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Bohlen LC, LaRowe LR, Dunsiger SI, Dionne L, Griffin E, Kim AE, Marcus BH, Unick J, Wu WC, Williams DM. Comparing a recommendation for self-paced versus moderate intensity physical activity for midlife adults: Rationale and design. Contemp Clin Trials 2023; 128:107169. [PMID: 36972866 PMCID: PMC10183157 DOI: 10.1016/j.cct.2023.107169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023]
Abstract
Current U.S. guidelines recommend that adults obtain 150 min per week of moderate intensity physical activity (PA), 75 min of vigorous intensity PA, or some equivalent combination. However, less than half of U.S. adults reach this goal, with the proportion even smaller among adults with overweight or obesity. Moreover, regular PA declines after age 45-50. Previous research suggests a shift in national guidelines to emphasize PA of a self-selected intensity (i.e., self-paced), instead of prescribed moderate intensity PA, may result in better adherence to PA programs, particularly among midlife adults with overweight or obesity. The present paper presents the protocol for a field-based RCT testing the hypothesis that adherence to PA programs is improved when PA is explicitly recommended to be self-paced rather than prescribed at moderate intensity among midlife (ages 50-64) adults (N = 240) with overweight or obesity. All participants receive a 12-month intervention designed to help them overcome barriers to regular PA and are randomly assigned to either self-paced or prescribed moderate intensity PA. The primary outcome is total volume of PA (minutes by intensity) as measured by accelerometry. Secondary outcomes include self-reported min/week of PA and changes in bodyweight. Additionally, using ecological momentary assessment, we examine putative mediators of treatment effects. We hypothesize self-paced PA will lead to a more positive affective response to PA, more perceived autonomy, and lower perceived exertion during PA, and thus greater increases in PA behavior. Findings will have direct implications for PA intensity recommendations among midlife adults with overweight or obesity.
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Affiliation(s)
- Lauren Connell Bohlen
- Brown University School of Public Health, Center for Health Promotion and Health Equity, Providence, RI, USA
| | - Lisa R LaRowe
- Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, USA
| | - Shira I Dunsiger
- Brown University School of Public Health, Center for Health Promotion and Health Equity, Providence, RI, USA
| | - Laura Dionne
- Brown University School of Public Health, Center for Health Promotion and Health Equity, Providence, RI, USA
| | - Elizabeth Griffin
- Brown University School of Public Health, Center for Health Promotion and Health Equity, Providence, RI, USA
| | - Alison E Kim
- Brown University School of Public Health, Center for Health Promotion and Health Equity, Providence, RI, USA
| | - Bess H Marcus
- Brown University School of Public Health, Center for Health Promotion and Health Equity, Providence, RI, USA
| | - Jessica Unick
- The Miriam Hospital, Weight Control and Diabetes Research Center, Providence, RI, USA
| | - Wen-Chih Wu
- The Miriam Hospital, Lifespan Cardiovascular Wellness and Prevention Center, Providence, RI, USA
| | - David M Williams
- Brown University School of Public Health, Center for Health Promotion and Health Equity, Providence, RI, USA.
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Cleven L, Dziuba A, Krell-Roesch J, Schmidt SCE, Bös K, Jekauc D, Woll A. Longitudinal associations between physical activity and five risk factors of metabolic syndrome in middle-aged adults in Germany. Diabetol Metab Syndr 2023; 15:82. [PMID: 37098550 PMCID: PMC10131386 DOI: 10.1186/s13098-023-01062-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 04/14/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND We examined the longitudinal association between (change in) physical activity (PA) with new onset of five risk factors of metabolic syndrome among 657 middle-aged adults (mean age 44.1 (standard deviation (SD) 8.6) years) who were free of the respective outcome at baseline, in a longitudinal cohort study spanning over 29 years. METHODS Levels of habitual PA and sports-related PA were assessed by a self-reported questionnaire. Incident elevated waist circumference (WC), elevated triglycerides (TG), reduced high-density lipoprotein cholesterols (HDL), elevated blood pressure (BP), and elevated blood-glucose (BG) were assessed by physicians and by self-reported questionnaires. We calculated Cox proportional hazard ratio regressions and 95% confidence intervals. RESULTS Over time, participants developed (cases of incident risk factor; mean (SD) follow-up time) elevated WC (234 cases; 12.3 (8.2) years), elevated TG (292 cases; 11.1 (7.8) years), reduced HDL (139 cases; 12.4 (8.1) years), elevated BP (185 cases; 11.4 (7.5) years), or elevated BG (47 cases; 14.2 (8.5) years). For PA variables at baseline, risk reductions ranging between 37 and 42% for reduced HDL levels were detected. Furthermore, higher levels of PA (≥ 16.6 METh per week) were associated with a 49% elevated risk for incident elevated BP. Participants who increased PA levels over time, had risk reductions ranging between 38 and 57% for elevated WC, elevated TG and reduced HDL. Participants with stable high amounts of PA from baseline to follow-up had risk reductions ranging between 45 and 87% for incident reduced HDL and elevated BG. CONCLUSIONS PA at baseline, starting PA engagement, maintaining and increasing PA level over time are associated with favorable metabolic health outcomes.
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Affiliation(s)
- Laura Cleven
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany.
| | - Anna Dziuba
- Institute of Sport Sciences, Department of Sport Psychology, Goethe University Frankfurt, Ginnheimer Landstraße 39, 60487, Frankfurt, Germany
| | - Janina Krell-Roesch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
| | - Steffen C E Schmidt
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
| | - Klaus Bös
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
| | - Darko Jekauc
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
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Perry AS, Annis JS, Master H, Nayor M, Hughes A, Kouame A, Natarajan K, Marginean K, Murthy V, Roden DM, Harris PA, Shah R, Brittain EL. Association of Longitudinal Activity Measures and Diabetes Risk: An Analysis From the National Institutes of Health All of Us Research Program. J Clin Endocrinol Metab 2023; 108:1101-1109. [PMID: 36458881 PMCID: PMC10306083 DOI: 10.1210/clinem/dgac695] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/18/2022] [Accepted: 11/29/2022] [Indexed: 12/04/2022]
Abstract
CONTEXT Prior studies of the relationship between physical activity and incident type 2 diabetes mellitus (T2DM) relied primarily on questionnaires at a single time point. OBJECTIVE We sought to investigate the relationship between physical activity and incident T2DM with an innovative approach using data from commercial wearable devices linked to electronic health records in a real-world population. METHODS Using All of Us participants' accelerometer data from their personal Fitbit devices, we used a time-varying Cox proportional hazards models with repeated measures of physical activity for the outcome of incident T2DM. We evaluated for effect modification with age, sex, body mass index (BMI), and sedentary time using multiplicative interaction terms. RESULTS From 5677 participants in the All of Us Research Program (median age 51 years; 74% female; 89% White), there were 97 (2%) cases of incident T2DM over a median follow-up period of 3.8 years between 2010 to 2021. In models adjusted for age, sex, and race, the hazard of incident diabetes was reduced by 44% (95% CI, 15%-63%; P = 0.01) when comparing those with an average daily step count of 10 700 to those with 6000. Similar benefits were seen comparing groups based on average duration of various intensities of activity (eg, lightly active, fairly active, very active). There was no evidence for effect modification by age, sex, BMI, or sedentary time. CONCLUSION Greater time in any type of physical activity intensity was associated with lower risk of T2DM irrespective of age, sex, BMI, or sedentary time.
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Affiliation(s)
- Andrew S Perry
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Jeffrey S Annis
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Hiral Master
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Matthew Nayor
- Sections of Cardiovascular Medicine and Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA
| | - Andrew Hughes
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, USA
| | - Aymone Kouame
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Karthik Natarajan
- Department of Biomedical Informatics, Columbia University, New York, NY 10032, USA
| | - Kayla Marginean
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Venkatesh Murthy
- Department of Medicine and Radiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Dan M Roden
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, USA
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37203, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN 37203, USA
| | - Paul A Harris
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN 37203, USA
- Department of Biomedical Engineering, Vanderbilt University Medical Center, Nashville, TN 37203, USA
| | - Ravi Shah
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Evan L Brittain
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
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Li C, Shang S, Liang W. Physical Activity Types, Physical Activity Levels and Risk of Diabetes in General Adults: The NHANES 2007-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1398. [PMID: 36674154 PMCID: PMC9858810 DOI: 10.3390/ijerph20021398] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/23/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Recreational activities show benefits for diabetes prevention, but work-related activity and the total amount of individual physical activity is rarely discussed. PURPOSE The purpose of this study was to evaluate the participation in five typical physical activities (vigorous work activity, vigorous recreational activities, moderate work activity, moderate recreational activities, and walk/bicycle for transportation), as well as the weekly distribution of total physical activity intensity, and to explore the relationships between physical activity types, physical activity levels, and risk of diabetes. STUDY DESIGN Cross-sectional study. METHODS The self-reported physical activity data on specific domains of physical activity were acquired from individuals in the 2007-2018 National Health and Nutrition Examination Survey (NHANES) using the Physical Activity Questionnaire (PAQ). Diabetes status was assessed by self-reported medical diagnosis or medication usage, or a fasting glucose concentration ≥ 126 mg/dL (fasting is defined as no caloric intake for at least 8 h) or HbA1c ≥ 6.5%. Weighted logistic regression was used to investigate the associations between physical activity types, physical activity levels, and risk of diabetes. RESULTS Diabetes was less prevalent in people who participated in physical activity and the risk of diabetes reduced progressively as total physical activity levels increased. Younger adults (20-44 years) and males reported a higher proportion of high-intensity physical activity participation. CONCLUSIONS Our findings highlight the importance of a physically active lifestyle for preventing diabetes. Distinct types of physical activity had different effects on the risk of diabetes. A greater total physical activity level was related to a substantial reduction in diabetes risk.
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Affiliation(s)
- Chunnan Li
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
- Institute for Healthy China, Tsinghua University, Beijing 100084, China
- School of Nursing, Peking University, Beijing 100191, China
| | - Shaomei Shang
- School of Nursing, Peking University, Beijing 100191, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
- Institute for Healthy China, Tsinghua University, Beijing 100084, China
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Huber J, Smeikal M, Saely CH, Stingl H, Clodi M, Lechleitner M, Fasching P. [Geriatric aspects for the management of diabetes mellitus (Update 2023)]. Wien Klin Wochenschr 2023; 135:307-318. [PMID: 37101051 PMCID: PMC10133361 DOI: 10.1007/s00508-022-02124-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2022] [Indexed: 04/28/2023]
Abstract
There is a high prevalence of diabetes mellitus in the elderly population of industrial countries. The present article provides recommendations for the screening, prevention and treatment of elderly diabetic patients according to current scientific evidence.
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Affiliation(s)
- Joakim Huber
- Abteilung für Innere Medizin mit Akutgeriatrie und Palliativmedizin, Franziskus Spital, Standort Landstraße, Landstraßer Hauptstraße 4a, 1030 Wien, Österreich
| | - Michael Smeikal
- Abteilung für Innere Medizin mit allgemeiner Geriatrie und Palliativmedizin, Haus der Barmherzigkeit, Wien, Österreich
| | - Christoph H. Saely
- Abteilung für Innere Medizin und Kardiologie/VIVIT-Institut, Landeskrankenhaus Feldkirch, Feldkirch, Österreich
| | - Harald Stingl
- Interne Abteilung, Landesklinikum Melk, Melk, Österreich
| | - Martin Clodi
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4040 Linz, Österreich
| | - Monika Lechleitner
- Interne Abteilung, Landeskrankenhaus Hochzirl – Natters, Hochzirl, Österreich
| | - Peter Fasching
- 5. Medizinische Abteilung mit Endokrinologie, Rheumatologie und Akutgeriatrie, Klinik Ottakring der Stadt Wien, Wien, Österreich
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Xu YY, Xie J, Yin H, Yang FF, Ma CM, Yang BY, Wan R, Guo B, Chen LD, Li SL. The Global Burden of Disease attributable to low physical activity and its trends from 1990 to 2019: An analysis of the Global Burden of Disease study. Front Public Health 2022; 10:1018866. [PMID: 36590002 PMCID: PMC9798308 DOI: 10.3389/fpubh.2022.1018866] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Low physical activity (LPA) is associated with several major non-communicable diseases (NCDs) and premature mortality. In this study, we aimed to assess the global burden and trends in disease attributable to LPA (DALPA) from 1990 to 2019. Methods Annual age-standardized disability-adjusted life years (DALYs) and death rates of DALPA [all-cause and five specific causes (ischaemic heart disease, diabetes mellitus, stroke, colon and rectal cancer, and breast cancer)] by sex, age, geographical region and social deprivation index (SDI) score from 1990 to 2019 were available from the Global Burden of Disease (GBD) study 2019. The estimated annual percentage changes (EAPCs) were calculated to quantify the changing trend. A generalized linear model (GLM) was used to explore the relationship between DALYs/death rates of DALPA and sociodemographic factors. Results Globally, in 2019, the age-standardized DALYs and death rates of DALPA were 198.42/100,000 (95% UI: 108.16/100,000-360.32/100,000) and 11.10/100,000 (95% UI: 5.66/100,000-19.51/100,000), respectively. There were 15.74 million (8.51-28.61) DALYs and 0.83 million (0.43-1.47) deaths attributable to LPA. Overall, age-standardized DALYs and death rates presented significant downward trends with EAPCs [-0.68% (95% CI: -0.85- -0.50%) for DALYs and -1.00% (95% CI: -1.13- -0.86%) for deaths] from 1990 to 2019. However, age-standardized DALYs and death rates of diabetes mellitus attributable to LPA were substantially increased [EAPC: 0.76% (95% CI: 0.70-0.82%) for DALYs and 0.33% (95% CI: 0.21-0.51%) for deaths]. In the 15-49 age group, DALPA presented significant upward trends [EAPC: 0.74% (95% CI: 0.58-0.91%) for DALYs and 0.31% (95% CI: 0.1-0.51%) for deaths]. The GLM revealed that higher gross domestic product and current health expenditure (% of GDP) were negatively associated with DALYs and death rates of DALPA. Conclusion Although global age-standardized DALYs and death rates of DALPA presented downward trends, they still cause a heavy burden worldwide. These rates showed upward trends in the diabetic and 15-49 age groups, which need more attention and health interventions.
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Affiliation(s)
- Yuan-Yi Xu
- Department of Rehabilitation and Advancement, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Jin Xie
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
- Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Hao Yin
- Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Fang-Fang Yang
- Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Chun-Ming Ma
- Department of Rehabilitation and Advancement, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Bao-Yi Yang
- Department of Intensive Care Unit, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Rui Wan
- Department of Intensive Care Unit, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Bin Guo
- Department of Outpatient, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Li-Dian Chen
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Song-Lin Li
- Division of Financial Services, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
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Naseri P, Amiri P, Masihay-Akbar H, Vaighan NS, Ahmadizad S, Ghanbarian A, Azizi F. Time-varying association between physical activity and risk of diabetes in the early and late adulthood: A longitudinal study in a West-Asian country. Prim Care Diabetes 2021; 15:1026-1032. [PMID: 34326015 DOI: 10.1016/j.pcd.2021.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 07/04/2021] [Accepted: 07/16/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND The time-varying association between physical activity (PA) and incidence of type 2 diabetes (T2DM) is still unclear. The present study aimed to investigate this association in the early- and late-adulthood during a 9-year follow-up. METHODS This study was conducted on 3905 participants in early and late adulthood, using the Tehran Lipid and Glucose Study (TLGS) dataset. PA was assessed via the Iranian version of Modified Activity Questionnaire (MAQ). The association between trend of PA and incident T2DM was investigated using time-varying Cox's proportional hazard model. Variables including job, education, smoking and body mass index (BMI) were adjusted in the final model. RESULTS The distribution of sex- and age-specific levels of PA changed significantly over time. Compared with physically inactive women, for older women with high level of PA, the risk of T2DM was 0.64 (95% CI: 0.43-0.95, P = 0.02) in adjusted model. Moreover, hazard for low PA group was significantly higher than the moderate group, and for these two groups were significantly higher than high PA level (P < 0.05). CONCLUSION High PA level can postpone the incident T2DM in early-aged and elderly women, over time. Therefore, gender and age are of great importance in designing the PA modifying programs to prevent T2DM.
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Affiliation(s)
- Parisa Naseri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hasti Masihay-Akbar
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Navideh Sahebi Vaighan
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sajad Ahmadizad
- Department of Biological Sciences in Sport, Faculty of Sports Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Arash Ghanbarian
- Prevention of Metabolic Disease Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Feature selection for unsupervised machine learning of accelerometer data physical activity clusters - A systematic review. Gait Posture 2021; 90:120-128. [PMID: 34438293 DOI: 10.1016/j.gaitpost.2021.08.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 03/03/2021] [Accepted: 08/08/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Identifying clusters of physical activity (PA) from accelerometer data is important to identify levels of sedentary behaviour and physical activity associated with risks of serious health conditions and time spent engaging in healthy PA. Unsupervised machine learning models can capture PA in everyday free-living activity without the need for labelled data. However, there is scant research addressing the selection of features from accelerometer data. The aim of this systematic review is to summarise feature selection techniques applied in studies concerned with unsupervised machine learning of accelerometer-based device obtained physical activity, and to identify commonly used features identified through these techniques. Feature selection methods can reduce the complexity and computational burden of these models by removing less important features and assist in understanding the relative importance of feature sets and individual features in clustering. METHOD We conducted a systematic search of Pubmed, Medline, Google Scholar, Scopus, Arxiv and Web of Science databases to identify studies published before January 2021 which used feature selection methods to derive PA clusters using unsupervised machine learning models. RESULTS A total of 13 studies were eligible for inclusion within the review. The most popular feature selection techniques were Principal Component Analysis (PCA) and correlation-based methods, with k-means frequently used in clustering accelerometer data. Cluster quality evaluation methods were diverse, including both external (e.g. cluster purity) or internal evaluation measures (silhouette score most frequently). Only four of the 13 studies had more than 25 participants and only four studies included two or more datasets. CONCLUSION There is a need to assess multiple feature selection methods upon large cohort data consisting of multiple (3 or more) PA datasets. The cut-off criteria e.g. number of components, pairwise correlation value, explained variance ratio for PCA, etc. should be expressly stated along with any hyperparameters used in clustering.
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Gabrys L, Baumert J, Heidemann C, Busch M, Finger JD. Sports activity patterns and cardio-metabolic health over time among adults in Germany: Results of a nationwide 12-year follow-up study. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:439-446. [PMID: 32738519 PMCID: PMC8343057 DOI: 10.1016/j.jshs.2020.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/27/2020] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Physical activity is favorable for health, and vigorous sports activity is particularly beneficial. This study investigates the association between changes in sports participation patterns over time and cardio-metabolic and self-perceived health outcomes. METHODS Data from 3752 adults (18-79 years of age) who participated in 2 national health interview and examination surveys in 1997-1999 and 2008-2011 were included, with a mean follow-up time of about 12 years. A change in self-reported sports activity was analyzed with respect to the incidence of type 2 diabetes, coronary heart disease (CHD), hypertension, obesity, dyslipidemia, metabolic syndrome, and poor self-perceived health. Participants with pre-existing disease or risk factor of interest at baseline were excluded from the analysis. Being sufficiently active in sports was specified as doing sports for at least 1-2 h per week, and 4 activity categories were defined: 1) inactive at both time points (inactive-inactive), 2) inactive at baseline and active at follow-up (inactive-active), 3) active at baseline and inactive at follow-up (active-inactive), and 4) active at both time points (active-active). Associations between sports activity engagement and health outcomes were estimated by logistic regression models with different stages of adjustments. RESULTS Not engaging in any regular sports activity at both time points (inactive-inactive) was associated with higher rates of type 2 diabetes (odds ratio (OR) = 1.82, 95% confidence interval (95%CI): 1.08-3.08), CHD (OR = 1.82, 95%CI: 1.16-2.84), hypertension (OR = 1.36, 95%CI: 1.03-1.81), metabolic syndrome (OR = 1.58, 95%CI: 1.08-2.32), and poor self-perceived health (OR = 2.54, 95%CI: 1.83-3.53) compared to doing regular sports for a minimum of 1-2 h per week over time (active-active). In case of change from inactivity to any regular sports activity (inactive-active), the rate of risk factor occurrence was not statistically different from the active-active reference group except for poor self-perceived health, but it was higher for type 2 diabetes (OR = 2.15, 95%CI: 1.12-4.14) and CHD (OR = 1.77, 95%CI: 1.03-3.03). Being active at baseline but inactive at follow-up (active-inactive) was not associated with higher disease incidence of type 2 diabetes (OR = 0.70, 95%CI: 0.25-1.97) or CHD (OR = 1.20, 95%CI: 0.49-2.99), but was associated with higher rates of hypertension (OR = 1.61, 95%CI: 1.11-2.34), obesity (OR = 2.34, 95%CI: 1.53-3.57), metabolic syndrome (OR = 1.70, 95%CI: 1.11-2.63), and poor self-perceived health (OR = 2.16, 95%CI: 1.53-3.07) at follow-up. CONCLUSION Even a low weekly quantity (1-2 h) of regular sports activity is partly associated with health benefits. Being formerly but not currently active was not associated with an increased disease incidence, but was associated with a higher risk-factor development compared to the reference group (active-active). Becoming active was preventive for risk-factor development but was not preventive for disease incidence, which probably means that the health benefits from sports activity are not sustainable and disease incidence is only shifted to a later period in life. For this reason, the promotion of and commitment to regular sports activity should be addressed as early as possible over the lifespan to achieve the best health benefits.
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Affiliation(s)
- Lars Gabrys
- University of Applied Sciences of Sport and Management, 14471 Potsdam, Germany; Robert Koch Institute, Department of Epidemiology and Health Monitoring, 12101 Berlin, Germany.
| | - Jens Baumert
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, 12101 Berlin, Germany
| | - Christin Heidemann
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, 12101 Berlin, Germany
| | - Markus Busch
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, 12101 Berlin, Germany
| | - Jonas David Finger
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, 12101 Berlin, Germany
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Barberan-Garcia A, Cano I, Bongers BC, Seyfried S, Ganslandt T, Herrle F, Martínez-Pallí G. Digital Support to Multimodal Community-Based Prehabilitation: Looking for Optimization of Health Value Generation. Front Oncol 2021; 11:662013. [PMID: 34249698 PMCID: PMC8270684 DOI: 10.3389/fonc.2021.662013] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/03/2021] [Indexed: 12/12/2022] Open
Abstract
Prehabilitation has shown its potential for most intra-cavity surgery patients on enhancing preoperative functional capacity and postoperative outcomes. However, its large-scale implementation is limited by several constrictions, such as: i) unsolved practicalities of the service workflow, ii) challenges associated to change management in collaborative care; iii) insufficient access to prehabilitation; iv) relevant percentage of program drop-outs; v) need for program personalization; and, vi) economical sustainability. Transferability of prehabilitation programs from the hospital setting to the community would potentially provide a new scenario with greater accessibility, as well as offer an opportunity to effectively address the aforementioned issues and, thus, optimize healthcare value generation. A core aspect to take into account for an optimal management of prehabilitation programs is to use proper technological tools enabling: i) customizable and interoperable integrated care pathways facilitating personalization of the service and effective engagement among stakeholders; ii) remote monitoring (i.e. physical activity, physiological signs and patient-reported outcomes and experience measures) to support patient adherence to the program and empowerment for self-management; and, iii) use of health risk assessment supporting decision making for personalized service selection. The current manuscript details a proposal to bring digital innovation to community-based prehabilitation programs. Moreover, this approach has the potential to be adopted by programs supporting long-term management of cancer patients, chronic patients and prevention of multimorbidity in subjects at risk.
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Affiliation(s)
- Anael Barberan-Garcia
- Prehabilitation Unit, Hospital Clínic de Barcelona, Barcelona, Spain.,Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Departemenr of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Isaac Cano
- Prehabilitation Unit, Hospital Clínic de Barcelona, Barcelona, Spain.,Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Departemenr of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Bart C Bongers
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, Netherlands.,Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Steffen Seyfried
- University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Thomas Ganslandt
- University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Florian Herrle
- University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Graciela Martínez-Pallí
- Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Departemenr of Medicine, Universitat de Barcelona, Barcelona, Spain.,Anesthesiology Medicine Department, Hospital Clínic de Barcelona, Barcelona, Spain
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Bock BC, Palitsky R, Dunsiger SI, Williams DM, Serber ER. Exercise Video Games are Associated with More Positive Affective Response, which Predicts Physical Activity Adherence. PSYCHOLOGY OF SPORT AND EXERCISE 2021; 52:101802. [PMID: 37975018 PMCID: PMC10653676 DOI: 10.1016/j.psychsport.2020.101802] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Background A more positive affective valence during exercise is predictive of adherence to physical activity programs. This study examines the relationship between affective response during exercise and longer-term maintenance of physical activity among individuals using exercise video games (EVGs) and standard modalities of physical activity (i.e., walking, cycling). Methods Healthy adults (mean age 45.4, SD=14.5) were randomly assigned to a 12-week supervised, thrice weekly program of EVGs (n=93) or Standard exercise (n=96), and were assessed for affect immediately before, at the mid-point, and immediately after one exercise session per week. Participation in moderate-to-vigorous physical activity (MVPA) was conducted at end of treatment (EOT) and 6-month follow up. Results EVG participants reported more positive affective valence during exercise compared to Standard participants (b=.63, SE=.08, p<.001), and perceived less exertion (b=.52, SE=.36, p=.04) compared to Standard participants. For both groups, a more positive affective valence during exercise was significantly predictive of continued physical activity at 6-months (b=6.64, SE=2.50, p=.01). EVG participants also showed a significant chronic effect such that week-to-week there were improvements in affect prior to exercise and this effect was significantly associated with greater MPVA at EOT and follow-up (b=21.96, SE=10.10, p=.03 at EOT). Among Standard participants no significant chronic effect was seen over time. Conclusions EVGs may provide an effective means of promoting more positive shifts in affective valence both during, and in anticipation of, physical activity that encourages longer-term participation.
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Affiliation(s)
- Beth C Bock
- Alpert Medical School at Brown University, The Miriam Hospital, 164 Summit Ave, Providence, RI, 02906
| | - Roman Palitsky
- Alpert Medical School at Brown University, The Miriam Hospital, 164 Summit Ave, Providence, RI, 02906
- University of Arizona, Department of Psychology, 1503 E University Blvd, Tucson, AZ 85721
| | - Shira I Dunsiger
- Alpert Medical School at Brown University, The Miriam Hospital, 164 Summit Ave, Providence, RI, 02906
| | - David M Williams
- Alpert Medical School at Brown University, The Miriam Hospital, 164 Summit Ave, Providence, RI, 02906
| | - Eva R Serber
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, 67 President St, MSC 861, Charleston, SC 29425
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Hall KS, Hyde ET, Bassett DR, Carlson SA, Carnethon MR, Ekelund U, Evenson KR, Galuska DA, Kraus WE, Lee IM, Matthews CE, Omura JD, Paluch AE, Thomas WI, Fulton JE. Systematic review of the prospective association of daily step counts with risk of mortality, cardiovascular disease, and dysglycemia. Int J Behav Nutr Phys Act 2020; 17:78. [PMID: 32563261 PMCID: PMC7305604 DOI: 10.1186/s12966-020-00978-9] [Citation(s) in RCA: 177] [Impact Index Per Article: 44.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 05/28/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Daily step counts is an intuitive metric that has demonstrated success in motivating physical activity in adults and may hold potential for future public health physical activity recommendations. This review seeks to clarify the pattern of the associations between daily steps and subsequent all-cause mortality, cardiovascular disease (CVD) morbidity and mortality, and dysglycemia, as well as the number of daily steps needed for health outcomes. METHODS A systematic review was conducted to identify prospective studies assessing daily step count measured by pedometer or accelerometer and their associations with all-cause mortality, CVD morbidity or mortality, and dysglycemia (dysglycemia or diabetes incidence, insulin sensitivity, fasting glucose, HbA1c). The search was performed across the Medline, Embase, CINAHL, and the Cochrane Library databases from inception to August 1, 2019. Eligibility criteria included longitudinal design with health outcomes assessed at baseline and subsequent timepoints; defining steps per day as the exposure; reporting all-cause mortality, CVD morbidity or mortality, and/or dysglycemia outcomes; adults ≥18 years old; and non-patient populations. RESULTS Seventeen prospective studies involving over 30,000 adults were identified. Five studies reported on all-cause mortality (follow-up time 4-10 years), four on cardiovascular risk or events (6 months to 6 years), and eight on dysglycemia outcomes (3 months to 5 years). For each 1000 daily step count increase at baseline, risk reductions in all-cause mortality (6-36%) and CVD (5-21%) at follow-up were estimated across a subsample of included studies. There was no evidence of significant interaction by age, sex, health conditions or behaviors (e.g., alcohol use, smoking status, diet) among studies that tested for interactions. Studies examining dysglycemia outcomes report inconsistent findings, partially due to heterogeneity across studies of glycemia-related biomarker outcomes, analytic approaches, and sample characteristics. CONCLUSIONS Evidence from longitudinal data consistently demonstrated that walking an additional 1000 steps per day can help lower the risk of all-cause mortality, and CVD morbidity and mortality in adults, and that health benefits are present below 10,000 steps per day. However, the shape of the dose-response relation is not yet clear. Data are currently lacking to identify a specific minimum threshold of daily step counts needed to obtain overall health benefit.
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Affiliation(s)
- Katherine S. Hall
- Geriatric Research, Education, and Clinical Center, Durham VA Health Care System, Durham, NC USA
- Claude D. Pepper Older Americans Independence Center, Duke Aging Center, and the Department of Medicine, Duke University, Durham, NC USA
| | - Eric T. Hyde
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - David R. Bassett
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, TN USA
| | - 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, GA USA
| | | | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway and Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina – Chapel Hill, Chapel Hill, NC USA
| | - Deborah A. Galuska
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - William E. Kraus
- Claude D. Pepper Older Americans Independence Center, Duke Aging Center, and the Department of Medicine, Duke University, Durham, NC USA
| | - I-Min Lee
- Brigham and Women’s Hospital, Harvard Medical School; Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Charles E. Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD USA
| | - John D. Omura
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Amanda E. Paluch
- Department of Kinesiology, Institute for Applied Life Sciences, University of Massachusetts, Amherst, MA USA
| | - William I. Thomas
- Office of Library Science, Office of Science, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - 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, GA USA
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Cleven L, Krell-Roesch J, Nigg CR, Woll A. The association between physical activity with incident obesity, coronary heart disease, diabetes and hypertension in adults: a systematic review of longitudinal studies published after 2012. BMC Public Health 2020; 20:726. [PMID: 32429951 PMCID: PMC7238737 DOI: 10.1186/s12889-020-08715-4] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 04/15/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND A growing body of studies that investigated the longitudinal association between physical activity (PA) and the outcome of incident obesity, coronary heart disease (CHD), diabetes and hypertension has become available in recent years. Thus, the purpose of this systematic review was to provide an update on the association between PA and onset of obesity, CHD, diabetes and hypertension in individuals aged ≥18 years who were free of the respective conditions at baseline. METHODS We systematically searched OVID, Pubmed, and Web of Science databases for pertinent literature published between January of 2012 and February of 2019. To ensure that conclusions are based on high quality evidence, we only included longitudinal studies conducted in samples of ≥500 participants and with ≥5 years of follow-up. RESULT The search yielded 8929 records of which 26 were included in this review. Three studies were conducted on the outcome of incident obesity, eight on incident CHD, nine on incident diabetes, four on incident hypertension, one on the outcome of both diabetes and hypertension, and one on the outcome of CHD, diabetes and hypertension. Overall, there was an association between PA and lower risk of incident obesity, CHD and diabetes, but not hypertension. Higher levels or amount of PA were associated with a reduced risk of new onset of the respective diseases in 20 studies (77%). Whereas four studies reported an elevated risk of incidence of diseases with lower PA levels (15%). PA was not associated with incidence of diseases in two studies (8%). CONCLUSION Higher levels of PA are likely associated with a lower risk of becoming obese, develop CHD or diabetes. These findings replicate and strengthen conclusions from earlier reviews underlining the importance of promoting PA in adults. The associations between PA and incident hypertension were less consistent. More research, particularly using prospective cohort designs in large population-based samples, is needed to further untangle the association between PA and incident hypertension. TRAIL REGISTRATION CRD42019124474 (PROSPERO Protocol registration). Date of registration in PROSPERO 27 February 2019.
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Affiliation(s)
- Laura Cleven
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Janina Krell-Roesch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
- Translational Neuroscience and Aging Laboratory, Mayo Clinic, Scottsdale, AZ USA
| | - Claudio R. Nigg
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
- Present address: Institute of Sports Science, University of Bern, Bern, Switzerland
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Development of a Tool to Increase Physical Activity among People at Risk for Diabetes in Low-Resourced Communities in Cape Town. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030865. [PMID: 32019135 PMCID: PMC7037043 DOI: 10.3390/ijerph17030865] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 12/20/2019] [Accepted: 12/29/2019] [Indexed: 12/23/2022]
Abstract
Targeted lifestyle interventions, including physical activity (PA), have been proven to prevent or delay the onset of diabetes. South Africa’s unique context, complex environment and varied cultures and ethnicities require tailored interventions. Our objective was to develop a context-appropriate tool for the South African Diabetes Prevention Programme’s PA lifestyle component in order to enable people at risk of developing diabetes to adopt PA. We used mixed methods to inform the development of the tool. Descriptive analyses of baseline survey data included socio-demographics, anthropometrics, blood pressure and biochemical measurements, reported medical history, PA behaviours, and built environment information. Focus group discussions assisted in understanding perceived challenges, barriers and facilitators/opportunities to PA. A literature search on successful South African PA interventions was done, and PA experts in Cape Town were consulted. Quantitative data were analysed using the software R, version 3.4.4 and qualitative data were thematically analysed. Participants (n = 316) recruited were mostly black (54.4%) and of mixed-ancestry (44.6%); they were mainly female (80.1%), obese (75.2%), and had an haemoglobin A1c (HbA1c) above 5.7% (65.5%), with 30% having hypertension and 87% (self-reported) meeting the World Health Organisation (WHO) PA recommendation. Main barriers to PA practice were safety, cost and accessibility of sports facilities, and laziness. We included practising moderate-intensity aerobic and resistance exercises and take-home self-help materials as recommended. By combining results, we produced a targeted, practical and promotional PA booklet.
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Bock BC, Dunsiger SI, Ciccolo JT, Serber ER, Wu WC, Sillice M, Marcus BH. Mediators of physical activity between standard exercise and exercise video games. Health Psychol 2019; 38:1107-1115. [PMID: 31512923 PMCID: PMC6861627 DOI: 10.1037/hea0000791] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Exercise video games (EVGs) may offer an attractive, sustainable alternative or supplement to traditional modes of exercise. Understanding the psychosocial factors that influence the appeal of EVGs is important for improving the efficacy of video games as a method of promoting the uptake and long-term maintenance of physical activity. METHODS This study examined changes in psychosocial constructs from self-determination theory and self-efficacy theory as mediators of intervention efficacy among 189 healthy, sedentary adults randomized to 12-week programs of either EVGs or standard exercise (e.g., treadmill walking, stationary cycling) followed by 6 months of follow-up. The EVG group engaged in significantly more weekly minutes of moderate to vigorous physical activity (MVPA) at the end of treatment compared with the standard exercise group. Univariate and multivariate mediational models were used to examine theoretically derived psychosocial constructs as potential mediators of differential intervention effects. RESULTS Univariate mediational models suggest a significant indirect effect of treatment on MVPA outcomes through enjoyment, self-efficacy, stress management, depressive symptoms, and positive engagement (p < .05). Multiple mediational analyses confirm all the univariate results (p < .05), with the exception of enjoyment. CONCLUSIONS Differences in the efficacy of EVG versus standard exercise interventions were mediated by several psychosocial constructs, suggesting that qualities specific to game play may enhance adherence to physical activity both in and outside of the laboratory environment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Beth C Bock
- Centers for Behavioral and Preventive Medicine
| | | | | | - Eva R Serber
- Department of Psychiatry and Behavioral Sciences
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Santos CESD, Rech CR, Antes DL, Schneider IJC, d’Orsi E, Benedetti TRB. Incidence and prevalence of diabetes self-reported on elderly in south of Brazil: results of EpiFloripa Ageing Study. CIENCIA & SAUDE COLETIVA 2019; 24:4191-4200. [DOI: 10.1590/1413-812320182411.31092017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 04/17/2018] [Indexed: 11/22/2022] Open
Abstract
Abstract This study investigated the prevalence and incidence of diabetes self-referred in the elderly. Longitudinal population-based study (EpiFloripa Ageing Study), with 1.702 elderly in 2009/10 and 1.197 in 2013/14 of Florianópolis, SC. Self-reported and anthropometric data were collected at home. The prevalence of diabetes self-referred in 2009/10 was 22.1% (95%CI 20.1-24.1). The characteristics were: no formal schooling (2.30; CI95% 1.32-4.00); 5 to 8 years of schooling (OR = 1.70, CI95% 1.07-2.69); increased waist circumference (OR = 3.31, CI95% 2.05-5.34) and hypertension (OR = 2.38, CI95%: 1.68-3.36). The incidence of diabetes self-reported after four years of follow-up was 8.3% (95% CI, 6.7-10.3). After adjustment: increased waist circumference (OR= 2.23, CI95% 1.09-4.57) at baseline was associated with the incidence of diabetes. The prevalence and incidence of diabetes were high among the elderly. Interventions must be performed especially with elderly with low and without formal schooling, with increased waist circumference and hypertension, thus they were the subgroups with higher odds ratio of reporting and developing diabetes.
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Chowdhury AK, Tjondronegoro D, Chandran V, Zhang J, Trost SG. Prediction of Relative Physical Activity Intensity Using Multimodal Sensing of Physiological Data. SENSORS 2019; 19:s19204509. [PMID: 31627335 PMCID: PMC6833090 DOI: 10.3390/s19204509] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/08/2019] [Accepted: 10/15/2019] [Indexed: 01/04/2023]
Abstract
This study examined the feasibility of a non-laboratory approach that uses machine learning on multimodal sensor data to predict relative physical activity (PA) intensity. A total of 22 participants completed up to 7 PA sessions, where each session comprised 5 trials (sitting and standing, comfortable walk, brisk walk, jogging, running). Participants wore a wrist-strapped sensor that recorded heart-rate (HR), electrodermal activity (Eda) and skin temperature (Temp). After each trial, participants provided ratings of perceived exertion (RPE). Three classifiers, including random forest (RF), neural network (NN) and support vector machine (SVM), were applied independently on each feature set to predict relative PA intensity as low (RPE ≤ 11), moderate (RPE 12–14), or high (RPE ≥ 15). Then, both feature fusion and decision fusion of all combinations of sensor modalities were carried out to investigate the best combination. Among the single modality feature sets, HR provided the best performance. The combination of modalities using feature fusion provided a small improvement in performance. Decision fusion did not improve performance over HR features alone. A machine learning approach using features from HR provided acceptable predictions of relative PA intensity. Adding features from other sensing modalities did not significantly improve performance.
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Affiliation(s)
- Alok Kumar Chowdhury
- Science and Engineering Faculty, Queensland University of Technology, Brisbane 4000, Australia.
| | - Dian Tjondronegoro
- Department of Business Strategy and Innovation, Griffith University, Nathan 4111, Australia.
| | - Vinod Chandran
- Science and Engineering Faculty, Queensland University of Technology, Brisbane 4000, Australia.
| | - Jinglan Zhang
- Science and Engineering Faculty, Queensland University of Technology, Brisbane 4000, Australia.
| | - Stewart G Trost
- Institute of Health and Biomedical Innovation at QLD Centre for Children's Health Research, School of Exercise and Nutrition Sciences, Queensland University of Technology, South Brisbane 4101, Australia.
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Jemmott JB, Zhang J, Jemmott LS, Icard LD, Ngwane Z, Makiwane M, O’Leary A. Intervention Increases Physical Activity and Healthful Diet Among South African Adolescents Over 54 Months: A Randomized Controlled Trial. J Adolesc Health 2019; 65:139-146. [PMID: 31028006 PMCID: PMC9393844 DOI: 10.1016/j.jadohealth.2019.01.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 01/11/2019] [Accepted: 01/15/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Scant research has investigated whether health promotion interventions have sustained effects in increasing physical activity and healthful diet among adolescents in sub-Saharan Africa, which is experiencing an epidemiological transition from infectious diseases to noncommunicable diseases as leading causes of mortality. We examined whether an intervention increased adherence to 5-a-day diet and physical activity guidelines during a 54-month postintervention period among South African adolescents and whether its effects weakened at long-term (42 and 54 months postintervention) compared with short-term (3, 6, and 12 months postintervention) follow-up. METHODS We randomized 18 randomly selected schools serving grade 6 learners (mean age = 12.6) in a township and a semirural area in Eastern Cape Province, South Africa, to one of the two 12-hour interventions: health promotion, targeting healthful diet and physical activity; attention-matched control, targeting sexual risk behaviors. We tested the intervention's effects on adherence to 5-a-day diet and physical activity guidelines using generalized estimating equations logistic regression models adjusting for baseline behavior and clustering within schools. RESULTS Health promotion intervention participants had higher odds of meeting 5-a-day diet and physical activity guidelines than control participants. The effect on 5-a-day diet did not weaken at long-term compared with short-term follow-up, but the effect on physical activity guidelines was weaker at long-term follow-up, mainly because of a reduced effect on muscle-strengthening physical activity. The intervention also increased health promotion attitude and intention and health knowledge and reduced binge drinking compared with the control group. CONCLUSIONS A 12-hour intervention in grade 6 shows promise in increasing self-reported adherence to healthful diet and physical activity guidelines during a 4.5-year postintervention period among South African adolescents.
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Affiliation(s)
- John B. Jemmott
- Annenberg School for Communication and Perelman School of Medicine, University of Pennsylvania, Philadelphia PA, United States
| | - Jingwen Zhang
- Department of Communication, University of California, Davis, CA, United States
| | - Loretta S. Jemmott
- College of Nursing and Health Professionals, Drexel University, Philadelphia, PA, United States
| | - Larry D. Icard
- College of Public Health, Temple University, Philadelphia, PA, United States
| | - Zolani Ngwane
- Department of Anthropology, Haverford College, Haverford PA, United States
| | | | - Ann O’Leary
- Centers for Disease Control and Prevention, Atlanta GA, United States
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Huber J, Smeikal M, Saely CH, Stingl H, Lechleitner M, Fasching P. Geriatrische Aspekte bei Diabetes mellitus (Update 2019). Wien Klin Wochenschr 2019; 131:236-245. [DOI: 10.1007/s00508-019-1463-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Bock BC, Dunsiger SI, Ciccolo JT, Serber ER, Wu WC, Tilkemeier P, Walaska KA, Marcus BH. Exercise Videogames, Physical Activity, and Health: Wii Heart Fitness: A Randomized Clinical Trial. Am J Prev Med 2019; 56:501-511. [PMID: 30777705 PMCID: PMC7100962 DOI: 10.1016/j.amepre.2018.11.026] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Adults who engage in regular physical activity have lower rates of morbidity and mortality than those who do not. Exercise videogames may offer an attractive, sustainable alternative or supplement to traditional modes of exercise. This study compared exercise videogames with standard exercise modalities for improving uptake and maintenance of moderate to vigorous physical activity, and health risk indices. STUDY DESIGN A three-arm clinical RCT including 12 weeks of supervised laboratory-based moderate to vigorous physical activity followed by 6 months follow-up. SETTING/PARTICIPANTS This study was conducted at a university affiliated hospital research lab. Healthy, sedentary adults were eligible. INTERVENTIONS This study compared a 12-week program of supervised exercise videogames versus standard exercise (e.g., treadmill) versus control. Data were collected from January 2012 to September 2017 and analyzed in 2018. MAIN OUTCOME MEASURES The primary outcome was weekly minutes of moderate to vigorous physical activity at end of treatment, assessed at 3 and 6 months post-intervention by using self-report and accelerometer data. Health risk indices (e.g., HbA1c, lipids) were also assessed. RESULTS Participants (N=283) had an average age of 46.2 ±13.5 years; 79% were female. At end of treatment, those in the exercise videogame arm engaged in 30 minutes/week more moderate to vigorous physical activity compared with standard exercise and 85 more minutes/week than controls (all p<0.05). Exercise videogame participants had greater reductions in cholesterol, HbA1c, and body fat versus other groups. Reductions in cholesterol were twice as large in exercise videogame versus standard participants. CONCLUSIONS Exercise videogames produced greater uptake and maintenance of moderate to vigorous physical activity compared with standard exercise and improvements in multiple health risk indices. Exercise videogames may promote sustainable physical activity with significant health benefits. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov NCT03298919.
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Affiliation(s)
- Beth C Bock
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, Rhode Island; Department of Behavioral and Social Science, Brown School of Public Health, Providence, Rhode Island; The Miriam Hospital, Centers for Behavioral and Preventive Medicine, Providence, Rhode Island.
| | - Shira I Dunsiger
- Department of Behavioral and Social Science, Brown School of Public Health, Providence, Rhode Island; The Miriam Hospital, Centers for Behavioral and Preventive Medicine, Providence, Rhode Island
| | - Joseph T Ciccolo
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York
| | - Eva R Serber
- Department of Psychiatry and Behavioral Science, Medical University of South Carolina, Charleston, South Carolina
| | - Wen-Chih Wu
- Department of Medicine, Brown Medical School, Providence, Rhode Island; Department of Cardiology, Providence VA Medical Center, Providence, Rhode Island
| | - Peter Tilkemeier
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, Rhode Island; Department of Internal Medicine, Greenville Health System, Greenville, South Carolina
| | - Kristen A Walaska
- The Miriam Hospital, Centers for Behavioral and Preventive Medicine, Providence, Rhode Island
| | - Bess H Marcus
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, Rhode Island; Department of Behavioral and Social Science, Brown School of Public Health, Providence, Rhode Island
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Aggio D, Papachristou E, Papacosta O, Lennon LT, Ash S, Whincup PH, Wannamethee SG, Jefferis BJ. Association Between 20-Year Trajectories of Nonoccupational Physical Activity From Midlife to Old Age and Biomarkers of Cardiovascular Disease: A 20-Year Longitudinal Study of British Men. Am J Epidemiol 2018; 187:2315-2323. [PMID: 30124747 PMCID: PMC6211233 DOI: 10.1093/aje/kwy157] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 01/31/2023] Open
Abstract
The trajectories of physical activity (PA) from midlife into old age and their associations with established and novel cardiovascular disease (CVD) risk factors in later life remain unclear. This study examined associations between 20-year nonoccupational PA trajectories and a range of CVD biomarkers at ages 60-79 years. We used data from a sample of 3,331 men (mean baseline age = 50.2 ± 5.8 years) recruited in 1978-1980, with follow-up after 12, 16, and 20 years, reporting habitual nonoccupational PA at each wave. At the 20-year follow-up, surviving men attended a physical examination and provided a fasting blood sample. Group-based trajectory modeling was used to identify trajectories. Adjusted regression analyses examined the association between trajectory-group membership and several cardiometabolic, cardiac, and inflammatory markers at follow-up. Three distinct 20-year trajectories were identified: low/decreasing (21.3%), light/stable (51.8%), and moderate/increasing (27.0%). Compared with the low/decreasing group, membership in the light/stable and moderate/increasing trajectory groups was associated with a more favorable cardiometabolic profile and lower levels of inflammation and endothelial dysfunction. Although following a moderate-increasing PA trajectory was most favorable, more modest but sustained doses of PA into old age may be sufficient to lower CVD risk.
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Affiliation(s)
- Daniel Aggio
- Department of Primary Care and Population Health, University College London, London, United Kingdom
- University College London Physical Activity Research Group, London, United Kingdom
| | - Efstathios Papachristou
- Department of Psychology and Human Development, University College London, London, United Kingdom
| | - Olia Papacosta
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Lucy T Lennon
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Sarah Ash
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Peter H Whincup
- Population Health Research Institute, St George’s University of London, London, United Kingdom
| | - S Goya Wannamethee
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Barbara J Jefferis
- Department of Primary Care and Population Health, University College London, London, United Kingdom
- University College London Physical Activity Research Group, London, United Kingdom
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22
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Bowe B, Xie Y, Li T, Yan Y, Xian H, Al-Aly Z. The 2016 global and national burden of diabetes mellitus attributable to PM 2·5 air pollution. Lancet Planet Health 2018; 2:e301-e312. [PMID: 30074893 DOI: 10.1016/s2542-5196(18)30140-2] [Citation(s) in RCA: 195] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/22/2018] [Accepted: 06/05/2018] [Indexed: 05/22/2023]
Abstract
BACKGROUND PM2·5 air pollution is associated with increased risk of diabetes; however, a knowledge gap exists to further define and quantify the burden of diabetes attributable to PM2·5 air pollution. Therefore, we aimed to define the relationship between PM2·5 and diabetes. We also aimed to characterise an integrated exposure response function and to provide a quantitative estimate of the global and national burden of diabetes attributable to PM2·5. METHODS We did a longitudinal cohort study of the association of PM2·5 with diabetes. We built a cohort of US veterans with no previous history of diabetes from various databases. Participants were followed up for a median of 8·5 years, we and used survival models to examine the association between PM2·5 and the risk of diabetes. All models were adjusted for sociodemographic and health characteristics. We tested a positive outcome control (ie, risk of all-cause mortality), negative exposure control (ie, ambient air sodium concentrations), and a negative outcome control (ie, risk of lower limb fracture). Data for the models were reported as hazard ratios (HRs) and 95% CIs. Additionally, we reviewed studies of PM2·5 and the risk of diabetes, and used the estimates to build a non-linear integrated exposure response function to characterise the relationship across all concentrations of PM2·5 exposure. We included studies into the building of the integrated exposure response function if they scored at least a four on the Newcastle-Ottawa Quality Assessment Scale and were only included if the outcome was type 2 diabetes or all types of diabetes. Finally, we used the Global Burden of Disease study data and methodologies to estimate the attributable burden of disease (ABD) and disability-adjusted life-years (DALYs) of diabetes attributable to PM2·5 air pollution globally and in 194 countries and territories. FINDINGS We examined the relationship of PM2·5 and the risk of incident diabetes in a longitudinal cohort of 1 729 108 participants followed up for a median of 8·5 years (IQR 8·1-8·8). In adjusted models, a 10 μg/m3 increase in PM2·5 was associated with increased risk of diabetes (HR 1·15, 95% CI 1·08-1·22). PM2·5 was associated with increased risk of death as the positive outcome control (HR 1·08, 95% CI 1·03-1·13), but not with lower limb fracture as the negative outcome control (1·00, 0·91-1·09). An IQR increase (0·045 μg/m3) in ambient air sodium concentration as the negative exposure control exhibited no significant association with the risk of diabetes (HR 1·00, 95% CI 0·99-1·00). An integrated exposure response function showed that the risk of diabetes increased substantially above 2·4 μg/m3, and then exhibited a more moderate increase at concentrations above 10 μg/m3. Globally, ambient PM2·5 contributed to about 3·2 million (95% uncertainty interval [UI] 2·2-3·8) incident cases of diabetes, about 8·2 million (95% UI 5·8-11·0) DALYs caused by diabetes, and 206 105 (95% UI 153 408-259 119) deaths from diabetes attributable to PM2·5 exposure. The burden varied substantially among geographies and was more heavily skewed towards low-income and lower-to-middle-income countries. INTERPRETATION The global toll of diabetes attributable to PM2·5 air pollution is significant. Reduction in exposure will yield substantial health benefits. FUNDING US Department of Veterans Affairs.
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Affiliation(s)
- Benjamin Bowe
- Clinical Epidemiology Center, Research and Education Service, VA Saint Louis Health Care System, Saint Louis, Missouri, MO, USA; Department of Epidemiology and Biostatistics, Saint Louis University, Saint Louis, MO, USA
| | - Yan Xie
- Clinical Epidemiology Center, Research and Education Service, VA Saint Louis Health Care System, Saint Louis, Missouri, MO, USA
| | - Tingting Li
- Clinical Epidemiology Center, Research and Education Service, VA Saint Louis Health Care System, Saint Louis, Missouri, MO, USA; Department of Medicine, Washington University School of Medicine, Saint Louis, MO, USA
| | - Yan Yan
- Clinical Epidemiology Center, Research and Education Service, VA Saint Louis Health Care System, Saint Louis, Missouri, MO, USA; Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA
| | - Hong Xian
- Clinical Epidemiology Center, Research and Education Service, VA Saint Louis Health Care System, Saint Louis, Missouri, MO, USA; Department of Epidemiology and Biostatistics, Saint Louis University, Saint Louis, MO, USA
| | - Ziyad Al-Aly
- Clinical Epidemiology Center, Research and Education Service, VA Saint Louis Health Care System, Saint Louis, Missouri, MO, USA; Nephrology Section, Medicine Service, VA Saint Louis Health Care System, Saint Louis, Missouri, MO, USA; Department of Medicine, Washington University School of Medicine, Saint Louis, MO, USA; Institute for Public Health, Washington University in Saint Louis, Saint Louis, MO, USA.
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23
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Sanchez A, Silvestre C, Campo N, Grandes G. Effective translation of a type-2 diabetes primary prevention programme into routine primary care: The PreDE cluster randomised clinical trial. Diabetes Res Clin Pract 2018; 139:32-42. [PMID: 29476888 DOI: 10.1016/j.diabres.2018.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 12/21/2017] [Accepted: 01/09/2018] [Indexed: 12/30/2022]
Abstract
AIMS We assessed the effectiveness of a Type 2 diabetes mellitus (T2D) prevention programme in routine primary health care (PHC) in high-risk patients. METHODS Phase IV cluster clinical trial involving 14 PHC centres in the Basque Health Service were randomised to the DE-PLAN educational healthy lifestyle promotion programme or standard care. All non-diabetic 45- to 70-year-old PHC attendees considered at high risk of T2D (FINDRISC ≥ 14 points) were eligible. The primary outcome was the 24-month cumulative incidence of T2D confirmed by oral glucose tolerance testing. Secondary outcomes were self-reported physical activity and dietary changes at 12 months in a subsample. RESULTS Of the 4170 patients screened, 2128 (51%) were considered high risk, but 355 (33%) and 459 (43.6%) refused to participate in the control and intervention groups, respectively. Of all eligible non-diabetic patients, 634 and 454 were included in the control and intervention arms, 545 (85.9%) and 411 (90.5%) completed the follow-up. Intention-to-treat cumulative incidences of T2D were 12.1% (77/634) in the control group and 8.4% (38/454) in intervention group, with an absolute difference of 3.8% (95% CI: 0.18%-7.4%, p = 0.045) and a relative risk reduction of 32% (0.68; 95% CI: 0.47-0.99, p = 0.048) in favour of the intervention. Intervention patients were 1.83-fold more likely to meet recommended physical activity levels at 12 months (95% CI: 1.06-3.17, p = 0.03). CONCLUSIONS The DE-PLAN programme was effective in reducing T2D incidence in PHC high-risk patients. Research on implementation strategies to improve its feasible and sustainable adoption, reach and public health impact is warranted.
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Affiliation(s)
- Alvaro Sanchez
- Primary Care Research Unit of Bizkaia, Basque Healthcare Service - Osakidetza, BioCruces Health Research Institute, Luis Power 18, E48014 Bilbao, Spain.
| | - Carmen Silvestre
- Healthcare and Quality Management, Navarre Healthcare Service, Av. del Ejercito N° 2, E31002 Pamplona, Spain.
| | - Natalia Campo
- Primary Care Research Unit of Bizkaia, Basque Healthcare Service - Osakidetza, BioCruces Health Research Institute, Luis Power 18, E48014 Bilbao, Spain.
| | - Gonzalo Grandes
- Primary Care Research Unit of Bizkaia, Basque Healthcare Service - Osakidetza, BioCruces Health Research Institute, Luis Power 18, E48014 Bilbao, Spain.
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24
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Williams DM, Lee HH, Connell L, Boyle H, Emerson J, Strohacker K, Galárraga O. Small sustainable monetary incentives versus charitable donations to promote exercise: Rationale, design, and baseline data from a randomized pilot study. Contemp Clin Trials 2018; 66:80-85. [PMID: 29374526 PMCID: PMC6022749 DOI: 10.1016/j.cct.2018.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 01/08/2018] [Accepted: 01/18/2018] [Indexed: 11/26/2022]
Abstract
Regular physical activity (PA) enhances weight-loss and reduces risk of chronic disease. However, as few as 10% of U.S. adults engage in regular PA. Incentive programs to promote PA have shown some promise, but have typically used incentives that are too large to sustain over time and have not demonstrated habit formation or been tested in community settings. This report presents the rationale and design of a randomized pilot study testing the feasibility and preliminary efficacy of small monetary incentives for PA (n=25) versus charitable donations in the same amount (n=25) versus control (n=25) over 12months among 75 low-active but otherwise healthy adults at a local YMCA. Incentives are based on YMCA attendance, which is verified by electronic swipe card data and is the primary study outcome, with self-reported minutes/week of PA assessed as a secondary outcome. Incentives are intentionally small enough-$1/session, maximum of $5/week-such that they could be indefinitely sustained by community organizations, privately-owned health clubs, healthcare organizations, or employers (e.g., employer fitness facilities). Costs of the incentive program for the sponsoring organization may be partially offset by increases in membership resulting from the appeal of the program. Moreover, if efficacious, the charitable donation incentive program may have the added benefit of building social capital for the sponsoring organization and potentially serving as a tax write-off, thus further offsetting the cost of the incentives. Findings will also have implications for the use of financially sustainable community-based incentive programs for other health-related behaviors (e.g., weight loss, smoking).
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Affiliation(s)
| | | | | | - Holly Boyle
- Brown University School of Public Health, USA
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25
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Lao XQ, Deng HB, Liu X, Chan TC, Zhang Z, Chang LY, Yeoh EK, Tam T, Wong MCS, Thomas GN. Increased leisure-time physical activity associated with lower onset of diabetes in 44 828 adults with impaired fasting glucose: a population-based prospective cohort study. Br J Sports Med 2018; 53:895-900. [PMID: 29331993 DOI: 10.1136/bjsports-2017-098199] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2017] [Indexed: 02/06/2023]
Abstract
AIMS To evaluate the effects of habitual leisure-time physical activity (LTPA) on incident type 2 diabetes in a prospective cohort of Chinese adults with impaired fasting glucose (IFG). METHODS 44 828 Chinese adults aged 20-80 years with newly detected IFG but free from cardiovascular and cerebrovascular disease were recruited and followed up from 1996 to 2014. Incident type 2 diabetes was identified by fasting plasma glucose ≥7 mmol/L. The participants were classified into four categories based on their self-reported weekly LTPA: inactive, low, moderate, or high. Hazard ratios (HRs) and population attributable fractions (PAFs) were estimated with adjustment for established diabetic risk factor. RESULTS After 214 148 person-years of follow-up, we observed an inverse dose-response relationship between LTPA and diabetes risk. Compared with inactive participants, diabetes risk in individuals reporting low, moderate and high volume LTPA were reduced by 12% (HR 0.88, 95% CI 0.80 to 0.99; P=0.015), 20% (HR 0.80, 95% CI 0.71 to 0.90; P<0.001), and 25% (HR 0.75, 95% CI 0.67 to 0.83; P<0.001), respectively. At least 19.2% (PAF 19.2%, 95% CI 5.9% to 30.6%) of incident diabetes cases could be avoided if the inactive participants had engaged in WHO recommendation levels of LTPA. This would correspond to a potential reduction of at least 7 million diabetic patients in the Greater China area. CONCLUSIONS Our results show higher levels of LTPA are associated with a lower risk of diabetes in IFG subjects. These data emphasise the urgent need for promoting physical activity as a preventive strategy against diabetes to offset the impact of population ageing and the growing obesity epidemic.
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Affiliation(s)
- Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.,Shenzhen Research Institute, the Chinese University of Hong Kong, Shenzhen, China
| | - Han-Bing Deng
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Xudong Liu
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
| | - Zilong Zhang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Ly-Yun Chang
- Institute of Sociology, Academia Sinica, Taipei, Taiwan.,MJ Group, MJ Health Research Foundation, Taipei, Taiwan
| | - Eng-Kiong Yeoh
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Tony Tam
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong
| | - Martin Chi Sang Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - G Neil Thomas
- Institute for Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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26
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Chowdhury AK, Tjondronegoro D, Chandran V, Trost SG. Ensemble Methods for Classification of Physical Activities from Wrist Accelerometry. Med Sci Sports Exerc 2018; 49:1965-1973. [PMID: 28419025 DOI: 10.1249/mss.0000000000001291] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To investigate whether the use of ensemble learning algorithms improve physical activity recognition accuracy compared to the single classifier algorithms, and to compare the classification accuracy achieved by three conventional ensemble machine learning methods (bagging, boosting, random forest) and a custom ensemble model comprising four algorithms commonly used for activity recognition (binary decision tree, k nearest neighbor, support vector machine, and neural network). METHODS The study used three independent data sets that included wrist-worn accelerometer data. For each data set, a four-step classification framework consisting of data preprocessing, feature extraction, normalization and feature selection, and classifier training and testing was implemented. For the custom ensemble, decisions from the single classifiers were aggregated using three decision fusion methods: weighted majority vote, naïve Bayes combination, and behavior knowledge space combination. Classifiers were cross-validated using leave-one subject out cross-validation and compared on the basis of average F1 scores. RESULTS In all three data sets, ensemble learning methods consistently outperformed the individual classifiers. Among the conventional ensemble methods, random forest models provided consistently high activity recognition; however, the custom ensemble model using weighted majority voting demonstrated the highest classification accuracy in two of the three data sets. CONCLUSIONS Combining multiple individual classifiers using conventional or custom ensemble learning methods can improve activity recognition accuracy from wrist-worn accelerometer data.
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Affiliation(s)
- Alok Kumar Chowdhury
- 1Science and Engineering Faculty, Queensland University of Technology, Brisbane, AUSTRALIA; and 2Institute of Health and Biomedical Innovation at QLD Centre for Children's Health Research, School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, AUSTRALIA
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27
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Cao X, Han C, Wen J, Guo X, Zhang K. Nicotine increases apoptosis in HUVECs cultured in high glucose/high fat via Akt ubiquitination and degradation. Clin Exp Pharmacol Physiol 2017; 45:198-204. [PMID: 28963785 DOI: 10.1111/1440-1681.12865] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 09/04/2017] [Accepted: 09/19/2017] [Indexed: 12/12/2022]
Abstract
It is well-documented that nicotine, the main active ingredient in cigarettes, results in endothelial cell injury in numerous diseases. However, whether nicotine plays a crucial role in endothelial cell injury in diabetes and the exact molecular mechanism that mediates this process have not been fully elucidated. The current study aimed to investigate the effects of nicotine on endothelial cell injury in diabetes and the specific molecular mechanism by which it plays a role. Human umbilical vein endothelial cells (HUVECs) were incubated in HG/HF media and treated with nicotine, PYR-41 (a selective ubiquitin E1 inhibitor), Akt-overexpressing adenovirus, or TTC3 and MUL1 shRNA adenovirus. Cell viability was subsequently detected by the CCK8 assay, and apoptosis was examined by caspase-3 cleavage and activity analysis. Compared to the HG/HF incubated group, nicotine incubation significantly decreased cell survival and increased apoptosis. Moreover, nicotine induced Akt degradation via UPS, and Akt overexpression blocked nicotine-induced apoptosis in HUVECs cultured in HG/HF media. Furthermore, the TTC3 and MUL1 shRNA adenovirus dramatically decreased the Akt ubiquitination and apoptosis induced by nicotine. These results indicate that nicotine-induced Akt ubiquitination and degradation occurs through TTC3 and MUL1 and results in a dramatic increase in apoptosis in HUVECs cultured in HG/HF media.
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Affiliation(s)
- Xiaofang Cao
- Center for Disease Control and Prevention of Baoji City, Baoji City, Shanxi Province, China
| | - Chunling Han
- Baoji Maternal and Child Health Hospital, Baoji City, Shanxi Province, China
| | - Jinsuo Wen
- Center for Disease Control and Prevention of Baoji City, Baoji City, Shanxi Province, China
| | - Xiaokun Guo
- Center for Disease Control and Prevention of Baoji City, Baoji City, Shanxi Province, China
| | - Kejian Zhang
- Center for Disease Control and Prevention of Baoji City, Baoji City, Shanxi Province, China
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28
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Millar BM, Starks TJ, Gurung S, Parsons JT. The Impact of Comorbidities, Depression, and Substance Use Problems on Quality of Life Among Older Adults Living With HIV. AIDS Behav 2017; 21:1684-1690. [PMID: 27864625 DOI: 10.1007/s10461-016-1613-5] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Older adults living with HIV (OALWH) comprise a growing population with a range of complex and interconnecting medical and psychosocial needs. Based on the biopsychosocial model with its emphasis on a holistic approach to various aspects of people's lives, the current study explored associations between physical health, psychological health, substance use, and overall quality of life. Drawing on data from 114 substance-using OALWH (aged 50 or older), we employed linear regression to show associations between the number of current comorbid health conditions on quality of life, over and above depression, substance use problems, and demographic characteristics (age, race/ethnicity, gender, sexual orientation, education, and relationship status). In both bivariate and multivariable contexts, the number of comorbid conditions was associated with reduced quality of life. Depression and substance use were also negatively associated with quality of life. These findings indicate that clinical and supportive care for OALWH, particularly when related to mental health and substance use, should also include an integrated focus on the comparatively high number of current comorbid conditions that often accompany, and potentially complicate, HIV treatment and quality of life.
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Affiliation(s)
- Brett M Millar
- Center for HIV/AIDS Educational Studies & Training, Hunter College of the City University of New York (CUNY), New York, NY, USA
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center, CUNY, New York, NY, USA
| | - Tyrel J Starks
- Center for HIV/AIDS Educational Studies & Training, Hunter College of the City University of New York (CUNY), New York, NY, USA
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center, CUNY, New York, NY, USA
- Department of Psychology, Hunter College, CUNY, 695 Park Ave., New York, NY, 10065, USA
| | - Sitaji Gurung
- Center for HIV/AIDS Educational Studies & Training, Hunter College of the City University of New York (CUNY), New York, NY, USA
- CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Jeffrey T Parsons
- Center for HIV/AIDS Educational Studies & Training, Hunter College of the City University of New York (CUNY), New York, NY, USA.
- Health Psychology and Clinical Sciences Doctoral Program, The Graduate Center, CUNY, New York, NY, USA.
- Department of Psychology, Hunter College, CUNY, 695 Park Ave., New York, NY, 10065, USA.
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29
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Chowdhury AK, Tjondronegoro D, Chandran V, Trost SG. Physical Activity Recognition Using Posterior-Adapted Class-Based Fusion of Multiaccelerometer Data. IEEE J Biomed Health Inform 2017; 22:678-685. [PMID: 28534801 DOI: 10.1109/jbhi.2017.2705036] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This paper proposes the use of posterior-adapted class-based weighted decision fusion to effectively combine multiple accelerometer data for improving physical activity recognition. The cutting-edge performance of this method is benchmarked against model-based weighted fusion and class-based weighted fusion without posterior adaptation, based on two publicly available datasets, namely PAMAP2 and MHEALTH. Experimental results show that: 1) posterior-adapted class-based weighted fusion outperformed model-based and class-based weighted fusion; 2) decision fusion with two accelerometers showed statistically significant improvement in average performance compared to the use of a single accelerometer; 3) generally, decision fusion from three accelerometers did not show further improvement from the best combination of two accelerometers; and 4) a combination of ankle and wrist located accelerometers showed the best overall performance compared to any combination of two or three accelerometers.
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30
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Caron N, Peyrot N, Caderby T, Verkindt C, Dalleau G. Energy Expenditure in People with Diabetes Mellitus: A Review. Front Nutr 2016; 3:56. [PMID: 28066773 PMCID: PMC5177618 DOI: 10.3389/fnut.2016.00056] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 12/08/2016] [Indexed: 12/22/2022] Open
Abstract
Physical activity (PA) is an important non-therapeutic tool in primary prevention and treatment of diabetes mellitus (DM). To improve activity-based health management, patients need to quantify activity-related energy expenditure and the other components of total daily energy expenditure. This review explores differences between the components of total energy expenditure in patients with DM and healthy people and presents various tools for assessing the energy expenditure in subjects with DM. From this review, it appears that patients with uncontrolled DM have a higher basal energy expenditure (BEE) than healthy people which must be considered in the establishment of new BEE estimate equations. Moreover, studies showed a lower activity energy expenditure in patients with DM than in healthy ones. This difference may be partially explained by patient with DMs poor compliance with exercise recommendations and their greater participation in lower intensity activities. These specificities of PA need to be taken into account in the development of adapted tools to assess activity energy expenditure and daily energy expenditure in people with DM. Few estimation tools are tested in subjects with DM and this results in a lack of accuracy especially for their particular patterns of activity. Thus, future studies should examine sensors coupling different technologies or method that is specifically designed to accurately assess energy expenditure in patients with diabetes in daily life.
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Affiliation(s)
- Nathan Caron
- Laboratoire IRISSE, UFR des Sciences de l'Homme et de l'Environnement, Université de la Réunion, Le Tampon , La Réunion , France
| | - Nicolas Peyrot
- Laboratoire IRISSE, UFR des Sciences de l'Homme et de l'Environnement, Université de la Réunion, Le Tampon , La Réunion , France
| | - Teddy Caderby
- Laboratoire IRISSE, UFR des Sciences de l'Homme et de l'Environnement, Université de la Réunion, Le Tampon , La Réunion , France
| | - Chantal Verkindt
- Laboratoire IRISSE, UFR des Sciences de l'Homme et de l'Environnement, Université de la Réunion, Le Tampon , La Réunion , France
| | - Georges Dalleau
- Laboratoire IRISSE, UFR des Sciences de l'Homme et de l'Environnement, Université de la Réunion, Le Tampon , La Réunion , France
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31
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Lennon LT, Ramsay SE, Papacosta O, Shaper AG, Wannamethee SG, Whincup PH. Cohort Profile Update: The British Regional Heart Study 1978-2014: 35 years follow-up of cardiovascular disease and ageing. Int J Epidemiol 2016; 44:826-826g. [PMID: 26232420 PMCID: PMC4521137 DOI: 10.1093/ije/dyv141] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Lucy T Lennon
- Department of Primary Care & Population Health, Institute of Epidemiology and Health Care, UCL Medical School, London, UK and
| | - Sheena E Ramsay
- Department of Primary Care & Population Health, Institute of Epidemiology and Health Care, UCL Medical School, London, UK and
| | - Olia Papacosta
- Department of Primary Care & Population Health, Institute of Epidemiology and Health Care, UCL Medical School, London, UK and
| | - A Gerald Shaper
- Department of Primary Care & Population Health, Institute of Epidemiology and Health Care, UCL Medical School, London, UK and
| | - S Goya Wannamethee
- Department of Primary Care & Population Health, Institute of Epidemiology and Health Care, UCL Medical School, London, UK and
| | - Peter H Whincup
- Population Health Research Institute, St George's, University of London, London, UK
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32
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Huber J, Smeikal M, Lechleitner M, Fasching P. [Geriatric aspects for the management of diabetes mellitus]. Wien Klin Wochenschr 2016; 128 Suppl 2:S124-30. [PMID: 27052230 DOI: 10.1007/s00508-016-0955-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
There is a high prevalence of diabetes mellitus in the elderly population of industrial countries. The present article provides recommendations for the screening, prevention and treatment of elderly diabetic patients according to current scientific evidence.
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Affiliation(s)
- Joakim Huber
- 5. Medizinische Abteilung mit Endokrinologie, Rheumatologie und Akutgeriatrie, Wilhelminenspital der Stadt Wien, Wien, Österreich.
| | - Michael Smeikal
- 5. Medizinische Abteilung mit Endokrinologie, Rheumatologie und Akutgeriatrie, Wilhelminenspital der Stadt Wien, Wien, Österreich
| | - Monika Lechleitner
- Interne Abteilung, Landeskrankenhaus Hochzirl - Natters, Hochzirl, Österreich
| | - Peter Fasching
- 5. Medizinische Abteilung mit Endokrinologie, Rheumatologie und Akutgeriatrie, Wilhelminenspital der Stadt Wien, Wien, Österreich
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Hesselink AE, Rutten GEH, Slootmaker SM, de Weerdt I, Raaijmakers LGM, Jonkers R, Martens MK, Bilo HJG. Effects of a lifestyle program in subjects with Impaired Fasting Glucose, a pragmatic cluster-randomized controlled trial. BMC FAMILY PRACTICE 2015; 16:183. [PMID: 26695176 PMCID: PMC4688978 DOI: 10.1186/s12875-015-0394-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 12/08/2015] [Indexed: 11/11/2022]
Abstract
BACKGROUND The worldwide epidemic of type 2 diabetes (T2DM) underlines the need for diabetes prevention strategies. In this study the feasibility and effectiveness of a nurse led lifestyle program for subjects with impaired fasting glucose (IFG) is assessed. METHODS A cluster randomized clinical trial in 26 primary care practices in the Netherlands included 366 participants older than 45 years with newly diagnosed IFG and motivated to change their lifestyle (intervention group, n = 197; usual care group, n = 169). The one-year intervention, consisting of four to five individual nurse-led consultations, was directed at improving physical activity and dietary habits. The primary outcome measure was body mass index (BMI). Linear and logistic multilevel analyses and a process evaluation were performed. RESULTS Both groups showed small reductions in BMI at 1 and 2 years, but differences between groups were not significant. At both 1 and 2-year follow-up the number of participants physically active for at least 30 minutes at least five days a week was significantly improved in the intervention group compared to the usual care group (intervention group vs. usual care group: OR1year = 3.53; 95 % CI = 1.69-7.37 and OR2years = 1.97; 95 % CI = 1.22-3.20, respectively). The total drop-out rate was 24 %. Process evaluation revealed that participants in the intervention group received fewer consultations than advised, while some practice nurses and participants considered the RM protocol too intensive. CONCLUSIONS This relatively simple lifestyle program in subjects with IFG resulted in a significant improvement in reported physical activity, but not in BMI. Despite its simplicity, some participants still considered the intervention too intensive. This viewpoint could be related to poor motivation and an absence of disease burden due to IFG, such that participants do not feel a need for behavioural change. Although the intervention provided some benefit, its wider use cannot be advised. TRIAL REGISTRATION Current Controlled Trials ISRCTN41209683 , date of registration 16/10/2013h .
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Affiliation(s)
- Arlette E Hesselink
- ResCon, Research & Consultancy, Kennemerplein 7, 2011 MH, Haarlem, The Netherlands.
| | - Guy E H Rutten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Inge de Weerdt
- Netherlands Diabetes Federation, Amersfoort, The Netherlands
| | - Lieke G M Raaijmakers
- Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ruud Jonkers
- ResCon, Research & Consultancy, Kennemerplein 7, 2011 MH, Haarlem, The Netherlands
| | - Marloes K Martens
- ResCon, Research & Consultancy, Kennemerplein 7, 2011 MH, Haarlem, The Netherlands
| | - Henk J G Bilo
- Diabetes Centre and Department of Internal Medicine, Isala Clinics, Zwolle; and, University Medical Centre Groningen, Groningen, The Netherlands
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34
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Physical activity and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis. Eur J Epidemiol 2015; 30:529-42. [PMID: 26092138 DOI: 10.1007/s10654-015-0056-z] [Citation(s) in RCA: 495] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 06/09/2015] [Indexed: 02/08/2023]
Abstract
We investigated the association between specific types of physical activity and the risk of type 2 diabetes in a systematic review and meta-analysis of published studies. PubMed, Embase and Ovid databases were searched for prospective studies and randomized trials up to 2nd of March 2015. Summary relative risks (RRs) were calculated using a random effects model. Eighty-one studies were included. The summary RRs for high versus low activity were 0.65 (95 % CI 0.59-0.71, I(2) = 18 %, n = 14) for total physical activity, 0.74 (95 % CI 0.70-0.79, I(2) = 84 %, n = 55) for leisure-time activity, 0.61 (95 % CI 0.51-0.74, I(2) = 73 %, n = 8) for vigorous activity, 0.68 (95 % CI 0.52-0.90, I(2) = 93 %, n = 5) for moderate activity, 0.66 (95 % CI 0.47-0.94, I(2) = 47 %, n = 4) for low intensity activity, and 0.85 (95 % CI 0.79-0.91, I(2) = 0 %, n = 7) for walking. Inverse associations were also observed for increasing activity over time, resistance exercise, occupational activity and for cardiorespiratory fitness. Nonlinear relations were observed for leisure-time activity, vigorous activity, walking and resistance exercise (p nonlinearity < 0.0001 for all), with steeper reductions in type 2 diabetes risk at low activity levels than high activity levels. This meta-analysis provides strong evidence for an inverse association between physical activity and risk of type 2 diabetes, which may partly be mediated by reduced adiposity. All subtypes of physical activity appear to be beneficial. Reductions in risk are observed up to 5-7 h of leisure-time, vigorous or low intensity physical activity per week, but further reductions cannot be excluded beyond this range.
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Callahan DM, Tourville TW, Miller MS, Hackett SB, Sharma H, Cruickshank NC, Slauterbeck JR, Savage PD, Ades PA, Maughan DW, Beynnon BD, Toth MJ. Chronic disuse and skeletal muscle structure in older adults: sex-specific differences and relationships to contractile function. Am J Physiol Cell Physiol 2015; 308:C932-43. [PMID: 25810256 DOI: 10.1152/ajpcell.00014.2015] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 03/24/2015] [Indexed: 11/22/2022]
Abstract
In older adults, we examined the effect of chronic muscle disuse on skeletal muscle structure at the tissue, cellular, organellar, and molecular levels and its relationship to muscle function. Volunteers with advanced-stage knee osteoarthritis (OA, n = 16) were recruited to reflect the effects of chronic lower extremity muscle disuse and compared with recreationally active controls (n = 15) without knee OA but similar in age, sex, and health status. In the OA group, quadriceps muscle and single-fiber cross-sectional area were reduced, with the largest reduction in myosin heavy chain IIA fibers. Myosin heavy chain IIAX fibers were more prevalent in the OA group, and their atrophy was sex-specific: men showed a reduction in cross-sectional area, and women showed no differences. Myofibrillar ultrastructure, myonuclear content, and mitochondrial content and morphology generally did not differ between groups, with the exception of sex-specific adaptations in subsarcolemmal (SS) mitochondria, which were driven by lower values in OA women. SS mitochondrial content was also differently related to cellular and molecular functional parameters by sex: greater SS mitochondrial content was associated with improved contractility in women but reduced function in men. Collectively, these results demonstrate sex-specific structural phenotypes at the cellular and organellar levels with chronic disuse in older adults, with novel associations between energetic and contractile systems.
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Affiliation(s)
- Damien M Callahan
- Department of Medicine, College of Medicine, University of Vermont, Burlington, Vermont
| | - Timothy W Tourville
- Department of Orthopaedics and Rehabilitation, College of Medicine, University of Vermont, Burlington, Vermont
| | - Mark S Miller
- Department of Molecular Physiology and Biophysics, College of Medicine, University of Vermont, Burlington, Vermont; and
| | - Sarah B Hackett
- Department of Medicine, College of Medicine, University of Vermont, Burlington, Vermont
| | - Himani Sharma
- Department of Medicine, College of Medicine, University of Vermont, Burlington, Vermont
| | | | - James R Slauterbeck
- Department of Orthopaedics and Rehabilitation, College of Medicine, University of Vermont, Burlington, Vermont
| | - Patrick D Savage
- Department of Medicine, College of Medicine, University of Vermont, Burlington, Vermont
| | - Philip A Ades
- Department of Medicine, College of Medicine, University of Vermont, Burlington, Vermont
| | - David W Maughan
- Department of Molecular Physiology and Biophysics, College of Medicine, University of Vermont, Burlington, Vermont; and
| | - Bruce D Beynnon
- Department of Orthopaedics and Rehabilitation, College of Medicine, University of Vermont, Burlington, Vermont
| | - Michael J Toth
- Department of Medicine, College of Medicine, University of Vermont, Burlington, Vermont; Department of Molecular Physiology and Biophysics, College of Medicine, University of Vermont, Burlington, Vermont; and
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36
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Jemmott JB, Stephens-Shields A, O'Leary A, Jemmott LS, Teitelman A, Ngwane Z, Mtose X. Mediation of effects of a theory-based behavioral intervention on self-reported physical activity in South African men. Prev Med 2015; 72:1-7. [PMID: 25565482 PMCID: PMC4351128 DOI: 10.1016/j.ypmed.2014.12.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 12/22/2014] [Accepted: 12/26/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Increasing physical activity is an important public-health goal worldwide, but there are few published mediation analyses of physical-activity interventions in low-to-middle-income countries like South Africa undergoing a health transition involving markedly increased mortality from non-communicable diseases. This article reports secondary analyses on the mediation of a theory-of-planned-behavior-based behavioral intervention that increased self-reported physical activity in a trial with 1181 men in Eastern Cape Province, South Africa. METHOD Twenty-two matched-pairs of neighborhoods were randomly selected. Within pairs, neighborhoods were randomized to a health-promotion intervention or an attention-matched control intervention with baseline, immediate-post, and 6- and 12-month post-intervention assessments. Theory-of-planned-behavior constructs measured immediately post-intervention were tested as potential mediators of the primary outcome, self-reported physical activity averaged over the 6- and 12-month post-intervention assessments, using a product-of-coefficients approach in a generalized-estimating-equations framework. Data were collected in 2007-2010. RESULTS Attitude, subjective norm, self-efficacy, and intention were significant mediators of intervention-induced increases in self-reported physical activity. The descriptive norm, not affected by the intervention, was not a mediator, but predicted increased self-reported physical activity. CONCLUSION The results suggest that interventions targeting theory-of-planned-behavior constructs may contribute to efforts to increase physical activity to reduce the burden of non-communicable diseases among South African men.
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Affiliation(s)
- John B Jemmott
- Department of Psychiatry, Perelman School of Medicine and Annenberg School for Communication, University of PA, USA.
| | - Alisa Stephens-Shields
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of PA, USA
| | - Ann O'Leary
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, USA
| | | | | | | | - Xoliswa Mtose
- Faculty of Education, University of Fort Hare, Alice, South Africa
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Oyewole OO, Odusan O, Oritogun KS, Idowu AO. Predictability of physical activity and bodyweight on health-related quality of life amongst Nigerian type 2 diabetes mellitus. Int J Diabetes Dev Ctries 2015. [DOI: 10.1007/s13410-015-0335-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Watz H, Pitta F, Rochester CL, Garcia-Aymerich J, ZuWallack R, Troosters T, Vaes AW, Puhan MA, Jehn M, Polkey MI, Vogiatzis I, Clini EM, Toth M, Gimeno-Santos E, Waschki B, Esteban C, Hayot M, Casaburi R, Porszasz J, McAuley E, Singh SJ, Langer D, Wouters EFM, Magnussen H, Spruit MA. An official European Respiratory Society statement on physical activity in COPD. Eur Respir J 2014; 44:1521-37. [PMID: 25359358 DOI: 10.1183/09031936.00046814] [Citation(s) in RCA: 336] [Impact Index Per Article: 33.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
This European Respiratory Society (ERS) statement provides a comprehensive overview on physical activity in patients with chronic obstructive pulmonary disease (COPD). A multidisciplinary Task Force of experts representing the ERS Scientific Group 01.02 "Rehabilitation and Chronic Care" determined the overall scope of this statement through consensus. Focused literature reviews were conducted in key topic areas and the final content of this Statement was agreed upon by all members. The current knowledge regarding physical activity in COPD is presented, including the definition of physical activity, the consequences of physical inactivity on lung function decline and COPD incidence, physical activity assessment, prevalence of physical inactivity in COPD, clinical correlates of physical activity, effects of physical inactivity on hospitalisations and mortality, and treatment strategies to improve physical activity in patients with COPD. This Task Force identified multiple major areas of research that need to be addressed further in the coming years. These include, but are not limited to, the disease-modifying potential of increased physical activity, and to further understand how improvements in exercise capacity, dyspnoea and self-efficacy following interventions may translate into increased physical activity. The Task Force recommends that this ERS statement should be reviewed periodically (e.g. every 5-8 years).
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Affiliation(s)
| | - Fabio Pitta
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Carolyn L Rochester
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Judith Garcia-Aymerich
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Richard ZuWallack
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Thierry Troosters
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Anouk W Vaes
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Milo A Puhan
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Melissa Jehn
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Michael I Polkey
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Ioannis Vogiatzis
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Enrico M Clini
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Michael Toth
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Elena Gimeno-Santos
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Benjamin Waschki
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Cristobal Esteban
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Maurice Hayot
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Richard Casaburi
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Janos Porszasz
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Edward McAuley
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Sally J Singh
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Daniel Langer
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Emiel F M Wouters
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
| | - Helgo Magnussen
- For a full list of the authors' affiliations please refer to the Acknowledgements. Task Force co-chairs
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Jemmott JB, Jemmott LS, Ngwane Z, Zhang J, Heeren GA, Icard LD, O'Leary A, Mtose X, Teitelman A, Carty C. Theory-based behavioral intervention increases self-reported physical activity in South African men: a cluster-randomized controlled trial. Prev Med 2014; 64:114-20. [PMID: 24736094 PMCID: PMC4142492 DOI: 10.1016/j.ypmed.2014.04.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 04/04/2014] [Accepted: 04/06/2014] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To determine whether a health-promotion intervention increases South African men's adherence to physical-activity guidelines. METHOD We utilized a cluster-randomized controlled trial design. Eligible clusters, residential neighborhoods near East London, South Africa, were matched in pairs. Within randomly selected pairs, neighborhoods were randomized to theory-based, culturally congruent health-promotion intervention encouraging physical activity or attention-matched HIV/STI risk-reduction control intervention. Men residing in the neighborhoods and reporting coitus in the previous 3 months were eligible. Primary outcome was self-reported individual-level adherence to physical-activity guidelines averaged over 6-month and 12-month post-intervention assessments. Data were collected in 2007-2010. Data collectors, but not facilitators or participants, were blind to group assignment. RESULTS Primary outcome intention-to-treat analysis included 22 of 22 clusters and 537 of 572 men in the health-promotion intervention and 22 of 22 clusters and 569 of 609 men in the attention-control intervention. Model-estimated probability of meeting physical-activity guidelines was 51.0% in the health-promotion intervention and 44.7% in attention-matched control (OR=1.34; 95% CI, 1.09-1.63), adjusting for baseline prevalence and clustering from 44 neighborhoods. CONCLUSION A theory-based culturally congruent intervention increased South African men's self-reported physical activity, a key contributor to deaths from non-communicable diseases in South Africa. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01490359.
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Affiliation(s)
- John B Jemmott
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA; University of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, USA.
| | - Loretta S Jemmott
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA
| | - Zolani Ngwane
- Haverford College, Department of Anthropology, Haverford, PA, USA
| | - Jingwen Zhang
- University of Pennsylvania, Annenberg School for Communication, Philadelphia, PA, USA
| | - G Anita Heeren
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA
| | - Larry D Icard
- Temple University, College of Health Professions and Social Work, Philadelphia, PA, USA
| | - Ann O'Leary
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Xoliswa Mtose
- University of Fort Hare, Faculty of Education, East London, South Africa
| | - Anne Teitelman
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA
| | - Craig Carty
- University of Pennsylvania, Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA
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Huber J, Smeikal M, Lechleitner M, Fasching P. [Geriatric aspects for the management of diabetes mellitus]. Wien Klin Wochenschr 2013; 124 Suppl 2:74-8. [PMID: 23371328 DOI: 10.1007/s00508-012-0283-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
There is a high incidence of Diabetes mellitus in the elderly population of industrial countries. The present article provides recommendations for the screening, prevention and treatment of elderly diabetic patients according to current scientific evidence.
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Affiliation(s)
- Joakim Huber
- 5. Medizinische Abteilung mit Endokrinologie, Rheumatologie und Akutgeriatrie, Wilhelminenspital der Stadt Wien, Montleartstraße 37, 1160 Wien, Österreich.
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