Persistent Physical Inactivity Research Articles

Longitudinal changes in physical activity during and after the first national lockdown due to the COVID-19 pandemic in England

Recent studies have shown reduced physical activity at early stages of the COVID-19 pandemic. However, there is a lack of investigation on longitudinal changes in physical activity beyond lockdowns and stay-at-home orders. Moreover, it is unclear if there is heterogeneity in physical activity growth trajectories. This study aimed to explore longitudinal patterns of physical activity and factors associated with them. Data were from the UCL COVID-19 Social Study. The analytical sample consisted of 35,915 adults in England who were followed up for 22 weeks from 24th March to 23rd August 2020. Data were analysed using growth mixture models. Our analyses identified six classes of growth trajectories, including three stable classes showing little change over time (62.4% in total), two classes showing decreasing physical activity (28.6%), and one class showing increasing physical activity over time (9%). A range of factors were found to be associated the class membership of physical activity trajectories, such as age, gender, education, income, employment status, and health. There is substantial heterogeneity in longitudinal changes in physical activity during the COVID-19 pandemic. However, a substantial proportion of our sample showed persistent physical inactivity or decreasing physical activity. Given the well-established link between physical activity and health, persistent or increased physical inactivity is likely to have both immediate and long-term implications for people’s physical and mental health, as well as general wellbeing. More efforts are needed to promote physical activity during the pandemic and beyond.

Synergistic harmful interaction between sustained physical inactivity and hypertension/diabetes mellitus on the risk of all-cause mortality: a retrospective observational cohort study.

Hypertension, diabetes mellitus and physical inactivity can cause cardiovascular complications or premature death. However, it has not been clarified whether those major comorbidities and physical activity interact in affecting health outcomes. The aim of this study is to evaluate the potential interaction between temporal physical activity profiles and hypertension or diabetes mellitus on the risk for all-cause mortality. This study used Korea National Health Insurance Service (KNHIS) database and included about 6.5 million participants who underwent health screening in 2009 and 2011. Physical activity was evaluated as 2-year change based on self-reported survey using 7-day recall method, and grouped as remained active, inactive-to-active, active-to-inactive, or remained inactive. Participants were categorized into groups according to the presence of hypertension/diabetes mellitus. Outcome included all-cause mortality. In total, 6 554 082 participants (48.4 ± 13.3 years; 56.7% men) were included. During a median 6.4-year follow-up, 83 241 deaths occurred. Compared with the 'remained active' group, other groups had a higher mortality risk after adjustment for covariates [adjusted hazard ratio (aHR) 1.17, 95% CI 1.13-1.21 in the 'inactive-to-active' group, aHR 1.28, 95% CI 1.24-1.32 in the 'active-to-inactive' group, aHR 1.52, 95% CI 1.48-1.57 in the 'remained inactive' group). Hypertension and diabetes mellitus were significant effect modifiers in the association between physical activity and the risk of all-cause mortality (P for interaction <0.001). The harmful effects of persistent physical inactivity on all-cause mortality were the most obvious in those with both hypertension and diabetes mellitus among groups. Sustained physical inactivity was associated with increased risk of all-cause mortality in those with hypertension or diabetes mellitus more strongly than in those without. Physicians should emphasize sustained physical activity even more in patients with hypertension or diabetes mellitus.

Physical inactivity from youth to adulthood and adult cardiometabolic risk profile

Adults with a low physical activity (PA) level are at increased risk for cardiometabolic diseases, but little is known on the association between physical inactivity since youth and cardiometabolic health in adulthood. We investigated the association of persistent physical inactivity from youth to adulthood with adult cardiometabolic risk factors. Data were drawn from the ongoing Cardiovascular Risk in Young Finns Study with seven follow-ups between 1980 and 2011 (baseline age 3–18 years, n = 1961). Physical activity data from a standardized questionnaire was expressed as a PA-index. Using the PA-index, four groups were formed: 1)persistently physically inactive (n = 246), 2)decreasingly active (n = 305), 3)increasingly active (n = 328), and 4)persistently active individuals (n = 1082). Adulthood cardiometabolic risk indicators included waist circumference, body mass index (BMI), blood pressure, and fasting lipids, insulin, and glucose. Clustered cardiometabolic risk was defined using established criteria for metabolic syndrome. Persistently physically inactive group was used as a reference. Compared to the persistently physically inactive group, those who were persistently active had lower risk for adult clustered cardiometabolic risk (RR = 0.67;CI95% = 0.53–0.84; Harmonized criteria), obesity (BMI > 30 kg/m2, RR = 0.76;CI95% = 0.59–0.98), high waist circumference (RR = 0.82;CI95% = 0.69–0.98), and high triglyceride (RR = 0.60;CI95% = 0.47–0.75), insulin (RR = 0.58;CI95% = 0.46–0.74) and glucose (RR = 0.77;CI95% = 0.62–0.96) concentrations as well as low high-density lipoprotein cholesterol (HDLC) concentration (RR = 0.78;CI95% = 0.66–0.93). Comparable results were found when persistently physically inactive individuals were compared with those who increased PA. The results remained essentially similar after adjustment for education, diet, smoking, and BMI. Persistently physically inactive lifestyle since youth is associated with an unfavorable cardiometabolic risk profile in adulthood. Importantly, even minor increase in PA lowers the cardiometabolic risk.

STEPS to Enhance Physical Activity after Hematopoietic Cell Transplantation for Multiple Myeloma

Topic Significance & Study Purpose/Background/Rationale High dose chemotherapy followed by hematopoietic cell transplantation (HCT) is an intensive cancer treatment associated with devastating complications. Persistent physical inactivity after HCT is sufficient to cause muscle mass loss, decreased strength, physical deconditioning, and potential progression to disability. Sustainable physical activity incorporated into activities of daily living may break this negative cycle. This pilot, randomized controlled trial tested the feasibility and preliminary effects of a free-living physical activity intervention (STEPS) compared to usual care on fatigue (primary outcome), functional ability, muscle strength, physical activity, and quality of life (secondary outcomes) in people with multiple myeloma treated with autologous HCT. Methods, Intervention, & Analysis This study used a two-group, randomized block, repeated measures design (n = 32). The six-week STEPS intervention aimed to increase physical activity by 10% weekly through education, goal-setting, daily step tracking using wearable technology, and guided integration of physical activity into daily routines. Data were collected using self-report questionnaires, physical performance tests, and wrist actigraphy prior to HCT and seven weeks following hospital discharge. Split-plot 2 × 2 ANOVAs were used to analyze the preliminary group (STEPS versus usual care), time (prior to HCT versus seven weeks after hospital discharge), and group x time interactions effects. Findings & Interpretation The STEPS group achieved their daily physical activity goal 53% of the time. Compared to usual care, the STEPS group experienced greater appetite loss (p = .05), more diarrhea (p = .05), and slept more (p = .03). Both groups reported improvements in mental fatigue (p = .02), emotional functioning (p = .01), pain (p = .009), sleep disturbance (p = .001), anger (p = .003), anxiety (p = .001), and depression (p = .02) seven weeks after HCT discharge compared to baseline. Conversely, both groups climbed the stairs slower (p = .003) and had weaker hand-grips (p Discussion & Implications The STEPS intervention is feasible for people with multiple myeloma treated with HCT. Although preliminary, differential improvement in the STEPS group's patient outcomes did not occur (no significant group x time interactions). Both groups reported improved symptoms and experienced some declines in physical function seven weeks after HCT hospital discharge.

Impact of Cancer Cachexia on Hospitalization-associated Physical Inactivity in Elderly Patients with Advanced Non-small-cell Lung Cancer

Objective:New or worsening disability can develop in elderly patients in just 1 week of hospitalization for acute illness. Elderly patients with cancer, particularly those with cancer cachexia, are vulnerable to disability. This study aimed to explore the impact of hospitalization and cachexia on physical activity (PA) in elderly patients during chemotherapy.Methods:We prospectively enrolled 18 patients aged ≥70 years with newly-diagnosed, advanced non-small-cell lung cancer scheduled to initiate first-line chemotherapy. PA was measured using an accelerometer (Lifecorder®, Suzuken Co., Ltd., Japan). Mean daily steps at baseline, during hospitalization, and subsequent weeks (1st, 2nd, and 3rd week after discharge) were compared.Results:A total of 30 hospitalizations for chemotherapy were evaluated in 18 patients with a median age of 74.5 years. The median number of baseline daily steps was 3756. Fifteen cases (50%) showed fewer daily steps during hospitalization and no recovery to baseline level during the 1st week after discharge. Long hospitalizations (≥8 days) and the presence of cachexia were associated with persistent physical inactivity. One patient developed disability within 30 days after hospitalization.Conclusions:Physical inactivity was frequently seen after hospitalization for chemotherapy in elderly patients with advanced lung cancer. Longer in-hospital days and the presence of cancer cachexia caused slow recovery from physical inactivity. Individualized hospitalization planning based on careful consideration of patient age and the presence of cancer cachexia may be needed to prevent physical inactivity and disability.

Physical Inactivity from Youth to Adulthood and Risk of Impaired Glucose Metabolism.

Physical activity (PA) is important in the prevention and treatment of impaired glucose metabolism. However, association of physical inactivity during the transition between childhood and adulthood with glucose metabolism is unknown. Therefore, we studied the association of persistent physical inactivity since childhood with glucose metabolism in adulthood. Data were drawn from the ongoing, Cardiovascular Risk in Young Finns Study with repeated follow-ups between 1980 and 2011 (baseline age, 3-18 yr; n = 3596). Impaired glucose metabolism was defined as having impaired fasting glucose (6.1-6.9 mmol·L) or type 2 diabetes in adulthood. Leisure-time PA habits were repeatedly collected with a standardized questionnaire and expressed as a PA Index. Using PA Index, four groups were formed (n = 2000): 1) persistently low PA, 2) decreasingly active, 3) increasingly active, and 4) persistently active subjects. Poisson regression model was used to examine the association between PA groups and impaired glucose metabolism. The proportion of the sample with impaired glucose metabolism was 16.1% in individuals with persistently low PA, 14.5% in decreasingly active, 6.8% in increasingly active, and 11.1% in persistently active. Compared with individuals with persistently low PA, age and sex-adjusted risk for impaired glucose metabolism were lower in those who increased PA (relative risk [RR], 0.47; 95% confidence interval [CI], 0.29-0.76) and in those who were persistently active (RR, 0.70; 95% CI, 0.51-0.97), but similar in those who decreased PA (RR, 0.93; 95% CI, 0.66-1.36). Persistently physically inactive lifestyle from youth to adulthood is associated with increased risk of impaired glucose metabolism in adulthood. Importantly, a moderate increase in PA lowered the risk. The results highlight the importance of avoiding physically inactive lifestyle at all stages of life.

Changes in Leisure-time Physical Activity and Risk of Subsequent Common Mental Disorders

PURPOSE: Physical inactivity is a major public health problem associated with an increased risk of mental health problems. The aim of this study was to examine whether changes in leisure-time physical activity are associated with subsequent common mental disorders among middle-aged women and men. METHODS: Baseline questionnaire data were collected in 2000-2002 among 40-60-year-old employees of the City of Helsinki. First follow-up survey was conducted in 2007 and second in 2012. Leisure-time physical activity was asked using identical questions and participants were classified as inactive or active at the baseline and 2007. This yielded a four category variable describing changes and persistency in physical activity between the baseline and 2007. Common mental disorders were examined by the General Health Questionnaire (GHQ-12). Logistic regression was used to calculate odds ratios. We excluded those with common mental disorders at baseline (n=1160) and in total 4724 respondents (81% women) were available for the present analyses. RESULTS: Over fifty per cent were persistently active and about 15% were persistently inactive. Also about 15% moved from active to inactive as well as from inactive to active. Overall about 12% of the participants had common mental disorders in 2012. Compared with those persistently inactive, those becoming (OR=0.69, 95% CI 0.52-0.92) and those persistently active (OR=0.63, 95% CI 0.50-0.79) had reduced risk of subsequent common mental disorders (2012) when age and gender were adjusted. However, also those decreasing physical activity had similarly reduced risk of common mental disorders (OR=0.64, 95% CI 0.47-0.87). Adjusting for binge drinking, smoking and mental functioning had no effects on these associations, whereas physical functioning somewhat attenuated the associations found which, however, remained significant. CONCLUSIONS: Persistent physical inactivity at middle-age may be harmful for mental health. Promoting leisure-time physical activity among the middle-aged may prove useful for preventing mental health problems.

Smoking and physical inactivity patterns during midlife as predictors of all-cause mortality and disability: A 39-year prospective study.

This study estimated the long-term mortality hazards and disability risks associated with various combinations of smoking and physical inactivity measured over time in a sample of middle-aged adults. Data came from a national sample of Swedish adults, originally interviewed in 1968 and followed until 2007 (N=1,682). Smoking and physical activity status were measured at baseline and 13 years later (1981). Different patterns of change and stability in smoking and physical inactivity over this 13 year period were used as predictors of mortality through 2007. Also, associations between different patterns of these health behaviors and the odds of disability (measured in 2004) were estimated among survivors (n=925). Results suggest that mortality rates were elevated among persistent (HR=1.7; 95% CI=1.5, 2.0) and new smokers (HR=2.5; 95% CI=1.6, 4.1), but not among discontinued smokers. However, mortality rates remained elevated among discontinued smokers who were also persistently inactive (HR=1.9; 95% CI=1.3, 2.6). Additional findings suggest that persistent physical inactivity during midlife was associated with increased odds of late-life disability (OR=1.8; 95% CI=1.1, 2.7), but that smoking had no clear additive or multiplicative effects on disability. As such, these findings indicate that while persistent smoking during midlife primarily impacts subsequent mortality, persistent physical inactivity during midlife appears to counteract the survival benefits of smoking cessation, while also imposing a long-term risk on late life disability among those who do survive to old age.

Contribution of Social Isolation, Restraint, and Hindlimb Unloading to Changes in Hemodynamic Parameters and Motion Activity in Rats

The most accepted animal model for simulation of the physiological and morphological consequences of microgravity on the cardiovascular system is one of head-down hindlimb unloading. Experimental conditions surrounding this model include not only head-down tilting of rats, but also social and restraint stresses that have their own influences on cardiovascular system function. Here, we studied levels of spontaneous locomotor activity, blood pressure, and heart rate during 14 days under the following experimental conditions: cage control, social isolation in standard rat housing, social isolation in special cages for hindlimb unloading, horizontal attachment (restraint), and head-down hindlimb unloading. General activity and hemodynamic parameters were continuously monitored in conscious rats by telemetry. Heart rate and blood pressure were both evaluated during treadmill running to reveal cardiovascular deconditioning development as a result of unloading. The main findings of our work are that: social isolation and restraint induced persistent physical inactivity, while unloading in rats resulted in initial inactivity followed by normalization and increased locomotion after one week. Moreover, 14 days of hindlimb unloading showed significant elevation of blood pressure and slight elevation of heart rate. Hemodynamic changes in isolated and restrained rats largely reproduced the trends observed during unloading. Finally, we detected no augmentation of tachycardia during moderate exercise in rats after 14 days of unloading. Thus, we concluded that both social isolation and restraint, as an integral part of the model conditions, contribute essentially to cardiovascular reactions during head-down hindlimb unloading, compared to the little changes in the hydrostatic gradient.

Leadership Component of Type A Behavior Predicts Physical Activity in Early Midlife

Research on the long-term effects of Type A behavior and its components in the prediction of physical activity in adulthood is scarce and there is a lack of prospective data that are able to show such an association. We examined the relations between components of Type A behavior and physical activity from youth to early midlife. The sample included 2,031 participants (43.8% of males) aged 9 to 24 years in 1986 from the Young Finns Study. Type A behavior was measured by the Hunter-Wolf A-B Rating Scale at three phases in 1986, 1989, and 2001. Physical activity was assessed using a short self-report questionnaire at five phases between 1986 and 2007. High Type A leadership was associated with high physical activity in 1986 (r = 0.37, P < 0.01), 1989 (r = 0.36, P < 0.01) and 2001 (r = 0.31, P < 0.01), and youth leadership also predicted high adult physical activity (P < 0.001). After adjustment for age, education, occupation, smoking, body mass index, and baseline physical activity, the association remained significant. There was also a bidirectional association between Type A leadership and physical activity. Persistent physical activity during the adult years was associated with a higher Type A leadership than persistent physical inactivity (Cohen's d = 0.34, P < 0.001), even after controlling for potential confounders. The associations of other components of Type A behavior, i.e., hard-driving, eagerness-energy, and aggression with physical activity were marginal. There is a direct relation between Type A leadership and physical activity at different development phases that maybe bidirectional.

Longitudinal impact of physical activity on lipid profiles in middle-aged adults: the Atherosclerosis Risk in Communities Study

Evidence exists that increased levels of physical activity decrease the population burden of cardiovascular disease (CVD). Although risk factors for CVD, including plasma lipids and lipoproteins, have been associated with physical activity, studies including a sizeable number of minority participants are lacking. Our purpose was to interrogate the longitudinal effect of physical activity on plasma lipids and lipoproteins in the African American and white participants of the Atherosclerosis Risk in Communities (ARIC) Study. Nine years of follow-up data on 8,764 individuals aged 45-64 years at baseline were used in linear mixed-effects models to estimate the association between increases in baseline physical activity on mean change in HDL, LDL, total cholesterol, and triglyceride levels. Increases in the level of activity were associated with increases in HDL in all strata and decreases in triglycerides among white participants. Physical activity was associated with LDL in all women, while the association with total cholesterol was limited to African American women. This study is one of the few to investigate the effect of physical activity on lipids and lipoproteins in a race- and sex-specific manner. Overall our results highlight the importance of physical activity on plasma lipid profiles and provide evidence for novel differential associations.

Physical Activity in Adolescence as a Predictor of Alcohol and Illicit Drug Use in Early Adulthood: A Longitudinal Population-Based Twin Study

We investigated prospectively whether physical activity level in adolescence predicts use of alcohol and illicit drugs in early adulthood. We studied 4,240 individual twins (1,870 twin pairs). We classified those who consistently reported frequent leisure physical activity at ages 16, 17 and 181/2 as persistent exercisers, those exercising less than three times monthly as persistently inactive, and all others as occasional exercisers. To control for familial confounds, within-family analyses compared activity-substance use associations in co-twins discordant for baseline physical activity. Individual-based analyses showed no clear association between baseline physical activity and subsequent weekly alcohol consumption. However, weekly alcohol intoxication (OR = 1.9, p = .002) and problems due to alcohol use (OR = 2.0, p < .001) were more common among persistently inactive participants. After excluding those reporting weekly intoxication at baseline, the risk for alcohol intoxication remained elevated among women occasionally (OR = 2.4, p = .017) or persistently (OR = 5.8, p < .001) inactive at baseline, but this association was not replicated within discordant twin pairs. Individual-based analyses showed that drug use in adulthood was more common among those persistently physically inactive in adolescence (OR = 3.7, p < .001) in comparison to those persistently active. This finding was replicated within discordant twin pairs. Among those with no drug experience during adolescence, persistent inactivity (OR = 1.9, p = .007) increased risk for drug use. We conclude that persistent physical inactivity in adolescence may increase the risk of later problems due to excess alcohol use. Sedentary lifestyle predicts illicit drug use even when controlling for familial factors.

The Longitudinal Effects of Physical Activity History on Metabolic Syndrome

To examine the relationship of physical activity and its changes over a 9-yr follow-up to the prevalence of metabolic syndrome (MetS) in 2060 young adults (24-39 yr) enrolled in the Cardiovascular Risk in Young Finns Study. Leisure-time physical activity (LTPA) was assessed using a self-report questionnaire completed in connection with a medical examination at two consecutive measurements in 1992 and 2001. By summing the LTPA items, a physical activity index (PAI) was formed for both measurement points according to which the participants were divided into tracking groups: persistently active, increasingly active, decreasingly active, and persistently inactive. MetS in 2001 was defined by the guidelines of the European Group for the Study of Insulin Resistance (EGIR), the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), and the International Diabetes Federation (IDF). A continuous metabolic risk score was also calculated by summing the z-scores for the metabolic risk factors. There was a significant linear relationship between MetS and LTPA at baseline in men and at follow-up in both sexes according to all three definitions. Persistent physical activity during 9 yr was associated with a lower prevalence of MetS than persistent physical inactivity on all definitions (all P < 0.05). Similar results were found for increasingly active women (all P < 0.05). All of these associations remained significant after adjustment for potential confounders. In both men and women, the 9-yr change in LTPA was related to the metabolic risk score after adjustments for baseline LTPA, age, smoking, and education. A physically active lifestyle across the lifespan may prevent or delay the onset of metabolic syndrome in young male and female adults.

Physical activity in adolescence and smoking in young adulthood: a prospective twin cohort study

To control for familial confounds, we studied the association between adolescent physical activity and later smoking in twin siblings discordant for their baseline physical activity. In this prospective population-based twin study, we asked whether persistent physical activity/inactivity in adolescence (assessed at 16, 17 and 18.5 years) predicted questionnaire-reported daily smoking at ages 22-27. Twins who, on the three baseline questionnaires, consistently reported frequent leisure physical activity (more than three times weekly) were classified as persistent exercisers, those who exercised less than three times monthly were called persistently inactive, others were occasional exercisers. Finland. A total of 4240 individuals, including 1870 twin pairs. Findings In analyses of individual twins, compared to persistent activity, persistent physical inactivity predicted increased risk of daily smoking (age- and sex-adjusted odds ratio 5.53, 95% confidence interval 3.88-7.88, P < 0.001). The risk remained elevated even after excluding all those who had smoked 50 cigarettes or more life-time at baseline and adjusted for educational level in adolescence. In within-pair analyses compared to the active members of discordant twin pairs, the physically inactive co-twins had increased risk of future daily smoking (sex-adjusted odds ratio 3.39, 95% confidence interval 1.56-7.39, P = 0.002). Persistent physical inactivity in adolescence relates to adult smoking, even after familial factors are taken into account.

Associations of health related behaviour, social relationships, and health status with persistent physical activity and inactivity: a study of Finnish adolescent twins

Objective: To examine the association between leisure time physical activity over a three year period and health related behaviour, social relationships, and health status in late adolescence as part of...

Physical growth and general nutrition

Obesity is now one of the most prevalent diseases in the US population. Many observations suggest that two and possibly three critical periods exist for the development of obesity and its complications. An expert committee has developed guidelines for obesity in adolescence and recommendations for preventive services, whereas others have examined adolescent obesity and its cardiovascular risks and have suggested a rational approach to management and the effects of persistent physical activity and inactivity on coronary risk factors in children and young adults.

Effects of Persistent Physical Activity and Inactivity on Coronary Risk Factors in Children and Young Adults The Cardiovascular Risk in Young Finns Study

The tracking of physical activity and its influence on selected coronary heart disease risk factors were studied in a 6-year (original survey in 1980, with follow-ups in 1983 and 1986) study of Finnish adolescents and young adults as part of the Cardiovascular Risk in Young Finns Study. The subjects in this analysis were aged 12, 15, and 18 years at baseline. Physical activity was assessed with a standardized questionnaire, and a sum index was derived from the product of intensity, frequency, and duration of leisure time physical activity. Complete data on physical activity index from each study year were available on 961 participants. Significant tracking of physical activity was observed with 3-year correlations of the index ranging from 0.35 to 0.54 in boys and from 0.33 to 0.39 in girls. Tracking was better in older age groups. Two groups of adolescents (active and sedentary groups) were formed at baseline according to high and low values of the index, respectively. Approximately 57% of those classified as inactive remained inactive after a 6-year follow-up. The corresponding value for active subjects was 44% (p < 0.01, active vs. inactive). The long-term effects of physically active and sedentary life-styles were studied by comparing groups of young adults who had remained active or inactive in every three examinations. Serum insulin and serum triglyceride concentrations were significantly lower in active young men. They had a more beneficial high density lipoprotein to total cholesterol ratio and thinner subscapular skinfolds. Among young women, significant differences were seen in adiposity (subscapular skinfold) and in serum triglyceride concentration. Physical activity was also related to less smoking in both sexes and, among young men, to lower consumption of saturated fatty acids and to higher polyunsaturated to saturated fatty acids ratio of the diet. In regression analyses adjusted for the 6-year change in obesity, smoking status, and diet, the change in physical activity was inversely associated with changes in serum insulin and triglycerides in boys. Independent association with triglycerides disappeared when insulin change was added to the model, suggesting that the effect may partly be mediated through insulin metabolism. The authors conclude that the level of physical activity tracks significantly from adolescence to young adulthood. Physical inactivity shows better tracking than does physical activity, and subjects who are constantly inactive express a less beneficial coronary risk profile compared with those who are constantly active.(ABSTRACT TRUNCATED AT 400 WORDS)