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Wang J, Yao J, He Y. A comparison of the physical activity levels of 3-to-6-year-old children with autism spectrum disorder and children with typical development. Front Psychol 2024; 15:1432389. [PMID: 39295756 PMCID: PMC11408300 DOI: 10.3389/fpsyg.2024.1432389] [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: 05/15/2024] [Accepted: 08/14/2024] [Indexed: 09/21/2024] Open
Abstract
Background Physical activity during early development is closely related to health. Differences in physical activity between young children with autism spectrum disorder and those with typical development are unclear. The purpose of this study was to compare the physical activity levels in children with autism spectrum disorder and typically developing children from the same area, including their sedentary physical activity, light physical activity, moderate-to-vigorous physical activity, and number of days in which the moderate-to-vigorous physical activity guideline recommendation of 60 min per day was met. Methods A total of 77 participants aged 3-6 years were included: 41 children with autism spectrum disorder (mean age = 61.41 ± 10.69 months) and 36 children with typical development (mean age = 60.36 ± 10.16 months). The physical activity of the children was measured using an ActiGraph GT3x accelerometer. Results There were no significant differences in daily sedentary physical activity (439.70 ± 54.98 vs. 450.42 ± 53.67) or moderate-to-vigorous physical activity (46.62 ± 18.93 vs. 47.47 ± 18.26) between the two groups. The average daily moderate-to-vigorous physical activity of the two groups did not reach 60 min, and they had similar proportions of participants who reached 60 min a given number of times (24.4% vs. 25%). Daily light physical activity was significantly higher in the autism spectrum disorder group (263.96 ± 43.17 vs. 242.32 ± 37.91, p < 0.05). The moderate-to-vigorous physical activity of both groups was similar and lower than the recommended minimum physical activity. Conclusion Targeted interventions should be considered in early intervention programs for children with autism spectrum disorder to increase their moderate-to-vigorous physical activity.
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Affiliation(s)
- Jing Wang
- School of Education and Psychology, Tianjin University of Sport, Tianjin, China
- Key Laboratory of Competitive Sport Psychological and Psychological Regulation, Tianjin University of Sport, Tianjin, China
| | - Jiaxin Yao
- School of Education and Psychology, Tianjin University of Sport, Tianjin, China
- Key Laboratory of Competitive Sport Psychological and Psychological Regulation, Tianjin University of Sport, Tianjin, China
| | - Yingli He
- Tianjin Rehabilitation Service Guidance Center for the Disabled, Tianjin, China
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Brar R, Katz A, Ferguson T, Whitlock R, Di Nella M, Bohm C, Rigatto C, Komenda P, Boreskie S, Solmundson C, Kosowan L, Tangri N. Impact of the medical fitness model on long term health outcomes in older adults. BMC Geriatr 2024; 24:695. [PMID: 39164654 PMCID: PMC11337618 DOI: 10.1186/s12877-024-05208-6] [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: 11/24/2023] [Accepted: 07/08/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND Physical inactivity is common among older adults and is associated with poor health outcomes. Medical fitness facilities provide a medically focused approach to physical fitness and can improve physical activity in their communities. This study aimed to assess the relationship between membership in the medical fitness model and all-cause mortality, health care utilization, and major adverse cardiac events in older adults. METHODS A propensity weighted retrospective cohort study linked individuals that attended medical fitness facilities to provincial health administrative databases. Older adults who had at least 1 year of health coverage from their index date between January 1st, 2005 to December 31st 2015 were included. Controls were assigned a pseudo-index date at random based on the frequency distribution of index dates in members. Members were stratified into low frequency attenders (< 1 Weekly Visits) and regular frequency attenders (> 1 Weekly Visits). Time to event models estimated the hazard ratios (HRs) for risk of all-cause mortality and major adverse cardiac event. Negative binomial models estimated the risk ratios (RRs) for risk of hospitalizations, outpatient primary care visits and emergency department visits. RESULTS Among 3,029 older adult members and 91,734 controls, members had a 45% lower risk of all-cause mortality (HR: 0.55, 95% CI: 0.50 - 0.61), 20% lower risk of hospitalizations (RR: 0.80, 95% CI: 0.75 - 0.84), and a 27% (HR: 0.72, 95% CI: 0.66 - 0.77), lower risk of a major adverse cardiovascular event. A dose-response effect with larger risk reductions was associated with more frequent attendance as regular frequency attenders were 4% more likely to visit a general practitioner for a routine healthcare visit (RR: 1.04, 95% CI: 1.01 - 1.07), but 23% less likely to visit the emergency department (RR: 0.87, 95% CI: 0.82 - 0.92). CONCLUSIONS Membership at a medical fitness facility was associated with a decreased risk of mortality, health care utilization and cardiovascular events. The medical fitness model may be an alternative approach for public health strategies to promote positive health behaviors in older adult populations.
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Affiliation(s)
- Ranveer Brar
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Canada.
| | - Alan Katz
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada
- Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, Manitoba, Canada
| | - Thomas Ferguson
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Canada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Reid Whitlock
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Canada
| | - Michelle Di Nella
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Canada
| | - Clara Bohm
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Canada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Claudio Rigatto
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Canada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Paul Komenda
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Canada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | | | | | - Leanne Kosowan
- Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, Manitoba, Canada
| | - Navdeep Tangri
- Department of Community Health Sciences, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, Canada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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Vazquez-Guajardo M, Rivas D, Duque G. Exercise as a Therapeutic Tool in Age-Related Frailty and Cardiovascular Disease: Challenges and Strategies. Can J Cardiol 2024; 40:1458-1467. [PMID: 38215969 DOI: 10.1016/j.cjca.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/12/2023] [Accepted: 01/07/2024] [Indexed: 01/14/2024] Open
Abstract
Understanding the link between heart disease and frailty in older adults is crucial. Although medical progress has extended life, it has not fully addressed the decline in function and quality of life in frail older people. Frailty is a state of vulnerability to health stressors that needs comprehensive solutions. Its assessment within health care, especially in cardiology, is important owing to its association with worse clinical outcomes. Recent evidence and guidelines suggest that the prescription of a comprehensive exercise regimen, tailored to progressively include strength, balance, mobility, and endurance training improves adherence, functionality, and health-related quality of life, in both acute and chronic cardiovascular diseases. In addition, exercise is a vital tool that improves function, targets frailty, and holistically affects the body's systems. Still, many frail people do not exercise enough, and when they do, they usually do not follow an appropriate plan tailored for better functional outcomes. Overcoming barriers and limitations in exercise enrollment and adherence through strategies such as automated cardiac rehabilitation referral, patient education, and eHealth tools can notably improve clinical outcomes.
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Affiliation(s)
| | - Daniel Rivas
- Bone, Muscle and Geroscience Research Group, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Gustavo Duque
- Bone, Muscle and Geroscience Research Group, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada; Geriatric Medicine, Faculty of Medicine, McGill University, Montréal, Québec, Canada.
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4
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Wang Y, Yang X, Zhou Y, Ruan W, Li H, Han Y, Wang H. High-level physical activity provides protection against all-cause mortality among U.S. adults with depression. J Affect Disord 2024; 358:458-465. [PMID: 38750801 DOI: 10.1016/j.jad.2024.05.057] [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: 10/18/2023] [Revised: 04/09/2024] [Accepted: 05/12/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND Regular physical activity (PA) offers numerous benefits, decreasing all-cause mortality (ACM) among the general population. However, its impact on individuals with depression remains unknown. The present study aimed to investigate the correlation between various PA levels and ACM among adult patients with depression in the United States. METHODS Data from the National Health and Nutrition Examination Survey from 2007 to 2018, as well as relevant mortality data up to December 31, 2018 were extracted. 4850 adults with depression were incorporated into this cohort study. PA level was quantified based on weekly metabolic equivalent of task (MET-min/week) and categorized into four groups according to the Physical Activity Guidelines for Americans. Weighted Cox proportional-hazards models were leveraged to assess the association of different PA levels with ACM among adults with depression, and adjustments were made for various sociodemographic and health factors. RESULTS Among the 4850 patients with depression, 503 deaths were noted over a median follow-up of 6.6 years. The weighted Cox regression analysis showed that participants with high-level PA (>1200 MET-min/week) had a markedly lower risk of ACM (HR = 0.48, 95 % CI 0.33 to 0.68) compared to those with no PA (0 MET-min/week). The benefit conferred by the high-level PA group (HR = 0.65, 95CI 0.45 to 0.94) remained significant (p < 0.05) after adjustment for other confounders. LIMITATIONS PA and some covariates were assessed through self-reported questionnaires. CONCLUSION High-level PA has the most pronounced effect on reducing ACM among adult patients with depression, which should be recognized in clinical and public health guidelines.
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Affiliation(s)
- Yifei Wang
- College of Physical Education and Health, Guangxi Normal University, Guilin, Guangxi 541006, China
| | - Xin Yang
- College of Physical Education and Health, Guangxi Normal University, Guilin, Guangxi 541006, China
| | - Ying Zhou
- College of Physical Education and Health, Guangxi Normal University, Guilin, Guangxi 541006, China
| | - Weiqi Ruan
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China
| | - Honglei Li
- School of Chemistry and Chemical Engineering, Nanjing University, Nanjing, Jiangsu 210023, China
| | - Yanbai Han
- College of Physical Education and Health, Guangxi Normal University, Guilin, Guangxi 541006, China
| | - Hongli Wang
- College of Physical Education and Health, Guangxi Normal University, Guilin, Guangxi 541006, China.
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Kazibwe R, Schaich CL, Muhammad AI, Epiu I, Namutebi JH, Chevli PA, Kazibwe J, Hughes T, Rikhi RR, Shapiro MD, Yeboah J. Effect of vigorous-intensity physical activity on incident cognitive impairment in high-risk hypertension. Alzheimers Dement 2024; 20:4602-4612. [PMID: 38842100 PMCID: PMC11247677 DOI: 10.1002/alz.13887] [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: 10/05/2023] [Revised: 04/04/2024] [Accepted: 04/22/2024] [Indexed: 06/07/2024]
Abstract
INTRODUCTION We investigated the effect vigorous physical activity (VPA) on the risk of incident mild cognitive impairment (MCI) and probable dementia among individuals with high-risk hypertension. METHODS Baseline self-reported frequency of VPA was categorized into low VPA (<1 session/week), and high VPA (≥1 session/week). We used multivariate Cox regression analysis to examine the association of VPA categories with incident MCI and probable dementia events. RESULTS Participants in the high VPA category, compared with low VPA, experienced lower events rates (per 1000 person-years) of MCI (13.9 vs 19.7), probable dementia (6.3 vs 9.0), and MCI/probable dementia (18.5 vs 25.8). In the multivariate Cox regression model, high VPA, compared with low VPA, was associated with lower risk of MCI, probable dementia, and MCI/probable dementia (HR [95% CI]: 0.81 [0.68-0.97], 0.80 [0.63-1.03], and 0.82 [0.70-0.96]), respectively. DISCUSSION This study provides evidence that VPA may preserve cognitive function in high-risk patients with hypertension. HIGHLIGHTS Hypertension is associated with an increased risk of cognitive impairment Physical activity (PA) is associated with a lower risk of decline in cognition The effect of ≥1 sessions of vigorous-intensity PA (VPA) per week was assessed This analysis included SPRINT MIND trial participants with high-risk hypertension ≥1 VPA sessions/week was associated with lower risk of future cognitive impairment.
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Affiliation(s)
- Richard Kazibwe
- Department of Internal MedicineWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Christopher L. Schaich
- Hypertension and Vascular Research CenterWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Ahmad Imtiaz Muhammad
- Department of MedicineSection on Hospital MedicineWisconsin College of MedicineMilwaukeeWisconsinUSA
| | - Isabella Epiu
- Prince of Wales Clinical SchoolUniversity of New South Wales SydneySydneyNew South WalesAustralia
| | - Juliana H. Namutebi
- Wake Forest UniversitySchool of Graduate StudiesWinston‐SalemNorth CarolinaUSA
| | - Parag A. Chevli
- Department of Internal MedicineWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Joseph Kazibwe
- Department of CardiologySheffield Teaching HospitalSheffieldUK
| | - Timothy Hughes
- Department of MedicineSection on Cardiovascular Medicine, Wake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Rishi R. Rikhi
- Department of Internal MedicineSection on Gerontology and Geriatrics Medicine & Sticht Center for Healthy Aging and Alzheimer's PreventionWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Michael D. Shapiro
- Department of Internal MedicineSection on Gerontology and Geriatrics Medicine & Sticht Center for Healthy Aging and Alzheimer's PreventionWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Joseph Yeboah
- Department of Internal MedicineSection on Gerontology and Geriatrics Medicine & Sticht Center for Healthy Aging and Alzheimer's PreventionWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
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Colas C, Hodaj E, Pichot V, Roche F, Cracowski C. Impact of spa therapy on physical activity, sleep and heart rate variability among individuals with fibromyalgia: Results of an ancillary study. Complement Ther Clin Pract 2024; 57:101879. [PMID: 38968692 DOI: 10.1016/j.ctcp.2024.101879] [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: 03/27/2024] [Revised: 06/12/2024] [Accepted: 06/27/2024] [Indexed: 07/07/2024]
Abstract
Spa therapy is recommended to manage symptoms of fibromyalgia, but the physiological mechanisms underlying this improvement have been poorly studied. In an original study, we explored the effect of a 3-week rheumatology spa treatment for fibromyalgia patients on quality of life and with a symptom severity questionnaire. We present here the results of an ancillary study which explored three secondary criteria using objective measurement methods: diurnal actimetry for physical activity analysis, nocturnal actimetry for sleep analysis and heart rate variability. Eighty-three fibromyalgia patients were randomized to participate in an immediate 3-week rheumatological spa therapy, either a start within 6 weeks after inclusion (interventional group, n = 39) or a delayed, start 6 months after inclusion (control group, n = 44). Patients were asked to wear an actimeter (n = 56) to assess diurnal physical activity and sleep quality and a 24-h Holter ECG (n = 60) to assess nocturnal heart rate variability at baseline, 3 months and 6 months after inclusion. Time spent in sedentary and light physical activity was reduced to ∼30 min at 6 months in the interventional group (P = 0.027). Sleep quality and heart rate variability were not improved. Spa therapy made it possible to reduce sedentary activities in patients' daily life for up to 6 months afterwards, concomitant with the improvement in quality of life, pain and fatigue as highlighted in the original Thermalgi study.
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Affiliation(s)
- Claire Colas
- INSERM, U1059, SAINBIOSE, DVH, Jean Monnet University, Saint-Étienne, France; Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France
| | - Enkelejda Hodaj
- Grenoble Alpes University Hospital, Clinical Research Center, INSERM CIC1406, Grenoble, France
| | - Vincent Pichot
- INSERM, U1059, SAINBIOSE, DVH, Jean Monnet University, Saint-Étienne, France; Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France
| | - Frédéric Roche
- INSERM, U1059, SAINBIOSE, DVH, Jean Monnet University, Saint-Étienne, France; Department of Clinical and Exercise Physiology, University Hospital Center, Saint-Étienne, France
| | - Claire Cracowski
- Grenoble Alpes University Hospital, Clinical Research Center, INSERM CIC1406, Grenoble, France.
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Baquero B, Novak N, Sewell DK, Kava CM, Daniel-Ulloa J, Pham H, Askleson N, Ashida S, Laroche H, Maldonado Gonzalez A, Bucklin R, Haines H, Parker EA. Effectiveness of implementing evidence-based approaches to promote physical activity in a Midwestern micropolitan area using a quasi-experimental hybrid type I study design. BMC Public Health 2024; 24:1082. [PMID: 38637782 PMCID: PMC11027347 DOI: 10.1186/s12889-024-18523-9] [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: 04/12/2023] [Accepted: 04/04/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Much evidence-based physical activity (PA) interventions have been tested and implemented in urban contexts. However, studies that adapt, implement, and evaluate the effectiveness of these interventions in micropolitan rural contexts are needed. The study aimed to evaluate the effectiveness of the Active Ottumwa intervention to promote PA in a micropolitan community. METHODS Between 2013 - 2019, we implemented Active Ottumwa in a micropolitan setting, and subsequently implemented and evaluated its effectiveness using a Hybrid Type I design. In this paper, we describe the intervention's effectiveness in promoting PA. We collected PA data over 24 months from a cohort of community residents using accelerometers and PA data from two cross-sectional community surveys administered in 2013 and 2018, using the Global Physical Activity Questionnaire. RESULTS From the cohort, we found significant change in PA over 24 months (P = 0.03) corresponding to a 45-min daily decrease in sedentary activity, a daily increase of 35-min in light PA and 9 min in moderate-to-vigorous PA. There was a statistically significant (P = 0.01) increasing trend at the population-level in the moderate-to-vigorous composition of 7 min between the two cross-sectional assessments (95% CI: 0.1%-1.34%). CONCLUSIONS The study demonstrates that the adapted evidence-based PA interventions in a micropolitan context is effective.
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Affiliation(s)
- Barbara Baquero
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA.
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA.
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA.
| | - Nicole Novak
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
| | - Daniel K Sewell
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Christine M Kava
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
| | - Jason Daniel-Ulloa
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
- Department of Health Systems and Population Health, University of Washington, School of Public Health, Seatle, WA, USA
| | - Hanh Pham
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Natoshia Askleson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
| | - Sato Ashida
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
| | - Helena Laroche
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Adriana Maldonado Gonzalez
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
| | - Rebecca Bucklin
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
| | - Heidi Haines
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
| | - Edith A Parker
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
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Brar R, Whitlock RH, Katz A, Di Nella M, Komenda P, Bohm C, Rigatto C, Tangri N, Solmundson C, Collister D. Impact of a Medical Fitness Model on Incident Major Adverse Cardiovascular Events: A Prospective Cohort Study of 11 000 Members. J Am Heart Assoc 2024; 13:e030028. [PMID: 38533967 PMCID: PMC11179749 DOI: 10.1161/jaha.123.030028] [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: 06/26/2023] [Accepted: 02/27/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Cardiovascular disease remains the leading cause of disease burden and death in the world. The medical fitness model may be an alternative public health strategy to address cardiovascular risk factors with medical integrated programming. METHODS AND RESULTS We performed a retrospective cohort study between January 1, 2005, and December 31, 2015. Adults (aged ≥18 years) who did not have a prior major adverse cardiovascular event were included. Controls were assigned a pseudo-index date at random on the basis of the frequency distribution of start dates in the medical fitness facility group. Multivariate Cox proportional hazards regression models were adjusted for age, sex, socioeconomic status, comorbidities, and year of index date. We stratified the medical fitness facility group into low-frequency attenders (≤1 weekly visit) and regular-frequency attenders (>1 weekly visit). Our primary outcome was a hospitalization for nonfatal myocardial infarction and stroke, heart failure, or cardiovascular death. We included 11 319 medical fitness facility members and 507 400 controls in our study. Compared with controls, members had a lower hazard risk of a major adverse cardiovascular event-plus (hazard ratio [HR], 0.88 [95% CI, 0.81-0.96]). Higher weekly attendance was associated with a lower hazard risk of a major adverse cardiovascular event-plus compared with controls, but the effect was not significant for lower weekly attendance (low-frequency attenders: HR, 0.94 [95% CI, 0.85-1.04]; regular-frequency attenders: HR, 0.77 [95% CI, 0.67-0.89]). CONCLUSIONS Medical fitness facility membership and attendance at least once per week may lower the risk of a major adverse cardiovascular event-plus. The medical fitness model should be considered as a public health intervention, especially for individuals at risk for cardiovascular disease.
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Affiliation(s)
- Ranveer Brar
- Department of Community Health Sciences, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Chronic Disease Innovation CentreSeven Oaks General HospitalWinnipegManitobaCanada
| | - Reid H. Whitlock
- Chronic Disease Innovation CentreSeven Oaks General HospitalWinnipegManitobaCanada
| | - Alan Katz
- Department of Community Health Sciences, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Manitoba Centre for Health Policy, Department of Community Health Sciences, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Department of Family Medicine, Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
| | - Michelle Di Nella
- Chronic Disease Innovation CentreSeven Oaks General HospitalWinnipegManitobaCanada
| | - Paul Komenda
- Department of Community Health Sciences, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Chronic Disease Innovation CentreSeven Oaks General HospitalWinnipegManitobaCanada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
| | - Clara Bohm
- Department of Community Health Sciences, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Chronic Disease Innovation CentreSeven Oaks General HospitalWinnipegManitobaCanada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
| | - Claudio Rigatto
- Department of Community Health Sciences, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Chronic Disease Innovation CentreSeven Oaks General HospitalWinnipegManitobaCanada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
| | - Navdeep Tangri
- Department of Community Health Sciences, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Chronic Disease Innovation CentreSeven Oaks General HospitalWinnipegManitobaCanada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
| | - Carrie Solmundson
- Chronic Disease Innovation CentreSeven Oaks General HospitalWinnipegManitobaCanada
- Wellness InstituteWinnipegManitobaCanada
| | - David Collister
- Chronic Disease Innovation CentreSeven Oaks General HospitalWinnipegManitobaCanada
- Department of Internal Medicine, Section of Nephrology, Max Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Department of Medicine, Faculty of Medicine & DentistryUniversity of AlbertaEdmontonAlbertaCanada
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9
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Gardner B, Mainsbridge CP, Rebar AL, Cooley PD, Honan C, O'Brien J, Pedersen SJ. Breaking the Habit? Identifying Discrete Dimensions of Sitting Automaticity and Their Responsiveness to a Sitting-Reduction Intervention. Int J Behav Med 2024; 31:55-63. [PMID: 36750501 PMCID: PMC10803392 DOI: 10.1007/s12529-023-10155-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 02/09/2023]
Abstract
BACKGROUND Growing evidence suggests that sitting is activated automatically on exposure to associated environments, yet no study has yet sought to identify in what ways sitting may be automatic. METHOD This study used data from a 12-month sitting-reduction intervention trial to explore discrete dimensions of sitting automaticity, and how these dimensions may be affected by an intervention. One hundred ninety-four office workers reported sitting automaticity at baseline, and 3 months, 6 months, 9 months and 12 months after receiving one of two sitting-reduction intervention variants. RESULTS Principal component analysis extracted two automaticity components, corresponding to a lack of awareness and a lack of control. Scores on both automaticity scales decreased over time post-intervention, indicating that sitting became more mindful, though lack of awareness scores were consistently higher than lack of control scores. CONCLUSION Attempts to break office workers' sitting habits should seek to enhance conscious awareness of alternatives to sitting and afford office workers a greater sense of control over whether they sit or stand.
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Affiliation(s)
- Benjamin Gardner
- Department of Psychology, University of Surrey, Guildford, GU2 7XH, Surrey, UK
| | - Casey P Mainsbridge
- School of Education, University of New England, Armidale, NSW, 2351, Australia
| | - Amanda L Rebar
- School of Health, Medical, and Applied Sciences, Central Queensland University, Rockhampton, QLD, 4702, Australia
| | - P Dean Cooley
- Active Work Laboratory, School of Education, University of Tasmania, Newnham, TAS, 7250, Australia
| | - Cynthia Honan
- School of Psychological Sciences, University of Tasmania, Newnham, TAS, 7250, Australia
| | - Jane O'Brien
- School of Nursing, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia
| | - Scott J Pedersen
- Active Work Laboratory, School of Education, University of Tasmania, Newnham, TAS, 7250, Australia.
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Diaconașu DE, Stoleriu I, Câmpanu IA, Andrei AM, Boncu Ș, Honceriu C, Mocanu V, Juravle G. Predictors of sustained physical activity: behaviour, bodily health, and the living environment. Front Physiol 2024; 14:1213075. [PMID: 38260099 PMCID: PMC10800461 DOI: 10.3389/fphys.2023.1213075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 12/08/2023] [Indexed: 01/24/2024] Open
Abstract
This study examined the determinants of sustained physical activity. Eighty-four participants undertook a 7-weeks walking regime (i.e., a 1-h biometrically-monitored walk, at least 5 days/week), with bioelectrical impedance (BIA) and total cholesterol capillary blood measurements performed before and after programme. To investigate behavioural habit formation, 7 weeks after walking termination, all participants were interviewed and (health) re-tested. Data were modelled with an artificial neural network (ANN) cascading algorithm. Our results highlight the successful prediction of continued physical activity by considering one's physical fitness state, the environmental living context, and risk for cardiovascular disease. Importantly, those artificial neural network models also taking body mass index (BMI) and blood cholesterol as predictors excel at predicting walking continuation (i.e., predictions with 93% predictability). These results are first to highlight the type and importance of available physiological drivers in maintaining a sustained physical activity regime such as walking. They are discussed within the framework of habit formation and the nowadays health and/or wellbeing focus.
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Affiliation(s)
- Delia Elena Diaconașu
- Sensorimotor Dynamics Laboratory, Faculty of Psychology and Educational Sciences, Alexandru Ioan Cuza University, Iasi, Romania
- Department of Social Sciences and Humanities, Institute of Interdisciplinary Research, Alexandru Ioan Cuza University, Iasi, Romania
| | - Iulian Stoleriu
- Faculty of Mathematics, Alexandru Ioan Cuza University, Iasi, Romania
| | - Ioana Andreea Câmpanu
- Sensorimotor Dynamics Laboratory, Faculty of Psychology and Educational Sciences, Alexandru Ioan Cuza University, Iasi, Romania
| | - Ana-Maria Andrei
- Sensorimotor Dynamics Laboratory, Faculty of Psychology and Educational Sciences, Alexandru Ioan Cuza University, Iasi, Romania
- Faculty of Educational Sciences, Stefan cel Mare University, Suceava, Romania
| | - Ștefan Boncu
- Faculty of Psychology and Educational Sciences, Alexandru Ioan Cuza University, Iasi, Romania
| | - Cezar Honceriu
- Faculty of Physical Education and Sports, Alexandru Ioan Cuza University, Iasi, Romania
| | - Veronica Mocanu
- Department of Morpho-Functional Sciences 2—Pathophysiology, Grigore T. Popa Medical University of Iasi, Iasi, Romania
| | - Georgiana Juravle
- Sensorimotor Dynamics Laboratory, Faculty of Psychology and Educational Sciences, Alexandru Ioan Cuza University, Iasi, Romania
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Kazibwe R, Singleton MJ, Chevli PA, Kaze AD, Namutebi JH, Shapiro MD, Yeboah J. Association between physical activity and clinical outcomes in high-risk hypertension: Post-hoc analysis of SPRINT. Am J Prev Cardiol 2023; 16:100524. [PMID: 37576387 PMCID: PMC10415631 DOI: 10.1016/j.ajpc.2023.100524] [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: 03/08/2023] [Revised: 07/10/2023] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
Objective Engaging in physical activity (PA) is recommended to reduce the risk of morbidity and mortality in patients with hypertension. However, the association between PA and clinical outcomes in individuals with high-risk hypertension is understudied. We examined the relationship between PA and clinical outcomes in the Systolic Blood Pressure Intervention Trial (SPRINT). SPRINT investigated the benefit of intensive (vs. standard) blood pressure treatment in patients with high-risk hypertension. Methods Baseline data on PA was self-reported. Vigorous-intensity PA (VPA) was categorized into 2 groups based on frequency of "Rarely or Never" and 1 or more sessions/month. Moderate-intensity PA (MPA) was also categorized into 2 groups based on average duration/day of <15 min and 15 or more minutes. Using multivariable Cox regression, we estimated the associations between PA the primary outcome which was a composite of cardiovascular events, and all-cause mortality. Results A total of 8,320 (age 67.8 ± 9.3, 34.9% women) of SPRINT participants with data on PA were included. During a median follow-up of 3.8 years, 619 primary outcome, and 419 all-cause mortality events occurred. Compared to not engaging in VPA, the risk of the primary outcome, myocardial infarction, and all-cause mortality (HR 95% CIs) associated with VPA of ≥1sessions/month was 0.79(0.65-0.94; p=0.009), 0.70(0.52-0.93; p=0.014) and 0.75(0.60-0.94; p=0.011), respectively. Similarly, the risk of the primary outcome and all-cause mortality (HR 95% CI) associated with engaging in MPA for ≥15 min/day, relative to <15 min/day was 0.76(0.63-0.93; p=0.008) and 0.80(0.62-1.02; p=0.066), respectively. Conclusion Among individuals with hypertension from the SPRINT study, VPA and MPA at a threshold of ≥1sessions/month and MPA of ≥15 min/day respectively, were both associated with a lower risk for cardiovascular events, and VPA was also associated with a reduced risk for all-cause mortality. Further studies are required to identify the optimal volume and intensity of PA in high-risk hypertension.
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Affiliation(s)
- Richard Kazibwe
- Department of Medicine, Section on Hospital Medicine, Wake Forest University School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Matthew J. Singleton
- Department of Medicine, Section on Cardiovascular Medicine, WellSpan Health, York, PA, USA
| | - Parag A. Chevli
- Department of Medicine, Section on Hospital Medicine, Wake Forest University School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | | | | | - Michael D. Shapiro
- Center for the Prevention of Cardiovascular Disease Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Joseph Yeboah
- Center for the Prevention of Cardiovascular Disease Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Alexander HB, Arnel M, O'Connell N, Munger Clary HM, Fanning J, Brubaker P, Fountain NB, Duncan P. A single-center survey on physical activity barriers, behaviors and preferences in adults with epilepsy. Epilepsy Behav 2023; 149:109491. [PMID: 37951132 PMCID: PMC10842096 DOI: 10.1016/j.yebeh.2023.109491] [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: 07/17/2023] [Revised: 10/11/2023] [Accepted: 10/13/2023] [Indexed: 11/13/2023]
Abstract
BACKGROUND Improved understanding of physical activity barriersand preferences in people with epilepsyis needed to successfully design and perform larger, more robust effectivenesstrials. METHODS Adult patients at a single tertiary epilepsy center between January and April 2020 were surveyed. The survey included a validated physical activity questionnaire (Physical Activity Scale for the Elderly) plus 15 items aimed to address 1) perceptions and beliefs regarding physical activity, 2) barriers to routine physical activity, and 3) willingness and ability to participate in a physical activity intervention and 4) current physical abilities, activities, and preferences. RESULTS 95 participants with epilepsy (age 42 ± 16.2, 59 % female) completed the survey. Sixty-five participants (68.4 %) reported that they believe that physical activity could improve their seizure frequency. However, 40 % of those surveyed said their neurologist had never talked to them about physical activity. The most commonly reported barriers to physical activity were lack of time (24.7 %) and fear of having a seizure (19.7 %), while barriers to intervention participation included being unable to come to in-person sessions (53 % of those willing to participate),living far away (39.3 %), time constraints (28.6 %), and lack of transportation (21.4 %). CONCLUSION Future physical activity studies in people with epilepsy should focus on using tailored interventions that accommodate their unique beliefs and barriers.
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Affiliation(s)
- Halley B Alexander
- Wake Forest University School of Medicine, Department of Neurology, Winston-Salem, NC, USA.
| | - Madison Arnel
- Wake Forest University School of Medicine, Department of Neurology, Winston-Salem, NC, USA
| | - Nathaniel O'Connell
- Wake Forest School of Medicine, Department of Biostatistics and Data Science in the Division of Public Health Sciences, Winston-Salem, NC, USA
| | - Heidi M Munger Clary
- Wake Forest University School of Medicine, Department of Neurology, Winston-Salem, NC, USA
| | - Jason Fanning
- Wake Forest University, Department of Health and Exercise Science, Winston-Salem, NC, USA
| | - Peter Brubaker
- Wake Forest University, Department of Health and Exercise Science, Winston-Salem, NC, USA
| | - Nathan B Fountain
- University of Virginia, Department of Neurology, Charlottesville, VA, USA
| | - Pamela Duncan
- Wake Forest University School of Medicine, Department of Neurology, Winston-Salem, NC, USA
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Lei XL, Gao K, Wang H, Chen W, Chen GR, Wen X. The role of physical activity on healthcare utilization in China. BMC Public Health 2023; 23:2378. [PMID: 38037037 PMCID: PMC10691091 DOI: 10.1186/s12889-023-16625-4] [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: 03/30/2023] [Accepted: 08/26/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Evidence on the role of physical activity (PA) on healthcare utilization and expenditure is limited in China. We aimed to examine the association between the total physical activity (TPA) per week, healthcare service use and expenditure. METHODS We extracted the data from China Health and Retirement Longitudinal Study (CHARLS) 2011, 2013, and 2015. Participants more than 50 years old who completed the follow-up for the three waves were enrolled. We converted the volume of vigorous physical activity (VPA) into an equivalent volume of moderate physical activity (MPA) and calculated the TPA per week for each participant. 12,927 of the 17,708 participants in CHARLS were included in our analysis. More than one-third of participants over 50 years old never participate in any moderate or intensity activity, and the median of self-reported moderate or intensity PA was about 525 (IQR 0-1680) MET-minutes per week in 2015. RESULTS Compared to inactive subjects, the highest level of TPA was significantly related to the decreased risk number of inpatient visits (IRR: 0.58; 95% CI:0.50-0.67, p < 0.001), inpatient hospital days (IRR: 0.60; 95% CI: 0.42-0.84, p < 0.01), healthcare expenditure (IRR: 0.71; 95% CI: 0.65-0.79, p < 0.001) and catastrophic health expenditures (OR: 0.57; 95% CI: 0.45-0.72, p < 0.001) after adjusting for covariates. CONCLUSIONS Engaging in moderate-to-vigorous PA may drive a potential decrease in healthcare utilization, healthcare expenditure and household financial risk with a dose-response relationship in China, and some possible policy implications in public health may be considered to promote exercise in the middle-aged and elderly to reduce the medical burden on individuals and healthcare systems.
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Affiliation(s)
- Xiao-Lin Lei
- Department of Cardiology, Xijing Hospital, Air Force Military Medical University (Fourth Military Medical University), Xi'an, 710032, China
| | - Ke Gao
- Department of Cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Huan Wang
- Department of Cardiology, Xijing Hospital, Air Force Military Medical University (Fourth Military Medical University), Xi'an, 710032, China
| | - Wei Chen
- Department of Cardiology, Xijing Hospital, Air Force Military Medical University (Fourth Military Medical University), Xi'an, 710032, China
| | - Gen-Rui Chen
- Department of Cardiology, Xijing Hospital, Air Force Military Medical University (Fourth Military Medical University), Xi'an, 710032, China.
| | - Xing Wen
- The Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu &The Affiliated Hospital of Southwest, Jiaotong University, Chengdu, 610032, China.
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Fang W, Cao Y, Chen Y, Zhang H, Ni R, Hu W, Pan G. Associations of family income and healthy lifestyle with all-cause mortality. J Glob Health 2023; 13:04150. [PMID: 37962358 PMCID: PMC10644849 DOI: 10.7189/jogh.13.04150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023] Open
Abstract
Background There is a lack of evidence on whether combined lifestyle factors mediate the association between family income and all-cause mortality, as well as the joint relations between family income and lifestyle factors with mortality. Methods Using data on family income and lifestyle factors of participants in the US National Health Interview Survey 2016-2018, we performed multivariable logistic regression models to estimate the odds ratios (ORs) and 95% confidence intervals (CI) for the association of all-cause mortality with said data. Results We included 73 729 participants with a mean age of 47.1 years (standard deviation (SD) = 18.0), 51% of whom were women and 65% of whom were non-Hispanic Whites. There were 2284 deaths documented. After multivariable adjustment, middle-income participants had an OR of 0.73 (95% CI = 0.61-0.88) for mortality, while high-income participants had an OR of 0.47 (95% CI = 0.37-0.60) compared with low-income participants. We found that lower all-cause mortality was related to higher lifestyle scores. Adults from high-income families with lifestyle scores of 3 and 4 had an OR for mortality of 0.44 (95% CI = 0.30-0.65) compared to those from low-income families and lifestyle scores of 0 or 1. When comparing those in highest vs lowest income groups in the mediation analysis, 9.8% (95% CI = 7.4-13.0) of the relation for all-cause mortality was mediated by lifestyles. Adults from high-income families with lifestyle scores of 3 or 4 had an OR of 0.23 (95% CI = 0.17-0.33) for mortality compared with those from low-income families and lifestyle scores of 0 or 1. Conclusions A lower risk of all-cause mortality was linked to higher family income and healthier lifestyles. Furthermore, lifestyle factors mediated a small proportion of the association between family income and mortality among US adults. Economic disparity in health may not be eliminated by changing only one's lifestyle. Therefore, besides promoting a healthy lifestyle, we should stress how family income inequality affects health outcomes.
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Liu YT, Liao Y, Hsueh MC, Yen HY, Park JH, Chang JH. Domain-specific Physical Activity and the Risk of All-cause Mortality Among Middle-aged and Older Adults in Taiwan: A Prospective Cohort Study. J Epidemiol 2023; 33:574-581. [PMID: 36310060 PMCID: PMC10518382 DOI: 10.2188/jea.je20220105] [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: 04/08/2022] [Accepted: 09/15/2022] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The impact of meeting leisure-time physical activity (LTPA) recommendations and household physical activity (HPA) on all-cause mortality in the Taiwanese population is unclear. We aimed to investigate the relationship between sufficient LTPA and all-cause mortality in middle-aged and older Taiwanese adults and the role of HPA in those with insufficient LTPA. METHODS This nationwide prospective cohort study included 4,960 participants aged ≥50 years from the Taiwan Longitudinal Study in Aging (TLSA) survey. Physical activity patterns were assessed in 2003 and then followed up until 2015 for mortality through the National Death Registration Record. Cox proportional hazards regression was conducted to evaluate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality. RESULTS Of the 4,960 participants, 1,712 died of all-cause mortality. Compared to those who had insufficient LTPA, participants who engaged in sufficient LTPA showed a significantly lower risk of all-cause mortality (HR = 0.84, 95% CI, 0.73-0.97). For those with insufficient LTPA, HPA also had a significantly reduced risk of all-cause mortality (HR = 0.85, 95% CI, 0.75-0.96) among general population. Similar associations were observed in subsequent sensitivity analyses. The subgroup analysis showed that the relationship between HPA and reduced mortality risk was only found in the women with insufficient LTPA group. CONCLUSION This study confirmed that sufficient LTPA is associated with a lower risk of all-cause mortality. If sufficient LTPA cannot be performed, additional HPA is related to lower mortality.
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Affiliation(s)
- Yu-Tai Liu
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
| | - Yung Liao
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, Taipei, Taiwan
| | - Ming-Chun Hsueh
- Graduate Institute of Sport Pedagogy, University of Taipei, Taipei, Taiwan
| | - Hsin-Yen Yen
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Jong-Hwan Park
- Health Behaviors & Disease Prevention Research Group, Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Jae Hyeok Chang
- Department of Rehabilitation Medicine, School of Medicine, Pusan National University, Busan, South Korea
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Golsteijn RHJ, Bolman C, Peels DA, Volders E, de Vries H, Lechner L. Long-term efficacy of a computer-tailored physical activity intervention for prostate and colorectal cancer patients and survivors: A randomized controlled trial. JOURNAL OF SPORT AND HEALTH SCIENCE 2023; 12:690-704. [PMID: 37591482 PMCID: PMC10658345 DOI: 10.1016/j.jshs.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/18/2023] [Accepted: 07/24/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Physical activity (PA) can improve the physical and psychological health of prostate and colorectal cancer survivors, but PA behavior change maintenance is necessary for long-term health benefits. OncoActive is a print- and web-based intervention in which prostate and colorectal cancer patients and survivors receive automatically generated, personalized feedback aimed at integrating PA into daily life to increase and maintain PA. We evaluated the long-term outcomes of OncoActive by examining the 12-month follow-up differences between OncoActive and a control group, and we explored whether PA was maintained during a 6-month non-intervention follow-up period. METHODS Prostate or colorectal cancer patients were randomly assigned to an OncoActive (n = 249) or a usual care waitlist control group (n = 229). OncoActive participants received PA advice and a pedometer. PA outcomes (i.e., ActiGraph and self-report moderate-to-vigorous intensity PA (MVPA) min/week and days with ≥30 min PA) and health-related outcomes (i.e., fatigue, depression, physical functioning) were assessed at baseline, 6 months, and 12 months. Differences between groups and changes over time were assessed with multilevel linear regressions for the primary outcome (ActiGraph MVPA min/week) and all additional outcomes. RESULTS At 12 months, OncoActive participants did not perform better than control group participants at ActiGraph MVPA min/week, self-report MVPA min/week, or ActiGraph days with PA. Only self-report days with PA were significantly higher in OncoActive compared to the control group. For health-related outcomes only long-term fatigue was significantly lower in OncoActive. When exploratively examining PA within OncoActive, the previously found PA effects at the end of the intervention (6 months follow-up) were maintained at 12 months. Furthermore, all PA outcomes improved significantly from baseline to 12 months. The control group showed small but non-significant improvements from 6 months to 12 months (and from baseline to 12 months), resulting in a decline of differences between groups. CONCLUSION The majority of previously reported significant between-group differences at 6 months follow-up were no longer present at long-term follow-up, possibly because of natural improvement in the control group. At long-term follow-up, fatigue was significantly lower in OncoActive compared to control group participants. Computer-tailored PA advice may give participants an early start toward recovery and potentially contributes to improving long-term health.
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Affiliation(s)
| | - Catherine Bolman
- Department of Psychology, Open University of the Netherlands, Heerlen, 6401 DL, the Netherlands
| | - Denise Astrid Peels
- Department of Psychology, Open University of the Netherlands, Heerlen, 6401 DL, the Netherlands
| | - Esmee Volders
- Department of Psychology, Open University of the Netherlands, Heerlen, 6401 DL, the Netherlands
| | - Hein de Vries
- Department of Health Promotion, Maastricht University, Maastricht, 6200 MD, the Netherlands
| | - Lilian Lechner
- Department of Psychology, Open University of the Netherlands, Heerlen, 6401 DL, the Netherlands
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Nagai T, Bates NA, Rigamonti L, Hollman JH, Laskowski ER, Schilaty ND. Effects of neuromuscular and proprioceptive training on self-reported wellness and health scores and knee sensorimotor characteristics in active seniors. J Bodyw Mov Ther 2023; 36:370-379. [PMID: 37949586 DOI: 10.1016/j.jbmt.2023.06.008] [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: 03/14/2022] [Revised: 04/20/2023] [Accepted: 06/05/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION Athletes regularly engage in comprehensive neuromuscular and proprioceptive training (NPT) to prevent musculoskeletal (MSK) injuries. NPT exercises such as movement technique, agility, balance, and posture as well as yoga-based stretching and slow/deep breathing have shown added benefits in psychological and other well-being. This study aimed to examine the effects of NPT on knee sensorimotor characteristics and multi-domain wellness and health scores in active seniors. METHODS Twenty seniors participated in the NPT intervention (15-20min session twice a week for 10 weeks) while the control group did not receive any intervention. All participants completed surveys (general health, frailty, anxiety, stress, mindfulness, optimism, and sleep quality) and laboratory testing before and after intervention. Laboratory testing included frailty tests (grip strength, 4-m walk speed, and calcaneal ultrasound-based bone density) and knee sensorimotor characteristics (peak force, visual-motor reaction time, and force steadiness). RESULTS There was significant increase in general mental health (Short Form 36 Mental Health; p = 0.005) and decrease in stress (Perceived Stress Scale; p = 0.010) and sleep disturbances (Pittsburgh Sleep Quality Index; p = 0.019) post-intervention while no significant changes were observed in the control group (p = 0.310-0.654). Peak knee forces in all directions and some visual-motor reaction time and force steadiness were significantly improved post-intervention only in the experimental group (p = 0.001-0.038). CONCLUSION A simple, yet, comprehensive NPT has potential to improve MSK health as well as various domains of well-being among active seniors.
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Affiliation(s)
- Takashi Nagai
- United States Army Research Institute and Environmental Medicine, Natick, MA, USA; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
| | - Nathaniel A Bates
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Orthopaedics, The Ohio State University, Columbus, OH, USA
| | - Luca Rigamonti
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - John H Hollman
- Department of Physical Medicine, Rehabilitation and Division of Sports Medicine, Department of Orthopedics, Mayo Clinic, Rochester, MN, USA
| | - Edward R Laskowski
- Department of Physical Medicine, Rehabilitation and Division of Sports Medicine, Department of Orthopedics, Mayo Clinic, Rochester, MN, USA
| | - Nathan D Schilaty
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Neurosurgery & Brain Repair, University of South Florida, Tampa, FL, USA; University of South Florida Center for Neuromusculoskeletal Research, Tampa, FL, USA
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Liu BP, Zhu JH, Wan LP, Zhao ZY, Wang X, Jia CX. The Impact of Physical Activity Intensity on the Dynamic Progression of Cardiometabolic Multimorbidity: Prospective Cohort Study Using UK Biobank Data. JMIR Public Health Surveill 2023; 9:e46991. [PMID: 37747776 PMCID: PMC10562971 DOI: 10.2196/46991] [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: 03/04/2023] [Revised: 06/02/2023] [Accepted: 08/10/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Although many studies have reported on the associations between the amount of physical activity (PA) and the transitions of cardiometabolic multimorbidity (CMM), the evidence for PA intensity has not been fully evaluated. OBJECTIVE This study aimed to explore the impact of PA intensity on the dynamic progression of CMM. METHODS The prospective cohort of this study using data from the UK Biobank included 359,773 participants aged 37-73 years who were recruited from 22 centers between 2006 and 2010. The diagnoses of CMM, which included the copresence of type 2 diabetes (T2D), ischemic heart disease, and stroke, were obtained from first occurrence fields provided by the UK Biobank, which included data from primary care, hospital inpatient record, self-reported medical condition, and death registers. The PA intensity was assessed by the proportion of vigorous PA (VPA) to moderate to vigorous PA (MVPA). Multistate models were used to evaluate the effect of PA intensity on the dynamic progression of CMM. The first model (model A) included 5 transitions, namely free of cardiometabolic disease (CMD) to first occurrence of CMD (FCMD), free of CMD to death, FCMD to CMM, FCMD to mortality, and CMM to mortality. The other model (model B) used specific CMD, namely T2D, ischemic heart disease, and stroke, instead of FCMD and included 11 transitions in this study. RESULTS The mean age of the included participants (N=359,773) was 55.82 (SD 8.12) years at baseline, and 54.55% (196,271/359,773) of the participants were female. Compared with the participants with no VPA, participants with intensity levels of >0.75 to <1 for VPA to MVPA had a 13% and 27% lower risk of transition from free of CMD to FCMD (hazard ratio [HR] 0.87, 95% CI 0.83-0.91) and mortality (HR 0.73, 95% CI 0.66-0.79) in model A, respectively. The HR for the participants with no moderate PA was 0.82 (95% CI 0.73-0.92) compared with no VPA. There was a substantially protective effect of higher PA intensity on the transitions from free of CMD to T2D and from T2D to mortality, which reveals the importance of PA intensity for the transitions of T2D. More PA and greater intensity had a synergistic effect on decreasing the risk of the transitions from free of CMD to FCMD and mortality. Male participants, younger adults, adults with a higher BMI, current or previous smokers, and excessive alcohol drinkers could obtain more benefits from higher PA intensity for the lower risk of at least 1 transition from free of CMD, then to CMM, and finally to mortality. CONCLUSIONS This study suggests that higher PA intensity is an effective measure for preventing CMM and mortality in the early period of CMM development. Relevant interventions related to higher PA intensity should be conducted.
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Affiliation(s)
- Bao-Peng Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jia-Hui Zhu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Li-Peng Wan
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhen-Yu Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xinting Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
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Leszczynski EC, Schwartz NE, McPeek AC, Currie KD, Ferguson DP, Garland T. Selectively breeding for high voluntary physical activity in female mice does not bestow inherent characteristics that resemble eccentric remodeling of the heart, but the mini-muscle phenotype does. SPORTS MEDICINE AND HEALTH SCIENCE 2023; 5:205-212. [PMID: 37753423 PMCID: PMC10518799 DOI: 10.1016/j.smhs.2023.07.003] [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: 12/20/2022] [Revised: 05/18/2023] [Accepted: 07/05/2023] [Indexed: 09/28/2023] Open
Abstract
Physical activity engagement results in a variety of positive health outcomes, including a reduction in cardiovascular disease risk partially due to eccentric remodeling of the heart. The purpose of this investigation was to determine if four replicate lines of High Runner mice that have been selectively bred for voluntary exercise on wheels have a cardiac phenotype that resembles the outcome of eccentric remodeling. Adult females (average age 55 days) from the 4 High Runner and 4 non-selected control lines were anaesthetized via vaporized isoflurane, then echocardiographic images were collected and analyzed for structural and functional differences. High Runner mice in general had lower ejection fractions compared to control mice lines (2-tailed p = 0.023 6) and tended to have thicker walls of the anterior portion of the left ventricle (p = 0.065). However, a subset of the High Runner individuals, termed mini-muscle mice, had greater ejection fraction (p = 0.000 6), fractional shortening percentage (p < 0.000 1), and ventricular mass at dissection (p < 0.002 7 with body mass as a covariate) compared to non-mini muscle mice. Mice from replicate lines bred for high voluntary exercise did not all have inherent positive cardiac functional or structural characteristics, although a genetically unique subset of mini-muscle individuals did have greater functional cardiac characteristics, which in conjunction with their previously described peripheral aerobic enhancements (e.g., increased capillarity) would partially account for their increased V ˙ O2max.
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Affiliation(s)
| | - Nicole E. Schwartz
- Department of Evolution, Ecology, and Organismal Biology, University of California Riverside, Riverside, CA, USA
| | - Ashley C. McPeek
- Department of Kinesiology, Michigan State University, East Lansing, MI, USA
| | | | - David P. Ferguson
- Department of Kinesiology, Michigan State University, East Lansing, MI, USA
| | - Theodore Garland
- Department of Evolution, Ecology, and Organismal Biology, University of California Riverside, Riverside, CA, USA
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20
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Clemente-Suárez VJ, Beltrán-Velasco AI, Redondo-Flórez L, Martín-Rodríguez A, Tornero-Aguilera JF. Global Impacts of Western Diet and Its Effects on Metabolism and Health: A Narrative Review. Nutrients 2023; 15:2749. [PMID: 37375654 PMCID: PMC10302286 DOI: 10.3390/nu15122749] [Citation(s) in RCA: 89] [Impact Index Per Article: 89.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
The Western diet is a modern dietary pattern characterized by high intakes of pre-packaged foods, refined grains, red meat, processed meat, high-sugar drinks, candy, sweets, fried foods, conventionally raised animal products, high-fat dairy products, and high-fructose products. The present review aims to describe the effect of the Western pattern diet on the metabolism, inflammation, and antioxidant status; the impact on gut microbiota and mitochondrial fitness; the effect of on cardiovascular health, mental health, and cancer; and the sanitary cost of the Western diet. To achieve this goal, a consensus critical review was conducted using primary sources, such as scientific articles, and secondary sources, including bibliographic indexes, databases, and web pages. Scopus, Embase, Science Direct, Sports Discuss, ResearchGate, and the Web of Science were used to complete the assignment. MeSH-compliant keywords such "Western diet", "inflammation", "metabolic health", "metabolic fitness", "heart disease", "cancer", "oxidative stress", "mental health", and "metabolism" were used. The following exclusion criteria were applied: (i) studies with inappropriate or irrelevant topics, not germane to the review's primary focus; (ii) Ph.D. dissertations, proceedings of conferences, and unpublished studies. This information will allow for a better comprehension of this nutritional behavior and its effect on an individual's metabolism and health, as well as the impact on national sanitary systems. Finally, practical applications derived from this information are made.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (J.F.T.-A.)
| | | | - Laura Redondo-Flórez
- Department of Health Sciences, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, C/Tajo s/n, 28670 Villaviciosa de Odón, Spain;
| | - Alexandra Martín-Rodríguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (J.F.T.-A.)
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21
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Brown A, Wilson DK, Sweeney AM, van Horn ML, Zarrett N, Pate RR. Buffering effects of protective factors on light and moderate-to-vigorous physical activity among african american women. J Behav Med 2023; 46:405-416. [PMID: 36260160 PMCID: PMC10113398 DOI: 10.1007/s10865-022-00360-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 08/22/2022] [Indexed: 10/24/2022]
Abstract
Physical activity (PA) plays an integral role in reducing risk for the leading causes of death and has also been shown to buffer stress. Based on the stress-buffering hypothesis, the present study examined whether protective factors (self-efficacy and informal social control) buffered the effects of perceived stress on PA over time. Secondary data analyses of female African American caregivers (N = 143) were conducted using data from the Families Improving Together (FIT) trial. Validated measures of stressors and protective factors were assessed at baseline. Light PA and moderate-to-vigorous PA were assessed using seven-day accelerometry estimates over sixteen weeks. Multilevel growth modeling was used to assess whether protective factors moderated the effects of perceived stress on PA outcomes across 16 weeks. There was a significant two-way interaction between informal social control and time (B = 0.40, SE = 0.17, p = .019) such that higher informal social control was positively associated with MVPA over time. There was a marginal three-way interaction (B = -18.90, SE = 10.31, p = .067) such that stress was associated with greater LPA at baseline under conditions of high but not low self-efficacy. This study provides preliminary support that social factors may be important for maintaining MVPA regardless of stress levels, while cognitive resources may be more important to target for influencing LPA engagement under conditions of high stress.
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Affiliation(s)
- Asia Brown
- Department of Psychology, University of South Carolina, Columbia, SC, USA.
| | - Dawn K Wilson
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | | | - M Lee van Horn
- Department of Educational Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Nicole Zarrett
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Russell R Pate
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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22
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Liu BP, Jia CX. The associations of physical activity and lifetime depression with all-cause and cause-specific mortality: evidence from a prospective cohort study. Psychiatry Res 2023; 324:115206. [PMID: 37098300 DOI: 10.1016/j.psychres.2023.115206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/05/2023] [Accepted: 04/11/2023] [Indexed: 04/27/2023]
Abstract
This study aims to explore the joint associations of physical activity and lifetime depression with all-cause and cause-specific mortality. The present study using data from UK Biobank, included 316568 participants aged 37 to 73 years recruited from 22 centers between 2006 and 2010. Total physical activity (TPA), moderate-to-vigorous physical activity (MVPA) and vigorous physical activity (VPA), assessed by metabolic equivalent task (MET) were used and Cox-proportional hazard models were performed in this study. The incidence rate of all-cause, CVD, and cancer mortality was 4.35(95%CI: 4.29-4.42), 0.69 (95%CI: 0.67-0.72), and 2.23 (95%CI: 2.19-2.28) per 1000 person-years after an average follow-up time of 12.49 years. Lower levels of TPA, MVPA, and VPA were all independently associated with elevated risk of all-cause and cancer mortality. Lifetime depression was significantly associated with increased risk of all-cause (HR=1.46, 95%CI: 1.40-1.52), CVD (HR=1.48, 95%CI: 1.33-1.64), and cancer mortality (HR=1.13, 95%CI: 1.06-1.21). Significant interactive effect of low levels of TPA, MVPA, and VPA and lifetime depression on all-cause mortality were found in this study. The risk of all-cause mortality associated with lifetime depression was deteriorated with low levels of physical activity. Relevant interventions for regular PA should be performed among depressed population.
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Affiliation(s)
- Bao-Peng Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
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23
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Bo YC, Yu T, Guo C, Lin CC, Yang HT, Chang LYY, Thomas GN, Tam T, Lau AKH, Lao XQ. Cardiovascular Mortality, Habitual Exercise, and Particulate Matter 2.5 Exposure: A Longitudinal Cohort Study. Am J Prev Med 2023; 64:250-258. [PMID: 36272861 DOI: 10.1016/j.amepre.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 08/27/2022] [Accepted: 09/01/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Habitual exercise may amplify the respiratory uptake of air pollutants in the lung, exacerbating the adverse effects of air pollution. However, it is unclear whether this can reduce the health benefits of habitual exercise (referred to as leisure-time exercise). Thus, the combined effects of habitual exercise and chronic exposure to ambient fine particulate matter 2.5 on cardiovascular mortality were examined among adults in Taiwan. METHODS A total of 384,128 adults were recruited between 2001 and 2016 and followed up to May 31, 2019. Participants' vital status was obtained by matching their unique identification numbers with records of cardiovascular death in the National Death Registry of Taiwan. A time-varying Cox regression model was used to analyze the data. Analyses were conducted in 2021. RESULTS Cardiovascular death risks were inversely associated with habitual exercise and positively associated with chronic exposure to particulate matter 2.5. The beneficial effects of habitual exercise on cardiovascular mortality were not modified by chronic exposure to particulate matter 2.5. Inactive participants with high particulate matter 2.5 exposure exhibited a 123% higher risk of cardiovascular death than high-exercise-group participants exposed to low levels of particulate matter 2.5 (95% CI=89, 163). CONCLUSIONS High level of habitual exercise combined with low exposure level of ambient particulate matter 2.5 is associated with the lowest risk of cardiovascular death. A higher level of habitual exercise is associated with a lower risk of cardiovascular death at all levels of particulate matter 2.5 exposure studied. The results indicate that habitual exercise is a safe health promotion strategy even for people residing in relatively polluted regions.
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Affiliation(s)
- Yacong C Bo
- School of Public Health, Zhengzhou University, Zhenghzou, China
| | - Tsung Yu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Cui Guo
- Department of Urban Planning and Design, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Changqing C Lin
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong
| | - Hsiao Ting Yang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Central Ave, Hong Kong
| | | | - G N Thomas
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, United Kingdom
| | - Tony Tam
- Department of Sociology, The Chinese University of Hong Kong, Central Ave, Hong Kong
| | - Alexis K H Lau
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong; Department of Civil and Environmental Engineering, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Central Ave, Hong Kong; Department of Biomedical Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong.
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24
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Weziak-Bialowolska D, Bialowolski P, Sacco PL. Mind-stimulating leisure activities: Prospective associations with health, wellbeing, and longevity. Front Public Health 2023; 11:1117822. [PMID: 36875413 PMCID: PMC9982162 DOI: 10.3389/fpubh.2023.1117822] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/20/2023] [Indexed: 02/19/2023] Open
Abstract
Introduction This study examines prospective associations within a 6-year perspective between three mind-stimulating leisure activities (relaxed and solitary: reading; serious and solitary: doing number and word games; serious and social: playing cards and games) and 21 outcomes in (1) physical health, (2) wellbeing, (3) daily life functioning, (4) cognitive impairment, and (5) longevity domains. Methods Data were obtained from 19,821 middle-aged and older adults from 15 countries participating in the Survey of Health, Ageing, and Retirement in Europe (SHARE). Temporal associations were obtained using generalized estimating equations. All models were controlled for prior sociodemographic, personality, lifestyle factors, health behaviors, and pre-baseline leisure activity values and all outcome variables. The Bonferroni correction was used to correct for multiple testing. E-values were calculated to examine the sensitivity of the associations to unmeasured confounding. Secondary analyses (1) under the complete case scenario, (2) after excluding respondents with health conditions, and (3) using a limited set of covariates were conducted to provide evidence for the robustness of the results. Results The relaxed solitary activity of reading almost daily was prospectively associated with a lower risk of depression, experiencing pain, daily functioning limitations, cognitive impairment, lower loneliness scores, and more favorable wellbeing outcomes. Engaging in serious solitary leisure activities almost daily was prospectively associated with a lower risk of depression, feeling full of energy, and a lower risk of death by any cause. Occasionally engaging in these activities was prospectively associated with greater optimism and a lower risk of cognitive impairment. Engaging in serious social activities was prospectively associated with greater happiness, lower scores on the loneliness scale, a lower risk of Alzheimer's disease, and an increased risk of cancer. Additionally, occasionally engaging in serious social activities was associated with greater optimism and lower risk of depression, pain, and mobility limitations. These associations were independent of demographics, socioeconomic status, personality, history of diseases, and prior lifestyle. The sensitivity analyses provided substantial evidence for the robustness of these associations. Discussion Mind-engaging leisure activities can be considered a health and wellbeing resource. Practitioners may consider them tools that help middle-aged and older adults maintain their health and quality of life.
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Affiliation(s)
- Dorota Weziak-Bialowolska
- Centre for Evaluation and Analysis of Public Policies, Faculty of Philosophy, Jagiellonian University, Cracow, Poland.,Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States
| | - Piotr Bialowolski
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States.,Department of Economics, Kozminski University, Warsaw, Poland
| | - Pier Luigi Sacco
- Dipartimento di Scienze Filosofiche, Pedagogiche ed Economico-Quantitative, University of Chieti-Pescara, Pescara, Italy.,metaLAB (at) Harvard, Harvard University, Cambridge, MA, United States.,Consiglio Nazionale delle Ricerche - L'Istituto di Scienze del Patrimonio Culturale, Naples, Italy
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25
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Sun J, Wu H, Zhao M, Magnussen CG, Xi B. Dose-response association of leisure time physical activity with mortality in adults with major chronic diseases. Front Nutr 2022; 9:1048238. [PMID: 36618699 PMCID: PMC9811256 DOI: 10.3389/fnut.2022.1048238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
We aimed to evaluate the association between leisure-time physical activity (PA) and mortality risk in adults with major chronic diseases. A total of 170,579 adults with major chronic diseases aged 30-84 years from the U.S. National Health Interview Surveys (1997-2014) with linkage to the National Death Index (NDI) through December 31, 2015 were included in this study. During a median follow-up of 7.25 years, 36,914 adults with chronic diseases died from all causes, 8,767 died from cardiovascular disease (CVD), and 9,090 died from cancer. Compared with participants with no leisure-time PA, those with a low level (10-59 min/week) of total leisure-time PA had a 23% [hazard ratio (HR) 0.77, 95% confidence interval (CI) 0.73-0.82] reduced risk of all-cause mortality. Adults with higher levels of leisure time had more reduced risk of all-cause mortality, as well as CVD-specific and cancer-specific mortality. Adults with leisure-time PA ≥ 1,500 min/week had more reduced risk of CVD-specific mortality (61%) but less reduced risk of cancer-specific mortality (29%) compared with the reduced risk of all-cause mortality (43%). There was an inversely non-linear dose-response relationship between leisure-time PA and all-cause and cause-specific mortality. Reduced risk of all-cause and cancer-specific mortality between leisure-time light-to-moderate PA and vigorous-intensity PA time were largely comparable. Low and high levels of leisure-time PA showed substantial survival benefits compared with no leisure-time PA in adults with major chronic diseases. The light-to-moderate-intensity leisure-time PA is largely comparable with vigorous PA to provide survival benefits for all-cause and cancer-specific mortality.
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Affiliation(s)
- Jiahong Sun
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Han Wu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Min Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Costan G. Magnussen
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland,Centre for Population Health Research, University of Turku, Turku University Hospital, Turku, Finland
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, China,*Correspondence: Bo Xi,
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26
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Mu X, Liu S, Fu M, Luo M, Ding D, Chen L, Yu K. Associations of physical activity intensity with incident cardiovascular diseases and mortality among 366,566 UK adults. Int J Behav Nutr Phys Act 2022; 19:151. [PMID: 36514169 PMCID: PMC9745930 DOI: 10.1186/s12966-022-01393-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The associations of the proportion of vigorous physical activity (VPA) to moderate to vigorous physical activity (MVPA) with incident cardiovascular disease (CVD) and all-cause mortality are unclear. METHODS The present study included 366,566 participants (aged 40-69 years) without baseline CVD from the UK biobank during 2006 to 2010. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for risks of outcomes. RESULTS During a median 11.8 years of follow-up, among 366,566 participants (mean age [SD]: 56.0 [8.1]), 31,894 incident CVD and 19,823 total deaths were documented. Compared with no VPA, 0%-30% of VPA to MVPA was associated with 12% and 19% lower risks of incident CVD (HR, 0.88 [95% CI, 0.86-0.91]) and all-cause mortality (HR, 0.81 [95% CI, 0.78-0.84]), respectively. Furthermore, we found that the maximum reduction of risks of incident CVD and all-cause mortality occurred at performing approximately 30% of VPA to MVPA (P < 0.001). Compared with participants reporting the lowest levels of MVPA (moderate physical activity [MPA], 0-150 min/week; VPA, 0-75 min/week), those performing 150-300 min/week of MPA and ≥ 150 min/week of VPA experienced the lowest risk of incident CVD (HR, 0.87 [95% CI, 0.79-0.95]) and all-cause mortality (HR, 0.71 [95% CI, 0.63-0.80]). Interestingly, we found that smokers yielded more cardiovascular benefits than non-smokers by performing a higher volume of VPA. CONCLUSIONS Comparing with UK adults reporting no VPA, engaging in 30% of VPA was associated with the lowest risk of incident CVD and all-cause mortality.
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Affiliation(s)
- Xuanwen Mu
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Shuangyan Liu
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Mingjian Fu
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Mengyun Luo
- grid.1013.30000 0004 1936 834XSydney School of Public Health, Faculty of Medicine and Health, the University of Sydney, Camperdown, NSW 2006 Australia ,grid.1013.30000 0004 1936 834XCharles Perkins Center, the University of Sydney, Camperdown, NSW 2006 Australia ,grid.16821.3c0000 0004 0368 8293School of Public Health, School of Medicine, Shanghai Jiao Tong University, 200240 Shanghai, People’s Republic of China
| | - Ding Ding
- grid.1013.30000 0004 1936 834XSydney School of Public Health, Faculty of Medicine and Health, the University of Sydney, Camperdown, NSW 2006 Australia ,grid.1013.30000 0004 1936 834XCharles Perkins Center, the University of Sydney, Camperdown, NSW 2006 Australia
| | - Liangkai Chen
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China ,grid.33199.310000 0004 0368 7223Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Kuai Yu
- grid.33199.310000 0004 0368 7223Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
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Li Q, Pan X, Li X, Huang W. Association of Physical Activity Intensity with All-Cause Mortality in Cancer Survivors: A National Prospective Cohort Study. Cancers (Basel) 2022; 14:cancers14235760. [PMID: 36497247 PMCID: PMC9740265 DOI: 10.3390/cancers14235760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/10/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
We designed this study to investigate the associations between physical activity (PA) and the risk of all-cause mortality in cancer survivors using a nationally representative cohort of US adults. This cohort study included 13 cycles of the National Health Interview Surveys, and by matching participants with the National Death Index (2015), survival status was determined. The main outcome was all-cause mortality during follow-up. A total of 20,088 participants aged 62.2 (15.9) years (62.4% women) were analyzed. After an average follow-up of 117.5 months, 7214 (35.9%) participants died. Compared with inactive cancer survivors, we observed a 25% lower all-cause mortality risk among participants performing PA 10 min to 1 h/week (hazard ratio [HR] = 0.75, 95% confidence interval [CI] = 0.67-0.85), a 28% lower risk among those performing PA 1-2.5 h/week (HR = 0.72, 95% CI = 0.67-0.78), a 34% lower risk among those performing PA 2.5-5 h/week (HR = 0.66, 95% CI = 0.60-0.72), a 37% lower risk among those performing PA 5-7.5 h/week (HR = 0.63, 95% CI = 0.56-0.70), a 47% lower risk among those performing PA 7.5-13.3 h/week (HR = 0.53, 95% CI = 0.47-0.61), and a 43% lower risk among those performing PA 13.3-24 h/week (adjusted HR = 0.53, 95% CI = 0.49-0.66). In cancer survivors, leisure-time PA was associated with a lower all-cause mortality. Inactive cancer survivors should be encouraged to perform more PA to reduce the risk of all-cause mortality.
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Affiliation(s)
- Qiguang Li
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Xueqiang Pan
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Xiao Li
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China
| | - Wei Huang
- Department of Oncology, Xiangya Hospital, Central South University, Changsha 410017, China
- Research Center of Carcinogenesis and Targeted Therapy, Xiangya Hospital, Central South University, Changsha 410017, China
- National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Changsha 410017, China
- Correspondence: ; Tel.: +86-0731-84328888
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Liang ZD, Zhang M, Wang CZ, Yuan Y, Liang JH. Association between sedentary behavior, physical activity, and cardiovascular disease-related outcomes in adults-A meta-analysis and systematic review. Front Public Health 2022; 10:1018460. [PMID: 36339165 PMCID: PMC9632849 DOI: 10.3389/fpubh.2022.1018460] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 09/26/2022] [Indexed: 01/28/2023] Open
Abstract
Background Sedentary behavior (SB) and physical activity (PA) are modifiable risk factors for cardiovascular disease (CVD); however, previous research on the effects of PA and SB on CVD has been relatively homogeneous. Our study investigated the association between PA, SB, and CVD-related outcomes. Methods A comprehensive search strategy was conducted in the MEDLINE, Embase, Cochrane Library, and Web of Science databases from their inception to September 2022. We identified eligible studies according to PICOS: the populations comprised healthy adults, the interventions or exposures were PA or SB, the outcomes were CVD-related outcomes, and the study designs were randomized controlled trials (RCTs) and longitudinal studies (LS). Outcomes were pooled using fixed or random effects models, and the quality of individual studies was assessed by the Cochrane Risk of Bias Instrument and the Newcastle Ottawa Scale. Results A total of 148 RCTs and 36 LS were included, comprising a total of 75,075 participants. The study quality was rated as low to moderate. We found an increased hazard ratio (HR) for CVD in the population with SB (HR = 1.34; 95% confidence interval [CI]: 1.26 to 1.43; I2 = 52.3%; Pheterogeneity < 0.001, random model) and a decreased HR for CVD in those who performed long-term PA (HR = 0.71; 95% CI: 0.66 to 0.77; I2 = 78.0%, Pheterogeneity < 0.001, random model). Long-term PA improved the lipid profiles in healthy adults; participants in this group exhibited increased high-density lipoprotein (weighted mean difference [WMD] = 2.38; 95% CI: 1.00 to 3.76; I2 = 84.7%; Pheterogeneity < 0.001, random model), decreased triglycerides (WMD = -7.27; 95% CI: -9.68 to -4.87; I2 = 0%, Pheterogeneity = 0.670, fixed model), and lower total-cholesterol (WMD = -6.84; 95% CI: -9.15 to -4.52; I2 = 38.4%, Pheterogeneity < 0.001, random model). Conclusions Long-term SB increases the risk of CVD in healthy adults, whereas PA reduces the risk of CVD and improves indicators associated with CVD. However, the ability of PA to improve blood lipids appeared to be limited. The detailed association of SB and PA on CVD needs to be further investigated in the future.
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Affiliation(s)
- Zhi-de Liang
- Cancer Institute of The Affiliated Hospital of Qingdao University and Qingdao Cancer Institute, Qingdao, China
| | - Meng Zhang
- Postgraduate Department, Xi'an Physical Education University, Xi'an, China
| | - Chuan-zhi Wang
- Department of Physical Education, College of Physical Education, Qingdao University, Qingdao, China
| | - Yang Yuan
- Cancer Institute of The Affiliated Hospital of Qingdao University and Qingdao Cancer Institute, Qingdao, China,*Correspondence: Yang Yuan
| | - Jing-hong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China,Jing-hong Liang
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Sui X, Sarzynski MA, Gribben N, Zhang J, Lavie CJ. Cardiorespiratory Fitness and the Risk of All-Cause, Cardiovascular and Cancer Mortality in Men with Hypercholesterolemia. J Clin Med 2022; 11:jcm11175211. [PMID: 36079141 PMCID: PMC9457072 DOI: 10.3390/jcm11175211] [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] [Received: 07/21/2022] [Revised: 08/27/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Whether higher cardiorespiratory fitness (CRF) confers protection against cardiovascular disease (CVD) in individuals with manifest hypercholesterolemia is poorly understood. Methods: Participants were 8920 men aged 20−82 years with hypercholesterolemia but no history of CVD and/or cancer and who received a preventive examination at the Cooper Clinic in Dallas, TX, USA, during 1974−2001. CRF was quantified as maximal treadmill test duration and was grouped for analysis as low, moderate, or high based on the traditional Aerobics Center Longitudinal Study cutpoints. Using Cox regression analyses, we computed hazard ratios and 95% confidence intervals for risk of mortality based on CRF. Results: During an average of 17 years of follow-up, 329 CVD and 290 cancer deaths occurred. After control for baseline age, examination year, body mass index, total cholesterol, smoking, alcohol intake, physical activity, hypertension, diabetes, and parental history of CVD, hazard ratios (95% confidence interval) for CVD deaths across moderate and high categories of CRF (with low fit as referent) were: 0.66 (0.50−0.87) and 0.55 (0.39−0.79), respectively. There was an inverse association between CRF and CVD death among normal-weight (trend p < 0.0001), younger (<60 y, trend p = 0.01), and inactive men (trend p = 0.002). However, no significant association was found between CRF and cancer mortality. Conclusions: Among men with hypercholesterolemia, higher CRF was associated with a lower risk of dying from CVD independent of other clinical risk factors. Our findings underscored the importance of promoting CRF in the primary prevention of CVD in patients with hypercholesterolemia.
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Affiliation(s)
- Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Correspondence: ; Tel.: +1-803-777-3881; Fax: +1-803-777-2504
| | - Mark A. Sarzynski
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Nicole Gribben
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Carl J. Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, LA 70121, USA
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Doré I, Plante A, Bedrossian N, Montminy S, St-Onge K, St-Cyr J, Pomey MP, Charpentier D, Pettigrew L, Brisson I, Saad F, Tournoux F, Raynault MF, Mes-Masson AM, Gauvin L. Developing practice guidelines to integrate physical activity promotion as part of routine cancer care: A knowledge-to-action protocol. PLoS One 2022; 17:e0273145. [PMID: 35969619 PMCID: PMC9377590 DOI: 10.1371/journal.pone.0273145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/28/2022] [Indexed: 11/19/2022] Open
Abstract
Background Cancer is a leading cause of disease burden worldwide and the first cause of mortality in Canada with 30.2% of deaths attributable to cancer. Given aging of the population and the improvement of prevention and treatment protocols, the number of cancer survivors is steadily increasing. These individuals have unique physical and mental health needs some of which can be addressed by integrating physical activity promotion into ongoing and long-term care. Despite the benefits of being active, delivery of PA programs for cancer patients in both clinical and community settings remains challenging. This knowledge-to-action protocol–called Kiné-Onco–aims to develop a practice guideline for the delivery, implementation, and scaling-up of cancer-specific physical activity promotion programs and services in clinical and community settings located in Québec, Canada. Method The Kiné-Onco project involves knowledge synthesis of scientific and grey literature to establish the benefits and added value of physical activity for cancer patients and survivors, describes current practices in delivering physical activity programs, analyses quantitative data from electronic health records (EHR) of patients participating in a novel hospital-based physical activity program, collects and analyses qualitative data from patients and healthcare providers interviews about lived experience, facilitators, and barriers to physical activity promotion, outlines deliberative workshops among multidisciplinary team members to develop implementation guidelines for physical activity promotion, and summarizes a variety of knowledge transfer and exchange activities to disseminate the practice guidelines. Discussion This paper describes the protocol for a knowledge-to-action project aimed at producing and sharing actionable evidence. Our aim is that physical activity promotion programs and services be scaled up in such a way as to successfully integrate physical activity promotion throughout cancer treatment and survivorship in order to improve the physical and mental health of the growing population of individuals having received a cancer diagnosis.
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Affiliation(s)
- Isabelle Doré
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, Canada
- School of Public Health, Université de Montréal, Montréal, Canada
- * E-mail:
| | - Audrey Plante
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- School of Public Health, Université de Montréal, Montréal, Canada
| | - Nathalie Bedrossian
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- School of Public Health, Université de Montréal, Montréal, Canada
| | - Sarah Montminy
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Kadia St-Onge
- Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Jany St-Cyr
- Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Marie-Pascale Pomey
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- School of Public Health, Université de Montréal, Montréal, Canada
| | | | - Lise Pettigrew
- Fondation Virage, Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Isabelle Brisson
- Fondation Virage, Centre Hospitalier de l’Université de Montréal, Montréal, Canada
| | - Fred Saad
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- Faculty of Medicine, Université de Montréal, Montréal, Canada
| | - François Tournoux
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- Faculty of Medicine, Université de Montréal, Montréal, Canada
| | - Marie-France Raynault
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- Centre de recherche Léa-Roback, Montréal, Canada
| | - Anne-Marie Mes-Masson
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- Faculty of Medicine, Université de Montréal, Montréal, Canada
| | - Lise Gauvin
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Canada
- School of Public Health, Université de Montréal, Montréal, Canada
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Long-term dietary intervention influence on physical activity in the Women's Health Initiative Dietary Modification randomized trial. Breast Cancer Res Treat 2022; 195:43-54. [PMID: 35821536 DOI: 10.1007/s10549-022-06655-8] [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: 11/08/2021] [Accepted: 06/08/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE In the Women's Health Initiative (WHI) Dietary Modification (DM) randomized trial, dietary intervention significantly reduced breast cancer mortality (P = 0.02). In observational studies, physical activity is associated with lower breast cancer incidence. Currently, dietary intervention influence on other health-related behaviors is unknown. Therefore, we evaluated whether the WHI dietary intervention influenced self-directed physical activity. METHODS Of 48,835 postmenopausal women, 19,541 were randomized to dietary intervention (18 nutritionist-led group sessions first year, then quarterly sessions throughout 8.5 years [median] intervention) and 29,294 to a usual diet comparison (written health-related materials only). Neither randomization group received specific or ongoing instructions to increase physical activity. Episodes per week of moderate or vigorous recreational physical activity (MVPA) were serially reported. Marginal longitudinal logistic regression models were used to assess physically inactive (MVPA = 0) or physically active (MVPA > 0) participants by randomization group. Marginal Poisson regression models estimated mean weekly MVPA. RESULTS At entry, 45.6% of all participants reported physical inactivity (MVPA = 0). In 43,760 women with MVPA information, throughout 15.9 years (median) cumulative follow-up, dietary intervention group participation was associated with 7% lower physical inactivity rate (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.91, 0.95, P < 0.001) and a 4% higher mean MVPA (ratio of means [RM] 1.04 95% CI 1.02, 1.06, P < 0.001), relative to the comparison group. CONCLUSION In a randomized trial setting, a low-fat dietary pattern intervention was associated with a long-term, favorable influence on self-directed recreational physical activity. TRIAL REGISTRATION NCT00000611.
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Lewey J, Murphy S, Zhang D, Putt ME, Elovitz MA, Riis V, Patel MS, Levine LD. Effectiveness of a Text-Based Gamification Intervention to Improve Physical Activity Among Postpartum Individuals With Hypertensive Disorders of Pregnancy: A Randomized Clinical Trial. JAMA Cardiol 2022; 7:591-599. [PMID: 35442393 PMCID: PMC9021982 DOI: 10.1001/jamacardio.2022.0553] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Importance Hypertensive disorders of pregnancy are associated with increased risk of cardiovascular disease, yet few interventions have targeted this population to decrease long-term risk. Objective To determine whether a digital health intervention improves physical activity in postpartum individuals with hypertensive disorders of pregnancy. Design, Setting, and Participants This 12-week randomized clinical trial enrolled postpartum individuals who delivered at the University of Pennsylvania and had a hypertensive disorder of pregnancy between October 2019 and June 2020. Analysis was intention to treat. Interventions All participants received a wearable activity tracker, established a baseline step count, selected a step goal greater than baseline, and were randomly assigned to control or intervention. Participants in the control arm received daily feedback on goal attainment. Participants in the intervention arm were placed on virtual teams and enrolled in a game with points and levels for daily step goal achievement and informed by principles of behavioral economics. Main Outcomes and Measures The primary outcome was change in mean daily step count from baseline to 12-week follow-up. Secondary outcome was proportion of participant-days that step goal was achieved. Results A total of 127 participants were randomized (64 in the control group and 63 in the intervention group) and were enrolled a mean of 7.9 weeks post partum. Participants had a mean (SD) age of 32.3 (5.6) years, 70 (55.1%) were Black, and 52 (41.9%) had Medicaid insurance. The mean (SD) baseline step count was similar in the control and intervention arms (6042 [2270] vs 6175 [1920] steps, respectively). After adjustment for baseline steps and calendar month, participants in the intervention arm had a significantly greater increase in mean daily step steps from baseline compared with the control arm (647 steps; 95% CI, 169-1124 steps; P = .009). Compared with the control arm, participants in the intervention arm achieved their steps goals on a greater proportion of participant-days during the intervention period (0.47 vs 0.38; adjusted difference 0.11; 95% CI, 0.04-0.19; P = .003). Conclusions and Relevance In this study, a digital health intervention using remote monitoring, gamification, and social incentives among postpartum individuals at elevated cardiovascular risk significantly increased physical activity throughout 12 weeks. Trial Registration ClinicalTrials.gov Identifier: NCT03311230.
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Affiliation(s)
- Jennifer Lewey
- Division of Cardiology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Samantha Murphy
- Maternal and Child Health Research Program, Department of Obstetrics & Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Dazheng Zhang
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Mary E. Putt
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Michal A. Elovitz
- Maternal and Child Health Research Program, Department of Obstetrics & Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Valerie Riis
- Maternal and Child Health Research Program, Department of Obstetrics & Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | | | - Lisa D. Levine
- Maternal and Child Health Research Program, Department of Obstetrics & Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia
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Changes in the Frequency of Moderate-to-Vigorous Physical Activity and Subsequent Risk of All-Cause and Cardiovascular Disease Mortality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010504. [PMID: 35010764 PMCID: PMC8744773 DOI: 10.3390/ijerph19010504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/29/2021] [Accepted: 12/29/2021] [Indexed: 01/08/2023]
Abstract
We investigated the association of changes in the frequency of moderate-to-vigorous physical activity (MVPA) and the risks of all-cause and cardiovascular disease (CVD) mortality. This study used the nationally representative National Health Insurance Service-National Sample Cohort database. We included 286,402 individuals aged ≥20 years and estimated changes in the frequency of MVPA over a two-year period. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard regression models. The HRs (95% CIs) for the risk of all-cause and CVD mortality for an increased frequency of MVPA from physical inactivity compared with continual physical inactivity were 0.82 and 0.68 (0.73–0.92 and 0.51–0.91) for 1–2, 0.72 and 0.48 (0.62–0.84 and 0.31–0.74) for 3–4, and 0.73 and 0.70 (0.63–0.85 and 0.50–0.98) for ≥5 sessions of MVPA/week. The HRs (95% CIs) for the risk of all-cause and CVD mortality were 1.28 and 1.58 (1.07–1.53 and 1.01–2.46), 1.25 and 2.17 (1.01–1.57 and 1.14–4.12), and 1.43 and 1.44 (1.15–1.77 and 0.84–2.47) for changes from 1–2, 3–4, and ≥5 sessions of MVPA/week to physical inactivity, respectively. This study showed the beneficial effect of increasing physical activity, particularly for those who were physically inactive at baseline, as well as the increased risk of all-cause and CVD mortality after adapting a physically inactive lifestyle regardless of their baseline physical activity status.
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Schrader B, Bünker AM, Conradi C, Lüders S, Vaske B, Koziolek M, Haller H, Elsässer A, Schrader J. Regular Exercise is Associated with a More Favorable Cardiovascular Risk Profile, Better Quality of Life, Less Depression and Less Psychological Stress. Int J Gen Med 2022; 15:545-554. [PMID: 35058709 PMCID: PMC8765450 DOI: 10.2147/ijgm.s338496] [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: 10/27/2021] [Accepted: 12/31/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Methods Results Conclusion
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Affiliation(s)
- Bastian Schrader
- Department of Cardiology in Klinikum Oldenburg, University of Oldenburg, Oldenburg, Germany
- Correspondence: Bastian Schrader Email
| | - Anna-Maria Bünker
- Institute for Hypertension and Cardiovascular Research (INFO), Cloppenburg, Germany
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany
| | - Charis Conradi
- Department of Cardiology in Klinikum Oldenburg, University of Oldenburg, Oldenburg, Germany
| | - Stephan Lüders
- Institute for Hypertension and Cardiovascular Research (INFO), Cloppenburg, Germany
- Department of Nephrology, St.-Josefs-Hospital, Cloppenburg, Germany
| | - Bernhard Vaske
- Department of Statistics, Institute for Hypertension and Cardiovascular Research (INFO), Cloppenburg, Germany
| | - Michael Koziolek
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany
| | - Hermann Haller
- Clinic for Renal and Hypertensive Diseases, Hannover Medical School, Hanover, Germany
| | - Albrecht Elsässer
- Department of Cardiology in Klinikum Oldenburg, University of Oldenburg, Oldenburg, Germany
| | - Joachim Schrader
- Department of Cardiology in Klinikum Oldenburg, University of Oldenburg, Oldenburg, Germany
- Institute for Hypertension and Cardiovascular Research (INFO), Cloppenburg, Germany
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Riani Costa LA, F Barreto R, de Leandrini SMM, Gurgel ARB, de Sales GT, Voltarelli VA, de Castro G, Fenton SAM, Turner JE, Klausener C, Neves LM, Ugrinowitsch C, Farah JC, Forjaz CLDM, Brito CMM, Brum PC. The influence of a supervised group exercise intervention combined with active lifestyle recommendations on breast cancer survivors' health, physical functioning, and quality of life indices: study protocol for a randomized and controlled trial. Trials 2021; 22:934. [PMID: 34922621 PMCID: PMC8684206 DOI: 10.1186/s13063-021-05843-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 11/18/2021] [Indexed: 12/09/2022] Open
Abstract
Background Most cancer patients, under active treatment or not, are sedentary, despite increasing scientific and clinical understanding of the benefits of exercise and physical activity, such as improving quality of life, limiting disease symptoms, decreasing cancer recurrence, and increasing overall survival. Studies have shown that both supervised exercise and unsupervised physical activity programs have low adherence and limited long-term benefits among cancer survivors. Therefore, interventions focused on increasing physical activity levels have clinical and psychological relevance. The present study will examine the feasibility and efficacy of an intervention that combines supervised group exercise with active lifestyle recommendations, analyzing its clinical, psychological, physiological, functional, and immunological effects in breast cancer survivors. Methods Women aged 35–75 years who have completed chemotherapy, radiotherapy, and surgery for breast cancer will be recruited from the Cancer Institute of the State of Sao Paulo (ICESP) and take part in a 16-week, parallel-group, randomized, and controlled trial. They will receive a booklet with recommendations for achieving a physically active lifestyle by increasing overall daily movement and undertaking at least 150 min/week of structured exercise. Then, they will be randomized into two groups: the supervised group will take part in two canoeing group exercise sessions every week, and the unsupervised group will increase their overall physical activity level by any means, such as active commuting, daily activities, or home-based exercise. Primary outcome includes aerobic capacity. Secondary outcomes are physical activity, physical functioning, self-reported quality of life, fatigue, presence of lymphedema, body composition, immune function, adherence to physical activity guidelines, and perceptions of self-image. Discussion Results should contribute to advance knowledge on the impact of a supervised group exercise intervention to improve aspects related to health, physical functioning, and quality of life in female breast cancer survivors. Trial registration Brazilian Registry of Clinical Trials Number: RBR-3fw9xf. Retrospectively Registered on 27 December 2018. Items from the World Health Organization Trial Registration Data Set can be accessed on http://www.ensaiosclinicos.gov.br/rg/RBR-3fw9xf/. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05843-z.
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Affiliation(s)
- Luiz Augusto Riani Costa
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Raphael F Barreto
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Sarah Milani Moraes de Leandrini
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Aline Rachel Bezerra Gurgel
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Gabriel Toledo de Sales
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Vanessa Azevedo Voltarelli
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Gilberto de Castro
- Instituto do Cancer do Estado de Sao Paulo, ICESP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Sally A M Fenton
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | | | - Christian Klausener
- Centro de Práticas Esportivas da Universidade de Sao Paulo (CEPEUSP), Sao Paulo, Brazil
| | - Lucas Melo Neves
- Master's Program in Health Sciences at Santo Amaro University - UNISA, Sao Paulo, Brazil.,Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo - USP, Sao Paulo, Brazil
| | - Carlos Ugrinowitsch
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Jose Carlos Farah
- Centro de Práticas Esportivas da Universidade de Sao Paulo (CEPEUSP), Sao Paulo, Brazil
| | - Cláudia Lúcia de Moraes Forjaz
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil
| | - Christina May Moran Brito
- Instituto do Cancer do Estado de Sao Paulo, ICESP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Patricia Chakur Brum
- School of Physical Education and Sport, University of Sao Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil. .,Departamento de Biodinamica do Movimento do Corpo Humano, Escola de Educação Física e Esporte da Universidade de São Paulo, Av. Professor Mello Moraes, 65- Butantã, São Paulo, SP, 05508-900, Brazil.
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Mu X, Yu K, Long P, Niu R, Li W, Chen H, Gao H, Li X, Yuan Y, Yang H, Zhang X, He MA, Liu G, Guo H, Wu T. Leisure-time physical activity and risk of incident cardiovascular disease in Chinese retired adults. Sci Rep 2021; 11:24202. [PMID: 34921190 PMCID: PMC8683485 DOI: 10.1038/s41598-021-03475-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 11/24/2021] [Indexed: 11/08/2022] Open
Abstract
The optimum amounts and types of leisure-time physical activity (LTPA) for cardiovascular disease (CVD) prevention among Chinese retired adults are unclear. The prospective study enrolled 26,584 participants (mean age [SD]: 63.3 [8.4]) without baseline disease from the Dongfeng-Tongji cohort in 2013. Cox-proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During a mean 5.0 (1.5) years of follow-up, 5704 incident CVD cases were documented. Compared with less than 7.5 metabolic equivalent of task-hours per week (MET-hours/week) of LTPA, participating LTPA for 22.5-37.5 MET-hours/week, which was equivalent to 3 to 5 times the world health organization (WHO) recommended minimum, was associated with a 18% (95% CI 9 to 25%) lower CVD risk; however, no significant additional benefit was gained when exceeding 37.5 MET-hours/week. Each log10 increment of MET-hours/week in square dancing and cycling was associated with 11% (95% CI 2 to 20%) and 32% (95% CI 21 to 41%), respectively, lower risk of incident CVD. In Chinese retired adults, higher LTPA levels were associated with lower CVD risk, with a benefit threshold at 3 to 5 times the recommended physical activity minimum. Encouraging participation in square dancing and cycling might gain favourable cardiovascular benefits.
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Affiliation(s)
- Xuanwen Mu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd, Wuhan, 430030, Hubei, China
| | - Kuai Yu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd, Wuhan, 430030, Hubei, China
| | - Pinpin Long
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd, Wuhan, 430030, Hubei, China
| | - Rundong Niu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd, Wuhan, 430030, Hubei, China
| | - Wending Li
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd, Wuhan, 430030, Hubei, China
| | - Huiting Chen
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd, Wuhan, 430030, Hubei, China
| | - Hui Gao
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd, Wuhan, 430030, Hubei, China
| | - Xingxing Li
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd, Wuhan, 430030, Hubei, China
| | - Yu Yuan
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd, Wuhan, 430030, Hubei, China
| | - Handong Yang
- Department of Cardiovascular Diseases, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, 442000, China
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd, Wuhan, 430030, Hubei, China
| | - Mei-An He
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd, Wuhan, 430030, Hubei, China
| | - Gang Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Huan Guo
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd, Wuhan, 430030, Hubei, China
| | - Tangchun Wu
- Department of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating) School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd, Wuhan, 430030, Hubei, China.
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Nayor M, Chernofsky A, Spartano NL, Tanguay M, Blodgett JB, Murthy VL, Malhotra R, Houstis NE, Velagaleti RS, Murabito JM, Larson MG, Vasan RS, Shah RV, Lewis GD. Physical activity and fitness in the community: the Framingham Heart Study. Eur Heart J 2021; 42:4565-4575. [PMID: 34436560 PMCID: PMC8633734 DOI: 10.1093/eurheartj/ehab580] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/14/2021] [Accepted: 08/10/2021] [Indexed: 12/21/2022] Open
Abstract
AIMS While greater physical activity (PA) is associated with improved health outcomes, the direct links between distinct components of PA, their changes over time, and cardiorespiratory fitness are incompletely understood. METHODS AND RESULTS Maximum effort cardiopulmonary exercise testing (CPET) and objective PA measures [sedentary time (SED), steps/day, and moderate-vigorous PA (MVPA)] via accelerometers worn for 1 week concurrent with CPET and 7.8 years prior were obtained in 2070 Framingham Heart Study participants [age 54 ± 9 years, 51% women, SED 810 ± 83 min/day, steps/day 7737 ± 3520, MVPA 22.3 ± 20.3 min/day, peak oxygen uptake (VO2) 23.6 ± 6.9 mL/kg/min]. Adjusted for clinical risk factors, increases in steps/day and MVPA and reduced SED between the two assessments were associated with distinct aspects of cardiorespiratory fitness (measured by VO2) during initiation, early-moderate level, peak exercise, and recovery, with the highest effect estimates for MVPA (false discovery rate <5% for all). Findings were largely consistent across categories of age, sex, obesity, and cardiovascular risk. Increases of 17 min of MVPA/day [95% confidence interval (CI) 14-21] or 4312 steps/day (95% CI 3439-5781; ≈54 min at 80 steps/min), or reductions of 249 min of SED per day (95% CI 149-777) between the two exam cycles corresponded to a 5% (1.2 mL/kg/min) higher peak VO2. Individuals with high (above-mean) steps or MVPA demonstrated above average peak VO2 values regardless of whether they had high or low SED. CONCLUSIONS Our findings provide a detailed assessment of relations of different types of PA with multidimensional cardiorespiratory fitness measures and suggest favourable longitudinal changes in PA (and MVPA in particular) are associated with greater objective fitness.
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Affiliation(s)
- Matthew Nayor
- Sections of Cardiology and Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, 72 E Concord St, Suite L-514, Boston, MA 02118, USA
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ariel Chernofsky
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Nicole L Spartano
- Department of Medicine, Section of Endocrinology, Diabetes, Nutrition and Weight Management, Boston University School of Medicine, Boston, MA, USA
| | - Melissa Tanguay
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jasmine B Blodgett
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Venkatesh L Murthy
- Division of Cardiovascular Medicine, Department of Medicine, University of Michigan, Ann Arbor, MI, USA
- Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI, USA
| | - Rajeev Malhotra
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Nicholas E Houstis
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Raghava S Velagaleti
- Cardiology Section, Department of Medicine, Boston VA Healthcare System, West Roxbury, MA, USA
| | - Joanne M Murabito
- Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, MA, USA
| | - Martin G Larson
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, MA, USA
| | - Ramachandran S Vasan
- Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, MA, USA
- Sections of Preventive Medicine and Epidemiology, and Cardiology, Department of Medicine, Department of Epidemiology, Boston University Schools of Medicine and Public Health, Center for Computing and Data Sciences, Boston University, Boston, MA, USA
| | - Ravi V Shah
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Vanderbilt Clinical and Translational Research Center, Cardiology Division, Vanderbilt University Medical Center, Nashville, TN
| | - Gregory D Lewis
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Pulmonary Critical Care Unit, Massachusetts General Hospital, Boston, MA USA
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38
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Nutritional status, lifestyle habits and cancer mortality: a population-based prospective cohort study. Eur J Nutr 2021; 61:1343-1352. [PMID: 34791510 DOI: 10.1007/s00394-021-02739-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 11/04/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE We aimed to investigate the relationship between overall nutritional status and cancer mortality. METHODS A total of 12 262 US adults from six consecutive surveys of the National Health and Nutrition Examination Survey (NHANES 2003-2014) were analyzed. The overall health nutritional biomarkers index (HNBI) score, capturing characteristics of 17 biomarkers was developed to assess the overall nutritional status. The lower the HNBI score, the healthier nutritional status would be. Hazard ratio (HR) and 95% confidence intervals (95% CIs) were calculated by Cox proportional hazards regression models to evaluate the association between the HNBI score and cancer mortality. RESULTS The lower overall HNBI score was associated with decreased risk of cancer mortality, compared with participants in the 4th quartile of overall HNBI score, the HR (95% CIs) for participants in the 1st quartiles was 0.54 (0.33-0.89) (P-trend = 0.019). Healthier lifestyle habits and not obesity interacted with HNBI score, compared with participants with higher HNBI score and smoking currently/not exercising regularly/obesity, participants with lower HNBI score and not smoking currently/exercising regularly/not obesity were associated with lower risk of cancer mortality, the HR (95% CIs) were 0.43 (0.26-0.73), 0.57 (0.33-0.97), and 0.62 (0.47-0.97), respectively. These significant associations remained among participants who were followed-up more than 2 years. CONCLUSION Our findings suggested that healthier overall nutritional status was associated with lower risk of cancer mortality among US adults. Not smoking, exercise regularly and not obesity interacted with overall nutritional status. Adherence to better overall nutritional status, lifestyle habits and optimal weight would prevent premature death from cancer.
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39
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Dvorák M, Tóth M, Ács P. The Role of Individualized Exercise Prescription in Obesity Management-Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212028. [PMID: 34831781 PMCID: PMC8621483 DOI: 10.3390/ijerph182212028] [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: 09/30/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 12/02/2022]
Abstract
Introduction: Obesity, or adiposity-based chronic disease (ABCD), is one of the most common health risk factors nowadays. Regular exercise—part of complex lifestyle medicine program—is effective treatment for obesity but is still underestimated. Monitoring andindividualization by an exercise professional is needed to define the accurate dose effect. Materials and Methods: The 30-week lifestyle change program of a 65-year-old male patient (body mass index (BMI) 43.8 kg/m2) was followed by a medical doctor, exercise physiologist, and nutritionist. Over regular controls and blood tests, each training activity was measured with a heart rate monitor watch, and a diet diary was written. Results: Bodyweight decreased by 24.1 kg (18.4%) and BMI to 35.8 kg/m2. Decreased resting heart rate (from 72 bpm to 63 bpm), diastolic blood pressure (from 72 mmHg to 67 mmHg), and increased systolic blood pressure (from 126 mmHg to 135 mmHg) were reported, besides the reduction in antihypertensive and antidiabetic medicines. Blood test results and fitness level improved, and daily steps and time spent training increased. Conclusions: Lifestyle medicine with professional support is an effective and long-term treatment for ABCD. Individualized exercise and nutritional therapy are essential, and wearable technology with telemedicine consultation also has an important role.
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Affiliation(s)
- Márton Dvorák
- Department of Health Sciences and Sport Medicine, University of Physical Education, 1123 Budapest, Hungary;
- YourPowerMed Health Center, 1015 Budapest, Hungary
- Correspondence: ; Tel.: +36-305-192-381
| | - Miklós Tóth
- Department of Health Sciences and Sport Medicine, University of Physical Education, 1123 Budapest, Hungary;
- Institute of Physiotherapy and Sport Science, Faculty of Health Science, University of Pécs, 7621 Pécs, Hungary;
- Szentágothai Research Centre, University of Pécs, 7624 Pécs, Hungary
| | - Pongrác Ács
- Institute of Physiotherapy and Sport Science, Faculty of Health Science, University of Pécs, 7621 Pécs, Hungary;
- Szentágothai Research Centre, University of Pécs, 7624 Pécs, Hungary
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40
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Bergwall S, Acosta S, Ramne S, Mutie P, Sonestedt E. Leisure-time physical activities and the risk of cardiovascular mortality in the Malmö diet and Cancer study. BMC Public Health 2021; 21:1948. [PMID: 34702239 PMCID: PMC8549319 DOI: 10.1186/s12889-021-11972-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 10/11/2021] [Indexed: 11/12/2022] Open
Abstract
Background The association between leisure-time physical activity and cardiovascular mortality has been previously studied, but few studies have focused on specific activities and intensities. Methods The association between different leisure-time physical activities and cardiovascular mortality was investigated among 25,876 individuals without diabetes or cardiovascular disease from the population-based Malmö Diet and Cancer Study cohort. The individuals estimated the average duration spent on 17 physical activities at baseline in 1991–1996 and after 5 years. Cardiovascular mortality was obtained from a register during a mean of 20 years of follow-up. Results A total leisure-time physical activity of 15–25 metabolic equivalent task (MET) hours/week was associated with a decreased risk of cardiovascular mortality (HR 15–25 vs < 7.5 MET-h/week =0.80, 95% CI 0.69–0.93), with no further risk reduction at higher levels. Several high-intensity activities (i.e., lawn tennis and running) and moderate-intensity activities (i.e., golf, cycling and gardening) were associated with a reduced risk. Individuals who engaged in high-intensity physical activity for an average of 2.29 MET h/week (30 min/week) had an 18% (95% CI 0.72–0.93) reduced risk of cardiovascular mortality compared with non-participants, and no further risk reductions were observed at higher levels. Decreased risk was observed among individuals who had started (HR 0.56, 95% CI 0.32–0.97) or continued (HR 0.49, 95% CI 0.36–0.66) high-intensity activities at the five-year follow-up. Conclusions Moderate- and high-intensity leisure-time physical activities reduced the risk of cardiovascular mortality. With regard to total leisure-time physical activity, the largest risk reduction was observed for 15–25 MET-h/week (equivalent to walking for approximately 5 h/week).
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Affiliation(s)
- Sara Bergwall
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
| | - Stefan Acosta
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.,Vascular Centre, Department of Cardio-Thoracic and Vascular Surgery, Skåne University Hospital Malmö, Malmö, Sweden
| | - Stina Ramne
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Pascal Mutie
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Emily Sonestedt
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
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Morishita S, Hamaue Y, Fukushima T, Tanaka T, Fu JB, Nakano J. Effect of Exercise on Mortality and Recurrence in Patients With Cancer: A Systematic Review and Meta-Analysis. Integr Cancer Ther 2021; 19:1534735420917462. [PMID: 32476493 PMCID: PMC7273753 DOI: 10.1177/1534735420917462] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose: Exercise could lower the risk of cancer recurrence and
improve mortality, exercise capacity, physical and cardiovascular function,
strength, and quality of life in patients with cancer. This systematic review
and meta-analysis of randomized controlled trials (RCTs) aimed to determine the
effects of exercise on mortality and recurrence in patients with cancer.
Methods: We searched for articles published before May 2019 in
MEDLINE, CINAHL, the Cochrane Library, Scopus, ProQuest, and PEDro. We included
RCTs of exercise interventions, such as resistance exercise and aerobic
exercise, in patients with cancer that evaluated the risk of mortality and
recurrence. The standardized mean difference with 95% confidence intervals (CIs)
was calculated for quantitative indices. The random-effect model was used as the
pooling method. Results: Of 2868 retrieved articles, 8 RCTs were
included in the meta-analysis, with a mean PEDro score of 4.50 (SD = 1.25).
Exercise significantly reduced the risk of mortality in patients with cancer and
in cancer survivors (risk ratio [RR] = 0.76, 95% CI = 0.40-0.93,
I2 = 0%, P = .009). Exercise
significantly reduced the risk of recurrence in cancer survivors (RR = 0.52, 95%
CI = 0.29-0.92, I2 = 25%, P =
.030). Conclusion: This study found that exercise has a favorable
effect on mortality and recurrence in patients with cancer. However, the effect
could not be fully determined due to data insufficiency.
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Affiliation(s)
| | - Yohei Hamaue
- Niigata University of Health and Welfare, Niigata, Japan
| | | | - Takashi Tanaka
- Hyogo College of Medicine Hospital, Nishinomiya, Hyogo, Japan
| | - Jack B Fu
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Crooke R, Haseler C, Haseler T, Collins J, Crockett A. Physical activity and moving more for health. J R Coll Physicians Edinb 2021; 50:173-180. [PMID: 32568295 DOI: 10.4997/jrcpe.2020.223] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Non-communicable diseases are a leading cause of death and levels are rising. Lifestyle changes, including physical activity, have benefits in all-cause mortality, cardiovascular and metabolic disease, respiratory conditions and cognitive and mental health. In some cancers, particularly colon, prostate and breast, physical activity improves quality of life and outcomes before, during and after treatment. Sedentary time is an independent risk factor with adverse effects in hospitalised patients. Mechanisms include anti-inflammatory effects and augmentation of physiological and neuroendocrine responses to stressors. Engaging patients is affected by barriers: for clinicians, awareness of guidelines and personal physical activity levels are important factors; for patients, barriers are influenced by life events, socioeconomic and cultural factors. Interventions to increase activity levels are effective in the short- and medium-term, including brief interventions. Face-to-face is more effective than remote advice and behavioural interventions are more effective than cognitive. There are no published guidelines for physical activity in hospitalised patients.
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Affiliation(s)
| | | | | | - Jack Collins
- Trafalgar Medical Group Practice, Portsmouth, UK
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Skarpsno ES, Nilsen TIL, Mork PJ. The effect of long-term poor sleep quality on risk of back-related disability and the modifying role of physical activity. Sci Rep 2021; 11:15386. [PMID: 34321561 PMCID: PMC8319142 DOI: 10.1038/s41598-021-94845-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 07/19/2021] [Indexed: 12/23/2022] Open
Abstract
Sleep problems and regular leisure time physical activity (LTPA) are interrelated and have contrasting effects on risk of back pain. However, no studies have investigated the influence of long-term poor sleep quality on risk of back-related disability, or if LTPA modifies this association. The study comprised data on 8601 people who participated in three consecutive surveys over ~ 22 years, and who reported no chronic back pain at the two first surveys. Adjusted risk ratios (RRs) for back-related disability were calculated at the last survey, associated with the joint effect of changes in sleep quality between the two first surveys and meeting physical activity guidelines at the second survey. Compared to people with long-term good sleep, people with long-term poor sleep had nearly twice the risk of back-related disability (RR 1.92, 95% CI 1.48-2.49). There was no statistical interaction between sleep and LTPA but people who reported long-term poor sleep and meeting the physical activity guidelines had 35% lower risk of back-related disability compared to people with same level of sleep problems, but who not met the guidelines. These findings suggest that long-term poor sleep quality contributes to a substantially increased risk of chronic and disabling back pain irrespective of LTPA.
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Affiliation(s)
- Eivind Schjelderup Skarpsno
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway. .,Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway.
| | - Tom Ivar Lund Nilsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway.,Clinic of Anaesthesia and Intensive Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway
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Mino E, Geidl W, Naber I, Weissenfels A, Klamroth S, Gelius P, Abu-Omar K, Pfeifer K. Physical activity referral scheme components: a study protocol for systematic review and meta-regression. BMJ Open 2021; 11:e049549. [PMID: 34145021 PMCID: PMC8215250 DOI: 10.1136/bmjopen-2021-049549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION In its attempt to establish effective physical activity promotion methods, research on physical activity referral schemes (PARS) is attracting significant attention. Sometimes known as physical activity on prescription schemes, PARS involve a well-defined procedure whereby a primary healthcare professional introduces a participant to the topic of physical activity and employs prescription or referral forms to connect the participant to physical activity opportunities, such as local fitness offers. The planned systematic review will focus on these referral routes and scheme components and how they are integrated into various PARS models worldwide. We seek to identify the evidence-based core components that play the most important roles in the effectiveness of PARS. METHODS AND ANALYSIS The development and reporting of the protocol follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. We plan to conduct a systematic main literature search on PubMed, Scopus, Web of Science, CINAHL, HTA, SpringerLink and other databases. We will include studies that report outcomes on physical activity, PARS uptake and adherence rates or descriptive information about PARS models. We intend for all review stages, citation screening, data extraction and risk of bias assessment to be conducted by at least two independent reviewers. As a broad spectrum of study designs, including randomised and non-randomised studies of interventions and mixed methods, will be eligible, we will use three separate tools to assess the risk of bias in individual studies. The data will be primarily synthesised narratively, following Intervention Component Analysis. If the data allow, we will perform a random-effects meta-analysis and meta-regression to investigate the impact of specific PARS components on effect sizes. ETHICS AND DISSEMINATION This systematic review does not require formal ethics approval. The results will be submitted to a peer-reviewed journal and international conferences to reach the scientific community. PROSPERO REGISTRATION NUMBER CRD42021233229.
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Affiliation(s)
- Eriselda Mino
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Wolfgang Geidl
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Inga Naber
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Anja Weissenfels
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Sarah Klamroth
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bayern, Germany
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Physical activity attenuates the associations of systemic immune-inflammation index with total and cause-specific mortality among middle-aged and older populations. Sci Rep 2021; 11:12532. [PMID: 34131164 PMCID: PMC8206152 DOI: 10.1038/s41598-021-91324-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/20/2021] [Indexed: 01/04/2023] Open
Abstract
Systemic immune-inflammation index (SII) emerged as a biomarker of chronic inflammation and an independent prognostic factor for many cancers. We aimed to investigate the associations of SII level with total and cause-specific mortality risks in the general populations, and the potential modification effects of lifestyle-related factors on the above associations. In this study, we included 30,521 subjects from the Dongfeng-Tongji (DFTJ) cohort and 25,761 subjects from the National Health and Nutrition Examination Survey (NHANES) 1999–2014. Cox proportional hazards regression models were used to estimate the associations of SII with mortality from all-cause, cardiovascular diseases (CVD), cancer and other causes. In the DFTJ cohort, compared to subjects in the low SII subgroup, those within the middle and high SII subgroups had increased risks of total mortality [hazard ratio, HR (95% confidence interval, CI) = 1.12 (1.03–1.22) and 1.26 (1.16–1.36), respectively) and CVD mortality [HR (95%CI) = 1.36 (1.19–1.55) and 1.50 (1.32–1.71), respectively]; those within the high SII subgroup had a higher risk of other causes mortality [HR (95%CI) = 1.28 (1.09–1.49)]. In the NHANES 1999–2014, subjects in the high SII subgroup had higher risks of total, CVD, cancer and other causes mortality [HR (95%CI) = 1.38 (1.27–1.49), 1.33 (1.11–1.59), 1.22 (1.04–1.45) and 1.47 (1.32–1.63), respectively]. For subjects with a high level of SII, physical activity could attenuate a separate 30% and 32% risk of total and CVD mortality in the DFTJ cohort, and a separate 41% and 59% risk of total and CVD mortality in the NHANES 1999–2014. Our study suggested high SII level may increase total and CVD mortality in the general populations and physical activity exerted a beneficial effect on the above associations.
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Chinese Guideline on the Primary Prevention of Cardiovascular Diseases. CARDIOLOGY DISCOVERY 2021; 1:70-104. [DOI: 10.1097/cd9.0000000000000025] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Abstract
Cardiovascular disease is the leading cause of mortality in China. Primary prevention of cardiovascular disease with a focus on lifestyle intervention and risk factor control has been shown to effectively delay or prevent the occurrence of cardiovascular events. To promote a healthy lifestyle and enhance the detection, diagnosis, and treatment of cardiovascular risk factors such as hypertension, dyslipidemia, and diabetes, and to improve the overall capacity of primary prevention of cardiovascular disease, the Chinese Society of Cardiology of Chinese Medical Association has collaborated with multiple societies to summarize and evaluate the latest evidence with reference to relevant guidelines and subsequently to develop recommendations for primary cardiovascular disease prevention in Chinese adults. The guideline consists of 10 sections: introduction, methodology for developing the guideline, epidemiology of cardiovascular disease in China and challenges in primary prevention, general recommendations for primary prevention, assessment of cardiovascular risk, lifestyle intervention, blood pressure control, lipid management, management of type 2 diabetes, and use of aspirin. The promulgation and implementation of this guideline will play a key role in promoting the practice of primary prevention for cardiovascular disease in China.
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47
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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: 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: 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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Nie J, Haberstroh M, Acosta T, Huang W, Wang Y, Barengo NC. Independent and joint associations between leisure time physical activity and strength activities with mortality outcomes in older adults ≥65 years-of-age: a prospective cohort study. J Gerontol A Biol Sci Med Sci 2021; 76:2122-2131. [PMID: 33858013 DOI: 10.1093/gerona/glab114] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Indexed: 11/13/2022] Open
Abstract
Scientific evidence regarding the combined effect of both aerobic leisure time physical activity (LTPA) and muscle strengthening activities on all-cause, CVD or cancer mortality in older adults is scant. The aim of the study was to investigate the associations between recommended physical activity and mortality in older adults ≥65 years-of-age. This prospective cohort study used data from the National Health Interview Surveys from 1997-2013 linked with mortality files through December 31, 2015 (n=89,962). The main outcomes included all-cause, cardiovascular disease (CVD) and cancer mortality. The main exposure variables were aerobic leisure time physical activity and guideline-concordant strength training during leisure time. Cox regression models were used to calculate the hazard ratios (HR) and the corresponding 95% confidence intervals (CI). Muscle-strengthening activity at least twice per week were associated with lower hazards of all-cause mortality (HR 0.92; 95% CI 0.88-0.96), CVD mortality (HR 0.90; 95% CI 0.81-0.99) and cancer mortality (HR 0.87; 95% CI 0.79-0.96). Those who reached the recommended weekly amount of LTPA, had lower hazard of all-cause mortality by 35% (HR 0.66; 95% CI 0.63-0.67), the hazard of CVD 38% (HR 0.62; 95% CI 0.58-0.67), and cancer mortality by 22% (HR 0.78; 95% CI 0.73-0.84). The hazard of death among those who were physically active in both leisure time and engaged in muscle-strengthening activities were 0.57 (95% CI 0.54-0.60) for all-cause mortality, 0.53 (95% CI 0.47-0.61) for CVD mortality, and 0.66 (95% CI 0.58-0.75) for cancer mortality. Thus, engaging in muscle-strengthening activity ≥2 times/week may provide additional benefits among physically active older adults.
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Affiliation(s)
- Jing Nie
- Department of Sociology & Institute for Empirical Social Science Research, School of Humanities and Social Sciences, Xi'an Jiaotong University, Xi'an, China
| | - Michelle Haberstroh
- Department of Human Service Department and Department of Public Health, University of Illinois Springfield, Illinois, USA
| | - Tania Acosta
- Department of Public Health, Universidad del Norte, Barranquilla, Colombia
| | - Wentao Huang
- School of Nursing, Guangdong Pharmaceutical University, 283 Jianghai Avenue, Haizhu District, Guangzhou, China
| | - Yafeng Wang
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, China
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.,Faculty of Medicine, Riga Stradins University, Riga, Latvia.,Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
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49
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Pereira AM, Verhagen E, Figueiredo P, Seabra A, Martins A, Brito J. Physical Activity Levels of Adult Virtual Football Players. Front Psychol 2021; 12:596434. [PMID: 33868076 PMCID: PMC8044777 DOI: 10.3389/fpsyg.2021.596434] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 03/05/2021] [Indexed: 12/02/2022] Open
Abstract
Esports, including virtual football, are a worldwide phenomenon. Yet, little is known about the physical activity levels of individuals engaged in virtual football game play. Therefore, we aimed to perform a preliminary evaluation of the levels of physical activity, sedentarism, and habits of physical training of adults engaged with virtual football in Portugal. This was a cross-sectional investigation based on a structured online survey using the International Physical Activity Questionnaire (IPAQ) and a set of questions regarding habits of physical training. The participants (n = 433) reported spending a median of 5,625 MET-min⋅week−1 being physically active. Still, the participants spent 320 min/day sitting, and 150 min/day practicing virtual football. According to the IPAQ scores, high physical activity levels were reported by 84.5% of the participants, and 87.1% were considered physically active considering the WHO guidelines on physical activity and sedentary behavior. Overall, 60.0% of the participants reported planning their own physical training. Maintaining or improving overall physical health was one of the main reasons for doing physical training (66.7%), with only 6.1% responding being active to improve virtual football performance. Overall, the results showed that virtual football players accomplished the standard recommendations for physical activity, with high levels of physical activity, and encompassing regular physical training focused mostly on health promotion, rather than improved virtual football performance.
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Affiliation(s)
- Ana M Pereira
- Portugal Football School, Portuguese Football Federation, FPF, Cruz Quebrada, Portugal.,Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University Institute of Maia, ISMAI, Maia, Portugal
| | - Evert Verhagen
- Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam (UMC), University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Pedro Figueiredo
- Portugal Football School, Portuguese Football Federation, FPF, Cruz Quebrada, Portugal.,Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University Institute of Maia, ISMAI, Maia, Portugal
| | - André Seabra
- Portugal Football School, Portuguese Football Federation, FPF, Cruz Quebrada, Portugal.,Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - António Martins
- Public Health Unit of Alto Ave, North Regional Health Administration, Porto, Portugal
| | - João Brito
- Portugal Football School, Portuguese Football Federation, FPF, Cruz Quebrada, Portugal
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Rampersad C, Brar R, Connelly K, Komenda P, Rigatto C, Prasad B, Bohm C, Tangri N. Association of Physical Activity and Poor Health Outcomes in Patients With Advanced CKD. Am J Kidney Dis 2021; 78:391-398. [PMID: 33581165 DOI: 10.1053/j.ajkd.2020.12.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 12/14/2020] [Indexed: 12/13/2022]
Abstract
RATIONALE & OBJECTIVE Chronic kidney disease (CKD) is associated with declining physical function and activity. In the general population, lower physical activity is associated with poorer quality of life and greater all-cause mortality. The aim of this study was to assess if lower physical activity levels are associated with adverse health outcomes in patients with advanced CKD. STUDY DESIGN A multicenter prospective cohort study. SETTING & PARTICIPANTS 579 adult patients with CKD glomerular filtration rate categories 4 and 5 (G4-G5) treated at 4 Canadian multidisciplinary kidney health clinics between 2012 and 2018. EXPOSURE Patient-reported measures of physical activity using the Physical Activity Scale for the Elderly (PASE) questionnaire and subsequently stratified PASE scores into tertiles. OUTCOME All-cause mortality, progression to kidney failure, and future falls. ANALYTICAL APPROACH Outcomes were analyzed using time-dependent proportional hazards models and logistic regression models. RESULTS In 1,193 days of follow-up observation, 118 patients died, 204 progressed to dialysis, and 129 reported a fall. When compared with low physical activity, higher levels of physical activity were associated with a 52% lower all-cause mortality (adjusted HR, 0.48; 95% CI, 0.27-0.85) in models adjusted for age, sex, and comorbidity. No associations were detected between higher levels of physical activity and either slower progression to kidney failure or a lower rate of future falls. LIMITATIONS Physical activity and falls were self-reported. Our population was of limited racial/ethnic diversity, which may affect generalizability. Findings were observational and do not indicate whether interventions targeting physical activity may affect adverse health outcomes. CONCLUSIONS Higher levels of physical activity were associated with about 50% lower all-cause mortality in the advanced CKD population. These findings are consistent with a potential benefit from maintained physical activity as patients approach kidney failure.
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Affiliation(s)
- Christie Rampersad
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
| | - Ranveer Brar
- Seven Oaks General Hospital, Chronic Disease Innovation Centre, Winnipeg, MB, Canada
| | - Kelsey Connelly
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Paul Komenda
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Seven Oaks General Hospital, Chronic Disease Innovation Centre, Winnipeg, MB, Canada
| | - Claudio Rigatto
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Seven Oaks General Hospital, Chronic Disease Innovation Centre, Winnipeg, MB, Canada
| | - Bhanu Prasad
- Seven Oaks General Hospital, Chronic Disease Innovation Centre, Winnipeg, MB, Canada
| | - Clara Bohm
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Seven Oaks General Hospital, Chronic Disease Innovation Centre, Winnipeg, MB, Canada
| | - Navdeep Tangri
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Seven Oaks General Hospital, Chronic Disease Innovation Centre, Winnipeg, MB, Canada
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