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Min J, Cao Z, Duan T, Wang Y, Xu C. Accelerometer-derived 'weekend warrior' physical activity pattern and brain health. NATURE AGING 2024:10.1038/s43587-024-00688-y. [PMID: 39169268 DOI: 10.1038/s43587-024-00688-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 07/16/2024] [Indexed: 08/23/2024]
Abstract
Extensive evidence shows the beneficial effect of adhering to a regular physical activity (PA) pattern on brain health. However, whether the 'weekend warrior' pattern, characterized by concentrated moderate-to-vigorous PA (MVPA) over 1-2 days, is associated with brain health is unclear. Here, we perform a prospective cohort study including 75,629 participants from the UK Biobank with validated accelerometry data. Individuals were classified into three PA patterns using current guideline thresholds: inactive (<150 min week-1 of MVPA), weekend warrior (≥150 min week-1 with ≥50% of total MVPA occurring within 1-2 days) and regularly active (≥150 min week-1 but not meeting weekend warrior criteria). We find that the weekend warrior pattern is associated with similarly lower risks of dementia, stroke, Parkinson's disease, depressive disorders and anxiety compared to a regularly active pattern. Our findings highlight the weekend warrior pattern as a potential alternative in preventive intervention strategies, particularly for those unable to maintain daily activity routines.
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Affiliation(s)
- Jiahao Min
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Zhi Cao
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Tingshan Duan
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Tianjin, China.
- School of Integrative Medicine, Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
- National Institute of Health Data Science at Peking University, Peking University, Beijing, China.
| | - Chenjie Xu
- School of Public Health, Hangzhou Normal University, Hangzhou, China.
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2
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Sagelv EH, Hopstock LA, Morseth B, Hansen BH, Steene-Johannessen J, Johansson J, Nordström A, Saint-Maurice PF, Løvsletten O, Wilsgaard T, Ekelund U, Tarp J. Device-measured physical activity, sedentary time, and risk of all-cause mortality: an individual participant data analysis of four prospective cohort studies. Br J Sports Med 2023; 57:1457-1463. [PMID: 37875329 DOI: 10.1136/bjsports-2022-106568] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVES To examine whether moderate-to-vigorous physical activity (MVPA) modifies the association between sedentary time and mortality and vice versa, and estimate the joint associations of MVPA and sedentary time on mortality risk. METHODS This study involved individual participant data analysis of four prospective cohort studies (Norway, Sweden, USA, baseline: 2003-2016, 11 989 participants ≥50 years, 50.5% women) with hip-accelerometry-measured physical activity and sedentary time. Associations were examined using restricted cubic splines and fractional polynomials in Cox regressions adjusted for sex, education, body mass index, smoking, alcohol, study cohort, cardiovascular disease, cancer, and/or diabetes, accelerometry wear time and age. RESULTS 6.7% (n=805) died during follow-up (median 5.2 years, IQR 4.2 years). More than 12 daily sedentary hours (reference 8 hours) was associated with mortality risk only among those accumulating <22 min of MVPA per day (HR 1.38, 95% CI 1.10 to 1.74). Higher MVPA levels were associated with lower mortality risk irrespective of sedentary time, for example, HR for 10 versus 0 daily min of MVPA was 0.85 (95% CI 0.74 to 0.96) in those accumulating <10.5 daily sedentary hours and 0.65 (95% CI 0.53 to 0.79) in those accumulating ≥10.5 daily sedentary hours. Joint association analyses confirmed that higher MVPA was superior to lower sedentary time in lowering mortality risk, for example, 10 versus 0 daily min of MVPA was associated with 28-55% lower mortality risk across the sedentary time spectrum (lowest risk, 10 daily sedentary hours: HR 0.45, 95% CI 0.31 to 0.65). CONCLUSIONS Sedentary time was associated with higher mortality risk but only in individuals accumulating less than 22 min of MVPA per day. Higher MVPA levels were associated with lower mortality risk irrespective of the amount of sedentary time.
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Affiliation(s)
- Edvard H Sagelv
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila Arnesdatter Hopstock
- Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromso Department of Community Medicine, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bjørge H Hansen
- Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | | | - Jonas Johansson
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anna Nordström
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Pedro F Saint-Maurice
- National Cancer Institute Division of Cancer Epidemiology and Genetics, Rockville, Maryland, USA
| | - Ola Løvsletten
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Chronic Diseases and Ageing, the Norwegian Institute for Public Health, Oslo, Norway
| | - Jakob Tarp
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus Universitet, Aarhus, Denmark
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Speirs C, Dunlop MD, Roper M, Granat M. Beyond the Clinic: Maximum Free-Living Stepping as a Potential Measure of Physical Performance. SENSORS (BASEL, SWITZERLAND) 2023; 23:6555. [PMID: 37514849 PMCID: PMC10383089 DOI: 10.3390/s23146555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/27/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023]
Abstract
Measures of physical performance captured within a clinical setting are commonly used as a surrogate for underlying health or disease risk within an individual. By measuring physical behaviour within a free-living setting, we may be able to better quantify physical performance. In our study, we outline an approach to measure maximum free-living step count using a body-worn sensor as an indicator of physical performance. We then use this approach to characterise the maximum step count over a range of window durations within a population of older adults to identify a preferred duration over which to measure the maximum step count. We found that while almost all individuals (97%) undertook at least one instance of continuous stepping longer than two minutes, a sizeable minority of individuals (31%) had no periods of continuous stepping longer than six minutes. We suggest that the maximum step count measured over a six-minute period may be too sensitive to the adults' lack of opportunity to undertake prolonged periods of stepping, and a two-minute window could provide a more representative measure of physical performance.
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Affiliation(s)
- Craig Speirs
- PAL Technologies Ltd., Glasgow G4 0TQ, UK
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow G1 1XH, UK
| | - Mark D Dunlop
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow G1 1XH, UK
| | - Marc Roper
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow G1 1XH, UK
| | - Malcolm Granat
- School of Health and Society, University of Salford, Salford M6 6PU, UK
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4
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Salerno EA, Saint-Maurice PF, Wan F, Peterson LL, Park Y, Cao Y, Duncan RP, Troiano RP, Matthews CE. Prospective associations between accelerometry-derived physical activity and sedentary behaviors and mortality among cancer survivors. JNCI Cancer Spectr 2023; 7:pkad007. [PMID: 36786414 PMCID: PMC10038185 DOI: 10.1093/jncics/pkad007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/20/2022] [Accepted: 01/21/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Survival benefits of self-reported recreational physical activity (PA) during cancer survivorship are well-documented in common cancer types, yet there are limited data on the associations between accelerometer-derived PA of all domains, sedentary behavior, and mortality in large, diverse cohorts of cancer survivors. METHODS Participants included adults who reported a cancer diagnosis in the National Health and Nutrition Examination Survey and wore an accelerometer for up to 7 days in 2003-2006. Participants were followed for subsequent mortality through 2015. We examined the association of light PA, moderate to vigorous PA, total PA, and sedentary behavior, with all-cause mortality. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for demographics and health indicators. RESULTS A total of 480 participants (mean age of 68.8 years [SD = 12.4] at the time of National Health and Nutrition Examination Survey assessment) reported a history of cancer. A total of 215 deaths occurred over the follow-up period. For every 1-h/d increase in light PA and moderate to vigorous PA (MVPA), cancer survivors had 49% (HR = 0.51, 95% CI = 0.34 to 0.76) and 37% (HR = 0.63 , 95% CI = 0.40 to 0.99) lower hazards of all-cause mortality, respectively. Total PA demonstrated similar associations with statistically significantly lower hazards of death for each additional hour per day (HR = 0.68, 95% CI = 0.54 to 0.85), as did every metabolic equivalents of task-hour per day increase in total PA estimations of energy expenditure (HR = 0.88, 95% CI = 0.82 to 0.95). Conversely, more sedentary time (1 h/d) was not associated with statistically significantly higher hazards (HR = 1.08, 95% CI = 0.94 to 1.23). CONCLUSIONS These findings reinforce the current recommendations for cancer survivors to be physically active and underscore the continued need for widespread PA promotion for long-term survival in older cancer survivors.
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Affiliation(s)
- Elizabeth A Salerno
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St. Louis, MO, USA
- Alvin J. Siteman Cancer Center, Washington University School of Medicine in St. Louis, MO, USA
| | - Pedro F Saint-Maurice
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Fei Wan
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St. Louis, MO, USA
- Alvin J. Siteman Cancer Center, Washington University School of Medicine in St. Louis, MO, USA
| | - Lindsay L Peterson
- Alvin J. Siteman Cancer Center, Washington University School of Medicine in St. Louis, MO, USA
- Division of Medical Oncology, Department of Medicine, Washington University School of Medicine in St. Louis, MO, USA
| | - Yikyung Park
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St. Louis, MO, USA
- Alvin J. Siteman Cancer Center, Washington University School of Medicine in St. Louis, MO, USA
| | - Yin Cao
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St. Louis, MO, USA
- Alvin J. Siteman Cancer Center, Washington University School of Medicine in St. Louis, MO, USA
- Division of Gastroenterology, Department of Medicine, Washington University School of Medicine in St. Louis, MO, USA
| | - Ryan P Duncan
- Program in Physical Therapy, Washington University School of Medicine in St. Louis, MO, USA
| | - Richard P Troiano
- Risk Factor Assessment Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Charles E Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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Feng H, Yang L, Liang YY, Ai S, Liu Y, Liu Y, Jin X, Lei B, Wang J, Zheng N, Chen X, Chan JWY, Sum RKW, Chan NY, Tan X, Benedict C, Wing YK, Zhang J. Associations of timing of physical activity with all-cause and cause-specific mortality in a prospective cohort study. Nat Commun 2023; 14:930. [PMID: 36805455 PMCID: PMC9938683 DOI: 10.1038/s41467-023-36546-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/06/2023] [Indexed: 02/20/2023] Open
Abstract
There is a growing interest in the role of timing of daily behaviors in improving health. However, little is known about the optimal timing of physical activity to maximize health benefits. We perform a cohort study of 92,139 UK Biobank participants with valid accelerometer data and all-cause and cause-specific mortality outcomes, comprising over 7 years of median follow-up (638,825 person-years). Moderate-to-vigorous intensity physical activity (MVPA) at any time of day is associated with lower risks for all-cause, cardiovascular disease, and cancer mortality. In addition, compared with morning group (>50% of daily MVPA during 05:00-11:00), midday-afternoon (11:00-17:00) and mixed MVPA timing groups, but not evening group (17:00-24:00), have lower risks of all-cause and cardiovascular disease mortality. These protective associations are more pronounced among the elderly, males, less physically active participants, or those with preexisting cardiovascular diseases. Here, we show that MVPA timing may have the potential to improve public health.
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Affiliation(s)
- Hongliang Feng
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.,Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Lulu Yang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Yannis Yan Liang
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
| | - Sizhi Ai
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.,Department of Cardiology, Heart Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, Henan, China.,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yaping Liu
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yue Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Xinyi Jin
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Binbin Lei
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Jing Wang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Nana Zheng
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xinru Chen
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.,Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Joey W Y Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Raymond Kim Wai Sum
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiao Tan
- Department of Big Data in Health Science, Zhejiang University School of Public Health and Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Christian Benedict
- Molecular Neuropharmacology, Department of Pharmaceutical Biosciences, Uppsala University, 751 24, Uppsala, Sweden
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jihui Zhang
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China. .,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China. .,Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China. .,Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
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6
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Watts EL, Saint-Maurice PF, Doherty A, Fensom GK, Freeman JR, Gorzelitz JS, Jin D, McClain KM, Papier K, Patel S, Shiroma EJ, Moore SC, Matthews CE. Association of Accelerometer-Measured Physical Activity Level With Risks of Hospitalization for 25 Common Health Conditions in UK Adults. JAMA Netw Open 2023; 6:e2256186. [PMID: 36795414 PMCID: PMC9936337 DOI: 10.1001/jamanetworkopen.2022.56186] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 12/29/2022] [Indexed: 02/17/2023] Open
Abstract
Importance Higher physical activity levels are associated with lower risks of cancer, cardiovascular disease, and diabetes, but associations with many common and less severe health conditions are not known. These conditions impose large health care burdens and reduce quality of life. Objectives To investigate the association between accelerometer-measured physical activity and the subsequent risk of hospitalization for 25 common reasons for hospitalization and to estimate the proportion of these hospitalizations that might have been prevented if participants had higher levels of physical activity. Design, Setting, and Participants This prospective cohort study used data from a subset of 81 717 UK Biobank participants aged 42 to 78 years. Participants wore an accelerometer for 1 week (between June 1, 2013, and December 23, 2015) and were followed up over a median (IQR) of 6.8 (6.2-7.3) years; follow-up for the current study ended in 2021 (exact date varied by location). Exposures Mean total and intensity-specific accelerometer-measured physical activity. Main Outcomes and Measures Hospitalization for the most common health conditions. Cox proportional hazards regression analysis was used to estimate hazard ratios (HRs) and 95% CIs for mean accelerometer-measured physical activity (per 1-SD increment) and risks of hospitalization for 25 conditions. Population-attributable risks were used to estimate the proportion of hospitalizations for each condition that might be prevented if participants increased their moderate to vigorous physical activity (MVPA) by 20 minutes per day. Results Among 81 717 participants, the mean (SD) age at accelerometer assessment was 61.5 (7.9) years; 56.4% were female, and 97.0% self-identified as White. Higher levels of accelerometer-measured physical activity were associated with lower risks of hospitalization for 9 conditions: gallbladder disease (HR per 1 SD, 0.74; 95% CI, 0.69-0.79), urinary tract infections (HR per 1 SD, 0.76; 95% CI, 0.69-0.84), diabetes (HR per 1 SD, 0.79; 95% CI, 0.74-0.84), venous thromboembolism (HR per 1 SD, 0.82; 95% CI, 0.75-0.90), pneumonia (HR per 1 SD, 0.83; 95% CI, 0.77-0.89), ischemic stroke (HR per 1 SD, 0.85; 95% CI, 0.76-0.95), iron deficiency anemia (HR per 1 SD, 0.91; 95% CI, 0.84-0.98), diverticular disease (HR per 1 SD, 0.94; 95% CI, 0.90-0.99), and colon polyps (HR per 1 SD, 0.96; 95% CI, 0.94-0.99). Positive associations were observed between overall physical activity and carpal tunnel syndrome (HR per 1 SD, 1.28; 95% CI, 1.18-1.40), osteoarthritis (HR per 1 SD, 1.15; 95% CI, 1.10-1.19), and inguinal hernia (HR per 1 SD, 1.13; 95% CI, 1.07-1.19), which were primarily induced by light physical activity. Increasing MVPA by 20 minutes per day was associated with reductions in hospitalization ranging from 3.8% (95% CI, 1.8%-5.7%) for colon polyps to 23.0% (95% CI, 17.1%-28.9%) for diabetes. Conclusions and Relevance In this cohort study of UK Biobank participants, those with higher physical activity levels had lower risks of hospitalization across a broad range of health conditions. These findings suggest that aiming to increase MVPA by 20 minutes per day may be a useful nonpharmaceutical intervention to reduce health care burdens and improve quality of life.
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Affiliation(s)
- Eleanor L. Watts
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Pedro F. Saint-Maurice
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Aiden Doherty
- Big Data Institute, Nuffield Department of Population Health, British Heart Foundation Centre of Research Excellence, University of Oxford, Oxford, United Kingdom
| | - Georgina K. Fensom
- Cancer Epidemiology Unit, Nuffield Department of Population Health, Oxford, United Kingdom
| | - Joshua R. Freeman
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | | | - David Jin
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Kathleen M. McClain
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Keren Papier
- Cancer Epidemiology Unit, Nuffield Department of Population Health, Oxford, United Kingdom
| | - Shreya Patel
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Eric J. Shiroma
- Laboratory of Epidemiology and Population Science, National Institute on Aging, Bethesda, Maryland
| | - Steven C. Moore
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Charles E. Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
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Mañas A, Del Pozo Cruz B, Ekelund U, Losa Reyna J, Rodríguez Gómez I, Carnicero Carreño JA, Rodríguez Mañas L, García García FJ, Ara I. Association of accelerometer-derived step volume and intensity with hospitalizations and mortality in older adults: A prospective cohort study. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:578-585. [PMID: 34029758 PMCID: PMC9532608 DOI: 10.1016/j.jshs.2021.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/23/2021] [Accepted: 02/23/2021] [Indexed: 05/21/2023]
Abstract
PURPOSE This study aimed to examine the associations of accelerometer-derived steps volume and intensity with hospitalizations and all-cause mortality in older adults. METHODS This prospective cohort study involved 768 community-dwelling Spanish older adults (78.8 ± 4.9 years, mean ± SD; 53.9% females) from the Toledo Study for Healthy Aging (2012-2017). The number of steps per day and step cadence (steps/min) were derived from a hip-mounted accelerometer worn for at least 4 days at baseline. Participants were followed-up over a mean period of 3.1 years for hospitalization and 5.7 years for all-cause mortality. Cox proportional hazards regression models were used to estimate the individual and joint associations between daily steps and stepping intensity with hospitalizations and all-cause mortality. RESULTS Included participants walked 5835 ± 3445 steps/day with an intensity of 7.3 ± 4.1 steps/min. After adjusting for age, sex, body mass index (BMI), education, income, marital status and comorbidities, higher step count (hazard ratio (HR) = 0.95, 95% confidence interval (95%CI: 0.90-1.00, and HR = 0.87, 95%CI: 0.81-0.95 per additional 1000 steps) and higher step intensity (HR = 0.95, 95%CI: 0.91-0.99, and HR = 0.89, 95%CI: 0.84-0.95 per each additional step/min) were associated with fewer hospitalizations and all-cause mortality risk, respectively. Compared to the group having low step volume and intensity, individuals in the group having high step volume and intensity had a lower risk of hospitalization (HR = 0.72, 95%CI: 0.52-0.98) and all-cause mortality (HR = 0.60, 95%CI: 0.37-0.98). CONCLUSION Among older adults, both high step volume and step intensity were significantly associated with lower hospitalization and all-cause mortality risk. Increasing step volume and intensity may benefit older people.
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Affiliation(s)
- Asier Mañas
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo 45071, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid 28029, Spain.
| | - Borja Del Pozo Cruz
- Motivation and Behaviour Research Program, Institute for Positive Psychology and Education, Faculty of Health Sciences, Australian Catholic University, Sydney, NSW 2060, Australia
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo 0806, Norway; Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo 0473, Norway
| | - José Losa Reyna
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo 45071, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid 28029, Spain; Geriatric Department, Hospital Virgen del Valle, Toledo 45071, Spain
| | - Irene Rodríguez Gómez
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo 45071, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid 28029, Spain
| | - José Antonio Carnicero Carreño
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid 28029, Spain; Geriatric Department, Hospital Universitario de Getafe, Getafe 28905, Spain
| | | | - Francisco J García García
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid 28029, Spain; Geriatric Department, Hospital Virgen del Valle, Toledo 45071, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo 45071, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid 28029, Spain
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8
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Accelerometer-Measured Daily Steps, Physical Function, and Subsequent Fall Risk in Older Women: The Objective Physical Activity and Cardiovascular Disease in Older Women Study. J Aging Phys Act 2021; 30:635-645. [PMID: 34627127 DOI: 10.1123/japa.2021-0159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/26/2021] [Accepted: 09/04/2021] [Indexed: 11/18/2022]
Abstract
Steps per day were measured by accelerometer for 7 days among 5,545 women aged 63-97 years between 2012 and 2014. Incident falls were ascertained from daily fall calendars for 13 months. Median steps per day were 3,216. There were 5,473 falls recorded over 61,564 fall calendar-months. The adjusted incidence rate ratio comparing women in the highest versus lowest step quartiles was 0.71 (95% confidence interval [0.54, 0.95]; ptrend across quartiles = .01). After further adjustment for physical function using the Short Physical Performance Battery, the incidence rate ratio was 0.86 ([0.64, 1.16]; ptrend = .27). Mediation analysis estimated that 63.7% of the association may be mediated by physical function (p = .03). In conclusion, higher steps per day were related to lower incident falls primarily through their beneficial association with physical functioning. Interventions that improve physical function, including those that involve stepping, could reduce falls in older adults.
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Löppönen A, Karavirta L, Portegijs E, Koivunen K, Rantanen T, Finni T, Delecluse C, Roie EV, Rantalainen T. Day-to-Day Variability and Year-to-Year Reproducibility of Accelerometer-Measured Free-Living Sit-to-Stand Transitions Volume and Intensity among Community-Dwelling Older Adults. SENSORS 2021; 21:s21186068. [PMID: 34577275 PMCID: PMC8471908 DOI: 10.3390/s21186068] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 12/31/2022]
Abstract
(1) Background: The purpose of this study was to evaluate the day-to-day variability and year-to-year reproducibility of an accelerometer-based algorithm for sit-to-stand (STS) transitions in a free-living environment among community-dwelling older adults. (2) Methods: Free-living thigh-worn accelerometry was recorded for three to seven days in 86 (women n = 55) community-dwelling older adults, on two occasions separated by one year, to evaluate the long-term consistency of free-living behavior. (3) Results: Year-to-year intraclass correlation coefficients (ICC) for the number of STS transitions were 0.79 (95% confidence interval, 0.70-0.86, p < 0.001), for mean angular velocity-0.81 (95% ci, 0.72-0.87, p < 0.001), and maximal angular velocity-0.73 (95% ci, 0.61-0.82, p < 0.001), respectively. Day-to-day ICCs were 0.63-0.72 for number of STS transitions (95% ci, 0.49-0.81, p < 0.001) and for mean angular velocity-0.75-0.80 (95% ci, 0.64-0.87, p < 0.001). Minimum detectable change (MDC) was 20.1 transitions/day for volume, 9.7°/s for mean intensity, and 31.7°/s for maximal intensity. (4) Conclusions: The volume and intensity of STS transitions monitored by a thigh-worn accelerometer and a sit-to-stand transitions algorithm are reproducible from day to day and year to year. The accelerometer can be used to reliably study STS transitions in free-living environments, which could add value to identifying individuals at increased risk for functional disability.
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Affiliation(s)
- Antti Löppönen
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, 40014 Jyväskylä, Finland; (L.K.); (E.P.); (K.K.); (T.R.); (T.R.)
- Physical Activity, Sports and Health Research Group, Department of Movement Sciences, KU Leuven, 3000 Leuven, Belgium; (C.D.); (E.V.R.)
- Correspondence: ; Tel.: +358-406201771
| | - Laura Karavirta
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, 40014 Jyväskylä, Finland; (L.K.); (E.P.); (K.K.); (T.R.); (T.R.)
| | - Erja Portegijs
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, 40014 Jyväskylä, Finland; (L.K.); (E.P.); (K.K.); (T.R.); (T.R.)
| | - Kaisa Koivunen
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, 40014 Jyväskylä, Finland; (L.K.); (E.P.); (K.K.); (T.R.); (T.R.)
| | - Taina Rantanen
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, 40014 Jyväskylä, Finland; (L.K.); (E.P.); (K.K.); (T.R.); (T.R.)
| | - Taija Finni
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, University of Jyväskylä, 40014 Jyväskylä, Finland;
| | - Christophe Delecluse
- Physical Activity, Sports and Health Research Group, Department of Movement Sciences, KU Leuven, 3000 Leuven, Belgium; (C.D.); (E.V.R.)
| | - Evelien Van Roie
- Physical Activity, Sports and Health Research Group, Department of Movement Sciences, KU Leuven, 3000 Leuven, Belgium; (C.D.); (E.V.R.)
| | - Timo Rantalainen
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, 40014 Jyväskylä, Finland; (L.K.); (E.P.); (K.K.); (T.R.); (T.R.)
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10
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Jayedi A, Gohari A, Shab-Bidar S. Daily Step Count and All-Cause Mortality: A Dose-Response Meta-analysis of Prospective Cohort Studies. Sports Med 2021; 52:89-99. [PMID: 34417979 DOI: 10.1007/s40279-021-01536-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Uncertainty remains about the optimum step count per day for health promotion. OBJECTIVE We aimed to investigate the association between step count per day and all-cause mortality risk. METHODS PubMed, Scopus, and ISI Web of Science were searched to January 2021 to find prospective cohort studies of the association between device-based step count per day and all-cause mortality risk in the general population. Two reviewers extracted data in duplicate and rated the certainty of evidence using the GRADE approach. Study-specific hazard ratios (HRs) were pooled using a random-effects model. RESULTS Seven prospective cohort studies with 175,370 person-years and 2310 cases of all-cause mortality were included. The HR for each 1000 steps per day was 0.88 (95% CI 0.83-0.93; I2 = 79%, n = 7) in the overall analysis, 0.87 (95% CI 0.78-0.97; I2 = 59%, n = 3) in adults older than 70 years, and 0.92 (95% CI 0.89-0.95; I2 = 37%, n = 2) in studies controlled for step intensity. Dose-response meta-analysis indicated a strong inverse association, wherein the risk decreased linearly from 2700 to17,000 steps per day. The HR for 10,000 steps per day was 0.44 (95% CI 0.31-0.63). The certainty of evidence was rated strong due to upgrades for large effect size and dose-response gradient. CONCLUSIONS Even a modest increase in steps per day may be associated with a lower risk of death. These results can be used to develop simple, efficient and easy-to-understand public health messages.
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Affiliation(s)
- Ahmad Jayedi
- Food Safety Research Center (Salt), Semnan University of Medical Sciences, Semnan, Iran.,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P. O. Box 14155/6117, Tehran, Iran
| | - Ali Gohari
- Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P. O. Box 14155/6117, Tehran, Iran.
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11
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Kandola AA, Del Pozo Cruz B, Osborn DPJ, Stubbs B, Choi KW, Hayes JF. Impact of replacing sedentary behaviour with other movement behaviours on depression and anxiety symptoms: a prospective cohort study in the UK Biobank. BMC Med 2021; 19:133. [PMID: 34134689 PMCID: PMC8210357 DOI: 10.1186/s12916-021-02007-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 05/17/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Sedentary behaviour is potentially a modifiable risk factor for depression and anxiety disorders, but findings have been inconsistent. To assess the associations of sedentary behaviour with depression and anxiety symptoms and estimate the impact of replacing daily time spent in sedentary behaviours with sleep, light, or moderate to vigorous physical activity, using compositional data analysis methods. METHODS We conducted a prospective cohort study in 60,235 UK Biobank participants (mean age: 56; 56% female). Exposure was baseline daily movement behaviours (accelerometer-assessed sedentary behaviour and physical activity, and self-reported total sleep). Outcomes were depression and anxiety symptoms (Patient Health Questionnaire-9 and Generalised Anxiety Disorders-7) at follow-up. RESULTS Replacing 60 min of sedentary behaviour with light activity, moderate-to-vigorous activity, and sleep was associated with lower depression symptom scores by 1.3% (95% CI, 0.4-2.1%), 12.5% (95% CI, 11.4-13.5%), and 7.6% (95% CI, 6.9-8.4%), and lower odds of possible depression by 0.95 (95% CI, 0.94-0.96), 0.75 (95% CI, 0.74-0.76), and 0.90 (95% CI, 0.90-0.91) at follow-up. Replacing 60 min of sedentary behaviour with moderate-to-vigorous activity and sleep was associated with lower anxiety symptom scores by 6.6% (95% CI, 5.5-7.6%) and 4.5% (95% CI, 3.7-5.2%), and lower odds of meeting the threshold for a possible anxiety disorder by 0.90 (95% CI, 0.89-0.90) and 0.97 (95%CI, 0.96-0.97) at follow-up. However, replacing 60 min of sedentary behaviour with light activity was associated with higher anxiety symptom scores by 4.5% (95% CI, 3.7-5.3%) and higher odds of a possible anxiety disorder by 1.07 (95% CI, 1.06-1.08). CONCLUSIONS Sedentary behaviour is a risk factor for increased depression and anxiety symptoms in adults. Replacing sedentary behaviour with moderate-to-vigorous activity may reduce mental health risks, but more work is necessary to clarify the role of light activity.
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Affiliation(s)
- A A Kandola
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Rd, London, W1T 7BN, UK. .,Institute of Mental Health, University College London, London, UK.
| | - B Del Pozo Cruz
- Motivation and Behaviour Program, Institute for Positive Psychology and Education, Faculty of Health Sciences, Australian Catholic University, Sydney, Australia
| | - D P J Osborn
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Rd, London, W1T 7BN, UK.,Camden and Islington NHS Foundation Trust, London, UK
| | - B Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.,Physiotherapy Department, South London, and Maudsley National Health Services Foundation Trust, London, UK
| | - K W Choi
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Psychiatric & Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.,Stanley Center for Psychiatric Research, Broad Institute, Boston, MA, USA
| | - J F Hayes
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Rd, London, W1T 7BN, UK.,Camden and Islington NHS Foundation Trust, London, UK
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12
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Pindus DM, Edwards CG, Walk AM, Reeser G, Burd NA, Holscher HD, Khan NA. Sedentary time is related to deficits in response inhibition among adults with overweight and obesity: An accelerometry and event-related brain potentials study. Psychophysiology 2021; 58:e13843. [PMID: 34021599 DOI: 10.1111/psyp.13843] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 04/01/2021] [Accepted: 04/13/2021] [Indexed: 11/28/2022]
Abstract
Excessive sedentariness has been related to poorer cognitive control in adults. Sedentariness may compound obesity-related impairments in response inhibition, but its relationship to response inhibition remains poorly understood. This study investigated the relationship between accelerometer-measured sedentary time (ST, min/day), performance on the Oddball and NoGo tasks, N2 and P3-ERP indices of response inhibition and attentional control in 80 adults with overweight and obesity (55 females, Mage = 35.2 ± 5.8 years, BMI = 32.8 ± 5.3 kg/m2 ). ST was not related to performance on the Oddball task. However, more sedentary adults had larger P3b amplitude to targets. Higher ST was also related to increased attentional resource allocation during NoGo target and nontarget trials as indicated by higher P3b amplitudes across centroparietal sites (C1, Cz, C2, CP1, CPz, CP2; ps ≤ .03). ST was negatively indirectly related to target accuracy on NoGo trials through its association with faster response times to nontargets (95% percentile bootstrap CI for a standardized effect: -0.182, -0.014). ST was not related to N2 amplitude on either Oddball or NoGo target trials. Adjustment for moderate-to-vigorous physical activity (MVPA; all models), age (models with P3b NoGo target amplitude, N2 NoGo target amplitude and latency), and % fat mass (models with target NoGo accuracy and N2 NoGo target amplitude) did not modulate behavioral findings. MVPA did not significantly predict P3b amplitude. Our results suggest suboptimal response inhibition due to trading accuracy for speed and despite the upregulation of attentional resources among more sedentary adults with overweight and obesity.
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Affiliation(s)
- Dominika M Pindus
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Caitlyn G Edwards
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, USA
| | - Anne M Walk
- Department of Psychology, Eastern Illinois University, Charleston, IL, USA
| | - Ginger Reeser
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Nicholas A Burd
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Hannah D Holscher
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Naiman A Khan
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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13
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Matthews CE, Troiano RP, Salerno EA, Berrigan D, Patel SB, Shiroma EJ, Saint-Maurice PF. Exploration of Confounding Due to Poor Health in an Accelerometer-Mortality Study. Med Sci Sports Exerc 2021; 52:2546-2553. [PMID: 32472927 DOI: 10.1249/mss.0000000000002405] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE Confounding due to poor health is a concern in accelerometer-based studies of physical activity and health, but detailed investigations of this source of bias are lacking. METHODS US adults (n = 4840) from the National Health and Nutrition Examination Survey (2003 to 2006) wore an accelerometer for 1 to 7 d (mean = 5.7 d) and were followed for mortality through 2015. Logistic regression was used to examine odds ratios between poor health (chronic conditions, self-reported health, mobility limitations, frailty) and low physical activity levels; Cox models were used to estimate adjusted hazard ratios (HR) and 95% CI for mortality associations for a 1 h·d increase in moderate-to-vigorous-intensity physical activity (MVPA) using two commonly used cut-points (MVPA760, MVPA2020). Modeling scenarios with shorter and longer follow-up time, increasing adjustment for poor health, by age group, and after excluding early years of follow-up were used to assess bias. RESULTS Over a mean of 10.1 yr of follow-up, 1165 deaths occurred. Poor health was associated with low MVPA760 levels and increased mortality risk. In fully adjusted MVPA760 models, HR was 26% stronger comparing 0 to 4 yr (HR = 0.46) with 0 to 12 yr of follow-up (HR = 0.62), particularly in older adults (65 yr and older). Increasing statistical adjustment for poor health attenuated MVPA760 associations by 13% to 15%, and exclusion of the first 2 yr of follow-up had limited effects. Comparable results were obtained with the MVPA2020 cut-point. CONCLUSIONS We did not find evidence that confounding by health status resulted in entirely spurious MVPA-mortality associations; however, potential bias was appreciable in modeling scenarios involving shorter follow-up (<6 yr), older adults, and more limited statistical adjustment for poor health. The strength of MVPA-mortality associations in studies reflecting these scenarios should be interpreted cautiously.
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Affiliation(s)
- Charles E Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Richard P Troiano
- Risk Factor Assessment Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Elizabeth A Salerno
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - David Berrigan
- Health Behaviors Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Shreya B Patel
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Eric J Shiroma
- Laboratory of Epidemiology and Population Sciences, National Institute of Aging, Bethesda, MD
| | - Pedro F Saint-Maurice
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
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14
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Ramakrishnan R, Doherty A, Smith-Byrne K, Rahimi K, Bennett D, Woodward M, Walmsley R, Dwyer T. Accelerometer measured physical activity and the incidence of cardiovascular disease: Evidence from the UK Biobank cohort study. PLoS Med 2021; 18:e1003487. [PMID: 33434193 PMCID: PMC7802951 DOI: 10.1371/journal.pmed.1003487] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 11/26/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Higher levels of physical activity (PA) are associated with a lower risk of cardiovascular disease (CVD). However, uncertainty exists on whether the inverse relationship between PA and incidence of CVD is greater at the highest levels of PA. Past studies have mostly relied on self-reported evidence from questionnaire-based PA, which is crude and cannot capture all PA undertaken. We investigated the association between accelerometer-measured moderate, vigorous, and total PA and incident CVD. METHODS AND FINDINGS We obtained accelerometer-measured moderate-intensity and vigorous-intensity physical activities and total volume of PA, over a 7-day period in 2013-2015, for 90,211 participants without prior or concurrent CVD in the UK Biobank cohort. Participants in the lowest category of total PA smoked more, had higher body mass index and C-reactive protein, and were diagnosed with hypertension. PA was associated with 3,617 incident CVD cases during 440,004 person-years of follow-up (median (interquartile range [IQR]): 5.2 (1.2) years) using Cox regression models. We found a linear dose-response relationship for PA, whether measured as moderate-intensity, vigorous-intensity, or as total volume, with risk of incident of CVD. Hazard ratios (HRs) and 95% confidence intervals for increasing quarters of the PA distribution relative to the lowest fourth were for moderate-intensity PA: 0.71 (0.65, 0.77), 0.59 (0.54, 0.65), and 0.46 (0.41, 0.51); for vigorous-intensity PA: 0.70 (0.64, 0.77), 0.54 (0.49,0.59), and 0.41 (0.37,0.46); and for total volume of PA: 0.73 (0.67, 0.79), 0.63 (0.57, 0.69), and 0.47 (0.43, 0.52). We took account of potential confounders but unmeasured confounding remains a possibility, and while removal of early deaths did not affect the estimated HRs, we cannot completely dismiss the likelihood that reverse causality has contributed to the findings. Another possible limitation of this work is the quantification of PA intensity-levels based on methods validated in relatively small studies. CONCLUSIONS In this study, we found no evidence of a threshold for the inverse association between objectively measured moderate, vigorous, and total PA with CVD. Our findings suggest that PA is not only associated with lower risk for of CVD, but the greatest benefit is seen for those who are active at the highest level.
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Affiliation(s)
- Rema Ramakrishnan
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
- University of New South Wales, Sydney, Australia
| | - Aiden Doherty
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- National Institute of Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
| | - Karl Smith-Byrne
- International Agency for Research on Cancer, Genetic Epidemiology Group, Lyon, France
| | - Kazem Rahimi
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
- National Institute of Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
- Deep Medicine, Oxford Martin School, University of Oxford, United Kingdom
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Derrick Bennett
- National Institute of Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
- Clinical Trials Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Mark Woodward
- The George Institute for Global Health, Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- Department of Epidemiology, Johns Hopkins University, Baltimore, United States of America
| | - Rosemary Walmsley
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Terence Dwyer
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
- Murdoch Children’s Research Institute, Melbourne, Australia
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15
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Chen GC, Qi Q, Hua S, Moon JY, Spartano NL, Vasan RS, Sotres-Alvarez D, Castaneda SF, Evenson KR, Perreira KM, Gallo LC, Pirzada A, Diaz KM, Daviglus ML, Gellman MD, Kaplan RC, Xue X, Mossavar-Rahmani Y. Accelerometer-assessed physical activity and incident diabetes in a population covering the adult life span: the Hispanic Community Health Study/Study of Latinos. Am J Clin Nutr 2020; 112:1318-1327. [PMID: 32910816 PMCID: PMC7657343 DOI: 10.1093/ajcn/nqaa232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 07/23/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The association between accelerometer-assessed physical activity and risk of diabetes remains unclear, especially among US Hispanic/Latino adults who have lower levels of physical activity and a higher diabetes burden compared with other racial/ethnical populations in the country. OBJECTIVES To examine the association between accelerometer-assessed physical activity and incident diabetes in a US Hispanic/Latino population. METHODS We included 7280 participants of the Hispanic Community Health Study/Study of Latinos who aged 18-74 y and free of diabetes at baseline. Data on moderate-to-vigorous physical activity (MVPA) were collected using a 7-d accelerometer measurement. Incident diabetes was assessed after a mean ± SD of 6.0 ± 0.8 y using standard procedures including blood tests. RRs and 95% CIs of diabetes associated with MVPA were estimated using survey Poisson regressions. The associations of MVPA with 6-y changes in adiposity measures were also examined. RESULTS A total of 871 incident cases of diabetes were identified. MVPA was inversely and nonlinearly associated with risk of diabetes (P-nonlinearity = 0.006), with benefits accruing rapidly at the lower end of MVPA range (<30 min/d) and leveling off thereafter. The association differed by population age (P-interaction = 0.006). Higher MVPA was associated with lower risk of diabetes among individuals older than 50 y (RRQ4 versus Q1 = 0.50; 95% CI: 0.35, 0.73; P-trend < 0.001) but not among younger individuals (RRQ4 versus Q1 = 0.98; 95% CI: 0.66, 1.47; P-trend = 0.92). An inverse association between MVPA and 6-y gain in waist circumference was also limited to the older group (P-interaction with age < 0.001). CONCLUSIONS Among US Hispanic/Latino adults, baseline accelerometer-derived MVPA was inversely associated with incident diabetes only among individuals aged 50 y and older. Further studies are needed to confirm our findings and to clarify potential mechanisms underlying the possible age differences in the MVPA-diabetes association. This study was registered at clinicaltrials.gov as NCT02060344.
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Affiliation(s)
- Guo-Chong Chen
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Qibin Qi
- Address correspondence to QQ (E-mail: )
| | - Simin Hua
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jee-Young Moon
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nicole L Spartano
- Sections of Preventative Medicine and Epidemiology, and Cardiology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA,The Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA
| | - Ramachandran S Vasan
- Departments of Medicine and Epidemiology, Boston University Schools of Medicine and Public Health, Boston, MA, USA
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sheila F Castaneda
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois at Chicago, IL, USA
| | - Keith M Diaz
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, IL, USA
| | - Marc D Gellman
- Behavioral Medicine Research Center, Department of Psychology, University of Miami, Miami, FL, USA
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Xiaonan Xue
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
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16
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Physical Activity, Step Counts, and Grip Strength in the Chinese Children and Families Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176202. [PMID: 32859094 PMCID: PMC7504127 DOI: 10.3390/ijerph17176202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/16/2020] [Accepted: 08/19/2020] [Indexed: 11/30/2022]
Abstract
Objectives: This paper describes the development of a physical activity questionnaire (PAQ) designed for Chinese adolescents and their mothers in urban and rural settings, and reports on results of the PAQ, pedometry, and hand grip dynamometry from the Chinese Children and Families Cohort Study pilot investigation (CFCS). Methods: As part of a pilot investigation to evaluate the feasibility to follow-up and obtain detailed nutrition, dietary, physical activity, and ultraviolet radiation (UVR) data from CFCS participants, data were collected in 2013 for 93 adolescent/mother pairs from a rural (n = 41) and an urban site (n = 52) in two provinces. Respondents were asked to wear a pedometer for seven days (Omron HJ-151), use a Takei Digital Grip Strength Dynamometer on (each hand; three trials; two separate days), and complete a 39 item, eight domain PAQ covering the past year. Self-reported physical activity (PA) was linked to metabolic equivalent of task (MET) scores in kcal/kg/hr and used to calculate METs for different domains of PA and intensity categories. Results: Compliance was high (95%) in this measurement protocol administered by health staff during a series of data collection efforts at home and local clinics or health centers. Step counts were highly variable, averaging between 5000 and 10000 per day with somewhat higher step counts in rural adolescent boys. Maximum grip strength (Kgs) was greater in children (Mean = 36.5, SE = 0.8) than mothers (Mean = 28.8, SE = 0.8) and similar in the urban (Mean = 29.6, SE = 0.6) compared to the rural (Mean = 29.6, SE = 0.5) communities overall. Grip strength, step counts, and measures of time spent in different activities or activity intensities were uncorrelated. Conclusion: Device and question-based measurement of PA and strength were readily accepted in these Chinese urban and rural populations. The PAQ on physical activity in the past year produced some plausible population averages, but individual responses suggested recall challenges. If data about specific activities are required, future studies should explore use of standardized survey questions concerning such fewer specific activities or instruments examining shorter time periods such as one, three, or seven day recalls.
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Saint-Maurice PF, Troiano RP, Bassett DR, Graubard BI, Carlson SA, Shiroma EJ, Fulton JE, Matthews CE. Association of Daily Step Count and Step Intensity With Mortality Among US Adults. JAMA 2020; 323:1151-1160. [PMID: 32207799 PMCID: PMC7093766 DOI: 10.1001/jama.2020.1382] [Citation(s) in RCA: 342] [Impact Index Per Article: 85.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
IMPORTANCE It is unclear whether the number of steps per day and the intensity of stepping are associated with lower mortality. OBJECTIVE Describe the dose-response relationship between step count and intensity and mortality. DESIGN, SETTING, AND PARTICIPANTS Representative sample of US adults aged at least 40 years in the National Health and Nutrition Examination Survey who wore an accelerometer for up to 7 days ( from 2003-2006). Mortality was ascertained through December 2015. EXPOSURES Accelerometer-measured number of steps per day and 3 step intensity measures (extended bout cadence, peak 30-minute cadence, and peak 1-minute cadence [steps/min]). Accelerometer data were based on measurements obtained during a 7-day period at baseline. MAIN OUTCOMES AND MEASURES The primary outcome was all-cause mortality. Secondary outcomes were cardiovascular disease (CVD) and cancer mortality. Hazard ratios (HRs), mortality rates, and 95% CIs were estimated using cubic splines and quartile classifications adjusting for age; sex; race/ethnicity; education; diet; smoking status; body mass index; self-reported health; mobility limitations; and diagnoses of diabetes, stroke, heart disease, heart failure, cancer, chronic bronchitis, and emphysema. RESULTS A total of 4840 participants (mean age, 56.8 years; 2435 [54%] women; 1732 [36%] individuals with obesity) wore accelerometers for a mean of 5.7 days for a mean of 14.4 hours per day. The mean number of steps per day was 9124. There were 1165 deaths over a mean 10.1 years of follow-up, including 406 CVD and 283 cancer deaths. The unadjusted incidence density for all-cause mortality was 76.7 per 1000 person-years (419 deaths) for the 655 individuals who took less than 4000 steps per day; 21.4 per 1000 person-years (488 deaths) for the 1727 individuals who took 4000 to 7999 steps per day; 6.9 per 1000 person-years (176 deaths) for the 1539 individuals who took 8000 to 11 999 steps per day; and 4.8 per 1000 person-years (82 deaths) for the 919 individuals who took at least 12 000 steps per day. Compared with taking 4000 steps per day, taking 8000 steps per day was associated with significantly lower all-cause mortality (HR, 0.49 [95% CI, 0.44-0.55]), as was taking 12 000 steps per day (HR, 0.35 [95% CI, 0.28-0.45]). Unadjusted incidence density for all-cause mortality by peak 30 cadence was 32.9 per 1000 person-years (406 deaths) for the 1080 individuals who took 18.5 to 56.0 steps per minute; 12.6 per 1000 person-years (207 deaths) for the 1153 individuals who took 56.1 to 69.2 steps per minute; 6.8 per 1000 person-years (124 deaths) for the 1074 individuals who took 69.3 to 82.8 steps per minute; and 5.3 per 1000 person-years (108 deaths) for the 1037 individuals who took 82.9 to 149.5 steps per minute. Greater step intensity was not significantly associated with lower mortality after adjustment for total steps per day (eg, highest vs lowest quartile of peak 30 cadence: HR, 0.90 [95% CI, 0.65-1.27]; P value for trend = .34). CONCLUSIONS AND RELEVANCE Based on a representative sample of US adults, a greater number of daily steps was significantly associated with lower all-cause mortality. There was no significant association between step intensity and mortality after adjusting for total steps per day.
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Affiliation(s)
- Pedro F. Saint-Maurice
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Richard P. Troiano
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland
| | - David R. Bassett
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville
| | - Barry I. Graubard
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Susan A. Carlson
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Eric J. Shiroma
- Epidemiology and Population Science Laboratory, National Institute on Aging, Bethesda, Maryland
| | - Janet E. Fulton
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Charles E. Matthews
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
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