Impact of physical activity category on incidence of cardiovascular disease: Results from the 10-year follow-up of the ATTICA Study (2002-2012)

Enhancing physical activity participation among female employees: evaluating the effectiveness of an educational intervention

This paper evaluates the effectiveness of an educational intervention based on the transtheoretical model aimed at increasing physical activity (PA) participation among female employees in Bandar Abbas city (Iran) healthcare centers in December 2017 and August 2018. Using a semi-experimental interventional study design with a randomized and multi-stage method, 100 participants were included in both the intervention (n = 50) and control groups (n = 50). Data collection involved questionnaires assessing demographic information (age, gender, marital status and education), stages of change in PA behavior, Perceived Benefits, Barriers and Self-efficacy. The data were analyzed using SPSS-16, employing both descriptive (mean, SD, frequency, percentage) and inferential statistics (t-tests, chi-squared tests, etc.). Prior to the educational intervention, 19 participants (0.38%) in the intervention group engaged consistently in PA (stages 4-5). After 3 and 6 months of intervention, these numbers increased to 29 (0.58%) and 25 (0.50%), respectively. This improvement was statistically significant compared to the pre-intervention stage (P < 0.001). The findings highlight the importance of theory-based behavior change models and health education programs in promoting PA and combating sedentary lifestyles. Although focused on a specific population in Bandar Abbas, the intervention can serve as a model for similar programs targeting diverse social classes and populations.

Nutrition, body composition and physical activity have differential impact on the determination of lipidemic blood profiles between young females with different blood cholesterol concentrations

INTRODUCTION

This cross-sectional study explored whether nutrition, body composition, and physical activity energy expenditure (PAΕΝ) have a differential impact on lipidemic blood profiles among young females with different blood cholesterol concentrations.

METHODS

One hundred thirty-five young female students (N = 135) were allocated into three groups according to their blood cholesterol concentrations (Chol): (A) Normal [NL; Chol: < 200 mg·dL^-1; n = 56 Age: 21.4 ± 2.6 yrs, Body Mass Index (BMI): 22.1 ± 2.0 kg·m^-2], (B) Borderline (BL; Chol: ≥200 mg·dL^-1 and <240 mg·dL^-1; n = 44 Age: 21.6 ± 2.5 yrs, BMI: 24.2 ± 3.1 kg·m^-2) and (C) High level (HL; Chol: ≥240 mg·dL^-1; n = 35 Age: 22.5 ± 2.4 yrs, BMI: 28.9 ± 2.1 kg·m^-2). Body composition [bioelectrical impedance analysis including lean body mass (LBM) and body fat mass], nutritional intake (recall questionnaire), daily physical activity energy expenditure through activity trackers and resting blood lipids concentrations were evaluated.

RESULTS

Multiple linear regression analyses revealed that in the NL group, lean mass, daily PAΕΝ and daily energy balance were the determinant parameters of blood lipidemic profiles (B: -0.815 to 0.700). In the BL group, nutrition, body composition and daily physical activity energy expenditure exhibited similar impacts (B: -0.440 to 0.478). In the HL group, nutritional intake and body fat mass determined blood lipidemic profile (B: -0.740 to 0.725).

CONCLUSION

Nutrition, body composition and daily PAΕΝ impact on blood lipids concentration is not universal among young females. In NL females, PAEN, energy expenditure and LBM are the strongest determinants of blood lipids, while in HL females, nutritional intake and body fat mass are. As PAΕΝ increases, the importance of nutrition and body fat decreases, and vice versa.

The emerging role of skeletal muscle as a modulator of lipid profile the role of exercise and nutrition

The present article aims to discuss the hypothesis that skeletal muscle per se but mostly its muscle fiber composition could be significant determinants of lipid metabolism and that certain exercise modalities may improve metabolic dyslipidemia by favorably affecting skeletal muscle mass, fiber composition and functionality. It discusses the mediating role of nutrition, highlights the lack of knowledge on mechanistic aspects of this relationship and proposes possible experimental directions in this field.

Sedentary behavior and risk of incident cardiovascular disease among Chinese adults

Although emerging studies from high-income countries investigated the relationship between sedentary behavior (SB) and cardiovascular risk, little evidence came from developing countries. Moreover, the benefits of reallocating time from SB to physical activity (PA) on incident cardiovascular disease (CVD) are unknown. Using three cohorts from the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project, we included 93 110 adults who were free from CVD at baseline. Cox proportional hazards models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD, including stroke, coronary heart disease, and CVD death. Isotemporal substitution models were applied to estimate the per-hour effects of replacing SB with PA. After 5.8 years follow-up, 3799 CVD cases were identified. A gradient positive association between sedentary time and incident CVD was observed. Relative to those with < 5 h/d sedentary time, the multivariable-adjusted HRs (95% CIs) of CVD incidence were 1.07(0.96-1.20), 1.27(1.13-1.43) and 1.51(1.34-1.70) for those having 5-<8, 8-<10, and ≥ 10 h/d sedentary time, respectively. When participants were cross-classified by SB and moderate to vigorous physical activity (MVPA) level, the CVD risk was highest in those with ≥ 10 h/d SB and < 150 min/week MVPA. Among those who reported ≥ 5 h/d sedentary time, per-hour substitution of SB with light, moderate, and vigorous PA reduced incident CVD risk by 5%, 6%, and 8%, respectively. The study first found that sedentary time was associated with increased incident CVD risk among Chinese adults and that substitution of SB with PA of any intensity could convey cardiovascular benefits among those with ≥ 5 h/d SB.

Associations between vigorous physical activity and chronic diseases in older adults: a study in 13 European countries

Background

This study aimed to assess cross-sectional and prospective relationships between vigorous physical activity (VPA) and the risk of major chronic diseases among European older adults.

Methods

Participants were 37 524 older adults who responded to the fourth (in 2011) and fifth (in 2013) wave of the SHARE project, from 13 European countries. Participants answered interview questions about the presence of chronic conditions and VPA. The cross-sectional and prospective association between PA and the number of chronic diseases was assessed using logistic regression models.

Results

Among men and women, the prevalence of chronic diseases was significantly lower among those who reported VPA once a week or more than once a week. For men, VPA once a week was prospectively related with lower odds of heart attack, chronic lung disease, Parkinson's disease and Alzheimer's disease. VPA more than once a week was prospectively related with lower odds of having all chronic diseases. Women who engaged in VPA once a week presented lower odds of having chronic diseases, except for hypertension, high blood cholesterol and cancer. For VPA more than once a week, cancer was the only disease not associated with physical activity.

Conclusion

VPA is associated with reduced risk of chronic diseases in men and women. Even the practice of VPA once a week seems to be sufficient to reduce risks of chronic diseases.

Cross-Sectional and Prospective Relationship Between Low-to-Moderate-Intensity Physical Activity and Chronic Diseases in Older Adults From 13 European Countries

AIM

To assess the relationship between low-to-moderate-intensity physical activity (LMPA) in 2011 and chronic diseases in 2011 and 2013 among older European adults.

METHODS

Participants (16,157 men and 21,260 women) from 13 European countries were interviewed about the presence of chronic conditions and LMPA. The association between LMPA and number of chronic diseases was assessed using logistic regression models.

RESULTS

Most of the older adults participated in LMPA more than once a week (81.9%), 8.4% participated once a week, and 9.3% did not participate. The prevalence of chronic diseases was significantly lower among those who reported engaging in LMPA. The LMPA in 2011 was related with lower odds of having several chronic diseases in 2013.

CONCLUSION

Engaging in LMPA is associated with reduced risk for chronic diseases in older European men and women. Even the practice of LMPA once a week seems to be enough to diminish the risk of having chronic diseases.

Persistent effect at 30-month post intervention of a community-based randomized trial of KM2H2 in reducing stroke and heart attack among senior hypertensive patients

BACKGROUND

The effect of the Keep Moving toward Healthy Heart and Healthy Brain (KM2H2) program at 6-month post intervention has been assessed.  The purpose of this study is to evaluate the KM2H² program at 30-month post intervention.

METHODS

A total of 450 senior hypertensive patients from 12 community health centers were randomized by center to either receive KM2H² plus standard care (6 centers, n = 232) or standard care only (6 centers, n = 218). Data for outcome measures at 30-month post intervention were analyzed. New cases of stroke and heart attack were verified with medical records; levels of physical activity were assessed using self-reported questionnaire. In addition to comparative analysis, adjusted incidence rate and program effects were determined using mixed effects modeling method.

RESULTS

At the 30-month follow-up, the adjusted incidence rate [95% CI] of stroke was 11.81% [5.90, 17.72] for patients in the intervention group and 19.78% [14.07, 25.50] (p = 0.03) for the control group. The adjusted incidence rate of heart attack was 3.34% [1.91, 8.58] and 6.68% [1.64, 11.73] for the intervention and control groups (p = 0.16), respectively; the proportion and the duration of engaging in regular physical activity were significantly greater for the intervention group than the control group. The reductions in blood pressure between the intervention and the control was not statistically significant.

CONCLUSIONS

The KM2H² program showed a persistent effect up to 30 months post intervention in enhancing physical activity and reducing the risk of cardio-cerebrovascular events, particularly stroke. These findings demonstrate the persistent effect of the KM2H² and suggest the need for a full-scale evaluation of the intervention program for practical use.

TRIAL REGISTRATION

ISRCTN Register ISRCTN12608966 . Registered 03 March 2015. Retrospectively registered.

Association between Meeting Physical Activity Guidelines and Mortality in Korean Adults: An 8-year Prospective Study

PURPOSE

Although previous studies have investigated the association between physical activity and various health outcomes, limited information is available on the effect of meeting new governmental guidelines for physical activity on the risk of mortality in Korean adults. This study aimed to examine the prospective association between meeting these guidelines and all-cause mortality during an 8-year follow-up using a large nationwide sample of middle-aged and older adults in Korea.

METHODS

This prospective study was conducted based on the Korean Longitudinal Study of Ageing. The study participants included 9,177 adults aged 45 years or older at baseline, and all participants were monitored in a 2-year cycle during an 8-year period (70,873 person-years). The risk of mortality was analyzed by determining physical activity levels using the Cox proportional hazard models, and the hazard ratio (HR) and 95% confidence interval (CI) were estimated using Cox models.

RESULTS

A statistically significant effect of physical activity on the reduced risk of mortality was observed in cases in which the participants met the guidelines compared to the inactive group (HR: 0.68, 95% CI: 0.58-0.81 vs. the inactive group). A strong association between meeting the recommended physical activity levels and the reduced risk of mortality was also found for non-smokers (HR: 0.62; 95% CI: 0.51-0.76 vs. the inactive group), but not for current smokers (HR: 0.93; 95% CI: 0.67-1.29 vs. the inactive group).

CONCLUSION

Meeting physical activity guidelines was associated with a decreased risk of all-cause mortality for Korean adults. Our results also suggest that smoking reduces the protective effect of physical activity on the risk of mortality.