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Chen Y, Song Y, Zhou N, Wang W, Hong X. Association between movement behavior patterns and cardiovascular risk among Chinese adults aged 40-75: a sex-specific latent class analysis. BMC Public Health 2024; 24:1170. [PMID: 38664676 PMCID: PMC11047026 DOI: 10.1186/s12889-024-18573-z] [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: 01/08/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is a major global health threat, particularly in China, contributing to over 40% of deaths. While sleep behaviors, sedentary behaviors, and physical activities are recognized as independent lifestyle risk factors for CVD, there remains limited understanding of specific movement behavior patterns and their CVD risks, especially considering sex-specific differences. This study examines movement behavior patterns among Chinese adults (40-75) and their associations with cardiovascular risk, with a focus on sleep, physical activity (PA), and sedentary behavior (SB). METHODS Data pertaining to 13,465 male participants and 15,613 female participants, collected from the Chronic Disease and Risk Factor Surveillance Survey in Nanjing from February 2020 to December 2022. The latent class analysis method was employed to identify underlying movement patterns across sexes. Multinomial logistic regression models assessed CVD risk, and the China-PAR model calculated 10-year risk. RESULTS Three male and four female movement patterns emerged. Active Movers (17.10% males, 5.93% females) adhered to PA recommendations but had poorer sleep quality. Moderate Achievers (61.42% males, 45.32% females) demonstrated moderate behavior. Sedentary Sleepers (21.48% males, 10.20% females) exhibited minimal PA but good sleep. Female Moderate Physical Activity (MPA) Dominant Movers demonstrated a prevalent adherence to recommended MPA levels. Active movers had the lowest CVD risk. After adjusting for potential confounders, moderate achievers (OR = 1.462, 95% CI 1.212, 1.764) and sedentary sleepers (OR = 1.504, 95% CI 1.211, 1.868) were both identified as being associated with a high-risk of cardiovascular diseases (CVDs) compared to active movers in males, demonstrating a similar trend for intermediate risk. Such associations were not statistically significant among females. CONCLUSIONS Our study revealed sex-specific movement patterns associated with CVD risks among middle-aged Chinese adults. We suggest that adopting an active movement behavior pattern, characterized by meeting or exceeding recommended levels of vigorous physical activity (VPA) and reducing sedentary behavior, is beneficial for all middle-aged adults, particularly males. An active lifestyle could help counteract the adverse effects of relatively poor sleep quality on the risk of developing CVD in this population. Integrating sleep, PA, and SB information provides a holistic framework for understanding and mitigating CVD risks.
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Affiliation(s)
- Yichao Chen
- Nanjing Medical University Affiliated Nanjing Center for Disease Control and Prevention, No. 2 Zi'ZhuLin, 210003, Nanjing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yingqian Song
- Nanjing Medical University Affiliated Nanjing Center for Disease Control and Prevention, No. 2 Zi'ZhuLin, 210003, Nanjing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Nan Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Weiwei Wang
- Nanjing Medical University Affiliated Nanjing Center for Disease Control and Prevention, No. 2 Zi'ZhuLin, 210003, Nanjing, China
| | - Xin Hong
- Nanjing Medical University Affiliated Nanjing Center for Disease Control and Prevention, No. 2 Zi'ZhuLin, 210003, Nanjing, China.
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.
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Kawada T. Sedentary Behavior and Sleep Quality in Women. J Am Med Dir Assoc 2024; 25:555. [PMID: 38307121 DOI: 10.1016/j.jamda.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/06/2024] [Accepted: 01/08/2024] [Indexed: 02/04/2024]
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan
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Chrysant SG. Effects of physical activity on sleep quality and wellbeing. Hosp Pract (1995) 2024; 52:13-18. [PMID: 38407170 DOI: 10.1080/21548331.2024.2320069] [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: 09/05/2023] [Accepted: 02/12/2024] [Indexed: 02/27/2024]
Abstract
Physical activity (PA) has pluripotential beneficial effects on body functions. These benefits include reduction in the incidence of cardiovascular disease (CVD), coronary heart disease (CHD), hypertension, type 2 diabetes mellitus (T2DM), and death. In addition to these effects, PA exerts significant beneficial effects on sleep onset, duration and quality, which add to its beneficial effects. In contrast, lack of sleep has been associated with increased incidence of CVD complications and death. In this regard, PA serves as a non-pharmacologic means for sleep improvement especially in older people, who frequently have difficulties in falling asleep. Regarding the timing of exercise and its effect on sleep, there has been no difference between morning and evening exercise on the onset and quality of sleep. With respect the beneficial cardiovascular effects of PA on sleep, there has been a debate among several investigators with some reporting significant beneficial effects of PA, and others reporting not significant beneficial effects. In order to get a better perspective on the effects of PA on quality of sleep, and its cardiovascular beneficial effects, a Medline search of the English literature was conducted between 2017 and 2023 using the terms exercise, sleep, cardiovascular disease, death and 36 pertinent papers were selected (Figure 1). The findings from these papers together with collateral literature will be discussed in this review.
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Affiliation(s)
- Steven G Chrysant
- Department of Cardiology, University of Oklahoma Health Sciences Center, Oklahoma, OK, USA
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Stoner L, Higgins S, Paterson C. The 24-h activity cycle and cardiovascular outcomes: establishing biological plausibility using arterial stiffness as an intermediate outcome. Am J Physiol Heart Circ Physiol 2023; 325:H1243-H1263. [PMID: 37737729 DOI: 10.1152/ajpheart.00258.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 09/07/2023] [Accepted: 09/15/2023] [Indexed: 09/23/2023]
Abstract
This review proposes a biologically plausible working model for the relationship between the 24-h activity cycle (24-HAC) and cardiovascular disease. The 24-HAC encompasses moderate-to-vigorous physical activity (MVPA), light physical activity, sedentary behavior (SB), and sleep. MVPA confers the greatest relative cardioprotective effect, when considering MVPA represents just 2% of the day if physical activity guidelines (30 min/day) are met. While we have well-established guidelines for MVPA, those for the remaining activity behaviors are vague. The vague guidelines are attributable to our limited mechanistic understanding of the independent and additive effects of these behaviors on the cardiovascular system. Our proposed biological model places arterial stiffness, a measure of vascular aging, as the key intermediate outcome. Starting with prolonged exposure to SB or static standing, we propose that the reported transient increases in arterial stiffness are driven by a cascade of negative hemodynamic effects following venous pooling. The subsequent autonomic, metabolic, and hormonal changes further impair vascular function. Vascular dysfunction can be offset by using mechanistic-informed interruption strategies and by engaging in protective behaviors throughout the day. Physical activity, especially MVPA, can confer protection by chronically improving endothelial function and associated protective mechanisms. Conversely, poor sleep, especially in duration and quality, negatively affects hormonal, metabolic, autonomic, and hemodynamic variables that can confound the physiological responses to next-day activity behaviors. Our hope is that the proposed biologically plausible working model will assist in furthering our understanding of the effects of these complex, interrelated activity behaviors on the cardiovascular system.
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Affiliation(s)
- Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Department of Epidemiology, The Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Simon Higgins
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Craig Paterson
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
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Kim N, Ka S, Park J. Effects of exercise timing and intensity on physiological circadian rhythm and sleep quality: a systematic review. Phys Act Nutr 2023; 27:52-63. [PMID: 37946447 PMCID: PMC10636512 DOI: 10.20463/pan.2023.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 11/12/2023] Open
Abstract
PURPOSE Humans show near-24-h physiological and behavioral rhythms, which encompass the daily cycle of sleep and wakefulness. Exercise stimulates circadian rhythms, including those of cortisol, melatonin, and core body temperature, and affects sleep quality. We systematically reviewed studies that examined the effects of exercise intensity and timing on physiological circadian rhythms and sleep quality. METHODS In this systematic review, we used the online databases PubMed, Science Direct, Web of Science, and Embase. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two independent and experienced systematic reviewers performed the search and selected relevant studies. The participant, intervention, comparison, and outcome characteristics were: (1) adults; (2) exercise treatment; (3) no exercise treatment or different types of exercise (pre-exercise baseline); (4) cortisol, melatonin, or core body temperature measurement, and subjective or objective sleep quality assessments. RESULTS We identified 9 relevant articles involving 201 participants (77.1% of whom were male). Our review revealed that short-term evening exercise delayed melatonin rhythm and increased nocturnal core body temperature; however, no negative effects on non-rapid eye movement sleep and sleep efficiency were observed. Moreover, no differences in sleep quality were observed between acute high-intensity and moderate-intensity exercises. With long exercise durations, the core body temperature tended to increase and return to baseline levels at 30-120 min. CONCLUSION Our review showed that short-term evening exercise and high-intensity exercise did not have a significant negative effect on sleep quality but physiological circadian rhythm tended to alter. Longterm morning exercise tended to decrease cortisol concentrations after awakening and improve sleep quality. Future studies should examine the effects of long-term exercise timing and intensity on circadian rhythm and sleep.
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Affiliation(s)
- Nahyun Kim
- Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Soonjo Ka
- Department of Physical Education, Korea University, Seoul, Republic of Korea
| | - Jonghoon Park
- Department of Physical Education, Korea University, Seoul, Republic of Korea
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Menezes-Júnior LAAD, de Moura SS, Miranda AG, de Souza Andrade AC, Machado-Coelho GLL, Meireles AL. Sedentary behavior is associated with poor sleep quality during the COVID-19 pandemic, and physical activity mitigates its adverse effects. BMC Public Health 2023; 23:1116. [PMID: 37308867 PMCID: PMC10258778 DOI: 10.1186/s12889-023-16041-8] [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: 01/06/2023] [Accepted: 06/02/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND We aimed to evaluate the association of sedentary behavior (SB) and moderate to vigorous leisure-time physical activity (MVPA) with sleep quality during the COVID-19 pandemic. METHODS Cross-sectional, population-based study in adults, conducted from October to December 2020 in the Iron Quadrangle region, Brazil. The outcome was sleep quality, evaluated with the Pittsburgh Sleep Quality Index. SB was assessed by self-report of total sitting time, before and during the pandemic. Individuals with ≥ 9 h of total sitting time were classified as SB. In addition, the ratio of time spent in MVPA to time in SB was analyzed. A contrasted directed acyclic graph (DAG) model was constructed to adjust logistic regression models. RESULTS A total of 1629 individuals were evaluated, the prevalence of SB before the pandemic was 11.3% (95%CI: 8.6-14.8), and during the pandemic 15.2% (95%CI: 12.1-18.9). In multivariate analysis, the chance of poor sleep quality was 77% higher in subjects with SB ≥ 9 h per day (OR: 1.77; 95% CI: 1.02-2.97). Furthermore, a one-hour increase in SB during the pandemic, increased the chance of poor sleep quality by 8% (OR: 1.08; 95%CI 1.01-1.15). In the analysis of the ratio of MVPA per SB in individuals with SB ≥ 9 h, practicing 1 min of MVPA per hour of SB reduces the chance of poor sleep quality by 19% (OR: 0.84; 95%CI: 0.73-0.98). CONCLUSION SB during the pandemic was a factor associated with poor sleep quality, and the practice of MVPA can reduce the effects of SB.
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Affiliation(s)
- Luiz Antônio Alves de Menezes-Júnior
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro, Preto, Ouro Preto, Minas Gerais, Brazil.
- Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Ouro Preto, Brazil.
| | - Samara Silva de Moura
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro, Preto, Ouro Preto, Minas Gerais, Brazil
- Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Amanda Gonçalves Miranda
- Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Ouro Preto, Brazil
| | | | | | - Adriana Lúcia Meireles
- Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro, Preto, Ouro Preto, Minas Gerais, Brazil
- Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Ouro Preto, Brazil
- Department of Clinical and Social Nutrition, School of Nutrition, Federal University of Ouro, Preto, Ouro Preto, Minas Gerais, Brazil
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