ActiGraph GT1M Research Articles

Predictors associated with an increase in daily steps among people with prediabetes or type 2 diabetes participating in a two-year pedometer intervention

BackgroundThis study aimed to explore predictors associated with intermediate (six months) and post-intervention (24 months) increases in daily steps among people with prediabetes or type 2 diabetes participating in a two-year pedometer intervention.MethodsA secondary analysis was conducted based on data from people with prediabetes or type 2 diabetes from two intervention arms of the randomised controlled trial Sophia Step Study. Daily steps were measured with an ActiGraph GT1M accelerometer. Participants were divided into two groups based on their response to the intervention: Group 1) ≥ 500 increase in daily steps or Group 2) a decrease or < 500 increase in daily steps. Data from baseline and from six- and 24-month follow-ups were used for analysis. The response groups were used as outcomes in a multiple logistic regression together with baseline predictors including self-efficacy, social support, health-related variables, intervention group, demographics and steps at baseline. Predictors were included in the regression if they had a p-value < 0.2 from bivariate analyses.ResultsIn total, 83 participants were included. The mean ± SD age was 65.2 ± 6.8 years and 33% were female. At six months, a lower number of steps at baseline was a significant predictor for increasing ≥ 500 steps per day (OR = 0.82, 95% CI 0.69–0.98). At 24 months, women had 79% lower odds of increasing ≥ 500 steps per day (OR = 0.21, 95% CI 0.05–0.88), compared to men. For every year of increase in age, the odds of increasing ≥ 500 steps per day decreased by 13% (OR = 0.87, 95% CI 0.78–0.97). Also, for every step increase in baseline self-efficacy, measured with the Self-Efficacy for Exercise Scale, the odds of increasing ≥ 500 steps per day increased by 14% (OR = 1.14, 95% CI 1.02–1.27).ConclusionsIn the Sophia Step Study pedometer intervention, participants with a lower number of steps at baseline, male gender, lower age or higher baseline self-efficacy were more likely to respond to the intervention with a step increase above 500 steps per day. More knowledge is needed about factors that influence response to pedometer interventions.Trial registrationClinicalTrials.gov, NCT02374788.

Tracking of MVPA across childhood and adolescence

ObjectivesTracking of physical activity from childhood onwards is an important public health issue, but evidence on tracking is limited. This study quantified the tracking of Moderate-Vigorous Physical Activity (MVPA) across childhood and adolescence in a recent cohort from England. DesignLongitudinal, with a socio-economically representative sample from North-East England, over an 8-year period. MethodsMeasures of time spent in MVPA, with an Actigraph GT1M accelerometer, were made at age 7–8y (n = 622, T1), age 9–10y (n = 585, T2), age 12–13y (n = 525, T3) and age 14–16y (n = 361, T4). Tracking of MVPA was assessed using rank order correlations between time spent in MVPA T1–T2, T1–T3, and T1–T4, and by using Cohen's kappa to examine tracking of meeting the MVPA guideline (mean of 60 min/d). We examined whether tracking varied by sex, socio-economic status (SES), initial MVPA, or initial body fatness. ResultsRank order correlations were all statistically significant at p < 0.01 and moderate: 0.58 between T1 and T2; 0.42 between T1 and T3; 0.41 between T1 and T4. Cohen's kappas for meeting the global MVPA guideline were all significant, weakening from moderate to low over the 8 years. Tracking was stronger in higher SES compared to lower SES groups, and there was some evidence that it was stronger in girls than boys, but the other explanatory variables had little influence on tracking. ConclusionsTracking of MVPA from mid-childhood to mid-adolescence in this cohort was moderate. This study suggests there is a need to establish high MVPA by mid-childhood, and to mitigate the age-related reduction in MVPA which occurs from mid-childhood.

Effect of physical activity on erectile and sexual function in healthy males

Physical activity (PA) has beneficial effects on erectile dysfunction (ED). It has been proposed to affect ED physiologically via the vascular and nervous systems. This study aimed to evaluate the effect of physical activity on endothelial erectile function, sex hormones and sperm production in healthy males. Sixty-one healthy men aged 18–35 years were eligible to participate in this biochemical and questionnaire-based study. The participants were classified into two groups according to their physical activity level: a physically active group (PA = 38) and a physically inactive group (PINA = 23). PA was evaluated using the ACTi graph GT1M accelerometer. Erectile function was evaluated using the International Index of Erectile Function (IIEF-15) questionnaire. The levels of the sex hormones testosterone (T) and free testosterone (f-T), and the nitric oxide (NO) and E-selectin levels were measured by enzyme linked immuno sorbent assay (ELISA). In addition, a complete semen analysis was performed for all subjects. Better sperm production was reported in physically active subjects than in nonactive subjects. There was a significant increase (p = 0.001) in the IIEF-15 score, and the levels of T, f-T, NO and E-selectin were estimated in physically active subjects compared with those in nonactive subjects. Erectile function (IIEF-15 score) correlated positively with PA and with increased levels of T, f-T, NO and E-selectin, whereas the IIEF-15 score correlated negatively with age and adiposity. Seminological parameters such as the spermatozoa concentration, sperm viability, motility, morphology and normal forms were significantly improved in physically active subjects. Physical activity at mild to moderate levels is significantly associated with improved erectile function, increased endothelial function, increased sex hormone levels and better sperm production in healthy men aged 18–35 years. This study proposes that physical activity physiologically affects erectile function and spermatogenesis via cellular free radical-antioxidant mechanisms.

Hand grip strength, vitamin D status, and diets as predictors of bone health in 6–12 years old school children

BackgroundVitamin D and calcium-rich foods, exposure to sunlight, and physical activities (PA) play a pivotal role in promoting the production of sufficient vitamin D and improving grip strength needed for better bone health among school children.PurposeThis study aimed to determine the effects of hand grip muscle strength (HGS), vitamin D in addition to diets, and PA on bone health status among 6–12 years old schoolchildren.MethodsThis study was based on a cross-sectional observational design, which was descriptive in nature. A diverse sample of 560 elementary school children aged 6–12 years old were invited to participate in this descriptive cross-sectional study. The Dual-Energy X-Ray Absorptiometry (DXA), QUS technique, and ACTi graph GT1M accelerometer were used respectively as a valid tools to identify BMD, BMC, and other parameters of bone health like c-BUA values and bone stiffness (SI), and physical activity (PA) of all individuals participated in this study. In addition, a hydraulic dynamometer was used to measure hand grip strength among the participants. Moreover, an immunoassay technique was used to measure the serum levels of vitamin 25(OH)D level, and bone metabolism markers; NTX, DPD, Ca, and sBAP in all participants. Bone loss (osteoporosis) was cross-sectionally predicted in 19.64% of the total population, most of whom were girls (14.3% vs. 5.4% for boys; P = 0.01). Compared to boys, the incidence of osteoporosis was higher and significantly correlated in girls with lower HGS, deficient vitamin D, inadequate vitamin D and Ca intake, greater adiposity, poor PA, and lower sun exposure. Also, in girls, lower vitamin 25(OH)D levels, and poor HGS were shown to be significantly associated with lower values of BMD, BMC, SI, and higher values of bone resorption markers; NTX, DPD, and sBAP and lower serum Ca than do in boys. The findings suggested that deficient vitamin D, lower HGS, adiposity, PA, and sun exposure as related risk factors to the pravelence of bone loss among school children, particularly in girls. In addition, these parameters might be considered diagnostic non-invasive predictors of bone health for clinical use in epidemiological contexts; however, more studies are required.

Relative time in physical activity and sedentary behaviour across a 2-year pedometer-based intervention in people with prediabetes or type 2 diabetes: a secondary analysis of a randomised controlled trial

BackgroundPeople with prediabetes or type 2 diabetes (T2D) need to be physically active, including moderate-to-vigorous intensity physical activity (MVPA) and light-intensity physical activity (LIPA) and reduce time in sedentary behaviour (SB). Few studies have evaluated the effect of randomised controlled trials taking all movement behaviours into account. This study aimed to investigate the effects of a 2-year pedometer-based intervention in people with prediabetes or T2D on relative time in movement behaviours.MethodsSecondary analysis of longitudinal data on individuals with prediabetes or T2D from a three-armed randomised controlled trial, the Sophia Step Study, was conducted. The three groups were (1) a multi‑component group (self‑monitoring of steps with a pedometer plus counselling), (2) a single‑component group (self‑monitoring of steps with a pedometer, without counselling), and (3) a standard care group (control). The three behaviours MVPA, LIPA and SB during waking hours were measured with an ActiGraph GT1M accelerometer at baseline, 6, 12, 18 and 24 months. Relative time in MVPA, LIPA and SB for each participant at each time point was calculated and used as outcome measures. Linear mixed models assessed the effect of the intervention over time.ResultsIn total 184 participants with mean (SD) age 64.3 (7.6) years and 41% female was included. In the multi-component group, compared to the control group, a significant group-by-time interaction effect for relative time in all three behaviours was found at 6 and 18 months and for MVPA and SB at 24 months. In the single-component group, compared to the control group, an effect occurred in the MVPA and SB behaviours at 6 months and MVPA and LIPA at 24 months. The estimated marginal means ranged from 0.9 to 1.5% of more MVPA, 1.9–3.9% of less LIPA and from 0.5% of less SB to 1.7 more SB in the intervention groups compared to the control group.ConclusionsThe findings show a beneficial effect on all behaviours over time in the two intervention groups compared to the control group. A more pronounced effect occurred in the multi-component intervention compared to the single-component intervention, implicating the importance of counselling in pedometer-based interventions.Trial registration ClinicalTrials.gov, NCT02374788

The Validity of a Novel Low-Cost, Wearable Physical Activity Monitor in a Laboratory Setting

Introduction: Wearable physical activity monitors are popular and may provide a more accurate data than subjective methods. The present study assessed the validity of a novel, low-cost wearable physical activity monitor (Movband 3) relative to established measures. Methods: Participants (N = 19) completed four treadmill stages (1.5, 3.0, 4.0, 6.0 MPH) while wearing the Movband 3 and the validated Actigraph GT1M monitor. Oxygen consumption (VO2 ml/kg/min) and heart rate (beats/min) were recorded. The relationship between Movband data and established measures was assessed via Pearson’s correlations. Tests of agreement were performed for actual and Movband miles traveled. Results: There were large, positive, significant (p &lt; 0.001) effect sizes for the associations between Movband counts and Actigraph counts (r = 0.72), VO2 (r = 0.59), and heart rate (r = 0.63). There was also a large, positive, significant (p &lt; 0.001) association between actual and Movband miles (r = 0.97). However, the difference (Δ) between Movband and actual miles was greater than a null hypothesis of zero (∆ = 0.77 ± 0.45 miles or 31.8%, t = 7.4, p &lt; 0.001). Conclusion: While there was evidence to support the validity of the Movband 3 for the assessment of physical activity intensity this device did not provide an accurate measure of miles traveled.

P10-11 The effect of a pedometer-based intervention across two years, in people with type 2 diabetes and prediabetes - a compositional data analysis

BackgroundFor people with prediabetes and type 2 diabetes it is important to be regularly physical active. Increasing and maintaining physical activity (PA) can be challenging. The aim of this study was to evaluate the effects of a pedometer-based intervention on PA, with a compositional data analysis (CoDA) approach, in individuals with prediabetes or type 2 diabetes.MethodsLongitudinal data on 188 participants with prediabetes and type 2 diabetes (40% female, mean age = 64.1 years) from a three-armed randomized controlled trail, the Sophia Step Study, was used. The three groups were a multi?component group (self?monitoring of steps with a pedometer, together with group (12 occasions) and individual counselling (10 occasions)), a single?component group (self?monitoring of steps with a pedometer, without counselling) and a standard care group. PA (moderate-to-vigorous PA (MVPA), light-intensity PA (LIPA) and sedentary behaviour (SB)) during the awake time were measured with ActiGraph GT1M accelerometer at baseline, 6, 12, 18 and 24 months. Relative time in MVPA, LIPA and SB for each participant at each measurement point was calculated by using the CoDA approach. Linear mixed models were used to evaluate the intervention effect between the three groups on the relative time in MVPA, LIPA and SB over the two-year period.ResultsIn total, 41% had ≤30 min MVPA at baseline. Significant group by time interactions were found for the multi-component group and the standard care group for the relative time in MVPA, at 6, 18 and 24 months. Differences in predicted group means between the groups were 1.2% at 6 months, 1.3% at 18 months and 0.9% at 24 months. Significant group by time interactions were also found for the single-component group and the standard care group for the relative time in MVPA at 24 months, with a difference in predicted group means of 0.8%. No significant interactions for LIPA or SB were found.ConclusionsThe multi-component group and the single-component component group maintained their relative time in MVPA, while the standard care group decreased their relative time in MVPA over the two-year period. This indicate that the Sophia Step Study intervention can prevent a decrease in MVPA in people with prediabetes and type 2 diabetes.

School’s outdoor area as an educational and health-promoting resource for young teenagers

Regular physical activity (PA) is positive for the health of young people, but previous research has indicated that the proportion of the population attaining recommended levels of activity decreases with age. Several studies indicate that the PA pupils get during school hours represents an important part of their total PA. The purpose of this study was to examine the relation between the size of the school’s total outdoor area and pupils’ PA behavior during schooltime. ActiGraph GT1M accelerometers were used to measure objectively 12–13-year-old schoolchildren’s minutes of moderate-to-vigorous PA (MVPA) during schooltime. The pupils (n = 300, 155 girls and 145 boys) came from 18 primary schools in two medium-sized municipalities in mid-Norway. Linear regression analysis was used to examine the relationship between the schools’ total outdoor area and outdoor area per pupil in relation to pupils’ weekly minutes of MVPA during schooltime. The results show no association with either the schools’ total outdoor area or the outdoor area per pupil, and the pupils’ weekly minutes of MVPA during schooltime. This finding indicates that there are probably factors in the school environment affecting young people’s level of activity during schooltime, other than the size of the schools’ outdoor area.

A 4-Yr Mixed Longitudinal Study of Health Behaviors and Fat Mass Accrual during Adolescence and Early Adulthood.

Physical activity (PA), sedentary time (SED), and energy intake (EI) are associated with fat mass accrual in children and youth. Previous studies relied primarily on cross-sectional designs and proxy measures of body composition such as body mass index. We aimed to prospectively investigate associations between PA, SED, EI, and total body fat mass accrual using dual-energy x-ray absorptiometry. This analysis of the mixed longitudinal Healthy Bones III Study included data from 312 participants (138 boys age 9 to 21 yr at baseline). For each participant, we acquired a maximum of four annual total body dual-energy x-ray absorptiometry scans from which we determined fat mass (in kilograms; n = 748 observations). We assessed total PA, moderate-to-vigorous PA (MVPA) and SED with accelerometers (ActiGraph GT1M) and measured EI via 24-h dietary recall. We fit sex-specific multilevel models adjusting for maturity (years from age at peak height velocity (APHV)), weight status, ethnicity, total PA, MVPA, SED, and EI. Boys and girls demonstrated divergent trajectories of fat mass accrual; rate of fat mass accrual in girls was four times greater than boys at APHV and increased across adolescence, whereas boys' fat mass plateaued after APHV. In boys, within-person change in MVPA negatively predicted fat mass independent of SED; each annual increase in MVPA of 6 min·d -1 was associated with a 0.21-kg lower fat mass. In girls, between-person average MVPA negatively predicted fat mass accrual independent of SED; greater MVPA of 4 min·d -1 across adolescence was associated with a 0.31-kg lower fat mass. MVPA demonstrates an independent and negative effect on fat mass in boys and girls. Given different trajectories of fat mass accrual and movement behaviors between boys and girls, PA interventions aimed at preventing obesity in youth may benefit from a sex and gendered approach.

Is there an association between total physical activity level and VO2max among fitness club members? A cross-sectional study

BackgroundSince cardiorespiratory fitness is an important predictor for all-cause mortality, it is of interest to know if meeting the physical activity (PA) recommendations is associated with higher levels of maximal oxygen uptake (VO2max). We aimed to investigate the association between total PA level given as counts per minute (cpm) and minutes in moderate-to-vigorous PA (MVPA), and VO2max in new fitness club members.MethodsA total of 62 men and 63 women (≥ 18 years), defined as healthy (no disease considered to hinder PA) participated in this study. VO2max (mL kg−1 min−1) was measured with a cardiopulmonary exercise (modified Balke protocol), and total PA level was measured with ActiGraph GT1M for seven consecutive days. All participants accumulating ≥ 10 h of activity recordings ≥ 4 days were included in the data analysis. To examine associations between PA level and VO2max, a Pearson correlation and a multiple linear regression analysis adjusted for covariates were used.ResultsVO2max (mL kg−1 min−1) was 40.5 ± 7.2 in men and 35.1 ± 6.0 in women. Total PA level (cpm) and MVPA (min) were 352.4 ± 123.4 and 260.0 ± 132.6 in men and 361.4 ± 103.8 and 273.2 ± 137.0 in women. Total PA level (men: r = 0.346, p < 0.01, women: r = 0.267 p < 0.01) and MVPA (men: r = 0.359, p = < 0.01, women: r = 0.236, p = 0.03) was associated with VO2max. When adjusting for age and body fat percentage, total PA level and MVPA were no longer associated with VO2max (men: p = 0.11 and p = 0.79, women: p = 0.40 and p = 0.61). In men, age (β = − 0.469 p < 0.01) and body fat percentage (β = − 0.483, p < 0.01) were the strongest predictor for VO2max. For women, body fat percentage was the strongest predictor for VO2max (β = − 0.483, p < 0.01).ConclusionsTotal PA level and MVPA were associated with VO2max, but the association was low and diminished when adjusted for age and body fat percentage. Body fat percentage (men and women) and age (men) were more strongly associated with VO2max than total PA level and MVPA.

Physical Activity Patterns among Individuals with Prediabetes or Type 2 Diabetes across Two Years-A Longitudinal Latent Class Analysis.

Background: This study aimed to identify distinct profiles of physical activity (PA) patterns among individuals with prediabetes or type 2 diabetes participating in a two-year PA trial and to investigate predictors of the profiles. Methods: Data (n = 168, collected 2013–2020) from the cohort of a randomized trial aimed at increasing PA in individuals with prediabetes and type 2 diabetes were used. PA and sedentary behaviours were assessed by waist-worn ActiGraph GT1M accelerometers at baseline and at 6, 12, 18 and 24 months. Fifteen PA and sedentary variables were entered into a latent class mixed model for multivariate longitudinal outcomes. Multinominal regression analysis modelled profile membership based on baseline activity level, age, gender, BMI, disease status and group randomisation. Results: Two profiles of PA patterns were identified: “Increased activity” (n = 37, 22%) included participants increasing time in PA and decreasing sedentary time. “No change in activity” (n = 131, 78%) included participants with no or minor changes. “Increased activity” were younger (p = 0.003) and more active at baseline (p = 0.011), compared to “No change in activity”. No other predictor was associated with profile membership. Conclusions: A majority of participants maintained PA and sedentary patterns over two years despite being part of a PA intervention. Individuals improving PA patterns were younger and more active at baseline.

Parents' Inadequate Estimate of Their Children's Objectively Physical Activity Level.

This study aimed to investigate parents’ estimation of their preschool children’s leisure-time physical activity (PA) and the correlation between parents’ reported participation in PA with their children in leisure time and their children’s PA levels. A total of 244 Norwegian preschool children aged 4–6 and their parents were enrolled in the study. According to standard protocols, the children’s PA level was measured with Actigraph GT1M accelerometers. The parents completed a questionnaire that provided information about their estimation of their children’s PA and their reported participation in their children’s PA. Correlation analyses and scatter plots showed no significant association between parents’ estimation of their children’s PA level at leisure time and the children’s objectively measured PA level. Only 5% of the parents estimated their children’s PA level correctly. In general, the parents overestimated their children’s PA levels by three times. Furthermore, the results found no significant correlation between children’s PA levels at leisure time and parents’ reported participation in PA with their children. Our findings indicate that parents’ self-estimation of their children’s PA is inaccurate, which is problematic. Considering that the PA levels of many children are too low to fulfill internationally established health recommendations, parents’ ‘wrong’ perception about their children’s PA urgently needs to be addressed and rectified.

Simultaneous Validation of Count-to-Activity Thresholds for Five Commonly Used Activity Monitors in Adolescent Research: A Step Toward Data Harmonization

Background: Multiple activity monitors are utilized for the estimation of moderate- to vigorous-intensity physical activity in youth. Due to differing methodological approaches, results are not comparable when developing thresholds for the determination of moderate- to vigorous-intensity physical activity. This study aimed to develop and validate count-to-activity thresholds for 1.5, 3, and 6 metabolic equivalents of task in five of the most commonly used activity monitors in adolescent research. Methods: Fifty-two participants (mean age = 16.1 [0.78] years) selected and performed activities of daily living while wearing a COSMED K4b2 and five activity monitors; ActiGraph GT1M, ActiGraph wGT3X-BT, activPAL3 micro, activPAL, and GENEActiv. Receiver-operating-characteristic analysis was used to examine the area under the curve and to define count-to-activity thresholds for the vertical axis (all monitors) and the sum of the vector magnitude (ActiGraph wGT3X-BT and activPAL3 micro) for 15 s (all monitors) and 60 s (ActiGraph monitors) epochs. Results: All developed count-to-activity thresholds demonstrated high levels of sensitivity and specificity. When cross-validated in an independent group (N = 20), high levels of sensitivity and specificity generally remained (≥73.1%, intensity and monitor dependent). Conclusions: This study provides researchers with the opportunity to analyze and cross-compare data from different studies that have not employed the same motion sensors.

The Association between Physical Activity, Motor Skills and School Readiness in 4-5-Year-Old Children in the Northeast of England.

The benefits of being physically active, possessing good motor skills and being school-ready are well documented in early years. Nevertheless, the association between physical activity and motor skills with school readiness remains unknown. Therefore, the aim of this cross-sectional study was to explore the relationship between these variables. We collected data on 326 four to five-year-old children from the northeast of England. Children’s PA (ActiGraph GT1M accelerometers), motor skills (MABC-2 and the locomotor section of the TGMD-2) and school readiness (EYFSP) were measured, and associations between these variables were examined. This study found that, on average, children engaged in more MVPA (99.6 min/day) and less sedentary behaviour (261 min/day) than documented in previous research. Motor-skill scores were consistent with existing literature in early years. A higher percentage of children in the sample (79.6%) achieved school readiness than the average for England. Regression analyses found that motor-skill variables and sedentary behaviour were significantly predictive of school readiness, whereas physical activity was not. Motor skills and sedentary behaviour significantly predict school readiness. Therefore, promoting motor skills and developmentally appropriate sedentary behaviour activities may increase the number of children achieving school readiness.

Can the Childhood Physical Activity Questionnaire Be Used to Identify Physical Activity Levels in Children With Asthma?

Objective: Children with asthma who are physically active have a better quality of life, emphasizing the importance of activity monitoring and promotion in daily life. The validity of self-reported activity measurements has been questioned in pediatric populations. In this study, we aim to compare the Physical Activity Questionnaire for Children (PAQ-C) with objectively measured PA using accelerometry.Design: In this comparison study, the pooled dataset of two cross-sectional studies was used, which prospectively home-monitored PA using the alternative self-report PAQ-C questionnaire as well as with the criterion standard accelerometry (Actigraph wGT3X-BT and GT1M).Participants:Ninety children with pediatrician-diagnosed asthma participated in the study.Main Outcome Measures:Correlation coefficients were calculated to determine the relation between the PAQ-C and accelerometer data. The predictive value of the PAQ-C in differentiating between achieving and failing the recommended daily level of moderate-to-vigorous activity (MVPA) was evaluated with receiver operator characteristic (ROC) analysis.Results: The results showed weak to moderate correlations of the PAQ-C with the accelerometer data (r = 0.29–0.47). A PAQ-C cutoff of 3.09 showed the best performance on predicting whether the recommended level of MVPA was achieved. With this cutoff, 21 of the 39 children that did achieve their daily MVPA level (53.8% sensitivity) and 33 of the 46 children that did fail their daily MVPA level (71.7% specificity) were correctly classified. A PAQ-C score of 3.5 revealed a negative predictive value of 100% for assessing physical inactivity.Conclusion: This study revealed a weak relation between the PAQ-C and PA assessed with accelerometry. However, a PAQ-C score of 3.5 or higher might be used as a low-cost and easy-to-use PA screening tool for ruling out physical inactivity in a portion of the pediatric asthma population.Clinical Trial Registration: Netherlands Trial Register: Trial NL6087.

Effects of a three-armed randomised controlled trial using self-monitoring of daily steps with and without counselling in prediabetes and type 2 diabetes\u2014the Sophia Step Study

BackgroundThis aimed to evaluate the effects of self-monitoring of daily steps with or without counselling support on HbA1c, other cardiometabolic risk factors and objectively measured physical activity (PA) during a 2-year intervention in a population with prediabetes or type 2 diabetes.MethodsThe Sophia Step Study was a three-armed parallel randomised controlled trial. Participants with prediabetes or type 2 diabetes were recruited in a primary care setting. Allocation (1:1:1) was made to a multi-component intervention (self-monitoring of steps with counselling support), a single-component intervention (self-monitoring of steps without counselling support) or standard care. Data were collected for primary outcome HbA1c at baseline and month 6, 12, 18 and 24. Physical activity was assessed as an intermediate outcome by accelerometer (ActiGraph GT1M) for 1 week at baseline and the 6-, 12-, 18- and 24-month follow-up visits. The intervention effects were evaluated by a robust linear mixed model.ResultsIn total, 188 subjects (64, 59, 65 in each group) were included. The mean (SD) age was 64 (7.7) years, BMI was 30.0 (4.4) kg/m2 and HbA1c was 50 (11) mmol/mol, 21% had prediabetes and 40% were female. The dropout rate was 11% at 24 months. Effect size (CI) for the primary outcome (HbA1c) ranged from -1.3 (-4.8 to 2.2) to 1.1 (-2.4 to 4.6) mmol/mol for the multi-component vs control group and from 0.3 (-3.3 to 3.9) to 3.1 (-0.5 to 6.7) mmol/mol for the single-component vs control group. Effect size (CI) for moderate-to-vigorous physical activity ranged from 8.0 (0.4 to 15.7) to 11.1 (3.3 to 19.0) min/day for the multi-component vs control group and from 7.6 (-0.4 to 15.6) to 9.4 (1.4 to 17.4) min/day for the single-component group vs control group.ConclusionThis 2-year intervention, including self-monitoring of steps with or without counselling, prevented a decrease in PA but did not provide evidence for improved metabolic control and cardiometabolic risk factors in a population with prediabetes or type 2 diabetes.Trial registrationClinicalTrials.gov, NCT02374788. Registered 2 March 2015—Retrospectively registered.

The Importance of Parents' Income and Education Level in Relation to Their Preschool Children's Activity Level at Leisure.

Previous research indicate that socioeconomic status positively corresponds with adults’ and adolescents’ physical activity levels. This study investigated the relationship between parents’ education and income, and preschool children’s physical activity level. A total of 244 Norwegian preschool children aged four to six and their parents were enrolled in the study. The children wore an Actigraph GT1M accelerometer for seven consecutive days to measure their physical activity level. Parents completed a questionnaire that provided information about their education level and income level. To examine the relationship between the parents’ education and income and their children’s physical activity level at leisure, the Kruskal-Wallis H test was conducted. The results revealed that neither mothers’ nor fathers’ education level or income, were associated with their children’s minutes in moderate to vigorous physical activity (MVPA) at leisure. The preschool curriculum of Norway may be one explanation why socioeconomic status was not linked to physical activity in this study. Another possibility is that this study was limited to full-time students with two parents. More research is needed to determine whether parent income or education is linked to physical activity among more diverse or older children in Norway.

Daily Walking and the Risk of Knee Replacement Over 5 Years Among Adults With Advanced Knee Osteoarthritis in the United States

ObjectiveTo examine the association of the volume and intensity of daily walking at baseline with the risk of knee replacement (KR) over 5 years in adults with advanced structural knee osteoarthritis. DesignProspective, longitudinal, and multicenter observational study. SettingOsteoarthritis Initiative study with follow-up from 2008-2015. ParticipantsCommunity-dwelling adults with or at risk of knee osteoarthritis were recruited from 4 sites in the United States (N=516; mean age, 67.7±8.6y; body mass index, 29.3±4.7 kg/m2; 52% female). We included participants with advanced structural disease, without KR and had valid daily walking data (quantified using Actigraph GT1M), at baseline. InterventionsNot applicable. Main outcomesKR. Walking volume was measured as steps/day and intensity as minutes/day spent not walking (0 steps/min) and walking at very light (1-49 steps/min), light (50-100 steps/min), or moderate (>100 steps/min) intensities. To examine the relationship of walking volume and intensity with the risk of KR, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) adjusting for covariates. ResultsOf 516 adults with advanced structural disease, 88 received a KR over 5 years (17%). Walking an additional 1000 steps/d was not associated with the risk of KR (adjusted HR=0.95; 95% CI, 0.84-1.04). Statistically, replacing 10 min/d of very light and light walking with 10 min/d of moderate walking reduced the risk of KR incidence by 35% and 37%, respectively (adjusted HR=0.65, 95% CI, 0.45-0.94, for very light and adjusted HR=0.63; 95% CI, 0.40-1.00, for light). ConclusionsDaily walking volume and intensity did not increase KR risk over 5 years and may be protective in some cases in adults with advanced structural knee osteoarthritis.

Volume and accumulation patterns of physical activity and sedentary time: longitudinal changes and tracking from early to late childhood

BackgroundPhysical activity (PA) decreases and sedentary time (SED) increases across childhood, with both behaviours tracking. However, no studies have examined how accumulation patterns of PA and SED (i.e., prolonged bouts, frequency of breaks in sedentary time) change and track over time. The aim of this study was to investigate longitudinal changes in and tracking of total volume and accumulation patterns of SED, light-intensity PA (LPA), moderate-intensity PA (MPA), vigorous-intensity PA (VPA) among boys and girls.MethodsIn 2008/09 (T1), children in HAPPY (3-5y; n = 758) in Melbourne, Australia wore ActiGraph GT1M accelerometers to objectively assess SED, LPA, MPA and VPA. This was repeated at age 6-8y (T2; n = 473) and 9-11y (T3; n = 478). Ten pattern variables were computed: bouts of ≥ 5-, ≥ 10-, ≥ 15- and ≥ 20-min for SED, ≥ 1- and ≥ 5-min for LPA, ≥ 1-min for MPA, ≥ 1- and ≥ 5-min for VPA, and breaks in SED (interruptions of > 25 counts 15 s− 1). Longitudinal mixed models examined changes from T1-3, controlling for T1 age. Generalized estimating equations assessed tracking over the three time points, controlling for T1 age and time between measurements. Analyses were stratified by sex.ResultsTotal volume and bouts of SED and SED breaks increased, while total volume and bouts of LPA decreased for both sexes. There was a small decrease in total volume of MPA for girls, but time spent in ≥ 1-min bouts increased for both sexes. Total volume of VPA increased for both sexes, with time spent in ≥ 1-min bouts increasing for boys only. All volume and pattern variables tracked moderately for boys, except for all SED bouts ≥ 15-min, LPA bouts ≥ 5-min and MPA bouts ≥ 1-min (which tracked weakly). For girls, total SED and SED bouts ≥ 1-min tracked strongly, total volume of LPA, MPA and VPA, ≥ 5- and ≥ 10-min SED bouts, and ≥ 1-min LPA and MPA bouts tracked moderately, and SED breaks, all SED bouts ≥ 15 min, LPA bouts ≥ 5 min and all VPA bouts tracked weakly.ConclusionsPatterns of SED and PA change from early to late childhood; with the exception of SED breaks and VPA, changes were detrimental. Total volumes and short bouts tended to track more strongly than longer bouts. Interventions to prevent declines in PA and increases in SED are important from early in life.

Relationship between Gender, Physical Activity, Screen Time, Body Mass Index and Wellbeing in Irish Children from Social-Disadvantage

ABSTRACT Research has shown that childhood physical activity participation has a positive relationship with markers of wellbeing, such as self-esteem and quality of life, and physical activity participation may serve as protective mechanism against some mental illnesses including depression. The aim of the current study was to examine the relationship between gender, physical activity, screen time, body mass index and wellbeing in Irish school children (N = 705; mean age: 8.74 ± 0.52 years) from social disadvantage. In Northern Ireland, schools included in the 2010 Multiple Deprivation Measure (NIMDM) were invited to participate. Schools included for participation in the Republic of Ireland were from the Delivering Equality of Opportunity in Schools (DEIS) index. Data gathered included accelerometry (physical activity), self-report (screen time and wellbeing), and anthropometric measurements. Physical activity was objectively measured during eight consecutive days using Actigraph GT1M and GT3X devices, using stringent accelerometer protocol. Screen time activities were derived using questions adapted from the Health Promotion Agencies National Children’s Survey in Northern Ireland. The KIDSCREEN-27 is a health-related quality of life measurement, and this tool was used by participants to self-report their health and wellbeing. Results suggest that boys accumulated more minutes of daily screen time than girls, however, boys were more physically active when compared to girls. Wellbeing scores for gender showed inverse associations with daily screen time. Standard multiple regression revealed that gender, physical activity, screen time and body mass index (combined) explained little variance in the prediction of wellbeing. Results indicate the importance of gender-based considerations for physical activity and screen time with children from social disadvantage. The inverse relationship found between overall screen time and wellbeing will help guide future healthy lifestyle interventions for Irish children of low-income communities.