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Feter N, Leite JS, Weymar MK, Dumith SC, Umpierre D, Caputo EL. Physical activity during early life and the risk of all-cause mortality in midlife: findings from a birth cohort study. Eur J Public Health 2023; 33:872-877. [PMID: 37381074 PMCID: PMC10567256 DOI: 10.1093/eurpub/ckad084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND The objective of this study was to examine the association between physical activity during childhood and adolescence and the risk of all-cause mortality in midlife. We analyzed data from a birth cohort (The 1958 National Child Development Survey), including births in England, Wales and Scotland. METHODS Physical activity was assessed using questionnaires at ages 7, 11 and 16. Death certificates defined all-cause mortality. Cumulative exposure, sensitive and critical periods, and physical activity trajectory from childhood to adolescence were tested using multivariate Cox proportional hazard models. The sweep the death was confirmed was defined as the time event. RESULTS From age 23 to 55, 8.9% of participants (n = 9398) died. Physical activity in childhood and adolescence affected the risk of all-cause mortality in midlife. In men, physical activity at ages 11 [hazard ratio (HR): 0.77; 95% confidence interval (CI): 0.60-0.98] and 16 (HR: 0.60; 95% CI: 0.46-0.78) was associated with reduced risk of all-cause mortality. In women, physical activity at age 16 (HR: 0.68; 95% CI: 0.48-0.95) was associated with reduced risk of all-cause mortality. Physical activity in adolescence eliminated the risk of all-cause mortality associated with physical inactivity in adulthood in women. CONCLUSIONS Physical activity during childhood and adolescence was associated with reduced risk of all-cause mortality with different effects by sex.
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Affiliation(s)
- Natan Feter
- Postgraduate Program in Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Jayne S Leite
- Postgraduate Program in Health Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Marina K Weymar
- Postgraduate Program in Physical Education, School of Physical Education, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Samuel C Dumith
- Postgraduate Program in Health Sciences, School of Medicine, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Daniel Umpierre
- Postgraduate Program in Health Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Eduardo L Caputo
- Postgraduate Program in Physical Education, School of Physical Education, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Choi J, Park J, Kim JE, Lee JK, Kang D, Lee M, Chung IJ, Choi JY. Relative Effects of Demographic, Psychological, Behavioral, and Social Factors on the Initiation and Maintenance of Leisure-time Physical Activity: Results From a Confirmatory Path Analysis in a Longitudinal Study. J Epidemiol 2021; 31:557-565. [PMID: 32779627 PMCID: PMC8502832 DOI: 10.2188/jea.je20200073] [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] [Indexed: 11/22/2022] Open
Abstract
Background There is a lack of evidence of the complicated pathways of underlying determinants in the phases of physical activity. The purpose of this study was to evaluate simultaneously a set of potential determinants on the initiation and maintenance phases of leisure-time physical activity (LTPA). Methods The longitudinal data of 54,359 Korean adults aged 40–69 years from the Health Examinees study were used. The median follow-up duration was 4.2 years. The self-reported durations per week of LTPA was repeatedly assessed. Based on previous longitudinal studies, the potential determinants were selected, and hypothetical models were constructed that consider the complex associations between the determinants. The standardized coefficients for direct and indirect effects were estimated using path analysis to differentiate contributions of mediation from the total effects. Results In the total population, age, education, chronic diseases, smoking, depression symptoms, and self-rated health were significantly associated with both initiation and maintenance phases. Income (B = 0.025) and social supports (B = 0.019) were associated only with the initiation phase. Waist-to-hip ratio (B = −0.042) and stress (B = −0.035) were associated only with the maintenance phase. After stratifying by sex, the significant effects of education, chronic diseases, and smoking were found only in men. The initiation phase-specific effects of income and social supports and the maintenance phase-specific effects of stress were found only in women. It was estimated that indirect effects contributed approximately 15% of the total effect. Conclusion The findings suggested that there were initiation- or maintenance-specific determinants of leisure-time physical activity according to sex.
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Affiliation(s)
- Jaesung Choi
- Institute of Health Policy and Management, Seoul National University Medical Research Center.,BK21plus Biomedical Science Project, Seoul National University College of Medicine
| | - JooYong Park
- BK21plus Biomedical Science Project, Seoul National University College of Medicine.,Department of Biomedical Sciences, Seoul National University Graduate School
| | - Ji-Eun Kim
- BK21plus Biomedical Science Project, Seoul National University College of Medicine.,Department of Biomedical Sciences, Seoul National University Graduate School
| | - Jong-Koo Lee
- JW Lee Center for Global Medicine, Seoul National University College of Medicine.,Department of Family Medicine, Seoul National University College of Medicine
| | - Daehee Kang
- Department of Biomedical Sciences, Seoul National University Graduate School.,Department of Preventive Medicine, Seoul National University College of Medicine.,Cancer Research Institute, Seoul National University.,Institute of Environmental Medicine, Seoul National University Medical Research Center
| | - Miyoung Lee
- College of Physical Education and Sport Science, Kookmin University
| | | | - Ji-Yeob Choi
- Institute of Health Policy and Management, Seoul National University Medical Research Center.,BK21plus Biomedical Science Project, Seoul National University College of Medicine.,Department of Biomedical Sciences, Seoul National University Graduate School.,Department of Preventive Medicine, Seoul National University College of Medicine.,Cancer Research Institute, Seoul National University
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Pinto Pereira SM, De Stavola BL, Rogers NT, Hardy R, Cooper R, Power C. Adult obesity and mid-life physical functioning in two British birth cohorts: investigating the mediating role of physical inactivity. Int J Epidemiol 2021; 49:845-856. [PMID: 32142119 PMCID: PMC7394955 DOI: 10.1093/ije/dyaa014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 01/17/2020] [Indexed: 12/31/2022] Open
Abstract
Background Associations between obesity and physical inactivity are bi-directional. Both are associated with physical functioning (PF, ability to perform physical tasks of daily living) but whether obesity influences PF via inactivity is unknown. We investigated whether mid-adult obesity trajectories were associated with subsequent PF and mediated by inactivity. Methods Body mass index (BMI; kg/m²) and inactivity were recorded at: 36, 43, 53 and 60–64 years in the 1946 Medical Research Council (MRC) National Survey of Health and Development (1946-NSHD; n = 2427), and at 33, 42 and 50 years in the 1958 National Child Development Study (1958-NCDS; n = 8674). Poor PF was defined as the lowest (gender and cohort-specific) 10% on the Short-form 36 Physical Component Summary subscale at 60–64 years (1946-NSHD) and 50 years (1958-NCDS). Estimated randomized-interventional-analogue natural direct (rNDE) and indirect (rNIE) effects of obesity trajectories on PF via inactivity are expressed as risk ratios [overall total effect (rTE) is rNDE multiplied by rNIE]. Results In both cohorts, most individuals (∼68%) were never obese in adulthood, 16–30% became obese and ≤11% were always obese. In 1946-NSHD, rTE of incident obesity at 43 years (vs never) on poor PF was 2.32 (1.13, 3.51); at 53 years it was 1.53 (0.91, 2.15). rNIEs via inactivity were 1.02 (0.97, 1.07) and 1.02 (0.99, 1.04), respectively. Estimated rTE of persistent obesity from 36 years was 2.91 (1.14, 4.69), with rNIE of 1.03 (0.96, 1.10). In 1958-NCDS, patterns of association were similar, albeit weaker. Conclusions Longer duration of obesity was associated with increased risk of poor PF. Inactivity played a small mediating role. Findings reinforce the importance of preventing and delaying obesity onset to protect against poor PF.
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Affiliation(s)
- Snehal M Pinto Pereira
- UCL Research Department of Epidemiology & Public Health, London WC1E 7HB, UK.,MRC Unit for Lifelong Health and Ageing at UCL, London WC1E 7HB, UK
| | - Bianca L De Stavola
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
| | - Nina T Rogers
- UCL Research Department of Epidemiology & Public Health, London WC1E 7HB, UK.,MRC Unit for Lifelong Health and Ageing at UCL, London WC1E 7HB, UK
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing at UCL, London WC1E 7HB, UK.,CLOSER, Department of Social Science, UCL Institute of Education, London WC1H 0AL, UK
| | - Rachel Cooper
- Musculoskeletal Science and Sports Medicine Research Centre, Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester M15 6BH, UK
| | - Chris Power
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK
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Cohabiting and becoming a parent: associations with changes in physical activity in the 1970 British cohort study. BMC Public Health 2020; 20:1085. [PMID: 32650747 PMCID: PMC7353783 DOI: 10.1186/s12889-020-09187-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 07/01/2020] [Indexed: 11/10/2022] Open
Abstract
Background We examined the association between family–related life events (cohabitation/marriage and becoming a parent) and change in physical activity. Methods Longitudinal data (n = 8045) from the 1970 British Cohort Study (30 and 34 years) were included. Life events (beginning cohabitation/marriage and becoming a parent) were reported and coded: 0 no, 1 yes, for each event occurring between 30 and 34 years. Participants reported frequency of participation in leisure-time physical activity at 30 and 34 years (Likert scale: mean change calculated ranging between − 4 and 4). Linear regression models were used to examine the association between life events and physical activity change (comparing individuals experiencing events between 30 and 34 years versus never experiencing the event - excluding participants that experienced previous events – with a final analysis sample of n = 3833 in parenthood analysis; n = 1137 in cohabitation analysis). Interaction terms were used to analyse combined parenthood and cohabitation status. Analyses were adjusted for level of education achieved, ethnicity, country of origin and other life events. ANCOVA was used to examine associations between change in physical activity and child age. Results Compared to remaining without children, becoming a parent was associated with a greater reduction in physical activity among men [β:-0.234(95%CI:-0.396 to − 0.072)] but not women [0.126(− 0.048;0.301)]. No associations were found between cohabitation and physical activity. Men who became fathers both while cohabitating [− 0.201(− 0.383;-0.020)] and without cohabiting [− 0.937(− 1.623;-0.250)] experienced greater physical activity declines than those remaining single and without children; the decline was greatest among non-cohabiting fathers. These associations did not differ by child age. Conclusions Parenthood appears to differentially impact physical activity for men and women; this association also differs by cohabitation status. Parenthood appears to be most detrimental to physical activity levels among men. Interventions for physical activity could target new or soon-to-be parents, especially fathers. Further analyses with device-measured physical activity data would be valuable to advance understanding of these associations.
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Pinto Pereira SM, Power C. Change in health and social factors in mid-adulthood and corresponding changes in leisure-time physical inactivity in a prospective cohort. Int J Behav Nutr Phys Act 2018; 15:89. [PMID: 30219081 PMCID: PMC6139142 DOI: 10.1186/s12966-018-0723-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 09/05/2018] [Indexed: 12/12/2022] Open
Abstract
Background To identify whether changes in adult health and social factors are associated with simultaneous changes in inactivity. Methods Health, social factors and leisure-time inactivity (activity frequency < 1/week) were self-reported at 33y and 50y in the 1958 British birth cohort (N = 12,271). Baseline (33y) health and social factors and also patterns of change in factors 33y-to-50y were related to inactivity 33y-to-50y (never inactive, persistently inactive, deteriorating to inactivity, or improving from inactivity) using multinomial logistic regression. Results Approximately 31% were inactive at 33y and 50y; 35% changed status 33y-to-50y (17% deteriorating to inactivity, 18% improving from inactivity). Baseline poor health and obesity were associated with subsequent (33y-to-50y) inactivity; e.g. for poor health, relative risk ratios (RRRs) for deteriorating to inactivity (vs never inactive) and improving from inactivity (vs persistently inactive) were 1.38(1.16,1.64) and 0.77(0.63,0.94) respectively. Adverse changes in health and weight were associated with simultaneous adverse changes in inactivity; e.g. worsening health (vs always good/excellent health) was associated with higher risk of deteriorating to inactivity (RRR:2.20(1.85,2.62)) and lower risk of improving from inactivity (RRR:0.61(0.49,0.77)). However, improving health and weight loss were not associated with improving from inactivity. Worsening self-efficacy 33y-to-50y was associated with lower risk of improving from inactivity; there was no association between improving self-efficacy and inactivity change. Downward social mobility was not associated with deteriorating to or improving from inactivity. Changes in depression symptom level, marriage/co-habitation or parenthood 33y-to-50y were not associated with inactivity changes. No associations were observed for employment. Conclusions Associated changes in mid-life health factors with deleterious inactivity changes, highlight the importance of maintaining health, weight and self-efficacy across adulthood to deter inactivity. Electronic supplementary material The online version of this article (10.1186/s12966-018-0723-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Chris Power
- Population, Policy and Practice, UCL Great Ormond Street Hospital Institute of Child Health, University College London, London, WC1N 1EH, UK
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Pinto Pereira SM, Li L, Power C. Lifetime risk factors for leisure-time physical inactivity in mid-adulthood. Prev Med Rep 2018; 11:23-30. [PMID: 30065911 PMCID: PMC6066603 DOI: 10.1016/j.pmedr.2018.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 05/05/2018] [Indexed: 12/13/2022] Open
Abstract
We aimed to identify factors from different life-stages that were associated with inactivity at two adult ages and stability and change between these ages. Leisure-time inactivity (activity frequency <1/wk) was assessed at 33y and 50y in the 1958 British Birth cohort (N = 12,271). We created scores representing several domains, i.e. physical health, mental function, social, family and neighbourhood circumstances at different life-stages, and examined associations with adult inactivity. 31% were inactive at 33y and 50y with 17% deteriorating to, and 18% improving from, inactivity. Adjusting for all domains and life-stages, most concurrent factors were associated with inactivity: e.g. per 1-unit worsening physical status (score range:0-2) ORadjusted for 50y inactivity was 1.56(1.44,1.70). Physical status at 33y was associated with inactivity patterns 33y-to-50y (Relative risk ratios (RRRs) of inactivity persistence and deterioration (vs never inactive) per 1-unit worsening status (score:0-1) were 1.73(1.51,1.99) and 1.28(1.10,1.49) respectively; RRR for improvement (vs persistently inactive) was 0.75(0.63,0.88). Some early-life domain scores were associated with inactivity independent of concurrent factors: e.g. per 1-unit worsening early-life social score (range:0-3) ORadjusted for 50y inactivity was 1.12(1.05,1.19). Highly urbanised neighbourhood in early adulthood was associated with inactivity (e.g. RRRs for persistent inactivity and deterioration were 1.42(1.22,1.65) and 1.15(1.01,1.31) respectively; 0.82(0.68,0.98) for improvement). Concurrent physical and mental function were associated with adult inactivity at two ages; poorer physical status was associated with greater risk of inactivity persistence and deterioration and lower risk of improvement 33y-to-50y. Young adult neighbourhood and early-life social and family circumstances were independently associated with mid-life inactivity.
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Affiliation(s)
| | | | - Chris Power
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
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