Tertile Of Activity Research Articles

The associations between physical activity intensity, cardiorespiratory fitness, and non-alcoholic fatty liver disease.

High levels of physical activity and cardiorespiratory fitness may protect against non-alcoholic fatty liver disease. We investigated whether different physical activity intensities and cardiorespiratory fitness were independent predictors of non-alcoholic fatty liver disease. We included healthy adults with no prior diagnosis of liver dysfunction. Non-alcoholic fatty liver disease prevalence was estimated based on fatty liver index scores. We created tertiles of self-reported low, moderate, and vigorous physical activity. Participants completed an incremental treadmill test to estimate cardiorespiratory fitness, and data were subsequently separated into quintile groups (Q1 [least fit] through Q5 [most fit]). Non-alcoholic fatty liver disease prevalence in our sample of 7111 adults was 28.3% in male adults and 6.5% in female adults. Logistic regression showed the relative odds of non-alcoholic fatty liver disease were 42% lower if >60min/week of vigorous physical activity was maintained (odds ratio [OR]=0.58, confidence interval [CI]: 0.49-0.68). There was a negative dose-response association between cardiorespiratory fitness and non-alcoholic fatty liver disease between Q1 and Q4. Compared with Q1, odds were 39% (OR=0.61, CI: 0.51-0.73) lower in Q2, through to 51% lower in Q5 (OR=0.49, CI: 0.41-0.60). Moderate physical activity did not reduce the odds of non-alcoholic liver disease. We found the lowest prevalence of non-alcoholic fatty liver disease in adults achieving >60min/week of vigorous physical activity. However, a stronger dose-response relationship existed between cardiorespiratory fitness and non-alcoholic fatty liver disease. Improving cardiorespiratory fitness as a potential therapeutic target for treatment and prevention of non-alcoholic fatty liver disease warrants further investigation.

Vigorous Physical Activity and Cognitive Trajectory Later in Life: Prospective Association and Interaction by Apolipoprotein E e4 in the Nurses' Health Study.

The apolipoprotein E (APOE) e4 allele is a well-established genetic risk factor of brain aging. Vigorous physical activity may be particularly important in APOE-e4 carriers, but data have been inconsistent, likely due to differences in the timing of the physical activity assessment, definition of cognitive decline, and/or sample size. We prospectively evaluated the association between vigorous physical activity and cognition assessed at least 9 years later, according to APOE-e4 carrier status. Biennially from 1986, Nurses' Health Study participants reported their leisure-time physical activities. Starting in 1995-2001 and through 2008, participants (aged 70+ years) underwent up to 4 repeated cognitive telephone assessments (6 tasks averaged together using z-scores). Among 7252 women, latent process mixed models identified 3 major patterns of cognitive change over 6 years: high-stable, medium-stable, and decline. Taking the high-stable cognitive trajectory as the outcome reference in multinomial logistic regressions, highest tertile of vigorous physical activity (≥5.9 metabolic-equivalent [MET]-hours/wk) compared to lowest tertile (≤0.9 MET-hours/wk) was significantly associated with subsequent lower likelihood of the medium-stable trajectory in the global score (odds ratio [OR] [95% CI] = 0.72 [0.63, 0.82]), verbal memory (OR [95% CI] = 0.78 [0.68-0.89]), and telephone interview of cognitive status score (OR [95% CI] = 0.81 [0.70-0.94]). Vigorous physical activity was also associated with lower likelihood of decline in category fluency (OR [95% CI] = 0.72 [0.56, 0.92]). We observed some evidence (p-interaction = .07 for the global score) that the association was stronger among APOE-e4 carriers than noncarriers (OR [95% CI] = 0.60 [0.39, 0.92] vs 0.82 [0.59, 1.16]). Midlife vigorous physical activity was associated with better cognitive trajectories in women in their seventies, with suggestions of stronger associations among APOE-e4 carriers.

Injury Profile Among Street Workout Practitioners.

Background:Street workout (SW) is an urban sport based on calisthenic exercises. Injury profiles and risk factors are widely explored in various sport disciplines. However, because of the lack of research in SW, injury profiles have not yet been established.Purpose:To investigate the characteristics and prevalence of injuries and variables that may increase these odds in SW practitioners.Study Design:Case-control study; Level of evidence, 4.Methods:An electronic survey was conducted between September 2018 and March 2019 in order to obtain practitioner information, physical activity level, training characteristics, and injury information of SW practitioners. Responses from 93 practitioners were eligible for analysis. Univariate and multivariate binary logistic regression analyses were used to examine the association among several variables and the presence of injury in the past 12 months based on odds ratios (ORs).Results:Overall, 62.4% of the 93 participants reported an injury in the previous 12 months, and tendinopathy was the most reported diagnosis (31.0% of injured practitioners). High injury frequency was reported in the shoulder (23.0%) and back (upper and mid) (18.4%). Overtraining was the most reported perception of cause of injury (56.9%). Most injured practitioners (20.7%) performed freestyle exercises before the injury, followed by upper body exercises. A history of previous injuries (OR, 4.078; P = .005) and the middle and higher tertiles of vigorous physical activity (OR, 4.370; P = .015 and OR, 5.634; P = .003, respectively) were associated with a higher odds of injury.Conclusion:In SW, the shoulder and back (upper and mid) were the most injured body parts, with tendinopathy being the most frequent diagnosis. Overtraining was typically reported as the perceived cause of injury, with freestyle and upper limb exercises the most performed exercises when injured. A history of previous injuries, along with vigorous physical activity, was found to augment the odds of injury. More research is needed to corroborate our findings, along with increased knowledge about SW practice and injuries.

A pro-diabetogenic mtDNA polymorphism in the mitochondrial-derived peptide, MOTS-c.

Type 2 Diabetes (T2D) is an emerging public health problem in Asia. Although ethnic specific mtDNA polymorphisms have been shown to contribute to T2D risk, the functional effects of the mtDNA polymorphisms and the therapeutic potential of mitochondrial-derived peptides at the mtDNA polymorphisms are underexplored. Here, we showed an Asian-specific mitochondrial DNA variation m.1382A>C (rs111033358) leads to a K14Q amino acid replacement in MOTS-c, an insulin sensitizing mitochondrial-derived peptide. Meta-analysis of three cohorts (n = 27,527, J-MICC, MEC, and TMM) show that males but not females with the C-allele exhibit a higher prevalence of T2D. In J-MICC, only males with the C-allele in the lowest tertile of physical activity increased their prevalence of T2D, demonstrating a kinesio-genomic interaction. High-fat fed, male mice injected with MOTS-c showed reduced weight and improved glucose tolerance, but not K14Q-MOTS-c treated mice. Like the human data, female mice were unaffected. Mechanistically, K14Q-MOTS-c leads to diminished insulin-sensitization in vitro. Thus, the m.1382A>C polymorphism is associated with susceptibility to T2D in men, possibly interacting with exercise, and contributing to the risk of T2D in sedentary males by reducing the activity of MOTS-c.

Physical activity may not be associated with long-term risk of dementia and Alzheimer's disease.

BackgroundWhile it is well established that physical activity is associated with reduced risk of vascular and nonvascular outcomes as well as mortality, evidence on the association between physical activity and dementia is inconsistent. We aimed to assess the associations of physical activity with the risk of dementia and Alzheimer's disease (AD).Material and methodsWe analysed data on 2394 apparently healthy men with good baseline cognitive function from the prospective population‐based Kuopio Ischaemic Heart Disease study. We assessed habits of physical activity at baseline using a 12‐month leisure time physical activity (LTPA) questionnaire. Using Cox regression, we calculated hazard ratios adjusted for body mass index, systolic blood pressure, smoking status, history of type‐2 diabetes, total cholesterol, high‐density lipoprotein cholesterol, alcohol consumption, history of coronary heart disease and high‐sensitivity C‐reactive protein.ResultsDuring a median follow‐up of 24.9 years (interquartile range: 18.3‐26.9), 208 men developed dementia and 128 developed AD. Multivariable adjusted hazard ratios for dementia comparing top vs bottom tertiles of physical activity were 0.97 (95% confidence intervals: 0.69‐1.38) for total physical activity volume, 0.96 (0.69‐1.34) for conditioning LTPA volume and 1.13 (0.80‐1.61) for total LTPA volume. Corresponding hazard ratios for AD were 1.19 (0.76‐1.85), 0.98 (0.64‐1.49) and 1.22 (0.77‐1.93). Associations were consistent in analyses restricted to participants with ≥10 years of follow‐up.ConclusionsIn middle‐aged Caucasian men, various physical activity exposures were not associated with all‐cause dementia or AD. Future studies should address biases due to reverse causation and regression dilution and should involve objective measures of physical activity.

Sex hormones, SHBG and risk of colon and rectal cancer among men and women in the UK Biobank

BackgroundExperimental studies have suggested a role for sex hormones in the etiology of colorectal cancer (CRC) but epidemiological data are inconclusive. MethodsWe examined the associations of testosterone, estradiol, and sex hormone binding globulin (SHBG), with risk of CRC (n = 3,247) in 206,508 men and 219,106 women enrolled in the UK Biobank. Participants were followed for a median of 7.1 years. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for CRC risk. ResultsIn men, in multivariable adjusted models testosterone and SHBG were not associated with CRC. Among men in the highest tertile of physical activity, SHBG was inversely associated with risk (HRq5vs. q1 0.75, 0.56−0.99,). In women, testosterone and SHBG were not associated with CRC risk. There were no differences in the associations between testosterone, SHBG and CRC risk in the analyses stratified by menopausal status. We did not observe an association between estradiol and CRC risk; however, given the limited number of individuals with detectable values of estradiol (13.2 % of the total sample) we are unable to draw a firm conclusions regarding this association. ConclusionThe results of this study did not provide support for associations of sex hormones and SHBG with CRC risk.

SARS-CoV-2 neutralization and serology testing of COVID-19 convalescent plasma from donors with nonsevere disease.

The transfer of passive immunity with convalescent plasma is a promising strategy for treatment and prevention of COVID-19, but donors with a history of nonsevere disease are serologically heterogenous. The relationship between SARS-Cov-2 antigen-binding activity and neutralization activity in this population of donors has not been defined. Convalescent plasma units from 47 individuals with a history of nonsevere COVID-19 were assessed for antigen-binding activity of using three clinical diagnostic serology assays (Beckman, DiaSorin, and Roche) with different SARS-CoV-2 targets. These results were compared with functional neutralization activity using a fluorescent reporter strain of SARS-CoV-2 in a microwell assay. Positive correlations of varying strength (Spearman r = 0.37-0.52) between antigen binding and viral neutralization were identified. Donors age 48 to 75 years had the highest neutralization activity. Units in the highest tertile of binding activity for each assay were enriched (75%-82%) for those with the highest levels of neutralization. The strength of the relationship between antigen-binding activity and neutralization varies depending on the clinical assay used. Units in the highest tertile of binding activity for each assay are predominantly comprised of those with the greatest neutralization activity.

Aspartate aminotransferase and mortality in patients with ischemic heart disease

Background and aimsEvidence on the association between aspartate aminotransferase (AST) activity and mortality of patients with ischemic heart disease (IHD) is limited. We investigated whether there is an association between AST activity and mortality in IHD patients. Methods and resultsThe study included 6857 patients with coronary angiography-proven IHD and AST activity within the reference range. AST activity measurements were available in all patients. The primary outcome was 3-year cardiac mortality. Patients were categorized in groups according to the AST activity tertiles: a group with AST within the 1st tertile (AST < 17.0 U/L), a group with AST within the 2nd tertile (AST > 17–24.5 U/L) and a group with AST within the 3rd tertile (AST > 24.5 U/L). Cardiac death (n = 297) occurred in 109, 69 and 119 patients in the 1st to 3rd AST tertiles (Kaplan–Meier estimates of mortality: 5.3%, 3.6% and 5.9%; univariable hazard ratio [HR] = 1.75, 95% confidence interval [CI] 1.30–2.36, P < 0.001 for tertile 3 vs. 2; HR = 1.13 [0.87–1.46], P = 0.370 for tertile 3 vs. 1; and HR = 0.65 [0.48–0.87], P = 0.004 for tertile 2 vs. 1). The association between AST and cardiac mortality was U-shaped. AST values <15 U/L (HR = 1.118 [1.009–1.238]) and >23 U/L (HR = 1.029 [1.003–1.056]) were associated with higher cardiac mortality compared with the reference value (21 U/L). After adjustment, the association between AST and cardiac mortality was attenuated (P = 0.133) but remained non-linear (P = 0.047). ConclusionsIn patients with IHD, AST activity was associated with the risk of cardiac mortality with a U-shaped relationship. After adjustment, the association between AST and mortality was attenuated.

Association between physical activity and sedentary behaviour on carotid atherosclerotic plaques: an epidemiological and histological study in 90 asymptomatic patients

ObjectiveCarotid atherosclerotic plaques are a source of emboli for stroke. ‘Unstable’ carotid atherosclerotic plaques may have intraplaque haemorrhages, neovessels, prevalent macrophages, excessive calcium deposits, a large lipid core and a...

Physical activity and incidence of subclinical and clinical pregnancy loss: a secondary analysis in the effects of aspirin in gestation and reproduction randomized trial

To estimate the association between physical activity and risk of subclinical and clinical pregnancy loss among women with a history of pregnancy loss. Prospective cohort study as a secondary analysis of the Effects of Aspirin in Gestation and Reproduction randomized controlled trial of preconception-initiated low-dose aspirin among women with one or two prior pregnancy losses. Four U.S. clinical centers, 2007-2011. Women with confirmed pregnancy (n = 785) as determined from hCG testing in longitudinally collected biospecimens. Subclinical loss of pregnancy detected only by hCG testing and clinically recognized loss. Among 785 women (mean [SD] age, 28.7 [4.6] years) with an hCG-confirmed pregnancy, 188 (23.9%) experienced pregnancy loss. In multivariable models adjusted for confounders, compared with the first tertile of physical activity (median = 7.7 metabolic equivalent of task hours/week), there was a roughly twofold higher risk of subclinical loss in the second (risk ratio=2.06; 95% confidence interval, 1.03-4.14) and third tertiles (risk ratio = 1.92; 95% confidence interval, 0.94-3.90), with median metabolic equivalent of task hours/week of 27.8 and 95.7, respectively. No relations were observed between physical activity and clinically recognized loss. Risk related to physical activity is different for pregnancy failure close to the time of implantation compared with that for later, clinical pregnancy loss. Higher physical activity levels were associated with an elevated risk of subclinical loss (i.e., pregnancies detected only by hCG, n = 55); however, no relationship was observed with clinically recognized loss. Further work is required to confirm these findings, assess generalizability to women without prior losses, and evaluate mechanisms. Each participating center's Institutional Review Board approved the study, and participants provided written informed consent. The trial was registered on ClinicalTrials.gov (NCT00467363), and a Data Safety and Monitoring Board provided oversight.

Volume and Intensity of Stepping Activity and Cardiometabolic Risk Factors in a Multi-ethnic Asian Population.

The health benefits of objectively measured physical activity volume versus intensity have rarely been studied, particularly in non-western populations. The aim of this study was to investigate the association between cardiometabolic risk factors and stepping activity including; volume (step count), intensity (cadence) or inactivity (zero-steps/minute/day), in a multi-ethnic Asian population. Participants clinical data was collected at baseline and their physical activity was monitored for seven days, using an accelerometer (Actigraph GT3X+) in 2016. Tertiles (low, moderate, high) of the mean daily step count, peak one-minute, 30-min, 60-min cadences and time/day spent at zero-steps/minute were calculated. Adjusted linear regressions explored the association between stepping activity tertiles and cardiometabolic risk factors. A total of 635 participants (41% male, 67% Chinese, mean age 48.4 years) were included in the analyses. The mean daily step count was 7605 (median daily step count 7310) and 7.8 h of awake time per day were spent inactive (zero-steps/minute). A greater number of associations were found for step intensity than volume. Higher step intensity was associated with reduced body mass index (BMI), waist circumference, blood pressures and higher high-density lipoprotein (HDL). Future health promotion initiatives should consider the greater role of step intensity to reduce cardiometabolic risk.

Physical activity and sedentary behaviour during pregnancy are associated with gestational weight gain in Vietnamese women.

Gestational weight gain is known to impact maternal and child health outcomes. Energy intake and energy expenditure are major components of clinical nutrition in relation to weight gain during pregnancy. The study was to determine the association of physical activity and sitting time during pregnancy with gestational weight gain in Vietnamese women. A multicentre prospective cohort study was conducted in Vietnam from 2015 to 2017. A total of 1873 women with a singleton pregnancy were included. Physical activity and sitting exposures during pregnancy were determined using an interviewer-administered validated questionnaire. Multiple regression analysis was performed to assess physical activity and sitting time in relation to gestational weight gain, adjusting for the confounding effects of maternal characteristics and total energy intake during pregnancy. The mean weight gain was 12.9 (Standard deviation 4.1) kg throughout pregnancy. Pregnant women with prolonged sitting time gained an average of 0.6 kg more weight (p=0.016 for highest versus lowest tertiles). Conversely, women who were physically active, in terms of having higher tertiles of total physical activity, moderate-to-vigorous-intensity, household/ caregiving activities, and occupational physical activity, experienced significantly less gestational weight gain (p<0.05 for highest versus lowest tertiles). Inverse associations were found between gestational weight gain and physical activity (i.e. intensities and several domains), whereas gestational weight gain tended to increase with longer sitting time. Therefore, being physically active and less sedentary is important to regulate weight gain during pregnancy.

Physical activity calorie expenditure (PACE) labels in worksite cafeterias: effects on physical activity

BackgroundRegular physical activity is an important component of healthy living and wellbeing. Current guidelines recommend that adults participate in at least 150 min of moderate or vigorous-intensity physical activity weekly. In spite of the benefits, just over half of U.S. adults meet these recommendations. Calorie-only food labels at points of food purchase have had limited success in motivating people to change eating behaviors and increase physical activity. One new point of purchase approach to promote healthy behaviors is the addition of food labels that display the physical activity requirement needed to burn the calories in a food item (e.g. walk 15 min).MethodsThe Physical Activity Calorie Expenditure (PACE) Study compared activity-based calorie-expenditure food labels with calorie-only labels at three Blue Cross and Blue Shield of North Carolina worksite cafeterias. After 1 year of baseline data collection, one cafeteria had food items labeled with PACE labels, two others had calorie-only food labels. Cohort participants were asked to wear an accelerometer and complete a self-report activity questionnaire on two occasions during the baseline year and twice during the intervention year.ResultsA total of 366 study participants were included in the analysis. In the PACE-label group, self-reported physical activity increased by 13–26% compared to the calorie-only label group. Moderate-to-vigorous physical activity (MVPA) increased by 24 min per week in the PACE-label group compared to the calorie-label group (p = 0.06). Changes in accelerometer measured steps, sedentary time, and MVPA had modest increases. Change ranged from 1 to 12% with effect size values from 0.08 to 0.15. Baseline physical activity level significantly moderated the intervention effects for all physical activity outcomes. Participants in both label groups starting in the lowest tertile of activity saw the largest increase in their physical activity.ConclusionResults suggest small positive effects for the PACE labels on self-reported and objective physical activity measures. Minutes of weekly MVPA, strength training, and exercise activities showed modest increases. These results suggest that calorie-expenditure food labels may result in some limited increases in physical activity.

Influence of lifestyle factors and staple foods from the Mediterranean diet on non-alcoholic fatty liver disease among older individuals with metabolic syndrome features.

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver morbidity. This condition often is accompanied by obesity, diabetes, and metabolic syndrome (MetS). The aim of this study was to evaluate the connection between lifestyle factors and NAFLD in individuals with MetS. A cross-sectional study with 328 participants (55-75 y of age) diagnosed with MetS participating in the PREDIMED-Plus trial was conducted. NAFLD status was evaluated using the non-invasive hepatic steatosis index (HSI). Sociodemographic, clinical, and dietary data were collected. Adherence to the Mediterranean diet (mainly assessed by the consumption of olive oil, nuts, legumes, whole grain foods, fish, vegetables, fruits, and red wine) and physical activity were assessed using validated questionnaires. Linear regression analyses revealed that HSI values tended to be lower with increasing physical activity tertiles (T2, β=-1.47; 95% confidence interval [CI], -2.73 to -0.20; T3, β=-1.93; 95% CI, -3.22 to -0.65 versus T1, Ptrend=0.001) and adherence to the Mediterranean diet was inversely associated with HSI values: (moderate adherence β=-0.70; 95% CI, -1.92 to 0.53; high adherence β=-1.57; 95% CI, -3.01 to -0.13 versus lower, Ptrend=0.041). Higher tertiles of legume consumption were inversely associated with the highest tertile of HSI (T2, relative risk ratio [RRR], 0.45; 95% CI, 0.22-0.92; P=0.028; T3, RRR, 0.48; 95% CI, 0.24-0.97; P=0.041 versus T1). Physical activity, adherence to the Mediterranean diet, and consumption of legumes were inversely associated with a non-invasive marker of NAFLD in individuals with MetS. This data can be useful in implementing precision strategies aimed at the prevention, monitoring, and management of NAFLD.

Obesity in Adolescents Who Skip Breakfast Is Not Associated with Physical Activity.

It has been hypothesized that breakfast consumption is generally associated with healthy lifestyle behaviors, such as increased physical activity. The aim of this study was to examine the relations between breakfast consumption, adiposity measures and physical activity among adolescents. This investigation is a part of the Croatian physical activity in adolescence longitudinal study (CRO-PALS). This investigation is based on 802 participants (48% girls and 52% boys), aged between 15.2 and 16.0 years. Physical activity level and sedentary behaviors were assessed using the SHAPES questionnaire. Adiposity measures included the sum of four skinfolds, and multi-pass 24-h recall was used as the dietary assessment method. Participants who consumed breakfast had significantly lower body fat % (p = 0.011 for boys; p ≤ 0.001 for girls) compared to breakfast non-consumers. Physical activity has no mediating effect in the association of breakfast consumption on adiposity in boys (Sobel’s t = −0.541; p = 0.588) and girls (Sobel’s t = 1.020; p = 0.307). Breakfast consumption was negatively associated with adiposity only in the boys at the highest tertile of physical activity (p = 0.04). Physical activity has no mediating effect on the associations between breakfast consumption and adiposity, but has a moderation effect only in the most active boys. Breakfast consumption might exert beneficial effects only in the most active male adolescents, but not in the inactive ones.

The role of C-reactive protein levels on the association of physical activity with lung function in adults

ObjectiveRegular physical activity may be associated with improved lung function via reduced systemic inflammation, although studies exploring this mechanism are rare. We evaluated the role of C-reactive protein in blood, which is a common marker of systemic inflammation, on the association of physical activity with forced expiratory volume in one second and forced vital capacity.MethodsCross-sectional data on spirometry, C-reactive protein levels and self-reported physical activity (yes/no; ≥2 times and ≥1hr per week of vigorous physical activity) were available in the European Community Respiratory Health Survey (N = 2347 adults, 49.3% male, 28–56 years-old). A subsample was also assessed 10 years later using the International Physical Activity Questionnaire, and tertiles of Metabolic Equivalent of Task—minutes per week spent in vigorous, moderate and walking activities were calculated (N = 671, 49.6% male, 40–67 years-old). Adjusted cross-sectional mixed linear regression models and the “mediate” package in “R” were used to assess the presence of mediation.ResultsDespite positive significant associations between nearly all physical activity metrics with forced expiratory volume in one second and forced vital capacity, there was no evidence that C-reactive protein levels played a role. An influence of C-reactive protein levels was only apparent in the smaller subsample when comparing the medium to low tertiles of moderate activity (mean difference [95% CIs]: 21.1ml [5.2, 41.9] for forced expiratory volume in one second and 17.3ml [2.6, 38.0] for forced vital capacity).ConclusionsIn a population of adults, we found no consistent evidence that the association of physical activity with forced expiratory volume in one second or forced vital capacity is influenced by the level of C-reactive protein in blood.

The impact of short-term incentives on physical activity in a UK behavioural incentives programme

This observational study investigates whether the provision of ongoing short-term-incentives for verified physical activity increases and sustains levels of physical activity. We compared UK members at baseline (years 1 and 2) prior to Vitality’s Active Rewards (VAR) intervention commencing (year 3) and follow-up (year 4) for verified, self-reported (encompassing additional physical activities), mortality relative risk and satisfaction with physical activity. Members were categorised into low-active, medium-active and high-active by tertiles of baseline physical activity. Of 11,881 participants, 6477(54.5%) were male, with mean age 39.7(SD 9.8) years. At follow-up, annual active days had increased by 56% overall [60.8(59.7–61.9)–94.8(93.0–96.5)]; 554% in low-active [8.5(8.3–8.7)–47.1(44.7–49.5)]; 205% in medium-active [39.8(39.4–40.2)–81.4(78.7–84.1)] and 17% in high-active members [131.7(129.9–133.5)–153.7(150.7–156.7)] (all p < 0.001). Annual weeks of attaining international physical activity recommendations increased by 19% overall [22.2(42.8%)–26.4(50.8%)] and by 316% for low-active members [4.9(9.5%)–15.5(29.8%)]. Self-reported active minutes/week increased by 45% overall [1423(139.4–145.2)–207.0(201.8–212.3)] and 712% in low-active members [20.1(19.3–21.0)–143.2(134.6–151.9)]. Happiness with exercise levels also increased from 1985(49.4%) to 3414(84.9%) members (all p < 0.001). The relative risk of mortality from a lack of physical activity reduced by 7% for low-active members [from 0.99 to 0.92], 5% for medium-active [0.94–0.89] and 3% for high-active [0.89–0.86](p < 0.001) and by 0.02% for each additional year of age (p = 0.02). This large-scale, real-world, short-term-incentives intervention led to a dramatic increase in physical activity which was sustained for, and still increasing after, two years. If applied at broader level, this approach could considerably aid progress towards WHO targets in its Global Action Plan for Physical Activity.

Lysosomal acid lipase activity and liver fibrosis in the clinical continuum of non-alcoholic fatty liver disease.

Recent evidence showed a reduced activity of the lysosomal acid lipase (LAL) in patients with non-alcoholic fatty liver disease (NAFLD) and cryptogenic cirrhosis (CC). However, the relationship between LAL activity and liver fibrosis has never been investigated. Cross-sectional study including 575 outpatients referred for the management of cardio-metabolic and liver disease. The absence of liver fibrosis was defined by a FIB-4<1.30 and NAFLD fibrosis score (NFS) <-1.455. LAL activity was measured with dried blood spot technique. Overall, 515 patients had a diagnosis of NAFLD (454 NAFL and 61 biopsy-proven NASH) and 60 of CC. The value of LAL activity progressively decreased from healthy subjects to NAFL/NASH patients to CC (P<.001). LAL activity was reduced by 10% in patients with NAFL, by 20% in NASH and by 50% in CC. The prevalence of CC decreased across the tertiles of LAL activity: 22.2% in the lowest, 4.6% in the intermediate and 0.5% in the highest tertile. In NAFLD patients, 69.9% had a FIB4<1.30, and 43.1% a NFS <-1.455. Multivariate logistic regression analysis showed that Log(LAL activity) was associated with FIB-4<1.30 (Odds ratio [OR] 2.19 95% confidence interval [CI] 1.33-3.62, P=.002) and NFS < -1.455 (OR 2.43, 95% CI 1.51-3.91, P<.001) after adjustment for confounding factors. We found a progressive reduction of LAL activity according to liver disease severity. LAL activity was inversely associated with markers of liver fibrosis in patients with NAFLD.

Physical activity is associated with a large number of cardiovascular-specific proteins: Cross-sectional analyses in two independent cohorts.

We aimed to discover and replicate associations between leisure-time physical activity and cardiovascular candidate plasma protein biomarkers and to examine whether the associations were independent of body fat. We used cross-sectional data from two population-based cohorts, the EpiHealth (discovery cohort; n = 2239) and the Swedish Mammography Cohort - Clinical (SMCC; replication cohort; n = 4320). Physical activity during leisure time was assessed using questionnaires, and plasma concentrations of 184 proteins were assayed using the Olink Proseek Multiplex Cardiovascular 2 and 3 kits. We applied adjusted linear regression models using the False Discovery Rate to control for multiple testing in discovery. In EpiHealth, physical activity was associated with 75 cardiovascular plasma biomarkers, of which 28 associations were verified (replicated) in SMCC. Findings include seven novel associations in human: paraoxonase 3, cystatin B, cathepsin Z, alpha-L-iduronidase, prostasin, growth differentiation factor 2 and tumour necrosis factor alpha receptor superfamily member 11A. Estimates for associations were similar across tertiles of body fat and physical activity was associated with four biomarkers independent of body fat percentage: paraoxonase 3, cystatin B, fatty acid-binding protein 4 and interleukin-1 receptor antagonist. Leisure-time physical activity was associated with 28 cardiovascular-specific proteins; four associations were independent of body fat. Biomarkers in novel associations are involved in several atherosclerotic processes including regulation of low-density lipoprotein oxidation, protein degradation and immune cell adhesion and migration. Further research into these pathways may yield new insights into how physical activity affects cardiovascular health.

Physical activity is associated with neuromuscular and physical function in patients with multiple sclerosis independent of disease severity

Purpose Examine the association between physical activity and neuromuscular and physical function in patients with multiple sclerosis when also considering disease severity. Methods 91 patients with multiple sclerosis were enrolled. Assessments included physical activity by 7-day thigh-worn accelerometry, knee extensor neuromuscular function by dynamometry (maximal isometric muscle strength, rate of force development (0–50 ms)), and physical function by 5× sit-to-stand, 2-min walk test, and timed 25 ft walk test. Physical activity tertile comparisons along with simple and multiple regressions (adjusting for age, gender, EDSS, time since diagnosis) were performed. Results Physical activity tertiles revealed differences (p < 0.05) in maximal muscle strength (1.77 ≈ 1.97 < 2.28 Nm/kg), rate of force development (4.66 < 8.03 ≈ 10.55 Nm/kg/s), 5× sit-to-stand (11.4 ≈ 9.7 > 8.5 s), 2-min walk test (153 < 183 < 207 m), and timed 25 ft walk test (6.3 > 4.4 > 4.3 s). Moreover, physical activity was associated (p < 0.05) with maximal muscle strength and rate of force development (r 2 = 0.13–0.15) along with 5× sit-to-stand, 2-min walk test, and timed 25 ft walk test (r 2 = 0.18–0.24), also after adjusting for age + gender + EDSS + time since diagnosis (r 2 = 0.25–0.37 and 0.24–0.52), with physical activity consistently being a strong predictor. Conclusions Higher levels of physical activity are associated with greater neuromuscular and physical function in ambulatory patients with multiple sclerosis independent of disease severity. These findings emphasize the importance of performing regular physical activity at all stages of multiple sclerosis. IMPLICATIONS FOR REHABILITATION Physical activity is associated with neuromuscular and physical function, independent of disease severity. Physical activity may be important in improving or preserving neuromuscular and physical function at all stages of ambulatory multiple sclerosis patients, yet longitudinal studies are warranted. Clinicians and rehabilitation professionals should encourage ambulatory patients at all stages of their disease to be as physically active as possible.