Changes in physical activity patterns in the United States, by sex and cross-sectional age

Rationale and Design of the Women's Health And Daily Experiences Project: Protocol for an Ecological Momentary Assessment Study to Identify Real-Time Predictors of Midlife Women's Physical Activity

BACKGROUND

Midlife women are at an elevated risk for cardiovascular disease (CVD) and associated mortality. Those who have additional risk conditions such as obesity or hypertension report specific barriers to engaging in cardioprotective behaviors such as physical activity (PA). Considerable effort has been devoted to understanding PA determinants and designing interventions for midlife women, although with suboptimal success, as increasing PA could meaningfully attenuate CVD risk. An updated approach to understanding PA among midlife women could improve upon existing resources by focusing on novel psychosocial influences on PA in this population (ie, body satisfaction, social interactions, social comparisons, mood state) and within-person relations between these influences and PA in the natural environment.

OBJECTIVE

The overarching goal of Project WHADE (Women's Health And Daily Experiences) is to use an ecological momentary assessment (EMA) approach to capture ecologically valid relations between midlife women's psychosocial experiences and PA as they engage in their normal daily activities. The primary aim of the study is to identify within-person psychosocial predictors of variability in PA (ie, experiences associated with higher vs lower PA for a given individual).

METHODS

Midlife women (aged 40-60 years) with one or more additional risk markers for CVD (eg, hypertension) will be recruited from primary care clinics and the general community (target n=100). Eligible women will complete an initial survey and a face-to-face baseline session before engaging in a 10-day EMA protocol. Psychosocial experiences will be assessed using a brief self-report via a smartphone 5 times per day, and PA will be assessed throughout waking hours using a research-grade monitor. Participants will return for a brief exit interview at the end of 10 days. Multilevel models that address the nested structure of EMA data will be used to evaluate the study aims.

RESULTS

Recruitment and enrollment are ongoing, and a total of 75 women have completed the protocol to date. Data collection is expected to be completed in Fall 2020.

CONCLUSIONS

Project WHADE is designed to identify naturally occurring psychosocial experiences that predict short-term variability in midlife women's PA. As such, the results of this study should advance the current understanding of PA among midlife women by providing further insight into within-person psychosocial influences on PA in this group. In the future, this information could help inform the design of interventions for this population.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/19044.

We Need You: Influence of Hiring Demand and Modified Applicant Testing on the Physical Fitness of Law Enforcement Recruits

A challenge for law enforcement agencies is the many positions that need filling. Agencies may modify their applicant test battery (ATB; multilevelled testing including fitness, background checks, psychological evaluations) to increase the hiring pool of potential recruits by augmenting the utility of testing. This study determined fitness differences of law enforcement recruits hired under two different ATB protocols. Retrospective analysis was conducted on seven academy classes (442 males, 84 females) hired under an older ATB, and one class (45 males, 13 females) hired under a newer ATB. Recruits completed the following before academy: 60 s push-ups and sit-ups (muscular endurance); vertical jump (lower-body power); medicine ball throw (upper-body power); 75 yard pursuit run (75PR; change-of-direction speed); and 20 m multistage fitness test (20MSFT; aerobic fitness). Independent sample t-tests (p ≤ 0.001) and effect sizes (d) evaluated between-group fitness differences for recruits hired under the different ATB protocols (combined sexes, males, and females). There were no significant differences between the ATB groups. However, newer ATB female recruits completed 13% fewer 20MSFT shuttles than the older ATB group, which, although not significant (p = 0.007), did have a moderate effect (d = 0.62). Females hired under the newer ATB had lower aerobic fitness, which could impact physical training performance and graduation.

Physical Activity and Trajectories of Cognitive Change in Community-Dwelling Older Adults: The Rancho Bernardo Study

BACKGROUND

Although physical activity has been associated with better cognitive function and reduced dementia risk, its association with cognitive decline in normal aging remains uncertain.

OBJECTIVE

To determine whether physical activity in youth and older age are associated with age-related cognitive change.

METHODS

Over a period of 27 years, 2,027 community-dwelling adults (mean age 73.5; 60% women) of the Rancho Bernardo Study of Healthy Aging completed up to seven cognitive assessments, including tests of global cognitive function, executive function, verbal fluency, and episodic memory. At each visit, participants reported concurrent physical activity. At baseline (1988- 1992), participants additionally reported physical activity as a teenager and at age 30. For each age period, participants were classified as regularly active (3+ times/week) or inactive.

RESULTS

Associations between concurrent physical activity and better cognitive function were stronger with advancing age on all tests, even after accounting for education, health, and lifestyle factors, as well as survival differences (ps < 0.05). Baseline physical activity did not predict rates of cognitive decline (ps > 0.40). Individuals who were physically active at age 30 and older age maintained the highest global cognitive function with advancing age (p = 0.002).

CONCLUSION

Regular physical activity is associated with better cognitive function with advancing age. Physical activity in young adulthood may contribute to cognitive reserve, which together with physical activity in later years, may act to preserve cognitive function with age.

Association between objectively measured physical activity and longitudinal changes in body composition in adolescents: the Tromsø study fit futures cohort

OBJECTIVES

Physical activity may be important in deterring the obesity epidemic. This study aimed to determine whether objectively measured physical activity in first year of upper secondary high school predicted changes in body composition over 2 years of follow-up in a cohort of Norwegian adolescents (n=431).

DESIGN

A longitudinal study of adolescents (mean age of 16 (SD 0.4) at baseline, 60.3% girls) participating in the Fit Futures studies 1 (2010-2011) and 2 (2012-2013).

SETTING

All eight upper secondary high schools in two municipalities in Northern Norway.

PARTICIPANTS

Students participating in both studies and under the age of 18 at baseline and with valid measurement of physical activity at baseline and body composition in both surveys.

PRIMARY AND SECONDARY OUTCOMES

Change in objectively measured body mass index and waist circumference and change in dual-energy X-ray absorptiometry measured fat mass index, lean mass index (LMI) and appendicular LMI (aLMI) between baseline and follow-up.

RESULTS

At baseline, boys had significantly higher physical activity volume (p=0.01) and spent on average of 6.4 (95% CI 2.1 to 10.6) more minutes in moderate-to-vigorous physical activity (MVPA) than girls (p<0.01). In girls, multivariate regression analyses showed that more sedentary time was negatively associated with changes in LMI (p<0.01) and aLMI (p<0.05), whereas more light activity had opposite effects on these measures (p<0.01 and p<0.05, respectively). No significant associations between measures of baseline physical activity and changes in body composition parameters were observed in boys.

CONCLUSIONS

In this cohort of Norwegian adolescents, sedentary and light physical activity was associated with changes in LMI and aLMI in girls, but not boys. Minutes spent in MVPA in first year of upper secondary high school was not associated with changes in measures of body composition in neither sex after 2 years.

Do children's expectations about future physical activity predict their physical activity in adulthood?

Background

Much of the population fails to meet recommended physical activity (PA) levels, but there remains considerable individual variation. By understanding drivers of different trajectories, interventions can be better targeted and more effective. One such driver may be a person’s physical activity identity (PAI)—the extent to which a person perceives PA as central to who they are.

Methods

Using survey information and a unique body of essays written at age 11 from the National Child Development Study (N = 10 500), essays mentioning PA were automatically identified using the machine learning technique support vector classification and PA trajectories were estimated using latent class analysis. Analyses tested the extent to which childhood PAI correlated with activity levels from age 23 through 55 and with trajectories across adulthood.

Results

42.2% of males and 33.5% of females mentioned PA in their essays, describing active and/or passive engagement. Active PAI in childhood was correlated with higher levels of activity for men but not women, and was correlated with consistently active PA trajectories for both genders. Passive PAI was not related to PA for either gender.

Conclusions

This study offers a novel approach for analysing large qualitative datasets to assess identity and behaviours. Findings suggest that at as young as 11 years old, the way a young person conceptualizes activity as part of their identity has a lasting association with behaviour. Still, an active identity may require a supportive sociocultural context to manifest in subsequent behaviour.

Objective scoring of streetscape walkability related to leisure walking: Statistical modeling approach with semantic segmentation of Google Street View images

Although the pedestrian-friendly qualities of streetscapes promote walking, quantitative understanding of streetscape functionality remains insufficient. This study proposed a novel automated method to assess streetscape walkability (SW) using semantic segmentation and statistical modeling on Google Street View images. Using compositions of segmented streetscape elements, such as buildings and street trees, a regression-style model was built to predict SW, scored using a human-based auditing method. Older female active leisure walkers living in Bunkyo Ward, Tokyo, are associated with SW scores estimated by the model (OR = 3.783; 95% CI = 1.459 to 10.409), but male walkers are not.

Preferences of Physical Education Profiles Among Polish Adolescents

The purpose of this study was to examine the association of the preferred profiles of physical education (PE) classes with gender and school level among Polish adolescents. In the cross-sectional survey study, 1,340 Polish students (including 50% of girls) attending middle and high schools, aged between 13 and 19 years, participated. The participants selected one of four preferred profiles of PE classes. The majority (n = 845, 63%) of students participated in PE for "fun-pleasure-entertainment," whereas only one third of students (n = 419, 31%) preferred "exercise-sweat-fitness" as a profile of PE classes. The preference for "fun-pleasure-entertainment" decreased about 41% for boys and 31% for high school students. A preference for "exercise-sweat-fitness" increased about 56% for men and 31% for high school students. Teachers should comply with students' preferences related to PE profiles, organizing PE classes in more fun-related forms for girls and in more exercise-related forms for boys. The proportions of these two preferred profiles of PE classes should turn across adolescence, increasing exercise-related forms and decreasing those fun-related ones.

Associations of Activity and Sleep With Quality of Life: A Compositional Data Analysis

INTRODUCTION

Associations between time spent on physical activity, sedentary behavior, and sleep and quality of life are usually studied without considering that their combined time is fixed. This study investigates the reallocation of time spent on physical activity, sedentary behavior, and sleep during the 24-hour day and their associations with quality of life.

METHODS

Data from the 2011-2016 Rotterdam Study were used to perform this cross-sectional analysis among 1,934 participants aged 51-94 years. Time spent in activity levels (sedentary, light-intensity physical activity, moderate-to-vigorous physical activity, and sleep) were objectively measured with a wrist-worn accelerometer combined with a sleep diary. Quality of life was measured using the EuroQoL 5D-3L questionnaire. The compositional isotemporal substitution method was used in 2018 to examine the association between the distribution of time spent in different activity behaviors and quality of life.

RESULTS

Reallocation of 30 minutes from sedentary behavior, light-intensity physical activity, or sleep to moderate-to-vigorous physical activity was associated with a higher quality of life, whereas reallocation from moderate-to-vigorous physical activity to sedentary behavior, light-intensity physical activity, or sleep was associated with lower quality of life. To illustrate this, a reallocation of 30 minutes from sedentary behavior to moderate-to-vigorous physical activity was associated with a 3% (95% CI=2, 4) higher quality of life score. By contrast, a reallocation of 30 minutes from moderate-to-vigorous physical activity to sedentary behavior was associated with a 4% (95% CI=2, 6) lower quality of life score.

CONCLUSIONS

Moderate-to-vigorous physical activity is important with regard to the quality of life of middle-aged and elderly individuals. The benefits of preventing less time spent in moderate-to-vigorous physical activity were greater than the benefits of more time spent in moderate-to-vigorous physical activity. These results could shift the attention to interventions focused on preventing reductions in moderate-to-vigorous physical activity levels. Further longitudinal studies are needed to confirm these findings and explore causality.

Gender differences in barriers to physical activity among adolescents

BACKGROUND AND AIMS

Great attention is now being paid to effective policies and programs to promote physical activity among adolescents, girls consistently found to be less active than boys. The aim of this study was to assess gender differences in perceived barriers for physical activity practice and their relationship with physical activity levels and physical condition among adolescents.

METHODS AND RESULTS

A cross-sectional study was conducted in February-April 2017 among students (n = 368) in the last year of two state high schools in Florence (Italy). Participants underwent the measurements of anthropometric parameters (height, weight, waist, and hip circumferences), blood pressure and administration of 3 standardized questionnaires (International Physical Activity Questionnaire, Mediterranean Diet Score Quiz, and Barriers to Being Active Quiz). Gender differences were assessed using a multivariate logistic regression model (adjusted for age and body mass index). The prevalence of participants who reached recommended levels was lower among girls compared to boys (OR 0.27; 95% CI 0.17-0.43). The number of perceived barriers to physical activity was higher among girls than among boys (OR 1.52; 95% CI 1.29-1.79), lack of energy for exercise and lack of willpower being the two barriers most frequently reported by girls. At multivariable adjusted logistic regression analysis, gender (female), and positivity of at least one perceived barrier (score ≥ 5) were independently selected as the main determinants of non-compliance with WHO criteria for physical activity.

CONCLUSIONS

Exercise professionals should be aware of the barriers that young girls can face during exercise prescription and be able to contrast them with useful individual strategies.

Study of the role of regular physical activity on promoting hedonism and eudaimonia in breast cancer survivors

Background

Individuals who have completed cancer treatment may have psychological and physical challenges. Participating in regular physical activity is considered as one of the most important factors for improving postcancer experience.

Aims

The aim of this study was to examine the effect of participating in physical activities on hedonism and eudaimonia among breast cancer survivors.

Methods

The research method was a semi-experimental design in the form of time-series using two experimental and control groups. 42 breast cancer survivors participated in this study in Urmia. Data using motives for activation of hedonism and eudiamonia (HEMA) were gathered before the intervention program (pre-test), at the end of intervention (the first post-test), and two weeks after the first post-test (the second post-test). For data analysis, descriptive and inferential statistics (T-test, Chi-square, and repeated measures ANOVA) were used.

Result

Repeated measures ANOVA analysis in the three different periods of pre-test, post-test, and a month later post-test showed that changes in the mean score of hedonism and eudaimonia motivation were not similar in the two groups and indicated the improvement of dialysis adequacy in the intervention group compared with the control group.

Conclusion

Generally, the results showed that participating in regular physical activity is an effective intervention on enhancing the motives for hedonism and eduaimonia in breast cancer survivors.

No effect of the endurance training status on senescence despite reduced inflammation in skeletal muscle of older individuals

The aim of the present study was to determine if the training status decreases inflammation, slows down senescence, and preserves telomere health in skeletal muscle in older compared with younger subjects, with a specific focus on satellite cells. Analyses were conducted on skeletal muscle and cultured satellite cells from vastus lateralis biopsies (n = 34) of male volunteers divided into four groups: young sedentary (YS), young trained cyclists (YT), old sedentary (OS), and old trained cyclists (OT). The senescence state and inflammatory profile were evaluated by telomere dysfunction-induced foci (TIF) quantification, senescence-associated β-galactosidase (SA-β-Gal) staining, and quantitative (q)RT-PCR. Independently of the endurance training status, TIF levels (+35%, P < 0.001) and the percentage of SA-β-Gal-positive cells (+30%, P < 0.05) were higher in cultured satellite cells of older compared with younger subjects. p16 (4- to 5-fold) and p21 (2-fold) mRNA levels in skeletal muscle were higher with age but unchanged by the training status. Aging induced higher CD68 mRNA levels in human skeletal muscle (+102%, P = 0.009). Independently of age, both trained groups had lower IL-8 mRNA levels (-70%, P = 0.011) and tended to have lower TNF-α mRNA levels (-40%, P = 0.10) compared with the sedentary subjects. All together, we found that the endurance training status did not slow down senescence in skeletal muscle and satellite cells in older compared with younger subjects despite reduced inflammation in skeletal muscle. These findings highlight that the link between senescence and inflammation can be disrupted in skeletal muscle.

Physical activity of patients with a primary open angle glaucoma

AIM

To assess physical activity (PA) including its intensity in primary open angle glaucoma (POAG).

METHODS

PA was characterized by the use of questionnaires: Seven-Day Physical Activity Recall and Historical Leisure Activity Questionnaire. A questionnaire of 36 questions, developed by the authors, was used to assess the level of knowledge about glaucoma.

RESULTS

The study was conducted among 625 adults. The study group comprised 312 POAG patients aged over 40y, including 238 women (76%) and 74 men (24%). The control group consisted of 313 adults (>40 years old), including 202 (65%) women and 111 men (35%). The duration of current PA with an intensity of 4 metabolic equivalents (METs) was significantly shorter among people with POAG. PA in the past was significantly lower among people from the study group, regardless of gender. The level of glaucoma knowledge in patients with POAG was poor and significantly lower in men.

CONCLUSION

Regular PA is an important and underestimated factor predisposing to the progression of POAG. There is a necessity to undertake educational and preventive actions with a view to modify the health behavior of glaucoma patients.

Partnering and parenting transitions in Australian men and women: associations with changes in weight, domain-specific physical activity and sedentary behaviours

Background

Partnering and parenting are important life-stage transitions often accompanied by changes in social networks, roles and responsibilities. There have been no longitudinal studies examining associations of partnering and parenting with changes in domain-specific physical activity (PA) and sedentary behaviours, and our understanding of whether these transitions are associated with weight change is limited.

Methods

Two thousand one hundred and twenty-four Australian adults from a national cohort (mean age 31.7 (2.7) years, 47.5% male) completed questionnaires at baseline (2004–06) and follow-up (2009–11), reporting marital and parental status. Weight (kg) was measured at baseline and self-reported at follow-up. PA and sedentary behaviours (sitting and television (TV) viewing) were self-reported in a subset (n = 1221). Linear regression estimated the longitudinal associations of parenting and partnering transitions with PA, sedentary behaviours and weight at follow-up, adjusted for baseline value of the respective outcome variable, age, education, follow-up duration and other life-stage transition.

Results

During the 5-year follow-up, 17.3% men and 12.9% women partnered, and 27.3% men and 19.1% women had their first child. Compared to staying not partnered, partnering was associated with an increase in total PA (177.5mins/week, 95% Confidence Interval (CI) 18.0 to 337.0) among men and a greater weight gain (2.2 kg, 95% CI 0.6 to 3.7) among women. Compared to remaining child-free, having a first child was associated with greater reductions in total PA (− 123.9mins/week, 95% CI − 248.8 to 1.1) and TV viewing time (− 27.0mins/day, 95% CI − 50.6 to − 3.3) among men. Women who had their first child had greater weight gain (1.4 kg, 95% CI 0.1 to 2.7) but spent less time sitting (− 103.8mins/day, 95% CI − 135.5 to − 72.1) than those remaining child-free. For women, having additional children was associated with less sitting time (− 39.4mins/week, 95% CI − 66.0 to − 12.8) than having the same number of children.

Conclusions

Partnering was associated with an increase in men’s total PA and women’s weight. Transitions into parenthood with a first child or additional children were associated with potentially health-impairing changes in weight and PA, but health-promoting changes in sedentary behaviours. Future PA promotion strategies should pay attention to men who had their first child to mitigate declining total PA.

Consistent participation in organized physical activity predicts emotional adjustment in children

BACKGROUND

The objectives of this study were to derive trajectories of childhood participation in organized physical activity (PA) and to examine how these trajectories are associated with pre-existing and subsequent emotional adjustment.

METHODS

Trajectories of mother-reported participation in organized PA were derived from age 6 to 10 for 1492 children from the Québec Longitudinal Study of Child Development birth cohort. Parents and teachers reported on internalizing behavior (emotional distress, anxiety, shyness, social withdrawal) at ages 4 and 12, respectively.

RESULTS

Longitudinal latent class analysis identified two typical trajectories of participation in organized PA. The Consistent Participation trajectory (61%) included children with elevated probability of participation at all ages. The Low-Inconsistent Participation trajectory (39%) included children who did not participate or participated only once or twice, generally in late childhood. Pre-existing internalizing behavior at age 4 did not predict trajectory membership. However, children in the Low-Inconsistent Participation trajectory showed higher subsequent emotional distress (B = 0.87, 95% confidence interval [CI] = 0.46-1.28), anxiety (B = 0.61, 95% CI = 0.18-1.04), shyness (B = 0.92, 95% CI = 0.39-1.44), and social withdrawal (B = 0.86, 95% CI = 0.37-1.34) at age 12 than those in the Consistent Participation trajectory.

CONCLUSIONS

Our findings suggest that early and sustained involvement in organized PA is beneficial for children's emotional development.

Strategies to Improve Health Communication: Can Health Professionals be Heroes?

Communicating evidence-based nutrition messages to the public is challenging and is often in conflict with popular opinions, particularly from social media influencers (SMIs). In order to increase engagement with nutrition professionals (NPs) on social media, we aimed to explore young adults' perceptions of the authenticity and trustworthiness of SMIs and NPs Instagram posts. A cross-sectional questionnaire was administered to students (n = 149) from an Australian University. Participants viewed a real-life Instagram profile and one post from both a NP and a SMI. Main outcomes were post authenticity and trustworthiness, and emotional message appeals measured on five-point Likert scales. Regression models were developed to assess whose post (the NP or SMI) was perceived to be more authentic and trustworthy. Participants were young adults (median age (25th, 75th percentiles): 20 (19,21)), with approximately half identifying as female. A high heroic message appeal (+1SD above mean) significantly increased the perceived authenticity of the NPs post only (p = 0.01). Post authenticity enhanced post trustworthiness, but only when a heroic message appeal was used by the NP. When appropriate, NPs should convey positive emotions such as bravery and success to enhance the authenticity and trustworthiness of their posts.

Using motivational interviewing to enhance emerging adults' engagement in weight loss: The Live Well RVA pilot randomized clinical trial

Background

Emerging adults (ages 18–25) are at high risk for overweight/obesity, yet traditional adult behavioural weight loss (BWL) interventions do not meet the needs of individuals at this developmental stage. Motivational interviewing (MI) is an evidence‐based approach to promote behaviour change but has not been tested for weight loss in this population. The study aimed to test the feasibility and preliminary efficacy of an MI‐enhanced weight loss programme to promote engagement, retention and weight loss in emerging adults.

Methods

Emerging adults with overweight/obesity (N = 47, 81% female, 47% racial/ethnic minority, body mass index [BMI] = 33.2 ± 4.6 kg/m²) were randomized to either standard BWL or MI‐enhanced BWL (MIBWL). Weight was assessed objectively at baseline and posttreatment (3 months). Engagement (in‐person session attendance [weeks 1 and 2], online self‐monitoring [weeks 3–12] and online content viewing [weeks 3–12]) was tracked throughout the program.

Results

Though results did not reach the level of statistical significance, participants in MIBWL demonstrated greater programme engagement (77% vs. 61.0%, p = .11; Cohen d = .48), retention (71% vs. 48.0%, p = .10; Cohen h = .47) and intent‐to‐treat weight loss (−3.3% vs. −2.2%, p = .37; Cohen d = .26) compared with those in BWL.

Conclusions

Effect sizes suggest that MI might be a viable approach to enhance engagement and retention in weight loss programmes targeting emerging adults. This finding is meaningful, given the documented challenges with engagement and retention in this vulnerable population and the relationship between engagement and better weight loss outcomes. The results of this small pilot study support efforts to replicate these findings within the context of a fully powered trial.

The Role of Family Time Together in Meeting the Recommendation for Physical Activity among Primary School Children

Family time may have an influence on children’s physical activity (PA) participation or may contribute to increased sedentary behaviour. The aim of this paper was to examine whether spending family time is associated with the PA of children aged 10–11. Cross-sectional data on 158 primary school children (80 girls and 78 boys) with a mean age of 10.6 ± 0.49 years were collected. Weight and height were used to calculate body mass index. The level of moderate-to-vigorous physical activity (MVPA) was determined with a physical activity screening measure. Participants wore a Vivofit^® wrist band activity tracker to measure their daily number of steps. The Health Behaviour in School-Aged Children questionnaire was used to obtain information from children about the frequency of activities undertaken by the family. Analyses entailed descriptive statistics of the total sample and by gender, t-test, and the Mann–Whitney U-test to examine the gender differences and Spearman’s correlation coefficients. It was found that 32.3% of the children did not accomplish at least 60 min per day on ≥5 of the seven days and more than 75.9% of them did not accumulate at least 12,000 or more steps daily. More boys than girls tended to be sufficiently active and met the guideline of at least 60 min per day on ≥5 of the seven days (70.5% and 65.0%, respectively) or 12,000 steps per day (25.8% and 10.0%, respectively). The number of steps during the weekday was significantly and inversely associated both in girls and in boys with active family time (r = −0.27 and r = −0.25, respectively), and with total family time (r = −0.28) and non-active family time (r = −0.25) only in boys. Average MVPA was also inversely correlated with active family time (r = −0.31), non-active family time (r = −0.24), and total family time (r = −0.29) in boys. The correlation effect size values ranged between small to medium significant differences for these measures. The findings underscore the need for community-based PA programmes designed for whole families to meet the recommended PA of children and also to develop and promote active leisure activities among families.

Physical activity, use of alcohol and smoking in middle-aged and aging men. A longitudinal study among Finnish male former athletes and controls

It is not known whether decrease in physical activity (PA) is associated with binge drinking among former athletes. The purpose of this study was to investigate the reciprocal associations between PA and use of alcohol among former athletes and controls at four time points. Furthermore, we examined whether there were longitudinal latent profiles related to use of alcohol, smoking and PA during the follow-up. Finnish male former elite athletes (n = 1633) and matched controls (n = 1099) questionnaire-reported their PA, alcohol consumption and smoking at four time points in 1985, 1995, 2001 and 2008. Former athletes were more physically active and smoked less than controls, but in all profiles smoking decreased during the follow-up. Former athletes consumed alcohol significantly more compared to controls in 1985, especially if their athletic career had ended suddenly by sports injury. At other time points, no differences were seen. Five latent profiles were found, and there were significant differences between former athletes and controls in the probabilities to belong to four of them. PA decreased in four of five profiles, while alcohol consumption decreased or increased in some profiles. But PA did not predict later alcohol consumption at any time point. Cross-lagged path model indicated that the mutual associations of alcohol use and PA were weak at most. Although risk of excessive alcohol consumption may increase in individuals, whose athletic career has ended suddenly by sports injury, overall PA and alcohol affected each other's development only modestly among former athletes and controls during the 23-year follow-up.

Differences between accelerometer cut point methods among midlife women with cardiovascular risk markers

OBJECTIVE

Midlife women experience elevated risk for cardiovascular disease and often receive advice to increase physical activity to mitigate this risk. Use of accelerometers to measure ambulatory physical activity requires selection of appropriate thresholds for estimating moderate-to-vigorous physical activity (MVPA), and choice of cut points may lead to meaningfully different conclusions about midlife women's physical activity (PA) engagement. This is particularly important given the recent elimination of 10-minute bout requirements for MVPA. This two-phase study examined differences between four cut point methods among midlife women with cardiovascular disease (CVD) risk. We used findings from Study 1 (exploratory) to generate hypotheses for Study 2 (confirmatory).

METHODS

Across studies, participants (N = 65) were midlife women with an additional CVD risk factor (eg, hypertension). Participants wore waistband accelerometers for seven days. Daily totals were calculated for minutes in light and MVPA using four common quantification methods (Freedson, Matthews, Swartz, and Troiano).

RESULTS

Multilevel models showed meaningful differences between methods (P < 0.0001). For total (non-bouted) minutes of MVPA, Freedson and Troiano methods showed that participants barely met MVPA recommendations (30 min per day), whereas Matthews and Swartz methods showed that participants greatly exceeded this goal. As differences between methods were smaller using MVPA bouts of 10 minutes or more (though remained significant), the observed variation was due in part to small bursts of MVPA dispersed throughout the day.

CONCLUSIONS

Findings demonstrate the need for careful consideration of PA quantification among midlife women with CVD risk, and for further investigation to determine the most appropriate quantification method. : Video Summary:http://links.lww.com/MENO/A545.

The impact of breast cancer on physical activity from midlife to early older adulthood and predictors of change post-diagnosis

PURPOSE

To examine physical activity (PA) patterns from pre- to post-diagnosis, and compare these changes to women without breast cancer. To determine pre-diagnosis predictors of PA change, post-diagnosis, in breast cancer survivors (BCS).

METHODS

Data were from 2314 Study of Women's Health Across the Nation (SWAN) participants, average age of 46.4 ± 2.7 years at baseline (1996-1997). In Pink SWAN, 151 women who reported an incident breast cancer diagnosis over 20 years were classified as BCS; the remaining 2163 women were controls. LOESS plots and linear mixed models were used to illustrate and compare PA changes (sports/exercise [primary measure] and total PA) from pre- to post-diagnosis (or corresponding period) in BCS versus controls. Adjusted linear regression models were used to determine pre-diagnosis predictors of at-risk post-diagnosis PA change patterns (consistently low and decreased PA).

RESULTS

No differences in pre- to post-diagnosis PA (or corresponding period) were observed in BCS versus controls. Among BCS, the odds of at-risk post-diagnosis PA change patterns was 2.50 (95% CI 0.96-6.48) times higher for those who reported sleep problems at ≥ 50% (compared to 0%) of pre-diagnosis visits and 3.49 (95% CI 1.26-9.65) times higher for those who were overweight or obese at all (compared to no) pre-diagnosis visits. No other statistically significant predictors were noted.

CONCLUSIONS

Age-related declines in PA were not amplified by a breast cancer diagnosis. Given the beneficial role of PA across the cancer control continuum, efforts to increase or maintain adequate PA, post-diagnosis, should be continued.

IMPLICATIONS FOR CANCER SURVIVORS

While age-related physical activity declines were not amplified breast cancer diagnosis, efforts to identify breast cancer survivors at increased risk for post-diagnosis physical activity declines (or maintenance of low activity) may be a high-yield strategy to improve prognosis and quality of life.

Well-being and Long-term Physical Activity Participation in Midlife Adults: A Latent Class Analysis

Background

Despite the benefits of physical activity, a large majority of adults fail to get the recommended amount of regular exercise, and interventions to increase physical activity typically achieve only temporary improvements. The potential contribution of positive psychological functioning to the maintenance of physical activity has not been widely examined.

Purpose

To test the hypothesis that psychological well-being would increase the likelihood of sustained physical activity in adults using a person-centered approach with longitudinal data.

Methods

Participants (N = 2,214) were from the longitudinal Survey of Midlife Development in the United States (MIDUS). Continuous latent variables representing physical activity at three waves of MIDUS were used to partition respondents into distinct (categorical) classes based on longitudinal activity profiles.

Results

Latent class analyses identified three distinct physical activity profiles: sustained, consistently low, and declining activity (the normative class). Multinomial logistic regression analyses showed that the odds of membership in the sustained activity class were significantly higher for those with higher eudaimonic well-being (OR = 1.08 [1.03-1.13], p = .001), after adjustment for diverse covariates. Supplemental analyses revealed similar associations for specific subdomains of eudaimonic well-being.

Conclusion

This study provides evidence that greater well-being may help sustain physical activity in the long term. These results suggest that improving well-being may be a useful addition to interventions aimed at increasing long-term physical activity participation.

Language of Health of Young Australian Adults: A Qualitative Exploration of Perceptions of Health, Wellbeing and Health Promotion via Online Conversations

Young adults (YA) are in a critical stage of life for the encouragement of healthy behaviours such as healthy eating and exercising. This research explored Australian YA values and perceptions related to health, healthy behaviours and health promotion efforts. This qualitative analysis involved n = 166, Australian 18–24 year-olds recruited through a market research field house. Participants (63% currently studying at tertiary level) engaged in a facilitated in-depth online conversation around health and healthy eating over four weeks. Leximancer^TM and manual inductive thematic coding were utilised for analysis via the lens of emerging adulthood and health communication theories. Health was seen as multi-faceted, with particular importance placed on mental health and exercise. Some participants focussed on physical appearance, often fuelled by comparison to others. Many believed that at their age and health status, adopting health-enhancing behaviours without short-term tangible benefits was not a priority. Participants did not prioritise health-enhancing behaviours due to barriers such as a perceived lack of money, knowledge and time often due to studying or working and perceived effort. Strategies they proposed to encourage healthy eating included: incentivising healthy food; quick and affordable healthy recipes; and communicating the short-term tangible benefits of healthy behaviours. There is a need for focussed health messaging that address the needs and desires of YA and directly address the barriers they face.

The time spent sitting does not always mean a low level of physical activity

Background

The problem of spending most of the day in a sitting position concerns all people, regardless of their age. Unfortunately, this trend is more and more often observed among young people.

The aim of the study was to assess self-reported physical activity and time spent sitting among students of different fields of health related faculty.

Methods

The study group included 216 students (22.3 ± 1.8 years of age) of the Medical University of Lodz: physiotherapy students (n = 101), pharmacy students (n = 73), and dietetics students (n = 42). The time spent sitting and physical activity level were assessed based on the International Physical Activity Questionnaire-long version.

Results

The time spent sitting among health related faculty students was on average more than 46 h a week (2781.8 ± 1238.5 MET-minutes/week). Regarding all the students the pharmacy students spent most time sitting (3086.0 ± 1032.1 MET-minutes/week), while the dietetics students spent the least (2215.7 ± 1230.1 MET-minutes/week). Taking into account the physical activity level almost 65% of all the students were in a high category (mainly physiotherapy students). Only 1.4% of all the surveyed students were classified as the low physical activity category. Statistical analysis showed no significant differences (P = 0.6880) between the time spent sitting and level of physical activity among all students.

Conclusions

Students of medical universities spend too much hours on sitting, mostly 5–8 h a day. Despite this, they undertake various activities due to which their level of physical activity is moderate or even high. Therefore, it cannot be unequivocally stated that there is a relationship between the time spent sitting and physical activity level.

Daily Relations between Social Perceptions and Physical Activity among College Women

OBJECTIVES

There is a need to develop more effective physical activity (PA) promotion programs for college women. Theory and evidence suggest that perceptions of the social environment play a role in college women's PA, though little is known about how these perceptions are associated with PA at the day level. The goal of this study was to examine relations between changes in college women's daily social perceptions and objectively assessed PA over seven days.

DESIGN

Daily diary method.

METHOD

College women (n = 80, M Age = 20, M BMI = 23.1 kg/m2) wore Fitbit wristbands and completed daily self-reports of (1) the quantity and perceived intensity of their social interactions (positive/negative), and (2) the occurrence of social comparisons (based on appearance/health/status) for seven days.

RESULTS

Multilevel models showed daily variability in predictors and outcomes (ps < 0.0001), as well as relations between within-person changes in social perceptions and PA. Increases in negative interactions (particularly those with friends) were consistently associated with decreases in daily PA, whereas increases in positive interactions showed limited relations (srs = -0.22-0.34). Days with health comparisons were days with greater PA for women who had stronger overall interest in comparisons, but were days with less PA for women with weaker overall interest (srs = 0.22-0.33). PA did not differ between days with vs. without appearance comparisons.

CONCLUSIONS

Social perceptions show meaningful day-to-day variability and relations with college women's daily PA, and specific associations may be useful for improving tailored interventions for college women.

Mighty men: A faith-based weight loss intervention to reduce cancer risk in African American men

According to the American Cancer Society's guidelines on nutrition and physical activity for cancer prevention, weight control, eating practices and physical activity are second only to tobacco use as modifiable determinants of cancer risk. However, no evidence-based interventions have been targeted to African American men or tailored to individual African American men's preferences, needs or identities. The goal of this chapter is to describe the rationale for the components, aims and setting of Mighty Men: A Faith-Based Weight Loss Intervention for African American Men. We begin by discussing the rationale for focusing on weight loss in the context of cancer prevention, and argue that obesity and obesogenic behaviors are important yet modifiable determinants of cancer risk. Next, we briefly review the scarce literature on interventions to promote healthy eating, physical activity and weight loss in our population of interest, and then discuss the rationale for conducting the intervention in faith- based organizations rather than other common settings for recruiting African American men. We conclude with a discussion of the conceptual foundations and components of Mighty Men, and discuss our focus and goals in the context of the larger literature in this area.

Is change in mental distress among adolescents predicted by sedentary behaviour or screen time? Results from the longitudinal population study The Tromsø Study: Fit Futures

OBJECTIVE

There is growing interest in the relationship between sedentary behaviour and mental distress among adolescents, but the majority of studies to date have relied on self-reported measures with poor validity. Consequently, current knowledge may be affected by various biases. The aim of this study was to investigate the cross-sectional and longitudinal association between (1) objectively measured sedentary time and (2) self-reported screen time with mental distress among adolescents participating in The Tromsø Study: Fit Futures, in order to see if the association is dependent on mode of measurement of sedentary behaviour.

DESIGN

Prospective study.

SETTING

Sample drawn from upper secondary school students (mean age 16.3 years at baseline) from two municipalities in Northern Norway participating in The Tromsø Study: Fit Futures 1 and 2.

PARTICIPANTS

686 adolescents (54.5% female), with complete self-reported and accelerometer data after multiple imputation.

PRIMARY OUTCOME MEASURES

Mental distress assessed via the Hopkins Symptom Checklist-10 (HSCL-10).

RESULTS

Minutes in sedentary behaviour measured by accelerometer showed no significant relationship with mental distress in neither crude, partly adjusted nor multiple adjusted hierarchic linear regression analyses. Self-reported screen time was positively associated with mental distress in all analyses (multiple adjusted, B=0.038, p=0.008, 95% CI 0.010 to 0.066). However, the effect was small.

CONCLUSIONS

Self-reported screen time was associated with slightly elevated mental distress 2 years later, whereas objectively measured minutes in sedentary behaviour was not, indicating a discrepancy in the results depending on measurement methods.

Everyday stress components and physical activity: examining reactivity, recovery and pileup

The experience of naturally-occurring stress in daily life has been linked with lower physical activity levels. However, most of this evidence comes from general and static reports of stress. Less is known how different temporal components of everyday stress interfere with physical activity. In a coordinated secondary analysis of data from two studies of adults, we used intensive, micro-longitudinal assessments (ecological momentary assessments, EMA) to investigate how distinct components of everyday stress, that is, reactivity to stressor events, recovery from stressor events, and pileup of stressor events and responses predict physical activity. Results showed that components of everyday stress predicted subsequent physical activity especially for indicators of stress pileup. In both studies, the accumulation of stress responses over the previous 12 h was more predictive of subsequent physical activity than current stress reactivity or recovery responses. Results are compared to the effects of general measures of perceived stress that showed an opposite pattern of results. The novel everyday stress approach used here may be fruitful for generating new insights into physical activity specifically and health behaviors in general.

Children’s neighbourhood physical environment and early development: an individual child level linked data study

Background

Identification of features of the neighbourhood physical environment that have a causal association with positive child development is important for promoting long-term developmental health. Previous research on these associations have been conducted at the neighbourhood level, and do not account for individual variation in exposure to these features.

Methods

This cross-sectional study utilised de-identified linked administrative data. Neighbourhood features were measured with Geographic Information Systems and identified within a 1600 m service area around the child’s home address. The study population included a random selection of 5024 Western Australian children who participated in the 2012 Australian Early Development Census (AEDC; median age 5 years, 5 months). Multi-level logistic regressions modelled the odds of children scoring in the bottom 10% on the physical, social or emotional AEDC domains as an outcome of neighbourhood features.

Results

After adjustment for individual and neighbourhood sociodemographic factors, lower odds of physical vulnerability were associated with increased neighbourhood residential density, presence of railway station, and higher counts of playgroups and kindergartens. Larger areas of neighbourhood home-yard space were associated with increased odds of physical and social vulnerability. Presence of high-quality green spaces was associated with lower odds of social vulnerability. Increased road traffic exposure was associated with higher odds of social and emotional vulnerability.

Conclusions

The neighbourhood physical environment has a weak but significant association with early childhood development. Future research should consider the interplay between the neighbourhood environment and proximal influences, including parenting attributes and socioeconomic status, and how they influence early child development.

Educational differentials in key domains of physical activity by ethnicity, age and sex: a cross-sectional study of over 40 000 participants in the UK household longitudinal study (2013-2015)

OBJECTIVES

To assess whether educational differentials in three key physical activity (PA) domains vary by age, sex and ethnicity.

DESIGN

National cross-sectional survey.

SETTING

UK.

PARTICIPANTS

Altogether 40 270 participants, aged 20 years and over, from the UK Household Longitudinal Study with information on education, PA and demographics collected in 2013-2015.

OUTCOME MEASURES

Participation in active travel (AT), occupational activity (OA) and leisure time physical activity (LTPA) at the time of assessment.

RESULTS

Lower educational attainment was associated with higher AT and OA, but lower weekly LTPA activity; these associations were modified by sex, ethnicity and age. Education-related differences in AT were larger for women-the difference in predicted probability of activity between the highest and the lowest education groups was -10% in women (95% CI: -11.9% to 7.9%) and -3% in men (-4.8% to -0.4%). Education-related differences in OA were larger among men -35% (-36.9% to -32.4%) than women -17% (-19.4% to -15.0%). Finally, education-related differences in moderate-to-vigorous LTPA varied by ethnicity; for example, differences were 17% (16.2% to 18.7%) for white individuals compared with 6% (0.6% to 11.6%) for black individuals.

CONCLUSIONS

Educational differences in PA vary by domain and are modified by age, sex and ethnicity. A better understanding of physically inactive subgroups may aid development of interventions to both increase activity levels and reduce health inequalities.

Relationship between Morbidity and Health Behavior in Chronic Diseases

This study aimed to analyze the demographic characteristics and health behaviors related to chronic diseases and to identify factors that may affect chronic diseases. Data from the Seventh Korea National Health and Nutrition Examination Survey were used, and 3795 adults aged above 40 years were included. The following demographic variables were obtained: sex, age, education, income, type of health insurance, and private insurance. The following health behavior factors were also analyzed: medical checkup, drinking, smoking, exercise, obesity, and hypercholesterolemia. Participants with lower socioeconomic status had a higher risk of developing chronic diseases. Meanwhile, those with private health insurance had a lower risk of developing chronic diseases. In addition, participants who underwent medical checkups and performed exercises had a lower risk, while those with obesity and hypercholesterolemia had a higher risk of developing chronic diseases. It is necessary to manage chronic diseases through comprehensive programs, rather than managing these diseases individually, and through community primary care institutions to improve health behaviors.

Weight Stigma Experiences and Physical (In)activity: A Biographical Analysis

INTRODUCTION

People with obesity often report experiences of weight-related discrimination. In order to find out how such experiences throughout the life course are related to physical activity behavior, we exploratively studied activity-related biographies of people with obesity from a social constructivist perspective.

METHODS

We collected biographical data of 30 adults (mean age 37.66 years; 14 males and 16 females) with obesity (average BMI 40.64, including a range from 33 to 58) using a biography visualization tool that allows participants to map developmental courses and critical life experiences over their life course.

RESULTS

Participants remembered a continuous decrease of physical activity from childhood to mid-adulthood. Weight-related discrimination, both in sport and non-sport settings, was especially experienced in adolescence and mid-adulthood. Against the background of our findings, we assume that the degree of felt stigma rather than the stigmatizing behavior itself influences physical activity behavior over the life course.

CONCLUSION

The results of our exploratory study reiterate the detrimental effect weight stigma can have on health behaviors. Initiatives are needed to reduce weight stigma in exercise contexts; additionally, initiatives to promote physical activity should focus on helping individuals with obesity to establish coping strategies to reduce the experienced burden from weight stigma.

Greater maintenance of bone mineral content in male than female athletes and in sprinting and jumping than endurance athletes: a longitudinal study of bone strength in elite masters athletes

We investigated longitudinal changes in tibia bone strength in master power (jumping and sprinting) and endurance (distance) athletes of both sexes. Bone mass but not cross-sectional moment of inertia was better maintained in power than endurance athletes over time, particularly in men and independent of changes in performance.

OBJECTIVE

Assessment of effects of sex and athletic discipline (lower limb power events, e.g. sprint running and jumping versus endurance running events) on longitudinal changes in bone strength in masters athletes.

METHODS

We examined tibia and fibula bone properties at distal (4% distal-proximal tibia length) and proximal (66% length) sites using peripheral quantitative computed tomography (pQCT) in seventy-one track and field masters athletes (30 male, 41 female, age at baseline 57.0 ± 12.2 years) in a longitudinal cohort study that included at least two testing sessions over a mean period of 4.2 ± 3.1 years. Effects of time, as well as time × sex and time × discipline interactions on bone parameters and calf muscle cross-sectional area (CSA), were examined.

RESULTS

Effects of time were sex and discipline-dependent, even following adjustment for enrolment age, sex and changes in muscle CSA and athletic performance. Male sex and participation in power events was associated with better maintenance of tibia bone mineral content (BMC, an indicator of bone compressive strength) at 4% and 66% sites. In contrast, there was no strong evidence of sex or discipline effects on cross-sectional moment of inertia (CSMI, an indicator of bone bending and torsional strength-P > 0.3 for interactions). Similar sex and discipline-specific changes were also observed in the fibula.

CONCLUSIONS

Results suggest that male athletes and those participating in lower limb power-based rather than endurance-based disciplines have better maintenance of bone compressive but not bending and torsional strength.

Aging and Physiological Lessons from Master Athletes

Sedentary aging is often characterized by physical dysfunction and chronic degenerative diseases. In contrast, masters athletes demonstrate markedly greater physiological function and more favorable levels of risk factors for cardiovascular disease, osteoporosis, frailty, and cognitive dysfunction than their sedentary counterparts. In many cases, age-related deteriorations of physiological functions as well as elevations in risk factors that are typically observed in sedentary adults are substantially attenuated or even absent in masters athletes. Older masters athletes possess greater functional capacity at any given age than their sedentary peers. Impressive profiles of older athletes provide insight into what is possible in human aging and place aging back into the domain of "physiology" rather than under the jurisdiction of "clinical medicine." In addition, these exceptional aging athletes can serve as a role model for the promotion of physical activity at all ages. The study of masters athletes has provided useful insight into the positive example of successful aging. To further establish and propagate masters athletics as a role model for our aging society, future research and action are needed. © 2020 American Physiological Society. Compr Physiol 10:261-296, 2020.

Does having a pet influence the physical activity of their young female owners?

Background

Many studies have shown that having a dog has an impact on the increase in physical activity (PA) of people. However, what is often not taken into account in many such studies is owning of other pets. The aim of this study was to compare PA levels between animal owners and non-owners and to research potential differences between owners of different kinds of animals.

Method

111 young females of mean age 21 ± 1.2 years enrolled in this cross-sectional study. Czech version of short International physical activity questionnaire (IPAQ) was used to assess PA level, supplemented with a question about whether they owned an animal and what kind.

Results

People who owned a pet had higher frequency and duration of moderate physical activity (MPA) and spent more MET/min/wk. (p < 0.05). This difference has projected into total PA duration and also into calories burned in a week. Furthermore, a statistically significant difference between subgroups of animal owners was also confirmed for MPA and total PA in favour of horse owners.

Conclusions

Animal owners generally reported higher PA levels compared to people who do not own any pets. However, similarly significant in this particular age group was the kind of animal these young women owned.

Influence of Health Literacy on the Physical Activity of Working Adults: A Cross-Sectional Analysis of the TRISEARCH Trial

Studies show that high health literacy (HL) can support the promotion and maintenance of healthy behavior such as physical activity (PA). However, most studies rely on subjective data. The aim of the present study is to investigate the relationship between HL and PA, not only with subjectively but also with objectively measured PA data. The present study is a pooled analysis of baseline data from the research association TRISEARCH (2015-2018), which focused on the HL of working adults. HL was measured by Lenartz' questionnaire, and PA by the Global Physical Activity Questionnaire (GPAQ; n = 1056). A subsample (n = 124) also received accelerometers (Actigraph GT3X+) to provide more objective PA data. Partial correlations and regression models were used to investigate the relationship between HL and questionnaire- and accelerometer-derived PA. Very low and medium partial correlations could be found for HL subscales and daily PA by questionnaire (r = -0.06, p < 0.05) and accelerometer (r = 0.26, p < 0.01). No subscale of HL made a significant contribution to the amount of daily PA (all p > 0.05). Not all subscales of HL seem to have an influence on the occurrence of healthy behavior, such as PA. This should be considered when HL-based interventions are designed. Further investigation of the relationship between HL and PA is needed. Objective assessments of both HL and PA can provide additional information for this task.

Influence of Health Literacy on the Physical Activity of Working Adults: A Cross-Sectional Analysis of the TRISEARCH Trial

Studies show that high health literacy (HL) can support the promotion and maintenance of healthy behavior such as physical activity (PA). However, most studies rely on subjective data. The aim of the present study is to investigate the relationship between HL and PA, not only with subjectively but also with objectively measured PA data. The present study is a pooled analysis of baseline data from the research association TRISEARCH (2015–2018), which focused on the HL of working adults. HL was measured by Lenartz’ questionnaire, and PA by the Global Physical Activity Questionnaire (GPAQ; n = 1056). A subsample (n = 124) also received accelerometers (Actigraph GT3X+) to provide more objective PA data. Partial correlations and regression models were used to investigate the relationship between HL and questionnaire- and accelerometer-derived PA. Very low and medium partial correlations could be found for HL subscales and daily PA by questionnaire (r = −0.06, p < 0.05) and accelerometer (r = 0.26, p < 0.01). No subscale of HL made a significant contribution to the amount of daily PA (all p > 0.05). Not all subscales of HL seem to have an influence on the occurrence of healthy behavior, such as PA. This should be considered when HL-based interventions are designed. Further investigation of the relationship between HL and PA is needed. Objective assessments of both HL and PA can provide additional information for this task.

Assessing the feasibility and impact of specially adapted exercise interventions, aimed at improving the multi-dimensional health and functional capacity of frail geriatric hospital inpatients: protocol for a feasibility study

BACKGROUND

Frailty is a common and clinically significant condition in older adults, predominantly due to its association with adverse health outcomes such as hospitalisation, disability and mortality. Exercise interventions have been shown to be a beneficial treatment for frailty. However, more high-quality studies are needed to assess the feasibility and impact of these interventions in frail geriatric populations within different settings, and their impact on broader aspects of health and well-being.

METHODS AND ANALYSIS

This study will use a 2-week, interventional, independent measures research design in order to assess the feasibility and impact of two specially adapted exercise training interventions (a specially adapted resistance training intervention, and Move It Or Lose It: an established community-based exercise intervention for older adults) aimed at improving the multidimensional health and functional capacity of frail geriatric hospital inpatients.

ETHICS AND DISSEMINATION

This study has received a favourable ethical opinion by the Coventry and Warwickshire NHS Research Ethics Committee and sponsorship by the University of Birmingham after review by the sponsors research governance office. The findings will be disseminated through publication in open access scientific journals, public engagement events, online via social media, conference presentations and directly to study participants on request.

TRIAL REGISTRATION NUMBER

NCT03141866.

Associations among Neighborhood Socioeconomic Deprivation, Physical Activity Facilities, and Physical Activity in Youth during the Transition from Childhood to Adolescence

Background: This study aims to examine the longitudinal association of neighborhood socioeconomic deprivation (SED) with physical activity in youth during the transition from elementary to middle school, and to determine if access to physical activity facilities moderates this relationship. Methods: Data were obtained from the Transitions and Activity Changes in Kids (TRACK) study, which was a multilevel, longitudinal study designed to identify the factors that influence changes in physical activity as youth transition from elementary to middle school. The analytic sample for the current study included 660 youth with complete data in grades 5 (baseline) and 7 (follow-up). A repeated measures multilevel framework was employed to examine the relationship between SED and physical activity over time and the potential moderating role of elements of the built environment. Results: Decreases in physical activity varied by the degree of neighborhood SED with youth residing in the most deprived neighborhoods experiencing the greatest declines in physical activity. Access to supportive physical activity facilities did not moderate this relationship. Conclusion: Future research studies are needed to better understand how neighborhood SED influences youth physical activity over time.

Comparison of the Physical Activity Frequency Questionnaire (PAFQ) with accelerometry in a middle-aged and elderly population: The CoLaus study

OBJECTIVE

The Physical Activity Frequency Questionnaire (PAFQ) has been used in several studies, but its validation dates from 1998. We compared the PAFQ with accelerometry data for measuring levels of physical activity (PA) in a middle-aged and elderly population.

DESIGN

Cross-sectional analysis was conducted with a sample of 1752 adults from the general population (50.7% female, age range 45.2-87.1 years) living in Switzerland. Participants completed the PAFQ and wore a wrist-worn accelerometer for 14 consecutive days. Spearman correlation, Lin's concordance coefficient and Bland-Altman plots were performed to compare PAFQ and accelerometry data.

RESULTS

Compared with the accelerometer, the PAFQ overestimated total, light, moderate and vigorous activity by a median [interquartile range] of 143 [34.5; 249], 72 [12; 141], 23 [-46; 100] and 13 [-1; 41] minutes/day, respectively, and underestimated sedentary behaviour by 123 [14; 238] minutes/day. Spearman's correlation coefficients ranged from 0.171 for vigorous PA and 0.387 for total PA and sedentary behaviour. Lin's concordance coefficients ranged from 0.044 for vigorous PA and 0.254 for moderate to vigorous PA. The difference between PAFQ and accelerometer results increased with increasing time spent at each activity level.

CONCLUSION

There is limited agreement between estimates of activity obtained by PAFQ and those obtained from accelerometers, suggesting that these tools measure activity differently. Although there is some degree of comparability, they should be considered as complementary tools to obtain comprehensive information on both individual and population activity levels.

Behavioural Patterns of Physical Activity and Nutritional Habits among Urban and Rural Students

Background:

Adolescence is considered as one of the most vulnerable periods. The deficiencies and poor nutritional habits and lack of physical activity will have irreparable consequences in adulthood. This study was aimed to determine the behavioural patterns of nutritional and physical activity among the urban and rural students in Urmia, Iran.

Methods:

The present study was designed and implemented using a sectional and descriptive-analytic approach. Using a stratified random sampling method, 194 males and 191 female high school students were chosen to participate. Health-Promoting Lifestyle Profile II (HPLPII) was used for data collection. The overall average score of physical activity in students was 55.57 ± 4.88, and in the aspect of nutritional behaviour it was equal to 64.04 ± 3.67.

Results:

No significant difference was observed between physical activity, nutritional behaviours and socio-demographic variables (gender, type of school, place of residence, parental education). Based on multivariate regression analysis, there was a significant relationship between physical activity and the field of education. Furthermore, a significant relationship was found between children’s nutritional behaviour and mothers’ education.

Conclusion:

Considering importance of mothers’ role in upbringing adolescents and forming their healthy behavioural patterns and the significant relationship of mothers’ education and healthy behaviours, training and increasing health literacy level of this class of population can be an imperative step in promoting the mental and physical health of adolescents.

Differences in college students' aerobic physical activity and muscle-strengthening activities based on gender, race, and sexual orientation

Aerobic physical activity and muscle-strengthening activities are beneficial to both physical and mental health, though disparities in these behaviors exist based on social determinants. The purpose of this study was to examine differences in college students' aerobic physical activity and muscle-strengthening activities based on gender, race, and sexual orientation. Undergraduates enrolled in general education health and wellness courses at a large northeastern University in the United States responded to an online survey in August 2018 that assessed their demographics and physical activity behaviors. Differences in physical activity behaviors based on social determinants were examined using independent-samples t-tests and chi-square tests for independence. Less than half (40.3%) of participants (n = 606) met both aerobic physical activity and muscle-strengthening recommendations. No differences were found in physical activity based on sexual orientation. However, significantly more non-Hispanic white participants met aerobic physical activity (74.4% vs. 63.8%) and muscle-strengthening recommendations (47.2% vs. 37.6%); and, men reported significantly greater vigorous physical activity (p = .034, η² = 0.01) and participation in muscle-strengthening activities (p < .001, η² = 0.06), and were more likely to meet muscle-strengthening recommendations compared to women (50.8% vs. 41.4%). Findings demonstrate disparities in physical activity based on race and sex, particularly with respect to muscle-strengthening activities. Findings are of concern given the importance of muscle-strengthening activities to both physical and mental health. Colleges should consider ways in which they can facilitate increased participation of racial/ethnic minorities and women in muscle-strengthening activities.

Physical Activity among Spanish Undergraduate Students: A Descriptive Correlational Study

Achieving the recommended levels of physical activity (PA) is associated with better health. Despite this, most undergraduate students report low levels of PA. This study aimed to assess the achievement of recommended PA levels in a wide sample of undergraduate students from Madrid (N = 2960). Overall PA and leisure-time PA (LTPA) were measured with the Global Physical Activity Questionnaire (GPAQ). Descriptive analyses and logistic regression were performed. It was revealed that 22.4% and 55.6% of overall PA and LTPA, respectively, did not achieve World Health Organization (WHO) recommendations. When PA was measured as overall PA, the achievement of the recommended level was positively predicted by male sex; a Body Mass Index (BMI) indicative of normal weight or being overweight; spending less time sitting or reclining; work; and studying health science, social sciences, engineering, or architecture (all p < 0.001; r2 = 0.075). Using LTPA, the positive predictors of achieving recommended PA levels were male sex, having a BMI indicative of normal weight or being overweight, work, studying at a public university, and studying health science (r2 = 0.048). These findings suggest that universities should implement strategies to promote PA.

Epidemiological and Treatment Trends of Distal Radius Fractures across Multiple Age Groups

Background  The purpose of this study is to assess the epidemiology, population-specific treatment trends, and complications of distal radius fractures in the United States. Methods  The PearlDiver database (Humana [2007-2014], Medicare [2005-2014]) was used to access US inpatient and outpatient data for all patients who had undergone operative and nonoperative treatment for a distal radius fracture in the United States. Epidemiologic analysis was performed followed by age-based stratification, to assess prevalence, treatment trends, and rates of complications. Results  A total of 1,124,060 distal radius treatment claims were captured. The incidence of distal radius fractures follows a bimodal distribution with distinct peaks in the pediatric and elderly population. Fractures in the pediatric population occurred predominately in males, whereas fractures in the elderly population occurred more frequently in females. The most commonly used modality of treatment was nonoperative; however, the use of internal fixation increased significantly during the study period, from 8.75 to 20.02%, with a corresponding decrease in percutaneous fixation. The overall complication rate was 8.3%, with mechanical symptoms most frequently reported. Conclusions  The last decade has seen a significant increase in the use of internal fixation as treatment modality for distal radius fractures. The impetus for this change is likely multifactorial and partly related to recent innovations including volar locking plates and an increasingly active elderly population. The implicated financial cost must be weighed against the productivity cost of maintaining independent living to determine the true burden to the healthcare system.

Determinants of physical activity: A path model based on an ecological model of active living

Maintaining physical activity is necessary to promote health in our daily lives. The Ecological Model of Active Living was proposed to examine whether individuals participate in active living. The purpose of this study was to understand the determinants of physical activity and create a predictive path model of the intrapersonal, perceived environment, behavior settings, and policy environment domains. Data were obtained from open government data and questionnaires, including the International Physical Activity Questionnaire, Health Belief Model Inventory, Physical Activity Neighborhood Environment Survey, and Accessibility of Open Spaces. Participants comprised 1085 healthy adults who completed a self-reported internet survey. An analysis of the intrapersonal domain revealed that the variables of female, an older age, and a low educational level, and individuals with obesity or cardiometabolic diseases presented lower odds ratios for active living. We found significant statistical support for our path model (The Ecological Model of Active Living), with a predictive power of 23.1%. The predictive path model is a good approach to quantitatively measure the impacts of various determinants on active living that suggests further lines of research in approaches for modeling relationships.

Assessing the feasibility and impact of an adapted resistance training intervention, aimed at improving the multi-dimensional health and functional capacity of frail older adults in residential care settings: protocol for a feasibility study

Background

Frailty is a common and clinically significant condition in older adults, predominantly due to its association with adverse health outcomes such as hospitalisation, disability and mortality. Exercise interventions have been shown to be a beneficial treatment for frail older adults. However, more high-quality studies are needed within this area to assess the feasibility and impact of these interventions in frail geriatric populations within different settings, and with regards to their impact on broader aspects of health and wellbeing.

Methods

This study will utilise an interventional, randomised, controlled research design in order to assess the feasibility (acceptability, demand, implementation, practicality, adaptation, integration, expansion) and potential impact (limited-efficacy testing) of a specially adapted resistance training intervention; aimed at improving the multi-dimensional health and functional capacity of frail geriatric care home residents.

Discussion

The most immediate implication of this research from a scientific perspective is informing the feasibility, and potential efficacy, of a proposed future clinical trial within this setting. Additionally, if the study proves feasible, and the limited-efficacy testing proves positive, this study also has the potential to lead to advancement in the care for frail geriatric populations within residential care settings; and the ability to measurably improve various aspects of health and functional capacity within this population. This study has been granted a favourable ethical opinion by the London Harrow NHS Research Ethics Committee and is sponsored by the University of Birmingham. The findings of this study will be disseminated through publication in open access scientific journals, public engagement events, online via social media, conference presentations and directly to study participants.

Trial registration

ClinicalTrials.gov: NCT03141879. Registered 5 May 2017.

Electronic supplementary material

The online version of this article (10.1186/s40814-019-0470-1) contains supplementary material, which is available to authorized users.

Change in physical activity is not associated with change in mental distress among adolescents: the Tromsø study: Fit Futures

Background

Previous research shows that physical activity has a protective effect on mental distress in adults, but the relationship is less researched and seems more ambiguous for adolescents. Studies in this field have typically been cross-sectional by design and based on self-reported physical activity measures, which are known to be vulnerable to response bias. The aim of this study was to investigate the relationship between change in objectively assessed physical activity as measured by accelerometer and change in mental distress among adolescents using longitudinal data from The Tromsø Study: Fit Futures.

Method

This study was based on data from 676 upper-secondary school students (mean age 16.23 years at baseline, 45.26% boys) from The Tromsø Study: Fit Futures. Physical activity, mental distress and covariates were measured at baseline (T1) and follow-up (T2) 2 years later. Physical activity was objectively measured with an ActiGraph GT3X accelerometer over 7 days. Mental distress was measured with the Hopkins Symptom Checklist-10 (HSCL-10). Change score variables were computed as the difference between T1 and T2 in number of steps, number of minutes of moderate to vigorous physical activity (MVPA) and mental distress between T1 and T2, and analyzed using linear regression analysis.

Results

Changes in steps per day were not associated with changes in mental distress in neither the crude, partially, nor fully adjusted model. Neither was changes in minutes of MVPA per day. Interaction effects between change in both steps per day and minutes of MVPA and gender were also not statistically significant, nor was the interaction effects between baseline levels of mental distress and physical activity.

Conclusion

The results of our study indicate that for adolescents in the sample, change in physical activity is unrelated to change in mental distress over a two-year period.

Using Health and Well-Being Apps for Behavior Change: A Systematic Search and Rating of Apps

Background

Smartphones have allowed for the development and use of apps. There is now a proliferation of mobile health interventions for physical activity, healthy eating, smoking and alcohol cessation or reduction, and improved mental well-being. However, the strength or potential of these apps to lead to behavior change remains uncertain.

Objective

The aim of this study was to review a large sample of healthy lifestyle apps at a single point in time (June to July 2018) to determine their potential for promoting health-related behavior change with a view to sharing this information with the public. In addition, the study sought to test a wide range of apps using a new scale, the App Behavior Change Scale (ABACUS).

Methods

Apps focusing on 5 major modifiable lifestyle behaviors were identified using a priori key search terms across the Australian Apple iTunes and Google Play stores. Lifestyle behavior categories were selected for their impact on health and included smoking, alcohol use, physical activity, nutrition, and mental well-being. Apps were included if they had an average user rating between 3 and 5, if they were updated in the last 18 months, if the description of the app included 2 of 4 behavior change features, and if they were in English. The selected behavior change apps were rated in 2 ways using previously developed rating scales: the Mobile App Rating Scale (MARS) for functionality and the ABACUS for potential to encourage behavior change.

Results

The initial search identified 212,352 apps. After applying the filtering criteria, 5018 apps remained. Of these, 344 were classified as behavior change apps and were reviewed and rated. Apps were given an average MARS score of 2.93 out of 5 (SD 0.58, range 1.42-4.16), indicating low-to-moderate functionality. Scores for the ABACUS ranged from 1 to 17, out of 21, with an average score of 7.8 (SD 2.8), indicating a low-to-moderate number of behavior change techniques included in apps. The ability of an app to encourage practice or rehearsal, in addition to daily activities, was the most commonly identified feature across all apps (310/344, 90.1%), whereas the second most common feature was the ability of the user to easily self-monitor behavior (289/344, 84.0%).

Conclusions

The wide variety of apps included in this 2018 study and the limited number of behavior change techniques found in many apps suggest an opportunity for improvement in app design that will promote sustained and significant lifestyle behavior change and, therefore, better health. The use of the 2 scales for the review and rating of the apps was successful and provided a method that could be replicated and tested in other behavior change areas.

Trends in Adherence to the Physical Activity Guidelines for Americans for Aerobic Activity and Time Spent on Sedentary Behavior Among US Adults, 2007 to 2016

Importance

The updated 2018 Physical Activity Guidelines for Americans (PAG) reaffirmed key recommendations regarding aerobic activity in the 2008 edition and recently introduced health risks of sedentary behaviors and their association with physical activity.

Objective

To examine the concurrent changing trends in adherence to the PAG for aerobic activity and time spent on sedentary behavior in US adults from 2007 to 2016.

Design, Setting, and Participants

This study used data from a series of cross-sectional, nationally representative surveys on adults 18 years or older from the National Health and Nutrition Examination Surveys from 2007 to 2016. Data analysis was performed from September 1, 2018, to March 31, 2019.

Main Outcomes and Measures

Duration, frequency, and intensity of leisure-time, work-related, and transportation-related aerobic activity were ascertained by a standardized questionnaire and summed as minutes per week. Adherence to the PAG for aerobic activity was defined as engaging in at least 150 minutes a week of moderate-intensity or 75 minutes a week of vigorous-intensity aerobic physical activity or an equivalent combination of moderate- and vigorous-intensity aerobic physical activity. Time spent on sedentary behavior was estimated by hours spent sitting on a typical day.

Results

Among 27 343 participants 18 years or older (13 630 [52.0%] female; 14 628 [66.6%] non-Hispanic white), the weighted adherence rate to the PAG for aerobic activity was 65.2% (95% CI, 62.3%-68.2%) in 2015-2016, with no significant change from 2007-2008 (63.2%; 95% CI, 60.2%-66.1%) to 2015-2016 (P = .15 for trend). Time spent on sedentary behavior significantly increased over time from a weighted mean (SE) of 5.7 (0.3) hours per day in 2007-2008 to 6.4 (0.2) hours per day in 2015-2016 (P < .001 for trend). The weighted proportion of people not adhering to the PAG for aerobic activity and reporting long sedentary time (>6 hours per day) increased from 16.1% (95% CI, 14.4%-17.8%) in 2007-2008 to 18.8% (95% CI, 17.7%-20.0%) in 2015-2016.

Conclusions and Relevance

The findings suggest that the adherence rate to the PAG for aerobic activity in US adults has not improved since the release of the first edition in 2008 but that time spent on sedentary behavior has significantly increased over time. Further nationwide efforts appear to be warranted to not only promote physical activity but also reduce sedentary time in the United States.

Greater Physical Activity Is Associated with Slower Visual Field Loss in Glaucoma

PURPOSE

To determine the association between physical activity levels and the rate of visual field (VF) loss in glaucoma.

DESIGN

Longitudinal, observational study.

PARTICIPANTS

Older adults with suspect or manifest glaucoma.

METHODS

Participants wore accelerometers for 1 week to define average steps per day, minutes of moderate-to-vigorous activity, and minutes of nonsedentary activity. All available VF measurements before and after physical activity assessment were retrospectively analyzed to measure rates of VF loss.

MAIN OUTCOME MEASURES

Pointwise changes in VF sensitivity associated with physical activity measures.

RESULTS

A total of 141 participants (mean age, 64.9±5.8 years) were enrolled. Eye mean deviation (MD) at the time of physical activity assessment was -6.6 decibels (dB), and average steps per day were 5613±3158. The unadjusted average rate of VF loss as measured by pointwise VF sensitivity was 0.36 dB/year (95% confidence interval, -0.37 to -0.35). In multivariable models, slower VF loss was observed for patients demonstrating more steps (+0.007 dB/year/1000 daily steps, P < 0.001), more moderate-to-vigorous activity (+0.003 dB/year/10 more minutes of moderate-to-vigorous activity per day, P < 0.001), and more nonsedentary activity (+0.007 dB/year/30 more minutes of nonsedentary time per day, P = 0.005). Factors associated with a faster rate of VF loss included older age, non-white race, glaucoma surgery, cataract surgery, and moderate baseline VF damage (-6 dB ≥ MD >-12 dB) as opposed to mild VF damage (MD >-6 dB). Similar associations between baseline accelerometer-measured physical activity and rates of VF loss were observed over other time periods (e.g., within 1, 3, and 5 years of activity assessment).

CONCLUSIONS

Increased walking, greater time spent doing moderate-to-vigorous physical activity, and more time spent in nonsedentary activity were associated with slower rates of VF loss in a treated population of patients with glaucoma, with an additional 5000 daily steps or 2.6 hours of nonsedentary physical activity decreasing the average rate of VF loss by approximately 10%. Future prospective studies are needed to determine if physical activity can slow VF loss in glaucoma or if progressive VF loss results in activity restriction. If the former is confirmed, this would mark physical activity as a novel modifiable risk factor for preventing glaucoma damage.