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Bouras E, Gill D, Zuber V, Murphy N, Dimou N, Aleksandrova K, Lewis SJ, Martin RM, Yarmolinsky J, Albanes D, Brenner H, Castellví-Bel S, Chan AT, Cheng I, Gruber S, Van Guelpen B, Li CI, Le Marchand L, Newcomb PA, Ogino S, Pellatt A, Schmit SL, Wolk A, Wu AH, Peters U, Gunter MJ, Tsilidis KK. Identification of potential mediators of the relationship between body mass index and colorectal cancer: a Mendelian randomization analysis. Int J Epidemiol 2024; 53:dyae067. [PMID: 38725300 PMCID: PMC11082423 DOI: 10.1093/ije/dyae067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 04/15/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is the third-most-common cancer worldwide and its rates are increasing. Elevated body mass index (BMI) is an established risk factor for CRC, although the molecular mechanisms behind this association remain unclear. Using the Mendelian randomization (MR) framework, we aimed to investigate the mediating effects of putative biomarkers and other CRC risk factors in the association between BMI and CRC. METHODS We selected as mediators biomarkers of established cancer-related mechanisms and other CRC risk factors for which a plausible association with obesity exists, such as inflammatory biomarkers, glucose homeostasis traits, lipids, adipokines, insulin-like growth factor 1 (IGF1), sex hormones, 25-hydroxy-vitamin D, smoking, physical activity (PA) and alcohol consumption. We used inverse-variance weighted MR in the main univariable analyses and performed sensitivity analyses (weighted-median, MR-Egger, Contamination Mixture). We used multivariable MR for the mediation analyses. RESULTS Genetically predicted BMI was positively associated with CRC risk [odds ratio per SD (5 kg/m2) = 1.17, 95% CI: 1.08-1.24, P-value = 1.4 × 10-5] and robustly associated with nearly all potential mediators. Genetically predicted IGF1, fasting insulin, low-density lipoprotein cholesterol, smoking, PA and alcohol were associated with CRC risk. Evidence for attenuation was found for IGF1 [explained 7% (95% CI: 2-13%) of the association], smoking (31%, 4-57%) and PA (7%, 2-11%). There was little evidence for pleiotropy, although smoking was bidirectionally associated with BMI and instruments were weak for PA. CONCLUSIONS The effect of BMI on CRC risk is possibly partly mediated through plasma IGF1, whereas the attenuation of the BMI-CRC association by smoking and PA may reflect confounding and shared underlying mechanisms rather than mediation.
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Affiliation(s)
- Emmanouil Bouras
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Dipender Gill
- Chief Scientific Advisor Office, Research and Early Development, Novo Nordisk, Copenhagen, Denmark
- Department of Epidemiology and Biostatistics, Imperial College London, School of Public Health, London, UK
| | - Verena Zuber
- Department of Epidemiology and Biostatistics, Imperial College London, School of Public Health, London, UK
| | - Neil Murphy
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Niki Dimou
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Krasimira Aleksandrova
- Faculty of Human and Health Sciences, University of Bremen, Bremen, Germany
- Department Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Sarah J Lewis
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Richard M Martin
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol
| | - James Yarmolinsky
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sergi Castellví-Bel
- Department of Gastroenterology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Hospital Clínic, Barcelona, Spain
| | - Andrew T Chan
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, CA, USA
| | - Stephen Gruber
- Department of Medical Oncology & Therapeutics Research and Center for Precision Medicine, City of Hope National Medical Center, Duarte, CA, USA
| | - Bethany Van Guelpen
- Department of Radiation Sciences, Oncology Unit, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | - Christopher I Li
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | | | - Polly A Newcomb
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Shuji Ogino
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
- Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Andrew Pellatt
- Department of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Stephanie L Schmit
- Genomic Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
- Population and Cancer Prevention Program, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna H Wu
- University of Southern California, Preventative Medicine, Los Angeles, CA, USA
| | - Ulrike Peters
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Marc J Gunter
- Department of Epidemiology and Biostatistics, Imperial College London, School of Public Health, London, UK
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Konstantinos K Tsilidis
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Department of Epidemiology and Biostatistics, Imperial College London, School of Public Health, London, UK
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2
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Marks-Vieveen JM, Uijtdewilligen L, Motazedi E, Stijnman DPM, van den Akker-Scheek I, Bouma AJ, Buffart LM, de Groot V, de Hollander E, Jelsma JGM, de Jong J, van Keeken HG, Krops LA, van der Leeden M, Loer SA, van Mechelen W, van Nassau F, Nauta J, Verhagen E, Wendel-Vos W, van der Woude LHV, Zwerver J, Dekker R, van der Ploeg HP. Physical Activity Levels, Correlates, and All-Cause Mortality Risk in People Living With Different Health Conditions. J Phys Act Health 2024; 21:394-404. [PMID: 38402878 DOI: 10.1123/jpah.2023-0387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 01/02/2024] [Accepted: 01/15/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND To better understand physical activity behavior and its health benefits in people living with health conditions, we studied people with and without 20 different self-reported health conditions with regard to (1) their physical activity levels, (2) factors correlated with these physical activity levels, and (3) the association between physical activity and all-cause mortality. METHODS We used a subsample (n = 88,659) of the Lifelines cohort study from the Netherlands. For people living with and without 20 different self-reported health conditions, we studied the aforementioned factors in relation to physical activity. Physical activity was assessed with the Short Questionnaire to Assess Health-Enhancing Physical Activity Questionnaire, and mortality data were obtained from the Dutch death register. RESULTS People with a reported health condition were less likely to meet physical activity guidelines than people without a reported health condition (odds ratios ranging from 0.55 to 0.89). Higher body mass index and sitting time, and lower self-rated health, physical functioning, and education levels were associated with lower odds of meeting physical activity guidelines across most health conditions. Finally, we found a protective association between physical activity and all-cause mortality in both people living with and without different health conditions. CONCLUSION People living with different health conditions are generally less physically active compared with people living without a health condition. Both people living with and without self-reported health conditions share a number of key factors associated with physical activity levels. We also observed the expected protective association between physical activity and all-cause mortality.
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Affiliation(s)
- Jenny M Marks-Vieveen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Anesthesiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Léonie Uijtdewilligen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Ehsan Motazedi
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Dominique P M Stijnman
- Department of Geriatrics, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Inge van den Akker-Scheek
- Department of Orthopedics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Adrie J Bouma
- Department of Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Laurien M Buffart
- Department of Medical BioSciences, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Vincent de Groot
- Department of Rehabilitation Medicine and Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ellen de Hollander
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Judith G M Jelsma
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Johan de Jong
- School of Sport Studies, Hanze University of Applied Sciences, Groningen, The Netherlands
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Helco G van Keeken
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Leonie A Krops
- Department of Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marike van der Leeden
- Department of Rehabilitation Medicine and Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Stephan A Loer
- Department of Anesthesiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Willem van Mechelen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Joske Nauta
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Evert Verhagen
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Wanda Wendel-Vos
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Lucas H V van der Woude
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Johannes Zwerver
- Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Sports Medicine, Gelderse Vallei Hospital, Ede, The Netherlands
| | - Rienk Dekker
- Department of Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Årnes AP, Fjeld MK, Stigum H, Nielsen CS, Stubhaug A, Johansen A, Hopstock LA, Morseth B, Wilsgaard T, Steingrímsdóttir ÓA. Does pain tolerance mediate the effect of physical activity on chronic pain in the general population? The Tromsø Study. Pain 2024:00006396-990000000-00543. [PMID: 38442413 DOI: 10.1097/j.pain.0000000000003209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 01/28/2024] [Indexed: 03/07/2024]
Abstract
ABSTRACT Knowledge is needed regarding mechanisms acting between physical activity (PA) and chronic pain. We investigated whether cold pain tolerance mediates an effect of leisure-time physical activity on the risk of chronic pain 7 to 8 years later using consecutive surveys of the population-based Tromsø Study. We included participants with information on baseline leisure-time PA (LTPA) and the level of cold pressor-assessed cold pain tolerance, who reported chronic pain status at follow-up as any of the following: chronic pain for ≥3 months, widespread chronic pain, moderate-to-severe chronic pain, or widespread moderate-to-severe chronic pain. We included 6834 participants (52% women; mean age, 55 years) in counterfactual mediation analyses. Prevalence decreased with severity, for example, 60% for chronic pain vs 5% for widespread moderate-to-severe chronic pain. People with one level higher LTPA rating (light to moderate or moderate to vigorous) at baseline had lower relative risk (RR) of 4 chronic pain states 7 to 8 years later. Total RR effect of a 1-level LTPA increase was 0.95 (0.91-1.00), that is, -5% decreased risk. Total effect RR for widespread chronic pain was 0.84 (0.73-0.97). Indirect effect for moderate-to-severe chronic pain was statistically significant at RR 0.993 (0.988-0.999); total effect RR was 0.91 (0.83-0.98). Statistically significantly mediated RR for widespread moderate-to-severe chronic pain was 0.988 (0.977-0.999); total effect RR was 0.77 (0.64-0.94). This shows small mediation of the effect of LTPA through pain tolerance on 2 moderate-to-severe chronic pain types. This suggests pain tolerance to be one possible mechanism through which PA modifies the risk of moderate-to-severe chronic pain types with and without widespread pain.
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Affiliation(s)
- Anders Pedersen Årnes
- Department of Pain, University Hospital of North Norway, Tromsø, Norway
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Mats Kirkeby Fjeld
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Hein Stigum
- Institute of Health and Society, University of Oslo, Norway
| | - Christopher Sivert Nielsen
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Audun Stubhaug
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Aslak Johansen
- Department of Pain, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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4
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Johnsen B, Martinaityte I, Wilsgaard T, Schirmer H. Incidence of dementia over a period of 20 years in a Norwegian population. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12479. [PMID: 37780861 PMCID: PMC10540268 DOI: 10.1002/dad2.12479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/08/2023] [Accepted: 08/22/2023] [Indexed: 10/03/2023]
Abstract
INTRODUCTION In Norway, the prevalence of dementia is higher than in demographically comparable, high income countries, but reliable incidence studies are lacking. This study calculated the incidence of age-specific dementia from 2000 to 2019. METHODS Participants from The Tromsø Study (n = 44,214) were included. Participants with a dementia diagnosis (n = 2049 cases) were identified. Poisson regression was used to calculate age-specific yearly and 5-year incidence rates from 2000 to 2019. RESULTS The incidence of dementia has decreased from 2000 to 2019. The trend was highly significant for ages of 60-99 years, and was similar for both sexes. DISCUSSION The incidence of dementia in North Norway has decreased over the past two decades similar to that in Western countries, indicating that the total prevalence is increasing due to an aging population. This decrease of incidence could introduce a reduction in future estimation of dementia prevalence.
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Affiliation(s)
- Bente Johnsen
- Department of Clinical MedicineUiT The Arctic University of NorwayTromsøNorway
- Department of Geriatric MedicineUniversity Hospital of North NorwayTromsøNorway
| | - Ieva Martinaityte
- Department of Clinical MedicineUiT The Arctic University of NorwayTromsøNorway
- Department of Geriatric MedicineUniversity Hospital of North NorwayTromsøNorway
| | - Tom Wilsgaard
- Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
| | - Henrik Schirmer
- Department of CardiologyAkershus University HospitalLørenskogNorway
- Institute of Clinical MedicineUniversity of OsloOsloNorway
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Women carry the weight of deprivation on physical inactivity: Moderated mediation analyses in a European sample of adults over 50 Years of age. SSM Popul Health 2022; 20:101272. [PMID: 36387017 PMCID: PMC9641026 DOI: 10.1016/j.ssmph.2022.101272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Deprived people are less physically active than privileged individuals. However, pathways underlying the association between deprivation and physical activity remain overlooked. We examined whether the association between deprivation and physical activity was mediated by body mass index (BMI). Consistent with an intersectional perspective (how the combination of belongingness to vulnerable social categories widens inequalities), we tested whether gender moderated this mediating pathway and hypothesized that the mediating effect of BMI would be stronger among women (vs men). Large-scale longitudinal data from 20,961 adults 50 years of age or older (57% women) from the Survey of Health, Ageing and Retirement in Europe were used. Social and material deprivation were measured by questionnaire, BMI and physical activity were reported from two to six years later. Simple mediation models showed that BMI partly mediated the association of material (total effect c = -0.14, proportion of mediated effect = 8%) and of social deprivation (c = -0.24, proportion of mediated effect = 4%) with physical activity. Moderated mediation models revealed that this mediating pathway was moderated by gender. The effect of deprivation on BMI was stronger among women (vs men), with BMI mediating 18% and 7% of the association of material and social deprivation with physical activity among women (vs 4% and 2% among men). Lower levels of physical activity observed among deprived older adults could be partly attributed to a higher BMI. Critically, this mechanism was exacerbated among women, reinforcing the need to understand how deprivation and gender interact to predict health behaviors. Body mass index mediates the association of material and social deprivation with physical activity. This mediating pattern is more pronounced among women, relative to men. The association between deprivation and a higher body mass index is exacerbated among women, compared to men.
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Yates T, Sargeant JA, King JA, Henson J, Edwardson CL, Redman E, Gulsin GS, Brady EM, Ahmad E, Stensel DJ, Webb DR, McCann GP, Khunti K, Davies MJ. Initiation of New Glucose-Lowering Therapies May Act to Reduce Physical Activity Levels: Pooled Analysis From Three Randomized Trials. Diabetes Care 2022; 45:2749-2752. [PMID: 35984425 DOI: 10.2337/dc22-0888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/26/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1RA) reduce body weight and improve cardiometabolic health, but their effect on physical activity is unknown. RESEARCH DESIGN AND METHODS We pooled data (n = 148) from three randomized trials to investigate the effect of empagliflozin (SGLT2i) and liraglutide (GLP-1RA), in comparison with sitagliptin (dipeptidyl peptidase 4 inhibitor) and dietary therapies, on accelerometer-assessed physical activity. RESULTS Liraglutide (mean -1,144 steps/day; 95% CI -2,069 to -220), empagliflozin (-1,132 steps/day; -1,739, -524), and sitagliptin (-852 steps/day; -1,625, -78) resulted in reduced total daily physical activity after 6 months (P < 0.01 vs. control). Moderate- to vigorous-intensity physical activity was also reduced. Dietary interventions led to no change or an increase in physical activity. CONCLUSIONS The initiation of all glucose-lowering therapies was associated with reduced physical activity, warranting further investigation.
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Affiliation(s)
- Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, U.K
- National Institute for Health Research, Leicester Biomedical Research Centre, Leicester, U.K
| | - Jack A Sargeant
- Diabetes Research Centre, University of Leicester, Leicester, U.K
- National Institute for Health Research, Leicester Biomedical Research Centre, Leicester, U.K
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, U.K
| | - James A King
- National Institute for Health Research, Leicester Biomedical Research Centre, Leicester, U.K
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, U.K
| | - Joe Henson
- Diabetes Research Centre, University of Leicester, Leicester, U.K
- National Institute for Health Research, Leicester Biomedical Research Centre, Leicester, U.K
| | - Charlotte L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester, U.K
- National Institute for Health Research, Leicester Biomedical Research Centre, Leicester, U.K
| | - Emma Redman
- National Institute for Health Research, Leicester Biomedical Research Centre, Leicester, U.K
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust, Leicester, U.K
| | - Gaurav S Gulsin
- National Institute for Health Research, Leicester Biomedical Research Centre, Leicester, U.K
- Department of Cardiovascular Sciences, University of Leicester, Leicester, U.K
| | - Emer M Brady
- National Institute for Health Research, Leicester Biomedical Research Centre, Leicester, U.K
- Department of Cardiovascular Sciences, University of Leicester, Leicester, U.K
| | - Ehtasham Ahmad
- Diabetes Research Centre, University of Leicester, Leicester, U.K
- National Institute for Health Research, Leicester Biomedical Research Centre, Leicester, U.K
| | - David J Stensel
- National Institute for Health Research, Leicester Biomedical Research Centre, Leicester, U.K
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, U.K
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - David R Webb
- Diabetes Research Centre, University of Leicester, Leicester, U.K
- National Institute for Health Research, Leicester Biomedical Research Centre, Leicester, U.K
| | - Gerry P McCann
- National Institute for Health Research, Leicester Biomedical Research Centre, Leicester, U.K
- Department of Cardiovascular Sciences, University of Leicester, Leicester, U.K
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, U.K
- NIHR Applied Research Collaboration East Midlands, Leicester, U.K
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, U.K
- National Institute for Health Research, Leicester Biomedical Research Centre, Leicester, U.K
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7
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Specht IO, Heitmann BL, Larsen SC. Physical Activity and Subsequent Change in Body Weight, Composition and Shape: Effect Modification by Familial Overweight. Front Endocrinol (Lausanne) 2022; 13:787827. [PMID: 35242107 PMCID: PMC8886019 DOI: 10.3389/fendo.2022.787827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/24/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Physical activity (PA) has been shown to attenuate the genetic risk of obesity as measured using polygenic risk scores. However, familial obesity history might be an easier predictor. We examined associations between PA and subsequent changes in BMI, body fat percentage (BF%) and waist circumference (WC) among participants with and without adiposity and a familial overweight. METHODS In total, 1971 participants from the Danish MONICA cohort were included. Mean differences for 6-year changes in BMI, BF% and WC across PA levels were estimated. Association between walking and biking and subsequent change in adiposity were analysed. Effect modification by familial obesity was assessed by adding product terms to the models. RESULTS We observed weak associations between leisure PA level and changes in WC [participants with low PA: 3.4 cm (95%CI: 2.8;4.0), participants with high PA: 2.4 cm (95%CI: 1.8;3.0)], with no evidence of effect modification by familial obesity. We found effect modification in analyses on walking and biking in relation to changes in BMI (P-interaction<0.01) and BF% (P-interaction=0.04), suggesting lower gain with more hours of activity among participants with adiposity and familial overweight. CONCLUSIONS The results were modest but suggested that PA, especially walking and biking, may prevent future adiposity.
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Affiliation(s)
- Ina Olmer Specht
- The Parker Institute, Research Unit for Dietary Studies, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
- *Correspondence: Ina Olmer Specht,
| | - Berit Lilienthal Heitmann
- The Parker Institute, Research Unit for Dietary Studies, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
- The Boden Group, Faculty of Medicine and Health, Sydney University, Sydney, NSW, Australia
- The Department of Public Health, Section for General medicine, University of Copenhagen, Copenhagen, Denmark
| | - Sofus Christian Larsen
- The Parker Institute, Research Unit for Dietary Studies, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
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Abstract
Regular physical activity has an impact on all human organ systems and mediates multiple beneficial effects on overall health. Physical activity alone is a poor strategy for weight loss; however, physical activity is of crucial importance for weight loss maintenance. The role of exercise in maintaining a stable body weight is not clear but might be related to better appetite regulation and food preference. In relation to exercise, muscle secretes myokines and other factors that can influence the metabolism in other organs, not least fat and brain tissues. Thereby, physical activity reduces the risk of obesity-associated diseases, such as type 2 diabetes and cardiovascular diseases, independently of weight loss and BMI. Therefore, physical activity should always be included in weight loss strategies and as a tool to maintain a healthy weight, despite its modest effect on energy expenditure and overall body weight.
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Affiliation(s)
- Claus Brandt
- Centre of Inflammation and Metabolism/Centre for Physical Activity Research (CIM/CFAS), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Bente Klarlund Pedersen
- Centre of Inflammation and Metabolism/Centre for Physical Activity Research (CIM/CFAS), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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