Moderate-intensity Physical Activity Research Articles

Reversal of Soleus Muscle Atrophy in Older Adults: A Non-Volitional Exercise Intervention for a Changing Climate.

The World Health Organization recommends that older adults undertake at least 150 minutes of moderate intensity physical activity over the course of each week in order to maintain physical, mental, and social health. This goal turns out to be very difficult for most community dwelling older adults to achieve, due to both actual and perceived barriers. These barriers include personal health limitations, confinement issues, and self-imposed restrictions such as fear of injury. Climate change exacerbates the confinement issues and injury fears among the elderly. To assist older adults in obtaining the benefits of increased physical activity under increasingly challenging climate conditions, we propose a targeted non-volitional intervention which could serve as a complement to volitional physical activity. Exogenous neuro-muscular stimulation of the soleus muscles is a non-invasive intervention capable of significantly increasing cardiac output in sedentary individuals. Long-term daily use has been shown to improve sleep, reduce bone loss, and reverse age-related cognitive decline, all of which are significant health concerns for older adults. These outcomes support the potential benefit of exogenous neuro-muscular stimulation as a complementary form of physical activity which older adults may find convenient to incorporate into their daily life when traditional forms of exercise are difficult to achieve due to barriers to completing traditional physical activities as a result of in-home or in-bed confinement, perceptual risks, or real environmental risks such as those arising from climate change.

Association Between Physical Activity Amount and Cardiorespiratory Fitness, Sleep Quality, and Health-Related Quality of Life in Patients With Long COVID: A Cross-sectional Study

ObjectiveTo investigate the association between physical activity (PA) amount and gender differences on cardiorespiratory fitness (CRF), sleep quality, and health-related quality of life (HRQoL) in individuals with long COVID. DesignCross-sectional study. SettingAn integrated outpatient clinic for post-COVID-19 at a medical center. ParticipantsConvenience sample of patients (N=264) diagnosed with long COVID. InterventionsNot applicable. Main Outcome MeasuresPA amounts, sleep quality, and HRQoL were measured by the International Physical Activity Questionnaire, Pittsburgh Sleep Quality Index, and the World Health Organization Questionnaire on Quality of Life: Short Form, respectively. CRF was evaluated through graded exercise testing. ResultsThe participants had a mean age of 42.5±13.5 years and a mean duration of post-COVID-19 symptoms of 12.7±6.8 weeks. More than half (n=149, 56.5%) were female patients. Female participants had significantly lower CRF than male participants (P<.05). Older age and higher body mass index were associated with worse CRF and HRQoL (P<.05). Less sitting behavior and greater amounts of vigorous-intensity PA (VPA) or total PA were associated with better CRF (P<.05). In addition, greater total PA and moderate-intensity PA (MPA) were associated with better sleep quality and HRQoL (P<.05), respectively. ConclusionsGender differences were found in CRF among patients with long COVID. Greater self-reported VPA or total PA was associated with better CRF, whereas greater total PA and MPA were associated with better sleep quality and HRQoL, respectively, in patients with long COVID. Further research is needed to explore these associations in longitudinal studies.

A brief bout of moderate intensity physical activity improves preadolescent children's behavioral inhibition but does not change their energy intake.

Children in rural communities consume more energy-dense foods relative to their urban peers. Identifying effective interventions for improving energy intake patterns are needed to address these geographic disparities. The primary aim of this study was to harness the benefits of physical activity on children's executive functioning to see if these improvements lead to acute changes in eating behaviors. In a randomized crossover design, 91 preadolescent (8-10y; M age = 9.48 ± 0.85; 50.5% female; 85.7% White, 9.9% Multiracial, 9.9% Hispanic) children (86% rural) completed a 20-minute physical activity condition (moderate intensity walking) and time-matched sedentary condition (reading and/or coloring) ~ 14 days apart. Immediately following each condition, participants completed a behavioral inhibition task and then eating behaviors (total energy intake, relative energy intake, snack intake) were measured during a multi-array buffet test meal. After adjusting for period and order effects, body fat (measured via DXA), and depressive symptoms, participants experienced significant small improvements in their behavioral inhibition following the physical activity versus sedentary condition (p = 0.04, Hedge's g = 0.198). Eating behaviors did not vary by condition, nor did improvements in behavioral inhibition function as a mediator (ps > 0.09). Thus, in preadolescent children, small improvements in behavioral inhibition from physical activity do not produce acute improvements in energy intake. Additional research is needed to clarify whether the duration and/or intensity of physical activity sessions would produce different results in this age group, and whether intervention approaches and corresponding mechanisms of change vary by individual factors, like age and degree of food cue responsivity.

The Influence of High Intensity Interval Training on Improving Physiological Performance and Social Status in a Sedentary Lifestyle: Review of the Literature

High-Intensity Interval Training (HIIT) has skyrocketed and become the most interesting training trend this year, providing short and effective training sessions to shape the ideal body. The World Health Organization (WHO) has recommended engaging in at least 150-300 minutes of moderate-intensity physical activity at 40-60% of the Maximal Heart Rate (MHR) or opt for 75-150 minutes of high-intensity/vigorous exercise. Physical activity at 60-85% MHR per week can maintain and improve fitness in adults. However, frequently cited challenges to engaging in physical activity are time limitation, low motivation, and non-compliance with established guidelines. This study aims to determine the effect of HIIT on physical fitness, VO2Max, and social status. The study employed a literature review, searching for articles from electronic databases, such as PubMed, ScienceDirect, ProQuest, and Google Scholar. The results showed that HIIT can improve physical fitness and have a significant and efficient positive effect on social status. In conclusion, HIIT training can potentially improve physical fitness, VO2max, and social status in adults with a sedentary lifestyle. Keywords: HIIT, Physical Fitness, VO2Max, Social Status, Sedentary Lifestyle.

The Impact of Physical Activity on Thyroid Health: Insights From Representative Data in Korea.

Thyroid hormones are essential for energy metabolism related to thermogenesis and oxygen consumption. This study evaluated the potential association of thyroid function including thyroid peroxidase antibodies (TPOAb) with physical activity in nationally representative data. This retrospective cohort study used data from the Korean National Health and Nutrition Examination Survey between 2013 and 2015. Physical activity (PA) was assessed using metabolic equivalents based on the validated Korean version of the International Physical Activity Questionnaire Short Form. PA level was categorized into 3 groups of high, moderate, and low. Participants with abnormal thyroid function test, restricted activity, or previous history of thyroid disease were excluded in the study. A total of 5372 participants was finally selected. The free T4 level was lowest in the low PA group, while TSH was not significantly different among the groups. TPOAb titers increased in the following order: moderate PA, low PA, and high PA. After adjustment for confounding factors, moderate PA was associated with a high T4 level and a decrease in TSH and TPOAb with significance. However, there were no significant changes in free T4, TSH, or TPOAb titer in the high PA group. In a subanalysis, females with moderate PA showed a significant decrease in TSH and TPOAb. In both males and females, insulin sensitivity was increased with moderate PA. In obese participants, TSH negatively correlated with PA, and free T4 levels decreased in the low PA. The sensitivity to thyroid hormone did not differ in our study. The present study found an association between thyroid function and moderate PA. Therefore, moderate-intensity PA should be recommended to improve thyroid function.

Physical Activity Levels in Transplant Recipients.

BACKGROUND Physical activity is a key factor in improvement of quality of life. This study aimed to assess the extent of physical activity in solid-organ transplant recipients. MATERIAL AND METHODS The study involved 106 patients, mostly kidney (64.15%) and liver (28.30%) recipients, observed in a Warsaw transplant center. The study group was dominated by women (56.6%), mean age 49.25±14.09 years, the time since transplantation ranged from 1 month to 28 years, with a mean of 93.9±71.83 months. Recipients were educated about physical activity in the immediate post-transplant period and during follow-up visits. The study was conducted in early 2021 and used the long form of the International Physical Activity Questionnaire (IPAQ) validated for Polish patients, consisting of the of 5 parts - physical activity, professional work, travel, housework, recreation, and time spent sitting - containing a total of 27 questions in the main part of the questionnaire and 7 questions in the introductory part determining the typicality of the last 7 days. RESULTS More than half (57.5%) of the transplant recipients reported high levels of physical activity. Patients reported the highest mean physical activity in job-related physical activity (P<0.001). Patients also had high scores for walking and moderate-intensity physical activity, while the lowest mean scores were for leisure-time physical activity, total vigorous-intensity physical activity, and housework-related activity. CONCLUSIONS When undertaking physical activity, patients turn to activities that do not involve intense effort, are less physically demanding, and do not result in high energy expenditure. Employed patients had higher PA levels in all domains.

Associations between physical activity, sedentary behaviour and cognitive domain performance of people living with mild cognitive impairment in the community.

Physical activity is known to positively influence cognitive performance. For adults with mild cognitive impairment (MCI), the relationship between physical activity levels and cognitive performance is unknown. This cross-sectional study aimed to determine if cognitive performance [as measured by the Montreal Cognitive Assessment (MoCA)] of people living in the community with MCI is associated with their physical activity levels or sedentary behaviour. ActivPAL™ accelerometers were used to objectively measure physical activity and sedentary behaviour for seven full days. Cognitive performance was measured using the MoCA. No involvement other than as research participants RESULTS: Eighty-two participants from the Balance on the Brain randomised controlled trial were included. Most participants were retired (88%), with 33 (40%) reporting a fall in the last year. The median MoCA score was 24 (IQR 22-26). Participants achieved a mean of 6296 (±2420) steps per day and were sedentary for 10.6 (±2) hours per day. The only physical activity outcomes that had a fair, positive correlation were moderate- to vigorous-intensity physical activity measures of total stepping time and total number of steps (with a cadence of ≥100 steps/min) with the orientation MoCA domain score (r(82) =0.36, p≤0.001 and r(82) =0.37, p≤0.001, respectively). Higher total sedentary time had a weak, positive correlation with better visuospatial/executive performance (r(82) =0.23, p= 0.041). The orientation outcomes remained significant when analysed in an adjusted logistic regression model. This study found that performance in the MoCA orientation domain had a fair-positive correlation with moderate-intensity physical activity (i.e., stepping time and step count with a cadence of ≥100 steps/min) as measured by a thigh-worn accelerometer for community-dwelling older adults with MCI. When considering the relationship between cognitive domains and sedentary behaviour, consideration may be needed regarding whether cognitive enhancing activities (such as crosswords and other brain games) are being performed, which may confound this relationship. Further investigation is required to confirm these results.

Effect of a 12-Week Walking Program Monitored by Global Physical Capacity Score (GPCS) on Circulating Cell-Free mtDNA and DNase Activity in Patients with Irritable Bowel Syndrome.

Irritable bowel syndrome (IBS) involves low-grade mucosal inflammation. Among the various approaches capable of managing the symptoms, physical activity is still under investigation. Despite its benefits, it promotes oxidative stress and inflammation. Mitochondria impacts gut disorders by releasing damage-associated molecular patterns, such as cell-free mtDNA (cf-mtDNA), which support inflammation. This study evaluated the effects of a 12-week walking program on the cf-mtDNA and DNase in 26 IBS and 17 non-IBS subjects. Pro- and anti-inflammatory cytokines were evaluated by ELISA. Digital droplet PCR was used to quantify cf-mtDNA; DNase activity was assessed using a single radial enzyme diffusion assay. PCR-RFLP was used to genotype DNASE1 rs1053874 SNP. Significantly lower IL-10 levels were found in IBS than in non-IBS individuals. Exercise reduced cf-mtDNA in non-IBS subjects but not in IBS patients. DNase activity did not correlate with the cf-mtDNA levels in IBS patients post-exercise, indicating imbalanced cf-mtDNA clearance. Different rs1053874 SNP frequencies were not found between groups. The study confirms the positive effects of regular moderate-intensity physical activity in healthy subjects and its role in cf-mtDNA release and clearance. Walking alone might not sufficiently reduce subclinical inflammation in IBS, based on imbalanced pro- and anti-inflammatory molecules. Prolonged programs are necessary to investigate their effects on inflammatory markers in IBS.

The association between intensity-specific physical activity and the number of multiple chronic diseases among Chinese elderly: A study based on the China Health and Retirement Longitudinal study (CHARLS)

BackgroundWith ageing, the elderly are facing a complex situation where multiple chronic diseases coexist. This paper aims to investigate the effect of intensity-specific physical activity on the number of multiple chronic diseases in the elderly. MethodsOur data came from wave 4 of the China Health and Retirement Longitudinal Survey (CHARLS), which involved 10,341 residents aged ≥ 60 years. The intensity-specific physical activity was divided into two categories: moderate-intensity physical activity (MPA) lasting ≥ 150 min/week and vigorous-intensity physical activity (VPA) lasting ≥ 75 min/week. Data on 14 types of chronic diseases were collected. Propensity score matching (PSM) with controlling nine confounding factors were used to analyse the effects of intensity-specific physical activity. ResultsAmong 10,341 samples, 40.12% of the elderly often participated in MPA and 25.72% participated in VPA. The PSM results showed that performing 150 min/week of MPA leads to 0.0675(P<0.05) fewer multiple chronic diseases than not achieving this standard, and VPA up to 75 min/week leads to 0.0785(P<0.05) fewer multiple chronic disease than that does not meet this criterion. Additionally, VPA is more effective than MPA. ConclusionBoth MPA of at least 150 min/week and VPA of at least 75 min/week can significantly reduce the number of multiple chronic diseases in elderly. Elderly people should increase their exercise intensity as much as possible while ensuring safety.

Identifying app components that promote physical activity: a group concept mapping study.

Digital interventions are a promising avenue to promote physical activity in healthy adults. Current practices recommend to include end-users early on in the development process. This study focuses on the wishes and needs of users regarding an a mobile health (mHealth) application that promotes physical activity in healthy adults, and on the differences between participants who do or do not meet the World Health Organization's recommendation of an equivalent of 150 minutes of moderate intensity physical activity. We used a mixed-method design called Group Concept Mapping. In a first phase, we collected statements completing the prompt "In an app that helps me move more, I would like to see/ do/ learn the following…" during four brainstorming sessions with physically inactive individuals (n=19). The resulting 90 statements were then sorted and rated by a new group of participants (n=46). Sorting data was aggregated, and (dis)similarity matrices were created using multidimensional scaling. Hierarchical clustering was applied using Ward's method. Analyses were carried out for the entire group, a subgroup of active participants and a subgroup of inactive participants. Explorative analyses further investigated ratings of the clusters as a function of activity level, gender, age and education. Six clusters of statements were identified, namely 'Ease-of-use and Self-monitoring', 'Technical Aspects and Advertisement', 'Personalised Information and Support', 'Motivational Aspects', 'Goal setting, goal review and rewards', and 'Social Features'. The cluster 'Ease-of-use and Self-monitoring' was rated highest in the overall group and the active subgroup, whereas the cluster 'Technical Aspects and Advertisement' was scored as most relevant in the inactive subgroup. For all groups, the cluster 'Social Features' was scored the lowest. Explorative analysis revealed minor between-group differences. The present study identified priorities of users for an mHealth application that promotes physical activity. First, the application should be user-friendly and accessible. Second, the application should provide personalized support and information. Third, users should be able to monitor their behaviour and compare their current activity to their past performance. Fourth, users should be provided autonomy within the app, such as over which and how many notifications they would like to receive, and whether or not they want to engage with social features. These priorities can serve as guiding principles for developing mHealth applications to promote physical activity in the general population.

One leg testing in hip and knee osteoarthritis: A comparison with a two-leg oriented functional outcome measure and self-reported functional measures

ObjectiveTo compare the responsiveness of two unilateral lower-limb performance-based tests, the one-leg rise test and the maximal step-up test, with the bilateral 30-second chair-stand test and the self-reported measure of physical function (HOOS/KOOS). Specific aims were to evaluate responsiveness, floor/ceiling effect and association between the instruments. MethodData was included from 111 participants, mean age 61.3 years (8.3), with clinically verified hip or knee osteoarthritis, who reported less than 150 minutes/week of moderate or vigorous intensity physical activity. Responsiveness, how well the instruments captured improvements, was measured as Cohen’s standardised mean difference (SMD) for effect size, and was assessed from baseline to 12 months following a physical activity intervention. Other assessments were floor and ceiling effects, and correlations between tests. ResultsThe maximal step-up test had an effect size of 0.57 (95% CI 0.37, 0.77), the 30-second chair-stand 0.48 (95% CI 0.29, 0.68) and the one-leg rise test 0.12 (95% CI -0.60, 0.31). The one-leg rise test had a floor effect as 72% of the participants scored zero at baseline and 63% at 12 months. The correlation between performance-based tests and questionnaires was considered to be minor, (r= 0.188 to 0.226) (p=0.018 to 0.048). ConclusionThe unilateral maximal step-up test seems more responsive to change in physical function compared to the bilateral 30-second chair-stand test, although the tests did not differ statistically in effect size. The maximal step-up test provides specific information about each leg for the individual and allows for comparison between the legs.

Associations between objectively measured overall and intensity-specific physical activity and phase angle in older adults

Phase angle (PhA) is an indicator of cellular health and is positively associated with overall physical activity (PA). However, varied associations between different intensities of PA and PhA by body segment in older populations remain unexplored. We investigated the associations between overall and different intensities of PA and upper-, lower-, and whole-body PhA in older adults. Overall exposure to light-intensity (LPA), moderate-intensity (MPA), and vigorous-intensity physical activity (VPA) was assessed using a triaxial accelerometer (GT3X + , ActiGraph). The outcome variables were upper-, lower-, and whole-body PhA measured using bioelectrical impedance analysis (MC-780MA, TANITA). Multiple linear regression helped examine the associations between the exposure and outcome variables after adjusting for age, gender, body mass index, and accelerometer wear time. A cross-sectional analysis involved 166 community-dwelling older participants (mean age = 72.1 ± 5.5 years; 78.3% women). Overall PA was associated with larger upper- (B: 0.057, 95% confidence interval [CI] 0.018–0.095) and whole-body PhA (B: 0.044, 95% CI 0.006–0.081). LPA was associated with larger upper-body PhA (B: 0.059, 95% CI 0.017–0.101), and MPA was associated with larger lower- (B: 0.273, 95% CI 0.128–0.419) and whole-body PhA (B: 0.141, 95% CI 0.002–0.280). VPA and PhA were not associated. Future interventions targeting PhA in older adults should consider the differential impact of PA intensity on various body segments of the PhA.

Physical Activity After Heart Surgery: Associations With Psychosocial and Sleep Factors.

Heart surgery is an effective intervention for managing heart disease, the leading cause of death globally. After surgery, physical activity is key to improving patients' quality of life and decreasing mortality, but patients are frequently physically inactive after heart surgery. This cross-sectional pilot study aimed to examine how psychosocial and sleep factors influenced physical activity in patients after heart surgery. The mediating role of sleep factors between psychosocial factors and physical activity was also examined. Thirty-three patients who had undergone heart surgery were recruited. Psychosocial and sleep factors and physical activity were measured using an online survey and a wrist-worn ActiGraph for 7 days and nights. The participants had heart surgery an average of about 7 years previously. They exceeded the recommended 150 minutes per week of moderate-intensity physical activity for Americans; however, 64% of them showed poor sleep quality (Pittsburgh Sleep Quality Index >5). Higher anxiety and depressive symptoms, lower self-efficacy, and greater sleep disturbances were associated with lower physical activity. Moreover, self-efficacy, sleep duration, sleep disturbance, sleep efficiency, and wake after sleep onset were predictors for physical activity. No mediating role of sleep factors was observed between psychosocial factors and physical activity. Psychosocial and sleep factors should be considered when developing and implementing physical activity strategies for patients after heart surgery. Researchers should examine the relationships among the study variables with larger samples of postsurgical cardiac patients during different periods after heart surgery.

Investigation of the Effect of Ramadan Fasting on Sleep Patterns, Nutritional Characteristics, and Physical Activity Levels in Young Individuals Doing Active Sports

Fasting during Ramadan causes significant changes in important features of human life, such as sleep behaviors, nutrition, and physical activity. This study aimed to investigate the effects of Ramadan fasting on sleep patterns, nutritional characteristics, and physical activity levels in young individuals doing active sports. Twenty-six individuals (14 males-12 females) between the ages of 19-25 and doing active sports participated in the study voluntarily. In the study, the athletes' sleep patterns, nutrition, and physical activity characteristics were determined using a questionnaire. Participants answered a questionnaire about their sleep patterns, nutritional characteristics, and physical activity levels one week before and during the first week of Ramadan. Comparisons between before and Ramadan answers were made by paired t-tests. Wilcoxon’s z was calculated for comparisons between the non-parametric variables. According to the statistical comparisons, the number of workouts per week, and daily training time, were significantly (p&lt;0.05) decreased during Ramadan. In addition, it has been determined that the sleeping and waking hours have changed. It is seen that there is no statistically significant difference in total sleep times. There was no significant difference was found in the high-intensity, moderate-intensity physical activity and sitting times of the athletes (p&gt;0.05). Significant decreases were found in walking and total calorie (MET) parameters (p&lt;0.001). Moreover, no significant difference was found in the total calorie, carbohydrate, fat, protein, and liquid consumption. Ramadan fasting was affected by the number of workouts per week, daily training number, bedtime, waking-up time, walking, and total calorie (MET) parameters.

Abstract P423: Individual and Combined Effects of Diet, Exercise, and Metformin on Risk of Microvascular Complications in Older Type 2 Diabetes Patients: Post-Hoc Analysis of Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial Data

Introduction: Microvascular complications are a major burden on the health of type 2 diabetes (T2D) patients. The literature has yielded mixed results regarding synergistic effects of common diabetes treatments (i.e., metformin, exercise, and diet) on microvascular complication risk. Some trials demonstrated that the combination of metformin and exercise diminished beneficial effects. We aimed to explore this ambiguity in findings by examining the effects of metformin, exercise, and diet on microvascular complication risk over time among T2D patients in the U.S. and Canada. Hypothesis: We hypothesize that the combined effects of metformin, exercise, and diet would be better than their individual effects on microvascular complication risk. Methods: We analyzed data from 923 participants [mean age: 62.6; 39.2% female; mean years with diabetes: 10.7] of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) (2003-2009) trial. Adequate exercise was defined as &gt; 150 mins of moderate-intensity physical activity per week. Metformin use was defined as yes vs. no. An adequate diet score was ≤ 2.4 of the summary fat intake score (range: 0 - 5). We defined composite outcomes for microvascular complications (i.e., nephropathy, retinopathy, and neuropathy) based on several measurements including serum creatinine doubling, decrease in estimated glomerular filtration ratio (≥ 20 ml/min/1.73 m2 decrease), vision loss, Michigan Neuropathy Screening Instrument. We performed longitudinal analysis with synergy factor (SF) approach using multinomial logistic regression models adjusted for sex, diabetes years, education, alcohol, treatment arm, and baseline outcome. Results: Among individuals with poor diet score, those taking metformin but not adequate exercise had an odds ratio of 1.12 (95% CI: 0.65 - 1.94, p = 0.68) for microvascular complication. Those not taking metformin but had adequate exercise had an odds ratio of 2.71 (95% CI: 1.12 - 6.59, p &lt; 0.05). However, taking metformin and having adequate exercise produced an odds ratio of 0.90 (95% CI: 0.49 - 1.67, p = 0.75), which was 0.30 times less than the predicted odds of the joint effect (SF = 0·30, 95% CI: 0 - 0.59, p = 0·05). Individuals with an adequate diet, adequate exercise, and taking metformin had an odds ratio of 0.85 (95% CI: 0.48 - 1.49, p = 0.57). However, we did not find these associations to be statistically significant. A similar pattern holds for individual microvascular complication outcomes. Conclusion: Additional randomized controlled trials are needed to confirm the potential additive beneficial effect of metformin, adequate exercise, and adequate diet combination over their individual effects on odds of microvascular complications.

Abstract P222: Prolonged Sitting Time Was Associated With Central Obesity-Related Parameters Among Hong Kong Chinese Women: A Cross-Sectional Study

Introduction: The evidence concerning the association between sitting time and central obesity in Hong Kong Chinese women was still scarce. Hypothesis: Prolonged sitting time was positively associated with increased waist circumference (WC), hip circumference, and trunk body fat percentage; and also larger waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) among Hong Kong Chinese women. Methods: Data were extracted from a cohort study named “Migraine Exposures and Cardiovascular Health in Hong Kong Chinese Women”. The baseline data (2019-2021) were used for analysis. Sitting time and physical activity level were measured by the International Physical Activity Questionnaire short form. Body weight, height, WC, hip circumference, and trunk body fat percentage were measured according to standard protocol. The WHR and WHtR were then calculated. Central obesity was defined as WC ≥80.0 cm. Subgroup analysis were conducted based on age (≥60 and &lt;60 years) and whether participants met the recommended physical activity guidelines (≥75 minutes/week of vigorous physical activity or ≥150 minutes/week of moderate-intensity physical activity). Results: A total of 3,280 Hong Kong Chinese women aged 56.46±8.30 years were included. The overall prevalence of central obesity was 32.26% (1,058 of 3,280). Participants with central obesity had a longer sitting time compared to those without (8.01±3.27 vs. 7.60±3.25 hours/day, P =0.001). After adjusting for age, education, living alone or with family members, drink, smoking, and physical activity, each additional hour of daily sitting time was significantly correlated with 0.678 unit increase in hip circumference ( P &lt;0.001), 0.003 unit increase in WHR ( P =0.004), 0.004 unit increase in WHtR ( P =0.002), and 5.485 unit increase in trunk body fat percentage ( P &lt;0.001). With a one-unit augment in sitting time, the odds of being central obesity was 1.187-fold higher ( 95% CI= 1.108-1.587, P &lt;0.001). In subgroup analysis, the sitting time-central obesity association was significant in women aged ≥60 years ( OR =1.192, 95% CI= 1.085-1.309, P &lt;0.001). Whereas, such positive association existed both in women who did not meet the physical activity guidelines ( OR =1.413, 95% CI =1.011-1.977, P =0.043, 8+ vs. &lt;8 hours/day) and those who adhered to the guidelines ( OR =1.326, 95% CI =1.108-1.587, P =0.002, 8+ vs. &lt;8 hours/day). Conclusions: Longer sitting time exhibited a positive relationship with central obesity-related indices in terms of WC, hip circumference, trunk body fat percentage, WHR and WHtR. The significant association between sitting time and central obesity was only observed in older women, but it remained consistent and robust regardless of whether the subjects followed the recommended physical activity guidelines.

Benefits of physical activity self-monitoring in patients with haemophilia: a prospective study with one-year follow-up.

Activity wristbands have been shown to be effective in relation to self-monitoring activity levels and increasing exercise adherence. However, previous reports have been based on short-term follow-ups in people with haemophilia (PWH). (1) To evaluate compliance with physical activity (PA) recommendations in PWH during a 1-year follow-up period using activity wristbands to record daily steps and intensity; (2) To determine the effect of PA self-monitoring on clinical outcomes. A prospective observational study was conducted in 27 adults with severe haemophilia undergoing prophylactic treatment. The Fitbit Charge HR was used to track daily PA for an entire year. The participants were encouraged to try to reach a goal of 10,000 steps/day and to track their progress. The pre- and post-evaluation included quality of life (A36 Hemophilia-QoL Questionnaire), joint health (Haemophilia Joint Health Score), functionality (Timed Up and Go test), and muscle strength. A total of 323.63 (95%CI: 194-364) valid days (i.e.,>2000 steps) were recorded. The annual average number of steps per day taken by participants was 10,379. Sixteen (59%) PWH reached 10,000 steps/day at baseline and 17 (63%) at 1 year follow-up, with no significant differences (x2=.33; p=.56). A statistically significant improvement was observed in daily moderate activity time (p=.012) and in the 'physical health' quality of life subscale (mean difference: 2.15 points; 95%CI:.64-3.65; p=.007). Our results suggest that patients with severe haemophilia who self-managed their PA can improve their long-term quality of life in the domain of physical health and also the daily time spent in moderate-intensity PA.

Impact of immersive virtual reality games or traditional physical exercise on cardiovascular and autonomic responses, enjoyment and sleep quality: a randomized crossover study

Objectives: To assess the potential of immersive virtual reality (IVR) in achieving moderate exercise intensity, and 2) to examine the acute effects of two IVR exergame sessions (BOXVR and Beat Saber), comparing them with the impact of traditional exercise on heart rate variability (HRV), perceived effort, delayed onset muscle soreness, motivation, and sleep. Materials and methods: A crossover design was used. The participants (n = 22) randomly performed two sessions of IVR and one session of moderate intensity physical activity, each session lasting 30 min. Heart Rate (HR) and HRV, Perceived Exertion Scale, Intrinsic Motivation Inventory, sleep quality, and perceived pain, were evaluated. Results: The cardiac response to the activities was significantly higher when participants performed traditional physical activity as compared to the BOXVR and Beat Saber games. Traditional training provided a different HRV response as compared to Beat Saber (LnRMSSD, p = 0.025; SDNN, p = 0.031). Although the sessions were planned for moderate intensity, BOXVR generated a moderate intensity (49.3% HRreserve), Beat Saber (29.6% HRreserve) a light one, and the Circuit session, a vigorous one (62.9% HRreserve). In addition, traditional training reported higher perceived exertion and pain with less enjoyment. Differences were observed between the exergames. BOXVR resulted in a lower cardiac response (HRmax and HRmean), and a higher perception of exertion and pain at 72 h. The sleep variables analyzed were not altered by any of the sessions. Conclusions: BOXVR and traditional training can lead to moderate intensity physical activity. However, traditional training could result in lower adherence to physical exercise programs, as it was perceived as more intense and less enjoyable.

Barriers to Exercise in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease: A Patient Survey.

Although adequate physical activity is an essential component of treatment for metabolic dysfunction-associated steatotic liver disease (MASLD), the majority of people with MASLD do not engage in regular exercise and lead sedentary lifestyles. We aimed to identify perceived barriers to exercise and to examine awareness about the role of exercise in the treatment of MASLD. Individuals aged 18 years and above were recruited from a hepatology outpatient clinic. MASLD severity was assessed using controlled attenuation parameter (CAP) and transient elastography (TE) determined liver stiffness measurement (LSM) for the severity of hepatic steatosis and fibrosis, respectively. An online questionnaire was administered to record self-reported exercise patterns, barriers to exercise, and knowledge regarding effectiveness of different types of exercise for MASLD. Eighty-one participants (57% female) with a mean age of 55.3 ± 13.4 years and a mean body mass index (BMI) of 33.8 ± 6.4 answered the questionnaire. The mean CAP score was 335.7 ± 47.8 dB/m, and the median LSM was 12.45 kPa. While most patients (83%) considered MASLD to be a serious health concern, 73% did not achieve the recommended exercise levels of ≥ 150 min of moderate-intensity physical activity per week, and 54% were unsure about the role of exercise in the treatment of MASLD. Commonly reported barriers to exercise included physical and mental health issues (57%), lack of time (43%), lack of enjoyment in exercising (31%), fatigue caused by exercise (24%), and others (25%). Most participants with MASLD were unaware of the role of exercise as a potential treatment option and were not achieving recommended exercise levels. Inadequate time, physical and mental health problems, lack of enjoyment in exercise, and fatigue were major barriers.

Mapping Lifestyle Interventions for Gestational Diabetes Prevention: A Scoping Review.

The purpose of this study was to conduct a scoping review to map intervention, sample, and physiologic measurement characteristics of lifestyle interventions for gestational diabetes mellitus (GDM) prevention. A total of 19 studies met selection criteria from 405 articles screened (PubMed, Web of Science). No studies were US-based (47% multi-site), and all were delivered in clinical settings. The most targeted nutrition components were low carbohydrate intake (sugar rich foods/added sugars, low glycemic index), low fat intake (mainly low-fat meat, dairy, and saturated fat), and increased fruits and vegetables. Many studies promoted 150min/week moderate-intensity physical activity. Only two studies provided supervised physical activity sessions. Dietitians and nurses were the most common implementers. Samples were characterized as adults with obesity (mean age 31yr, BMI 31kg/m2). Asian populations were predominantly studied. Four studies used theoretical frameworks (75% of which used Social Cognitive Theory). GDM diagnostic criteria set forth by the American Diabetes Association were the most widely used. Insulin sensitivity was commonly assessed via fasting indices. There was a lack of multi-disciplinary, multi-level, and theory-based lifestyle interventions for reducing GDM risk. Addressing these gaps and prioritizing high-risk populations in the US with measurement of traditional and novel biomarkers will advance the field.