Higher Volumes Of Physical Activity Research Articles

Physical activity volume, frequency, and intensity: Associations with hypertension and obesity over 21 years in Australian women

BackgroundOptimal patterns of accrual of recommended levels of physical activity (PA) for prevention of hypertension and obesity are not known. The overall aim of this study was to investigate whether different patterns of accumulation of PA are differentially associated with hypertension and obesity in Australian women over 21 years. Specifically, we investigated whether, for the same weekly volume of PA, the number of sessions (frequency) and vigorousness of PA (intensity) were associated with a reduction in the occurrence of hypertension and obesity in women. MethodsData from the 1973–1978 and 1946–1951 cohorts of the Australian Longitudinal Study on Women's Health were analyzed (n = 20,588; 12%–16% with a Bachelor's or higher degree). Self-reported PA, hypertension, height, and weight were collected using mail surveys every 3 years from 1998/2000 to 2019/2021. Generalized Estimating Equation models with a 3-year lag model were used to investigate the association of PA volume (metabolic equivalent min/week) (none; 33–499; 500–999; ≥1000, weekly frequency (none; 1–2 times; 3–4 times; 5–7 times; ≥8 times), and the proportion of vigorous PA to total volume of PA (none; 0%; 1%–33%; 34%–66%; 67%–100%) with odds of hypertension and obesity from 2000 to 2021. ResultsThe cumulative incidence of hypertension was 6% in the 1973–1978 and 23% in the 1946–1951 cohort; 27% of women in the 1973–1978; and 15% in the 1946–1951 cohort developed obesity over the period. Overall, a higher volume of PA was associated with reduced odds of hypertension and obesity. When the volume of PA was considered, the odds of hypertension did not vary according to the frequency or intensity of PA. However, increased proportion of vigorous PA to the total volume of PA was associated with a small additional reduction in the risk of obesity. ConclusionPA volume appears to be more important than the pattern of accumulation for the prevention of hypertension and obesity. Incorporating more sessions, particularly of vigorous-intensity PA, may provide extra benefits for the prevention of obesity.

Ecological Momentary Assessment to Explore Fatigue, Mood, and Physical Activity Levels in People Receiving Peritoneal Dialysis

Fatigue is a frequent and debilitating symptom that contributes to poor quality of life for people receiving peritoneal dialysis. Ecological momentary assessment using mobile technology (mEMA) is a novel survey technique that can collect symptom data in real-time and has not been trialed in a peritoneal dialysis cohort. The study aimed to explore real-time fluctuations and associations between fatigue, mood, and physical activity using mEMA. Adults receiving peritoneal dialysis completed fatigue and mood scales, via a mobile application (app), 5 times daily for 7 days and, concurrently wore an accelerometer. A feasibility questionnaire was completed on the eighth day. Forty-eight adults completed the study. Within-day fatigue fluctuations were observed with severity lowest during mid-morning to early afternoon and peaking at bedtime. Associations between fatigue and mood were observed with a 1-unit change in mood score conferring a 5.2-unit change in fatigue (P< 0.01). Higher volume of physical activity was associated with lower fatigue and enhanced mood. Overall adherence to the app-based surveys was 73% with most participants reporting mobile phones and the mEMA app being easy to use. People receiving peritoneal dialysis experience within day and day-to-day fluctuations in fatigue that appear highly variable. Higher fatigue severity was associated with poorer mood and lower physical activity levels with future studies required to explore if physical activity-based interventions could be a potential strategy for the management of these symptoms. Furthermore, mEMA, and mobile phones, were feasible to capture symptom data with potential to be employed in future research or, as part of improved care.

SAT405 Bone Analysis Of Transgender Women Amateur Athletes Undergoing Gender-affirming Hormone Therapy

Abstract Disclosure: L.D. Santos: None. F.P. Nakamoto: None. R.E. Ferreira: None. R.C. Barbosa: None. L.H. Falcão: None. C.P. Cruz: None. G.B. Achkar: None. B.M. Sá: None. F.M. Lima: None. L.A. Alvares: None. Introduction: At the end of puberty, cisgender men (CM) have stronger bones and muscle mass than cisgender women (CW). Studies have shown a high prevalence of low bone mass in the general population of (transgender womenan) (TW). However, few articles are concerned with lean mass and bone mass in TW athletes. Objective: To assess the bone density of amateur volleyball TW athletes and compare them with CM and CW. Methods: A cross-sectional study was carried out with 8 TW (29 yo, range 27-36); BMI 24.1, range 19.3-31.7), 11 cisgender women (CW) and 8 cisgender men (CM) matched by age and BMI. The height (cm) of TW was 172 (range 164-181), that of CW was 176±0.1 and that of CM was 185±5.6. The TW had received hormone therapy for 3 (range 1-16) years. Measurements of BMD and body composition were taken with dual-energy X-ray absorptiometry. Results: The LS-BMD (lumbar spine) (g/cm2) of TW was 1.283 (range 0.9770-1.498), that of CW was 1.529±0.1614, and that of CM was 1.5115±0.1883 (TW vs. CW, p&amp;gt;0.05; TW vs. CM, p&amp;gt;0.05; CW vs. CM p&amp;gt;0.05). The FN-BMD (femur neck) (g/cm2) of TW was 1.203 (range 0.9660-1.332), that of CW was 1.337±0.1629, and that of CM was 1.4448±0.1334 (TW vs. CW, p&amp;gt;0.05; TW vs. CM, p&amp;lt;0.05; CW vs. CM p&amp;gt;0.05). Android/gynecoid (AG) ratio: TW: 0.85 (range 0.47-1.4); CW 0.73±0.13, CM 1.10±0.24. The lean corporal mass (kg) was 54.4 (range 44.3-66.9) in TW, 51.9±8.1 in CW, and 67.5±6.3 in CM (TW vs. CW, p&amp;gt;0.05; TW vs. CM, p&amp;lt;0.05; CW vs. CM p&amp;lt;0.05). Discussion: We observed lower bone density in TW amateur athletes undergoing gender-affirming hormone therapy, as well as in the general TW population. Despite the lack of statistical significance, probably as a consequence of the number of volunteers, the AG ratio was intermediate in TW. Lean mass was equal between TW and CW, unlike in the general TW population in other cohorts thay analyzed non-athelets. Conclusion: Despite their high volume of physical activity, there was a lower BMD in the TW group than in the other groups. Presentation: Saturday, June 17, 2023

Joint association of physical activity and sleep duration with risk of all-cause and cause-specific mortality: a population-based cohort study using accelerometry.

To investigate the joint association of accelerometer-measured physical activity (PA) and sleep duration with mortality risk. A 7-day accelerometer recording was performed on 92 221 participants (age 62.4 ± 7.8 years; 56.4% women) from the UK Biobank between February 2013 and December 2015. We divided sleep duration into three groups (short, normal, and long), total volume of PA into three levels according to tertiles (high, intermediate, low), and moderate-to-vigorous PA (MVPA) into two groups based on the World Health Organization guidelines. The mortality outcomes were prospectively collected through the death registry. Over a median follow-up of 7.0 years, 3080 adults died, of which 1074 died from cardiovascular disease (CVD) and 1871 from cancer. The associations of PA and sleep duration with mortality risk were all in a curvilinear dose-response pattern (Pnonlinearity <0.001). PA and sleep duration had additive and multiplicative interactions on mortality risk (Pinteraction <0.05). Compared with the participants with guideline-recommended MVPA and normal sleep duration, those without recommended MVPA but having short or long sleep duration were at a higher risk for all-cause mortality [short sleep: hazard ratio (HR) = 1.88; 95% confidence interval (CI), 1.61-2.20; long sleep: HR = 1.69; 95% CI, 1.49-1.90]. A higher volume of PA or recommended MVPA attenuated the detrimental effects of short or long sleep duration on all-cause and CVD mortality risks. MVPA meeting recommendations or a higher volume of PA at any intensity potentially diminished the adverse effects on all-cause and cause-specific mortality associated with short and long sleep duration.

Outdoor gyms and physical function: A cross-sectional comparative study between active and sedentary older adults

Outdoor gyms (OG) are public places designed for physical activity, especially for older adults. This is a cross-sectional study that aimed to compare morphofunctional characteristics of sedentary and active older adults regarding OG. The participants consisted of 194 older people divided into three groups: sedentary (n = 76, mean age = 70.5 ± 6.4 years, 38.7% male); OG + walking (n = 86; mean age = 69 ± 6.1 years; male 50.6%); and OG (n = 32; mean age = 70.3 ± 8.3 years; male 56.3%). Socioeconomic and morphofunctional characteristics, anthropometric measurements, body composition, and functional tests were collected. For comparison among groups ANOVA, for categorical variables the chi-square test or Fisher's exact test, and to verify factors related to gait speed logistic regression were used. We found that sedentary older adults had lower educational level and lower prevalence of polypharmacy. OG + walking participants had lower waist circumference and fat percentage, and better gait speed. Older people in the OG + walking were less likely to show gait difficulty (i.e., <1.0 m/s) in reference to the sedentary group. In addition, strength and better performance on the Timed Up and Go were also associated with gait speed >1 m/s. It is understood that the higher volume of physical activity performed by OG + walking may be one of the reasons why they obtained better indicators in health aspects. The findings, especially regarding the characterization of profiles of older adults who use OG, leads to the definition of public policies aimed at the real needs of this public.

English

Objective: To describe the physical and physiological characteristics of a group formed by ultra-distance runners, to compare their training habits with the guidelines established by the WHO and to study the possible harmful consequences of the high volume of physical activity performed. Material and method: The sample was formed by runners who repeated their participation in the “Ehunmilak” ultra-distance race in 2017 and 2018. Data collected through the medical certificates of the race and an own questionnaire were analyzed. For the analysis of variables, the Mann-Whitney U and Chi-square tests were used, with a 95% confidence interval. A value of p &lt;0.05 was considered statistically significant. Results: A low prevalence of several well known risk factors was observed (HT 1.8%, DM 0%, dyslipidemia 0-1.8%, smoking 5.3-10.5%, overweight 17.5%). During the last two years, 0% suffered cardiovascular injuries and 52.6% suffered musculoskeletal injuries. Medical examinations were performed frequently, each year by 91.2%. 72% complied with the latest WHO recommendations regarding volume of physical activity. Finally, no relationship was found between the parameters that indicate a high volume of physical exercise and the ECG result. The same occurred with musculoskeletal injuries, although in this case significant relationships were observed with BMI (p = 0.004) and training intensity (p = 0.009). Conclusions: It was observed that the group of runners studied is in good health and that their training habits are correct, according to the latest WHO recommendations. In addition, their characteristics and training habits did not show a relationship with the risk of developing a pathological ECG or suffering musculoskeletal injuries, except for the significant relationship that BMI and training intensity showed with the latter.

Association Between Physical Activity and Risk of Depression

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

Reframing How Physical Activity Reduces The Incidence of Clinically-Diagnosed Cancers: Appraising Exercise-Induced Immuno-Modulation As An Integral Mechanism.

Undertaking a high volume of physical activity is associated with reduced risk of a broad range of clinically diagnosed cancers. These findings, which imply that physical activity induces physiological changes that avert or suppress neoplastic activity, are supported by preclinical intervention studies in rodents demonstrating that structured regular exercise commonly represses tumour growth. In Part 1 of this review, we summarise epidemiology and preclinical evidence linking physical activity or regular structured exercise with reduced cancer risk or tumour growth. Despite abundant evidence that physical activity commonly exerts anti-cancer effects, the mechanism(s)-of-action responsible for these beneficial outcomes is undefined and remains subject to ongoing speculation. In Part 2, we outline why altered immune regulation from physical activity - specifically to T cells - is likely an integral mechanism. We do this by first explaining how physical activity appears to modulate the cancer immunoediting process. In doing so, we highlight that augmented elimination of immunogenic cancer cells predominantly leads to the containment of cancers in a ‘precancerous’ or ‘covert’ equilibrium state, thus reducing the incidence of clinically diagnosed cancers among physically active individuals. In seeking to understand how physical activity might augment T cell function to avert cancer outgrowth, in Part 3 we appraise how physical activity affects the determinants of a successful T cell response against immunogenic cancer cells. Using the cancer immunogram as a basis for this evaluation, we assess the effects of physical activity on: (i) general T cell status in blood, (ii) T cell infiltration to tissues, (iii) presence of immune checkpoints associated with T cell exhaustion and anergy, (iv) presence of inflammatory inhibitors of T cells and (v) presence of metabolic inhibitors of T cells. The extent to which physical activity alters these determinants to reduce the risk of clinically diagnosed cancers – and whether physical activity changes these determinants in an interconnected or unrelated manner – is unresolved. Accordingly, we analyse how physical activity might alter each determinant, and we show how these changes may interconnect to explain how physical activity alters T cell regulation to prevent cancer outgrowth.

Physical Activity, Mental Health and Wellbeing of Adults within and during the Easing of COVID-19 Restrictions, in the United Kingdom and New Zealand.

Physical activity (PA) participation was substantially reduced at the start of the COVID-19 pandemic. The purpose of this study was to assess the association between PA, mental health, and wellbeing during and following the easing of COVID-19 restrictions in the United Kingdom (UK) and New Zealand (NZ). In this study, 3363 adults completed online surveys within 2–6 weeks of initial COVID-19 restrictions (April/May 2020) and once restrictions to human movement had been eased. Outcome measures included the International Physical Activity Questionnaire Short-Form, Depression Anxiety and Stress Scale-9 (mental health) and World Health Organisation-5 Wellbeing Index. There were no differences in PA, mental health or wellbeing between timepoints (p > 0.05). Individuals engaging in moderate or high volume of PA had significantly better mental health (−1.1 and −1.7 units, respectively) and wellbeing (11.4 and 18.6 units, respectively) than individuals who engaged in low PA (p < 0.001). Mental health was better once COVID-19 restrictions were eased (p < 0.001). NZ had better mental health and wellbeing than the UK (p < 0.001). Participation in moderate-to-high volumes of PA was associated with better mental health and wellbeing, both during and following periods of COVID-19 containment, compared to participation in low volumes of PA. Where applicable, during the current or future pandemic(s), moderate-to-high volumes of PA should be encouraged.

Activity Level and Sport Type in Adolescents Correlate with the Development of Cam Morphology.

Background:The purpose of this study was to evaluate the influence of the volume and type of sport on the development of cam-type femoroacetabular impingement and acetabular dysplasia.Methods:The Physical Activity Questionnaire for Adolescents (PAQ-A) was administered to Iowa Bone Development Study participants at the age of 17 years to identify those who had participated in at least 2 seasons of high school interscholastic sports. Based on relative peak strain and ground reaction forces, subjects were grouped as power sport athletes (basketball, cheerleading, football, gymnastics, soccer, and volleyball), non-power sport athletes (wrestling, baseball, cross-country or track and field, softball, or tennis), or non-athletes. Using anteroposterior views of the left hip formatted from dual x-ray absorptiometry (DXA) scans, the alpha angle, head-neck offset ratio (HNOR), and lateral center-edge angle (LCEA) were evaluated longitudinally at the ages of 17, 19, and 23 years. Logistic regression was used to evaluate the odds of hip cam morphology (alpha angle >55° and/or HNOR <0.17) or acetabular dysplasia (LCEA <24°) at the age of 23 years in all athlete groups. The relationships between physical activity level and hip measures (alpha angle, HNOR, and LCEA) from the ages of 17 to 23 years were examined using linear mixed models adjusted for sex.Results:Compared with non-athletes at the age of 23 years, power sport athletes had significantly greater odds of cam morphology according to the alpha angle (odds ratio [OR], 2.93 [95% confidence interval (CI), 1.02 to 8.41]; p = 0.046) and HNOR (OR, 1.91 [95% CI, 1.01 to 3.60]; p = 0.047), but not greater odds of acetabular dysplasia (p > 0.05). There were no significant differences in the odds of cam morphology or acetabular dysplasia in non-power sport athletes compared with non-athletes (all p > 0.05). Higher physical activity levels were significantly associated with an increase in the alpha angle (beta and standard error, 0.77° ± 0.30°; p = 0.011) and a decrease in the HNOR (−0.003 ± 0.001; p = 0.003), but not the LCEA (−0.05 ± 0.15; p = 0.744).Conclusions:A higher volume of physical activity and participation in sports with higher peak strain and ground reaction forces during the process of skeletal maturation may increase the risk of developing cam morphology during late adolescence.Level of Evidence:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Frequency of interruptions to prolonged sitting and postprandial metabolic responses in young, obese, Chinese men

ABSTRACT This study aimed to examine the effects of 3-min light-intensity walking every 30 min (3-min) and 6-min light-intensity walking every 60 min (6-min) compared with prolonged sitting (SIT) on the postprandial metabolic responses in young, centrally obese, Chinese men. Twenty-one Chinese men with central obesity (age, 23 ± 4 years; body mass index, 29.8 ± 3.2 kg·m−2; waist circumference, 98.7 ± 7.1 cm; mean ± SD) underwent three 6-h experiments with a 7-day washout period, SIT, 3-min, and 6-min, in randomized order. Compared with SIT, neither walking condition showed differences in total and net incremental area under the curve (tAUC and iAUC, respectively) for glucose, insulin, nor non-esterified fatty acids. The tAUC and iAUC for triglycerides for the SIT condition (10.8 [9.3, 12.2] and 4.4 [3.7, 5.1] mmol·h·L−1, respectively; mean [95% confidence interval]) was higher than 3-min (10.4 [9.0, 11.8] and 3.8 [3.3, 4.3] mmol·h·L−1, respectively, both Ps <0.05) and 6-min (9.6 [8.1, 11.0] and 3.5 [2.9, 4.2] mmol·h·L−1, respectively, both Ps <0.01) conditions. Interrupting prolonged sitting regardless of frequency-reduced postprandial triglycerides. A higher volume of physical activity may be required to obtain greater glycaemic benefits in young Chinese men with central obesity.

Predictors of Physical Activity in Patients With Fibromyalgia: A Path Analysis.

The aim of this study was to identify psychological factors that influence moderate-vigorous physical activity (MVPA) participation in patients with fibromyalgia. In this secondary data analysis, 170 patients received personalized exercise plans and completed baseline and follow-up assessments of self-reported physical activity at weeks 12, 24, and 36. Structural equation modeling was used to examine the predictive strengths of psychological factors (exercise self-efficacy, perceived barriers, and intention) on MVPA participation. Using a threshold increase in MVPA of 10 or greater metabolic equivalent hours per week (MET h/wk), 3 groups were defined based on subjects who achieved a minimum increase of 10 MET h/wk that was sustained for at least 12 weeks (SUS-PA), achieved an increase of 10 MET h/wk that was not sustained for at least 12 weeks (UNSUS-PA), and did not achieve an increase of 10 MET h/wk (LO-PA). Increases in exercise self-efficacy and intention and reductions in perceived barriers were associated with increased volume of PA, showing the greatest change in the SUS-PA, followed by UNSUS-PA. For the LO-PA group, there was no change in exercise self-efficacy, a decrease in intention, and an increase in barriers. Using path analysis, exercise self-efficacy and perceived barriers were associated with higher volumes of physical activity via greater intention to engage in MVPA. For patients with fibromyalgia, exercise self-efficacy, perceived barriers, and intention to exercise are important constructs for increasing physical activity. Our findings provide guidance for practitioners who seek to promote physical activity in fibromyalgia and suggestions for researchers aiming to improve prediction models.

Self-Reported Physical Activity, Injury, and Illness in Canadian Adolescent Ski Racers.

Youth ski racers spend a considerable amount of time on snow and this may detract from other activities known to influence fundamental movement skills and overall health related outcomes. Parents of racers (n = 52 F; n = 44 M; age range 9–14 years) registered in the Canadian club system completed a baseline medical questionnaire during preseason testing in 2017. We describe physical activity volume and sport participation outside of physical education classes over the previous 12 months and report on injuries, medication use and health care utilization. The mean number of activities participated was five (range 1–14) with cycling, hiking, and swimming as the preferred choice and a cumulative mean of just under 400 h of activity was reported (range F 27–1,015; M 62–869 h/year) in the past year. During the past 12 months 16% of the athletes reported being injured and injury severity impacted return to sport with range of reported days missed from 1 to 365 days. Thirteen non-concussive injuries were reported in alpine skiing and females (12%, 6/52) reported more lower limb injuries than males (7%, 3/44). More males were concussed over their lifetime, with alpine skiing accounting for 46% and mountain biking 15%. Most athletes (85%) did not take medication on a regular basis and those that did had a medical diagnosis. The frequency of respiratory conditions was 13% (12/96) with males reporting slightly more cases than females. No difference in emergency visits occurred (25%) between males and females in the past 12 months, however females reported more (n = 102) allied health care, sport medicine and x-rays appointments when compared to males (n = 65). In summary, a high volume of physical activity (an hour plus per day) over the previous 12 months was reported with racers participating in several activities outside of skiing, likely honing their fundamental movement skills. Close proximity to the mountains may have influenced their choices of activity outside of ski racing, and their injuries and a variety of health conditions were typical of their age group. Future research employing wearable technology to objectively quantify the volume and intensity of physical activity participation is recommended.

Body weight composition and physical fitness of 17-18-year-old agricultural university students with different motor activity amounts

The article presents the comparative analysis results of body weight composition and physical fitness of 17-18-year-old students who are engaged in sports and not engaged in sports. Students with a higher volume of physical activity have a higher content of active cell mass, water in the body (by 1.62 % and 3.31%, respectively), a lower body mass index, and the content of total and visceral fat (by 1.59%, 4.98% and 1.44%, respectively). There is a high correlation with a higher level of physical fitness. For all seven motor tests that characterize the development of basic conditioning and coordination abilities, the indicators of athletes are higher. In general, 27.2 % of female athletes have an above-average level of physical fitness, the average level was found in 54.45 % and below the average in 18.18 %. It is significantly higher than the same indicators for non-sports students.

Dose-response Effects of Aerobic Exercise Among Colon Cancer Survivors: A Randomized Phase II Trial

BackgroundObservational studies suggest that higher volumes of physical activity are associated with a lower risk of disease recurrence among survivors of colon cancer. However, the feasibility and safety of prescribing higher volumes of physical activity to survivors of colon cancer are unknown. Furthermore, the pathways through which exercise may reduce disease recurrence are unknown. Patients and MethodsSurvivors of stage I to III colon cancer were randomized to usual-care control, 150 minutes per week of aerobic exercise (low-dose), or 300 minutes per week of aerobic exercise (high-dose). Changes in soluble intercellular adhesion molecule-1 and vascular adhesion molecule-1 prognostic biomarkers were examined. ResultsFrom January 2015 to February 2016, 39 patients were enrolled (n = 13 usual-care control; n = 14 low-dose; n = 12 high-dose), and 38 participants completed the study (97% follow-up). Over 6 months, the low-dose group completed 142 minutes per week (92.8% adherence), and the high-dose group completed 247 minutes per week (89.0% adherence) of exercise. Compared with the control group, changes in soluble intercellular adhesion molecule-1 were −134.9 ng/mL (95% confidence interval, −238.1 to −31.6 ng/mL) in the low-dose group and −114.8 ng/mL (95% confidence interval, −222.5 to −7.1 ng/mL) in the high-dose group (linear Ptrend = .023; nonlinear Ptrend = .044). No changes were observed for soluable vascular adhesion molecule-1 (linear Ptrend = .791; nonlinear Ptrend = .604). Non-serious adverse events occurred at similar rates among randomized groups. No serious adverse events occurred. ConclusionHigher volumes of moderate-intensity aerobic exercise, up to 300 minutes per week, are feasible, safe, and elicit favorable changes in prognostic biomarkers among patients recently treated for stage I to III colon cancer. These data can be used to guide clinical recommendations for patients, and inform future trials.

Accelerometer-measured physical activity is not associated with two-year weight change in African-origin adults from five diverse populations.

BackgroundIncreasing population-levels of physical activity (PA) is a controversial strategy for managing the obesity epidemic, given the conflicting evidence for weight loss from PA alone per se. We measured PA and weight change in a three-year prospective cohort study in young adults from five countries (Ghana, South Africa, Jamaica, Seychelles and USA).MethodsA total of 1,944 men and women had baseline data, and at least 1 follow-up examination including measures of anthropometry (weight/BMI), and objective PA (accelerometer, 7-day) following the three-year study period. PA was explored as 1-minute bouts of moderate and vigorous PA (MVPA) as well as daily sedentary time.ResultsAt baseline; Ghanaian and South African men had the lowest body weights (63.4 ± 9.5, 64.9 ± 11.8 kg, respectively) and men and women from the USA the highest (93.6 ± 25.9, 91.7 ± 23.4 kg, respectively). Prevalence of normal weight ranged from 85% in Ghanaian men to 29% in USA men and 52% in Ghanaian women to 15% in USA women. Over the two-year follow-up period, USA men and Jamaican women experienced the smallest yearly weight change rate (0.1 ± 3.3 kg/yr; −0.03 ± 3.0 kg/yr, respectively), compared to South African men and Ghanaian women greatest yearly change (0.6.0 ± 3.0 kg/yr; 1.22 ± 2.6 kg/yr, respectively). Mean yearly weight gain tended to be larger among normal weight participants at baseline than overweight/obese at baseline. Neither baseline MVPA nor sedentary time were associated with weight gain. Using multiple linear regression, only baseline weight, age and gender were significantly associated with weight gain.DiscussionFrom our study it is not evident that higher volumes of PA alone are protective against future weight gain, and by deduction our data suggest that other environmental factors such as the food environment may have a more critical role.

A randomized phase II dose–response exercise trial among colon cancer survivors: Purpose, study design, methods, and recruitment results

BackgroundObservational studies indicate that higher volumes of physical activity are associated with improved disease outcomes among colon cancer survivors. The aim of this report is to describe the purpose, study design, methods, and recruitment results of the courage trial, a National Cancer Institute (NCI) sponsored, phase II, randomized, dose–response exercise trial among colon cancer survivors. Methods/resultsThe primary objective of the courage trial is to quantify the feasibility, safety, and physiologic effects of low-dose (150min·week−1) and high-dose (300min·week−1) moderate-intensity aerobic exercise compared to usual-care control group over six months. The exercise groups are provided with in-home treadmills and heart rate monitors. Between January and July 2015, 1433 letters were mailed using a population-based state cancer registry; 126 colon cancer survivors inquired about participation, and 39 were randomized onto the study protocol. Age was associated with inquiry about study participation (P<0.001) and randomization onto the study protocol (P<0.001). No other demographic, clinical, or geographic characteristics were associated with study inquiry or randomization. The final trial participant was randomized in August 2015. Six month endpoint data collection was completed in February 2016. DiscussionThe recruitment of colon cancer survivors into an exercise trial is feasible. The findings from this trial will inform key design aspects for future phase 2 and phase 3 randomized controlled trials to examine the efficacy of exercise to improve clinical outcomes among colon cancer survivors.

Severe Obesity and the Ambivalence of Attending Physical Activity: Exploring Lived Experiences.

Physical activity is considered fundamental in lifestyle interventions. We explore experiences of physical activity prior to, during, and following a 10- to 14-week inpatient lifestyle modification program, including high volume of physical activity, for the treatment of severe obesity. Eight participants from a prospective clinical trial were selected to participate in a complementary qualitative study. The participants' experiences with physical activity during and following the treatment program represented different opposites: "pain and pleasure," "desire and duty," and "bubble and battle." We summarized the findings into one overall theme: "the ambivalence of attending physical activity." The ambivalence is experienced as a shift in how participants experience physical activity during the intervention period and as an ongoing, dynamic, and constantly shifting experience during such activity. To address and reflect upon such experiences with the participants, and acknowledge ambivalence as a legitimate part of being physically active, might be important within obesity treatment.

Extremes of weight gain and weight loss with detailed assessments of energy balance: Illustrative case studies and clinical recommendations

Extreme weight changes, or changes in weight greater than 10 kg within a 2-year period, can be caused by numerous factors that are much different than typical weight fluctuations. This paper uses two interesting cases of extreme weight change (a female who experienced extreme weight gain and a male who experienced extreme weight loss) from participants in the Energy Balance Study to illustrate the physiological and psychosocial variables associated with the weight change over a 15-month period, including rigorous assessments of energy intake, physical activity (PA) and energy expenditure, and body composition. In addition, we provide a brief review of the literature regarding the relationship between energy balance (EB) and weight change, as well as insight into proper weight management strategies. The case studies presented here are then placed in the context of the literature regarding EB and weight change. This report further supports previous research on the importance of regular doses of PA for weight maintenance, and that even higher volumes of PA are necessary for weight loss. Practitioners should emphasize the importance of PA to their patients and take steps to monitor their patients’ involvement in PA.

Beyond weight reduction: Improvements in quality of life after an intensive lifestyle intervention in subjects with severe obesity

Introduction. We examined the effects of 10–14 weeks of inpatient intensive lifestyle intervention (ILI), including a minimum of 90 minutes of adapted physical activity 5 days/week, with regard to changes in quality of life and associations with weight loss in subjects with severe obesity.Methods. A total of 100 severely obese subjects (BMI 42.6 ± 5.3 kg/m2; 42.7 ± 10.6 years) were included. Quality of life was assessed by Binge Eating Scale, Hospital Anxiety, and Depression Scale, and SF- 36. The ILI group completed the questionnaires at inclusion, after 10–14 weeks and 12 months, and controls at inclusion and after 10–14 weeks.Results. Compared to controls, self-reported binge eating (–6.4, P < 0.0001), anxiety (–1.7, P = 0.005), and depression (–3.0, P < 0.0001) were reduced, and physical (8.0, P < 0.0001) and mental (7.6, P < 0.0001) health increased in the ILI group. After 12 months, reduction in self-reported binge eating (–7.2, P < 0.0001) and depression (–3.4, P < 0.0001) and increase in physical (8.9, P < 0.0001) and mental (3.6, P = 0.035) health were maintained. Decreased self-reported binge eating (β = 0.555, P = 0.010) and increased physical health (β = –0.554, P = 0.003) were associated with weight loss.Conclusion. ILI including a high volume of physical activity in subjects with severe obesity improved quality of life by favorable changes in self-reported binge eating, depression, and mental and physical health. Improvements in binge eating and physical health were associated with weight loss.Trial registration: ClinicalTrials.gov identifier: NCT01675713.