Dose response association between physical activity and biological, demographic, and perceptions of health variables

Effects of Recreational Physical Activity on Abdominal Obesity in Obese South Korean Adults

This study investigated the effects of general characteristics, health behaviors, and level of physical activity on abdominal obesity in obese adults (BMI (body mass index) ≥ 25 kg/m2) using data from the seventh period (2016-2018) of the Korea National Health and Nutrition Examination Survey (KNHANES). We also prepared basic data on the improvement and management of abdominal obesity. The participants were 2343 obese adults (men, 1338; women, 1005) from the KNHANES. Factors relevant to abdominal obesity in obese Korean women were general characteristics (age, marital status, occupation, education, and menopause) and health behaviors (time for recreational physical activities and energy intake). In men, these factors tended to be health behaviors, including time spent on leisure physical activity, and sitting. It was found that over 600 Mets/week of recreational physical activity for both adult men and women reduced the incidence of abdominal obesity after adjusting for general characteristics and health behaviors (odds ratio (95% CI); men 0.69 (0.51-0.92); women, 0.61 (0.40-0.94)). Therefore, to prevent or improve abdominal obesity in obese adults in Korea, it is necessary to consider general characteristics and health behaviors according to sex. In addition, maintaining a physical activity rate of over 600 Mets/week is also recommended.

Sedentary behavior among breast cancer survivors: a longitudinal study using ecological momentary assessments

PURPOSE

Sedentary behavior (SB) or any waking behavior ≤ 1.5 METs is associated with an increase in body weight and fatigue and poor quality of life among cancer survivors. The purpose of this study was to explore longitudinal trends in SB using accelerometers and associated variables via ecological momentary assessments (EMA) among breast cancer survivors.

METHODS

Breast cancer survivors (within 5 years post-diagnosis) were recruited for a 12-month observational study. Participants were asked to download an EMA application to their smartphones to receive prompts for 7 days and to concurrently wear an Actigraph accelerometer. Participants responded to 35 prompts during each 7-day assessment period at baseline, and at 3, 6, 9, and 12 months. Within each prompt, participants were asked questions about their current level of affect, sadness, anxiety, stress, worry and fatigue, and cancer-related symptoms (e.g., neuropathy).

RESULTS

Twenty-two survivors (mean age = 51.5 years) were recruited and 20 participants completed the study. Mean baseline SB averaged 76.7 h/week. Univariate longitudinal models suggested higher levels of sadness, anxiety, stress, worry, and fatigue were associated with more SB while more positive affect was associated with less SB. Additionally, non-leisure context (work) was associated with more SB. Autoregressive models indicated cross-lagged effects of affective valence, fatigue, and SB.

CONCLUSIONS

More negative affective valence and higher fatigue were associated with more SB. Reducing negative affect valence and offering non-sedentary approaches to manage fatigue may help reduce SB.

IMPLICATIONS FOR CANCER SURVIVORS

Specific interventions are needed to reduce SB among cancer survivors-particularly those that target negative affect valence and fatigue.

Use of Compositional Data Analysis to Show Estimated Changes in Cardiometabolic Health by Reallocating Time to Light-Intensity Physical Activity in Older Adults

BACKGROUND

All physical activity (PA) behaviours undertaken over the day, including sleep, sedentary time, standing time, light-intensity PA (LIPA) and moderate-to-vigorous PA (MVPA) have the potential to influence cardiometabolic health. Since these behaviours are mutually exclusive, standard statistical approaches are unable to account for the impact on time spent in other behaviours.

OBJECTIVE

By employing a compositional data analysis (CoDA) approach, this study examined the associations of objectively measured time spent in sleep, sedentary time, standing time, LIPA and MVPA over a 24-h day on markers of cardiometabolic health in older adults.

METHODS

Participants (n =366; 64.6 years [5.3]; 46% female) from the Mitchelstown Cohort Rescreen Study provided measures of body composition, blood lipid and markers of glucose control. An activPAL3 Micro was used to obtain objective measures of sleep, sedentary time, standing time, LIPA and MVPA, using a 7-day continuous wear protocol. Regression analysis, using geometric means derived from CoDA (based on isometric log-ratio transformed data), was used to examine the relationship between the aforementioned behaviours and markers of cardiometabolic health.

RESULTS

Standing time and LIPA showed diverging associations with markers of body composition. Body mass index (BMI), body mass and fat mass were negatively associated with LIPA (all p <0.05) and positively associated with standing time (all p <0.05). Sedentary time was also associated with higher BMI (p <0.05). No associations between blood markers and any PA behaviours were observed, except for triglycerides, which were negatively associated with standing time (p < 0.05). Reallocating 30 min from sleep, sedentary time or standing time, to LIPA, was associated with significant decreases in BMI, body fat and fat mass.

CONCLUSION

This is the first study to employ CoDA in older adults that has accounted for sleep, sedentary time, standing time, LIPA and MVPA in a 24-h cycle. The findings support engagement in LIPA to improve body composition in older adults. Increased standing time was associated with higher levels of adiposity, with increased LIPA associated with reduced adiposity; therefore, these findings indicate that replacing standing time with LIPA is a strategy to lower adiposity.

Gender differences in lifestyle and risk factors of metabolic syndrome: Do women have better health habits than men?

AIMS AND OBJECTIVES

To examine the gender-specific lifestyles of adults with metabolic syndrome in the Taiwanese community.

BACKGROUND

Many studies show different prevalence of metabolic syndrome in males and females; however, few studies have investigated gender-specific lifestyle risk factors, which are important for effectively reducing prevalence.

DESIGN

A cross-sectional study design was used.

METHODS

Between 2012 and 2015, a total of 1,066 individuals were recruited in northern Taiwan. Data were collected by questionnaires and analysed by descriptive statistics, chi-square tests and logistic regression. This study followed the STROBE guidelines.

RESULTS

The prevalence of metabolic syndrome was 40.8% in men and 36.0% in women. Women had healthier dietary habits, a higher rate of moderate-vigorous physical activity, and a lower rate of smoking and obesity than men. Men, who were overweight or obese, lacked vigorous physical activity, often consumed excess amounts of salt and fat, and seldom consumed appropriate amounts of protein tended to have metabolic syndrome. Women with an unhealthy metabolism tended to be overweight or obese and seldom consumed dairy products.

CONCLUSIONS

Men, who had normal body weight, performed vigorous physical activity, seldom consumed excess amounts of salt and fat, and often consumed appropriate amounts of protein tended not to have metabolic syndrome. Women with a healthy metabolism were of normal body weight and often consumed dairy products. There exist gender differences in health habits with metabolic syndrome.

RELEVANCE TO CLINICAL PRACTICE

Although the associated risk factors differed between men and women, controlling body weight and maintaining a healthy lifestyle may reduce the risk of metabolic syndrome.

The Daily Mile: teachers' perspectives of the barriers and facilitators to the delivery of a school-based physical activity intervention

OBJECTIVES

Children spend a significant amount of their time in a school environment, often engaged in sedentary activities. The Daily Mile is a physical activity intervention which aims to increase physical activity and fitness in children through the completion of an outdoor teacher-led walk or run during the school day. This study aimed to explore the barriers, facilitators and perceived benefits of the Daily Mile from the perspectives of teachers through the use of qualitative semi-structured interviews. It also aimed to identify important context-specific factors, which might require consideration for those who intend to adopt the Daily Mile.

SETTING

Eight Local Authority primary schools in the City of Edinburgh and East Lothian, UK.

PARTICIPANTS

Thirteen teachers (eleven women) who teach children in primaries one to seven in a school which delivered the Daily Mile.

RESULTS

Data were analysed using an interpretative thematic analysis. Teachers were positive and enthusiastic about the Daily Mile and perceived it to be beneficial to children's health and fitness. A number of barriers to participation were identified including inadequate all-weather running surfaces and time constraints in an already full school curriculum. The perceived impact on learning time was identified as a concern for teachers, while other benefits were also identified including increased teacher-child rapport and perceived enhanced classroom concentration levels.

CONCLUSION

The Daily Mile appears to be a valuable addition to the school day, however important context-specific barriers to delivery of the Daily Mile exist, which should be considered when implementing the Daily Mile in schools.

Health Benefits of Light-Intensity Physical Activity: A Systematic Review of Accelerometer Data of the National Health and Nutrition Examination Survey (NHANES)

BACKGROUND

The health effects of light-intensity physical activity (PA) are not well known today.

OBJECTIVE

We conducted a systematic review to assess the association of accelerometer-measured light-intensity PA with modifiable health outcomes in adults and older adults.

METHODS

A systematic literature search up to March 2016 was performed in the PubMed, EMBASE, Web of Science and Google Scholar electronic databases, without language limitations, for studies of modifiable health outcomes in adults and older adults in the National Health and Nutrition Examination Survey accelerometer dataset.

RESULTS

Overall, 37 cross-sectional studies and three longitudinal studies were included in the analysis, with considerable variation observed between the studies with regard to their operationalization of light-intensity PA. Light-intensity PA was found to be beneficially associated with obesity, markers of lipid and glucose metabolism, and mortality. Few data were available on musculoskeletal outcomes and results were mixed.

CONCLUSIONS

Observational evidence that light-intensity PA can confer health benefits is accumulating. Currently inactive or insufficiently active people should be encouraged to engage in PA of any intensity. If longitudinal and intervention studies corroborate our findings, the revision of PA recommendations to include light-intensity activities, at least for currently inactive populations, might be warranted.

Physical activity and diet on atherogenic index of plasma among adults in the United States: mediation considerations by central adiposity

BACKGROUND/OBJECTIVES

The potential interactive or combined association of moderate-to-vigorous physical activity (MVPA) and dietary behavior with atherogenic index of plasma (AIP) has yet to be explored in a representative sample of US adults. Thus, the study aim was to examine the association of MVPA and dietary behavior on AIP, with potential mediation considerations by central adiposity.

SUBJECTS/METHODS

Data from the National Health and Nutrition Examination Survey were used (N = 2701 adults aged 20-85 years). AIP was evaluated via blood sample, MVPA was assessed via accelerometry, and two 24-h recalls were utilized to calculate Healthy Eating Index (HEI), a metric of dietary quality. Android-specific dual energy X-ray absorptiometry (DXA) was used to measure central adiposity.

RESULTS

Meeting MVPA guidelines (OR = 0.58; 95% CI: 0.41-0.82; P = 0.004), but not meeting dietary guidelines (OR = 0.89; 95% CI: 0.69-1.15; P = 0.37), was associated with reduced odds of having an elevated (>0.24 mmol/L) AIP. Having one (OR = 0.68; 95% CI: 0.52-0.89; P = 0.007) or both (OR = 0.55; 95_% CI: 0.37-0.82; P = 0.005) health-enhancing behaviors (adequate physical activity and/or healthy diet), when compared to having neither, was associated with reduced odds (32 and 45%) for having an elevated AIP. The relative excess risk due to interaction (RERI) was 0.06 (95% CI: -0.06 to 0.18; P = 0.31), suggesting there is no additive interaction between MVPA and dietary behavior on AIP. All associations were attenuated when including central adiposity as a covariate, suggesting a mediation effect of central adiposity.

CONCLUSIONS

MVPA is independently associated with reduced odds of having an elevated AIP, having both adequate levels of MVPA and a healthy diet does not substantively reduce the odds of AIP, and there is no additive interaction effect between MVPA and diet on AIP. Central adiposity mediated the relationship between MVPA and AIP.

Relationship Between Objectively Measured Physical Activity, Cardiovascular Disease Biomarkers, and Hearing Sensitivity Using Data From the National Health and Nutrition Examination Survey 2003-2006

PURPOSE

Limited research has examined the interrelationships among cardiometabolic parameters, physical activity, and hearing function, which was this study's purpose.

METHOD

Data from the National Health and Nutrition Examination Survey (NHANES) 2003-2006 were used in the path analyses. Physical activity and hearing function were both objectively measured. Various cardiometabolic parameters were assessed from a blood sample. Adults 30-85 years (N = 1,070) constituted the analytic sample.

RESULTS

Physical activity was negatively associated with triglycerides (β = -0.11, p < .05) and insulin (β = -0.27, p < .05); triglycerides (β = 0.01, p < .05), and insulin (β = 0.05, p < .05) were positively associated with high-frequency pure-tone average (HPTA). The direct path from physical activity to HPTA was nonsignificant (β = 0.01, p = .99).

CONCLUSION

Physical activity was associated with select cardiovascular disease risk factors. Several cardiovascular disease risk factors were associated with hearing function.

Light and sporadic physical activity overlooked by current guidelines makes older women more active than older men

Background

Men are generally believed to be more physically active than women when evaluated using current physical activity (PA) guidelines, which count only moderate-to-vigorous physical activity (MVPA) in bouts lasting at least 10 min. However, it remains unclear men are truly more physically active provided that all-intensity PA are evaluated. This population based cross-sectional study aimed to examine gender differences in patterns of objectively-assessed PA in older adults.

Methods

One thousand two hundred ten community-dwelling Japanese older adults who were originally randomly selected from residential registry of three municipalities were asked to respond a questionnaire and wear an accelerometer (HJA-350IT, Omron Healthcare). The prevalence of achieving current PA guidelines, ≥150 min/week MVPA in bouts lasting at least 10 min, was calculated. Gender differences in volume of each-intensity activity (METs-hour) were assessed by analysis of covariance after adjustment for age and wear time.

Results

Data from 450 (255 men, mean 74 years) participants who had valid accelerometer data were analyzed. Women were less likely to meet the guidelines (men: 31.0, women: 21.5%; p < 0.05). However, women accumulated more light-intensity PA (LPA) and short-bout (1–9 min) MVPA, and thus established higher total volume of PA (men: 22.0 METs-hour/day, women: 23.9 METs-hour/day) (p < 0.05).

Conclusions

Older women were less active when evaluated against current PA guidelines, but more active by total PA. Considering accumulated evidence on health benefits of LPA and short-bout MVPA, our findings highlight the potential for the limitation of assessing PA using current PA guidelines.

GINÁSTICA GERAL PODE MELHORAR A MARCHA E A CAPACIDADE CARDIOVASCULAR DE IDOSOS

RESUMO Introdução: É bem descrito na literatura que o exercício físico de diferentes naturezas tem vários benefícios para a saúde de diferentes populações, no entanto, os programas de ginástica geral vêm recebendo pouca atenção quanto aos possíveis benefícios para a saúde de seus praticantes, especialmente para medidas de desempenho físico e para a capacidade de marcha. Objetivo: Avaliar a eficácia de um treinamento de ginástica geral sobre o VO2máx e a qualidade da marcha de idosos. Métodos: Selecionou-se um grupo de cento e vinte sujeitos com média de idade de 64,81 ± 2,71 anos, massa corporal de 66,97 ± 4,81 kg e estatura de 164,6 ± 4,81 cm de ambos os sexos. Utilizou-se o teste de 15 minutos de Balke para determinar o VO2máx e o Dynamic Gait Index para verificar a qualidade da marcha. O tratamento estatístico foi realizado por meio do teste de Wilcoxon para amostras relacionadas com significância de 5%. Resultados: Em todos os tratamentos houve diferença de VO2máx e os resultados do Dynamic Gait Index sugerem melhora na qualidade da marcha. Conclusão: Parece que o treinamento de ginástica geral proposto no presente estudo foi eficaz em melhorar o VO2máx e a qualidade de marcha do grupo selecionado.

Performance-Focussed Sport – An Avenue to Gold-Medal Clinical Outcomes for People with Neurological Impairments?

This paper investigates the premise that long-term engagement in performance-focussed sports training may lead to significantly enhanced clinical outcomes for people with neurological impairments (NI). The minimum volume of moderate-intensity activity recommended for good health is 450 MET.minutes/week, although evidence from the general population indicates that outcomes may be enhanced by completing up to five times this volume (2250 MET.minutes/week) at vigorous (rather than moderate) intensity. Most studies evaluating physical activity interventions for people with NI deliver low volumes (<450 MET.minutes/week), which may explain why evidence for some clinical outcomes is weak. Athletes (with or without NI) who aim to achieve high-level sports performance undertake an increasingly large volume of vigorous intensity physical activity over several seasons. Evidence that people with NI may enhance clinical outcomes through performance-focussed sports training includes: evidence from studies investigating the benefits of high-intensity and/or high volume clinical exercise; scientific evidence from elite/high-level athletes; and anecdotal evidence from Paralympic athlete testimonials. Additionally, sports participants with NI may also accrue an important array of psychosocial benefits, including higher rates of employment, and higher satisfaction with life and social integration. Rigorous, prospective, longitudinal clinical monitoring of people with NI undertaking performance-focussed sports training are required to evaluate its clinical utility.

Age-Related Macular Degeneration Is Associated with Less Physical Activity among US Adults: Cross-Sectional Study

BACKGROUND

We have a limited understanding of the effects of age-related macular degeneration (AMD) on physical activity (PA), and we have no prevalence estimates of the daily movement patterns among Americans with AMD. Therefore, we examined the association between AMD and PA and provided estimates of the daily movement patterns of Americans with AMD.

METHODS

Data from the 2005-2006 National Health and Nutrition Examination Survey were used, including 1,656 adults (40-85 yrs). Retinal imaging was performed to classify individuals as no AMD, early AMD, or late AMD. Participants wore an ActiGraph 7164 accelerometer for 7 days to measure PA behavior.

RESULTS

93.2% of participants with late AMD were in the least desirable group (not sufficiently active and having a negative light intensity-sedentary behavior balance). After adjustments (including age), participants with late AMD, as compared to those with no AMD, engaged in 50% less moderate-to-vigorous physical activity (MVPA) (RR = 0.50; 95% CI: 0.28-0.90). When visual acuity was entered into the model along with the other covariates, the association between late AMD and MVPA was no longer significant (RR = 0.54; 95% CI: 0.29-1.01), suggesting that visual acuity may partially mediate this relationship.

CONCLUSIONS

Individuals with late AMD engage in very little moderate-to-vigorous physical activity. Visually acuity, in part, explains the relationship between late AMD and PA.

Association between fecal incontinence and objectively measured physical activity in u.s. Adults

Background:

Brisk physical activity may facilitate fecal incontinence due to physical activity-induced colonic motility. However, there currently are no studies that have examined the relationship between fecal incontinence and free-living physical activity behavior.

Aim:

Therefore, the purpose of this study was to examine the association between fecal incontinence and objectively measured physical activity among adults.

Materials and Methods:

A national sample of adults in the United States (n = 2565, 20-85 years) completed the Fecal Incontinence Severity Index questionnaire and wore an accelerometer for a week to objectively measure physical activity behavior.

Results:

After adjustments, fecal incontinence was positively associated with moderate-to-vigorous physical activity (β = 0.85, P = 0.04), suggesting that lower perceived severity of fecal incontinence was associated with greater engagement in moderate-to-vigorous physical activity. Fecal incontinence was not significantly associated with light-intensity physical activity (P = 0.27).

Conclusion:

Our results suggest that adults in the United States with greater perceived severity of fecal incontinence engage in less moderate-to-vigorous physical activity; however, those with greater severity of fecal incontinence do not appear to have different levels of light-intensity physical activity behavior. Given the emerging research showing beneficial effects of light-intensity physical activity, health care professionals should encourage light-intensity physical activity to their patients with fecal incontinence.

Seasonal alterations in park visitation, amenity use, and physical activity--Grand Forks, North Dakota, 2012-2013

INTRODUCTION

Park amenities promote visitation and physical activity during summer. Physical activity declines during winter. Identifying park amenities that promote visitation during winter would increase year-round activity. The purpose of this study was to determine how park visitation, amenity choice, and physical activity intensity change across seasons.

METHODS

Physical activity intensity of children and adults was assessed at 16 parks in Grand Forks, North Dakota, during summer and fall of 2012, and winter and spring of 2013.

RESULTS

Park visitation was highest in spring and lowest in winter. Amenity use varied by season. Parks with water splash pads were visited more during summer, and playgrounds and open spaces were visited more during spring. Ice rinks were visited most in winter. Physical activity intensity was lowest in summer and highest in winter for each age group. The activity intensity observed for all young age groups ranged from 2.7 to 2.9 metabolic equivalents in summer and greater than 3 metabolic equivalents in all other seasons. Adults' mean activity intensity was greater than 3 metabolic equivalents in winter.

CONCLUSION

Information on park visitation, amenity use, and activity intensity across seasons is valuable; it can be used when designing or redesigning parks in order to promote year-round physical activity. Redesigning parks in cold climates to include ice rinks, sledding hills, cross-country skiing, and indoor areas for physical activity would increase winter visitation and allow the park to serve as a year-round resource for physical activity.

Improving the Efficiency of Electrical Stimulation Activities After Spinal Cord Injury

In order to enhance spinal cord injury (SCI) rehabilitation programs using neuromuscular electrical stimulation (NMES) and functional electrical stimulation (FES) it is important to examine the manner in which muscle fibers are recruited and the dose-response relationship. A review of the literature suggests that premature force decline and early fatigue with NMES and FES activities may be alleviated with decreased current frequency and increased current intensity. Dose-response relationships with NMES and FES are dependent on the goals of interest as reversing muscle atrophy can be achieved with activities 2-3 times per week for 6 or more weeks while increasing bone mass is more limited and requires more intense activity with greater exercise frequency and duration, e.g., 3-5 days per week for at least 6-12 months. The best known protocol to elicit neurological improvement is massed practice activities-based restorative therapies (ABRT) (3-5 h per day for several weeks).

Objectively measured physical activity among US cancer survivors: considerations by weight status

PURPOSE

We have a limited understanding of the objectively determined physical activity levels of cancer survivors at the population level. Further, we have even less of an understanding of this behavior by weight status (i.e., normal weight, overweight, and obese). Therefore, the purpose of this study was to describe accelerometer-assessed physical activity levels among US cancer survivors and to do so across weight status.

METHODS

Data from the 2003-2006 NHANES was used. One hundred twenty-six adult cancer survivors wore an accelerometer for ≥4 days, with weight status determined from measured body mass index.

RESULTS

Approximately 13 % of cancer survivors were sufficiently active (i.e., met current physical activity guidelines). Results were not significant for light-intensity physical activity; however, results showed that obese cancer survivors engaged in 47 % less MVPA than normal weight cancer survivors (rate ratio = 0.53; 95 % CI, 0.29-0.93).

CONCLUSION

Most adult cancer survivors are insufficiently active and obese cancer survivors engage in less MVPA than their counterparts.

IMPLICATIONS FOR CANCER SURVIVORS

Health care professionals are encouraged to increase cancer survivors' awareness of the minimum levels of MVPA needed for optimal health, particularly among obese cancer survivors. Additionally, cancer survivors should also be informed of the positive health outcomes associated with light-intensity physical activity.