Current Physical Activity Recommendations Research Articles

Half Of Adolescents Never Met Physical Activity Guidelines Over A Nine Week Period

PURPOSE: Consistency in physical activity is crucial to acquire maximum health benefits. The current physical activity (PA) recommendation for adolescents is to accrue 420 minutes of PA a week. The purpose of this study was to examine proximal changes in adolescent physical activity. METHODS: Adolescents in a freshman high school health class answered Exercise Vital Sign (EVS) questions over the course of nine weeks. Minutes of PA per week was calculated by multiplying days of PA by minutes of PA. Participants were then categorized as meeting (≥420 minutes/week) or not meeting (<420 minutes per week) current PA guidelines. An alluvial diagram was created to perform exploratory visual analysis of the magnitude and variability in meeting and not meeting PA trajectories across the four time points. RESULTS: Of the twenty-five who participated, 21 had EVS data at four points in time. The average PA across all time points was 312 ± 272 minutes per week. PA between the time points ranged from 245-355 minutes per week. 14% of adolescents always met PA recommendations and 48% never met PA recommendations. 10% of adolescents missed the recommended PA only once, 24% missed twice, and 5% missed PA recommendations three times. From Time Point 1 to Time Point 4 the percentage of adolescents who did not meet PA recommendations were 57%, 71%, 71%, and 62%, respectfully. DISCUSSION: The benefits of regular, consistent exercise include improved mood, physical fitness and sleep quality as well as a decreased risk of chronic diseases. Adolescence is a key developmental stage because developed health behaviors often translate into adulthood. A large majority (86%) did not meet PA guidelines at least once during the study. There may be differences between those who never meet and those who sometimes meet the recommended PA levels. Individual Trajectories of Meeting and Not Meeting PA Guidelines over Four points in Time

Interaction Between Automatic And Reflective Processes In The Prediction Of Accelerometer-derived PA Behaviors

Grounded in dual process theories related to physical activity (PA) behavior, both reflective and automatic processes have been shown to predict PA. However, relatively little is known about the interaction or relative contributions of these two processing systems in relation to PA behavior, and even less is known about how individual factors alter these relationships. PURPOSE: To examine the relationships among automatic and reflective processes (i.e., PA intentions) across four different PA domains (i.e., exercise [EX], light [LPA] and moderate-to-vigorous intensity non-leisure time PA [MVPA], and sedentary behavior [SED]), and explore how individual factors modulate these associations. METHODS: Participants (≥18 years old) completed a computerized Single Category Implicit Association Test (SCIAT) measuring implicit attitudes towards PA and SED behaviors using images depicting the four different PA domains. Positive SCIAT scores indicated positive affective evaluation (AE) toward the target behavior. PA intention and PA self-efficacy (SES) were measured using questionnaires. Habitual PA was measured using an accelerometer. Multiple regression analysis was used to examine whether AE predicted unique variance in habitual PA levels after controlling for PA intentions and SES. RESULTS: Sixty-six participants (63% women; 92% students) were included in our final sample (M±SD: 23±8 y, 26.2±19.1 kg/m2, 53.4±13.0 min/d and 505.3±315.1 min/d of MVPA and SED, respectively; 80% met current PA recommendations). AE of the different PA domains did not differ: EX=0.00±0.67, LPA=0.00±0.89, MVPA=-0.08±0.46, SED=-0.08±0.72. AE of EX was strongly and positively correlated with LPA (r=0.53, p<0.001). AE of EX and SES interacted to predict min/d of MVPA (β=-0.21; p=0.04) and total activity counts per day (a measure of total PA) (β=-0.26; p=0.01). Simple slope analysis revealed that at high SES, AE of EX was negatively correlated with both MVPA (β=-0.29, p=0.05) and total PA (β=-0.31, p=0.04). CONCLUSIONS: Our results, although somewhat unexpected, support the role of AE in relation to PA behavior and suggest that its effect may depend on self-regulatory resources such as SES. Caution is warranted in generalizing our findings to other samples as ours was comprised of young, healthy, and active adults.

Physical Activity And All-cause Mortality In Type 2 Diabetes: A Cross-country Comparison

The main physical activity recommendation (i.e. 150-300 minutes of moderate intensity activity (MVPA) per week) for individuals with type 2 diabetes (T2D) is identical to the general adult recommendation despite substantially less evidence for the recommendation aimed at those living with chronic conditions. PURPOSE: To examine the dose-response associations between leisure-time physical activity (LTPA) and risk of death in individuals with prevalent T2D; and to compare the magnitude of this association between the UK and China. METHODS: Individuals with prevalent T2D in the UK Biobank (UKB) and China Kadoorie Biobank (CKB) prospective cohort studies. Deaths were obtained from registries. Self-reported leisure-time physical activity was categorized as ‘no activity’ (reference), and activity ‘below’ (1-149 min of MVPA/week), ’meeting’ (150-300 min MVPA/w), or ‘above’ (>300 min of MVPA/w) the physical activity recommendations. Individuals with prevalent diseases were excluded. Associations with all-cause mortality were determined using multivariable-adjusted cox proportional hazard regression models. The continuous dose-response pattern was modelled using restricted cubic splines. RESULTS: We included 14,876 (mean (SD) age: 59.5 (7.2) years) and 17,459 (57.7 (9.7) years) men and women with T2D from UKB and CKB, respectively. During a median of 11.3 and 9.7 years of follow-up, 1227 (UKB) and 2351 (CKB) deaths were recorded. In UKB, Hazard ratios were 0.95 (95%CI 0.78, 1.15), 0.88 (0.70, 1.09) and 0.81 (0.66, 1.00) ‘below’, ’meeting’, and ‘above’ physical activity recommendations, respectively. The same contrasts yielded similar magnitude of associations in CKB; 0.87 (0.68, 1.09), 0.88 (0.75, 1.04) and 0.77 (0.70, 0.85). The continuous dose-response analysis did not support an optimal threshold or point of no added benefit in UKB (p-values for non-linearity 0.78), but no further risk reduction was observed above 600 min of MVPA/w in CKB (p-value for non-linearity 0.03). CONCLUSION: LTPA is inversely associated with mortality risk in individuals with T2D. Meeting current physical activity recommendations were associated with a 12% lower risk in both the UK and China cohorts. Stronger associations were observed at higher activity levels with conflicting support for an upper limit of benefit.

Association Between Device-Measured Physical Activity and Incident Heart Failure: A Prospective Cohort Study of 94 739 UK Biobank Participants.

Studies of objectively measured physical activity (PA) have investigated acute cardiovascular outcomes but not heart failure (HF), an emerging chronic condition. This study aimed to investigate the dose-response relationship between device-measured PA and HF by intensity of PA. This was a prospective cohort study of 94 739 UK Biobank participants who had device-measured PA in 2013 to 2015 and were free from myocardial infarction and HF. PA was measured with a wrist-worn accelerometer, and time spent on light-, moderate-, and vigorous-intensity PA was extracted. Incident HF was ascertained from linked hospital and death records. Cox proportional hazard models with cubic penalized splines were used to study the associations, which were adjusted for sociodemographic and lifestyle factors. Competing risk was handled with cause-specific hazard ratios. The overall incidence of HF was 98.5 per 10 000 person-years over a median 6.1 years of follow-up. Compared with participants who undertook no moderate- to vigorous-intensity PA, those who performed 150 to 300 min/wk of moderate-intensity PA (hazard ratio, 0.37 [95% CI, 0.34-0.41]) and 75 to 150 min/wk of vigorous-intensity PA (hazard ratio, 0.34 [95% CI, 0.25-0.46]) were at lower HF risk. The association between vigorous-intensity PA and HF was reverse-J shaped with a potentially lower risk reduction above 150 min/wk. Device-measured PA, especially moderate-intensity PA, was associated with a lower risk of HF. Current vigorous-intensity PA recommendations should be encouraged but not increased. In contrast, increasing moderate-intensity PA may be beneficial even among those meeting current recommendations.

Prevention and treatment of psychiatric disorders through physical activity, exercise, and sport

Prevention and treatment of psychiatric disorders through physical activity, exercise, and sport

Physical activity measured by accelerometry among adolescents participating in sports clubs and non-participating peers

ABSTRACT The purpose of this descriptive cross-sectional study is to describe the amount and intensity of physical activity (PA) measured by accelerometry among adolescents participating in organized sports (SCP) and age-matched non-participating peers (NP). SCPs (332) and NPs (139) wore an accelerometer on the hip for seven days. PA was reported using the 1-min exponential moving average. The current moderate-to-vigorous physical activity (MVPA) recommendation of at least an average of 60 min of MVPA daily was reached by 85% of SCPs and 45% of NPs (p < .001). During training days, the MVPA times among SCPs ranged from 153 ± 39 min in males and 109 ± 35 min in females participating in basketball to 113 ± 33 min in males participating in floorball and 83 ± 32 min in females participating in gymnastics. Sports participation contributes rather strongly to the accumulation of the recommended amount of MVPA. During training days, SCPs, except for females participating in gymnastics, accumulated more MVPA than NPs. During non-training days, only males participating in cross-country skiing and females participating in track and field accumulated more MVPA than NPs. HIGHLIGHTS PA of Finnish adolescents participating in nine different organized sports and age-matched non-participating peers was measured by accelerometry for one week and the results are reported using the 1-min exponential moving average. Adolescents participating in many organized sports accumulated more PA than non-participants; this was observed in meeting the PA recommendations, total amount of PA at different intensities, and step count. The current PA recommendation of at least an average of 60 min of MVPA per day was reached by 85% of SCPs and 45% of non-participating peers. Vigorous physical activity at least three times per week was incorporated by 96% of SCPs and 81% of NPs. During training days, males participating in soccer, basketball, and cross-country skiing spent more time in MVPA than females participating in the same sports. During non-training days, the time spent in MVPA was similar between males and females participating in sports clubs.

EFFECT OF ONLINE MESSAGING INTERVENTION TO ENGAGE ADULTS FROM THE QATAR COMMUNITY IN PHYSICAL ACTIVITY

In Qatar, physical inactivity amongst 18-64 years old adults is at risk of NCD diseases (obesity (41.4%), high cholesterol level (21.9%), diabetes (6.7%), low participation in physical activity (63.3%), with annual mortality due to physical inactivity of 9. 3% and 36.8%. not meeting current national physical activity recommendations. This study evaluates the effect of online messaging intervention and walking program to engage adults from Qatar community in PA. The concept of online messaging intervention as motivation and awareness of PA in Qatar is explored. Randomized pretest-posttest experimental study method with a follow-up period of 16 weeks was applied to a total of 299 healthy adults (18 to 64 years) in SIH community settings (143 adults control group, 156 adults experiment group, 68 (22.7%) adults IPAQ participants). Evaluation of PA levels and daily steps from pedometers and mob app classified into categories. Evaluation of IPAQ results calculated as MET minutes per week. The walking program combined with online messaging motivated a percentage of 22.7% of adults to continue an active lifestyle, at 16 weeks of follow-up. Self-rated PA level similar to data reported by pedometers demonstrates that adults in the IPAQ group (68 (22.7%)) have a good PA awareness. The statistical findings demonstrate that walking in combination with online messaging programs implemented among adults in the Qatari community can increase awareness of the health benefits of physical activity by forming the basis of an active lifestyle.

Association Between Physical Activity and Risk of Depression

Depression is the leading cause of mental health-related disease burden and may be reduced by physical activity, but the dose-response relationship between activity and depression is uncertain. To systematically review and meta-analyze the dose-response association between physical activity and incident depression from published prospective studies of adults. PubMed, SCOPUS, Web of Science, PsycINFO, and the reference lists of systematic reviews retrieved by a systematic search up to December 11, 2020, with no language limits. The date of the search was November 12, 2020. We included prospective cohort studies reporting physical activity at 3 or more exposure levels and risk estimates for depression with 3000 or more adults and 3 years or longer of follow-up. Data extraction was completed independently by 2 extractors and cross-checked for errors. A 2-stage random-effects dose-response meta-analysis was used to synthesize data. Study-specific associations were estimated using generalized least-squares regression and the pooled association was estimated by combining the study-specific coefficients using restricted maximum likelihood. The outcome of interest was depression, including (1) presence of major depressive disorder indicated by self-report of physician diagnosis, registry data, or diagnostic interviews and (2) elevated depressive symptoms established using validated cutoffs for a depressive screening instrument. Fifteen studies comprising 191 130 participants and 2 110 588 person-years were included. An inverse curvilinear dose-response association between physical activity and depression was observed, with steeper association gradients at lower activity volumes; heterogeneity was large and significant (I2 = 74%; P < .001). Relative to adults not reporting any activity, those accumulating half the recommended volume of physical activity (4.4 marginal metabolic equivalent task hours per week [mMET-h/wk]) had 18% (95% CI, 13%-23%) lower risk of depression. Adults accumulating the recommended volume of 8.8 mMET hours per week had 25% (95% CI, 18%-32%) lower risk with diminishing potential benefits and higher uncertainty observed beyond that exposure level. There were diminishing additional potential benefits and greater uncertainty at higher volumes of physical activity. Based on an estimate of exposure prevalences among included cohorts, if less active adults had achieved the current physical activity recommendations, 11.5% (95% CI, 7.7%-15.4%) of depression cases could have been prevented. This systematic review and meta-analysis of associations between physical activity and depression suggests significant mental health benefits from being physically active, even at levels below the public health recommendations. Health practitioners should therefore encourage any increase in physical activity to improve mental health.

Evidence of Better Autonomic, Metabolic and Psychological Profile in Breast Cancer Survivors Meeting Current Physical Activity Recommendations: An Observational Study.

The increased cardiometabolic risk observed in breast cancer survivors (BCS) is due to multiple mechanisms: Hormonal and immunological dysfunction are well-identified ones, while cardiac autonomic regulation (CAR) is less recognized but may play a new complementary role particularly relevant when considering conditions and behaviors associated with a better prognosis in BCS, such as physical training. This observational study investigated a group of consecutive (172) BCS subdivided in two groups: those who reached the physical activity goals above 600 (MET·min/week) and those who did not. We assessed CAR by autoregressive spectral analysis of cardiovascular variabilities (considering in particular the unitary autonomic nervous system index—ANSI), body mass composition, stress perception and lifestyle in order to verify possible differences due to execution of physical activity. Subjects who spontaneously met physical activity recommendations presented a better autonomic, metabolic and psychological profile compared to those who did not. Lower physical activity volume, poor metabolic parameters, increased stress and fatigue perception may cluster together, leading to worsened CAR. This control mechanism may play a complementary role in determining the increased cardiometabolic risk observed in BCS. Furthermore, it may also explain, albeit in part, the better prognosis observed in patients following interventions aiming to improve the sympathetic–parasympathetic balance, such as physical training, using a personalized medicine approach.

Accelerometer derived physical activity patterns in 27.890 middle‐aged adults: The SCAPIS cohort study

The present study aims to describe accelerometer‐assessed physical activity (PA) patterns and fulfillment of PA recommendations in a large sample of middle‐aged men and women, and to study differences between subgroups of socio‐demographic, socio‐economic, and lifestyle‐related variables. A total of 27 890 (92.5% of total participants, 52% women, aged 50–64 years) middle‐aged men and women with at least four days of valid hip‐worn accelerometer data (Actigraph GT3X+, wGT3X+ and wGT3X‐BT) from the Swedish CArdioPulmonary bioImage Study, SCAPIS, were included. In total, 54.5% of daily wear time was spent sedentary, 39.1% in low, 5.4% in moderate, and only 0.1% in vigorous PA. Male sex, higher education, low financial strain, born in Sweden, and sedentary/light working situation were related to higher sedentary time, but also higher levels of vigorous PA. High BMI and having multiple chronic diseases associated strongly with higher sedentary time and less time in all three PA intensities. All‐year physically active commuters had an overall more active PA pattern. The proportion fulfilling current PA recommendations varied substantially (1.4% to 92.2%) depending on data handling procedures and definition used. Twenty‐eight percent was defined as having an “at‐risk” behavior, which included both high sedentary time and low vigorous PA. In this large population‐based sample, a majority of time was spent sedentary and only a fraction in vigorous PA, with clinically important variations between subgroups. This study provides important reference material and emphasizes the importance of a comprehensive assessment of all aspects of the individual PA pattern in future research and clinical practice.

TEACHING SUBJECTS AND PARTICIPATION RATES IN PHYSICAL EDUCATION COURSES AMONG CHILDREN AGED 10 TO 12 YEARS

&lt;p&gt;Physical activity (PA) is a parameter of children's life that is straight connected to the benefits of their life (protection against obesity, better psychological profile, and predisposition for increased levels of PA as adult etc.). The purpose of the present study was to evaluate parameters of PA during Physical Education (PE) classes and to explore the subjects that the children participate in the PE course. PA, PE, and sedentary behaviors were assessed by a self-administrated PA checklist, proper for children. Body mass index (BMI) was calculated from measured body weight and height. A representative sample of Greek boys and girls aged 10 to 12 years (N=3195) participated in the study. Results showed that boys had higher levels of total and vigorous-intensity PA (VPA), than girls (all p-values&amp;lt;0.05), while girls presented higher light-to-moderate intensity PA as compared to boys. In those days that students participated in PE classes, total PA and VPA were higher in comparison with days didn't, in both sexes (p&amp;lt;0.001), while, a greater proportion of children met the current recommendations for PA (86.1% vs. 69.1% for boys and 68.4% vs. 53.5% for girls). During PE classes, boys participated in a greater proportion than girls in basketball and soccer (all p-values&amp;lt;0.05), while, more girls in comparison to boys participated in volleyball, dance, and jump-rope (all p-values&amp;lt;0.05). Stratified data analysis by BMI category among children who participated in PE classes did not reveal significant differences in time participated in PE components among categories, except for games (e.g. chase, tag) among boys. In conclusion, boys have higher levels of total PA than girls, while, it seems that school and PE classes play a significant role in students' levels of PA which could grow up further with interventions as the increase of hours in PE lessons.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0992/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Use of the Behavioral Regulation in Exercise Questionnaire-2 to assess motivation for physical activity in persons with rheumatoid arthritis: an observational study

Arthritis patients may show little motivation for physical activity (PA), resulting in a sedentary lifestyle. The primary objective of the study was to investigate whether motivation for PA and fulfillment of PA recommendations were associated with cardiorespiratory fitness in patients with RA. The exploratory objective was to study whether university students could be used as controls for RA patients in future studies of PA motivation. Peak oxygen uptake (VO2peak) was measured in 93 RA patients. The patients and 354 students filled in the Behavioral Regulation in Exercise Questionnaire-2 (BREQ-2). Data were analyzed using structural equation modeling with adjustment for age and sex. The BREQ-2 scores were also compiled to an overall motivational style “Relative Autonomy Index” as previously published. Mean VO2peak for the RA patients was 32.2 (SD: 9.6) mL × min−1 × kg−1. Only 29 patients (31%) fulfilled the current recommendations for PA. BREQ-2 scores were associated with measured VO2peak (standardized coefficient 0.33, p < 0.001). Whether a person fulfilled the current recommendations for PA was a significant mediator of this effect (standardized coefficients: mediated effect; 0.22, p = 0.001, remaining direct effect; 0.11, p = 0.18). The Relative Autonomy Index also significantly predicted measured VO2peak (standardized coefficient 0.30, p < 0.001). The underlying BREQ-2 factor structure was significantly different between RA patients and university students, and comparison of scores would not be adequate. Motivation for PA was significantly associated with measured VO2peak in RA patients. The effect was mediated by whether the patient fulfilled the current recommendations for PA. Addressing and stimulating motivation is important when intervening to increase PA and cardiovascular fitness in RA patients.

Physical activity before pregnancy and the risk of hypertensive disorders of pregnancy

It is unclear whether prepregnancy physical activity influences the risk of hypertensive disorders of pregnancy and whether any impact is similar for preeclampsia and gestational hypertension. To evaluate the relation of prepregnancy physical activity with hypertensive disorders of pregnancy and its alignment with the current recommendations for physical activity for the general population. We studied 28,147 singleton pregnancies from 18,283 women without chronic hypertension, cardiovascular disease, or cancer, participating in the Nurses' Health Study-II between 1989 and 2010. The women self-reported their physical activity before pregnancy and pregnancy complications, including preeclampsia and gestational hypertension. Logistic regression models using generalized estimating equations to account for within-woman correlations across pregnancies were used to estimate the relative risk (95% confidence interval) of preeclampsia and gestational hypertension across quartiles of prepregnancy physical activity, adjusting for age at pregnancy, parity, smoking, multivitamin use, infertility history, marital status, race, year of pregnancy, and history of preeclampsia. We identified 842 (3.0%) pregnancies with preeclampsia and 905 (3.2%) pregnancies with gestational hypertension. Physical activity before pregnancy was related to a lower risk of hypertensive disorders of pregnancy (relative risk, 0.75 [95% confidence interval, 0.65-0.87] for women in the highest quartile compared with the lowest quartile). This relation was driven by a 39% lower risk of gestational hypertension (relative risk, 0.61; 95% confidence interval, 0.50-0.76) comparing women in the highest quartile of physical activity (≥30.6 metabolic equivalents of task-hours/week) vs women in the lowest quartile (<6.0 metabolic equivalents of task-hours/week). Women whose moderate physical activity levels exceeded those recommended in the Physical Activity Guidelines for Americans (>5 hours/week) had a 50% lower (relative risk, 0.50; 95% confidence interval, 0.36-0.69) risk of gestational hypertension than women who did not meet this recommendation (<2.5 hours/week). For vigorous physical activity, the risk of gestational hypertension was lower among the women who met (1.25-2.5 hours/week; relative risk, 0.77; 95% confidence interval, 0.64-0.93) or exceeded (>2.5 hours/week; relative risk, 0.76; 95% confidence interval, 0.62-0.92) the recommendations than women whose activity levels were below those recommended. Physical activity was not related to the risk of preeclampsia (relative risk, 0.93; 95% confidence interval, 0.76-1.14). Physical activity before pregnancy may lower the risk of developing gestational hypertension but not preeclampsia.

Facilitators and barriers to fitness bootcamp participation using the Behaviour Change Wheel

Objective: Despite its importance for mental and physical health, many adults fail to meet current physical activity recommendations. Furthermore, most adults who begin a physical activity programme revert to being less active or even inactive within the first 6 months. Fitness bootcamps represent a potential intervention for improving physical activity in healthy adults. However, no study to date has examined the influences on long-term participation in fitness bootcamps, which is the first step to developing an effective intervention. Using the Behaviour Change Wheel (BCW) framework, this study identified the facilitators and barriers to long-term (1 year or more) fitness bootcamp participation, which were then linked to behaviour change techniques (BCTs) to facilitate intervention development. Design: Qualitative research design. Setting: Data collection occurred in England. Method: Interviews were conducted with 15 long-term fitness bootcamp participants. Results: Thematic analysis revealed 17 facilitators and 6 barriers to long-term fitness bootcamp participation. Participants highlighted the importance of facilitators such as convenience, being outdoors and enjoyment. The social environment, including having a positive instructor and supportive group members, was further noted as a key influence on participation. While long-term participants faced occasional barriers to their routine such as physical injury, bad weather and competing events, the impact of these could be minimised through appropriate BCTs such as ‘demonstration of the behaviour’ and ‘restructuring the social/physical environment’. Conclusion: Findings from this study highlight the importance of social and environmental factors to promoting long-term fitness bootcamp participation and the inclusion of social and physical environmental restructuring as key intervention components.

Evidence of Better Psychological Profile in Working Population Meeting Current Physical Activity Recommendations.

Workplace Health Promotion (WHP) may improve health, productivity and safety and reduce absenteeism. However, although desirable, it is difficult to design tailored (and thus effective) WHP programs, particularly in small–medium companies, which rarely have access to sufficient economic and organizational resources. In this study, 1305 employees filled out an online anonymous lifestyle questionnaire hosted on the website of a non-profit organization, which aims to promote a healthy lifestyle among workers. The data show gender differences regarding stress perception and, in the working population meeting current physical activity recommendations (threshold = 600 MET·min/week), they point out the evidence of a better psychological and nutrition profile, a perception of better job performance, and improved sleep and health quality. Moreover, a unitary index (ranging from 0–100 (with higher scores being healthier)), combining self-reported metrics for diet, exercise and stress, was significantly higher in active employees (67.51 ± 12.46 vs. 39.84 ± 18.34, p < 0.001). The possibility of assessing individual lifestyle in an easy, timely and cost-effective manner, offers the opportunity to collect grouped data useful to drive tailored WHP policies and to have metric to quantify results of interventions. This potentiality may help in creating effective programs and in improving employees’ and companies’ motivation and attitude towards a feasible WHP.

Individuals With Type 1 Diabetes May Have Altered Metabolic Responses During Exercise

Individuals with type 1 diabetes (T1D) benefit from regular physical activity (PA). Despite the positive gains, more than 60% of people with T1D do not meet current PA recommendations. Previous research suggests exercise has mixed effects on blood glucose (BG). Understanding the influence of exercise intensity substrate metabolism in individuals with T1D during various intensities of exercise is essential in providing appropriate recommendations for PA in those with T1D. PURPOSE: The purpose of this study is to examine energy metabolism during a graded exercise test, specifically fuel substrate usage as assessed respiratory exchange ratio (RER) and blood metabolites in individuals with T1D in comparison to individuals without T1D. METHODS: Individuals with T1D were matched for sex and PA level with healthy individuals without T1D (N = 14; 7 per group). Each individual participated in a GXT on an electronically braked cycle ergometer. BG, blood lactate, and RPE were measured every two minutes. Gas exchange, including RER, were measured throughout the GXT using the ParvoMedics system. VO2peak was judged as >90% age predicted maximal heart rate and RPE >16 on the Borg scale. Mixed model regression was used to estimate the trajectory of change in all outcomes during GXT. RESULTS: Demographics and VO2peak were not statistically significant between groups (p > 0.05). There were no significant differences in RER at peak workload between T1D (1.06 +/-0.049) and controls (1.05+/-0.031) t(12) = 0.456, p = 0.66. There were no significant differences in blood lactate at peak workload between T1D (10.37+/-3.07) and controls (8.514+/-3.11) t(12) = 1.1237, p = 0.28. The estimated trajectory of change in RER (B = 0.014, p < 0.001), lactate (B = 0.379, p = 0.004), glucose (B = 1.521, p = 0.060), and RPE (B = 0.202, p = 0.018) were significantly higher in individuals with T1D during GXT as compared to controls. CONCLUSIONS: Our results suggest that individuals with T1D may have altered metabolic responses during exercise, shifting to anaerobic exercise and carbohydrate utilization at lower intensities. This could be due to altered carbohydrate or lipid metabolism. Additional research with larger sample sizes is needed to examine the effects of exercise interventions on metabolism and various fitness goals as well as glucose management.

Implementing the physical activity vital sign in an academic preventive cardiology clinic.

The aims were to implement physical activity (PA) screening as part of the electronic kiosk check-in process in an adult preventive cardiology clinic and assess factors related to patients' self-reported PA. The 3-question physical activity vital sign (PAVS) was embedded in the Epic electronic medical record and included how many days, minutes and intensity (light, moderate, vigorous) of PA patients conducted on average. This is a data analysis of PAVS data over a 60-day period. We conducted multivariable logistic regression to identify factors associated with not meeting current PA recommendations. Over 60days, a total of 1322 patients checked into the clinic using the kiosk and 72% (n=951) completed the PAVS at the kiosk. The majority of those patients were male (58%) and White (71%) with a mean age of 64±15years. Of the 951 patients completing the PAVS, 10% reported no PA, 55% reported some PA, and 35% reported achieving at least 150min moderate or 75min vigorous PA/week. In the logistic model, females (AOR=1.4, 95%CI: 1.002-1.8, p=.049) vs. males, being Black (AOR=2.0, 95%CI: 1.04-3.7, p=.038) or 'Other' race (AOR=1.5, 95%CI: 1.02-2.3, p=.035) vs. White, unknown or other types of relationships (AOR=0.0.26, 95%CI: 0.10-0.68, p=.006) vs. being married/partnered, and those who were retired (AOR=1.9, 95% CI: 1.4-2.8, p<.001) or unemployed (AOR=2.2, 95%CI: 1.3-3.7, p=.002) vs. full-time workers were associated with not achieving recommended levels of PA. The PAVS is a feasible electronic tool for quickly assessing PA and may prompt providers to counsel on this CVD risk factor.

Young adults’ physical activity and physical function: 12 months follow up

BACKGROUND: The knowledge about university students generally demonstrates that they do not meet current recommendations for Physical Activity (PA). However, PA and Physical Fitness are not an indicator for Physical Function (PFn), being PFn a separate construct that is related to movement skill proficiency. AIM: To analyze the rate of changes in PFn accessed by the Functional Movement Screen (FMS) and PA levels (sports and leisure) in a group of Sport Science university students after one year. METHOD: 41 men (22.3±5.7years) and 22 women (20.7±0.9years) participated in this research. The data were collected in the first month of the academic year and after 12 months in the following order: Baecke Habitual Physical Activity Questionnaire, anthropometrics, and FMS. RESULTS: PFn assessment, from baseline to second assessment, revealed significant changes in Trunk Stability Push-up (p=0.003; ES=0.656) and total score (p=0.026; ES=0.497) for women and in Deep Squat (p=0.003; ES=0.334) for men. No significant changes were found in women PA levels. Men decreased in leisure PA (p=0.002; ES=0.538) and total PA (p=0.003; ES=0.519). CONCLUSION: Sports Science university students’ daily routines may mediate physical activity patterns with following physical function improvements or decrements, occurring due to contextual environments that over-or under-produce the stimulation required to develop those skills.

Recursive Partitioning Methods to Examine the Effects of Physical Activity on Physical and Mental Health: A Case Study at One Public University in the United States

The purpose of this study was to examine the effects of physical activity (PA) on physical and mental health within an adult sample, while controlling for demographic characteristics. Data were analyzed from the 2018–2019 Exercise is Medicine® On Campus (EIM-OC) assessment of students, faculty, and staff at one public university in the United States. Participants completed a survey including a demographic questionnaire, the 12-Item Short Form Health Survey (SF-12), and the International Physical Activity Questionnaire (IPAQ). Classification and Regression Trees, a supervised learning technique based upon recursive partitioning, were utilized to explore the relationships between PA and health. Variable-importance was assessed via the permutation method and confirmed with ensemble learning methods. Results indicated that PA, especially in leisure, was predictive of both physical and mental health. Further, leisure PA was the single most important variable contributing to mental health. Greater levels of physical health were observed in adults achieving at least 672 MET minutes of leisure PA per week, while greater levels of mental health were observed in adults achieving at least 950 MET minutes of leisure PA per week. Despite current recommendations for PA (irrespective of domain), more PA (especially in leisure) improves physical and mental health.

The effects of different doses of exercise on pancreatic \u03b2-cell function in patients with newly diagnosed type 2 diabetes: study protocol for and rationale behind the \u201cDOSE-EX\u201d multi-arm parallel-group randomised clinical trial

BackgroundLifestyle intervention, i.e. diet and physical activity, forms the basis for care of type 2 diabetes (T2D). The current physical activity recommendation for T2D is aerobic training for 150 min/week of moderate to vigorous intensity, supplemented with resistance training 2–3 days/week, with no more than two consecutive days without physical activity. The rationale for the recommendations is based on studies showing a reduction in glycated haemoglobin (HbA1c). This reduction is supposed to be caused by increased insulin sensitivity in muscle and adipose tissue, whereas knowledge about effects on abnormalities in the liver and pancreas are scarce, with the majority of evidence stemming from in vitro and animal studies. The aim of this study is to investigate the role of the volume of exercise training as an adjunct to dietary therapy in order to improve the pancreatic β-cell function in T2D patients less than 7 years from diagnosis. The objective of this protocol for the DOSE-EX trial is to describe the scientific rationale in detail and to provide explicit information about study procedures and planned analyses.Methods/designIn a parallel-group, 4-arm assessor-blinded randomised clinical trial, 80 patients with T2D will be randomly allocated (1:1:1:1, stratified by sex) to 16 weeks in either of the following groups: (1) no intervention (CON), (2) dietary intervention (DCON), (3) dietary intervention and supervised moderate volume exercise (MED), or (4) dietary intervention and supervised high volume exercise (HED). Enrolment was initiated December 15th, 2018, and will continue until N = 80 or December 1st, 2021. Primary outcome is pancreatic beta-cell function assessed as change in late-phase disposition index (DI) from baseline to follow-up assessed by hyperglycaemic clamp. Secondary outcomes include measures of cardiometabolic risk factors and the effect on subsequent complications related to T2D. The study was approved by The Scientific Ethical Committee at the Capital Region of Denmark (H-18038298). Trial registration: The Effects of Different Doses of Exercise on Pancreatic β-cell Function in Patients With Newly Diagnosed Type 2 Diabetes (DOSE-EX), NCT03769883, registered 10 December 2018 https://clinicaltrials.gov/ct2/show/NCT03769883). Any modification to the protocol, study design, and changes in written participant information will be approved by The Scientific Ethical Committee at the Capital Region of Denmark before effectuation.DiscussionThe data from this study will add knowledge to which volume of exercise training in combination with a dietary intervention is needed to improve β-cell function in T2D. Secondarily, our results will elucidate mechanisms of physical activity mitigating the development of micro- and macrovascular complications correlated with T2D.