Modifiable Activity Questionnaire Research Articles

Abstract 15: Associations of Physical Activity and Sedentary Behavior With Clinical Cardiovascular Health 2-7 Year After Pregnancy: The nuMoM2b Heart Health Study (HHS)

Introduction: The reproductive years are a critical period when clinical cardiovascular health (CVH) often declines. Though lifestyle behaviors such as increasing physical activity (PA) are recommended, limited longitudinal data supports these strategies following delivery. Hypothesis: We posited that higher moderate-vigorous intensity PA (MVPA) and lower sedentary behavior (SB) would be associated with more favorable changes in CVH in the years after delivery. Methods: We conducted a prospective analysis in the nuMoM2b Heart Health Study (HHS). nuMoM2b followed primiparas from 8 clinical centers from the 1 st trimester through delivery. The HHS followed a subset of these participants 2-7 years later. Self-reported leisure MVPA from an adapted Modifiable Activity Questionnaire and leisure SB duration were measured only at the HHS follow-up. Clinical components of ideal CVH (BMI, blood pressure [BP], glucose, and lipids) were assessed in the 1 st trimester and the HHS follow-up. CVH components were scored by Life’s Essential 8, where 0 = poorest and 100 = ideal, to calculate component-specific and an average clinical ideal CVH score. Linear regression evaluated associations of MVPA guideline categories and SB quartiles with changes in ideal CVH scores (from 1st trimester to HHS visit), adjusting for baseline and confounders. Results: Participants (n = 3,985) were 27 ± 6 years old, 36% from a racial/ethnic minority group, with average MVPA of 261 ± 332 min/week and SB of 3.8 ± 3.2 hr/day at follow-up. Clinical ideal CVH score declined from the 1 st trimester (85.6 ± 14.5 pts) to follow-up (81.6 ± 16.3 pts; p<0.001). Both higher MVPA and lower SB were associated with more favorable changes in ideal CVH score and ideal BMI score (see Table). Only lower SB was associated with more favorable changes in ideal BP score; only higher MVPA was associated with more favorable changes in ideal glucose and lipid scores. Conclusion: Higher MVPA and lower SB each contribute to the maintenance of ideal clinical CVH in the years following pregnancy.

Self-rated Health in Youth with Different Screen Time in Their Adolescence: Tehran Lipid and Glucose Study.

The long-term effects of childhood screen time on health-related quality of life (HRQoL) are still unclear. This study aimed to investigate the relationship between screen time during adolescence and sex-specific HRQoL in early youth. We studied the data from 642 adolescents aged 13-19 years, who participated in the Tehran Lipid and Glucose Study from 2005 to 2011 (baseline) with complete data on HRQoL in their early adulthood (22-28 years at the last follow-up). Physical and Mental HRQoL were assessed using the Iranian version of the short-form 12-item health survey version 2 (SF-12v2). Screen time and leisure-time physical activity were evaluated using the Iranian Modifiable Activity Questionnaire (MAQ). All analyses were conducted in Stata (version 14); MI used the mi impute command. The mean±SD of age, body mass index (BMI), and physical activity in childhood were 16.33±1.27, 23.27±4.63 and 13.77±16.07, respectively. Overall, 35% of boys and 34% of girls had high screen time (HST) in childhood. In general, the HRQoL scores in male participants were higher than in females in both the mental and physical domains. HST in males in childhood was associated with decreased mental health (β=-6.41, 95% CI: -11.52, -1.3 and P=0.014), social functioning (β=-5.9, 95% CI: -11.23, -0.57 and P=0.03) and mental component summary (MCS) (β=-2.86, 95% CI: -5.26, -0.45 and P=0.02). The odds of poor MCS were significantly higher in those with HST compared to their counterparts with low screen time (LST) after adjusting for all potential cofounders. The results of the present study showed the negative effect of screen time during adolescence on HRQoL in early youth. This effect was observed in men, mainly in the mental dimension. Investigating the long-term consequences of screen-time behaviors on self-assessed health in other populations with the aim of effective primary prevention is also suggested.

Higher daily physical activity levels may facilitate pre-diabetes regression to normoglycemia: A longitudinal study among an Iranian population

The possible association of habitual physical activity (PA) and the risk of pre-diabetes (Pre-DM) progression to type 2 diabetes (T2D) or the chance of returning to normoglycemia was investigated. This cohort study included 1167 Pre-DM individuals (mean age of 53.5 years, and 45.3% men) who participated in the third phase of the Tehran Lipid and Glucose Study (2006–2008) and followed up to a median of 9 years. PA, including leisure time and job activities, was measured using a reliable and validated Iranian version of the Modifiable Activity Questionnaire and reported as metabolic equivalent (MET)-minutes per week. The odds ratios (ORs) and 95% confidence intervals (CIs) of incident T2D and returning to normoglycemia were estimated in relation to PA levels (i.e., per every 500 MET-minutes/week, or across categories of PA levels < 600 as a reference, 600–1500 and > 1500 MET-minutes/week). During the study follow-up, 39.0 % progressed to T2D, and 37.8% returned to normoglycemia. Compared to subjects with a PA < 600 MET-minutes/week, the chance of regression to normoglycemia increased by 58% [OR = 1.58, 95% CI = 1.03–2.40 ∼ relative risk (RR) = 1.32, 95% CI = 1.02–1.63] among the participants who had a PA > 1500 MET-minutes/week. We further noted that each 500 MET-min/week activity corresponded to an elevated chance of returning to normoglycemia by 5% (OR = 1.05, 95% CI = 1.01–1.11). The study’s findings provided evidence that higher daily PA levels may facilitate Pre-DM regression to normoglycemia. The beneficial effect of PA in Pre-DM subjects needs to exceed the recommended levels (i.e., 600 MET-minutes/week).

Higher levels of vigorous physical activity are associated with enhanced nocturnal blood pressure dipping

Introduction: Nocturnal blood pressure (BP) dipping determined from 24-hour ambulatory blood pressure monitoring (ABPM) is associated with reduced cardiovascular disease (CVD) risk. Physical activity lowers the risk of CVD related, in part, to preserved endothelial function and lower aortic stiffness, however the relation between physical activity and nocturnal dipping remains unclear. The objective of our cross-sectional retrospective analysis was to assess the relation between physical activity and nocturnal BP dipping, and whether this relation was confounded by measures of vascular function. We hypothesized that higher levels of physical activity would be associated with greater nocturnal BP dipping. Methods: Healthy adults (n=172, age 19 to 65 years, 55% female) had 24-hour ABPM measured. BP recordings were taken every 30 min during the daytime and every 60 min during the nighttime. Nocturnal “dippers” had a 10-20% difference between their mean daytime and nighttime systolic BP and “non-dippers/inverse dippers” had &lt;10% difference. The modifiable activity questionnaire was used to assess physical activity levels via self-reported days/week with greater than 30 min of moderate activity (3.0-6.0 METs) and vigorous activity (&gt;6.0 METs). Endothelial function (brachial artery flow-mediated dilation, FMD), and aortic stiffness (carotid-femoral pulse wave velocity, cfPWV) were also assessed. Results: Nocturnal BP dippers performed more days/week of moderate and vigorous physical activity compared to non-dippers (P=0.007 and P=0.008, respectively). Both moderate (B=0.386, P=0.042) and vigorous physical activity (B=0.604, P=0.002) were associated with nocturnal BP dipping in univariate linear regression analyses. However, only vigorous activity (B=0.926, P=0.001) remained associated with nocturnal BP dipping after adjustment for age, BMI, 24-hr systolic BP and diastolic BP, brachial FMD and cfPWV. Conclusion: Vigorous physical activity may attenuate CVD risk in part from enhanced nocturnal BP dipping. Future studies should investigate additional mechanisms by which vigorous physical activity may enhance nocturnal BP dipping. This study was supported by grants from the National Institutes of Health (AG063790; HL014388, HL07121; AG043722). Dr. Pierce is supported by the Russell B. Day and Florence D. Day Endowed Chair in Liberal Arts and Sciences, University of Iowa. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

A pragmatic multi-setting lifestyle intervention to improve leisure-time physical activity from adolescence to young adulthood: the vital role of sex and intervention onset time.

BackgroundThe long-term effectiveness of healthy lifestyle interventions on improving leisure-time physical activity (LTPA) in adolescents and its factors in low- and middle-income communities is unclear. This study is the first to investigate LTPA trends in a population of Iranian adolescents who underwent a multi-setting lifestyle intervention, considering sex and the time of intervention onset.MethodsParticipants were 2374 adolescents (57.2% girls), aged 12–18 years, who participated in the Tehran Lipid and Glucose Study (TLGS) during 1999–2001 and followed for a median follow-up of 15.9 over five data points every 3 years. Adolescent participants were assigned to the intervention or control groups based on their residential areas. Boys and girls were categorized into 12–15 or 16–18 years old to minimize participants’ bio-psychological differences, facilitate environmental interventions by more compliance with the Iranian educational system and identify the best time to start the intervention. All adolescents in the intervention area received healthy lifestyle interventions via the school-, family-, and community-based programs. LTPA was assessed using the reliable and validated Iranian Modifiable Activity Questionnaire (MAQ) version over the five data points. The Generalized Estimating Equations method was used to evaluate educational intervention’s effect on LTPA in adolescents during the follow-up.ResultsIn boys who experienced the early onset of intervention (12–15 years), the interaction effect of follow-up examinations and the intervention was significant where the impact of the intervention differed over time. In this group, LTPA was higher in the control group than in the intervention group at the first follow-up examination (β = − 1088.54). However, an increasing trend of LTPA was observed in the intervention group until the third follow-up examination (β = 1278.21, p = 0.08, and β = 1962.81, p = 0.02, respectively), with borderline significance levels at the 2nd (P = 0.08) and the 4th (P = 0.08) measurements. The interaction terms and main effects of intervention and follow-up examinations were not significant in boys with late intervention onset. Although older boys in the intervention group had higher LTPA than the control group, there were no significant differences among study groups in all follow-up examinations. Regarding girls, LTPA did not differ significantly between intervention and control groups in all follow-up examinations (P > 0.05).ConclusionOur results showed that a multi-setting practical lifestyle intervention could improve long-term energy expenditure in LTPA in adolescent boys who have experienced an early onset intervention. Findings emphasized the vital role of gender and the onset of these interventions. The current results would be valuable to plan tailored interventions to improve LTPA and community health.Trial registrationThis study is registered at Iran Registry for Clinical Trials (IRCT), a WHO primary registry (http://irct.ir). The TLGS clinical trial was the very first registration in the IRCT (Iran Registry of Clinical Trials). it was registered on 2008-10-29 by the registration number IRCT138705301058N1. Based on the international committee of medical journal Editors (ICMJE), “retrospective registration” is acceptable for trials that began before July 1, 2005.

Long-Term Parallel Changes of Physical Activity and Body Mass Index in Different Predisposing Risk Trajectories of Obesity.

The long-term parallel changes of physical activity and body mass index (BMI) in the adult population are still unclear. The present study assessed the association between physical activity and BMI over time, considering obesity risk trajectory groups and sex strata. Total sample of 6897 adults was followed for an average of 12 years. The reliable and validated Iranian version of the Modifiable Activity Questionnaire measured physical activity. After determining the risk clusters in each reexamination using a 2-step cluster analysis, the latent growth curve modeling was used to identify distinct subgroups of individuals following a similar change of risk cluster over time. Latent growth curve modeling estimated the parameters of cross-sectional, prospective, and parallel associations. Three trajectories were identified, including stable low risk, unstable risk, and stable high risk. The results showed significant increases in BMI (kg/m2/year) for the stable low-risk trajectory group 0.478 (95% confidence interval [CI] 0.444 to 0.513), unstable risk 0.360 (95% CI, 0.324 to 0.396), and those in the stable high-risk trajectory group 0.255 (95% CI, 0.221 to 0.289). In cross-sectional -0.483kg/m2 (95% CI, -0.836 to -0.129) and parallel -0.93kg/m2 (95% CI, -1.862 to 0.00) estimations, significant statistical associations were observed in the stable high-risk trajectory group. The current results showed that changes in physical activity could slightly affect BMI only in stable high-risk adults.

Network Associations Among Body Image, Lifestyle, Body Mass Index, and Quality of Life in Adolescents.

BackgroundBody image is known as an important factor affecting different aspects of adolescents’ health; however, its relationship with lifestyle, body mass index (BMI), and health-related quality of life (HRQoL) in Iranian adolescents has not been addressed in a conceptual model.ObjectivesThis study aimed to investigate the network associations among body image, lifestyle, BMI, and HRQoL in adolescent boys and girls.MethodsThe present study examined 760 adolescents (15 - 18 years) from Tehran. Adolescents reported their weight and height, according to which the participants’ BMIs were calculated. The adolescents’ body image, lifestyle, and HRQoL were assessed using a set of questionnaires, including the Body Image Scale for Youth (BISY), Modifiable Activity Questionnaire (MAQ), Eating Habits Checklist, Eating Attitudes Test (EAT-26), and Pediatric Quality of Life Inventory (PedsQLTM).ResultsThe participants’ mean age and BMI were 16.5 ± 1.0 years and 22.4 ± 4.6 kg/m2, respectively. More than one-third of boys (39.9%) and less than a quarter of girls (22.6%) were overweight/obese. In the final model, body image was significantly and directly associated with physical activity, disordered eating, eating habits, and HRQoL in both genders (P < 0.05). Moreover, body image was directly correlated with screen time in boys (P = 0.012) and BMI in girls (P = 0.001). Body image was indirectly correlated with BMI by the mediating role of disordered eating in girls. Moreover, body image was indirectly associated with HRQoL by the mediating role of physical activity and eating habits in both genders and screen time only in boys.ConclusionsThe network associations among body image, lifestyle, BMI, and HRQoL revealed a gender-specific pattern among the study population. Body image was a significant determinant of lifestyle and HRQoL in both genders and excessive weight in girls. The present findings would contribute to designing and implementing relevant health promotion interventions.

Men and women show partly distinct effects of physical activity on markers of brain integrity

AbstractBackgroundPhysical inactivity in older adults has been linked to an increased risk of dementia. On the other hand, increasing evidence indicates that sex is likely to influence Alzheimer’s disease (AD) pathophysiology, leading to a differential susceptibility to the disease in women versus men. We propose to investigate the interplay between sex and physical activity on brain integrity.MethodWe included baseline data of 134 cognitively unimpaired older adults (&gt;65 years old, 82 women; Table) from the Age‐Well randomized control trial. They underwent multimodal neuroimaging, including structural MRI, FDG‐ and AV45‐PET, providing measures of grey matter volume (GMv), glucose metabolism, perfusion and Aβ burden. The Modifiable Activity Questionnaire was used to measure leisure time physical activity over the last 12 months. We assessed 1) the effect of sex on the amount of physical activity reported, 2) the main effects of sex and physical activity on each neuroimaging measure and 3) the interaction between sex and physical activity on the same variables. All analyses were controlled for age, education and APOE4 status.ResultThere was no sex differences in physical activity levels. GMv and brain perfusion in frontal medial regions were associated with both sex and physical activity, such that volume and perfusion were higher in women than in men and increased as a function of physical activity, without significant interaction between both terms. In contrast, there was an interaction between sex and physical activity on precuneus and posterior cingulate cortex perfusion and, at a trend level, on Aβ deposition (Figure). More specifically, the effect of physical activity on perfusion was stronger in women (higher activity being associated with higher perfusion), while its effect on amyloid burden was stronger in men (higher activity being associated with lower amyloid burden).ConclusionOur results suggest that physical activity has both sex‐dependent and sex‐independent effects on markers of brain integrity. Interestingly, the interaction between physical activity and biological sex suggests the existence of different reserve mechanisms in men and women, which might in turn influence their risk of AD.

Association of Physical Activity and Sedentary Time with Cardio-Autonomic Regulation in Women.

Background: Low moderate-to-vigorous-intensity physical activity (MVPA) and high sedentary time (ST) may contribute to cardiovascular disease (CVD) risk in women, perhaps via cardiac autonomic dysregulation. We examined associations of total, leisure, and occupational MVPA and ST with cardiac autonomic regulation in women. Methods: Data were from 522 women (age = 37.7 ± 5.7 years; 59%white) who participated in the follow-up study of the Pregnancy Outcomes and Community Health Study (between 2011 and 2014). MVPA and ST (hours/day) were self-reported using the Modifiable Activity Questionnaire. Cardiac autonomic regulation was assessed by calculating heart rate variability (HRV) indices (resting heart rate, natural logarithm standard deviation of normal R-R intervals; lnSDNN [total variability], natural logarithm root mean square of the successive differences; lnRMSSD [cardiac parasympathetic activity]) with Kubios software from a 5-minute, seated electrocardiogram. Progressive generalized linear models evaluated associations of total, leisure, and occupational MVPA and ST with HRV indices while adjusting for confounders (demographics, health-related factors), and then potential mediators (clinical variables). A final model evaluated the relationship between ST and HRV stratified by MVPA level. Results: Adjusting for confounders, total and leisure MVPA were associated with favorable lnSDNN (B = 0.027 [p = 0.014] and B = 0.074 [p = 0.009], respectively) and lnRMSSD (B = 0.036 [p = 0.015] and B = 0.075 [p = 0.043], respectively). Adjustment for mediators tended to strengthen the observed significant associations. No associations were found between occupational MVPA or any ST measure with HRV indices (p > 0.05). Neither MVPA nor ST were associated with heart rate. When stratified by MVPA level, leisure ST was associated with unfavorable lnRMSSD (B = -0.041, [p = 0.042]) only among women who did not meet leisure MVPA recommendations. Conclusion: Cardiac autonomic dysregulation may be a mechanism through which low leisure MVPA and, among low-active women, high leisure ST contribute to CVD risk among women.

Associations Of Domain-specific Sedentary Time And Physical Activity With Heart Rate Variability In Women

PURPOSE: Growing evidence suggests that associations of sedentary time (ST) or physical activity (PA) with cardiovascular health may differ by domain (leisure vs. occupational). We examined associations between leisure and occupational ST and PA with heart rate variability (HRV) in women. METHODS: Cross-sectional data were obtained at the Pregnancy Outcomes and Community Health Study follow-up exam (POUCHmoms) which occurred 7 to 15 years after the study pregnancy. Women (n = 522; age = 37.7 ± 5.7 yr; 59% white) who self-reported leisure and occupational ST and PA (hours/day) using the Modifiable Activity Questionnaire and had a valid HRV assessment were included in the analysis. Five minutes of resting HRV (average heart rate, standard deviation of normal R-R intervals [SDNN], root mean square of successive differences [RMSSD], and high frequency [HF]) were calculated from seated ECG data using Kubios software. All HRV indexes were natural log (ln) transformed due to skewness. Progressive generalized linear mixed models evaluated associations of leisure and occupational ST and PA with HRV while adjusting for potential confounders (demographics and health-related factors) [Model 1], and mediators (clinical variables) [Model 2]. RESULTS: In Model 1, higher leisure ST was associated with greater HR, lower lnSDNN, and lower lnRMSSD indicating unfavorable HRV (Table 1). After adjusting for mediators (Model 2), higher leisure ST remained associated with greater HR, but other associations were attenuated. Higher leisure PA was associated with higher lnSDNN, lnRMSSD, and lnHF in all models. Occupational ST and PA were not associated with HRV. CONCLUSION: Associations between ST and PA with HRV appeared to differ by activity domain. Decreasing ST and increasing PA during leisure time are potential behavioral targets to improve HRV in women.Table 1: Associations between leisure and occupational ST and PA with heart rate and HRV (n = 522)

Time-varying association between physical activity and risk of diabetes in the early and late adulthood: A longitudinal study in a West-Asian country

BackgroundThe time-varying association between physical activity (PA) and incidence of type 2 diabetes (T2DM) is still unclear. The present study aimed to investigate this association in the early- and late-adulthood during a 9-year follow-up. MethodsThis study was conducted on 3905 participants in early and late adulthood, using the Tehran Lipid and Glucose Study (TLGS) dataset. PA was assessed via the Iranian version of Modified Activity Questionnaire (MAQ). The association between trend of PA and incident T2DM was investigated using time-varying Cox’s proportional hazard model. Variables including job, education, smoking and body mass index (BMI) were adjusted in the final model. ResultsThe distribution of sex- and age-specific levels of PA changed significantly over time. Compared with physically inactive women, for older women with high level of PA, the risk of T2DM was 0.64 (95% CI: 0.43−0.95, P = 0.02) in adjusted model. Moreover, hazard for low PA group was significantly higher than the moderate group, and for these two groups were significantly higher than high PA level (P < 0.05). ConclusionHigh PA level can postpone the incident T2DM in early-aged and elderly women, over time. Therefore, gender and age are of great importance in designing the PA modifying programs to prevent T2DM.

Changes in Body Composition and Activity Levels of a Division-1 Football Team During COVID-19

Introduction: The effect that training cessation due to the COVID-19 pandemic had on a Division-1 football team’s activity levels and body composition.Methods: Dual-energy X-ray absorptiometry (DXA) were taken in February and upon return to campus during the athletic department’s normal medical screenings. To measure the athletes’ activity during the suspended activity period the validated Modifiable Activity Questionnaire (MAQ) was given to the athletes to confidentially complete. Along with the MAQ were two rating of perceived exertion (RPE) scales that corresponded to cardiovascular work or strength work.Results: Strength/Weight training was the most frequent activity recorded during this time (n = 56) with an average of 16.14 sessions (SD = 6.92) per-month. Significant fat mass increased and lean mass losses were seen in both linemen/non-linemen. Frequency of training was a significant predictor of lean mass loss in non-linemen but not linemen.Conclusions: During the COVID-19 suspension of activities the athletes saw significant decreases in fat free mass with increases in fat mass and body fat percentage. Although, strength/weight training was the most frequently reported activity undertaken during this time it was still not sufficient to maintain the fat free mass of the athletes.

Comparing Incoming College Freshman in 2019 and 2020: Differences in Psychological Well-being, Sleep Quality, Physical Activity, and Eating Disturbances

Abstract Objectives The main objective was to compare incoming college freshman from 2019 to incoming college freshman from 2020. Due to the pandemic, it was expected that incoming college freshman in 2020, relative to those in 2019, would demonstrate poorer functioning in terms of psychological well-being, sleep quality, physical activity, and eating disorders. Methods Prior to starting college at a mid-sized university, incoming college freshman were invited to complete surveys related to health and well-being (2019 n = 32; 2020 n = 64). Participants completed the following measures: Beck Depression Inventory II, Beck Anxiety Inventory, Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, Pittsburgh Sleep Quality Index, Exercise Dependence Scale, Modifiable Physical Activity Questionnaire, Yale Food Addiction Scale, and the Eating Disorder Examination Questionnaire. Results T-tests were used to compare mean differences between the cohorts. Cohen's d is reported as an index of effect size. The 2020 cohort reported greater depression (d = .44, P = .045), anxiety (d = .48, P = .036), and perceived stress (d = .44, P = .05), but did not differ on social support (P = .84). Although differences were in the expected direction, the cohorts did not significantly differ in sleep quality, moderate and vigorous physical activity per week, exercise dependence, eating disorders symptoms, or food addiction (p's &amp;gt; .20). Conclusions Incoming college freshman in 2020, compared to their counterparts in 2019, reported worse psychological well-being in terms of perceived stress, depression, and anxiety. Observed differences did not extend to disturbances in sleep, physical activity, or eating. Funding Sources Brooks College of Health, University of North Florida

Assessment of Lifestyle Factors Helps to Identify Liver Fibrosis Due to Non-Alcoholic Fatty Liver Disease in Obesity.

Only some individuals with obesity develop liver fibrosis due to non-alcoholic fatty liver disease (NAFLD-fibrosis). We determined whether detailed assessment of lifestyle factors in addition to physical, biochemical and genetic factors helps in identification of these patients. A total of 100 patients with obesity (mean BMI 40.0 ± 0.6 kg/m2) referred for bariatric surgery at the Helsinki University Hospital underwent a liver biopsy to evaluate liver histology. Physical activity was determined by accelerometer recordings and by the Modifiable Activity Questionnaire, diet by the FINRISK Food Frequency Questionnaire, and other lifestyle factors, such as sleep patterns and smoking, by face-to-face interviews. Physical and biochemical parameters and genetic risk score (GRS based on variants in PNPLA3, TM6SF2, MBOAT7 and HSD17B13) were measured. Of all participants 49% had NAFLD-fibrosis. Independent predictors of NAFLD-fibrosis were low moderate-to-vigorous physical activity, high red meat intake, low carbohydrate intake, smoking, HbA1c, triglycerides and GRS. A model including these factors (areas under the receiver operating characteristics curve (AUROC) 0.90 (95% CI 0.84–0.96)) identified NAFLD-fibrosis significantly more accurately than a model including all but lifestyle factors (AUROC 0.82 (95% CI 0.73–0.91)) or models including lifestyle, physical and biochemical, or genetic factors alone. Assessment of lifestyle parameters in addition to physical, biochemical and genetic factors helps to identify obese patients with NAFLD-fibrosis.

Dental Student's Physical Activity in Epidemic Covid 19

Introduction: Physical activity during the Covid 19 pandemic is essential for Dental students to uphold their physical and mental health. Objective: The purpose of this study was to expose the physical activity approved by basic dental students with an age range of 18-23 years while remaining at home during the Covid 19 widespread. Method: The research using survey method A total of 122 dental students participating, the sampling used was ease sampling. They have passionately ready to be involved in this research. Modifiable Activity Questionnaire (MAQ) altered back by the Guttman scale was recycled as an instrument in this study. The distribution of the survey using google form assistance started from March to April 2021. The data analysis used was expressive statistics with a simple percentage supply. Results: The results displayed that male dental students action level was at a moderate action level, while female dental students were at a low motion level. This alteration occurs because the behaviours of physical activity and motivation to move are diverse in gender. Management from physical education teachers and parents is needed to supervise the physical activities of dental students mainly women though at home during the Covid 19 widespread.

Long-term incidence of cardiovascular outcomes in the middle-aged and elderly with different patterns of physical activity: Tehran lipid and glucose study

BackgroundFollowing the global upward trend of cardiovascular diseases (CVD/CHD), much attention has been paid to lifestyle behaviors such as physical activity (PA). However, most of previous studies were conducted in developed countries and with just one measurement of physical activity. The aim of the current study is to assess the effect of changes in the PA on the incidence of CVD/CHD in middle-aged and older men and women in an Eastern-Mediterranean population, over a decade follow-up.MethodsThis study has been conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) including 4073 (57% women) participants without CVD/CHD at baseline. The participants were followed up for an average period of 12 years. The Iranian version of Modified Activity Questionnaire (MAQ) was used to measure PA at baseline and at the closest follow-up to the outcome. Subsequently, participants were categorized as “compliers”, “non-compliers”, “adopters” and “relapsers”, based on their adherence to the PA guideline recommendations. All analysis has been conducted in two separate age groups including middle-aged and elderly in both men and women. The effect of PA patterns on incidence of CVD/CHD was investigated using Cox proportional hazard model. Variables including marital status, job status, education, smoking, and family history of CVD/CHD were adjusted in the models.ResultsAdherence to guideline recommendation increased from 63.5 to 66.6% between the two measurements. At the second measurement of PA, the percentages of compliers, non-compliers, adopters and relapsers were 48.4, 18.3, 18.2, and 15.1%, respectively. In fully adjusted models, HRs of CVD and CHD for men aged 40–60 years in the complier group were 0.58 (95% CI: 0.38–0.87, P = 0.008) and 0.58 (95% CI: 0.38–0.89, P = 0.01), respectively. HRs of CVD and CHD for men aged 40–60 years in adopter group were 0.61 (95% CI: 0.38–0.96, P = 0.03) and 0.60 (95% CI: 0.37–0.97, P = 0.04) respectively. The corresponding values were not significant in women.ConclusionsAdhering to established PA recommendations have a protective effect on the incidence of CVD/CHD among middle-aged men; findings which need to be considered in reducing cardiovascular outcomes in this population.

The prevalence of physical inactivity in Iranian adolescents and the impact of economic and social inequalities on it: results of a National Study in 2018

BackgroundThis study aims to determine the prevalence of physical inactivity in Iranian adolescents aged 10–12 years and the impact of socioeconomic inequality on it.MethodsIn this descriptive study, the study population consisted of 10–12 years old adolescents from an Iranian population from Kurdistan, Fars and Markazi provinces in 2018. The sample size was 1590 individuals. The sampling method was cluster sampling. Data was collected using demographic questionnaire, modifiable activity questionnaire (MAQ) and socioeconomic questionnaire. Cut points on the MAQ for light activity, moderate activity and heavy activity were MET< 3, MET = 3–6 and MET> 6, respectively. Linear and logistic regression were used to estimate the final model and the Oaxaca analysis method was applied. All analyses were performed in Stata/SE 14.0.ResultsOf the 1590 participants, 52.82% were male. The results showed that 25.79% of the subjects were physically inactive and 7.30% engaged in moderate physical activity during the week. The average physical activity during 1 week was more in boys than in girls (P-value< 0.05). Adolescents of mothers with secondary and high school education were more likely to have physical inactivity than mothers with a high school diploma or higher (AOR: 1.35, 95% CI: 1.02–1.77). The concentration index was −.11, indicating a greater concentration of physical inactivity in adolescents with low socioeconomic levels.ConclusionOne-fourth of the study population had physical inactivity in this age group. Socioeconomic levels, parental literacy, and sex of adolescents were associated with the level of physical activity.

Persian participation measures for adolescents: A systematic review

Introduction Enhancing participation is the focus of occupational therapy. Comprehensive and accurate assessment ensures that clinicians can tailor an intervention to the client’s needs. This systematic review was completed to identify Persian adolescents’ participation measures and critically appraise them. It would be helpful in the selection of the most appropriate instrument to use in adolescent-related research and clinical practice. Method Ten bibliographic databases, four Iranian and six international, without year limits were searched up to June 2019. A systematic search was directed according to COSMIN guidelines for systematic reviews of patient-reported outcome measures and PRISMA guidelines (Systematic review registration: CRD42017073581). Results Seven measures were extracted from the articles. Reviewing the content and psychometric properties of the measures as well as the methodological quality of the studies indicated that the Modified Activity Questionnaire is the only measure with consistent and moderately reliable results. It measures adolescent participation in leisure activities but not all domains of participation. Conclusion There may be a growing need for adapting existing Persian measures or developing new ones based on specific age features related to puberty-stage alongside cultural, social and academic demands, which have a significant effect on adolescents’ participation in meaningful occupations. High methodological quality in designing such studies also has great importance.

Longitudinal association between body mass index and physical activity among adolescents with different parental risk: a parallel latent growth curve modeling approach

BackgroundData available on the association between physical activity (PA) and body mass index (BMI) in different periods of life is controversial. Using a parallel latent growth curve modeling (LGCM) approach, the current study aimed to investigate the influence of daily PA on adolescents’ BMI over a 12 year follow-up, taking into account their parental risk.MethodParticipants comprised 1323 adolescents (53.5% girls), aged 12–18 years who had participated in the baseline phase of Tehran Lipid and Glucose Study (TLGS) (2001–2003), and were followed for an average period of 12 years. Physical activity, including leisure time and occupational activities, was assessed using the reliable and validated Iranian version of the Modifiable Activity Questionnaire (MAQ). Weight and height were objectively measured in order to calculateBMI.Atwo-step cluster analysis was conducted to classify parents into two high- and low-risk clusters. Parallel LGCM was fitted to estimate cross-sectional, prospective and parallel associations, which assessed the longitudinal association between simultaneous changes in PA and BMI during the study period. Analyses were stratified by gender and parental clusters.ResultsA rising trend of BMI per 3 years was observed in boys 1.39 kg.m2(95% CI; 1.32, 1.48) and girls 0.9 kg.m2(95% CI; 0.82, 0.98), as well as in the low risk 1.11 kg.m2(95% CI; 1.03, 1.18) and high-risk 1.12 kg.m2(95% CI; 1.03, 1.22) clusters. Moreover, a positive prospective association between PA at baseline and BMI change over the 12 year follow-up, was observed in adolescents in the low-risk parental cluster 0.27(95% CI; 0.14, 0.41) indicating that higher levels of PA at baseline may lead to greater BMI in adolescents over time. However, examining longitudinal parallel association between simultaneous changes of PA and BMI per 3 years revealed adverse associations for adolescents in the low-risk parental cluster − 0.07 (95% CI; − 0.13, − 0.01) and in boys − 0.06 (95% CI; − 0.11, − 0.01).ConclusionDespite a positive prospective association between BMI and PA at baseline, there was a weak inverse parallel association between these variables over time, particularly in boys and adolescents with low parental risk. These findings imply the potential role of other influential factors indetermining adolescents’ weight status which need to be considered in the future plannings.

Higher Maximal Cardiorespiratory Fitness is Associated with Lower Cerebrovascular Stiffness in Healthy Mid‐Life and Older Adults

BackgroundAge‐related impairments in cerebrovascular function likely contribute to cognitive decline with aging. In particular, cerebral artery stiffening with aging leads to transmission of damaging, pulsatile blood flow to the microcirculation, causing suboptimal tissue perfusion and cerebrovascular dysfunction. Conversely, physically active older adults with higher cardiorespiratory fitness (CRF) often have greater cerebrovascular function, as evidenced by greater cerebrovascular reactivity, than sedentary peers. This suggests that either regular physical activity, higher CRF, or both has beneficial effects on the cerebrovasculature and may contribute to preserved cognitive function with aging. However, little is known about the relations between physical activity, as assessed by leisure time physical activity (LTPA), or CRF and cerebrovascular stiffness.PurposeTo determine if cerebrovascular stiffness is related to LTPA, CRF or both among healthy mid‐life and older adults, and if individuals with higher levels of LTPA and/or CRF have greater cerebrovascular stiffness reactivity in response to a vasodilatory stimulus and/or better cognitive function.MethodsCerebrovascular stiffness (pulsatility index, PI), LTPA, CRF and cognitive function were assessed in 27 mid‐life/older adults (12F/15M; 67±1 years) free from chronic diseases and dementia. Middle cerebral artery velocity (MCAv) was measured with a 2‐MHz Doppler probe during 5 minutes of normocapnia and hypercapnia (breathing 5% CO2). PI was defined as (MCAvsystolic‐MCAvdiastolic)/MCAvmean measured over the final 60 seconds of each phase. LTPA was calculated using the Modifiable Activity Questionnaire. CRF was determined by assessing maximal oxygen consumption (VO2max) during incremental treadmill exercise to exhaustion. The cognitive domains of executive function, processing speed, working memory, and language were assessed with the NIH Toolbox Cognition Domain and composite scores for fluid, crystallized, and total cognition were calculated.ResultsPI was inversely related to CRF under both normocapnic (r=0.41, p=0.04) and hypercapnic (r=0.46, p=0.02) conditions, indicating lower cerebrovascular stiffness in those with greater CRF. However, there was no relation between LTPA and PI under normocapnic (r=0.04, p=0.86) or hypercapnic (r=0.12, p=0.55) conditions. There were no relations between the change in PI from normocapnia (baseline) to hypercapnia and CRF (r=0.06, p=0.23) or LTPA (r=0.041, p=0.84). Finally, there were no relations between any measures of cognitive function and PI under either normocapnic or hypercapnic conditions (all p&gt;0.05).ConclusionsThese preliminary results suggest cerebrovascular stiffness is inversely related to CRF, but unrelated to LTPA, among healthy mid‐life/older adults. However, the change in cerebrovascular stiffness in response to a vasodilatory stimulus was not related to CRF, suggesting that absolute cerebrovascular stiffness may be more strongly associated with CRF than functional reactivity. Cognitive performance was not related to CRF or LTPA, likely because subjects were healthy and without cognitive impairments.Support or Funding InformationAHA 18POST33990034