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Hou X, Wu X, Chen L, Zheng X, Zheng Y, Zhang Y, Wang S, Cao T, Sun Y, Ding R, Wu J, Yu B. Effectiveness and Influencing Factors of Home-Center-Based Cardiac Rehabilitation as a Transitional Strategy for Acute Myocardial Infarction Patients. Int Heart J 2024; 65:612-620. [PMID: 39010223 DOI: 10.1536/ihj.24-030] [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] [Indexed: 07/17/2024]
Abstract
Currently, providing patients, particularly those with acute myocardial infarction (AMI), with comprehensive cardiac rehabilitation (CR) has been challenging because of the inadequate availability of medical resources in developing countries. To ensure balance between disease instability and early rehabilitation, strategies for facilitating professional and comprehensive CR opportunities for patients with AMI must be explored.A prospective cohort study was carried out on 1,533 patients with AMI who were admitted to a tertiary hospital between July 2018 and October 2019. Following the principle of voluntarism, 286 patients with AMI participated in home-center-based CR (HCB group), whereas 1,247 patients received usual care (UC group). The primary endpoint of this study was the occurrence of cardiovascular events at 30 months after AMI. Moreover, the study analyzed factors that influence participation rate and effectiveness of the CR model.After analysis, a significant difference in the occurrence of cardiovascular endpoints between the HCB group and the UC group was observed (harzard ratio, 0.68 [95%CI, 0.51-0.91], P = 0.008), with participation in home-center-based CR being an independent influencing factor. Multivariate regression analysis revealed age, gender, smoking history, triglyceride levels, and ejection fraction as independent factors that influence participation rate. Female gender, peak oxygen uptake per kilogram body weight, and ventilation/carbon dioxide production slope were identified as factors that affect the effectiveness of the CR model.In the context of developing countries, this study demonstrates that the home-center-based CR model is efficient and analyzes factors that influence participation rate and effectiveness of the model. These findings provide practical insights for further development of CR programs.
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Affiliation(s)
- Xinyu Hou
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University
| | - Xiaojun Wu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University
- Department of Cardiac Rehabilitation Center, The Second Affiliated Hospital of Harbin Medical University
| | - Liangqi Chen
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University
| | - Xianghui Zheng
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University
- Department of Cardiac Rehabilitation Center, The Second Affiliated Hospital of Harbin Medical University
| | - Yang Zheng
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University
- Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, The Second Affiliated Hospital of Harbin Medical University
| | - Yongxiang Zhang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University
| | - Shiyu Wang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University
- Department of Cardiac Rehabilitation Center, The Second Affiliated Hospital of Harbin Medical University
| | - Tianhui Cao
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University
- Department of Cardiac Rehabilitation Center, The Second Affiliated Hospital of Harbin Medical University
| | - Yong Sun
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University
- Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, The Second Affiliated Hospital of Harbin Medical University
| | - Rongjing Ding
- Department of Rehabilitation Medicine, Peking Union Medical College Hospital
| | - Jian Wu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University
- Department of Cardiac Rehabilitation Center, The Second Affiliated Hospital of Harbin Medical University
- Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, The Second Affiliated Hospital of Harbin Medical University
| | - Bo Yu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University
- Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, The Second Affiliated Hospital of Harbin Medical University
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Germano-Soares AH, Farah BQ, Da Silva JF, Barros MVG, Tassitano RM. Clustering of 24H movement behaviors associated with clinic blood pressure in older adults: a cross-sectional study. J Hum Hypertens 2024; 38:575-579. [PMID: 38890411 DOI: 10.1038/s41371-024-00925-2] [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: 02/11/2024] [Revised: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 06/20/2024]
Abstract
Physical activity (PA), sedentary behavior (SB), and sleep duration are known to have an individual effect on clinic blood pressure (BP) of older adults. However, whether different patterns of these so-called movement behaviors over the 24h-cycle on BP remains poorly investigated. The study aimed to identify movement behavior patterns associated with clinic BP among older adults with chronic diseases. Cross-sectional study with 238 older adults (80.3% female; mean age 68.8 ± 6.6) with at least one chronic disease. PA, SB, and sleep duration were measured by a triaxial accelerometer. Clinic systolic BP (SBP) and diastolic BP (DBP) were obtained through an automated method following standard procedures. Non-hierarchical K-means cluster and linear regression modeling were employed to identify the clusters of movement behaviors and to examine the associations. Two clusters were identified [active and non-sedentary, n = 103 (i.e., sufficient sleep duration, higher LPA and MVPA, and lower SB) and sedentary and inactive, n = 135 (i.e., sufficient sleep duration, lower LPA and MVPA, and higher SB). Active and non-sedentary older adults presented lower systolic BP compared to sedentary and inactive ones, even after adjustments for sociodemographic and clinical characteristics (β = 6.356; CI 95% from 0.932 to 11.779; P = 0.022). No associations were found for diastolic BP. In conclusion, higher PA and lower SB were associated with lower systolic BP in older adults with chronic diseases. However, sleep duration did not modify this association. Therefore, interventions focusing on concomitantly increasing PA levels and reducing SB should be the priority for controlling blood pressure.
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Affiliation(s)
- Antonio H Germano-Soares
- Graduate Program in Physical Education University of Pernambuco, Recife, Brazil
- Department of Physical Education Faculdade Pernambucana de Saúde, Recife, Pernambuco, Brazil
| | - Breno Q Farah
- Department of Physical Education Federal Rural University of Pernambuco, Recife, Brazil
| | - José F Da Silva
- Graduate Program in Physical Education University of Pernambuco, Recife, Brazil
| | - Mauro V G Barros
- Graduate Program in Physical Education University of Pernambuco, Recife, Brazil
| | - Rafael M Tassitano
- Department of Health and Kinesiology University of Illinois at Urbana-Champaign, Champaign, IL, USA.
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Silva JKTNF, Menêses AL, Silva GO, O'Driscoll JM, Ritti-Dias RM, Correia MA, Farah BQ. Acute Effects of Breaking up Sitting Time With Isometric Wall Squat Exercise on Vascular Function and Blood Pressure in Sedentary Adults: Randomized Crossover Trial. J Cardiopulm Rehabil Prev 2024:01273116-990000000-00158. [PMID: 38885063 DOI: 10.1097/hcr.0000000000000877] [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: 06/20/2024]
Abstract
PURPOSE The World Health Organization has recommended breaking up sitting time to improve cardiovascular health. However, whether isometric exercise can be effectively used as a strategy to break up sitting time remains unclear. Thus, the aim of this study was to analyze the acute effects of breaking up prolonged sitting with isometric wall squat exercise (IWSE) on vascular function and blood pressure (BP) in sedentary adults. METHODS This randomized crossover trial included 17 adults (53% male, 26 ± 6 yr, 22.4 ± 3.6 kg/m2) with high sedentary behavior (≥ 6 hr/d). The participants completed 2 experimental sessions in a randomized order, both sharing a common sitting period of 180 min: Breaks (2-min breaks were incorporated into the IWSE, with participants maintaining their knees at the angle determined by the incremental test, which occurred every 30 min) and Control (sitting for 180 min continuously). Popliteal artery flow-mediated dilation (FMD) and brachial BP were measured before and at 10 and 30 min after the experimental sessions. RESULTS The results did not indicate significant session vs time interaction effects on popliteal FMD and brachial BP (P > .05). A subanalysis including only participants with popliteal FMD reduction after the Control session (n = 11) revealed that Breaks enhanced popliteal FMD after 10 min (1.38 ± 6.45% vs -4.87 ± 2.95%, P= .002) and 30 min (-0.43 ± 2.48% vs -2.11 ± 5.22%, P= .047). CONCLUSION Breaking up prolonged sitting with IWSE mitigates impaired vascular function resulting from prolonged sitting but has no effect on BP in sedentary adults.
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Affiliation(s)
- Jéssika K T N F Silva
- Author Affiliations: Department of Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, São Paulo, Brazil (Ms Silva, Mr O. Silva, and Drs Ritti-Dias, Correia, and Farah); Graduate Program in Physical Education, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil (Ms Silva and Dr Farah); University of Pernambuco (UPE), Recife, Pernambuco, Brazil (Dr Menêses); School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, United Kingdom (Dr O'Driscoll); Department of Physical Education, Federal Rural University of Pernambuco (UFRPE), Recife, Pernambuco, Brazil (Dr Farah)
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Zablocki RW, Hartman SJ, Di C, Zou J, Carlson JA, Hibbing PR, Rosenberg DE, Greenwood-Hickman MA, Dillon L, LaCroix AZ, Natarajan L. Using functional principal component analysis (FPCA) to quantify sitting patterns derived from wearable sensors. Int J Behav Nutr Phys Act 2024; 21:48. [PMID: 38671485 PMCID: PMC11055353 DOI: 10.1186/s12966-024-01585-8] [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: 05/26/2023] [Accepted: 03/21/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Sedentary behavior (SB) is a recognized risk factor for many chronic diseases. ActiGraph and activPAL are two commonly used wearable accelerometers in SB research. The former measures body movement and the latter measures body posture. The goal of the current study is to quantify the pattern and variation of movement (by ActiGraph activity counts) during activPAL-identified sitting events, and examine associations between patterns and health-related outcomes, such as systolic and diastolic blood pressure (SBP and DBP). METHODS The current study included 314 overweight postmenopausal women, who were instructed to wear an activPAL (at thigh) and ActiGraph (at waist) simultaneously for 24 hours a day for a week under free-living conditions. ActiGraph and activPAL data were processed to obtain minute-level time-series outputs. Multilevel functional principal component analysis (MFPCA) was applied to minute-level ActiGraph activity counts within activPAL-identified sitting bouts to investigate variation in movement while sitting across subjects and days. The multilevel approach accounted for the nesting of days within subjects. RESULTS At least 90% of the overall variation of activity counts was explained by two subject-level principal components (PC) and six day-level PCs, hence dramatically reducing the dimensions from the original minute-level scale. The first subject-level PC captured patterns of fluctuation in movement during sitting, whereas the second subject-level PC delineated variation in movement during different lengths of sitting bouts: shorter (< 30 minutes), medium (30 -39 minutes) or longer (> 39 minute). The first subject-level PC scores showed positive association with DBP (standardized β ^ : 2.041, standard error: 0.607, adjusted p = 0.007), which implied that lower activity counts (during sitting) were associated with higher DBP. CONCLUSION In this work we implemented MFPCA to identify variation in movement patterns during sitting bouts, and showed that these patterns were associated with cardiovascular health. Unlike existing methods, MFPCA does not require pre-specified cut-points to define activity intensity, and thus offers a novel powerful statistical tool to elucidate variation in SB patterns and health. TRIAL REGISTRATION ClinicalTrials.gov NCT03473145; Registered 22 March 2018; https://clinicaltrials.gov/ct2/show/NCT03473145 ; International Registered Report Identifier (IRRID): DERR1-10.2196/28684.
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Affiliation(s)
- Rong W Zablocki
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, 9500 Gilman Drive, La Jolla, 92093, California, USA
| | - Sheri J Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, 9500 Gilman Drive, La Jolla, 92093, California, USA
| | - Chongzhi Di
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, 98109, Washington, USA
| | - Jingjing Zou
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, 9500 Gilman Drive, La Jolla, 92093, California, USA
| | - Jordan A Carlson
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, 610 E. 22nd St., Kansas City, 64108, Missouri, USA
| | - Paul R Hibbing
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 W Taylor St, Chicago, IL, 60612, USA
| | - Dori E Rosenberg
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, 98101, Washington, USA
| | | | - Lindsay Dillon
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, 9500 Gilman Drive, La Jolla, 92093, California, USA
| | - Andrea Z LaCroix
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, 9500 Gilman Drive, La Jolla, 92093, California, USA
| | - Loki Natarajan
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, 9500 Gilman Drive, La Jolla, 92093, California, USA.
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Contardo Ayala AM, Ridgers ND, Timperio A, Arundell L, Dunstan DW, Hesketh KD, Daly RM, Salmon J. The association between device-measured sitting time and cardiometabolic health risk factors in children. BMC Public Health 2024; 24:1015. [PMID: 38609909 PMCID: PMC11010425 DOI: 10.1186/s12889-024-18495-w] [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: 12/14/2023] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND There is limited evidence of the associations between postural-derived sitting time, waist-worn derived sedentary time and children's health and the moderation effect of physical activity (PA). This study examined associations of children's device-measured sitting time with cardiometabolic health risk factors, including moderation by physical activity. METHODS Cross-sectional baseline data from children (mean-age 8.2 ± 0.5 years) in Melbourne, Australia (2010) participating in the TransformUs program were used. Children simultaneously wore an activPAL to assess sitting time and an ActiGraph GT3X to assess sedentary time and physical activity intensity. Cardiometabolic health risk factors included: adiposity (body mass index [BMI], waist circumference [WC]), systolic and diastolic blood pressure (SBP, DBP), high-density lipoprotein (HDL), low-density lipoprotein (LDL), cholesterol, triglycerides, fasting plasma glucose (FPG), serum insulin, and 25-hydroxyvitaminD (25[OH]D). Linear regression models (n = 71-113) assessed associations between sitting time with each health risk factor, adjusted for different PA intensities (i.e. light [LIPA], moderate-vigorous intensities [MVPA], separately on each model), age, sex, adiposity, and clustering by school. Interaction terms examined moderation. The analyses were repeated using device-measured sedentary time (i.e. ActiGraph GT3X) for comparison. RESULTS Sitting time was positively associated with SBP (b = 0.015; 95%CI: 0.004, 0.026), DBP (b = 0.012; 95%CI:0.004, 0.020), and FPG (b = 0.001; 95%CI: 0.000, 0.000), after adjusting for higher PA intensities. The association between sitting time and insulin (b = 0.003; 95%CI: 0.000, 0.006) was attenuated after adjusting for higher PA intensities. When the models were adjusted for LIPA and MVPA, there was a negative association with LDL (b=-0.001; 95%CI: -0.002, -0.000 and b=-0.001; 95%CI: -0.003, -0.000, respectively). There was a negative association of sedentary time with WCz (b=-0.003; 95%CI: -0.005, 0.000) and BMIz (b=-0.003; 95%CI: -0.006, -0.000) when the models were adjusted by MVPA. Sedentary time was positively associated with triglycerides (b = 0.001; 95%CI: 0.000, 0.001) but attenuated after adjusting for MVPA. No evidence of moderation effects was found. CONCLUSIONS Higher volumes of sitting and sedentary time were associated with some adverse associations on some cardiometabolic health risk factors in children. These associations were more evident when sitting time was the predictor. This suggests that reducing time spent sitting may benefit some cardiometabolic health outcomes, but future experimental research is needed to confirm causal relationships and identify the biological mechanisms that might be involved. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12609000715279.
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Affiliation(s)
- Ana María Contardo Ayala
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia.
| | - Nicola D Ridgers
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
| | - Lauren Arundell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
| | - David W Dunstan
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Victoria, Australia
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Prince SA, Dempsey PC, Reed JL, Rubin L, Saunders TJ, Ta J, Tomkinson GR, Merucci K, Lang JJ. The Effect of Sedentary Behaviour on Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis. Sports Med 2024; 54:997-1013. [PMID: 38225444 PMCID: PMC11052788 DOI: 10.1007/s40279-023-01986-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND Cardiorespiratory fitness (CRF) is an important indicator of current and future health. While the impact of habitual physical activity on CRF is well established, the role of sedentary behaviour (SB) remains less understood. OBJECTIVE We aimed to determine the effect of SB on CRF. METHODS Searches were conducted in MEDLINE, Embase, PsycINFO, CINAHL and SPORTDiscus from inception to August 2022. Randomised controlled trials, quasi-experimental studies and cohort studies that assessed the relationship between SB and CRF were eligible. Narrative syntheses and meta-analyses summarised the evidence, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) certainty was based on evidence from randomised controlled trials. RESULTS This review included 18 studies that focused on youth (four randomised controlled trials, three quasi-experimental studies, 11 cohort studies) and 24 on adult populations (15 randomised controlled trials, five quasi-experimental studies, four cohort studies). In youth and adults, evidence from randomised controlled trials suggests mixed effects of SB on CRF, but with the potential for interventions to improve CRF. Quasi-experimental and cohort studies also support similar conclusions. Certainty of evidence was very low for both age groups. A meta-analysis of adult randomised controlled trials found that interventions targeting reducing SB, or increasing physical activity and reducing SB, had a significant effect on post-peak oxygen consumption (mean difference = 3.16 mL.kg-1.min-1, 95% confidence interval: 1.76, 4.57). CONCLUSIONS Evidence from randomised controlled trials indicates mixed associations between SB and CRF, with the potential for SB to influence CRF, as supported by meta-analytical findings. Further well-designed trials are warranted to confirm the relationship between SB and CRF, explore the effects of SB independent from higher intensity activity, and investigate the existence of such relationships in paediatric populations. CLINICAL TRIAL REGISTRATION PROSPERO CRD42022356218.
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Affiliation(s)
- Stephanie A Prince
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, K1A 0K9, Canada.
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - Paddy C Dempsey
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Jennifer L Reed
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Exercise Physiology and Cardiovascular Health Lab, University of Ottawa Heart Institute, Ottawa, ON, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Lukas Rubin
- Department of Physical Education and Sport, Faculty of Science, Humanities and Education, Technical University of Liberec, Liberec, Czech Republic
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Travis J Saunders
- Department Applied Human Sciences, University of Prince Edward Island, Charlottetown, PEI, Canada
| | - Josephine Ta
- Telfer School of Management, University of Ottawa, Ottawa, ON, Canada
| | - Grant R Tomkinson
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | | | - Justin J Lang
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, ON, K1A 0K9, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
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Rosenberg DE, Zhu W, Greenwood-Hickman MA, Cook AJ, Florez Acevedo S, McClure JB, Arterburn DE, Cooper J, Owen N, Dunstan D, Perry SR, Yarborough L, Mettert KD, Green BB. Sitting Time Reduction and Blood Pressure in Older Adults: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e243234. [PMID: 38536177 PMCID: PMC10973891 DOI: 10.1001/jamanetworkopen.2024.3234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/28/2024] [Indexed: 04/28/2024] Open
Abstract
Importance Practical health promotion strategies for improving cardiometabolic health in older adults are needed. Objective To examine the efficacy of a sedentary behavior reduction intervention for reducing sitting time and improving blood pressure in older adults. Design, Setting, and Participants This parallel-group randomized clinical trial was conducted in adults aged 60 to 89 years with high sitting time and body mass index of 30 to 50 from January 1, 2019, to November 31, 2022, at a health care system in Washington State. Intervention Participants were randomized 1:1 to the sitting reduction intervention or a healthy living attention control condition for 6 months. Intervention participants received 10 health coaching contacts, sitting reduction goals, and a standing desk and fitness tracker to prompt sitting breaks. The attention control group received 10 health coaching contacts to set general healthy living goals, excluding physical activity or sedentary behavior. Main Outcomes and Measures The primary outcome, measured at baseline, 3 months, and 6 months, was sitting time assessed using accelerometers worn for 7 days at each time point. Coprimary outcomes were systolic and diastolic blood pressure measured at baseline and 6 months. Results A total of 283 participants (140 intervention and 143 control) were randomized (baseline mean [SD] age, 68.8 [6.2] years; 186 [65.7%] female; mean [SD] body mass index, 34.9 [4.7]). At baseline, 147 (51.9%) had a hypertension diagnosis and 97 (69.3%) took at least 1 antihypertensive medication. Sitting time was reduced, favoring the intervention arm, with a difference in the mean change of -31.44 min/d at 3 months (95% CI, -48.69 to -14.19 min/d; P < .001) and -31.85 min/d at 6 months (95% CI, -52.91 to -10.79 min/d; P = .003). Systolic blood pressure change was lower by 3.48 mm Hg, favoring the intervention arm at 6 months (95% CI, -6.68 to -0.28 mm Hg; P = .03). There were 6 serious adverse events in each arm and none were study related. Conclusions and Relevance In this study of a 6-month sitting reduction intervention, older adults in the intervention reduced sedentary time by more than 30 min/d and reduced systolic blood pressure. Sitting reduction could be a promising approach to improve health in older adults. Trial Registration ClinicalTrials.gov Identifier: NCT03739762.
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Affiliation(s)
- Dori E. Rosenberg
- Kaiser Permanente Washington Health Research Institute, Seattle
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Weiwei Zhu
- Kaiser Permanente Washington Health Research Institute, Seattle
| | | | - Andrea J. Cook
- Kaiser Permanente Washington Health Research Institute, Seattle
| | - Stefani Florez Acevedo
- Department of Health Services, School of Public Health, University of Washington, Seattle
| | - Jennifer B. McClure
- Kaiser Permanente Washington Health Research Institute, Seattle
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | | | - Julie Cooper
- Kaiser Permanente Washington Health Research Institute, Seattle
| | - Neville Owen
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - David Dunstan
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
| | | | | | | | - Beverly B. Green
- Kaiser Permanente Washington Health Research Institute, Seattle
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
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Tamiya H, Hoshiai M, Abe T, Watanabe H, Fujii Y, Tsubaki A. Prolonged Sitting Induces Elevated Blood Pressure in Healthy Young Men: A Randomized Crossover Trial. Cureus 2024; 16:e55224. [PMID: 38558663 PMCID: PMC10981358 DOI: 10.7759/cureus.55224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Prolonged sitting-induced blood pooling in the lower legs can increase blood pressure through increased sympathetic nerve activity and peripheral vascular resistance, an aspect that has been understudied as a primary outcome. This study compared the effects of prolonged sitting with those of prolonged supination on blood pressure in healthy young men. Methods This randomized crossover study included 16 healthy young men (mean age: 21.6 ± 0.7 years) who were randomly assigned to a three-hour supine (CON) or three-hour sitting (SIT) condition, followed by a washout period of at least one week. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), low-frequency/high-frequency (LF/HF) ratio derived from heart rate variability, and leg circumference were measured at 60, 120, and 180 minutes from baseline. These indices were compared by two-way (time × conditions) analysis of variance (ANOVA). Results In the SIT condition, DBP, MAP, HR, LF/HF ratio, and leg circumference increased significantly over time (P < 0.05) and were significantly higher than those in the CON condition (P < 0.05). However, SBP showed no significant change over time and between conditions. Conclusions The findings indicate the involvement of sympathetic nerve activity and increased peripheral vascular resistance induced by fluid retention in the lower legs with increased DBP and MAP in healthy young men.
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Affiliation(s)
- Hajime Tamiya
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, JPN
| | - Megumi Hoshiai
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Nikko, JPN
| | - Takuya Abe
- Department of Clinical Engineering and Medical Technology, Niigata University of Health and Welfare, Niigata, JPN
| | - Hiroaki Watanabe
- Department of Clinical Engineering and Medical Technology, Niigata University of Health and Welfare, Niigata, JPN
| | - Yutaka Fujii
- Department of Clinical Engineering and Medical Technology, Niigata University of Health and Welfare, Niigata, JPN
| | - Atsuhiro Tsubaki
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, JPN
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de Luna TA, Rezende DAN, de Brito LC, Fecchio RY, Lima FR, de Sá Pinto AL, de Medeiros Ribeiro AC, Bonfiglioli KR, Gualano B, Roschel H, Peçanha T. A single session of aerobic exercise reduces systolic blood pressure at rest and in response to stress in women with rheumatoid arthritis and hypertension. J Hum Hypertens 2024; 38:168-176. [PMID: 37857757 PMCID: PMC10844091 DOI: 10.1038/s41371-023-00869-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 09/15/2023] [Accepted: 09/26/2023] [Indexed: 10/21/2023]
Abstract
Rheumatoid arthritis (RA) is an autoimmune inflammatory disease characterized by increased risk of cardiovascular disease and hypertension (HT). A single session of aerobic exercise may reduce blood pressure (BP) in different clinical groups; however, little is known about the acute effects of exercise on BP in RA patients. This is a randomized controlled crossover study that assessed the effects of a single session of aerobic exercise on resting BP, on BP responses to stressful stimuli, and on 24-h BP in women with RA and HT. Twenty women with RA and HT (53 ± 10 years) undertook sessions of 30-min treadmill exercise (50% VO2max) or control (no exercise) in a crossover fashion. Before and after the sessions, BP was measured at rest, and in response to the Stroop-Color Word Test (SCWT), the Cold Pressor Test (CPT), and an isometric handgrip test. After the sessions, participants were also fitted with an ambulatory BP monitor for the assessment of 24-h BP. A single session of exercise reduced resting systolic BP (SBP) (-5 ± 9 mmHg; p < 0.05), and reduced SBP response to the SCWT (-7 ± 14 mmHg; p < 0.05), and to the CPT (-5 ± 11 mmHg; p < 0.05). Exercise did not reduce resting diastolic BP (DBP), BP responses to the isometric handgrip test or 24-h BP. In conclusion, a single session of aerobic exercise reduced SBP at rest and in response to stressful stimuli in hypertensive women with RA. These results support the use of exercise as a strategy for controlling HT and, hence, reducing cardiovascular risk in women with RA.Clinical Trial Registration: This study registered at the Brazilian Clinical Trials ( https://ensaiosclinicos.gov.br/rg/RBR-867k9g ) at 12/13/2019.
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Affiliation(s)
- Tatiane Almeida de Luna
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Laboratory of Assessment and Conditioning in Rheumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Diego Augusto Nunes Rezende
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Laboratory of Assessment and Conditioning in Rheumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Leandro Campos de Brito
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, Sao Paulo, SP, Brazil
- Applied Chronobiology and Exercise Physiology, School of Arts, Sciences and Humanities, University of São Paulo, Sao Paulo, SP, Brazil
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Rafael Yokoyama Fecchio
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, Sao Paulo, SP, Brazil
| | - Fernanda Rodrigues Lima
- Laboratory of Assessment and Conditioning in Rheumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Ana Lúcia de Sá Pinto
- Laboratory of Assessment and Conditioning in Rheumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Ana Cristina de Medeiros Ribeiro
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Karina Rossi Bonfiglioli
- Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Bruno Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Laboratory of Assessment and Conditioning in Rheumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Hamilton Roschel
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Laboratory of Assessment and Conditioning in Rheumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Tiago Peçanha
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport and Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
- Laboratory of Assessment and Conditioning in Rheumatology, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester Metropolitan University, Manchester, UK.
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10
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Charchar FJ, Prestes PR, Mills C, Ching SM, Neupane D, Marques FZ, Sharman JE, Vogt L, Burrell LM, Korostovtseva L, Zec M, Patil M, Schultz MG, Wallen MP, Renna NF, Islam SMS, Hiremath S, Gyeltshen T, Chia YC, Gupta A, Schutte AE, Klein B, Borghi C, Browning CJ, Czesnikiewicz-Guzik M, Lee HY, Itoh H, Miura K, Brunström M, Campbell NR, Akinnibossun OA, Veerabhadrappa P, Wainford RD, Kruger R, Thomas SA, Komori T, Ralapanawa U, Cornelissen VA, Kapil V, Li Y, Zhang Y, Jafar TH, Khan N, Williams B, Stergiou G, Tomaszewski M. Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension. J Hypertens 2024; 42:23-49. [PMID: 37712135 PMCID: PMC10713007 DOI: 10.1097/hjh.0000000000003563] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/12/2023] [Accepted: 08/22/2023] [Indexed: 09/16/2023]
Abstract
Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools.
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Affiliation(s)
- Fadi J. Charchar
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
- Department of Physiology, University of Melbourne, Melbourne, Australia
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Priscilla R. Prestes
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
| | - Charlotte Mills
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang
- Department of Medical Sciences, School of Medical and Live Sciences, Sunway University, Bandar Sunway, Selangor, Malaysia
| | - Dinesh Neupane
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Francine Z. Marques
- Hypertension Research Laboratory, School of Biological Sciences, Monash University
- Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne
| | - James E. Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Liffert Vogt
- Department of Internal Medicine, Section Nephrology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Microcirculation, Amsterdam, The Netherlands
| | - Louise M. Burrell
- Department of Medicine, University of Melbourne, Austin Health, Melbourne, Australia
| | - Lyudmila Korostovtseva
- Department of Hypertension, Almazov National Medical Research Centre, St Petersburg, Russia
| | - Manja Zec
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, USA
- Colorado Program for Musculoskeletal Research, Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, USA
| | - Mansi Patil
- Department of Nutrition and Dietetics, Asha Kiran JHC Hospital, Chinchwad
- Hypertension and Nutrition, Core Group of IAPEN India, India
| | - Martin G. Schultz
- Department of Internal Medicine, Section Nephrology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Microcirculation, Amsterdam, The Netherlands
| | | | - Nicolás F. Renna
- Unit of Hypertension, Hospital Español de Mendoza, School of Medicine, National University of Cuyo, IMBECU-CONICET, Mendoza, Argentina
| | | | - Swapnil Hiremath
- Department of Medicine, University of Ottawa and the Ottawa Hospital, Ottawa, Canada
| | - Tshewang Gyeltshen
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Yook-Chin Chia
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Selangor
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Abhinav Gupta
- Department of Medicine, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, India
| | - Aletta E. Schutte
- School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney, New South Wales, Australia
- Hypertension in Africa Research Team, SAMRC Unit for Hypertension and Cardiovascular Disease, North-West University
- SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Britt Klein
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, Faculty of Medicine, University of Bologna, Bologna, Italy
| | - Colette J. Browning
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
| | - Marta Czesnikiewicz-Guzik
- School of Medicine, Dentistry and Nursing-Dental School, University of Glasgow, UK
- Department of Periodontology, Prophylaxis and Oral Medicine; Jagiellonian University, Krakow, Poland
| | - Hae-Young Lee
- Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hiroshi Itoh
- Department of Internal Medicine (Nephrology, Endocrinology and Metabolism), Keio University, Tokyo
| | - Katsuyuki Miura
- NCD Epidemiology Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Mattias Brunström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Norm R.C. Campbell
- Libin Cardiovascular Institute, Department of Medicine, University of Calgary, Calgary, Canada
| | | | - Praveen Veerabhadrappa
- Kinesiology, Division of Science, The Pennsylvania State University, Reading, Pennsylvania
| | - Richard D. Wainford
- Department of Pharmacology and Experimental Therapeutics, The Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston
- Division of Cardiology, Emory University, Atlanta, USA
| | - Ruan Kruger
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Shane A. Thomas
- Health Innovation and Transformation Centre, Federation University Australia, Ballarat, Australia
| | - Takahiro Komori
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Udaya Ralapanawa
- Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | | | - Vikas Kapil
- William Harvey Research Institute, Centre for Cardiovascular Medicine and Devices, NIHR Barts Biomedical Research Centre, BRC, Faculty of Medicine and Dentistry, Queen Mary University London
- Barts BP Centre of Excellence, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Yan Li
- Department of Cardiovascular Medicine, Shanghai Institute of Hypertension, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai
| | - Yuqing Zhang
- Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences, Chinese Hypertension League, Beijing, China
| | - Tazeen H. Jafar
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Nadia Khan
- Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Bryan Williams
- University College London (UCL), Institute of Cardiovascular Science, National Institute for Health Research (NIHR), UCL Hospitals Biomedical Research Centre, London, UK
| | - George Stergiou
- Hypertension Centre STRIDE-7, School of Medicine, Third Department of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Maciej Tomaszewski
- Division of Cardiovascular Sciences, Faculty of Medicine, Biology and Health, University of Manchester
- Manchester Academic Health Science Centre, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
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11
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Stoner L, Higgins S, Paterson C. The 24-h activity cycle and cardiovascular outcomes: establishing biological plausibility using arterial stiffness as an intermediate outcome. Am J Physiol Heart Circ Physiol 2023; 325:H1243-H1263. [PMID: 37737729 DOI: 10.1152/ajpheart.00258.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 09/07/2023] [Accepted: 09/15/2023] [Indexed: 09/23/2023]
Abstract
This review proposes a biologically plausible working model for the relationship between the 24-h activity cycle (24-HAC) and cardiovascular disease. The 24-HAC encompasses moderate-to-vigorous physical activity (MVPA), light physical activity, sedentary behavior (SB), and sleep. MVPA confers the greatest relative cardioprotective effect, when considering MVPA represents just 2% of the day if physical activity guidelines (30 min/day) are met. While we have well-established guidelines for MVPA, those for the remaining activity behaviors are vague. The vague guidelines are attributable to our limited mechanistic understanding of the independent and additive effects of these behaviors on the cardiovascular system. Our proposed biological model places arterial stiffness, a measure of vascular aging, as the key intermediate outcome. Starting with prolonged exposure to SB or static standing, we propose that the reported transient increases in arterial stiffness are driven by a cascade of negative hemodynamic effects following venous pooling. The subsequent autonomic, metabolic, and hormonal changes further impair vascular function. Vascular dysfunction can be offset by using mechanistic-informed interruption strategies and by engaging in protective behaviors throughout the day. Physical activity, especially MVPA, can confer protection by chronically improving endothelial function and associated protective mechanisms. Conversely, poor sleep, especially in duration and quality, negatively affects hormonal, metabolic, autonomic, and hemodynamic variables that can confound the physiological responses to next-day activity behaviors. Our hope is that the proposed biologically plausible working model will assist in furthering our understanding of the effects of these complex, interrelated activity behaviors on the cardiovascular system.
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Affiliation(s)
- Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Department of Epidemiology, The Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Simon Higgins
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Craig Paterson
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
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12
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Wójcik M, Alvarez-Pitti J, Kozioł-Kozakowska A, Brzeziński M, Gabbianelli R, Herceg-Čavrak V, Wühl E, Lucas I, Radovanović D, Melk A, González Lopez-Valcarcel B, Fernández-Aranda F, Mazur A, Lurbe E, Borghi C, Drożdż D. Psychosocial and environmental risk factors of obesity and hypertension in children and adolescents-a literature overview. Front Cardiovasc Med 2023; 10:1268364. [PMID: 38054100 PMCID: PMC10694215 DOI: 10.3389/fcvm.2023.1268364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/24/2023] [Indexed: 12/07/2023] Open
Abstract
Childhood obesity has become a worldwide epidemic in the 21st century. Its treatment is challenging and often ineffective, among others due to complex, often not obvious causes. Awareness of the existence and meaning of psychosocial and environmental risk factors seems to be an essential element in the prevention and treatment of obesity and its complications, especially arterial hypertension. In this review, we will discuss the role of that risk factors linking obesity and increased cardiovascular disorders including the role of nutritional factors (including the role of unhealthy diet, inadequate hydration), unhealthy behaviors (e.g. smoking, alcohol and drugs, sedentary behavior, low physical activity, disrupted circadian rhythms, sleep disorders, screen exposure), unfavorable social factors (such as dysfunctional family, bullying, chronic stress, mood disorders, depression, urbanization, noise, and environmental pollution), and finally differences in cardiovascular risk in girls and boys.
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Affiliation(s)
- Małgorzata Wójcik
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College in Kraków, Kraków, Poland
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Kraków, Kraków, Poland
| | - Julio Alvarez-Pitti
- Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- INCLIVA Biomedical Research Institute, Hospital Clínico, University of Valencia, Valencia, Spain
| | - Agnieszka Kozioł-Kozakowska
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Kraków, Kraków, Poland
- Department of Pediatrics, Gastroenterology and Nutrition, Pediatric Institute, Jagiellonian University Medical College in Kraków, Kraków, Poland
| | - Michał Brzeziński
- Department of Pediatrics, Gastroenterology, Allergology and Pediatric Nutrition, Medical University of Gdansk, Kraków, Poland
| | - Rosita Gabbianelli
- Unit of Molecular Biology and Nutrigenomics, School of Pharmacy, University of Camerino, Camerino, Italy
| | - Vesna Herceg-Čavrak
- Faculty of Health Science, Libertas International University, Zagreb, Croatia
| | - Elke Wühl
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg University, Heidelberg, Germany
| | - Ignacio Lucas
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Psychology, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Clinical Psychology Unit, University Hospital of Bellvitge, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviours Group, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Dragan Radovanović
- Department of Medical Sciences, Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
| | - Anette Melk
- Children’s Hospital, Hannover Medical School, Hannover, Germany
| | - Beatriz González Lopez-Valcarcel
- Department of Quantitative Methods for Economics and Management, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Psychology, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Artur Mazur
- Department of Pediatrics, Pediatric Endocrinology and Diabetes, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | - Empar Lurbe
- Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- INCLIVA Biomedical Research Institute, Hospital Clínico, University of Valencia, Valencia, Spain
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Dorota Drożdż
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Kraków, Kraków, Poland
- Department of Pediatric Nephrology and Hypertension, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College, Kraków, Poland
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13
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Pinto AJ, Bergouignan A, Dempsey PC, Roschel H, Owen N, Gualano B, Dunstan DW. Physiology of sedentary behavior. Physiol Rev 2023; 103:2561-2622. [PMID: 37326297 PMCID: PMC10625842 DOI: 10.1152/physrev.00022.2022] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 05/10/2023] [Accepted: 06/14/2023] [Indexed: 06/17/2023] Open
Abstract
Sedentary behaviors (SB) are characterized by low energy expenditure while in a sitting or reclining posture. Evidence relevant to understanding the physiology of SB can be derived from studies employing several experimental models: bed rest, immobilization, reduced step count, and reducing/interrupting prolonged SB. We examine the relevant physiological evidence relating to body weight and energy balance, intermediary metabolism, cardiovascular and respiratory systems, the musculoskeletal system, the central nervous system, and immunity and inflammatory responses. Excessive and prolonged SB can lead to insulin resistance, vascular dysfunction, shift in substrate use toward carbohydrate oxidation, shift in muscle fiber from oxidative to glycolytic type, reduced cardiorespiratory fitness, loss of muscle mass and strength and bone mass, and increased total body fat mass and visceral fat depot, blood lipid concentrations, and inflammation. Despite marked differences across individual studies, longer term interventions aimed at reducing/interrupting SB have resulted in small, albeit marginally clinically meaningful, benefits on body weight, waist circumference, percent body fat, fasting glucose, insulin, HbA1c and HDL concentrations, systolic blood pressure, and vascular function in adults and older adults. There is more limited evidence for other health-related outcomes and physiological systems and for children and adolescents. Future research should focus on the investigation of molecular and cellular mechanisms underpinning adaptations to increasing and reducing/interrupting SB and the necessary changes in SB and physical activity to impact physiological systems and overall health in diverse population groups.
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Affiliation(s)
- Ana J Pinto
- Division of Endocrinology, Metabolism, and Diabetes, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Applied Physiology & Nutrition Research Group, Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Audrey Bergouignan
- Division of Endocrinology, Metabolism, and Diabetes, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Institut Pluridisciplinaire Hubert Curien, Centre National de la Recherche Scientifique, Université de Strasbourg, Strasbourg, France
| | - Paddy C Dempsey
- Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, United Kingdom
| | - Hamilton Roschel
- Applied Physiology & Nutrition Research Group, Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Neville Owen
- Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group, Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
- Food Research Center, University of Sao Paulo, Sao Paulo, Brazil
| | - David W Dunstan
- Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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14
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Hung SH, Tierney C, Klassen TD, Schneeberg A, Bayley MT, Dukelow SP, Hill MD, Krassioukov A, Pooyania S, Poulin MJ, Yao J, Eng JJ. Blood pressure trajectory of inpatient stroke rehabilitation patients from the Determining Optimal Post-Stroke Exercise (DOSE) trial over the first 12 months post-stroke. Front Neurol 2023; 14:1245881. [PMID: 37794879 PMCID: PMC10546336 DOI: 10.3389/fneur.2023.1245881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/28/2023] [Indexed: 10/06/2023] Open
Abstract
Background High blood pressure (BP) is the primary risk factor for recurrent strokes. Despite established clinical guidelines, some stroke survivors exhibit uncontrolled BP over the first 12 months post-stroke. Furthermore, research on BP trajectories in stroke survivors admitted to inpatient rehabilitation hospitals is limited. Exercise is recommended to reduce BP after stroke. However, the effect of high repetition gait training at aerobic intensities (>40% heart rate reserve; HRR) during inpatient rehabilitation on BP is unclear. We aimed to determine the effect of an aerobic gait training intervention on BP trajectory over the first 12 months post-stroke. Methods This is a secondary analysis of the Determining Optimal Post-Stroke Exercise (DOSE) trial. Participants with stroke admitted to inpatient rehabilitation hospitals were recruited and randomized to usual care (n = 24), DOSE1 (n = 25; >2,000 steps, 40-60% HRR for >30 min/session, 20 sessions over 4 weeks), or DOSE2 (n = 25; additional DOSE1 session/day) groups. Resting BP [systolic (SBP) and diastolic (DBP)] was measured at baseline (inpatient rehabilitation admission), post-intervention (near inpatient discharge), 6- and 12-month post-stroke. Linear mixed-effects models were used to examine the effects of group and time (weeks post-stroke) on SBP, DBP and hypertension (≥140/90 mmHg; ≥130/80 mmHg, if diabetic), controlling for age, stroke type, and baseline history of hypertension. Results No effect of intervention group on SBP, DBP, or hypertension was observed. BP increased from baseline to 12-month post-stroke for SBP (from [mean ± standard deviation] 121.8 ± 15.0 to 131.8 ± 17.8 mmHg) and for DBP (74.4 ± 9.8 to 78.5 ± 10.1 mmHg). The proportion of hypertensive participants increased from 20.8% (n = 15/72) to 32.8% (n = 19/58). These increases in BP were statistically significant: an effect [estimation (95%CI), value of p] of time was observed on SBP [0.19 (0.12-0.26) mmHg/week, p < 0.001], DBP [0.09 (0.05-0.14) mmHg/week, p < 0.001], and hypertension [OR (95%CI): 1.03 (1.01-1.05), p = 0.010]. A baseline history of hypertension was associated with higher SBP by 13.45 (8.73-18.17) mmHg, higher DBP by 5.57 (2.02-9.12) mmHg, and 42.22 (6.60-270.08) times the odds of being hypertensive at each timepoint, compared to those without. Conclusion Blood pressure increased after inpatient rehabilitation over the first 12 months post-stroke, especially among those with a history of hypertension. The 4-week aerobic gait training intervention did not influence this trajectory.
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Affiliation(s)
- Stanley H. Hung
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Rehabilitation Research Program, Center for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | | | - Tara D. Klassen
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Amy Schneeberg
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Mark T. Bayley
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sean P. Dukelow
- Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Michael D. Hill
- Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Andrei Krassioukov
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Sepideh Pooyania
- Division of Physical Medicine and Rehabilitation, University of Manitoba, Winnipeg, MB, Canada
| | - Marc J. Poulin
- Department of Physiology and Pharmacology and Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Jennifer Yao
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Janice J. Eng
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Rehabilitation Research Program, Center for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
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15
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Zheng X, Liu M, Wu Z, Jia Z. Identifying the causal relationship between sedentary behavior and heart failure: Insights from a Mendelian randomization study and mediation analysis. Clin Cardiol 2023; 46:1082-1089. [PMID: 37641542 PMCID: PMC10540015 DOI: 10.1002/clc.24101] [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: 02/13/2023] [Revised: 06/14/2023] [Accepted: 07/14/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Observational studies have revealed that a lack of physical exercise may be linked to a higher risk of heart failure (HF). Here, the causal relationship between sedentary behavior (SB) and HF was investigated using Mendelian randomization (MR). HYPOTHESIS SB was considered as an important risk factor of HF. METHODS Single nucleotide polymorphisms with a genome-wide statistical significance threshold of <5 × 10-8 among the SB-proxied phenotypes (TV screen time, computer use, and driving) from genome-wide association study (GWAS) datasets were identified as instrumental variables (IVs). The MR study was performed using the inverse-variance weighting (IVW) model as a primary standard to evaluate causal relationships. Simultaneously, MR-Egger regression, weighted median, and maximum likelihood models were used as supplements. Sensitivity analysis, consisting of a heterogeneity and horizontal pleiotropy test, was performed using Cochran's Q, MR-Egger intercept, and MR-PRESSO tests to ensure the reliability of conclusions. RESULTS The IVW model results showed that increased TV screen time correlated with a higher genetic susceptibility for HF in both HF-associated GWAS datasets, which was also supported by weighted median and maximum likelihood model results. The odds ratios with 95% confidence intervals were 1.418 (1.182-1.700) and 1.486 (1.136-1.943), respectively. Although the results of Cochran's Q test indicated certain heterogeneity among the IVs. The MR-Egger intercept and MR-PRESSO tests suggested no horizontal pleiotropy and verified the reliability of the conclusion. CONCLUSIONS This MR study identified that increased TV screen time may predispose individuals to the development of HF.
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Affiliation(s)
- Xifeng Zheng
- Department of CardiologyAffiliated Hospital of Guangdong Medical UniversityZhanjiangGuangdongChina
| | - Manqi Liu
- Department of CardiologyAffiliated Hospital of Guangdong Medical UniversityZhanjiangGuangdongChina
| | - Zijun Wu
- Department of CardiologyAffiliated Hospital of Guangdong Medical UniversityZhanjiangGuangdongChina
| | - Zhen Jia
- Department of GeriatricsAffiliated Hospital of Guangdong Medical UniversityZhanjiangGuangdongChina
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16
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de Oliveira GL, Sobrinho ACS, Benjamim CJR, da Silva Rodrigues G, Rodrigues KP, Fernandes CH, Corrêa AB, Felicio TN, de Oliveira Gomes GA, Júnior CRB. Physical training improves physical activity levels but is associated with amplification of sedentary behavior in older women. Front Public Health 2023; 11:1180901. [PMID: 37333564 PMCID: PMC10272807 DOI: 10.3389/fpubh.2023.1180901] [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: 03/07/2023] [Accepted: 05/15/2023] [Indexed: 06/20/2023] Open
Abstract
Physical activity level (PAL) and sedentary behavior (SB) are independent predictors of mortality. It is unclear how these predictors interact with each other and health variables. Investigate the bidirectional relationship between PAL and SB, and their impact and health variables of women aged 60 to 70 years. One hundred forty-two older adults women (66.3 ± 2.9 years) considered insufficiently active were submitted to 14 weeks of multicomponent training (MT), multicomponent training with flexibility (TMF), or the control group (CG). PAL variables were analyzed by accelerometry and QBMI questionnaire, physical activity (PA) light, moderate, vigorous and CS by accelerometry, 6 min walk (CAM), SBP, BMI, LDL, HDL, uric acid, triglycerides, glucose and cholesterol total. In linear regressions, CS was associated with glucose (B:12.80; CI:9.31/20.50; p < 0.001; R2:0.45), light PA (B:3.10; CI:2, 41/4.76; p < 0.001; R2:0.57), NAF by accelerometer (B:8.21; CI:6.74/10.02; p < 0.001; R2:0.62), vigorous PA (B:794.03; CI:682.11/908.2; p < 0.001; R2:0.70), LDL (B:13.28; CI:7.45/16.75; p < 0.002; R2:0.71) and 6 min walk (B:3.39; CI:2.96/8.75; p < 0.004; R2:0.73). NAF was associated with mild PA (B:0.246; CI:0.130/0.275; p < 0.001; R2:0.624), moderate PA (B:0.763; CI:0.567/0.924; p < 0.001; R2:0.745), glucose (B:-0.437; CI:-0.789/-0.124; p < 0.001; R2:0.782), CAM (B:2.223; CI:1.872/4.985; p < 0.002; R2:0.989) and CS (B:0.253; CI: 0.189/0.512; p < 0.001; R2:1.94). The NAF can enhance CS. Build a new look at how these variables are independent but dependent simultaneously, being able to influence the quality of health when this dependence is denied.
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Affiliation(s)
- Guilherme Lima de Oliveira
- Escola de Educação Física e Esporte de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Andressa C. S. Sobrinho
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Cicero Jonas R. Benjamim
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | | | - Karine Pereira Rodrigues
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Carlos Henrique Fernandes
- Escola de Educação Física e Esporte de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Adriano Bruno Corrêa
- Escola de Educação Física e Esporte de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Tamara Nascimento Felicio
- Escola de Educação Física e Esporte de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | | | - Carlos Roberto Bueno Júnior
- Escola de Educação Física e Esporte de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
- Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
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17
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Syeda UA, Battillo D, Visaria A, Malin SK. The importance of exercise for glycemic control in type 2 diabetes. AMERICAN JOURNAL OF MEDICINE OPEN 2023; 9:100031. [PMID: 39035065 PMCID: PMC11256236 DOI: 10.1016/j.ajmo.2023.100031] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 12/01/2022] [Accepted: 01/10/2023] [Indexed: 07/23/2024]
Abstract
Exercise is a first-line therapy recommended for patients with type 2 diabetes (T2D). Although moderate to vigorous exercise (e.g. 150 min/wk) is often advised alongside diet and/or behavior modification, exercise is an independent treatment that can prevent, delay or reverse T2D. Habitual exercise, consisting of aerobic, resistance or their combination, fosters improved short- and long-term glycemic control. Recent work also shows high-intensity interval training is successful at lowering blood glucose, as is breaking up sedentary behavior with short-bouts of light to vigorous movement (e.g. up to 3min). Interestingly, performing afternoon compared with morning as well as post-meal versus pre-meal exercise may yield slightly better glycemic benefit. Despite these efficacious benefits of exercise for T2D care, optimal exercise recommendations remain unclear when considering, dietary, medication, and/or other behaviors.
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Affiliation(s)
- U.S. Afsheen Syeda
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, United States
| | - Daniel Battillo
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, United States
| | - Aayush Visaria
- Center for Pharmacoepidemiology and Treatment Sciences, Rutgers Institute for Health, Health Care Policy, and Aging Research, New Brunswick, NJ, United States
| | - Steven K. Malin
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, United States
- Center for Pharmacoepidemiology and Treatment Sciences, Rutgers Institute for Health, Health Care Policy, and Aging Research, New Brunswick, NJ, United States
- New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, NJ, United States
- Institute of Translational Medicine and Science, Rutgers University, New Brunswick, NJ, United States
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18
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Duran AT, Friel CP, Serafini MA, Ensari I, Cheung YK, Diaz KM. Breaking Up Prolonged Sitting to Improve Cardiometabolic Risk: Dose-Response Analysis of a Randomized Crossover Trial. Med Sci Sports Exerc 2023; 55:847-855. [PMID: 36728338 DOI: 10.1249/mss.0000000000003109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE Sedentary time is ubiquitous in developed nations and is associated with deleterious health outcomes. Physical activity guidelines recommend reductions in sedentary time; however, quantitative guidelines that inform how often and how long sedentary time should be interrupted have not been provided. The purpose of this study was to examine the acute effects of multiple doses of a sedentary break intervention on cardiometabolic risk factors, concurrently evaluating efficacy of varying frequencies and durations of sedentary breaks. METHODS In a randomized crossover study, middle- and older-age adults ( n = 11) completed the following 8-h conditions on five separate days: 1 uninterrupted sedentary (control) condition and four acute (experimental) trials that entailed different sedentary break frequency/duration combinations: every 30 min for 1 min, every 30 min for 5 min, every 60 min for 1 min, and every 60 min for 5 min. Sedentary breaks entailed light-intensity walking. Glucose and blood pressure (BP) were measured every 15 and 60 min, respectively. RESULTS Compared with control, glucose incremental area under the curve was significantly attenuated only for the every 30 min for 5-min dose (-11.8[4.7]; P = 0.017). All sedentary break doses yielded significant net decreases in systolic BP from baseline compared with control ( P < 0.05). The largest reductions in systolic BP were observed for the every 60 min for 1 min (-5.2 [1.4] mm Hg) and every 30 min for 5 min (-4.3[1.4] mm Hg) doses. CONCLUSIONS The present study provides important information concerning efficacious sedentary break doses. Higher-frequency and longer-duration breaks (every 30 min for 5 min) should be considered when targeting glycemic responses, whereas lower doses may be sufficient for BP lowering.
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Affiliation(s)
- Andrea T Duran
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, New York, NY
| | - Ciaran P Friel
- Institute of Health System Science, Feinstein Institutes of Medical Research, Northwell Health, Manhasset, NY
| | - Maria A Serafini
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, New York, NY
| | - Ipek Ensari
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ying Kuen Cheung
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY
| | - Keith M Diaz
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, New York, NY
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19
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Koh YS, Asharani PV, Devi F, Roystonn K, Wang P, Abdin E, Sum CF, Lee ES, Chong SA, Subramaniam M. Benefits of leisure-related physical activity and association between sedentary time and risk for hypertension and type 2 diabetes. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2023; 52:172-181. [PMID: 38904530 DOI: 10.47102/annals-acadmedsg.2022399] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Introduction Lifestyle modifications can reduce the risk of type 2 diabetes mellitus (T2DM) and hypertension. Our study investigated whether domain-specific physical activity (such as work, transport and leisure) and sedentary behaviour were associated with T2DM and hypertension, and whether these associations were moderated by sex and age. Method For this cross-sectional study, data were obtained from a population survey in Singapore (n=2,867) conducted from February 2019 to March 2020. T2DM and hypertension were self-reported. Global physical activity questionnaire was used to assess domain-specific physical activity (in metabolic equivalent of task [MET]-minutes) and sedentary time (in hours). Logistic regression models were generated to examine the abovementioned associations, and adjusted for age, sex, education, ethnicity, personal income, body mass index, diet and hypertension/diabetes. Interaction terms were included individually to investigate whether age and sex moderated the associations. Results Individuals with >826 MET-minutes of leisure-related physical activity per week had lower odds of having T2DM (odds ratio [OR] 0.46, 95% confidence interval [CI] 0.24-0.86) and hypertension (OR 0.59, 95% CI 0.37-0.94) than those with no leisure-related physical activity. Individuals with >8 hours of sedentary time daily had higher odds of having hypertension (OR 1.69, 95% CI 1.06-2.69) than those with 0-5 hours of sedentary time. Logistic regression models including interaction terms showed that the association between leisure-related physical activity and hypertension was significant for those aged 18-34 (OR 0.15, 95% CI 0.03-0.66) and 50-64 years (OR 0.44, 95% CI 0.21-0.91). The association between sedentary time and hypertension was significant for those aged 18-34 years (OR 15.07, 95% CI 1.69-133.92). Conclusion Our results support the widespread promotion of an active lifestyle to lower the prevalence of diabetes and hypertension in Singapore.
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Affiliation(s)
- Yen Sin Koh
- Research Division, Institute of Mental Health, Singapore
| | - P V Asharani
- Research Division, Institute of Mental Health, Singapore
| | - Fiona Devi
- Research Division, Institute of Mental Health, Singapore
| | | | - Peizhi Wang
- Research Division, Institute of Mental Health, Singapore
| | | | - Chee Fang Sum
- Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore
| | - Eng Sing Lee
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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20
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Silva GO, Cunha PM, Oliveira MD, Christofaro DGD, Tebar WR, Gerage AM, Kanegusuku H, Correia MA, Ritti-Dias RM. Patterns of sedentary behavior in adults: A cross-sectional study. Front Cardiovasc Med 2023; 10:1116499. [PMID: 36993993 PMCID: PMC10042287 DOI: 10.3389/fcvm.2023.1116499] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/23/2023] [Indexed: 03/14/2023] Open
Abstract
IntroductionSedentary behavior (SB) has been associated with adverse health outcomes, however, it is not completely clear whether total time in SB during the day or prolonged uninterrupted SB are interrelated. The aim of the current study was to describe the different patterns of SB of adults, their relationships, and associated factors.MethodsThe sample included 184 adults aged ranging from 18 to 59 years old. SB was objectively measured by an accelerometer and the following SB pattern parameters were obtained: total time in sedentary bouts, mean time of sedentary bouts, and total time in sedentary breaks. Demographic data (age and sex), anthropometry [weight, height, body mass index (BMI)], blood pressure (BP), medical history (self-reported comorbid conditions), and cardiac autonomic modulation, were assessed to identify factors associated with SB. Multiple linear regressions were used to analyze the relationship between SB parameters and the associated factors.ResultsThe parameters of SB indicated 2.4 (0.9) h/day for total time in sedentary bouts, 36.4 (7.9) min for the mean time of sedentary bouts, and 9.1 (1.9) h/day for the total time in sedentary breaks. Multiple adjusted regression indicated that age was the only factor associated with SB patterns (p < 0.05) after adjustment for confounding variables (sex, age, BMI, dyslipidemia, systolic and diastolic BP). Young adults (18–39 years old) spent more time in sedentary bouts and less time in uninterrupted sedentary bouts compared to middle-aged adults (40–59 years old) (2.58 (0.88) h/day vs. 2.13 (0.90) h/day, respectively; p = 0.001 and 34.5 (5.8) min 18–39 years old vs. 38.8 (9.6) min 40–59 years old; p ≤ 0.001; respectively). The total time in sedentary breaks was similar between age groups (p = 0.465). The total time in sedentary bouts was significantly correlated with the mean time of sedentary bouts (r = −0.58; p ≤ 0.001), and with the total time in sedentary breaks (r = −0.20; p = 0.006). The mean time of sedentary bouts was significantly related to the total time in sedentary breaks (r -= 0.19; p = 0.007).Discussion and ConclusionIn conclusion, age seems to be a relevant factor associated with sedentary behavior with young adults spending more time in SB and accumulating this behavior in a higher amount of sedentary bouts compared to middle-aged adults.
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Affiliation(s)
- Gustavo O. Silva
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), Sao Paulo, Brazil
| | - Paolo M. Cunha
- Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEP), Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Max D. Oliveira
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), Sao Paulo, Brazil
| | - Diego G. D. Christofaro
- Faculty of Science and Technology, Sao Paulo State University (Unesp), Presidente Prudente, Brazil
| | - William R. Tebar
- Center for Clinical and Epidemiological Research, University Hospital, University of Sao Paulo, Sao Paulo, Brazil
| | - Aline M. Gerage
- Physical Education Department, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Hélcio Kanegusuku
- Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEP), Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Marilia A. Correia
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), Sao Paulo, Brazil
| | - Raphael M. Ritti-Dias
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), Sao Paulo, Brazil
- Correspondence: Raphael M. Ritti-Dias
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21
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Clinical Impacts of Interventions for Physical Activity and Sedentary Behavior on Patients with Chronic Obstructive Pulmonary Disease. J Clin Med 2023; 12:jcm12041631. [PMID: 36836165 PMCID: PMC9963889 DOI: 10.3390/jcm12041631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Recently, physical activity has increasingly become the focus in patients with chronic obstructive airway disease (COPD) because it is a strong predictor of COPD-related mortality. In addition, sedentary behavior, which is included as a category of physical inactivity including such behaviors as sitting or lying down, has an independent clinical impact on COPD patients. The present review examines clinical data related to physical activity, focusing on the definition, associated factors, beneficial effects, and biological mechanisms in patients with COPD and with respect to human health regardless of COPD. The data related to how sedentary behavior is associated with human health and COPD outcomes are also examined. Lastly, possible interventions to improve physical activity or sedentary behavior, such as bronchodilators and pulmonary rehabilitation with behavior modification, to ameliorate the pathophysiology of COPD patients are described. A better understanding of the clinical impact of physical activity or sedentary behavior may lead to the planning of a future intervention study to establish high-level evidence.
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22
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van Bakel BMA, Kroesen SH, Bakker EA, van Miltenburg RV, Günal A, Scheepmaker A, Aengevaeren WRM, Willems FF, Wondergem R, Pisters MF, de Bruin M, Hopman MTE, Thijssen DHJ, Eijsvogels TMH. Effectiveness of an intervention to reduce sedentary behaviour as a personalised secondary prevention strategy for patients with coronary artery disease: main outcomes of the SIT LESS randomised clinical trial. Int J Behav Nutr Phys Act 2023; 20:17. [PMID: 36788615 PMCID: PMC9927064 DOI: 10.1186/s12966-023-01419-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/26/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND A high sedentary time is associated with increased mortality risk. Previous studies indicate that replacement of sedentary time with light- and moderate-to-vigorous physical activity attenuates the risk for adverse outcomes and improves cardiovascular risk factors. Patients with cardiovascular disease are more sedentary compared to the general population, while daily time spent sedentary remains high following contemporary cardiac rehabilitation programmes. This clinical trial investigated the effectiveness of a sedentary behaviour intervention as a personalised secondary prevention strategy (SIT LESS) on changes in sedentary time among patients with coronary artery disease participating in cardiac rehabilitation. METHODS Patients were randomised to usual care (n = 104) or SIT LESS (n = 108). Both groups received a comprehensive 12-week centre-based cardiac rehabilitation programme with face-to-face consultations and supervised exercise sessions, whereas SIT LESS participants additionally received a 12-week, nurse-delivered, hybrid behaviour change intervention in combination with a pocket-worn activity tracker connected to a smartphone application to continuously monitor sedentary time. Primary outcome was the change in device-based sedentary time between pre- to post-rehabilitation. Changes in sedentary time characteristics (prevalence of prolonged sedentary bouts and proportion of patients with sedentary time ≥ 9.5 h/day); time spent in light-intensity and moderate-to-vigorous physical activity; step count; quality of life; competencies for self-management; and cardiovascular risk score were assessed as secondary outcomes. RESULTS Patients (77% male) were 63 ± 10 years and primarily diagnosed with myocardial infarction (78%). Sedentary time decreased in SIT LESS (- 1.6 [- 2.1 to - 1.1] hours/day) and controls (- 1.2 [ ─1.7 to - 0.8]), but between group differences did not reach statistical significance (─0.4 [─1.0 to 0.3]) hours/day). The post-rehabilitation proportion of patients with a sedentary time above the upper limit of normal (≥ 9.5 h/day) was significantly lower in SIT LESS versus controls (48% versus 72%, baseline-adjusted odds-ratio 0.4 (0.2-0.8)). No differences were observed in the other predefined secondary outcomes. CONCLUSIONS Among patients with coronary artery disease participating in cardiac rehabilitation, SIT LESS did not induce significantly greater reductions in sedentary time compared to controls, but delivery was feasible and a reduced odds of a sedentary time ≥ 9.5 h/day was observed. TRIAL REGISTRATION Netherlands Trial Register: NL9263. Outcomes of the SIT LESS trial: changes in device-based sedentary time from pre-to post-cardiac rehabilitation (control group) and cardiac rehabilitation + SIT LESS (intervention group). SIT LESS reduced the odds of patients having a sedentary time >9.5 hours/day (upper limit of normal), although the absolute decrease in sedentary time did not significantly differ from controls. SIT LESS appears to be feasible, acceptable and potentially beneficial, but a larger cluster randomised trial is warranted to provide a more accurate estimate of its effects on sedentary time and clinical outcomes. CR: cardiac rehabilitation.
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Affiliation(s)
- B. M. A. van Bakel
- grid.10417.330000 0004 0444 9382Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - S. H. Kroesen
- grid.10417.330000 0004 0444 9382Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - E. A. Bakker
- grid.10417.330000 0004 0444 9382Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - R. V. van Miltenburg
- grid.10417.330000 0004 0444 9382Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - A. Günal
- grid.470077.30000 0004 0568 6582Department of Cardiology, Bernhoven Hospital, Uden, The Netherlands
| | - A. Scheepmaker
- grid.470077.30000 0004 0568 6582Department of Cardiology, Bernhoven Hospital, Uden, The Netherlands
| | - W. R. M. Aengevaeren
- grid.415930.aDepartment of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands
| | - F. F. Willems
- grid.415930.aDepartment of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands
| | - R. Wondergem
- grid.5477.10000000120346234Department of Rehabilitation, Physical Therapy Science and Sport, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands ,grid.448801.10000 0001 0669 4689Research Group Empowering Healthy Behaviour, Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, The Netherlands ,Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, the Netherlands
| | - M. F. Pisters
- grid.5477.10000000120346234Department of Rehabilitation, Physical Therapy Science and Sport, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands ,grid.448801.10000 0001 0669 4689Research Group Empowering Healthy Behaviour, Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, The Netherlands ,Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, the Netherlands
| | - M. de Bruin
- grid.10417.330000 0004 0444 9382Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M. T. E. Hopman
- grid.10417.330000 0004 0444 9382Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - D. H. J. Thijssen
- grid.10417.330000 0004 0444 9382Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands ,grid.4425.70000 0004 0368 0654Research Institute for Sports and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - T. M. H. Eijsvogels
- grid.10417.330000 0004 0444 9382Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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23
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Alobaid AM, Dempsey PC, Francois M, Zulyniak MA, Hopkins M, Campbell MD. Reducing Sitting Time in Type 1 Diabetes: Considerations and Implications. Can J Diabetes 2023; 47:300-304. [PMID: 36872136 DOI: 10.1016/j.jcjd.2023.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/05/2023] [Accepted: 02/06/2023] [Indexed: 02/13/2023]
Abstract
Sedentary behaviours are ubiquitous in modern society with Western populations spending approximately ∼50% of their waking hours in low levels of energy expenditure. This behaviour is associated with cardiometabolic derangements and increased morbidity and mortality. In individuals living with or at risk of developing type 2 diabetes (T2D), "breaking up" sedentariness, by interrupting prolonged periods of sitting has been shown to acutely improve glucose control and cardiometabolic risk factors related to diabetes complications. As such, current guidelines recommend interrupting prolonged periods of sitting with short, frequent activity breaks. However, the evidence underpinning these recommendations remain preliminary and are focussed on those with or at risk of developing T2D, with little information regarding whether and how reducing sedentariness may be effective and safe in those living with type 1 diabetes (T1D). In this review, we discuss the potential application of interventions that target prolonged sitting time in T2D within the context of T1D.
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Affiliation(s)
- Anwar M Alobaid
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom; Ministry of Health, Farwaniya Hospital, Kuwait city, Kuwait
| | - Paddy C Dempsey
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, United Kingdom; MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom; Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Monique Francois
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Michael A Zulyniak
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Mark Hopkins
- School of Food Science and Nutrition, University of Leeds, Leeds, United Kingdom
| | - Matthew D Campbell
- School of Nursing and Health Sciences, University of Sunderland, Sunderland, United Kingdom; Wellcome-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom; Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom.
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Lu AS, Pelarski V, Alon D, Baran A, McGarrity E, Swaminathan N, Sousa CV. The effect of narrative element incorporation on physical activity and game experience in active and sedentary virtual reality games. VIRTUAL REALITY 2023; 27:1-16. [PMID: 36742343 PMCID: PMC9888740 DOI: 10.1007/s10055-023-00754-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 01/09/2023] [Indexed: 06/18/2023]
Abstract
Narratives are pervasive in video games and have been found to increase physical activity in active video games. However, the effect of incorporating narrative elements has seldom been examined in fully immersive virtual reality games. We investigated the effect of narrative element incorporation (between-subject: narrative vs. no narrative) in active virtual reality and sedentary virtual reality games (within-subject) and examined between- and within-subject effects on physical activity behavior, game experience, and physical activity engagement. We randomized 36 sedentary college students to either the narrative or the non-narrative group. All participants played an active virtual reality and a sedentary virtual reality game in counter-balanced order. Before each game session, they either watched a 5-min narrative video (narrative) or directly played the original virtual reality games without narratives (non-narrative). We collected participants' physical activity data using wrist-worn accelerometers; we obtained their game experience and physical activity engagement via questionnaires. The narrative group spent a greater proportion of time in moderate-to-vigorous physical activity (%) and had less non-movement time during the active virtual reality gameplay than the non-narrative group (all p values < .05). The active virtual reality sessions induced a greater positive affect and greater physical activity engagement ratings than the sedentary virtual reality sessions. The incorporation of narrative elements in active virtual reality increased the relative time spent in moderate-to-vigorous physical activity and reduced non-movement time, compared to the non-narrative group. Active virtual reality encouraged more activity by participants and offered them a more enjoyable gaming experience in which they engaged more. Active virtual reality is a feasible physical activity promotion option among sedentary adults; the incorporation of narrative elements in active virtual reality helps increase relative moderate-to-vigorous physical activity and should be further explored for its efficacy. Supplementary Information The online version contains supplementary material available at 10.1007/s10055-023-00754-7.
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Affiliation(s)
- Amy Shirong Lu
- Health Technology Lab, College of Arts, Media and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115 USA
| | - Victoria Pelarski
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205 USA
| | - Dar Alon
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115 USA
| | - Aleksandra Baran
- Health Technology Lab, College of Arts, Media and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115 USA
| | - Emma McGarrity
- Health Technology Lab, College of Arts, Media and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115 USA
| | - Neha Swaminathan
- Health Technology Lab, College of Arts, Media and Design, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115 USA
| | - Caio Victor Sousa
- Health and Human Sciences, Frank R. Seaver College of Science and Engineering, Loyola Marymount University, Los Angeles, CA 90045 USA
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25
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Zou L, Wang T, Herold F, Ludyga S, Liu W, Zhang Y, Healy S, Zhang Z, Kuang J, Taylor A, Kramer AF, Chen S, Tremblay MS, Hossain MM. Associations between sedentary behavior and negative emotions in adolescents during home confinement: Mediating role of social support and sleep quality. Int J Clin Health Psychol 2023; 23:100337. [PMID: 36199367 PMCID: PMC9508146 DOI: 10.1016/j.ijchp.2022.100337] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/06/2022] [Accepted: 08/07/2022] [Indexed: 01/10/2023] Open
Abstract
Background Prolonged periods of sedentary behaviour, for instance, engendered by home confinement in Shenzhen city, has led to negative mental health consequences, especially in adolescents. Previous research suggests, in general, that sedentary behavior can increase negative emotions. However, the specific mechanism driving the relationship between sedentary behavior and negative emotions is still relatively unclear. Social support and sleep quality might partly explain the effect of sedentary behavior on negative emotions. Thus, the current study aimed to examine the associations between sedentary behavior and negative emotions, and to investigate if social support and sleep quality mediate such a relationship. Method During home confinement due to the COVID-19 Omicron variant outbreak, 1179 middle and high school students in Shenzhen were invited to voluntarily complete an e-questionnaire, including the 21-item Depression Anxiety Stress Scale (DASS-21), the short form of the International Physical Activity Questionnaire (IPAQ-SF), the Social Support Rating Scale (SSRS) and the Pittsburgh Sleep Quality Index (PSQI). Data from 1065 participants were included in the analysis. Results We observed significant sex-related and demografic-related differences in emotional (e.g., anxiety, stress and social support) and other outcome variables (e.g., sitting duration and PSQI score). Furthermore, sedentary behavior, social support, and sleep quality were associated with negative emotions (p < .01), even after controlling for sex, age, only-child case, body mass index, and metabolic equivalent level. In addition, social support and sleep quality partially mediated the association between sedentary behavior and negative emotions. Conclusion The findings of the current study suggest that social support and sleep quality partially mediate the relationship between sedentary behavior and negative emotions in middle and high school students during home confinement in Shenzhen city.
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Affiliation(s)
- Liye Zou
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, College of Physical Education & Health, East China Normal University, Shanghai 200241, China
- Body-Brian-Mind Laboratory; Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, School of Psychology, Shenzhen University, 518060, China
- Corresponding author.
| | - Ting Wang
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam
| | - Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam
| | - Sebastian Ludyga
- Department of Sport, Exercise & Health, University of Basel, Grosse Allee 6, 4052 Basel, Switzerland
| | - Weina Liu
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, College of Physical Education & Health, East China Normal University, Shanghai 200241, China
| | - Yanjie Zhang
- Physical Education Unit, School of Humanities and Social Science, The Chinese University of Hong Kong–Shenzhen, Shenzhen 518172, China
| | - Sean Healy
- School of Nursing, Psychotherapy, and Community Health, Dublin City University, Ireland
| | - Zhihao Zhang
- Body-Brian-Mind Laboratory; Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, School of Psychology, Shenzhen University, 518060, China
| | - Jin Kuang
- Body-Brian-Mind Laboratory; Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, School of Psychology, Shenzhen University, 518060, China
| | - Alyx Taylor
- School of Rehabilitation, Sport and Psychology, AECC University College, Bournemouth, BH5 2DF, UK
| | - Arthur F. Kramer
- Center for Cognitive & Brain Health, Northeastern University, Boston, USA
- Beckman Institute, University of Illinois, Illinois, USA
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne 8001, Australia
| | - Mark S. Tremblay
- Children's Hospital of Eastern Ontario Research Institute and Department of Pediatrics, University of Ottawa, Ottawa, Canada, K1H 8L1
| | - M. Mahbub Hossain
- Department of Decision and Information Sciences, C.T. Bauer College of Business, University of Houston, TX 77204, USA
- Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, TX 77204, USA
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26
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Won MH, Son YJ. Combined influence of sedentary behaviours and chronic pain on depressive symptoms in older Korean adults with hypertension. Eur J Cardiovasc Nurs 2022; 21:791-800. [PMID: 35285897 DOI: 10.1093/eurjcn/zvac015] [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: 10/12/2021] [Revised: 12/29/2021] [Accepted: 02/25/2022] [Indexed: 12/29/2022]
Abstract
AIMS Depressive symptoms in hypertensive patients are linked to poor adherence to treatment. Sedentary behaviours and chronic pain can increase blood pressure and depressive symptoms, respectively. However, the impact of their coexistence on depressive symptoms in older adults with hypertension has not yet been investigated. This study aimed to identify the combined influence of sedentary behaviours and chronic pain on depressive symptoms in older adults with hypertension in Korea. METHODS AND RESULTS This cross-sectional study used data from the sixth Korea National Health and Nutrition Examination Survey from January to December 2014. The survey adopted multistage stratified sampling by geographical region, gender, and age. For the data analysis, a total of 573 patients with hypertension aged 65 years or older were included. Approximately, 61.0% of depressed older patients had both sedentary behaviours and chronic pain compared with patients without depressive symptoms. In multivariate logistic regression analysis, compared with patients without either sedentary behaviours or chronic pain, older adults with hypertension who presented both sedentary behaviours, and chronic pain had the highest risk of depressive symptoms (odds ratio = 13.86, 95% confidence interval = 5.87-32.71; P < 0.001). CONCLUSION Coexistence of sedentary behaviours and chronic pain in older hypertensive patients may lead to depressive symptoms. Evaluating both sedentary behaviours and chronic pain when assessing depressive symptoms in patients with hypertension would be beneficial in planning a patient-centred approach for controlling blood pressure. More prospective cohort studies with larger samples are required to identify the causal relationships.
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Affiliation(s)
- Mi Hwa Won
- Department of Nursing, Wonkwang University, Iksan, South Korea
| | - Youn-Jung Son
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
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27
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Abate TW, Gedamu H, Ayalew E, Genanew A, Ergetie T, Tesfa G. A systematic review and meta-analysis of the Ethiopian cohort of adult hypertensive people's adherence to healthy behaviors. Heliyon 2022; 8:e11555. [DOI: 10.1016/j.heliyon.2022.e11555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 06/25/2022] [Accepted: 11/02/2022] [Indexed: 11/11/2022] Open
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Wattanapisit A, Ng CJ, Angkurawaranon C, Wattanapisit S, Chaovalit S, Stoutenberg M. Summary and application of the WHO 2020 physical activity guidelines for patients with essential hypertension in primary care. Heliyon 2022; 8:e11259. [PMID: 36325139 PMCID: PMC9618974 DOI: 10.1016/j.heliyon.2022.e11259] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/15/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
The new World Health Organization (WHO) 2020 guidelines on physical activity (PA) and sedentary behavior include recommendations for adults with chronic conditions. The guidelines provide adaptable and general recommendations for people living with chronic medical conditions. This article summarizes the content and provides suggestions for the application of the guidelines for patients with essential hypertension in primary care. The WHO 2020 PA guidelines recommend broad advice for adults and older adults with chronic conditions. The key recommendations are consistent with other hypertension guidelines. A systemic approach to promote PA in primary care (i.e., PA assessment, safety considerations, PA prescription, behavioral counseling, and referral) along with applying the WHO guidelines is required. Health risk assessment and safety issues related to hypertension (e.g., current PA levels, level of blood pressure, treatment plans, comorbidities) should be concerned. The FITT Pro (frequency, intensity, time, type, and progression) can be adopted as a framework to break down the guidelines into specific PA prescription. The WHO 2020 PA guidelines address the importance of PA in clinical populations. The guidelines can be adapted for patients with hypertension in primary care settings.
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Affiliation(s)
- Apichai Wattanapisit
- Department of Clinical Medicine, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand,Family Medicine Clinic, Walailak University Hospital, Nakhon Si Thammarat, Thailand
| | - Chirk Jenn Ng
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia,SingHealth Polyclinics, Singapore, Singapore,Duke-NUS Medical School, Singapore, Singapore
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand,Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, Thailand,Corresponding author.
| | | | - Sirawee Chaovalit
- Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Mark Stoutenberg
- Department of Kinesiology, College of Public Health, Temple University, Philadelphia, USA
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29
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Macêdo GAD, Freire YA, Browne RAV, Câmara M, Cabral LLP, Schwade D, Paulo-Pereira R, Silva RDM, Silva AMB, Farias-Junior LF, Duhamel TA, Costa EC. Pre-Frailty Phenotype and Arterial Stiffness in Older Adults Free of Cardiovascular Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013469. [PMID: 36294048 PMCID: PMC9603482 DOI: 10.3390/ijerph192013469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/06/2022] [Accepted: 10/11/2022] [Indexed: 06/02/2023]
Abstract
PURPOSE Arterial stiffness is a subclinical marker of cardiovascular disease (CVD). The pre-frailty phenotype is associated with a higher risk for CVD. This study investigated the association between the pre-frailty phenotype and arterial stiffness in community-dwelling older adults without diagnosed CVD. METHODS In total, 249 community-dwelling older adults aged 60-80 years were included in this cross-sectional study. The pre-frailty phenotype was defined by the standardized Fried criteria (muscle weakness; slow walking speed; low physical activity; unintentional weight loss; self-reported exhaustion). Participants with one or two standardized Fried criteria were classified as pre-frail and those with zero criteria as robust. Arterial stiffness was measured by aortic pulse wave velocity (aPWV). The data were analyzed using the generalized linear model. RESULTS From 249 participants (66.1 ± 5.3 years; 79.5% females), 61.8% (n = 154) were pre-frail and 38.2% (n = 95) robust. Pre-frail older adults had a higher aPWV (β = 0.19 m/s; p = 0.007) compared to their robust peers. CONCLUSIONS The pre-frailty phenotype was associated with higher arterial stiffness in community-dwelling older adults aged 60-80 years. Pre-frail older adults may have a higher risk for CVD.
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Affiliation(s)
- Geovani Araújo Dantas Macêdo
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Yuri Alberto Freire
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, RN, Brazil
| | - Rodrigo Alberto Vieira Browne
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, RN, Brazil
| | - Marcyo Câmara
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, RN, Brazil
| | - Ludmila Lucena Pereira Cabral
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, RN, Brazil
| | - Daniel Schwade
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, Winnipeg, MB R3T 2N2, Canada
| | - Ronildo Paulo-Pereira
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, RN, Brazil
| | - Raíssa de Melo Silva
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Alana Monteiro Bispo Silva
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Luiz Fernando Farias-Junior
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Graduate Program in Psychobiology, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Todd A. Duhamel
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, Winnipeg, MB R3T 2N2, Canada
| | - Eduardo Caldas Costa
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, RN, Brazil
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Browne RAV, Cabral LLP, Oliveira GTA, Macêdo GAD, Sócrates J, Silva RDM, Araújo MBF, Freire YA, Costa EC. Life-Space Mobility and Objectively Measured Movement Behavior in Older Adults with Hypertension after Receiving COVID-19 Vaccination. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12532. [PMID: 36231832 PMCID: PMC9566032 DOI: 10.3390/ijerph191912532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/10/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
This study examined the changes in life-space (LS) mobility and objectively measured movement behavior in older adults with hypertension after receiving the COVID-19 vaccine and their associations with housing type. A total of 32 participants were included in this exploratory longitudinal study with a 1-year follow-up. LS mobility and accelerometer-based physical activity (PA) and sedentary behavior (SB) were assessed before and ~2 months after receiving COVID-19 vaccination. Participants residing in apartment/row housing showed an increase in LS mobility composite score (β = 14, p < 0.05). In addition, they showed an increase in light PA on weekdays and the weekend (β = 3.5%; β = 6.5%; p < 0.05) and a decrease in SB on weekdays and the weekend (β = -3.7%; β = -6.6%; p < 0.05). Furthermore, changes in SB pattern were found (less time spent in bouts of ≥10 and 30 min, more breaks/day and breaks/hour). Significant associations were found between changes in LS mobility composite score and PA (positive association) and SB (negative association) in older adults residing in apartment/row housing (p < 0.05). Older adults with hypertension, particularly those who resided in houses with limited outdoor space (apartment/row housing), showed positive changes in LS mobility and objectively measured movement behavior in a period after receiving the COVID-19 vaccine and characterized by social distancing policies without mobility restrictions when compared with the period of social distancing policies with high mobility restrictions and without vaccine.
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Affiliation(s)
- Rodrigo A. V. Browne
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, Brazil
| | - Ludmila L. P. Cabral
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, Brazil
| | - Gledson T. A. Oliveira
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, Brazil
| | - Geovani A. D. Macêdo
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil
| | - Júlio Sócrates
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, Brazil
| | - Raíssa de M. Silva
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil
| | - Maria B. F. Araújo
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil
| | - Yuri A. Freire
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, Brazil
| | - Eduardo C. Costa
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, Brazil
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, Brazil
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Daniele A, Lucas SJE, Rendeiro C. Detrimental effects of physical inactivity on peripheral and brain vasculature in humans: Insights into mechanisms, long-term health consequences and protective strategies. Front Physiol 2022; 13:998380. [PMID: 36237532 PMCID: PMC9553009 DOI: 10.3389/fphys.2022.998380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
The growing prevalence of physical inactivity in the population highlights the urgent need for a more comprehensive understanding of how sedentary behaviour affects health, the mechanisms involved and what strategies are effective in counteracting its negative effects. Physical inactivity is an independent risk factor for different pathologies including atherosclerosis, hypertension and cardiovascular disease. It is known to progressively lead to reduced life expectancy and quality of life, and it is the fourth leading risk factor for mortality worldwide. Recent evidence indicates that uninterrupted prolonged sitting and short-term inactivity periods impair endothelial function (measured by flow-mediated dilation) and induce arterial structural alterations, predominantly in the lower body vasculature. Similar effects may occur in the cerebral vasculature, with recent evidence showing impairments in cerebral blood flow following prolonged sitting. The precise molecular and physiological mechanisms underlying inactivity-induced vascular dysfunction in humans are yet to be fully established, although evidence to date indicates that it may involve modulation of shear stress, inflammatory and vascular biomarkers. Despite the steady increase in sedentarism in our societies, only a few intervention strategies have been investigated for their efficacy in counteracting the associated vascular impairments. The current review provides a comprehensive overview of the evidence linking acute and short-term physical inactivity to detrimental effects on peripheral, central and cerebral vascular health in humans. We further examine the underlying molecular and physiological mechanisms and attempt to link these to long-term consequences for cardiovascular health. Finally, we summarize and discuss the efficacy of lifestyle interventions in offsetting the negative consequences of physical inactivity.
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Affiliation(s)
- Alessio Daniele
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Samuel J. E. Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Catarina Rendeiro
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
- *Correspondence: Catarina Rendeiro,
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32
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Liu Z, Zhou C, Wang H, He Y. Blood pressure monitoring techniques in the natural state of multi-scenes: A review. Front Med (Lausanne) 2022; 9:851172. [PMID: 36091712 PMCID: PMC9462511 DOI: 10.3389/fmed.2022.851172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
Blood pressure is one of the basic physiological parameters of human physiology. Frequent and repeated measurement of blood pressure along with recording of environmental or other physiological parameters when measuring blood pressure may reveal important cardiovascular risk factors that can predict occurrence of cardiovascular events. Currently, wearable non-invasive blood pressure measurement technology has attracted much research attention. Several different technical routes have been proposed to solve the challenge between portability or continuity of measurement methods and medical level accuracy of measurement results. The accuracy of blood pressure measurement technology based on auscultation and oscillography has been clinically verified, while majority of other technical routes are being explored at laboratory or multi-center clinical demonstration stage. Normally, Blood pressure measurement based on oscillographic method outside the hospital can only be measured at intervals. There is a need to develop techniques for frequent and high-precision blood pressure measurement under natural conditions outside the hospital. In this paper, we discussed the current status of blood pressure measurement technology and development trends of blood pressure measurement technology in different scenarios. We focuses on the key technical challenges and the latest advances in the study of miniaturization devices based on oscillographic method at wrist and PTT related method at finger positions as well as technology processes. This study is of great significance to the application of high frequency blood pressure measurement technology.
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Affiliation(s)
- Ziyi Liu
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China
- Guangdong Transtek Medical Electronics Co., Ltd., Zhongshan, China
| | - Congcong Zhou
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Biosensor National Special Laboratory, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Hongwei Wang
- Tongde Hospital of Zhejiang Province, Hangzhou, China
- *Correspondence: Hongwei Wang,
| | - Yong He
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China
- Yong He,
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Mogi M, Maruhashi T, Higashi Y, Masuda T, Nagata D, Nagai M, Bokuda K, Ichihara A, Nozato Y, Toba A, Narita K, Hoshide S, Tanaka A, Node K, Yoshida Y, Shibata H, Katsurada K, Kuwabara M, Kodama T, Shinohara K, Kario K. Update on Hypertension Research in 2021. Hypertens Res 2022; 45:1276-1297. [PMID: 35790879 PMCID: PMC9255494 DOI: 10.1038/s41440-022-00967-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 12/16/2022]
Abstract
In 2021, 217 excellent manuscripts were published in Hypertension Research. Editorial teams greatly appreciate the authors' contribution to hypertension research progress. Here, our editorial members have summarized twelve topics from published work and discussed current topics in depth. We hope you enjoy our special feature, "Update on Hypertension Research in 2021".
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Affiliation(s)
- Masaki Mogi
- Department of Pharmacology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Tohon, Ehime, 791-0295, Japan.
| | - Tatsuya Maruhashi
- Department of Regenerative Medicine, Division of Radiation Medical Science, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Yukihito Higashi
- Department of Regenerative Medicine, Division of Radiation Medical Science, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Takahiro Masuda
- Division of Nephrology, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Daisuke Nagata
- Division of Nephrology, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Michiaki Nagai
- Department of Cardiology, Hiroshima City Asa Hospital, 1-2-1 Kameyamaminami Asakita-ku, Hiroshima, 731-0293, Japan
| | - Kanako Bokuda
- Department of Endocrinology and Hypertension, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Atsuhiro Ichihara
- Department of Endocrinology and Hypertension, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Yoichi Nozato
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan
| | - Ayumi Toba
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Sakaecho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Keisuke Narita
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, 5-1-1, Nabeshima, Saga, 849-8501, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, 5-1-1, Nabeshima, Saga, 849-8501, Japan
| | - Yuichi Yoshida
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, 1-1, 1-1 Idaigaoka, Hasama-machi, Yufu city, Oita, 879-5593, Japan
| | - Hirotaka Shibata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, 1-1, 1-1 Idaigaoka, Hasama-machi, Yufu city, Oita, 879-5593, Japan
| | - Kenichi Katsurada
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
- Division of Clinical Pharmacology, Department of Pharmacology, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Masanari Kuwabara
- Department of Cardiology, Toranomon Hospital, 2-2-2, Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Takahide Kodama
- Department of Cardiology, Toranomon Hospital, 2-2-2, Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Keisuke Shinohara
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
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Chauntry AJ, Bishop NC, Hamer M, Kingsnorth AP, Chen YL, Paine NJ. Sedentary behaviour is associated with heightened cardiovascular, inflammatory and cortisol reactivity to acute psychological stress. Psychoneuroendocrinology 2022; 141:105756. [PMID: 35483244 DOI: 10.1016/j.psyneuen.2022.105756] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Sedentary behaviour is a risk factor for cardiovascular disease (CVD), but the underlying mechanisms remain unclear. Exaggerated psychobiological responses to acute psychological stress increase CVD risk. Sedentary behaviour is associated with characteristics that can predict large psychobiological stress response patterns (e.g., elevated resting blood pressure and systemic inflammation), but it is currently unknown whether sedentary behaviour and stress reactivity are directly linked. The aim of this study was to examine associations between device-assessed sedentary behaviour and measures of stress reactivity. METHODS Sixty-one healthy adults wore an activPAL (thigh) and ActiGraph (wrist) for seven days to measure habitual levels of sedentary behaviour (mean ± SD = 9.96 ± 1.48 h/day) and moderate-to-vigorous physical activity (mean ± SD = 101.82 ± 42.92 min/day). Participants then underwent stress reactivity testing, where beat-to-beat cardiovascular (e.g., blood pressure, total peripheral resistance), inflammatory (plasma interleukin-6, leukocytes) and salivary cortisol measurements were taken in response to an 8-minute socially evaluative Paced Auditory Serial Addition Test. RESULTS Higher volumes of daily sedentary behaviour were associated with larger stress responses for diastolic blood pressure (Β=1.264, 95%CI=0.537-1.990, p = .005), total peripheral resistance (Β=40.563, 95%CI=19.310-61.812, p < .001), interleukin-6 (Β=0.219, 95%CI=0.109-0.329, p < .001) and cortisol (Β=1.844, 95%CI=1.139-2.549, p < .001). These findings emerged independent of a priori determined covariates, including daily levels of moderate-to-vigorous physical activity and adiposity. DISCUSSION Exaggerated stress reactivity is characteristic of high sedentary behaviour and could be a novel mechanism linking sedentary behaviour with CVD. Future work should examine the impact of reducing sedentary behaviour on measures of stress reactivity, as this may have clinical relevance for preventing CVD.
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Affiliation(s)
- Aiden J Chauntry
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, United Kingdom; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicestershire, United Kingdom
| | - Nicolette C Bishop
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, United Kingdom; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicestershire, United Kingdom
| | - Mark Hamer
- The Institute of Sport, Exercise and Health, Division of Surgery & Interventional Science, University College London, London, United Kingdom
| | - Andrew P Kingsnorth
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, United Kingdom; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicestershire, United Kingdom; Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
| | - Yu-Ling Chen
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, United Kingdom
| | - Nicola J Paine
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, Leicestershire, United Kingdom; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicestershire, United Kingdom.
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Sedentary Behaviour, Physical Activity and Psychobiological Stress Reactivity: A Systematic Review. Biol Psychol 2022; 172:108374. [DOI: 10.1016/j.biopsycho.2022.108374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 11/18/2022]
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Sedentary behavior is associated with reduced cardiovagal baroreflex sensitivity in healthy adults. Hypertens Res 2022; 45:1193-1202. [DOI: 10.1038/s41440-022-00904-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 01/24/2022] [Accepted: 02/18/2022] [Indexed: 11/08/2022]
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Li J, Herold F, Ludyga S, Yu Q, Zhang X, Zou L. The acute effects of physical exercise breaks on cognitive function during prolonged sitting: The first quantitative evidence. Complement Ther Clin Pract 2022; 48:101594. [DOI: 10.1016/j.ctcp.2022.101594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/04/2022] [Accepted: 04/12/2022] [Indexed: 01/02/2023]
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Duran AT, Romero E, Diaz KM. Is Sedentary Behavior a Novel Risk Factor for Cardiovascular Disease? Curr Cardiol Rep 2022; 24:393-403. [PMID: 35182312 DOI: 10.1007/s11886-022-01657-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2021] [Indexed: 01/16/2023]
Abstract
PURPOSE OF REVIEW Review the most recent evidence on the role of sedentary behavior in the prevention of cardiovascular disease (CVD). RECENT FINDINGS Prospective cohort studies continue to suggest a relationship between sedentary behavior and CVD, but the dose-response association, and the implications of sedentary pattern (vs. total volume) and context on CVD risk require further investigation. Most recent evidence suggests that physical activity influences the association between sedentary time and CVD risk, and that replacing sedentary time with other movement behaviors yields cardiometabolic benefits. Short-term intervention studies have further demonstrated that interrupting prolonged sitting with bouts of physical activity can elicit acute improvements on cardiometabolic biomarkers and vascular function relative to prolonged, uninterrupted sitting, albeit limited evidence exists on the long-term effects. More conclusive evidence regarding the implications of sedentary time on CVD risk is warranted before the optimal sedentary behavior reduction prescription for the prevention of CVD can be elucidated.
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Affiliation(s)
- Andrea T Duran
- Columbia University Irving Medical Center, 622 West 168 Street, New York, NY, 10032, USA.
| | - Emily Romero
- Teachers College, Columbia University, 525 West 120th Street, New York, NY, USA
| | - Keith M Diaz
- Columbia University Irving Medical Center, 622 West 168 Street, New York, NY, 10032, USA
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Gamble A, Beech BM, Blackshear C, Herring SJ, Welsch MA, Moore JB. Changes in Physical Activity and Television Viewing From Pre-pregnancy Through Postpartum Among a Socioeconomically Disadvantaged Perinatal Adolescent Population. J Pediatr Adolesc Gynecol 2021; 34:832-838. [PMID: 34271198 PMCID: PMC8578293 DOI: 10.1016/j.jpag.2021.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/16/2021] [Accepted: 06/29/2021] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVE Adolescent pregnancy contributes to accelerated trajectories of adiposity and cardiometabolic diseases. Two potentially low-cost prevention strategies include promoting physical activity (PA) and limiting television (TV) viewing. Few studies have explored these behavior patterns in perinatal adolescents. This study sought to characterize PA and TV viewing in a socioeconomically disadvantaged perinatal adolescent population. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS A cross-sectional, retrospective, 10-item survey was used to explore behavior patterns in 79 predominantly Black (86%) postpartum adolescents. MAIN OUTCOME MEASURES Outcomes included self-reported changes in PA from pre-pregnancy through pregnancy, and 7-day recall of PA and TV viewing in postpartum. RESULTS The majority of adolescents (66%) reported being active on ≥3 days/week in pre-pregnancy; however, many reported low PA (≤2 days/wk) in their first (59%), second (66%), and third (54%) trimesters. Adolescents who reported being active on ≥5 days/wk in pre-pregnancy (19%) experienced first trimester PA decline, which subsequently plateaued. This group remained the most active throughout pregnancy. In postpartum, over half (54%) of all adolescents reported low PA and irrespective of PA, spent considerable time watching TV (median = 1680.0 minutes, inerquartile range = 2940). CONCLUSION Interventions promoting PA coupled with reducing TV viewing during pregnancy and in postpartum may benefit perinatal adolescents. The findings from this study suggest that PA history is a predictor of gestational PA, and low PA and high TV viewing in postpartum underscore the need for behavioral intervention. Conducting a brief assessment of PA history in early gestation may offer important insight.
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Affiliation(s)
- A Gamble
- Department of Preventive Medicine, University of Mississippi Medical Center, Jackson, Mississippi; Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi.
| | - B M Beech
- Office of the Provost, University of Houston, Houston, Texas; College of Medicine, University of Houston, Houston, Texas
| | - C Blackshear
- Department of Data Science, University of Mississippi Medical Center, Jackson, Mississippi
| | - S J Herring
- Program for Maternal Health Equity, Center for Urban Bioethics, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - M A Welsch
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, Mississippi
| | - J B Moore
- Department of Implementation Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Di Fusco SA, Spinelli A, Castello L, Mocini E, Gulizia MM, Oliva F, Gabrielli D, Imperoli G, Colivicchi F. Impact of Working from Home on Cardiovascular Health: An Emerging Issue with the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211882. [PMID: 34831636 PMCID: PMC8621324 DOI: 10.3390/ijerph182211882] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/04/2021] [Accepted: 11/06/2021] [Indexed: 12/18/2022]
Abstract
Mandatory working from home is one of the consequences of the COVID-19 pandemic for a large number of workers. Transition to working from home may significantly impact lifestyle, psychosocial status, and the overall health of workers. This review summarizes available data about the effects of lockdown measures, particularly working from home, on cardiovascular risk factors including sedentary lifestyle, unhealthy diet pattern, psychological distress, smoking, alcohol misuse, and cardiometabolic parameters. Finally, we suggest countermeasures that can attenuate the negative health impact of working from home. Indeed, timely and tailored interventions implemented by companies in cooperation with the health care system could allow workers to benefit more from some of the advantages associated with working from home.
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Affiliation(s)
- Stefania Angela Di Fusco
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital, Martinotti Street 20, 00135 Rome, Italy; (A.S.); (L.C.); (F.C.)
- Correspondence: ; Tel.: +39-06-33061
| | - Antonella Spinelli
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital, Martinotti Street 20, 00135 Rome, Italy; (A.S.); (L.C.); (F.C.)
| | - Lorenzo Castello
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital, Martinotti Street 20, 00135 Rome, Italy; (A.S.); (L.C.); (F.C.)
| | - Edoardo Mocini
- Department of Experimental Medicine, Sapienza University, 00185 Rome, Italy;
| | - Michele Massimo Gulizia
- Cardiology Division, Garibaldi-Nesima Hospital, 95122 Catania, Italy;
- ANMCO Heart Care Foundation, 50121 Florence, Italy
| | - Fabrizio Oliva
- De Gasperis Cardio Center, Niguarda Hospital, 20162 Milano, Italy;
| | - Domenico Gabrielli
- Cardiology/CCU Unit, Cardiovascular Department, San Camillo Hospital, 00152 Rome, Italy;
| | - Giuseppe Imperoli
- Medicine Unit, Emergency Department, San Filippo Neri Hospital, 00135 Rome, Italy;
| | - Furio Colivicchi
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital, Martinotti Street 20, 00135 Rome, Italy; (A.S.); (L.C.); (F.C.)
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Al-Raddadi R, Al-Ahmadi J, Bahijri S, Ajabnoor GM, Jambi H, Enani S, Eldakhakhny BM, Alsheikh L, Borai A, Tuomilehto J. Gender Differences in The Factors associated with Hypertension in Non-Diabetic Saudi Adults-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111371. [PMID: 34769893 PMCID: PMC8583204 DOI: 10.3390/ijerph182111371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/26/2021] [Accepted: 10/26/2021] [Indexed: 12/11/2022]
Abstract
The association between lifestyle practices, obesity and increased BP are under-investigated. We aimed to investigate this association to identify the factors associated with hypertension and prehypertension in Saudis. Non-diabetic adults were recruited from public healthcare centers using a cross-sectional design. Recruits were interviewed using a predesigned questionnaire. Weight, height, waist circumference (WC), hip circumference (HC), neck circumference (NC) and BP were measured. The variables were analyzed by comparing the prehypertensive and hypertensive groups with the normotensive group. A total of 1334 adults were included. The study found that 47.2% of men and 24.7% of women were prehypertensive, and 15.1% of men and 14.4% of women were hypertensive. High BMI, WC, NC, and WC: HC ratios were associated with an increased risk of prehypertension and hypertension in men and women. Low physical activity was associated with an increased risk of elevated BP in men, while sleep duration of ≤6 h and sitting for ≥4 h were associated with increased risk in women. Women from central Asia, southeast Asia, and those of mixed origin had a higher prevalence of hypertension compared to those from Arabian tribes. In conclusion, prehypertension and hypertension increase with age and obesity. Gender differences were apparent in the association between several lifestyle practices and prehypertension or hypertension among various ethnic/racial groups.
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Affiliation(s)
- Rajaa Al-Raddadi
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Department of Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Jawaher Al-Ahmadi
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Suhad Bahijri
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Correspondence: ; Tel.: +966-564-370-571
| | - Ghada M. Ajabnoor
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Hanan Jambi
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah 3270, Saudi Arabia
| | - Sumia Enani
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah 3270, Saudi Arabia
| | - Basmah Medhat Eldakhakhny
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, King Abdulaziz University, Jeddah 22252, Saudi Arabia
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Lubna Alsheikh
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- Food, Nutrition and Lifestyle Research Unit, King Fahd for Medical Research Centre, King Abdulaziz University, Jeddah 22252, Saudi Arabia
| | - Anwar Borai
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), College of Medicine, King Abdulaziz Medical City, Jeddah 22384, Saudi Arabia
| | - Jaakko Tuomilehto
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 3270, Saudi Arabia; (R.A.-R.); (J.A.-A.); (G.M.A.); (H.J.); (S.E.); (B.M.E.); (L.A.); (A.B.); (J.T.)
- Department of Public Health, University of Helsinki, 00014 Helsinki, Finland
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
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Alansare AB, Gibbs BB, Catov JM, Jennings JR, Kline CE, Nagle E, Holzman C. Association of Physical Activity and Sedentary Time with Cardio-Autonomic Regulation in Women. J Womens Health (Larchmt) 2021; 31:600-608. [PMID: 34648723 DOI: 10.1089/jwh.2021.0243] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Low moderate-to-vigorous-intensity physical activity (MVPA) and high sedentary time (ST) may contribute to cardiovascular disease (CVD) risk in women, perhaps via cardiac autonomic dysregulation. We examined associations of total, leisure, and occupational MVPA and ST with cardiac autonomic regulation in women. Methods: Data were from 522 women (age = 37.7 ± 5.7 years; 59%white) who participated in the follow-up study of the Pregnancy Outcomes and Community Health Study (between 2011 and 2014). MVPA and ST (hours/day) were self-reported using the Modifiable Activity Questionnaire. Cardiac autonomic regulation was assessed by calculating heart rate variability (HRV) indices (resting heart rate, natural logarithm standard deviation of normal R-R intervals; lnSDNN [total variability], natural logarithm root mean square of the successive differences; lnRMSSD [cardiac parasympathetic activity]) with Kubios software from a 5-minute, seated electrocardiogram. Progressive generalized linear models evaluated associations of total, leisure, and occupational MVPA and ST with HRV indices while adjusting for confounders (demographics, health-related factors), and then potential mediators (clinical variables). A final model evaluated the relationship between ST and HRV stratified by MVPA level. Results: Adjusting for confounders, total and leisure MVPA were associated with favorable lnSDNN (B = 0.027 [p = 0.014] and B = 0.074 [p = 0.009], respectively) and lnRMSSD (B = 0.036 [p = 0.015] and B = 0.075 [p = 0.043], respectively). Adjustment for mediators tended to strengthen the observed significant associations. No associations were found between occupational MVPA or any ST measure with HRV indices (p > 0.05). Neither MVPA nor ST were associated with heart rate. When stratified by MVPA level, leisure ST was associated with unfavorable lnRMSSD (B = -0.041, [p = 0.042]) only among women who did not meet leisure MVPA recommendations. Conclusion: Cardiac autonomic dysregulation may be a mechanism through which low leisure MVPA and, among low-active women, high leisure ST contribute to CVD risk among women.
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Affiliation(s)
- Abdullah Bandar Alansare
- Department of Exercise Physiology, College of Sport Sciences and Physical Activity, King Saud University, Riyadh, Saudi Arabia
| | - Bethany Barone Gibbs
- Department of Health and Human Development, School of Education, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Janet M Catov
- Department of Obstetrics, Gynecology, and Reproductive Sciences and University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - J Richard Jennings
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Christopher E Kline
- Department of Health and Human Development, School of Education, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Elizabeth Nagle
- Department of Health and Human Development, School of Education, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Claudia Holzman
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA
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Low Physical Activity Levels Are Linked to Early Hypertension Risk in College-Going Young Adults. Healthcare (Basel) 2021; 9:healthcare9101258. [PMID: 34682938 PMCID: PMC8535231 DOI: 10.3390/healthcare9101258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Sedentary behaviour and physical inactivity along with body mass are identified as critical determinants of vascular health along with body mass in young adults. However, the relationship between potential physical health and anthropometric variables with high blood Eid pressure remain unexplored in young adults from the United Arab Emirates region. Methodology: We administered a cross-sectional study in young adults assessing their self-reported physical activity levels, anthropometric variables (body mass index and waist circumference) and ambulatory blood pressure. The associations among potential physical health, anthropometric variables and high blood pressure were analysed through logistic regression after necessary transformation. Results: Of 354 participants (176 males, 178 females), we found 17.79% (n = 63) had higher mean arterial pressure. Males (n = 40; 22.73%) had higher risk of hypertension than females (n = 12.92%). Weekly physical activity levels (β = −0.001; p = 0.002), age (β = −0.168; p = 0.005) and gender (β = −0.709; p = 0.028) were found to be more strongly associated with hypertension risk than the body mass index (β = 0.093; p = 0.075), waist circumference (β = 0.013; p = 0.588) and the weekly sitting time (β = 0.000; p = 0.319) of the individuals. Conclusions: Lower physical activity was associated with hypertension risk compared to other modifiable risk factors such as waist circumference, body mass index and sedentary time in college-going young adults. Public health measures should continue to emphasise optimisation of weekly physical activity levels to mitigate vascular health risks at educational institution levels.
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Monteagudo P, Cordellat A, Roldán A, Gómez-Cabrera MC, Pesce C, Blasco-Lafarga C. Exploring Potential Benefits of Accumulated Multicomponent-Training in Non-Active Older Adults: From Physical Fitness to Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9645. [PMID: 34574570 PMCID: PMC8469847 DOI: 10.3390/ijerph18189645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 11/16/2022]
Abstract
The present study aimed to analyze the impact of a multicomponent training (MCT) program in a group of non-active older adults, comparing two different dose distributions. Twenty-four individuals, assigned to two groups, completed 15 weeks of MCT (2 days/week). The continuous group (CMCT; n = 14, 9 females; 71.07 ± 5.09 years) trained for 60 min/session in the morning. The accumulated group (AMCT; n = 10, 5 females; 72.70 ± 3.59 years) performed the same exercises, volume, and intensity, but the training was distributed twice per day (30 min in the morning; 30 more in the afternoon). Bonferroni post hoc comparisons revealed significant (p < 0.001) and similar large improvements in both groups in lower limb strength (five times sit-to-stand test: CMCT, 12.55 ± 2.83 vs. 9.44 ± 1.72 s; AMCT, 10.37 ± 2.35 vs. 7.46 ± 1.75 s). In addition, there were large gains in preferred walking speed and instrumental daily life activities, which were higher for CMCT and AMCT, respectively (in this order: 1.00 ± 0.18 vs. 1.44 ± 0.26 m/s and 1.09 ± 0.80 vs. 1.58 ± 0.18 m/s; 33.07 ± 2.88 vs. 36.57 ± 1.65 points and 32.80 ± 1.93 vs. 36.80 ± 0.92 points); improvements in cardiorespiratory fitness, now moderate for CMCT (474.14 ± 93.60 vs. 529.64 ± 82.76 m) and large for AMCT (515.10 ± 20.24 vs. 589.60 ± 40.38 m); and medium and similar enhancements in agility in both groups (TUG test: CMCT: 7.49 ± 1.11 vs. 6.77 ± 1.16 s; AMCT: 6.84 ± 1.01 vs. 6.18 ± 0.62 s). None of the protocols had an impact on the executive function, whereas health-related quality of life showed a trend to significance in the whole sample only (EQindex overall sample, p = 0.062; d = 0.48 CMCT; d = 0.34 AMCT). Regardless of the type of dose distribution, starting multicomponent training improves physical function in non-active older adults, but does not improve cognitive function at mid-term. Because both forms of MCT showed similar compliance, slightly positive differences in accumulated strategies may indicate some benefits related to breaking afternoon sedentary behaviors, which deserves further research in longer and larger interventions. The mixed nature of MCT suggests accumulative group interventions may be a promising approach to address sedentary aging.
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Affiliation(s)
- Pablo Monteagudo
- Sport Performance and Physical Fitness Research Group (UIRFIDE), University of Valencia, 46010 Valencia, Spain; (A.C.); (A.R.)
- Department of Education and Specific Didactics, Jaume I University, 12071 Castellon, Spain
| | - Ana Cordellat
- Sport Performance and Physical Fitness Research Group (UIRFIDE), University of Valencia, 46010 Valencia, Spain; (A.C.); (A.R.)
- Physical Education and Sports Department, University of Valencia, 46010 Valencia, Spain
| | - Ainoa Roldán
- Sport Performance and Physical Fitness Research Group (UIRFIDE), University of Valencia, 46010 Valencia, Spain; (A.C.); (A.R.)
- Physical Education and Sports Department, University of Valencia, 46010 Valencia, Spain
| | - Mari Carmen Gómez-Cabrera
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, 46010 Valencia, Spain;
| | - Caterina Pesce
- Department of Movement, Human and Health Sciences, Foro Italico University, 00135 Rome, Italy;
| | - Cristina Blasco-Lafarga
- Sport Performance and Physical Fitness Research Group (UIRFIDE), University of Valencia, 46010 Valencia, Spain; (A.C.); (A.R.)
- Physical Education and Sports Department, University of Valencia, 46010 Valencia, Spain
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Sit less and move more for cardiovascular health: emerging insights and opportunities. Nat Rev Cardiol 2021; 18:637-648. [PMID: 34017139 DOI: 10.1038/s41569-021-00547-y] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/22/2021] [Indexed: 02/01/2023]
Abstract
Sedentary behaviour - put simply, too much sitting, as a distinct concept from too little exercise - is a novel determinant of cardiovascular risk. This definition provides a perspective that is complementary to the well-understood detrimental effects of physical inactivity. Sitting occupies the majority of the daily waking hours in most adults and has become even more pervasive owing to the COVID-19 pandemic. The potential for a broad cardiovascular health benefit exists through an integrated approach that involves 'sitting less and moving more'. In this Review, we first consider observational and experimental evidence on the adverse effects of prolonged, uninterrupted sitting and the evidence identifying the possible mechanisms underlying the associated risk. We summarize the results of randomized controlled trials demonstrating the feasibility of changing sedentary behaviour. We also highlight evidence on the deleterious synergies between sedentary behaviour and physical inactivity as the underpinnings of our case for addressing them jointly in mitigating cardiovascular risk. This integrated approach should not only reduce the specific risks of too much sitting but also have a positive effect on the total amount of physical activity, with the potential to more broadly benefit the health of individuals living with or at risk of developing cardiovascular disease.
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Post-exercise hypotension time-course is influenced by exercise intensity: a randomised trial comparing moderate-intensity, high-intensity, and sprint exercise. J Hum Hypertens 2021; 35:776-784. [PMID: 32980866 DOI: 10.1038/s41371-020-00421-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/11/2020] [Accepted: 09/16/2020] [Indexed: 01/31/2023]
Abstract
Reductions in blood pressure (BP) induced by exercise training may be associated with the acute reduction in BP observed minutes to hours following an exercise session, termed post-exercise hypotension (PEH). However, the magnitude and time-course of PEH, including the optimal exercise characteristics to maximise it, are still unclear. Using a randomised crossover design, 16 normotensive participants (median age (range) 22 (19-31) years; 50% female) undertook three different exercise sessions: sprint interval exercise (SIE, 30 × 8-s sprints with 32 s recovery), high-intensity interval exercise (HIIE, 15 × 1-min intervals at 90% peak heart rate (HR) with 1-min recovery), and moderate-intensity continuous exercise (MICE, 48 min at 65% peak HR). BP and HR were monitored before and up to 90 min following each session. The three exercise sessions each showed distinct PEH and of similar overall magnitude up to 90 min post exercise; however, there were distinct differences in the time-course. Systolic BP was lower 40 min after MICE compared to HIIE (-7.7 (-13.9 to -2.4) mmHg) and diastolic BP was higher 5 min after HIIE compared to SIE (8.5 (2.3-14.7) mmHg). MICE induced lower HR up to 40 min after exercise compared to HIIE and SIE. HIIE and SIE induced PEH of similar magnitude to MICE. A phasic or 'W-shaped' time-course of PEH observed following HIIE and SIE contrasted to a distinct 'V-shaped' PEH following MICE, indicating the physiological mechanisms driving BP regulation after exercise are influenced by exercise intensity.
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Alansare AB, Bates LC, Stoner L, Kline CE, Nagle E, Jennings JR, Hanson ED, Faghy MA, Gibbs BB. Associations of Sedentary Time with Heart Rate and Heart Rate Variability in Adults: A Systematic Review and Meta-Analysis of Observational Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168508. [PMID: 34444256 PMCID: PMC8391190 DOI: 10.3390/ijerph18168508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/07/2021] [Accepted: 08/09/2021] [Indexed: 01/18/2023]
Abstract
PURPOSE To evaluate if sedentary time (ST) is associated with heart rate (HR) and variability (HRV) in adults. METHODS We systematically searched PubMed and Google Scholar through June 2020. Inclusion criteria were observational design, humans, adults, English language, ST as the exposure, resting HR/HRV as the outcome, and (meta-analysis only) availability of the quantitative association with variability. After qualitative synthesis, meta-analysis used inverse variance heterogeneity models to estimate pooled associations. RESULTS Thirteen and eight articles met the criteria for the systematic review and meta-analysis, respectively. All studies were cross-sectional and few used gold standard ST or HRV assessment methodology. The qualitative synthesis suggested no associations between ST and HR/HRV. The meta-analysis found a significant association between ST and HR (β = 0.24 bpm per hour ST; CI: 0.10, 0.37) that was stronger in males (β = 0.36 bpm per hour ST; CI: 0.19, 0.53). Pooled associations between ST and HRV indices were non-significant (p > 0.05). Substantial heterogeneity was detected. CONCLUSIONS The limited available evidence suggests an unfavorable but not clinically meaningful association between ST and HR, but no association with HRV. Future longitudinal studies assessing ST with thigh-based monitoring and HRV with electrocardiogram are needed.
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Affiliation(s)
- Abdullah Bandar Alansare
- Department of Exercise Physiology, College of Sport Sciences and Physical Activity, King Saud University, King Khalid Rd, Riyadh 80200, Saudi Arabia
- Correspondence: ; Tel.: +966-555061381; Fax: +966-11-806-3370
| | - Lauren C. Bates
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA; (L.C.B.); (L.S.); (E.D.H.)
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA; (L.C.B.); (L.S.); (E.D.H.)
| | - Christopher E. Kline
- Department of Health and Human Development, School of Education, University of Pittsburgh, 140 Trees Hall, Pittsburgh, PA 15261, USA; (C.E.K.); (E.N.); (B.B.G.)
| | - Elizabeth Nagle
- Department of Health and Human Development, School of Education, University of Pittsburgh, 140 Trees Hall, Pittsburgh, PA 15261, USA; (C.E.K.); (E.N.); (B.B.G.)
| | - J. Richard Jennings
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15219, USA;
| | - Erik D. Hanson
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC 27599, USA; (L.C.B.); (L.S.); (E.D.H.)
| | - Mark A. Faghy
- Human Sciences Research Centre, University of Derby, Derby DE22 1GB, UK;
| | - Bethany Barone Gibbs
- Department of Health and Human Development, School of Education, University of Pittsburgh, 140 Trees Hall, Pittsburgh, PA 15261, USA; (C.E.K.); (E.N.); (B.B.G.)
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Maasakkers CM, de Heus RAA, Thijssen DHJ, Melis RJF, Gardiner PA, Claassen JAHR. Objectively-Measured Activity Patterns are Associated with Home Blood Pressure in Memory Clinic Patients. J Alzheimers Dis 2021; 74:691-697. [PMID: 32083587 PMCID: PMC7175935 DOI: 10.3233/jad-191310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background: Physicians are cautious to prescribe antihypertensive drugs in frail older adults because of the potential adverse effects, especially in those with cognitive complaints. Lifestyle aspects might provide safe targets to lower blood pressure in older adults. Objective: Our goal was to evaluate the associations between activity patterns and blood pressure in memory clinic patients. Methods: We used an observational cross-sectional study to measure activity patterns with the ActivPAL accelerometer, and simultaneous home blood pressure levels in memory clinic patients (age range 51–87 years old). Office blood pressure was assessed during routine clinical practice. Results: 41 patients (mean age of 74.3 (7.7) years of age, 46% female) were included. Sedentary parameters were associated with higher mean home blood pressure, with the strongest correlation between more prolonged sitting bouts and higher SBP (r = 0.58, p < .0001). Physical activity parameters were negatively associated with mean home blood pressure. Adjusted regression estimates remained significant, showing, e.g., a 4.5 (95% CI = 1.6;7.4) mmHg increase in SBP for every hour of sitting per day and a –1.0 (95% CI = –1.8;–0.2) mmHg decrease in DBP for every additional 1000 steps per day. No strong correlations were found between any of the activity pattern variables and office blood pressure. Conclusion: Associations between activity pattern variables and blood pressure were only found with home blood pressure measurements, not with office measurements. Longitudinal evaluations of these associations are now needed to explore if reducing prolonged sedentary bouts and increasing step count indeed serve as safe targets to lower blood pressure.
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Affiliation(s)
- Carlijn M Maasakkers
- Department of Geriatrics/Radboud Alzheimer Center, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rianne A A de Heus
- Department of Geriatrics/Radboud Alzheimer Center, Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dick H J Thijssen
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom
| | - René J F Melis
- Department of Geriatrics/Radboud Alzheimer Center, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paul A Gardiner
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia.,Mater Research Institute, The University of Queensland, South Brisbane, Australia
| | - Jurgen A H R Claassen
- Department of Geriatrics/Radboud Alzheimer Center, Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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50
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Whipple MO, Masters KS, Huebschmann AG, Scalzo RL, Reusch JE, Bergouignan A, Regensteiner JG. Acute effects of sedentary breaks on vascular health in adults at risk for type 2 diabetes: A systematic review. Vasc Med 2021; 26:448-458. [PMID: 33977799 PMCID: PMC9074004 DOI: 10.1177/1358863x211009307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this systematic review was to evaluate the available evidence regarding the acute effects of interrupting/breaking up prolonged sedentary behavior (SB) on vascular health among individuals at elevated risk for type 2 diabetes (T2D). Searches of MEDLINE, Embase, Web of Science, and Cochrane Library databases were conducted on April 7, 2020. Included studies: (1) examined the effect of breaking up prolonged SB in adults with or at elevated risk for T2D and (2) assessed a vascular health outcome, such as blood pressure (BP), flow-mediated dilation (FMD), pulse-wave velocity, or endothelin-1. A total of 20 articles (17 unique studies) were included. Only three studies reported adequate statistical power for the specified vascular outcome. The available evidence suggests that light and moderate intensity activity breaks are effective in acutely lowering BP when compared to prolonged sitting. The small number of studies that included FMD or other vascular outcomes prohibits conclusions regarding the impact of SB breaks on these outcomes. Few studies evaluating the impact of breaking up SB among adults at risk for T2D have included and been adequately powered to examine vascular outcomes, but our preliminary finding, that certain SB breaks improve BP, provides proof-of-concept for this line of inquiry. Future studies should examine both the acute and chronic vascular effects of breaking up SB among individuals most vulnerable to the effects of SB (e.g. older adults, those with T2D), as these individuals are both highly sedentary and at greatest risk of poor health outcomes. PROSPERO ID: CRD42020183423.
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Affiliation(s)
- Mary O. Whipple
- Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Center for Women’s Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Kevin S. Masters
- Department of Psychology, Clinical Health Psychology, University of Colorado Denver, Denver, CO
- Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Amy G. Huebschmann
- Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Center for Women’s Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Rebecca L. Scalzo
- Center for Women’s Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Rocky Mountain Regional VA, Aurora, CO
| | - Jane E.B. Reusch
- Center for Women’s Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Rocky Mountain Regional VA, Aurora, CO
| | - Audrey Bergouignan
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Institut Pluridisciplinaire Hubert Curien, French National Center for Scientific Research, Université de Strasbourg, UMR 7178, Strasbourg, France
| | - Judith G. Regensteiner
- Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
- Center for Women’s Health Research, University of Colorado Anschutz Medical Campus, Aurora, CO
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