Classification of occupational activity categories using accelerometry: NHANES 2003-2004

Socioeconomic status and health disparities drive differences in accelerometer-derived physical activity in fatty liver disease and significant fibrosis

BACKGROUND AND AIMS

The cornerstone of clinical management of patients with nonalcoholic fatty liver disease (NAFLD) are lifestyle changes such as increasing physical activity (PA) aimed at improving cardiometabolic risk. To inform NAFLD prevention and treatment guidelines we aimed to: (i) quantify the role of PA on lowering the risk for NAFLD and fibrosis; (ii) characterize NAFLD and fibrosis association with PA in the context of socioeconomic environment.

METHODS

A sample of 2648 participants from the NHANES 2003-2006 was selected to develop survey weighted multivariable logistic regression models for predicting NAFLD and significant fibrosis, diagnosed non-invasively via fatty liver index (FLI) and fibrosis-4 (FIB-4) index. The PA measures were obtained from a hip-worn accelerometer.

RESULTS

The predictive model for NAFLD showed AUC of 0.687 and a decrease of 43% in NAFLD risk with moderate vigorous PA (MVPA) (OR = 0.569, p < 0.001). The predictive model for fibrosis had AUC of 0.755 and there was a 48% and a 70% decrease in significant fibrosis risk with MVPA (OR = 0.518, p = 0.022) and total log activity count (TLAC) (OR = 0.296, p = 0.017), respectively. Participants with NAFLD and NAFLD with fibrosis engage in declining PA. Despite having jobs with higher level of PA and participating in more moderate-to-vigorous PA, a larger proportion of Hispanics participants had NAFLD and significant fibrosis.

CONCLUSIONS

These findings demonstrate the role of PA as a protective factor against the presence of NAFLD and significant fibrosis. Protective levels of PA in NAFLD differ by races.

Impact of treadmill running on distal femoral cartilage thickness: a cross-sectional study of professional athletes and healthy controls

PURPOSE

This present study aimed to assess the impact of treadmill running on distal femoral cartilage thickness.

METHODS

Professional athletes aged 20 to 40 years with a history of treadmill running (minimum 75 min per week for the past three months or more) and age-, sex-, and body mass index (BMI)-matched healthy controls were recruited. Demographics and clinical features of participants were recorded. Athletes were divided into subgroup 1 with less than 12 months of treadmill running and subgroup 2 with 12 months or more of treadmill running. Distal femoral cartilage thicknesses were measured at the midpoints of the right medial condyle (RMC), right intercondylar area (RIA), right lateral condyle (RLC), left medial condyle (LMC), left intercondylar area (LIA), and left lateral condyle (LLC) via ultrasonography.

RESULT

A total of 72 athletes (mean age: 29.6 ± 6.6 years) and 72 controls (mean age: 31.9 ± 6.7 years) were enrolled. Athletes had significantly thinner cartilages in the RLC (2.21 ± 0.38 vs. 2.39 ± 0.31 cm, p = 0.002), LLC (2.28 ± 0.37 vs. 2.46 ± 0.35 cm, p = 0.004), and LMC (2.28 ± 0.42 vs. 2.42 ± 0.36 cm, p = 0.039) compared with the control group. Furthermore, cartilage thickness was significantly thinner in subgroup 2 athletes compared with the control group in the RLC (2.13 ± 0.34 vs. 2.39 ± 0.31 cm, p = 0.001), LLC (2.22 ± 0.31 vs. 2.46 ± 0.35 cm, p = 0.005), and LMC (2.21 ± 0.46 vs. 2.42 ± 0.36 cm, p = 0.027); however, subgroup 1 athletes did not have such differences. There was a weak negative correlation between total months of treadmill running and cartilage thickness in the RLC (r = - 0.0236, p = 0.046) and LLC (r = - 0.0233, p = 0.049). No significant correlation was found between the distal femoral cartilage thickness at different sites and the patients' demographic features, including age, BMI, speed and incline of treadmill running, and minutes of running per session and week (p > 0.05).

CONCLUSION

Compared with healthy controls, professional athletes with a history of long-term high-intensity treadmill running had thinner femoral cartilages. The duration (months) of treadmill running was weakly negatively correlated with distal femoral cartilage thickness. Longitudinal studies with prolonged follow-ups are needed to clarify how treadmill running affects femoral cartilage thickness in athletes.

The association between lower limb fractures and weight gain in adults: a prospective analysis of body mass index trends

PURPOSE

Despite understanding the connection between obesity and fracture risk, there is limited research on the implications of lower limb fractures on subsequent changes in body mass index (BMI). Our study aimed to assess the impact of lower limb fractures on BMI alterations over an 18-month period.

METHODS

A multi-center, prospective cohort study was conducted between January 2021 to June 2023, involving 494 adults with lower limb fractures. Participants were recruited within 2 weeks post-injury and were assessed for demographics, injury details, and weight at seven distinct time points. By 18 months, the primary outcome was the mean weight gain.

RESULTS

The average age of the participants was 39 (± 12.7) with a baseline weight and BMI of 80.4 kg and 27.6, respectively. At the 18-month follow-up, 75% of patients experienced an average weight increase in 4 kg (± 5.39 kg), equating to a BMI rise of 1.39 (± 1.88). Most patients attributed weight changes to their injury, with nearly half expressing distress from their weight change. Only 37% believed that they had resumed their previous activity levels by the final follow-up. Approximately 31% of the patients sought some form of external weight management care in the form of nutritionist advice, training programs, medication and weight management procedures.

CONCLUSIONS

Lower limb fractures significantly affect weight gain over an 18-month period, with substantial psychological and physical consequences. Healthcare providers should anticipate potential weight gain post-fracture and incorporate strategies addressing both physical and mental aspects of rehabilitation to enhance recovery outcomes. Early and even immediate weight bearing may play a pivotal role in mitigating weight changes and returning the patient to their previous level of activity. Further detailed studies focusing on different fractures and postoperative interventions are recommended.

Occupational physical activity as a determinant of daytime activity patterns and pregnancy and infant health

Though physical activity (PA) is recommended during pregnancy, it remains unclear how occupational physical activity (OPA) and sedentary behavior (SB) contribute to activity patterns and health during pregnancy. The purpose of this secondary analysis was to determine if OPA pattern is a determinant of all-day PA and evaluate associations with pregnancy/infant health outcomes. Data was from two prospective cohorts with study visits each trimester: MoM Health (Pittsburgh, PA; n = 120) and PRAMS (Iowa City, Iowa; n = 20). Using employment status/job hours (self-reported in demographic questionnaires) and OPA from the Pregnancy Physical Activity Questionnaire, latent class analysis identified three groups: sitting (n = 61), part-time mixed (n = 9), and active (n = 29). A fourth group included non-working participants (n = 32). Device-based PA (ActiGraph GT3X), SB (activPAL3 micro), and blood pressure were measured each trimester. Glucose screening test, gestational age, gestational weight gain, adverse pregnancy outcomes (APOs: gestational hypertension, preeclampsia, eclampsia, gestational diabetes, intrauterine growth restriction, and preterm birth), and infant outcomes (length, weight, and sex) were abstracted from medical records. Associations between groups with APOs and pregnancy/infant health were calculated using linear/logistic regression with adjustment for age, pre-pregnancy BMI, education, and race. Self-reported participant characteristics were similar across groups, except education which was higher in the sitting versus other groups. All-day device-based PA differed across groups; for example, the sitting group had the highest SB across trimester (all p<0.01) while the active group had the highest steps per day across trimesters (all p<0.01). Pregnancy/infant health did not differ between groups (all p>0.09). Compared to the non-working group, the risk of any APO was non-significantly higher in the sitting (OR = 2.27, 95%CI = 0.63-8.18) and active groups (OR = 2.40, 95%CI = 0.66-9.75), though not the part-time mixed (OR = 0.86, 95%CI = 0.08-9.1). OPA pattern is a determinant of all-day PA during pregnancy. Future studies with larger samples should examine associations between pregnancy OPA patterns and pregnancy/infant health.

Plant protein consumption is associated with body mass index among women of reproductive age in Indonesia

Introduction

One of the known determinants of obesity in Southeast Asia countries, including Indonesia, is the nutritional transition, which is indicated by fast changes in food production, dietary habits, and physical activity. With rising incomes, plant protein from grains, tubers, and legumes is gradually being replaced by animal protein from poultry, eggs, dairy, and red meat. This change is identified as a protein transition. Different choices of protein sources in the diet have varying health effects. However, there is limited information on the Asian population on the role of protein consumption on the increasing obesity prevalence. Therefore, this study aimed to investigate the association of protein sources consumption with body mass index (BMI) among women of reproductive age in Indonesia.

Methods

This study used secondary data from the 2018 Indonesia Food Barometer (IFB) conducted using a quantitative cross-sectional survey. A total of 467 Indonesian reproductive-aged women (20-49 years) were included in this study. Dietary intake, including protein consumption, was obtained using 24-h dietary recall. Multiple linear regression was applied to find the association of protein consumption with BMI with a p-value <0.05 considered as a significant outcome variable.

Results

The Mean BMI was 25.02 kg/m2, median of animal and plant protein was 28.01 g/day and 25.37 g/day, respectively. Consumption of plant protein was significantly associated with BMI after adjusting for marital status and age (p-value = 0.043; R2 = 0.080). The quality of plant protein should be considered to prevent obesity problems among women of reproductive age.

Occupational physical activity: the good, the bad, and the proinflammatory

Background

Physical activity (PA) is beneficial for preventing several conditions associated with underlying chronic inflammation, e. g., cardiovascular disease (CVD) and cancer. While an active lifestyle appears to have anti-inflammatory effects, high levels of occupational PA (OPA) were associated with inflammation and elevated mortality risks. We aimed to summarize the current knowledge (1) on the association between inflammation and OPA and (2) its implications for health and mortality.

Methods and results

This mini-review summarized relevant literature published before January 2023 using established scientific databases and sources. For the primary outcome, observational studies (S) reporting immunological effects (O) in subjects (P), with high (I) vs. low OPA (C), were included. For secondary outcomes, i.e., morbidity and mortality associated with inflammatory processes, (systematic) reviews were included. While "active" occupations and "moderate" OPA appear to have beneficial effects, low (particularly sedentary) and "high-intensity" OPA (particularly including heavy lifting tasks) were associated with inflammation and (CVD and cancer-related) mortality; higher leisure-time PA has been almost consistently associated with lower proinflammatory markers and all-cause mortality risks. Workplace interventions appear to counter some of the observed health effects of unfavorable work strain.

Conclusion

The few studies addressing OPA "intensity" and inflammatory markers are largely heterogeneous regarding OPA classification and confounder control. Sedentary and "heavy" OPA appear to promote proinflammatory effects. In addition to targeted management of work-related physical strain and hazardous environmental co-factors, occupational health providers should focus on employer-initiated exercise interventions and the promotion of leisure-time PA.

Is Occupation a Risk Factor for Developing Inflammatory Bowel Disease? A Case-Control Study

Background and aims

The role of occupation is uncertain in the onset of inflammatory bowel diseases. The aim of this study is to identify if there is a role of occupation in these diseases.

Materials and methods

A case-control study with incident cases with inflammatory bowel diseases was designed. Cases and controls were recruited simultaneously and controls followed a sex and age frequency matching with cases. A detailed questionnaire was completed by all the participants. To analyze the results, a logistic regression was used. A subgroup analysis was performed for each inflammatory bowel disease.

Results

A total of 141 patients with incident inflammatory bowel disease (80 ulcerative colitis, 55 Crohn's disease, and 6 unclassified colitis) and 114 controls were included. There were no statistically significant differences in type of work, working hours, contact with animals, or physical activity at work between inflammatory bowel disease patients and controls. After stratifying results according to type of IBD, there were no statistically significant differences either.

Conclusions

There seems to be no risk for inflammatory bowel disease onset regarding the type of work, working hours, contact with animals, or sedentariness.

Evidence- and data-driven classification of low back pain via artificial intelligence: Protocol of the PREDICT-LBP study

In patients presenting with low back pain (LBP), once specific causes are excluded (fracture, infection, inflammatory arthritis, cancer, cauda equina and radiculopathy) many clinicians pose a diagnosis of non-specific LBP. Accordingly, current management of non-specific LBP is generic. There is a need for a classification of non-specific LBP that is both data- and evidence-based assessing multi-dimensional pain-related factors in a large sample size. The "PRedictive Evidence Driven Intelligent Classification Tool for Low Back Pain" (PREDICT-LBP) project is a prospective cross-sectional study which will compare 300 women and men with non-specific LBP (aged 18-55 years) with 100 matched referents without a history of LBP. Participants will be recruited from the general public and local medical facilities. Data will be collected on spinal tissue (intervertebral disc composition and morphology, vertebral fat fraction and paraspinal muscle size and composition via magnetic resonance imaging [MRI]), central nervous system adaptation (pain thresholds, temporal summation of pain, brain resting state functional connectivity, structural connectivity and regional volumes via MRI), psychosocial factors (e.g. depression, anxiety) and other musculoskeletal pain symptoms. Dimensionality reduction, cluster validation and fuzzy c-means clustering methods, classification models, and relevant sensitivity analyses, will classify non-specific LBP patients into sub-groups. This project represents a first personalised diagnostic approach to non-specific LBP, with potential for widespread uptake in clinical practice. This project will provide evidence to support clinical trials assessing specific treatments approaches for potential subgroups of patients with non-specific LBP. The classification tool may lead to better patient outcomes and reduction in economic costs.

Equating NHANES Monitor-Based Physical Activity to Self-Reported Methods to Enhance Ongoing Surveillance Efforts

PURPOSE

Harmonization of assessment methods represents an ongoing challenge in physical activity research. Previous research has demonstrated the utility of calibration approaches to enhance agreement between measures of physical activity. The present study utilizes a calibration methodology to add behavioral context from the Global Physical Activity Questionnaire (GPAQ), an established report-based measure, to enhance interpretations of monitor-based data scored using the novel Monitor Independent Movement Summary (MIMS) methodology.

METHODS

Matching data from the GPAQ and MIMS were obtained from adults (20-80 yr of age) assessed in the 2011-2014 National Health and Nutrition Examination Survey. After developing percentile curves for self-reported activity, a zero-inflated quantile regression model was developed to link MIMS to estimates of moderate to vigorous physical activity (MVPA) from the GPAQ.

RESULTS

Cross-validation of the model showed that it closely approximated the probability of reporting MVPA across age and activity-level segments, supporting the accuracy of the zero-inflated model component. Validation of the quantile regression component directly corresponded to the 25%, 50%, and 75% values for both men and women, further supporting the model fit.

CONCLUSIONS

This study offers a method of improving activity surveillance by translating accelerometer signals into interpretable behavioral measures using nationally representative data. The model provides accurate estimates of minutes of MVPA at a population level but, because of the bias and error inherent in report-based measures of physical activity, is not suitable for converting or interpreting individual-level data. This study provides an important preliminary step in utilizing information from both device- and report-based methods to triangulate activity related outcomes; however additional measurement error modeling is needed to improve precision.

Association between pelvic floor muscle strength and sexual function based on PISQ-12-an analysis of data from a multicenter cross-sectional study on 735 nulliparae during pregnancy

Background

Pelvic floor muscle strength is well-known to be associated with female sexual function. However, there were a few studies that reported on the relationship between pelvic floor muscle strength and female sexual function in pregnant women, and the presented results were inconsistent. Nulliparae represent a specific cohort with simplicity to exclude confounding factors that are caused by parity. The present study aimed to explore the association of pelvic floor muscle strength and sexual function based on the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) of nulliparae during pregnancy.

Methods

This is the second analysis of the baseline data from a randomized controlled trial (RCT), which aimed to study the protective efficacy of pelvic floor muscle training on stress urinary incontinence at 6th week postpartum (registration number: ChiCTR2000029618). Nulliparae aged 20-40 years with singleton pregnancy before 16 weeks of gestation were enrolled in this study, and data, including participants' demographic information, the Modified Oxford Scale (MOS), and PISQ-12, were collected. Eligible nulliparae were divided into two groups: Group MOS > 3 and Group MOS ≤ 3. Demographic information of the two groups was compared. Sexual function based on the PISQ-12 scores of the two groups was compared. A comparison of the PISQ-12 scores between the two groups was calculated by the Mann-Whitney U-test using SPSS version 23.0.

Results

A total of 735 eligible nulliparae were enrolled in this study. Along with MOS grading up, PISQ-12 scores tended to get lower. Of the 735 nulliparae, there were 378 and 357 participants included in Group MOS > 3 and Group MOS ≤ 3, respectively. The PISQ-12 scores of Group MOS > 3 were significantly lower than those of Group MOS ≤ 3 (11 vs. 12, p < 0.001). The scores of the frequency of feeling sexual desire, orgasm achievement, sexual excitement, sexual activity satisfaction, sexual intercourse pain, fear of urinary incontinence, and negative emotion reactions with the sexual intercourse of Group MOS > 3 were lower than those of Group MOS ≤ 3 (p < 0.05).

Conclusion

Pelvic floor muscle strength was positively associated with sexual function based on the questionnaire of young nulliparae during their first trimester. Up to half of the nulliparae during the first trimester were suffering from weak pelvic floor muscle strength and nearly a quarter of the nulliparae were facing this weakness combined with sexual dysfunction.

Trial registration

This study has been registered at http://www.chictr.org.cn (registration number: ChiCTR2000029618).

Cervical kinematic change after posterior full-endoscopic cervical foraminotomy for disc herniation or foraminal stenosis

OBJECTIVE

Posterior full-endoscopic cervical foraminotomy (PECF) is one of minimally invasive surgical techniques for cervical radiculopathy. Because of minimal disruption of posterior cervical structures, such as facet joint, cervical kinematics was minimally changed. However, a larger resection of facet joint is required for cervical foraminal stenosis (FS) than disc herniation (DH). The objective was to compare the cervical kinematics between patients with FS and DH after PECF.

METHODS

Consecutive 52 patients (DH, 34 vs. FS, 18) who underwent PECF for single-level radiculopathy were retrospectively reviewed. Clinical parameters (neck disability index, neck pain and arm pain), and segmental, cervical and global radiological parameters were compared at postoperative 3, 6, and 12 months, and yearly thereafter. A linear mixed-effect model was used to assess interactions between groups and time. Any occurrence of significant pain during follow-up was recorded during a mean follow-up period of 45.5 months (range 24-113 months).

RESULTS

Clinical parameters improved after PECF, with no significant differences between groups. Recurrent pain occurred in 6 patients and surgery (PECF, anterior discectomy and fusion) was performed in 2 patients. Pain-free survival rate was 91% for DH and 83% for FS, with no significant difference between the groups (P = 0.29). Radiological changes were not different between groups (P > 0.05). Segmental neutral and extension curvature became more lordotic. Cervical curvature became more lordotic on neutral and extension X-rays, and the range of cervical motion increased. The mismatch between T1-slope and cervical curvature decreased. Disc height did not change, but the index level showed degeneration at postoperative 2 years.

CONCLUSION

Clinical and radiological outcomes after PECF were not different between DH and FS patients and kinematics were significantly improved. These findings may be informative in a shared decision-making process.

Association of plant-based dietary patterns with the risk of colorectal cancer: a large-scale case-control study

Plant-based diets are associated with a lower risk of colorectal cancer, but the risk might differ by the quality of plant-based diets. This study aimed to investigate the association between different types of plant-based dietary patterns and colorectal cancer risk in the Chinese population. We conducted a case-control study with 2799 eligible colorectal cancer cases and 2799 sex- and age-matched controls in Guangzhou, China. A validated food frequency questionnaire was used to collect dietary data, from which we derived plant-based diet indices, including the plant-based diet index (PDI), the healthy PDI (hPDI), and the unhealthy PDI (uPDI). The PDI, hPDI, and uPDI assess the adherence to overall, healthy, and unhealthy plant-based dietary patterns, respectively. The odds ratios (ORs) and 95% confidence intervals (CIs) for colorectal cancer risk were estimated using unconditional logistic regression models. Higher adherence to the PDI, particularly the hPDI, was associated with a lower risk of colorectal cancer, whereas greater adherence to the uPDI was associated with a higher risk of colorectal cancer. Compared with the lowest quintile, the adjusted ORs in the highest quintile were 0.79 (95% CI: 0.66-0.95) for the PDI, 0.45 (95% CI: 0.38-0.55) for the hPDI, and 1.45 (95% CI: 1.18-1.78) for the hPDI, respectively. In stratified analysis, the inverse association between the PDI and colorectal cancer risk was not observed in women, and the positive association between the uPDI and colorectal cancer risk was not observed in men. In conclusion, these results support recommendations that shifting to a healthy plant-based dietary pattern is important for the prevention of colorectal cancer, particularly in the Chinese population that habitually consumes plant foods.

Anemia, Weight Status, and Fatigue Among Farmworkers in California: A Cross-Sectional Study

OBJECTIVE

This study aimed to determine the prevalence of anemia and overweight/obesity and assess the relationships between hematocrit (Hct) and body mass index (BMI), and between fatigue and Hct, among a sample of farmworkers in California.

METHODS

We estimated the prevalence of anemia (using Hct), overweight/obesity (BMI ≥25 kg/m 2 ), and self-reported fatigue in 587 farmworkers. Multivariable linear and logistic regression models were used to examine the associations between Hct and BMI, and between fatigue and Hct.

RESULTS

Anemia prevalence was 3.1%, overweight/obesity prevalence was 80.7%, and 78% of workers reported fatigue at work. There was no association between Hct and BMI or between Hct and reported fatigue. Women were more likely than men to have lower Hct and higher BMI.

CONCLUSIONS

A majority of farmworkers in this sample were overweight/obese, but anemia was uncommon. Anemia among more vulnerable subgroups of farmworkers should be explored.

Frequency-Response Relationship Between Exercise and Locomotive Syndrome Across Age Groups: Secondary Analysis of a Nationwide Cross-Sectional Study in Japan

OBJECTIVES

This study aimed to clarify the frequency-response relationship between exercise habits and locomotive syndrome in different age groups.

METHODS

We analyzed 8,681 independent community dwellers who participated in a nationwide cross-sectional locomotive syndrome study. Participants were divided into young (20-39 years), middle (40-64 years), and old (≥ 65 years) groups. The presence of locomotive syndrome was evaluated using the locomotive syndrome risk tests. Exercise habits were assessed by exercise frequency (almost every day/sometimes/occasionally/never). The association between locomotive syndrome and exercise was assessed using the multiple logistic regression analysis adjusted for participant characteristics for each age category.

RESULTS

Overall, 3,528 (41%) participants had locomotive syndrome. In the old group, the risk of locomotive syndrome was lower with an increased exercise frequency. However, this dose-response relationship was not found in the young group. The proportion of locomotive syndrome was lower even in participants who occasionally exercised (1-3 days/month) than those who never exercise in the young and middle age groups.

CONCLUSIONS

Regular exercise reduced the risk of locomotive syndrome not only in middle and older adults but also in young adults. Moreover, increasing exercise frequency may provide benefits for locomotive syndrome prevention, especially among older adults.

Real-world evidence of mesenchymal stem cell therapy in knee osteoarthritis: a large prospective two-year case series

Objective: To evaluate the long-term safety and efficacy of adipose-derived mesenchymal stem cell (ADMSC) therapy in the treatment of knee osteoarthritis (OA). Methods: 329 participants with knee OA underwent intra-articular ADMSC therapy. Participants were followed up for 24 months and were separated based on radiological OA grade. Results: Treatment was well tolerated with no related serious adverse events. All participant groups reported clinically and statistically significant pain improvement. Clinical outcome was not influenced by patients' age or BMI. Conclusion: ADMSC therapy is an effective, safe and long-lasting treatment option for knee OA with the potential to delay total joint replacement. In addition to the observed clinical benefits, ADMSC therapy promises to reduce the global economic burden of OA. Trial registration number: ACTRN12617000638336.

Occupational physical activity differentially affects the risk for developing later-onset Crohn's disease and ulcerative colitis among middle-aged and older populations

BACKGROUND

A person's occupation may increase his/her risk for developing inflammatory bowel disease (IBD). This study investigated the association between risk for later-onset of IBD and both specific occupations and occupational physical activity (OPA) levels.

MATERIALS AND METHODS

A multicenter hospital-based matched case-control study was conducted using the Inpatient Clinico-Occupational Survey database. Cases were patients with Crohn's disease (CD) and ulcerative colitis (UC) patients admitted for the first time between 2005 and 2015. Four controls matched by age, sex, admission year and hospital were selected for each case. Cases and controls were grouped into the longest-held occupations as classified by the Japanese Standard Occupational Classification and OPA levels. We conducted conditional logistic regressions to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for IBD, CD and UC adjusted for alcohol consumption and smoking status.

RESULTS

There were 564 cases (172 CD, 392 UC) and 2086 controls. The risk for UC was higher among sales workers and carrying, cleaning and packing workers (ORs 2.62 [95%CIs 1.18-5.82], 2.52 [1.04-6.09]). There was no association between occupation type and CD risk. Higher OPA level decreased CD risk (OR 0.51 [95%CIs 0.26-1.00]) and increased UC risk (OR 1.53 [95%CIs 1.02-2.30]).

CONCLUSIONS

Our study revealed that the risk for later-onset of UC, but not CD, was associated with longest-held 'service' and 'manufacture' work. The risk by OPA levels was inversely associated between CD and UC. Further studies are needed by follow-up method for long-term effects of physical activity.

Occupational determinants of physical activity at work: Evidence from wearable accelerometer in 2005-2006 NHANES

Occupation determines workers' physical activity (PA) in the workplace, an important health behavior contributing to health outcomes. However, self-reported measure limits our understanding of how occupational tasks differentiate workers' PA in terms of the type, frequency, intensity, and duration. In addition, accurate estimation of occupation-based PA during workers' actual working hours requires precise work schedule information. To address these limitations, this study employs data on accelerometer-monitored PA and work schedule from the 2005-2006 National Health and Nutrition Examination Survey (NHANES). It asks two questions: How do occupations determine PA among regular daytime workers in the United States? Second, how large a share of PA difference between two occupations is attributable to differences in the implicit occupational tasks, relative to workers' demographic, health preconditions, and socioeconomic attributes? Calculating PA during the 9-to-5 period among daytime regular workers on weekdays and conducting Blinder-Oaxaca decomposition analysis, we yield insights into the occupational determinant of both PA volume (total activity counts) and fragmentation (bouts of activities). Worksite health promotion can utilize the objective occupation-PA link and design occupation-tailored interventions, which is currently underdeveloped in the United States. Moreover, our findings shed light on the physical nature of occupation, suggesting a fruitful step to reconcile the documented mixed findings on occupation-based PA and health outcomes in future studies.

Validity of Domain-Specific Sedentary Time Using Accelerometer and Questionnaire with activPAL Criterion

Accelerometers based on the cut-point method are generally the most used in sedentary time (ST) research. However, mixed cut-points are an issue, so an accelerometer based on metabolic equivalents (METs) could be used as an alternative. This study aimed to validate a METs-based accelerometer (HJA-750C, OMRON) and a questionnaire that estimates domain-specific sedentary time measures using activPAL as a criterion value. We also examined whether measurement validity differed according to gender and occupation. We used data from 242 workers in the validation study. Participants wore activPAL on the thigh and OMRON on the waist for seven consecutive days with daily recording logs. The Workers Living Activity-time Questionnaire (WLAQ) was administered once. The domain-specific ST assessed quantities of ST during commuting, working time, non-working time on a workday, and non-workday. Intraclass correlation coefficients (ICC) and Spearman's rho coefficients were then used to conduct analyses. The OMRON accelerometer showed acceptable values (r = 0.67-0.86 and ICC of 0.63-0.87) in the overall domain-specific ST. Additionally, each measurement result suggested that working time is the most accurate domain to measure ST (ICC of 0.87 for OMRON and 0.68 for WLAQ). Moreover, there were no differences in the overall validity of the results according to gender and occupation. The METs-based accelerometer has acceptable validity for ST measurements to be used among workers. Additionally, working time may be the preferred domain for the accurate assessment of ST in both objective and subjective measurements. These results can advance the quality of the sedentary research field.

Factors associated with mobility decrease leading to disability: a cross-sectional nationwide study in Japan, with results from 8681 adults aged 20-89 years

Background

Mobility decrease leading to disability can gradually develop during early life, however, its related factors are not well clarified. Therefore, we investigate the related factors of mobility decrease at various levels, using nationwide data in Japan.

Methods

In total, 8681 independent community dwellers aged 20-89 years were analysed (average age, 51.6 years; 58.5% women). Three stages of mobility decrease were based on the locomotive syndrome risk test: Stage 1, emerging; Stage 2, progressing; Stage 3, progressed to restrict social engagement. Age was analysed using a simple quadratic function model.

Results

The prevalence of Stages 1-3 was 31.6% (n = 2746), 5.8% (n = 504), and 3.2% (n = 278), respectively. On the multivariable logistic regression, increased age in participants aged ≥40 years (stage 1: odds ratio[OR] 1.05-1.20, stage 2: OR 1.04-1.22, stage 3: OR 1.05-1.22), female (stage 1: OR 2.28, 95% confidence interval [CI] 1.99-2.61, stage 2: OR 2.40, 95% CI 1.77-3.25, stage 3: OR 1.80, 95% CI 1.19-2.72), overweight status (stage 1: OR 1.56, 95% CI 1.34-1.82, stage 2: OR 3.19, 95% CI 2.38-4.27, stage 3: OR 2.87, 95% CI 1.90-4.32), hypertension (stage 1: OR 1.20, 95% CI 1.01-1.41, stage 2: OR 1.99, 95% CI 1.49-2.64, stage 3: OR 2.10, 95% CI 1.44-3.05), and diabetes mellitus (stage 1: OR 1.62, 95% CI 1.17-2.24, stage 2: OR 1.57, 95% CI 0.93-2.66, stage 3: OR 2.10, 95% CI 1.13-3.90) were positively associated. The frequency of physical activity/sports, even a few per month, was inversely associated with all stages (stage 1: OR 0.59-0.72, stage 2: OR 0.50-0.67, stage 3: 0.36-0.53). A one-year increase in age had a stronger impact on mobility decrease in older adults than in younger ones. Increased age in participants aged < 40 years and smoking were associated with Stage 1, while intake of various foods was inversely associated with Stages 1 and 2.

Conclusion

Increased age (< 40 years) was associated with emerging mobility decrease, while that (≥ 40 years) was associated with any levels of mobility decrease. Female, lifestyle habits, including physical activities and overweight status, were associated with mobility decrease at every level.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02600-4.

Leisure but Not Occupational Physical Activity and Sedentary Behavior Associated With Better Health

OBJECTIVE

This study explores relations between occupational and leisure-time physical activity (OPA, LTPA) and sedentary behavior (OSB, LTSB) and several health outcomes.

METHODS

A total 114 full-time workers had their body composition, waist circumference, height, weight, resting heart rate, and resting blood pressure measured. ActivPal monitor measured physical activity behaviors. Stress, mood, and pain were measured with ecological momentary assessment. General linear models were used to examine the relationship between high and low OPA, LTPA, OSB, and LTSB with each health outcome while controlling for covariates.

RESULTS

The high LTPA group had lower body mass index (BMI) (P = 0.04) and better mood (P = 0.007) than the low LTPA group. The high LTSB group had higher systolic blood pressure (P = 0.001), higher diastolic blood pressure (P = 0.01), higher BMI (P = 0.027), higher body fat percentage (P = 0.003), higher waist circumference (P = 0.01), and worse mood (P = 0.032) than the low LTSB group. No differences were found between OPA and OSB groups.

CONCLUSIONS

These findings suggest there may be differential relations between PA and SB accumulated during leisure versus occupational time.

Heart Health in Teachers-Do We Need to Know More?

OBJECTIVES

To evaluate the relationship between the prevalence and risk factors for cardiovascular disease and hypertension, physical activity, and mental health in teachers.

METHODS

Data were drawn from the 2011-2012 National Health and Nutrition Examination Survey. A series of analyses were conducted utilizing exploratory data analysis, nominal logistic regression, and multivariate regression analysis.

RESULTS

The study sample included 148 participants. The results showed that an increase in age and BMI contributed to an increase in high blood pressure. Significance was not seen between physical activity, anxiety, and mental well-being as they related to cardiovascular disease and teaching.

CONCLUSIONS

Our results showed that the prevalence of cardiovascular disease and hypertension could be related to the occupation of teaching; however, additional research should be done to assess the relationship between the occupation of teaching and cardiovascular disease.

Health Risk Behavior Profile of Construction Workers, 32 States, 2013 to 2016

BACKGROUND

Research has suggested that several health risk behaviors were more prevalent among construction workers than among the general workforce.

METHODS

The prevalences of six health risk behaviors among construction workers were compared with workers in other industries using data from 32 states in the 2013 to 2016 Behavioral Risk Factor Surveillance System (BRFSS).

RESULTS

Smoking, smokeless tobacco use, binge drinking, no leisure-time physical activity, and not always using a seatbelt were significantly more prevalent (P < 0.001), and short sleep significantly less prevalent (P < 0.05), for all construction workers combined compared with workers in other industries. Prevalences varied substantially for all six health risk behaviors by construction occupation.

CONCLUSIONS

Due to the high prevalence of some health risk behaviors, construction workers may benefit from interventions to reduce these behaviors, particularly since they are also potentially exposed to workplace hazards.

Risk of Osteoarthritis is Positively Associated with Vitamin D Status, but Not Bone Mineral Density, in Older Adults in the United States

OBJECTIVE

We examined the risk of osteoarthritis (OA) according to vitamin D status and bone mineral density (BMD) using a cross-sectional nationally representative database.

METHODS

National Health and Nutrition Examination Survey (NHANES) data from 2007 to 2010 were used to assess the relationship between OA and vitamin D status in adults aged ≥40 years (n = 2934). NHANES data from 2005 to 2010 and 2013 to 2014 were analyzed to investigate the association between OA and BMD (n = 5949). Vitamin D status was categorized as serum 25-hydroxyvitamin D (25OHD) <20 ng/mL or ≥20 ng/mL. Bone health was classified according to T-score (normal, osteopenia, or osteoporosis) and BMD tertile. Risk of OA was assessed using logistic regression and adjusted for covariates.

RESULTS

Participants with serum 25OHD <20 ng/mL had a 37% lower risk of OA (95% confidence interval (CI) [0.39-0.99], P = 0.046). When stratified by sex, the odds ratio for OA in men with lower vitamin D status was 0.35 (95% CI [0.15-0.81], P = 0.02). No association was found in women. The risk for OA did not differ according to BMD tertile or T-score classification.

CONCLUSIONS

The risk of OA is lower in older men with 25OHD less than 20 ng/mL but not in older women. Bone mineral density is not associated with OA risk in older adults in the United States.

A Cross-Sectional Analysis of Physical Activity Patterns, Aerobic Capacity and Perceptions about Exercise among Male Farmers in the Mid-West Region of Ireland

In Ireland, farmers have been identified as a high-risk population, with higher rates of cardiovascular disease (CVD) and overall mortality, compared with the general population. Farming has always been considered a physically active lifestyle. However, in recent times, with the increased use of technology and machinery, farmers may not be completing as much physical activity as before. There is a lack of research on physical activity patterns, fitness, and perception about exercise among farmers. Physical activity patterns were assessed using ActivPAL₃ micro monitors for a duration of 7 consecutive days. Aerobic capacity was measured using a validated sub-maximal exercise test to calculate Metabolic Equivalent Task (MET) levels. The Exercise Benefits and Barriers Scale (EBBS) questionnaire was used to explore perceived benefits and barriers towards exercise. Farmers completed a mean (standard deviation) of 16,452 (5,170) steps and 124 (43) minutes of moderate-vigorous intensity physical activity (MVPA) daily. The volume of weekly MVPA was largely accumulated in bouts lasting <10 minutes, with only 17.89% completing bouts of ≥10 minutes. Daily sitting time was 8.26 hours. Farmers are fit, have positive perceptions about exercise, and complete large quantities of physical activity, but not in a CVD protective pattern. CVD risk can be reduced in this population by encouraging them to sit less and engage in MVPA in bouts of ≥10 minutes, in line with current guidelines.

Assessment of plasma BMP-2, BMP-7, BMP-10, vitamin D, and TGF β1 in simple fractures among Sudanese patients

Background

Bone morphogenetic proteins (BMP) are multifunctional proteins. They work as cytokines regulating osteogenesis during fracture healing process. The objectives of this study were to assess changes in BMPs during fracture and their correlations to Fracture’s healing.

Methods

Case-Control hospital–based study conducted from January 2018 to January 2019. Demographic data, anthropometric measurements, and blood samples were collected from patients and controls (18–65 years old). Plasma concentrations of selected BMPs and vitamin D were measured using quantitative enzyme linked immunosorbent assay (ELISA). SPSS version 25 was used to calculate frequencies, Pearson correlation tests, chi-square and unpaired t-test.

Results

Sixty-five patients with fractures and Sixty-five controls were studied. Means of plasma concentrations were (TGFβ1 = 21.07 ng/ml ±8.49 and 19.8 ng/ml ±7.2) (BMP-2 = 76.3 pg/ml ± 156.6 and 55.5 ng/ml ± 127.9) (BMP-7 = 13.02 pg/ml ±43.5 and 64.6pg/ml ±250) (BMP-10 = 8.14 pg/ml ±12.7 and 5.48 pg/ml ±11.3) (Vitamin D mean was 24.94 ng/ml ±13.2 and 26.2 ng/ml ±11.6) in patients and controls, respectively. Forty-five subjects were enrolled into follow up study: 30 males, 15 females. Healing time mean was 4.13± 2.6 months. No significant correlation between BMP-2/BMP-7 with healing time.

Conclusions

BMP-7 was significantly lowers in the plasma of patients that controls (P = 0.042). Low Vitamin D was observed among Sudanese participants.

Nonsurgical treatment outcomes for surgical candidates with lumbar disc herniation: a comprehensive cohort study

Physicians often encounter surgical candidates with lumbar disc herniation (LDH) who request non-surgical management even though surgery is recommended. However, second opinions may differ among doctors. Therefore, a prospective comprehensive cohort study (CCS) was designed to assess outcomes of nonsurgical treatment for surgical candidates who were recommended to undergo surgery for LDH but requested a second opinion. The CCS includes both randomized and observational cohorts, comprising a nonsurgery cohort and surgery cohort, in a parallel fashion. Crossover between the nonsurgery and surgery cohorts was allowed at any time. The present study was an as-treated interim analysis of 128 cases (nonsurgery cohort, n = 71; surgery cohort, n = 57). Patient-reported outcomes included visual analogue scores for the back (VAS-B) and leg (VAS-L), the Oswestry Disability Index, the EuroQol 5-Dimension instrument, and the 36-Item Short-Form Health Survey (SF-36), which were evaluated at baseline and at 1, 3, 6, 12, and 24 months. At baseline, age and SF-36 physical function were significantly lower in the surgery cohort than in the nonsurgery cohort (p < 0.05). All adjusted outcomes significantly improved after both nonsurgical and surgical treatment (p < 0.05). The nonsurgery cohort showed less improvement of VAS-B and VAS-L scores at 1 month (p < 0.01), but no difference between cohorts was observed thereafter for 24 months (p > 0.01). Nonsurgical management may be a negotiable option even for surgical candidates in the shared decision-making process.

The Dietary Inflammatory Index Is Positively Associated with Colorectal Cancer Risk in a Chinese Case-Control Study

Diet may modulate chronic inflammation. The aim of this study is to investigate whether the dietary inflammatory index (DII^®) was associated with the risk of colorectal cancer in a Chinese population. A case-control study was conducted from July 2010 to April 2019, in Guangzhou, China. A total of 2502 eligible cases were recruited along with 2538 age- (5-year interval) and sex-matched controls. Dietary data derived from a validated food frequency questionnaire were used to calculate the energy-adjusted DII (E-DII) scores. Odds ratios (ORs) and 95% confidence intervals (CIs) for colorectal cancer risk were estimated using unconditional logistic regression models. In this study, E-DII scores ranged from -5.96 (the most anti-inflammatory score) to +6.01 (the most pro-inflammatory score). A positive association was found between the E-DII and colorectal cancer risk, with the OR = 1.40 (95% CI 1.16, 1.68; P_trend < 0.01) for the highest E-DII quartile compared with the lowest quartile after adjusting for potential confounders. When stratified based on cancer subsite, sex, body mass index, and smoking status, significant associations were not observed in women or underweight individuals. Results from this study confirmed that a higher E-DII score was associated with an increased risk of colorectal cancer in a Chinese population.

Nível de atividade física e sobrecarga cardiovascular em bombeiros militares durante combate a incêndio florestal: um estudo exploratório

Resumo Introdução : combates a incêndios florestais expõem bombeiros a elevado risco cardiovascular. Objetivo : avaliar o nível de atividade física (ATF), o comportamento sedentário e a sobrecarga cardiovascular de bombeiros durante um combate a incêndio florestal de grande porte. Métodos : durante 9 dias de atividade, 24h/dia, avaliaram-se 7 bombeiros do sexo masculino. Os participantes tiveram a frequência cardíaca (FC) medida a cada segundo e a ATF registrada por um sensor de movimento, do tipo acelerômetro, a cada 60 segundos. Foram computadas as médias dos registros do 2º, 3º e 4º dias. A ATF e o comportamento sedentário foram avaliados pelo vetor magnitude do acelerômetro, e a sobrecarga cardiovascular, pelo comportamento da FC. Resultados : os participantes apresentaram média de 112 (DP 24) min/dia de ATF moderada/vigorosa (MV), acumularam em média 14.803 (DP 1.667) passos/dia e gasto energético de 1.860 (DP 481) kcal/dia. A sobrecarga cardiovascular permaneceu, em média, 47 (DP 42) min/dia em esforço vigoroso e 8 (DP 12) min/dia em esforço muito vigoroso. Conclusão: os bombeiros avaliados acumularam mais que o dobro da recomendação mínima de ATF-MV semanal em três dias, apresentaram mais de 50 min/dia de elevada sobrecarga cardiovascular e pouco tempo em comportamento sedentário, se comparados a outras profissões.

Physical activity and work activities in Florida agricultural workers

BACKGROUND

Laboring in hot and humid conditions is a risk factor for heat-related illnesses. Little is known about the amount of physical activity performed in the field setting by agricultural workers, a population that is among those at highest risk for heat-related mortality in the United States.

METHODS

We measured accelerometer-based physical activity and work activities performed in 244 Florida agricultural workers, 18 to 54 years of age, employed in the fernery, nursery, and crop operations during the summer work seasons of 2015-2017. Environmental temperature data during the participant's workdays were collected from the Florida Automated Weather Network and used to calculate wet bulb globe temperature (WBGT). Generalized linear mixed model regression was used to examine the association between WBGT on physical activity, stratified by the agricultural sector.

RESULTS

Fernery workers had the highest overall volume of physical activity, spending nearly 4 hours in moderate to vigorous activity per workday. Activity over the course of the workday also differed by the agricultural sector. A reduction on average physical activity with increasing environmental temperature was observed only among crop workers.

CONCLUSIONS

The quantity and patterns of physical activity varied by the agricultural sector, sex, and age, indicating that interventions that aim to reduce heat-related morbidity and mortality should be tailored to specific subpopulations. Some workers did not reduce overall physical activity under dangerously hot environmental conditions, which has implications for policies protecting worker health. Future research is needed to determine how physical activity and climatic conditions impact the development of heat-related disorders in this population.

Sedentary Time and Physical Activity Across Occupational Classifications

PURPOSE

To examine differences in activity patterns across employment and occupational classifications.

DESIGN

Cross-sectional.

SETTING

A 2005-2006 Coronary Artery Risk Development in Young Adults (CARDIA) study.

SAMPLE

Participants with valid accelerometry data (n = 2068).

MEASURES

Uniaxial accelerometry data (ActiGraph 7164), accumulated during waking hours, were summarized as mean activity counts (counts/min) and time spent (min/d) in long-bout sedentary (≥30 minutes, SED_≥30), short-bout sedentary (<30 minutes, SED_<30), light physical activity (LPA), short-bout moderate-to-vigorous physical activity (<10 minutes, MVPA_<10), and long-bout MVPA (≥10 minutes, MVPA_≥10) using Freedson cut-points. Employment status was self-reported as full time, part time, unemployed, keeping house, or raising children. Self-reported job duties were categorized into 23 major groups using the 2010 Standard Occupational Classification.

ANALYSIS

Omnibus differences were analyzed using adjusted analysis of covariance and repeated after stratification by race (black/white) and sex (female/male).

RESULTS

SED_≥30, SED_<30, LPA, and MVPA_<10 differed significantly by employment and occupational categories (P ≤ .05), while MVPA_≥10 did not (P ≥ .50). SED_≥30, SED_<30, and LPA differed by occupational classification in men, women, blacks, and whites (P < .05). Mean activity counts, MVPA_<10, and MVPA_≥10 were significantly different across occupational classifications in whites (P ≤ .05), but not in blacks (P > .05). Significant differences in mean activity counts and MVPA_<10 across occupational classifications were found in males (P ≤ .001), but not in females (P > .05).

CONCLUSION

Time within activity intensity categories differs across employment and occupational classifications and by race and sex.

Effects of Long-Versus Short-Term Exposure to the Mediterranean Diet on Skin Microvascular Function and Quality of Life of Healthy Adults in Greece and the UK

The beneficial effects of the Mediterranean diet (MD) adherence in reducing cardiovascular disease (CVD) risk and improving CVD-related physiological indices have been well-documented. However, the exact MD adherence duration needed for these effects to occur is under-researched. The aim of the present, two-arm, two-site study clinical trial was to assess the effects of long- vs. short-term MD adherence on the skin microvascular circulation, and quality of life. Two groups were recruited, one being long-term MD adherers (>5 years; from Greece; control group), and one of the non-adherers (from the UK), with the latter participating in a four-week MD intervention (intervention group). Our main outcome was skin microvascular function assessed by cutaneous vascular conductance (CVC). Secondary outcomes included quality of life, dietary intake, blood pressure and lipidemic profile. At the end of the intervention, both groups had high MD adherence. For the intervention group, significantly improved post-intervention CVC values were noted concerning the initial peak phase (2.0 ± 0.6 vs. 2.8 ± 0.8; p < 0.05). CVC values of the control group, were however higher at the plateau phase in comparison to the intervention group (intervention end; 3.8 ± 0.8 vs. 3.1 ± 1.2; p < 0.05). As per QoL, the physical domain was improved post-intervention (13.7 ± 1.2 vs. 15.9 ± 1.2; p < 0.05). No differences were observed in the lipidemic profile between groups, or between the baseline and final intervention phases. The findings indicate that although short-term MD adherence is effective in improving certain microvascular physiological properties and QoL domains, there is room for additional improvement, observed in long-term adherers. Our findings are important in the design of future, MD-based, lifestyle interventions, with the advisable durations differing between target groups.

Risk of cancer and longest-held occupations in Japanese workers: A multicenter hospital-based case-control study

Objectives

Little is known about the risk of developing various cancers according to occupation and occupational physical activity.

Methods

Using nationwide clinical inpatient data (1984‐2017) in Japan, we undertook a multicentered, matched case‐control study with regard to the risk of developing various cancers according to occupation and using patients admitted with fractures as controls. Using standardized national occupation and industrial classifications, we first identified the longest‐held job for each patient. Using sales workers as the reference group, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by conditional logistic regression, adjusted for age, admission period, and the admitting hospital, with smoking, alcohol consumption, and lifestyle diseases as covariates. The risk of high and low occupational physical activity was also estimated.

Results

Across all occupations, a reduced risk for all common cancers among males was observed among those occupations associated with high physical activities, such as agriculture. People in these occupations tended to show a lower risk for most cancers, including, for example, prostate cancer (OR 0.58, 95% CI 0.45‐0.75) and lung cancer (OR 0.63, 95% CI 0.51‐0.76). For females, the breast cancer risk was low in women engaged in agriculture (OR 0.58, 95% CI 0.45‐0.75) and in those occupations with high levels of occupational physical activity (OR 0.58, 95% CI 0.52‐0.66).

Conclusions

This study revealed differences in cancer risk among diverse occupations in Japan. Specifically, those occupations associated with high levels of physical activity may be associated with a decreased risk of cancer.

The relationship between occupational physical activity and self-reported vs measured total physical activity

Introduction

Despite the well-established benefits of physical activity (PA), a large portion of U.S. adults are not meeting recommended health-based guidelines. Although PA occurs in several domains, population-based studies tend to focus on leisure-time PA, with few studies examining occupational activity (OA) level as a separate determinant of overall PA.

Methods

Data were obtained from the 2014-2016 Survey of Health of Wisconsin (SHOW). Currently employed SHOW participants (n = 822) were categorized into OA level categories. Bivariate analyses and multinomial logistic regression analyses were used to identify predictors and to test associations between OA and odds of meeting total PA guidelines using both self-reported and accelerometer-based data.

Results

Individuals with high OA level jobs tended to be males (p < 0.01), current smokers (p < 0.01), and have low education (p < 0.01). When measured by self-report, a greater proportion of individuals in high OA jobs (89%) met the physical activity guidelines compared to those in medium (78%) and low (76%) OA jobs (p = 0.01). Further, adjusted odds of doing some PA vs meeting PA guidelines were higher for low OA vs. high OA level (OR = 2.40, 95% CI 1.46-3.94, p < 0.01). This trend was not observed when PA was measured via accelerometer (OR = 1.00, 95% CI 0.62-1.60, p = 0.99).

Conclusions

Correlations between low, intermediate, and high OA and levels of overall PA varied by measurement type. Further research is needed to improve PA measurements within subdomains such as OA and to examine the tradeoffs between OA and leisure-time PA and relationships with health.

Daily metabolic expenditures: estimates from US, UK and polish time-use data

BACKGROUND

Behaviour has diverse economic, social and health consequences. Linking time spent in different daily activities to energy expenditure (EE) is one way of investigating the health and physiological consequences of behaviour and identifying targets to improve population health and well-being.

METHODS

We estimated behaviour-related EE for respondents to time use surveys (TUS) from three countries: UK 2001, Poland 2012 and US 2003-13. The Harmonised Multinational Time Use Survey (MTUS) activity categories were matched to MET estimates from the 2011 Compendium of Physical Activities. We attach METs values to each successive activity in the TUS, together with both the original UK, Polish and US activity classifications and the 68-category MTUS activity classification. We used TUS estimates of activity durations across 24-h to estimate the Physical Activity Level (PAL) for respondents from the three countries and the average time spent and MET values for different activity categories.

RESULTS

PAL values ranged from 1.59 in the US to 1.74 in Poland. The main sources of daily EE from PA were paid and unpaid work activities. Discretionary PA accounted for only a very small part (~ 3%) of adult daily energy expenditures. Using the harmonised MTUS 68-activity classification reduced the variability of the aggregate PAEE measure by ~ 20%, but the patterns of association between key demographics (age, sex, educational attainment) were unaffected. TUS data were further used to (1) identify sources of daily PA, and (2) assess adherence to physical activity guidelines (PAG) on a single-day basis. Estimated adherence levels were similar to those reported from other TUS as well as frequency based estimates.

CONCLUSIONS

Comparative studies of energy expenditure based on harmonised time use activity categories could provide insight into the relative importance of different activities for energy expenditure across different countries and demographic groups. However, new observational studies combining TUS data with accelerometer, direct observation and other measures of activity intensity are required for more accurate MET assignments to activity categories in TUS.

The DPhacto cohort: An overview of technically measured physical activity at work and leisure in blue-collar sectors for practitioners and researchers

For improved prevention of health issues among blue-collar workers, there is a need for an overview of the physical activity at work and leisure using technical long-term measurements in blue-collar sectors investigation of differences between the sectors. Thus, the objective of this paper was to provide an overview and investigate differences in physical activities and body postures at work and leisure among blue-collar sectors. The Dphacto cohort consists of 1087 workers from manufacturing, transportation and cleaning sectors (901 blue-collar and 186 white-collar workers) in Denmark. Eligible workers provided physical activity and heart rate measurements over several days with follow-up on health-related outcomes by self-report and registers. Considerable differences in sitting, standing, time on feet (walking, shuffling and standing combined) and forward bending of the back were found between work and leisure, and between the sectors. This overview of physical activity at work and leisure can be useful for better prevention of work-related health issues among blue-collar workers.

Device-measured physical activity, sedentary behaviour and cardiometabolic health and fitness across occupational groups: a systematic review and meta-analysis

BACKGROUND

With approximately 8 hours of one's waking day spent at work, occupational tasks and environments are important influencers on an individual's physical activity (PA) and sedentary behaviours. Little research has compared device-measured physical activity, sedentary behaviour and cardiometabolic outcomes between occupational groups.

OBJECTIVE

To compare device-measured movement (sedentary time [ST], light intensity physical activity [LPA], moderate-to-vigorous intensity physical activity [MVPA], and steps) across occupations. The secondary objective was to examine whether cardiometabolic and fitness outcomes differed by occupation.

METHODS

Five bibliographic databases were searched to identify all studies which included working age, employed adults from high-income countries, and reported on device-measured movement within occupations. Risk of bias within and across studies was assessed. Results were synthesized using meta-analyses and narrative syntheses.

RESULTS

The review includes 132 unique studies with data from 15,619 participants. Working adults spent ~ 60% of their working and waking time engaged in sedentary behaviour; a very small proportion (~ 4%) of the day included MVPA. On average, workers accumulated 8124 steps/day. Office and call center workers' steps/day were among the lowest, while those of postal delivery workers were highest. Office workers had the greatest ST and the lowest time in LPA both at work and during wakeful time. However, office workers had the greatest minutes sent in MVPA during wakeful hours. Laborers had the lowest ST and spent a significantly greater proportion of their work time in LPA and MVPA. Healthcare and protective services workers had higher levels of LPA at work compared to other occupations. Workers in driving-based occupations tended to have a higher body mass index and blood pressure.

CONCLUSION

This review identifies that occupational and wakeful time PA and ST differed between occupations. Future studies are needed to assess whether patterns differ by age and sex, describe leisure-time movement and movement patterns, and the relationship with cardiometabolic health.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42017070448 .

Physical activity levels of allied health professionals working in a large Australian metropolitan health district - an observational study

PURPOSE

The aim of this observational cross-sectional study was to determine if allied health professionals working in a large metropolitan health district were meeting the minimal physical activity (PA) recommendations and the proportion that occupational PA contributed to the recommended PA levels. A secondary aim was to determine possible relationships between self-report questionnaire measures of PA and PA measured by accelerometry.

MATERIALS AND METHODS

Allied health professionals, working in the Sydney Local Health District (SLHD) in 2016-2017, completed the Active Australia Survey (AAS), Occupational Sitting and Physical Activity Questionnaire (OSPAQ), International Physical Activity Questionnaire Long form (IPAQ-L), and wore the ActiGraph GT1M accelerometer for 7 days consecutively.

RESULTS

Based on accelerometry results, allied health professionals (N=126) spent a mean (SD) of 51 (23) minutes in moderate-to-vigorous physical activity (MVPA)/day, representing 171% of the total recommended MVPA/day, with work contributing 76% to this recommendation. Participants walked a mean of 10,077 (2,766) steps/day, meeting 100% of the recommended 10,000 steps/day, with work contributing 54% to this recommendation. Sedentary behaviors were predominant throughout the entire day and work day. Compared with the ActiGraph MVPA time measurements, AAS MVPA time showed a fair level of agreement [intraclass correlation coefficient (ICC)=0.44, P<0.01], while OSPAQ and IPAQ-L MVPA time showed no agreement (ICC=0.05, P=0.27; ICC=0.13, P=0.10, respectively).

CONCLUSION

Allied health professionals working in a large metropolitan health district met the daily PA recommendations based on accelerometry measures but tended to overreport their MVPA on self-report questionnaires.

Importance and Potential of Dentists in Identifying Patients at High Risk of Diabetes

OBJECTIVES

The study was conducted to assess the utilization of medical and dental services by dental patients at two dental school hospitals and to approximate the number of patients having no known previous diagnosis of type 2 diabetes but are at high risk of acquiring it.

METHODS

A cross-sectional study was conducted at two dental school hospitals in India. A 20-item questionnaire was administered as interviews among the dental patients aged 35 to 55 years. Data was collected on past dental and medical visits, medical history, family history relevant to diabetes, cardiovascular health, BMI and waist circumference (measured).

RESULTS

A total of 413 adult patients (males 61.26%, females 38.74%) participated in the surveys. The mean age was 43.06 years. Results revealed that nearly 50% did not have a medical or a dental visit in the last 1 year, 33% had Cardiovascular Diseases (CVD). Among those who did not have medical visit in last one year 45% had BMI >25 kg, 55% had waist circumference above the normal range and 38% were at high risk of diabetes.

CONCLUSION

The high number of patients without a medical visit in the past year or more, as well as the high levels of diabetes risk indicators, affirms the need for dentists to perform chair-side screenings for diabetes. These results suggest the need for additional training among dental students to improve early detection and identification of high-risk patients to minimize potential morbidity due to diabetes.

Changes in the configuration and patterns of physical activity among Mongolian adults, 2005-2013

Objective: This study examined the change in physical activity status and patterns and their associations with urban and rural residence and employment status in Mongolia.

Methods: We analyzed data from 7,738 adults aged from 20 to 64 years (n = 2,877 and 4,861 for 2005 and 2013, respectively) from the Mongolian STEPS Survey on the Prevalence of Non-Communicable Disease Risk Factors (NCD-STEPS survey). Physical activity in three domains, including work (occupational and household work); transport (walk or cycling); and leisure (sport or fitness) was measured by Global Physical Activity Questionnaire (GPAQ). Physical activity levels were classified into three groups: low, moderate, and high according to the GPAQ analysis framework. The associations between physical activity time, residential area, and employment status were examined using a multivariate negative binomial regression model.

Results: The percentage of respondents with low-level physical activity increased from 10.9% in 2005 to 27.2% in 2013. The median minutes of physical activity time per week were 1,020 in 2005 and 600 in 2013. Physical activity time at work, transport and overall decreased in 2013. Work-related physical activity was the most dominant component of physical activity time (55.6% in 2005 and 54.6% in 2013), the transport domain was the second-highest contributor of physical activity time in 2005 (24.0%) and was replaced by the leisure domain (26.8%) in 2013. Rural residents practiced more physical activity at work, transport, and leisure than urban residents did in 2005 (prevalence ratio [PR]: 1.33, 95% confidence interval [CI]: 1.20–1.47; PR: 1.21, 95%CI: 1.14–1.29; and PR: 1.21, 95%CI: 1.13–1.30, respectively), but there was no significant difference by residential area in 2013. Mongolian adults with higher educational attainment, employee status, and non-employment status were less likely to engage in physical activity compared to those among adults with lower educational attainment and self-employed status.

Physical activity and common tasks of California farm workers: California Heat Illness Prevention Study (CHIPS)

Farm workers are at risk of heat related illness (HRI), but their work rates that contribute to HRI have not been objectively assessed. The CHIPS study collected accelerometer data and characterized the physical activity of major farm tasks. Demographic information, work characteristics, and accelerometer data were collected from 575 farm workers in California. Each participating worker contributed measurements over one work shift. An Actical accelerometer was attached securely to a belt worn at the hip. Data were collected at one-minute intervals throughout the work shift. A total of 13 major work-task categories were defined. The mean physical activity counts per minute (cpm) and percentage of the shift spent at moderate and/or vigorous levels of activity were described for each task. Multiple linear regression models were constructed to determine the worker and environmental characteristics contributing to the physical activity level. Mean levels of physical activity ranged from 700 cpm (workers who carry produce) to a low of 150 cpm "ground pruners" who tend low-level plants, with an overall mean of 345 cpm or "light" activity (2 to ≤3 metabolic equivalents). The environmental temperature was the major factor associated with physical activity. A 10°C increase in the median temperature reduced the mean cpm by 135 (95% CI = 87, 193). Age and the tasks of sorting, ground pruning, and harvesting low-level crops were also negatively and independently associated with mean cpm. Incentivized (piece rate) pay, multi-task work, and irrigator work were positively associated with cpm. An interaction was found between piece rate and sex. Men's activity significantly increased (p < 0.001) by a mean of 95 cpm, (95% CI = 38.3, 150.7) if they were paid by the piece, but there was a non-significant association with women's activity level. Workers conducting multiple tasks, irrigators, men, and those earning incentivized (piece rate) pay had higher adjusted mean physical activity levels and are likely at increased risk of heat-related illness on hot days.

Daily Physical Activity by Occupational Classification in US Adults: NHANES 2005-2006

BACKGROUND

Little is known about the daily physical activity (PA) levels of people employed in different occupational categories.

METHODS

Nine ActiGraph accelerometer-derived daily PA variables are presented and ranked for adults (N = 1465, 20-60 y) working in the 22 occupational categories assessed by NHANES 2005-2006. A composite score was generated for each occupational category by summing the rankings of 3 accelerometer-derived daily PA variables known to have strong associations with health outcomes (total activity counts [TAC], moderate to vigorous PA minutes per week in modified 10-minute bouts [MVPA 10], and percentage of time spent in sedentary activity [SB%]).

RESULTS

Classified as high-activity occupational categories, "farming, fishing, forestry," and "building & grounds cleaning, maintenance" occupations had the greatest TAC (461 996 and 449 452), most MVPA 10 (149.6 and 97.8), most steps per day (10 464 and 11 602), and near the lowest SB% (45.2% and 45.4%). "Community, social services" occupations, classified as low-activity occupational categories, had the second lowest TAC (242 085), least MVPA 10 (12.1), fewest steps per day (5684), and near the highest SB% (64.2%).

CONCLUSIONS

There is a strong association between occupational category and daily activity levels. Objectively measured daily PA permitted the classification of the 22 different occupational categories into 3 activity groupings.

Dose response association of objective physical activity with mental health in a representative national sample of adults: A cross-sectional study

Although higher physical activity (PA) levels are associated with better mental health, previous findings about the shape of the dose–response relationship between PA and mental health are inconsistent. Furthermore, this association may differ according to sedentary levels. We investigated the cross-sectional dose-response associations between objectively measured PA and mental health in a representative national sample of adults. We also examined whether sedentary time modified the PA—mental health associations. Based on 2007–2013 Canadian Health Measures Survey data, PA and sedentary time were measured using accelerometry among 8150 participants, aged 20 to 79 years. Generalized additive models with a smooth function were fitted to examine associations between minutes per day of moderate and vigorous PA (MVPA), light PA (LPA), daily steps (combined or not with sedentary time) and self-rated mental health. A significant curvilinear relationship between average daily minutes of MVPA and mental health was observed, with increasing benefits up to 50 minutes/day. For LPA, a more complex shape (monotonic and curvilinear) was found. For daily steps, inverted U-shaped curve suggested increasing benefits until a plateau between 5 000 and 16 000 steps. The MVPA-LPA combination was significantly associated with mental health but with a complex pattern (p < 0.0005^E-06). The tested PA-sedentary time combinations showed that increasing sedentary time decreased the positive PA-mental health associations. Non-linear dose-response patterns between the PA modalities and self-reported mental health were observed. Optimal doses of daily minutes of MVPA, LPA, MVPA combined with LPA and daily steps are independently associated with better mental health in adults. The results also suggest that PA-mental health associations could be hampered by daily sedentary time.

Does Physically Demanding Work Hinder a Physically Active Lifestyle in Low Socioeconomic Workers? A Compositional Data Analysis Based on Accelerometer Data

Leisure time physical activity (LTPA) is strongly associated with socioeconomic position (SEP). Few studies have investigated if demanding occupational physical activity (OPA) could impede a physically active lifestyle in low SEP groups. The aim of this study was to investigate the association between OPA and LTPA among low SEP men and women. We used cross-sectional data from 895 low SEP workers who wore accelerometers for 1–5 consecutive workdays. The associations between the relative importance of activities performed during work and leisure time were assessed using compositional regression models stratified on sex. Compositional isotemporal substitution models were used to assess the implication of increasing occupational walking, standing, or sitting on LTPA. We found dissimilarity in LTPA between the sexes, with men spending more waking leisure time sedentary than women (men ~67%, women ~61%), suggesting women performed more household tasks. In men, the associations between OPA and LTPA were weak. In women, the strongest association was observed between the relative importance of occupational walking and leisure time standing (β^ = −0.16; p = 0.01), where reallocating 15 min work time to occupational walking showed an expected decrease in leisure time standing of 7 min. If this time was spent on additional sedentary leisure time, it could have adverse health consequences.

The association between long work hours and leisure-time physical activity and obesity

Obesity affects approximately one-third of all U.S. adults, presenting a large economic and public health burden. Long work hours may be contributing to the rising obesity problem by reducing time for physical activity, particularly for individuals working in sedentary occupations. This study sought to investigate the association between long work hours, leisure-time physical activity (LTPA), and obesity across levels of occupational activity in order to identify potentially vulnerable groups. Cross sectional analysis was performed in 2017 using data from the 2015 Georgia Behavioral Risk Factor Surveillance System and prevalence ratios were estimated across work hour and occupational activity groups. Ability to meet guidelines for LTPA did not differ significantly across work hour categories overall. Those working in low activity occupations were more likely to meet aerobic guidelines for LTPA compared to those in intermediate and high activity occupations (χ2: 19.3; P-value: <0.01). Results of interaction assessment demonstrate that the effects of work hours on obesity risk and meeting aerobic guidelines are significantly different across OA categories, indicating OA to be an effect modifier of the relationship between long work hours and obesity (χ2: 13.33; P-value: <0.001; χ2: 4.42; P-value: <0.05). Employees in intermediate activity occupations working long hours were found to be at the greatest risk for obesity. Further research is required to better understand the mechanisms impacting the relationship between long work hours, domains of physical activity, and obesity risk as well as to identify effective intervention and prevention programs for employees in intermediate activity occupations.

Occupational Differences in BMI, BMI Trajectories, and Implications for Employment Status among Older U.S. Workers

We examined associations between employment and obesity, arguing that risk for unhealthy weight may vary across occupational groups because they shape workplace exposures, social class standing, material resources, and norms and expectations about healthy behaviors and weight. We used a large sample of 51-61-year-old workers from the Health and Retirement study, tracking their body mass index (BMI) over time while accounting for potentially confounding influences of socioeconomic status and gender and exploring whether gender modified associations between occupational group, BMI, and retirement timing. Compared with women in professional occupations, women managers were less likely to be obese at baseline and were less likely to be in the obese upward trajectory class, while female professionals and operators and laborers were less likely than women in farm and precision production to be in the normal stable trajectory. Male professionals were less likely than men in sales, service, and operator and laborer positions to be obese at baseline and more often followed the normal upward trajectory than most other groups, though they and farm and precision production men were more likely to be in the overweight to obese trajectory than men in service occupations. Adjustment for sociodemographic and lifestyle characteristics reduced associations more for men than for women. While retirement risk differed across occupational groups, most of these differences were explained by socioeconomic, demographic, and lifestyle characteristics, especially for men. Obesity at baseline was an independent predictor of retirement but did not further explain differences in the timing of retirement by occupational group.

Attaching metabolic expenditures to standard occupational classification systems: perspectives from time-use research

Background

Traditionally, time-use data have been used to inform a broad range of economic and sociological research topics. One of the new areas in time-use research is the study of physical activity (PA) and physical activity energy expenditure (PAEE). Time-use data can be used to study PAEE by assigning MET values to daily activities using the Ainsworth Compendium of Physical Activities. Although most diarists record their daily activities accurately and in detail, they are only required to record their paid working hours, not the job-specific tasks they undertake. This makes it difficult to assign MET values to paid work episodes.

Methods

In this methodological paper, we explain how we addressed this problem by using the detailed information about respondents’ occupational status included in time-use survey household and individual questionnaires. We used the 2008 ISCO manual, a lexicon of the International Labour Organization of occupational titles and their related job-specific tasks. We first assigned a MET value to job-specific tasks using the Ainsworth compendium (2011) then calculated MET values for each of the 436 occupations in the ISCO-08 manual by averaging all job-specific MET values for each occupation.

Results

The ISCO-08 Major Groups of ‘elementary occupations’ and ‘craft and related trades workers’ are associated with high PAEE variation in terms of their job-specific MET values and together represented 21.6% of the Belgian working population in 2013. We recommend that these occupational categories should be prioritised for further in-depth research into occupational activity (OA).

Conclusions

We developed a clear and replicable procedure to calculate occupational activity for all ISCO-08 occupations. All of our calculations are attached to this manuscript which other researchers may use, replicate and refine.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-017-4546-7) contains supplementary material, which is available to authorized users.