Vigorous Physical Activity Levels Research Articles

PHYSICAL ACTIVITY AND SYMPTOMS OF ANXIETY AND DEPRESSION AMONG MEDICAL STUDENTS DURING A PANDEMIC

ABSTRACT Introduction: Decreased physical activity has been associated with poorer mental health and is a cause for concern during the COVID-19 pandemic. Objective: To compare groups of medical students (MS) who practiced different levels of moderate and vigorous physical activity (MVPA) during the COVID-19 pandemic, in relation to symptoms of anxiety and depression (BAI-BDI), sleep quality (PSQI), and physical activity (PA) - light, moderate, vigorous (LPA-MPA and VPA), and sedentary behavior (SB). Methods: This research is a cross-sectional study involving 218 MS. Data on the characteristics of the MS were collected through online forms: PA, SB, BAI, BDI, and PSQI. The Cohen's D (Effect Size - ES) and confidence interval (95% CI), Mann-Whitney test: Lower MVPA (Median=0 minute) and Higher MVPA (Median=390 minutes) were recorded. For the statistical analyses, we used: the Odds ratio (OR) for the presence of symptoms of high levels of anxiety and depression and poor sleep quality in the MS and MVPA. Results: We found a small ES for symptoms of depression (ES 0.26 95% CI 0.00 0.53 p=0.029), and significant differences (p<0.05) for symptoms of anxiety (ES 0.17 95% CI −0.09 0.44 p=0.037). There was also a significant tendency for sedentary behavior on weekdays (ES 0.27 95% CI 0.00 0.53 p = 0.051). The OR for MVPA and the presence of symptoms of high levels of anxiety was 0.407 (95% CI = 0.228 to 0.724). Conclusions: the MS who practiced higher MVPA presented less symptoms of anxiety and depression during the COVID-19 pandemic. Level of evidence III; Case-control study.

Movement behaviors associated with mental health among US military service members

ABSTRACT Compared to the general adult population, military service members experience an excess burden of mental health problems (e.g., posttraumatic stress disorder, PTSD). Physical activity, screen time, and sleep (i.e., movement behaviors) are independently associated with mental health, but their combined effects are poorly understood, particularly in military populations. We analyzed data from active component service members in the national 2018 Health Related Behaviors Survey (N = 17,166). Weighted gender-stratified logistic regression models examined the associations of meeting recommended/healthy levels of moderate-to vigorous physical activity (MVPA), screen time, and sleep duration – separately and in combination (none, some, all) – with PTSD, suicide ideation, and serious psychological distress. In both men and women, meeting sleep recommendations was associated with reduced odds of each outcome. Meeting MVPA recommendations was associated with lower odds of serious psychological distress only in men (OR = 0.76, 95% CI: 0.58–1.00). No/low screen time was associated with lower odds of suicide ideation only in women (OR = 0.66, 95% CI: 0.45–0.95). The odds of all three outcomes were lower in those who reported some or all (vs. none) recommended/healthy movement behaviors, with the lowest odds found in the “all” group, suggesting a possible dose-response relationship. Findings can help inform multiple behavior change interventions to improve service members’ psychological fitness and military readiness.

Self-report Versus Measured Physical Activity Levels During Outpatient Cardiac Rehabilitation.

Many patients with coronary artery disease (CAD) do not achieve the recommended physical activity (PA) levels during and after cardiac rehabilitation (CR). The aim of this study was to analyze moderate to vigorous physical activity (MVPA) levels and the differences between perceived (self-reported) and measured (activity monitor) MVPA in CAD patients during CR. The second aim was to analyze which patient characteristics were associated with this difference. A two-center observational-sectional study was conducted within the Department of Rehabilitation Medicine of the University Medical Center Groningen between January and April 2018. Adults with CAD, following an outpatient CR program, were included. Perceived MVPA was assessed with the Short Questionnaire to Assess Health-enhancing Physical Activity and compared with ActivPAL3 activity monitor outcomes over a period of 7 d. Fifty-one patients with CAD (age 59.4 ± 7.1 yr, eight females) were recruited. Four patients (8%) did not achieve the recommended guideline level of ≥150 min/wk of MVPA. Patients spent ≥80% of the week in sedentary activities. Patients overestimated MVPA with a median of 805 (218, 1363) min/wk (P< .001). The selected patient characteristics (age, body mass index, type of CAD, type of CR, social support, and self-efficacy) were not associated with this overestimation. Most patients with CAD, participating in an outpatient CR program, do achieve MVPA exercise recommendations but spend simultaneously too much time in sedentary activities.

Lifestyle behaviors trend and their relationship with fear level of COVID-19: Cross-sectional study in Saudi Arabia.

IntroductionCOVID-19 pandemic cautionary measures have affected the daily life of people around the globe. Further, understanding the complete lifestyle behaviors profile can help healthcare providers in designing effective interventions and assessing overall health impact on risk of disease development. Thus, this study aims to assess the complete spectrum of lifestyle behaviors (physical activity, sedentary behavior, sleep, distress, social support, dietary habits, and smoking) prevalence and its association with fear of COVID-19 in people living in Saudi Arabia.MethodsSelf-administered survey consisted of seven sections was used to collect data on fear of COVID-19 using Fear of COVID-19 Scale (FCV-19S), physical activity and sedentary behavior using the Global Physical Activity Questionnaire (GPAQ), sleep quality using the Pittsburgh Sleep Quality Index (PSQI), psychosocial distress using Kessler Psychological Distress Scale (K-10), social support using the MOS social support survey, and dietary habits using a short version of food frequency questionnaire (FFQ). The online survey was distributed via social media platforms during lockdown period of COVID-19 pandemic (May–June 2020). Each section consisted of validated questionnaire examining one of aforementioned lifestyle behaviors. Associations were analyzed using multiple linear regression.ResultsA total of 669 individuals attempted to complete the online survey, 554 participants completed at least 2 sections of the survey (82.8%), and 41.3% (n = 276) completed the whole online survey. The majority of the sample were female (83%), not smokers (86.5%), had sufficient sleep duration (7.5 hrs ± 2.1), and only indicated mild level of distress (21.4 ± 8.9); they also reported high level of sedentary behavior (7.7 hrs ± 4.5), poor sleep quality (5.4 ± 2.4), were not engaged in healthy eating habits, and moderate level of perceived social support (62.0% ± 27). Only physical activity results indicated that about half of the sample were engaged in moderate to vigorous level of physical activity (54.3%). Further, being female (β = 0.12; 95% CI: 0.45, 2.94) and married (β = 0.13; 95% CI: 0.3, 2.63) were associated with fear of COVID-19 level (β = 0.21; 95% IC: 0.05, 0.19) with a confidence interval level of 95%. In addition, distress was associated with fear.ConclusionThe trend of lifestyle behaviors measured during lockdown period changed from previously published rates. Future research needs to establish the short-term and long-term effect of lifestyle behaviors complete profile on physical and mental health.

Do overweight/obesity and low levels of leisure-time vigorous physical activity moderate the effect of occupational physical activity on self-rated health of construction workers?

PurposeTo investigate the combined effects of occupational physical activity (OPA) and either overweight/obesity or low levels of leisure-time vigorous physical activity (LTVPA) on self-rated health.MethodsA longitudinal study was performed among 29,987 construction workers with complete data on 2 Workers’ Health Surveillance Programs during 2010–2018. Self-reported OPA involved strenuous work postures and manual material handling. Low level of LTVPA was defined as self-reported vigorous activity for less than three times per week lasting at least 20 min per session. Overweight and obesity were based on Body Mass Index (BMI) (25.0 ≤ BMI < 30.0 kg/m2 and BMI ≥ 30.0 kg/m2, respectively) using measured body height and weight. Self-rated health was measured using a single item question. Logistic regression analysis was used to investigate the associations between the separate risk factors at baseline and self-rated health at follow-up. The combined effects of demanding OPA and either overweight/obesity or low level of LTVPA on self-rated health were analyzed using the relative excess risk due to interaction (RERI).ResultsMean follow-up duration was 31.7 (SD = 14.9) months. Construction workers with strenuous work postures (OR 1.35 95% CI 1.25–1.46), manual material handling (OR 1.29 95% CI 1.19–1.40), obesity (OR 1.31 95% CI 1.17–1.47) and low LTVPA (OR 1.13 95% CI 1.01–1.25) were more likely to report poor self-rated health at follow-up. No statistically significant interaction effects were found for OPA and obesity or low LTVPA.ConclusionsOPA, obesity and low level of LTVPA were separate risk factors for poor self-rated health, but did not appear to have a synergistic effect.

The Impact of Total Joint Arthroplasty on Long-Term Physical Activity: A Secondary Analysis of the Health and Retirement Study.

Physical inactivity is the fourth-leading cause of global mortality and is prevalent among people with lower extremity osteoarthritis. Lower extremity osteoarthritis is the most common arthritis type afflicting older adults, and total joint arthroplasty (TJA) performed to address the condition is Medicare's largest annual expense. Despite TJA intervention to address the disabling effects of osteoarthritis, physical activity (PA) level remains stable 6months after TJA; however, the effect of TJA on long-term PA $(\ge$2 y) in a representative sample of older adults is unknown. The purpose of this study was to test the hypothesis that PA would remain stable in the long term. In this longitudinal observational study, a probability-weighted difference-in-differences analysis was conducted to observe the predictive margins of nontraumatic hip or knee TJA on levels of vigorous and moderate PA after 2years. A combined Health and Retirement Study data set of community-dwelling adults who were >55years old, had symptomatic osteoarthritis, and were in need of TJA between 2008 and 2018 (N = 4652) was used. TJA was not associated with vigorous PA ($\delta$ = 2.37; SE = 5.23) or moderate PA ($\delta$ = -2.84; SE = 7.76) after 2years. TJA was not associated with increased long-term PA in older adults with osteoarthritis. Physical therapists should not assume that there will be a natural increase in PA after functional recovery from TJA procedures. Older adults with lower extremity osteoarthritis may benefit from PA screening and promotion practices in physical therapy services. Receiving a total joint replacement does not lead to increased physical activity levels 2years after surgery.

Participation and Physical Activity in Recreovia of Bucaramanga, Colombia.

Open Streets initiatives have allowed for physical activity (PA) in cities worldwide. However, few studies have evaluated the use of small Open Streets in low- and middle-income countries, such as those in Latin America. Thus, this study aimed to describe participation and PA level of users in the Recreovia program in Bucaramanga, Colombia. A cross-sectional study was conducted during 5 Sundays from September to November 2017. Recreovia use was evaluated at 4 strategic points according to street accessibility (2 points) and aerobics class areas (2 points), using the System for Observing Play and Recreation in Communities. A total of 38,577 observations were made (34,969 on streets and 3608 in aerobics class areas). Men (63%) and adults (62%), with moderate to vigorous PA (MVPA) (98%) were observed on streets. The most common PAs were biking (50%), walking/dog walking (36%), and jogging (9%). In aerobics class areas, the most common groups were female (65%) and adults (89%). Participants were engaged in moderate to vigorous PA (91%). Measurement of number of participants at moderate to vigorous levels of PA was high. A difference between sexes and age in these street and aerobic class area groups was also observed.

Continuous Blood Glucose Monitoring Increases Vigorous Physical Activity Levels and Is Associated With Reduced Hypoglycemia Avoidance Behavior In Youth With Type 1 Diabetes.

The primary goal of this study was to explore physical activity (PA) levels, hypoglycemia fear scores and hypoglycemia episodes according to insulin administration and blood glucose monitoring methods in youth with type 1 diabetes (T1D). A self-administered questionnaire was completed by 28 children and 33 adolescents with T1D, and their PA was assessed. Hypoglycemia episodes, fear of hypoglycemia scores, insulin therapy (pump vs. injection) and blood glucose monitoring (continuous blood glucose monitors [CGMs] vs. blood glucose meters) methods are reported in the present work. There were no significant differences in the number of hypoglycemic episodes, child hypoglycemia fear survey behavior or total scores, or any components of the PA profile between youth using injections and those using a pump. However, these variables differed significantly when compared according to blood glucose monitoring method (CGMs vs. blood glucose meters): 41.2 vs. 81.8, p<0.01; 1.03 ± 0.05 vs. 2.6 ± 0.63, p<0.01; 1.09 ± 0.43 vs. 2.94 ± 0.22, p<0.01; and 222 ± 18 vs. 49 ± 11, p<0.01 (for total time in vigorous PA in minutes per week), respectively. CGM use correlated significantly with VPA levels (β=0.6; p=0.04). Higher VPA levels were associated with higher child hypoglycemia fear survey behavior scores (β=0.52; p=0.04). The latter correlates negatively with the number of episodes of hypoglycemia in the past 12 months in all category groups. The type of insulin injection was not associated with more activity in youth with T1D. In contrast, CGM use may be associated with increased vigorous PA among T1D youth. Those with higher hypoglycemia fear survey behavior scores engaged in more VPA and had fewer hypoglycemia episodes. Although CGM use ensures continuous monitoring of glycemia during exercise, increasing hypoglycemia avoidance behavior is still a necessary part of exercise management strategies in active youth with T1D.

Association of Diet, Physical Activity Guidelines and Cardiometabolic Risk Markers in Children

The aim was to identify different dietary and physical activity (PA) patterns in 5- to 14-year-old children with a high prevalence of overweight and obesity using cluster analysis based on their adherence to the Spanish Society of Community Nutrition dietary guidelines and levels of PA, and to determine their associations with age, sex, body composition, and cardiometabolic risk markers. In 549 children, hierarchical cluster analysis was used to identify subgroups with similar adherence to dietary recommendations and level of PA. Three clusters were identified: Cluster 1, with the lowest level of vigorous PA and adherence to dietary recommendations; Cluster 2, with the lowest levels of moderate and vigorous PA and the highest adherence to dietary recommendations; and Cluster 3, with the highest level of PA, especially vigorous PA and a medium level adherence to dietary recommendations. Cluster 3 had lower total body fat and higher lean body mass percentages than Cluster 2. Cluster 2 had lower high-density lipoprotein cholesterol and higher low-density lipoprotein cholesterol levels than Cluster 1. The results from our study suggest that it is important to consider adherence to PA recommendations together with adherence to dietary guidelines to understand patterns of obesogenic habits in pediatric populations with high prevalence of overweight and obesity.

Current status and correlates of screen time among children in Guangdong during the COVID-19 pandemic

Objective To investigate the current status of online classes, screen time and its influencing factors among primary school students in Guangdong during the 2019 novel coronavirus pandemic. Methods Using the convenience sampling method, a total of 5 266 pupils aged 6–12-years-old from Guangzhou, Zhanjiang, and Zhongshan participated in the online questionnaire. ANOVA or chi-square tests were performed to compare differences in online classes and screen time between grades, and multinomial Logistic regression was performed to analyze the correlates of recreational screen time. Results The prevalence of prolonged recreational screen time was 42.2% and 55.2% on weekdays and weekends, respectively. Recreational screen time increased by 40.31 min/d on weekdays and 33.07 min/d on weekends, compared to usual school semesters. The average duration of an online class was (26.07±9.62) min, which totaled (110.41±51.98) min per day. Sex, grade, being the only child, and parents’ education levels were identified as the influencing factors of prolonged recreational screen time. Children who practiced moderate levels (weekdays: OR =1.27; weekends: OR =1.40; P<0.05) or lower levels of physical activity (weekdays: OR=1.86; weekend: OR=1.84; P< 0.05) were at a higher risk of prolonged recreational screen time than those who practiced more vigorous physical activity. Children whose parents limited their screen time to a moderate (weekdays: OR=1.61, P<0.05) or lower level (weekdays: OR=1. 32, P< 0.05) had a higher risk of prolonged recreational screen time than those with a higher frequency. Children with parents’ recreational screen time ≥2 h/d had a higher risk of prolonged recreational screen time than the reference group; children who exhibited moderate to vigorous levels of physical activity <1 h/d (weekdays: OR=1.31, P<0.05), and those used electronic devices for learning 1-2 h/d (weekdays: OR=2.65; weekend: OR=2.65; P<0.05) or for ≥ 2 h/d (weekdays: OR=4.05, weekend: OR=5.24, P<0.05) were at a higher risk of prolonged recreational screen time than the reference group. Conclusion During the COVID-19 pandemic, the level of screen time among children in Guangdong was high. Behavioral monitoring and targeted interventions are needed to promote children’s health. 【摘要】 目的 了解新型冠状肺炎疫情期间广东省小学生网课及视屏行为现状及其影响因素, 为儿童视屏行为干预和健康促进提供依据。 方法 采用方便抽样的方法抽取广东省广州市、湛江市、中山市共 5 266 名 6~12 岁小学生家长进行线上问卷调查。采用方差分析或 χ 2 检验比较各年级学生网课和视屏行为现状的差异, 采用多因素 Logistic 回归分析娱乐型视屏时间过长的影响因素。 结果 小学生学习日和周末娱乐型视屏时间过长检出率分别为 42.2% 和 55.2%; 与非疫情的学期相比, 娱乐型视屏时间在学习日和周末分别增长了 40.31 和 33.07 min/d。各年级小学生平均单节网课时长为 (26.07±9.62) min, 单日网课时长为 (110.41±51.98) min。性别、年级、是否独生子女、父母文化程度等人口学因素是娱乐型视屏时间过长的影响因素;与父母陪伴运动锻炼频率较高的儿童相比, 父母陪伴运动锻炼频率中等(学习日： OR=1.27, 周末: OR=1.40) 和较低 (学习日： OR=1.86, 周末: OR=1.84) 儿童娱乐型视屏时间过长的风险较高 ( P 值均<0.05); 相较于父母限制视屏行为频率较高的儿童, 父母限制视屏行为频率中等和较低儿童学习日娱乐型视屏时间过长的风险较高 ( OR 值分别为 1.61, 1.32, P 值均<0.05); 父母娱乐型视屏时间 ≥2h/d 较 <2 h/d 易使儿童娱乐型视屏时间过长的风险增加(学习日： OR=3.09, 周末: OR=2.81, P 值均<0.05); 儿童中高强度体力活动 <1 h/d (学习日: OR =1.31) 相较于 ≥1 h/d, 用电子设备学习时间 1~2 h/d (学习日: OR=2.65, 周末： OR=2.65)、≥2 h/d (学习日: OR=4.05, 周末： OR=5.24) 相较于 <1 h/d 也增加了娱乐型视屏时间过长的风险 ( P 值均<0.05)。 结论 疫情期间, 广东省儿童视屏时间水平较高, 需加强恢复学校教学秩序后儿童的行为监测以及实施有针对性的干预措施。

Low physical activity levels 1 year after pregnancy complications.

Women with previous preeclampsia (PE), gestational hypertension (GH), or gestational diabetes mellitus (GDM) have increased cardiovascular disease (CVD) risk. Physical activity (PA) is an important CVD risk modifier. We aimed to assess PA levels, using a validated objective method, and other modifiable CVD risk factors in women with these previous pregnancy complications. One year postpartum we assessed PA levels for 1week in women with previous PE (n=68), GH (n=26), GDM (n=23), and normotensive pregnancies (n=65), using the ActiGraph-wGT3X-BT™ accelerometer. We assessed adherence to American PA guidelines (≥150min/week of moderate or ≥75min/week of vigorous intensity PA), and time spent in moderate and vigorous PA. We also assessed steps/day, blood pressure and anthropometric indices. Recommended PA levels were achieved in only 50%, 39%, and 35% following PE, GH, and GDM, respectively, not significantly different from controls (52%). Differences in moderate and vigorous PA levels and steps/day between the groups were non-significant, except from lower vigorous PA in women with previous GDM. Elevated blood pressure (systolic BP≥120mmHg and/or diastolic BP≥80mmHg) was more common after PE and GH. Overweight rates were significantly higher in PE, GH, and GDM groups compared to controls. Less than half of women achieved recommended PA levels 1year postpartum. This did not differ significantly between women with previous PE, GH, or GDM compared to controls. Measures to increase PA in postpartum women are warranted, especially in women with pregnancy complications associated with high risk of premature CVD.

Is Physical Activity Associated With Loneliness or Social Isolation in Older Adults? Results of a Longitudinal Analysis Using the Irish Longitudinal Study on Ageing.

Social relationships are central to the health and well-being of older adults. Evidence exploring the association of physical activity (PA) with social isolation and loneliness is limited. This study uses a path analysis to investigate the longitudinal association between loneliness and social isolation with PA using the Irish Longitudinal Study on Ageing. Higher levels of social isolation measured using the Berkman-Syme Social Network Index were directly and indirectly associated with lower levels of walking, moderate PA, and vigorous PA over 6 years. Additionally, higher levels of walking were associated with lower levels of loneliness measured using a modified version of the University of California, Los Angeles loneliness scale over a 3-year period. Future interventions should target individuals who are more socially isolated and explore the effects of different types of PA on loneliness over time.

The frailty and falling in related with functional performance, balance and physical activity in elderly during Covid-19 pandemics

Funding AcknowledgementsType of funding sources: None.BackgroundFalls and frailty are main causes of morbidity and frequenty associated with functional performance, balance and physical activity. The restrictions imposed by the COVID-19 pandemic force the elderly to spend most of their time at home which may cause further functional problems. Therefore, identifying the risk factors during the pandemic can help to prevent the elderly from frailty and falls. Aim: Our aims are to investigate the clinical frailty profile and falls in relation to functional performance, balance, fear of falling and physical activity and to compare these parameters of the elderly with and without falling history during the COVID-19 pandemics. Method: Thirty-three participants aged 65-85 (mean = 71.33 ± 5.35/years, 20 women, 13 men) who have never had COVID-19 were included in the study. The participants were invited to an online video-conference based assessment. The number of falls during the last year were asked. Clinical frailty severity was assessed with Clinical Frailty Scale. The fear of falling were assessed using Falls Efficacy Scale (FES). The functional performance of the participants were tested with 30 seconds Sit-to-Stand test. The balance and mobility was evaluated with Timed-Up and Go test in a 3 meter corridor. The physical activity level of the participants were questioned using International Physical Activity Questionnaire-Short Form (IPAQ-SF) and vigorous level of physical activity (VPA), moderate level of physical activity (MPA) and walking were also calculated. Results: The mean scores of the outcomes among participants were shown in Table 1. Clinical frailty was significantly higher in women compared to men (p = 0.08). Clinical frailty score, fear of falling and sit to stand performance were significantly worse in fallers. There were negative weak to moderate correlations between frailty and sit to stand performance (p = 0.001) and MPA (p = 0,016). The clinical frailty was also positively correlated with FES (p < 0.001). FES showed positive correlation with Time-Up and Go performance (p = 0.001) and negative correlation with sit to stand performance (p < 0.001) and MPA (p = 0,036). Conclusion: Our results demonstrated that; clinical frailty, fear of falling and sit to stand performance were associated with the fall history in elderly. In addition, clinical frailty score were higher in women. Our results indicate that, people who have fall history may tend to be frailer and may have lower functional performance, balance and physical activity. The encouragement of the elderly to increased physical activity and exercise program may decrease the frailty score and falling risk especially in elderly women during COVID-19 pandemics. Table.1

Effects of and Lessons Learned from an Internet-Based Physical Activity Support Program (with and without Physiotherapist Telephone Counselling) on Physical Activity Levels of Breast and Prostate Cancer Survivors: The PABLO Randomized Controlled Trial.

Simple SummaryMany cancer survivors have difficulties in attaining and maintaining physical activity (PA) after treatment. Therefore, we developed an Internet-based PA support program (IPAS), embedded in a patient portal. The aim of this study is to evaluate the effectiveness and costs of IPAS alone (online only) or IPAS combined with physiotherapist telephone counselling (blended care), compared to a control group. Our RCT included 137 breast and prostate cancer survivors. IPAS in its current form did not prove to be effective in increasing moderate to vigorous PA levels or secondary outcomes, compared to a control group, either as a standalone intervention or offered as blended care. We observed low to moderate satisfaction scores, with better scores for blended care. Recruitment and adherence to the study were challenging. Lessons learned led to suggestions for future trials, such as improved accessibility of the support program, increased frequency of support and use of activity trackers. Background: We developed an Internet-based physical activity (PA) support program (IPAS), which is embedded in a patient portal. We evaluated the effectiveness and costs of IPAS alone (online only) or IPAS combined with physiotherapist telephone counselling (blended care), compared to a control group. Methods: Breast or prostate cancer survivors, 3–36 months after completing primary treatment, were randomized to 6-months access to online only, blended care, or a control group. At baseline and 6-month post-baseline, minutes of moderate-to-vigorous PA (MVPA) were measured by accelerometers. Secondary outcomes were self-reported PA, fatigue, mood, health-related quality of life, attitude toward PA, and costs. (Generalized) linear models were used to compare the outcomes between groups. Results: We recruited 137 survivors (participation rate 11%). We did not observe any significant between-group differences in MVPA or secondary outcomes. Adherence was rather low and satisfaction scores were low to moderate, with better scores for blended care. Costs for both interventions were low. Conclusions: Recruitment to the study was challenging and the interventions were less efficacious than anticipated, which led to lessons learned for future trials. Suggestions for future research are as follows: improved accessibility of the support program, increased frequency of support, and use of activity trackers.

Longitudinal bidirectional associations of physical activity and depressive symptoms: The CARDIA study

Depression affects many aspects of health and may be attenuated through increases in physical activity. While bidirectional associations between physical activity (PA) and depressive symptoms have been examined, few studies have examined these associations using both self-reported and accelerometer-estimated measures. Using data from Years 20 (2005–06, age 38–50) and 30 of the Coronary Artery Risk Development in Young Adults (CARDIA) study (N = 2,871), the bidirectional associations between moderate to vigorous intensity physical activity (MVPA) and depressive symptoms were examined using a cross-lagged panel model. Differences in the observed associations by physical activity assessment method were also examined. An inverse bidirectional association between self-reported MVPA and depressive symptoms was found. In subsequent analyses stratified by intensity category, higher levels of vigorous intensity physical activity at baseline, but not moderate intensity physical activity were associated with lower levels of depressive symptoms at the 10-year follow-up (ϕ = −0.04, p < 0.01; ϕ = −0.03, p = 0.15, respectively). A 10-year increase in self-reported MVPA was associated with a 10-year decrease in depressive symptoms. No associations were observed between accelerometer MVPA estimates and depressive symptoms. These findings may support the notion that each assessment method captures related, but also unique, aspects of physical activity behavior. When possible, future studies should explore measures of association by each physical activity assessment method to gain a better understanding of the complex relationship between physical activity and health.

Physical activity, sleep, and quality of life of patients with asthma during the COVID-19 pandemic

Objective There is limited information in literature on how coronavirus disease-2019 (COVID-19) pandemic period affects people with asthma. This study aimed to compare levels of physical activity, stress, and fear and quality of life and sleep quality between patients with asthma and healthy individuals during the pandemic. Methods Twenty-two patients with asthma and 22 healthy individuals aged between 18 and 65 years were included. Physical activity level using “International Physical Activity Questionnaire”; stress level, using “Perceived Stress Scale-14”; fear level, using “Fear of COVID-19 Scale”; sleep quality, using “Pittsburgh Sleep Quality Index”; and quality of life, using “World Health Organization Quality of Life” were evaluated. Results Total physical activity level, vigorous physical activity level, and walking score of patients with asthma were lower than healthy individuals (p < .05). Sitting time of patients with asthma was higher than healthy individuals (p < .05). Subjective sleep quality, latency, duration, efficiency, sleeping medication use, and daytime dysfunction of both were similar (p > .05). Only sleep disturbance score of patients with asthma were higher than healthy individuals (p < .05). Quality of life, stress, and fear levels of both were similar (p > .05). Conclusion During pandemic, patients with asthma are more inactive than healthy individuals regardless of the presence of a chronic disease; pandemic negatively affected stress, fear levels, sleep, and quality of life. To minimize the effects of restrictions and psychological burden caused by pandemic and to encourage patients with asthma to perform physical activities, conducting studies to control stress levels and increasing quality of life and sleep of all individuals are important.

Mental well-being and physical activity of young people experiencing homelessness before and during COVID-19 lockdown: A longitudinal study

BackgroundWhile lockdown restrictions in response to COVID-19 indisputably mitigated virus transmission, the aim of this longitudinal study was to establish indirect effects on vulnerable young people's mental well-being and physical activity (PA) levels. MethodsSurveys conducted at time 1 (February 2020), and time 2 (April 2020) comprised of the short Warwick Edinburgh Mental Well-Being Scale, the Rosenberg Self-Esteem Scale, and self-reported moderate and vigorous PA levels. Repeated measures analyses established changes pre-post lockdown restrictions, and differences between sub-groups. Associations between changes in well-being, self-esteem and PA over time were explored through further regression analyses. Results65 respondents completed the survey at time 1, and 50 respondent at time 2. Wellbeing increased significantly over time, yet remained significantly lower than the population average. Self-esteem increased significantly post-lockdown, however remained significantly lower for females, compared with males. Overall, PA levels increased-whereby ‘inactive’ participants at time 1 reported significant increases in moderate and total activity levels at time 2. Increased PA levels significantly predicted increased well-being: F(1, 48) = 4.15, p < .05; while participants who had become less active accounted for 69.2% with low self-esteem at time 2. ConclusionsFindings indicate that increased PA accounted for improved mental well-being, while decreased PA was associated with reduced levels of self-esteem. PA may represent a modifiable means of mitigating risk, and promoting resilience for vulnerable young people experiencing adverse conditions.

Dietary intervention influence on physical activity in the Women’s Health Initiative randomized Dietary Modification trial.

10511 Background: In the Women’s Health Initiative (WHI) Dietary Modification (DM) randomized trial, after 8.5 years dietary intervention and 19.5 years cumulative (median) follow-up, dietary intervention participation was associated with a statistically significantly 22% lower breast cancer mortality (P = 0.02). In observational studies, physical activity has been associated with lower breast cancer risk with emerging results now indicating, compared to inactivity, any increase in physical activity has health benefits. Currently, longitudinal data on whether an intervention targeting dietary change influences other health-related behaviors as a gateway effect is limited. To evaluate whether randomization to a dietary intervention was associated with self-directed change in physical activity. Methods: In the WHI DM trial, 48,835 postmenopausal women, ages 50-79 years, with no prior breast cancer and baseline normal mammogram were randomized at 40 US clinical centers to a dietary intervention (19,541) or a comparison group. Dietary goals were to reduce fat intake to 20% of energy and increase intake of vegetable, fruit, and grains addressed in 18 group sessions in year 1 then quarterly. Neither randomization group received specific or ongoing instructions to increase physical activity, but physical activity was referenced in written materials given to the intervention groups in 7 of the 56 sessions. Episodes per week of moderate or vigorous recreational physical activity (MVPA) were collected at baseline and serially through 15.9 years follow-up by self-report questionnaire. Marginal longitudinal logistic regression models were used to assess physically inactive (MVPA = 0) or physically active (MVPA &gt; 0) participants by randomization group. Marginal Poisson regression models estimated mean weekly MVPA by randomization group. Results: 45.6% of participants reported 0 MVPA at baseline which largely persisted throughout follow-up. During cumulative follow-up, relative to the comparison group, dietary intervention group participation was associated with 7% lower physical inactivity rate (odds ratio [OR] 0.93 95% confidence interval [CI] 0.91, 0.95, P &lt; 0.001) and a 4% higher mean MVPA (ratio of means [RM] 1.04 95% CI 1.02, 1.06, P &lt; 0.001). The association between dietary intervention participation with higher physical activity level was stronger with increasing BMI (P-interaction 0.01) and for women with waist circumference ≥ 88 cm (P-interaction 0.02). Conclusions: In conclusion, in a randomized trial setting, a low-fat dietary pattern intervention was associated with a significantly lower physical inactivity rate and significantly higher moderate and vigorous physical activity level which could be associated with health benefits. Clinical trial information: NCT00000611 .

Moderate and vigorous physical activity levels are associated with circulating CD34+ progenitor cells which are predictive of all-cause and cardiovascular mortality

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Edinburgh Napier University Research Excellence Grant Background Circulating progenitor cells (CPCs) play an important role in vascular repair and may influence cardiovascular (CV) health and longevity. Physical activity is known to promote vascular health and may do so by modulating CPC counts. Purpose The primary aims of this study were to evaluate the association of CPCs with mortality and explore the association between physical activity (PA) and CPCs. Methods We studied 1,751 individuals from the Framingham Offspring cohort (66 ± 9 years, 54% female). CPCs (CD34+, CD34 + CD133+, CD34 + CD133 + KDR+) were measured from blood samples by flow cytometry. Multivariable cox regression analyses were performed to investigate the relationship of CPCs with future CV event, mortality, and all-cause mortality. Multivariate regression analyses were performed to determine the relationship between self-reported PA and CPC counts. Results Following adjustment for standard risk factors, there was an inverse association between CD34+ CPCs and all-cause mortality (hazard ratio (HR) per unit increase in CD34+, 0.79; 95% CI 0.64 – 0.98). CD34 + CD133+ CPCs were inversely associated with CV mortality (HR 0.63, 95% CI 0.44 – 0.91, P = 0.013). Associations of CD34+ and CD34 + CD133+ with mortality were strongest in participants with pre-existing CVD. PA was associated with CD34+ CPCs only in CVD participants. This relationship was maintained after adjustment for confounding variables. Conclusions Higher number of CD34+ and CD34+ CD133+ CPCs were inversely associated with all-cause and CV mortality. These associations were strongest in participants already diagnosed with CVD. PA is independently associated with CD34+ CPCs in individuals with CVD only, suggestive of greater benefit for this population group.

Effects of yoga and resistance training on blood lipids in people without preexisting cardiovascular disease

Abstract Funding Acknowledgements Type of funding sources: None. Background Yoga and resistance exercise are gaining popularity and can improve the health status in the adult population. There is a lack of evidence that compares these two types of physical activity and their influence on lipid profile and cardiovascular risk on people without preexisting cardiovascular disease. Aim To estimate and compare effects of yoga and resistance training on blood lipids and anthropometric parameters in people without preexisting cardiovascular disease. Methods 123 adults without preexisting cardiovascular disease were enrolled in the study. Participants had practiced in yoga (63 people) or resistance exercise (60 people) at least 2 times a week during the last 12 months. The control consisted of 35 people who did not engage in any regular physical exercise. Weight, height, waist, hip circumference and body mass index (BMI), blood pressure, total cholesterol, triglycerides and high-density lipoproteins cholesterol, blood glucose were measured. To assess physical activity and sedentary time, the International Questionnaire on long Physical Activity (IPAQ) was used. Daily calorie food intake were measured by Test of rational nutrition TRN-D03. Result The average age of all participants was 35,06 ± 8,45 years old. BMI was significantly affected in "yoga training" (1-st group) and "resistance training" (2-nd group) groups (22,9 ± 2,6 and 24,2 ± 3,7; p = 0,19), but was significantly lower than in control group (3-rd group) 25,8 ± 2,1. Total Cholesterol, triglycerides, non-HDL cholesterol and blood glucose were not with significant difference between "yoga training" and "resistance training" groups. High-density lipoprotein (HDL) level was in "yoga training" group - 1,65 ± 0,37; in "resistance training" - 1,43 ± 0,21, and in control group - 1,34 ± 0,22 mmol/l (p1-2 = 0,001; p1-3 = 0,0001; p2-3 = 0,037). Low-density lipoprotein (LDL) was in yoga training group - 2,69 ± 0,98; in resistance training group - 2,72 ± 0,77, and in control group - 2,93 ± 0,89 mmol/l (p1-2 = 0,35; p1-3 = 0,053; p2-3 = 0,20). The systolic and diastolic blood pressure were in "yoga training" group - 117,0 ± 9,79; in "resistance training" - 118,5 ± 8,93; 3-rd - 120,2 ± 10,1 mm Hg (p &amp;gt; 0.05). Although, there were no significant differences in LDL-cholesterol levels between the yoga and resistance training groups, we found an association between weekly vigorous physical activity level and LDL cholesterol in the male group. LDL-cholesterol level in group 1 (vigorous physical activity 0-960 MET-min/week) was 3,4 ± 0,88 mmol/l; group 2 (vigorous physical activity 960 - 1440 MET-min/week) was 2,6 ± 0,74 mmol/l and in group 3 (vigorous physical activity &amp;gt; 1440 MET-min/week) - 2,1 ± 0,71 mmol/l (ANOVA-test F = 16,3; p = 0,03). Conclusion Yoga and resistance training have positive effects on HDL, LDL level and BMI, without effects on blood pressure in people without preexisting cardiovascular disease. The level of LDL was influenced not by the type of training, but by intensity of weekly physical activity.