Leisure-time physical activity from adolescence to late middle age and its associations with the COVID-19 pandemic: A 45-year follow-up

Changes in leisure time physical activity and risk of all-cause mortality in men and women: The Baltimore Longitudinal Study of Aging

Retirement brings changes in daily life, which may have implications for life satisfaction and leisure-time physical activity (LTPA). This study sought to examine associations between concurrent changes in life satisfaction and LTPA across retirement, addressing gaps in understanding how life satisfaction influences physical activity in retirees. Study included 3535 public sector workers (83% women) from the Finnish Retirement and Aging study with annual surveys before and after retirement. Participants were categorized based on their Life Satisfaction Scale responses before and after retirement into Stable Low, Low-Increasing, Intermediate-Decreasing, Stable Intermediate, Intermediate-Increasing, High-Decreasing, and Stable High life satisfaction. Self-reported weekly LTPA during past 12 months was summarized as metabolic equivalent hours (METh/week). Generalized estimating equations were used to examine changes in LTPA across retirement transition among these groups, adjusting for sociodemographic and health-related factors. Compared to Stable Low, Low-Increasing life satisfaction was associated with increasing LTPA (mean difference 4.16 METh/week, 95%CI 0.85 to7.47). Compared to Stable Intermediate, Intermediate-Increasing life satisfaction was associated with increasing LTPA (mean difference 1.96 METh/week, 95%CI 0.03 to 3.88), while Intermediate-Decreasing life satisfaction was linked to decreasing LTPA (mean difference −3 .79 METh/week, 95%CI −7.62 to 0.04). No differences were observed between Stable High and High-Decreasing life satisfaction. Changes in life satisfaction during retirement transition are associated with changes in LTPA, especially among those with low or intermediate life satisfaction before retirement. Further research is needed to assess, whether supporting life satisfaction in retirees could foster greater engagement in LTPA.

Whether changes in leisure-time physical activity (LTPA) over time are associated with lower risk of stroke is not well established. We examined the association between changes in self-reported LTPA 10 years apart, with risk of incident stroke in the CTS (California Teachers Study). We hypothesized that the risk of stroke would be lowest among those who remained active. Sixty-one thousand two hundred and fifty-six CTS participants reported LTPA at 2 intensity levels (moderate and strenuous activity) at 2 time points (baseline 1995-96; 10-year follow-up 2005-2006). LTPA at each intensity level was categorized based on American Heart Association (AHA) recommendations (moderate, >150 minutes/week; strenuous, >75 minutes/week). Changes in LTPA were summarized as follows: (1) not meeting recommendations at both time points; (2) meeting recommendations only at follow-up; (3) meeting recommendations only at baseline; and (4) meeting recommendations at both time points. Incident strokes were identified through California state hospitalization records. Using multivariable Cox models, we examined the associations between changes in LTPA with incident stroke. Nine hundred and eighty-seven women were diagnosed with stroke who completed both questionnaires. Meeting AHA recommendations at both the time points was associated with a lower risk of all stroke (adjusted hazard ratio, 0.84; 95% confidence interval, 0.72-0.98). The protective effects for stroke were driven by meeting AHA recommendations for moderate activity and largely observed for ischemic strokes (adjusted hazard ratio, 0.70; 95% confidence interval, 0.55-0.88). Meeting AHA recommendations for moderate activity had a protective effect for reducing ischemic stroke risk. Participants who met AHA recommendations at baseline but not at follow-up, however, were not afforded reduced stroke risk.

The association of changes in leisure-time physical activity on depressive symptoms during Covid-19 in German adults: A longitudinal study

Introduction: Leisure time physical activity (LTPA) has been consistently associated with a lower risk of stroke across several populations. Less is known however about how changes over the life-time in physical activity may influence the risk of stroke. We examined the association of changes in engaging in moderate and strenuous physical activity with risk of stroke in the California Teachers Study. Methods: The California Teachers Study is a prospective cohort study established in 1995. Baseline LTPA was obtained using a questionnaire outlining time spent in moderate (brisk walking for example) and strenuous (swimming and running for example); the same questionnaire was repeated in 2005-6. We defined the exposure as engaging in any activity for at least 15 minutes per week (any) in the second questionnaire when not engaging in any on the first questionnaire, with the reference being no change or a decline in activity between both. Multi-variable Cox models were constructed to examine the association of the change in LTPA with risk of stroke. Separate models were created for moderate and strenuous activity. Results: There were a total of 61,256 participants with two LTPA questionnaires available separated by 10 years. A total of 3,111 participants increased their level of moderate activity, 11,744 remained active in both, 2,760 declined from the first to the second questionnaire, while 2,508 reported no activity in both. There were 987 (709 ischemic, 221 hemorrhagic, 247 deaths) strokes after the second questionnaires (mean follow up 6.5 years). In multi-variable models increasing any moderate intensity from none from the two questionnaires, versus no change or decline in activity, was associated with a lower risk of all stroke (adjusted HR 0.83, 95% CI 0.72-0.95). We found no associations of changes in strenuous LTPA with risk of stroke (adjusted HR 0.99, 95% CI 0.83-1.17). The associations were statistically significant for ischemic stroke (adjusted HR 0.75, 95% CI 0.64-0.89) but not hemorrhagic stroke (adjusted HR 0.94, 95% CI 0.72-1.25). Conclusion: Improving or maintaining moderate intensity physical activity is associated with a lower risk of stroke, while changes in strenuous activity is not.

Although research indicates that low fitness in youth is associated with a higher risk of chronic disability in men, the association of fitness in adolescence with work ability in working men and women remains unknown. To examine the associations of adolescent health-related physical fitness with future work ability. This 45-year observational cohort study, conducted in Finland, examined the direct and indirect longitudinal associations of objectively measured health-related fitness in adolescence (in 1976) with self-reported work ability and sickness absence in early middle age (in 2001) and the Work Ability Index in late middle age (in 2021). A countrywide stratified random baseline sample included fitness measurements for cardiorespiratory fitness (CRF) (running 1.5 km for girls and 2 km for boys), musculoskeletal fitness (MF; standing broad jump and sit-ups for both sexes, pull-ups for boys, and flexed-arm hang for girls), and height and weight, from which body mass index (BMI) was calculated. Structural equation modeling-based path analysis, adjusted for age and sex at baseline and for educational level, work-related physical strain, and leisure-time physical activity in late middle age, was conducted. Data analysis was performed from January to July 2023. Self-reported work ability was measured with structured questions in early middle age and with the validated Work Ability Index in late middle age. The final sample from longitudinal analyses (1207 individuals; 579 [48%] male individuals) consisted of participants with fitness measurement from age 12 to 19 years, and work ability assessment from age 37 to 44 years and/or age 57 to 64 years. Higher adolescent CRF was associated with higher work ability (839 participants; β = 0.12; 95% CI, 0.01 to 0.22; P = .03) and lower sickness absence (834 participants; β = -0.07; 95% CI, -0.12 to -0.02; P = .004) in early middle age and, indirectly, mediated by work ability in early middle age, with a higher work ability at the end of working age (603 participants; β = 0.04; 95% CI, 0.001 to 0.08; P = .04). The results remained consistent in both sexes and after adjustment for the confounders. Neither MF nor BMI was associated with work ability (MF, 1192 participants; β = -0.07; 95% CI, -0.17 to 0.03; BMI, 1207 participants, β = 0.09; 95% CI, -0.004 to 0.19) or sickness absence (MF, 1185 participants, β = 0.02; 95% CI, -0.03 to 0.06; BMI, 1202 participants, β = -0.03; 95% CI, -0.09 to 0.03) in early middle age or with late middle age work ability, mediated by work ability in early middle age (MF, 603 participants, β = -0.02; 95% CI, -0.06 to 0.01; BMI, 603 participants, β = 0.03; 95% CI, -0.004 to 0.07). These findings suggest that low CRF in youth is associated with poor work ability at the middle and end of working life, which highlights the informative and prognostic value of CRF assessment early in youth. Enhancing CRF in the first decades of life might contribute to better work capacity and productivity in the labor force, which would have implications for health, quality of life, society, and the economy.

Background: The benefit of leisure time physical activity (LTPA) in preventing peripheral artery disease (PAD) is well established. However, no prior studies have examined how longitudinal changes in LTPA during mid-life influence the risk of future PAD in men and women. Methods: We included participants from the Atherosclerosis Risk in Communities (ARIC) study who attended visit 3 and were free of PAD [ankle brachial index (ABI) >0.90] with available ABI during follow-up (measured ~5, 18, and 25 years after visit 3). LTPA was assessed using the modified Baecke questionnaire and defined as ideal, intermediate, or poor by the American Heart Association. Change in LTPA from visit 1 (1987-1989) to 3 (1993-1995) was subcategorized as 1) persistently poor, 2) decreased, 3) increased, or 4) persistently active. The primary outcome of time-to-incident PAD after visit 3 (ABI ≤ 0.90), was assessed using Cox models adjusted for relevant covariates. Results: A total of 8,421 participants were included (mean age 59 ± 5.5 years, 56% women, 20% Black). From visit 1 to 3, 1,609 participants had persistently poor LTPA, 1,860 decreased their activity, 2,015 increased their activity, and 2,937 remained persistently active. During a median follow-up of 17.7 years, 853 ARIC participants developed PAD (471 women and 382 men). An increasing or persistently active level of LTPA was associated with lower risk of incident PAD (HR 0.74 (0.60, 0.89) p=0.003 and HR 0.71 (0.58, 0.85) p<0.001 respectively) compared to persistently poor LTPA. There was no difference between those in the decreasing LTPA category and those with persistently poor LTPA (HR 0.88 (0.72, 1.09) p=0.24). There were no interactions with race, age, or body mass index; however, there was significant effect modification by sex (p-int 0.01). Men who increased activity or were persistently active had lower risk of developing PAD as compared to those with persistently poor LTPA (Table). There was no association between changes in LTPA and incident PAD in women. Conclusions: Maintaining or increasing LTPA over six years was associated with decreased risk of incident PAD in men but not in women. Further research is needed to clarify sex differences in these associations.

Trends in Leisure Time and Occupational Physical Activity in the Madrid Region, 1995–2008

Risky business: The effects of an individualized health information intervention on health risk perceptions and leisure time physical activity among people with spinal cord injury

BackgroundThe COVID-19 pandemic containment measures may affect lifestyle. We aimed to examine the changes in key lifestyle factors based on the data from same individuals before (2017) and during (2020) the COVID-19 pandemic.MethodsThe study is based on the FinHealth 2017 Study representing the Finnish adult population, and its follow-up questionnaire conducted in autumn 2020. A total of 4814 individuals aged 25 and older at baseline answered the same questions on lifestyle in both years. Regular leisure-time physical activity (LPA), daily use of vegetables and/or fruits, experience of adequate sleep, daily use of nicotine products and high-risk use of alcohol, were dichotomized (yes/no) for the analysis. Weighted prevalence (no/favorable/unfavorable change) for three age groups (25-49, 50-69, 70+ years) was analyzed using multinomial logistic regression, sampling design and non-response acknowledged.ResultsIn general, the prevalence of total changes observed varied 6 − 27% between lifestyle factors. The changes were both unfavorable and favorable for health. About 14% (95% CI 11,17) and 12% (95% CI 9,16) of older women and men, respectively, had LPA in 2017 but not in 2020. Corresponding prevalence for favorable change in LPA were smaller, 6% (95% CI 4,8) in older women and 7% (95% CI 4,9) in men. In older women, the results concerning daily use of vegetables and fruits were parallel. In contrast, in older women the changes observed in the experience of adequate sleep were mainly favorable. In all age groups, high-risk use of alcohol slightly decreased especially in men but the changes in use of nicotine products were minor.ConclusionsThe results highlight unfavorable changes in LPA and vegetable consumption especially in older women during the COVID-19 pandemic. Part of the unfavorable changes may be explained by aging, but the pandemic containment measures may have accelerated them indicating the need for health promotion actions among the elderly.Key messages The lifestyle changes observed during COVID-19 pandemic were complex, varying by sex and age groups and being both favorable and unfavorable for health.Special attention should be given to promotion of physical activity in the elderly during and after the pandemic.

Although the benefits of leisure-time physical activity (LTPA) in middle age are established, the health effects of long-term participation and changes in LTPA between adolescence and middle age have not been documented. To determine whether an association exists between LTPA life course patterns and mortality. This prospective cohort study used data from the National Institutes of Health-AARP (formerly American Association of Retired Persons) Diet and Health Study established in 1995 to 1996. Data analysis was conducted from March 2017 through February 2018. Data were analyzed for 315 059 adult AARP members living in 6 states, namely, California, Florida, Louisiana, New Jersey, North Carolina, or Pennsylvania, or 2 metropolitan areas, Atlanta, Georgia, or Detroit, Michigan. Self-reported LTPA (hours per week) at the baseline interview for ages grouped as 15 to 18, 19 to 29, 35 to 39, and 40 to 61 years. All-cause, cardiovascular disease (CVD)-related, and cancer-related mortality records available through December 31, 2011. Of 315 059 participants, 183 451 (58.2%) were men, and the participants were 50 to 71 years of age at enrollment. Ten LTPA trajectories (categorized as maintaining, increasing, and decreasing LTPA across time) were identified, and 71 377 deaths due to all causes, 22 219 deaths due to CVD, and 16 388 deaths due to cancer occurred. Compared with participants who were consistently inactive throughout adulthood, participants who maintained the highest amount of LTPA in each age period were at lower risks for all-cause, CVD-related, and cancer-related mortality. For example, compared with participants who were consistently inactive, maintaining higher amounts of LTPA was associated with lower all-cause (hazard ratio [HR], 0.64; 95% CI, 0.60-0.68), CVD-related (HR, 0.58; 95% CI, 0.53-0.64), and cancer-related (HR, 0.86; 95% CI, 0.77-0.97) mortality. Adults who were less active throughout most of the adult life course but increased LTPA in later adulthood (40-61 years of age) also had lower risk for all-cause (HR, 0.65; 95% CI, 0.62-0.68), CVD-related (HR, 0.57; 95% CI, 0.53-0.61), and cancer-related (HR, 0.84; 95% CI, 0.77-0.92) mortality. Maintaining higher LTPA levels and increasing LTPA in later adulthood were associated with comparable low risk of mortality, suggesting that midlife is not too late to start physical activity. Inactive adults may be encouraged to be more active, whereas young adults who are already active may strive to maintain their activity level as they get older.

BackgroundRegular leisure time physical activity (LTPA) has beneficial health effects in people with spinal cord injury (SCI). Yet, participation in LTPA is low, and little is known about changes many years after injury. ObjectivesTo determine changes in LTPA in middle-aged and older adults with long-term SCI over six years, investigate associations with gender, age, injury characteristics and changes in secondary health conditions and activity limitations, and investigate factors related to being physically active or sedentary. MethodsPart of the Swedish Aging with Spinal Cord Injury Study (SASCIS). LTPA was assessed twice over a six-year period with the Physical Activity Recall Assessment for people with Spinal Cord Injury (n = 75; 32% women, mean age 67 years, mean time since injury 31 years, injury levels C1-L3, AIS A-D). Changes were assessed with paired t-tests, McNemar test and Wilcoxon signed-rank test, associations with multivariable regression and group comparisons with Mann-Whitney U test and Chi Square test. ResultsOn group level participation in LTPA did not change, but the variability was substantial on individual level. There were no significant associations between changes in LTPA and the investigated variables. Among sedentary participants, higher level and severity of injury were overrepresented and the activity limitations were greater. ConclusionOur findings indicate stability in LTPA over time, but with a large individual variation. In many participants LTPA was insufficient to reach positive health effects. Promoting participation in LTPA is therefore an important part of the long-term management of middle-aged and older adults aging with long-term SCI.

BackgroundLow levels of leisure-time physical activity (LTPA) during pregnancy have been shown in studies conducted worldwide. Surveillance is extremely important to monitor the progress of physical activity patterns over time and set goals for effective interventions to decrease inactivity among pregnant women. The aim of this study was to evaluate time changes in LTPA among Brazilian pregnant women in an 11-year period (2004–2015) by comparing data from two birth cohort studies.MethodsTwo population-based birth cohort studies were carried out in the city of Pelotas, southern Brazil, in 2004 and 2015. A total of 4244 and 4271 mothers were interviewed after delivery. Weekly frequency and duration of each session of LTPA in a typical week were reported for the pre-pregnancy period and for each trimester of pregnancy. Trends in both recommended LTPA (≥150 min/week) and any LTPA (regardless of weekly amount) were analysed overtime. Changes were also calculated separately for subgroups of maternal age, schooling, family income, parity, pre-pregnancy body mass index and pre-pregnancy LTPA.ResultsThe proportion of women engaged in recommended levels of LTPA pre-pregnancy increased from 11.2% (95%CI 10.0–12.2) in 2004 to 15.8% (95%CI 14.6–16.9) in 2015. During pregnancy, no changes were observed over the period for the first (10.6 to 10.9%) and second (8.7 to 7.9%) trimesters, whereas there was a decrease from 3.4% (95%CI 2.9–4.0) to 2.4% (95%CI 1.9–2.8) in the last trimester. Major decreases in LTPA in the last trimester were observed among women who were younger, with intermediate to high income, high schooling, primiparous, pre-pregnancy obese and, engaged in LTPA before pregnancy. Changes in any LTPA practice followed the same patterns described for recommended LTPA.ConclusionsDespite the increase in the proportion of women engaged in LTPA before pregnancy between 2004–2015, LTPA levels remained stable during the first and second trimesters of pregnancy and declined during the third gestational trimester over the period. Interventions to encourage the maintenance of LTPA practice throughout pregnancy are urgently needed.

Association between leisure-time physical activity and health-related quality of life changes over time

Theory-based approaches imply that values may be a construct that influences motivation and adherence to health behavior change. PURPOSE: This study examined the associations between individual values and change in physical activity in adults enrolled in a 6-month behavioral weight loss intervention. METHODS: Baseline data for 67 participants (age = 44.2±9.0 years; body mass index = 32.6±3.9 kg/m2) and 58 participants at 6 months (age = 43.9±9.2 years; body mass index = 32.6±4.0 kg/m2) were analyzed. The 6-month behavioral weight loss intervention included prescribed moderate-to-vigorous physical activity of 150 to 250min/wk. Only participants prescribed physical activity within the intervention were included in the statistical analysis. Assessments at baseline and 6 months included: 1) self-reported leisure-time physical activity, 2) personal values, 3) perception of engaging in physical activity would have on their values. RESULTS: At both baseline and 6 months, the three most frequently identified values were marriage/couples/intimate relationships (75.9%), family (60.3%), and parenting (56.9%). Spearman correlation coefficients were not statistically significant between change in leisure-time physical activity and perception of the impact engaging in a physical activity will have on their values at baseline (range of r’s: -0.029 to 0.154, p’s range: 0.364 to 0.927) and 6 months (range of r’s: -0.018 to 0.098, p’s range: 0.564 to 0.916). DISCUSSION: Self-reported values did not change following participation in a behavioral weight loss intervention. Perceptions of how engagement in physical activity would alter values were also not associated with change in leisure-time physical activity. These results suggest that linking physical activity to values would not impact the magnitude of improvement in leisure-time physical activity within the context of a comprehensive behavioral weight loss intervention. However, this warrants additional investigation to determine if interventions specifically linking values to physical activity would elicit similar effects.