Higher Moderate-vigorous Physical Activity Research Articles

Tracking of MVPA across childhood and adolescence

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

Accelerometer-Measured Latent Physical Activity Profiles and Neurocognition Among Middle-Aged and Older Hispanic/Latino Adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

Derive latent profiles of accelerometry-measured moderate-vigorous physical activity (MVPA) for Hispanic/Latino adults, examine associations between latent MVPA profiles and neurocognition, and describe profiles via self-reported MVPA. Complex survey design methods were applied to cross-sectional data from 7,672 adults ages 45-74 years in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL; 2008-2011). MVPA was measured via hip-worn accelerometers. Latent profile analysis was applied to derive latent MVPA profiles (minutes/day of week). Neurocognition was assessed with the Brief-Spanish English Verbal Learning Test (B-SEVLT) Sum, B-SEVLT Recall, Controlled Oral Word Association Test (word fluency), and Digit Symbol Substitution (DSS) test. All tests were z-scored, and a global neurocognition score was generated by averaging across scores. Survey linear regression models were used to examine associations between latent MVPA profiles and neurocognitive measures. Self-reported MVPA domains were estimated (occupational, transportation, and recreational) for each latent profile. Four latent MVPA profiles from the overall adult target population (18-74 years) were derived and putatively labeled: No MVPA, low, moderate, and high. Only the high MVPA profile (compared to moderate) was associated with lower global neurocognition. Sensitivity analyses using latent MVPA profiles with only participants aged 45-74 years showed similar profiles, but no associations between latent MVPA profiles and neurocognition. The occupational MVPA domain led in all latent MVPA profiles. We found no consistent evidence to link accelerometry-measured MVPA profiles to neurocognitive function. Research to better characterize the role of high occupational MVPA in relation to neurocognition among Hispanic/Latino adults are needed.

Abstract P138: Post-partum Maternal Vascular Function Is Reduced In Preeclampsia And Preterm Births: A Pilot Study

Introduction: Women with a history of preeclampsia (PreE) or preterm (PreT) birth are at elevated risk of future hypertension, ischemic heart disease, and stroke. Mechanisms for this increased risk are unknown. Flow-mediated dilation of the brachial artery (FMD) is an established surrogate for cardiovascular risk. Hypothesis: In this pilot study, we hypothesize that maternal vascular dysfunction associated with PreE is reversible, and the extent of recovery is predicated on specific maternal characteristics. Methods: In this prospective study, subjects were recruited to three groups: PreE with delivery at 27-34 weeks; PreT delivery at 27-34 weeks without preeclampsia; and healthy controls at 39-40 weeks. Vascular function (FMD), nutrition (validated questionnaire), and physical activity (accelerometers) data were collected at 1-2 days post-partum and 3 months. Results: Fourteen subjects were enrolled (mean age 32±6 years). Systolic blood pressure was higher for PreE subjects (average 131±6) compared to controls (109 ± 9, p=0.004) and PreT (110±8, p=0.008) at visit 1. This difference resolved at visit 2. Though non-significant, FMD (mean±SE) was higher in controls compared to PreE and PreT groups at visit 1 (7.7%±0.8 v. 7.4%±0.7 and 6.9%±1.0, Figure 1). FMD remains depressed at 3 months, but subject follow-up was impacted by the Covid 19 pandemic. Alternate Healthy Eating Index scores were non-significantly higher in the PreT group than PreE and controls. PreT subjects were less sedentary and more physically active (higher moderate-vigorous physical activity, higher total steps). Conclusions: Maternal FMD is reduced immediately post-partum in PreE and PreT births. The PreT group had lower FMD despite better nutrition and physical activity scores. This is a pilot study, and we are not powered for significance. Data from our small cohort support the ability to collect meaningful data in these understudied populations which could inform future studies of long-term cardiovascular risk.

Physical activity and fitness in the community: the Framingham Heart Study.

While greater physical activity (PA) is associated with improved health outcomes, the direct links between distinct components of PA, their changes over time, and cardiorespiratory fitness are incompletely understood. Maximum effort cardiopulmonary exercise testing (CPET) and objective PA measures [sedentary time (SED), steps/day, and moderate-vigorous PA (MVPA)] via accelerometers worn for 1 week concurrent with CPET and 7.8 years prior were obtained in 2070 Framingham Heart Study participants [age 54 ± 9 years, 51% women, SED 810 ± 83 min/day, steps/day 7737 ± 3520, MVPA 22.3 ± 20.3 min/day, peak oxygen uptake (VO2) 23.6 ± 6.9 mL/kg/min]. Adjusted for clinical risk factors, increases in steps/day and MVPA and reduced SED between the two assessments were associated with distinct aspects of cardiorespiratory fitness (measured by VO2) during initiation, early-moderate level, peak exercise, and recovery, with the highest effect estimates for MVPA (false discovery rate <5% for all). Findings were largely consistent across categories of age, sex, obesity, and cardiovascular risk. Increases of 17 min of MVPA/day [95% confidence interval (CI) 14-21] or 4312 steps/day (95% CI 3439-5781; ≈54 min at 80 steps/min), or reductions of 249 min of SED per day (95% CI 149-777) between the two exam cycles corresponded to a 5% (1.2 mL/kg/min) higher peak VO2. Individuals with high (above-mean) steps or MVPA demonstrated above average peak VO2 values regardless of whether they had high or low SED. Our findings provide a detailed assessment of relations of different types of PA with multidimensional cardiorespiratory fitness measures and suggest favourable longitudinal changes in PA (and MVPA in particular) are associated with greater objective fitness.

Associations between elementary and middle school teachers\u2019 physical activity promoting practices and teacher- and school-level factors

BackgroundFew studies have evaluated teacher- and school-level characteristics associated with implementation of recommended physical activity (PA) promoting practices. The purpose of this study is to examine associations between teachers’ PA practices and: [1] teacher-level factors, including their own PA, and [2] school-level factors.MethodsThis cross-sectional study examined time spent daily in light PA (LPA) and moderate-vigorous PA (MVPA) in association with 7 teacher PA practices among 288 classroom/special area teachers and teaching assistants in 20 urban, suburban and rural schools (recruited through a school wellness trial) in 4 districts. LPA and MVPA was assessed using 24-h ankle accelerometry (up to seven consecutive days). A sum score for teacher PA practices was assessed via survey (7 items; sum score range: 7–35; Cronbach’s alpha = 0.73; higher scores indicate more PA promoting practices). Teacher-level factors included gender, race, self-reported height/weight, years teaching, and education. School-level factors included school type, free-and-reduced-price meal eligibility, student racial/ethnic composition, and urbanicity. Analyses included multilevel regression models, accounting for clustering within schools and adjusting for demographic covariates and school district.ResultsTeachers were 91% female, 63% elementary, 60% white, mean age 43.2 years (SD = 11.3), and 41% obese). Teachers wore accelerometers an average of 5.8 days, spent 399.6 min in LPA (SD = 85.0) per day, 24.1 min in MVPA (SD = 14.4) per day, and the mean teacher PA practices sum score was 22.4 (SD = 5.0). Every 15-min increase in MVPA was related to an increase in teacher PA practices sum score (coeff =1.07; SE = 0.28; p < 0.001). Female gender (versus males; coeff = − 1.95; SE = 0.92, p = 0.034), an obese weight status (versus non-obese; coeff = − 1.38; SE = 0.54, p = 0.010), and teaching in a middle school (versus elementary; coeff = − 3.86; SE = 0.54, p < 0.001) were associated with lower teacher PA practices scores. LPA was not associated with teacher PA promoting practices.ConclusionsTeachers with higher MVPA, but not higher LPA, and those without obesity were more likely to implement PA promoting practices that could positively impact their students’ PA. Similar to prior studies, these practices were more commonly implemented in elementary schools and by male teachers. Future studies in schools should explore whether improvement of teacher health behaviors subsequently impacts student health behaviors.Trial registrationClinical Trials, NCT03432715; Registered on 02/2/2018.

Association of Accelerometer-Measured Physical Activity and Cardiovascular Health in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

Evidence regarding the associations between accelerometer-measured moderate-vigorous physical activity (MVPA) and cardiovascular health (CVH) indicators among Hispanic/Latino adults are unavailable. Examined cross-sectional data from 12,008 Hispanic/Latino adults aged 18-74 years participating in the Hispanic Community Health Study/Study of Latinos. Accelerometer-measured MVPA was assessed categorically and dichotomously per 2008 PA guidelines. Adverse and ideal CVH indicators were determined by standard cut-points for blood glucose, total cholesterol, blood pressure, body mass index (BMI), and smoking. A composite of low CV risk, defined as achieving all ideal CVH indicators, was included. Adjusted Poisson regression models and complex survey design methods were used for all analyses. Compared to high MVPA, lower MVPA categories were associated with higher prevalence of all adverse CVH indicators, except hypertension, and with lower prevalence of low CV risk and ideal blood glucose, blood pressure, and BMI. Similarly, non-adherence to PA guidelines was associated with a higher prevalence of diabetes (16%), hypercholesterolemia (9%), obesity (28%), and smoking (9%); and lower prevalence of low CV risk (24%), ideal blood glucose (6%), ideal blood pressure (6%), and ideal BMI (22%). Overall, high accelerometer-measured MVPA and meeting PA guidelines were associated with favorable CVH in Hispanic/Latino adults.

Physical activity, stress, and cardiovascular disease risk: HCHS/SOL Sociocultural Ancillary Study.

We assess whether the cross-sectional associations between moderate-vigorous physical activity (MVPA) and CVD risk factors are modified by various stress types. Complete baseline data from 4,000 participants, ages 18-74 years, of the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (HCHS/SOL SCAS) were analyzed using complex survey design methods. Accelerometer-measured MVPA was assessed continuously (average minutes per day). CVD risk factors assessed were diabetes, hypercholesterolemia, hypertension, and obesity. Stress was assessed using the Chronic Burden Scale for chronic stress, Traumatic Stress Schedule for traumatic stress, and the Perceived Stress Scale for perceived stress. Poisson regression models estimated prevalence ratios of CVD risk factors. The interaction was evaluated by cross-product terms with p<0.10. There was a significant interaction between chronic stress and MVPA among those with prevalent diabetes (pinteraction=0.09). Among those reporting low chronic stress, higher MVPA was associated with a low prevalence of diabetes, however among those reporting high chronic stress, the prevalence of diabetes remained high even with higher MVPA. We did not observe interactions between chronic stress and MVPA for the remaining CVD risk factors, or interactions between traumatic stress or perceived stress and MVPA. This study provides initial evidence on the role of chronic stress on the association between MVPA and diabetes for Hispanic/Latino adults. Mostly, however, chronic stress, traumatic stress, and perceived stress did not modify the associations between MVPA and CVD risk factors for Hispanic/Latino adults.

Diurnal patterns of sedentary behavior and changes in physical function over time among older women: a prospective cohort study

BackgroundSedentary behavior (SB) is linked to negative health outcomes in older adults. Most studies use summary values, e.g., total sedentary minutes/day. Diurnal timing of SB accumulation may further elucidate SB-health associations.MethodsSix thousand two hundred four US women (mean age = 79 ± 7; 50% White, 34% African-American) wore accelerometers for 7-days at baseline, yielding 41,356 person-days with > 600 min/day of data. Annual follow-up assessments of health, including physical functioning, were collected from participants for 6 years. A novel two-phase clustering procedure discriminated participants’ diurnal SB patterns: phase I grouped day-level SB trajectories using longitudinal k-means; phase II determined diurnal SB patterns based on proportion of phase I trajectories using hierarchical clustering. Mixed models tested associations between SB patterns and longitudinal physical functioning, adjusted for covariates including total sedentary time. Effect modification by moderate-vigorous-physical activity (MVPA) was tested.ResultsFour diurnal SB patterns were identified: p1 = high-SB-throughout-the-day; p2 = moderate-SB-with-lower-morning-SB; p3 = moderate-SB-with-higher-morning-SB; p4 = low-SB-throughout-the-day. High MVPA mitigated physical functioning decline and correlated with better baseline and 6-year trajectory of physical functioning across patterns. In low MVPA, p2 had worse 6-year physical functioning decline compared to p1 and p4. In high MVPA, p2 had similar 6-year physical functioning decline compared to p1, p3, and p4.ConclusionsIn a large cohort of older women, diurnal SB patterns were associated with rates of physical functioning decline, independent of total sedentary time. In particular, we identified a specific diurnal SB subtype defined by less SB earlier and more SB later in the day, which had the steepest decline in physical functioning among participants with low baseline MVPA. Thus, diurnal timing of SB, complementary to total sedentary time and MVPA, may offer additional insights into associations between SB and physical health, and provide physicians with early warning of patients at high-risk of physical function decline.

Abstract P230: Association of Accelerometer-Measured Physical Activity and Cardiovascular Health in the Hispanic Community Health Study/Study of Latinos

Background: Detailed information on associations between accelerometer-measured moderate-vigorous physical activity (MVPA) and cardiovascular (CV) health among Hispanic/Latino adults are unavailable. Methods: Cross-sectional data from 12,008 Hispanic/Latino adults aged 18-74 years in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) 2008-2011 were analyzed using complex survey design methods. Poisson regression models were used to examine the associations between accelerometer-measured MVPA and CV health indicators (blood glucose, total cholesterol, blood pressure, body mass index [BMI], and smoking) and a composite of low CV risk. Results: Compared to high MVPA, low MVPA was associated with a higher prevalence of diabetes, hypercholesterolemia, obesity, smoking, but not hypertension. Low MVPA was associated with lower prevalence of ideal blood glucose, blood pressure, BMI and low CV risk. Similar results were observed with non-adherence of PA guideline recommendations. Conclusions: Overall in Hispanic/Latino adults, high accelerometer-measured MVPA and meeting PA guideline recommendations were associated with favorable CV health.

Low gait speed is associated with low physical activity and high sedentary time following stroke

Purpose This study describes physical activity levels and factors associated with physical activity at the end of stroke rehabilitation. Methods Primary stroke survivors were assessed at completion of physical rehabilitation. Outcomes included physical activity (e.g. step count, moderate-vigorous physical activity duration) and sedentary time measured with the Sensewear Armband, gait speed, and cognition. The number of participants meeting physical activity recommendations was calculated. Differences in physical activity were examined between household ambulators (gait speed <0.4 m/s), limited community ambulators (0.4–0.8 m/s), and unlimited community ambulators (>0.8 m/s). The influence of age, cognition, and gait speed on physical activity was determined by multiple regression. Results Seventy-nine stroke survivors participated. Twenty-one participants achieved 30 min/day of moderate-vigorous physical activity accumulated in 10 min bouts. Unlimited community ambulators took more steps/day (median 4975 vs. 469 limited, 355 household, p < 0.001), had higher moderate-vigorous physical activity (median 74 min/day vs. 22 limited, 31 household, p < 0.001) and lower sedentary time (mean 1105 vs. 1239 limited, 1232 household minutes/day, p < 0.001). Age, gait speed, and cognition predicted 21.3% of the variance in moderate-vigorous physical activity (p = 0.001); adding employment status to the model predicted 57.3% of the variance in step count (p < 0.001). Conclusions Physical activity is low following stroke and should be a target for treatment, particularly in those with gait speeds ≤0.8 m/s. Implications for rehabilitation Seventy-three percent of stroke survivors performed ≥30 minutes of moderate to vigorous physical activity throughout the day. Twenty-seven percent of stroke survivors accumulated ≥30 minutes of moderate to vigorous physical activity in 10 minute bouts. Despite relatively good physical ability, daily step count was low in this sample. Those with gait speeds ≤0.8 m/s had lower physical activity levels and higher sedentary time.

Moderate-vigorous physical activity and health-related quality of life among Hispanic/Latino adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

BackgroundPhysical activity is a modifiable healthy behavior that has been shown to positively influence health-related quality of life. However, research examining the link between physical activity and health-related quality of life among Hispanic/Latino adults is limited and inconsistent. The purpose of this study is to assess whether accelerometer-measured moderate-vigorous physical activity (MVPA) is associated with self-reported (a) mental health-related quality of life, and (b) physical health-related quality of life among diverse Hispanic/Latino adults in the US.MethodsCross-sectional data from 12,379 adults ages 18–74 years in 2008–2011, who participated in HCHS/SOL and had complete data were analyzed using complex survey design methods. Accelerometer data were categorized into no MVPA, low, moderate, and high MVPA. Health-related quality of life was assessed with the Short-Form 12 and we used the mental and physical component subscales where higher scores indicate better health-related quality of life. Multivariate linear regression models were used to derive adjusted means with 95% confidence intervals and linear trends.ResultsWe observed no significant linear trend between accelerometer-measured MVPA and mental health-related quality of life (ptrend = 0.73). There was a significant positive association between MVPA and physical health-related quality of life (ptrend < 0.001) where higher MVPA corresponded with higher scores in physical health-related quality of life. The adjusted means were 46.67 (44.85–48.48) for no MVPA, 49.33 (49.03–49.63) for low MVPA, 50.61 (50.09–51.13) for moderate MVPA, and 51.36 (50.86–51.86) for high MVPA.ConclusionsAmong diverse Hispanic/Latino adults in the US, accelerometer-measured MVPA was associated with physical health-related quality of life, but not mental health-related quality of life. Future interventions should evaluate if increases in MVPA lead to improvements in health-related quality of life.

A Comparison of Physical Activity Behaviors and Sleep in Female NCAA Division-I Athletes versus Controls

Physical activity behaviors and sleep patterns influence health in the general population but have not been evaluated in collegiate student athletes. For these individuals the demands of academics and athletics alter these parameters but have not been fully characterized or compared to students who are not collegiate athletes. PURPOSE: This study compared physical activity (PA) behaviors and sleep patterns of female NCAA D I student-athletes (Athletes) to recreationally active female students (Controls). METHODS: Across three consecutive semesters, subjects were recruited for one to three weeks of monitoring. Sleep was monitored with Actiwatches. PA was monitored using ActivPals. Forty-five females were recruited from the University of Colorado, Boulder. Athletes were recruited from the Golf (n=6) and Tennis teams (n=8). Controls were recruited from the general student body (n=31). Subjects were instructed to wear devices at all times except during competitions. Travel days and days with less than 90% waking wear time were removed from analysis. Time spent in Sedentary (SED), Low Intensity (LIT) and Moderate-Vigorous Physical Activity (MVPA) are presented as percent of waking day. RESULTS: Mean days recorded per individual was: Controls 15.1; golf 10.2; and tennis 15. Compared to Controls, Athletes had higher daily step counts (12,040 ± 6498 vs 8,992 ± 5240, p<.01), less SED (63.5±15.0 vs 71.4±13.3, p<.05), higher LIT (26.4 ± 12.9 vs 21±10.8, p<.05)) and higher MVPA (9.7 ± 3 vs 7.6 ± 3.3, p<.01). For both groups, weekends had higher LIT (+3.0%, p<.01), decreased MVPA (-.75%, p<.05), and a trend toward decreased SED (-2.3%, p=.0563) compared to weekdays. There were no differences in PA between Golf and Tennis. Sleep was not significantly different in Athletes versus Controls, including duration of sleep (07:04 ± 00:49 vs 7:32 ± 00:42, p=.6) and sleep midpoint. Yet, midpoint was significantly later on weekends vs. weekdays in both groups (04:35 ± 01:01 vs 04:03 ± 00:55, p<.01) CONCLUSION: Female Athletes had higher physical activity demands than Controls. Yet both groups, on average, slept only slightly more than the American Academy of Sleep Medicine recommended 7-hours. This may negatively impact overall health. Research is needed on how these sleep and activity behaviors influence academic and athletic outcomes.

PO-158 Association Of Glucose Metabolism and Physical Activity By Chronotype in Elderly Japanese Adults

Objective Chronotype is a trait determining individual circadian preference in behavioral and biological rhythm relative to external light-dark cycle. Although evening chronotype has been reported to be associated with bad glucose control and low physical activity in middle-aged adults, it is not known whether it is true in elderly people. Therefore, the aim of this study was to investigate the relationship between glucose metabolism and physical activity by chronotype (circadian rhythm) in elderly Japanese adults.&#x0D; Methods A cross-sectional study was conducted in 178 adults (72 men and 106 women), aged 60-79 years, who were classified into three chronotype groups, ”definitely morning type (DMT)”, “moderately morning type (MMT)” and “neither type (NET)”, based on the Morningness/Eveningness Questionnaire scores (MEQ-Score). All participants were required to report their daily rhythms of behavior, such as meal time and sleep-wake cycle. Additionally, their physical activity were measured by an uniaxial accelerometer (Kenz Lifecorder EX, SUZUKEN, Nagoya, Japan). Energy intake was assessed by a brief self-administered diet-history questionnaire. Blood was drawn for biochemical analysis after an overnight fast.&#x0D; Results BMI and serum insulin in the DMT group was significantly higher than MMT and NET groups in male. The DMT group had a significantly shorter time interval between dinner and sleep than the other two groups, both in male and female. After adjustment for covariates (age, smoking and alcohol status, energy intakes, moderate-vigorous physical activity (MVPA) and sleep duration), the BMI, serum insulin, fasting blood glucose (FBG) and HOMA-IR in the DMT group was significantly higher than other groups. However, after adjustment for the time interval between dinner and sleep, the significant difference had disappeared.&#x0D; There was significant difference in terms of low-intensity physical activity between male and female. And MVPA in the DMT group, the subjects with low MVPA (&lt;23Mets·hour/week) had higher FBG, serum insulin and HOMA-IR than the subjects with high MVPA (&gt;23Mets·hour/week) in men, but not in women.&#x0D; Conclusions This study demonstrated that the DMT group with early sleep-wake lifestyle had higher BMI, FBG, serum insulin and HOMA-IR, specially in elderly Japanese men with low MVPA, but not in women.

Direct healthcare costs associated with device assessed and self-reported physical activity: results from a cross-sectional population-based study

BackgroundPhysical inactivity (PIA) is an important risk factor for many chronic conditions and therefore might increase healthcare utilization and costs. This study aimed to analyze the association of PIA using device assessed and self-reported physical activity (PA) data with direct healthcare costs.MethodsCross-sectional data was retrieved from the population based KORA FF4 study (Cooperative Health Research in the Region of Augsburg) that was conducted in southern Germany from 2013 to 2014 (n = 2279). Self-reported PA was assessed with two questions regarding sports related PA in summer and winter and categorized into “high activity”, “moderate activity”, “low activity” and “no activity”. In a subsample (n = 477), PA was assessed with accelerometers and participants were categorized into activity quartiles (“very high”, “high”, “low” and “very low”) according to their mean minutes per day spent in light intensity, or in moderate-vigorous PA (MVPA). Self-reported healthcare utilization was used to estimate direct healthcare costs. We regressed direct healthcare costs on PA using a two-part gamma regression, adjusted for age, sex and socio-demographic variables. Additional models, including and excluding potential additional confounders and effect mediators were used to check the robustness of the results.ResultsAnnual direct healthcare costs of individuals who reported no sports PA did not differ from those who reported high sports PA [+€189, 95% CI: -188, 598]. In the subsample with accelerometer data, participants with very low MVPA had significantly higher annual costs than participants with very high MVPA [+€986, 95% CI: 15, 1982].ConclusionDevice assessed but not self-reported PIA was associated with higher direct healthcare costs. The magnitude and significance of the association depended on the choice of covariates in the regression models. Larger studies with device assessed PA and longitudinal design are needed to be able to better quantify the impact of PIA on direct healthcare costs.

Evaluation of a Family-Based Interactive Lifestyle Intervention to Reduce the Risk of Developing Type 2 Diabetes in the Future (PRE-STARt Intervention)

Aim: Evaluate the PRE-STARt intervention in five European countries (UK, Portugal, Spain, Germany and Greece). Methods: The 8 family based interactive workshops aimed to elicit positive lifestyle behavior change in 12-14 year olds. The written curriculum was underpinned by specific learning theories and philosophy. Demographic, biomedical, anthropometric and lifestyle behavior measures were collected at baseline, 3 and 6 months. Due to design differences across countries, the analysis assesses changes within each country. Results: 318 participants were recruited (50% male, 69% Caucasian ethnicity). Control group were more overweight than the intervention group (10%). Average time spent doing moderate-vigorous physical activity (MVPA) was 45 minutes/day. A trend towards increased MVPA at 6 months in the UK was observed (8 mins/day). The attendance data for change in MVPA at 6 months indicate a dose response. Those attending at least 4 workshops had significantly higher MVPA compared to those who attended less than 4 (OR:12.64 (3.63 to 21.66), 18.92 (5.74 to 32.09)). A trend towards clinical and statistical significant reduction in both BMI and weight for all countries was observed. The UK observed a non-significant reduction in self-reported sitting time on weekdays (1 hour/day). Eating behaviors improved in each country at 6 months; in Greece increased frequency of eating breakfast; a reduction in the number of days snacks eaten in the UK; a trend across all countries for increased fruit and vegetable consumption. Conclusion: The intervention is accepted by the target population. The data point to positive emerging trends in changes in health behaviors (both eating and activity) in addition to health outcomes namely a reduction in body weight and BMI. A definitive randomized controlled trial is required to test effectiveness and cost effectiveness of the intervention. Disclosure E.M. Brady: None. L.J. Gray: None. S. Weihrauch-Blüher: None. C. Edwardson: None. D. Harrington: None. R.T. Ribeiro: None. A. Vazeou: None. A.L. Northern: None. E. Alustiza: None. M. Davies: Advisory Panel; Self; AstraZeneca. Board Member; Self; AstraZeneca. Consultant; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca. Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Board Member; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Advisory Panel; Self; Eli Lilly and Company. Board Member; Self; Eli Lilly and Company. Consultant; Self; Eli Lilly and Company. Speaker's Bureau; Self; Eli Lilly and Company. Advisory Panel; Self; Janssen Pharmaceuticals, Inc.. Board Member; Self; Janssen Pharmaceuticals, Inc.. Consultant; Self; Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc.. Advisory Panel; Self; Novo Nordisk Inc.. Board Member; Self; Novo Nordisk Inc.. Consultant; Self; Novo Nordisk Inc.. Research Support; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc.. Board Member; Self; Sanofi-Aventis. Consultant; Self; Sanofi-Aventis. Research Support; Self; Sanofi-Aventis. Advisory Panel; Self; Sanofi-Aventis. Speaker's Bureau; Self; Sanofi-Aventis. Advisory Panel; Self; Servier. Consultant; Self; Intarcia Therapeutics, Inc.. Speaker's Bureau; Self; Mitsubishi Tanabe Pharma Corporation.

Community level predictors of physical activity among women in the preconception period.

Although physical activity is a key behavior targeted during the preconception period given its significant impact on pregnancy/birth outcomes and psychological well-being, few women meet national guidelines. While intrapersonal factors influencing physical activity among this population have been studied, community factors remain unexplored. The objective of this study was to examine community level predictors of physical activity among preconception women. Data from Add Health were limited to women (Wave III; age 18-28; n = 7,596) and excluded respondents who were pregnant, physically disabled, and missing data. The outcome variable was ≥5 instances of moderate-vigorous physical activity (MVPA) in 1 week. Community predictor variables included neighborhood-level structural and social determinants (e.g., socio-demographic composition; landscape diversity; urbanization; access to resources; crime; vehicle availability). Multilevel logistic regression modeling was used to estimate the odds of engaging in ≥5 instances of MVPA. Few women (26 %) reported ≥5 instances of MVPA in 1 week. Adjusted multilevel analysis revealed women in the preconception period were more likely to report high MVPA when living in communities with larger population densities (OR 1.34, 95 % CI 1.02-1.77) and median household income greater than $50,000 (OR 1.33, 95 % CI 1.06-1.66). Additionally, a significant inverse trend was found between high MVPA and proportion of the community without a high school diploma. Findings suggest that neighborhood composition may have an impact on preconception physical activity status. Implications include increased efforts targeting community conditions for facilitating physical activity; ultimately, improving health among women and subsequent offspring.

Effects of a Print-mediated Intervention on Physical Activity during Transition to the First Year of University

Transition to the first year of university is linked to steep declines in moderate–vigorous physical activity (MVPA). The purpose of this study was to investigate the effects of a targeted, theory-driven, print-based intervention on MVPA during transition to university. Volunteer participants from five Canadian universities (n = 255) completed measures of MVPA at the start of their first semester at university and were randomly assigned to conditions receiving a first-year-student physical activity and action-planning brochure, Canada's Physical Activity Guide (CPAG), or a no-intervention control group. Six weeks later, a follow-up measure of MVPA was obtained as well as retrospective accounts of physical activity action-planning strategies and self-efficacy for scheduling physical activity. At the follow-up, students who received the targeted first-year student physical activity brochure reported significantly higher levels of MVPA compared to controls (p < .05) and a trend towards higher MVPA compared to the CPAG group (p = .06). However, there were no differences between groups on action planning or self-efficacy. A theory-driven and targeted print media intervention can offer low-cost and broad-reaching effects that may help students stay more active or curb declining levels of MVPA that occur during transition to university.