Trends in Aerobic Physical Activity Participation Across Multiple Domains Among US Adults, National Health and Nutrition Examination Survey 2007/2008 to 2017/2018

Longitudinal description and prediction of physical inactivity among patients with borderline personality disorder and personality-disordered comparison subjects

BACKGROUND

The physical and psychological benefits of physical activity are well-known, and physical activity has been proven to be a helpful adjunct to psychotherapeutic treatment for many symptomatic disorders, including mood and anxiety disorders. The current study explores physical inactivity levels in patients with borderline personality disorder (BPD). The first aim of this study is to describe the 12-year course of physical inactivity in patients with BPD. The second aim is to examine predictors of physical inactivity, including adversity experiences, comorbid symptomatic (formerly axis I) disorders, medical disorders, and demographic factors.

METHODS

Two hundred and forty-five patients with BPD were interviewed seven times over 12-years of prospective follow-up as part of the McLean Study of Adult Development (MSAD). Patients were categorized as ever-recovered (i.e., patient had experienced a symptomatic and psychosocial recovery from BPD) or never-recovered. At each follow-up, patients reported physical activity levels (minutes of exercise per week) via a semi-structured interview- the Medical History and Services Utilization Interview (MHSUI). Data was collected from June 1992 to December 2018.

RESULTS

Never-recovered patients with BPD were significantly more inactive than their ever-recovered counterparts (p < 0.001). These rates of inactivity remained stable over time for both groups. Two significant multivariate predictors of inactivity were found: obesity (p = 0.003) and PTSD (p < 0.001).

CONCLUSIONS

Non-recovered BPD patients are more likely to be inactive than patients who have recovered. Both clinical and medical factors appear to contribute to inactivity levels in patients with BPD.

Movement Behaviors and Mental Health of Catholic Priests in the Eastern United States

The purpose of this observational study was to examine (a) the proportion of Catholic priests in the United States that have anxiety/depression and meet the Canadian 24-Hour of Movement Guidelines, and (b) the association of meeting these guidelines with the likelihood of anxiety and depression. A sample of (arch)diocesan priests (n = 335) completed demographic and behavior survey, International Physical Activity Questionnaire (IPAQ-SF), and Hospital Anxiety and Depression Scale (HADS). Results indicated that 21.1% of priests surveyed met all three movement guidelines (physical activity, sleep, and screentime) and 7.8% met none. Priests who reported excessive recreational screentime (≥ 3 h/day) were more likely to have anxiety (OR = 3.17) and depression (OR = 2.91), and who were physically inactive (< 150 min/week) were more likely to have depression (OR = 8.89). Data from this study addresses a gap in the literature regarding Catholic priests, movement behavior, and mental wellbeing.

Association Between Leisure-Time Physical Activity and Occupation Activity Level, National Health Interview Survey-United States, 2020

BACKGROUND

Physical activity for any purpose counts toward meeting Physical Activity Guidelines (PAG). However, national surveillance systems traditionally focus on leisure-time physical activity. There is an incomplete understanding of the association between meeting PAG in leisure time and occupation activity level among US workers.

METHODS

We used cross-sectional 2020 National Health Interview Survey data to examine US adults aged 18-64 years who worked the week before the survey (n = 14,814). We estimated the proportion meeting aerobic and muscle-strengthening PAG in leisure time by occupation activity level (low, intermediate, and high). Using logistic regression, we examined the association between meeting PAG in leisure time and occupation activity level, adjusted for sociodemographic characteristics and stratified by hours worked. We compared the sociodemographic characteristics of adults working ≥40 hours (the previous week) in high-activity occupations to those in low- or intermediate-activity occupations.

RESULTS

Adults working in high-activity occupations were less likely to meet PAG in leisure time (26.1% [24.3-28.1]) versus those in low-activity (30.6% [29.1-32.2], P < .01) or intermediate-activity (32.4% [30.8-34.2]) occupations. In stratified, adjusted models, adults working ≥40 hours in low- and intermediate-activity occupations were 13% and 20%, respectively, more likely to meet PAG in leisure time versus those in high-activity occupations. Among those working ≥40 hours, adults in high-activity occupations were more likely to be Hispanic or Latino, male, younger, and have a high school education or lower compared with those in less active occupations.

CONCLUSION

Traditional surveillance may underestimate meeting PAG among people working in high-activity occupations, potentially disproportionately affecting certain groups.

Meeting the Aerobic and Muscle-Strengthening Physical Activity Guidelines Among Older US Adults, National Health Interview Survey 1998-2018

The Physical Activity Guidelines for Americans, second edition, recommends older adults participate in ≥150 minutes per week of moderate-intensity equivalent aerobic activity and ≥2 days per week of muscle-strengthening activity. We estimated prevalence and trends of meeting the guidelines among US adults aged ≥65 years from 1998 to 2018. Using the 1998-2018 National Health Interview Survey, we estimated the prevalence of meeting aerobic, muscle-strengthening, and combined physical activity guidelines stratified by age group, sex, race and ethnicity, and education level. Within age groups, we calculated prevalence differences by sociodemographic categories. Prevalence of meeting each guideline increased for all age groups and most sociodemographic subgroups. The increased magnitude of meeting the combined guideline from 1998-2000 to 2016-2018 differed across levels of educational attainment for most age groups. Despite increasing over time, the prevalence among older adults of meeting physical activity guidelines remains low (range for combined guideline: 7.2%-17.2%).

Racial/Ethnic Differences in Physical Activity in a Low-Income Sample in Texas

INTRODUCTION

National data reveal that the age-adjusted prevalence of leisure-time physical inactivity is higher among Blacks and Hispanics compared with Whites. However, these estimates do not consider nonleisure physical activity (PA). Also, race/ethnicity in these findings may by confounded by socioeconomic status disparities in PA. Here, we examine racial/ethnic differences in multiple measures of PA within a lower socioeconomic status sample.

METHODS

Participants in the current cross-sectional study (n = 1526 adults, aged ≥ 18 y) were recruited from Supplemental Nutrition Assistance Program-Education classes (nutrition education classes that target low-income people) in Texas. Self-report data were obtained using survey questionnaires in spring and fall 2018. PA outcomes of 4 different intensities were assessed: mean daily time spent walking, engaging in moderate and vigorous PA, and sitting. Additional PA-related measures included use and awareness of community PA resources. Linear regression models examined racial/ethnic differences in the 4 PA outcomes after adjusting for participant gender, age, household composition measures, and various socioeconomic status measures.

RESULTS

In this low-income sample, Hispanic and Black participants spent 6 to 9 more minutes per day walking and engaging in moderate and vigorous PA compared with White/other participants (P < .05 for each measure). Conversely, White/other participants reported spending 82 more minutes sitting per day than Black and Hispanic participants (P < .01). Overall, Black participants were most likely to utilize community PA resources and report ease of engaging in exercise.

DISCUSSION

Together, these results reveal greater engagement in PA by racial/ethnic minorities in low-income communities compared with Whites. Our results have implications for tailoring PA programming to these communities.

Multimorbidity is associated with lower total 24-hour movement activity among US adults

Objective

Having chronic conditions may result in reduced physical and cognitive function but less is known about multimorbidity with daily movement. We examined the association of multimorbidity and device-measured total daily movement in a nationally representative sample of US adults aged ≥ 30 years from the 2011-2014 National Health and Nutrition Examination Surveys.

Methods

Any multimorbidity (≥2 conditions) and complex multimorbidity (≥3 conditions across ≥ 3 body systems) were quantified using 16 chronic conditions via self-report and/or clinical thresholds. Total movement over 24-hours (Monitor-Independent Movement Summary units [MIMS-units]) was measured using a wrist-worn device (ActiGraph GT3X). Multivariable linear regression examined the association of 1) each chronic condition, 2) number of conditions, 3) any multimorbidity, and 4) complex multimorbidity with total movement. Covariates included age, gender, race/ethnicity, educational attainment, and smoking status.

Results

Among US adults (N = 7304, mean age: 53.2 ± 0.34 years, 53.2% female, 69.4% Non-Hispanic White), 62.2% had any multimorbidity with 34.2% having complex multimorbidity. After adjustment, a higher number of chronic conditions was associated with incrementally lower total movement (β MIMS-units [95% CI] compared to those with no chronic conditions; one: -419 [-772, -66], two: -605 [-933, -278], three: -1201 [-1506, -895], four: -1908 [-2351, -1465], 5+: -2972 [-3384, -2560]). Complex multimorbidity presence was associated with -1709 (95% CI: -2062, -1357) and -1269 (-1620, -918) lower total movement compared to those without multimorbidity and multimorbidity but not complex, respectively.

Conclusions

Multimorbidity was associated with lower 24-h movement among US adults and may be helpful for identifying adults at risk for low movement.

Trends in physical activity and sedentary time among U.S. adults with diabetes: 2007-2020

AIMS

To examine temporal trends in physical activity and sedentary time among U.S. adults with diabetes from 2007 to 2020.

METHODS

We performed serial cross-sectional analyses for participants aged ≥ 20 years with diagnosed diabetes from the U.S. National Health and Nutrition Examination Survey from 2007 to 2020. Participants completed the Global Physical Activity Questionnaire.

RESULTS

The analytic sample comprised 5096 adults with diabetes (mean age: 60.3 years; 48.2% females; 60.1% White people; mean body mass index: 33.0 kg/m2). From 2007-2008 through 2017-March 2020, the proportion of being physically sufficiently active increased from 41.5% (95% CI, 35.9%-47.2%) to 55.8% (95% CI, 51.3%-60.3%) (P-trend<0.001), whereas that of physical inactivity declined from 43.7% (95% CI, 38.1%-49.2%) to 31.0% (95% CI, 27.7%-34.3%) (P-trend<0.001). The decline was driven by increasing engagement in work-related and leisure-time activity. However, engagement in transportation-related activity stayed persistently low (16.7% [95% CI, 14.8%-18.8%] in 2017-March 2020) (P-trend = 0.25), and the mean daily sitting hours remained unaltered (6.2 [95% CI, 5.9-6.5] in 2017-March 2020) (P-trend = 0.60). Adults who were middle-aged or older, or with class III obesity, cardiovascular or chronic kidney concomitants were less likely to be sufficiently active and prone to prolonged sitting.

CONCLUSIONS

Physical activity levels in U.S. adults with diabetes have increased from 2007 to 2020, but about one in two remains inactive or insufficiently active. Sedentary time has not decreased. For diabetes management, nationwide efforts are needed to promote transportation-related physical activity while minimizing prolonged sitting, especially among those who are middle-aged or older, or with severe obesity or other complications.

Explaining adult obesity, severe obesity, and BMI: Five decades of change

Obesity rates have increased across all segments of society since the late 1970s, but the reason behind population-level increases in body weight remains unclear. We used the 1971-2020 NHANES data to examine whether the observed trend in obesity prevalence is attributable to changing public health behaviors (i.e., intracohort change) or changing publics (i.e., cohort replacement). We partitioned total change in mean BMI, and rates of obesity and severe obesity, into its IC and CR components using linear and algebraic decomposition methods. We found that the IC mechanism (i.e., broad sectors of individuals changing) plays a dominant role in the overall increase in mean BMI, and obesity and severe obesity prevalence. Birth cohort membership (i.e., the CR mechanism) is also influencing mean BMI, and rates of obesity and severe obesity, but in differing ways. Specifically, the large positive IC and the small positive CR effects are amplifying one another, thus creating a steep increase in the observed rates of severe obesity. Conversely, the large positive IC effect is offset by a small negative CR effect, which created a more gradual rise in mean BMI and rates of obesity. Furthermore, we computed total change for models that entered separately sociodemographic, lifestyle, nutritional, and physical activity measures to estimate differences in mean BMI, and rates of obesity and severe obesity, among cohorts and time periods. Adjustment for all the compositional differences among the cohorts during the study period indicate that a combination of a more pronounced IC and a less pronounced CR drove the observed increase in mean BMI, and rates of obesity and severe obesity. Thus, "universal prevention" (i.e., entire community) strategies for healthy weight promotion may need to be combined with "selective prevention" (i.e., at-risk groups) and/or "targeted prevention" (i.e., at-risk individuals) approaches in order to reverse the obesity epidemic.

Daily and hourly patterns of physical activity and sedentary behavior of older adults: Atherosclerosis risk in communities (ARIC) study

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Older adult activity patterns varied by day of the week with Sunday the least active.

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Most physical activity was accrued during the morning hours (9 AM-12 PM).

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Men and those with overweight and obesity had highest sedentary minutes.

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Older adult movement patterns show opportunities for physical activity promotion.

This cross-sectional study of older adults ≥ 65 years describes daily and hourly patterns of accelerometer-derived steps, sedentary, and physical activity behaviors and examines differences by day of the week and sociodemographic and health-related factors to identify time-use patterns. Data were from 459 Atherosclerosis Risk in Communities (ARIC) study participants (60% female; mean ± SD age = 78.3 ± 4.6 years; 20% Black) who wore a hip accelerometer ≥ 4 of 7 days, for ≥ 10 h/day in 2016. We used linear mixed models to examine daily patterns of steps, sedentary, low light, high light, and moderate-to-vigorous intensity physical activity (MVPA). Differences by sex, median age (</≥ 78 years), body mass index, self-rated health, depressive symptoms, and performance in a two-minute walk test were explored. Men (vs women), and those with overweight and obesity (vs normal weight), had significantly higher sedentary minutes and lower minutes of low light per day. For each additional meter walked during the two-minute walk test, sedentary behavior was lower while high light, MVPA, and daily steps were higher. No significant differences in time-use behaviors were found by self-reported race, age, education, self-rated health, or depressive symptoms. Participants were least active (22.5 min MVPA, 95% CI: 11.5, 33.5) and most sedentary (453.9 min, 95% CI: 417.7, 490.2) on Sunday. Most activity was accrued in the morning (before 12 PM) while the evening hours (3–11 PM) were spent ≥ 50% sedentary. Movement patterns suggest opportunities for promotion of activity and reduction in sedentary time on Sundays, in the evening hours, and for those with overweight or obesity.

Observation of and intention to use new places and changed spaces for physical activity during the COVID-19 pandemic - United States, June 2021

The COVID-19 pandemic prompted built environment changes throughout the United States. We assessed the prevalence of new places and changed spaces for physical activity as observed by US adults and their intentions to use them. We used data from SummerStyles, a web-based survey of US adults conducted in June 2021 (n = 4073). Respondents were asked if they had discovered new places to be physically active during the past year, and if changes had been made to streets or outdoor areas to allow additional space for recreating. Those responding "yes" were asked if they intended to use the respective space. We estimated the weighted prevalence of adults who observed new places and changed spaces, and their intended use, by sociodemographic and geographic characteristics, physical activity level, and walking status. We compared subgroups with prevalence ratios (PR). Overall, 25.0% of US adults reported discovering new places for physical activity, and 25.3% reported changes to streets and outdoor spaces. Intention to use new places and changed spaces exceeded 50% among all sociodemographic and geographic subgroups. Among those reporting changes, adults who were physically inactive compared to those who were sufficiently active had similar intentions to use new places (PR = 0.83; 95% CI = 0.63, 1.10) and changed spaces (PR = 0.90; 95% CI = 0.69, 1.17). Approximately 1 in 4 adults reported discovering new places or changed spaces to support physical activity during the COVID-19 pandemic, and most intended to use these features. Expanding access to such supportive environments may help promote physical activity participation.