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Ding D, Van Buskirk J, Partridge S, Clare P, Giovannucci E, Bauman A, Freene N, Gallagher R, Nguyen B. The association of diet quality and physical activity with cardiovascular disease and mortality in 85,545 older Australians: A longitudinal study. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:841-850. [PMID: 38810689 PMCID: PMC11336305 DOI: 10.1016/j.jshs.2024.05.011] [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: 01/09/2024] [Revised: 03/04/2024] [Accepted: 03/21/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND A quality diet and an active lifestyle are both important cornerstones of cardiovascular disease (CVD) prevention. However, despite their interlinked effects on metabolic health, the 2 behaviors are rarely considered jointly, particularly within the context of CVD prevention. We examined the independent, interactive, and joint associations of diet and physical activity with CVD hospitalization, CVD mortality, and all-cause mortality. METHODS CVD-free Australian participants aged 45-74 years (n = 85,545) reported physical activity, diet, sociodemographic, and lifestyle characteristics at baseline (2006-2009) and follow-up (2012-2015), and data were linked to hospitalization and death registries (03/31/2019 for CVD hospitalization and all-cause mortality and 12/08/2017 for CVD mortality). Diet quality was categorized as low, medium, and high based on meeting dietary recommendations. Physical activity was operationalized as (a) total moderate-to-vigorous physical activity (MVPA) as per guidelines, and (b) the composition of MVPA as the ratio of vigorous-intensity physical activity (VPA) to total MVPA. We used a left-truncated cause-specific Cox proportional hazards model using time-varying covariates. RESULTS During a median of 10.7 years of follow-up, 6576 participants were admitted to the hospital for CVD and 6581 died from all causes (876 from CVD during 9.3 years). A high-quality diet was associated with a 17% lower risk of all-cause mortality than a low-quality diet, and the highest MVPA category (compared with the lowest) was associated with a 44% and 48% lower risk of CVD and all-cause mortality, respectively. Multiplicative interactions between diet and physical activity were non-significant. For all outcomes, the lowest risk combinations involved a high-quality diet and the highest MVPA categories. Accounting for total MVPA, some VPA was associated with further risk reduction of CVD hospitalization and all-cause mortality. CONCLUSION For CVD prevention and longevity, one should adhere to both a healthy diet and an active lifestyle and incorporate some VPA when possible.
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Affiliation(s)
- Ding Ding
- Sydney School of Public Health, Faculty of Medicine and Health, the University of Sydney, Camperdown, NSW 2006, Australia; Charles Perkins Centre, the University of Sydney, Camperdown, NSW 2006, Australia.
| | - Joe Van Buskirk
- Sydney School of Public Health, Faculty of Medicine and Health, the University of Sydney, Camperdown, NSW 2006, Australia; Sydney Local Health District, Camperdown, NSW 2050, Australia
| | - Stephanie Partridge
- School of Health Sciences, Faculty of Medicine and Health, the University of Sydney, Camperdown, NSW 2006, Australia
| | - Philip Clare
- Sydney School of Public Health, Faculty of Medicine and Health, the University of Sydney, Camperdown, NSW 2006, Australia; Charles Perkins Centre, the University of Sydney, Camperdown, NSW 2006, Australia; National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Edward Giovannucci
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Adrian Bauman
- Sydney School of Public Health, Faculty of Medicine and Health, the University of Sydney, Camperdown, NSW 2006, Australia; Charles Perkins Centre, the University of Sydney, Camperdown, NSW 2006, Australia
| | - Nicole Freene
- Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia
| | - Robyn Gallagher
- Charles Perkins Centre, the University of Sydney, Camperdown, NSW 2006, Australia; Susan Wakil School of Nursing and Midwifery, the University of Sydney, Camperdown, NSW 2050, Australia
| | - Binh Nguyen
- Sydney School of Public Health, Faculty of Medicine and Health, the University of Sydney, Camperdown, NSW 2006, Australia; Charles Perkins Centre, the University of Sydney, Camperdown, NSW 2006, Australia
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Kunutsor SK, Kurl S, Laukkanen JA. Cardiorespiratory fitness, atrial fibrillation and stroke: a review of the evidence in 2024. Expert Rev Cardiovasc Ther 2024:1-16. [PMID: 39329169 DOI: 10.1080/14779072.2024.2409440] [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: 04/19/2024] [Revised: 09/15/2024] [Accepted: 09/23/2024] [Indexed: 09/28/2024]
Abstract
INTRODUCTION The body of evidence linking cardiorespiratory fitness (CRF) levels with the risk of atrial fibrillation (AF) and stroke - two interconnected cardiovascular conditions - is not entirely consistent. Furthermore, specific CRF thresholds beyond which the risk of AF or stroke might not decrease are not well defined. AREAS COVERED This review summarizes research evidence on the role of CRF in the development of AF and stroke including dose-response relationships in general population participants, explores the biological mechanisms through which CRF may exert its effects, assesses the potential implications for clinical care and population health, identifies gaps in the current evidence, and suggest directions for future research. MEDLINE and Embase were searched from inception until July 2024 to identify observational longitudinal and interventional studies as well as systematic reviews and meta-analyses related to these study designs. EXPERT OPINION In the general population, increasing levels of CRF, achieved through consistent physical activity, can significantly reduce the likelihood of developing AF and stroke. The findings also advocate for a tailored approach to exercise prescriptions, acknowledging the plateau in benefits for AF risk beyond certain CRF levels, while advocating for higher intensity or prolonged activity to further reduce stroke risk.
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Affiliation(s)
- Setor K Kunutsor
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
- Section of Cardiology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Saint Boniface Hospital, Winnipeg, Manitoba, Canada
| | - Sudhir Kurl
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Brain Research Unit, Department of Neurology, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Wellbeing Services County of Central Finland, Jyväskylä, Finland
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Jiang X, Tang L, Zhang Y, Bai Y, Luo H, Wang R, Bi X, Chen R, Wang X. Does sedentary time and physical activity predict chronic back pain and morphological brain changes? A UK biobank cohort study in 33,402 participants. BMC Public Health 2024; 24:2685. [PMID: 39354455 PMCID: PMC11446088 DOI: 10.1186/s12889-024-20188-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Accepted: 09/25/2024] [Indexed: 10/03/2024] Open
Abstract
BACKGROUND The relationship between sedentary time, physical activity, and chronic back pain remains unclear. The study aims to investigate whether sedentary time and physical activity predict chronic back pain and morphological brain changes. METHODS This cohort study recruited adults aged 37-73 years enrolled between 2006 and 2010, with follow-up until 2014. The total cohort comprised 33,402 participants (mean age: 54.53). Data were collected on daily sedentary time, physical activity, lifestyle factors, and health outcomes. RESULTS After nearly 8-year follow-up, 3,006 individuals (9.00%) reported chronic back pain in total. Individuals with daily sedentary time exceeding 6 h had a 33% higher risk of chronic back pain compared to those with sedentary time of 2 h or less (RR, 1.33, 95%CI, 1.17-1.52). Sedentary time was also associated with decreased grey matter volume in several brain regions, including bilateral primary somatosensory cortex (S1), secondary somatosensory cortex, putamen, primary motor cortex (M1), insula, hippocampus, amygdala, as well as right supplementary motor area, left medial frontal cortex, and right anterior cingulate cortex (FDR-corrected p-value < 0.05). Compared to individuals who sat for more than 6 h with light physical activity, those engaging in moderate physical activity with sedentary time of 2 h or less (RR, 0.71, 95%CI, 0.52-0.99) exhibited a significant decrease in chronic back pain risk. In addition, replacing sedentary time with equivalent amount of physical activity also demonstrated a reduction in the risk of chronic back pain (RR, 0.87, 95%CI, 0.77-0.99) and increased the reginal grey matter volumes including the amygdala, insula, M1, putamen and S1. CONCLUSIONS Prolonged sedentary time is associated with heightened risks of chronic back pain and deterioration in brain health.
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Affiliation(s)
- Xue Jiang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Le Tang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Yonghui Zhang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Yiwen Bai
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Huihuan Luo
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Rui Wang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Xia Bi
- Department of Rehabilitation Medicine, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Xueqiang Wang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China.
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
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Lucena Alves CPD, Leão OADA, Delpino FM, Mielke GI, Ekelund U, Costa EC, Crochemore-Silva I. Independent, Stratified, and Joint Associations of Sedentary Time and Physical Activity With Cardiovascular Disease: A Systematic Review. J Phys Act Health 2024; 21:980-989. [PMID: 39151901 DOI: 10.1123/jpah.2024-0019] [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: 01/10/2024] [Revised: 05/21/2024] [Accepted: 06/20/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Recent statistics highlight cardiovascular diseases (CVD) as a major global cause of death. This review examines the methodological approaches and the main results of independent, stratified, and joint association of sedentary time (ST) and physical activity (PA) on CVD outcomes. METHODS We searched PubMed, Embase, Web of Science, and Scopus for prospective cohorts that examined the independent, stratified, or joint associations of ST and PA with CVD outcomes. Independent associations were defined as analyses mutually adjusted for PA and ST. Stratified associations were considered when there was a reference group in each stratum of PA or ST, and joint associations were defined by a single reference group for all other combined categories of ST and PA levels. RESULTS Of 45 articles, 69% explored independent association of ST or PA on CVD outcomes, while 31% using a stratified/joint approach. Most studies used self-reports for ST and PA and focused on CVD mortality. Mutually adjusted analyses identified ST positively and PA inversely associated to CVD outcomes. Stratified studies showed higher ST's pronounced impact on CVD for lower PA levels. High PA mitigated but did not eliminate ST's negative impact. Joint analyses revealed highest CVD risk in those with both high ST and low PA, and elevated risk in various intermediate combinations. CONCLUSIONS Employing independent, stratified, and joint association approaches can yield distinct and complementary public health messages aimed at promoting cardiovascular health. Recommendations should aim to not only to encourage boosting PA levels, but also, concurrently decrease ST.
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Affiliation(s)
| | - Otávio Amaral de Andrade Leão
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Felipe Mendes Delpino
- Postgraduate Program in Nursing, Federal University of Pelotas, Rio Grande do Sul, RS, Brazil
| | - Gregore Iven Mielke
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Eduardo Caldas Costa
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Inácio Crochemore-Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil
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JOENSUU LAURA, WALLER KATJA, KANKAANPÄÄ ANNA, PALVIAINEN TEEMU, KAPRIO JAAKKO, SILLANPÄÄ ELINA. Genetic Liability to Cardiovascular Disease, Physical Activity, and Mortality: Findings from the Finnish Twin Cohort. Med Sci Sports Exerc 2024; 56:1954-1963. [PMID: 38768019 PMCID: PMC11419275 DOI: 10.1249/mss.0000000000003482] [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] [Indexed: 05/22/2024]
Abstract
PURPOSE We investigated whether longitudinally assessed physical activity (PA) and adherence specifically to World Health Organization PA guidelines mitigate or moderate mortality risk regardless of genetic liability to cardiovascular disease (CVD). We also estimated the causality of the PA-mortality association. METHODS The study used the older Finnish Twin Cohort with 4897 participants aged 33 to 60 yr (54.3% women). Genetic liability to coronary heart disease and systolic and diastolic blood pressure was estimated with polygenic risk scores (PRS) derived from the Pan-UK Biobank ( N ≈ 400,000; >1,000,000 genetic variants). Leisure-time PA was assessed with validated and structured questionnaires three times during 1975 to 1990. The main effects of adherence to PA guidelines and the PRS × PA interactions were evaluated with Cox proportional hazards models against all-cause and CVD mortality. A cotwin control design with 180 monozygotic twin pairs discordant for meeting the guidelines was used for causal inference. RESULTS During the 17.4-yr (mean) follow-up (85,136 person-years), 1195 participants died, with 389 CVD deaths. PRS (per 1 SD increase) were associated with a 17% to 24% higher CVD mortality risk but not with all-cause mortality except for the PRS for diastolic blood pressure. Adherence to PA guidelines did not show significant independent main effects or interactions with all-cause or CVD mortality. Twins whose activity levels adhered to PA guidelines over a 15-yr period did not have statistically significantly reduced mortality risk compared with their less active identical twin sibling. The findings were similar among high, intermediate, and low genetic risk levels for CVD. CONCLUSIONS The genetically informed Finnish Twin Cohort data could not confirm that adherence to PA guidelines either mitigates or moderates genetic CVD risk or causally reduces mortality risk.
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Affiliation(s)
- LAURA JOENSUU
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
- Gerontology Research Center, University of Jyväskylä, Jyväskylä, FINLAND
| | - KATJA WALLER
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
| | - ANNA KANKAANPÄÄ
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
- Gerontology Research Center, University of Jyväskylä, Jyväskylä, FINLAND
| | - TEEMU PALVIAINEN
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, FINLAND
| | - JAAKKO KAPRIO
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, FINLAND
| | - ELINA SILLANPÄÄ
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
- Wellbeing Services County of Central Finland, Jyväskylä, FINLAND
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Du L, Li T, Xue X, He Q, Pan Y, Chen S, Zhang X. Independent and joint role of inflammatory diet and physical activity with cognitive function in aging: Evidence from a population-based survey. Gen Hosp Psychiatry 2024; 91:52-59. [PMID: 39260191 DOI: 10.1016/j.genhosppsych.2024.09.003] [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: 05/05/2024] [Revised: 09/06/2024] [Accepted: 09/06/2024] [Indexed: 09/13/2024]
Abstract
OBJECTIVE This study aims to explore the independent and joint association of physical activity (PA) and inflammatory diet with cognitive function in aging. METHOD Data from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) was used. 2249 NHANES participants with valid data represented a weighted population of 50.5 million American residents aged 60 and older. This study separately analyzed the independent associations of PA (measured by global physical activity questionnaire) and inflammatory diet (measured by energy-adjusted dietary inflammatory index from 24-h dietary recall), and their joints (inactive & pro-inflammatory as reference) with cognitive function (assessed by three cognitive tests), and considered an individual of different status and non-linear effect by sub-group and restricted cubic splines (RCS) analysis, respectively. All analysis was multivariable-adjusted and sample-weighted. RESULTS The results showed that inflammatory diet was independently associated with lower cognitive function, with a 1.08, 1.29, 2.67, 0.56 lower score in the Registry for Alzheimer's Disease word list learning test (CERAD), the Animal Fluency Test (AFT), the Digit Symbol Substitution test (DSST), Z-scores, and 51 %, 62 %, 63 %, 93 % higher odds ratio (OR) of lower performance in CERAD, AFT, DSST, and p-MCI, respectively. PA was independently associated with higher cognitive function, with a 1.41, 3.37, and 0.52 higher score in AFT, DSST, Z-scores, and 28 %, 51 %, 41 % lower ORs of lower performance in CERAD and DSST and p-MCI, respectively. Active & Anti-inflammatory was always positively associated with cognitive function, with a 1.42, 2.69, 5.47, and 1.04 higher score for CERAD, AFT, DSST, and Z-score, a 58 %, 56 %, 74 %, 76 % lower ORs of lower performance in CERAT, AFT, DSST, and p-MCI, respectively, which elicited the maximum compared to other joints. CONCLUSION Adhering to both active PA and anti-inflammatory diet is recommended for cognitive management in older adults. Sticking to either active PA or anti-inflammatory diet also shows potential cognitive benefits, with the diet possibly playing more vital role.
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Affiliation(s)
- Litao Du
- School of Physical Education, Shandong University, Jinan, China
| | - Ting Li
- School of Physical Education, Shandong University, Jinan, China
| | - Xiangli Xue
- School of Physical Education, Shandong University, Jinan, China
| | - Qiang He
- School of Physical Education, Shandong University, Jinan, China
| | - Yang Pan
- School of Physical Education, Shandong University, Jinan, China
| | - Si Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xianliang Zhang
- School of Physical Education, Shandong University, Jinan, China.
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Bhattacharyya M, Miller LE, Miller AL, Bhattacharyya R, Herbert WG. Disparities in adherence to physical activity guidelines among US adults: A population-based study. Medicine (Baltimore) 2024; 103:e39539. [PMID: 39252263 PMCID: PMC11384062 DOI: 10.1097/md.0000000000039539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/11/2024] Open
Abstract
The objective of this study was to determine adherence to national guidelines for aerobic and muscle-strengthening physical activity among United States (US) adults and identify factors associated with guideline nonadherence. The 2022 National Health Interview Survey data were analyzed to evaluate self-reported physical activity among 26,494 US adults. Adherence to national guidelines was defined as engaging in ≥150 minutes moderate-intensity or ≥75 minutes vigorous-intensity aerobic activity/week, and muscle-strengthening activity ≥2 days/week. A multivariable logistic regression model evaluated associations between 24 sociodemographic and health variables with nonadherence to physical activity guidelines. Shapley Additive Explanations were used to assess the relative importance of each factor in the model. The population-weighted analysis revealed that only 24.3% of US adults met both the aerobic and muscle-strengthening activity guidelines. The regression model identified 17 factors significantly associated with nonadherence. When evaluating the relative importance of these variables, older age, lower educational attainment, and lower household income emerged as the primary determinants of nonadherence. Guideline adherence was lowest among subgroups with multiple risk factors, with only 6.5% of older adults with lower income and education meeting the guidelines. In contrast, adherence was 42.7% in younger respondents with higher incomes and educational attainment. In conclusion, physical activity rates among US adults remain below public health targets, with significant disparities among sociodemographic groups. Expanded outreach efforts targeting higher-risk populations are urgently needed to address barriers, promote physical activity engagement, and achieve health equity.
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Affiliation(s)
| | - Larry E Miller
- Department of Biostatistics, Miller Scientific, Johnson City, TN
| | - Anna L Miller
- Department of Biostatistics, Miller Scientific, Johnson City, TN
| | | | - William G Herbert
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA
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Lu TY, Wang J, Jiang CQ, Jin YL, Cheng KK, Lam TH, Zhang WS, Xu L. Active longevity and aging: dissecting the impacts of physical and sedentary behaviors on longevity and age acceleration. GeroScience 2024:10.1007/s11357-024-01329-3. [PMID: 39230773 DOI: 10.1007/s11357-024-01329-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 08/23/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND To examine the associations of physical activity (PA) and sedentary behavior (SB) with longevity and age acceleration (AA) using observational and Mendelian randomization (MR) studies, and quantify the mediating effects of lipids. METHODS In Guangzhou Biobank Cohort Study (GBCS), PA and SB were assessed by the Chinese Version of the International Physical Activity Questionnaire. Longevity was defined as participants whose age at follow-up or at death was at or above the 90th age percentile. AA was defined as the residual resulting from a linear model that regressed phenotypic age against chronological age. Linear regression and Poisson regression with robust error variance were used to assess the associations of total and specific PA in different intensities, and SB with AA and longevity, yielding βs or relative risks (RRs) and 95% confidence intervals (CIs). Two-sample MR was conducted to examine the causal effects. Mediation analysis was used to assess the mediating effects of lipids. RESULTS Of 20,924 participants aged 50 + years in GBCS, during an average follow-up of 15.0 years, compared with low PA, moderate and high PA were associated with higher likelihood of longevity (RR (95% CI): 1.56 (1.16, 2.11), 1.66 (1.24, 2.21), respectively), and also cross-sectionally associated with lower AA (β (95% CI): -1.43 (-2.41, -0.45), -2.09 (-3.06, -1.11) years, respectively). Higher levels of moderate PA (MPA) were associated with higher likelihood of longevity and lower AA, whereas vigorous PA (VPA) showed opposite effects. The association of PA with longevity observed in GBCS was mediated by low-density lipoprotein cholesterol (LDL-C) by 8.23% (95% CI: 3.58-39.61%), while the association with AA was mediated through LDL-C, triglycerides and total cholesterol by 5.13% (3.94-7.30%), 7.81% (5.98-11.17%), and 3.37% (2.59-4.80%), respectively. Additionally, in two-sample MR, SB was positively associated with AA (β (95% CI): 1.02 (0.67, 1.36) years). CONCLUSIONS PA showed protective effects on longevity and AA, with the effects being partly mediated through lipids. Conversely, SB had a detrimental impact on AA. MPA was associated with higher likelihood of longevity and reduced AA, whereas VPA showed adverse effects. Our findings reinforce the recommendation of "sit less and move more" to promote healthy longevity, and highlight the potential risks associated with VPA in the elderly.
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Affiliation(s)
- Ting Yu Lu
- School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Jiao Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Chao Qiang Jiang
- Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Ya Li Jin
- Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
| | - Kar Keung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Tai Hing Lam
- School of Public Health, the University of Hong Kong, Hong Kong, China
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Wei Sen Zhang
- Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China
| | - Lin Xu
- School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.
- School of Public Health, the University of Hong Kong, Hong Kong, China.
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK.
- Greater Bay Area Public Health Research Collaboration, Guangzhou, China.
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Cuthbertson CC, Evenson KR, Wen F, Moore CC, Howard AG, Di C, Parada H, Matthews CE, Manson JE, Buring J, Shiroma EJ, LaCroix AZ, Lee IM. Associations of steps per day and step intensity with the risk of cancer: Findings from the Women's Health Accelerometry Collaboration cohort. Prev Med 2024; 186:108070. [PMID: 39029743 PMCID: PMC11338699 DOI: 10.1016/j.ypmed.2024.108070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 07/14/2024] [Accepted: 07/15/2024] [Indexed: 07/21/2024]
Abstract
OBJECTIVE Accumulating more steps/day is associated with a lower risk of cancer mortality and composite cancer outcomes. However, less is known about the relationship of steps/day with the risk of multiple site-specific cancers. METHODS This study included >22,000 women from the Women's Health Accelerometry Collaboration Cohort (2011-2022), comprised of women from the Women's Health Study and Women's Health Initiative Objective Physical Activity and Cardiovascular Health Study. Steps/day and step intensity were collected with accelerometry. Incident cancer cases and deaths were adjudicated. Stratified Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the associations of steps/day and step intensity with incident breast, colon, endometrial, lung, and ovarian cancers, a composite of 13 physical activity-related cancers, total invasive cancer, and fatal cancer. RESULTS On average, women were 73.4 years old, accumulated 4993 steps/day, and had 7.9 years of follow-up. There were small nonsignificant inverse associations with the risks of colon cancer (HR = 0.94, 95% CI: 0.83, 1.05), endometrial cancer (HR = 0.91, 95% CI: 0.82, 1.01), and fatal cancer (HR = 0.95 95% CI: 0.90, 1.00) per 1000 steps/day. More minutes at ≥40 steps/min and a faster peak 10- and 30-min step cadence were associated with a lower risk of endometrial cancer, but findings were attenuated after adjustment for body mass index and steps/day. CONCLUSIONS Among women 62-97 years, there were small nonsignificant inverse associations of colon, endometrial, and fatal cancer with more steps/day. Epidemiologic studies with longer follow-up and updated assessments are needed to further explore these associations.
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Affiliation(s)
- Carmen C Cuthbertson
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, United States of America.
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Fang Wen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Christopher C Moore
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Annie G Howard
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Chongzhi Di
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States of America
| | - Humberto Parada
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, United States of America
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, Metabolic Epidemiology Branch, National Cancer Institute, Bethesda, MD, United States of America
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Julie Buring
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Eric J Shiroma
- Division of Cardiovascular Sciences, National Heart Lung Blood Institute, Bethesda, MD, United States of America
| | - Andrea Z LaCroix
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, United States of America
| | - I-Min Lee
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
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10
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Shaw C, Mizdrak A, Gage R, McLeod M, Jones R, Woodward A, Cobiac L. Policy approaches to decarbonising the transport sector in Aotearoa New Zealand: modelling equity, population health, and health-system effects. Lancet Planet Health 2024; 8:e647-e656. [PMID: 39243780 DOI: 10.1016/s2542-5196(24)00171-2] [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: 12/05/2023] [Revised: 07/05/2024] [Accepted: 07/22/2024] [Indexed: 09/09/2024]
Abstract
BACKGROUND Health co-benefits are a key potential advantage of transport decarbonisation policy. However, health effects will occur in the context of existing transport-health inequities and decarbonisation policies will themselves affect inequities. This research examines the effects of national decarbonisation pathways for transport on population health, health inequity, and health-system costs in Aotearoa New Zealand. METHODS We modelled the health, health-system, and environmental impacts of two pathways to net zero for transport developed by the New Zealand Climate Change Commission using a proportional multistate lifetable model. The behaviour pathway emphasises a mixed approach, including reduced driving, increased cycling and use of public transport, and light vehicle electrification, and the technology pathway focuses on vehicle electrification. We used data from transport, environmental, population health, and health-care sources to populate the model. We simulated changes in health effects through the pathways of physical activity, air pollution (PM2·5 and NO2), and injury for the Aotearoa New Zealand population from 2018 to 2050. We modelled impacts for Māori (the Indigenous People of Aotearoa) and non-Māori. For each pathway to net zero, we calculated changes in overall health-adjusted life-years (HALYs), age-standardised HALYs, and rate ratios for Māori and non-Māori. We also calculated changes in health-system costs and transport greenhouse gas emissions. 95% uncertainty intervals (95% UIs) were derived for all model outputs by use of a Monte Carlo simulation. FINDINGS Both pathways show improvements in population health, reductions in health-system costs, and reduced lifecycle greenhouse gas emissions compared with baseline, although health gains were substantially larger in the behaviour pathway. For example, an extra 2100 HALYs (95% UI 1500-3100) were gained in the behaviour scenario compared with baseline. Health gains were 20-30% larger for Māori than non-Māori in both pathways, although more HALYs were gained by Māori in the behaviour pathway. For the cohort aged 0-4 years in 2018, healthy life expectancy differences between Māori and non-Māori reduced by 0·5% in the behaviour pathway over their lifetime. HALYs gained by Māori and non-Māori were altered substantially depending on assumptions about the equity of the implemented pathway. INTERPRETATION Decarbonising transport might improve overall population health, save the health system money, and reduce health inequities between Māori and non-Māori. Pathways that increase physical activity have a larger effect on population health than those that rely on low-emission vehicles. The effects on inequity between Māori and non-Māori are larger in the behaviour pathway than in the technology pathway but dependent on how equitably policies supporting decarbonisation are implemented. FUNDING Health Research Council of New Zealand and University of Otago.
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Affiliation(s)
- Caroline Shaw
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand.
| | - Anja Mizdrak
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Ryan Gage
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Melissa McLeod
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Rhys Jones
- Te Kupenga Hauora Māori, University of Auckland, Auckland, New Zealand
| | - Alistair Woodward
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Linda Cobiac
- School of Medicine and Dentistry, Griffith University, Southport, QLD, Australia
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11
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Tao C, Liu Z, Fan Y, Yuan Y, Wang X, Qiao Z, Li Z, Xu Q, Lou Z, Wang H, Li X, Li R, Lu C. Estimating neighborhood-based mortality risk associated with air pollution: A prospective study. JOURNAL OF HAZARDOUS MATERIALS 2024; 475:134861. [PMID: 38870855 DOI: 10.1016/j.jhazmat.2024.134861] [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: 04/08/2024] [Revised: 06/06/2024] [Accepted: 06/07/2024] [Indexed: 06/15/2024]
Abstract
Effect modification of integrated neighborhood environment on associations of air pollution with mortality remained unclear. We analyzed data from UK biobank prospective study (n = 421,650, median 12.5 years follow-up) to examine disparities of mortality risk associated with air pollution among varied neighborhood settings. Fine particulate matter (PM2.5), PM10 and nitrogen dioxide (NO2) were measured and assigned to each participants' address. Diverse ecological and societal settings of neighborhoods were integrated with principal component analysis and categorized into disadvantaged, intermediate and advantaged levels. We estimated mortality risk associated with air pollution across diverse neighborhoods using Cox regression. We calculated community-level proportions of mortality attributable to air pollutants. There was evidence of higher all-cause and respiratory disease mortality risk associated with PM2.5 and NO2 among those in disadvantaged neighborhoods. In disadvantaged communities, air pollutants explained larger proportions of deaths and such disparities persisted over past decades. Across 2010-2021, reducing PM2.5 and NO2 to 10 μg/m3 (World Health Organization limits) would save 87,000 (52,000-120,000) and 91,000 (37,000-145,000) deaths of populations aged ≥ 40 years, with 150 000 deaths occurred in disadvantaged neighborhood settings. These findings suggested that disadvantaged neighborhoods can exacerbate mortality risk associated with air pollution.
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Affiliation(s)
- Chengzhe Tao
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Zhaoyin Liu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Yun Fan
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Yiting Yuan
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Xinru Wang
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Ziyan Qiao
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Zhi Li
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Qiaoqiao Xu
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Zhe Lou
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Haowei Wang
- School of Public Health, Imperial College London, UK; MRC Centre for Global Infectious Disease Analysis and Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, UK
| | - Xiang Li
- School of Public Health, Imperial College London, UK; MRC Centre for Global Infectious Disease Analysis and Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, UK
| | - Ruiyun Li
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
| | - Chuncheng Lu
- State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
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12
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Rodríguez-Gutiérrez E, Torres-Costoso A, Del Pozo Cruz B, de Arenas-Arroyo SN, Pascual-Morena C, Bizzozero-Peroni B, Martínez-Vizcaíno V. Daily steps and all-cause mortality: An umbrella review and meta-analysis. Prev Med 2024; 185:108047. [PMID: 38901742 DOI: 10.1016/j.ypmed.2024.108047] [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: 04/11/2024] [Revised: 06/03/2024] [Accepted: 06/16/2024] [Indexed: 06/22/2024]
Abstract
OBJECTIVE This study aimed to describe the variability in estimates of the association of daily steps and all-cause mortality in systematic reviews with meta-analyses, to identify the factors potentially responsible for it, and to provide an updated estimate. METHODS Five databases were systematically searched up to May 2024 to identify systematic reviews with meta-analyses and prospective cohort studies. A qualitative synthesis of previous reviews and an updated meta-analysis of cohort studies were performed. Pooled hazard ratios (HRs) with their 95% confidence intervals (CIs) were calculated using a random-effects model. RESULTS Eleven systematic reviews with meta-analyses and 14 cohort studies were included, revealing considerable variability in result presentation. Our updated meta-analysis showed a nonlinear association, indicating a lower risk of all-cause mortality with increased daily steps, with a protective threshold at 3143 steps/day, and a pooled HR of 0.91 (95% CI: 0.87, 0.95) per 1000 steps/day increment. Physical activity categories consistently indicated progressively reduced mortality risk, with the highly active category (>12,500 steps/day) exhibiting the lowest risk (0.35 (95% CI: 0.29, 0.42)). CONCLUSION Systematic reviews and meta-analyses showed considerable variability in effect estimates due to different methods of quantifying exposure. Despite it, our study underscores the importance of increased daily steps in reducing all-cause mortality, with a minimum protective dose of 3000 steps/day, although the optimal dose differed according to age and sex. It is recommended that future studies categorise daily steps by physical activity category, perform dose-response analyses, and use increments of 1000 steps/day.
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Affiliation(s)
- Eva Rodríguez-Gutiérrez
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Cuenca, Spain
| | - Ana Torres-Costoso
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, 45071 Toledo, Spain.
| | - Borja Del Pozo Cruz
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, University of Cádiz, Spain; Faculty of Education, University of Cádiz, Cádiz, Spain; Faculty of Sports Sciencies, Universidad Europea de Madrid, Madrid, Spain; Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Sergio Núñez de Arenas-Arroyo
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Cuenca, Spain
| | - Carlos Pascual-Morena
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; Facultad de Enfermería de Albacete, Universidad de Castilla-La Mancha - Campus Albacete, Albacete, Spain
| | - Bruno Bizzozero-Peroni
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; Instituto Superior de Educación Física, Universidad de la República, 40000 Rivera, Uruguay
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain; Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, 3460000 Talca, Chile
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13
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Schmidt-Trucksäss A, Lichtenstein AH, von Känel R. Lifestyle factors as determinants of atherosclerotic cardiovascular health. Atherosclerosis 2024; 395:117577. [PMID: 38852021 DOI: 10.1016/j.atherosclerosis.2024.117577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 05/02/2024] [Accepted: 05/03/2024] [Indexed: 06/10/2024]
Abstract
A sedentary lifestyle, low levels of physical activity and fitness, poor dietary patterns, and psychosocial stress are strongly associated with increased morbidity and mortality from atherosclerotic cardiovascular disease (ASCVD). Conversely, engaging in regular physical activity, maintaining optimal fitness levels, adhering to a heart-healthy dietary pattern, effectively managing body weight, ensuring adequate sleep, implementing stress-reduction strategies, and addressing psychosocial risk factors are associated with a reduced risk of ASCVD. This comprehensive review synthesizes current evidence from large observational studies and randomized controlled trials on lifestyle factors as determinants of ASCVD health. It also briefly reviews mechanistic insights into how factors such as low shear stress, increased reactive oxygen species production, chronic inflammation, platelets and coagulation activation, endothelial dysfunction, and sympathetic hyperactivity contribute to the initiation and exacerbation of ASCVD risk factors. These include obesity, hyperglycemia, type 2 diabetes, hypertension, and dyslipidemia, subsequently leading to the development and progression of atherosclerosis, ultimately resulting in chronic ASCVD or acute cardiovascular events. To bridge the translational gap between epidemiologic and trial-based evidence and clinical practice, practical recommendations are summarized to facilitate the translation of scientific knowledge into actionable interventions to promote ASCVD health. Acknowledged is the gap between the evidence-based knowledge and adoption within healthcare systems, which remains a crucial objective in advancing cardiovascular health at the population level.
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Affiliation(s)
- Arno Schmidt-Trucksäss
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Switzerland.
| | - Alice H Lichtenstein
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zürich, Switzerland
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14
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Lai S, Zhu C, Zhou X, Zeng Q, Huang L, Cao X, Zhou Q, Zhong Y, Huang J, Liu J, Zeng G, Chen H. Effect of Physical Activity on the Association Between Diet and Constipation: Evidence From the National Health and Nutrition Examination Survey 2007-2010. J Neurogastroenterol Motil 2024; 30:322-331. [PMID: 38972867 PMCID: PMC11238098 DOI: 10.5056/jnm23134] [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: 08/24/2023] [Revised: 10/13/2023] [Accepted: 11/06/2023] [Indexed: 07/09/2024] Open
Abstract
Background/Aims Previous studies have shown that diet and physical activity can influence constipation. However, the combined effect of diet and physical activity on constipation remains unclear. Methods Constipation was defined based on stool consistency and frequency, while overall diet quality was assessed using Healthy Eating Index (HEI)-2015 scores. Participants were categorized into low (metabolic equivalent [MET]-min/wk < 500) and high physical activity groups (MET-min/wk ≥ 500). The association between diet and constipation across physical activity groups was analyzed using survey logistic regression and restricted cubic splines. Results Higher HEI-2015 scores were associated with reduced constipation risk in the high physical activity group when constipation was defined by stool consistency (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97-0.99). However, in the low physical activity group, increased HEI-2015 scores did not significantly affect constipation risk (OR, 1.01; 95% CI, 0.97-1.05). Similar results were found when constipation was defined based on stool frequency. In the high physical activity group, increased HEI-2015 scores were significantly associated with a reduced constipation risk (OR, 0.96; 95% CI, 0.94-0.98). Conversely, in the low physical activity group, increased HEI-2015 scores did not affect the risk of constipation (OR, 0.96; 95% CI, 0.90-1.03). Conclusions Our findings suggest that a higher HEI-2015 score is negatively associated with constipation among individuals with high physical activity levels but not among those with low physical activity levels. This association was consistent when different definitions of constipation were used. These results highlight the importance of combining healthy diet with regular physical activity to alleviate constipation.
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Affiliation(s)
- Shijun Lai
- Gastroenterology Department, The Second Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Changdong Zhu
- Department of Endocrinology and Metabolism, Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital, Ganzhou, China
| | - Xiaoqing Zhou
- General Surgery Department, The Second Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Qingfeng Zeng
- Gastroenterology Department, The Second Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Lihua Huang
- Department of Clinical Laboratory, The Second Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Xiaodong Cao
- Gastroenterology Department, The Second Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Qiang Zhou
- Gastroenterology Department, The Second Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Yuhua Zhong
- Gastroenterology Department, The Second Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Jinjing Huang
- Gastroenterology Department, The Second Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Jianlan Liu
- Gastroenterology Department, The Second Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Guifang Zeng
- Gastroenterology Department, The Second Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Hong Chen
- Gastroenterology Department, The Second Affiliated Hospital of Gannan Medical University, Ganzhou, China
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15
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Ballin M, Berglind D, Henriksson P, Neovius M, Nordström A, Ortega FB, Sillanpää E, Nordström P, Ahlqvist VH. Adolescent Cardiorespiratory Fitness and Risk of Cancer in Late Adulthood: Nationwide Sibling-Controlled Cohort Study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.07.01.24309761. [PMID: 39006434 PMCID: PMC11245056 DOI: 10.1101/2024.07.01.24309761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Objective To investigate whether the higher risks of certain cancers associated with high cardiorespiratory fitness can be explained by increased detection and unobserved confounders. Design Nationwide sibling-controlled cohort study of adolescents. Setting Sweden. Participants 1 124 049 men of which 477 453 were full siblings, who underwent mandatory military conscription examinations between 1972 and 1995 at a mean age of 18.3 years. Main outcome measures Hazard ratios (HR) and 95% confidence intervals (CI) of overall cancer diagnosis and cancer mortality, and 14 site-specific cancers (diagnosis or death), as recorded in the Swedish National Patient Register or Cause of Death Register until 31 December 2023, modelled using flexible parametric regressions. Results Participants were followed until a median (maximum) age of 55.9 (73.5) years, during which 98 410 were diagnosed with cancer and 16 789 had a cancer-related death (41 293 and 6908 among full siblings respectively). The most common cancers were non-melanoma skin (27 105 diagnoses & 227 deaths) and prostate cancer (24 211 diagnoses & 869 deaths). In cohort analysis, those in the highest quartile of cardiorespiratory fitness had a higher risk of prostate (adjusted HR 1.10; 95% CI: 1.05 to 1.16) and skin cancer (e.g., non-melanoma HR 1.44; 1.37 to 1.50) compared to those in the lowest quartile, which led to a higher risk of any type of cancer diagnosis (HR 1.08; 1.06 to 1.11). However, those in the highest quartile had a lower risk of cancer mortality (HR 0.71; 0.67 to 0.76). When comparing full siblings, and thereby controlling for all behavioural, environmental, and genetic factors they share, the excess risk of prostate (HR 1.01; 0.90 to 1.13) and skin cancer (e.g., non-melanoma HR 1.09; 0.99 to 1.20) attenuated to the null. In contrast, the lower risk of overall cancer mortality was still statistically significant after control for such shared confounders (HR 0.78; 0.68 to 0.89). For other site-specific cancers, the influence of such confounding tended to vary, but none showed the same excess risk as prostate and non-melanoma skin cancer. Conclusions The association between high levels of adolescent cardiorespiratory fitness and excess risk of some cancers, such as prostate and non-melanoma skin cancer, appears to be fully explained by unobserved confounders shared between full siblings. However, the protective association with cancer mortality persists even after control for such confounding.
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Affiliation(s)
- Marcel Ballin
- Department of Public Health and Caring Sciences, Clinical Geriatrics, Uppsala University, Uppsala, Sweden
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
| | - Daniel Berglind
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Center for Wellbeing, Welfare and Happiness, Stockholm School of Economics, Stockholm, Sweden
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Martin Neovius
- Department of Medicine, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
| | - Anna Nordström
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- School of Sports Science, UiT The Arctic University of Norway, Tromsø, Norway
| | - Francisco B Ortega
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada; CIBEROBN, ISCIII, Granada, Andalucía, Spain
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Elina Sillanpää
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Wellbeing Services County of Central Finland, Jyväskylä, Finland
| | - Peter Nordström
- Department of Public Health and Caring Sciences, Clinical Geriatrics, Uppsala University, Uppsala, Sweden
| | - Viktor H Ahlqvist
- Department of Public Health and Caring Sciences, Clinical Geriatrics, Uppsala University, Uppsala, Sweden
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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16
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Li Z, Cheng S, Guo B, Ding L, Liang Y, Shen Y, Li J, Hu Y, Long T, Guo X, Ge J, Gao R, Pibarot P, Zhang B, Xu H, Clavel MA, Wu Y. Wearable device-measured moderate to vigorous physical activity and risk of degenerative aortic valve stenosis. Eur Heart J 2024:ehae406. [PMID: 38953786 DOI: 10.1093/eurheartj/ehae406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 04/04/2024] [Accepted: 06/17/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND AND AIMS Physical activity has proven effective in preventing atherosclerotic cardiovascular disease, but its role in preventing degenerative valvular heart disease (VHD) remains uncertain. This study aimed to explore the dose-response association between moderate to vigorous physical activity (MVPA) volume and the risk of degenerative VHD among middle-aged adults. METHODS A full week of accelerometer-derived MVPA data from 87 248 UK Biobank participants (median age 63.3, female: 56.9%) between 2013 and 2015 were used for primary analysis. Questionnaire-derived MVPA data from 361 681 UK Biobank participants (median age 57.7, female: 52.7%) between 2006 and 2010 were used for secondary analysis. The primary outcome was the diagnosis of incident degenerative VHD, including aortic valve stenosis (AS), aortic valve regurgitation (AR), and mitral valve regurgitation (MR). The secondary outcome was VHD-related intervention or mortality. RESULTS In the accelerometer-derived MVPA cohort, 555 incident AS, 201 incident AR, and 655 incident MR occurred during a median follow-up of 8.11 years. Increased MVPA volume showed a steady decline in AS risk and subsequent AS-related intervention or mortality risk, levelling off beyond approximately 300 min/week. In contrast, its association with AR or MR incidence was less apparent. The adjusted rates of AS incidence (95% confidence interval) across MVPA quartiles (Q1-Q4) were 11.60 (10.20, 13.20), 7.82 (6.63, 9.23), 5.74 (4.67, 7.08), and 5.91 (4.73, 7.39) per 10 000 person-years. The corresponding adjusted rates of AS-related intervention or mortality were 4.37 (3.52, 5.43), 2.81 (2.13, 3.71), 1.93 (1.36, 2.75), and 2.14 (1.50, 3.06) per 10 000 person-years, respectively. Aortic valve stenosis risk reduction was also observed with questionnaire-based MVPA data [adjusted absolute difference Q4 vs. Q1: AS incidence, -1.41 (-.67, -2.14) per 10 000 person-years; AS-related intervention or mortality, -.38 (-.04, -.88) per 10 000 person-years]. The beneficial association remained consistent in high-risk populations for AS, including patients with hypertension, obesity, dyslipidaemia, and chronic kidney disease. CONCLUSIONS Higher MVPA volume was associated with a lower risk of developing AS and subsequent AS-related intervention or mortality. Future research needs to validate these findings in diverse populations with longer durations and repeated periods of activity monitoring.
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Affiliation(s)
- Ziang Li
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China
- Research Center, Institut Universitaire de Cardiologie et de Pneumologie de Québec (Quebec Heart & Lung Institute), Université Laval, 2725 Chemin Sainte-Foy, Québec City, Québec, Canada G1V-4G5
| | - Sijing Cheng
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China
| | - Bo Guo
- Department of Medicine for Sports and Performing Arts, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Lu Ding
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, QLD, Australia
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yu Liang
- Department of Mathematical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Yinghan Shen
- Institute of Computing Technology, Chinese Academy of Sciences, Beijing, China
| | - Jinyue Li
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yiqing Hu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Tianxin Long
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China
| | - Xinli Guo
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Runlin Gao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, No.167 Beilishi Road, Beijing 100037, China
| | - Philippe Pibarot
- Research Center, Institut Universitaire de Cardiologie et de Pneumologie de Québec (Quebec Heart & Lung Institute), Université Laval, 2725 Chemin Sainte-Foy, Québec City, Québec, Canada G1V-4G5
| | - Bin Zhang
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China
- Research Center, Institut Universitaire de Cardiologie et de Pneumologie de Québec (Quebec Heart & Lung Institute), Université Laval, 2725 Chemin Sainte-Foy, Québec City, Québec, Canada G1V-4G5
| | - Haiyan Xu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, No.167 Beilishi Road, Beijing 100037, China
| | - Marie-Annick Clavel
- Research Center, Institut Universitaire de Cardiologie et de Pneumologie de Québec (Quebec Heart & Lung Institute), Université Laval, 2725 Chemin Sainte-Foy, Québec City, Québec, Canada G1V-4G5
| | - Yongjian Wu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, No.167 Beilishi Road, Beijing 100037, China
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Qi Y, Meng F, Yan X, Huang H, Chen X, He F. The effects of health risk behaviors to excess mortality in the population with depression: A cohort study based on NHANES data. J Affect Disord 2024; 356:233-238. [PMID: 38608768 DOI: 10.1016/j.jad.2024.04.038] [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: 12/19/2023] [Revised: 03/28/2024] [Accepted: 04/09/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND The population with depression had a considerable excess mortality risk. This increased mortality may be attributed to the biological consequences of depression or the substantial prevalence of health risk behaviors (HRBs). This study aimed to quantify the combined effects of four major HRBs - smoking, excessive alcohol use, physical inactivity, and an unhealthy diet - on excess mortality among depressed individuals. METHODS This study included 35,738 adults from the National Health and Nutrition Examination Survey 2005-06 to 2017-18, with mortality follow-up data censored through 2019. The standardized prevalence of HRBs was calculated for populations with and without depression. Poisson regression models were used to calculate the mortality rate ratio (MRR). Based on model adjusting for socio-demographic factors, the attenuation of MRR was determined after further adjustment for HRBs. RESULTS A total of 3147 participants were identified as having depression. All HRBs showed a significantly higher prevalence among the population with depression. After adjusting for socio-demographic factors, depression was associated with 1.7 and 1.8 times higher all-cause and cardiovascular disease mortality rate, respectively. Further adjustment for all current HRBs resulted in a 21.9 % reduction in all-cause mortality rate and a 15.4 % decrease in cardiovascular disease mortality rate. LIMITATION HRBs were reported at a single time point, and we are unable to demonstrate a causal effect. CONCLUSION At least 1/5 of excess mortality for population with depression was attributable to HRBs. Efforts should be made to address HRBs among population with depression.
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Affiliation(s)
- Yanjie Qi
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Fanchao Meng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xiuping Yan
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Huanhuan Huang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xu Chen
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Fan He
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
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18
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Liang JH, Liu ML, Huang SY, Huang S, Pu YQ, Jiang N, Bao WW, Zhang YS, Gui ZH, Hu LX, Pu XY, Li J, Chen YJ. Outdoor gardening activity with different frequency and duration may be associated with reduction of total and cause-specific mortality risk for general U.S. adults: Findings from the NHANES. Nutr Metab Cardiovasc Dis 2024; 34:1496-1507. [PMID: 38658226 DOI: 10.1016/j.numecd.2024.02.010] [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: 12/31/2023] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND AND AIMS Engaging in recommended levels of physical activity (PA) is associated with reduced overall and cause-specific mortality rates. Our study aims to examine the relationship between gardening-specific PA and all-cause and cause-specific mortality based on representative U.S. adults. METHODS AND RESULTS A total of 13,812 adults representing 663.5 million non-institutionalized U.S. adults were included in the National Health and Nutrition Examination Survey. Self-reported gardening activity (GA) was assessed by a validated questionnaire, and outcomes of interest were all-cause mortality and mortality specific to certain causes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using survey-multivariable Cox proportional hazards models. During a median follow-up period of 16.8 years (Interquartile range = 14.8-18.7), there were 3,476 deaths. After adjusting for potential covariates, we found that participants exposed to GA were more likely to have a lower risk of total mortality [HR (95% CI): 0.76 (0.68, 0.85), P-value < 0.001], cancer-specific mortality [HR (95% CI): 0.81 (0.67, 0.99), P-value < 0.05], cardiovascular disease mortality [HR (95% CI): 0.65 (0.53, 0.80), P-value < 0.001], and respiratory disease mortality [HR (95% CI): 0.66 (0.45, 0.98), P-value < 0.05], compared to those without GA exposure. Furthermore, engaging in GA more frequently and for longer durations was significantly associated with a lower total mortality risk. CONCLUSION Our study provides evidence that engaging in GA is associated with a decreased risk of overall and cause-specific mortality. However, further longitudinal or interventional studies are needed to investigate the potential benefits of GA.
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Affiliation(s)
- Jing-Hong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, PR China
| | - Mei-Ling Liu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, PR China
| | - Shao-Yi Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, PR China
| | - Shan Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, PR China
| | - Ying-Qi Pu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, PR China
| | - Nan Jiang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, PR China
| | - Wen-Wen Bao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, PR China
| | - Yu-Shan Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, PR China
| | - Zhao-Huan Gui
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, 74 Zhongshan 2nd Rd., Yuexiu District, Guangzhou, 510080, PR China
| | - Li-Xin Hu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, PR China
| | - Xue-Ya Pu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, PR China
| | - Jing Li
- Department of Child and Adolescent Health, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, 750000, PR China.
| | - Ya-Jun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, PR China.
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Qu C, Cao Z, Zhou J, He S, Liu F, Liu Z. Preoperative walking exercise to improve prognosis in patients with supratentorial brain tumours after craniotomy: protocol for a randomised controlled trial. BMJ Open 2024; 14:e080787. [PMID: 38754891 PMCID: PMC11097828 DOI: 10.1136/bmjopen-2023-080787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/01/2024] [Indexed: 05/18/2024] Open
Abstract
INTRODUCTION Cardiopulmonary complications and cognitive impairment following craniotomy have a significantly impact on the general health of individuals with brain tumours. Observational research indicates that engaging in walking is linked to better prognosis in patient after surgery. This trial aims to explore whether walking exercise prior to craniotomy in brain tumour patients can reduce the incidence of cardiopulmonary complications and preserve patients' cognitive function. METHODS AND ANALYSIS In this randomised controlled trial, 160 participants with supratentorial brain tumours aged 18-65 years, with a preoperative waiting time of more than 3-4 weeks and without conditions that would interfere with the trial such as cognitive impairment, will be randomly assigned in a ratio of 1:1 to either receive traditional treatment or additional combined with a period of 3-4 weeks of walking exercise of 10 000-15 000 steps per day. Wearable pedometer devices will be used to record step counts. The researchers will evaluate participants at enrolment, baseline, 14 days preoperatively, 3 days prior to surgery and 1 week after surgery or discharge (select which occurs first). The primary outcomes include the incidence of postoperative cardiopulmonary complications and changes in cognitive function (gauged by the Montreal Cognitive Assessment test). Secondary outcomes include the average length of hospital stay, postoperative pain, participant contentment, healthcare-associated costs and incidence of other postoperative surgery-related complications. We anticipate that short-term preoperative walking exercises will reduce the incidence of surgery-related complications in the short term after craniotomy, protect patients' cognitive function, aid patients' postoperative recovery and reduce the financial cost of treatment. ETHICS AND DISSEMINATION The study protocol has been approved by Ethics Committee of Xiangya Hospital of Central South University (approval number: 202305117). The findings of the research will be shared via publications that have been reviewed by experts in the field and through presentations at conferences. TRIAL REGISTRATION NUMBER NCT05930288.
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Affiliation(s)
- Chunrun Qu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- XiangYa School of Medicine, Central South University, Changsha, China
| | - Zeng Cao
- Department of Rehabilitation, Xiangya Hospital, Central South University, Changsha, China
| | - Jun Zhou
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Shihan He
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Fangkun Liu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Zhixiong Liu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Song J, Wang BH, Gao Y, Chen Y, Sun X, Zhang Z, Wu IXY, Dai W. Interaction of physical activity and low-level air pollution on cardiovascular disease: a prospective cohort study in UK Biobank. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2024; 46:188. [PMID: 38696021 DOI: 10.1007/s10653-024-01922-7] [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: 12/20/2023] [Accepted: 02/19/2024] [Indexed: 06/17/2024]
Abstract
To investigate the associations of physical activity (PA), low-level air pollution, and interaction on cardiovascular diseases (CVD) incidence based on the UK Biobank. PA was measured by the International Physical Activity Questionnaire and five air pollutants were estimated using Land Use Regression. All association estimates were based on Cox regression. Dose-response relationship was explored by restricted cubic spline, while multiplicative and additive interaction were examined by Pinteraction and relative excess risk due to interaction (RERI). As deviating proportional hazards assumption, we analyzed data as follow-up < 4 years and ≥ 4 years, separately. PA with 1000-4000 Metabolic Equivalent Task (MET) min/week showed the strongest protective impact on CVD incidence, while only low-level nitrogen dioxides (NO2) showed negative impact among five air pollutants and was considered for further analysis. Multiplicative interaction between PA and NO2 was observed during ≥ 4 years follow-up (Pinteraction = 0.049) while not during < 4 years (Pinteraction = 0.290). Positive additive interactions were found for high PA and low NO2 (< 20 μg/m3) group (RERI: 0.07, 95% confidence intervals: 0.02-0.11) during < 4 years, and for moderate PA with NO2 at 40- μg/m3 (0.07, 0.02-0.13) and < 20 μg/m3 (0.07, 0.02-0.12), while high PA showed similar results with NO2 at 40-, 20- and < 20 μg/m3 during ≥ 4 years. PA about 1000-4000 METs min/week showed the lowest CVD risk. Possibility of interaction with PA and NO2 is more likely to present with the increase in follow-up duration. We call for the optimal thresholds of PA, and exploring interaction thoroughly by considering types of PA.
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Affiliation(s)
- Jinlu Song
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
| | - Betty H Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong
| | - Yinyan Gao
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
| | - Yancong Chen
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
- Changsha Center for Disease Control and Prevention, Changsha, Hunan, China
| | - Xuemei Sun
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
| | - Zixuan Zhang
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
- Changsha Center for Disease Control and Prevention, Changsha, Hunan, China
| | - Irene X Y Wu
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China.
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Central South University, Changsha, Hunan, China.
| | - Wenjie Dai
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China.
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Grellier J, White MP, de Bell S, Brousse O, Elliott LR, Fleming LE, Heaviside C, Simpson C, Taylor T, Wheeler BW, Lovell R. Valuing the health benefits of nature-based recreational physical activity in England. ENVIRONMENT INTERNATIONAL 2024; 187:108667. [PMID: 38642505 DOI: 10.1016/j.envint.2024.108667] [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: 08/15/2023] [Revised: 03/15/2024] [Accepted: 04/15/2024] [Indexed: 04/22/2024]
Abstract
Physical activity (PA) reduces the risk of several non-communicable diseases (NCDs). Natural environments support recreational PA. Using data including a representative cross-sectional survey of the English population, we estimated the annual value of nature-based PA conducted in England in 2019 in terms of avoided healthcare and societal costs of disease. Population-representative data from the Monitor of Engagement with the Natural Environment (MENE) survey (n = 47,580; representing 44,386,756) were used to estimate the weekly volume of nature-based recreational PA by adults in England in 2019. We used epidemiological dose-response data to calculate incident cases of six NCDs (ischaemic heart disease (IHD), ischaemic stroke (IS), type 2 diabetes (T2D), colon cancer (CC), breast cancer (BC) and major depressive disorder (MDD)) prevented through nature-based PA, and estimated associated savings using published costs of healthcare, informal care and productivity losses. We investigated additional savings resulting from hypothetical increases in: (a) visitor PA and (b) visitor numbers. In 2019, 22million adults > 16 years of age in England visited natural environments at least weekly. At reported volumes of nature-based PA, we estimated that 550 cases of IHD, 168 cases of IS, 1,410 cases of T2D, 41 cases of CC, 37 cases of BC and 10,552 cases of MDD were prevented, creating annual savings of £108.7million (95 % uncertainty interval: £70.3million; £150.3million). Nature-based recreational PA in England results in reduced burden of disease and considerable annual savings through prevention of priority NCDs. Strategies that increase nature-based PA could lead to further reductions in the societal burden of NCDs.
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Affiliation(s)
- James Grellier
- European Centre for Environment & Human Health, University of Exeter, Penryn, Cornwall, UK; Institute of Psychology, Jagiellonian University, Krakow, Poland.
| | - Mathew P White
- European Centre for Environment & Human Health, University of Exeter, Penryn, Cornwall, UK; Vienna Cognitive Science Hub, University of Vienna, Kolingasse 14-16, 1090 Vienna, Austria
| | - Siân de Bell
- European Centre for Environment & Human Health, University of Exeter, Penryn, Cornwall, UK; Exeter HS&DR Evidence Synthesis Centre, University of Exeter, Exeter, Devon, UK
| | - Oscar Brousse
- The Bartlett School of Environment, Energy and Resources, Faculty of the Built Environment, University College London, London, UK
| | - Lewis R Elliott
- European Centre for Environment & Human Health, University of Exeter, Penryn, Cornwall, UK
| | - Lora E Fleming
- European Centre for Environment & Human Health, University of Exeter, Penryn, Cornwall, UK
| | - Clare Heaviside
- The Bartlett School of Environment, Energy and Resources, Faculty of the Built Environment, University College London, London, UK
| | - Charles Simpson
- The Bartlett School of Environment, Energy and Resources, Faculty of the Built Environment, University College London, London, UK
| | - Tim Taylor
- European Centre for Environment & Human Health, University of Exeter, Penryn, Cornwall, UK
| | - Benedict W Wheeler
- European Centre for Environment & Human Health, University of Exeter, Penryn, Cornwall, UK
| | - Rebecca Lovell
- European Centre for Environment & Human Health, University of Exeter, Penryn, Cornwall, UK
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Bergum H, Grimsmo J, Anderssen SA, Klemsdal TO. Effects on physical activity, physical fitness and well-being in a 36-months randomized controlled study, comparing a multimodal hospital-based intervention programme for primary cardiovascular prevention with usual care. BMC Cardiovasc Disord 2024; 24:225. [PMID: 38664620 PMCID: PMC11044290 DOI: 10.1186/s12872-024-03892-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 04/15/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Cardiovascular disease is a major cause of mortality and morbidity worldwide, and primary prevention efforts are poorly developed in people at high cardiovascular risk. On this background, we performed the Hjerteløftet Study and demonstrated that participation over 36 months in a multimodal primary prevention programme, significantly reduced validated cardiovascular risk scores. In the current substudy we aimed to further explore several elements and effects following the intervention programme. METHODS A random sample from the original Hjerteløftet Study was included for further examinations (n = 255, 40% women), and these patients were already randomized to an intervention group (IG) (n = 127), or a control group (CG) (n = 128). We compared changes from baseline to 36-months follow-up in physical activity, cardiorespiratory fitness, psychological well-being (WHO-5), cardiovascular medication use, smoking habits, and cardiometabolic risk factors (blood pressure, lipids, blood glucose, HbA1c, Apolipoprotein A-I, Apolipoprotein B and high-sensitive C-reactive protein). RESULTS Self-reported physical activity increased significantly with absolute difference in mean delta Physical Activity Index score in the IG compared to the CG: 0.90, 95% CI: 0.10 to 1.70, p = 0.028 (ANCOVA). There were no corresponding differences in cardiorespiratory fitness. The participation resulted in psychological well-being improvement in both groups with a larger increase in the IG compared to the CG. The mean difference in delta WHO-5 score was 5.06, 95% CI: 0.68 to 9.45, p = 0.024, and 3.28, 95% CI: -0.69 to 5.25, p = 0.104 when controlled for baseline values (ANCOVA). The use of antihypertensive medication increased significantly more in the CG (p = 0.044). Only minor, nonsignificant changes were observed for traditional risk factors and cardiometabolic variables. CONCLUSIONS Participation in the Hjerteløftet Study intervention programme resulted in an improved physical activity level, but without changing cardiorespiratory fitness. Participation in the programme also tended to improve psychological well-being, possibly related to increased physical activity, less smoking and less use of cardiovascular medication. Concerning the metabolic status, no major differences were observed, but minor changes may have been concealed by a larger increase in cardiovascular medication use in the control group. TRIAL REGISTRATION ClinicalTrials.gov (NCT01741428), 04/12/2012.
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Affiliation(s)
- Hilde Bergum
- Department of Cardiac and Pulmonary Rehabilitation, Lovisenberg Rehabilitation, Cathinka Guldbergs Hospital, Jessheim, 2051, Norway.
- University of Oslo, Oslo, Norway.
| | - Jostein Grimsmo
- Department of Cardiac and Pulmonary Rehabilitation, Lovisenberg Rehabilitation, Cathinka Guldbergs Hospital, Jessheim, 2051, Norway
| | - Sigmund Alfred Anderssen
- Department of Sports Medicine, the Norwegian School of Sports Sciences, Sognsveien 220, 0806, Oslo, Norway
| | - Tor Ole Klemsdal
- Department of Preventive Cardiology, Oslo University Hospital Aker, Trondheimsveien 235, 0586, Oslo, Norway
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Kazemi A, Soltani S, Aune D, Hosseini E, Mokhtari Z, Hassanzadeh Z, Jayedi A, Pitanga F, Akhlaghi M. Leisure-time and occupational physical activity and risk of cardiovascular disease incidence: a systematic-review and dose-response meta-analysis of prospective cohort studies. Int J Behav Nutr Phys Act 2024; 21:45. [PMID: 38659024 PMCID: PMC11044601 DOI: 10.1186/s12966-024-01593-8] [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: 10/21/2023] [Accepted: 04/14/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Physical activity has benefits for the cardiovascular system, however, what levels and types of activity provide optimal cardiovascular health is unclear. We aimed to determine the level of physical activity that has the most benefits against cardiovascular diseases (CVD). METHODS PubMed, Scopus, and Web of Science were searched for prospective cohort studies on leisure-time (LTPA) or occupational physical activity (OPA) as the exposure and major types of CVD (total CVD, coronary heart disease [CHD], stroke, and atrial fibrillation [AF]) incidence as the outcome. Risk of bias of studies was evaluated using the ROBINS-I tool. Summary hazard ratios (HR) were calculated using random-effects pairwise model. RESULTS A total of 103 studies were included in the analysis. The highest versus the lowest LTPA was associated with a lower risk of overall CVD (HR = 0.81; 95% CI: 0.77-0.86), CHD (HR = 0.83; 0.79-0.88), and stroke (HR = 0.83; 0.79-0.88), but not AF (HR = 0.98; 0.92-1.05). Linear dose-response analyses showed a 10%, 12%, 9%, and 8% risk reduction in CVD, CHD, stroke, and AF incidence, respectively, for every 20 MET-hours/week increase in LTPA. In nonlinear dose-response analyses, there were inverse associations up to 20 MET-hours/week with 19% and 20% reduction in CVD and CHD risk, and up to 25 MET-hours/week with 22% reduction in stroke, with no further risk reduction at higher LTPA levels. For AF, there was a U-shaped nonlinear association with the maximum 8% risk reduction at 10 MET-hours/week of LTPA. Higher levels of OPA were not associated with risk of CVD, CHD, stroke, or AF. CONCLUSIONS Overall, results showed an inverse dose-response relationship between LTPA and risk of CVD, CHD, stroke, and AF. Running was the most beneficial LTPA but the risk was similar among various LTPA intensities. OPA showed no benefits in total or any type of CVD.
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Affiliation(s)
- Asma Kazemi
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sepideh Soltani
- Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Nutrition, Oslo New University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Elham Hosseini
- Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zeinab Mokhtari
- Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Hassanzadeh
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Jayedi
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | | | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Razi Blvd, 7153675541, Shiraz, Iran.
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Seino S, Abe T, Nofuji Y, Hata T, Shinkai S, Kitamura A, Fujiwara Y. Dose-response associations between physical activity and sedentary time with functional disability in older adults with or without frailty: a prospective cohort study. Front Public Health 2024; 12:1357618. [PMID: 38721536 PMCID: PMC11076770 DOI: 10.3389/fpubh.2024.1357618] [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: 12/18/2023] [Accepted: 04/02/2024] [Indexed: 05/14/2024] Open
Abstract
Purpose Evidence regarding the dose-response curve shapes of physical activity (PA) and sedentary time (ST) in older adults with functional disability (FD) is extremely limited. Moreover, these associations may differ depending on with/without frailty. We examined the dose-response associations between moderate-to-vigorous PA (MVPA) and ST with FD among older adults with/without frailty. Methods We included 7,480 initially nondisabled adults (3,795 men and 3,685 women) aged 65-84 years in Ota City, Tokyo, Japan. MVPA and ST were evaluated using the International Physical Activity Questionnaire-Short Form. FD was prospectively identified using a nationally unified database of the long-term care insurance system. Frailty was determined using Check-List 15, validated against Fried's frailty criteria. Multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of MVPA and ST for FD were calculated, and dose-response curves were examined using restricted cubic splines. Results During 3.6 years of follow-up, 1,001 (13.4%) participants had FD. Among all participants, compared with no MVPA, the HRs for FD reduced linearly up to approximately 2000 metabolic equivalents (METs)■min/week of MVPA, and the lowest HR (HR: 0.61, 95% CI: 0.51-0.74) was reached at around 3,000-4,000 METs■min/week. Although the shape of this association was consistent regardless of with/without frailty, the magnitude of the association tended to be stronger in frail older adults than in non-frail older adults. Compared with those for the median (300 min/day) of ST, the HRs for FD increased linearly as ST reached approximately 600 min/day or more, independent of MVPA, with a maximum HR of 1.31 (95% CI: 1.01-1.71) for 1,080 min/day among all participants. This association was more pronounced among non-frail older adults but not statistically significant among frail older adults. Conclusion Higher MVPA levels consistently reduced the incidence of FD regardless of frailty in a significant inverse nonlinear dose-response manner. A significant positive nonlinear dose-response association between ST and FD risk was identified among non-frail older adults but not among frail older adults. Increasing MVPA and reducing prolonged ST are important for preventing FD among non-frail older adults. However, reducing ST alone may be insufficient; increasing MVPA, even if by only small increments, is highly recommended for frail older adults.
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Affiliation(s)
- Satoshi Seino
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Takumi Abe
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Yu Nofuji
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Toshiki Hata
- The Tokyo Metropolitan Support Center for Preventative Long-term and Frail Elderly Care, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
| | - Shoji Shinkai
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
- Department of Nutrition Sciences, Kagawa Nutrition University, Sakado, Saitama, Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
- Health Town Development Science Center, Yao City Public Health Center, Yao City, Osaka, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi, Tokyo, Japan
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Thu W, Woodward A, Cavadino A, Tin Tin S. Associations between transport modes and site-specific cancers: a systematic review and meta-analysis. Environ Health 2024; 23:39. [PMID: 38609941 PMCID: PMC11015678 DOI: 10.1186/s12940-024-01081-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 04/08/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Physical inactivity is a global public health problem. A practical solution would be to build physical activity into the daily routine by using active modes of transport. Choice of transport mode can influence cancer risk through their effects on levels of physical activity, sedentary time, and environmental pollution. This review synthesizes existing evidence on the associations of specific transport modes with risks of site-specific cancers. METHODS Relevant literature was searched in PubMed, Embase, and Scopus from 1914 to 17th February 2023. For cancer sites with effect measures available for a specific transport mode from two or more studies, random effects meta-analyses were performed to pool relative risks (RR) comparing the highest vs. lowest activity group as well as per 10 Metabolic Equivalent of Task (MET) hour increment in transport-related physical activity per week (∼150 min of walking or 90 min of cycling). RESULTS 27 eligible studies (11 cohort, 15 case-control, and 1 case-cohort) were identified, which reported the associations of transport modes with 10 site-specific cancers. In the meta-analysis, 10 MET hour increment in transport-related physical activity per week was associated with a reduction in risk for endometrial cancer (RR: 0.91, 95% CI: 0.83-0.997), colorectal cancer (RR: 0.95, 95% CI: 0.91-0.99) and breast cancer (RR: 0.99, 95% CI: 0.89-0.996). The highest level of walking only or walking and cycling combined modes, compared to the lowest level, were significantly associated with a 12% and 30% reduced risk of breast and endometrial cancers respectively. Cycling, compared to motorized modes, was associated with a lower risk of overall cancer incidence and mortality. CONCLUSION Active transport appears to reduce cancer risk, but evidence for cancer sites other than colorectum, breast, and endometrium is currently limited.
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Affiliation(s)
- Win Thu
- Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Alistair Woodward
- Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Alana Cavadino
- Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Sandar Tin Tin
- Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand.
- Cancer Epidemiology Unit, Oxford Population Health, University of Oxford, Oxford, UK.
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Jakše B, Gilić B, Đurović M, Šajber D. The Effects of an Eight-Week Swimming Program on Body Composition and Assessment of Dietary Intake in Post-COVID-19 Patients. J Nutr Metab 2024; 2024:3037784. [PMID: 38571925 PMCID: PMC10990646 DOI: 10.1155/2024/3037784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 02/22/2024] [Accepted: 03/14/2024] [Indexed: 04/05/2024] Open
Abstract
COVID-19 infection and its consequences (long-term COVID-19 syndrome) have implications for weight loss, body composition, and diet quality. In the context of the "PostCovSwim" project, which is part of a broader international study, the impact of an eight-week swimming program on post-COVID-19 patients' nutritional status (i.e., body composition and dietary intake) was evaluated. Body composition and dietary intake were assessed by medically approved and calibrated bioelectrical impedance (Tanita 780 S MA) and food frequency questionnaires. At the baseline, most participants were classified as overweight based on their body mass index (BMI). However, their body fat percentage (BF%) classification indicated normal weight, although females were near obesity thresholds. Furthermore, at the baseline, according to the BMI classification, 62% of females and 61% of males were female, whereas according to the BF% for obesity classification, 44% of females and 43% of males were considered overweight or obese. Surprisingly, despite the eight-week program, there were no significant changes in body composition. Additionally, the assessment of dietary intake, which remained consistent throughout the study, revealed dietary imbalances characterized by an unhealthy low-carbohydrate, high-fat dietary pattern. This dietary pattern entailed excessive consumption of ultraprocessed foods; reduced carbohydrate intake (39% E vs. 37% E); increased total fat intake (46% E vs. 47% E); increased saturated fatty acids (14% E vs. 13% E); increased cholesterol (412 mg/d vs. 425 mg/d); increased free sugars (7% E vs. 7% E); and inadequate intake of fibre (24 g/d vs. 20 g/d), polyunsaturated fatty acids (6.6% E vs. 7.7% E), vitamin B12 (in females: 3.1 µg/d), vitamin C (86 mg/d vs. 66 mg/d), vitamin D (2 µg/d vs. 3.2 µg/d), folate (in males: 258 µg/d), calcium (777 mg/d vs. 743 mg/d), and selenium (in males: 66 µg/d). After an eight-week swimming program following COVID-19, no significant changes were observed in the subjects' body composition. Their dietary intake was found to not align with the dietary recommendations. These findings underscore the urgency of implementing comprehensive dietary and lifestyle interventions for post-COVID-19 patients to optimize their recovery and overall well-being. Physical activity, like a swimming program, may positively affect various aspects of human well-being.
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Affiliation(s)
| | - Barbara Gilić
- University of Split, Faculty of Kinesiology, Split, Croatia
| | - Marko Đurović
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
| | - Dorica Šajber
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
- Swimming Association of Slovenia, Ljubljana, Slovenia
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Stattin K, Eriksson M, Frithiof R, Kawati R, Hultström M, Lipcsey M. Physical activity is associated with a lower risk of contracting and dying in infection and sepsis: a Swedish population-based cohort study. Crit Care 2024; 28:98. [PMID: 38523312 PMCID: PMC10962192 DOI: 10.1186/s13054-024-04881-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/18/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Sepsis is a condition where the immune response to infection becomes dysregulated and life-threatening. It is not known whether lifestyle factors influence the risk of sepsis. The aim of the present study is to investigate the association between physical activity and the risk of acquiring and dying in infection or sepsis. METHODS The population-based Swedish Mammography Cohort and Cohort of Swedish Men sent participants lifestyle questionnaires in 1997 and have subsequently followed participants in national Swedish registers, including the National Patient Register, the Swedish Intensive Care Registry and the Cause of Death Register. The risk of contracting infection and sepsis, the risk of intensive care unit admission and the risk of death were estimated using multivariable Cox regression. RESULTS Among 64,850 cohort participants, 26,124 individuals suffered at least one episode of infection or sepsis and 4708 individuals died of infection or sepsis during the study period. In adjusted analyses, compared to exercising less than one hour per week, stated exercise one hour per week was associated with lower risk of contracting infection or sepsis, hazard ratio (HR) 0.93 (95% confidence interval (CI) 0.90-0.97), and lower risk of dying in infection or sepsis, HR 0.87 (95% CI 0.80-0.96). Further exercise was associated with even lower risk, and similar patterns were observed for walking. The population-attributable risks of contracting and dying in infection or sepsis for not exercising were 2.6% and 4.5%, respectively. CONCLUSIONS Exercise and walking demonstrate inverse dose-response associations with both the risk of contracting and dying in infection and sepsis, presenting possible preventative interventions for this critical condition.
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Affiliation(s)
- Karl Stattin
- Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Akademiska Sjukhuset, Ingång 70, 75 185, Uppsala, Sweden.
| | - Mikael Eriksson
- Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Akademiska Sjukhuset, Ingång 70, 75 185, Uppsala, Sweden
| | - Robert Frithiof
- Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Akademiska Sjukhuset, Ingång 70, 75 185, Uppsala, Sweden
| | - Rafael Kawati
- Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Akademiska Sjukhuset, Ingång 70, 75 185, Uppsala, Sweden
| | - Michael Hultström
- Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Akademiska Sjukhuset, Ingång 70, 75 185, Uppsala, Sweden
- Department of Medical Cell Biology, Unit for Integrative Physiology, Uppsala University, Uppsala, Sweden
| | - Miklos Lipcsey
- Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Akademiska Sjukhuset, Ingång 70, 75 185, Uppsala, Sweden
- Hedenstierna Laboratory, Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
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Loch MR, Augusto NA, Souza BLS, Rufino JV, Carvalho FFBD. Association between physical activity domains and depressive symptoms among Brazilian adults: does every move count? CAD SAUDE PUBLICA 2024; 40:e00095723. [PMID: 38477730 PMCID: PMC10929886 DOI: 10.1590/0102-311xpt095723] [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: 05/25/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 03/14/2024] Open
Abstract
This study aimed to investigate the practice of physical activities in the four domains (leisure time, transportation, household, and work) and the prevalence of depressive symptoms in Brazilian adults, in general and stratified by sex, schooling level, and having or not a self-reported diagnosis of depression. This is a cross-sectional study with data from 88,531 individuals aged 18 years or older, who responded to the Brazilian National Health Survey in 2019. The depressive symptoms were evaluated by the Patient Health Questionnaire-9 (PHQ-9). Those who practice physical activities at least once a week in a given domain were considered physically active. Additionally, the calculation of physical activities duration was conducted and later divided into quartiles for each domain. For the association analyses, the crude odds ratio (crudeOR) and adjusted odds ratio (adjustedOR) were calculated for the total and stratified analyses. Individuals who are physically active during leisure time showed a lower chance of presenting depressive symptoms, in total (adjustedOR = 0.74; 95%CI: 0.64-0.86) and in all stratifications, except for individuals with self-reported depression. The associations of leisure-time physical activity were most frequent in those who practice from 121 to 360 minutes/week. The individuals who were active in the transportation, household, and work domains had a higher chance of presenting depressive symptoms in some groups, with more consistent results for household physical activities. The results showed that the relationship between physical activities and depression among Brazilians varies according to domain and duration, and that the concept that "every move counts" seemed to be correct only for the leisure-time domain.
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Caporossi D, Dimauro I. Exercise-induced redox modulation as a mediator of DNA methylation in health maintenance and disease prevention. Free Radic Biol Med 2024; 213:113-122. [PMID: 38242245 DOI: 10.1016/j.freeradbiomed.2024.01.023] [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: 10/16/2023] [Revised: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 01/21/2024]
Abstract
The evidence for physical activity (PA) as a major public health preventive approach and a potent medical therapy has increased exponentially in the last decades. The biomolecular mechanisms supporting the associations between PA and/or structured exercise training with health maintenance and disease prevention are not completely characterized. However, increasing evidence pointed out the role of epigenetic modifications in exercise adaptation and health-enhancing PA throughout life, DNA methylation being the most intensely studied epigenetic modification induced by acute and chronic exercise. The current data on the modulation of DNA methylation determined by physically active behavior or exercise interventions points out genes related to energy regulation, mitochondrial function, and biosynthesis, as well as muscle regeneration, calcium signaling pathways, and brain plasticity, all consistent with the known exercise-induced redox signaling and/or reactive oxygen species (ROS) unbalance. Thus, the main focus of this review is to discuss the role of ROS and redox-signaling on DNA methylation profile and its impact on exercise-induced health benefits in humans.
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Affiliation(s)
- Daniela Caporossi
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis 15, Rome, 00135, Italy.
| | - Ivan Dimauro
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis 15, Rome, 00135, Italy
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Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Barone Gibbs B, Beaton AZ, Boehme AK, Commodore-Mensah Y, Currie ME, Elkind MSV, Evenson KR, Generoso G, Heard DG, Hiremath S, Johansen MC, Kalani R, Kazi DS, Ko D, Liu J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Perman SM, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Tsao CW, Urbut SM, Van Spall HGC, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Palaniappan LP. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation 2024; 149:e347-e913. [PMID: 38264914 DOI: 10.1161/cir.0000000000001209] [Citation(s) in RCA: 182] [Impact Index Per Article: 182.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Florindo M, Gregório J, Rodrigues LM. Lower-Limb Perfusion and Cardiovascular Physiology Are Significantly Improved in Non-Healthy Aged Adults by Regular Home-Based Physical Activities-An Exploratory Study. Life (Basel) 2024; 14:241. [PMID: 38398750 PMCID: PMC10890040 DOI: 10.3390/life14020241] [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: 01/21/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Common daily activities including walking might be used to improve cardiovascular health in the presence of disease. Thus, we designed a specific home-based physical activity program to assess cardiovascular indicators in an older, non-active, non-healthy population. Ten participants, with a mean age of 62.4 ± 5.6 years old, were chosen and evaluated twice-upon inclusion (D0), and on day 30 (D30)-following program application. Perfusion was measured in both feet by laser Doppler flowmetry (LDF) and by polarised spectroscopy (PSp). Measurements were taken at baseline (Phase 1) immediately after performing the selected activities (Phase 2) and during recovery (Phase 3). Comparison outcomes between D0 and D30 revealed relevant differences in Phase 1 recordings, namely a significant increase in LDF perfusion (p = 0.005) and a significant decrease in systolic blood pressure (p = 0.008) and mean arterial pressure (MAP) (p = 0.037). A correlation between the increase in perfusion and the weekly activity time was found (p = 0.043). No differences were found in Phase 2, but, in Phase 3, LDF values were still significantly higher in D30 compared with D0. These simple activities, regularly executed with minimal supervision, significantly improved the lower-limb perfusion while reducing participants' systolic pressure and MAP, taken as an important improvement in their cardiovascular status.
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Affiliation(s)
- Margarida Florindo
- CBIOS—Research Center for Biosciences & Health Technologies, Universidade Lusófona, 1749 024 Lisboa, Portugal; (M.F.)
- Department of Physiotherapy, ESSCVP—Portuguese Red Cross Health School, 1300 125 Lisboa, Portugal
- Escuela de Doctorado, Programa de Ciencias de la Salud, Universidade de Alcalá, 28034 Madrid, Spain
| | - João Gregório
- CBIOS—Research Center for Biosciences & Health Technologies, Universidade Lusófona, 1749 024 Lisboa, Portugal; (M.F.)
| | - Luís Monteiro Rodrigues
- CBIOS—Research Center for Biosciences & Health Technologies, Universidade Lusófona, 1749 024 Lisboa, Portugal; (M.F.)
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Powers-James C, Morse M, Narayanan S, Ramondetta L, Lopez G, Wagner R, Cohen L. Integrative Oncology Approaches to Reduce Recurrence of Disease and Improve Survival. Curr Oncol Rep 2024; 26:147-163. [PMID: 38180690 DOI: 10.1007/s11912-023-01467-5] [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] [Accepted: 10/10/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE OF REVIEW After a cancer diagnosis, patients ask what they can do in addition to the recommended treatments to increase their survival. Many turn to integrative medicine modalities and lifestyle changes to improve their chances of survival. Numerous studies have demonstrated that lifestyle changes can significantly improve survival rates for cancer patients. Less support exists for the use of natural products or supplements to improve cancer survival. In this manuscript, we review key findings and evidence in the areas of healthy eating habits, physical activity, stress management and social support, and sleep quality, as well as natural products and supplements as they relate to the cancer recurrence and survival. RECENT FINDINGS While more research is needed to fully understand the mechanisms underlying the associations between lifestyle changes and cancer survival, findings suggest that lifestyle modifications in the areas of diet, physical activity, stress management and social support, and sleep quality improve clinical cancer outcomes. This is especially true for programs that modify more than one lifestyle habit. To date, outside of supplementing with vitamin D to maintain adequate levels, conflicting conclusion within the research remain regarding the efficacy of using natural products or supplement to improve cancer recurrence of disease or cancer survival. A call for further research is warranted. Lifestyle screening and counseling should be incorporated into cancer treatment plans to help improve patient outcomes. While the scientific community strives for the pursuit of high-quality research on natural products to enhance cancer survival, transparency, dialogue, and psychological safety between patients and clinicians must continue to be emphasized. Proactive inquiry by clinicians regarding patients' supplement use will allow for an informed discussion of the benefits and risks of natural products and supplements, as well as a re-emphasis of the evidence supporting diet and other lifestyle habits to increase survival.
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Affiliation(s)
- Catherine Powers-James
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
| | - Meroë Morse
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Santhosshi Narayanan
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Lois Ramondetta
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Gabriel Lopez
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Richard Wagner
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414, 1515 Holcombe Blvd, Houston, TX, 77030, USA
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Ekelund U, Sanchez-Lastra MA, Dalene KE, Tarp J. Dose-response associations, physical activity intensity and mortality risk: A narrative review. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:24-29. [PMID: 37734548 PMCID: PMC10818107 DOI: 10.1016/j.jshs.2023.09.006] [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: 08/31/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 09/23/2023]
Abstract
Physical activity is consistently associated with reduced mortality, decreased risk for non-communicable diseases, and improved mental health in observational studies. Randomized controlled trials and observational Mendelian randomization studies support causal links between physical activity and health outcomes. However, the scarcity of evidence from randomized controlled trials, along with their inherent challenges like exposure contrasts, healthy volunteer biases, loss to follow-up, and limited real-world dose-response data, warrants a comprehensive approach. This review advocates synthesizing insights from diverse study designs to better understand the causal relationship between physical activity, mortality risk, and other health outcomes. Additionally, it summarizes recent research since the publication of current physical activity recommendations. Novel observational studies utilizing device-measured physical activity underscore the importance of every minute of activity and suggest that all intensity levels confer health benefits, with vigorous-intensity potentially requiring lower volumes for substantial benefits. Future guidelines, informed by device-measured physical activity studies, may offer refined age-specific recommendations, emphasize vigorous-intensity physical activity, and include daily step counts as a simple, easily assessable metric using commercial wearables.
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Affiliation(s)
- Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo 0806, Norway; Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo 0213, Norway.
| | - Miguel Adriano Sanchez-Lastra
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo 0806, Norway; Department of Special Didactics, Faculty of Education and Sports Sciences, University of Vigo, Pontevedra 36005, Spain; Well-Move Research Group, Galicia-Sur Health Research Institute (SERGAS-UVIGO), Vigo 36213, Spain
| | - Knut Eirik Dalene
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo 0213, Norway
| | - Jakob Tarp
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo 0806, Norway
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Hansen D, Coninx K, Beckers P, Cornelissen V, Kouidi E, Neunhauserer D, Niebauer J, Spruit MA, Takken T, Dendale P. Appropriate exercise prescription in primary and secondary prevention of cardiovascular disease: why this skill remains to be improved among clinicians and healthcare professionals. A call for action from the EXPERT Network†. Eur J Prev Cardiol 2023; 30:1986-1995. [PMID: 37458001 DOI: 10.1093/eurjpc/zwad232] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/03/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
In Europe alone, on a yearly basis, millions of people need an appropriate exercise prescription to prevent the occurrence or progression of cardiovascular disease (CVD). A general exercise recommendation can be provided to these individuals (at least 150 min of moderate-intensity endurance exercise, spread over 3-5 days/week, complemented by dynamic moderate-intensity resistance exercise 2 days/week). However, recent evidence shows that this one size does not fit all and that individual adjustments should be made according to the patient's underlying disease(s), risk profile, and individual needs, to maximize the clinical benefits of exercise. In this paper, we (i) argue that this general exercise prescription simply provided to all patients with CVD, or elevated risk for CVD, is insufficient for optimal CVD prevention, and (ii) show that clinicians and healthcare professionals perform heterogeneously when asked to adjust exercise characteristics (e.g. intensity, volume, and type) according to the patient's condition, thereby leading to suboptimal CVD risk factor control. Since exercise training is a class 1A intervention in the primary and secondary prevention of CVD, the awareness of the need to improve exercise prescription has to be raised among clinicians and healthcare professionals if optimized prevention of CVD is ambitioned.
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Affiliation(s)
- Dominique Hansen
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- UHasselt, BIOMED (Biomedical Research Institute) and REVAL (Rehabilitation Research Centre), Hasselt University, Hasselt, Belgium
| | - Karin Coninx
- UHasselt, Human-Computer Interaction and eHealth, Faculty of Sciences, Hasselt University, Hasselt, Belgium
| | - Paul Beckers
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp Hasselt, Belgium
| | - Véronique Cornelissen
- Research group of Cardiovascular Rehabilitation, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Belgium
- Department Rehabilitation Sciences, University Leuven, Leuven, Belgium
| | - Evangelia Kouidi
- Laboratory of Sports Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Daniel Neunhauserer
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padova, Italy
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation, Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Rehab-Center Salzburg, Ludwig Boltzmann Institute for digital Health and Prevention, Salzburg, Austria
| | - Martijn A Spruit
- Department of Research & Education; CIRO+, Centre of Expertise for Chronic Organ Failure, Horn/Department of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Tim Takken
- Division of Pediatrics, Child Development & Exercise Center, Wilhelmina Children's Hospital, UMC Utrecht, Utrecht, The Netherlands
| | - Paul Dendale
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- UHasselt, BIOMED (Biomedical Research Institute) and REVAL (Rehabilitation Research Centre), Hasselt University, Hasselt, Belgium
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Phan A, Askim T, Lydersen S, Indredavik B, Wethal T. Accelerometer-measured physical activity at 3 months as a predictor of symptoms of depression and anxiety 1 year after stroke: a multicentre prospective cohort study in central Norway. J Rehabil Med 2023; 55:jrm12309. [PMID: 37970656 PMCID: PMC10666064 DOI: 10.2340/jrm.v55.12309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 10/24/2023] [Indexed: 11/17/2023] Open
Abstract
OBJECTIVES To study sedentary behaviour and physical activity at 3 months as predictors for symptoms of depression and anxiety at 1-year post-stroke. DESIGN A prospective cohort study. PATIENTS Patients with first-ever ischaemic stroke. METHODS Mood was assessed 3- and 12-months post-stroke using the Hospital Anxiety and Depression Scale. Sedentary behaviour and physical activity were measured using accelerometry 3 months post-stroke. RESULTS A total of 292 participants (116 (39.7%) females; mean age 71.7 (standard deviation 11.3) years) were included. At 12 months, 16.7% experienced depression and 19.5% anxiety, respectively. Adjusting for age and sex, regression analysis showed that comorbidity burden (β 0.26; 95% confidence interval (95% CI) 0.02, 0.51; p = 0.038), stroke severity (β 0.22; 95% CI 0.10, 0.35; p = 0.001), functional disability (β 0.89, 95% CI 0.49, 1.30; p = 0.000), and global cognition (β-0.15; 95% CI -0.25, -0.05; p = 0.004) predicted depression. Multi-adjusted analysis showed sedentary behaviour and physical activity did not significantly predict depression or anxiety (p > 0.05). CONCLUSION Sedentary behaviour and physical activity did not significantly predict mood after stroke. Comorbidity burden, stroke severity, functional disability, and global cognition were identified as possible predictors of depression. More research is needed to determine the impact of physical activity on depression and anxiety symptoms.
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Affiliation(s)
- Ailan Phan
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Torunn Askim
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bent Indredavik
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Medical Quality Registries, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Stroke Unit, Department of Internal Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Torgeir Wethal
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Stroke Unit, Department of Internal Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Hailey V, Bloomberg M, Hamer M, Fisher A. Association between neighbourhood cohesion and physical activity trajectories during the COVID-19 pandemic using data from Understanding Society: The UK Household Longitudinal Study & COVID-19 sub-study. Prev Med Rep 2023; 35:102392. [PMID: 37680857 PMCID: PMC10480663 DOI: 10.1016/j.pmedr.2023.102392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/28/2023] [Accepted: 08/28/2023] [Indexed: 09/09/2023] Open
Abstract
Neighbourhood cohesion is increasingly recognised as a key determinant of health and health-related behaviours. Positive association between social support and physical activity have been demonstrated on an interpersonal level, there is less evidence at group-level. This study aimed to examine the association between neighbourhood cohesion and physical activity trajectories during the COVID-19 pandemic. Hypothesizing that higher neighbourhood cohesion was a protective factor against reduced physical activity during the pandemic. Data from Understand Society (wave 9, Jan 2017-Dec 2019), and the COVID-19 sub-study (waves 1, 5, 7) was used. Participants (N = 14,475) had baseline data and at least one Covid physical activity measure. We used linear mixed models with a random intercept and slope at the individual level and an unstructured correlation matrix to examine the association between neighbourhood cohesion and physical activity during the follow-up period. We found a significant reduction in physical activity (-441 MET-min/wk, (CI 374.51 - 507.65, p < 0.001) through the COVID-19 pandemic, and that higher neighbourhood cohesion was related to higher physical activity after control for covariates. There was a significant difference between neighbourhood cohesion categories and change seen in PA during the 39-month follow-up period (difference in change between lowest and highest neighbourhood cohesion categories = 373 MET-min/wk, p = 0.036), higher neighbourhood cohesion had a protective effect. Strong relationships between public health and urban planning sectors are needed to build communities with structures in place to support a sense of community, social interaction and attraction to the neighbourhood. This will help long-term neighbourhood cohesion and support increased physical activity.
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Affiliation(s)
- Verity Hailey
- Department of Behavioural Science and Health, University College London, London, UK
| | - Mikaela Bloomberg
- Department of Behavioural Science and Health, University College London, London, UK
| | - Mark Hamer
- Institute Sport Exercise & Health, Division Surgery & Interventional Science, University College London, London, UK
| | - Abi Fisher
- Department of Behavioural Science and Health, University College London, London, UK
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Xu L, Wang J, Li Y, Li X, Chen C, Xu Z, Zhang M, Qiu Y, Zhong Z, Zhang Z, Li F, Luo Y, Lyu Y, Chen G, Shi X. The Relationship Between Physical Activity and All-Cause Mortality Among Older Adults - China, 1998-2018. China CDC Wkly 2023; 5:866-871. [PMID: 37814611 PMCID: PMC10560385 DOI: 10.46234/ccdcw2023.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/19/2023] [Indexed: 10/11/2023] Open
Abstract
What is already known about this topic? Previous research indicates that non-occupational physical activity can reduce mortality risk. Nevertheless, the relationship between occupational physical activity and health improvements has not been consistently established. What is added by this report? The study found that regular exercise and leisure activities reduced the risk of all-cause mortality. However, the combination of exercise and leisure activities demonstrated more substantial benefits. Additionally, no meaningful association was identified between physical work and mortality risk within the older population. What are the implications for public health practice? It may be beneficial to encourage older adults to engage in regular exercise and to partake actively in leisure activities. Combining these two elements might yield greater benefits than regular exercise alone.
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Affiliation(s)
- Lanjing Xu
- School of Public Health, Zhejiang University, Hangzhou City, Zhejiang Province, China
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jun Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yang Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
- School of Public Health, Nanjing Medical University, Nanjing City, Jiangsu Province, China
| | - Xinwei Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun City, Jilin Province, China
| | - Chen Chen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zinan Xu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou City, Guangdong Province, China
| | - Min Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
- School of Public Health, Nanjing Medical University, Nanjing City, Jiangsu Province, China
| | - Yidan Qiu
- School of Public Health, Zhejiang University, Hangzhou City, Zhejiang Province, China
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhuchun Zhong
- School of Public Health, Zhejiang University, Hangzhou City, Zhejiang Province, China
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zheng Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
- School of Public Health, Nanjing Medical University, Nanjing City, Jiangsu Province, China
| | - Fangyu Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
- School of Public Health, China Medical University, Shenyang City, Liaoning Province, China
| | - Yufei Luo
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
- Department of Occupational Health and Environment Health, School of Public Health, Anhui Medical University, Hefei City, Anhui Province, China
| | - Yuebin Lyu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Guangdi Chen
- School of Public Health, Zhejiang University, Hangzhou City, Zhejiang Province, China
| | - Xiaoming Shi
- School of Public Health, Zhejiang University, Hangzhou City, Zhejiang Province, China
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
- School of Public Health, Nanjing Medical University, Nanjing City, Jiangsu Province, China
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Johnson SS. A Rationale and Framework for Activating Employers as Agents of Change in the Implementation of Lifestyle as Medicine. Am J Health Promot 2023; 37:997-1023. [PMID: 37594390 DOI: 10.1177/08901171231184527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Affiliation(s)
- Sara S Johnson
- ProChange Behavior Solutions, Inc., South Kingstown, RI, USA
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Johnson SS. A Rationale and Framework for Activating Employers as Agents of Change in the Implementation of Lifestyle as Medicine. Am J Health Promot 2023; 37:997-1013. [PMID: 37594391 DOI: 10.1177/08901171231184527a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Affiliation(s)
- Sara S Johnson
- ProChange Behavior Solutions, Inc., South Kingstown, RI, USA
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40
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Bergengren O, Pekala KR, Matsoukas K, Fainberg J, Mungovan SF, Bratt O, Bray F, Brawley O, Luckenbaugh AN, Mucci L, Morgan TM, Carlsson SV. 2022 Update on Prostate Cancer Epidemiology and Risk Factors-A Systematic Review. Eur Urol 2023; 84:191-206. [PMID: 37202314 PMCID: PMC10851915 DOI: 10.1016/j.eururo.2023.04.021] [Citation(s) in RCA: 127] [Impact Index Per Article: 127.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/29/2023] [Accepted: 04/20/2023] [Indexed: 05/20/2023]
Abstract
CONTEXT Prostate cancer (PCa) is one of the most common cancers worldwide. Understanding the epidemiology and risk factors of the disease is paramount to improve primary and secondary prevention strategies. OBJECTIVE To systematically review and summarize the current evidence on the descriptive epidemiology, large screening studies, diagnostic techniques, and risk factors of PCa. EVIDENCE ACQUISITION PCa incidence and mortality rates for 2020 were obtained from the GLOBOCAN database of the International Agency for Research on Cancer. A systematic search was performed in July 2022 using PubMed/MEDLINE and EMBASE biomedical databases. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and was registered in PROSPERO (CRD42022359728). EVIDENCE SYNTHESIS Globally, PCa is the second most common cancer, with the highest incidence in North and South America, Europe, Australia, and the Caribbean. Risk factors include age, family history, and genetic predisposition. Additional factors may include smoking, diet, physical activity, specific medications, and occupational factors. As PCa screening has become more accepted, newer approaches such as magnetic resonance imaging (MRI) and biomarkers have been implemented to identify patients who are likely to harbor significant tumors. Limitations of this review include the evidence being derived from meta-analyses of mostly retrospective studies. CONCLUSIONS PCa remains the second most common cancer among men worldwide. PCa screening is gaining acceptance and will likely reduce PCa mortality at the cost of overdiagnosis and overtreatment. Increasing use of MRI and biomarkers for the detection of PCa may mitigate some of the negative consequences of screening. PATIENT SUMMARY Prostate cancer (PCa) remains the second most common cancer among men, and screening for PCa is likely to increase in the future. Improved diagnostic techniques can help reduce the number of men who need to be diagnosed and treated to save one life. Avoidable risk factors for PCa may include factors such as smoking, diet, physical activity, specific medications, and certain occupations.
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Affiliation(s)
- Oskar Bergengren
- Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
| | - Kelly R Pekala
- Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Jonathan Fainberg
- Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sean F Mungovan
- Westmead Private Physiotherapy Services and The Clinical Research Institute, Westmead Private Hospital, Sydney, Australia
| | - Ola Bratt
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Otis Brawley
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Lorelei Mucci
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Todd M Morgan
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | - Sigrid V Carlsson
- Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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41
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Katzmarzyk PT, Jakicic JM. Physical Activity for Health-Every Minute Counts. JAMA 2023; 330:213-214. [PMID: 37462698 DOI: 10.1001/jama.2023.11014] [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] [Indexed: 07/21/2023]
Abstract
This Viewpoint discusses the amount of physical activity recommended by the Physical Activity Guidelines for Americans, 2nd Edition, and how clinicians should use these recommendations to personalize and set achievable physical activity goals for their patients.
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Affiliation(s)
| | - John M Jakicic
- Division of Physical Activity and Weight Management, Department of Internal Medicine, University of Kansas Medical Center, Kansas City
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42
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Pérez-Rivas FJ, Jiménez-González J, Bayón Cabeza M, Belmonte Cortés S, de Diego Díaz-Plaza M, Domínguez-Bidagor J, García-García D, Gómez Puente J, Gómez-Gascón T. Design and Content Validation using Expert Opinions of an Instrument Assessing the Lifestyle of Adults: The 'PONTE A 100' Questionnaire. Healthcare (Basel) 2023; 11:2038. [PMID: 37510479 PMCID: PMC10379326 DOI: 10.3390/healthcare11142038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/04/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Lifestyle, a major determinant of health status, comprises a number of habits and behaviours that form a part of daily life. People with healthy lifestyles have a better quality of life, suffer less disease, and have a longer life expectancy. This work reports the design and content validation of a questionnaire-the 'PONTE A 100' questionnaire-assessing the lifestyle of adults. This collects information across five dimensions-'Eating Habits', 'Physical Activity', 'Smoking and use of Alcohol and other Drugs', 'Emotional Wellbeing', and 'Safety and Non-intentional Injuries'-via the answering of a total 33 items. Psychometric validation of the instrument's content was obtained via expert opinions. This was performed by two rounds of assessment and involved 34 experts representing different health science disciplines (mean experience, 27.4 ± 9.4 years). At the end of each round, adjustments were made according to their recommendations. Agreement between the experts was examined using the Aiken V test. A final V value of 0.95 (95% CI, 0.90-1.00) was obtained for the questionnaire as a whole, highlighting the validity of its content. The questionnaire would therefore appear to be an appropriate instrument for assessing the lifestyle of adults.
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Affiliation(s)
- Francisco Javier Pérez-Rivas
- Grupo de Investigación UCM "Salud Pública-Estilos de Vida, Metodología Enfermera y Cuidados en el Entorno Comunitario", Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud-RICAPPS-(RICORS), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas12), 28041 Madrid, Spain
| | - Jennifer Jiménez-González
- Programa de Doctorado 'Cuidados en Salud', Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Marianela Bayón Cabeza
- Área de Procesos y Calidad, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Consejería de Sanidad, Comunidad de Madrid, 28035 Madrid, Spain
| | - Susana Belmonte Cortés
- Área de Nutrición y Estilos de Vida, Subdirección de Prevención y Promoción de la Salud, Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, 28002 Madrid, Spain
| | - Marta de Diego Díaz-Plaza
- Área de Nutrición y Estilos de Vida, Subdirección de Prevención y Promoción de la Salud, Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid, 28002 Madrid, Spain
| | - Julia Domínguez-Bidagor
- Unidad Técnica Promoción de Salud, Subdirección General Prevención y Promoción de Salud, Dirección General de Salud Pública, Comunidad de Madrid, 28002 Madrid, Spain
| | - David García-García
- Programa de Doctorado 'Cuidados en Salud', Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Juana Gómez Puente
- Centro de Salud Eloy Gonzalo, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Consejería de Sanidad, 28010 Madrid, Spain
| | - Tomás Gómez-Gascón
- Grupo de Investigación UCM "Salud Pública-Estilos de Vida, Metodología Enfermera y Cuidados en el Entorno Comunitario", Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud-RICAPPS-(RICORS), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas12), 28041 Madrid, Spain
- Fundación para la Investigación e Innovación Biosanitaria de Atención Primaria (FIIBAP), 28003 Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Moller AC, Sousa CV, Lee KJ, Alon D, Lu AS. Active Video Game Interventions Targeting Physical Activity Behaviors: Systematic Review and Meta-analysis. J Med Internet Res 2023; 25:e45243. [PMID: 37191992 DOI: 10.2196/45243] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/02/2023] [Accepted: 04/14/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Research on digital games designed to increase physical activity (PA), also known as exergames or active video games (AVGs), has proliferated over the past 2 decades. As a result, reviews of literature in this field can become outdated, revealing the need for updated high-quality reviews that identify overarching insights. Furthermore, given the significant heterogeneity in AVG research, study inclusion criteria may significantly influence conclusions. To the best of our knowledge, no prior systematic review or meta-analysis has specifically focused on studies of longitudinal AVG interventions targeting increases in PA behaviors. OBJECTIVE The aim of this study was to obtain insights into when and why longitudinal AVG interventions are more or less successful for sustained increases in PA, especially for public health. METHODS Six databases (PubMed, PsycINFO, SPORTDiscus, MEDLINE, Web of Science, and Google Scholar) were reviewed until December 31, 2020. This protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020204191). For inclusion, randomized controlled trials had to prominently (>50% of intervention) feature AVG technology, involve repeated AVG exposure, and target changes in PA behavior. Experimental designs had to include ≥2 within- or between-participant conditions with ≥10 participants per condition. RESULTS A total of 25 studies published in English between 1996 and 2020 were identified, with 19 studies providing sufficient data for inclusion in the meta-analysis. Our findings indicated that AVG interventions had a moderately positive effect, thereby increasing overall PA (Hedges g=0.525, 95% CI 0.322-0.728). Our analysis showed substantial heterogeneity (I2=87.7%; Q=154.1). The main findings were consistent across all subgroup analyses. The comparison between PA assessment type groups showed a moderate effect for objective measures (Hedges g=0.586, 95% CI 0.321-0.852) and a small effect for subjective measures (Hedges g=0.301, 95% CI 0.049-0.554) but no significant difference between the groups (P=.13). The platform subgroup analysis indicated a moderate effect for stepping devices (Hedges g=0.303, 95% CI 0.110-0.496), combination of handheld and body-sensing devices (Hedges g=0.512, 95% CI 0.288-0.736), and other devices (Hedges g=0.694, 95% CI 0.350-1.039). The type of control group showed a wide range of effects sizes, ranging from a small effect size (Hedges g=0.370, 95% CI 0.212-0.527) for the passive control group (nothing) to a moderate effect size for the conventional PA intervention group (Hedges g=0.693, 95% CI 0.107-1.279) and ultimately to a large effect size for sedentary game as control groups (Hedges g=0.932, 95% CI 0.043-1.821). There was no significant difference among the groups (P=.29). CONCLUSIONS AVGs represent a promising tool for PA promotion among the general population and clinical subpopulations. However, significant variabilities in AVG quality, study design, and impact were also detected. Suggestions for improving AVG interventions and related research will be discussed. TRIAL REGISTRATION PROSPERO CRD42020204191; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=204191.
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Affiliation(s)
- Arlen C Moller
- Department of Psychology, Lewis College of Science and Letters, Illinois Institute of Technology, Chicago, IL, United States
| | - Caio Victor Sousa
- Department of Health and Human Sciences, Seaver College of Science & Engineering, Loyola Marymount University, Los Angeles, CA, United States
- College of Arts, Media & Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States
| | - Kelly Jihyeon Lee
- College of Arts, Media & Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States
| | - Dar Alon
- College of Arts, Media & Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States
- T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | - Amy Shirong Lu
- College of Arts, Media & Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States
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Luft FC. Sixty Years of Confronting Diabetes and Kidney Disease. Semin Nephrol 2023; 43:151426. [PMID: 37862743 DOI: 10.1016/j.semnephrol.2023.151426] [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] [Indexed: 10/22/2023]
Abstract
The good old days were not good, at least in terms of treating patients with type 2 diabetes. In the 1960s, the development of a radioimmunoassay for insulin permitted determination of the distinguishing features of type 1 and type 2 diabetes. The latter was treated with sulfonylureas and then phenformin, although the mechanisms of action at the time were unknown. The University Group Diabetes Program was a randomized controlled trial experienced by my medical generation, and the results were dramatic, both medically and legally. Next came the thiazolidinediones. All compounds were associated with weight gain and any end point benefits were uncertain. Nevertheless, basic science explained how glucose is sensed and even found a home for sulfonylureas in some patients. Next came the boom in renin-angiotensin-aldosterone system blockade, sacred ground for many, albeit the benefits were less than astounding. Other wonder drugs came and went. Over the decades, great strides were made in defining the pathology of diabetic renal disease, which is appropriate because the condition has become a primary cause of end-stage renal failure. Nonetheless, recent advances have turned around a depressing situation and are reasons for optimism. We now have compounds that actually could help patients with type 2 diabetes. One hundred years after insulin's introduction, it is high time.
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Affiliation(s)
- Friedrich C Luft
- Experimental and Clinical Research Center, Max-Delbrück Center for Molecular Medicine, Charité Medical Faculty, Berlin, Germany.
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