Minutes Of Moderate-intensity Activity Research Articles

Adherence to Selected Pillars of Lifestyle Medicine in the United States: A Cross-Sectional Analysis

Background: The American College of Lifestyle Medicine proposed 6 evidenced-based pillars to tackle the increasing burden from chronic non-communicable diseases, including regular physical activity, 7+ hours of restorative sleep, a whole-food plant-based diet, stress management, avoidance of risky substances and positive social connections. Methods: We used cross-sectional nationally representative data from the National Health and Nutrition Examination Surveys to analyze the degree of adherence to 4 of these pillars in the US general population. Results: We analyzed data from n = 1217 participants (representing n = 64,468,933 US adults). Results suggested a low population prevalence of established lifestyle medicine behaviors. Less than 50% of the population met the minimal weekly physical activity goal of 150 minutes of moderate intensity activity. We observed a high prevalence of risky substances (excessive alcohol and tobacco) in younger participants aged 20-38 years. Only .52% met common indicators of a whole-food plant-based diet. We found substantial differences between sexes and age groups, with an alarmingly low percentage of young adults achieving optimal levels of common lifestyle practices. Conclusions: Lifestyle medicine as a cost-effective strategy to reduce premature mortality is widely established. Our findings reiterate the required shift from symptom management via interventions towards “tackling the cause” of chronic diseases.

Physical Activity And All-cause Mortality In Type 2 Diabetes: A Cross-country Comparison

The main physical activity recommendation (i.e. 150-300 minutes of moderate intensity activity (MVPA) per week) for individuals with type 2 diabetes (T2D) is identical to the general adult recommendation despite substantially less evidence for the recommendation aimed at those living with chronic conditions. PURPOSE: To examine the dose-response associations between leisure-time physical activity (LTPA) and risk of death in individuals with prevalent T2D; and to compare the magnitude of this association between the UK and China. METHODS: Individuals with prevalent T2D in the UK Biobank (UKB) and China Kadoorie Biobank (CKB) prospective cohort studies. Deaths were obtained from registries. Self-reported leisure-time physical activity was categorized as ‘no activity’ (reference), and activity ‘below’ (1-149 min of MVPA/week), ’meeting’ (150-300 min MVPA/w), or ‘above’ (>300 min of MVPA/w) the physical activity recommendations. Individuals with prevalent diseases were excluded. Associations with all-cause mortality were determined using multivariable-adjusted cox proportional hazard regression models. The continuous dose-response pattern was modelled using restricted cubic splines. RESULTS: We included 14,876 (mean (SD) age: 59.5 (7.2) years) and 17,459 (57.7 (9.7) years) men and women with T2D from UKB and CKB, respectively. During a median of 11.3 and 9.7 years of follow-up, 1227 (UKB) and 2351 (CKB) deaths were recorded. In UKB, Hazard ratios were 0.95 (95%CI 0.78, 1.15), 0.88 (0.70, 1.09) and 0.81 (0.66, 1.00) ‘below’, ’meeting’, and ‘above’ physical activity recommendations, respectively. The same contrasts yielded similar magnitude of associations in CKB; 0.87 (0.68, 1.09), 0.88 (0.75, 1.04) and 0.77 (0.70, 0.85). The continuous dose-response analysis did not support an optimal threshold or point of no added benefit in UKB (p-values for non-linearity 0.78), but no further risk reduction was observed above 600 min of MVPA/w in CKB (p-value for non-linearity 0.03). CONCLUSION: LTPA is inversely associated with mortality risk in individuals with T2D. Meeting current physical activity recommendations were associated with a 12% lower risk in both the UK and China cohorts. Stronger associations were observed at higher activity levels with conflicting support for an upper limit of benefit.

Effect of Structured, Moderate Exercise on Kidney Function Decline in Sedentary Older Adults

Observational evidence suggests that higher physical activity is associated with slower kidney function decline; however, to our knowledge, no large trial has evaluated whether activity and exercise can ameliorate kidney function decline in older adults. To evaluate whether a moderate-intensity exercise intervention can affect the rate of estimated glomerular filtration rate per cystatin C (eGFRCysC) change in older adults. This ancillary analysis of the Lifestyle Interventions and Independence For Elders randomized clinical trial enrolled 1199 community-dwelling, sedentary adults aged 70 to 89 years with mobility limitations and available blood specimens. The original trial was conducted across 8 academic centers in the US from February 2010 through December 2013. Data for this study were analyzed from March 29, 2021, to February 28, 2022. Structured, 2-year, partially supervised, moderate-intensity physical activity and exercise (strength, flexibility) intervention compared with a health education control intervention with 2-year follow-up. Physical activity was measured by step count and minutes of moderate-intensity activity using accelerometers. The primary outcome was change in eGFRCysC. Rapid eGFRCysC decline was defined by the high tertile threshold of 6.7%/y. Among the 1199 participants in the analysis, the mean (SD) age was 78.9 (5.2) years, and 800 (66.7%) were women. At baseline, the 2 groups were well balanced by age, comorbidity, and baseline eGFRCysC. The physical activity and exercise intervention resulted in statistically significantly lower decline in eGFRCysC over 2 years compared with the health education arm (mean difference, 0.96 mL/min/1.73 m2; 95% CI, 0.02-1.91 mL/min/1.73 m2) and lower odds of rapid eGFRCysC decline (odds ratio, 0.79; 95% CI, 0.65-0.97). Results of this ancillary analysis of a randomized clinical trial showed that when compared with health education, a physical activity and exercise intervention slowed the rate of decline in eGFRCysC among community-dwelling sedentary older adults. Clinicians should consider targeted recommendation of physical activity and moderate-intensity exercise for older adults as a treatment to slow decline in eGFRCysC. ClinicalTrials.gov Identifier: NCT01072500.

Preconception health in the well woman

Key content It is important to focus on preconception care in the well woman because prevention is better than treatment, and interventions commenced in pregnancy may have limited benefit. A lower socioeconomic status is associated with poorer maternal and neonatal outcomes, including gestational diabetes mellitus (GDM), preterm birth (PTB), pre‐eclampsia (PET), and small‐for‐gestational‐age babies. Poor nutrition contributes to epigenetic dysregulation, which can alter gene expression and effect phenotypic change. A healthy diet during pregnancy, high in grains and vegetables, may help to reduce the risk of obesity, GDM, cardiovascular disease, hypertension, PET, and maternal anaemia; the benefits to the fetus include the prevention of low birthweight, macrosomia, PTB and stillbirth. The minimum amount of aerobic activity recommended during the preconception and pregnancy period is either 150 minutes of moderate intensity activity per week, or 30 minutes of activity per day, or 75 minutes of intense activity per week. Alcohol is a teratogen that can cause fetal growth restriction and facial malformations, learning and behavioural challenges and impairment to the central nervous system. Smoking in pregnancy can lead to impaired fetal growth and adverse effects on the immune system. Learning objectives To understand the importance of the preconception period. To evaluate key nutritional requirements in the preconception period. To critically evaluate the benefits and disadvantages of vaccination in the preconception period.

Barriers and Incentives to Physical Activity: Findings fromIndonesian Pregnant and Postpartum Mothers

Objective: The current study intends to inquire if pregnant and postpartum mothers are meeting the recommended level of physical activity, that is, 150 minutes of moderate-intensity activity throughout a week. The study also explores possible barriers and facilitating factors to exercising regularly to see differing patterns among the regularly exercising mothers and the non-exercisers. Method: A total of 190 mothers (69 pregnant) participated in an online-based survey. They answer questionnaires that gather their demographic information, physical activity pattern, and barriers-incentives to exercise. Results: The ones who do not exercise regularly outnumber those who regularly do. Both pregnant and postpartum mothers were not meeting the recommended physical activity level, although the postpartum mothers reported significantly higher engagement in physical activity. The mothers, however, did not differ in total time spent sitting. The pregnant and non-pregnant mothers differed in their perception of barriers and incentives to exercise, with non-exercising mothers reporting significantly more obstacles than their counterparts. The mothers' lack of motivation, self-efficacy, and absence of social support were the primary hindrances to participants exercising regularly. Conclusion: Mothers, especially pregnant and postpartum mothers, continue to be a high-risk group for physical inactivity. Understanding the mother's primary barriers and incentives to exercise may be crucial in improving their physical activity level and reducing their sedentary time.

Adapted Physical Activity for Breast Cancer Patients Treated with Neoadjuvant Chemotherapy and Trastuzumab Against HER2 (APACAN2): A Protocol for a Feasibility Study.

BackgroundThe standard care for HER2-positive breast cancer is chemotherapy plus a HER2-directed therapy. This can lead to treatment-induced cardiotoxicity. On the other hand, the practice of physical activity is known to improve cardiac function; thus HER2-positive breast cancer patients could draw particular benefit from physical activity during treatment. However, at the time of diagnosis for breast cancer, the majority of patients are insufficiently active according to physical activity recommendations of World Health Organisation, and it is difficult to remain or become active during the treatment. There is a lack of data in the literature on the optimal program to propose to patients to encourage them to be active during treatment. The aim of our study is to assess the feasibility of a home-based physical activity program during neoadjuvant chemotherapy and trastuzumab for HER2-positive breast cancer.MethodsThe APACAN2 study is a single-centre, non-randomized interventional trial. Patients with HER2-positive breast cancer treated with anthracycline-based neoadjuvant chemotherapy and trastuzumab are eligible for enrolment. The supervised home-based physical activity program takes place during neoadjuvant chemotherapy (NACT). It combines aerobic and strengthening exercises. The primary endpoint is the proportion of patients reaching the international physical activity recommendations, i.e. 150 minutes of moderate-intensity activity per week at the end of NACT. The study started in April 2018 and seventy patients are expected to be recruited.DiscussionIn the literature, the majority of studies on practice of physical activity in breast cancer focus on adjuvant chemotherapy or on the period after the end of treatment. To the best of our knowledge, the APACAN2 study is the first to evaluate a home-based physical activity program during neoadjuvant chemotherapy for HER2-positive breast cancer.Trial Registration NumberClinicaltrials.gov: NCT02963363, registered on July 11, 2016. Identifier with the French National Agency for the Safety of Medicines and Health Products N°ID RCB 2016-A01344-47, registered in August 2016. Protocol: version 8, 24 February 2021.

Abstract P495: Trends in Physical Activity Among US Older Adults With Heart Failure 2007-2016

Introduction: Heart failure (HF) is a growing public health problem which is the leading cause of hospitalization. About half of people who develop HF die within 5 years of diagnosis. Recent evidence suggests that physical inactivity may be an important risk for HF. However, the importance of physical activity in the prevention and treatment have not been adequately recognized. Self-reported physical activity can provide insights into the impact of lifestyle behaviors on mortality. The objective of this study was to determine the relationship between physical activity and HF in a nationally representative sample of United States (US) adults. Methods: The 2007-2016 National Health and Nutrition Examination Survey data collection cycles were used for this analysis. Participants aged 65 and older with HF were defined as those who answered “yes” to the question: “Has a doctor or other health professional ever told you that you had congestive HF?” Frequency and duration of self-reported moderate-intensity (“Days moderate recreational activities” and “Minutes moderate recreational activities”) and vigorous-intensity Days vigorous recreational activities” and “Minutes vigorous recreational activities”) physical activity were collected through questionnaires as well in all data cycles. We used 2018 Physical Activity Guidelines for Americans Older Adults, which recommended that most older adults (age≥65 years) participate in at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week as our cut-off points for calculating moderate-to-vigorous physical activity. Results: Between 2007-2008 and 2015-2016, the percentage of US adults ≥65 years with HF increased from 2.76% to 3.69% (p=0.04). Although a similar percentage of participants who met the criteria of at least 150 minutes of moderate-intensity activity per week was noted in both groups from 2007 to 2016 (on average, HF: 56.9% vs. HF-free: 56.7%, respectively, p>0.05), more HF-free participants reported at least 75 minutes of vigorous-intensity recreational activities per week compared to HF participants in each calendar year (82.8% vs. 66.7%, 85.0% vs. 70.0%, 83.5% vs. 55.0%, 87.0% vs.75%, 85.2% vs. 63.6%, respectively, p<0.01). Additionally, among those who reported activities, older adults with HF were less than 20 times as likely to report moderate or vigorous recreational activities compared to those without HF. Conclusions: Our findings illustrate lower self-reported physical recreational activities, especially vigorous activities, in older participants who report a diagnosis of HF and more participants without HF report vigorous-intensity recreational activities. Future study should focus on understanding the physical limitations of HF patients, which is paramount in developing cardiac rehabilitation strategies to improve their function capacity.

Abstract PD6-04: Lifestyle intervention study (LISA) in early breast cancer (BC): An RCT of the effects of a telephone-based weight loss intervention (with educational materials) vs educational materials alone on disease-free survival (DFS)

Abstract Background: Obesity has been associated with poor BC outcomes. We investigated whether a standardized, telephone-based weight loss lifestyle intervention in recently diagnosed BC patients would lower recurrence and death rates. Methods: We conducted a multicenter RCT comparing mail-based educational material alone (control arm) or combined with a standardized, telephone-based lifestyle intervention (19 calls over 2 years, (intervention arm) that focused on diet (500-100 kcal/day deficit), physical activity (150-200 minutes of moderate-intensity activity per week) and behavior (compliance, relapse prevention) to achieve up to 10% weight loss. 338 (of 2150 planned) T1-3, N0-3, M0 ER/PgR+ BC patients with body mass index (BMI) ≥ 24 kg/m2 receiving adjuvant letrozole were randomized Aug 2007 to Jan 2010 (enrolment ended due to funding loss). Primary outcome was DFS; secondary outcome OS. Weight loss (5.3 vs 0.7% at 6 months and 3.6 vs 0.4% at 24 months in the intervention vs control arms, respectively) has been reported (JCO 2014;32:2331). At 8 years median follow-up (May 2018), DFS and OS were compared using Cox proportional hazards regression. Results: Mean age was 61.6 vs 60.4 years, mean BMI 31.4 vs 31.0 kg/m2 and adjuvant chemotherapy was received by 56.1 vs 57.5% in intervention vs controls arms respectively. T1/T2/T3 66.7/27.5/5.9% vs 61.7/33.5/3.6% and N0/1/2+ 62.6/28.7/8.8 vs 63.5/32.3/4.2% in intervention vs controls arms respectively. HER2+ in 8.8 vs 15.0% (intervention vs control). 20 of 171 (11.7%) in the lifestyle intervention arm vs 30 of 167 (18.0%) in the mail-based arm had DFS events, HR 0.71, 95%CI 0.41-1.24, p=0.23). DFS curves separated at 2 yrs; beyond 3-3.5 yrs separation approximated 5%. In a landmark DFS analysis of women alive at 24 months, DFS HR=0.68 (0.34-1.37, p=0.28). Conclusions: We identified fewer DFS events in the lifestyle intervention arm. Although loss of funding reduced sample size and lowered power, these results are consistent with a potential beneficial effect of a lifestyle intervention on DFS in postmenopausal ER/PgR+ BC patients. They provide strong support for completion of ongoing RCTs (e.g. BWEL) that will provide definitive evidence regarding the effect of lifestyle based weight loss on BC outcomes. Funded by Novartis Pharmaceuticals Inc.; Sponsored by the Ontario Clinical Oncology Group Citation Format: Goodwin PJ, Segal R, Vallis M, Ligibel JA, Pond GR, Robidoux A, Findlay BP, Gralow JR, Mukherjee SD, Levine MN, Pritchard KI. Lifestyle intervention study (LISA) in early breast cancer (BC): An RCT of the effects of a telephone-based weight loss intervention (with educational materials) vs educational materials alone on disease-free survival (DFS) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD6-04.

Longitudinal physical activity assessment in post-surgical gynecologic cancer patients.

e21582 Background: Physical activity is a key determinant of health, and exercise can be effective for decreasing anxiety and depression and improving quality of life in cancer survivors. The primary aim of this study was to report the trajectory of physical activity over time for post-operative gynecologic cancer patients. The secondary aim was to identify correlates of total physical activity over time. Methods: The study population included patients who underwent surgery for endometrial (n = 80) or ovarian (n = 43) cancer and wore an accelerometer for a 3-day period at 1 week, 1 month and 4 months after surgery. Accelerometer data were captured during all waking hours and were transformed into categories of light, moderate and vigorous intensity physical activity. The outcome of interest was total minutes of moderate to vigorous intensity physical activity (MVPA) collected over the three day period at each time point, analyzed using a linear mixed effect model approach, assessing the correlates of age, body mass index (BMI), self-rated health, laparotomy vs. laparoscopic (endometrial only) and neoadjuvant chemotherapy yes/no (ovarian only). Results: Mean age was 58.8 ± 10.1 years with mean BMI of 35.5±10.3 kg/m2. Over each three-day period, patients performed 7 ± 12 minutes of total accumulated MVPA at 1 week, 20 ± 41 minutes of total MVPA at 1 month, and 25 ± 36 minutes at 4-months post-surgery (p = 0.01). Federal guidelines recommend approximately 70 minutes of moderate intensity activity over a three-day period to collect 150 minutes of moderate activity a week. Better self-rated health at baseline was associated with increased activity over time (p = 0.02). BMI, age, type of surgery or use of neoadjuvant chemotherapy did not predict physical activity in patients of either disease site. Conclusions: Physical activity increased over time for endometrial and ovarian cancer patients. Self-reported health at baseline was also positively associated with increased moderate-vigorous physical activity over time. There is insufficient evidence to show that BMI significantly contributes to changes in moderate-to-vigorous physical activity over time. Future research should address barriers to activity and novel interventions.

Diabetes and physical activity

Diabetes and physical activity

COMT and OPRM1 genotype associations with daily knee pain variability and activity induced pain

BackgroundOsteoarthritis (OA) of the knee is a common and increasingly prevalent condition that is one of the primary causes of chronic pain. Staying physically active protects against disability from knee OA but is also very challenging. A critical but unexamined question is whether patients at greatest risk for becoming less active are those with a genetic predisposition for greater sensitivity to daily pain. AimsWe examined day-to-day variability in knee OA pain for patients with different variants of catechol-O-methyltransferase (COMT) and mu-opioid receptor (OPRM1) single nucleotide polymorphisms (SNPs), and whether patients with a specific genotype experience more pain following daily physical activity. We predicted that patients having one or more copies of the Met158 allele of COMT rs4680 (A-A or A-G) and one or more copies of the Asp40 allele of OPRM1 rs1799971 (A-G or G-G) would show greater pain variability. We expected to see the same pattern for these SNPs with regard to moderation (i.e., exacerbation) of the activity-pain association. MethodsA total of 120 knee OA patients reported on their pain 3 times per day over 22 days using handheld computers, and wore an accelerometer to capture daily physical activity. Multilevel modelling was used to examine the magnitude of within-person variability in pain by genetic group. We also examined whether lagged, within-patient associations between level of activity in the afternoon (i.e., minutes of moderate intensity activity, and number of steps) and knee pain at the end-of-day were moderated by between-patient differences in genotype. ResultsRegarding OPRM1 rs1799971 (Asn40Asp), patients with two copies of the Asn40 allele showed the greatest day-to-day pain variability. Regarding COMT rs4680 (Val158Met), patients with the Val/Val genotype showed the greatest pain variability and also experienced the greatest increase in pain as a result of physical activity. A similar pattern of findings across bi-directional temporal lags was consistent with a negative feedback loop between daily physical activity and pain according to genotype. Consistent with some previous studies, there were no significant between-person differences in daily pain when comparing patients according to COMT rs4680, or OPRM1 rs1799971. ConclusionThis study provides preliminary evidence that patients with certain genotypes for COMT rs4680 and OPRM1 rs1799971 (G-G and A-A, respectively) experience more variability in their day-to-day pain and exacerbation of pain after daily physical activity compared to patients with other genotypes. Our findings should be replicated in larger study populations. ImplicationsPrevious clinical research has focused primarily on differences in average level of pain between patients with and without a specific genotype. Assessment of within-person variability through repeated measurements in daily life enhances the reliability, power, and ecological validity of phenotypic measurement. PerspectiveThis study provides preliminary evidence that patients with certain variations in the COMT and OPRM1 SNPs experience more variability in their day-to-day pain and exacerbation of pain after daily physical activity.

Abstract MP026: Does the Replacement of Moderate-Intensity with Vigorous-Intensity Physical Activity Further Reduce All-Cause and Cardiovascular Mortality?

The 2008 US federal guidelines require a minimum of 150 minutes/week of moderate-intensity, or 75 minutes/week of vigorous-intensity physical activity, or an equivalent combination of the two, for health benefits. Thus, they assume a 2:1 equivalence between the two intensities of activity; i.e., 2 minutes of moderate-intensity activity is equivalent to 1 minute of vigorous-intensity activity. However, no studies have specifically examined whether this assumption is correct. Purpose: To examine the effect of replacing 150 minutes/week of moderate-intensity with 75 minutes/week of vigorous-intensity physical activity on all-cause and cardiovascular disease (CVD) mortality. Methods: 8,859 men (mean age, 66.4 yr) from the Harvard Alumni Health Study, free from CVD and cancer, were followed from 1988 to 2008. At baseline (1988) and in 1993, men reported physical activity (blocks walked, stairs climbed, and a listing of sports/recreational activities and participation time). Time spent per week in sports/recreational activities of moderate-intensity (3 to <6 METs, or multiples of resting metabolic rate) was summed and expressed as units (or fraction of units) of 150 minutes/week. Similarly, time spent in vigorous-intensity (≥6 METs) sports/recreational activities was summed, expressed as units (or fraction of units) of 75 min/week. Total and cause-specific mortality was identified from the National Death Index. Cox proportional hazards models calculated the risks of all-cause and CVD mortality, examining the effect of replacing 150 minutes/week of moderate-intensity with 75 minutes/week of vigorous-intensity physical activity, controlling for the total amount of physical activity. Results: During follow-up, 4,064 men died, including 1,192 from CVD. In multivariate analyses, controlling for the total physical activity, age, smoking, intakes of alcohol, vegetable, fruit, and saturated fat, and total caloric intake, replacing 150 minutes/week of moderate-intensity with 75 minutes/week of vigorous-intensity physical activity was associated with an additional 2% reduction in all-cause mortality (Hazard Ratio (95% confidence interval) = 0.98 (0.96, 1.00); p = 0.05), and an additional 5% reduction in CVD mortality (0.95 (0.92, 0.99); p = 0.02). Conclusions: The assumption that 2 minutes of moderate-intensity activity is equivalent to 1 minute of vigorous-intensity activity under current federal guidelines is not strictly correct. Vigorous-intensity physical activity is associated with additional risk reduction for CVD mortality compared to moderate-intensity physical activity. Although there is an added, statistically significant benefit of vigorous-intensity over moderate-intensity physical activity, the magnitude of benefit is small.

CSM 2012 Orthopaedic Section Platform Presentations (Abstracts OPL1–OPL64)

CSM 2012 Orthopaedic Section Platform Presentations (Abstracts OPL1–OPL64)

Meeting Physical Activity Recommendations for Colon Cancer Prevention Among Japanese Adults: Prevalence and Sociodemographic Correlates

Although physical activity is associated with a lower risk of colon cancer, few studies have described the physical activity required for colon cancer prevention in various sociodemographic subgroups. The current study examined the prevalence and sociodemographic correlates of attaining the 2 recommended physical activity criteria for colon cancer prevention among Japanese adults. The sample included 5322 Japanese adults aged 20 to 79 years. Seven sociodemographic attributes (eg, gender, age, education level, employment status) and the International Physical Activity Questionnaire were assessed via an Internet-based survey. The odds of meeting each physical activity criterion by sociodemographic variables were calculated. Overall, 23.8% of the study population met the criterion of ≥ 420 minutes of moderate-intensity activity, and 6.4% met the criterion of ≥ 210 minutes of vigorous activity. Being male, highly educated, employed, living with another person, being married and having a higher household income were significantly correlated with the attainment of recommendations. Participants who met the 2 activity recommendations differed in gender, education level, employment status, marital status, living conditions, and household income. The findings of the current study imply that strategies to promote more intense physical activity in all demographic groups may be necessary.

Self-Reported Physical Activity Patterns Among Low-Income Latina Women In Arizona

Adherence to recommendations for PA among adults in the US is poor, particularly among low-income Latinos. In 2009, 53.6% of Hispanics nationwide did not meet the guidelines for 30 minutes of moderate intensity activity on most, if not all, days of the week. In particular, Latina women are at increased risk for inactivity and chronic illness, but national health survey reports aggregate data across demographic strata, limiting descriptive information that could guide targeted PA promotion. PURPOSE: To determine PA patterns among a very low-income, low acculturated group of Latina women in the southwestern US. METHODS: As part of a large community intervention trial to increase cancer prevention behaviors, PA data were collected from 1,006 Latina women (mean age 39.3 +/- 13.8 years) using a modified version of the Arizona Activity Frequency Questionnaire (AAFQ). RESULTS: At baseline, the total average daily PA reported in minutes was 89.98 (+/- 147.71) for those reporting any exercise (10% reporting no exercise). Per specific activity, the total average daily minutes were: Walking, 44.11 (+/- 11.60; n=498); Jogging, 11.05 (+/- 28.68; n=165); Dancing, 17.78 (+/- 40.53; n=258); Light yard work, 19.99 (+/- 40.53; n=445); Lifting, 43.01 (+/- 85.25; n=397); Heavy yard work, 40.79 (+/- 85.49; n=45); Cleaning, 80.42 (+/- 111.51; n=305); Biking, 8.35 (+/-5.65; n=73); and Swimming, 25.59 (+/- 31.70, n=57). In categories with >300 participants reporting PA (Walking, Lifting, Light yard work, Cleaning), there is a bimodal distribution showing very low and very high levels of PA. CONCLUSION: In this sample Latina women, the average daily PA minutes/day exceeds the current PA recommendations. PA categories for which women reported highest levels of activity are those that may be tied to very active jobs. Among the lowest income Latinas, differences in low and high levels of PA suggests the need to target PA promotion efforts to population segments with differing profiles.

Meeting physical activity recommendations for colon cancer prevention among Japanese adults: Prevalence and sociodemographic correlates

Background: Although physical activity is associated with a lower risk of colon cancer, few studies have described the physical activity required for colon cancer prevention in various sociodemographic subgroups. The current study examined the prevalence and sociodemographic correlates of attaining the 2 recommended physical activity criteria for colon cancer prevention among Japanese adults. Methods: The sample included 5322 Japanese adults aged 20 to 79 years. Seven sociodemographic attributes (eg, gender, age, education level, employment status) and the International Physical Activity Questionnaire were assessed via an Internet-based survey. The odds of meeting each physical activity criterion by sociodemographic variables were calculated. Results: Overall, 23.8% of the study population met the criterion of ≥ 420 minutes of moderate-intensity activity, and 6.4% met the criterion of ≥ 210 minutes of vigorous activity. Being male, highly educated, employed, living with another person, being married and having a higher household income were significantly correlated with the attainment of recommendations. Conclusions: Participants who met the 2 activity recommendations differed in gender, education level, employment status, marital status, living conditions, and household income. The findings of the current study imply that strategies to promote more intense physical activity in all demographic groups may be necessary.

Active or Sedentary? Objectively Measured Physical Activity of Latinos and Implications for Intervention

Latinos have the lowest leisure-time physical activity (LTPA) rates. However, measurement of only LTPA might underestimate total physical activity. This study compares the objective physical activity of Latinos reporting high or low levels of LTPA and also compares gender differences. Data were obtained from 148 Latinos (n = 83 women, n = 65 men). Freedson cut points were employed to determine daily minutes of activity. Latinos reporting high LTPA engaged in more daily minutes of vigorous and very vigorous activity than Latinos reporting low LTPA (P values < .05). There was no difference in daily minutes of moderate-intensity activity (P = .12), with both groups of Latinos meeting Centers for Disease Control and Prevention/American College of Sports Medicine guidelines. Men engaged in more daily minutes of moderate activity than women (P < .01). Many Latinos met physical activity guidelines even when reporting low levels of LTPA. Future studies should determine whether equivalent health benefits are achieved by meeting guidelines through LTPA and non-LTPA.

Vigorous Intensity Physical Activity is Associated with Higher HDL-C in Older Adults

PURPOSE: The purpose of this study was to examine the impact of time spent in moderate or vigorous intensity physical activity (PA) on blood lipids, after controlling for total PA in an older adult population. METHODS: Data were collected on 89 older adults (30 males, 59 females; 64.8 ± 8.1 y; 31.5 ±9.7 % body fat). Measures of body height, mass, 3-compartment body composition using dual-energy x-ray absorptiometry were collected. A fasting blood sample was analyzed for total cholesterol (TC), HDL-C, LDL-C, and triglycerides (TRIG). Participants were then asked to wear an accelerometer (Actigraph 7164, Fort Walton Beach, FL) during all waking hours for seven consecutive days. Total time spent in moderate intensity PA (MPA) and vigorous intensity PA (VPA) was calculated with the Freedson et al. (1998) equation. Total PA level was determined from average total accelerometer counts/d. Hierarchical multiple regression analyses were completed to determine the impact of time spent in MPA or VPA while controlling for age, gender, % BF and total PA on TC, HDL-C, LDL-C and TRIG. RESULTS: This group of older adults had borderline high TC (202.6 ± 40.7 mg/dL), normal TRIG (111.6 ±66.0 mg/dL), high HDL-C (62 ± 19.3 mg/dL), and near optimal/ above optimal LDL-C (112 ± 33.3 mg/dL). Participants spent an average of 32.6 ± 24.6 minutes in MPA (range: 0.7 to 127.7 minutes) and 3.1 ±7.2 minutes in VPA (range: 0-38.3 minutes). Regression analysis revealed that VPA accounted for 4.1% of the variance in HDL-C (p=0.017), after controlling for age, gender, %BF and total PA. MPA did not significantly impact HDL-C, and neither MPA or VPA significantly contributed to TC, LDL-C, or TRIG after controlling for age, gender, %BF and total PA. CONCLUSION: Although these participants engaged in 30 minutes of moderate intensity activity, this amount of activity was not associated with higher HDL-C or lower TC, TRG or LDL-C. These data show that a higher quality of PA appeared to have a stronger impact on HDL-C levels. This work was partially supported by a Career Development Award from the National Institute on Aging (K01AG025962)

Unique Environmental Effects on Physical Activity Participation: A Twin Study

BackgroundThe health benefits of regular physical activity are well established. However, the relative contribution of heritable and environmental factors to physical activity participation remains controversial. Using a cut-point of 60 minutes of total activity per week, data from the GenomEUtwin project revealed consistent genetic influence on physical activity participation in 37,051 twin pairs from seven countries. We hypothesized that the heritability of physical activity participation would be attenuated using the CDC/ACSM recommended minimum threshold of 150 minutes of moderate intensity activity per week.MethodsData were obtained from 1,389 twin pairs from the community-based University of Washington Twin Registry. Twin similarity in physical activity participation using both cut-points was analyzed using tetrachoric correlations and structural equation modeling in all same-sex pairs.ResultsCorrelations were higher in monozygotic (rMZ = 0.43, 95% CI = 0.33–0.54) than dizygotic pairs (rDZ = 0.30, 95% CI = 0.12–0.47) using the 60 minute cut-point. However, differences were attenuated using the 150 minute standard (rMZ = 0.30, 95% CI = 0.20–0.40; rDZ = 0.25, 95% CI = 0.07–0.42). Using the lower cut-point, the best fitting model of twin resemblance only included additive genetics and unique environment, with a heritability of 45%. In contrast, using the higher threshold, the best fitting model included the common and unique environment, with the unique environment contributing 72% of the variance.ConclusionUnique environment factors provide the strongest influence on physical activity participation at levels recommended for health benefits.

The role of physical activity in maintaining a reduced weight

Current physical activity recommendations call for 30 minutes of moderate-intensity activity on most days of the week, or the equivalent of expending approximately 1000 kcal in activity per week. These recommendations were formulated based on reducing the risk for chronic disease, but they do not appear adequate for weight loss and maintenance. Data from epidemiologic studies and randomized trials indicate that closer to 60 to 90 minutes of moderate-intensity activity every day is required for maintaining a reduced body weight, equivalent to expending 2500 to 2800 kcal in activity per week. Relevant studies leading to this conclusion are reviewed in this manuscript. However, to make a dent in the prevalence of obesity by targeting physical activity and food intake, it is imperative to address the current "built" environment, which is conducive to a sedentary lifestyle and overconsumption of energy. Only then will rigorous activity recommendations be easier to implement.