Aerobic Physical Activity Guidelines Research Articles

Health-Related Benefits and Adherence for Multiple Short Bouts of Aerobic Physical Activity Among Adults

Most adults do not adhere to established aerobic physical activity (PA) guidelines due in part to various barriers. PA snacks, or periodic short bouts of activity (<10 minutes) offer a potential strategy to overcoming such barriers and increasing PA. Previous efforts have been focused on eliciting the health benefits of PA and exercise snacks, yet adherence to this concept has not been examined. The purpose of this review is to summarize the current literature assessing adherence to PA snacks and health-related outcomes associated with PA snacks. PubMed, CINAHL, and SPORTDiscus were searched for literature published between January 2018-September 2023. Studies investigating adherence and/or the health-related outcomes of PA snacks were included. Of 4201 articles identified, 12 studies were included in the review. Most of the studies were randomized (n = 10), focused on adults with a chronic disease/life-long condition or exhibited a sedentary lifestyle (n = 8), and reported positive health outcomes (n = 12; e.g., improvements in cardiometabolic markers and body composition). Five studies reported adherence to supervised and unsupervised PA snack interventions, with high rates ≥92%. This review supports and extends the previously reported health-related benefits of PA snacks. It also shows promise for increasing overall PA and adherence to the PA guidelines.

Abstract PO4-12-09: National Physical Activity Guidelines and It’s Association with Fatigue in Patients with Breast Cancer Pre- and Post-Chemotherapy in a Prospective, Nationwide Study

Abstract Background: Cancer-related fatigue (CRF) is one of the most pervasive side effects of cancer and its treatment, reported by nearly 90% of patients. Physical activity (PA) during treatment may prevent or lessen CRF burden. Current aerobic PA guidelines for cancer patients recommend at least 150 minutes of moderate PA or 75 minutes of vigorous PA or some equivalent combination of moderate and vigorous PA (MVPA). Many patients have difficulty meeting these guidelines during treatment, however, meeting these guidelines may not be necessary to alleviate CRF. This study evaluated patterns of PA below the recommended guidelines and their association with CRF in cancer patients during treatment. Methods: In a nationwide, prospective cohort study of patients with stage I-IIIC breast cancer (n=580) we assessed the relationship between self-reported PA (Aerobics Center Longitudinal Study PA) and CRF (Multidimensional Fatigue Symptom Inventory, MFSI) pre- and post-chemotherapy. Spearman correlations were utilized to evaluate the association of all PA (MET hr/wk) and MVPA (MET hr/wk) with overall CRF (total MFSI) and 5 CRF subdimensions (general, physical, emotional, mental CRF and vigor) at pre- and post-chemotherapy. ANCOVA estimated mean CRF score according to whether patients weekly MVPA (1) met 100% of the PA guidelines, (2) met 50%-99% of the PA guidelines (75-149 minutes), or (3) did not meet 50% of the PA guidelines (< 75 minutes). Results: Pre-chemotherapy, only 34% of participants met the PA guidelines, post-chemotherapy, only 21% of patients met the PA guidelines. At both time points, we observed small to moderate inverse correlations of MVPA with overall CRF and several subdimensions of CRF (Table 1; r = -0.11, -0.19). Pre-chemotherapy, those who did not meet 50% of the PA guidelines report significantly higher total CRF compared to those who met the PA guidelines (12.5 ± 1.2 vs 5.3 ± 1.5; p< 0.001). However, those who met only 50%-99% of the PA guidelines, had comparable total CRF to those who fully met the PA guidelines (7.2 ± 2.2; p=0.474). A similar pattern was observed for the subdimensions general, mental, and physical CRF. Those who met 50% of the guidelines also had significantly lower vigor compared to those who met the guidelines (11.9 ± 0.3 vs 13.8 ± 0.4; p< 0.001), while those who met 50%-99% of the guidelines had comparable vigor to those who fully met guidelines (13.1 ± 0.6; p=0.278). Post-chemotherapy CRF was higher among all patient’s, again there was no significant difference in total, general, physical CRF and vigor between those who met the PA guidelines and those who met 50%-99% of the PA guidelines. Conclusions: All PA was consistently inversely associated with CRF pre- and post-chemotherapy for patients with breast cancer. Current minimum aerobic PA guidelines for patients with cancer are difficult to achieve during treatment. Lower doses of MVPA than the current PA guidelines suggest may provide equal benefit and represent a more achievable goal for patients with cancer. Table 1: Spearman correlations of CRF and physical activity in patients with breast cancer pre- and post-chemotherapy. Table 2: ANCOVA; Mean CRF score according to the PA guidelines. Citation Format: Lindsey Mattick, Hongying Sun, Karen Mustian, Luke Peppone, AnnaLynn Williams, Po-Ju Lin, Evelyn Arana, Jeremy McGuire, Amarinthia Curtis, Alison Conlin, Lora Weiselberg, Michelle Janelsins. National Physical Activity Guidelines and It’s Association with Fatigue in Patients with Breast Cancer Pre- and Post-Chemotherapy in a Prospective, Nationwide Study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-12-09.

The Physical Activity Guidelines and Diabetes-Related Mortality: National Health and Nutrition Examination Survey 1999-2006.

Background: Previous studies have indicated an inverse relationship between aerobic physical activity (PA) and risk of diabetes-related mortality (DRM). However, the contribution of aerobic PA across multiple domains, while also considering the contribution of muscle-strengthening activity (MSA), in reduction of risk for DRM has yet to be examined. Purpose: The aim of this study is to examine the individual and combined associations of aerobic PA and MSA with DRM. Methods: The study sample (n = 13,350) included adult (20-79 years of age) participants from the 1999 to 2006 National Health and Nutrition Examination Survey. PA was categorized into 6 categories based around the 2018 PA guidelines: category 1 (inactive), category 2 (insufficient aerobic PA and no MSA), category 3 [active (aerobic) and no MSA], category 4 (no aerobic PA and sufficient MSA), category 5 (insufficient aerobic PA and sufficient MSA), and category 6 (meeting both recommendations). The dependent variable in this study was DRM, which includes those who had diabetes as the primary cause of death as well as those with diabetes listed as an underlying cause of death. Cox proportional hazards models were used for all analyses. Results: Following adjustment for covariates, significant risk reductions for DRM were found only in category 3 (HR = 0.57; 95% confidence interval: 0.37-0.88). Conclusions: Results suggest that meeting the aerobic PA guidelines significantly reduces the risk for DRM. Those meeting versus not meeting the MSA guidelines seem to have no difference in risk for DRM independent of aerobic PA.

Engagement in physical activity among African American women caregivers: a cross-sectional study

Family caregivers and African Americans often do not achieve the recommended 150 minutes of moderate-intensity aerobic activity per week. Factors associated with engaging in physical activity among African American caregivers have not been systematically examined. This cross-sectional study examined how contextual factors were associated with meeting the recommended amount of physical activity among African American women caregivers. We used a population-based sample of 1,478 African American women caregivers in the U.S. from the 2015, 2017, and 2019 Behavioral Risk Factor Surveillance System. We used survey-weighted multivariate regression analyses to examine associations between condition-specific factors, physical and social environment, and individual and family factors and meeting the national aerobic physical activity guideline (i.e., participating in 150 minutes (or vigorous equivalent minutes) of physical activity per week). Over half (53.9%) of African American women caregivers in the U.S. did not meet the guideline. Being age 65 years or older was associated with decreased odds of meeting the guideline compared to being between the ages of 25-44 years (OR = 0.50, 95% CI[0.26-0.99]). Compared to college graduates, women with partial college education had higher odds of meeting the guideline (OR = 2.08, 95%CI[1.24–3.51]). Having health insurance was associated with increased odds of meeting the guideline (OR = 2.28, 95%CI[1.12–4.63]). Our findings suggest several contextual factors are independently associated with meeting the national guideline. Understanding the relationships between contextual factors and engaging in physical activity among African American women caregivers can inform interventions aimed at protecting and promoting the health of these women.

Meeting the Aerobic and Muscle-Strengthening Physical Activity Guidelines Among Older US Adults, National Health Interview Survey 1998-2018.

The Physical Activity Guidelines for Americans, second edition, recommends older adults participate in ≥150minutes per week of moderate-intensity equivalent aerobic activity and ≥2days per week of muscle-strengthening activity. We estimated prevalence and trends of meeting the guidelines among US adults aged ≥65years from 1998 to 2018. Using the 1998-2018 National Health Interview Survey, we estimated the prevalence of meeting aerobic, muscle-strengthening, and combined physical activity guidelines stratified by age group, sex, race and ethnicity, and education level. Within age groups, we calculated prevalence differences by sociodemographic categories. Prevalence of meeting each guideline increased for all age groups and most sociodemographic subgroups. The increased magnitude of meeting the combined guideline from 1998-2000 to 2016-2018 differed across levels of educational attainment for most age groups. Despite increasing over time, the prevalence among older adults of meeting physical activity guidelines remains low (range for combined guideline: 7.2%-17.2%).

The association between work-related activities and leisure-time physical activity among Latinos

ABSTRACT Objectives Latinos engage in high levels of occupational physical activity, yet low levels of leisure-time physical activity. Limited research has examined specific work-based activities that may contribute to leisure-time physical activity for meeting current physical activity recommendations among Latinos. The purpose of our study was to examine associations between frequency of work-related exertion and standing/walking with meeting the aerobic and muscle-strengthening physical activity guidelines among Latinos and whether associations varied by nativity. Design We used cross-sectional 2015 National Health Interview Survey data on Latinos ≥18 years of age (n = 3162). Logistic regression models were used to estimate associations between the frequency of work-related activities with meeting the aerobic and muscle-strengthening physical activity guidelines. Models were adjusted for age, sex, education, Latino subpopulation, shift work, and nativity. We also examined whether associations varied by nativity. Results In adjusted models, compared with those never engaging in exertion at work, participants always exerting themselves were significantly less likely to meet the aerobic activity guideline (Odds Ratio [OR]: 0.66, 95% Confidence Interval [CI]: 0.51–0.87). Compared with those never standing/walking at work, participants seldom standing/walking were also less likely to meet the aerobic activity guideline (OR: 0.57, 95% CI: 0.34, 0.95). Models were adjusted for age, sex, education, Latino subpopulation, shift work, and nativity. When stratified by nativity, the patterns in the strength of the associations were similar, while differences were observed in the associations of work-related activities with meeting guidelines. Conclusion Our findings suggest that engaging in higher frequency of exertion and standing/walking at work are associated with being less likely to meet the aerobic physical activity guideline during leisure time among Latinos, with variation observed in meeting guidelines by nativity. Insight into physical activities performed at work could inform efforts aimed at promoting recommended levels of physical activity among Latinos.

Physical Activity Intensity and Risk of Dementia

IntroductionRegular participation in aerobic physical activity is associated with a reduced risk of dementia. It is currently unclear whether this association is due to the total volume or intensity of physical activity. MethodsThis prospective cohort study analyzed 386,486 adults from the UK Biobank who were free of dementia and self-reported >0 minutes of moderate-to-vigorous intensity physical activity (MVPA) at baseline (2007-2010). Participants were categorized as performing 0%, >0% to 30%, or >30% of their total MVPA in vigorous activity (VPA). Cox proportional hazards regression models were used to examine the associations between categories of VPA and incident dementia while adjusting for sociodemographic and lifestyle factors including total MVPA. Analyses were performed in 2022. ResultsOver an average follow-up of 12.0 (1.7) years, there were 5,177 (1.3%) cases of dementia. Compared to the group reporting 0% VPA, the hazard ratios (95% confidence intervals) of dementia for the groups reporting >0% to 30% and >30% VPA were 0.73 (0.68-0.78) and 0.81 (0.75-0.87), respectively, in the fully adjusted model. In a joint analysis, reporting some VPA was associated with a reduced risk of dementia regardless of meeting the aerobic physical activity guidelines (HR=0.78 [0.72-0.85]) or not (HR=0.76 [0.60-0.98]), while meeting the aerobic physical activity guidelines alone without VPA was not associated with incident dementia (HR=0.98 [0.90-1.07]), compared to the group that did not meet the guidelines and reported no VPA. ConclusionsThese results suggest that engaging in VPA as part of MVPA is associated with a lower risk of dementia.

Abstract 12491: Impact of Augmented Treatments on Physical Activity Outcomes in a Sequential Multiple Assignment Randomized Trial

Background: Nearly half of women do not meet aerobic physical activity (PA) guidelines. Despite proven efficacy of PA interventions, response varies. Little is known about when treatment should be augmented. The Working Women Walking Program is a Sequential Multiple Assignment Randomized Trial testing two initial treatments (Fitbit vs. Fitbit+text messages) for eight weeks and two augmented treatments (personal calls vs. group meetings) added at eight weeks for non-responders to the initial treatments. Aims: We aim to compare the two augmented treatments among non-responders to the initial treatments on PA after 34 weeks of the program. Methods: Participants ( N = 301; women ages 18-70) were randomly assigned to an initial treatment of either Fitbit ( n = 149) or Fitbit+text messages ( n = 152). Both groups received a Fitbit and PA prescription (increase daily steps by ≥600 above baseline). Response to treatment was defined as (a) wearing the Fitbit 10 hours per day 3 of 7 days weekly in weeks 6-8 and (b) reaching a step goal ≥600 steps above baseline for 2-3 weeks in weeks 6-8. Non-responders were randomly assigned to an augmented treatment with personal calls ( n = 72; 50.7%) or group meetings ( n = 70; 49.3%). Objective PA was assessed with the waist-worn ActiGraph accelerometer (≥4 days with one weekend day and ≥10 hours daily wear time) at baseline and 34 weeks to assess daily steps and minutes of light and moderate-vigorous intensity PA (MVPA). Self-report PA was measured with the International PA Questionnaire to assess daily MVPA and walking. Results: Across all PA measures, there were no significant differences between augmented treatments (personal calls vs. group meetings). Overall, both treatments showed non-significant increases in objective PA, including steps ( d = .15; p = .30), light PA ( d = .11; p = .39), and MVPA ( d = .22; p = .15), but showed significant increases in self-report PA, including ( d = 1.02; p < .001) and walking ( d = .73; p = .30). Conclusion: In this sample of working women who were non-responsive to an initial PA treatment (Fitbit or Fitbit+texts), augmenting with personal calls or group meetings did not yield a difference in PA outcomes. Next, we will explore participant characteristics that may differentiate response to augmented treatments.

Patterns and correlates of physical activity and sedentary behavior among Bangkok residents: A cross-sectional study.

Physical inactivity and sedentary behavior are significant risk factors for various non-communicable diseases. Bangkok, Thailand's capital, is one of the fastest-growing metropolitans in Southeast Asia. Few studies have investigated the epidemiology of physical activity and sedentary behavior among Bangkok residents. This study aims to investigate the prevalence of combined physical activity and sedentary behavior patterns among Bangkok residents and examine relationships between participants' characteristics and the combined movement patterns. We analyzed data from the nationally representative 2021 Health Behavior Survey conducted by the Thailand National Statistical Office. The Global Physical Activity Questionnaire was used to assess physical activity and sedentary behavior. 'Sufficiently active' was defined as meeting the World Health Organization's guidelines for aerobic physical activity (≥150 minutes of moderate-to-vigorous physical activity per week). 'Low sedentary time' was defined as sitting for ≤7 hours per day. Participants were categorized into one of four movement patterns: highly active/low sedentary, highly active/highly sedentary, low active/low sedentary, and low active/highly sedentary. Multinomial logistic regression was used to identify the factors associated with each group of four movement patterns. Among the 3,137 individuals included in the study, the majority were categorized as highly active/highly sedentary (64.8%), followed by highly active/low sedentary (17.9%) and low active/highly sedentary (14.3%). Only a few (3.0%) of participants were categorized as being low active/low sedentary. Compared to males, female participants had a significantly higher likelihood of belonging to the highly active/low sedentary (AOR = 1.69, 95%CI: 1.25, 2.28) or highly active/highly sedentary (AOR = 1.51, 95%CI: 1.19, 1.93) group, rather than the low active/high sedentary group. Compared to unemployed/retired participants, those in labor-intensive occupations had a significantly higher likelihood of being in the highly active/low sedentary group (AOR = 1.89, 95%CI: 1.22, 2.94). Compared to participants with no chronic physical conditions, participants who reported multimorbidity had a significantly lower likelihood of being in the highly active/low sedentary group (AOR = 0.60, 95%CI: 0.37, 0.98). This study provides valuable insights into the patterns of physical activity and sedentary behavior among residents of Bangkok using up-to-date data. The majority belonged to the highly active/highly sedentary group, followed by the highly active/low sedentary group. Correlates such as sex, occupation, and chronic conditions were associated with these patterns. Targeted interventions in recreational activities, workplaces, and urban areas, including screen time control measures, movement breaks and improved built environments, are crucial in reducing sedentary behavior and promoting physical activity.

O.2.1-9 Are doctors and nurses engaging in physical activity and its promotion?

Abstract Purpose Healthcare professionals (HCPs) are ideal providers of physical activity (PA) promotion; a large portion of the population have contact with a form of HCP and they are viewed as trusted and respected role models for health advice. Despite this, we have a very limited understanding of HCPs PA counselling practices. The aim of this study was to evaluate PA levels, attitudes towards PA counselling and counselling practices of UK doctors and nurses. Methods The study included two cross-sectional, anonymised, online surveys conducted in 2018/19 (survey 1) and 2019/20 (survey 2). Whether or not participants were achieving the aerobic PA guideline was evaluated using the first 2 questions of the Scot-PASQ survey. Counselling practices were assessed using likert scales to assess the proportion of patients that participants had discussed PA with in the past week and their perceived importance of PA counselling as part of their role. Results 460 doctors and 169 nurses from the UK completed the survey. 78.3% of doctors and 73.4% of nurses met the UK aerobic PA guidelines. Perceived importance of counselling was high but participants were providing PA counselling on average for less than 25% of their patients. PA counselling was more likely in primary care and doctors were marginally more likely than nurses to counsel on PA. Conclusion This cohort of doctors and nurses were active and viewed PA counselling as important. Despite this, PA counselling levels were low especially in secondary care. Efforts should be made to improve knowledge of, and opportunity for, PA counselling in HCPs.

College Students' Readiness to Change in Physical Inactivity Behavior using Perfection Quotient Behavioral Model

Background: In 2022, about 25% of U.S. adults reported engaging in no leisure-time physical activity, and among those who reported being physically active, only 24% engaged in enough physical activity to meet both aerobic and muscle-strengthening physical activity guidelines. Physical inactivity has been linked to a higher risk of all-cause mortality, numerous chronic diseases, and negative mental health outcomes such as anxiety and depression. Physical inactive behavior is influenced by individual and environmental influences and becomes more acute in college students. Objectives: In this study, we deploy a novel behavioral model called Perfection Quotient (PQ) and its components/ constructs Health Emotional Quotient (HEQ), Health X Quotient (HXQ), and Health Spiritual Quotient (HSQ) to explain the readiness to change for physical inactivity behavior in a sample of college students in Mississippi, USA. Methods: Cross-sectional study was undertaken at a public university in Mississippi. A random sample of 572 was drawn from 5,000 students from the university registrar’s list. A 37-item survey delivered via QualtricsTM online survey software was administered among students aged > 18 years. The survey included questions on the three constructs of PQ. The association between these three components and physical inactivity was assessed using binomial logistic regression. Results: Of the survey respondents 51.2% (n=293) reported intentions to change their physical inactivity behavior. The mean scores of the constructs of the PQ model were, HEQ = 29.81 units (SD = 5.74; observed and possible range: 0-40), HXQ = 23.67 units (SD = 4.67; observed range: 0-34; possible 0-36), HSQ = 17.78 units (SD = 4.93; observed and possible range: 0-24), PQ = 71.38 units (SD 12.18; observed range: 0-97; possible 0-100). HEQ with its components of self-awareness, mood management, and self-motivation had an odds ratio of 0.947 (95% CI: 0.905 to 0.992) and was marginally negatively associated with the likelihood of readiness to change physical inactivity behavior (p<0.02). HXQ with its components of cautiousness, independence, and competition had an odds ratio of 0.996 (95% CI: 0.944 to 1.051) and was not a significant predictor (p>0.05). HSQ with its components of self-love and love for others was marginally positively associated with the likelihood of readiness to change physical activity behavior (p<0.005) and had an odds ratio of 1.077 (95% CI: 1.022 to 1.135). Conclusion: These findings suggest that the three constructs of the PQ model need to evolve further, instrumentation augmented, and further longitudinal studies designed.

Cost effectiveness of a technology-enhanced physical activity intervention for Latinas.

Latinas report low levels of physical activity (PA) and disproportionate risk of lifestyle-related diseases. Enhancements to evidence-based PA interventions may increase efficacy; however, uptake of interventions will likely depend on costs. To describe costs and examine the cost-effectiveness of two interventions for helping Latinas reach national aerobic PA guidelines. Adult Latinas (N = 199) were randomly assigned to an Original theory-based mail-delivered intervention or an Enhanced version with texting and additional calls and materials. Meeting PA guidelines was measured by the 7-Day PA Recall interview at baseline, 6 and 12 months. Intervention costs were estimated from a payer perspective. Incremental cost-effectiveness ratios (ICERs) were calculated as the additional cost per participant meeting guidelines in the Enhanced versus Original intervention. At baseline, no participants met guidelines. After 6 months, 57% and 44% in the Enhanced and Original arms met guidelines, respectively; at 12 months, rates fell to 46% and 36%. Cost per person of the Enhanced and Original interventions were $184 and $173 at 6 months, respectively, and $234 and $203 at 12 months. The primary additional expense in the Enhanced arm was staff time. ICERs were $87 per additional person meeting guidelines at 6 months (per sensitivity analysis, $26 if delivered by volunteers and $114 by medical assistants), and $317 at 12 months (sensitivity analysis: $57 and $434). Incremental costs per person meeting guidelines in the Enhanced arm were modest and could be warranted given the potential health benefits of meeting PA guidelines.

Survey of emergency medicine doctors in London physical activity characteristics, awareness of guidelines and prescribing behaviours

ObjectiveTo determine London emergency medicine (EM) doctors’ physical activity (PA) characteristics, awareness of PA guidelines and PA prescription practice from London emergency departments (EDs).MethodsAn anonymous online survey of EM doctors...

Abstract P508: Social Polarization and Parent Support for Child Physical Activity and Cardiovascular Health

Healthy People 2030 estimates that 3 out of 4 children (ages 6-13) do not meet guidelines for aerobic physical activity, an important contributor to cardiovascular health. Determinants of physical activity (PA) occur at individual, household, and neighborhood levels yet little is known about how geospatial risk factors (neighborhood segregation and income inequity) interact with parental influences on child PA. The current study explored the association between index of concentration of extremes (ICE) and child cardiovascular health outcomes, and whether parents PA, child PA, and parent support of child PA modified this association. Methods: A subsample of parent-child dyads from the Family Matters Phase II cohort study (n=350) participated in a multi-method follow up study including survey, geospatial (American Community Survey), and biomarker data collection in Minneapolis-St. Paul, MN (2019-2022). Parents self-reported PA, child PA and parent support of child PA, and sociodemographic characteristics (e.g., family structure, educational attainment, annual household income) via an online survey. Children attended a clinic visit to measure height, weight, pulse, and systolic [SBP] and diastolic [DBP] blood pressure. ICE, used as a measure of census tract social polarization reflecting racial segregation and tract income inequity, was operationalized in these tertiles: concentrated deprivation, middle, and concentrated privilege. Multivariable linear regressions were used to evaluate the association between ICE tertiles and child cardiovascular health indicators (SBP, DBP, pulse, and BMI percentile). Models were adjusted for parent age, education, race and ethnicity, and household income. Interaction terms between ICE and parents PA, child PA, and parent support of child PA were further explored in these models. Results: Increases in parent engagement in light- and moderate-intensity PA (~30-45-minute increments) were associated with -2.65 mmHg lower DBP (P<0.001) and -2.39 mmHg lower SBP respectively (P=0.001) among children living in the least privileged tracts. The overall interaction of the relationship depended on the census tract privilege (Int. P=0.014), and there was no evidence of a favorable parent PA relationship in medium and most privileged tracts. Light parent PA and ICE interactions were consistent for child pulse and DBP (Int. P<0.05). Parent limiting of screen time had favorable interaction effects for child moderate PA in medium privilege tracts but not at the extremes (Int. P=0.024). Conclusions: Interventions targeting structural disadvantages should consider multilevel components that integrate parent support and modeling of PA to address cardiovascular health disparities in pre-adolescent children. In privileged contexts, alternative interventions may need to target sedentary behaviors to improve child PA.

Prevalence of Meeting Aerobic, Muscle-Strengthening, and Combined Physical Activity Guidelines During Leisure Time Among Adults, by Rural-Urban Classification and Region — United States, 2020

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Physical activity is important in health promotion and disease prevention; rural-urban and regional disparities among adults in meeting the combined leisure time physical activity guidelines exist. WHAT IS ADDED BY THIS REPORT?: Analysis of 2020 National Health Interview Survey data found a low proportion of U.S. adults met leisure-time aerobic, muscle-strengthening, and combined physical activity guidelines. Residents in larger metropolitan areas and in the West U.S. Census Bureau region were more likely than were those in less populated urban and rural areas or other regions to meet these guidelines. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: Rural residents might benefit from investments in structural capacity and policy, systems, and environment change to support leisure-time physical activity.

Prevalence of Meeting Aerobic, Muscle-Strengthening, and Combined Physical Activity Guidelines During Leisure Time Among Adults, by Rural-Urban Classification and Region — United States, 2020

The healthful effects of physical activity on a multitude of physical and mental health outcomes are well documented (1). Despite promising increases in the percentage of U.S. adults meeting aerobic and muscle-strengthening physical activity guidelines (guidelines)* (1) during leisure time in nearly all demographic and regional subgroups 1998-2018 (2,3), differences by rurality and U.S. Census Bureau region (Northeast, Midwest, South, and West), persist (4). Before 2020, analyses of rural-urban differences were dichotomized into nonmetropolitan (rural) versus metropolitan (urban) areas; however, in 2020 a four-category rural-urban variable† to classify rural-urban status was included in the National Health Interview Survey (NHIS) public-use dataset. NHIS 2020 data were used to conduct multivariate logistic regression analyses by rural-urban status and U.S. Census Bureau region of the prevalence of meeting the aerobic, muscle-strengthening, and combined aerobic and muscle-strengthening guidelines during leisure time among adults aged ≥18 years, controlling for demographic characteristics. Prevalence of meeting the aerobic, muscle-strengthening, and combined aerobic and muscle-strengthening guidelines was consistently the lowest in Nonmetropolitan counties (38.2%, 21.1%, and 16.1%, respectively) and highest in the West region (52.1%, 35.3%, and 28.5%, respectively). Regardless of rural-urban classification and region, no more than 28% of adults met combined aerobic and muscle-strengthening guidelines. Adults in the most rural category were significantly less likely to meet aerobic, muscle-strengthening, and combined guidelines than were adults in each of the three other categories (adjusted odds ratio [aOR] range = 0.68-0.89). In addition, adults in medium and small metropolitan counties were less likely to meet guidelines than were adults in the two most urban categories (aOR range = 0.85-0.89). Adults in the Northeast, Midwest, and South U.S. Census Bureau regions were less likely to meet guidelines than were adults in the West region (aOR range = 0.75-0.82). These analyses identify geographic disparities in leisure-time physical activity where focused population-level intervention efforts could help reduce or eliminate the consequent disparities in chronic conditions (e.g., cardiovascular diseases) and the resulting mortality (5,6).

Physical activity is inversely associated with overall cancer risk among college students in the United States: Results from the National College Health Assessment.

To our knowledge, this is the first epidemiologic study to examine the association between physical activity (PA) and cancer using data from the American College Health Association-National College Health Assessment (ACHA-NCHA). The goal of the study was to understand the dose-response relation between PA and cancer, as well as the associations between meeting US PA guidelines and overall cancer risk in US college students. The ACHA-NCHA provided self-reported information on demographic characteristics, PA, body mass index, smoking status, and overall cancer during 2019-2022 (n = 293,682; 0.08% cancer cases). To illustrate the dose-response relationship, a restricted cubic spline logistic regression analysis was used to evaluate the association of overall cancer with moderate-to-vigorous PA (MVPA) on a continuous basis. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals for the associations between meeting the three U.S. PA guidelines and overall cancer risk. The cubic spline observed that MVPA was inversely associated with the odds of overall cancer risk after adjusting for covariates; a one hour/week increase in moderate and vigorous PA was associated with a 1% and 5% reduced overall cancer risk, respectively. Multivariable-adjusted logistic regression analyses showed that meeting the US guidelines for aerobic PA for adults (≥150 minutes/week of moderate aerobic PA or ≥75 minutes of vigorous PA) (OR: 0.85), for PA for adults (≥2 days of muscle strengthening activity in addition to aerobic MVPA) (OR: 0.90), and for highly active adults (≥2 days of muscle strengthening activity and ≥300 minutes/week of aerobic moderate PA or 150 minutes/week of vigorous PA) (OR: 0.89) were statistically significant and inversely associated with cancer risk. MVPA, especially meeting US guidelines, may be inversely associated with overall cancer among college students in the US. To reduce cancer risks, multilevel interventions to promote US physical activity guidelines among college students are warranted.

A mental health-informed, online health promotion programme targeting physical activity and healthy eating for adults aged 60+ years: study protocol for the MovingTogether randomised controlled trial

BackgroundThe COVID-19 pandemic and associated social distancing regulations have led to an increased risk of social isolation and physical inactivity, particularly among older adults. The benefits of physical activity for reducing fall risk and improving mood and mental functioning have been well documented. The aim of this trial is to investigate the effect of the MovingTogether programme on psychological distress (primary outcome) and physical activity, social capital, cognition, concern about falling, loneliness, physical functioning, quality of life and physical activity enjoyment (secondary outcomes).MethodsA randomised controlled trial with a waitlist control will be conducted, recruiting 80 adults aged 60+ years with access to Facebook and a computer or tablet and not currently meeting the aerobic physical activity guidelines. Randomisation will be completed using REDCap. The intervention group (n = 40) will join a private Facebook group where allied health facilitators will provide targeted healthy lifestyle education throughout the 10-week programme with weekly telehealth group calls. Intervention participants will also be provided access to tailored strength and aerobic exercise guidance and an evidence-based eHealth balance exercise programme. Psychological distress and secondary outcomes will be assessed at baseline, 11 weeks (post-intervention) and 16 weeks (1-month follow-up). Linear mixed models will be applied for each outcome measure as per an intention-to-treat approach to determine the between-group differences. Secondary analyses are planned in people with greater adherence and those with higher psychological distress.DiscussionCOVID-19 has highlighted the need for scalable, effective and novel methods to improve and protect the health of older adults. The integration of an evidence-based fall prevention programme with a mental health-informed online health promotion programme may help to improve mental and physical health outcomes among older adults.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12621001322820p. Registered on 29 September 2021

The Difference in the Prevalence of Metabolic Syndrome According to Meeting Guidelines for Aerobic Physical Activity and Muscle-Strengthening Exercise: A Cross-Sectional Study Performed Using the Korea National Health and Nutrition Examination Survey, 2014-2019.

Physical activity and muscle strengthening are essential for preventing and managing metabolic syndrome. This study was conducted to investigate the relationship between the prevalence of metabolic syndrome and meeting the guidelines for aerobic physical activity (APA), muscle strengthening exercise (MSE), and combined exercise. We used data from 22,467 Koreans aged 40 years or older, who participated in in the Korea National Health and Nutrition Examination Survey (KNHANES) 2014-2019. We used the Global Physical Activity Questionnaire (GPAQ) to measure physical activity and surveyed frequency of MSE through a questionnaire. Metabolic syndrome was defined according to the American heart association and the National Heart, Lung, and Blood Institute. Compared with none exercise group, odds ratios of APA, MSE, and combined exercise group (CEG) on metabolic syndrome prevalence were 0.85 (95% confidence interval (CI), 0.74-0.98), 0.81 (95% CI, 0.67-0.99), and 0.65 (95% CI, 0.54-0.78) among men, respectively. Among women, ORs of APA, MSE, and CEG were 0.83 (95% CI, 0.73-0.93), 0.73 (95% CI, 0.58-0.91), and 0.74 (95% CI, 0.58-0.93), respectively. This study showed that meeting guidelines for APA and MSE was associated with lower prevalence of metabolic syndrome. Furthermore, subjects who met both APA and MSE had the lowest metabolic syndrome prevalence.

Long-term Weight Training and Mortality in U.S. Male Health Professionals With and Without Type 2 Diabetes.

To investigate the relationship between long-term weight training and mortality in male health professionals with and without type 2 diabetes. We analyzed 31,140 men without type 2 diabetes and 2,588 with type 2 diabetes from the Health Professionals Follow-up Study (1992-2018). Information on weight training was repeatedly assessed using a biennial questionnaire. Cox regression was used to estimate hazard ratios (HRs) and 95% CIs. During up to 26 years of follow-up, we documented 12,607 deaths (988 deaths among men with type 2 diabetes). Among participants without type 2 diabetes, 1-59 and 60-149 min/week of long-term weight training were associated with 14% (HR 0.86; 95% CI 0.82-0.89) and 8% (HR 0.92; 95% CI 0.85-0.99) lower mortality versus no weight training, respectively, after adjustment for aerobic activity. However, ≥150 min/week of weight training was not significantly associated with mortality (HR 1.05; 95% CI 0.91-1.20; overall P trend = 0.94; P quadratic < 0.001). Meeting the recommended aerobic physical activity guideline (≥150 min/week) and performing any weight training were associated with 20-34% lower mortality. Among participants with type 2 diabetes, a moderate level of pre-diagnosis weight training was associated with lower mortality, whereas post-diagnosis weight training showed no association. Performing both weight training and aerobic activity before and after diagnosis was associated with lower mortality. A moderate level of long-term weight training was associated with lower mortality, independently of aerobic activity, among male health professionals with and without type 2 diabetes. Addition of weight training to aerobic activities may provide further benefit in mortality risk reduction. Studies are required to confirm our findings in diverse populations.