Metabolic Equivalent Of Task Minutes Research Articles

Physical Activity and Progression of Coronary Artery Calcification in Men and Women.

Prior cross-sectional studies have suggested that very high levels of physical activity (PA) are associated with a higher prevalence of coronary artery calcium (CAC). However, less is known regarding the association between high-volume PA and progression of CAC over time. To explore the association between PA (measured at baseline and during follow-up) and the progression of CAC over time. This cohort study included data from 8771 apparently healthy men and women 40 years and older who had multiple preventive medicine visits at the Cooper Clinic (Dallas, Texas), with a mean (SD) follow-up time of 7.8 (4.7) years between the first and last clinic visit. Participants with reported PA and CAC measurements at each visit during 1998 to 2019 were included in the study. Data were analyzed from March 2023 to February 2024. PA reported at baseline and follow-up, examined continuously per 500 metabolic equivalent of task minutes per week (MET-min/wk) and categorically: less than 1500, 1500 to 2999, 3000 or more MET-min/wk. Negative binomial regression was used to estimate the rate of mean CAC progression between visits, with potential modification by PA volume, calculated as the mean of PA at baseline and follow-up. In addition, proportional hazards regression was used to estimate hazard ratios for baseline PA as a predictor of CAC progression to 100 or more Agatston units (AU). Among 8771 participants, the mean (SD) age at baseline was 50.2 (7.3) years for men and 51.1 (7.3) years for women. The rate of mean CAC progression per year from baseline was 28.5% in men and 32.1% in women, independent of mean PA during the same time period. That is, the difference in the rate of CAC progression per year was 0.0% per 500 MET-min/wk for men and women (men: 95% CI, -0.1% to 0.1%; women: 95% CI, -0.4% to 0.5%). Moreover, baseline PA was not associated with CAC progression to a clinically meaningful threshold of 100 AU or more over the follow-up period. The hazard ratio for a baseline PA value of 3000 or more MET-min/wk vs less than 1500 MET-min/wk to cross this threshold was 0.84 (95% CI, 0.66 to 1.08) in men and 1.16 (95% CI, 0.57 to 2.35) in women. This study found that PA volume was not associated with progression of CAC in a large cohort of healthy men and women who were initially free of overt cardiovascular disease.

Associations of Lifelong Exercise Characteristics With Valvular Function and Aortic Diameters in Patients With a Bicuspid Aortic Valve.

The potential impact of exercise on valvular function and aortic diameters in patients with a bicuspid aortic valve remains unclear. Therefore, we assessed the association between lifelong exercise characteristics, valvular dysfunction, and aortic dilatation in patients with a bicuspid aortic valve. In this cross-sectional study, exercise volume (metabolic equivalent of task minutes per week), exercise intensity, and sport type were determined from the age of 12 years to participation using a validated questionnaire. Echocardiography was used to assess aortic stenosis or aortic regurgitation and to measure diameters at the sinuses of Valsalva and ascending aorta. Aortic dilatation was defined as a Z-score ≥2. Four hundred and seven patients (42±17 years, 60% men) were included, of which 133 were sedentary (<500 metabolic equivalent of task minutes per week), 94 active (500-1000 metabolic equivalent of task minutes per week), and 180 highly active (≥1000 metabolic equivalent of task minutes per week). Moderate-to-severe aortic stenosis or aortic regurgitation was present in 23.7% and 20.0%, respectively. Sinuses of Valsalva and ascending aorta diameters were 34.8±6.6 and 36.5±8.1 mm, whereas aortic dilatation was found in 21.6% and 53.4%, respectively. Exercise volume was not associated with valve dysfunction or aortic dilatation. Vigorous intensity and mixed sports were associated with a lower prevalence of aortic stenosis (adjusted odds ratios, 0.43 [0.20-0.94] and adjusted odds ratios, 0.47 [0.23-0.95]). Exercise intensity and sport type were not associated with aortic regurgitation and aortic dilatation. We found no deleterious associations between lifelong exercise characteristics, valvular dysfunction, and aortic dilatation in patients with a bicuspid aortic valve. Vigorous intensity and exercise in mixed sports were associated with a lower prevalence of moderate-to-severe aortic stenosis. These observations suggest that lifelong exercise does not appear to induce adverse cardiovascular effects in patients with a bicuspid aortic valve.

Young Danish Esports Players Physical Health, and Their Opportunities and Wishes for Physical Activity From Their Esports Club: A Cross-Sectional Study

Electronic sports (esports) refer to competitive video gaming at professional and amateur levels. The increasing popularity of esports may lead to an increased tendency toward inactivity and sedentary behavior among players. Currently, 150 min of physical activity (PA) of moderate to high intensity per week is recommended to main a healthy lifestyle. The aim of this study was to investigate whether young esports players are offered to participate in PA and what type of PA they would like to participate in. The level of PA, bodily pain, and sleeping habits were also investigated through a self-reported questionnaire. The median score for PA was 2,850 metabolic equivalent of task minutes per week. One in every five esports players was offered PA by their esports association, and most of them have used this offer. For participants who were not offered PA, the most often called-for type of PA was resistance training, ballgames, and cardiovascular training.

Associations of Lifelong Exercise Characteristics with Valvular Function and Aortic Diameters in Subjects with a Bicuspid Aortic Valve

Abstract Background Whether exercise-induced hemodynamic stress accelerates the development of valvular dysfunction and aortic dilatation in subjects with a bicuspid aortic valve (BAV) is unclear. Purpose To examine the association between lifelong exercise characteristics (i.e. exercise volume, exercise intensity and type of exercise), valvular dysfunction and aortic dilatation in subjects with BAV. Methods Adults with BAV were classified as inactive (&amp;lt;500 metabolic equivalent of task minutes per week [MET-min/wk]), active (500-1000 MET-min/wk) or highly active (≥1000 MET-min/wk) based on their reported lifetime exercise characteristics. Subjects’ lifelong predominant exercise intensity was classified as moderate (3-6 MET) or vigorous (≥6 MET) and predominant sport type as skill, power, mixed or endurance. Transthoracic echocardiography was used to assess the presence of aortic stenosis (AS) or regurgitation (AR) and to measure aortic diameters at the sinus of Valsalva (SV) and in the ascending aorta (AA). Aortic dilatation was defined as a Z-score ≥ 2. Results 407 subjects (42±17 years old, 60% male) were included of which 133 were inactive, 94 active and 180 highly active. 61 subjects did not perform exercise, whereas 136 and 207 subjects predominantly participated in moderate or vigorous intensity exercise, respectively. Subjects performing sports were allocated to the skill (n=12), power (n=41), mixed (n=218), endurance (n=75) or non-dominant (n=24) exercise type group. Moderate-to-severe AS or AR was present in 96 (23.6%) and 81 (19.9%) subjects, respectively. SV and AA diameters were 34.8±6.6 and 36.5±8.1 mm, whereas 74 (18.2%) and 194 (47.7%) subjects had a Z-score ≥ 2. Exercise volume was not associated with valve dysfunction or aortic dilatation. Vigorous intensity exercise and mixed sports were associated with lower odds ratios for the risk of moderate-to-severe AS (ORadjusted: 0.43 (0.20-0.94) and ORadjusted: 0.47 (0.23-0.95), respectively). Exercise intensity and sport type were not associated with AR and aortic dilatation (Figure 1). Conclusions We found no deleterious associations between lifelong exercise characteristics, valvular dysfunction and aortic dilatation in subjects with BAV. In contrast, vigorous intensity and mixed sports were associated with a lower risk for moderate-to-severe AS. These observations suggest that lifelong exercise does not appear to induce deleterious cardiovascular effects in subjects with BAV.Figure 1.

Abstract 17586: Physical Activity Associates With a Greater Reduction in Heart Failure Risk Among Individuals With Depression and/or Anxiety

Introduction: Physical activity (PA) has shown a dose-dependent reduction in the incidence of heart failure (HF) by mitigating stress-related neural activity (SNA). Accordingly, we postulated that the impact of PA on HF incidence may be more pronounced in individuals with chronic stress conditions (e.g., depression and/or anxiety) that associate with heightened baseline SNA. Objective: To test whether PA confers a greater reduction in HF incidence among individuals with (vs. without) pre-existing depression and/or anxiety. Methods: Among 48,673 participants (median age 60 years, 40% male) in the Mass General Brigham Biobank, self-reported PA data were collected through a health survey and converted to metabolic equivalent of task minutes per week. Data on incident HF, its subtypes, depression, anxiety, and cardiovascular risk factors were obtained using the International Classification of Disease Codes. Cox regression was employed to assess the association between PA and ten-year HF risk and to examine potential interactions. Results: PA (per each standard deviation) is independently associated with greater reductions in all HF risk among individuals with depression and/or anxiety (standardized hazard ratio [HR] [95% confidence interval (CI)]: 0.735 [0.648, 0.834], p&lt;0.001) compared to those without depression and/or anxiety (0.821 [0.781, 0.864], p&lt;0.001, p-interaction=0.038*). Similar associations were observed between PA and the risk of HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF) among those in whom HF could be classified, Fig1. Conclusions: PA is associated with greater reductions in risk of incident HF, including HFpEF and HFrEF, with the greatest reductions in those with pre-existing depression and/or anxiety. These findings highlight the potential for improved cardiovascular benefits linked to PA in individuals with elevated baseline SNA.

Exercise and Insulin Resistance Markers in Children and Adolescents With Excess Weight

Although benefits have been reported for most exercise modalities, the most effective exercise approaches for reducing insulin resistance in children and adolescents with excess weight and the optimal exercise dose remain unknown. To compare exercise training modalities and their association with changes in insulin resistance markers among children and adolescents with excess weight and to establish the optimal exercise dose. For this systematic review and network meta-analysis, 6 electronic databases (PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and CINAHL) were searched for studies from inception to April 1, 2023. Randomized clinical trials (ie, randomized controlled trials and randomized trials without a control group) were included if they reported outcomes associated with aerobic training, resistance training, high-intensity interval training (HIIT), or a combination of these interventions. Data extraction for this systematic review was conducted following a network meta-analysis extension of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. Effect sizes were calculated as the mean difference (MD) with 95% CI using random-effects inverse-variance models with the Hartung-Knapp-Sidik-Jonkman method. The hierarchy of competing interventions was defined using the surface under the cumulative ranking curve. The Cochrane Risk-of-Bias tool, version 2 (RoB2), was used to independently assess the risk of bias of the included studies. The certainty of evidence in consistent networks was assessed using the Grading of Recommendation, Assessment, Development and Evaluation approach. The study protocol was prospectively registered with PROSPERO. Data analyses were conducted between May and June 2023. The primary outcomes were fasting glucose, insulin, and homeostatic model assessment for insulin resistance (HOMA-IR). This analysis included 55 studies with a total of 3051 children and adolescents (mean [SD] age, 13.5 [2.3] years; 1537 girls [50.4%] and 1514 boys [49.6%]). Exercise was associated with reductions in fasting insulin (MD, -4.38 μU/mL [95% CI, -5.94 to -2.82 μU/mL]) and HOMA-IR (MD, -0.87 [95% CI, -1.20 to -0.53]). A nonlinear association in both markers was observed, with a required minimal exercise dosage of approximately 900 to 1200 metabolic equivalent of task minutes per week, especially in children and adolescents with insulin resistance at baseline. Combination HIIT and resistance training and concurrent training were the most effective approaches for reducing insulin resistance markers. On average, the certainty of evidence varied from low to moderate. These findings underscore the role of exercise interventions in enhancing insulin resistance markers among children and adolescents with overweight and obesity. It is advisable to include resistance exercises alongside aerobic and HIIT programs for a minimum of two to three 60-minute sessions per week.

Preliminary Efficacy of a Multi-Behavioral Zoom-Based Peer Health Coaching Intervention in Young Adults: A Stepped Wedge Randomized Controlled Trial.

The purpose of this study was to test the preliminary efficacy of a Zoom-based peer coaching intervention on health and risk behaviors in young adults. A convenience sample of young adults was recruited from one U.S. university (N = 89; 73.0 percent female). Participants were randomized to one of two coaching session sequences within the framework of a stepped wedge randomized controlled trial. One experimental sequence received a control condition and a single coaching session, and the second sequence received two sessions. The intervention was a 1-hour program delivered by peer health coaches in a one-on-one setting on Zoom. The program consisted of a behavior image screen, a consultation, and goal planning. Behavioral assessments were completed after each condition. Mixed-effects models were employed to test for behavior differences after coaching sessions compared with the control condition (no coaching session) adjusting for baseline scores. Participants reported significantly higher levels of vigorous physical activity (b = 750 metabolic equivalent of task minutes, p < 0.001), a lower frequency of e-cigarette use (b = -2.1 days; p < 0.001), and a lower risk of e-cigarette susceptibility after two sessions (relative risk = 0.04, p = 0.05), and higher odds of using stress reduction techniques after one session (odds ratio = 1.4, p = 0.04). A nonsignificant trend was observed for longer weekday sleep (b = 0.4 h/night, p = 0.11) after two coaching sessions. The Zoom-based peer health coaching intervention may be an efficient way to improve vigorous physical activity, lower e-cigarette use and susceptibility, and facilitate the use of stress reduction techniques in young adults. The results observed from this preliminary study warrants further investigation using powered effectiveness trials.

Impact of risk for severe COVID-19 illness on physical activity during the pandemic

BackgroundPrecautions to mitigate spread of COVID-19 such as the closing of exercise facilities impacted physical activity behaviors. Varied risks for severe COVID-19 may have influenced participation in regular physical activity to maintain precautions. ObjectiveDescribe differences in the amount and intensity of physical activity between adults at high versus low risk for severe COVID-19 illness during the pandemic. We hypothesized that over 13 months, 1) high-risk adults would have greater odds of inactivity than low-risk adults, and 2) when active, high-risk adults would have lower metabolic equivalent of task minutes (MET-min) than low-risk adults. MethodsThis longitudinal observational cohort study surveyed U.S. adults’ demographics, health history, and physical activity beginning March 2020 using REDCap. Using self-report, health history was assessed with a modified Charlson Comorbidity Index and physical activity with the International Physical Activity Questionnaire. Repeated physical activity measurements were conducted in June, July, October, and December of 2020, and in April of 2021. Two models, a logistic model evaluating physical inactivity (hypothesis 1) and a gamma model evaluating total MET-min for physically active individuals (hypothesis 2), were used. Models were controlled for age, gender, and race. ResultsThe final sample consisted of 640 participants (mean age 42.7 ± 15.7, 78% women, 90% white), with n = 175 categorized as high-risk and n = 465 as low-risk. The odds of inactivity for the high-risk adults were 2.8 to 4.1 times as high than for low-risk adults at baseline and 13 months. Active high-risk adults had lower MET-min levels than low-risk adults in March (28%, p = 0.001), June (29%, p = 0.002), and July of 2020 (30%, p = 0.005) only. ConclusionsAdults at high risk of severe COVID-19 illness were disproportionately more likely to be physically inactive and exhibit lower MET-min levels than adults at low risk during the early months of the COVID-19 pandemic.

The relationship between physical activity and depression among community-dwelling adults in Wuhan, China.

While the association between physical activity (PA) and depression has been established, there is limited research on the effect of PA on the risk of depression among Chinese individuals. Thus, this study aimed to investigate the relationship between PA and depression among Chinese individuals. We used a stratified random sampling approach to recruit participants from five urban districts in Wuhan, China. A total of 5,583 permanent residents aged 18 years or older completed questionnaires, which included the International Physical Activity Questionnaire Short Form (IPAQ-SF) to measure PA, and the 9-item Patient Health Questionnaire (PHQ-9) to evaluate depressive symptoms. To control for potential confounders, multiple logistic regression was employed to assess the association of PA with depression. The depression group had significantly lower weekly PA levels, measured in metabolic equivalent of task-minutes per week (MET-min/w), compared to the non-depression group [1,770 (693-4,200) MET-min/w vs. 2,772 (1,324-4,893) MET-min/w, p < 0.001]. In the fully adjusted model, the moderate and high PA level groups had lower odds ratios (ORs) for depressive symptoms compared to the low PA level group [OR (95% confidence interval (CI)) = 0.670 (0.523-0.858), 0.618 (0.484-0.790), respectively]. Among males, moderate and high levels of PA were associated with lower risk of depression compared to low PA levels [OR (95% CI) = 0.417 (0.268-0.649), 0.381 (0.244-0.593), respectively]. However, this association was not observed in females [OR (95% CI) = 0.827 (0.610-1.121), 0.782 (0.579-1.056), respectively]. The study found a significant interaction between PA levels and gender in relation to depression (P for interaction = 0.019). The findings suggest a negative association between PA and risk of depressive symptoms, indicating that moderate to high levels of PA may serve as a protective factor against depressive symptoms.

The Effect of Tailored Short Message Service (SMS) on Physical Activity: Results from a Three-Component Randomized Controlled Lifestyle Intervention in Women with PCOS

This analysis of secondary outcome measures of a randomized controlled trial was conducted to study the effect of a one-year three-component (cognitive behavioural therapy, diet, exercise) lifestyle intervention (LSI), with or without additional Short Message Service (SMS) support, on physical activity and aerobic capacity in overweight or obese women with polycystic ovary syndrome (PCOS). Women diagnosed with PCOS and a BMI > 25 kg/m2 were randomly assigned to LSI with SMS support (SMS+, n = 60), LSI without SMS support (SMS-, n = 63) or care as usual (CAU, n = 60) in order to lose weight. Based on results from the International Physical Activity Questionnaire (IPAQ), we found a significant within-group increase after one year for SMS+ in the high physical activity category (+31%, p < 0.01) and sitting behaviour decreased (Δ -871 min/week, p < 0.01). Moreover, the peak cycle ergometer workload increased within SMS+ (Δ +10 watts, p < 0.01). The SMS+ group also demonstrated a significantly different increase in walking metabolic equivalent of task minutes (METmin)/week compared with CAU after one year (Δ 1106 METmin/week, p < 0.05). Apart from this increase in walking activity, no other between-group differences were found in this trial. Overall, based on within-group results, SMS support seemed to help with improving physical activity and aerobic capacity and decreasing sedentary behaviour.

Stress related neural activity: potential mechanism contributing to benefit of physical activity on heart failure incidence

Abstract Background We previously observed that: 1) physical activity (PA) decreases stress-related neural activity (SNA) in a dose-dependent manner and 2) resting SNA predicts incident heart failure (HF). Thus, we hypothesize that PA may decrease the risk of incident HF in part through its beneficial effect on SNA. Methods Self-reported PA data were acquired from Partners Biobank participants. Metabolic equivalent of task-minutes per week (MET*minutes/week) were calculated and participants were categorized according to their adherence to current PA recommendations (&amp;lt;500 and ≥500 MET-min/wk). In a subset with clinically indicated 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) imaging (n=744), SNA was measured as a ratio of amygdalar to ventromedial prefrontal cortical activity. Subsequent HF and baseline CVD risk factor data were obtained using International Classification of Diseases Codes. Kaplan-Meier and Cox regression analyses were used to evaluate the relationship between PA vs HF risk. Mediation analysis was used to test whether PA's impact on SNA significantly mediated the association between PA and HF. Results Among 50,363 participants (median age 59 years [IQR 42, 70], 40% male), 13,850 (11.6%) were diagnosed with HF over a median period of 3.1 years. PA within recommendations was associated with lower risk of subsequent HF (hazard ratio (HR) [95% confidence interval (CI)]: 0.849 [0.760, 0.948], p=0.004, Figure 1) in a model adjusted for CVD risk factors and history of myocardial infarction. As noted previously, higher SNA associated with higher risk of subsequent HF (HR [95% CI]: 1.34 [1.08, 1.66], p=0.007); and PA within guideline recommendations (vs.below) associated with lower SNA (Zscore ± SD: −0.14±0.92 vs 0.02±1, p=0.037). Moreover, mediation analysis shows that exercise reduces HF risk in part via reductions in SNA, accounting for 9% of the total relationship between exercise and HF risk (p&amp;lt;0.05, Figure 2). Conclusion PA associates with reductions in: A) stress-associated neural activity and B) subsequent HF risk. Moreover, the mechanism by which PA reduces HF risk may involve salutary effects on stress-related neural pathways. Funding Acknowledgement Type of funding sources: None.

What is the association between lifelong exercise volumes, valvular function and aortic diameters in subjects with a bicuspid aortic valve?

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Hartstichting and Stichting Hartekind Background/Introduction Subjects with bicuspid aortic valve disease (BAV) have a higher risk of developing valvular and aortic complications. There is debate if hemodynamic stress associated with long-term exercise training may accelerate the development of complications. Current exercise guidelines are rather restrictive and primarily based on expert opinion. Hence, more insight is needed into the association between exercise volumes and disease characteristics in BAV subjects, especially since exercise training is a powerful strategy to improve cardiovascular health. Purpose To assess the association between lifelong exercise volumes and disease characteristics in BAV subjects. Methods We enrolled BAV subjects ≥35 years old who have not undergone an aortic valve or aorta intervention. Lifelong physical activity was determined using a validated questionnaire and quantified as Metabolic Equivalent of Task minutes per week (MET-min/wk). Participants were classified as 1) insufficiently active, 2) active, or 3) highly active, based on their lifelong physical activity volumes (&amp;lt;500, 500-1000 and &amp;gt;1000 MET-min/wk, respectively). Disease characteristics were assessed from echocardiographic images that were obtained during the most recent visit to our outpatient clinic, whereas patient characteristics were extracted from electronic health records. Results 152 participants (54±10 years, 55% male) were included of which n=59 insufficiently active, n=47 active and n=46 very active. Median lifelong physical activity volumes were 235 [108-387], 713 [653-828] and 1499 [1198-1875] MET-min/wk (p&amp;lt;0.001), respectively. Subject characteristics did not differ across groups (Table 1). No difference was found in aortic valve dysfunction across exercise volume groups, measured as peak aortic valve velocity (1.8 [1.5-2.4] m/s vs. 1.7 [1.4-2.6] m/s vs. 1.8 [1.5-2.5] m/s, p = .52) and presence of moderate-severe aortic valve regurgitation (n=7 (12%) vs. n=7 (15%) vs. n=6 (13%), p=.89) Also, aortic diameters at the level of the sinus of Valsalva (36.0±4.9 mm vs 35.8±5.5 mm vs 36.7±6.1 mm, p=.69) and ascending aorta (36.5±6.3 mm vs 39.0±7.0 mm vs 37.5±7.0 mm, p=.18) did not significantly differ across groups. Conclusion Lifelong exercise volumes are not associated with characteristics of disease severity in BAV subjects who have not undergone an aortic valve or aorta intervention. These observations may support a less cautious approach for habitual physical activity and exercise training in BAV subjects, so they can profit from the cardiovascular health benefits of a physically active lifestyle.

Effects of exercise on reducing diabetes risk in Korean women according to menopausal status

Background: Exercise and estrogen play key roles in preventing diabetes and obesity. Women’s risk of diabetes could increase due to the loss of the protective effect of estrogen after menopause. Therefore, we investigated the relationship of the intensity and frequency of exercise with diabetes risk in Korean women.Methods: Hazard ratios (HRs) for the development of diabetes were analyzed in 926,807 premenopausal and 1,188,346 postmenopausal women without diabetes over the age of 40 who underwent the Korean National Health Examination in 2009 and were followed up until 2018. The number of days of physical activity according to exercise intensity and metabolic equivalent of task-minutes per week (MET-min/wk) were calculated.Results: In total, 38,096 premenopausal (4.1%) and 120,605 postmenopausal (10.2%) women were newly diagnosed with diabetes. Regardless of menopausal history, the risk of diabetes was significantly lower in groups with higher MET-min/wk than in sedentary participants (0 MET-min/wk, reference), although this effect disappeared in postmenopausal women with the highest level of MET-min/wk (MET-min/wk ≥1,500) after adjusting for all variables (HR, 1.0; 95% confidence interval, 0.97–1.02). Participants who exercised for more than 1 day per week had a significantly lower risk of diabetes, regardless of the intensity. However, this benefit was lost in women with near-daily exercise (≥6 days/wk).Conclusions: Exercise was effective in preventing diabetes in both premenopausal and postmenopausal women. A moderate amount of exercise should be actively encouraged to lower the risk of diabetes in women, especially after menopause, while simultaneously considering the insignificant benefits of excessive exercise.

Leisure-Time and Transport-Related Physical Activity and the Risk of Mortality: The CRONICAS Cohort Study.

The long-term health association of the leisure-time and transport-related physical activity domains of the International Physical Activity Questionnaire have not been established in Latin American settings. The authors aimed to quantify the 7-year all-cause mortality risk associated with levels of leisure-time and transport-related physical activity. Ongoing prospective cohort study conducted in 4 sites in Peru. People ≥35years were randomly selected from the general population in each study site. The exposures were leisure-time and transport-related physical activity (International Physical Activity Questionnaire) at baseline. The outcome was all-cause mortality based on information retrieved from national records. Cox regression and sensitivity analyses were conducted. There were 3601 people (mean age 55.8y, 51.5% women). Greater levels of physical activity were associated with lower risk of all-cause mortality, an observation confirmed in sensitivity analyses. Compared with those with low levels of physical activity, leisure-time (≥500 metabolic equivalent of task minutes per week) and transport-related (500-1499 and ≥1500 metabolic equivalent of task minutes per week) physical activity were associated with 70% (95% confidence interval, 3%-90%), 43% (95% confidence interval, 18%-61%), and 42% (95% confidence interval, 8%-63%) lower all-cause mortality, respectively. Greater levels of leisure-time and transport-related physical activity were associated with a strong reduction in the risk of all-cause mortality across different geographical sites.

A Wearable Activity Tracker Intervention With and Without Weekly Behavioral Support Emails to Promote Physical Activity Among Women Who Are Overweight or Obese: Randomized Controlled Trial.

BackgroundPhysical activity (PA) plays a fundamental role in combating the current obesity epidemic; however, most women who are overweight or obese are generally physically inactive. Wearable activity tracker interventions can help increase the PA levels in this population. Supplementing such interventions with behavioral support emails may further improve their effectiveness, but this remains to be confirmed.ObjectiveThis study aims to determine if adding behavioral support emails to a wearable activity tracker intervention can further increase PA levels among women who are overweight or obese in comparison to a wearable activity tracker–only intervention and a control condition.MethodsWomen with a BMI ≥25 kg/m2 who were not meeting the Canadian PA guidelines for aerobic and strength training were randomized into 1 of 3 groups. Group 1 received 6 weekly behavioral support emails, a wearable activity tracker, and a copy of the Canadian PA guidelines. Group 2 received a wearable activity tracker and a copy of the Canadian PA guidelines, and group 3 (control condition) received a copy of the Canadian PA guidelines. Self-reported data for walking and moderate to vigorous intensity PA were collected preintervention (week 0; prerandomization), postintervention (7 weeks postrandomization), and at follow-up (21 weeks postrandomization) and analyzed as metabolic equivalent of task minutes per week. In addition, potential mechanisms of behavior change (ie, basic psychological needs satisfaction and motivational regulations) were assessed for within- and between-group differences at all 3 time points. Data were analyzed using nonparametric statistical tests.ResultsA total of 49 women were recruited; data from 47 women (mean age 37.57 years, SD 11.78 years; mean BMI 31.69 kg/m2, SD 5.97 kg/m2) were available for analysis. Group 1 reported a significant increase in walking from preintervention to postintervention (χ22=7.5; P=.02) but not in moderate to vigorous intensity PA (P=.24). Group 1 also reported significant increases in perceptions of competence from preintervention to follow-up (χ22=7.6; P=.02) and relatedness from preintervention to follow-up (χ22=8.7; P=.005). Increases in perceived autonomy were observed for group 2 (χ22=7.0) and group 3 (χ22=10.6). There were no significant changes in the motivational regulations within the groups. The difference between the groups was not significant for any outcome variable.ConclusionsThe results suggest that adding behavioral support emails to a wearable activity tracker intervention may help to increase time spent walking and perceptions of competence and relatedness for PA among women who are overweight or obese.Trial RegistrationClinicalTrials.gov NCT03601663; http://clinicaltrials.gov/ct2/show/NCT03601663

Concurrent Validity Between Electronically Administered Physical Activity Questionnaires and Objectively Measured Physical Activity in Danish Community-Dwelling Older Adults.

To investigate the concurrent validity of the International Physical Activity Questionnaire-short form (IPAQ-SF) and the Nordic Physical Activity Questionnaire-short (NPAQ-short) when compared with objectively measured daily steps among older adults. Spearman's ρ between IPAQ-SF and NPAQ-short and objectively measured steps using Garmin Vivofit 3 physical activity monitors. A total of 54 participants were included. The IPAQ-SF subscales' moderate physical activity (PA), moderate to vigorous PA (MVPA), and sedentary time showed little or no correlation with daily steps. The NPAQ-short subscales' vigorous PA, moderate PA, and MVPA showed little or no correlation. The IPAQ-SF subscales' vigorous PA and walking showed fair correlation. Only the IPAQ-SF metabolic equivalent of task minutes showed moderate to good correlation with daily steps. The IPAQ-SF categories and NPAQ-short categorization of World Health Organization compliance were significantly different, but the magnitudes were small and distributions indicated problems with the categorization. The concurrent validity is low, as the scores did not reflect objectively measured daily steps.

Physical Activity during the First COVID-19-Related Lockdown in Italy

The spread of the COVID-19 virus was met by a strict lockdown in many countries around the world, with the closure of all physical activity (PA) facilities and limitations on moving around freely. The aim of the present online survey was to assess the effect of lockdown on physical activity in Italy. Physical activity was assessed using the European Health Interview Survey questionnaire. A total of 1500 datasets were analyzed. Differences between conditions were tested with a chi2-based (χ2) test for categorical variables, and with the Student’s t-test for paired data. A fixed effects binary logistic regression analysis was conducted to identify relevant predictor variables to explain the compliance with World Health Organisation (WHO) recommendations. We found a substantial decline in all physical activity measures. Mean differences in walking and cycling metabolic equivalent of task minutes per week (METmin/week), respectively, were 344.4 (95% confidence interval (95% CI): 306.6–382.2; p < 0.001) and 148.5 (95% CI: 123.6–173.5; p < 0.001). Time spent in leisure time decreased from 160.8 to 112.6 min/week (mean difference 48.2; 95% CI: 40.4–56.0; p < 0.001). Compliance with WHO recommendations decreased from 34.9% to 24.6% (chi2 (1, 3000) = 38.306, p < 0.001, V = 0.11). Logistic regression showed a reduced chance (OR 0.640, 95% CI: 0.484–0.845; p = 0.001) to comply with WHO PA recommendations under lockdown conditions. Measures to promote physical activity should be intensified to limit detrimental health effects.

Physical Activity Level and Cardiovascular Risks of Hospital Employees: A Cross-Sectional Study in a Private Hospital.

OBJECTIVES: To assess physical activity at work of hospital employees in order to identify association between physical activity at work and risks for cardiovascular diseases MATERIAL AND METHODS: From 3,383 employees of a private hospital in Thailand in 2017, 12 percent were randomly selected based on a ten percent sample size with two percent compensation to represent eight strata of job types. After screening and exclusion, 301 subjects remained in the study. Each subject was asked to fill in the International Physical Activity Questionnaire (IPAQ) and was assessed for body fat composition using an Inbody Bio-electric Impedance Analysis (BIA) R20 model at the initiation. Each subject was equipped with an activity tracker device “Feelfit” for five days during work hours to estimate Metabolic Equivalent of Task (MET) and MET minutes per person per work week. Relevant laboratory data were extracted from annual health checkup database for the assessment of cardiovascular risk factors. Statistical analysis was conducted using STATA version 15. RESULT: The majority (85.4%) of 301 subjects were female and a little more than half (53.5%) were older than 35 years. Data from Feelfit showed 257/301 (85.4%) employees had sufficient (i.e. 600 or more MET minutes per week) physical activity (PA) at work. Operational or clinical employees were 9.8 times more likely to have adequate PA (OR 9.8, 95%CI 4.3 to 22.4). Associations between adequate PA and Body Mass Index (BMI) and waist circumference were in a different direction. Subjects with high BMI (&gt;23 Kg/sq.m.) were more likely to have adequate PA at work (OR 3.3, 95%CI 1.0, 10.5), while those with abnormal waist circumference were less likely to have adequate PA at work (OR 0.8, 95% CI 0.2, 2.5). Around one-third of our subjects had “normal BMI obesity”, i.e. 54 (34.6%) of 156 normal BMI subjects had high body fat composition. Laboratory findings were inconclusive to demonstrate association with adequate PA. CONCLUSION: Although most hospital employees had adequate physical activity at work, one-third of subjects still had high fat composition regardless of normal BMI. Back office subjects were almost ten times less likely to have sufficient PA at work, suggesting urgent interventions for them. Relationship between impulsivity and PA was inconclusive, suggesting a larger study with greater sample size.

No Evidence for a Decrease in Physical Activity Among Swiss Office Workers During COVID-19: A Longitudinal Study.

PurposeThe COVID-19 lockdown interrupted normal daily activities, which may have led to an increase in sedentary behavior (Castelnuovo et al., 2020). The aim of this study was to investigate the effect of the COVID-19 pandemic on the level of physical activity among Swiss office workers.MethodsOffice workers from two Swiss organizations, aged 18–65 years, were included. Baseline data from January 2020 before the COVID-19 pandemic became effective in Switzerland were compared with follow-up data during the lockdown phase in April 2020. Levels of physical activity were assessed using the International Physical Activity Questionnaire. Paired sample t-tests or Wilcoxon signed-rank test were performed for statistical analysis.ResultsData from 76 participants were analyzed. Fifty-four participants were female (71.1%). The mean age was 42.7 years (range from 21.8 to 62.7) at baseline. About 75% of the participants met the recommendations on minimal physical activity, both before the COVID-19 pandemic and during the lockdown. Weak statistical evidence for a decline in total physical activity in metabolic equivalent of task minutes per week (MET min/week) was found (estimate = −292, 95% CI from – ∞ to 74, p-value = 0.09), with no evidence for a decrease in the three types of activity: walking (estimate = −189, 95% CI from – ∞ to 100, p-value = 0.28), moderate-intensity activity (estimate = −200, 95% CI from – ∞ to 30, p-value = 0.22) and vigorous-intensity activity (estimate = 80, 95% CI from – ∞ to 460, p-value = 0.74). Across the three categories “high,” “moderate,” and “low” physical activity, 17% of the participants became less active during the lockdown while 29% became more active.ConclusionThe COVID-19 pandemic did not result in a reduction in total physical activity levels among a sample of Swiss office workers during the first weeks of lockdown. Improved work-life balance and working times may have contributed to this finding.Clinical Trial Registrationwww.ClinicalTrials.gov, NCT04169646. Registered 15 November 2019 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04169646.

The bidirectional association between sleep and physical activity: A 6.9 years longitudinal analysis of 38,601 UK Biobank participants

Although physical activity and sleep may influence each other, little is known about the bidirectional association of these two behaviors. The present analyses included 38,601 UK Biobank participants (51% female, 55.7 ± 7.6 years old, 6.9 ± 2.2 years of follow-up). Physical activity was categorized by the weekly metabolic equivalent of task minutes (highly active: ≥ 1200; active: 600 to <1200; inactive: < 600), and sleep patterns were determined using a composite score of healthy sleep characteristics: morning chronotype, adequate sleep duration (7–8 h/d), never or rare insomnia, never or rare snoring, and infrequent daytime sleepiness. We categorized the sleep score into three patterns (healthy: ≥ 4; intermediate: 2–3; poor: ≤ 1). Multiple logistic regressions examined the association of baseline (or the temporal changes in) sleep/physical activity with physical inactivity/poor sleep at follow-up. Participants with an intermediate or poor sleep pattern at baseline had higher odds (adjusted odds ratio: 1.24 [1.17, 1.32] and 1.65 [1.45, 1.88], respectively) for physical inactivity at follow-up, compared to those with healthy sleep, while shifting to a healthy sleep pattern over time attenuated these adverse associations. Compared to individuals highly active at both time points, being physically inactive at baseline and reducing physical activity over time were both associated with higher odds for poor sleep at follow-up. In conclusion, sleep improvements over time benefitted physical activity at follow-up, while reduced physical activity had a detrimental effect on sleep patterns at follow-up. Our results provide scope for interventions to concurrently target physical activity and sleep.