jacobsen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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13
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Wang CC, Grubbs A, Foley OW, Bharadwa S, Vega B, Bilimoria K, Barber EL. The activity advantage: Objective measurement of preoperative activity is associated with postoperative recovery and outcomes in patients undergoing surgery with gynecologic oncologists. Gynecol Oncol 2024; 186:137-143. [PMID: 38669768 DOI: 10.1016/j.ygyno.2024.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/03/2024] [Accepted: 04/20/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVE To examine the association between objectively-measured preoperative physical activity with postoperative outcomes and recovery milestones in patients undergoing gynecologic oncology surgeries. METHODS Prospective cohort study of patients undergoing surgery with gynecologic oncologists who wore wearable actigraphy rings before and after surgery from 03/2021-11/2023. Exposures encompassed preoperative activity intensity (moderate- and vigorous-intensity metabolic equivalent of task-minutes [MAVI MET-mins] over seven days) and level (average daily steps over seven days). Intensity was categorized as <500, 500-1000, and >1000 MAVI MET-mins; level categorized as <8000 and ≥8000 steps/day. Primary outcome was 30-day complications. Secondary outcomes included reaching postoperative goal (≥70% of recommended preoperative intensity and level thresholds) and return to baseline (≥70% of individual preoperative intensity and level). RESULTS Among 96 enrolled, 87 met inclusion criteria, which constituted 39% (n = 34) with <500 MET-mins and 56.3% (n = 49) with <8000 steps preoperatively. Those with <500 MET-mins and <8000 steps had higher ECOG scores (p = 0.042 & 0.037) and BMI (p = 0.049 & 0.002) vs those with higher activity; all other perioperative characteristics were similar between groups. Overall, 29.9% experienced a 30-day complication, 29.9% reached postoperative goal, and 64.4% returned to baseline. On multivariable models, higher activity was associated with lower odds of complications: 500-1000 MET-mins (OR = 0.26,95%CI = 0.07-0.92) and >1000 MET-mins (OR = 0.25,95%CI = 0.07-0.94) vs <500 MET-mins; ≥8000 steps (OR = 0.25,95%CI = 0.08-0.73) vs <8000 steps. Higher preoperative activity was associated fewer days to reach postoperative goal. CONCLUSION Patients with high preoperative activity are associated with fewer postoperative complications and faster attainment of recovery milestones. Physical activity may be considered a modifiable risk factor for adverse postoperative outcomes.
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Affiliation(s)
- Connor C Wang
- Northwestern University Feinberg School of Medicine, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chicago, IL, USA.
| | - Allison Grubbs
- Rush University School of Medicine, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chicago, IL, USA
| | - Olivia W Foley
- Northwestern University Feinberg School of Medicine, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chicago, IL, USA
| | - Sonya Bharadwa
- Northwestern University Feinberg School of Medicine, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chicago, IL, USA
| | - Brenda Vega
- Northwestern University Feinberg School of Medicine, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chicago, IL, USA
| | - Karl Bilimoria
- Indiana University School of Medicine, Division of Surgical Oncology, Department of Surgery, Indianapolis, IN, USA
| | - Emma L Barber
- Northwestern University Feinberg School of Medicine, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chicago, IL, USA
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14
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Seino S, Abe T, Nofuji Y, Hata T, Shinkai S, Kitamura A, Fujiwara Y. Dose-response associations between physical activity and sedentary time with functional disability in older adults with or without frailty: a prospective cohort study. Front Public Health 2024; 12:1357618. [PMID: 38721536 PMCID: PMC11076770 DOI: 10.3389/fpubh.2024.1357618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/02/2024] [Indexed: 05/14/2024] Open
Abstract
Purpose Evidence regarding the dose-response curve shapes of physical activity (PA) and sedentary time (ST) in older adults with functional disability (FD) is extremely limited. Moreover, these associations may differ depending on with/without frailty. We examined the dose-response associations between moderate-to-vigorous PA (MVPA) and ST with FD among older adults with/without frailty. Methods We included 7,480 initially nondisabled adults (3,795 men and 3,685 women) aged 65-84 years in Ota City, Tokyo, Japan. MVPA and ST were evaluated using the International Physical Activity Questionnaire-Short Form. FD was prospectively identified using a nationally unified database of the long-term care insurance system. Frailty was determined using Check-List 15, validated against Fried's frailty criteria. Multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of MVPA and ST for FD were calculated, and dose-response curves were examined using restricted cubic splines. Results During 3.6 years of follow-up, 1,001 (13.4%) participants had FD. Among all participants, compared with no MVPA, the HRs for FD reduced linearly up to approximately 2000 metabolic equivalents (METs)■min/week of MVPA, and the lowest HR (HR: 0.61, 95% CI: 0.51-0.74) was reached at around 3,000-4,000 METs■min/week. Although the shape of this association was consistent regardless of with/without frailty, the magnitude of the association tended to be stronger in frail older adults than in non-frail older adults. Compared with those for the median (300 min/day) of ST, the HRs for FD increased linearly as ST reached approximately 600 min/day or more, independent of MVPA, with a maximum HR of 1.31 (95% CI: 1.01-1.71) for 1,080 min/day among all participants. This association was more pronounced among non-frail older adults but not statistically significant among frail older adults. Conclusion Higher MVPA levels consistently reduced the incidence of FD regardless of frailty in a significant inverse nonlinear dose-response manner. A significant positive nonlinear dose-response association between ST and FD risk was identified among non-frail older adults but not among frail older adults. Increasing MVPA and reducing prolonged ST are important for preventing FD among non-frail older adults. However, reducing ST alone may be insufficient; increasing MVPA, even if by only small increments, is highly recommended for frail older adults.
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Affiliation(s)
- Satoshi Seino
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Takumi Abe
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Yu Nofuji
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Toshiki Hata
- The Tokyo Metropolitan Support Center for Preventative Long-term and Frail Elderly Care, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Shoji Shinkai
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
- Department of Nutrition Sciences, Kagawa Nutrition University, Sakado, Saitama, Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
- Health Town Development Science Center, Yao City Public Health Center, Yao City, Osaka, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
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15
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Turoń-Skrzypińska A, Mińko A, Rył A, Mańkowska K, Ciechanowski K, Bereda Z, Rotter I, Dutkiewicz G. Impact of Effectiveness of Physical Activity in a Virtual Environment on the Regulation of Sclerostin and Interleukin 6 Levels in Haemodialysis Patients. J Clin Med 2024; 13:2321. [PMID: 38673595 PMCID: PMC11051331 DOI: 10.3390/jcm13082321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Chronic kidney disease is a significant public health issue associated with reduced physical activity. This can lead to mineral and bone disorders and increased levels of inflammatory markers. One innovative solution that can significantly contribute to increasing patient motivation is the combination of physical training with virtual reality technology during haemodialysis sessions. The aim of this study is to comprehensively assess the impact of regular virtual reality-based physical activity on plasma sclerostin and interleukin 6 levels, as well as on physical performance and the level of physical activity in patients undergoing renal replacement therapy through haemodialysis. Methods: This study is a prospective cohort study. Patients included in the study were randomly assigned to two groups: the study group and the control group. The study group consisted of patients who were entrusted with the task of conducting training using the prototype of the NefroVR system. The duration of the study period for both the study and control groups was 3 months. Results: One hundred and two (102) patients with stage 5 chronic kidney disease who underwent haemodialysis as a renal replacement therapy participated in the study. Patients from the study group were characterized by higher physical activity compared to the control group. There was a significant difference in the level of IL-6 and SOST between the study and control groups in the second measurement. Conclusions: Regular physical activity, especially using approaches such as virtual reality, contributes to improving physical fitness and overall activity levels in patients undergoing haemodialysis. The study demonstrated that regular exercise may be associated with a reduction in inflammatory parameters and positive effects on bone metabolism in patients undergoing haemodialysis.
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Affiliation(s)
- Agnieszka Turoń-Skrzypińska
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland; (A.T.-S.); (A.R.); (Z.B.); (I.R.)
| | - Alicja Mińko
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland; (A.T.-S.); (A.R.); (Z.B.); (I.R.)
| | - Aleksandra Rył
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland; (A.T.-S.); (A.R.); (Z.B.); (I.R.)
| | - Katarzyna Mańkowska
- Department of Microbiology, Immunology and Laboratory Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland;
| | - Kazimierz Ciechanowski
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland; (K.C.); (G.D.)
| | - Zuzanna Bereda
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland; (A.T.-S.); (A.R.); (Z.B.); (I.R.)
| | - Iwona Rotter
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland; (A.T.-S.); (A.R.); (Z.B.); (I.R.)
| | - Grażyna Dutkiewicz
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland; (K.C.); (G.D.)
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16
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Brinkley A, Sandercock G, Lowry R, Freeman P. What determines participation in sport for older adults in England: A multilevel analysis of Active Lives data. PLoS One 2024; 19:e0301790. [PMID: 38574011 PMCID: PMC10994306 DOI: 10.1371/journal.pone.0301790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 03/21/2024] [Indexed: 04/06/2024] Open
Abstract
Physical inactivity within an ageing population is an ongoing public health concern for policymakers. Engagement in sport forms a foundation of policy designed to encourage physical activity participation and improve health and wellbeing. This study aimed to (i) understand the extent to which older adults participate in sport and the (ii) correlates that predict this involvement within an English population sample of older adults. A further aim was (iii) to examine the extent in which sports participation may vary due to the opportunity provided across Active Partnerships in England. To address this, a multi-level analysis framed through COM-B was conducted of the 2021 English Active Lives dataset (i.e., during the COVID-19 pandemic). The Active Lives survey provides population-level insight into sport, exercise, and physical activity participation across England. It samples upwards of n = 180,000 participants beyond the age of 16 years and asks questions on factors that influence participation. Our findings drawn from a sample of n = 68,808 older adults (i.e., >60-years of age) indicate that when accounting for variation across regions sports participation was significantly predicted by age (β = -.246, p = .040) and multiple deprivation (β = .706, p = .030). Further, our analysis suggests sports participation across regions is associated with changes in the perceptions of opportunity to participate (β = -28.70, p = .001). As the UK transitions from the COVID-19 pandemic, findings have implications for the promotion of sports participation for older adults, in that local, regional, and national stakeholders must do more to change perceptions of social and physical opportunity within an ageing population. This may be achieved through adaptations to the recreational sporting landscape, raising awareness, and supportive policy changes on a national level.
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Affiliation(s)
- Andrew Brinkley
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Essex, United Kingdom
| | - Gavin Sandercock
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Essex, United Kingdom
| | - Ruth Lowry
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Essex, United Kingdom
| | - Paul Freeman
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Essex, United Kingdom
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17
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Johansson LM, Fransson EI, Lingfors H, Golsäter M. Exploring how people achieve recommended levels of physical activity, despite self-reported economic difficulties: a sense of coherence perspective. BMC PRIMARY CARE 2024; 25:105. [PMID: 38575903 PMCID: PMC10993487 DOI: 10.1186/s12875-024-02354-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/27/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND The salutogenic theory forms the basis for health promotion and describes health as a continuum from a dis-ease pole of health to an ease pole. The core concept for the salutogenic theory is sense of coherence (SOC). For a strong SOC, general resistance resources, such as solid economic situation, are essential. The aim was to explore how people - despite self-reported economic difficulties - comprehend, manage and find it meaningful to achieve the level of physical activity recommended by World Health Organisation (WHO). METHOD The study is based on interviews with people achieving the recommended physical activity (PA) level despite economic difficulties. The interviews were conducted at primary health care centres and family centres after a targeted health dialogue. We used a qualitative deductive content analysis based on sense of coherence as the main category, with the three generic categories of comprehensibility, manageability and meaningfulness. RESULT The findings elucidate a pattern of a process. In this process, the participants comprehend their knowledge of the health benefits of PA and have a plan for performing their PA. They utilise their resources in order to manage to apply their knowledge and plan for PA in their lives despite their challenges. When PA becomes meaningful to them, they have an intrinsic motivation to perform it and experience its benefits. CONCLUSION This study suggests a possible process that might help in achieving the recommended PA level among people with economic difficulties and other challenges. The findings might be used in health promotion work, such as targeted health dialogues in primary health care, to reduce health inequalities when supporting people who are not achieving the recommended levels of PA. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Lisbeth M Johansson
- Unit for Research and Development in Primary Care, Futurum - Academy for Health and Care, Region Jönköping County, Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Box 1026, Jönköping, 551 11, Sweden.
| | - Eleonor I Fransson
- School of Health and Welfare, Jönköping University, Box 1026, Jönköping, 551 11, Sweden
| | - Hans Lingfors
- Unit for Research and Development in Primary Care, Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden
| | - Marie Golsäter
- Child Research Group, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Child Health Service and Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden
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18
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Bakker EA, Aengevaeren VL, Lee DC, Thompson PD, Eijsvogels TMH. All-cause mortality risks among participants in mass-participation sporting events. Br J Sports Med 2024; 58:421-426. [PMID: 38316539 DOI: 10.1136/bjsports-2023-107190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVES Exercise transiently increases the risk for sudden death, whereas long-term exercise promotes longevity. This study assessed acute and intermediate-term mortality risks of participants in mass-participation sporting events. METHODS Data of participants in Dutch running, cycling and walking events were collected between 1995 and 2017. Survival status was obtained from the Dutch Population Register. A time-stratified, case-crossover design examined if deceased participants more frequently participated in mass-participation sporting events 0-7 days before death compared with the reference period (14-21 days before death). Mortality risks during follow-up were compared between participants and non-participants from the general population using Cox regression. RESULTS 546 876 participants (median (IQR) age 41 (31-50) years, 56% male, 72% runners) and 211 592 non-participants (41 (31-50) years, 67% male) were included. In total, 4625 participants died of which more participants had partaken in a sporting event 0-7 days before death (n=23) compared with the reference period (n=12), and the mortality risk associated with acute exercise was greater but did not reach statistical significance (OR 1.92; 95% CI 0.95 to 3.85). During 3.3 (1.1-7.4) years of follow-up, participants had a 30% lower risk of death (HR 0.70; 95% CI 0.67 to 0.74) compared with non-participants after adjustment for age and sex. Runners (HR 0.65; 95% CI 0.62 to 0.69) and cyclists (HR 0.70; 95% CI 0.64 to 0.77) had the best survival during follow-up followed by walkers (HR 0.88; 95% CI 0.80 to 0.94). CONCLUSION Participating in mass-participation sporting events was associated with a non-significant increased odds (1.92) of mortality and a low absolute event rate (4.2/100 000 participants) within 7 days post-event, whereas a 30% lower risk of death was observed compared with non-participants during 3.3 years of follow-up. These results suggest that the health benefits of mass sporting event participation outweigh potential risks.
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Affiliation(s)
- Esmée A Bakker
- Department of Medical BioSciences (Exercise Physiology Group), Radboud University Medical Center, Nijmegen, Netherlands
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Vincent L Aengevaeren
- Department of Medical BioSciences (Exercise Physiology Group), Radboud University Medical Center, Nijmegen, Netherlands
| | | | | | - Thijs M H Eijsvogels
- Department of Medical BioSciences (Exercise Physiology Group), Radboud University Medical Center, Nijmegen, Netherlands
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19
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Brar R, Whitlock RH, Katz A, Di Nella M, Komenda P, Bohm C, Rigatto C, Tangri N, Solmundson C, Collister D. Impact of a Medical Fitness Model on Incident Major Adverse Cardiovascular Events: A Prospective Cohort Study of 11 000 Members. J Am Heart Assoc 2024; 13:e030028. [PMID: 38533967 PMCID: PMC11179749 DOI: 10.1161/jaha.123.030028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 02/27/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Cardiovascular disease remains the leading cause of disease burden and death in the world. The medical fitness model may be an alternative public health strategy to address cardiovascular risk factors with medical integrated programming. METHODS AND RESULTS We performed a retrospective cohort study between January 1, 2005, and December 31, 2015. Adults (aged ≥18 years) who did not have a prior major adverse cardiovascular event were included. Controls were assigned a pseudo-index date at random on the basis of the frequency distribution of start dates in the medical fitness facility group. Multivariate Cox proportional hazards regression models were adjusted for age, sex, socioeconomic status, comorbidities, and year of index date. We stratified the medical fitness facility group into low-frequency attenders (≤1 weekly visit) and regular-frequency attenders (>1 weekly visit). Our primary outcome was a hospitalization for nonfatal myocardial infarction and stroke, heart failure, or cardiovascular death. We included 11 319 medical fitness facility members and 507 400 controls in our study. Compared with controls, members had a lower hazard risk of a major adverse cardiovascular event-plus (hazard ratio [HR], 0.88 [95% CI, 0.81-0.96]). Higher weekly attendance was associated with a lower hazard risk of a major adverse cardiovascular event-plus compared with controls, but the effect was not significant for lower weekly attendance (low-frequency attenders: HR, 0.94 [95% CI, 0.85-1.04]; regular-frequency attenders: HR, 0.77 [95% CI, 0.67-0.89]). CONCLUSIONS Medical fitness facility membership and attendance at least once per week may lower the risk of a major adverse cardiovascular event-plus. The medical fitness model should be considered as a public health intervention, especially for individuals at risk for cardiovascular disease.
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Affiliation(s)
- Ranveer Brar
- Department of Community Health Sciences, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Chronic Disease Innovation CentreSeven Oaks General HospitalWinnipegManitobaCanada
| | - Reid H. Whitlock
- Chronic Disease Innovation CentreSeven Oaks General HospitalWinnipegManitobaCanada
| | - Alan Katz
- Department of Community Health Sciences, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Department of Family Medicine, Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
| | - Michelle Di Nella
- Chronic Disease Innovation CentreSeven Oaks General HospitalWinnipegManitobaCanada
| | - Paul Komenda
- Department of Community Health Sciences, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Chronic Disease Innovation CentreSeven Oaks General HospitalWinnipegManitobaCanada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
| | - Clara Bohm
- Department of Community Health Sciences, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Chronic Disease Innovation CentreSeven Oaks General HospitalWinnipegManitobaCanada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
| | - Claudio Rigatto
- Department of Community Health Sciences, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Chronic Disease Innovation CentreSeven Oaks General HospitalWinnipegManitobaCanada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
| | - Navdeep Tangri
- Department of Community Health Sciences, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Chronic Disease Innovation CentreSeven Oaks General HospitalWinnipegManitobaCanada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
| | - Carrie Solmundson
- Chronic Disease Innovation CentreSeven Oaks General HospitalWinnipegManitobaCanada
- Wellness InstituteWinnipegManitobaCanada
| | - David Collister
- Chronic Disease Innovation CentreSeven Oaks General HospitalWinnipegManitobaCanada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Department of Medicine, Faculty of Medicine & DentistryUniversity of AlbertaEdmontonAlbertaCanada
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20
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Harada K, Masumoto K, Okada S. Between- and Within-Couple Concordance for Health Behaviors Among Japanese Older Married Couples: Examining the Moderating Role of Working Time. Int J Behav Med 2024; 31:215-228. [PMID: 36991277 DOI: 10.1007/s12529-023-10174-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Although previous studies report spousal concordance for health behaviors at between-couple levels, concordance at within-couple levels remains unconfirmed. To clarify the behavioral mechanisms of spousal concordance for health behaviors among older couples at both levels, it is necessary to examine the moderators (effect modifiers) of spousal concordance. This study examined (1) whether spousal concordance for dietary variety, exercise behavior, and TV viewing behavior was observed at both the between-couple and the within-couple levels and (2) whether this spousal concordance was moderated by working time among older Japanese couples. METHOD This study analyzed data obtained from a questionnaire-based, three-wave longitudinal survey (baseline, 1-year follow-up, 3-year follow-up) among 210 Japanese older couples. Each spouse's dietary variety, exercise time, TV viewing time, the couple's working time, and demographic factors were investigated by multi-level analyses. RESULTS One spouse's dietary variety and TV viewing time, but not exercise time, were significantly associated with the other spouse's corresponding behaviors at both levels. The regressions of the wife's TV viewing time on the husband's TV viewing time were moderated by working time at the within-couple level; the regressive effects of wife's TV viewing time on husband's TV viewing time were more relevant as working time was lower. CONCLUSION This study found that spousal concordance for dietary variety and TV viewing was observed at within-couple and between-couple levels among older Japanese couples. In addition, shorter working time partly moderates the wife's influence on the husband's TV viewing among older couples at the within-couple level.
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Affiliation(s)
- Kazuhiro Harada
- Active Aging Research Hub, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, 657-8501, Japan.
| | - Kouhei Masumoto
- Active Aging Research Hub, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, 657-8501, Japan
| | - Shuichi Okada
- Active Aging Research Hub, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, 657-8501, Japan
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21
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Moore AZ, Simonsick EM, Landman B, Schrack J, Wanigatunga AA, Ferrucci L. Correlates of life course physical activity in participants of the Baltimore longitudinal study of aging. Aging Cell 2024; 23:e14078. [PMID: 38226778 PMCID: PMC11019133 DOI: 10.1111/acel.14078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/17/2024] Open
Abstract
Physical activity is consistently associated with better health and longer life spans. However, the extent to which length and intensity of exercise across the life course impact health outcomes relative to current activity is undefined. Participants of the Baltimore Longitudinal Study of Aging were asked to categorize their level of physical activity in each decade of life from adolescence to the current decade. In linear mixed effects models, self-reported past levels of physical activity were significantly associated with activity assessed at study visits in the corresponding decade of life either by questionnaire or accelerometry. A pattern of life course physical activity (LCPA) derived by ranking participants on reported activity intensity across multiple decades was consistent with the trajectories of activity estimated from standard physical activity questionnaires assessed at prior study visits. In multivariable linear regression models LCPA was associated with clinical characteristics, measures of body composition and indicators of physical performance independent of current physical activity. After adjustment for minutes of high intensity exercise, LCPA remained significantly associated with peak VO2, fasting glucose, thigh muscle area and density, abdominal subcutaneous fat, usual gait speed, lower extremity performance, and multimorbidity (all p < 0.01) at the index visit. The observed associations suggest that an estimate of physical activity across decades provides complementary information to information on current activity and reemphasizes the importance of consistently engaging in physical activity over the life course.
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Affiliation(s)
- Ann Zenobia Moore
- Translational Gerontology Branch, Intramural Research ProgramNational Institute on AgingBaltimoreMarylandUSA
| | - Eleanor M. Simonsick
- Translational Gerontology Branch, Intramural Research ProgramNational Institute on AgingBaltimoreMarylandUSA
| | - Bennett Landman
- Department of Electrical and Computer EngineeringVanderbilt UniversityNashvilleTennesseeUSA
| | - Jennifer Schrack
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Center on Aging and HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Amal A. Wanigatunga
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Center on Aging and HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Luigi Ferrucci
- Translational Gerontology Branch, Intramural Research ProgramNational Institute on AgingBaltimoreMarylandUSA
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22
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Peng W, Bai X, Wu C, Zhang H, Li X, Lu J. Sociodemographic Factors, Leisure-Time Physical Activity and Mortality. Am J Prev Med 2024; 66:598-608. [PMID: 37972796 DOI: 10.1016/j.amepre.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 11/03/2023] [Accepted: 11/05/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Exploring sociodemographic effect modification is important to provide evidence for developing targeted recommendations and reducing health inequalities. This study evaluated how sociodemographic factors including age, sex, race/ethnicity and socioeconomic status (SES) modify the association between leisure-time physical activity (LTPA) and all-cause and major cause-specific mortality. METHODS The study sample included 471,992 people from the 1997-2018 National Health Interview Survey (NHIS) and 41,830 people from the 1999-2018 National Health and Nutrition Examination Survey (NHANES). Data were analyzed in December 2022. Mortality data from the National Death Index were available to December 31, 2019. Sufficient LTPA was defined as at least 150 minutes of moderate and/or vigorous intensity per week. RESULTS There were 46,289 deaths in NHIS participants and 4,617 deaths in NHANES participants during a mean follow-up of 10 years. Individuals with sufficient LTPA had lower risk of all-cause (NHIS: hazard ratio, 0.74, 95% CI: [0.74-0.74]; NHANES: 0.73 [0.68-0.79]) and cardiovascular mortality (NHIS: 0.75 [0.75-0.75]; NHANES: 0.80 [0.69-0.93]) compared with inactive participants. The subgroup analysis showed significant interactions between LTPA and all sociodemographic factors. Associations between LTPA and mortality were weaker among younger individuals, males, Hispanic adults or those of low SES, respectively. CONCLUSIONS Sociodemographic factors significantly modified the associations between LTPA and mortality. The health benefits of sufficient LTPA were smaller in younger individuals, males, Hispanic adults or those of low SES. These findings can help identify target populations for promotion of physical activity to reduce health inequalities and the development of physical activity guidelines.
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Affiliation(s)
- Wenyao Peng
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xueke Bai
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chaoqun Wu
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haibo Zhang
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xi Li
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, China; Central China Sub-Center of the National Center for Cardiovascular Diseases, Zhengzhou, China
| | - Jiapeng Lu
- National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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23
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Fiuza-Luces C, Valenzuela PL, Gálvez BG, Ramírez M, López-Soto A, Simpson RJ, Lucia A. The effect of physical exercise on anticancer immunity. Nat Rev Immunol 2024; 24:282-293. [PMID: 37794239 DOI: 10.1038/s41577-023-00943-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/06/2023]
Abstract
Regular physical activity is associated with lower cancer incidence and mortality, as well as with a lower rate of tumour recurrence. The epidemiological evidence is supported by preclinical studies in animal models showing that regular exercise delays the progression of cancer, including highly aggressive malignancies. Although the mechanisms underlying the antitumorigenic effects of exercise remain to be defined, an improvement in cancer immunosurveillance is likely important, with different immune cell subtypes stimulated by exercise to infiltrate tumours. There is also evidence that immune cells from blood collected after an exercise bout could be used as adoptive cell therapy for cancer. In this Perspective, we address the importance of muscular activity for maintaining a healthy immune system and discuss the effects of a single bout of exercise (that is, 'acute' exercise) and those of 'regular' exercise (that is, repeated bouts) on anticancer immunity, including tumour infiltrates. We also address the postulated mechanisms and the clinical implications of this emerging area of research.
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Affiliation(s)
- Carmen Fiuza-Luces
- Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital 12 de Octubre ('imas12'), Madrid, Spain.
| | - Pedro L Valenzuela
- Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital 12 de Octubre ('imas12'), Madrid, Spain
- Systems Biology Department, Universidad de Alcalá, Alcalá de Henares, Spain
| | - Beatriz G Gálvez
- Physical Activity and Health Research Group ('PaHerg'), Research Institute of the Hospital 12 de Octubre ('imas12'), Madrid, Spain
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Universidad Complutense de Madrid, Madrid, Spain
| | - Manuel Ramírez
- Oncohematology Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
- Biomedical Research Foundation, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
- La Princesa Institute of Heah, Madrid, Spain
| | - Alejandro López-Soto
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Oviedo, Oviedo, Spain.
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Asturias, Spain.
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Asturias, Spain.
| | - Richard J Simpson
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ, USA
- Department of Paediatrics, The University of Arizona, Tucson, AZ, USA
- Department of Immunobiology, The University of Arizona, Tucson, AZ, USA
| | - Alejandro Lucia
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.
- Faculty of Sport Sciences, Universidad Europea, Madrid, Spain.
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O'Donovan G, Petermann-Rocha F, Ferrari G, Lee IM, Hamer M, Stamatakis E, Sarmiento OL, Ibáñez A, Lopez-Jaramillo P. Associations of the 'weekend warrior' physical activity pattern with all-cause, cardiovascular disease and cancer mortality: the Mexico City Prospective Study. Br J Sports Med 2024; 58:359-365. [PMID: 38302280 DOI: 10.1136/bjsports-2023-107612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVES The objective was to investigate the benefits of the 'weekend warrior' physical activity pattern in Latin America, where many people take part in high levels of non-exercise physical activity. METHODS Participants in the Mexico City Prospective Study were surveyed from 1998 to 2004 and resurveyed from 2015 to 2019. Those who exercised up to once or twice per week were termed weekend warriors. Those who exercised more often were termed regularly active. Analyses were adjusted for potential confounders. RESULTS The main analysis included 26 006 deaths in 154 882 adults (67% female) aged 52±13 years followed for 18±4 years (mean±SD). Compared with those who reported no exercise, the HR (95% CI) was 0.88 (0.83 to 0.93) in the weekend warriors and 0.88 (0.84 to 0.91) in the regularly active. Similar results were observed for cardiovascular disease and cancer mortality, but associations were weaker. Stratified analyses showed that substantial reductions in all-cause mortality risk only occurred when the duration of exercise sessions was at least 30-60 min. The repeated-measures analysis included 843 deaths in 10 023 adults followed for 20±2 years. Compared with being inactive or becoming inactive, the HR was 0.86 (95% CI 0.65 to 1.12) when being a weekend warrior or becoming a weekend warrior and 0.85 (95% CI 0.70 to 1.03) when being regularly active or becoming regularly active. CONCLUSIONS This is the first prospective study to investigate the benefits of the weekend warrior physical activity pattern in Latin America. The results suggest that even busy adults could benefit from taking part in one or two sessions of exercise per week.
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Affiliation(s)
- Gary O'Donovan
- Facultad de Medicina, Universidad de los Andes, Bogotá, Colombia
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
- Instituto Masira, Universidad de Santander (UDES), Bucaramanga, Colombia
| | - Fanny Petermann-Rocha
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile
- Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago, Chile
| | - I-Min Lee
- Harvard Medical School, Boston, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
| | - Mark Hamer
- Institute Sport Exercise Health, Division Surgery Interventional Science, University College London, London, UK
| | - Emmanuel Stamatakis
- Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Olga L Sarmiento
- Facultad de Medicina, Universidad de los Andes, Bogotá, Colombia
| | - Agustín Ibáñez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
- Cognitive Neuroscience Center (CNC) and CONICET, Universidad de San Andrés, Buenos Aires, Argentina
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Bühne D, Elling JM, Hetzel C, Alles T. Promoting Return to Work After Vocational Rehabilitation Using a Work-Related Fitness App: Protocol for a Cluster-Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e50200. [PMID: 38498051 PMCID: PMC10985606 DOI: 10.2196/50200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Retraining programs in vocational rehabilitation are often characterized by a low level of physical activity, even when targeting jobs with primarily physical demands. They might therefore be accompanied by a decline in functional capacity if the lack of physical activity is not compensated by increased activity during leisure time. The implementation of a work-related exercise app might be a promising approach to promoting a return to work in vocational rehabilitation. We developed the "WORKout-app" which provides exercise plans based on a comparison of the physical demands of the retraining profession and the current functional capacity. OBJECTIVE The aim of this study is to examine the effects of app-based exercise during vocational rehabilitation on perceived work ability (primary outcome), occupational self-efficacy, days of sick leave, and return to work (secondary outcomes). METHODS We conducted a cluster-randomized controlled trial with 2 arms (intervention: WORKout-app vs control: treatment as usual) in 4 cohorts of 5 vocational rehabilitation centers in Germany. Participants are nested within retraining classes per vocational rehabilitation center and per cohort assigned to either the intervention condition or the control condition. The target sample size at the participant level is 598. Measurement time points include baseline, the end of rehabilitation, 3 months after the end of rehabilitation, and 6 months after the end of rehabilitation. Linear and generalized linear mixed-effects models are performed to test for treatment differences in outcomes. RESULTS This study is funded by the German Federal Pension Insurance. The trial is registered with the German Clinical Trials Register (DRKS00030775) and approved by the Ethics Committee of the German Sport University Cologne (145/2022). CONCLUSIONS The findings of the study will inform researchers and practitioners about the effectiveness of an exercise app developed to counteract the effects of physical inactivity during vocational rehabilitation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/50200.
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Affiliation(s)
- David Bühne
- Institute for Quality Assurance in Prevention and Rehabilitation (IQPR), German Sport University Cologne, Köln, Germany
| | - Jan Mathis Elling
- Institute for Quality Assurance in Prevention and Rehabilitation (IQPR), German Sport University Cologne, Köln, Germany
| | - Christian Hetzel
- Institute for Quality Assurance in Prevention and Rehabilitation (IQPR), German Sport University Cologne, Köln, Germany
| | - Torsten Alles
- Institute for Quality Assurance in Prevention and Rehabilitation (IQPR), German Sport University Cologne, Köln, Germany
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Jackowska B, Wiśniewski P, Noiński T, Bandosz P. Effects of lifestyle-related risk factors on life expectancy: A comprehensive model for use in early prevention of premature mortality from noncommunicable diseases. PLoS One 2024; 19:e0298696. [PMID: 38483876 PMCID: PMC10939220 DOI: 10.1371/journal.pone.0298696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/29/2024] [Indexed: 03/17/2024] Open
Abstract
Morbidity and premature mortality from noncommunicable diseases can be largely prevented by adopting a healthy lifestyle at the earliest possible age. However, tools designed for the early identification of those at risk among young adults are lacking. We developed and validated a multivariable model for the prediction of life expectancy, allowing the early identification of apparently healthy adults at risk of lifestyle-related diseases. We used a cross-sectional approach to calculate life expectancy using data from 38,481 participants of the National Health and Nutrition Examination Survey (1999-2014), aged ≥20 years. A multivariable logistic model was used to quantify the impact of risk factors on mortality. The model included the following lifestyle-related mortality risk factors as predictors: smoking, diet, physical activity, and body mass index. The presence of the following chronic diseases was considered: diabetes, arrhythmia, coronary artery disease, myocardial infarction, stroke, and malignant neoplasms. The model showed a good predictive ability; the area under the receiver operating characteristic curve measure was 0.846 (95% uncertainty interval 0.838-0.859). Life expectancy was determined using the life table method and the period life tables for the US population as the baseline. The results of this model underscore the importance of lifestyle-related risk factors in life expectancy. The difference between life expectancy for 30-year-old individuals with lifestyle characteristics ranked in 90% and 10% of their gender and age groups was 23 years for males and 18 years for females, whereas in 75% and 25%, it was 14 years for males and 10 years for females. In addition to early risk identification, the model estimates the deferred effect of lifestyle and the impact of lifestyle changes on life expectancy. Thus, it can be used in early prevention to demonstrate the potential risks and benefits of complex lifestyle modifications for educational purposes or to motivate behavioral changes.
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Affiliation(s)
- Beata Jackowska
- Department of Statistics, Faculty of Management, University of Gdańsk, Sopot, Poland
| | - Piotr Wiśniewski
- Chair and Department of Endocrinology and Internal Diseases, Medical University of Gdańsk, Gdańsk, Poland
- Lab4Life Sp. z o.o., Gdynia, Poland
| | | | - Piotr Bandosz
- Lab4Life Sp. z o.o., Gdynia, Poland
- Division of Preventive Medicine & Education, Medical University of Gdańsk, Gdańsk, Poland
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Timmins IR, Jones ME, O'Brien KM, Adami HO, Aune D, Baglietto L, Bertrand KA, Brantley KD, Chen Y, Clague DeHart J, Clendenen TV, Dossus L, Eliassen AH, Fletcher O, Fournier A, Håkansson N, Hankinson SE, Houlston RS, Joshu CE, Kirsh VA, Kitahara CM, Koh WP, Linet MS, Park HL, Lynch BM, May AM, Mellemkjær L, Milne RL, Palmer JR, Ricceri F, Rohan TE, Ruddy KJ, Sánchez MJ, Shu XO, Smith-Byrne K, Steindorf K, Sund M, Vachon CM, Vatten LJ, Visvanathan K, Weiderpass E, Willett WC, Wolk A, Yuan JM, Zheng W, Nichols HB, Sandler DP, Swerdlow AJ, Schoemaker MJ. International Pooled Analysis of Leisure-Time Physical Activity and Premenopausal Breast Cancer in Women From 19 Cohorts. J Clin Oncol 2024; 42:927-939. [PMID: 38079601 PMCID: PMC10927335 DOI: 10.1200/jco.23.01101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/07/2023] [Accepted: 10/19/2023] [Indexed: 02/12/2024] Open
Abstract
PURPOSE There is strong evidence that leisure-time physical activity is protective against postmenopausal breast cancer risk but the association with premenopausal breast cancer is less clear. The purpose of this study was to examine the association of physical activity with the risk of developing premenopausal breast cancer. METHODS We pooled individual-level data on self-reported leisure-time physical activity across 19 cohort studies comprising 547,601 premenopausal women, with 10,231 incident cases of breast cancer. Multivariable Cox regression was used to estimate hazard ratios (HRs) and 95% CIs for associations of leisure-time physical activity with breast cancer incidence. HRs for high versus low levels of activity were based on a comparison of risk at the 90th versus 10th percentiles of activity. We assessed the linearity of the relationship and examined subtype-specific associations and effect modification across strata of breast cancer risk factors, including adiposity. RESULTS Over a median 11.5 years of follow-up (IQR, 8.0-16.1 years), high versus low levels of leisure-time physical activity were associated with a 6% (HR, 0.94 [95% CI, 0.89 to 0.99]) and a 10% (HR, 0.90 [95% CI, 0.85 to 0.95]) reduction in breast cancer risk, before and after adjustment for BMI, respectively. Tests of nonlinearity suggested an approximately linear relationship (Pnonlinearity = .94). The inverse association was particularly strong for human epidermal growth factor receptor 2-enriched breast cancer (HR, 0.57 [95% CI, 0.39 to 0.84]; Phet = .07). Associations did not vary significantly across strata of breast cancer risk factors, including subgroups of adiposity. CONCLUSION This large, pooled analysis of cohort studies adds to evidence that engagement in higher levels of leisure-time physical activity may lead to reduced premenopausal breast cancer risk.
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Affiliation(s)
- Iain R. Timmins
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
- Statistical Innovation, AstraZeneca, Cambridge, United Kingdom
| | - Michael E. Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
| | - Katie M. O'Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC
| | - Hans-Olov Adami
- Clinical Effectiveness Group, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Nutrition, Oslo New University College, Oslo, Norway
- Department of Research, The Cancer Registry of Norway, Oslo, Norway
| | - Laura Baglietto
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Kristen D. Brantley
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Yu Chen
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, New York, NY
| | | | - Tess V. Clendenen
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, New York, NY
| | - Laure Dossus
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - A. Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Olivia Fletcher
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, United Kingdom
| | - Agnès Fournier
- UVSQ, CESP, Gustave Roussy, Team “Exposome, Heredity, Cancer, and Health”, INSERM, Paris-Saclay University, Paris-South University, Villejuif, France
| | - Niclas Håkansson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Susan E. Hankinson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA
| | - Richard S. Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
| | - Corinne E. Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Victoria A. Kirsh
- Ontario Institute for Cancer Research, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Cari M. Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore
| | - Martha S. Linet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Hannah Lui Park
- Department of Pathology and Laboratory Medicine, Department of Epidemiology, UC Irvine School of Medicine, Irvine, CA
| | - Brigid M. Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Anne M. May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | | | - Roger L. Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | | | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, Centre for Biostatistics, Epidemiology, and Public Health, University of Turin, Turin, Italy
- Unit of Epidemiology, Regional Health Service ASL TO3, Turin, Italy
| | | | | | - Maria-Jose Sánchez
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Karl Smith-Byrne
- Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Malin Sund
- Department of Surgical and Perioperative Sciences/Surgery, Umeå University, Umeâ, Sweden
- Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Celine M. Vachon
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN
| | - Lars J. Vatten
- Department of Public Health and Nursing, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Walter C. Willett
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Alicja Wolk
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, Pittsburgh, PA
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Hazel B. Nichols
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC
| | - Anthony J. Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
- Division of Breast Cancer Research, The Institute of Cancer Research, London, United Kingdom
| | - Minouk J. Schoemaker
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
- Real World Solutions, IQVIA, Amsterdam, the Netherlands
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Tarp J, Luo M, Sanchez-Lastra MA, Dalene KE, Cruz BDP, Ried-Larsen M, Thomsen RW, Ekelund U, Ding D. Leisure-time physical activity and all-cause mortality and cardiovascular disease in adults with type 2 diabetes: Cross-country comparison of cohort studies. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:212-221. [PMID: 37839525 PMCID: PMC10980889 DOI: 10.1016/j.jshs.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/24/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023]
Abstract
PURPOSE This study aimed to quantify the dose-response association and the minimal effective dose of leisure-time physical activity (PA) to prevent mortality and cardiovascular disease in adults with type 2 diabetes. METHODS Cross-country comparison of 2 prospective cohort studies including 14,913 and 17,457 population-based adults with type 2 diabetes from the UK and China. Baseline leisure-time PA was self-reported and categorized by metabolic equivalent hours per week (MET-h/week) according to World Health Organization recommendations: none, below recommendation (>0-7.49 MET-h/week); at recommended level (7.5-14.9 MET-h/week); above recommendation (≥15 MET-h/week). Mortality and cardiovascular disease data were obtained from national registries. RESULTS During a median follow-up of 12.4 and 9.7 years, in the UK and China cohorts, repectively, higher levels of leisure-time PA were inversely associated with all-cause (1571 and 2351 events) and cardiovascular mortality (392 and 1060 events), mostly consistent with a linear dose-response relationship. PA below, at, and above recommendations, compared with no activity, yielded all-cause mortality hazard ratios of 0.94 (95% confidence interval (95%CI): 0.79-1.12), 0.90 (95%CI: 0.74-1.10), and 0.85 (95%CI: 0.70-1.02) in British adults and 0.87 (95%CI: 0.68-1.10), 0.88 (95%CI: 0.74-1.03), and 0.77 (95%CI: 0.70-0.85) in Chinese adults. Associations with cardiovascular mortality were more pronounced in British adults (0.80 (95%CI: 0.58-1.11), 0.75 (95%CI: 0.52-1.09), and 0.69 (95%CI: 0.48-0.97)) but less pronounced in Chinese adults (1.06 (95%CI: 0.76-1.47), 1.01 (95%CI: 0.80-1.28), and 0.79 (95%CI: 0.69-0.92)). PA at recommended levels was not associated with lower rates of major adverse cardiovascular events (2345 and 4458 events). CONCLUSION Leisure-time PA at the recommended levels was not convincingly associated with lower mortality and had no association with risk of major adverse cardiovascular events in British or Chinese adults with type 2 diabetes. Leisure-time PA above current recommendations may be needed to prevent cardiovascular disease and premature mortality in adults with type 2 diabetes.
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Affiliation(s)
- Jakob Tarp
- Department of Clinical Epidemiology, Aarhus University & Aarhus University Hospital, Aarhus 8200, Denmark.
| | - Mengyun Luo
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia; Charles Perkins Centre, the University of Sydney, Camperdown, NSW 2050, Australia
| | - Miguel Adriano Sanchez-Lastra
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo 0806, Norway; Department of Special Didactics, Faculty of Education and Sports Sciences, University of Vigo, Pontevedra 36005, Spain; Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo 36213, Spain
| | - Knut Eirik Dalene
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo 0473, Norway
| | - Borja Del Pozo Cruz
- Centre for Active and Healthy Ageing, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense 5230, Denmark; Faculty of Education, University of Cádiz, Cádiz 11519, Spain; Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz 11009, Spain
| | - Mathias Ried-Larsen
- The Centre of Inflammation and Metabolism & the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen 2100, Denmark; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense 5230, Denmark
| | - Reimar Wernich Thomsen
- Department of Clinical Epidemiology, Aarhus University & Aarhus University Hospital, Aarhus 8200, Denmark
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo 0806, Norway; Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo 0473, Norway
| | - Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia; Charles Perkins Centre, the University of Sydney, Camperdown, NSW 2050, Australia
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Zhou HH, Jin B, Liao Y, Hu Y, Li P, YangLha T, Liu Y, Xu J, Wang B, Zhu M, Xiao J, Liu J, Nüssler AK, Liu L, Hao X, Chen J, Peng Z, Yang W. Associations of Various Physical Activities with Mortality and Life Expectancy are Mediated by Telomere Length. J Am Med Dir Assoc 2024; 25:431-438.e15. [PMID: 37660722 DOI: 10.1016/j.jamda.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/28/2023] [Accepted: 08/02/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVES Physical activity (PA) and telomeres both contribute to healthy aging and longevity. To investigate the optimal dosage of various PA for longevity and the role of telomere length in PA and mortality. DESIGN Prospective cohort study. SETTING AND PARTICIPANTS A total of 333,865 adults (mean age of 56 years) from the UK Biobank were analyzed. METHODS Walking, moderate PA (MPA), and vigorous PA (VPA) were self-reported via questionnaire, and leukocyte telomere length (LTL) was measured. Cox proportional hazards regression was used to predict all-cause mortality risk. A flexible parametric Royston-Parmar survival model was used to estimate life expectancy. RESULTS During a median follow-up of 13.8 years, 19,789 deaths were recorded. Compared with the no-walking group, 90 to 720 minutes/week of walking was similarly associated with 27% to 31% of lower mortality and about 6 years of additional life expectancy. We observed nearly major benefits for mortality and life expectancy among those meeting the PA guidelines [151-300 minutes/wk for MPA: hazard ratio (HR) 0.80, 95% CI 0.75-0.85, 3.40-3.42 additional life years; 76-150 minutes/wk for VPA: HR 0.78, 95% CI 0.75-0.82, 2.61 years (2.33-2.89)] vs the no-PA group. Similar benefits were also observed at 76-150 and 301-375 minutes/wk of MPA (18%-19% lower mortality, 3.20-3.42 gained years) or 151-300 minutes/wk of VPA (20%-26% lower mortality, 2.41-2.61 gained years). The associations between MPA, VPA, and mortality risk were slightly mediated by LTL (≈1% mediation proportion, both P < .001). CONCLUSIONS AND IMPLICATIONS Our study suggests a more flexible range of PA than the current PA guidelines, which could gain similar benefits and is easier to achieve: 90 to 720 minutes/wk of walking, 75 to 375 minutes/wk of MPA, and 75 to 300 minutes/wk of VPA. Telomeres might be a potential mechanism by which PA promotes longevity.
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Affiliation(s)
- Huan-Huan Zhou
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Biyu Jin
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuxiao Liao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yaling Hu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pengwan Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tesring YangLha
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yiran Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingwen Xu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Biyao Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Minglin Zhu
- Department of Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jie Xiao
- Department of Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jinping Liu
- Department of Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Andreas K Nüssler
- Department of Traumatology, BG Trauma Center, University of Tübingen, Tübingen, Germany
| | - Liegang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xingjie Hao
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiuling Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhao Peng
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Krtalić S, Križan H, Milanović SM. Frequency of regular walking among Croatian adults. Arh Hig Rada Toksikol 2024; 75:32-40. [PMID: 38548378 PMCID: PMC10978097 DOI: 10.2478/aiht-2024-75-3808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 12/01/2023] [Accepted: 02/01/2024] [Indexed: 04/01/2024] Open
Abstract
The aim of this study was to determine the share of Croatian adults who walk 210 min or more a week and to explore the relationship between regular walking and demographic factors, health-related behaviours, and chronic non-communicable diseases/conditions. To this end, we used the EHIS-PAQ questionnaire and collected self-reported data on minutes spent walking during a typical week from a total of 3,496 respondents. The data were additionally analysed by gender, age, education, residence (urban/rural), counties and regions, smoking, other types of physical activity, and diseases/chronic conditions. The results show that, overall, 40.9 % of the adult Croatian population walks 210 or more minutes a week, with the largest share found among those from the Lika-Senj County (76.8 %), those who spend 300 min or more weekly on health-enhancing (non-work-related) aerobic physical activity (57.6 %), those who reported having diabetes (49.3 %), and those aged 65-74 years (44.7 %). Despite its limitations, our study gives a valuable insight into the frequency and factors determining healthy walking habits in a representative sample of Croatian adults and provides grounds for further research.
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Affiliation(s)
| | - Helena Križan
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Sanja Musić Milanović
- Croatian Institute of Public Health, Zagreb, Croatia
- University of Zagreb School of Medicine, School of Public Health Andrija Štampar, Zagreb, Croatia
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31
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Fukushima N, Kikuchi H, Sato H, Sasai H, Kiyohara K, Sawada SS, Machida M, Amagasa S, Inoue S. Dose-Response Relationship of Physical Activity with All-Cause Mortality among Older Adults: An Umbrella Review. J Am Med Dir Assoc 2024; 25:417-430. [PMID: 37925162 DOI: 10.1016/j.jamda.2023.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/25/2023] [Accepted: 09/25/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVES To examine the dose-response relationship between physical activity (PA) and all-cause and cardiovascular disease (CVD) mortality, specifically among older adults. DESIGN Umbrella review. SETTING AND PARTICIPANTS Eligible studies included systematic reviews with meta-analyses that investigated the association of aerobic PA, muscle-strengthening activity, and multicomponent PA, including exercise programs (such as aerobic, muscle strengthening, and balance training), with all-cause and CVD mortality among older adults aged ≥60 years. METHODS We performed a literature search in PubMed, CINAHL, and the Cochrane Library for eligible studies published between January 2017 and March 2023 to update an umbrella review initially conducted by the United States 2018 PA Guidelines Advisory Committee. Studies included in the 2018 US PA and 2020 World Health Organization (WHO) Guidelines were also reviewed. In addition, meta-analyses that reported effect sizes stratified by age and recruiting older adults (aged ≥60 years) were included. RESULTS Overall, 16 relevant systematic reviews (10 from our review and 6 from the US and WHO guidelines) met the inclusion criteria. All these reviews showed that 7.5 to 15.0 metabolic equivalents (METs)-hours/week (around the recommended PA levels outlined in the US and WHO guidelines) substantially reduced mortality risks among older adults (approximately 19%-30% for all-cause mortality and 25%-34% for CVD mortality). Moreover, 15.0 to 22.5 MET-hours/week, exceeding the guideline-recommended PA levels, resulted in greater reductions in mortality risks by 35% to 37% and 38% to 40%, respectively. CONCLUSIONS AND IMPLICATIONS PA substantially reduced all-cause and CVD mortality risks among older adults. Larger risk reductions may be achieved by engaging in PA levels higher than those recommended by the current international PA guidelines. Our findings suggest that recommending higher PA levels beyond the current guidelines may benefit older adults when developing future international PA guidelines.
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Affiliation(s)
- Noritoshi Fukushima
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
| | - Hiroyuki Kikuchi
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
| | - Hiroki Sato
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kosuke Kiyohara
- Department of Food Science, Faculty of Home Economics, Otsuma Women's University, Tokyo, Japan
| | - Susumu S Sawada
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Masaki Machida
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
| | - Shiho Amagasa
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan; Graduate School of Public Health, Teikyo University, Tokyo, Japan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan.
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Correia ÉM, Monteiro D, Bento T, Rodrigues F, Cid L, Vitorino A, Figueiredo N, Teixeira DS, Couto N. Analysis of the Effect of Different Physical Exercise Protocols on Depression in Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials. Sports Health 2024; 16:285-294. [PMID: 37994044 PMCID: PMC10916777 DOI: 10.1177/19417381231210286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023] Open
Abstract
CONTEXT Physical exercise (PE) is an effective treatment for depression, alone or as an adjunct. OBJECTIVE There is a lack of indicators regarding the frequency, intensity, duration, and type of physical exercise (PE). This study aims to synthesize and analyze the dose-effect of different PE protocols in adult subjects in the treatment of depression, based on the analysis of randomized controlled trials (RCTs). DATA SOURCES The search was conducted using Web of Science, PubMed, and Cochrane Library electronic databases. STUDY SELECTION Studies with an exercise-based intervention published by December 31, 2021 were identified. RCTs and meta-analyses involving adults with depression were also included; 10 studies were selected, including a total of 956 subjects. STUDY DESIGN Systematic review and meta-analysis. LEVEL OF EVIDENCE Level 1. RESULTS Effect sizes were summarized using standardized mean differences (95% confidence interval) by effected randomized models. The results reinforce that exercise appears to be beneficial in improving depression among adults aged 18 to 65 years. Interventions lasting above 150 minutes per week of moderate intensity and group interventions seem to have a more significant effect on reducing depression. Studies have revealed that aerobic exercise, compared with resistance or flexibility, has a more positive effect on depression. CONCLUSION PE can be a way to reduce depression and can be used as a possible adjunctive tool for pharmacological and/or alternative treatments. Considering the findings of this study, it is important that health professionals (eg, exercise physiologists, physicians, nurses, psychologists) promote the practice of PE as a complementary alternative and act early to prevent the worsening of depression. PROSPERO REGISTRATION NUMBER CRD42020188909.
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Affiliation(s)
- Érica M Correia
- Sport Sciences School of Rio Maior, Polytechnic of Santarém [ESDRM-IPSantarém], Rio Maior, Portugal
| | - Diogo Monteiro
- ESECS - Polytechnic of Leiria, Leiria, Portugal and Research Center in Sports Sciences, Health Sciences and Human Development [CIDESD], Vila Real, Portugal
| | - Teresa Bento
- Sport Sciences School of Rio Maior, Polytechnic of Santarém [ESDRM-IPSantarém], Rio Maior, Portugal; and Research Center in Sports Sciences, Health Sciences and Human Development [CIDESD], Vila Real, Portugal
| | - Filipe Rodrigues
- ESECS - Polytechnic of Leiria, Leiria, Portugal and Life Quality Research Center [CIEQV], Rio Maior, Portugal
| | - Luís Cid
- Sport Sciences School of Rio Maior, Polytechnic of Santarém [ESDRM-IPSantarém], Rio Maior, Portugal; and Research Center in Sports Sciences, Health Sciences and Human Development [CIDESD], Vila Real, Portugal
| | - Anabela Vitorino
- Sport Sciences School of Rio Maior, Polytechnic of Santarém [ESDRM-IPSantarém], Rio Maior, Portugal; Research Center in Sports Sciences, Health Sciences and Human Development [CIDESD], Vila Real, Portugal, and Life Quality Research Center [CIEQV], Rio Maior, Portugal
| | | | - Diogo S Teixeira
- Faculty of Physical Education and Sport, Lusófona University [ULHT/FEFD], Lisbon, Portugal, and Research Center in Physical Education, Sport, Exercise and Health [CIDEFES], Lisbon, Portugal
| | - Nuno Couto
- Sport Sciences School of Rio Maior, Polytechnic of Santarém [ESDRM-IPSantarém], Rio Maior, Portugal and Research Center in Sports Sciences, Health Sciences and Human Development [CIDESD], Vila Real, Portugal
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Duarte Junior MA, Pintos Carrillo S, Martínez-Gómez D, Sotos Prieto M, Rodríguez-Artalejo F, Cabanas Sánchez V. Lifestyle behaviors, social and economic disadvantages, and all-cause and cardiovascular mortality: results from the US National Health Interview Survey. Front Public Health 2024; 12:1297060. [PMID: 38481841 PMCID: PMC10933051 DOI: 10.3389/fpubh.2024.1297060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/31/2024] [Indexed: 05/03/2024] Open
Abstract
Aim To examine the independent relationships of lifestyle and social and economic factors with all-cause and cardiovascular disease (CVD) mortality in a large representative sample of the US adult population. Furthermore, the association between the combination of lifestyle and social and economic factors with mortality was analyzed in detail. Methods The sample included 103,314 participants with valid records and eligible for mortality follow-up, and information on lifestyle factors and social and economic disadvantages (NHIS waves 2000, 2005, 2010, and 2015). An unhealthy lifestyle score was constructed using information on physical activity, alcohol consumption, diet, and smoking status. Social and economic disadvantages were assessed using information on education, receipt of dividends, employment, family's home, and access to private health. Information on mortality data was determined by the National Death Index records. Results Compared with favorable lifestyle, unfavorable lifestyle was associated with higher all-cause (HR 2.07; 95% CI 1.97-2.19) and CVD (HR 1.84; 95% CI 1.68-2.02) mortality. Higher social and economic disadvantages were also associated with higher all-cause (HR 2.44; 95% CI 2.30-2.59) and CVD mortality (HR 2.44; 95% CI 2.16-2.77), compared to low social and economic disadvantages. In joint associations, participants in the high social and economic disadvantage and unfavorable lifestyle showed a greater risk of all-cause (HR 4.06; 95% CI 3.69-4.47) and CVD mortality (HR 3.98; 95% CI 3.31-4.79). Conclusion Lifestyle and social and economic disadvantages are associated with all-cause and CVD mortality. The risk of mortality increases as the number of social and economic disadvantages and unhealthy lifestyles increases.
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Affiliation(s)
- Miguel Angelo Duarte Junior
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Salud Pintos Carrillo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - David Martínez-Gómez
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mercedes Sotos Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Verónica Cabanas Sánchez
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- IMDEA Food Institute, CEI UAM+CSIC, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Yu S, Liu L, Li M, He S, Hu Y, Sun S, Yan Y, Zhao F, Cheng X, Li J, Gao F, Liu Y, Zhang X. Swimming behavior indicates stress and adaptations to exercise. Front Physiol 2024; 15:1357120. [PMID: 38468702 PMCID: PMC10925659 DOI: 10.3389/fphys.2024.1357120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 02/02/2024] [Indexed: 03/13/2024] Open
Abstract
Introduction: Behaviors of swimming rodents are not uniform, exhibiting large variations, which may underlie the individual differences in swimming exercise-induced benefits. The study aimed to monitor individualized swimming behavior and evaluate its biological significance. Methods: A swimming tank which can monitor individualized rodent swimming behavior during exercise was established. A total of 45 mice were subjected to swimming training for 1 month (1 h per day) and the swimming behaviors of each mouse were recorded. Results: The swimming behaviors of mice displayed considerable variations in aspects of distance, velocity, and area preference. For example, nearly one-third of mice preferred to swim in central area and most of the mice exhibited an even area distribution. Long-term exercise training improved cardiac systolic function and decreased blood pressure in mice, but hardly changed swimming behaviors. Analyses of the relationship between swimming behavior and cardiovascular adaptations to exercise training revealed that swimming behavior indicated the biological effects of swimming training. Specifically, mice which preferred swimming at the central zone or were trainable in behavior during 1-month training exhibited better outcomes in cardiac function and blood pressure post long-term exercise. Mechanistically, a centralized swimming behavior indicated a smaller stress during exercise, as evidenced by a milder activation of hypothalamic-pituitary-adrenal axis. Discussion: These results suggest that swimming behavior during training indicates individualized adaptations to long-term exercise, and highlight a biological significance of swimming behavior monitoring in animal studies.
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Affiliation(s)
- Sen Yu
- Key Laboratory of Ministry of Education, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Lantao Liu
- Department of Medical Electronics, School of Biomedical Engineering, Fourth Military Medical University, Xi’an, China
| | - Min Li
- Key Laboratory of Ministry of Education, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Siyan He
- Chengdu Techman Software Co., Ltd., Chengdu, China
| | - Yang Hu
- Key Laboratory of Ministry of Education, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Shichao Sun
- Key Laboratory of Ministry of Education, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Yizhen Yan
- Key Laboratory of Ministry of Education, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Fangfang Zhao
- Key Laboratory of Ministry of Education, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | | | - Jia Li
- Key Laboratory of Ministry of Education, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Feng Gao
- Key Laboratory of Ministry of Education, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Yong Liu
- Key Laboratory of Ministry of Education, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
| | - Xing Zhang
- Key Laboratory of Ministry of Education, School of Aerospace Medicine, Fourth Military Medical University, Xi’an, China
- Department of Rehabilitation, Air Force Medical Center, Beijing, China
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35
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Zhao Y, Wang G, Wei Z, Li D, Morshedi M. Wnt, notch signaling and exercise: what are their functions? Hum Cell 2024:10.1007/s13577-024-01036-3. [PMID: 38386243 DOI: 10.1007/s13577-024-01036-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 01/18/2024] [Indexed: 02/23/2024]
Abstract
In the last decade, the study of Wnt and Notch signaling in cell biology has led to significant progress in understanding embryogenesis, bone development, muscle healing, neurogenesis, and tumorigenesis. It has been found that regular physical activity can counteract the decline of skeletal muscle caused by aging, which is linked to osteoporosis, regenerative neurogenesis, hippocampal function, cognitive ability, and the creation of neuromuscular junctions. Despite these discoveries, there is still uncertainty about how cell biology and exercise can impact the Wnt and Notch signaling pathways in the locomotor system. This review aims to summarize the potential influence of exercise on Wnt and Notch signaling.
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Affiliation(s)
- Yijie Zhao
- Ministry of Public Sports, Hebei North University, Zhangjiakou, 075000, Hebei, China
| | - Guangjun Wang
- Ministry of Public Sports, Hebei North University, Zhangjiakou, 075000, Hebei, China.
| | - Zhifeng Wei
- The First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, Hebei, China
| | - Duo Li
- The First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, Hebei, China
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36
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Waaler PN, Bongo LA, Rolandsen C, Lorem GF. An individually adjusted approach for communicating epidemiological results on health and lifestyle to patients. Sci Rep 2024; 14:3199. [PMID: 38331938 PMCID: PMC10853548 DOI: 10.1038/s41598-024-53275-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 01/30/2024] [Indexed: 02/10/2024] Open
Abstract
If scientific research on modifiable risk factors was more accessible to the general population there is a potential to prevent disease and promote health. Mobile applications can automatically combine individual characteristics and statistical models of health to present scientific information as individually tailored visuals, and thus there is untapped potential in incorporating scientific research into apps aimed at promoting healthier lifestyles. As a proof-of-concept, we develop a statistical model of the relationship between Self-rated-health (SRH) and lifestyle-related factors, and a simple app for conveying its effects through a visualisation that sets the individual as the frame of reference. Using data from the 6th (n = 12 981, 53.4% women and 46.6% men) and 7th (n = 21 083, 52.5% women and 47.5% men) iteration of the Tromsø population survey, we fitted a mixed effects linear regression model that models mean SRH as a function of self-reported intensity and frequency of physical activity (PA), BMI, mental health symptoms (HSCL-10), smoking, support from friends, and HbA1c ≥ 6.5%. We adjusted for socioeconomic and demographic factors and comorbidity. We designed a simple proof-of-concept app to register relevant user information, and use the SRH-model to translate the present status of the user into suggestions for lifestyle changes along with predicted health effects. SRH was strongly related to modifiable health factors. The strongest modifiable predictors of SRH were mental health symptoms and PA. The mean adjusted difference in SRH between those with 10-HSCL index = 1.85 (threshold for mental distress) and HSCL-10 = 1 was 0.59 (CI 0.61-0.57). Vigorous physical activity (exercising to exhaustion ≥ 4 days/week relative to sedentary) was associated with an increase on the SRH scale of 0.64 (CI 0.56-0.73). Physical activity intensity and frequency interacted positively, with large PA-volume (frequency ⨯ intensity) being particularly predictive of high SRH. Incorporating statistical models of health into lifestyle apps have great potential for effectively communicating complex health research to a general audience. Such an approach could improve lifestyle apps by helping to make the recommendations more scientifically rigorous and personalised, and offer a more comprehensive overview of lifestyle factors and their importance.
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Affiliation(s)
- Per Niklas Waaler
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lars Ailo Bongo
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
| | - Christina Rolandsen
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
- Deloitte AS, Oslo, Norway
| | - Geir F Lorem
- Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway.
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37
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Margolis G, Cohen O, Roguin A. Vigorous physical activity and atrial fibrillation in healthy individuals: What is the correct approach? Clin Cardiol 2024; 47:e24237. [PMID: 38440948 PMCID: PMC10913085 DOI: 10.1002/clc.24237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/24/2024] [Accepted: 02/01/2024] [Indexed: 03/06/2024] Open
Abstract
Sport activity compared to sedentary life is associated with improved wellbeing and risk reduction in many different health conditions including atrial fibrillation (AF). Vigorous physical activity is associated with increased AF risk. We describe four individuals, who regularly perform endurance sport activity and developed AF. We discuss the changes occurring in the heart of endurance athletes and the possible etiology for AF, as well as currently available treatment options in this seemingly healthy population. Although the etiology of AF in the general population differs from the one in the usually younger endurance sport activity population, the treatment options are similar. There are several factors unique to those involved in vigorous physical activity that can influence their management. Despite a lack of evidence, endurance athletes with AF have traditionally been advised to "de-training," to reduce both the amount and intensity of exercise. Some of the current offered treatment options (beta-blockers, class III antiarrhythmic) have a varied range of adverse effect, hindering them unattractive for these individuals. Depending on risk stratification tools, anticoagulation may be indicated. Some suggest an intermittent dosing therapy, while others recommend following current guidelines. AF ablation is recommended in exercising individuals with recurrent, symptomatic AF and/or in those who do not want drug therapy, given its impact on athletic performance, AF treatment decisions should be individualized for those engaging vigorous physical activity, while considering the potential risks, the urgency of returning to training, and the will and expectations of the patient.
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Affiliation(s)
- Gilad Margolis
- Hillel Yaffe Medical CenterCardiology DepartmentHaderaIsrael
- Ruth and Bruc Rappaport Faculty of MedicineTechnion Israel Institute of TechnologyHaifaIsrael
| | - Oshri Cohen
- Hillel Yaffe Medical CenterCardiology DepartmentHaderaIsrael
- Ruth and Bruc Rappaport Faculty of MedicineTechnion Israel Institute of TechnologyHaifaIsrael
| | - Ariel Roguin
- Hillel Yaffe Medical CenterCardiology DepartmentHaderaIsrael
- Ruth and Bruc Rappaport Faculty of MedicineTechnion Israel Institute of TechnologyHaifaIsrael
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38
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Lu J, Cao X, Chang X, Zheng G, Zhu H, Gao S, Wang Z, Jia X, Shi X, Yang Y. Associations between physical activity and all-cause and cardiovascular mortality in adults with type 2 diabetes mellitus: A prospective cohort study from NHANES 2007-2018. Prim Care Diabetes 2024; 18:44-51. [PMID: 38052713 DOI: 10.1016/j.pcd.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 11/19/2023] [Accepted: 11/25/2023] [Indexed: 12/07/2023]
Abstract
AIMS To investigate the dose-response association between physical activity and all-cause and cardiovascular mortality in adults with type 2 diabetes mellitus and the effects of replacing sedentary behavior with physical activity. METHODS 4808 adults with type 2 diabetes mellitus were included in NHANES 2007-2018. Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals. Isotemporal substitution analyses were further to determine the possible benefit of replacing sedentary time. RESULTS During a median follow-up of 6.58 years, 902 deaths occurred, including 290 deaths from cardiovascular disease. Compared with the inactive group, the low-active and high-active groups were associated with declined risks of all-cause mortality [HRs (95% CIs) 0.64 (0.50, 0.83); 0.60 (0.50, 0.73), respectively] and cardiovascular mortality [0.50 (0.29, 0.88); 0.54 (0.39, 0.76)), respectively]. Dose-response analysis showed a significant U-shaped curve between physical activity and all-cause and cardiovascular mortality. Replacing 30 min/day of sedentary time with physical activity was substantially linked to a reduced risk of 8-32% mortality. CONCLUSION A high level of PA of 40.52 and 31.66 MET-h/week was respectively related to the lowest risk of all-cause and cardiovascular mortality. Replacing sedentary time with physical activity could benefit the type 2 diabetes mellitus population.
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Affiliation(s)
- Jie Lu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, No. 100, Science Avenue, Zhongyuan District, Zhengzhou 450001, Henan, China
| | - Xiting Cao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, No. 100, Science Avenue, Zhongyuan District, Zhengzhou 450001, Henan, China
| | - Xinyu Chang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, No. 100, Science Avenue, Zhongyuan District, Zhengzhou 450001, Henan, China
| | - Guowei Zheng
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, No. 100, Science Avenue, Zhongyuan District, Zhengzhou 450001, Henan, China
| | - Hao Zhu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, No. 100, Science Avenue, Zhongyuan District, Zhengzhou 450001, Henan, China
| | - Shuaijie Gao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, No. 100, Science Avenue, Zhongyuan District, Zhengzhou 450001, Henan, China
| | - Zhenwei Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, No. 100, Science Avenue, Zhongyuan District, Zhengzhou 450001, Henan, China
| | - Xiaocan Jia
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, No. 100, Science Avenue, Zhongyuan District, Zhengzhou 450001, Henan, China
| | - Xuezhong Shi
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, No. 100, Science Avenue, Zhongyuan District, Zhengzhou 450001, Henan, China
| | - Yongli Yang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, No. 100, Science Avenue, Zhongyuan District, Zhengzhou 450001, Henan, China.
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Everard G, Boivin S, Boulay G, Duchemin R, Batcho CS. Immersive Virtual Reality to Assess Arm Kinematics among Older Adults with and without Major Neurocognitive Disorder - An Exploratory Cross-Sectional Study. Neuroscience 2024; 537:47-57. [PMID: 38006964 DOI: 10.1016/j.neuroscience.2023.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/23/2023] [Accepted: 10/30/2023] [Indexed: 11/27/2023]
Abstract
Despite the recommendation of improving assessment objectivity and frequency, the use of immersive virtual reality to measure and quantify movement quality remains underexplored. In this study, we aimed to evaluate the reliability, validity and usability of an immersive virtual reality application, KinematicsVR, to assess upper limb kinematics among older adults with and without major neurocognitive disorder. The KinematicsVR involves the drawing of three-dimensional straight lines, circles and squares using a controller in a virtual environment. Twenty-eight older adults with or without major neurocognitive disorder were recruited. Reliability was evaluated through correlations on test-retest and validity through correlations between KinematicsVR variables and other functional tests (TEMPA, BBT-VR and Finger-Nose Test). The usability of the KinematicsVR was assessed with the System Usability Scale questionnaire. Kinematic indexes were compared between eight adults with major neurocognitive disorder and eight matched controls. Results indicated that most variables provided by the KinematicsVR had excellent reliability for tasks involving the drawing of straight lines and circles, but moderate reliability for tasks involving the drawing of squares. Secondary analyses showed that the usability of the application was excellent but few significant and strong correlations were observed between variables of the KinematicsVR and the scores of the TEMPA scale, Finger-Nose Test and BBT-VR. Adults with major neurocognitive disorder, when compared to other older adults, made larger and less linear hand movements. These findings provide perspectives for the use of immersive virtual reality to improve assessment frequency and objectivity through the autonomous measure of upper limb kinematics in older adults.
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Affiliation(s)
- Gauthier Everard
- School of Rehabilitation Sciences, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Université Laval, Quebec, Canada; Neuro Musculo Skeletal Lab (NMSK), Institut de Recherche Expérimentale et Clinique, Secteur des Sciences de la Santé, UCLouvain, Brussels, Belgium
| | - Sophie Boivin
- School of Rehabilitation Sciences, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Geneviève Boulay
- School of Rehabilitation Sciences, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Roxane Duchemin
- School of Rehabilitation Sciences, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Charles Sebiyo Batcho
- School of Rehabilitation Sciences, Faculty of Medicine, Laval University, Quebec, QC, Canada; Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Université Laval, Quebec, Canada.
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40
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Di Fusco SA, Spinelli A, Castello L, Marino G, Maraschi I, Gulizia MM, Gabrielli D, Colivicchi F. Do Pathophysiologic Mechanisms Linking Unhealthy Lifestyle to Cardiovascular Disease and Cancer Imply Shared Preventive Measures? - A Critical Narrative Review. Circ J 2024; 88:189-197. [PMID: 34544961 DOI: 10.1253/circj.cj-21-0459] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Growing evidence has shown a bidirectional link between the cardiologic and oncologic fields. Several investigations support the role of unhealthy behaviors as pathogenic factors of both cardiovascular disease and cancer. We report epidemiological and research findings on the pathophysiological mechanisms linking unhealthy lifestyle to cardiovascular disease and cancer. For each unhealthy behavior, we also discuss the role of preventive measures able to affect both cardiovascular disease and cancer occurrence and progression.
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Affiliation(s)
| | | | - Lorenzo Castello
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital
| | - Gaetano Marino
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital
| | - Ilaria Maraschi
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital
| | | | | | - Furio Colivicchi
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital
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Huang X, He Y, Xu H, Shen Y, Pan X, Wu J, Chen K. Association between sociodemographic status and the T2DM-related risks in China: implication for reducing T2DM disease burden. Front Public Health 2024; 11:1297203. [PMID: 38259760 PMCID: PMC10801005 DOI: 10.3389/fpubh.2023.1297203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/07/2023] [Indexed: 01/24/2024] Open
Abstract
Objective Analyzing the association between sociodemographic status and the type 2 diabetes mellitus (T2DM)-related risks in China to reduce the disease burden of T2DM. Methods We downloaded data from the Global Burden of Disease Study 2019 to estimate the disease burden of T2DM in China. Secondary analyses were performed by year, age, gender, summary exposure value (SEV), and sociodemographic index (SDI). Results In China, it is estimated that 3.74 (3.44-4.10) million incidence, 90.0 (82.3-98.5) million prevalence, 168.4 (143.2-194.0) thousand deaths, and 9.6 (7.6-11.9) million DALYs occurred in 2019, showing an increase of 96.8, 156.7, 162.8, and 145.4% compared to 1990. An inverse U-shaped curve was observed for the correlations between T2DM-related burden and SDI. A heavier burden was found in males. The top four risk factors were high body mass index (HBMI), dietary risks, air pollution and tobacco. HBMI, as the key risk, accounted for half of the disease burden of T2DM in China. Lower degree of SEV and higher level of attributable T2DM-related burden could be found in main risks, meaning their critical role of them in the development and progression of T2DM. An inverse U-shaped curve could be found in the association between age-standardized incidence, mortality, DALYs rate, and SDI. Conclusion The disease burden of T2DM has rapidly increased in China. Gender disparities, different age distributions and inconsistent socioeconomic levels all played an important role in it. The key risk was HBMI. With the improvement of socioeconomic level, the main risk factors for T2DM have changed from environmental factors to lifestyle factors. Targeted control and preventative strategies to address adjustable risk factors could put an end to this soaring burden.
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Affiliation(s)
- Xin Huang
- Department of Endocrinology and Metabolism, Lishui Municipal Central Hospital, Lishui, China
| | - Yinhui He
- Department of Endocrinology and Metabolism, Lishui Municipal Central Hospital, Lishui, China
| | - Haiyan Xu
- Department of Endocrinology and Metabolism, Lishui Municipal Central Hospital, Lishui, China
| | - Yuyan Shen
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of ZheJiang University School of Medicine, Zhejiang, China
| | - Xiaowen Pan
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of ZheJiang University School of Medicine, Zhejiang, China
| | - Junyun Wu
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of ZheJiang University School of Medicine, Zhejiang, China
| | - Kai Chen
- Department of Endocrinology and Metabolism, Lishui Municipal Central Hospital, Lishui, China
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Seino S, Abe T, Nofuji Y, Hata T, Shinkai S, Kitamura A, Fujiwara Y. Dose-response Associations of Physical Activity and Sitting Time With All-cause Mortality in Older Japanese Adults. J Epidemiol 2024; 34:23-30. [PMID: 36567129 PMCID: PMC10701252 DOI: 10.2188/jea.je20220246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/11/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Although examining the dose-response curves of physical activity (PA) and sitting time with health-related outcomes is an important research agenda, the results for older Japanese adults are extremely limited. We examined the dose-response associations of PA and sitting time with all-cause mortality among older Japanese. METHODS Initially, 8,069 non-disabled residents (4,073 men; 3,996 women) aged 65-84 years of Ota City, Japan, were analyzed. Moderate-to-vigorous PA (MVPA) and sitting time were evaluated using the International Physical Activity Questionnaire-Short Form. Multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of MVPA and sitting time for all-cause mortality were calculated, and the dose-response curves were examined using restricted cubic splines (RCS). RESULTS During 4.1 years of follow-up, 458 participants (5.7%; 331 men and 127 women) died. Compared with the low MVPA (<600 metabolic equivalents [METs]·minutes/week) group, HR for mortality gradually reduced in moderate (600-3,000 METs·minutes/week) and high (>3,000 METs·minutes/week) MVPA groups (moderate: HR 0.66; 95% CI, 0.54-0.82; high: HR 0.58; 95% CI, 0.45-0.75; P < 0.001 for trend). RCS showed that the HR for mortality reduced linearly up to approximately 2,000 METs·minutes/week of MVPA, and maximal risk reduction was seen at approximately 3,000-4,500 METs·minutes/week of MVPA. No significant dose-response association of sitting time with mortality was observed. CONCLUSION Higher MVPA levels reduced all-cause mortality risk, in a significant inverse non-linear dose-response manner. Sitting time was not significantly associated with all-cause mortality. It is important to disseminate the significance of even a slight increase in the MVPA for reducing mortality risk.
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Affiliation(s)
- Satoshi Seino
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Takumi Abe
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yu Nofuji
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Toshiki Hata
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- Department of Food and Nutritional Science, Graduate School of Applied Bioscience, Tokyo University of Agriculture, Tokyo, Japan
| | - Shoji Shinkai
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- Department of Nutrition Sciences, Kagawa Nutrition University, Saitama, Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- Health Town Development Science Center, Osaka, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Han Y, Sung H, Choi Y, Kim YS. Trends in obesity, leisure-time physical activity, and sedentary behavior in Korean adults: Korea national health and nutritional examinations survey from 2014 to 2021. PLoS One 2024; 19:e0296042. [PMID: 38170709 PMCID: PMC10763961 DOI: 10.1371/journal.pone.0296042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES This study aimed to investigate trends in obesity by dividing it based on body mass index (BMI) and waist circumference indicators, sedentary behavior, and leisure-time physical activity (LTPA) in Korean adults from 2014 to 2021. This study also aimed to determine the adherence rate of people with obesity to physical activity. METHODS Data from the Korea National Health and Nutritional Examination Survey (KNHANES) from 2014 to 2021 were used. A total of 42,676 participants 19 years or older were included in the final analysis. Sociodemographic characteristics, anthropometric measurements, and physical activity levels were recorded. Physical activity levels were assessed using the Global Physical Activity Questionnaire, a self-reported questionnaire. Multivariable logistic regression analysis adjusted for covariates was used to investigate the prevalence of obesity and sitting time or adherence to meeting the physical activity guidelines for each survey year. RESULTS This study included 42,676 adults. The weighted prevalence of obesity in all ages significantly increased from 30.8% (29.1%-32.5%) in 2014 to 34.5% (32.9%-36.2%) in 2017 and 37.3% (35.5%-39.1%) in 2021 (p for trend < 0.004). The weighted adherence rate to LTPA ranged from 25.5% (95% confidence interval [CI], 23.7%-27.2%) in 2014 to 20.5% (95% CI, 18.7%-22.2%) in 2021(p for trend < 0.001). The weighted prevalence of sitting time for 8 h/day or more significantly increased from 46.7% (44.4%-49.0%) in 2014 to 56.2% (54.4%-58.0%) in 2017 and 63% (60.7%-65.3%) in 2021 (p for trend < 0.001). According to this study, the LTPA level among women with obesity was significantly low. CONCLUSION From 2014 to 2021, obesity and sedentary behavior significantly increased and adherence to LTPA decreased among Korean adults. Given these concerning trends, comprehensive interventions are needed at the national level to encourage healthy lifestyle behaviors.
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Affiliation(s)
- Yunmin Han
- Seoul National University, Seoul, Republic of Korea
| | - Hoyong Sung
- Department of Military Kinesiology, Korea Military Academy, Seoul, Republic of Korea
| | | | - Yeon Soo Kim
- Seoul National University, Seoul, Republic of Korea
- Institute of Sports Science, Seoul National University, Seoul, Republic of Korea
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Cho MJ, Jung YJ, Min HJ, Kim HJ, Kunutsor SK, Jae SY. Sex disparities in physical activity domains and hypertension prevalence. Clin Hypertens 2024; 30:1. [PMID: 38163915 PMCID: PMC10759492 DOI: 10.1186/s40885-023-00260-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND This study aimed to examine the associations of leisure time physical activity (LTPA) and occupational physical activity (OPA) with the prevalence of hypertension, while exploring the sex disparities in these associations. METHODS A cross-sectional study was conducted using data from the Korea National Health and Nutrition Examination Survey between 2014 and 2019 (n = 26,534). Hypertension was defined as the use of antihypertensive drugs or systolic and diastolic blood pressure ≥ 140/90 mm Hg. Self-reported physical activity (PA), assessed by the global PA questionnaire, was categorized into three domains: total PA, LTPA and OPA. Each PA domain was classified based on METs-min/wk and intensity. RESULTS In a multivariable adjusted model, the odds ratio (OR) with 95% confidence intervals (CIs) for the prevalence of hypertension in the active versus inactive group, based on METs, was 0.92 (95% CI 0.85-0.99) for total PA, 0.90 (95% CI 0.83-0.98) for LTPA and 1.21 (95% CI 1.05-1.38) for OPA. Compared to the inactive group, moderate to vigorous intensity was associated with a lower odds of hypertension for total PA and LTPA (total PA: OR 0.95, 95% CI 0.89-1.00 and LTPA: OR 0.92, 95% CI 0.86-0.98), but a higher odd for OPA (OR 1.17, 95% CI 1.05-1.30). Subgroup analyses showed significant evidence of effect modification by sex on the associations of total PA and LTPA (METs and intensity) with hypertension prevalence (p-values for interaction < 0.01); the associations were generally stronger for women. OPA was associated with a higher prevalence of hypertension in women, but not in men (p-value for interaction > 0.05). CONCLUSIONS Higher levels of total PA and LTPA were associated with lower prevalence of hypertension in both men and women, with slightly stronger associations for women. However, higher OPA was associated with a higher prevalence of hypertension in women. These findings support the PA health paradox hypothesis and highlight the sex disparities in the association between OPA and hypertension prevalence.
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Affiliation(s)
- Min Jeong Cho
- Department of Sport Science, University of Seoul, Seoul, Republic of Korea
| | - Yong Joon Jung
- Department of Sport Science, University of Seoul, Seoul, Republic of Korea
| | - Ho Jeong Min
- Department of Sport Science, University of Seoul, Seoul, Republic of Korea
| | - Hyun Jeong Kim
- Department of Sport Science, University of Seoul, Seoul, Republic of Korea
| | - Setor K Kunutsor
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
| | - Sae Young Jae
- Department of Sport Science, University of Seoul, Seoul, Republic of Korea.
- Graduate School of Urban Public Health, University of Seoul, Seoul, Republic of Korea.
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Kumar SJ, Shukla S, Kumar S, Mishra P. Immunosenescence and Inflamm-Aging: Clinical Interventions and the Potential for Reversal of Aging. Cureus 2024; 16:e53297. [PMID: 38435871 PMCID: PMC10906346 DOI: 10.7759/cureus.53297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
Inflammation is often associated with the impairment of the ability to sustain the consequences of the physical, chemical, nutritional, and antigenic triggers of inflammation. The process of immunosenescence may only partially be explained by the senescence of cells, tissues, or the organism, and, hence, the hallmarks of immunosenescence may be markedly and differentially affected by the history of an individual's pathogenic encounter. Inflammation is a key component of immunosenescence, which itself is a direct consequence of aging. This review article highlights the therapeutic interventions for slowing the processes of inflamm-aging and immunosenescence and the possible reversal of aging and includes domains of immunomodulatory interventions, vaccination strategies, nutritional interventions, stem cell therapies, personalized medicine, microbiome interventions, and the positive effects of physical activity and exercise.
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Affiliation(s)
- Samayak J Kumar
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Samarth Shukla
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sunil Kumar
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Preeti Mishra
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Kawamura T, Radak Z, Tabata H, Akiyama H, Nakamura N, Kawakami R, Ito T, Usui C, Jokai M, Torma F, Kim H, Miyachi M, Torii S, Suzuki K, Ishii K, Sakamoto S, Oka K, Higuchi M, Muraoka I, McGreevy KM, Horvath S, Tanisawa K. Associations between cardiorespiratory fitness and lifestyle-related factors with DNA methylation-based ageing clocks in older men: WASEDA'S Health Study. Aging Cell 2024; 23:e13960. [PMID: 37584423 PMCID: PMC10776125 DOI: 10.1111/acel.13960] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/17/2023] Open
Abstract
DNA methylation-based age estimators (DNAm ageing clocks) are currently one of the most promising biomarkers for predicting biological age. However, the relationships between cardiorespiratory fitness (CRF), measured directly by expiratory gas analysis, and DNAm ageing clocks are largely unknown. We investigated the relationships between CRF and the age-adjusted value from the residuals of the regression of DNAm ageing clock to chronological age (DNAmAgeAcceleration: DNAmAgeAccel) and attempted to determine the relative contribution of CRF to DNAmAgeAccel in the presence of other lifestyle factors. DNA samples from 144 Japanese men aged 65-72 years were used to appraise first- (i.e., DNAmHorvath and DNAmHannum) and second- (i.e., DNAmPhenoAge, DNAmGrimAge, and DNAmFitAge) generation DNAm ageing clocks. Various surveys and measurements were conducted, including physical fitness, body composition, blood biochemical parameters, nutrient intake, smoking, alcohol consumption, disease status, sleep status, and chronotype. Both oxygen uptake at ventilatory threshold (VO2 /kg at VT) and peak oxygen uptake (VO2 /kg at Peak) showed a significant negative correlation with GrimAgeAccel, even after adjustments for chronological age and smoking and drinking status. Notably, VO2 /kg at VT and VO2 /kg at Peak above the reference value were also associated with delayed GrimAgeAccel. Multiple regression analysis showed that calf circumference, serum triglyceride, carbohydrate intake, and smoking status, rather than CRF, contributed more to GrimAgeAccel and FitAgeAccel. In conclusion, although the contribution of CRF to GrimAgeAccel and FitAgeAccel is relatively low compared to lifestyle-related factors such as smoking, the results suggest that the maintenance of CRF is associated with delayed biological ageing in older men.
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Affiliation(s)
- Takuji Kawamura
- Waseda Institute for Sport Sciences, Waseda UniversitySaitamaJapan
- Research Centre for Molecular Exercise ScienceHungarian University of Sports ScienceBudapestHungary
| | - Zsolt Radak
- Research Centre for Molecular Exercise ScienceHungarian University of Sports ScienceBudapestHungary
- Faculty of Sport SciencesWaseda UniversitySaitamaJapan
| | - Hiroki Tabata
- Waseda Institute for Sport Sciences, Waseda UniversitySaitamaJapan
- Sportology CentreJuntendo University Graduate School of MedicineTokyoJapan
| | - Hiroshi Akiyama
- Graduate School of Sport SciencesWaseda UniversitySaitamaJapan
| | | | - Ryoko Kawakami
- Waseda Institute for Sport Sciences, Waseda UniversitySaitamaJapan
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and WelfareTokyoJapan
| | - Tomoko Ito
- Waseda Institute for Sport Sciences, Waseda UniversitySaitamaJapan
- Department of Food and NutritionTokyo Kasei UniversityTokyoJapan
| | - Chiyoko Usui
- Faculty of Sport SciencesWaseda UniversitySaitamaJapan
| | - Matyas Jokai
- Research Centre for Molecular Exercise ScienceHungarian University of Sports ScienceBudapestHungary
| | - Ferenc Torma
- Faculty of Health and Sport SciencesUniversity of TsukubaIbarakiJapan
| | - Hyeon‐Ki Kim
- Research Centre for Molecular Exercise ScienceHungarian University of Sports ScienceBudapestHungary
| | | | - Suguru Torii
- Faculty of Sport SciencesWaseda UniversitySaitamaJapan
| | | | - Kaori Ishii
- Faculty of Sport SciencesWaseda UniversitySaitamaJapan
| | - Shizuo Sakamoto
- Faculty of Sport SciencesWaseda UniversitySaitamaJapan
- Faculty of Sport ScienceSurugadai UniversitySaitamaJapan
| | - Koichiro Oka
- Faculty of Sport SciencesWaseda UniversitySaitamaJapan
| | | | - Isao Muraoka
- Faculty of Sport SciencesWaseda UniversitySaitamaJapan
| | - Kristen M. McGreevy
- Department of Biostatistics, Fielding School of Public HealthUniversity of California Los AngelesLos AngelesCaliforniaUSA
| | - Steve Horvath
- Department of Biostatistics, Fielding School of Public HealthUniversity of California Los AngelesLos AngelesCaliforniaUSA
- Department of Human Genetics, David Geffen School of MedicineUniversity of California Los AngelesLos AngelesCaliforniaUSA
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Kunutsor SK, Laukkanen JA. Physical activity, exercise and adverse cardiovascular outcomes in individuals with pre-existing cardiovascular disease: a narrative review. Expert Rev Cardiovasc Ther 2024; 22:91-101. [PMID: 38488568 PMCID: PMC11057847 DOI: 10.1080/14779072.2024.2328644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 03/06/2024] [Indexed: 03/28/2024]
Abstract
INTRODUCTION The evidence supporting the cardiovascular health benefits of physical activity and/or exercise training is well-established. While the role of physical activity in primary prevention is unequivocal, its significance in secondary prevention (among those with preexisting cardiovascular disease) is less definitive. Though guidelines universally recommend physical activity as part of the secondary preventive strategy, the empirical evidence underpinning these recommendations is not as robust as that for primary prevention. AREAS COVERED This review distills the body of available observational and interventional evidence on the relationship between physical activity, exercise, and adverse cardiovascular outcomes among those with preexisting cardiovascular disease. The postulated biologic mechanisms underlying the relationships, areas of prevailing uncertainty, and potential public health implications are also discussed. EXPERT OPINION A physical activity level of 500 MET-min/week (equivalent to 150 min of moderate-intensity physical activity or 75 min of vigorous-intensity physical activity or an equivalent combination) may be a minimum requirement for patients with preexisting CVD. However, to reap the maximum benefits of physical activity and also minimize adverse effects, physical activity and/or exercise regimens should be tailored to unique factors such as individual's baseline physical activity habits, cardiovascular health status and the specific nature of their cardiovascular disease.
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Affiliation(s)
- Setor K. Kunutsor
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Jari A. Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland
- Wellbeing Services County of Central Finland, Department of Medicine, Jyväskylä, Finland
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Rymuza H, Mączyńska J, Krauze N, Kowalik I, Smolis-Bąk E, Ciszewski A, Szwed H, Dąbrowski R. Effects of exercise training after acute coronary syndromes in octogenarians - prospective 12-month evaluation. POLSKI MERKURIUSZ LEKARSKI : ORGAN POLSKIEGO TOWARZYSTWA LEKARSKIEGO 2024; 52:145-152. [PMID: 38642349 DOI: 10.36740/merkur202402102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/22/2024]
Abstract
OBJECTIVE Aim: To demonstrate the impact of individual exercise training on the course of the disease, exercise tolerance and quality of life (QoL) in patients over 75 years after acute coronary syndrome (ACS). PATIENTS AND METHODS Materials and methods: Study included octogenarians after ACS randomly assigned into two groups: a training group (ExT) subjected to individualized physical training and a control group (CG) with standard recommendations for activity. Patients underwent exercise tolerance test (ETT), 6-minute walk test (6-MWT), NHP and QoL questionnaires evaluation, lab tests, ECG, echocardiographic examination at the beginning and after 2, 6 and 12 months. RESULTS Results: Study included 51 patients, mean age 80 years, 50% men, all patients completed the study. Initial physical capacity was comparable in both groups. After 2-month training the average ETT exercise time increased by 12.5% (p=0.0004), the load increased by 13% (p=0.0005) and the 6-MWT results improved by 8.3% (p=0.0114). Among CG these changes were not significant. But 6 and 12 months after training cessation 6-MWT results returned to the initial values (p=0.069, p=0.062 respecitvely). Average ETT exercise time and average load decreased significantly after 12 months (p=0.0009, p=0.0006). Level of pain was significantly lower at the end of the training in ExT group (p=0.007), but it returned to initial 12 months later (p=0.48). QoL deteriorated significantly in the ExT group 12 months after training cessation (p=0.04). CONCLUSION Conclusions: Cardiac rehabilitation in octogenarians after ACS was safe and improved physical performance in a short period of time. Cessation of training resulted in a loss of achieved effects and deterioration of the QoL.
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Affiliation(s)
- Hanna Rymuza
- CARDIOLOGY CLINIC, NATIONAL INSTITUTE OF CARDIOLOGY, WARSAW, POLAND
| | - Justyna Mączyńska
- DEPARTMENT OF CORONARY DISEASE AND CARDIOLOGICAL REHABILITATION, NATIONAL INSTITUTE OF CARDIOLOGY, WARSAW, POLAND
| | - Natasza Krauze
- DEPARTMENT OF CARDIOLOGY, MEDICAL UNIVERSITY OF WARSAW, WARSAW, POLAND
| | - Ilona Kowalik
- DEPARTMENT OF CORONARY DISEASE AND CARDIOLOGICAL REHABILITATION, NATIONAL INSTITUTE OF CARDIOLOGY, WARSAW, POLAND
| | - Edyta Smolis-Bąk
- DEPARTMENT OF CORONARY DISEASE AND CARDIOLOGICAL REHABILITATION, NATIONAL INSTITUTE OF CARDIOLOGY, WARSAW, POLAND
| | - Andrzej Ciszewski
- DEPARTMENT OF INTERVENTIONAL CARDIOLOGY AND ANGIOLOGY, NATIONAL INSTITUTE OF CARDIOLOGY, WARSAW, POLAND
| | - Hanna Szwed
- DEPARTMENT OF CORONARY DISEASE AND CARDIOLOGICAL REHABILITATION, NATIONAL INSTITUTE OF CARDIOLOGY, WARSAW, POLAND
| | - Rafał Dąbrowski
- DEPARTMENT OF CORONARY DISEASE AND CARDIOLOGICAL REHABILITATION, NATIONAL INSTITUTE OF CARDIOLOGY, WARSAW, POLAND
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Hardcastle SJ, Maxwell-Smith C, Cavalheri V, Boyle T, Román ML, Platell C, Levitt M, Saunders C, Sardelic F, Nightingale S, McCormick J, Lynch C, Cohen PA, Bulsara M, Hince D. A randomized controlled trial of Promoting Physical Activity in Regional and Remote Cancer Survivors (PPARCS). JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:81-89. [PMID: 36736725 PMCID: PMC10818110 DOI: 10.1016/j.jshs.2023.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/09/2022] [Accepted: 12/13/2022] [Indexed: 05/09/2023]
Abstract
BACKGROUND Physical activity (PA) is important for cancer survivors. Trials of remotely delivered interventions are needed to assist in reaching under-served non-metropolitan cancer survivors. The objective of this study was to ascertain whether wearable technology, coupled with health coaching was effective in increasing PA in breast and colorectal cancer survivors living in regional and remote areas in Australia. METHODS Cancer survivors from 5 states were randomized to intervention and control arms. Intervention participants were given a Fitbit Charge 2TM and received up to 6 telephone health coaching sessions. Control participants received PA print materials. Accelerometer assessments at baseline and 12 weeks measured moderate-to-vigorous PA (MVPA), light PA, and sedentary behavior. RESULTS Eighty-seven participants were recruited (age = 63 ± 11 years; 74 (85%) female). There was a significant net improvement in MVPA of 49.8 min/week, favoring the intervention group (95% confidence interval (95%CI): 13.6-86.1, p = 0.007). There was also a net increase in MVPA bouts of 39.5 min/week (95%CI: 11.9-67.1, p = 0.005), favoring the intervention group. Both groups improved light PA and sedentary behavior, but there were no between-group differences. CONCLUSION This is the first study to demonstrate that, when compared to standard practice (i.e., PA education), a wearable technology intervention coupled with distance-based health coaching, improves MVPA in non-metropolitan cancer survivors. The results display promise for the use of scalable interventions using smart wearable technology in conjunction with phone-based health coaching to foster increased PA in geographically disadvantaged cancer survivors.
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Affiliation(s)
- Sarah J Hardcastle
- Sport and Physical Activity Research Centre, Sheffield Hallam University, Sheffield, S10 2BP, UK; Institute for Health Research, The University of Notre Dame, Fremantle, WA 6959, Australia; Curtin School of Population Health, Curtin University, Perth, WA 6845, Australia.
| | - Chloe Maxwell-Smith
- Curtin School of Population Health, Curtin University, Perth, WA 6845, Australia
| | - Vinicius Cavalheri
- Curtin School of Allied Health, Curtin University, Perth, WA 6845, Australia; Allied Health, South Metropolitan Health Service, Murdoch, WA 6150, Australia
| | - Terry Boyle
- Australian Centre for Precision Health, University of South Australia, Adelaide, SA 5001, Australia
| | - Marta Leyton Román
- Department of Didactics of Musical, Plastic and Body Expression, University of Extremadura, Caceres 10071, Spain
| | | | - Michael Levitt
- St. John of God Subiaco Hospital, Perth, WA 6008, Australia
| | - Christobel Saunders
- St. John of God Subiaco Hospital, Perth, WA 6008, Australia; Department of Surgery, University of Melbourne, Melbourne, VIC 3010, Australia
| | | | | | - Jacob McCormick
- Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
| | - Craig Lynch
- College of Health and Medicine, Australian National University, Canberra, ACT 2600, Australia
| | - Paul A Cohen
- Institute for Health Research, The University of Notre Dame, Fremantle, WA 6959, Australia; St. John of God Subiaco Hospital, Perth, WA 6008, Australia; Division of Obstetrics and Gynaecology, Medical School, University of Western Australia, Perth, WA 6009, Australia
| | - Max Bulsara
- Institute for Health Research, The University of Notre Dame, Fremantle, WA 6959, Australia
| | - Dana Hince
- Institute for Health Research, The University of Notre Dame, Fremantle, WA 6959, Australia
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Ekelund U, Sanchez-Lastra MA, Dalene KE, Tarp J. Dose-response associations, physical activity intensity and mortality risk: A narrative review. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:24-29. [PMID: 37734548 PMCID: PMC10818107 DOI: 10.1016/j.jshs.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 09/23/2023]
Abstract
Physical activity is consistently associated with reduced mortality, decreased risk for non-communicable diseases, and improved mental health in observational studies. Randomized controlled trials and observational Mendelian randomization studies support causal links between physical activity and health outcomes. However, the scarcity of evidence from randomized controlled trials, along with their inherent challenges like exposure contrasts, healthy volunteer biases, loss to follow-up, and limited real-world dose-response data, warrants a comprehensive approach. This review advocates synthesizing insights from diverse study designs to better understand the causal relationship between physical activity, mortality risk, and other health outcomes. Additionally, it summarizes recent research since the publication of current physical activity recommendations. Novel observational studies utilizing device-measured physical activity underscore the importance of every minute of activity and suggest that all intensity levels confer health benefits, with vigorous-intensity potentially requiring lower volumes for substantial benefits. Future guidelines, informed by device-measured physical activity studies, may offer refined age-specific recommendations, emphasize vigorous-intensity physical activity, and include daily step counts as a simple, easily assessable metric using commercial wearables.
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Affiliation(s)
- Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo 0806, Norway; Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo 0213, Norway.
| | - Miguel Adriano Sanchez-Lastra
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo 0806, Norway; Department of Special Didactics, Faculty of Education and Sports Sciences, University of Vigo, Pontevedra 36005, Spain; Well-Move Research Group, Galicia-Sur Health Research Institute (SERGAS-UVIGO), Vigo 36213, Spain
| | - Knut Eirik Dalene
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo 0213, Norway
| | - Jakob Tarp
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo 0806, Norway
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