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Habib A, Ali T, Nazir Z, Muskan F, Jawed I, Akilimali A. Unveiling Pakistan's transport problems: a call to safeguard public health. Front Public Health 2024; 12:1325193. [PMID: 38932765 PMCID: PMC11199719 DOI: 10.3389/fpubh.2024.1325193] [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: 10/20/2023] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
Public transportation is an important mode of transportation in developing countries like Pakistan since it is accessible and convenient. But there are also serious health hazards associated with it, especially when it comes to the transmission of infectious diseases including COVID-19, TB, and Haemophilus influenzae. Worldwide transportation systems are vulnerable, as the COVID-19 pandemic has shown, underscoring the necessity for study and mitigating measures. The danger of disease transmission is increased in Pakistan by crowded metropolitan areas, inadequate sanitation, and low health awareness. In addition, congested public transportation and inadequate ventilation lead to reduced air quality and elevated stress levels among commuters. Comprehensive actions are needed to address these health hazards, such as promoting physical distance, improving cleanliness, enforcing traffic safety laws, and implementing policy changes that support sustainable transportation. Community involvement and advocacy are critical in campaigning for safer and more sustainable transportation networks. Pakistan can enhance public health outcomes and reduce the health hazards linked to public transportation by giving priority to these measures.
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Affiliation(s)
- Ashna Habib
- Dow University of Health Sciences, Karachi, Pakistan
| | - Tooba Ali
- Dow University of Health Sciences, Karachi, Pakistan
| | - Zainab Nazir
- Dow University of Health Sciences, Karachi, Pakistan
| | - Fiza Muskan
- Dow University of Health Sciences, Karachi, Pakistan
| | - Ifra Jawed
- Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan
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Chan JA, Bosma H, Lakerveld J, Schram MT, van Greevenbroek M, Koster A. Social cohesion and associations with sedentary time, physical activity and dietary quality in The Maastricht Study. Prev Med 2024; 183:107970. [PMID: 38653391 DOI: 10.1016/j.ypmed.2024.107970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/04/2024] [Accepted: 04/20/2024] [Indexed: 04/25/2024]
Abstract
INTRO We aim to investigate the relationship between social cohesion and sedentary behavior (SB), total physical activity (PA), moderate-to-vigorous PA (MVPA), and dietary quality. Additionally, we assess whether these associations are independent of neighborhood walkability and the food environment. METHODS A total of 7641 participants from The Maastricht Study in the Netherlands between the ages of 40 and 75 years were analyzed. Neighborhood social cohesion was obtained by participant questionnaire completed at baseline and measured by the Dutch Livability meter. Home addresses were linked to geographic information system (GIS) data from the Geoscience and Health Cohort Consortium (GECCO) to create neighborhood exposures of walkability and food environment. A thigh worn accelerometer collected data to measure sedentary time, total daily PA, and MVPA. Dietary quality was measured with a food frequency questionnaire. Multivariate linear regression analyses were adjusted for age, sex, socioeconomic position, neighborhood walkability, and food environment. RESULTS Those living in the highest quartile area of perceived social cohesion had statistically significant lower levels of SB (Q4 B: -13.04; 95% CI = -20.23, -5.85), higher total PA (Q4 B: 4.39; 95% CI = 1.69, 7.10), and higher MVPA (Q4 B: 2.57; 95% CI = 0.83, 4.31) and better diet quality (Q4 B: 1.12; 95% CI = 0.24, 2.01) compared to the lowest quartile independent of walkability and food environment. Similar results were found using the Livability meter. CONCLUSION We discovered neighborhood social cohesion as an important obesogenic determinant that should be considered in policymaking to encourage higher levels of PA and higher diet quality.
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Affiliation(s)
- Jeffrey Alexander Chan
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands; Department of Physical Medicine and Rehabilitation, Northern California VA Healthcare System, Martinez, CA, USA.
| | - Hans Bosma
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Miranda T Schram
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands; Heart and Vascular Centre, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Marleen van Greevenbroek
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands
| | - Annemarie Koster
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
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Tabibi MA, Samouei R, Salimian N, Shahidi S, Atapour A, Nazemi F, Ghenaat M, Nikbakht S, Sarbazi MH, Soleymany M, Roshanaeian Z, Khajeheian B, Khaki Z, Sokani AS, Ebrahimi R, Ahmadi S. Validity and reliability of Persian version of Low Physical Activity Questionnaire (LoPAQ). BMC Nephrol 2024; 25:178. [PMID: 38778292 PMCID: PMC11112922 DOI: 10.1186/s12882-024-03615-w] [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: 03/09/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The Low Physical Activity Questionnaire (LoPAQ) was specifically developed to measure the low activity level observed in extremely inactive hemodialysis (HD) patients. This study aims to evaluate reliability and validity of Persian version of the LoPAQ. METHODS This study was a cross sectional study, conducted in three HD centers in Iran. The LoPAQ was translated into Persian. After cultural adaptions, it was filled out by 120 HD patiens. Convergent validity, was evaluated by calculating the correlations among the Persian version of the LoPAQ and Persian version of the Community Healthy Adults Model Program for Seniors (CHAMPS) questionnaire, physical function scale of the SF-36 and physical function (Short Physical Performance Battery (SPPB) test) using Spearman's correlation coefficients. The test-retest reliability was analyzed using the intraclass correlation coefficient (ICC). RESULTS In total, 109 patients completed all of the questionnaires, took part in physical performance tests and had valid data. Their mean age was 64 ± 11 years, with a dialysis history of 31 ± 10 months. For total calories, there was a strong correlation between the Persian version of the LoPAQ and CHAMPS-measured physical activity (rho = 0.85, p < 0.001). In addition, the higher physical activity level reported by Persian version of the LoPAQ was also correlated with better self-reported physical function (rho = 0.7, p < 0.001) and better physical performance (rho = 0.67, p < 0.001). The ICC ranged from 0.65 to 0.78, indicating strong reliability. CONCLUSION The assessment of the validity and reliability of the Persian version of the questionnaire confirmed its suitability for evaluating the level of physical activity. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05930964, Registered on 05/07/2023. Registered trial name: Validity and Reliability of Persian Version of Low Physical Activity Questionnaire (LoPAQ).
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Affiliation(s)
- Mohammad Ali Tabibi
- Department of Exercise Physiology, Pardis Specialized Wellness Institute, Isfahan, Iran.
| | - Rahele Samouei
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasrin Salimian
- Department of Research and Development, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Shahrzad Shahidi
- Isfahan Kidney Diseases Research Center, Internal Medicine Department, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdolamir Atapour
- Isfahan Kidney Diseases Research Center, Internal Medicine Department, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzad Nazemi
- Department of Exercise Physiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Mahsa Ghenaat
- Department of Exercise Physiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Saghar Nikbakht
- Department of Kinesiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | | | - Mahsa Soleymany
- Department of Exercise Physiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Zahra Roshanaeian
- Department of Sport Nutrition, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Behnaz Khajeheian
- Department of Kinesiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Zahra Khaki
- Department of Exercise Physiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Ali Sadeghi Sokani
- Department of Exercise Physiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Reyhane Ebrahimi
- Department of Kinesiology, Pardis Specialized Wellness Institute, Isfahan, Iran
| | - Saghar Ahmadi
- Department of Health and Palliative Care, Pardis Specialized Wellness Institute, Isfahan, Iran
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Jin X, Chen Y, Xu B, Tian H. Exercise-Mediated Protection against Air Pollution-Induced Immune Damage: Mechanisms, Challenges, and Future Directions. BIOLOGY 2024; 13:247. [PMID: 38666859 PMCID: PMC11047937 DOI: 10.3390/biology13040247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/29/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024]
Abstract
Air pollution, a serious risk factor for human health, can lead to immune damage and various diseases. Long-term exposure to air pollutants can trigger oxidative stress and inflammatory responses (the main sources of immune impairment) in the body. Exercise has been shown to modulate anti-inflammatory and antioxidant statuses, enhance immune cell activity, as well as protect against immune damage caused by air pollution. However, the underlying mechanisms involved in the protective effects of exercise on pollutant-induced damage and the safe threshold for exercise in polluted environments remain elusive. In contrast to the extensive research on the pathogenesis of air pollution and the preventive role of exercise in enhancing fitness, investigations into exercise resistance to injury caused by air pollution are still in their infancy. In this review, we analyze evidence from humans, animals, and cell experiments on the combined effects of exercise and air pollution on immune health outcomes, with an emphasis on oxidative stress, inflammatory responses, and immune cells. We also propose possible mechanisms and directions for future research on exercise resistance to pollutant-induced damage in the body. Furthermore, we suggest strengthening epidemiological studies at different population levels and investigations on immune cells to guide how to determine the safety thresholds for exercise in polluted environments.
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Affiliation(s)
| | | | - Bingxiang Xu
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (X.J.); (Y.C.)
| | - Haili Tian
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (X.J.); (Y.C.)
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Jayedi A, Zargar MS, Emadi A, Aune D. Walking speed and the risk of type 2 diabetes: a systematic review and meta-analysis. Br J Sports Med 2024; 58:334-342. [PMID: 38050034 DOI: 10.1136/bjsports-2023-107336] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2023] [Indexed: 12/06/2023]
Abstract
OBJECTIVE To investigate the association between walking speed and the risk of type 2 diabetes. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed, Scopus, CENTRAL and Web of Science to 30 May 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included cohort studies that explored the association between walking speed and the risk of type 2 diabetes in adults. We used random-effects meta-analyses to calculate relative risk (RR) and risk difference (RD). We rated the credibility of subgroup differences and the certainty of evidence using the Instrument to assess the Credibility of Effect Modification ANalyses (ICEMAN) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) tools, respectively. RESULTS Ten cohort studies were included. Compared with easy/casual walking (<3.2 km/hour), the RR of type 2 diabetes was 0.85 (95% CI 0.70 to 1.00); RD=0.86 (95% CI 1.72 to 0) fewer cases per 100 patients; n=4, GRADE=low) for average/normal walking (3.2-4.8 km/hour), 0.76 (95% CI 0.65 to 0.87); RD=1.38 (95% CI 2.01 to 0.75) fewer cases per 100 patients; n=10, GRADE=low) for fairly brisk walking (4.8-6.4 km/hour) and 0.61 (95% CI 0.49 to 0.73; RD=2.24 (95% CI 2.93 to 1.55) fewer cases per 100 patients; n=6, GRADE=moderate) for brisk/striding walking (>6.4 km/hour). There was no significant or credible difference across subgroups based on adjustment for the total volume of physical activity and time spent walking per day. Dose-response analysis suggested that the risk of type 2 diabetes decreased significantly at a walking speed of 4 km/h and above. CONCLUSIONS Low to moderate certainty evidence, mainly from studies with a high risk of bias, suggests that walking at faster speeds is associated with a graded decrease in the risk of type 2 diabetes. PROSPERO REGISTRATION NUMBER CRD42023432795.
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Affiliation(s)
- Ahmad Jayedi
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Mahdieh-Sadat Zargar
- Clinical Research Development Unit, Kowsar Educational, Research and Therapeutic Hospital, Semnan University of Medical Sciences, Semnan, Iran
| | - Alireza Emadi
- Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iran
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Nutrition, Oslo New University College, Oslo, Norway
- Department of Research, The Cancer Registry of Norway, Oslo, Norway
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Zhou HH, Jin B, Liao Y, Hu Y, Li P, YangLha T, Liu Y, Xu J, Wang B, Zhu M, Xiao J, Liu J, Nüssler AK, Liu L, Hao X, Chen J, Peng Z, Yang W. Associations of Various Physical Activities with Mortality and Life Expectancy are Mediated by Telomere Length. J Am Med Dir Assoc 2024; 25:431-438.e15. [PMID: 37660722 DOI: 10.1016/j.jamda.2023.08.002] [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: 06/01/2023] [Revised: 07/28/2023] [Accepted: 08/02/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVES Physical activity (PA) and telomeres both contribute to healthy aging and longevity. To investigate the optimal dosage of various PA for longevity and the role of telomere length in PA and mortality. DESIGN Prospective cohort study. SETTING AND PARTICIPANTS A total of 333,865 adults (mean age of 56 years) from the UK Biobank were analyzed. METHODS Walking, moderate PA (MPA), and vigorous PA (VPA) were self-reported via questionnaire, and leukocyte telomere length (LTL) was measured. Cox proportional hazards regression was used to predict all-cause mortality risk. A flexible parametric Royston-Parmar survival model was used to estimate life expectancy. RESULTS During a median follow-up of 13.8 years, 19,789 deaths were recorded. Compared with the no-walking group, 90 to 720 minutes/week of walking was similarly associated with 27% to 31% of lower mortality and about 6 years of additional life expectancy. We observed nearly major benefits for mortality and life expectancy among those meeting the PA guidelines [151-300 minutes/wk for MPA: hazard ratio (HR) 0.80, 95% CI 0.75-0.85, 3.40-3.42 additional life years; 76-150 minutes/wk for VPA: HR 0.78, 95% CI 0.75-0.82, 2.61 years (2.33-2.89)] vs the no-PA group. Similar benefits were also observed at 76-150 and 301-375 minutes/wk of MPA (18%-19% lower mortality, 3.20-3.42 gained years) or 151-300 minutes/wk of VPA (20%-26% lower mortality, 2.41-2.61 gained years). The associations between MPA, VPA, and mortality risk were slightly mediated by LTL (≈1% mediation proportion, both P < .001). CONCLUSIONS AND IMPLICATIONS Our study suggests a more flexible range of PA than the current PA guidelines, which could gain similar benefits and is easier to achieve: 90 to 720 minutes/wk of walking, 75 to 375 minutes/wk of MPA, and 75 to 300 minutes/wk of VPA. Telomeres might be a potential mechanism by which PA promotes longevity.
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Affiliation(s)
- Huan-Huan Zhou
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Biyu Jin
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuxiao Liao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yaling Hu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pengwan Li
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tesring YangLha
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yiran Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingwen Xu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Biyao Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Minglin Zhu
- Department of Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jie Xiao
- Department of Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jinping Liu
- Department of Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Andreas K Nüssler
- Department of Traumatology, BG Trauma Center, University of Tübingen, Tübingen, Germany
| | - Liegang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xingjie Hao
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiuling Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhao Peng
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Yang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Fukushima N, Kikuchi H, Sato H, Sasai H, Kiyohara K, Sawada SS, Machida M, Amagasa S, Inoue S. Dose-Response Relationship of Physical Activity with All-Cause Mortality among Older Adults: An Umbrella Review. J Am Med Dir Assoc 2024; 25:417-430. [PMID: 37925162 DOI: 10.1016/j.jamda.2023.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/25/2023] [Accepted: 09/25/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVES To examine the dose-response relationship between physical activity (PA) and all-cause and cardiovascular disease (CVD) mortality, specifically among older adults. DESIGN Umbrella review. SETTING AND PARTICIPANTS Eligible studies included systematic reviews with meta-analyses that investigated the association of aerobic PA, muscle-strengthening activity, and multicomponent PA, including exercise programs (such as aerobic, muscle strengthening, and balance training), with all-cause and CVD mortality among older adults aged ≥60 years. METHODS We performed a literature search in PubMed, CINAHL, and the Cochrane Library for eligible studies published between January 2017 and March 2023 to update an umbrella review initially conducted by the United States 2018 PA Guidelines Advisory Committee. Studies included in the 2018 US PA and 2020 World Health Organization (WHO) Guidelines were also reviewed. In addition, meta-analyses that reported effect sizes stratified by age and recruiting older adults (aged ≥60 years) were included. RESULTS Overall, 16 relevant systematic reviews (10 from our review and 6 from the US and WHO guidelines) met the inclusion criteria. All these reviews showed that 7.5 to 15.0 metabolic equivalents (METs)-hours/week (around the recommended PA levels outlined in the US and WHO guidelines) substantially reduced mortality risks among older adults (approximately 19%-30% for all-cause mortality and 25%-34% for CVD mortality). Moreover, 15.0 to 22.5 MET-hours/week, exceeding the guideline-recommended PA levels, resulted in greater reductions in mortality risks by 35% to 37% and 38% to 40%, respectively. CONCLUSIONS AND IMPLICATIONS PA substantially reduced all-cause and CVD mortality risks among older adults. Larger risk reductions may be achieved by engaging in PA levels higher than those recommended by the current international PA guidelines. Our findings suggest that recommending higher PA levels beyond the current guidelines may benefit older adults when developing future international PA guidelines.
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Affiliation(s)
- Noritoshi Fukushima
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
| | - Hiroyuki Kikuchi
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
| | - Hiroki Sato
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kosuke Kiyohara
- Department of Food Science, Faculty of Home Economics, Otsuma Women's University, Tokyo, Japan
| | - Susumu S Sawada
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Masaki Machida
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
| | - Shiho Amagasa
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan; Graduate School of Public Health, Teikyo University, Tokyo, Japan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan.
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Rigaud M, Buekers J, Bessems J, Basagaña X, Mathy S, Nieuwenhuijsen M, Slama R. The methodology of quantitative risk assessment studies. Environ Health 2024; 23:13. [PMID: 38281011 PMCID: PMC10821313 DOI: 10.1186/s12940-023-01039-x] [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: 06/23/2023] [Accepted: 12/05/2023] [Indexed: 01/29/2024]
Abstract
Once an external factor has been deemed likely to influence human health and a dose response function is available, an assessment of its health impact or that of policies aimed at influencing this and possibly other factors in a specific population can be obtained through a quantitative risk assessment, or health impact assessment (HIA) study. The health impact is usually expressed as a number of disease cases or disability-adjusted life-years (DALYs) attributable to or expected from the exposure or policy. We review the methodology of quantitative risk assessment studies based on human data. The main steps of such studies include definition of counterfactual scenarios related to the exposure or policy, exposure(s) assessment, quantification of risks (usually relying on literature-based dose response functions), possibly economic assessment, followed by uncertainty analyses. We discuss issues and make recommendations relative to the accuracy and geographic scale at which factors are assessed, which can strongly influence the study results. If several factors are considered simultaneously, then correlation, mutual influences and possibly synergy between them should be taken into account. Gaps or issues in the methodology of quantitative risk assessment studies include 1) proposing a formal approach to the quantitative handling of the level of evidence regarding each exposure-health pair (essential to consider emerging factors); 2) contrasting risk assessment based on human dose-response functions with that relying on toxicological data; 3) clarification of terminology of health impact assessment and human-based risk assessment studies, which are actually very similar, and 4) other technical issues related to the simultaneous consideration of several factors, in particular when they are causally linked.
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Affiliation(s)
- Maxime Rigaud
- Inserm, University of Grenoble Alpes, CNRS, IAB, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, France
| | - Jurgen Buekers
- VITO, Flemish Institute for Technological Research, Unit Health, Mol, Belgium
| | - Jos Bessems
- VITO, Flemish Institute for Technological Research, Unit Health, Mol, Belgium
| | - Xavier Basagaña
- ISGlobal, Barcelona, 08003, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, 08003, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, 28029, Spain
| | - Sandrine Mathy
- CNRS, University Grenoble Alpes, INRAe, Grenoble INP, GAEL, Grenoble, France
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, 08003, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, 08003, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, 28029, Spain
| | - Rémy Slama
- Inserm, University of Grenoble Alpes, CNRS, IAB, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, France.
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Suorsa K, Gupta N, Leskinen T, Andersen LL, Pasanen J, Hettiarachchi P, Johansson PJ, Pentti J, Vahtera J, Stenholm S. Modifications of 24-h movement behaviors to prevent obesity in retirement: a natural experiment using compositional data analysis. Int J Obes (Lond) 2023; 47:922-930. [PMID: 37221289 PMCID: PMC10511314 DOI: 10.1038/s41366-023-01326-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Retirement often leads to a more passive lifestyle and may therefore lead to weight gain. This study aims to investigate longitudinal associations between changes in 24-h movement behaviors and BMI and waist circumference in relation to the transition from work to retirement. METHODS The study population included 213 retiring public sector workers (mean age 63.5 years, standard deviation 1.1) from the Finnish Retirement and Aging study. Before and after retirement participants wore an Axivity accelerometer on their thigh and filled in a daily log for at least four days to measure daily time spent sleeping, in sedentary behavior (SED), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA). Also, their body mass index (BMI) and waist circumference were measured repeatedly. Compositional linear regression analysis and isotemporal substitution analysis were used to study associations between one-year changes in 24-h movement behaviors and concurrent changes in BMI and waist circumference. RESULTS An increase in MVPA in relation to sleep, SED and LPA was associated with a decreasing BMI (β = -0.60, p = 0.04) and waist circumference (β = -2.14, p = 0.05) over one year from before retirement to after retirement. In contrast, increasing sleep in relation to SED, LPA and MVPA was associated with an increasing BMI (β = 1.34, p = 0.02). Reallocating 60 min from MVPA to SED or sleep was estimated to increase BMI by on average 0.8-0.9 kg/m2 and waist circumference by 3.0 cm during one year. CONCLUSIONS During the transition from work to retirement, increasing MVPA was associated with a slight decrease in BMI and waist circumference, whereas increasing sleep was associated with an increasing BMI. Common life transitions, like retirement, should be considered when giving recommendations and guidance for physical activity and sleep.
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Affiliation(s)
- Kristin Suorsa
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
| | - Nidhi Gupta
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Tuija Leskinen
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Jesse Pasanen
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Pasan Hettiarachchi
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Peter J Johansson
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Jaana Pentti
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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10
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Greenwalt D, Phillips S, Ozemek C, Arena R, Sabbahi A. The Impact of Light Physical Activity, Sedentary Behavior and Cardiorespiratory Fitness in Extending Lifespan and Healthspan Outcomes: How Little is Still Significant? A Narrative Review. Curr Probl Cardiol 2023; 48:101871. [PMID: 37302646 DOI: 10.1016/j.cpcardiol.2023.101871] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/06/2023] [Indexed: 06/13/2023]
Abstract
To describe the relationship between mortality and measures of low intensity physical activity (LIPA) as well as sedentary behavior (SB), and cardiorespiratory fitness (CRF). Study selection was performed through multiple database searches from January 1, 2000 until May 1, 2023. Seven LIPA studies, 9 SB studies, and 8 studies CRF studies were selected for primary analysis. LIPA and non-SB follow a reverse J shaped curve with mortality. The greatest benefits occur initially, and the rate of mortality reduction slows with increasing physical activity. Increasing CRF reduces mortality although the dose response curve is uncertain. For special populations such as individuals with, or at high risk of developing cardiovascular disease the benefit from exercise is heightened. LIPA, decreased SB and higher CRF lead to reductions in mortality and improved quality of life. Individualized counseling on the benefits of any amount of physical activity may increase compliance and serve as a starting point for lifestyle modifications.
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Affiliation(s)
- Dakota Greenwalt
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
| | - Shane Phillips
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL.
| | - Cemal Ozemek
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
| | - Ahmad Sabbahi
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL
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11
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Green DJ, Chasland LC, Naylor LH, Yeap BB. New Horizons: Testosterone or Exercise for Cardiometabolic Health in Older Men. J Clin Endocrinol Metab 2023; 108:2141-2153. [PMID: 36964918 PMCID: PMC10438896 DOI: 10.1210/clinem/dgad175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/14/2023] [Accepted: 03/22/2023] [Indexed: 03/27/2023]
Abstract
Middle-aged and older men have typically accumulated comorbidities, are increasingly sedentary, and have lower testosterone concentrations (T) compared to younger men. Reduced physical activity (PA) and lower T both are associated with, and may predispose to, metabolically adverse changes in body composition, which contribute to higher risks of cardiometabolic disease. Exercise improves cardiometabolic health, but sustained participation is problematic. By contrast, rates of T prescription have increased, particularly in middle-aged and older men without organic diseases of the hypothalamus, pituitary, or testes, reflecting the unproven concept of a restorative hormone that preserves health. Two recent large randomized trials of T, and meta-analyses of randomized trials, did not show a signal for adverse cardiovascular (CV) events, and T treatment on a background of lifestyle intervention reduced type 2 diabetes by 40% in men at high risk. Men with both higher endogenous T and higher PA levels have lower CV risk, but causality remains unproven. Exercise training interventions improve blood pressure and endothelial function in middle-aged and older men, without comparable benefits or additive effects of T treatment. Therefore, exercise training improves cardiometabolic health in middle-aged and older men when effectively applied as a supervised regimen incorporating aerobic and resistance modalities. Treatment with T may have indirect cardiometabolic benefits, mediated via favorable changes in body composition. Further evaluation of T as a pharmacological intervention to improve cardiometabolic health in aging men could consider longer treatment durations and combination with targeted exercise programs.
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Affiliation(s)
- Daniel J Green
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, 6009, Australia
| | - Lauren C Chasland
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, 6009, Australia
- Allied Health Department, Fiona Stanley Hospital, Perth, WA, 6150, Australia
| | - Louise H Naylor
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, 6009, Australia
- Allied Health Department, Fiona Stanley Hospital, Perth, WA, 6150, Australia
| | - Bu B Yeap
- Medical School, The University of Western Australia, Perth, WA, 6009, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, WA, 6150, Australia
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12
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Velázquez-Cortés D, Nieuwenhuijsen MJ, Jerrett M, Rojas-Rueda D. Health benefits of Open Streets programmes in Latin America: a quantitative health impact assessment. Lancet Planet Health 2023; 7:e590-e599. [PMID: 37438000 DOI: 10.1016/s2542-5196(23)00109-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND To improve physical activity in Latin American cities, several interventions have been promoted, such as Open Streets programmes. Our study aims to quantify the health and economic effects of Open Streets-related physical activity in 15 Latin American cities. METHODS We used a quantitative health impact assessment approach to estimate annual premature deaths and disease incidence (ischaemic heart disease, ischaemic stroke, type 2 diabetes, colon cancer, breast cancer, and dementia) avoided, the disability-adjusted life-years (DALYs) gained, and the cost saving (from reduced premature mortality) related to increased physical activity from Open Streets programmes in 15 Latin American cities. Input data were obtained from scientific publications, reports, and open street city surveys spanning 2017 to 2019. Physical activity data were converted to metabolic equivalent of the task. Exposure-response relationship functions were applied to estimate relative risk and population-attributable fraction, enabling the assessment of premature deaths and disease incidence. FINDINGS The percentage of male users of the Open Streets programmes ranged from 55% (27 500 of 50 000 in Guatemala) to 75% (2250 of 3000 in El Alto, Bolivia), and female users ranged from 25% (750; El Alto) to 45% (22 500; Guatemala). We estimated that the current Open Streets programmes in the 15 Latin American cities studied could prevent 363 (95% CI 271-494) annual premature deaths due to increased physical activity, with an annual economic impact of US$194·1 million (144·9 million-263·9 million) saved and an annual reduction of 1036·7 DALYs (346·7-1778·3). If one Open Streets event is added per week in each of those cities, the potential benefit could increase to 496 (370 to 677) premature deaths prevented each year. INTERPRETATION Open Streets programmes in Latin America can provide health and economic benefits related to increased physical activity and can be used as a health promotion and disease prevention tool. FUNDING EU's Horizon 2020 research and innovation programme.
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Affiliation(s)
- Daniel Velázquez-Cortés
- Center for Nutrition and Health Research, Department of Physical Activity and Healthy Lifestyles, National Institute of Public Health, Mexico City, Mexico; ISGlobal, Centre for Research in Environmental Epidemiology, Barcelona, Spain
| | - Mark J Nieuwenhuijsen
- ISGlobal, Centre for Research in Environmental Epidemiology, Barcelona, Spain; Municipal Institute of Medical Research, IMIM-Hospital del Mar, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - David Rojas-Rueda
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; Colorado School of Public Health, Colorado State University, Fort Collins, CO, USA.
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13
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Bohlen LC, LaRowe LR, Dunsiger SI, Dionne L, Griffin E, Kim AE, Marcus BH, Unick J, Wu WC, Williams DM. Comparing a recommendation for self-paced versus moderate intensity physical activity for midlife adults: Rationale and design. Contemp Clin Trials 2023; 128:107169. [PMID: 36972866 PMCID: PMC10183157 DOI: 10.1016/j.cct.2023.107169] [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: 01/26/2023] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023]
Abstract
Current U.S. guidelines recommend that adults obtain 150 min per week of moderate intensity physical activity (PA), 75 min of vigorous intensity PA, or some equivalent combination. However, less than half of U.S. adults reach this goal, with the proportion even smaller among adults with overweight or obesity. Moreover, regular PA declines after age 45-50. Previous research suggests a shift in national guidelines to emphasize PA of a self-selected intensity (i.e., self-paced), instead of prescribed moderate intensity PA, may result in better adherence to PA programs, particularly among midlife adults with overweight or obesity. The present paper presents the protocol for a field-based RCT testing the hypothesis that adherence to PA programs is improved when PA is explicitly recommended to be self-paced rather than prescribed at moderate intensity among midlife (ages 50-64) adults (N = 240) with overweight or obesity. All participants receive a 12-month intervention designed to help them overcome barriers to regular PA and are randomly assigned to either self-paced or prescribed moderate intensity PA. The primary outcome is total volume of PA (minutes by intensity) as measured by accelerometry. Secondary outcomes include self-reported min/week of PA and changes in bodyweight. Additionally, using ecological momentary assessment, we examine putative mediators of treatment effects. We hypothesize self-paced PA will lead to a more positive affective response to PA, more perceived autonomy, and lower perceived exertion during PA, and thus greater increases in PA behavior. Findings will have direct implications for PA intensity recommendations among midlife adults with overweight or obesity.
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Affiliation(s)
- Lauren Connell Bohlen
- Brown University School of Public Health, Center for Health Promotion and Health Equity, Providence, RI, USA
| | - Lisa R LaRowe
- Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, USA
| | - Shira I Dunsiger
- Brown University School of Public Health, Center for Health Promotion and Health Equity, Providence, RI, USA
| | - Laura Dionne
- Brown University School of Public Health, Center for Health Promotion and Health Equity, Providence, RI, USA
| | - Elizabeth Griffin
- Brown University School of Public Health, Center for Health Promotion and Health Equity, Providence, RI, USA
| | - Alison E Kim
- Brown University School of Public Health, Center for Health Promotion and Health Equity, Providence, RI, USA
| | - Bess H Marcus
- Brown University School of Public Health, Center for Health Promotion and Health Equity, Providence, RI, USA
| | - Jessica Unick
- The Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Wen-Chih Wu
- The Miriam Hospital, Lifespan Cardiovascular Wellness and Prevention Center, Providence, RI, USA
| | - David M Williams
- Brown University School of Public Health, Center for Health Promotion and Health Equity, Providence, RI, USA.
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14
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Kirchner H, Weisner L, Wilms B. When should I run-the role of exercise timing in metabolic health. Acta Physiol (Oxf) 2023; 237:e13953. [PMID: 36815281 DOI: 10.1111/apha.13953] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/24/2023]
Abstract
The prevalence of type 2 diabetes is reaching epidemic proportions. First line therapy approaches are lifestyle interventions including exercise. Although a vast amount of studies reports on beneficial effects of exercise on metabolism in humans per se, overall data are contradictory which makes it difficult to optimize interventions. Innovative exercise strategies and its underlying mechanism are needed to elucidate in order to close this therapeutic gap. The skeletal muscle produces and secretes myokines and microRNAs in response to exercise and both are discussed as mechanisms linking exercise and metabolic adaptation. Aspects of chronophysiology such as diurnal variation in insulin sensitivity or exercise as a signal to reset dysregulated peripheral clocks are of growing interest in the context of impaired metabolism. Deep insight of how exercise timing determines metabolic adaptations is required to optimize exercise interventions. This review aims to summarize the current state of research on the interaction between timing of exercise and metabolism in humans, providing insights into proposed mechanistic concepts focusing on myokines and microRNAs. First evidence points to an impact of timing of exercise on health outcome, although data are inconclusive. Underlying mechanisms remain elusive. It is currently unknown if the timed release of mykokines depends on time of day when exercise is performed. microRNAs have been found as an important mediator of processes associated with exercise adaptation. Further research is needed to evaluate their full relevance. In conclusion, it seems to be too early to provide concrete recommendations on timing of exercise to maximize beneficial effects.
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Affiliation(s)
- Henriette Kirchner
- Institute for Human Genetics, Epigenetics and Metabolism Lab, University of Lübeck, Lübeck, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Leon Weisner
- Institute of Endocrinology and Diabetes, University of Luebeck, Luebeck, Germany
| | - Britta Wilms
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute of Endocrinology and Diabetes, University of Luebeck, Luebeck, Germany
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15
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Moriyama N, Kuga T, Oshima T, Sato K, Kurita M, Yasumura S. Association between Tai Chi Yuttari Exercise and Longevity and Prevention of Long-Term Care Need: Survival Analysis in Kitakata City, Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3472. [PMID: 36834168 PMCID: PMC9961723 DOI: 10.3390/ijerph20043472] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/10/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
This study examined whether participation in Tai Chi Yuttari exercise is associated with a delay in the death and new certification for long-term care need of older adults. Individuals who participated in Tai Chi Yuttari exercise classes in 2011-2015 (participation group) were compared with individuals from the Basic Resident Register of Kitakata City (non-participation group). Death and new certification for long-term care need were selected to evaluate the effectiveness of participation in Tai Chi Yuttari exercise classes. The periods from the start date of the observation to each person's date of occurrence of events were calculated. The Kaplan-Meier method and log-rank test were used to compare survival curves between the groups. A total of 105 and 202 individuals in the participation and non-participation groups, respectively, were observed. Survival duration (χ2 = 8.782, p = 0.003) and the period before receiving certification for long-term care (χ2 = 5.354, p = 0.021) were longer in the participation group than in the non-participation group. In the stratified analysis by sex, survival duration was longer in the participation group in men only (χ2 = 7.875, p = 0.005). Participation in Tai Chi Yuttari exercise might be effective in delaying death, especially in men, and new certification for long-term care.
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Affiliation(s)
- Nobuaki Moriyama
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Tomomi Kuga
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Tetsuzo Oshima
- Health and Welfare Department, Elderly Welfare Division, Kitakata 966-8601, Japan
| | - Kumiko Sato
- Health and Welfare Department, Elderly Welfare Division, Kitakata 966-8601, Japan
| | - Miho Kurita
- Health and Welfare Department, Elderly Welfare Division, Kitakata 966-8601, Japan
| | - Seiji Yasumura
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
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16
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Olsen SH, Aparicio EM, Jaeger PT, Howard DE. Exploring motivations to be active among amputees: a phenomenological approach to leisure time physical activity. Int J Qual Stud Health Well-being 2023; 18:2143053. [DOI: 10.1080/17482631.2022.2143053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Sara H. Olsen
- Department of Behavioral and Community Health, University of Maryland at College Park, College Park, Maryland, USA
| | - Elizabeth M. Aparicio
- Department of Behavioral and Community Health, University of Maryland at College Park, College Park, Maryland, USA
| | - Paul T. Jaeger
- College of Information Studies, University of Maryland at College Park, College Park, Maryland, USA
| | - Donna E. Howard
- Department of Behavioral and Community Health, University of Maryland at College Park, College Park, Maryland, USA
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17
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Wave 1 results of the INTerventions, Research, and Action in Cities Team (INTERACT) cohort study: Examining spatio-temporal measures for urban environments and health. Health Place 2023; 79:102646. [PMID: 34366232 DOI: 10.1016/j.healthplace.2021.102646] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/29/2021] [Accepted: 07/16/2021] [Indexed: 11/20/2022]
Abstract
Built environment interventions have the potential to improve population health and reduce health inequities. The objective of this paper is to present the first wave of the INTErventions, Research, and Action in Cities Team (INTERACT) cohort studies in Victoria, Vancouver, Saskatoon, and Montreal, Canada. We examine how our cohorts compared to Canadian census data and present summary data for our outcomes of interest (physical activity, well-being, and social connectedness). We also compare location data and activity spaces from survey data, research-grade GPS and accelerometer devices, and a smartphone app, and compile measures of proximity to select built environment interventions.
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18
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Yang D, Liu M, Willey JZ, Khasiyev F, Tom SE, Rundek T, Cheung YK, Wright CB, Sacco RL, Elkind MSV, Gutierrez J. Physical Activity Is Inversely Associated With Severe Intracranial Stenosis in Stroke-Free Participants of NOMAS. Stroke 2023; 54:159-166. [PMID: 36416126 PMCID: PMC9780184 DOI: 10.1161/strokeaha.122.039660] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 09/30/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although protective in secondary stroke prevention of intracranial arterial stenosis (ICAS), it is uncertain if the benefits of leisure time physical activity (LTPA) extend to asymptomatic ICAS or extracranial carotid stenosis (ECAS). Therefore, we sought to determine LTPA's relationship with ECAS and ICAS in a stroke-free, race-ethnically diverse cohort. METHODS This cross-sectional study included participants from the magnetic resonance imaging substudy of the Northern Manhattan Study, of whom 1274 had LTPA assessments at enrollment. LTPA was represented continuously as metabolic equivalent score (MET-score) and ordinally as model-based cluster analysis (LTPA-cluster), both based on the same LTPA assessments. We evaluated ECAS sonographically using carotid intima-media thickening and number of carotid plaques. ICAS was assessed with time-of-flight magnetic resonance angiograph and defined as ≥50% or ≥70% stenosis. We applied regression analyses to evaluate the association between LTPA with ECAS and ICAS, adjusting for confounders. RESULTS Of 1274 included participants (mean age 71±9 years; 60% women; 65% Hispanic), the mean MET-score was 10±16 and 60% were in a LTPA-cluster with any activity. Among those with carotid ultrasound (n=1234), the mean carotid intima-media thickening was 0.97±0.09 mm, and 56% of participants had at least one carotid plaque identified. Among those with magnetic resonance angiograph (n=1211), 8% had ≥50% ICAS and 5% had ≥70% ICAS. For ICAS, MET-score was associated with ≥70% ICAS (adjusted odds ratio per unit increase in MET-score [95% CI, 0.97 [0.94-0.99]) but not with ECAS measures (carotid intima-media thickening, adjusted β-estimate per unit increase in MET-score [95% CI], 0.002 [-0.003 to 0.006] or number of plaques, adjusted β-estimate [95% CI], 0.0001 [-0.0001 to 0.0003]). Substituting MET-score with LTPA-clusters replicated the association between ≥70% ICAS and LTPA (adjusted odds ratio per each increased LTPA-cluster [95% CI], 0.83 [0.70-0.99]). CONCLUSIONS In this diverse stroke-free population, we found LTPA most strongly associated with asymptomatic ≥70% ICAS. Given the high-risk nature of ≥70% ICAS, these findings may emphasize the role of LTPA in people at risk for ICAS.
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Affiliation(s)
- Dixon Yang
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Minghua Liu
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Joshua Z Willey
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Farid Khasiyev
- Department of Neurology, Saint Louis University, Saint Louis, MO, USA
| | - Sarah E Tom
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Tatjana Rundek
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
- Evelyn McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ying K Cheung
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Clinton B Wright
- National Institute of Neurologic Disorders and Stroke, Bethesda, MD, USA
| | - Ralph L Sacco
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
- Evelyn McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mitchell S V Elkind
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jose Gutierrez
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
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19
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Васюкова ОВ, Окороков ПЛ, Безлепкина ОБ. [Modern strategies for the treatment of childhood obesity]. PROBLEMY ENDOKRINOLOGII 2022; 68:131-136. [PMID: 36689718 PMCID: PMC9939972 DOI: 10.14341/probl13208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/07/2022] [Accepted: 12/07/2022] [Indexed: 01/25/2023]
Abstract
The prevalence of obesity and related metabolic disorders in children and adolescents in the Russian Federation is steadily increasing, which requires healthcare professionals to search for new methods of treatment and prevention. The treatment of childhood obesity should be based on a comprehensive approach, including diet therapy, increased physical activity, behavioral therapy and psychological support. To increase the effectiveness of the formation of new eating habits and proper eating behavior, as well as to increase the adherence of children and adolescents to treatment, drug therapy of obesity is used, aimed primarily at reducing appetite. Considering the efficacy and safety of glucagon-like peptide 1 analog (Liraglutide) in adolescents, as well as a small number of gastrointestinal side effects, this drug is promising in the complex treatment of childhood obesity. This review presents an analysis of the literature on non-medicated and drug-based methods of treatment of childhood obesity.
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20
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Li X, Farrukh M, Lee C, Khreis H, Sarda S, Sohrabi S, Zhang Z, Dadashova B. COVID-19 impacts on mobility, environment, and health of active transportation users. CITIES (LONDON, ENGLAND) 2022; 131:103886. [PMID: 35935595 PMCID: PMC9345890 DOI: 10.1016/j.cities.2022.103886] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 06/05/2022] [Accepted: 07/30/2022] [Indexed: 06/15/2023]
Abstract
Active transportation could be an effective way to promote healthy physical activity, especially during pandemics like COVID-19. A comprehensive evaluation of health outcomes derived from COVID-19 induced active transportation can assist multiple stakeholders in revisiting strategies and priorities for supporting active transportation during and beyond the pandemic. We performed a two-step reviewing process by combining a scoping review with a narrative review to summarize published literature addressing the influence of COVID-19 on mobility and the environment that can lead to various health pathways and health outcomes associated with active transportation. We summarized the COVID-19 induced changes in active transportation demand, built environment, air quality, and physical activity. The results demonstrated that, since the pandemic began, bike-sharing users dropped significantly while recreational bike trips and walking activities increased in some areas. Meanwhile, there have been favorable changes to the air quality and the built environment for active transportation users. We then discussed how these changes impact health outcomes during the pandemic and their implications for urban planning and policymaking. This review also suggests that walking and biking can make up for the reduced physical activities during the pandemic, helping people stay active and healthy.
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Affiliation(s)
- Xiao Li
- Texas A&M Transportation Institute, Bryan, TX, USA
| | - Minaal Farrukh
- School of Public Health, Texas A&M University, College Station, TX, USA
| | - Chanam Lee
- Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX, USA
| | - Haneen Khreis
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Soham Sarda
- University of California Berkeley, Berkeley, CA, USA
| | | | - Zhe Zhang
- Department of Geography, Texas A&M University, College Station, TX, USA
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21
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Reid H, Smith R, Williamson W, Baldock J, Caterson J, Kluzek S, Jones N, Copeland R. Use of the behaviour change wheel to improve everyday person-centred conversations on physical activity across healthcare. BMC Public Health 2022; 22:1784. [PMID: 36127688 PMCID: PMC9487060 DOI: 10.1186/s12889-022-14178-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 08/09/2022] [Indexed: 11/12/2022] Open
Abstract
Background An implementation gap exists between the evidence supporting physical activity in the prevention and management of long-term medical conditions and clinical practice. Person-centred conversations, i.e. focussing on the values, preferences and aspirations of each individual, are required from healthcare professionals. However, many currently lack the capability, opportunity, and motivation to have these conversations. This study uses the Behaviour Change Wheel (BCW) to inform the development of practical and educational resources to help bridge this gap. Methods The BCW provides a theoretical approach to enable the systematic development of behaviour change interventions. Authors followed the described eight-step process, considered results from a scoping review, consulted clinical working groups, tested and developed ideas across clinical pathways, and agreed on solutions to each stage by consensus. Results The behavioural diagnosis identified healthcare professionals’ initiation of person-centred conversations on physical activity at all appropriate opportunities in routine medical care as a suitable primary target for interventions. Six intervention functions and five policy categories met the APEASE criteria. We mapped 17 Behavioural Change Techniques onto BCW intervention functions to define intervention strategies. Conclusions This study uses the BCW to outline a coherent approach for intervention development to improve healthcare professionals’ frequency and quality of conversations on physical activity across clinical practice. Time-sensitive and role-specific resources might help healthcare professionals understand the focus of their intervention. Educational resources aimed at healthcare professionals and patients could have mutual benefit, should fit into existing care pathways and support professional development. A trusted information source with single-point access via the internet is likely to improve accessibility. Future evaluation of resources built and coded using this framework is required to establish the effectiveness of this approach and help improve understanding of what works to change conversations around physical activity in clinical practice.
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Affiliation(s)
- Hamish Reid
- Moving Medicine, Faculty of Sport and Exercise Medicine, 6 Hill Square, Edinburgh, UK. .,Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK.
| | - Ralph Smith
- Oxford University Hospital NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, UK
| | - Wilby Williamson
- School of Medicine, Trinity College Dublin, 152-160 Pearse Street, Dublin, Ireland
| | - James Baldock
- Oxford University Hospital NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, UK
| | - Jessica Caterson
- Imperial College Healthcare NHS Trust, Praed Street, London, GB, W2 1NY, UK
| | - Stefan Kluzek
- School of Medicine, University of Nottingham, Medical School, Nottingham, NG7 2UH, UK
| | - Natasha Jones
- Moving Medicine, Faculty of Sport and Exercise Medicine, 6 Hill Square, Edinburgh, UK.,Oxford University Hospital NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, UK
| | - Robert Copeland
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
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Crist K, Benmarhnia T, Frank LD, Song D, Zunshine E, Sallis JF. The TROLLEY Study: assessing travel, health, and equity impacts of a new light rail transit investment during the COVID-19 pandemic. BMC Public Health 2022; 22:1475. [PMID: 35918683 PMCID: PMC9344230 DOI: 10.1186/s12889-022-13834-1] [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] [Received: 07/15/2022] [Accepted: 07/20/2022] [Indexed: 11/25/2022] Open
Abstract
Background The COVID-19 pandemic disrupted life in extraordinary ways impacting health and daily mobility. Public transit provides a strategy to improve individual and population health through increased active travel and reduced vehicle dependency, while ensuring equitable access to jobs, healthcare, education, and mitigating climate change. However, health safety concerns during the COVID-19 pandemic eroded ridership, which could have longstanding negative consequences. Research is needed to understand how mobility and health change as the pandemic recedes and how transit investments impact health and equity outcomes. Methods The TROLLEY (TRansit Opportunities for HeaLth, Livability, Exercise and EquitY) study will prospectively investigate a diverse cohort of university employees after the opening of a new light rail transit (LRT) line and the easing of campus COVID-19 restrictions. Participants are current staff who live either < 1 mile, 1–2 miles, or > 2 miles from LRT, with equal distribution across economic and racial/ethnic strata. The primary aim is to assess change in physical activity, travel mode, and vehicle miles travelled using accelerometer and GPS devices. Equity outcomes include household transportation and health-related expenditures. Change in health outcomes, including depressive symptoms, stress, quality of life, body mass index and behavior change constructs related to transit use will be assessed via self-report. Pre-pandemic variables will be retrospectively collected. Participants will be measured at 3 times over 2 years of follow up. Longitudinal changes in outcomes will be assessed using multilevel mixed effects models. Analyses will evaluate whether proximity to LRT, sociodemographic, and environmental factors modify change in outcomes over time. Discussion The TROLLEY study will utilize rigorous methods to advance our understanding of health, well-being, and equity-oriented outcomes of new LRT infrastructure through the COVID-19 recovery period, in a sample of demographically diverse adult workers whose employment location is accessed by new transit. Results will inform land use, transportation and health investments, and workplace interventions. Findings have the potential to elevate LRT as a public health priority and provide insight on how to ensure public transit meets the needs of vulnerable users and is more resilient in the face of future health pandemics. Trial registration The TROLLEY study was registered at ClinicalTrials.gov (NCT04940481) June 17, 2021, and OSF Registries (10.17605/OSF.IO/PGEHU) June 24, 2021, prior to participant enrollment. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13834-1.
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Affiliation(s)
- Katie Crist
- Department of Urban Studies & Planning, UC San Diego, 9500 Gilman Drive, La Jolla, San Diego, CA, 92093, USA.
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, UC San Diego, 9500 Gilman Drive, La Jolla, San Diego, CA, 92093, USA
| | - Lawrence D Frank
- Department of Urban Studies & Planning, UC San Diego, 9500 Gilman Drive, La Jolla, San Diego, CA, 92093, USA
| | - Dana Song
- Department of Urban Studies & Planning, UC San Diego, 9500 Gilman Drive, La Jolla, San Diego, CA, 92093, USA
| | - Elizabeth Zunshine
- Moores Cancer Center, UC San Diego, 9500 Gilman Drive, La Jolla, San Diego, CA, 92093, USA
| | - James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, 9500 Gilman Drive, La Jolla, San Diego, CA, 92093, USA.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
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23
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Koch S, Khomenko S, Cirach M, Ubalde-Lopez M, Baclet S, Daher C, Hidalgo L, Lõhmus M, Rizzuto D, Rumpler R, Susilo Y, Venkataraman S, Wegener S, Wellenius GA, Woodcock J, Nieuwenhuijsen M. Impacts of changes in environmental exposures and health behaviours due to the COVID-19 pandemic on cardiovascular and mental health: A comparison of Barcelona, Vienna, and Stockholm. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 304:119124. [PMID: 35367103 PMCID: PMC8967404 DOI: 10.1016/j.envpol.2022.119124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 05/19/2023]
Abstract
Responses to COVID-19 altered environmental exposures and health behaviours associated with non-communicable diseases. We aimed to (1) quantify changes in nitrogen dioxide (NO2), noise, physical activity, and greenspace visits associated with COVID-19 policies in the spring of 2020 in Barcelona (Spain), Vienna (Austria), and Stockholm (Sweden), and (2) estimated the number of additional and prevented diagnoses of myocardial infarction (MI), stroke, depression, and anxiety based on these changes. We calculated differences in NO2, noise, physical activity, and greenspace visits between pre-pandemic (baseline) and pandemic (counterfactual) levels. With two counterfactual scenarios, we distinguished between Acute Period (March 15th - April 26th, 2020) and Deconfinement Period (May 2nd - June 30th, 2020) assuming counterfactual scenarios were extended for 12 months. Relative risks for each exposure difference were estimated with exposure-risk functions. In the Acute Period, reductions in NO2 (range of change from -16.9 μg/m3 to -1.1 μg/m3), noise (from -5 dB(A) to -2 dB(A)), physical activity (from -659 MET*min/wk to -183 MET*min/wk) and greenspace visits (from -20.2 h/m to 1.1 h/m) were largest in Barcelona and smallest in Stockholm. In the Deconfinement Period, NO2 (from -13.9 μg/m3 to -3.1 μg/m3), noise (from -3 dB(A) to -1 dB(A)), and physical activity levels (from -524 MET*min/wk to -83 MET*min/wk) remained below pre-pandemic levels in all cities. Greatest impacts were caused by physical activity reductions. If physical activity levels in Barcelona remained at Acute Period levels, increases in annual diagnoses for MI (mean: 572 (95% CI: 224, 943)), stroke (585 (6, 1156)), depression (7903 (5202, 10,936)), and anxiety (16,677 (926, 27,002)) would be anticipated. To decrease cardiovascular and mental health impacts, reductions in NO2 and noise from the first COVID-19 surge should be sustained, but without reducing physical activity. Focusing on cities' connectivity that promotes active transportation and reduces motor vehicle use assists in achieving this goal.
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Affiliation(s)
- Sarah Koch
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
| | - Sasha Khomenko
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Marta Cirach
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Mònica Ubalde-Lopez
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Sacha Baclet
- The Marcus Wallenberg Laboratory for Sound and Vibration Research (MWL), Department of Engineering Mechanics, KTH Royal Institute of Technology, Stockholm, Sweden; The Centre for ECO2 Vehicle Design, KTH Royal Institute of Technology, SE-100 44, Stockholm, Sweden
| | - Carolyn Daher
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Laura Hidalgo
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Mare Lõhmus
- Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Debora Rizzuto
- Department of Neurobiology, Care Sciences and Society, Aging Research Center (ARC), Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Romain Rumpler
- The Marcus Wallenberg Laboratory for Sound and Vibration Research (MWL), Department of Engineering Mechanics, KTH Royal Institute of Technology, Stockholm, Sweden; The Centre for ECO2 Vehicle Design, KTH Royal Institute of Technology, SE-100 44, Stockholm, Sweden
| | - Yusak Susilo
- Institute for Transport Studies, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Siddharth Venkataraman
- The Marcus Wallenberg Laboratory for Sound and Vibration Research (MWL), Department of Engineering Mechanics, KTH Royal Institute of Technology, Stockholm, Sweden; The Centre for ECO2 Vehicle Design, KTH Royal Institute of Technology, SE-100 44, Stockholm, Sweden
| | - Sandra Wegener
- Institute for Transport Studies, University of Natural Resources and Life Sciences, Vienna, Austria
| | | | - James Woodcock
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
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An R, Kang H, Cao L, Xiang X. Engagement in outdoor physical activity under ambient fine particulate matter pollution: A risk-benefit analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:537-544. [PMID: 33035708 PMCID: PMC7537654 DOI: 10.1016/j.jshs.2020.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/16/2020] [Accepted: 08/24/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Outdoor physical activity (PA) brings important health benefits, but exposure to polluted air increases health risks. This study aimed to quantify the tradeoff of PA under fine particulate matter (PM2.5) air pollution by estimating the optimal PA duration under various pollution levels. METHODS A risk-benefit analysis was performed to estimate the optimal outdoor moderate-intensity PA (MPA) duration under varying PM2.5 concentrations. RESULTS An inverse nonlinear relationship was identified between optimal MPA duration and background PM2.5 concentration levels. When background PM2.5 concentration increased to 186 µg/m3, the optimal outdoor MPA duration decreased to 2.5 h/week, the minimum level recommended by current PA guidelines. When background PM2.5 concentration further increased to 235 µg/m3, the optimal outdoor MPA duration decreased to 1 h/week. The relationship between optimal MPA duration and background PM2.5 concentration levels was stronger when exercising at a location closer to a source of air pollution. Compared to the general adult population, adults aged 60 years and older had substantially steeper curves-the optimal outdoor MPA duration decreased to 2.5 h/week when background PM2.5 concentration reached 45 µg/m3. CONCLUSION The health benefit of outdoor MPA by far outweighs the health risk of PM2.5 pollution for the global average urban background concentration (22 μg/m3). This modeling study examined a single type of air pollutant and suffered from measurement errors and estimation uncertainties. Future research should examine other air pollutants and indoor PA, incorporate short- and mid-term health effects of MPA and air pollution into the risk-benefit analysis, and provide estimates specific for high-risk subgroups.
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Affiliation(s)
- Ruopeng An
- Brown School, Washington University, St. Louis, MO 63130, USA
| | - Hyojung Kang
- Department of Kinesiology and Community Health, University of Illinois, Champaign, IL 61820, USA
| | - Lianzhong Cao
- School of Management and Journalism, Shenyang Sport University, Shenyang 110102, China.
| | - Xiaoling Xiang
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA
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25
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Filigrana P, Levy JI, Gauthier J, Batterman S, Adar SD. Health benefits from cleaner vehicles and increased active transportation in Seattle, Washington. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2022; 32:538-544. [PMID: 35288650 PMCID: PMC8919173 DOI: 10.1038/s41370-022-00423-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 02/07/2022] [Accepted: 02/17/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Climate mitigation policies that focus on the transportation sector yield near-term health co-benefits that could motivate policy action. OBJECTIVE We quantified CO2 emission reductions as well as the air pollution and health benefits of urban transportation policies promoting electric vehicles (EV) and walking and bicycling in Seattle, Washington. METHODS We compared a business-as-usual scenario projected to 2035 with intervention scenarios in which 35% of gasoline vehicles were switched to EV, and 50% of car trips less than 8 kilometers were replaced by walking or bicycling. We modeled changes in primary traffic-generated oxides of nitrogen (NOx) and fine particulate matter (PM2.5) as well as walking and bicycling activity, CO2 emissions from traffic, and fatal traffic injuries due to the transportation policy scenarios. We estimated the impacts of these changes on annual cases of asthma and premature mortality in the Seattle population. RESULTS Increasing the use of EV, walking, and bicycling is estimated to reduce CO2 emissions by 744 tons/year (30%) and lower annual average concentrations of primary traffic-generated NOx and PM2.5 by 0.32 ppb (13%) and 0.08 μg/m3 (19%), respectively. In Seattle, the lower air pollutant concentrations, greater active transportation, and lower fatal traffic injuries would prevent 13 (95% CI: -1, 28), 49 (95% CI: 19, 71), and 5 (95% CI: 0, 14) premature deaths per year, respectively and 20 (95% CI: 8, 27) cases of asthma per year. SIGNIFICANCE Moving towards cleaner vehicles and active transportation can reduce CO2 emissions, improve air quality, and population health. The resulting public health benefits provide important motivation for urban climate action plans. IMPACT STATEMENT Using key components of the health impact assessment framework, we quantify the environmental and health benefits of urban transportation policy scenarios that promote electric vehicle use and replace short car trips with walking and bicycling as compared with a business as usual scenario in 2035. Our findings demonstrate that transportation scenarios promoting cleaner vehicles and active transportation can reduce CO2 emissions, improve air quality, and increase physical activity levels, resulting in significant public health benefits.
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Affiliation(s)
- Paola Filigrana
- Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA.
- 1579 Rhinelander Avenue, Bronx, NY, 10461, USA.
| | - Jonathan I Levy
- Department of Environmental Health, Boston University, 715 Albany St, T4W, Boston, MA, 02118-2526, USA
| | - Josette Gauthier
- Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA
| | - Stuart Batterman
- Department of Environmental Health Sciences, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA
| | - Sara D Adar
- Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA
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Physical activity telephone coaching intervention for insufficiently physically active ambulatory hospital patients: Economic evaluation of the Healthy 4U-2 randomised controlled trial. PLoS One 2022; 17:e0270211. [PMID: 35737687 PMCID: PMC9223391 DOI: 10.1371/journal.pone.0270211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/02/2022] [Indexed: 11/19/2022] Open
Abstract
The Healthy 4U-2 randomised controlled trial demonstrated that a physical activity (PA) telephone coaching intervention was effective for improving objectively-measured PA and health-related outcomes. The current study reports on an economic evaluation performed alongside the trial to determine whether this effective intervention is also cost-effective from a healthcare funder perspective. Participants (N = 120) were insufficiently physically active adults recruited from an ambulatory care clinic in a public hospital in regional Australia. The primary outcome was change in moderate-to-vigorous physical activity (MVPA) measured using accelerometers. Changes in quality-adjusted life-years (QALYs) were derived from the 12-Item Short Form Health Survey Questionnaire (SF-12). Incremental cost-effectiveness ratios (ICERs) were calculated for each outcome. Uncertainty of cost-effectiveness results were estimated using non-parametric bootstrapping techniques and sensitivity analyses. The mean intervention cost was $132 per person. The control group incurred higher overall costs compared to intervention ($2,465 vs. $1,743, respectively). Relative to control, the intervention resulted in incremental improvements in MVPA and QALYs and was deemed cost-effective. Probabilistic sensitivity analysis indicated that compared to control, the intervention would be cost-effective for improving MVPA and QALYs at very low willingness to pay thresholds. Sensitivity analyses indicated that results were robust to varied assumptions. This study shows that PA telephone coaching was a low-cost strategy for increasing MVPA and QALYs in insufficiently active ambulatory hospital patients. Findings of health benefits and overall cost-savings are uncommon and PA telephone coaching offers a potentially cost-effective investment to produce important public health outcomes.
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Reid H, Caterson J, Smith R, Baldock J, Jones N, Copeland R. What do healthcare professionals want from a resource to support person-centred conversations on physical activity? A mixed-methods, user-centric approach to developing educational resources. BMJ Open Sport Exerc Med 2022; 8:e001280. [PMID: 35813130 PMCID: PMC9226873 DOI: 10.1136/bmjsem-2021-001280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2022] [Indexed: 06/15/2023] Open
Abstract
OBJECTIVES Healthcare is a fundamental action area in population efforts to address the global disease burden from physical inactivity. However, healthcare professionals lack the knowledge, skills and confidence to have regular conversations about physical activity. This study aimed to: (1) understand the requirements of healthcare professionals and patients from a resource to support routine physical activity conversations in clinical consultations and (2) develop such a resource. METHODS This study used codesign principles across two phases, actively involving relevant stakeholders in an iterative development process. The preparatory phase included a scoping literature review and workshops with multidisciplinary healthcare professionals and patients. The Delphi phase included the development of a draft resource, a three-stage modified online Delphi study and an external review. RESULTS The scoping review highlighted the importance of addressing time restrictions, a behaviour change skill deficit, the need for resources to fit into existing systems and meeting patient expectations. Consultation included 69 participants across two clinical workshops. They recommended using the internet, valued guidance on all aspects of physical activity conversations and were concerned about how to use a person-centred approach. The Delphi phase, including 15 expert participants, met agreement criteria in two stages to develop the resource. CONCLUSION This mixed-methods study delivered an online resource that was codesigned with and based on the requirements of healthcare professionals and patients. The resource presents condition-specific '1-minute', '5-minute' and 'more minute' person-centred and evidence-based conversation templates on physical activity in an accessible and usable format to meet the needs of real-life clinical practice.
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Affiliation(s)
- Hamish Reid
- Moving Medicine, Faculty of Sport And Exercise Medicine, Edinburgh, UK
- Advanced Wellbeing Research Centre (AWRC), Sheffield Hallam University, Sheffield, UK
| | | | - Ralph Smith
- Oxsport, Oxford University Hospitals NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, Oxfordshire, UK
| | - James Baldock
- Oxsport, Oxford University Hospitals NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, Oxfordshire, UK
| | - Natasha Jones
- Moving Medicine, Faculty of Sport And Exercise Medicine, Edinburgh, UK
- Oxsport, Oxford University Hospitals NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, Oxfordshire, UK
| | - Robert Copeland
- Advanced Wellbeing Research Centre (AWRC), Sheffield Hallam University, Sheffield, UK
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Smith R, Thomas C, Squires H, Goyder E. A comparison of the World Health Organisation's HEAT model results using a non-linear physical activity dose response function with results from the existing tool. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.17411.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction: The WHO-Europe’s Health Economic Assessment Tool is a tool used to estimate the costs and benefits of changes in walking and cycling. Due to data limitations the tool’s physical activity module assumes a linear dose response relationship be-tween physical activity and mortality. Methods: This study estimates baseline population physical activity distributions for 44 countries included in the HEAT. It then compares, for three different scenarios, the results generated by the current method, using a linear dose-response relationship, with results generated using a non-linear dose-response relationship. Results: The study finds that estimated deaths averted are relatively higher (lower) using the non-linear effect in countries with less (more) active populations. This difference is largest for interventions which affect the activity levels of the least active the most. Since more active populations, e.g. in Eastern Europe, also tend to have lower Value of a Statistical Life estimates the net monetary benefit estimated by the scenarios are much higher in western-Europe than eastern-Europe. Conclusions: Using a non-linear dose response function results in materially different estimates where populations are particularly inactive or particularly active. Estimating base-line distributions is possible with limited additional data requirements, although the method has yet to be validated. Given the significant role of the physical activity module within the HEAT tool it is likely that in the evaluation of many interventions the monetary benefit estimates will be sensitive to the choice of the physical activity dose response function.
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Prevalence, Trends, and Correlates of Joint Patterns of Aerobic and Muscle-Strengthening Activity and Sleep Duration: A Pooled Analysis of 359,019 Adults in the National Health Interview Survey 2004-2018. J Phys Act Health 2022; 19:246-255. [PMID: 35272266 DOI: 10.1123/jpah.2021-0682] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/23/2022] [Accepted: 01/27/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Physical activity (PA) and sleep duration have established associations with health outcomes individually but tend to co-occur and may be better targeted jointly. This study aimed to describe the cross-sectional prevalence, trends, and population characteristic correlates of activity-sleep patterns in a population-representative sample of US adults from the National Health Interview Survey (2004-2018). METHODS Participants (N = 359,019) self-reported aerobic and muscle-strengthening activity and sleep duration. They were categorized as "meeting both"/"meeting PA only"/"meeting sleep only"/"meeting neither" of the 2018 US PA guidelines and age-based sleep duration recommendations. Trends in activity-sleep patterns were analyzed using weighted multinomial logistic regression, and correlates were identified using weighted binary Poisson regressions, with P ≤ .001 considered significant. RESULTS "Meet sleep only" was most prevalent (46.4%) by 2018, followed by "meet neither" (30.3%), "meet both" (15.6%), and "meet PA only" (7.7%). Many significant sociodemographic, biological, and health-behavior correlates of the activity-sleep groups were identified, and the direction and magnitude of these associations differed between groups. CONCLUSIONS Public health campaigns should emphasize the importance of both sufficient PA and sleep; target women and older adults, current smokers, and those with lower education and poorer physical and mental health; and consider specific barriers experienced by minority ethnic groups.
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Fernández-Ballesteros R, Valeriano-Lorenzo E, Sánchez-Izquierdo M, Botella J. Behavioral Lifestyles and Survival: A Meta-Analysis. Front Psychol 2022; 12:786491. [PMID: 35185686 PMCID: PMC8854179 DOI: 10.3389/fpsyg.2021.786491] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of the study is to determine the association between Behavioral Lifestyles (regular physical activity, healthy diet, sleeping, and weight control) and longevity in the elderly. A search strategy was conducted in the PsycInfo, Medline, PubMed, Web of Science (WoS), and Scopus databases. The primary outcome was mortality/survival. Four variables (mean of participant's age at the baseline of the study, follow-up years of the study, gender, and year of publication) were analyzed to evaluate the role of potential moderators. Ninety-three articles, totaling more than 2,800,000 people, were included in the meta-analysis. We found that the lifestyles analyzed predict greater survival. Specifically, doing regular physical activity, engaging in leisure activities, sleeping 7-8 h a day, and staying outside the BMI ranges considered as underweight or obesity are habits that each separately has a greater probability associated with survival after a period of several years.
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Affiliation(s)
| | | | | | - Juan Botella
- Department of Social Psychology and Methodology, Autonomous University of Madrid, Madrid, Spain
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Nieuwenhuijsen MJ, Barrera-Gómez J, Basagaña X, Cirach M, Daher C, Pulido MF, Iungman T, Gasparrini A, Hoek G, de Hoogh K, Khomenko S, Khreis H, de Nazelle A, Ramos A, Rojas-Rueda D, Pereira Barboza E, Tainio M, Thondoo M, Tonne C, Woodcock J, Mueller N. Study protocol of the European Urban Burden of Disease Project: a health impact assessment study. BMJ Open 2022; 12:e054270. [PMID: 35058262 PMCID: PMC8783806 DOI: 10.1136/bmjopen-2021-054270] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Cities have long been known to be society's predominant engine of innovation and wealth creation, yet they are also hotspots of pollution and disease partly due to current urban and transport practices. The aim of the European Urban Burden of Disease project is to evaluate the health burden and its determinants related to current and future potential urban and transport planning practices and related exposures in European cities and make this evidence available for policy and decision making for healthy and sustainable futures. METHODS AND ANALYSIS Drawing on an established comparative risk assessment methodology (ie, Urban and Transport Planning Health Impact Assessment) tool), in nearly 1000 European cities we will (1) quantify the health impacts of current urban and transport planning related exposures (eg, air pollution, noise, excess heat, lack of green space) (2) and evaluate the relationship between current levels of exposure, health impacts and city characteristics (eg, size, density, design, mobility) (3) rank and compare the cities based on exposure levels and the health impacts, (4) in a number of selected cities assess in-depth the linkages between urban and transport planning, environment, physical activity and health, and model the health impacts of alternative and realistic urban and transport planning scenarios, and, finally, (5) construct a healthy city index and set up an effective knowledge translation hub to generate impact in society and policy. ETHICS AND DISSEMINATION All data to be used in the project are publicly available data and do not need ethics approval. We will request consent for personal data on opinions and views and create data agreements for those providing information on current and future urban and transport planning scenarios.For dissemination and to generate impact, we will create a knowledge translation hub with information tailored to various stakeholders.
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Affiliation(s)
| | | | - Xavier Basagaña
- Barcelona Institute for Global Health, Barcelona, Spain
- Pompeu Fabra University Faculty of Health and Life Sciences, Barcelona, Spain
| | - Marta Cirach
- Barcelona Institute for Global Health, Barcelona, Spain
| | - Carolyn Daher
- Barcelona Institute for Global Health, Barcelona, Spain
| | - Maria Foraster Pulido
- Barcelona Institute for Global Health, Barcelona, Spain
- Ramon Llull University, Barcelona, Spain
| | | | | | - Gerard Hoek
- IRAS, Utrecht University Faculty of Veterinary Medicine, Utrecht, Netherlands
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- Basel University Faculty of Philosophy and Natural Sciences, Basel, Switzerland
| | | | - Haneen Khreis
- Texas A&M University System, College Station, Texas, USA
| | | | - Ana Ramos
- Barcelona Institute for Global Health, Barcelona, Spain
| | | | | | - Marko Tainio
- SYKE, Helsinki, Finland
- Polish Academy of Sciences, Warszawa, Poland
| | | | - Cathryn Tonne
- Barcelona Institute for Global Health, Barcelona, Spain
| | | | - N Mueller
- Barcelona Institute for Global Health, Barcelona, Spain
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Bouscasse H, Gabet S, Kerneis G, Provent A, Rieux C, Ben Salem N, Dupont H, Troude F, Mathy S, Slama R. Designing local air pollution policies focusing on mobility and heating to avoid a targeted number of pollution-related deaths: Forward and backward approaches combining air pollution modeling, health impact assessment and cost-benefit analysis. ENVIRONMENT INTERNATIONAL 2022; 159:107030. [PMID: 34890901 DOI: 10.1016/j.envint.2021.107030] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 06/13/2023]
Abstract
CONTEXT Policies aiming at decreasing air pollutants (e.g., fine particulate matter, PM2.5) are often designed without targeting an explicit health benefit nor carrying out cost-benefit analyses. METHODS We developed a transdisciplinary backward and forward approach at the conurbation level: from health objectives set by local decision-makers, we estimated which reductions in PM2.5 exposures and emissions would allow to reach them, and identified urban policies leading to these reductions (backward approach). We finally conducted health impact and cost-benefit analyses of these policies (forward approach). The policies were related to the most emitting sectors in the considered area (Grenoble, France), wood heating and transport sectors. The forward approach also considered the health impact and co-benefits of these policies related to changes in physical activity and CO2 emissions. FINDINGS Decision-makers set three health targets, corresponding to decreases by 33% to 67% in PM2.5-attributable mortality in 2030, compared to 2016. A decrease by 42% in PM2.5 exposure (from 13.9 µg/m3) was required to reach the decrease by 67% in PM2.5-attributable mortality. For each Euro invested, the total benefit was about 30€ for policies focusing on wood heating, and 1 to 68€ for traffic policies. Acting on a single sector was not enough to attain a 67% decrease in PM2.5-attributable mortality. This target could be achieved by replacing all inefficient wood heating equipment by low-emission pellet stoves and reducing by 36% the traffic of private motorized vehicles. This would require to increase the share of active modes (walking, biking…), inducing increases in physical activity and additional health benefits beyond the initial target. Annual net benefits were between €484 and €629 per capita for policies with report on active modes, compared to between €162 and €270 without. CONCLUSIONS Urban policies strongly reducing air pollution-attributable mortality can be identified by our approach. Such policies can be cost-efficient.
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Affiliation(s)
- Hélène Bouscasse
- CESAER, Agrosup Dijon, INRAE, Bourgogne Franche-Comté Univ., Dijon, France
| | - Stephan Gabet
- Univ. Grenoble Alpes, Inserm, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, IAB, 38000 Grenoble, France
| | - Glen Kerneis
- Univ. Grenoble Alpes, CNRS, INRAE, Grenoble INP, GAEL, Grenoble, France
| | | | | | | | | | | | - Sandrine Mathy
- Univ. Grenoble Alpes, CNRS, INRAE, Grenoble INP, GAEL, Grenoble, France.
| | - Rémy Slama
- Univ. Grenoble Alpes, Inserm, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, IAB, 38000 Grenoble, France.
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Smith R, Thomas C, Squires H, Goyder E. A comparison of the World Health Organisation's HEAT model results using a non-linear physical activity dose response function with results from the existing tool. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.17411.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
IntroductionThe WHO-Europe’s Health Economic Assessment Tool is a tool used to estimatethe costs and benefits of changes in walking and cycling. Due to data limitationsthe tool’s physical activity module assumes a linear dose response relationship be-tween physical activity and mortality.MethodsThis study estimates baseline population physical activity distributions for 44 coun-tries included in the HEAT. It then compares, for three different scenarios, the re-sults generated by the current method, using a linear dose-response relationship,with results generated using a non-linear dose-response relationship.ResultsThe study finds that estimated deaths averted are relatively higher (lower) using thenon-linear effect in countries with less (more) active populations. This difference islargest for interventions which affect the activity levels of the least active the most.Since more active populations, e.g. in Eastern Europe, also tend to have lowerValue of a Statistical Life estimates the net monetary benefit estimated by the sce-narios are much higher in western-Europe than eastern-Europe.ConclusionsUsing a non-linear dose response function results in materially different estimateswhere populations are particularly inactive or particularly active. Estimating base-line distributions is possible with limited additional data requirements, although themethod has yet to be validated. Given the significant role of the physical activitymodule within the HEAT tool it is likely that in the evaluation of many interventionsthe monetary benefit estimates will be sensitive to the choice of the physical activitydose response function.
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Self-Reported Physical Activity and Survival in Adults Treated With Hemodialysis: A DIET-HD Cohort Study. Kidney Int Rep 2021; 6:3014-3025. [PMID: 34901570 PMCID: PMC8640545 DOI: 10.1016/j.ekir.2021.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/22/2021] [Accepted: 09/03/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction Regular physical activity is associated with longevity in adults receiving hemodialysis, but it is uncertain whether this association varies by causal pathways (cardiovascular and noncardiovascular). Methods DIET-HD was a prospective, multinational study of adults undergoing hemodialysis across Europe and Argentina. We classified participants as physically inactive, occasionally active (irregularly to once a week), or frequently active (twice a week or more), using a self-reported questionnaire. Potential confounders were balanced across exposure groups using propensity scores. Weighted Cox proportional hazards models with double robust estimators evaluated the association between physical activity and all-cause, cardiovascular, and noncardiovascular mortality. Results Of 8043 participants in DIET-HD, 6147 (76%) had information on physical activity. A total of 2940 (48%) were physically inactive, 1981 (32%) occasionally active, and 1226 (20%) frequently active. In a median follow-up of 3.8 years (19,677 person-years), 2337 (38%) deaths occurred, including 1050 (45%) from cardiovascular causes. After propensity score weighting, occasional physical activity was associated with lower all-cause (adjusted hazard ratio [aHR] = 0.80, 95% CI = 0.72–0.89), cardiovascular (aHR = 0.82, 95% CI = 0.70–0.96), and noncardiovascular (aHR = 0.81, 95% CI = 0.69–0.94) mortality compared with inactivity. Frequent physical activity was associated with lower all-cause (aHR = 0.82, 95% CI = 0.71–0.95) and cardiovascular (aHR = 0.77, 95% CI = 0.62–0.94) mortality, but not noncardiovascular mortality (aHR = 0.88, 95% CI = 0.72–1.08). A dose-dependent association of physical activity with cardiovascular death was observed (P trend = 0.01). Conclusion Compared with self-reported physical inactivity, occasional and frequent physical activities were associated, dose dependently, with lower cardiovascular mortality in adults receiving hemodialysis.
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Egiguren J, Nieuwenhuijsen M, Rojas-Rueda D. Premature Mortality of 2050 High Bike Use Scenarios in 17 Countries. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:127002. [PMID: 34851171 PMCID: PMC8634902 DOI: 10.1289/ehp9073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 10/07/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Biking plays a significant role in urban mobility and has been suggested as a tool to promote public health. A recent study has proposed 2050 global biking scenarios based on large shifts from motorized vehicles to bikes. No previous studies have estimated the health impacts of global cycling scenarios, either future car-bike shift substitutions. OBJECTIVES We aimed to quantify changes in premature mortality of 2050 global biking scenarios in urban populations from 17 countries. METHODS Through a quantitative Health Impact Assessment, the mortality risks and benefits of replacing car trips by bike (mechanica bike and electric bike) in urban populations from 17 countries were estimated. Multiple bike scenarios were created based on current transport trends or large shifts from car trips to bike trips. We quantified the estimated change in the number of premature deaths (reduced or increased) concerning road traffic fatalities, air pollution, and physical activity. This study focuses on urban populations between 20 and 64 y old. RESULTS We found that, among the urban populations (20-64 y old) of 17 countries, 205,424 annual premature deaths could be prevented if high bike-use scenarios are achieved by 2050 (assuming that 100% of bike trips replace car trips). If only 8% of bike trips replace car trips in a more conservative scenario, 18,589 annual premature deaths could be prevented by 2050 in the same population. In all the countries and scenarios, the mortality benefits related to bike use (rather than car use) outweighed the mortality risks. DISCUSSION We found that global biking policies may provide important mortality benefits in 2050. Current and future bike- vs. car-trip policies should be considered key public health interventions for a healthy urban design. https://doi.org/10.1289/EHP9073.
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Affiliation(s)
- Julen Egiguren
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - M.J. Nieuwenhuijsen
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - David Rojas-Rueda
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
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Clockston RLM, Rojas-Rueda D. Health impacts of bike-sharing systems in the U.S. ENVIRONMENTAL RESEARCH 2021; 202:111709. [PMID: 34280419 DOI: 10.1016/j.envres.2021.111709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Bike-sharing systems (BSS) are short-term bike rentals that can be borrowed from one location and retired to another at the conclusion of the trip. In 2019, 109,589 BSS trips were made each day in the U.S, and half of those in New York City (NYC). AIM This study aims to quantify the health risks and benefits of BSS in the U.S. and NYC. METHODS This study followed a quantitative health impact assessment approach to estimate the risks and benefits of BSS. Specifically, we quantified the health impacts of physical activity, air pollution, and traffic incidents. We analyzed all the trips made by BSS in the U.S. and NYC. Input data on transport, traffic safety, air quality, and physical activity were collated from public records and scientific publications. We modeled the health impacts on adult users related to mortality, disease incidence, disability-adjusted life years (DALYs), and health economic impacts (related to morbidity and mortality). RESULTS We estimated that in the U.S. BSS trips resulted in an annual reduction of 4.7 premature deaths, 737 DALYs, and 36 million $USD in health economic impacts, mainly derived from the increment in physical activity. In NYC, we estimated an annual reduction of 2 premature deaths, 355 DALYs, and 15 million $USD in health economic impacts. CONCLUSION BSS in the U.S. and NYC provide a health benefit for bicyclists. Improvements in air quality and traffic safety across U.S. cities will maximize the health benefits of BSS.
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Affiliation(s)
- Raeven Lynn M Clockston
- Colorado School of Public Health, Colorado State University, Fort Collins, USA; Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, USA
| | - David Rojas-Rueda
- Colorado School of Public Health, Colorado State University, Fort Collins, USA; Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, USA.
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Do we know enough to quantify the impact of urban green spaces on mortality? An analysis of the current knowledge. Public Health 2021; 200:91-98. [PMID: 34710719 DOI: 10.1016/j.puhe.2021.09.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/23/2021] [Accepted: 09/14/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The addition of green spaces (GS) in cities is perceived as an efficient solution to combat climate change and biodiversity loss while also improving human health. Quantitative health impact assessment (QHIA) is a powerful tool to assess the health benefits of GS and support policy-making decisions. In France, a preliminary analysis of the literature led to the decision of developing guidance for QHIA applied to GS and mortality. This paper focuses on the choice of exposure-response functions (ERF) for those QHIA. STUDY DESIGN Literature review and analysis of the key steps of QHIA. METHODS Articles providing ERF for all-cause, cardiovascular and respiratory mortality in relation to GS were identified through a literature review and ranked based on a quality score. ERF from the articles with the highest scores was pooled in meta-analyses. RESULTS In total, 13 ERF were selected for all-cause mortality, 10 for cardiovascular mortality and 5 for respiratory mortality. Meta-risk for a 0.1 increase in the normalised differential vegetation index were, 0.96 (95% confidence interval [CI] 0.94; 0.97), 0.98 (95% CI 0.96; 0.99) and 0.97 (95% CI 0.92; 1.02) for all-cause, cardiovascular and respiratory mortality, respectively. CONCLUSIONS While current knowledge makes it possible to use QHIA on GS and mortality, interdisciplinary research is still needed to clarify the shape of the relationship and its temporality and to assess exposure in a meaningful way for decision-making.
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Ghayour Najafabadi M, Sobhrakhshan Khah A, Parent-Nichols J. The Effects Of Exercise Training On Physical, Physiological And Psychological Risk Factors Of Patients With Cardiovascular Disease. RUSSIAN OPEN MEDICAL JOURNAL 2021. [DOI: 10.15275/rusomj.2021.0310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background — Exercise training is an important component of wellness for individuals diagnosed with cardiovascular disease (CVD). Exercise may have an effect on cardiovascular risk factors such as hypertension, lipid levels, and other associated physical, psychological, and physiological risk factors. Exercise intensity may further impact those risk factors. Aim — This narrative review of the literature aims to identify the effect of regular physical exercise on modifying risk factors for CVD and increased morbidity and mortality related to CVD. Methods — Published English-language papers from 2011 to 2020, available in Scopus, PubMed, Cochrane, Google Scholar, and Thompson were included in this review. Keywords for this search were exercise training, cardiovascular disease, hypertension, physical function, physiological, and psychological risk factors. Conclusions — Exercise training may be a cost-effective intervention that improves the physical, physiological, and psychological risk factors and the motor function of patients with cardiovascular disease.
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The Active Hospital pilot: A qualitative study exploring the implementation of a Trust-wide Sport and Exercise Medicine-led physical activity intervention. PLoS One 2021; 16:e0257802. [PMID: 34559846 PMCID: PMC8462703 DOI: 10.1371/journal.pone.0257802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 09/10/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In 2017 Public Health England and Sport England commissioned a Consultant-led Sport and Exercise Medicine (SEM) pilot to test the feasibility and acceptability of embedding physical activity interventions in secondary care clinical pathways. The aim of this paper is to report qualitative findings exploring the experience of healthcare professionals (HCPs) and patients involved in the Active Hospital pilot. METHODS Qualitative data was collected by semi-structured interviews with Active Hospital pilot SEM Consultants, and staff and patients involved in three clinical pathways. Interviews with SEM Consultants explored the experience of developing and implementing the pilot. Interviews with staff and patients explored the experience of delivering and receiving Active Hospital interventions. Data were analysed thematically. RESULTS Interviews identified the importance of the Active Hospital pilot being Consultant-led for the following reasons; i) having trusting relationships with decision makers, ii) having sufficient influence to effect change, iii) identifying champions within the system, and iv) being adaptable to change and ensuring the programme fits within the wider strategic frameworks. HCPs emphasised the importance of the Active Hospital interventions fitting easily within existing work practices, the need for staff training and to tailor interventions for individual patient needs. The Active Hospital pilot was well received by patients, however a lack of dedicated resource and capacity to deliver the intervention was highlighted as a challenge by both patients and HCPs. CONCLUSION The SEM Consultants' ability to navigate the political climate of a large National Health Service (NHS) Trust with competing agendas and limited resource was valuable. The interventions were well received and a valued addition to usual clinical care. However, implementation and ongoing delivery of the pilot encountered challenges including lack of capacity within the system and delays with recruiting to the delivery teams in each pathway.
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Socioeconomic Inequalities in Physical Activity and Sedentary Behaviour among the Chilean Population: A Systematic Review of Observational Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189722. [PMID: 34574644 PMCID: PMC8468594 DOI: 10.3390/ijerph18189722] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/07/2021] [Accepted: 09/11/2021] [Indexed: 12/17/2022]
Abstract
Socioeconomic inequalities in physical (in)activity and sedentary behaviours are key mediators in obesity and health socioeconomic inequalities. Considering the high and uneven obesity rates in Chile, this review aims to systematically assess the socioeconomic inequalities in physical activity (PA) and sedentary behaviour (SB) among the Chilean population from different age groups. Peer-reviewed and grey literature were searched from inception until 31st December 2019 in PubMed, Scopus, PsycINFO, Web of Sciences and LILACS. Publications in English and Spanish, from observational studies that reported the comparison of at least one indicator of PA or SB between at least two groups of different socioeconomic positions (SEP), from the general Chilean population, were included. Data searches, screening, extraction, and quality assessment, using the Newcastle Ottawa Quality Assessment Scale for observational studies, were conducted by two independent researchers. Seventeen articles (from 16 studies) met the inclusion criteria (14 cross-sectional; two cohort). Across these, quality was considered low, medium and high for 19%, 69% and 13%, respectively. Results showed consistent evidence for a lower leisure-time PA and sitting time, and higher physical inactivity among adults from the lower, compared to the highest, SEP groups. Associations between SEP and total PA, moderate-to-vigorous PA, low PA, and transport and work-related PA were inconsistent. These findings provide insights to public health and physical activity researchers and policymakers aiming to reduce socioeconomic inequalities in PA and SB in Chile and other countries.
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Chen X, Su D, Chen X, Chen Y. What intensity of exercise is most suitable for the elderly in China? A propensity score matching analysis. BMC Public Health 2021; 21:1396. [PMID: 34261461 PMCID: PMC8281566 DOI: 10.1186/s12889-021-11407-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The strategy of successful ageing is an important means to deal with the challenges of the current ageing society. This paper aims to explore the effects of different intensities of physical activity on the successful ageing of the elderly. METHODS Our data were from wave 4 of the China Health and Retirement Longitudinal Survey (CHARLS), involving 9026 residents aged 60 years and older. The intensity of physical activity was divided into three levels: vigorous, moderate and mild. The concept of successful ageing adopted a four-dimensional model of life satisfaction added to the theoretical model of Rowe and Kahn's. Propensity score matching (PSM) with controlling nine confounding factors were used to analyse the effects of different intensities of physical activity. RESULTS The percentage of successful ageing was 1.88% among all subjects. Among them, 30.26, 29.57 and 29.40% of the elderly often participated in vigorous, moderate and mild physical activity, respectively. The results of PSM showed that participation in moderate activity increased the probability of successful ageing of the elderly by 0.76-0.78% (P < 0.001), while participation in vigorous and mild physical activity had no significant effect on successful ageing (P > 0.05). Moderate physical activity had statistically significant effects on four components of successful aging, including major disease, physical function, life satisfaction, and social participation (P < 0.05). CONCLUSION Moderate-intensity physical activity was most beneficial to the successful ageing of the elderly and should be promoted in the elderly population.
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Affiliation(s)
- Xinlin Chen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
- Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, 430030 China
| | - Dai Su
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
- Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, 430030 China
| | - Xinlan Chen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
- Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, 430030 China
| | - Yingchun Chen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
- Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, 430030 China
- Present address: Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
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Giurgiu M, Nissen R, Müller G, Ebner-Priemer UW, Reichert M, Clark B. Drivers of productivity: Being physically active increases yet sedentary bouts and lack of sleep decrease work ability. Scand J Med Sci Sports 2021; 31:1921-1931. [PMID: 34170563 DOI: 10.1111/sms.14005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 06/14/2021] [Indexed: 11/28/2022]
Abstract
Physical behavior (ie, physical activity, sedentary behavior, and sleep) is a crucial lifestyle factor for preventing and managing diseases across the lifespan. However, less is known about potential work-related psychological and cognitive outcomes such as productivity. The present study examined within-person associations between physical behavior and self-perceived work ability. To investigate the degree to which physical behavior parameters influence self-perceived work ability in everyday life, we conducted an Ambulatory Assessment study in 103 university students over 5 days. Physical behavior was assessed continuously via a multi-sensor system. Self-perceived work ability was assessed repeatedly up to six times per day on smartphones. We employed multilevel modeling to analyze the within-person effects of physical behavior on self-perceived work ability. Physical activity intensity (MET) (β = 0.15 ± 0.06, t = 2.59, p = 0.012) and sit-to-stand transitions (β = 0.07 ± 0.03, t = 2.44, p = 0.015) were positively associated with self-perceived work ability. Sedentary bouts (≥20 min) (β = -0.21 ± 0.08, t = -2.74, p = 0.006) and deviation from a recommended sleep duration (ie, 8 h) (β = -0.1 ± 0.04, t = -2.38, p = 0.018) were negatively associated with self-perceived work ability. Exploratory analyses supported the robustness of our findings by comparing various time frames. Total sedentary time and sleep quality were not associated with self-perceived work ability. Regular sleep durations, breaking up sedentary time through sit-to-stand transitions, and higher intensities of physical activity may be important for the regulation of self-perceived work ability in university students' daily lives.
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Affiliation(s)
- Marco Giurgiu
- Department of Sports and Sports Science, Mental mHealth Lab, Karlsruhe Institute of Technology (KIT, Karlsruhe, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Rebecca Nissen
- Department of Sports and Sports Science, Mental mHealth Lab, Karlsruhe Institute of Technology (KIT, Karlsruhe, Germany
| | - Gerhard Müller
- Department of Health Promotion, AOK Baden-Wuerttemberg, Stuttgart, Germany
| | - Ulrich W Ebner-Priemer
- Department of Sports and Sports Science, Mental mHealth Lab, Karlsruhe Institute of Technology (KIT, Karlsruhe, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Markus Reichert
- Department of Sports and Sports Science, Mental mHealth Lab, Karlsruhe Institute of Technology (KIT, Karlsruhe, Germany.,Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Bronwyn Clark
- School of Public Health, The University of Queensland, Brisbane, QL, Australia
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McCune S, Promislow D. Healthy, Active Aging for People and Dogs. Front Vet Sci 2021; 8:655191. [PMID: 34164450 PMCID: PMC8215343 DOI: 10.3389/fvets.2021.655191] [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: 01/18/2021] [Accepted: 05/05/2021] [Indexed: 01/08/2023] Open
Abstract
Dogs act as companions who provide us with emotional and physical support. Their shorter lifespans compel us to learn about the challenges and gifts of caring for older individuals. Our companion dogs can be exemplars of healthy or unhealthy aging, and sentinels of environmental factors that might increase or decrease our own healthy lifespan. In recent years, the field of aging has emphasized not just lifespan, but healthspan—the period of healthy, active lifespan. This focus on healthy, active aging is reflected in the World Health Organization's current focus on healthy aging for the next decade and the 2016 Healthy Aging in Action initiative in the US. This paper explores the current research into aging in both people and companion dogs, and in particular, how the relationship between older adults and dogs impacts healthy, active aging for both parties. The human-dog relationship faces many challenges as dogs, and people, age. We discuss potential solutions to these challenges, including suggestions for ways to continue contact with dogs if dog ownership is no longer possible for an older person. Future research directions are outlined in order to encourage the building of a stronger evidence base for the role of dogs in the lives of older adults.
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Affiliation(s)
- Sandra McCune
- School of Psychology, School of Life Sciences, University of Lincoln, Lincoln, United Kingdom.,Animal Matters Consultancy Ltd., Stamford, United Kingdom
| | - Daniel Promislow
- Department of Lab Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States.,Department of Biology, University of Washington, Seattle, WA, United States
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Mueller N, Daher C, Rojas-Rueda D, Delgado L, Vicioso H, Gascon M, Marquet O, Vert C, Martin I, Nieuwenhuijsen M. Integrating health indicators into urban and transport planning: A narrative literature review and participatory process. Int J Hyg Environ Health 2021; 235:113772. [PMID: 34102572 DOI: 10.1016/j.ijheh.2021.113772] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 11/18/2022]
Abstract
Today, urban and transport planners face considerable challenges in designing and retrofitting cities that are prepared for increasing urban populations, and their service and mobility needs. When it comes to health-promoting urban and transport developments, there is also a lack of standardized, quantitative indicators to guide the integration of health components right from the outset, i.e. in the formal planning or zoning phase. We narratively reviewed the literature and organized stakeholder workshops to identify and tailor planning principles and indicators that can be linked to health outcomes. We defined four core planning objectives that previous authoritative studies have suggested to result in positive health outcomes among city dwellers, which are: I) development of compact cities, II) reduction of private motorized transport, III) promotion of active (i.e. walking and cycling) and public transport, IV) development of green and public open space. Built on the review and stakeholder consensus, we identified 10 urban and transport planning principles that work towards achieving the four core objectives thought to provide health benefits for European city dwellers. These 10 planning principles are: 1) land use mix, 2) street connectivity, 3) density, 4) motorized transport reductions, 5) walking, 6) cycling, 7) public transport, 8) multi-modality, 9) green and public open space, and 10) integration of all planning principles. A set of indicators was developed and tailored for each planning principle. The final output of this work is a checklist ready to be applied by urban and transport professionals to integrate health into urban and transport developments in urban environments right from the outset.
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Affiliation(s)
- Natalie Mueller
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carolyn Daher
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - David Rojas-Rueda
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, USA
| | - Laura Delgado
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Horacio Vicioso
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mireia Gascon
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Oriol Marquet
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Cristina Vert
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Irene Martin
- Generalitat de Catalunya, Direcció General de Polítiques Ambientals i Medi Natural, Barcelona, Spain
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Kim H, Turiano NA, Forbes MK, Kotov R, Krueger RF, Eaton NR. Internalizing psychopathology and all-cause mortality: a comparison of transdiagnostic vs. diagnosis-based risk prediction. World Psychiatry 2021; 20:276-282. [PMID: 34002512 PMCID: PMC8129836 DOI: 10.1002/wps.20859] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Previous studies have documented the utility of a transdiagnostic internalizing factor in predicting important future outcomes (e.g., subsequent mental disorder diagnoses). To date, however, no study has investigated whether an internalizing factor predicts mortality risk. Also, while pre-vious studies of mortality risk have emphasized its associations with particular internalizing disorders, no study has assessed how the transdiagnostic internalizing factor vs. disorder-specific variance differently predict that risk. The primary aims of this study were to explore: a) whether the internalizing factor predicts mortality risk, b) whether particular internalizing psychopathologies uniquely predict mortality risk over and beyond the transdiagnostic internalizing factor, and c) whether there is a significant interaction of internalizing with self-reported health in the prediction of mortality risk. We utilized a large national sample of American adults from the Midlife in the United States (MIDUS), a longitudinal study that examined midlife development of individuals across multiple waves between 1995 and 2015. Data were analyzed for the 6,329 participants who completed the phone interview and self-administered questionnaire in MIDUS 1 (1995-1996) and were then followed up until October 31, 2015 or until death. To investigate the association between internalizing and mortality risk, we used the semi-parametric proportional hazards Cox model, where survival time was regressed on a latent internalizing factor. Overall findings indicate that a transdiagnostic internalizing factor significantly predicts mortality risk over a 20-year period (hazard ratio, HR=1.12, 95% CI: 1.05-1.16, p<0.01) and that internalizing outperforms disorder-specific variance (e.g., depression-specific variance) in the prediction of that risk. Further, there was a significant interaction between transdiagnostic internalizing and self-reported health, whereby internalizing psychopathology had a specific association with early death for individuals with excellent self-reported health condition (HR=1.50, 95% CI: 1.17-1.84, p<0.05). This highlights the clinical utility of using the transdiagnostic internalizing factor for prediction of an important future outcome, and supports the argument that internalizing psychopathology can be a meaningful liability to explore in public health practice.
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Affiliation(s)
- Hyunsik Kim
- Department of PsychologySogang UniversitySeoulSouth Korea
| | | | | | - Roman Kotov
- Department of PsychiatryStony Brook UniversityStony Brook, New YorkNYUSA
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Li J, Zhang Z, Si S, Xue F. Leisure-Time Physical Activity and Cardiovascular Disease Risk Among Hypertensive Patients: A Longitudinal Cohort Study. Front Cardiovasc Med 2021; 8:644573. [PMID: 34124188 PMCID: PMC8193126 DOI: 10.3389/fcvm.2021.644573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/10/2021] [Indexed: 12/13/2022] Open
Abstract
Objective: Few studies estimated the effect of leisure-time physical activity (LTPA) on cardiovascular disease (CVD) risk among hypertensive patients in a longitudinal cohort. This study aims to evaluate the association between LTPA and CVD in a longitudinal management cohort of hypertensive patients. Methods: A total of 58,167 hypertensive patients without baseline CVD from a longitudinal cohort were included in this study. LTPA and other covariates were measured at the follow-up four times annually. The primary outcome was CVD events. The association between LTPA and CVD was assessed by the marginal structure model (MSM) and Cox model with adjustment for age, gender, body mass index (BMI), smoking, drinking, diabetes, hyperlipidemia, and antihypertensive medication. The restricted cubic spline and segmented regression were used to assess the dose-response relationship between LTPA and CVD. Results: We recorded 16,332 CVD events; crude incidence of CVD were 89.68, 80.39, 62.64, and 44.04 per 1,000 person-years for baseline 0, 1-150, 151-300, and >300 min/week LTPA, respectively. Compared with inactive LTPA, the adjusted hazard ratios (HRs) estimated by Cox model and MSM-Cox model for CVD associated with 1-150,151-300, and 300 min/week LTPA were 0.85 (95% CI, 0.83-0.88), 0.67 (95% CI, 0.64-0.71), 0.47 (95% CI, 0.44-0.51), and 0.83 (95% CI, 0.76-0.91), 0.58 (95% CI, 0.52-0.63), and 0.39 (95% CI, 0.35-0.44), respectively. Per 60 min/week increase in LTPA was associated with a 13% reduction in CVD risk. LTPA breakpoint was 417 min/week for CVD. Before and after the break-point, the slopes of the piecewise-linear relationship between LTPA and CVD risk were -0.0017 and -0.0003, respectively. Conclusion: LTPA was more strongly associated with the CVD risk than that estimated by conventional analyses based on baseline LTPA; 417 min/week is a breakpoint, after which the incremental health benefits on CVD prevention obtained from the increase in LTPA are much less than before.
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Affiliation(s)
- Jiqing Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhentang Zhang
- Qingdao Huangdao District Center for Disease Control and Prevention, Qingdao, China
| | - Shucheng Si
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China
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Stehr P, Rossmann C, Kremer T, Geppert J. Determinants of Physical Activity in Older Adults: Integrating Self-Concordance into the Theory of Planned Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5759. [PMID: 34072012 PMCID: PMC8199322 DOI: 10.3390/ijerph18115759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 11/25/2022]
Abstract
Based on the theory of planned behavior (TPB), augmented by the concept of self-concordance (derived from self-determination theory, SDT), we conducted a study to identify the key determinants of physical activity in older adults. We applied structural equation modeling of telephone survey data from a random sample of adults aged 65 years and older living in Germany (N = 865). Relations of attitude, subjective norms, and perceived behavioral control (PBC) with intention strength and self-concordance of intention to be physically active were tested. Habit strength was analyzed as a moderator. Data analysis showed this model to be well-suited for explaining the intention to be physically active-especially for people with a weak habit. The influence of TPB components on intention would have been underestimated if we had investigated intention strength only, without considering the self-concordance of intention. While attitude and PBC had positive relations with a strong and self-determined intention, the subjective norm showed no relation with intention strength but, rather, with non-self-determined regulation forms. We conclude that the combined model provides a better theoretical foundation from which to explain physical activity intentions than does just one of the theories.
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Affiliation(s)
- Paula Stehr
- Department of Media and Communication Science, University of Erfurt, 99089 Erfurt, Germany; (C.R.); (T.K.); (J.G.)
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Sommar JN, Johansson C, Lövenheim B, Schantz P, Markstedt A, Strömgren M, Stigson H, Forsberg B. Overall health impacts of a potential increase in cycle commuting in Stockholm, Sweden. Scand J Public Health 2021; 50:552-564. [PMID: 33977822 PMCID: PMC9203661 DOI: 10.1177/14034948211010024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS To estimate the overall health impact of transferring commuting trips from car to bicycle. METHODS In this study registry information on the location of home and work for residents in Stockholm County was used to obtain the shortest travel route on a network of bicycle paths and roads. Current modes of travel to work were based on travel survey data. The relation between duration of cycling and distance cycled was established as a basis for selecting the number of individuals that normally would drive a car to work, but have a distance to work that they could bicycle within 30 minutes. The change in traffic flows was estimated by a transport model (LuTrans) and effects on road traffic injuries and fatalities were estimated by using national hospital injury data. Effects on air pollution concentrations were modelled using dispersion models. RESULTS Within the scenario, 111,000 commuters would shift from car to bicycle. On average the increased physical activity reduced the one-year mortality risk by 12% among the additional bicyclists. Including the number of years lost due to morbidity, the total number of disability adjusted life-years gained was 696. The amount of disability adjusted life-years gained in the general population due to reduced air pollution exposure was 471. The number of disability adjusted life-years lost by traffic injuries was 176. Also including air pollution effects among bicyclists, the net benefit was 939 disability adjusted life-years per year. CONCLUSIONS Large health benefits were estimated by transferring commuting by car to bicycle.
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Affiliation(s)
- Johan Nilsson Sommar
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Christer Johansson
- Department of Environmental Science, Stockholm University, Stockholm, Sweden.,Environment and Health Administration, SLB, Stockholm, Sweden
| | - Boel Lövenheim
- Environment and Health Administration, SLB, Stockholm, Sweden
| | - Peter Schantz
- The Research Unit for Movement, Health and Environment, The Swedish School of Sport and Health Sciences, GIH, Stockholm, Sweden
| | | | | | - Helena Stigson
- Folksam Research, Stockholm, Sweden.,Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Changes in Compliance With Physical Activity Guidelines and Cardiovascular Disease Mortality. J Phys Act Health 2021; 18:638-643. [PMID: 33837159 DOI: 10.1123/jpah.2020-0740] [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: 11/03/2020] [Revised: 02/07/2021] [Accepted: 02/15/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The effects of compliance with the US Physical Activity (PA) Guidelines and changes in compliance over time on cardiovascular disease (CVD) mortality are unknown. METHODS Male participants in the Aerobics Center Longitudinal Study (n = 15,411; 18-100 y) reported leisure-time PA between 1970 and 2002. The frequency of and time spent in PA were converted into metabolic equivalent minutes per week. The participants were classified into remained inactive, became active, became inactive, or remained active groups according to their achievement of the PA guidelines along the follow-up, equivalent here to at least 500 metabolic equivalent minutes of PA per week. Cox regression adjusted for different models was used for the analyses, using age, body mass index, smoking and drinking status, hypertension, diabetes, hypercholesterolemia, and parental history of CVD. RESULTS Over a mean follow-up of 6.2 years, 439 CVD deaths occurred. Consistently meeting the PA guidelines, compared with not meeting, was associated with a 54% (95% confidence interval, 0.32-0.67) decreased risk of CVD mortality. After controlling for all potential confounders, the risk reduction was 47% (95% confidence interval, 0.36-0.77). CONCLUSIONS Maintaining adherence to the PA guidelines produces substantial reductions in the risk of CVD deaths in men. Furthermore, discontinuing compliance with the guidelines may offset the beneficial effects on longevity.
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50
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Population-level Interventions Based on Walking and Cycling as a Means to Increase Physical Activity. PHYSICAL ACTIVITY AND HEALTH 2021. [DOI: 10.5334/paah.87] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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