Meeting Physical Activity Guidelines Research Articles

The Need for Enhanced Physical Activity Levels among Adults in South East Nigeria: Barriers, Implications, and Recommendations

Abstract Physical activity (PA) is globally recognized as essential for overall health, particularly in preventing noncommunicable diseases among adults. However, the level of PA among adults in South East Nigeria presents a complex scenario marked by disparities and challenges. This study examines PA levels among adults in South East Nigeria, identifies barriers, and proposes strategies for improvement. Despite the World Health Organization recommendations, studies indicate that a significant portion of adults in South East Nigeria do not meet PA guidelines, with notable disparities between urban and rural areas. Recommendations include establishing community-based initiatives, increasing research efforts, leveraging health-care providers’ roles, and promoting grassroots advocacy for PA as well as involving stakeholders at all levels to create a supportive environment conducive to increased PA levels and improved public health outcomes.

Muscle-Strengthening Activity among College Students: Who, What, Where, and Is It Enough?

ABSTRACT Introduction Muscle-strengthening activity (MSA) is recommended for all major muscle groups ≥2 d·wk−1. Assessment is often based on the number of days per week of MSA without determining if all major muscle groups are being used, precluding accurate determination of compliance with physical activity (PA) guidelines. Thus, characteristics of MSA remain inadequately characterized, especially among college students. Although it is known that males engage in more MSA than females across the lifespan, more detailed information regarding sex differences in this behavior is needed. The purpose of this study was to comprehensively describe MSA among male and female college students to a) characterize adherence to MSA guidelines according to frequency of MSA and number of muscle groups used, and b) explore sex differences in MSA. Methods College students (n = 651, 79.1% female, 20.3 ± 1.3 yr old) reported frequency of participation in MSA, muscle groups used, types of MSA performed, and location of MSA engagement via online questionnaires. The proportion of students meeting public health recommendations for MSA and characteristics of MSA participation were analyzed for the total sample and separately for male and female students. Results The proportion of students meeting MSA recommendations ranged from 9.8% to 52.7% depending on the minimum number of muscle groups required. Regardless of criteria, males were more likely to meet PA guidelines and reported more days of MSA, more muscle groups used, more types of MSA, and MSA at more locations than females (all P ≤ 0.05). Conclusions Estimates of compliance with MSA guidelines vary substantially depending upon the number of muscle groups required for compliance. Frequency of MSA and specific muscle groups worked should be included as part of MSA assessment to align with PA guidelines. Sex differences also influence MSA participation; thus, tailoring of messages and programming may improve MSA participation on college campuses.

Association of resting heart rate and physical activity with cardiovascular mortality: A population-based cohort study of Korean adults

ABSTRACT To examine the independent and combined association of resting heart rate (RHR) and physical activity (PA) with risk of cardiovascular disease (CVD) mortality. RHR was categorized as < 60, 60–69, 70–79, and ≥ 80 bpm. Meeting PA guidelines was defined as ≥ 150 min/week of moderate to vigorous physical activity (MVPA). Cox proportional hazard models were used to calculate hazard ratios (HRs) for CVD mortality associated with RHR and PA. Among 31,697 participants, 311 CVD deaths occurred during 9.2 years of follow-up. Compared to RHR of 60–69 bpm, the risk of CVD mortality was higher in RHR of < 60 bpm (HR, 1.48; 95% CI, 1.05–2.10) and ≥ 80 bpm (HR, 1.42; 95% CI, 1.06–1.91). Participants who met PA guidelines had a lower risk of CVD mortality (HR, 0.59; 95% CI, 0.44–0.78). Among physically inactive adults compared to participants in RHR of 60–69 bpm with meeting PA guidelines, the adjusted HR for CVD mortality was 2.41 (95% CI, 1.42–4.08) for RHR of < 60 bpm, 1.59 (95% CI, 1.01–2.49) for RHR of 60–69 bpm, 1.98 (95% CI, 1.23–3.20) for RHR of 70–79 bpm and 2.41 (95% CI, 1.50–3.89) for RHR of ≥ 80 bpm Exceeding the minimum level of PA guidelines may attenuate the risk of CVD mortality associated with RHR.

A web-based physical activity intervention targeting affect regulation: a randomized feasibility trial

Early career professionals (ECPs) are a critical target for physical activity (PA) promotion. Affect contributes to an established PA intention-behaviour gap and is pertinent among ECPs. Objective The purpose of this study was to examine the feasibility and acceptability of a web-based intervention and explore the effects on secondary outcomes (moderate-to-vigorous PA (MVPA), emotion regulation, multi-process action control constructs). Methods Adults aged 25-44 who were employed at least part-time in a desk-based job and not meeting PA guidelines (<150 min MVPA) were recruited and randomized into a 6-week online intervention integrating acceptance and commitment principles and affect regulation strategies, or a control group. Results Forty adults were recruited and randomized to the web-based intervention (n = 21) and waitlist control (n = 19). The recruitment rate was 29%, retention was 75%, engagement was 68%, and satisfaction was high in both quantitative and qualitative assessment. Participants allocated to the intervention improved MVPA (ηp 2=0.30), emotion regulation (ηp 2 =0.49), behavioural regulation (ηp 2=0.53), affective attitude (ηp 2=0.23), identity (ηp 2=0.24), and constructs of mindfulness (ηp 2=0.44), and valued living (ηp 2=0.20). Conclusions Primary outcomes concerning feasibility were adequate and secondary outcomes improved, suggesting a full-scale randomized controlled trial is feasible with minor modifications. A large-scale study is warranted to establish intervention effectiveness.

The role of breast cancer-related arm lymphedema in physical functioning and physical activity participation among long-term African American breast cancer survivors.

Breast cancer-related arm lymphedema (BCRL) is a common chronic and debilitating condition that involves accumulation of lymphatic fluid in the arm or hand. Limited data are available on BCRL in African American women. Lack of physical activity (PA) and poor physical functioning (PF) are both associated with increased morbidity and mortality among breast cancer survivors. We examined the association of BCRL with PA and PF among African American breast cancer survivors. 323 African American women who previously participated in a case-only study in three states (TN, GA, SC) completed a survivorship-focused questionnaire (mean: 4.2years post-diagnosis) in 2015-2016. Validated measures were used to determine BCRL, PF, and PA. Adjusted binary logistic regression models estimated ORs and 95% CIs for the association of BCRL and meeting PA guidelines (≥ 150min/week), while multinomial logistic regression was used for PF and PA (minutes/week) categorized based on tertiles. Approximately 32% reported BCRL since diagnosis; 25.4% reported BCRL in the last 12-months. About 26% and 50% reported that BCRL interfered with exercise and ability to do daily activities, respectively. The mean PF among those with BCRL was 51.0(SD:29.0) vs. 68.5(SD:30.1) among those without BCRL. BCRL was associated with lower PF (adjusted-OR for tertile 2: 2.12(95% CI:1.03-4.36) and adjusted-OR for tertile 1: 2.93(95% CI:1.44-5.96)). BCRL was associated with lower PF among long-term African American breast cancer survivors. Continued monitoring by health care professionals and increased education and behavioral interventions to support PA and improved PF among survivors living with BCRL are warranted.

Compliance with the 24-hour movement behavior guidelines and the impact of sleep methods among toddler, preschool, and school-aged children enrolled in the Guelph Family Health Study

Canadian movement guidelines focused on physical activity (PA), sleep, and screen time support childhood development and reduce the risk of chronic disease. Accelerometers are often used to capture these behaviors; however, they are limited in their ability to record daytime sleep due to potential misclassification. ObjectivesThe objectives of this study were to 1) determine the prevalence of children enrolled in the Guelph Family Health Study who met the guidelines and to 2) compare the impact of different sleep measurement methods. Design/methodsToddlers (1.5–<3 years; n = 128; valid data for all movement behaviors, n = 70), preschoolers (3–<5 years; n = 143; valid data for all movement behaviors, n = 104), and school-aged (5–<6 years; n = 49; valid data for all movement behaviors, n = 31) children were included. Screen time and sleep habits were obtained through parental report and published normative data. PA and sleep were recorded using accelerometers (wGT3X-BT ActiGraph; right hip). ResultsIt was found that 66 % of toddler, 44 % of preschool, and 63 % of school-aged children met the screen time guidelines. Further, 63 % of toddler, 98 % of preschooler, and 80 % of school-aged children met PA guidelines. Sleep guideline compliance ranged from 3 % to 83 % in toddler, 27 % to 92 % in preschooler, and 32 % to 90 % in school-aged children. These proportions were found to be significantly different (Cochran's Q and McNemar's tests). ConclusionsNearly all children met PA guidelines. In contrast, less than half to two-thirds met screen time guidelines. Compliance with sleep guidelines varied substantially with measurement method, highlighting the need for standardization.

Examining associations between physical activity context and children meeting daily physical activity guidelines: the role of outdoor play, sports, and other organized activities.

Less than one-quarter of US children meet physical activity (PA) guidelines. Understanding the context in which PA occurs and how these contexts may play a role in meeting PA guidelines is an essential step toward developing effective behavioral interventions. The purpose of this study was to examine associations between PA context (sports participation, participation in other organized physical activities, active travel to school, and outdoor play) and the number of days children met PA guidelines in a representative sample of children living in Texas. We analyzed cross-sectional data from a statewide sample of fourth-grade children in Texas who completed the 2019-2020 Texas School Physical Activity and Nutrition (Texas SPAN) survey. The Texas SPAN survey was designed to monitor the statewide prevalence of overweight/obesity among school children and assess habitual self-reported obesity-related behaviors, including diet and PA. Weighted Poisson regression models were employed to examine the associations between PA contexts (sports participation, participation in other organized physical activities, active travel to school, and outdoor play) and the number of days children met PA guidelines, adjusting for sex, race/ethnicity, overweight/obesity, urban-rural status, and economic disadvantage. A total of 16.7% of fourth-grade children met physical activity guidelines every day during the week (mean age = 9.4 ± 0.6 years; female = 48.7, 51.8% Hispanic, mean days meeting PA guideline = 3.6 ± 2.3 days). One in ten (11.2%) children did not meet daily PA guidelines on any day of the week, and 72.1% met them between 1 and 6 days. Participating in sports (b = 0.22, 95%CI:0.14, 0.30), any other organized physical activities (b=0.13, 95%CI:0.017, 0.19), and playing outdoors 1-3 days (b = 0.25, 95%CI:0.04, 0.46) and 4-7 days in the past week (b = 0.77, 95%CI:0.57, 0.97) was significantly and positively associated with the number of days children met PA guidelines. Participating in sports, participating in other organized physical activities, and playing outdoors may beneficially influence the number of days children meet PA guidelines. PA programs should consider these contextual factors and investigate how to promote organized activities and outdoor play effectively and appropriately among children.

Physical activity and functional social support in community-dwelling older adults: a scoping review

BackgroundGlobally, the population of older people is increasing and is estimated to reach nearly 2.1 billion by 2050. Physical activity (PA) is one of the key components for successful ageing. However, PA decreases with age and many older adults do not meet PA guidelines. Previous research has shown that social support (SOSU) is related to PA in older people. The aim of this scoping review is to identify and map all of the available evidence and to explore the association between functional SOSU and PA in older adults. Functional SOSU consists of emotional, informational, instrumental and companionship SOSU and social comparison.MethodsA scoping review was conducted using the Joanna-Briggs manual. Quantitative and qualitative studies investigating associations between functional SOSU and PA levels in older adults (mean age ≥ 60 years) were identified through a systematic search in seven electronic databases up to August 2023. After removing duplicates, 20,907 articles were screened for titles and abstracts. The results were analysed separately for different types of SOSU.Results116 articles met the inclusion criteria; 72% were quantitative studies and 28% were qualitative studies. Most studies used self-reported PA measures, only 23% of the studies used objective-reported PA measures. Most studies of SOSU for PA reported positive associations but the evidence is inconclusive when the source of support is considered. PA is positively associated with general, emotional, informational, and companionship SOSU, while instrumental support may occasionally be negatively associated. Companionship support is particularly influential on PA, especially in group settings, as it promotes social connectedness. Qualitative studies show that social comparison also supports PA. Different forms of SOSU generally show positive associations with PA.ConclusionsWhile the evidence on the association between functional SOSU and PA is mixed, most studies show that there is a positive association. PA may also be a strategy for improving social contact and social integration. This study offers a comprehensive overview of measures for SOSU and PA and thereby informs future research and policy-making.

Abstract PO2-11-07: Early Integration of Exercise into Breast Cancer Care: The MSK Healthy Living Program

Abstract Background: In patients with early-stage breast cancer, quality of life (QoL) worsens within 3-6 months following diagnosis. Physical activity (PA) can mitigate the adverse effects of treatment and improve QoL, and low PA level is associated with cancer recurrence and mortality. However, PA interventions are not included in standard cancer care. Early intervention to increase PA levels may improve QoL during active cancer therapy. The Healthy Living Program (HLP) at Memorial Sloan Kettering Cancer Center (MSK) is a lifestyle and survivorship program that engages early-stage breast cancer patients at the time of diagnosis using lifestyle risk stratification and matched referrals. We investigated whether early exercise intervention through the MSK HLP impacts QoL within the first months after cancer diagnosis. Methods: At the time of diagnosis, patients complete a lifestyle questionnaire (LQ), which is a composite of validated instruments, including the Godin Leisure Time Exercise Questionnaire (GLTEQ). Patients not meeting PA guidelines per the GLTEQ are offered a referral to an exercise physiologist (EP). The EP creates an individualized, home-based exercise program using the FITT Principle (Frequency, Intensity, Time, and Type). Patients meet with the EP every 4 weeks for 16 weeks; if exercise recommendations continue to be unmet, the program is extended. The Functional Assessment of Cancer Therapy-Breast (FACT-B) and 36-Item Short Form Survey Instrument (SF-36) were completed at baseline and the 16-week follow-up. Results: 252 patients enrolled between April 2020 – February 2023, of whom 92 volunteered to complete the QoL assessments. Median age was 53 years [range 23-84]; 12/252 (13.0%) of patients had ductal carcinoma in situ, 60/252 (65.2%) had Stage 1 disease, 17/252 (18.5%) had Stage 2 disease, and 3/252 (3.1%) had Stage 3 disease. 29/252 (31.5%) received chemotherapy, 62/252 (67.4%) received radiation, and 79/252 (85.9%) received hormone therapy. The mean baseline FACT scores were FACT-B: 116, FACT-G: 87, and FACT-B Trial Outcome Index (TOI): 73. At the 16-week follow-up, all QOL scores remained stable from baseline (means FACT-B: 118, FACT-G: 89, and TOI: 75). Improvements were observed among the subscales of the SF-36 from baseline to follow-up. The largest improvements were observed in physical and emotional role function scores, with 22% and 13% improvements from baseline to follow-up, respectively. Conclusions: A clinically implemented exercise intervention embedded in standard of care prevented decreases in QoL and improved physical and emotional functioning during the initial course of adjuvant breast cancer therapy. These findings support early implementation of lifestyle modification after a breast cancer diagnosis. Citation Format: Kylie Rowed, Sherry Shen, Andrea Smith, Bridget Kelly, Rocco Magnoli, Stacie Corcoran, Melissa Emerzian, Cynthia Cruz, Erica Salehi, Cara Anselmo, Mark Robson, Neil Iyengar. Early Integration of Exercise into Breast Cancer Care: The MSK Healthy Living Program [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-11-07.

PHYSICAL ACTIVITY AND SPINAL CORD INJURY: BEHAVIOUR, BARRIERS, MOTIVATIONS AND GAINS

INTRODUCTION &amp; AIMS To attain a comprehensive understanding of physical activity (PA) behaviour in individuals with a spinal cord injury (SCI) in Australia. Investigation and analysis included volumes, guideline-adherence, barriers, motivators, and perceived benefits of PA. METHODS Methodology included quantitative and qualitative approaches. Statistical tests were used on national survey data (n=1,579) to scrutinise PA volumes and guideline-adherence. Semi-structured interviews (n=105) were used to explore barriers to PA, whilst focus groups (six groups of six people) were used to uncover motivations for, and gains of, PA. RESULTS The average PA per week was 333 (+/-318) minutes, 42% of people were sedentary, and less than half (47%) of individuals met PA-specific guidelines. Sociodemographic and injury characteristics displayed very weak capacity (2-5% variance) in predicting PA volume. Barriers pertained to cost, accessibility, pain, self-consciousness, and a perceived lack of return of investment in PA. Whilst appearance/weight management and improved health appeared initially as motivators to PA, participants reported they gained more affiliation and revitalisation through PA, and less appearance/weight management and health change than they had anticipated. Focus group analysis highlighted that the primary (and more significant) motivators and benefits of PA include independence, reclamation of identity, restitution, reduced familial burden, and mitigation of perceived hastened aging. CONCLUSION People with SCI in Australia are amongst the most sedentary in the nation, and less than half of individuals meet PA guidelines. Specific attention is needed toward females, older individuals and people injured non-traumatically. Barriers are significant and affordable and accessible services, skilful and knowledgeable clinicians, and an inclusive environment are needed to improve consumer confidence. Motivation and perceived benefits extend beyond obvious physical advantages of PA. Clinicians and scientists need to understand the psychosocial influence of PA in this sedentary population and harness this knowledge to improve participation and quality of life.

Meeting the WHO Physical Activity Guidelines is Associated With Lower Odds of Depression in Older Adults: Potential Psychosomatic Mechanisms

ObjectivesLimited data exist on the association between physical activity (PA) and depression in older adults from low- and middle-income countries (LMICs). In this study, we examine the association between meeting the World Health Organization (WHO) PA guidelines and depression in adults aged ≥50 years in Ghana and investigate the psychosomatic factors explaining this association. MethodsCross-sectional data from the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study in Ghana (2016–18) were analyzed. Depression was assessed with the Center for Epidemiological Studies Depression Scale (CES-D-10). PA was assessed using the International Physical Activity Questionnaire Short Form (IPAQ-SF). Multivariable logistic regression and Hayes PROCESS macro with bootstrapping mediation analyses were performed to evaluate the hypothesized associations. ResultsThe study included 1201 individuals (mean [SD] age 66.1 [11.9] years; 63.3% women). The prevalence of meeting PA guidelines and depression was 36.7% and 29.5%, respectively. Meeting the WHO-recommended PA guidelines was associated with a 16% lower rate of developing depression even after adjusting for potential confounders (OR = 0.84, p <0.001). This association was much stronger among men and those aged 50–64 years. Loneliness, social isolation, sleep problems, functional limitations, and pain characteristics largely mediated the association of PA with depression. ConclusionsPA was negatively associated with depression among older adults in Ghana, and psychosocial and physical factors partially explained the association. The promotion of PA in old age may aid in the prevention of depression, especially in men and those aged 50–64 years. Longitudinal data may confirm our findings.

Abstract P213: Examining Sociodemographic Disparities in Physical Activity and Diabetes: Preliminary Findings From 2007-2020 National Health and Nutrition Examination Survey

Purpose: Physical activity (PA) plays a crucial role in preventing diabetes, but few studies have examined whether sociodemographic factors were associated to PA, and PA and sociodemographic factors were related to diabetes. We aimed to 1) examine associations between sociodemographic factors and PA, and 2) investigate whether PA and sociodemographic are related to the prevalence of diabetes. Methods: Data came from the 2007-2020 National Health and Nutrition Examination Survey (NHANES), a series of cross-sectional cohort studies (total sample=30,788, Female: 49.1%, mean age =49.6). Two binary outcomes included: 1) Meeting PA guidelines (≥500 MET minutes/week) and 2) diabetes (yes/no). Sociodemographic variables included age group (20-44 [referent], 45-64, 65-79), sex, race/ethnicity (White [referent], Black, Hispanic, and other adults), and poverty income ratio (low, middle, high-income [referent]). PA guideline was also considered as exposure for diabetes analysis. By accounting for the complex survey design, two weighted generalized Poisson models were used to conduct the analyses, adjusting for covariates. Results: Model 1 showed that participants aged 45-64 and 65-79 had 14% and 16% lower likelihood of meeting PA guidelines than those aged 20-44. Females had an 18 % lower likelihood of meeting PA guidelines than males. Furthermore, Black, Hispanic, and other racial/ethnic adults were 7%, 8%, and 12% less likely to meet the PA guidelines than White adults. Adults with low- and middle-income had 13% and 8% lower likelihood of meeting PA guidelines than those with high income. Model 2 showed that participants from 2017-2020 were 22% more likely to have diabetes (AOR = 1.22) than those from 2007-2008. Adults aged 45-64 and 65-79 years had a 4.35- and 7.36-times higher likelihood of having diabetes than those aged 20-44. Females had a 25% lower likelihood of having diabetes than males. Black, Hispanic, and other groups were 49%, 35%, and 73% more likely to have diabetes than White adults, respectively. Adults with low- and middle-income had a 52% and 32% higher likelihood of having diabetes than those with high income. Adults meeting PA guidelines had a 28% lower likelihood of having diabetes than those not meeting the PA guidelines. Conclusion: The study highlights persistent disparities in PA levels and diabetes across different sociodemographic groups within the U.S. population. Future interventions targeting diabetes should prioritize addressing these disparities among vulnerable populations who do not meet PA guidelines. Emphasis should be placed on promoting PA as an integral component of diabetes prevention.

Abstract P215: Activity Behaviors and Cardiometabolic Health Outcomes in People Living With HIV

Introduction: Physical activity (PA) and sedentary behavior (SB) are independently associated with cardiometabolic health; data on activity behaviors and cardiometabolic health among people living with HIV (PWH) are limited. Hypothesis: Activity behaviors would differ by age and that not meeting PA Guidelines would be associated with an increased risk of cardiometabolic diseases among PWH. Methods: Using NHANES 2007-08 through 2017-18, PWH (n=125; age 44.3 yrs) were characterized as emerging (18-29 yrs), early (30-44 yrs) and middle (45-59 yrs) adulthood. Achieving Guidelines (≥150 min/wk) was derived from self-reported PA across three domains. SB was reported as time spent sitting. Chronic conditions were high cholesterol, obesity, hypertension, and chronic kidney disease. Prevalence estimates of joint high SB (≥8 h/day) and inactivity (&lt;10 min/wk) were calculated, and regression models were used to estimate differences in behaviors by age and investigate the association between achieving Guidelines and chronic conditions. Results: PWH reported 395.8 min/day of SB with 37.5% spending over 8 h/day sitting. There was no significant difference in SB across lifestage. A total of 67.2% achieved Guidelines although 14% were jointly inactive and highly sedentary. Compared with early adult PWH, middle adult PWH spent more time performing transport-related PA (β= 102.7 min/wk, p =0.009) and less time performing leisure-time PA (β= -211 min/wk, p =0.044) ( Figure ). Compared with PWH meeting Guidelines , those that did not meet Guidelines had higher diastolic blood pressure (β= 6.1 mmHg [CI: 2.6, 9.6]) and higher odds of obesity (OR=2.5[CI: 1.0, 6.4]). Conclusions: Domain-specific differences occurred in transportation and leisure time PA among PWH - a high-risk group for cardiovascular disease. Not meeting the Guidelines resulted in greater odds of obesity and higher diastolic blood pressure. Future research should incorporate device-based measures of movement to understand its relation to chronic disease in PWH.

Examining the relationship between meeting 24-hour movement behaviour guidelines and mental health in Chinese preschool children.

Limited research has explored the relationship between adhering to 24-h Movement Behaviour guidelines and mental health in Chinese preschool children. The objectives of this study encompassed two primary goals: (1) to investigate the adherence of preschool children in China to the 24-h Movement Behaviour guidelines; and (2) to analyze the relationship between fulfilling various combinations of these guidelines and mental health, identifying the most advantageous combination. Utilizing a convenience sampling approach, this study included 205 preschool children (117 boys and 88 girls, average age 4.8 ± 0.51 years) from five kindergartens in Hengyang, Hunan Province. The physical activity (PA) and sedentary behaviour of preschool children were objectively assessed using waist-worn accelerometers, while sleep duration and screen time were reported by the children's parents. To evaluate mental health, the parent version of the internationally validated Strength and Difficulties Questionnaire (SDQ) was employed, which measures externalizing problems, internalizing problems, and prosocial behaviour. Employing Mplus 8.0 for Structural Equation Modeling analysis, while controlling for demographic variables, the study explored the connection between preschool children's mental health and their adherence to the 24-h Movement Behaviour guidelines. Worryingly, merely 14.6% of preschoolers met the recommended guidelines for all three aspects (PA, sleep duration, and screen time). Positive correlations were identified between meeting PA guidelines and displaying prosocial behaviour (β = 0.184; p < 0.05), while screen time adherence exhibited a negative correlation with externalizing problems (β = -0.207; p < 0.05). Similarly, there was a negative association between sleep duration adherence and externalizing problems (β = -0.191; p < 0.05). Meeting all three recommended guidelines was notably linked to enhanced prosocial behaviour (β = 0.464; p < 0.05), while following the screen time and sleep duration guidelines was negatively associated with externalizing problems (β = -0.246; p < 0.05). This study underscores the limited adherence of Chinese preschoolers to the comprehensive 24-h Movement Behaviour guidelines. Noteworthy findings include the positive influence of PA on prosocial behaviour, alongside the significant roles that sleep duration and screen time play in mitigating externalizing problems within this age group. Alignment with the 24-h Movement Behaviour guidelines is associated with more favorable mental health indicators in preschoolers.

Perspectives of the World Health Organization's physical activity guidelines among patients with musculoskeletal conditions: A mixed-methods survey.

Physical activity (PA) promotion is a core element of musculoskeletal rehabilitation. Many people with musculoskeletal conditions do not meet PA guidelines, such as those provided by the World Health Organization (WHO). This study aimed to explore the level of awareness and perspectives on the WHO PA guidelines among people with musculoskeletal conditions and identify how patients can be supported with PA in clinical practice. A mixed-method cross-sectional survey was conducted using a uniquely developed questionnaire, which was disseminated to patients attending outpatient physiotherapy or occupational therapy appointments. The questionnaire collected data on participant characteristics, awareness and perspectives on the WHO guidelines and suggestions for supporting patients with PA in clinical practice. Descriptive statistics and content analysis were used to analyse the quantitative and qualitative data respectively. One-hundred and two responses were included in the analysis. Forty-two percent of respondents were aware of the guidelines, 50% knew why they existed and 53% felt they were achievable. Perspectives varied, ranging from the guidelines being positive and aiding motivation to being unachievable. Some respondents felt an individualised approach is required. Suggestions for supporting patients with PA included facilitating social support, providing education, exercise groups and personalised advice, and signposting to community services. There is limited awareness of the WHO PA guidelines and a variety of perspectives on the guidelines among patients with musculoskeletal conditions. There is a need to enhance the promotion of the guidelines in clinical practice, whilst considering local context and individual patient's circumstances.

Handbike Riding in the Brescia Urban Loose Space: Topographical Evaluation and Metabolic Demand Estimation of Four Suitable Tracks

This study examines four tracks (Ts) suitable for handbikes (HBs) in the urban area of Brescia, Italy. WHO physical activity (PA) recommendations challenge kinesiologists to find opportunities to promote exercise in the urban context using HBs. This study aims to characterize T features, assess the physical demands of HB cycling, and promote the use of HBs. Track length, elevation changes, slope, and ascent sections were analyzed. Participants’ physiological engagement during HB cycling was measured. The data were gathered using specialized equipment including a metabolimeter, a power meter, a heart rate monitor, and a cycle computer. Crucially, the findings demonstrate that all four Ts facilitate PA above the recommended threshold (&gt;3 MET) regardless of the speed. The study identifies specific speeds required to achieve vigorous PA (&gt;6 MET) on each T. In summary, this study’s analysis of various tracks reveals their potential to meet PA guidelines, even at a slow pace. Moreover, this research establishes speed thresholds for vigorous PA. This information is valuable for both able-bodied individuals and those with mobility challenges when planning effective exercise routines. Moreover, the findings support municipalities in promoting adapted PA in urban areas, enhancing path usability.

Household Food Insecurity Is Associated With Physical Activity in Youth and Young Adults With Diabetes: A Cross-Sectional Study.

Physical activity (PA) is essential for optimal diabetes management. Household food insecurity (HFI) may negatively affect diabetes management behaviors. The purpose of this study was to cross-sectionally examine the association between HFI and PA in youth and young adults (YYA) with type 1 (N = 1998) and type 2 (N = 391) diabetes from the SEARCH for Diabetes in Youth Study. HFI was measured with the US Household Food Security Survey Module. PA was measured with the International Physical Activity Questionnaire Short Form. Walking, moderate-intensity PA (excluding walking), vigorous-intensity PA, moderate- to vigorous-intensity PA, and total PA were estimated as minutes per week, while time spent sitting was assessed in minutes per day. All were modeled with median regression. Meeting PA guidelines or not was modeled using logistic regression. YYA with type 1 diabetes who experienced HFI spent more time walking than those who were food secure. YYA with type 2 diabetes who experienced HFI spent more time sitting than those who were food secure. Future research should examine walking for leisure versus other domains of walking in relation to HFI and use objective PA measures to corroborate associations between HFI and PA in YYA with diabetes.

P56: Exercising your worries away – what do older adults think about physical activity and technology interventions to reduce anxiety

Objective:Older adults have low levels of mental health literacy relating to anxiety which may contribute to delaying or not seeking help. Lifestyle interventions, including physical activity (PA), have increasing evidence supporting their effectiveness in reducing anxiety. The COVID-19 pandemic also highlighted the potential for technology to facilitate healthcare provision. This study aimed to investigate perspectives of older adults about their understanding of anxiety, possible use of PA interventions to reduce anxiety, and whether technology could help this process.Methods:The INDIGO trial evaluated a PA intervention for participants aged 60 years and above at risk of cognitive decline and not meeting PA guidelines. Twenty-nine of the INDIGO trial completers, including some with anxiety and/or cognitive symptoms, attended this long-term follow-up study including semi-structured qualitative interviews. Transcripts were analyzed thematically.Results:There was quite a diverse understanding of anxiety amongst participants. Some participants were able to describe anxiety as involving worry, uncertainty and fear, as well as relating it to physical manifestations and feeling out of control. Others had less understanding of the concept of anxiety or found it confusing. Participants generally believed that PA could potentially reduce anxiety and thought that this could occur through a “mindfulness” and/or “physiological” process. Technology use was a more controversial topic with some participants quite clearly expressing a dislike or distrust of technology or else limited access or literacy in relation to technology. Participants who were supportive of using technology described that it could help with motivation, information provision and health monitoring. Wearable activity monitors were described favorably, with online platforms and portable devices also being options.Conclusion:Our results highlight the importance of increasing information and education about anxiety to older adults. This may increase awareness of anxiety and reduce delays in seeking help or not seeking help at all. Findings also emphasize the need for clinicians to support understanding of anxiety in older adults that they are seeing and provide information and education where needed. It is likely that PA interventions to reduce anxiety, with the option of a technology component with support, will be acceptable to most older adults.

Effects of physical activity on the levels of remnant cholesterol: A population-based study.

Physical activity (PA) has the potential to bring about favourable changes in plasma lipid profile. However, the relationship between PA and remnant cholesterol (RC) remains unclear. We aimed to study the link between PA and RC using the database of the 2007-2020 National Health and Nutrition Examination Survey (NHANES). PA was categorized based on Physical Activity Guidelines for Americans. A multivariate linear regression model was used to determine the correlations between PA and RC. The study involved a total of 18,396 participants and revealed that individuals whose PA met the guidelines by engaging in moderate-intensity PA at least 150 min per week had lower body mass index and showed decreased levels of triglyceride, TC, and haemoglobin A1c compared to those who were physically inactive, exercising <150 min per week. Participants whose intensity of PA meets PA guidelines had a lower level of RC than those who did not met PA guidelines (β = -1.3, 95% confidence interval [CI]: -1.9 to -0.7, p < 0.001), even after adjusting for confounders. During subgroup analysis, we observed that race (pinteraction = 0.0089) emerged as a significant factor of interaction.

Functional social support and physical activity in community-dwelling older adults: A scoping review

Abstract Background Globally, the population of older people is increasing and is estimated to reach nearly 2.1 billion by 2050. Physical activity (PA) is one of the key components for healthy ageing, as it can prevent noncommunicable diseases, improve mental health, cognitive functioning and quality of life. However, PA decreases with age. About two-thirds of those aged 65-74 years and three-quarters of those aged 75 or more do not meet PA guidelines. A systematic review from 2017 showed that social support (SOSU) and loneliness are associated with PA in older people. The aim of this scoping review was to update that systematic review by identifying and mapping all of the available knowledge, including results from mixed-methods and qualitative studies, and to explore associations between functional SOSU and PA in older people. Methods A scoping review was conducted using the Joanna-Briggs manual. Empirical studies investigating associations between functional SOSU and PA levels in older adults were identified through a systematic search of the electronic databases Web of Science, PubMed, ProQuest, PsycInfo, PSYINDEX, SocINDEX and Scopus up to March 2022, without time or geographic restrictions. After removing duplicates, 17,196 articles were screened for titles and abstracts by two independent researchers. Strict inclusion and exclusion criteria were set in advance. Results 88 articles matched the inclusion criteria; 71% were quantitative studies and 29% qualitative studies. Most studies used self-reported PA measures, only 13% of the studies used objective-reported PA measures. Most studies showed a significant positive association between functional SOSU and PA. The results were analysed separately for the different SOSU types. Conclusions Functional SOSU is positively associated with PA while lack of SOSU is a major barrier to exercise. The study offers a comprehensive overview of measures for SOSU and PA and thereby informs future research and policy-making. Key messages • Older adults have lower levels of SOSU and PA. • One way of promoting PA in older age is facilitating high levels of SOSU.