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Fernandes-Silva MM, Conti-Pelanda JD, Vosgerau LM, Cunha GSP, Vercka KC, Crestani A, Goedert GM, Cerci RJ, Silvestre OM, Nadruz W, Vitola JV. Temporal trends in the contribution of modifiable cardiovascular risk factors to cardiovascular and all-cause mortality in patients undergoing myocardial perfusion imaging in a large city in Brazil. Int J Cardiol 2024; 409:132178. [PMID: 38754591 DOI: 10.1016/j.ijcard.2024.132178] [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: 02/29/2024] [Revised: 05/03/2024] [Accepted: 05/13/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Most cardiovascular (CV) events stem from modifiable risk factors, but it remains uncertain whether their impact on mortality has decreased in recent years as a result of treatment, particularly in low- and middle-income countries. We evaluated the temporal trends in the population attributable fraction (PAF) of modifiable risk factors to CV mortality in patients undergoing myocardial perfusion imaging (MPI) for suspected coronary artery disease in a large city in Brazil. METHODS The cohort comprised 25,127 patients without established CV disease undergoing MPI in a referral center in Curitiba, Brazil, from 2010 to 2018. Baseline demographic, clinical and risk factors were prospectively collected. Modifiable risk factors encompassed hypertension, dyslipidemia, diabetes mellitus, sedentary lifestyle, obesity, and smoking. The primary outcome was CV death occurring up to 4 years of follow-up. The PAF of each risk factor was calculated for each triennium using multivariable Cox proportional regression models, adjusting for age, sex and family history of premature coronary disease. RESULTS Over 9 years, there were 1438 deaths, 444 due to CV causes. In the first triennium, sedentary lifestyle exhibited the highest PAF (49%) for CV death, followed by hypertension (17%), diabetes mellitus (8%) and smoking habit (6%). The PAF for all risk factors combined remained relatively stable thorough the triennia (2010-2012: 57% vs 2013-2015: 64% vs 2016-2018: 47%, p = NS). CONCLUSION In this large cohort of patients referred to MPI, the PAF of modifiable CV risk factors did not diminish in the last decade, with sedentary lifestyle having the largest contribution for CV mortality. CONDENSED ABSTRACT This study examinated temporal trends in the impact of modifiable cardiovascular (CV) risk factors on CV and overall mortality in a cohort of 25,127 patients undergoing myocardial perfusion imaging from 2010 to 2018. Sedentary behavior consistently had the greatest impact on both CV and overall mortality, followed by hypertension and diabetes. Smoking had a lesser effect, while obesity showed no independent association with the outcomes. The contributions of these modifiable CV risk factors remained stable over the study period, suggesting that interventions promoting physical activity may be essential in mitigating the burden of CV disease.
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Affiliation(s)
- Miguel M Fernandes-Silva
- Quanta Diagnóstico por Imagem, Curitiba, PR, Brazil; Universidade Federal do Paraná, Curitiba, PR, Brazil.
| | | | | | | | | | - Andre Crestani
- Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil
| | - Gianne M Goedert
- Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil
| | | | - Odilson M Silvestre
- Universidade Federal do Acre, Rio Branco, AC, Brazil; Hospital Silvestre Santé, Rio Branco, AC, Brazil
| | - Wilson Nadruz
- Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - João V Vitola
- Quanta Diagnóstico por Imagem, Curitiba, PR, Brazil.
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Han MA, Kim SH, Hwang EC, Jung JH, Park SM. Population attributable fractions of modifiable cancer risk factors in Korea: A systematic review. Asia Pac J Clin Oncol 2024; 20:299-314. [PMID: 36899477 DOI: 10.1111/ajco.13950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVES The population attributable fraction (PAF), an epidemiologic measure of exposures and health outcomes, can provide information on the public health impacts of exposures in populations. This study aimed to systematically summarize the PAF estimates of modifiable cancer risk factors in Korea. METHODS This review included studies that determined PAFs of modifiable risk factors for cancer in Korea. We performed systematic searches in EMBASE, MEDLINE, Cochrane library, and Korean databases for studies published up to July 2021. Two reviewers independently screened studies for eligibility, extracted data, and performed quality assessments of the included studies. Due to high variability among the data acquisition methods and PAF estimates, we presented the results qualitatively and did not perform quantitative data synthesis. RESULTS We reviewed 16 studies that reported the PAFs of risk factors for cancer, including smoking, alcohol consumption, obesity, and various cancer sites. We found considerable variability in the PAF estimates across exposure and cancer pairs. However, PAF estimates for smoking and respiratory cancer were consistently high in men. PAF estimates were higher in men than in women for smoking and alcohol consumption but higher in women for obesity. We found limited evidence for other exposures and cancers. CONCLUSION Our findings may be used to prioritize and plan strategies to reduce cancer burden. We encourage further and updated assessments of cancer risk factors, including those not addressed in the studies included in this review, and their potential contributions to cancer burden to better inform strategies for cancer control.
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Affiliation(s)
- Mi Ah Han
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, The Republic of Korea
| | - Seo-Hee Kim
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, The Republic of Korea
- Department of Public Health, Graduate School, Chosun University, Gwangju, The Republic of Korea
| | - Eu Chang Hwang
- Department of Urology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Hwasun, The Republic of Korea
| | - Jae Hung Jung
- Department of Urology, Yonsei University Wonju College of Medicine, Wonju, The Republic of Korea
- Center of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul, The Republic of Korea
| | - Sun Mi Park
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, The Republic of Korea
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Mickute M, Zaccardi F, Razieh C, Sargeant J, Smith AC, Wilkinson TJ, Young HML, Webb D, Khunti K, Davies MJ, Yates T. Individual frailty phenotype components and mortality in adults with type 2 diabetes: A UK Biobank study. Diabetes Res Clin Pract 2023; 195:110155. [PMID: 36427627 DOI: 10.1016/j.diabres.2022.110155] [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: 10/12/2022] [Accepted: 11/08/2022] [Indexed: 11/25/2022]
Abstract
AIMS This study aimed to explore associations between frailty components and mortality and rank prognostic relevance of each frailty component in predicting mortality in adults with and without type 2 diabetes (T2D). METHODS We used data from the UK Biobank. Associations and prognostic discrimination of individual Fried's frailty components and the overall frailty status with all-cause and cardiovascular (CVD) mortality were investigated using Cox proportional-hazard models and C-index in adults with and without T2D. RESULTS In both populations the strongest association with all-cause mortality across all frailty components and overall frailty status was observed for slow walking pace (without T2D Hazard Ratio [HR] 2.25, 95 %CI: 2.12-2.38 and with T2D HR 1.95, 95 %CI: 1.67-2.28). Similarly, slow walking pace was associated with a greater risk of CVD mortality. The combination of T2D and slow walking pace had the strongest association with all-cause and CVD mortality, compared to the combination of T2D and other frailty components or overall frailty status. Slow walking pace also provided the greatest prognostic discrimination. CONCLUSION Slow walking pace has a stronger predictive factor for all-cause and CVD mortality compared to other frailty components and overall frailty status, especially when simultaneously present with T2D.
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Affiliation(s)
- Monika Mickute
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK.
| | - Francesco Zaccardi
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK; Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester LE5 4PW, UK; NIHR Applied Research Collaboration East Midlands (ARC EM), University of Leicester, UK
| | - Cameron Razieh
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK; Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester LE5 4PW, UK; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
| | - Jack Sargeant
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Alice C Smith
- Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, UK
| | - Thomas J Wilkinson
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK; NIHR Applied Research Collaboration East Midlands (ARC EM), University of Leicester, UK
| | - Hannah M L Young
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - David Webb
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Kamlesh Khunti
- Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester LE5 4PW, UK; NIHR Applied Research Collaboration East Midlands (ARC EM), University of Leicester, UK
| | - Melanie J Davies
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
| | - Thomas Yates
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
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Dhungana RR, Pedisic Z, de Courten M. Implementation of non-pharmacological interventions for the treatment of hypertension in primary care: a narrative review of effectiveness, cost-effectiveness, barriers, and facilitators. BMC PRIMARY CARE 2022; 23:298. [PMID: 36418958 PMCID: PMC9686020 DOI: 10.1186/s12875-022-01884-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The current guidelines for the prevention, detection, evaluation, and management of hypertension recommend six types of non-pharmacological interventions: alcohol reduction, salt intake reduction, increased potassium intake, physical activity, weight loss, and heart-healthy diets. However, the non-pharmacological interventions are still not widely used in primary care. In this paper, we, therefore, reviewed and summarised the evidence on the effectiveness, cost-effectiveness, barriers, and facilitators of non-pharmacological interventions for the treatment of hypertension in primary care. METHODS A thorough literature search was conducted in Embase, Google Scholar, and PubMed databases, to identify the most recent reviews or, in their absence, primary studies on alcohol reduction, salt intake reduction, potassium supplementation, physical activity, weight reduction, heart-healthy diets, and other non-pharmacological interventions for the treatment of hypertension in primary care. RESULTS Alcohol reduction is a non-pharmacological intervention for the treatment of hypertension in primary care with proven effectiveness, feasibility, and acceptability. Interventions for sodium intake reduction, physical activity, and weight reduction are effective but there is insufficient evidence regarding their feasibility and acceptability in primary care settings. Evidence on the effectiveness of potassium intake and heart-healthy diets is limited and inconsistent. There is a lack of evidence on the cost-effectiveness of non-pharmacological interventions in the treatment of hypertension. The most common barriers to deliver such interventions related to healthcare providers include a lack of time, knowledge, self-confidence, resources, clear guidelines, and financial incentives. The most common barriers related to patients include a lack of motivation and educational resources. Less evidence is available on facilitators of implementing non-pharmacological interventions in primary care. Besides, facilitators differed by different types of interventions. CONCLUSIONS Available evidence suggests that more pragmatic, clinically feasible, and logistically simple interventions are required for sodium intake reduction, physical activity, and weight reduction in primary care settings. Future studies should provide further evidence on the effectiveness of weight control, potassium intake, and heart-healthy diets. More research is also needed on cost-effectiveness and facilitators of all types of effective non-pharmacological interventions for the treatment of hypertension in primary care.
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Affiliation(s)
- Raja Ram Dhungana
- Institute for Health and Sport, Victoria University, Melbourne, Australia.
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| | - Zeljko Pedisic
- Institute for Health and Sport, Victoria University, Melbourne, Australia
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Alòs F, Colomer MÀ, Martin-Cantera C, Solís-Muñoz M, Bort-Roig J, Saigi I, Chirveches-Pérez E, Solà-Gonfaus M, Molina-Aragonés JM, Puig-Ribera A. Effectiveness of a healthcare-based mobile intervention on sedentary patterns, physical activity, mental well-being and clinical and productivity outcomes in office employees with type 2 diabetes: study protocol for a randomized controlled trial. BMC Public Health 2022; 22:1269. [PMID: 35768818 PMCID: PMC9244393 DOI: 10.1186/s12889-022-13676-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 06/22/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Prolonged sedentary time is associated with an increased incidence of chronic disease including type 2 diabetes mellitus (DM2). Given that occupational sedentary time contributes significantly to the total amount of daily sedentariness, incorporating programmes to reduce occupational sedentary time in patients with chronic disease would allow for physical, mental and productivity benefits. The aim of this study is to evaluate the short-, medium- and long-term effectiveness of a mHealth programme for sitting less and moving more at work on habitual and occupational sedentary behaviour and physical activity in office staff with DM2. Secondary aims. To evaluate the effectiveness on glycaemic control and lipid profile at 6- and 12-month follow-up; anthropometric profile, blood pressure, mental well-being and work-related post-intervention outcomes at 3, 6 and 12 months. METHODS Multicentre randomized controlled trial. A sample size of 220 patients will be randomly allocated into a control (n = 110) or intervention group (n = 110), with post-intervention follow-ups at 6 and 12 months. Health professionals from Spanish Primary Health Care units will randomly invite patients (18-65 years of age) diagnosed with DM2, who have sedentary office desk-based jobs. The control group will receive usual healthcare and information on the health benefits of sitting less and moving more. The intervention group will receive, through a smartphone app and website, strategies and real-time feedback for 13 weeks to change occupational sedentary behaviour. VARIABLES (1) Subjective and objective habitual and occupational sedentary behaviour and physical activity (Workforce Sitting Questionnaire, Brief Physical Activity Assessment Tool, activPAL3TM); 2) Glucose, HbA1c; 3) Weight, height, waist circumference; 4) Total, HDL and LDL cholesterol, triglycerides; (5) Systolic, diastolic blood pressure; (6) Mental well-being (Warwick-Edinburgh Mental Well-being); (7) Presenteeism (Work Limitations Questionnaire); (8) Impact of work on employees´ health, sickness absence (6th European Working Conditions Survey); (9) Job-related mental strain (Job Content Questionnaire). Differences between groups pre- and post- intervention on the average value of the variables will be analysed. DISCUSSION If the mHealth intervention is effective in reducing sedentary time and increasing physical activity in office employees with DM2, health professionals would have a low-cost tool for the control of patients with chronic disease. TRIAL REGISTRATION ClinicalTrials.gov NCT04092738. Registered September 17, 2019.
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Affiliation(s)
- Francesc Alòs
- Primary Healthcare Centre Passeig de Sant Joan, Catalan Health Institute, 08010, Barcelona, Spain.
| | - Mª Àngels Colomer
- Department of Mathematics, ETSEA, University of Lleida, Lleida, Spain
| | - Carlos Martin-Cantera
- Barcelona Research Support Unit, Primary Care Research Institute IDIAP Jordi Gol, Barcelona, Spain
| | - Montserrat Solís-Muñoz
- Health Care Research Unit, Puerta de Hierro Majadahonda University Hospital. Nursing and Health Care Research Group, Puerta de Hierro-Segovia de Arana, Health Research Institute, Madrid, Spain
| | - Judit Bort-Roig
- Sport and Physical Activity Research Group, Centre for Health and Social Care Research, University of Vic-Central University of Catalonia, Vic, Spain
| | - I Saigi
- Endocrinology and Nutrition Department, Vic University Hospital, Barcelona, Spain
| | - E Chirveches-Pérez
- Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences, Centre for Health and Social Care Research, University of Vic-Central University of Catalonia, Barcelona, Spain
| | - Mercè Solà-Gonfaus
- Primary Healthcare Centre Les Planes, Catalan Health Institute, Barcelona, Spain
| | | | - Anna Puig-Ribera
- Sport and Physical Activity Research Group, Centre for Health and Social Care Research, University of Vic-Central University of Catalonia, Vic, Spain
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Eizagirre-Sagastibeltza O, Fernandez-Lasa U, Yanci J, Romaratezabala E, Cayero R, Iturrioz I, Usabiaga O. Design and Validation of a Questionnaire to Assess the Leisure Time Physical Activity of Adult Women in Gipuzkoa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095736. [PMID: 35565129 PMCID: PMC9103327 DOI: 10.3390/ijerph19095736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/01/2022] [Accepted: 05/06/2022] [Indexed: 12/10/2022]
Abstract
Inactivity is higher among women than among men, and there are few specific questionnaires used to assess physical activity (PA) in women that are truly meaningful to them. This article tackles the design and validation process of an ad hoc multidimensional questionnaire to assess leisure time physical activity (LTPA) among adult women of Gipuzkoa. The questionnaire was completed by 3595 adult women (43.5 ± 12.1 years), 32% of which were inactive and 68% of which were active. Content validation, ecological validation, and internal consistency analysis results were satisfactory. The Gipuzkoa Women’s Physical Activity Questionnaire (GWPAQ) consists of four dimensions and 21 items. Barriers to PA were found related to intrapersonal, environmental, and socio-cultural aspects. The importance of family and spousal support in increasing PA levels was also observed. It is concluded that the GWPAQ is valid for obtaining evidence that can be used by public institutions to optimise women-specific PA promotion policies.
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Affiliation(s)
| | - Uxue Fernandez-Lasa
- Society, Sport and Physical Activity (GIKAFIT) Research Group, Department of Physical Education and Sports, Faculty of Education and Sport, University of the Basque Country (UPV/EHU), Lasarteko Bidea 71, 01007 Vitoria-Gasteiz, Spain; (J.Y.); (E.R.); (O.U.)
- Correspondence: ; Tel.: +34-945013530
| | - Javier Yanci
- Society, Sport and Physical Activity (GIKAFIT) Research Group, Department of Physical Education and Sports, Faculty of Education and Sport, University of the Basque Country (UPV/EHU), Lasarteko Bidea 71, 01007 Vitoria-Gasteiz, Spain; (J.Y.); (E.R.); (O.U.)
| | - Estibaliz Romaratezabala
- Society, Sport and Physical Activity (GIKAFIT) Research Group, Department of Physical Education and Sports, Faculty of Education and Sport, University of the Basque Country (UPV/EHU), Lasarteko Bidea 71, 01007 Vitoria-Gasteiz, Spain; (J.Y.); (E.R.); (O.U.)
| | - Ruth Cayero
- Department of Physical Education and Sports, Faculty of Education and Sport, University of the Basque Country (UPV/EHU), 01007 Vitoria-Gasteiz, Spain;
| | - Iñaki Iturrioz
- Diputación Foral de Gipuzkoa, Gipuzkoa Provincial Council, 20004 Donostia-San Sebastian, Spain;
| | - Oidui Usabiaga
- Society, Sport and Physical Activity (GIKAFIT) Research Group, Department of Physical Education and Sports, Faculty of Education and Sport, University of the Basque Country (UPV/EHU), Lasarteko Bidea 71, 01007 Vitoria-Gasteiz, Spain; (J.Y.); (E.R.); (O.U.)
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7
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Swift HT, O'Driscoll JM, Coleman DD, Caux AD, Wiles JD. Acute cardiac autonomic and haemodynamic responses to leg and arm isometric exercise. Eur J Appl Physiol 2022; 122:975-985. [PMID: 35089384 DOI: 10.1007/s00421-022-04894-7] [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: 09/09/2021] [Accepted: 01/13/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Acute cardiovascular responses following a single session of isometric exercise (IE) have been shown to predict chronic adaptations in blood pressure (BP) regulation. It was hypothesised that exercises which recruit more muscle mass induce greater reductions in BP compared to exercises using smaller muscle mass. To test this hypothesis, the current study aimed to compare the acute haemodynamic and autonomic responses to a single session of isometric wall squat (IWS) and isometric handgrip (IHG) training. METHODS Twenty-six sedentary participants performed a single IWS and IHG session in a randomised cross-over design, with training composed of 4 × 2-min contractions, with 2-min rest, at 95 HRpeak and 30% MVC respectively. Haemodynamic and cardiac autonomic variables were recorded pre, during, immediately post, and 1-h post-exercise, with the change from baseline for each variable used for comparative analysis. RESULTS During IWS exercise, there was a significantly greater increase in systolic BP (P < 0.001), diastolic BP (P < 0.001), mean BP (P < 0.001), heart rate (P < 0.001), and cardiac output (P < 0.001), and a contrasting decrease in baroreflex effectiveness index (BEI) and cardiac baroreceptor sensitivity (cBRS). In the 10-min recovery period following IWS exercise, there was a significantly greater reduction in systolic BP (P = 0.005), diastolic BP (P = 0.006), mean BP (P = 0.003), total peripheral resistance (TPR) (P < 0.001), BEI (P = 0.003), and power spectral density (PSD-RRI) (P < 0.001). There were no differences in any variables between conditions 1-h post exercise. CONCLUSIONS Isometric wall squat exercise involving larger muscle mass is associated with a significantly greater post-exercise hypotensive response during a 10-min recovery window compared to smaller muscle mass IHG exercise. The significantly greater reduction in TPR may be an important mechanism for the differences in BP response.
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Affiliation(s)
- Harry T Swift
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK
| | - Jamie M O'Driscoll
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK
| | - Damian D Coleman
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK
| | - Anthony De Caux
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK
| | - Jonathan D Wiles
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK.
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Azul AM, Almendra R, Quatorze M, Loureiro A, Reis F, Tavares R, Mota-Pinto A, Cunha A, Rama L, Malva JO, Santana P, Ramalho-Santos J. Unhealthy lifestyles, environment, well-being and health capability in rural neighbourhoods: a community-based cross-sectional study. BMC Public Health 2021; 21:1628. [PMID: 34488709 PMCID: PMC8422758 DOI: 10.1186/s12889-021-11661-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 08/25/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Non-communicable diseases are a leading cause of health loss worldwide, in part due to unhealthy lifestyles. Metabolic-based diseases are rising with an unhealthy body-mass index (BMI) in rural areas as the main risk factor in adults, which may be amplified by wider determinants of health. Changes in rural environments reflect the need of better understanding the factors affecting the self-ability for making balanced decisions. We assessed whether unhealthy lifestyles and environment in rural neighbourhoods are reflected into metabolic risks and health capability. METHODS We conducted a community-based cross-sectional study in 15 Portuguese rural neighbourhoods to describe individuals' health functioning condition and to characterize the community environment. We followed a qualitatively driven mixed-method design to gather information about evidence-based data, lifestyles and neighbourhood satisfaction (incorporated in eVida technology), within a random sample of 270 individuals, and in-depth interviews to 107 individuals, to uncover whether environment influence the ability for improving or pursuing heath and well-being. RESULTS Men showed to have a 75% higher probability of being overweight than women (p-value = 0.0954); and the reporting of health loss risks was higher in women (RR: 1.48; p-value = 0.122), individuals with larger waist circumference (RR: 2.21; IC: 1.19; 4.27), overweight and obesity (RR: 1.38; p-value = 0.293) and aged over 75 years (RR: 1.78; p-value = 0.235; when compared with participants under 40 years old). Metabolic risks were more associated to BMI and physical activity than diet (or sleeping habits). Overall, metabolic risk linked to BMI was higher in small villages than in municipalities. Seven dimensions, economic development, built (and natural) environment, social network, health care, demography, active lifestyles, and mobility, reflected the self-perceptions in place affecting the individual ability to make healthy choices. Qualitative data exposed asymmetries in surrounding environments among neighbourhoods and uncovered the natural environment and natural resources specifies as the main value of rural well-being. CONCLUSIONS Metabolic risk factors reflect unhealthy lifestyles and can be associated with environment contextual-dependent circumstances. People-centred approaches highlight wider socioeconomic and (natural) environmental determinants reflecting health needs, health expectations and health capability. Our community-based program and cross-disciplinary research provides insights that may improve health-promoting changes in rural neighbourhoods.
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Affiliation(s)
- Anabela Marisa Azul
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, 3004-504 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3030-789 Coimbra, Portugal
- University of Coimbra, Institute for Interdisciplinary Research (IIIUC), 3030-789 Coimbra, Portugal
| | - Ricardo Almendra
- Centre of Studies in Geography and Spatial Planning (CEGOT), Faculty of Arts and Humanities, Colégio de São Jerónimo, University of Coimbra, 3004-530 Coimbra, Portugal
- Department of Geography and Tourism, Faculty of Arts and Humanities, Colégio de São Jerónimo, University of Coimbra, 3004-530 Coimbra, Portugal
| | - Marta Quatorze
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3030-789 Coimbra, Portugal
| | - Adriana Loureiro
- Centre of Studies in Geography and Spatial Planning (CEGOT), Faculty of Arts and Humanities, Colégio de São Jerónimo, University of Coimbra, 3004-530 Coimbra, Portugal
| | - Flávio Reis
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3030-789 Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3030-789 Coimbra, Portugal
- Institute of Pharmacology & Experimental Therapeutics, Faculty of Medicine, University of Coimbra, 3030-370 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3030-370 Coimbra, Portugal
| | - Rui Tavares
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, 3004-504 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3030-789 Coimbra, Portugal
- University of Coimbra, Institute for Interdisciplinary Research (IIIUC), 3030-789 Coimbra, Portugal
| | - Anabela Mota-Pinto
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3030-789 Coimbra, Portugal
- CIMAGO-Center for Research in the Environment, Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - António Cunha
- IPN-Laboratory of Automatics and Systems, Pedro Nunes Institute, 3030-199 Coimbra, Portugal
- Ageing@Coimbra, EIP on AHA Reference Site, Coimbra, Portugal
| | - Luís Rama
- Faculty of Sport Sciences and Physical Education, University of Coimbra, 3040-256 Coimbra, Portugal
| | - João Oliveira Malva
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3030-789 Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3030-789 Coimbra, Portugal
- Institute of Pharmacology & Experimental Therapeutics, Faculty of Medicine, University of Coimbra, 3030-370 Coimbra, Portugal
- Ageing@Coimbra, EIP on AHA Reference Site, Coimbra, Portugal
| | - Paula Santana
- Centre of Studies in Geography and Spatial Planning (CEGOT), Faculty of Arts and Humanities, Colégio de São Jerónimo, University of Coimbra, 3004-530 Coimbra, Portugal
- Department of Geography and Tourism, Faculty of Arts and Humanities, Colégio de São Jerónimo, University of Coimbra, 3004-530 Coimbra, Portugal
| | - João Ramalho-Santos
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, 3004-504 Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3030-789 Coimbra, Portugal
- Department of Life Sciences (DCV), Faculty of Sciences and Technology, University of Coimbra, 3000-456 Coimbra, Portugal
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Feter N, Leite JS, Cardoso RK, Rombaldi AJ. Economic burden of physical inactivity in hospitalizations due to dementia: a Brazilian nationwide study. CAD SAUDE PUBLICA 2021; 37:e00046520. [PMID: 33566988 DOI: 10.1590/0102-311x00046520] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/24/2020] [Indexed: 11/21/2022] Open
Abstract
Our study aimed at determining the economic burden of leisure-time physical inactivity in hospitalizations due to dementia in Brazil. In this national-wide descriptive study, we used secondary data from the Brazilian Health Informatics Department and from the latest Brazilian National Health Survey (2013). Rate of hospitalization and economic cost were extracted from 2013. Leisure-time physical inactivity prevalence was used to estimate its population attributable fraction for dementia. Outcomes were stratified into sex (man/woman), age groups (< 50, 50-59, 60-69, 70-79, 80+), ethnicity (white, black, mixed race, other), and region (South, Southeast, North, Northeast, and Central). In 2013, 3,724 people were hospitalized due to dementia in Brazil resulting in a total cost of BRL 17,971,833.85 (USD 7,673,973.05). More than half of cost among men was spent with individuals younger than 59 years, white and mixed-race, and from Southeast region. Proportion of cost was higher in women older than 60 years and white. In 2013, 37% of all hospitalization from dementia in Brazil were attributable to physical inactivity, with values reaching 42.9% and 43.8% for men and women aged 80 or older, respectively. Physical inactivity cost BRL 6,994,254.75 (USD 2,986,546.78) in 2013 on hospitalizations due to dementia in Brazil. Higher attributable-cost was found for patients younger than 50 years and women older than 80. Strategies to preserve the quality of life of these patients are needed to reduce the burden for the patients, their family, and on the healthcare system.
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Affiliation(s)
- Natan Feter
- Universidade Federal de Pelotas, Pelotas, Brasil.,The University of Queensland, St. Lucia, Australia
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Physical Activity Habits and Determinants, Sedentary Behaviour and Lifestyle in University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093272. [PMID: 32397068 PMCID: PMC7246858 DOI: 10.3390/ijerph17093272] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 04/30/2020] [Accepted: 05/06/2020] [Indexed: 12/11/2022]
Abstract
University students, as a result of their lifestyles, represent a section of the population that is most likely to adopt sedentary behaviours. The aim of the present study was to analyse the determining factors dictating the performance of physical activity as well as sedentary behaviour among university students. A total of 608 students (64.6% women) from the University of Santiago de Compostela (Spain) were selected by stratified random sampling to take part in the study, which involved completing a questionnaire on lifestyle and physical activity. Of the participating students, 69.6% indicated that they performed physical activity; the main reasons given were to maintain fitness and for health, while a lack of time and laziness were the principal reasons given for abandoning or not taking up physical exercise. Significant associations were established between not doing physical activity and the time exposed to screens, time studying, feeling low and smoking; on the other hand, associations could be seen between doing physical activity and the participation of relatives (parents, mothers, partners, older siblings and friends) in physical activity, as well as a positive sense of satisfaction relating to physical education taught in schools. In conclusion, most of the university students did some physical activity, which was associated with less sedentary behaviour, while the influence of school physical education and of the habits of relatives played an important role.
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Khosravi A, Nielsen RO, Mansournia MA. Methods matter: population attributable fraction (PAF) in sport and exercise medicine. Br J Sports Med 2020; 54:1049-1054. [PMID: 32051120 DOI: 10.1136/bjsports-2020-101977] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2020] [Indexed: 01/03/2023]
Affiliation(s)
- Ahmad Khosravi
- Department of Epidemiology, Shahroud University of Medical Sciences, Shahroud, Iran.,Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Rasmus Oestergaard Nielsen
- Department of Public Health, Section for Sports Science, Aarhus University, Aarhus, Denmark.,Research Unit for General Practice, Aarhus, Denmark
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran .,Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Gallardo-Alfaro L, Bibiloni MDM, Mateos D, Ugarriza L, Tur JA. Leisure-Time Physical Activity and Metabolic Syndrome in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3358. [PMID: 31514471 PMCID: PMC6765775 DOI: 10.3390/ijerph16183358] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/06/2019] [Accepted: 09/09/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS) is a cluster of risk factors for cardiovascular disease, atherosclerosis and diabetes mellitus type 2 which may be reduced by practicing regular physical activity. OBJECTIVE To assess the leisure-time physical activity (LTPA) of older adults with MetS and without MetS. METHODS Cross-sectional study of older adults (55-80 years old) from Balearic Islands (Spain) with MetS (n = 333; 55% men) and without MetS (n = 144; 43.8% men). LTPA was assessed with the validated Spanish version of the Minnesota LTPA Questionnaire. Two criteria of physically active were used: >150 min/week of moderate physical activity or >75 min/week of vigorous physical activity or a combination of both, and total leisure-time energy expenditure of >300 MET·min/day. Sociodemographic and lifestyle characteristics, anthropometric variables, MetS components, and adherence to the Mediterranean diet (MD) were also measured. RESULTS MetS subjects showed lower energy expenditure in LTPA, lower adherence to the MD, higher obesity and waist circumference, and were less active than non-MetS peers. LTPA increased as participants got older and there was higher LTPA intensity as educational level increased. Adherence to MD was as high as LTPA was. CONCLUSIONS MetS is associated with physical inactivity and unhealthy diet. To increase LTPA recommendations and raise awareness in the population about the health benefits of PA and high adherence to MD is highly recommended.
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Affiliation(s)
- Laura Gallardo-Alfaro
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, IDISBA &CIBEROBN (Physiopathology of Obesity and Nutrition), 07122 Palma de Mallorca, Spain.
| | - Maria Del Mar Bibiloni
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, IDISBA &CIBEROBN (Physiopathology of Obesity and Nutrition), 07122 Palma de Mallorca, Spain.
| | - David Mateos
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, IDISBA &CIBEROBN (Physiopathology of Obesity and Nutrition), 07122 Palma de Mallorca, Spain.
| | - Lucía Ugarriza
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, IDISBA &CIBEROBN (Physiopathology of Obesity and Nutrition), 07122 Palma de Mallorca, Spain.
- Camp Redó Primary Health Care Center, IBSalut, Palma de Mallorca, 07120 Palma de Mallorca, Spain.
| | - Josep A Tur
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, IDISBA &CIBEROBN (Physiopathology of Obesity and Nutrition), 07122 Palma de Mallorca, Spain.
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