COVID-19 pandemic-induced physical inactivity: the necessity of updating the Global Action Plan on Physical Activity 2018-2030

Stair-climbing interventions on cardio-metabolic outcomes in adults: A scoping review

Objective

Physical inactivity is linked with high chronic disease risk; however, only a fraction of the global population meets the recommendations for physical activity. Stair-climbing is a simple and accessible form of physical activity that has been shown to improve cardio-metabolic outcomes in adults. The present scoping review explores the physiological and therapeutic effects of stair-climbing interventions on adult cardio-metabolic disease risk factors.

Methods

This scoping review followed the reporting guidelines of the Arksey & O'Malley framework, which collates evidence in stages. The research question was framed as "What are the effects of stair climbing on cardio-metabolic outcomes in adults?". Eligible articles were identified through an extensive search of four electronic databases, and data from 24 research studies were charted and organized.

Results

Stair climbing improves aerobic capacity (8-33 ml kg/min) and serum biomarkers by ≈9-15 %. A minimum of 4-8 weeks are necessary to alter cardiometabolic risk. Regular stair climbing can improve cardio-metabolic risk indicators, including body composition, blood pressure, cholesterol levels, and insulin sensitivity. The research regarding inflammatory and musculoskeletal changes with stair climbing bouts is still in its infancy.

Conclusion

Stair climbing interventions are a no-cost and feasible form of physical activity for improving cardiometabolic disease risk in adults.

Psychological predictors of physical activity intensity among college students

Objective: The purpose of this study was to investigate the association of mental health, subjective well-being, and the impact of COVID-19 on quality of life with PA intensity among college students. Participants: The sample included 1262 college students from a large Midwestern research university (mean age = 21.5 ± 3.6 years). Methods: Participants voluntarily and anonymously completed the Qualtrics questionnaires which included the Patient Health Questionnaire -Anxiety and Depression Scale, the Satisfaction with Life Scale, the Impact of COVID-19 on Quality of Life (QoL) Scale, and the International Physical Activity Questionnaire. Results: Multiple linear regression models indicated that COVID-19 QoL and life satisfaction were significant predictors of the total, vigorous, and moderate PA (p's < .05). Life satisfaction was also a significant predictor of walking. Conclusion: Higher level satisfaction and lower impact of COVID-19 on quality of life were related to higher total, vigorous, and moderate PA levels.

A 6-month exercise intervention clinical trial in women: effects of physical activity on multi-omics biomarkers and health during the first wave of COVID-19 in Korea

BACKGROUND

Coronavirus disease 2019 (COVID-19) was first reported in December 2019 and the first case in Korea was confirmed on January 20, 2020. Due to the absence of therapeutic agents and vaccines, the Korean government implemented social distancing on February 29, 2020. This study aimed to examine the effect of physical activity (PA) on health through changes in multi-omics biomarkers with a 6-month of exercise intervention during the first wave of COVID-19 in Korea.

METHODS

Twenty-seven healthy middle-aged women were recruited and 14 subjects completed the exercise intervention. The mean age (± SD) was 46.3 (± 5.33) and the mean BMI (± SD) was 24.9 (± 3.88). A total of three blood and stool samples were collected at enrollment, after period 1, and after period 2 (3-month intervals). The amount of PA was measured with an accelerometer and by questionnaire. Clinical variables were used, including blood pressure, grip strength, flexibility, and blood glucose levels and lipid markers obtained from laboratory tests. The concentration of blood metabolites was measured by targeted metabolomics. Fecal microbiome data were obtained by 16 S rRNA gene amplicon sequencing.

RESULTS

During the second half period (period 2), Coronavirus disease 2019 occurred and spread out in Korea, and PA decreased compared with the first half period (period 1) (185.9 ± 168.73 min/week to 102.5 ± 82.30 min/week; p = 0.0101). Blood pressure, hemoglobin A1c (HbA1c), and low-density lipoprotein cholesterol (LDL-C) decreased in period 1 (p < 0.05) and tended to increase again during period 2 (p < 0.05). Forty metabolites were changed significantly during period 1 (FDR p < 0.05), and we found that 6 of them were correlated with changes in blood pressure, HbA1c, and LDL-C via network analysis.

CONCLUSIONS

Our results may suggest that exercise improves health through changes in biomarkers at multi-omics levels. However, reduced PA due to COVID-19 can adversely affect health, emphasizing the necessity for sustained exercise and support for home-based fitness to maintain health.

TRIAL REGISTRATION

The trial is retrospectively registered on ClinicalTrials.gov (NCT05927675; June 30, 2023).

Harnessing Passive Pulsatile Shear Stress for Alzheimer's Disease Prevention and Intervention

 Alzheimer's disease (AD) affects more than 40 million people worldwide and is the leading cause of dementia. This disease is a challenge for both patients and caregivers and puts a significant strain on the global healthcare system. To address this issue, the Lancet Commission recommends focusing on reducing modifiable lifestyle risk factors such as hypertension, diabetes, and physical inactivity. Passive pulsatile shear stress (PPSS) interventions, which use devices like whole-body periodic acceleration, periodic acceleration along the Z-axis (pGz), and the Jogging Device, have shown significant systemic and cellular effects in preclinical and clinical models which address these modifiable risks factors. Based on this, we propose that PPSS could be a potential non-pharmacological and non-invasive preventive or therapeutic strategy for AD. We perform a comprehensive review of the biological basis based on all publications of PPSS using these devices and demonstrate their effects on the various aspects of AD. We draw from this comprehensive analysis to support our hypothesis. We then delve into the possible application of PPSS as an innovative intervention. We discuss how PPSS holds promise in ameliorating hypertension and diabetes while mitigating physical inactivity, potentially offering a holistic approach to AD prevention and management.

Taoist way of a balanced exercise training cocktail for the management of primary hypertension in older persons

High blood pressure is the world's leading risk factor for mortality, affecting nearly half of the global population aged 50-79 years. Physical inactivity is one factor contributing to the prevalence of hypertension. This paper discusses a new concept for the management of hypertension in older persons. We are inclined to fade the current guidelines used in China, the United States, and Europe. Although demonstrating irrefutable benefits for blood pressure regulation, the guidelines fail to address the need to incorporate balance exercises, which are crucial for mitigating the risk of falling. We address three pressing questions regarding the efficacy of various combinations of exercise modes for blood pressure regulation, alongside providing an overview of balance exercises. At the core of our concept, we explicate the challenges inherent in addressing the global pandemic of physical inactivity and hypertension in regular socioeconomic people. No guidelines could change the state of inactivity by jumping between zero and all things, where "zero" symbolizes conditions such as physical inactivity and hypertension, and the concept of "all things" encompasses the ideals of an active lifestyle and healthy aging. We advocate a Taoist way, "zero-one-all things," where "one" in this context refers to an inclusive and culturally diverse exercise training cocktail. The Tao guides us to illuminate an ancient way of overcoming physical inactivity-associated diseases in the present day.

Observing Others' Workouts on Social Network Sites Improves the Observer's Physical Activity: A Moderated-Mediation Model

Many people like to share their physical activity (PA) experiences on social network sites (SNSs). Drawing on social cognitive theory, we examined in two studies whether observing others' workouts on SNSs could improve the observer's PA via the mediation of workout self-efficacy. In study 1, a two-wave longitudinal online survey of 461 participants, exposure to SNS workout posts was positively associated with PA through workout self-efficacy. In study 2, an online experimental study with 124 participants, manipulating perceived similarity revealed that it moderates between exposure to SNS workout posts and workout self-efficacy. Moreover, moderation of the indirect effect between exposure to SNS workout posts and PA via workout self-efficacy was supported. These findings reveal the mechanisms and boundary conditions of social media exposure improving workout self-efficacy and promoting PA.

Intervention Effects of Physical Activity on Type 2 Diabetic Patients Potentially Infected with COVID-19

The coronavirus disease 2019 (COVID-19) pandemic has clearly had a great influence on the lifestyles of the population, especially on patients with type 2 diabetes mellitus. During the COVID-19 outbreak, many countries/regions implemented social-isolation measures, leading to an increase in negative behaviors and impairing the capability of diabetic patients to resist COVID-19, ultimately causing severe prognoses. Moreover, as the epidemic progressed, multiple studies emphasized the significance of physical exercise in the management of type 2 diabetic patients infected with COVID-19. In this study, we selected research from 1 December 2019 to 9 August 2023 that focused on COVID-19-infected diabetic patients to investigate the impact of type 2 diabetes on the immune functions, inflammation factor levels, lung injuries, and mental disorders of such patients, as well as to assess the risk of novel coronavirus pneumonia in these patients. Additionally, the effects of high-intensity, moderate-intensity, and low-intensity exercises on novel coronavirus pneumonia infection in type 2 diabetic patients and the mechanisms of the effects of such exercise were considered. We concluded that elderly diabetic patients with COVID-19 should perform low-intensity exercises to facilitate their recoveries. This study offers guidance for a proper understanding of the dangers of diabetes and the use of appropriate measures to reduce the risk of novel coronavirus pneumonia infections in type 2 diabetic patients.

Influence of 8 Weeks of Tabata High-Intensity Interval Training and Nanocurcumin Supplementation on Inflammation and Cardiorespiratory Health among Overweight Elderly Women

Nanocurcumin (NaC) and high-intensity interval training (HIIT) play crucial role in weight and inflammation control. The purpose of the current study was to evaluate the separate and combined effects of 8 weeks of Tabata-HIIT and NaC supplementation on the NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome, long non-coding RNA myocardial infarction associated transcript (lncRNA MIAT) expression, body composition, and cardiorespiratory health in elderly overweight women. A total of 48 healthy overweight elderly women were randomly divided into four groups: NaC, Tabata-HIIT+Pla, Tabata-HIIT+NaC, and placebo. Participants underwent a Tabata HIIT program (2 days per week, at 80∼0% of maximal HR) and NaC supplementation (daily 80 mg in two 40 mg capsules) for 8 weeks. Blood sampling, cardiorespiratory hemodynamic responses, and body composition evaluations were obtained before and after treadmill stress testing at the baseline timepoint and following 8 weeks of intervention. The mRNA of lncRNA-MIAT and NLRP3 were measured by real-time polymerase chain reaction. After 8 weeks, a significant improvement was observed in body composition and cardiorespiratory hemodynamics in the Tabata-HIIT groups compared to the NaC alone and placebo groups (P<0.05). Tabata training, both with and without the addition of nano curcumin supplementation, did not result significant effect on the resting levels of lncRNA-MIAT expression (P>0.05). Nevertheless, NaC supplementation along with Tabata training led to a significant reduction in NLRP3 inflammasome. In addition, NaC supplementation in overweight/preobese women improved systemic inflammation during treadmill stress testing. These findings indicating the suppressive effects of non-pharmacologic interventions on the sympathetic system and downregulation of the inflammasome.

Combined Effect of Leisure-Time Physical Activity and Sedentary Behavior on Abdominal Obesity in ELSA-Brasil Participants

INTRODUCTION

Abdominal obesity is a pattern of obesity that has been considered a public health problem. Physical activity is considered an important factor for the prevention of abdominal obesity. Increased time in sedentary behavior has been associated with negative health outcomes, including abdominal obesity.

OBJECTIVE

The aim of this study was to investigate which combination of leisure-time physical activity and sedentary behavior contributes most to the prevention of abdominal obesity in adults participating in ELSA-Brasil (Longitudinal Study of Adult Health).

METHODS

The study was cross-sectional and participants from the first follow-up of the ELSA-Brasil cohort (2012-2014) were analyzed. The independent variables were physical activity, assessed by IPAQ, and sedentary behavior, assessed by a standard questionnaire applied in ELSA-Brasil; the dependent variable was abdominal obesity, determined by waist circumference. The covariates analyzed were the following: age, education, binge drinking, smoking and menopause. The associations between the dependent variable and the independent variables were analyzed using logistic regression. The odds ratio with 95 CI% was estimated.

RESULTS

For men, the combinations were more significant when they were more physically active and spent less time on the sedentary behaviors analyzed, on both a weekday and a weekend day. For menopausal women, both younger and older, all associations of the combinations between sufficient leisure-time physical activity and little time spent in sedentary behaviors contributed to the prevention of abdominal obesity. In non-menopausal women, positive associations were observed in almost all combinations between leisure-time physical activity and sedentary behaviors, with some results that were not statistically significant among younger women.

CONCLUSIONS

Our results showed that being sufficiently active and reducing the time spent in sedentary behavior was the combination that contributed the most to the prevention of abdominal obesity, both in men and women.

The Effectiveness of Digital Apps Providing Personalized Exercise Videos: Systematic Review With Meta-Analysis

BACKGROUND

Among available digital apps, those providing personalized video exercises may be helpful for individuals undergoing functional rehabilitation.

OBJECTIVE

We aimed to assess the effectiveness of apps providing personalized video exercises to support rehabilitation for people with short- and long-term disabling conditions, on functional capacity, confidence in exercise performance, health care consumption, health-related quality of life, adherence, and adverse events.

METHODS

In this systematic review, we searched MEDLINE, CENTRAL, and Embase databases up to March 2022. All randomized controlled trials evaluating the effect of apps providing personalized video exercises to support rehabilitation for any condition requiring physical rehabilitation were included. Selection, extraction, and risk of bias assessment were performed by 2 independent reviewers. The primary outcome was functional capacity at the end of the intervention. The secondary outcomes included confidence in exercise performance, care consumption, health-related quality of life, adherence, and adverse events. A meta-analysis was performed where possible; the magnitude of the effect was assessed with the standardized mean difference (SMD).

RESULTS

From 1641 identified references, 10 papers (n=1050 participants, 93% adults) were included: 7 papers (n=906 participants) concerned musculoskeletal disorders and 3 (n=144 participants) concerned neurological disorders. Two (n=332 participants) were employee based. The apps were mostly commercial (7/10); the videos were mostly elaborated on by a physiotherapist (8/10). The duration of app use was 3-48 weeks. All included studies had a high overall risk of bias. Low-quality evidence suggested that the use of apps providing personalized video exercises led to a significant small to moderate improvement in physical function (SMD 0.35, 95% CI 0.19-0.51; Phet=.86; I2=0%) and confidence in exercise performance (SMD 0.67; 95% CI 0.37-0.96; Phet=.22; I2=33%). Because of the very low quality of the evidence, the effects on quality of life and exercise adherence were uncertain. Apps did not influence the rate of adverse events.

CONCLUSIONS

Apps providing personalized video exercises to support exercise performance significantly improved physical function and confidence in exercise performance. However, the level of evidence was low; more robust studies are needed to confirm these results.

TRIAL REGISTRATION

PROSPERO CRD42022323670; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=323670.

Gender as a determinant of physical activity levels and mental health of medical students from Poland and Belarus in the context of the COVID-19 pandemic

Background

COVID-19 pandemic has brought about unfavourable changes regarding both physical activity (PA) levels and patterns of behaviour associated with mental health. The study sought to assess PA levels and kinesiophobia in medical students from Poland and Belarus taking account of gender.

Methods

A total of 779 students (405 students from University of Grodno (UG), Belarus, and 374 students from John Paul II University of Applied Sciences (ABNS) in Biala Podlaska, Poland) took part in the study. Women constituted 74.2% of the study population. A diagnostic survey as well as two research tools, i.e., the International Physical Activity Questionnaire (IPAQ)-short form, and the Tampa Scale for Kinesiophobia (TAMPA) were employed in the study.

Results

Students from ABNS manifested significantly higher levels of PA. Taking into account gender, male respondents displayed significantly higher levels of MET-min/week (MET-metabolic equivalent of task). As for kinesiophobia, significantly higher levels were demonstrated by students from UG. Its higher levels were also noted among women.

Conclusion

The findings of the study did not reveal strong correlations between kinesiophobia and PA levels in students from Poland and Belarus in the context of different approaches to the pandemic that both countries adopted. Students from ABNS proved to be more physically active. In turn, participants from UG exhibited significantly higher levels of kinesiophobia. Gender was the factor that significantly differentiated levels of kinesiophobia, with women displaying its higher levels.

Exercise Adherence in Older and Middle-Aged Adults With Coronary Artery Disease Before and During COVID-19

BACKGROUND

Regular exercise is advised for individuals given a diagnosis of cardiovascular disease. COVID-19 presented challenges to exercise adherence.

OBJECTIVE

The objective of this study was to determine long-term exercise adherence and whether individuals with cardiovascular disease adhered to American Heart Association/American College of Cardiology Foundation guidelines before and during the COVID-19 pandemic.

METHODS

This is an observational cross-sectional study in which men (73%) and women discharged from a multiwide hospital system after an acute coronary event were enrolled. Participants completed 3 questionnaires, including the Exercise Adherence Rating Scale.

RESULTS

Five hundred eighty-two individuals (mean [SD] age, 67 [9.8] years) completed the survey. Fifty-three percent of participants met minimum exercise guidelines during COVID-19. Exercise days per week decreased significantly during COVID-19 in women (P = .013) but not significant for men (P = .301). Categorized by age, the decrease was significant for middle-aged women (P = .002), not older women (P = .336). Men exercised more minutes per session (P = .034), and had greater exercise adherence (P = .003) and greater exercise intensity (P < .001). Overall, women participated less in cardiac rehabilitation (P = .046) and reported the greatest disparity in exercise adherence and intensity.

CONCLUSION

Exercise after an acute event is beneficial, and the percentage of individuals meeting recommended guidelines should be higher considering the relationship between exercise and the possibility of future cardiac events. On the basis of the many physical and mental benefits of maintaining exercise, healthcare practitioners are encouraged to screen all patients for exercise adherence with a major emphasis on educating women and older adults.

Cross-sectional study of characteristics and prevalence of musculoskeletal complaints in 1170 male golfers

Objectives

The primary aim was to describe the characteristics and prevalence of musculoskeletal complaints of a large group of non-professional golfers. Secondary aims were to compare golfers different in (A) skill-level, (B) presence of low back pain (LBP) and (C) performance of prevention exercises.

Methods

A sample of 1170 male golfers (mean age 54.98, SD=13.3) were surveyed online on personal and golf-specific characteristics, medical history and complaints in the preceding 7 days. Subgroups (A) with different golfing handicap (0 to 5, >5 to 10, >10), (B) with and without LBP and (C) who performed versus did not perform injury prevention exercises were compared using analysis of variance and χ2test.

Results

The prevalence and severity of musculoskeletal complaints was similar in everyday life and when playing golf. More than one-third of the golfers (n=436; 37.3%) reported LBP in the preceding 7 days, while other frequently affected body parts were the shoulder and knee. Golfers with different skill level differed in age and most golf-related characteristics but not in prevalence and severity of musculoskeletal complaints. Golfers with and without LBP were similar in almost all variables. Golfers who performed prevention exercises (n=371; 27.1%) were older and had a higher prevalence of complaints.

Conclusion

The prevalence and severity of musculoskeletal complaints in golfers were similar to the wider population. It seems that injury prevention exercises were implemented after injury, rather than as primary prevention. Prospective studies looking at the epidemiology of injury, risk factors and interventions are required.

Exploiting Mobile Gamification to Foster Physical Activity: A Remotely-Managed Field Study

Physical inactivity is a plague for public health, especially in Western Countries. Among the countermeasures, mobile applications promoting physical activity seem particularly promising, thanks to the spread and adoption of mobile devices. However, the dropout rates of users are high, thereby calling for strategies to increase retention rates. Moreover, user testing can be problematic, because it is typically conducted in a laboratory, leading to a limited ecological validity. In the present research, we developed a custom mobile app to promote physical activity. Three versions of the app were implemented, each featuring a different pattern of gamification elements. Moreover, the app was designed to work as a self-managed experimental platform. A remote field study was conducted to investigate the effectiveness of the different versions of the app. Behavioral log data of physical activity and interaction with the app were collected. Our results show the feasibility of using a mobile app running on personal devices as an independently managed experimental platform. Moreover, we found that gamification elements per se do not ensure higher retention rates, rather it emerged that the richer combination of gamified elements was effective.

The Association of Outdoor Walking Per Week with Mental Health and Costs of Psychotropic Drugs in Adults

Regular walking confers many physical health benefits, including a reduced risk of disease-specific and all-cause mortality and better physical fitness. However, less is known about its role in mental health. Thus, the aims of this study were to determine the associations of outdoor walking per week with costs of psychotropic drugs used and mental health in adults. 500 adults aged 18 to 64 years in Hangzhou (China) reported sex, age, the name of the psychotropic drugs used and their dosage, and outdoor walking during the past 7 days. The cost that a person spends on buying psychotropic drugs for a month was considered psychotropic drugs costs. Overall mental health was assessed using the Chinese Version of the 12-Item General Health Questionnaire. The levels of walking in participants taking psychotropic were significantly lower than participants who did not taking psychotropic (p = 0.002). There was a significant negative correlation between mental health scores and minutes of walking per week and a significant positive correlation between the number of psychotropic drugs used and walking per week (p < 0.05). However, no particular associations were found between costs of psychotropic drug used and walking per week. Outdoor walking is prospectively associated with better overall mental health in adults. Then, awareness should be raised about the possible positive effects of outdoor walking on the mental health of adults.

Recognizing risk factors associated with poor outcomes among patients with COVID-19

The coronavirus disease 2019 (COVID-19) pandemic has affected >610 million people globally, exerting major social, economic, and health impacts. Despite the large number of global casualities and severe symptomatology associated with COVID-19, a large number of individuals remain at elevated risk of infection and severe outcomes related to poor lifestyle behaviors and/or associated comorbidities. Beyond the well-known social distance and masking policies, maintaining an active lifestyle, minimizing the consumption of tobacco products, and maintaining an adequate nutrition status are some of the key factors that, in an affordable and accessible way, have the potential to improve health and minimize COVID-19 impact. In addition, bringing awareness of the higher risks and poor prognosis of COVID-19 when other conditions are present seems to be essential to protect those individuals with the highest risks.

A scoping review on the implementation of Global Observatory on Physical Activity recommendations for school children in Sub-Saharan Africa

Background: Promoting physical activity (PA) is a critical first step in preventing and lowering the prevalence of non-communicable chronic diseases across all age groups. The Global Observatory on Physical Activity (GoPA) of the World Health Organization (WHO) suggested country-specific guidelines for promoting PA across all age categories to achieve this. However, despite an increase in obesity, there is no information on their compliance for pre-secondary school children in sub-Saharan Africa (SSA). We mapped evidence in the literature and described the available evidence on implementing GoPA recommendations for presecondary school children in SSA. Methods: This scoping review included a search in PubMed, Google Scholar, Scopus, and Cochrane Library with the dates 2013-2020, using keywords and the terms (Physical activity OR exercise AND (GoPA recommendations OR Guidelines) AND ((presecondary school children) OR (primary school children) OR (basic school children) OR (children)). The most important data were tabulated. Results: Twenty-three studies were identified of which ten were eligible for data extraction. Of these ten studies, 2 (20%) were conducted in Nigeria, 4 (40%) in South Africa, 2 (20%) in Ghana and 1(10%) each in Kenya and Senegal were extracted. None of these nations has a national plan or strategy to promote PA and reduce sedentary behaviors (SB). Conclusion: A gap in the formulation of PA guidelines exists in SSA. Urgent action is needed for a national plan or strategy by individual country in SSA to reduce the burden of physical inactivity among school children in SSA.

Relationship between Fitness and Healthy Lifestyle

Background: In our study we will refer to the benefits of practicing appropriate fitness exercises that can contribute to maintaining or returning to a closer weight, to achieving an ade-quate physical condition reflected in self-confidence and to adopting a healthy lifestyle.; (2) Methods:.Our theoretical study is based on the analysis of perspectives offered by specialists in fields complementary to physical education, in order to understand not only from a medical but also a social perspective, the importance of fitness in the lives of young people. (3) Results: We believe that the physical exercises that make up the fitness set have beneficial effects on the hu-man body, from the point of view: morphogenetic, physiological, educational, prophylactic and curative. (4) Conclusions: In this context, we believe that it is necessary to reconsider the benefits of fitness - a good remedy against sedentarism and aging, being able to delay, diminish or com-pletely prevent the mechanisms associated with these processes (arterial diseases, diabetes, high cholesterol, etc.). Fitness is part of a healthy lifestyle Keywords: Fitness, Health Lifestyle, Physical exercises

Multi-Component Intervention to Promote Physical Activity in Japanese Office Workers: A Single-Arm Feasibility Study

This study investigated the feasibility of a multi-component intervention to promote physical activity (PA) among Japanese office workers. It was an 8-week single-arm trial conducted in Japan in 2021, in which 76 employees aged 20 or older, from an insurance company, participated. They received a multi-component PA intervention that comprised individual (lecture, print material, goal setting, and feedback), socio-cultural (team building and supportive atmosphere), physical (poster), and organizational (encouraging message from an executive) strategies. The primary outcome was change in objectively measured moderate-to-vigorous PA (MVPA). A paired t-test was used to compare the changes between weeks 0 and 8. We also conducted a subdomain analysis of PA divided into four domains (working, non-working, commuting working, and remote working). Excluding 26 participants who could not complete valid assessments, the MVPA among participants (n = 50, age 49.6 ± 9.7) significantly increased by +7.3 min/day [95% confidence interval (CI) 0.8 to 13.8]. We also identified significant changes in MVPA by +10.0 min/day [95% CI, 3.7 to 16.3] in working days (n = 40), and by +7.1 min/day [95% CI, 0.4 to 13.7] in remote working days (n = 34). We demonstrated that multi-component PA interventions might improve MVPA among Japanese office workers.

Promoting Physical Activity Habits after Completing Secondary School: Does the Age Matter?

Physical inactivity is one of the most important problems in our society, especially during adolescence. During this stage of schooling, students practice physical activity in physical education classes, but after they finish school, many of them stop practicing it. This research aims to determine which variables predict the intention to practice physical activity after finishing secondary school and to discover the effect that age during adolescence has on these predictive variables. A questionnaire was administered to a sample of secondary school students. The results show that physical exercise identity influences the three antecedents of this theory, while the attitude towards the behaviour (β = 0.13; p < 0.05), perceived behavioural control (β = 0.46; p < 0.05), and physical self-concept (β = 0.41; p < 0.05), have a statistically significant influence on the intention to be physically active. Moreover, when the age is lower, is more important to develop a positive perceived behavioural control and physical exercise identity. Moreover, for younger male adolescents instead of the physical exercise itself, identity seems more important in developing a positive attitude towards behaviour. Likewise, in young female adolescents a low level of support from their close environment (subjective norm) leads to dropping out. The research concludes with the importance of including these variables in physical education classes to promote physical activity practice after completion of secondary school. Some practical implications are presented.

The Relationship between Postmenopausal Women’s Self-Esteem and Physical Activity Level—A Survey Study from Poland

Introduction: Physical inactivity has become one of the major public health and economic concerns in Western societies. The consequences of physical inactivity are associated with many physical problems, however, the influence of physical activity (PA) on psychological health is unclear. The aims of our study were to assess self-esteem and physical activity levels in postmenopausal women and to examine the association between physical activity levels and self-esteem in this group. Material and methods: Survey research was conducted on postmenopausal women aged M = 58.81 ± 7.68 in women’s health clinics in Silesia, Poland. The total number of participants was 131, and 18 were excluded. A questionnaire with socio-demographic data and other international questionnaires were used: International Physical Activity Questionnaire, Rosenberg Self-Esteem Scale and Beck Depression inventory. Results: 78.76% of postmenopausal women were physically active. Mean value of MET-min/week was M = 1543.46 ± 1060.92. A total of 11.51% of women reported low self-esteem, with the mean total value of SES M = 31.79 ± 2.93. There was a lack of correlation between total IPAQ score and self-esteem (r = −0.241, p = 0.01). Conclusions: Postmenopausal women have mostly average self-esteem. They are generally active, and walking is the most common form of physical activity, however, a higher PA level does not influence self-esteem.

Green exercise, mental health symptoms, and state lockdown policies: A longitudinal study

Lockdown policies aimed at decreasing the transmission of COVID-19 showed unintended mental health consequences; however, natural settings may offer a respite for individuals suffering from depression or anxiety symptoms. Previous cross-sectional literature reports protective effects of outdoor exposure on mental health during the COVID-19 pandemic. We longitudinally assess whether green exercise corresponded with a decline in adverse mental health symptoms, controlling for state lockdown policies. We also examine whether the relation differed by state lockdown status. As our exposure variable, we specificized participation in an outdoor walk, jog, or hike (green exercise). We used, as the outcome variable, the 4-item Patient Health Questionnaire (PHQ-4) to measure anxiety and depression symptoms. We utilized the Understanding America Study (UAS), a nationally representative sample of 8253 adults across 50 states in the US, surveyed biweekly between March 10, 2020-May 26, 2021. Linear fixed effect analyses controlled for time-invariant individual factors, as well as employment status, and household income. Regression results indicate a modest decline in PHQ-4 scores of approximately 0.10 (less mental health symptoms) as a function of green exercise, controlling for state lockdown status. We also find a slightly greater protective effect of green exercise on mental health symptoms during state lockdown policies. Additionally, we find that green exercise, as opposed to indoor exercise, corresponds with a decrease in PHQ-4 scores during lockdown. Contact with nature may improve mood and decrease mental health symptoms, especially during stress-inducing periods such as the COVID-19 pandemic. Green exercise as a recommended behavioral intervention may hold relevance for greater public health.

Associations between Physical Activity Level and Health Services Use in Spanish Adults

One of the main concerns of governments and organisations worldwide is the cost and burden of health services, with sedentary lifestyles being a significant impacting factor, and physical activity is one of the potential solutions. Therefore, this study aims to analyse the possible associations between the physical activity level, hospitalisation prevalence, and the use and number of visits to emergency services in the Spanish population, examining potential differences between sex and age groups. This is a cross-sectional study based on data from the Spanish National Health Survey 2017 (ENSE 2017), the last one before the COVID-19 pandemic, with 17,199 participants. A descriptive analysis was performed using median and interquartile range (continuous variables) and absolute and relative frequencies (ordinal variables). Intergroup differences were analysed with non-parametric tests: chi-square and z-test for independent proportions (categorical variables), and Kruskal−Wallis and Mann−Whitney U (continuous variables). Spearman’s rho was used to study correlations between variables. A multiple binary regression analysis was performed to predict hospitalisations. Hospitalisations and emergency services use showed a dependence relation with the physical activity level (p < 0.001): those who performed moderate and/or vigorous physical activity used those services less than sedentary individuals and those whose only activity was walking. Thus, associations could be drawn between the hospitalisation prevalence, the use and number of visits to emergency departments, and the physical activity level in the Spanish population aged 18−69 years in the pre-pandemic period.

Prevalence of Health-Risk Behaviors and Mental Well-Being of ASEAN University Students in COVID-19 Pandemic

The prevalence of epidemiological health-risk behaviors and mental well-being in the COVID-19 pandemic, stratified by sociodemographic factors in Association of South East Asian Nations (ASEAN) university students, were examined in the research. Data were collected in March–June 2021 via an online survey from 15,366 university students from 17 universities in seven ASEAN countries. Analyzed data comprised results on physical activity, health-related behaviors, mental well-being, and sociodemographic information. A large proportion of university students consumed sugar-sweetened beverages (82.0%; 95%CI: 81.4, 82.6) and snacks/fast food daily (65.2%; 95%CI: 64.4, 66.0). About half (52.2%; 95%CI: 51.4, 53.0) consumed less than the recommended daily amounts of fruit/vegetable and had high salt intake (54%; 95%CI: 53.3, 54.8). Physical inactivity was estimated at 39.7% (95%CI: 38.9, 40.5). A minority (16.7%; 95%CI: 16.1, 17.3) had low mental well-being, smoked (8.9%; 95%CI: 8.4, 9.3), and drank alcohol (13.4%; 95%CI: 12.8, 13.9). Country and body mass index had a significant correlation with many health-risk behaviors and mental well-being. The research provided important baseline data for guidance and for the monitoring of health outcomes among ASEAN university students and concludes that healthy diet, physical activity, and mental well-being should be key priority health areas for promotion among university students.

Recommending Physical Activity to Your Aging Patients? What Clinicians Need to Know to Increase Adherence From the Older Adult Perspective

A wealth of scientific evidence supports that being physically active may prevent or delay the onset of cognitive impairment and dementia. However, a critical barrier is that while most clinicians recommend physical activity (PA) and older adults recognize its health benefits, most older adults fail to regularly practice PA. Thus, it is necessary to explore and disseminate knowledge on how to help clinicians truly partner with people and help them to change their behavior and become more active. Clinical and scientific efforts are underway to establish dose-specific PA recommendations for cognitive brain health. However, an important knowledge gap is how to develop effective strategies to increase PA adherence in aging. To better understand the perspective of older adults, we undertook a mixed-method study on sixty-five sedentary older adults at risk for cognitive decline. Participants answered a questionnaire battery related to PA engagement, and a subcohort participated in a remote focus group. Our findings revealed four main themes: First, age and aging are determinants in PA practice. Second, maintaining both an active mind and autonomy are priorities, but planned PA is not usually related as part of being “active.” Third, motivational challenges in PA engagement were noted. And fourth, they emphasized a call for tailored recommendations. Therefore, we present a multidimensional model of PA adherence to maximize brain health in older adults and suggest a tool kit and key questions to effectively screen sedentary aging adults and translate current guidelines into the needs of the individual by using behavior change strategies.

Influence of Family Environment on the Scientific Fitness Literacy of Preschool and School Children in China: A National Cross-Sectional Study

Scientific fitness literacy (SFL) is a holistic concept based on physical literacy but has a smaller scope and is more specific to exercise and scientific fitness. We developed an instrument to assess SFL and explored the differences and similarities in the effects of the home environment on children’s SFL. Data from a nationwide stratified random sample of children were analyzed using multiple linear regression. SFL scores were significantly lower for preschoolers than for school-age children. The family environment has an impact throughout the preschool and school years, with school-age children’s SFL being less influenced by family members than preschool children; screen time has a negative impact on their SFL but reducing the number of electronic devices and increasing parental physical activity and modeling can alleviate its impact. The economic status of the family is crucial, with sports consumption expenditure and household sports equipment ownership being favourable factors for children’s SFL. Positive parental attitudes and sporting habits have a positive impact on their children’s SFL. The findings of this study can be used to improve children’s SFL in the home environment and to take effective measures to avoid the risk factors.

Effectiveness of a healthcare-based mobile intervention on sedentary patterns, physical activity, mental well-being and clinical and productivity outcomes in office employees with type 2 diabetes: study protocol for a randomized controlled trial

BACKGROUND

Prolonged sedentary time is associated with an increased incidence of chronic disease including type 2 diabetes mellitus (DM2). Given that occupational sedentary time contributes significantly to the total amount of daily sedentariness, incorporating programmes to reduce occupational sedentary time in patients with chronic disease would allow for physical, mental and productivity benefits. The aim of this study is to evaluate the short-, medium- and long-term effectiveness of a mHealth programme for sitting less and moving more at work on habitual and occupational sedentary behaviour and physical activity in office staff with DM2. Secondary aims. To evaluate the effectiveness on glycaemic control and lipid profile at 6- and 12-month follow-up; anthropometric profile, blood pressure, mental well-being and work-related post-intervention outcomes at 3, 6 and 12 months.

METHODS

Multicentre randomized controlled trial. A sample size of 220 patients will be randomly allocated into a control (n = 110) or intervention group (n = 110), with post-intervention follow-ups at 6 and 12 months. Health professionals from Spanish Primary Health Care units will randomly invite patients (18-65 years of age) diagnosed with DM2, who have sedentary office desk-based jobs. The control group will receive usual healthcare and information on the health benefits of sitting less and moving more. The intervention group will receive, through a smartphone app and website, strategies and real-time feedback for 13 weeks to change occupational sedentary behaviour.

VARIABLES

(1) Subjective and objective habitual and occupational sedentary behaviour and physical activity (Workforce Sitting Questionnaire, Brief Physical Activity Assessment Tool, activPAL3TM); 2) Glucose, HbA1c; 3) Weight, height, waist circumference; 4) Total, HDL and LDL cholesterol, triglycerides; (5) Systolic, diastolic blood pressure; (6) Mental well-being (Warwick-Edinburgh Mental Well-being); (7) Presenteeism (Work Limitations Questionnaire); (8) Impact of work on employees´ health, sickness absence (6th European Working Conditions Survey); (9) Job-related mental strain (Job Content Questionnaire). Differences between groups pre- and post- intervention on the average value of the variables will be analysed.

DISCUSSION

If the mHealth intervention is effective in reducing sedentary time and increasing physical activity in office employees with DM2, health professionals would have a low-cost tool for the control of patients with chronic disease.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04092738. Registered September 17, 2019.

Insufficient Level of Physical Activity and Its Effect on Health Costs in Low- and Middle-Income Countries

Evidence suggests that mortality attributed to noncommunicable diseases (NCDs) will increase from 38 million in 2012 to 52 million by 2030. The recent epidemiological data show that these diseases are increasing in low- and middle-income countries so that about 80% of all deaths of NCDs occurred in low- and middle-income countries. It has been estimated that an insufficient level of physical activity leads to a large share of the burden of these diseases. Evidence suggests that the rate of insufficient levels of physical activity in low- and middle-income countries has increased over the past 15 years. The authorities and policymakers must be advocated with consistent evidence from low- and middle-income countries on productivity loss and increased healthcare costs due to the absence or insufficient levels of physical activity. It is also necessary to include physical activity across all policies to prevent possible escalation of the economic burden related to physical inactivity in the near future.

Differential impacts of COVID-19 pandemic on physical activity involvements and exercise habits in people with and without chronic diseases: A systematic review and meta-analysis

Objective

To conduct a systematic review and meta-analysis to summarize evidence regarding differential changes in physical activity (PA) involvements and exercise habits in people with and without chronic diseases during the COVID-19 outbreak.

Data Sources

MEDLINE, Embase, SPORTDiscus, Cumulative Index to Nursing and Allied Health, PsycINFO, Cochrane Library, and Physiotherapy Evidence Database were searched from November 2019 to May 2021.

Study Selection

Two reviewers independently screened cross-sectional and longitudinal studies that investigated changes in PA-related outcomes in people with and without chronic diseases during the pandemic.

Data Extraction

PA-related outcomes and sedentary time were extracted from the included studies. Relevant risk of bias were assessed. Meta-analyses were conducted for each PA-related outcome, if applicable. Quality of evidence of each PA-related outcome was evaluated by Grading of Recommendations Assessment, Development, and Evaluation.

Data Synthesis

Of 1226 identified citations, 36 articles (28 with and 8 without chronic diseases) with 800,256 participants were included. Moderate evidence from wearable sensors supported a significant reduction in pooled estimates of step count (standardized mean differences [SMD]=−2.79, P<.01). Very limited to limited evidence substantiated significant decreases in self-reported PA-related outcomes and significant increases in sedentary behaviors among people with and without chronic diseases. Specifically, pooled estimates of metabolic equivalent-minute per week (SMD=−0.16, P=.02) and PA duration (SMD=−0.07, P<.01) were significantly decreased, while sedentary time (SMD=0.09, P=.04) showed significant increases in the general population (small to large effects). Very limited evidence suggested no significant PA changes among people in a country without lockdown.

Conclusions

During the pandemic, objective and self-reported assessments showed significant reductions in PA in people with and without chronic diseases globally. This mainly occurred in countries with lockdowns. Although many countries have adopted the “live with the coronavirus” policy, authorities should implement population-based strategies to revert the potential lockdown-related long-term deleterious effects on people's health.

Physical Activity Is Associated with a Lower Risk of Osteoporotic Fractures in Osteoporosis: A Longitudinal Study

The purpose of our study was to examine the occurrence of osteoporotic fractures (fxs) according to the level of physical activity (PA) among osteoporosis using the Korean National Health Insurance Service (NHIS) customized database. From NHIS data from 2009 to 2017, osteoporosis was selected as requested. PA was classified into ‘high PA’ (n = 58,620), ‘moderate PA’ (n = 58,620), and ‘low PA’ (n = 58,620) and were matched in a 1:1:1 ratio by gender, age, income within the household unit, and region of residence. A stratified Cox proportional hazard model was used to calculate hazard ratios (HRs) for each type of fx comparing PA groups. The ‘low PA’ group was the reference group. For vertebral fx, the adjusted HR (95% confidence intervals (CIs)) was 0.27 (0.26–0.28) for the ‘high PA’ group and 0.43 (0.42–0.44) for the ‘moderate PA’ group. For hip fx, the adjusted HR (95% CIs) was 0.37 (0.34–0.40) for the ‘high PA’ group and 0.51 (0.47–0.55) for the ‘moderate PA’ group. For distal radius fx, the adjusted HR (95% CIs) was 0.32 (0.30–0.33) for the ‘high PA’ group and 0.46 (0.45–0.48) for the ‘moderate PA’ group. The results of this study suggest that a higher intensity of PA is associated with a lower risk of osteoporotic fxs, including vertebral fx, hip fx, and distal radius fx.

Comparative Study on Nutrition and Lifestyle of Information Technology Workers from Romania before and during COVID-19 Pandemic

The study aimed to evaluate lifestyle factors among Information Technology (IT) workers from Romania before and during the pandemic. We used an online applied questionnaire, filled in by 1638 respondents, that assessed nutrition status-Body Mass Index (BMI), weight and diet change, physical activity, alcohol consumption, number of hours working in front of the computer, stress, and sleep. Multivariate logistic regression was used to establish the lifestyle factors that lead to weight gain. Although the level of physical activity (PA) was low before the pandemic, the results of our study showed a further decrease in physical activity. In total, 61.1% of men and 71.1% of women performed PA for less than 30 min per day. Weight gain was reported in 50.5% of men and 45.3% of women (mean weight gain was 5.11 ± 3.52 kg) as a result of increased screen time (with a mean of 3.52 ± 4.29 for females and 3.05 ± 2.09 for males, p > 0.05 h per day) and the reported changes in diet. Despite the popularity of home-cooked foods, the intake of vegetables and fruit remained low. The quality of sleep was poor for 55.7% of the respondents. Public health and corporation policies are required to encourage a healthy lifestyle and avoid chronic diseases.

Opportunities to engage health system leaders in whole systems approaches to physical activity in England

Background

Physical activity plays an important role in maintaining good health and wellbeing, non-communicable disease prevention and can improve healthcare outcomes. Some progress is being made on incorporating physical activity into routine care, but less on engaging health system leaders in the ‘whole systems’ approaches which are increasingly recognised as important for addressing complex public health challenges such as physical inactivity. This commentary builds upon the findings of a recent study and aims to identify opportunities for engaging National Health Service (NHS) systems leaders in whole systems approaches to physical activity.

Opportunities for action in England

Pockets of good practice exist from which lessons can be learned, but there are systemic issues that discourage and create barriers, and a need for meaningful engagement, leadership and action at national, regional and local levels. National and regional actors like Sport England, NHS England, health professional bodies, Active Partnerships, the Local Government Association and the Office for Health Improvement and Disparities can encourage and support government and the NHS to change policy drivers, culture and practices. Emerging opportunities include the 2021 White Paper Integration and Innovation, development of local integrated care systems, leadership from health charities and investment in non-clinical interventions (‘social prescribing’). At local level, public health and physical activity specialists and other organisations have a key role as champions and facilitators of local whole systems approaches and engagement of local NHS leaderships. Finally, although whole systems action is about collaborative leadership, individual champions of physical activity can make a difference in influencing NHS leaders at every level towards whole systems working.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12602-5.

Physical activity and COVID-19. The basis for an efficient intervention in times of COVID-19 pandemic

The Coronavirus Disease 2019 (COVID-19) pandemic has shocked world health authorities generating a global health crisis. The present study aimed to analyze the different factors associated with physical activity that could have an impact in the COVID-19, providing a practical recommendation based on actual scientific knowledge. We conducted a consensus critical review using primary sources, scientific articles, and secondary bibliographic indexes, databases, and web pages. The method was a narrative literature review of the available literature regarding physical activity and physical activity related factors during the COVID-19 pandemic. The main online database used in the present research were PubMed, SciELO, and Google Scholar. COVID-19 has negatively influenced motor behavior, levels of regular exercise practice, eating and nutritional patterns, and the psychological status of citizens. These factors feed into each other, worsening COVID-19 symptoms, the risk of death from SARS-CoV-2, and the symptoms and effectiveness of the vaccine. The characteristics and symptoms related with the actual COVID-19 pandemic made the physical activity interventions a valuable prevention and treatment factor. Physical activity improves body composition, the cardiorespiratory, metabolic, and mental health of patients and enhancing antibody responses in vaccination.

Increased Risks of Mental Disorders: Youth with Inactive Physical Activity

Before COVID-19, one of the most dangerous pandemics of the 21st century was physical inactivity (PI). Sedentary habits had increased in the last decades, reducing physical condition and increasing non-communicable diseases and mental disorders in the population. This study aimed to analyse the relationships between physical activity level (PAL) and the prevalence of anxiety, depression, and other mental disorders in Spanish young aged 15-35 years and to calculate the odd ratio (OR) of developing from these mental disorders in inactive young people, based on PAL.

METHODS

A cross-sectional study based on data from the Spanish National Health Survey 2017 with 4195 participants was conducted. A descriptive analysis was performed. Possible differences between groups were analysed using the non-parametric statistical tests. OR and relative risks for mental disorders in inactive versus others PAL were calculated.

RESULTS

Dependence relationships were found between PAL and the prevalence of anxiety, depression, and other mental disorders (p < 0.001). In addition, the risk of developing: anxiety (OR: 6.14. 95% CI: 3.28-11.50), depression (OR: 5.35. 95% CI: 2.40-11.96), and other mental disorders (OR: 8.52. 95% CI: 2.90-25.06) was higher in inactive young people.

CONCLUSIONS

PI is associated to high risk of mental disorders in Spanish young people.

Changes to Physical Activity Levels in Adults Aged 50+ in the First Six Months of the COVID-19 Pandemic

The purpose of this study is to qualitatively explore the impact of the COVID-19 pandemic on older adults’ PA nearly 6 months into the pandemic. Approximately 230 interviews were conducted with a diverse sample of participants (22.1% Black and 10.8% Hispanic). Data were transcribed in fall 2020 and analyzed using NVivo 12. Overall, most older adults (54.6%) interviewed reported no change in their PA, often reporting that their work kept them active. Decreases in PA for older adults (42.7%) were attributed to little social connectedness and stay-at-home restrictions. The few reporting an increase in PA (2.6%) had more time available to be active, including setting goals while staying home. This data provides an insight on how COVID-19 impacted PA levels for older adults. These findings can inform tailored interventions to promote PA during the pandemic.

Effect of Physical Activity on Cardiovascular Event Risk in a Population-Based Cohort of Patients with Type 2 Diabetes

Cardiovascular disease (CVD) is the most common cause of morbidity and mortality among patients with type 2 diabetes (T2D). Physical activity (PA) is one of the few modifiable factors that can reduce this risk. The aim of this study was to estimate to what extent PA can contribute to reducing CVD risk and all-cause mortality in patients with T2D. Information from a population-based cohort including 26,587 patients with T2D from the Navarre Health System who were followed for five years was gathered from electronic clinical records. Multivariate Cox regression models were fitted to estimate the effect of PA on CVD risk and all-cause mortality, and the approach was complemented using conditional logistic regression models within a matched nested case–control design. A total of 5111 (19.2%) patients died during follow-up, which corresponds to 37.8% of the inactive group, 23.9% of the partially active group and 12.4% of the active group. CVD events occurred in 2362 (8.9%) patients, which corresponds to 11.6%, 10.1% and 7.6% of these groups. Compared with patients in the inactive group, and after matching and adjusting for confounders, the OR of having a CVD event was 0.84 (95% CI: 0.66–1.07) for the partially active group and 0.71 (95% CI: 0.56–0.91) for the active group. A slightly more pronounced gradient was obtained when focused on all-cause mortality, with ORs equal to 0.72 (95% CI: 0.61–0.85) and 0.50 (95% CI: 0.42–0.59), respectively. This study provides further evidence that physically active patients with T2D may have a reduced risk of CVD-related complications and all-cause mortality.

COVID-19 and Cardiovascular Disease: a Global Perspective

PURPOSE OF REVIEW

This review aims to assess the global impact of the COVID-19 pandemic on the cardiovascular diseases (CVDs), trying to assess the possible future trajectory of the CVDs and their management.

RECENT FINDINGS

The COVID-19 pandemic has had a deleterious impact on the CV risk factors, with an increase in both sedentary and unhealthy food habits. The fear of contagion has decreased the access to the emergency systems with an increase in out-of-hospital-cardiac-arrests and late presentation of acute myocardial infarctions. The closure of the non-urgent services has delayed cardiac rehabilitation programmes and chronic clinical care. As a result of the COVID-19 pandemic impact on the population habits and on the management of CVDs, we will probably face an increase in CVD and heart failure cases. It is crucial to use all the non-traditional approaches, such as telemonitoring systems, in order to overcome the difficulties raised by the pandemic.