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Zhang Y, Folarin AA, Sun S, Cummins N, Ranjan Y, Rashid Z, Stewart C, Conde P, Sankesara H, Laiou P, Matcham F, White KM, Oetzmann C, Lamers F, Siddi S, Simblett S, Vairavan S, Myin-Germeys I, Mohr DC, Wykes T, Haro JM, Annas P, Penninx BW, Narayan VA, Hotopf M, Dobson RJ. Longitudinal Assessment of Seasonal Impacts and Depression Associations on Circadian Rhythm Using Multimodal Wearable Sensing: Retrospective Analysis. J Med Internet Res 2024; 26:e55302. [PMID: 38941600 DOI: 10.2196/55302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/22/2024] [Accepted: 03/29/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Previous mobile health (mHealth) studies have revealed significant links between depression and circadian rhythm features measured via wearables. However, the comprehensive impact of seasonal variations was not fully considered in these studies, potentially biasing interpretations in real-world settings. OBJECTIVE This study aims to explore the associations between depression severity and wearable-measured circadian rhythms while accounting for seasonal impacts. METHODS Data were sourced from a large longitudinal mHealth study, wherein participants' depression severity was assessed biweekly using the 8-item Patient Health Questionnaire (PHQ-8), and participants' behaviors, including sleep, step count, and heart rate (HR), were tracked via Fitbit devices for up to 2 years. We extracted 12 circadian rhythm features from the 14-day Fitbit data preceding each PHQ-8 assessment, including cosinor variables, such as HR peak timing (HR acrophase), and nonparametric features, such as the onset of the most active continuous 10-hour period (M10 onset). To investigate the association between depression severity and circadian rhythms while also assessing the seasonal impacts, we used three nested linear mixed-effects models for each circadian rhythm feature: (1) incorporating the PHQ-8 score as an independent variable, (2) adding seasonality, and (3) adding an interaction term between season and the PHQ-8 score. RESULTS Analyzing 10,018 PHQ-8 records alongside Fitbit data from 543 participants (n=414, 76.2% female; median age 48, IQR 32-58 years), we found that after adjusting for seasonal effects, higher PHQ-8 scores were associated with reduced daily steps (β=-93.61, P<.001), increased sleep variability (β=0.96, P<.001), and delayed circadian rhythms (ie, sleep onset: β=0.55, P=.001; sleep offset: β=1.12, P<.001; M10 onset: β=0.73, P=.003; HR acrophase: β=0.71, P=.001). Notably, the negative association with daily steps was more pronounced in spring (β of PHQ-8 × spring = -31.51, P=.002) and summer (β of PHQ-8 × summer = -42.61, P<.001) compared with winter. Additionally, the significant correlation with delayed M10 onset was observed solely in summer (β of PHQ-8 × summer = 1.06, P=.008). Moreover, compared with winter, participants experienced a shorter sleep duration by 16.6 minutes, an increase in daily steps by 394.5, a delay in M10 onset by 20.5 minutes, and a delay in HR peak time by 67.9 minutes during summer. CONCLUSIONS Our findings highlight significant seasonal influences on human circadian rhythms and their associations with depression, underscoring the importance of considering seasonal variations in mHealth research for real-world applications. This study also indicates the potential of wearable-measured circadian rhythms as digital biomarkers for depression.
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Affiliation(s)
- Yuezhou Zhang
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Amos A Folarin
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Institute of Health Informatics, University College London, London, United Kingdom
- NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, United Kingdom
- NIHR Biomedical Research Centre at University College London Hospitals, NHS Foundation Trust, London, United Kingdom
- Health Data Research UK London, University College London, London, United Kingdom
| | - Shaoxiong Sun
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Computer Science, University of Sheffield, Sheffield, United Kingdom
| | - Nicholas Cummins
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Yatharth Ranjan
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Zulqarnain Rashid
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Callum Stewart
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Pauline Conde
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Heet Sankesara
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Petroula Laiou
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Faith Matcham
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- School of Psychology, University of Sussex, Falmer, United Kingdom
| | - Katie M White
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Carolin Oetzmann
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Femke Lamers
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands
- Mental Health Program, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Sara Siddi
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Teaching Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Barcelona, Spain
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Sara Simblett
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | | | - Inez Myin-Germeys
- Department of Neurosciences, Center for Contextual Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium
| | - David C Mohr
- Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
| | - Til Wykes
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Josep Maria Haro
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
- Teaching Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Barcelona, Spain
- Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | | | - Brenda Wjh Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands
- Mental Health Program, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Vaibhav A Narayan
- Janssen Research and Development LLC, Titusville, NJ, United States
- Davos Alzheimer's Collaborative, Geneva, Switzerland
| | - Matthew Hotopf
- NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Richard Jb Dobson
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Institute of Health Informatics, University College London, London, United Kingdom
- NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, United Kingdom
- NIHR Biomedical Research Centre at University College London Hospitals, NHS Foundation Trust, London, United Kingdom
- Health Data Research UK London, University College London, London, United Kingdom
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Chevance G, Minor K, Vielma C, Campi E, O'Callaghan-Gordo C, Basagaña X, Ballester J, Bernard P. A systematic review of ambient heat and sleep in a warming climate. Sleep Med Rev 2024; 75:101915. [PMID: 38598988 DOI: 10.1016/j.smrv.2024.101915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/31/2024] [Accepted: 02/20/2024] [Indexed: 04/12/2024]
Abstract
Climate change is elevating nighttime and daytime temperatures worldwide, affecting a broad continuum of behavioral and health outcomes. Disturbed sleep is a plausible pathway linking rising ambient temperatures with several observed adverse human responses shown to increase during hot weather. This systematic review aims to provide a comprehensive overview of the literature investigating the relationship between ambient temperature and valid sleep outcomes measured in real-world settings, globally. We show that higher outdoor or indoor temperatures are generally associated with degraded sleep quality and quantity worldwide. The negative effect of heat persists across sleep measures, and is stronger during the hottest months and days, in vulnerable populations, and the warmest regions. Although we identify opportunities to strengthen the state of the science, limited evidence of fast sleep adaptation to heat suggests rising temperatures induced by climate change and urbanization pose a planetary threat to human sleep, and therefore health, performance, and wellbeing.
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Affiliation(s)
| | - Kelton Minor
- Data Science Institute, Columbia University, New York, United States.
| | | | | | - Cristina O'Callaghan-Gordo
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain; Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, Québec, Canada; Research Center, University Institute of Mental Health at Montreal, Montréal, Québec, Canada
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Wullems JA, Degens H, Verschueren SMP, Morse CI, Grant DM, Onambélé-Pearson GL. Sedentary behaviour (especially accumulation pattern) has an independent negative impact on skeletal muscle size and architecture in community-dwelling older adults. PLoS One 2024; 19:e0294555. [PMID: 38394127 PMCID: PMC10889859 DOI: 10.1371/journal.pone.0294555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 11/03/2023] [Indexed: 02/25/2024] Open
Abstract
Prolonged sedentary behaviour (SB) i.e. longer bouts, is suggested to have a range of negative health effects, independent of habitual light and medium-to-vigorous physical activity (LIPA or MVPA). Any effect on musculoskeletal size, architecture or morphology has seldom been reported in older adults. Moreover, no study has yet determined if any association would persist following adjustment for covariates. Therefore, the aim of the present study was to investigate the associations between SB, and properties of the Gastrocnemius Medialis (GM) muscle, in a cross-sectional sample of older adults using compositional data analysis. 105 healthy older adults (73±6y) wore a thigh mounted tri-axial accelerometer for seven consecutive days, and underwent ultrasound [e.g. muscle length (Lm), anatomical cross-sectional area (ACSA), muscle volume (VM), fascicle length (LF), & physiological cross-sectional area (PCSA)], body composition (e.g. DEXA) and health (e.g. medical history) assessments. In-unadjusted models, SB time was negatively associated with ACSA at 75% of Lm (R2adj = 0.085), VM (R2adj = 0.020), and PCSA (R2adj = 0.039). Standing was positively associated with pennation angle (R2adj = 0.110), which persisted following co-variate adjustment (R2adj = 0.296). In fully adjusted models, both SB & LIPA time were associated with ACSA at 75% of Lm (Both R2adj = 0.393). Standing and light activity time were also associated with LF, VM, & PCSA (R2adj 0.116-0.573). In fully adjusted models, SB pattern parameters (i.e. the manner in which sedentary behaviour is accumulated daily throughout waking hours such as the timing, duration and frequency of sedentary bouts), were associated with GM muscle properties (R2adj 0.156-0.564) including LM, LF, and VM. The pattern, rather than accumulated daily SB time, was associated with the size and architecture of the GM. Our results suggest that regardless of co-existing habitual physical activities, SB bouts should be kept short and frequently interrupted to offset some of the deleterious ageing-related muscle architecture characteristics changes.
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Affiliation(s)
- Jorgen A. Wullems
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Hans Degens
- Department of Life Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Lithuanian Sports University, Kaunas, Lithuania
| | - Sabine M. P. Verschueren
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Christopher I. Morse
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
| | - Dale M. Grant
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
| | - Gladys L. Onambélé-Pearson
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
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Yerrakalva D, Hajna S, Khaw KT, Griffin SJ, Brage S. Prospective associations between changes in physical activity and sedentary time and subsequent lean muscle mass in older English adults: the EPIC-Norfolk cohort study. Int J Behav Nutr Phys Act 2024; 21:10. [PMID: 38279174 PMCID: PMC10811887 DOI: 10.1186/s12966-023-01547-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 12/05/2023] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND The longitudinal associations between physical behaviours and lean muscle mass indices need to be better understood to aid healthy ageing intervention development. METHODS We assessed physical behaviours (total physical activity, moderate-to-vigorous physical activity (MVPA), light physical activity, total sedentary time and prolonged sedentary bout time) for 7 days using hip-worn accelerometers. We also assessed domain-specific physical behaviours (walking, cycling, gardening and housework time) with self-report questionnaires at baseline (2006-2011) and follow-up (2012-2016) in the European Prospective Investigation into Cancer (EPIC)-Norfolk study. We assessed body composition using dual-energy X-ray absorptiometry (DEXA) at follow-up in 1535 participants (≥ 60 years at baseline). From this, we derived appendicular lean muscle mass (ALM) indices (% relative ALM = (ALM/total body weight)*100), body mass index (BMI)-scaled ALM (ALM/BMI, kg/kg/m2) and height-scaled ALM (ALM/height2, kg/m2)). We evaluated the prospective associations of both baseline and change in physical behaviours with follow-up muscle mass indices using multivariable linear regression. RESULTS Over 5.5 years (SD 14.8) follow-up, higher baseline accelerometer-measured physical activity and lower sedentary time were associated with higher subsequent relative ALM and BMI-scaled ALM, but not height-scaled ALM (e.g. 0.02% higher subsequent relative ALM per minute/day of baseline MVPA for men). Greater increases in physical activity and greater declines in sedentary time variables were associated with higher subsequent relative ALM and BMI-scaled ALM, but not height-scaled ALM (e.g. 0.001 kg/kg/m2 subsequent BMI-scaled ALM and 0.04% subsequent relative ALM per min/day/year increases in LPA over follow-up; 0.001 kg/kg/m2 subsequent BMI-scaled ALM and -0.03% subsequent relative ALM per min/day/year less of total sedentary time over follow-up). Greater increases in women's cycling and gardening over follow-up were associated with greater subsequent relative ALM (cycling 0.9% per hour/week/year; gardening 0.2% per hour/week/year) and BMI-scaled ALM (cycling 0.03 kg/kg/m2 per hour/week/year; gardening 0.004 kg/kg/m2 per hour/week/year). CONCLUSION Physical behaviours across all intensities, and in women more specifically cycling and gardening, may help prevent age-related declines in muscle mass.
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Affiliation(s)
- Dharani Yerrakalva
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Samantha Hajna
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St Catharines, ON, Canada
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Simon J Griffin
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
- 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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Santos JS, Skene DJ, Crispim CA, Moreno CRDC. Seasonal and Regional Differences in Eating Times in a Representative Sample of the Brazilian Population. Nutrients 2023; 15:4019. [PMID: 37764802 PMCID: PMC10535183 DOI: 10.3390/nu15184019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/13/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Human food intake and its timing are a complex behavior that can be influenced by a variety of factors, some of which may vary from season to season or from region to region. In this study, our aim was to investigate the seasonal variation in food intake times, with a particular focus on how these may vary across different regions of a country. We conducted an analysis of data from 20,622 adults from the National Household Budget Survey (POF-IBGE), encompassing complete food diaries collected from individuals residing in Brazil, and thereby ensuring representation across different latitudes. Each participant's daily food intake was reported for two non-consecutive days at different times in the same week using food diaries. An ANOVA revealed a later food intake time in the evening in high-latitude regions compared to low-latitude regions. The Sidak post-hoc test showed a significant interaction effect between region and season, demonstrating a pattern of early First Intake Time and Eating Midpoint in the Northeast region during spring/summer. Additionally, we observed an independent effect of the region, as early food intake times were found in low-latitude regions. These findings offer a basis for discussing food intake times among individuals living in different regions located on distinct latitudes.
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Affiliation(s)
- Jefferson Souza Santos
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil;
| | - Debra Jean Skene
- Chronobiology, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK; (D.J.S.); (C.A.C.)
| | - Cibele Aparecida Crispim
- Chronobiology, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK; (D.J.S.); (C.A.C.)
- Chrononutrition Research Group, Faculty of Medicine, Federal University of Uberlândia, Uberlândia 38405-320, Brazil
| | - Claudia Roberta de Castro Moreno
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil;
- Psychology Department, Stockholm University, 114 19 Stockholm, Sweden
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Stanaszek M, Fugiel J, Kozieł S, Sebastjan A, Suder A, Ignasiak Z. Effect of Winter Outdoor Physical Activity on Body Composition and Motor Performance of Polish Adult Men. Healthcare (Basel) 2023; 11:2348. [PMID: 37628545 PMCID: PMC10454497 DOI: 10.3390/healthcare11162348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/04/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
There is a relationship between physical activity and environmental factors, including weather conditions. Winter should not be a season in which physical activity is abandoned. Previous studies indicate that reducing the daily level of physical activity in adults has a negative impact on their motor proficiency and respiratory endurance, which subsequently translates into diminished quality of life. The aim of the study was to assess the impact of winter outdoor physical activity on somatic parameters, body composition, and motor performance of adult men (age 45.4 ± 5.9 years) involved in regular physical activity (physically active PA, n = 31) during the winter season (study group) compared to the control group of physically inactive men (PI, n = 22). Somatic parameters and selected parameters of motor fitness (Eurofit for Adults) were measured in both groups twice, at the beginning (pre) and at the end (post) of the winter season. An analysis of variance (ANOVA) with repeated measures and a post hoc LSD test were performed to evaluate the difference between the mean parameter values. In the PA group, a decrease in body fat mass, waist circumference, and abdominal obesity indicators, as well as an increase in skeletal muscle mass were confirmed. Improvements in motor performance parameters, i.e., flexibility, the speed of upper limb movements, hand and forearm muscle grip strength, the strength of the lower part of the torso, and cardiorespiratory endurance were also observed. Regular physical activity in the open air during the winter brings measurable health benefits, positively influencing the body composition and motor efficiency of adult men.
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Affiliation(s)
- Monika Stanaszek
- Department of Physiotherapy, Witelon Collegium State University, 59-220 Legnica, Poland
| | - Jarosław Fugiel
- Department of Biostructure, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Sławomir Kozieł
- Department of Anthropology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wroclaw, Poland
| | - Anna Sebastjan
- Department of Biostructure, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Agnieszka Suder
- Department of Anatomy, University of Physical Education, 31-571 Cracow, Poland
| | - Zofia Ignasiak
- Department of Biostructure, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
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Yerrakalva D, Hajna S, Suhrcke M, Wijndaele K, Westgate K, Khaw KT, Wareham N, Brage S, Griffin S. Associations between change in physical activity and sedentary time and health-related quality of life in older english adults: the EPIC-Norfolk cohort study. Health Qual Life Outcomes 2023; 21:60. [PMID: 37349799 PMCID: PMC10288723 DOI: 10.1186/s12955-023-02137-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 05/23/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND No previous studies have examined the associations between changes in objectively-measured physical behaviours with follow-up QoL in older adults. Based on cross-sectional evidence, it is biologically plausible that such associations exist. If so, this bolsters the case for the commissioning of activity interventions and for including QoL as an outcome in trials of such interventions. METHODS We assessed physical behaviours (total physical activity, moderate-to-vigorous physical activity (MVPA), light physical activity, total sedentary time and prolonged sedentary bout time) for 7 days using hip-worn accelerometers at baseline (2006-2011) and follow-up (2012-2016) and health-related quality-of-life (QoL) using EQ-5D questionnaires at follow-up in 1433 participants (≥ 60 years) of the EPIC (European Prospective Investigation into Cancer)-Norfolk study. The EQ-5D summary score was used, with 0 as the worst to 1 as best perceived quality-of-life. We evaluated the prospective associations of baseline physical behaviours with follow-up QoL, and of changes in behaviours with follow-up QoL using multi-level regression. RESULTS On average, MVPA decreased by 4.0 min/day/year (SD 8.3) for men and 4.0 min/day/year for women (SD 12.0) between baseline and follow-up. Total sedentary time increased by an average 5.5 min/day/yr (SD 16.0) for men and 6.4 min/day/yr (SD 15.0) for women between baseline and follow-up. Mean (SD) follow-up time was 5.8 (1.8) years. We found that higher baseline MVPA and lower sedentary time was associated with higher subsequent QoL (e.g. 1 h/day greater baseline MVPA was associated with 0.02 higher EQ-5D score, 95% CI 0.06, 0.36). More pronounced declines in activity were associated with worse Hr-QoL (0.005 (95% CI 0.003, 0.008) lower EQ-5D per min/day/yr decrease in MVPA). Increases in sedentary behaviours were also associated with poorer QoL (0.002 lower EQ-5D, 95% CI -0.003, -0.0007 per hour/day/yr increase in total sedentary time). CONCLUSIONS Promotion of physical activity and limiting sedentary time among older adults may improve quality-of-life, and therefore this relationship ought to be included in future cost effectiveness analyses so that greater commissioning of activity interventions can be considered.
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Affiliation(s)
- Dharani Yerrakalva
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK.
| | - Samantha Hajna
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | | | - Katrien Wijndaele
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Kate Westgate
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Nick Wareham
- 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
| | - Simon Griffin
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
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8
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Yu H, Song Y, Wang Y, Wang X, Li H, Feng X, Yu M. The Impact of Temperature on 24-Hour Movement Behaviors among Chinese Freshmen Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4970. [PMID: 36981878 PMCID: PMC10049201 DOI: 10.3390/ijerph20064970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Human populations worldwide have experienced substantial climate change issues. Gaps in scientific literature remain regarding the relationship between temperature and 24-hour movement behavior among people. The purpose of this study is to examine the impact of temperature on 24-hour movement behavior including physical activity (PA), sedentary behavior (SB) and sleep duration among university students living in Beijing, China. METHODS We conducted follow-up health surveys on 44,693 freshmen students enrolled at Tsinghua University from 2012 to 2018. PA and SB were measured by using the short version of the International Physical Activity Questionnaire (IPAQ-s); sleep duration was estimated by using The Pittsburgh Sleep Quality Index (CPSQI). Corresponding temperature data measured by the Beijing Meteorological Service were collected to include average daily temperature from the nearest weather station to Tsinghua university. The data were analyzed using linear individual fixed-effect regressions. RESULTS An increase in temperature (temperature range 2.29-28.73 °C) by 1 °C was associated with an increase in 0.66 weekly minutes of vigorous physical activity (VPA) (95% confidence interval [CI] = 0.49, 0.82), an increase in 0.56 weekly minutes of moderate physical activity (MPA)(95% CI = 0.32, 0.79), an increase in 1.21 weekly minutes of moderate to vigorous physical activity (MVPA) (95% CI = 0.90, 1.53), an increase in 0.55 weekly minutes of walking (95% CI = 0.31, 0.78), an increase in 1.76 weekly minutes of total PA (95% CI = 1.35, 2.17), and a reduction in 1.60 weekly minutes of sleeping (95% CI = -2.09, -1.11). There was no significant correlation between temperature and sedentary behavior among participants. CONCLUSIONS Temperature was significantly positively correlated with physical activity levels in the Chinese freshmen students, and significantly negatively correlated with sleep duration. Replication of this study is warranted among various populations within China. The evidence of this novel study focused on understanding the relationship between climate change and 24-hour movement behaviors among people for developing effective adaptation strategies to climate change to improve people's health behavior. This study has important implications for future study, as knowledge of the impact of temperature on movement behavior may help in the interpretation of their results and translate into improving people's health behavior.
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Affiliation(s)
- Hongjun Yu
- Department of Physical Education, Tsinghua University, Beijing 100084, China
| | - Yiling Song
- Department of Physical Education, Tsinghua University, Beijing 100084, China
| | - Yangyang Wang
- Department of Physical Education, Tsinghua University, Beijing 100084, China
| | - Xiaoxin Wang
- Department of Physical Education, Tsinghua University, Beijing 100084, China
| | - Haoxuan Li
- Department of Physical Education, Tsinghua University, Beijing 100084, China
| | - Xiaolu Feng
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou 310058, China
| | - Miao Yu
- Renmin University of China Libraries, Beijing 100872, China
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9
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Lim R, Dumuid D, Parfitt G, Stanford T, Post D, Bilton R, Kalisch Ellett LM, Pratt N, Roughead EE. Using wrist-worn accelerometers to identify the impact of medicines with anticholinergic or sedative properties on sedentary time: A 12-month prospective analysis. Maturitas 2023; 172:9-14. [PMID: 37054659 DOI: 10.1016/j.maturitas.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 03/06/2023] [Accepted: 03/19/2023] [Indexed: 04/03/2023]
Abstract
INTRODUCTION Studies have shown that use of medicines with sedative or anticholinergic properties is associated with a decline in physical function; however, the effects have not been quantified, and it is not known how and which specific physical movements are affected. This prospective study quantified the impact of a change in sedative or anticholinergic load over time on 24-hour activity composition. METHODS This study used data collected from a randomised trial assessing an ongoing pharmacist service in residential aged care. The 24-hour activity composition of sleep, sedentary behaviour, light-intensity physical activity, and moderate to vigorous physical activity was derived from 24-hour accelerometry bands. Mixed effect linear models were used to regress the multivariate outcome of 24-hour activity composition on medication load at baseline and at 12 months. A fixed effect interaction between trial stage and medication load was included to test for differing sedative or anticholinergic load effects at the two trial stages. RESULTS Data for 183 and 85 participants were available at baseline and 12 months respectively. There was a statistically significant interaction between medication load and time point on the multivariate outcome of 24-hour activity composition (sedative F = 7.2, p < 0.001 and anticholinergic F = 3.2, p = 0.02). A sedative load increase from 2 to 4 over the 12-month period was associated with an average increase in daily sedentary behaviour by an estimated 24 min. CONCLUSION As sedative or anticholinergic load increased, there was an increase in sedentary time. Our findings suggest wearable accelerometry bands are a possible tool for monitoring the effects on physical function of sedative and anticholinergic medicines. TRIAL REGISTRATION The ReMInDAR trial was registered on the Australian and New Zealand Trials Registry ACTRN12618000766213.
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Affiliation(s)
- Renly Lim
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide 5000, Australia.
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health and Human Performance, University of South Australia, Adelaide 5000, Australia
| | - Gaynor Parfitt
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health and Human Performance, University of South Australia, Adelaide 5000, Australia
| | - Tyson Stanford
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health and Human Performance, University of South Australia, Adelaide 5000, Australia
| | - Dannielle Post
- Alliance for Research in Exercise, Nutrition and Activity, UniSA Allied Health and Human Performance, University of South Australia, Adelaide 5000, Australia
| | - Rebecca Bilton
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide 5000, Australia
| | - Lisa M Kalisch Ellett
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide 5000, Australia
| | - Nicole Pratt
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide 5000, Australia
| | - Elizabeth E Roughead
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide 5000, Australia
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Shi C, Lin X, Huang T, Zhang K, Liu Y, Tian T, Wang P, Chen S, Guo T, Li Z, Liang B, Qin P, Zhang W, Hao Y. The association between wind speed and the risk of injuries among preschool children: New insight from a sentinel-surveillance-based study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 856:159005. [PMID: 36162582 DOI: 10.1016/j.scitotenv.2022.159005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/09/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Injuries among preschool children are an important public health concern worldwide. Significant gaps remain in understanding the potential impact of wind speed on injuries among preschoolers. We aimed to clarify the association and its variation across subgroups to capture the vulnerability features. METHODS Using a case-crossover design and conditional logistic regression model, we compared the exposure to wind speed right before the injury events (case period) with that of control periods to determine the excess rate (ER) of injury on each of 0-3 lag days in Guangzhou, 2016-2020. Results were also stratified by sociodemographic characteristics of patients, basic characteristics of injury events, and clinical features of injuries to identify the most vulnerable subgroups of preschoolers. RESULTS Higher wind speed was significantly associated with an increased risk of injuries among preschoolers on lag 0, reaching an ER of 2.93 % (95 % confidence interval [CI] = 0.87, 5.03), but not on other lag days. The results of the stratified analyses showed that children under 3-year-old (3.41 %; 95 % CI = 0.36, 6.55), boys (3.66 %; 95 % CI = 1.04, 6.35), and non-locally registered children (3.65; 95 % CI = 0.02, 7.40) were more prone to wind-related injuries. Falls (2.67 %; 95 % CI = 0.11, 5.30) were the main cause of wind-related injuries, and taking transportation was the main activity when injuries occurred (13.16 %; 95 % CI = 4.45, 22.60). Additionally, injuries involving buildings/grounds/obstacles (4.69 %; 95 % CI = 1.66, 7.81) and the occurrence of sprain/strain (7.60 %; 95 % CI = 0.64, 15.04) showed a positive association with wind speed. CONCLUSIONS Higher wind speed was associated with a significantly elevated rate of injuries among preschoolers without delayed effects, where children under 3-year-old, boys, and non-locally registered subgroups were more susceptible to wind-related injuries. This study may provide new insights for refining the prevention measures against wind-related injuries among preschoolers.
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Affiliation(s)
- Congxing Shi
- Department of Medical Statistics, Center for Health Information Research, Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Xiao Lin
- Department of Medical Statistics, Center for Health Information Research, Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Tingyuan Huang
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, Guangdong, China
| | - Kai Zhang
- Department of Environmental Health Sciences, University at Albany, the State University of New York, Rensselaer, NY, USA
| | - Yanan Liu
- Department of Medical Statistics, Center for Health Information Research, Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Tian Tian
- Department of Medical Statistics, Center for Health Information Research, Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Pengyu Wang
- Department of Medical Statistics, Center for Health Information Research, Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Shimin Chen
- Department of Medical Statistics, Center for Health Information Research, Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Tong Guo
- Department of Medical Statistics, Center for Health Information Research, Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Zhiqiang Li
- Department of Medical Statistics, Center for Health Information Research, Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Boheng Liang
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, Guangdong, China
| | - Pengzhe Qin
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, Guangdong, China.
| | - Wangjian Zhang
- Department of Medical Statistics, Center for Health Information Research, Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China.
| | - Yuantao Hao
- Department of Medical Statistics, Center for Health Information Research, Guangdong Key Laboratory of Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China; Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou 510080, Guangdong, China; Peking University Center for Public Health and Epidemic Preparedness & Response, Peking University, 100191, Beijing, China.
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11
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Tian T, Lin X, Huang T, Zhang K, Shi C, Wang P, Chen S, Guo T, Li Z, Qin P, Liang B, Zhang W, Hao Y. The risk of injuries during work and its association with precipitation: New insight from a sentinel-based surveillance and a case-crossover design. Front Public Health 2023; 11:1117948. [PMID: 36935708 PMCID: PMC10018157 DOI: 10.3389/fpubh.2023.1117948] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/09/2023] [Indexed: 03/06/2023] Open
Abstract
Background Injuries during work are often exogenous and can be easily influenced by environmental factors, especially weather conditions. Precipitation, a crucial weather factor, has been linked to unintentional injuries, yet evidence of its effect on work-related injuries is limited. Therefore, we aimed to clarify the impact of precipitation on injuries during work as well as its variation across numerous vulnerability features. Methods Records on the work-related injury during 2016-2020 were obtained from four sentinel hospitals in Guangzhou, China, and were matched with the daily weather data during the same period. We applied a time-stratified case-crossover design followed by a conditional logistic regression to evaluate the association between precipitation and work-related injuries. Covariates included wind speed, sunlight, temperature, SO 2, NO 2, and PM 2.5. Results were also stratified by multiple factors to identify the most vulnerable subgroups. Results Daily precipitation was a positive predictor of work-related injuries, with each 10 mm increase in precipitation being associated with an increase of 1.57% in the rate of injuries on the same day and 1.47-1.14% increase of injuries on subsequent 3 days. The results revealed that precipitation had a higher effect on work-related injuries in winter (4.92%; 95%CI: 1.77-8.17%). The elderly (2.07%; 95%CI: 0.64-3.51%), male (1.81%; 95%CI: 0.96-2.66%) workers or those with lower educational levels (2.58%; 95%CI: 1.59-3.54%) were more likely to suffer from injuries on rainy days. There was a higher risk for work-related injuries caused by falls (2.63%; 95%CI: 0.78-4.52%) or the use of glass products (1.75%; 95%CI: 0.49-3.02%) on rainy days. Conclusions Precipitation was a prominent risk factor for work-related injury, and its adverse effect might endure for 3 days. Certain sub-groups of workers were more vulnerable to injuries in the rain.
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Affiliation(s)
- Tian Tian
- Guangdong Key Laboratory of Medicine, Department of Medical Statistics, Center for Health Information Research, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiao Lin
- Guangdong Key Laboratory of Medicine, Department of Medical Statistics, Center for Health Information Research, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Tingyuan Huang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Kai Zhang
- Department of Environmental Health Sciences, University at Albany, The State University of New York, Rensselaer, NY, United States
| | - Congxing Shi
- Guangdong Key Laboratory of Medicine, Department of Medical Statistics, Center for Health Information Research, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Pengyu Wang
- Guangdong Key Laboratory of Medicine, Department of Medical Statistics, Center for Health Information Research, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Shimin Chen
- Guangdong Key Laboratory of Medicine, Department of Medical Statistics, Center for Health Information Research, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Tong Guo
- Guangdong Key Laboratory of Medicine, Department of Medical Statistics, Center for Health Information Research, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhiqiang Li
- Guangdong Key Laboratory of Medicine, Department of Medical Statistics, Center for Health Information Research, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Pengzhe Qin
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Boheng Liang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
- *Correspondence: Boheng Liang
| | - Wangjian Zhang
- Guangdong Key Laboratory of Medicine, Department of Medical Statistics, Center for Health Information Research, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
- Wangjian Zhang
| | - Yuantao Hao
- Guangdong Key Laboratory of Medicine, Department of Medical Statistics, Center for Health Information Research, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
- Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, China
- Peking University Center for Public Health and Epidemic Preparedness and Response, Peking University, Beijing, China
- Yuantao Hao
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12
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Evenson KR, Scherer E, Peter KM, Cuthbertson CC, Eckman S. Historical development of accelerometry measures and methods for physical activity and sedentary behavior research worldwide: A scoping review of observational studies of adults. PLoS One 2022; 17:e0276890. [PMID: 36409738 PMCID: PMC9678297 DOI: 10.1371/journal.pone.0276890] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 10/15/2022] [Indexed: 11/22/2022] Open
Abstract
This scoping review identified observational studies of adults that utilized accelerometry to assess physical activity and sedentary behavior. Key elements on accelerometry data collection were abstracted to describe current practices and completeness of reporting. We searched three databases (PubMed, Web of Science, and SPORTDiscus) on June 1, 2021 for articles published up to that date. We included studies of non-institutionalized adults with an analytic sample size of at least 500. The search returned 5686 unique records. After reviewing 1027 full-text publications, we identified and abstracted accelerometry characteristics on 155 unique observational studies (154 cross-sectional/cohort studies and 1 case control study). The countries with the highest number of studies included the United States, the United Kingdom, and Japan. Fewer studies were identified from the continent of Africa. Five of these studies were distributed donor studies, where participants connected their devices to an application and voluntarily shared data with researchers. Data collection occurred between 1999 to 2019. Most studies used one accelerometer (94.2%), but 8 studies (5.2%) used 2 accelerometers and 1 study (0.6%) used 4 accelerometers. Accelerometers were more commonly worn on the hip (48.4%) as compared to the wrist (22.3%), thigh (5.4%), other locations (14.9%), or not reported (9.0%). Overall, 12.7% of the accelerometers collected raw accelerations and 44.6% were worn for 24 hours/day throughout the collection period. The review identified 155 observational studies of adults that collected accelerometry, utilizing a wide range of accelerometer data processing methods. Researchers inconsistently reported key aspects of the process from collection to analysis, which needs addressing to support accurate comparisons across studies.
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Affiliation(s)
- Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Elissa Scherer
- RTI International, Research Triangle Park, North Carolina, United States of America
| | - Kennedy M. Peter
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Carmen C. Cuthbertson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Stephanie Eckman
- RTI International, Research Triangle Park, North Carolina, United States of America
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13
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Yerrakalva D, Hajna S, Wijndaele K, Dempsey PC, Westgate K, Wareham N, Griffin SJ, Brage S. Bidirectional associations of accelerometer-assessed physical activity and sedentary time with physical function among older English adults: the EPIC-Norfolk cohort study. Eur J Ageing 2022; 19:1507-1517. [PMID: 36692782 PMCID: PMC9729509 DOI: 10.1007/s10433-022-00733-y] [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] [Accepted: 09/27/2022] [Indexed: 01/26/2023] Open
Abstract
To develop healthy ageing interventions, longitudinal associations between objectively assessed physical behaviours and physical function need to be better understood. We assessed associations between accelerometer-assessed total physical activity (PA), moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary time and prolonged sedentary bout time, and clinically assessed physical function (grip strength, usual walking speed (UWS), chair stand speed) at two time-points in 3188 participants (≥ 60 years) of the EPIC-Norfolk study. Bidirectional associations were assessed using multivariable linear regression. Over an average of 6.1 years, baseline physical behaviours (greater total PA, MVPA and LPA, and less sedentary time) were associated with better subsequent walking and chair stand speed. Better baseline physical function was associated with better follow-up physical behaviours. There were no bidirectional associations between changes in physical behaviours and grip strength. Improvements in UWS were associated with improvements in all physical behaviours. Improvements in chair stand speed were associated with improvements in total PA, MVPA, and sedentary bout time. Improvements in physical behaviours were associated with improvements in UWS (3.1 cm/s/yr per 100 cpm/yr total PA, 3.6 cm/s/yr per hr/day/yr MVPA, 2.5 cm/s/yr per hr/day/yr LPA, - 2.9 cm/s/yr per hour/day/yr sedentary time, and - 1.6 cm/s/yr per hr/day/yr prolonged sedentary bout time). Only improvements in total PA, MVPA and sedentary bout time were associated with improvements in chair stand speed. In conclusion, we found bidirectional associations between changes in some physical behaviours and physical function and between baseline physical behaviours and subsequent physical function, highlighting the importance of considering the full range of physical behaviours to promote healthy ageing.
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Affiliation(s)
- Dharani Yerrakalva
- Department of Public Health and Primary Care, University of Cambridge, School of Clinical Medicine, Cambridge Institute of Public Health, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK.
| | - Samantha Hajna
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Katrien Wijndaele
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Paddy C. Dempsey
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK ,grid.1051.50000 0000 9760 5620Physical Activity and Behavioural Epidemiology Laboratories, Baker Heart and Diabetes Institute, Melbourne, Australia ,grid.9918.90000 0004 1936 8411Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
| | - Kate Westgate
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Nick Wareham
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Simon J. Griffin
- grid.5335.00000000121885934Department of Public Health and Primary Care, University of Cambridge, School of Clinical Medicine, Cambridge Institute of Public Health, Forvie Site, Robinson Way, Cambridge, CB2 0SR UK ,grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Soren Brage
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
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14
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Wang T, Voss J, Perazzo J, Phillips JC, Musanti R, Orton P, Hamilton MJ, Chaiphibalsarisdi P, Schnall R, Dawson-Rose C, Nokes KM, Tufts KA, Portillo C, Sefcik E, Webel AR. Working status and seasonal meteorological conditions predict physical activity levels in people living with HIV. AIDS Care 2022; 34:926-935. [PMID: 34612090 PMCID: PMC11034746 DOI: 10.1080/09540121.2021.1981219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 09/09/2021] [Indexed: 10/20/2022]
Abstract
Little is known about how demographic, employment and meteorological factors impact physical activity. We conducted an analysis to explore these associations from participants (N = 447) from six cities in the United States and matched their activity data with abstracted local meteorological data from National Oceanic and Atmospheric Administration (NOAA) weather reports. Participants were purposively recruited in 3-month blocks, from December 2015 to October 2017, to reflect physical activity engagement across the seasons. We calculated total physical activity (minutes/week) based on 7-day physical activity recall. Mild correlations were observed between meteorological factors and correlated with lower physical activity. Participants were least active in autumn (Median = 220 min/week) and most active in spring (Median = 375 min/week). In addition to level of education and total hours of work, maximum temperature, relative humidity, heating degree day, precipitation and sunset time together explained 17.6% of variance in total physical activity. Programs assisting in employment for PLHIV and those that promote indoor physical activity during more strenuous seasons are needed. Additional research to better understand the selection, preferences, and impact of indoor environments on physical activity is warranted.
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Affiliation(s)
- Tongyao Wang
- Case Western Reserve University, FPB School of Nursing, Cleveland, United States
| | - Joachim Voss
- Case Western Reserve University, FPB School of Nursing, Cleveland, United States
| | - Joseph Perazzo
- University of Cincinnati, School of Nursing, Cincinnati, United States
| | - J. Craig Phillips
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Ottawa, Canada
| | - Rita Musanti
- Rutgers University, School of Nursing, Newark, New Jersey, United States
| | - Penelope Orton
- Durban University of Technology, School of Nursing, Durban, South Africa
| | - Mary Jane Hamilton
- Texas A&M University, School of Nursing, Corpus Christi, Texas, United States
| | | | - Rebecca Schnall
- Columbia University, School of Nursing, New York City, New York, United States
| | - Carol Dawson-Rose
- University of California, School of Nursing, San Francisco, California, United States
| | - Kathleen M. Nokes
- Durban University of Technology, School of Nursing, Durban, South Africa
| | | | - Carmen Portillo
- Yale University, School of Nursing, Connecticut, United States
| | - Elizabeth Sefcik
- Texas A&M University, School of Nursing, Corpus Christi, Texas, United States
| | - Allison R. Webel
- Case Western Reserve University, FPB School of Nursing, Cleveland, United States
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15
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Measuring Productivity, Perceived Stress and Work Engagement of a Nationally Delivered Workplace Step Count Challenge. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031843. [PMID: 35162865 PMCID: PMC8835687 DOI: 10.3390/ijerph19031843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/12/2022] [Accepted: 01/26/2022] [Indexed: 11/25/2022]
Abstract
Workplace step count challenges show promise with regard to increasing physical activity, with walking linked to many positive physical and mental health benefits. Few studies have investigated their effects on work-related outcomes. The aim of this study was to describe (1) the process of collecting work-related outcomes as part of a real-world workplace intervention, the Step Count Challenge, and (2) report step counts and work-related outcomes (productivity, perceived stress and work engagement) during the Step Count Challenge. This pre-post study was conducted as part of a four-week 2018 National Step Count Challenge (SCC) in Scotland, UK. A survey was administered to collect self-reported steps, productivity (HWQ), perceived stress (Cohen Perceived Stress Scale) and work engagement (UWES) on the week prior to the intervention starting (baseline), week 1 and week 4. Process data such as recruitment and response rates were monitored throughout. Of 2042 employees who signed up to the SCC, baseline data were reported for 246 (12% of total; mean age 42.5 years, 83% female). Process data suggest low uptake to the study and poor compliance between surveys time points. Preliminary data suggest positive changes in step counts (3374 steps/day by week 4), stress and productivity. No changes in work engagement were found. The findings highlight the need to integrate research more effectively into real-world interventions, including a true baseline period. The Step Count Challenge may have positive change on some work-related outcomes warranting further investigation into how robust research designs can be delivered without negatively influencing real-world interventions.
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16
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A description of physical activity behaviors, barriers, and motivators in stroke survivors in Quebec. Disabil Health J 2022; 15:101265. [DOI: 10.1016/j.dhjo.2021.101265] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 12/19/2021] [Accepted: 12/30/2021] [Indexed: 11/17/2022]
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17
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Greenwood-Hickman MA, Zhou J, Cook A, Mettert KD, Green B, McClure J, Arterburn D, Florez-Acevedo S, Rosenberg DE. Exploring Differences in Older Adult Accelerometer-Measured Sedentary Behavior and Resting Blood Pressure Before and During the COVID-19 Pandemic. Gerontol Geriatr Med 2022; 8:23337214221096007. [PMID: 35506125 PMCID: PMC9051995 DOI: 10.1177/23337214221096007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/16/2022] [Accepted: 04/05/2022] [Indexed: 11/30/2022] Open
Abstract
Older adults have higher sedentary behavior (SB), lower physical activity, and are particularly susceptible to negative impacts from the COVID-19 pandemic and associated public health restrictions. Pandemic impacts to SB and health, particularly via objective assessment, are not well documented in the literature. Here we described differences in SB, physical activity, and blood pressure (BP) for older adults before and during the pandemic. Baseline thigh-worn activPAL accelerometer and BP measurements from 95 participants enrolled in a SB intervention trial pre-pandemic were compared to 60 enrolled post-pandemic. We used linear regression models adjusted for demographic and health factors to estimate differences in sample means of SB measures and BP. The post-COVID sample was older (age 67 vs. 70), more female (60% vs. 72%), and included more individuals of color (21% vs. 32%). In fully adjusted models, systolic BP was statistically significantly higher in the post-COVID group (6.8, 95% CI: [0.3,13.3]). After adjustment, activPAL-measured and self-reported activity were non-significant but trended towards greater total sitting (0.4 hours [-0.3, 1.1]), fewer daily steps (-270 [-1078, 538]), and greater self-reported TV time (0.4 hours, [-0.3, 1.1]) post-COVID. Future analyses are warranted to better quantify these impacts and guide clinical care and future interventions.
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Affiliation(s)
| | - Jing Zhou
- Kaiser Permanente Washington Health
Research Institute, Seattle, WA, USA
| | - Andrea Cook
- Kaiser Permanente Washington Health
Research Institute, Seattle, WA, USA
| | - Kayne D. Mettert
- Kaiser Permanente Washington Health
Research Institute, Seattle, WA, USA
| | - Bev Green
- Kaiser Permanente Washington Health
Research Institute, Seattle, WA, USA
| | - Jennifer McClure
- Kaiser Permanente Washington Health
Research Institute, Seattle, WA, USA
| | - David Arterburn
- Kaiser Permanente Washington Health
Research Institute, Seattle, WA, USA
| | - Stefani Florez-Acevedo
- Kaiser Permanente Washington Health
Research Institute, Seattle, WA, USA
- Department of Health Services, University of
Washington, Seattle, WA, USA
| | - Dori E. Rosenberg
- Kaiser Permanente Washington Health
Research Institute, Seattle, WA, USA
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Aarts E, Akkerman A, Altgassen M, Bartels R, Beckers D, Bevelander K, Bijleveld E, Blaney Davidson E, Boleij A, Bralten J, Cillessen T, Claassen J, Cools R, Cornelissen I, Dresler M, Eijsvogels T, Faber M, Fernández G, Figner B, Fritsche M, Füllbrunn S, Gayet S, van Gelder MMHJ, van Gerven M, Geurts S, Greven CU, Groefsema M, Haak K, Hagoort P, Hartman Y, van der Heijden B, Hermans E, Heuvelmans V, Hintz F, den Hollander J, Hulsman AM, Idesis S, Jaeger M, Janse E, Janzing J, Kessels RPC, Karremans JC, de Kleijn W, Klein M, Klumpers F, Kohn N, Korzilius H, Krahmer B, de Lange F, van Leeuwen J, Liu H, Luijten M, Manders P, Manevska K, Marques JP, Matthews J, McQueen JM, Medendorp P, Melis R, Meyer A, Oosterman J, Overbeek L, Peelen M, Popma J, Postma G, Roelofs K, van Rossenberg YGT, Schaap G, Scheepers P, Selen L, Starren M, Swinkels DW, Tendolkar I, Thijssen D, Timmerman H, Tutunji R, Tuladhar A, Veling H, Verhagen M, Verkroost J, Vink J, Vriezekolk V, Vrijsen J, Vyrastekova J, van der Wal S, Willems R, Willemsen A. Protocol of the Healthy Brain Study: An accessible resource for understanding the human brain and how it dynamically and individually operates in its bio-social context. PLoS One 2021; 16:e0260952. [PMID: 34965252 PMCID: PMC8716054 DOI: 10.1371/journal.pone.0260952] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 11/20/2021] [Indexed: 12/29/2022] Open
Abstract
The endeavor to understand the human brain has seen more progress in the last few decades than in the previous two millennia. Still, our understanding of how the human brain relates to behavior in the real world and how this link is modulated by biological, social, and environmental factors is limited. To address this, we designed the Healthy Brain Study (HBS), an interdisciplinary, longitudinal, cohort study based on multidimensional, dynamic assessments in both the laboratory and the real world. Here, we describe the rationale and design of the currently ongoing HBS. The HBS is examining a population-based sample of 1,000 healthy participants (age 30–39) who are thoroughly studied across an entire year. Data are collected through cognitive, affective, behavioral, and physiological testing, neuroimaging, bio-sampling, questionnaires, ecological momentary assessment, and real-world assessments using wearable devices. These data will become an accessible resource for the scientific community enabling the next step in understanding the human brain and how it dynamically and individually operates in its bio-social context. An access procedure to the collected data and bio-samples is in place and published on https://www.healthybrainstudy.nl/en/data-and-methods/access. Trail registration:https://www.trialregister.nl/trial/7955.
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Affiliation(s)
- Healthy Brain Study consortium
- Radboud University, Nijmegen, The Netherlands
- Radboud University Medical Center, Nijmegen, The Netherlands
- Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
| | - Esther Aarts
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Agnes Akkerman
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | | | - Ronald Bartels
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Debby Beckers
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | | | - Erik Bijleveld
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | | | | | - Janita Bralten
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Toon Cillessen
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Jurgen Claassen
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roshan Cools
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Martin Dresler
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Myrthe Faber
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Guillén Fernández
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
- * E-mail:
| | - Bernd Figner
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Matthias Fritsche
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Sascha Füllbrunn
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | - Surya Gayet
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | | | - Marcel van Gerven
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Sabine Geurts
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Corina U. Greven
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Martine Groefsema
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Koen Haak
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter Hagoort
- Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Yvonne Hartman
- Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Erno Hermans
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Florian Hintz
- Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
| | | | - Anneloes M. Hulsman
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Sebastian Idesis
- Center for Brain and Cognition, University Pompeu Fabra, Barcelona, Spain
| | - Martin Jaeger
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Esther Janse
- Centre for Language Studies, Radboud University, Nijmegen, The Netherlands
| | - Joost Janzing
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Johan C. Karremans
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Willemien de Kleijn
- School of Psychology and Artificial Intelligence, Radboud University, Nijmegen, The Netherlands
| | - Marieke Klein
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Floris Klumpers
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Nils Kohn
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hubert Korzilius
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | - Bas Krahmer
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Floris de Lange
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Judith van Leeuwen
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Huaiyu Liu
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Maartje Luijten
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Peggy Manders
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Katerina Manevska
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | - José P. Marques
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Jon Matthews
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - James M. McQueen
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Pieter Medendorp
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - René Melis
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Antje Meyer
- Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
| | - Joukje Oosterman
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Lucy Overbeek
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marius Peelen
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Jean Popma
- Interdisciplinary Hub for Security, Privacy and Data Governance, Radboud University, Nijmegen, The Netherlands
| | - Geert Postma
- Institute for Molecules and Materials, Radboud University, Nijmegen, The Netherlands
| | - Karin Roelofs
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | | | - Gabi Schaap
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Paul Scheepers
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Luc Selen
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Marianne Starren
- Centre for Language Studies, Radboud University, Nijmegen, The Netherlands
| | | | - Indira Tendolkar
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dick Thijssen
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hans Timmerman
- University Medical Center Groningen, Groningen, The Netherlands
| | - Rayyan Tutunji
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anil Tuladhar
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Harm Veling
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Maaike Verhagen
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | | | - Jacqueline Vink
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | | | - Janna Vrijsen
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jana Vyrastekova
- Institute for Management Research, Radboud University, Nijmegen, The Netherlands
| | | | - Roel Willems
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
- Centre for Language Studies, Radboud University, Nijmegen, The Netherlands
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Garriga A, Sempere-Rubio N, Molina-Prados MJ, Faubel R. Impact of Seasonality on Physical Activity: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:2. [PMID: 35010262 PMCID: PMC8751121 DOI: 10.3390/ijerph19010002] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/15/2021] [Accepted: 12/18/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The purpose of this study was to collect and analyze the available scientific evidence of the impact of seasonality on physical activity (PA). PA refers to walking, biking, sports and/or active recreation. METHODS The search was performed in the following databases: PubMed, PEDro, Cochrane and Embase. All publications from January 2015 to September 2020 assessing seasonal variations on physical activity development in adults were selected. RESULTS A total of 1159 articles were identified, of which 26 fulfilled the selection criteria involving 9300 participants from 18 different countries. The results obtained suggest that seasonality affects PA independently of the countries, pathologies of the participants and the tool to collect PA information. CONCLUSIONS PA level varies across the seasons, with higher PA level in summer compared with other seasons, especially in winter. Sedentary behavior follows the opposite trend. Impact of seasonality variations should be considered in clinical research involving PA as a primary outcome as well as in interventions on PA promotion.
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Affiliation(s)
- Antonio Garriga
- Faculty of Physiotherapy, Universitat de València, 46010 Valencia, Spain;
| | - Nuria Sempere-Rubio
- Department of Physiotherapy, Universitat de València, 46010 Valencia, Spain; (M.J.M.-P.); (R.F.)
- Clinical Biomechanics Research Unit (UBIC), Department of Physiotherapy, Universitat de València, 46010 Valencia, Spain
| | - María José Molina-Prados
- Department of Physiotherapy, Universitat de València, 46010 Valencia, Spain; (M.J.M.-P.); (R.F.)
| | - Raquel Faubel
- Department of Physiotherapy, Universitat de València, 46010 Valencia, Spain; (M.J.M.-P.); (R.F.)
- Joint Research Unit in IctAapplied to Reengineering Socio-Sanitary Process, IIS La Fe—Universitat Politècnica de València, 46026 Valencia, Spain
- PTinMOTION—Physiotherapy in Motion Multispeciality Research Group, Department of Physiotherapy, Universitat de València, 46010 Valencia, Spain
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Park JH, Kim Y, Welk GJ, Silva P, Lee JM. Association with Temperature Variability and Physical Activity, Sedentary Behavior, and Sleep in a Free-Living Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413077. [PMID: 34948687 PMCID: PMC8701207 DOI: 10.3390/ijerph182413077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/06/2021] [Accepted: 12/09/2021] [Indexed: 11/16/2022]
Abstract
The present study examines the temperature variability in physical activity (PA), sedentary behavior (SB), and sleep in a free-living population. A representative sample of 1235 adults (ages 21–70) from Iowa, U.S.A., wore a SenseWear Mini Armband (SWA) for a randomly assigned day. Koppen’s weather climate classification was used to precisely classify the temperature: cold (−13 to 32 °F), cool (32 to 50 °F), mild (50 to 64 °F), warm (64 to 73 °F), and hot (73 to 95 °F). The main effect of three-way ANOVA (age × gender × temperature) had differences for SB and sleep, with older adults having higher levels than younger adults (p < 0.05). However, moderate to vigorous PA (MVPA) did not vary systematically by age or gender, and contrary to expectations, the main effect of the weather was not significant for MVPA (p > 0.05). Participants spent more time participating in PA at cold than at hot temperatures. The results clarify the impact of temperature on shaping PA and SB patterns in adults. The variable impacts and differential patterns by age suggest that weather should be considered when interpreting differences in PA patterns in research or surveillance applications.
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Affiliation(s)
- Jeong-Hui Park
- Department of Physical Education, Kyung Hee University (Global Campus), 1732 Deokyoungdaero, Giheung-gu, Yongin-si 17014, Gyeonggi-do, Korea;
| | - Youngwon Kim
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China;
| | - Gregory J. Welk
- Department of Kinesiology, Iowa State University, Ames, IA 50011-4008, USA;
| | - Pedro Silva
- CIAFEL (Research Centre in Physical Activity, Health, and Leisure), Faculty of Sports-University of Porto, 4200-450 Porto, Portugal;
| | - Jung-Min Lee
- Department of Physical Education, Kyung Hee University (Global Campus), 1732 Deokyoungdaero, Giheung-gu, Yongin-si 17014, Gyeonggi-do, Korea;
- Sports Science Research Center, Kyung Hee University (Global Campus), 1732 Deokyoungdaero, Giheung-gu, Yongin-si 17014, Gyeonggi-do, Korea
- Correspondence:
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21
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Zhang Y, Tong M, Wang B, Shi Z, Wang P, Li L, Ning Y, Lu T. Geographic, Gender, and Seasonal Variation of Diabetes: A Nationwide Study With 1.4 Million Participants. J Clin Endocrinol Metab 2021; 106:e4981-e4992. [PMID: 34314489 DOI: 10.1210/clinem/dgab543] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT China has experienced a rapid increase in the prevalence of diabetes. OBJECTIVE We assessed the prevalence of diabetes among Chinese adults who attended preventive physical examinations and analyzed geographical and gender difference in seasonal variation of fasting blood glucose (FBG). METHODS The study used data from 1 390 088 participants attending preventive health examination at 430 health screening centers in 220 cities. Diagnosis of diabetes and prediabetes were based on FBG and glycated hemoglobin A1c and self-reported physician's diagnosis. We calculated age- and sex-standardized prevalence of diabetes according to the sixth Chinese population census data in 2010. Geographical distribution of diabetes and prediabetes were represented on a country map. FBG levels were analyzed to detect seasonal variation adjusted for age and gender by geographic location. RESULTS The standardized prevalence of diabetes was 8.70% (95% CI, 8.22%-9.19%), 10.7% in men and 6.61% in women. Among those with diabetes, 43.7% (95% CI, 40.9%-46.5%) were aware of their conditions and 38.5% (95% CI, 36.0%-41.1%) were treated. Only 49.3% (95% CI, 47.0%-51.6%) of treated patients achieved glycemic control. The mean level of FBG was higher in winter than summer and in the northern than the southern region. CONCLUSION The prevalence of diabetes was high while the percentages of awareness, treatment, and glycemic control were low among adults. Effective measures are needed to prevent and manage diabetes in China. Geographic and seasonal variation of diabetes should be considered for its prevention and control.
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Affiliation(s)
- Yuanfeng Zhang
- China Traditional Chinese Medicine Science and Technology Development Center (Talent Exchance Center of National Administration of Traditional Chinese Medicine), Beijing 100027, China
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Mingkun Tong
- Meinian Public Health Institute, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Bo Wang
- Meinian Public Health Institute, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, 2713, Qatar
| | - Ping Wang
- Beijing Centers for Disease Control and Preventative Medical Research, Beijing Research Center for Preventive Medicine, Beijing, 100013, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Liming Li
- Meinian Public Health Institute, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Yi Ning
- Meinian Public Health Institute, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
- Beijing Academy of Artificial Intelligence, Beijing, 100084, China
| | - Tao Lu
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, 100029, China
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22
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Maciel de Lima AP, Schneider BC, Bertoldi AD, Tomasi E, Gonzalez MC, Demarco FF, Domingues MR, Bielemann RM. NCD behavioral risk factors and mortality among older adults in Brazil. Clin Nutr ESPEN 2021; 45:462-468. [PMID: 34620356 DOI: 10.1016/j.clnesp.2021.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUNDS & AIMS Literature shows that the most studied concurrent risk factors for mortality in elderly individuals are smoking, inadequate diet, alcohol consumption and physical inactivity. The combination of such habits can increase from 3 to 11 times the chance of death. To measure the association between concurrence of behavioral risk factors (BRF) for non-communicable diseases (NCD's) and mortality up to three years among the elderly. METHODS Cohort study started in 2014 named "COMO VAI?" with community-dwelling aged ≥60 years in Pelotas, Rio Grande do Sul, Brazil. We investigated the deaths from all causes occurred until April 2017. The exposure was defined by the presence of physical inactivity, low-quality diet, alcohol consumption and smoking that composed a score ranging from 0 (none) to 4 (all). Cox proportional hazard regression models were used to evaluate the association between BRF concurrence and mortality. RESULTS In 2014, 1451 elderly people were interviewed, 145 deaths were identified (10%) by April 2017. Higher risk of death was observed for the combinations of physical inactivity + smoking and low-quality diet + physical inactivity. The simultaneous presence of three or more BRF was associated with a nearly six-fold higher risk of death. CONCLUSIONS Higher mortality during a 3-year period was observed among those with at least three BRF for NCD's.
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Affiliation(s)
| | | | - Andréa Dâmaso Bertoldi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Elaine Tomasi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Maria Cristina Gonzalez
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, Pelotas, RS, Brazil; Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | | | | | - Renata Moraes Bielemann
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, Pelotas, RS, Brazil; Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil; Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil
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23
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Physical activity, dietary intake and quality of life during COVID-19 lockdown in patients awaiting transcatheter aortic valve implantation. Neth Heart J 2021; 29:460-467. [PMID: 34373999 PMCID: PMC8351765 DOI: 10.1007/s12471-021-01609-z] [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] [Accepted: 06/24/2021] [Indexed: 11/26/2022] Open
Abstract
Background The COVID-19 pandemic has led to a national lockdown in the Netherlands, which also affected transcatheter aortic valve implantation (TAVI) patients. The objective of the study was to describe physical activity, dietary intake and quality of life (QoL) in patients on the waiting list for TAVI pre-lockdown and during lockdown. Methods Consecutive patients awaiting TAVI at the Amsterdam University Medical Centers, the Netherlands were included. Measurements were self-reported effect of lockdown, physical activity, dietary intake and QoL. Results In total, 58 patients (median age 80, interquartile range (IQR) 76–84, 45% female) were observed pre-lockdown and 16 patients (median age 78, IQR 76–82, 25% female) during lockdown. Ten of the 16 patients during lockdown reported a decline in physical activity. However, we observed a median number of 5861 steps a day (IQR 4579–7074) pre-lockdown and 8404 steps a day (IQR 7653–10,829) during lockdown. Median daily protein intake was 69 g (IQR 59–82) pre-lockdown and 90 g (IQR 68–107) during lockdown. Self-rated health on a visual analogue scale was 63 points (IQR 51–74) pre-lockdown and 73 points (IQR 65–86) during lockdown. Conclusions More than half of the patients during lockdown reported less physical activity, while we observed a higher number of steps a day, a similar dietary intake and a higher QoL. Therefore, patients on the TAVI waiting list appeared to be able to cope with the lockdown measures.
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24
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The Internet of Things in Geriatric Healthcare. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:6611366. [PMID: 34336163 PMCID: PMC8313366 DOI: 10.1155/2021/6611366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 06/27/2021] [Accepted: 07/09/2021] [Indexed: 11/17/2022]
Abstract
There is a significant increase in the geriatric population across the globe. With the increase in the number of geriatric people and their associated health issues, the need for larger healthcare resources is inevitable. Because of this, healthcare service-providing industries are facing a severe challenge. However, technological advancement in recent years has enabled researchers to develop intelligent devices to deal with the scarcity of healthcare resources. In this regard, the Internet of things (IoT) technology has been a boon for healthcare services industries. It not only allows the monitoring of the health parameters of geriatric patients from a remote location but also lets them live an independent life in a cost-efficient way. The current paper provides up-to-date comprehensive knowledge of IoT-based technologies for geriatric healthcare applications. The study also discusses the current trends, issues, challenges, and future scope of research in the area of geriatric healthcare using IoT technology. Information provided in this paper will be helpful to develop futuristic solutions and provide efficient cost-effective healthcare services to the needy.
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25
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Blair CK, Adsul P, Guest DD, Sussman AL, Cook LS, Harding EM, Rodman J, Duff D, Burgess E, Quezada K, Brown-Glaberman U, King TV, Baca E, Dayao Z, Pankratz VS, Davis S, Demark-Wahnefried W. Southwest Harvest for Health: An Adapted Mentored Vegetable Gardening Intervention for Cancer Survivors. Nutrients 2021; 13:2319. [PMID: 34371829 PMCID: PMC8308636 DOI: 10.3390/nu13072319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 01/22/2023] Open
Abstract
Harvest for Health is a home-based vegetable gardening intervention that pairs cancer survivors with Master Gardeners from the Cooperative Extension System. Initially developed and tested in Alabama, the program was adapted for the different climate, growing conditions, and population in New Mexico. This paper chronicles the feasibility, acceptability, and preliminary efficacy of "Southwest Harvest for Health". During the nine-month single-arm trial, 30 cancer survivor-Master Gardener dyads worked together to establish and maintain three seasonal gardens. Primary outcomes were accrual, retention, and satisfaction. Secondary outcomes were vegetable and fruit (V and F) intake, physical activity, and quality of life. Recruitment was diverse and robust, with 30 survivors of various cancers, aged 50-83, roughly one-third minority, and two-thirds females enrolled in just 60 days. Despite challenges due to the COVID-19 pandemic, retention to the nine-month study was 100%, 93% reported "good-to-excellent" satisfaction, and 87% "would do it again." A median increase of 1.2 servings of V and F/day was documented. The adapted home-based vegetable gardening program was feasible, well-received, and resulted in increased V and F consumption among adult cancer survivors. Future studies are needed to evaluate the effectiveness of this program and to inform strategies to increase the successful implementation and further dissemination of this intervention.
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Affiliation(s)
- Cindy K. Blair
- Department of Internal Medicine, University of New Mexico, MSC07-4025, Albuquerque, NM 87131, USA; (P.A.); (D.D.G.); (L.S.C.); (U.B.-G.); (Z.D.); (V.S.P.)
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87102, USA; (A.L.S.); (J.R.); (E.B.); (K.Q.)
| | - Prajakta Adsul
- Department of Internal Medicine, University of New Mexico, MSC07-4025, Albuquerque, NM 87131, USA; (P.A.); (D.D.G.); (L.S.C.); (U.B.-G.); (Z.D.); (V.S.P.)
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87102, USA; (A.L.S.); (J.R.); (E.B.); (K.Q.)
| | - Dolores D. Guest
- Department of Internal Medicine, University of New Mexico, MSC07-4025, Albuquerque, NM 87131, USA; (P.A.); (D.D.G.); (L.S.C.); (U.B.-G.); (Z.D.); (V.S.P.)
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87102, USA; (A.L.S.); (J.R.); (E.B.); (K.Q.)
| | - Andrew L. Sussman
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87102, USA; (A.L.S.); (J.R.); (E.B.); (K.Q.)
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM 87131, USA
| | - Linda S. Cook
- Department of Internal Medicine, University of New Mexico, MSC07-4025, Albuquerque, NM 87131, USA; (P.A.); (D.D.G.); (L.S.C.); (U.B.-G.); (Z.D.); (V.S.P.)
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87102, USA; (A.L.S.); (J.R.); (E.B.); (K.Q.)
| | - Elizabeth M. Harding
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT 05405, USA;
| | - Joseph Rodman
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87102, USA; (A.L.S.); (J.R.); (E.B.); (K.Q.)
| | - Dorothy Duff
- Albuquerque Area Extension Master Gardener Program, NMSU Cooperative Extension Service, Albuquerque, NM 87107, USA;
| | - Ellen Burgess
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87102, USA; (A.L.S.); (J.R.); (E.B.); (K.Q.)
| | - Karen Quezada
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87102, USA; (A.L.S.); (J.R.); (E.B.); (K.Q.)
| | - Ursa Brown-Glaberman
- Department of Internal Medicine, University of New Mexico, MSC07-4025, Albuquerque, NM 87131, USA; (P.A.); (D.D.G.); (L.S.C.); (U.B.-G.); (Z.D.); (V.S.P.)
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87102, USA; (A.L.S.); (J.R.); (E.B.); (K.Q.)
| | - Towela V. King
- School of Medicine, University of New Mexico, Albuquerque, NM 87131, USA; (T.V.K.); (E.B.)
| | - Erika Baca
- School of Medicine, University of New Mexico, Albuquerque, NM 87131, USA; (T.V.K.); (E.B.)
| | - Zoneddy Dayao
- Department of Internal Medicine, University of New Mexico, MSC07-4025, Albuquerque, NM 87131, USA; (P.A.); (D.D.G.); (L.S.C.); (U.B.-G.); (Z.D.); (V.S.P.)
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87102, USA; (A.L.S.); (J.R.); (E.B.); (K.Q.)
| | - Vernon Shane Pankratz
- Department of Internal Medicine, University of New Mexico, MSC07-4025, Albuquerque, NM 87131, USA; (P.A.); (D.D.G.); (L.S.C.); (U.B.-G.); (Z.D.); (V.S.P.)
- University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87102, USA; (A.L.S.); (J.R.); (E.B.); (K.Q.)
| | - Sally Davis
- Department of Pediatrics, University of New Mexico, Albuquerque, NM 87131, USA;
- University of New Mexico Prevention Research Center, Albuquerque, NM 87131, USA
| | - Wendy Demark-Wahnefried
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL 35294, USA
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Ho JY, Zijlema WL, Triguero-Mas M, Donaire-Gonzalez D, Valentín A, Ballester J, Chan EYY, Goggins WB, Mo PKH, Kruize H, van den Berg M, Gražuleviciene R, Gidlow CJ, Jerrett M, Seto EYW, Barrera-Gómez J, Nieuwenhuijsen MJ. Does surrounding greenness moderate the relationship between apparent temperature and physical activity? Findings from the PHENOTYPE project. ENVIRONMENTAL RESEARCH 2021; 197:110992. [PMID: 33705766 DOI: 10.1016/j.envres.2021.110992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 02/21/2021] [Accepted: 03/04/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Physical activity can be affected by both meteorological conditions and surrounding greenness, but few studies have evaluated the effects of these environmental factors on physical activity simultaneously. This multi-city comparative study aimed to assess the synergetic effects of apparent temperature and surrounding greenness on physical activity in four European cities. Specifically, we aimed to identify an interaction between surrounding greenness and apparent temperature in the effects on physical activity. METHODS Data were collected from 352 adult residents of Barcelona (Spain), Stoke-on-Trent (United Kingdom), Doetinchem (The Netherlands), and Kaunas (Lithuania) as part of the PHENOTYPE study. Participants wore a smartphone for seven consecutive days between May-December 2013 and provided additional sociodemographic survey data. Hourly average physical activity (Metabolic Equivalent of Task (MET)) and surrounding greenness (NDVI) were derived from the Calfit mobile application collecting accelerometer and location data. Hourly apparent temperature was calculated from temperature and relative humidity, which were obtained from local meteorological stations along with other meteorological covariates (rainfall, windspeed, and sky darkness). We assessed the interaction effects of apparent temperature and surrounding greenness on hourly physical activity for each city using linear mixed models, while adjusting for meteorological, demographic, and time-related variables. RESULTS We found significant interactions between apparent temperature and surrounding greenness on hourly physical activity in three of four cities, aside from the coastal city of Barcelona. Significant quadratic effects of apparent temperature were found in the highest level of surrounding greenness for Stoke-on-Trent and Doetinchem, with 4% decrease in median MET observed for a 10°C departure from optimal temperature (15.2°C and 14.6°C, respectively). Significant linear effects were found for higher levels of surrounding greenness in Kaunas, whereby an increase of 10°C was associated with ∼4% increase in median MET. CONCLUSION Apparent temperature and surrounding greenness interacted in the effect on hourly physical activity across three of four European cities, with varying effect between cities. While quadratic effects of temperature suggest diminishing levels of physical activity in the highest greenness levels in cities of temperate climates, the variation in surrounding greenness between cities could be further explored, particularly by looking at indoor-outdoor locations. The study findings support the need for evidence-based physical activity promotion and urban design.
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Affiliation(s)
- Janice Y Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Wilma L Zijlema
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Margarita Triguero-Mas
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain
| | - David Donaire-Gonzalez
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia; Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology (EEPI), Utrecht University, Utrecht, the Netherlands
| | - Antònia Valentín
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Joan Ballester
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain
| | - Emily Y Y Chan
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - William B Goggins
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix K H Mo
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Hanneke Kruize
- Centre for Sustainability, Environment and Health, RIVM, Bilthoven, the Netherlands
| | | | | | - Christopher J Gidlow
- Centre for Sport, Health and Exercise Research, Staffordshire University, Stoke-on-Trent, UK
| | - Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Edmund Y W Seto
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Jose Barrera-Gómez
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mark J Nieuwenhuijsen
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Heino MTJ, Knittle K, Noone C, Hasselman F, Hankonen N. Studying Behaviour Change Mechanisms under Complexity. Behav Sci (Basel) 2021; 11:77. [PMID: 34068961 PMCID: PMC8156531 DOI: 10.3390/bs11050077] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/22/2021] [Accepted: 04/28/2021] [Indexed: 01/13/2023] Open
Abstract
Understanding the mechanisms underlying the effects of behaviour change interventions is vital for accumulating valid scientific evidence, and useful to informing practice and policy-making across multiple domains. Traditional approaches to such evaluations have applied study designs and statistical models, which implicitly assume that change is linear, constant and caused by independent influences on behaviour (such as behaviour change techniques). This article illustrates limitations of these standard tools, and considers the benefits of adopting a complex adaptive systems approach to behaviour change research. It (1) outlines the complexity of behaviours and behaviour change interventions; (2) introduces readers to some key features of complex systems and how these relate to human behaviour change; and (3) provides suggestions for how researchers can better account for implications of complexity in analysing change mechanisms. We focus on three common features of complex systems (i.e., interconnectedness, non-ergodicity and non-linearity), and introduce Recurrence Analysis, a method for non-linear time series analysis which is able to quantify complex dynamics. The supplemental website provides exemplifying code and data for practical analysis applications. The complex adaptive systems approach can complement traditional investigations by opening up novel avenues for understanding and theorising about the dynamics of behaviour change.
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Affiliation(s)
- Matti T. J. Heino
- Faculty of Social Sciences, University of Helsinki, P.O. Box 54, 00014 Helsinki, Finland; (M.T.J.H.); (K.K.)
| | - Keegan Knittle
- Faculty of Social Sciences, University of Helsinki, P.O. Box 54, 00014 Helsinki, Finland; (M.T.J.H.); (K.K.)
| | - Chris Noone
- School of Psychology, National University of Ireland, H91 TK33 Galway, Ireland;
| | - Fred Hasselman
- Behavioural Science Institute, Radboud University Nijmegen, Postbus 9104, 500 HE Nijmegen, The Netherlands;
| | - Nelli Hankonen
- Faculty of Social Sciences, University of Helsinki, P.O. Box 54, 00014 Helsinki, Finland; (M.T.J.H.); (K.K.)
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28
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Mattingly SM, Grover T, Martinez GJ, Aledavood T, Robles-Granda P, Nies K, Striegel A, Mark G. The effects of seasons and weather on sleep patterns measured through longitudinal multimodal sensing. NPJ Digit Med 2021; 4:76. [PMID: 33911176 PMCID: PMC8080821 DOI: 10.1038/s41746-021-00435-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 02/25/2021] [Indexed: 11/16/2022] Open
Abstract
Previous studies of seasonal effects on sleep have yielded unclear results, likely due to methodological differences and limitations in data size and/or quality. We measured the sleep habits of 216 individuals across the U.S. over four seasons for slightly over a year using objective, continuous, and unobtrusive measures of sleep and local weather. In addition, we controlled for demographics and trait-like constructs previously identified to correlate with sleep behavior. We investigated seasonal and weather effects of sleep duration, bedtime, and wake time. We found several small but statistically significant effects of seasonal and weather effects on sleep patterns. We observe the strongest seasonal effects for wake time and sleep duration, especially during the spring season: wake times are earlier, and sleep duration decreases (compared to the reference season winter). Sleep duration also modestly decreases when day lengths get longer (between the winter and summer solstice). Bedtimes and wake times tend to be slightly later as outdoor temperature increases.
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Affiliation(s)
- Stephen M Mattingly
- Department of Computer Science & Engineering, University of Notre Dame, Notre Dame, IN, USA.
| | - Ted Grover
- Department of Informatics, University of California, Irvine, CA, USA
| | - Gonzalo J Martinez
- Department of Computer Science & Engineering, University of Notre Dame, Notre Dame, IN, USA
| | | | - Pablo Robles-Granda
- Department of Computer Science & Engineering, University of Notre Dame, Notre Dame, IN, USA
| | - Kari Nies
- Department of Informatics, University of California, Irvine, CA, USA
| | - Aaron Striegel
- Department of Computer Science & Engineering, University of Notre Dame, Notre Dame, IN, USA
| | - Gloria Mark
- Department of Informatics, University of California, Irvine, CA, USA
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29
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Interrelationship of Seasons with Inflammation, Red Meat, Fruit, and Vegetable Intakes, Cardio-Metabolic Health, and Smoking Status among Breast Cancer Survivors. J Clin Med 2021; 10:jcm10040636. [PMID: 33562354 PMCID: PMC7915094 DOI: 10.3390/jcm10040636] [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: 12/13/2020] [Revised: 01/18/2021] [Accepted: 02/01/2021] [Indexed: 12/13/2022] Open
Abstract
Seasons can affect human inflammatory status and the occurrence of diseases, and foods may also have differential impacts on inflammation across seasons; however, few studies have investigated whether there are independent and joint impacts of seasons and red meat, fruit and vegetable intakes on inflammation in breast cancer survivors. We conducted a cross-sectional study by leveraging a large cohort, the Women’s Healthy Eating and Living (WHEL) study. The WHEL study comprised primarily early stage breast cancer survivors and collected blood samples, dietary intake, demographic, and health status information at baseline. We selected 2919 participants who provided baseline dietary information and had measurement of C-reactive protein (CRP), a general marker of inflammation. In our multivariable-adjusted analyses, we found that red meat intakes were positively associated, while fruit and vegetable intakes were inversely associated with CRP; blood collected in the winter season was associated with lower CRP when compared to summer; and increased smoking intensity and body mass index (BMI) as well as having cardio-metabolic conditions (such as heart disease or diabetes) were positively associated with CRP. Furthermore, we examined the joint associations of food intakes and the season of blood draw with CRP in different subgroups. We found that moderate intakes of red meat were associated with a reduction of CRP in winter but not in other seasons; increased intakes of fruit and vegetables were associated with reduced inflammation in most seasons except winter. These associations were observed in most subgroups except past smokers with pack-years ≥ 15, in whom we observed no benefit of red meat intakes in winter. Our study provides valuable evidence for considering seasonal impacts on inflammation and seasonal food impacts in different subgroups among breast cancer survivors. The results of our study are in line with one of the emphases of the current NIH 2020–2030 nutrition strategy plan—namely, pay attention to what, when, and who should eat.
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30
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Turrisi TB, Bittel KM, West AB, Hojjatinia S, Hojjatinia S, Mama SK, Lagoa CM, Conroy DE. Seasons, weather, and device-measured movement behaviors: a scoping review from 2006 to 2020. Int J Behav Nutr Phys Act 2021; 18:24. [PMID: 33541375 PMCID: PMC7863471 DOI: 10.1186/s12966-021-01091-1] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 01/22/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND This scoping review summarized research on (a) seasonal differences in physical activity and sedentary behavior, and (b) specific weather indices associated with those behaviors. METHODS PubMed, CINAHL, and SPORTDiscus were searched to identify relevant studies. After identifying and screening 1459 articles, data were extracted from 110 articles with 118,189 participants from 30 countries (almost exclusively high-income countries) on five continents. RESULTS Both physical activity volume and moderate-to-vigorous physical activity (MVPA) were greater in summer than winter. Sedentary behavior was greater in winter than either spring or summer, and insufficient evidence existed to draw conclusions about seasonal differences in light physical activity. Physical activity volume and MVPA duration were positively associated with both the photoperiod and temperature, and negatively associated with precipitation. Sedentary behavior was negatively associated with photoperiod and positively associated with precipitation. Insufficient evidence existed to draw conclusions about light physical activity and specific weather indices. Many weather indices have been neglected in this literature (e.g., air quality, barometric pressure, cloud coverage, humidity, snow, visibility, windchill). CONCLUSIONS The natural environment can influence health by facilitating or inhibiting physical activity. Behavioral interventions should be sensitive to potential weather impacts. Extreme weather conditions brought about by climate change may compromise health-enhancing physical activity in the short term and, over longer periods of time, stimulate human migration in search of more suitable environmental niches.
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Affiliation(s)
- Taylor B Turrisi
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Kelsey M Bittel
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Ashley B West
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802, USA
| | | | - Sahar Hojjatinia
- Department of Electrical Engineering & Computer Science, The Pennsylvania State University, University Park, PA, USA
| | - Scherezade K Mama
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Constantino M Lagoa
- Department of Electrical Engineering & Computer Science, The Pennsylvania State University, University Park, PA, USA
| | - David E Conroy
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, 16802, USA.
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA.
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31
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Yerrakalva D, Hajna S, Wijndaele K, Westgate K, Khaw KT, Wareham N, Griffin SJ, Brage S. Correlates of change in accelerometer-assessed total sedentary time and prolonged sedentary bouts among older English adults: results from five-year follow-up in the EPIC-Norfolk cohort. Aging (Albany NY) 2021; 13:134-149. [PMID: 33431710 PMCID: PMC7835006 DOI: 10.18632/aging.202497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 12/18/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Development of effective strategies to reduce sedentary time among older adults necessitates understanding of its determinants but longitudinal studies of this utilising objective measures are scarce. METHODS Among 1536 older adults (≥60 years) in the EPIC-Norfolk study, sedentary time was assessed for seven days at two time-points using accelerometers. We assessed associations of change in total and prolonged bouts of sedentary time (≥ 30 minutes) with change in demographic and behavioural factors using multi-level regression. RESULTS Over follow-up (5.3±1.9 years), greater increases in total sedentary time were associated with older age, being male, higher rate of increase in BMI, lower rate of increase in gardening (0.5 min/day/yr greater sedentary time per hour/week/yr less gardening, 95% CI 0.1, 1.0), a lower rate of increase in walking (0.2 min/day/yr greater sedentary time per hour/week/yr less walking, 95% CI 0.1, 0.3) and a higher rate of increase in television viewing. Correlates of change in prolonged sedentary bouts were similar. CONCLUSION Individuals in specific sub-groups (older, male, higher BMI) and who differentially participate in certain behaviours (less gardening, less walking and more television viewing) but not others increase their sedentary time at a higher rate than others; utilising this information could inform successful intervention content and targeting.
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Affiliation(s)
- Dharani Yerrakalva
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Samantha Hajna
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Katrien Wijndaele
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Kate Westgate
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Nick Wareham
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Simon J Griffin
- Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK
- 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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32
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Oviedo-Caro MA, Mayolas-Pi C, Bueno-Antequera J, Paris-García F, Murillo-Fuentes A, Reverter-Masia J, Munguía-Izquierdo D, Legaz-Arrese A. Training volume and amateur cyclists' health: a six-month follow-up from coinciding with a high-demand cycling event. Res Sports Med 2021; 29:373-385. [PMID: 33401968 DOI: 10.1080/15438627.2020.1871349] [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: 10/22/2022]
Abstract
This study aimed to analyse the longitudinal association of amateur cycling training volume with health by comparing the proximity of participation in a high-demand cycling event. Variations in cycling training volume, behavioural cardiometabolic risk factors, and physical and psychosocial health were examined. Cyclists decreased their training volume by approximately 40% and their total physical activity volumes by approximately 20%, while controls maintained (~5%). A time*group interaction was found for men's physical conditioning, body mass index and anxiety and, independent of gender, for behavioural cardiometabolic risk factors. Variation in cycling training volume was positively correlated with variation in physical conditioning and total physical activity and negatively correlated with variation in body mass index. The high level of cycling training volume developed at the time coinciding with a high demand cycling event predisposes to better physical health and behavioural cardiometabolic risk factors, without negatively affect psychosocial health, compared with six month later.
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Affiliation(s)
- Miguel Angel Oviedo-Caro
- Physical Performance & Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain.,Research Group in Development Movimiento Humano, Universidad de Zaragoza, Zaragoza, Spain
| | - Carmen Mayolas-Pi
- Research Group in Development Movimiento Humano, Universidad de Zaragoza, Zaragoza, Spain.,Department of Physiatry and Nursery, Section of Physical Education and Sports, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain
| | - Javier Bueno-Antequera
- Physical Performance & Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain.,Research Group in Development Movimiento Humano, Universidad de Zaragoza, Zaragoza, Spain
| | - Federico Paris-García
- Research Group in Development Movimiento Humano, Universidad de Zaragoza, Zaragoza, Spain.,Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain
| | - Alfonso Murillo-Fuentes
- Research Group in Development Movimiento Humano, Universidad de Zaragoza, Zaragoza, Spain.,Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain
| | - Joaquín Reverter-Masia
- Research Group in Development Movimiento Humano, Universidad de Zaragoza, Zaragoza, Spain.,Section of Physical Education and Sports, Faculty of Education, Psychology and Social Work, University of Lleida, Lleida, Spain
| | - Diego Munguía-Izquierdo
- Physical Performance & Sports Research Center, Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, Seville, Spain.,Research Group in Development Movimiento Humano, Universidad de Zaragoza, Zaragoza, Spain.,Biomedical Research Networking Center on Frailty and Healthy Aging, Madrid, Spain
| | - Alejandro Legaz-Arrese
- Research Group in Development Movimiento Humano, Universidad de Zaragoza, Zaragoza, Spain.,Department of Physiatry and Nursery, Section of Physical Education and Sports, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain
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33
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Garrett JK, White MP, Elliott LR, Wheeler BW, Fleming LE. Urban nature and physical activity: Investigating associations using self-reported and accelerometer data and the role of household income. ENVIRONMENTAL RESEARCH 2020; 190:109899. [PMID: 32750550 DOI: 10.1016/j.envres.2020.109899] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Physical inactivity is a major public health concern. Natural, or semi-natural, environments may encourage physical activity, but the influences of socio-economic factors have been under-researched. METHODS We explored the associations between meeting physical activity (PA) guidelines and both neighbourhood green (area coverage) and blue (freshwater coverage and coastal proximity) environments for urban adults using data from the Health Survey for England [HSE] (2008/2012). We considered different domains of self-reported PA: walking (n = 18,391), sports and other exercise (n = 18,438), non-recreational (domestic/gardening/occupational; n = 18,446) and all three domains combined (n = 18,447); as well as accelerometer-derived PA data using a subsample (n = 1,774). Relationships were stratified by equivalised household income as an indicator of socio-economic status. RESULTS After adjusting for covariates, living <5 km from the coast was associated with significantly higher odds of meeting UK 2010 guidelines through self-reported total, walking and non-recreational PA (e.g. total PA, <5 km vs. >20 km, adjusted odds ratio (ORadj) = 1.26; 95% confidence interval (CI) = 1.15-1.39) but unrelated to sports and exercise. Greater neighbourhood greenspace, however, was only associated with significantly higher odds of meeting guidelines through non-recreational PA alone (e.g. 80-100% vs. <20% ORadj = 1.32; 95% CI = 1.12-1.56). Although associations were most consistent in the lowest income quintile, income-related results were mixed. Relationships were not replicated in the smaller accelerometry subsample. CONCLUSION Our self-report findings for the differing domains of PA as a function of neighbourhood green and blue space broadly replicated previous research, yet the reasons for the observed differences between PA domains and environments remain unclear. We did not observe any associations between environmental variables and accelerometer-measured PA; further research with larger samples is needed.
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Affiliation(s)
- Joanne K Garrett
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK.
| | - Mathew P White
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK
| | - Lewis R Elliott
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK
| | - Benedict W Wheeler
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK
| | - Lora E Fleming
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK
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Sailani MR, Metwally AA, Zhou W, Rose SMSF, Ahadi S, Contrepois K, Mishra T, Zhang MJ, Kidziński Ł, Chu TJ, Snyder MP. Deep longitudinal multiomics profiling reveals two biological seasonal patterns in California. Nat Commun 2020; 11:4933. [PMID: 33004787 PMCID: PMC7529769 DOI: 10.1038/s41467-020-18758-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 08/21/2020] [Indexed: 02/06/2023] Open
Abstract
The influence of seasons on biological processes is poorly understood. In order to identify biological seasonal patterns based on diverse molecular data, rather than calendar dates, we performed a deep longitudinal multiomics profiling of 105 individuals over 4 years. Here, we report more than 1000 seasonal variations in omics analytes and clinical measures. The different molecules group into two major seasonal patterns which correlate with peaks in late spring and late fall/early winter in California. The two patterns are enriched for molecules involved in human biological processes such as inflammation, immunity, cardiovascular health, as well as neurological and psychiatric conditions. Lastly, we identify molecules and microbes that demonstrate different seasonal patterns in insulin sensitive and insulin resistant individuals. The results of our study have important implications in healthcare and highlight the value of considering seasonality when assessing population wide health risk and management.
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Affiliation(s)
- M Reza Sailani
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA
| | - Ahmed A Metwally
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA
| | - Wenyu Zhou
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA
| | | | - Sara Ahadi
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA
| | - Kevin Contrepois
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA
| | - Tejaswini Mishra
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA
| | - Martin Jinye Zhang
- Department of Electrical Engineering, Stanford University, Stanford, CA, 94305, USA
| | - Łukasz Kidziński
- Department of Bioengineering, Stanford University, Stanford, CA, 94305, USA
| | - Theodore J Chu
- Department of Pediatrics, Division of Allergy and Immunology, Stanford University, Stanford, CA, 94305, USA
| | - Michael P Snyder
- Department of Genetics, Stanford University, Stanford, CA, 94305, USA.
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Test-Retest Reliability of activPAL in Measuring Sedentary Behavior and Physical Activity in People With Type 2 Diabetes. J Phys Act Health 2020; 17:1134-1139. [PMID: 32971519 DOI: 10.1123/jpah.2019-0506] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 08/20/2020] [Accepted: 08/24/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND To investigate how changes in sedentary behavior relate to health outcomes, it is important to establish the test-retest reliability of activity monitors in measuring habitual sedentary behavior in people with type 2 diabetes (T2D) as a prerequisite for interpreting this information. Thus, the authors' objective was to examine the test-retest reliability of a common activity monitor (activPAL™) in measuring sedentary behavior and physical activity in people with T2D. METHODS Sedentary-time, standing-time, stepping-time, step-count, and sit-to-stand transitions were obtained from two 7-day assessment periods separated by at least 1 week. Test-retest reliability was determined with the intraclass correlation coefficient (ICC) to compare sedentary and activity measures between the 2 time points. RESULTS A total of 30 participants with self-reported T2D completed the study (age 65 [6] y, 63% women, body mass index 33.3 [5] kg/m2). High test-retest reliability was found for sedentary-time (ICC = .79; 95% confidence interval [CI], .61-.89) and standing-time (ICC = .74; 95% CI, .53-.87). Very high test-retest reliability was found for stepping-time (ICC = .90; 95% CI, .81-.95), step-count (ICC = .91; 95% CI, .83-.96), and sit-to-stand transitions (ICC = .90; 95% CI, .79-.95). CONCLUSION The activPAL™ device showed high to very high test-retest reliability in measuring all tested activity categories in people with T2D.
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Qi X, Wang Z, Guo X, Xia X, Xue J, Jiang G, Gu Y, Han S, Yao Q, Cai Z, Wang X, Wang L, Leng SX, Li X. Short-term effects of outdoor air pollution on acute ischaemic stroke occurrence: a case-crossover study in Tianjin, China. Occup Environ Med 2020; 77:862-867. [PMID: 32855345 PMCID: PMC7677458 DOI: 10.1136/oemed-2019-106301] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 07/07/2020] [Accepted: 08/02/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Ambient air pollution is associated with ischaemic stroke incidence. However, most of the previous studies used stroke-related hospital admission rather than stroke onset itself. This study aimed to evaluate the relationship between ambient air pollutant exposures and acute ischaemic stroke based on the timing of symptom onset. METHODS A time-stratified, case-crossover analysis was performed among 520 patients who had ischaemic stroke admitted to the Second Hospital of Tianjin Medical University (Tianjin, China) between 1 April 2018 and 31 March 2019 (365 days). Daily air pollutant concentrations of particulate matter with aerodynamic diameter 2.5 µm, particulate matter with aerodynamic diameter 10 µm (PM10), sulfur dioxide, nitrogen dioxide, carbon monoxide and ozone were obtained from fixed-site monitoring stations. We used conditional logistic regression to estimate OR and 95% CI corresponding to an increase in IQR of each air pollutant after adjusting for the effects of temperature and relative humidity. RESULTS Overall, a higher risk of ischaemic stroke was found between April and September. During this period PM10 was associated with an increased risk of ischaemic stroke (1-day lag: OR=1.49, 95% CI 1.09 to 2.02; 3-day mean: OR=1.58, 95% CI 1.09 to 2.29) among patients between 34 and 70 years old. Positive associations were also observed between PM10 (1-day lag: OR=1.51, 95% CI 1.10 to 2.07; 3-day mean: OR=1.57, 95% CI 1.08 to 2.29), ozone (1-day lag: OR=1.83, 95% CI 1.16 to 2.87; 3-day mean: OR=1.90, 95% CI 1.06 to 3.42) and ischaemic stroke occurrence among those with hyperlipidaemia. CONCLUSION Our results suggest that air pollution is associated with a higher risk of ischaemic stroke in younger people or people with hyperlipidemia. These findings still need to be further investigated.
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Affiliation(s)
- Xuemei Qi
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhongyan Wang
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiaokun Guo
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Juanjuan Xue
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Guojing Jiang
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yumeng Gu
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Suqin Han
- CMA-NKU Cooperative Laboratory for Atmospheric Environment-Health Research (CLAER/CMA-NKU), Tianjin Environmental Meteorology Center, Tianjin, China
| | - Qing Yao
- CMA-NKU Cooperative Laboratory for Atmospheric Environment-Health Research (CLAER/CMA-NKU), Tianjin Environmental Meteorology Center, Tianjin, China
| | - Ziying Cai
- CMA-NKU Cooperative Laboratory for Atmospheric Environment-Health Research (CLAER/CMA-NKU), Tianjin Environmental Meteorology Center, Tianjin, China
| | - Xiaojia Wang
- CMA-NKU Cooperative Laboratory for Atmospheric Environment-Health Research (CLAER/CMA-NKU), Tianjin Environmental Meteorology Center, Tianjin, China
| | - Lin Wang
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Sean X Leng
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
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37
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Naber A, Molitor WL, Farriell A, Honius K, Poppe B. The Exploration of Occupational Therapy Interventions to Address Sedentary Behavior and Pain Among Older Adults. J Aging Phys Act 2020; 28:391-398. [PMID: 31722292 DOI: 10.1123/japa.2019-0217] [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: 06/12/2019] [Revised: 08/14/2019] [Accepted: 09/06/2019] [Indexed: 11/18/2022]
Abstract
This study aimed to determine the feasibility of an occupational therapy intervention to address sedentary behavior and pain among older adults residing in assisted living facilities. A single group pretest and posttest design was implemented using the Sedentary Behavior Questionnaire, actigraphy technology, and daily activity logs to measure sedentary behavior. The Short-Form McGill Pain Questionnaire was used to assess pain. Occupational therapy intervention focused on individualized goals related to participation in meaningful physical activities, which were established in collaboration with the participant and were tracked for 3 weeks. A total of 12 participants were recruited for this study. The mean number of steps and daily calories burned over the course of a week increased by 3,058.3 steps (30.82%) and 57.64 calories (19.96%), respectively. Individualized goal setting may have a positive impact on the reduction of pain and increasing activity levels among older adults residing in assisted living facilities.
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Abeler K, Sand T, Friborg O, Bergvik S. Seasonality in pain, sleep and mental distress in patients with chronic musculoskeletal pain at latitude 69° N. Chronobiol Int 2020; 37:1650-1661. [PMID: 32460567 DOI: 10.1080/07420528.2020.1764011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Seasonality is evident in several aspects of human health and behavior, whereas seasonality in chronic pain is less well studied. We examined seasonal variation in pain severity and pain dissemination, as well as in pain-associated conditions, such as sleep impairment, sleep timing, mental distress, fatigue and physical activity. We also examined if any of these associated conditions moderated the seasonality in pain. This prospective study was conducted in the subarctic municipality of Tromsø, Norway (69º North), on a sample of patients with chronic musculoskeletal pain (N = 56). Data were collected with self-report questionnaires and objective actigraphy measures (7 days) twice: winter and summer. Mixed linear regression models were fitted. A modest seasonality effect was observed in pain severity (highest in summer), but not in pain dissemination. Seasonality with increased physical activity and delayed sleep timing in the summer was also present. The remaining pain-associated self-report or objective measures indicated no seasonality. The season-pain association was not significantly moderated by any of the pain-associated conditions. Previous studies on healthy individuals residing in polar areas have suggested an opposite seasonal effect with delay of the sleep-wake rhythm in winter. Our results based on a clinical sample thus represent a novel finding that needs to be examined further with regard to seasonal circadian entrainment and alignment in pain populations. These results may have clinical value for the treatment of patients with musculoskeletal pain as seasonality may require seasonal adjustments of pain treatment strategies.
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Affiliation(s)
- Karin Abeler
- Department of Psychology, Faculty of Health Sciences, The Arctic University of Norway , Tromsø, Norway.,Department of Neurology and Neurophysiology, University Hospital of North Norway , Tromsø, Norway
| | - Trond Sand
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology , Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim University Hospital , Trondheim, Norway
| | - Oddgeir Friborg
- Department of Psychology, Faculty of Health Sciences, The Arctic University of Norway , Tromsø, Norway
| | - Svein Bergvik
- Department of Psychology, Faculty of Health Sciences, The Arctic University of Norway , Tromsø, Norway
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Ikram MA, Brusselle G, Ghanbari M, Goedegebure A, Ikram MK, Kavousi M, Kieboom BCT, Klaver CCW, de Knegt RJ, Luik AI, Nijsten TEC, Peeters RP, van Rooij FJA, Stricker BH, Uitterlinden AG, Vernooij MW, Voortman T. Objectives, design and main findings until 2020 from the Rotterdam Study. Eur J Epidemiol 2020; 35:483-517. [PMID: 32367290 PMCID: PMC7250962 DOI: 10.1007/s10654-020-00640-5] [Citation(s) in RCA: 291] [Impact Index Per Article: 72.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/23/2020] [Indexed: 12/19/2022]
Abstract
The Rotterdam Study is an ongoing prospective cohort study that started in 1990 in the city of Rotterdam, The Netherlands. The study aims to unravel etiology, preclinical course, natural history and potential targets for intervention for chronic diseases in mid-life and late-life. The study focuses on cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, otolaryngological, locomotor, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. Since 2016, the cohort is being expanded by persons aged 40 years and over. The findings of the Rotterdam Study have been presented in over 1700 research articles and reports. This article provides an update on the rationale and design of the study. It also presents a summary of the major findings from the preceding 3 years and outlines developments for the coming period.
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Affiliation(s)
- M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Guy Brusselle
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Brenda C T Kieboom
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Caroline C W Klaver
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Robert J de Knegt
- Department of Gastroenterology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Tamar E C Nijsten
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Robin P Peeters
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Frank J A van Rooij
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
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Buijink MR, Olde Engberink AHO, Wit CB, Almog A, Meijer JH, Rohling JHT, Michel S. Aging Affects the Capacity of Photoperiodic Adaptation Downstream from the Central Molecular Clock. J Biol Rhythms 2020; 35:167-179. [PMID: 31983261 PMCID: PMC7134598 DOI: 10.1177/0748730419900867] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Aging impairs circadian clock function, leading to disrupted sleep-wake patterns and a reduced capability to adapt to changes in environmental light conditions. This makes shift work or the changing of time zones challenging for the elderly and, importantly, is associated with the development of age-related diseases. However, it is unclear what levels of the clock machinery are affected by aging, which is relevant for the development of targeted interventions. We found that naturally aged mice of >24 months had a reduced rhythm amplitude in behavior compared with young controls (3-6 months). Moreover, the old animals had a strongly reduced ability to adapt to short photoperiods. Recording PER2::LUC protein expression in the suprachiasmatic nucleus revealed no impairment of the rhythms in PER2 protein under the 3 different photoperiods tested (LD: 8:16, 12:12, and 16:8). Thus, we observed a discrepancy between the behavioral phenotype and the molecular clock, and we conclude that the aging-related deficits emerge downstream of the core molecular clock. Since it is known that aging affects several intracellular and membrane components of the central clock cells, it is likely that an impairment of the interaction between the molecular clock and these components is contributing to the deficits in photoperiod adaptation.
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Affiliation(s)
- M Renate Buijink
- Department of Cellular and Chemical Biology, Laboratory for Neurophysiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Anneke H O Olde Engberink
- Department of Cellular and Chemical Biology, Laboratory for Neurophysiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Charlotte B Wit
- Department of Cellular and Chemical Biology, Laboratory for Neurophysiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Assaf Almog
- Lorentz Institute for Theoretical Physics, Leiden University, Leiden, the Netherlands
| | - Johanna H Meijer
- Department of Cellular and Chemical Biology, Laboratory for Neurophysiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jos H T Rohling
- Department of Cellular and Chemical Biology, Laboratory for Neurophysiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Stephan Michel
- Department of Cellular and Chemical Biology, Laboratory for Neurophysiology, Leiden University Medical Center, Leiden, the Netherlands
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Albrecht BM, Stalling I, Recke C, Bammann K. Accelerometer-assessed outdoor physical activity is associated with meteorological conditions among older adults: Cross-sectional results from the OUTDOOR ACTIVE study. PLoS One 2020; 15:e0228053. [PMID: 31978178 PMCID: PMC6980536 DOI: 10.1371/journal.pone.0228053] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 01/06/2020] [Indexed: 12/03/2022] Open
Abstract
Background Meteorological conditions are potential determinants of physical activity (PA). A profound understanding of the determinants of PA behaviour is required for PA promotion. This study examined the association between accelerometer-assessed PA and meteorological conditions among older adults. Methods This cross-sectional study included data of 577 adults aged 65–75 years living in Bremen, Germany (52% female; 3278 days). PA was measured with accelerometers for seven consecutive days (10/15-08/16). A threshold of 240 lx was used to differentiate between outdoor physical activity (OPA) and indoor physical activity (IPA). Linear mixed models estimated the association between PA (daily accelerometer counts per minute (CPM)) and meteorological factors (temperature, cloud cover, wind, and no precipitation) derived by principal component analysis. Results The analyses showed associations between PA in CPM and the meteorological factors temperature (93.7; 95%-CL: 64.9, 122.5) and no precipitation (48.4; 95%-CL: 19.8, 77.0) in women and wind (-40.3; 95%-CL: -59.7, -20.8) and no precipitation (30.1; 95%-CL: 5.6, 54.6) in men. After distinguishing in OPA and IPA for a subsample of 128 participants (473 days), the sex differences were no longer present. OPA in CPM was associated with temperature (women: 174.5; 95%-CL: 81.3, 267.6; men: 183.3; 95%-CL: 81.2, 285.4), cloud cover (women: -153.0; 95%-CL: -200.3, -105.7; men: -123.2; 95%-CL: -174.7, -71.7), and wind (women: -118.6; 95%-CL: -189.6; -47.7; men: -96.9; 95%-CL: -177.0, -16.7). No association between OPA and no precipitation was found (women: 2.9; 95%-CL: -89.0, 94.8; men: -17.1; 95%-CL: -116.7, 82.4). Conclusions The results of this study emphasize the importance of meteorological conditions as environmental determinants of PA among older adults. Meteorological conditions should be accounted for in the unbiased assessment of habitual PA and the development of PA promotion programs. Future research should focus on the associations of OPA and IPA with meteorological conditions in different climatic regions.
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Affiliation(s)
- Birte Marie Albrecht
- Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany
- * E-mail:
| | - Imke Stalling
- Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany
| | - Carina Recke
- Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany
| | - Karin Bammann
- Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany
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Alfonsi V, Palmizio R, Rubino A, Scarpelli S, Gorgoni M, D'Atri A, Pazzaglia M, Ferrara M, Giuliano S, De Gennaro L. The Association Between School Start Time and Sleep Duration, Sustained Attention, and Academic Performance. Nat Sci Sleep 2020; 12:1161-1172. [PMID: 33328774 PMCID: PMC7735793 DOI: 10.2147/nss.s273875] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 11/14/2020] [Indexed: 02/05/2023] Open
Abstract
PURPOSE In adolescence, physiological (circadian and homeostatic regulation of sleep) and social habits contribute to delayed sleep onset, while social obligations impose early sleep offset. The effects of delayed school start time on the subjective/objective measures of sleep-wake patterns and academic achievement have not been established. METHODS This pre-, post-, and longitudinal non-randomized study included an early (8:00 am; ESC=30 students) and the late (9:00 am; LSC=21 students) start class. Multiple sleep data included a weekly sleep diary, Karolinska Sleepiness Scale, Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale. Sustained attention was measured using the Psychomotor Vigilance Task. Academic performance was evaluated by two different mathematical and scientific standard tests (entrance and final) and by school attendance indicators. Data were collected at monthly intervals from October 2018 to May 2019 and the beginning and end of the academic year (pre/post). RESULTS All students turned their lights off at similar times (LSC=11:21pm, ESC=11:11pm), but LSC students woke up later (7:23am) than ESC students (6:55am; F1,48=11.81, p=0.001) on school days. The groups did not differ in total sleep duration on non-school days. Longitudinal measures revealed a significant increase (8.9%, 34 min) in total sleep duration of LSC students across the academic year. ESC students maintained approximately the same sleep duration. Furthermore, changes in sleep duration had parallelled significant differences in sustained attention, with LSC students outperforming ESC students. Longitudinal changes of sleep and sustained attention were associated with a coherent pattern of changes in academic performance. CONCLUSION Findings indicate that a one-hour delay in school start time is associated with longer sleep, better diurnal sustained attention, attendance, and improved academic performance. Notably, sleep changes were limited to school days. A delay in school start time should be seriously considered to improve sleep and academic achievements of students.
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Affiliation(s)
- Valentina Alfonsi
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy.,I.R.C.C.S. Fondazione Santa Lucia, Rome, Italy
| | | | | | | | - Maurizio Gorgoni
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Aurora D'Atri
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Mariella Pazzaglia
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy.,I.R.C.C.S. Fondazione Santa Lucia, Rome, Italy
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | | | - Luigi De Gennaro
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy.,I.R.C.C.S. Fondazione Santa Lucia, Rome, Italy
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43
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Sulkava S, Taka AM, Kantojärvi K, Pölkki P, Morales-Muñoz I, Milani L, Porkka-Heiskanen T, Saarenpää-Heikkilä O, Kylliäinen A, Juulia Paavonen E, Paunio T. Variation near MTNR1A associates with early development and interacts with seasons. J Sleep Res 2019; 29:e12925. [PMID: 31588999 DOI: 10.1111/jsr.12925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 08/20/2019] [Accepted: 09/04/2019] [Indexed: 11/30/2022]
Abstract
Melatonin is a circadian regulatory hormone with neuroprotective properties. We have previously demonstrated the association of the genetic variant rs12506228 near the melatonin receptor 1A gene (MTNR1A) with intolerance to shift-work. Furthermore, this variant has been connected to Alzheimer's disease. Because of the previously suggested role of melatonin signalling in foetal neurocognitive and sleep development, we studied here the association of rs12506228 with early development. The study sample comprised 8-month-old infants from the Finnish CHILD-SLEEP birth cohort (n = 1,301). Parental questionnaires assessed socioemotional, communication and motor development, as well as sleep length and night awakenings. The A allele of rs12506228 showed an association with slower socioemotional (p = .025) and communication (p = .0098) development, but no direct association with sleep. However, the association of the Finnish seasons with infant sleep length interacted with rs12506228. Taken together, rs12506228 near MTNR1A, which has been previously linked to adult and elderly traits, is shown here to associate with slower early cognitive development. In addition, these results suggest that the darker seasons associate with longer infant sleep time, but only in the absence of the rs12506228 AA genotype. Because the risk allele has been connected to fewer brain MT1 melatonin receptors, these associations may reflect the influence of decreased melatonin signalling in early development.
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Affiliation(s)
- Sonja Sulkava
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Antti-Mathias Taka
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Katri Kantojärvi
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Pirjo Pölkki
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Isabel Morales-Muñoz
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland.,Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Lili Milani
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | | | - Outi Saarenpää-Heikkilä
- Tampere Center for Child Health Research, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Anneli Kylliäinen
- Psychology, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - E Juulia Paavonen
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland.,Pediatric Research Center, Child Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tiina Paunio
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
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44
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Toward an Integrated Model for Soft-Mobility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193669. [PMID: 31569591 PMCID: PMC6801748 DOI: 10.3390/ijerph16193669] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 08/19/2019] [Accepted: 09/27/2019] [Indexed: 11/30/2022]
Abstract
A key urban design challenge is to create built environments that encourage outdoor activity all year round. This study explores a new model for soft-mobility that places the interaction between the urban form, the seasonal climate and climate change, and the individual at the center of people’s soft-mobility choices, or in more general, their modal choice. The research methods used were comparative studies of documents, surveys, mental mapping, and photo elicitation. These studies were undertaken to research people’s outdoor activity in the built environment during the winter season of a cold climate settlement. The results were analyzed against the three-dimensions of the model. In the discussion it is argued that in places with significant climate variation, the interaction between the urban form, the season, and the individual together influence soft-mobility choices. In turn, these interactions influence people’s level of outdoor activity and the individual health benefits such activity can afford. In conclusion, it is highlighted that all three dimensions of the model are in a constant state of change and evolution, especially in relation to planning and development processes and climate change.
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Dėdelė A, Miškinytė A, Andrušaitytė S, Nemaniūtė-Gužienė J. Seasonality of physical activity and its association with socioeconomic and health factors among urban-dwelling adults of Kaunas, Lithuania. BMC Public Health 2019; 19:1067. [PMID: 31391017 PMCID: PMC6686566 DOI: 10.1186/s12889-019-7399-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 07/30/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Physical activity (PA) has been declining dramatically over time in many countries worldwide. The decrease of PA levels affects a person's health and quality of life as it is a significant risk factor for many noncommunicable diseases. Understanding the factors that determine PA is particularly important in promoting greater PA in adults and reducing the risk of diseases associated with physical inactivity. This study investigated associations of seasonal PA levels with socioeconomic and health factors among adults. METHODS A cross-sectional study included 1111 participants of Kaunas city, Lithuania who completed a questionnaire about PA and mobility behaviour, socioeconomic, health and demographic factors. Commuting PA and sufficient PA (sPA) on weekdays and weekends in the summer and winter seasons was investigated in this study. Data on daily commuting duration and forms of transportation were collected using a questionnaire survey. Daily commuting was categorized into two categories: 1) using motorized transportation or walking or cycling 0 to 29 min, 2) and walking or cycling for 30 min or more. RESULTS Our findings showed significant seasonal impact on PA levels. The results revealed that employment status was significantly associated with PA. Unemployed individuals were 2 times more likely to engage in sPA in winter and almost 3 times in summer compared to workers. CONCLUSIONS Our findings suggest the importance of considering environmental, socioeconomic and health factors when assessing PA. Promoting PA through active commuting is an important part of a healthy lifestyle and strategies to support the implementation of health-promoting policies and practices are needed.
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Affiliation(s)
- Audrius Dėdelė
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Vileikos Street 8, 44404 Kaunas, Lithuania
| | - Auksė Miškinytė
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Vileikos Street 8, 44404 Kaunas, Lithuania
| | - Sandra Andrušaitytė
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Vileikos Street 8, 44404 Kaunas, Lithuania
| | - Jolanta Nemaniūtė-Gužienė
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Vileikos Street 8, 44404 Kaunas, Lithuania
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46
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Gait Speed with Anti-Slip Devices on Icy Pedestrian Crossings Relate to Perceived Fall-Risk and Balance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142451. [PMID: 31295887 PMCID: PMC6678553 DOI: 10.3390/ijerph16142451] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 07/05/2019] [Accepted: 07/08/2019] [Indexed: 12/31/2022]
Abstract
It is important to find criteria for preventive measures and appropriate assistive devices to reduce pedestrian injuries and increase walking in winter. Reducing the rate of falls on icy surfaces and improving people’s ability to safely cross a street in winter conditions by achieving an adequate walking speed, for example, need to be considered. This study explores pedestrian perceptions of fall risk, balance, and footfall transitions while using different designs for anti-slip devices on ice and snow-covered ice and relates these to measures of gait speed and friction. Trials were performed with nine pedestrians testing 19 anti-slip devices on ice and ice covered with snow. Laboratory tests of the dynamic coefficient of friction (DCOF) on plain ice were also performed. The findings suggest that there was conformity in the participants’ perceptions of good balance and low fall risk for one-fifth of the devices (three whole-foot designs and one design with built-in spikes). We also found that gait speed on icy pedestrian crossings is related to perceived fall-risk and balance control, but not to DCOF of the anti-slip devices.
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47
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Noordam R, Ramkisoensing A, Loh NY, Neville MJ, Rosendaal FR, Willems van Dijk K, van Heemst D, Karpe F, Christodoulides C, Kooijman S. Associations of Outdoor Temperature, Bright Sunlight, and Cardiometabolic Traits in Two European Population-Based Cohorts. J Clin Endocrinol Metab 2019; 104:2903-2910. [PMID: 30759251 PMCID: PMC6543772 DOI: 10.1210/jc.2018-02532] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 02/07/2019] [Indexed: 11/19/2022]
Abstract
CONTEXT Seasonal variation in cold and light exposure may influence metabolic health. OBJECTIVE We assessed the associations of bright sunlight and outdoor temperature with measures of glucose and lipid metabolism in two populations of middle-aged European subjects. DESIGN Cross-sectional study. SETTING Two population-based European cohorts. PARTICIPANTS Middle-aged nondiabetic subjects from the Oxford Biobank (OBB; N = 4327; mean age, 41.4 years) and the Netherlands Epidemiology of Obesity (NEO) study (N = 5899; mean age, 55.6 years). INTERVENTIONS Data on outdoor bright sunlight and temperature collected from local weather stations. MAIN OUTCOME MEASURES Insulin resistance and fasting lipid levels. Multivariable regression analyses were adjusted for age, sex, percentage body fat, season, and either outdoor temperature or bright sunlight. RESULTS In the OBB cohort, increased bright sunlight exposure was associated with lower fasting insulin [-1.27% (95% CI, -2.09 to -0.47%) per extra hour of bright sunlight], lower homeostatic model assessment for insulin resistance (-1.36%; 95% CI, -2.23 to -0.50), lower homeostatic model assessment for β-cell function (-0.80%; 95% CI, -1.31 to -0.30), and lower triglyceride (-1.28%; 95% CI, -2.07 to -0.50) levels. In the NEO cohort generally unidirectional but weaker associations were observed. No associations between outdoor temperature and measures of glucose or lipid metabolism were detected following adjustment for bright sunlight. CONCLUSIONS Bright sunlight, but not outdoor temperature, might be associated with increased insulin sensitivity and lower triglyceride levels.
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Affiliation(s)
- Raymond Noordam
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, Netherlands
| | - Ashna Ramkisoensing
- Department of Molecular Cell Biology, Division of Neurophysiology, Leiden University Medical Center, Leiden, Netherlands
| | - Nellie Y Loh
- Radcliffe Department of Medicine, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford, United Kingdom
| | - Matt J Neville
- Radcliffe Department of Medicine, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford, United Kingdom
- National Institute for Health Research, Oxford Biomedical Research Centre, Oxford, United Kingdom
- Oxford University Hospitals Foundation Trust, Oxford, United Kingdom
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Ko Willems van Dijk
- Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
| | - Diana van Heemst
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, Netherlands
| | - Fredrik Karpe
- Radcliffe Department of Medicine, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford, United Kingdom
- National Institute for Health Research, Oxford Biomedical Research Centre, Oxford, United Kingdom
- Oxford University Hospitals Foundation Trust, Oxford, United Kingdom
| | - Constantinos Christodoulides
- Radcliffe Department of Medicine, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford, United Kingdom
- Oxford University Hospitals Foundation Trust, Oxford, United Kingdom
- Correspondence and Reprint Requests: Constantinos Christodoulides, MD, PhD, Radcliffe Department of Medicine, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Churchill Hospital, Headington OX3 7LE, United Kingdom. E-mail:
| | - Sander Kooijman
- Radcliffe Department of Medicine, Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford, United Kingdom
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands
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48
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Meyer JD, Torres ER, Grabow ML, Zgierska AE, Teng HY, Coe CL, Barrett BP. Benefits of 8-wk Mindfulness-based Stress Reduction or Aerobic Training on Seasonal Declines in Physical Activity. Med Sci Sports Exerc 2019; 50:1850-1858. [PMID: 30113538 PMCID: PMC6130204 DOI: 10.1249/mss.0000000000001636] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Mindfulness-based stress reduction (MBSR) and aerobic exercise training (AET) programs improve health and well-being. Exercise participation has been related to mindfulness and may be altered by MBSR training.
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Affiliation(s)
- Jacob D Meyer
- Department of Kinesiology, Iowa State University, Ames, IA
| | | | - Maggie L Grabow
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, WI
| | - Aleksandra E Zgierska
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, WI
| | - Hao Yang Teng
- Department of Statistics, University of Wisconsin-Madison, Madison, WI
| | - Christopher L Coe
- Department of Psychology, University of Wisconsin-Madison, Madison, WI
| | - Bruce P Barrett
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, WI
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49
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Hamacher D, Liebl D, Hödl C, Heßler V, Kniewasser CK, Thönnessen T, Zech A. Gait Stability and Its Influencing Factors in Older Adults. Front Physiol 2019; 9:1955. [PMID: 30733686 PMCID: PMC6354563 DOI: 10.3389/fphys.2018.01955] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 12/22/2018] [Indexed: 11/29/2022] Open
Abstract
A stable gait pattern is a prerequisite to successfully master various activities of daily living. Furthermore, reduced gait stability is associated with a higher risk of falling. To provide specific intervention strategies to improve gait stability, gaining detailed knowledge of the underlying mechanism and influencing factors is of utmost importance. The effects of relevant influencing factors on gait stability are poorly examined, yet. Therefore, the aim of the current study was to quantify the effects of various influencing factors on gait stability. In a cross-sectional study, we assessed dynamic gait stability and relevant influencing factors in 102 older adults (age >65 years). In addition to dynamic gait stability (largest Lyapunov exponent [LLE] and gait variability measures) during normal over-ground (single-task: ST) and dual-task (DT) walking, we registered the following influencing factors: health status (SF12), pain status (painDETECT, SES), fear of falling (falls efficacy scale), depression (CES-D), cognition performance (Stroop test), physical activity (Freiburger Fragebogen zur körperlichen Aktivität), proprioception (joint position sense), peripheral sensation (mechanical and vibration detection threshold), balance performance (static balance on force plate) and muscular fitness (instrumented sit-to-stand test). We used a principal components regression to link the identified principal components with the gait stability and gait variability responses. The four principal components “strength and gender” (e.g., p = 0.001 for LLE during ST), “physical activity” (e.g., p = 0.006 for LLE during ST), “pain” (e.g., p = 0.030 for LLE during DT) and “peripheral sensation” (e.g., p = 0.002 for LLE during ST) were each significantly associated with at least two of the analyzed gait stability/variability measures. The dimension “balance” was a significant predictor in only one gait measure. While “proprioception” tends to correlate with a gait variability measure, we did not find a dependency of mental health on any gait measure. In conclusion, the participants' ability to recover from small perturbations (as measured with the largest Lyapunov exponent) seems to be related to gender and strength, the amount of physical activity the participants spent every week, peripheral sensation and pain status. Since the explained variance is still rather low, there could be more relevant factors that were not addressed, yet.
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Affiliation(s)
- Daniel Hamacher
- Institute of Sport Science, Friedrich Schiller University of Jena, Jena, Germany
| | - Dominik Liebl
- Department of Statistics, University of Bonn, Bonn, Germany
| | - Claudia Hödl
- Institute of Sport Science, Friedrich Schiller University of Jena, Jena, Germany
| | - Veronika Heßler
- Institute of Sport Science, Friedrich Schiller University of Jena, Jena, Germany
| | | | - Thomas Thönnessen
- Institute of Sport Science, Friedrich Schiller University of Jena, Jena, Germany
| | - Astrid Zech
- Institute of Sport Science, Friedrich Schiller University of Jena, Jena, Germany
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50
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Marzec L, Raghavan S, Banaei-Kashani F, Creasy S, Melanson EL, Lange L, Ghosh D, Rosenberg MA. Device-measured physical activity data for classification of patients with ventricular arrhythmia events: A pilot investigation. PLoS One 2018; 13:e0206153. [PMID: 30372463 PMCID: PMC6205644 DOI: 10.1371/journal.pone.0206153] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 10/07/2018] [Indexed: 12/23/2022] Open
Abstract
Low levels of physical activity are associated with increased mortality risk, especially in cardiac patients, but most studies are based on self-report. Cardiac implantable electronic devices (CIEDs) offer an opportunity to collect data for longer periods of time. However, there is limited agreement on the best approaches for quantification of activity measures due to the time series nature of the data. We examined physical activity time series data from 235 subjects with CIEDs and at least 365 days of uninterrupted measures. Summary statistics for raw daily physical activity (minutes/day), including statistical moments (e.g., mean, standard deviation, skewness, kurtosis), time series regression coefficients, frequency domain components, and forecasted predicted values, were calculated for each individual, and used to predict occurrence of ventricular tachycardia (VT) events as recorded by the device. In unsupervised analyses using principal component analysis, we found that while certain features tended to cluster near each other, most provided a reasonable spread across activity space without a large degree of redundancy. In supervised analyses, we found several features that were associated with the outcome (P < 0.05) in univariable and multivariable approaches, but few were consistent across models. Using a machine-learning approach in which the data was split into training and testing sets, and models ranging in complexity from simple univariable logistic regression to ensemble decision trees were fit, there was no improvement in classification of risk over naïve methods for any approach. Although standard approaches identified summary features of physical activity data that were correlated with risk of VT, machine-learning approaches found that none of these features provided an improvement in classification. Future studies are needed to explore and validate methods for feature extraction and machine learning in classification of VT risk based on device-measured activity.
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Affiliation(s)
- Lucas Marzec
- Individualized Data Analysis Organization, Colorado Center for Personalized Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Division of Cardiology, Kaiser Permanente of Colorado, Lafayette, Colorado, United States of America
| | - Sridharan Raghavan
- Individualized Data Analysis Organization, Colorado Center for Personalized Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Veterans Affairs Eastern Colorado Health Care System, Denver, Colorado, United States of America
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Farnoush Banaei-Kashani
- Individualized Data Analysis Organization, Colorado Center for Personalized Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- College of Engineering and Applied Science, University of Colorado Denver, Denver, Colorado, United States of America
| | - Seth Creasy
- Individualized Data Analysis Organization, Colorado Center for Personalized Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Division of Endocrinology, Diabetes, Metabolism, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Edward L. Melanson
- Individualized Data Analysis Organization, Colorado Center for Personalized Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Division of Endocrinology, Diabetes, Metabolism, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Geriatric Research, Education, and Clinical Center, VA Eastern Colorado Health Care System, Denver, Colorado, United States of America
| | - Leslie Lange
- Individualized Data Analysis Organization, Colorado Center for Personalized Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Debashis Ghosh
- Individualized Data Analysis Organization, Colorado Center for Personalized Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, United States of America
| | - Michael A. Rosenberg
- Individualized Data Analysis Organization, Colorado Center for Personalized Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Division of Cardiac Electrophysiology, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- * E-mail:
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