Joint Associations Of Physical Activity Research Articles

The joint associations of physical activity and TV viewing time with COVID-19 mortality: An analysis of UK Biobank

ABSTRACT We used logistic regression to investigate the joint associations of physical activity level (high: ≥3000 MET-min/week, moderate: ≥600 MET-min/week, low: not meeting either criteria) and TV viewing time (low: ≤1 h/day, moderate: 2–3 h/day, high: ≥4 h/day) with COVID-19 mortality risk in UK Biobank. Additional models were performed with adjustment for body mass index (BMI) and waist circumference. Within the 373, 523 included participants, there were 940 COVID-19 deaths between 16 March 2020 and 12 November 2021. Compared to highly active individuals with a low TV viewing time, highly active individuals with a high TV viewing time were at significantly higher risk of COVID-19 mortality (odds ratio = 1.54, 95% confidence interval = 1.11–2.15). However, the greatest risk was observed for the combination of a low physical activity level and a high TV viewing time (2.29, 1.63–3.21). After adjusting for either BMI or waist circumference, only this latter combination remained at a significantly higher risk, although the effect estimate was attenuated by 43% and 48%, respectively. In sum, a high TV viewing time may be a risk factor for COVID-19 mortality even amongst highly active individuals. Higher adiposity appears to partly explain the elevated risk associated with a low physical activity level and a high TV viewing time.

The joint association of physical activity and sedentary behavior with health-related quality of life among children and adolescents in Mainland China.

ObjectivesThe objective of this study was to investigate the joint association of physical activity (PA) and sedentary behavior (SB) with health-related quality of life (HRQoL) among children in Mainland China.MethodsChildren were randomly recruited from primary, junior, and senior high schools (graders 4–12) in Nanjing municipality of China in this cross-sectional survey in 2018. The outcome variable, HRQoL, was assessed using the validated Chinese version of Child Health Utility 9D (CHU9D-CHN) instrument. PA and SB were measured using a validated Physical Activity Scale and Food Frequency Questionnaire for Chinese school-aged children. The associations of PA and SB with HRQoL were assessed using mixed-effects linear regression models and reported as mean difference (MD) and 95% confidence interval (CI).ResultsTotally, 4,388 participants completed the survey (response rate = 97.6%). After adjustment for potential confounders and class-level clustering effects, relative to those with insufficient PA and prolonged SB, students with insufficient PA and shortened SB (MD = 0.054, 95%CI = 0.018, 0.089), or children with sufficient PA and prolonged SB (MD = 0.034, 95%CI = −0.030, 0.098), or students with sufficient PA and shortened SB (MD = 0.083, 95%CI = 0.045, 0.120), respectively, reported increased HRQoL scores.ConclusionPA was positively associated with HRQoL, and SB was in negative relation to HRQoL. Furthermore, sufficient PA and shortened SB might exert additive influence on HRQoL among children and adolescents in China. This study has public health implications that PA promotion and SB reduction are encouraged to be considered simultaneously for the purpose to maximally improve HRQoL in population-based behavior intervention campaigns among children and adolescents.

Physical activity attenuated the associations between ambient air pollutants and metabolic syndrome (MetS): A nationwide study across 28 provinces

The independent associations of air pollution and Physical activity (PA) with metabolic syndrome (MetS) were inconsistent, while the joint associations between PA and air pollution with MetS were still unknown. We aimed to (1) further confirm the independent associations of PA and air pollution; (2) examine whether PA would attenuate the positive associations of air pollutants with MetS. We included 13,418 adults above 45 years old in this study. We defined MetS according to the Joint Interim Societies. The concentration of air pollutants (including fine particulate matter (PM2.5), inhalable particles (PM10), ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO)) were estimated by ground-based measurements and satellite remote sensing products. We assessed the level of PA by metabolic equivalent (MET)-hour/week by summing the MET of all activities. We applied logistic regression models with sampling weight to explore the independent and joint associations of PA and air pollutants on MetS. Interaction plots were conducted to exhibit estimates of air pollutants on MetS as a function of PA. We found that all air pollutants were positively associated with the odds of MetS, while PA showed beneficial associations with MetS. The associations of air pollution on MetS decreased accompanied the increase of PA, while the detrimental effects between air pollutants and MetS did not be reversed by PA. In conclusion, PA may attenuate the associations of air pollutants with MetS, although in polluted areas, suggesting that keeping PA might be an effective way to reduce the adverse effects of air pollution with MetS.

Joint associations of physical activity and sedentary time with adiposity during adolescence: ALSPAC.

BackgroundIn developing evidence-based physical activity (PA) guidelines for youth, a knowledge gap exists regarding the health effects of sedentary time (SED). The aim of this study was to determine the joint associations of moderate- and vigorous-intensity PA (MVPA) and SED with adiposity during adolescence.MethodsThe study sample was 2619 non-obese participants (56.7% female) from the UK Avon Longitudinal Study of Parents and Children. Accelerometer-measured MVPA and SED at age 11, 13, 15 years and self-reported TV viewing at age 13 and 16 years were used to create two exposure variables: six MVPA&SED combinations based on two MVPA patterns [≥60 (active) and <60 min/day (inactive)] and three SED patterns [≈25 (low), ≈30 (middle) and ≈35 min/h (high)] and six MVPA&TV combinations based on two MVPA patterns and three TV viewing patterns [<1–2 (low), 1–2 (middle) and >1–2 h/day (high)]. Adiposity was evaluated using fat mass index (FMI) at age 17 years.ResultsSED was not significantly associated with FMI in either active or inactive adolescents. However, higher TV viewing was associated with higher FMI in both active [adjusted FMI = 4.53 vs. 5.09 (95% CI = 4.87, 5.33) for low TV vs. high TV] and inactive adolescents [adjusted FMI = 4.91 vs. 5.21 (95% CI = 5.02, 5.39) for low TV vs. high TV].ConclusionsHigher TV viewing time, but not total SED, was prospectively associated with higher adiposity among both active and inactive adolescents, suggesting a specific sedentary behavior target for public health.

Interactions of physical activity, muscular fitness, adiposity, and genetic risk for NAFLD.

Genetic predisposition and unhealthy lifestyle are risk factors for nonalcoholic fatty liver disease (NAFLD). We investigated whether the genetic risk of NAFLD is modified by physical activity, muscular fitness, and/or adiposity. In up to 242,524 UK Biobank participants without excessive alcohol intake or known liver disease, we examined cross‐sectional interactions and joint associations of physical activity, muscular fitness, body mass index (BMI), and a genetic risk score (GRS) with alanine aminotransferase (ALT) levels and the proxy definition for suspected NAFLD of ALT levels > 30 U/L in women and >40 U/L in men. Genetic predisposition to NAFLD was quantified using a GRS consisting of 68 loci known to be associated with chronically elevated ALT. Physical activity was assessed using accelerometry, and muscular fitness was estimated by measuring handgrip strength. We found that increased physical activity and grip strength modestly attenuate genetic predisposition to elevation in ALT levels, whereas higher BMI markedly amplifies it (all p values < 0.001). Among those with normal weight and high level of physical activity, the odds of suspected NAFLD were 1.6‐fold higher in those with high versus low genetic risk (reference group). In those with high genetic risk, the odds of suspected NAFLD were 12‐fold higher in obese participants with low physical activity versus those with normal weight and high physical activity (odds ratio for NAFLD = 19.2 and 1.6, respectively, vs. reference group). Conclusion: In individuals with high genetic predisposition for NAFLD, maintaining a normal body weight and increased physical activity may reduce the risk of NAFLD.

Abstract P015: Associations Of Physical Activity And Lactation Duration With Cardiometabolic Risk Factors: The Cardia Study

Background: Physical activity (PA) and lactation individually benefit cardiometabolic health. Joint associations of PA and lactation with cardiometabolic risk factors have not been described. Methods: We averaged PA across all attended exams and summed total lactation duration in 1,068 Black and White parous women who attended the Year 30 Coronary Artery Risk Development in Young Adults (CARDIA) examination. Two categories were created for PA (-PA: below median; +PA: ≥median) and lactation duration (-L: &lt;3 months, +L: ≥3months). Participants were assigned to one of four groups based on PA patterns and cumulative lactation duration: -PA/-L, -PA/+L, +PA/-L, +PA/+L (most favorable). Cardiometabolic risk factors measured at Y30 were combined and standardized into a composite cardiometabolic risk score. We used linear regression to evaluate associations of group assignments with individual cardiometabolic risk factors and risk score. Covariates included age, race, study center, parity, education, smoking, medication use, alcohol consumption, baseline body mass index (BMI), and baseline diet quality. Results: Median PA=256 exercise units (IQR: 168-379), and 581 (54%) of participants reported cumulative lactation duration ≥3 months. Of the 1,068 participants, 303 were in the -PA/-L category, 231 in -PA/+L, 184 in +PA/-L, and 350 in +PA/+L. Participants in the +PA/+L category were older, had more years of education, lower BMI, gained less weight during follow-up, and were less likely to be Black versus the -PA/-L category. Mean cardiometabolic risk scores improved across categories and were not significantly different between -PA/+L and +PA/-L: -PA/-L: 0.23±0.04, -PA/+L: 0.08±0.04, +PA/-L: -0.02±0.05, +PA/+L: -0.23±0.03 all p≤0.08. After adjustment, +PA/+L assignment was associated with a lower (better) cardiometabolic risk score (β= -0.15, 95%CI: -0.25, -0.04) with no interactive effect of race, p=0.22. Associations were nonsignificant after accounting for 30-year change in BMI. Conclusions: Attaining above average PA combined with ≥3 months of lactation was associated with the most favorable cardiometabolic risk score in Black and White women. Participants who achieved either one of these behaviors had lower risk scores versus those with neither behavior. Attaining these levels of PA and/or lactation may reduce cardiometabolic risk in parous women due to less weight gain over time.

Prospective associations between joint categories of physical activity and insomnia symptoms with onset of poor mental health in a population-based cohort

BackgroundPhysical inactivity and insomnia symptoms are independently associated with increased risk of depression and anxiety; however, few studies jointly examine these risk factors. This study aimed to prospectively examine the joint association of physical activity (PA) and insomnia symptoms with onset of poor mental health in adults. MethodsParticipants from the 2013 to 2018 annual waves of the Household Income and Labour Dynamics in Australia panel study who had good mental health (Mental Health Inventory-5 >54) in 2013, and who completed at least 1 follow-up survey (2014–2018), were included (n = 10,977). Poor mental health (Mental Health Inventory-5 ≤ 54) was assessed annually. Baseline (2013) PA was classified as high/moderate/low, and insomnia symptoms (i.e., trouble sleeping) were classified as no insomnia symptoms/insomnia symptoms, with 6 mutually exclusive PA-insomnia symptom groups derived. Associations of PA–insomnia symptom groups with onset of poor mental health were examined using discrete-time proportional-hazards logit-hazard models. ResultsThere were 2322 new cases of poor mental health (21.2%). Relative to the high PA/no insomnia symptoms group, there were higher odds (odds ratio and 95% confidence interval (95%CI)) of poor mental health among the high PA/insomnia symptoms (OR = 1.87, 95%CI: 1.57–2.23), moderate PA/insomnia symptoms (OR = 1.93, 95%CI: 1.61–2.31), low PA/insomnia symptoms (OR = 2.33, 95%CI: 1.96–2.78), and low PA/no insomnia symptoms (OR = 1.14, 95%CI: 1.01–1.29) groups. Any level of PA combined with insomnia symptoms was associated with increased odds of poor mental health, with the odds increasing as PA decreased. ConclusionThese findings highlight the potential benefit of interventions targeting both PA and insomnia symptoms for promoting mental health.

Joint Associations of Physical Activity and Body Mass Index with Incident Cardiovascular Diseases in Chinese Adults: A 13-Year Prospective Study in the Kailuan Cohort

Joint Associations of Physical Activity and Body Mass Index with Incident Cardiovascular Diseases in Chinese Adults: A 13-Year Prospective Study in the Kailuan Cohort

Joint Associations of Physical Activity and Insomnia Symptoms with Incident Mood Disorder in a population-based cohort study

Background: When examined as separate risk factors, low physical inactivity and insomnia symptoms are both associated with increased risk of mood disorders including depression, however few studies examine these risk factors jointly. The aim of this study was to examine the joint association of physical activity and insomnia symptoms with the incidence of mood disorder in Australian adults. Methods: Data were drawn from the 2013-2018 waves of the annual Household Income and Labour Dynamics in Australia panel study. In 2013, participants completed a survey assessing mood and anxiety disorder, physical activity, insomnia symptoms, lifestyle behaviours (i.e., diet, sleep duration, smoking, alcohol), reported diagnosis of depression/anxiety, and sociodemographic characteristics. Incident mood disorder was assessed using the MHI-5 and defined as mood disorder (MHI-5 score <54) in 2013 and no mood disorder (MHI-5 score >54) in 2014-2018. Physical activity was assessed using the IPAQ-SF and classified as low, moderate, and high using standard scoring protocols. Insomnia symptoms were assessed using three items assessing poor sleep quality and difficulty initiating and/or maintaining sleep and dichotomised as Insomnia symptoms/ No Insomnia. Participants were then classified into one of six groups representing distinct combinations of physical activity and insomnia symptoms. Only participants with complete data on covariates and exposure variables and who were free of mood disorder in 2013, and who had at least one follow-up survey during 2014-2018 were included in the analysis. A discrete-time proportional-hazards model was estimated using a logit-hazard (i.e., logistic) regression model to examine the association between joint categories of physical activity and insomnia symptoms and incident mood disorder between 2014-2018 adjusted for sociodemographics, lifestyle behaviours and prior/current diagnosis of depression/anxiety. Results: There were 11,023 participants with complete data and no mood disorder in 2013. The incidence of mood disorder in 2014-2018 was 21.1%. Relative to participants classified as High PA/No insomnia symptoms, reporting either High PA/Insomnia (OR = 1.87, 95% CI 1.57, 2.23), Moderate PA/Insomnia (OR = 1.94, 95% CI 1.62, 2.32), or Low PA/Insomnia (OR = 2.33, 95% CI 1.96, 2.77) was significantly associated with increased likelihood of incident mood disorder. Discussion: The combination of any level of physical activity and insomnia symptoms was associated with an increased likelihood of reporting mood disorder during the following five years, and this increased as physical activity decreased. These observations highlight the potential benefit of interventions targeting physical activity and insomnia symptoms to promote good mental health. Conflict of Interest Statement: My co-authors and I acknowledge that we have no conflict of interest of relevance to the submission of this abstract

Independent and joint association of physical activity and sedentary behavior on all-cause mortality.

Backgrounds:Physical activity (PA) and sedentary behavior (SB) have been associated with mortality, while the joint association with mortality is rarely reported among Chinese population. We aimed to examine the independent and joint association of PA and SB with all-cause mortality in southern China.Methods:A cohort of 12,608 China Hypertension Survey participants aged ≥35 years were enrolled in 2013 to 2014, with a follow-up period of 5.4 years. Baseline self-reported PA and SB were collected via the questionnaire. Kaplan–Meier curves (log-rank test) and Cox proportional hazards regression were performed to evaluate the associations of PA and SB on all-cause mortality.Results:A total of 11,744 eligible participants were included in the analysis. Over an average of 5.4 years of follow-up, 796 deaths occurred. The risk of all-cause mortality was lower among participants with high PA than those with low to moderate level (5.2% vs. 8.9%; hazards ratio [HR]: 0.75, 95% confidence interval [CI]: 0.61–0.87). Participants with SB ≥ 6 h had a higher risk of all-cause mortality than those with SB <6 h (7.8% vs. 6.0%; HR: 1.37, 95% CI: 1.17–1.61). Participants with prolonged SB (≥6 h) and inadequate PA (low to moderate) had a higher risk of all-cause mortality compared to those with SB < 6 h and high PA (11.2% vs. 4.9%; HR: 1.67, 95% CI: 1.35–2.06). Even in the participants with high PA, prolonged SB (≥6 h) was still associated with the higher risk of all-cause mortality compared with SB < 6 h (7.0% vs. 4.9%; HR: 1.33, 95% CI: 1.12–1.56).Conclusions:Among Chinese population, PA and SB have a joint association with the risk of all-cause mortality. Participants with inadequate PA and prolonged SB had the highest risk of all-cause mortality compared with others.

Sleep and physical activity in relation to all-cause, cardiovascular disease and cancer mortality risk

ObjectivesAlthough both physical inactivity and poor sleep are deleteriously associated with mortality, the joint effects of these two behaviours remain unknown. This study aimed to investigate the joint association of...

The joint association of physical activity and fine particulate matter exposure with incident dementia in elderly Hong Kong residents.

The evidence for the beneficial effects of physical activity (PA) and potentially detrimental effects of long-term exposure to fine particulate matter (PM2.5) on neurodegeneration diseases is accumulating. However, their joint effects remain unclear. We evaluated joint associations of habitual PA and PM2.5 exposure with incident dementia in a longitudinal elderly cohort in Hong Kong. A total of 57,775 elderly participants (≥65years) without dementia were enrolled during 1998-2001 and followed up till 2011. Their information on PA and other relevant covariates were collected at baseline (1998-2001) by a standard self-administered questionnaire, including PA volumes (high, moderate, low, and inactive) and types (aerobic exercise, traditional Chinese exercise, stretching exercise, walking slowly, and no exercise). Their annual mean PM2.5 exposures at the residential address were estimated using a satellite-based spatiotemporal model. We then adopted the Cox proportional hazards model to examine the joint associations with the incidence of all-cause dementia, Alzheimer's diseases, and vascular dementia on additive and multiplicative scales. During the follow-up period, we identified 1,157 incident cases of dementia, including 642 cases of Alzheimer's disease and 324 cases of vascular dementia. A higher PA level was associated with a lower risk of incident all-cause dementia (hazard ratio (HR) for the high-PA volume was 0.59 (95% CI, 0.47, 0.75), as compared with the inactive-PA), whereas a high level of PM2.5 was related to the higher risk with an HR of 1.15 (95%CI: 1.00, 1.33) compared with the low-level of PM2.5. No clear evidence was observed of interaction between habitual PA (volume and type) and PM2.5 inhalation to incident dementia on either additive or multiplicative scale. Habitual PA and long-term PM2.5 exposure were oppositely related to incident dementia in the Hong Kong aged population. The benefits of PA remain in people irrespective of exposure to air pollution.

Striking the Right Balance: Evidence to Inform Combined Physical Activity and Sedentary Behavior Recommendations.

Crucial evidence gaps regarding: (1)the joint association of physical activity and sedentary time with health outcomes and (2)the benefits of light-intensity physical activity were identified during the development of recommendations for the World Health Organization Guidelines on physical activity and sedentary behavior (SB). The authors present alternative ways to evidence the relationship between health outcomes and time spent in physical activity and SB and examine how this could be translated into a combined recommendation in future guidelines. We used compositional data analysis to quantify the dose-response associations between the balance of time spent in physical activity and SB with all-cause mortality. The authors applied this approach using 2005-2006 National Health and Nutrition Examination Survey accelerometer data. Different combinations of time spent in moderate- to vigorous-intensity physical activity, light-intensity physical activity, and SB are associated with similar all-cause mortality risk level. A balance of more than 2.5 minutes of moderate- to vigorous-intensity physical activity per hour of daily sedentary time is associated with the same magnitude of risk reduction for all-cause mortality as obtained by being physically active according to the current recommendations. This method could be applied to provide evidence for more flexible recommendations in the future with options to act on different behaviors depending on individuals' circumstances and capacity.

Joint association of physical activity and sleep difficulties with the incidence of hypertension in mid-age Australian women

IntroductionLittle is known about the joint effects of physical activity and sleep difficulties on hypertension. The aim of this study was to examine the joint associations of physical activity and sleep difficulties with the incidence of hypertension in mid-aged women. Study DesignProspective cohort study. Main Outcome MeasuresMid-aged participants (n = 5,300) in the Australian Longitudinal Study on Women's Health completed four triennial surveys starting in 2004, when they had a mean age of 55 years. The presence of hypertension, physical activity and the number of sleep difficulties (range 0-4) were reported at each survey. Total MET.min/week of physical activity was assessed, and dichotomised as inactive (<500 MET.min/wk) or active (≥500 MET.min/wk). Joint categories of physical activity and sleep difficulties were created using six mutually exclusive groups. Associations of joint physical activity and sleep difficulty groups with incident hypertension were examined via discrete-time survival analysis using logit-hazard models. ResultsThere were 1,175 cases of incident hypertension (22.2%). Compared with the Active and No Difficulties group, women in the Inactive and 1 Difficulty (Odds Ratio (95% confidence interval) (1.31 (1.06, 1.62)) and Inactive and 2-4 Difficulties (1.44 (1.16, 1.78)) groups were more likely to develop hypertension. Sleep difficulties were not associated with hypertension among active women. ConclusionsMid-aged inactive women with sleep difficulties were more likely to develop hypertension. Physical activity appeared to protect against the increased risk of hypertension in women with sleeping difficulties.

Joint associations of physical activity and body mass index with the risk of established excess body fatness-related cancers among postmenopausal women.

Excess body fatness and physical activity independently influence the risk of several types of cancer. However, few studies have examined whether physical activity mitigates the excess risk associated with higher body mass index (BMI). We examined the individual and joint associations between BMI (kg/m2) and leisure-time moderate-to-vigorous physical activity (MVPA, MET-hours/week) with the risk of three established excess body fatness-related cancers (breast, colon, and endometrial) among 43,795 postmenopausal women in the Cancer Prevention Study II (CPS-II) Nutrition Cohort (1992/1993-2015). Further exclusions for women without an intact uterus resulted in 31,805 women for endometrial cancer analyses. Multivariable Cox proportional hazards regression was used to calculate hazard ratio (HR) and 95% confidence intervals (CIs) with interaction terms to assess multiplicative interaction. The relative excess risk due to interaction (RERI) was calculated to assess additive interaction. BMI and MVPA were individually associated with breast and endometrial cancer risk, but only BMI was associated with colon cancer risk. In joint analyses, increasing levels of MVPA did not lower the risk of these cancers among obese women. For example, compared to the common referent (BMI 18.5- < 25kg/m2, MVPA > 0- < 7.5 MET-hours/week), BMI ≥ 30kg/m2 was associated with a higher risk of breast cancer among women with low MVPA (> 0-< 7.5 MET-hours/week: HR = 1.42, 95% CI: 1.22 - 1.67) and high MVPA (≥ 15 MET-hours/week: HR = 1.53, 95% CI: 1.25 - 1.87; RERI = 0.20, 95% CI: -0.14, 0.54, multiplicative Pinteraction = 0.64). Our results do not support the hypothesis that leisure-time physical activity mitigates the excess risk associated with higher BMI for risk of breast, endometrial, or colon cancer among postmenopausal women.

Independent and Joint Associations of Physical Activity and Dietary Behavior with Older Adults' Lower Limb Strength.

Studies have indicated that sufficient physical activity levels and balanced dietary behavior are independently related to physical function in older populations; however, their joint association with physical function remain unclear. This study examined the independent and combined associations of sufficient physical activity and balanced selection of foods with lower limb strength among 122 older Taiwanese adults living in community (mean age: 69.9 ± 5.0 years). The assessments included accelerometer-measured moderate-to-vigorous physical activity (MVPA) and self-reported selection of foods. Lower limb strength performance was measured using the five times sit-to-stand test. Binary logistic regression analyses were performed to estimate the associations in question before and after adjusting for potential confounders. The results showed that in the adjusted model, lower limb strength had no significant independent association with either meeting the recommended level of MVPA or balanced selection of foods. Compared to older adults who neither met the recommended MVPA level nor reported a balanced selection of foods, those who conformed to both these criteria were more likely to have better lower limb strength (odds ratio = 6.28, 95% confidence interval = 1.36–29.01) after adjusting for covariates. Health promotion initiatives addressing disability prevention for older adults need to consider promoting both MVPA and food selection.

Physical activity, sedentary leisure-time and risk of incident type 2 diabetes: a prospective study of 512 000 Chinese adults

ObjectiveAim to examine the independent and joint associations of physical activity (PA) and sedentary leisure-time (SLT) with risk of diabetes and assess the extent to which these associations were mediated...

Abstract 961: Joint associations of physical activity and body mass index and the risk of excess body fatness-related cancer

Abstract Background: Consistent evidence has linked excess body fatness (EBF), typically measured in large epidemiologic studies using body mass index (BMI), with a higher risk of 13 types of cancer. Whether physical activity mitigates any of the excess risk associated with EBF is unclear—as few studies have examined the joint association between BMI and physical activity. Methods: We examined the joint association of BMI and physical activity on the risk of 12 of the 13 EBF-related cancers (excluding meningioma and including esophagus [adenocarcinoma], gastric cardia, colon and rectum, liver, gallbladder, pancreas, postmenopausal breast, corpus uteri, ovary, kidney [renal cell], thyroid, and multiple myeloma) among 70,658 men and 72,209 postmenopausal women (median age: 63 years) without a history of cancer at study entry in the Cancer Prevention Study II Nutrition Cohort (1992-2013). Multivariable Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for the individual and joint associations between BMI (kg/m2) and recreational physical activity (MET-hours/week) at study entry and first cancer incidence. Results: Between 1992-2013, 3,860 men and 9,001 women were diagnosed with an EBF-related cancer. Compared to normal weight (BMI 18.5-&amp;lt;25 kg/m2), overweight (25-&amp;lt;30 kg/m2) was associated with a modest increased risk of EBF-related cancer (men: HR 1.12; 95% CI: 1.04, 1.21; women: HR 1.13; 95% CI: 1.08, 1.19) and obesity (≥30 kg/m2) with a stronger risk (men: HR 1.48; 95% CI: 1.34, 1.63; women: HR 1.48; 95% CI: 1.40, 1.57). Higher levels of physical activity (&amp;gt;15 vs. &amp;gt;0-&amp;lt;7.5 MET-hrs/wk) were associated with a lower risk for EBF-related cancer among women (HR: 0.90; 95% CI: 0.85-0.95) but less so among men (HR: 0.96; 95% CI: 0.88, 1.04). Among women, there was no evidence of interaction between physical activity and BMI for the risk of EBF-related cancer (P-interaction=0.59); however, there was suggestive evidence that the excess risk associated with overweight was modestly mitigated by the highest level of physical activity (HR: 1.00; 95% CI: 0.91, 1.10). Among men, there was some evidence of an interaction between BMI and physical activity on risk (P-interaction=0.06) with the higher risk associated with overweight limited to those who were inactive (HR: 1.27; 95% CI: 1.08, 1.49). However, risk was higher for obese men irrespective of physical activity level. Conclusion: Our results suggest that higher levels of recreational physical activity may offset a small amount of the increased risk of EBF-related cancer among overweight men and women. However, physical activity does not appear to mitigate the strong effect of obesity (BMI ≥30 kg/m2) on risk of EBF-related cancers, thus reinforcing the importance of maintaining a healthy body weight even if physically active. Citation Format: Maret L. Maliniak, Susan M. Gapstur, Lauren E. McCullough, Erika Rees-Punia, Mia M. Gaudet, Caroline Y. Um, Mark A. Guinter, Elizabeth A. Fallon, Alpa V. Patel. Joint associations of physical activity and body mass index and the risk of excess body fatness-related cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 961.

Fluid and total water intake in a senior mediterranean population at high cardiovascular risk: demographic and lifestyle determinants in the PREDIMED-Plus study.

We aimed to evaluate associations between compliance with recommendations for total water intake (TWI) and total water intake from fluids (TWIF), and some socio-demographic and lifestyle factors of a senior Mediterranean population at high cardiovascular risk. Cross-sectional analysis with data of 1902 participants from the PREDIMED-Plus study. A validated 32-item Spanish fluid-intake questionnaire was used to assess beverage consumption and water intake. Multivariable logistic regression models were used to assess the odds ratio (OR) and the 95% confidence interval (CI) for complying with European Food Safety Agency recommendations for TWI and TWIF according to various socio-demographic and lifestyle factors, and for the joint associations of Mediterranean diet (MedDiet) adherence and moderate-vigorous physical activity (MVPA). The mean total volume of fluid intake in the population studied was 1934 ± 617mL/day. Water was the most frequently consumed beverage. Significant differences between sex were only observed in alcoholic and hot beverage consumption. Compliance with TWIF was associated with being women (OR 3.02; 2.40, 3.80), high adherence to MedDiet (OR 1.07; 1.02, 1.12), and participants who were more engaged in physical activity (PA) (OR 1.07; 1.02, 1.13). Age was inversely associated (OR 0.96; 0.94, 0.98). Similar results for TWI recommendations compliance were observed in relation to being women (OR 5.34; 3.85, 7.42), adherence to MedDiet (OR 1.16; 1.02, 1.31) and PA (OR 1.07; 1.00, 1.15). The joint association of PA and MedDiet, showed that participants with higher adherence to MedDiet and meeting WHO recommendations for MVPA complied better with the TWI recommendations (OR 1.66; 1.19, 2.32). High compliance with recommendations for TWI was associated with being a woman, and a healthy lifestyle characterized by high adherence to the MedDiet and PA.

Association of screen time and physical activity with health-related quality of life in Iranian children and adolescents

BackgroundHealth-related quality of life (HRQoL) is a multidimensional concept with significant effects and children and adolescence; while physical activity (PA) and screen time (ST) have been suggested as its probable predictors. Present study aims to investigate the association of PA, ST and their combination, with HRQoL in a nationally-representative sample of Iranian children and adolescents.MethodsAs for the estimated sample size, 25,000 students aged 6–18 years were selected via multi-stage cluster sampling from 30 provinces of Iran. Sociodemographic data was obtained by using the questionnaire of the World Health Organization-Global school based student health survey (GSHS). Persian Pediatric Quality of Life inventory (PedsQL) and Physical Activity Questionnaire for the pediatric age group (PAQ-A) were applied for evaluating HRQoL and PA, respectively. PA scores 1–1.9 and 2–5 were respectively considered as low and high PA. The average duration of time spent on watching TV and leisure time computer use were considered as ST behaviors. ST of less than 2 h was considered low.ResultsOut of 25,000 invited individuals, 23,043 students (mean age: 12.5) completed the study (response rate: 92.17%). In linear regression models, ST duration had significant inverse association with total QoL (β: − 0.49, p < 0.05). PA showed positive significant associations with HRQoL total score (β: 1.8, p < 0.05). Joint association of PA and ST revealed the strongest association of “high PA-low ST” category with total HRQoL (β: 2.2, p < 0.05); while “high PA-high ST” showed better total HRQoL score (β: 1.3) compared to “low PA-low ST” subgroup.ConclusionBoth PA and ST are significantly and independently associated with HRQoL in Iranian children and adolescents; while the adverse effect of prolonged ST could be diminished by a high PA.