Biological mechanisms underlying the role of physical fitness in health and resilience

Evaluation of the LLUH Intensive Therapeutic Lifestyle Change Program: Integrative Health Coaching Impact Study

This pilot study investigated the impact of Integrative Health Coaching (IHC) frequency on biometrics, dietary intake, and physical activity changes among participants of the Loma Linda University Health (LLUH) Intensive Therapeutic Lifestyle Change (ITLC) program. This retrospective cohort design analyzed the effects of IHC frequency on pre-post participant behaviors and health outcomes among forty-four participants (aged 35-78). Participants engaged in the 8-week ITLC program and received individual and group health coaching sessions. Assessments included an InBody scan, various laboratory panels, and the American College of Lifestyle Medicine (ACLM) lifestyle forms. Weak positive correlations were observed between IHC frequency and pre-post physical activity, and fruit and vegetable intake, but were not statistically significant. Clinically significant changes were noted in physical activity levels among participants with hyperlipidemia and diabetes/prediabetes. High physical activity was associated with a reduction in high-density lipoproteins (HDL-C) levels and showed slight decreases in body mass index (BMI), HbA1c, and low-density lipoproteins (LDL-C). The change in HbA1c was positively associated with a similar change in BMI (rho = .42, P < .01). Clinically significant changes were observed in BMI, total cholesterol, and LDL due to lifestyle changes which included modifying physical activity and nutrition.

Moderate-to-Vigorous Physical Activity and Suicidal Ideation in Adolescents with Attention Deficit/Hyperactivity Disorder: the Mediating Effects of Mental Health

This study aimed to (a) examine whether device-assessed moderate-to-vigorous physical activity (MVPA) was associated with suicidal ideation (SI) in adolescents with attention-deficit/hyperactivity disorders (ADHD), (b) investigate whether the association was mediated by depression, and (c) assess whether anxiety, stress, and resilience would work with depression to constitute chain mediation paths between MVPA and SI. Sixty adolescents with ADHD aged 12-17 (Mage = 14.33 ± 1.43 years) met the inclusion criteria. MVPA data were assessed using accelerometers worn around the waist for seven consecutive days. SI, depression, anxiety, stress, and resilience were examined using self-report questionnaires. Bivariate correlations were estimated for all variables. Lavaan package was used to examine the association between MVPA and SI, and the mediating effects of depression, anxiety, stress, and resilience by adjusting for a minimally sufficient confounder set and applying the bootstrap method. MVPA was negatively associated with SI. Depression fully mediated this association. Anxiety, stress, and resilience combining with depression formed three chain mediation paths between MVPA and SI, respectively. The integrative mediation model, including anxiety, stress, resilience, and depression, revealed that anxiety and depression explained 38.2% of the variance in the association between MVPA and SI, and resilience and depression explained 22.1%, while stress did not. MVPA could serve as an alternative or adjunctive approach, particularly in conjunction with depression-focused interventions, to increase resilience, decrease anxiety and depression, and in turn to prevent or attenuate SI in adolescents with ADHD.

Enteric nervous system dysfunction as a driver of central nervous system disorders: The Forgotten brain in neurological disease

The Enteric Nervous System (ENS), often called the "second brain," is a complex network of neurons and glial cells within the gastrointestinal (GI) tract. It functions autonomously while maintaining close communication with the central nervous system (CNS) via the gut-brain axis (GBA). ENS dysfunction plays a crucial role in neurodegenerative and neurodevelopmental disorders, including Parkinson's disease, Alzheimer's disease, and autism spectrum disorder. Disruptions such as altered neurotransmission, gut microbiota imbalance, and neuroinflammation contribute to disease pathogenesis. The GBA enables bidirectional communication through the vagus nerve, gut hormones, immune signaling, and microbial metabolites, linking gut health to neurological function. ENS dysregulation is implicated in conditions like irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), influencing systemic and CNS pathology through neuroinflammation and impaired barrier integrity. This review highlights emerging therapeutic strategies targeting ENS dysfunction, including prebiotics, probiotics, fecal microbiota transplantation (FMT), and vagus nerve stimulation, which offer novel ways to modulate gut-brain interactions. Unlike previous perspectives that view the ENS as a passive disease marker, this review repositions it as an active driver of neurological disorders. By integrating advances in ENS biomarkers, therapeutic targets, and GBA modulation, this article presents a paradigm shift-emphasizing ENS dysfunction as a fundamental mechanism in neurodegeneration and neurodevelopmental disorders. This perspective paves the way for innovative diagnostics, personalized gut-targeted therapies, and a deeper understanding of the ENS's role in brain health and disease.

The effects of physical activity on mental health in adolescents with attention-deficit hyperactivity disorder: a randomized controlled trial

BACKGROUND

Adolescents with attention-deficit hyperactivity disorder (ADHD) represent a high-risk population with an elevated likelihood of developing mental health disorders. Physical activity (PA) has emerged as a promising intervention to enhance mental health in youth. However, no studies to date have comprehensively examined the immediate and sustained effects of PA, especially aerobic exercise-based PA, on mental ill-being-including internalizing problems (e.g., depression, anxiety, and stress) and externalizing problems (e.g., aggression)-as well as on two other critical indicators of mental health: psychological well-being (e.g., resilience) and cognitive function (e.g., inhibitory control) in adolescents with ADHD. Therefore, this study aimed to investigate whether an aerobic exercise-based PA intervention could elicit immediate and sustained benefits for mental health outcomes, including internalizing problems, externalizing problems, psychological well-being, and cognitive function, in adolescents with ADHD.

METHOD

This study was an assessor-masked, multicenter, randomized clinical trial. A total of 88 adolescents with ADHD were enrolled. Eligible participants were randomized in a 1:1 ratio to either the exercise group or the control group. Participants in the exercise group attended a 60-min session of aerobic exercise once a week for 12 weeks. Depression, anxiety, stress, aggression, and resilience were assessed using self-report questionnaires, and inhibitory control was evaluated through computer-based neurocognitive tasks. Assessments were conducted at baseline (T0), at the end of the intervention (T1), and 3 months following the intervention (T2).

RESULTS

The 80 eligible participants included 72 (90%) males with a mean age of 14.74 (± 1.59) years. Generalized estimating equation analyses revealed that the current PA intervention resulted in significantly better and sustained improvements in depression, anxiety, stress, and inhibitory control. Compared to the control group, the exercise group showed a significant increase in resilience at T1, but this effect was not sustained at T2. No significant reduction in aggression was found.

CONCLUSIONS

The current aerobic exercise-based PA intervention was found to be effective in reducing depression, anxiety, and stress, as well as in promoting inhibitory control and resilience in adolescents with ADHD. The current findings suggest that an aerobic exercise-based PA intervention may be an alternative or adjunctive approach to enhancing mental health, particularly in alleviating internalizing problems, in this population.

TRIAL REGISTRATION

ChiCTR, ChiCTR2400087025. Registered 17 July 2024-Retrospectively registered, https://www.chictr.org.cn/showproj.html?proj=230614 .

Body mass index having a mediating role between diet quality & mental and physical health among women

BACKGROUND

Women experience unique dynamics in health and Quality of Life (QoL) due to biological, psychological, and social factors. These dynamics necessitate a comprehensive examination of the indirect effects of Diet Quality (DQ) on Mental and Physical well-being through Body Mass Index (BMI). This study aims to elucidate the indirect pathways through which DQ influences mental and physical well-being, with a particular focus on the mediating role of BMI.

METHODS

This cross-sectional study was conducted with women (n = 985) aged 19-64 years. Anthropometric measurements and 24-Hour Dietary Recall (24HDR) data were collected. QoL was assessed using the Short Form-36 (SF-36), which comprises two primary subdimensions: (1) Mental Well-being, represented by the Mental Component Summary (MCS), and (2) Physical Well-being, represented by the Physical Component Summary (PCS). The Nutrient-Based Diet Quality Index (NBDQ) and Carbohydrate-to-Fibre Ratio (CHO-FBR) were calculated from 24HDR data to evaluate DQ. Two mediation models were employed. Model 1 examined the indirect effects of NBDQ on Mental and Physical well-being through BMI, with age as a confounder. Model 2 assessed the indirect effects of CHO-FBR on Mental and Physical well-being through BMI, also considering age as a confounder.

RESULTS

The mean age of participants was 31.68 ± 11.95 years. No significant differences were found in educational attainment across DQ quartiles (p = 0.228). Younger women (19-24 years) were more prevalent in lower DQ quartiles, while older women (45-64 years) showed higher DQ scores (p = 0.001). Women with spouses had higher DQ (p = 0.007). MCS score improved with a better NBDQ (p = 0.033), although PCS score did not show significant difference ( p = 0.607). Mediation analysis revealed that NBDQ was significantly associated with MCS (β = 0.169, p = 0.004) but not with BMI (β = 0.004, p = 0.568). Aditionally, NBDQ showed a non-significant relationship with PCS (β = -0.022, p = 0.505).

CONCLUSION

Improving DQ can enhance mental well-being (MCS), particularly among older women and those with spouses, while no impact was found on physical well-being (PCS). Since BMI did not mediate these effects and CHO-FBR showed no significant associations, nutritional strategies should prioritize DQ alongside age and social dynamics to effectively enhance women's QoL.

Associations of 24-hour movement behaviors with emotional and behavioral problems among Chinese adolescents

PURPOSE

The role of adherence to the recommendations for 24-hour movement behaviors (24-HMB), including physical activity (PA), screen time (ST), and sleep duration (SLP), in relation to emotional and behavioral problems in Chinese adolescents remains uncertain. This study aimed to investigate these associations and explore potential sex differences.

METHODS

This school-based cross-sectional study included 15,071 Chinese adolescents with a mean age of 14.53 (SD: 1.65) years. Data on emotional and behavioral problems and 24-HMB (including PA, ST, and SLP) were collected. Analysis was performed using general linear mixed models, with additional sex-stratified analyses conducted.

RESULTS

The number of 24-HMB recommendations met was negatively associated with total difficulties (β estimate=-0.96, 95% CI: -1.07 to -0.85) and positively related to prosocial behavior (β estimate = 0.41, 95% CI: 0.37 to 0.46) among adolescents. Compared with none of the recommendations met, meeting all recommendations (total difficulties: β estimate=-2.98, 95% CI: -3.41 to -2.55; prosocial behaviors: β estimate = 1.05, 95%CI: 0.87 to 1.24) demonstrated the strongest association with both difficulties and prosocial behaviors, followed by meeting recommendations for PA + ST (total difficulties: β estimate=-2.15, 95% CI: -2.41 to -1.90; prosocial behaviors: β estimate = 0.98, 95% CI: 0.87 to 1.09). These associations were consistently significant in both boys and girls.

CONCLUSION

Adherence to more 24-HMB recommendations, particularly meeting all recommendations or combined PA + ST recommendations, could improve emotional and behavioral well-being among adolescent girls and boys. The significance of balanced movement behaviors for promoting adolescent mental health merits increased attention.

Sleep quality and physical fitness as modifiable contributors of fatigue in childhood cancer survivors

PURPOSE

Advances in cancer treatment have increased childhood cancer patient's survival rates. However, many childhood cancer survivors (CCS) face long-term effects such as fatigue. This study assessed fatigue in CCS and healthy controls (HCs), its contributors, and associated outcomes.

METHODS

This cross-sectional study included 90 CCS and 55 age and sex-matched HCs. Fatigue was measured using the Pediatric Quality of Life Multidimensional Fatigue Scale, and modifiable contributors included sleep quality (Pittsburgh Sleep Quality Index [PSQI]) and physical fitness (VO2 peak during a treadmill test). Quality of life (QoL) and emotional and cognitive functioning were evaluated using the Pediatric Quality of Life Inventory, Beck Depression Inventory II, Cognitive Failure Questionnaire, and the Impact of Event Scale-Revised. Stepwise linear regressions identified predictors of general, sleep/rest, cognitive, and total fatigue.

RESULTS

General, cognitive, and total fatigue were significantly higher in CCS compared to HCs (44.7% vs. 23%, p < .001; cognitive: 64.7% vs. 29.3%, p < .001; total fatigue: 56.5% vs. 25%, p < .001). Sex, PSQI, PSQI × sex, and PSQI × VO₂ were significant predictors for general fatigue, PSQI and PSQI × VO₂ for cognitive fatigue, and PSQI for sleep/rest and total fatigue. Cognitive and total fatigue correlated most strongly with cognitive and work-related functioning, whereas general and sleep/rest fatigue were more related to psychosocial functioning.

CONCLUSION

Fatigue is highly prevalent among CCS, with distinct factors influencing general, sleep/rest, cognitive, and total fatigue. Female survivors, those with poorer sleep quality and lower physical fitness, are at risk.

IMPLICATIONS FOR CANCER SURVIVORS

This study underscores the need for tailored interventions for each type of fatigue. Improving sleep quality, physical fitness, and psychological well-being may contribute to reducing fatigue and enhancing overall quality of life in CCS.

Associations of cardiorespiratory fitness with cerebral cortical thickness and gray matter volume across the adult lifespan

High cardiorespiratory fitness (CRF) is associated with reduced cortical thinning and gray matter (GM) shrinkage in older adults. We investigated associations of CRF measured with peak oxygen consumption (V̇o2peak) with cortical thickness and GM volume across the adult lifespan. We hypothesized that higher CRF is associated with less cortical thinning and GM shrinkage across the adult lifespan, which is associated with better cognitive performance. This cross-sectional study recruited 172 sedentary yet healthy adults (65% women, 22-81 yr) who underwent treadmill exercise testing to measure V̇o2peak, structural magnetic resonance imaging to assess cortical thickness and GM volume, and a comprehensive cognitive test battery to assess fluid cognitive function. Linear regression models were used to examine the associations of total and regional cortical thickness and GM volume with age, V̇o2peak, and age × V̇o2peak interaction after adjusting for sex, education, and total intracranial volume, and the associations of cortical thickness and GM volume with fluid cognitive performance. Mean and regional cortical thickness and total GM volume were associated negatively with age, whereas no associations were observed with V̇o2peak. However, a significant interaction between age and V̇o2peak on the right superior parietal volume indicated that aging was associated with smaller right superior parietal volume in the lower CRF group, whereas no association was observed in the higher CRF group. Larger right superior parietal volume was associated with better fluid cognitive performance. These findings highlight the importance of maintaining CRF to prevent or slow brain aging from an adult lifespan perspective.NEW & NOTEWORTHY High cardiorespiratory fitness may mitigate regional gray matter shrinkage across the adult lifespan.

Childhood Physical Fitness as a Predictor of Cognition and Mental Health in Adolescence: The PANIC Study

BACKGROUND

Cognitive and mental health problems are highly prevalent in adolescence. While higher levels of physical fitness may mitigate these problems, there is a lack of long-term follow-up studies on the associations of physical fitness from childhood with cognition and mental health in adolescence.

OBJECTIVE

We investigated the associations of physical fitness from childhood to adolescence over an 8-year follow-up with cognition and mental health in adolescence.

METHODS

The participants were 241 adolescents (112 girls), who were 6-9 years at baseline and 15-17 years at 8-year follow-up. Average and change scores for cardiorespiratory fitness (maximal power output [Wmax]; peak oxygen uptake [VO2peak]), motor fitness (10 × 5-m shuttle run), and muscular fitness (standing long jump; hand grip strength) were calculated. Global cognition score was computed from six individual cognitive tasks, and perceived stress and depressive symptoms were assessed at the 8-year follow-up. The data were analysed using linear regression models adjusted for age, sex, and parental education.

RESULTS

Average motor fitness was positively associated with global cognition score (standardised regression coefficient [β] - 0.164, 95% confidence interval [CI] - 0.318 to - 0.010) and inversely with perceived stress (β = 0.182, 95% CI 0.032-0.333) and depressive symptoms (β = 0.181, 95% CI 0.028-0.333). Average cardiorespiratory fitness was inversely associated with perceived stress (Wmax: β =  - 0.166, 95% CI - 0.296 to - 0.036; VO2peak: β =  - 0.149, 95% CI - 0.295 to - 0.002) and depressive symptoms (Wmax: β =  - 0.276, 95% CI - 0.405 to - 0.147; VO2peak: β =  - 0.247, 95% CI - 0.393 to - 0.102). A larger increase in cardiorespiratory fitness was associated with lower perceived stress (Wmax: β =  - 0.158, 95% CI - 0.312 to - 0.003; VO2peak: β =  - 0.220, 95% CI - 0.395 to - 0.044) and depressive symptoms (Wmax: β =  - 0.216, 95% CI - 0.371 to - 0.061; VO2peak: β =  - 0.257, 95% CI - 0.433 to - 0.080).

CONCLUSIONS

Higher levels of motor fitness in childhood and adolescence were associated with better cognition in adolescence. Higher levels of and larger increases in cardiorespiratory fitness from childhood to adolescence were associated with better mental health in adolescence.

Walking football for Health - physiological response to playing and characteristics of the players

Walking Football (WF) is one type of recreational football increasing in popularity, targeting older adults. Further knowledge on the intensity and physical workload of WF, characteristics of the players, the social context, and reasons for playing WF is needed. Thus, the aim of the study was to characterize the individuals that regularly play WF and their experience of WF, and the physiological characteristics of the sport. Sixty-three players from three clubs taking part in organised WF in Sweden were included. The players participated in up to four WF-games and underwent performance tests and answered a questionnaire. The participants mean age was 70.9 years, ranging from 63 to 85 years with 71% (n = 27) of the men and 68% (n = 13) of the women having a BMI > 25. Fifty-one percent (n = 27) of the players had hypertension, and 73% (n = 39) regularly used prescription drugs due to illness. During WF, the players covered on average 2,409 m (2,509 m for men and 2,205 m for women, p = .001). Expressed in percentage of their age-estimated maximal heart rate, mean heart rate represented 80 ± 9 and 80 ± 8% of max for men, and 78 ± 9 and 79 ± 9% of max for women in the first and second halves, respectively, hence WF can be considered a moderate intensity activity for older adults. The main reason for WF participation was to socialize. WF includes a considerable number of accelerations and decelerations, making it more energetically and mechanically demanding than walking.

Impact of air pollution on depressive symptoms and the modifying role of physical activity: Evidence from the CHARLS study

The association between air pollution and depressive symptoms has not been thoroughly investigated, and the role of physical activity (PA) is particularly unclear. Although PA has been shown to alleviate depression, it may also increase exposure to air pollution, potentially exacerbating its adverse effects. A total of 17,332 participants aged 45 years and older from the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS) were included in this study to assess the causal effect of air pollution on depressive symptoms in China and to clarify the role of PA in this relationship. Depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale (CES-D). Data on particulate matter (PM1, PM2.5, and PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO) were obtained from the ChinaHighAirPollutants (CHAP) dataset. PA levels were measured using a standardized questionnaire and categorized as low or high. An instrumental variable (IV) approach was used to estimate the causal effect of air pollution on depressive symptoms. Potential effect modification by PA was assessed. The IV estimates showed that all air pollutants were significantly and adversely associated with depressive symptoms, with a per interquartile range (IQR) increase in PM1, PM2.5, PM10, NO2, SO2, O3, and CO associated with 1.57 (95% confidence interval (CI): 1.15, 1.99), 1.49 (95% CI: 1.10, 1.89), 1.71 (95% CI: 1.26, 2.17), 2.22 (95% CI: 1.62, 2.81), 1.30 (95% CI: 0.96, 1.65), 4.67 (95% CI: 3.37, 5.98), and 0.97 (95% CI: 0.71, 1.22) units increase in CES-D scores, respectively. PA significantly modified this association, with higher PA levels mitigating the adverse effects of air pollution on depressive symptoms.

Is Physical Activity Related to Depression and Anxiety among Adults? Observations from a Noncommunicable Disease Screening Clinic in North India

Background

Physical activity (PA) offers innumerable benefits and is a promising intervention against common mental disorders, such as depression and anxiety. We examined the association between PA and depression or anxiety in adults.

Materials and Methods

A study was conducted between March 2021 and August 2022 using a cross-sectional study design. We recruited 334 participants >40 years of age from the noncommunicable disease (NCD) screening clinic of a tertiary care institute in North India. Health-enhancing PA (HEPA) was estimated using the International Physical Activity Questionnaire (IPAQ), while depression and anxiety were screened using the 9-item Patient Health Questionnaire (PHQ-9) and 7-item Generalized Anxiety Disorder scales. Bivariate and univariate analyses were performed using Statistical Package for the Social Sciences (SPSS) version 21 to depict our results.

Results

Engagement in HEPA was 23.4%. The HEPA depicted significant socioeconomic disparities. The mean total cholesterol and triglyceride levels were considerably higher in the HEPA active group, despite having lower GAD-7 and PHQ-9 scale scores. The prevalence of depressive and anxiety symptoms was 59.0% and 13.4%. PA depicted better odds against depression but not against anxiety symptoms.

Conclusions

Low HEPA engagement in adults is a matter of concern, and it is high time we look beyond NCDs toward the risk factors. It is essential to incorporate PA counseling universally and not be restricted to a particular clinical department to realize its full potential in restraining the growing NCD burden.

Understanding immune system dysfunction and its context in mood disorders: psychoneuroimmunoendocrinology and clinical interventions

Mood disorders include a set of psychiatric manifestations of increasing prevalence in our society, being mainly represented by major depressive disorder (MDD) and bipolar disorder (BD). The etiopathogenesis of mood disorders is extremely complex, with a wide spectrum of biological, psychological, and sociocultural factors being responsible for their appearance and development. In this sense, immune system dysfunction represents a key mechanism in the onset and pathophysiology of mood disorders, worsening mainly the central nervous system (neuroinflammation) and the periphery of the body (systemic inflammation). However, these alterations cannot be understood separately, but as part of a complex picture in which different factors and systems interact with each other. Psychoneuroimmunoendocrinology (PNIE) is the area responsible for studying the relationship between these elements and the impact of mind-body integration, placing the immune system as part of a whole. Thus, the dysfunction of the immune system is capable of influencing and activating different mechanisms that promote disruption of the psyche, damage to the nervous system, alterations to the endocrine and metabolic systems, and disruption of the microbiota and intestinal ecosystem, as well as of other organs and, in turn, all these mechanisms are responsible for inducing and enhancing the immune dysfunction. Similarly, the clinical approach to these patients is usually multidisciplinary, and the therapeutic arsenal includes different pharmacological (for example, antidepressants, antipsychotics, and lithium) and non-pharmacological (i.e., psychotherapy, lifestyle, and electroconvulsive therapy) treatments. These interventions also modulate the immune system and other elements of the PNIE in these patients, which may be interesting to understand the therapeutic success or failure of these approaches. In this sense, this review aims to delve into the relationship between immune dysfunction and mood disorders and their integration in the complex context of PNIE. Likewise, an attempt will be made to explore the effects on the immune system of different strategies available in the clinical approach to these patients, in order to identify the mechanisms described and their possible uses as biomarkers.

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

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

Poor stress resilience in adolescence predicts higher risk of severe COVID-19 and other respiratory infections: A prospective cohort study of 1.4 million Swedish men

OBJECTIVES

To investigate the associations between stress resilience in late adolescence and later risk of severe COVID-19 and other lower respiratory infections. A secondary aim was to examine potential confounding between low cardiorespiratory fitness (CRF) and stress resilience in relation to respiratory infection.

METHODS

We conducted a registry-based cohort study of 1.4 million Swedish men, undergoing military conscription between 1968 and 2005. All were assessed by a psychologist for stress resilience, receiving a score between 1 and 9. The outcomes were hospitalization or death due to COVID-19 from March 2020 to September 2021 and hospitalization due to bacterial or viral pneumonia from conscription until January 2020. A secondary aim was to examine potential confounding between low cardiorespiratory fitness (CRF) and stress resilience in relation to respiratory infection.

RESULTS

Poor stress resilience in late adolescence is associated with later risk of severe lower respiratory infections. Using a high resilience score as the reference, the hazard ratio (95 % CI) for death due to COVID-19 for the lowest scores was 1.49 (1.01-2.18) adjusted for CRF and other confounders. The corresponding adjusted hazard ratios for hospitalization due to bacterial pneumonia were 2.28 (2.03-2.57) and for viral pneumonia 1.92 (1.33-2.79). No significant interaction was seen between stress resilience and CRF in the analysis.

CONCLUSIONS

Poor stress resilience is a prospective factor for severe COVID-19 as well as for bacterial and viral respiratory pneumonia endpoints, independent of CRF. These findings imply an effect of late adolescent stress resilience on the immune system later in life.

Effects of Integrating Stair Climbing-Based Exercise Snacks Into the Campus on Feasibility, Perceived Efficacy, and Participation Perspectives in Inactive Young Adults: A Randomized Mixed-Methods Pilot Study

This 6-week pilot study aimed to investigate the feasibility, perceived efficacy, and participation perspectives of a university campus stair climbing-based exercise snack (ES) intervention and to compare it to moderate-intensity continuous training (MICT). Healthy, young, inactive adults (age: 21.6 ± 2.3 years, BMI: 22.5 ± 3.6 kg/m2) were randomly assigned to three groups (ES, MICT, and Control [CON]). ES (n = 14, 6 females) and MICT (n = 13, 9 females) groups performed three sessions per week over 6 weeks, while the control group (n = 15, 9 females) maintained their habitual lifestyle. ES involved 3 × ~30 s 'all-out' stair-climbing (6 flights, total 126 steps and 18.9 m elevation) bouts separated by > 1 h rest, and MICT involved 40 min stationary cycling at 60%-70% HRmax. Mixed linear effect models were used to explore within and between-group differences, and the change in magnitude was determined using mean difference (MD), 95% confidence interval (CI), and Cohen's d effect size. Fourteen participants also completed post-intervention semi-structured interviews. Retention rates of 93% (ES, 14/15), 93% (MICT, 13/14), and 100% (CON, 15/15) were achieved from baseline to post-assessments, with compliance (participants' attendance to scheduled ES sessions) of 97% (733/756 sessions) and 93% (217/234 sessions) in ES and MICT, respectively. No significant differences were found between ES and MICT for future intentions (4.8 ± 1.4 and 5.0 ± 0.9), enjoyment (PACES, 89.0 ± 16.4 and 94.5 ± 11.9), and satisfaction. A significant group × time interaction was found in the quality of life and perceived stress. ES and MICT significantly increased the quality of life by 8% (MD = 5.5 [95% CI = 0.3, 10.7], Cohen's d = 0.64) and 6% (MD = 4.6 [95% CI = 0.9, 8.2], Cohen's d = 0.88) compared to baseline, whereas CON experienced a significant decrease (MD = -7.9 [95% CI = -14.4, -1.6], Cohen's d = 0.56). ES significantly decreased perceived stress by 7% (MD = -4.6 [95% CI = -8.9, -0.3], Cohen's d = 0.58), while MICT (MD = 2.0 [95% CI = -0.1, 4.1], Cohen's d = 0.28) and CON (MD = -2.4 [95% CI = -6.1, 1.3], Cohen's d = 0.22) had no significant effects. The majority (12/14) of participants generally demonstrated positive attitudes toward participation in ES and found it easier than expected while highlighting enablers, barriers, and future recommendations. Stair climbing-based ES could be integrated into the campus setting, appeared feasible, and was similar to MICT regarding future intentions, enjoyment, and satisfaction. Both ES and MICT might induce relevant positive effects on the quality of life, and ES demonstrated greater benefits compared to MICT or CON for reducing perceived stress. Interviews provided positive insights into fostering adherence to ES among university students.

Self-perceived physical fitness as a moderating variable in the relationship between motor self-efficacy and physical self-concept in school-age physical education students

Introduction

The increasing prevalence of mental health disorders has elicited significant concern within society, particularly among adolescents who are disproportionately affected by this concerning trend. Consequently, institutions are seeking efficacious and cost-effective interventions to address this situation, while the scientific community has identified physical activity as a potential means to mitigate this epidemic. Motor self-efficacy and physical self-concept have been demonstrated to confer benefits to the mental health of young individuals, comparable to those of physical fitness. These aspects not only influence physical health but also the emotional and psychological well-being of individuals, contributing to a better overall quality of life. Objective: The aim of this study was to analyze the moderating role of self-perceived physical fitness in motor self-efficacy and physical self-concept, in high school physical education students.

Methods

To this end, the Kolmogorov-Smirnov test was applied to identify the non-normality of the data and the Mann-Whitney U test to determine the differences by sex in the variables studied to subsequently perform a moderation analysis and a regression test for the physical self-concept prediction model.

Results

The results showed that self-perceived physical fitness positively moderated the relationship motor self-efficacy and physical self-concept, enhancing the positive effect size of self-efficacy on physical self-concept.

Conclusion

Thus, self-perceived physical fitness could be important in interventions aimed at improving physical and emotional well-being and health of adolescents.

Expectations regarding school decreases emotional distress among college students in Western China: the buffering role of physical exercises

Background

College students in Western China face unique economic, cultural, and educational environments, yet limited studies have specifically investigated the factors or interventions concerning emotional distress within this population.

Aim

This study aimed to explore whether school belongingness mediates the relationship between expectations regarding school and emotional distress among college students in Western China, and whether physical exercise moderates this mediation.

Methods

Employing a cross-sectional design, 1,063 college students in Xinjiang, China were recruited for this study. A self-administered electronic questionnaire assessed expectations regarding school, school belongingness, physical exercise, anxiety, and depression. Structural equation modeling was utilized to analyze mediating and moderating effects.

Results

Expectations regarding school was negatively associated with emotional distress. School exclusion and school acceptance fully mediated the effect of expectations regarding school on emotional distress. Physical exercise moderated the mediating effect of school exclusion, but not that of school acceptance.

Conclusion

Expectations regarding school and school belongingness, particularly the exclusion component, emerge as pivotal factors influencing emotional distress among college students in Western China. Furthermore, physical exercise presents itself as a promising targeted intervention for alleviating emotional distress within this demographic.

Contributors to mental health resilience in middle-aged and older adults: an analysis of the Canadian Longitudinal Study on Aging

OBJECTIVES

Identifying the correlates of mental health resilience (MHR)-defined as the discrepancy between one's reported current mental health and one's predicted mental health based on their physical performance-may lead to strategies to alleviate the burden of poor mental health in aging adults. Socioeconomic factors, such as income and education, may promote MHR via modifiable factors, such as physical activity and social networks.

DESIGN

A cross-sectional study was conducted. Multivariable generalized additive models characterized the associations between socioeconomic and modifiable factors with MHR.

SETTING

Data were taken from the population-based Canadian Longitudinal Study on Aging (CLSA), which collected data at various data collection sites across Canada.

PARTICIPANTS

Approximately 31,000 women and men between the ages of 45 and 85 years from the comprehensive cohort of the CLSA.

MEASUREMENTS

Depressive symptoms were assessed by the Center for Epidemiological Studies Depression Scale. Physical performance was measured objectively using a composite of grip strength, sit-to-stand, and balance performance. Socioeconomic and modifiable factors were measured by self-report questionnaires.

RESULTS

Household income, and to a lesser extent, education were associated with greater MHR. Individuals reporting more physical activity and larger social networks had greater MHR. Physical activity accounted for 6% (95% CI: 4 to 11%) and social network accounted for 16% (95% CI: 11 to 23%) of the association between household income and MHR.

CONCLUSIONS

The burden of poor mental health in aging adults may be alleviated through targeted interventions involving physical activity and social connectedness for individuals with lower socioeconomic resources.

Active longevity and aging: dissecting the impacts of physical and sedentary behaviors on longevity and age acceleration

BACKGROUND

To examine the associations of physical activity (PA) and sedentary behavior (SB) with longevity and age acceleration (AA) using observational and Mendelian randomization (MR) studies, and quantify the mediating effects of lipids.

METHODS

In Guangzhou Biobank Cohort Study (GBCS), PA and SB were assessed by the Chinese Version of the International Physical Activity Questionnaire. Longevity was defined as participants whose age at follow-up or at death was at or above the 90th age percentile. AA was defined as the residual resulting from a linear model that regressed phenotypic age against chronological age. Linear regression and Poisson regression with robust error variance were used to assess the associations of total and specific PA in different intensities, and SB with AA and longevity, yielding βs or relative risks (RRs) and 95% confidence intervals (CIs). Two-sample MR was conducted to examine the causal effects. Mediation analysis was used to assess the mediating effects of lipids.

RESULTS

Of 20,924 participants aged 50 + years in GBCS, during an average follow-up of 15.0 years, compared with low PA, moderate and high PA were associated with higher likelihood of longevity (RR (95% CI): 1.56 (1.16, 2.11), 1.66 (1.24, 2.21), respectively), and also cross-sectionally associated with lower AA (β (95% CI): -1.43 (-2.41, -0.45), -2.09 (-3.06, -1.11) years, respectively). Higher levels of moderate PA (MPA) were associated with higher likelihood of longevity and lower AA, whereas vigorous PA (VPA) showed opposite effects. The association of PA with longevity observed in GBCS was mediated by low-density lipoprotein cholesterol (LDL-C) by 8.23% (95% CI: 3.58-39.61%), while the association with AA was mediated through LDL-C, triglycerides and total cholesterol by 5.13% (3.94-7.30%), 7.81% (5.98-11.17%), and 3.37% (2.59-4.80%), respectively. Additionally, in two-sample MR, SB was positively associated with AA (β (95% CI): 1.02 (0.67, 1.36) years).

CONCLUSIONS

PA showed protective effects on longevity and AA, with the effects being partly mediated through lipids. Conversely, SB had a detrimental impact on AA. MPA was associated with higher likelihood of longevity and reduced AA, whereas VPA showed adverse effects. Our findings reinforce the recommendation of "sit less and move more" to promote healthy longevity, and highlight the potential risks associated with VPA in the elderly.

The effect of different exercise on physical fitness, cognition, and mental health in healthy older adults

Objective

This study aimed to examine the effects of different exercise programs on physical fitness, cognition, and mental health in healthy older adults.

Methods

A randomized controlled study was performed with 89 healthy older adults. They were separated into four groups: the control (Con; n = 20), physical activity (PA; n = 23), cognitive training (CT; n = 23), and physical activity coupled with cognitive training groups (PA + CT; n = 23). The subjects in PA, CT, and PA + CT groups received exercise programs that lasted 40 min daily, conducted at least three days a week for 20 weeks. The PA group received regular aerobic physical activity interventions, the CT group received cognitive training interventions, and the PA + CT group received physical activity combined with cognitive training interventions. Physical fitness (by chair stand, biceps curl, 2-min step, 8-step up and walk, and sit and reach tests), cognitive function (attention, simple reaction time, and spatial memory), and mental health (anxiety and depression status) were evaluated before and after 20 weeks.

Results

The body composition results reveal no significant effects among the four groups after 20 weeks before and after aerobic exercise interventions (p > 0.05). Compared with Con, the PA, CT, and PA + CT groups significantly improved physical fitness parameters (p < 0.05). The post-hoc analysis demonstrated that the PA and PA + CT groups had higher fitness levels than the CT group. Similarly, a significant difference was observed in the cognitive index among the four groups (p < 0.05). As determined by post-hoc analysis, attention and simple reaction time differed sequentially between the Con, PA, CT, and PA + CT groups. The spatial memory was superior in the PA, CT, and PA + CT groups compared to the Con group (p < 0.05), with the PA + CT group exhibiting the highest level of performance. However, there was no significant difference in the mental health parameters among all the groups (p < 0.05).

Conclusion

A 20-week intervention involving different exercise methods can enhance physical fitness, cognition, and mental health in older adults. These methods include physical activity, cognitive training, and a combination of physical and cognitive training. The combined physical activity and cognitive training interventions yielded more favorable outcomes than individual physical or cognitive training interventions.

Walking away from depression: the mediating role of walking activity in depression impacting blood glucose levels of people with diabetes or prediabetes

Introduction

Depression can exacerbate diabetes by impairing self-care behaviors and increasing the risk of complication; however, the underlying mechanism is still unclear. Given the suggested associations between walking activity, depression status, and blood glucose levels this study explores the intricate relationship between depression and blood glucose (BG) control, with a focus on walking activity as a behavioral mediator. The purpose of this study is to examine walking activity's mediating role in depression's impact on BG levels, investigating and validating the non-linear association between BG levels and walking activity. This retrospective real-world study demonstrates the potential of regular walking activity as a simple and accessible intervention to mitigate the negative effects of depression on BG levels in T2D and prediabetes.

Methods

A cohort of 989 users with T2D and prediabetes, who regularly tracked their steps levels and BG levels for 12 months using the Dario digital health platform was evaluated. The mediating role of the monthly average number of steps on the relationship between the self-reported depression status and lagged monthly average BG was assessed. Additionally, the association between monthly walking activity and monthly average BG was tested using a piecewise linear mixed effects model.

Results

Users with self-reported depression demonstrated increased BG levels compared to users without depression (B=8.00, P=.01). The association between depression and monthly average number of steps was significant (B=-.27, P<.005) and monthly average number of steps significantly predicted the following months' average BG (B=-.81, P=.001), adjusting for depression. The monthly average number of steps significantly mediated the effect of self-reported depression on the following month's average BG (M=.22, P<.005). Further sensitivity analysis demonstrated model robustness over various periods. Finally, non-linear dynamics of walking activity over time was validated using unseen data showing a decrease in monthly average BG for users with over an average of 400 steps per day (B=-1.87, P<.01).

Discussion

This study shows how regular walking may reduce the negative impact of depression on BG levels in people with T2D. Our findings advocate for the integration of walking activity into treatment protocols as a cost-effective, accessible intervention strategy to improve glycemic management and depressive symptoms in this population.

Remote Exercise Training Intervention During the COVID-19 Pandemic: Randomized Controlled Trial

BACKGROUND

Societal measures to contain the spread of COVID-19 (eg, lockdown and contact restrictions) have been associated with decreased health and well-being. A multitude of prepandemic studies identified the beneficial effects of physical exercise on both physical and mental health.

OBJECTIVE

We report on the feasibility of a remote physical exercise intervention and its stress-buffering potential in 2 untrained cohorts: a pre-COVID-19 cohort that completed the intervention in 2019 and a lockdown cohort that started the intervention shortly before pandemic-related restrictions were implemented.

METHODS

In a randomized controlled trial, participants were assigned to either an intervention group (IG; pre-COVID-19 cohort: n=7 and lockdown cohort: n=9) or a control group (CG; pre-COVID-19 cohort: n=6 and lockdown cohort: n=6). IG participants received weekly individualized training recommendations delivered via web-based support. The intervention period was initially planned for 8 weeks, which was adhered to in the pre-COVID-19 cohort (mean 8.3, SD 0.5 weeks) but was extended to an average of 17.7 (SD 2.0) weeks in the lockdown cohort. Participants' health parameters were assessed before and after the intervention: aerobic capacity was measured as peak oxygen uptake (VO2peak) via cardiopulmonary exercise testing. Depressive symptoms were scored via the depression subscale of the Brief Symptom Inventory-18.

RESULTS

Dropout rates were low in both cohorts in the IG (pre-COVID-19 cohort: n=0, 0% and lockdown cohort: n=2, 16.7%) and the CG (pre-COVID-19 cohort: n=0, 0% and lockdown cohort: n=2, 20%). The mean adherence to the training sessions of the IG for both cohorts was 84% (pre-COVID-19 cohort: SD 5.5% and lockdown cohort: SD 11.6%). Aligned rank transform ANOVAs in the lockdown cohort indicated deterioration of VO2peak and depressive symptoms from before to after the intervention in the CG but no longitudinal changes in the IG. Analyses in the pre-COVID-19 cohort revealed significant increases in VO2peak for the IG compared to the CG (P=.04) but no intervention effects on depressive symptoms.

CONCLUSIONS

With low dropout rates and high adherence, the remote intervention was feasible for healthy adults under regular conditions and in the face of pandemic-related stressors. Moreover, our results hint at a stress-buffering effect as well as a buffering of a lockdown-induced deconditioning of remote physical exercise interventions in the pandemic scenario, which can be used in future studies to overcome equally stressful periods of life. However, due to limited statistical power, these findings should be replicated in similar scenarios.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00018078; https://drks.de/search/en/trial/DRKS00018078.

Accumulated HIIT inhibits anxiety and depression, improves cognitive function, and memory-related proteins in the hippocampus of aged rats

This study aimed to compare the effects of High-Intensity Interval Training (HIIT) performed in a single session(1xHIIT) versus three daily sessions (3xHIIT) on fitness level and behavior of aged rats. Eighteen-month-old Wistar rats were assigned to Untrained (UN), 1xHIIT, or 3xHIIT (n = 12/group). Both groups, 1xHIIT and 3xHIIT, performed 15 min of a treadmill running HIIT protocol during 8 weeks. 1xHIIT protocol consisted of a single daily session of 15 min, while the 3xHIIT performed three daily sessions of 5 min with a 4 h interval between the sessions. Morris Water Maze (MWM) task was used to evaluate spatial learning and memory. Splash test, Forced Swim test, and Elevated Plus Maze task (EPM) were used to evaluate anhedonic, depressive-like, and anxious behaviors, respectively. Rats were euthanized, and the hippocampus was harvested for western blot analyses (CaMKII and BDNF). Both HIIT protocols improved VO2max and spatial memory. Notably, only the 3xHIIT protocol attenuated anxious and depressive-like behaviors. Western blot analyses of the hippocampus revealed that both HIIT protocols increased BDNF levels. BDNF levels were higher in the 3xHIIT when compared with 1xHIIT group, and we observed increasement of the CamKII levels just in the 3x HIIT group. Therefore, this study provides evidence indicating that accumulated HIIT sessions is more effective than traditional daily HIIT sessions in improving fitness level, cognitive function, memory, inhibiting the development of mood disorders, and enhancing BDNF and CaMKII levels in the hippocampus of aged rats.

The Mediating Role of Cardiorespiratory Fitness in the Association between a Negative Lifestyle and Poor Mental Health in Chilean Schoolchildren

BACKGROUND

A negative lifestyle has a reported relationship with psychological problems and deteriorated well-being. However, there is little information regarding the mediating role of cardiorespiratory fitness (CRF) in this relationship.

OBJECTIVES

The objectives of the present study are twofold: first, to investigate the association between negative lifestyle, physical self-concept (PSC), and depression, and second, to assess the potential mediating role of CRF in this complex relationship.

METHODS

This cross-sectional study included 612 schoolchildren aged between 9 and 14 years from the Araucanía region (southern Chile). CRF was measured using the Leger test, and lifestyle, depression, and PSC were measured using validated questionnaires.

RESULTS

A negative lifestyle reported an inverse association with PSC (p < 0.001) and a positive association with depression levels (p < 0.001). The mediation analysis showed that CRF was positively related to PSC (p < 0.001) and inversely related to depression (p = 0.001); besides, the indirect effect CRF acted as a partial mediator in the association between a negative lifestyle and PSC (indirect effect = -1.15; SE = 0.01; 95% CI, -1.87, -0.55) and depression levels (indirect effect = 0.22; SE = 0.08; 95% CI, 0.08, 0.38).

CONCLUSION

In conclusion, CRF in schoolchildren played a potential mediating role in the association between a negative lifestyle and depression and PSC.

The association between physical fitness and mental health among college students: a cross-sectional study

Introduction

Physical inactivity and mental health disorders are emerging threats to public health in China. Previous research on links between exercise and mental wellbeing have focused on clinical populations, with little evidence from the general population, particularly younger adults. We aimed to investigate associations between physical fitness and mental health in Chinese college students.

Methods

In this series, of cross-sectional observational studies, we enrolled 7,468 Chinese college students aged 16-24 years in 199 classes at Changzhou Vocational Institute of Engineering between Sept 1, 2017, and Jun 30, 2018. Exposures of interest were the students' physical fitness level, measured by the Chinese University Students Physique Test. The primary outcomes were mental health situations, measured by the University Personality Inventory (UPI). The multivariable linear regression models were used to assess the relationship between the levels of physical fitness and mental disorders symptoms.

Results

Completed mental health and physical fitness data were available for 6,724 participants aged 16-24 years. Compared with the failed group, the corresponding levels of difference in overall UPI scores were - 1.45 scores (95% CI: -2.45, -0.46; p < 0.01) for the passed group and - 2.95 scores (95% CI: -4.13, -1.77; p < 0.01) for the good group. Similar results were observed in the four different aspects of psychotic disorder symptoms.

Discussion

There was a significantly negative correlation between the level of physical fitness and phycological situations among Chinese college students. Our findings highlight the psychological situations of students with low physical fitness levels should be concerned.

Resilience among Turkish adolescents: A multi-level approach

The objective of this study is to determine the components that contribute to psychological resilience in adolescents and to determine if physical exercise, emotion control, or self-efficacy are more effective predictors of resilience. Data from participants was collected through a personal information form, the International Physical Activity Questionnaire-Short Form, the Self-Efficacy Scale for Children, the Emotion Regulation Scale for Children and Adolescents, and the Psychological Resilience Scale for Children and Adolescents. The data were gathered online from 16 out of the 81 provinces in Turkey, representing 7 different regions, using convenience sampling. The study sample comprised 505 adolescents, with 309 females and 196 males. The average age of the participants was 15.66 years, with a standard deviation of 1.34. The data obtained from the students was analyzed using SPSS 27.0 statistical software. The Chi-Square test was employed to establish the correlation between the demographic features of adolescents and their levels of physical activity. The relationship between the independent variables and the dependent variable was determined using correlation analysis and hierarchical regression analysis. According to the analyzed results, there was a substantial positive correlation between physical activity and resilience, reappraisal and resilience, and self-efficacy and resilience. In addition, it was noted that physical activity alone explains 4.8% of the overall variation in resilience and is a significant predictor of resilience. The inclusion of reappraisal in the model resulted in a partial prediction of resilience by physical activity. However, the primary strength of the model was attributed to reappraisal. The inclusion of self-efficacy in the model resulted in a significant prediction of resilience, accounting for 36.8% of the total variance. The self-efficacy variable had a higher impact level compared to the other variables. Furthermore, the inclusion of self-efficacy in the model resulted in the elimination of the influence of physical activity on resilience. The research conclusions point out that self-efficacy has a greater impact on psychological resilience compared to physical activity and emotion regulation.

Modifiable factors influencing attention performance in healthy children: insights from a comprehensive school nutrition study

BACKGROUND

There is inconclusive evidence for the effects of various leisure activities on attention performance in children. The literature reports inconsistent associations between activities such as physical activities or media use. To date, no study has thoroughly examined the various factors influencing attentional performance in a larger cohort of healthy children. This study aims to close this research gap.

METHODS

From 2018 to 2019, the Leipzig School Nutrition Study collected data from 1215 children and their families. The children report their dietary behavior (using CoCu- Questionnaire), especially their participation in school lunch and their breakfast habits, through a paper questionnaire. Furthermore, attention performance was assessed using a validated test (FAIR-2) at school. Data on physical activity, media consumption, family eating habits and socio-economic status (SES) were collected from parents using questionnaires. Associations between attention and influencing factors were estimated using hierarchical linear regression. Analyses were adjusted for age, SES, and school type.

RESULTS

Attending upper secondary schools (ßadj= 23.6, p < 0.001) and having a higher SES (ß= 1.28, p < 0.001) was associated with higher attention performance. Children doing leisure-time sports (ßadj= 4.18, p = 0.046) or reading books for at least one hour/weekday showed better attention performance (ßadj= 3.8, p = 0.040). Attention performance was also better in children having no electronic devices in the bedroom (ßadj= 13.0, p = 0.005) and in children whose parents limited their children's Internet access (ßadj= 5.2, p = 0.012). We did not find any association between nutritional habits and attention performance.

CONCLUSIONS

We found that fostering modifiable habits such as reading and physical activity could enhance attention performance. These findings have substantial implications for the development of prevention and intervention programs that aim to improve attention in schoolchildren. It is important to note, however, that social status as a hardly modifiable factor also impacts attention performance. Therefore, interventions should address personal habits in a systemic approach considering the child's social status.

TRIAL REGISTRATION

The study is retrospectively registered with the German Clinical Trials Register (DRKS00017317, registration: 05-29-2019).

Enjoyment and Affective Responses to Moderate and High-Intensity Exercise: A Randomized Controlled Trial in Individuals with Subsyndromal PTSD

This crossover randomized controlled trial examined the acute psychological effects of a bout of moderate-intensity continuous aerobic exercise (MICE) and a bout of high-intensity functional exercise (HIFE), relative to a no-exercise sedentary control (SED), in participants (N = 21; 15 f; 24.7 ± 9.3 years) with subsyndromal post-traumatic stress disorder (PTSD). Affective state (Energy, Tiredness, Tension, Calmness) was assessed before (Pre), immediately after (Post 0), 20-min after (Post 20), and 40-min after (Post 40) each condition. Affective valence was assessed during each condition, and exercise enjoyment was assessed at Post 0. Enjoyment was significantly greater following HIFE and MICE relative to SED. Energy was significantly increased Post 0 HIFE and MICE but decreased Post 0 SED. Tension was reduced following all conditions and was significantly lower at Post 40 relative to Pre for HIFE, MICE, and SED. Tiredness was significantly reduced at Post 40 relative to Pre following MICE only, while Calmness was significantly lower at Post 40 relative to Pre following MICE and SED. Overall, both exercise conditions were enjoyed to a greater extent than the control, but MICE may provide greater psychological benefits with respect to Calmness and Tiredness. This study is among the first to assess acute changes in affective states relative to various exercise modes in individuals living with subsyndromal PTSD.

A comprehensive study of the academic benefits and practical recommendations to include resistance training programs in institutional education

The connection between physical activity and cognitive function has become a focus of attention in educational research in recent years. Regular exercise has been shown to have significant positive effects on physical health, but it also appears to have a significant impact on cognitive function and academic performance. Of all the exercise modalities, resistance training has drawn interest for its ability to improve cerebral abilities in addition to physical well-being. However, there is limited available knowledge exploring the relationship between resistance training regimens and academic performance. This narrative review aims to investigate the underlying mechanisms linking resistance training to academic performance. Firstly, we will examine the biological mechanisms and psychosocial links that potentially connect resistance training to academic performance to find and describe the different mechanisms by which resistance training improves academic performance. In the next part of the work, we delve into the existing observational and intervention studies that have explored the relationship between resistance training and academic performance. Lastly, we provide practical recommendations for including resistance training in institutional education settings, emphasizing the need of dispelling myths and addressing barriers to increase participation as well as the relevance of considering key training variables and adaptation of protocols to developmental stages, always guided by a properly trained professional. Overall, the available evidence supports that resistance training provides potential benefits to the academic performance of youth students with many biological and psychosocial factors that explain this relationship. However, most of the studies are observational, and broader interventional studies are needed to understand and maximize the benefits of this type of physical exercise.

Association between exposure to chemical mixtures and epigenetic ageing biomarkers: Modifying effects of thyroid hormones and physical activity

Evidence on the effects of internal chemical mixture exposures on biological age is limited. It also remains unclear whether hormone homeostasis and lifestyle factors can modify such a relationship. Based on the Biomarkers for Air Pollutants Exposure (BAPE) study, which involved healthy older adults aged 60-69 years in China, we found that chemical mixture exposures, including metals, polycyclic aromatic hydrocarbons (PAHs), per- and polyfluoroalkyl substances (PFASs), phthalates (PAEs), and organophosphate esters (OPEs), were significantly associated with shortened DNAmTL and accelerated SkinBloodClock, in which PFASs and OPEs in blood were the primary contributors to DNAmTL, while metals and PAEs had relatively higher contributions in urine. Furthermore, lower levels of thyroxin appeared to exacerbate the adverse effects of environmental chemicals on epigenetic ageing but relatively higher levels of physical activity had the beneficial impact. These findings may have important implications for the development of healthy ageing strategy and aged care policy, particularly in light of the global acceleration of population ageing.

Latent profiles of academic resilience in undergraduate nursing students and their association with resilience and self-efficacy

AIM

This study aimed to investigate the heterogeneity of academic resilience among nursing students using latent profile analysis and its associated influencing factors.

BACKGROUND

Nursing students experience higher levels of stress compared to their peers in other professions, and the cultivation of academic resilience plays a pivotal role in their ability to effectively cope with this stress. Academic resilience not only facilitates success in the face of academic adversity but also contributes to the promotion of mental well-being among nursing students. However, the current research on the academic resilience of nursing students has predominantly focused on a scale-centered total score approach, disregarding individual variability, and hindering the development to inform personalized interventions for enhancing academic resilience.

DESIGN

A cross-sectional study.

METHODS

A convenience sampling method was used to collect a total of 644 nursing students from two medical schools in Guangzhou City. The participants were recruited through an online survey conducted from January to March 2023. The questionnaires consisted of a general information form, the Chinese version of the Academic Resilience Scale-30 (C-ARS-30), the 10-item Connor Davidson Resilience Scale (CD-RISC-10), and the General Self-Efficacy Scale (GSES). Latent profile analysis was used to identify distinct categories of academic resilience among nursing students, and influencing factors were examined through ordinal logistic regression analysis.

RESULTS

The academic resilience levels of nursing students can be divided into three potential categories: 'low academic resilience' (13.0%), 'moderate academic resilience' (70.0%), and 'high academic resilience' (17.0%). Level of grade, GPA, self-reported physical health level, resilience and self-efficacy were significantly influenced the different categories of academic resilience of nursing students (P<0.05).

CONCLUSIONS

The majority of undergraduate nursing students were placed in the moderate academic resilience group, however, educational institutions should pay special attention to nursing students demonstrating low levels. Regular assessments of academic resilience are recommended, and personalized interventions should be tailored to address specific academic resilience characteristics across different grades of nursing students. Strategies aimed at enhancing academic resilience among nursing students may include improvements in GPA performance, attention to physical health, and the reinforcement of resilience and self-efficacy.

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

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

Association between sports participation and resilience in school-attending students: a cross-sectional study

Aim

This research sought to identify the association between sports participation and resilience in children and adolescents as a means to enhance mental health.

Methods

A comprehensive survey was carried out, encompassing primary, middle, and high school students from chosen educational institutions. The analytical sample comprised 67,281 students of school age. Sports participation and resilience were evaluated using validated assessment tools, while relevant covariates, such as sex and school grade, were assessed through self-reported questionnaires. Generalized Linear Models were applied to ascertain the association between sports participation and resilience for the entire sample, and separately for subgroups divided by gender or school grade, after controlling for covariates.

Results

Among the 67,281 school students, males constituted 51.9% of the sample. Approximately 47.1% of the entire sample reported no sports participation, and the average resilience score was 24.7. The regression model analysis revealed that, in the entire sample, increased in sports participation was linked to higher resilience scores (odds ratio [OR] for 1-3 times per month: 1.20, 95%CI: 1.16-1.24; OR for 1-2 times per week: 1.38, 95%CI: 1.33-1.43; OR for 3 times or more per week: 1.72, 95%CI: 1.65-1.79). Analyses stratified by gender and school grade indicated that sports participation was consistently associated with greater resilience.

Conclusion

This study provides cross-sectional evidence supporting the positive association between sports participation and the resilience of children and adolescents, underscoring the potential of encouraging sports participation as a strategy for promoting mental health resilience. The findings presented herein should be subject to further confirmation or refutation in future research endeavors.

Longitudinal Associations Between Physical Activity and Depressive Symptoms in Chinese Children: Evidence from the Tongji Mental Health Cohort Study

BACKGROUND

We aimed to examine the associations between depressive symptoms and physical activity parameters (e.g., intensity, frequency, and duration) among Chinese school-aged children.

METHOD

Participants in this study were extracted from the Tongji Mental Health Cohort Study. The baseline survey was conducted in June 2020 involving 2588 school-aged children from two primary schools in Hubei Province, China. A total of 2435 children were followed up successfully in December 2020. The Children's Depression Inventory Short Form (CDI-S) was applied to evaluate depressive symptoms among school-aged children. The Physical Activity Rating Scale-3 (PARS-3) was adopted to estimate children's physical activity parameters including the intensity, frequency, and duration. Generalized estimation equation models were used to explore the longitudinal associations between physical activity and depressive symptoms among school-aged children.

RESULTS

Engaging in moderate levels of physical activity (OR, 0.800; 95%CI, 0.692-0.924) or high levels of physical activity (OR, 0.808; 95%CI, 0.689-0.947) in the baseline survey was associated with a reduced risk of developing depressive symptoms in the follow-up survey compared with children engaging in low levels of physical activity. Stratified analyses revealed that the associations between physical activity and depressive symptoms exhibited a significant correlation among boys and children in the older age group (11-12 years). Our findings showed that engaging in physical activity more than once a week, with each session lasting 20 min or longer, was related to significant reductions in depressive symptoms by 43.8% and 22.3%, respectively.

CONCLUSION

Self-reported physical activity is positively associated with improved mental health among Chinese school-aged children, especially when considering parameters such as frequency and duration. The association between vigorous-intensity physical activity and depressive symptoms in children should be cautiously interpreted. Future research should continue to explore the effects of vigorous-intensity physical activity on depressive symptoms in children.

How Much Energy Do E'Athletes Use during Gameplay? Quantifying Energy Expenditure and Heart Rate Variability Within E'Athletes

BACKGROUND

Research into esports suggests that e'athletes experience physiological stressors and demands during competition and training. The physiological demands of esports are poorly understood and need to be investigated further to inform future training guidelines, optimise performance outcomes, and manage e'athlete wellbeing. This research aimed to quantify the metabolic rate of esports gameplay and compare this outcome with heart rate variability within expert e'athletes.

RESULTS

Thirteen healthy male participants ranked within the top 10% of their respective esports title participated in the study (age = 20.7 ± 2.69 years; BMI = 24.6 ± 5.89 kg·m- 2). Expired gas analysis indirect calorimetry measured gas exchange during rest and gaming. Compared to resting conditions, competitive esports gameplay significantly increased median energy expenditure (1.28 (IQR 1.16-1.49) kcal·min- 1 vs. 1.45 (IQR 1.20-1.77) kcal·min- 1, p = .02), oxygen consumption (0.27 (IQR 0.24-0.30) L·min- 1 vs. 0.29 (IQR 0.24-0.35) L·min- 1, p = .02) and carbon dioxide production (0.20 (IQR 0.19-0.27) L·min- 1vs. 0.27 (IQR 0.24-0.33) L·min- 1, p = .01). Competitive gameplay also resulted in a significant increase in heart rate (84.5 (IQR 74.1-96.1) bpm vs. 87.1 (IQR 80.3-104) bpm, p = .01) and decrease in R-R interval's (710 (IQR 624-810) ms vs. 689 (IQR 579-747) ms, p = .02) when compared to rest. However, there were no significant differences in time or frequency measures of heart rate variability.

CONCLUSIONS

The data reveal increased physiological responses to metabolic rate, energy expenditure and cardiovascular function to esports game play within expert e'athletes. Further physiological research into the physical demands on e'athletes, the influence of different training programs to esport performance, and the added multivariate determinants to elite level esport performance are warranted.

Analysis of Sleep, Nocturnal Physiology, and Physical Demands of NCAA Women's Ice Hockey Across a Championship Season

ABSTRACT

Merrigan, JJ, Stone, JD, Kraemer, WJ, Friend, C, Lennon, K, Vatne, EA, and Hagen, JA. Analysis of sleep, nocturnal physiology, and physical demands of NCAA women's ice hockey across a championship season. J Strength Cond Res 38(4): 694-703, 2024-The aims of this study were to evaluate the (a) relationships between daily physical demands and nighttime sleep, heart rate (HR), and heart rate variability (HRV); (b) weekly changes in physical demands and sleep; and (c) differences among positions and between training and competition during a competitive season in National Collegiate Athletic Association (NCAA) women's ice hockey. Twenty-five NCAA Division I women's ice hockey athletes wore a sensor at night to monitor sleep quantity or quality (e.g., time asleep and sleep efficiency) and physiology (e.g., HR and HRV). During training and competitions (31 regular season and 7 postseason), athletes wore performance monitoring systems to assess workload demands (e.g., training impulse and TRIMP). As internal workload (TRIMP, Time >80% of HRmax, Average HR) during training or competition increased, nocturnal HRV decreased, HR increased, and Sleep Duration, Sleep Score, and Readiness Score decreased that night. Across the season, athletes experienced lower HRV, but exhibited longer sleep durations. Training Distance, Duration, Time >80% HRmax, Average HR, and TRIMP decreased, whereas competition Total Distance, Duration, and TRIMP increased across weeks throughout the season. There were differences across positions and season blocks when evaluating these data at the mesocycle level. Athletes slept longer before competition compared with training, but physiological data did not differ. Competitions had greater physiological demands than training. We speculate that the increased focus on sleep hygiene, as evidenced by the increase in sleep over the season, may have served as a recovery aid to combat physiological stress of accumulated demands of competitions that increased over time into postseason tournaments.

Physical Activity and Psychological Resilience in Older Adults: A Systematic Review of the Literature

Older adults face numerous unfavorable functional changes caused by aging, but many exhibit resilience, which helps them cope with challenges. Physical activity is positively associated with resilience. Therefore, this systematic literature review aimed to uncover the relationships between physical activity and resilience in older adults. We have analyzed three freely and openly available databases: (a) PubMed/Medline, (b) ScienceDirect, and (c) Google Scholar, which yielded 20 eligible articles based on the inclusion and exclusion criteria. Most studies (14) were cross-sectional, three were longitudinal, and three others used mindfulness-based or endurance-enhancing physical activity interventions. Their results revealed increased resilience even after short-duration and low-frequency interventions. Cross-sectional research results also support the positive relationship between physical activity and resilience in older adults, suggesting that the relationship might depend on exercise volume. Still, further research is needed to design interventions, understand the mechanism(s) involved in altering resilience, and maximize physical activity's benefits in aging people.

Effects of short-term exercise and endurance training on skeletal muscle mitochondria damage induced by particular matter, atmospherically relevant artificial PM2.5

Introduction

This study aimed to investigate the potential of short-term aerobic exercise to mitigate skeletal muscle mitochondrial damage following ambient PM2.5 exposure, and how 12 weeks of endurance training can enhance aerobic fitness to protect against such damage.

Methods

Twenty-four male C57BL/6 J mice were split into sedentary (SED, n = 12) and endurance training (ETR, n = 12) groups. The ETR group underwent 12 weeks of training (10-15 m/min, 60 min/day, 4 times/week), confirmed by an Endurance Exercise Capacity (EEC) test. Post-initial training, the SED group was further divided into SSED (SED and sedentary, n = 6) and SPE (SED and PM2.5 + Exercise, n = 6). Similarly, the ETR group was divided into EEX (ETR and Exercise, n = 6) and EPE (ETR and PM2.5 + Exercise, n = 6). These groups underwent 1 week of atmospherically relevant artificial PM2.5 exposure and treadmill running (3 times/week). Following treatments, an EEC test was conducted, and mice were sacrificed for blood and skeletal muscle extraction. Blood samples were analyzed for oxidative stress indicators, while skeletal muscles were assessed for mitochondrial oxidative metabolism, antioxidant capacity, and mitochondrial damage using western blot and transmission electron microscopy (TEM).

Results

After 12 weeks of endurance training, the EEC significantly increased (p < 0.000) in the ETR group compared to the SED group. Following a one-week comparison among the four groups with atmospherically relevant artificial PM2.5 exposure and exercise treatment post-endurance training, the EEX group showed improvements in EEC, oxidative metabolism, mitochondrial dynamics, and antioxidant functions. Conversely, these factors decreased in the EPE group compared to the EEX. Additionally, within the SPE group, exercise effects were evident in HK2, LDH, SOD2, and GPX4, while no impact of short-term exercise was observed in all other factors. TEM images revealed no evidence of mitochondrial damage in both the SED and EEX groups, while the majority of mitochondria were damaged in the SPE group. The EPE group also exhibited damaged mitochondria, although significantly less than the SPE group.

Conclusion

Atmospherically relevant artificial PM2.5 exposure can elevate oxidative stress, potentially disrupting the benefits of short-term endurance exercise and leading to mitochondrial damage. Nonetheless, increased aerobic fitness through endurance training can mitigate PM2.5-induced mitochondrial damage.

Reducing Anxiety and Enhancing Mindfulness in College Students during COVID-19 through WeActive and WeMindful Interventions

OBJECTIVE

The purpose of this study was to examine the immediate and short-term, sustained effects of two virtual interventions, WeActive, an aerobic and resistance training program, and WeMindful, a mindful exercise, in reducing anxiety and improving mindfulness among college students during the COVID-19 pandemic.

METHODS

Participants were 60 students from a large Midwestern university who were randomly assigned to either the WeActive group (n = 36) or the WeMindful group (n = 24). The WeActive group participated in two virtual 30 min aerobic and resistance training sessions per week (WeActive) and the WeMindful group participated in two virtual 30 min mindful exercise sessions per week for eight weeks. All participants completed the Generalized Anxiety Disorder scale and the Five Facet Mindfulness Questionnaire through Qualtrics at three time points: one week prior to (pre-test), one week after (post-test), and six weeks after (follow-up) the intervention.

RESULTS

A repeated-measures ANOVA revealed a significant main effect of time on anxiety (F = 7.51, η2 = 0.036, p = 0.001) in both groups. WeActive significantly decreased anxiety scores between the pre-test and follow-up (t = 2.7, p = 0.027) and post-test and follow-up (t = 3.1, p = 0.007), and WeMindful significantly decreased anxiety scores between the post-test and follow-up (t = 0.641, p = 0.028). For mindfulness, there was a significant main effect of time in both groups (F = 3.91, η2 = 0.009, p = 0.025), where only WeMindful significantly increased mindfulness from the pre-test to follow-up (t = -2.7, p = 0.025).

CONCLUSIONS

Anxiety decreased significantly in both the WeActive and WeMindful groups and mindfulness increased significantly in the WeMindful group. Furthermore, the decrease in anxiety was sustained in a short-term period following the end of the intervention.

Adulthood effects of developmental exercise in rats

Exercise is known to promote efficient function of stress circuitry. The developing brain is malleable and thus exercise during adolescence could potentially exert lasting beneficial effects on the stress response that would be detectable in adulthood. The current study determined whether adolescent wheel running was associated with reduced stress response in adulthood, 6 weeks after cessation of exercise. Male and female adolescent rats voluntarily ran for 6 weeks and then were sedentary for 6 weeks prior to 10 days of chronic restraint stress in adulthood. Fecal corticosterone levels were measured during stress, and escape from the restraint tube was assessed on the final day as a proxy for depressive-like behavior. Anxiety-like behavior was measured 24 h later with the elevated plus maze and locomotor behaviors with the open field. Brain and body measurements were taken immediately following behavioral testing. Developmental exercise and adulthood stress both exerted independent effects on physiological and behavioral outcomes in adulthood. Exercise history increased the odds ratio of escape from restraint stress in males, but did not influence other stress-induced behaviors. In summary, exercise early in life exerted lasting effects, but did not substantially alter the adulthood response to restraint stress.

Effect of Training for an Athletic Challenge on Illness Cognition in Individuals with Chronic Disability: A Prospective Cohort Study

Illness cognitions (IC) influence how a patient adapts to a chronic disease. The aim was (1) to determine if training for a handcycling mountain time trial (HandbikeBattle) improves IC and (2) to identify factors associated with IC change scores. Persons with a chronic disability (N = 220; including N = 151 with spinal cord disorder) trained 5 months and participated in the time trial. The IC Questionnaire measured helplessness, acceptance, perceived benefits and was assessed before training (T1), after training (T2), and four months after the event (T3). Age, sex, body mass index (BMI), time since injury (TSI), disability characteristics, self-efficacy, mental health (MH) and musculoskeletal pain were obtained at T1. Multilevel regression analyses showed that helplessness decreased (from 11.96 to 11.28, p < 0.01) and perceived benefits increased (from 16.91 to 17.58, p < 0.01) from T1 to T2. For helplessness this decrease persisted during follow-up (11.16 at T3). Changes in helplessness were associated with self-efficacy (p = 0.02), MH (p = 0.02) and lesion completeness (p = 0.02), and were independent of disability type (p = 0.66), lesion level (p = 0.30) and demographics such as sex (p = 0.29) and age (p = 0.67). Training with peers may improve helplessness and perceived benefits in individuals with a chronic disability. Especially individuals with MH problems might benefit from training for an athletic challenge with peers to improve illness cognitions, and ultimately, quality of life.

Relating depression, anxiety, stress and loneliness to 5-year decline in physical function and frailty

OBJECTIVES

While depression has been associated with physical function decline and worsening frailty in older adults, the impact of other mental health symptoms on physical function and frailty is unknown. The study objective was to determine whether depression, perceived stress, loneliness, and anxiety symptoms affect 5-year physical function and frailty trajectories of older adults.

METHODS

The National Social Life, Health, and Aging Project (NSHAP) is a nationally-representative study of adults born between 1920 and 1947. The analysis included data collected in 2010-11 and 2015-16. Mental health symptoms were quantified using NSHAP's measures of anxiety (range:0-21), perceived stress (0-8), depression (0-22), and loneliness (0-6); higher scores indicated worse symptoms. We regressed 2015-16 3 m usual walk time, five-repeated chair stand time or an adapted frailty phenotype scale (0-4) separately on each 2010-11 mental health scale, adjusting for baseline physical function or frailty, demographics, and comorbidities.

RESULTS

In separate models, every one-point increase on the depression or perceived stress scales was associated with, respectively, a 0.06 s slower (95 % CI: 0.03, 0.10) or 0.09 s slower (95 % CI: 0.01, 0.16) 5-year walk time. Every one-point increase on the depression or perceived stress scales was associated with a 0.15 s slower (95 % CI: 0.06, 0.23) or 0.16 s slower (95 % CI: 0.02, 0.29) 5-year chair stand time. Every one-point increase on the depression scale predicted 0.06 higher log odds of having a worse frailty score 5 years later. Only depression's association with 3 m walk time and chair stands remained significant in models including all four mental health scales.

DISCUSSION

Older adults with more depression and to a lesser extent stress symptoms may experience faster physical function decline and worsening frailty. Future work exploring and addressing the mechanisms underlying these relationships are warranted.

Exercise evaluation with metabolic and ventilatory responses and blood lactate concentration in mice

This study aimed to clarify the differential exercise capacity between 2-month-old and 10-month-old mice using an incremental running test. Metabolic and ventilatory responses and blood lactate concentration were measured to evaluate exercise capacity. We examined whether incremental running test results reflected metabolic and ventilatory responses and blood lactate concentration observed during the steady-state running test. Metabolic response significantly declined with age, whereas ventilatory response was similar between the groups. A low-intensity/moderate exercise load of 10/min in an incremental running test was performed on both mice for 30 min. They showed a characteristic pattern in ventilatory response in 10-month mice. The results of incremental running tests didn't necessarily reflect the steady-state metabolic and ventilatory responses because some parameters showed an approximation and others did not in incremental and steady-state tests, which changed with age. Our study suggests metabolic and ventilatory responses depending on age and provides basic knowledge regarding the objective and quantitative assessment of treadmill running in an animal model.

What Tests are Used to Assess the Physical Qualities of Male, Adolescent Rugby League Players? A Systematic Review of Testing Protocols and Reported Data Across Adolescent Age Groups

BACKGROUND

Understanding the physical qualities of male, adolescent rugby league players across age groups is essential for practitioners to manage long-term player development. However, there are many testing options available to assess these qualities, and differences in tests and testing protocols can profoundly influence the data obtained.

OBJECTIVES

The aims of this systematic review were to: (1) identify the most frequently used tests to assess key physical qualities in male, adolescent rugby league players (12-19 years of age); (2) examine the testing protocols adopted in studies using these tests; and (3) synthesise the available data from studies using the most frequently used tests according to age group.

METHODS

A systematic search of five databases was conducted. For inclusion, studies were required to: (1) be original research that contained original data published in a peer-reviewed journal; (2) report data specifically for male, adolescent rugby league players; (3) report the age for the recruited participants to be between 12 and 19 years; (4) report data for any anthropometric quality and one other physical quality and identify the test(s) used to assess these qualities; and (5) be published in English with full-text availability. Weighted means and standard deviations were calculated for each physical quality for each age group arranged in 1-year intervals (i.e., 12, 13, 14, 15, 16, 17 and 18 years) across studies.

RESULTS

37 studies were included in this systematic review. The most frequently used tests to assess anthropometric qualities were body mass, standing height, and sum of four skinfold sites. The most frequently used tests to assess other physical qualities were the 10-m sprint (linear speed), 505 Agility Test (change-of-direction speed), Multistage Fitness Test (aerobic capacity), bench press and back squat one-repetition maximum tests (muscular strength), and medicine ball throw (muscular power). Weighted means calculated across studies generally demonstrated improvements in player qualities across subsequent age groups, except for skinfold thickness and aerobic capacity. However, weighted means could not be calculated for the countermovement jump.

CONCLUSION

Our review identifies the most frequently used tests, but highlights variability in the testing protocols adopted. If these tests are used in future practice, we provide recommended protocols in accordance with industry standards for most tests. Finally, we provide age-specific references for frequently used tests that were implemented with consistent protocols. Clinical Trial Registration This study was conducted in accordance with the Preferred Reporting Items of Systematic Review and Meta-analysis guidelines and was registered with PROSPERO (ID: CRD42021267795).

Domain-specific Physical Activity and the Risk of All-cause Mortality Among Middle-aged and Older Adults in Taiwan: A Prospective Cohort Study

BACKGROUND

The impact of meeting leisure-time physical activity (LTPA) recommendations and household physical activity (HPA) on all-cause mortality in the Taiwanese population is unclear. We aimed to investigate the relationship between sufficient LTPA and all-cause mortality in middle-aged and older Taiwanese adults and the role of HPA in those with insufficient LTPA.

METHODS

This nationwide prospective cohort study included 4,960 participants aged ≥50 years from the Taiwan Longitudinal Study in Aging (TLSA) survey. Physical activity patterns were assessed in 2003 and then followed up until 2015 for mortality through the National Death Registration Record. Cox proportional hazards regression was conducted to evaluate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality.

RESULTS

Of the 4,960 participants, 1,712 died of all-cause mortality. Compared to those who had insufficient LTPA, participants who engaged in sufficient LTPA showed a significantly lower risk of all-cause mortality (HR = 0.84, 95% CI, 0.73-0.97). For those with insufficient LTPA, HPA also had a significantly reduced risk of all-cause mortality (HR = 0.85, 95% CI, 0.75-0.96) among general population. Similar associations were observed in subsequent sensitivity analyses. The subgroup analysis showed that the relationship between HPA and reduced mortality risk was only found in the women with insufficient LTPA group.

CONCLUSION

This study confirmed that sufficient LTPA is associated with a lower risk of all-cause mortality. If sufficient LTPA cannot be performed, additional HPA is related to lower mortality.

Investigating and promoting health behaviors reactivity among Hong Kong older adults in the post-COVID-19 Era: An exploratory network analysis

BACKGROUND

Physical distance has increased the risk of developing a variety of health problems, especially among older people. During the COVID-19 lockdown period, physical activity decreased, screen time increased, food consumption increased, as well as exposure to unhealthy behaviour, leading to poorer sleep quality and more negative emotions, which ultimately led to poorer physical health, mental health, and subjective vitality among older adults. Although there were numerous research studies on changes in health behaviours during COVID-19, only a few were targeted at older adults, and none were conducted in Asian countries.

METHOD

The current study is aiming to identify the changes in health behaviours, as well as their associations with older adults' mental health as a result of the COVID-19 pandemic among Hong Kong older adults, using exploratory network analysis. In this study, a random tele-survey was conducted among older adults.

RESULTS

A total of 664 participants have been involved in the telephone survey, with 213 males and 451 females, of which mean age was 74.37. The explored network showed strong centrality and edge stability, thus enabling to reveal an overview of the associations between health behaviours and mental well-being of older adults. The lavaan model has also demonstrated the casual paths within the explored network, which indicated the significant impact of sleeping quality, eating habits and social networking on resilience.

CONCLUSION

The outcomes of the study were able to identify the lifestyle changes of Hong Kong older adults due to COVID-19. Although the present study is not regarded as novel internationally, it may be representative of the Hong Kong community. In order to facilitate active aging during the pandemic, a user-friendly electronic platform for healthy living should include older adults in the future.

Anticipatory Heart Rate Before Moderate- and Vigorous-Intensity Exercise Among Sedentary and Physically Active Young Adult Males

Background Anticipatory heart rate (HR) refers to an increase in HR that occurs in anticipation of a future event or activity. The anticipatory heart rate (HR) response before exercise is an important physiological indicator of exercise readiness. This study aimed to compare the anticipatory HR changes between sedentary and physically active young adult males during moderate- and vigorous-intensity exercise. Understanding these anticipatory heart rate patterns can provide insights into the physiological adaptations and cardiovascular health of individuals with varying physical activity levels. Materials and methods A total of 60 young adult males, comprising sedentary (n = 30) and physically active individuals (n = 30), participated in this study. A brisk walking for a distance of 50 m was considered moderate intensity and one minute of spot jogging at maximum effort with verbal encouragement was considered vigorous intensity exercise. The HR was recorded at baseline, just before the exercise, and on each minute up to 5 minutes after the exercise. Results The study involved 30 physically active young adult males (mean age 20.23 ± 1.43 years) and 30 sedentary adult males (mean age 20.07 ± 1.17 years). In physically active young adults, the resting HR was 76.4±10.89 bpm and just before starting moderate-intensity exercise, it was 78.83±12.98 bpm, paired t-test P = 0.22. The HR just before vigorous-intensity exercise was 80.83±11.18 bpm (paired t-test P = 0.03). In sedentary young adults, the resting HR was 82.23±12.69 bpm and just before starting moderate-intensity exercise, it was 90.13±18.69 bpm, paired t-test P = 0.0008. The HR just before vigorous-intensity exercise was 91.7±15.04 bpm (paired t-test P <0.0001). Conclusion Physically active young adults did not exhibit a significant increase in anticipatory HR before moderate-intensity exercise. However, sedentary individuals exhibit a significant anticipatory HR response. Before vigorous-intensity exercise, both exhibited significant increments in HR. The result highlights the importance of considering the anticipatory HR response as a potential marker of cardiovascular health and exercise readiness.

The physical, psychological, and social impacts of participation in the Invictus Pathways Program: A qualitative analysis of veterans' perceptions and experiences

INTRODUCTION

UniSA's Invictus Pathways Program (IPP) is motivated by the spirit of the Invictus Games to mobilise the benefits of sport to aid physical, psychological, and social wellbeing. Originally developed to assist veterans to train for and participate in the Invictus Games, the program has extended its scope to promote recovery and wellbeing for all veterans through physical activity. This paper describes the expectations and experiences of the IPP from the perspective of program participants.

METHODS

Objective measures of physical and psychological wellbeing were collected by survey, to enable description of the participating veterans' wellbeing status. Semi-structured interviews were conducted with 15 participants of the IPP who had not participated in an Invictus Games or Warrior Games. Reflexive thematic analysis was used to analyse the interview data. Coding and themes were developed through a mixture of inductive and deductive approaches to analysis. Initial themes related to previous life experience, expectations of participation, and outcomes of participation were preconceived, but the analysis provided scope for an inductive approach to formulate additional themes.

FINDINGS

Five of the participants had very high K10 scores, and scores above the norm for PCL-C, whilst one would be classified with an alcohol disorder. The qualitative analysis identified five higher order themes: Life experiences prior to participation in the IPP, Making a choice to participate in the IPP, Expectations of participation in the IPP, Impact of participation in the IPP, and Future Plans. There were perceptions that the IPP was beneficial for the participating veterans, irrespective of their physical and psychological health status. Participants described the positive impact of the IPP on their physical fitness, their social engagement, and their sense of belonging within the IPP and the university. Participants perceived the IPP to be an opportunity for them to 'give back' by contributing to the education of the students delivering the IPP. Participants reported the intention to continue being physically active. For some, this meant selection in an Invictus Games team, for others, this meant getting involved in community sporting organisations.

CONCLUSION

The Invictus Pathways Program has been shown to have a positive impact on the physical and psychological wellbeing of the veterans who participated in its initial stages. As the program evolves, the longitudinal impact of participation, for veterans and their families, will be assessed.