Breaking the Sedentary Cycle: Exploring the Link between Physical Activity and Academic Performance among Female College Students in Bangladesh

IntroductionOur aims were to provide the first national estimates of physical activity (PA) for Vietnam, and to investigate issues affecting their accuracy.MethodsMeasurements were made using the Global Physical Activity Questionnaire (GPAQ) on a nationally-representative sample of 14706 participants (46.5% males, response 64.1%) aged 25−64 years selected by multi-stage stratified cluster sampling.ResultsApproximately 20% of Vietnamese people had no measureable PA during a typical week, but 72.9% (men) and 69.1% (women) met WHO recommendations for PA by adults for their age. On average, 52.0 (men) and 28.0 (women) Metabolic Equivalent Task (MET)-hours/week (largely from work activities) were reported. Work and total PA were higher in rural areas and varied by season. Less than 2% of respondents provided incomplete information, but an additional one-in-six provided unrealistically high values of PA. Those responsible for reporting errors included persons from rural areas and all those with unstable work patterns. Box-Cox transformation (with an appropriate constant added) was the most successful method of reducing the influence of large values, but energy-scaled values were most strongly associated with pathophysiological outcomes.ConclusionsAround seven-in-ten Vietnamese people aged 25–64 years met WHO recommendations for total PA, which was mainly from work activities and higher in rural areas. Nearly all respondents were able to report their activity using the GPAQ, but with some exaggerated values and seasonal variation in reporting. Data transformation provided plausible summary values, but energy-scaling fared best in association analyses.

Objectives: The prevalence of overweight and obesity among university students is increasing, with physical inactivity being a key contributing factor. This study aimed to assess physical activity (PA) patterns among overweight and obese students at the University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam. Methods: A cross-sectional study was conducted on 411 overweight and obese students using the World Health Organization’s Global Physical Activity Questionnaire (GPAQ). Data were entered using Microsoft Office Excel 2016 and analyzed in RStudio version 4.5.0. Results: A total of 50.9% of overweight and obese students did not meet the WHO’s recommendations on PA for health. The proportions of low, moderate, and high PA levels were 58.9%, 13.4%, and 27.7%, respectively. Male students engaged in more physical activity and were more likely to meet recommended PA levels than female students, who tended to engage in more sedentary behaviours (p < 0.05). A non-linear trend was found between PA levels and BMI categories. Conclusions: A large proportion of overweight and obese medical students did not meet the WHO physical activity recommendations. The findings indicate a need for medical universities to promote travel-related and recreational physical activity to support weight management.

Background: The transition to young adulthood offers more autonomy in making lifestyle choices, many of which can be unhealthy. Lack of physical activity (PA) and prolonged sedentary behaviour (SB) can have adverse effects on the concurrent and future health and wellbeing of young adults. However, little is known about PA and SB among young adults in low-and-middle-income countries (LMICs), where rapid urban-industrial transformation may promote a sedentary lifestyle and affect wellbeing. Bangladesh is an LMIC with young adults representing one-fifth of the country’s population. Major causes of poor health in this age group are attributed to non-communicable diseases and psychosocial disorders. Given the established associations with health and wellbeing, it is essential to understand PA and SB of young adults in Bangladesh. Objectives: To assess the (i) prevalence and sociodemographic patterns of PA and SB, (ii) individual-level correlates of PA, SB, and changes in PA and SB, and (iii) associations of PA and SB with psychological distress and sleep difficulties among university-based young adults in Bangladesh.Design and Methods: A one-year prospective study with two assessment points was conducted to collect data. The self-administered written survey included the Global Physical Activity Questionnaire (GPAQ) to assess PA and SB. Wellbeing was assessed using the Kessler 6 Psychological Distress scale and a single item on sleep difficulties. Data on sociodemographic, health, wellbeing, lifestyle, and environmental factors were also collected.Setting/participants: Participants were undergraduate students aged 18 to 24 years from six universities (3 public and 3 private) in Dhaka city, Bangladesh (Wave 1=573; response rate 92%, 45% female; Wave 2=395).Results: Overall, 17% of participants at Wave 1 and 23% at Wave 2 met the World Health Organization recommendations to do ≥150 mins/week of moderate-to-vigorous PA (MVPA). Significantly more males than females were meeting the recommendations at both waves (Wave 1: 27% vs. 6%; Wave 2: 34% vs. 12%). Median duration of MVPA was significantly higher (p<.0001) for males [120 mins/week] than females [90 mins/week]. Jogging/running was the most common recreational PA, with 20% males and 12% females doing this at least once per week. Females participated more in indoor activities (e.g., yoga, stationary exercise), and males did more outdoor activities (e.g., cricket, football) at Wave 1.Overall, 45% participants at Wave 1 and 39% at Wave 2 had high SB (≥480 mins/day). More females than males had high SB at both waves (Wave 1: 52% vs. 39%; Wave 2: 46% vs. 32%). Females reported more time than males in sitting-talking and telephone time during both weekends and weekdays, and television time during weekend days, at Wave 1. Based on Wave 1 data on perceived environmental barriers to PA, poor street lighting at night (62%) and lack of convenient places for PA (56%) were the most common environmental barriers to PA. Analysis of Wave 1 data found that lack of safety and lack of convenient places were more salient to females than males.Multivariable modelling of prospective data showed that PA efficacy and participation in organised sports were positively associated with both females and males’ PA. PA outcome expectations, healthy sleep duration, life satisfaction, and increased age were positive correlates of females’, but not males’, PA. Being male, high phone time, and not participating in organised sports at Wave 1 were associated with a decrease in PA over one year. Prospective data modelling of SB found that female gender, increased age, studying in a public university, and living with the family were positively associated with SB. Prospective data modelling indicated that insufficient PA (<150 mins/week) was independently associated with both distress and sleep difficulties. High SB (≥480 mins/day) was not significantly associated with either wellbeing measures. Participants with insufficient PA+high SB or insufficient PA+low SB had more distress than those with sufficient PA+low SB. Participants with insufficient PA+high SB had higher odds of often experiencing sleep difficulties than those with sufficient PA+low SB.Conclusions: Findings suggest a high prevalence of insufficient PA and prolonged SB among university-based young adults in urban Bangladesh, in particular among females. There were gender-based differences in correlates of PA. Insufficient PA, irrespective of SB, was significantly associated with poor psychological wellbeing. Findings of this research can be instrumental in developing strategies to promote an active and healthy lifestyle among young adults in Bangladesh. Proposed initiatives include organised and weekend sports, female-friendly PA facilities at universities as well as in local residential areas, and female only gym or dedicated hours for females. Recommendations also include government initiatives and a national PA policy for the development of infrastructures that foster healthy activity behaviours, implementation of the existing policies for active lifestyle, and investment in national surveillance. Long-term prospective research is needed with population-based representative samples, including regional and metropolitan areas, to understand the trajectory of these behaviours, and to assess the direction of associations between PA, SB and wellbeing.

e13085 Background: The association between physical activity and breast cancer has not been studied among Nigerian women and in particular by breast cancer sub-types. Therefore are studies aims are to examine the association between leisure time physical activity (LTPA) and breast cancer in Nigerian women and to examine the association between LTPA and estrogen receptor positive (ER+), triple negative breast cancer (TNBC+), Luminal A breast cancer in Nigerian women. Methods: We enrolled 739 newly diagnosed primary invasive breast cancer and 739 age-matched controls in Nigeria from 01/2014 to 07/2016. This analysis is restricted to the 40% of cases for whom we have complete ER, TNBC and Luminal-A data and their matched controls. We derived the average amount of time per week spent on LTPA over the past one year using a modified Nurses’ Health Study II PA questionnaire. LTPA was calculated from the total metabolic equivalent (METs) assigned for each reported physical activity hour/week (i.e. walking, cycling, and dancing). We examined LTPA by comparing participants who attained the WHO physical activity recommendations of at least 150 minutes of moderate-intensity or/and 75 minutes of vigorous-intensity aerobic activity weekly with those who did not. We used conditional logistic regression to estimate the adjusted Odds Ratio (OR) of LTPA and overall as well as subtypes of breast cancer. Results: The mean (SD) age of cases was 41.6 (9.1) and controls was 43.9 (11.8) years. Women who attained the WHO physical activity recommendations had 43% decreased risk of breast cancer (OR = 0.57 95% CI:0.42-0.77) compared with those who did not, after controlling for demographic, anthropometric and fertility related factors. LTPA was also associated with reduced risk of breast cancer subtypes by 41% for ER+, 59% for TNBC+ and 59% for Luminal A. Conclusions: Physical activity is associated with reduced risk of breast cancer overall and by subtypes in Nigerian women.

Physical Activity in 22 African Countries: Results from the World Health Organization STEPwise Approach to Chronic Disease Risk Factor Surveillance

BackgroundSufficient physical activity (PA) is a key element for the prevention of non-communicable diseases. Considering leisure time physical activity (LTPA), the purpose of the survey was to provide descriptive data for LTPA, find the proportion of the study population meeting the recommended WHO PA criteria, and to detect the possible relationship between LTPA and overweight.MethodsThe National Physical Activity Survey was carried out in autumn 2015 in the Estonian population (n = 914) aged 15–69 years. For LTPA assessment, the LTPA domain of IPAQ-L interview version was used. LTPA was analysed in regard to fulfilment of the WHO PA recommendations and in association with BMI.ResultsSeventy-three percent of study participants reported any LTPA in the preceding 7 days. 22 % (26 % of men, 20 % of women) met WHO PA recommendations. 50 % of the study participants were considered overweight (48 % of men, 51 % of women) with BMI > 25.0 kg/m2, whereas 20 % of the total study population was obese (BMI ≥ 30.0 kg/m2). Lower adherence to WHO PA recommendations was associated with older age in men, and obesity in both men and women.ConclusionsA strikingly low proportion of people met WHO PA recommendations and a relatively high proportion of overweight people were detected in the study group. Obesity had significant inverse associations with LTPA.

Leisure Time Physical Activity Is Associated with Substantial Reduction in Risk of Breast Cancer and Breast Cancer Subtypes in Nigerian Women (P16-007-19)

BackgroundThe successful promotion of health-enhancing physical activity (HEPA) requires reliable and valid prevalence data of physical activity (PA) to enable the design, implementation and evaluation of effective and cost-effective policies. As part of the development of a new integrated monitoring framework in Europe, the reliability and validity of the Eurobarometer, European Health Interview Survey (EHIS), International Physical Activity Questionnaire (IPAQ) and Global Physical Activity Questionnaire (GPAQ) were studied in the ongoing European Union Physical Activity and Sport Monitoring System project (EUPASMOS) among 18 European Union member states.MethodsPhysical activity (PA) and sedentary behavior (SB) were assessed among 80-100 adults per member state using the four questionnaires and the UKK RM42 accelerometer. Participants completed the questionnaires in random order and wore the accelerometer seven consecutive days on their right hip (during the day) and on their non-dominant wrist (overnight). Time spent in moderate-to-vigorous intensity physical activity (MVPA), sedentary behavior and adherence to the WHO PA guidelines were calculated based on the 5 methods. The reproducibility and validity of the four questionnaires were tested by using the Spearman's correlation coefficient (ρ) or Cohen's kappa coefficient (κ), dependent of the outcome measure.ResultsPreliminary results from the Netherlands (N = 91) showed that the correlations for reproducibility of all four questionnaires varied between 0.51 and 0.63 for MVPA, between 0.30 and 0.60 for the WHO PA guidelines and between 0.65 and 0.82 for SB. All correlations were statically significant (p > 0.05). Significant correlations for validity of the questionnaires were found for MVPA (ρ = 0.22-0.43) and the WHO PA guidelines (ρ = 0.19-0.25). The only exception was the association between the EHIS questionnaire and the WHO PA guidelines. For SB, only GPAQ and the EHIS questionnaire showed significant associations (ρ = 0.31-0.32).ConclusionsFirst analyses of the Dutch data within the EUPASMOS project showed that the four commonly used questionnaires in Europe are fairly to strongly reliable methods depending on the outcome measure. The four questionnaires are fairly valid methods, except the Eurobarometer and IPAQ when examining SB. It is of interest to examine the quality of these questionnaires in all 18 member states for national and European policy makers.

Issue The convergence of global sustainability and health promotion implies integrated policies and actions. Initiatives like the European Green Deal and the UN’s Sustainable Development Goals emphasize the urgent need to address climate change while promoting health through behaviours such as physical activity (PA). Description We explore the relationship between PA, sustainability, and health outcomes, highlighting the European Green Deal’s impact on PA promotion and the 2030 Agenda for Sustainable Development’s alignment with health behaviours. In addition, we further discuss the concept of “green exercise” and provide insights about how eco-friendly initiatives (e.g., plogging) may have dual benefits in both individual and environmental domains. Results Emerging eco-friendly activities, including plogging, plalking and pliking, directly benefit the environment, while holding the potential to contribute to PA accumulation. Walking while picking up litter (i.e., plalking) can represent up to 4-5 metabolic equivalents (METs), which corresponds to performing a moderate-intensity PA. If other activities - running or cycling - are performed while picking up litter, the number of METs (i.e., &amp;gt;6 METs) involved may correspond to performing a vigorous-intensity PA. Lessons The physiological impact of eco-friendly activities, such as litter picking, reveals their potential as moderate to vigorous-intensity PA, favouring compliance with WHO PA recommendations (i.e., 150 min/week). Integrated policies and actions are needed to address global challenges effectively, emphasizing the interconnectedness of PA promotion, sustainability efforts, and health outcomes. Key messages • Engaging in green initiatives fosters PA and supports the United Nations’ goals for health and sustainability. • Plogging and similar eco-activities offer dual benefits: cleaner environments and healthier lifestyles.

BackgroundPrevious research showed negative associations between physical activity and loneliness in older adults. However, information on associations among middle-aged adults is scarce. In this prognostic factor study, we investigated if starting or stopping to follow the WHO physical activity recommendations was associated with changes in perceived social exclusion and loneliness in this age bracket.MethodsWe used longitudinal representative data of participants aged 40 to 64 years from the German Ageing Survey waves in 2014 and 2017 (analytical sample = 4,264 observations, 54% women). Perceived social exclusion was investigated with the scale from Bude and Lantermann. Loneliness was quantified with the 6-items loneliness scale from De Jong Gierveld. Information from the International Physical Activity Survey items on the time spend in moderate and vigorous physical activity per week was dichotomized. Participants were coded as either following or not following the WHO´s physical activity recommendations of spending at least 150 min of moderate, 75 min of vigorous or an appropriated combination of physical activity per week. We investigated the within (individual) association between starting and stopping to follow WHO´s physical activity recommendations and perceived social exclusion as well as loneliness in asymmetric fixed effects regressions. Analyses were adjusted for age, marital status, employment status, social-network size, general self-efficacy, depressive symptoms, self-rated health, BMI, comorbidities, and physical functioning (SF-36).ResultsStopping to follow the physical activity recommendations from the WHO was associated with perceived social exclusion (ß= 0.09 p = 0.04) but not with loneliness (ß=-0.01, p = 0.71). Starting to follow the WHO physical activity recommendations was neither associated with social exclusion (ß=-0.02, p = 0.54) nor with loneliness (ß=-0.01, p = 0.74) in adjusted asymmetric fixed effects regressions.ConclusionIn middle-aged adults, longitudinal associations were found for physical activity and perceived social exclusion. Perceived social exclusion may be prevented by maintaining at least 150 min of moderate physical activities per week, which is the WHO physical activity recommendation. Future research should investigate moderators and mediators in the association between physical activity and social exclusion as well as loneliness.

Objectives After cardiac surgery, there may be barriers to being physically active. Patients are encouraged to gradually increase physical activity, but limited knowledge exists regarding postoperative physical activity levels. This study aimed to assess patient-reported physical activity six months after cardiac surgery, determine adherence to WHO's physical activity recommendations, and explore potential relationships between pain, dyspnea, fear of movement, and activity levels. Methods The study design was a cross-sectional study at Örebro University Hospital, Sweden. Preoperative and surgical data were retrieved from medical records and questionnaires concerning physical activity (Frändin-Grimby Activity Scale, the Physical activity Likert-scale Haskell, Patient-Specific Functional Scale, and Exercise Self-efficacy Scale) were completed six months after surgery. Data were collected on pain, dyspnea, general health status and kinesiophobia i.e. fear of movement, using the Tampa Scale of Kinesiophobia Heart. Results In total, 71 patients (68 ± 11 years, males 82%) participated in this study. Most patients (76%) reported a light to moderate activity level (Frändin-Grimby levels 3-4) six months after cardiac surgery. In total, 42% of the patients adhered to the WHO’s physical activity recommendations (150 min/week). Pain and dyspnea were low. Patients with lower activity levels exhibited significantly higher levels of fear of movement (p =.025). Conclusions The majority of patients reported engaging in light to moderate activity levels six months after cardiac surgery. Despite this, less than half of the patients met the WHO's physical activity recommendations. Potential barriers to physical activity such as pain, dyspnea and fear of movement were reported to be low.

The World Health Organization has set physical activity guidelines to reduce physical inactivity and its consequences. However, 1.4 billion adults worldwide are not meeting the recommendation. Adherence to this recommendation and its correlates has not been assessed in Southwest Ethiopia. To determine the proportion of healthy adults meeting the physical activity recommendations and identify its correlates in urban centers of Southwest Ethiopia. A community-based cross-sectional study was conducted in 2021, involving 1191 adults. Data was collected using the Global Physical Activity Questionnaire. Multivariable logistic regression was used to identify factors associated with meeting the physical activity recommendations using a 95% confidence interval of adjusted odds ratio (AOR) at a p-value of < 0.05. A total of 1191adults participated in this study with a 93.3% response rate. Females accounted for more than half of the participants 643(54.0%). Only 38.8% of participants met the physical activity recommendations. Age 18-29 years (AOR=3.6;95% CI (2.4-5.4)), 30-44 years (AOR=2.8; 95% CI (1.9-4.0)), male sex (AOR=4.2; 95% CI (3.1-5.6)), lower educational status (AOR=1.83; 95%CI (1.35-2.5)), community participation (AOR=2.3;95% CI (1.6-3.4)),physical exercise of family members (AOR=2.4; 95%CI (1.8-3.3)) and physical exercise of friends (AOR=1.9; 95% CI (1.4-2.5)) were significantly associated with meeting the recommendations. The proportion of adults who met the recommendations in the study area is low. Socio-demographic, family, and social characteristics were associated with meeting the recommendations. Community participation and family-based physical activity have to be advocated to avert the consequences of physical inactivity.

Background: Physical activity is associated with many health benefits like maintaining weight and decreased risk factors for Non-communicable Diseases. Physical inactivity is seen as prevalent among students who have a higher workload especially students in the medical field. Lack of physical activity in students could be one of the reasons for low performance in academics as well as other day-to-day activities Objective: Among the students of a medical college in Dakshina Kannada district in April 2023: to assess levels of physical activity and to determine the barriers to physical activity. Methodology: A cross sectional study recruiting 256 medical students chosen equally from each admission year (4 years) by Stratified Random Sampling with gender. Study duration was 6 months. Global Physical Activity Questionnaire (GPAQ) was used to obtain data. Data collected were entered in Microsoft Excel and reported as frequency and proportions. METs (Metabolic Equivalents) were calculated that are used to express the intensity of physical activities. Results: Most participants were in the age group of 18-24. Less than 4 out of 5 students exhibited lower recommended WHO physical activity. Conclusion: Despite a majority falling within the 18-24 age range and diverse parental education backgrounds, a significant proportion fails to meet WHO recommendations. Identified barriers emphasize need for targeted interventions. The study highlights how critical it is to address these problems in order to encourage medical students to lead more active lives.

Introduction &amp; Purpose The Global Physical Activity Questionnaire (GPAQ; Armstrong &amp; Bull, 2006) is commonly used to assess frequency, duration and intensity of physical activity (PA) in three domains: work, travel and recreation. It is frequently used as a self-administered questionnaire; however, the execution was originally designed for an interviewer. With the continuous development of app-based technology, the evaluation of PA online-assessment is relevant (Mosa et al., 2012). The objective of the study was to compare an online self-administered version of the GPAQ with the original version administered by an interviewer. Methods The physical activity behaviour of 533 participants (70% female, average age 44, ± 13.9) from the LIFE-Tirol Study (Lasting Health through Intermittent Fasting, Emotional Firmness and Exercise) was assessed by an interviewer using the GPAQ. The interviewer used generic show cards for explaining different levels of exercise intensities as recommended in the analysis guidelines (Armstrong &amp; Bull, 2006). After two months, participants were asked to fill in the GPAQ via online app without show cards. Participant were advised not to change their usual physical activity levels during the two months. The movement domains and intensities of the two versions were compared with Jamovi v2.3 using a series of Wilcoxon W-tests and a series of 2 × 2 mixed ANOVAs to analyse gender- and age-specific aspects. Results Total metabolic equivalent task (MET) minutes were significantly different between interview and self-assessed online version (1,971 ± 2,590 vs. 4,143 ± 4,370 MET minutes; p &lt; .001, d = 0.670). Significantly more MET minutes were reported in the online version compared to the interview version across all three PA-domains and both vigorous and moderate intensities (F(1, 552) = 167, p &lt; .001, ƞ² = .232). This difference was not influenced by gender. 18–34-year-old participants reported significantly less MET minutes during recreational PA than participants older than 55 years in both versions (F(1, 551) = 113, p &lt; .001, ƞ²= .170). No further gender/age × assessment interaction effects were found. Male participants tend to report higher intensity minutes more likely than females in both assessment versions (F(1, 551) = 4.43, p = 0.360, ƞ²= .008). Discussion The amount of PA as well as its intensities seem to differ between the self-assessed online version compared to the interview assessment of the GPAQ, although the interview was conducted as the first measurement and PA as well as intensities were explained in detail to participants using generic show cards. It was previously reported that show cards have no significant impact on the results of the self-administered version of the GPAQ (Rudolf et al., 2020). Therefore, the authors suggest that the main differences between both assessments were caused by the presence of the interviewer independent of age or gender. Conclusion Regardless of the use of show cards and detailed explanations of PA, the main difference between guided and self-administered PA-assessments may result from the presence or absence of an interviewer. Therefore, it is important to interpret self-administered app-based GPAQ evaluations with caution. Future studies should validate app-based GPAQ data by using objective PA measurements, such as accelerometers.

Physical activity (PA) is an important preventive factor of non-communicable diseases (NCDs), particularly cardiovascular disease, yet progress towards reducing physical inactivity in populations is slow. Population-levels of PA are most often estimated using self-report questionnaires in population surveys, such as the Global PA Questionnaire (GPAQ), which may not accurately reflect objectively measured PA, such as accelerometers. The aim of the current study was to compare self-report vs objectively measured PA across 5 African-origin populations. Approximately 2,000 African-origin men and women (35-55 yrs) were enrolled in a prospective cohort study to explore the relationship between lifestyle and cardiometabolic health. Participants were from Ghana, South Africa (SA), Jamaica, Seychelles, and the United States (US). Data collection included objective PA (accelerometer) and self-reported PA (GPAQ). WHO defines "sufficiently active" as performing >150 minutes of moderate intensity PA per week, or >600 MET*min/week (metabolic equivalent of task in minutes/week). Logistic regression was used to determine the proportion of participants that were physically active by accelerometry, among those who were found as sufficiently active based on GPAQ. 1,161 participants had complete self-reported PA and accelerometery data. Overall, 23.5% were classified as sufficiently active by both PA measures, while 38.2% of those classified as sufficiently active based on self-reported PA did not meet the criteria using objective monitoring (sensitivity of GPAQ: 74%, specificity: 44%). Among participants who were classified as sufficiently active according to the questionnaire (n=717), participants from Ghana (OR=3.2, p<0.01), SA (OR=5.3, p<0.01), Jamaica (OR=2.3, p=0.01), and Seychelles (OR=1.9, p=0.03) were more likely to be similarly classified as sufficiently active based on accelerometry, compared to those from the US, and men (OR=2.9, p<0.01) more likely than women. Finally, obese participants had 0.4 times lower adjusted odds to be similarly classified as sufficiently active using objective measures compared to non-obese participants (p<0.01). Our findings further underscore difficulties in interpreting self-reported PA, which may furthermore vary across different settings and socio-economic settings. Given the importance of PA interventions for reducing the NCD burden, future research should explore tailored approaches to better understand self-report PA accuracy and to better assess the dose-response between PA and cardiometabolic risk.