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Zheng C, Huang WYJ, Sun FH, Wong MCS, Siu PMF, Chen XK, Wong SHS. Association of Sedentary Lifestyle with Risk of Acute and Post-Acute COVID-19 Sequelae: A Retrospective Cohort Study. Am J Med 2023:S0002-9343(23)00757-X. [PMID: 38110069 DOI: 10.1016/j.amjmed.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Evidence suggests that coronavirus disease 2019 (COVID-19) survivors could experience COVID-19 sequelae. Although various risk factors for COVID-19 sequelae have been identified, little is known about whether a sedentary lifestyle is an independent risk factor. METHODS In this retrospective cohort study, 4850 participants self-reported their COVID-19 sequelae symptoms between June and August 2022. A sedentary lifestyle included physical inactivity (<150 min/week of moderate-to-vigorous intensity physical activity) and prolonged sedentary behavior (≥10 h/day) before the fifth COVID-19 wave was recorded. Logistic regression analysis was performed to determine the relationships between sedentary lifestyle and risk of acute and post-acute (lasting ≥2 months) COVID-19 sequelae. RESULTS A total of 1443 COVID-19 survivors and 2962 non-COVID-19 controls were included. Of the COVID-19 survivors, >80% and >40% self-reported acute and post-acute COVID-19 sequelae, respectively. In the post-acute phase, COVID-19 survivors who were physically inactive had a 37% lower risk of insomnia, whereas those with prolonged sedentary behavior had 25%, 67%, and 117% higher risks of at least one symptom, dizziness, and "pins and needles" sensation, respectively. For the acute phase, prolonged sedentary behavior was associated with a higher risk of fatigue, "brain fog," dyspnea, muscle pain, joint pain, dizziness, and "pins and needles" sensation. Notably, sedentary behavior, rather than physical inactivity, was correlated with a higher risk of severe post-COVID-19 sequelae in both acute and post-acute phases. CONCLUSIONS Prolonged sedentary behavior was independently associated with a higher risk of both acute and post-acute COVID-19 sequelae, whereas physical inactivity played contradictory roles in COVID-19 sequelae.
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Affiliation(s)
- Chen Zheng
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China; Department of Health and Physical Education, Faculty of Liberal Arts and Social Sciences, The Education University of Hong Kong, Tai Po, Hong Kong, China
| | - Wendy Ya-Jun Huang
- Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China
| | - Feng-Hua Sun
- Department of Health and Physical Education, Faculty of Liberal Arts and Social Sciences, The Education University of Hong Kong, Tai Po, Hong Kong, China
| | - Martin Chi-Sang Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Parco Ming-Fai Siu
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong, China
| | - Xiang-Ke Chen
- Division of Life Science, School of Science, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China.
| | - Stephen Heung-Sang Wong
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China
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Abstract
The purpose of this study was to examine the effects of different amounts of whey protein in carbohydrate-electrolyte (CE) drinks on post-exercise rehydration. Ten males completed 5 trials in a randomised cross-over design. A 4-h recovery was applied after a 60-min run at 65% VO2peak in each trial. During recovery, the participants ingested a high-carbohydrate CE drink (CE-H), a low-carbohydrate CE drink (CE-L), a high-whey-protein (33 g·L-1) CE drink (CW-H), a medium-whey-protein (22 g·L-1) CE drink (CW-M) or a low-whey-protein (15 g·L-1) CE drink (CW-L) in a volume equivalent to 150% of their body mass (BM) loss. The drinks were provided in six equal boluses and consumed by the participants within 150 min in each trial. After exercise, a BM loss of 2.15% ± 0.05% was achieved. Urine production was less in the CW-M and CW-H trials during recovery, which induced a greater fluid retention in the CW-M (51.0% ± 5.7%) and CW-H (55.4% ± 3.8%) trials than in any other trial (p < .05). The plasma albumin content was higher in the CW-H trial than in the CE-H and CE-L trials at 2 h (p < .05) and 3 h (p < .01) during recovery. The aldosterone concentration was lower in the CE-H trial than in the CW-M and CW-H trials after recovery (p < .05). It is concluded that the rehydration was improved when whey protein was co-ingested with CE drinks during a 4-h recovery after a 60-min run. However, this additive effect was only observed when whey protein concentration was at least 22 g·L-1 in the current study.
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Affiliation(s)
- Liang Li
- a Youth Sport Research & Development Center , China Institute of Sport Science , Beijing , People's Republic of China
| | - Feng-Hua Sun
- b Department of Health and Physical Education , The Education University of Hong Kong , Tai Po , New Territories , Hong Kong
| | - Wendy Ya-Jun Huang
- c Department of Physical Education , Hong Kong Baptist University , Kowloon Tong , Kowloon , Hong Kong
| | - Stephen Heung-Sang Wong
- d Department of Sports Science and Physical Education , The Chinese University of Hong Kong , Shatin , New Territories , Hong Kong
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Heung-Sang Wong S, Sun FH, Chen YJ, Li C, Zhang YJ, Ya-Jun Huang W. Effect of pre-exercise carbohydrate diets with high vs low glycemic index on exercise performance: a meta-analysis. Nutr Rev 2017; 75:327-338. [PMID: 28383695 DOI: 10.1093/nutrit/nux003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Context Although pre-exercise consumption of a low-glycemic-index (LGI) carbohydrate meal is generally recommended, the findings regarding subsequent exercise performance are inconsistent. Objective This meta-analytic study was conducted to determine whether a pre-exercise LGI carbohydrate meal leads to greater endurance performance than a pre-exercise high-glycemic-index (HGI) meal. Data sources The following electronic databases were searched until April 2016: MEDLINE, SPORTDiscus, Web of Science, and Cochrane Central Register of Controlled Trials. The reference lists of selected articles were searched manually. Study selection Randomized controlled or crossover trials comparing the effects of LGI and HGI pre-exercise carbohydrate meals on subsequent exercise performance of healthy participants were included. Data extraction The Jadad scale was used to assess the methodological quality of the included studies. A fixed-effects model was used to evaluate overall and subgroup estimates. Results In total, 15 eligible studies from 727 articles were included in this meta-analysis. All included studies were of low research quality. The synthesized effect size ( d = 0.42, z = 3.40, P = 0.001) indicated that the endurance performance following an LGI meal was superior to that following an HGI meal. Subgroup analyses demonstrated that the treatment effect did not vary across outcome measures (exercise to exhaustion, time trial, and work output) or athletic status (trained or recreational participants). Conclusions Weak evidence supports the claim that endurance performance following a pre-exercise LGI meal is superior to that following a pre-exercise HGI meal. Further high-quality research in this area is warranted.
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Affiliation(s)
- Stephen Heung-Sang Wong
- S. H.-S. Wong is with the Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong. F-H. Sun and C. Li are with the Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, New Territories, Hong Kong. Y.-J. Chen is with the Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China. Y.-J. Zhang is with the School of Humanities and Social Science, Chinese University of Hong Kong, Shenzhen, Guangdong, China. W.Y.-J. Huang is with the Department of Physical Education, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Feng-Hua Sun
- S. H.-S. Wong is with the Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong. F-H. Sun and C. Li are with the Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, New Territories, Hong Kong. Y.-J. Chen is with the Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China. Y.-J. Zhang is with the School of Humanities and Social Science, Chinese University of Hong Kong, Shenzhen, Guangdong, China. W.Y.-J. Huang is with the Department of Physical Education, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Ya-Jun Chen
- S. H.-S. Wong is with the Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong. F-H. Sun and C. Li are with the Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, New Territories, Hong Kong. Y.-J. Chen is with the Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China. Y.-J. Zhang is with the School of Humanities and Social Science, Chinese University of Hong Kong, Shenzhen, Guangdong, China. W.Y.-J. Huang is with the Department of Physical Education, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Chunxiao Li
- S. H.-S. Wong is with the Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong. F-H. Sun and C. Li are with the Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, New Territories, Hong Kong. Y.-J. Chen is with the Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China. Y.-J. Zhang is with the School of Humanities and Social Science, Chinese University of Hong Kong, Shenzhen, Guangdong, China. W.Y.-J. Huang is with the Department of Physical Education, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Yan-Jie Zhang
- S. H.-S. Wong is with the Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong. F-H. Sun and C. Li are with the Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, New Territories, Hong Kong. Y.-J. Chen is with the Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China. Y.-J. Zhang is with the School of Humanities and Social Science, Chinese University of Hong Kong, Shenzhen, Guangdong, China. W.Y.-J. Huang is with the Department of Physical Education, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Wendy Ya-Jun Huang
- S. H.-S. Wong is with the Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong. F-H. Sun and C. Li are with the Department of Health and Physical Education, The Education University of Hong Kong, Tai Po, New Territories, Hong Kong. Y.-J. Chen is with the Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China. Y.-J. Zhang is with the School of Humanities and Social Science, Chinese University of Hong Kong, Shenzhen, Guangdong, China. W.Y.-J. Huang is with the Department of Physical Education, Hong Kong Baptist University, Kowloon, Hong Kong
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