Neighborhood environment, physical activity, and quality of life in adults: Intermediary effects of personal and psychosocial factors

Global trends in burden of type 2 diabetes attributable to physical inactivity across 204 countries and territories, 1990-2019

Background

To promote a comprehensive understanding of global trends and burden of type 2 diabetes attributable to physical inactivity.

Methods

We utilized data regarding mortality, disability-adjusted life years (DALYs), as well as age-standardized mortality rates (ASMR) and DALYs rates (ASDR) derived from the global burden of disease study 2019 to evaluate the impact of physical inactivity on the prevalence of type 2 diabetes in 204 countries and territories over the period from 1990 to 2019. This method facilitated the analysis of the diabetes burden across different ages, genders, and regions. To determine the long-term progression of type 2 diabetes prevalence, we computed the estimated annual percentage change (EAPC) in burden rates.

Results

Globally, the number of deaths and DALYs from type 2 diabetes due to physical inactivity more than doubled between 1990 and 2019. Concurrently, there was an increase in the ASMR and ASDR, with EAPC of 0.26 (95% CI: 0.13-0.39) and 0.84 (95% CI: 0.78-0.89), respectively. As of 2019, the global ASMR and ASDR for physical inactivity stood at 1.6 (95% UI: 0.8-2.7) per 100 000 and 55.9 (95% UI: 27.2-97.6) per 100 000, respectively. Notable disparities were observed in the type 2 diabetes burden associated with physical inactivity worldwide, with higher sociodemographic index (SDI) countries experiencing lower ASDR and ASMR compared to lower SDI countries. Initially, females exhibited higher ASMR and ASDR than males, but this gender disparity in ASMR and ASDR has lessened in recent years. The mortality and DALYs rates associated with physical inactivity exhibit an inverted V-shaped pattern across various age groups, predominantly affecting the elderly population.

Conclusion

Between 1990 and 2019, there was a marked rise in the worldwide burden of type 2 diabetes associated with physical inactivity, underscoring the role of physical inactivity as a key changeable risk factor in the global landscape of this disease. This necessitates additional research to explore the variables contributing to the varying levels of disease burden across different countries and between sexes. Furthermore, it calls for the formulation of public health policies aimed at guiding prevention tactics, promoting early detection, and enhancing the management of type 2 diabetes.

Gender Differences in Factors Associated With Physical Activity in Patients With Coronary Artery Disease

BACKGROUND

Although patients with coronary artery disease can benefit from adequate physical activity, low physical activity levels have been reported among these patients. Gender-based disparities might contribute to variations in physical activity. However, knowledge regarding gender differences in factors associated with physical activity among patients with coronary artery disease is limited.

OBJECTIVE

This study aimed to examine gender differences in factors associated with physical activity in Taiwanese patients with coronary artery disease.

METHODS

A cross-sectional design was used. A convenience sample of 215 patients with coronary artery disease was recruited from 1 medical center in northern Taiwan. Participants were interviewed using structured questionnaires to obtain information regarding their demographics, physical conditions, physical activity, self-efficacy, social support, and community exercise environment.

RESULTS

Only 17.8% of male patients and 20% of female patients reported performing the recommended physical activity level. Men performed more vigorous and work-related activities, whereas women engaged in more household activities. In both genders, physical activity was significantly associated with age, disease symptoms, social support, self-efficacy, and environmental appraisal. Self-efficacy and age were significantly associated with physical activity in the linear regression analysis. Among male patients, physical activity was also related to work status, angina, comorbidity, medication, and hospitalizations, whereas disease duration was associated with physical activity among female patients.

CONCLUSION

Patients of both genders reported low levels of physical activity. Nurses should recognize gender differences in factors associated with physical activity in patients with coronary artery disease and develop individualized physical activity programs to improve patients' physical activity.

Association of Regular Leisure-Time Physical Activity with Happiness among Middle-Aged and Older Adults in Taiwan

The aim of the present study was to clarify the relationship between regular LTPA (i.e., 150-300 min of moderate-intensity or 75-150 min of high-intensity physical activity) and happiness among middle-aged and older adults in Taiwan. The cross-sectional study data were obtained from the Taiwan National Physical Activity Survey, a nationally representative survey of the Taiwanese population. A total of 12,687 middle-aged and older adults (45-108 years) were ultimately enrolled in this study. The questionnaire data obtained through this national telephone survey included sociodemographic characteristics, self-reported health status, self-evaluations (comprising height, body weight, and happiness), and zip code of residence. The results suggest a significant positive relationship between regular LTPA and happiness scores; that is, the middle-aged adults who engaged in more LTPA may report higher happiness occurrence than others. This study suggests that regular LTPA is an essential factor influencing happiness. LTPA is an essential form of physical activity that helps middle-aged and older people to relax.

Quality of life in Brazilian martial arts and combat sports practitioners

Study aim: Martial arts and combat sports have been an alternative for individuals seeking the health benefits of physical activity and exercise, but little is known about its practitioners’ quality of life. Therefore, this study aimed to investigate the quality of life of practitioners of five of the most common modalities in Brazil.

Material and methods: A total of 922 young men, competitive and recreational practitioners of Brazilian jiu-jitsu, judo, karate, kung-fu, and taekwondo, answered the Brazilian version of the WHOQOL-BREF questionnaire.

Results: The results for each domain – physical, psychological, social, and environmental – are, respectively, as follow (mean ± standard deviation): Brazilian jiu-jitsu: 74 ± 11, 75 ± 12, 77 ± 17, 67 ± 14; judo: 74 ± 13, 75 ± 12, 77 ± 15, 64 ± 12; karate: 76 ± 13, 75 ± 12, 78 ± 15, 64 ± 13; kung-fu: 77 ± 13, 75 ± 13, 74 ± 17, 65 ± 13; taekwondo: 76 ± 12, 76 ± 11, 78 ± 16, 64 ± 13; total: 75 ± 13, 75 ± 12, 77 ± 16, 65 ± 13. There was no difference between modalities and no interaction between modalities and experience level. All groups and the total sample presented higher values than the normative national data in the physical and psychological domains. This was also the case for the judo, karate, and taekwondo groups, as well as the total sample in the social domain, and for the Brazilian jiu-jitsu and the whole sample in the environmental domain. Additionally, in the whole sample competitors scored higher than recreational practitioners in the psychological domain.

Conclusion: These findings reveal that the practice of these modalities is associated with higher quality of life than the normative values. Longitudinal studies are warranted for a better understanding of this association.

Perceived built environment, health-related quality of life and health care utilization

Previous research has shown that the built environment plays a crucial role for health-related quality of life (HRQoL) and health care utilization. But, there is limited evidence on the independence of this association from lifestyle and social environment. The objective of this cross-sectional study was to investigate these associations, independent of the social environment, physical activity and body mass index (BMI). We used data from the third follow-up of the Swiss study on Air Pollution and Lung and Heart diseases In Adults (SAPALDIA), a population based cohort with associated biobank. Covariate adjusted multiple quantile and polytomous logistic regressions were performed to test associations of variables describing the perceived built environment with HRQoL and health care utilization. Higher HRQoL and less health care utilization were associated with less reported transportation noise annoyance. Higher HRQoL was also associated with greater satisfaction with the living environment and more perceived access to greenspaces. These results were independent of the social environment (living alone and social engagement) and lifestyle (physical activity level and BMI). This study provides further evidence that the built environment should be designed to integrate living and green spaces but separate living and traffic spaces in order to improve health and wellbeing and potentially save health care costs.

Egocentric social network correlates of physical activity

BACKGROUND

The social environment might play an important role in explaining people's physical activity (PA) behavior. However, little is known regarding whether personal networks differ between physically active and physically inactive people. This study aimed to examine the relationship between personal network characteristics and adults' physical (in)activity.

METHODS

An egocentric social network study was conducted in a random sample in Switzerland (n = 529, mean age of 53 years, 54% females). Individual and personal network measures were compared between regular exercisers and non-exercisers. The extent of these factors' association with PA levels was also examined.

RESULTS

Non-exercisers (n = 183) had 70% non-exercising individuals in their personal networks, indicating homogeneity, whereas regular exercisers (n = 346) had 57% regularly exercising individuals in their networks, meaning more heterogeneous personal networks. Additionally, having more regular exercisers in personal networks was associated with higher PA levels, over and above individual factors. Respondents with an entirely active personal network reported, on average, 1 day of PA more per week than respondents who had a completely inactive personal network. Other personal network characteristics, such as network size or gender composition, were not associated with PA.

CONCLUSION

Non-exercisers seem to be clustered in inactive networks that provide fewer opportunities and resources, as well as less social support, for PA. To effectively promote PA, both individuals and personal networks need to be addressed, particularly the networks of inactive people (e.g., by promoting group activities).

Associations between Self-Determined Motivation, Accelerometer-Determined Physical Activity, and Quality of Life in Chinese College Students

Purpose: To better promote college students’ physical activity (PA) and quality of life (QoL), it is imperative to understand this population’s PA correlates, such as self-determined motivation and perceived competence. However, few studies existed in this area of inquiry among Chinese college students. Thus, the purpose of this study was to examine the relationships among Chinese college students’ self-determined motivation, PA, and QoL. Method: A total of 220 college students (115 females; M_age = 20.29 years, SD = 2.37; M_BMI = 20.67) were recruited from one university in south-central China. Participants were instructed to wear the ActiGraph GT9X Link (ActiGraph, Pensacola, FL, USA) accelerometers for 7 days. A minute-by-minute stepping rate methodology was used to determine participants sedentary behaviors, light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA). Participants’ self-determined motivation (autonomous, controlled, and amotivation), perceived competence, and QoL (physical function, stress, depression, fatigue, sleep, and social issues) were assessed by a battery of validated surveys in June 2017. Results: Participants reported moderate–high levels of PA correlates and QoL as the means ranged from 5.5 to 6 (out of 7) for PA correlates and 2.75 to 4 (out of 4) for QoL. The minute-by-minute stepping rate revealed participants had average 580.51 min/day in sedentary, 134.77 min/day in LPA, and 1.57 min/day in MVPA. Regression analyses for physical function, stress, depression, and social issues suggested that the models explained 4%–8% of the variances. Specifically, perceived competence was the negative predictor of the problems with physical function (β = −0.17, p < 0.05) and depression (β = −0.18, p < 0.01), amotivation was positively associated with depression and stress (p < 0.05). Additionally, controlled motivation predicted the ability to participate in social roles and activities (β = 0.22, p < 0.05). No significant predictors emerged for fatigue or for sleep. Conclusions: Findings suggest Chinese college students’ perceived competence and social support are critical for improving PA and QoL. In addition, strategies are needed to motivate Chinese college students to engage in PA participation and improve overall well-being.

The association between leisure time physical activity and happiness: Testing the indirect role of health perception

AIMS

Research supports the influence of leisure time physical activity (LTPA) on well-being; however, little is known about the mechanisms that drive the relationship. The aim of this study was to investigate the indirect influence of health perception on the association between neighborhood LTPA and happiness.

METHODS

Telephone interviews were conducted using random digit dialing among a sample of adult residents aged 18+ (n = 570) to gather information about neighborhood LTPA behaviors, perceptions of health and happiness, and sociodemographics.

RESULTS

Results of a structural equation modeling analysis indicated that health had a small significant indirect influence on the relationship between LTPA and happiness.

CONCLUSION

Focusing on perceptions offers a holistic conceptualization of how behavior impacts happiness and may offer important insights into how the experience of engaging in LTPA contributes to the subjective evaluation of personal happiness through perceived health.

Effectiveness of Combined Smartwatch and Social Media Intervention on Breast Cancer Survivor Health Outcomes: A 10-Week Pilot Randomized Trial

Physical activity (PA) among breast cancer survivors (BCS) can improve this population's health and quality of life (QoL). This study evaluated the effectiveness of a combined smartwatch- and social media-based health education intervention on BCS's health outcomes. Thirty BCS ( X ¯ age = 52.6 ± 9.3 years; X ¯ Wt = 80.2 ± 19.6 kg) participated in this 10-week, 2-arm randomized trial, with BCS randomized into: (1) experimental group (n = 16): received Polar M400 smartwatches for daily PA tracking and joined a Facebook group wherein Social Cognitive Theory-related PA tips were provided twice weekly; and (2) comparison group (n = 14): only joined separate, but content-identical Facebook group. Outcomes included PA, physiological, psychosocial, and QoL variables. Specifically, PA and energy expenditure (EE) was assessed by ActiGraph GT3X+ accelerometers while physiological, psychosocial, and QoL were examined via validated instruments at baseline and post-intervention. No baseline group differences were observed for any variable. Ten BCS dropped out of the study (experimental: 4; comparison: 6). Compared to completers, dropouts differed significantly on several outcomes. Thus, a per-protocol analysis was performed, revealing significant group differences for changes in social support (t = -2.1, p = 0.05) and barriers (t = -2.2, p = 0.04). Interestingly, the comparison group demonstrated improvements for both variables while the intervention group demonstrated slightly decreased social support and no change in barriers. Notably, both groups demonstrated similarly increased daily light PA, moderate-to-vigorous PA, EE, and steps of 7.7 min, 5.1 min, 25.1 kcals, and 339 steps, respectively, over time. Despite extensive user training, several experimental BCS found the Polar M400 use difficult-possibly decreasing intervention adherence. Future interventions should utilize simpler smartwatches to promote PA among middle-aged clinical/non-clinical populations.

Neighbourhood socioeconomic deprivation and health-related quality of life: A multilevel analysis

Objective

To assess the relationship between socioeconomic deprivation and health-related quality of life in urban neighbourhoods, using a multilevel approach.

Methods

Of the population-based cohort EPIPorto, 1154 georeferenced participants completed the 36-Item Short-Form Health Survey. Neighbourhood socioeconomic deprivation classes were estimated using latent-class analysis. Multilevel models measured clustering and contextual effects of neighbourhood deprivation on physical and mental HRQoL.

Results

Residents from the least deprived neighbourhoods had higher physical HRQoL. Neighbourhood socioeconomic deprivation together with individual-level variables (age, gender and education) and health-related factors (smoking, alcohol consumption, sedentariness and chronic diseases) explained 98% of the total between-neighbourhood variance. Neighbourhood socioeconomic deprivation was significantly associated with physical health when comparing least and most deprived neighbourhoods (class 2—beta coefficient: -0.60; 95% confidence interval:-1.76;-0.56; class 3 –beta coefficient: -2.28; 95% confidence interval:-3.96;-0.60), and as neighbourhood deprivation increases, a decrease in all values of physical health dimensions (physical functioning, role physical, bodily pain and general health) was also observed. Regarding the mental health dimension, no neighbourhood clustering or contextual effects were found. However, as neighbourhood deprivation increases, the values of vitality and role emotional dimensions significantly decreased.

Conclusion

Neighbourhood socioeconomic deprivation is associated with HRQoL, affecting particularly physical health. This study suggests that to improve HRQoL, people and places should be targeted simultaneously.