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Schjerven FE, Ingeström EML, Steinsland I, Lindseth F. Development of risk models of incident hypertension using machine learning on the HUNT study data. Sci Rep 2024; 14:5609. [PMID: 38454041 PMCID: PMC10920790 DOI: 10.1038/s41598-024-56170-7] [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: 11/09/2023] [Accepted: 03/03/2024] [Indexed: 03/09/2024] Open
Abstract
In this study, we aimed to create an 11-year hypertension risk prediction model using data from the Trøndelag Health (HUNT) Study in Norway, involving 17 852 individuals (20-85 years; 38% male; 24% incidence rate) with blood pressure (BP) below the hypertension threshold at baseline (1995-1997). We assessed 18 clinical, behavioral, and socioeconomic features, employing machine learning models such as eXtreme Gradient Boosting (XGBoost), Elastic regression, K-Nearest Neighbor, Support Vector Machines (SVM) and Random Forest. For comparison, we used logistic regression and a decision rule as reference models and validated six external models, with focus on the Framingham risk model. The top-performing models consistently included XGBoost, Elastic regression and SVM. These models efficiently identified hypertension risk, even among individuals with optimal baseline BP (< 120/80 mmHg), although improvement over reference models was modest. The recalibrated Framingham risk model outperformed the reference models, approaching the best-performing ML models. Important features included age, systolic and diastolic BP, body mass index, height, and family history of hypertension. In conclusion, our study demonstrated that linear effects sufficed for a well-performing model. The best models efficiently predicted hypertension risk, even among those with optimal or normal baseline BP, using few features. The recalibrated Framingham risk model proved effective in our cohort.
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Affiliation(s)
- Filip Emil Schjerven
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Emma Maria Lovisa Ingeström
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ingelin Steinsland
- Department of Mathematical Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Frank Lindseth
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
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Ding L, Ponzano M, Grotta A, Adami HO, Xue F, Lagerros YT, Bellocco R, Ye W. Ideal cardiovascular health and risk of death in a large Swedish cohort. BMC Public Health 2024; 24:358. [PMID: 38308327 PMCID: PMC10837860 DOI: 10.1186/s12889-024-17885-4] [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: 12/04/2022] [Accepted: 01/25/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Ideal cardiovascular health (CVH) can be assessed by 7 metrics: smoking, body mass index, physical activity, diet, hypertension, dyslipidemia and diabetes, proposed by the American Heart Association. We examined the association of ideal CVH metrics with risk of all-cause, CVD and non-CVD death in a large cohort. METHODS A total of 29,557 participants in the Swedish National March Cohort were included in this study. We ascertained 3,799 deaths during a median follow-up of 19 years. Cox regression models were used to estimate hazard ratios with 95% confidence intervals (95% CIs) of the association between CVH metrics with risk of death. Laplace regression was used to estimate 25th, 50th and 75th percentiles of age at death. RESULTS Compared with those having 6-7 ideal CVH metrics, participants with 0-2 ideal metrics had 107% (95% CI = 46-192%) excess risk of all-cause, 224% (95% CI = 72-509%) excess risk of CVD and 108% (31-231%) excess risk of non-CVD death. The median age at death among those with 6-7 vs. 0-2 ideal metrics was extended by 4.2 years for all-causes, 5.8 years for CVD and 2.9 years for non-CVD, respectively. The observed associations were stronger among females than males. CONCLUSIONS The strong inverse association between number of ideal CVH metrics and risk of death supports the application of the proposed seven metrics for individual risk assessment and general health promotion.
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Affiliation(s)
- Lijie Ding
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, Stockholm, SE17177, Sweden
- Department of Health Management, Shandong Sports University, Jinan, China
| | - Marta Ponzano
- Department of Health Sciences, University of Genoa, Genoa, Italy
- Department of Statistics and Quantitative Methods, University of Milano, Bicocca, Italy
| | - Alessandra Grotta
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, Stockholm, SE17177, Sweden
- Clinical Effectiveness Group, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Ylva Trolle Lagerros
- Unit of Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
| | - Rino Bellocco
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, Stockholm, SE17177, Sweden
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, Stockholm, SE17177, Sweden.
- Department of Epidemiology and Health Statistics & Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.
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Manskow US, Sagelv EH, Antypas K, Zanaboni P. Adoption, acceptability and sustained use of digital interventions to promote physical activity among inactive adults: a mixed-method study. Front Public Health 2024; 11:1297844. [PMID: 38239801 PMCID: PMC10794730 DOI: 10.3389/fpubh.2023.1297844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/12/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Despite the positive effects of physical activity (PA) to prevent lifestyle diseases and improve health and well-being, only one-third of Norwegian adults meet the minimum recommendations on PA. Digital interventions to promote PA in inactive adults may improve health and well-being by being available, personalized and adequate. Knowledge on users' adoption, acceptability and sustainability of digital interventions to promote PA is still limited. Objective To investigate the adoption, acceptability and sustained use of three digital interventions for promoting PA among inactive adults. Design A randomized control trial (ONWARDS) with 183 participants assigned to 3 groups and followed up for 18 months. All participants received a wearable activity tracker with the personalized metric Personal Activity Intelligence (PAI) on a mobile app, two groups received additional access to online training and one group had also access to online social support. Methods A mixed-methods approach was used to address the study objective. Acceptability was evaluated through the System Usability Scale (SUS) (n = 134) at 6 months. Adoption and sustained use were evaluated through a set of questions administered at 12 months (n = 109). Individual interviews were performed at 6 months with a sample of participants (n = 18). Quantitative data were analyzed with descriptive statistics, whereas qualitative data were analyzed using the Framework approach. Results PAI was the most successful intervention, with satisfactory usability and positive effects on motivation and behavior change, contributing to high adoption and sustained use. Online social support had a high acceptability and sustained use, but the intervention was not perceived as motivational to increase PA. Online training had low adoption, usability and sustained use. The qualitative interviews identified five main themes: (1) overall approach to physical activity, (2) motivation, (3) barriers to perform PA, (4) effects of PA, and (5) usability and acceptability of the digital interventions. Conclusion Personalized digital interventions integrating behavior change techniques such as individual feedback and goal setting are more likely to increase acceptability, adoption and sustained use. Future studies should investigate which digital interventions or combinations of different interventions are more successful in promoting PA among inactive adults according to the characteristics and preferences of the users. Trial registration Clinical trial registered at ClinicalTrials.gov: NCT04526444.
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Affiliation(s)
- Unn S. Manskow
- Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway
- Department of Health and Care Sciences, Faculty of Health Sciences, The Arctic University of Norway UiT, Tromsø, Norway
| | - Edvard H. Sagelv
- Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Konstantinos Antypas
- Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway
- SINTEF Digital, Oslo, Norway
| | - Paolo Zanaboni
- Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Khaled A, Ahmed E, Mamdouh M, Saad H, Mohamed A, Sobhy M, Piatti D, Sabry M, Saad MA, Sabry OM, Caprioli G. Natural angiotensin converting enzyme inhibitors: A safeguard against hypertension, respiratory distress syndrome, and chronic kidney diseases. Phytother Res 2023; 37:5464-5472. [PMID: 37675925 DOI: 10.1002/ptr.7987] [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: 02/28/2023] [Revised: 08/05/2023] [Accepted: 08/08/2023] [Indexed: 09/08/2023]
Abstract
Hypertension is a serious concern as it is one of the causes of kideny failure and pulmonary fibrosis. An important therapeutic strategy for treating chronic hypertension is to inhibit the angiotensin converting enzyme (ACE). ACE inhibition reduces kidney damage, pulmonary artery pressure, and high blood pressure. Due to their high efficacy and low risk of side effects, natural renin-angiotensin system inhibitors have drawn increasing attention over the past decades. Alkaloids, amino acids, anthocyanidins, flavonoids, glucosinolates, isoflavonoids, phenolic acids, polyphenolics, and triterpenoids are among the bioactive metabolites pocessing an impressive ACE inhibitory activity. Many herbs including Rosmarinus officinalis, Hibiscus sabdariffa, Curcuma longa, Rauwolfia serpentina, Emblica officinalis, Cynara scolymus, Punica granatum, Mucuna pruriens, Capsicum annuum, and Moringa olifera were found having ACE inhibitory activities comparable to captopril and enalpril. These enticing natural ACE inhibitors deserve to be a safeguard medicine against hypertension, respiratory distress syndrome, and chronic kidney diseases. More clinical trials are required before new natural compounds and herbs can be used to treat chronic hypertension and its ramifications, such as respiratory distress syndrome and kidney failure.
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Affiliation(s)
- Aya Khaled
- Pharmacognosy Department, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
| | - Esraa Ahmed
- Pharmacognosy Department, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
| | - Mohamed Mamdouh
- Pharmacognosy Department, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
| | - Hager Saad
- Pharmacognosy Department, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
| | - Aya Mohamed
- Pharmacognosy Department, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
| | - Marina Sobhy
- Pharmacognosy Department, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
| | - Diletta Piatti
- School of Pharmacy, University of Camerino, Camerino, Italy
| | - Miral Sabry
- Pharmacognosy Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Muhammed A Saad
- Pharmacognosy Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
- Department of Pharmaceutical Sciences, College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Omar M Sabry
- Pharmacognosy Department, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
- Pharmacognosy Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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Bjørdalsbakke NL, Sturdy J, Ingeström EML, Hellevik LR. Monitoring variability in parameter estimates for lumped parameter models of the systemic circulation using longitudinal hemodynamic measurements. Biomed Eng Online 2023; 22:34. [PMID: 37055807 PMCID: PMC10099701 DOI: 10.1186/s12938-023-01086-y] [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: 08/16/2022] [Accepted: 02/23/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND Physics-based cardiovascular models are only recently being considered for disease diagnosis or prognosis in clinical settings. These models depend on parameters representing the physical and physiological properties of the modeled system. Personalizing these parameters may give insight into the specific state of the individual and etiology of disease. We applied a relatively fast model optimization scheme based on common local optimization methods to two model formulations of the left ventricle and systemic circulation. One closed-loop model and one open-loop model were applied. Intermittently collected hemodynamic data from an exercise motivation study were used to personalize these models for data from 25 participants. The hemodynamic data were collected for each participant at the start, middle and end of the trial. We constructed two data sets for the participants, both consisting of systolic and diastolic brachial pressure, stroke volume, and left-ventricular outflow tract velocity traces paired with either the finger arterial pressure waveform or the carotid pressure waveform. RESULTS We examined the feasibility of separating parameter estimates for the individual from population estimates by assessing the variability of estimates using the interquartile range. We found that the estimated parameter values were similar for the two model formulations, but that the systemic arterial compliance was significantly different ([Formula: see text]) depending on choice of pressure waveform. The estimates of systemic arterial compliance were on average higher when using the finger artery pressure waveform as compared to the carotid waveform. CONCLUSIONS We found that for the majority of participants, the variability of parameter estimates for a given participant on any measurement day was lower than the variability both across all measurement days combined for one participant, and for the population. This indicates that it is possible to identify individuals from the population, and that we can distinguish different measurement days for the individual participant by parameter values using the presented optimization method.
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Affiliation(s)
- Nikolai L Bjørdalsbakke
- Department of Structural Engineering, Norwegian University of Science and Technology (NTNU), Richard Birkelandsvei 1a, Trondheim, Norway.
| | - Jacob Sturdy
- Department of Structural Engineering, Norwegian University of Science and Technology (NTNU), Richard Birkelandsvei 1a, Trondheim, Norway
| | - Emma M L Ingeström
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Prinsesse Kristinas gt. 3, Trondheim, Norway
| | - Leif R Hellevik
- Department of Structural Engineering, Norwegian University of Science and Technology (NTNU), Richard Birkelandsvei 1a, Trondheim, Norway
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Zanaboni P, Manskow US, Sagelv EH, Morseth B, Edvardsen AE, Aamot IL, Nes BM, Hastings B, Gagnon MP, Antypas K. Digital interventions to promote physical activity among inactive adults: A study protocol for a hybrid type I effectiveness-implementation randomized controlled trial. Front Public Health 2022; 10:925484. [PMID: 36339169 PMCID: PMC9634084 DOI: 10.3389/fpubh.2022.925484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 10/07/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction Physical inactivity is the fourth leading risk factor for global mortality, and inactive adults have a higher risk to develop lifestyle diseases. To date, there is preliminary evidence of the efficacy of fitness technologies and other digital interventions for physical activity (PA) promotion. Intervention studies are needed to test the effectiveness and implementation of innovative PA promotion strategies. Methods and analysis The ONWARDS study is a hybrid type I effectiveness-implementation randomized control trial aiming at an inactive and presumably high-risk population living in Northern Norway. One hundred and eighty participants will be assigned to 3 groups in a 1:1:1 ratio and participate for 18 months. Participants in group A will be provided an activity tracker with the personalized metric Personal Activity Intelligence (PAI). Participants in group B will be provided with both an activity tracker with the personalized metric PAI and access to online training videos (Les Mills+) to perform home-based training. Participants in group C will be provided an activity tracker with the personalized metric PAI, home-based online training and additional peer support via social media. The primary objective is to test which combination of interventions is more effective in increasing PA levels and sustaining long-term exercise adherence. Secondary objectives include: proportion of participants reaching PA recommendations; exercise adherence; physical fitness; cardiovascular risk; quality of life; perceived competence for exercise; self-efficacy; social support; usability; users' perspectives on implementation outcomes (adoption, acceptability, adherence, sustainability). The study design will allow testing the effectiveness of the interventions while gathering information on implementation in a real-world situation. Discussion This study can contribute to reduce disparities in PA levels among inactive adults by promoting PA and long-term adherence. Increased PA might, in turn, result in better prevention of lifestyle diseases. Digital interventions delivered at home can become an alternative to training facilities, making PA accessible and feasible for inactive populations and overcoming known barriers to PA. If effective, such interventions could potentially be offered through national health portals to citizens who do not meet the minimum recommendations on PA or prescribed by general practitioners or specialists. Trial registration https://clinicaltrials.gov/ct2/show/NCT04526444, Registered 23 April 2021, identifier: NCT04526444.
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Affiliation(s)
- Paolo Zanaboni
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway,Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway,*Correspondence: Paolo Zanaboni
| | - Unn Sollid Manskow
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Edvard Hamnvik Sagelv
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway,School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Inger-Lise Aamot
- Norwegian National Advisory Unit on Exercise Training as Medicine for Cardiopulmonary Condition, St. Olavs Hospital, Trondheim, Norway,K.G. Jebsen Center for Exercise in Medicine - CERG, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bjarne Martens Nes
- K.G. Jebsen Center for Exercise in Medicine - CERG, Norwegian University of Science and Technology, Trondheim, Norway
| | | | | | - Konstantinos Antypas
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway,SINTEF Digital, Oslo, Norway
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Tari AR, Selbæk G, Franklin BA, Bergh S, Skjellegrind H, Sallis RE, Bosnes I, Stordal E, Ziaei M, Lydersen S, Kobro-Flatmoen A, Huuha AM, Nauman J, Wisløff U. Temporal changes in personal activity intelligence and the risk of incident dementia and dementia related mortality: A prospective cohort study (HUNT). EClinicalMedicine 2022; 52:101607. [PMID: 36034407 PMCID: PMC9403490 DOI: 10.1016/j.eclinm.2022.101607] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND The Personal Activity Intelligence (PAI) translates heart rate during daily activity into a weekly score. Obtaining a weekly PAI score ≥100 is associated with reduced risk of premature morbidity and mortality from cardiovascular diseases. Here, we determined whether changes in PAI score are associated with changes in risk of incident dementia and dementia-related mortality. METHODS We conducted a prospective cohort study of 29,826 healthy individuals. Using data from the Trøndelag Health-Study (HUNT), PAI was estimated 10 years apart (HUNT1 1984-86 and HUNT2 1995-97). Adjusted hazard-ratios (aHR) and 95%-confidence intervals (CI) for incidence of and death from dementia were related to changes in PAI using Cox regression analyses. FINDINGS During a median follow-up time of 24.5 years (interquartile range [IQR]: 24.1-25.0) for dementia incidence and 23.6 years (IQR: 20.8-24.2) for dementia-related mortality, there were 1998 incident cases and 1033 dementia-related deaths. Individuals who increased their PAI score over time or maintained a high PAI score at both assessments had reduced risk of dementia incidence and dementia-related mortality. Compared with persistently inactive individuals (0 weekly PAI) at both time points, the aHRs for those with a PAI score ≥100 at both occasions were 0.75 (95% CI: 0.58-0.97) for incident dementia, and 0.62 (95% CI: 0.43-0.91) for dementia-related mortality. Using PAI score <100 at both assessments as the reference cohort, those who increased from <100 at HUNT1 to ≥100 at HUNT2 had aHR of 0.83 (95% CI: 0.72-0.96) for incident dementia, and gained 2.8 (95% CI: 1.3-4.2, P<0.0001) dementia-free years. For dementia-related mortality, the corresponding aHR was 0.74 (95% CI: 0.59-0.92) and years of life gained were 2.4 (95% CI: 1.0-3.8, P=0.001). INTERPRETATION Maintaining a high weekly PAI score and increases in PAI scores over time were associated with a reduced risk of incident dementia and dementia-related mortality. Our findings extend the scientific evidence regarding the protective role of PA for dementia prevention, and suggest that PAI may be a valuable tool in guiding research-based PA recommendations. FUNDING The Norwegian Research Council, the Liaison Committee between the Central Norway Regional Health Authority and Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
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Affiliation(s)
- Atefe R. Tari
- Cardiac Exercise Research Group at Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Neurology, St. Olav's Hospital, Trondheim, Norway
| | - Geir Selbæk
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Barry A. Franklin
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA
- Preventive Cardiology and Cardiac Rehabilitation, William Beaumont Hospital, Royal Oak, MI, USA
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Sverre Bergh
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Håvard Skjellegrind
- Department of Public Health and Nursing, HUNT Research Centre, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Robert E. Sallis
- Department of Family Medicine, Kaiser Permanente Medical Center, Fontana, CA, USA
| | - Ingunn Bosnes
- Clinic for Mental Health and Substance Abuse, Namsos Hospital, Nord-Trøndelag Hospital Trust, Namsos, Norway
- Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Eystein Stordal
- Clinic for Mental Health and Substance Abuse, Namsos Hospital, Nord-Trøndelag Hospital Trust, Namsos, Norway
- Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Maryam Ziaei
- Kavli Institute for Systems Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
- Jebsen Centre for Alzheimer's Diseases, Norwegian University of Science and Technology, Trondheim, Norway
- Queensland Brain Institute, University of Queensland, Brisbane, Australia
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway
| | - Asgeir Kobro-Flatmoen
- Kavli Institute for Systems Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
- Jebsen Centre for Alzheimer's Diseases, Norwegian University of Science and Technology, Trondheim, Norway
| | - Aleksi M. Huuha
- Cardiac Exercise Research Group at Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Neurology, St. Olav's Hospital, Trondheim, Norway
| | - Javaid Nauman
- Cardiac Exercise Research Group at Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Ulrik Wisløff
- Cardiac Exercise Research Group at Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA
- School of Human Movement & Nutrition Sciences, University of Queensland, Australia
- Corresponding author at: Cardiac Exercise Research Group at the Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim 7491, Norway.
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Tari AR, Berg HH, Videm V, Bråthen G, White LR, Røsbjørgen RN, Scheffler K, Dalen H, Holte E, Haberg AK, Selbaek G, Lydersen S, Duezel E, Bergh S, Logan-Halvorsrud KR, Sando SB, Wisløff U. Safety and efficacy of plasma transfusion from exercise-trained donors in patients with early Alzheimer's disease: protocol for the ExPlas study. BMJ Open 2022; 12:e056964. [PMID: 36538409 PMCID: PMC9453994 DOI: 10.1136/bmjopen-2021-056964] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Given that exercise training reduces the risk of developing Alzheimer's disease (AD), induces changes in the blood composition and has widespread systemic benefits, it is reasonable to hypothesise that exercised plasma (ExPlas) may have rejuvenative properties. The main objective is to test safety and tolerability of transfusing ExPlas from young, healthy, fit adults to patients with mild cognitive impairment (MCI) or early AD. The study is a pilot for a future efficacy study. The key secondary objectives are examining the effect of plasma transfusions on cognitive function, fitness level, vascular risk profile, assessment of cerebral blood flow and hippocampal volume, quality of life, functional connectivity assessed by resting state functional MRI and biomarkers in blood and cerebrospinal fluid. METHODS AND ANALYSIS ExPlas is a double-blinded, randomised controlled clinical single-centre trial. Patients up to 75 years of age with diagnosis early symptomatic phase AD will be recruited from two Norwegian hospitals. ExPlas is plasma drawn by plasmapheresis once a month for 4 months, from a total of 30 fit male donors (aged 18-40, BMI≤27 kg/m2 and maximal oxygen uptake>55 mL/kg/min). All units will be virus inactivated by the Intercept method in accordance with procedures at St. Olavs University Hospital. Comparison with isotonic saline allows differentiation from a non-blood product. The main study consists of 6 rounds of examinations in addition to 12 plasma transfusions divided over three 4-week periods during study year-1. It is also planned to conduct follow-up examinations 2 and 5 years after baseline ETHICS AND DISSEMINATION: Written informed consent will be obtained from all participants and participation is voluntary. All participants have a next of kin who will follow them throughout the study to represent the patient's interest. The study is approved by the Regional Committee for Medical and Health Research Ethics (REK 2018/702) and the Norwegian Medicines Agency (EudraCT No. 2018-000148-24). The study will be published in an open access journal and results will be presented at numerous national and international meetings as well as on social media platforms. TRIAL REGISTRATION NUMBER EudraCT No. 2018-000148-24. CLINICALTRIALS gov, NCT05068830.
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Affiliation(s)
- Atefe R Tari
- Cardiac Exercise Research Group at the Department of Circulation and Medical Imaging, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olavs University Hospital, Trondheim, Norway
| | - Helene Haugen Berg
- Cardiac Exercise Research Group at the Department of Circulation and Medical Imaging, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olavs University Hospital, Trondheim, Norway
| | - Vibeke Videm
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Immunology and Transfusion Medicine, St Olavs University Hosptial, Trondheim, Norway
| | - Geir Bråthen
- Department of Neurology and Clinical Neurophysiology, St. Olavs University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Linda R White
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ragnhild Nyhus Røsbjørgen
- Cardiac Exercise Research Group at the Department of Circulation and Medical Imaging, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Trondheim, Norway
| | - Katja Scheffler
- Department of Neurology and Clinical Neurophysiology, St. Olavs University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Havard Dalen
- Cardiac Exercise Research Group at the Department of Circulation and Medical Imaging, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Trondheim, Norway
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway
| | - Espen Holte
- Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway
| | - Asta K Haberg
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway
| | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital-Ullevål, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Stian Lydersen
- Department of Mental Health, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway
| | - Emrah Duezel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany
| | - Sverre Bergh
- Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | | | - Sigrid Botne Sando
- Department of Neurology and Clinical Neurophysiology, St. Olavs University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ulrik Wisløff
- Cardiac Exercise Research Group at the Department of Circulation and Medical Imaging, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Trondheim, Norway
- School of Human Movement and Nutrition Science, University of Queensland, Queensland, Australia
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9
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Quantile Differences in the Age-Related Decline in Cardiorespiratory Fitness Between Sexes in Adults Without Type 2 Diabetes Mellitus in the United States. Mayo Clin Proc Innov Qual Outcomes 2022; 6:302-310. [PMID: 35769223 PMCID: PMC9234339 DOI: 10.1016/j.mayocpiqo.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To comprehensively assess the extent to which the decline in cardiorespiratory fitness (CRF) with age differs between sexes. Participants and Methods This study used data from the Aerobics Center Longitudinal Study, conducted between September 1974 and August 2006, consisting primarily of White adults from middle-to-upper socioeconomic strata restricted to adults without type 2 diabetes mellitus (33,742 men and 9,415 women). Quantile regression models were used to estimate the differences in age-associated changes in CRF between the sexes, estimated using a maximal treadmill test. Results For adults aged up to 45 years, significant differences in slopes relating to age and CRF between men and women were observed for all adjusted percentiles of CRF other than the 90th percentile; women reported significantly greater declines in CRF per year. For those aged 45-60 years and those older than 60 years, no significant differences in age-related declines in CRF were observed between the sexes. Conclusion This study found that compared with men, the onset of decline in CRF was found to occur earlier and at lower CRF percentiles in women. This is of particular concern, given that compared with men, women already tend to have lower CRF levels. These findings suggest that maintaining the levels of physical activity sufficient to maintain moderate-to-high levels of fitness is particularly important for women earlier during adulthood.
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Kim J, Yang PS, Park BE, Kang TS, Lim SH, Cho S, Lee SY, Chung YH, Lee MY, Kim D, Joung B. Association of Light-Intensity Physical Activity With Mortality in the Older Population: A Nationwide Cohort Study. Front Cardiovasc Med 2022; 9:859277. [PMID: 35528831 PMCID: PMC9072650 DOI: 10.3389/fcvm.2022.859277] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/29/2022] [Indexed: 12/19/2022] Open
Abstract
BackgroundThere is a paucity of information about mortality related to light-intensity physical activity (LPA) in the older population. We examine the associations between physical activity and mortality, focusing on the effect of light-intensity physical activity and the dose-response relationship between physical activity and mortality.MethodsWe analyzed a total of 58,537 participants aged ≥ 65 years (mean age, 73.9 ± 5.8 years; male, 36.0%) in the Korean National Health Insurance Service database between 2009 and 2012. The Date of the end of follow-up was December 31, 2013. Individuals were divided into four categories according to physical activity intensity: totally sedentary (43.3%), LPA only (35.8%), LPA and moderate- to vigorous-intensity physical activity (MVPA) (16.3%), MVPA only (4.5%). Physical activity was quantified using standardized self-reported questionnaires which composed of the duration and frequency of physical activity.ResultsDuring a mean follow-up of 39.6 ± 14.0 months, 5,651 (9.7%) deaths occurred. Compared with totally sedentary individuals, those in the LPA only, LPA and MVPA, and MVPA only groups showed 26% [hazard ratio (HR) 0.74, 95% confidence interval (CI) 0.68–0.82], 27% (HR 0.73, 95% CI 0.63–0.84), and 34% (HR 0.66, 95% CI 0.54–0.79) lower all-cause mortality risk, showing an inverse relationship between physical activity intensity and mortality risk. In contrast, the LPA only, LPA and MVPA, and MVPA only groups represented a stronger inverse association with CV mortality (LPA: HR 0.76, 95% CI 0.62–0.92; LPA with MVPA: HR 0.74, 95% CI 0.55–0.999; MVPA, HR 0.57, 95% CI 0.37–0.87). Among participants performing LPA alone, participants performing less than the recommended dose of physical activity had lower all-cause mortality than those with sedentary activity (1–249 MET-min/week: HR 0.74, 95% CI 0.67–0.82, 250–499 MET-min/week: HR 0.65, 95% CI 0.59–0.72).ConclusionPhysical activity, even low doses of LPA, was associated with reduced mortality risk in the elderly population. This study may motivate sedentary individuals to engage in any physical activity for mortality benefits.
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Affiliation(s)
- Juntae Kim
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, Cheonan-si, South Korea
| | - Pil-Sung Yang
- Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam-si, South Korea
| | - Byoung-Eun Park
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, Cheonan-si, South Korea
| | - Tae Soo Kang
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, Cheonan-si, South Korea
| | - Seong-Hoon Lim
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, Cheonan-si, South Korea
| | - Sungsoo Cho
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, Cheonan-si, South Korea
| | - Su-Yeon Lee
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, Cheonan-si, South Korea
| | - Young Hak Chung
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, Cheonan-si, South Korea
| | - Myung-Yong Lee
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, Cheonan-si, South Korea
| | - Dongmin Kim
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, Cheonan-si, South Korea
| | - Boyoung Joung
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
- *Correspondence: Boyoung Joung,
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11
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Nauman J, Franklin BA, Nes BM, Sallis RE, Sawada SS, Marinović J, Stensvold D, Lavie CJ, Tari AR, Wisløff U. Association Between Personal Activity Intelligence and Mortality: Population-Based China Kadoorie Biobank Study. Mayo Clin Proc 2022; 97:668-681. [PMID: 34865822 DOI: 10.1016/j.mayocp.2021.10.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/02/2021] [Accepted: 10/14/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To prospectively investigate the association between personal activity intelligence (PAI) - a novel metabolic metric which translates heart rate during physical activity into a simple weekly score - and mortality in relatively healthy participants in China whose levels and patterns of physical activity in addition to other lifestyle factors are different from those in high-income countries. PATIENTS AND METHODS From the population-based China Kadoorie Biobank study, 443,792 healthy adults were recruited between June 2004 and July 2008. Participant's weekly PAI score was estimated and divided into four groups (PAI scores of 0, ≤50, 51-99, or ≥100). Using Cox proportional hazard analyses, we calculated adjusted hazard ratios (AHRs) for cardiovascular disease (CVD) and all-cause mortality related to PAI scores. RESULTS During a median follow-up of 8.2 (interquartile range, 7.3 to 9.1) years, there were 21,901 deaths, including 9466 CVD deaths. Compared with the inactive group (0 PAI score), a baseline weekly PAI score greater than or equal to 100 was associated with a lower risk of CVD mortality, an AHR of 0.87 (95% CI, 0.81 to 0.94) in men, and an AHR of 0.84 (95% CI, 0.78 to 0.92) in women, after adjusting for multiple confounders. Participants with a weekly PAI score greater than or equal to 100 also had a lower risk of all-cause mortality (AHR, 0.93; 95% CI, 0.89 to 0.97 in men, and AHR, 0.93; 95%, 0.88 to 0.98 in women). Moreover, this subgroup gained 2.7 (95% CI, 2.4 to 3.0) years of life, compared with the inactive cohort. CONCLUSION Among relatively healthy Chinese adults, the PAI metric was inversely associated with CVD and all-cause mortality, highlighting the generalizability of the score in different races, ethnicities, and socioeconomic strata.
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Affiliation(s)
- Javaid Nauman
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates; Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA.
| | - Barry A Franklin
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Preventive Cardiology and Cardiac Rehabilitation, William Beaumont Hospital, Royal Oak, MI, and Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Bjarne M Nes
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Clinic of Cardiology, St Olav's Hospital, Trondheim, Norway
| | - Robert E Sallis
- Department of Family Medicine, Kaiser Permanente Medical Center, Fontana, CA, USA
| | - Susumu S Sawada
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Jasna Marinović
- Department of Physiology, University of Split School of Medicine, Split, Croatia
| | - Dorthe Stensvold
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA
| | - Carl J Lavie
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School - University of Queensland School of Medicine, New Orleans, LA, USA
| | - Atefe R Tari
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neurology, St Olav's Hospital, Trondheim, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; School of Human Movement & Nutrition Sciences, University of Queensland, Australia
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12
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Xiao L. Influence of Healthy Physical Fitness on the Teaching of Aerobics Course Based on Big Data Mining Technology. Appl Bionics Biomech 2021; 2021:9755214. [PMID: 34976115 PMCID: PMC8716231 DOI: 10.1155/2021/9755214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/05/2021] [Accepted: 11/19/2021] [Indexed: 11/18/2022] Open
Abstract
Healthy physical fitness is one of the hot topics discussed by scholars at home and abroad in recent years, and it is a key indicator for evaluating students' physical function and body shape. Aerobics, also known as bodybuilding, means that the body and health of students should have a better promotion effect, but in reality, many students found that after elective aerobics, body shape and health level basically did not improve, which is related to the setting of aerobics courses, especially the lack of physical training. Aerobics and other sports have common requirements in physical training, such as strength quality, speed quality, endurance quality, agility quality, and flexibility quality. This article is aimed at studying the impact of healthy physical fitness based on big data mining technology on the teaching of aerobics. On the basis of analyzing the process of data mining, the composition of healthy physical fitness, and the role of aerobics, it is used to test students in a certain university through experimental methods and statistical methods. Carry out aerobics teaching experiment, and compare and analyze the data measured by the experimental samples. The experimental results show that the use of healthy physical fitness in aerobics teaching can effectively promote the learning and improvement of aerobics skills.
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13
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Schnohr P, O'Keefe JH, Lavie CJ, Holtermann A, Lange P, Jensen GB, Marott JL. U-Shaped Association Between Duration of Sports Activities and Mortality: Copenhagen City Heart Study. Mayo Clin Proc 2021; 96:3012-3020. [PMID: 34412854 DOI: 10.1016/j.mayocp.2021.05.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/16/2021] [Accepted: 05/27/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the association between the duration of weekly leisure-time sports activity and all-cause mortality. METHODS As part of the prospective Copenhagen City Heart Study, 8697 healthy adults completed a comprehensive questionnaire about leisure-time sports activities. Duration (minutes per week) of leisure-time sports activities was recorded for tennis, badminton, soccer, handball, cycling, swimming, jogging, calisthenics, health club activities, weightlifting, and other sports. The primary end point was all-cause mortality, and the median follow-up was 25.6 years. The association between duration of leisure-time sports activities and all-cause mortality was studied using multivariable Cox proportional hazards regression analysis. RESULTS Compared with the reference group of 2.6 to 4.5 hours of weekly leisure-time sports activities, we found an increased risk for all-cause mortality for those with 0 hours (hazard ratio [HR], 1.51; 95% CI, 1.29 to 1.76), for those with 0.1 to 2.5 hours (HR, 1.24; 95% CI, 1.05 to 1.46), and for those with more than 10 hours (HR, 1.18; 95% CI, 1.00 to 1.39) of weekly leisure-time sports activities. These relationships were generally consistent with additional adjustments for potential confounders among subgroups of age, sex, education, smoking, alcohol intake, and body mass index, when the first 5 years of follow-up were excluded, and for cardiovascular disease mortality. CONCLUSION We observed a U-shaped association between weekly duration of leisure sports activities and cardiovascular and all-cause mortality, with lowest risk for those participating in 2.6 to 4.5 weekly hours, being consistent across subgroups. Participation in sport activities should be promoted, but the potential risk of very high weekly hours of sport participation should be considered for inclusion in guidelines and recommendations.
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Affiliation(s)
- Peter Schnohr
- Copenhagen City Heart Study, Copenhagen University Hospital-Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.
| | - James H O'Keefe
- Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Peter Lange
- Copenhagen City Heart Study, Copenhagen University Hospital-Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark; Medical Department, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
| | - Gorm Boje Jensen
- Copenhagen City Heart Study, Copenhagen University Hospital-Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Jacob Louis Marott
- Copenhagen City Heart Study, Copenhagen University Hospital-Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
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14
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Sheng M, Yang J, Bao M, Chen T, Cai R, Zhang N, Chen H, Liu M, Wu X, Zhang B, Liu Y, Chao J. The relationships between step count and all-cause mortality and cardiovascular events: A dose-response meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:620-628. [PMID: 34547483 PMCID: PMC8724621 DOI: 10.1016/j.jshs.2021.09.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/01/2021] [Accepted: 07/21/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND A goal of 10,000 steps per day is widely advocated, but there is little evidence to support that goal. Our purpose was to examine the dose-response relationships between step count and all-cause mortality and cardiovascular disease risk. METHODS Cochrane Central Register of Controlled Trials, EMBASE, OVID, PubMed, Scopus, and Web of Science databases were systematically searched for studies published before July 9, 2021, that evaluated the association between daily steps and at least 1 outcome. RESULTS Sixteen publications (12 related to all-cause mortality, 5 related to cardiovascular disease; and 1 article contained 2 outcomes: both all-cause death and cardiovascular events) were eligible for inclusion in the meta-analysis. There was evidence of a nonlinear dose-response relationship between step count and risk of all-cause mortality or cardiovascular disease (p = 0.002 and p = 0.014 for nonlinearity, respectively). When we restricted the analyses to accelerometer-based studies, the third quartile had a 40.36% lower risk of all-cause mortality and a 35.05% lower risk of cardiovascular event than the first quartile (all-cause mortality: Q1 = 4183 steps/day, Q3 = 8959 steps/day; cardiovascular event: Q1 = 3500 steps/day, Q3 = 9500 steps/day; respectively). CONCLUSION Our meta-analysis suggests inverse associations between higher step count and risk of premature death and cardiovascular events in middle-aged and older adults, with nonlinear dose-response patterns.
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Affiliation(s)
- Mingxin Sheng
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing 210009, China
| | - Junyue Yang
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing 210009, China
| | - Min Bao
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing 210009, China
| | - Tianzhi Chen
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
| | - Ruixue Cai
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing 210009, China
| | - Na Zhang
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing 210009, China
| | - Hongling Chen
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing 210009, China
| | - Minqi Liu
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing 210009, China
| | - Xueyu Wu
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing 210009, China
| | - Bowen Zhang
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing 210009, China
| | - Yiting Liu
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing 210009, China
| | - Jianqian Chao
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing 210009, China.
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15
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Hannan AL, Hing W, Coombes JS, Gough S, Climstein M, Adsett G, Jayasinghe R, Furness J. Effect of personal activity intelligence (PAI) monitoring in the maintenance phase of cardiac rehabilitation: a mixed methods evaluation. BMC Sports Sci Med Rehabil 2021; 13:124. [PMID: 34629086 PMCID: PMC8503999 DOI: 10.1186/s13102-021-00350-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 09/27/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Personal activity intelligence (PAI) is a single physical activity metric based upon heart rate responses to physical activity. Maintaining 100 PAI/week is associated with a 25% risk reduction in cardiovascular disease mortality and 50 PAI/week provides 60% of the benefits. The effect of utilising this metric within a cardiac population has not been previously investigated. The aim of this study was to determine the effect of PAI monitoring on the amount and/or intensity of physical activity for people in the maintenance phase of cardiac rehabilitation and to explore participants' perceptions of this approach. METHODS A concurrent mixed methods approach was undertaken. Participants in the maintenance phase of cardiac rehabilitation monitored PAI for six weeks via a wearable physical activity monitoring device (WPAM). In the first three weeks participants were blinded to their PAI score. A quality-of-life questionnaire (EQ-5D-5L) was completed, and semi-structured interviews conducted to investigate attitudes to PAI monitoring. Daily PAI data was collected throughout the 6-week period. RESULTS Twenty participants completed the trial. PAI earned/day was increased after participants could view their data (mean difference: 2.1 PAI/day (95% CI 0.3, 4.0), p = 0.027). The median change in percentage of days participants achieved a Total PAI score of 25 (p = 0.023) and 50 (p = 0.015) were also increased. The mean change in total scores for the EQ-5D-5L and EQVAS were improved after 6 weeks (0.6 ± 1.05; 95% CI (0.11-1.09); p = 0.019); (5.8/100; 95% CI (2.4-9.2); p = 0.002 respectively). Thematic framework analysis identified three global themes (perceptions on the WPAM, PAI and factors affecting exercise). Most participants stated motivation to exercise increased after they could view their PAI data. Many of the participants believed they would continue to use PAI long-term. Others were undecided; the latter primarily due to technical issues and/or preferring devices with greater functionality and attractiveness. All participants would recommend PAI. CONCLUSION This exploratory study showed monitoring PAI via a WPAM increased the amount and/or intensity of physical activity within the cardiac population. Participants found PAI interesting, beneficial, and motivating. If technical issues, aesthetics, and functionality of the WPAM were improved, participants may continue to use the approach long-term. PAI may be a viable strategy to assist people with cardiac disease maintain physical activity adherence.
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Affiliation(s)
- Amanda L Hannan
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia. .,Bond Institute of Health and Sport, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Wayne Hing
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia.,Water Based Research Unit, Bond University, Gold Coast, Australia
| | - Jeff S Coombes
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Suzanne Gough
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Mike Climstein
- Clinical Exercise Physiology, School of Health and Human Sciences, Southern Cross University, Bilinga, QLD, Australia.,Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, University of Sydney, Sydney, NSW, Australia.,Water Based Research Unit, Bond University, Gold Coast, Australia
| | | | - Rohan Jayasinghe
- Cardiology Department, Gold Coast University Hospital, Queensland, Griffith University, Brisbane, QLD, Australia.,Macquarie University, Sydney, NSW, Australia
| | - James Furness
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia.,Water Based Research Unit, Bond University, Gold Coast, Australia
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Affiliation(s)
- Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine in New Orleans, United States of America.
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17
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Kieffer SK, Nauman J, Syverud K, Selboskar H, Lydersen S, Ekelund U, Wisløff U. Association between Personal Activity Intelligence (PAI) and body weight in a population free from cardiovascular disease - The HUNT study. THE LANCET REGIONAL HEALTH. EUROPE 2021; 5:100091. [PMID: 34557819 PMCID: PMC8454800 DOI: 10.1016/j.lanepe.2021.100091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND Personal Activity Intelligence (PAI) is a new metric for physical activity tracking, and is associated with reduced risk of all-cause and cardiovascular mortality. We prospectively investigated whether PAI is associated with lower body weight gain in a healthy population. METHODS We included 85,243 participants (40,037 men and 45,206 women) who participated in at least one of three waves of the Trøndelag Health Study (HUNT1: 1984-86, HUNT2: 1995-97, and HUNT3: 2006-08). We used questionnaires to estimate PAI, and linear mixed models to examine body weight according to PAI levels at three study waves. We also conducted regression analyses to assess separate relationships between change in PAI and the combined changes in PAI and physical activity recommendations, according to body weight from HUNT1 to HUNT3. FINDINGS Compared with HUNT1, body weight was 8.6 and 6.7 kg higher at HUNT3 for men and women, respectively, but was lower among those with ≥200 PAI at HUNT3. For both sexes, a change from inactive (0 PAI) at HUNT1 to ≥100 weekly PAI-score at HUNT2 and HUNT3, and a ≥100 PAI-score at all three occasions were associated with lower body weight gain, compared with the reference group (0 PAI at all three waves). Importantly, among both sexes, obtaining ≥100 weekly PAI at HUNT1 and HUNT3 was associated with lower body weight gain regardless of adhering to physical activity guidelines. INTERPRETATION Adhering to a high PAI over time may be a useful tool to attenuate excessive body weight gain in a population free from cardiovascular disease. FUNDING Norwegian Research Council and the Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and technology.
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Affiliation(s)
- Sophie K. Kieffer
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491 Trondheim, Norway
| | - Javaid Nauman
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491 Trondheim, Norway
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA
| | - Kari Syverud
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491 Trondheim, Norway
| | - Hege Selboskar
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491 Trondheim, Norway
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Postboks 8905, 7491 Trondheim, Norway
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA
- School of Human Movement and Nutrition Science, University of Queensland, Queensland, Australia
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Wen CP, Wai JPM, Chen CH, Gao W. Can weight loss be accelerated if we exercise smarter with wearable devices by subscribing to Personal Activity Intelligence (PAI)? THE LANCET REGIONAL HEALTH. EUROPE 2021; 5:100133. [PMID: 34557826 PMCID: PMC8454580 DOI: 10.1016/j.lanepe.2021.100133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Chi Pang Wen
- Institute of Population Science, National Health Research Institutes, Zhunan, Taiwan
- China Medical University Hospital, Taichung, Taiwan
| | - Jackson Pui Man Wai
- Graduate Institute of Sport Science, National Taiwan Sport University, Taoyuan, Taiwan
- Department of Nutrition Science, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Chien Hua Chen
- Digestive Disease Center, Changbing Show-Chwan Memorial Hospital, Lukang, Taiwan
| | - Wayne Gao
- College of Public Health, Taipei Medical University, Taipei City, Taiwan
- Institute of Sport Science, National Taiwan Sport University, Taoyuan, Taiwan
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Epstein E, Patel N, Maysent K, Taub PR. Cardiac Rehab in the COVID Era and Beyond: mHealth and Other Novel Opportunities. Curr Cardiol Rep 2021; 23:42. [PMID: 33704611 PMCID: PMC7947942 DOI: 10.1007/s11886-021-01482-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/17/2021] [Indexed: 12/17/2022]
Abstract
Purpose of Review The COVID-19 pandemic has forced many center-based cardiac rehabilitation (CBCR) programs to close or limit their usual offerings. In order for patients to continue to benefit from CR, programs need to rapidly adapt to the current environment. This review highlights ways CR has evolved, and reviews the history of CR and recent advancements in telemedicine including remote patient monitoring, and mobile health that can be applied to CR. Recent Findings Despite that initial studies indicate that home-based CR (HBCR) is safe and effective, HBCR has faced several challenges that have prevented it from becoming more widely implemented. Many previous concerns can now be addressed through the use of new innovations in home-based healthcare delivery. Summary Since its inception, CR has become increasingly recognized as an important tool to improve patient mortality and quality of life in a broad range of cardiac diseases. While there has been little need to modify the delivery of CR since the 1950s, COVID-19 now serves as the necessary impetus to make HBCR an equal alternative to CBCR.
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Affiliation(s)
- Elizabeth Epstein
- University of California, 9300 Campus Point Drive, La Jolla, San Diego, CA 92037 USA
| | - Neeja Patel
- University of California, 9300 Campus Point Drive, La Jolla, San Diego, CA 92037 USA
| | - Kathryn Maysent
- University of California, 9300 Campus Point Drive, La Jolla, San Diego, CA 92037 USA
| | - Pam R. Taub
- University of California, 9300 Campus Point Drive, La Jolla, San Diego, CA 92037 USA
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Affiliation(s)
- Carl J Lavie
- Cardiac Rehabilitation and Prevention, Exercise Laboratories, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA, USA.
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Nauman J, Arena R, Zisko N, Sui X, Lavie CJ, Laukkanen JA, Blair SN, Dunn P, Nes BM, Tari AR, Stensvold D, Whitsel LP, Wisløff U. Temporal changes in personal activity intelligence and mortality: Data from the aerobics center longitudinal study. Prog Cardiovasc Dis 2020; 64:127-134. [PMID: 33370551 DOI: 10.1016/j.pcad.2020.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 12/13/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Personal activity intelligence (PAI) is a metric developed to simplify a physically active lifestyle for the participants. Regardless of following today's advice for physical activity, a PAI score ≥100 per week at baseline, an increase in PAI score, and a sustained high PAI score over time were found to delay premature cardiovascular disease (CVD) and all-cause mortality in a large population of Norwegians. However, the association between long-term temporal change in PAI and mortality in other populations have not been investigated. OBJECTIVE To test whether temporal change in PAI is associated with CVD and all-cause mortality in a large population from the United States. METHODS We studied 17,613 relatively healthy participants who received at least two medical examinations in the Aerobics Center Longitudinal Study between 1974 and 2002. The participant's weekly PAI scores were estimated twice, and adjusted hazard ratios (AHR) and 95% confidence intervals (CI) for CVD and all-cause mortality related to changes in PAI between baseline and last examination were assessed using Cox proportional hazard regression analyses. RESULTS During a median follow-up time of 9.3 years [interquartile range, 2.6-16.6; 181,765 person-years], there were 1144 deaths, including 400 CVD deaths. We observed an inverse linear association between change in PAI and risk of CVD mortality (P=0.007 for linear trend, and P=0.35 for quadratic trend). Compared to participants with zero PAI at both examinations, multivariable-adjusted analyses demonstrated that participants who maintained high PAI scores (≥100 PAI at both examinations) had a 51% reduced risk of CVD mortality [AHR, 0.49: 95% CI, 0.26-0.95)], and 42% reduced risk of all-cause mortality [AHR, 0.58: 95% CI, 0.41-0.83)]. For participants who increased their PAI scores over time (PAI score of zero at first examination and ≥100 at last examination), the AHRs were 0.75 (95% CI, 0.55-1.02) for CVD mortality, and 0.82 (95% CI, 0.69-0.99) for all-cause mortality. Participants who maintained high PAI score had 4.8 (95% CI, 3.3-6.4) years of life gained. For those who increased their PAI score over time, the corresponding years gained were 1.8 years (95% CI, 0.1-3.5). CONCLUSION Among relatively healthy participants, an increase in PAI and maintaining a high PAI score over time was associated with reduced risk of CVD and all-cause mortality. CONDENSED ABSTRACT Our objective was to investigate the association between temporal changes in PAI and mortality in a large population from the United States. In this prospective cohort study of 17,613 relatively healthy participants at baseline, maintaining a high PAI score and an increase in PAI score over an average period of 6.3 years was associated with a significant reduction in CVD and all-cause mortality. Based on our results, clinicians can easily recommend that patients obtain at least 100 PAI for most favourable protection against CVD- and all-cause mortality, but can also mention that significant benefits also occur at maintaining low-to-moderate PAI levels.
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Affiliation(s)
- Javaid Nauman
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.
| | - Ross Arena
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Department of Physical Therapy, College of Applied Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Nina Zisko
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Carl J Lavie
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, LA, USA
| | - Jari A Laukkanen
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland; Department of Medicine, Central Finland, Health Care District, Jyväskylä, Finland
| | - Steven N Blair
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Patrick Dunn
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; American Heart Association, Washington, DC, TX, USA; Walden University, Minneapolis, MN, USA
| | - Bjarne M Nes
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Atefe R Tari
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neurology, St. Olavs Hospital, Trondheim, Norway
| | - Dorthe Stensvold
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA
| | - Laurie P Whitsel
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; American Heart Association, Washington, DC, TX, USA
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; School of Human Movement & Nutrition Sciences, University of Queensland, Australia
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Nauman J, Sui X, Lavie CJ, Wen CP, Laukkanen JA, Blair SN, Dunn P, Arena R, Wisløff U. Personal activity intelligence and mortality - Data from the Aerobics Center Longitudinal Study. Prog Cardiovasc Dis 2020; 64:121-126. [PMID: 32560967 DOI: 10.1016/j.pcad.2020.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
IMPORTANCE Personal activity intelligence (PAI) is a novel activity metric that can be integrated into self-assessment heart rate devices, and translates heart rate variations during exercise into a weekly score. Previous studies relating to PAI have been conducted in the same populations from Norway where the PAI metric has been derived, limiting generalizability of the results. OBJECTIVE To test whether PAI is associated with total and cause-specific mortality in a large cohort from the United States. DESIGN Aerobics Center Longitudinal Study (ACLS) - a prospective cohort between January 1974 and December 2002 with a mean follow-up of 14.5 years. SETTING Population-based. PARTICIPANTS 56,175 relatively healthy participants (26.5% women) who underwent extensive preventive medical examinations at Cooper Clinic (Dallas, TX). EXPOSURE Personal activity intelligence (PAI) score per week was estimated and divided into 4 groups (PAI scores of 0, ≤50, 51-99, and ≥100). MAIN OUTCOMES AND MEASURES Total and cause-specific mortality. RESULTS During a median follow-up time of 14.9 (interquartile range, 6.7-21.4) years, there were 3434 total deaths including 1258 cardiovascular (CVD) deaths. Compared with the inactive (0 PAI) group, participants with a baseline weekly ≥100 PAI had lower risk of mortality: adjusted hazard ratio (AHR), 0.79: 95% CI, 0.71-0.87 for all-cause mortality, and AHR, 0.72: 95% CI, 0.60-0.87 for CVD mortality among men; AHR, 0.85: 95% CI, 0.64-1.12 for all-cause mortality, and AHR, 0.48: 95% CI, 0.26-0.91 for CVD mortality among women. For deaths from ischemic heart disease (IHD), PAI score ≥100 was associated with lower risk in both men and women (AHR, 0.70: 95% CI, 0.55-0.88). Obtaining ≥100 weekly PAI was also associated with significantly lower risk of CVD mortality in pre-specified age groups, and in participants with known CVD risk factors. Participants with ≥100 weekly PAI gained 4.2 (95% CI, 3.5-4.6) years of life when compared with those who were inactive at baseline. CONCLUSIONS AND RELEVANCE PAI is associated with long-term all-cause, CVD, and IHD, mortality. Clinicians and the general population can incorporate PAI recommendations and thresholds in their physical activity prescriptions and weekly physical activity assessments, respectively, to maximize health outcomes. KEY POINTS Question: What is the association between personal activity intelligence (PAI), a novel activity metric, and mortality in a large cohort from the United States? FINDINGS In this prospective study of 56,175 healthy participants at baseline, followed-up for a mean of 14.5 years, ≥100 PAI score/week was associated with significant 21% lower risk of all-cause and 30% lower risk of CVD mortality in comparison with inactive people. Participants with ≥100 PAI/week lived on average 4.2 years longer compared with inactive. Meaning: PAI is associated with long-term all-cause and CVD mortality. Clinicians and general population may incorporate PAI recommendations into weekly physical activity assessments to maximize CVD prevention.
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Affiliation(s)
- Javaid Nauman
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Carl J Lavie
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, LA, USA
| | - Chi Pang Wen
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan; Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Jari A Laukkanen
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland; Department of Medicine, Central Finland Health Care District, Jyväskylä, Finland
| | - Steven N Blair
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Patrick Dunn
- American Heart Association, Dallas, TX, USA; Walden University, Minneapolis, MN, USA
| | - Ross Arena
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; Department of Physical Therapy, College of Applied Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA; School of Human Movement & Nutrition Sciences, University of Queensland, Australia
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Nauman J, Khan MAB, Joyner MJ. Walking in the Fast Lane: High-Intensity Walking for Improved Fitness and Health Outcomes. Mayo Clin Proc 2019; 94:2378-2380. [PMID: 31806093 DOI: 10.1016/j.mayocp.2019.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 10/24/2019] [Indexed: 11/20/2022]
Affiliation(s)
- Javaid Nauman
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates; Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Moien A B Khan
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Michael J Joyner
- Department of Anaesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
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Laukkanen JA, Kunutsor SK, Ozemek C, Mäkikallio T, Lee DC, Wisloff U, Lavie CJ. Cross-country skiing and running's association with cardiovascular events and all-cause mortality: A review of the evidence. Prog Cardiovasc Dis 2019; 62:505-514. [PMID: 31505192 DOI: 10.1016/j.pcad.2019.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 09/02/2019] [Indexed: 12/17/2022]
Abstract
A large body of evidence demonstrates positive, graded effects of PA on cardiovascular disease (CVD) morbidity and mortality with increasing intensity compared with lower PA intensity. Running is often designated as a high-intensity PA with substantial evidence supporting its health benefits. Cross-country skiing is among the most demanding aerobic endurance exercises and requires engaging the upper- and lower-body. Cross-country skiing is often regarded as high-intensity PA, which has been associated with significant health benefits. However, a robust body of evidence identifying the dose-response relation between cross-country skiing volume and health outcomes is sparse. Therefore, this review aims to summarize the available evidence linking cross-country skiing with CVD morbidity and all-cause mortality; postulated pathways that may elucidate the relation between these associations; outline areas of ongoing uncertainty; and the implications for primary and secondary CVD prevention. To put the findings into perspective, we also summarized the evidence linking running with CVD morbidity and all-cause mortality. Though a head-to-head comparison is not available, the evidence indicates that performing PA as cross-country skiing associates with lower mortality risk when compared with that observed in those undertaking their PA as running. Potential adverse effects of extreme high weekly doses of cross-country skiing over decades may be cardiac arrhythmias, such as atrial fibrillation. Evidence suggests that cross-country skiing may reduce the risk of CVD events and all-cause mortality via anti-inflammatory pathways, improvements in endothelial function and reduced levels of CVD risk factors, such as lipids, glucose, and blood pressure; and enhancement of cardiorespiratory fitness.
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Affiliation(s)
- Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland; Department of Medicine, Central Finland Health Care District, Jyväskylä, Finland.
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK; Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK
| | - Cemal Ozemek
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Timo Mäkikallio
- Division of Cardiology, Department of Internal Medicine, Oulu University Hospital, Oulu, Finland
| | - Duck-Chul Lee
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames, IA, USA
| | - Ulrik Wisloff
- Cardiac Exercise Research Group, Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; School of Human Movement & Nutrition Sciences, University of Queensland, Australia
| | - Carl J Lavie
- Department of Cardiovascular Diseases, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA
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