Physical activity and 4-year changes in body weight in 52,498 non-obese people: the Lifelines cohort

Objectively measured moderate-to-vigorous physical activity does not attenuate prospective weight gain among african-origin adults spanning the epidemiological transition

Traditional obesity-related public health messaging often includes physical activity (PA) recommendations. However, at the population level, the data are conflicting, especially when comparing different self-reported vs. measured techniques across different settings and populations. We measured the association between moderate-to-vigorous intensity PA (MVPA) and prospective weight change across five African-origin populations and the extent to which MVPA attenuated weight change over time. At baseline, 2,500 adults (median age: 37y) were recruited into the Modelling the Epidemiologic Transition Study (METS), from Ghana, South Africa, Jamaica, Seychelles, and US. 2000 participants were followed up 8 years later, with 851 participants having complete 7-day accelerometry to measure MVPA at both time points. Generalised estimating equations were used to explore the longitudinal association between weight and MVPA adjusted for several confounders. The obesity prevalence at baseline was 27.5% which increased to 38.0% at follow-up. Baseline MVPA varied from 7 (IQR: 4, 16) min/day in US women to 52 (IQR: 36, 78) min/day in South African men, and similarly at follow-up ranged from 8 min/day to 41 min/day among the same participant groups. While overall, engaging in higher MVPA levels was associated with a lower body weight, such that every additional 30 min of MVPA equalled a 600 g lower body weight (p = 0.04), the interaction between time and MVPA was not statistically significant (p = 0.18). Therefore, regardless of the amount of MVPA at any time point, body weight increased over time. Despite the association between MVPA and weight, our results suggest that objectively measured longitudinal MVPA was not associated with the change in 8-year weight in African-origin adults. Our research confirms that while PA is a critical determinant of cardiovascular health, it alone may not be enough to stem the rising obesity burden.

Objectively measured moderate-to-vigorous physical activity does not attenuate prospective weight gain among African-origin adults spanning the epidemiological transition

Traditional obesity-related public health messaging often includes physical activity (PA) recommendations. However, at the population level, the data are conflicting, especially when comparing different self-reported vs measured techniques across different settings and populations. We measured the association between moderate-to-vigorous intensity PA (MVPA) and prospective weight change across five African-origin populations and the extent to which MVPA attenuated weight change over time. At baseline, 2,500 adults (median age: 37y) were recruited into the Modelling the Epidemiologic Transition Study (METS), from Ghana, South Africa, Jamaica, Seychelles, and US. 2000 participants were followed up 8 years later, with 851 participants having complete 7-day accelerometry to measure MVPA at both time points. Generalised estimating equations were used to explore the longitudinal association between weight and MVPA adjusted for several confounders. The obesity prevalence at baseline was 27.5% which increased to 38.0% at follow-up. Baseline MVPA varied from 7 (IQR: 4, 16) min/day in US women to 52 (IQR: 36, 78) min/day in South African men, and similarly at follow-up ranged from 8 min/day to 41 min/day among the same participant groups. While overall, engaging in higher MVPA levels was associated with a lower body weight, such that every additional 30 min of MVPA equalled a 600g lower body weight (p = 0.04), the interaction between time and MVPA was not statistically significant (p = 0.18). Therefore, regardless of the amount of MVPA at any time point, body weight increased over time. Despite the association between MVPA and weight, our results suggest that objectively measured longitudinal MVPA was not associated with the change in 8-year weight in African-origin adults. Our research confirms that while PA is a critical determinant of cardiovascular health, it alone may not be enough to stem the rising obesity burden.

Short term e-bicycle riding results in favorable cardiometabolic shifts in moderately active adults

PURPOSE

Electric bikes (EB) are a form of active transportation with demonstrated health benefits. The purpose of this study was to determine the influence of riding an EB for one week on indices of cardiometabolic health in middle-aged adults.

METHODS

Adults (n = 22; age = 57.1 ± 11.3 year; BMI = 27.7 ± 4.9) participated in a 2 week study. During Week 1, participants were instructed to continue regular activities. Starting Week 2 participants were provided an EB to ride at least 3 days for a minimum of 30 min·day-1. Physical activity (PA) and glucose were measured continuously. Body composition, blood lipids, glucose, insulin, hemoglobin A1c (HbA1c), plasma endothelin-1 (ET-1), and carotid-femoral pulse wave velocity (cf-PWV) were measured on days 1 and 14.Data and Statistical analyses or Statistics. Each participant served as their own control. Paired t-tests compared dependent variables between week 1 (without EB) and week 2 (with EB).

RESULTS

When provided an EB for one week, moderate to vigorous PA increased by 6-9 min·day-1 (P < 0.05) and sedentary time decreased by ~ 77 min·day-1 (P < 0.05). Data from 24 h continuous glucose monitoring showed the percentage of time in healthy range (70-120 mg·dl-1 glucose) increased (P < 0.05) from week 1 to week 2. Compared to day 1, cf-PWV was lower at day 14 (P < 0.05) following one week of riding an EB.

CONCLUSION

Moderately-active, middleaged adults showed improved continuous glucose regulation and lower central arterial stiffness following one week of riding an EB.

Diet quality, food intake and incident adult-onset asthma: a Lifelines Cohort Study

PURPOSE

Dietary factors have been suggested as drivers of the rising prevalence of adult-onset asthma, but evidence is inconclusive, possibly due to the complex interrelation with obesity. We aim to explore the relation of diet quality and food intake with incident adult-onset asthma in normal weight and overweight adults of the prospective population-based Lifelines Cohort Study.

METHODS

Incident adult-onset asthma was defined as self-reported asthma at ± 4-year follow-up, in adults free of airway disease at baseline. Diet quality scores and food group intake were assessed at baseline. Log-binomial regression analyses were used to estimate adjusted relative risks (RR) between dietary intake (per portion) and incident adult-onset asthma, in categories of BMI (cutoff: 25 kg/m²).

RESULTS

477 incident asthma cases (75% female, 62% overweight) and 34,698 controls (60% female, 53% overweight) were identified. Diet quality-assessed by the Lifelines Diet Score and Mediterranean Diet Score-was not associated with incident adult-onset asthma in the two BMI groups. Although the dietary intake of several food groups differed between cases and controls, after adjustment for confounders only few remained associated with adult-onset asthma, including red and processed meat (RR: 0.93 per 15 g intake; 95% CI 0.86-0.99) in the normal weight group and intake of cheese (RR 1.09 per 20 g intake; 95% CI 1.00-1.17) and vegetables (RR 1.10 per 50 g intake; 95% CI 1.00-1.21) in the overweight group.

CONCLUSION

The results of this study question the role of food as a 'simple' predictor of adult-onset asthma and call for an integrative approach, including a range of modifiable lifestyle factors and further asthma phenotyping.

Leisure-time physical activity, occupational physical activity and the physical activity paradox in healthcare workers: A systematic overview of the literature

BACKGROUND

Physical activity positively influences cardiovascular health. Results from male-dominated physically active occupations suggest that a high level of occupational physical activity may be detrimental to cardiovascular health. This observation is referred to as the physical activity paradox. Whether this phenomenon can also be observed in female-dominated occupations remains unknown.

OBJECTIVE

We aimed to provide an overview of (1) leisure-time and occupational physical activity in healthcare workers. Therefore, we reviewed studies (2) to assess the relationship between the two physical activity domains and analyzed (3) their effects on cardiovascular health outcomes in relation to the paradox.

METHODS

Five databases (CINAHAL, PubMed, Scopus, Sportdiscus, Web of Science) were systematically searched. Both authors independently screened the titles, abstracts, and full texts and assessed the quality of the studies using the National Institutes of Health's quality assessment tool for observational cohort and cross-sectional studies. All studies that assessed leisure-time and occupational physical activity in healthcare workers were included. The two authors independently rated the risk of bias using the ROBINS-E tool. The body of evidence was evaluated using the GRADE approach.

RESULTS

The review included 17 studies that assessed the leisure-time and occupational physical activity of people working in healthcare, determined the relationship between the domains (n = 7) and/or examined their effects on the cardiovascular system (n = 5). Measurements for leisure-time and occupational physical activity varied between studies. Leisure-time physical activity typically ranged between low and high intensity, with a short duration (approx. 0.8-1.5 h). Occupational physical activity was typically performed at light to moderate intensity with a very long duration (approx. 0.5-3 h). Moreover, leisure-time and occupational physical activity were almost negatively related. The few studies investigating effects on cardiovascular parameters revealed a rather unfavorable effect of occupational physical activity, while leisure-time physical activity was beneficial. The study quality was rated as fair and the risk of bias was moderate to high. The body of evidence was low.

CONCLUSIONS

This review confirmed that leisure-time and occupational physical activity of healthcare workers are opposed in their duration and intensity. Moreover, leisure-time and occupational physical activity seem to be negatively related and should be analyzed according to their relation to each other in specific occupations. Furthermore, results support the relationship between the paradox and cardiovascular parameters.

REGISTRATION

Preregistered on PROSPERO (CRD42021254572). Date of registration on PROSPERO: 19 May 2021.

TWEETABLE ABSTRACT

Does occupational physical activity adversely affect the cardiovascular health of healthcare workers in comparison to leisure-time physical activity?

Objectively determined physical activity and adiposity measures in adult women: A systematic review and meta-analysis

The prevalence of adiposity is increasing among adult women. Although emerging evidence suggest that all patterns of heightened physical activity (PA) are important to benefit adiposity, the relationship between objectively assessed intensities of PA and adiposity in women has not yet been assessed. Therefore, this systematic review and meta-analysis aims to qualitatively synthesize and quantitatively assess the evidence for any relationship between objectively measured PA and a wide range of adiposity indicators to guide PA prescription in adult women. Four databases (PubMed, Web of Science, Scopus, and the Cochrane library) were searched for eligible studies. 35 studies were included (25 observational and 10 interventional studies), with a total of 9,176 women from 20 countries included. The overall pooled correlation for random effects model (n = 1 intervention and n = 15 cross-sectional studies) revealed that the total volume of physical activity (TPA) was moderately associated with percentage body fat (%BF) (r = −0.59; 95% CI: −1.11, −0.24; p = 0.003). There was a weak but significant association between MVPA with body mass index (BMI), waist circumference (WC), and visceral adiposity. Daily steps were significantly associated with BMI, %BF, WC, and fat mass, with the strongest association with %BF (r = −0.41; 95% CI: −0.66, −0.19; p < 0.001). Walking programs resulting in increasing daily steps only had a significant effect on WC (SMD = −0.35; 95% CI: −0.65, −0.05; p = 0.02). Overall, objectively determined PA in terms of steps, TPA and MVPA were favorably associated with adiposity outcomes. The improvement in adiposity can be achieved by simply accumulating more PA than previously and adiposity is more likely to be benefited by PA performed at higher intensity. Nonetheless, these results should be interpreted with caution as there were a small number of studies included in the meta-analysis and the majority of studies included utilized cross-sectional designs.

The association between the presence of fast-food outlets and BMI: the role of neighbourhood socio-economic status, healthy food outlets, and dietary factors

Background

Evidence on the association between the presence of fast-food outlets and Body Mass Index (BMI) is inconsistent. Furthermore, mechanisms underlying the fast-food outlet presence-BMI association are understudied. We investigated the association between the number of fast-food outlets being present and objectively measured BMI. Moreover, we investigated to what extent this association was moderated by neighbourhood socio-economic status (NSES) and healthy food outlets. Additionally, we investigated mediation by frequency of fast-food consumption and amount of fat intake.

Methods

In this cross-sectional study, we used baseline data of adults in Lifelines (N = 149,617). Geo-coded residential addresses were linked to fast-food and healthy food outlet locations. We computed the number of fast-food and healthy food outlets within 1 kilometre (km) of participants’ residential addresses (each categorised into null, one, or at least two). Participants underwent objective BMI measurements. We linked data to Statistics Netherlands to compute NSES. Frequency of fast-food consumption and amount of fat intake were measured through questionnaires in Lifelines. Multivariable multilevel linear regression analyses were performed to investigate associations between fast-food outlet presence and BMI, adjusting for individual and environmental potential confounders. When exposure-moderator interactions had p-value < 0.10 or improved model fit (∆AIC ≥ 2), we conducted stratified analyses. We used causal mediation methods to assess mediation.

Results

Participants with one fast-food outlet within 1 km had a higher BMI than participants with no fast-food outlet within 1 km (B = 0.11, 95% CI: 0.01, 0.21). Effect sizes for at least two fast-food outlets were larger in low NSES areas (B = 0.29, 95% CI: 0.01, 0.57), and especially in low NSES areas where at least two healthy food outlets within 1 km were available (B = 0.75, 95% CI: 0.19, 1.31). Amount of fat intake, but not frequency of fast-food consumption, explained this association for 3.1%.

Conclusions

Participants living in low SES neighbourhoods with at least two fast-food outlets within 1 km of their residential address had a higher BMI than their peers with no fast-food outlets within 1 km. Among these participants, healthy food outlets did not buffer the potentially unhealthy impact of fast-food outlets. Amount of fat intake partly explained this association. This study highlights neighbourhood socio-economic inequalities regarding fast-food outlets and BMI.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13826-1.

The Profiling of Diet and Physical Activity in Reproductive Age Women and Their Association with Body Mass Index

Pre-pregnancy, pregnancy and postpartum are critical life stages associated with higher weight gain and obesity risk. Among these women, the sociodemographic groups at highest risk for suboptimal lifestyle behaviours and core lifestyle components associated with excess adiposity are unclear. This study sought to identify subgroups of women meeting diet/physical activity (PA) recommendations in relation to sociodemographics and assess diet/PA components associated with body mass index (BMI) across these life stages. Cross-sectional data (Australian National Nutrition and Physical Activity Survey 2011–2012) were analysed for pre-pregnancy, pregnant and postpartum women. The majority (63–95%) of women did not meet dietary or PA recommendations at all life stages. Core and discretionary food intake differed by sociodemographic factors. In pre-pregnant women, BMI was inversely associated with higher whole grain intake (β = −1.58, 95% CI −2.96, −0.21; p = 0.025) and energy from alcohol (β = −0.08, −0.14, −0.005; p = 0.035). In postpartum women, BMI was inversely associated with increased fibre (β = −0.06, 95% CI −0.11, −0.004; p = 0.034) and PA (β = −0.002, 95% CI −0.004, −0.001; p = 0.013). This highlights the need for targeting whole grains, fibre and PA to prevent obesity across life stages, addressing those most socioeconomically disadvantaged.