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Jordakieva G, Hasenoehrl T, Steiner M, Jensen-Jarolim E, Crevenna R. Occupational physical activity: the good, the bad, and the proinflammatory. Front Med (Lausanne) 2023; 10:1253951. [PMID: 37869170 PMCID: PMC10587420 DOI: 10.3389/fmed.2023.1253951] [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: 07/06/2023] [Accepted: 09/11/2023] [Indexed: 10/24/2023] Open
Abstract
Background Physical activity (PA) is beneficial for preventing several conditions associated with underlying chronic inflammation, e. g., cardiovascular disease (CVD) and cancer. While an active lifestyle appears to have anti-inflammatory effects, high levels of occupational PA (OPA) were associated with inflammation and elevated mortality risks. We aimed to summarize the current knowledge (1) on the association between inflammation and OPA and (2) its implications for health and mortality. Methods and results This mini-review summarized relevant literature published before January 2023 using established scientific databases and sources. For the primary outcome, observational studies (S) reporting immunological effects (O) in subjects (P), with high (I) vs. low OPA (C), were included. For secondary outcomes, i.e., morbidity and mortality associated with inflammatory processes, (systematic) reviews were included. While "active" occupations and "moderate" OPA appear to have beneficial effects, low (particularly sedentary) and "high-intensity" OPA (particularly including heavy lifting tasks) were associated with inflammation and (CVD and cancer-related) mortality; higher leisure-time PA has been almost consistently associated with lower proinflammatory markers and all-cause mortality risks. Workplace interventions appear to counter some of the observed health effects of unfavorable work strain. Conclusion The few studies addressing OPA "intensity" and inflammatory markers are largely heterogeneous regarding OPA classification and confounder control. Sedentary and "heavy" OPA appear to promote proinflammatory effects. In addition to targeted management of work-related physical strain and hazardous environmental co-factors, occupational health providers should focus on employer-initiated exercise interventions and the promotion of leisure-time PA.
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Affiliation(s)
- Galateja Jordakieva
- Department of Physical Medicine, Rehabilitation, and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Timothy Hasenoehrl
- Department of Physical Medicine, Rehabilitation, and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Margarete Steiner
- Department of Physical Medicine, Rehabilitation, and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Erika Jensen-Jarolim
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
- The Interuniversity Messerli Research Institute, Medical University of Vienna, Vienna, Austria
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation, and Occupational Medicine, Medical University of Vienna, Vienna, Austria
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2
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Garcia L, Pearce M, Abbas A, Mok A, Strain T, Ali S, Crippa A, Dempsey PC, Golubic R, Kelly P, Laird Y, McNamara E, Moore S, de Sa TH, Smith AD, Wijndaele K, Woodcock J, Brage S. Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose-response meta-analysis of large prospective studies. Br J Sports Med 2023; 57:979-989. [PMID: 36854652 PMCID: PMC10423495 DOI: 10.1136/bjsports-2022-105669] [Citation(s) in RCA: 41] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To estimate the dose-response associations between non-occupational physical activity and several chronic disease and mortality outcomes in the general adult population. DESIGN Systematic review and cohort-level dose-response meta-analysis. DATA SOURCES PubMed, Scopus, Web of Science and reference lists of published studies. ELIGIBILITY CRITERIA Prospective cohort studies with (1) general population samples >10 000 adults, (2) ≥3 physical activity categories, and (3) risk measures and CIs for all-cause mortality or incident total cardiovascular disease, coronary heart disease, stroke, heart failure, total cancer and site-specific cancers (head and neck, myeloid leukaemia, myeloma, gastric cardia, lung, liver, endometrium, colon, breast, bladder, rectum, oesophagus, prostate, kidney). RESULTS 196 articles were included, covering 94 cohorts with >30 million participants. The evidence base was largest for all-cause mortality (50 separate results; 163 415 543 person-years, 811 616 events), and incidence of cardiovascular disease (37 results; 28 884 209 person-years, 74 757 events) and cancer (31 results; 35 500 867 person-years, 185 870 events). In general, higher activity levels were associated with lower risk of all outcomes. Differences in risk were greater between 0 and 8.75 marginal metabolic equivalent of task-hours per week (mMET-hours/week) (equivalent to the recommended 150 min/week of moderate-to-vigorous aerobic physical activity), with smaller marginal differences in risk above this level to 17.5 mMET-hours/week, beyond which additional differences were small and uncertain. Associations were stronger for all-cause (relative risk (RR) at 8.75 mMET-hours/week: 0.69, 95% CI 0.65 to 0.73) and cardiovascular disease (RR at 8.75 mMET-hours/week: 0.71, 95% CI 0.66 to 0.77) mortality than for cancer mortality (RR at 8.75 mMET-hours/week: 0.85, 95% CI 0.81 to 0.89). If all insufficiently active individuals had achieved 8.75 mMET-hours/week, 15.7% (95% CI 13.1 to 18.2) of all premature deaths would have been averted. CONCLUSIONS Inverse non-linear dose-response associations suggest substantial protection against a range of chronic disease outcomes from small increases in non-occupational physical activity in inactive adults. PROSPERO registration number CRD42018095481.
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Affiliation(s)
- Leandro Garcia
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Matthew Pearce
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Ali Abbas
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Alexander Mok
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Tessa Strain
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Sara Ali
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Alessio Crippa
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paddy C Dempsey
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rajna Golubic
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh Institute for Sport, Physical Education and Health Sciences, Edinburgh, UK
| | - Yvonne Laird
- Sydney School of Public Health, Prevention Research Collaboration, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Eoin McNamara
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Economic and Social Research Institute, Dublin, Ireland
| | - Samuel Moore
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Thiago Herick de Sa
- Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Andrea D Smith
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Department of Behavioural Science and Health, University College London, London, UK
| | - Katrien Wijndaele
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - James Woodcock
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
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3
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Park Y, Sinn DH, Kim K, Gwak GY. Associations of physical activity domains and muscle strength exercise with non-alcoholic fatty liver disease: a nation-wide cohort study. Sci Rep 2023; 13:4724. [PMID: 36959316 PMCID: PMC10036618 DOI: 10.1038/s41598-023-31686-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/15/2023] [Indexed: 03/25/2023] Open
Abstract
It is unclear if various types and domains of exercise have an identical effect on non-alcoholic fatty liver disease (NAFLD). Thus, this study aimed to investigate associations of different physical activity domains and muscle strength exercise with NAFLD using a nation-wide cohort database. Adults aged 20-79 years who participated in the Korean National Health and Nutrition Examination Survey between 2014 and 2018 were analyzed. Hepatic steatosis index was used to identify NAFLD. Physical activity was assessed with the Global Physical Activity Questionnaire. Of 21,015 participants, 4942 (23.5%) had NAFLD. Participants with ≥ 150 min/week of total physical activity had a lower risk of NAFLD than those with < 150 min/week (the fully adjusted OR: 0.86, 95% CI 0.78-0.95). When the individual domain of physical activity was assessed, ≥ 150 min/week of recreation activity was associated with a reduced risk of NAFLD (OR: 0.77, 95% CI 0.67-0.88), whereas ≥ 150 min/week of travel or work activity was not. The fully adjusted OR for NAFLD comparing participants with ≥ 2/week to those with < 2/week of muscle strength exercise was 0.83 (95% CI 0.73-0.94). Muscle strength exercise ≥ 2/week showed a lower risk of NAFLD for all levels of total and each specific domains of physical activity except for ≥ 150 min/week of work activity. An increased level of physical activity and muscle strength exercise was associated with a reduced risk of NAFLD, albeit the effect varied depending on domains of physical activity. Thus, physical activity should be differentiated by domains for the management of NAFLD. Muscle strength exercise could also be a good option for individuals who could not perform moderate-to-vigorous physical activity.
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Affiliation(s)
- Yewan Park
- Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Korea
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Dong Hyun Sinn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyunga Kim
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Korea
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Geum-Youn Gwak
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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4
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Mu X, Liu S, Fu M, Luo M, Ding D, Chen L, Yu K. Associations of physical activity intensity with incident cardiovascular diseases and mortality among 366,566 UK adults. Int J Behav Nutr Phys Act 2022; 19:151. [PMID: 36514169 PMCID: PMC9745930 DOI: 10.1186/s12966-022-01393-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The associations of the proportion of vigorous physical activity (VPA) to moderate to vigorous physical activity (MVPA) with incident cardiovascular disease (CVD) and all-cause mortality are unclear. METHODS The present study included 366,566 participants (aged 40-69 years) without baseline CVD from the UK biobank during 2006 to 2010. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for risks of outcomes. RESULTS During a median 11.8 years of follow-up, among 366,566 participants (mean age [SD]: 56.0 [8.1]), 31,894 incident CVD and 19,823 total deaths were documented. Compared with no VPA, 0%-30% of VPA to MVPA was associated with 12% and 19% lower risks of incident CVD (HR, 0.88 [95% CI, 0.86-0.91]) and all-cause mortality (HR, 0.81 [95% CI, 0.78-0.84]), respectively. Furthermore, we found that the maximum reduction of risks of incident CVD and all-cause mortality occurred at performing approximately 30% of VPA to MVPA (P < 0.001). Compared with participants reporting the lowest levels of MVPA (moderate physical activity [MPA], 0-150 min/week; VPA, 0-75 min/week), those performing 150-300 min/week of MPA and ≥ 150 min/week of VPA experienced the lowest risk of incident CVD (HR, 0.87 [95% CI, 0.79-0.95]) and all-cause mortality (HR, 0.71 [95% CI, 0.63-0.80]). Interestingly, we found that smokers yielded more cardiovascular benefits than non-smokers by performing a higher volume of VPA. CONCLUSIONS Comparing with UK adults reporting no VPA, engaging in 30% of VPA was associated with the lowest risk of incident CVD and all-cause mortality.
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Affiliation(s)
- Xuanwen Mu
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Shuangyan Liu
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Mingjian Fu
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Mengyun Luo
- grid.1013.30000 0004 1936 834XSydney School of Public Health, Faculty of Medicine and Health, the University of Sydney, Camperdown, NSW 2006 Australia ,grid.1013.30000 0004 1936 834XCharles Perkins Center, the University of Sydney, Camperdown, NSW 2006 Australia ,grid.16821.3c0000 0004 0368 8293School of Public Health, School of Medicine, Shanghai Jiao Tong University, 200240 Shanghai, People’s Republic of China
| | - Ding Ding
- grid.1013.30000 0004 1936 834XSydney School of Public Health, Faculty of Medicine and Health, the University of Sydney, Camperdown, NSW 2006 Australia ,grid.1013.30000 0004 1936 834XCharles Perkins Center, the University of Sydney, Camperdown, NSW 2006 Australia
| | - Liangkai Chen
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China ,grid.33199.310000 0004 0368 7223Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Kuai Yu
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
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5
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Effect of Household Type on the Prevalence of Metabolic Syndrome in Korea: Using Propensity Score Matching. Healthcare (Basel) 2022; 10:healthcare10101894. [PMID: 36292341 PMCID: PMC9601769 DOI: 10.3390/healthcare10101894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022] Open
Abstract
This study analyzed the effect of the household type on the prevalence of metabolic syndrome in Koreans utilizing data from the sixth, seventh, and eighth Korea National Health and Nutrition Examination Surveys conducted by the Korea Disease Control and Prevention Agency from 2015 to 2019. The demographic characteristics, metabolic syndrome characteristics according to household type, and risk factors of 25,092 subjects were identified using the Rao−Scott χ2−test and weighted multiple logistic regression results. Furthermore, to understand the effect of the household type on prevalence of metabolic syndrome, the selection bias between the groups was eliminated using the propensity score matching method. The average treatment effect for those treated for metabolic syndrome prior to propensity score matching was higher for single-person households, with 0.353 and 0.268 for single- and multi-person households, respectively. The difference was statistically significant (p < 0.0001). However, after propensity score matching, it was observed to be higher for multi-person households, with 0.290 and 0.316 for single- and multi-person households, respectively. However, the difference was not statistically significant (p < 0.1822). Difference was observed regarding the prevalence of metabolic syndrome by individual characteristics, some of which were considered in previous studies. However, the household type alone did not explain the prevalence of metabolic syndrome.
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Galmes-Panades AM, Abbate M, Bennasar-Veny M, López-González AA, Vicente-Herrero MT, Busquets-Cortés C, Leiva A, Yañez AM. Occupational and Leisure Physical Activity on Cardiovascular Risk and Body Composition Among Courier Workers. Biol Res Nurs 2022; 24:560-572. [PMID: 35613699 DOI: 10.1177/10998004221105535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE There is some controversy about the beneficial effects of occupational physical activity (OPA) on cardiovascular risk (CVR). The main aim of this study was to explore the effect of the combination of different frequencies of leisure-time physical activity (LTPA) and two types of OPA on CVR and body composition, and whether the association between physical activity (PA) and CVR was mediated by visceral adipose tissue (VAT). METHODS This cross-sectional study included data from 2516 couriers living in Spain, delivering either by motorbike or foot, and practicing LTPA never, occasionally, or regularly. Couriers were classified into six categories according to LTPA and OPA; body composition was assessed by Bioelectrical Impedance, and CVR by the Framingham equation. General linear models were performed to explore the association between different categories with each outcome (CVR and body composition) and the possible role of VAT as a mediator between PA and CVR. RESULTS Compared with the most sedentary group (motorbike couriers that never practice PA), walking couriers who practice regular PA presented the lowest CVR [β -1.58 (95% CI -2.31; -0.85)] and the lowest VAT [β -2.86 (95% CI -3.74; -1.98) followed by the motorbike couriers who practiced regular PA [β -0.51 (95% CI -1.00; -0.03) for CVR and β -2.33 (95% CI -2.91; -1.75) for VAT]. The association between PA and CVR was partially mediated by VAT. CONCLUSION The present results indicated that both OPA and LTPA are protective factors for CVR and play an important role on VAT accumulation.
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Affiliation(s)
- Aina Maria Galmes-Panades
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Research Group on Nutritional Epidemiology & Cardiovascular Physiopathology (NUTRECOR), 219656Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma, Spain
| | - Manuela Abbate
- Research Group on Global Health and Lifestyle (EVES), 219656Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma, Spain
| | - Miquel Bennasar-Veny
- Research Group on Global Health and Lifestyle (EVES), 219656Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma, Spain.,Nursing and Physiotherapy Department, 16745Universitat de les Illes Balears, Palma, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), 117368Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Angel Arturo López-González
- Prevention of Occupational Risks in Health Services, 88144Balearic Islands Health Service, Palma, Spain.,Escuela Universitaria ADEMA, Palma, Illes Balears, Spain.,Instituto Universitario de Investigación en Ciencias de la Salud (IUNICS), 16745Universitat de les Illes Balears, Palma, Spain
| | | | - Carla Busquets-Cortés
- Escuela Universitaria ADEMA, Palma, Illes Balears, Spain.,Instituto Universitario de Investigación en Ciencias de la Salud (IUNICS), 16745Universitat de les Illes Balears, Palma, Spain
| | - Alfonso Leiva
- Primary Care Research Unit of Mallorca, 88144Balearic Islands Health Services (IbSalut), Palma, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Palma, Spain
| | - Aina María Yañez
- Research Group on Global Health and Lifestyle (EVES), 219656Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases (HUSE), Palma, Spain.,Nursing and Physiotherapy Department, 16745Universitat de les Illes Balears, Palma, Spain.,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Palma, Spain
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7
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Peterman JE, Bassett DR, Finch WH, Harber MP, Whaley MH, Fleenor BS, Kaminsky LA. Associations Between Active Commuting and Cardiovascular Disease in the United States. J Phys Act Health 2021; 18:1525-1531. [PMID: 34689123 DOI: 10.1123/jpah.2021-0245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/06/2021] [Accepted: 08/20/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Active commuting is inversely related with cardiovascular disease (CVD) risk factors yet associations with CVD prevalence in the US population are unknown. METHODS Aggregate data from national surveys conducted in 2017 provided state-level percentages of adults who have/had coronary heart disease, myocardial infarction, and stroke, and who actively commuted to work. Associations between active commuting and CVD prevalence rates were assessed using Pearson correlations and generalized additive models controlling for covariates. RESULTS Significant correlations were observed between active commuting and all CVD rates (r range = -.31 to -.47; P < .05). The generalized additive model analyses for active commuting (walking, cycling, or public transport) in all adults found no relationships with CVD rates; however, a significant curvilinear association was observed for stroke within men. The generalized additive model curves when examining commuting via walking or cycling in all adults demonstrated nuanced, generally negative linear or curvilinear associations between coronary heart disease, myocardial infarction, and stroke. CONCLUSION Significant negative correlations were observed between active commuting and prevalence rates of coronary heart disease, myocardial infarction, and stroke. Controlling for covariates influenced these associations and highlights the need for future research to explore the potential of active commuting modes to reduce CVD in the United States.
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Lin Y, Yang X, Liang F, Huang K, Liu F, Li J, Xiao Q, Chen J, Liu X, Cao J, Chen S, Shen C, Yu L, Lu F, Wu X, Zhao L, Wu X, Li Y, Hu D, Huang J, Lu X, Liu Y, Gu D. Benefits of active commuting on cardiovascular health modified by ambient fine particulate matter in China: A prospective cohort study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 224:112641. [PMID: 34461320 PMCID: PMC9188394 DOI: 10.1016/j.ecoenv.2021.112641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Active commuting as a contributor to daily physical activity is beneficial for cardiovascular health, but leads to more chances of exposure to ambient air pollution. This study aimed to investigate associations between active commuting to work with cardiovascular disease (CVD), mortality and life expectancy among general Chinese adults, and to further evaluate the modification effect of fine particulate matter (PM2.5) exposure on these associations. METHODS We included 76,176 Chinese adults without CVD from three large cohorts of the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project. Information about commuting mode and physical activity were collected by unified questionnaire. Satellite-based PM2.5 concentrations at 1-km spatial resolution was used for estimating PM2.5 exposure of participants. Hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD incidence, mortality and all-cause mortality were estimated using Cox proportional hazards regression models. Multiplicative interaction term of commuting mode and PM2.5 level was tested to investigate potential effect modification. RESULTS During 448,499 person-years of follow-up, 2230 CVD events and 2777 all-cause deaths were recorded. Compared with the non-active commuters, the multivariable-adjusted HRs (95% CIs) of CVD incidence and all-cause mortality were 0.95(0.85-1.05) and 0.79(0.72-0.87) for walking commuters, respectively. Corresponding HRs (95% CIs) for cycling commuters were 0.71(0.62-0.82) and 0.67(0.59-0.76). Active commuters over 45 years old were estimated to have more CVD-free years and life expectancy than non-active commuters under lower PM2.5 concentration. However, these beneficial effects of active commuting were alleviated or counteracted by long-term exposure to high PM2.5 concentration. Significant multiplicative interaction of commuting mode and PM2.5 level was showed in all-cause mortality, with the lowest risk observed in cycling participants exposed to lower level of PM2.5. CONCLUSIONS Active commuting was associated with lower risk of CVD, all-cause mortality, and longer life expectancy among Chinese adults under ambient settings with lower PM2.5 level. It will be valuable to encourage active commuting among adults and develop stringent strategies on ambient PM2.5 pollution control for prevention of CVD and prolongation of life expectancy.
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Affiliation(s)
- Yuan Lin
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Fengchao Liang
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China
| | - Keyong Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Fangchao Liu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Jianxin Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Qingyang Xiao
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Jichun Chen
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xiaoqing Liu
- Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou 510080, China
| | - Jie Cao
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Shufeng Chen
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Chong Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Ling Yu
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou 350014, China
| | - Fanghong Lu
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan 250062, China
| | - Xianping Wu
- Center for Chronic and Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - Liancheng Zhao
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xigui Wu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Ying Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518071, China
| | - Jianfeng Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xiangfeng Lu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Yang Liu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Dongfeng Gu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China.
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9
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Prince SA, Rasmussen CL, Biswas A, Holtermann A, Aulakh T, Merucci K, Coenen P. The effect of leisure time physical activity and sedentary behaviour on the health of workers with different occupational physical activity demands: a systematic review. Int J Behav Nutr Phys Act 2021; 18:100. [PMID: 34284795 PMCID: PMC8290554 DOI: 10.1186/s12966-021-01166-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/30/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Although it is generally accepted that physical activity reduces the risk for chronic non-communicable disease and mortality, accumulating evidence suggests that occupational physical activity (OPA) may not confer the same health benefits as leisure time physical activity (LTPA). It is also unclear if workers in high OPA jobs benefit from LTPA the same way as those in sedentary jobs. Our objective was to determine whether LTPA and leisure time sedentary behaviour (LTSB) confer the same health effects across occupations with different levels of OPA. METHODS Searches were run in Medline, Embase, PsycINFO, ProQuest Public Health and Scopus from inception to June 9, 2020. Prospective or experimental studies which examined the effects of LTPA or LTSB on all-cause and cardiovascular mortality and cardiovascular disease, musculoskeletal pain, diabetes, metabolic syndrome, arrhythmias and depression among adult workers grouped by OPA (low OPA/sitters, standers, moderate OPA/intermittent movers, high OPA/heavy labourers) were eligible. Results were synthesized using narrative syntheses and harvest plots, and certainty of evidence assessed with GRADE. RESULTS The review includes 38 papers. Across all outcomes, except cardiovascular mortality, metabolic syndrome and atrial fibrillation, greater LTPA was consistently protective among low OPA, but conferred less protection among moderate and high OPA. For cardiovascular mortality and metabolic syndrome, higher levels of LTPA were generally associated with similar risk reductions among all OPA groups. Few studies examined effects in standers and none examined effects of LTSB across OPA groups. CONCLUSIONS Evidence suggests that LTPA is beneficial for all workers, but with larger risk reductions among those with low compared to high OPA jobs. This suggests that, in our attempts to improve the health of workers through LTPA, tailored interventions for different occupational groups may be required. More high-quality studies are needed to establish recommended levels of LTPA/LTSB for different OPA groups. PROTOCOL REGISTRATION PROSPERO # CRD42020191708 .
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Affiliation(s)
- Stephanie A Prince
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, Ontario, K1A 0K9, Canada.
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | | | - Aviroop Biswas
- Institute for Work & Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Tarnbir Aulakh
- School of Kinesiology and Health Studies, Queen's University, Kingston, Canada
| | | | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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10
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Salier Eriksson J, Olsson KSE, Rosdahl H, Schantz P. Heart Rate Methods Can Be Valid for Estimating Intensity Spectrums of Oxygen Uptake in Field Exercise. Front Physiol 2021; 12:687566. [PMID: 34295264 PMCID: PMC8290204 DOI: 10.3389/fphys.2021.687566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/24/2021] [Indexed: 11/22/2022] Open
Abstract
Purpose Quantifying intensities of physical activities through measuring oxygen uptake (V̇O2) is of importance for understanding the relation between human movement, health and performance. This can in principle be estimated by the heart rate (HR) method, based on the linear relationship between HR and V̇O2 established in the laboratory. It needs, however, to be explored whether HR methods, based on HR-V̇O2 relationships determined in the laboratory, are valid for estimating spectrums of V̇O2 in field exercise. We hereby initiate such studies, and use cycle commuting as the form of exercise. Methods Ten male and ten female commuter cyclists underwent measurements of HR and V̇O2 while performing ergometer cycling in a laboratory and a normal cycle commute in the metropolitan area of Stockholm County, Sweden. Two models of individual HR-V̇O2 relationships were established in the laboratory through linear regression equations. Model 1 included three submaximal work rates, whereas model 2 also involved a maximal work rate. The HR-V̇O2 regression equations of the two models were then used to estimate V̇O2 at six positions of field HR: five means of quintiles and the mean of the whole commute. The estimations obtained were for both models compared with the measured V̇O2. Results The measured quintile range during commuting cycling was about 45–80% of V̇O2max. Overall, there was a high resemblance between the estimated and measured V̇O2, without any significant absolute differences in either males or females (range of all differences: −0.03–0.20 L⋅min–1). Simultaneously, rather large individual differences were noted. Conclusion The present HR methods are valid at group level for estimating V̇O2 of cycle commuting characterized by relatively wide spectrums of exercise intensities. To further the understanding of the external validity of the HR method, there is a need for studying other forms of field exercises.
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Affiliation(s)
- Jane Salier Eriksson
- The Research Unit for Movement, Health and Environment, Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Karin S E Olsson
- The Research Unit for Movement, Health and Environment, Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Hans Rosdahl
- The Research Unit for Movement, Health and Environment, Department of Physiology, Nutrition and Biomechanics, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | - Peter Schantz
- The Research Unit for Movement, Health and Environment, Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
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Abstract
From health and sustainability perspectives, reduction in the consumption of animal-based foods, especially red meat, is a key strategy. The present study examined the prevalence, sociodemographic and lifestyle factors, food consumption and food choice motives of vegetarians and consumers of low and high amounts of red and processed meat (RPM) among Finnish adults. We applied the data from three national health studies: FINRISK 2007 (n 4874), FINRISK 2012 (n 4812) and FinHealth 2017 (n 4442). Participants addressed their food consumption with a FFQ and answered other questionnaires about sociodemographic and lifestyle factors, as well as food choice motives. The prevalence of vegetarianism increased from 0·7 % in 2012 to 1·8 % in 2017, and median daily RPM consumption decreased from 128 g in 2007 to 119 g in 2012 and to 96 g in 2017. Vegetarians and members of the low-RPM group were more often women, younger and more highly educated than the high-RPM group, both in 2007 and 2017. Still, the importance of sex for the probability of a vegetarian diet decreased, while its importance for high-RPM consumption increased. Vegetarians consumed more fruit, vegetables, legumes, nuts and seeds than either the low- or high-RPM groups. The high-RPM group had the lowest scores in several aspects of healthy and sustainable diet, healthy food choice motives and healthy lifestyle. Vegetarians and groups differing in their RPM consumption levels might benefit from differing interventions and nutrition information taking into account their other dietary habits, food choice motives and lifestyle factors.
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Kolehmainen L, Havulinna S, Ngandu T, Strandberg T, Levälahti E, Lehtisalo J, Antikainen R, Hietikko E, Peltonen M, Pölönen A, Soininen H, Tuomilehto J, Laatikainen T, Rauramaa R, Kivipelto M, Kulmala J. Earlier life leisure-time physical activity in relation to age-related frailty syndrome. Age Ageing 2021; 50:161-168. [PMID: 32808971 DOI: 10.1093/ageing/afaa132] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND frailty syndrome is common amongst older people. Low physical activity is part of frailty, but long-term prospective studies investigating leisure-time physical activity (LTPA) during the life course as a predictor of frailty are still warranted. The aim of this study is to investigate whether earlier life LTPA predicts frailty in older age. METHODS the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) included older adults (aged 60-77 years) from the general population who were at increased risk of cognitive decline. Frailty was assessed for 1,137 participants at a baseline visit using a modified version of Fried's phenotype, including five criteria: weight loss, exhaustion, weakness, slowness and low physical activity. Self-reported data on earlier life LTPA were available from previous population-based studies (average follow-up time 13.6 years). A binomial logistic regression analysis was used to investigate the association between earlier life LTPA and pre-frailty/frailty in older age. RESULTS the prevalence of frailty and pre-frailty was 0.8% and 27.3%, respectively. In the analyses, pre-frail and frail groups were combined. People who had been physically very active (OR 0.37, 95% CI 0.23-0.60) or moderately active (OR 0.45, 95% CI 0.32-0.65) earlier in life had lower odds of becoming pre-frail/frail than individuals who had been sedentary. CONCLUSIONS frailty was rare in this relatively healthy study population, but almost a third of the participants were pre-frail. Earlier life LTPA was associated with lower levels of pre-frailty/frailty. The results highlight the importance of physical activity when aiming to promote healthy old age.
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Affiliation(s)
- Laura Kolehmainen
- Ageing, Disability and Functioning Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Satu Havulinna
- Ageing, Disability and Functioning Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tiia Ngandu
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Timo Strandberg
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Esko Levälahti
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jenni Lehtisalo
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
| | - Riitta Antikainen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
- Oulu City Hospital, Oulu, Finland
| | - Elina Hietikko
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
- Oulu City Hospital, Oulu, Finland
| | - Markku Peltonen
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Hilkka Soininen
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
- Neurocenter, Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Jaakko Tuomilehto
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- National School of Public Health, Madrid, Spain
- South Ostrobothnia Central Hospital, Seinäjoki, Finland
| | - Tiina Laatikainen
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), Joensuu, Finland
| | - Rainer Rauramaa
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Miia Kivipelto
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, UK
| | - Jenni Kulmala
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
- School of Health Care and Social Work, Seinäjoki University of Applied Sciences, Seinäjoki, Finland
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Wang C, De Roos AJ, Fujishiro K, Allison MA, Wallace R, Seguin RA, Nassir R, Michael YL. Occupational Physical Activity and Coronary Heart Disease in Women's Health Initiative Observational Study. J Gerontol A Biol Sci Med Sci 2020; 74:1952-1958. [PMID: 30590438 DOI: 10.1093/gerona/gly288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Women comprise nearly half of the labor force in our society, but the impact of the occupational psychical activity on women's heart health in later life was unclear. We conducted a case-cohort study to assess the association of occupational physical activity (OPA), alone and jointly with leisure-time physical activity (LTPA) and risk of coronary heart disease (CHD). METHODS We included women enrolled in Women's Health Initiative Observational Study who provided an occupational history at baseline and were followed until 2013 for the first occurrence of myocardial infarction or death from CHD (mean age ± SD = 63.4 ± 7.2). A total of 5,243 women free of CHD at baseline were randomly selected into a subcohort and 3,421 CHD events were adjudicated during follow-up. Through linkage of Standard Occupational Classification codes to the Occupational Information Network, we assessed cumulative and most recent exposure of OPA. LTPA was assessed through Women's Health Initiative's physical activity questionnaire. Weighted Cox proportional hazard models were used to evaluate CHD risk. RESULTS After adjustment for demographic and socioeconomic factors, levels of OPA were not associated with CHD risk. Compared with women with low OPA and high LTPA, women with moderate to high cumulative OPA and low LTPA had relative high CHD risk (hazard ratio [HR]: 1.54, 95% confidence interval [CI]: 1.26, 1.88 for moderate OPA and HR: 1.46. 95% CI: 1.20, 1.78 for high OPA). DISCUSSION Results from this study suggest no overall association between lifetime OPA and CHD risk in women, but the impact of OPA varies by LTPA levels.
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Affiliation(s)
- Conglong Wang
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Anneclaire J De Roos
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Kaori Fujishiro
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio
| | - Matthew A Allison
- Department of Family Medicine and Public Health University of California, San Diego, La Jolla
| | - Robert Wallace
- Department of Preventive Medicine and Environmental Health, University of Iowa, Ithaca, New York
| | - Rebecca A Seguin
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
| | - Rami Nassir
- Department of Biochemistry and Molecular Medicine, University of California, Davis
| | - Yvonne L Michael
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
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Medina I, Petermann-Rocha F, Waddell H, Díaz-Martínez X, Matus-Castillo C, Cigarroa I, Concha-Cisternas Y, Salas-Bravo C, Martínez-Sanguinetti MA, Celis-Morales C. Association between Different Modes of Travelling and Adiposity in Chilean Population: Findings from the Chilean National Health Survey 2016-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103731. [PMID: 32466197 PMCID: PMC7277509 DOI: 10.3390/ijerph17103731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/19/2020] [Accepted: 05/22/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Active travel has been suggested as a feasible way of increasing physical activity levels. Although international studies have demonstrated its effect over different health outcomes and adiposity, there is still limited evidence on this topic in developing countries, such as Chile. AIM To investigate the associations between different types of travelling and markers of obesity in the Chilean adult population. METHODS 5411 participants from the Chilean National Health Survey 2016-2017 (CNHS) were included in this study. Active travel was assessed using a questionnaire. Car commuters, public transport (PT), walking and cycling were the four forms of travelling assessed. Bodyweight, body mass index and waist circumference were used as markers of adiposity. RESULTS Compared to car travellers, body weight, WC and BMI levels were lower for PT walking and cycling travellers. The odds for obesity (Odds ratio (OR): 0.41 (95% CI: 0.28; 0.61 p ≤ 0.001) were lower for walking and the odds (OR: 0.56 (95%CI: 0.35; 0.89 p = 0.014) for central obesity were significantly lower for cyclist in comparison to car travellers. Additionally, participation in any form of active travel (walking or cycling) was low, with only 20.9% of the population reporting being active travellers. CONCLUSION Active travel, such as walking and cycling, was associated with lower adiposity levels in the Chilean adult population. Promoting active travel could be a feasible strategy to tackle the high prevalence of obesity and physical inactivity in the Chilean population.
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Affiliation(s)
- Ignacio Medina
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK; (I.M.); (F.P.-R.); (H.W.)
| | - Fanny Petermann-Rocha
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK; (I.M.); (F.P.-R.); (H.W.)
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
| | - Heather Waddell
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK; (I.M.); (F.P.-R.); (H.W.)
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
- Medical Research Council Centre for Inflammation Research, The Queen’s Medical Research Institute, The University of Edinburgh, Edinburgh EH16 4TJ, UK
| | - Ximena Díaz-Martínez
- Grupo de Investigación en Calidad de Vida, Departamento de Ciencias de la Educación, Facultad de Educación y Humanidades, Universidad del Biobío, Chillán 378000, Chile
| | - Carlos Matus-Castillo
- Departamento de Ciencias del Deporte y Acondicionamiento Físico, Universidad Católica de la Santísima Concepción, Concepción 4090541, Chile;
| | - Igor Cigarroa
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Santiago 8370003, Chile; (I.C.); (Y.C.-C.)
| | - Yeny Concha-Cisternas
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Santiago 8370003, Chile; (I.C.); (Y.C.-C.)
- Pedagogía en Educación Física, Facultad de Educación, Universidad Autónoma de Chile, Talca 3467987, Chile
| | - Carlos Salas-Bravo
- Departamento de Educación Física, Facultad de Educación, Universidad de Concepción, Concepción 4070386, Chile
| | | | - Carlos Celis-Morales
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK; (I.M.); (F.P.-R.); (H.W.)
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
- Centro de Investigación en Fisiología del Ejercicio (CIFE), Universidad Mayor, Santiago 7510041, Chile
- Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca 3480112, Chile
- Correspondence: ; Tel.: +562-2518-9701
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15
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Welsh C, Celis-Morales CA, Ho F, Lyall DM, Mackay D, Ferguson L, Sattar N, Gray SR, Gill JMR, Pell JP, Welsh P. Association of injury related hospital admissions with commuting by bicycle in the UK: prospective population based study. BMJ 2020; 368:m336. [PMID: 32161038 PMCID: PMC7190046 DOI: 10.1136/bmj.m336] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine whether bicycle commuting is associated with risk of injury. DESIGN Prospective population based study. SETTING UK Biobank. PARTICIPANTS 230 390 commuters (52.1% women; mean age 52.4 years) recruited from 22 sites across the UK compared by mode of transport used (walking, cycling, mixed mode versus non-active (car or public transport)) to commute to and from work on a typical day. MAIN OUTCOME MEASURE First incident admission to hospital for injury. RESULTS 5704 (2.5%) participants reported cycling as their main form of commuter transport. Median follow-up was 8.9 years (interquartile range 8.2-9.5 years), and overall 10 241 (4.4%) participants experienced an injury. Injuries occurred in 397 (7.0%) of the commuters who cycled and 7698 (4.3%) of the commuters who used a non-active mode of transport. After adjustment for major confounding sociodemographic, health, and lifestyle factors, cycling to work was associated with a higher risk of injury compared with commuting by a non-active mode (hazard ratio 1.45, 95% confidence interval 1.30 to 1.61). Similar trends were observed for commuters who used mixed mode cycling. Walking to work was not associated with a higher risk of injury. Longer cycling distances during commuting were associated with a higher risk of injury, but commute distance was not associated with injury in non-active commuters. Cycle commuting was also associated with a higher number of injuries when the external cause was a transport related incident (incident rate ratio 3.42, 95% confidence interval 3.00 to 3.90). Commuters who cycled to work had a lower risk of cardiovascular disease, cancer, and death than those who did not. If the associations are causal, an estimated 1000 participants changing their mode of commuting to include cycling for 10 years would result in 26 additional admissions to hospital for a first injury (of which three would require a hospital stay of a week or longer), 15 fewer first cancer diagnoses, four fewer cardiovascular disease events, and three fewer deaths. CONCLUSION Compared with non-active commuting to work, commuting by cycling was associated with a higher risk of hospital admission for a first injury and higher risk of transport related incidents specifically. These risks should be viewed in context of the health benefits of active commuting and underscore the need for a safer infrastructure for cycling in the UK.
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Affiliation(s)
- Claire Welsh
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, G12 8TA, UK
| | - Carlos A Celis-Morales
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, G12 8TA, UK
- Centre for Exercise Physiology Research (CIFE), Universidad Mayor, Santiago, San Pío, Chile
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Frederick Ho
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, G12 8TA, UK
| | - Donald M Lyall
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Daniel Mackay
- School of Medicine, Dentistry and Nursing, University of Glasgow, UK
| | - Lyn Ferguson
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, G12 8TA, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, G12 8TA, UK
| | - Stuart R Gray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, G12 8TA, UK
| | - Jason M R Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, G12 8TA, UK
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Paul Welsh
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, BHF Glasgow Cardiovascular Research Centre, Glasgow, G12 8TA, UK
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16
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Kim SW, Jung SW, Seo MW, Park HY, Song JK. Effects of bone-specific physical activity on body composition, bone mineral density, and health-related physical fitness in middle-aged women. J Exerc Nutrition Biochem 2019; 23:36-42. [PMID: 32018345 PMCID: PMC7004569 DOI: 10.20463/jenb.2019.0030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 12/18/2019] [Accepted: 12/18/2019] [Indexed: 12/19/2022] Open
Abstract
PURPOSE The study aimed to determine the effects of bone-specific physical activity on body composition, bone mineral density (BMD), and health-related physical fitness in middle-aged women. METHODS One hundred eighty-six middle-aged women aged 31-49 years participated in this study. The subjects were divided into tertile groups according to the level of physical activity (low-score group, n=62; middle-score group, n=62; high-score group, n=62). Bone-specific physical activity participation was assessed using the bone-specific physical activity questionnaire. Body composition and BMD were measured using dual-energy X-ray absorptiometry. Health-related physical fitness test included isometric muscle strength (grip strength), muscular endurance (sit-ups), flexibility (sit and reach), and cardiorespiratory fitness (maximal oxygen uptake [VO2max]). RESULTS The high-score group had a significantly higher fat-free mass (p=.045, partial eta-squared value [ηp2]=.033) than the middle- and low-score groups, whereas the high-score group had significantly lower percent body fat (p=.005, ηp2=.056) than the other two groups. Whole-body BMD (p=.034, ηp2=.036) and lumbar BMD (p=.003, ηp2=.060) were significantly higher in the high-score group than in the low-score group. The high-score group performed significantly better for grip strength (p=.0001, ηp2=.101), sit-ups (p=.0001, ηp2=.108), and VO2max (p=.0001, ηp2=.092) than the other two groups. CONCLUSION The present study suggests that bone-specific physical activity could be useful in improving body composition, BMD, and health-related physical fitness in middle-aged women, significantly enhancing their BMD and health conditions.
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Affiliation(s)
- Sung-Woo Kim
- Physical Activity and Performance Institute (PAPI), Konkuk University, SeoulRepublic of Korea
| | - Sung-Woo Jung
- Department of Taekwondo, College of Physical Education, Kyung Hee University, YonginRepublic of Korea
| | - Myong-Won Seo
- Department of Taekwondo, College of Physical Education, Kyung Hee University, YonginRepublic of Korea
| | - Hun-Young Park
- Physical Activity and Performance Institute (PAPI), Konkuk University, SeoulRepublic of Korea
- Department of Sports Medicine and Science, Konkuk University, SeoulRepublic of Korea
| | - Jong-Kook Song
- Department of Taekwondo, College of Physical Education, Kyung Hee University, YonginRepublic of Korea
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Feig EH, Levy DE, McCurley JL, Rimm EB, Anderson EM, Gelsomin ED, Thorndike AN. Association of work-related and leisure-time physical activity with workplace food purchases, dietary quality, and health of hospital employees. BMC Public Health 2019; 19:1583. [PMID: 31775714 PMCID: PMC6882114 DOI: 10.1186/s12889-019-7944-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 11/13/2019] [Indexed: 11/22/2022] Open
Abstract
Background While leisure-time physical activity (PA) has been associated with reduced risk of cardiometabolic disease, less is known about the relationship between work-related PA and health. Work-related PA is often not a chosen behavior and may be associated with lower socioeconomic status and less control over job-related activities. This study examined whether high work-related PA and leisure-time PA reported by hospital employees were associated with healthier dietary intake and reductions in cardiometabolic risk. Methods This was a cross-sectional analysis of 602 hospital employees who used workplace cafeterias and completed the baseline visit for a health promotion study in 2016–2018. Participants completed the International Physical Activity Questionnaire and clinical measures of weight, blood pressure, HbA1c, and lipids. Healthy Eating Index (HEI) scores were calculated from two 24-h dietary recalls, and a Healthy Purchasing Score was calculated based on healthfulness of workplace food/beverage purchases. Regression analyses examined Healthy Purchasing Score, HEI, and obesity, hypertension, hyperlipidemia, and diabetes/prediabetes by quartile of work-related PA, leisure-time PA, and sedentary time. Results Participants’ mean age was 43.6 years (SD = 12.2), 79.4% were female, and 81.1% were white. In total, 30.3% had obesity, 20.6% had hypertension, 26.6% had prediabetes/diabetes, and 32.1% had hyperlipidemia. Median leisure-time PA was 12.0 (IQR: 3.3, 28.0) and median work-related PA was 14.0 (IQR: 0.0, 51.1) MET-hours/week. Higher leisure-time PA was associated with higher workplace Healthy Purchasing Score and HEI (p’s < 0.01) and lower prevalence of obesity, diabetes/prediabetes, and hyperlipidemia (p’s < 0.05). Work-related PA was not associated with Healthy Purchasing Score, HEI, or cardiometabolic risk factors. Increased sedentary time was associated with lower HEI (p = 0.02) but was not associated with the workplace Healthy Purchasing Score. Conclusions Employees with high work-related PA did not have associated reductions in cardiometabolic risk or have healthier dietary intake as did employees reporting high leisure-time PA. Workplace wellness programs should promote leisure-time PA and healthy food choices for all employees, but programs may need to be customized and made more accessible to meet the unique needs of employees who are physically active at work. Trial registration This trial was prospectively registered with clinicaltrials.gov (Identifier: NCT02660086) on January 21, 2016. The first participant was enrolled on September 16, 2016.
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Affiliation(s)
- Emily H Feig
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Douglas E Levy
- Harvard Medical School, Boston, MA, USA.,Mongan Institute Health Policy Research Center, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Jessica L McCurley
- Harvard Medical School, Boston, MA, USA.,Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, 100 Cambridge Street, Boston, MA, 02114, USA
| | - Eric B Rimm
- Harvard Medical School, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Woman's Hospital, Boston, MA, USA
| | - Emma M Anderson
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, 100 Cambridge Street, Boston, MA, 02114, USA
| | - Emily D Gelsomin
- Department of Nutrition and Food Services, Massachusetts General Hospital, Boston, MA, USA
| | - Anne N Thorndike
- Harvard Medical School, Boston, MA, USA. .,Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, 100 Cambridge Street, Boston, MA, 02114, USA.
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18
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Steell L, Garrido-Méndez A, Petermann F, Díaz-Martínez X, Martínez MA, Leiva AM, Salas-Bravo C, Alvarez C, Ramirez-Campillo R, Cristi-Montero C, Rodríguez F, Poblete-Valderrama F, Floody PD, Aguilar-Farias N, Willis ND, Celis-Morales CA. Active commuting is associated with a lower risk of obesity, diabetes and metabolic syndrome in Chilean adults. J Public Health (Oxf) 2019; 40:508-516. [PMID: 28977515 DOI: 10.1093/pubmed/fdx092] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 07/04/2017] [Indexed: 11/12/2022] Open
Abstract
Background There is limited evidence on how active commuting is associated with health benefits in developing countries. The aim of this study therefore was to investigate the associations between active commuting and markers of adiposity and cardiometabolic risk in the Chilean adult population. Methods In total, 5157 participants from the Chilean National Health Survey 2009-10 were included in this cross-sectional study. Active commuting was measured using the Global Physical Activity Questionnaire (GPAQ v2). Body mass index (BMI) and waist circumference (WC) were measured and used to define obesity and central obesity. Type 2 diabetes (T2D) and metabolic syndrome were determined using WHO and updated ATPIII-NCEP criteria, respectively. Results The main finding of this study is that a 30 min increase in active commuting is associated with lower odds for BMI > 25.0 kg m-2 (0.93 [95% CI: 0.88-0.98, P = 0.010]). Similarly, the odds for central obesity was 0.87 [0.82-0.92, P < 0.0001]. Similar associations were found for T2D (0.81 [0.75-0.88], P < 0.0001) and metabolic syndrome (OR: 0.86 [0.80-0.92], P < 0.0001). Conclusion Our findings show that active commuting is associated with lower adiposity and a healthier metabolic profile including lower risk for obesity, diabetes and metabolic syndrome.
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Affiliation(s)
- Lewis Steell
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK
| | | | - Fanny Petermann
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK
| | - Ximena Díaz-Martínez
- Grupo de Investigación Calidad de Vida, Departamento de Ciencias de la Educación, Facultad de Educación y Humanidades, Universidad del Bio-Bio, Chillan, Chile
| | - María Adela Martínez
- Instituto de Farmacia, Facultad de Ciencias, Universidad Austral de Chile, Valdivia, Chile
| | - Ana María Leiva
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Carlos Salas-Bravo
- Departamento de Educación Física, Facultad de Educación, Universidad de Concepción, Concepción, Chile
| | - Cristian Alvarez
- Department of Physical Activity Sciences, Research Nucleus in Health, Physical Activity and Sport, Universidad de Los Lagos, Osorno, Chile
| | - Rodrigo Ramirez-Campillo
- Department of Physical Activity Sciences, Research Nucleus in Health, Physical Activity and Sport, Universidad de Los Lagos, Osorno, Chile
| | - Carlos Cristi-Montero
- Grupo IRyS, Escuela de Educación Física, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Fernando Rodríguez
- Grupo IRyS, Escuela de Educación Física, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | | | - Pedro Delgado Floody
- Departamento de Educación Física, Deportes y Recreación, Universidad de La Frontera, Temuco, Chile
| | - Nicolás Aguilar-Farias
- Departamento de Educación Física, Deportes y Recreación, Universidad de La Frontera, Temuco, Chile
| | - Naomi D Willis
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Carlos A Celis-Morales
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK.,Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
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19
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Fan M, Lv J, Yu C, Guo Y, Bian Z, Yang S, Yang L, Chen Y, Huang Y, Chen B, Fan L, Chen J, Chen Z, Qi L, Li L. Association Between Active Commuting and Incident Cardiovascular Diseases in Chinese: A Prospective Cohort Study. J Am Heart Assoc 2019; 8:e012556. [PMID: 31576770 PMCID: PMC6818036 DOI: 10.1161/jaha.119.012556] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 08/29/2019] [Indexed: 11/16/2022]
Abstract
Background Active commuting is related to a higher level of physical activity but more exposure to ambient air pollutants. With the rather serious air pollution in urban China, we aimed to examine the association between active commuting and risk of incident cardiovascular disease in the Chinese population. Methods and Results A total of 104 170 urban commuters without major chronic diseases at baseline were included from China Kadoorie Biobank. Self-reported commuting mode was defined as nonactive commuting, work at home or near home, walking, and cycling. Multivariable Cox regression was used to examine associations between commuting mode and cardiovascular disease. Overall, 47.2% of the participants reported nonactive commuting, 13.4% reported work at home or work near home, 20.1% reported walking, and 19.4% reported cycling. During a median follow-up of 10 years, we identified 5374 incidents of ischemic heart disease, 664 events of hemorrhagic stroke, and 4834 events of ischemic stroke. After adjusting for sex, socioeconomic status, lifestyle factors, sedentary time, body mass index, comorbidities, household air pollution, passive smoking, and other domain physical activity, walking (hazard ratio, 0.90; 95% CI, 0.84-0.96) and cycling (hazard ratio, 0.81; 95% CI, 0.74-0.88) were associated with a lower risk of ischemic heart disease than nonactive commuting. Cycling was associated with a lower risk of ischemic stroke (hazard ratio, 0.92; 95% CI, 0.84-1.00). No significant association was found of walking or cycling with hemorrhagic stroke. The associations of commuting mode with major cardiovascular disease were consistent among men and women and across different levels of other domain physical activity. Conclusions In urban China, cycling was associated with a lower risk of ischemic heart disease and ischemic stroke. Walking was associated with a lower risk of ischemic heart disease.
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Affiliation(s)
- Mengyu Fan
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking University Health Science CenterBeijingChina
- Department of EpidemiologySchool of Public Health and Tropical MedicineTulane UniversityNew OrleansLA
| | - Jun Lv
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking University Health Science CenterBeijingChina
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University)Ministry of EducationBeijingChina
- Peking University Institute of Environmental MedicineBeijingChina
| | - Canqing Yu
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking University Health Science CenterBeijingChina
| | - Yu Guo
- Chinese Academy of Medical SciencesBeijingChina
| | - Zheng Bian
- Chinese Academy of Medical SciencesBeijingChina
| | - Songchun Yang
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking University Health Science CenterBeijingChina
| | - Ling Yang
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU)Nuffield Department of Population HealthUniversity of OxfordUnited Kingdom
| | - Yiping Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU)Nuffield Department of Population HealthUniversity of OxfordUnited Kingdom
| | - Yuelong Huang
- Hunan Center for Disease Control and PreventionHunanChina
| | - Biyun Chen
- Hunan Center for Disease Control and PreventionHunanChina
| | - Lei Fan
- Henan Center for Disease Control and PreventionHenanChina
| | - Junshi Chen
- China National Center for Food Safety Risk AssessmentBeijingChina
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU)Nuffield Department of Population HealthUniversity of OxfordUnited Kingdom
| | - Lu Qi
- Department of EpidemiologySchool of Public Health and Tropical MedicineTulane UniversityNew OrleansLA
- Department of NutritionHarvard School of Public HealthBostonMA
| | - Liming Li
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking University Health Science CenterBeijingChina
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20
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Risk of Cardiovascular Disease Related to Metabolic Syndrome in College Students: A Cross-Sectional Secondary Data Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193708. [PMID: 31581588 PMCID: PMC6801641 DOI: 10.3390/ijerph16193708] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 09/30/2019] [Accepted: 09/30/2019] [Indexed: 12/16/2022]
Abstract
Early detection of metabolic syndrome (MS) in young adults can lead to decreased aggravation and help prevent diabetes and cardiovascular diseases. This cross-sectional study aimed to identify the prevalence of MS and its components in Korean college students and was based on the Korean National Health and Nutrition Examination Survey, which used a stratified multistage probability sampling design. In total, 6.5% male and 4.1% female students had MS; of these, 26.6% of male and 25.8% of female students presented with at least one MS component. Height, weight, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), glucose, high-density lipoprotein cholesterol, and triglycerides were significantly higher in men than in women, and all of these variables showed significant differences according to BMI. As the BMI increased, the level of each anthropometric, biochemical, and clinical variable increased. Although only a few students in Korea had three or more risk factors, the proportion of college students with one risk factor for MS was relatively high. Therefore, educational and intervention programs should be conducted in college students with overweight or obesity so that they can change their lifestyle to reduce the risk of cardiovascular diseases and diabetes.
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21
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Petermann-Rocha F, Brown RE, Diaz-Martínez X, Leiva AM, Martinez MA, Poblete-Valderrama F, Garrido-Méndez A, Matus-Castillo C, Luarte-Rocha C, Salas-Bravo C, Troncoso-Pantoja C, García-Hermoso A, Ramírez-Vélez R, Vásquez-Gómez JA, Rodríguez-Rodríguez F, Alvarez C, Celis-Morales C. Association of leisure time and occupational physical activity with obesity and cardiovascular risk factors in Chile. J Sports Sci 2019; 37:2549-2559. [DOI: 10.1080/02640414.2019.1647738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Fanny Petermann-Rocha
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK
| | - Rosemary E. Brown
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK
| | - Ximena Diaz-Martínez
- Grupo de Investigación en Calidad de Vida, Departamento de Ciencias de la Educación, Facultad de Educación y Humanidades, Universidad del Biobío, Chillan, Chile
| | - Ana M. Leiva
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - María A. Martinez
- Instituto de Farmacia, Facultad de Ciencias, Universidad Austral de Chile, Valdivia, Chile
| | - Felipe Poblete-Valderrama
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Sede Valdivia, Chile
- Departamento de Ciencias del Deporte y Acondicionamiento Físico, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Alex Garrido-Méndez
- Departamento de Ciencias del Deporte y Acondicionamiento Físico, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Carlos Matus-Castillo
- Departamento de Ciencias del Deporte y Acondicionamiento Físico, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Cristian Luarte-Rocha
- Escuela de Educación Física, Facultad de Ciencias de la Educación, Universidad San Sebastián, Concepción, Chile
| | - Carlos Salas-Bravo
- Departamento de Educación Física, Facultad de Educación, Universidad de Concepción, Concepción, Chile
| | - Claudia Troncoso-Pantoja
- Centro de Investigación en Educación y Desarrollo (CIEDE-UCSC), Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Antonio García-Hermoso
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Santiago, Chile
| | - Robinson Ramírez-Vélez
- Department of Health Sciences, Public University of Navarra, Navarrabiomed-Biomedical Research Centre, IDISNA-Navarra’s Health Research Institute, Pamplona, Navarra, Spain
| | - Jaime A. Vásquez-Gómez
- Vicerrectoría de Investigación y Postgrado, Universidad Católica del Maule, Talca, Chile
| | - Fernando Rodríguez-Rodríguez
- IRyS Research Group, School of Physical Education, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Cristian Alvarez
- Research Nucleus in Health, Physical Activity and Sport, Laboratory of Measurement and Assessment in Sport, Universidad de Los Lagos, Department of Physical Activity Sciences, Osorno, Chile
| | - Carlos Celis-Morales
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK
- Centro de Investigación en Fisiología del Ejercicio - CIFE, Universidad Mayor, Santiago, Chile
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22
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Garcia JM, Duran AT, Schwartz JE, Booth JN, Hooker SP, Willey JZ, Cheung YK, Park C, Williams SK, Sims M, Shimbo D, Diaz KM. Types of Sedentary Behavior and Risk of Cardiovascular Events and Mortality in Blacks: The Jackson Heart Study. J Am Heart Assoc 2019; 8:e010406. [PMID: 31238767 PMCID: PMC6662345 DOI: 10.1161/jaha.118.010406] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Previous cross‐sectional studies have shown conflicting results regarding the effects of television viewing and occupational sitting on cardiovascular disease (CVD) risk factors. The purpose of this study was to compare the association of both television viewing and occupational sitting with CVD events and all‐cause mortality in blacks. Methods and Results Participants included 3592 individuals enrolled in the Jackson Heart Study, a community‐based study of blacks residing in Jackson, Mississippi. Television viewing (<2, 2–4, and >4 h/day) and occupational sitting (never/seldom, sometimes, often/always) were self‐reported. Over a median follow‐up of 8.4 years, there were 129 CVD events and 205 deaths. The highest category of television viewing (>4 h/day) was associated with a greater risk for a composite CVD events/all‐cause mortality end point compared with the lowest category (<2 h/day; hazard ratio, 1.49; 95% CI, 1.13–1.97). In contrast, the highest category of occupational sitting (often/always) was not associated with risk for a composite CVD events/all‐cause mortality end point compared with the lowest category (never/seldom; hazard ratio, 0.90; 95% CI, 0.69–1.18). Moderate‐to‐vigorous physical activity moderated the association of television viewing with CVD events/all‐cause mortality such that television viewing was not associated with greater risk among those with high moderate‐to‐vigorous physical activity levels. Conclusions Television viewing was associated with greater risk of CVD events and all‐cause mortality, while occupational sitting had no association with these outcomes. These findings suggest that minimizing television viewing may be more effective for reducing CVD and mortality risk in blacks compared with reducing occupational sedentary behavior.
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Affiliation(s)
- Jeanette M Garcia
- 1 Department of Education and Human Services University of Central Florida Orlando FL
| | - Andrea T Duran
- 2 Center for Behavioral Cardiovascular Health Columbia University Medical Center New York NY
| | - Joseph E Schwartz
- 2 Center for Behavioral Cardiovascular Health Columbia University Medical Center New York NY.,3 Department of Psychiatry and Behavioral Science Stony Brook University Stony Brook NY
| | - John N Booth
- 4 Department of Epidemiology School of Public Health University of Alabama Birmingham AL
| | - Steven P Hooker
- 5 San Diego State University College of Health and Human Services San Diego State University CA
| | - Joshua Z Willey
- 6 Department of Neurology Columbia University Medical Center New York NY
| | - Ying Kuen Cheung
- 7 Department of Biostatistics Columbia University Medical Center New York NY
| | - Chorong Park
- 8 Department of Population Health New York University School of Medicine New York NY
| | - Stephen K Williams
- 8 Department of Population Health New York University School of Medicine New York NY
| | - Mario Sims
- 9 Department of Medicine University of Mississippi Medical Center Jackson MS
| | - Daichi Shimbo
- 2 Center for Behavioral Cardiovascular Health Columbia University Medical Center New York NY
| | - Keith M Diaz
- 2 Center for Behavioral Cardiovascular Health Columbia University Medical Center New York NY
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23
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Lindbohm JV, Rautalin I, Jousilahti P, Salomaa V, Kaprio J, Korja M. Physical activity associates with subarachnoid hemorrhage risk- a population-based long-term cohort study. Sci Rep 2019; 9:9219. [PMID: 31239477 PMCID: PMC6592878 DOI: 10.1038/s41598-019-45614-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 06/10/2019] [Indexed: 11/28/2022] Open
Abstract
Benefit of physical activity in prevention of aneurysmal subarachnoid hemorrhage (SAH) is unclear. We aimed to clarify this by studying how different types of physical activity associate with SAH risk. By following 65 521 population-based FINRISK participants prospectively from medical and autopsy registries since 1972 until 2014, we detected 543 incident SAHs. At baseline, we measured leisure-time physical activity (LTPA), occupational physical activity (OPA), and commuting physical activity (CPA) levels. The Cox model adjusted for all well-known SAH risk factors and for socioeconomic status, provided hazard ratios (HRs) for physical activity variables. Every 30-minute increase in weekly LTPA decreased SAH risk linearly in men and women HR = 0.95 (95% CI = 0.90–1.00). CPA reduced SAH risk as well, but the association diminished as participants retired. In contrast, individuals with moderate (1.41, 1.04–1.92) and high OPA (1.34, 0.99–1.81) had elevated SAH risk. Protective association of LTPA persisted in all age and hypertension groups, and was even greater in current smokers 0.88 (0.81–0.96) than non-smokers (p = 0.04 for difference). Commuting and leisure time physical activity seem to reduce SAH risk in men and women and is most beneficial for smokers. Future intervention studies should investigate whether physical activity can reduce the rupture risk of intracranial aneurysms.
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Affiliation(s)
- Joni V Lindbohm
- Clinicum, Department of Public Health, University of Helsinki, P.O. Box 41, FI-00014, Helsinki, Finland. .,Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, P.O. Box 266, FI-00029, Helsinki, Finland.
| | - Ilari Rautalin
- Clinicum, Department of Public Health, University of Helsinki, P.O. Box 41, FI-00014, Helsinki, Finland.,Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, P.O. Box 266, FI-00029, Helsinki, Finland
| | - Pekka Jousilahti
- National Institute for Health and Welfare, P.O. Box 30, FI-00271, Helsinki, Finland
| | - Veikko Salomaa
- National Institute for Health and Welfare, P.O. Box 30, FI-00271, Helsinki, Finland
| | - Jaakko Kaprio
- Clinicum, Department of Public Health, University of Helsinki, P.O. Box 41, FI-00014, Helsinki, Finland.,Institute for Molecular Medicine FIMM, P.O. Box 20, FI-00014, Helsinki, Finland
| | - Miikka Korja
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, P.O. Box 266, FI-00029, Helsinki, Finland
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24
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Lund Rasmussen C, Palarea-Albaladejo J, Korshøj M, Gupta N, Nabe-Nielsen K, Holtermann A, Jørgensen MB. Is high aerobic workload at work associated with leisure time physical activity and sedentary behaviour among blue-collar workers? A compositional data analysis based on accelerometer data. PLoS One 2019; 14:e0217024. [PMID: 31170169 PMCID: PMC6553845 DOI: 10.1371/journal.pone.0217024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/30/2019] [Indexed: 01/01/2023] Open
Abstract
Objective This study aimed to investigate the hypothesized negative association between duration of work time spent at a high relative aerobic workload and leisure time movement behaviours among blue-collar workers. Methods This was a cross-sectional study based on heart rate and accelerometer data from 803 blue-collar workers (447 men and 356 women). Relative aerobic workload was measured as percentage of heart rate reserve during work (%HRR). Leisure time movement behaviours were expressed in terms of leisure time spent in sedentary and active behaviours in uninterrupted bouts (i.e. <10 min, ≥10–30 min and >30 min). Compositional regression and isotemporal substitution models were used to assess the association between the predominance of work time spent at ≥40%HRR and leisure time spent in sedentary and active bouts. All analyses were stratified by sex. Results For men, there was no statistically significant association between the predominance of work time spent at ≥40%HRR and leisure time movement behaviours. Among women, the predominance of ≥40%HRR at work was negatively associated with relative leisure time spent in ≥10 min bouts of active behaviour ( β^ = -0.21, p = 0.02) and a theoretical 15 min reallocation of work time from <40%HRR to ≥40%HRR was estimated to decrease active behaviour by 6 min during leisure time. Conclusion Our result highlights the need for considering work-related barriers for an active leisure time in high-risk populations. Longitudinal studies are warranted to disentangle the relationship between physically demanding work characteristics and leisure time movement behaviours in such populations.
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Affiliation(s)
- Charlotte Lund Rasmussen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
| | | | - Mette Korshøj
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Nidhi Gupta
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Kirsten Nabe-Nielsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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25
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Cochrane M, Watson PM, Timpson H, Haycox A, Collins B, Jones L, Martin A, Graves LEF. Systematic review of the methods used in economic evaluations of targeted physical activity and sedentary behaviour interventions. Soc Sci Med 2019; 232:156-167. [PMID: 31100696 DOI: 10.1016/j.socscimed.2019.04.040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 04/04/2019] [Accepted: 04/26/2019] [Indexed: 01/22/2023]
Abstract
The burden of noncommunicable diseases (NCD) on health systems worldwide is substantial. Physical inactivity and sedentary behaviour are major risk factors for NCD. Previous attempts to understand the value for money of preventative interventions targeting physically inactive individuals have proved to be challenging due to key methodological challenges associated with the conduct of economic evaluations in public health. A systematic review was carried out across six databases (Medline, SPORTSDiscus, EconLit, PsychINFO, NHS EED, HTA) along with supplementary searches. The review examines how economic evaluations published between 2009-March 2017 have addressed methodological challenges with the aim of bringing to light examples of good practice for future studies. Fifteen economic evaluations from four high-income countries were retrieved; there is a dearth of studies targeting sedentary behaviour as an independent risk factor from physical activity. Comparability of studies from the healthcare and societal perspectives were limited due to analysts' choice in cost categories, valuation technique and time horizon differing substantially. The scarcity of and inconsistencies across economic evaluations for these two behaviours have exposed a mismatch between calls for more preventative action to tackle NCD and the lack of information available on how resources may be optimally allocated in practice. Consequently, this paper offers a table of recommendations on how future studies can be improved.
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Affiliation(s)
- M Cochrane
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 5 Primrose Hill, Liverpool, L3 2EX, UK.
| | - P M Watson
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 5 Primrose Hill, Liverpool, L3 2EX, UK
| | - H Timpson
- Public Health Institute, Faculty of Health, Education and Community, Liverpool John Moores University, 3rd Floor, Exchange Station, Tithebarn Street, Liverpool, L2 2QP, UK
| | - A Haycox
- (c)Management School, University of Liverpool, Chatham Street, Liverpool, L69 7ZH, UK
| | - B Collins
- Department of Public Health and Policy, University of Liverpool, Waterhouse Building, Block B, 2nd Floor Liverpool, L69 3BX, UK
| | - L Jones
- (c)Management School, University of Liverpool, Chatham Street, Liverpool, L69 7ZH, UK
| | - A Martin
- Department of Public Health and Policy, University of Liverpool, Waterhouse Building, Block B, 2nd Floor Liverpool, L69 3BX, UK; HCD Economics, The Innovation Centre, Keckwick Lane, Daresbury, Warrington, WA4 4FS, UK
| | - L E F Graves
- Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 5 Primrose Hill, Liverpool, L3 2EX, UK
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Harris T, Kerry S, Victor C, Iliffe S, Ussher M, Fox-Rushby J, Whincup P, Ekelund U, Furness C, Limb E, Anokye N, Ibison J, DeWilde S, David L, Howard E, Dale R, Smith J, Normansell R, Beighton C, Morgan K, Wahlich C, Sanghera S, Cook D. A pedometer-based walking intervention in 45- to 75-year-olds, with and without practice nurse support: the PACE-UP three-arm cluster RCT. Health Technol Assess 2019; 22:1-274. [PMID: 29961442 DOI: 10.3310/hta22370] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Guidelines recommend walking to increase moderate to vigorous physical activity (MVPA) for health benefits. OBJECTIVES To assess the effectiveness, cost-effectiveness and acceptability of a pedometer-based walking intervention in inactive adults, delivered postally or through dedicated practice nurse physical activity (PA) consultations. DESIGN Parallel three-arm trial, cluster randomised by household. SETTING Seven London-based general practices. PARTICIPANTS A total of 11,015 people without PA contraindications, aged 45-75 years, randomly selected from practices, were invited. A total of 6399 people were non-responders, and 548 people self-reporting achieving PA guidelines were excluded. A total of 1023 people from 922 households were randomised to usual care (n = 338), postal intervention (n = 339) or nurse support (n = 346). The recruitment rate was 10% (1023/10,467). A total of 956 participants (93%) provided outcome data. INTERVENTIONS Intervention groups received pedometers, 12-week walking programmes advising participants to gradually add '3000 steps in 30 minutes' most days weekly and PA diaries. The nurse group was offered three dedicated PA consultations. MAIN OUTCOME MEASURES The primary and main secondary outcomes were changes from baseline to 12 months in average daily step counts and time in MVPA (in ≥ 10-minute bouts), respectively, from 7-day accelerometry. Individual resource-use data informed the within-trial economic evaluation and the Markov model for simulating long-term cost-effectiveness. Qualitative evaluations assessed nurse and participant views. A 3-year follow-up was conducted. RESULTS Baseline average daily step count was 7479 [standard deviation (SD) 2671], average minutes per week in MVPA bouts was 94 minutes (SD 102 minutes) for those randomised. PA increased significantly at 12 months in both intervention groups compared with the control group, with no difference between interventions; additional steps per day were 642 steps [95% confidence interval (CI) 329 to 955 steps] for the postal group and 677 steps (95% CI 365 to 989 steps) for nurse support, and additional MVPA in bouts (minutes per week) was 33 minutes per week (95% CI 17 to 49 minutes per week) for the postal group and 35 minutes per week (95% CI 19 to 51 minutes per week) for nurse support. Intervention groups showed no increase in adverse events. Incremental cost per step was 19p and £3.61 per minute in a ≥ 10-minute MVPA bout for nurse support, whereas the postal group took more steps and cost less than the control group. The postal group had a 50% chance of being cost-effective at a £20,000 per quality-adjusted life-year (QALY) threshold within 1 year and had both lower costs [-£11M (95% CI -£12M to -£10M) per 100,000 population] and more QALYs [759 QALYs gained (95% CI 400 to 1247 QALYs)] than the nurse support and control groups in the long term. Participants and nurses found the interventions acceptable and enjoyable. Three-year follow-up data showed persistent intervention effects (nurse support plus postal vs. control) on steps per day [648 steps (95% CI 272 to 1024 steps)] and MVPA bouts [26 minutes per week (95% CI 8 to 44 minutes per week)]. LIMITATIONS The 10% recruitment level, with lower levels in Asian and socioeconomically deprived participants, limits the generalisability of the findings. Assessors were unmasked to the group. CONCLUSIONS A primary care pedometer-based walking intervention in 45- to 75-year-olds increased 12-month step counts by around one-tenth, and time in MVPA bouts by around one-third, with similar effects for the nurse support and postal groups, and persistent 3-year effects. The postal intervention provides cost-effective, long-term quality-of-life benefits. A primary care pedometer intervention delivered by post could help address the public health physical inactivity challenge. FUTURE WORK Exploring different recruitment strategies to increase uptake. Integrating the Pedometer And Consultation Evaluation-UP (PACE-UP) trial with evolving PA monitoring technologies. TRIAL REGISTRATION Current Controlled Trials ISRCTN98538934. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 37. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Tess Harris
- Population Health Research Institute, St George's, University of London, London, UK
| | - Sally Kerry
- Pragmatic Clinical Trials Unit, Queen Mary University of London, London, UK
| | - Christina Victor
- Gerontology and Health Services Research Unit, Brunel University London, London, UK
| | - Steve Iliffe
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Michael Ussher
- Population Health Research Institute, St George's, University of London, London, UK
| | - Julia Fox-Rushby
- Health Economics Research Group, Brunel University London, London, UK
| | - Peter Whincup
- Population Health Research Institute, St George's, University of London, London, UK
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Cheryl Furness
- Population Health Research Institute, St George's, University of London, London, UK
| | - Elizabeth Limb
- Population Health Research Institute, St George's, University of London, London, UK
| | - Nana Anokye
- Health Economics Research Group, Brunel University London, London, UK
| | - Judith Ibison
- Population Health Research Institute, St George's, University of London, London, UK
| | - Stephen DeWilde
- Population Health Research Institute, St George's, University of London, London, UK
| | - Lee David
- 10 Minute CBT, Devonshire Business Centre, Letchworth Garden City, UK
| | - Emma Howard
- Population Health Research Institute, St George's, University of London, London, UK
| | - Rebecca Dale
- Population Health Research Institute, St George's, University of London, London, UK
| | - Jaime Smith
- Population Health Research Institute, St George's, University of London, London, UK
| | - Rebecca Normansell
- Population Health Research Institute, St George's, University of London, London, UK
| | - Carole Beighton
- Population Health Research Institute, St George's, University of London, London, UK
| | - Katy Morgan
- Pragmatic Clinical Trials Unit, Queen Mary University of London, London, UK
| | - Charlotte Wahlich
- Population Health Research Institute, St George's, University of London, London, UK
| | - Sabina Sanghera
- Health Economics Research Group, Brunel University London, London, UK
| | - Derek Cook
- Population Health Research Institute, St George's, University of London, London, UK
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Dinu M, Pagliai G, Macchi C, Sofi F. Active Commuting and Multiple Health Outcomes: A Systematic Review and Meta-Analysis. Sports Med 2018; 49:437-452. [DOI: 10.1007/s40279-018-1023-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Zwald ML, Fakhouri THI, Fryar CD, Whitfield G, Akinbami LJ. Trends in active transportation and associations with cardiovascular disease risk factors among U.S. adults, 2007-2016. Prev Med 2018; 116:150-156. [PMID: 30227156 PMCID: PMC7216826 DOI: 10.1016/j.ypmed.2018.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 08/06/2018] [Accepted: 09/11/2018] [Indexed: 11/27/2022]
Abstract
Active transportation (AT), or walking or bicycling for transportation, represents one way individuals can achieve recommended physical activity (PA) levels. This study describes AT prevalence and temporal trends, and examines associations between AT levels and measured CVD risk factors (hypertension, hypercholesterolemia, low high-density [HDL] cholesterol, diabetes, and obesity) among U.S. adults. National Health and Nutrition Examination Survey (NHANES) 2007-2016 data (analyzed in 2017) were used to conduct overall trend analyses of reported AT in a typical week [none (0-9 min/week); low (10-149 min/week); or high (≥150 min/week)]. Logistic regression was used to examine associations between AT level and each CVD risk factor from NHANES 2011-2016 (n = 13,943). Covariates included age, sex, race/Hispanic origin, education, income, smoking, survey cycle, non-transportation PA, and urbanization level. U.S. adults who engaged in high AT levels increased from 13.1% in 2007-2008 to 17.9% in 2011-2012, and then decreased to 10.6% in 2015-2016 (p for quadratic trend = 0.004). Over the same period, the quadratic trend for low AT was not significant. During 2011-2016, 14.3% of adults engaged in high AT, 11.4% in low AT, and 74.4% in no AT. High AT levels were associated with decreased odds of each CVD risk factor assessed, compared to no AT. Low AT (versus no AT) was associated with decreased odds of hypertension (aOR = 0.77, 95% CI 0.64, 0.91) and diabetes (aOR = 0.68, 95% CI 0.54, 0.85). AT prevalence among adults has fluctuated from 2007 to 2016. Despite favorable associations between AT and CVD risk factors, most U.S. adults do not engage in any AT.
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Affiliation(s)
- Marissa L Zwald
- Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Nutrition Examination and Health Surveys, United States of America; Centers for Disease Control and Prevention, Epidemic Intelligence Service, United States of America; United States Public Health Service, United States of America.
| | - Tala H I Fakhouri
- Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Nutrition Examination and Health Surveys, United States of America
| | - Cheryl D Fryar
- Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Nutrition Examination and Health Surveys, United States of America
| | - Geoffrey Whitfield
- Centers for Disease Control and Prevention, National Center for Chronic Disease and Health Promotion, Division of Nutrition, Physical Activity and Obesity, United States of America
| | - Lara J Akinbami
- Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Nutrition Examination and Health Surveys, United States of America; United States Public Health Service, United States of America
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29
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Anokye N, Fox-Rushby J, Sanghera S, Cook DG, Limb E, Furness C, Kerry SM, Victor CR, Iliffe S, Ussher M, Whincup PH, Ekelund U, deWilde S, Harris T. Short-term and long-term cost-effectiveness of a pedometer-based exercise intervention in primary care: a within-trial analysis and beyond-trial modelling. BMJ Open 2018; 8:e021978. [PMID: 30337309 PMCID: PMC6196874 DOI: 10.1136/bmjopen-2018-021978] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES A short-term and long-term cost-effectiveness analysis (CEA) of two pedometer-based walking interventions compared with usual care. DESIGN (A) Short-term CEA: parallel three-arm cluster randomised trial randomised by household. (B) Long-term CEA: Markov decision model. SETTING Seven primary care practices in South London, UK. PARTICIPANTS (A) Short-term CEA: 1023 people (922 households) aged 45-75 years without physical activity (PA) contraindications. (b) Long-term CEA: a cohort of 100 000 people aged 59-88 years. INTERVENTIONS Pedometers, 12-week walking programmes and PA diaries delivered by post or through three PA consultations with practice nurses. PRIMARY AND SECONDARY OUTCOME MEASURES Accelerometer-measured change (baseline to 12 months) in average daily step count and time in 10 min bouts of moderate to vigorous PA (MVPA), and EQ-5D-5L quality-adjusted life-years (QALY). METHODS Resource use costs (£2013/2014) from a National Health Service perspective, presented as incremental cost-effectiveness ratios for each outcome over a 1-year and lifetime horizon, with cost-effectiveness acceptability curves and willingness to pay per QALY. Deterministic and probabilistic sensitivity analyses evaluate uncertainty. RESULTS (A) Short-term CEA: At 12 months, incremental cost was £3.61 (£109)/min in ≥10 min MVPA bouts for nurse support compared with control (postal group). At £20 000/QALY, the postal group had a 50% chance of being cost saving compared with control. (B) Long-term CEA: The postal group had more QALYs (+759 QALYs, 95% CI 400 to 1247) and lower costs (-£11 million, 95% CI -12 to -10) than control and nurse groups, resulting in an incremental net monetary benefit of £26 million per 100 000 population. Results were sensitive to reporting serious adverse events, excluding health service use, and including all participant costs. CONCLUSIONS Postal delivery of a pedometer intervention in primary care is cost-effective long term and has a 50% chance of being cost-effective, through resource savings, within 1 year. Further research should ascertain maintenance of the higher levels of PA, and its impact on quality of life and health service use. TRIAL REGISTRATION NUMBER ISRCTN98538934; Pre-results.
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Affiliation(s)
- Nana Anokye
- Health Economics Research Group, Brunel University, London, UK
| | - Julia Fox-Rushby
- Department of Population Health Sciences, Guy’s Campus, King’s College London, London, UK
| | - Sabina Sanghera
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Derek G Cook
- Population Health Research Institute, St George’s University of London, London, UK
| | - Elizabeth Limb
- Population Health Research Institute, St George’s University of London, London, UK
| | - Cheryl Furness
- Population Health Research Institute, St George’s University of London, London, UK
| | | | | | - Steve Iliffe
- Population Health Research Institute, St George’s University of London, London, UK
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Michael Ussher
- Population Health Research Institute, St George’s University of London, London, UK
| | - Peter H Whincup
- Population Health Research Institute, St George’s University of London, London, UK
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- MRC Epidemiology Unit, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Stephen deWilde
- Population Health Research Institute, St George’s University of London, London, UK
| | - Tess Harris
- Population Health Research Institute, St George’s University of London, London, UK
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Ferrario MM, Roncaioli M, Veronesi G, Holtermann A, Clays E, Borchini R, Cavicchiolo M, Grassi G, Cesana G. Differing associations for sport versus occupational physical activity and cardiovascular risk. Heart 2018; 104:1165-1172. [PMID: 29440185 DOI: 10.1136/heartjnl-2017-312594] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/28/2017] [Accepted: 01/05/2018] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES We investigate the independent and interacting long-term associations of occupational physical activity (OPA) and sport physical activity (SpPA) with the incidence of coronary heart disease (CHD) and cardiovascular diseases (CVD; CHD plus ischaemic stroke) in North Italian male workers. METHODS 3574 employed men aged 25-64 years, free of CVD at baseline, recruited in three population-based and one factory-based cohorts, were included in the analysis. The Baecke Questionnaire was used to assess OPA and SpPA in 'minutes per week' of moderate or vigorous PA. We estimated the associations between different domains of PA and the endpoints, adjusting for major CVD risk factors, using Cox models. RESULTS During a median follow-up of 14 years, 135 and 174 first CHD and CVD events, fatal and non-fatal, occurred. Compared with the intermediate OPA tertile, the HRs for CHD among low and high OPA workers were 1.66 (95% CI 1.06 to 2.59) and 1.18 (0.72 to 1.94), respectively (P value=0.07). Decreasing trends in CHD and CVD rates across increasing levels of SpPA were also found, with an HR for CVD of 0.68 (0.46 to 0.98) for intermediate/recommended SpPA compared with poor SpPA. We also found a statistically significant SpPA-OPA interaction, and the protective effect of SpPA was only found among sedentary workers, for both endpoints. Conversely, high OPA workers with intermediate/recommended SpPA levels had increased CHD and CVD rates compared with the poor SpPA category. CONCLUSIONS Our results provide further evidence on the health paradox of OPA, with higher CVD rates among workers with intense PA at work. Moreover, the protective effect on CVDs of SpPA is prominent in sedentary workers, but it attenuates and even reverses in moderate and strenuous OPA workers.
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Affiliation(s)
- Marco Mario Ferrario
- Department of Medicine and Surgery, School of Medicine, Research Center in Epidemiology and Preventive Medicine, University of Insubria, Varese, Italy.,Occupational Medicine Unit, University hospital of Varese, Varese, Italy.,School of Occupational Medicine, University of Insubria, Varese, Italy
| | - Mattia Roncaioli
- School of Occupational Medicine, University of Insubria, Varese, Italy
| | - Giovanni Veronesi
- Department of Medicine and Surgery, School of Medicine, Research Center in Epidemiology and Preventive Medicine, University of Insubria, Varese, Italy
| | - Andreas Holtermann
- The National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Els Clays
- Department of Public Health, Ghent University, Ghent, Belgium
| | - Rossana Borchini
- Occupational Medicine Unit, University hospital of Varese, Varese, Italy
| | - Marco Cavicchiolo
- Department of Medicine and Surgery, School of Medicine, Research Center in Epidemiology and Preventive Medicine, University of Insubria, Varese, Italy
| | - Guido Grassi
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,IRCCS Multimedica, Sesto San Giovanni, Italy
| | - Giancarlo Cesana
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
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Huang JH, Li RH, Huang SL, Sia HK, Lee SS, Wang WH, Tang FC. Relationships between different types of physical activity and metabolic syndrome among Taiwanese workers. Sci Rep 2017; 7:13735. [PMID: 29061986 PMCID: PMC5653817 DOI: 10.1038/s41598-017-13872-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 10/03/2017] [Indexed: 11/24/2022] Open
Abstract
This study aimed to investigate the relationships between different types of physical activity (PA) and metabolic syndrome (MetS). In this cross-sectional study, 3,296 Taiwanese workers were enrolled. A self-reported questionnaire was used to assess nutritional health behavior and PA levels related to occupation, leisure time, and commuting. Anthropometric measures, blood pressure and biochemical determinations of the blood were also obtained. Multiple logistic regression was used to evaluate the adjusted odds ratios (ORs) and 95% confidence intervals (CI) of MetS and its components associated with different types of PA. The prevalence of MetS was 16.6% in workers. Compared with a low level of leisure-time PA, a high level of leisure-time PA showed a significantly lower risk of high triglycerides (OR 0.73, 95% CI 0.61-0.87) and MetS (OR 0.76, 95% CI 0.62-0.95). Compared with a low level of occupational PA, a high level of occupational PA represented a significantly lower risk of both abdominal adiposity (OR 0.64, 95% CI 0.49-0.84) and high triglycerides (OR 0.71, 95% CI 0.55-0.90). However, commuting PA levels were not significantly associated with MetS and its components. In conclusion, occupational PA as well as leisure-time PA could be important for the prevention of MetS.
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Affiliation(s)
- Jui-Hua Huang
- Occupational Health Center, Changhua Christian Hospital, Changhua, 500, Taiwan
| | - Ren-Hau Li
- Department of Psychology, Chung Shan Medical University, Taichung, 402, Taiwan
| | - Shu-Ling Huang
- Department of Psychology, Chung Shan Medical University, Taichung, 402, Taiwan
- Room of Clinical Psychology, Chung Shan Medical University Hospital, Taichung, 402, Taiwan
| | - Hon-Ke Sia
- Division of Endocrinology and Metabolism, Changhua Christian Hospital, Changhua, 500, Taiwan
| | - Su-Shiang Lee
- Department of Leisure Services Management, Chaoyang University of Technology, Taichung, 413, Taiwan
| | - Wei-Hsun Wang
- Department of Orthopedic, Changhua Christian Hospital, Changhua, 500, Taiwan
- Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung, 821, Taiwan
- Department of Golden-Ager Industry Management, Chaoyang University of Technology, Taichung, 413, Taiwan
| | - Feng-Cheng Tang
- Department of Leisure Services Management, Chaoyang University of Technology, Taichung, 413, Taiwan.
- Department of Occupational Medicine, Changhua Christian Hospital, Changhua, 500, Taiwan.
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Masala G, Bendinelli B, Occhini D, Bruno RM, Caini S, Saieva C, Ungar A, Ghiadoni L, Palli D. Physical activity and blood pressure in 10,000 Mediterranean adults: The EPIC-Florence cohort. Nutr Metab Cardiovasc Dis 2017; 27:670-678. [PMID: 28755806 DOI: 10.1016/j.numecd.2017.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 06/08/2017] [Accepted: 06/08/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIMS The relevant role of physical activity (PA) in cardiovascular risk prevention is widely agreed. We aimed to evaluate, in a large Mediterranean population, the influence of PA on systolic (SBP) and diastolic blood pressure (DBP), taking into account individual characteristics and lifestyle habits. METHODS AND RESULTS In the Florence section of the European Prospective Investigation into Cancer and Nutrition 10,163 individuals, 35-64 years, without a previous diagnosis of hypertension were recruited. Information on occupational and leisure-time PA and blood pressure were collected at recruitment, together with data on lifestyle, dietary habits and anthropometry. Multivariate regression models were applied to evaluate the effect of total, occupational and leisure-time PA on SBP and DBP. Mean values of SBP and DBP in the study subjects were 124.4 (SD 15.6) and 79.7 mmHg (SD 9.4), respectively. Overall, a total PA index and an index including cycling, fitness and occupational PA (Cambridge index) were inversely associated with DBP (beta -0.87, p-value 0.02 actives vs inactives, p for trend 0.02 and beta -0.84, p value 0.003 actives vs inactives, p for trend 0.002, respectively), while SBP was associated only with the latter index (beta -1.14, p-value 0.01 actives vs inactives, p for trend 0.006). An inverse association emerged between manual/heavy manual occupation and DBP (p 0.02, ref sedentary/standing occupation) and between increasing cycling activity and SBP (p for trend 0.04). CONCLUSIONS In this large cohort of Mediterranean adults without a diagnosis of hypertension we confirm the role of overall PA in modulating SBP and DBP values. Cycling and manual occupations were associated with lower DBP values.
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Affiliation(s)
- G Masala
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - B Bendinelli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - D Occhini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - R M Bruno
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - S Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - C Saieva
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy
| | - A Ungar
- Division of Geriatric Cardiology and Medicine, University of Florence, Florence, Italy; Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - L Ghiadoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - D Palli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Florence, Italy.
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Dutheil F, Ferrières J, Esquirol Y. [Occupational sedentary behaviors and physical activity at work]. Presse Med 2017; 46:703-707. [PMID: 28757176 DOI: 10.1016/j.lpm.2017.06.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 06/27/2017] [Indexed: 11/26/2022] Open
Abstract
Sedentary behaviors are a leading cause of preventable mortality in developed countries. We mainly have sedentary behaviors at work. Sedentary behaviors must be considered as an occupational risk, and therefore must be a major concern for managers and physicians/health researchers. Recreational physical activity only partly compensates for the negative effects of physical inactivity at work. Physical activity at work without excess (walking, standing) is beneficial. Initiatives to reduce physical inactivity and increase physical activity among employees are effective in terms of mental health, physical health, and productivity. Prevention of sedentary behaviors at work is a win-win partnership between employers and employees.
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Affiliation(s)
- Frédéric Dutheil
- CHU de Clermont-Ferrand, médecine du travail, 63000 Clermont-Ferrand, France; Université Clermont-Auvergne, équipe « Stress physiologique et psychosocial », UMR CNRS 6024, LaPSco, 63000 Clermont-Ferrand, France; Australian Catholic University, Faculty of Health, School of Exercise Science, Melbourne, Victoria 3065, Australie; WittyFit, 75000 Paris, France.
| | - Jean Ferrières
- CHU de Toulouse, unité de prévention de l'athérosclérose, 31000 Toulouse, France; Université Paul-Sabatier, UMR Inserm 1027, « Épidémiologie de l'athérosclérose et des maladies cardiovasculaires : facteurs de risque et prise en charge en population », 31000 Toulouse, France
| | - Yolande Esquirol
- Université Paul-Sabatier, UMR Inserm 1027, « Épidémiologie de l'athérosclérose et des maladies cardiovasculaires : facteurs de risque et prise en charge en population », 31000 Toulouse, France; CHU de Toulouse, médecine du travail, 31000 Toulouse, France
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Barengo NC, Antikainen R, Borodulin K, Harald K, Jousilahti P. Leisure-Time Physical Activity Reduces Total and Cardiovascular Mortality and Cardiovascular Disease Incidence in Older Adults. J Am Geriatr Soc 2016; 65:504-510. [PMID: 28024086 DOI: 10.1111/jgs.14694] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine whether leisure-time physical activity (LTPA) is independently associated with all-cause and cardiovascular mortality and with incidence of cardiovascular disease (CVD) and stroke in older adults. DESIGN Population-based cohort study (median follow-up 11.8 years). SETTING Community, five Finnish provinces. PARTICIPANTS Men and women aged 65 to 74 who participated in a baseline risk factor survey between 1997 and 2007 in Finland (N = 2,456). MEASUREMENTS The study protocol included a self-administered questionnaire, health examination at the study site, and blood sample for laboratory analysis. LTPA was classified into three levels: low, moderate, high. Mortality data were obtained from the National Causes of Death Register and data on incident CVD (coronary heart disease, stroke) events from the National Hospital Discharge Register. RESULTS Multifactorial-adjusted (age, area, study year, sex, smoking, body mass index, systolic blood pressure, serum cholesterol, education, marital status) risks of total mortality (moderate: hazard ratio (HR) = 0.61, 95% confidence interval (CI) = 0.50-0.74; high: HR = 0.47, 95% CI = 0.34-0.63, P for trend <.001), CVD mortality (moderate: HR = 0.46, 95% CI = 0.33-0.64; high: HR = 0.34, 95% CI = 0.20-0.59, P for trend <.001), and an incident CVD event (moderate HR = 0.69, 95% CI = 0.54-0.88; high: HR = 0.55, 95% CI = 0.38-0.79, P for trend <.001) were lower for those with moderate or high LTPA levels than for those with low LTPA levels. Further adjustment for self-reported inability to perform LTPA did not change the associations remarkably. CONCLUSIONS Baseline LTPA reduces the risk of total and CVD mortality and incident CVD events in older adults independently of the major known CVD risk factors. The protective effect of LTPA is dose dependent.
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Affiliation(s)
- Noël C Barengo
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida.,Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Riitta Antikainen
- Center for Life Course Health Research/Geriatrics, Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.,Oulu City Hospital, Oulu, Finland
| | - Katja Borodulin
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Kennet Harald
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Pekka Jousilahti
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
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Treff C, Benseñor IM, Lotufo PA. Leisure-time and commuting physical activity and high blood pressure: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). J Hum Hypertens 2016; 31:278-283. [DOI: 10.1038/jhh.2016.75] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 08/03/2016] [Accepted: 09/07/2016] [Indexed: 11/09/2022]
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Gray BJ, Stephens JW, Williams SP, Davies CA, Turner D, Bracken RM. Cardiorespiratory fitness testing and cardiovascular disease risk in male steelworkers. Occup Med (Lond) 2016; 67:38-43. [PMID: 27694428 DOI: 10.1093/occmed/kqw131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The workplace has been advocated as a setting to perform cardiovascular disease (CVD) risk assessments. These risk assessments usually focus on traditional risk factors rather than cardiorespiratory fitness (CRF) despite established associations between CRF and CVD. The lack of guidance on interpreting health-related CRF values has been suggested as a barrier to utilizing CRF in practice. AIMS To assess the merits of CRF testing in the workplace and explore whether a CRF value identified male individuals above the recommended threshold for further clinical investigation. METHODS Cross-sectional analysis of male steelworkers from Carmarthenshire, South Wales, UK who completed a workplace-based CVD risk assessment with an added CRF protocol based on heart rate responses (Chester Step Test). Receiver operating characteristic (ROC) analysis was undertaken to explore the possibility of a CRF value to identify individuals at an increased 10-year risk of CVD (QRISK2 ≥ 10%). RESULTS There were 81 participants. ROC analysis revealed that a CRF level of 34.5ml/kg/min identified those individuals above the ≥10% QRISK2 threshold with the best sensitivity (0.800) and specificity (0.687) to discriminate against true- and false-positive rates. Further analysis revealed that individuals with either 'Average' or 'Below Average' CRF would be five times more likely to have a 10-year CVD risk above the ≥10% QRISK2 threshold than individuals with an 'Excellent' or 'Good' level of fitness [OR 5.10 (95% CI 1.60-16.3)]. CONCLUSIONS This study suggests CRF assessments are a useful addition to a workplace CVD assessment and could identify male individuals at increased predicted risk of the condition.
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Affiliation(s)
- B J Gray
- Policy, Research and International Development, Public Health Wales, Cardiff CF10 4BZ, UK,
| | - J W Stephens
- Diabetes Research Group, College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK
| | - S P Williams
- TATA Steel Packaging Recycling, Trostre, Llanelli, Carmarthenshire SA14 9SD, UK
| | - C A Davies
- TATA Steel Packaging Recycling, Trostre, Llanelli, Carmarthenshire SA14 9SD, UK
| | - D Turner
- Red Bull North America, Santa Monica, CA 90404, USA
| | - R M Bracken
- Diabetes Research Group, College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK.,Applied Sports Technology Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea University (Bay Campus), Swansea SA1 8EN, UK
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Wennman H, Vasankari T, Borodulin K. Where to Sit? Type of Sitting Matters for the Framingham Cardiovascular Risk Score. AIMS Public Health 2016; 3:577-591. [PMID: 29546184 PMCID: PMC5689818 DOI: 10.3934/publichealth.2016.3.577] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 08/10/2016] [Indexed: 12/16/2022] Open
Abstract
Background Current evidence on associations of type-specific sedentary behavior with cardiovascular disease (CVD) is limited to mainly screen-time sedentary behavior (SB). We aimed to study the associations of type-specific and total time spent sitting with the Framingham 10-year cardiovascular disease risk score (Framingham score) in Finnish adults. Methods Data comprise the National FINRISK 2007 and 2012 health examination surveys with 10,185 participants aged 25–74 years, apparently free of CVD. Participants reported average daily time spent sitting in different locations: work-related sitting, at home in front of television (TV), at home in front of computer, in a vehicle, and elsewhere. Total SB time was calculated from these context-specific self-reports. Accelerometer-based sedentary time was assessed in 988 FINRISK 2012 participants. Framingham score was calculated using information on blood pressure and its medication, cholesterol levels, age, diabetes status, and smoking. Analyses were adjusted for age, study year, education, employment status, leisure time physical activity, and body mass index. Results Out of several type-specific sitting behaviors, only TV sitting showed systematic associations with the Framingham score in both genders. The lowest Framingham risk was found for TV sitting from 6 minutes to less than 1 hour daily. Of other types of sitting, computer sitting was inversely associated with the Framingham risk in men only. Total self-reported sitting time did not show significant associations with the Framingham score, but instead higher objectively assessed sedentary time showed higher Framingham risk in men. Conclusions TV sitting showed most systematic associations with CVD risk score. This suggests that of all types of SB, reducing TV sitting should be targeted for reducing CVD risk.
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Affiliation(s)
- Heini Wennman
- National Institute for Health and Welfare, PO Box 30, FI-00271 Helsinki, Finland
| | - Tommi Vasankari
- UKK-Institute for Research and Health Promotion, PO Box 30, FI-33501 Tampere, Finland
| | - Katja Borodulin
- National Institute for Health and Welfare, PO Box 30, FI-00271 Helsinki, Finland
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40
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Hayashi R, Iso H, Cui R, Tamakoshi A. Occupational physical activity in relation to risk of cardiovascular mortality: The Japan Collaborative Cohort Study for Evaluation for Cancer Risk (JACC Study). Prev Med 2016; 89:286-291. [PMID: 27311336 DOI: 10.1016/j.ypmed.2016.06.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 06/08/2016] [Accepted: 06/11/2016] [Indexed: 11/19/2022]
Abstract
We examined the association between patterns of occupational physical activity (OPA) and mortality from cardiovascular disease (CVD) in a Japanese population. A community-based, prospective cohort of 66,161 men and women aged 40-79years without a history of CVD or cancer at baseline (1988-1990) was followed until 2009. OPA was divided into four types: mostly sitting, sitting and standing (sitting/standing), mostly standing, and standing and walking (standing/walking). During follow-up for a median of 19.2years, 3728 deaths from CVD were registered. Compared with mostly sitting OPA, standing/walking OPA was not associated with a reduced risk of CVD mortality for all subjects, but it was associated with a 20% lower risk of CVD mortality among overweight individuals (body mass index ≥25kg/m(2)). Compared with mostly sitting OPA, mostly standing OPA was associated with an approximately 20% higher risk of CVD mortality, especially among overweight individuals or those with lower exercise (<2.5h/week). In conclusion, compared with mostly sitting OPA, standing/walking OPA is associated with lower CVD mortality among overweight individuals, while mostly standing OPA is associated with higher CVD mortality, especially in physically inactive individuals.
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Affiliation(s)
- Rie Hayashi
- Public Health, Department of Social Medicine, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Renzhe Cui
- Public Health, Department of Social Medicine, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University, Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
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Verhoef TI, Trend V, Kelly B, Robinson N, Fox P, Morris S. Cost-effectiveness analysis of offering free leisure centre memberships to physically inactive members of the public receiving state benefits: a case study. BMC Public Health 2016; 16:616. [PMID: 27449787 PMCID: PMC4957286 DOI: 10.1186/s12889-016-3300-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 07/13/2016] [Indexed: 11/24/2022] Open
Abstract
Background We evaluated the cost-effectiveness of the Give-it-a-Go programme, which offers free leisure centre memberships to physically inactive members of the public in a single London Borough receiving state benefits. Methods A decision analytic Markov model was developed to analyse lifetime costs and quality-adjusted life-years (QALYs) of 1025 people recruited to the intervention versus no intervention. In the intervention group, people were offered 4 months of free membership at a leisure centre. Physical activity levels were assessed at 0 and 4 months using the International Physical Activity Questionnaire (IPAQ). Higher levels of physical activity were assumed to decrease the risk of coronary heart disease, stroke and diabetes mellitus type II, as well as improve mental health. Costs were assessed from a National Health Service (NHS) perspective. Uncertainty was assessed using one-way and probabilistic sensitivity analyses. Results One-hundred fifty nine participants (15.5 %) completed the programme by attending the leisure centre for 4 months. Compared with no intervention, Give it a Go increased costs by £67.25 and QALYs by 0.0033 (equivalent to 1.21 days in full health) per recruited person. The incremental costs per QALY gained were £20,347. The results were highly sensitive to the magnitude of mental health gain due to physical activity and the duration of the effect of the programme (1 year in the base case analysis). When the mental health gain was omitted from the analysis, the incremental cost per QALY gained increased to almost £1.5 million. In the probabilistic sensitivity analysis, the incremental costs per QALY gained were below £20,000 in 39 % of the 5000 simulations. Conclusions Give it a Go did not significantly increase life-expectancy, but had a positive influence on quality of life due to the mental health gain of physical activity. If the increase in physical activity caused by Give it a Go lasts for more than 1 year, the programme would be cost-effective given a willingness to pay for a QALY of £20,000. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3300-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Talitha I Verhoef
- Department of Applied Health Research, University College London, Gower Street, London, WC1E 6BT, UK.
| | | | - Barry Kelly
- Camden Borough Council, London, UK.,London Sport, London, UK
| | | | - Paul Fox
- Camden Borough Council, London, UK
| | - Stephen Morris
- Department of Applied Health Research, University College London, Gower Street, London, WC1E 6BT, UK
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Edwards ES, Sackett SC. Psychosocial Variables Related to Why Women are Less Active than Men and Related Health Implications. CLINICAL MEDICINE INSIGHTS. WOMEN'S HEALTH 2016; 9:47-56. [PMID: 27398045 PMCID: PMC4933535 DOI: 10.4137/cmwh.s34668] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 05/12/2016] [Accepted: 05/15/2016] [Indexed: 12/22/2022]
Abstract
This article reviews psychosocial influences on women’s participation in physical activity as they differ from men and how associated activity differences impact women’s risk for a number of chronic diseases. This topic directly aligns with the mission of this special edition related to disparities in women’s health as the typically lower level of physical activity in females directly impacts their health. On average, females participate in physical activity at lower rates than their male counterparts. These lower rates of physical activity are directly related to both incidence of and outcomes from cardiovascular disease, type 2 diabetes, and breast and gynecological cancers. The relationship between psychosocial factors that are understood to affect physical activity differs between men and women. Specifically, self-efficacy, social support, and motivation are empirically substantiated factors that found to impact physical activity participation among women differently than men. Understanding these relationships is integral to designing effective interventions to target physical activity participation in women so that the related health risks are adequately addressed.
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Affiliation(s)
| | - Sarah Carson Sackett
- Department of Kinesiology, James Madison University, Morrison Bruce Center, Harrisonburg, VA, USA
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Campbell F, Holmes M, Everson-Hock E, Davis S, Buckley Woods H, Anokye N, Tappenden P, Kaltenthaler E. A systematic review and economic evaluation of exercise referral schemes in primary care: a short report. Health Technol Assess 2016. [PMID: 26222987 DOI: 10.3310/hta19600] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND It is estimated that only 39% of men and 29% of women in England achieve the levels of physical activity that are recommended to protect health and prevent disease. One approach to addressing this problem has been the development of exercise referral schemes (ERSs), in which health professionals refer patients to external exercise providers. These schemes have been widely rolled out across the UK despite concerns that they may not produce sustained changes in levels of physical activity and, therefore, may not be cost-effective interventions. The evidence to determine clinical effectiveness and cost-effectiveness was evaluated in 2009. This review seeks to update this earlier work by incorporating new evidence and re-examining the cost-effectiveness. OBJECTIVES To assess the clinical effectiveness and cost-effectiveness of ERSs compared with usual care. DESIGN Exhaustive searches of relevant electronic databases and journals were undertaken to identify new studies evaluating ERSs using a randomised controlled trial (RCT) design. RCTs that incorporated a qualitative evaluation of the intervention were identified in order to explore the barriers and facilitators to the uptake of and adherence to ERSs. Data were extracted using a previously designed tool and study quality assessed for potential bias. Where data could be pooled, meta-analyses were carried out. Qualitative analysis was also undertaken using a thematic approach. The cost-effectiveness was evaluated using a Markov structure which estimated the likelihood of becoming physically active and the subsequent risk reduction on coronary heart disease (CHD), stroke and type 2 diabetes mellitus. The model adopts a lifetime horizon, and a NHS and Personal Social Services perspective was taken with discounting at 1.5% for both costs and benefits. RESULTS The search identified one new RCT and one new qualitative study. The new data were pooled with existing data from the 2011 review by Pavey et al. [Pavey TG, Anokye N, Taylor AH, Trueman P, Moxham T, Fox KR, et al. The clinical effectiveness and cost-effectiveness of exercise referral schemes: a systematic review and economic evaluation. Health Technol Assess 2011;15(44)] to give a total of eight studies with 5190 participants. The proportion of individuals achieving 90-150 minutes of at least moderate-intensity activity per week at 6-12 months' follow-up was greater for ERSs than usual care (relative risk 1.12; 95% confidence interval 1.04 to 1.20). Older patients and those referred for CHD risk factors appeared to be more likely than others to increase their levels of physical activity. Qualitative evidence suggests that interventions enabling the development of social support networks are beneficial in promoting uptake and adherence. Exercise referral gained 0.003 quality-adjusted life-years (QALYs) at an additional cost of £225 per person. The estimated mean incremental cost-effectiveness ratio (ICER) in the probabilistic sensitivity analysis was £76,276. In the univariate sensitivity analysis the results were very sensitive (ICERs ranged from < £30,000 to > £100,000) to changes in the effect of ERSs on physical activity uptake and the duration of the protective effects and the direct health-related quality-of-life gains attributable to physical activity. CONCLUSIONS Exercise referral schemes result in a small improvement in the number of people who increase their levels of physical activity. The cost-effectiveness analysis indicates that the ICER for ERSs compared with usual care is around £76,000 per QALY, although the cost-effectiveness of ERSs is subject to considerable uncertainty. STUDY REGISTRATION This study is registered as PROSPERO CRD42013005200. FUNDING National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Fiona Campbell
- Health Economics and Decision Science, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Mike Holmes
- Health Economics and Decision Science, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Emma Everson-Hock
- Health Economics and Decision Science, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Sarah Davis
- Health Economics and Decision Science, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Helen Buckley Woods
- Health Economics and Decision Science, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Nana Anokye
- Health Economics Research Group (HERG), Brunel University, Uxbridge, UK
| | - Paul Tappenden
- Health Economics and Decision Science, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Eva Kaltenthaler
- Health Economics and Decision Science, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
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Koolhaas CM, Dhana K, Golubic R, Schoufour JD, Hofman A, van Rooij FJA, Franco OH. Physical Activity Types and Coronary Heart Disease Risk in Middle-Aged and Elderly Persons: The Rotterdam Study. Am J Epidemiol 2016; 183:729-38. [PMID: 27022033 DOI: 10.1093/aje/kwv244] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 09/04/2015] [Indexed: 12/22/2022] Open
Abstract
Physical activity is associated with decreased risk of coronary heart disease (CHD). The specific physical activity types that provide beneficial effects in an older population remain unclear. We assessed the association of total physical activity, walking, cycling, domestic work, sports, and gardening with CHD by using Cox proportional hazard models among 5,901 participants aged >55 (median age, 67) years from the prospective population-based Rotterdam Study, enrolled between 1997 and 2001. Activities were categorized into tertiles, and the lowest tertiles were used as reference. In the multivariable model, we adjusted for age, sex, smoking, alcohol consumption, education, diet, and other physical activity types. During 15 years of follow-up (median, 10.3 (interquartile range, 8.0-11.8) years), 642 participants (10.9%) experienced a CHD event. In the multivariable model, the respective hazard ratios for the medium and high categories compared with the low category were 0.79 (95% confidence interval CI): 0.66, 0.96) and 0.71 (95% CI: 0.58, 0.87) for total physical activity, 0.76 (95% CI: 0.63, 0.92) and 0.70 (95% CI: 0.57, 0.88) for cycling, and 0.81 (95% CI: 0.66, 0.98) and 0.71 (95% CI: 0.56, 0.90) for domestic work. Walking, sports, and gardening were not associated with CHD. In conclusion, in this long-term follow-up study of older adults, domestic work and cycling were associated with reduced CHD risk. Physical activity should be promoted in this population with the aim to prevent CHD.
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Blood elements concentration in cyclists investigated by instrumental neutron activation analysis. J Radioanal Nucl Chem 2016. [DOI: 10.1007/s10967-016-4778-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Allesøe K, Søgaard K, Aadahl M, Boyle E, Holtermann A. Are hypertensive women at additional risk of ischaemic heart disease from physically demanding work? Eur J Prev Cardiol 2016; 23:1054-61. [PMID: 26876489 DOI: 10.1177/2047487316631681] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/20/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND The combination of hypertension and high physical activity at work may increase blood pressure considerably and increase the risk of atherosclerosis and thereby ischaemic heart disease (IHD), but only a few studies in men, and none among women, have examined this topic. DESIGN This was a prospective cohort study. METHODS In 1993, 12,093 female nurses from the Danish Nurse Cohort Study, aged 45-64 years answered a baseline questionnaire on physical activity at work, history of hypertension, a selection of known risk factors for IHD and occupational factors. Information on incident IHD from baseline to 2008 was retrieved by individual linkage to the National Register of Hospital Discharges. RESULTS In a fully adjusted Cox model, hypertensive nurses with high physical activity at work had nearly three times higher risk of IHD (hazard ratio (HR) 2.87 (95% confidence interval (CI) 2.12-3.87)) compared to normotensive nurses with moderate physical activity at work. Significant additive interaction between physical activity at work and hypertension was found measured by the relative excess risk due to additive interaction (RERI) (1.20 (95% CI 0.26-2.14), and in an additive hazards model. Hypertensive nurses with high physical activity at work had 60 additional cases of IHD per 10,000 person years compared to normotensive nurses with moderate physical activity at work (60.0 (95% CI 38.1-81.9; p < 0.001)), of which more than half was explained by additive interaction (40.7 (95% CI 11.7-69.7; p = 0.006)). No multiplicative interaction (p = 0.249) was found. CONCLUSIONS This study among Danish nurses indicated that hypertensive women may be at particular high risk of IHD from physically demanding work.
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Affiliation(s)
- Karen Allesøe
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark Research Centre for Prevention and Health, Centre for Health, Rigshospitalet-Glostrup, Denmark
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - Mette Aadahl
- Research Centre for Prevention and Health, Centre for Health, Rigshospitalet-Glostrup, Denmark Department of Public Health, University of Copenhagen, Denmark
| | - Eleanor Boyle
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark Dalla Lana School of Public Health, University of Toronto, Canada
| | - Andreas Holtermann
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark National Research Centre for the Working Environment, Denmark
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Lafortune L, Martin S, Kelly S, Kuhn I, Remes O, Cowan A, Brayne C. Behavioural Risk Factors in Mid-Life Associated with Successful Ageing, Disability, Dementia and Frailty in Later Life: A Rapid Systematic Review. PLoS One 2016; 11:e0144405. [PMID: 26845035 PMCID: PMC4742275 DOI: 10.1371/journal.pone.0144405] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 10/18/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Smoking, alcohol consumption, poor diet and low levels of physical activity significantly contribute to the burden of illness in developed countries. Whilst the links between specific and multiple risk behaviours and individual chronic conditions are well documented, the impact of these behaviours in mid-life across a range of later life outcomes has yet to be comprehensively assessed. This review aimed to provide an overview of behavioural risk factors in mid-life that are associated with successful ageing and the primary prevention or delay of disability, dementia, frailty and non-communicable chronic conditions. METHODS A literature search was conducted to identify cohort studies published in English since 2000 up to Dec 2014. Multivariate analyses and a minimum follow-up of five years were required for inclusion. Two reviewers screened titles, abstracts and papers independently. Studies were assessed for quality. Evidence was synthesised by mid-life behavioural risk for a range of late life outcomes. FINDINGS This search located 10,338 individual references, of which 164 are included in this review. Follow-up data ranged from five years to 36 years. Outcomes include dementia, frailty, disability and cardiovascular disease. There is consistent evidence of beneficial associations between mid-life physical activity, healthy ageing and disease outcomes. Across all populations studied there is consistent evidence that mid-life smoking has a detrimental effect on health. Evidence specific to alcohol consumption was mixed. Limited, but supportive, evidence was available relating specifically to mid-life diet, leisure and social activities or health inequalities. CONCLUSIONS There is consistent evidence of associations between mid-life behaviours and a range of late life outcomes. The promotion of physical activity, healthy diet and smoking cessation in all mid-life populations should be encouraged for successful ageing and the prevention of disability and chronic disease.
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Affiliation(s)
- Louise Lafortune
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Steven Martin
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Sarah Kelly
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Isla Kuhn
- University of Cambridge Medical Library, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Olivia Remes
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Andy Cowan
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Carol Brayne
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
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Gray BJ, Stephens JW, Williams SP, Davies CA, Turner D, Bracken RM. Cardiorespiratory fitness is a stronger indicator of cardiometabolic risk factors and risk prediction than self-reported physical activity levels. Diab Vasc Dis Res 2015; 12:428-35. [PMID: 26361778 DOI: 10.1177/1479164115599907] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study investigated the relationships of self-reported physical activity levels and cardiorespiratory fitness in 81 males to assess which measurement is the greatest indicator of cardiometabolic risk. Physical activity levels were determined by the General Practice Physical Activity Questionnaire tool and cardiorespiratory fitness assessed using the Chester Step Test. Cardiovascular disease risk was estimated using the QRISK2, Framingham Lipids, Framingham body mass index and Joint British Societies' Guidelines-2 equations, and type 2 diabetes mellitus risk calculated using QDiabetes, Leicester Risk Assessment, Finnish Diabetes Risk Score and Cambridge Risk Score models. Categorising employees by cardiorespiratory fitness categories ('Excellent/Good' vs 'Average/Below Average') identified more differences in cardiometabolic risk factor (body mass index, waist circumference, total cholesterol, total cholesterol:high-density lipoprotein ratio, high-density lipoprotein cholesterol, triglycerides, HbA(1c)) scores than physical activity (waist circumference only). Cardiorespiratory fitness levels also demonstrated differences in all four type 2 diabetes mellitus risk prediction models and both the QRISK2 and Joint British Societies' Guidelines-2 cardiovascular disease equations. Furthermore, significant negative correlations (p < 0.001) were observed between individual cardiorespiratory fitness values and estimated risk in all prediction models. In conclusion, from this preliminary observational study, cardiorespiratory fitness levels reveal a greater number of associations with markers of cardiovascular disease or type 2 diabetes mellitus compared to physical activity determined by the General Practice Physical Activity Questionnaire tool.
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Affiliation(s)
- Benjamin J Gray
- Policy, Research and International Development, Public Health Wales, Cardiff, UK
| | - Jeffrey W Stephens
- Diabetes Research Group, College of Medicine, Swansea University, Swansea, UK
| | | | | | - Daniel Turner
- Diabetes Research Group, College of Medicine, Swansea University, Swansea, UK Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea University, Swansea, UK
| | - Richard M Bracken
- Diabetes Research Group, College of Medicine, Swansea University, Swansea, UK Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea University, Swansea, UK
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Health Impacts of Increased Physical Activity from Changes in Transportation Infrastructure: Quantitative Estimates for Three Communities. BIOMED RESEARCH INTERNATIONAL 2015; 2015:812325. [PMID: 26504832 PMCID: PMC4609517 DOI: 10.1155/2015/812325] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 07/22/2015] [Indexed: 11/21/2022]
Abstract
Recently, two quantitative tools have emerged for predicting the health impacts of projects that change population physical activity: the Health Economic Assessment Tool (HEAT) and Dynamic Modeling for Health Impact Assessment (DYNAMO-HIA). HEAT has been used to support health impact assessments of transportation infrastructure projects, but DYNAMO-HIA has not been previously employed for this purpose nor have the two tools been compared. To demonstrate the use of DYNAMO-HIA for supporting health impact assessments of transportation infrastructure projects, we employed the model in three communities (urban, suburban, and rural) in North Carolina. We also compared DYNAMO-HIA and HEAT predictions in the urban community. Using DYNAMO-HIA, we estimated benefit-cost ratios of 20.2 (95% C.I.: 8.7–30.6), 0.6 (0.3–0.9), and 4.7 (2.1–7.1) for the urban, suburban, and rural projects, respectively. For a 40-year time period, the HEAT predictions of deaths avoided by the urban infrastructure project were three times as high as DYNAMO-HIA's predictions due to HEAT's inability to account for changing population health characteristics over time. Quantitative health impact assessment coupled with economic valuation is a powerful tool for integrating health considerations into transportation decision-making. However, to avoid overestimating benefits, such quantitative HIAs should use dynamic, rather than static, approaches.
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MacDonald Gibson J, Rodriguez D, Dennerlein T, Mead J, Hasch T, Meacci G, Levin S. Predicting urban design effects on physical activity and public health: A case study. Health Place 2015; 35:79-84. [PMID: 26275934 DOI: 10.1016/j.healthplace.2015.07.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 07/21/2015] [Accepted: 07/23/2015] [Indexed: 10/23/2022]
Abstract
With increasing global concerns about obesity and related health effects, tools to predict how urban form affects population physical activity and health are needed. However, such tools have not been well established. This article develops a computer simulation model for forecasting the health effects of urban features that promote walking. The article demonstrates the model using a proposed small-area plan for a neighborhood of 10,400 residents in Raleigh, North Carolina, one of the fastest-growing and most sprawling U.S. cities. The simulation model predicts that the plan would increase average daily time spent walking for transportation by 17 min. As a result, annual deaths from all causes are predicted to decrease by 5.5%. Annual new cases of diabetes, coronary heart disease, stroke, and hypertension are predicted to decline by 1.9%, 2.3%, 1.3%, and 1.6%, respectively. The present value of these health benefits is $21,000 per resident.
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Affiliation(s)
- Jacqueline MacDonald Gibson
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Campus Box 7431, Chapel Hill, NC 27599-7431, USA.
| | - Daniel Rodriguez
- Department of City and Regional Planning and Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Taylor Dennerlein
- Department of City and Regional Planning and Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jill Mead
- Department of City and Regional Planning and Department of Health Behavior and Health Education, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Stuart Levin
- Wake Internal Medicine Consultants and University of North Carolina School of Medicine, Raleigh, NC, USA
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