Modifiable Activity Questionnaire Research Articles

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>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

Five-year Evolution Patterns of Physical Activity and Sedentary Behavior in Patients with Lower-limb Osteoarthritis and Their Sociodemographic and Clinical Correlates.

The present study aimed to identify trajectories of physical activity (PA) components (frequency, duration, intensity, and type) and screen-based sedentary behavior (SB) as well as baseline predictors of each trajectory in patients with hip and/or knee osteoarthritis (OA). We included 878 patients with a 5-year follow-up from the KHOALA cohort. PA and SB were measured by the Modifiable Activity Questionnaire. We used group-based trajectory analysis to identify the trajectories of PA components and screen-based SB, and multivariable logistic regression to determine predictors of the identified trajectories. Two groups of trajectories were identified for each PA component and 3 for SB. High and decreasing PA duration was associated with female sex (OR 0.3, 95% CI 0.1-0.5) as was low and stable, more so than high and decreasing prevalence of weight-bearing activities (OR 0.6, 95% CI 0.4-0.9). Patients with impaired patient-reported outcome measures and obese patients often featured low versus high and decreasing prevalence of weight-bearing activities. Predictors of moderate and high versus low and slightly increasing screen-based SB trajectories were male sex, age < 60 years, single status (OR 1.5, 95% CI 1.1-2.1), obesity (OR 2.1, 95% CI 1.4-3.1), smoking (OR 2.0, 95% CI 1.1-3.7), and less physical jobs. Predictors of moderate and high versus low screen-based SB trajectories were all sociodemographic: male sex, age < 60 years, single status, obesity, smoking, and less physical jobs. Sociodemographic and clinical predictors of trajectories vary between PA components; they are associated mainly with PA frequency and type. No clinical characteristics were associated with screen-based SB.

Association of leisure and occupational physical activities and health-related quality of life: Tehran Lipid and Glucose Study

BackgroundLittle is known about the association between different levels of physical activity (PA) and health-related quality of life (HRQoL) in the general Iranian population across sex groups. The current study aims to investigate the association between PA and HRQoL across sex groups, various types of physical activity (leisure time and occupational) and different dimensions of HRQoL in a large population of Tehranian adults.MethodsThis cross-sectional study was conducted using data from the Tehran Lipid and Glucose Study (TLGS). Data was collected from 7800 adults on their PA habits and HRQoL. Information on PA and HRQoL were assessed using the Modifiable Activity Questionnaire (MAQ) and Short-Form 12-Item Health Survey version 2 (SF-12v2), respectively. Poor HRQoL was defined as the first quartile of HRQoL scores and logistic regression analysis was used to assess the association between physical activity levels and poor HRQoL.ResultsThe mean age of participants was 46.4 ± 14.9 years and 45.6% of them were male. Levels of PA were significantly associated with most subscales of HRQoL in both men (p < 0.05) and women (p < 0.01). In both sexes, leisure time PA was significantly correlated to all subscales of HRQoL (p < 0.05) except for bodily pain in both sexes and for social functioning and role emotional in men. In adjusted models, men with both moderate (OR: 1.55, 95%CI: 1.18–2.04; p = 0.002) and low (OR: 1.46, 95%CI: 1.11–1.91; p = 0.007) levels of PA had a significantly higher chance of reporting poor mental component summary (MCS) compared to their counterparts with high levels of PA. Furthermore, women with low levels of PA had a significantly higher chance of reporting poor physical component summary (PCS) (OR: 2.39, 95% CI: 1.63–3.49; p < 0.001) compared to those with high levels of PA.ConclusionThe findings show an association between PA and both domains of HRQoL in men and mostly the physical domain in women, suggesting a sex-specific pattern for this association, which could be considered to motivate participation in PA programs in future health promotion interventions.

Abstract P314: Physical Activity and Sedentary Behavior Phenotypes in a Majority-Minority Community-Based Sample: Houston TRAIN Study

Background: Inadequate physical activity and prolonged sedentary behavior is related to premature mortality and suboptimal cardiovascular health. Yet, the health impacts of these behaviors are typically considered in isolation using a single method assessment approach. Use of accelerometer and reported data from a diverse sample provides the novel opportunity to identify and characterize distinct phenotypes to improve exposure ascertainment. Methods: Data are from 366 participants (61.4% female; 70.3% non-white; aged 50.7 years) enrolled in the Houston Travel Related Activity in Neighborhoods (TRAIN) Study; a natural experiment designed to determine the effect of a light rail train expansion on transit use and physical activity. Latent class analysis using baseline accelerometer (ActiGraph wGT3X-BT) and reported (self-administered, 7-day Modifiable Activity Questionnaire) data were used to derive the phenotypes and multinomial regression models were used to determine correlates of membership. Results: Four phenotypes emerged with the majority classified as Phenotype 4 or insufficient activity and high sedentary ( Table 1 ). When compared to Phenotype 2 (reference group), women were less likely than men to be classified as Phenotype 1 or 3. Every 1 kg/m 2 increase in body mass index increases the odds of membership in Phenotype 3 or 4 when compared to Phenotype 2. Black participants were more likely, and participants identifying as mixed race were less likely, than white participants to be classified as Phenotype 3 compared to Phenotype 2 (all p &lt;0.05). Age was not a significant correlate of phenotype membership. Conclusions: A phenotype characterized by insufficient physical activity and high sedentary behavior represented the majority of study participants. This supports continued development of physical activity interventions targeting minority groups. Study findings also support use of methodological approaches to combine accelerometer and reported data to reduce potential exposure misclassification.

Using Oaxaca Decomposition to Study Socioeconomic Inequity of Physical Activity among Children Aged 10-12 Years: A Study in West of Iran.

Background:Low physical activity (PA) is increasing public health problem. The present study aimed to determine socioeconomic inequality in PA among children aged 10–12 years old in Kurdistan, west of Iran in 2015.Methods:The present cross-sectional study was conducted on 2506 children aged 10–12 in Sanandaj, Iran, in 2015. Data on the children's level of PA were collected using the Modifiable Activity Questionnaire. The concentration index was used to measure inequality and the Oaxaca decomposition to examine the different determinants of the inequality. The data were analyzed in Stata 13 and SPSS 20.Results:Of the 2506 participants, 40.90% (38.97–42.82) had insufficient PA. Girls had a lower level of PA than boys (odds ratio [OR] = 0.34; 95% confidence intervals [CI]: 0.28–0.41) and it is directly related to maternal education (OR = 1.71; 95% CI: 1.18–2.47), the family's Socioeconomic status (SES) (OR = 2.18; 95% CI: 1.56–3.05), and the place of residence (OR = 1.68; 95% CI: 1.16–2.44). The concentration index for insufficient PA was −0.25 (95 CI: −0.30 to −0.21), revealing an insufficient PA in the group with a low SES. The prevalence of insufficient PA is 51.38% (95% CI: 48.45–54.31) in poor group and 28.40% (95% CI: 22.80–33.99) in the wealthier group. The Oaxaca decomposition showed maternal education and the place of residence was the most important determinants of inequality.Conclusions:According to the findings, most of the children especially in the poor groups didn’t have sufficient PA and socioeconomic factors could have the important role.

PO137 Gender Differences In Physiological and Behavioral Risk Factors Among Patients With Acute Myocardial Infarction: Findings From the Yoga-Care Trial

The directionality of the associations of domain-specific physical activity (PA) and sedentary behaviour (SB) with health-related quality of life (HRQoL) in adults remain insufficiently known. This study investigated the longitudinal associations of 10-year cumulative levels of PA and SB with HRQoL and the reverse associations.A sample of 2093 (47.8% men) participants from a cohort of French adult (SU.VI.MAX) was included. Data were collected at 3 time points (1998, 2001 and 2007) using the Modifiable Activity Questionnaire (MAQ) for PA (leisure-time and occupational) and SB (screen-viewing, reading and total sitting time) and the DUKE Health Profile for HRQoL. The cumulative level (from 0 to 3) referred to the number of time points where a high PA level, high SB or good HRQoL was reported. Regression models examined the 10-year cumulative level of PA, SB as predictors of HRQoL and reverse associations.The 10-year cumulative level of high PA, both leisure-time and occupational, predicted a higher HRQoL while the 10-year cumulative level of high screen-viewing time and high total sitting time was associated with lower HRQoL. For the reverse association, cumulative level of good HRQoL predicted more leisure-time PA, less screen-viewing time and less total sitting time but was not related to occupational PA.Relationships between PA, SB and HRQoL are complex and should not be oversimplified in one or the other direction. Taking into account domain-specific PA and SB in health promotion programs appears of prime importance to design interventions aiming at improving HRQoL.

Influence of maternal exercise on fetal heart response during labor and delivery.

ObjectivesThe purpose of this study was to determine if prenatal exercise alters the maternal and fetal heart responses during labor and delivery. We hypothesized that fetuses of exercising mothers would exhibit a lower baseline heart rate (HR), increased HR variability (HRV), and no differences in fetal heart accelerations and decelerations.DesignThis study employed a cross‐sectional design.MethodsThe Modifiable Physical Activity Questionnaire was used for group classification. Exercising women were those participating in 30 minutes of moderate‐to‐vigorous exercise at least 3×/week throughout the entire pregnancy. Women achieving a lower dose of exercise were classified as non‐exercisers. Cardiotocography recordings during the first hour of labor and delivery assessed fetal baseline HR, HRV, accelerations, decelerations, and contractions. ANCOVA analyses were performed to assess group differences in these outcomes and were adjusted for maternal body mass index.ResultsThirty‐one women were included in the analyses. No group mean differences were found for maternal and fetal characteristics, except for maternal age (EX: mean (SD) 28.5 (±4.6y) vs NON‐EX: 24.1 (±1.2y)). After controlling for body mass index, no statistical differences in maternal HR response (β = 3.9, SE = 5.0, 95%CI −6.4‐14.2) or fetal HR response (β = 3.9, SE = 2.5, 95%CI −1.2‐9.11), accelerations and decelerations (β= −0.03, SE = 0.4, 95%CI −0.9‐0.8; β= −0.10, SE = 0.4, 95%CI −0.8‐0.9, respectively), or HRV (β = 0.6, SE = 1.7, 95%CI −2.8‐4.0) were observed.ConclusionsBased on the findings of this study, we found no evidence that maternal exercise during pregnancy was associated with maternal or fetal HR response during labor and delivery. These data suggest maternal exercise may not elicit positive or negative effects on maternal and fetal cardiovascular responses to the physiological stress of labor and delivery.

Trajectories of pain, physical function and physical activity components in patients with symptomatic knee and hip osteoarthritis: A group-based multi-trajectory approach

Introduction The aims of this study were to identify homogeneous subgroups with distinct trajectories of pain, physical function and physical activity (PA) components in patients with symptomatic knee and/or hip osteoarthritis (OA) and to identify the baseline predictive factors associated with these trajectories. Methods The KHOALA cohort is a French population-based multicenter cohort of 878 patients with symptomatic knee and/or hip OA, aged between 40 and 75 years old recruited between 2007 and 2009. Six outcomes assessed annually during a period of 5 years were modeled in the multi-trajectory model. Pain and physical function were measured with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire while PA intensity [in metabolic equivalent of task (MET)], frequency (times per week), duration (hours per week) and type (weight-bearing exercises or not) were assessed by the Modifiable Activity Questionnaire (MAQ). At baseline, the radiological severity of OA was assessed using Kellgren and Lawrence (KL) grades, comorbidities by the Functional Comorbidity Index (FCI) and perceived vitality with the Short Form Health Survey (SF-36). Group-based multi-trajectory modeling was used to identify subgroups with distinct trajectories of pain, function and PA components. Patients with at least two available measures were included in the analyses. First, trajectory models were estimated with varying number of groups for each of the outcomes separately to clarify the types of distinct trajectories to be represented in the multi-trajectory model. The selection of the optimal models was based on maximization of the Bayesian information criterion, the proportion of patients in each trajectory group (> 5%) and the statistical significance of the equation modeled (intercept only, linear, quadratic or cubic). Then, each outcome trajectories characteristics were included in the multi-trajectory model and the optimal one was chosen according the same selection criteria. Multinomial logistic regressions were performed to identify the predictive baseline characteristics associated with each group and were adjusted for sociodemographic and clinical factors. Results Among the 878 patients, 609 (69.4%) were women, 222 (25.3%) had hip OA, 607 (69.1%) knee OA and 49 (5.6%) both hip and knee OA. Group-based multi-trajectory modeling revealed 3 distinct trajectories of pain, physical function and PA components over 5 years. The first (n = 187, 35.2%) included patients with low pain levels, no functional limitations and who practiced intense PA and weight-bearing exercises. The second (n = 218, 41.0%) included patients with moderate levels of pain and functional limitations and who practiced a less intense PA. Patients belonging to the third group (n = 127, 23.9%) had severe pain, severe functional limitations and a low-intensity practice with rare weight-bearing exercises. Overall, a decrease in intensity, frequency and duration of PA was observed in all groups over 5 years, even in the group of subjects with low pain levels and no functional limitations. In multivariate analyses, female sex (odds ratio [OR] = 2.76, 95% confidence interval [CI] = 1.48–5.17), increasing age (OR = 1.05, 95% CI = 1.01–1.08), a high number of comorbidities (OR = 1.51, 95% CI = 1.21–1.90), a low vitality score (reflecting a high level of fatigue; OR = 0.94, 95% CI = 0.92–0.97) and a high KL grade (reflecting a high radiological severity; OR = 3.42, 95% CI = 1.53–7.65) were associated with the third group membership. Conclusion Based on the 5-year follow-up data, we identified 3 distinct trajectories of pain, physical function and PA components. A high number of comorbidities, a high level of fatigue and a high radiological severity were associated with the trajectories of severe pain and functional limitations. The management of these factors seems important to maintain physical function, limit pain and maintain PA practice in patients with symptomatic knee and/or hip OA.

Protective Role of Recent and Past Long-Term Physical Activity on Age-Related Cognitive Decline: The Moderating Effect of Sex.

This study aimed to investigate if the impact of both recent and long-term physical activity on age-related cognitive decline would be modified by sex. One-hundred thirty-five men (N = 67) and women (N = 68) aged 18 to 80 years completed the Modifiable Activity Questionnaire and the Historical Leisure Activity Questionnaire. A composite score of cognitive functions was computed from five experimental tasks. Hierarchical regression analyses performed to test the moderating effect of recent physical activity on age-cognition relationship had not revealed significant result regardless of sex. Conversely, past long-term physical activity was found to slow down the age-related cognitive decline among women (β = 0.22, p = .03), but not men. The findings support a lifecourse approach in identifying determinants of cognitive aging and the importance of taking into account the moderating role of sex. This article presented potential explanations for these moderators and future avenues to explore.

Impact of Lifestyle Strategies on Longer-Term Physical Activity and Weight.

Lifestyle interventions promote increased physical activity (PA) and weight loss; however, relapse to sedentary behavior and weight regain are common. We analyzed baseline and 24-month data from participants in the Slow the Adverse Vascular Effects (SAVE) study. SAVE included an 18-month behavioral intervention. At 24 months, participants completed a survey about lifestyle strategies used in past 6 months. PA levels were assessed with the Modifiable Activity Questionnaire. We compared change in weight, BMI, and PA from baseline to 24 months by use of strategies vs. no use. 214 participants (61%) completed 24-month visit. 74% were female and 86% were white. At 24 months, 65% used self-monitoring, 67% group/commercial support, 94% other behavioral skills, and 27% used professional support within past 6 months. At 24 months, participants who used self-monitoring (5.2 vs. -0.8 MET-hr/wk; P = .001) and group/commercial support (4.3 vs. 0 MET-hrs/wk; P = .01) had greater PA increases compared with those who did not use strategies. Participants who used other behavioral strategies had a significantly greater percent decrease in weight than those who did not. Of the lifestyle strategies used following intervention, self-monitoring and group/commercial support may be particularly important in longer-term PA levels.

Physical Activity Levels in a Community Lifestyle Intervention

A behavioral lifestyle intervention program with goals of increasing physical activity (PA) and losing weight was shown to be efficacious for preventing type 2 diabetes and decreasing risk for cardiovascular disease in the U.S. Diabetes Prevention Program (DPP). Modified versions of the DPP lifestyle intervention are being translated into diverse community settings and have been successful in decreasing weight and improving metabolic markers. However, comprehensive evaluations of PA levels within these community translation intervention efforts are rare. To evaluate the effectiveness of a DPP-based community lifestyle intervention for improving PA levels. 223 overweight adults at-risk for type 2 diabetes and/or cardiovascular disease were randomized (immediate or 6-month delayed-start) to a 12-month DPP-based lifestyle intervention. Past-month PA level was assessed at baseline and post-intervention with the Modifiable Activity Questionnaire. Simple and mixed-effects regression models were used to determine changes in PA level between and within groups over time. The between-group mean difference for change in PA levels from baseline to 6 months indicated significantly greater improvement in the intervention compared to the delayed-start group [+6.72 (SE=3.01) MET-hrs/week; p=0.03]. Examining combined within-group change from baseline to post-intervention, mean PA levels significantly increased by +14.69 (SE=1.43) and +9.50 (SE= 1.40) MET-hrs/week at 6 and 12 months post-intervention, respectively. This PA change offset to approximately +10 MET-hrs/week at both 6 and 12 months after adjusting for baseline PA level and season (all; p<0.01). Other than season, sex impacted on change in PA level. This community-based lifestyle intervention significantly increased PA levels among overweight adults at risk for type 2 diabetes and cardiovascular disease, even after adjusting for key variables. NCT01050205.

Associations of Individual and Neighborhood Level Characteristics with Leisure-Time Physical Activity

Although access to transit may affect transport-related physical activity (PA), built environment features such as green space, may differentially influence PA in other domains. The Houston TRAIN Study is a natural experiment assessing the impact of light-rail infrastructure on transit behaviors and PA. PURPOSE: Assess the relations of individual and neighborhood level characteristics with leisure-time PA (LTPA) among TRAIN participants. METHODS: Participants were adults (≥18 years) residing within 3 miles of new light-rail corridors in Houston, TX. LTPA was assessed with the self-administered Modifiable Activity Questionnaire (past week), and weekly met-minutes of LTPA were derived. Individual level sociodemographic characteristics (age, gender, race/ethnicity, education) were also reported. Participant addresses were geocoded and matched to census block groups (neighborhood unit). Neighborhood level sociodemographic (median income, racial distribution) and built environment (park access and tree canopy coverage) variables were constructed using public georeferenced data. Generalized mixed effect regression models were used to estimate the relation of individual and neighborhood factors on meeting PA guidelines with LTPA (≥500 weekly met-minutes). RESULTS: Among 618 participants at baseline, 60% reported meeting PA guidelines with LTPA. At the individual level, Black race was inversely related to meeting guidelines with LTPA (vs. white, OR: 0.4, CI: 0.3-0.7) and having at least some college education was directly related to meeting PA guidelines with LTPA (vs. no college, OR: 1.5, CI: 1.0-2.1). Age and gender were not significantly associated with LTPA. At the neighborhood level, being in the top tertile of neighborhood income (vs. tertile 1, OR: 2.3, CI: 1.4-3.8) was directly associated with meeting guidelines with LTPA. Neighborhood racial distribution, park access and tree canopy coverage were not related to LTPA. CONCLUSIONS: Among TRAIN participants, individual level education and neighborhood level income are independently related to LTPA, suggesting that socioeconomic status is an important multilevel predictor of LTPA for Houston residents. Other factors were not related to LTPA, contrasting with findings from other studies in different settings. Funded by NIH R01 DK101593

10-year cumulative and bidirectional associations of domain-specific physical activity and sedentary behaviour with health-related quality of life in French adults: Results from the SU.VI.MAX studies

BackgroundThe directionality of the associations of domain-specific physical activity (PA) and sedentary behaviour (SB) with health-related quality of life (HRQoL) in adults remain insufficiently known. This study investigated the longitudinal associations of 10-year cumulative levels of PA and SB with HRQoL and the reverse associations. MethodsA sample of 2093 (47.8% men) participants from a cohort of French adult (SU.VI.MAX) was included. Data were collected at 3 time points (1998, 2001 and 2007) using the Modifiable Activity Questionnaire (MAQ) for PA (leisure-time and occupational) and SB (screen-viewing, reading and total sitting time) and the DUKE Health Profile for HRQoL. The cumulative level (from 0 to 3) referred to the number of time points where a high PA level, high SB or good HRQoL was reported. Regression models examined the 10-year cumulative level of PA, SB as predictors of HRQoL and reverse associations. ResultsThe 10-year cumulative level of high PA, both leisure-time and occupational, predicted a higher HRQoL while the 10-year cumulative level of high screen-viewing time and high total sitting time was associated with lower HRQoL. For the reverse association, cumulative level of good HRQoL predicted more leisure-time PA, less screen-viewing time and less total sitting time but was not related to occupational PA. ConclusionRelationships between PA, SB and HRQoL are complex and should not be oversimplified in one or the other direction. Taking into account domain-specific PA and SB in health promotion programs appears of prime importance to design interventions aiming at improving HRQoL.

Concurrent Validity of a Self-Reported Physical Activity "Vital Sign" Questionnaire With Adult Primary Care Patients.

IntroductionNo tool currently used by primary health care providers to assess physical activity has been evaluated for its ability to determine whether or not patients achieve recommended levels of activity. The purpose of this study was to assess concurrent validity of physical activity self-reported to the brief (<30 sec) Physical Activity “Vital Sign” questionnaire (PAVS) compared with responses to the lengthier (3–5 min), validated Modifiable Activity Questionnaire (MAQ).MethodsAgreement between activity reported to the PAVS and MAQ by primary care patients at 2 clinics in 2014 was assessed by using percentages and κ coefficients. Agreement consisted of meeting or not meeting the 2008 Aerobic Physical Activity Guidelines for Americans (PA Guidelines) of the US Department of Health and Human Services. We compared self-reported usual minutes per week of moderate-to-vigorous physical activity among patients at a primary care clinic in 2014 who reported to PAVS and to MAQ by using Pearson correlation and Bland–Altman plots of agreement.ResultsAmong 269 consenting patients who reported physical activity, PAVS results agreed with those of MAQ 89.6% of the time and demonstrated good agreement in identifying patients who did not meet PA Guidelines recommendations (κ = 0.55, ρ = 0.57; P < .001). Usual minutes per week of moderate-to-vigorous physical activity reported to PAVS had a high positive correlation with the same reported to MAQ (r = 0.71; P < .001).ConclusionPAVS may be a valid tool for identifying primary care patients who need counseling about physical activity. PAVS should be assessed further for agreement with repeated objective measures of physical activity in the patient population.

Leisure-Time Physical Activity and Sedentary Behavior and Their Cross-Sectional Associations with Excessive Daytime Sleepiness in the French SU.VI.MAX-2 Study.

The potential benefit of physical activity in terms of decreasing excessive daytime sleepiness (EDS) prevalence is unclear, especially in aging adults. We aimed to elucidate the associations among physical activity, sedentariness, and EDS in middle-aged and older adults. We conducted a cross-sectional analysis using data from a subsample of participants in the SU.VI.MAX-2 observational study (2007-2009; N = 4179; mean age = 61.9 years). EDS was defined as a score >10 on the Epworth Sleepiness Scale. Leisure-time physical activity and different types of sedentary behavior were assessed with the Modifiable Activity Questionnaire. The associations were examined with multivariable logistic regression models. In the adjusted multivariable model, total leisure-time physical activity (modeled in quartiles, Q) was significantly, inversely associated with EDS (odds ratios (OR)Q4 vs Q1 = 0.70, 95 % confidence interval (CI) = 0.54-0.89). The association persisted in analyses restricted to individuals not taking sleep medication (ORQ4 vs Q1 = 0.72, 95 % CI = 0.54-0.95). In turn, time spent watching television and time spent reading appeared protective against EDS (ORQ4 vs Q1 = 0.73, 95 % CI = 0.57-0.94; ORQ4 vs Q1 = 0.76, 95 % CI = 0.60-0.97, respectively), whereas time spent on a computer appeared to confer an increased risk for EDS (ORQ4 vs Q1 = 1.30, 95 % CI = 1.05-1.62). When physical activity and sedentariness were modeled jointly, using WHO recommendation-based cutoffs for high/low levels, no significant associations were observed in the fully adjusted models. The findings reinforce public health recommendations promoting behavior modification and specifically moderate-intensity exercise in middle-aged and older adults. The association of high physical activity/low sedentariness with EDS, which was not supported by the data, merits further investigation before firm conclusions could be drawn.

Dietary habits and leisure-time physical activity in relation to adiposity, dyslipidemia, and incident dysglycemia in the pathobiology of prediabetes in a biracial cohort study

BackgroundDietary and exercise data are frequently recorded in clinical research, but their correlation with metabolic measures needs further evaluation. ObjectiveWe examined the association of food and exercise habits with body size, lipid profile, and glycemia in a prospective biracial cohort. MethodsThe Pathobiology of Prediabetes in A Biracial Cohort study followed initially normoglycemic offspring of parents with type 2 diabetes (T2DM) for the occurrence of incident prediabetes, defined as impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT). At enrollment, participants underwent a 75-gram OGTT, anthropometry, measurement of fasting lipids, insulin, and body fat (DEXA), and completed the Food Habits Questionnaire (FHQ), and Modifiable Activity Questionnaire (MAQ). We assessed the relationship between FHQ and MAQ scores and adiposity, cardiometabolic measures, and incident dysglycemia. ResultsAmong our cohort of 338 subjects (188 black, 150 white; mean age {±SD} 45.2±10.2 years, BMI 30.3±7.2 kg/m2), FHQ and MAQ scores were individually correlated with BMI (r=0.14, −0.12; P=0.01, 0.03) and waist circumference (r=0.19, −0.11; P=0.004, 0.05). Diet-adjusted leisure activity (MAQ/FHQ) was significantly correlated with total body fat (r=−0.20, P=0.0007), trunk fat (r=−0.20, P=0.0006), and serum triglycerides (r=−0.17, P=0.003) and HDL cholesterol (r=0.11, P=0.04) levels. During 5.5 years of follow-up, 111 subjects (Progressors) developed prediabetes (n=101) or diabetes (n=10) and 227 remained normoglycemic (Non-progressors). Age, BMI, MAQ and MAQ/FHQ values were significant predictors of incident prediabetes/diabetes. Progressors reported similar dietary habits (FHQ score 2.57±0.49 vs. 2.57±0.53) but 30% lower physical activity (MAQ score 15.2±20.5 vs. 22.3±30.5 MET-hr/wk, P=0.015) compared with non-progressors. ConclusionsAmong African-American and Caucasian offspring of parents with T2DM, self-reported dietary and exercise habits correlated with measures of adiposity and dyslipidemia; however, physical activity, but not dietary recall, significantly predicted incident dysglycemia during 5.5 years of follow-up.

Abstract 469: Relationship of Heart Rate and Physical Activity with Cardiovascular Risk Factors in a Multi-ethnic Population.

Introduction: Resting heart rate (RHR) has been identified as an independent risk factor for cardiovascular disease and mortality. Hypothesis: Physical activity and RHR are associated with hypertension, dyslipidemia and insulin resistance in a multiethnic population. Methods: Cross-sectional data from 1,440 participants of Native Hawaiian, Japanese, Filipino, Caucasian, and mixed ethnic ancestries were examined. Body fat was estimated using body mass indices (BMI); fat distribution by waist-hip ratios (WHR); and insulin resistance using the Homeostasis Model (HOMA-IR). Total cholesterol, triglycerides, and HDL-cholesterol levels were assayed from fasting plasma samples. LDL cholesterol was calculated using the Friedewald formula. Blood pressure measurements and medical histories were obtained to determine hypertension status. Leisure time physical activity (PA) was estimated by calculating metabolic equivalents (METS) using the Modifiable Activity Questionnaire. Associations were estimated using logistic regression for dichotomous outcomes (HTN) and general linear models (GLM) for continuous variables. Results: Caucasians had lower prevalence of HBP and insulin resistance than all other ethnic groups; there were no statistically significant differences between other ethnic groups on mean RHR. HOMA-IR, RHR, BMI and WHR all differed significantly by ethnic group. Low RHR and high levels of physical activity were inversely associated with insulin resistance. After adjusting for covariates, only RHR remained significantly associated with HBP prevalence. Likewise, only RHR was significantly associated with total cholesterol, LDL and triglycerides. In contrast, HDL cholesterol was positively associated with physical activity but not associated with RHR. Conclusion: The relationship of RHR and PA is complex with RHR and PA actions differing for different CVD risk factors. Since low RHR may be an indicator of cardiovascular fitness, these findings suggest fitness, rather than energy expenditure, may be important in preventing most CVD risk factors, while activity level may be more important for increasing HDL levels. A customized approach to activity plans may need to consider specific patient risk profiles.

Reliability and validity of the modifiable activity questionnaire for an Iranian urban adolescent population.

Background:The purpose of this study was to evaluate the validity and reliability on the Persian translation of the Modifiable Activity Questionnaire (MAQ) in a sample of Tehranian adolescents.Methods:Of a total of 52 subjects, a sub-sample of 40 participations (55.0% boys) was used to assess the reliability and the validity of the physical activity questionnaire. The reliability of the two MAQs was calculated by intraclass correlation coefficients, and validation was evaluated using Pearson correlation coefficients to compare data between mean of the two MAQs and mean of four physical activity records.Results:Intraclass correlation coefficient was calculated to assess the reliability between two MAQs and the results of leisure time physical activity over the past year were 0.97. Pearson correlation coefficients between mean of two MAQs and mean of four physical activity records were 0.49 (P < 0.001), for leisure time physical activities.Conclusions:High reliability and relatively moderate validity were found for the Persian translation of the MAQ in a Tehranian adolescent population. Further studies with large sample size are suggested to assess the validity more precisely.

Utility of Actiwatch Sleep Monitor to Assess Waking Movement Behavior in Older Women

Wrist-worn accelerometer devices measure sleep in free-living settings. Few studies, however, have investigated whether these devices can also measure waking movement behavior (e.g., total movement volume, physical activity). The purpose of this study was to investigate the ability of a wrist-worn Actiwatch 2 sleep monitor to rank total movement volume and physical activity levels compared with a waist-worn ActiGraph GT1M accelerometer and self-reported leisure time physical activity, respectively. In addition, we compared temporally matched activity measured via the ActiGraph GT1M and Actiwatch 2 over the study week. A subset of women from the Healthy Women Study (n = 145; age, 73.3 ± 1.7 yr) wore an Actiwatch 2 on their nondominant wrist and an ActiGraph GT1M on their dominant hip for seven consecutive days. Participants recorded their leisure time physical activity in a 7-d diary and completed the past year version of the Modifiable Activity Questionnaire. Analyses were conducted for all wake periods and separately for active periods when both devices were worn. Spearman rank-order correlation coefficients for total movement volume between the Actiwatch 2 and ActiGraph GT1M were significant for wake periods (r = 0.47, P < 0.001) and, to a lesser extent, for active periods (r = 0.26, P < 0.01). However, the Actiwatch 2 did not rank participant's physical activity levels similarly to self-reported leisure time physical activity estimates (κ ≤ 0.05, P > 0.05). Multilevel model analyses comparing temporally matched activity measured via the ActiGraph GT1M and Actiwatch 2 suggest that the two devices yielded similar levels of activity during wake periods (B = 0.90; SE, 0.008; P < 0.001) and during active periods (B = 0.81; SE, 0.01; P < 0.001). A wrist-worn Actiwatch 2 may be useful for ranking total movement volume and for assessing the pattern of activity over a day in older women. However, our data do not support using a wrist-worn Actiwatch 2 device for measuring physical activity.