Changes In Physical Activity Research Articles

Exercise to socialize? Bidirectional relationships between physical activity and loneliness in middle-aged and older American adults.

Physical inactivity and loneliness are both associated with health risks and can affect each other through various social and behavioral mechanisms. However, current evidence on this relationship is equivocal and mostly based on cross-sectional data. This longitudinal study aimed to determine whether current levels of physical activity (moderate and vigorous intensity) and loneliness are associated with future respective states of themselves and each other. We used data from waves 6-14 (2002-2018) of the Health and Retirement Study (n= 20 134) in a mixed-effects and random-intercept cross-lagged panel model. Analysis showed that current loneliness and physical activity were associated with each future respective state. Additionally, weekly participation in moderate-intensity, but not vigorous-intensity, physical activity was associated with a lower likelihood of becoming lonely in the future (relative risk [RR] = 0.94; 95% CI, 0.90-0.99). However, changes in physical activity were not associated with deviation from a person's typical level of loneliness (for vigorous intensity, mean deviation [MD] = 0.00; 95% CI: -0.04 to 0.03; for moderate-intensity, MD = 0.01; 95% CI: -0.03 to 0.04). Loneliness was not associated with moderate- or vigorous-intensity physical activity in subsequent waves. This suggests that while lower physical activity levels can be associated with future loneliness, changing levels of physical activity has little impact on loneliness at the individual level.

Implementation and mixed-methods evaluation of "Walk with a Doc" program at Stony Brook.

Walking groups run by trained individuals, lasting under an hour in a natural environment, may be a cost-effective way by which to encourage sustainable changes in physical activity as well as foster companionship and a shared experience of wellness among participants. Walk with a Doc (WWaD) is a national program that provides a platform for medical professionals, including physicians and medical students, to deliver a short talk on a health topic prior to walking side by side with patients and community members. To evaluate the WWaD Chapter at Stony Brook following implementation, a questionnaire was designed utilizing a mixed-methods approach (i.e.,containing qualitative and quantitative items) and administered to all attendees monthly prior to the health discussion. The aim of the questionnaire was fourfold: first, to obtain participant demographics; second, to obtain information on attendees' own perceptions of their health status and the role exercise plays in their health; third, to gain data on physical activity levels, including lengths of exercise sessions and types of activities performed; and fourth, to learn more about attendees' motivations and goals for participating in the walks. We received an IRB exemption. Physician and medical student volunteers were recruited from Stony Brook University Hospital, a suburban tertiary care center, to oversee program logistics. WWaD was scheduled to take place on the third Sunday of every month for 1 h at Heritage Park in Mount Sinai, New York. The event was advertised by volunteers to colleagues, peers, patients, and community members utilizing word of mouth, printed flyers, emails to listservs, and social media outlets. Each month, a physician volunteer oversaw a brief discussion (approximately 10 min in length). Over the course of the 5 month evaluation period, 91individuals participated in the walks, including repeat attendees. After excluding duplicate or incomplete entries, data from 30 participants were included in this analysis. The majority of participants were female (n=24) with a mean age of 50 years (range, 23-98 years). Feedback on WWaD program elements was largely positive. Participants commended the monthly speakers for "informative talks" (n=6) on "interesting topics" (n=4), with plans to review the supplemental information in educational pamphlets following the walk (n=4). The brochures were also deemed "helpful." Overwhelmingly, patients referred to the community gathering and team building aspects of WWaD as the "most enjoyable" aspect of the program (n=8) and a key driver for participation. This mixed-methods study of the WWaD chapter at Stony Brook contributes to a growing body of evidence highlighting the value of walking groups as effective avenues for collaboration in producing accessible healthy behavior.

Abstract TMP26: Density of Physical Activity Resources is Associated With Post-Stroke Physical Activity

Background: Exercise post-stroke can improve health-related quality of life and promote physical fitness, walking, and balance. Physical activity (PA) is important in post-stroke rehabilitation and recovery through the reduction of cardiovascular risk factors and lowering the risk of recurrent stroke and mortality. Objective: To assess if area PA resources influence the change in PA 12-months post-stroke. Methods: Addresses of 546 mild stroke survivors from the Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) study were geocoded to the census tract level and merged with the density of physical activity resources from the National Neighborhood Data Archive (NaNDA). We modeled the odds of perceived change in PA at 12-months post-stroke (more active vs. about the same vs. less active) and number of fitness and recreational sports centers per square mile using multinomial logistic regression. Selection bias due to loss-to-follow-up was accounted for using stablized inverse probability weights with robust standard errors. Models were adjusted for age, gender, race/ethnicity, education, insurance, BMI, and intervention. Results: A total of 333 participants had 12-month PA data with 17.2% reporting being more physically active and 48.0% being about the same at 12 months. The adjusted odds of being more active compared to less active were 1.57 times larger when comparing the 90 th percentile of PA resources to the 10 th percentile (range: 58 resources; 95% CI: 0.99, 2.48). Similarly, adjusted odds of reporting the same level of PA compared to less active were 1.47 times larger when the 90 th and 10 th percentiles of PA resources are compared (95% CI: 0.99, 2.17). Conclusion: Stroke survivors report higher odds of both maintaining the same level of PA and being more physically active when there are more PA resources in the area. This study demonstrates the potentially important role of the physical and built environment on physical fitness post-stroke.

Consequences of COVID-19 pandemic on weight gain and physical activity: a prospective cohort study from Italy.

It is crucial to monitor changes in body weight and physical activity (PA) to understand if short-term effects of COVID-19 pandemic have had implications over time. This longitudinal study is based on data from 4,831 Italians aged 18-74 years interviewed during the first phase of COVID-19 pandemic (April-May 2020) and two years later (February-March 2022). Changes in body weight and PA were assessed through multivariable analyses in association with socio-demographic and psychological characteristics. Over the two years, 17.4% reported a weight gain of at least 5 kg and 32.8% a decreased PA by at least 4 hours per week. Weight gain and decreased PA were more frequent in participants from the less wealthy areas, with lower educational level and those who reported a worsening in mental health. After two years from the start of the pandemic, in Italy we observed a trend toward a renormalization of body weight and PA. The segments of the population mostly affected by the pandemic are subjects with more disadvantaged socio-economic status and with an impaired mental health.

Health-Related Quality of Life and Psychological Outcomes in Participants with Symptomatic and Non-Symptomatic Knees after ACL Reconstruction.

Individuals who sustain an ACL injury and undergo reconstruction (ACLR) are at risk for the development of osteoarthritis. Recent investigations have applied the Englund criteria to categorize people with a history of ACLR as someone with a symptomatic or asymptomatic knee. The purpose of this study was to examine differences in health-related quality of life (HRQL) and psychological outcomes in people with a history of ACLR who were categorized as symptomatic or non-symptomatic by application of the Englund criteria. The authors' hypothesized participants classified as symptomatic would have lower HRQL, increased fear-avoidance beliefs, and decreased resilience compared to participants classified as non-symptomatic. Cross-sectional, survey. Participants at least one-year after ACLR were recruited for the study and completed the Tegner Activity Scale, the Brief Resilience Scale (BRS), the modified Disablement in the Physically Active Scale (mDPA), and the Fear-Avoidance Belief Questionnaire (FABQ) at one time-point. Descriptive statistics were summarized using median [interquartile range] and differences between groups were examined using separate Mann-Whitney U tests. Participants with symptomatic knees had a significantly higher BMI (24.8 [6.4]) than the non-symptomatic group (21.2 [4.3], p=0.013). Participants in the symptomatic group had worse HRQL on the physical subscale (12.5 [16.3] vs.0.0 [2.5], p<0.001) and mental subscale (2.0 [1] vs.0.0 [1], p=0.031), higher scores on the FABQ-Sport (14.5 [11] vs.0.0 [6], p<0.001) and FABQ-Physical Activity (20 [24] vs.1 [4], p<0.001) and less resilience (3.7[0.42] vs.4.0 [0.83], p=0.028) compared to those participants in the non-symptomatic group. There were no differences in current physical activity (p=0.285) or change in physical activity (p=0.124) levels between the two groups. This series of differences may represent a cascade of events that can continue to negatively impact health outcomes across the lifespan for individuals with a history of ACLR. Future research should consider longitudinal investigations of these outcomes after injury and throughout the post-surgical and post-rehabilitation timeframe. Level 3b.

A Digitally Enabled, Pharmacist service to detecT medicine harms in residential aged care (nursing home) (ADEPT): protocol for a feasibility study

IntroductionThis feasibility study aims to develop and test a new model of practice in Australia using digital technologies to enable pharmacists to monitor early signs and symptoms of medicine-induced harms...

Physical activity and unexpected weight change in Ontario children and youth during the COVID-19 pandemic: A cross-sectional analysis of the Ontario Parent Survey 2.

The objective of this study was to investigate the association between children's parent-reported physical activity levels and weight changes during the COVID-19 pandemic among children and youth in Ontario Canada. A cross-sectional online survey was conducted in parents of children 5-17 years living in Ontario from May to July 2021. Parents recalled their child's physical activity and weight change during the year prior to their completion of the survey. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using multinomial logistic regression for the association between physical activity and weight gain or loss, adjusted for child age and gender, parent ethnicity, current housing type, method of school delivery, and financial stability. Overall, 86.8% of children did not obtain 60 minutes of moderate-to-vigorous physical activity per day and 75.4% of parents were somewhat or very concerned about their child's physical activity levels. For all physical activity exposures (outdoor play, light physical activity, and moderate-to-vigorous physical activity), lower physical activity was consistently associated with increased odds of weight gain or loss. For example, the adjusted OR for the association between 0-1 days of moderate-to-vigorous physical activity versus 6-7 days and child weight gain was 5.81 (95% CI 4.47, 7.56). Parent concern about their child's physical activity was also strongly associated with child weight gain (OR 7.29; 95% CI 5.94, 8.94). No differences were observed between boys and girls. This study concludes that a high proportion of children in Ontario had low physical activity levels during the COVID-19 pandemic and that low physical activity was strongly associated with parent reports of both weight gain and loss among children.

Hubungan Beban Kerja Dengan Kelengkapan Dokumentasi Asuhan Keperawatan Ruang Rawat Inap Rumah Sakit Bakti Timah Karimun Tahun 2023

Old age is said to be the final stage of development in the human life cycle which experiences various health problems and is at high risk of dangerous diseases. Health problems that occur in the elderly in general are a decrease in organ function, changes in lifestyle, diet and physical activity which are often the main factors in degenerative diseases including hypertension which disrupts blood flow. This hypertension often occurs in the elderly where the blood pressure is at the upper limit ( Systole) is more than 140 mmHg and lower limit blood pressure (diastole) is more than 90 mmHg. One non-pharmacological treatment that can improve the flow of oxygen in the blood is laughter therapy. The aim of this research is to analyze the effect of laughter therapy using comedy videos on reducing blood pressure in elderly people with hypertension at the Tiban Baru Community Health Center, Batam City. The Batam City Health Service noted that hypertension occurs more frequently in elderly people aged 60-70 years and over with the highest number being 9,282 people at the Tiban Baru Community Health Center, Batam City. This research uses a quasi-experimental method with a pre-test and post-test design without control. The sample provided used the purpose sampling method with a total research sample of 20 respondents. Therefore, it can be concluded that there is an effect of laughter therapy on reducing blood pressure in elderly people with hypertension.

Correlation between daily physical activity and intestinal microbiota in perimenopausal women

This study aimed to examine the correlation between daily physical activity levels and gut microbiota during the perimenopausal period. To explore the physiopathological traits of perimenopause women, and provide a theoretical basis for the development of menopause exercise intervention program. In this study, daily physical activity was assessed using the ActiGraph wGT3X-BT wearable sensor, and 16S rRNA sequencing was employed to analyze gut microbiota diversity and composition. Comparative analysis was conducted to evaluate the association between physical activity and specific phyla and genera in the gut microbiota, comparing perimenopausal women to youth women. The results showed perimenopausal women exhibited significantly lower levels of daily physical activity, including Kcals, metabolic equivalents (METs), and moderate-to-vigorous physical activity (MVPA), compared to youth women. The composition of the gut microbiota was markedly different between the two groups. Specifically, the abundance of Acidobacteria, Chloroflexi, Nitrospirae, and Gemmatimonadetes were lower at the phylum level (p < 0.01). Collinsella, Ruminococcus gnavus, Rothia, Haemophilus, Sphingomonas, Lactobacillales, and Lactococcus were lower at the genus level, while Phascolarctobacterium, Paraprevotella, Acinetobacter, Flavonifractor, and Intestinimonas exhibited a significant increase (p < 0.05, p < 0.01). Furthermore, a positive correlation was observed between Chloroflexi or Sphingomonas and physical activity (kcals, METs, and MVPA), while a negative correlation was found between Intestinimonas and physical activity (METs: p < 0.01, and MVPA: p < 0.05). Doubtlessly, the perimenopausal period is associated with lower levels of physical activity and distinct changes in gut microbiota. Sphingomonas may serve as a sensitive bacterium closely linked to physical activity.

Multi-strain probiotic improves subjective sleep quality with no impact on body composition, hemodynamics, and physical activity.

The objective of the study was to examine the impact of a multi-strain probiotic (MSP) on sleep, physical activity, and body composition changes. We used a randomised, double-blind, placebo-controlled approach with 70 healthy men and women (31.0± 9.5 years, 173.0± 10.4cm, 73.9± 13.8kg, 24.6± 3.5kg/m2) supplemented daily with MSP (4× 109 live cells Limosilactobacillus fermentum LF16, Lacticaseibacillus rhamnosus LR06, Lactiplantibacillus plantarum LP01, and Bifidobacterium longum 04; Probiotical S.p.A., Novara, Italy) or placebo (PLA). In response to supplementation (after 0, 2, 4, and 6 weeks of supplementation) and 3 weeks after stopping supplementation, participants had subjective (Pittsburgh Sleep Quality Index, PSQI) and objective sleep indicators, body composition, daily physical activity and resting hemodynamics assessed. Subjective sleep quality indicators using the PSQI (sleep latency, sleep disturbance, and global PSQI score) improved ( P < 0.05) at various time points with MSP supplementation. Systolic blood pressure in PLA increased ( P < 0.05) after 6 weeks of supplementation with no change in MSP. No changes ( P > 0.05) in sleep (hours asleep, minutes awake, number of times awake) or physical activity (step count, minutes of sedentary activity, total active minutes) metrics assessed by the wearable device were observed. Additionally, no changes in resting heart rate, diastolic blood pressure, and body composition were discerned. In conclusion, MSP supplementation improved the subjective ability to fall asleep faster and disturbances experienced during sleep, which resulted in improved overall sleep quality as assessed by the PSQI. No differences in other sleep indicators, physical activity, hemodynamics, and body composition were observed during or following MSP supplementation. Registered at clinicaltrials.gov: NCT05343533.

COVID-19 lockdowns weigh heavily on youth: an analysis of the impact on BMI for Age Z scores in children and adolescents.

The COVID-19 pandemic has significantly impacted the lifestyle and health of children and adolescents. This study aimed to assess the lifestyle changes brought about by COVID-19-related school closures and their impact on the Body Mass Index for Age Z (BAZ) scores of governmental school students in Qatar. An analytical cross-sectional study was conducted between June and August 2022 targeting students aged 8-15years. Data on lifestyle behaviors were gathered through telephone interviews with parents of selected students. The BAZ scores before and after school closures that were automatically calculated by the electronic health records system were extracted. We completed 1546 interviews. We found a significant increase in unhealthy food categories, a reduction in physical activity and an increase in the screen time over the period of schools' closure. The BAZ increased significantly by 0.30 (95% CI 0.26-0.35). The increase in BAZ scores was significantly higher among male students and the younger age group compared to females and older counterparts, respectively. The student's age group, sex, nationality and change in physical activity were significant predictors of the change in BAZ scores. School closures during the COVID-19 pandemic negatively impacted the lifestyle of students in Qatar and resulted in a significant increase in the BAZ scores.

A Systematic Review of the Impact of COVID-19 on Children’s Outcomes

Background: The COVID-19 pandemic has had an impact on the health of children. Nurses and healthcare professionals should know the latest information regarding the impact of Covid-19 on children. Aims: This literature review aims to identify the impact of COVID-19 on children’s outcomes. Method: This literature study uses the narrative review method. CINAHL, PubMed, Proquest, Science Direct, and Google Scholar were used to conduct the literature search. The keywords used are “Children” AND “Coronavirus Disease 2019” OR “COVID-19” AND “Impact” OR “Effect”. The articles used were subjected to critical assessment. Seven quantitative research articles were reviewed in this literature study. Results: This study shows that the COVID-19 pandemic has impacted children’s health and education. In terms of health, COVID-19 causes changes in physical activity to more sedentary behavior, delayed immunization, a negative impact on the mental health of children and adolescents, and children with special needs health. In the education aspect, COVID-19 has brought about a transformation in the field. Conclusion: The ongoing COVID-19 pandemic makes assessing the short- and long-term effects on children difficult. The need to conduct further research will benefit nurses and healthcare professionals in providing appropriate nursing services to children and families.

Prospective associations between changes in physical activity and sedentary time and subsequent lean muscle mass in older English adults: the EPIC-Norfolk cohort study

BackgroundThe longitudinal associations between physical behaviours and lean muscle mass indices need to be better understood to aid healthy ageing intervention development.MethodsWe assessed physical behaviours (total physical activity, moderate-to-vigorous physical activity (MVPA), light physical activity, total sedentary time and prolonged sedentary bout time) for 7 days using hip-worn accelerometers. We also assessed domain-specific physical behaviours (walking, cycling, gardening and housework time) with self-report questionnaires at baseline (2006–2011) and follow-up (2012–2016) in the European Prospective Investigation into Cancer (EPIC)-Norfolk study. We assessed body composition using dual-energy X-ray absorptiometry (DEXA) at follow-up in 1535 participants (≥ 60 years at baseline). From this, we derived appendicular lean muscle mass (ALM) indices (% relative ALM = (ALM/total body weight)*100), body mass index (BMI)-scaled ALM (ALM/BMI, kg/kg/m2) and height-scaled ALM (ALM/height2, kg/m2)). We evaluated the prospective associations of both baseline and change in physical behaviours with follow-up muscle mass indices using multivariable linear regression.ResultsOver 5.5 years (SD 14.8) follow-up, higher baseline accelerometer-measured physical activity and lower sedentary time were associated with higher subsequent relative ALM and BMI-scaled ALM, but not height-scaled ALM (e.g. 0.02% higher subsequent relative ALM per minute/day of baseline MVPA for men). Greater increases in physical activity and greater declines in sedentary time variables were associated with higher subsequent relative ALM and BMI-scaled ALM, but not height-scaled ALM (e.g. 0.001 kg/kg/m2 subsequent BMI-scaled ALM and 0.04% subsequent relative ALM per min/day/year increases in LPA over follow-up; 0.001 kg/kg/m2 subsequent BMI-scaled ALM and -0.03% subsequent relative ALM per min/day/year less of total sedentary time over follow-up).Greater increases in women’s cycling and gardening over follow-up were associated with greater subsequent relative ALM (cycling 0.9% per hour/week/year; gardening 0.2% per hour/week/year) and BMI-scaled ALM (cycling 0.03 kg/kg/m2 per hour/week/year; gardening 0.004 kg/kg/m2 per hour/week/year).ConclusionPhysical behaviours across all intensities, and in women more specifically cycling and gardening, may help prevent age-related declines in muscle mass.

Determinants of body weight changes during Ramadan fasting in India amid COVID-19: A cross-sectional study.

Ramadan intermittent fasting (RIF) presents unique challenges and opportunities for public health and clinical practice, especially in populations with a high prevalence of non-communicable diseases. This study aims to investigate the impact of RIF on weight change among Indian Muslims and explore the associated demographic, dietary, and behavioral factors. A cross-sectional survey was conducted with a sample of Indian Muslim adults who observed RIF. Participants were asked to report their demographic information, family and personal health history, and dietary and lifestyle behaviors before and during Ramadan month. The primary outcome was body weight change, with secondary outcomes including changes in dietary patterns, physical activity, and other health-related lifestyle behaviors. The study found that during Ramadan, nearly half of the participants (48.5%) self-reported a retained initial weight, while a significant fraction (30.9%) self-reported a modest weight reduction between 0.5 to 2.5 kg at the end of Ramadan. Additionally, self-reported eating practices demonstrated moderately altered by about half (48.4%) of the study participants, with 32.2% reporting minor changes and 8.2% indicating substantial changes. An urban residence was associated with a higher likelihood of weight gain, where urban residents showed 3 times the odds of increased weight compared to rural inhabitants. Employment status emerged as a significant determinant for weight fluctuation, influencing both weight gain and loss. During Ramadan, there was a significant rise in snacking frequency, increasing from 21.7% to 32.6% in comparison with pre-Ramadan. The consumption of large quantities of food more frequently grew from 14.9% to 36%, and the incidence of eating despite not being hungry went up from 17.4% to 33.2%. The study demonstrates that RIF is associated with variable changes in body weight among adult Indian Muslims, influenced by urbanization, employment status, and dietary changes. The findings suggest that clinicians should provide tailored advice about body weight regulation during Ramadan and consider integrating community-based health initiatives within religious settings to improve health outcomes.

Feasibility of wearable activity tracking devices to measure physical activity and sleep change among adolescents with chronic pain—a pilot nonrandomized treatment study

PurposePersonal informatics devices are being used to measure engagement in health behaviors in adults with chronic pain and may be appropriate for adolescent use. The aim of this study was to evaluate the utilization of a wearable activity tracking device to measure physical activity and sleep among adolescents attending a three-week, intensive interdisciplinary pain treatment (IIPT) program. We also assessed changes in physical activity and sleep from baseline to the treatment phase.MethodsParticipants (57.1% female, average age 15.88, SD = 1.27) wore an activity tracking device three weeks prior to starting and during the treatment program.ResultsOf 129 participants contacted, 47 (36.4%) agreed to participate. However, only 30 (64%) complied with the instructions for using the device prior to programming and during program participation. Preliminary analyses comparing averages from 3-weeks pre-treatment to 3-weeks during treatment indicated increases in daily overall activity minutes, daily step counts, and minutes of moderate to vigorous physical activity (by 353%), as well as a corresponding decrease in sedentary minutes. There was more missing data for sleep than anticipated.ConclusionsWearable activity tracking devices can be successfully used to measure adolescent physical activity in-person, with more difficulty obtaining this information remotely. Adolescents with chronic pain experience improvements in objective measurements of physical activity over the course of a 3-week IIPT program. Future studies may want to spend more time working with pediatric patients on their understanding of how to use trackers for sleep and physical activity.

Moderate-to-Vigorous Physical Activity Changes with the Risk of SARS-CoV-2 Infection: A Nested Case-Control Study.

We identified the association of changes in moderate-to-vigorous physical activity (MVPA) with SARS-CoV-2 infection. From 6,396,500 patients, we performed a nested case-control study who participated in both biennial check-ups. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression. From physically inactive patients at period I, the odds increased when engaged in 1-2, 3-4, or ≥5 times of MVPA/week at period II. This study found that MVPA was directly associated with SARS-CoV-2 infection.

Delivery of a telehealth supported home exercise program with dietary advice to increase plant-based protein intake in people with non-alcoholic fatty liver disease: a 12-week randomised controlled feasibility trial.

This study evaluated the feasibility and safety of a telehealth delivered exercise plus plant-based protein diet in adults with non-alcoholic fatty liver disease (NAFLD). This was a 12-week, randomised controlled feasibility trial including twenty-eight adults aged > 45 years with NAFLD randomised to a home muscle strengthening program (3 d/week) with increased protein intake (target ∼1·2-1·5 g/kg/d) from predominately plant-based sources and behavioural change support (3-4 text messages/week) (Pro-Ex n 14) or usual care (UC, n 14). Feasibility was assessed via retention (≤ 10 % attrition), adherence (exercise ≥ 66 %; recommended daily protein serves ≥ 80 %) and safety (adverse events). Secondary outcomes included macronutrient intake (3 × 24-h records), weight, moderate-to-vigorous physical activity (MVPA) and 30 s sit-to-stand (STS) performance. Study retention was 89 %. Mean exercise adherence (Pro-Ex) was 52 % with one adverse event from 241 sessions. In Pro-Ex, mean daily plant protein serves increased (0·9 to 1·4/d) and animal protein decreased (1·5 to 1·2/d) after 12-weeks, but overall adherence (serves/day) was 32[RD1] % (plant) and 42 % (animal). Relative to UC, Pro-Ex experienced a mean 2·7 (95 % CI: 0·9, 4·4) increase in 30 s STS number, 46-minute (95 % CI: -153, 245) increase in MVPA, 1·7 kg (95 % CI: -3·5, 0·2) decrease in weight, 35·2 g (95 % CI: 11·0, 59·3) increase in protein. In adults with NAFLD a telehealth home exercise and dietary intervention was safe and improved habitual plant and animal protein intake, but overall adherence was modest suggesting more intensive healthcare support may be required.

Physical activity positively impacts disability outcomes during transition from midlife to early older age irrespective of body mass index

We examined the effects of physical activity (PA) and body mass index (BMI) longitudinal patterns (trajectories) on subjective measures of mobility, function, and disability in adults and assessed whether effects of PA trajectories on function varied due to BMI. Group-based trajectory analyses were used to determine patterns of change in PA and BMI using data from the Health and Retirement Study 1931–1941 birth cohort (n = 10,507). Physical function was assessed by Mobility Limitations (0–5 scale) and Large Muscle Function (0–4 scale) Indexes, as well as with score for activities of daily living (ADLs) and instrumental activities of daily living (IADLs), with higher scores being worse. Our analyses estimated four distinct PA trajectories: decreasing, (2) fluctuating, (3) stable high, and (4) emergent (previously low/sedentary with increased PA over the study period). Worse mobility limitations, large muscle function, ADLs, and IADLs were associated with Decreasing and Fluctuating PA groups. Better outcomes were associated with Emergent and Stable High PA groups. The five BMI trajectories were stable normal/overweight, modest decreasing, fluctuating, steep decreasing, and increasing. No significant interaction existed between PA and BMI trajectories for Mobility Limitations (P= 0.577), Large Muscle Function (P= 0.511), ADLs (P= 0.600), and IADLs (P= 0.152). These findings may empower clinicians to promote messages to midlifers that meaningful changes in PA can improve function in older age.

Increasing physical activity among Indonesian adolescents: a social marketing intervention reflection

Purpose This paper aims to provide an overview of a social marketing intervention that aimed to increase physical activity (aligned to UN SDG 3) among adolescents in Bali, Indonesia. Design/methodology/approach Three sequential phases were followed to deliver the social marketing intervention. Phrase 1 (formative research) gained insights that guided a subsequent social marketing intervention. Phase 2 (pilot intervention) gathered preliminary results, to support the development of the final intervention. Phase 3 (intervention) evaluated the effectiveness of the two-month social marketing intervention. Findings The results from the intervention tested in this paper identified significant behaviour change in physical activity, demonstrating the effectiveness of the intervention. Furthermore, the paper identifies which intervention inputs contribute to behaviour change and which do not. Research limitations/implications This paper describes the outcomes from an eight-week pilot programme that aimed to increase rates of physical activity for Indonesian adolescents and provides early evidence of impact. Practical implications This study found that providing adolescents with the opportunity to play team sports increases physical activity behaviour. Originality/value There is a lot of ground that needs to be made in terms of designing programs capable of achieving impact in the Global South. The approach reported in this paper can serve as a best-practice model for researchers wanting to drive lasting behaviour change to overcome known inequities in the Global South.

Effect of angiotensin receptor neprilysin inhibitor on physical activity in patients with heart failure with reduced ejection fraction, monitored by implantable electronic device home monitoring.

Angiotensin receptor neprilysin inhibitor (ARNI) therapy is a cornerstone in the treatment of heart failure with reduced ejection fraction (HFrEF), with significant improvement in mortality as well as morbidity and quality of life. However, maximal ARNI doses often result in hypotension. Recent studies with 'real world' experience suggest that lower doses of ARNI are as effective as higher doses.In order to evaluate the symptomatic effect of low-dose ARNI in HFrEF patients, we analyzed physical activity data obtained via home monitoring of patients with cardiac implantable electronic devices (CIEDs). We retrospectively analyzed physical activity data obtained from HFrEF patients with CIED-active home monitoring during the years 2021-2022. Patients with ARNI therapy were further divided into subgroups according to the administered dose. Low-dose ARNI included doses of up to 24/26 mg sacubitril/valsartan daily. Intermediate dose and high dose included doses of 72/78-120/130 mg/day, and 144/156-194/206 mg/day, respectively. A total of 122 patients had home monitoring-compatible CIEDs and HFrEF during the study period. Sixty-four of these patients were treated with ARNI. Administration of low-dose ARNI resulted in a 20% increase in daily activity when compared with patients without ARNI treatment ( P = 0.038). Change in physical activity of patients in the intermediate-dose and high-dose groups was not significant. Younger patients, patients with cardiac resynchronization therapy, and patients without diabetes mellitus were more physically active. Low-dose ARNI had a beneficial effect on physical activity in HFrEF patients. MH via CIED provided real-life objective data for patients' follow-up.