Moderate Recreational Activity Research Articles

Comparative study on the association between types of physical activity, physical activity levels, and the incidence of osteoarthritis in adults: the NHANES 2007–2020

It is known that physical activity is beneficial for the prevention of osteoarthritis (OA), but specific discussions on which types and levels of physical activity are more effective in reducing the incidence of OA are restricted. This study is aimed at exploring the correlation concerning the types of physical activity, levels of physical activity, and the incidence of OA by assessing the participation in five typical forms of physical activity (vigorous work activity, vigorous recreational activity, moderate work activity, moderate recreational activity, and walking or bicycling). Cross-sectional study was conducted. Self-reported data on specific types of physical activity were obtained from individuals in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2020 with the use of the Physical Activity Questionnaire (PAQ). The incidence of OA was assessed through the "Health Conditions" questionnaire section of NHANES. Weighted logistic regression analysis was employed to study the correlation between physical activity types and levels, and the incidence of OA. Different kinds of physical activity and physical activity levels have varying impacts on the incidence of OA. Among the types of physical activity, vigorous recreational activity and moderate recreational activity are found to have a preventive effect on OA. In terms of physical activity levels, low physical activity levels of moderate work activity are associated with an increased risk of OA, while moderate physical activity levels are confirmed to have a protective effect against OA in the age groups of 20–44 and 45–64. However, gender-stratified analyses reveal that both low and moderate physical activity levels provide protection against OA in males, with moderate physical activity levels showing a more significant protective effect.

The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio with type 2 diabetes mellitus: recent findings from NHANES 2007–2018

ObjectiveThis study aims to assess the relationship between NHHR (non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio) and Type 2 diabetes mellitus (T2DM) in US adults, using National Health and Nutrition Examination Survey (NHANES) data from 2007 to 2018.MethodsThis study explored the connection between NHHR and T2DM by analyzing a sample reflecting the adult population of the United States (n = 10,420; NHANES 2007–2018). NHHR was characterized as the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol. T2DM was defined based on clinical guidelines. This research used multivariable logistic models to examine the connection between NHHR and T2DM. Additionally, it included subgroup and interaction analyses to assess variations among different groups. Generalized additive models, smooth curve fitting, and threshold effect analysis were also employed to analyze the data further.ResultsThe study included 10,420 subjects, with 2160 diagnosed with T2DM and 8260 without. The weighted multivariate logistic regression model indicated an 8% higher probability of T2DM for each unit increase in NHHR (OR: 1.08, 95% CI: 1.01–1.15) after accounting for all covariates. Subgroup analysis outcomes were uniform across various categories, demonstrating a significant positive relationship between NHHR and T2DM. Interaction tests showed that the positive link between NHHR and T2DM remained consistent regardless of age, body mass index, smoking status, moderate recreational activities, hypertension, or stroke history, with all interaction P-values exceeding 0.05. However, participants’ sex appeared to affect the magnitude of the connection between NHHR and T2DM (interaction P-value < 0.05). Also, a nonlinear association between NHHR and T2DM was discovered, featuring an inflection point at 1.50.ConclusionsOur study suggests that an increase in NHHR may be correlated with a heightened likelihood of developing T2DM. Consequently, NHHR could potentially serve as a marker for estimating the probability of T2DM development.

Association between Sitting Time and Urinary Incontinence in the US population: Data from the National Health and Nutrition Examination Survey (NHANES) 2007 to 2018

BackgroundUrinary incontinence (UI) is a common health problem that affects the quality of life and health of millions of people in the United States (US). We aimed to investigate the association between sitting time and UI symptoms in the US population. MethodsA cross-sectional survey of participants aged 20 and above from the National Health and Nutrition Examination Survey 2007–2018 was performed. A self-report questionnaire that reported complete data on UI, sitting time and covariates was included. Weighted multivariable logistic and regression models were used to assess the association between sitting time and UI symptoms. ResultsA total of 22,916 participants were enrolled. Prolonged sitting time was associated with urgency UI (UUI, odds ratio [OR] = 1.2, 95% confidence interval [CI] = 1.1 to 1.3, p = 0.001). Compared with patients with sitting a time shorter than 7 hours (h), moderate recreational activity modified the association between sitting time and mixed UI in males in the fully adjusted model (OR = 2.5, 95% CI = 1.4 to 4.5, p = 0.002). A sitting time over 7 h was related to mixed UI (MUI, OR = 1.6, 95% CI = 1.1 to 2.2, p = 0.01) in males, and stress UI (SUI, OR = 0.9, 95% CI = 0.8 to 0.98, p = 0.03) in females. However, no significant difference was found among the UI, SUI, and MUI groups in fully adjusted model. ConclusionsA prolonged sitting time (≥7 h) was associated with UUI symptoms in all populations, SUI symptoms in females and MUI symptoms in males compared with sitting time lower than 7 h. Compared with those sit shorter than 7 h, moderate recreational activity may be a modifier between prolonged sitting and MUI symptoms in male participants, which warrants further studies for confirmation.

The impact of recreational activities on the current state of the state landscape reserve «Baydarsky», Mountain Crimea, Ukraine

Ukraine is taking measures to continue monitoring of the natural environment in the temporarily occupied territory of Crimea. In particular, natural territories and objects subject to special protection, the state of the natural environment, and recording the facts of environmental offenses and crimes are carried out. The issue of the current state of the objects of the nature reserve fund of the Crimea in the conditions of unregulated recreation has not been investigated. We chose a tract the «Bizyuk» of the state landscape reserve «Baydarsky» as an object of research. The state landscape reserve is located on the southwestern north of the macroslope of the Crimean Mountains (height 200–900 m) on the territory of the Sokolinsky, Kuibyshivskyi, Chornorichenskyi, Orlynivskyi and Ternivskyi forest divisions within the Baydar Valley. The purpose of the study was to analyse the ecological, phytocenotic and spatial features of recreational changes in the tract «Bizyuk» of the reserve «Baydarsky». The ecological profile was carried out according to the gradient of the intensity of the recreational load from three experimental plots (EP1 – intensive; EP2 – medium; EP3 – moderate as a control; areas without violations were not detected) in accordance with the principles of ecosystem, comparative analyzes and forestry methods in the last decade of June 2021. Forestry taxation, sanitary and vitality structures of the tree stand were studied. Biomorphological and ecomorphic structure of the herbaceous layer were studied too. The stages of recreational transformation of the soil surface were determined. It was established that changes in the ecological conditions of the «Bizyuk» tract were caused by unregulated recreational activities. The main consequences of recreational activities were the change in the hydrological regime of the soil due to the trampling of the litter and herbaceous layer, clogging, mechanical damage to tree trunks, stripping and trimming of the bark, woodfires, collecting plants, which led to a significant weakening of the stands (III category of state). The state of the soil surface changed along the gradient of recreational transformation from the 1st stage of digression (zone of moderate recreational activities) to the 4th stage of digression of the soil surface (zone of intensive recreational activities). A change in the species composition of the herbaceous cover was recorded. Adventitious, ruderal plants were widespread in all zones of the tract, but most in the zone of intensive recreational transformation. The max share of perennial plants was established in the zone of moderate recreational transformation, the min – in the zone of intensive recreational transformation. Rosetteless herbaceous plants and plants without specialized modifications of underground shoots were predominated. Hemicryptophytes and phanerophytes were dominated. The proportion of therophytes and chamephytes did not correlate with the level of recreational activities. Forest and ruderal plants in various proportions were dominated in all zones. It has been proven that the ecomorphic composition of the herbaceous cover also reflects recreational transformation in the tract. Hydromesophytes and mesophytes were prevailed among hydromorphs. The phytocoenotic contribution of mesophytes was increased in the most transformation plots. Hemistenotopic and hemieurytopic subacidophilous plants were dominated. The share of hemiaerophobes gradually was decreased along the transformation gradient. The intense recreational impact was caused a certain nitrification of ecotopes (distribution by nitromorphs).

Association between waist circumference and female infertility in the United States.

Obesity has significant implications for fertility and reproductive health. However, evidences linking abdominal obesity to female infertility were limited and inconclusive. Our objective was to figure out the potential relationship between waist circumference (WC) and infertility among women of childbearing age in the United States using data from the National Health and Nutrition Examination Survey (NHANES). Our cross-sectional study included 3239 female participants aged 18-45 years. To explore the independent relationship between WC and female infertility, the weighted multivariable logistic regression and smoothed curve fitting were performed. Interaction and subgroup analyzes were then conducted for secondary analysis. WC was positively associated with female infertility independent of BMI after adjusting for BMI and other potential confounders. In fully adjusted model, for every 1cm increase in waist circumference, the risk of infertility increased by 3% (OR = 1.03, 95% CI: 1.01-1.06). When WC was divided into five equal groups, women in the highest quintile had 2.64 times risk of infertility than that in the lowest quintile (OR = 2.64, 95% CI: 1.31-5.30). Smooth curve fitting revealed a non-linear but positively dose-dependent relationship between WC and female infertility. Furthermore, we found an inverted U-shaped relationship (turning point: 113.5 cm) between WC and female infertility in participants who had moderate recreational activities and a J-shaped relationship (turning point: 103 cm) between WC and female infertility in participants who had deficient recreational activities. Waist circumference is a positive predictor of female infertility, independent of BMI. Moderate recreational activities can lower the risk of female infertility associated with abdominal obesity.

Physical Activity among Colorectal Cancer Patients and Survivors in Egypt.

Understanding physical activity (PA) levels is important when developing tertiary cancer prevention interventions, especially in Egypt where colorectal cancer (CRC) is more often diagnosed at later stages and at a younger age of onset (≤40 years). We assessed PA levels among CRC patients and survivors in Alexandria, Egypt. All participants completed two self-reported PA assessments: Global Physical Activity Questionnaire (GPAQ) and Godin Leisure-Time Exercise Questionnaire (GLTEQ). Participants could opt to wear an accelerometer for seven days. Results were compared against WHO recommendations of ≥150 minutes or ≥600 metabolic equivalents of tasks (METs) of moderate-to-vigorous PA weekly. Of 86 participants enrolled, all completed the surveys and 29 agreed to accelerometer use. Prevalence of meeting PA recommendations was 62.8% based on the GPAQ, 14.0% based on GLTEQ, and 41% based on accelerometer. Based on the GPAQ, very few respondents reported vigorous occupational, vigorous recreational, or moderate recreational activity (median = 0 with interquartile range [IQR] of 0 - 0 weekly minutes for all three) while most activity resulted from moderate occupational and transportation (median [IQR] of 60 [0-840] and 60 [0-187.5] weekly minutes, respectively). Participants meeting PA recommendations were less likely to be married (p = 0.043) according to GPAQ and more likely to be female (p=0.047) and early cancer stage (p=0.007) by GLTEQ. Non-leisure free-living PA is a major contributor to meeting PA recommendations while leisure-time PA is a potential target for future interventions that increase PA in this population.

The Role of Sarcopenia in Overactive Bladder in Adults in the United States: Retrospective Analysis of NHANES 2011-2018.

To investigate the association between sarcopenia and overactive bladder (OAB) in a United States adult population from 2011 to 2018, and whether sarcopenia can predict the risk of OAB. We analyzed data from the 2011-2018 National Health and Nutrition Examination Survey in a cross-sectional study(NHANES) of 8746 participants, of whom 1213 were diagnosed with OAB, we analyzed correlations by sex, age, race, education level, marital status, household income-to-poverty ratio, hypertension, diabetes, strenuous work activity, moderate work activity, strenuous recreational activity, moderate recreational activity, blood urea nitrogen, creatinine, and uric acid levels using restricted cubic spline plots of dose-response curves, univariate and multivariate Logistic regression. Models based on sex, age, education, household income to poverty ratio, hypertension, diabetes, sarcopenia index, and cotinine were developed and evaluated using Nomogram, calibration curves, receiver operating characteristic curves, and clinical decision curves. Of the 1213 OAB patients, 388 (32.0%) were male and 825 (68.0%) were female. Univariate and multivariate Logistic regression analysis showed that sarcopenia index was negatively correlated with the prevalence of OAB (OR=0.084, 95% CI, 0.056 - 0.130, P <0.001;OR=0.456, 95%CI, 0.215-0.968, P= 0.0041). Dose curve analysis of the sarcopenia index and prevalence of OAB showed that the prevalence of OAB decreased significantly with increasing sarcopenia index. Sarcopenia was positively correlated with OAB (OR=2.400, 95%CI, 2.000 - 2.800, P <0.001;OR=1.46, 95%CI, 1.096 -1.953, P = 0.010). In addition, our model shows that sarcopenia can predict the prevalence of OAB (AUC = 0.750) and has some clinical decision-making implications. Sarcopenia is positively associated with the risk of OAB in United States adults and can be used as a predictor of OAB prevalence.

The dietary inflammatory index is positively associated with insulin resistance in underweight and healthy weight adults.

The aim of this study was to explore the relationship between dietary inflammatory index (DII) and insulin resistance (IR) in underweight and healthy weight adults. This cross-sectional study involved 3205 participants from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. All dietary data used to calculate the DII were obtained based on the average of two 24-h dietary recall interviews. Participants were divided into an anti-inflammatory diet group and a pro-inflammatory diet group based on DII<0 and DII≥0, respectively. Fasting blood glucose and fasting insulin data used to calculate IR index (HOMA-IR) were from laboratory data in the NHANES database. According to the linear regression analysis results of DII and HOMA-IR, we found that there was a positive relationship between DII and IR. A positive association between DII and HOMA-IR was seen in the following groups after stratification: by age in 20-39-year olds, by sex in males, by race in Non-Hispanic Whites, by family history of diabetes in those without a family history of diabetes, by education level in those with high school education, by smoking status in current smokers and non-smokers, by hypertension in those with hypertension, by BMI in those with a BMI of 18.5-24.99, by hypertriglyceridemia (HTG) in those without HTG, by poverty impact ratio (PIR) in those with PIR≤1.3 and>1.3, and by physical activity in those with moderate recreational activities. In conclusion, in underweight and healthy weight adults, DII was positively correlated with the risk of IR.

Physical Activity Types, Physical Activity Levels and Risk of Diabetes in General Adults: The NHANES 2007-2018.

Recreational activities show benefits for diabetes prevention, but work-related activity and the total amount of individual physical activity is rarely discussed. The purpose of this study was to evaluate the participation in five typical physical activities (vigorous work activity, vigorous recreational activities, moderate work activity, moderate recreational activities, and walk/bicycle for transportation), as well as the weekly distribution of total physical activity intensity, and to explore the relationships between physical activity types, physical activity levels, and risk of diabetes. Cross-sectional study. The self-reported physical activity data on specific domains of physical activity were acquired from individuals in the 2007-2018 National Health and Nutrition Examination Survey (NHANES) using the Physical Activity Questionnaire (PAQ). Diabetes status was assessed by self-reported medical diagnosis or medication usage, or a fasting glucose concentration ≥ 126 mg/dL (fasting is defined as no caloric intake for at least 8 h) or HbA1c ≥ 6.5%. Weighted logistic regression was used to investigate the associations between physical activity types, physical activity levels, and risk of diabetes. Diabetes was less prevalent in people who participated in physical activity and the risk of diabetes reduced progressively as total physical activity levels increased. Younger adults (20-44 years) and males reported a higher proportion of high-intensity physical activity participation. Our findings highlight the importance of a physically active lifestyle for preventing diabetes. Distinct types of physical activity had different effects on the risk of diabetes. A greater total physical activity level was related to a substantial reduction in diabetes risk.

Egy csontritkulás-specifikus kérdőív magyar nyelvű adaptációja és validálása

Osteoporosis affects one in three women and one in five men over the age of 50. We do not have an osteoporosis-related knowledge questionnaire over the age of 50, which is considered strong evidence in the prevention and treatment of the disease. Aim of the study was to validate the Hungarian form of the Osteoporosis Questionnaire in Hungarian-speaking women over the age of 50. The questionnaire was validated into Hungarian according to Beaton's six-step method. Our sample consisted of 326 women. During our statistical analysis, we calculated descriptive statistics, difference tests, Cronbach's alpha value, and Spearman's correlation coefficient for test-retest and for external validity. Quality of life and physical activity were examined to support the external validity. Our sample (63.08 ± 9.36 years) scored 8.76 ± 6.94 points on the questionnaire. Cronbach's alpha value was 0.89. For the test-retest, Spearman's correlation coefficient showed a value of p≥0.25 for all the questions. Significant correlations were found between knowledge and age (R = 0.37; p<0.001) and years of using hormone replacement therapy (R = 0.34; p = 0.02). The correlation analysis showed significant (p<0.001) correlation between knowledge and all sub-dimensions of quality of life. Significant correlation was found between transport movement (p<0.001; R = 0.21), intensive (p<0.001; R = 0.354), moderate recreational activity (p<0.001; R = 0.348), total moderate (p = 0.041; R = 0.125) total intense movements (p = 0.018; R = 0.145) and knowledge. The Hungarian questionnaire was validated in accordance with international practice. The Hungarian version of the Osteoporosis Questionnaire is a reliable, adaptable questionnaire for measuring the osteoporosis-related knowledge of the Hungarian female population over 50. Orv Hetil. 2022; 163(51): 29-37.

Role of metabolic equivalent between calcium intake and vertebral fractures: a cross-sectional study of NHANES 2013–2014

BackgroundThis study was to analyze the association of calcium intake and metabolic equivalent (MET) with vertebral fractures, and to explore the role of MET between calcium intake and vertebral fractures.MethodThis cross-sectional study used data from the National Health and Nutrition Examination Surveys (NHANES) 2013–2014. The study involved individuals aged ≥ 50 years old with complete information on vertebral fracture, calcium intake, and physical activity. Vertebral fracture assessment is obtained using dual-energy x-ray absorptiometry to perform a lateral scan of the thoracolumbar spine. Calcium intake included total nutrient intake and total dietary supplements. The total MET is the sum of the METs for each activity (Vigorous/ moderate work-related activities, walking or bicycling for transportation and vigorous/ moderate recreational activities). Univariate and multivariate logistic regression analyses were utilized to investigate the effect of calcium intake, MET, and their combined effect on vertebral fracture.ResultsA total of 766 participants were included in the analysis, and 54 participants had vertebral fractures. The median calcium intake and MET were 8.43 mcg and 280.00, respectively. Multivariate results showed that neither calcium intake nor MET as continuous or categorical variables was significantly associated with vertebral fractures. MET < 160 and calcium intake ≥ 670 mg group was associated with the decreased risks of vertebral fracture [odds ratio (OR) = 0.47, 95% confidence interval (CI): 0.26–0.83, P = 0.032] after adjusting for age, race, energy, total femur bone mineral density (BMD), and femoral neck BMD. In the group of MET < 160, increased calcium intake was associated with a reduced risk of vertebral fracture, with a decreased OR value. In the group of MET ≥ 160, increased calcium intake was associated with an increased risk of vertebral fracture, with an increased OR value.ConclusionThe combination of MET < 160 and calcium intake ≥ 670 mg was associated with decreased risks of vertebral fractures. There may be an interaction between calcium intake and MET on vertebral fracture risk.

The relationship between ethylene oxide levels in hemoglobin and the prevalence of kidney stones in US adults: an exposure-response analysis from NHANES 2013-2016.

Exposure to ethylene oxide may cause a number of diseases. The purpose of this study was to investigate whether there is an association between hemoglobin ethylene oxide (HbEO) and the risk of developing kidney stones in US adults. We analyzed 3348 patients from the National Health and Nutrition Survey (NHANES) 2013-2016 and conducted a cross-sectional study. Dose-response analysis curves of restricted cubic spline function, multiple logistic regression, and subgroup analysis were used to investigate the association between HbEO and the risk of kidney stones. Logistic regression models were used to analyze the correlation between HbEO and kidney stones. Among the 3348 participants, 3016 people self-reported having a kidney stone. After adjusting for age, sex, race, marital status, education level, diabetes, vigorous recreational activity, moderate recreational activity, body mass index, blood urea nitrogen, creatinine, eGFR, and uric acid, we found a positive association between HbEO and the risk of kidney stones. We divided patients into four groups based on quartiles of HbEO levels and performed multifactorial logistic regression after adjusting for confounders, which showed that the incidence of kidney stones increased with increasing HbEO concentrations compared with Q1 (Q2, OR = 0.922, 95% CI, 0. 657-1.295, P = 0.639; Q3, OR = 1.004, 95% CI, 0.713-1.414, P = 0.983; Q4, OR = 1.535, 95% CI, 1.114-2.114, P = 0.009). High levels of HbEO were positively correlated with the risk of kidney stone development and could be used as an indicator of kidney stone prevention.

MedDiet adherence score for the association between inflammatory markers and cognitive performance in the elderly: a study of the NHANES 2011–2014

BackgroundTo explore the optimal Mediterranean diet (MedDiet) adherence score threshold for the association between inflammatory markers and cognitive performance among older adults.MethodsIn this cross-sectional study, we selected data of the elderly (≥ 60 years old) from the National Health and Nutrition Examination Survey (NHANES) 2011–2014 (n = 2830). Participants completed at least one cognitive measurement and two 24-h food recalls. By analyzing the relation between inflammatory markers and cognitive performance using the subdivided MedDiet adherence score, we got the optimal MedDiet adherence score threshold. Then the optimal threshold was used to divide participants into high and low MedDiet adherence groups and multivariate logistic regression models were developed to examine the association between inflammatory markers and cognitive performance in each group. Subgroup analysis was conducted based on gender, race, BMI, physical activity level, and chronic diseases.ResultsWe chose 4 as the optimal MedDiet adherence score threshold and included these participants whose MedDiet adherence score was 4 or above into the high MedDiet adherence group, while the MedDiet adherence score of the low adherence group was less than 4. We found that the increased white blood cell (WBC) count (OR = 1.44, 95% CI: 1.09–1.90, P = 0.008), neutrophil count (OR = 1.30, 95% CI: 1.03–1.65, P = 0.023), and neutrophil-albumin ratio (NAR) (OR = 1.34, 95% CI: 1.06–1.70, P = 0.012) were all related to a higher risk of low cognitive performance in the low MedDiet adherence group. A higher PLR was linked to a reduced risk of low cognitive performance (OR = 0.86, 95% CI: 0.74–1.00, P = 0.036) in the high MedDiet adherence group. Significant differences were found in the associations of WBC count, neutrophil count and NAR with low cognitive performance between the low and high MedDiet adherence groups (all P < 0.001). The weakened negative association between inflammatory markers and cognitive performance in the high MedDiet adherence group also existed among male, non-Hispanic white, normal-weight, overweight, moderate work activity, moderate recreational activity, non-depression, hypertension, non-hypertension, non-diabetes, non-stroke, non-heart failure, non-coronary heart disease, or non-heart attack subpopulations of older adults.ConclusionsThe optimal threshold for the MedDiet adherence score was 4, and the negative association between inflammation and cognitive performance could be weakened in older adults whose MedDiet adherence score was ≥ 4.

The Association of Physical Activity and Urinary Incontinence in US Women: Results from a Multi-Year National Survey

ObjectivesTo evaluate the relationships between physical activity, both work and recreational, and urinary incontinence among women. MethodsWe assessed women aged 20 years and older in 2008-2018 NHANES (National Health and Nutrition Examination Survey) cycles who answered self-reported urinary incontinence and physical activity questions. Weighted, multivariate logistic regression model was used to determine the association between incontinence and physical activity levels after adjusting for age, body mass index, diabetes, race, parity, menopause and smoking. ResultsA total of 30,213 women were included in analysis, of whom 23.15% had stress incontinence, 23.16% had urge incontinence, and 8.42% had mixed incontinence (answered “yes” to both stress and urge incontinence). Women who engaged in moderate recreational activity were less likely to report stress and urge incontinence (OR 0.79, 95% CI 0.62-0.99 and OR 0.66, 95% CI 0.48-0.90, respectively). Similarly, women who engaged in moderate activity work were less likely to report stress, urge and mixed incontinence (OR 0.84, 95% CI 0.70-0.99; OR 0.84, 95% CI 0.72-0.99; and OR 0.66 95% CI 0.45-0.97, respectively). ConclusionsModerate physical activity and greater time spent participating in moderate physical activity are associated with a decreased likelihood of stress, urge and mixed incontinence in women. This relationship holds for both recreational and work-related activity. We hypothesize that the mechanism of this relationship is multifactorial, with moderate physical activity improving pelvic floor strength and modifying neurophysiological mediators (such as stress) involved in the pathogenesis of incontinence.

High Satisfaction and Activity Levels After Total Hip Arthroplasty in Patients Under Age 21

BackgroundWith improved materials and bearing surfaces, the use of total hip arthroplasty (THA) in young patients is increasing. Functional outcomes and activity level are particularly relevant in this higher-demand patient population. There is a paucity of data on patient-reported outcomes and activity levels after THA in extremely young (<21 years old) patients. MethodsWe identified 196 patients (222 hips) who underwent THA at age <21 years at our institution from 1982 to 2018. After applying exclusion criteria, 113 of 160 (70.6%) patients (129 hips) were available for follow-up. Patient activity levels and functional outcomes were evaluated using the UCLA activity score, Forgotten Joint Score (FJS), Hip Disability and Osteoarthritis Outcome Score for Joint Replacement, and a validated 5-question satisfaction survey. Survivorship and reasons for revision were recorded. ResultsThe mean age at surgery was 17.0 ± 2.8 years, and the mean follow-up was 13.2 years (range 2-38 years). The most common indications for THA were osteonecrosis (34%) and juvenile idiopathic arthritis (30%). The mean UCLA activity score was 5.9 ± 2.0, and 64% of patients reported a score ≥6. The mean FJS was 57.9 ± 31.0. The mean Hip Disability and Osteoarthritis Outcome Score for Joint Replacement score was 84.6 ± 16.6. Ninety percent of patients reported that they were very or somewhat satisfied with their surgery. At final follow-up, 27 of 129 (20.9%) hips had undergone revision surgery. ConclusionTHA performed in patients under 21 years of age with end-stage hip disease allows for high levels of activity and satisfaction postoperatively, with most patients being able to participate in moderate recreational activities. These data may be useful for surgeons in planning for and counseling extremely young patients indicated for THA.

Patients with different types of arthritis may be at risk for major depression: results from the National Health and Nutrition Examination Survey 2007-2018.

Arthritis is one of the common causes of physical pain and disability, which often makes patients fall into major depression. However, the correlation between arthritis and major depression, and how different types of arthritis correspond to major depression remain to be explored. The purpose of this study is to explore the relationship between arthritis and major depression. Arthritis status was reported by participants themselves, and the Patient Health Questionnaire-9 in National Health and Nutrition Examination Survey (NHANES) was used to evaluate major depression, logistic regression was used to evaluate the relationship between arthritis and major depression. We analyzed the data of 25,990 adults who participated in the NHANES from 2007 to 2018. Participants with major depression were more likely to be female, Hispanic, smoker, less educated, less recreational activities, poverty-to-income ratio <5, coronary heart disease, stroke, cancer or malignant tumor, diabetes, hypertension and higher body mass index (BMI). Arthritis was significantly correlated with major depression (25.4% vs. 44.9%; P<0.001), even after adjusting for gender, age, race, BMI, PIR, education, marriage, moderate recreational activities, smoking, history of coronary heart disease, stroke, cancer or malignant tumor, diabetes, and hypertension (OR =2.30, 95% CI, 2.06-2.56, P<0.001). Subgroup analysis showed that compared with degenerative arthritis, rheumatoid arthritis (RA), or other arthritis, psoriatic arthritis (PsA) had the greatest influence on major depression patients. All patients with arthritis, especially PsA, may have the risk of major depression. Psychological intervention necessary for patients with arthritis.

The effects of physical activity and sedentary behavior in the associations between cardiovascular diseases and depression: A four-way decomposition

BackgroundNegative effects of cardiovascular diseases (CVDs) on depression have been reported, but the relative contribution of physical activity (PA) and sedentary behavior (SB) to such effects remains unclear. Our objective was to precisely quantify the effects modified or mediated by PA and SB using the recently developed four-way effect decomposition. MethodsOur analysis included 22,117 adults (aged≥20 years) participating in the 2007–2016 National Health and Nutrition Examination Survey (NHANES). Depression was assessed by the Patient Health Questionnaire-9. Moderate recreational activity (MRA), moderate work activity (MWA), and walk or bicycle for transportation, were measured by the Global Physical Activity Questionnaire (GPAQ). A four-way decomposition was applied with PA and SB as mediator to decompose the total effects of CVDs on depression into four components: controlled direct effect (CDE), pure indirect effect (PIE), reference interaction (INTref), and mediated interaction effect (INTmed). ResultsThere were statistically significant associations between CVDs, MRA, and depression, with the adjusted odds ratios (95% confidence intervals) of being 1.73 (1.42~2.30), 1.81 (1.42~2.30), respectively. With MRA as a mediator, there were interaction and mediation effects in the associations between CVDs and depression, and the proportions attributable of INTref, INTmed, and PIE were 94.08% (P<0.001), 3.92% (P = 0.007), and 1.68% (P = 0.006), respectively. Furthermore, the mediation effect was statistically significant in females rather than males. ConclusionsMRA strongly modified and mediated the effects of CVDs on depression, especially in females. Our results suggested that sufficient MRA (at least 150 min per week) was considered as requirement for preventing depression in CVDs patients in females.

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&gt;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&lt;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.

Associations between physical activity and constipation in adult Americans: Results from the National Health and Nutrition Examination Survey

There is mixed evidence that physical activity is associated with constipation on the population level. This analysis aimed to determine whether amount and types of physical activity are cross-sectionally associated with constipation. A total of 9963 adults from the 2007-2010 National Health and Nutrition Examination Survey (NHANES) were included. Constipation was defined based on low stool frequency (<3stools/wk) and a hard/lumpy consistency (type 1 or 2 on the Bristol Stool Form Scale). Univariate logistic regression models evaluated associations between physical activity variables and constipation, while multivariate models were built to account for other variables (age, gender, education, race/ethnicity, relationship status, health status, body mass index, fiber intake, and moisture intake). Based on <3stools/wk, 3.4% (95% CI, 2.8%-4.2%) of Americans were constipated, whereas 7.3% (95% CI, 6.7%-8.1%) were deemed constipated when using the hard/lumpy definition. Odds ratios (ORs) of experiencing<3stools/wk were 1.82 (95% CI, 1.11-2.97) for people engaging in no vigorous recreational activity (vs. any) and 1.41 (95% CI, 1.08-1.85) for those doing no moderate recreational activity (vs. any). Likewise, doing no moderate recreational activity was associated with slightly higher odds of hard/lumpy stools (OR=1.23, 95% CI, 1.03-1.46). These associations were attenuated and insignificant in multivariate models (all ORs<1.45). On the population level, self-reported physical inactivity is not strongly associated with passing<3stools/wk or hard/lumpy stools. Better-designed prospective observational and intervention studies are needed to clarify how physical inactivity impacts different forms of constipation.

Niacin, lutein and zeaxanthin and physical activity have an impact on Charlson comorbidity index using zero-inflated negative binomial regression model: National Health and Nutrition Examination Survey 2013\u20132014

BackgroundCombined with the increasing life expectancy, chronic medical conditions have gradually become the dominant cause of death and disability, and multimorbidity became an increasingly serious public health challenge. However, most existing studies have focused on the coexistence of specific diseases or relatively few diseases. Given one person may have multiple diseases at the same time, we applied Charlson Comorbidity Index (CCI) to systematically evaluate one’s 10-year mortality. In this study, we explored the effects of nutrients and physical activity on CCI using National Health and Nutrition Examination Survey (NHANES) 2013–2014 data.MethodsThe study sample consists of one continuous cycle (2013–2014) of NHANES, and 4386 subjects were included in the study. Nutrients intake was measured by dietary recall, and physical activity was evaluated by the Global Physical Activity Questionnaire respectively. Besides, CCI was the sum of the scores assigned for each medical condition. We utilized zero-inflated negative binomial (ZINB) model to investigate the effects in nutrients intake and physical activity on CCI by adjusting for seven sociodemographic characteristics, smoking and drinking.ResultsAmong the 4386 participants, 2018 (68.7%) are Non-Hispanic White, over half participants (78.6%) drink. In count part (CCI ≥ 0), holding other variables constant, the expected change in CCI for a one-unit increase in niacin is 1.621(RR = 1.621, p = 0.016), in lutein + zeaxanthin is 0.974 (RR = 0.974, p = 0.031), and in sedentary time is 1.035 (RR = 1.035, p = 0.005). Moreover, those who do not have vigorous work activity would be more likely to have higher CCI than those who have (RR = 1.275, P = 0.045). In logit part (CCI = 0), the log odds of having CCI equals zero would increase by 0.541 and 0.708 for every additional vigorous recreational activity (OR = 0.541, p = 0.004) and moderate recreational activity (OR = 0.708, p = 0.017) respectively.ConclusionsLutein and zeaxanthin intake, vigorous work activity, vigorous recreational activity and moderate recreational activity may be good for one’s health. Rather, increasing niacin intake and sedentary activity may be likely to raise 10-year mortality. Our findings may be significant for preventing diseases and improving health, furthermore, reducing people’s financial burden on healthcare.