Climate change, 24-hour movement behaviors, and health: a mini umbrella review

Global trends in importance of 24-hour movement behaviors to pediatric health: implications for South Korea

Cultivating a 24-hour movement behavioral profile conducive to health and well-being, marked by adequate levels of physical activity, limited screen time, and sufficient sleep, has emerged as an important avenue for promoting pediatric health. We aimed to provide evidence of this potential, this multiphase, multimethod, and integrative review comprehensively investigated the global trends in health promotion initiatives and status of the Korean pediatric population. This integrative review comprised 3 phases employing various review methods: an environmental scan of existing guidelines for 24-hour movement behaviors worldwide, a rapid review of physical activity-related indicators from Global Matrix data, and a systematic review of 24-hour movement behaviors among children and adolescents in South Korea. The growing recognition of a holistic approach to the 24-hour movement behavior paradigm in pediatric health promotion has led to the establishment and adoption of 24-hour movement guidelines in different countries and by the World Health Organization (WHO). Korean health authorities have also responded to this need by releasing a translated report of the WHO guidelines for physical activity and sedentary behavior as well as the 2024 update of the Physical Activity Guidelines for Koreans. Accordingly, actions must be followed in policy, research, and practice. This is critical considering that Korean children and adolescents exhibit an unfavorable profile of 24-hour movement behaviors compared to the global average. Among those aged 0-6 years, the weighted averages for guideline adherence were 18.2% for physical activity, 38.1% for sedentary behavior, and 76.2% for sleep. For those aged 12-18 years, the weighted averages for guideline adherence were 20.4% for physical activity, 55.9% for sedentary behavior, and 26.2% for sleep. Building on these current findings, this integrative review provides 3 priorities for pediatric health promotion policy and practice and 3 recommendations for future research.

Exploring the Interplay Between Climate Change, 24-Hour Movement Behavior, and Health: A Systematic Review

BACKGROUND

Given the emergence of climate change and health risks, this review examined potential relationships between varying indicators of climate change, movement behaviors (ie, physical activity [PA], sedentary behavior, and sleep), and health.

METHODS

Seven databases were searched in March 2020, April 2023, and April 2024. To be included, studies must have examined indicators of climate change and at least one of the movement behaviors as either an exposure or a third variable (ie, mediator/moderator), and a measure of health as outcome. Evidence was summarized by the role (mediator/moderator) that either climate change or movement behavior(s) has with health measures. Relationships and directionality of each association, as well as the strength and certainty of evidence were synthesized.

RESULTS

A total of 79 studies were eligible, representing 6,671,791 participants and 3137 counties from 25 countries (40% low- and middle-income countries). Of 98 observations from 17 studies that examined PA as a mediator, 34.7% indicated that PA mediated the relationship between climate change and health measure such that indicators of adverse climate change were associated with lower PA, and worse health outcome. Of 274 observations made from 46 studies, 28% showed that PA favorably modified the negative association between climate change and health outcome. Evidence was largely lacking and inconclusive for sedentary behavior and sleep, as well as climate change indicators as an intermediatory variable.

CONCLUSIONS

PA may mitigate the adverse impact of climate change on health. Further evidence is needed to integrate PA into climate change mitigation, adaptation, and resilience strategies.

Associations of weather and air pollution with objective physical activity and sedentary time before and after bariatric surgery: a secondary analysis of a prospective cohort study

Purpose

Identifying factors that influence moderate-to-vigorous intensity physical activity (MVPA) and sedentary time in metabolic and bariatric surgery (MBS) patients is necessary to inform the development of interventions. Weather/environmental factors may be especially important considering rapid climate change and the vulnerability of people with obesity to heat and pollution. Our study aimed to examine the associations of weather (maximal, average and Wet Bulb Globe Temperatures), and air pollution indices (air quality index [AQI]) with daily physical activity (PA) of both light (LPA) and MVPA and sedentary time before and after MBS.

Materials and methods

Participants (n = 77) wore an accelerometer at pre- and 3, 6, and 12-months post-MBS to assess LPA/MVPA/ sedentary time (min/d). These data were combined with participants' local (Boston, MA or Providence, RI, USA) daily weather and AQI data (extracted from federal weather and environmental websites).

Results

Multilevel generalized additive models showed inverted U-shaped associations between weather indices and MVPA, with a marked reduction in MVPA for daily maximal temperatures ≽20 °C. Sensitivity analysis showed a less marked decrease of MVPA (min/d) during higher temperatures after versus before MBS. Both MVPA before and after MBS and sedentary time before MBS were negatively impacted by higher AQI levels.

Conclusion

This study is the first to show that weather and air pollution indices, even in locations with good AQI and moderate temperatures, are related to variability in activity behaviors, particularly MVPA, during pre- and post-MBS. Weather/environmental conditions should be considered in MVPA prescription/strategies for adults who have undergone MBS.

Physical Activity Dependence on Relative Temperature and Humidity Characteristics in a Young, Insufficiently Active Population: A Weather Typing Analysis

BACKGROUND

Physical activity (PA) is an important contributor to one's physical and mental health both acutely and across the lifespan. Much research has done on the ambient environment's impact on PA; however, these studies have used absolute values of atmospheric measures such as temperature and humidity, which vary spatiotemporally and make comparisons between studies which differ in location or time of year difficult to square with one another.

METHODS

Here, we employ the Global Weather Type Classification, Version 2, to determine the combined impact of temperature and humidity on PA in a sample of insufficiently active young adults. We conducted secondary analyses of data from a single-group behavioral intervention trial that varied the number of digital messages sent daily. Young adults (n = 81) wore Fitbit Versa smartwatches for a 6-month period sometime between April 2019 and July 2020, and location was tracked using a custom smartphone application.

RESULTS

Mixed linear models indicated that, across 8179 person-days, PA was significantly lower on days with humid conditions and significantly higher on warm dry days, though the latter relationship was no longer significant when controlling for timing in relation to the COVID-19 pandemic declaration. Demographic factors did not affect the relationship between weather and PA.

CONCLUSIONS

Results are a first step in providing additional guidance for encouraging PA in insufficiently active individuals given forecasted daily weather conditions. Future work should examine seasonal variability in the weather type-PA relationship without the influence of a world-altering event influencing results.

Heat impacts on human health in the Western Pacific Region: an umbrella review

Background

High temperatures and heatwaves are occurring more frequently and lasting longer because of climate change. A synthesis of existing evidence of heat-related health impacts in the Western Pacific Region (WPR) is lacking. This review addresses this gap.

Methods

The Scopus and PubMed databases were searched for reviews about heat impacts on mortality, cardiovascular morbidity, respiratory morbidity, dehydration and heat stroke, adverse birth outcomes, and sleep disturbance. The last search was conducted in February 2023 and only publications written in English were included. Primary studies and reviews that did not include specific WPR data were excluded. Data were extracted from 29 reviews.

Findings

There is strong evidence of heat-related mortality in the WPR, with the evidence concentrating on high-income countries and China. Associations between heat and cardiovascular or respiratory morbidity are not robust. There is evidence of heat-related dehydration and stroke, and preterm and still births in high-income countries in the WPR. Some evidence of sleep disturbance from heat is found for Australia, Japan and China.

Interpretation

Mortality is by far the most studied and robust health outcome of heat. Future research should focus on morbidity, and lower income countries in continental Asia and Pacific Island States, where there is little review-level evidence.

Funding

Funded by the World Health Organization WPR Office.

Impacts of temperature and solar radiation changes in northern Europe on key population health behaviors: a scoping review of reviews

AIM

Climate change threatens health directly as well as indirectly through impacts on health-related behaviors. Physical activity, nutrition and sleep are key health-related behaviors for population health. We aimed at elucidating the impacts of climate change which emerge gradually on these three key health-related behaviors, particularly focusing on scenarios and projections relevant to people living in the northern Europe.

METHODS

We conducted a systematic literature search in three different databases in January 2023 to identify English language review articles summarizing the effects of climate change on either physical activity, nutrition, sleep, or their combination.

RESULTS

We identified 15 review articles on the topic. Data on climate change impacts on nutrition and sleep were sparse, and those on physical activity were heterogeneous. The climate in northern Europe will become warmer and sunnier in summer as well as warmer and darker in winter, which will probably increase the level of physical activity, but decrease the consumption of fruits and vegetables, as well as increase the occurrence of sleep disturbances in a population.

CONCLUSIONS

The anticipated changes in physical activity, nutrition and sleep driven by climate change influence population health and call for grass-roots action plans for adaptation.

University indigenous students' perspectives on climate change and survival of indigenous peoples in Brazil: a concept mapping study

Introduction

This study aimed to identify what indigenous university students in Brazil perceived to be important and feasible actions to protect the survival of indigenous peoples from climate change-related impacts.

Methods

Concept mapping, which is a participatory mixed methodology, was conducted virtually with 20 indigenous students at two universities in Brazil. A focus prompt was developed from consultations with indigenous stakeholders and read "To protect the survival of the Indigenous Peoples from climate change, it is necessary to…". Students brainstormed 46 statements, which they then sorted into clusters based on conceptual similarity. They rated each statement for importance and feasibility. Quantitative multivariate analyses of clusters and ratings were conducted to produce multiple visual maps of perceived actionable priorities. These analyses used the Group Wisdom TM software.

Results

Students agreed on 8 clusters that reflect the factors that influence the survival of indigenous peoples-preservation of lands 0.16 (SD 0.13), protection of demarcated lands 0.31 (SD 0.10), indigenous health and wellbeing 0.35 (SD 0.14), ancestral customs 0.46 (SD 0.04), global and national actions 0.61 (SD 0.13), indigenous rights 0.64 (SD 0.23), collective living 0.71 (SD 0.21), and respect 0.75 (SD 0.14).

Discussion

The most actionable priorities are related to the respect for their lands and customs, educational initiatives in schools about the importance of indigenous peoples to society, guarantees for basic health rights, and culturally appropriate provision of care, with specific mention of mental healthcare. The findings aligned closely with the concept of indigenous self-determination, which is rooted in autonomy and respect for cultural diversity, and the right to make decisions that impact their lives, land, and resources.

Regular physical activity across the lifespan to build resilience against rising global temperatures

Population aging, high prevalence of non-communicable diseases, physical inactivity, and rising global temperatures are some of the most pressing issues in public health of the current century. Such trends suggest that individuals increasingly less equipped to tolerate heat will be increasingly exposed to it, which from a public health perspective is alarming. Nonetheless, future impacts of extreme heat events will depend not only on the magnitude of climate change, but on our ability to adapt by becoming less sensitive and vulnerable. Although physical activity's role in mitigating climate change has received attention, its potential contribution to climate change adaptation and resilience remains largely unaddressed. Accordingly, in this viewpoint, we discuss how regular physical activity throughout life could have an important contribution to adapting to rising global temperatures, allowing to be better equipped to cope with heat-related health hazards and increasing individual and community resilience. This viewpoint constitutes a call for more research into the contribution that physical activity can have in adapting to rising global temperatures and, more broadly, to climate change.

Associations of weather and air pollution with objective physical activity and sedentary time before and after bariatric surgery: a secondary analysis of a prospective cohort study

Background--

Most metabolic and bariatric surgery (MBS) patients perform too little moderate-to-vigorous intensity physical activity (MVPA) and too much sedentary time (ST). Identifying factors that influence MVPA and ST in MBS patients is necessary to inform the development of interventions to target these behaviors. Research has focused on individual-level factors and neglected those related to the physical environment (e.g., weather and pollution). These factors may be especially important considering rapid climate change and emerging data that suggest adverse effects of weather and pollution on physical activity are more severe in people with obesity.

Objectives--

To examine the associations of weather (maximal, average and Wet Bulb Globe Temperatures), and air pollution indices (air quality index [AQI]) with daily physical activity (PA) of both light (LPA) and MVPA and ST before and after MBS.

Methods--

Participants (n=77) wore an accelerometer at pre- and 3, 6, and 12-months post-MBS to assess LPA/MVPA/ST (min/d). These data were combined with participants' local (Boston, MA or Providence, RI, USA) daily weather and AQI data (extracted from federal weather and environmental websites).

Results--

Multilevel generalized additive models showed inverted U-shaped associations between weather indices and MVPA (R2≥.63, p<.001), with a marked reduction in MVPA for daily maximal temperatures ≥20°C. Sensitivity analysis showed a less marked decrease of MVPA (min/d) during higher temperatures after versus before MBS. Both MVPA before and after MBS (R2=0.64, p<.001) and ST before MBS (R2=0.395; p≤.05) were negatively impacted by higher AQI levels.

Discussion--

This study is the first to show that weather and air pollution indices are related to variability in activity behaviors, particularly MVPA, during pre- and post-MBS. Weather/environmental conditions should be considered in MVPA prescription/strategies for MBS patients, especially in the context of climate change.

The Impact of Temperature on 24-Hour Movement Behaviors among Chinese Freshmen Students

BACKGROUND

Human populations worldwide have experienced substantial climate change issues. Gaps in scientific literature remain regarding the relationship between temperature and 24-hour movement behavior among people. The purpose of this study is to examine the impact of temperature on 24-hour movement behavior including physical activity (PA), sedentary behavior (SB) and sleep duration among university students living in Beijing, China.

METHODS

We conducted follow-up health surveys on 44,693 freshmen students enrolled at Tsinghua University from 2012 to 2018. PA and SB were measured by using the short version of the International Physical Activity Questionnaire (IPAQ-s); sleep duration was estimated by using The Pittsburgh Sleep Quality Index (CPSQI). Corresponding temperature data measured by the Beijing Meteorological Service were collected to include average daily temperature from the nearest weather station to Tsinghua university. The data were analyzed using linear individual fixed-effect regressions.

RESULTS

An increase in temperature (temperature range 2.29-28.73 °C) by 1 °C was associated with an increase in 0.66 weekly minutes of vigorous physical activity (VPA) (95% confidence interval [CI] = 0.49, 0.82), an increase in 0.56 weekly minutes of moderate physical activity (MPA)(95% CI = 0.32, 0.79), an increase in 1.21 weekly minutes of moderate to vigorous physical activity (MVPA) (95% CI = 0.90, 1.53), an increase in 0.55 weekly minutes of walking (95% CI = 0.31, 0.78), an increase in 1.76 weekly minutes of total PA (95% CI = 1.35, 2.17), and a reduction in 1.60 weekly minutes of sleeping (95% CI = -2.09, -1.11). There was no significant correlation between temperature and sedentary behavior among participants.

CONCLUSIONS

Temperature was significantly positively correlated with physical activity levels in the Chinese freshmen students, and significantly negatively correlated with sleep duration. Replication of this study is warranted among various populations within China. The evidence of this novel study focused on understanding the relationship between climate change and 24-hour movement behaviors among people for developing effective adaptation strategies to climate change to improve people's health behavior. This study has important implications for future study, as knowledge of the impact of temperature on movement behavior may help in the interpretation of their results and translate into improving people's health behavior.

Association between air pollution and 24-h movement behaviours in a representative sample of Spanish youth

PURPOSE

The aim of this study was to analyse the relationship between air pollution and 24-h movement guidelines in Spanish children/adolescents.

METHODS

This cross-sectional study analysed secondary data from the Encuesta Nacional de Salud Española (2017), a representative survey for the Spanish population. The original dataset included 6016 Spanish young people (aged 0-14 years). Since the data on 24-h movement recommendations were limited to Spanish young people aged 2-14 years, the final sample included 4398 (49.2% girls) Spanish young people. Air pollution was evaluated by particulate matter 2.5 (PM_2.5) from different Spanish regions and divided into tertiles representing areas with low, medium, and high pollution. Sleep duration and recreational screen time and were reported by the parents/caregivers. Physical activity was evaluated by an adapted version of the International Physical Activity Questionnaire. Time spent in screen time, sleep, and physical activity were classified as meeting or not the 24-h movement guidelines.

RESULTS

After adjusting for several covariates (sex, age, immigrant status, region, socioeconomic status, and body mass index), lower odds of meeting with the 24-h movement recommendations were found in those living in areas with medium (odds ratio [OR] = 0.55; confident interval [CI] 95%, 0.46-0.67) or high air pollution (OR = 0.45; CI 95%, 0.36-0.55), compared with those living in areas with low air pollution.

CONCLUSIONS

The movement behaviour of young people seems to be associated with the presence of air pollution among Spanish youth. Spanish public health agencies could consider the development of strategies to mitigate the health risks for children/adolescents in high air polluted areas.

Economic Freedom, Climate Culpability, and Physical Activity Indicators Among Children and Adolescents: Report Card Grades From the Global Matrix 4.0

Background: Macrolevel factors such as economic and climate factors can be associated with physical activity indicators. This study explored patterns and relationships between economic freedom, climate culpability, and Report Card grades on physical activity-related indicators among 57 countries/jurisdictions participating in the Global Matrix 4.0. Methods: Participating countries/jurisdictions provided Report Card grades on 10 common indicators. Information on economic freedom and climatic factors were gathered from public data sources. Correlations between the key variables were provided by income groups (ie, low- and middle-income countries/jurisdictions and high-income countries/jurisdictions [HIC]). Results: HIC were more economically neoliberal and more responsible for climate change than low- and middle-income countries. Annual temperature and precipitation were negatively correlated with behavioral/individual indicators in low- and middle-income countries but not in HIC. In HIC, correlations between climate culpability and behavioral/individual and economic indicators were more apparent. Overall, poorer grades were observed in highly culpable countries/jurisdictions in the highly free group, while in less/moderately free groups, less culpable countries/jurisdictions showed poorer grades than their counterparts in their respective group by economic freedom. Conclusions: Global-level physical activity promotion strategies should closely evaluate different areas that need interventions tailored by income groups, with careful considerations for inequities in the global political economy and climate change.

A Review of the Impact That Healthcare Risk Waste Treatment Technologies Have on the Environment

Health-Care Risk Waste (HCRW) treatment protects the environment and lives. HCRW is waste from patient diagnostics, immunization, surgery, and therapy. HCRW must be treated before disposal since it pollutes, spreads illnesses, and causes harm. However, waste treatment increases the healthcare sector's carbon footprint, making the healthcare sector a major contributor to anthropogenic climate change. This is because treating HCRW pollutes the environment and requires a lot of energy. Treating HCRW is crucial, but its risks are not well-studied. Unintentionally, treating HCRW leads to climate change. Due to frequent climate-related disasters, present climate-change mitigation strategies are insufficient. All sectors, including healthcare, must act to mitigate and prevent future harms. Healthcare can reduce its carbon footprint to help the environment. All contributing elements must be investigated because healthcare facilities contribute to climate change. We start by evaluating the environmental impact of different HCRW treatment technologies and suggesting strategies to make treatments more sustainable, cost-effective, and reliable to lower the carbon footprint.

Moving in a hotter world: Maintaining adequate childhood fitness as a climate change countermeasure

Children cope with high temperatures differently than adults do, largely because of slight alterations in their body proportions and heat loss mechanisms compared to fully mature humans. Paradoxically, all current tools of assessing thermal strain have been developed on adults. As the Earth's warming continues to accelerate, children are set to bear the health risk brunt of rising global temperatures. Physical fitness has a direct impact on heat tolerance, yet children are less fit and more obese than ever before. Longitudinal research reveals that children have 30% lower aerobic fitness than their parents did at the same age; this deficit is greater than can be recovered by training alone. So, as the planet's climate and weather patterns become more extreme, children may become less capable of tolerating it. This comprehensive review provides an outline of child thermoregulation and assessment of thermal strain, before moving to summarize how aerobic fitness can modulate hyperthermia, heat tolerance, and behavioral thermoregulation in this under-researched population. The nature of child physical activity, physical fitness, and one's physical literacy journey as an interconnected paradigm for promoting climate change resilience is explored. Finally, future research foci are suggested to encourage continued exploration of this dynamic field, notable since more extreme, multifactorial environmental stressors are expected to continue challenging the physiological strain of the human population for the foreseeable future.