Differences in health-related quality of life between three clusters of physical activity, sitting time, depression, anxiety, and stress

Physical activity as a predictor of fremanezumab response in chronic migraine - the Phy-Fre-Mig study

BACKGROUND

The relationship between physical activity (PA) and migraine is insufficiently understood. Studies have not analysed levels of PA or Time Sitting (TS) during preventive treatment, nor the role these might play in the response to preventive treatment.

METHODS

An observational, longitudinal prospective study in a headache clinic was conducted. All consecutive chronic migraine patients initiating fremanezumab were invited to participate and were followed for three visits. The International Physical Activity Questionnaire (IPAQ) - long version was used.

RESULTS

Seventy-six patients with a median of 46 years old, 84.2% female were enrolled. One month after fremanezumab administration, there was a significant increase of most PA variables and a significant decrease in TS levels compared with baseline; headache days and walking, TS and migraine days showed a moderate correlation. Three months after initiation, all PA variables statistically increased and TS levels statistically decreased, and variables such as headache/migraine days showed a moderate correlation with all PA variables analysed. In the multivariate analysis, higher levels of walking at baseline were independently associated with response to fremanezumab (ORa: 1.194; CI: 1.018-1.401, p = 0.029).

CONCLUSION

Patients who spent more time walking before starting treatment, were more likely to have a response to fremanezumab. PA and TS levels changed since the first month and correlated with clinical variables.

Joint association of sedentary behavior and physical activity with pulmonary function

BACKGROUND

Sedentary behavior may influence the respiratory health, but the joint effects of sedentary behavior and physical activity on pulmonary function remains poorly elucidated. We aimed to estimate the association between sedentary behavior and physical activity with pulmonary function.

METHODS

A total of 12,343 participants aged 12-79 years were analyzed from the U.S. NHANES 2007-2012. Participants were categorized into 16 groups according to the cross-tabulation of sedentary behavior time (0-4.0, 4.1-8.0, 8.1-12.0, and > 12.0 h/day) and moderate or vigorous physical activity (MVPA) (0, 1-149, 150-299, and ≥ 300 min/week). Generalized linear models were used to test the association of sedentary behavior and MVPA with pulmonary function.

RESULTS

Participants with sedentary behavior > 4.0 h/day were negatively related to FEV1 (forced expiratory volume in 1 s) (β ranging from -0.015 to -0.009, p < 0.05). Compared with the reference group (0 min of MVPA and > 12.0 h/day of sedentary behavior), the negative association of sedentary behavior ≤ 8.0 h/day with FEV1 may be reduced through appropriate MVPA (β ranging from 0.019 to 0.030, p < 0.05). For sedentary behavior > 8.0 h/day, even MVPA ≥ 300 min/week may not decrease the negative relationships. Similar results were also observed in FVC (forced vital capacity) (β ranging from 0.018 to 0.030, p < 0.05). In participants aged ≥ 45 years, the associations were more notable.

CONCLUSION

This study indicated the sedentary behavior ≤ 4.0 h/day was a relatively healthy lifestyle for pulmonary function. Only below 8.0 h/day of sedentary behavior, the negative association with pulmonary function may be reduced through appropriate MVPA.

Joint associations of leisure-time physical activity and sitting time with emotional wellbeing, physical functioning and work ability: an occupational study among young and early midlife Finnish municipal employees

BACKGROUND

Physical inactivity and sedentary behaviour are major public health problems. We examined the individual and joint associations of leisure-time physical activity (LTPA) and total sitting time with emotional wellbeing, physical functioning and work ability in young and early midlife employees.

METHODS

Cross-sectional questionnaire survey data were collected in 2017 among 19-39-year-old employees of the City of Helsinki (response rate 51.5%). LTPA (including commuting PA) was converted into a metabolic equivalent (MET) index. We classified the participants into four groups according to PA recommendations and participation in vigorous intensity activities. Total sitting time was classified into three groups using tertile cut-points (5.5 and 8.5 h/day). For joint analyses, we truncated LTPA into three groups and sitting time into two groups yielding a six-category variable. Emotional wellbeing and physical functioning were measured using the RAND-36 questionnaire and work ability with a scale ranging from 0 to 100. Linear regression analysis was used to estimate adjusted means and their 95% confidence intervals (CIs). The analytical sample included 4544 participants (80% females).

RESULTS

Adjusting for age and sex, high sitting time (> 8.5 h/day) was associated only with poorer emotional wellbeing. LTPA, especially vigorous activity, showed clear positive associations with emotional wellbeing, physical functioning and work ability. For emotional wellbeing, the low activity groups with low (70.51, 95% CI 69.1-71.9) and high (67.5, 65.5-69.5) sitting time and the moderate activity groups with low (72.5, 71.3-73.7) and high (70.4, 68.6-72.1) sitting time had statistically significantly lower mean scores than the corresponding vigorous activity groups with low (74.9, 74.2-75.7) and high (72.7, 71.6-73.9) sitting time. For physical functioning, the vigorous activity groups with low (96.3, 95.8-96.7) and high (96.2, 95.5-96.9) sitting time had significantly higher scores than the other groups. For work ability, the vigorous activity groups with low (82.0, 81.3-82.6) and high (80.8, 79.8-81.8) sitting time had significantly higher scores than the other groups. Adjusting for covariates only slightly attenuated these associations.

CONCLUSIONS

Promoting PA among employees can contribute to better physical and mental health as well as better work ability.

Physical activity, physical capacity and sedentary behavior among asthma patients

BACKGROUND: Although exercise and daily physical activity (PA) have long been known to benefit patients with chronic disorders, knowledge is limited regarding asthma.

OBJECTIVE: In a Danish setting, our aim was to measure physical activity, sedentary behavior, and physical capacity among patients with asthma. We hypothesized that people with severe asthma would be less active and more sedentary than their mild-moderate counterparts.

METHODS: Adults with asthma were recruited through respiratory outpatient clinics and subsequently examined twice, 4 weeks apart. At each visit, participants underwent a series of lung function tests, questionnaires, and maximum oxygen uptake testing (VO₂max). Between the visits, participants wore an accelerometer continuously for 4 weeks, measuring sedentary time and daily steps. Sixty patients, 27 with mild-moderate asthma (GINA 1–3) and 33 with severe asthma (GINA 4–5), completed both visits and had valid accelerometer measurements.

RESULTS: No significant differences between the two groups were found in sedentary time, number of steps or VO₂max.   VO₂max was significantly correlated with FeNO (r = −0.30, p < 0.05), Short Form-12 Mental Health (r = 0.37, p < 0.05), Asthma Control Questionnaire (r = −0.35, p < 0.05), and Mini Asthma Quality of Life Questionnaire (r = 0.36, p < 0.05).

CONCLUSION: No differences were observed between patients with mild-moderate and severe asthma regarding sedentary behavior, daily steps or level of cardiopulmonary fitness. Furthermore, patients with the highest VO₂max had the higher quality of life scores.

Abbreviations: VO₂max: Maximal Oxygen Uptake; CPET: Cardiopulmonary Exercise Testing; BMI: Body Mass Index; FEV1: Forced Expired Volume in the First Second; FVC: Forced Vital Capacity; PEF: Peak Expiratory Flow; EIB: Exercise-Induced Bronchoconstriction; COPD: Chronic Obstructive Pulmonary Disease; ACQ: Asthma Control Questionnaire; Mini-AQLQ: Mini Asthma Quality of Life Questionnaire; SF-12: Short Form 12 Health Survey; SNOT-22: Sino-Nasal Outcome Test 22; GINA: The Global Initiative for Asthma; CRP: C-reactive Protein; Hgb:Hemoglobin count; EOS: Eosinophil count; EVH: Eucapnic Voluntary Hyperventilation; FeNO: Fractional Exhaled Nitric Oxide; PA: Physical Activity ERS: European Respiratory Society; ATS: American Thoracic Society; CRS: Chronic Rhinosinusitis; AHR: Airway Hyperresponsiveness

The Effects of UPcomplish on Office Workers' Sedentary Behaviour, Quality of Life and Psychosocial Determinants: A Stepped-Wedge Design

BACKGROUND

Sedentary behaviour (SB) affects cardiometabolic health and quality of life (QoL). We examine the effects of UPcomplish, a 12-week data-driven intervention, on SB, QoL and psychosocial determinants among office workers.

METHODS

Participants were recruited via judgement sampling. Five groups starting with time-lags of 7 weeks (n = 142, 96 females) received 14 feedback messages (FBMs) which were tailored to SB patterns, goals and hurdles. Participants received questionnaires at the beginning, middle and end of the intervention and wore an accelerometer measuring SB, operationalized as proportions (compositional data approach, CoDA) and summed squared sitting bouts (SSSB). We used linear mixed-effects models with random intercepts for weeks (between-subjects) and individuals (within-subjects).

RESULTS

UPcomplish did not reduce SB. Within-subjects compared to baseline, FBM #3 (βCoDA = 0.24, p < .001, 95% CI [0.15, 0.33]; βSSSB = 20.83, p < .001, 95% CI [13.90, 27.28]) and #4 (βCoDA = 0.20, p < .001, 95% CI [0.11, 0.29]; βSSSB = 24.80, p < .001, 95% CI [15.84, 33.76]) increased SB. QoL was unaffected. Perceived susceptibility was lower after FBMs #6 to #8 (βbetween = - 0.66, p = .04, 95% CI [- 1.03, - 0.30]; βwithin = - 0.75, p = .02, 95% CI [- 1.18, - 0.32]). Within-subjects, intentions to sit less were higher after FBMs #1 to #5 (1.14, p = .02, 95% CI [0.61, 1.66]). Improvements in determinants and in SB were not associated, nor were improvements in SB and in QoL.

CONCLUSIONS

Compared to VitaBit only, UPcomplish was not beneficial. Environmental restructuring might be superior, but detailed analyses of moderators of effectiveness are needed.

Health effects of reduced occupational sedentary behaviour in type 2 diabetes using a mobile health intervention: a study protocol for a 12-month randomized controlled trial-the ROSEBUD study

BACKGROUND

Short-term trials conducted in adults with type 2 diabetes mellitus (T2DM) showed that reducing sedentary behaviour by performing regular short bouts of light-intensity physical activity enhances health. Moreover, support for reducing sedentary behaviour may be provided at a low cost via mobile health technology (mHealth). There are a wide range of mHealth solutions available including SMS text message reminders and activity trackers that monitor the physical activity level and notify the user of prolonged sitting periods. The aim of this study is to evaluate the effects of a mHealth intervention on sedentary behaviour and physical activity and the associated changes in health in adults with T2DM.

METHODS

A dual-arm, 12-month, randomized controlled trial (RCT) will be conducted within a nationwide Swedish collaboration for diabetes research in primary health care. Individuals with T2DM (n = 142) and mainly sedentary work will be recruited across primary health care centres in five regions in Sweden. Participants will be randomized (1:1) into two groups. A mHealth intervention group who will receive an activity tracker wristband (Garmin Vivofit4), regular SMS text message reminders, and counselling with a diabetes specialist nurse, or a comparator group who will receive counselling with a diabetes specialist nurse only. The primary outcomes are device-measured total sitting time and total number of steps (activPAL3). The secondary outcomes are fatigue, health-related quality of life and musculoskeletal problems (self-reported questionnaires), number of sick leave days (diaries), diabetes medications (clinical record review) and cardiometabolic biomarkers including waist circumference, mean blood pressure, HbA1c, HDL-cholesterol and triglycerides.

DISCUSSION

Successful interventions to increase physical activity among those with T2DM have been costly and long-term effectiveness remains uncertain. The use of mHealth technologies such as activity trackers and SMS text reminders may increase awareness of prolonged sedentary behaviour and encourage increase in regular physical activity. mHealth may, therefore, provide a valuable and novel tool to improve health outcomes and clinical management in those with T2DM. This 12-month RCT will evaluate longer-term effects of a mHealth intervention suitable for real-world primary health care settings.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04219800 . Registered on 7 January 2020.

Obesity and the risk of developing chronic diseases in middle-aged and older adults: Findings from an Australian longitudinal population survey, 2009-2017

Background

Overweight and obesity impose a significant health burden in Australia, predominantly the middle-aged and older adults. Studies of the association between obesity and chronic diseases are primarily based on cross-sectional data, which is insufficient to deduce a temporal relationship. Using nationally representative panel data, this study aims to investigate whether obesity is a significant risk factor for type 2 diabetes, heart diseases, asthma, arthritis, and depression in Australian middle-aged and older adults.

Methods

Longitudinal data comprising three waves (waves 9, 13 and 17) of the Household, Income and Labour Dynamics in Australia (HILDA) survey were used in this study. This study fitted longitudinal random-effect logistic regression models to estimate the between-person differences in the association between obesity and chronic diseases.

Results

The findings indicated that obesity was associated with a higher prevalence of chronic diseases among Australian middle-aged and older adults. Obese adults (Body Mass Index [BMI] ≥ 30) were at 12.76, 2.05, 1.97, 2.25, and 1.96, times of higher risks of having type 2 diabetes (OR: 12.76, CI 95%: 8.88–18.36), heart disease (OR: 2.05, CI 95%: 1.54–2.74), asthma (OR: 1.97, CI 95%: 1.49–2.62), arthritis (OR: 2.25, 95% CI: 1.90–2.68) and depression (OR: 1.96, CI 95%: 1.56–2.48), respectively, compared with healthy weight counterparts. However, the study did not find any evidence of a statistically significant association between obesity and cancer. Besides, gender stratified regression results showed that obesity is associated with a higher likelihood of asthma (OR: 2.64, 95% CI: 1.84–3.80) among female adults, but not in the case of male adults.

Conclusion

Excessive weight is strongly associated with a higher incidence of chronic disease in Australian middle-aged and older adults. This finding has clear public health implications. Health promotion programs and strategies would be helpful to meet the challenge of excessive weight gain and thus contribute to the prevention of chronic diseases.

Sedentary behavior and health outcomes in patients with heart failure: a systematic review and meta-analysis

A better understanding of the association between sedentary behavior and heart failure is essential for the development of interventions to improve patients' outcomes. Therefore, a systematic review was conducted to determine the association between sedentary behavior and all-cause mortality, health-related quality of life, and depression in heart failure patients. We searched Web of Science, PubMed, Embase, and Cochrane Library and articles in references on 7 May 2021. The search results were limited to articles on heart failure patients over the age of 18, observational studies investigating the association between sedentary behavior and heart failure, and studies reporting one or more outcomes of interest. Two reviewers independently screened the literature and extracted data. Strengthening the Reporting of Observational Studies in Epidemiology was used to assess the quality of articles. Nine observational studies were included, of which, four were of high quality. Four cohort studies indicated that sedentary behavior was significantly associated with increased all-cause mortality (hazard ratio: 1.97; 95% confidence interval: 1.60 to 2.44; I² = 38.9%). In addition, subgroup analysis based on geographical regions was conducted (hazard ratio: 1.82; 95% confidence interval: 1.46 to 2.29; I² = 0%). Sedentary behavior was associated with worse health-related quality of life in patients with heart failure, and the regression coefficients ranged from 0.004 to 0.033 (95% confidence interval: 0.0004 to 0.055). Although sedentary behavior was associated with increased all-cause mortality and worse quality of life in patients with heart failure, further studies are needed to determine whether this association is causal.

More habitual physical activity is linked to the use of specific, more adaptive cognitive reappraisal strategies in dealing with stressful events

Physical activity may improve stress resilience and well-being. However, specific links to individuals' coping abilities with stressful events are sparse. This study tested whether individuals reporting more physical activity in daily life showed a higher capacity for cognitive reappraisal in dealing with potential stressors. Ninety-eight participants reported their regular physical activity in the Freiburger Questionnaire on Physical Activity and completed a maximum performance test of their inventiveness in generating reappraisals for situations depicting real-life stressors. The latter provides scores for overall cognitive reappraisal capacity (quantity of ideas) and preference for specific cognitive reappraisal strategies (quality of ideas; positive reinterpretation; problem-oriented, de-emphasizing reappraisals). Additionally, participants' anxious and depressive dispositions and general creative abilities were assessed. Results showed no association between time spent on physical activities per week and total quantity of generated reappraisal ideas. However, a higher degree of physical activity was specifically linked to a greater relative preference for the reappraisal strategy of positive reinterpretation. Opposite associations emerged for the strategy of de-emphasizing reappraisals. The findings support the notion of more adaptive cognitive reappraisal use in more physically active individuals and may advance research on interrelationships between physical activity and cognitive and affective functions implicated in stress management.

Ageing and Alcohol: Drinking Typologies among Older Adults

Objectives: Alcohol consumption and harms among older people are increasing. We examined different demographic characteristics and drinking patterns among an older population. Methods: Secondary analyses of nationally representative Australian data; subjects aged 50+ years (N = 10,856). Two-step cluster analysis was performed to identify demographic groups and alcohol consumption behaviours. Results: Three groups were identified: Group 1 (older, unmarried, and lived alone): >65 years, moderate drinkers, poorest health, psychological distress, social disadvantage, smokers, illicit drug users, and more frequent previous alcohol treatment. Group 3 (older married): >65 years, good health, low psychological distress, less likely to drink at risky levels, and one in five drank daily. Group 2 (younger married): 50-64 years, mostly employed, highest proportion of risky drinkers and of 5+ standard drinks per session, and liberal drinking attitudes with most concern from others about their drinking. Discussion: These demographic typologies can inform targeted prevention efforts for an estimated 1.3 million adults older than 50 years drinking at risky levels.

Quality of Life in Older Adults with Benign Prostatic Hyperplasia

The purpose of this study is to identify factors that affect health-related quality of life (HRQOL) of older patients with Benign Prostatic Hyperplasia (BPH) and suggest ways to improve the same. Through this, we will improve the self-management practice of patients and promote the treatment of BPH in older patients. The 2015 Korea Health Panel Survey data were used in this study. A total of 422 BPH patients aged 65 or older were included. Logistic regression analysis was conducted to identify factors affecting the HRQOL of older patients with BPH. General characteristics of factors affecting older patients with BPH included income level and type of insurance. In addition, among medical-related characteristics and health behavior factors, subjective health status, unmet medical care needs, moderate physical activity, sitting time, and drinking influenced the HRQOL. Therefore, in order to improve the HRQOL of adult patients with BPH, it is necessary to improve medical accessibility by strengthening primary care. In addition, it is necessary to increase the amount of activity in daily life through healthcare medical devices.

Associated factors and impacts of sedentary behaviour in patients with heart failure: A longitudinal study

BACKGROUND

Sedentary behaviours may be related to factors such as self-efficacy, mood and social support. However, there is a paucity of longitudinal follow-up studies examining factors related to sedentary behaviour from physical-psychosocial perspectives in patients with heart failure.

AIMS

The purpose of this study was to explore the multidimensional associated factors and impacts of sedentary behaviour in heart failure patients.

METHODS

A longitudinal design was used. A convenience sample of 128 heart failure patients recruited from two large medical centres in northern Taiwan was obtained. Patients were interviewed with structured questionnaires to assess physical activity, symptom distress, exercise self-efficacy, anxiety and depression, social support, sleep quality and quality of life before discharge and at 3 and 6 months after discharge.

RESULTS

Heart failure patients reported low physical activity and tended to be sedentary. Sedentary behaviour was gradually reduced from hospitalization to 6 months after discharge. Sleep quality, quality of life, analgesic use, symptom distress and exercise self-efficacy were significant associated factors that explained 42.1-51% of the variance in sedentary behaviour. Patients with high sedentary behaviour had significantly greater depression and poorer sleep and quality of life than those with low sedentary behaviour at hospitalization and showed a significant improvement in depression at 3 and 6 months after discharge.

CONCLUSION

Sedentary behaviour is common in heart failure patients and has impacts on depression and quality of life. An appropriate physical activity programme focusing on disease self-management and enhancing self-efficacy is needed for heart failure patients to improve their sedentary behaviour and quality of life.

Job Demand-Control-Support Model as Related to Objectively Measured Physical Activity and Sedentary Time in Working Women and Men

A physically active lifestyle incurs health benefits and physically active individuals show reduced reactivity to psychosocial stressors. However, the findings are inconclusive and are based on self-reported physical activity and sedentary time. The present study aimed at studying the associations between psychological stressors (job demand, control, support, JD-C-S) and objectively measured physical activity (PA) on various intensities from sedentary (SED) to vigorous physical activity. The participants were 314 employees from a cross-sectional study. PA data were collected with the accelerometer ActiGraph GT3X (Pensacola, FL, USA), SED data with the inclinometer activPAL (PAL Technologies Ltd., Glasgow, Scotland, UK), and psychosocial stressors with a web questionnaire. Results showed that vigorous-intensity PA was negatively associated with demand (β -0.15, p < 0.05), even when adjusted for the covariates. SED was negatively associated to support (β -0.13, p < 0.05). Stress significantly moderated relations between support and sedentary time (β -0.12, p < 0.05). Moderate PA (MVPA) was negatively associated with demand, but only when controlling for overtime (β -0.13, p < 0.05). MVPA was also negatively associated with control (β -0.15, p < 0.05) but not when work engagement was included in the model. Being more physically active and spending less time sedentary may help to handle job situations with high demand and low support.

The association between elderly people's sedentary behaviors and their health-related quality of life: focusing on comparing the young-old and the old-old

Background

Research on the effects of sedentary behavior on the health-related quality of life (HRQoL) of the elderly is limited. The present study aimed to determine the association between sedentary behavior and the HRQoL of the young-old (aged 65–74 years) people and old-old (aged ≥75 years) people.

Methods

This study used the raw data of the 7th Korea National Health and Nutrition Examination Survey for 2016. The study subjects were 1,415 people aged over 65 years. The association between HRQoL and average daily sitting time was analyzed using the point biserial correlation coefficient. The effect of sedentary behavior on HRQoL was analyzed by logistic regression analysis.

Results

Overall, elderly people aged ≥65 years spent 7.9 h in sedentary pursuits: the young-old spent 7.7 h and the old-old spent 9.0 h. Longer sitting time was found to be associated with lower HROoL while shorter sitting time was associated with higher HROoL, with the relationship stronger among the old-old than among the young-old. This means that the effects of either having longer time sitting per day and low quality of life or shorter time sitting per day and high quality of life are more pronounced in the old-old in comparison to the young-old.

Conclusions

Sedentary behavior is significantly associated with people’s HRQoL. Interventions towards improving the HRQoL by reducing sedentary behavior based on the respective characteristics of young-old and old-old people are needed.

Impact of exercise on psychological burden in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study

BACKGROUND

Childhood cancer survivors are at risk for adverse psychological outcomes. Whether exercise can attenuate this risk is unknown.

METHODS

In total, 6199 participants in the Childhood Cancer Survivor Study (median age, 34.3 years [range, 22.0-54.0 years]; median age at diagnosis, 10.0 years [range, 0-21.0 years]) completed a questionnaire assessing vigorous exercise and medical/psychological conditions. Outcomes were evaluated a median of 7.8 years (range, 0.1-10.0 years) later and were defined as: symptom level above the 90th percentile of population norms for depression, anxiety, or somatization on the Brief Symptom Inventory-18; cancer-related pain; cognitive impairment using a validated self-report neurocognitive questionnaire; or poor health-related quality of life. Log-binomial regression estimated associations between exercise (metabolic equivalent [MET]-hours per week^-1 ) and outcomes adjusting for cancer diagnosis, treatment, demographics, and baseline conditions.

RESULTS

The prevalence of depression at follow-up was 11.4% (95% CI, 10.6%-12.3%), anxiety 7.4% (95% CI, 6.7%-8.2%) and somatization 13.9% (95% CI, 13.0%-14.9%). Vigorous exercise was associated with lower prevalence of depression and somatization. The adjusted prevalence ratio for depression was 0.87 (95% CI, 0.72-1.05) for 3 to 6 MET hours per week^-1 , 0.76 (95% CI, 0.62-0.94) for 9 to 12 MET-hours per week^-1 , and 0.74 (95% CI, 0.58-0.95) for 15 to 21 MET-hours per week^-1 . Compared with 0 MET hours per week^-1 , 15 to 21 MET-hours per week^-1 were associated with an adjusted prevalence ratio of 0.79 (95% CI, 0.62-1.00) for somatization. Vigorous exercise also was associated with less impairment in the physical functioning, general health and vitality (P_trend  < .001), emotional role limitations (P_trend  = .02), and mental health (P_trend  = .02) domains as well as higher cognitive function in the domains of task completion, organization, and working memory (P < .05 for all), but not in the domain of cancer pain.

CONCLUSIONS

Vigorous exercise is associated with less psychological burden and cognitive impairment in childhood cancer survivors.

Effect of university students' sedentary behavior on stress, anxiety, and depression

PURPOSE

We identified the effect of sedentary behavior on stress, anxiety, and depression among Korean university students.

DESIGN AND METHODS

Data were collected from 244 students using self-reported sitting time, the Perceived Stress Scale, the Beck Anxiety Inventory, and the Center for Epidemiological Studies-Depression Scale.

FINDINGS

Mean sitting time was 7.96 h per day. As sitting hours increased, university students' stress, anxiety, and depression significantly increased despite controlling for sex, economic level, body mass index, underlying disease, and health self-management.

PRACTICAL IMPLICATIONS

Intervention programs that reduce sedentary behavior and improve physical activity and mental health for university students are necessary.

Effectiveness of interventions aiming at reducing sedentary behaviour in a non-surgical population with overweight or obesity: A systematic review and meta-analysis

AIM

This systematic review and meta-analyses of randomised controlled trials (RCTs) investigated the effectiveness of interventions to reduce sedentary behaviour amongst people with overweight or obesity. Secondarily, it aimed to investigate the effectiveness of these interventions on body mass index (BMI), time spent in moderate-to-vigorous physical activity (MVPA) and health-related quality of life (HRQoL).

METHODS

A search of six databases (CENTRAL, PubMed, Embase, PEDro, CINAHL and PsycINFO) was conducted from inception to July 2018. RCTs in which sedentary behaviour was measured by accelerometry or inclinometry, with participants of any age with overweight or obesity were included. Subgroup analyses were undertaken comparing studies that included adults versus children and studies with an active component (e.g., treadmill desk, physically active breaks) versus no active component to their intervention.

RESULTS

Nine studies (n=1859) were included. Compared to the control group, the interventions significantly reduced time spent in sedentary behaviour (standardised mean difference [95% confidence interval] -0.33 [-0.59 to -0.08] overall; -0.53 [-0.95 to -0.11] in adults). Subgroup analyses demonstrated that only interventions that included active components reduced time spent in sedentary behaviour (-0.54 [-0.88 to -0.20]) and increased time spent in MVPA (1.29 [0.02 to 2.56]). Subgroup analyses demonstrated that interventions only reduced BMI in studies of children (-0.09 [-0.18 to -0.00]) and in those with no active component (-0.09 [-0.18 to -0.01]). There were insufficient data to investigate the effectiveness of these interventions on HRQoL.

CONCLUSIONS

This novel systematic review and meta-analyses suggests interventions aiming to effectively reduce objectively-measured sedentary behaviour need to specifically include an active component.

Effects of Exercise on Depression and Anxiety. A Comparison to Transdiagnostic Cognitive Behavioral Therapy

The aims of this study were (i) to know the effects of an exercise program on a group of people with depression and anxiety and (ii) to compare theses effects with a transdiagnostic cognitive behavioral group therapy (TCBGT). The participants were 15 people with depression and/or anxiety symptoms. The participants followed an exercise program. Depression and anxiety symptoms were assessed with validated questionnaires. An exercise program can be used as a treatment option for people with depression and/or anxiety with good results in comparison with TCBGT.

Sedentary behaviours and health-related quality of life. A systematic review and meta-analysis

Researchers have speculated that sedentary behaviour may reduce health-related quality of life (HRQOL), but the extent to which this is true remains unknown. Our study sought to systematically review and synthesise research on the relationship between sedentary behaviours and HRQOL and to investigate if these relationships are moderated by age, health status, and HRQOL domain. The review was registered with PROSPERO (no. CRD42016036342). We searched six electronic databases. The selection process resulted in including k = 27 original studies; k = 18 were included in a meta-analysis. Data were synthesised twice, using the methods of systematic review and meta-analysis, in order to reduce biases related to a small number of included studies. Both the systematic review and meta-analytical methods indicated that lower levels of sedentary behaviours were associated with higher physical HRQOL (estimate of average effect: r = -.140; 95% CI -.191, -.088). Moderator analyses indicated that associations between the physical HRQOL domain and sedentary behaviours may be similar in strength across age- and health status groups. Causal inferences could not be drawn as most studies were cross-sectional. Concluding, sedentary behaviours were related to better physical HRQOL but not reliably to mental and social HRQOL.

Physical activity and anxiety: A perspective from the World Health Survey

BACKGROUND

Despite the known benefits of physical activity (PA) among people with anxiety, little is known about PA levels in people with anxiety at the population level. This study explored the global prevalence of anxiety and its association with PA.

METHODS

Cross-sectional, community-based data from the World Health Survey was analyzed. Prevalence of anxiety was estimated for 237,964 individuals (47 countries). PA was categorized as low, moderate, and high based on the International Physical Activity Questionnaire (short form). The association between PA and anxiety was assessed by multivariable logistic regression.

RESULTS

The overall global prevalence of anxiety was 11.4% (47 countries). Across 38 countries with available data on PA, 62.5%, 20.2%, and 17.3% of the sample engaged in high, moderate, and low levels of PA respectively. The prevalence of low physical activity in those with and without anxiety was 22.9% vs. 16.6% (p<0.001) (38 countries, n=184,920). In the pooled model adjusted for socio-demographics, depression, and country, individuals engaging in low PA (vs. high PA) had 1.32 (95% CI=1.17-1.47) times higher odds for anxiety than those with high PA. Female sex, older age, lower education and wealth, and depression were also associated with low PA. At the individual country level, there was a significant positive association between low PA and anxiety in 17 of the 38 countries.

CONCLUSION

Low PA levels are associated with increased prevalence of anxiety. There is a need for longitudinal research to establish the directionality of the relationships observed.

Sedentary Behavior and Cardiovascular Morbidity and Mortality: A Science Advisory From the American Heart Association

Epidemiological evidence is accumulating that indicates greater time spent in sedentary behavior is associated with all-cause and cardiovascular morbidity and mortality in adults such that some countries have disseminated broad guidelines that recommend minimizing sedentary behaviors. Research examining the possible deleterious consequences of excess sedentary behavior is rapidly evolving, with the epidemiology-based literature ahead of potential biological mechanisms that might explain the observed associations. This American Heart Association science advisory reviews the current evidence on sedentary behavior in terms of assessment methods, population prevalence, determinants, associations with cardiovascular disease incidence and mortality, potential underlying mechanisms, and interventions. Recommendations for future research on this emerging cardiovascular health topic are included. Further evidence is required to better inform public health interventions and future quantitative guidelines on sedentary behavior and cardiovascular health outcomes.

Trajectories of Television Watching from Childhood to Early Adulthood and Their Association with Body Composition and Mental Health Outcomes in Young Adults

INTRODUCTION

Prior studies examining longitudinal patterns of television (TV) watching have tended to use analytical approaches which do not allow for heterogeneity in the variation of TV watching over time. In the current study, we used latent class analysis (LCA) to examine the relationships between television watching (from childhood to early adulthood) and body fat percentage (%) and mental health.

METHODS

Data were collected from 2411 participants (50% female) from the Raine Study, a prospective birth cohort study in Australia. Participants were followed up over 15 years and answered questions about hours of TV watching per week at six time-points (5, 8, 10, 14, 17 and 20yrs). Trajectories of television watching were estimated using LCA and appropriate regression models used to test the association of television watching class with percentage body fat (measured by DXA) and mental health (DASS-21) at age 20. Physical activity was used as a covariate.

RESULTS

Three distinct trajectories of TV watching were identified. Class 1 (47.4%) had consistently high (>14 hrs/wk) levels of TV watching, Class 2 (37.9%) was characterised by an increase in TV watching over adolescence and Class 3 (14.7%) had consistently lower (<14 hrs/wk) TV watching over 15 years. Sex was used as an active covariate in the latent class model and was significantly associated with class membership (p<0.001), with females comprising 45%, 47% and 59% of Class 1, 2 and 3 respectively. In females, membership in Class 2 or 3 was associated with lower body fat % at age 20, compared to Class 1 (p<0.001). For males, membership in Class 2 was associated with lower body fat % compared with males in Class 1 (p = 0.026). Membership of TV watching class and mental health were not related (p>0.05).

CONCLUSIONS

TV watching from childhood to young adulthood appears to be a relatively stable behavior for around two thirds of participants, but not everyone tracks consistently. This study identified a subset of participants with low levels of TV watching in childhood and also that this group, despite an increase in TV watching over adolescence, maintained a lower level of body fat in young adulthood.