Higher Total Physical Activity Research Articles

Association of Physical Activity and Dietary Diversity with Cognitive Function in the Elderly with Type 2 Diabetes Mellitus: Findings from a Cross-Sectional Study

Aims Mild cognitive impairment (MCI) is a common complication of type 2 diabetes mellitus (T2DM). Changes in lifestyle and dietary patterns play a crucial role in preventing both diabetes and cognitive impairment. Methods A cross-sectional study was conducted on 899 aging participants. The Dietary Diversity Score (DDS) was used to evaluate dietary diversity. The physical activity (PA) levels were divided based on metabolic equivalents and weekly activity time. Individual PA levels were further re-scored and combined with DDS scores to obtain each participant’s total score. Results Regardless of T2DM status, individuals with MCI had lower DDS and plant-derived DDS compared to non-MCI individuals. Non-MCI subjects had higher total PA and DDS scores than MCI subjects. There were differences in the correlation between DDS or PA scores and blood glucose and MoCA scores among different groups. The subjects with high DDS levels showed a significantly decreased risk of MCI and T2DM + MCI. Those with a total PA and DDS score in Q4 showed a significantly decreased risk of MCI and T2DM + MCI compared to Q1. Conclusions A diversified diet improved blood glucose levels and cognitive function. Elderly individuals with diverse diets and adequate PA had a reduced risk of developing T2DM and MCI.

Total physical activity, plant-based diet and neurodegenerative diseases: A prospective cohort study of the UK biobank

IntroductionNeurodegenerative diseases (NDDs) result from a complex interplay of genetic, environmental and aging factors. A balanced diet and adequate physical activity (PA) are recognized as pivotal components among modifiable environmental factors. The independent impact on NDD incidence has been previously debated. This investigation seeks to delineate the association between PA and NDDs across various levels of adherence to a plant-based diet. MethodsIn this study, a cohort of 368,934 participants from the UK Biobank was analyzed. Total physical activity (TPA) levels and healthful plant-based diet index (hPDI) were calculated and categorized. A multiple adjusted Cox model was utilized to evaluate the influence of TPA and hPDI on common NDDs, respectively. ResultsFinally, 4602 identified cases diagnosed as Alzheimer's disease (AD), Parkinson's disease (PD) or amyotrophic lateral sclerosis (ALS). We found that higher TPA was significantly associated with a reduced risk of developing AD (Q3: HR 0.87; Q4: HR 0.78) and PD (Q3: HR 0.86; Q4: HR 0.81). The protective effect was further accentuated with adherence to a plant-based diet. However, these connections were not observed in the analysis of ALS regardless of dietary patterns. ConclusionOur findings underscore a significant association between higher TPA and reduced risks of AD and PD, with an enhanced effect observed in conjunction with a plant-based diet. This study contributes to addressing the knowledge gap regarding the combined impact of TPA and a plant-based diet on NDDs occurrence, providing insights into potential underlying mechanisms.

Longitudinal associations of participation in organized and unorganized sports in youth with physical activity in mid-adulthood: The Young Finns Study

ABSTRACT We investigated the longitudinal associations between sports participation patterns in youth and physical activity (PA) in adulthood. PA was self-reported triannually between ages 9–18 (n = 2550, 52% females) and measured by accelerometers in mid-adulthood (n = 1002, 61% females, aged 48 ± 4 years). Three latent classes of youth sports participation emerged for both genders: 1) “organized sports” (persistent high PA with regular sports club activities), 2) “unorganized sports” (persistent high PA without sports club activities and 3) “low activity” (low PA with decreasing sports involvement). These groups comprised 29%, 34% and 37% of males, and 23%, 27% and 50% of females, respectively. Youth “organized sports” was associated with higher adult PA in both males (+1166 steps/day, p = 0.012) and females (+15 min/day moderate-to-vigorous PA [MVPA], +1064 steps/day, +1066 leisure-time steps/day; p ≤ 0.005) compared to “low activity”. In males, youth “organized sports” was associated with higher adult PA (+1103 steps/day, −26 min/day sedentary time and +133 counts/minute higher total PA, p ≤ 0.039) compared to “unorganized sports”. In females, “unorganized sports” in youth was related to higher adult PA (+10 min/day MVPA, p = 0.034) when compared to “low activity”. Sustained participation in youth organized sports, and for females, also in unorganized sports, is positively linked with adult PA.

Free bus fares, bus use and physical activity: An exploratory cross-sectional study.

Public transport (PT) users often accumulate more physical activity (PA) than private motor vehicle users and financial incentives may increase PT use. Responding to rising petrol prices, from 28 March to 1 May 2022, the Tasmanian government made public bus use fare-free. This exploratory study examined the perceived impact of fare-free buses on bus use and PA. Tasmanian adults who had used the fare-free buses (N = 548) completed an online survey (4 May-14 June 2022). Quantitative data were analysed using descriptive and inferential methods and responses to open-ended questions categorised. Over the fare-free period, 46% of participants reported more bus use-average weekly bus trips increased from 3.0 to 4.0 (p < 0.001). Most (81%) participants, including 36% (n = 33/93) who were not previous bus users, planned continued bus use despite financial cost. Total PA was reported higher (36%), the same (60%) and lower (4%) than usual during the fare-free period. Higher total PA was more common amongst those reporting increased bus use (n = 186/240; 78%). Responses to open-ended questions revealed: bus use-related PA gain was through walking to/from bus stops, more frequently attending PA settings (e.g., the gym) and unexpected walking due to bus service limitations; household-level cost savings, improved travel opportunities and better social/mental health were additional fare-free benefits. Fare-free buses were commonly perceived to increase bus use and PA. Intervention studies would determine if PA and financially incentivised PT have a causal relationship. Individual- and societal-level health economic analysis of free PT is warranted.

Premorbid physical activity and prognosis after incident myocardial infarction: The atherosclerosis risk in communities study

High to moderate levels of physical activity (PA) are associated with low risk of incident cardiovascular disease. However, it is unclear whether the benefits of PA in midlife extend to cardiovascular health following myocardial infarction (MI) in later life. Among 1,111 Atherosclerosis Risk in Communities study participants with incident MI during Atherosclerosis Risk in Communities follow-up (mean age 73 [SD 9] years at MI, 54% men, 21% Black), PA on average 11.9 (SD 6.9) years prior to incident MI (premorbid PA) was evaluated as the average score of PA between visit 1 (1987-1989) and visit 3 (1993-1995) using a modified Baecke questionnaire. Total and domain-specific PA (sport, nonsport leisure, and work PA) was analyzed for associations with composite and individual outcomes of mortality, recurrent MI, and stroke after index MI using multivariable Cox models. During a median follow-up of 4.6 (IQI 1.0-10.5) years after incident MI, 823 participants (74%) developed a composite outcome. The 10-year cumulative incidence of the composite outcome was lower in the highest, as compared to the lowest tertile of premorbid total PA (56% vs. 70%, respectively). This association remained statistically significant even after adjusting for potential confounders (adjusted hazard ratio [aHR] 0.80 [0.67-0.96] for the highest vs. lowest tertile). For individual outcomes, high premorbid total PA was associated with a low risk of recurrent MI (corresponding aHR 0.64 [0.44, 0.93]). When domain-specific PA was analyzed, similar results were seen for sport and work PA. The association was strongest in the first year following MI (e.g., aHR of composite outcome 0.66 [95% CI 0.47, 0.91] for the highest vs. lowest tertile of total PA). Premorbid PA was associated positively with post-MI cardiovascular health. Our results demonstrate the additional prognostic advantages of PA beyond reducing the risk of incident MI.

Social cohesion and associations with sedentary time, physical activity and dietary quality in The Maastricht Study

IntroWe aim to investigate the relationship between social cohesion and sedentary behavior (SB), total physical activity (PA), moderate-to-vigorous PA (MVPA), and dietary quality. Additionally, we assess whether these associations are independent of neighborhood walkability and the food environment. MethodsA total of 7641 participants from The Maastricht Study in the Netherlands between the ages of 40 and 75 years were analyzed. Neighborhood social cohesion was obtained by participant questionnaire completed at baseline and measured by the Dutch Livability meter. Home addresses were linked to geographic information system (GIS) data from the Geoscience and Health Cohort Consortium (GECCO) to create neighborhood exposures of walkability and food environment. A thigh worn accelerometer collected data to measure sedentary time, total daily PA, and MVPA. Dietary quality was measured with a food frequency questionnaire. Multivariate linear regression analyses were adjusted for age, sex, socioeconomic position, neighborhood walkability, and food environment. ResultsThose living in the highest quartile area of perceived social cohesion had statistically significant lower levels of SB (Q4 B: -13.04; 95% CI = −20.23, −5.85), higher total PA (Q4 B: 4.39; 95% CI = 1.69, 7.10), and higher MVPA (Q4 B: 2.57; 95% CI = 0.83, 4.31) and better diet quality (Q4 B: 1.12; 95% CI = 0.24, 2.01) compared to the lowest quartile independent of walkability and food environment. Similar results were found using the Livability meter. ConclusionWe discovered neighborhood social cohesion as an important obesogenic determinant that should be considered in policymaking to encourage higher levels of PA and higher diet quality.

Joint Associations of Diet and Device-Measured Physical Activity with Mortality and Incident CVD and Cancer: A Prospective Analysis of the UK Biobank Study.

We examined the joint associations of diet and device-measured intensity-specific physical activity (PA) with all-cause mortality (ACM), cardiovascular disease (CVD), and cancer incidence. We used data from 79,988 participants from the UK Biobank, a population-based prospective cohort study. Light PA (LPA), moderate-to-vigorous PA (MVPA), vigorous PA (VPA), and total PA (TPA) were measured using a wrist-worn accelerometer. Diet quality score (DQS) was based on 10 foods and ranged from 0 (unhealthiest) to 100 (healthiest) points. We derived joint PA and diet variables. Outcomes were ACM, CVD, and cancer incidence including PA, diet and adiposity-related (PDAR) cancer. During a median follow-up of 8 years, 2,863 deaths occurred, 11,053 participants developed CVD, 7,005 developed cancer, and 3,400 developed PDAR cancer. Compared with the least favorable referent group (bottom PA tertile/low DQS), participants with middle and high (total and intensity specific) PA, except for LPA, had lower ACM risk and incident CVD risk, regardless of DQS. For example, among middle and high VPA and high DQS groups, CVD HR were 0.79 (95% CI, 0.74-0.86) and 0.75 (95% CI, 0.69-0.82), respectively. The pattern of cancer results was less pronounced but in agreement with the ACM and CVD incidence findings (e.g., HR, 0.90, 95% CI, 0.81-0.99; 0.88, 0.79-0.98; and 0.82, 0.74-0.92 among high VPA for low, moderate, and high DQS groups, respectively). Device-measured PA reveals novel joint associations with diet on health outcomes. Our results emphasize the crucial role of PA in addition to a healthy diet for reducing chronic diseases and mortality risk.

Associations of postdiagnosis changes in physical activity with all-cause mortality among patients with stage I-IIA colorectal cancer.

87 Background: Several observational studies show an association between physical activity (PA) at diagnosis and reduced risk of mortality among colorectal cancer (CRC) patients, but there has been limited research examining the potential benefit of changes in PA levels after CRC diagnosis. Here we investigate the association between change of PA and all-cause mortality in patients with stage I-IIA CRC receiving resection with curative intent. Methods: Data were used from two large Dutch CRC cohort studies (PLCRC &amp; COLON), which assessed PA at diagnosis (T0), six (T6) and twelve (T12) months after diagnosis, using the SQUASH questionnaire. A total of 2540 stage I-IIA CRC patients with repeated PA measures (i.e. a T0 and at least a T6 or T12 questionnaire) were used for this analysis. Total PA was quantified by calculating Metabolic Equivalent Task (MET) hours per week and categorized as low, moderate, and high PA, based on tertiles of an age- and sex-matched sample of the general population. PA changes were evaluated at T6 and T12 relative to T0. Being active was defined per timepoint as being in the moderate or high total PA group, or adhering to the PA guideline (minimum of 150 minutes per week of moderate-intensity PA). Cox proportional hazards models were used to study the association between PA variables and all-cause mortality, adjusted for age, sex, BMI, and tumor location (colon vs rectum). Results: Median follow-up time was 35 months (interquartile range 19 – 55) during which a total of 133 deaths occurred. Being active at both T0 and T6 compared to being inactive at these timepoints, was associated with a lower rate of all-cause mortality for both PA variables (adjusted hazard ratio (HR) 0.39 [95% confidence interval 0.24-0.63] and 0.41 [0.23-0.72] for total PA and guideline adherence, respectively). Similar results were found when comparing T12 to T0 (being active according to total PA HR 0.20 [0.09-0.42] and guideline adherence HR 0.31 [0.14-0.72]). Changing to either activity or inactivity at T6 or T12 was not significantly associated with all-cause mortality (Table). Conclusions: Maintaining a physically active lifestyle following surgery for stage I to IIA CRC is associated with longer overall survival, reinforcing the recommendations for physical activity. [Table: see text]

Dose-response of accelerometer-measured physical activity, step count, and cancer risk in the UK Biobank: a prospective cohort analysis

BackgroundCancer is an age-related condition, but changes to modifiable lifestyle-related behaviours, including physical activity, could impact risk. While step count is an accessible metric of activity for older adults, its association with cancer risk remains poorly understood. We investigated the association between accelerometer-measured total activity, step count, and cancer risk. MethodsWe analysed data from a prospective UK Biobank cohort of consenting participants who wore wrist-based Axivity AX3 accelerometer devices for 7 days between June 1, 2013 and Dec 23, 2015, had valid accelerometer data, and no previous cancer diagnosis at baseline. Machine learning models estimated total physical activity (vector magnitude) and step count. The primary outcome, a composite of 13 cancers previously associated with physical activity, was obtained from national registries. Hazard ratios (HR) and were calculated using Cox proportional hazard models, with attained age as the underlying timescale and adjustment for sex, ethnicity, smoking status, alcohol consumption, education, and Townsend Deprivation Index. The impact of reallocating time between behaviours was evaluated using compositional data analyses. Dose-response associations were assessed with restricted cubic splines. FindingsWe analysed data from 86 556 participants, who were followed up during an average of 6·1 years (age range 43–78; 48 478 [56%] female and 38 078 [44%] male; 83 830 [97%] white). 5577 incident malignant cancers occurred among these 86 556 participants. Greater total physical activity was associated with a lower risk of physical-activity-related cancer (HR per 1 SD [+8·33 milligravity per day] 0·85, 95% CI 0·81–0·89). Reallocating 30 min/day from other activities to moderate-to-vigorous physical activity behaviour was associated with lower cancer risk (HR 0·96, 0·94–0·98), as was reallocating 1 h/day to light intensity activity (HR 0·94, 0·92–0·96), compared with the mean behaviour composition among included participants. Compared with taking 5000 steps per day, taking 10 000 daily steps was associated with a significantly lower risk of physical-activity-related cancer (HR 0·81, 0·73–0·90). InterpretationIn this sample from the UK Biobank, higher total physical activity and daily step count were associated with lower risk of physical-activity-related cancers. Findings suggest additional physical activity time, irrespective of intensity, may be beneficial. Increasing low intensity activity time and increasing daily step counts could be practical public health interventions to lower cancer risk, especially for aging adults. FundingNational Institute of Health Oxford Cambridge Scholars Program, Wellcome Trust, Swiss Re, Health Data Research UK, and Cancer Research UK.

The Epidemiology of Domain-Specific Physical Activity in New Zealand Adults: A Nationally Representative Cross-Sectional Survey.

Surveillance of domain-specific physical activity (PA) helps to target interventions to promote PA. We examined the sociodemographic correlates of domain-specific PA in New Zealand adults. A nationally representative sample of 13,887 adults completed the International PA Questionnaire-long form in 2019/20. Three measures of total and domain-specific (leisure, travel, home, and work) PA were calculated: (1)weekly participation, (2)mean weekly metabolic energy equivalent minutes (MET-min), and (3)median weekly MET-min among those who undertook PA. Results were weighted to the New Zealand adult population. The average contribution of domain-specific activity to total PA was 37.5% for work activities (participation = 43.6%; median participating MET-min = 2790), 31.9% for home activities (participation = 82.2%; median participating MET-min = 1185), 19.4% for leisure activities (participation = 64.7%; median participating MET-min = 933), and 11.2% for travel activities (participation = 64.0%; median MET-min among participants = 495). Women accumulated more home PA and less work PA than men. Total PA was higher in middle-aged adults, with diverse patterns by age within domains. Māori accumulated less leisure PA than New Zealand Europeans but higher total PA. Asian groups reported lower PA across all domains. Higher area deprivation was negatively associated with leisure PA. Sociodemographic patterns varied by measure. For example, gender was not associated with total PA participation, but men accumulated higher MET-min when taking part in PA than women. Inequalities in PA varied by domain and sociodemographic group. These results should be used to inform interventions to improve PA.

The Role of Spirituality on Physical Activity and Sleep Among African American Long-Term Breast Cancer Survivors.

African Americans with chronic conditions have reported the importance of spirituality in their lives. Aspects of spirituality have been shown to be related to physical activity (PA) and sleep, and PA and sleep affect quality of life (QOL). This study examined the association between spirituality, PA, and sleep in long-term African American breast cancer survivors. This cross-sectional study included 323 breast cancer survivors who previously participated in a case-only study. During 2015-2016, participants completed a questionnaire focused on survivorship that used validated measures for spirituality, PA, and sleep. Adjusted binary and multinomial logistic regression models estimated odds ratios (aORs) and 95% confidence intervals (CIs) for the associations of spirituality with total PA, meeting PA guidelines, sleep duration, and sleep medication. The mean age at diagnosis was 54.8 (SD = 9.89) years. The range of spirituality scores was 7-48 (median = 44). Among participants who had a score ≥ 44, 59% had high total PA, 61% met PA guidelines, 59% had high sleep duration, and 55% did not use sleep medication. Higher spirituality score was associated with higher total PA (aOR for ≥ 681 min/week: 1.90, 95% CI: 1.03-3.50), meeting PA guidelines (aOR: 1.78, 95% CI: 1.06-2.98), sleep duration > 7 h/night (aOR: 1.72, 95% CI 1.05-2.83), and lack of sleep medication use (aOR: 0.45, 95% CI: 0.24-0.84). In African American long-term breast cancer survivors, a higher spirituality score increased the likelihood of greater PA and high sleep duration. These results indicate that interventions surrounding spirituality may benefit the QOL of African American breast cancer survivors.

Joint associations of physical activity and sedentary time with body mass index: A prospective study of mortality risk.

Device-measured physical activity and sedentary time are suggested to be more important determinants of all-cause mortality compared to body mass index (BMI) in mainly older adults. However, the joint associations of physical activity and sedentary time with BMI in relation to mortality risk in relatively healthy middle-aged individuals are unclear. We followed 770 adults (56% women, mean age 55.6 years) from a population-based cohort study for up to 15.3 years. BMI categories were combined with tertiles of total, light, and moderate-to-vigorous physical activity and sedentary time. Cox proportional hazards models estimated hazard ratios (HR) of all-cause mortality with 95% confidence intervals (CI). High total and light intensity physical activity and low sedentary time were associated with a lower risk of mortality in normal weight individuals compared with low active overweight/obese; HR: 0.35 (CI: 0.14, 0.86), HR: 0.33 (CI: 0.12, 0.89), and HR: 0.34 (CI: 0.13, 0.92). Among overweight/obese individuals, those who were medium active in light physical activity had a lower mortality risk, HR: 0.36 (CI: 0.15, 0.83), compared with low active. Medium sedentary individuals had a lower risk, HR: 0.43 (CI: 0.20, 0.94) compared with those who were most sedentary. Associations among the most active or least sedentary tertiles were similar irrespective of BMI category. In conclusion, higher physical activity and lower sedentary time were associated with lower mortality risk irrespective of BMI. Physical activity should be promoted and prescribed to individuals with low physical activity levels irrespective of weight status.

Abstract 12084: Premorbid Physical Activity and Prognosis After Incident Myocardial Infarction: The Atherosclerosis Risk in Communities (ARIC) Study

Introduction: Physical activity (PA) is associated with a reduced risk of mortality and cardiovascular disease in the general population. However, it is unclear whether PA level in midlife impacts prognosis after myocardial infarction (MI) in later life. Methods: In 1,115 ARIC participants with incident non-fatal MI during ARIC follow-up (mean age 73 [SD 9] years at MI, 54% men, 21% Black), PA prior to incident MI (premorbid PA) was evaluated at visit 1 (1987-89) and visit 3 (1993-95) using a modified Baecke questionnaire; we studied the cumulative PA index scores across these two visits. Total and domain-specific PA (sport, leisure time, and work PA) were analyzed for their associations with mortality, recurrent MI, stroke, and heart failure after MI using multivariable Cox models. Elapsed time between visit 3 and incident MI was on average 11.9 (SD 6.9) years. Results: During a median follow-up of 2.0 [IQI 0.03-8.0] years after incident MI, 914 participants (82%) developed a composite outcome. The 8-year cumulative incidence of composite outcome was lower in the highest tertile of premorbid total PA than the lowest tertile (62% vs. 72%, respectively) ( Figure ). When adjusting for MI risk factors, the association was not significant. However, for individual outcomes, higher premorbid total PA was associated with a lower risk of recurrent MI (adjusted hazard ratio [HR] 0.66 [95% CI 0.45, 0.96] for the highest vs. lowest tertile). Results were similar for sport and work PA but not leisure time PA. When we focused on short-term prognosis within one year after MI, both higher total PA and sport PA were associated with lower mortality (HR 0.62 [95% CI 0.43, 0.90] and 0.62 [0.44, 0.89], respectively). Conclusions: Greater premorbid PA was associated with better prognosis after MI occurrence, both short-term and long-term post-MI. Our results demonstrate additional prognostic advantage of PA beyond reducing the risk of incident MI.

Accelerometer-Measured Physical Activity and Sedentary Behavior of Adults with Prader-Willi Syndrome Attending and Not Attending a Small-Scale Community Workshop.

This cross-sectional study aimed to compare the accelerometer-assessed physical activity (PA) and sedentary behavior (SB) of adults with Prader-Willi syndrome (PWS) attending or not attending a small-scale community workshop (SSCW). A total of 18 adults with PWS were recruited in this study. Of these participants, 10 regularly attended an SSCW and 8 did not. All of the participants were asked to wear accelerometers for eight continuous days for measuring their PA and SB. The independent sample t-test was used. The results showed that the adults with PWS who attended the SSCW engaged in more moderate-to-vigorous PA (MVPA) and daily steps than those who did not. By stratifying between daytime/nighttime on weekdays, we found the participants who attended the SSCW had higher total PA, MVPA, daily steps, as well as lower total sedentary time, during the daytime on weekdays than those who did not. Policies or programs promoting PA and reducing SB among adults with PWS should thus consider providing structured programs or courses in a community center.

Physical activity and technology usage performed by patients with coronary artery disease: a gender approach

Abstract Funding Acknowledgements Type of funding sources: None. Background Recent studies show that cardiac telerehabilitation, including exercise and lifestyle modification, is effective in reducing cardiovascular risk factors in patients with coronary artery disease (CAD). Thus, physical activity and technology usage of patients with CAD are important key points in order to create technology-based cardiac rehabilitation programs to improve physical patients´ condition and reduce cardiovascular risk. Purpose The aim of this study was to compare the physical activity and the technological usage of women and men with CAD. Methods A cross-sectional study in patients with CAD was performed. Sociodemographic data, physical activity (measured with the International Physical Activity Questionnaire, IPAQ) and the technology usage (measured with the Technology use subscale of the Technology Usage Questionnaire) were collected. Descriptive and inferential analyzes were performed to explore the differences between men and women with CAD. Results A total of 70 participants were included (84.28% men, mean age=59±8.54 years). Regarding the IPAQ, men significantly reported higher walking time (99.31±95.22 METS vs. 33.28±37.42 METS, p=0.001, respectively) and higher total physical activity (4164.91±4164.91 METS vs. 1390.68±1609.05 METS, p&amp;lt;0.001, respectively) than women. In relation to technology usage, the entire sample used a mobile phone, whilst there were no significant gender differences in the functions/applications used (phone calls, text messages, camera, receive videos/photos, internet searches, apps, instant messages, social media, games) (p=0.068). Although the majority of the participants (85.71%) had regular access to internet, men used their phone more frequently than women (81.10% vs. 37.50%, p=0.005, respectively). Comparison by gender showed no significant differences in the type of device used for internet searches (computer, tablet, mobile phone) (p=0.169), familiarization with technology-based physical activity games (p=0.801), use of heart rate monitors (p=0.193), preference to monitor heart rate when exercising (p=0.664), nor use of other devices to monitor physical activity (pedometer, etc.) (p=0.193). Conclusion Based on the results obtained, we conclude that men with CAD were more physical active and used the Internet more often than women, whilst there were no differences by gender in the rest of variables. Assessment of physical activity and technology usage should be implemented in patients with CAD, in order to adapt and improve the design of technology-based telerehabilitation programs

The association of sedentary behaviour and physical activity with periodontal disease in NHANES 2011-2012.

Periodontal disease is one of the most prevalent oral pathologies and a major chronic disease worldwide. Lifestyle habits such as poor nutrition and smoking have been established to contribute to the development of periodontal disease, but limited research has investigated whether physical activity and sedentary lifestyle play a role. The purpose of this study is to evaluate the association between physical activity, sedentary behaviour, and periodontal disease. We used a nationally representative data set from the National Health and Nutrition Examination Survey (NHANES) 2011-2012. We examined the association between physical activity and sedentary behaviour and periodontal disease using multivariable logistic regression models and reported odds ratios (ORs). Individuals with higher total physical activity, higher leisure time physical activity, and lower amount of total sedentary behaviour had lower periodontal disease prevalence. Adjusted multivariable regression models showed that higher sedentary behaviour (more than 7.5h/day) was associated with higher odds of periodontal disease (OR=1.17; 95% confidence interval= 1.00-1.36; p= .045). The findings showed that higher sedentary behaviour is associated with higher odds of periodontal disease. Future prospective longitudinal studies and strategies are needed to investigate implications further and define the magnitude of the association between physical activity and periodontal disease.

Physical activity pre- and during pregnancy and gestational diabetes onset across multi-ethnic pregnant populations: a systematic review and meta-analysis of epidemiological studies

Background: Gestational diabetes mellitus (GDM) is a common complication during pregnancy and is associated with adverse pregnancy outcomes and maternal and neonatal risks. Lifestyle intervention through physical activity is generally similar to dietary management in that it helps reduce weight and improve metabolism. However, it functions more on the preventive side of the spectrum in managing risk rather than actual treatment and management of the condition. This review aims to present an updated systematic review to determine the relationship between physical activity and onset of GDM across multi-ethnic pregnant populations. Methods: A systematic review and meta-analysis of epidemiological studies was conducted. We identified papers published from 2010 onwards using CINAHL, MEDLINE, EMBASE, Cochrane, ASSIA, PsycInfo, PubMed and Web of Science databases. Studies were limited to English language only, pregnant populations by ethnicity and reported physical activity pre- and during pregnancy. Results: Our research identified one pre-pregnancy and seven during-pregnancy studies. These studies were six prospective cohort studies, two case-control studies and one cross-sectional study. Physical activity was assessed pre-pregnancy in four studies, giving a pooled odds ratio (OR) of 0.68 (95% CI 0.53, 0.86). Physical activity in early and mid-pregnancy was assessed in five studies, giving a pooled OR of 0.77 (95% CI 0.66, 0.90) and 0.70 (95% CI 0.35, 1.40), respectively. Conclusion: Findings suggest that high total physical activity pre- and during pregnancy has a significant protective effect against GDM.

Physical activity levels after low anterior resection for rectal cancer: one-year follow-up

BackgroundOverall survival rates after rectal cancer have increased. Therefore, functional outcomes rightly deserve more interest. The aims of this study were to assess progression in total, sports, occupational and household physical activity levels of rectal cancer survivors, from preoperatively to 12 months after surgery/stoma closure and to explore predictive factors.MethodsMulti-center prospective study with 125 patients who underwent low anterior resection for rectal cancer. The Flemish Physical Activity Computerized Questionnaire was completed concerning all physical activity levels at baseline (past preoperative year) and at 1, 4, 6 and 12 months after surgery/stoma closure. At these timepoints, questionnaires (LARS−/ COREFO-questionnaire) regarding bowel symptoms were also filled out. Results were analyzed using linear mixed models for repeated measures.ResultsTotal physical activity levels up to 12 months remained significantly lower than preoperative. Occupational and sports physical activity levels remained significantly lower until 6 and 4 months postoperative, respectively. Predictive factors for decreased physical activity levels at a specific timepoint were: younger age and no stoma (total physical activity, 1 month), low/mid rectal tumor, no stoma, non-employed status (total, 4 months), higher COREFO-scores (occupational, 4 months) and non-employed status (total, 12 months). At all timepoints, lower COREFO-scores were associated with higher total physical activity levels; male gender and lower educational levels with higher occupational levels; younger age, normal BMI, employed status and adjuvant therapy with higher sports levels; and female gender, lower educational level and unemployed status with higher household levels.ConclusionsOne year after rectal cancer treatment, total physical activity levels were still not recovered. Rectal cancer patients, especially those at risk for decreased physical activity levels and with major bowel complaints, should be identified and guided to increase their activities.Trial registrationThis trial has been registered at Netherlands Trial Register (NTR6383, 23/01/2017).

Effects of a school-based intervention to reduce cardiovascular disease risk factors among secondary school students: A cluster-randomized, controlled trial.

BackgroundCardiovascular diseases (CVDs) are the number cause of death worldwide. In Ghana CVD has been the leading cause of death since 2001. The prevalence of CVD risk factors among adolescents in Ghana has been increasing. This study seeks to develop, implement and evaluate the effects of a behavioral modification intervention program to reduce CVD risk factors among secondary school students in Brong Ahafo, Ghana.MethodsA cluster-randomized controlled trial was conducted with schools as clusters over a period of six-months with pre and post intervention evaluations. Participants were public secondary school students (14–19 years) from four schools in Brong Ahafo, Ghana. Students in the intervention group were trained by the researchers whereas those of the control group received no intervention. The intervention included health education and physical activity modules. Follow-up data using same questionnaire were collected within two weeks after the intervention was completed. Intention-to-treat analysis was performed after replacing missing values using the multiple imputation method. The generalized linear mixed model (GLMM) was used to assess the effects of the intervention study.ResultsThe GLMM analyses showed the intervention was effective in attaining 0.77(p<0.001), 0.72(p<0.001), 0.47(p<0.001), 0.56(p<0.001), and 0.39(p = 0.045) higher total physical activity, fruits, vegetables, seafood, and water scores respectively for the intervention group over the control group. The intervention was also significant in reducing -0.15(p<0.001),-0.23(p<0.001),-0.50(p<0.001),-0.32(p<0.001),-0.90(p<0.001),-0.87(p<0.001),-0.38(p<0.001), -0.63(p<0.001), -1.63(p<0.001), 0.61(p<0.001), and -1.53(p = 0.005) carbohydrates, fats and oils, fried eggs, fried chicken, carbonated drinks, sugar, sweet snacks, salted fish, weight, BMI, and diastolic BP. The odds of quitting alcohol use in the intervention group were 1.06 times more than the control group. There was no significant effect on reducing smoking and systolic BP.ConclusionThere is an urgent need for the intervention program to be integrated into the existing curriculum structure of secondary school schools. Implementing the intervention will allow for longer and more consistent impact on the reduction of CVD risk factors among secondary school students.

Physical activity and sitting time in occupational groups from Papua New Guinea.

To assess physical activity and sitting time in workers from varied occupations in a regional urban population of Papua New Guinea (PNG), to identify priorities for worker health in a country experiencing rapid industrial development. PNG workers from a variety of settings (office [n = 213], blue-collar [n = 131], and retail [n = 52]) completed an interviewer-administered demographic questionnaire, the International Physical Activity Questionnaire-short form (IPAQ) and the Occupational Sitting and Physical Activity Questionnaire (OSPAQ); and had height and weight measured. Comparison of activity and sitting time between occupational groups was undertaken using generalised linear equations, with models including demographic variables and sitting time/physical activity as appropriate. Participants reported median total physical activity (walking, moderate and vigorous PA) of 5025 MET-min/week (80% constituting walking) and over 97% of participants met physical activity guidelines (> 600 MET-min/week). Total sitting time was 7 hours/day (IPAQ) and workers sat for 50% of working hours (OSPAQ). There was no difference between groups total physical activity. Office workers reported more total sitting time and a greater proportion of their work time spent sitting than blue-collar and retail workers reported significantly less total sitting time both p < 0.001) and retail workers reported a greater proportion of their work hours standing than office workers and blue-collar workers. Sitting time in PNG office workers was high, similar to findings from high-income countries, but total physical activity was also high in all groups. As the PNG economy develops and office-based work becomes more prevalent, the challenge will be to minimise sitting time at work whilst maintaining high total physical activity.