Exercise Research Articles

Association of physical activity and sitting time with tobacco and alcohol use in 222,495 adolescents from 66 countries

BackgroundThe prevalence of tobacco and alcohol use among adolescents is alarming, and these substances are among the leading risk factors for current and future health among adolescents. Physical activity has the potential to help prevent substance use among adolescents. The objective of this study was to evaluate the association between physical activity, modes of transportation to or from school, and sitting time with tobacco and alcohol use among 222,495 adolescents.MethodsThis cross-sectional study used data from national surveys conducted in 66 countries, obtained through the Global School-based Student Health Survey, and included adolescents aged 11 to 17 years. Information on physical activity, transportation to or from school, sitting time, and tobacco and alcohol use was collected through self-report questionnaires. Generalized linear models were employed to estimate the associations between these variables.ResultsThe analysis, adjusted for sex, age, and region, revealed that being physically active was associated with lower odds of smoking (OR: 0.86, 95%CI: 0.83–0.89), alcohol use (OR: 0.74, 95%CI: 0.72–0.76), binge drinking (OR: 0.66, 95%CI: 0.62–0.69), and drunkenness (OR: 0.85, 95%CI: 0.83–0.88) compared to inactivity. Insufficiently active participants also had lower odds of tobacco use (OR: 0.83, 95%CI: 0.80–0.85), alcohol use (OR: 0.77, 95%CI: 0.75–0.79), binge drinking (OR: 0.91, 95%CI: 0.87–0.96), and drunkenness (OR: 0.88, 95%CI: 0.85–0.90) compared to inactive participants. Additionally, active transportation to or from school was associated with lower odds of tobacco use (OR: 0.97, 95%CI: 0.95–0.99), alcohol use (OR: 0.94, 95%CI: 0.92–0.96), and binge drinking (OR: 0.78, 95%CI: 0.75–0.81) compared to those using passive transportation. Participants with acceptable sitting time, however, were more likely to use tobacco (OR: 1.48, 95%CI: 1.45–1.52), use alcohol (OR: 1.68, 95%CI: 1.64–1.72), binge drink (OR: 1.68, 95%CI: 1.62–1.75), and experience drunkenness (OR: 1.66, 95%CI: 1.62–1.69) compared to those with excessive sitting time.ConclusionBeing physically active, even at insufficient levels, may have beneficial effects on tobacco and alcohol use in adolescents. Acceptable sedentary time, on the other hand, was positively associated with tobacco and alcohol use.

Predictive Utility of the Multi-Process Action Control Framework for Self-Reported and Device-Measured Physical Activity Behavior of Adolescents

Understanding the correlates of physical activity behavior is imperative for informing the development of interventions to address the low rates of physical activity guideline adherence among adolescents living in the United States. This cross-sectional study examined the predictive utility of the Multi-Process Action Control (M-PAC) framework for explaining self-reported and device-measured physical activity behavior among a Hispanic-majority sample of adolescents. A total of 1849 high school students (mean age = 16.0 ± 1.22 SD years; 52.3% women; 87.8% Hispanic) enrolled in one school district in south-central Texas completed a survey including instruments to assess M-PAC framework constructs (instrumental and affective attitudes, perceived capability and opportunity, behavioral regulation, habit, identity) and moderate-to-vigorous physical activity (MVPA) behavior. A subsample (n = 435) wore accelerometers for seven days. The results from robust linear regression models revealed role identity and habit were significant predictors of self-reported MVPA. Role identity was a significant predictor of accelerometer-derived daily MVPA and raw acceleration in the most active hour but not daily raw acceleration. The findings indicated reflexive processes are robust predictors of adolescent physical activity and should be the focus of interventions designed to promote adoption and maintenance of physical activity during this developmental life stage.

Should we work smarter or harder for our health? A comparison of intensity and domain-based time-use compositions and their associations with cognitive and cardiometabolic health

Abstract BACKGROUND Each day is made up of a composition of ‘time-use behaviours’. These can be classified by their intensity (e.g., light or moderate-vigorous physical activity (PA)) or domain (e.g., chores, socialising). Intensity-based time-use behaviours are linked with cognitive function and cardiometabolic health in older adults, but it is unknown whether these relationships differ depending on the domain (or type/context) of behaviour. METHODS This study included 397 older adults (65.5 ± 3.0 years, 69% female, 16.0 ± 3.0 years education) from Adelaide and Newcastle, Australia. Time-use behaviours were recorded using the Multimedia Activity Recall for Children and Adults (MARCA), cognitive function was measured using the Addenbrooke’s Cognitive Examination III (ACE-III) and Cambridge Neuropsychological Test Automated Battery (CANTAB), and systolic and diastolic blood pressure, total cholesterol and waist-hip ratio were also recorded. Two 24-hr time-use compositions were derived from each participant’s MARCA, including a four-part intensity composition (sleep, sedentary behaviour, light and moderate-vigorous PA) and an eight-part domain composition (Sleep, Self-Care, Chores, Screen Time, Quiet Time, Household Administration, Sport/Exercise, and Social). RESULTS Linear regressions found significant associations between the domain composition and both ACE-III (p=0.010) and waist-hip ratio (p=0.009), and between the intensity composition and waist-hip ratio (p=0.025). Isotemporal substitution modelling demonstrated that the domains of sedentary behaviours and PA impacted their associations with ACE-III, whilst any PA appeared beneficial for waist-hip ratio. CONCLUSIONS Findings suggest the domain of behaviour should be considered when aiming to support cognitive function, whereas for cardiometabolic health, it appears sufficient to promote any type of PA

Impact of a Clinical Placement on Pre-Professional Health Students Perceived Knowledge, Skills, and Confidence in the Delivery of Behaviour Change and Physical Activity Support

Background: Clinical placements may provide an appropriate setting for health professional students to learn and apply skills for supporting clients to improve their physical activity. Methods: A mixed methods study was conducted with pre-professional health students completing clinical placement at one of two interprofessional community clinics. Surveys assessed student self-reported perceived skills, knowledge, and confidence for behaviour change and physical activity support pre- and post-placement (unmatched n=40). Interviews were conducted with students (n=18) and clinical educators (n=4). Change in student knowledge, skills, and confidence were assessed using non-parametric tests; qualitative data underwent inductive thematic analysis. Results: Post-placement, unmatched participants perceived knowledge and understanding (p = 0.017), skills (p = 0.001), and confidence (p = 0.004) in behaviour change significantly increased. Perceived confidence in providing physical activity behavior change support for low-risk (p = 0.022) and complex conditions (p = 0.009) significantly improved. Qualitative data emphasised the importance of clinical educators and direct clinical experiences in preparing students for future practice. Conclusion: Student-facilitated interprofessional clinical placements may be important for developing pre-professional knowledge, skills, and confidence in delivering behaviour change and physical activity support. Further exploration of clinical placement opportunities for strengthening pre-professional health students training in physical activity promotion and behaviour change is recommended.

Strategies for minimizing muscle loss during use of incretin-mimetic drugs for treatment of obesity.

The rapid and widespread clinical adoption of highly effective incretin-mimetic drugs (IMDs), particularly semaglutide and tirzepatide, for the treatment of obesity has outpaced the updating of clinical practice guidelines. Consequently, many patients may be at risk for adverse effects and uncertain long-term outcomes related to the use of these drugs. Of emerging concern is the loss of skeletal muscle mass and function that can accompany rapid substantial weight reduction; such losses can lead to reduced functional and metabolic health, weight cycling, compromised quality of life, and other adverse outcomes. Available evidence suggests that clinical trial participants receiving IMDs for the treatment of obesity lost 10% or more of their muscle mass during the 68- to 72-week interventions, approximately equivalent to 20 years of age-related muscle loss. The ability to maintain muscle mass during caloric restriction-induced weight reduction is influenced by two key factors: nutrition and physical exercise. Nutrition therapy should ensure adequate intake and absorption of high-quality protein and micronutrients, which may require the use of oral nutritional supplements. Additionally, concurrent physical activity, especially resistance training, has been shown to effectively minimize loss of muscle mass and function during weight reduction therapy. All patients receiving IMDs for obesity should participate in comprehensive treatment programs emphasizing adequate protein and micronutrient intakes, as well as resistance training, to preserve muscle mass and function, maximize the benefit of IMD therapy, and minimize potential risks.

Sex differences in the association between the muscle quality index and the incidence of depression: A cross-sectional study

BACKGROUND Depression presents significant challenges to mental health care. Although physical activity is highly beneficial to mental and physical health, relatively few studies have conducted on the relationship between them. AIM To investigate the association between muscle quality index (MQI) and incidence of depression. METHODS The data used in this cross-sectional study were obtained from the 2011-2014 National Health and Nutritional Examination Survey, which included information on MQI, depression, and confounding factors. Multivariable logistic regression models were employed, while taking into account the complex multi-stage sampling design. A restricted cubic spline model was utilized to investigate the non-linear relationship between the MQI and depression. Additionally, subgroup analyses were performed to identify influential factors. RESULTS The prevalence of depression in this population was 8.44%. With the adjusted model, the MQI was associated with depression in females (odds ratio = 0.68, 95% confidence interval: 0.49-0.95) but not in males (odds ratio = 1.08, 95% confidence interval: 0.77-1.52). Restricted cubic spline adjustment of all covariates showed a significant negative non-linear relationship between depression and the MQI in females. The observed trend indicated an 80% decrease in the risk of depression for each unit increase in MQI, until a value of 2.2. Subsequently, when the MQI exceeded 2.2, the prevalence of depression increased by 20% for every unit increase in the MQI. Subgroup analyses further confirmed that the MQI was negatively associated with depression. CONCLUSION The MQI was inversely correlated with depression in females but not males, suggesting that females with a higher MQI might decrease the risk of depression.

Caregiving-Related Depression Increases Neuroinflammation in Spousal Caregivers to Individuals with Cognitive Impairment: A Longitudinal Study

Abstract Background The caregiving burden of the spousal caregivers (SCGs) to individuals with cognitive impairment poses public health challenges with adverse psychosocial and physiological effects. However, few studies have investigated the neurobiological impact of caregiving, particularly through the investigation of neuroinflammation and neurodegeneration. Methods Using data from a longitudinal cohort at Chungnam National University Hospital, the relationship between caregiving burden, neuroinflammation and neurodegeneration was examined in 38 older adult couples over a 16-month period. Caregiving burden was assessed through a multifaceted approach. For factors related to the care recipient, we assessed cognitive function and neuropsychiatric symptoms. Factors regarding the SCGs included the measurement of perceived depression. Glial fibrillary acidic protein (GFAP) was used as a plasma biomarker for neuroinflammation and neurofilament light chain (NfL) for neurodegeneration. Regression analyses were adjusted for age, sex, apolipoprotein E status, follow-up interval, vascular risk factors, and physical activity. Results Changes in depression among SCGs were significantly correlated with increased GFAP levels (p = 0.003), indicating that greater depressive symptoms during caregiving are associated with increased neuroinflammation. In contrast, no significant correlations were found between changes in cognitive function or neuropsychiatric symptoms in care recipients and the plasma biomarker levels of SCGs. Additionally, there was no significant association between changes in depression and NfL levels in SCGs. Conclusions The psychological stress experienced by SCGs while caring for partners with cognitive impairment actively contributes to neuroinflammation, a well-known risk factor for various diseases. This study emphasizes the need to address psychological stress experienced by older adult caregivers.

Characteristics of natural environment use by occupational therapists working in mental health care: a scoping review.

The objective of this review was to identify and characterize the use of the natural environment/outdoor space by occupational therapists working in mental health care. This included consideration of the characteristics of the environment used, interventions, mental health conditions being treated, and the outcomes being used. Research has demonstrated the link between human health and the environment. The benefits appear to be particularly relevant to people with mental health conditions. Occupational therapists already consider the environment when assessing and developing interventions, and therefore are well placed to consider and use the natural environment in mental health practice. However, the use of the natural environment by occupational therapists working in mental health is unclear. The scoping review included any publication relating to the use of the natural environment/outdoor space in mental health occupational therapy practice. All forms of the natural environment or outdoor space were included, such as hospital gardens and local parks. There were no geographical, gender, or age restrictions. All mental health diagnoses were eligible for inclusion. Seven databases were searched: Embase (Ovid), Emcare (Ovid), MEDLINE (Ovid), PsycINFO (ProQuest), AMED (Ovid), Trip Database, and CINAHL (EBSCOhost). Gray literature was also searched using a selection of websites and digital repositories. Papers written in English were searched, with no time limit set on publication. Titles and abstracts were screened by 2 independent reviewers for assessment against the inclusion criteria, followed by a full-text review and data extraction. Data were extracted using the data extraction tool developed by the authors. Findings were presented in a tabular format, accompanied by a narrative summary describing how the results relate to the review objectives and question. Of peer-reviewed publications, 7 papers used qualitative methods and 7 used mixed methodology. The remaining sources included conference abstracts, unpublished works, a book chapter, and a website article. The environments used included forests, beaches, gardens, and parks. A variety of interventions were delivered in these environments, including gardening and nature-based activities, physical activities, and animal-assisted interventions. Such activity-focused interventions are largely delivered in a group context, thus providing a social element. A diverse range of mental health conditions were treated. Several methods were used to consider the outcomes on the individual, including both qualitative measures and quantitative outcome measurement tools. The review highlights many characteristics of how the natural environment is being used across mental health services by occupational therapists. A variety of conditions are targeted for such interventions, and several outcome measures have been used to understand impact. This review can support further development and implementation of nature-based approaches in mental health occupational therapy.

Validity of Wrist-Worn Activity Tracker Heart Rate Detection in Fontan Patients During Exercise.

Physical activity and a healthy lifestyle play an essential role in optimizing long-term health in patients with Fontan physiology. Wrist-worn activity trackers may be useful in medically directed exercise programs for patients with Fontan physiology. The objective of this study was to measure the validity of Garmin and Fitbit activity tracker heart rate detection in patients with Fontan circulation when compared to electrocardiogram (ECG) during cardiopulmonary exercise testing (CPET). 47 Fontan patients undergoing CPET for clinical indications were included and wore activity trackers during CPET. Heart rate via the activity tracker was collected at baseline, maximal exercise, and recovery. Patient heart rates, peak VO2, and peak respiratory exchange ratio (RER) were collected using standard CPET protocols and equipment. Heart rate at each time point was compared between the activity trackers and CPET ECG. Median age of participants was 17.1 years, 15.1 years since Fontan completion. Mean percent of predicted peak VO2 was 56.8%, z-score -3.2 with 61.7% of participants completing a maximal CPET (RER ≥ 1.09). Baseline oxygen saturation mean was 92.9%, 90.0% at maximal exercise. Activity trackers demonstrated mean absolute percentage error < 10% at most time points, comparable with other studies. Demographics, Fontan-associated comorbidities, and echocardiogram findings did not impact the accuracy. Consumer-oriented wrist-worn activity trackers show promising accuracy for heart rate monitoring in medically directed exercise programs for adolescents and young adults with Fontan physiology. Further validation across different exercise modalities is needed.

Long COVID Cardiopulmonary Symptoms and Health Resort Treatment: A Retrospective Study

Background/Objectives: Long COVID covers many cardio-pulmonary symptoms, worsening individuals’ health status. Health resort treatment applies balneological factors, physical medicine modalities, climate actions, and exercises that may be beneficial for COVID-19 survivors. This study aimed to assess the severity of the cardiopulmonary symptoms in people qualified for health resort treatment and its efficacy in this group of patients. Methods: Medical records of 239 people attending health resort treatment were analysed. A total of 122 people (71 women and 51 men) with a mean age of 64.35 years ± 8.66 years were enrolled in the analysis. The cardiopulmonary symptoms of long COVID were assessed twice: before and after health resort treatment. Results: Persisting COVID-19 symptoms do not differentiate between women and men. Health resort treatment reduces symptoms severity in both sexes. Age does not mediate the efficacy of health resort treatment. Conclusions: The persistent symptoms of COVID-19 are of low intensity in people qualified for health resort treatment and are independent of gender. Health resort treatment effectively mitigates dyspnoea, tightness of chest, and sputum in long COVID patients, so it should be implemented into the standard treatment course for COVID-19 survivors as a continuation of therapy.

Musculoskeletal Injury in Australian Infantry Personnel: A Cross-sectional Study to Understand Prevention Priorities.

Musculoskeletal injury patterns are under-investigated in the Royal Australian Infantry Corps. Subsequently, more evidence is needed to support injury prevention processes in this population. One difficulty in collecting injury information to monitor injury patterns within combat populations accurately is known injury concealment behaviors in such populations. This study aims to examine musculoskeletal injury epidemiology within Australian infantry battalions using a tailored approach to mitigate reporting avoidance. A cross-sectional study using an anonymous online survey captured musculoskeletal injury information directly from personnel serving within 2 Australian infantry battalions. The survey requested information on participants' injury frequency in the previous 12 months and the context of participants' most severe injury. Injury context was restricted to the most severe during the period to limit recall bias. The applied injury case definition encompassed all injuries that affected an individual's ability to perform in their role. A descriptive analysis of all data recorded across the 2 battalions was conducted. Subgroup statistical difference was assessed by examining the 95% CI overlap between groups. The Department of Defence and Veterans' Affairs Human Research Ethics Committee granted ethical approval for this study. Overall, 166 individuals self-reported at least 1 injury in the past 12 months, representing a period prevalence of 55.5% (95% CI, 49.8-61.0%). No statistically significant prevalence differences existed between employment type, age, or sex. Approximately a quarter of injured participants were medically reclassified because of their injury, impacting their deployment fitness (n = 40, 24.4%). The following results relate to the most severe injury personnel experienced. Most injuries were service-related (n = 152, 91.6%). Field activities (n = 64, 39.3%) and physical training (n = 59, 36.2%) were the most common injury-related activities. Running was the most reported injury mechanism (n = 35, 21.7%), followed by pack marching (n = 29, 18.9%) and fall, slip, or trip (n = 18, 11.2%). Musculoskeletal injuries are common in the Australian infantry and significantly burden the workforce. Physical training and field exercises are most associated with injury and represent opportunities for injury risk-mitigation strategies to support the overall deployability of personnel and the combat effectiveness of their battalions. Future research should more formally explore the injury risk factors related to these activities using more robust study designs to collect injury and exposure information more accurately and reliably. One study strength includes using military-specific international injury surveillance guidelines to inform the survey design, to collect the recommended injury information for effective surveillance, and to enable future research comparison. A second study strength was tailoring the survey to promote participatory engagement, providing a high completion rate. A challenge in conducting this research was coordinating participant recruitment and data collection during domestic operations. Such challenges reflect the reality of conducting research in the military.

Long-term self-reported attendance in exercise training or lung choir and status of quality of life following initial pulmonary rehabilitation for COPD

BackgroundBoth adherence rates to pulmonary rehabilitation (PR) programmes and long-term attendance in exercise training after PR remain a challenge. In our previous randomised controlled trial (RCT), effects were positively associated with a dose-response pattern, regardless of whether PR contained conventional physical exercise training (PExT) or Singing for Lung Health (SLH) as a training modality within a 10 weeks’ PR programme for chronic obstructive pulmonary disease (COPD). However, long-term status of this RCT cohort remains unknown. In this study, we investigated whether current status (=attendance in supervised exercise training or a lung choir and scoring in quality of life (QoL)) was related to initial PR completion, randomisation, or adherence.MethodsWe collected data via telephone, using a researcher-developed questionnaire on current self-reported attendance in supervised exercise training or a lung choir and on perceived benefits of the initial RCT intervention. Additionally, we used COPD-validated questionnaires (primarily: QoL (measure: St George's Respiratory Questionnaire; SGRQ).ResultsIn 2023 (i.e., mean/median 4.7 years after initial PR), surviving participants were contacted (n = 196; 73% of 270), and 160 (82% of 196) were included. Out of the included participants, 30 (19%) had not completed initial PR. Compared to the initial PR-completers, non-completers reported less current attendance in exercise training or lung choir (24% vs. 46%, p = 0.03) but SGRQ scores were comparable. Yet, those who attended exercise training or lung choir at present (n = 66/160; 41% out of 160) reported better QoL score than those with no current attendance (SGRQ; Attending: 39.9 ± 15.4; Not attending: 43.1 ± 16.7; p = 0.02). Neither having had SLH instead of PExT, nor adherence level during initial PR, was related to current attendance or to QoL scores.ConclusionThis study indicates that long-term self-reported attendance and current QoL scores are positively related to initial completion of a PR programme. Surprisingly, neither initial PR content (PExT or SLH) nor initial PR adherence was related to long-term outcomes. We suggest that future PR programmes include special attention to those who do not complete PR to support long-term attendance and QoL status.

Pulmonary Rehabilitation Program Is an Effective Treatment Approach for Post-COVID-19 Syndrome Patients

Background/Objectives: Patients with post-COVID-2019 syndrome may have reduced functional capacity and physical activity levels. The pulmonary rehabilitation program (PRP)—an exercise training program—is designed to restore these functions and has been shown to improve dyspnea, exercise capacity, and other measures in these patients. This study aimed to analyze the effects of the RP on post-COVID-19 syndrome patients with respect to objective and subjective functional capacity, balance, and musculoskeletal strength. Methods: A prospective interventional trial was conducted before and after this phase. Patients were referred to the hospital with a confirmed diagnosis of SARS-CoV-2 and subsequently directed to the RP. These patients underwent an 8-week pulmonary rehabilitation program (45-min sessions 3 times/week). Each session consisted of stationary cycle-ergometer and resistance musculoskeletal exercises tailored to individuals’ performance. They were evaluated pre- and post-PRP using the maximal handgrip strength (HGS) test, timed up-and-go test, 6-min walk test and its derived variables, and Duke Activity Status Index questionnaire. Results: From 142 hospitalized patients admitted with a diagnosis of SARS-CoV-2 infection, 60 completed the program, with an attendance rate of 85%. Nineteen patients were categorized as severe/critical, with a significantly higher hospital stay, compared to mild/moderate patients, and there were no differences in terms of sex distribution, age, or BMI between groups. Compared to the pre-PRP evaluation, both groups showed significant (p &lt; 0.001) improvements in TUG, HGS, DASI D6MWT, 6MWS, and DSP variables after the PRP conduction. In addition, the groups exhibited similar improvement patterns following PRP (intragroup analysis), with no intergroup differences. Conclusions: RPs promote both objective and subjective functional capacity in patients with post-COVID-19 syndrome, with no difference in improvement regardless of the severity of the initial infection.

The link between childhood physical activity enjoyment and adult kinesiophobia in individuals with chronic low back pain

The link between childhood physical activity enjoyment and adult kinesiophobia in individuals with chronic low back pain

Physical activity from the perspective of older adults: a convergent mixed-method study

BackgroundOlder adults are insufficiently physically active, despite its importance for healthy aging. To develop appropriate physical activity interventions, it is necessary to understand their physical activity. This study applies a theoretical perspective, the COM-B model, and a mixed-method design to examine what influences older adults’ physical activity levels with three questions: (1) What individual and external factors predict older adults’ physical activity levels? (2) What do older adults perceive as influencing their levels of physical activity? (3) To what extent do the quantitative results on older adults’ physical activity levels agree and disagree with the qualitative findings on older adults’ physical activity levels?MethodsA convergent mixed-method design was used with questionnaire (n = 334) and interview (n = 14) data from adults 65 years and older. Regression analyses were used for quantitative measurements: physical activity, age, subjective socioeconomic status, health status, capability, opportunity, motivation, and depression. Content analysis was applied to the qualitative data. The two forms of data were then integrated to provide greater insights than would be obtained by either dataset separately.ResultsThe regression analyses showed that previous physical activity, current motivation, health status, and age significantly predicted older adults’ physical activity levels. The content analysis revealed that participants addressed all subcomponents of the COM-B model, indicating its pertinence in understanding how older adults discuss their current physical activity levels. The integrated findings showed convergent and divergent results. Overall results indicated that previous physical activity engagement, present motivation, capability, and opportunity influenced older adults’ physical activity levels.ConclusionsThis study is the first to use this mixed-methods design to examine factors influencing physical activity levels among older adults living in rental apartments with community hosts. The integrated result reveals convergence for findings on motivation and physical capability but divergence on psychological capability, opportunity, and previous physical activity. The findings underscore a complex interplay of factors influencing older adults’ physical activity levels and indicate relevance for the COM-B model. The results can guide future research on theoretically informed interventions to promote physical activity and healthy aging. Future research should clarify the role of opportunity for older adults’ physical activity.

Physical activity and the risk of developing 8 age-related diseases: epidemiological and Mendelian randomization studies

BackgroundWe aimed to characterize the associations between physical activity levels and the risk of developing age-related diseases in the Coronary Artery Risk Development in Young Adults (CARDIA) study and used Mendelian randomization (MR) to assess whether there are causal relationships between physical activity levels and the risk of developing 8 age-related diseases (coronary atherosclerosis, ischemic heart disease, angina, Alzheimer’s disease, hypertension, type 2 diabetes, hyperlipidemia, and venous thromboembolism).MethodsBased on the data available in the CARDIA, we obtained data related to five disease states: coronary heart disease, hypertension, diabetes, hyperlipidemia, and venous thromboembolism. Binary logistic regression analysis estimated the multivariable-adjusted associations between different physical activity statuses and diseases. For the MR study, we used summary-level data from a recently published genome-wide association study on physical activity (including vigorous physical activity and accelerometer-based physical activity) conducted with participants from the UK Biobank study. We selected the above 8 age-related diseases as our outcomes.ResultsIn the CARDIA-based analysis, the risk of developing coronary heart disease [OR (95% CI): 0.562 (0.397–0.795)], hypertension [OR (95% CI): 0.703 (0.601–0.821)], diabetes [OR (95% CI): 0.783 (0.620–0.988)], and hyperlipidemia [OR (95% CI): 0.792 (0.662–0.949)] was negatively related to physical activity status when participants achieved the physical activity target. Our MR results support a negative causal association between genetically determined vigorous physical activity levels and the risk of developing 3 age-related diseases, namely, angina, hypertension and type 2 diabetes. Moreover, our results also support a negative causal association between genetically determined accelerometer-based physical activity levels and the risk of developing angina.ConclusionsPromotion of physical activity is likely to prevent specific age-related diseases.

Effects of physical activity on anxiety levels in college students: mediating role of emotion regulation

Objectives To explore the effects of physical activity on anxiety levels in college students, as well as to examine the mediating role of emotion regulation. Methods A convenience sample of 1,721 college students from Shanghai, Jiangsu, Shandong, Guangxi, and Hunan was used to conduct an evaluation and a survey through the Physical Activity Rating Scale (PARS-3), the Anxiety Self-Rating Scale (SAS), and the Emotion Regulation Scale (ERQ). Results College students’ anxiety level, cognitive reappraisal, and expression inhibition scores were (44.72 ± 10.37), (30.16 ± 6.51), and (16.96 ± 4.99), respectively. There were significant grade and physical activity level differences in anxiety levels and cognitive reappraisal, and significant gender and physical activity level differences in expression inhibition among college students. Process model 4 mediated effect regression analysis showed that physical activity had a significant positive effect on cognitive reappraisal (R2 = 0.14, β = 0.04, P &lt; 0.001), and physical activity did not have a significant expression inhibition effect (R2 = 0.17, β = 0.01, P = 0.27). Physical activity (β = −0.03, P = 0.012), cognitive reappraisal (β = −0.59, P &lt; 0.001), and expression inhibition had a significant effect on (β = 0.57, P &lt; 0.001) anxiety levels (R2 = 0.37). In the model effect relationship, the direct and indirect effects of physical activity on anxiety levels were −0.028 and −0.019, respectively. Conclusion Physical activity has a significant negative effect on college students’ anxiety levels. Cognitive reappraisal is a mediating variable for the effect of physical activity on anxiety levels. The higher the level of physical activity and the higher the intensity of the activity, the lower the level of anxiety.

The Relationship Between Physical Activity, Life Satisfaction and Well-being of College-going Students: A Cross-sectional Study

Background and Objectives: Physical health is a state of lack of illness and disease. The psychological well-being of college-going students is closely related to physical activity and life satisfaction. It can lead to low life satisfaction, mental disorders, and overall low QoL (QoL). The present study aims to evaluate the relationship between physical activity, life satisfaction, and mental well-being of students. Methods: A cross-sectional study was conducted among college-going students to evaluate the relationship between physical activity, life satisfaction, and mental well-being of college students. Data were collected with online Google Forms, using the convenience sampling method to achieve the required sample size of 279 students. Follow-up data was entered into an Excel sheet and evaluated with SPSS software, version 20. Results: After data collection using online Google Forms, data were evaluated using the SPSS software, version 20, and the results showed that physical activity is significantly correlated with mental well-being with a P of 0.004. Life satisfaction is correlated with physical activity according to a P of 0.038 and mental well-being is also correlated with life satisfaction with a P of 0.032. Conclusion: The study concluded that physical activity, life satisfaction, and mental well-being in college-going students are significantly correlated with each other.

Investigating the Impact of Learning Modality Shifts on K-12 Students’ Physical Activity Participation During the COVID-19 Pandemic

The COVID-19 pandemic created many challenges for K-12 schools during the 2020-2021 school year (e.g., establishing social dis-tancing measures, decisions regarding testing protocols, and transition from in-person to distance learning). Changes in teaching and learning modalities, from in-person to remote learning options, quickly became a reality for many students [an estimated 95%, according to Engzell et al. (2021)]. With an increase in distance learning came changes in stu-dents’ structured and unstructured physical activity participation. The impact of these changes is unknown and justifies research investigating the effect modality shifts held on students’ participation in physical activity and any associated outcomes. A mixed-methods survey was administered to examine changes in K-12 students’ learning modality, 521Chiara et al.participation in physical activity, and associated outcomes. Changes in learning modality from in-person to online were most frequently in-dicated (90%). Respondents stated both challenges and success stories associated with students’ participation in physical activities resulting from modality shifts (e.g., decreased social engagements, decreased ex-posure to structured and facilitated physical education, and increased outdoor play). Positive outcomes were most prevalent in children engaging in moderate PA. However, 85% of respondents indicated a decrease in their child’s physical activity participation. Our findings justify further investigation of the immediate and long-term impact of school modality shifts on students’ engagement in physical activities.

Association of Physical Activity and Psychological Distress in Adolescents

Background: Adolescence is a critical period for the development of health-related behaviors and the onset of psychological distress, including anxiety, depression, and stress. Physical activity has been associated with improved mental health, but its specific relationship with psychological distress in adolescents remains unclear.Objective: To evaluate the association between physical activity levels and psychological distress (stress, anxiety, and depression) in adolescents.Methods: A cross-sectional study was conducted on 109 adolescents aged 14-19 years from the University of Lahore and Beacon House School System, Valencia Campus, Lahore. Participants were recruited through non-probability convenience sampling. Psychological distress was assessed using the DASS-21, and physical activity levels were measured with the PAQ-A. Data were analyzed using Spearman’s rank correlation and Chi-square tests via SPSS version 23.Results: Significant but weak negative correlations were found between physical activity and stress (Spearman’s rho = -0.236, p = 0.013) and depression (Spearman’s rho = -0.219, p = 0.022). The association with anxiety was not significant (p = 0.075).Conclusion: Higher physical activity levels were associated with lower stress and depression among adolescents, suggesting potential mental health benefits of regular exercise.