Physical Activity Behavior Research Articles

Assessing the impact of 24-hour activity behaviors on cardiorespiratory fitness in the older adult: a component analysis approach

BackgroundCardiorespiratory fitness (CRF) serves as a critical measure of the cardiovascular system’s efficiency in delivering oxygenated blood to tissues and organs. Understanding the relationship between various activity behaviors and CRF is essential for devising effective health interventions for the older adult population.ObjectiveThis study aimed to investigate the association between 24-h activity behaviors and CRF in older adult individuals, utilizing compositional data analysis.MethodsWe utilized baseline data from the “Fifth National Physical Fitness Monitoring Cohort Study in Tianjin, China,” which included 540 older adult participants. Physical activity and sedentary behavior were objectively measured using a three-dimensional accelerometer, and CRF was assessed via a gas metabolism analyzer. Compositional data analysis was employed to examine the relationships between 24-h activity behaviors—specifically, moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behavior (SB), and sleep (SLP)—and CRF.ResultsThe analysis demonstrated that MVPA was significantly positively associated with CRF (βMVPA = 5.36, p < 0.01), whereas SB was significantly negatively associated (βSB = −3.97, p < 0.01). No significant associations were observed for LPA and SLP with CRF. The isochronous substitution model revealed that reallocating 15 min of MVPA to SB, LPA, or SLP significantly decreased CRF by 0.31, 0.27, and 0.23 mL/kg/min, respectively. Conversely, substituting 15 min of SB, LPA, or SLP with MVPA resulted in increases in CRF by 0.29, 0.22, and 0.17 mL/kg/min, respectively. Additionally, replacing SB with LPA or SLP led to improvements in CRF, though these changes were not significant, underscoring the potential benefits of reducing sedentary time and enhancing physical activity levels.ConclusionThese findings underscore the critical role of increasing MVPA and reducing SB in improving CRF among the older adult. This study provides a robust scientific foundation for health promotion and intervention strategies targeting older adults. Comprehensive modifications to daily activity patterns are imperative for optimizing cardiovascular health in this population.

Reassessing the Association of Sedentary Behavior and Physical Activity with Ischemic Stroke: A Mendelian Randomization Study

ABSTRACT Purpose Findings from previous Mendelian randomization (MR) studies disagreed with the current scientific consensus regarding the role of physical activity (PA) and sedentary behavior in ischemic stroke (IS). We reassessed these associations with a focus on etiological subtypes of IS and the potential mediating roles of cardiometabolic traits and brain imaging-derived phenotypes (IDPs). Methods We performed MR analyses using summary statistics from genome-wide association studies of sedentary behavior and PA (n = 88,411~608,595), cardiometabolic traits (n = 393,193~694,649), brain IDPs (n = 33,224) and the latest IS data (62,100 cases and 1,234,808 controls). Inverse-variance weighted regression was used as the primary method, complemented by several sensitivity analyses. A two-step MR approach was employed to assess the mediating effects of cardiometabolic traits and brain IDPs. Results Genetic liability to leisure-time moderate-to-vigorous PA (LTMVPA) and higher overall PA (OPA) were associated with reduced risks of IS and small vessel stroke (Benjamini–Hochberg adjusted P < 0.05). Suggestive associations were observed between longer leisure-screen time and higher IS risk and between higher OPA and lower cardioembolic stroke risk (P < 0.05). The isotropic volume fraction in the anterior limb of the left internal capsule (ALIC), as well as some cardiometabolic metrics, partially mediated these associations. There was no evidence for causal effects of overall MVPA, overall light-intensity PA or overall sedentary duration on IS. Conclusions Longer LST, less OPA and not engaging in moderate-to-vigorous PA during leisure time were associated with higher risk of ischemic stroke. The associations between PA and ischemic stroke depended on different subtypes and were mediated by changes in ALIC and cardiometabolic biomarkers.

Associations of Physical Activity and Sedentary Behavior With Mental Distress According to Caregiver Status: Analysis of the Health Information National Trends Survey, 2022.

To (1) examine how physical activity and sedentary behavior are related to mental distress and (2) identify and compare how various levels of sedentary behaviors may differentially predict mental distress after accounting for physical activity, among caregivers vs non-caregivers. Cross-sectional secondary data. National Cancer Institute's Health Information National Trends Survey Cycle 6 fielded online from March-November 2022. U.S. adults aged 18 and older. The Patient Health Questionnaire-4 was administered along with caregiving status, moderate weekly physical activity, sedentary behavior, and sociodemographic characteristics. After applying population weights, we conducted multiple adjusted logistic regression models and estimated predictive margins to understand whether a specific dose of sedentary behavior (hours/day) is associated with risk of mental distress, at different levels of physical activity. Caregivers (15.41% of sample) reporting 10-hour of daily sedentary behavior were significantly more likely to experience mental distress, than those reporting lower amounts of sedentary behavior (OR = 3.372, 95%CI = 1.968, 5.776, P < 0.001). Regardless of physical activity amount, 10 hours of sedentary behavior may be a risk factor for mental distress among non-caregivers. Just 6 hours of sedentary behavior may be related to mental distress among caregivers. Physical activity interventions tailored to caregivers' needs, responsibilities, and circumstances are required. Innovative methodologies are needed to understand caregivers' daily behaviors and the intensity of their caregiving activities.

Development of a habit-based intervention to support healthy eating and physical activity behaviours for pregnant women with overweight or obesity: Healthy Habits in Pregnancy and Beyond (HHIPBe).

The number of women entering pregnancy with overweight or obesity is increasing. This can increase the risk for excessive gestational weight gain (GWG) which is associated with health complications for mother and baby. There are limited evidence-based interventions within antenatal care settings to encourage healthy eating and physical activity behaviours and support women with managing GWG. A previous habit-based intervention 'Ten Top Tips for a Healthy Weight' (10TT) was adapted and made suitable for pregnancy in line with the Medical Research Council's (MRC) complex intervention development guidelines. It involved three key activities: (1) identifying the evidence base; (2) identifying appropriate theory; and, (3) modelling processes. A core element was integrating lived experience via personal and public involvement (PPI). The original 10TTs were adapted with PPI in line with current advice on nutrition and physical activity in pregnancy. New intervention materials were devised, including a leaflet and a logbook and app for self-monitoring to be delivered alongside a brief 1:1 conversation. Behaviour change techniques (BCTs) included in the new materials were coded using a number of behavioural taxonomies. An E-learning resource was created to help standardise the approach to delivery of the intervention and avoid stigmatising conversations. Following MRC guidance for the development of complex interventions alongside significant PPI allowed for the adaption of 10TT habit-based weight management intervention into the 'Healthy Habits in Pregnancy and Beyond' (HHIPBe) intervention. The feasibility and acceptability of implementing this intervention in the antenatal setting will be explored in a feasibility randomised controlled trial. This study was registered on Clinical Trials as 'Healthy Habits in Pregnancy and Beyond (HHIPBe)' ClinicalTrials.gov Identifier: NCT04336878. The study was registered on 07/04/2020.

Screening for Frailty According to Rural and Suburban Health Areas in the Context of Adapted Integrated Care for Older People Approach: The FRAGING Study.

The integrated care for older people (ICOPE) program, developed by the World Health Organization, serves as a public health initiative to maintain older adults' functional abilities and promote healthier aging. Here, we adapted the ICOPE approach to assess overall prevalence of frailty in rural and semi-urban areas. We also investigated health-related quality of life and physical activity and sedentary behavior in older people. The FRAGING multicenter cohort study was performed on screening days dedicated to older adults (≥65 years) without chronic disease in a rural area (RU) and in a semi-urban area (SU). The study included a total of 105 participants: 98.4% of participants were frail, with a mean of 4.3 [SD:2.5] frailties per participant. RU participants had higher number of frailties (p = 0.02) and a higher percentage of frail participants in the dimensions of health-related quality of life (p<0.0001), socioeconomical level (p = 0.008), colorectal cancer screening (p = 0.022), and tetanus booster doses (p = 0.008). Globally, women were less sedentary than men (p = 0.02) and engaged more in low physical activity (LPA) than men (p = 0.01). RU participants engaged more in LPA than SU participants (p = 0.03). The prevalence of frailty is alarmingly underestimated in older adults without chronic disease. This study demonstrated the need to propose appropriate, validated screening tests that consider territorial issues and organization of care delivery. The ICOPE framework serves as a good startpoint for reorganizing person-centered healthcare pathways.

Optimal levels of sleep, sedentary behaviour, and physical activity needed to support cognitive function in children of the early years.

Sleep, sedentary behaviour, physical activity, and the composition of these movement behaviours across the 24-h day are associated with cognitive function in early years children. This study used a Goldilocks day compositional data analysis approach to identify the optimal duration of sleep, sedentary behaviour, light physical activity, and moderate-to-vigorous physical activity associated with desired cognitive function outcomes in early years children. This cross-sectional study included 858 children aged 2.8-5.5 years from the Sleep and Activity Database for the Early Years. 24-h movement behaviours (sleep, sedentary behaviour, light physical activity, moderate-to-vigorous physical activity) were measured using ActiGraph accelerometers. Cognitive function was measured using three tasks from the Early Years Toolbox: visual-spatial working memory, response inhibition, and expressive vocabulary. A Goldilocks day compositional data analysis approach was used in R software to identify the optimal time-use compositions associated with the best 10% of the cognitive function scores. The movement behaviour composition and the relative time spent in sleep and sedentary behaviour but not different intensities of physical activity were significantly associated with working memory (P ≤ 0.01). The movement behaviour composition and relative time spent in sleep, sedentary behaviour, and different intensities of physical activity were not significantly associated with response inhibition or expressive vocabulary (P > 0.2). Therefore, optimal time use was only determined for working memory. Optimal daily durations for working memory were observed with 11:00 (hr:min) of sleep, 5:42 of sedentary behaviour, 5:06 of light physical activity, and 2:12 of moderate-to-vigorous physical activity. Working memory was the only cognitive function outcome related to the 24-h movement behaviour composition. Optimal sleep for working memory was consistent with current recommended durations, while optimal moderate-to-vigorous physical activity greatly exceeded minimal recommended levels. Optimal sedentary behaviour was longer and light physical activity was shorter than the sample average.

The key to life satisfaction in emerging adults: unlocking the secrets of self-efficacy and physical activity

PurposeThis study aimed to explore the relationships among characteristics of emerging adulthood, self-efficacy, and physical activity behaviors, and how these factors collectively influence the life satisfaction of college students. By delving into the interconnections between these elements, insights for relevant interventions and policy formulation can be provided.MethodsIn this cross-sectional study conducted from November to December 2022, a total of 3,387 Chinese college students were surveyed via the Maike electronic questionnaire platform. The Inventory of the Dimensions of Emerging Adulthood (IDEA), General Self-Efficacy Scale (GSE-8), Physical Activity Rating Scale (PARS-3), and a single-item life satisfaction question were utilized for assessments. Data analysis was performed using the Bollen–Stine bootstrap method, with the aid of Amos software (version 26.0) and IBM SPSS (version 26.0).ResultsInstability, possibility, and self-exploration were significantly associated with self-efficacy, which in turn influenced life satisfaction. Factors such as possibility and instability were related to physical activity behaviors, further predicting life satisfaction. Characteristics of emerging adulthood indirectly affected life satisfaction through self-efficacy and physical activity behaviors.ConclusionCharacteristics of emerging adulthood enhance life satisfaction by bolstering self-efficacy and promoting physical activity behaviors.

Park proximity and all-day and time-specific physical activity and sedentary behaviour in older adults.

Proximity to parks has been suggested as a factor influencing physical activity in older adults. However, it remains unclear the optimal distance between residences and parks for promoting physical activity and reducing sedentary time and whether these associations vary by the time of day. We examined whether the proximity to neighbourhood parks at varying distances is associated with all-day and time-specific physical activity and sedentary behaviour in older adults. Data were collected from 214 older adults receiving hospital services in Taipei, Taiwan. The number of parks within 400m, 800m, and 1,600m of participants' residences. Physical activity and sedentary behaviour, stratified by time of day (morning, afternoon, and evening), were measured using accelerometers. Adjusted linear regression models were used to estimate associations of park proximity with activity and sedentary outcomes. Parks located within 400m and 800m of participants' residences were more markedly associated with longer time in physical activity and less sedentary time compared to parks located 1,600m away. A greater number of parks within 400m and 800m was positively associated with walking steps and light-intensity physical activity while both distances were negatively associated with sedentary time. The associations between park proximity and behavioural outcomes were mainly attributable to that during the afternoon and evening. Our findings suggest that favourable access to parks within 800m of older adults' residences is associated with more physical activity and less sedentary time, particularly during the afternoon and evening. Future longitudinal studies are required to corroborate these associations.

The impact of family and friend support of physical activity on the participation in physical activity within Indigenous individuals in Saskatoon

IntroductionSocial support within Indigenous worldviews is recognized as a component of health and has been associated with physical activity and sedentary behaviour. Physical Activity (PA) is a modifiable behaviour that can help reduce risks of disease and benefit many dimensions of health. The purpose of this study was to compare the physical activity of Indigenous adults in Saskatchewan with and without family/friend support of PA.MethodsThe Family Influence on Physical Activity questionnaire was used to record the extent and forms of family/friend support of PA. The Godin Shepard Leisure Exercise Questionnaire (GSLEQ) was used to measure weekly PA, including moderate PA (MPA), vigorous PA (VPA), exercise frequency (WEF) and GSLEQ scores.ResultsIndigenous participants overall, First Nations and Cree participants specifically with family/friend involvement in PA reported greater weekly WEF and GSLEQ scores. Indigenous participants overall and First Nations participants specifically with family and friends who watch them engage in PA reported greater weekly VPA and GSLEQ scores. Among First Nations and Cree participants specifically, those with family/friends encouragement of PA reported greater weekly VPA, WEF and GSLEQ scores. Furthermore, First Nations participants with active family/friends reported significantly greater weekly VPA (36.8 ± 51.5 min·week−1 vs. 80.2 ± 108.5 min·week−1; p = 0.01). Greater weekly VPA was found in Métis participants with family/friend involvement in PA and with family/friends who watch them engage in PA (67.6 ± 59.6 min·week−1 vs. 29.5 ± 40.8 min·week−1; p = 0.01).DiscussionSocial support, specifically family/friends involvement, has a significant impact on Indigenous participation in PA.

'Can do' versus 'Do do' in nursing home residents: identification of contextual factors discriminating groups with aligned or misaligned physical activity and physical capacity.

Physical activity (PA) is fundamental to nursing home residents' health. Likewise, physical capacity (PC) is essential to carry out activities of daily living. Although PC and PA are associated, misalignment has been reported in specific subgroups. Increased PC is oftentimes not linked to high PA (i.e., Can do - don't do) and vice versa (i.e., Can't do - do do). Therefore, identifying other contextual factors influencing PA in misaligned groups is important. This study aimed to identify contextual factors in nursing home residents with aligned or misaligned PA and PC. In total, 180 nursing home residents (≥ 65 years, 79.4% females) were divided into four quadrants (Q1: Can do - do do; Q2: Can do - don't do; Q3: Can't do - do do; Q4: Can't do - don't do) based on thresholds for PA (≥ or < 2,500 steps/day) and PC (≤ or > 0.5m/s gait speed). Kruskal-Wallis H test and effect sizes (ES) were applied to analyze quadrants' differences regarding PA (steps per day), objective motor capacity, life-space mobility, activities of daily living (ADL), psychosocial well-being, cognition, subjective mobility-related concerns, and spatial orientation. Specific contextual factors differed significantly between the groups. Compared to Q1, Q2 presents a significantly lower life-space mobility (ES: 0.35) and objective motor capacity (ES: 0-36-0.49); Q3 has a lower objective motor capacity (ES: 0.55-1.10); Q4 shows lower independence in ADL (ES: 0.57), life-space mobility (ES: 0.48), subjective mobility-related concerns (ES: 0.38) and objective motor capacity (ES: 0.99-1.08). No significant group differences were found for psychosocial well-being, cognition, and spatial orientation. This study provides new insights into PA behavior of nursing home residents. Key variables linked to PA are objective motor capacity, life-space mobility, ADL, and subjective mobility-related concerns. Surprisingly, some potentially impactful variables such as cognition, orientation, and psychosocial well-being did not differ between the groups. This may suggest that these variables may not represent key targets for interventions aiming to improve PA. This study builds the foundation for further research into the underlying mechanisms behind PA behaviors and supports future efforts to plan specific, targeted interventions for nursing home residents. The trial was prospectively registered at DRKS.de with registration number DRKS00021423 on April 16, 2020.

24-hour movement behaviors and changes in quality of life over time among community-dwelling older adults: a compositional data analysis.

Favorable movement behavior patterns, comprising more physical activity, less sedentary behavior, and sufficient sleep, may promote the maintenance of good quality of life (QoL) with advancing age. The aim of the present study was to investigate whether movement behaviors predict future changes in QoL among community-dwelling older adults over a four-year follow-up. Participants were 75-, 80- and 85-year-old community-dwelling older adults (n = 203) followed up for 4 years. Participants wore thigh- and trunk-mounted accelerometers for 3-7 days at baseline. Proportion of time-use in physical activity, standing and sedentary behavior were assessed based on body posture and movement intensity. Time in bed was determined using an automated algorithm. QoL was assessed during a home interview using the short Older People's Quality of Life Questionnaire at baseline and follow-up (range 13-65, higher scores indicate higher QoL). Compositional linear regression analysis was used to study whether baseline time-use composition predicts changes in QoL. Over the 4-year follow-up, QoL scores decreased by 5% on average. Higher physical activity in relation to the other movement behaviors was associated with increase in QoL over time (βilr 0.94, p = 0.013), but this association attenuated after adding baseline physical function into the model. Sedentary behavior, standing, and time in bed were not associated with changes in QoL. Theoretical reallocation of 30min of physical activity into sedentary behavior, standing or time in bed was estimated to decrease QoL by 0.5 (CI 95% -0.6 to -0.4), 0.6 (-0.7 to -0.5) and 0.4 (-0.5 to -0.3) points, respectively. Theoretical reallocation of physical activity into sedentary behavior, standing, and time in bed was found to be associated with prospective decline in QoL among older adults. Engaging more in physical activity and less in more passive activities may promote better QoL with advancing age.

Abstract 4135629: Grades and trends from the 2024 United States Report Card on Physical Activity for Children and Youth

Background: Regular physical activity provides numerous health benefits including improved cardiovascular health. Population-level physical activity surveillance is critical for informing research, practice, and policy efforts for supporting population health and health disparities. The United States Report Card on Physical Activity for Children and Youth addresses physical activity surveillance needs by integrating data from numerous sources capturing levels of physical activity and related behaviors (e.g., sedentary behavior, sleep), and facilitators and barriers for physical activity among United States youth. The 2024 Report Card is the 5 th and decennial iteration in the series, released October 2024. Methods: A Report Card Working Group was assembled under the auspices of the Physical Activity Alliance and National Physical Activity Plan. Members reviewed the evidence for 11 indicators using data from nationally representative surveys and assigned grades. Data were examined for the overall population and, when possible, by age, sex, race/ethnicity, and disability subgroups. A standardized grading rubric was used to assign a letter grade to each indicator ranging from A to F. Trends in key benchmarks over time were examined since the first report card (2014) or earliest available data. Results: Sufficient data were available to assign grades for 8 of the 11 indicators. The assigned grades ranged from B- to F, with overall physical activity levels earning a D- (Table 1). No indicators improved since 2014. Five indicators - overall physical activity, organized sport participation, active transportation, sedentary behaviors, and school - worsened since 2014. Conclusions: The compiled surveillance report indicates generally poor grades and concerning trends over the recent decade. These findings highlight opportunities to improve physical activity levels and resources for supporting cardiovascular health among United States youth. Policy approaches are needed to combat societal factors that interfere with physical activity. Gaps in data availability, specificity, and quality point to needs for improved surveillance to track impacts. The 2024 Report Card can be a tool for supporting advocacy of regular physical activity at the national and local level.

Abstract 4125691: A machine learning approach to examining the associations of minority stressors and physical activity among sexual and gender minority adults

Introduction: Physical activity (PA) is an important modifiable factor for cardiovascular disease (CVD). Sexual and gender minority (SGM; e.g., lesbian/gay, bisexual, transgender) adults face higher risks of inadequate PA and CVD due to increased exposure to minority stressors, such as experienced and anticipated discrimination, which may influence SGM adults’ willingness to engage in PA. To our knowledge, researchers have not investigated the impact of minority stressors on objectively-measured PA among SGM adults. Goal: Using k-means clustering, we sought to identify whether clusters characterized by greater exposure to minority stressors were associated with lower moderate and vigorous PA (MVPA) and higher sedentary behavior among SGM adults. Methods: This daily diary study included an online sample of SGM adults living in the United States. Participants completed daily surveys about personally experienced discrimination and anticipated discrimination (i.e., expectation of experiencing discrimination) and wore wrist accelerometers for 28 days to objectively measure PA. We used k-means clustering to identify clusters based on reports of experienced and anticipated discrimination. We first determined the optimal number of clusters using established partition criteria. Next, we ran linear regression models (adjusted for demographic factors) to examine the associations of minority stress clusters with MVPA and sedentary time per week. Results: Among 42 SGM adults (mean age 27.0±7.7 years) with 1133 person-days of accelerometry data (~3% missing data), we identified four minority stress clusters: low anticipated/low experienced (LALE; reference group); low anticipated/high experienced (LAHE); high anticipated/low experienced (HALE); and high anticipated/high experienced discrimination (HAHE). Participants in the HALE cluster (n=12) engaged in 202 fewer minutes of MVPA than those in the LALE cluster (n=7). Participants in the LAHE cluster (n=10) had 123 fewer minutes of vigorous PA than those in the LALE cluster. No differences were identified for sedentary time. Conclusions: This is the first study to examine the association of minority stressors with objective PA among SGM adults. Participants in the HALE and LAHE clusters engaged in significantly lower PA than those with low levels of both experienced and anticipated discrimination. Findings underscore the importance of assessing minority stressors and the need for interventions to improve PA among SGM adults.

A Systematic Review Exploring Dietary Behaviors, Psychological Determinants and Lifestyle Factors Associated with Weight Regain After Bariatric Surgery

Background: Weight regains after bariatric surgery presents a significant challenge to long-term weight management and overall health outcomes. While clinical and surgical factors influencing bariatric outcomes have been extensively reviewed, there remains a notable gap in understanding how behavioral factors—specifically dietary habits, psychological influences, and lifestyle choices—impact long-term weight maintenance. This systematic review addresses this gap, highlighting the unique role of these behavioral factors in sustaining weight loss post-bariatric surgery. Aim: This systematic review aims to explore the behavioral factors—including dietary, psychological, and lifestyle influences—associated with weight regain after bariatric surgery. Methods: A comprehensive search was conducted across multiple databases, focusing on peer-reviewed articles published in English. We included observational studies exclusively focused on adults who experienced weight regain after bariatric surgery, with an emphasis on behavioral factors. Searches were conducted in MEDLINE via PubMed, Embase, Web of Science, Scopus, and Google Scholar, with the last search completed on 10 July 2024. Studies published within the past 10 years were considered. The Joanna Briggs Institute (JBI) critical appraisal tool for cross-sectional studies was used to assess the risk of bias. A total of 16 studies met the inclusion criteria: 12 cross-sectional studies, 3 cohort studies, and 1 in-depth interview study. Results: The review found inconsistencies in the definitions of weight regain across studies. Nonetheless, three primary behavioral factors were identified as potentially contributing to weight regain: dietary non-adherence and eating patterns, psychological determinants, and lifestyle behaviors. Dietary non-adherence included high-calorie food consumption, excessive intake of sweets, carbohydrates, and sweetened beverages, and low protein intake. Psychological factors such as depression, anxiety, emotional eating, and binge eating were prevalent among individuals experiencing weight regain. Lifestyle behaviors, including physical inactivity, smoking, and sedentary habits, also played significant roles. Conclusions: Post-bariatric weight management is multifaceted, necessitating a comprehensive approach that addresses dietary, psychological, and lifestyle factors. Most studies on behavioral factors linked to weight regain were cross-sectional with small sample sizes, limiting the ability to infer causality. Future research should include detailed information on dietary adherence, standardized tools to assess physical activity and sedentary behavior, and validated measures for psychological health. Tailored interventions and continuous support from healthcare professionals are essential for maximizing the effectiveness of bariatric surgery, promoting sustainable weight loss, and enhancing overall health outcomes.

Global trends in importance of 24-hour movement behaviors to pediatric health: Implications for South Korea.

Cultivating a 24-hour movement behavioral profile conducive to health and well-being, marked by adequate levels of physical activity, limited screen time, and sufficient sleep, has emerged as an important avenue for promoting pediatric health. We aimed to provide evidence of this potential, this multiphase, multimethod, and integrative review comprehensively investigated the global trends in health promotion initiatives and status of the Korean pediatric population. This integrative review comprised three phases employing various review methods: an environmental scan of existing guidelines for 24-hour movement behaviors worldwide, a rapid review of physical activity-related indicators from Global Matrix data, and a systematic review of 24-hour movement behaviors among children and adolescents in South Korea. The growing recognition of a holistic approach to the 24-hour movement behavior paradigm in pediatric health promotion has led to the establishment and adoption of 24-hour movement guidelines in different countries and by the World Health Organization (WHO). Korean health authorities have also responded to this need by releasing a translated report of the WHO guidelines for physical activity and sedentary behavior as well as the 2024 update of the Physical Activity Guidelines for Koreans. Accordingly, actions must be followed in policy, research, and practice. This is critical considering that Korean children and adolescents exhibit an unfavorable profile of 24-hour movement behaviors compared to the global average. Among those aged 0-6 years, the weighted averages for guideline adherence were 18.2% for physical activity, 38.1% for sedentary behavior, and 76.2% for sleep. For those aged 12-18 years, the weighted averages for guideline adherence were 20.4% for physical activity, 55.9% for sedentary behavior, and 26.2% for sleep. Building on these current findings, this integrative review provides three priorities for pediatric health promotion policy and practice and three recommendations for future research.

Influences on the physical activity behaviour of inpatients after stroke outside of staff-led rehabilitation sessions: a systematic review.

To use behavioural science frameworks to synthesise evidence on the factors influencing physical activity of patients hospitalised after stroke outside of staff-led rehabilitation sessions. A systematic review of qualitative and mixed-methods studies. MEDLINE, PsycINFO, CINAHL, and AMED were searched from inception to October 2024 for studies that explored influences on the physical activity of patients hospitalised after stroke. Data were coded with reference to the Theoretical Domains Framework and the COM-B ('capability', 'opportunity', 'motivation' and 'behaviour') model. Thematic analysis was used to group data extracts into themes within each Theoretical Domains Framework domain. Risk of bias was assessed using the Mixed Methods Appraisal Tool. We identified 17 studies. There was no significant risk of bias concerns. We identified 19 themes across eight Theoretical Domains Framework domains and all COM-B model categories. The most frequently recognised themes were found in three Theoretical Domains Framework domains: Environmental Context and Resources (themes: 1 -- availability of sufficient skilled staff to facilitate physical activity; 2 - design and use of the physical environment; 3 - lack of opportunities or incentives; 4 - passivity and institutionalisation; 5 - perceived and actual rules and culture of the ward); Skills (theme: physical impairments); and Social Influences (theme: activity influenced by family and friends). The review highlights the complexity of the influences on the physical activity of patients hospitalised after stroke outside of staff-led rehabilitation sessions. It is likely multi-component interventions addressing a number of influences will be required to effectively improve physical activity. PROSPERO ID: CRD42022383506.

Prevalence and lifestyle determinants of depressive symptoms among Chinese children and adolescents

Based on Chinese Students’ Fitness Health Examination, this study sought to investigate the relationships between depressive symptoms and family environment, physical activity, dietary habits, sleep and sedentary behavior among children and adolescents. A cross-sectional study was carried out to estimate the prevalence of depressive symptoms in 32,389 participants (grades 4–12) using the CES-D. Logistic regression was used to evaluate the relationships between lifestyle determinants and depressive symptoms, and a random forest model was used to rank the importance of those determinants. The overall prevalence of depressive symptoms was 39.93%. Students with depressive symptoms had higher grades, lower parental educational levels and unhealthy lifestyles (P < 0.05). The top ten most important determinants of depressive symptoms were grade, egg intake, milk/soy product intake, frequency of muscle strength training, screen time, sleep duration, parental educational level, sugar beverage intake and total physical activity. Socioeconomic status, physical activity, sleep and screen time, and diet habits are determinants of depressive symptoms, and surveillance of lifestyles may be an effective way to detect students with depressive symptoms early.

Feasibility, usability and acceptability of a lifestyle-integrated multicomponent exercise delivered via a mobile health platform in community-dwelling pre-frail older adults: a short-term, mixed-methods, prospective pilot study

BackgroundPre-frailty is a window of opportunity for frailty reversal and can be enhanced by multicomponent exercise. The Lifestyle-integrated Functional Exercise (LiFE) program may be a promising alternative to overcome traditional exercise barriers. The latest advancements in mobile health (mHealth) technology have enabled individuals to retain the advantages of supervised exercise training within group settings while providing exercise programs that can be accessed and completed at home. This study aims to assess the feasibility, acceptability, and primary efficacy of the PF-Life program, which is the Lifestyle-Integrated Functional Exercise program for Pre-Frail supported by an mHealth platform.MethodsSixteen pre-frail adults aged ≥ 65 years were recruited from five community health centers in Fuzhou, China. All participants were prescribed the PF-Life program by geriatricians using the mhealth platform (web-based portal). Participants engaged in the customized exercises program following in-app video instructions and feedback on the mhealth platform (smartphone application). Physical activity (PA) and sedentary behavior (SB) were registered daily through wearable devices. Study endpoints were feasibility (retention rate, compliance rate, adverse events), usability (system usability scale), acceptability (qualitative interviews), changes in physical function (timed up and go (TUG), handgrip strength (HGS), and 30-second chair rise tests), PA and SB.ResultsThe intervention was feasible, 88% of participants adhered completely to the study protocol, and 95% had completed at least 75% of the prescribed experimental duration. System usability was high (85 out of 100 best imaginable). Changes were observed from baseline to follow-up for total HGS (21.41 ± 6.38 vs. 24.12 ± 6.62 kg, P < 0.05, d = 0.714), TUG (8.23 ± 1.33 vs. 7.48 ± 2.01 s, P < 0.01, d = 1.647) and 30-second chair rise test (17.13 ± 4.3 vs. 20.04 ± 4.54 repetitions, P < 0.01, d = 0.94). In addition, SB decreased by a mean of 33 min/day (P < 0.01), and low physical activity increased by 31 min/day (P < 0.01). No adverse events occurred. The majority of participants found the PF-Life program to be straightforward, adaptable, and easily integrable into their daily routines.ConclusionsPreliminary studies have demonstrated that the PF-life program exhibits good compliance, safety, and usability for the pre-frail elderly population. Large-scale randomized controlled trials are required to ascertain its long-term effectiveness.

Influence of Health Literacy on Physical Activity and Sedentary Behaviors in Older Patients with Coronary Artery Disease.

Coronary artery disease is a chronic condition that requires continuous adherence to healthy behaviors. Adhering to physical activity and reducing prolonged sedentary behavior are important for the physical health of older patients with coronary artery disease (CAD). Health literacy is increasingly recognized as a key factor in secondary prevention for these patients. However, evidence regarding the associations among health literacy, physical activity, and sedentary behaviors for secondary prevention in older patients with coronary artery disease remains limited. This study aimed to identify the prevalence of limited health literacy and the influence of health literacy on physical activity and sedentary behaviors in older patients with CAD. This study was a descriptive cross-sectional study conducted from May to December 2022 in South Korea. A total of 186 patients aged 65 and older diagnosed with coronary artery disease participated. Data on health literacy, physical activity, and sedentary behaviors were collected through self-reported questionnaires and electronic medical records. The prevalence of limited health literacy in older patients was 66.7%. Hierarchical linear regression revealed that health literacy was a significant determinant of physical activity (β = -0.50, P < .001) and sedentary behaviors (β = 0.58, P < .001) after adjusting for confounding variables. Our main findings showed that health literacy can facilitate improvements in physical activity and sedentary behaviors. Health literacy can facilitate health decisions for secondary prevention in older patients with CAD. Thus, healthcare professionals should assess patient health literacy and illness severity when designing secondary prevention programs.

Weight loss in patients with severe obesity after bariatric surgery-the potential role of the chrono-nutrition, chronotype and the circadian misalignment: A study protocol of the ChronoWise prospective cohort.

Despite the potential effectiveness of bariatric surgery in promoting weight loss, a considerable proportion of patients still face the challenge of achieving optimal post-surgery outcomes. The timing of eating, in addition to the content of what is eaten, as well as chronotype and social jetlag (a marker of circadian misalignment), have been implicated in weight regulation. However, the current understanding of these chrono-related behaviours in individuals undergoing bariatric surgery is still scarce. Thus, this study aims to evaluate the role of chrono-nutrition, chronotype, and circadian misalignment in the weight-loss trajectory among individuals living with severe obesity who underwent bariatric surgery. The ChronoWise project is a prospective single-centre cohort study designed to follow patients experiencing bariatric surgery at the Santo António Local Health Unit (ULSSA), Porto, Portugal. Participants will be recruited and evaluated at pre-surgery and followed-up over 3 and 6 months after surgery. The baseline evaluation will be conducted face-to-face during the hospital stay and by telephone or video call on the subsequent evaluations, following standard procedures. Data collection includes sociodemographics, food intake, chrono-nutrition behaviours, sleep time behaviour, sleep quality, screen time, physical activity and exercise behaviours, anthropometric measurements, and biochemical parameters. The 'Munich Chronotype Questionnaire' will be used to assess chronotype and social jet lag. Chrono-nutrition dimensions will be measured by the 'Chrononutrition Profile-Questionnaire' in all evaluations. Weight and height will be self-reported and retrieved from medical registries. trajectories of weight-loss will be obtained. This study will add important evidence on the role of chrono-nutrition, chronotype and social jetlag profile in weight-loss outcomes after bariatric surgery. Identifying novel approaches to change the paradigm of post-surgical weight management towards a tailored treatment aligned with circadian rhythm may be useful to strengthen the existing treatments and improve patients' response to bariatric surgery.