Sedentary behavior: emerging evidence for a new health risk

Prolonged exposure to leisure screen time notably accelerates biological aging: Evidence from observational studies and genetic associations

LST is steadily increasing and is associated with various health issues. However, its impact on aging remains unclear. A total of 7212 participants from NHANES 1999-2002 were included. LTL, ALM, and FI were selected as aging phenotypes. Observational association between LST and aging traits was analyzed using linear regression models. MR analyses based on 112 genetic variants were performed to test the causal estimates from LST on aging. TWAS and PPI analyses were conducted to investigate underlying biological mechanisms. After adjusting for physical activity, per 1 ​h increase in LST, participants had a shorter LTL (β ​= ​-1.39, 95 ​% CI: -2.47 to -0.30), a lower ALM (β ​= ​-1.09, 95 ​% CI: -1.39 to -0.70), and an increased FI (β ​= ​8.22, 95 ​% CI: 4.29 to 12.30). Likewise, TSMR analyses indicated that genetically increased LST was significantly associated with shorter LTL (β ​= ​-2.63, 95 ​% CI: -4.86 to -0.35), lower ALM (β ​= ​-6.56, 95 ​% CI: -9.43 to -3.60), and increased FI (β ​= ​20.16, 95 ​% CI: 15.73 to 24.77). The trend remained robust after tests for pleiotropy and heterogeneity, consistent with the results of MVMR. 4 hub genes and 15 co-localized genes are identified, respectively, from PPI networks and TWAS. Pathways related to immune reactions, oxidative stress, and protein metabolism were significantly enriched. This study revealed that increased LST is significantly associated with adverse aging phenotypes. Reducing LST may help alleviate the burden of aging.

Lifestyle Factors as Perceived Causes of Psychological Distress: Implications for Mental Health Stigma

Purpose: The current study aimed to understand how mental health stigma was affected by a person's causal beliefs about mental illness, specifically, believing that mental distress is caused by poor lifestyle choices. This study also examined whether a participant's own levels of healthy lifestyle behaviors moderated this relationship. These lifestyle factors included behaviors such as daily vegetable intake, physical activity, and sleep, along with substance use characteristics. Major Findings: The consistent finding across both samples was that believing that lifestyle behaviors predicted psychological distress was associated with greater pity towards those with mental illness. In the general adult sample, but not the undergraduate sample, lifestyle causal beliefs were also associated with greater anger and fear. There was some evidence that the degree to which a person followed their own healthy lifestyle behaviors (specifically their substance use) was associated with lower pity and greater anger, but only for those who reported using more substances themselves. Conclusions: The association of lifestyle causal beliefs with pity may be due to the known challenge of maintaining healthy lifestyles. These associations may be important to understand in the application of lifestyle medicine approaches to mental health and may provide targets for stigma reduction interventions.

Perceptions of Immersive Virtual Reality for Physical Activity Among Individuals with Hypertension at Risk of Cardiovascular Disease: A Qualitative Study

Background: Hypertension, obesity, and a sedentary lifestyle are interrelated, forming a vicious cycle that deteriorates cardiovascular health. In addition to being a pathology, hypertension is a risk factor for cardiovascular diseases, one of the leading causes of mortality worldwide. Interventions that combine weight loss and physical activity (PA) reduce cardiovascular risk, but many people face barriers in adhering to regular PA regimens such as a lack of time or motivation. Immersive virtual reality (IVR) has emerged as an innovative alternative to promote PA. This study explored the perceptions of individuals with hypertension and cardiovascular risk regarding the use of IVR as a tool for PA. Methods: Fifteen hypertensive adults with cardiovascular risk completed twelve IVR exercise sessions over thirty days. Semi-structured interviews were conducted. Results: The thematic analysis identified three main themes: (1) PA, sedentary lifestyle, and health; (2) experiences and perceptions of IVR and PA; and (3) IVR as a useful and safe tool. The participants found IVR engaging, motivating, and effective in overcoming barriers such as a lack of time and social anxiety. Gamification and immersion facilitated greater adherence and enjoyment. Conclusions: The participants of this study perceived IVR as an innovative, engaging, and motivating tool for promoting PA. The participants positively valued IVR's ability to overcome common barriers such as lack of time, adverse weather conditions, and lack of motivation, as well as its immersive and gamified features, which enhanced the adherence to and enjoyment of PA. These results suggest that IVR could complement traditional exercise programs by facilitating the initiation of active routines in sedentary individuals.

Association of physical activity, cardiorespiratory fitness, grip strength, and grip strength asymmetry with incident musculoskeletal disorders in 406,080 White adults

BACKGROUND

Musculoskeletal disorders (MSDs) represent a significant global health burden. While physical activity (PA) and physical fitness are both thought to reduce MSD risk, their independent and joint associations with MSD incidence have not been fully explored. This study investigated the independent and combined effects of PA, cardiorespiratory fitness (CRF), grip strength (GS), and GS asymmetry on MSD incidence in a large prospective cohort.

METHODS

We analyzed data from the UK Biobank cohort (2006-2023), including 406,080 participants aged 37-73 years (age = 55.7 ± 8.2 years, mean ± SD; 53.0% female) who were free of MSD at baseline and during the first 2 years of follow-up. PA, derived from self-reported data and expressed in total metabolic equivalent hours per week (MET-h/week); CRF (watts (W)/kilogram (kg)), measured using a cycling exercise test; and GS (kg), measured by hydraulic hand dynamometer, were included as exposures. GS asymmetry was defined by the left-to-right hand strength ratio. MSD incidence was determined via hospital records. Time-to-event associations were analyzed using Cox proportional hazards regression models with restricted cubic splines to account for non-linear relationships. The analysis was conducted in April 2024.

RESULTS

Over a median follow-up of 14.7 years, a total of 73,002 incident cases of MSDs were recorded (rheumatoid arthritis: 2923; osteoarthritis: 54,955; degenerative spinal diseases: 15,124). Lower self-reported PA (<4.8 MET-h/week) was associated with increased MSD risk (hazard ratio (HR) = 1.07, 95% confidence interval (95% CI), 1.07-1.08). Low CRF (<1.7 W/kg; HR = 1.09, 95% CI, 1.06-1.13), low GS (<30.0 kg mean GS; HR = 1.11, 95% CI, 1.10-1.13), and GS asymmetry (HR = 1.11, 95% CI, 1.08-1.13) were also significantly associated with increased MSD risk. Good CRF and GS, and lower GS asymmetry mitigated the higher MSD risk associated with low PA levels.

CONCLUSION

Low levels of PA, CRF, GS, and GS asymmetry were associated with a higher risk of incident MSD. Meanwhile, improvements in CRF, GS, and GS balance could help offset the risk of MSD incidence in populations with insufficient PA.

Resistance Exercise Training on Musculoskeletal, Metabolic and Psychological Health in Sedentary Office Workers - Systematic Review and Meta-analysis

PURPOSE

To consolidate the emerging evidence on the effectiveness of resistance training (RT) in reducing the health risks among sedentary office workers.

METHODS

Four electronic databases were searched for evidence from its inception till september 20, 2024. Studies were included if they examined any form of RT program targeting musculoskeletal, metabolic, or psychological health outcomes in office workers aged 18 years or older using PICOS criteria (Population - office workers, Intervention - RT program, Comparison - placebo or sham control and Outcomes - musculoskeletal, cardiometabolic and psychological health variables). Two reviewers independently screened the studies for risk of bias and assessed the certainty of the evidence.

RESULTS

Out of 60 identified studies, 17 studies were eligible for narrative synthesis, and 16 were included in the meta-analysis. Modest reductions in neck (SMD = -1.76, I2 = 88%, p < 0.00001) and shoulder discomfort (SMD = -13.29, I2 = 91%, p < 0.00001), while marginal improvement in shoulder (SMD = 4.13, I2 = 99%, p = 0.03) and neck extensor muscle strength (SMD = 9.07, I2 = 9%, p < 0.00001). The cardiometabolic and mental health risk markers remain unaltered. High uncertainty of evidence was observed due to high heterogeneity, risk of bias, inconsistency and publication bias.

CONCLUSION

Limited evidence demonstrate supervised RT programs of any dose has a potential to improve muscular strength and discomfort while potential cardiometabolic and mental health risk outcomes remain unaltered. However, more high-quality research trials are needed to understand the effects of RT on health benefits.

Mental Health in Young Adult University Students During COVID-19 Lockdown: Associations with Physical Activity, Sedentary Behaviors and Sleep Quality

This study analyzed associations between physical activity (PA), sedentary behaviors (SB), sleep, and mental health indicators in young adults during the COVID-19 lockdown (15 January-19 April 2021). The participants were 549 Portuguese university students (18-30 years, 57.7% male). Mental health was assessed using the DASS-21 for depression, anxiety, stress, and DASS-21 total score (DASSt). Physical activity (vigorous, moderate, walking) was measured with the IPAQ, while SB (e.g., sitting, screen time) and sleep were evaluated using self-reported measures and the Pittsburgh Sleep Quality Index (PSQI). Multiple linear regressions showed that sleep quality (β = 2.116), sitting time (ST; β = 0.451), vigorous PA (VPA; β = -0.005), and computer use for work/study (β = 0.444) were significantly associated with overall mental health, DASSt (R2 = 0.358). Sleep quality, sitting, and VPA were also linked to depression (R2 = 0.308), anxiety (R2 = 0.275), and stress (R2 = 0.338). Computer use for work/study was additionally associated with anxiety and stress. Overall, poor sleep quality, increased sitting, and computer use for work/study, alongside lower VPA, showed significant associations with poorer mental health outcomes. These findings highlight the importance of sleep, PA, and limiting sedentary behaviors, particularly during lockdowns, in mitigating mental health issues among Portuguese young adults.

Food matrices as delivery units of nutrients in processed foods

Processed food products (PFPs) are amply consumed and important sources of nutrients worldwide. Evaluating PFPs by their composition fails to recognize that nutrients are embedded in food matrices and processing modifies their nutritional functionality, for example, the bioaccessibility and bioavailability. PFPs with equivalent chemical composition may experience the "food matrix effect": a difference in the nutritional outcome and health potential. This review presents food matrices attained after processing and their nutritional significance. It also delves into the complex kinetics of digestion conducive to nutrient release from matrices and nutrient interactions before absorption in the small intestine, and the role of microbial fermentation in the colon. Matrices of PFPs can be designed or redesigned and manufactured to be tasty, nutritious, sustainable, as special foods for vulnerable groups, innovative products from novel food sources, and to feed a healthy microbiota. The potential for nutritional improvement of PFPs is driven by understanding the food materials science and changes in food matrices during processing, control of formulation and manufacturing variables, the application of novel technologies, and a multifactor toolbox that supports the rational design of healthy food matrices.

Neural Determinants of Sedentary Lifestyle in Older Adults: A Brain Network Analysis

PURPOSE

The prevalence of sedentary lifestyles (SL), which includes both high volumes of extended sitting behavior and a low volume of steps accumulated across the day, among older adults continues to rise contributing to increases in associated comorbidities and the loss of independence. The social, personal, and economic burdens are enormous. In recognition of the health implications of SL, current public health physical activity guidelines now emphasize the complimentary goals of sitting less by moving more. We recently completed a 6-month weight loss (WL) study followed by 12 months of reduced contact to examine weight regain in older adults with obesity. One of the treatment conditions involved WL + a day-long movement intervention that explicitly targeted reducing sitting time and increasing steps across the day (SitLess).

METHOD

The goal of the current study, using baseline fMRI and accelerometry data from 36 participants and advanced machine learning tools, was to determine if we could identify complex brain circuits underlying variability associated with changes in sitting time and daily steps during the 6-month intensive phase among participants randomized to the WL + SitLess treatment condition. Models generated from these analyses produced accuracy in predicting pre-post change in both measures that exceeded 92%, suggesting a critical role for the identified brain subnetworks in explaining variability in these outcomes in response to the intervention. The identified networks comprised regions, predominantly in the default mode and sensorimotor networks, that have been extensively linked to self-regulation and decision-making.

FINDING

These results provide insights into the theoretical basis of SL for older adults and in the design of future intervention research.

The interplay of factors in metabolic syndrome: understanding its roots and complexity

Metabolic syndrome (MetS) is an indicator and diverse endocrine syndrome that combines different metabolic defects with clinical, physiological, biochemical, and metabolic factors. Obesity, visceral adiposity and abdominal obesity, dyslipidemia, insulin resistance (IR), elevated blood pressure, endothelial dysfunction, and acute or chronic inflammation are the risk factors associated with MetS. Abdominal obesity, a hallmark of MetS, highlights dysfunctional fat tissue and increased risk for cardiovascular disease and diabetes. Insulin, a vital peptide hormone, regulates glucose metabolism throughout the body. When cells become resistant to insulin's effects, it disrupts various molecular pathways, leading to IR. This condition is linked to a range of disorders, including obesity, diabetes, fatty liver disease, cardiovascular disease, and polycystic ovary syndrome. Atherogenic dyslipidemia is characterized by three key factors: high levels of small, low-dense lipoprotein (LDL) particles and triglycerides, alongside low levels of high-density lipoprotein (HDL), the "good" cholesterol. Such a combination is a major player in MetS, where IR is a driving force. Atherogenic dyslipidemia contributes significantly to the development of atherosclerosis, which can lead to cardiovascular disease. On top of that, genetic alteration and lifestyle factors such as diet and exercise influence the complexity and progression of MetS. To enhance our understanding and consciousness, it is essential to understand the fundamental pathogenesis of MetS. This review highlights current advancements in MetS research including the involvement of gut microbiome, epigenetic regulation, and metabolomic profiling for early detection of Mets. In addition, this review emphasized the epidemiology and fundamental pathogenesis of MetS, various risk factors, and their preventive measures. The goal of this effort is to deepen understanding of MetS and encourage further research to develop effective strategies for preventing and managing complex metabolic diseases.

Microbial Champions: The Influence of Gut Microbiota on Athletic Performance via the Gut-Brain Axis

In recent years, exercise has shown a powerful ability to regulate the gut microbiota received with concern. For instance, compared with the sedentary group, high-level athletes showed a different gut microbiota composition and remarkable capability of physiological metabolism. In addition, different diet patterns (eg, high-fat diet, high carbohydrate diet et.al) have different effects on gut microbiota, which can also affect exercise performance. Furthermore, adaptations to exercise also might be influenced by the gut microbiota, due to its important role in the transformation and expenditure of energy obtained from the diet. Therefore, appropriate dietary supplementation is important during exercise. And exploring the mechanisms by which dietary supplements affect exercise performance by modulating gut microbiota is of considerable interest to athletes wishing to achieve health and athletic performance. In this narrative review, the relationship between gut microbiota, dietary supplements, training adaptations and performance is discussed as follows. (i) The effects of the three main nutritional supplements on gut microbiota and athlete fitness. (ii) Strategies for dietary supplements and how they exerted function through gut microbiota alteration based on the gut-brain axis. (iii) Why dietary supplement interventions on gut microbiota should be tailored to different types of exercise. Our work integrates these factors to elucidate how specific nutritional supplements can modulate gut microbiota composition and, consequently, influence training adaptations and performance outcomes, unlike previous literature that often focuses solely on the effects of exercise or diet independently. And provides a comprehensive framework for athletes seeking to optimize their health and performance through a microbiota-centric approach.

Prevalence of obesity, determinants, and its association with hyperglycaemia among community dwelling older adolescents in India

BACKGROUND

Globally, obesity and diabetes mellitus (DM) are emergent public health concerns in the adolescent population. India, home to the largest adolescent population and the second largest diabetes cohort is experiencing rapid but unplanned urbanization, with accompanying unhealthy nutritional transition, and sedentary lifestyle.

AIM

To determine prevalence and determinants of obesity and hyperglycaemia and their association among community-dwelling older adolescents (15-19 years) in India.

METHODS

This cross-sectional analysis from the national family health survey-5 included data of 258028 adolescents aged 15-19 across India (2019-2021). The survey employed stratified two-stage sampling, with systematic random sampling in rural and urban areas. Statistical analysis included descriptive statistics, bivariate, and multivariable logistic regression, employing generalized linear models.

RESULTS

The weighted prevalence of DM was 1.09% including 0.77% [95% confidence interval (CI): 0.72-0.83] previously diagnosed and 0.32% (95%CI: 0.29-0.35) newly diagnosed cases detected on survey screening. On adjusted analysis, increasing age, higher education levels, higher wealth index, and overweight/obesity were the factors significantly associated with presence of DM. Only 61% of the adolescents with previously diagnosed DM were on anti-diabetes treatment. The weighted prevalence of overweight/obesity among older adolescents was 6.9% with significantly higher odds in the male sex, having higher educational levels, urban residence, and those with a higher wealth index.

CONCLUSION

Nearly one in hundred older adolescents in India have diabetes, with one in three undiagnosed. Strengthening DM screening and treatment access among adolescents through public health programs is urgently warranted.

Seasonal variations and a demographic analysis of digital evacuation incidence for constipation management: A Japanese population-based cohort study

Objective Digital evacuation (DE) is an intervention used to address severe constipation. Literature exists on easily administered laxatives; however, reports on mildly invasive DE usage are limited. This study aimed to elucidate the fundamental data regarding constipation management using a comprehensive national database of DE incidence. Methods This observational epidemiological study analyzed the age- and sex-stratified DE incidence per 1,000 person-years during 2014-2021 using the medical receipt database in Japan. The annual trends were evaluated using Poisson regression models. We examined the month-stratified incidence during 2019-2021 to assess potential seasonal variations using a one-way analysis of variance and unpaired t-tests with the Bonferroni correction for comparisons across the four seasons. Correlation coefficients were calculated to determine the relationship between the meteorological variables and DE incidence. Results Over the 8-year period, the DE incidence amounted to 32,361,846 procedures, with a median of 10.3 procedures per 1,000 person-years. A demographic analysis revealed a minor peak, nadir, and progressive increase peaking in the 0-4-year (22.1 procedures), 5-9-year (1.5 procedures), and ≥90-year (370.7 procedures) age groups, respectively. The age-adjusted DE incidence across all age groups per 1,000 person-years showed a declining annual trend [incidence rate ratio: 0.971 (P<0.0001)]. A seasonal analysis revealed a significant increase in DE procedures during winter compared with summer (P<0.0125). A correlation was observed between the DE incidence and certain meteorological variables, particularly the temperature. Conclusion This study highlights the notable demographic patterns and the impact of seasonal and meteorological factors on the DE incidence.

The price of pressure: nationwide survey on lifestyle disturbances, occupational burnout and compromised perceived-competency among radiology residents in China

Objectives

The competency of radiology directly affects the quality and equity of medical services. Due to their different occupational characteristics compared to other specialists, this study aims to evaluate the impacts of lifestyles on competency and burnout in radiology residents in China.

Materials and methods

A nationwide, cross-sectional survey was conducted from December 1, 2020 to April 30, 2021. A total of 12,208 radiology residents during their standardized residency training in China were invited. Multivariate linear regression and logistic regression were conducted to identify perceived competency and burnout associated with lifestyles.

Results

Of the 3,666 participants, 58.02% were female, 82.24% were aged <30 years, 40.53% were from the Eastern region, and 92.06% obtained a bachelor's degree. The radiology residents with high-level lifestyles had higher competency (β = 0.16, 95% CI = [0.01, 0.32]), particularly in the realms of sleep, physical activity, and alcohol consumption. The correlation was stronger in residents with longer work hours and more night shifts. Residents with insomnia (OR = 7.69, 95% CI = [4.23, 14.67]) and less exercise (OR = 6.24, 95% CI = [1.33, 29.37]) had higher burnout risk, while residents who smoked had a lower risk (OR = 0.60, 95% CI = [0.40, 0.89]). And lifestyle factors had a slightly different impact on emotional exhaustion and depersonalization.

Conclusion

Radiology residents' lifestyles can be emphasized, as it may reflect their pressure and wellbeing and influence their concentration, competency, burnout and performance. Policymakers and hospital administrators should incorporate practical and modifiable strategies into work routines to improve the lifestyle quality of residents.

The development of an augmented reality application for exercise prescription within paediatric oncology: App design and protocol of a pilot study

Background: Children and young people with cancer face barriers when engaging with exercise, such as treatment-related side effects, psychosocial burdens and lack of individualised provisions. Digital health tools, such as smartphone applications, have emerged as a promising driver to support healthcare provisions in exercise prescription among patients. It is vital to explore how such technologies can be developed more effectively in order to strengthen the evidence supporting their use and for more appropriate implementation within healthcare. This study aims to explore user experiences, preferences and suggested improvements from healthy children and young people aged 9-21 years. Methods: An augmented reality (AR) application was specifically developed for children and young people aged 9-21 years undergoing cancer treatment and a protocol for a pilot study was designed. The target sample of this pilot study is 90 healthy children and young people aged 9-21 years. Practical 30-min workshops will be conducted encouraging participants to engage with the smartphone app. Focus groups will explore participant experiences, preferences, and suggested improvements. Data will be analysed deductively with apriori themes derived from the semi-structured interviews. Discussion: Obtaining user experiences, preferences and suggested improvements is especially important for the development of novel apps, such as those prescribing exercise and using algorithms and augmented reality software. Results from this study will directly influence the development of an augmented reality application, which will also be applied within a long-term trial in paediatric oncology.

Time to reach equilibrium deep body temperatures in young and older adults resting in the heat: a descriptive secondary analysis

It is commonly thought that steady-state thermoregulatory responses are achieved within 30-90 min of compensable heat stress. However, this assumption is based on measurements of whole body heat exchange during exercise, which stabilize (equilibrate) more rapidly than deep body temperatures, especially under resting conditions. To support the design of ecologically relevant heat exposure studies, we quantified equilibrium times for deep body temperature, as indexed by rectal temperature, in young and older adults resting in the heat. We also evaluated the lag in rectal temperature equilibrium relative to whole body heat storage (direct calorimetry). Equilibrium times were estimated with data from two laboratory-based trials (NCT04353076 and NCT04348630) in which 83 adults aged 19-80 yr (34 female) were exposed to simulated heat-wave conditions for 8-9 h. When assessed at the group level, it took rectal temperature 3.3 [bootstrap 95% confidence interval: 2.9-3.9] h to reach thermal equilibrium (<0.05°C/h rate of change) in young adults exposed to 40°C, 9% relative humidity (RH). In older adults, who were exposed to a greater range of conditions (31°C-40°C, 9-45% RH), equilibrium times were longer, ranging from 4.4 [3.8-5.3] to 5.2 [4.9-5.4] h. Furthermore, rectal temperature equilibrium was delayed 0.9 [0.5-1.4] and 1.8 [0.9-2.7] h compared with whole body heat storage in young and older adults, respectively (only assessed in 40°C, 9% RH). Individual-level equilibrium times ranged from 1 to 8 h. These findings highlight the importance of ecologically relevant exposure durations in translational research assessing the physiological impacts of hot weather.NEW & NOTEWORTHY Deep body (rectal) temperature took 3-5 h on average and up to 6-8 h at the individual level to reach thermal equilibrium in young and older adults resting in the heat. Furthermore, stable rectal temperatures were delayed by up to 2 h relative to the achievement of heat balance (0 kJ/min rate of heat storage). We provide the first quantification of the temporal profiles of thermal strain during extended rest in conditions simulating hot weather.

Influencing factors of sedentary behaviour in people with chronic obstructive pulmonary disease: a systematic review

BACKGROUND

People with chronic obstructive pulmonary disease (COPD) are more likely to adopt a sedentary lifestyle. Increased sedentary behaviour is associated with adverse health consequences and reduced life expectancy.

AIM

This mixed-methods systematic review aimed to report the factors contributing to sedentary behaviour in people with COPD.

METHODS

A systematic search of electronic databases (Medline, CINAHL, PsycINFO and Cochrane Library) was conducted and supported by a clinician librarian in March 2023. Papers were identified and screened by two independent researchers against the inclusion and exclusion criteria, followed by data extraction and analysis of quality. Quantitative and qualitative data synthesis was performed.

RESULTS

1037 records were identified, 29 studies were included (26 quantitative and 3 qualitative studies) and most studies were conducted in high-income countries. The most common influencers of sedentary behaviour were associated with disease severity, dyspnoea, comorbidities, exercise capacity, use of supplemental oxygen and walking aids, and environmental factors. In-depth findings from qualitative studies included a lack of knowledge, self-perception and motivation. However, sedentarism in some was also a conscious approach, enabling enjoyment when participating in hobbies or activities.

CONCLUSIONS

Influencers of sedentary behaviour in people living with COPD are multifactorial. Identifying and understanding these factors should inform the design of future interventions and guidelines. A tailored, multimodal approach could have the potential to address sedentary behaviour.

PROSPERO REGISTRATION NUMBER

CRD42023387335.

Association between meeting 24-h movement guidelines and health in children and adolescents aged 5-17 years: a systematic review and meta-analysis

Twenty-four-hour movement behaviors have significant implications for physical and mental health throughout one's lifespan. Consistent with movement behaviors, several countries have formulated and published 24-h movement guidelines. This review summarized the studies related to 24-h movement guidelines among children and adolescents from six databases (MEDLINE, EMBASE, PubMed, Web of Science, CINAHL, and SPORTDiscus). In a total of 61 studies that discussed compliance with 24-h movement guidelines, the overall adherence rate was very low (7.1%), with boys exceeding girls, children surpassing adolescents, and regional differences. A total of 39 studies examined the associations between 24-h movement guidelines and health indicators. Findings indicated that meeting all three guidelines was favorably associated with adiposity, cardiometabolic health, mental and social health, physical fitness, health-related quality of life, academic achievement, cognitive development, perceived health, dietary patterns, and myopia. Future research should utilize longitudinal and experimental designs to enhance our understanding of the associations between 24-h movement guidelines and health indicators, thereby aiding the formulation and refinement of such guidelines.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, CRD42023481230.

Chronic exercise and neuropsychological function in healthy young adults: a randomised controlled trial investigating a running intervention

Despite the well-known physical and mental health benefits of regular exercise, many of the world's population, including healthy young adults, grossly undershoot recommended physical activity levels. Chronic exercise has potential to improve cognitive performance and affect in most age groups. However, there is currently a poverty of relevant research in young adults, especially randomised controlled trials. To address this, the current research investigated the effects of a running intervention on neuropsychological function (cognition and affect) in young adults. We predicted that following a running intervention, neuropsychological performance would improve alongside increases in aerobic fitness. Thirty-two healthy young adult university students were randomised (using a 3:1 ratio) into an intervention or control group, with the intervention group (n = 24) asked to run for 30 min three times a week over a 6-week period and the control group (n = 8) asked to maintain their current level of exercise over a 6-week period. We assessed fitness, cognitive performance, affect and running enjoyment at baseline and follow-up, and runners recorded the environmental conditions of their runs. Repeated measures ANCOVAs failed to find any significant effects of the running intervention on fitness or the neuropsychological measures. Anecdotal evidence supported running environment and enjoyment as potentially relevant factors. The failure to find any fitness improvements, which likely underpins the lack of neuropsychological improvements, highlights the importance of monitoring exercise sessions. Coupled with other insights gained from this trial, this article may prove useful towards future endeavours to develop exercise interventions beneficial to young adults.TRN: ACTRN12621000242820, Date of registration: 08/03/2021.

An mHealth Intervention Promoting Physical Activity and Healthy Eating in a Family Setting (SMARTFAMILY): Randomized Controlled Trial

BACKGROUND

Numerous smartphone apps are targeting physical activity (PA) and healthy eating (HE), but empirical evidence on their effectiveness for the initialization and maintenance of behavior change, especially in children and adolescents, is still limited. Social settings influence individual behavior; therefore, core settings such as the family need to be considered when designing mobile health (mHealth) apps.

OBJECTIVE

The purpose of this study was to evaluate the effectiveness of a theory- and evidence-based mHealth intervention (called SMARTFAMILY [SF]) targeting PA and HE in a collective family-based setting.

METHODS

A smartphone app based on behavior change theories and techniques was developed, implemented, and evaluated with a cluster randomized controlled trial in a collective family setting. Baseline (t0) and postintervention (t1) measurements included PA (self-reported and accelerometry) and HE measurements (self-reported fruit and vegetable intake) as primary outcomes. Secondary outcomes (self-reported) were intrinsic motivation, behavior-specific self-efficacy, and the family health climate. Between t0 and t1, families of the intervention group (IG) used the SF app individually and collaboratively for 3 consecutive weeks, whereas families in the control group (CG) received no treatment. Four weeks following t1, a follow-up assessment (t2) was completed by participants, consisting of all questionnaire items to assess the stability of the intervention effects. Multilevel analyses were implemented in R (R Foundation for Statistical Computing) to acknowledge the hierarchical structure of persons (level 1) clustered in families (level 2).

RESULTS

Overall, 48 families (CG: n=22, 46%, with 68 participants and IG: n=26, 54%, with 88 participants) were recruited for the study. Two families (CG: n=1, 2%, with 4 participants and IG: n=1, 2%, with 4 participants) chose to drop out of the study owing to personal reasons before t0. Overall, no evidence for meaningful and statistically significant increases in PA and HE levels of the intervention were observed in our physically active study participants (all P>.30).

CONCLUSIONS

Despite incorporating behavior change techniques rooted in family life and psychological theories, the SF intervention did not yield significant increases in PA and HE levels among the participants. The results of the study were mainly limited by the physically active participants and the large age range of children and adolescents. Enhancing intervention effectiveness may involve incorporating health literacy, just-in-time adaptive interventions, and more advanced features in future app development. Further research is needed to better understand intervention engagement and tailor mHealth interventions to individuals for enhanced effectiveness in primary prevention efforts.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00010415; https://drks.de/search/en/trial/DRKS00010415.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/20534.

Use of Genomics to Develop Novel Therapeutics and Personalize Hypertension Therapy

Hypertension is a prevalent public health problem, contributing to >10 million deaths annually. Though multiple therapeutics exist, many patients suffer from treatment-resistant hypertension or try several medications before achieving blood pressure control. Genomic advances offer mechanistic understanding of blood pressure variability, therapeutic targets, therapeutic response, and promise a stratified approach to treatment of primary hypertension. Cyclic guanosine monophosphate augmentation, aldosterone synthase inhibitors, and angiotensinogen blockade with silencing RNA and antisense therapies are among the promising novel approaches. Pharmacogenomic studies have also been done to explore the genetic bases underpinning interindividual variability in response to existing therapeutics. A polygenic approach using risk scores is likely to be the next frontier in stratifying responses to existing therapeutics.

The key determinants of low back pain among lifestyle behaviors in adolescents: A cross-sectional study from Saudi Arabia

Establishing preventive measures and treatment strategies for adolescents with low back pain (LBP) may be greatly enhanced by fully grasping the complex interaction between LBP and lifestyle behaviors. The key objective of this study was to explore the possible associations between lifestyle behaviors and LBP among adolescents in Saudi Arabia. A cross-sectional study was conducted among high school students from 5 major regions in Saudi Arabia. Participants were enlisted for the research project between May and November 2021. To evaluate the presence/severity of LBP, physical activity, sedentary duration, sleep quality, nutrition, health responsibility, interpersonal relationships, spiritual growth, and stress management, a well-established web-based survey was employed. A total of 2000 students participated, with 57.9% reporting LBP. Students with LBP had lower scores on overall health-promoting lifestyle behaviors and all subscales, including physical activity, compared to those without LBP. Linear regression analysis revealed significant associations between sedentary duration and global sleep quality with pain severity among students with LBP. This study highlights the association between lifestyle behaviors and LBP among adolescents in Saudi Arabia. Promoting physical activity, reducing sedentary behavior, and improving sleep quality may be crucial in preventing and managing LBP in this population. Comprehensive strategies targeting lifestyle behaviors should be implemented to improve the well-being of adolescents and reduce the burden of LBP. Further research is needed to better understand the underlying mechanisms and develop effective preventive and treatment strategies for LBP among adolescents.

The Associations of Physical Activity and Health-Risk Behaviors toward Depressive Symptoms among College Students: Gender and Obesity Disparities

Engaging in health-risk behaviors (HRBs) may be correlated with depressive symptoms among college students, but these relationships require more research. The purpose of this study was to examine the associations of physical activity levels (i.e., light [LPA] and moderate-vigorous [MVPA]) and HRBs (i.e., sedentary behavior [screen-based and non-screen-based behavior] and cigarette and e-cigarette tobacco use) with depressive symptoms in a sample of college students. Physical activity levels and HRBs were assessed through validated questionnaires. In total, 366 students participated (Mage = 22.59 ± 3.54; 60.1% female; 52.9% normal weight). E-cigarette use in males (β = 0.23, p < 0.05) and screen-based sedentary behavior in females (β = 0.14, p < 0.05) showed significant predictive utility toward depressive symptoms. In the overweight/obese group, screen-based sedentary behaviors (β = 0.19, p < 0.05) and e-cigarette use (β = 0.23, p < 0.01) showed significant predictive utility toward depressive symptoms. Females reported higher levels of depressive symptoms (Mfemale = 18.23 vs. Mmale = 14.81; η2 = 0.03) and less MVPA (Mmale = 52.83 vs. Mfemale = 41.09; η2 = 0.06) than males. Enhancing mental health by improving physical activity and eliminating HRBs should be tailored toward at-risk demographics.

[Evolution of sedentarism prevalence in Spanish population between 1987 and 2020]

BACKGROUND AND OBJECTIVE

Sedentary behavior is a predictive factor for numerous diseases. The objective of this study was to assess the evolution of the prevalence of sedentary behavior in the Spanish adult population between 1987 and 2020.

METHODS

The data sources were the National and European Health Surveys. The prevalence of sedentary behavior was assessed in three scenarios (main activity, leisure time and all scenarios). Prevalence of sedentary behavior was estimated overall, by sex and age group. In all scenarios, prevalence was also estimated by Autonomous Community. The prevalence trend was analyzed with the annual percent change (APC) obtained through joinpoint models.

RESULTS

The prevalence of sedentary in the main activity ranged from 31.2% in 1987 to 38.4% in 2020 [PCA: 0.7 (0.5-1.0)], being higher in men than in women and higher in younger and older people. The prevalence of sedentary in the leisure time varied between 55.1% in 1993 and 36.4% in 2020 [PCA: -1.4 (-1.9 to -0.9)], being always higher in women, higher in those over 64 years of age and lower in those aged 16-24 years. Cantabria and the Canary Islands were the Autonomous Communities with the lowest prevalence of sedentary behavior in all scenarios.

CONCLUSIONS

The prevalence of sedentary behavior in the main activity is increasing in Spain, whereas during leisure time it is decreasing. It is important to implement prevention and health promotion measures aimed at reducing sedentary behavior in the population.

Active time at work following the introduction of a standing and a cycling workstation into worker's office space

Objectives. Active workstations have been proposed to counteract sedentary behavior at work. This study describes office workers' use of and perceptions toward standing and cycling workstations, and assesses whether the two active workstations were sufficient to break sitting time and replace it with 2-4 h of light activity per workday. Methods. This mixed-method study utilized video recording, semi-structured interviews and a questionnaire. The quantitative data covered time spent sitting, standing and on a cycling workstation. The qualitative data were analyzed based on preferences, barriers and facilitators. Results. Participants (n = 15) used active workstations 125.3 (74.5) min/day and spent 79.0 (63.6) min/day using standing versus 46.3 (47.6) min/day using cycling workstations (p = 0.153, d = 0.58). Following the interviews, the standing workstation was preferred over cycling. The ergonomics of the cycling workstation were not optimal and caused discomfort in use. Seven participants broke their sitting time and accumulated 2+ h of light physical activity per workday. Those participants meeting recommendations were older, had a higher body fat percentage and engaged in less physical activity per week. Conclusion. With a preference for standing workstations, our results showed that 47% of workers used standing and cycling workstations to accumulate 2+ h of active time per day.

Effects of active video games on physical activity among overweight and obese college students: a systematic review

Background

The purpose of this study was to critically review the existing literature on the effects of active video games (AVGs) on physical activity in overweight and obese college students to determine whether AVGs can promote and achieve recommended levels of physical activity. The results should provide constructive input for future research.

Methods

A total of five international databases including PubMed, SCOPUS, Web of Science, CINAHL Plus, and EBSCOhost were searched with keywords related to "active video games," "physical activity," and "obese college students" from July 2022. A systematic review was conducted using the PRISMA guidelines and randomised controlled trial (RCT) studies that met the inclusion criteria were included. Furthermore, the quality assessment of the studies was measured using the PEDro scale.

Results

One thousand and twenty-three articles were retrieved, of which eight randomised controlled trial studies met the inclusion criteria. AVGs can reduce sedentary behaviour and positively affect physical activity, time spent on moderate-to-vigorous physical activity (MVPA), positive psychological factors, and game attendance rate. Combining AVGs with other assistive devices (such as mini-trampolines and stationary bikes) can enhance the effects of AVGs and provide greater physiological stimulation. Different types of AVGs and game modes can achieve different emotional responses, physiological stimulation, and physical activity levels.

Conclusion

The research findings prove that AVGs can be a viable intervention to increase physical activity in overweight or obese college students, ultimately reaching the recommended physical activity level(PAL). Physical activity can be further increased by incorporating assistive devices or using features supported by self-determination theory (SDT). As a new modality, AVGs could be a potential alternative to traditional physical activity.Systematic Review Registration:https://www.crd.york.ac.uk/prospero, identifier: CRD42022363993.

Development and validation of a lifestyle risk index to screen for metabolic syndrome and its components in two multi-ethnic cohorts

BACKGROUND

Metabolic syndrome (MetS) is a precursor to cardiovascular diseases and type 2 diabetes. Existing MetS prediction models relied heavily on biochemical measures and those based on non-invasive predictors such as lifestyle behaviours were limited. We aim to (1) develop a weighted lifestyle risk index for MetS and (2) externally validate this index using two Asian-based cohorts in Singapore.

METHODS

Using data from the Multi-Ethnic Cohort (MEC) 1 (n = 2873, 41% male), multiple logistic regression was used to identify predictors associated with MetS. A weighted lifestyle risk index was generated using coefficients of the selected predictors in the development cohort (MEC1). Subsequently, the performance of the lifestyle risk index in predicting the occurrence of MetS within 10 years was assessed by discrimination and calibration in an external validation cohort (MEC2) (n = 6070, 43% male).

RESULTS

A lifestyle risk index for MetS with nine predictors was developed (age, sex, ethnicity, having a family history of diabetes, BMI, diet, physical activity, smoking status, and screen time). This index demonstrated acceptable discrimination in the development cohort [AUC (95% CI) = 0.74 (0.71, 0.76)] and the validation cohort [AUC (95% CI) = 0.79 (0.77, 0.81)].

CONCLUSION

This lifestyle risk index exhibits potential for risk stratification in population-based screening programmes. Future research could apply a similar methodology to develop disease-specific lifestyle risk indices using nationwide registry-based data.

Chronic blue light-emitting diode exposure harvests gut dysbiosis related to cholesterol dysregulation

Night shift workers have been associated with circadian dysregulation and metabolic disorders, which are tightly coevolved with gut microbiota. The chronic impacts of light-emitting diode (LED) lighting at night on gut microbiota and serum lipids were investigated. Male C57BL/6 mice were exposed to blue or white LED lighting at Zeitgeber time 13.5-14 (ZT; ZT0 is the onset of "lights on" and ZT12 is the "lights off" onset under 12-hour light, 12-hour dark schedule). After 33 weeks, only the high irradiance (7.2 J/cm2) of blue LED light reduced the alpha diversity of gut microbiota. The high irradiance of white LED light and the low irradiance (3.6 J/cm2) of both lights did not change microbial alpha diversity. However, the low irradiance, but not the high one, of both blue and white LED illuminations significantly increased serum total cholesterol (TCHO), but not triglyceride (TG). There was no significant difference of microbial abundance between two lights. The ratio of beneficial to harmful bacteria decreased at a low irradiance but increased at a high irradiance of blue light. Notably, this ratio was negatively correlated with serum TCHO but positively correlated with bile acid biosynthesis pathway. Therefore, chronic blue LED lighting at a high irradiance may harvest gut dysbiosis in association with decreased alpha diversity and the ratio of beneficial to harmful bacteria to specifically dysregulates TCHO metabolism in mice. Night shift workers are recommended to be avoid of blue LED lighting for a long and lasting time.

Pilot study testing the effects of a multicomponent intervention for increasing moderate-intensity physical exercise

Physical inactivity has been associated with several health problems, including diabetes, obesity, and heart disease. Although many of these health problems are preventable through regular exercise, a small percentage of the adult population engages in the recommended levels. Reinforcement-based interventions have been implemented successfully to promote physical activity, but studies targeting moderate or vigorous physical exercise using behavior-analytic interventions are scarce. The purpose of the current study was to investigate the feasibility of a multicomponent intervention that provided monetary incentives for increasing running, jogging, or brisk walking distance for five adults. The intervention lasted 6 weeks and comprised weekly goal setting, feedback, public posting, and group contingencies. The results of the study suggest that the intervention may be feasible and effective at increasing moderate physical activity to levels recommended by the federal guidelines, but further research is warranted.

Feasibility of student-designed, peer-led classroom physical activity breaks in graduate school

Objective: We evaluated the feasibility of Pitt Moves, a classroom-based, peer-led physical activity break (PAB) intervention developed by graduate students to improve mood, focus, and boredom among students. Participants: One hundred and thirty-two graduate-level students in 10 courses during an academic semester. Methods: Process evaluation with a formative focus involving document review, surveys, and interviews with students and facilitators. Results: Eighty-four percent of eligible students participated in ≥1 of 65 PABs. Participants said Pitt Moves provided a mental break, promoted community building, and increased their physical activity. They recommended increasing accessibility. Organizers' time was a constraint in running this program. Conclusion: Pitt Moves was feasible based on successful recruitment of participants, delivery of PABs as planned, and participant acceptability. A formal study should evaluate whether Pitt Moves can improve mood, focus, and boredom among graduate students. Organizational encouragement and audiovisuals could enhance marketing and program implementation.

Physical activity level and sedentary time determinants among Moroccan hypertensive patients

INTRODUCTION

Hypertension is closely associated with an inactive lifestyle. Physical activity and/or exercise have been shown to delay the development of hypertension. This study aimed to assess the level of physical activity and sedentary time, and its determinants among Moroccan Hypertensive patients.

PATIENTS AND METHODS

A cross-sectional study was conducted between March and July 2019 including 680 hypertensive patients. We administered international physical activity questionnaire in face-to-face interview to assess the level of physical activity and sedentary time.

RESULTS

The results showed that only 43.4% of participants met recommended physical activity levels (≥ 600 MET min/week). Adherence to physical activity recommendations was observed more in male participants (p = 0.035), in participants aged less than 40 years (p = 0.040) and those aged between 41 and 50 years (p = 0.047). The average sedentary time was 37.19 ± 18.92 hours per week. This time was significantly longer in people aged 51 and over, in married, divorced, and widowed people, and in those with low levels of physical activity.

CONCLUSIONS

The level of physical inactivity and the sedentary time was high. In addition, participants with a high-level sedentary lifestyle had a low level of physical activity. Educational actions should be undertaken among this group of participants to prevent the risks associated with inactivity and sedentary behavior.

Association between Physical Activity and Sitting Time Related to Excess Body Weight in Brazilian University Students

High exposure to sedentary behavior and lower levels of physical activity can lead to excess body weight (EBW). The aim of this study was to estimate the prevalence of EBW and the direct association under the condition of sociodemographic, university, and behavioral moderating characteristics, between physical activity and sitting time related to EBW in Brazilian university students. A cross-sectional study was carried out with 1,110 university students from a federal public institution in Minas Gerais, Brazil. The outcome was the EBW (body mass index: ≥25.0 kg/m2) and the independent variables were physical activity (insufficiently active and active) and sitting time (<6 h/day; ≥6 h/day). Association analyses were estimated via odds ratio (OR) using binary logistic regression. The significance level was 5%. The prevalence of EBW was 27.8%. No direct association was observed between physical activity and time sitting related to EBW. However, insufficiently active university students were more likely to have EBW (OR = 1.91; 95% CI: 1.06-3.47) when they did not consume alcoholic beverages, and university students with a sitting time of ≥6 h/day had lower chances of having EBW (OR = 0.62; 95% CI: 0.40-0.95) when they had spent more time at university (3 years or more). It is concluded that the prevalence of EBW in university students was high and there was no direct association between physical activity and sitting time; however, alcohol consumption and university time moderated the association with higher and lower chances of occurrence of EBW in university students, respectively.

Trends in non-operative management of low-energy pelvic fracture: An analysis of the Nationwide Inpatient Sample

Introduction

Non-operative management is common for low-impact pelvic fractures. In this study, we characterize the epidemiology of those treated nonoperatively following low-energy pelvic fracture, while identifying recent management trends.

Methodology

Data from the Nationwide Inpatient Sample (NIS) database from 2011 to 2018 were analyzed. We identified adult patients diagnosed with pelvic fracture based on International Classification of Diseases (ICD) codes, excluding fractures of the acetabulum, femur, polytrauma, and open fractures to isolate cases caused by low-impact mechanisms. Codes indicating operative management were excluded. Demographic information and outcomes (length of stay, in-hospital mortality, hospital discharge status) were collected. Sub-analyses were performed to identify trends.

Findings

123,936 eligible patients were identified. The average age was 68.7 years. 70% were female, showing a decline from 75% to 66% over the study period. Pubic bone involvement was observed in 59% of fractures. The mean Charlson Comorbidity Index (CCI) was 3.83, corresponding to a 10-year survival rate of 58.5%, which remained relatively stable throughout the study period. 62.4% of patients received treatment at urban teaching hospitals. Average length of hospital stay was 6.3 days. Discharge to a skilled nursing facility (SNF) was the most common outcome, ranging from 62.1% to 65.0% during the study period, while 20.0% of patients were discharged home (18.4%-21.1%). Mean in-hospital mortality was 3.28%, showing no significant change, with higher rates among male patients (5.1%) and patients of Asian descent (3.8%).

Conclusion

The majority of patients receiving nonoperative treatment for low-energy pelvic fractures were females in their mid-60s with moderate comorbidity. The study reveals a relatively high in-hospital mortality rate of 3.28%, particularly among male patients and those of Asian descent, indicating the need for increased surveillance for further injury in these groups. Most patients were discharged to a SNF, highlighting the necessity for extended rehabilitation in this population. This persistent trend is noteworthy considering the growing emphasis on the cost of inpatient admissions and advancements in outpatient management of orthopedic injuries.

Use of electronic devices in leisure time modifies the prevalence and factors associated with sedentary behavior derived exclusively from excessive television viewing among Brazilian adults

The growing interest in the study of sedentary behavior is justified by its increasing presence in people's daily lives, particularly in leisure time. The aim of this study was to compare the prevalence and factors associated with sedentary behavior derived exclusively from TV time and from its combination with the time spent using other electronic devices among Brazilian adults (n = 52,443). This cross-sectional study used data from the Vigitel survey (2019), which included subjects ≥ 18 years old who resided in the capitals of the 26 Brazilian states and Federal District. High TV time (≥ 4 h/day), and its combination with computer, tablet, or cell phone use (≥ 4 h/day), as well as sociodemographic, behavioral, and health characteristics were self-reported. Adjusted logistic regression was used to estimate odds ratios and 95% confidence intervals (95%CI). The prevalence of high sedentary behavior almost tripled when TV viewing was added to the time spent using other electronic devices (from 12.2%; 95%CI: 11.6; 12.8, to 34.7%; 95%CI: 33.8; 35.6), notably among the youngest (32.0 percentage points). Individuals living without a partner, who smoked, consumed alcohol and processed foods excessively, were physically inactive, and had hypertension were more likely to have both outcomes than their counterparts. Older and less educated individuals were more likely to spend excessive time watching TV and less likely to have high use of other electronic devices in addition to TV viewing than their peers. Including computer, tablet, or cell phone led to an increase in the prevalence of high sedentary behavior. The magnitude and direction of the associations of age and education with high sedentary behavior varied according to the method how high sedentary behavior was defined. Projects, programs, and policies must consider the different indicators of sedentary behavior in monitoring and promoting a healthier lifestyle.

A Potential Role for Sirtuin-1 in Alzheimer's Disease: Reviewing the Biological and Environmental Evidence

Sirtuin-1 (Sirt1), encoded by the SIRT1 gene, is a conserved Nicotinamide adenine dinucleotide (NAD+) dependent deacetylase enzyme, considered as the master regulator of metabolism in humans. Sirt1 contributes to a wide range of biological pathways via several mechanisms influenced by lifestyle, such as diet and exercise. The importance of a healthy lifestyle is of relevance to highly prevalent modern chronic diseases, such as Alzheimer's disease (AD). There is growing evidence at multiple levels for a role of Sirt1/SIRT1 in AD pathological mechanisms. As such, this review will explore the relevance of Sirt1 to AD pathological mechanisms, by describing the involvement of Sirt1/SIRT1 in the development of AD pathological hallmarks, through its impact on the metabolism of amyloid-β and degradation of phosphorylated tau. We then explore the involvement of Sirt1/SIRT1 across different AD-relevant biological processes, including cholesterol metabolism, inflammation, circadian rhythm, and gut microbiome, before discussing the interplay between Sirt1 and AD-related lifestyle factors, such as diet, physical activity, and smoking, as well as depression, a common comorbidity. Genome-wide association studies have explored potential associations between SIRT1 and AD, as well as AD risk factors and co-morbidities. We summarize this evidence at the genetic level to highlight links between SIRT1 and AD, particularly associations with AD-related risk factors, such as heart disease. Finally, we review the current literature of potential interactions between SIRT1 genetic variants and lifestyle factors and how this evidence supports the need for further research to determine the relevance of these interactions with respect to AD and dementia.

Planning engagement with web resources to improve diet quality and break up sedentary time for home-working employees: A mixed methods study

As home working becomes more common, employers may struggle to provide health promotion interventions that can successfully bridge the gap between employees' intentions to engage in healthier behaviors and actual action. Based on past evidence that action planning can successfully encourage the adoption of healthier behaviors, this mixed-methods study of a web-based self-help intervention incorporated a randomized planning trial that included quantitative measures of engagement and follow-up qualitative interviews with a subsample of participants. Participants either (a) selected a movement plan for incorporating a series of 2-min exercise videos into their work week to break up sedentary time and a balanced meal plan with recipe cards for a week's lunches and dinners or (b) received access to these resources without a plan. Selecting a movement plan was more effective at increasing engagement with the web resources compared to the no-plan condition. In the follow-up interviews, participants indicated that the plan helped to remind participants to engage with the resources and made it simpler for them to follow the guidance for exercises and meals. Ease of use and being able to fit exercises and meals around work tasks were key factors that facilitated uptake of the resources, while lack of time and worries about how colleagues would perceive them taking breaks to use the resources were barriers to uptake. Participants' self-efficacy was associated with general resource use but not plan adherence. Overall, including plans with online self-help resources could enhance their uptake. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Vigorously cited: a bibliometric analysis of the 100 most cited sedentary behaviour articles

OBJECTIVES

No citation analysis has examined peer-reviewed sedentary behaviour research articles, which is needed to assess the impact of this research and identify knowledge gaps. Therefore, this study aimed to identify the 100 most cited sedentary behaviour articles and examine their bibliometric characteristics.

METHODS

All databases indexed in the Web of Science database were searched in October 2022, and bibliometric characteristics of the studies, irrespective of the publication year, were imported and calculated. Descriptive statistics and visualisations by the VOSviewer were used for the presentation of bibliometric characteristics.

RESULTS

The 100 most cited articles received 49,062 citations in total, with a median citation density of 32.5 citations per article per year. The majority of included articles were reviews (n = 48; 22,856 citations), focused on adults (58%; 26,809 citations) and reported on the relationship of sedentary behaviour with health (n = 64; 34,598 citations); more specifically they focused on anthropometric indices (28%), metabolic health (24%), and mortality (23%). The United States was ranked first in terms of the overall for most cited articles. However, Australia was ranked first for institutions and authors contributing to the most cited sedentary behaviour articles.

CONCLUSIONS

Papers published after 2007 were predominant in the list of 100 most cited sedentary behaviour papers, as were those focusing on associations with physical health outcomes and those focusing on adults. While original articles were cited more, discussion papers had more impact on the field as they received more citations in less time. Research examining associations between sedentary behaviour and health was cited more. The field is dominated by contributions from high-income countries.

Systematic Review of Easy-to-Learn Behavioral Interventions for Dietary Changes Among Young Adults

INTRODUCTION

Improving the diet quality of young adults may support chronic disease prevention. The approaches used and efficacy of promoting small dietary behavior changes through easy-to-learn (ETL) interventions (requiring no more than 1 hour to teach the behavior) among young adults have not yet been systematically reviewed.

METHODS

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 2 independent electronic searches across 6 databases were conducted to identify any articles describing ETL interventions among young adults (aged 18-35 years) and reporting dietary intake outcomes.

RESULTS

Among 9,538 articles identified, 9 studies met eligibility criteria. Five studies reported significant improvement in the selected dietary outcome. Of these, 3 studies used an implementation intentions approach, in which participants were given or asked to write out a simple dietary behavior directive and carry it on their person. Less than half of included studies were rated as positive for overall quality.

DISCUSSION

The available evidence suggests that ETL interventions targeting the dietary behaviors of young adults may be effective in improving dietary intake. Limitations of included studies were lack of follow-up after the intervention period and low generalizability.

IMPLICATIONS FOR RESEARCH AND PRACTICE

Further dietary intervention studies targeting young adults should systematically evaluate the efficacy of ETL intervention approaches among diverse samples.

Energy Costs of Chair Sitting and Standing Video Exercises in Chinese Older Adults Over 60 Years

Home-based video exercise interventions improve older adults' physiological performance and functional capacity. Little is known about the energy costs of video exercises in older adults. The Compendium of Physical Activities (PAs) has few items with PA metabolic equivalents (METs) in older adults. This study measured the energy costs of four chair and two standing exercises (sitting Tai Chi, Yoga, mobility ball, aerobics: standing, slow aerobics, and fast aerobics). Fifteen females and 14 males, 62-87 years (M ± SD, 73 ± 7.7 years), were categorized into three age groups (60-69, 70-79, 80-89). Oxygen uptake (VO2, ml·min-1·kg-1) and heart rate (HR, b·min-1) were measured by indirect calorimetry and heart rate monitor. MET values were calculated as standard- (activity VO2/3.5), rounded- (significant digit rounded to 0, 3, 5, 8), and corrected METs (individual resting metabolism). Results showed chair Yoga, Tai Chi, and mobility ball ranged from 2.0 to 2.8 rounded METs (light intensity). Chair- and standing aerobics ranged from 3.0 to 4.3 rounded METs (moderate intensity). Averaged HR ranged from 91.9 ± 12.7 b·min-1 to 115.4 ± 19.1 b·min-1 for all PAs. Corrected METs were higher than standard METs (P < .05). Standard METs were similar between age groups (P > .05). In conclusion, this study is unique as it measures the energy costs of sitting and standing video exercises that can be performed by older adults at home or in an exercise facility. Knowing the energy costs of PAs for older adults can provide exercises interventions to prevent sedentary lifestyles.

Knowledge of physical activity, physical activity level and waist-to-hip ratio in adults with diabetes in a Ghanaian municipality

Objectives

To investigate the knowledge about physical activity, physical activity levels and waist-to-hip ratio among persons living with diabetes in the Ho Municipality.

Design

Cross-sectional observation study.

Setting

The researcher collected data from two diabetes clinics in the Ho Municipality of Ghana.

Participants

Consenting persons living with diabetes who attended the diabetes clinics.

Main outcome measures

Participants' waist-to-hip ratio, knowledge of the physical activity and level of activity according to the International Physical Activity Questionnaire.

Results

There were 106 participants, and the modal age was 60 years or older (50.94% (n= 54)). Of the total, 62.3% (n = 66) were women, and the mean knowledge level was 12.7±1.58 (range: 0-17). Mean waist-to-hip ratio was 0.92 ± 0.10) with 25.5% (n = 27) men and 48.1% (n = 51) women recording abnormally increased waist-to-hip ratios. Additionally, 44% of participants engaged in low physical activity levels, whereas 10% participated in high levels. There were no significant associations between physical activity levels and waist-to-hip ratios (r = 0.176, p=0.071).

Conclusion

Persons with diabetes in the Ho Municipality mostly engaged in low and moderate physical activity levels and had abnormally increased waist-to-hip ratios suggesting abdominal obesity. Knowledge of physical activity may be associated with physical activity performance and waist-to-hip ratio, bearing an inverse association with physical activity levels.

Funding

None declared.

Exergames to Limit Weight Gain and to Fight Sedentarism in Children and Adolescents with Obesity

Exergames are defined as digital games that require bodily movements to play, stimulating an active gaming experience to function as a form of physical activity (PA). The players interact with the game through whole-body movements improving energy expenditure. Exergames may be effective in improving physical and psychological aspects of children and adolescents with obesity. In this narrative review, we synthesized the current evidence regarding the role of exergames in modifying body composition and weight and in promoting changes in sedentary behavior to define the benefits of active video games as useful tools for fighting sedentarism and to outline the future directions of exergaming as a supplementation exercise rather than a replacement in educational programs for pediatric obesity. Data from the literature indicate that exergames may offer an interesting impact on childhood obesity and may be considered a potential strategy for controlling weight gain and body composition, promote PA, and decrease time spent on sedentary behavior in children and adolescents with obesity. However, exergame use also has some limits, such as children's poor self-regulation and poor structuring of exergame use. Therefore, a prudent approach should be maintained, and additional high-quality research is needed to determine if exergames can be effectively used in the treatment of childhood obesity and if new digital media, as a supplementation of exercise rather than a replacement, could be considered to combat sedentary behavior in educational programs for pediatric obesity prevention.

The Role of Wearable Sensors to Monitor Physical Activity and Sleep Patterns in Older Adult Inpatients: A Structured Review

Low levels of physical activity (PA) and sleep disruption are commonly seen in older adult inpatients and are associated with poor health outcomes. Wearable sensors allow for objective continuous monitoring; however, there is no consensus as to how wearable sensors should be implemented. This review aimed to provide an overview of the use of wearable sensors in older adult inpatient populations, including models used, body placement and outcome measures. Five databases were searched; 89 articles met inclusion criteria. We found that studies used heterogenous methods, including a variety of sensor models, placement and outcome measures. Most studies reported the use of only one sensor, with either the wrist or thigh being the preferred location in PA studies and the wrist for sleep outcomes. The reported PA measures can be mostly characterised as the frequency and duration of PA (Volume) with fewer measures relating to intensity (rate of magnitude) and pattern of activity (distribution per day/week). Sleep and circadian rhythm measures were reported less frequently with a limited number of studies providing both physical activity and sleep/circadian rhythm outcomes concurrently. This review provides recommendations for future research in older adult inpatient populations. With protocols of best practice, wearable sensors could facilitate the monitoring of inpatient recovery and provide measures to inform participant stratification and establish common objective endpoints across clinical trials.

The impact of the covid-19 pandemic on lifestyle behaviors in U.S. college students

OBJECTIVE

To investigate COVID-19's impact on college student health behaviors.

PARTICIPANTS

189 college students.

METHODS

Participants completed an online survey on behaviors relating to sleep, sedentary activities, and physical activity before and during the COVID-19 pandemic. Comparisons utilized Students' dependent t-test or Wilcoxon signed-rank tests.

RESULTS

There was an increase in time to fall asleep (before: 23.4 ± 18.0 vs. during: 42.8 ± 44.3 min·day^-1, p < 0.001), time spent in bed (before: 7.8 ± 1.5 vs. during: 8.5 ± 1.5 hr·day^-1, p < 0.001), as well as shifts in later bed and awake time (p < 0.001). Total sedentary time increased during the pandemic (before: 9.0 ± 3.8 vs. during: 9.9 ± 4.1 hr·day^-1, p = 0.016); and time spent using a TV, computer, or phone (before: 3.1 ± 1.9 vs. during: 4.2 ± 2.3 hr·day^-1, p < 0.001). There was a significant decrease in moderate-vigorous activity (before: 123.8 ± 96.0 vs. during: 108.9 ± 75.5 min·week^-1, p = 0.028) and resistance training days (before: 2.4 ± 2.1 vs. during: 1.7 ± 2.1 days·week^-1, p < 0.001).

CONCLUSIONS

COVID-19 negatively influenced health behaviors in college students.

Musculoskeletal pain among medical students and its association with perceived stress level: A cross-sectional study

BACKGROUND

Musculoskeletal pain (MSP) is common among medical students across the world. The present study was done to estimate the prevalence of MSP among medical students in the state of Sikkim, India, and to assess perceived stress levels among medical students and its association with MSP.

MATERIALS AND METHOD

A cross-sectional study was carried out at a private medical college in the state of Sikkim, India. Fifty students each from the third, fifth, seventh, and ninth semesters were included in the study. Students were asked to complete a questionnaire that included data regarding lifestyle habits and activities, the modified Nordic scale for MSP, perceived stress score (PSS-10), and Oswestry disability index (ODI) questionnaire.

RESULTS

The majority (73%) of the participants reported one or more episodes of MSP in the past 12 months and 50% of them had pain in the past 7 days. No significant association was found between MSP and lifestyle habits, mean time spent on physical activities and sedentary behavior. The perceived stress level was significantly higher among those with MSP in the past 12 months (19.7 ± 5.6) (P-0.021), as well as in those who had MSP in the past 7 days (20.8 ± 5.5) (P-0.001). Severe pain was significantly associated with a higher perceived stress score (23 ± 5) (P-0.003). Students who had MSP in the past 12 months as well as in past 7 days had a higher quality of life score (9.8 ± 10.6, P-0.039 and 13 ± 10.9, P-0.000, respectively).

CONCLUSION

The majority of our medical students have experienced musculoskeletal pain in the past 12 months, which is significantly associated with perceived stress and quality of life.

Examining the effects of the COVID-19 pandemic on life through interviews conducted by nursing students: a qualitative study

This study was aimed to determine the effects of the pandemic on life. This is a qualitative descriptive study and data were collected through semi-structured interviews (n = 200). The data were obtained by retrospectively examining the interviews made by the students between January and May 2021. The researchers prepared 'Participant Information Form' and 'Semi-Structured Interview Form', which were utilised as data collection tools during the interviews. The qualitative data acquired from the semi-structured interview using descriptive analysis. In the interviews, nursing students are in the role of interviewers. Participants were determined from among the relatives of the students. The research was structured and reported in accordance with the Consolidated Criteria for Reporting Qualitative Research Checklist. The data acquired regarding the effects of the pandemic on life were conceptualised under three themes (nine sub-themes): the meaning of the pandemic(1), the effects of the pandemic on life(2), and coping with the pandemic(3). The study revealed that the pandemic included individual meanings at levels of emotions (fear, hopelessness, loneliness, despair, and uncertainty) and cognition - behaviour (danger, attention-caution, restriction and awareness).Pandemic resulted in changes in the life routines of the participants, changes in mental and social spheres, and various effects as the effect of the disease such as pain.Spiritual approaches (prayer and positive thinking), as well as social support and healthy lifestyle habits, were the methods used to cope with the pandemic. It is recommended that psychiatric nurses plan and implement individual/social interventions based on a psychosocial approach in order to cope with the short and long-term effects of the pandemic.

Supplementary information

The online version contains supplementary material available at 10.1007/s12144-023-04522-3.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Effects of physical activity breaks during prolonged sitting on vascular and executive function—A randomised cross-over trial

Objectives

High sedentary behaviour is associated with adverse effects on central vascular function and cognitive function. Although interventions to mitigate the adverse effects of workplace sitting are intriguing, evidence of the efficacy of such interventions remains lacking. This randomised cross-over trial was aimed at exploring the effectiveness of prolonged sitting, with or without physical activity breaks, on central, peripheral vascular and cognitive function in adults.

Methods

Twenty one healthy adults completed 4 h of simulated work conditions in three experimental visits: (1) uninterrupted sitting (SIT); (2) sitting interrupted by 3 min of walking every hour (LIT); and (3) sitting interrupted by 3 min of stair climbing every hour (MIT). Carotid (CA) and superficial femoral artery (SFA) diameter, velocity, shear rate and blood flow were measured with Duplex ultrasound at 50 MHz at three time points (hours 0, 2 and 4), and executive function was assessed with the computer based Eriksen Flanker task every hour.

Results

The decreases in reaction time (-30.59%) and accuracy (-10.56%) during SIT conditions were statistically significant, and less of a decrease was observed under LIT and MIT conditions. No significant differences in CA and SFA function were observed with LIT and MIT interventions.

Conclusion

Physical activity breaks of varying intensity during prolonged sitting improve reaction time. However, the vascular benefits of physical activity breaks should be confirmed in the future through long term studies in natural environment.

Effect of physical activity intervention on the musculoskeletal health of university student computer users during homestay

Objectives. The coronavirus outbreak delivered the condition of dying from infection and forced people (especially university student computer users) to perform all working and non-working activities during homestay. In this situation, device usage for a longer duration is mainly responsible for work-related health issues. This study aims to discover the effect of a physical activity intervention (PAI) on computer users' musculoskeletal health during homestay. Methods. The investigation was performed on 40 university student computer users. To measure body discomfort before and after using the PAI, the body part discomfort scale of Corlett and Bishop was applied. Results. After implementing the PAI, the musculoskeletal disorder (MSD) decrement in major body regions was reported as wrist/forearm (from 8.17 ± 1.45 to 4.57 ± 1.10), lower back (from 8.01 ± 1.42 to 4.40 ± 1.14), elbow (from 7.57 ± 1.71 to 3.49 ± 1.13) and neck (from 7.40 ± 1.71 to 4.02 ± 0.81). Conclusions. PAI significantly decreased the discomfort among users in various body regions. This research suggested that PAIs may reduce the risk of MSDs in the long term for different body regions.

New management of surveillance in patients with baseline serrated polyps: a large single-center retrospective cohort study in China

BACKGROUND

Serrate d polyps (SP) is associated with an increased risk of colorectal cancer. Patients with SP history tend to have SP recurrence. However, the risk factors for metachronous polyps (MP) in those patients are not well established.

METHODS

Data of colonoscopy were retrospectively reviewed from October 2012 to October 2021. The pathology database, electronic medical records and telephone follow-up data were also observed.

RESULTS

A total of 906 patients were studied including 278 patients with MPs and 628 patients without. The multiplicity of polyps (OR, 13.63; 95% CI, 8.80-21.75), older age (OR, 5.71; 95% CI, 1.87-20.63), abdominal obesity (OR, 2.46; 95% CI, 0.98-6.42), current smoker (OR, 2.93; 95% CI, 1.15-7.83) and sedentary lifestyle (OR, 1.41; 95% CI, 1.22-1.65) are significantly associated with the risk of MPs. Patients with baseline SP < 10 mm were more likely to develop higher or same risk-grade polyps (HSRGP) ( P  = 0.0014). Patients with non-clinically significant SPs whether coexisted with adenoma or not were more likely to develop HSRGPs when compared to others ( P  < 0.001).

CONCLUSION

Total number of polyps, older age, sedentary behavior, abdominal obesity and smoking status contributed to the risk of MPs at surveillance colonoscopy. Patients with grade 1 SPs might require closer surveillance. SPs coexisting with conventional adenoma did not increase the risk of MPs but may increase the risk of developing HSRGPs.

Effect of simultaneous exercise and cognitive training on executive functions, baroreflex sensitivity, and pre-frontal cortex oxygenation in healthy older adults: a pilot study

Aging is characterized by cognitive decline affecting daily functioning. To manage this socio-economic challenge, several non-pharmacological methods such as physical, cognitive, and combined training are proposed. Although there is an important interest in this subject, the literature is still heterogeneous. The superiority of simultaneous training compared to passive control and physical training alone seems clear but very few studies compared simultaneous training to cognitive training alone. The aim of this pilot study was to investigate the effect of simultaneous exercise and cognitive training on several cognitive domains in healthy older adults, in comparison with either training alone. Thirty-five healthy older adults were randomized into one of three experimental groups: exercise training, cognitive training, and simultaneous exercise and cognitive training. The protocol involved two 30-min sessions per week for 24 weeks. Cognitive performance in several domains, pre-frontal cortex oxygenation, and baroreflex sensitivity were assessed before and after the intervention. All groups improved executive performance, including flexibility or working memory. We found a group by time interaction for inhibition cost (F(2,28) = 6.44; p < 0.01) and baroreflex sensitivity during controlled breathing (F(2,25) = 4.22; p = 0.01), the magnitude of improvement of each variable being associated (r = -0.39; p = 0.03). We also found a decrease in left and right pre-frontal cortex oxygenation in all groups during the trail making test B. A simultaneous exercise and cognitive training are more efficient than either training alone to improve executive function and baroreflex sensitivity. The results of this study may have important clinical repercussions by allowing to optimize the interventions designed to maintain the physical and cognitive health of older adults.

The role of physical activity in the regulation of body weight: The overlooked contribution of light physical activity and sedentary behaviors

The role of physical activity (PA) in the regulation of body weight is still a major topic of debate. This may be because studies have essentially focused on the effects of moderate/vigorous PA (MVPA) on body weight while overlooking the other components of PA, namely, light-intensity PA (LPA, daily life activities) and sedentary behaviors (SB, too much sitting). In this review, we will (i) describe the history of changes in PA behaviors that occurred with modernization; (ii) review data from cross-sectional and longitudinal studies that examined the associations between PA, SB, and measures of obesity; (iii) review interventional studies that investigated the effects of changes in PA and SB on body weight and adiposity; and (iv) discuss experimental studies that addressed potential biological mechanisms underlying the effects of PA and SB on weight regulation. Overall recent findings support the importance of considering all components of PA to better understand the regulation of energy balance and suggest an important role for LPA and SB in addition to MVPA on body weight regulation. Longitudinal large-scale rigorous studies are needed to advance our knowledge of the role of PA/SB in combating the obesity epidemic.