Physical Activity In Middle-aged Adults Research Articles

Accelerometer-Measured, Habitual Physical Activity and Circulating Brain-Derived Neurotrophic Factor: A Cross-Sectional Study.

One of the mechanisms suggested to link physical activity (PA) to favorable brain health is through stimulation of neural growth factors such as brain-derived neurotrophic factor (BDNF). Acute bouts of PA stimulate circulating BDNF levels. In this investigation, we assessed whether habitual, accelerometer-measured PA levels were related to circulating BDNF levels in a middle-aged cohort. In the Framingham Heart Study Third Generation cohort, 1,769 participants provided reliable accelerometry data and were not missing BDNF measurement or platelet counts. In a cross-sectional analysis, using multivariable regression, we related PA measures to serum BDNF levels, adjusting for age, sex, smoking status, platelet count, depression status, and accelerometer wear time. Our study participants (mean age 47±9 years, 50.8% women) spent an average of 22.3 mins/day in moderate-to-vigorous (MV)PA. Most PA variables (steps, MVPA, light activity, and sedentary time) were not related to BDNF levels (p > 0.05). We observed a non-linear trend, where 15-50 mins/week vigorous activity was associated with lower BDNF compared to those with 0 min vigorous activity (β= -0.049±0.024, p = 0.05), but with no significant associations at lower or higher vigorous activity levels. In smokers, MVPA was also associated with lower BDNF levels (β= -0.216±0.079, p = 0.01). Our study reveals that circulating BDNF is not chronically elevated in individuals with higher levels of habitual PA in middle-aged adults from the community and may even be chronically suppressed with higher PA in subgroups, including current smokers. These results do not contradict previous studies demonstrating that circulating BDNF rises acutely after PA.

The accuracy of self-reported physical activity questionnaires varies with sex and body mass index.

BackgroundFactors contributing to the accurate measurement of self-reported physical activity are not well understood in middle-aged adults. We investigated the associations between two self-reported surveys and objectively measured physical activity in middle-aged adults, and the influence of individual and sociodemographic factors on these associations, at different intensities utilizing an observational study design.MethodsParticipants (n = 156) wore a SenseWear Armband™ (SWA) for a continuous seven-day period over the triceps of the left arm, to measure energy expenditure in metabolic equivalents. Participants also completed the Physical Activity Recall questionnaire (PAR) and Active Australia Survey (AAS). Associations were analyzed separately in general linear models for each intensity. The influence of individual and sociodemographic factors was assessed through moderator analyses.ResultsThe PAR and SWA were significantly positively associated at moderate (β = 0.68, 95% CI 0.16–1.20), vigorous (β = 0.36, 95% CI 0.20–0.53), moderate-to-vigorous physical activity (MVPA) (β = 0.52, 95% CI 0.20–0.83), and total METmins (β = 0.63, 95% CI 0.35–0.90), the AAS and SWA were associated at all intensities (moderate (β = 0.41, 95% CI 0.15–0.67), vigorous (β = 0.32, 95% CI 0.19–0.46), MVPA (β = 0.42, 95% CI 0.18–0.65) and total METmins (β = 0.62, 95% CI 0.29–0.96). A significant interaction between the PAR and sex for vigorous-intensity unveiled a weaker association in women. Both surveys tended to under-report physical activity. The largest margins of error were present at light and moderate intensities. For the PAR, participants reported over 20 hours, or 69% less light physical activity than recorded by the SWA per week. For the AAS, participants reported over 7 hours, or 38% less moderate physical activity. Compared to lighter intensities, time spent at a vigorous intensity was overreported by participants with the PAR and AAS by 91 and 43 minutes per week, respectively. The addition of Body Mass Index (BMI) resulted in non-significant interactions between the PAR and SWA for moderate-intensity, and the AAS and SWA for vigorous-intensity; a significant interaction between AAS and BMI indicated that the strength of the association differed by BMI for vigorous-intensity.ConclusionsThe PAR and AAS are not equivalent to the SWA, and sex and BMI may alter the associations between the measures.

Time for change: using implementation intentions to promote physical activity in a randomised pilot trial

Objective: A common barrier to exercise is a perceived lack of time. The current pilot study examined the effects of an implementation intention intervention to enhance exercise self-efficacy, increase confidence to exercise when facing time constraints, and increase physical activity in middle-aged adults (n = 63, aged 35–69). Design: Participants received a pedometer (Fitbit) to objectively measure activity and were randomly assigned to either a control or intervention condition. After a 1-week baseline, the intervention condition received instructions to plan how, where, and when they would add steps to their daily routine to meet their step goal, using personalised schedules and maps. Both groups were contacted nightly via email. Main Outcome Measures: Physical activity (steps and time spent in moderate-to-vigorous activity), goal achievement, exercise self-efficacy, time-relevant exercise self-efficacy and affect. Results: Compared to the control, the intervention condition significantly increased in steps, time spent in moderate-to-vigorous activity, and time-relevant exercise self-efficacy. Goal achievement was related to greater time-relevant exercise self-efficacy and more positive affect at the daily level. Conclusion: Findings suggest that the personalised planning intervention increased physical activity and confidence in achieving physical activity goals under time constraints. Avenues for future directions, especially for producing more sustained effects, are discussed.

PO-158 Association Of Glucose Metabolism and Physical Activity By Chronotype in Elderly Japanese Adults

Objective Chronotype is a trait determining individual circadian preference in behavioral and biological rhythm relative to external light-dark cycle. Although evening chronotype has been reported to be associated with bad glucose control and low physical activity in middle-aged adults, it is not known whether it is true in elderly people. Therefore, the aim of this study was to investigate the relationship between glucose metabolism and physical activity by chronotype (circadian rhythm) in elderly Japanese adults.
 Methods A cross-sectional study was conducted in 178 adults (72 men and 106 women), aged 60-79 years, who were classified into three chronotype groups, ”definitely morning type (DMT)”, “moderately morning type (MMT)” and “neither type (NET)”, based on the Morningness/Eveningness Questionnaire scores (MEQ-Score). All participants were required to report their daily rhythms of behavior, such as meal time and sleep-wake cycle. Additionally, their physical activity were measured by an uniaxial accelerometer (Kenz Lifecorder EX, SUZUKEN, Nagoya, Japan). Energy intake was assessed by a brief self-administered diet-history questionnaire. Blood was drawn for biochemical analysis after an overnight fast.
 Results BMI and serum insulin in the DMT group was significantly higher than MMT and NET groups in male. The DMT group had a significantly shorter time interval between dinner and sleep than the other two groups, both in male and female. After adjustment for covariates (age, smoking and alcohol status, energy intakes, moderate-vigorous physical activity (MVPA) and sleep duration), the BMI, serum insulin, fasting blood glucose (FBG) and HOMA-IR in the DMT group was significantly higher than other groups. However, after adjustment for the time interval between dinner and sleep, the significant difference had disappeared.
 There was significant difference in terms of low-intensity physical activity between male and female. And MVPA in the DMT group, the subjects with low MVPA (<23Mets·hour/week) had higher FBG, serum insulin and HOMA-IR than the subjects with high MVPA (>23Mets·hour/week) in men, but not in women.
 Conclusions This study demonstrated that the DMT group with early sleep-wake lifestyle had higher BMI, FBG, serum insulin and HOMA-IR, specially in elderly Japanese men with low MVPA, but not in women.

A randomised controlled trial and cost-effectiveness evaluation of ‘booster’ interventions to sustain increases in physical activity in middle-aged adults in deprived urban neighbourhoods

More evidence is needed on the potential role of 'booster' interventions in the maintenance of increases in physical activity levels after a brief intervention in relatively sedentary populations. To determine whether objectively measured physical activity, 6 months after a brief intervention, is increased in those receiving physical activity 'booster' consultations delivered in a motivational interviewing (MI) style, either face to face or by telephone. Three-arm, parallel-group, pragmatic, superiority randomised controlled trial with nested qualitative research fidelity and geographical information systems and health economic substudies. Treatment allocation was carried out using a web-based simple randomisation procedure with equal allocation probabilities. Principal investigators and study statisticians were blinded to treatment allocation until after the final analysis only. Deprived areas of Sheffield, UK. Previously sedentary people, aged 40-64 years, living in deprived areas of Sheffield, UK, who had increased their physical activity levels after receiving a brief intervention. Participants were randomised to the control group (no further intervention) or to two sessions of MI, either face to face ('full booster') or by telephone ('mini booster'). Sessions were delivered 1 and 2 months post-randomisation. The primary outcome was total energy expenditure (TEE) per day in kcal from 7-day accelerometry, measured using an Actiheart device (CamNtech Ltd, Cambridge, UK). Independent evaluation of practitioner competence was carried out using the Motivational Interviewing Treatment Integrity assessment. An estimate of the per-participant intervention costs, resource use data collected by questionnaire and health-related quality of life data were analysed to produce a range of economic models from a short-term NHS perspective. An additional series of models were developed that used TEE values to estimate the long-term cost-effectiveness. In total, 282 people were randomised (control = 96; mini booster = 92, full booster = 94) of whom 160 had a minimum of 4 out of 7 days' accelerometry data at 3 months (control = 61, mini booster = 47, full booster = 52). The mean difference in TEE per day between baseline and 3 months favoured the control arm over the combined booster arm but this was not statistically significant (-39 kcal, 95% confidence interval -173 to 95, p = 0.57). The autonomy-enabled MI communication style was generally acceptable, although some participants wanted a more paternalistic approach and most expressed enthusiasm for monitoring and feedback components of the intervention and research. Full boosters were more popular than mini boosters. Practitioners achieved and maintained a consistent level of MI competence. Walking distance to the nearest municipal green space or leisure facilities was not associated with physical activity levels. Two alternative modelling approaches both suggested that neither intervention was likely to be cost-effective. Although some individuals do find a community-based, brief MI 'booster' intervention supportive, the low levels of recruitment and retention and the lack of impact on objectively measured physical activity levels in those with adequate outcome data suggest that it is unlikely to represent a clinically effective or cost-effective intervention for the maintenance of recently acquired physical activity increases in deprived middle-aged urban populations. Future research with middle-aged and relatively deprived populations should explore interventions to promote physical activity that require less proactive engagement from individuals, including environmental interventions. Current Controlled Trials ISRCTN56495859, ClinicalTrials.gov NCT00836459. This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 18, No. 13. See the NIHR Journals Library website for further project information.

A qualitative exploration of social motivational influences in determining the physical activity of 30–60 year old adults

Introduction: Adults over 60–65 years old are a group considered vulnerable to the risks of sedentary lifestyle causing decreased quality of life and poor health. Australian government figures estimate the number of over 65s will reach 8.1 million by 2056, and 11.2 million by 2101. One key opportunity to prevent sedentary lifestyles in older adults is to understand and promote motivation towards physical activity in middle-aged adults. This study qualitatively examined the motivationally relevant behaviours (‘motivational atmosphere’) of key social agents towards physical activity and sedentary lifestyles in adults between 30 and 60 years of age. Methodology: Twenty participants (32–60 years old) of varying activity levels were recruited from local workplaces and a GP referral scheme. Participants took part in semi-structured interviews to examine which social agents affected their motivation towards PA and how/why. A critical rationalist philosophy was deployed in the gathering and analysis of data. Results: Using inductive content analysis, 307 raw themes were coded into 38 categories and five higher dimensions, labelled: (1) providing information and impetus; (2) supporting progress and competence; (3) affiliation and belongingness; (4) logistical considerations; and (5) emotional support. Spouses, close family, work colleagues, GPs and the media were perceived to be highly influential social agents, with many others listed (e.g., personal trainers, local government). Whilst spouses, family and work colleagues influenced motivation through ‘leading-by-example’, ‘reminding/persuading’ and ‘support/encouragement’, GPs and the media were more likely to exert an influence by offering advice, guidance and recommendations, or in some cases ‘sounding-the-alarm-bell’. The consistency of messages from these different agents (media, health professionals, friends/family) was also noted as a key determinant of attitudes and actions. Whilst health was often central to participants’ responses, social interactions and friendships were also key reasons people gave for becoming or staying active (and for being sedentary). Further, there was preliminary evidence that the sources and types of influence changed as a function of current activity level. Conclusion: The results facilitate future interventions by suggesting specific behavioural recommendations in relation to known social agents, as well as guiding theoretical development/ refinement. The findings suggest that interventions should encompass psychological and social as-well-as health considerations, and that health professionals must understand the ‘motivational atmosphere’ of each client. Finally, the findings suggest that future research and modelling should adopt methodologies that better address the complexity inherent in the social determination of motivation.

Community group exercise versus physiotherapist-led home-based physical activity program: barriers, enablers and preferences in middle-aged adults

Background/Purpose: Barriers and enablers of physical activity have been investigated, but it remains unclear what middle-aged adults’ physical activity preferences are. Two physical activity interventions were compared to determine barriers, enablers and preferences for physical activity format in sedentary, community-dwelling 50- to 65-year-olds. Methods: Using mixed methods, 37 Physical Activity at Home (PAAH) participants took part in focus groups at the end of the intervention period and completed the Active Australia Survey (AAS). Participants were divided into three sub-groups: (1) group exercise attendees (GA, n = 14); (2) group exercise non-attendees (GNA, n = 9); and (3) physiotherapist-led home-based physical activity program attendees (HB, n = 14). Focus groups were audio-taped, transcribed, coded and analysed using an inductive thematic approach. Thirty-seven exit telephone calls with GNA were included in the analysis. Results: Cost, self-efficacy, work and carer commitments were major themes identified for GA and GNA. HB participants reported fewer barriers and a number of enablers, including flexibility of the program and physiotherapist instruction. HB and GNA were younger than GA (p< 0.05), more likely to be in paid employment and GNA participants were insufficiently active (p ≤ 0.01). All participants preferred some home-based physical activity, although a variety of formats was indicated. Conclusion: The barriers, enablers and preferences indicate that the physiotherapist-led home-based physical activity program with initial face-to-face contact and telephone support may increase the adoption and maintenance of physical activity in middle-aged adults, particularly for those not interested in, or unable to attend, group exercise.

The association between sedentary leisure and physical activity in middle-aged adults

AimThe aim of this study was to examine the association between time spent in sedentary leisure and physical activity level in mid-aged men and women.MethodsData were from the 2007 HABITAT...

"Booster" interventions to sustain increases in physical activity in middle-aged adults in deprived urban neighbourhoods: internal pilot and feasibility study

BackgroundSystematic reviews have identified a range of brief interventions which increase physical activity in previously sedentary people. A randomised controlled trial is needed to assess whether providing motivational interviewing, three months after giving initial advice, sustains physical activity levels in those who recently became physically active. This paper reports the results of an internal pilot study designed to test the feasibility of the study in terms of recruitment, per protocol delivery of the intervention and retention at three months.MethodsParticipants were: aged 40-64 years; resident in deprived areas of Sheffield, UK; and, had recently become physically active as a result of using a brief intervention following an invitation from a mass mailout. Interventions: Motivational Interviewing 'boosters' aimed at sustaining change in physical activity status delivered face-to-face or over the telephone compared with no further intervention. Outcomes of the feasibility study: recruitment of 60 participants from mailout of 3,300; retention of 45 participants with 3-month follow-up accelerometry measurements; 70% of those randomised to boosters receiving intervention per protocol. Sample size and power were recalculated using the accelerometry data collected.ResultsForty-seven participants were randomised (78% of the feasibility target); 37 participants were retained at three months, 29 with at least four days of accelerometry data (64% of the feasibility target); 79% of those allocated boosters received them per protocol (surpassing the feasibility target). The proposed sample size of 600 was confirmed as appropriate and power is expected to be sufficient to detect a difference between groups.ConclusionsThe main study will continue with the original recruitment target of 600 participants but to ensure feasibility, it is necessary to increase recruitment and improve the numbers of those followed-up who have evaluable data. Strategies will include increasing the number of initial invitations sent out and improving the training of research assistants and participants in the positioning of the accelerometer.Trial RegistrationISRCTN: ISRCTN56495859, ClinicalTrials (NCT): NCT00836459

A randomised controlled trial and cost-effectiveness evaluation of "booster" interventions to sustain increases in physical activity in middle-aged adults in deprived urban neighbourhoods

BackgroundSystematic reviews have identified a range of brief interventions which increase physical activity in previously sedentary people. There is an absence of evidence about whether follow up beyond three months can maintain long term physical activity. This study assesses whether it is worth providing motivational interviews, three months after giving initial advice, to those who have become more active.Methods/DesignStudy candidates (n = 1500) will initially be given an interactive DVD and receive two telephone follow ups at monthly intervals checking on receipt and use of the DVD. Only those that have increased their physical activity after three months (n = 600) will be randomised into the study. These participants will receive either a "mini booster" (n = 200), "full booster" (n = 200) or no booster (n = 200). The "mini booster" consists of two telephone calls one month apart to discuss physical activity and maintenance strategies. The "full booster" consists of a face-to-face meeting with the facilitator at the same intervals. The purpose of these booster sessions is to help the individual maintain their increase in physical activity. Differences in physical activity, quality of life and costs associated with the booster interventions, will be measured three and nine months from randomisation. The research will be conducted in 20 of the most deprived neighbourhoods in Sheffield, which have large, ethnically diverse populations, high levels of economic deprivation, low levels of physical activity, poorer health and shorter life expectancy. Participants will be recruited through general practices and community groups, as well as by postal invitation, to ensure the participation of minority ethnic groups and those with lower levels of literacy. Sheffield City Council and Primary Care Trust fund a range of facilities and activities to promote physical activity and variations in access to these between neighbourhoods will make it possible to examine whether the effectiveness of the intervention is modified by access to community facilities. A one-year integrated feasibility study will confirm that recruitment targets are achievable based on a 10% sample.DiscussionThe choice of study population, study interventions, brief intervention preceding the study, and outcome measure are discussed.Trial RegistrationCurrent Controlled Trials: ISRCTN56495859; ClinicalTrials.gov: NCT00836459.

Randomized trial of a neighborhood environment-focused physical activity website intervention

Objective To evaluate the use of a local neighborhood environment-focused physical activity website and its effects on walking and overall physical activity in middle-aged adults. Method One-hundred and six (72% women) inactive adults aged 52 ± 4.6 years were randomly allocated to receive access to a neighborhood environment-focused website, (Neighborhood group, n = 52) or a motivational-information website (Comparison group n = 54). Participants also received eleven emails over the 26 weeks. Study outcomes were objectively-monitored website use, and self-reported total walking (min/wk), total physical activity (min/wk) and neighborhood walking (min/wk) collected at baseline, 12 and 26 weeks. The study was conducted between August 2005 and February 2006 in Brisbane, Australia. Results Website use was significantly greater among Neighborhood participants ( p = 0.01). Statistically significant increases in walking and total physical activity were observed in both groups. There was also a statistically significant interaction effect for total physical activity, with Neighborhood group participants maintaining more of their initial increase in physical activity at week-26 ( p < 0.05). Further, those in the Neighborhood group who used the website more often reported significantly more walking along the community trail at week-26 ( p = 0.05) compared with those who did not. Conclusions A local neighborhood-environment focused physical activity website was more effective at engaging participants than a motivational-information website. Moreover, its use resulted in meaningful increases in physical activity relative to the comparison website.

Behavioral Evidence of Brain Changes Moderated by APOE and Physical Activity in Middle-aged Adults

Behavioral Evidence of Brain Changes Moderated by APOE and Physical Activity in Middle-aged Adults

The Effects of Age and BMI on Daily Physical Activity in Middle-Aged Adults

2175 According to the Surgeon General's Report on Physical Activity and Health, physical inactivity is more prevalent among the less affluent than more affluent and among older than younger adults. PURPOSE: To determine the amount of physical activity in low socioeconomic status middle-aged adults. METHODS: Physical activity surveys were mailed to a random sample of 10,000 adult Medicaid recipients statewide. The survey included the Godin Leisure-Time Exercise Questionnaire; questions about walking, age, weight, height, and health status. Completed surveys were returned by 687 adults (40 to 64 years). One-way ANOVAs were run with age groups (40–44, 45–49, 50–54, 55–59, 60–64), Body Mass Index (BMI) groups (≤ 24.99, 25–29.99, ≥ 30), and ethnicity groups (Hispanics, African Americans, Caucasians) as dependent variables. RESULTS: Walking speeds were significantly different among age groups (p = 0.005). The female 40–44 age group walked significantly faster (M = 2.37 ± 0.78 mph) than the 60–64 (M = 1.92 ± 0.81 mph) age group, and walked significantly more minutes (M = 44.44 ± 60 min) than the 60–64 (M = 23.88 ± 22 min) age group. The male 40–44 age group walked significantly faster (M = 2.69 ± 0.90 mph) than the 45–49 (M = 2.15 ± 0.84 mph), 50–54 (M = 2.09 ± 0.66 mph), and the 60–64 (M = 1.86 ± 0.54 mph) male age groups. The ≥ 30 BMI group had significantly higher incidences of diabetes than the ≤ 24.99 BMI and the 25–29.99 BMI groups. Weekly moderate intensity exercise amount was also significant (p = 0.011) with the ≤ 24.99 BMI group doing more moderate intensity exercise/week than the ≥ 30 BMI group. African American women weighed significantly more (198.3 ± 0.52 lbs) than Hispanics (175.1 ± 0.53 lbs) and Caucasians (174.9 ± 0.55 lbs), but the BMI for African American women (34.3 ± 0.10) was only significantly greater than Caucasian woman (30.3 ± 0.09). No significant differences in weight and BMI were found among the three Male ethnic groups. CONCLUSIONS: Among low socioeconomic status middle-aged adults, younger age groups spend more time walking and walk faster than older age groups, while, those with a higher BMI have a higher incidence of diabetes, and are less likely to participate in weekly moderate intensity exercise. The BMI is high in all three female ethnic groups, with African American women being the highest. Supported by the Florida Agency for Health Care Administration.

The Effects of Age and BMI on Daily Physical Activity in Middle-Aged Adults

The Effects of Age and BMI on Daily Physical Activity in Middle-Aged Adults