Different physical activity subtypes and risk of metabolic syndrome in middle-aged and older Chinese people

The relationship between physical activity, physical health, and mental health among older Chinese adults: A scoping review

The aging Chinese population is growing fast, and the proportion of the population aged 60 years old is projected to reach 28% by 2040, estimated 402 million. With increased life expectancy, the aging population tends to suffer from health risks and diseases, which create a burden on public health policy. Hence, it is essential to promote healthy and active aging, which includes improving older adults' physical and mental capacities and advocating for the achievement of a healthy life expectancy. Despite the rapidly growing aging population in China, there have been no reviews investigating the effect of physical activity on physical and mental health among older Chinese adults. Therefore, the current study aimed to review studies from the past 15 years that illustrate the effect of physical activity on physical and mental health among Chinese older adults. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews (PRISMA-ScR), this review addresses the associations between physical activity, physical health and mental health among older Chinese adults. A total of 371 studies were included in the scoping review, which covered the relationships between physical activity, physical health and mental health variables. The scoping review also revealed the impact of various kinds of physical activity affecting older adults' physical health, such as functional fitness, body composition, fall risk and balance, and mental health issues, such as depression, anxiety, cognitive function and quality of life. Moreover, studies have identified innovative forms of physical activity as emerging trends in physical activity interventions for older adults. To conclude, this scoping review captured the common effects between physical activity and overall wellbeing, including physical, mental, and cognitive health. Additionally, diverse forms of physical activity intervention, such as group-based and supervised individual interventions, should be supported, and cross-cultural exercise comparisons should be made in future explorations.

Leisure-time physical activity and risk of incident cardiovascular disease in Chinese retired adults

The optimum amounts and types of leisure-time physical activity (LTPA) for cardiovascular disease (CVD) prevention among Chinese retired adults are unclear. The prospective study enrolled 26,584 participants (mean age [SD]: 63.3 [8.4]) without baseline disease from the Dongfeng-Tongji cohort in 2013. Cox-proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During a mean 5.0 (1.5) years of follow-up, 5704 incident CVD cases were documented. Compared with less than 7.5 metabolic equivalent of task-hours per week (MET-hours/week) of LTPA, participating LTPA for 22.5-37.5 MET-hours/week, which was equivalent to 3 to 5 times the world health organization (WHO) recommended minimum, was associated with a 18% (95% CI 9 to 25%) lower CVD risk; however, no significant additional benefit was gained when exceeding 37.5 MET-hours/week. Each log10 increment of MET-hours/week in square dancing and cycling was associated with 11% (95% CI 2 to 20%) and 32% (95% CI 21 to 41%), respectively, lower risk of incident CVD. In Chinese retired adults, higher LTPA levels were associated with lower CVD risk, with a benefit threshold at 3 to 5 times the recommended physical activity minimum. Encouraging participation in square dancing and cycling might gain favourable cardiovascular benefits.

Performing arts as a health resource? An umbrella review of the health impacts of music and dance participation

An increasing body of evidence notes the health benefits of arts engagement and participation. However, specific health effects and optimal modes and 'doses' of arts participation remain unclear, limiting evidence-based recommendations and prescriptions. The performing arts are the most popular form of arts participation, presenting substantial scope for established interest to be leveraged into positive health outcomes. Results of a three-component umbrella review (PROSPERO ID #: CRD42020191991) of relevant systematic reviews (33), epidemiologic studies (9) and descriptive studies (87) demonstrate that performing arts participation is broadly health promoting activity. Beneficial effects of performing arts participation were reported in healthy (non-clinical) children, adolescents, adults, and older adults across 17 health domains (9 supported by moderate-high quality evidence (GRADE criteria)). Positive health effects were associated with as little as 30 (acute effects) to 60 minutes (sustained weekly participation) of performing arts participation, with drumming and both expressive (ballroom, social) and exercise-based (aerobic dance, Zumba) modes of dance linked to the broadest health benefits. Links between specific health effects and performing arts modes/doses remain unclear and specific conclusions are limited by a still young and disparate evidence base. Further research is necessary, with this umbrella review providing a critical knowledge foundation.

Prevalence of metabolic syndrome and its associated risk factors among staffs in a Malaysian public university

Public health systems are concerned with the commensurate rise of metabolic syndrome (MetS) incidence across populations worldwide, due to its tendency to amplify greater risk of diabetes and cardiovascular diseases within communities. This study aimed to determine the prevalence of MetS and its associated risk factors among staffs in a Malaysian public university. A cross-sectional study was conducted among 538 staffs from the Universiti Kebangsaan Malaysia (UKM) between April and June 2019. MetS was defined according to JIS "Harmonized" criteria. A questionnaire that consisted of items on socio-demographics, lifestyle risk behaviors and personal medical history information was administered to participants. Subsequently, a series of physical examination and biochemical assessment was conducted at the hall or foyer of selected faculties in the university. Descriptive and inferential statistics were conducted using SPSS version 22.0. Multivariate models were yielded to determine the risk factors associated with MetS. Statistical significance was set at P < 0.05. The overall prevalence of MetS was 20.6%, with men having greater prevalence than women (24.9% vs. 18.3%). Prevalence of MetS increased with age. Factors contributed to MetS in the overall sample were BMI, hypertension, diabetes and physical activity of moderate intensity. Diabetes and hypertension were significantly associated with MetS in men, whereas BMI, diabetes and hyperlipidemia were significantly associated with MetS in women. Lifestyle behaviors and cardio-metabolic risk factors were associated with MetS for the overall sample, and across genders.

The Association of Different Types of Leisure Time Physical Activities with Cardiometabolic Outcomes in Singapore-Findings from the Multi-Ethnic Cohort Study

The study aimed to investigate the association between leisure time physical activity (LTPA) subtypes and cardiometabolic outcomes in the Singapore Multi-Ethnic Cohort (MEC). Self-reported data on socio-demographics, lifestyle factors, LTPA subtypes, and health screening data on body-mass index (BMI), waist circumference (WC), systolic and diastolic blood pressure (SBP and DBP), triglycerides (TG), and HDL-and LDL cholesterol were collected. Multivariable linear regression analyses were used adjusting for confounders. The mean age of 9768 participants was 45.2 ± 12.5 years (57.3% female, 47.3% Chinese, 26.0% Malay, and 26.8% Indians). Overall, 65.8% engaged in LTPA, and walking, strength/fitness and running were most common. Higher total LTPA was associated with lower WC, DBP, TG, a trend towards lower BMI, and higher SBP and HDL. Running was beneficially associated with all outcomes except for SBP and LDL. Balance exercises (BMI, SBP and DBP), cycling (BMI, WC and HDL), and strength/fitness (BMI, WC, TG and HDL) were also favorably associated with a number of outcomes, whereas ball games (DBP and TG), dancing (HDL) and other LTPA (DBP) were only favorably associated with selected outcomes. Unfavorable associations were found for total LTPA (SBP), strength/fitness (SBP), golf (DBP) and swimming (BMI and WC). Further research is warranted to inform future health promotion efforts.

A 12-Week Multi-Modal Exercise Program: Feasibility of Combined Exercise and Simplified 8-Style Tai Chi Following Lung Cancer Surgery

Objective:

To assess the feasibility, safety, and preliminary effect of a 12-week multi-modal rehabilitation program targeted at improving health-related quality of life and physical activity levels of patients with lung cancer following treatment.

Methods:

Patients with stage I to IIIA non-small cell lung cancer were included 6 to 12 weeks following completion of treatment. The intervention comprised of aerobic exercise (brisk walking), resistance training and 8-style Tai Chi. The 12-week program included 2 supervised center-based sessions per week of 90 minutes duration and home-based exercise. The primary outcomes were the feasibility and safety of the intervention. Secondary outcomes (assessed pre and post program) were physical and patient-reported outcomes.

Results:

Seventy-eight patients were approached during the 6-month recruitment period and 17 (22%) consented to the study. Eight participants (47%) met the definition of adherence to the program (attending at least 70% of supervised sessions). No serious adverse events occurred. A significant reduction in anxiety and depression was observed post-program. In addition, improvements in respiratory function, sleep quality, and some health-related quality of life domains were observed post-program. There were no significant differences in functional capacity or physical activity levels.

Conclusion:

This multi-modal exercise training program was safe, although the feasibility of the program in its current state is not supported given the low consent rate and low adherence to the intervention.

Effects of Meditation and Mind-Body Exercises on Older Adults' Cognitive Performance: A Meta-analysis

BACKGROUND AND OBJECTIVES

Meditation and mind-body exercises are suggested to delay decline or enhance cognitive capabilities in older adults. However, their effectiveness remains uncertain. This study assessed the effectiveness of meditation and mind-body exercises to improve cognition in elderly people aged 60 years or above. Moderator variables were also explored.

RESEARCH DESIGN AND METHODS

A databases search (MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Library, Web of Science, CNKI, and Wangfang) was conducted from the first available date to January 10, 2018. Inclusion criteria include (a) human older adults aged 60 years or above, (b) meditation, Tai Chi, Qigong, or yoga intervention, (c) intervention should be structured, (d) inclusion of a control group, (e) at least one outcome measure of cognition was measured at baseline and post-training, and (f) peer-reviewed journal articles in English or Chinese.

RESULTS

Forty-one studies (N = 3,551) were included in the meta-analysis. In general, meditation and mind-body exercises improve cognition in the elderly people (SMD = 0.34, 95% CI: 0.19 to 0.48), but the cognition-enhancing effects depend on the type of exercise. In addition, cognitive performance is only improved when the length of intervention is longer than 12 weeks, exercise frequency is 3-7 times/week, or duration of an exercise session is 45-60 min/session.

DISCUSSION AND IMPLICATIONS

This study suggests that meditation and mind-body exercises are effective to improve cognition of older adults aged 60 years or above, and exercise parameters should be considered for intervention planning.

Effect of Physical Activity on Hospital Service Use and Expenditures of Patients with Coronary Heart Disease: Results from Dongfeng-Tongji Cohort Study in China

The intervention of behaviors, including physical activity (PA), has become a strategy for many hospitals dealing with patients with chronic diseases. Given the limited evidence available about PA and healthcare use with chronic diseases, this study explored the association between different levels of PA and annual hospital service use and expenditure for inpatients with coronary heart disease (CHD) in China. We analyzed PA information from the first follow-up survey (2013) of the Dongfeng-Tongji cohort study of 1460 CHD inpatients. We examined factors such as PA exercise volume and years of PA and their associations with the number of inpatient visits, number of hospital days, and inpatient costs and total medical costs. We found that the number of hospital days and the number of inpatient visits were negatively associated with intensity of PA level. Similarly, total inpatient and outpatient costs declined when the PA exercise volume levels increased. Furthermore, there were also significant associations between the number of hospital days, inpatient costs or total medical costs and levels of PA years. This study provides the first empirical evidence about the effects of the intensity and years of PA on hospital service use and expenditure of CHD in China. It suggests that the patients' PA, especially the vigorous PA, should be promoted widely to the public and patients in order to relieve the financial burden of CHD.

Metabolic syndrome prevalence and its risk factors among adults in China: A nationally representative cross-sectional study

OBJECTIVES

The aim of this study was to examine sex disparity in metabolic syndrome prevalence and its risk factors among Chinese adults.

METHODS

Using the 2010-2012 China National Nutrition and Health Survey (CNNHS), a nationally representative cross-sectional study on nutrition and non-communicable chronic diseases, a total of 98,042 participants aged 18 years and older were included in the analysis. Dietary information was collected with a food frequency questionnaire (FFQ). Metabolic syndrome was defined according to the updated NCEP ATP III criteria. A multivariable logistic regression model was performed to examine the associations between sociodemographic and dietary factors with metabolic syndrome prevalence, and the results are presented using odd ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

The overall standardized prevalence of metabolic syndrome was 24.2% (24.6% in men and 23.8% in women). The metabolic syndrome prevalence was positively associated with age in men and women. The prevalence of metabolic syndrome was negatively associated with the physical activity level among men and inversely associated with the education level among women (P for trend < 0.01). Frequent consumption of fungi and algae was an underlying risk factor for metabolic syndrome in men, whereas frequent consumption of nuts and pork was associated with a decreased prevalence of metabolic syndrome in women.

CONCLUSIONS

The prevalence of metabolic syndrome in men was not different from that in women. There are sex-specific associations between multiple risk factors and metabolic syndrome.

Hypoglycemic and antioxidant effect of Tai chi exercise training in older adults with metabolic syndrome

Introduction

The antioxidant and anti-inflammatory effects of Tai chi (TC) exercise training in healthy older adults has been demonstrated. However, there are no studies on this effect in older adults with metabolic syndrome (MetS).

Purpose

The aim of this study was to determine the effect of TC exercise on oxidative stress and inflammatory markers in older adults with MetS.

Methods

A quasi-experimental study was carried out with a sample of 110 older sedentary volunteers with clinical diagnoses of MetS: (i) a control group, n = 50, of individuals who do not participate in physical exercise, of which 37 fulfilled the entire study protocol, and (ii) an experimental group, n = 60, of subjects enrolled in a TC exercise training program (eight-form easy), 5 days a week for 6 months, in sessions of 50 min, under the supervision of a qualified instructor, of which 48 fulfilled the entire study protocol. We measured in both groups (pre- and post-intervention) the following cardiovascular parameters: resting heart rate (RHR), diastolic and systolic blood pressure (DBP and SBP), mean arterial pressure (MAP), RHR-SBP product, RHR-MAP product; glycosylated hemoglobin (HbA1c); oxidative stress markers (superoxide dismutase, total antioxidant status, thiobarbituric acid reacting substances, and oxidative stress score); and inflammation markers (TNF-α, IL-6, IL-8, and IL-10).

Results

A statistically significant decrease in HbA1c concentration was observed in the TC group compared with the control group (p < 0.05). This group also showed a statistically significant increase in TAS and a decrease in the oxidative stress score (p < 0.05). We did not observe changes in the cardiovascular parameters (RHR, DBP, SBP, MAP, RHR-SBP product, and RHR-MAP product) in the TC experimental group compared to the control group.

Conclusion

Our findings suggest that the practice of TC exercise has an antioxidative and hypoglycemic effect in the elderly with MetS.

Tai Chi Chuan in postsurgical non-small cell lung cancer patients: study protocol for a randomized controlled trial

Background

Impairment of exercise capacity remains a common adverse effect of non-small cell lung cancer (NSCLC) survivors after surgery. Previous research has suggested that Tai Chi Chuan (TCC) offers an exercise capacity benefit in several types of cancers. This is a randomized trial to investigate the efficacy and safety of TCC in postoperative NSCLC patients over an observation period of 3 months and a 9-month follow-up.

Methods/design

Using a prospective, one center and randomized design, 120 subjects with histologically confirmed stage I–IIIA NSCLC following complete surgical resection will potentially be eligible for this trial. Following baseline assessments, eligible participants will be randomly assigned to one of two conditions: (1) TCC training, or (2) placebo control. The training sessions for both groups will last 60 min and take place three times a week for 3 months. The sessions will be supervised with target intensity of 60–80% of work capacity, dyspnea, and heart rate management. The primary study endpoint is peak oxygen consumption (VO_2peak), and the secondary endpoints include: 6-min walk distance (6MWD), health-related quality of life (HRQoL), lung function, immunity function, and the state of depression and anxiety. All endpoints will be assessed at the baseline and postintervention (3 months). A follow-up period of 9 months will be included. The main time points for the evaluation of clinical efficacy and safety will be months 3, 6, 9, and 12 after enrollment.

Discussion

This study will assess the effect of group TCC in postsurgery NSCLC survivors on VO_2peak, lung function, and other aspects. The results of this study will eventually provide clinical proof of the application of TCC as one kind of exercise training for patients across the entire NSCLC continuum, as well as information on the safety and feasibility of exercise.

Trial Registration

Chinese Clinical Trial Registry: ChiCTR-IOR-15006548. Registered on 12 June 2015.

Electronic supplementary material

The online version of this article (doi:10.1186/s13063-017-2320-x) contains supplementary material, which is available to authorized users.

Associations of Neighborhood Environmental Attributes with Walking in Japan: Moderating Effects of Area-Level Socioeconomic Status

Several studies have examined how the associations of built environment attributes with walking behaviors may be moderated by socioeconomic status (SES). Such understanding is important to address socioeconomic inequalities in health through urban design initiatives. However, to date, there is no study examining the moderation effects of SES in the relationships of environmental attributes and walking in non-Western countries. The current study aims to examine associations of environmental attributes with walking behaviors among Japanese adults, and to test whether these associations were moderated by area-level SES. Data on walking were collected from Japanese adults using a nationwide Internet survey (N = 4605). Built environment measures including population density, street density, distance to the nearest public open space, and distance to the nearest commercial destination were calculated using geographic information systems software. An index of neighborhood deprivation was used as an area-level indicator of SES. Logistic regression models adjusted for clustering and sociodemographic variables were used. It was found that more residents in high SES areas walked for commuting, for errands, and for exercise compared with those who lived in low SES areas. When the whole sample was examined, all environmental attributes were associated with walking behaviors (except for street density not being associated with walking for exercise). Associations of environmental attributes with walking behaviors were moderated by area-level SES only in walking for exercise. Walking for exercise was associated with higher population density, higher street density (marginally significant), and shorter distance to the nearest commercial destination only in high SES areas. Our findings showed that the associations of these environmental attributes and walking behaviors were largely consistent across different SES levels. Therefore, urban design interventions focusing on low SES areas may help to reduce socioeconomic disparities in walking.

Risk factors of metabolic syndrome among hypertensive patients at Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia

Background

Data regarding the prevalence of metabolic syndrome (MetS) among hypertensive patients in Ethiopia is very scarce, and the nature and the burden of MetS among these patients has not been well investigated. Therefore, the aim of this study was to assess the pattern and risk factors of MetS in hypertensive patients.

Methods

A cross-sectional study was conducted at Hawassa University comprehensive specialized hospital from September 2015 to June 2016. Data on socio-demographic, clinical and anthropometric characteristics were collected from 238 hypertensive participants using WHO stepwise technique. Blood glucose and lipid profiles were determined after overnight fasting. Finally, MetS was defined according to National Cholesterol Education Program Adult Treatment Panel III Criteria.

Results

The overall prevalence of MetS was 48.7% and urban dwellers had significantly higher prevalence of MetS (82.8%) compared to rural inhabitants (17.2%), p = 0.003. About 37.8%, 62.2%, 60.9% and 35.7% of the participants had abdominal obesity, elevated triglycerides, low HDL-c, and increased fasting blood glucose, respectively. In addition the mean HDL-c was significantly lower in MetS group compared to non-MetS group (39.4 vs.47.6), P < 0.0001. Age over 60 years, overweight, and obesity were associated risk factors of MetS. The adjusted odds ratio (95% CI) was 8.2 (1.1–62.4) for age over 60 years, 2.8 (1.4–5.9) for overweight and 10.7 (3.8–29.8) for obesity. Moreover monthly income of 1001–2000 Ethiopian birr, income ≥2001birr, a retirement pension, being married, divorced/widowed were also significantly associated risk factors of MetS, the adjusted odds ratio (95% CI) was 3.6 (1.1–12.5), 5.8 (1.5–22.3),5.3 (1.1–25.9),7.2 (1.4–35.9) and 16.4 (1.1–244.2), respectively.

Conclusion

Metabolic syndrome is highly prevalent among hypertensive patients and this may potentiate the risk of cardiovascular problems. Therefore, regular screening of patients for individual components of MetS is vital in order to avert/limit the risks before developing cardiovascular related morbidity and mortality.

Feasibility and Acceptability of Qigong Exercise in Community-Dwelling Older Adults in the United States

OBJECTIVES

Qigong exercise has been shown to improve physical and psychological well-being in adults with chronic conditions, but little is known about the feasibility and acceptability of engaging in a qigong exercise program in community-dwelling older adults in the United States. The purpose of this study was to explore the feasibility, acceptance, and adherence to an 8-week qigong exercise intervention in community-dwelling American older adults.

DESIGN

An exploratory study design.

SETTING

Two senior centers in southern Connecticut.

SUBJECTS

Forty-five community-dwelling older adults aged 65 to 85 years enrolled.

INTERVENTION

A supervised 1-h health qigong exercise session twice weekly for 8 weeks.

OUTCOME MEASURES

An investigator-designed questionnaire with seven items that were rated on a 1 to 6 scale, with higher scores indicating better results, and nine open-ended questions were used to obtain data on feasibility and acceptability. Adherence was calculated as the proportion of the 16 planned sessions attended.

RESULTS

Of the 45 older adults enrolled, 6 never started and 6 withdrew, with 33 evaluable at the end of the intervention. The mean age of the sample was 74.8 years; the majority were female (84.4%) and white (91.1%). Mean scores on aspects of difficulty, acceptability, suitability, or effectiveness of qigong exercise were all ≥5. Participants identified benefits of qigong exercise, such as calming and relaxing feelings, inner peace, better balance, and flexibility. Attendance rate was 78.8%, with 94% performing qigong exercise at least once weekly outside the class. All participants indicated that they would recommend qigong exercise to others. No adverse events occurred.

CONCLUSION

An 8-week qigong exercise program was feasible, acceptable, and safe for American older adults. Future robust randomized controlled trials are needed to confirm these findings.

Association of drinking pattern with risk of coronary heart disease incidence in the middle-aged and older Chinese men: Results from the Dongfeng-Tongji cohort

Background

Epidemiologic studies have found that moderate alcohol consumption was associated with a decreased risk of coronary heart disease (CHD) incidence. Nevertheless, whether the drinking pattern is associated with CHD incidence still remains inconclusive.

Methods

We included 8,469 Chinese men aged 45–81 years, who were free of CHD, stroke, or cancer at baseline from Dongfeng-Tongji cohort. A semi-structured questionnaire was used to collect information on alcohol consumption and other covariates. Cox proportional hazard regression model was applied to estimate the multivariable-adjusted hazard rations (HRs) and 95% confidence intervals (95% CIs).

Results

During an average of 4.36 years of follow-up, we identified 959 incident CHD events. Compared with non-drinkers, the multivariable-adjusted HR (95% CI) of CHD incidence was 0.84 (0.71–0.98) in current drinkers. With respect to drinking pattern, men who consumed 20.01–40 grams ethanol once a time had a 24% lower risk of incident CHD (HR = 0.76, 95% CI = 0.62, 0.94) compared with non-drinkers. The adjusted HRs (95% CI) of CHD incidence were 0.80 (0.65, 0.99), 1.02 (0.84, 1.22), and 0.75 (0.59–0.96) in subjects who consumed 0.01–10, 10.01–30, and > 30 grams ethanol per day, respectively. Participants who consumed 20.01–40 grams ethanol per time with less than 5 times per week had the lowest risk of CHD incidence (HR = 0.73, 95% CI = 0.52, 0.96). No significant associations were observed between type or frequency of alcohol consumption and CHD incidence.

Conclusions

Drinking was associated with a lower risk of CHD incidence in middle-aged and older Chinese men and moderate quantity of ethanol amounts once a time with lower frequency could been considered as a healthy drinking pattern, which might modify the relationship between alcohol consumption and incident CHD.

Global participation in sport and leisure-time physical activities: A systematic review and meta-analysis

This review aimed to determine the most popular physical activities performed by children, adolescents, and adults globally. Statistic bureau websites and article databases Scopus, ProQuest, SPORTDiscus, and Science Direct were searched between November 17th, 2014 and April 31st, 2015. Eligible studies were published in the last 10years with participation rates for specific physical activities among individuals five years or older. Data extraction for included articles (n=64) was assessed independently and agreed upon by two authors. A random-effects model was used to calculate participation rates in specific activities for each age group and region. In total 73,304 articles were retrieved and 64 articles representing 47 countries were included in the final meta-analysis. Among adults, walking was the most popular activity in the Americas (18.9%; 95% CI 10.2 to 32.5), Eastern Mediterranean (15.0%; 95% CI 5.8 to 33.6), Southeast Asia (39.3%; 95% CI 0.9 to 98.0) and Western Pacific (41.8%; 95% CI 25.2 to 60.6). In Europe and Africa, soccer (10.0%; 95% CI 6.5 to 15.1) and running (9.3%; 95% CI 0.9 to 53.9), respectively, were top activities. Child and adolescent participation results were highly dependent upon region. American youth team sport participation was high, while youth from the Eastern Mediterranean and Western Pacific were more likely to report participation in lifelong physical activities. Global data for adults reflects a consistent pattern of participation in running and walking. Among all age groups and regions soccer was popular. In children and adolescents, preferences were variable between regions.

Association of regular physical activity with total and cause-specific mortality among middle-aged and older Chinese: a prospective cohort study

Association between physical activity and mortality has rarely been investigated among the Chinese population. Furthermore, the most appropriate amount of physical activity for longevity benefits remains unclear. We used data from the Dongfeng-Tongji cohort, including 24,606 middle-aged and older retired adults in 2008 and followed to 2013, to quantify linear and non-linear dose-response relationships between regular physical activity and mortality risks by Cox proportional hazards model. Compared with participants who did not engage in regular physical activity, those performing regular physical activity had significantly 46%, 56%, and 49% decreased risks of mortality from all causes, circulatory, and respiratory diseases, respectively. Each one-SD increase in regular physical activity was associated with 32% decrease of respiratory disease mortality. There were significant nonlinear dose-response associations between regular physical activity and mortality from all causes and circulatory diseases. Mortality risks decreased monotonically with increased regular physical activity amount, and appeared to reach a threshold at around 100 MET-hours/week. More mortality benefits were found among non-smokers than that among current and former smokers. Our results suggest that middle-aged and older Chinese adults can achieve mortality benefits from regular physical activity at the WHO recommended minimum, and the benefit threshold appears at approximately 100 MET hours/week.

Effects of dance interventions on cardiovascular risk with ageing: Systematic review and meta-analysis

BACKGROUND

Exercising, including dancing, has been recommended to improve cardiovascular health of older people. Herein, we conducted a systematic review and meta-analysis verifying the effects of dance interventions on cardiovascular risk (CVR) in the elderly, comparing dancers to non-exercise controls and other types of exercise, in randomised (RCTs) and non-randomised control trials (nRCTs). Primary/Secondary outcomes: peak oxygen consumption (VO₂peak)/anthropometric measurements (body weight, BMI), and lipid profile.

METHODS

Data Sources: MEDLINE, Cochrane Wiley, Clinical Trials.gov, PEDRO and LILACS databases.

STUDY SELECTION

RCTs and nRCTs comparing elderly before and after dance interventions with non-exercising controls and/or practitioners of other types of exercise. Two independent reviewers extracted data and assessed the quality of included studies.

RESULTS

A total of 937 articles were retrieved, 64 full texts were assessed for eligibility, and 7 articles met the inclusion criteria. Pooled mean differences between intervention and control were calculated by random-effects model. VO₂peak improved in favour of dancers (3.4mLkg^-1min^-1, 95%CI: 1.08, 5.78, I2=71%), compared to non-exercise controls. No differences were found between dance and other exercises. Body weight and BMI were not altered by dance interventions.

CONCLUSIONS

Dance interventions may increase VO₂peak compared to non-exercising controls. Results also indicate it is as effective as other types of exercise in improving aerobic capacity of the elderly. Dancing might be a potential exercise intervention for improving cardiorespiratory fitness and consequent CVR associated with ageing. Proper reporting on adverse events is needed to base the benefits of dancing for the older on both efficacy and safety of the interventions.

Health benefits of traditional Chinese sports and physical activity for older adults: A systematic review of evidence

BACKGROUND

Traditional Chinese sports and physical activities (PAs) have a long history and are practiced by millions of Chinese. However, relatively few systematic reviews of the scientific evidence for their health benefits, especially for older Chinese adults, have been undertaken.

EVIDENCE ACQUISITION

Between January and March 2016, a systematic search was conducted using the CNKI and PubMed databases to identify studies published between 2000 and 2015. Studies were selected for review if they were designed specifically to evaluate the health benefits of traditional Chinese sports and PAs in adults aged 50 years and older in the Mainland of China. The studies included observational, uncontrolled, and randomized and controlled designs. Papers published without an English title or abstract were excluded.

EVIDENCE SYNTHESIS

The initial search identified a total of 229 studies. After removing duplicates and studies that did not meet the inclusion/exclusion criteria, 95 studies were selected for review. Special attention was given to studies of the most commonly practiced activities: Tai Ji Quan, Qigong, and Yangko exercises. A positive association between these types of exercise and health benefits was noted for healthy older adults and those with chronic diseases. Evidence on other types of activities was less clear due to the limited number of studies conducted.

CONCLUSION

There is promising evidence that traditional Chinese sports and PAs provide many health benefits for older Chinese adults. While additional scientifically rigorous research is warranted, promoting these traditional and culturally-based sports and PAs as forms of behavioral medicine in primary and secondary prevention of diseases among the aging Chinese population will help fulfill an urgent public health need.

Practicing Tai Chi had lower energy metabolism than walking but similar health benefits in terms of aerobic fitness, resting energy expenditure, body composition and self-perceived physical health

OBJECTIVE

To examine the effects of Tai Chi and walking training on aerobic fitness, resting energy expenditure (REE), body composition, and quality of life; as well as analyzing the energy metabolism during exercises, to determine which one had better advantage in improving health status.

METHODS

Three hundred seventy-four middle-aged Chinese subjects who were recruited from nine geographic areas in Sha Tin were randomized into Tai Chi, walking, or control groups at area level. The 12-week (45min per day, 5days per week) Tai Chi or brisk walking training were conducted in respective intervention groups. Measures were performed at baseline and end of trial. Another 30 subjects were recruited to compare the energy metabolism between practicing Tai Chi and walking.

RESULTS

The between-group difference of VO2max was 3.3ml/min/kg for Tai Chi vs. control and 3.7ml/min/kg for walking vs. control (both P<0.001). BMI, skinfold thicknesses, and SF-12 physical component scores all improved significantly compared with the control group (all P<0.01). Tai Chi had higher effect on improving REE-VO2 and REE-kilocalorie expenditure than walking. Regarding to energy metabolism test, the self-paced walking produced approximately 46% higher metabolic costs than Tai Chi.

CONCLUSION

Practicing Tai Chi consumes a smaller amount of energy metabolism but similar health benefits as self-paced brisk walking.

Effects of Tai Chi and Walking Exercises on Weight Loss, Metabolic Syndrome Parameters, and Bone Mineral Density: A Cluster Randomized Controlled Trial

Tai Chi and walking are both moderate-intensity physical activity (PA) that can be easily practiced in daily life. The objective of the study was to determine the effects of these two PAs on weight loss, metabolic syndrome parameters, and bone mineral density (BMD) in Chinese adults. We randomized 374 middle-aged subjects (45.8 ± 5.3 years) into 12-week training (45 minutes per day, 5 days per week) of Tai Chi (n = 124) or self-paced walking (n = 121) or control group (n = 129). On average, Tai Chi and walking groups lost 0.50 and 0.76 kg of body weight and 0.47 and 0.59 kg of fat mass after intervention, respectively. The between-group difference of waist circumference (WC) and fasting blood glucose (FBG) was −3.7 cm and −0.18 mmol/L for Tai Chi versus control and −4.1 cm and −0.22 mmol/L for walking versus control. No significant differences were observed regarding lean mass, blood pressure, triglycerides, total cholesterol, high-density and low-density lipoprotein cholesterol, and BMD compared to control. Change in lean mass, not fat mass or total weight loss, was significantly correlated to the change in BMD. Our results suggest that both of these two PAs can produce moderate weight loss and significantly improve the WC and FBG in Hong Kong Chinese adults, with no additional effects on BMD.

Sex difference in the prevalence of metabolic syndrome and cardiovascular-related risk factors in urban adults from 33 communities of China: The CHPSNE study

Little is known about the epidemiology of metabolic syndrome in urban areas of China. To estimate the prevalence of MetS and identify its cardiovascular-related factors in men and women, a representative sample of 15,477 urban adults aged 18-74 years in Northeast China was selected from 2009 to 2010. The diagnosis of metabolic syndrome was based on criteria set by the National Cholesterol Education Program/Adult Treatment Panel. The overall prevalence of metabolic syndrome was 27.4% (men 27.9% and women 26.8%). Multivariable logistic regression analysis revealed that a higher education level and a higher family income were associated with a higher prevalence of metabolic syndrome in men, but associated with lower prevalence of metabolic syndrome among women. Higher physical activity was associated with a decreased prevalence of metabolic syndrome in men (adjusted odds ratios (aORs) = 0.88, 95% confidence interval (CI): 0.79-0.99), but associated with an increased prevalence of metabolic syndrome in women (aOR = 1.14, 95% CI: 1.00-1.29). Compared with rice as the major staple food, cooked wheaten foods were associated with lower adjusted odds for metabolic syndrome both in men (aOR = 0.72, 95% CI: 0.58-0.90) and in women (aOR = 0.72, 95% CI: 0.56-0.92). In conclusion, metabolic syndrome is highly prevalent in urban areas of China, and there is heterogeneity by sex in the relationships between risk factors and metabolic syndrome prevalence.

Prevalence of metabolic syndrome and its relationship with physical activity in suburban Beijing, China

BACKGROUND

The present study aimed to estimate the up-to-date prevalence of metabolic syndrome and its relationship with physical activity among suburban adults in Beijing, China.

METHODS

A cross-sectional survey in a representative sample of 19,003 suburban adults aged 18-76 years was carried out in 2007-2008. Data was collected via questionnaires and blood pressure, anthropometric, and laboratory measurements.

RESULTS

Of the residents aged 18-76 years in suburban Beijing, 25.9% (27.3% in men and 25.1% in women), 21.3% (19.4% in men and 22.9% in women), and 25.3% (24.2% in men and 26.1% in women) had 1 component, 2 components, and 3 or more components of metabolic syndrome, respectively. The age-standardized prevalence of metabolic syndrome and its components, including abdominal obesity, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure, and elevated fasting plasma glucose, decreased across categories with increasing physical activity. After adjusting for age, sex, education level, smoking, and alcohol consumption, residents were more likely to have metabolic syndrome across categories with decreasing physical activity; a similar relationship also applied to components of metabolic syndrome.

CONCLUSION

A high prevalence of metabolic syndrome and its components is commonly present in suburban Beijing. Increasing physical activity can reduce the relative risk of metabolic syndrome and it components.

Predicting the occurrence of cancer-associated colorectal polyp using a metabolic risk score

This study was conducted with the aim of developing a metabolic risk score to help identify patients who are likely to have a cancer-associated polyp (CAP) on colonoscopy, based on a metabolic syndrome-related clinical profile. The clinical history and anthropometric and metabolic profiles of patients who came for a screening colonoscopy at our institute between June, 2010 and December, 2012 were prospectively collected. The data were analyzed for their association with the occurrence of CAP. Subsequently, six parameters were selected in order to construct a metabolic risk score that correlated with the presence of CAP. A total of 286 subjects (132 males and 154 females), with an age range of 19-85 years, were included in this study. The colonoscopy detected polyps in 56 cases (19.6%). Anthropometric parameters that were significantly associated with CAP included a body mass index (BMI) of >23.4 kg/m² and a waist circumference of >32 inches in females. Laboratory profiles that were significantly associated with CAP were fasting blood sugar (FBS) >110 mg%, hemoglobin A1C (HbA1C) >7%, aspartate transaminase (SGOT) >40 IU/l, alanine transaminase (SGPT) >50 IU/l and uric acid >7 mg%. When a metabolic risk score was constructed, it was observed that moderate (2-3) and high risk (4-6) was significantly associated with CAP [odds ratio (OR)=4.9, 95% confidence interval (CI): 2.0-12.0 and OR=13.7, 95% CI: 4.4-43.0, respectively]. The association between the risk score and CAP was stronger in the subgroup of patients aged <65 years, in whom the moderate and high metabolic risk groups exhibited ORs of 5.6 (95% CI: 1.8-17.9) and 39.0 (95% CI: 8.2-186.6), respectively. In conclusion, this study demonstrated that it is possible to use a metabolic profile to construct a reliable scoring method to identify patients at higher risk of having CAP who should be fast-tracked for a colonoscopy.

Associations of Tai Chi, walking, and jogging with mortality in Chinese men

Moderate-intensity exercise has attracted considerable attention because of its safety and many health benefits. Tai Chi, a form of mind-body exercise that originated in ancient China, has been gaining popularity. Practicing Tai Chi may improve overall health and well-being; however, to our knowledge, no study has evaluated its relationship with mortality. We assessed the associations of regular exercise and specifically participation in Tai Chi, walking, and jogging with total and cause-specific mortality among 61,477 Chinese men in the Shanghai Men's Health Study (2002-2009). Information on exercise habits was obtained at baseline using a validated physical activity questionnaire. Deaths were ascertained through biennial home visits and linkage with a vital statistics registry. During a mean follow-up of 5.48 years, 2,421 deaths were identified. After adjustment for potential confounders, men who exercised regularly had a hazard ratio for total mortality of 0.80 (95% confidence interval: 0.74, 0.87) compared with men who did not exercise. The corresponding hazard ratios were 0.80 (95% confidence interval: 0.72, 0.89) for practicing Tai Chi, 0.77 (95% confidence interval: 0.69, 0.86) for walking, and 0.73 (95% confidence interval: 0.59, 0.90) for jogging. Similar inverse associations were also found for cancer and cardiovascular mortality. The present study provides the first evidence that, like walking and jogging, practicing Tai Chi is associated with reduced mortality.