Barriers and Facilitators to Participation in Vigorous Lifestyle Physical Activity in Adults Aged 55-75 Years: A Scoping Review

Despite the well-known benefits of physical activity, less than half of adults aged 55-75 years participate in sufficient physical activity. Short bouts of vigorous intermittent lifestyle physical activity (VILPA) accumulated throughout the day can contribute toward the recommended volume of physical activity. A rich characterization of the barriers and facilitators to participation in VILPA is needed to develop targeted interventions. This scoping review aimed to identify barriers and facilitators to participation in different components of VILPA in adults aged 55-75 years, and to map barriers and facilitators to the Theoretical Domains Framework. Within the 18 eligible studies, the most prevalent barriers were related to a person's skills, environmental context, and social influences. Most facilitators were related to a person's goals, social influences, and environmental context. Interventions to promote VILPA should test the effectiveness of behavioral change measures related to the unique barriers and facilitators in this age group.

Associations of Various Physical Activities with Mortality and Life Expectancy are Mediated by Telomere Length

OBJECTIVES

Physical activity (PA) and telomeres both contribute to healthy aging and longevity. To investigate the optimal dosage of various PA for longevity and the role of telomere length in PA and mortality.

DESIGN

Prospective cohort study.

SETTING AND PARTICIPANTS

A total of 333,865 adults (mean age of 56 years) from the UK Biobank were analyzed.

METHODS

Walking, moderate PA (MPA), and vigorous PA (VPA) were self-reported via questionnaire, and leukocyte telomere length (LTL) was measured. Cox proportional hazards regression was used to predict all-cause mortality risk. A flexible parametric Royston-Parmar survival model was used to estimate life expectancy.

RESULTS

During a median follow-up of 13.8 years, 19,789 deaths were recorded. Compared with the no-walking group, 90 to 720 minutes/week of walking was similarly associated with 27% to 31% of lower mortality and about 6 years of additional life expectancy. We observed nearly major benefits for mortality and life expectancy among those meeting the PA guidelines [151-300 minutes/wk for MPA: hazard ratio (HR) 0.80, 95% CI 0.75-0.85, 3.40-3.42 additional life years; 76-150 minutes/wk for VPA: HR 0.78, 95% CI 0.75-0.82, 2.61 years (2.33-2.89)] vs the no-PA group. Similar benefits were also observed at 76-150 and 301-375 minutes/wk of MPA (18%-19% lower mortality, 3.20-3.42 gained years) or 151-300 minutes/wk of VPA (20%-26% lower mortality, 2.41-2.61 gained years). The associations between MPA, VPA, and mortality risk were slightly mediated by LTL (≈1% mediation proportion, both P < .001).

CONCLUSIONS AND IMPLICATIONS

Our study suggests a more flexible range of PA than the current PA guidelines, which could gain similar benefits and is easier to achieve: 90 to 720 minutes/wk of walking, 75 to 375 minutes/wk of MPA, and 75 to 300 minutes/wk of VPA. Telomeres might be a potential mechanism by which PA promotes longevity.

Device-measured physical activity and type 2 diabetes mellitus risk

Objectives

We investigated how device-measured physical activity (PA) volume (PA energy expenditure [PAEE]) and intensity (fraction of PAEE from moderate-to-vigorous PA [FMVPAEE]) were associated with the incidence of type 2 diabetes mellites (T2DM).

Methods

This population-based prospective cohort study included 90,044 participants. The primary exposures were PAEE and FMVPAEE. The secondary exposures were energy expenditure exerted during light, moderate, and vigorous PA and their fraction of PAEE.

Results

Each 1-SD increase in PAEE was associated with a 17% lower risk of T2DM (hazard ratio [HR]: 0.83, 95% confidence interval [CI]: 0.78-0.98). Each 1-SD increase in FMVPAEE was associated with a 21% lower incidence of T2DM (HR: 0.79, 95% CI: 0.74-0.83). Achieving the same PA volume (KJ/kg/day) through vigorous PA (HR: 0.88, 95% CI: 0.85-0.91) was more effective in preventing T2DM than moderate PA (HR: 0.97, 95% CI: 0.96-0.98) and light PA (HR: 0.99, 95% CI: 0.98-1.00).

Conclusion

A higher PA volume is associated with a lower incidence of T2DM. Achieving the same PA volumes through higher-intensity PA is more effective than low-intensity PA in reducing T2DM incidence.

Physical Activity and Mental Health of Parents of Children With Autism Spectrum Disorder

This study aimed to examine physical activity (PA) levels and mental health status (i.e., anxiety and depression) among parents of children with autism spectrum disorder (ASD). Secondary data analysis was conducted using the 2018 National Health Interview Survey. We identified 139 parents of children with ASD and 4,470 parents of children with no disability. Their PA levels, anxiety, and depression were analyzed. Compared with parents of children with no disability, parents of children with ASD were significantly less likely to meet the PA guideline for Americans and had lower odds of vigorous PA (aOR = 0.702), strengthening PA (aOR = 0.885), and light to moderate PA (aOR = 0.994). Parents of children with ASD reported significantly higher odds of anxiety (aOR = 1.559) and depression (aOR = 1.885). This study revealed lower PA levels and higher risks of anxiety and depression in parents of children with ASD.

Vigorous-intensity exercise as a modulator of cardiac adipose tissue in women with obesity: a cross-sectional and randomized pilot study

Cardiac adipose tissue (CAT) has become an important target for the reduction of disease risk. Supervised exercise programs have shown potential to "significantly" reduce CAT; however, the impact of different exercise modalities is not clear, and the relationships between CAT, physical activity (PA) levels and fitness (PFit) remain unknown. Therefore, the purpose of this study was to analyze the relationships between CAT, PA and PFit, and to explore the effects of different exercise modalities in a group of women with obesity. A total of 26 women (age: 23.41 ± 5.78 years-old) were enrolled in the cross-sectional study. PA, cardiorespiratory fitness, muscular strength, body composition and CAT were evaluated. The pilot intervention included 16 women randomized to a control (CON, n=5), high intensity interval training (HIIT, n = 5) and high-intensity circuit training (HICT, n=6) groups. Statistical analysis showed negative correlations between CAT and vigorous PA (VPA) (r _s=-0.41, p=0.037); and between percent body fat (%BF), fat mass (FM), and all PA levels (r _s=-0.41- -0.68, p<0.05); while muscle mass was positively associated with moderate-to-vigorous PA, and upper-body lean mass with all PA levels (r _s =0.40-0.53, p<0.05). The HICT intervention showed significant improvements (p<0.05) in %BF, FM, fat free mass, and whole-body and lower extremities lean mass and strength after three weeks; however, only leg strength and upper extremities' FM improved significantly compared to CON and HICT. In conclusion, although all types of PA showed a positive influence on body fat content, only VPA significantly impacted on CAT volume. Moreover, three weeks of HICT induced positive changes in PFit in women with obesity. Further research is needed to explore VPA levels and high-intensity exercise interventions for short- and long-term CAT management.

Vigorous physical activity and self-rated health during adolescence: A cross-sectional survey

Background

Despite the positive relationship between self-rated health and general physical activity, very little research has touched upon the relationship between self-rated health and vigorous physical activity. Such research will help to promote self-rated health among adolescents by addressing the close relationship between self-rated health and the components of physical activity.

Purpose

In this study, the relationship between self-rated health and vigorous physical activity among Chinese adolescents were analyzed.

Methods

The current study was based on a collaborative survey conducted by the WHO in several nations, and the data generated by Health Behavior in School-aged Children every 4 years on health behavior were adopted. The school class was taken as a basic unit for sampling. Cluster sampling was performed systematically, and the possibility was proportional to the population. The sampling was conducted to collect typical cases. The class teachers were informed of the sampling activities, and they were to collect data on the students by distributing the questionnaires.

Results

The research included 116,828 respondents from 36 countries. Among them, 51.82% were girls and 48.18% were boys. A total of 98.54% of the respondents considered their health status as fair or above when completing the questionnaire, while 1.46% believed that their health status was poor. Moreover, more than 86% of the respondents participated in vigorous exercise more than weekly, and better self-health ratings were found among respondents who exercised more than weekly (once a week: OR = 1.95, CI: 1.86-2.04; two or three times a week: OR = 1.69, CIL: 1.63-1.76; four or six times a week: OR = 1.30, CI: 1.25-1.35). Certain respondents reported better results for self-rated health (4-6 h every week: OR = 1.36, CI: 1.30-1.43; 2 or 3 h every week: OR = 1.48, CI: 1.42-1.55; 1 h every week: OR = 1.64, CI: 1.57-1.72).

Conclusion

In this study, empirical evidence is provided for the relationship between self-rated health and vigorous physical activity among adolescents. From the results, it can be observed that there is a positive relationship between self-rated health and vigorous physical activity among adolescents.

Association between vigorous physical activity and life satisfaction in adolescents

Purpose

The association between overall physical activity (PA) and life satisfaction has been confirmed in adolescents. However, the associations between different forms of PA at various intensities and life satisfaction are under-studied. This study aimed to explore the association between vigorous PA (VPA) and life satisfaction, and whether the associations vary by gender and age.

Methods

Using data from the Health Behavior in School-aged Children (HSBC) investigation, the research samples of 11- to 15-year-old adolescents were included for further. The information on VPA was collected via two self-reported questions, including frequency per week and hours per week. Life satisfaction was assessed by a ladder of 0-10 scores, with being higher indicating better life satisfaction. Logistic models were carried out to analyse the association between VPA and life satisfaction among adolescents, and results were presented with odd ratio (OR) and associated 95% confidence interval.

Results

Among the 214,080 (49.2% male) adolescents studied, both boy and girl participants reporting higher frequency of VPA per week were more likely to be associated with higher life satisfaction (e.g., in boys, VPA for every day: OR = 1.054; in girls: VPA for every day: OR = 1.047). More hours of VPA was also associated with better life satisfaction in adolescents (in overall sample, 7 h or more: OR = 1.178).

Conclusions

In conclusion, this research provided evidence on the roles of VPA on life satisfaction among adolescents aged 11-15. Considering life satisfaction is regarded as an indicator of adolescents' psychological health development, our study supports and extends the evidence for the importance of VPA in adolescence.

Maintaining Moderate or Vigorous Exercise Reduces the Risk of Low Back Pain at 4 Years of Follow-Up: Evidence From the English Longitudinal Study of Ageing

Few studies have examined whether maintaining moderate or vigorous physical activity (PA) reduces the risk of low back pain in older people. This study aimed to examine the magnitude of the associations of changes in PA on the risk of low back pain at 4 years of follow-up. We analyzed 4,882 participants in the English Longitudinal Study of Ageing who were initially free from low back pain (mean age, 65.6 ± 8.9 years at baseline). Self-reported PA, which was assessed at wave 6 (2012-2013) and wave 7 (2014-2015), was used as the exposure. The PA of the respondents was categorized into "no PA at all," "up to moderate PA," and "up to vigorous PA" groups. Self-reported moderate/severe low back pain assessed at 4 years of follow-up (2016-2017) was used as the outcome. Maintaining moderate (relative risk [RR], 0.59; 95% confidence interval [CI], 0.36-0.99) or vigorous (RR, 0.46; 95% CI, 0.27-0.77) PA at least 1-3 times a month was negatively associated with prevalence of low back pain compared with no PA at all. Interventions for maintaining either moderate or vigorous PA might be beneficial in preventing the incidence of low back pain in the older population. PERSPECTIVE: Perspective: This study examined the magnitude of the association between changes in physical activity over time and the risk of low back pain. The findings suggest that encouraging people to maintain at least moderate physical activity over 2 years is useful for reducing the risk of low back pain at 4 years of follow-up.

Physical activity and sitting time prior to and during COVID-19 lockdown in Austrian high-school students

The COVID-19 pandemic has led in many countries to the implementation of policies that mandate social distancing and movement restrictions. While these measures are warranted in order to minimize the spread of the virus they may have detrimental effects on various behaviors, including physical activity (PA). The present study examined PA and sitting time in 14 to18-year-old Austrian high school students prior to and during the second COVID-19 lockdown in Austria. Data was collected via an online questionnaire during fall/winter 2020/21. Questions were based on the International Physical Activity Questionnaire, which examined frequency and duration of PA and sitting time. A total of 221 high school students provided valid data. Participants reported significantly lower moderate and vigorous PA during the lockdown while sitting time increased (p < 0.01). The frequency of walking (days/week) also decreased during COVID-19 lockdown, which also contributed to a significant decline in total walking time (p < 0.01). Further, the decline in PA was more pronounced in boys, while girls reported a greater decline in walking. These differences were due to higher PA and walking in boys and girls, respectively, prior to the lockdown. During the lockdown sex differences in PA and sitting time were limited. Taken together, these results highlight the impact of COVID-19 policies on PA in adolescents and emphasize the importance to promote an active lifestyle even in times of home confinement.

Physical Activity Intensity and Type 2 Diabetes: Isotemporal Substitution Models in the "Seguimiento Universidad de Navarra" (SUN) Cohort

Which intensity of physical activity (PA) is associated with type 2 diabetes (T2D) prevention remains unclear. Isotemporal substitution models assess the relationship of replacing the amount of time spent in one activity for another. We aimed to assess T2D incidence associated with light-to-moderate physical activity (LMPA) and vigorous physical activity (VPA) using isotemporal substitution models of one hour (1 h) sitting by 1 h of LMPA or VPA. Furthermore, we evaluated the effect on T2D of an isotemporal substitution of 1 h sitting by 1 h of slow (light physical activity) or brisk–very brisk walking (moderate physical activity). In total, 20,060 participants (both sexes) of the SUN cohort (Spain) initially free of T2D followed-up during a median of 12 years were included. Cox regression models were fitted to assess the association between the substitution of 1 h LMPA, VPA, slow and brisk–very brisk pace by 1 h sitting and T2D. The replacement of 1 h sitting time by 1 h of VPA was associated with an adjusted HR of 0.52 (95% CI: 0.34–0.80), not observed for the substitution by 1 h of LMPA (HR 0.93; 95% CI: 0.73–1.20). An apparent inverse association was observed for the replacement of 1 h sitting time by 1 h of brisk/very brisk walking (HR: 0.69; 95% CI: 0.46–1.04), not observed by 1 h of slow pace. From equal conditions of duration and frequency of PA, the higher the intensity of PA, the greater the T2D prevention.

The Association between Vigorous Physical Activity and Stress in Adolescents with Asthma

Asthma is a very common condition that affects 5-10% of the global population, and its prevalence is increasing. Vigorous physical activity (PA) is effective in improving cardiorespiratory fitness and managing stress. This study aimed to investigate the association between vigorous PA and stress among Korean adolescents with asthma using large-scale survey data. The questionnaire data of 57,303 adolescents were analyzed using raw data from the 2019 Korea Youth Risk Behavior Web-Based Survey. We performed logistic regression analysis to calculate the stress odds ratios (ORs) and 95% confidence intervals (CIs) for asthma and non-asthma groups using models 1 and 2. We also performed logistic regression analysis to calculate the stress OR for the asthma group with vigorous PA and non-vigorous PA using models 1, 2, and 3. Model 1 was adjusted for age, sex, obesity, smoking, and alcohol status; model 2 was further adjusted for household income, academic achievement, and comorbidities. Model 3 was further adjusted for moderate activity and resistance exercise. The OR of stress was 20% higher in the asthma group than in the non-asthma group (p < 0.05). In the fully adjusted models, the OR for the non-asthma group with vigorous PA versus non-vigorous PA was 0.89 (95% CI: 0.84-0.94). However, the OR for the asthma group with vigorous PA versus non-vigorous PA was 0.70 (95% CI: 0.57-0.86), indicating that adolescents who engage in vigorous PA had lower stress in the asthma group (p < 0.05). This study demonstrated that adolescents with asthma had higher stress levels than those without asthma; however, vigorous PA was associated with lower stress. These effects were more pronounced in adolescents with asthma.

The Association between Participation in Organized Physical Activity and the Structure of Weekly Physical Activity in Polish Adolescents

The main aim of the study was to determine the associations of participation in organized physical activity (OPA), and the structure of weekly physical activity (PA) with meeting the PA recommendations among Polish boys and girls. The research was conducted between 2012 and 2019 in the Silesian region of Poland among 3499 secondary school students. To determine the structure of PA (school, transportation, home, recreation, vigorous moderate, and walking), the International Physical Activity Questionnaire-Long Form (IPAQ-LF) questionnaire was used. Adolescents participating in OPA showed significantly more PA (p < 0.001) than non-participating adolescents. The strongest associations were observed between participation in OPA and vigorous PA. The weekly recommendation of vigorous PA was met by 61% of the students with three or more lessons of OPA per week, 29% of students with one or two lessons of OPA per week, and 24% of students not participating in OPA. Therefore, boys and girls with no OPA are at greatest risk of health issues. Schools, sports clubs, and leisure institutions should increase the participation of adolescents in OPA, especially non-participants. Comprehensive school PA programs should especially include those forms of OPA that respect health weaknesses, individual talents for specific types of PA, and preferred types of PA among adolescents.

Continuous Blood Glucose Monitoring Increases Vigorous Physical Activity Levels and Is Associated With Reduced Hypoglycemia Avoidance Behavior In Youth With Type 1 Diabetes

The primary goal of this study was to explore physical activity (PA) levels, hypoglycemia fear scores and hypoglycemia episodes according to insulin administration and blood glucose monitoring methods in youth with type 1 diabetes (T1D). A self-administered questionnaire was completed by 28 children and 33 adolescents with T1D, and their PA was assessed. Hypoglycemia episodes, fear of hypoglycemia scores, insulin therapy (pump vs. injection) and blood glucose monitoring (continuous blood glucose monitors [CGMs] vs. blood glucose meters) methods are reported in the present work. There were no significant differences in the number of hypoglycemic episodes, child hypoglycemia fear survey behavior or total scores, or any components of the PA profile between youth using injections and those using a pump. However, these variables differed significantly when compared according to blood glucose monitoring method (CGMs vs. blood glucose meters): 41.2 vs. 81.8, p<0.01; 1.03 ± 0.05 vs. 2.6 ± 0.63, p<0.01; 1.09 ± 0.43 vs. 2.94 ± 0.22, p<0.01; and 222 ± 18 vs. 49 ± 11, p<0.01 (for total time in vigorous PA in minutes per week), respectively. CGM use correlated significantly with VPA levels (β=0.6; p=0.04). Higher VPA levels were associated with higher child hypoglycemia fear survey behavior scores (β=0.52; p=0.04). The latter correlates negatively with the number of episodes of hypoglycemia in the past 12 months in all category groups. The type of insulin injection was not associated with more activity in youth with T1D. In contrast, CGM use may be associated with increased vigorous PA among T1D youth. Those with higher hypoglycemia fear survey behavior scores engaged in more VPA and had fewer hypoglycemia episodes. Although CGM use ensures continuous monitoring of glycemia during exercise, increasing hypoglycemia avoidance behavior is still a necessary part of exercise management strategies in active youth with T1D.

Vigorous Physical Activity Is Associated With Better Glycated Hemoglobin and Lower Fear of Hypoglycemia Scores in Youth With Type 1 Diabetes: A 2-Year Follow-Up Study

To correlate glycated hemoglobin (HbA1c) and fear of hypoglycemia scores with physical activity (PA) levels in children and adolescents with type 1 diabetes (T1D) over a period of 2 years. Twenty-eight children and 33 adolescents with T1D have been assessed for their PA profile. Personal and medical data for the patients were collected at baseline (visit 0: V0), 1 year later (V1), and 2 years later (V2). At baseline, children with T1D engaged in less moderate to vigorous PA (MVPA) (p < 0.01) per day than adolescents. These results did not differ across visits. On the contrary, adolescents spent fewer time in vigorous physical activity (VPA) (p < 0.01) than children did (p < 0.01). Fear of hypoglycemia scores correlated significantly with VPA levels (β = −0.41, p = 0.03; β = −0.44, p = 0.06; β = −0.61, p = 0.001). For HbA1c (%), significant correlations were reported with VPA levels (β = −0.54, p = 0.02; β = −0.47, p = 0.03; β = −0.62, p = 0.01) across visits. Body mass index percentile correlated with total screen time (β = 0.28, p = 0.02; β = 0.29, p = 0.01; β = 0.31, p = 0.04) and overall PA levels (β = −0.52, p = 0.02; β = −0.42, p = 0.03; β = −0.42, p = 0.01). Performing more vigorous PA a day is associated with better HbA1c with lower perceived fear of hypoglycemia among youth with T1D. Therefore, dedicating more time in VPA may be an appropriate advice for patients with T1D.

COVID-19, Psychological Well-being and Physical Activity Levels in Older Adults During the Nationwide Lockdown in Spain

OBJECTIVE

The novel coronavirus disease (COVID-19) has forced nationwide lockdowns in many countries. As a result, most of the Spanish population had to self-isolate at home. The physical and psychological consequences of this unexpected scenario could be particularly worrisome for people older than 60 years. This study is aimed to examine the psychological well-being of older adults during the home isolation due to the COVID-19 pandemic and to investigate whether meeting the World Health Organization's global recommendations on physical activity (PA) for health is associated with their resilience, affect, and depressive symptoms.

DESIGN, SETTING, AND PARTICIPANTS

In this cross-sectional study, a total of 483 citizens whose ages ranged from 60 to 92 years (overall sample: M = 65.49, SD = 5.14) were recruited via a snowball sampling strategy to answer to an online questionnaire.

MEASUREMENTS

The four instruments used were The Connor-Davidson CD-RISC resilience scale, The Positive and Negative Affect Schedule, the six-item self-report scale of Depressive Symptoms, and The international Physical Activity Questionnaire.

RESULTS

Results showed that older adults who regularly engaged in vigorous (VPA) and moderate-vigorous physical activity (MVPA) during the quarantine reported higher scores in resilience (Locus, Self-efficacy, and Optimism), positive affect, and lower in depressive symptoms.

CONCLUSION

These finding are the first quantitative evidence pointing toward a link between engagement in VPA and/or MVPA and resilience, positive affect, and depressive symptoms within the COVID-19 restrictions in Spain. Acknowledging these associations may be important in developing health promotion programs for older people during the remaining period of confinement or future ones.

Accelerometer-Determined Intensity and Duration of Habitual Physical Activity and Walking Performance in Well-Functioning Middle-Aged and Older Women: A Cross-Sectional Study

BACKGROUND

The association of physical activity (PA) intensities and duration spent in those activities with different walking tasks remains unclear.

OBJECTIVES

To examine the association between the duration of PA intensities and three walking speeds (usual walking speed, maximal walking speed and zig-zag walking speed).

DESIGN

Multiple linear regression analysis was used to estimate the association of age, BMI, maximum knee extension strength, light PA, moderate PA and vigorous PA with walking speeds.

SETTING

University lab.

PARTICIPANTS

Eighty-six older women (67 ± 7 years).

MEASUREMENTS

PA was measured for 30 consecutive days using the Lifecorder-EX accelerometer. Exercise intensity was categorized as light (levels 1-3), moderate (levels 4-6) and vigorous (levels 7-9) based on the manufacturer algorithms. Usual straight walking speed (20 m), maximal straight walking speed (20 m) and zig-zag walking speed tests (10 m) were performed by each participant.

RESULTS

For the usual straight walking speed model (R2 = 0.296, SEE = 0.15 m/s), the significant predictors were BMI, knee extension strength, light PA and vigorous PA. For the maximal straight walking speed model (R2 = 0.326, SEE = 0.20 m/s), only age was a significant predictor. For the zig-zag walking speed model (R2=0.417, SEE = 0.14 m/s), age and maximum knee strength were significant predictors in the model.

CONCLUSIONS

Overall, the results of this study suggest that vigorous PA and maximal knee extension strength are two important factors that are associated with different walking speeds in older women.

Fitness, physical activity and academic achievement in overweight/obese children

The aim of this study was to examine the associations of fitness and physical activity with academic achievement in children with overweight/obesity. A total of 106 (10.0 ± 1.1y, 61 boys) children participated. The fitness components were assessed by field and laboratory-based tests. Physical activity was measured via accelerometry. The academic achievement was assessed by a standardised test and school-grades. Field-based cardiorespiratory fitness was associated with language skills (ß-standardised- ranging from 0.281 to 0.365, p < 0.01). The field-based muscular strength was associated with grade point average, natural and social sciences, and foreign language (ß = 0.280-0.326, all p ≤ 0.01). Speed-agility was associated with some language-related skills (ß = 0.325-0.393, all p ≤ 0.01). The laboratory-based muscular strength also showed an association with mathematics skills (ß = 0.251-0.306, all p ≤ 0.01). Physical activity did not show significant association with academic achievement (p > 0.01). Overall, the significant associations observed for muscular strength and speed/agility were attenuated and disappeared in many cases after additional adjustments for body mass index and cardiorespiratory fitness, indicating that these associations are inter-dependent. Our study contributes by indicating that other fitness components apart from cardiorespiratory fitness, such as muscular strength and speed-agility, are positively associated with academic achievement. However, these associations appear to be dependent on body mass index and cardiorespiratory fitness.

Stronger Association between High Intensity Physical Activity and Cardiometabolic Health with Improved Assessment of the Full Intensity Range Using Accelerometry

An improved method of physical activity accelerometer data processing, involving a wider frequency filter than the most commonly used ActiGraph filter, has been shown to better capture variations in physical activity intensity in a lab setting. The aim of the study was to investigate how this improved measure of physical activity affected the relationship with markers of cardiometabolic health. Accelerometer data and markers of cardiometabolic health from 725 adults from two samples, LIV 2013 and SCAPIS pilot, were analyzed. The accelerometer data was processed using both the original ActiGraph method with a low-pass cut-off at 1.6 Hz and the improved method with a low-pass cut-off at 10 Hz. The relationship between the physical activity intensity spectrum and a cardiometabolic health composite score was investigated using partial least squares regression. The strongest association between physical activity and cardiometabolic health was shifted towards higher intensities with the 10 Hz output compared to the ActiGraph method. In addition, the total explained variance was higher with the improved method. The 10 Hz output enables correctly measuring and interpreting high intensity physical activity and shows that physical activity at this intensity is stronger related to cardiometabolic health compared to the most commonly used ActiGraph method.

Increased Physical Activity in Preparation for a Women-Only Mass Participation Sport Event: A Framework for Estimating the Health Impact

Mass participation sporting events (MPSEs) are increasing in popularity. However, little research exists into the potential value of these events for improving public health by enhancing physical activity (PA). The aim of this study is to estimate the health impact of increased physical activity as a result of preparing for an MPSE. Participants of a mass participation women-only running event were asked if they performed additional PA in preparation of the event, including the length (weeks) and intensity (min per week). Additionally, self-reported change in health status was evaluated. Based on these results, we have developed a framework for estimating the cumulatively gained quality adjusted life years (QALYs) and monetary value thereof. Of the respondents (N = 468; mean age 42.3 ± 11.9 years), 32% performed additional vigorous PA in preparation of the event, with an average of 63 min per week over 8.8 weeks. Performing additional vigorous PA significantly improved the odds of self-rated health. The estimated total health impact of participants preparing for the Marikenloop was 6.6 QALYs gained with a corresponding monetary value between EUR 133,000 and EUR 532,000. We believe our health impact framework helps to understand that MPSEs can be a notable part of the public health domain.

Injuries, dislocations, and poor health perceived by older adults to result from vigorous physical activity: implications for active living, health promotion, and gerontology

This study examines older adults' perceptions about their participation in vigorous physical activity (VPA) and the association between VPA and self-related health. A total of 686 older adults responded to self-reported questionnaires, and Pearson's ꭓ2 test and binary logistic regression were used to present findings. About 74% of older adults reported experiencing dislocations, fractures, or/and other forms of injury in intense physical activities lasting 30 minutes or more a day. After controlling for relevant socio-demographic factors, older adults who participated in VPA for 30 or more minutes a day were less likely (OR=0,129; p=0,000) to report good health compared with those who participated in VPA for less than 30 minutes. It is concluded that VPA in older populations can result in casualties that may compel older adults to underrate their health, which can discourage active living habits in older populations and discredit PA/health promotion programs.

A Cross-Sectional Examination of Physical Activity Levels and Their Socio-Demographic Determinants in Southern Tanzania

Physical activity is essential for healthy aging. Evidence suggests that vigorous-intensity physical activity (VPA) may be more beneficial than moderate-intensity physical activity (MPA). We examined physical activity levels (MPA, VPA and total physical activity), and their socio-demographic determinants in 2311 participants (15–93 years; 68% women) of the MZIMA Open Community Cohort, who had complete relevant data. Physical activity levels were estimated in minutes per week across three domains—work, leisure and transport. We created three outcome variables: low MPA (<150 min per week of MPA), low VPA (<75 min per week of VPA) and insufficient physical activity (IPA: <150 min per week of total physical activity) and applied sample-weighted multivariable logistic regression to assess associations with potential socio-demographic determinants. Prevalence of IPA, low MPA and low VPA were 25%, 26% and 65% respectively. IPA and low MPA were correlated (Spearman R = 0.98; p < 0.001). Work, leisure and transport contributed 54%, 25% and 21% to total physical activity respectively. IPA and low VPA were significantly associated with female sex, lower education, non-manual occupation and frequent fruit consumption. We observed significant differences by sex (P_{heterogeneity} < 0.001), on the associations between education and IPA, and between age, occupation and low VPA. In conclusion, low levels of VPA, which were more pronounced in women, support the monitoring and promotion of VPA alongside overall physical activity. Leisure-related activities should also be promoted towards gains in vigorous-intensity and total physical activity in this setting.

Vigorous physical activity, perceived stress, sleep and mental health among university students from 23 low- and middle-income countries

Background Vigorous physical activity (VPA) may be beneficial for mental health. The aim of the study was to investigate cross-sectional associations between VPA, perceived stress, sleep quality and quantity and mental health among university students. Methods In a cross-sectional study, using anonymous questionnaires, data was collected from 15122 (42.1% male and 57.9% female) university students [mean age 20.6, standard deviation (SD) = 2.0] from 23 countries in the Americas, Africa and Asia. They were assessed using the International Physical Activity Questionnaire (short version), and measures of sociodemographic, health status, health behaviour and anthropometrics. Results Students who met VPA recommendations were less likely to report perceived stress, more likely to report subjective good health and depression than students without VPA. There was no association between VPA and sleep quality and quantity and PTSD symptoms. Conclusion This study only found partial benefits of VPA in relation to well-being of university students.

Perspectives on high-intensity interval exercise for health promotion in children and adolescents

Physical activity lowers future cardiovascular disease (CVD) risk; however, few children and adolescents achieve the recommended minimum amount of daily activity. Accordingly, there is virtue in identifying the efficacy of small volumes of high-intensity exercise for health benefits in children and adolescents for the primary prevention of CVD risk. The purpose of this narrative review is to provide a novel overview of the available literature concerning high-intensity interval-exercise (HIIE) interventions in children and adolescents. Specifically, the following areas are addressed: 1) outlining the health benefits observed following a single bout of HIIE, 2) reviewing the role of HIIE training in the management of pediatric obesity, and 3) discussing the effectiveness of school-based HIIE training. In total, 39 HIIE intervention studies were included in this review. Based upon the available data, a single bout of high-intensity exercise provides a potent stimulus for favorable, acute changes across a range of cardiometabolic outcomes that are often superior to a comparative bout of moderate-intensity exercise (14 studies reviewed). HIIE also promotes improvements in cardiorespiratory fitness and cardiometabolic health status in overweight and obese children and adolescents (10 studies reviewed) and when delivered in the school setting (15 studies reviewed). We thus conclude that high-intensity exercise is a feasible and potent method of improving a range of cardiometabolic outcomes in children and adolescents. However, further work is needed to optimize the delivery of HIIE interventions in terms of participant enjoyment and acceptability, to include a wider range of health outcomes, and to control for important confounding variables (eg, changes in diet and habitual physical activity). Finally, research into the application of HIIE training interventions to children and adolescents of different ages, sexes, pubertal status, and sociocultural backgrounds is required.

The Issue of Aversion in Lifestyle Treatments

Increasing evidence suggests that vigorous physical activity (PA) is more beneficial than moderate PA for reducing adiposity and improving bone health in youth. However, beginning a vigorous PA program is not an easy behavior adjustment and the change is likely to be aversive for some individuals. In order to benefit from vigorous PA, health care providers need to help individuals increase self-efficacy.

Vigorous Physical Activity in Youth: Just One End of the Physical Activity Spectrum for Affecting Health?

This article provides commentary on the accompanying manuscript entitled "The Case for Vigorous Physical Activity in Youth" by Owens and colleagues. A major strength of the review was its aim to determine whether vigorous physical activity provides greater benefits with respect to several health outcomes among children and youth while also considering the limitations of the current evidence in terms of number of studies and study design. This commentary presents additional topics to consider, practical applications, and conclusions and recommendations that can be drawn from the current evidence. To expand "the case for vigorous physical activity in youth," future studies should consider delineating the relative benefits of vigorous physical activity compared not only with moderate physical activity, but also with light and total activity.

Physical Activity and Screen-based Activity in Healthy Development of School-aged Children

AIM

Physical and screen-based activity in adolescents plays a crucial role in future health outcomes. Therefore, the aim of the study was to examine the associations of physical activity and screen-based activity with behavioural and psychosocial characteristics of school-aged children.

METHODS

Data on 11, 13 and 15 years old elementary school pupils (N=9,014; mean age=13.59) who participated in the cross-sectional Health Behaviour in School-aged Children 2009/2010 study in the Czech Republic and the Slovak Republic were analyzed. The associations of vigorous physical activity and screen-based activity with substance use, violent behaviour, eating habits and school-related outcomes adjusted for age were explored using logistic regression.

RESULTS

Vigorous physical activity was positively associated with some of the health-related behaviours (smoking, breakfast consumption, vegetable and fruit consumption) and school related outcomes (perceived school achievement and school pressure), with gender and country based differences. Screen-based activity was significantly associated with all examined health-related behaviours and school related outcomes with only some country and gender based differences.

CONCLUSIONS

Vigorous physical activity is positively associated with healthy development of adolescents. Screen-based behaviour shows an inverse relationship with adolescents' healthy development, especially in the group of 11 and 13 years old children. Supporting physical activity conducive environments might lead to a reduction in screen-based behaviour in adolescents and should be highlighted in health-promoting strategies.

Associations of Objectively Measured Vigorous Physical Activity With Body Composition, Cardiorespiratory Fitness, and Cardiometabolic Health in Youth: A Review

Background. Increasing evidence suggests that vigorous physical activity (VPA) in youth may yield greater health benefits than moderate (MPA) or moderate-to-vigorous physical activity (MVPA). The purpose of this review was to assess the relationship between PA intensity and body composition, cardiorespiratory fitness (CRF), and cardiometabolic (CM) biomarkers in youth. Methods. We conducted a systematic review of observational studies examining PA intensity and selected health outcomes in youth aged 6 to 18 years. Forty-five articles were selected for final review. Results. VPA was more strongly associated with reduced body fat and central adiposity compared with MPA and/or MVPA. Additionally, VPA was more strongly associated with increased CRF when compared with lower intensities. Findings were inconclusive between all PA intensity levels and CM biomarkers, and several significant relationships observed for VPA were attenuated when controlling for CRF. Conclusions. A potential VPA dose is identified as yielding favorable health benefits in adiposity and fitness. While CM biomarkers were not consistently associated with PA intensity level, the literature suggests VPA may yield health benefits above those received from MPA for reduced adiposity and improved CRF. This review highlights the need for longitudinal observational and experimental studies to determine optimal VPA dose for CM health in youth.

Actical Accelerometry Cut-Points for Quantifying Levels of Exertion: Comparing Normal and Overweight Adults

Weight, body fatness and ambulatory pattern all have the potential to affect accelerometer output and cause differences in output between overweight and normal-weight adults. The purpose of this study was to determine if Actical (Philips Respironics, Bend, OR) activity count cut-points for moderate and vigorous intensity exercise are different for overweight adults compared to normal-weight adults. Overweight adults with BMI >25 kg/m² (n=29) and Normal-Weight adults (n=25) walked at 3.2 and 4.8 km·h^-1 and ran at 6.4 km·h^-1 on a treadmill while simultaneously wearing an Actical accelerometer and obtaining measurements of oxygen uptake. Counts per minute (counts·min^-1) were determined at 3 METS (moderate) and 6 METS (vigorous) using ROC curves. The counts·min^-1 at 3 METs was 1726 and 1923 counts·min^-1 for Overweight and Normal-Weight groups, respectively. The cut-points at 6 METs were 4117 and 4032 counts·min^-1 for Overweight and Normal-Weight groups, respectively. The differences between groups were not statistically significant (p>0.73 for both). Correlations between BMI and counts·min^-1 were not significant (p>0.05) at any speed for the Normal-Weight group but were significant at 3.2 and 4.8 km·h^-1 for the Overweight group. Although there appears to be some relationship between activity counts·min^-1 and BMI, the results suggest that similar cut-points may be used for normal weight and overweight adults. However, the greater variability in counts at each speed and lower ROC curve areas for overweight adults suggest that it is harder to classify the activity intensity of overweight subjects compared to normal weight subjects.

Exercise attenuates the association of body weight with diet in 106,737 runners

PURPOSE

The high prevalence of obesity in Western societies has been attributed in part to high-fat low-CHO food consumption. However, people have also become less active, and inactivity may have increased the risk for weight gain from poor dietary choices. Analyses were performed to test whether diet-weight relationships were attenuated by vigorous exercise.

METHODS

Age- and education-adjusted cross-sectional regression analyses of 62,042 men and 44,695 women recruited for the National Runners' Health Study were conducted. Reported meat and fruit intakes were analyzed separately and as indicators of high-risk diets.

RESULTS

The runners were generally lean (mean ± SD: males = 24.15 ± 2.81 kg·m(-2), females = 21.63 ± 2.70 kg·m(-2)) as measured by body mass index (BMI), educated (males = 16.42 ± 2.47 yr, females = 16.04 ± 2.32 yr), and middle-aged (males = 44.40 ± 10.83 yr, females = 38.21 ± 10.08 yr), who ran 5.30 ± 3.23 km·d(-1) if male and 4.79 ± 3.00 km·d(-1) if female. Running significantly attenuated BMI's relationship to reported meat and fruit intakes in men (P < 10(-8) and P < 10(-12), respectively) and women (P < 10(-15) and P < 10(-6), respectively). Specifically, compared with running <2 km·d(-1), running >8 km·d(-1) reduced the apparent BMI increase per serving of meat by 43% in men (slope ± SE = from 0.74 ± 0.10 to 0.42 ± 0.06) and 55% in women (from 1.26 ± 0.13 to 0.57 ± 0.09) and reduced the apparent BMI reduction per serving of fruit by 75% in men (from -0.28 ± 0.04 to -0.07 ± 0.02) and 94% in women (from -0.16 ± 0.05 to -0.01 ± 0.02). Running also significantly attenuated the concordant relationship between reported meat intake and waist and chest circumferences in men (P < 10(-9) and P = 0.0002, respectively) and women (P = 0.0004 and P < 10(-5), respectively) and the concordant relationship between meat intake and hip circumference in women (P < 10(-6)).

CONCLUSIONS

Vigorous exercise may mitigate diet-induced weight gain, albeit not guaranteeing protection from poor dietary choices.

What level of physical activity protects against premature cardiovascular death? The Caerphilly study

OBJECTIVE

To examine the optimal intensity of leisure time physical activity (LTPA) to decrease the risk of all cause, cardiovascular disease (CVD), and coronary heart disease (CHD) mortality in a population sample of middle aged British men.

DESIGN

Prospective study of middle aged men with an 11 year follow up.

SETTING

A whole population sample of men from Caerphilly, South Wales, UK.

SUBJECTS

1975 men aged 49-64 years without historical or clinical evidence of CHD at baseline examination.

MAIN OUTCOME MEASURES

All cause, CVD, and CHD mortality.

RESULTS

Total (cumulative) LTPA had a graded, significant relation with all cause, CVD, and CHD mortality but no trend with cancer deaths. When different intensities of activity were considered, light and moderate intensity LTPA had inconsistent and non-significant relations with all cause, CVD, or CHD mortality whether adjusted only for age or for other cardiovascular risk factors. In contrast a significant dose-response relation was found for heavy intensity LTPA for all cause, CVD, and CHD mortality fully adjusted for other risk factors.

CONCLUSIONS

These data suggest that, in a population of men without evidence of CHD at baseline, only leisure exercise classified as heavy or vigorous was independently associated with reduced risk of premature death from CVD.