Comparison of self-report versus accelerometer - measured physical activity and sedentary behaviors and their association with body composition in Latin American countries

Perceived neighborhood built environment and physical activity in urban population in Chile

BACKGROUND

Various indicators of neighborhood environmental perceptions are differently associated with physical activity (PA) domains, with notable variations by sex. However, few studies in Latin America have examined these associations across distinct PA domains. In this study, we analyzed the relationship between neighborhood environmental perceptions and PA in the domains of transportation and leisure among Chilean adults.

METHODS

This cross-sectional analytical study included 770 participants from the 2014-2016 Latin American Nutrition and Health Survey (ELANS). Perceptions of land use diversity, access to land use, street connectivity, walking and cycling infrastructure, aesthetics, safety from crime, and neighborhood traffic were assessed using the Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A) questionnaire. PA was measured with the International Physical Activity Questionnaire-Long Form (IPAQ-LF), focusing on the transportation and leisure-time domains. Logistic regression and multiple linear regression models were used for the analysis.

RESULTS

Logistic regression analysis in men showed no association between neighborhood characteristics and PA in the transportation or leisure-time domains. However, for women, greater perception of facilities for walking or cycling was inversely associated with transportation PA (OR: 0.62; 95%CI: 0.42;0.92). In the multiple linear regression analysis, higher perceived traffic safety was associated with greater PA (min/week) for both transportation (β: 0.098; 95%CI: 0.005;0.192) and leisure time (β: 0.160, 95%CI: 0.012;0.309). For men, higher scores for perceived access to land use were inversely associated with leisure-time PA (β: -0.150, 95%CI: -0.266;-0.034).

CONCLUSIONS

Different perceived neighborhood characteristics are associated with PA across various domains, with notable gender differences. A better perceived condition of traffic safety would promote urban population to engage in more transportation and leisure-time PA.

CLINICAL TRIAL NUMBER

ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014.

TRIAL REGISTRATION

ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014.

Health-related quality of life associated with fatigue, physical activity and activity pacing in adults with chronic conditions

BACKGROUND

Fatigue and inactivity are linked to decreased health-related quality of life (HRQoL) in chronic conditions. A multidimensional approach to activity pacing may improve HRQoL by promoting physical activity (PA) and alleviating fatigue. Addressing fatigue across chronic conditions is crucial, especially when underlying causes are unknown. This study aimed to (1) examine associations between HRQoL, fatigue, pacing, risk of overactivity, PA, and self-regulation of PA in adults with chronic conditions and (2) examine if these associations differ across HRQoL domains: physical, social, emotional, and functional well-being.

METHODS

Sixty-six adults with chronic conditions were recruited from UK fatigue clinics and the community. HRQoL, pacing, risk of overactivity, PA, and self-regulation of PA were assessed with standardised questionnaires and Actigraph monitor. Associations were analysed with linear mixed models, correcting for confounders.

RESULTS

HRQoL was significantly associated with fatigue (B=-7.82), pacing (B=-0.23), and self-regulation of PA (B = 0.11). Interaction effects revealed fatigue's impact on HRQoL varied significantly in physical (β=-13.49), social (β=-6.81), and emotional (β=-4.10) domains. Pacing showed significant differences in physical (β=-0.49), social (β=-7.12), and emotional (β=-7.45) domains. Perceived overactivity differed in social domain (β=-6.27), while device-based PA differed in physical (β = 0.35) and social (β = 5.73).

CONCLUSION

The negative association between fatigue and HRQoL underscores the importance of effective fatigue management. Higher pacing engagement and lower HRQoL may indicate higher fatigue. Positive associations between self-regulation and PA with HRQoL emphasise benefits of appropriate PA behaviours. The stronger impact of decreased fatigue, increased pacing, and PA on physical well-being suggests a multidimensional fatigue management approach.

Isotemporal substitution of physical activity patterns and sitting time with obesity indicators among workers in São Paulo

This study aimed to evaluate the association between substituting 10, 30, and 60 min/day of physical activity and sitting time with obesity indicators among workers. It is a cross-sectional study involving 394 adults (76.6% women) from São Paulo, Brazil. Physical activity and sitting time (min/day) were measured using the short version of the International Physical Activity Questionnaire (IPAQ) to determine physical activity levels. Obesity indicators included body mass index (BMI; kg/m²), waist circumference (cm), and body fat (kg). Isotemporal substitution models were analyzed using multivariate linear regression, adjusted for sociodemographic variables. Participants reported median values of 150.0 min/day (IQR: 60.0-360.0) for walking and 445.7 min/day (IQR: 317.1-565.7) for sitting time. The median values for BMI, waist circumference, and body fat were 27.1 kg/m², 91.0 cm, and 23.5 kg, respectively. Substituting 10 min/day of sitting time for 10 min/day of walking was associated with waist circumference (β: -0.216: 95% CI: -0.041; -0.007). In addition, substituting 60 min/day of sitting time for moderate physical activity (β -0.206; 95% CI: -0.123; -0.008) was negatively associated with body fat. The equivalent substitution of different periods of sitting time for more active behaviors was favorably associated with obesity indicators. These findings suggest that lifestyle interventions based on replacing sitting time with physical activity can reduce the obesity epidemic in adults.

Leisure-Time Physical Activity to Reduce Risk of Long-Term Sickness Absence Across Diverse Subgroups in the Working Population-A Prospective Cohort Study of 68,000 Participants

BACKGROUND

There is a dearth of knowledge regarding the relationship between engaging in moderate and vigorous physical activity and long-term sickness absence (LTSA), particularly among various population subgroups such as individuals of different ages or body mass indices. We aimed to evaluate the prospective associations of moderate and vigorous leisure-time physical activity with the risk of LTSA in the general working population.

METHODS

A prospective cohort study with a 2-year register follow-up was conducted, where 68,222 representative workers from Denmark completed a questionnaire about work environment, lifestyle, and health. Data on LTSA (≥6 consecutive weeks of sickness absence) were obtained from the Danish Register for Evaluation of Marginalization. We used Cox regression for the statistical analysis, adjusting for relevant confounding factors. We also performed age- and BMI-stratified analyses.

RESULTS

In the fully adjusted model, 2 to 4 hours per week of moderate activity (hazard ratios [HR] = 0.87; 95% CI, 0.77 to 0.99) and ≥2 hours per week of vigorous activity reduced LTSA risk compared with no physical activity. However, 2 to 4 hours per week of vigorous activity (HR = 0.84; 95% CI, 0.76 to 0.91) provided the greatest risk reduction. In the total sample, the complete absence of vigorous activity was associated with increased risk of LTSA (HR = 1.13; 95% CI, 1.05 to 1.22). In stratified analyses, the results were consistent for workers <50 years (HR = 1.14; 95% CI, 1.03 to 1.26), ≥50 years (HR = 1.13; 95% CI, 1.02 to 1.26), and those with a BMI ≥ 25 (HR = 1.16; 95% CI, 1.06 to 1.28). The complete absence of moderate activity was not associated with LTSA.

CONCLUSION

Vigorous leisure-time physical activity appears to be more important than moderate activity to prevent LTSA.

Combined Self-Reported and Device-Measured Physical Activity Assessment and Disability Incidence in Older Adults

OBJECTIVES

To clarify the relationship between self-reported and device-measured physical activity (PA) and disability incidences in community-dwelling older adults.

DESIGN

Prospective cohort study.

SETTING AND PARTICIPANTS

In total, 4504 (median age 75 [range, 72-79] years; women, 52.1%) community-dwelling older adults were included in this study.

METHODS

Device-measured moderate-to-vigorous PA (MVPA) was measured using a triaxial accelerometer. Self-reported MVPA was assessed using the Japanese version of the International Physical Activity Questionnaire, Short Form. The cutoff MVPA was 150 min/wk. PA was divided into 4 groups based on self-reported and device-measured assessments: (1) self-reported/device-measured inactive, (2) self-reported active/device-measured inactive, (3) self-reported inactive/device-measured active, and (4) self-reported/device-measured active. The disability incidence, defined as a long-term care insurance certification of any level indicating a requirement for support or continuous care, was prospectively determined using data extracted from the Japanese long-term care insurance system.

RESULTS

Of the participants, 892 (19.8%) developed disabilities within 62 (range, 60-64) months. The prevalence of self-reported inactive/device-measured inactive, self-reported active/device-measured inactive, self-reported inactive/device-measured active, and self-reported active/device-measured active were 884 (34.9%), 441 (17.4%), 693 (27.3%), and 515 (20.3%) participants, respectively. Multivariate Cox regression analysis showed that self-reported/device-measured active, self-reported inactive/device-measured active, and self-reported active/device-measured inactive independently decreased the disability incidence risk (self-reported/device-measured active: hazard ratio [HR], 0.555, 95% confidence interval [CI], 0.412-0.749; self-report inactive/device-measured active: HR, 0.656; 95% CI, 0.518-0.831; self-reported active/device-measured inactive: HR, 0.718; 95% CI, 0.556-0.928). In the post hoc analysis, those who were self-reported active/device-measured inactive were divided into 2 groups according to involvement in sports. Those who played sports had a lower disability risk; however, the difference was not significant.

CONCLUSIONS AND IMPLICATIONS

Combined self-reported and device-measured PA assessments may allow for disability risk stratification in older adults. The findings will also help in creating methods for evaluating PA levels to prevent disability incidences among older adults.

Comparing national device-based physical activity surveillance systems: a systematic review

BACKGROUND

Physical activity surveillance systems are important for public health monitoring but rely mostly on self-report measurement of physical activity. Integration of device-based measurements in such systems can improve population estimates, however this is still relatively uncommon in existing surveillance systems. This systematic review aims to create an overview of the methodology used in existing device-based national PA surveillance systems.

METHODS

Four literature databases (PubMed, Embase.com, SPORTDiscus and Web of Science) were searched, supplemented with backward tracking. Articles were included if they reported on population-based (inter)national surveillance systems measuring PA, sedentary time and/or adherence to PA guidelines. When available and in English, the methodological reports of the identified surveillance studies were also included for data extraction.

RESULTS

This systematic literature search followed the PRISMA guidelines and yielded 34 articles and an additional 18 methodological reports, reporting on 28 studies, which in turn reported on one or multiple waves of 15 different national and 1 international surveillance system. The included studies showed substantial variation between (waves of) systems in number of participants, response rates, population representativeness and recruitment. In contrast, the methods were similar on data reduction definitions (e.g. minimal number of valid days, non-wear time and necessary wear time for a valid day).

CONCLUSIONS

The results of this review indicate that few countries use device-based PA measurement in their surveillance system. The employed methodology is diverse, which hampers comparability between countries and calls for more standardized methods as well as standardized reporting on these methods. The results from this review can help inform the integration of device-based PA measurement in (inter)national surveillance systems.

Physical Activity and Obesity Risk in Adults in Colombia: The Prospective Urban Rural Epidemiology (PURE) Study

PURPOSE

This study aimed to investigate longitudinal associations between physical activity levels and obesity in adults in Colombia, where participation in large amounts of light-intensity physical activity is a necessity for many people.

METHODS

Participation in moderate- and vigorous-intensity physical activity was assessed from 2005 to 2009, and obesity was assessed from 2011 to 2019 in men and women from the Prospective Urban Rural Epidemiology (PURE) study. Total physical activity level was categorized as low (<600 MET·min·wk -1 ), medium (600-3000 MET·min·wk -1 ), or high (>3000 MET·min·wk -1 ; 600 MET·min·wk -1 is equivalent to 150 min of moderate activity or 75 min of vigorous activity per week). Obesity was defined as body mass index ≥30 kg·m -2 . Analyses were adjusted for age, sex, smoking, socioeconomic status, diet, alcohol, sedentary time, and sleep.

RESULTS

The main analysis included 3086 men and women aged 51 ± 9 yr at baseline (mean ± SD). Compared with the low physical activity group, the odds ratio (95% confidence interval) for obesity was 0.67 (0.53-0.85) in the medium physical activity group and 0.78 (0.62-0.98) in the high physical activity group after adjustment for potential confounders. Smoking is probably a major confounder, and it is noteworthy that similar associations were observed in participants who reported never smoking.

CONCLUSIONS

The PURE study is the only prospective cohort study in Colombia. The present analysis is important because it suggests that even the busy people of Colombia could substantially reduce their risk of obesity by participating in moderate- and vigorous-intensity physical activity.

Psychometric validation of four-item exercise identity and healthy-eater identity scales and applications in weight loss maintenance

BACKGROUND

Identifying as someone who engages in health promoting behaviors like healthy eating and exercising may be associated with sustained engagement in those behaviors, but reliable and valid instruments are needed to improve the rigor of this research. Two studies were conducted to (1) examine the psychometric properties of a four-item exerciser identity measure (4-EI) and an adapted healthy-eater identity measure (4-HEI) and (2) examine differences in identity strengths across categories of weight loss success.

METHODS

Data from 1,709 community dwelling adults in the International Weight Control Registry (IWCR) were used. A random half of the sample was used to assess the proposed unidimensional factor structure of the 4-EI and 4-HEI and examine convergent and discriminant validity using Spearman rank-order correlations. One-way ANOVA was used in the other random half of the sample to compare 4-EI and 4-HEI scores (-3 to + 3) across three self-defined weight loss categories ('Successful', 'Regain', and 'Unsuccessful') and those maintaining ≥ 5% weight loss for > 1 year vs. not.

RESULTS

Results support the unidimensional factor structure with all four items (eigenvalue scores > 2.89) as well as convergent and discriminant validity for both measures. Exercise identity was strongly correlated with self-reported physical activity (r (735) = 0.52, p <.001) and measures of autonomous motivation. Healthy eating identity was moderately correlated with cognitive restraint in eating (r (744) = 0.42, p <.001) and other measures predictive of eating behavior. 4-EI and 4-HEI are stronger in Successful (4-EI: M = 0.90, SD = 1.77; 4-HEI: M = 1.56 SD = 1.37) vs. Regain (4-EI: M=-0.18, SD = 1.68; 4-HEI: M =.57, SD = 1.48) and Unsuccessful (4-EI:M=-0.28, SD = 1.62; 4-HEI: M = 0.51, SD = 1.33) and those maintaining ≥ 5% weight loss (4-EI:M = 0.47, SD = 1.78; 4-HEI: M = 1.13, SD = 1.49) vs. not (4-EI:M=-0.27, SD = 1.66; 4-HEI: M = 0.53, SD = 1.47), p's < 0.001.

CONCLUSIONS

The 4-EI and 4-HEI have acceptable psychometric properties and can advance understanding of the role of identity in exercise and dietary behaviors and weight loss maintenance.

TRIAL REGISTRATION

The parent observational study, International Weight Control Registry (IWCR), for these sub-studies is registered in ClinicalTrials.gov (NCT04907396).

The Relationship between Body Composition and Physical Activity Level in Students of Medical Faculties

Maintaining an active lifestyle is crucial for good health. Markers of health risk include tissue components. This study aimed to indicate which body composition elements create the strongest correlations with physical activity performed in young students of medical faculties. The study group consisted of 75 students (33 men and 42 women) from Wroclaw Medical University. Each student underwent accelerometer and anthropometric measurements and body composition analysis. Both men and women had similar physical activity levels. The study found that the amount of vigorous physical activity correlated significantly with the basal metabolic rate (BMR), fat, water and muscle content, fat-free mass (FFM), bone mass, extracellular to intracellular water ratio (ECW/ICW), and phase angle (PA), with r~ ± (0.2-0.4). The amount of moderate physical activity correlated with body mass, body mass index (BMI), BMR, FFM, and bone mass, with r~0.3-0.5. There are dimorphic differences in the strength of correlations between physical activity and elements of body composition. A greater amount of moderate and vigorous physical activity is associated with greater FFM and bone mass in men, which causes BMI to increase as well (in this case, higher BMI is not a sign of being overweight). For women, the beneficial effect of higher amounts of vigorous physical activity on reducing fat content and increasing muscle mass is more pronounced. In both men and women, an improvement in hydration is evident with increased vigorous physical activity volume.

Reduced physical activity level was associated with poorer quality of life during the early phase of the COVID-19 pandemic: a sub-study of the last-long trial

OBJECTIVES

To assess how physical activity levels changed in a stroke cohort during the COVID-19 (SARS-CoV-2) pandemic, and how these changes were associated with quality of life (QoL).

METHODS

Between March and July 2021, 150 patients with stroke already included in the Life after Stroke (LAST-long) trial in Norway were invited to participate in this cross-sectional survey. Participants were asked to complete a questionnaire assessing changes in physical activity and self-reported health following the pandemic. Univariate and multivariate logistic regression analyses were used to explore the association between physical activity, loneliness, mental health, social activity and QoL.

RESULTS

In all, 118 (79%) participants completed the questionnaire. A total of 80 (68%) reported less physical activity, 46 (39%) felt lonelier, and 43 (37%) reported worse mental health, while 50 (42%) reported reduced QoL compared with before the lockdown. In the univariate analyses less physical activity, feeling lonelier and changes in mental health were associated with reduced QoL. In the multivariate analysis only less physical activity odds ratio (OR) = 4.04 (95% confidence interval (95% CI) 1.44-11.34, p = 0.008) was significantly associated with reduced QoL.

CONCLUSION

More than two-thirds of patients with stroke reported reduced physical activity during the COVID-19 pandemic, and less physical activity was strongly associated with reduced QoL.

Agreement between Accelerometer-Assessed and Self-Reported Physical Activity and Sedentary Behavior in Female Breast Cancer Survivors

An accurate quantitative assessment of physical activity and sedentary lifestyles enables a better understanding of their relationship with the health records of cancer survivors. The objective of this study was to compare the subjective and objective methods of physical activity measurement in female breast cancer survivors. Materials and methods: In total, 135 female breast cancer survivors at the Holycross Cancer Center, Kielce, Poland, were included in this study. A shortened version of the International Physical Activity Questionnaire (IPAQ) was used to subjectively assess the participants' physical activity (PA), and an ActiGraph GT3X-BT accelerometer was used for an objective assessment. In total, 75% of the studied women did not report any vigorous PA, irrespective of the measurement method. The average values of moderate PA and moderate-to-vigorous PA (MVPA) measured with IPAQ compared with the accelerometer were sevenfold and tenfold higher, respectively. Conversely, the sedentary behavior values measured with the accelerometer were almost three times higher than those measured with IPAQ. The PA and sedentary behavior measurements were significantly different. Irrespective of PA intensity, the accelerometer-based measurements produced significantly lower results than IPAQ, while higher results were observed for sedentary behavior. The measurement differences between these two methods increased as the average differences grew. Regardless of the measurement method, a negative association was observed between moderate PA with general adiposity and adipose tissue distribution, whereas sedentary behavior demonstrated an opposite trend. This indicates the detrimental role of obesity in limiting PA.

Associations between physical activity, physical fitness, and body composition in adults living in Germany: A cross-sectional study

BACKGROUND & AIMS

Body composition (BC) changes with age and is associated with morbidity and mortality. A physically active lifestyle influences BC and represents an important predictor of successful aging. To emphasize this, the World Health Organization established activity recommendations for all age groups. We describe BC during adulthood using a cross-sectional sample from a German community and investigate the associations between physical activity (PA), physical fitness (PF), and BC.

METHODS

Data from 329 men and women aged 35 to 86 years were analyzed. PA was measured by questionnaire and classified into sport activity and habitual activity. PF was measured through physical performance tests and BC by bioelectrical impedance analysis. Fat mass index (FMI) and fat-free mass index (FFMI) were calculated to represent height-adjusted BC. Associations between PA, PF, and BC were analyzed using linear regression models.

RESULTS

For both sexes, strength was positively associated with FFMI (♂: ß = 0.313; ♀: ß = 0.213) and phase angle (♂: ß = 0.357; ♀: ß = 0.409). For FMI, a significant negative association with strength was found only in women (ß = -0.189). Cardiorespiratory fitness showed a negative association with FMI (ß = -0.312) and FFMI (ß = -0.201) for men, while in women a positive association was found for FFMI (ß = 0.186). For coordination, a significant association with FMI was observed only in women (ß = -0.190). Regarding PA only one significant relationship between sport activity and FMI among women (ß = -0.170) was found.

CONCLUSIONS

In our sample, PF was closer related to BC than PA. Strength and cardiorespiratory fitness were the strongest predictors for BC. This supports the World Health Organization's activity recommendations to include both resistance and endurance training in the weekly sports program to maintain a healthy BC.

The role of daily adjustment disorder, depression and anxiety symptoms for the physical activity of cardiac patients

BACKGROUND

Physical activity (PA) is crucial in the treatment of cardiac disease. There is a high prevalence of stress-response and affective disorders among cardiac patients, which might be negatively associated with their PA. This study aimed at investigating daily differential associations of International Classification of Diseases (ICD)-11 adjustment disorder, depression and anxiety symptoms with PA and sedentary behaviour (SB) during and right after inpatient cardiac rehabilitation.

METHODS

The sample included N = 129 inpatients in cardiac rehabilitation, Mage = 62.2, s.d.age = 11.3, 84.5% male, n = 2845 days. Adjustment disorder, depression and anxiety symptoms were measured daily during the last 7 days of rehabilitation and for 3 weeks after discharge. Moderate-to-vigorous PA (MVPA), light PA (LPA) and SB were measured with an accelerometer. Bayesian lagged multilevel regressions including all three symptoms to obtain their unique effects were conducted.

RESULTS

On days with higher adjustment disorder symptoms than usual, patients engaged in less MVPA, and more SB. Patients with overall higher depression symptoms engaged in less MVPA, less LPA and more SB. On days with higher depression symptoms than usual, there was less MVPA and LPA, and more SB. Patients with higher anxiety symptoms engaged in more LPA and less SB.

CONCLUSIONS

Results highlight the necessity to screen for and treat adjustment disorder and depression symptoms during cardiac rehabilitation.

Physical activity is associated with adiposity in older adults with HIV in the modern HIV era

OBJECTIVES

People with HIV (PWH) are aging and are experiencing higher rates of abdominal adiposity. Physical activity is an effective nonpharmacological strategy to reduce adiposity in the general aging population. Yet, the relationship between physical activity and adiposity in people with well controlled HIV is unclear. Our objective was to describe the association between objectively-measured physical activity and abdominal adiposity in PWH.

METHODS

As part of the multisite, observational PROSPER-HIV study, virologically suppressed, adult PWH wore an Actigraph accelerometer for 7-10 days and completed duplicate waist and hip circumference measures. Demographic and medical characteristics were abstracted from the CFAR Network of Integrated Clinical Systems dataset. Descriptive statistics and multiple linear regressions were used to analyze the data.

RESULTS

On average, our 419 PWH were 58 years of age [interquartile range (IQR): 50, 64], male (77%), Black (54%), and currently taking an integrase inhibitor (78%). PWH completed a mean of 7.06 (±2.74) days of total actigraphy wear time. They took an average of 4905 (3233, 7140) steps per day and engaged in 5.4 h of sedentary time per day. Controlling for age, sex, employment and integrase inhibitor use, the number of steps taken per day was associated with reduced abdominal adiposity ( F  = 3.27; P  < 0.001) and the hours of daily sedentary time was associated with increased abdominal adiposity ( F  = 3.24; P  < 0.001).

CONCLUSIONS

Greater physical activity is associated with reduced abdominal adiposity in aging PWH. Future work should investigate how to tailor the amount, type and intensity of physical activity needed to reduce adiposity in PWH taking contemporary HIV medication.

REGISTRATION NUMBER

NCT03790501.

Validation of the LPA-SQUASH in post-liver-transplant patients

AIM

This study aimed to validate the revised Short Questionnaire to Assess Health-Enhancing Physical Activity (SQUASH) to measure sedentary activity in post-liver-transplant patients. The proposed scale could be useful for transplantation nurses to assess and modify sedentary lifestyles and increase physical activity.

METHODS

The SQUASH was modified to include items on sitting time and light-intensity physical activity (LPA-SQUASH). A pilot study was conducted with 20 liver transplant patients, and an expert panel validated the scale contents. Then, post-liver-transplant outpatients at a Japanese university hospital participated in the main study (September-October 2020), in which questionnaires were mailed twice to assess test-retest reliability, and accelerometers used to establish criterion validity. Intra-class correlation coefficients (ICC) were calculated for test-retest reliability. Spearman correlations and Bland-Altman plots were used to assess validity and measurement error.

RESULTS

In total, 173 participants returned the questionnaires, and 106 and 71 completed the reliability and validation studies, respectively. The range of LPA-SQUASH correlation coefficients for test-retest was .49-.58. ICCs ranged from .72 to .80 for items other than leisure. Accelerometer data and the LPA-SQUASH total physical activity amount and light-intensity physical activity correlated moderately.

CONCLUSION

We modified the SQUASH, which was developed to measure physical activity in healthy adults, to assess light-intensity physical activity in post-liver-transplant patients. The LPA-SQUASH showed acceptable validity and reliability. The questionnaire may be used by transplantation nurses to examine light-intensity physical activity content/duration, deliver patient education considering patients' sedentary lifestyle, and facilitate goal setting for physical activity interventions to prevent metabolic syndrome.

Combined association of physical activity and sitting time with cardiometabolic risk factors in Chilean adults

In this study we examined the combined association of physical activity and sitting time with cardiometabolic risk factors in adults in Chile. This is a cross-sectional study based on 3201 adults aged from 18 to 98 years from the Chilean National Health Survey (2016-2017) who responded to the GPAQ questionnaire. Participants were considered inactive if spent < 600 METs-min/wk^-1 in physical activity. High sitting time was defined as ≥ 8 h/day. We classified participants into the following 4 groups: active and low sitting time; active and high sitting time; inactive and low sitting time; inactive and high sitting time. The cardiometabolic risk factors considered were metabolic syndrome, body mass index, waist circumference, total cholesterol, and triglycerides. Multivariable logistic regression models were performed. Overall, 16.1% were classified as inactive and high sitting time. Compared to active participants with low sitting time, both inactive participants with low (OR: 1.51; 95% CI 1.10, 1.92) and high sitting time (1.66; 1.10, 2.22) had higher body mass index. Similar results were found for high waist circumference: inactive participants with low (1.57; 1.14, 2.00) and high sitting time (1.84; 1.25, 2.43). We found no combined association of physical activity and sitting time with metabolic syndrome, total cholesterol, and triglycerides. These findings may be useful to inform programs focused on obesity prevention in Chile.

Association of moderate and vigorous physical activity and relative muscle strength with neck circumference: a cross-sectional analysis of the Study of Health in Pomerode (SHIP-Brazil)

OBJECTIVE

Neck circumference is a simple anthropometric measurement that may be linked to chronic diseases, physical activity, and muscle strength. We sought to verify the association of moderate and vigorous physical activity levels and relative muscle strength with neck circumference in a community in southern Brazil.

METHODS

We cross-sectionally analyzed data from 2,488 participants (51% women), aged 20-79 years old from the Study of Health in Pomerode (SHIP-Brazil) conducted in Pomerode, Santa Catarina, Brazil. Increased neck circumference was defined with cutoff points of >39cm for men and >35cm for women. The independent variables were the level of moderate and vigorous physical activity using the short International Physical Activity Questionnaire, and relative muscle strength using the handgrip test and body mass. Univariate and multiple Poisson regression models were used to determine the association between variables (p≤0.05).

RESULTS

The prevalence of increased neck circumference was 48.2% (60.4% in men, 39.6% in women) and was associated with low relative muscle strength (PR=1.26, 95%CI: 1.17-1.35) in men, insufficient moderate and vigorous physical activity levels (PR=1.23, 95%CI: 1.14-1.32), and relative muscle strength (PR=1.73, 95%CI: 1.61-1.87) in women. After adjusting for covariates, no significant associations were observed between insufficient moderate and vigorous physical activity levels in men (PR=1.02, 95%CI: 0.95-1.07).

CONCLUSION

Increased neck circumference seems to be an important predictor of low moderate and vigorous physical activity and relative strength loss in adults, and more pronounced in women.

Extraordinary claims in the literature on high-intensity interval training (HIIT): III. Critical analysis of four foundational arguments from an interdisciplinary lens

Kinesiology aspires to be an integrated, interdisciplinary field that studies human movement from multiple perspectives. However, the main societal deliverables of the field, namely exercise prescriptions and physical activity recommendations, still reflect fragmentation, placing more emphasis on physiological outcomes than on behavioral and other considerations. Recently, researchers have called for the introduction of High-Intensity Interval Training (HIIT) to the domain of public health, based on the argument that HIIT can maximize fitness and health benefits for a fraction of the time recommended by the prevailing model of physical activity in public-health guidelines. Here, we show that an unintended side-effect of arguments underpinning the implementation of HIIT in the domain of public health might have been the exacerbation of segmentation. To highlight the value of interdisciplinarity, four foundational claims in support of HIIT are critiqued by tapping into cognate literatures: (1) the primary reason people do not exercise is lack of time, (2) HIIT is relevant to public health, (3) HIIT is being proposed as merely another option, so there is no basis for controversy, and (4) HIIT is safe and well tolerated. These claims are contradicted by credible lines of evidence. To improve the accuracy and effectiveness of its public claims, kinesiology should remain committed to the ideals of integration and interdisciplinarity.

Promoting physical activity-related health competence to increase leisure-time physical activity and health-related quality of life in German private sector office workers

BACKGROUND

Office workers (OWs) are at risk of low levels of health-enhancing physical activity (HEPA) and impaired health-related quality of life (HRQOL). Interventions based on physical activity-related health competence (PAHCO) aim to facilitate long-term changes in HEPA and HRQOL. However, these assumptions rely on the changeability and temporal stability of PAHCO and have not been tested empirically. This study therefore aims to test the changeability and temporal stability of PAHCO in OWs within an interventional design and to examine the effect of PAHCO on leisure-time PA and HRQOL.

METHODS

Three hundred twenty-eight OWs (34% female, 50.4 ± 6.4 years) completed an in-person, three-week workplace health promotion program (WHPP) focusing on PAHCO and HEPA. The primary outcome of PAHCO as well as the secondary outcomes of leisure-time PA and HRQOL were examined at four measurement points over the course of 18 months in a pre-post design by employing linear mixed model regressions.

RESULTS

PAHCO displayed a substantial increase from the baseline to the time point after completion of the WHPP (β = 0.44, p < 0.001). Furthermore, there was no decrease in PAHCO at the first (p = 0.14) and the second follow-up measurement (p = 0.56) compared with the level at the end of the WHPP. In addition, the PAHCO subscale of PA-specific self-regulation (PASR) had a small to moderate, positive effect on leisure-time PA (β = 0.18, p < 0.001) and HRQOL (β = 0.26, p < 0.001). The subscale of control competence for physical training (CCPT) also had a positive small to moderate effect on HRQOL (β = 0.22, p < 0.001).

CONCLUSION

The results substantiate PAHCO's theoretical characteristics of changeability and temporal stability, and underline the theoretically postulated effects on leisure-time PA and HRQOL. These findings highlight the potential of PAHCO for intervention development, which can be assumed to foster long-term improvements in HEPA and HRQOL in OWs.

TRIAL REGISTRATION

The study was retrospectively registered in the German Clinical Trials Register, which is an approved Primary Register in the WHO network, at the 14/10/2022 (DRKS00030514).

Physical Activity Is Associated With Macular Thickness: A Multi-Cohort Observational Study

Purpose

To assess the association between physical activity and spectral-domain optical coherence tomography (SD-OCT)-measured rates of macular thinning in an adult population with primary open-angle glaucoma.

Methods

The correlation between accelerometer-measured physical activity and rates of macular ganglion cell-inner plexiform layer (GCIPL) thinning was measured in 735 eyes from 388 participants of the Progression Risk of Glaucoma: RElevant SNPs with Significant Association (PROGRESSA) study. The association between accelerometer-measured physical activity and cross-sectional SD-OCT macular thickness was then assessed in 8862 eyes from 6152 participants available for analysis in the UK Biobank who had SD-OCT, ophthalmic, comorbidity, and demographic data.

Results

Greater physical activity was associated with slower rates of macular GCIPL thinning in the PROGRESSA study (beta = 0.07 µm/y/SD; 95% confidence interval [CI], 0.03-0.13; P = 0.003) after adjustment for ophthalmic, demographic and systemic predictors of macular thinning. This association persisted in subanalyses of participants characterized as glaucoma suspects (beta = 0.09 µm/y/SD; 95% CI, 0.03-0.15; P = 0.005). Participants in the upper tertile (greater than 10,524 steps/d) exhibited a 0.22-µm/y slower rate of macular GCIPL thinning than participants in the lower tertile (fewer than 6925 steps/d): -0.40 ± 0.46 µm/y versus -0.62 ± 0.55 µm/y (P = 0.003). Both time spent doing moderate/vigorous activity and mean daily active calories were positively correlated with rate of macular GCIPL thinning (moderate/vigorous activity: beta = 0.06 µm/y/SD; 95% CI, 0.01-0.105; P = 0.018; active calories: beta = 0.06 µm/y/SD; 95% CI, 0.006-0.114; P = 0.032). Analysis among 8862 eyes from the UK Biobank revealed a positive association between physical activity and cross-sectional total macular thickness (beta = 0.8 µm/SD; 95% CI, 0.47-1.14; P < 0.001).

Conclusions

These results highlight the potential neuroprotective benefits of exercise on the human retina.

Sedentary Behavior Patterns of the Hungarian Adult Population

BACKGROUND AND AIM

Nowadays, a high level of sedentary behavior (SB) is an important health issue. Many studies have focused on evaluating the physical activity (PA) level, while evaluation of SB has received less attention. The main goal of the present study is to describe the sedentary lifestyle of the Hungarian adult population and identify the vulnerable groups with high amount of sitting time and the patterns of SB. Another aim of this study is to compare the two types of questionnaires (International Physical Activity Questionnaire-IPAQ and Sedentary Behavior Questionnaire-SBQ) related to sitting time.

METHODS

This study analyzed cross-sectional primary data using self-reported questionnaires collected by a Hungarian research market company among the adult population in Hungary. The final sample of this study consisted of 1295 participants with a mean age of 45.9 years (SD = 15.2). Analysis of variance (ANOVA) test with post-hoc (Tukey) analysis were used to analyze the link between sitting time and socio-demographic variables (sex, age, BMI, settlement type, education level, marital status, work category, working hours, employment status, sport activity) and body mass index (BMI).

RESULTS AND CONCLUSIONS

According to the SBQ, on average, Hungarians sit for 469.53 min per day (7.81 h) on weekdays and 421.25 min per day (7.01 h) on weekends, which suggested a significant difference compared to IPAQ data: 287.82 min per day (4.79 h) on weekdays and 224.30 min per day (3.73 h) on weekends. Young people (aged between 18 and 29) were reported to have the highest average sitting time, i.e., 545 min per day (more than 9 h), and are showing the highest prevalence (53%) of sitting at least 480 min (8 h) per day. Sitting workers also had a high average sitting time, i.e., 514.82 min per day, and a high prevalence (49.3%) of sitting at least 480 min (8 h) per day. People who live in the capital city had higher sitting time, especially on working days. Men sat longer than woman, i.e., 19 min on working days and 45 min on weekends. The most frequent sedentary activities are: working on computer (126 min) on working days and watching TV (130 min) on weekends. Our results clearly show that the self-report single-item measure (IPAQ) significantly underestimates sedentary time compared to the multi-item questionnaire (SBQ). We identified vulnerable groups with high sitting times: men, young adults, inhabitants of the capital city and sitting workers. Consequently, these groups should be continuously surveyed, and requires specific interventions and strategies that particularly counteract the increased sitting time.

Validation of the SmartPlate for detecting food weight and type

This study determined accuracy (comparing to criterion), inter-plate reliability (comparing measures between two plates), and intra-plate reliability (comparing successive measures on one plate) of the SmartPlate for food weight and type. Food weight validation included comparing SmartPlate weights to criterion [reference] scale weights (1,980 measures) and weights of 188 foods (2,256 measures). Food type validation included assessing SmartPlate accuracy for 188 foods. For weight, mean absolute percent errors for accuracy, inter-plate reliability, and intra-plate reliability were 6.2, 7.4, and 4.9%, respectively. For food type, foods were correctly identified/listed or searchable 67.0 or 98.9% of the time, respectively, with 76.0% inter-plate reliability and 86.3% intra-plate reliability. The SmartPlate had acceptable accuracy and reliability for assessing food weight and type and may be appealing for monitoring dietary surveillance or intervention. Due to high intra-plate reliability, the SmartPlate may be especially useful for one-on-one interventions and assessing change over time.

Are the different cut-off points for sitting time associated with excess weight in adults? A population based study in Latin America

BACKGROUND

Excess weight is increasing worldwide, and in Latin America more than half of the population is excess weight. One of the reasons for this increase has been excessive sitting time. Still, it remains to be seen whether there is an excessive amount of that time in Latin American adults. This study aimed to associate different sitting time cut-off points with the excess weight.

METHODS

Data from the Latin American Study of Nutrition and Health (ELANS), a cross-sectional population-based survey conducted in eight Latin American countries, were used. The excess weight indicators used were body mass index, and waist and neck circumferences. Sitting time was obtained using questionnaires and categorized at different cut-off points. Differences between sitting time categories (< 4 or ≥ 4; < 6 or ≥ 6; and < 8 or ≥ 8 hours/day) and excess weight were obtained by Student's t test for independent samples and the association between sitting time categories and different indicators of excess weight were obtained by logistic regression.

RESULTS

The median of the sitting time was 420 min/day (IQR: 240-600). There were no significant differences between body mass index (kg/m2) and waist circumference (cm) with categories of sitting time. The mean values of neck circumference (cm) were significantly higher in ≥4, ≥6 and ≥ 8 hours/day than < 4, < 6, and < 8 hours/day of sitting time in the pooled sample. Some distinct differences by country were observed. There were significant differences among excess weight by body mass index (63.2% versus 60.8) with < 8 vs ≥8 hours/day of sitting time. The proportion of excess weight by neck circumference was higher in participants who reported ≥4, ≥6, and ≥ 8 hours/day compared to < 4, < 6, and < 8 hours/day of sitting time. Considering ≥8 hours/day of sitting time, higher odds of excess weight were found evaluated by body mass index (OR: 1.10; 95% CI: 1.01, 1.20) and neck circumference (OR: 1.13; CI 95%: 1.03, 1.24) overall.

CONCLUSIONS

Sitting time above 8 hours/day was associated with higher odds of excess weight, even though there were no differences in waist circumference between sitting time categories.

TRIAL REGISTRATION

Clinical Trials NCT02226627. (27/08/2014).

Associations of objectively measured movement behavior and cardiorespiratory fitness with mental health and quality of life in older adults with hypertension: an exploratory analysis during the COVID-19 pandemic

Objectives: Herein, we explored the associations of pre-pandemic COVID-19 physical activity (PA), sedentary behavior (SB) and cardiorespiratory fitness (CRF) with mental health and quality of life in older adults with hypertension.Method: Objectively measured PA and SB, perceived stress, depression symptoms, and quality of life were assessed before and during the pandemic in seventeen older adults with hypertension. CRF was assessed before the pandemic by cardiopulmonary exercise testing. Longitudinal and cross-sectional associations were analyzed using the mixed linear model.Results: Pre-pandemic light PA (positive association) and SB (negative association) were associated with quality of life during the pandemic. Higher pre-pandemic CRF was associated with less negative changes in perceived stress, depression symptoms, and quality of life during the pandemic.Conclusion: Our preliminary findings suggest that a healthier pre-pandemic movement behavior (more PA, less SB) and better CRF can mitigate the negative impact of the COVID-19 pandemic on mental health and quality of life in older adults with hypertension.

Meeting 24-h movement guidelines and markers of adiposity in adults from eight Latin America countries: the ELANS study

This study aimed to compare compliance with 24-h movement guidelines across countries and examine the associations with markers of adiposity in adults from eight Latin American countries. The sample consisted of 2338 adults aged 18-65 years. Moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) data were objectively measured using accelerometers. Sleep duration was self-reported using a daily log. Body mass index and waist circumference were assessed as markers of adiposity. Meeting the 24-h movement guidelines was defined as ≥ 150 min/week of MVPA; ≤ 8 h/day of SB; and between 7 and 9 h/day of sleep. The number of guidelines being met was 0.90 (95% CI 0.86, 0.93) with higher value in men than women. We found differences between countries. Meeting two and three movement guidelines was associated with overweight/obesity (OR: 0.75, 95% CI 0.58, 0.97 and OR: 0.69, 95% CI 0.51, 0.85, respectively) and high waist circumference (OR: 0.74, 95% CI 0.56, 0.97 and OR: 0.77, 95% CI 0.62, 0.96). Meeting MVPA and SB recommendations were related to reduced adiposity markers but only in men. Future research is needed to gain insights into the directionality of the associations between 24-h movement guidelines compliance and markers of adiposity but also the mechanisms underlying explaining differences between men and women.

A Web-Based, Time-Use App To Assess Children's Movement Behaviors: Validation Study of My E-Diary for Activities and Lifestyle (MEDAL)

BACKGROUND

Existing modes of collecting self-reported 24-hour movement information from children, including digital assessments, have not been demonstrated to be of acceptable validity when compared to objective measurements. My E-Diary for Activities and Lifestyle (MEDAL) is an interactive web-based diary developed to collect time-use information from children aged 10 years and older.

OBJECTIVE

This study evaluated the validity of MEDAL for assessing children's movement behaviors by comparing self-reported and accelerometer-measured time spent in movement behavior among children in Singapore aged 10-11 years.

METHODS

Funding for this study was obtained in October 2017, and data were collected between April and August 2020. Participants recorded their daily activities using MEDAL over 2 specified weekdays and 2 weekend days and wore an Actigraph accelerometer on their nondominant wrist throughout the study to objectively assess movement behaviors. Spearman correlation coefficient and intraclass correlation coefficient (ICC) were used to compare the accelerometer measurements and self-reports for each movement behavior. Bland-Altman plots were generated to investigate trends of bias in the self-reports.

RESULTS

Among the participants aged 10-11 years (29/49, 59% boys), we observed that children reported lower light physical activity (LPA) and higher moderate-to-vigorous physical activity (MVPA), inactivity, and night sleep than that measured by the accelerometer. There was a moderate-to-strong correlation between self-reported and accelerometer-measured MVPA (r=0.37; 95% CI 0.20-0.54), inactivity (r=0.36; 95% CI 0.18-0.54), and night sleep (r=0.58; 95% CI 0.43-0.74); the correlation for LPA was poor (r=0.19; 95% CI 0.02-0.36). Agreement was poor for all behaviors (MVPA: ICC=0.24, 95% CI 0.07-0.40; LPA: ICC=0.19, 95% CI 0.01-0.36; inactivity: ICC=0.29, 95% CI 0.11-0.44; night sleep: ICC=0.45, 95% CI 0.29-0.58). There was stronger correlation and agreement on weekdays for inactivity and night sleep; conversely, there was stronger correlation and agreement for MVPA and LPA on weekend days. Finally, based on Bland-Altman plots, we observed that with increasing MVPA, children tended to report higher MVPA than that measured by the accelerometer. There were no clear trends for the other behaviors.

CONCLUSIONS

MEDAL may be used to assess the movement behaviors of children. Based on self-reports, the children are able to estimate their time spent in MVPA, inactivity, and night sleep although actual time spent in these behaviors may differ from accelerometer-derived estimates; self-reported LPA warrant cautious interpretation. Observable differences in reporting accuracy exist between weekdays and weekend days.

mHealth Interventions to Reduce Physical Inactivity and Sedentary Behavior in Children and Adolescents: Systematic Review and Meta-analysis of Randomized Controlled Trials

Background

Children and adolescents increasingly do not meet physical activity (PA) recommendations. Hence, insufficient PA (IPA) and sedentary behavior (SB) among children and adolescents are relevant behavior change domains for using individualized mobile health (mHealth) interventions.

Objective

This review and meta-analysis investigated the effectiveness of mHealth interventions on IPA and SB, with a special focus on the age and level of individualization.

Methods

PubMed, Scopus, Web of Science, SPORTDiscus, and Cochrane Library were searched for randomized controlled trials published between January 2000 and March 2021. mHealth interventions for primary prevention in children and adolescents addressing behavior change related to IPA and SB were included. Included studies were compared for content characteristics and methodological quality and summarized narratively. In addition, a meta-analysis with a subsequent exploratory meta-regression examining the moderating effects of age and individualization on overall effectiveness was performed.

Results

On the basis of the inclusion criteria, 1.3% (11/828) of the preliminary identified studies were included in the qualitative synthesis, and 1.2% (10/828) were included in the meta-analysis. Trials included a total of 1515 participants (mean age (11.69, SD 0.788 years; 65% male and 35% female) self-reported (3/11, 27%) or device-measured (8/11, 73%) health data on the duration of SB and IPA for an average of 9.3 (SD 5.6) weeks. Studies with high levels of individualization significantly decreased insufficient PA levels (Cohen d=0.33; 95% CI 0.08-0.58; Z=2.55; P=.01), whereas those with low levels of individualization (Cohen d=−0.06; 95% CI −0.32 to 0.20; Z=0.48; P=.63) or targeting SB (Cohen d=−0.11; 95% CI −0.01 to 0.23; Z=1.73; P=.08) indicated no overall significant effect. The heterogeneity of the studies was moderate to low, and significant subgroup differences were found between trials with high and low levels of individualization (χ21=4.0; P=.04; I2=75.2%). Age as a moderator variable showed a small effect; however, the results were not significant, which might have been because of being underpowered.

Conclusions

Evidence suggests that mHealth interventions for children and adolescents can foster moderate reductions in IPA but not SB. Moreover, individualized mHealth interventions to reduce IPA seem to be more effective for adolescents than for children. Although, to date, only a few mHealth studies have addressed inactive and sedentary young people, and their quality of evidence is moderate, these findings indicate the relevance of individualization on the one hand and the difficulties in reducing SB using mHealth interventions on the other.

Trial Registration

PROSPERO CRD42020209417; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=209417

Relationship between socio-demographic correlates and human development index with physical activity and sedentary time in a cross-sectional multicenter study

BACKGROUND

Socio-demographic correlates and human development index (HDI) are associated with self-reported physical activity, but only a few studies have focused on device-measured physical activity and sedentary time in Latin America. We examined the relationship between socio-demographic correlates and HDI with physical activity and sedentary time in a cross-sectional study.

METHODS

We based our analyses on 2522 (53.1% women; 18-65 years [mean age 38.3 years]) adults drawn from the eight Latin America countries. Physical activity (light, moderate, vigorous, and moderate-to-vigorous intensity and steps) and sedentary time were assessed using Actigraph GT3X + accelerometers. Sex, age, and race/ethnicity were self-reported. The HDI country information was obtained from the United Nations Development Program.

RESULTS

For the age, ethnicity, vigorous physical activity and steps/day, there were significant differences between high and very high HDI countries. Women and younger age presented lower sedentary time than men and older. In moderate-to-vigorous physical activity, we found lower duration in women (-13.4 min/week), younger age (-0.1 min/week), and white/caucasian (-2.7 min/week) than men, older ages and mixed ethnicity. Women (-1266.5 steps/week) and very high HDI (-847.3 steps/week) presented lower steps than men and high HDI. Black (2853.9 steps/week), other (1785.4 steps/week), and white/caucasian ethnicity (660.6 steps/week) showed higher steps than mixed ethnicity.

CONCLUSIONS

Different socio-demographic correlates are associated with physical activity intensity; however, HDI is associated with vigorous physical activity and steps in the Latin American region, which can in turn guide policies to promote physical activity in the region.

TRIAL REGISTRATION

ClinicalTrials.Gov NCT02226627 . Retrospectively registered on August 27, 2014.

Perceived Urban Environment Attributes and Device-Measured Physical Activity in Latin America: An 8-Nation Study

INTRODUCTION

Attributes of the neighborhood-built environment are associated with self-reported physical activity, but only a few studies have concentrated on device-measured physical activity in Latin America. This study examines the associations of perceived neighborhood-built environment attributes, device-measured sedentary time, and light-intensity and moderate-to-vigorous physical activity in adults from 8 Latin American countries.

METHODS

Data from Estudio Latinoamericano de Nutrición y Salud adult study, an observational multicountry study (N=2,478), were analyzed in 2020. Data were collected between 2014 and 2015. Perceived neighborhood-built environment attributes were measured using the Neighbourhood Environment Walkability Survey. Sedentary time, light-intensity physical activity, and moderate-to-vigorous physical activity data were collected using accelerometers.

RESULTS

No associations between perceived neighborhood-built environment attributes and sedentary time were found. Positive perceptions of walking/cycling facilities (β=6.50, 95% CI=2.12, 10.39) were associated with more light-intensity physical activity. Perceptions of better aesthetics (Argentina) and better walking/cycling facilities (Brazil and Ecuador) were positively associated with light-intensity physical activity. Land use mix-diversity (β=0.14, 95% CI=0.03, 0.25), walking/cycling facilities (β=0.16, 95% CI=0.05, 0.27), aesthetics (β=0.16, 95% CI=0.02, 0.30), and safety from traffic (β=0.18, 95% CI=0.05, 0.24) were positively associated with moderate-to-vigorous physical activity. Land use mix-diversity, street connectivity, and safety from traffic were positively associated with moderate-to-vigorous physical activity in Venezuela.

CONCLUSIONS

These findings have implications for policy recommendations, which can guide policies to promote physical activity in the region. Land use mix-diversity, walking/cycling facilities, aesthetics, and safety from traffic can maintain or increase the levels of light-intensity and moderate-to-vigorous physical activity among Latin American adults.

Prevalence and sociodemographic correlates of meeting the Canadian 24-hour movement guidelines among latin american adults: a multi-national cross-sectional study

BACKGROUND

24-hour movement behaviors, including moderate-to-vigorous physical activity (MVPA), sedentary time (ST), and sleep duration, have important implications for health across the lifespan. However, no studies exist that have examined the integration of these 24-hour movement behaviors in Latin America. The purpose of this study was to examine the prevalence of meeting the Canadian 24-Hour Movement Guideline recommendations and sociodemographic correlates of meeting the guidelines in adults from eight Latin American countries.

METHODS

This was a multi-national cross-sectional study of 2338 adults aged 18 to 64 years from the Latin American Study of Nutrition and Health. MVPA and ST data were collected using accelerometers. Sleep duration was self-reported using a daily log. Socio-demographic correlates included sex, age, education level, and marital status. Meeting the 24-hour movement guidelines was defined as: ≥150 min/week of MVPA; ≤8 h/day of ST; and between 7 and 9 h/day of sleep. Logistic regression models were estimated on pooled data.

RESULTS

The prevalence of adults who met the MVPA, ST, sleep duration, and integrated recommendations was 48.3, 22.0, 19.4, and 1.6%, respectively. Overall, being a woman (OR: 0.72; 95%CI: 0.55,0.93) and having a middle (0.63; 0.47,0.85) or high education level (0.31; 0.17,0.56) was associated with lower odds of meeting all three of the 24-hour movement guideline recommendations. Being married (1.70; 1.25,2.29) was associated with greater odds of meeting all three recommendations. Being a woman (0.46; 0.39,0.55), aged 50-64 years (0.77; 0.60,0.97), and married (0.79; 0.65,0.96) were associated with lower odds of meeting the MVPA recommendation. Having a middle (0.64; 0.50,0.80) or high (0.36; 0.23,0.55) education level was associated with lower odds and being married (1.86; 1.46,2.36) was associated with greater odds of meeting the ST recommendation. Being a woman (0.63; 0.51,0.78) was associated with lower odds; whereas being aged 50-64 years (1.40; 1.04,1.88) and having a middle education level (1.37; 1.09,1.73) were associated with greater odds of meeting the sleep duration recommendation.

CONCLUSIONS

Overall, the proportion of Latin American adults achieving healthy levels of 24-hour movement behaviors was low. Further efforts are needed to promote more MVPA, less ST, and sufficient sleep in Latin American adults.

TRIAL REGISTRATION

Clinical Trials NCT02226627 . Retrospectively registered on August 27, 2014.

Leisure-Time and Transport-Related Physical Activity and the Risk of Mortality: The CRONICAS Cohort Study

BACKGROUND

The long-term health association of the leisure-time and transport-related physical activity domains of the International Physical Activity Questionnaire have not been established in Latin American settings. The authors aimed to quantify the 7-year all-cause mortality risk associated with levels of leisure-time and transport-related physical activity.

METHODS

Ongoing prospective cohort study conducted in 4 sites in Peru. People ≥35 years were randomly selected from the general population in each study site. The exposures were leisure-time and transport-related physical activity (International Physical Activity Questionnaire) at baseline. The outcome was all-cause mortality based on information retrieved from national records. Cox regression and sensitivity analyses were conducted.

RESULTS

There were 3601 people (mean age 55.8 y, 51.5% women). Greater levels of physical activity were associated with lower risk of all-cause mortality, an observation confirmed in sensitivity analyses. Compared with those with low levels of physical activity, leisure-time (≥500 metabolic equivalent of task minutes per week) and transport-related (500-1499 and ≥1500 metabolic equivalent of task minutes per week) physical activity were associated with 70% (95% confidence interval, 3%-90%), 43% (95% confidence interval, 18%-61%), and 42% (95% confidence interval, 8%-63%) lower all-cause mortality, respectively.

CONCLUSIONS

Greater levels of leisure-time and transport-related physical activity were associated with a strong reduction in the risk of all-cause mortality across different geographical sites.

The influence of a supervised group exercise intervention combined with active lifestyle recommendations on breast cancer survivors' health, physical functioning, and quality of life indices: study protocol for a randomized and controlled trial

Background

Most cancer patients, under active treatment or not, are sedentary, despite increasing scientific and clinical understanding of the benefits of exercise and physical activity, such as improving quality of life, limiting disease symptoms, decreasing cancer recurrence, and increasing overall survival. Studies have shown that both supervised exercise and unsupervised physical activity programs have low adherence and limited long-term benefits among cancer survivors. Therefore, interventions focused on increasing physical activity levels have clinical and psychological relevance. The present study will examine the feasibility and efficacy of an intervention that combines supervised group exercise with active lifestyle recommendations, analyzing its clinical, psychological, physiological, functional, and immunological effects in breast cancer survivors.

Methods

Women aged 35–75 years who have completed chemotherapy, radiotherapy, and surgery for breast cancer will be recruited from the Cancer Institute of the State of Sao Paulo (ICESP) and take part in a 16-week, parallel-group, randomized, and controlled trial. They will receive a booklet with recommendations for achieving a physically active lifestyle by increasing overall daily movement and undertaking at least 150 min/week of structured exercise. Then, they will be randomized into two groups: the supervised group will take part in two canoeing group exercise sessions every week, and the unsupervised group will increase their overall physical activity level by any means, such as active commuting, daily activities, or home-based exercise. Primary outcome includes aerobic capacity. Secondary outcomes are physical activity, physical functioning, self-reported quality of life, fatigue, presence of lymphedema, body composition, immune function, adherence to physical activity guidelines, and perceptions of self-image.

Discussion

Results should contribute to advance knowledge on the impact of a supervised group exercise intervention to improve aspects related to health, physical functioning, and quality of life in female breast cancer survivors.

Trial registration

Brazilian Registry of Clinical Trials Number: RBR-3fw9xf. Retrospectively Registered on 27 December 2018. Items from the World Health Organization Trial Registration Data Set can be accessed on http://www.ensaiosclinicos.gov.br/rg/RBR-3fw9xf/.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-021-05843-z.

Free-Living Physical Activity Measured With a Wearable Device Is Associated With Larger Hippocampus Volume and Greater Functional Connectivity in Healthy Older Adults: An Observational, Cross-Sectional Study in Northern Portugal

Several studies using neuroimaging techniques have established a positive relationship between physical activity (PA) and brain structure and function in older populations. However, the use of subjective measures of PA and the lack of multimodal neuroimaging approaches have limited the understanding of this association. This study aims to explore the associations between PA and brain structure and function by objectively evaluating PA. Community-dwelling cognitively healthy older adults (without diagnosed cognitive, neurological or degenerative disease) were recruited from local health centers and local gyms. In a cross-sectional design, participants were evaluated regarding cognitive, clinical, anthropometric, physical performance, and lifestyle characteristics. A 3 T magnetic resonance imaging (MRI) was performed for structural and functional brain measures. PA time and level was assessed via a Xiaomi Mi Band 2^® worn for 15 consecutive days. Participants (n = 110, after inclusion/exclusion criteria and completion of all evaluations) were 58 females (56%), with an average age of 68.42 years old (SD = 3.12), most were active. Multiple regression analysis revealed that higher time spent in vigorous PA associated with larger left parahippocampal gyrus and right hippocampus volumes. Furthermore, the analysis of the functional connectome indicated a greater functional connectivity (FC) between the frontal gyrus, cingulate gyrus, occipital inferior lobe for light, moderate, and total PA time, and sedentary time associated with lower FC in the same networks. Overall, the structural and functional findings may provide evidence on the relevant association between PA and brain health in aging.

Association between Active Transportation and Public Transport with an Objectively Measured Meeting of Moderate-to-Vigorous Physical Activity and Daily Steps Guidelines in Adults by Sex from Eight Latin American Countries

This study aimed to examine the associations between active transportation and public transport and the objectively measured meeting of moderate-to-vigorous physical activity (MVPA) and steps per day guidelines in adults by sex from eight Latin American countries. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants aged 18-65 years. MVPA and steps per day were evaluated using Actigraph GT3X accelerometers. The mode of transportation, its frequency and duration were collected using a self-reported questionnaire. The average time dedicated to active transportation was 12.8 min/day in men (IQR: 2.8-30.0) and 12.9 min/day in women (IQR: 4.3-25.7). A logistic regression analysis was conducted, showing that active transportation (≥10 min) was associated with higher odds of meeting MVPA guidelines (men: OR: 2.01; 95%CI: 1.58-2.54; women: OR: 1.57; 95%CI: 1.25-1.96). These results show a greater association when considering active transportation plus public transport (men: OR: 2.98; 95%CI: 2.31-3.91; women: OR: 1.82; 95%CI: 1.45-2.29). Active transportation plus public transport was positively associated with meeting steps per day guidelines only in men (OR: 1.55; 95%CI: 1.15-2.10). This study supports the suggestion that active transportation plus public transport is significantly associated with meeting the MVPA and daily steps recommendations.

Determinants of Physical Activity at 90 Days After Acute Stroke or Transient Ischemic Attack in Patients With Home Discharge: A Pilot Study

The aim was to identify the barriers to achieving premorbid physical activity in patients with home discharge after acute minor stroke or transient ischemic attack. Fifty-six patients (median age, 72 years) were analyzed. We assessed total physical activity in the premorbid condition and at 90 days after onset using the International Physical Activity Questionnaire. The patients were divided into two groups according to changes in total physical activity until 90 days after onset: decreased activity (n = 16) and nondecreased activity (n = 40) groups. Outcome measures were examined at discharge. The decreased activity group took significantly longer to perform the timed up and go test (median, 7.19 vs. 6.52 s) and contained more apathetic patients (44% vs. 15%). Apathy at discharge (relative risk 6.05, 95% confidence interval [1.33, 27.6]) was a significant determinant of decreased physical activity. Apathy is a barrier to the restoration of premorbid physical activity in stroke survivors.

Physical activity and sedentary behavior as multimorbidity discriminators among elderly Brazilians: a cross-sectional study

BACKGROUND

Associations between behaviors and individual chronic diseases have been demonstrated. However, the relationship between time spent on sedentary behavior and multimorbidity remains less clear.

OBJECTIVE

To identify the predictive power of various intensities of physical activity versus sedentary behavior, as discriminatory factors for cardiometabolic multimorbidity (cardiovascular diseases and diabetes) in the elderly.

DESIGN AND SETTING

Cross-sectional study in different residential census tracts and residential households in Florianópolis (SC).

METHODS

The participants were 425 elderly people (65% women) from the EpiFloripa Aging study in 2014. Sociodemographic variables and self-reported incidence of cardiovascular diseases and diabetes were obtained via a questionnaire. Light physical activity (LPA), moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) were measured using accelerometers. The analyses were stratified according to sex and included a diagnosis for interpretation. Behaviors were taken into consideration if their predictive power in terms of area under the receiver operating characteristic (ROC) curve was greater than 0.50. The time cutoff point was defined from sensitivity and specificity.

RESULTS

For older adult men with diabetes, the predictive value of MVPA for absence of multi-morbidity was an area of 0.75 (95% confidence interval, CI: 0.538-0.962), and a cutoff of 17 minutes per day. Older adult women with diabetes had an area of 0.71 (95% CI: 0.524-0.866) and a cutoff of 10 minutes per day. LPA and SB did not present predictive values.

CONCLUSION

The time spent on MVPA is a predictor of absence of multimorbidity in elderly people with diabetes, for both sexes.

A Comparison of Associations Between Self-Reported and Device-Based Sedentary Behavior and Obesity Markers in Adults: A Multi-National Cross-Sectional Study

The purpose of this study was to examine the associations between self-reported and device-based measures of sedentary behavior (SB) with obesity markers in adults from Latin American countries. Sitting time and total time spent in different SBs were self-reported using two different questionnaires. Accelerometers were used to assess total sedentary time. Body mass index, waist, and neck circumferences were assessed. The highest self-reported sitting time was in Argentina, the highest total time spent in different SBs was in Brazil and Costa Rica, and the highest device-based sedentary time was observed in Peru. Neither self-reported sitting time, total time spent in different SBs or device-based sedentary time were associated with body mass index. Device-based sedentary time was positively associated with waist circumference and self-reported sitting time was positively associated with neck circumference. Caution is warranted when comparing the associations of self-reported and device-based assessments of SB with anthropometric variables.

Accelerometer-Measured Daily Step Counts and Adiposity Indicators among Latin American Adults: A Multi-Country Study

The aim of the present study was to examine the sex-related associations between accelerometer-measured daily step counts and adiposity indicators in adults from eight Latin American countries. We analyzed data from 2524 adults (aged 18–65 years) from the Latin American Study of Nutrition and Health. Device-measured daily step counts were measured by accelerometers (ActiGraph GT3X). The outcomes were body mass index (BMI; (kg/m2), waist and neck circumference (in cm). Overall, the mean of daily steps counts, BMI, waist and neck circumference were 10699.8, 27.3, 89.6, and 35.8. Weak and negative associations were observed between daily steps counts and BMI (r = −0.17; p < 0.05) and waist circumference (r = −0.16; p < 0.05); however, step counts was not associated with neck circumference. Daily steps counts were negatively associated with BMI (β: −0.054; 95%CI: −0.077; −0.012) and waist circumference (−0.098; −0.165; −0.030) independently of age and socioeconomic level. In men, there were significant negative associations between daily steps counts with BMI (−0.075; −0.119; −0.031) and waist circumference (−0.140; −0.233; −0.048), and in women, there was no significant association with either of the body composition indicators. The findings from this study need to be examined in prospective settings that use device-measured from Latin America.

Device-Measured and Self-Reported Active Travel Associations with Cardiovascular Disease Risk Factors in an Ethnically Diverse Sample of Adults

Active travel (AT) provides an opportunity to alleviate the physical inactivity and climate crises contributing to the global chronic disease burden, including cardiovascular diseases (CVD). Though AT shows promising links to reduced CVD risk, prior studies relied on self-reported AT assessment. In the present study, device-measured and self-reported AT were compared across population subgroups and relationships with CVD risk biomarkers were evaluated for both measures. The study recruited an ethnically diverse sample (N = 602, mean age 59 years, 42% Hispanic/Latino ethnicity) from neighborhoods that varied by walkability and food access. AT was assessed using concurrently collected accelerometer and GPS data and self-report data from a validated survey. Relationships with body mass index (BMI), triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure (BP), and moderate-to-vigorous physical activity (MVPA) were modeled using multivariable linear regression. Devices captured more AT than did self-report. We found differences in AT measures by population subgroups, including race, ethnicity, education, income, vehicle access, and walkability. Men had more accelerometer-measured MVPA, though women self-reported more daily minutes. Both device and survey AT measures were positively associated with total accelerometer-measured MVPA, though the relationship was stronger with device-measured AT. Device-measured AT was associated with lower BMI. No other CVD risk biomarker was associated with either AT measure. No effect modification by Hispanic/Latino ethnicity was detected. Further studies with device-based measures are warranted to better understand the relationship between AT and cardiovascular health.

Analysis of Hearing Loss and Physical Activity Among US Adults Aged 60-69 Years

IMPORTANCE

Hearing loss may be a modifiable factor associated with decreased physical activity in older adults.

OBJECTIVE

To examine the association of hearing loss with objectively measured physical activity, including moderate-to-vigorous physical activity, light-intensity physical activity, sedentary behavior, and pattern of physical activity (physical activity fragmentation).

DESIGN, SETTING, AND PARTICIPANTS

This population-based cross-sectional study used National Health and Nutrition Examination Survey (NHANES) data collected in the 2003 to 2004 cycle and analyzed in 2017 to 2020. Participants aged 60 to 69 years with complete audiometry, physical activity, and comorbidity data were included in the analysis. Data analysis was performed from January 2017 to December 2020.

EXPOSURES

Hearing defined by the pure tone average (PTA; range, 0.5-4 kHz) in the better ear, with normal PTA defined as less than 25 dB hearing loss, mild hearing loss defined as PTA 25 to less than 40 dB hearing loss, and moderate or greater hearing loss defined as a PTA greater than or equal to 40 dB hearing loss.

MAIN OUTCOMES AND MEASURES

The primary outcomes were comprehensive metrics of objectively measured physical activity, including time spent in moderate-to-vigorous physical activity, light-intensity physical activity, and sedentary behavior, and physical activity fragmentation. Linear regression was used to model the association between hearing loss and physical activity.

RESULTS

Of the 291 participants (mean [SD] age, 64.53 [2.96] years), 139 (47.8%) were male, 48 (16.5%) had mild hearing loss, and 22 (7.6%) had moderate or greater hearing loss. After adjusting for age, sex, education, race/ethnicity, and comorbidities, hearing loss (vs normal hearing) was significantly associated with less time spent in moderate-to-vigorous physical activity by 5.53 minutes per day (95% CI, -10.15 to -0.90 minutes per day), less time spent in light-intensity physical activity by 28.55 minutes per day (95% CI, -53.07 to -4.02 minutes per day), more time spent in sedentary behaviors by 34.07 minutes per day (95% CI, 8.32 to 59.82 minutes per day), and more fragmented physical activity pattern by 0.38 SD higher in active-to-sedentary transition probability (95% CI, to 0.10 to 0.65). The magnitude of the association of hearing loss (vs normal hearing) with physical activity metrics was equivalent to 7.28 years (95% CI, 3.19 to 11.37 years) of accelerated age for moderate-to-vigorous physical activity, 5.84 years (95% CI, 1.45 to 10.23 years) of accelerated age for light-intensity physical activity, and 10.53 years (95% CI, 2.89 to 18.16 years) of accelerated age for degree of physical activity fragmentation.

CONCLUSIONS AND RELEVANCE

These findings suggest that hearing loss is associated with a worse physical activity profile. Whether interventions to address hearing loss in adults could improve physical activity profiles will require further study.

Association between Self-Reported and Accelerometer-Based Estimates of Physical Activity in Portuguese Older Adults

Accurate assessment of physical activity (PA) is crucial in interventions promoting it and in studies exploring its association with health status. Currently, there is a wide range of assessment tools available, including subjective and objective measures. This study compared accelerometer-based estimates of PA with self-report PA data in older adults. Additionally, the associations between PA and health outcomes and PA profiles were analyzed. Participants (n = 110) wore a Xiaomi Mi Band 2^® for fifteen consecutive days. Self-reported PA was assessed using the International Physical Activity Questionnaire (IPAQ) and the Yale Physical Activity Survey (YPAS). The Spearman correlation coefficient was used to compare self-reported and accelerometer-measured PA and associations between PA and health. Bland–Altman plots were performed to assess the agreement between methods. Results highlight a large variation between self-reported and Xiaomi Mi Band 2^® estimates, with poor general agreement. The highest difference was found for sedentary time. Low positive correlations were observed for IPAQ estimates (sedentary, vigorous, and total PA) and moderate for YPAS vigorous estimates. Finally, self-reported and objectively measured PA associated differently with health outcomes. Summarily, although accelerometry has the advantage of being an accurate method, self-report questionnaires could provide valuable information about the context of the activity.

Agreement Between Self-Reported and Device-Based Sedentary Time among Eight Countries: Findings from the ELANS

The purpose of this study was to analyze the agreement between self-reported and device-based sedentary time among eight countries in Latin America. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants (18-65 years) across eight countries. Participants reported time spent sedentary in different activities (computer use at home, videogame use, reading, sitting down to chat with friends/relatives or listening to music, speaking on the phone, watching TV, and riding in a car). Overall sitting time was assessed using a single item from the International Physical Activity Questionnaire (IPAQ). Device-based sedentary time was assessed using Actigraph GT3X accelerometers. Self-reported overall sitting time (227.1 min/day) produced the lowest values of the three assessment methods, followed by self-reported sum of different types of sedentary behavior (364.1 min/day) and device-based sedentary time (568.6 min/day). Overall, correlation coefficients and ICC varied from weak to moderate (rho: 0.25-0.39; ICC: 0.21:0.39) between self-reported sum of different types of sedentary behavior, self-reported overall sitting time, and device-based sedentary time. The Bland-Altman plots indicated low to moderate agreement between self-reported overall sitting time and device-based sedentary time by sex. Self-report measures underestimate sedentary behavior and overall sitting time when compared with device-based measures. The weak and moderate level of agreement between methods indicates that caution is required when comparing associations between different self-report and device-based measures of sedentary behavior with health outcomes.

Associations of Physical Activity and Sedentary Behaviour Assessed by Accelerometer with Body Composition among Children and Adolescents: A Scoping Review

The possible adverse health effects of reduced physical activity (PA) on children and adolescents have been extensively documented as a result of the global obesity epidemic. However, the research has sometimes led to controversial results, due to the different methods used for the assessment of PA. The main aim of this review was to evaluate the association between PA and body composition parameters based on quantitative PA studies using the same equipment (Actigraph accelerometer) and cutoffs (Evenson’s). A literature review was undertaken using PUBMED and Scopus databases. Subjects aged 6–15 were considered separately by sex. Weighted multiple regression analyses were conducted. From the analysis of fourteen selected articles, it emerged that 35.7% did not evaluate the association of sedentary time (ST) and moderate-to-vigorous physical activity (MVPA) with body composition, while the remaining 64.3% found a negative association of MVPA with BMI and fat mass with different trends according to sex. Furthermore, only 7.1% of these studies identified a positive association between ST and fat percentage. Based on the regression analyses conducted on the literature data, ST and MVPA were found to be significant predictors of body composition parameters, in addition to age and sex. Further studies using standardized methodologies to assess PA and body composition are needed. The inclusion of sex-disaggregated data may also be crucial to understand this phenomenon and to provide stronger evidence of the determinants of body composition in order to prevent the risk of obesity.

Active Transportation and Obesity Indicators in Adults from Latin America: ELANS Multi-Country Study

PURPOSE

The aim of this study was to determine the association between active transportation and obesity indicators in adults from eight Latin American countries.

METHODS

Data from the ELANS study, an observational multi-country study (n: 8336; 18-65 years), were used. Active transportation (walking and cycling) and leisure time physical activity was assessed using the International Physical Activity Questionnaire (long version). The obesity indicators considered were: body mass index, and waist and neck circumference.

RESULTS

In the total sample, the average time dedicated to active transportation was 24.3 min/day, with the highest amount of active transportation being Costa Rica (33.5 min/day), and the lowest being Venezuela (15.7 min/day). The countries with the highest proportion of active transportation were Ecuador (71.9%), and the lowest was Venezuela (40.5%). Results from linear regression analyses suggest that active transportation was significantly and independently associated with a lower body mass index (β: -0.033; 95% CI: -0.064; -0.002), but not with waist circumference (β: -0.037; 95% CI: -1.126; 0.390 and neck circumference (β: -0.007; 95% CI: -0.269; 0.130).

CONCLUSIONS

Active transportation is significantly associated with a lower body mass index. Governments should incentivize this type of transportation as it could help to reduce the obesity pandemic in Latin America.

Socio-Demographic Correlates of Total and Domain-Specific Sedentary Behavior in Latin America: A Population-Based Study

Purpose: The aim of this study was to identify socio-demographic correlates of total and domain-specific sedentary behavior (SB). Methods: Cross-sectional findings are based on 9218 participants (15–65 years) from the Latin American Study of Nutrition and Health. Data were collected between September 2014 and February 2015. Participants reported time spent in SB across specific domains. Sex, age, ethnicity, socioeconomic (SEL), and education level were used as sociodemographic indicators. Results: Participants spent a total of 373.3 min/day engaged in total SB. Men, younger adults, other ethnicities, higher SEL and educational level presented higher total SB when compared with women, older adults, white/Caucasian, and low SEL and educational level. Men spent more time on the playing videogames (b: 32.8: 95% CI: 14.6;51.1) and riding in an automobile (40.5: 31.3; 49.8). Computer time, reading, socializing or listening to music was higher in younger participants (<30 years) compared with those ≥50 years in the total sample. Compared to the low SEL and educational level groups, middle (11.7: 5.7; 17.6) and higher (15.1: 5.3; 24.9) SEL groups as well as middle (9.8: 3.6; 15.9) and higher (16.6: 6.5; 26.8) education level groups reported more time spent reading. Conclusion: Socio-demographic characteristics are associated with SB patterns (total and specific) across Latin American countries.