Family social class differences in children's leisure-time physical activity: The mediating role of parenting styles and the family sports environment.

Association of hospitalization costs with demographic, socioeconomic, and lifestyle characteristics: Population-based study in Sao Paulo city, Brazil, 2003-2015.

Leisure-Time Physical Activity Is Associated With Reduced Risks of Mortality in Adults With General or Abdominal Obesity in Mexico.

Associations of mortality with leisure-time physical activity and sitting time in postmenopausal women: Insights from NHANES.

Physical activity's impact on cardiac activity and autonomic regulation in university students: A baseline study.

The aim of this study was to determine the relationships between physical activity (PA) and fitness and mental health in persons with spinal cord injury (PwSCI) living with chronic pain. This cross-sectional baseline data analysis included n = 43 people PwSCI ≥ 18years reporting chronic pain. We administered the Satisfaction with Life Scale, EuroQol anxiety/depression, ICEpop CAPability Measure for Adults (ICECAP-A) enjoyment and pleasure and achievement and progress, Spinal Cord Injury Quality of Life Satisfaction with Social Roles and Activities scale, Leisure-Time PA Questionnaire for PwSCI, the 36-Item Short-Form Health Survey, and an arm-crank fitness test. Hierarchical multiple regressions, controlling for age, gender, injury level, fatigue, and pain, revealed that moderate to vigorous PA and fitness explained variance in enjoyment and pleasure (ΔR2 = .133, R2 = .344, p = .002), anxiety/depression (ΔR2 = .125, R2 = .258, p = .023), Satisfaction with Life Scale (ΔR2 = .036, R2 = .240, p = .030), achievement and progress (ΔR2 = .084, R2 = .260, p = .020), and Satisfaction with Social Roles and Activities (ΔR2 = .074, R2 = .444, p = .005). Future studies should test whether interventions that increase PA and fitness improve mental health in PwSCI living with chronic pain.

Aim/Background: Grounded in the Minority Stress Model, which conceptualizes discrimination as a chronic social stressor affecting health among minority populations, this study examines the association between perceived ethnic discrimination and leisure-time physical activity (LTPA) among adults in Sweden. Methods: Using representative cross-sectional data from the Health on Equal Terms survey, we analysed a sample of 64,273 individuals aged 16 to 84 years living in Sweden. Perceived discrimination was measured as offensive treatment and LTPA was measured through a question about physical movement during free time. Logistic regressions were performed to examine the association between perceived discrimination and LTPA. The relative excess risk due to interaction (RERI) was estimated to assess the contribution of the region of birth to the relationship between discrimination and LTPA. Results: Findings show a low prevalence of perceived discrimination (1.3%) and a high prevalence of LTPA in the population (86.6%). However, a significant negative association was observed between perceived ethnic discrimination and engagement in LTPA (odds ratio: 0.73, 95% confidence interval: 0.56-0.96). Migrants born in Asia who reported discrimination were more likely to engage in LTPA (RERI: 0.11 (0.03-0.19)) compared with those born in Nordic countries. No significant interactions were found for other birth regions (i.e. South America, Africa, North America, and Oceania). Conclusion: These results suggest that perceived discrimination might shape health-related behaviours in the Swedish context. Future research should further investigate the mechanisms linking discrimination and health behaviours using longitudinal designs and multidimensional measures of social integration and stress processes.

Encouraging leisure-time physical activity has proved to be a hard-to-solve complex problem. Underpinning this complexity is the range of determinants of sedentary behaviour. We report on a participatory actor mapping exercise which sought to understand the people and organisations in the local system in which a novel exercise referral scheme in a suburban/semi-rural region of England has been introduced. The participatory actor mapping exercise was conducted in two phases in September 2023. The first phase generated a draft actor map visually illustrating the key organisations and individuals (actors) that make up the local physical activity promotion system. The map was aligned to a socio-ecological model in which actors were positioned within a category of determinants. In the second phase, the draft actor map was refined during two workshops with participants (n = 30) representing the key local organisations who sought to promote physical activity. The process of mapping revealed several factors influencing physical activity promotion: (1) differing views on the determinants of physical inactivity, and hence, a hesitancy towards addressing sedentary behaviour through a strategic systems approach; (2) an emerging system of actors with interdependent roles which sometimes act independently; (3) local commitment to encouraging increased leisure time activity but supported via a generalised approach to physical activity promotion; and (4) a peripheral role of the studied exercise referral scheme in the system for local physical activity provisions. The process of a participatory approach to actor mapping highlighted both opportunities and challenges for physical activity promotion. Although there were challenges around differing actors' perspectives on sedentary behaviour and a lack of connection between actors, opportunities included an improved shared understanding of the complex issues of physical inactivity, and actor mapping provided a useful step towards adopting a systems approach with a common vision.

The "physical activity health paradox" posits that physical activity done during work (occupational physical activity [OPA]) may not yield the health benefits consistently observed for leisure-time physical activity (LTPA) and, in some cases, may be harmful. Given the broad implications for such a paradox, which contradicts current public health guidelines for physical activity, we conducted a narrative, non-systematic review to discuss the current epidemiological and mechanistic evidence on the topic to inform opportunities for research and practice moving forward. Epidemiological evidence shows that LTPA is reliably protective against mortality and cardiovascular disease, whereas OPA has mixed or adverse associations. Several recent meta-analyses found higher all-cause mortality risk among men with high vs low OPA and found LTPA to potentially mitigate this OPA risk. Studies with device-measured OPA further highlight potential heterogeneity by OPA task and context. These conclusions remain limited by low quality evidence due to heterogeneous OPA exposure measurements, referent group selection, challenges in study design, and varied confounder adjustments. Mechanistically, four interrelated pathways that may explain the observed presence of a paradox have been proposed and preliminarily tested: (1) acute cardiovascular strain catalyzed by long-duration OPA with little recovery; (2) downstream vascular changes such as greater arterial stiffness, blunted baroreflex sensitivity, and maladaptive cardiac remodeling from chronic OPA exposure; (3) systemic inflammation associated with high OPA levels; and (4) modifiers such as low cardiorespiratory fitness and high psychosocial stress amplifying strain, inflammation, and risk. Current evidence is limited by reliance on cross-sectional or between-subject designs, crude OPA classification, and limited mechanistic interventions. Unlike the clear benefits from LTPA, research findings examining the health effects of OPA remain mixed. While uncertainty remains, the balance of evidence suggests that OPA is less beneficial to health than LTPA which should be considered in public health messaging. Advancing the field will require multidimensional OPA exposure assessment, rigorous study designs, and evaluation of mechanism-driven outcomes to clarify causal pathways and identify feasible intervention targets to promote health in workers with physically demanding jobs.

ABSTRACT Despite extensive research on the well-being benefits of leisure-time physical activity (LTPA), the distinct roles of various LTPA locations in promoting well-being have received limited attention. This study examines how different LTPA locations contribute to LTPA frequency and perceived social capital, and how these factors are associated with life satisfaction and psychological well-being among middle-aged and older women. We collected data from a community sample of Japanese women aged 40–79 years (N = 1,413). A multiple mediation analysis revealed that LTPA at private indoor facilities, public sport facilities, and school exercise facilities was positively associated with LTPA frequency, leading to higher levels of life satisfaction and psychological well-being. Additionally, LTPA at private outdoor facilities, public sport facilities, school exercise facilities, and community centers was positively associated with perceived social capital, which, in turn, correlated with higher levels of life satisfaction and psychological well-being. These findings provide new insights into the unique roles of different LTPA locations in enhancing well-being among middle-aged and older women.

Social factors shape health behaviors and contribute to persistent inequalities, especially in the Global South. However, few studies have examined how intersecting social identities influence physical activity in low- and middle-income countries. This study explored social inequalities in leisure-time (LTPA) and transport physical activity (TRPA) through the lens of intersectionality among individuals living in São Paulo, Brazil. Longitudinal data from 978 participants of the Health Survey of São Paulo: Physical Activity and Environment cohort were analyzed from three waves: 2014/2015, 2020/2021, and 2023/2024. Physical activity was measured using the long-form International Physical Activity Questionnaire (IPAQ). To capture intersectional social disadvantage, a Multiple Jeopardy Index was constructed by combining sex, race/skin color, and educational level, with scores ranging from 0 (lower vulnerability) to 4 (higher vulnerability). Associations between Jeopardy Index and physical activity in both domains were assessed using multilevel Poisson regression models, considering repeated measures nested within three hierarchical levels: observations, individuals, and census tracts. Individuals in the highest vulnerability groups (female, belonging to racial or ethnic minority groups, and with low educational attainment) consistently reported lower levels of LTPA over time. In fully adjusted models, participants in higher vulnerability Jeopardy categories 3 and 4 showed significantly lower prevalence of LTPA compared to the lower vulnerability reference group (category 0: male, White, and highly educated), with prevalence ratios of 0.72 (95% CI: 0.57-0.91) and 0.62 (95% CI: 0.49-0.80), respectively. A clear inverse gradient and significant dose-response trend was observed (p < 0.001). Regarding TRPA, prevalence was higher among males and younger participants, and also more frequent among individuals from racialized or minority groups and those with a high school education. However, no significant associations were found between the Jeopardy Index and TRPA in any model. Persistent and widening inequalities in LTPA were observed among Brazilians over a 10-year period, with intersections of sex, race/skin color, and education disproportionately affecting the most vulnerable groups, particularly women from racialized or minority groups with lower educational attainment. Public policies and programs should prioritize socially disadvantaged groups by promoting inclusive and sustained opportunities for leisure-time activity.

Disordered eating (DE) is common among patients attending primary health care settings. However, the prevalence of DE among patients who receive care in nutrition practice settings has yet to be estimated. We aimed to determine the prevalence of DE and its correlates among outpatients in a nutrition service. A cross-sectional survey was conducted using a convenience sample of outpatients (N = 502) who received care from 2022 to 2024 at the Nutrition Care Offices, which is a university nutrition service in Mexico City. A screening questionnaire was created to identify DE. Items were derived from existing DE screening tools and patients’ experiences. Linear regression models were estimated, with the outcomes being the three indicators of DE (negative body image, binge eating-compensation, and exercise as a negative experience). The most common DE behaviours and cognitions were feeling uncomfortable or insecure about their body fat (74.7%), feeling ashamed of their weight (57.6%), feeling uncomfortable or insecure about their muscles (57.2%), feeling bad when their weight is measured (54.0%), and feeling they have lost control of what they eat (51.0%). Binge eating-compensation and negative body image scores were higher among women, younger individuals, those with higher body weight, and those with very light or light leisure-time physical activity (PA). The practice of leisure-time PA was positively associated with exercise as a negative experience but negatively related to negative body image. Our findings suggest that DE is a problem that arises recurrently in weight-related nutrition consultations. Higher risk groups deserved special attention.

Physical activity and sedentary behaviour are major modifiable risk factors for cardiovascular disease. However, the effect of leisure-time physical activity, particularly moderate-to-vigorous leisure-time physical activity, on the development of cardiovascular disease remains unclear. This study aimed to investigate the potential mediating role of white blood cell (WBC) count in the associations among moderate-to-vigorous leisure-time physical activity, sedentary behaviour, and cardiovascular disease. We assessed the data of 11,355 participants from the National Health and Nutrition Examination Survey between 2013 and 2018. multivariable logistic regression analyses were conducted to determine the associations of moderate-to-vigorous leisure-time physical activity and sedentary behaviour with cardiovascular disease. Subgroup mediation analyses were performed to identify potential modifying factors such as age, WBC count, and triglyceride-glucose index. After adjusting for demographic, lifestyle, and clinical covariates, our analyses revealed a significant negative association between moderate-to-vigorous leisure-time physical activity and cardiovascular disease, while sedentary behaviour (> 7.5h/day) showed no significant association, with odds ratios close to 1. Furthermore, the results from our subgroup mediation analyses suggested that WBC count partially mediated these associations, particularly in participants aged 41-59 years and those within the triglyceride-glucose index range of 6.719-8.684. These findings provide insight into the inflammatory mechanisms that link moderate-to-vigorous leisure-time physical activity and sedentary behaviour with reduced cardiovascular disease risk.

Little research has considered associations between walkability and multiple health outcomes and the moderating effect of social determinants of health. This study examined relationships between walkability and diverse health issues (depression, poor mental health, poor physical health, mobility disability, obesity) and no leisure-time physical activity and whether these relationships were moderated by social vulnerability. Then, we assessed whether these moderated effects varied between urbanicity. For 1089 census tracts in South Carolina, we compiled EPA National Walkability Index, 6 health metrics from the CDC-PLACES dataset, and the CDC Social Vulnerability Index. Multilevel regression models were employed to account for the nested structure of the data, with census tracts (level 1) nested within counties (level 2). Overall, tract walkability was significantly negatively associated with poor mental health, poor physical health, obesity, and no leisure-time physical activity. The interaction between National Walkability Index and Social Vulnerability Index suggested that the relationship between health metrics and walkability varied depending on the level of social vulnerability in the community. In addition, tract rural or urban classification significantly affected the relationship between walkability and some health metrics. This study’s findings provide valuable insights for equitable urban planning and strategies to address walkability and public health issues.

Background: Adult attained height reflects early-life exposures, including nutrition, infectious disease burden, and socioeconomic conditions, which influence lifelong health. Shorter stature is associated with higher risks of cardiometabolic conditions. Tanzania’s regional disparities in early-life nutrition provide a unique context to explore the relationship between height and non-communicable diseases (NCDs) risk factors. Objective: To assess the association between attained adult height and NCD risk factors, including body mass index (BMI), total cholesterol, diabetes mellitus, hypertension, and cardiovascular disease (CVD) risk, among Tanzanian adults aged 18–69 years. Methods: This population-based study analysed data from the Tanzania STEPS survey (September–November 2023). A cross-sectional design was used, with 4,320 individuals selected through stratified sampling. Data were collected via structured interviews, physical measurements, and biochemical sample collection. Multivariable analyses assessed associations between height quintiles and NCD risk factors, adjusting for age, sex, smoking status, and leisure-time physical activity. Results: Shorter stature was associated with increased risks of overweight/obesity, elevated total cholesterol, and diabetes mellitus. Compared to the tallest quintile (170.1–198.8 cm), the lowest quintile (100–153.9 cm) showed the highest risk of overweight/obesity (adjusted PR=2.17, 95% CI: 1.76–2.66), high total cholesterol (adjusted PR=1.85, 95% CI: 1.24–2.75), and diabetes mellitus (adjusted OR=2.20, 95% CI: 1.19–4.06). No significant associations were observed between height and hypertension. Conclusion: Shorter adult height is independently associated with increased risk of overweight/obesity, elevated cholesterol, and diabetes, suggesting height as a marker of early-life disadvantage. These findings highlight the importance of addressing early-life nutrition and growth determinants as part of comprehensive NCD prevention strategies in Tanzania.

The beneficial effects of physical activity (PA) on cardiovascular disease and its risk factors have been well established. However, evidence linking PA to chronic kidney disease (CKD) in patients with diabetes is limited. This study aimed to examine the association between PA, including leisure-time PA (LTPA) and daily life PA (DLPA), and CKD cross-sectionally. A total of 4,922 patients with type 2 diabetes were classified into quartiles of LTPA and three categories of DLPA (sedentary, light, and moderate/vigorous). CKD was defined as a decreased estimated glomerular filtration rate (eGFR) based on cystatin C (< 60mL/min/1.73 m2) and/or albuminuria (urinary albumin-to-creatinine ratio ≥ 30mg/g). Odds ratios for the presence of CKD were computed using logistic regression analyses. Higher LTPA levels were significantly associated with a lower likelihood of developing CKD (P for trend = 0.001). Higher DLPA was also associated with a lower prevalence of CKD (P for trend < 0.001). Similar associations were observed for decreased eGFR and albuminuria. The combination of higher LTPA and DLPA levels further decreased the likelihood of CKD, with a significant interaction between the two. Higher LTPA and DLPA levels were independently associated with a lower prevalence of CKD in patients with type 2 diabetes.

Although the association between handgrip strength and glycemic control has been reported, studies conducted exclusively within specific occupational groups remain limited. To explore the association between handgrip strength and metabolic health in industrial settings, this study examined the relationship between relative handgrip strength and glycated hemoglobin (HbA1c) among male automobile manufacturing workers using vibration tools in South Korea. Using 66,212 occupational health examination records collected at Inha University Hospital between January 2024 and April 2025, a total of 3,365 workers with HbA1c and handgrip strength measurements were identified. After excluding duplicates (n = 1,536), female workers (n = 2), and records without Hb and estimated glomerular filtration rate, 1,823 male participants were included in the final analysis. Relative handgrip strength was calculated as the maximum value of bilateral grip strength divided by body mass index. Multiple linear regression analyses were conducted to assess the association between relative handgrip strength and HbA1c, adjusting for age, smoking status, alcohol consumption, current hypertension, current dyslipidemia, current hypoglycemic-agents use, family diabetes history, leisure-time physical activity, and resistance exercise. Relative handgrip strength was inversely associated with HbA1c levels (B: -0.060; 95% confidence interval [CI]: -0.081 to -0.039; p < 0.001). The association was strongest among normoglycemic participants (B: -0.185; 95% CI: -0.305 to -0.065; p = 0.003). Effect size was reduced but significantly associated among individuals with prediabetes (B: -0.115; 95% CI: -0.180 to -0.050; p < 0.001) and further attenuated to a borderline significance in individuals with diabetes (B: -0.023; 95% CI: -0.050 to 0.003; p = 0.082). These findings indicate that greater muscle strength relative to body size is related to better glycemic control. Handgrip strength was associated with HbA1c levels in industrial workers. This study suggests that handgrip strength may provide complementary information on metabolic health in occupational settings.

ABSTRACT This study explores the impact of armed conflict (AC) on adolescents’ leisure-time physical activity (LTPA) in Iraq, an under-researched area despite its relevance to wellbeing. Interviews with fifteen adolescents aged 17–19 exposed to ISIS-related AC generated seven interrelated themes: play spaces transformed into survival spaces; leisure as passive waiting; spatial confinement and embodied decline; relational collapse of physical activity; physical activity as a sacrificed luxury; collapse of family support; and loss of future orientation and meaning. Findings show that AC disrupts the social, spatial, and moral conditions that sustain LTPA, producing cumulative, non-negotiable constraints that reshape routines, motivation, and social connections. The study advances leisure constraint theory under extreme adversity and underscores the need for interventions that restore safe, structured, and socially supportive environments to preserve the developmental and psychosocial benefits of adolescent LTPA.

Leisure time physical activity (LTPA) is a modifiable factor in the prevention and treatment of type 2 diabetes. While studies show LTPA reduces insulin resistance (IR), metabolic syndrome, and diabetes risk, the specific relationship between LTPA levels and IR needs further investigation. Participants were from the National Health and Nutrition Examination Survey between 2007 and 2018 (N = 11,143 adults aged 49.4 ± 17.6, male). LTPA was assessed using the Global Physical Activity Questionnaire. IR was dichotomized using the homeostatic model assessment with a threshold 2.5. Survey-weighted logistic regression and restricted cubic spline analyses examined LTPA-insulin resistance relationships. Statistical analyses were survey-weighted and adjusted for covariates. Analyses were performed using the R, and P-values ≤0.05 were considered statistically significant. Compared to inactive individuals, participants who met LTPA≥300 min/week showed significantly lower IR risk (OR = 0.68; 95% CI:0.57-0.82), while weekend warriors showed no benefit (OR = 1.01, P = 0.950). A significant overall association was observed between LTPA and IR risk (P-overall <0.001), with a non-linear dose-response pattern (P-non-linear = 0.022), with benefits plateauing at 450 min/week. Regular LTPA of 300-450 min/week may be optimal for preventing insulin resistance. These findings highlight the importance of engaging in regular LTPA for 300-450 min/week to maintain insulin sensitivity and reduce the risk of diabetes.

Polygenic scores (PGSs) may help assess genetic predisposition to multifactorial traits. We examined whether age, sex, and leisure-time physical activity (LTPA) modify the association between a PGS for handgrip strength (HGS) and measured HGS in older adults. PGS for HGS (PGShgs), based on Pan-UK Biobank GWAS data, was calculated for 5103 participants (aged 40-96; 44% women) from eight twin cohorts in Denmark, Sweden, Australia, the United States, and Finland within the IGEMS consortium. Sex-standardized HGS and self-reported LTPA were assessed cross-sectionally. Linear mixed models estimated associations between PGShgs and HGS, including interactions with age, country, and LTPA, as well as an association between PGShgs and LTPA. Fixed-effect within-pair models were conducted to assess environmental contributions. Higher PGShgs was associated with greater HGS (β = 2.14, SE = 0.15, p < 0.001), explaining 4.6% of HGS variance overall, with modest variation across countries. In sex-stratified models, PGShgs explained 5.2% of the variance in females and 4.3% in males. No statistically significant interaction with age was found. A significant PGShgs × LTPA interaction (β = -0.034, p = 0.013) indicated that the association between LTPA and HGS was more pronounced among individuals with lower PGShgs. The within-pair models offered limited support for the independent environmental impact of LTPA. The PGShgs was associated with measured HGS in the meta-analysis, highlighting the potential of PGSs to capture individual differences in strength-related traits across populations. The association of PGShgs with HGS was moderated by LTPA, such that the beneficial impact of LTPA on HGS was greater among individuals with a lower genetic propensity for HGS.