Leisure-time Physical Activity Research Articles

Abstract 13: Associations Between Leisure-Time Physical Activity and Mortality by Sociodemographic Factors in a Nationally Representative Sample of 567,483 US Adults

Introduction: The 2018 Physical Activity Guidelines Advisory Committee Scientific Report called for investigating whether the established health benefits of meeting physical activity guidelines (PAG) differ by sociodemographic factors. Guidelines for adults recommend engaging in muscle-strengthening activities (MSAs; ≥2 days per week) and moderate-to-vigorous aerobic physical activity (MVPA; ≥150 minutes per week at moderate intensity, ≥75 minutes per week at vigorous intensity, or an equivalent combination). Objective: To examine associations between meeting MVPA and MSA guidelines (combined PAG) in leisure time and all-cause and heart disease mortality across sociodemographic factors. Methods: We used nationally representative data on 567,483 adults from the 1998-2018 US National Health Interview Survey (NHIS) and 2019 public-use linked mortality files from the National Death Index. Median follow-up was 9.5 years (range=1-21.8 years). We classified participants into categories (met combined PAG, met MVPA only, met MSA only, met neither) based on reported leisure-time physical activity. We used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between meeting the combined PAG vs. meeting neither guideline and all-cause and heart disease mortality, overall and stratified by sex (women, men), race and ethnicity (six groups), or education (four levels). Models were adjusted for sociodemographic and health factors. We conducted pairwise comparisons (adjusted for multiple comparisons) to determine if associations differed across sociodemographic factors. Results: Compared to meeting neither PAG, meeting the combined PAG was associated with a reduced mortality risk between 14-36% for all-cause mortality and 25-52% for heart disease mortality across sociodemographic groups. Reductions in mortality risk were larger for some groups compared with others. For example, reduction in all-cause mortality was larger for non-Hispanic White compared with Hispanic or Latino adults (HR=0.66 [95% CI: 0.64-0.69] vs. 0.86 [0.75-0.99]; pairwise p <0.001) and for people with more vs. less education (college or more=0.64 [0.60-0.69] vs. less than high school=0.75 [0.69-0.82]; p <0.001). Reduction in heart disease mortality was larger for women compared with men (0.54 [0.48-0.62] vs. 0.66 [0.60-0.73]; p <0.001). Conclusions: Meeting the guidelines for MVPA and MSA generally provides a substantial reduction in risk of all-cause and heart disease mortality. There may be differences in the magnitude of benefit physical activity provides for health across sociodemographic groups. The reasons for these differences are unclear. Identifying factors contributing to these differences would further address research gaps identified in the 2018 Physical Activity Guidelines Advisory Committee Scientific Report.

Identifying the health benefits of city bike infrastructure expansion policy

ABSTRACT The aim of this study was to understand how policy actions implemented by city governments to improve infrastructure within the built environment can in turn influence healthy behaviors and population health. The authors investigated the associations between policy actions implemented by city governments to improve biking infrastructure and multiple health outcomes including leisure-time physical inactivity, obesity and coronary heart disease (CHD). In addition, this study tested if bike use for commuting and leisure-time physical activity were mediators between policy actions to improve biking infrastructure and health outcomes, and whether the health effects of bike infrastructure were different in cities of different population density. We merged local sustainability survey data with city-level chronic disease measures for the largest cities in the U.S. (n = 457). Results from regressions using Ordinary Least Squares estimation and mediation tests showed policies implemented to improve biking infrastructure were associated with lower prevalence of leisure-time physical inactivity, obesity and CHD. These relationships were most notable in medium-density cities (1,500–3,000/sq. mi). Moreover, leisure-time physical activity and active commuting mediated the relationship between bike infrastructure improvement policies and health outcomes. This study demonstrated the value of a policy-based intervention in enhancing population health.

Survey on Physical Activity Among Adolescents in Pune City

The main aim of the study was to assess the physical activity among adolescents of Pune City. For this study total 500 students were randomly selected from Pune city. The subject’s age was ranged in between 13-17 years. For the purpose of collecting the data the researcher used and selected International Physical Activity Questionnaire (IPAQ) is a widely used instrument for assessing physical activity levels in various populations by (Craig et al., 2003). The questionnaire is divided into four domains. These are Leisure-Time Physical Activity: Activities during discretionary time, such as sports, exercise, and recreational activities. Occupational Physical Activity: Activities related to work or employment. Transportation Physical Activity: Activities related to commuting, such as walking or cycling. Household and Garden Physical Activity: Activities related to household chores and gardening. Data were measured by IPAQ questionnaire which is used to calculate the total metabolic equivalent of task (MET) minutes per week. MET is a unit that represents the energy expenditure of an activity relative to resting metabolic rate. MET values are assigned to different levels of physical activity intensity (e.g., walking, moderate-intensity activities, vigorous-intensity activities), and the total MET minutes per week are calculated by multiplying the duration and frequency of each activity. Percentage was used as a statistical tool analyses the data. The result of the study revealed that students 57.6% (288) are less involved in physical activity, where as 23.4% (117) students are moderately involved in physical activity and 19% (95) students are highly involved in physical activity.

“Ten Bucks for yoga and a beer in a cool vibey spot”: exploring motivations for LTPA at craft breweries

ABSTRACT To attract consumers in an increasingly competitive marketplace, many breweries are now offering leisure time physical activity (LTPA) equipment, clubs, and events on-site. Given the growing number of craft beer entities in the U.S. opportunities may thus exist to capitalise on the popular phenomena as a means of encouraging participation in regular exercise amongst the general public. To promote engagement however, a clear understanding of motivations for participation is needed. Therefore, this paper explores why people participating in LTPA at breweries chose to engage in the experience; what they enjoyed (or did not enjoy) about the activity; and their intentions to return or not return for a future experience at the same location. Findings from interviews conducted during LTPA events at breweries in three U.S. cities revealed that people were prompted to participate by social aspects, atmosphere, timing, free beer and/or the low/no costs involved, and an overall interest in beer/breweries. Together data suggests craft breweries serve an important role in their communities; ones that extends far beyond economic impacts. Suggestions for the practical application of these findings are also discussed.

Genetic Background of Acute Heart Rate Response to Exercise.

The acute heart rate response (AHRR) to physical activity, which refers to the change in heart rate during and after exercise, has been associated with cardiovascular and all-cause mortality. Previous studies have shown that AHRR is significantly determined by genetics in addition to environmental and lifestyle factors. The aim of this study was to investigate the genetic background of AHRR by analysing ten single nucleotide polymorphisms (SNPs) associated with leisure-time physical activity (LTPA) in 620 samples from the Hungarian population. The AHRR can be characterised as the difference between post-exercise and resting heart rate, i.e., the delta heart rate (ΔHR) defined by the YMCA 3 min step test, with a lower value indicating better cardiovascular fitness. The association of SNPs with ΔHR was analysed both separately and in combination using an optimised polygenic score (oPGS). The results showed that five SNPs (rs10252228, rs459465, rs6022999, rs8097348, and rs12405556) had at least nominally significant (p < 0.05) individual associations with ΔHR. After optimizing the PGS, a cumulative effect was observed for eight SNPs (rs6022999, rs12405556, rs459465, rs10252228, rs8097348, rs10887741, rs12612420, and rs7023003) that had a strong and statistically significant association with ΔHR (B = -2.51, 95% CI: -3.46--1.76; p = 2.99 × 10-9). Of the four main domains of physical activity, the oPGS showed a significant positive association only with LTPA (B = 84.60; 95%CI: 25.23-143.98; p = 0.005). In conclusion, our results suggest that the SNPs we investigated influence individual leisure-time physical activity, mediated by their effects on the acute heart rate response.

Independent and joint association of physical activity and adequate weekday sleep duration with metabolic dysfunction-associated steatotic liver disease

BackgroundThe independent and joint association of physical activity (PA) and weekday sleep duration with metabolic dysfunction-associated steatotic liver disease (MASLD) remain unclear. Aims: We intended to explore this association in the United States. MethodsThis cross-sectional study recruited 4974 individuals from the National Health and Nutrition Examination Survey between 2017 and 2018. Information regarding PA and weekday sleep duration was obtained through questionnaires. Metabolic associated fatty liver disease (MAFLD) was diagnosed by transient elastography based on the consensus definitions. Multivariable logistic regression models were employed to investigate the independent and joint association of PA and weekday sleep duration with MAFLD. ResultsOf the 4974 subjects, engaging in active PA or sustaining adequate sleep duration was associated with decreased the odds of MAFLD (p < 0.05). Specifically, active leisure-time PA was linked to lower 37 % odds of MAFLD (OR, 0.63; 95 % CI, 0.55–0.73). Individuals who had one to twice times (150–299 min/week) or more than twice (≥300 min/week) the recommended amount of leisure-time PA by PA Guidelines had 19 % (OR, 0.81; 95 % CI, 0.67–0.99) and 45 % (OR, 0.55; 95 % CI, 0.47–0.65) lower odds of MAFLD, respectively (P for trend <0.001). Individuals with adequate weekday sleep duration was associated with 24 % lower odds of MAFLD (OR, 0.76;95 % CI,0.67–0.88). Notably, active PA combined with adequate weekday sleep duration significantly decreased the odds ratios for MAFLD by 35 % (OR: 0.65, 95 % CI, 0.52–0.80). However, in individuals with significant alcohol use, the joint effect of total PA and weekday sleep duration on MAFLD was not statistically significant. ConclusionsBoth active PA and adequate weekday sleep duration were inversely associated with the risk of MASLD independently, while combining them could further lower the risk of MASLD.

Association of domain-specific physical activity with albuminuria among prediabetes and diabetes: a large cross-sectional study

BackgroundAlbuminuria, the presence of excess of protein in urine, is a well-known risk factor for early kidney damage among diabetic/prediabetic patients. There is a complex interaction between physical activity (PA) and albuminuria. However, the relationship of specific-domain PA and albuminuria remained obscure.MethodsAlbuminuria was defined as urinary albumin/creatinine ratio (ACR) > 30 mg/g. PA was self-reported by participants and classified into transportation-related PA (TPA), occupation-related PA (OPA), and leisure-time PA (LTPA). Weighted logistic regression was conducted to compute the odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic spline (RCS) was used to evaluate the dose–response of PA domains with the risk of albuminuria.ResultsA total of 6739 diabetic/prediabetic patients (mean age: 56.52 ± 0.29 years) were enrolled in our study, including 3181 (47.20%) females and 3558 (52.80%) males. Of them, 1578 (23.42%) were identified with albuminuria, and 5161(76.58%) were without albuminuria. Diabetic/prediabetic patients who adhered the PA guidelines for total PA had a 22% decreased risk of albuminuria (OR = 0.78, 95%CI 0.64–0.95), and those met the PA guidelines for LTPA had a 28% decreased of albuminuria (OR = 0.72, 95%CI 0.57–0.92). However, OPA and TPA were both not associated with decreased risk of albuminuria. RCS showed linear relationship between the risk of albuminuria with LTPA.ConclusionsMeeting the PA guideline for LTPA, but not OPA and TPA, was inversely related to the risk of albuminuria among diabetic/prediabetic patients. Additionally, achieving more than 300 min/week of LTPA conferred the positive effects in reducing albuminuria among diabetic/prediabetic patients.

Socioeconomic disparities in diet and physical activity in children: evidence from well-child visit electronic health records in the Canary Islands, Spain

BackgroundDiet and physical activity (PA) in childhood are heavily influenced by the living environment. While diet quality follows a socioeconomic pattern, limited evidence is available in relation to PA in...

Feasibility of a Peer-Led Leisure Time Physical Activity Program for Manual Wheelchair Users Delivered Using a Smartphone

Active living lifestyles for wheelchair users (ALLWheel) was developed to improve leisure time physical activity (LTPA). The purpose of this study was to assess the feasibility of the ALLWheel program. In a pilot pre-post design, 12 manual wheelchair users in three Canadian cities completed the ALLWheel program (containing 14 sessions over 10 weeks delivered by a peer using a smartphone). Feasibility indicators were collected for process, resources, management, and intervention—before, during, and after ALLWheel. Exploratory outcomes were collected for LTPA (primary outcome), motivation, self-efficacy, and satisfaction with autonomy support and goal attainment—at baseline, immediately following ALLWheel, and three months later. Feasibility was evaluated using a priori criteria for success (yes/no), and within-subjects comparisons were made to explore the change in exploratory outcomes. The participants were 48.9 ± 15.1 years of age and women (66.7%), and had spinal cord injury (41.7%) or multiple sclerosis (16.7%). Feasibility was achieved in 11 of 14 indicators, with suggestions to consider subjective reports of LTPA as the primary outcome in a future randomized controlled trial to overcome limitations with device-based measures and to use strategies to enhance recruitment. Mild-intensity LTPA and satisfaction with goal attainment improved after the completion of ALLWheel. With minor modifications, it is feasible that ALLWheel can be administered to wheelchair users by a peer using a smartphone.

Does pain tolerance mediate the effect of physical activity on chronic pain in the general population? The Tromsø Study.

Knowledge is needed regarding mechanisms acting between physical activity (PA) and chronic pain. We investigated whether cold pain tolerance mediates an effect of leisure-time physical activity on the risk of chronic pain 7 to 8 years later using consecutive surveys of the population-based Tromsø Study. We included participants with information on baseline leisure-time PA (LTPA) and the level of cold pressor-assessed cold pain tolerance, who reported chronic pain status at follow-up as any of the following: chronic pain for ≥3 months, widespread chronic pain, moderate-to-severe chronic pain, or widespread moderate-to-severe chronic pain. We included 6834 participants (52% women; mean age, 55 years) in counterfactual mediation analyses. Prevalence decreased with severity, for example, 60% for chronic pain vs 5% for widespread moderate-to-severe chronic pain. People with one level higher LTPA rating (light to moderate or moderate to vigorous) at baseline had lower relative risk (RR) of 4 chronic pain states 7 to 8 years later. Total RR effect of a 1-level LTPA increase was 0.95 (0.91-1.00), that is, -5% decreased risk. Total effect RR for widespread chronic pain was 0.84 (0.73-0.97). Indirect effect for moderate-to-severe chronic pain was statistically significant at RR 0.993 (0.988-0.999); total effect RR was 0.91 (0.83-0.98). Statistically significantly mediated RR for widespread moderate-to-severe chronic pain was 0.988 (0.977-0.999); total effect RR was 0.77 (0.64-0.94). This shows small mediation of the effect of LTPA through pain tolerance on 2 moderate-to-severe chronic pain types. This suggests pain tolerance to be one possible mechanism through which PA modifies the risk of moderate-to-severe chronic pain types with and without widespread pain.

Analysis of physical activity and prescription opioid use among US adults: a cross-sectional study

BackgroundOpioid crisis has become a global concern, but whether physical activity (PA) can effectively reduce prescription opioid use remains unclear. The study aimed to examine the relationship of different domains of PA (e.g., occupation-related PA [OPA], transportation-related PA [TPA], leisure-time PA [LTPA]) with prescription opioid use and duration of prescription opioid use.MethodsThis cross-sectional study was conducted on 27,943 participants aged ≥ 18 years from National Health and Nutrition Examination Survey (NHANES, 2007– March 2020). We examined the relationship of different domains of PA with prescription opioid use and duration of prescription opioid use using multivariable logistic regression. Stratified analysis and a series of sensitivity analysis were used to elevate robustness. All analyses were conducted using appropriate sampling weights.ResultsOf the 27,943 participants, the mean age was 45.10 years, with 14,018 [weighted, 50.0%] females and 11,045 [weighted, 66.0%] non-Hispanic White. After multivariable adjustment, inverse associations between PA and prescription opioid use were observed for sufficient (≥ 150 min/week) total PA (OR,0.68 95%CI [0.56–0.81]), TPA (OR,0.73 95%CI [0.58–0.92]), and LTPA (OR,0.60 95%CI [0.48–0.75]) compared with insufficient PA(< 150 min/week), but not for sufficient OPA (OR,0.93 95%CI [0.79–1.10]). In addition, the associations were dose-responsive, participants had 22–40%, 27–36%, and 26–47% lower odds of using prescription opioids depending on the duration of total PA, TPA, and LTPA, respectively. Nevertheless, the impact of PA on prescription opioid use varied by duration of opioid use. Sufficient total PA was associated with elevated odds of short-term use of prescription opioids (< 90 days). Comparatively, sufficient total PA, TPA, and LTPA had different beneficial effects on reducing long-term use of prescription opioids (≥ 90 days) depending on the strength of opioids.ConclusionsThis study demonstrated sufficient total PA, TPA, and LTPA were inversely associated with prescription opioid use and varied depending on the duration and strength of prescription opioid use. These findings highlight PA can provide policy guidance to address opioid crisis.

Effectiveness of an intervention program on physical activity in children with narcolepsy type 1

ObjectivesPhysical activity (PA) is recommended as part of the management of narcolepsy type 1 (NT1). This study aimed at 1) characterizing PA in children and adolescents treated for NT1 using objective and subjective measurements, 2) evaluating how PA is associated with NT1 symptoms and comorbidities, and 3) evaluating the effects of an Adapted Physical Activity (APA) program on PA and clinical characteristics. Patients/methodsPatients with NT1 from the National Reference Center of Narcolepsy (Lyon, France) were consecutively included in an APA intervention protocol. Narcolepsy symptoms and comorbidities were collected using standardized questionnaires and sustained attention was evaluated using the Bron-Lyon Attention Stability Test before and after the four-week APA intervention. PA was measured objectively using actigraphy throughout the study. ResultsTwenty-seven NT1 patients were included (median age 14.7 years [8.3–18.4], cataplexy 88.9%, obesity 37.0%). At baseline, 52.4% of the patients had satisfactory PA levels according to international recommendations. Patients with leisure-time PA (LTPA) showed higher quality of life than patients without. 45% of the patients increased PA during the intervention compared to baseline. These responsive patients had more depressive feelings and tended to have lower objective PA than non-responsive patients at baseline. No significant correlation was found between PA levels before and during the intervention and other clinical data. ConclusionsMost children with NT1 showed satisfying PA levels despite their daytime sleepiness. LTPA engagement was associated with higher quality of life. An APA intervention could be effective in children with narcolepsy, especially for those with depressive feelings.

Promoting physical activity in rheumatoid arthritis through a physiotherapist led behaviour change-based intervention (PIPPRA): a feasibility randomised trial

Physical activity (PA) is recommended as a key component in the management of people with rheumatoid arthritis (RA). The objective of this study was to examine the feasibility of a physiotherapist led, behaviour change (BC) theory-informed, intervention to promote PA in people with RA who have low levels of current PA. A feasibility randomised trial (ClinicalTrials.gov NCT03644160) of people with RA over 18 years recruited from outpatient rheumatology clinics and classified as insufficiently physically active using the Godin−Shephard Leisure Time Physical Activity Questionnaire. Participants were randomised to intervention group (4 BC physiotherapy sessions in 8 weeks) delivered in person/virtually or control group (PA information leaflet only). Feasibility targets (eligibility, recruitment, and refusal), protocol adherence and acceptability were measured. Health care professionals (HCPs) involved in the study and patients in the intervention and control arms were interviewed to determine acceptability. Descriptive statistics were used to analyse the data with SPSS (v27) with interviews analysed using content analysis using NVivo (v14). Three hundred and twenty participants were identified as potentially eligible, with n = 183 (57%) eligible to participate, of which n = 58 (32%) consented to participate. The recruitment rate was 6.4 per month. Due to the impact of COVID-19 on the study, recruitment took place over two separate phases in 2020 and 2021. Of the 25 participants completing the full study, 23 were female (mean age 60 years (SD 11.5)), with n = 11 allocated to intervention group and n = 14 to control. Intervention group participants completed 100% of sessions 1 & 2, 88% of session 3 and 81% of session 4. The study design and intervention were acceptable overall to participants, with enhancements suggested. The PIPPRA study to improve promote physical activity in people with RA who have low PA levels was feasible, acceptable and safe. Despite the impact of COVID-19 on the recruitment and retention of patients, the study provides preliminary evidence that this physiotherapist led BC intervention is feasible and a full definitive intervention should be undertaken. Health care professionals involved in the study delivery and the patient participants described a number of positive aspects to the study with some suggestions to enhance the design. These findings hence inform the design of a future efficacy-focused clinical trial.

Association Between Different Types of Physical Activity and Hepatic Steatosis and Liver Fibrosis: A Cross-Sectional Study Based on NHANES.

Many studies have shown a link between physical activity (PA) and nonalcoholic fatty liver disease (NAFLD). However, more research is needed to investigate the relationship between different types of PA and NAFLD. This study aimed to explore the potential link between different types of PA, hepatic steatosis, and liver fibrosis. A cross-sectional study was conducted using the data set from the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020. A multiple linear regression model was used to examine the linear relationship between different types of PA, the controlled attenuation parameter (CAP), and liver stiffness measurement (LSM). In addition, smoothing curve fitting and threshold effect analysis were used to depict their nonlinear relationship. This study involved 5933 adults. Multiple linear regression analysis revealed a significantly negative correlation between leisure-time PA and CAP, while the relationship between occupation-related PA, transportation-related PA, and CAP was not significant. Subgroup analysis further revealed that leisure-time PA was significantly negatively correlated with CAP in women and younger age groups (under 60y old), while the relationship was not significant in men and older age groups. In addition, there was a significant negative correlation between leisure-time PA and liver fibrosis in men. Leisure-time PA can prevent hepatic steatosis, and women and young people benefit more. Occupation-related PA is not associated with hepatic steatosis and cannot replace leisure-time PA. In men, increasing leisure-time PA is more effective in preventing liver fibrosis.

Moderating effect of leisure-time physical activity on the relationship between bullying victimisation and self-esteem in young Finnish men

Background and aimsThe links between bullying victimisation and low self-esteem are well established. However, the relationship between physical activity (PA), bullying victimisation and self-esteem is still rather unexplored. The present study aims to investigate the moderating effect of PA on the relationship between bullying victimisation and self-esteem among young men. MethodsThe sample used for this study is based on registers of the Finnish Defence Forces and consists of questionnaire-based data collected from young healthy men (n = 146 767, aged 18–29 years, mean age 19 years) who started their conscript service during 2015–2021. Self-esteem was measured with the Rosenberg Self-esteem Scale and bullying victimisation and leisure-time PA (LTPA) with single questions. Unadjusted and adjusted linear regression models and the aligned rank transform Anova model were calculated. ResultsThe findings showed that there is a dose-response association of self-esteem with bullying victimisation and LTPA. Furthermore, a significant moderating effect of LTPA was found in the relationship between bullying victimisation and self-esteem. Vigorous LTPA at least once a week seems to lessen the negative effects of bullying victimisation on self-esteem. ConclusionsLTPA may have the potential to buffer against negative mental health outcomes resulting from past experiences of bullying victimisation on a young person's self-esteem. More opportunities for LTPA to support self-esteem among young people should be provided, especially for vulnerable groups and those with limited resources and possibilities to engage with PA.

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...

Occupational physical activity, all-cause, cardiovascular disease, and cancer mortality in 349,248 adults: Prospective and longitudinal analyses of the MJ Cohort

BackgroundEvidence on the health benefits of occupational physical activity (OPA) is inconclusive. We examined the associations of baseline OPA and OPA changes with all-cause, cardiovascular disease (CVD), and cancer mortality and survival times. MethodsThis study included prospective and longitudinal data from the MJ Cohort, comprising adults over 18 years recruited in 1998–2016, 349,248 adults (177,314 women) with baseline OPA, of whom 105,715 (52,503 women) had 2 OPA measures at 6.3 ± 4.2 years (mean ± SD) apart. Exposures were baseline OPA, OPA changes, and baseline leisure-time physical activity. ResultsOver a mean mortality follow-up of 16.2 ± 5.5 years for men and 16.4 ± 5.4 years for women, 11,696 deaths (2033 of CVD and 4631 of cancer causes) in men and 8980 deaths (1475 of CVD and 3689 of cancer causes) in women occurred. Combined moderately heavy/heavy baseline OPA was beneficially associated with all-cause mortality in men (multivariable-adjusted hazard ratio (HR) = 0.93, 95% confidence interval (95%CI): 0.89–0.98 compared to light OPA) and women (HR = 0.86, 95%CI: 0.79–0.93). Over a mean mortality follow-up of 12.5 ± 4.6 years for men and 12.6 ± 4.6 years for women, OPA decreases in men were detrimentally associated (HR = 1.16, 95%CI: 1.01–1.33) with all-cause mortality, while OPA increases in women were beneficially (HR = 0.83, 95%CI: 0.70–0.97) associated with the same outcome. Baseline or changes in OPA showed no associations with CVD or cancer mortality. ConclusionHigher baseline OPA was beneficially associated with all-cause mortality risk in both men and women. Our longitudinal OPA analyses partly confirmed the prospective findings, with some discordance between sex groups.

Socio-ecological Barriers to Leisure Time Physical Activity in Spanish Wheelchair Users With Spinal Cord Injury: Associations With Sociodemographic Characteristics and Functional Independence

Objective(1) To assess prevalence and severity of socio-ecological barriers to leisure time physical activity (LTPA) in a sample of adults with spinal cord injury (SCI); (2) to examine the association of these barriers with sociodemographic characteristics and functional independence (FI); and (3) to explore which socio-ecological levels of barriers might be associated with LTPA. DesignCross-sectional study. SettingNeurorehabilitation Hospital specialized in SCI. Participants207 wheelchair users with SCI living in the community who attended a comprehensive check-up (22.7% women, 47.5±10.7 mean age; N=207). InterventionsNot applicable. Main Outcome MeasuresThe short version of the Barriers to Physical Activity Questionnaire for People with Mobility Impairments was used to measure socio-ecological barriers to LTPA. The Spinal Cord Independence Measure III was used to measure FI. The Physical Activity Recall Assessment for People with SCI was used to quantify LTPA. Several multiple linear regression models were computed to examine the associations between socio-ecological barriers and sociodemographic factors, LTPA and FI. ResultsA high prevalence of barriers to LTPA was found. Seven of these barriers (2 intrapersonal, 3 organizational, and 2 community) were present for >60% of the participants. Intrapersonal and organizational barriers had a higher effect on participants with lower FI and women. Interpersonal barriers were higher for older participants and with lower FI, while community barriers were higher for unemployed participants. Finally, intrapersonal and interpersonal barriers were negatively associated with LTPA, and FI revealed as a moderator of the intrapersonal barriers-LTPA relation. ConclusionsGiven their high prevalence and their association with LTPA, the development of interventions targeting socio-ecological barriers to LTPA in people with SCI becomes crucial. The associations of these barriers with FI and sociodemographic characteristics should also be considered for these interventions to be as specific and effective as possible.

Factors related to depression in adults with oral health problems in Spain (2017 to 2020).

The need to study the link between gender, depression, and oral health is becoming increasingly evident. This study therefore aimed to determine the prevalence and evolution over time of depression among women and men with oral health problems and to evaluate the association between depression status, lifestyle-related variables health-related variables and use of dental health services in those people. We performed a nationwide cross-sectional study on 25,631 adults with oral health problems residing in Spain from the Spanish National Health Survey 2017 and the European Health Survey of Spain 2020, including as the main variable self-reported diagnosis of depression. We analysed independent variables such as lifestyle-related variables, health-related variables, and variables related to dental health services. Sociodemographic characteristics were considered as control variables. The prevalence of depression among adults with oral health problems in Spain was 7.81% (10.14% for women, 5.39% for men), with a notable decrease from 2017 to 2020 in women. Depressed women had a slightly higher percentage of filled or capped teeth, and had more covers (crowns), bridges or other types of prostheses or dentures, while men had more caries. Women also made more frequent, regular dental visits for check-ups and mouth cleaning, whereas men often needed extractions. Unfavourable associated factors in both genders were: perceiving their health as good, average, poor, or very poor, and having 1-2 and ≥ 3 comorbidities. Conversely, not being a current smoker was related to less likelihood of depression. In women only, not engaging in leisure-time physical activity produced more unfavourable associated factors. The prevalence of depression among adults with oral health problems in Spain from 2017 to 2020 was 7.81%, but this figure has been steadily decreasing over time. In addition, the favourable and unfavourable associated factors could help us inform health professionals and authorities in order to prevent depression and enhance the care of this population according to gender.

Physical activity improves stress load, recovery, and academic performance-related parameters among university students: a longitudinal study on daily level

BackgroundPhysical activity has been proven to be beneficial for physical and psychological health as well as for academic achievement. However, especially university students are insufficiently physically active because of difficulties in time management regarding study, work, and social demands. As they are at a crucial life stage, it is of interest how physical activity affects university students' stress load and recovery as well as their academic performance.MethodsStudent´s behavior during home studying in times of COVID-19 was examined longitudinally on a daily basis during a ten-day study period (N = 57, aged M = 23.5 years, SD = 2.8, studying between the 1st to 13th semester (M = 5.8, SD = 4.1)). Two-level regression models were conducted to predict daily variations in stress load, recovery and perceived academic performance depending on leisure-time physical activity and short physical activity breaks during studying periods. Parameters of the individual home studying behavior were also taken into account as covariates.ResultsWhile physical activity breaks only positively affect stress load (functional stress b = 0.032, p < 0.01) and perceived academic performance (b = 0.121, p < 0.001), leisure-time physical activity affects parameters of stress load (functional stress: b = 0.003, p < 0.001, dysfunctional stress: b = -0.002, p < 0.01), recovery experience (b = -0.003, p < 0.001) and perceived academic performance (b = 0.012, p < 0.001). Home study behavior regarding the number of breaks and longest stretch of time also shows associations with recovery experience and perceived academic performance.ConclusionsStudy results confirm the importance of different physical activities for university students` stress load, recovery experience and perceived academic performance in home studying periods. Universities should promote physical activity to keep their students healthy and capable of performing well in academic study: On the one hand, they can offer opportunities to be physically active in leisure time. On the other hand, they can support physical activity breaks during the learning process and in the immediate location of study.