Leisure-time Physical Activity Groups Research Articles

Association between glyphosate exposure and osteoarthritis in US adults: Especially in people who are obese and inactive in leisure time physical activity

ObjectiveLittle has been known on the effect of chronic glyphosate exposure on osteoarthritis (OA). The aim of this study was to investigate the association between glyphosate exposure and OA and to further investigate the different moderating effects of leisure time physical activity (LTPA) and body mass index (BMI) types on the association between glyphosate exposure and OA. MethodsCross-sectional data from 2540 participants in the 2015–2018 National Health and Nutrition Examination Survey (NHANES) were used to explore the association between glyphosate exposure and OA. Multivariate logistic regression models and restricted cubic spline models were used to investigate the association between glyphosate exposure and OA, and further analyses were conducted to determine the association between glyphosate exposure and OA under different LTPA and BMI types. ResultsOf the 2540 participants, 346 had OA. Participants with the highest glyphosate concentration (Q4) had a higher incidence of OA compared to participants with the lowest glyphosate concentration (Q1) (OR, 1.88; 95 % confidence interval [CI]: 1.13, 3.13), there was no nonlinear association between glyphosate and OA (non-linear P = 0.343). In the no LTPA group, glyphosate concentration in the Q4 group was correlated with OA (OR, 2.65; 95%CI: 1.27, 5.51). In the obese group, glyphosate concentration in the Q4 group was correlated with OA (OR, 2.74; 95 % CI: 1.48, 5.07). Among people with high BMI and inactive in LTPA, glyphosate concentrations in Q4 were associated with OA (OR, 2.19; 95 % CI: 1.07, 4.48). ConclusionsGlyphosate is associated with OA odd, and physical activity and moderate weight loss can mitigate this association to some degree. This study provides a scientific basis for rational prevention of OA by regulation of LTPA and BMI under glyphosate exposure.

Role of physical activity in the relationship between recovery from work and insomnia among early childhood education and care professionals: a cross-sectional study

ObjectivesThis study aimed to investigate the association between recovery from work and insomnia and the role of objectively measured leisure-time physical activity and occupational physical activity in this association.DesignCross-sectional.Setting and...

Domain-specific Physical Activity and the Risk of All-cause Mortality among Middle-aged and Older Adults in Taiwan: A Prospective Cohort Study.

The impact of meeting leisure time physical activity (LTPA) recommendations and household physical activity (HPA) on all-cause mortality in the Taiwanese population is unclear. We aimed to investigate the relationship between sufficient LTPA and all-cause mortality in middle-aged and older Taiwanese adults and the role of HPA in those with insufficient LTPA. This nationwide prospective cohort study included 4,960 participants aged ≥50 years from the Taiwan Longitudinal Study in Aging (TLSA) survey. Physical activity patterns were assessed in 2003 and then followed up until 2015 for mortality through the National Death Registration Record. Cox proportional hazards regression was conducted to evaluate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality. Of the 4,960 participants, 1712 died of all-cause mortality. Compared to those who had insufficient LTPA, participants who engaged in sufficient LTPA showed a significantly lower risk of all-cause mortality (HR=0.84, 95% CI, 0.73-0.97). For those with insufficient LTPA, HPA also had a significantly reduced risk of all-cause mortality (HR=0.85, 95% CI, 0.75-0.96) among general population. Similar associations were observed in subsequent sensitivity analyses. The subgroup analysis showed that the relationship between HPA and reduced mortality risk was only found in the women with insufficient LTPA group. This study confirmed that sufficient LTPA is associated with a lower risk of all-cause mortality. If sufficient LTPA cannot be performed, additional HPA is related to lower mortality.

Leisure time and occupational physical activity, overall and cardiovascular mortality: a 24-year follow-up in the OPERA study

Background In earlier studies, the health benefits of physical activity have only been related to leisure time physical activity (LTPA). High occupational physical activity (OPA) might even be harmful. The current physical activity recommendations do not separate the OPA and LTPA. We investigated the effect of LTPA and OPA on cardiovascular morbidity and mortality during long-term follow-up. We also examined how heavy work affects the benefits of leisure time exercise. Material and methods The study was part of the OPERA study and the baseline examinations were conducted between the years 1991 and 1993. The Follow-up of events continued until the end of the year 2020. Study subjects (n = 1044) were divided into four groups according to their LTPA (“no exercise”, “irregular”, “regular” and “heavy regular”) and into three groups according to their OPA (“no activity”, “mild” and “heavy”). The amount of exercise was self-reported and the exercise status was defined at the beginning of the study. Study subjects were followed up for their overall mortality (26 years), fatal and non-fatal CVD events (24 and 20 years) and heart failure (20 years). The survival analysis was performed using Kaplan–Meier curves and Cox-proportional hazard models. Results “Heavy” OPA group subjects belonging to the “irregular” (less than 1–2 times 30 min exercise per week) LTPA group experienced the lowest overall mortality compared to other LTPA groups. Also, overall mortality was increased in the “mild” (p = 0.002) and CVD mortality in the” heavy” (p = 0.005) OPA group compared to “no activity”. The incidence of heart failure was increased in the “no exercise” LTPA compared to the “heavy regular” (p = 0.015) group. Conclusions Study subjects who were in physically demanding occupations (heavy OPA) seemed to benefit from less LTPA than WHO currently recommends. Thus we suggest targeting different LTPA recommendations to different OPA groups.

Thirteen-Year Associations of Occupational and Leisure-Time Physical Activity with Cardiorespiratory Fitness in CARDIA.

Differential effects on fitness are hypothesized to contribute to the opposing health effects of leisure-time physical activity (LTPA) and occupational physical activity (OPA). As such, this study examined cross-sectional and longitudinal associations of fitness with LTPA and OPA. This study examined fitness associations with LTPA and OPA across 13 yr in the Coronary Artery Risk Development in Young Adults study (years 7 (baseline), 10, 15, and 20 (follow-up) examinations). Fitness was measured at baseline and follow-up via symptom-limited maximal graded exercise test (GXT) duration (in seconds), whereas LTPA and OPA were self-reported during each examination. Baseline and follow-up cross-sectional associations of LTPA (low, medium, high) and OPA (0, 1-6, and ≥6 months with OPA) with fitness were examined using linear regression. Longitudinal linear regression examined associations between 13-yr LTPA (low, medium, or high) and OPA (no, decreasing, or increasing) trajectories with fitness at follow-up, adjusted for baseline values. All models adjusted for center, sex, race, age, education, smoking history, alcohol intake, resting blood pressure, diabetes status, and body mass index. Stratified analyses examined associations by sex (female/male), race (Black/White), and LTPA groups. Compared with low, medium, and high LTPA were positively associated with fitness in all analyses ( P < 0.001). Reporting 1-6 or ≥6 months with OPA was negatively associated with fitness in cross-sectional follow-up models ( β = -15.6 and -15.4, respectively; P ≤ 0.01). Longitudinally, those with increasing OPA had lower follow-up fitness compared with no OPA ( β = -16.41, P < 0.01). Negative associations of OPA with fitness were not meaningfully different across sex and race groups. Significant LTPA-OPA interactions were observed ( P < 001). Physical activity research and public health promotion should consider domain-specific associations on cardiovascular health.

Leisure-time physical activity, desire to increase physical activity, and mortality: A population-based prospective cohort study

The aim was to investigate associations between leisure-time physical activity (LTPA) and mortality, and associations between desire to increase LTPA and mortality within the low LTPA group. A public health survey questionnaire was sent in 2008 to a stratified random sample of the population aged 18–80 in southernmost Sweden, yielding a 54.1% response rate. Baseline 2008 survey data with 25,464 respondents was linked to cause of death register data to create a prospective cohort with 8.3-year follow-up. Associations between LTPA, desire to increase LTPA and mortality were analyzed in logistic regression models. An 18.4% proportion performed regular exercise (at least 90 min/week, leading to sweating), 23.2% moderate regular exercise (once or twice a week at least 30 min/occasion, leading to sweating), 44.3% moderate exercise (more than two hours walking or equivalent activity/week) and 14.1% reported low LTPA (less than two hours walking or equivalent activity/week). These four LTPA groups were significantly associated with covariates included in the multiple analyses. The results showed significantly higher all-cause, cardiovascular (CVD), cancer and other cause mortality for the low LTPA group but not for the moderate regular exercise and moderate exercise groups compared to the regular exercise group. Both the “Yes, but I need support” and the “No” fractions within the low LTPA group had significantly increased ORs of all-cause mortality compared to the “Yes, and I can do it myself” reference, while no significant associations were observed for CVD mortality. Physical activity promotion is particularly warranted in the low LTPA group.

Positive impacts of leisure-time physical activity on cardiorespiratory fitness, co-morbidity level, cardiovascular health and quality of life among midlife adults: a cross-sectional study of a Nigerian population

BackgroundRegular physical activity (PA) improves general health and quality of life (QoL) of the general population. It is however not known if leisure-time PA (LTPA) behaviour will reduce co-morbidity and adiposity, and improve cardiorespiratory fitness and QoL in midlife men. This study explored the impacts of regular LTPA behaviour on co-morbidity, adiposity, cardiorespiratory fitness and QoL among male midlife sports club members in a Nigerian population.MethodsThis cross-sectional study involved 174 age-matched male midlife adults: 87 engaging in LTPA (LTPA group) and 87 not engaging in LTPA (non-LTPA group). Information on age, body mass index (BMI), waist circumference (WC), maximal oxygen uptake (VO2max), resting heart rate (RHR), QoL and co-morbidity level was collected using standardized procedures. Data were summarized using mean and standard deviation, and explored using frequency and proportion. Independent t-test, Chi Square and Mann–Whitney U test were employed to determine the impacts of LTPA at 0.05 significance level.ResultsThe LTPA group had lower co-morbidity score (p = 0.05) and RHR (p = 0.004), and higher QoL (p = 0.01) and VO2max (p = 0.003) than non-LTPA group. While heart disease (χ2 = 10.99; p = 0.01) and hypertension (χ2 = 15.24; p = 0.004) severity levels were associated with LTPA behaviour, hypertension (p = 0.01) was the only co-morbid condition that had a significantly lower score in the LTPA group than in the non-LTPA group.ConclusionsRegular LTPA improves cardiovascular health, physical work capacity and QoL in the sample of Nigerian mid-life men. Regular LTPA behaviour is recommended for cardiovascular health promotion, and improved physical work capacity and life satisfaction in midlife men.

Academic Helplessness and Life Satisfaction in Korean Adolescents: The Moderated Mediation Effects of Leisure Time Physical Activity.

This study examined whether depression mediates a relationship between academic helplessness and life satisfaction and whether the mediating effect differs depending on participation in leisure time physical activity (LTPA) from a sample of 2384 middle school students in South Korea. Identifying these factors could help in developing intervention strategies for promoting life satisfaction. Structural equation modeling analyses were employed to understand how various factors influence adolescents' life satisfaction. First, the effect of academic helplessness on life satisfaction was mediated by depression. Second, the mediating effect of depression was moderated according to participation in LTPA: the size of the negative mediating effect of depression on the relationship between academic helplessness and life satisfaction was reduced in the LTPA group compared to the non-LTPA group. The current findings suggest that encouraging engagement in physical activity may be a crucial vehicle for affecting academic helplessness, depression, and life satisfaction among early adolescents. Implications and future directions are discussed.

Association between spinal disorders and different domains of physical activity among young adult men.

BackgroundThere is limited evidence of how physical activity (PA) associates with low back pain (LBP) and neck pain (NP). Particularly, the association between occupational or commuting PA and LBP/NP is unclear. The aim of the present cross-sectional study was to investigate the association between spinal disorders and different physical activity domains in young and healthy adult men.MethodsSelf-reported leisure time, occupational and commuting PA, as well as LBP and NP, were studied using questionnaires among young Finnish males (n = 1,630). Logistic regression analysis was used to study the associations of PA domains, physical fitness, and spinal disorders. Regression models were adjusted for age, education, smoking, waist circumference, and the other PA domains.ResultsThere was a positive association between moderate leisure-time PA and both LBP (OR: 1.51, 95% CI: 1.18–1.95) and NP (OR: 1.29, 95% CI: 1.00–1.66) compared to low PA. Furthermore, moderate (OR: 1.31, 95% CI: 1.00–1.71) and high (OR: 1.53, 95% CI: 1.15–2.02) leisure time PA groups had a higher likelihood of lumbago. Moderate (OR: 0.67, 95% CI: 0.51–0.90) and high (OR: 0.68, 95% CI: 0.48–0.95) occupational PA groups had lower likelihood for radiating LBP, while high occupational PA (OR: 0.72, 95% CI: 0.52–0.99) had lower likelihood for lumbago.ConclusionsThe associations between physical activity and LBP or NP seem to vary between different domains of physical activity among young healthy men. Commuting and occupation-related PA appear not to be harmfully associated with LPB or NP, whereas moderate-level leisure time PA may be associated with increased LBP and NP, and the respective high level may be associated with an increase in the prevalence of lumbago.

Sleep, physical activity, sedentary behavior, and risk of incident dementia: a prospective cohort study of 431,924 UK Biobank participants.

Although sleep, physical activity and sedentary behavior have been found to be associated with dementia risk, findings are inconsistent and their joint relationship remains unclear. This study aimed to investigate independent and joint associations of these three modifiable behaviors with dementia risks. A total of 431,924 participants (median follow-up 9.0 years) without dementia from UK Biobank were included. Multiple Cox regressions were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Models fitted with restricted cubic spline were conducted to test for linear and nonlinear shapes of each association. Sleep duration, leisure-time physical activity (LTPA), and screen-based sedentary behavior individually associated with dementia risks in different non-linear patterns. Sleep duration associated with dementia in a U-shape with a nadir at 7 h/day. LTPA revealed a curvilinear relationship with dementia in diminishing tendency, while sedentary behavior revealed a J-shaped relationship. The dementia risk was 17% lower in the high LTPA group (HR[95%CI]: 0.83[0.76-0.91]) and 22% higher in the high sedentary behavior group (1.22[1.10-1.35]) compared to the corresponding low-level group, respectively. A combination of seven-hour/day sleep, moderate-to-high LTPA, and low-to-moderate sedentary behavior showed the lowest dementia risk (0.59[0.50-0.69]) compared to the referent group (longer or shorter sleep/low LTPA/high sedentary behavior). Notably, each behavior was non-linearly associated with brain structures in a pattern similar to its association with dementia, suggesting they may affect dementia risk by affecting brain structures. Our findings highlight the potential to change these three daily behaviors individually and simultaneously to reduce the risk of dementia.

Role of Physical Activity in Lowering Risk of End-Stage Renal Disease

ObjectiveTo investigate the association between the amount and intensity of leisure-time physical activity (LTPA) and the risk of end-stage renal disease (ESRD). MethodsThe study examined a cohort of 543,667 participants aged 20 years and older who participated in a health screening program from January 1, 1996, through December 31, 2017. We identified 2520 individuals undergoing dialysis or who had a kidney transplant by linking participants’ encrypted personal identification with the registry for ESRD with a median follow-up of 13 years. We classified participants into 5 categories measured by metabolic equivalent of tasks. Within each category, we analyzed the effect of moderate- and vigorous-intensity LTPA in reducing risk of ESRD. We used a Cox proportional hazards model to calculate hazard ratios (HRs). ResultsWe observed a dose-response relationship between LTPA and the risk of ESRD. The fully active group had a 12% lower hazard of ESRD compared with the no reported LTPA group (HR, 0.88; 95% CI, 0.80 to 0.98) adjusting for covariates including baseline estimated glomerular filtration rate and proteinuria. Within the same category of LTPA, vigorous-intensity exercise carried a 35% lower HR for ESRD compared with moderate-intensity exercise (HR, 0.65; 95% CI, 0.52 to 0.81). The effect was observed stronger among men, younger participants, and participants with diabetes or hyperlipidemia. ConclusionSustained LTPA (≥ 150 minutes per week), particularly with vigorous intensity, significantly lowered the ESRD risk, even among individuals with comorbidities such as diabetes or hyperlipidemia. This finding suggested that patients with no reported LTPA with cardiovascular risks should engage in more LTPA to lower their risk of ESRD.

Relationship between physical activity, lean body mass, and bone mass in the Mexican adult population.

To evaluate the effect of different kinds of leisure-time physical activity (LTPA) on bone mass values and its association with lean mass (LM) in the whole body (wb) and limbs of a large sample of Mexican men and premenopausal (pre-MP) women. We conducted a cross-sectional analysis of data from the Health Workers Cohort Study. Bone mineral content (BMC, kg), bone area (cm2), and LM (kg) were measured with DXA. The LTPA level and the "sedentary" condition were determined using a validated questionnaire adapted for the Mexican population. One-way ANOVA tests evaluated the differences in weight, height, body mass index, and wb, lower limb (ll) and upper limb (ul) BMC and LM between the active (those who engaged in LTPA) and sedentary group. Relationships between BMC and LM values were analyzed. Slopes of the curves and Z scores of LTPA groups with respect to the sedentary group were compared. In men, both wb-BMC and ll-BMC were significantly higher in the groups performing basketball, football, tennis, weightlifting, and running, and all wb-LM, ll-LM, and ul-LM were higher in running, weightlifting, football, and basketball groups with respect to the sedentary group. Both the Z scores and the slopes of BMC-vs-LM relationships were higher than the controls, but only in the ll of male basketball and football players. Our findings demonstrate that some types of LTPA with relatively high/medium impact on bones, such as football, basketball, tennis, and weightlifting, improve both BMC and LM compared to sedentary individuals. Finally, this relationship is stronger for the bones found in the legs and it seems that women are less sensitive to this effect, possibly due to hormonal, dietary, and pharmacological reasons.

Performance of the American Heart Association/American College of Cardiology Pooled Cohort Equations to Estimate Atherosclerotic Cardiovascular Disease Risk by Self-reported Physical Activity Levels

The American Heart Association/American College of Cardiology pooled cohort equations (PCEs) are used for predicting 10-year atherosclerotic cardiovascular disease (ASCVD) risk. Pooled cohort equation risk prediction capabilities across self-reported leisure-time physical activity (LTPA) levels and the change in model performance with addition of LTPA to the PCE are unclear. To evaluate PCE risk prediction performance across self-reported LTPA levels and the change in model performance by adding LTPA to the existing PCE model. Individual-level pooling of data from 3 longitudinal cohort studies-Atherosclerosis Risk in Communities, Multi-Ethnic Study of Atherosclerosis, and Cardiovascular Health Study-was performed. A total of 18 824 participants were stratified into 4 groups based on self-reported LTPA levels: inactive (0 metabolic equivalent of task [MET]-min/wk), less than guideline-recommended (<500 MET-min/wk), guideline-recommended (500-1000 MET-min/week), and greater than guideline-recommended (>1000 MET-min/wk). Pooled cohort equation risk discrimination was studied using the C statistic and reclassification capabilities were studied using the Greenwood Nam-D'Agostino χ2 goodness-of-fit test. Change in risk discrimination and reclassification on adding LTPA to PCEs was evaluated using change in C statistic, integrated discrimination index, and categorical net reclassification index. Adjudicated ASCVD events during 10-year follow-up. Among 18 824 participants studied, 10 302 were women (54.7%); mean (SD) age was 57.6 (8.2) years. A total of 5868 participants (31.2%) were inactive, 3849 (20.4%) had less than guideline-recommended LTPA, 3372 (17.9%) had guideline-recommended LTPA, and 5735 (30.5%) had greater than guideline-recommended LTPA level. Higher LTPA levels were associated with a lower risk of ASCVD after adjustment for risk factors (hazard ratio [HR] per 1-SD higher LTPA, 0.91; 95% CI, 0.86-0.96). Across LTPA groups, PCE risk discrimination (C statistic, 0.76-0.78) and risk calibration (all χ2 P > .10) was similar. Addition of LTPA to the PCE model resulted in no significant change in the C statistic (0.0005; 95% CI, -0.0004 to 0.0015; P = .28) and categorical net reclassification index (-0.003; 95% CI, -0.010 to 0.010; P = .95), but a minimal improvement in the integrated discrimination index (0.0008; 95% CI, 0.0002-0.0013; P = .005) was observed. Similar results were noted when cohort-specific coefficients were used for creating the baseline model. Higher self-reported LTPA levels appear to be associated with lower ASCVD risk and increasing LTPA promotes cardiovascular wellness. These findings suggest the American Heart Association/American College of Cardiology PCEs are accurate at estimating the probability of 10-year ASCVD risk regardless of LTPA level. The addition of self-reported LTPA to PCEs does not appear to be associated with improvement in risk prediction model performance.

Examining The Perceived Barriers To Physical Activity Among Older Adults: Moderating Effects Of Body Mass Index

Lack of physical activity (PA) is a major public health concern, especially for older people. However, data on possible factors limiting older adults’ engagement in PA are still under-investigated. PURPOSE: The purpose of this study is twofold: 1) to examine the association of perceived PA barriers with leisure-time PA (LTPA) in a sample of older adults; and 2) to explore the possible moderating effect of body mass index (BMI). METHODS: 296 older adults aged ≥60 years old took part in a cross-sectional survey. LTPA was measured by the International Physical Activity Questionnaire and participants were categorized into the three groups, no-LTPA group for individual who did not report LTPA; and below/upper 50th percentile of total LTPA MET values for low- and high-LTPA groups, respectively. Barriers to being active questionnaire (BBAQ) was used to assess perceived PA barriers in a binary manner (i.e., no barrier/at least 1 barrier) for each of the seven domains (i.e., time, social, energy, will, injury, skill, and resources). BMI (kg/m2) was calculated by self-reported height and weight and used to create the three BMI groups (BMI <25, 25 -29.99, and ≥30). Using a no-LTPA group as a referent, a multinomial logistic regression model predicting the likelihoods of being low- and high LTPA groups was established after adjusting for study covariates, followed by stratified analyses by BMI groups. RESULTS: In general, “lack of will” (49.66%) was the most frequently cited PA barrier followed by “social influence” (38.51%) and “fear of injury” (36.49%). In the fully adjusted multinomial logistic regression model, greater perceived barrier in “social influence” was associated with lower odds of reporting high-LTPA (odds ratio (OR) = 0.41). In the follow-up stratified analyses demonstrated that PA barriers differently affect LTPA levels by BMI groups. Among individuals with BMI between 25 and 29.99, “lack of time” (OR = 0.11) was the significant predictor of LTPA level. Whereas, “fear of injury” (OR = 0.11) and “lack of energy” (OR = 0.18) were the significant factors associated with LTPA among those with BMI≥30. CONCLUSIONS: The present study provides relevant data on barriers to LTPA for older adults. Promotion and intervention strategies should consider the exposed barriers of older adults in order to reduce their obstacles to PA.

Associations Between Leisure-Time Sedentary Behaviors with Unhealthy Dietary Behaviors and Leisure-Time Physical Activity Among Chinese Adults: A Cross-Sectional Study

Abstract Objectives Evidence that sedentary behaviors were correlated with unhealthy diet and physical activity were mostly among children and adolescents, but still limited for adults. The aim of this study was to examine the associations between screen-based leisure-time sedentary behaviors (LTSB) including television time and computer time with unhealthy dietary behaviors, and leisure-time physical activity (LTPA) among Chinese adults. Methods Participants (n = 10,108, aged 18–59 years) from a recent cross-sectional study of CHNS (China Health and Nutrition Survey) conducted in 2015 were analyzed. Time spent in LTSB and LTPA were collected from questionnaire. Unhealthy dietary behaviors were collected from three consecutive 24-hour food recalls and the food frequency method. Multivariable logistic regression models were produced to study the odds ratios for unhealthy dietary behaviors and LTPA as the function of the quintile of LTSB. Results Versus the lowest quartile, the OR(95%CI) of the highest quintile of computer time for insufficient vegetable intake (&amp;lt; 300 g/d) was 1.4(1.0,2.0) for male and 1.5(1.1,2.2) for female; the OR(95%CI) for excessive snack intake (≥1 time/day) was 1.6(1.0,2.3) for male and 1.7(1.3,2.4) for female; the OR(95%CI) for excessive western fast food intake (≥1 time/week) was 2.4(1.2,4.4) for male and 2.7(1.4,4.9) for female. The OR(95%CI) of the highest quintile of television time for no LTPA group (0 Mets.h/w) was 1.8(1.3,2.6) for male and 1.5(1.1,2.0) for female; the OR(95%CI) for sufficient LTPA group (≥8 Mets.h/w) was 0.5(0.4,0.8) for male and 0.7(0.5,0.9) for female. The OR(95%CI) of the highest quintile of computer time for no LTPA group (0 Mets.h/w) was 0.4(0.3,0.6) for male and 0.5(0.4,0.7) for female; the OR(95%CI) for sufficient LTPA (≥8 Mets.h/w) group was 2.4(1.7,3.3) for male and was 2.1(1.5,2.9) for female. Conclusions LTSB were associated with unhealthy dietary behaviors and mixed LTPA among Chinese adults. The patterns of “Television time-less LTPA” and “Computer time-unhealthy diet-more LTPA” for Chinese adults were principal associations. Our findings suggest the need for different behavior preventive intervention on different types of screen-based LTSB among Chinese adults. Funding Sources The survey received funding from NIH and from Ministry of Finance of the People's Republic of China.

The impact of leisure time physical activity on mental health and health perception among people with cancer.

Background: People with cancer often report high levels of negative psychological symptoms and poor perception of health due to cancer treatment and activity limitations. Prior studies have suggested that participation in leisure time physical activity (LTPA) can reduce negative psychological symptoms and improve health perception. However, a few studies have examined the contribution of LTPA to health benefits among people with cancer. Thus, we aimed to examine how a different level of LTPA engagement contributed to mental health and health perceptions among people with cancer. Methods: Using the 2017 Health Information National Trends Survey (HINTS) data, cross sectional data of 504 respondents diagnosed with any types of 22 cancers listed in the survey questionnaire were analyzed. A multivariate analysis of variance (MANOVA) was used to test for mean differences in mental health and health perception among the three different LTPA groups(i.e., inactive, moderately active, and vigorously active groups). Results: Results indicated that people with cancer who reported higher levels of LTPA scored higher on mental health and health perception than those with lower levels of LTPA (Pillai’s trace= 0.060, F (4,944) = 15.06, P < 0.001). Conclusion: This finding suggests that individuals with cancer gained more health benefits through high engagement in LTPA. Moreover, we suggested that LTPA can be used as an important therapeutic intervention to promote health quality and wellbeing among people with cancer. Implications for practical suggestions are further discussed.

4951Long-term prognostic value of adherence to leisure time physical activity prescription in patients undergoing exercise-based cardiac rehabilitation: an inverse dose-response relationship

Abstract Background The benefits associated with leisure time physical activity (LTPA) in primary and secondary cardiovascular prevention has been known for decades. Although several studies demonstrated that exercise-based cardiac rehabilitation (CR) programs reduce mortality, the long-term prognostic value of adherence to LTPA presciption after exercise-based CR has not been well estrablished. Purpose Evaluate the long-term prognostic value of adherence to LTPA presciption after exercise-based CR in patients undergoing myocardial revascularization and/or cardiac valve surgery. Methods A prospective registry of 2.340 consecutive patients, admitted to the Cardiovascular Prevention and Rehabilitation Unit was created. All patients completed a standard in-hospital CR program. Data regarding LTPA and outcomes were collected. End points were: overall and cardiovascular (CV) mortality and major adverse cardiovascular and cerebrovascular events (MACCEs). The population has been classified into: 1) Physical inactivity: almost completely sedentary or occasional physical activity; 2) Physical activity: regular aerobic LTPA. The amount of LTPA was further collected according to minutes per week. Results A total of 1.892 patients with available data on LTPA and outcomes were included in the study; mean follow-up was 50±23 months. One-thousand and twenty-two (54%) patients underwent myocardial revascularization (CABG), 662 (35%) cardiac valve surgery, 208 (11%) combined valve and CABG surgery. Adherence to a regular LTPA was found in the 42% (792 participants) of the population, while 58% (1.100 patients) reported occasional LTPA or a complete physical inactivity. Kaplan-Meier survival curve showed a lower overall mortality (p&lt;0.0001), CV mortality (p&lt;0.0001), and MACCEs (p&lt;0.0001) in LTPA group (figure). After adjustment for age, gender, arterial hypertension, diabetes, type of intervention, glomerular filtration rate and left ventricular ejection fraction, both overall and CV mortality were significantly lower in the LTPA groups (OR=0.24; p&lt;0.0001 and OR=0.35; p&lt;0.046, respectively), as well as combined MACCEs (OR=0.36; p&lt;0.0001). Moreover, an inverse relationship between the increase of minutes per week of LTPA and the decrease of overall (HR 0.990; p&lt;0.0001), CV mortality (HR 0.991; p&lt;0.0001) and MACCEs (HR 0.996; p&lt;0.0001) was found, with 1% reduction of relative risk of events for each minute per week increase of physical activity. Finally, comparing LTPA to standard medical therapy in our population, LTPA showed the lowest number needed to treat (NNT) to save a life (NTT=12). Central figure Conclusion Adherence to leisure time physical activity prescription is independently associated with significant reduction of overall mortality, CV mortality and MACCEs on top of exercise-based CR program after myocardial revascularization and/or cardiac valve surgery. Acknowledgement/Funding None

Physical activity, multimorbidity, and life expectancy: a UK Biobank longitudinal study

BackgroundMultimorbidity is an emerging public health priority. Physical activity (PA) is recommended as one of the main lifestyle behaviours, yet the benefits of PA for people with multimorbidity are unclear. We assessed the benefits of PA on mortality and life expectancy in people with and without multimorbidity.MethodsUsing the UK Biobank dataset, we extracted data on 36 chronic conditions and defined multimorbidity as (a) 2 or more conditions, (b) 2 or more conditions combined with self-reported overall health, and (c) 2 or more top-10 most common comorbidities. Leisure-time PA (LTPA) and total PA (TPA) were measured by questionnaire and categorised as low (< 600 metabolic equivalent (MET)-min/week), moderate (600 to < 3000 MET-min/week), and high (≥ 3000 MET-min/week), while objectively assessed PA was assessed by wrist-worn accelerometer and categorised as low (4 min/day), moderate (10 min/day), and high (22 min/day) walking at brisk pace. Survival models were applied to calculate adjusted hazard ratios (HRs) and predict life expectancy differences.Results491,939 individuals (96,622 with 2 or more conditions) had a median follow-up of 7.0 (IQR 6.3–7.6) years. Compared to low LTPA, for participants with multimorbidity, HR for mortality was 0.75 (95% CI 0.70–0.80) and 0.65 (0.56–0.75) in moderate and high LTPA groups, respectively. This finding was consistent when using TPA measures. Using objective PA, HRs were 0.49 (0.29–0.80) and 0.29 (0.13–0.61) in the moderate and high PA groups, respectively. These findings were similar for participants without multimorbidity. In participants with multimorbidity, at the age of 45 years, moderate and high LTPA were associated with an average of 3.12 (95% CI 2.53, 3.71) and 3.55 (2.34, 4.77) additional life years, respectively, compared to low LTPA; in participants without multimorbidity, corresponding figures were 1.95 (1.59, 2.31) and 1.85 (1.19, 2.50). Similar results were found with TPA. For objective PA, moderate and high levels were associated with 3.60 (− 0.60, 7.79) and 5.32 (− 0.47, 11.11) life years gained compared to low PA for those with multimorbidity and 3.88 (1.79, 6.00) and 4.51 (2.15, 6.88) life years gained in those without. Results were consistent when using other definitions of multimorbidity.ConclusionsThere was an inverse dose-response association between PA and mortality. A moderate exercise is associated with a longer life expectancy, also in individuals with multimorbidity.

Individual and environmental factors associated with green exercise in urban and suburban areas.

In this study, we mainly aimed to explore the associations of personal and socio-demographic factors, and the supply of green areas and built sports facilities with green exercise (GE). We also compared the residents of the core urban area and suburban areas according to the level of leisure time physical activity (LTPA) they had. A population-based sample of 3730 adults (aged 25-101 y) from Finland, filled out a questionnaire in 2015. Variables describing the supply of green areas and built sports facilities were objectively calculated. The green areas were classified into small (<25 ha), middle-sized (25-150 ha) and large (>150 ha) areas to reflect their qualities for GE. The data analysis methods included multinomial logistic regression, t-, and Chi Square tests. Our results indicate that having a short distance to at least a middle-sized green area and high nature relatedness are important for participation in GE, both in core urban and suburban areas. More factors were found to be related to GE in the suburban areas compared to core urban areas and among the low LTPA compared to the high LTPA group.

PO-279 Bidirectional Associations Between Physical Activity and Adiposity From Childhood to Early Adulthood

Objective Inverse association between physical activity and adiposity in children and adolescents have been documented in numerous studies. However, few studies have examined the direction of causation between these two variables. We aimed to examine the prospective bidirectional associations between physical activity and adiposity from childhood to early adulthood.&#x0D; Methods A total of 396 girls (mean age, 11.2 years at baseline) participated in a longitudinal study with 1, 2, 4, and 7 year follow-ups. Body height and weight were measured, body composition was assessed by DXA and BMI and fat mass index (FMI) were calculated. Leisure-time physical activity (LTPA) and physical inactivity was obtained from questionnaire and physical activity score and inactivity time was calculated. A bivariate cross-lagged panel model was used to estimate the bidirectional associations between physical activity and measures of adiposity across follow-up waves.&#x0D; We further examined whether persistently high or persistently low physical activity or change of physical activity level from low to high and high to low during pubertal years had differential effects on adiposity. For this, the study participants were first divided into two groups according to the median values of their LTPA scores at baseline and at the 7 year follow-up visit. Then four activity groups were formed: consistently high (CH), consistently low (CL), change from high to low (HL), and change from low to high (LH). Analysis of variance (ANOVA) with least significant difference post hoc test was used to compare differences in adiposity between the LTPA groups.&#x0D; Results BMI at each measurement wave strongly predicted subsequent BMI (standardized path coefficients ranged from 0.87 to 0.95, p &lt; 0.001 for all). Similar pattern was observed for LTPA and physical inactivity, though the path coefficients tended to be notably smaller. This auto-regressive part of the model indicates that the temporal stability of BMI from childhood to early adulthood is higher than the temporal stability of LTPA or physical inactivity over the same time period.&#x0D; The cross-lagged effects indicated that higher BMI at baseline and at 4-year follow-up predicted lower LTPA at 2-year and 7-year follow-ups, respectively (p&lt;0.05 for both), but LTPA did not predict subsequent BMI at any time point. Similarly, higher FMI at baseline and at 2-year follow-up predicted lower LTPA at subsequent follow-up waves (p&lt;0.05 for both). No associations were found between sedentary time and adiposity between any time points.&#x0D; The difference in participation in LTPA between consistently high and consistently low PA groups were on average 4 hours per week (p&lt;0.001); however, no significant difference in FMI was found at baseline, 2-year or 7-year follow-up). Similarly, no significant difference in FMI was found between the groups whose LTPA level changed from high to low or from low to high. &#x0D; Conclusions Our results suggest that reduced physical activity in children and adolescents is the result of increased fatness rather than its cause. Current physical activity recommendations may not be sufficient to combat pediatric obesity.