Biological determinants of physical activity across the life course: a "Determinants of Diet and Physical Activity" (DEDIPAC) umbrella systematic literature review

DE-PASS best evidence statement (BESt): determinants of adolescents' device-based physical activity and sedentary behaviour in settings: a systematic review and meta-analysis

BACKGROUND

Although physical activity (PA) is associated with significant health benefits, only a small percentage of adolescents meet recommended PA levels. This systematic review with meta-analysis explored the modifiable determinants of adolescents' device-based PA and/or sedentary behaviour (SB), evaluated in previous interventions and examined the associations between PA/SB and these determinants in settings.

METHODS

A search was conducted on five electronic databases, including papers published from January 2010 to July 2023. Randomized Controlled Trials (RCTs) or Controlled Trials (CTs) measuring adolescents' device-based PA/SB and their modifiable determinants at least at two time points: pre- and post-intervention were considered eligible. PA/SB and determinants were the main outcomes. Modifiable determinants were classified after data extraction adopting the social-ecological perspective. Robust Bayesian meta-analyses (RoBMA) were performed per each study setting. Outcomes identified in only one study were presented narratively. The risk of bias for each study and the certainty of the evidence for each meta-analysis were evaluated. The publication bias was also checked.

PROSPERO ID

CRD42021282874.

RESULTS

Fourteen RCTs (eight in school, three in school and family, and one in the family setting) and one CT (in the school setting) were included. Fifty-four modifiable determinants were identified and were combined into 33 broader determinants (21 individual-psychological, four individual-behavioural, seven interpersonal, and one institutional). RoBMAs revealed none or negligible pooled intervention effects on PA/SB or determinants in all settings. The certainty of the evidence of the impact of interventions on outcomes ranged from very low to low. Narratively, intervention effects in favour of the experimental group were detected in school setting for the determinants: knowledge of the environment for practicing PA, d = 1.84, 95%CI (1.48, 2.20), behaviour change techniques, d = 0.90, 95%CI (0.09, 1.70), choice provided, d = 0.70, 95%CI (0.36, 1.03), but no corresponding effects on PA or SB were found.

CONCLUSIONS

Weak to minimal evidence regarding the associations between the identified modifiable determinants and adolescents' device-based PA/SB in settings were found, probably due to intervention ineffectiveness. Well-designed and well-implemented multicomponent interventions should further explore the variety of modifiable determinants of adolescents' PA/SB, including policy and environmental variables.

Measuring Active Transportation on National Health Surveys in Canada From 1994 to 2020

BACKGROUND

Active transportation (AT), described as self-powered modes of travel (eg, walking and cycling), is an important source of health-promoting physical activity. While AT behaviors have been measured on national health surveys in Canada for over 2 decades, historic prevalence has not been previously reported. We aimed to document the measures of AT on Canada's various national health surveys, examine AT over time, and interpret them within the context of evolving methods of assessment.

METHODS

We compiled and summarized the questions used to measure AT among Canadians on 4 national health surveys: National Population Health Survey (1994-1998), Canadian Community Health Survey (2000-2020), Canadian Health Measures Survey (2007-2019), and the Health Behaviour in School-aged Children Study (2010-2018). Among youth and adults (12+ y), we summarized over time: (1) the prevalence of AT participation and (2) time spent in AT (in hours per week) among those who report any AT participation. Where possible, we reported separate estimates of walking and cycling and produced an aggregate estimate of total AT. We stratified results by age group and sex.

RESULTS

Changes in AT survey questions over time and between surveys limit the interpretation and comparability of temporal trends. Nevertheless, a consistently higher proportion of females report walking, while a higher proportion of males report cycling. Irrespective of mode, males report spending more total time in AT. Participation in AT tends to decrease with age, with youth reporting the highest rates of AT and young adults often spending the most time in AT.

CONCLUSIONS

Monitoring trends in AT can help assess patterns of behavior and identify whether promotion strategies are needed or whether population interventions are effective. Our evaluation of AT over time is limited by questions surveyed; however, consistent differences in AT by age and sex are evident over time. Moving forward, ensuring consistency of AT measurement over time is essential to monitoring this important behavior.

Quantifying Area-Level Physical Activity Offerings in Social Context: A Novel Concept That Goes Beyond Walkability and Access to Open Spaces

BACKGROUND

Social support is a crucial factor influencing the sustainability of physical activity (PA). This proof-of-concept study presents the development of a Social Physical Activity Index for Area (SPAIFA) an indicator reflecting opportunities for individuals to actively participate as part of a group within which opportunities for social interaction can be developed.

METHODS

Six government councils in the state of New South Wales, Australia, were selected encompassing 174 suburbs. Using 2 search engines' map tools, we identified PA venues for each suburb (eg, park, studios, etc). To enumerate activities per suburb, we used (1) venue websites, (2) New South Wales Office of Sport website, (3) national websites of grassroots PA for nonorganized activity (eg, parkrun, meetup, etc), and (4) social media. The database was linked to the suburb demographic profile, the area disadvantage score, walkability and open space scores, and the proportion of insufficiently active residents. Spatial analysis techniques were used to identify SPAIFA clusters.

RESULTS

SPAIFA councils' average was 9.9 activities per 10,000 people (ranging from 6.6/10,000 to 16.2/10,000). SPAIFA-Old (ie, activities specific to older adults) varied significantly (ranging from 11.7/10,000 to 0.8/10,000 seniors). Disadvantaged areas and a high proportion of insufficiently active residents were associated with being classified as low SPAIFA (P < .01). Three clusters of low SPAIFA were identified, and 17 high-risk areas where low SPAIFA was compounded by poor environmental support.

CONCLUSIONS

SPAIFA can be used by councils and policymakers as an indicator for monitoring and intervening in areas where natural and/or urban design is not conducive for PA.

Effects of size at birth on health, growth and developmental outcomes in children up to age 18: an umbrella review

BACKGROUND

Size at birth, an indicator of intrauterine growth, has been studied extensively in relation to subsequent health, growth and developmental outcomes. Our umbrella review synthesises evidence from systematic reviews and meta-analyses on the effects of size at birth on subsequent health, growth and development in children and adolescents up to age 18, and identifies gaps.

METHODS

We searched five databases from inception to mid-July 2021 to identify eligible systematic reviews and meta-analyses. For each meta-analysis, we extracted data on the exposures and outcomes measured and the strength of the association.

FINDINGS

We screened 16 641 articles and identified 302 systematic reviews. The literature operationalised size at birth (birth weight and/or gestation) in 12 ways. There were 1041 meta-analyses of associations between size at birth and 67 outcomes. Thirteen outcomes had no meta-analysis.Small size at birth was examined for 50 outcomes and was associated with over half of these (32 of 50); continuous/post-term/large size at birth was examined for 35 outcomes and was consistently associated with 11 of the 35 outcomes. Seventy-three meta-analyses (in 11 reviews) compared risks by size for gestational age (GA), stratified by preterm and term. Prematurity mechanisms were the key aetiologies linked to mortality and cognitive development, while intrauterine growth restriction (IUGR), manifesting as small for GA, was primarily linked to underweight and stunting.

INTERPRETATION

Future reviews should use methodologically sound comparators to further understand aetiological mechanisms linking IUGR and prematurity to subsequent outcomes. Future research should focus on understudied exposures (large size at birth and size at birth stratified by gestation), gaps in outcomes (specifically those without reviews or meta-analysis and stratified by age group of children) and neglected populations.

PROSPERO REGISTRATION NUMBER

CRD42021268843.

Determinants of physical activity in community-dwelling older adults: an umbrella review

INTRODUCTION

Physical activity (PA) is critical for disease prevention and maintaining functional ability with aging. Despite this, as many as 50% of older adults in populations worldwide are considered insufficiently active. There is a recognized need to mobilize policies targeted toward modifiable determinants of healthy aging like PA. This umbrella review aimed to summarize the evidence for determinants of PA in community-dwelling older adults.

METHODS

A research librarian searched six databases. Systematic and scoping reviews were included if they investigated community-dwelling people with a mean age of 60 + years and examined a relationship between a determinant and any type of PA. Two independent reviewers screened and extracted data from all reviews. JBI methodology and Critical Appraisal Checklist for Systematic Reviews and Research Syntheses were followed and information on the quality of the evidence was extracted.

RESULTS

From 17,277 records screened,11 reviews representing > 300 unique primary papers were ultimately included. Only 6% of studies included in all reviews had longitudinal designs. Included studies used a large variety of PA measures, with 76% using only self-report, 15% using only direct measures (e.g., accelerometry), 3% using both types, and 6% with no outcome measure reported. Only four reviews provided a definition of PA and there was substantial inconsistency in the way PA was categorised. Community level influences, which only included the physical environment, were the most commonly assessed (6/11) with more than 70% of the summarized relationships demonstrating null associations. Three out of four reviews reported a positive relationship between walkability and PA in general community-dwelling older adults. There was also evidence supporting relationships between presence of social support for PA, younger age, and men having higher PA from a single systematic review. None of the included reviews assessed the quality of evidence but over 60% performed a risk of bias assessment.

CONCLUSIONS

Walkability, age, gender, and social support for PA were the most supported PA determinants identified. Further research should focus on interpersonal and intrapersonal influences and incorporate direct measures of PA with clear operational definitions. There is a need for longitudinal study designs to further understand determinants of PA behaviour trajectories.

Does the Installation or the Improvement of Existing Outdoor Parks Increase Physical Activity Levels? A Systematic Review

Investment in outdoor parks is proposed as a promising large-scale strategy to promote physical activity (PA). This study aimed to systematically review the impact of park renovations or installing new ones in increasing PA. Searches were conducted using predefined terms in three databases (PubMed, Scopus, and Web of Science) in March 2022. Studies examining the effectiveness of park renovations or developing new ones in increasing PA and having control or comparison were eligible for inclusion. Study quality was assessed using the Quality Assessment Tool for Quantitative Studies. Data were extracted from the included records using a predefined extraction table. The database search yielded 959 records, and 26 were included. For park renovations (n = 17), 11 (65%) studies presented findings supporting a positive effect on PA. The other six (35%) studies found no PA benefits when compared to control or pre-renovations/improvement levels. Regarding new installations (n = 9), five (56%) studies presented improvements in PA, and four (44%) did not. A promising positive impact of park renovations and new installations on park use and PA was observed. The review findings reflect the need to understand the context, daily routines, and interests of the surrounding population before renovating or installing new outdoor parks.

Trajectories of Device-Measured Physical Activity During Early Childhood and Its Determinants: Findings From the 2015 Pelotas (Brazil) Birth Cohort Study

BACKGROUND

The objective was to describe trajectories of physical activity (PA) measured by accelerometry during early childhood and to test associations with sociodemographic, gestational, maternal, and perinatal determinants.

METHODS

Data from 1798 children from the 2015 Pelotas (Brazil) Birth Cohort were analyzed. PA was measured with wrist accelerometers at 1, 2, and 4 years. PA trajectories were estimated using group-based trajectory modeling, and associations with determinants were tested using Poisson regression with robust variance.

RESULTS

Two trajectories were identified: Moderate and high PA, both showing a linear increase in PA in the first years but differing in volume. Girls (prevalence ratio [PR]: 0.91; 95% confidence interval [CI], 0.88-0.94), highly educated mothers (PR: 0.93; 95% CI, 0.88-0.97), and high birth weight children (PR: 0.91; 95% CI, 0.85-0.97) showed less probability of high PA trajectory. Birth order ≥3 (PR: 1.06; 95% CI, 1.01-1.11) was associated with higher likelihood of high PA trajectory.

CONCLUSIONS

Children showed an increase in PA during the first years, with 2 trajectories that differ in PA levels. Female sex, high maternal schooling, and high birth weight reduced the probability of having a high PA trajectory, while higher birth order increased this probability. These characteristics should be considered when planning PA interventions for children in early childhood.

Longitudinal Changes in Moderate to Vigorous Physical Activity in Community-Dwelling Older Men and Women: A 2-Year Prospective Cohort Study in Japan

BACKGROUND

To examine longitudinal changes in accelerometer-measured moderate to vigorous physical activity (MVPA) and associated factors of changes in MVPA among community-dwelling older Japanese men and women over 2 years of follow-up.

METHODS

In total, 601 participants (72.2 [5.4] y, 40.6% men) were included. MVPA was assessed at baseline (2011) and follow-up (2013) using triaxial accelerometers. Sex-stratified multiple linear regression models were used to identify associated factors of changes in MVPA.

RESULTS

On average, a significant decrease in MVPA over 2 years was observed only in women (P < .001). Higher baseline MVPA levels and older age were significantly associated with a decrease in MVPA over 2 years in both men and women. Men who were currently drinking (vs no) and had faster maximum gait speed showed statistically significant increases in MVPA. Women who had very poor/poor economic status (vs fair/good) and were socially isolated (vs no) showed statistically significant increases in MVPA over 2 years, while those who had fear of falling (vs no) and poor/fair self-rated health (vs good/very good) showed statistically significant decreases in MVPA over 2 years.

CONCLUSIONS

Our findings showed different associated factors of changes in MVPA by sex, suggesting the importance of accounting for sex differences in terms of developing specific intervention strategies for promoting MVPA among older men and women.

Sociodemographic moderators of longitudinal changes in active play between childhood and adolescence in Australia

Physical activity (PA) participation is prone to decline during childhood and adolescence. In Australia, this decline has been shown to particularly occur in active play. This study aimed to identify sociodemographic moderators of change in active play between 10-11y and 12-13y among Australian youth. The data were sourced from Waves 6-7 of the Longitudinal Study of Australian Children (n = 3567). Active play participation was measured using one-day time-use diaries (TUDs) completed by youth. Potential sociodemographic moderators were tested using multilevel mixed modelling, adjusted for pubertal development, body mass index z-score and TUD contextual variables (school attendance and season). Active play declined more among girls (β= -7.6 min/day, 95% CI = -13.3, -1.8), those who spoke English at home (β= -12.3 min/day, 95% CI = -22.0, -2.7) and marginally among those in regional/remote areas (β= -6.3 min/day, 95% CI = -12.8, +0.1). A widening gap in active play by sex was observed, while differences by language spoken at home and geographical remoteness weakened or became marginal over time. Interventions to promote active play could target girls in the transition to adolescence. Future studies could investigate whether active play declines earlier than 10-11y among youth who speak languages other than English at home and those living in urban areas.

Sex as a biological determinant in anthropometric, biochemical, and dietary changes during Ramadan intermittent fasting in healthy people: A systematic review

AIMS

Observing Ramadan intermittent fasting (RIF) is associated with different behavioral, dietary, and health-related outcomes among healthy and unwell people. Sex is a major biological determinant that affects various health outcomes and impacts the effectiveness of dietary and lifestyle modifications. This systematic review aimed to identify differences in health-related outcomes following the practice of RIF by the sex of study participants.

METHODS

A systematic search was conducted across several databases to qualitatively identify studies focused on dietary, anthropometric, and biochemical outcomes associated with RIF in females and males.

RESULTS

Of 3870 retrieved studies, sex-based differences were reported in 29 studies that included 3167 healthy people (females n = 1558, 49.2%). Most differences between males and females were reported both before and during RIF. Sex differences were examined for 69 outcomes following RIF and included dietary factors (17 outcomes), anthropometrics (13 outcomes), and biochemical factors (39 outcomes), with the latter including metabolic, hormonal, regulatory, inflammatory, and nutrition-related biochemical markers.

CONCLUSIONS

Sex-based differences were observed in the examined dietary, anthropometric, and biochemical outcomes associated with the observance of RIF. More attention needs to be directed toward including both sexes in studies focused on the impact of observing RIF and differentiating outcomes based on sex.

The development of a family-based wearable intervention using behaviour change and co-design approaches: move and connect

BACKGROUND

Previous research has explored the effectiveness of wearable activity trackers (wearables) for increasing child physical activity (PA) levels, but there have been mixed results. The use of theoretical frameworks and co-design techniques are recognised ways of increasing an intervention's acceptability and effectiveness.

AIMS

This study aims to use co-design workshops and an evidence-based theoretical framework (the Behaviour Change Wheel) to develop a family-based PA intervention using wearables.

METHODS

Three stages of intervention development outlined by the Behaviour Change Wheel were used. Co-design workshops with seven families (11 parents and 12 children) and seven PA experts were conducted where stakeholders discussed how to overcome previously identified barriers to families being active and using wearables. This resulted in the intervention's components being developed, with each component's mechanisms of action (e.g. intervention functions and behaviour change techniques) being retrospectively identified.

RESULTS

The 'Move & Connect' intervention was developed, which targets family PA and wearable use. The intervention takes a flexible approach and includes eight components, including wearable devices (Fitbit Alta HR), support resources, an introductory workshop, collective challenges, goal setting and reviewing, engagement prompts, social support and health-related resources (e.g. educational videos). The intervention incorporates six intervention functions targeting PA and wearable use: education, training, modelling, persuasion, incentivisation and environmental restructuring and 24 behaviour change techniques, including goal setting, social comparison, feedback on behaviour and graded task.

CONCLUSIONS

This is the first known study to use an evidence-based framework and co-design to develop a family-based wearable intervention. The identification of the intervention's mechanisms of action will prove useful when implementing and evaluating the 'Move & Connect' intervention and allow researchers to replicate its components.

Motivational readiness for physical activity and health literacy: results of a cross-sectional survey of the adult population in Germany

BACKGROUND

Health literacy, defined as the knowledge, motivation, and competences to use health information to improve health and well-being, is associated with regular physical activity. However, there is limited evidence on whether health literacy is also related to the motivational readiness for physical activity in a general population. The aim of this study was to investigate whether motivational readiness for leisure-time physical activity is associated with health literacy.

METHODS

Analyses were based on data of 21,895 adults from the cross-sectional German Health Update and European Health Interview Survey 2014/2015 (GEDA 2014/2015-EHIS). Motivational readiness for leisure-time physical activity was assessed with stages of change for physical activity with a set of validated items. It was then classified, according to an established algorithm, into five stages: precontemplation, contemplation, preparation, action, and maintenance. Health literacy was measured with the short form of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) and categorised as low, medium, and high. For bivariate and multinomial logistic regression analyses, the stages were categorised in three phases as: (1) no intention (precontemplation), (2) planning (contemplation or preparation), and (3) in activity (action or maintenance). The models were adjusted for sex, age, education, health consciousness, self-efficacy, and self-perceived general health status.

RESULTS

High compared to low health literacy was associated with a 1.65-times (95% CI = 1.39-1.96) greater probability of being in activity than planning. High compared to low health literacy was associated with a reduced risk of having no intention to change physical activity behaviour (relative risk ratio, RRR = 0.84, 95% CI = 0.75-0.95). The associations persisted after adjusting for covariates.

CONCLUSION

High health literacy was positively associated with more advanced phases of motivational readiness for leisure-time physical activity. Therefore, taking health literacy into account in interventions to promote motivational readiness for leisure-time physical activity could be a useful approach.

DE-PASS Best Evidence Statement (BESt): modifiable determinants of physical activity and sedentary behaviour in children and adolescents aged 5-19 years-a protocol for systematic review and meta-analysis

INTRODUCTION

Physical activity among children and adolescents remains insufficient, despite the substantial efforts made by researchers and policymakers. Identifying and furthering our understanding of potential modifiable determinants of physical activity behaviour (PAB) and sedentary behaviour (SB) is crucial for the development of interventions that promote a shift from SB to PAB. The current protocol details the process through which a series of systematic literature reviews and meta-analyses (MAs) will be conducted to produce a best-evidence statement (BESt) and inform policymakers. The overall aim is to identify modifiable determinants that are associated with changes in PAB and SB in children and adolescents (aged 5-19 years) and to quantify their effect on, or association with, PAB/SB.

METHODS AND ANALYSIS

A search will be performed in MEDLINE, SportDiscus, Web of Science, PsychINFO and Cochrane Central Register of Controlled Trials. Randomised controlled trials (RCTs) and controlled trials (CTs) that investigate the effect of interventions on PAB/SB and longitudinal studies that investigate the associations between modifiable determinants and PAB/SB at multiple time points will be sought. Risk of bias assessments will be performed using adapted versions of Cochrane's RoB V.2.0 and ROBINS-I tools for RCTs and CTs, respectively, and an adapted version of the National Institute of Health's tool for longitudinal studies. Data will be synthesised narratively and, where possible, MAs will be performed using frequentist and Bayesian statistics. Modifiable determinants will be discussed considering the settings in which they were investigated and the PAB/SB measurement methods used.

ETHICS AND DISSEMINATION

No ethical approval is needed as no primary data will be collected. The findings will be disseminated in peer-reviewed publications and academic conferences where possible. The BESt will also be shared with policy makers within the DE-PASS consortium in the first instance.

SYSTEMATIC REVIEW REGISTRATION

CRD42021282874.

What Types of Exercise Are Best for Emotional Intelligence and Logical Thinking?

The aim of our study was to determine whether EI and LT vs. intuitive thinking (CRT score) are related to participation in professional sports, independent exercise, and exercise at a gym/health center compared with no exercise. We selected 20 of the most popular types of exercise in Lithuania among respondents who exercise independently or at a gym/health center, and we ranked these types of exercise according to the participants' emotional intelligence and logical thinking. We studied 4545 women and 1824 men aged 18-74 years with a focus on whether emotional intelligence and logical thinking are related to type of exercise. Participation in any exercise was significantly related to emotional intelligence in men and women. Women in professional sports solved the lowest number of logic tasks. Women who exercise independently or at a gym/health center had better logical thinking than those who do not exercise. Among men, logical thinking was not associated with the type of exercise. We found the tendency for a negative correlation between EI and LT in the 20 most popular types of exercise. Emotional intelligence correlated positively with participation in MVPA. The highest emotional intelligence was in women who participate in dance or Pilates and in men who participate in martial arts, wrestling, boxing, or yoga. Logical thinking was the highest in men who participate in triathlon and in women who perform CrossFit. Men who practice martial arts or track and field and women who participate in cycling were in the top five for emotional intelligence and logical thinking.

Investigating psychological variables for technologies promoting physical activity

Background

Many technological interventions designed to promote physical activity (PA) have limited efficacy and appear to lack important factors that could increase engagement. This may be due to a discrepancy between research conducted in this space, and software designers' and developers' use of this research to inform new digital applications.

Objectives

This study aimed to identify (1) what are the variables that act as barriers and facilitators to PA and (2) which PA variables are currently considered in the design of technologies promoting PA including psychological, physical, and personal/contextual ones which are critical in promoting PA. We emphasize psychological variables in this work because of their sparse and often simplistic integration in digital applications for PA.

Methods

We conducted two systematized reviews on PA variables, using PsycInfo and Association for Computing Machinery Digital Libraries for objectives 1 and 2.

Results

We identified 38 PA variables (mostly psychological ones) including barriers/facilitators in the literature. 17 of those variables were considered when developing digital applications for PA. Only few studies evaluate PA levels in relation to these variables. The same barriers are reported for all weight groups, though some barriers are stronger in people with obesity.

Conclusions

We identify PA variables and illustrate the lack of consideration of these in the design of PA technologies. Digital applications to promote PA may have limited efficacy if they do not address variables acting as facilitators or barriers to participation in PA, and that are important to people representing a range of body weight characteristics.

Prevalence, Patterns, and Predictors of Physical Inactivity in an Urban Population of India

Physical inactivity (PI) is a risk factor for mortality and morbidity. PI and its predictors among the urban population in Bhubaneswar, India, were unknown. Finding out the contribution of PI as a cause of existing noncommunicable diseases (NCD) is difficult without following up with a cohort. The study was hence done to find out the prevalence, patterns, and predictors of physical inactivity in an urban population, and simultaneously investigate its causal relationship with NCD from this cross-sectional study. Cluster random sampling was used with a sample size of 1203 with a design effect of three. Socio-demographic, health profile, physical activity levels, and stage of change for physical activity behavior were collected. Logistic regression and marginal structural model analysis (by inverse probability of treatment weighting {IPTW} using a generalized estimating equation {GEE} to investigate the relationship between physical activity and prevalence of NCDs) were done using IBM SPSS v20 software (Armonk, NY: IBM Corp.). Statistical significance was tested at p=0.05. A total of 1221 subjects participated. The mean age was 35.25 years and 71.9% were physically inactive. General caste, presence of NCD, and being in a static stage of change influenced physical activity positively. PI was found to be a risk factor for NCD with 1.54 times higher odds in this population. The study concluded that the prevalence of physical activity was low and PI was a causative factor for NCD.

Do Physical Activity, BMI, and Wellbeing Affect Logical Thinking?

We studied 6368 people (4544 women and 1824 men; aged 18–74 years). The research goal was to determine whether the Cognitive Reflection Test score (logical thinking compared with intuitive thinking) depends—and in what way it depends—on the healthy lifestyle components and emotional health-related components as well as age (18–74 years) and gender. We established that analytical vs. intuitive thinking depended on components of a healthy lifestyle, physical activity, sleep, eating habits, smoking and alcohol consumption, specificity of sporting activity, body mass index, and emotional health-related components (stress, depression, impulsivity, subjective health, emotional intelligence), as well as age and gender. We found that logical thinking was not associated with sleep, moderate-to-vigorous PA, impulsivity, subjective health, and components of a healthy lifestyle. However, logical thinking decreases with age, gender (higher in men than in women), BMI (decreases in both genders over the second degree of obesity), depression (the more severe depression in women, the worse their logical thinking), sedentary behavior (people who sat for longer periods had more difficulty solving problems), and in professional sportswomen (logical thinking is worse in professional sportswomen than in sedentary women, amateur sportswomen, or women who use gyms). Finally, we determined inverse correlations between logical thinking, emotional intelligence, and stress.

Comparison of bone mineral density according to domains of sedentary behavior in children and adolescents

BACKGROUND

Somatic maturation and the age at onset of puberty are closely related to bone mineral density (BMD), and are potential confounders of the associations between physical activity, sedentary behavior (SB) and BMD in adolescents. Thus the aim was compare BMD at different anatomical sites according to different domains of SB.

METHODS

The sample consisted of 88 young people (54 boys and 34 girls; 9.5 ± 1.5 years). The self-reported SB was measured by the time spent on TV, computer, video game and smartphone. BMD at each location and throughout the body was assessed by DEXA. Physical activity was assessed by a questionnaire. The comparison of the different types of BMD sites according to the SB levels for each screen device and the total SB were analyzed by Covariance Analysis (ANCOVA).

RESULTS

Whole-body BMD was higher in young people with low total SB (Total BMD = 0.957 ± 0.042) than in those with moderate (Total BMD = 0.921 ± 0.053) and high SB (Total BMD = 0.929 ± 0.051) (p-value = 0.011). Children and adolescents with low total SB had higher BMD legs (0.965 ± 0.056) than young people with high total SB (BMD legs = 0.877 ± 0.209), but this relationship was attenuated when the analyzes were adjusted for physical activity (p-value = 0.068).

CONCLUSION

Adolescents with high sedentary behavior tend to have lower whole body bone mineral density than those with low sedentary behavior.

Physical Activity, Stress, Depression, Emotional Intelligence, Logical Thinking, and Overall Health in a Large Lithuanian from October 2019 to June 2020: Age and Gender Differences Adult Sample

This study aimed to examine relationships and group differences among adult people’s (aged 18–74) physical activity (PA), expression of stress, depression, emotional intelligence (EI), logical thinking (LT), and overall health assessment. Two hypotheses were formulated before the study. The first hypothesis is that overweight and obesity in young adults (18 to 34 years) females and males, in particular, should increase sharply and this should be associated with decreased PA, abruptly deteriorating subject health, increased stress, depression, and poorer emotion management and EI. Second hypothesis: We further thought that the better people’s reflective thinking, the more they should live a healthier life (e.g., exercise more and eat healthier), their overweight and obesity should be small or none. We aimed to confirm or reject these two hypotheses. We applied a quantitative cross-sectional study design. The study results revealed that during the lifespan of 18–24 and 25–34 years (young adults) there was a sharp increase in overweight and obesity, a decrease in PA (and especially vigorous physical activity (VPA)) (and this was particularly evident in the male), while research participants felt less stress and depression, subjective assessment of health did not change, and EI increased steadily with age (18–24 to 65–74 years). The higher the EI of the research participants from 18–24 to 65–74 years of age the higher their moderate-to-vigorous physical activity (MVPA), the less stress and depression they felt. Based on the results, it can be said that both females and males prefer PA “with a hot heart rather than a cold mind.” We base this conclusion on the fact that females and males who have the highest EI also have the highest MVPA while LT is not associated with MVPA.

Digital Interventions on Healthy Lifestyle Management: Systematic Review

BACKGROUND

Digital interventions have tremendous potential to improve well-being and health care conveyance by improving adequacy, proficiency, availability, and personalization. They have gained acknowledgment in interventions for the management of a healthy lifestyle. Therefore, we are reviewing existing conceptual frameworks, digital intervention approaches, and associated methods to identify the impact of digital intervention on adopting a healthier lifestyle.

OBJECTIVE

This study aims to evaluate the impact of digital interventions on weight management in maintaining a healthy lifestyle (eg, regular physical activity, healthy habits, and proper dietary patterns).

METHODS

We conducted a systematic literature review to search the scientific databases (Nature, SpringerLink, Elsevier, IEEE Xplore, and PubMed) that included digital interventions on healthy lifestyle, focusing on preventing obesity and being overweight as a prime objective. Peer-reviewed articles published between 2015 and 2020 were included. We used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and a framework for an evidence-based systematic review. Furthermore, we improved the review process by adopting the Rayyan tool and the Scale for the Assessment of Narrative Review Articles.

RESULTS

Our initial searches identified 780 potential studies through electronic and manual searches; however, 107 articles in the final stage were cited following the specified inclusion and exclusion criteria. The identified methods for a successful digital intervention to promote a healthy lifestyle are self-monitoring, self-motivation, goal setting, personalized feedback, participant engagement, psychological empowerment, persuasion, digital literacy, efficacy, and credibility. In this study, we identified existing conceptual frameworks for digital interventions, different approaches to provide digital interventions, associated methods, and execution challenges and their impact on the promotion of healthy lifestyle management.

CONCLUSIONS

This systematic literature review selected intervention principles (rules), theories, design features, ways to determine efficient interventions, and weaknesses in healthy lifestyle management from established digital intervention approaches. The results help us understand how digital interventions influence lifestyle management and overcome the existing shortcomings. It serves as a basis for further research with a focus on designing, developing, testing, and evaluating the generation of personalized lifestyle recommendations as a part of digital health interventions.

Determinants of physical activity in older adults: an umbrella review protocol

OBJECTIVE

The aim of this review is to summarize the evidence for determinants of physical activity in older adults.

INTRODUCTION

Physical activity is an important predictor of multi-morbidity, falls, and cognitive decline in older adulthood. Understanding what influences older adults' physical activity behavior is an important first step for guiding effective interventions for promoting physical activity in this population.

INCLUSION CRITERIA

This umbrella review will include systematic reviews (including scoping reviews) reporting on the relationship between determinants (also referred to as correlates or factors), measured by either self-report or direct measurement, and physical activity in adults ≥60 years.

METHODS

A systematic search of six databases will be completed in MEDLINE, Embase, CINAHL, Cochrane Library, PsycINFO, and AgeLine. Two independent reviewers will screen titles, abstracts, and full-text articles, and perform data extraction and quality assessment. Evidence for determinants of physical activity will be synthesized using the socio-ecological model. If possible, evidence will be compared by study design, type of physical activity, outcome measure used, setting, and sex.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42020159332.

Active use and perceptions of parks as urban assets for physical activity: A mixed-methods study

Parks are potential key urban assets for improved population health; however, their use is not equal among all social groups. Individual and contextual factors could influence residents' perceptions of parks and how they interact with and, eventually, benefit from them. The use of complementary methodologies provides a deeper understanding of the relationship between park use, physical activity (PA), and residents' perceptions. Thus, we designed a mixed-methods study to analyze differences in park use and PA, and the perceptions of parks as urban assets for PA. We selected six parks from three neighborhoods in Madrid (Spain) with different neighborhood socioeconomic status (NSES) for systematic social observation. We registered park users by age, PA level (low, medium, and high), gender, and NSES using the System for Observing Play and Recreation in Communities (SOPARC) audit tool adapted for iOS software (iSOPARC). We also conducted 37 semi-structured interviews and 29 focus groups to analyze residents' perceptions of parks as urban assets for PA in the same neighborhoods. We adopted a convergent-parallel design to analyze both quantitative and qualitative data, and to describe the convergence and divergence areas between them. Parks within the high-NSES were more visited, showing a higher proportion of people performing high PA (11.9%) as compared to residents of the middle (9.3%) and low-NSES (3.2%). Female visitors showed lower PA levels compared to men, especially for parks within high-NSES. The following issues were reported as influence urban park use and perceptions: park maintenance and area perception, works constraints, insecurity and crime, differential perceptions by age, and the availability of organized activities in the parks. Residents from high-NSES reported fewer barriers to park use compared to residents from the other areas, who reported limitations such as less leisure time due to job constrains or perceived insecurity in parks. Senior participants reported that having parks with organized activities and a design oriented towards different age-groups are valuable. Our study shows consistency between the fewer and less intense use of parks registered in the middle and low-NSES neighborhoods, and the more barriers for PA reported in this areas during the qualitative analysis. Mixed-methods provided an insight of the potential causes leading to the differences in park use and PA within cities, which is essential in terms of environmental justice and health equity. Thus, a mixed-methods comprehensive approach to public health problems can help designing public policies addressing relevant factors related to urban health inequities.

Bayesian structural time series for biomedical sensor data: A flexible modeling framework for evaluating interventions

The development of mobile-health technology has the potential to revolutionize personalized medicine. Biomedical sensors (e.g., wearables) can assist with determining treatment plans for individuals, provide quantitative information to healthcare providers, and give objective measurements of health, leading to the goal of precise phenotypic correlates for genotypes. Even though treatments and interventions are becoming more specific and datasets more abundant, measuring the causal impact of health interventions requires careful considerations of complex covariate structures, as well as knowledge of the temporal and spatial properties of the data. Thus, interpreting biomedical sensor data needs to make use of specialized statistical models. Here, we show how the Bayesian structural time series framework, widely used in economics, can be applied to these data. This framework corrects for covariates to provide accurate assessments of the significance of interventions. Furthermore, it allows for a time-dependent confidence interval of impact, which is useful for considering individualized assessments of intervention efficacy. We provide a customized biomedical adaptor tool, MhealthCI, around a specific implementation of the Bayesian structural time series framework that uniformly processes, prepares, and registers diverse biomedical data. We apply the software implementation of MhealthCI to a structured set of examples in biomedicine to showcase the ability of the framework to evaluate interventions with varying levels of data richness and covariate complexity and also compare the performance to other models. Specifically, we show how the framework is able to evaluate an exercise intervention’s effect on stabilizing blood glucose in a diabetes dataset. We also provide a future-anticipating illustration from a behavioral dataset showcasing how the framework integrates complex spatial covariates. Overall, we show the robustness of the Bayesian structural time series framework when applied to biomedical sensor data, highlighting its increasing value for current and future datasets.

In this paper, we propose and describe a robust and flexible modeling framework called MhealthCI based on the Bayesian structural time series, for which we have found to excel at analyzing diverse biosensor data. While Bayesian modeling is often employed in various fields such as finance, marketing, and weather forecasting, it is rarely used in biomedicine, specifically for biosensor and wearable data relating to human health and behavior. We use and apply this framework with the goal of interpreting and quantifying the causal impact of an intervention, a widespread goal of biomedicine. We describe the diversity of data types to which it could apply, provide intuition to its mechanics, collect relevant data in various fields, provide a wrapper tool around well-known R packages that prepares and registers diverse biosensor data to be analyzed, and finally apply the method to showcase its strength in quantifying the impact of interventions.

Differential Effects of Resistance- and Endurance-Based Exercise Programs on Muscular Fitness, Body Composition, and Cardiovascular Variables in Young Adult Women: Contextualizing the Efficacy of Self-Selected Exercise Modalities

There is an evident lack of research simultaneously investigating endurance training (ET) and resistance training (RT) with regard to their potential influence on fitness and health status in young women. This study aimed to determine the effects of RT and ET three times a week over an eight-week period on anthropometric/body composition indices, blood pressure (BP), and muscular fitness in apparently healthy young women who participated in a self-preferred program. The sample of participants comprised 57 young healthy women (23.9 ± 3.08 years, 165.5 ± 5.8 cm, 66.8 ± 7.2 kg) divided into ET (n = 18), RT (n = 19), and non-exercising (C) (n = 20) groups. The variables consisted of anthropometric/body composition indices (body mass, BMI, body fat, and lean body mass), muscular fitness variables (lower body strength, upper body strength, abdominal strength, dynamometric force, and flexibility), and cardiovascular parameters (resting heart rate and systolic and diastolic BP). A pre- and post-testing design, with factorial analysis of variance for repeated measurements (ANOVA: Group × Measurement), including a consecutive post hoc test, was applied. The ANOVA indicated a similar improvement in body composition (increase in lean body mass and decrease in body fat percentage), resting heart rate, and flexibility in both of the exercise groups, with no significant changes in the C group. RT improved the participants' strength and force capacities to a greater extent than ET. BP showed a trend of improvement in both of the training groups, but without statistically significant pre- to post-changes. Correlation analysis calculated with variables of pre- to post-differences (VDs) indicated poor associations between VDs, indicating relative independence of the obtained effects for the different variables in each training group. Although this investigation comprised apparently healthy young women, numerous positive changes indicated the efficacy of both programs in a relatively short period of time. While the participants in this study self-selected training programs, the evidenced positive effects can be at least partially related to this fact.

Associations Between Occupational and Leisure-Time Physical Activity With Employee Stress, Burnout and Well-Being Among Healthcare Industry Workers

PURPOSE

Examine the associations of occupational and leisure-time physical activity with job stress, burnout, and well-being among healthcare industry workers.

DESIGN

Quantitative; cross-sectional.

SETTING

Healthcare Industry.

SAMPLE

US Amazon Mechanical Turk participants (n = 550) employed in the healthcare industry, worked 35 hours or more per week, had ≥ 1 supervisor and ≥ 1 co-worker, and were ≥ 18 years old.

MEASURES

Self-reported measures of occupational physical activity (OPA) and leisure-time physical activity (LTPA), employee well-being, job stress, and burnout operationalized as exhaustion and disengagement.

ANALYSIS

Associations between OPA and LTPA with employee well-being, job stress, exhaustion and disengagement were assessed with separate multiple linear regression models.

RESULTS

OPA had positive significant associations with job stress (β = 0.10, P value = .003) and exhaustion (β = 0.21, P value < .0001). No significant associations were found between OPA with other psychological outcomes. A significant inverse association was found between LTPA and exhaustion (β = -0.04, P value = .007).

CONCLUSION

In a sample of U.S. health care workers, and consistent with prior epidemiological studies, greater LTPA was associated with lower feelings of exhaustion. In contrast, health care workers with greater OPA reported higher perceptions of job stress and exhaustion. The findings underscore the need for more research aimed at understanding relationships between OPA and psychological health among healthcare workers.

Objectively Measured Physical Activity Increases Only in Males During a Summer Camp for Obese Children

Childhood obesity is a major public health challenge. Summer camps for children with obesity represent an alternative setting to improve eating and physical activity habits. Here we evaluated if the participation in the camp improves objectively measured physical activity and sedentary behavior and whether there are differences between male and female participants. Twenty-eight children, 13 males and 15 females (body mass index >97° centile, weight excess >30%, Tanner stage I), agreed to participate in an 8-day camp. During the summer camp, children participated in sports-like games and outdoor activities for at least 3 h a day, and the school-camp staff also provided a theoretical nutritional learning plan. Accelerometry-derived physical activity was measured through the SenseWear Mini Armband during a week at home and during the camp experience. Before camping, the participants were far above the minimum daily values of moderate- to vigorous-intensity physical activity (MVPA) to be considered sufficiently active (≥60 min/day), but male participants were more active than females (MVPA: 186.2 ± 94.2, 111.0 ± 64.7; P = 0.020). Male participants increased their MVPA (234.3 ± 114.8, P = 0.020), whereas females not (111.9 ± 52.9, P = 0.020). No difference emerged for the sedentary behavior either before or during the camp. This study suggests that participation in a summer camp for obese children can determine different responses in physical activity levels, depending on the sex of young participants. Thus, summer camps for obese children should put particular attention on female participants, besides reducing sedentary behavior in both males and females.

Correction to: Biological determinants of physical activity across the life course: a "Determinants of Diet and Physical Activity" (DEDIPAC) umbrella systematic literature review

An amendment to this paper has been published and can be accessed via the original article.

Changes in Physical Activity and Sedentary Behavior Amid Confinement: The BKSQ-COVID-19 Project

BACKGROUND

Coronavirus disease 19 (COVID-19) has compelled implementing confinement measure across the globe. These measures can potentially lead to many changes in lifestyle. However, no studies examined the effect of COVID-19-induced confinement on physical activity (PA) and sedentary behavior (SB).

METHODS

During April and May of 2020, the current study surveyed changes in PA and SB induced by COVID-19 confinement.

RESULTS

The participants of the study were 1844. Among the participants who were regularly involved in PA, the majority (41.8-42.2%) of the participants reported a "decrease" (p<0.05) in walking, jogging, and sports while the majority (46.3-53.1%) reported a "no change" (p<0.05) in swimming, cycling, and weight lifting. With regard to the SB, most of the participants reported an "increase" in watching TV (72.3%), using electronics (82.7%), and logging to social media (81.9%). Additionally, gender, job type, obesity, and being worried to contract the disease were associated (p<0.05) with changes in PA. On the other hand, age, gender, obesity, job type and income were related (p<0.05) to changes in SB.

CONCLUSION

Results of the current study might enhance knowledge about the impact of COVID-19 on lifestyle, particularly PA and SB. Subsequently, it can also be used to establish strategies to enhance engagement in activities during the current and future pandemics.

Association of Habitual Physical Activity With Cardiovascular Disease Risk

RATIONALE

A sedentary lifestyle is associated with increased risk for cardiovascular disease (CVD). Smartwatches enable accurate daily activity monitoring for physical activity measurement and intervention. Few studies, however, have examined physical activity measures from smartwatches in relation to traditional risk factors associated with future risk for CVD.

OBJECTIVE

To investigate the association of habitual physical activity measured by smartwatch with predicted CVD risk in adults.

METHODS AND RESULTS

We enrolled consenting FHS (Framingham Heart Study) participants in an ongoing eFHS (electronic Framingham Heart Study) at the time of their FHS research center examination. We provided participants with a smartwatch (Apple Watch Series 0) and instructed them to wear it daily, which measured their habitual physical activity as the average daily step count. We estimated the 10-year predicted risk of CVD using the American College of Cardiology/American Heart Association 2013 pooled cohort risk equation. We estimated the association between physical activity and predicted risk of CVD using linear mixed effects models adjusting for age, sex, wear time, and familial structure. Our study included 903 eFHS participants (mean age 53±9 years, 61% women, 9% non-White) who wore the smartwatch ≥5 hours per day for ≥30 days. Median daily step count was similar among men (7202 with interquartile range 3619) and women (7260 with interquartile range 3068; P=0.52). Average 10-year predicted CVD risk was 4.5% (interquartile range, 6.1%) for men and 1.2% (interquartile range, 2.2%) for women (P=1.3×10^-26). Every 1000 steps higher habitual physical activity was associated with 0.18% lower predicted CVD risk (P=3.2×10^-4). The association was attenuated but remained significant after further adjustment for body mass index (P=0.01).

CONCLUSIONS

In this community-based sample of adults, higher daily physical activity measured by a study smartwatch was associated with lower predicted risk of CVD. Future research should examine the longitudinal association of prospectively measured daily activity and incident CVD.

Levels of Physical Activity during School Hours in Children and Adolescents: A Systematic Review

BACKGROUND

This systematic review determines the levels of physical activity (PA) during school hours in children and adolescents.

METHODS

Studies carried out from January 1987 to December 2019 were retrieved from four databases (Web of Science, Pubmed, Scopus and SportDiscus). The 29 selected studies were cross-sectional, long-term and case studies.

RESULTS

Most of them used accelerometers and showed that male and female children accumulated a mean of between 14 and 68 min of moderate-to-vigorous PA (MVPA) during school hours (3%-22% of this daily segment), and male and female adolescents accumulated a mean of between 13 and 28 min of MVPA during this daily segment (3%-8% of the school hours). Less than a quarter of children and adolescents reached the recommended 30 min of MVPA during school hours, with notable differences between sexes.

CONCLUSIONS

These results suggest that the levels of PA during school hours are not enough, and consequently, schools should develop strategies for helping children and adolescents reach the school PA recommendation.

Endurance Training vs. Circuit Resistance Training: Effects on Lipid Profile and Anthropometric/Body Composition Status in Healthy Young Adult Women

Background: Endurance training (ET) and resistance training (RT) are known to be effective in improving anthropometric/body composition and lipid panel indicators, but there is an evident lack of studies on differential effects of these two forms of physical exercise (PE). This study aimed to evaluate the differential effects of 8-week ET and RT among young adult women. Methods: Participants were women (n = 57; age: 23 ± 3 years; initial body height: 165 ± 6 cm; body mass: 66.79 ± 7.23 kg; BMI: 24.37 ± 2.57 kg/m²) divided into the ET group (n = 20), RT group (n = 19), and non-exercising control group (n = 18). All participants were tested for cardiovascular risk factors (CRF), including total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, glucose, and anthropometric/body composition (body mass, body mass index, skinfold measures, body fat %) at the beginning and at the end of the study. Over the 8 weeks, the ET group trained three times/week on a treadmill while the RT group participated in equal number of circuit weight training sessions. Both types of training were planned according to participants’ pre-study fitness status. Results: A two-factor analysis of variance for repeated measurements (“group” × “measurement”) revealed significant main effects for “measurement” in CRF. The “group × measurement” interaction was significant for CRF. The post-hoc analysis indicated significant improvements in CRF for RT and ET. No significant differential effects between RT and ET were evidenced. Conclusions: The results of this study evidence improvements of CRF in young adult women as a result of 8-week ET and RT. The lack of differential training-effects may be attributed to the fact that all participants underwent pre-study screening of their fitness status, which resulted in application of accurate training loads.

Factors associated with habitual time spent in different physical activity intensities using multiday accelerometry

To investigate factors associated with time in physical activity intensities, we assessed physical activity of 249 men and women (mean age 51.3 years) by 7-day 24h-accelerometry (ActiGraph GT3X+). Triaxial vector magnitude counts/minute were extracted to determine time in inactivity, in low-intensity, moderate, and vigorous-to-very-vigorous activity. Cross-sectional associations with sex, age, body mass index, waist circumference, smoking, alcohol consumption, education, employment, income, marital status, diabetes, and dyslipidaemia were investigated in multivariable regression analyses. Higher age was associated with more time in low-intensity (mean difference, 7.3 min/d per 5 years; 95% confidence interval 2.0,12.7) and less time in vigorous-to-very-vigorous activity (−0.8 min/d; −1.4, −0.2), while higher BMI was related to less time in low-intensity activity (−3.7 min/d; −6.3, −1.2). Current versus never smoking was associated with more time in low-intensity (29.2 min/d; 7.5, 50.9) and less time in vigorous-to-very-vigorous activity (−3.9 min/d; −6.3, −1.5). Finally, having versus not having a university entrance qualification and being not versus full time employed were associated with more inactivity time (35.9 min/d; 13.0, 58.8, and 66.2 min/d; 34.7, 97.7, respectively) and less time in low-intensity activity (−31.7 min/d; −49.9, −13.4, and −50.7; −76.6, −24.8, respectively). The assessed factors show distinct associations with activity intensities, providing targets for public health measures aiming to increase activity.

Time spent cycling, walking, running, standing and sedentary: a cross-sectional analysis of accelerometer-data from 1670 adults in the Copenhagen City Heart Study : Physical behaviours among 1670 Copenhageners

Background

Information about how much time adults spend cycling, walking and running can be used for planning and evaluating initiatives for active, healthy societies. The objectives of this study were to describe how much time adult Copenhageners cycle, walk, run, stand and spend sedentary using accelerometers, and to describe differences between population groups.

Methods

In the fifth examination of the Copenhagen City Heart Study, 2335 individuals gave consent to wear accelerometers (skin-attached; right thigh and iliac crest; 24 h/day, 7 consecutive days) of which 1670 fulfilled our inclusion criteria (≥16 h/day for ≥5 days; median wear time: 23.8 h/day). Daily time spent cycling, walking, running, standing and sedentary was derived from accelerometer-based data using the Acti4 software, and differences between sex, age groups, level of education and BMI were investigated using Kruskal-Wallis rank sum tests.

Results

Among those cycling (61%), the median cycling time was 8.3 min/day. The median time walking, running, standing and sedentary was 82.6, 0.1, 182.5 and 579.1 min/day, respectively. About 88% walked fast (i.e., ≥100 steps/min) ≥30 min/day. The shortest duration and lowest prevalence of cycling, walking and running were found among older individuals, those with a low level of education, and individuals being overweight or obese.

Conclusions

We found a long duration and high prevalence of cycling and walking, but also that many adult Copenhageners spent much time sedentary. Population groups with low participation in physical activities such as cycling and walking should be targeted in future initiatives towards an active, healthy society.

Energy Balance and Active Lifestyle: Potential Mediators of Health and Quality of Life Perception in Aging

The relationship between aging and perception of health and quality of life is complex and its mediation mechanisms need to be further explored. The purpose of this study was to investigate the mediating effects of total energy expenditure and intake, body mass, and body image dissatisfaction on the relationship between age and perception of health and quality of life. Forty-two senior athletes, 55 physically active, and 61 sedentary individuals (aged 55–84 years) were evaluated for total energy expenditure (EE), energy intake (EI), body mass index (BMI), absolute Body Dissatisfaction Index (BDIabx), and physical (PCS) and mental (MCS) health and quality of life perception. Multiple mediation analyses were applied to assess the relationship between age and PCS and MCS indices, through the mediators EE, EI, BMI, and BDIabx. For MCS, but not for PSC, the mediation analysis showed: (a) a direct effect of age; (b) a mediation path through EE, EI, BMI, and BDIabx; and (c) a positive total effect. The combination of positive and negative mediating effects influencing the mental health perception underlined that with advancing age, the maintenance of high levels of energy expenditure through physical activity could positively impact body image satisfaction and, in turn, mental health.

Effects of a Judo Training on Functional Fitness, Anthropometric, and Psychological Variables in Old Novice Practitioners

This study aimed to investigate the effects of a 4-month judo training (1 hr session, biweekly) on physical and mental health of older adults (69.7 ± 4.2 years). Participants (N = 30) were assigned to a judo novice practitioners group (n = 16) or a control group (n = 14), which did not receive any training. Before and after the program, they underwent anthropometric (body mass index and waist and hip circumferences); functional fitness (upper and lower body flexibility and strength, coordination); and psychological assessments (perceived physical and mental health, body image, and fear of falling). The judo group showed reductions of waist circumference (Δ = -1%, d = 0.2) and improvements for lower and upper body flexibility (Δ = +69%, d = 0.4 and Δ = +126%, d = 0.5, respectively) and strength (Δ = +12%, d = 0.6 and Δ = +31%, d = 1.6, respectively). The control group showed a decline in lower body strength (Δ = -12%, d = 0.8). Psychological variables did not reveal statistically significant effects. Judo seems beneficial for improving anthropometric and functional fitness variables, relevant aspects of successful aging.