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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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2
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Ma D, Sun Y, Chen G, Hao S, Jiang Z, Wang R, Hao S. The association between physical activity intensity and frailty risk among older adults across different age groups and genders: Evidence from four waves of the China Health and Retirement Longitudinal Survey. PLoS One 2024; 19:e0305346. [PMID: 38861565 PMCID: PMC11166314 DOI: 10.1371/journal.pone.0305346] [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: 01/23/2024] [Accepted: 05/29/2024] [Indexed: 06/13/2024] Open
Abstract
"Exercise is the best medicine" is well known, but the optimal dose of physical activity (PA) for males and females across different age groups is still unknown. This study, using data from the four waves of CHARLS, aimed to determine the optimal PA dose that reduces frailty risks among older adults across various age groups and both sexes. We created a frailty index score using 63 health-related variables and used 0.21 as the frailty cut point. Binary logistic regression was used to compare the effect of vigorous, moderate, and light intensity PA under IPAQ criteria on frailty risk. The study found that regardless of whether males or females, the optimal effect of vigorous-intensity PA in reducing the risk of frailty is consistently observed throughout the entire old age career. Moreover, the age groups at which moderate-intensity PA reduces the risk of frailty were from age 70 for males and from age 80 for females. And light-intensity PA had no effect on reducing the risk of frailty. Moderate and vigorous intensity of PA in older adults should be promoted, but guidelines and recommendations must account for optimal associations with PA dose across genders and age groups.
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Affiliation(s)
- Di Ma
- Department of Sports Science, College of Sports & Arts, Hanyang University ERICA Campus, Ansan, South Korea
| | - Yulin Sun
- Department of Sports Science, College of Sports & Arts, Hanyang University ERICA Campus, Ansan, South Korea
| | - Guoyang Chen
- Department of Sports Science, College of Sports & Arts, Hanyang University ERICA Campus, Ansan, South Korea
| | - Siwei Hao
- Department of Sports Science, College of Sports & Arts, Hanyang University ERICA Campus, Ansan, South Korea
| | - Zhenping Jiang
- Department of Sports Science, College of Sports & Arts, Hanyang University ERICA Campus, Ansan, South Korea
| | - Rui Wang
- Department of Sports Science, College of Sports & Arts, Hanyang University ERICA Campus, Ansan, South Korea
| | - Shuaipeng Hao
- Department of Sports Science, College of Sports & Arts, Hanyang University ERICA Campus, Ansan, South Korea
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3
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Gower B, Blacket C, Girard D, Boyle T, Davison K. Prospective associations between systolic blood pressure, serum cholesterol, and physical activity behaviour and the development of cardiovascular disease. Prev Med 2024; 183:107958. [PMID: 38657686 DOI: 10.1016/j.ypmed.2024.107958] [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: 12/18/2022] [Revised: 03/22/2024] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
AIMS To systematically appraise and summarise meta-analyses of longitudinal studies to determine the effect size, and quality and certainty of the evidence summaries for systolic blood pressure (SBP), serum cholesterol, and physical activity behaviour in developing cardiovascular disease (CVD). METHODS AND RESULTS An umbrella review was conducted by searching MEDLINE, Embase, and Scopus databases. Eligible meta-analyses were longitudinal studies investigating the association between SBP, serum cholesterol, or physical activity behaviour on CVD development. Summary risk estimates were extracted. Quality and certainty of the evidence summaries of included records were performed using AMSTAR 2 and GRADE, respectively. Forty-one eligible records were found of which thirteen related to SBP, five to cholesterol, and twenty-three to physical activity behaviour. The quality and certainty of the evidence summaries were variable, with most studies rating 'low'. Reported risk estimates for the risk of developing CVD ranged from: no change to a 68% decreased risk for lower SBP; a 21% increased risk to a 44% decreased risk for lower cholesterol; and a 1% decreased risk to a 56% decreased risk for higher physical activity levels. CONCLUSIONS There were strong associations with CVD risk at the meta-analysis level for all three exposures, with a proportionally greater number of meta-analyses and primary studies for physical activity than SBP or serum cholesterol. Given the number of meta-analyses and similar CVD risk reductions and certainty of evidence associated with physical activity behaviour, there is a strong case for its routine assessment alongside SBP and serum cholesterol in primary CVD prevention.
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Affiliation(s)
- Bethany Gower
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide, Australia.
| | - Chloe Blacket
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide, Australia
| | - Danielle Girard
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide, Australia
| | - Terry Boyle
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia; University of South Australia, Australian Centre for Precision Health, Adelaide, Australia
| | - Kade Davison
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide, Australia
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4
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Gilbert S, Jordan A, Ding D, Tiedemann A, Sherrington C, Pinheiro MDB. Cultural, Linguistic, and Geographical Diversity of Participants in Australian Physical Activity Research Studies: A Systematic Review. J Phys Act Health 2024; 21:554-559. [PMID: 38479379 DOI: 10.1123/jpah.2023-0608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 01/18/2024] [Accepted: 02/05/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND The Australian population is highly diverse in terms of cultural heritage, languages spoken, and geographical dispersion. Health outcomes are often worse among these culturally, linguistically, and geographically diverse populations, and this is reflected in rates of physical activity participation, with people from these groups often engaging in insufficient physical activity for health benefits. This research aimed to investigate if physical activity intervention studies conducted in Australia were (1) designed to recruit culturally, linguistically, and geographically diverse participants and (2) recruiting culturally, linguistically, and geographically diverse participants. METHODS We conducted a systematic review of physical activity intervention studies conducted in adults in Australia between 2015 and November 2022. Information relevant to inclusivity in study recruitment methods and diversity of recruited participants was extracted. RESULTS We identified and extracted data from 371 studies, of which 98 were protocol papers for which no follow-up data was available. Only 26 studies (7%) included methods to recruit culturally or linguistically diverse participants. Most studies (189, 51%) recruited participants from major city locations, with few studies recruiting from more remote locations. No studies included recruitment from very remote regions. Information on cultural, linguistic, or geographic diversity of participants recruited to physical activity studies was provided by 109 studies (40% of studies including results) with the majority recruiting White, English-speakers from major cities. CONCLUSIONS Few Australian physical activity studies are designed to recruit culturally, linguistically, and geographically diverse participants. Due to limited reporting of the diversity of participants, comparisons with population-representative data are unreliable.
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Affiliation(s)
- Stephen Gilbert
- Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Institute for Musculoskeletal Health,Sydney Local Health District,The University of Sydney, Gadigal Country, NSW, Australia
| | - Alastair Jordan
- School of Science, Technology, and Health, York St John University, York, United Kingdom
| | - Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Gadigal Country, NSW, Australia
- The Charles Perkins Center, The University of Sydney, Gadigal Country, NSW, Australia
| | - Anne Tiedemann
- Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Institute for Musculoskeletal Health,Sydney Local Health District,The University of Sydney, Gadigal Country, NSW, Australia
| | - Catherine Sherrington
- Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Institute for Musculoskeletal Health,Sydney Local Health District,The University of Sydney, Gadigal Country, NSW, Australia
| | - Marina De Barros Pinheiro
- Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Institute for Musculoskeletal Health,Sydney Local Health District,The University of Sydney, Gadigal Country, NSW, Australia
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Shuval K, Leonard D, DeFina LF, Barlow CE, Berry JD, Turlington WM, Pavlovic A, Radford NB, Gabriel KP, Khera A, Levine BD. Physical Activity and Progression of Coronary Artery Calcification in Men and Women. JAMA Cardiol 2024:2818814. [PMID: 38748444 PMCID: PMC11097096 DOI: 10.1001/jamacardio.2024.0759] [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: 08/29/2023] [Accepted: 03/10/2024] [Indexed: 05/18/2024]
Abstract
Importance Prior cross-sectional studies have suggested that very high levels of physical activity (PA) are associated with a higher prevalence of coronary artery calcium (CAC). However, less is known regarding the association between high-volume PA and progression of CAC over time. Objective To explore the association between PA (measured at baseline and during follow-up) and the progression of CAC over time. Design, Setting, and Participants This cohort study included data from 8771 apparently healthy men and women 40 years and older who had multiple preventive medicine visits at the Cooper Clinic (Dallas, Texas), with a mean (SD) follow-up time of 7.8 (4.7) years between the first and last clinic visit. Participants with reported PA and CAC measurements at each visit during 1998 to 2019 were included in the study. Data were analyzed from March 2023 to February 2024. Exposures PA reported at baseline and follow-up, examined continuously per 500 metabolic equivalent of task minutes per week (MET-min/wk) and categorically: less than 1500, 1500 to 2999, 3000 or more MET-min/wk. Main Outcomes and Measures Negative binomial regression was used to estimate the rate of mean CAC progression between visits, with potential modification by PA volume, calculated as the mean of PA at baseline and follow-up. In addition, proportional hazards regression was used to estimate hazard ratios for baseline PA as a predictor of CAC progression to 100 or more Agatston units (AU). Results Among 8771 participants, the mean (SD) age at baseline was 50.2 (7.3) years for men and 51.1 (7.3) years for women. The rate of mean CAC progression per year from baseline was 28.5% in men and 32.1% in women, independent of mean PA during the same time period. That is, the difference in the rate of CAC progression per year was 0.0% per 500 MET-min/wk for men and women (men: 95% CI, -0.1% to 0.1%; women: 95% CI, -0.4% to 0.5%). Moreover, baseline PA was not associated with CAC progression to a clinically meaningful threshold of 100 AU or more over the follow-up period. The hazard ratio for a baseline PA value of 3000 or more MET-min/wk vs less than 1500 MET-min/wk to cross this threshold was 0.84 (95% CI, 0.66 to 1.08) in men and 1.16 (95% CI, 0.57 to 2.35) in women. Conclusions and Relevance This study found that PA volume was not associated with progression of CAC in a large cohort of healthy men and women who were initially free of overt cardiovascular disease.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Amit Khera
- University of Texas Southwestern Medical Center, Dallas
| | - Benjamin D. Levine
- University of Texas Southwestern Medical Center, Dallas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas
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Sparks JR, Wang X, Lavie CJ, Zhang J, Sui X. Cardiorespiratory Fitness as a Predictor of Non-Cardiovascular Disease and Non-Cancer Mortality in Men. Mayo Clin Proc 2024:S0025-6196(23)00599-2. [PMID: 38661595 DOI: 10.1016/j.mayocp.2023.11.024] [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: 07/07/2023] [Revised: 10/20/2023] [Accepted: 11/21/2023] [Indexed: 04/26/2024]
Abstract
OBJECTIVE To evaluate the association of 5 major cause-specific non-cardiovascular disease (CVD) and non-cancer deaths with cardiorespiratory fitness (CRF). METHODS Patients were 36,645 men (43.3±9.3 years) free of known CVD and cancer at baseline who completed a maximal treadmill graded exercise test during a preventive examination at the Cooper Clinic (Dallas, Texas) between 1971 and 2003. CRF was quantified as maximal treadmill exercise test duration and grouped as low (referent), moderate, and high. Cause-specific non-CVD non-cancer deaths were (1) diabetes or kidney disease, (2) chronic respiratory disease, (3) acute respiratory and infectious disease, (4) injuries, and (5) other non-CVD non-cancer deaths. RESULTS A total of 694 non-CVD non-cancer deaths occurred during an average of 17 years of follow-up. After adjustment for covariates, hazard ratios (95% confidence intervals) for moderate and high CRF, respectively, were 0.57 (0.47 to 0.69) and 0.43 (0.34 to 0.54) for overall non-CVD non-cancer deaths (P<.0001); 0.39 (0.28 to 0.54) and 0.17 (0.10 to 0.28) for diabetes or kidney disease (P<.001); 0.36 (0.22 to 0.59) and 0.09 (0.04 to 0.20) for chronic respiratory diseases (P<.001 for all); 0.74 (0.47 to 1.16) and 0.34 (0.19 to 0.61) for acute respiratory and infectious diseases (P<.01 for both); and 0.48 (0.35 to 0.66) and 0.38 (0.26 to 0.55) for any other non-CVD non-cancer deaths (P<.0001 for both). CONCLUSION Higher levels of CRF were significantly associated with lower risk of mortality from the 5 major non-CVD non-cancer causes. These results suggest that improvement in CRF may reduce non-CVD non-cancer deaths, which account for a significant proportion of adult mortality.
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Affiliation(s)
- Joshua R Sparks
- Department of Exercise Science, Norman J. Arnold School of Public Health, University of South Carolina, Columbia; Reproductive Endocrinology and Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge
| | - Xuewen Wang
- Department of Exercise Science, Norman J. Arnold School of Public Health, University of South Carolina, Columbia
| | - Carl J Lavie
- Department of Cardiovascular Disease, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, LA
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Norman J. Arnold School of Public Health, University of South Carolina, Columbia
| | - Xuemei Sui
- Department of Exercise Science, Norman J. Arnold School of Public Health, University of South Carolina, Columbia.
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Avoke D, Elshafeey A, Weinstein R, Kim CH, Martin SS. Digital Health in Diabetes and Cardiovascular Disease. Endocr Res 2024:1-13. [PMID: 38605594 DOI: 10.1080/07435800.2024.2341146] [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: 12/12/2023] [Accepted: 04/04/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Digital health technologies are rapidly evolving and transforming the care of diabetes and cardiovascular disease (CVD). PURPOSE OF THE REVIEW In this review, we discuss emerging approaches incorporating digital health technologies to improve patient outcomes through a more continuous, accessible, proactive, and patient-centered approach. We discuss various mechanisms of potential benefit ranging from early detection to enhanced physiologic monitoring over time to helping shape important management decisions and engaging patients in their care. Furthermore, we discuss the potential for better individualization of management, which is particularly important in diseases with heterogeneous and complex manifestations, such as diabetes and cardiovascular disease. This narrative review explores ways to leverage digital health technology to better extend the reach of clinicians beyond the physical hospital and clinic spaces to address disparities in the diagnosis, treatment, and prevention of diabetes and cardiovascular disease. CONCLUSION We are at the early stages of the shift to digital medicine, which holds substantial promise not only to improve patient outcomes but also to lower the costs of care. The review concludes by recognizing the challenges and limitations that need to be addressed for optimal implementation and impact. We present recommendations on how to navigate these challenges as well as goals and opportunities in utilizing digital health technology in the management of diabetes and prevention of adverse cardiovascular outcomes.
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Affiliation(s)
- Dorothy Avoke
- Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA
| | | | - Robert Weinstein
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Chang H Kim
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Seth S Martin
- Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Wilcox NS, Amit U, Reibel JB, Berlin E, Howell K, Ky B. Cardiovascular disease and cancer: shared risk factors and mechanisms. Nat Rev Cardiol 2024:10.1038/s41569-024-01017-x. [PMID: 38600368 DOI: 10.1038/s41569-024-01017-x] [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] [Accepted: 03/20/2024] [Indexed: 04/12/2024]
Abstract
Cardiovascular disease (CVD) and cancer are among the leading causes of morbidity and mortality globally, and these conditions are increasingly recognized to be fundamentally interconnected. In this Review, we present the current epidemiological data for each of the modifiable risk factors shared by the two diseases, including hypertension, hyperlipidaemia, diabetes mellitus, obesity, smoking, diet, physical activity and the social determinants of health. We then review the epidemiological data demonstrating the increased risk of CVD in patients with cancer, as well as the increased risk of cancer in patients with CVD. We also discuss the shared mechanisms implicated in the development of these conditions, highlighting their inherent bidirectional relationship. We conclude with a perspective on future research directions for the field of cardio-oncology to advance the care of patients with CVD and cancer.
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Affiliation(s)
- Nicholas S Wilcox
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Uri Amit
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jacob B Reibel
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Hematology Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Eva Berlin
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kendyl Howell
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Bonnie Ky
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Johansson LM, Fransson EI, Lingfors H, Golsäter M. Exploring how people achieve recommended levels of physical activity, despite self-reported economic difficulties: a sense of coherence perspective. BMC PRIMARY CARE 2024; 25:105. [PMID: 38575903 PMCID: PMC10993487 DOI: 10.1186/s12875-024-02354-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/27/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND The salutogenic theory forms the basis for health promotion and describes health as a continuum from a dis-ease pole of health to an ease pole. The core concept for the salutogenic theory is sense of coherence (SOC). For a strong SOC, general resistance resources, such as solid economic situation, are essential. The aim was to explore how people - despite self-reported economic difficulties - comprehend, manage and find it meaningful to achieve the level of physical activity recommended by World Health Organisation (WHO). METHOD The study is based on interviews with people achieving the recommended physical activity (PA) level despite economic difficulties. The interviews were conducted at primary health care centres and family centres after a targeted health dialogue. We used a qualitative deductive content analysis based on sense of coherence as the main category, with the three generic categories of comprehensibility, manageability and meaningfulness. RESULT The findings elucidate a pattern of a process. In this process, the participants comprehend their knowledge of the health benefits of PA and have a plan for performing their PA. They utilise their resources in order to manage to apply their knowledge and plan for PA in their lives despite their challenges. When PA becomes meaningful to them, they have an intrinsic motivation to perform it and experience its benefits. CONCLUSION This study suggests a possible process that might help in achieving the recommended PA level among people with economic difficulties and other challenges. The findings might be used in health promotion work, such as targeted health dialogues in primary health care, to reduce health inequalities when supporting people who are not achieving the recommended levels of PA. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Lisbeth M Johansson
- Unit for Research and Development in Primary Care, Futurum - Academy for Health and Care, Region Jönköping County, Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Box 1026, Jönköping, 551 11, Sweden.
| | - Eleonor I Fransson
- School of Health and Welfare, Jönköping University, Box 1026, Jönköping, 551 11, Sweden
| | - Hans Lingfors
- Unit for Research and Development in Primary Care, Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden
| | - Marie Golsäter
- Child Research Group, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Child Health Service and Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden
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10
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Xiong T, Krusche M. [Wearables in rheumatology]. Z Rheumatol 2024; 83:234-241. [PMID: 37289217 PMCID: PMC10973074 DOI: 10.1007/s00393-023-01377-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2023] [Indexed: 06/09/2023]
Abstract
As a result of digitalization in medicine wearable computing devices (wearables) are becoming increasingly more important. Wearables are small portable electronic devices with which the user can record data relevant to health, such as number of steps, activity profile, electrocardiogram (ECG), heart and breathing frequency or oxygen saturation. Initial studies on the use of wearables in patients with rheumatological diseases show the opening up of new possibilities for prevention, disease monitoring and treatment. This study provides the current data situation and the implementation of wearables in the discipline of rheumatology. Additionally, future potential fields of application as well as challenges and limits of the implementation of wearables are illustrated.
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Affiliation(s)
- Tingting Xiong
- Sektion für Rheumatologie und entzündliche Systemerkrankungen, III. Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
| | - Martin Krusche
- Sektion für Rheumatologie und entzündliche Systemerkrankungen, III. Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
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11
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Sallam NA, Wang B, Laher I. Exercise training and vascular heterogeneity in db/db mice: evidence for regional- and duration-dependent effects. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024; 397:2421-2436. [PMID: 37843589 DOI: 10.1007/s00210-023-02775-0] [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: 08/17/2023] [Accepted: 10/04/2023] [Indexed: 10/17/2023]
Abstract
Exercise training (ET) has several health benefits; however, our understanding of regional adaptations to ET is limited. We examined the functional and molecular adaptations to short- and long-term ET in elastic and muscular conduit arteries of db/db mice in relation to changes in cardiovascular risk factors. Diabetic mice and their controls were exercised at moderate intensity for 4 or 8 weeks. The vasodilatory and contractile responses of thoracic aortae and femoral arteries isolated from the same animals were examined. Blood and aortic samples were used to measure hyperglycemia, oxidative stress, inflammation, dyslipidemia, protein expression of SOD isoforms, COX, eNOS, and Akt. Short-term ET improved nitric oxide (NO) mediated vasorelaxation in the aortae and femoral arteries of db/db mice in parallel with increased SOD2 and SOD3 expression, reduced oxidative stress and triglycerides, and independent of weight loss, glycemia, or inflammation. Long-term ET reduced body weight in parallel with reduced systemic inflammation and improved insulin sensitivity along with increased SOD1, Akt, and eNOS expression and improved NO vasorelaxation. Exercise did not restore NOS- and COX-independent vasodilatation in femoral arteries, nor did it mitigate the hypercontractility in the aortae of db/db mice; rather ET transiently increased contractility in association with upregulated COX-2. Long-term ET differentially affected the aortae and femoral arteries contractile responses. ET improved NO-mediated vasodilation in both arteries likely due to collective systemic effects. ET did not mitigate all diabetes-induced vasculopathies. Optimization of the ET regimen can help develop comprehensive management of type 2 diabetes.
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Affiliation(s)
- Nada A Sallam
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo, 11562, Egypt
| | - Baohua Wang
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, V6T1Z4, Canada
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, V6T1Z4, Canada.
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Kikuchi H, Inoue S, Amagasa S, Kuwahara K, Ihira H, Inoue M, Iso H, Tsugane S, Sawada N. Relationships of Total and Domain-Specific Moderate-to-Vigorous Physical Activity with All-Cause and Disease-Specific Mortality. Med Sci Sports Exerc 2024; 56:520-527. [PMID: 37882065 DOI: 10.1249/mss.0000000000003331] [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: 10/27/2023]
Abstract
PURPOSE This study aimed to investigate the relationships of moderate-to-vigorous physical activity (MVPA) with all-cause and disease-specific mortality. We also investigated how the association between MVPA at leisure time (LT-MVPA) and health outcomes differs at different MVPA at work (WT-MVPA) levels. METHODS The 81,601 community-dwelling Japanese persons age 50-79 yr who responded to a questionnaire in 2000-2003 were followed until 2018. Cox proportional hazard model was used to examine the association of total MVPA with risks of all-cause, cancer, heart disease, stroke, and respiratory disease mortality. Then, we compared the mortality risk according to the tertile of LT-MVPA, stratified by the tertile of WT-MVPA. RESULTS During the 15.1 yr of average follow-up, 16,951 deaths were identified. Even total MVPA below the recommended volume (i.e., 0.1-1.49 MET·h·d -1 ) was associated with 11% to 24% reductions in all-cause (hazard ratio [HR], 0.89; 95% confidence interval [CI], 0.82-0.96) and heart disease mortality (HR, 0.76; 95% CI, 0.61-0.94), compared with no MVPA at all. The further reduced risks were seen in MVPA up to 10 MET·h·d -1 . The inverse association between LT-MVPA and mortality risks was more evident at lower WT-MVPA, which was also inversely associated with the risks. CONCLUSIONS Health benefits were observed at low levels of MVPA and up to 10 MET·h·d -1 , although the fine threshold for excessive MVPA was not clear. LT-MVPA had distinct health benefits especially for persons with lower WT-MVPA.
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Affiliation(s)
- Hiroyuki Kikuchi
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, JAPAN
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, JAPAN
| | | | | | - Hikaru Ihira
- Division of Cohort research, National Cancer Center Institute for Cancer Control, Tokyo, JAPAN
| | | | - Hiroyasu Iso
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, JAPAN
| | | | - Norie Sawada
- Division of Cohort research, National Cancer Center Institute for Cancer Control, Tokyo, JAPAN
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Fukushima N, Kikuchi H, Sato H, Sasai H, Kiyohara K, Sawada SS, Machida M, Amagasa S, Inoue S. Dose-Response Relationship of Physical Activity with All-Cause Mortality among Older Adults: An Umbrella Review. J Am Med Dir Assoc 2024; 25:417-430. [PMID: 37925162 DOI: 10.1016/j.jamda.2023.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/25/2023] [Accepted: 09/25/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVES To examine the dose-response relationship between physical activity (PA) and all-cause and cardiovascular disease (CVD) mortality, specifically among older adults. DESIGN Umbrella review. SETTING AND PARTICIPANTS Eligible studies included systematic reviews with meta-analyses that investigated the association of aerobic PA, muscle-strengthening activity, and multicomponent PA, including exercise programs (such as aerobic, muscle strengthening, and balance training), with all-cause and CVD mortality among older adults aged ≥60 years. METHODS We performed a literature search in PubMed, CINAHL, and the Cochrane Library for eligible studies published between January 2017 and March 2023 to update an umbrella review initially conducted by the United States 2018 PA Guidelines Advisory Committee. Studies included in the 2018 US PA and 2020 World Health Organization (WHO) Guidelines were also reviewed. In addition, meta-analyses that reported effect sizes stratified by age and recruiting older adults (aged ≥60 years) were included. RESULTS Overall, 16 relevant systematic reviews (10 from our review and 6 from the US and WHO guidelines) met the inclusion criteria. All these reviews showed that 7.5 to 15.0 metabolic equivalents (METs)-hours/week (around the recommended PA levels outlined in the US and WHO guidelines) substantially reduced mortality risks among older adults (approximately 19%-30% for all-cause mortality and 25%-34% for CVD mortality). Moreover, 15.0 to 22.5 MET-hours/week, exceeding the guideline-recommended PA levels, resulted in greater reductions in mortality risks by 35% to 37% and 38% to 40%, respectively. CONCLUSIONS AND IMPLICATIONS PA substantially reduced all-cause and CVD mortality risks among older adults. Larger risk reductions may be achieved by engaging in PA levels higher than those recommended by the current international PA guidelines. Our findings suggest that recommending higher PA levels beyond the current guidelines may benefit older adults when developing future international PA guidelines.
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Affiliation(s)
- Noritoshi Fukushima
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
| | - Hiroyuki Kikuchi
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
| | - Hiroki Sato
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Oita, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kosuke Kiyohara
- Department of Food Science, Faculty of Home Economics, Otsuma Women's University, Tokyo, Japan
| | - Susumu S Sawada
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Masaki Machida
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
| | - Shiho Amagasa
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan; Graduate School of Public Health, Teikyo University, Tokyo, Japan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan.
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Guan T, Cao M, Zheng C, Zhou H, Wang X, Chen Z, Zhang L, Cao X, Tian Y, Guo J, Han X, Wang Z. Dose-response association between physical activity and blood pressure among Chinese adults: a nationwide cross-sectional study. J Hypertens 2024; 42:360-370. [PMID: 38037282 PMCID: PMC10763713 DOI: 10.1097/hjh.0000000000003587] [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: 01/05/2023] [Accepted: 08/25/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVES The aim of this study was to examine the dose-response associations of physical activity with blood pressure (BP) and hypertension risk among Chinese adults. METHODS Derived from the national community-based China Hypertension Survey database during 2012--2015, a total of 203 108 residents aged at least 18 years were included. Individual-level physical activity was evaluated using a standardized questionnaire, and minutes of metabolic equivalent tasks per week (MET-min/week) were calculated, integrating domain, intensity, frequency, and duration. Multivariable linear and logistic regressions were used to estimate associations of physical activity with BP and hypertension risk, and restricted cubic spline regressions were performed for their nonlinear dose-response relationships. RESULTS Overall, the median total physical activity (TPA) was 3213.0 MET-min/week and the prevalence of physical inactivity was 14.8%. TPA was negatively associated with BP. Increasing TPA levels was related to a steep decrease in systolic BP, up to approximately 2500 MET-min/week, with more modest benefits above that level of TPA. Higher levels of domain-specific and intensity-specific physical activity were found to be associated with lower BP levels and hypertension risk, except for the association between vigorous-intensity physical activity and systolic BP. We found that TPA within the range of 2000--4000 MET-min/week, a higher frequency and shorter duration were inversely associated with diastolic BP levels. CONCLUSION Total, domain-specific, and intensity-specific physical activity were inversely related to BP levels, respectively, in a dose-response fashion. Of a given amount, higher-frequency, shorter-duration, and lower-intensity physical activity produced more beneficial effects.
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Affiliation(s)
| | - Man Cao
- School of Health Policy and Management
| | - Congyi Zheng
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital
| | - Haoqi Zhou
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital
| | - Xin Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital
| | - Zuo Chen
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital
| | - Linfeng Zhang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital
| | - Xue Cao
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital
| | - Yixin Tian
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital
| | - Jian Guo
- Medical Research Center
- Department of Cardiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | | | - Zengwu Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital
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Seino S, Abe T, Nofuji Y, Hata T, Shinkai S, Kitamura A, Fujiwara Y. Dose-response Associations of Physical Activity and Sitting Time With All-cause Mortality in Older Japanese Adults. J Epidemiol 2024; 34:23-30. [PMID: 36567129 PMCID: PMC10701252 DOI: 10.2188/jea.je20220246] [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: 08/31/2022] [Accepted: 12/11/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Although examining the dose-response curves of physical activity (PA) and sitting time with health-related outcomes is an important research agenda, the results for older Japanese adults are extremely limited. We examined the dose-response associations of PA and sitting time with all-cause mortality among older Japanese. METHODS Initially, 8,069 non-disabled residents (4,073 men; 3,996 women) aged 65-84 years of Ota City, Japan, were analyzed. Moderate-to-vigorous PA (MVPA) and sitting time were evaluated using the International Physical Activity Questionnaire-Short Form. Multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of MVPA and sitting time for all-cause mortality were calculated, and the dose-response curves were examined using restricted cubic splines (RCS). RESULTS During 4.1 years of follow-up, 458 participants (5.7%; 331 men and 127 women) died. Compared with the low MVPA (<600 metabolic equivalents [METs]·minutes/week) group, HR for mortality gradually reduced in moderate (600-3,000 METs·minutes/week) and high (>3,000 METs·minutes/week) MVPA groups (moderate: HR 0.66; 95% CI, 0.54-0.82; high: HR 0.58; 95% CI, 0.45-0.75; P < 0.001 for trend). RCS showed that the HR for mortality reduced linearly up to approximately 2,000 METs·minutes/week of MVPA, and maximal risk reduction was seen at approximately 3,000-4,500 METs·minutes/week of MVPA. No significant dose-response association of sitting time with mortality was observed. CONCLUSION Higher MVPA levels reduced all-cause mortality risk, in a significant inverse non-linear dose-response manner. Sitting time was not significantly associated with all-cause mortality. It is important to disseminate the significance of even a slight increase in the MVPA for reducing mortality risk.
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Affiliation(s)
- Satoshi Seino
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Takumi Abe
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yu Nofuji
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Toshiki Hata
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- Department of Food and Nutritional Science, Graduate School of Applied Bioscience, Tokyo University of Agriculture, Tokyo, Japan
| | - Shoji Shinkai
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- Department of Nutrition Sciences, Kagawa Nutrition University, Saitama, Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- Health Town Development Science Center, Osaka, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- Integrated Research Initiative for Living Well with Dementia, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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16
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Han Y, Sung H, Choi Y, Kim YS. Trends in obesity, leisure-time physical activity, and sedentary behavior in Korean adults: Korea national health and nutritional examinations survey from 2014 to 2021. PLoS One 2024; 19:e0296042. [PMID: 38170709 PMCID: PMC10763961 DOI: 10.1371/journal.pone.0296042] [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: 06/07/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES This study aimed to investigate trends in obesity by dividing it based on body mass index (BMI) and waist circumference indicators, sedentary behavior, and leisure-time physical activity (LTPA) in Korean adults from 2014 to 2021. This study also aimed to determine the adherence rate of people with obesity to physical activity. METHODS Data from the Korea National Health and Nutritional Examination Survey (KNHANES) from 2014 to 2021 were used. A total of 42,676 participants 19 years or older were included in the final analysis. Sociodemographic characteristics, anthropometric measurements, and physical activity levels were recorded. Physical activity levels were assessed using the Global Physical Activity Questionnaire, a self-reported questionnaire. Multivariable logistic regression analysis adjusted for covariates was used to investigate the prevalence of obesity and sitting time or adherence to meeting the physical activity guidelines for each survey year. RESULTS This study included 42,676 adults. The weighted prevalence of obesity in all ages significantly increased from 30.8% (29.1%-32.5%) in 2014 to 34.5% (32.9%-36.2%) in 2017 and 37.3% (35.5%-39.1%) in 2021 (p for trend < 0.004). The weighted adherence rate to LTPA ranged from 25.5% (95% confidence interval [CI], 23.7%-27.2%) in 2014 to 20.5% (95% CI, 18.7%-22.2%) in 2021(p for trend < 0.001). The weighted prevalence of sitting time for 8 h/day or more significantly increased from 46.7% (44.4%-49.0%) in 2014 to 56.2% (54.4%-58.0%) in 2017 and 63% (60.7%-65.3%) in 2021 (p for trend < 0.001). According to this study, the LTPA level among women with obesity was significantly low. CONCLUSION From 2014 to 2021, obesity and sedentary behavior significantly increased and adherence to LTPA decreased among Korean adults. Given these concerning trends, comprehensive interventions are needed at the national level to encourage healthy lifestyle behaviors.
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Affiliation(s)
- Yunmin Han
- Seoul National University, Seoul, Republic of Korea
| | - Hoyong Sung
- Department of Military Kinesiology, Korea Military Academy, Seoul, Republic of Korea
| | | | - Yeon Soo Kim
- Seoul National University, Seoul, Republic of Korea
- Institute of Sports Science, Seoul National University, Seoul, Republic of Korea
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17
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Timme S, Brand R. Exercise as the sum of our choices between behavioral alternatives: The Decisional Preferences in Exercising (DPEX) test. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 70:102509. [PMID: 38065658 DOI: 10.1016/j.psychsport.2023.102509] [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: 03/24/2023] [Revised: 08/10/2023] [Accepted: 08/13/2023] [Indexed: 12/18/2023]
Abstract
Exercising can be theorized as the result of choosing one behavior over alternative behaviors. The Decisional Preferences in Exercising (DPEX) test is a computerized, easy-to-use, publicly available (open source Python code: https://osf.io/ahbjr/) and highly adaptive research tool based on this rationale. In the DPEX, participants are asked to choose between two images by pressing a key on the computer keyboard, one showing a physical exercise and the other showing a non-exercise behavioral alternative in a series of trials. Combinations are randomly assembled from two definable pools of stimuli trial-per-trial. The test can be scored either based on a crossed random effects model (facilitating the use of different stimulus material in different studies without compromising the comparability of test scores) or with a simple proportion score. Data from diverse study samples (N = 451) showed strong correlations of DPEX scores with past and future exercise behavior (r = 0.42 and 0.47 respectively) as well as with affective experiences with exercise (e.g., 'pleasure-displeasure': r = 0.47). DPEX test scores discriminated between exercisers and non-exercisers according to receiver operating curve (ROC) analysis. The DPEX may be used to examine research questions derived from dual process theories, the effects of psychological states on behavioral choices can be tested, or the effects of behavior change interventions can be evaluated. The DPEX helps to avoid common method bias in the assessment of exercise behavior, for example, when psychological variables are measured with questionnaires.
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Affiliation(s)
- Sinika Timme
- Sport and Exercise Psychology, University of Potsdam, Potsdam, Germany
| | - Ralf Brand
- Sport and Exercise Psychology, University of Potsdam, Potsdam, Germany.
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18
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Zilio F, Di Fusco SA, Flori M, Malvezzi Caracciolo D'Aquino M, Pollarolo L, Ingianni N, Lucà F, Riccio C, Gulizia MM, Gabrielli D, Oliva F, Colivicchi F. Physical activity and the heart: from well-established cardiovascular benefits to possible adverse effects. Trends Cardiovasc Med 2024; 34:18-25. [PMID: 35738324 DOI: 10.1016/j.tcm.2022.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 06/12/2022] [Accepted: 06/17/2022] [Indexed: 12/12/2022]
Abstract
The favorable effects of physical activity on the cardiovascular system have been well described in scientific literature. Physical activity reduces cardiovascular morbidity and mortality in both healthy subjects and in patients with cardiovascular disease. However, different intensity levels of physical activity have a different impact on the cardiovascular system. Some data support the hypothesis of a "physical activity paradox": repetitive exposure to vigorous physical activity may induce biological effects that counteract the benefits of moderate intensity levels of physical activity. In this review, we report the main effects of acute and chronic physical activity on the cardiovascular system and we summarize the biochemical mechanisms that may explain these effects.
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Affiliation(s)
- Filippo Zilio
- Department of Cardiology, Santa Chiara Hospital, APSS, Trento Italy.
| | | | - Marco Flori
- Cardiology Unit, Presidio Ospedaliero Unico Urbino, Urbino, Italy
| | | | - Luigi Pollarolo
- Cardiology Unit, Santo Spirito Hospital, Casale Monferrato, Italy
| | - Nadia Ingianni
- Cardiologo ASP Trapani Distretti Marsala e Castelvetrano, Marsala, Italy
| | - Fabiana Lucà
- Division of Cardiology, Big Metropolitan Hospital, Bianchi Melacrino Morelli, Reggio Calabria, Italy
| | - Carmine Riccio
- UOSD "Follow up del paziente post acuto", Dipartimento Cardiovascolare, Azienda Ospedaliera Sant'Anna e San Sebastiano, Caserta, Italy
| | - Michele Massimo Gulizia
- Cardiology Division, Garibaldi-Nesima Hospital, Catania, Italy; ANMCO Heart Care Foundation, Florence, Italy
| | - Domenico Gabrielli
- Cardiology/CCU Unit, Cardiovascular Department, San Camillo Hospital, Rome, Italy
| | - Fabrizio Oliva
- De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy
| | - Furio Colivicchi
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital, Rome, Italy
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Goldney J, Dempsey PC, Henson J, Rowlands A, Bhattacharjee A, Chudasama YV, Razieh C, Laukkanen JA, Davies MJ, Khunti K, Yates T, Zaccardi F. Self-reported walking pace and 10-year cause-specific mortality: A UK biobank investigation. Prog Cardiovasc Dis 2023; 81:17-23. [PMID: 37778454 DOI: 10.1016/j.pcad.2023.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 09/24/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE To investigate associations of self-reported walking pace (SRWP) with relative and absolute risks of cause-specific mortality. PATIENTS AND METHODS In 391,652 UK Biobank participants recruited in 2006-2010, we estimated sex- and cause-specific (cardiovascular disease [CVD], cancer, other causes) mortality hazard ratios (HRs) and 10-year mortality risks across categories of SRWP (slow, average, brisk), accounting for confounders and competing risk. Censoring occurred in September 30, 2021 (England, Wales) and October 31, 2021 (Scotland). RESULTS Over a median follow-up of 12.6 years, 22,413 deaths occurred. In women, the HRs comparing brisk to slow SRWP were 0.74 (95% CI: 0.67, 0.82), 0.40 (0.33, 0.49), and 0.29 (0.26, 0.32) for cancer, CVD, and other causes of death, respectively, and 0.71 (0.64, 0.78), 0.38 (0.33, 0.44), and 0.29 (0.26, 0.32) in men. Compared to CVD, HRs were greater for other causes (women: 39.6% [6.2, 72.9]; men: 31.6% [9.8, 53.5]) and smaller for cancer (-45.8% [-58.3, -33.2] and - 45.9% [-54.8, -36.9], respectively). For all causes in both sexes, the 10-year mortality risk was higher in slow walkers, but varied across sex, age, and cause, resulting in different risk reductions comparing brisk to slow: the largest were for other causes of death at age 75 years [women: -6.8% (-7.7, -5.8); men: -9.5% (-10.6, -8.4)]. CONCLUSION Compared to slow walkers, brisk SRWP was associated with reduced cancer (smallest reduction), CVD, and other (largest) causes of death and may therefore be a useful clinical predictive marker. As absolute risk reductions varied across age, cause, and SRWP, certain groups may particularly benefit from interventions to increase SRWP.
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Affiliation(s)
- Jonathan Goldney
- Diabetes Research Centre, College of Life Sciences, University of Leicester, UK.
| | - Paddy C Dempsey
- Diabetes Research Centre, College of Life Sciences, University of Leicester, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW, UK
| | - Joseph Henson
- Diabetes Research Centre, College of Life Sciences, University of Leicester, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW, UK
| | - Alex Rowlands
- Diabetes Research Centre, College of Life Sciences, University of Leicester, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW, UK
| | - Atanu Bhattacharjee
- Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, UK
| | - Yogini V Chudasama
- Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, UK
| | - Cameron Razieh
- Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, UK; Office for National Statistics, Newport, UK
| | - Jari A Laukkanen
- Institute of Clinical Medicine and Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Central Finland Health Care District Hospital District, Department of Medicine, Finland District, Jyväskylä, Finland
| | - Melanie J Davies
- Diabetes Research Centre, College of Life Sciences, University of Leicester, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, College of Life Sciences, University of Leicester, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW, UK; Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, College of Life Sciences, University of Leicester, UK; NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW, UK
| | - Francesco Zaccardi
- Diabetes Research Centre, College of Life Sciences, University of Leicester, UK; Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, UK
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20
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Edwards JJ, Deenmamode AHP, Griffiths M, Arnold O, Cooper NJ, Wiles JD, O'Driscoll JM. Exercise training and resting blood pressure: a large-scale pairwise and network meta-analysis of randomised controlled trials. Br J Sports Med 2023; 57:1317-1326. [PMID: 37491419 DOI: 10.1136/bjsports-2022-106503] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVE To perform a large-scale pairwise and network meta-analysis on the effects of all relevant exercise training modes on resting blood pressure to establish optimal antihypertensive exercise prescription practices. DESIGN Systematic review and network meta-analysis. DATA SOURCES PubMed (Medline), the Cochrane library and Web of Science were systematically searched. ELIGIBILITY CRITERIA Randomised controlled trials published between 1990 and February 2023. All relevant work reporting reductions in systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) following an exercise intervention of ≥2 weeks, with an eligible non-intervention control group, were included. RESULTS 270 randomised controlled trials were ultimately included in the final analysis, with a pooled sample size of 15 827 participants. Pairwise analyses demonstrated significant reductions in resting SBP and DBP following aerobic exercise training (-4.49/-2.53 mm Hg, p<0.001), dynamic resistance training (-4.55/-3.04 mm Hg, p<0.001), combined training (-6.04/-2.54 mm Hg, p<0.001), high-intensity interval training (-4.08/-2.50 mm Hg, p<0.001) and isometric exercise training (-8.24/-4.00 mm Hg, p<0.001). As shown in the network meta-analysis, the rank order of effectiveness based on the surface under the cumulative ranking curve (SUCRA) values for SBP were isometric exercise training (SUCRA: 98.3%), combined training (75.7%), dynamic resistance training (46.1%), aerobic exercise training (40.5%) and high-intensity interval training (39.4%). Secondary network meta-analyses revealed isometric wall squat and running as the most effective submodes for reducing SBP (90.4%) and DBP (91.3%), respectively. CONCLUSION Various exercise training modes improve resting blood pressure, particularly isometric exercise. The results of this analysis should inform future exercise guideline recommendations for the prevention and treatment of arterial hypertension.
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Affiliation(s)
- Jamie J Edwards
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Algis H P Deenmamode
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Megan Griffiths
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Oliver Arnold
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Nicola J Cooper
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Jonathan D Wiles
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Jamie M O'Driscoll
- School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
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Christiansen HJ, Søgaard K, Justesen JB, Sjøgaard G, Dalager T. Long Term Cardiovascular Health Effects of Intelligent Physical Exercise Training Among Office Workers-A 2 Year Follow up of a Randomized Controlled Trial. J Occup Environ Med 2023; 65:813-819. [PMID: 37231634 DOI: 10.1097/jom.0000000000002892] [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: 05/27/2023]
Abstract
OBJECTIVE The aim of the study is to assess long-term effects of intelligent physical exercise training (IPET) on cardiorespiratory fitness (VO 2max ) and cardiometabolic measures. METHODS Office workers were randomized to a control group (CG, n = 194) or a training group (TG, n = 193). The TG received 1-hour weekly IPET during paid working hours for 2 years and recommendations to perform 30-minute leisure time physical activity 6 d/wk (LPA). RESULTS Training group compared with CG demonstrated a significantly larger increase in VO 2max of 0.13 ± 0.06 L/min and improved cardiometabolic measures at 1-year follow-up that were maintained at 2-year follow-up, with larger increases in VO 2max among high-adherence participants. CONCLUSIONS Intelligent physical exercise training and LPA showed the potential for long-term improved VO 2max and cardiometabolic measures. These findings emphasize the effectiveness of integrating IPET during paid working hours, and the significance of adherence to training was underlined.
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Affiliation(s)
- Helle Joon Christiansen
- From the Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark (H.J.C., K.S., J.B.J., G.S., T.D.); and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (H.J.C., T.D.)
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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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Onyekwere AO, Okobi OE, Ifiora FC, Akinboro MK, Akueme NT, Iroro J, Dan-Eleberi AO, Onyeaka FC, Ghansah AA. Association Between Wearable Device Use and Levels of Physical Activity Among Older Adults in the US: Evidence From the 2019-2020 Health Information National Trends Survey. Cureus 2023; 15:e44289. [PMID: 37779789 PMCID: PMC10533366 DOI: 10.7759/cureus.44289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 10/03/2023] Open
Abstract
Objective To examine the relationship between electronic wearable device (WD) use and physical activity (PA) levels among older adults in the US. Methods Data were pooled from 3310 older adults from the 2019 and 2020 Health Information National Trends Survey. The explanatory variable was WD use, and the outcomes were weekly PA levels, resistance training, and sedentary time. Logistic regression was conducted to investigate the association between WD use and the reported outcome variables. Separate logistic models were also fitted to explore the relationship between WD use and physical activity outcomes among a subgroup of older adults with chronic conditions. Results A total of 14.4% of older adults reported WD use. Older adults who use WD were more likely to meet national guidelines for weekly levels of PA (odds ratio (OR) 1.60, 95% confidence intervals (CI) (1.10, 2.32); p = 0.015) and resistance strength training (OR 1.54, 95% CI (1.14, 2.09); p = 0.005) when compared with their counterparts not using WD. After restricting the analysis to those with chronic conditions only, WD use was only associated with a higher level of weekly strength training (OR 1.68, 95% CI 1.19, 2.38; p = 0.004). Conclusion WD use may be associated with increased physical activity among older adults, including those with chronic health conditions. Further studies are needed to examine the factors influencing the adoption and sustained use of WD in older adults.
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Affiliation(s)
| | - Okelue E Okobi
- Family Medicine, Larkin Community Hospital Palm Springs Campus, Miami, USA
- Family Medicine, Medficient Health Systems, Laurel, USA
- Family Medicine, Lakeside Medical Center, Belle Glade, USA
| | - Francis C Ifiora
- Pharmacy, University of Texas Health Science Center at Houston, Houston, USA
| | - Micheal K Akinboro
- Epidemiology and Biostatistics, Texas A&M Health School of Public Health, College Station, USA
| | - Ngozi T Akueme
- Dermatology, University of Medical Sciences (UNIMED), Ondo, NGA
| | - Joy Iroro
- Internal Medicine, All Saints University School of Medicine, Roseau, DMA
| | | | - Faith C Onyeaka
- Haematology/Blood Transfusion Science, Madonna University, Calabar, NGA
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Ahn S, Pinheiro PS, McClure LA, Hernandez DR, Caban-Martinez AJ, Lee DJ. An examination of psychometric properties of study quality assessment scales in meta-analysis: Rasch measurement model applied to the firefighter cancer literature. PLoS One 2023; 18:e0284469. [PMID: 37494348 PMCID: PMC10370747 DOI: 10.1371/journal.pone.0284469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 03/31/2023] [Indexed: 07/28/2023] Open
Abstract
Most existing quality scales have been developed with minimal attention to accepted standards of psychometric properties. Even for those that have been used widely in medical research, limited evidence exists supporting their psychometric properties. The focus of our current study is to address this gap by evaluating the psychometrics properties of two existing quality scales that are frequently used in cancer observational research: (1) Item Bank on Risk of Bias and Precision of Observational Studies developed by the Research Triangle Institute (RTI) International and (2) Newcastle-Ottawa Quality Assessment Scale (NOQAS). We used the Rasch measurement model to evaluate the psychometric properties of two quality scales based on the ratings of 49 studies that examine firefighters' cancer incidence and mortality. Our study found that RTI and NOQAS have an acceptable item reliability. Two raters were consistent in their assessment, demonstrating high interrater reliability. We also found that NOQAS has more items that show better fit than the RTI scale. The NOQAS produced lower study quality scores with a smaller variation, suggesting that NOQAS items are much easier to rate. Our findings accord with a previous study, which conclude that the RTI scale was harder to apply and thus produces more heterogenous quality scores than NOQAS. Although both RTI and NOQAS showed high item reliability, NOQAS items are better fit to the underlying construct, showing higher validity of internal structure and stronger psychometric properties. The current study adds to our understanding of the psychometric properties of NOQAS and RTI scales for future meta-analyses of observational studies, particularly in the firefighter cancer literature.
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Affiliation(s)
- Soyeon Ahn
- Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami, Miami, Florida, United States of America
| | - Paulo S Pinheiro
- Sylvester Comprehensive Cancer Center, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Laura A McClure
- Sylvester Comprehensive Cancer Center, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, United States of America
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Diana R Hernandez
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Alberto J Caban-Martinez
- Sylvester Comprehensive Cancer Center, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, United States of America
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - David J Lee
- Sylvester Comprehensive Cancer Center, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, United States of America
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, United States of America
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Borodulin K, Anderssen S. Physical activity: associations with health and summary of guidelines. Food Nutr Res 2023; 67:9719. [PMID: 37441512 PMCID: PMC10335097 DOI: 10.29219/fnr.v67.9719] [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: 01/23/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 07/15/2023] Open
Abstract
The understanding of how physical activity and insufficient physical activity are associated with health outcomes has increased considerably over the past decades. Along with physical activity, the evidence on the associations between sedentary behavior and health has increased, which has resulted in the introduction of recommendations of sedentary behavior. In this article, we 1) present terminology for physical activity and sedentary behavior epidemiology, 2) show the relevant scientific evidence on associations of physical activity and sedentary behavior with selected health-related outcomes and 3) introduce the global guidelines for physical activity and sedentary behavior by the World Health Organization (WHO). Health-related outcomes include cardiovascular morbidity and mortality, total mortality, glucose regulation and type 2 diabetes, adiposity, overweight, obesity, cancer, musculoskeletal and bone health, brain health, and quality of life. These health-related outcomes are reflected across age groups and some population groups, such as pregnant and postpartum women. Furthermore, we discuss physical activity levels across Nordic countries and over time. For the Nordic Nutrition Recommendations, shared common physical activity guidelines were not developed. Instead, each country has created their own guidelines that are being referenced in the article, along with the global WHO guidelines.
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Affiliation(s)
| | - Sigmund Anderssen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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Kankaanpää A, Tolvanen A, Joensuu L, Waller K, Heikkinen A, Kaprio J, Ollikainen M, Sillanpää E. The associations of long-term physical activity in adulthood with later biological ageing and all-cause mortality - a prospective twin study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.06.02.23290916. [PMID: 37333101 PMCID: PMC10274991 DOI: 10.1101/2023.06.02.23290916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Objectives The association between leisure-time physical activity (LTPA) and a lower risk of mortality is susceptible to bias from multiple sources. We investigated the potential of biological ageing to mediate the association between long-term LTPA and mortality and whether the methods used to account for reverse causality affect the interpretation of this association. Methods Study participants were twins from the older Finnish Twin Cohort (n=22,750; 18-50 years at baseline). LTPA was assessed using questionnaires in 1975, 1981 and 1990. The mortality follow-up lasted until 2020 and biological ageing was assessed using epigenetic clocks in a subsample (n=1,153) with blood samples taken during the follow-up. Using latent profile analysis, we identified classes with distinct longitudinal LTPA patterns and studied differences in biological ageing between these classes. We employed survival models to examine differences in total, short-term and long-term all-cause mortality, and multilevel models for twin data to control for familial factors. Results We identified four classes of long-term LTPA: sedentary, moderately active, active and highly active. Although biological ageing was accelerated in sedentary and highly active classes, after adjusting for other lifestyle-related factors, the associations mainly attenuated. Physically active classes had a maximum 7% lower risk of total mortality over the sedentary class, but this association was consistent only in the short term and could largely be accounted for by familial factors. LTPA exhibited less favourable associations when prevalent diseases were exclusion criteria rather than covariate. Conclusion Being active may reflect a healthy phenotype instead of causally reducing mortality.
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Affiliation(s)
- Anna Kankaanpää
- Gerontology Research Center (GEREC), Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Asko Tolvanen
- Methodology Center for Human Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Laura Joensuu
- Gerontology Research Center (GEREC), Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Katja Waller
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Aino Heikkinen
- Institute for Molecular Medicine Finland (FIMM), HiLife, University of Helsinki, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), HiLife, University of Helsinki, Helsinki, Finland
| | - Miina Ollikainen
- Institute for Molecular Medicine Finland (FIMM), HiLife, University of Helsinki, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Elina Sillanpää
- Gerontology Research Center (GEREC), Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Wellbeing services county of Central Finland, Jyväskylä, Finland
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Li L, Wang Y, Yang C, Huang C, Duan L, Zhou J, Lu Y, Zhao G. Frailty in hypertensive population and its association with all-cause mortality: data from the National Health and Nutrition Examination Survey. Front Cardiovasc Med 2023; 10:945468. [PMID: 37180794 PMCID: PMC10167047 DOI: 10.3389/fcvm.2023.945468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 04/05/2023] [Indexed: 05/16/2023] Open
Abstract
Objectives This study aimed to investigate the relationship between frailty and all-cause mortality in hypertensive population. Methods We used data from the National Health and Nutrition Examination Survey (NHANES) 1999-2002 and mortality data from the National Death Index. Frailty was assessed using the revised version of the Fried frailty criteria (weakness, exhaustion, low physical activity, shrinking, and slowness). This study aimed to evaluate the association between frailty and all-cause mortality. Cox proportional hazard models were used to evaluate the association between frailty category and all-cause mortality, adjusted for age, sex, race, education, poverty-income ratio, smoking, alcohol, diabetes, arthritis, congestive heart failure, coronary heart disease, stroke, overweight, cancer or malignancy, chronic obstructive pulmonary disease, chronic kidney disease, and taking medicine for hypertension. Results We gathered data of 2,117 participants with hypertension; 17.81%, 28.77%, and 53.42% were classified as frail, pre-frail, and robust, respectively. We found that frail [hazard ratio (HR) = 2.76, 95% confidence interval (CI) = 2.33-3.27] and pre-frail (HR = 1.38, 95% CI = 1.19-1.59] were significantly associated with all-cause mortality after controlling for variables. We found that frail (HR = 3.02, 95% CI = 2.50-3.65) and pre-frail (HR = 1.35, 95% CI = 1.15-1.58) were associated with all-cause mortality in the age group ≥65 years. For the frailty components, weakness (HR = 1.77, 95% CI = 1.55-2.03), exhaustion (HR = 2.25, 95% CI = 1.92-2.65), low physical activity (HR = 2.25, 95% CI = 1.95-2.61), shrinking (HR = 1.48, 95% CI = 1.13-1.92), and slowness (HR = 1.44, 95% CI = 1.22-1.69) were associated with all-cause mortality. Conclusion This study demonstrated that frailty and pre-frailty were associated with an increased risk of all-cause mortality in patients with hypertension. More attention should be paid to frailty in hypertensive patients, and interventions to reduce the burden of frailty may improve outcomes in these patients.
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Affiliation(s)
- Li Li
- Department of Cardiovascular Surgery, The First Affliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuge Wang
- Department of Medicine, Jinggangshan University, Ji'an, China
| | - Chunlei Yang
- Department of Cardiology, The First Affliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chenhui Huang
- College of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Lanzhi Duan
- Department of Medicine, Jinggangshan University, Ji'an, China
| | - Jianghua Zhou
- Department of Cardiology, The First Affliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yanyu Lu
- Department of Cardiology, The First Affliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Guojun Zhao
- Department of Cardiology, The First Affliated Hospital of Zhengzhou University, Zhengzhou, China
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Jiravska Godula B, Jiravsky O, Pesova P, Jelinek L, Sovova M, Moravcova K, Ozana J, Hudec M, Miklik R, Hecko J, Sknouril L, Sovova E. Preparticipation Screening of Athletes: The Prevalence of Positive Family History. J Cardiovasc Dev Dis 2023; 10:jcdd10040183. [PMID: 37103062 PMCID: PMC10144243 DOI: 10.3390/jcdd10040183] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/08/2023] [Accepted: 04/19/2023] [Indexed: 04/28/2023] Open
Abstract
Sudden cardiac death (SCD) is a leading cause of death among athletes, and those with a positive family history (FH) of SCD and/or cardiovascular disease (CVD) may be at increased risk. The primary objective of this study was to assess the prevalence and predictors of positive FH of SCD and CVD in athletes using four widely used preparticipation screening (PPS) systems. The secondary objective was to compare the functionality of the screening systems. In a cohort of 13,876 athletes, 1.28% had a positive FH in at least one PPS system. Multivariate logistic regression analysis identified the maximum heart rate as significantly associated with positive FH (OR = 1.042, 95% CI = 1.027-1.056, p < 0.001). The highest prevalence of positive FH was found using the PPE-4 system (1.20%), followed by FIFA, AHA, and IOC systems (1.11%, 0.89%, and 0.71%, respectively). In conclusion, the prevalence of positive FH for SCD and CVD in Czech athletes was found to be 1.28%. Furthermore, positive FH was associated with a higher maximum heart rate at the peak of the exercise test. The findings of this study revealed significant differences in detection rates between PPS protocols, so further research is needed to determine the optimal method of FH collection.
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Affiliation(s)
- Bogna Jiravska Godula
- Faculty of Medicine, Palacky University, Krizkovskeho 511/8, 779 00 Olomouc, Czech Republic
- Sports Cardiology Center, Nemocnice Agel Trinec-Podlesi, Konska 453, 739 61 Trinec, Czech Republic
| | - Otakar Jiravsky
- Sports Cardiology Center, Nemocnice Agel Trinec-Podlesi, Konska 453, 739 61 Trinec, Czech Republic
- Faculty of Medicine, Masaryk University, Kamenice 735/5, 625 00 Brno, Czech Republic
| | - Petra Pesova
- Faculty of Medicine, Palacky University, Krizkovskeho 511/8, 779 00 Olomouc, Czech Republic
- Sports Cardiology Center, Nemocnice Agel Trinec-Podlesi, Konska 453, 739 61 Trinec, Czech Republic
| | - Libor Jelinek
- Faculty of Medicine, Palacky University, Krizkovskeho 511/8, 779 00 Olomouc, Czech Republic
| | - Marketa Sovova
- Faculty of Medicine, Palacky University, Krizkovskeho 511/8, 779 00 Olomouc, Czech Republic
| | - Katarina Moravcova
- Faculty of Medicine, Palacky University, Krizkovskeho 511/8, 779 00 Olomouc, Czech Republic
| | - Jaromir Ozana
- Faculty of Medicine, Palacky University, Krizkovskeho 511/8, 779 00 Olomouc, Czech Republic
| | - Miroslav Hudec
- Sports Cardiology Center, Nemocnice Agel Trinec-Podlesi, Konska 453, 739 61 Trinec, Czech Republic
- Faculty of Medicine, Masaryk University, Kamenice 735/5, 625 00 Brno, Czech Republic
| | - Roman Miklik
- Sports Cardiology Center, Nemocnice Agel Trinec-Podlesi, Konska 453, 739 61 Trinec, Czech Republic
- Faculty of Medicine, Masaryk University, Kamenice 735/5, 625 00 Brno, Czech Republic
| | - Jan Hecko
- Sports Cardiology Center, Nemocnice Agel Trinec-Podlesi, Konska 453, 739 61 Trinec, Czech Republic
- Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, 708 33 Ostrava, Czech Republic
| | - Libor Sknouril
- Sports Cardiology Center, Nemocnice Agel Trinec-Podlesi, Konska 453, 739 61 Trinec, Czech Republic
| | - Eliska Sovova
- Faculty of Medicine, Palacky University, Krizkovskeho 511/8, 779 00 Olomouc, Czech Republic
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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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Ocagli H, Agarinis R, Azzolina D, Zabotti A, Treppo E, Francavilla A, Bartolotta P, Todino F, Binutti M, Gregori D, Quartuccio L. Physical activity assessment with wearable devices in rheumatic diseases: a systematic review and meta-analysis. Rheumatology (Oxford) 2023; 62:1031-1046. [PMID: 36005834 DOI: 10.1093/rheumatology/keac476] [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: 03/27/2022] [Revised: 08/13/2022] [Accepted: 08/13/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES In the management of rheumatic musculoskeletal disorders (RMDs), regular physical activity (PA) is an important recognized non-pharmacological intervention. This systematic review and meta-analysis aims to evaluate how the use of wearable devices (WDs) impacts physical activity in patients with noninflammatory and inflammatory rheumatic diseases. METHODS A comprehensive search of articles was performed in PubMed, Embase, CINAHL and Scopus. A random-effect meta-analysis was carried out on the number of steps and moderate-vigorous physical activity (MVPA). Univariable meta-regression models were computed to assess the possibility that the study characteristics may act as modifiers on the final meta-analysis estimate. RESULTS In the analysis, 51 articles were included, with a total of 7488 participants. Twenty-two studies considered MVPA outcome alone, 16 studies considered the number of steps alone, and 13 studies reported information on both outcomes. The recommended PA threshold was reached for MVPA (36.35, 95% CI 29.39, 43.31) but not for daily steps (-1092.60, -1640.42 to -544.77). Studies on patients with fibromyalgia report a higher number (6290, 5198.65-7381.62) of daily steps compared with other RMDs. Patients affected by chronic inflammatory arthropathies seemed to fare better in terms of daily steps than the other categories. Patients of younger age reported a higher overall level of PA than elderly individuals for both the number of steps and MVPA. CONCLUSION Physical activity can be lower than the recommended threshold in patients with RMDs when objectively measured using WD. WDs could be a useful and affordable instrument for daily monitoring physical activity in RMDs and may support an increase in activity levels. PROSPERO TRIAL REGISTRATION CRD42021227681, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=227681.
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Affiliation(s)
- Honoria Ocagli
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova
| | - Roberto Agarinis
- Division of Rheumatology, Department of Medicine, University of Udine, ASUFC, Udine
| | - Danila Azzolina
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova.,Department of Medical Science, University of Ferrara, Ferrara, Italy
| | - Alen Zabotti
- Division of Rheumatology, Department of Medicine, University of Udine, ASUFC, Udine
| | - Elena Treppo
- Division of Rheumatology, Department of Medicine, University of Udine, ASUFC, Udine
| | - Andrea Francavilla
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova
| | - Patrizia Bartolotta
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova
| | - Federica Todino
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova
| | - Marco Binutti
- Division of Rheumatology, Department of Medicine, University of Udine, ASUFC, Udine
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova
| | - Luca Quartuccio
- Division of Rheumatology, Department of Medicine, University of Udine, ASUFC, Udine
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Erevik CB, Kleiven Ø, Frøysa V, Bjørkavoll-Bergseth M, Chivulescu M, Klæboe LG, Dejgaard L, Auestad B, Skadberg Ø, Melberg T, Urheim S, Haugaa K, Edvardsen T, Ørn S. Myocardial inefficiency is an early indicator of exercise-induced myocardial fatigue. Front Cardiovasc Med 2023; 9:1081664. [PMID: 36712275 PMCID: PMC9874326 DOI: 10.3389/fcvm.2022.1081664] [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: 10/27/2022] [Accepted: 12/22/2022] [Indexed: 01/12/2023] Open
Abstract
Background The effect of prolonged, high-intensity endurance exercise on myocardial function is unclear. This study aimed to determine the left ventricular (LV) response to increased exercise duration and intensity using novel echocardiographic tools to assess myocardial work and fatigue. Materials and methods LV function was assessed by echocardiography before, immediately, and 24 h after a cardiopulmonary exercise test (CPET) and a 91-km mountain bike leisure race. Cardiac Troponin I (cTnI) was used to assess myocyte stress. Results 59 healthy recreational athletes, 52 (43-59) years of age, 73% males, were included. The race was longer and of higher intensity generating higher cTnI levels compared with the CPET (p < 0.0001): Race/CPET: exercise duration: 230 (210, 245)/43 (40, 45) minutes, mean heart rate: 154 ± 10/132 ± 12 bpm, max cTnI: 77 (37, 128)/12 (7, 23) ng/L. Stroke volume and cardiac output were higher after the race than CPET (p < 0.005). The two exercises did not differ in post-exercise changes in LV ejection fraction (LVEF) or global longitudinal strain (GLS). There was an increase in global wasted work (p = 0.001) following the race and a persistent reduction in global constructive work 24 h after exercise (p = 0.003). Conclusion Increased exercise intensity and duration were associated with increased myocardial wasted work post-exercise, without alterations in LVEF and GLS from baseline values. These findings suggest that markers of myocardial inefficiency may precede reduction in global LV function as markers of myocardial fatigue.
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Affiliation(s)
- Christine Bjørkvik Erevik
- Department of Cardiology, Stavanger University Hospital, Stavanger, Norway,*Correspondence: Christine Bjørkvik Erevik,
| | - Øyunn Kleiven
- Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
| | - Vidar Frøysa
- Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
| | | | - Monica Chivulescu
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Lars Gunnar Klæboe
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Lars Dejgaard
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Bjørn Auestad
- Department of Mathematics and Physics, University of Stavanger, Stavanger, Norway,Research Department, Stavanger University Hospital, Stavanger, Norway
| | - Øyvind Skadberg
- Department of Biochemistry, Stavanger University Hospital, Stavanger, Norway
| | - Tor Melberg
- Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
| | - Stig Urheim
- Department of Cardiology, Bergen University Hospital, Bergen, Norway
| | - Kristina Haugaa
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Thor Edvardsen
- ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Stein Ørn
- Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
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Cardiac troponin release in athletes: What do we know and where should we go? CURRENT OPINION IN PHYSIOLOGY 2023. [DOI: 10.1016/j.cophys.2022.100629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Duncan MJ, Oftedal S, Kline CE, Plotnikoff RC, Holliday EG. Associations between aerobic and muscle-strengthening physical activity, sleep duration, and risk of all-cause mortality: A prospective cohort study of 282,473 U.S. adults. JOURNAL OF SPORT AND HEALTH SCIENCE 2023; 12:65-72. [PMID: 35872092 PMCID: PMC9923431 DOI: 10.1016/j.jshs.2022.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/25/2022] [Accepted: 06/14/2022] [Indexed: 05/28/2023]
Abstract
PURPOSE To examine the joint associations between meeting guidelines for physical activity (PA) and sleep duration and all-cause mortality risk among adults. METHODS Participants were adults (n = 282,473) aged 18-84 years who participated in the 2004-2014 U.S. National Health Interview Survey. Mortality status was ascertained using the National Death Index through December 2015. Self-reported PA (Active: meeting both aerobic (AER) and muscle-strengthening (MSA) guidelines, AER only (AER), MSA only (MSA), or not meeting either AER or MSA (Inactive)) and sleep duration (Short, recommended (Rec), or Long) were classified according to guidelines, and 12 PA-sleep categories were derived. Adjusted hazard ratios and 95% confidence intervals (95%CIs) for all-cause mortality risk were estimated using Cox proportional hazards regression models. RESULTS A total of 282,473 participants (55% females) were included; 18,793 deaths (6.7%) occurred over an average follow-up of 5.4 years. Relative to the Active-Rec group, all other PA-sleep groups were associated with increased mortality risk except for the Active-Short group (hazard ratio = 1.08; 95%CI: 0.92-1.26). The combination of long sleep with either MSA or Inactive appeared to be synergistic. For a given sleep duration, mortality risk progressively increased among participants classified as AER, MSA, and Inactive. Within each activity level, the mortality risk was greatest among adults with long sleep. CONCLUSION Relative to adults meeting guidelines for both PA and sleep duration, adults who failed to meet guidelines for both AER and muscle strengthening PA and who also failed to meet sleep duration guidelines had elevated all-cause mortality risks. These results support interventions targeting both PA and sleep duration to reduce mortality risk.
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Affiliation(s)
- Mitch J Duncan
- School of Medicine & Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia; Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Stina Oftedal
- School of Medicine & Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia; Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Christopher E Kline
- Department of Health & Human Development, The University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Ronald C Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia; School of Education, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Elizabeth G Holliday
- School of Medicine & Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
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Hassan L, Huhndorf P, Mikolajczyk R, Kluttig A. Physical activity trajectories at older age and all-cause mortality: A cohort study. PLoS One 2023; 18:e0280878. [PMID: 36701298 PMCID: PMC9879516 DOI: 10.1371/journal.pone.0280878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/10/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND A physically active lifestyle is recognized as a precondition of healthy aging. However, the majority of studies exploring its association with mortality in cohorts of adults used single-time physical activity (PA) estimate, which do not consider its dynamic nature with changes that occur with aging. The aim of the present study is to explore the presence of different PA trajectories in a population-based cohort and their association with mortality. METHODS We used data of the population-based cohort study CARLA and included 1041 older adults (45-83 years at baseline) with self-reported physical activity at baseline (2002-2006), first follow-up (2007-2010) and second follow-up (2013). Trajectories were identified using growth mixture modelling. Cox proportional hazard models were used to assess the association between trajectories of PA and all-cause mortality during ~6 years since the second follow-up after adjusting for age, sex, lifestyle factors and comorbidities and after correction for classification error. In a sensitivity analysis we weighted the models to account for selection bias during follow-up. As a further sensitivity analysis, we excluded the first year of follow-up to account for reverse causation. RESULTS Three PA trajectories (categorized as consistently low, consistently moderate, and high at baseline but strongly decreasing PA across time) were identified, and 121 deaths due to all causes occurred. Compared with participants who had consistently low PA-levels throughout the follow-up period, participants who maintained moderate PA-levels were at a lower risk of all-cause mortality (hazard ratio [HR], 0.49; 95%CI, 0.30-0.70). Participants with high PA-levels at baseline but strongly decreasing PA across time, had similar mortality risk compared to the participants with consistently low PA-levels (hazard ratio [HR], 0.97; 95%CI, 0.50-1.80). The effects were strengthened in the analysis weighted for selection bias. CONCLUSIONS Our results suggest that, compared to those who had consistently low PA levels, those who maintained a moderate level of PA showed a protective effect in terms of their mortality risk but not those who displayed a decline from high PA levels.
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Affiliation(s)
- Lamiaa Hassan
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Peter Huhndorf
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Rafael Mikolajczyk
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Alexander Kluttig
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- * E-mail:
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Lim E, Ramachandran HJ, Er JBT, Ng P, Tam WWS, Jiang Y. The predictors of health-enhancing physical activity among working women in Singapore two years into COVID-19: a cross-sectional study. Sci Rep 2022; 12:21493. [PMID: 36513715 PMCID: PMC9747910 DOI: 10.1038/s41598-022-26022-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
Physical activity (PA) levels may have changed since the COVID-19 pandemic. However, these changes are not well understood. The study aimed to describe the PA level and examine the predictive factors of a health-enhancing PA level among working women in Singapore two years into the COVID-19 pandemic. We undertook a cross-sectional descriptive correlational study. Three hundred participants were recruited and completed the online questionnaire between October and November 2021. In the PA analysis of 217 participants, only 32.7% of the participants achieved a health-enhancing PA level, while 44.7% of the total sample sat for 7 h or more daily. In the univariate analysis, occupation, nationality, monthly income, and average daily sitting hours were significantly associated with a high PA level. The current mode of work, living arrangement, and health-promoting lifestyle profile II_physical activity score remained significant in both univariate and multivariate analyses. Participants who worked from home and stayed with their families were less likely to achieve a health-enhancing PA level than those who had a regular workplace and did not stay with their families. Working women with a health-promoting physically active lifestyle were likelier to achieve a health-enhancing PA level. The long daily sitting time and suboptimal health-enhancing PA participation underscore the need for health promotion initiatives for working women.
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Affiliation(s)
- Ellene Lim
- National University Heart Center, National University Health System, Singapore, Singapore
| | - Hadassah Joann Ramachandran
- grid.4280.e0000 0001 2180 6431Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD, 11,10 Medical Drive, Singapore, 117597 Singapore
| | - Joyce Biaw Theng Er
- grid.413587.c0000 0004 0640 6829Alexandra Hospital, National University Health System, Singapore, Singapore
| | - Pearlyn Ng
- grid.413587.c0000 0004 0640 6829Alexandra Hospital, National University Health System, Singapore, Singapore
| | - Wilson Wai San Tam
- grid.4280.e0000 0001 2180 6431Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD, 11,10 Medical Drive, Singapore, 117597 Singapore
| | - Ying Jiang
- grid.4280.e0000 0001 2180 6431Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD, 11,10 Medical Drive, Singapore, 117597 Singapore
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Javaid A, Zghyer F, Kim C, Spaulding EM, Isakadze N, Ding J, Kargillis D, Gao Y, Rahman F, Brown DE, Saria S, Martin SS, Kramer CM, Blumenthal RS, Marvel FA. Medicine 2032: The future of cardiovascular disease prevention with machine learning and digital health technology. Am J Prev Cardiol 2022; 12:100379. [PMID: 36090536 PMCID: PMC9460561 DOI: 10.1016/j.ajpc.2022.100379] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/21/2022] [Accepted: 08/28/2022] [Indexed: 11/30/2022] Open
Abstract
Machine learning (ML) refers to computational algorithms that iteratively improve their ability to recognize patterns in data. The digitization of our healthcare infrastructure is generating an abundance of data from electronic health records, imaging, wearables, and sensors that can be analyzed by ML algorithms to generate personalized risk assessments and promote guideline-directed medical management. ML's strength in generating insights from complex medical data to guide clinical decisions must be balanced with the potential to adversely affect patient privacy, safety, health equity, and clinical interpretability. This review provides a primer on key advances in ML for cardiovascular disease prevention and how they may impact clinical practice.
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Xiao X, Tang C, Zhai X, Li S, Ma W, Liu K, Kokoro S, Sheerah HA, Zhu H, Cao J. Early-Adulthood Weight Change and Later Physical Activity in Relation to Cardiovascular and All-Cause Mortality: NHANES 1999-2014. Nutrients 2022; 14:nu14234974. [PMID: 36501003 PMCID: PMC9736862 DOI: 10.3390/nu14234974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/12/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022] Open
Abstract
Limited evidence investigated the combined influence of early-adulthood weight change and later physical activity on the risk of cardiovascular (CVD) and all-cause mortality. The aim of this study is to explore the associations of early-adulthood weight change and later physical activity with CVD and all-cause mortality. This is a cohort study of 23,193 US adults aged 40 to 85 years from the National Health and Nutrition Examination Survey (NHANES) 1999 to 2014. Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) of CVD and all-cause mortality associated with early-adulthood weight change and later physical activity. During a median follow-up of 9.2 years, there were 533 and 2734 cases of CVD and all-cause deaths. Compared with being physically inactive, the HRs of the CVD mortality of being physically active were 0.44 (0.26 to 0.73), 0.58 (0.19 to 1.82), 0.38 (0.17 to 0.86) and 0.46 (0.21 to 1.02) among individuals with stable normal, stable obese, non-obese to obese and maximum overweight early-adulthood weight change patterns. Using stable normal patterns that were physically active later as the reference, other early-adulthood weight change patterns did not show a significantly higher risk of CVD mortality when participants were physically active in later life; later physically inactive participants had a significantly increased risk of CVD mortality, with HRs of 2.17 (1.30 to 3.63), 5.32 (2.51 to 11.28), 2.59 (1.29 to 5.18) and 2.63 (1.32 to 5.26) in the stable normal, stable obese, non-obese to obese and maximum overweight groups, respectively. Similar results can be seen in the analyses for all-cause mortality. Our findings suggest that inadequate physical activity worsens the negative impact of unhealthy early-adulthood weight change patterns, which is worthy of being noted in the improvement of public health.
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Affiliation(s)
- Xinyu Xiao
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Chengyao Tang
- Biomedical Statistics, Department of Integrated Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi 565-0871, Osaka, Japan
| | - Xiaobing Zhai
- Center for Artificial Intelligence Driven Drug Discovery, Faculty of Applied Sciences, Macao Polytechnic University, Macau SAR, China
| | - Shiyang Li
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Wenzhi Ma
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Keyang Liu
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi 565-0871, Osaka, Japan
| | - Shirai Kokoro
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi 565-0871, Osaka, Japan
| | | | - Huiping Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, China
- Correspondence: (J.C.); (H.Z.); Tel./Fax: +86-27-68759299 (J.C.)
| | - Jinhong Cao
- School of Public Health, Wuhan University, Wuhan 430071, China
- Correspondence: (J.C.); (H.Z.); Tel./Fax: +86-27-68759299 (J.C.)
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Liu D, Han S, Zhou C. The Influence of Physical Exercise Frequency and Intensity on Individual Entrepreneurial Behavior: Evidence from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12383. [PMID: 36231684 PMCID: PMC9564728 DOI: 10.3390/ijerph191912383] [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: 08/25/2022] [Revised: 09/21/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
Physical exercise can benefit individuals' physical and mental health and also influence individuals' long-term behavioral choices. Doing exercise is particularly important given that physical exercise can impact individuals' cognitive abilities and positive emotional states, which may further impact entrepreneurial behavior. Therefore, understanding the relationship between exercise and entrepreneurial behavior is essential, because it can provide policy suggestions for popularizing athletic activities and boosting entrepreneurship. Consequently, the present study examined whether physical exercise could predict entrepreneurial behavior and the possible psychological mechanisms within this relationship. Based on the 2017 Chinese General Social Survey (CGSS2017), this study tested the hypotheses using the Probit and Tobit models. The results showed that individuals' physical exercise intensity and frequency positively affected their entrepreneurial behavior. In addition, five variables moderated the relationships between physical exercise and individual entrepreneurial behavior: urban-rural differences, education level, marital status, the existence of minor children, and age. Moreover, positive emotions and physical/mental health mediated the influence of physical exercise (exercise frequency and exercise intensity) on individual entrepreneurial behavior. Endogeneity explanations were ruled out by including instrumental variable, copula terms and adopting coarsened exact matching.
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Affiliation(s)
- Dewen Liu
- School of Management, Nanjing University of Posts and Telecommunications, Nanjing 210003, China
| | - Shenghao Han
- College of Business, Shanghai University of Finance and Economics, Shanghai 200433, China
| | - Chunyang Zhou
- College of Business, Shanghai University of Finance and Economics, Shanghai 200433, China
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Gorzelitz J, Trabert B, Katki HA, Moore SC, Watts EL, Matthews CE. Independent and joint associations of weightlifting and aerobic activity with all-cause, cardiovascular disease and cancer mortality in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Br J Sports Med 2022; 56:1277-1283. [PMID: 36167669 DOI: 10.1136/bjsports-2021-105315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Both aerobic moderate to vigorous physical activity (MVPA) and muscle-strengthening exercise (MSE) are recommended, but the mortality benefits of weightlifting, a specific type of MSE, are limited. METHODS In the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial, we used Cox proportional hazards regression to calculate hazard ratios (HRs) and 95% CIs for the associations between weightlifting and mortality, adjusting for demographics, lifestyle and behavioural risk factors. The sample included 99 713 adults who completed the follow-up questionnaire that assessed weightlifting who were subsequently followed up through 2016 to determine mortality (median 9, IQR 7.6-10.6 years). RESULTS Mean age at the follow-up questionnaire was 71.3 (IQR 66-76) years, 52.6% female, with mean body mass index of 27.8 (SD 4.9) kg/m2. Weightlifting was associated with a 9% lower risk of all-cause mortality (HR=0.91 (95% CI 0.88 to 0.94)) and CVD mortality (0.91 (95% CI 0.86 to 0.97)) after adjusting for MVPA. Joint models revealed that adults who met aerobic MVPA recommendations but did not weightlift had a 32% lower all-cause mortality risk (HR=0.68 (95% CI 0.65 to 0.70)), while those who also reported weightlifting 1-2 times/week had a 41% lower risk (HR=0.59 (95% CI 0.54 to 0.64)), both compared with adults reporting no aerobic MVPA or weightlifting. Without adjustment for MVPA, weightlifting was associated with lower cancer mortality (HR=0.85 (95% CI 0.80 to 0.91)). CONCLUSION Weightlifting and MVPA were associated with a lower risk of all-cause and CVD mortality, but not cancer mortality. Adults who met recommended amounts of both types of exercise appeared to gain additional benefit.
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Affiliation(s)
- Jessica Gorzelitz
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Britton Trabert
- University of Utah Health Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Hormuzd A Katki
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Steven C Moore
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Eleanor L Watts
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
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Dietary Inflammatory Index and Mortality from All Causes, Cardiovascular Disease, and Cancer: A Prospective Study. Cancers (Basel) 2022; 14:cancers14194609. [PMID: 36230532 PMCID: PMC9564054 DOI: 10.3390/cancers14194609] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
The Energy-adjusted Dietary Inflammatory Index (E-DIITM) is a comprehensive, literature-derived index for assessing the effect of dietary constituents on inflammatory biomarkers and inflammation-related chronic diseases. Several studies have examined the association between E-DII scores and mortality, with results that vary across populations. Therefore, in the present study, we aimed to investigate the potential association between E-DII scores and all-cause, cardiovascular disease (CVD), and cancer mortality using data from the Prostate, Lung, Colorectal and Ovarian (PLCO) Screening Trial. E-DII scores, calculated based on a food-frequency questionnaire, were analyzed both as a continuous variable and after categorization into quintiles. A multivariate Cox proportional hazards model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). A total of 101,832 individuals were included, with 24,141 deaths recorded after a median of 17.0 years of follow-up. In multivariable-adjusted analyses, the E-DII score was significantly associated with all-cause mortality. The HR (95% CI) in the highest E-DII quintile compared to the lowest quintile was 1.23 (1.18–1.29). The E-DII was also statistically related to CVD mortality (Q5 vs. Q1; HR, 1.30 [95% CI, 1.20–1.41]) and cancer mortality (Q5 vs. Q1; HR, 1.14 [95% CI, 1.06–1.24]). Similar results were obtained from sensitivity analyses and subgroup analyses. In conclusion, the inflammatory potential of the diet, as calculated by the E-DII, was significantly associated with overall and CVD- and cancer-specific mortality risk in the PLCO study.
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Tucker WJ, Fegers-Wustrow I, Halle M, Haykowsky MJ, Chung EH, Kovacic JC. Exercise for Primary and Secondary Prevention of Cardiovascular Disease: JACC Focus Seminar 1/4. J Am Coll Cardiol 2022; 80:1091-1106. [PMID: 36075680 DOI: 10.1016/j.jacc.2022.07.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/01/2022] [Accepted: 07/11/2022] [Indexed: 01/09/2023]
Abstract
Regular exercise that meets or exceeds the current physical activity guidelines is associated with a reduced risk of cardiovascular disease (CVD) and mortality. Therefore, exercise training plays an important role in primary and secondary prevention of CVD. In this part 1 of a 4-part focus seminar series, we highlight the mechanisms and physiological adaptations responsible for the cardioprotective effects of exercise. This includes an increase in cardiorespiratory fitness secondary to cardiac, vascular, and skeletal muscle adaptations and an improvement in traditional and nontraditional CVD risk factors by exercise training. This extends to the role of exercise and its prescription in patients with CVDs (eg, coronary artery disease, chronic heart failure, peripheral artery disease, or atrial fibrillation) with special focus on the optimal mode, dosage, duration, and intensity of exercise to reduce CVD risk and improve clinical outcomes in these patients.
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Affiliation(s)
- Wesley J Tucker
- Department of Nutrition and Food Sciences, Texas Woman's University, Houston, Texas, USA; Institute for Women's Health, College of Health Sciences, Houston, Texas, USA
| | - Isabel Fegers-Wustrow
- Department of Prevention and Sports Medicine, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Martin Halle
- Department of Prevention and Sports Medicine, University Hospital Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
| | - Mark J Haykowsky
- College of Health Sciences, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Eugene H Chung
- Cardiac Electrophysiology Service, Sports Cardiology Clinic, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Jason C Kovacic
- Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
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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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Lippi G, Sanchis-Gomar F, Lavie CJ. Increased HDL-C Values and Mortality: Revolutionizing a Historical Paradigm? Semin Thromb Hemost 2022; 48:988-990. [PMID: 36055258 DOI: 10.1055/s-0042-1753484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry and School of Medicine, University of Verona, Verona, Italy
| | - Fabian Sanchis-Gomar
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, Louisiana
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Lee DH, Rezende LFM, Joh HK, Keum N, Ferrari G, Rey-Lopez JP, Rimm EB, Tabung FK, Giovannucci EL. Long-Term Leisure-Time Physical Activity Intensity and All-Cause and Cause-Specific Mortality: A Prospective Cohort of US Adults. Circulation 2022; 146:523-534. [PMID: 35876019 PMCID: PMC9378548 DOI: 10.1161/circulationaha.121.058162] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The 2018 physical activity guidelines for Americans recommend a minimum of 150 to 300 min/wk of moderate physical activity (MPA), 75 to 150 min/wk of vigorous physical activity (VPA), or an equivalent combination of both. However, it remains unclear whether higher levels of long-term VPA and MPA are, independently and jointly, associated with lower mortality. METHODS A total of 116 221 adults from 2 large prospective US cohorts (Nurses' Health Study and Health Professionals Follow-up Study, 1988-2018) were analyzed. Detailed self-reported leisure-time physical activity was assessed with a validated questionnaire, repeated up to 15 times during the follow-up. Cox regression was used to estimate the hazard ratio and 95% CI of the association between long-term leisure-time physical activity intensity and all-cause and cause-specific mortality. RESULTS During 30 years of follow-up, we identified 47 596 deaths. In analyses mutually adjusted for MPA and VPA, hazard ratios comparing individuals meeting the long-term leisure-time VPA guideline (75-149 min/wk) versus no VPA were 0.81 (95% CI, 0.76-0.87) for all-cause mortality, 0.69 (95% CI, 0.60-0.78) for cardiovascular disease (CVD) mortality, and 0.85 (95% CI, 0.79-0.92) for non-CVD mortality. Meeting the long-term leisure-time MPA guideline (150-299 min/wk) was similarly associated with lower mortality: 19% to 25% lower risk of all-cause, CVD, and non-CVD mortality. Compared with those meeting the long-term leisure-time physical activity guidelines, participants who reported 2 to 4 times above the recommended minimum of long-term leisure-time VPA (150-299 min/wk) or MPA (300-599 min/wk) showed 2% to 4% and 3% to 13% lower mortality, respectively. Higher levels of either long-term leisure-time VPA (≥300 min/wk) or MPA (≥600 min/wk) did not clearly show further lower all-cause, CVD, and non-CVD mortality or harm. In joint analyses, for individuals who reported <300 min/wk of long-term leisure-time MPA, additional leisure-time VPA was associated with lower mortality; however, among those who reported ≥300 min/wk of long-term leisure-time MPA, additional leisure-time VPA did not appear to be associated with lower mortality beyond MPA. CONCLUSIONS The nearly maximum association with lower mortality was achieved by performing ≈150 to 300 min/wk of long-term leisure-time VPA, 300 to 600 min/wk of long-term leisure-time MPA, or an equivalent combination of both.
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Affiliation(s)
- Dong Hoon Lee
- Department of Nutrition, Harvard T.H. Chan School of Public
Health, Boston, MA, USA
| | - Leandro F. M. Rezende
- Department of Preventive Medicine, Escola Paulista de
Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Hee-Kyung Joh
- Department of Nutrition, Harvard T.H. Chan School of Public
Health, Boston, MA, USA
- Department of Medicine, Seoul National University College
of Medicine, Seoul, Republic of Korea
- Department of Family Medicine, Seoul National University
Hospital, Seoul, Republic of Korea
| | - NaNa Keum
- Department of Nutrition, Harvard T.H. Chan School of Public
Health, Boston, MA, USA
- Department of Food Science and Biotechnology, Dongguk
University, Goyang, South Korea
| | - Gerson Ferrari
- Universidad de Santiago de Chile (USACH), Escuela de
Ciencias de la Actividad Física, el Deporte y la Salud, Santiago, Chile
| | - Juan Pablo Rey-Lopez
- Faculty of Health Sciences, International University of
Valencia (VIU), Valencia, Spain
- Faculty of Sport, Catholic University of Murcia (UCAM),
Murcia, Spain
| | - Eric B. Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public
Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of
Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of
Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston,
MA, USA
| | - Fred K. Tabung
- Department of Nutrition, Harvard T.H. Chan School of Public
Health, Boston, MA, USA
- Division of Medical Oncology, Department of Internal
Medicine, The Ohio State University College of Medicine and Comprehensive Cancer
Center – James Cancer Hospital and Solove Research Institute, Columbus, OH,
USA
| | - Edward L. Giovannucci
- Department of Nutrition, Harvard T.H. Chan School of Public
Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of
Public Health, Boston, MA, USA
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Guo Z, Li R, Lu S. Leisure-time physical activity and risk of depression: A dose-response meta-analysis of prospective cohort studies. Medicine (Baltimore) 2022; 101:e29917. [PMID: 35905243 PMCID: PMC9333473 DOI: 10.1097/md.0000000000029917] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND There has never been a dose-response meta-analysis of the relationship between physical activity and the risk of depression. Hence, we aimed to explore the dose-response relationship between leisure-time physical activity (LTPA) and the risk of depression through a meta-analysis to provide a basis for the prevention of depression. METHODS PubMed and Web of Science databases were searched using a computer to collect prospective cohort studies on the relationship between LTPA and depression between January 1997 and July 2021. A dose-response meta-analysis was performed using the Stata 14 software to calculate the combined effect size relative risk (RR and 95% confidence interval CI). RESULTS Twelve cohort studies included 310,359 subjects who met the inclusion criteria. The categorical dose-response analysis results showed that the risk of incident depression was 27%, 17%, and 8% lower for the light, moderate, and highest dose LTPA participants, respectively (RR: 0.73, 95% CI: 0.64-0.82; RR: 0.83, 95% CI: 0.78-0.87; RR: 0.92, 95% CI: 0.86-0.99), compared with the lowest LTPA category. Continuous dose-response analysis showed a nonlinear relationship between LTPA and the risk of incident depression (P = .04). The risk of incident depression was reduced by 3% (RR: 0.97, 95% CI: 0.95-0.98) for every 5 MET-h/week increase in LTPA < 25 MET-h/week; when LTPA was higher than 25 MET-h/week, a 4% increase in the risk of depression for every 5 MET-h/week increase was observed (RR: 1.04, 95% CI: 1.02-1.05). CONCLUSIONS There was a nonlinear relationship between LTPA and the risk of incident depression. Moderate and low doses of LTPA were protective factors in preventing the risk of incident depression, while high doses of LTPA may increase the risk of incident depression.
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Affiliation(s)
- ZhiGuang Guo
- School of Sports Health, HuBei University of Chinese Medicine, Wuhan, China
| | - Rui Li
- School of Physical Education, Central China Normal University, Wuhan, China
- Institute of Physical Education, Kashgar University, Kashi, China
| | - Songtao Lu
- School of Physical Education, Central China Normal University, Wuhan, China
- School of Sports, Wuhan University of Science and Technology, Wuhan, China
- *Correspondence: Songtao Lu, MD, School of Sports, Wuhan University of Science and Technology, No.16, Huangjiahu West Road, Hongshan District, Wuhan 430065, Hubei Province, China (e-mail: )
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Kopec JA, Sayre EC, Shams B, Li LC, Xie H, Feehan LM, Esdaile JM. The Impact of 51 Risk Factors on Life Expectancy in Canada: Findings from a New Risk Prediction Model Based on Data from the Global Burden of Disease Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158958. [PMID: 35897329 PMCID: PMC9332720 DOI: 10.3390/ijerph19158958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 12/04/2022]
Abstract
The aims of this study were (1) to develop a comprehensive risk-of-death and life expectancy (LE) model and (2) to provide data on the effects of multiple risk factors on LE. We used data for Canada from the Global Burden of Disease (GBD) Study. To create period life tables for males and females, we obtained age/sex-specific deaths rates for 270 diseases, population distributions for 51 risk factors, and relative risk functions for all disease-exposure pairs. We computed LE gains from eliminating each factor, LE values for different levels of exposure to each factor, and LE gains from simultaneous reductions in multiple risk factors at various ages. If all risk factors were eliminated, LE in Canada would increase by 6.26 years for males and 5.05 for females. The greatest benefit would come from eliminating smoking in males (2.45 years) and high blood pressure in females (1.42 years). For most risk factors, their dose-response relationships with LE were non-linear and depended on the presence of other factors. In individuals with high levels of risk, eliminating or reducing exposure to multiple factors could improve LE by several years, even at a relatively advanced age.
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Affiliation(s)
- Jacek A. Kopec
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Arthritis Research Canada, Vancouver, BC V5Y 3P2, Canada; (E.C.S.); (L.C.L.); (H.X.); (J.M.E.)
- Correspondence:
| | - Eric C. Sayre
- Arthritis Research Canada, Vancouver, BC V5Y 3P2, Canada; (E.C.S.); (L.C.L.); (H.X.); (J.M.E.)
| | - Benajir Shams
- Fraser Health Authority, Surrey, BC V3T 0H1, Canada;
| | - Linda C. Li
- Arthritis Research Canada, Vancouver, BC V5Y 3P2, Canada; (E.C.S.); (L.C.L.); (H.X.); (J.M.E.)
- Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada;
| | - Hui Xie
- Arthritis Research Canada, Vancouver, BC V5Y 3P2, Canada; (E.C.S.); (L.C.L.); (H.X.); (J.M.E.)
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Lynne M. Feehan
- Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada;
| | - John M. Esdaile
- Arthritis Research Canada, Vancouver, BC V5Y 3P2, Canada; (E.C.S.); (L.C.L.); (H.X.); (J.M.E.)
- Department of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
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Vos AL, de Bruijn GJ, Klein MCA, Lakerveld J, Boerman SC, Smit EG. SNapp, a Tailored Smartphone App Intervention to Promote Walking in Adults of Low Socioeconomic Position: Development and Qualitative Pilot Study (Preprint). JMIR Form Res 2022; 7:e40851. [PMID: 37067890 PMCID: PMC10152336 DOI: 10.2196/40851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Adults of low socioeconomic position (SEP) are generally less physically active than those who are more socioeconomically advantaged, which increases their cardiovascular disease incidence risk. Moreover, individuals of low SEP are often less easily reached with physical activity (PA) interventions than individuals of higher SEP. Smartphone apps have been presented as a promising platform for delivering PA interventions to difficult-to-reach individuals of low SEP. Although PA apps are widely available, they are rarely based on health behavior theories and most predominantly offer generic PA advice. Consequently, it is unlikely that available apps are the most effective PA intervention tools. OBJECTIVE To respond to these areas for improvement, we developed SNapp, an app-based intervention encouraging adults of low SEP to increase PA by providing tailored coaching messages targeting walking behavior. This study aimed to describe SNapp's stepwise development and pilot evaluation process. METHODS We applied a stepwise approach: analyzing the health problem, developing a program framework, developing tailoring assessments, writing tailored messages, automating the tailoring process, and implementing and evaluating the program in a qualitative pilot study (11 participants). RESULTS SNapp consisted of several elements. First, an app was developed to collect step count and geolocation data using smartphone sensor functionalities. In addition, a survey measure was created to assess users' behavior change technique (BCT) preferences. These 3 data types were used to tailor SNapp's coaching messages to stimulate walking. This allows SNapp to offer feedback on performance levels, contextually tailored prompts when users are near green spaces, and coaching content that aligns with individual BCT preferences. Finally, a server-based Python program that interacts with databases containing user data and tailored messages was built using Microsoft Azure to select and automatically send messages to users through Telegram messenger. Pilot study findings indicated that SNapp was rated positively, with participants reporting that its design, technical functioning, and message content were acceptable. Participants suggested additional functionalities that are worth considering for future updates. CONCLUSIONS SNapp is an app-based intervention that aims to promote walking in adults of low SEP by offering tailored coaching messages. Its development is theory based, and it is among the first to incorporate contextualized feedback and content tailored to individual BCT preferences. The effectiveness of SNapp will be evaluated in a 12-month real-life parallel cluster-randomized controlled trial.
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Affiliation(s)
- Anne L Vos
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands
| | - Gert-Jan de Bruijn
- Department of Communication Studies, University of Antwerp, Antwerp, Belgium
| | - Michel C A Klein
- Social Artificial Intelligence Group, Department of Computer Science, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Jeroen Lakerveld
- Epidemiology and Data Science, Amsterdam University Medical Centers, Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Sophie C Boerman
- Strategic Communication Group, Wageningen University & Research, Wageningen, Netherlands
| | - Edith G Smit
- Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, Netherlands
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Hu P, Zheng M, Huang J, Zhao W, Wang HHX, Zhang X, Chen Y, Deng H, Qin P, Liu X. Association of Habitual Physical Activity With the Risk of All-Cause Mortality Among Chinese Adults: A Prospective Cohort Study. Front Public Health 2022; 10:919306. [PMID: 35812492 PMCID: PMC9263353 DOI: 10.3389/fpubh.2022.919306] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/27/2022] [Indexed: 01/09/2023] Open
Abstract
ObjectiveThis study was conducted to evaluate the association of the risk of all-cause mortality with habitual physical activity (HPA) and its different domains among Chinese adults.MethodsA total of 11,994 participants from the Guangzhou Heart Study were followed up until 1 January 2020. Information on HPA, including leisure-time physical activity (LTPA) and commute activity, was collected using a modified Global Physical Activity Questionnaire. Individual cause of death was obtained from the National Death Registry of China. Cox proportional hazards regression model was used to estimate hazard ratio (HR) and 95% confidence interval (CI) after adjustment for covariates.ResultsDuring 37,715 person-years of follow-up, 208 deaths (1.73%) were observed. When compared with the highest with the lowest exposure tertiles, HPA and LTPA were associated with 34% (HR: 0.66, 95% CI: 0.46–0.95) and 30% (HR: 0.70, 95% CI: 0.49–0.99) reduced risk of all-cause mortality after adjustment for covariates. Commute activity was not associated with mortality risk. For the specific component of LTPA, we found that every 1 MET-h/week increment of the housework was associated with a 1% (HR: 0.99, 95% CI: 0.98–0.99) decreased mortality risk, and performing brisk walking/health exercises/Yangko was associated with a 46% reduced mortality risk (HR: 0.54, 95% CI: 0.29–0.99).ConclusionThis study suggests that a higher level of HPA and LTPA was associated with a lower risk of all-cause mortality. Our findings suggest people to perform HPA, especially LTPA, as a strategy for mortality reduction and health promotion.
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Affiliation(s)
- Peng Hu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Murui Zheng
- Department of Community Health, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Jun Huang
- Department of Geriatrics, Institute of Geriatrics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, China
| | - Wenjing Zhao
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - Harry H. X. Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Faculty of Medicine, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- *Correspondence: Harry H. X. Wang
| | - Xiong Zhang
- Department of Neurology, Maoming People's Hospital, Maoming, China
| | - Yuanyuan Chen
- Department of Chronic Noncommunicable Disease Prevention and Control, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Hai Deng
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Science, Guangzhou, China
| | - Pengzhe Qin
- Department of Chronic Noncommunicable Disease Prevention and Control, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Pengzhe Qin
| | - Xudong Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
- Xudong Liu
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Frodi DM, Manea V, Diederichsen SZ, Svendsen JH, Wac K, Andersen TO. Using Consumer-Wearable Activity Trackers for Risk Prediction of Life-Threatening Heart Arrhythmia in Patients with an Implantable Cardioverter-Defibrillator: An Exploratory Observational Study. J Pers Med 2022; 12:jpm12060942. [PMID: 35743727 PMCID: PMC9225164 DOI: 10.3390/jpm12060942] [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: 05/10/2022] [Revised: 05/29/2022] [Accepted: 06/05/2022] [Indexed: 11/16/2022] Open
Abstract
Ventricular arrhythmia (VA) is a leading cause of sudden death and health deterioration. Recent advances in predictive analytics and wearable technology for behavior assessment show promise but require further investigation. Yet, previous studies have only assessed other health outcomes and monitored patients for short durations (7−14 days). This study explores how behaviors reported by a consumer wearable can assist VA risk prediction. An exploratory observational study was conducted with participants who had an implantable cardioverter-defibrillator (ICD) and wore a Fitbit Alta HR consumer wearable. Fitbit reported behavioral markers for physical activity (light, fair, vigorous), sleep, and heart rate. A case-crossover analysis using conditional logistic regression assessed the effects of time-adjusted behaviors over 1−8 weeks on VA incidence. Twenty-seven patients (25 males, median age 59 years) were included. Among the participants, ICDs recorded 262 VA events during 8093 days monitored by Fitbit (median follow-up period 960 days). Longer light to fair activity durations and a higher heart rate increased the odds of a VA event (p < 0.001). In contrast, lengthier fair to vigorous activity and sleep durations decreased the odds of a VA event (p < 0.001). Future studies using consumer wearables in a larger population should prioritize these outcomes to further assess VA risk.
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Affiliation(s)
- Diana My Frodi
- Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark; (D.M.F.); (S.Z.D.); (J.H.S.)
| | - Vlad Manea
- Department of Computer Science, Faculty of Science, University of Copenhagen, 2100 Copenhagen, Denmark; (V.M.); (K.W.)
- Vital Beats ApS, 1434 Copenhagen, Denmark
| | - Søren Zöga Diederichsen
- Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark; (D.M.F.); (S.Z.D.); (J.H.S.)
| | - Jesper Hastrup Svendsen
- Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark; (D.M.F.); (S.Z.D.); (J.H.S.)
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Katarzyna Wac
- Department of Computer Science, Faculty of Science, University of Copenhagen, 2100 Copenhagen, Denmark; (V.M.); (K.W.)
- Quality of Life Technologies Lab, Center for Informatics, University of Geneva, 1227 Carouge, Switzerland
| | - Tariq Osman Andersen
- Department of Computer Science, Faculty of Science, University of Copenhagen, 2100 Copenhagen, Denmark; (V.M.); (K.W.)
- Vital Beats ApS, 1434 Copenhagen, Denmark
- Correspondence: or ; Tel.: +45-26-14-91-69
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50
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Chen H, Xu J, Xie H, Huang Y, Shen X, Xu F. Effects of physical activity on heart rate variability in children and adolescents: a systematic review and meta-analysis. CIENCIA & SAUDE COLETIVA 2022; 27:1827-1842. [PMID: 35544812 DOI: 10.1590/1413-81232022275.10402021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 07/27/2021] [Indexed: 12/24/2022] Open
Abstract
The aim of the study was to investigate the effects of physical activity (PA) on heart rate variability (HRV) in children and adolescents. We conducted a research of Web of Science, PubMed, ScienceDirect, Springer-Link and EBSCO-host. The revised Newcastle-Ottawa Scale was used in an investigative analysis to assess bias risk. A total of 21 studies were included. Overall, medium-sized associations were found between PA and low frequency and high frequency in children and adolescents. High PA level had significantly higher standard deviation of RR intervals and root of the mean of the sum of the squares of differences between adjacent RR intervals in children and adolescents. The effects of PA on HRV were consistent in children and adolescents. Our systematic review and meta-analysis revealed medium-sized between PA and HRV in children and adolescents. Promoting children's and adolescents' participation in moderate-to-vigorous physical activity (MVPA) will increase parasympathetic nerve activity and decreased sympathetic nerve activity. Our findings support motivating children and adolescents to engage in more MVPA in their daily lives to improve autonomic nervous system function and promote cardiovascular safety.
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Affiliation(s)
- Hao Chen
- School of Physical Education, Hangzhou Normal University. 311121 Hangzhou China.
| | - Jing Xu
- School of Physical Education, Hangzhou Normal University. 311121 Hangzhou China.
| | - Hao Xie
- Department of Physical Education, Zhejiang University of Finance & Economics. Hangzhou China
| | - Yufen Huang
- The Children's Hospital, Zhejiang University School of Medicine. Hangzhou China
| | - Xin Shen
- The Children's Hospital, Zhejiang University School of Medicine. Hangzhou China
| | - Fei Xu
- School of Physical Education, Hangzhou Normal University. 311121 Hangzhou China.
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