Levels Of Moderate-to-vigorous Physical Activity Research Articles

The associations of physical activity and lifetime depression with all-cause and cause-specific mortality: evidence from a prospective cohort study

This study aims to explore the joint associations of physical activity and lifetime depression with all-cause and cause-specific mortality. The present study using data from UK Biobank, included 316568 participants aged 37 to 73 years recruited from 22 centers between 2006 and 2010. Total physical activity (TPA), moderate-to-vigorous physical activity (MVPA) and vigorous physical activity (VPA), assessed by metabolic equivalent task (MET) were used and Cox-proportional hazard models were performed in this study. The incidence rate of all-cause, CVD, and cancer mortality was 4.35(95%CI: 4.29-4.42), 0.69 (95%CI: 0.67-0.72), and 2.23 (95%CI: 2.19-2.28) per 1000 person-years after an average follow-up time of 12.49 years. Lower levels of TPA, MVPA, and VPA were all independently associated with elevated risk of all-cause and cancer mortality. Lifetime depression was significantly associated with increased risk of all-cause (HR=1.46, 95%CI: 1.40-1.52), CVD (HR=1.48, 95%CI: 1.33-1.64), and cancer mortality (HR=1.13, 95%CI: 1.06-1.21). Significant interactive effect of low levels of TPA, MVPA, and VPA and lifetime depression on all-cause mortality were found in this study. The risk of all-cause mortality associated with lifetime depression was deteriorated with low levels of physical activity. Relevant interventions for regular PA should be performed among depressed population.

Is Greater Social Support from Parents and Friends Related to Higher Physical Activity Levels among Adolescents?

Increasing physical activity levels during adolescence have been put on the agenda by several researchers. This study verified the association between social support from parents and friends and different amounts of moderate-to-vigorous physical activity (MVPA) among adolescents in public school. The present study had a cross-sectional design and included a representative sample of 1984 adolescents (aged 15-17). The ASAFA (Apoio Social para prática de Atividade Física para Adolescentes) scale and the QAFA (Questionário de Atividade Física para Adolescentes) were used to determine social support and physical activity, respectively. For statistical analysis, a conceptual model for structured equations and weighted least squares mean and variance adjusted were applied. Social support from parents increased the odds of engaging in 180 min/week of MVPA by 46.7%, 47.8% for 300 min/week, and 45.5% for 420 min/week. Social support from friends showed similar relations trends: 23.8% for 180 min/week, 23.6% for 300 min/week, and 21.2% for 420 min/week. Social support from parents and friends increased the probability of adolescents reaching the amounts of physical activity investigated. The results indicate that greater social support (from parents and friends) was associated with a higher level of MVPA in Brazilian adolescents.

Sex and Age Differences in Association between Physical Activity and Metabolic Syndrome: Results from NHANES 2003-2006.

To examine whether and how sex and age modify the association between accelerometer-based physical activity (PA) and metabolic syndrome (MetS) among American (US) adults. Adults aged ≥20 years old who participated in the mobile center examination during 2003-2006 in the National Health and Nutrition Examination Survey were included for analysis. The total minutes per day of moderate-to-vigorous PA (MVPA) was estimated using ActiGraph. Multivariable logistic regression was used to estimate the odds ratio (OR) of having MetS at an increasing MVPA time. The modification effects of gender and age on the association between MetS and MVPA time were examined by testing for two-way and three-way interaction terms of MVPA time, sex, and age in the model after adjusting for relevant covariates. The prevalence of MetS generally decreased with the MVPA time and was lower in females than in males, although the sex difference varied across age groups. After adjusting for demographic and lifestyle covariates, there was a significant sex difference in how an increased MVPA time lowered the odds of MetS. This interactive effect also varied with age. MVPA benefitted young and middle-age populations up until about 65 years old for both sexes, and the protective effect weakened with age. Although the effect of MVPA was stronger for males than females at young ages, the rate at which it attenuated was quicker in males. The OR of MetS between males and females per unit change of MVPA time was 0.73 (95% CI: [0.57, 0.93]) at age = 25 years, compared to OR = 1.00 (95% CI: [0.88, 1.16]) at age = 60 years. Before the age of 50, the gender difference in the protective effect on MetS was larger at low MVPA levels and became smaller at higher MVPA levels. The male advantage was quite stable with an increasing MVPA time for ages 50-60, and no longer significant at older ages. Young and middle-age populations benefitted from MVPA, lowering the risk of MetS for both sexes. A longer MVPA time was associated with a greater decrease in the risk of MetS in young men than in women, but the sex difference reduced with age and was no longer apparent in older populations.

Temperament and longitudinal changes in physical activity – the Northern Finland Birth Cohort 1966 Study

BackgroundInsufficient physical activity is risk factor for morbidity and premature mortality. This population-based birth cohort study investigated the cross-sectional and longitudinal associations between self-reported temperament at age 31 and self-reported leisure-time moderate to vigorous physical activity (MVPA) levels and changes thereof from the age of 31 to the age of 46 years.MethodsThe study population comprised 3,084 subjects (1,359 male and 1,725 female) from the Northern Finland Birth Cohort 1966. MVPA was self-reported at ages 31 and 46 years. Novelty seeking, harm avoidance, reward dependence, and persistence and their subscales were measured using Cloninger’s Temperament and Character Inventory at age 31. Four temperament clusters were used in the analyses: persistent, overactive, dependent, and passive. Logistic regression was used to evaluate the relationship between temperament and MVPA.ResultsThe persistent and overactive temperament profiles at age 31 were positively associated with higher MVPA levels both in young adulthood and in midlife, while the passive and dependent temperament profiles were associated with lower MVPA levels. The overactive temperament profile was associated with a decrease in MVPA levels from young adulthood to midlife among males.ConclusionA passive temperament profile characterized by high harm avoidance is associated with a higher risk of low MVPA level than other temperament profiles over the life cycle in females. The results suggest that temperament may play a role in determining the level and sustainability of MVPA. Individual targeting and intervention tailoring for promoting physical activity should consider temperament traits.

Abstract P327: Device-Measured Sedentary Behavior and Risk of 1-Year Hospital Readmission After Suspected Acute Coronary Syndrome

Background: Patients hospitalized with acute coronary syndrome (ACS) have an increased risk of a readmission during the first year after discharge; necessitating a need to identify modifiable therapeutic targets to improve outcomes. While moderate to vigorous physical activity (MVPA) has been a hallmark of secondary prevention efforts to prevent hospital readmission, sedentary behavior (SB) has emerged as a potentially unique and clinically important aspect of the physical activity profile. Yet, little is known regarding whether SB is associated with hospital readmission in ACS patients independent from or in addition to MVPA levels. Purpose: To examine the association between device-measured SB and risk of 1-year hospital readmission among patients evaluated for ACS, independent of MVPA. Methods: Patients (n=603, 47.8% female, 62.5±13.0 yrs) evaluated in the emergency department for ACS were fitted with a GENEActiv accelerometer in-hospital and were instructed to wear the device on their non-dominant wrist continuously in-hospital and for 30 days post-discharge. Hospital readmissions were ascertained by proactively searching medical records for any possible hospitalizations and by contacting participants or their closest contacts at 1- and 12-months follow-up; with supporting documentation secured from hospital medical records. Results: Over 1-year follow-up, 281 (46.6%) patients were readmitted. SB was associated with increased risk of 1-year hospital readmission after adjusting for socio-demographic factors, comorbidities, and disease severity indicators [HR per 1-hour per day increase in SB= 1.09, 95% CI: 1.01, 1.18]. The association remained significant after further adjusting for MVPA [HR per 1-hour per day increase in SB= 1.11, 95% CI: 1.02, 1.22]. In joint association analyses, high sedentary time in combination with low MVPA was associated with the greatest risk of 1-year hospital readmission in a fully adjusted model (HR: 2.18; 95%: CI: 1.44, 3.31) compared to the referent group (low SB/high MVPA). However, even among participants with higher levels of MVPA; high sedentary time was associated with a greater risk of 1-year re-hospitalization (HR: 1.54; 95% CI: 1.05, 2.27). For participants with low MVPA and low sedentary time, no significant association was observed (HR: 1.37; 95% CI: 0.84, 2.21). Conclusions: SB was associated with an increased risk of 1-year hospital readmission among patients evaluated for ACS. This increased risk was independent of MVPA and was not eliminated by high levels of MVPA. Implications of this study suggest that reducing SB should be considered as a modifiable therapeutic target in addition to MVPA to improve outcomes in ACS survivors.

Abstract P123: Moderation of Associations Between Lifetime Racial Discrimination and Cardiometabolic Health by Physical Activity in the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Introduction: Racial discrimination is associated with poorer cardiometabolic health. Whether physical activity can buffer these adverse health effects is unknown. We hypothesized that greater discrimination would be associated with poorer cardiometabolic health, but associations would be blunted with higher moderate-to-vigorous physical activity (MVPA). Methods: This was an analysis of 2,129 CARDIA participants. Perceived race discrimination was reported at baseline (2000-2001) and categorized as none, moderate, or high for Black participants and none or any for White participants. Different categorization was used to account for the low percentage of White participants reporting discrimination. Health markers including blood pressure (BP), cholesterol (total, HDL-C, LDL-C), HbA1c, and C-reactive protein were measured at baseline, 5, 10, and 15 years. MVPA was measured using an accelerometer at 5-year follow-up. Race stratified mixed effects linear regression examined the main effect of race specific discrimination with health markers. Moderation by MVPA was examined by its product with discrimination in each model. Main effect estimates were computed using linear predictions at the mean and ± 1 SD of MVPA if the interaction term was p<0.10. Results: Participants were 58% female, 40% black, and 45.3 ± 3.5 years of age at baseline. Contrary to our hypothesis, race discrimination was not significantly associated with health markers in Black or White participants. Significant interactions are presented in the Figure . Among Black participants, high discrimination was associated with higher HbA1c at higher MVPA (+1 SD) only. Conclusions: Perceived race discrimination was not associated with cardiometabolic health among Black or White participants though associations with HbA1c among Black participants may depend on MVPA levels in an unexpected direction. Future studies should further examine MVPA and additional factors which may be related to the health effects of discrimination among minoritized groups.

Riding to health: Investigating the relationship between micromobility use and objective physical activity in Barcelona adults

BackgroundIn recent years there has been an increase in the use of micromobility devices in cities worldwide. Due to their novelty, their effects on population health are still unknown. In this study, we aim to explore the association between conventional and electric micromobility modes and daily physical activity levels in an adult population in the city of Barcelona. MethodsTracking data for 129 adults were collected in 2020 and 2021 as part of the NEWMOB project. Participants each wore an accelerometer and answered daily travel diaries for a week. Participants reported their daily use of micromobility devices through the travel log. Objective daily reports of physical activity levels were obtained from the accelerometer data. Statistical analysis explored the association between self-reported use of micromobility modes -shared bike, shared e-bike, e-scooter- and objective levels of physical activity. ResultsOn average, bike users, and users that combined different micromobility modes reported higher daily time spent in moderate-to-vigorous physical activity (MVPA) than other users. The lowest mean daily levels of MVPA were found among electric scooter users and non-micromobility users. In terms of light activity levels, the highest mean daily levels correspond to users of mixed modes and electric scooters. Analysing health guidelines compliance, bike users and mix modes users were the groups that more often met physical activity guidelines. ConclusionsMicromobility modes such as conventional and electric bikes can help to maintain high levels of MVPA, while meeting health guidelines, in contrast to e-scooters.

Associations between the built environment, policies and curriculum in schools and primary school children’s physical activity

Background: A large proportion of children in the UK do not engage in the recommended amount of physical activity. Schools are an environment where children spend a considerable portion of their time and have the potential to facilitate more physical activity. There has been little exploration of the specific school environment factors that are most pertinent to child physical activity and sedentary behaviour. This study was intended to fill this important gap. Methods: Data were collected between March 2017 and May 2018 from 50 schools and 1223 children who participated in the B-Proact1v cohort study. School level measures were the built environment (e.g. playground equipment, cycling parking, allotments), physical activity-related policies (e.g. policy to encourage active travel) and the use of physical activity in the curriculum (e.g. regular physical activity breaks throughout day). Children’s weekday moderate-to-vigorous physical activity (MVPA) was estimated via Actigraph GT3X accelerometers. Associations between school context measures and children’s weekday MVPA were analysed using linear multilevel models, with children nested within schools, adjusted for individual characteristics. Results: On average, children at schools with allotments, a larger amount of playground equipment and where cycle training was offered, engaged in higher levels of MVPA. PE being compromised due to space was associated with lower levels of MVPA. Conclusions: Whilst there is a need for further exploration, the findings suggest that school-based provision and policies for active travel, sport and active play may be important to encouraging more primary school children to be more active more regularly.

Moderate-to-vigorous intensity physical activity during school hours in a representative sample of 10-11-year-olds in Scotland.

Growing concern about children and adolescent physical inactivity has made the promotion of physical activity a public health priority. International recommendations suggest children should accumulate at least 30 min of moderate-to-vigorous physical activity (MVPA) during school hours. This study assessed levels of objectively-measured MVPA in a large nationally representative sample of Scottish children aged 10-11. Risk factors for not meeting the school-hours MVPA recommendation were examined. Cross-sectional. Mean time spent in MVPA during school hours across five weekdays was measured using Actigraph accelerometry (May 2015-May 2016). Binary logistic regression, presented as odds ratio (O.R.) and confidence intervals (C.I.), explored associations between meeting/not meeting the recommendation by sex, socioeconomic status (SES), season, and urban/rural residence in 2022. Valid data were obtained from 773 children (53.9% girls, 46.1% boys) from 471 schools. Mean daily school-hours MVPA was 29 (SD 11) minutes; 42.7% of children reached the recommendation. The odds of girls (O.R. 0.43; C.I. 0.32, 0.57) meeting the recommendation was significantly lower (p < 0.001) compared to boys. Children living in rural areas had higher odds (O.R. 1.49; C.I. 1.04, 2.15) of meeting the recommendation compared with those in urban areas (p = 0.032). No significant differences in meeting the recommendation by SES (p = 0.700). The overall trend for season was significant (p < 0.001), with lower odds of meeting the recommendation in winter compared to summer. Most Scottish children aged 10-11 did not meet the 30 minute MVPA recommendation. Interventions to increase MVPA during school hours are essential to promote public health.

Cognitive Performance in Short Sleep Young Adults with Different Physical Activity Levels: A Cross-Sectional fNIRS Study

Short sleep is a common issue nowadays. The purpose of this study was to investigate prefrontal cortical hemodynamics by evaluating changes in concentrations of oxygenated hemoglobin (HbO) in cognitive tests among short-sleep young adults and to explore the relationship between sleep duration, physical activity level, and cognitive function in this specific population. A total of 46 participants (25 males and 21 females) were included in our study, and among them, the average sleep duration was 358 min/day. Stroop performance in the short sleep population was linked to higher levels cortical activation in distinct parts of the left middle frontal gyrus. This study found that moderate-to-vigorous physical activity (MVPA) was significantly associated with lower accuracy of incongruent Stroop test. The dose-response relationship between sleep duration and Stroop performance under different levels of light-intensity physical activity (LPA) and MVPA was further explored, and increasing sleep time for different PA level was associated with better Stroop performance. In summary, this present study provided neurobehavioral evidence between cortical hemodynamics and cognitive function in the short sleep population. Furthermore, our findings indicated that, in younger adults with short sleep, more MVPA was associated with worse cognitive performance. Short sleep young adults should increase sleep time, rather than more MVPA, to achieve better cognitive function.

Improvement of In-School Physical Activity with Active School-Based Interventions to Interrupt Prolonged Sitting: A Systematic Review and Meta-Analysis.

Sedentary behaviors have increased in recent years and their consequences have led the World Health Organization to make recommendations for promoting a more active lifestyle. The school environment has been defined as a key place for achieving this objective for children and adolescents. This systematic review and meta-analysis aims to analyze the effect of active-break interventions for interrupting prolonged sitting times during school-time on physical activity (PA) and sedentary behavior (SB), at school, in childhood and youth. A systematic review and meta-analysis were carried out, including clinical trials aimed at assessing the effects of interrupting prolonged sitting at school with active breaks on in-school PA and/or SB. Multimodal and static interventions were excluded. Six databases were analyzed: Medline, WOS, Cochrane Library, SPORT Discus, CINAHL and EMBASE. PA, SB; moderate-to-vigorous physical activity (MVPA) were the variables considered. Nine studies were included, with a total of 2145 children between 6 and 12 years old. The heterogeneity in the duration (five-sixty min), the frequency (one-three times per-day up to three times per week), and duration (five days to three years) of the interventions was detected. The meta-analyses for in-school PA, MVPA, and SB were performed, showing a significant improvement in both PA and MVPA. Interrupting prolonged sitting with active-based school interventions could improve PA and MVPA levels during school time. (PROSPERO: CRD42022358933).

Comparison of Pre-Diagnosis Physical Activity and Its Correlates between Lung and Other Cancer Patients: Accelerometer Data from the UK Biobank Prospective Cohort.

Purpose: Physical activity (PA) plays an important role in health outcomes for people with cancer, and pre-diagnosis PA influences PA behaviors after cancer treatment. Less is known about the PA of lung cancer patients, and the strong history of smoking could influence pre-diagnosis levels of PA and place them at risk for health problems. This study aimed to compare pre-diagnosis PA and its correlates in patients with lung cancer and other types of cancer (female breast, colorectal, and prostate cancer) and examine the relationship between pre-diagnosis PA and all-cause mortality. Methods: This study used data from the UK Biobank, which is a national cohort study with accelerometry data. We included 2662 participants and used adjusted linear regressions and survival analyses. Results: Male and female lung cancer groups spent a mean of 78 and 91 min/day in pre-diagnosis moderate to vigorous PA (MVPA), respectively; this is lower than the 3 other types of cancer (p < 0.001). Younger age and faster walking pace had a strong association with PA in all the four types of cancer (p < 0.01). Smoking status had a strong association with PA in the lung cancer group, while obesity had a strong association with PA in female breast, colorectal, and prostate cancer (p < 0.01). Higher levels of pre-diagnosis MVPA (≥1.5 h/day) were associated with a significantly lower all-cause mortality risk. Conclusions: The present study suggests that lung cancer patients are the most inactive population before diagnosis. The identified difference in correlates of PA suggest that cancer-specific approaches are needed in PA research and practices. This study also highlights the importance of high PA for individuals with high cancer risk.

The mediating role of resilience in the association between MVPA and psychological ill-being in children with ADHD.

This study investigated the mediating role of resilience in the association between moderate-to-vigorous physical activity (MVPA) and psychological ill-being, as well as the moderating role of age in the direct and indirect relationship between MVPA and psychological ill-being in children with attention-deficit/hyperactivity disorder (ADHD). Eighty-five children aged 6-12 years (Mage =8.41 ± 1.44 years) diagnosed with ADHD were recruited. Participants wore an accelerometer on their non-dominant wrist for seven consecutive days to record MVPA. Resilience and psychological ill-being were assessed using self-reported questionnaires. MVPA was positively associated with resilience but negatively related to depression and stress. Resilience was negatively correlated with depression and stress. Using the bootstrapping method, the indirect effect of resilience was found between MVPA and depression (-0.006%, 95% confidence interval [CI]=[-0.060, -0.020]) in children with ADHD, supporting partial mediation. Moderated mediation analysis further demonstrated that the indirect effect of MVPA on depression via resilience was stronger in older children (-0.008, 95% CI=[-0.023, -0.001]) than in younger children with ADHD. The findings may inform future empirical studies on designing exercise interventions with MVPA levels that help to improve resilience and depression in children with ADHD.

The prevalence of obesity and lifestyle behaviors of parents of youth with intellectual and developmental disabilities

BackgroundParents of youth with intellectual and developmental disabilities (IDD) may have a higher prevalence of overweight and obesity and poorer weight management behaviors compared to the general population. ObjectiveTo describe the prevalence of overweight/obesity and related socioeconomic and lifestyle factors including diet quality, physical activity, and reported health habits in parents of youth with IDD. MethodsWe assessed: BMI (kg/m2), moderate-to-vigorous physical activity (MVPA), fruit and vegetable intake (FVI), parental diet and physical activity habits, and socioeconomic characteristics. Associations of BMI on MVPA and FVI were assessed with Spearman's correlation; differences in BMI by parental diet and physical activity habits were assessed with Kruskall-Wallis tests; and the relationships of BMI to household income, race, and education were assessed with Kendall Tau-b and Mann Whitney U tests. ResultsData was obtained from 110 parents (97.3% female) who were study partners for their adolescents/young adults with IDD participating in a weight loss clinical trial. Approximately 81% of parents were overweight or obese (25.7% overweight, 55.1% obese), with 46.3% and 20% meeting the recommended U.S. guidelines for MVPA and FVI, respectively. Higher FVI and higher income were significantly associated with lower parent BMI. BMI was significantly lower in parents who reported to be physically active and choose healthy food. ConclusionWe observed a high prevalence of overweight/obesity, low FVI and low levels of MVPA in parents of adolescents with IDD. These observations suggest that interventions designed to address these factors have the potential to improve the health and wellbeing of both parents and adolescents with IDD. Clinical trials numberNCT02561754.

Associations of physical activity intensity with incident cardiovascular diseases and mortality among 366,566 UK adults

BackgroundThe associations of the proportion of vigorous physical activity (VPA) to moderate to vigorous physical activity (MVPA) with incident cardiovascular disease (CVD) and all-cause mortality are unclear.MethodsThe present study included 366,566 participants (aged 40–69 years) without baseline CVD from the UK biobank during 2006 to 2010. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for risks of outcomes.ResultsDuring a median 11.8 years of follow-up, among 366,566 participants (mean age [SD]: 56.0 [8.1]), 31,894 incident CVD and 19,823 total deaths were documented. Compared with no VPA, 0%-30% of VPA to MVPA was associated with 12% and 19% lower risks of incident CVD (HR, 0.88 [95% CI, 0.86–0.91]) and all-cause mortality (HR, 0.81 [95% CI, 0.78–0.84]), respectively. Furthermore, we found that the maximum reduction of risks of incident CVD and all-cause mortality occurred at performing approximately 30% of VPA to MVPA (P < 0.001). Compared with participants reporting the lowest levels of MVPA (moderate physical activity [MPA], 0–150 min/week; VPA, 0–75 min/week), those performing 150–300 min/week of MPA and ≥ 150 min/week of VPA experienced the lowest risk of incident CVD (HR, 0.87 [95% CI, 0.79–0.95]) and all-cause mortality (HR, 0.71 [95% CI, 0.63–0.80]). Interestingly, we found that smokers yielded more cardiovascular benefits than non-smokers by performing a higher volume of VPA.ConclusionsComparing with UK adults reporting no VPA, engaging in 30% of VPA was associated with the lowest risk of incident CVD and all-cause mortality.

Active School-Based Interventions to Interrupt Prolonged Sitting Improve Daily Physical Activity: A Systematic Review and Meta-Analysis.

Sedentary behavior (SB) is a negative routine for health, especially during advancing age. Promoting an active lifestyle and reducing SB is a global endeavor. The aim of this study was to analyze the effects of active school-based programs to interrupt prolonged sitting for daily physical activity (PA) and daily SB in children and adolescents. A systematic review was conducted. Clinical trials analyzing the effect of interrupting prolonged sitting with active breaks and classroom-based PA were included. Studies that implemented PA in class without interrupting prolonged sitting or those that implemented multimodal interventions were excluded. A systematic search was conducted in 6 databases: Medline, WOS, Cochrane Library, SPORTDiscus, CINAHL and EMBASE. Primary outcomes were daily PA and daily SB, while moderate-to vigorous physical activity (MVPA) was considered a secondary outcome. Six studies were included, with a total of 976 participants between 6-14 years. The interventions were heterogeneous in duration of the sitting time interruption (5-30 min), frequency (1-3 times per-day up to three times per-week) and total duration (five days to three years). 50% of the studies scored "high risk" of bias. Three meta-analyses were performed for daily PA, MVPA and SB, showing a significant improvement in the daily PA and MVPA. School-based programs aimed to interrupt prolonged sitting could be a good strategy to improve daily PA and MVPA levels. (Registration number: CRD42022358933).

Asthma-related lung function and physical activity patterns among children living in urban neighborhoods

Objective Black and Latino American children residing in urban environments are at increased risk for comorbid asthma and obesity. Physical activity (PA) is a modifiable behavior known to contribute to the asthma-obesity phenotype. While research has indicated links between optimal asthma status and high PA among children, little is documented about whether this group may display other asthma and PA patterns that warrant clinical attention and tailored interventions. Methods Children with persistent asthma (N = 97) ages 7–9 and their caregivers from urban neighborhoods completed daily measures of asthma status and moderate-to-vigorous physical activity (MVPA) and questionnaires about health and sociodemographic characteristics. Clinical asthma guidelines (e.g. FEV1 ≥ 80%) and sample means were used to categorize children into high or low lung function and MVPA patterns. Individual, family, and contextual differences across lung function and MVPA patterns were investigated. Results Twenty-nine percent of participants displayed optimal lung function and high MVPA. The remainder of the sample exhibited various less optimal patterns (e.g. poorer lung function and high MVPA). Caregivers of children displaying poorer lung function and high MVPA levels were more likely to report asthma related fears than caregivers of children with low MVPA levels regardless of lung function status. Conclusions Asthma and PA interventions can be tailored to better address each child’s unique clinical and behavioral patterns. An enhanced understanding of risk factors for suboptimal patterns of asthma status and PA may aid in multicomponent intervention efforts.

Physical activity and diabetes mortality in people with type 2 diabetes: a prospective cohort study of 0.5 million US people

AimTo examine the association between physical activity and the cause of death with the greatest risk related to type 2 diabetes mellitus (T2DM) in a large population-based cohort representative of the general US adult population. MethodsA total of 41,726 adults suffering from T2DM (age 62 ± 14 years) and 459,660 adults without diabetes (age 46 ± 18 years) who participated in the National Health Interview Survey from 1997 to 2014 were included in this prospective cohort study. Self-reported moderate-to-vigorous physical activity (MVPA) was categorized into inactive, insufficiently active, active and very active. Mortality data was obtained from the National Death Index. Cox regression models adjusted for potential confounders were performed to estimate hazard ratio (HR) and 95% confidence interval (CI). ResultsDiabetes mortality cause showed the highest relative risk of death among adults with T2DM compared to adults without diabetes (HR 5.72 [3.15;10.39]). There was a non-linear inverse dose-response association between MVPA and diabetes mortality among adults with T2DM, up to a plateau in risk reduction at approximately 500 min/week. Any level of activity was inversely associated with a significantly lower risk of diabetes mortality compared with being inactive (insufficiently active HR 0.71[0.54;0.97], active HR 0.68 [0.49;0.95], very active HR 0.44 [0.32;0.60]). Compared to adults without diabetes, the risk of diabetes mortality decreased from HR 7.38 [4.00;13.58] for inactive people with T2DM to HR 3.34 [1.76;6.32] for very active people with T2DM. ConclusionsHigher levels of MVPA were associated with lower risk of diabetes mortality among adults with T2DM.

Examining the Associations of and Interactions Between Intrapersonal and Perceived Environmental Factors With Objectively Assessed Physical Activity Among Rural Midwestern Adults, USA.

We investigated associations of intrapersonal and environmental factors with objectively assessed weekly moderate to vigorous physical activity (MVPA) minutes, and their interactions in rural adults. Cross-sectional. 14 rural towns participating in a multilevel intervention to promote physical activity. Baseline data from 241 rural community members (19% losses due to missing data). Self-reported demographics, behavioral factors, and neighborhood environment perceptions. Weekly MVPA minutes were assessed using accelerometry data. Generalized linear models using a negative binomial distribution examined associations of and interactions between intrapersonal and environmental correlates with weekly MVPA. Older age (β = -1.37; P= .025) and identifying as a woman (β = -.71; p= <.001) were inversely associated with MVPA. Self-efficacy (β = .34; p = <.001) and trail use (β = .44; P-value = .003) were directly associated with MVPA. Further, among women, perceived safety from traffic was inversely associated with MVPA (β = -.37; P = .003), while indoor recreational facility access was directly associated with MVPA (β = .24; P = .045). Rural residents, especially women, face disproportionately lower MVPA levels. Improving recreational access and self-efficacy may be effective strategies for increasing MVPA.

The Associations Between Accelerometer-Measured Physical Activity Levels and Mental Health in Children and Adolescents with Intellectual Disabilities During the COVID-19 Pandemic.

To examine the associations between physical activity (PA) levels and mental health in children and adolescents with intellectual disabilities (IDs) during the COVID-19 pandemic, 117 participants aged between 6 and 17 years with IDs from 10 Hong Kong special schools were included. There were positive dose–response associations between PA (i.e., light PA, moderate PA, and vigorous PA) and mental health, and participants with higher levels of moderate-to-vigorous PA (MVPA) and self-concept (SC) had better social quality of life (QoL) than those with lower levels of MVPA and SC. Moreover, personal and environmental factors such as age, body mass index, school, sex, ID level, and parental education level influenced the PA levels and QoL in children and adolescents with IDs.