Lack Of Leisure Time Physical Activity Research Articles

Unhealthy Behaviors, Prevention Measures, and Neighborhood Cardiovascular Health: A Machine Learning Approach.

This study identifies and ranks predictors of cardiovascular health at the neighborhood level in the United States. We merged the 500 Cities Data and the 2011-2015 American Community Survey to create a new data set that includes sociodemographic characteristics, health behaviors, prevention measures, and cardiovascular health outcomes for more than 28 000 census tracts in the United States. We used random forest to rank predictors of coronary heart disease and stroke. For coronary heart disease, the top 5 ordered predictors were the prevalence of taking medicine for high blood pressure control, binge drinking, being aged 65 years or older, lack of leisure-time physical activity, and obesity. For stroke, the top 5 ordered predictors were the prevalence of obesity, lack of leisure-time physical activity, taking medicine for high blood pressure, being black, and binge drinking. Machine learning approaches have the potential to inform policy makers on important resource allocation decisions at the neighborhood level.

Gender differences in the pathways from childhood disadvantage to metabolic syndrome in adulthood: An examination of health lifestyles

We investigate whether socioeconomic status (SES) in childhood shapes adult health lifestyles in domains of physical activity (leisure, work, chores) and diet (servings of healthy [i.e., nutrient-dense] vs. unhealthy [energy-dense] foods). Physical activity and food choices vary by gender and are key factors in the development of metabolic syndrome (MetS). Thus, we examined gender differences in the intervening role of these behaviors in linking early-life SES and MetS in adulthood. We used survey data (n = 1054) from two waves of the Midlife in the U.S. Study (MIDUS 1 and 2) and biomarker data collected at MIDUS 2. Results show that individuals who were disadvantaged in early life are more likely to participate in physical activity related to work or chores, but less likely to participate in leisure-time physical activity, the domain most consistently linked with health benefits. Women from low SES families were exceedingly less likely to complete recommended amounts of physical activity through leisure. Men from low SES consumed more servings of unhealthy foods and fewer servings of healthy foods. The observed associations between childhood SES and health lifestyles in adulthood persist even after controlling for adult SES. For men, lack of leisure-time physical activity and unhealthy food consumption largely explained the association between early-life disadvantage and MetS. For women, leisure-time physical activity partially accounted for the association, with the direct effect of childhood SES remaining significant. Evidence that material deprivation in early life compromises metabolic health in adulthood calls for policy attention to improve economic conditions for disadvantaged families with young children where behavioral pathways (including gender differences therein) may be shaped. The findings also underscore the need to develop gender-specific interventions in adulthood.

Abstract MP97: Physical Inactivity is a Strong Risk Factor for Stroke in the Oldest Old Findings From the Northern Manhattan Study

Introduction: The fastest growing segment of the population is those over age 80, in whom there is the highest incidence of stroke. Few clinical trials, however, have targeted this population, and management of risk factors is complicated by higher rates of side effects and polypharmacy. We aimed to characterize whether the risk factors for stroke are different in those age >80 versus <80 in a multi-ethnic prospective cohort study. Methods: The study sample derives from the Northern Manhattan Study (n=3298), a prospective cohort study among an urban dwelling multi-ethnic population. At enrollment risk factors were assessed by self-report, physical examination, and laboratory data. Leisure-time physical activity (LTPA) was assessed by validated questionnaire and categorized as none versus any. Participants are followed annually for incident stroke which is adjudicated by study neurologists after review of all records and imaging. We fit Cox proportional hazard models to calculate hazard ratios (HR) and 95% confidence intervals (95% CI) for the association of cardiovascular disease risk factors (LTPA, reported alcohol use, fasting HDL-C and LDL-C, history of diabetes, hypertension, heart disease, and tobacco use) with risk of stroke. Multi-variable models also included two-way interaction terms between the primary exposures and age (<80 and ≥80) and stratified models are presented if p-interaction < 0.05. Results: The mean age was 69 years and 562 (17%) were age ≥80 years. Physical inactivity was common (41%) and did not differ by age. Subjects were followed for a median of 14 years, and there were 391 total strokes. We found a statistically significant interaction of age ≥80 on the risk of stroke with physical inactivity (p=0.02), diabetes (p=0.04), hypertension (p=0.005), and LDL-C (p=0.03). In stratified models no LTPA versus any (adjusted HR 1.61, 95%CI 1.06-2.43) was associated with an increased risk of stroke among those age ≥80 but not in those younger; LDL-C, hypertension and diabetes were mainly associated with risk of stroke in those below age 80. Conclusion: Lack of leisure-time physical activity is a potentially modifiable stroke risk factor and was more notable than hypertension, diabetes or dyslipidemia among those older than age 80. Improving activity may reduce the risk of stroke in this segment of the population.

Neuromuscular exercise and back counselling for female nursing personnel with recurrent non-specific low back pain: study protocol of a randomised controlled trial (NURSE-RCT)

IntroductionNursing personnel have high risk for incidence of low back pain (LBP) followed by development of chronic pain and disability. Multiple risk factors such as patient handling, night shift work...

Relationship of Sedentary Behavior and Physical Activity to Incident Cardiovascular Disease: Results From the Women's Health Initiative

The aim of this study was to examine the independent and joint associations of sitting time and physical activity with risk of incident cardiovascular disease (CVD). Sedentary behavior is recognized as a distinct construct beyond lack of leisure-time physical activity, but limited data exist on the interrelationship between these 2 components of energy balance. Participants in the prospective Women's Health Initiative Observational Study (n= 71,018), 50 to 79 years of ageand free of CVD at baseline (1993 to 1998), provided information on sedentary behavior, defined as hours of sitting/day, and usual physical activity at baseline and during follow-up through September 2010. First CVD (coronary heart disease or stroke) events were centrally adjudicated. Sitting≥10 h/day compared with≤5 h/day was associated with increased CVD risk (hazard ratio: 1.18, 95% confidence interval: 1.09 to 1.29) in multivariable models including physical activity. Low physical activity was also associated with higher CVD risk (p for trend< 0.001). When women were cross-classified by sitting time and physical activity (p for interaction= 0.94), CVD risk was highest in inactive women (≤1.7 metabolic equivalent task-h/week) who also reported≥10 h/day of sitting. Results were similar for coronary heart disease and stroke when examined separately. Associations between prolonged sitting and risk of CVD were stronger in overweight versus normal weight women and women 70 years of age and older compared with younger women. Prolonged sitting time was associated with increased CVD risk, independent of leisure-time physical activity, in postmenopausal women without a history of CVD. A combination of low physical activity and prolonged sitting augments CVD risk.

Mental Health and Family Functioning as Correlates of a Sedentary Lifestyle Among Low-Income Women with Young Children

The authors in this cross-sectional study examined mental health and family environmental factors related to a sedentary lifestyle, including lack of leisure-time physical activity and high levels of television viewing, among low-income mothers/female guardians of preschool-aged children. A self-administered questionnaire was completed by 131 mothers in 2010. Primary outcome measures included television viewing time (minutes/day) and leisure-time physical activity (<150 versus ≥150 minutes per week). Independent variables included depressive symptoms, perceived stress, and family functioning. Demographic factors (age, marriage, work status, education, number of children in the household, and race/ethnicity) were examined as potential covariates. Participating women watched television on average 186.1 minutes/day (i.e., >3 hours). Additionally, 36% of women engaged in less than the recommended 150-minute leisure-time physical activity per week. Hierarchical multiple regression analyses indicated that greater depressive symptoms (B = 76.4, p < 0.01) and lower family functioning (B = 33.0, p < 0.05) were independently related to greater television viewing when controlling for other variables. No independent factors were identified for lack of leisure-time physical activity when controlling for other covariates. Findings suggest that health promotion efforts to promote an active lifestyle among low-income women with young children should address mental health and family functioning factors, especially depressive symptoms.

Abstract 006: Relationship of Sedentary Behavior and Physical Inactivity to Incident Coronary Heart Disease: Results from the Women's Health Initiative

Background: Sedentary behavior, such as prolonged sitting, is becoming recognized as a distinct construct that may not merely reflect lack of leisure-time physical activity (PA), usually defined as physical inactivity. Our objective was to examine the independent and joint associations of sedentary time and physical inactivity with risk of incident coronary heart disease (CHD) in women. Methods: This study included 84,798 post-menopausal women, aged 50-79 and free of CHD at baseline, participating in the Women's Health Initiative Observational Study. At baseline, participants reported information on sedentary behavior, defined as hours of sitting and lying per day, and usual PA, defined as energy expenditure from recreational activity including walking, mild, moderate and strenuous PA. Participants were followed from the baseline visit through September 2010 for first occurrence of CHD (MI and CHD death). Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for incident CHD according to tertiles of sedentary time (hrs/day) and physical activity (MET-hrs/wk). Results: Sedentary time ≥10 hrs/day was associated with increased CHD risk (HR=1.13, 95% CI 1.04,1.23) in age-adjusted models, but was non-significant in multivariable-adjusted models (HR=1.08, 95% CI 0.99,1.17). In multivariable-adjusted models, the HR of CHD comparing moderate (5.1 - 16.25 MET-hrs/wk) and low (≤ 5 MET-hrs/wk) levels of PA to high (&gt;16.25 MET-hrs/wk) levels were 1.10 (95%CI 1.01,1.21) and 1.21 (95%CI 1.11,1.32), respectively (P for trend &lt;.0001). When we cross-classified women by sedentary time and PA (P for interaction = 0.91), CHD risk was significantly increased only in women with low PA regardless of their sedentary behavior, with the greatest risk seen in women reporting low PA and ≥10 hrs/day of sedentary time. Conclusion: Physical inactivity is associated with increased CHD risk in a dose-response manner, whereas sedentary behavior was only modestly associated with CHD risk in this analysis. Physical Activity (MET-hours/week) Sedentary Time (hours/day) High (&gt; 16.25) Moderate (5.1 - 16.25) Low (≤ 5) ≤6 1.00 (Referent) 1.12 (0.96, 1.30) 1.17 (1.01, 1.36) 6.1-9.9 0.96 (0.82, 1.13) 1.09 (0.94, 1.27) 1.18 (1.02, 1.38) ≥10 1.08 (0.92, 1.27) 1.14 (0.99, 1.32) 1.32(1.15, 1.51) The multivariable model includes age, race, education, income, marital status, smoking, family history of MI, depression, alcohol intake, and history of diabetes, hypertension, or hypercholesterolemia

Non-leisure time physical activity is an independent predictor of longevity for a Taiwanese elderly population: an eight-year follow-up study

BackgroundThe aim of this study is to determine the relationship between leisure time physical activity (LTPA) and non-leisure time physical activity (NLTPA) on mortality among the elderly in Taiwan.MethodsThis is a prospective observational cohort study. We analyzed the mortality data from a cohort of 876 non-institutionalized community-dwelling men and women aged 65 years or over, who were recruited by stratified clustering random sampling from Tainan city and participated in the 1996 Elderly Medication Survey. Information about activities and other variables were collected by structured interviews at baseline in the participants' home. The Cox proportional hazards model and crude death rate were applied to estimate mortality risk.ResultsAmong the 876 participants, 312 died during the follow-up period (1996-2004). In the unadjusted Cox regression model, subjects aged over 75, having difficulty in carrying out activities of daily living (ADLs), a BMI less than 18.5, a history of diabetes mellitus or stroke, without LTPA or being inactive in NLTPA, were found to have a higher risk of eight-year mortality. With the adjustment for age, gender, education level, habitual smoking and drinking, living status, BMI and medical history, the mortality was found to be higher among the sedentary subjects, either defined by lack of LTPA or NLTPA, with the hazard ratio of 1.27 (95% confidence interval [CI] = 0.97-1.66) and 1.45 (95% CI = 1.07-1.97), respectively. Furthermore, when both LTPA and NLTPA were put into the model simultaneously, NLTPA (HR = 1.40; 95% CI = 1.03-1.91) but not LTPA (HR = 1.21, 95% CI = 0.92-1.59) significantly predicted mortality during eight-year follow-up. In addition, subjects who were actively engaged in NLTPA had a lower mortality risk especially in subjects without performing LTPA.ConclusionsNLTPA is an independent predictor of longevity among older people in Taiwan. A physically active lifestyle, especially engaged in NLTPA, is associated with lower mortality risk in the elderly population. We thus suggest that encouraging older people to keep on engaging in customary NLTPA is good for their health.

Lack of Leisure-Time Physical Activity in Non-Obese Japanese Men with Components of Metabolic Syndrome

A focus exclusively on waist circumference, the main component used in the diagnosis of metabolic syndrome (MetS), may lead to ignoring non-obese individuals with other MetS components, including high levels of blood pressure, fasting blood glucose, and triglycerides and low levels of high-density lipoprotein. This study investigated lifestyles and eating behaviors among non-obese individuals with components of MetS. Of the 918 Japanese male workers, 151 subjects (16.4%) had a waist circumference < 85 cm with more than one MetS component. This non-obese high-risk group for MetS gained weight in adulthood, consume alcohol, and engage in less leisure-time physical activity compared to 317 subjects (34.5%) with a waist circumference < 85 cm and without MetS components (p < 0.05). The remaining 450 subjects (49%) were obese with a waist circumference ≥ 85, including 93 men with MetS. A lack of leisure-time physical activity was associated with the non-obese high-risk group for MetS [odds ratio 1.59, 95% confidence interval 1.02 - 2.49] compared to the 317 non-obese men without MetS (reference group). Such a difference in physical activity was not found between the 450 obese subjects and the reference group. Instead, eating behaviors, such as eating rapidly, preference for fatty foods, and eating out for dinner, were significantly associated with MetS. Thus, men with smaller waist circumferences and any MetS component should be carefully monitored for physical activity to prevent further development of MetS, while men with larger waist circumferences including MetS need to be monitored for unfavorable eating behaviors.

Incidence of and risk factors for type-2 diabetes in a general population: The Tromsø Study

To determine the gender-specific incidence and risk factors of type-2 diabetes mellitus (T2DM) in a general population. The study is based on 12,431 men and 13,737 women aged 25-98 years, attending the Tromsø Study in 1994 and followed through 2005, who did not have diabetes when entering the study. Sex-specific hazard ratios were estimated from Cox proportional hazard models. A total of 522 cases of T2DM were registered, 308 among men and 214 among women. The age-standardised incidence rate was higher in men than in women, 2.6 (95% CI 2.32-2.90) and 1.6(95% CI 1.40-1.83) per 1000 person-years, respectively. In multivariate survival analysis, age, body mass index (BMI),triglycerides, high-density lipoprotein (HDL) cholesterol, hypertension, family history of diabetes, low education and smoking were independent predictors of T2DM in both genders (p<0.05). Total cholesterol and lack of leisure-time physical activity were independent predictors in men only. We found an interaction between HDL cholesterol and triglyceride levels(p<0.001) and between triglyceride levels and a positive family history of diabetes (p=.04). These interactions were independent of BMI. A positive family history combined with triglycerides in the highest tertile and BMI >25 kg/m(2) conveyed a 10-year risk of T2DM of 10% (95% CI 8-12%) vs. 0.2% (95% CI 0.08-0.31%) for the lowest risk group. A family history of diabetes, elevated BMI, and high triglyceride levels identifies independent of cardiovascular risk factors, a group with especially high risk of T2DM. [corrected]

Impact of risk factors for non-fatal acute myocardial infarction

The impact of risk factors for acute myocardial infarction (AMI) strongly differs across populations and most studies do not consider age as an effect modifier. This study aims to estimate the population attributable fractions (PAFs) of established risk factors for non-fatal AMI, considering age stratification, within a population-based case-control study of Portuguese men. Cases were male patients consecutively admitted with an incident AMI, during 1999-2003 (n = 638) and controls were a representative sample of the non-institutionalized Porto, Portugal inhabitants (n = 851). PAFs were derived by the equation: PAF = 1 - Sigma (rho/R), in which rho is the proportion of cases in each exposure stratum and R is the adjusted odds ratio. PAFs were obtained for the individual effect of each factor and for combinations of them, after allowance for confounding. High waist-to-hip ratio (> 0.90), smoking and lower education levels (0-4 years) had the highest PAFs among men aged < or = 45 years: 81.2% (95% CI: 71.2-88.2), 63.5% (95% CI: 42.0-80.6) and 53.8% (95% CI: 40.9-66.2), respectively. For the oldest men, high waist-to-hip ratio (PAF = 88.7%, 95% CI: 77.6-94.7) and lack of leisure-time physical activity (PAF = 44.8%, 95% CI: 32.0-58.2) were the risk factors with the highest impact. Lifestyles explained 77.2% (95% CI: 53.4-90.9) of young myocardial infarction cases and 77.6% (95% CI: 65.3-86.4) of the cases aged > 45 years. Preventive targeted interventions to decrease the prevalence of such modifiable risk factors would likely reduce morbidity and mortality of cardiovascular events and related conditions.

Occupation, Hours Worked, Caregiving, and Leisure Time Physical Activity

Many studies have found that caregivers tend to neglect their own health care needs (Acton, 2001; Castro, King, Bacak, Housemann, Gardiner, & Brownson, 2003; Janevic & Connell, 2001). This neglect comes in many forms, but one of considerable interest is neglect of leisure time physical activity (LTPA) and exercise. Caregivers who do not exercise regularly miss out on many well documented benefits of regular physical exercise including improved overall health, decreases in blood pressure, improvements in lipid profile, weight control, helps in diabetes control, reduction of stress, promotion of relaxation, as well as a number of positive psychological effects.It is essential that caregivers make time to provide care for themselves, including sufficient LTPA. The entire experience of caregiving can be undermined when the caregiver does not take sufficient care of themselves. Compromised caregiver health has been linked to potentially harmful behaviors by caregivers, including screaming, yelling, insulting, swearing, threatening to send to a nursing home and withholding food (Beach, Schulz, Williamson, Miller, Weiner, & Lance, 2005). Karlin (2004) concluded that lack of LTPA or exercise during care-giving periods predicted higher levels of caregiver burden. Alternatively, Rabinowitz, Cardenas, Mausback, Gray and Ambler (2003) found that overall burden was predictive of poor health behaviors for caregivers. Exercise programs directed to caregivers have shown success in reducing sense of caregiver burden (Boise, Congleton & Schmall, 2000; Castro, Wilcox, O'Sullivan, Baumann, & King, 2002).The exploration of the barriers to regular LTPA for caregivers has revealed regional variation (Wilcox, Castro, King, Housemann, & Brownson, 2006) in that rural caregivers are more sedentary than their urban counterparts. Rural women cited care-giving duties as their top barrier to LTPA as compared to lack of time for the urban women. Variation has also been reported due to ethnicity, age, and education level (King, Castro, Wilcox, Eyler, Sallis, & Brownson, 2006). For all ethnic subgroups, care-giving duties ranked among the top four most frequently reported barriers to LTPA. The exploration of why some caregivers cannot engage in regular LTPA has incorporated the fact that caregiving and LTPA may be mediated by other factors. Caregivers often have multiple competing demands for their time including providing care to their own children as well as employment (Burton & Turrell, 2000).Occupational Status and LTPAOccupational status has an important bearing on LTPA pursuits. Studies have demonstrated that blue collar employees report lower levels of LTPA (Niknian, Linnan, Lasater, & Carleton, 1991; Oldridge, 1992). As a direct result, demographic studies have shown that blue collar employees experience higher mortality and morbidity rates (Bennett, 1996). A study by Burton and Turrell (2000) investigated the relationship between occupation, hours worked and LTPA. The authors reported that individuals in blue-collar occupations were approximately 50% more likely to be classified as insufficiently active. However, this occupation variability in leisure-time physical activity was not explained by hours worked. The authors suggested that identification of factors contributing to occupational variability in leisure time physical activity may add to our understanding of why population subgroups differ in their health risk profiles. One such factor proposed was that individuals may be constrained by other time demands, such as caregiving commitments.Occupational Status, Caregiving, and LTPAAlthough the literature presents a compelling case that caregiving interferes with LTPA and that individuals employed in particular occupation categories exercise more than others, there has yet to be an examination of the influence of both occupation and caregiving responsibility on LTPA. …