Low Levels Of Physical Activity Research Articles

Associations of comorbid headache disorders and depression with leisure‐time physical activity among 14,088 adults in The Brazilian Longitudinal Study of Adult Health

AbstractBackgroundWhile headache disorders are linked to low physical activity levels, the impact of depression on this relationship is unclear.ObjectiveTo assess how single and comorbid diagnoses of migraine and tension‐type headache (TTH) interact with depression and leisure‐time physical activity (LTPA) levels in The Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil).MethodsIn this cross‐sectional analysis based on the ELSA‐Brasil baseline data, the relationship of migraine, TTH (both assessed with the International Classification of Headache Disorders, Second Edition), and depression (assessed with the Clinical Interview Schedule–Revised) with LTPA levels (International Physical Activity Questionnaire) was investigated by employing linear regression models. Models were adjusted for sociodemographic, lifestyle, and clinical covariates, and interaction terms were created to examine additive effects of comorbid conditions.ResultsAmong 14,088 participants, 54.4% (7668/14,088) were female, prevalence rates were: TTH = 39.6% (5573/14,088), migraine = 27.0% (3806/14,088), depression = 0.7% (94/14,088), depression + TTH = 1.1% (148/14,088), and depression + migraine = 2.5% (356/14,088). The mean (standard deviation) LTPA levels across the groups were: no headache + no depression = 148.7 (183.0) min/week, TTH = 133.5 (170.1) min/week, migraine = 110.3 (154.8) min/week, depression = 76.5 (146.3) min/week, depression + TTH = 84.5 (127.7) min/week, and depression + migraine = 64.3 (123.2) min/week. Negative associations were found for depression (β = −55.1, 95% confidence interval [CI] −93.6 to −17.0; p = 0.005), migraine (β = −24.7, 95% CI −33.2 to −15.4; p < 0.001), and TTH (β = −15.5, 95% CI −23.1 to −7.6; p < 0.001) with LTPA. No interaction effect was observed for depression + TTH (β = 36.0, 95% CI −12.6 to 84.6; p = 0.147) and depression + migraine (β = 31.7, 95% CI −11.3 to 74.7; p = 0.149), indicating no additive effect of comorbid conditions on LTPA levels. After adjusting for headache attack frequency, only depression + migraine remained negatively associated with LTPA (β = −38.7, 95% CI −71.6 to −5.8; p = 0.021).ConclusionsHeadache disorders and depression were independently and inversely associated with LTPA, with the strongest effects seen in depression alone or comorbid with migraine.

Nutritional status and physical activity levels of adolescents in public and private schools

Highlights The prevalence of overweight and obesity was high in both educational institutions. The overall level of physical activity in the adolescents was low. Public school students were more physically inactive compared to private school students. Tenth and eleventh graders are more physically inactive than ninth graders. Introduction: Obesity and physical inactivity in adolescents are associated with some diseases, and poor academic performance. Studies have reported differences in the level of physical activity according to the type of school. Objective: To compare the prevalence of obesity and physical inactivity in adolescents in a public and a private school. Materials and Methods: A cross-sectional study was conducted among adolescents attending a public school and a private school. Ninth, tenth, and eleventh-grade students between 14 and 17 years were included. Physical activity level was assessed using the Physical Activity Questionnaire for Adolescents, and nutritional status using body mass index for age. Results: Information was collected from 343 students, of whom 55.10% (n=189) were from a public school. The 28.28% were overweight. The overall level of physical activity in adolescents was low (mean= 1.97 95% CI 1.92 – 2.01). It was found that public school students were more inactive adjusted (PR= 1.40; 95% CI 1.03 - 1.92) compared to private school students. Discussion: Adolescents do not achieve optimal levels of frequency and duration of physical activity, highlighting the need for educational programs and attractive interventions to promote physical activity. Conclusion: Adolescent students have low levels of physical activity, with more inactive students in the public school compared to the private school. The prevalence of overweight was high in both schools. How to cite this article: Arias-Silva María V, Pedreros-Lemuz Valentina, Rodríguez-Perdomo Angie L, González-Lozano Raúl A, Ramos-Castaneda Jorge A. Nutritional status and physical activity levels of adolescent in public and private schools. Revista Cuidarte. 2024;15(3):e3942. https://doi.org/10.15649/cuidarte.3942

Association of erectile dysfunction and peripheral arterial disease in NHANES 2001-2004: a cross-sectional study

ObjectiveTo evaluate the association between Erectile dysfunction (ED) and peripheral arterial disease (PAD) in adult American males using a large database.MethodsThe relationship between ED and PAD prevalence among participants in the 2001-2004 National Health and Nutrition Examination Survey (NHANES) database was assessed using a series of statistical analyses. ED was evaluated based on a single-item measure of self-reported erection problems from the Massachusetts Male Aging Study. PAD was defined as ankle-brachial index (ABI) < 0.9 in at least one leg. Multifactorial logistic regression models were used to investigate the association between ED and PAD.ResultsA total of 2394 participants were enrolled, of whom 905 individuals (37.8%) were diagnosed with ED. After adjusting for confounding variables, the association between ED and PAD remained positive, with an odds ratio of 2.05 (95% confidence interval 1.24-3.39). Subgroup analysis revealed that the relationship between ED and PAD was significant in patients aged >50 years old, without hypertension, without diabetes, without cardiovascular disease, without high cholesterol, former smokers, low physical activity levels, and a body mass index of 25-30 (P < 0.05). In addition, all subgroups analyzed were evaluated for any potential interaction, and no statistically significant association was discovered.ConclusionsIn a sample of US adults aged ≥40, this cross-sectional study found that ED is related to a higher occurrence of PAD. ED may be an independent predictor of PAD, and thus it should be considered in the treatment of patients with ED.

Physical activity and persistence of supra-threshold depressive symptoms in older adults: A ten-year cohort study

Few multination-based studies have examined the longitudinal association between PA (physical activity) and persistence of supra-threshold depressive symptoms (SDS). This cohort study aimed to assess the influence of PA on persistence of SDS. Data were obtained from the Population Survey of Health, Ageing and Retirement in Europe (SHARE). The cohort was composed of individuals with SDS at baseline. Depressive symptoms were ascertained using the EURO-D scale, with a value over 4 indicatives of SDS. The study included 6,631 participants with SDS. After adjusting for nine different covariates at baseline and the changes of PA level during the follow-up period, compared to very low PA, moderately high (OR=0.82; 95 %CI: 0.69–0.98; p = 0.03), and high (OR=0.80; 95 %CI: 0.66–0.95; p = 0.01) PA levels were associated with significantly reduced persistence of depressive symptoms. In a propensity score analysis, matching low and high PA level for baseline scores of EURO-D, people with high PA levels reported a lower EURO-D of 0.53 points (p < 0.0001). In conclusion, among adults with depression, higher levels of PA were associated with a reduced persistence of depression. These real-world data complement evidence on efficacy of exercise as a treatment for depression and can inform clinical guidelines.

Unhealthy Dietary Pattern Associated with Common Mental Disorders in Adults and Older Adults: A Population-based Study

Background:: Mental and behavioral disorders are influenced by biological, psychological and social factors, especially income, gender, age and family environment, indicating that physical health is directly associated with mental health. In this perspective, food consumption is highlighted as a risk factor for mental health, as healthy behaviors, along with a good quality diet, can reduce symptoms of anxiety and depression. Objective:: The objective of this a study is to investigate the association between CMD and dietary patterns, among other lifestyle and socioeconomic factors. Method:: Cross-sectional population-based and household study conducted with 1574 individuals aged over 20 years, of both sexes, residing in Teresina and Picos, Piaui, Brazil. Sociodemographic, lifestyle and food consumption data were collected. The instrument used to identify the presence of CMDs was the Self Reporting Questionnaire 20 (SRQ-20). Dietary patterns were obtained using the Principal Component Analysis method. Results:: Individuals of female sex, separated, with low education, smokers and lower level of physical activity had a higher prevalence of common mental disorders. As for the eating pattern, after adjustments, individuals who adhered to the unhealthy eating pattern had a 9% higher prevalence of CMD. Furthermore, adherence to the white meat standard represented 12% higher prevalence of CMD. Conclusion:: The results showed that, regardless of other socioeconomic and lifestyle factors, adherence to a more monotonous eating pattern in foods, characterized by the mainly consumption of animal protein and the lack consumption of foods like fruits and vegetables, as well as a less healthy one, characterized by the consumption of ultra-processed foods, increases the risk of developing CMD.

ВЛИЯНИЕ ЭКОНОМИЧЕСКИХ ФАКТОРОВ (ДЕТЕРМИНАНТ) НА СУБЪЕКТИВНЫЕ ОЦЕНКИ УРОВНЯ ФИЗИЧЕСКОЙ АКТИВНОСТИ НАСЕЛЕНИЯ ТРУДОСПОСОБНОГО ВОЗРАСТА

Despite the importance of physical activity indicators and their decisive influence on public health indicators, no studies have been conducted on the impact of health determinants, including economic ones, on physical activity indicators. The purpose of the study is to analyze the fact and degree of influence of economic factors as a component of lifestyle on physical activity indicators. Materials and methods of research. The individual economic characteristics of patients were considered as the object of the study. Since the normality of the distribution for quantitative features, as a rule, was not observed, a nonparametric criterion was used to assess the differences 2 and the nonparametric analogue of the correlation coefficient is the association coefficient. Approaches to the identification and measurement of the economic determinant of public health were described in detail earlier [24, 25]. The size of the real random sample was 1400 respondents. The average age of respondents of working age in the general sample was 39.7 years. As criteria of physical activity, subjective characteristics of physical activity given by the respondents themselves, the fact of performing physical exercises, and attitude to active recreation were used. Results. The use of complex (composite) features characterizing a person's financial situation and economic well-being makes it possible to identify differences in behavioral patterns regarding subjective perceptions of the level of physical activity among the working-age population. The influence of economic factors (determinants) is manifested in a decrease in the level of physical activity and a greater proportion of those who have low and very low levels of physical activity according to their own ideas, a more frequent negative attitude towards physical exercise among respondents with a low level of material security. However, the subjective attitude towards active recreation was positive for the majority of respondents, regardless of their level of material well-being.

A Tailored Postpartum eHealth Physical Activity Intervention for Individuals at High Risk of Postpartum Depression-the POstpartum Wellness Study (POW): Protocol and Data Overview for a Randomized Controlled Trial.

Postpartum depression (PPD) is associated with significant health consequences for the parent and child. Current recommendations for PPD prevention require intense health care system resources. Evidence-based interventions for PPD prevention that do not further burden the health care system are needed. Evidence suggests that physical activity (PA) can generally reduce depressive symptoms. Technology-based interventions may help decrease common barriers to PA. This study aims to report the protocol and provide a data overview of the POstpartum Wellness study (POW)-an effectiveness trial evaluating whether an eHealth PA intervention tailored for postpartum individuals increased PA and decreased depressive symptoms among individuals at high PPD risk. This remote parallel-group randomized controlled trial included postpartum individuals with a history of depression or at least moderate current depressive symptoms not meeting the PPD diagnostic threshold and with low PA levels from an integrated health care delivery system. Participants were randomized to an eHealth PA intervention or usual care. The intervention group received access to a library of web-based workout videos designed for postpartum individuals, which included interaction with their infants. At baseline and follow-up (3 and 6 months), PA was measured using questionnaires and a wrist-worn accelerometer. Depressive symptoms were measured using the Patient Health Questionnaire-8 (PHQ-8). Data were collected to assess exploratory outcomes of sleep, perceived stress, anxiety, parent-infant bonding, and infant development. The study was funded in January 2020. Participants were enrolled via REDCap (Research Electronic Data Capture) or telephonically between November 2020 and September 2022; data collection ended in April 2023. Randomized participants (N=99) were 4 months post partum at baseline with moderately severe depressive symptoms (mean PHQ-8 score 12.6, SD 2.2). Intervention (n=50) and usual care (n=49) groups had similar sociodemographic characteristics, months post partum, baseline depressive symptoms, number of children at home, and prepregnancy PA levels. Retention in assessments was ≥66% for questionnaires and ≥48% for accelerometry, with modest differences by group. At 3-month follow-up, 73 of 99 (74%) participants (intervention: 35/50, 70%; usual care: 38/49, 78%) completed questionnaires; 53 of 99 (54%) wore the accelerometer for 7 days (27 of 50 (54%) intervention, 26 of 49 (53%) usual care). At 6-month follow-up, 66 of 99 (67%) participants (30 of 50 (60%) intervention, 36 of 49 (73%) usual care) completed questionnaires and 43 of 99 (43%) wore the accelerometer for 7 days (21 of 50 (42%) intervention, 22 of 49 (45%) usual care). Data analysis is completed, and a manuscript with these findings is currently under review for publication. The POW trial evaluates the effectiveness of an eHealth PA intervention for improving depressive symptoms and increasing PA among postpartum individuals at high PPD risk. Results have implications for the design and delivery of behavioral interventions among vulnerable patients. ClinicalTrials.gov NCT04414696; https://clinicaltrials.gov/ct2/show/NCT04414696. DERR1-10.2196/56882.

Institutional Examples of Applying the SHAPE Appropriate Instructional Practice Guidelines for Higher Education Physical Activity Programs

This educational brief provides examples of applications of the recently updated Society of Health and Physical Educators (SHAPE) Appropriate Instructional Practice Guidelines for Higher Education Physical Activity Programs across several institutions (SHAPE America, 2022). Research has shown that movement and physical activity are essential for managing physical and mental health; therefore, the current low level of physical activity among college students is concerning (American College Health Association, 2024; Rodríguez-Romo et al., 2022). Academic instructional physical activity programs (IPAPs) provide students with quality learning environments that promote and support opportunities for lifelong physical activity and movement. Empowering physical activity instructors with appropriate instructional practices increases the likelihood of positive experiences for both students and instructors. The intent of this brief is to demonstrate how SHAPE IPAP Guidelines are incorporated in universities today. The institutional examples can serve as models to facilitate discussions within other colleges and universities. The information provided will assist program administrators and faculty in developing, better aligning, and supporting their respective IPAP with teaching, administrative, and instructional practices as identified in the SHAPE IPAP Guidelines document.

Exploring the perceived dynamic system driving inequities in the community obesogenic environment

Abstract Introduction Persons in socioeconomically disadvantaged situations (PSEDS) are more susceptible and disproportionally exposed to obesogenic environments, resulting in poorer dietary outcomes and lower levels of physical activity. This study aimed to map the complex dynamic system within the community obesogenic environment driving unhealthy eating and insufficient physical activity among PSEDS in Flanders, and to identify potential local actions. Methods Participatory group model building (GMB), a qualitative system dynamics method, was used to engage PSEDS (n = 7), local decision makers (n = 7) and local stakeholders (n = 5) in two Flemish municipalities. A two-day GMB session was held in each municipality during which a causal loop diagram (CLD) was created and potential local actions were identified by considering causal pathways and reinforcing loops in the system. Results The CLD was designed around two main variables (i) healthy eating and (ii) physical activity among PSEDS. Seven sub-systems could be identified: 1) social environment, 2) facilities and activities, 3) mobility options, 4) information, 5) affordability, 6) safety (specifically for physical activity), and 7) industry and advertisement (specifically for eating behaviour). Several actions to improve the local environment to promote eating behaviour and physical activity among PSEDS were identified. Conclusions The CLD illustrates the complex interactions between individual and environmental determinants contributing to inequalities in eating behaviour and physical activity by including multiple perspectives of community members in socioeconomically disadvantaged situations, local decision makers and local stakeholders. Both the participatory GMB approach and the final CLD visualization can provide the basis for planning local actions for promoting healthy eating behaviour and physical activity among PSEDS. Key messages • Group model building is an effective approach to explore and understand a dynamic complex system through a shared understanding among diverse stakeholders. • A systems approach is valuable to provide a more comprehensive and context-specific understanding of the perceived factors contributing to inequities in the obesogenic environment.

Effect of physical activity level on the association of LBBB, heart failure, and mortality

Abstract Background The beneficial effect of physical activity (PA) on adverse cardiovascular outcomes in patients with heart failure (HF) and left bundle branch block (LBBB) is well established. Yet, the impact of PA on individuals with LBBB without evident HF remains unexplored. Our objective is to investigate how PA modifies the outcomes of new-onset LBBB patients concerning HF-related hospitalizations and mortality. Methods Among the UK Biobank participants without a diagnosis of HF, we identified individuals with new-onset LBBB and available PA quantification. Patients were dichotomized into normal QRS and LBBB groups, following by stratification according to summed minutes of PA per week. The primary outcome was all-cause mortality, and HF-related hospitalizations. Cox proportional hazard model and Kaplan-Meier survival analysis were applied. Results The final cohort comprised 367,934 individuals, with a mean age of 56.6±8.2 years and 47% male. Among them, 3,427 (0.9%) developed new-onset LBBB, characterized by advanced age, male predominance, and higher rates of comorbidities. Median summed PA minutes per week were 100 (IQR: 125-180), with no significant difference between normal QRS and LBBB patients. Over a median follow-up of 13.8 years (IQR: 13-14.5), 26,304 patients (7.15%) died. Kaplan-Meier analysis revealed higher mortality risk with reduced PA level and/or LBBB (log-rank p&amp;lt;0.001 for both). Multivariate Cox analysis adjusted for age, sex, and comorbidities showed LBBB patients had over 3.5-fold increased risk of death (HR 3.67, 95% CI 3.39-3.97, p&amp;lt;0.001) compared to normal QRS. The association of LBBB with mortality was modified by weekly PA minutes; those with &amp;lt;150 minutes had nearly 40% higher risk compared to those with ≥150 minutes (HR 3.78, 95% CI 3.43–4.15, p&amp;lt;0.001; HR 3.4, 95% CI 2.93–3.95, p&amp;lt;0.001; p for interaction=0.035). The protective effect of PA was 6% among normal QRS patients, compared to 22% among individuals with LBBB (HR 0.94, 95% CI 0.91 – 0.96, p&amp;lt;0.001 vs. HR 0.78, 95% CI 0.66 – 0.93, p=0.004). Similar findings were observed for HF hospitalizations. Conclusions Although the correlation between LBBB and adverse cardiovascular outcomes remained consistent across both levels of physical activity (PA), it was more pronounced among patients with low PA levels. When assessing the risk in patients with newly diagnosed LBBB, particular attention should be directed towards their PA status.

Frailty, cognition and patient-reported outcomes in middle-aged and older adults with congenital heart disease: insights from an international multicentric study

Abstract Background Prior research has demonstrated that a significant proportion of older patients with congenital heart disease (CHD) are frail or pre-frail and experience cognitive impairment. However, it remains unclear whether frailty and cognition are related to patient-reported outcomes (PROs) such as perceived health, anxiety and depression symptoms or quality of life in CHD. Purpose The objective of this study was to explore the relationships between frailty, cognitive function, and PROs in middle-aged and older adults with CHD ranging from mild to severe complexity. Methods As part of the cross-sectional ‘Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease – International Study II’ (APPROACH-IS II), we enrolled 814 individuals aged 40 years and older (median age: 52.0 years [45.0-61.0]; 51.4% female; 12.7% mild, 70.1% moderate, 17.2% complex CHD; 41.9% pre-frail, 5.8% frail; 38.7% cognitively impaired) across 17 centers in 11 countries. Frailty status was assessed using the Fried criteria, which categorize individuals into robust, pre-frail, and frail based on five factors: weakness, slow gait, unintentional weight loss, exhaustion, and low physical activity levels. Cognitive function was determined using the Montréal Cognitive Assessment. Participants completed questionnaires to evaluate perceived health (RAND-12 Health Survey, yielding both Physical and Mental Component Summaries, and EuroQOL-5D Visual Analog Scale), depressive symptoms (Patient Health Questionnaire-8), anxiety symptoms (General Anxiety Disorder scale-7), and quality of life (QoL Linear Analog Scale). Results Frailty was significantly associated with all PROs, with frail and pre-frail individuals reporting less favorable outcomes (see Figure). Cognitive function was linked to perceived health and anxiety, with patients exhibiting cognitive impairments reporting poorer perceived health and more anxiety symptoms. Conclusion This study indicates that concepts of frailty, cognitive functioning and PROs are closely related in adults with CHD. Frailty and cognition thus represent important domains when developing strategies to optimize PROs in adults with CHD. Moreover, when working with patients who are frail or cognitively impaired, healthcare workers are encouraged to consider and inquire about potential impact on PROs. Longitudinal research is needed to explore the direction of the association.

Endothelial dysfunction in acute coronary syndrome: a complex association with cardiovascular risk factors, sleep quality and cardiorespiratory capacity

Abstract Introduction It is widely acknowledged that normal endothelial function plays a pivotal role in conferring cardioprotective effects against ischemia-reperfusion injury following acute myocardial infarction (AMI) treated by a primary percutaneous coronary intervention (PCI), thereby limiting infarct size (1). However, endothelial dysfunction (ED) has been extensively documented in patients with cardiovascular (CV) risk factors (2). This study proposes a novel perspective, positing that ED could be intricately linked not only with traditional CV risk factors, but also it can be associated with poor sleep quality. Consequently, this interplay might significantly contribute to the attenuation of exercise capacity. Objective The aim of this study was to assess endothelial function following AMI treated with a PCI and investigate the link between endothelial function, CV risk factors, sleep quality and exercise capacity. Furthermore, the study aimed to determine if endothelial function could serve as a predictive factor for future major adverse acute cardiac events (MAACE) following AMI. Materials and methods Sixty-three patients with AMI (56.21 ± 7.6 years) volunteered to participate in this study, . Endothelial function was assessed using the Endothelium Quality Index (EQI) . Sleep quality was evaluated using both actigraphy and the PSQI (Pittsburgh Sleep Quality Index) questionnaire. Exercise capacity was quantified through the 6-minute walking test (6mwt). Results ED was evident, as indicated by an EQI of 1.4 ± 0.7. Furthermore, ED was notably influenced by CV risk factors such as low physical activity level, age, and smoking. A significant correlation was found between EQI and both sleep efficiency (r = 0.340; p = 0.006) and PSQI score (r = -0.533; p &amp;lt; 0.001). Additionally, a strong association was observed between endothelial function and the results of the 6mwt (r = 0.291; p = 0.021). Furthermore, during a follow up period ( near 4 months) following PCI, MAACE were observed in patients with severe ED only. Conclusion In summary, findings of this study may emphasize the importance of enhancing sleep quality and advocating for an active lifestyle as modifiable elements to enhance endothelial function, which can be regarded as a prognostic tool subsequent to AMI, ultimately contributing to improved clinical outcomes. Moreover, this study concluded that AMI patients with severe endothelial dysfunction were more likely to develop MAACE.Endothelial Dysfunction after AMIED following AMI : Causes and effect

Integrating international lifestyle management of acute coronary syndrome and type 2 diabetes mellitus: a rapid review of guidelines

Abstract Background The rising prevalence of comorbidity has been described as an international health priority. There has been a dramatic increase in the levels of Type 2 Diabetes Mellitus (T2DM) among those with Acute Coronary Syndrome (ACS), with approximately 25-40% of patients admitted to hospital for ACS, also having diabetes. Comorbid ACS-T2DM provides a more complex set of symptoms for patients and clinicians to manage, and health policy makers to plan for. Those living with comorbid ACS-T2DM are at increased risk of death, another heart attack, re-hospitalisation, heart failure, reduced physical and psychological health, increased health service use and poorer quality of life. Due to shared disease determinants such as obesity, low physical activity levels and poorer dietary habits; individuals with ACS are more likely to have a comorbid T2DM. Care for patients with comorbidities is fragmented, siloed and poorly organised as it reflects a tradition of single disease management meaning comorbidity is rarely considered. Robust evidence is required to shape provision and guidance for those with comorbid ACS-T2DM and the clinicians involved in their care; with an emphasis on redesigning service provision and practice to address the needs of this growing population. Purpose To identify opportunities in existing clinical guidance to improve integrated care strategies and streamline management for those with comorbid ACS-T2DM. Methods Following Cochrane rapid review recommendations, a Population, Concept, and Context (PCC) framework guided eligibility. Guidelines for adults with ACS, T2DM, or both conditions in high-income countries were considered. Nineteen guidelines from the UK, Australia, Canada, Europe, Ireland, New Zealand, and the USA were compared, covering ACS (n = 10), T2DM (n = 6), and comorbid ACS-T2DM (n = 3). Lifestyle factors examined included diet/nutrition, physical activity, weight management, clinical and psychological aspects. Results The review identified consistent lifestyle recommendations for both ACS and T2DM, with overlaps in guidance for diet, physical activity, weight management, clinical, and psychological factors. The findings offer opportunity for integrated care strategies, potentially reducing duplicated lifestyle management efforts. The results lay the groundwork for more cohesive management of comorbid ACS-T2DM. Conclusions This research is relevant for healthcare providers, policymakers, and patients living with comorbid ACS-T2DM. Understanding the shared lifestyle factors provides valuable insights into the potential for integrated care. Recognising the overlap in existing clinical guidelines points to opportunity for a more streamlined and effective approach to managing comorbid ACS-T2DM. This knowledge can contribute to improved patient outcomes and seek to optimise healthcare resources.

The substantial role of sleep, stress and physical activity in persistent high levels of fatigue in patients with inflammatory bowel disease: A longitudinal trajectory study.

Fatigue is a common and burdensome problem for patients with inflammatory bowel disease (IBD). Previous studies lack insight into the individual variability in fatigue severity and course over time, and the characteristics of patients at risk of severe and persistent fatigue. This study aimed to identify distinct groups of IBD patients based on their level and course of fatigue over five years. Subsequently, we examined the relationship between these trajectories, patient characteristics and trajectories of perceived stress, sleep and physical activity. This longitudinal cohort study used prospectively collected data from the myIBDcoach telemedicine monitoring tool, including 320 IBD patients who completed three or more online consultations between 2016 and 2021. Latent class growth analyses were performed to identify distinct trajectories. We found five subgroups with distinct trajectories of fatigue, differing in level and course over time, with 33% of patients experiencing chronic stable and high levels of fatigue. Few differences in patient characteristics were found between trajectories, yet the chronic high fatigue subgroup was more likely to report persistent stable sleep problems, perceived stress, and little physical activity over time compared to the other groups. Distinct subgroups of IBD patients can be identified based on longitudinal fatigue trajectories. The relatively stable levels of fatigue, stress, sleep, and physical activity suggest that a one-time screening of patients on these topics may be sufficient to identify those at risk. Interventions aiming to reduce fatigue should target persistent stress, sleep problems, and low levels of physical activity.

Association Between Physical Activity and Pancreatic Cancer Risk and Mortality: A Systematic Review and Meta-Analysis

Background: Physical activity has been associated with a lower risk of various types of cancer and reduced cancer-specific mortality. Less is known about its impact on pancreatic cancer. The aim of this systematic review and meta-analysis was to summarize evidence on the association between physical activity and pancreatic cancer risk and mortality. Methods: PubMed and Embase were searched until May 2024 for studies examining physical activity in relation to pancreatic cancer incidence and mortality. Summary risk estimates for highest vs. lowest physical activity levels were calculated using a random-effects model. The risk of publication bias was assessed with a funnel plot and Egger’s regression test. Results: A total of seven case–control and eighteen prospective cohort studies were included that investigated the association between physical activity and pancreatic cancer incidence. Our meta-analysis showed a summary estimate of 0.75 (95% CI 0.64–0.88) for case–control studies (I2 = 23%, n = 7) and a summary estimate of 0.91 (95% CI 0.86–0.97) for prospective cohort studies (I2 = 5%, n = 18). Among the six prospective cohort studies that assessed pancreatic cancer mortality, the summary estimate was 1.03 (95% CI 0.83–1.27), I2 = 50%. Conclusions: Higher levels of physical activity were associated with reduced pancreatic cancer risk. Evidence from a limited number of studies suggests that pre-diagnosis physical activity does not affect pancreatic cancer mortality.

A Study of Hypertension and Fitness of Individuals with Spinal Cord Injury: A Cross-Sectional Study

Background/Objectives: Individuals with spinal cord injuries have a higher incidence of chronic conditions such as hypertension and cardiovascular diseases due to a sedentary lifestyle and low levels of physical activity caused by their disability. Additionally, their physical fitness levels are lower compared to those without disabilities. This cross-sectional study aimed to investigate the relationship between hypertension and the fitness of individuals with spinal cord injuries in South Korea while considering differences across sexes and spinal cord injury levels. Methods: This study used data for 835 individuals with spinal cord injuries aged 20–64 years who visited the Korea Paralympic Committee fitness standard test centers from 2018 to 2022, obtained from the Korea Culture Information Sports Association’s big data market. The data were analyzed using a series of t-tests, a one-way analysis of variance, a logistic regression analysis, and the four-quartile method. Results: The prevalence of hypertension was 24.4%, and it was different according to the spinal cord injury impairment level. A lower grip strength, a lower arm curl, and a higher body mass index were associated with increased blood pressure. Conclusions: Therefore, a high level of physical strength in people with spinal cord injuries is thought to contribute to lowering blood pressure.

Sex differences in the prevalence of metabolic syndrome and associated factors in the general population of Mongolia: A nationwide study.

The prevalence and factors associated with metabolic syndrome (MetS) between men and women in Mongolia were compared using secondary data from the STEPwise approach to non-communicable disease risk factor surveillance conducted in 2019. In total, 5,695 participants (2,577 males and 3,118 females) aged 18-69 years old were enrolled in the study. The prevalence of MetS was 37.4% in total and the prevalence was significantly higher in women (39.2%) than men (35.2%, P = 0.002). The most prevalent MetS components were abdominal obesity in women (74.2%) and high blood glucose levels in men (58.7%). All of the 2,128 participants who were categorized into MetS met the criteria of abdominal obesity. Factors associated with MetS included being 30-69 years old compared to 18-29 years old, low and moderate physical activity levels compared to high levels, history of hypertension and diabetes mellitus, and a high body mass index (overweight and obesity) compared to a normal body mass index in both sexes. Additional factors included Buryat ethnicity compared to Khalkh ethnicity, living in Ulaanbaatar, no education compared to primary education, higher monthly income, and currently drinking in men; and smoking and sufficient fruit and vegetable intake in women. Significant differences were observed between men and women in terms of the prevalence of MetS, components of MetS, and factors associated with MetS. To reduce MetS prevalence in Mongolia, sex-specific programs should be designed to promote health behavior, such as reducing alcohol consumption in men and smoking in women.

The feasibility and acceptability of engaging older adults living with multiple long-term conditions, frailty, and a recent deterioration in health in research: Findings from the Lifestyle in Later Life – Older People’s Medicine (LiLL-OPM) study

BackgroundOlder adults living with multiple long-term conditions (MLTC, also known as multimorbidity) and frailty are more likely to experience a deterioration in their health requiring specialist referral or hospital admission than individuals without these syndromes. However, this group of older people are underserved by research meaning that there is a limited evidence base for their care. This study therefore aimed (1) to determine if it is feasible to recruit and collect quantitative data to describe the health and lifestyle of older adults living with MLTC, frailty and a recent deterioration in health and (2) to assess if taking part in research is acceptable to this group of older adults.MethodsParticipants were approached and recruited for this study via an Older People’s Medicine Day Unit in Newcastle upon Tyne, UK. The study took a mixed methods approach, involving quantitative and qualitative data collection. To determine the feasibility of carrying out research in this group, we quantified recruitment rate and collected data on the health and lifestyle, including diet and physical activity, of the participants. Qualitative semi-structured interviews were undertaken to assess acceptability. Two separate interviews were carried out focusing on involving older adults in research and the participants’ experiences of taking part in the research. Interviews were analysed using thematic analysis.ResultsFifty patients were approached to participate in the study with twenty-nine (58%) successfully recruited. It was feasible to collect information to describe the health and lifestyle of these older adults who demonstrated very low levels of physical activity. Participants reported that taking part in the research was acceptable to them with interview analysis generating three themes (1) developing a meaningful partnership, (2) enabling factors to participation: research at home with flexible delivery and (3) social and psychological benefits of research participation.ConclusionsIt is feasible and acceptable to recruit and carry out research with this underserved group of older adults. Participants found taking part in this research to be acceptable and reported overall positive experiences of their involvement in the study and indicated that they would be willing to contribute to further research in the future.

Impact of daily physical activity level on mental health and quality of life in substance use disorders patients

ABSTRACT Background Substance use disorders patients often exhibit low levels of physical activity. However, the daily level of physical activity appears to significantly impact the patient’s rehabilitation process. Methods This study analyses the daily level of physical activity (International Physical Activity Questionnaire-Short Form) in a group of 125 patients undergoing rehabilitation, and its relationship with levels of mental health (Depression Anxiety Stress Scale) and quality of life (Short Form Health Survey). Additionally, gender differences in all measured variables were analyzed. Results The results show a strong correlation between daily physical activity and levels of mental health (ρ>0.787), as well as a moderate correlation between physical activity levels and quality of life (ρ:0.406–0.586). Furthermore, when analyzing gender differences, women exhibited lower levels compared to men in physical activity (p < 0.001), mental health (p < 0.05), and different quality of life indicators (p < 0.05). Conclusion The results of this study indicate that the level of daily physical activity could influence the quality of life and mental health of patients during the rehabilitation process. Therefore, rehabilitation treatments should include strategies to increase patients’ daily physical activity levels. Furthermore, considering the gender disparities identified, additional studies are warranted in this field.

Does reducing smartphone use impact physical activity?

A sedentary lifestyle and low levels of physical activity among the population are major public health challenges due to numerous associated health risks. These behaviors are influenced by a number of environmental and cultural factors, such as screen addiction. To study the impact of reducing smartphone use by one hour per day for one week on physical activity. We conducted a descriptive epidemiological study that included 490 individuals. Participants were recruited by means of a media campaign called "Let's put down our smartphones challenge", which was conducted in Brest, France. The questionnaires were widely publicized, and candidates from all over France were able to participate. Data reflecting physical activity were collected before and after the challenge, one week apart, through an online questionnaire. Among the 490 participants, 126 (25.7%) succeeded in the challenge and reduced the time spent on their smartphones by more than 60 minutes. Among those 126 participants, 112 individuals (89%) increased their physical activity. On average, participants who succeeded in the challenge reduced their smartphone use by 110.57 minutes (±53.66) (p< 0.001) and increased their number of steps by 841 (±14710) (p = 0.02). The proportion of patient reaching an increase of both 500 and 100 daily steps was statistically significant in the group reaching a reduction of smartphone use of 60 minutes versus the remainder (p = 0.016 and 0.018, respectively), but not for a cut off at 1000. A reduction in the time spent using smartphones results in an increase in the average number of daily steps. Limiting the leisure time spent on screens is a potential strategy for addressing physical inactivity and a sedentary lifestyle.