Epidemiology of leisure-time physical activity in socio-demographic, lifestyle and psychological characteristics of men and women in Greece: the ATTICA Study

Biomarkers and Data Visualization of Insulin Resistance and Metabolic Syndrome: An Applicable Approach

Type 2 diabetes, prediabetes, and insulin resistance (IR) are widespread yet often undetected in their early stages, contributing to a silent epidemic. Metabolic Syndrome (MetS) is also highly prevalent, increasing the chronic disease burden. Annual check-ups are inadequate for early detection due to conventional result formats that lack specific markers and comprehensive visualization. The aim of this study was to evaluate low-budget biochemical and hematological parameters, with data visualization, for identifying IR and MetS in a community-based laboratory. In a cross-sectional study with 1870 participants in Patras, Greece, blood samples were analyzed for key cardiovascular and inflammatory markers. IR diagnostic markers (TyG-Index, TyG-BMI, Triglycerides/HDL ratio, NLR) were compared with HOMA-IR. Innovative data visualization techniques were used to present metabolic profiles. Notable differences in parameters of cardiovascular risk and inflammation were observed between normal-weight and obese people, highlighting BMI as a significant risk factor. Also, the inflammation marker NHR (Neutrophils to HDL-Cholesterol Ratio) Index was successful at distinguishing the obese individuals and those with MetS from normal individuals. Additionally, a new diagnostic index of IR, combining BMI (Body Mass Index) and NHR Index, demonstrated better performance than other well-known indices. Lastly, data visualization significantly helped individuals understand their metabolic health patterns more clearly. BMI and NHR Index could play an essential role in assessing metabolic health patterns. Integrating specific markers and data visualization in routine check-ups enhances the early detection of IR and MetS, aiding in better patient awareness and adherence.

Stage of Change of Transtheoretical Model for Nine Health-Related Behaviors Among Hypertensive Patients: Cross-Sectional Study

Aim

This study aimed to determine the current stage of change (SOG) toward seven healthy eating behaviors and two healthy lifestyle behaviors related to blood pressure (BP) control. The lifestyle behaviors included smoking Behavior and practicing regular exercise, while the dietary behaviors included the DASH diet guidelines.

Methods

A total of 1109 outpatients participated in this cross-sectional study that was conducted between 2021 and 2022 in Jordan. A staging algorithm assessed SOG for several BP control-related behaviors for diagnosed hypertension patients. Data were collected by a structured interview-based questionnaire.

Results

There was a high degree of maintenance toward consuming diets with high grains, fruit, vegetables, meat, and poultry, less saturated fat, and more low-fat dairy products. More than half of the participants were in the pre-action stage for quitting smoking, practicing physical exercise, and consuming sweets and added sugars. Significant associations were observed between the degree of maintenance for several behaviors (p < 0.01). Age, income, education level, disease duration, and nutrition consultation availability were the most related factors to the SOG of the studied behaviors (p < 0.01).

Conclusion

Patients with hypertension in Jordan are still in the pre-action stages for quitting smoking, practicing physical exercise, and consuming 5 servings of refined sweets and added sugars weekly. The current outcome suggests a need for nutritional counseling, education, and interventions to raise awareness of lifestyle factors influencing BP among hypertension patients.

Level and limitations of physical activity in patients with excess body weight or diabetes

Physical activity (PA) is recommended to prevent or treat many diseases, but various factors may limit it. We analyse the level of PA and the barriers to undertaking it. Patients aged 18-64 with diabetes or at least overweight completed the following questionnaires: International Physical Activity Questionnaire (IPAQ) and Accompanying Survey (AS). For statistical analysis, non-parametric Mann-Whitney U, χ2-Pearson, correspondence analysis and meta-analysis (OR with ±95% CI) were used, and α=0.05 was assumed. Of 191 sets of questionnaires were analysed (67% from women). The median (MD) age for the group was 50.5 years, MD for metabolic equivalents (METs): 2079 (MET-min/week); 16.23% of subjects scored insufficient, 46.07% sufficient and 37.7% high PA according to the IPAQ scale. A relationship between the IPAQ and PA level results from the AS was confirmed (χ2; p=0.00047). The most common reasons indicated for not taking up PA were lack of time due to professional work (49%) and additional duties (32%) as well as fatigue from daily duties (44%). Participants <45 years were more likely to indicate additional duties (p=0.013), participants >45 years illnesses (p=0.04) and people with BMI (body mass index) ≥30 kg/m2, 'fatigue from daily duties' (p=0.019) as an obstacle to undertaking PA. 'Lack of suitable conditions to undertake PA' was indicated more often by patients with primary education (p<0.01), diabetes (p=0.037), after myocardial infarction (p=0.039) and those under psychiatric treatment (p=0.039). Women more often declared a lack of motivation (p=0.018). Residents of big cities and those with BMI ≥30 were more likely to assess their PA as 'insufficient' (p=0.0260 and p=0.0081, respectively). The overwhelming number of respondents who were in the age of professional activity had a sufficient level of PA. The most common barriers to undertaking PA were lack of time and fatigue, related to both work and non-work activities, but specific barriers were also found for women and patients with various diseases.

The combination of physical activity with fruit and vegetable intake associated with life satisfaction among middle-aged and older adults: a 16-year population-based cohort study

BACKGROUND

Life satisfaction (LS) is part of a positive psychological feeling that protects individuals from a physical decline in old age. A healthy lifestyle, including physical activity (PA) and a healthy diet, such as the intake of fruits and vegetables (F&V), can lead to a better experience of LS in older adults. However, the association between PA and F&V intake habits when occurring together in older adults is still unclear for LS. The study aimed to investigate the combined association of PA and F&V intake on LS among a cohort of older Taiwanese adults.

METHODS

Five waves of population-based data gathered by the Taiwan Longitudinal Survey on Aging between 1999 and 2015 were analyzed. The year 1999 was set as the baseline, and the number of respondents was 4,440. The independent variables included the frequency, duration, and intensity of PA and the frequency of F&V intake. LS was assessed by using the Life Satisfaction Index. We performed generalized estimating equations (GEE) analysis with adjustment for covariates of health behaviors and health indicators.

RESULTS

After adjusting for confounders, model 1 showed that moderate and high-PA levels significantly correlated with LS (odds ratio [OR] = 1.41, 95% CI = 1.12-1.79) and OR = 1.74, 95% CI = 1.50-2.02). Moreover, high-F&V intake significantly correlated with LS (OR = 2.07, 95% CI = 1.69-2.53). Regarding the combined association shown in model 2, compared with both the low PA and F&V intake group, there were significantly higher LS in the both-high-group (OR = 4.69, 95% CI = 3.49-6.31), only-high-F&V intake (OR = 2.87, 95% CI = 2.14-3.85), only-high-PA (OR = 2.48, 95% CI = 1.74-3.52).

CONCLUSIONS

Our findings show the significant combined association of PA and F&V intake on LS among older adults. In addition, older adults who engaged in higher frequency, duration, and intensity of daily PA combined more than seven times a week of F&V intake had significantly higher LS than those who only engaged in low PA or only intake less F&V. Adopting multiple healthy behaviors in daily life is a safe and effective approach to promote LS among older adults.

Socioeconomic inequalities in employees' health-enhancing physical activity: Evidence from the SHAHWAR cohort study in Iran

BACKGROUND

Increasing level of physical activity (PA) among working population is of particular importance, because of the high return of investment on employees' PA. This study was aimed to investigate socioeconomic inequalities in Health-Enhancing Physical Activity (HEPA) among employees of a Medical Sciences University in Iran.

METHODS

Data were extracted from the SHAHWAR Cohort study in Iran. Concentration index (C) and Wagstaff decomposition techniques were applied to determine socioeconomic inequality in the study outcomes and its contributors, respectively.

RESULTS

Nearly half of the university employees (44.6%) had poor HEPA, and employees with high socioeconomic status (SES) suffered more from it (C = 0.109; 95% CI: 0.075, 0.143). Also, we found while poor work-related PA (C = 0.175; 95% CI: 0.142, 0.209) and poor transport-related PA (C = 0.081, 95% CI: 0.047, 0.115) were more concentrated among high-SES employees, low-SES employees more affected by the poor PA at leisure time (C = -0.180; 95% CI: -0.213, -0.146). Shift working, and having higher SES and subjective social status were the main factors that positively contributed to the measured inequality in employees' poor HEPA by 33%, 31.7%, and 29%, respectively, whereas, having a married life had a negative contribution of -39.1%. The measured inequality in poor leisure-time PA was mainly attributable to SES, having a married life, urban residency, and female gender by 58.1%, 32.5%, 28.5%, and -32.6%, respectively. SES, urban residency, shift working, and female gender, with the contributions of 42%, 33.5%, 21.6%, and -17.3%, respectively, were the main contributors of poor work-related PA inequality. Urban residency, having a married life, SES, and subjective social status mainly contributed to the inequality of poor transport-related PA by 82.9%, -58.7%, 36.3%, and 33.5%, respectively, followed by using a personal car (12.3%) and female gender (11.3%).

CONCLUSIONS

To reduce the measured inequalities in employees' PA, workplace health promotion programs should aim to educate and support male, urban resident, high-SES, high-social-class, and non-shift work employees to increase their PA at workplace, and female, married, rural resident, and low-SES employees to increase their leisure-time PA. Active transportation can be promoted among female, married, urban resident, high-SES, and high-social-class employees and those use a personal car.

Socio-demographics, neighborhood characteristics, time use, and leisure-time physical activity engagement patterns over the life course

Physical inactivity remains a major public health challenge today. Understanding the determinants of changes in habitual leisure-time physical activity patterns by type across the life course is important for developing targeted interventions. This study presents a multiple discrete-continuous extreme value model to examine the determinants of habitual participation in and time allocation to multiple leisure-time physical activities over the life course. A comprehensive set of socio-demographics, life transitions, neighborhood characteristics, and time-related factors are considered as determinants of each activity type, including sports, recreational walking, cycling, outdoor playing, and dog walking. Results estimated on retrospective survey data collected in the Netherlands show significant differences in the determinants of the different types of leisure-time physical activity. Social-demographic factors have a strong influence on sports participation, followed by recreational walking, cycling, outdoor playing, and then dog walking. Life transitions have different effects. A change in marital status appears to be the most important life event for sports participation while changing jobs is the most important event for the other two activities. Neighborhood characteristics primarily affect participation in recreational walking, cycling, outdoor playing, and dog walking. As for time-related factors, they mainly impact sports engagement. The findings of this study could help develop effective interventions to promote leisure-time physical activity participation during life transitions and encourage healthy living.

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The determinants of different types of leisure-time physical activity differ significantly.

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Social-demographic factors have a strong impact on sports participation, followed by recreational-WCP, and then dog walking.

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Changes in marital status and work seem to be important events for joining sports and the other two activities, respectively.

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Neighborhood characteristics primarily affect participation in recreational-WCP and dog walking.

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Study-related physical activity time and work-related physical activity time mainly impact sports participation.

The combined effect of physical activity and fruit and vegetable intake on decreasing cognitive decline in older Taiwanese adults

The factors associated with cognitive decline among older adults include physical activity and fruit and vegetable intake. However, the long-term effects of concomitant physical activity and fruit and vegetable intake are unknown. This 16-year longitudinal study explored the joint effect of mitigating cognitive decline in a cohort of older Taiwanese individuals. Five population-based surveys (Taiwan Longitudinal Survey on Aging [1999–2015]) involving 4440 respondents over 53 years old in 1999 were conducted. Cognitive function was assessed using the Short Portable Mental Status Questionnaire (SPMSQ). The demographic, socioeconomic, health-related, behavioral, and disease status covariates were adjusted in the regression analysis. Trends in cognitive decline were observed over 16 years. The risk of cognitive decline decreased by 63% when high physical activity and high fruit and vegetable intake were combined (odds ratio 0.37; 95% confidence interval 0.23–0.59), indicating a potential combined effect of physical activity and fruit and vegetable intake on mitigating cognitive decline. These personal actions are safe, effective, and economical approaches to health promotion and disease prevention.

Exercise Preferences and Benefits in Patients Hospitalized with COVID-19

Background: Obese people are at risk of becoming severely ill due to SARS-CoV-2. The exercise benefits on health have been emphasized. Aim: To investigate the correlation of obesity with the length of hospitalization, the pre- and post-hospitalization exercise preferences of COVID-19 patients, and the impact of pre-admission or post-hospitalization physical activity on dyspnea one month after hospitalization and recovery time. Methods: A telephone survey was conducted in patients hospitalized at the Respiratory Medicine Department, University of Thessaly, Greece, from November to December 2020. Results: Two-thirds of the patients were obese. Obesity was not associated with the hospitalization time. Two-thirds of the patients used to engage in physical activity before hospitalization. Males exercised in a higher percentage and more frequently than women before and after hospitalization. The methodical pre-hospitalization exercise was associated with lower levels of dyspnea one month after hospitalization. In-hospital weight loss, comorbidities, and dyspnea on admission independently predicted longer recovery time. Lockdown had boosted men’s desire to exercise than females who were negatively affected. Conclusions: Obesity is common in COVID-19 hospitalized patients. In-hospital weight loss, comorbidities, and dyspnea on admission predicted a longer post-hospitalization recovery time. The pre-hospitalization exercise was associated with less post-hospitalization dyspnea and recovery time.

Using social security number to identify sub-populations vulnerable to the health impacts from extreme heat in Florida, U.S

BACKGROUND

Some socioeconomically vulnerable groups may experience disproportionately higher risk of extreme heat illness than other groups, but no study has utilized the presence/absence of a social security number (SSN) as a proxy for vulnerable sub-populations.

METHODS

This study focused on the warm season from 2008 to 2012 in Florida, U.S. With a total number of 8,256,171 individual level health outcomes, we devised separate case-crossover models for five heat-sensitive health outcomes (cardiovascular disease, dehydration, heat-related illness, renal disease, and respiratory disease), type of health care visit (emergency department (ED) and hospitalization), and patients reporting/not reporting an SSN. Each stratified model also considered potential effect modification by sex, age, or race/ethnicity.

RESULTS

Mean temperature raised the odds of five heat-sensitive health outcomes with the highest odds ratios (ORs) for heat-related illness. Sex significantly modified heat exposure effects for dehydration ED visits (Males: 1.145, 95 % CI: 1.137-1.153; Females: 1.110, 95 % CI: 1.103-1.117) and hospitalization (Males: 1.116, 95 % CI: 1.110-1.121; Females: 1.100, 95 % CI: 1.095-1.105). Patients not reporting an SSN between 25 and 44 years (1.264, 95 % CI: 1.192-1.340) exhibited significantly higher dehydration ED ORs than those reporting an SSN (1.146, 95 % CI: 1.136-1.157). We also observed significantly higher ORs for cardiovascular disease hospitalization from the no SSN group (SSN: 1.089, 95 % CI: 1.088-1.090; no SSN: 1.100, 95 % CI: 1.091-1.110).

CONCLUSIONS

This paper partially supports the idea that individuals without an SSN could experience higher risks of dehydration (for those 25-45 years), renal disease, and cardiovascular disease than those with an SSN.

Physical inactivity in healthy, obese, and diabetic adults in Germany: An analysis of related socio-demographic variables

BACKGROUND

Adults with diabetes or obesity are more likely to be physically inactive than healthy adults. Physical activity is essential in the management of both diseases, necessitating targeted interventions in these groups. This study analysed physical inactivity (defined as not taking part in leisure-time physical activity) in over 100,000 adults in Germany considering their body mass index and the presence of diabetes. Furthermore, the relationship between specific socio-demographic factors with physical inactivity was investigated, particularly focussing diabetic and obese people, to refine the identification of risk-groups for targeted interventions on physical activity promotion.

METHODS

Data from 13 population-based health surveys conducted in Germany from 1997 to 2018 were used. The relevant variables extracted from these datasets were merged and employed in the analyses. We included data from 129,886 individuals in the BMI analyses and 58,311 individuals in the diabetes analyses. Logistic regression analyses were performed to identify the importance of six socio-demographic variables (age, sex/gender, education, income, employment, and migration) for the risk of physical inactivity.

RESULTS

Obese and diabetic people reported a higher prevalence of physical inactivity than those who were not affected. Logistic regression analyses revealed advanced age, low education level, and low household income as risk factors for physical inactivity in all groups. A two-sided migration background and unemployment also indicated a higher probability of physical inactivity.

CONCLUSION

Similar socio-demographic barriers appear to be important determinants of physical inactivity, regardless of BMI status or the presence of diabetes. However, physical activity promoting interventions in obese and diabetic adults should consider the specific disease-related characteristics of these groups. A special need for target group specific physical activity programmes in adults from ethnic minorities or of advanced age was further identified.

Associations of partnering transition and socioeconomic status with a four-year change in daily steps among Finnish adults

Aim: The aim of this prospective four-year follow-up study was to examine how socioeconomic status (SES) and change in marital status are associated with the change in pedometer-measured physical activity (PA) in adulthood among participants in the ‘Cardiovascular Risk in Young Finns Study’. Methods: Questionnaires were completed and pedometers worn at baseline in 2007 and again at follow-up in 2011 by 1051 Finnish adults (62.3% female, aged 30–45 years in 2007). A latent change score model was used to examine mean change in daily total steps, aerobic steps and non-aerobic steps during weekdays and weekend days between 2007 and 2011. Results: In women re-coupling or finding a new partner was associated with decrease in total steps ( p=0.010) and being single was associated with increase in non-aerobic steps ( p=0.047) during weekdays from 2007 to 2011 compared to women who were married. In men, divorcing was associated with decrease in non-aerobic steps ( p=0.049). Conclusions: In order to promote PA in the general population of adults, it is recommended to pay attention to people with lower SES and those who have had changes in their marital status. These factors could be taken into account when developing strategies to promote PA among the adult population.

Measurement properties of tools used to assess depression in adults with and without autism spectrum conditions: A systematic review

Depression is the most commonly experienced mental health condition in adults with autism spectrum conditions (ASC). However, it is unclear what tools are currently being used to assess depression in ASC, or whether tools need to be adapted for this group. This systematic review therefore aimed to identify tools used to assess depression in adults with and without ASC, and then evaluate these tools for their appropriateness and measurement properties. Medline, PsychINFO and Web of Knowledge were searched for studies of depression in: (a) adults with ASC, without co‐morbid intellectual disability; and (b) adults from the general population without co‐morbid conditions. Articles examining the measurement properties of these tools were then searched for using a methodological filter in PubMed, and the quality of the evidence was evaluated using the COSMIN checklist. Twelve articles were identified which utilized three tools to assess depression in adults with ASC, but only one article which assessed the measurement properties of one of these tools was identified and thus evaluated. Sixty‐four articles were identified which utilized five tools to assess depression in general population adults, and fourteen articles had assessed the measurement properties of these tools. Overall, two tools were found to be robust in their measurement properties in the general population—the Beck Depression Inventory (BDI‐II), and the patient health questionnaire (PHQ‐9). Crucially only one study was identified from the COSMIN search, which showed weak evidence in support of the measurement properties of the BDI‐II in an ASC sample. Implications for effective measurement of depression in ASC are discussed. Autism Res2018, 11: 738–754. © 2018 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc.

Lay Summary

Depression is the most common mental health problem experienced by adults with autism. However, the current study found very limited evidence regarding how useful tools developed for the general population are for adults with autism. We therefore suggest how these tools could be adapted to more effectively assess depression in adults with autism, and improve these individuals access to mental health assessment and support.

Gender differences in the longitudinal associations of depressive symptoms and leisure-time physical activity with cognitive decline in ≥57year-old Taiwanese

OBJECTIVE

This study investigates the role of gender in the associations of long-term depressive symptoms and leisure-time physical activity (LTPA) with the risk of cognitive decline in elderly Taiwanese.

METHOD

We analyzed 3679 subjects (age ≥57) in the 2003 and 2007 datasets of the Taiwan Longitudinal Survey on Aging, of which data were collected via face-to-face interviews by trained interviewers. We excluded proxy respondents. Multivariable logistic regression analysis examined the associations of long-term depressive symptoms (increased symptoms: CES-D10 scores from <10 to ≥10; decreased symptoms: from ≥10 to <10) and LTPA (frequency, duration, and intensity) with cognitive decline (a decrease of two or more SPMSQ scores).

RESULTS

Women had significant higher percentages of cognitive impairment, compared to men, at the baseline (5.9 vs. 1.5%; χ(2)=51.24, p<0.001) and end-point (10.8 vs. 5.2%;χ(2)=39.5, p<0.001). Men with long-term depressive symptoms had 5.28 greater odds of cognitive decline (OR=5.28, 95%CI=2.84-9.82, p<0.001) and men with increased depressive symptoms had 2.09 greater odds (2.09, 1.24-3.51, p=0.006). No such association was observed in women. Men with consistently high LTPA had 65% (0.35, 0.19-0.65, p=0.001) and women with increased LTPA had 43% (0.57, 0.34-0.93, p=0.024) reduction in odds of developing cognitive decline.

CONCLUSION

We found gender differences in the longitudinal association between depressive symptoms and cognitive decline. Long-term LTPA may loosen the association between long-term depressive symptoms and cognitive decline. These findings are useful in the identification of vulnerable elderly in the Taiwanese population and public health interventions should focus on assisting their cognitive aging.

Introducing an Outcome Expectation Questionnaire and Its Psychometric Properties Regarding Leisure Time Physical Activity for Iranian Male Adolescent

BACKGROUND

Outcome expectation (OE) is known as a psychosocial determinant of leisure time physical activity (LTPA). Despite importance of this construct evaluation, there is no evidence of special questionnaire for measuring OE in Persian speaking Iranian male adolescents.

OBJECTIVES

This article reports development and psychometric evaluation process of a specific questionnaire that evaluates OE about LTPA among Iranian male adolescents.

MATERIALS AND METHODS

Literature review and group discussions were used to select 26 items of this questionnaire based on 3 dimensions of OE (self-evaluation, social expectancy, and physical expectancy). All Participants (n = 720) were divided into two groups randomly after evaluating comprehensibility, face and content validity, and items analysis. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were separately operated on one of these groups for evaluation of the construct validity of questionnaire. The reliability of the questionnaire was estimated by the Cronbach α.

RESULTS

EFA extracted 3 main factors explained 45.80%, 10.31%, and 7.51% of OE variance, respectively. Almost all fit indexes in CFA were acceptable (CMIN = 107.39, CMIN/DF = 2.619, CFI = 0.938, PCFI = 0.699, RMSEA = 0.067, PCLOSE = 0.034). Finally 11 items remained in the questionnaire, which showed excellent reliability on main study (α = 0.85).

CONCLUSIONS

This study provided evidence regarding the reliability and validity of the Iranian male adolescent outcome expectation about leisure time physical activity (IMAO-PAC) and illustrated that this new questionnaire can be used to measure the perceived exercise benefits among target group in observational and interventional studies.

Relações hipotéticas entre os determinantes sociais da saúde que influenciam na obesidade em idosos

Os elevados índices de prevalência de obesidade em idosos suscitam a necessidade de compreender os fatores envolvidos nesta desordem nutricional, por meio de métodos quantitativos que permitam uma análise relacional desses determinantes. O objetivo deste estudo foi propor um modelo hipotético que estabeleça as relações entre os determinantes sociais da saúde associados à obesidade em idosos. Para a construção do modelo hipotético, foram delineadas as variáveis latentes e observadas de acordo com a análise de 45 artigos nacionais e internacionais e em concordância com o referencial da Modelagem de Equações Estruturais. Foi construído um diagrama representativo para evidenciar as correlações entre os 11 determinantes sociais da saúde relacionados à obesidade no idoso: atividade física, tabagismo, etilismo, consumo alimentar, contato social, ocupação, renda, escolaridade, idade, sexo e estado civil. Espera-se que as relações hipotéticas estabelecidas no estudo contribuam para a compreensão das relações dos fatores que estão envolvidos nesse contexto visando ao desenvolvimento de estratégias para a saúde da pessoa idosa.

[Physical activity in adult working population: results from the European National Health Survey for Spain (2009)]

Objetivos

1) Describir la actividad física realizada por la población española trabajadora entre los 16 y los 70 años, y 2) determinar las variables sociodemográficas, la percepción del estado de salud y los hábitos relacionados con estilos de vida asociados a la actividad física en población adulta trabajadora.

Diseño

Estudio observacional, utilizando la Encuesta Europea de Salud en España.

Emplazamiento

Comunitario.

Participantes

Los sujetos con edades entre 16-70 años fueron 10.928 (5.628 mujeres, 5.300 hombres).

Intervenciones

No se aplicó ninguna intervención.

Mediciones principales

La actividad física y su intensidad fueron valoradas mediante preguntas incluidas en la encuesta. Se analizaron variables sociodemográficas, la percepción del estado de salud y variables de salud, utilizando modelos multivariados de regresión logística.

Resultados

No tener pareja (OR 1,44; p < 0,001), tener estudios universitarios (OR 1,62; p < 0,001), no fumar (OR 1,50; p < 0,001) y tomar medicación (OR 1,22; p < 0,5) eran predictores de actividad física intensa en los hombres. En las mujeres se asoció significativamente con los 3 primeros factores. Por el contrario, la obesidad (OR 0,58; p < 0,001) y tener 36-50 años (OR 0,68; p < 0,001) se asociaron con sedentarismo en los hombres. Tener ≥ 2 enfermedades (OR 1,30; p < 0,001), no fumar (OR 1,17; p < 0,5) y tener 36-50 años (OR 1,26; p < 0,01) estaban asociados a una actividad moderada en las mujeres. El estado mental positivo fue significativo para la actividad física intensa en ambos sexos (OR 1,01; p < 0,5).

Conclusiones

Se identifican factores que pueden influir en la actividad física de la población española trabajadora, con implicaciones para las estrategias y políticas de salud pública.

Prevalence of leisure-time sedentary behaviour and sociodemographic correlates: a cross-sectional study in Spanish adults

Background

Being physically inactive has been linked to a higher mortality and poorer quality of life. This cross-sectional study examines the prevalence of leisure-time sedentary behaviour in a population of Spanish adults and its correlates with several sociodemographic variables.

Methods

Data were collected from 1,330 subjects living in Madrid (age: 18-65 years, 51.6% women) by telephone interview. The sampling error was ±2.7% for a 95.5% confidence level. Leisure-time sedentary behaviour was assessed using the Global Physical Activity Questionnaire (version 2). Further factors examined were: country of birth, sex, age, civil state, education level, employment and economic status and physical activity of parents.

Results

76.3% of the subjects interviewed reported a mostly sedentary leisure-time lifestyle. The remaining subjects (23.7%) reported a moderate to high level of physical activity, meeting minimum recommendations. Logistic regression adjusted for all variables identified the following population subsets as showing a greater risk of sedentary behaviour: women (odds ratio (OR) = 2.14; 95% confidence interval (CI): 1.64, 2.79), participants aged 41-50 years (OR = 1.64; 95%CI:1.05, 2.51), those with a middle economic status (OR = 1.48; 95% CI: 1.04, 2.10) or not providing information about their income (OR = 1.97; 95% CI: 1.05, 3.67), and those whose father (OR = 1.53; 95% CI: 1.13, 2.07) and/or mother (OR = 1.41; 95% CI: 1.01, 1.97) were never physically active during leisure-time.

Conclusions

The high prevalence of self-reported sedentary behaviour recorded suggests the need for public health policies targeted at increasing leisure-time physical activity levels. Our data identified several population subsets as priority candidates for possible interventions pursuing this goal.

Association between habitual physical activity and lower cardiovascular risk in premenopausal, perimenopausal, and postmenopausal women: a population-based study

OBJECTIVE

Menopause is associated with an increased risk of cardiovascular disease. Habitual physical activity, defined as any form of body movement with energy expenditure above resting levels, may improve health parameters. We assessed the level of habitual physical activity and its effect on anthropometric measures and cardiovascular risk factors in a cohort of premenopausal, perimenopausal, and postmenopausal women.

METHODS

This cross-sectional study is nested on a longitudinal population-based study that was begun in 1995 in the city of Passo Fundo, Brazil. For the present analysis, 292 women were included. Anthropometric and metabolic profile was evaluated. Habitual physical activity was assessed by a digital pedometer for 7 days, and participants were stratified into active and inactive (≥6,000 and <6,000 steps/day, respectively).

RESULTS

The mean (SD) age was 57.1 (5.4) years. The average number of steps per day for the total sample was 5,250.7 (3,372.9): 3,472.4 (1,570.2) in the inactive group (61.8%) and 9,055.9 (3,033.4) in the active group (31.9%). A negative and statistically significant correlation was found between physical activity and smoking (P = -0.019), body mass index (P = -0.006), waist circumference (P = -0.013), and waist-to-hip ratio of 0.85 or higher (P = -0.043). Inactive women presented a higher risk of overweight/obesity (odds ratio [OR], 2.1; 95% CI, 1.233-3.622; P = 0.006) and waist circumference larger than 88 cm (OR, 1.7; 95% CI, 1.054-2.942; P = 0.03), even after adjustment for age, menopause status, smoking, and hormone therapy. Inactive women also had a higher risk of diabetes mellitus (OR, 2.7; 95% CI, 1.233-6.295; P = 0.014) and metabolic syndrome (OR, 2.5, 95% CI, 1.443-4.294; P = 0.001).

CONCLUSIONS

Habitual physical activity, specifically walking 6,000 or more steps daily, was associated with a decreased risk of cardiovascular disease and diabetes in middle-aged women, independently of menopause status.

Nicotine dependence matters: examining longitudinal association between smoking and physical activity among Canadian adults

OBJECTIVE

A number of studies point to the inverse relationship between physical activity and smoking; however, none has examined the role of nicotine dependence in physical activity participation among smokers. This study examined whether levels of nicotine dependence modify the association between leisure time physical activity and smoking status.

METHODS

The study used longitudinal data on 6795 adults from the Canadian National Population Health Survey (2004-2010). Generalized estimating equations were used to examine the association between physical activity, smoking, and nicotine dependence.

RESULTS

We found that nicotine dependent smokers were significantly less likely to be physically active compared to non-smokers. Specifically, using the Fagerstrom Test for Nicotine Dependence, nicotine dependent smokers (OR 0.65, 95% CI 0.55-0.76) were less likely to be physically active while no significant difference was found for non-dependent smokers (OR 0.90, 95% CI 0.80-1.02) compared to non-smokers.

CONCLUSIONS

Nicotine dependence matters in shaping engagement in physical activity among daily smokers. Efforts directed at promoting smoking cessation through nicotine dependence treatment intervention may provide additional benefits to health and well-being through an increased participation in physical activity.

The association between physical fitness and depressive symptoms among young adults: results of the Northern Finland 1966 birth cohort study

Background

The effect of physical activity on mental health has been the subject of research for several decades. However, there is a lack of studies investigating the association between physical fitness, including both cardiorespiratory and muscular fitness and depressive symptoms among general population. The aim of this study was to determine the association between physical fitness and depressive symptoms among young adults.

Methods

The study population consists of 5497 males and females, members of the Northern Finland birth cohort of 1966, who at age 31 completed fitness tests and filled in a questionnaire including questions about depressive symptoms (Hopkins’ Symptom Checklist-25) and physical activity. Cardiorespiratory fitness was measured by a 4-min step test and muscular fitness by tests of maximal isometric handgrip and isometric trunk extension. The odds ratios (OR) with 95% confidence intervals (95% CI) for having depressive symptoms were calculated for quintiles groups of physical fitness using the third, median quintile as reference group, and the results were adjusted for potential confounding variables.

Results

Depressive symptoms were most common among males and females in the lowest quintile group of trunk extension test (OR 1.58 and 95% CI 1.07-2.32 in males and OR 1.43 and 95% CI 1.03-2.0 in females) and among males in the lowest quintile group of handgrip strength (OR 1.64 95% CI 1.11-2.42) compared to the reference group. Level of self-reported physical activity was inversely associated with depressive symptoms both in males (OR 1.74 95% CI 1.25-2.36) and females (OR 1.36 95% CI 1.05-1.75). The cardiorespiratory fitness was not associated with depressive symptoms (OR 1.01 95% CI 0.68-1.49 in males and 0.82 95% CI 0.57-1.16 in females).

Conclusions

The results indicate that low level of isometric endurance capacity of trunk extensor muscles is associated with high level of depressive symptoms in both sexes. In males, also poor handgrip strength is associated with increased levels of depressive symptoms. The physical activity level is inversely associated with the prevalence of depressive symptoms among young adults.

Socioeconomic Inequality of Non-Communicable Risk Factors among People Living in Kurdistan Province, Islamic Republic of Iran

BACKGROUND

The most fundamental way to decrease the burden of noncommunicable diseases (NCDs) is to identify and control their related risk factors. The goal of this study is to determine socioeconomic inequalities in risk factors for NCDs using concentration index based on Non-Communicable Disease Surveillance Survey (NCDSS) data in Kurdistan province, Islamic Republic of Iran in 2005 and 2009.

METHODS

The required data for this study are taken from two NCDSSs in Kurdistan province in 2005 and 2009. A total of 2,494 persons in 2005 and 997 persons in 2009 were assessed. Concentration index was used to determine socioeconomic inequality. To assess the relationship between the prevalence of each risk factor and socioeconomic status (SES), logistic regression was used and odds ratio (OR) was calculated for each group, compared with the poorest group.

RESULTS

The concentration index for hypertension was -0.095 (-0.158, -0.032) in 2005 and -0.080 (-0.156, -0.003) in 2009. The concentration index for insufficient consumption of fruits and vegetables was -0.117 (-0.153, -0.082) in 2005 and -0.100 (-0.153, -0.082) in 2009. The concentration index for the consumption of unhealthy fat and oil was -0.034 (-0.049, -0.019) in 2005 and -0.108 (-0.165, -0.051) in 2009. The concentration index for insufficient consumption of fish was -0.070 (-0.096, -0.044) in 2005. The concentration index for physical inactivity was 0.008 (-0.057, 0.075) in 2005 and 0.139 (0.063, 0.215) in 2009. In all the cases, the OR of the richest group to the poorest group was significant.

CONCLUSION

Hypertension, insufficient consumption of fruits and vegetables, consumption of unhealthy fat and oil, and insufficient consumption of fish are more prevalent among poor groups. There was no significant socioeconomic inequality in the distribution of smoking, excess weight, and hypercholesterolemia. Physical inactivity was more prevalent among the rich groups of society in 2009. The reduction of socioeconomic inequalities must become a main goal in health-care policies.

Prevalence of physical activity among adults in a metropolitan Nigerian city: a cross-sectional study

BACKGROUND

Baseline information on physical activity is relevant to controlling the epidemic of chronic noncommunicable diseases occurring in many African countries. However, standardized data on physical activity are lacking in Nigeria. We assessed the prevalence of physical activity and its relationships with sociodemographic characteristics in a subnational sample of Nigerian adults.

METHODS

A cross-sectional survey was conducted among a representative sample of 934 adults (age, 20-82 years) living in metropolitan Maiduguri, Nigeria. Physical activity was measured using the validated Nigerian version of the International Physical Activity Questionnaire (Hausa IPAQ-SF). Using the World Health Organization (WHO) guideline, participants were classified as sufficiently active or insufficiently active. Sociodemographic correlates of sufficient physical activity were identified using multinomial logistic regression.

RESULTS

Overall, 68.6% of Nigerian adults were sufficiently active. There was no significant difference (P > 0.05) in prevalence of physical activity between men (68.0%) and women (69.3%), but physical activity tended to decrease with increasing age category, especially among men. Physical activity prevalence was positively associated with being married (OR = 1.52, CI = 1.04-4.37) and blue collar work (OR = 2.19, CI = 1.16-4.12) and negatively associated with car ownership (OR = 0.38, CI = 0.17-0.86) and higher income (OR = 0.54, CI = 0.10-0.95).

CONCLUSIONS

The prevalence of physical activity varied between sociodemographic subgroups of Nigerian adults; thus, public health policies and interventions based on ecologic models of health behaviors may be warranted in promoting physical activity in Nigeria.

Prevalence and patterns of physical activity among medical students in Bangalore, India

Background:

Physical activity is one of the leading health indicators. The objective was to study the prevalence and patterns of physical activity among young adults.

Methods:

259 Medical students (Men: Women = 116:143) in the age group of 18–22 yrs were interviewed using the official English long version of the International Physical Activity Questionnaire (IPAQ). The total level of physical activity and activity in each of the 4 life domains – work, transport, domestic and gardening and leisure-time were estimated and was expressed as metabolic equivalent-hours per week (MET-hour/week).

Results:

41.3 % showed high levels of physical activity, 43.2% and 15.4 % of students showed moderate level and low level of physical activity respectively. 84.6 % (n=219) were engaged in work related activity and 80.7% (n= 209) showed transport related activity. Domestic and gardening physical activity represented 63.7 % (n=165) of individuals total activity and 67.2% of students showed leisure time activity. The average time spent in sitting was 7.06 hrs/day. The median of the total physical activity for the whole sample was 39.13 MET/hour/week and 18.10 for work, 4.40 for transportation, 2.60 for domestic and gardening and 4 for leisure-time activity. There was significant gender difference observed with women having low physical activity.

Conclusion:

This study provides baseline information about the physical activity levels and patterns including sitting hours among Indian young adults using IPAQ that can used for comparison of data across different parts of world.

Prevalence and sociodemographic correlates of all domains of physical activity in Brazilian adults

OBJECTIVE

To estimate the prevalence and sociodemographic indicators associated with physical inactivity in leisure, commuting, work, and household in adults in Florianopolis, Brazil.

METHODS

Population-based cross-sectional study was conducted from September 2009 to January 2010, with adults between 20 to 59 years of age (n=1720). Sociodemographic indicators and physical inactivity in each domain were assessed by a validated questionnaire, applied through face-to-face interviews.

RESULTS

The prevalence of physical inactivity in each domain was: leisure (52.5%); commuting (50.4%); work (80.9%); and household (57.6%). Women were 27% more inactive in leisure, while men were significantly more inactive at commuting and household (p<0.001). Older adults were more inactive in leisure (p=0.04) and commuting (p=0.05). Physical inactivity in leisure was higher in black adults and those who living with a partner and with lower educational level and lower income. In commuting, those living with a partner and who had higher income were more inactive. Physical inactivity at work was higher in white or brown adults, who had higher educational level and higher income. Physical inactivity in household was found to be higher in adults with higher educational level and higher income.

CONCLUSIONS

Sociodemographic indicators presented different associations with physical inactivity in each domain.

Stage of change of 6 health-related behaviors among patients with type 2 diabetes

AIMS

Assessing patients' current stage of change toward 6 healthy behaviors related to diabetes control. Behaviors studied were smoking cessation (2) regular exercise; (3) consuming 5 servings or more of fruits and vegetables; (4) decreasing intake of refined sugar; (5) reducing saturated fat; and (6) self monitoring of blood glucose (SMBG).

METHODS

Stage of change (SOC) for several diabetes control-related behaviors was assessed for 737 patients with type 2 diabetes using a staging algorithm. Socio-demographic data were collected by a structured interview-based questionnaire.

RESULTS

There was high degree of readiness toward consuming diets with less saturated fat and simple sugar. Very low degree of readiness was reported for self-monitoring of blood glucose on a regular bases and for practicing physical exercise. Half of the participants (50.9%) were in the precontemplation stage for consuming ≥5 servings of fruits and vegetables every day. Significant correlations were obtained between the degree of readiness for several behaviors (p<0.01). Age, gender, income and education were all related to the stage of change of the studied behaviors (p<0.01).

CONCLUSIONS

Patients with diabetes in Jordan are still in the pre-action stages for practicing exercise, consuming 5 servings or more of fruit and vegetable, and self-monitoring of blood glucose. The current finding suggests a need for nutritional education and interventions to raise awareness of lifestyle factors influencing glycemic control among diabetics.

Socioeconomic inequalities in occupational, leisure-time, and transport related physical activity among European adults: a systematic review

Background

This study systematically reviewed the evidence pertaining to socioeconomic inequalities in different domains of physical activity (PA) by European region.

Methods

Studies conducted between January 2000 and December 2010 were identified by a systematic search in Pubmed, Embase, Web of Science, Psychinfo, Sportdiscus, Sociological Abstracts, and Social Service Abstracts. English-language peer-reviewed studies undertaken in the general population of adults (18–65 years) were classified by domain of PA (total, leisure-time including sport, occupational, active transport), indicator of socioeconomic position (education, income, occupation), and European region. Distributions of reported positive, negative, and null associations were evaluated.

Results

A total of 131 studies met the inclusion criteria. Most studies were conducted in Scandinavia (n = 47). Leisure-time PA was the most frequently studied PA outcome (n = 112). Considerable differences in the direction of inequalities were seen for the different domains of PA. Most studies reported that those with high socioeconomic position were more physically active during leisure-time compared to those with low socioeconomic position (68% positive associations for total leisure-time PA, 76% for vigorous leisure-time PA). Occupational PA was more prevalent among the lower socioeconomic groups (63% negative associations). Socioeconomic differences in total PA and active transport PA did not show a consistent pattern (40% and 38% positive associations respectively). Some inequalities differed by European region or socioeconomic indicator, however these differences were not very pronounced.

Conclusions

The direction of socioeconomic inequalities in PA in Europe differed considerably by domain of PA. The contradictory results for total PA may partly be explained by contrasting socioeconomic patterns for leisure-time PA and occupational PA.

Relationship between the physical environment and different domains of physical activity in European adults: a systematic review

BACKGROUND

In the past decade, various reviews described the relationship between the physical environment and different physical activity (PA) domains. Yet, the majority of the current review evidence relies on North American/Australian studies, while only a small proportion of findings refer to European studies. Given some clear environmental differences across continents, this raises questions about the applicability of those results in European settings. This systematic review aimed at summarizing Europe-specific evidence on the relationship between the physical environment and different PA domains in adults.

METHODS

Seventy eligible papers were identified through systematic searches across six electronic databases. Included papers were observational studies assessing the relationship between several aspects of the physical environment and PA in European adults (18-65y). Summary scores were calculated to express the strength of the relationship between each environmental factor and different PA domains.

RESULTS

Convincing evidence on positive relationships with several PA domains was found for following environmental factors: walkability, access to shops/services/work and the composite factor environmental quality. Convincing evidence considering urbanization degree showed contradictory results, dependent on the observed PA domain. Transportation PA was more frequently related to the physical environment than recreational PA. Possible evidence for a positive relationship with transportation PA emerged for walking/cycling facilities, while a negative relationship was found for hilliness. Some environmental factors, such as access to recreational facilities, aesthetics, traffic- and crime-related safety were unrelated to different PA domains in Europe.

CONCLUSIONS

Generally, findings from this review of European studies are in accordance with results from North American/Australian reviews and may contribute to a generalization of the relationship between the physical environment and PA. Nevertheless, the lack of associations found regarding access to recreational facilities, aesthetics and different forms of safety are likely to be Europe-specific findings and need to be considered when appropriate interventions are developed. More research assessing domain-specific relationships with several understudied environmental attributes (e.g., residential density) is needed.

Association of smoking, physical activity, and dietary habits with socioeconomic variables: a cross-sectional study in adults on both sides of the Hungarian-Romanian border

Background

The association between socioeconomic status and health-related behaviours has been clarified in several epidemiological studies. The aim of this study was to reveal the socioeconomic differences in health-related behaviours and in nutritional status of Hungarian and Romanian citizens living on both sides of the border.

Methods

A cross-sectional study based on interviewer-administered questionnaires was conducted on both sides of the Hungarian-Romanian border. The survey was completed by 1, 099 Hungarians (Hu) and 852 Romanians (Ro) aged 18 years and over; the overall participation rate was 92.9%. Demographic and socioeconomic factors, health-related behaviours (smoking, dietary habits and physical activity), body weight and height were recorded. All analyses were performed separately for Hungarians and Romanians. Simple descriptive statistics and logistic regression models were used to measure the associations between socioeconomic status and behaviour, as well as obesity.

Results

The prevalence of smoking was similar in Hungarians and Romanians (33.2% and 36.4%). The frequency of "unhealthy diet" was 70.6% in Hungarians and 75.2% in Romanians. Physical inactivity was more prevalent in Romanians (73.2%) than in Hungarians (32.0%), while the prevalence of obesity was higher in Hungarians (22.0%) than in Romanians (16.5%). Based on the univariate logistic regression models the risk of smoking was higher among those with medium educational level (ORHu = 1.66) and poor financial conditions (ORHu = 3.13) in Hungarians. The risk of unhealthy diet was higher among the low educated (ORHu = 1.77; ORRo = 7.91) and among those with poor financial conditions (ORHu = 2.05; ORRo = 4.25). None of the socioeconomic factors was associated with leisure time physical inactivity. In the multivariate models obesity was associated with medium level of education in Hungarians, and with unhealthy diet in Romanians (ORRo = 2.10). Physically inactive Hungarians were more (ORHu = 1.74), whereas inactive Romanians were less (ORRo = 0.64) likely to be obese than physically active people from the same country.

Conclusions

The present study shows that socioeconomic status is associated with health-related behaviours in a small area of Hungary and Romania. The results highlight the need for developing interventional strategies, focusing more on people in lower socioeconomic status, in order to reduce the existing inequalities in health and health-related behaviours.

Physical exercise in southern Germany: a cross-sectional study of an urban population

OBJECTIVES

The aim of this study was to investigate the degree of physical exercise and self-assessment of physical fitness (PF) and their relationship to health- and behaviour-specific factors in a randomly selected sample of an urban population in southern Germany.

DESIGN

Cross-sectional study.

SETTING

In the southern German city of Leutkirch.

PARTICIPANTS

2187 subjects randomly selected from the registry of inhabitants. Of the selected group, aged 18-65 years, 52.1% were women and 47.9% men.

PRIMARY AND SECONDARY OUTCOME MEASURES

Participants were asked how many hours per week they spent on physical exercise and sports. They were also asked to rate their own performance and/or PF.

RESULTS

Overall, 38.9% of the participants reported no physical exercise. Men reported a higher level of physical exercise than did women. Less exercise was reported by subjects with diabetes, high body mass index and waist-to-hip ratio and by those who were underweight. Alcohol consumption, smoker status and higher educational level showed a positive association with physical exercise. A negative trend with respect to moderate physical exercise was observed for those with metabolic syndrome, diabetes, hypertension and hepatic steatosis, but this was statistically significant only for subjects with diabetes. In both men and women, there was a relationship between self-assessed 'good' PF and high physical exercise.

CONCLUSIONS

The data show that a large proportion of the study population is not physically active; specific risk groups (overweight subjects, older subjects, smokers or subjects with low educational level) are even less active. The data suggest that there is a great potential for measures promoting physical exercise in these groups.

Fatores sociodemográficos e atividade física de lazer entre homens e mulheres de Duque de Caxias/RJ

OBJETIVOS: Avaliar prevalência, atividades praticadas no tempo destinado ao lazer (AFL) e suas variáveis associadas, entre gêneros, em Duque de Caxias/Rio de Janeiro, Brasil. Material e métodos: Trata-se de um estudo transversal, de base populacional, composto por 1246 adultos. Durante as visitas domiciliares foram aplicados questionários avaliando a prática de AFL, fatores sociodemográficos e medidas antropométricas. RESULTADOS: A inatividade física foi elevada (70%) (p-valor <0,001) sendo os homens mais ativos (43,3%) que as mulheres (20%) (p-valor < 0,0001). Homens praticaram significativamente mais AFL competitivas e do universo masculino. Tomar conta de crianças foi um fator que aumentou a chance dos homens se engajarem em AFL (OR=2,75, p-valor=0,034), enquanto que entre as mulheres, aquelas que dispendiam menos tempo em atividades domésticas (OR=0,99, p-valor=0,016), não fumavam (OR=2,63, p-valor=0,039) e que apresentavam maior acúmulo de gordura abdominal (OR=2,72, p-valor=0,023), tinham mais chance de praticarem AFL. CONCLUSÃO Conclui-se que homens repetiram modelo de escolhas de AFL consideradas masculinas. Fatores sócio-demográficos e medidas antropométricas se associaram com AFL de forma diferente entre gêneros.

Leisure Time Physical Activity and Its Determinants among Adults in Tehran: Tehran Lipid and Glucose Study

OBJECTIVES

The aim of this study was to assess leisure time physical activity and its determinants among adults in Tehran.

METHODS

This cross-sectional study comprised adults (n = 7285), aged 20 years and older. The subjects were participants of the Tehran Lipid and Glucose Study between 2002 and 2004. Information on the number of days spent on different activities during a week and the time devoted to each activity on a typical day was recorded. In addition, each activity, weighted by its relative intensity, was referred to as a metabolic equivalent.

RESULTS

The prevalence of inactivity was 69.8% (95% CI: 68.7-70.8) in the whole population and 30.2% (95% CI: 27.2-33.1%) of men and 30.3% (95% CI: 27.7-32.8%) of women were considered as active. Leisure time physical activity less than 30 min/week was scored in 1590 (50.6%) men and 1803 (43.5%) women. The most frequent leisure time physical activity performed by men (96.1%) and women (95.2%) was walking. A negative association was observed in men between leisure time physical activity and increased work hours, older age, more cigarette smoking and higher body mass index (69.8% were overweight and 75.3% were obese; P < 0.05). Leisure time physical activity was more likely to be associated with high educational levels in men. In addition, there was a statistically significant relationship between physical inactivity and occupation in both men and women.

CONCLUSIONS

The prevalence of physical inactivity among adults in Tehran was high. Leisure time physical inactivity was more likely to be associated with older age, more cigarette smoking, more working hours, and higher body mass index. Public health efforts are needed to improve people's participation in physical activities in Iran.

Social support and leisure-time physical activity: longitudinal evidence from the Brazilian Pró-Saúde cohort study

Background

Although social support has been observed to exert a beneficial influence on leisure-time physical activity (LTPA), multidimensional approaches examining social support and prospective evidence of its importance are scarce. The purpose of this study was to investigate how four dimensions of social support affect LTPA engagement, maintenance, type, and time spent by adults during a two-year follow-up.

Methods

This paper reports on a longitudinal study of 3,253 non-faculty public employees at a university in Rio de Janeiro (the Pró-Saúde study). LTPA was evaluated using a dichotomous question with a two-week reference period, and further questions concerning LTPA type (individual or group) and time spent on the activity. Social support was measured by the Medical Outcomes Study Social Support Scale (MOS-SSS). To assess the association between social support and LTPA, two different statistical models were used: binary and multinomial logistic regression models for dichotomous and polytomous outcomes, respectively. Models were adjusted separately for those who began LTPA in the middle of the follow up (engagement group) and for those who had maintained LTPA since the beginning of the follow up (maintenance group).

Results

After adjusting for confounders, statistically significant associations (p < 0.05) between dimensions of social support and group LTPA were found in the engagement group. Also, the emotional/information dimension was associated with time spent on LTPA (OR = 2.01; 95% CI 1.2-3.9). In the maintenance group, material support was associated with group LTPA (OR = 1.80; 95% CI; 1.1-3.1) and the positive social interaction dimension was associated with time spent on LTPA (OR = 1.65; 95% CI; 1.1-2.7).

Conclusions

All dimensions of social support influenced LTPA type or the time spent on the activity. However, our findings suggest that social support is more important in engagement than in maintenance. This finding is important, because it suggests that maintenance of LTPA must be associated with other factors beyond the individual's level of social support, such as a suitable environment and social/health policies directed towards the practice of LTPA.

[Factors associated with global and leisure-time physical activity in the elderly: a health survey in São Paulo (ISA-SP), Brazil]

The purpose of this study was to measure the prevalence of global and leisure-time physical activity and associated factors in the elderly. This was a population-based cross-sectional study covering a multiple-stage sample of 1,950 subjects 60 years or older living in areas of São Paulo State, Brazil. Prevalence of global physical activity (assessed through the short version of the International Physical Activity Questionnaire - IPAQ) was 73.9%, and prevalence of leisure-time physical activity was 28.4%. The results highlight the differences between factors associated with global and leisure-time physical activities. The social groups most prone to overall sedentary lifestyle and especially to lack of leisure-time physical activity should be the main targets of health policies aimed at promoting healthier lifestyles.

Occupation correlates of adults' participation in leisure-time physical activity: a systematic review

CONTEXT

The rapid changes to the labor force (e.g., advances in technology, overtime hours) have increased obesogenic behaviors (e.g., lack of physical activity, sedentariness on the job).

PURPOSE

The purpose of this review was to unite and appraise the existing research examining occupation correlates of adults' participation in leisure-time physical activity (LTPA) to establish direction for future research targeting habitual inactivity.

EVIDENCE ACQUISITION

Eligible studies were searched from January 2009 to July 2010 in English peer-reviewed journals. A total of 62 studies passed the inclusion criteria. Major findings were summarized based on common subtopics of occupation category/status, occupational physical activity (OPA), work hours, psychological work demands, and LTPA.

EVIDENCE SYNTHESIS

Included articles were published between 1984 and 2010, with sample sizes ranging from 158 to 203,120. Occupation factors correlated with LTPA, but the magnitude of the effect was difficult to determine because of heterogeneous measures. Occupation category/status was directly associated with LTPA, with white-collar/professionals showing the highest LTPA compared to blue-collar workers. When OPA was measured, a positive association with LTPA was found. Work hours appeared to have a negative threshold effect on LTPA. Some preliminary evidence found psychosocial work demands (e.g., job strain) to be negatively correlated with LTPA levels.

CONCLUSIONS

Convincing evidence supports the premise that those employed in occupations demanding long work hours and low OPA are at risk of inactivity. Existing research has focused heavily on cross-sectional data and study-created self-report measures. Longitudinal evaluations using robust research measures (e.g., accelerometry, National occupation classification tool) are a priority for future research.

Correlates of smoking with socioeconomic status, leisure time physical activity and alcohol consumption among Polish adults from randomly selected regions

AIM

To determine the association between smoking status and leisure time physical activity (LTPA), alcohol consumption, and socioeconomic status (SES) among Polish adults.

MATERIAL AND METHODS

466 randomly selected men and women (aged 18-66 years) responded to an anonymous questionnaire regarding smoking, alcohol consumption, LTPA, and SES. Multiple logistic regression was used to examine the association of smoking status with six socioeconomic measures, level of LTPA, and frequency and type of alcohol consumed. Smokers were defined as individuals smoking occasionally or daily.

RESULTS

The odds of being smoker were 9 times (men) and 27 times (women) higher among respondents who drink alcohol several times/ week or everyday in comparison to non-drinkers (p < 0.0001 and p < 0.0001). Among men with the elementary/vocational level of education the frequency of smoking was four times higher compared to those with the high educational attainment (p = 0.007). Among women we observed that students were the most frequent smokers. Female students were almost three times more likely to smoke than non-professional women, and two times more likely than physical workers (p = 0.018).

CONCLUSION

The findings of this study indicated that among randomly selected Polish man and women aged 18-66 smoking and alcohol consumption tended to cluster. These results imply that intervention strategies need to target multiple risk factors simultaneously. The highest risk of smoking was observed among low educated men, female students, and both men and women drinking alcohol several times a week or every day. Information on subgroups with the high risk of smoking will help in planning future preventive strategies.

Body mass index and regular smoking in young adult women

Little is known about the relationship between relative body weight and transition from experimentation to regular smoking in young adult women. In the current study, data from 2494 participants in wave 4 of the Missouri Adolescent Female Twin Study (aged 18-29years) who reported ever smoking a cigarette were analyzed using logistic regression. Body mass index (BMI) at time of interview was categorized according to CDC adult guidelines, and regular smoking was defined as having ever smoked 100 or more cigarettes and having smoked at least once a week for two months in a row. Since the OR's for the overweight and obese groups did not differ significantly from one another in any model tested, these groups were combined. Forty-five percent of women who had ever smoked had become regular smokers. Testing of interactions between potential covariates and levels of the categorical BMI variable revealed a significant interaction between overweight/obesity and childhood sexual abuse (CSA; p<0.001) associated with regular smoking. Among women reporting CSA, the association between overweight/obesity and having become a regular smoker was negative (n=374; OR=0.48, 95% CI: 0.28-0.81). Both underweight and overweight/obesity were positively associated with transition to regular smoking among women who did not report CSA (n=2076; OR=1.57, 95% CI: 1.05-2.35 and OR=1.73, 95% CI: 1.35-2.20, respectively). These results suggest that experiencing CSA alters the association between BMI and regular smoking in women who have experimented with cigarettes.

Physical activity and functional fitness in institutionalized vs. independently living elderly: a comparison of 70-80-year-old city-dwellers

The purpose of the study was to compare the level of energy expenditure due to physical activity (EEPA) and functional fitness (FF) in 59 women and 82 men aged 70-80 years, divided into three groups: permanent residents in assisted-living facilities (ALFs), participants in adult day care centers (DCCs) and older people living independently, members in community senior centers (CSCs). EEPA and FF were analyzed taking into consideration sex differences. The energy expenditure tended to be lower in DCCs and ALFs subjects than in CSCs members, but significant differences were obtained only in women. Women in different living settings differed only in endurance. In men, the differences were clear in most tests (endurance, strength, agility/dynamic balance) except for flexibility. Institutionalization was connected with a significantly lower level of FF and equalization of sex differences. Education seemed to be an important factor influencing the level of FF in men.

Determinants of sports, cycling, walking and overall leisure-time physical activity among postmenopausal women in Germany

OBJECTIVE

Convincing evidence exists for a beneficial effect of physical activity (PA) on health and well-being for elderly women. Nevertheless, many women in Germany are insufficiently physically active. Activity promotion programmes should target women in particular need. Thus, we examined subject-related determinants of PA for postmenopausal women in Germany.

DESIGN

Associations of sociodemographic, anthropometric, lifestyle and health-related factors with activity since the age of 50 years were assessed with multiple linear and logistic regression models, regarding overall leisure-time PA (LPA) in metabolic equivalent hours per week, engagement in sports (ever v. never), cycling (yes v. no) and walking (≥3·5 v. <3·5 h/week).

SETTING

All controls from a population-based case-control study carried out in 2002-2005 in Germany (MARIE study).

SUBJECTS

A total of 6569 postmenopausal women.

RESULTS

We found significant associations of overall LPA, sports, cycling and walking in postmenopausal years with several characteristics, among others: obese v. normal BMI (adjusted OR: ORsports = 0·73; ORcycling = 0·60; ORwalking = 0·63), tall v. short (ORsports = 1·49), worker v. medium employee (ORsports = 0·47), working full time v. unemployed/retired (ORsports = 0·80; ORwalking = 0·56), current v. non-smoker (ORsports = 0·62; ORcycling = 0·62; ORwalking = 0·82), non-German nationality (ORsports = 0·58; ORcycling = 0·41). Parity seemed more relevant than marital status for sports or cycling activity. Further, CVD, hypertension and diabetes were significantly associated with lower activity (ORsports = 0·77, 0·79 and 0·80; ORcycling = 0·80, 0·75 and 0·85, respectively).

CONCLUSIONS

Our results suggest potential target groups for promoting sports, cycling or walking activity. Postmenopausal women with chronic diseases may need to be stronger encouraged by their physicians to engage in adequate PA for the management of their diseases.

Leisure-time physical activity in a southern European mediterranean country: adherence to recommendations and determining factors

INTRODUCTION AND OBJECTIVES

To determine whether adults in Madrid, Spain adhere to leisure-time physical activity (LTPA) recommendations and to identify factors associated with adherence.

METHODS

A telephone survey of 12,037 individuals, representative of the Madrid population aged 18-64 years, was conducted. The LTPA level was quantified in metabolic equivalent (MET) hours per week from answers to a questionnaire on the frequency and duration of LTPA. This level was compared with the recommendation to engage in at least moderate activity >or=150 min/week or vigorous activity >or=60 min/week. Factors associated with adherence to the recommendation were identified using logistic regression analysis.

RESULTS

The mean LTPA level was 17.3 MET-hours/ week (95% confidence interval [CI], 16.9-17.7 MET-hours/week) and 28.8% (95% CI, 28%-29.7%) adhered to the recommendation. The recommended level was achieved more frequently in men than women (odds ratio [OR]=2.41; 95% CI, 2.20-2.64). In comparison with younger individuals, adherence decreased gradually with age until 60-64 years, when the OR was 0.20 (95% CI, 0.15-0.25). Compared with less well-educated individuals, the university-educated were more likely to meet the recommendation (OR=2.28; 95% CI, 1.82-2.87). Obese individuals achieved it less frequently (OR=0.49; 95% CI, 0.40-0.61) than normal-weight individuals. Those whose job involved low-intensity physical activity achieved it more frequently than those with sedentary occupations (OR=1.21; 95% CI, 1.10-1.34).

CONCLUSIONS

The majority of adults in Madrid did not achieve the recommended LTPA level. Adherence was lower in women, older individuals, the less well-educated and the obese, while it was greater in those with a job involving low-intensity physical activity.

Physical activity patterns of American Indian and Alaskan Native people living in Alaska and the Southwestern United States

PURPOSE

Assessment of self-reported physical activity (PA) and effects on health measures.

DESIGN

Cross-sectional analysis of baseline data from a cohort study.

SETTING

Education and Research Towards Health study participants from Alaska and the Southwestern United States enrolled from 2004 to 2007.

SUBJECTS

Total of 10,372 American Indian and Alaskan Native people (AI/AN) of at least 18 years.

MEASURES

Participants completed computer-assisted, self-administered questionnaires, and anthropometric and health measurements were taken of each participant.

ANALYSIS

Analysis of variance, chi2 tests, and multiple linear regressions were used.

RESULTS

Almost 23% of participants reported less than 30 minutes per week of moderate or vigorous activities. Half (49%) reported no vigorous activities. Characteristics associated with more time spent performing vigorous activity were male gender, age less than 40 years, higher income and education levels, and living in a rural area. Almost 70% of Alaskan participants and 36% of Southwest participants engaged in wild food-harvesting activities. Participants with higher levels of activity had significantly better clinical characteristics (high-density lipoprotein cholesterol, triglycerides, body mass index, and waist circumference).

CONCLUSION

AI/AN people engage in many different physical activities, including traditional harvesting activities. Women had lower levels of PA than men, and participation in vigorous PA was associated with better clinical characteristics. These data can be used to guide health promotion efforts in AI/AN populations.