The association between different types of physical activity and smoking behavior

Accelerometer-based sedentary time and physical activity with incident and progressive tobacco smoking in 2503 children: A 13-year mediation and temporal longitudinal study

BACKGROUND

Long-term accelerometer-based studies examining whether engaging in physical activity (PA) reduces the risk of smoking in children are lacking, and whether directly measured adiposity increases smoking risk is uncertain.

METHODS

From the Avon Longitudinal Study of Parents and Children (ALSPAC), UK birth cohort, 2503 children aged 11 years with complete smoking and at least one valid time-point movement behaviour data were followed up until age 24 years. ActiGraph assessed sedentary time (ST), light PA (LPA), and moderate-to-vigorous PA (MVPA) at ages 11, 15, and 24-year clinic visits and smoking-based questionnaires were administered, whilst fat mass was measured with dual-energy x-ray absorptiometry scanner. Data were analysed with generalized linear-mixed effect models with logit-links and structural equation models.

RESULTS

Mean [SD] age at baseline was 11.71 [0.20] years and the prevalence of smoking at ages 13, 15, and 24 years were 1.5%, 13.5%, and 26.6%, respectively. Higher MVPA at age 11 years was significantly associated with lower odds of smoking at age 13 years (odds ratio, 0.991; [95% CI, 0.983-0.999], P = 0.035). Cumulative MVPA during ages 11-24 years was significantly associated with lower odds of progressive smoking during growth from ages 13-24 years (0.992; [95% CI, 0.989-0.996], P < 0.001). Cumulative ST and LPA had no significant associations with smoking. Higher fat mass suppressed (10% suppression) the inverse relationship between MVPA and smoking. In path analysis, higher MVPA at age 15 years temporally preceded reduced smoking at age 24 years.

CONCLUSION

In the present study, engaging in MVPA from age 11 years may prevent 9 in 1000 children from starting smoking at the age of 13 years when smoking prevalence was 15 in 1000 children, i.e potentially preventing 60% of children from initiating smoking. However, the MVPA preventive approach diminished as children grew into young adults.

Association between work-related physical activity and mortality among US Cohort

PURPOSE

The benefits of leisure-time physical activity (LTPA) in reducing mortality are well-known, while the relationship between work-related physical activity (WRPA) and mortality remains controversial. The study aimed to investigate the association between WRPA and mortality, and to determine whether LTPA should be recommended in a population with a high level of WRPA.

METHOD

Data were obtained from a sample of adults aged 20-80 years included in the National Health and Nutrition Examination Survey (NHANES) cohort from 2007 to 2018. Hazard ratios (HRs) for the association between WRPA and all-cause mortality were estimated using Cox proportional regression models. All analyses were performed in accordance with NHANES guidelines, in which data were complex-weighted first and then analyzed in the next step, Statistical significance was defined as a two-sided P-value < 0.05.

RESULTS

A total of 27,567 participants were included in the study. Over a median follow-up period of 78 months, a total of 2,553 (weighted ratio, 6.5%) participants were assumed dead. The mean age (SD) of this cohort was 47.5 (16.7), and 48.5% were men. Compared to participants without WRPA (as the reference group), participants engaged in WRPA exhibited a significantly reduced risk of all-cause mortality over different time periods. Specifically, the HR for participants with less than 17.5 h of weekly participation were 0.70 (95% CI: 0.62-0.78). For those participating between 17.5 and 35 h per week, the HR was 0.80 (95% CI: 0.64-1.00), while participants engaging in more than 35 h of weekly participation had an HR of 0.71 (95% CI: 0.56-0.91).

CONCLUSIONS

WRPA is a protective factor that reduces the risk of all-cause death, especially in people without LTPA.

Chronotype and leisure-time physical activity among civil servants in Japan: a cross-sectional analysis of the Aichi workers' cohort study

BACKGROUND

The association between chronotype and leisure-time physical activity (LTPA) remains unclear. We investigated the difference in regular LTPA and for a sufficient duration between those with evening-type (ET) and morning-type chronotypes (MT).

METHODS

We conducted a cross-sectional analysis using the data of the Aichi Workers' Cohort Study. It included 3,221 men (mean [standard deviation] age: 45.0 [11.6] years) and 1,294 women (39.8 [11.2] years). Chronotypes were determined with the reduced version of the Morningness-Eveningness Questionnaire. We calculated the metabolic equivalents (METs) consumed per week based on the four types of LTPA: strolling, brisk walking, light- and moderate-intensity PA, and vigorous-intensity PA. Regular LTPA and for a sufficient duration was defined as doing once or more per week and for 30 min or longer per session, respectively. Logistic regression analysis was conducted separately by sex to calculate odds ratios of ET for regular LTPA and for a sufficient duration, adjusted for age and other factors, for each type of LTPA.

RESULTS

ET men consumed fewer total METs per week than MT men (p < .001), although this pattern is not found in women. Compared to MT men, ET men were less likely to be engaged in regular LTPA in all types of LTPA (prevalence and adjusted odds ratio [95% confidence interval]: strolling: 39.1% vs. 28.7%, 0.685 [0.524-0.895]; brisk walking: 23.9% vs. 14.4%, 0.639 [0.454-0.899]; light- and moderate-intensity PA: 15.4% vs. 8.4%, 0.613 [0.404-0.929]; vigorous-intensity PA: 21.4% vs. 16.8%, 0.715 [0.518-0.989]). They were less likely to spend a sufficient duration in brisk walking (25.9% vs. 16.5%, 0.635 [0.461-0.875]), light- and moderate-intensity PA (37.1% vs. 26.8%, 0.684 [0.521-0.899]), and vigorous-intensity PA (35.3% vs. 35.8%, 0.741 [0.568-0.968]). Compared with MT women, ET women were less likely to be engaged in strolling (30.5% vs. 22.2%, 0.629 [0.398-0.995]), and less likely to spend a sufficient duration in light- and moderate-intensity PA (27.3% vs. 15.3%, 0.561 [0.335-0.937]).

CONCLUSIONS

ET was inversely associated with LTPA in men and partly in women.

Exercise intensity and mortality in overweight and obese patients with chronic kidney disease: longitudinal analysis (1999-2016)

BACKGROUND

Chronic kidney disease (CKD) and overweight/obesity are significant global public health issues. Appropriate free-time physical activity (PA) is essential for overweight/obese patients with chronic kidney disease, but specific guidelines are lacking. The present study was conducted to determine the association between PA and all-cause mortality in these patients.

METHODS

Data from 3,434 overweight/obese adults with CKD from the 1999-2016 National Health and Nutrition Examination Surveys were analyzed. Associations between clinical/laboratory findings and PA intensity (moderate and vigorous) were investigated. The all-cause mortality of patients in different PA categories were compared by Kaplan-Meier analysis. Factors associated with all-cause mortality were determined using a Cox proportional hazards model. A restricted cubic spline was employed to obtain a more flexible and detailed representation of the relationship between PA intensity and all-cause mortality, with better predictive capability.

RESULTS

The Kaplan-Meier analysis revealed that greater all-cause mortality was associated with < 10 min/week moderate/vigorous PA (log-rank p < 0.001). A greater survival probability was associated with ≥ 150 min/week vigorous PA or 10-149 min/week moderate PA (log-rank p < 0.001). Age, gender, vigorous PA, smoking status, alcohol consumption, diabetes status, eGFR, serum albumin level, uric acid level, and blood urea nitrogen level were identified as factors associated independently with mortality in the Cox proportional hazards analysis. The restricted cubic splines revealed that these relationships were non-linear (all p < 0.05). Kaplan-Meier analysis of data from patients who engaged in 10-450 min/week moderate/vigorous PA revealed significant differences between the 0-74-min/week and other vigorous PA groups (all log-rank p < 0.001).

CONCLUSIONS

Extended durations of vigorous PA are associated with reduced all-cause mortality in overweight/obese patients with CKD. Clinicians should recommend vigorous free-time PA to these patients, and public health interventions should target this goal to maximize patient health.

The effects of physical inactivity on other risk factors for chronic disease: A systematic review of reviews

Background

The Global Burden of Disease (GBD) 2021 study updated methods for attributing burden to physical inactivity, to include all conditions from fasting plasma glucose (FPG) due to physical inactivity. However, physical inactivity influences several additional GBD risk factors that also effect other diseases. This study estimated effects of physical activity on high blood pressure (hypertension), FPG (as diabetes), osteoporosis, and LDL-cholesterol, to enable mediation effects modelling.

Methods

MEDLINE, ProQuest Central, Scopus, EMBASE, SPORTDiscus, and Cochrane Library databases were searched from inception to 29 June 2024 for systematic reviews reporting total physical activity levels as an exposure and at least one of the above GBD risk factors or BMI as outcomes.

Results

There were 25 systematic reviews that met the inclusion criteria (3 for hypertension, 5 for diabetes, 1 for osteoporosis, and 16 for LDL-cholesterol). Physical activity reduced levels of the risk factors investigated, with dose-response effects observed for blood pressure (6 % for every 600 MET-min/week; 19 % for high versus low activity level) and diabetes (14-28 % if active versus being inactive). Relative to adults not reporting any activity, approximately 600 METs/week reduced levels of LDL-cholesterol by 3.2 % (95 % CI: 1.0 % to 5.4 %) and reduced low bone mineral density by an odds ratio of 0.76 (0.64 to 0.91). No studies of high BMI were identified.

Conclusion

Current risk factor models do not comprehensively assess indirect effects of physical activity through all of the relevant biomedical risk factors. Our study estimated input parameters that can be used to assess these indirect pathways.

Weight-adjusted waist index is positively and linearly associated with all-cause and cardiovascular mortality in metabolic dysfunction-associated steatotic liver disease: findings from NHANES 1999-2018

BACKGROUND

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease. Body mass index (BMI) is the most used obesity index but has important limitations. The weight-adjusted waist index (WWI) is a novel obesity metric and accurately reflects body composition. We explored the association of WWI with all-cause and cardiovascular disease (CVD) mortality in MASLD.

METHODS

Adult participants with MASLD were included from NHANES 1999-2018. WWI was calculated by dividing the waist circumference (WC) by the square root of body weight. MASLD was diagnosed by the presence of hepatic steatosis and at least one cardiometabolic risk factor in the absence of other causes of steatosis. A fatty liver index ≥60 suggested the presence of hepatic steatosis. Mortality data was obtained by prospectively linking to the National Death Index. Multivariate Cox proportional hazards regression analyses were used to explore these associations and multiple adjustment models were constructed including crude, partial, and fully adjusted models.

RESULTS

After adjusting for all covariates including BMI, WWI remained positively and linearly associated with all-cause and CVD mortality in MASLD (hazard ratios [HR] 1.247 and 1.218, respectively). Higher WWI was associated with a significantly increased risk of mortality (both p for trend <0.05). There was an "obesity paradox" between BMI and all-cause mortality in MASLD, with significantly lower all-cause mortality in those with overweight/obesity compared to normal BMI (HR 0.625 and 0.596, respectively, p for trend = 0.024), and no association between BMI and CVD mortality. Interaction analyses indicated that these associations were influenced by several demographic variables and disease status. Time-dependent receiver operating characteristic curves indicated that the predictive value of WWI for mortality in MASLD was higher than that of BMI, WC, and waist-to-height ratio across all follow-up durations.

CONCLUSIONS

WWI was positively and linearly associated with all-cause and CVD mortality in MASLD, whereas BMI did not accurately reflect mortality risk. WWI provided the optimal predictive value for mortality compared to traditional obesity indicators. These findings emphasize the potential use of WWI as a novel obesity indicator for mortality risk assessment, stratification, and prevention in MASLD.

Determinants of moderate-to-high physical activity levels in hemodialysis patients: A multicenter cross-sectional study

Moderate physical activity is related to reduced mortality in hemodialysis patients. However, most hemodialysis patients have low physical activity levels for complex reasons. This study investigated the determinants of moderate-to-high physical activity levels and whether psychosocial correlates are associated with engagement in moderate-to-high physical activity among hemodialysis patients. A cross-sectional survey was conducted with 134 hemodialysis outpatients, aged 64.7 years, in three hemodialysis centers in Taiwan. Data on sociodemographics, comorbidities, lifestyles, and psychosocial correlates, including perceived benefits, barriers, and self-efficacy of physical activity, were collected. Multiple logistic regression analyses were performed. Results showed that patients with moderate-to-high physical activity levels constituted a significantly lower proportion of current smokers and had fewer perceived physical activity barriers and higher self-efficacy of physical activity compared with those with low levels. After adjusting for potential sociodemographic covariates, current employment, nonsmoking status, and high self-efficacy of physical activity were significantly associated with moderate-to-high physical activity levels. Developing strategies to improve the self-efficacy of physical activity, support employment, and enhance anti-smoking campaigns in hemodialysis patients can help them engage in moderate-to-high levels of physical activity.

Physical Activity Assessment of Physicians in Primary Healthcare Centers in Makkah, Saudi Arabia

BACKGROUND

Physical inactivity is a significant global health concern and a major contributor to numerous non-communicable diseases. A focus on physical activity in healthcare services, particularly among healthcare professionals, is crucial.

OBJECTIVE

This study aims to explore physical activity levels and influencing factors among physicians in Primary Healthcare Centers in Makkah, Saudi Arabia.

METHODS

A cross-sectional study was conducted involving physicians from Primary Healthcare Centers in Makkah. An online questionnaire was used to collect data, which included demographic factors and the General Practice Physical Activity Questionnaire (GPPAQ). Data were analyzed using the SPSS, version 29.0 (IBM Corp., Armonk, NY, USA).

RESULTS

Of the 194 physicians included in the study, 25.3% were found to be inactive, 24.1% moderately inactive, 25.3% moderately active, and 25.3% active. There was no significant association between the Physical Activity Index and age, gender, nationality, income, having children, or job classification. However, marital status, Body Mass Index (BMI), smoking status, and the presence of diabetes mellitus, hypertension, dyslipidemia, and depression were significantly associated with the Physical Activity Index (p<0.05).

CONCLUSION

The study provides valuable insights into the physical activity levels among physicians in Makkah, Saudi Arabia. The findings suggest the need for strategies to increase physical activity among physicians, particularly those who are single, overweight or obese, smokers, and those with certain health conditions.

Association between long-term sedentary behavior and depressive symptoms in U.S. adults

The study aimed to investigate the association between long-term sedentary behavior (LTSB) and depressive symptoms within a representative sample of the U.S. adult population. Data from NHANES 2017-2018 were used, encompassing information on demographics, depressive symptoms, physical activity (PA), and LTSB. Depressive symptoms were identified using the Patient Health Questionnaire (PHQ-9), with "depressive symptoms" defined as a PHQ-9 score of ≥ 5, and "moderate to severe depressive symptoms (MSDS)" defined as a PHQ-9 score of ≥ 10. PA and LTSB were assessed through the Global Physical Activity Questionnaire, where LTSB was interpreted as sedentary time ≥ 600 min. Restricted Cubic Spline (RCS) curves were utilized to observe potential nonlinear relationships. Binary Logistic regressions were conducted to analyze the associations. A total of 4728 participants (mean age 51.00 ± 17.49 years, 2310 males and 2418 females) were included in the study. Among these individuals, 1194 (25.25%) displayed depressive symptoms, with 417 (8.82%) exhibiting MSDS. RCS curves displayed increased risk of depressive symptoms with prolonged sedentary duration. Logistic regression models indicated significant associations between LTSB and depressive symptoms (OR 1.398, 95% CI 1.098-1.780), and LTSB and MSDS (OR 1.567, 95% CI 1.125-2.183), after adjusting for covariates. These findings suggest that LTSB may act as a potential risk factor for both depressive symptoms and MSDS in the studied population.