Total Leisure-time Physical Activity Research Articles

The association between leisure-time physical activity and cardiorespiratory and muscular fitness and job strain-Study with a Northern Finland birth cohort of 1966.

Job strain is a major concern in the workplace. Work-related stress is an increasing challenge worldwide as it is the leading cause of long-term sickness absences, disability pensions and lower productivity. Rarely studied simultaneously, both leisure-time physical activity (LTPA) and physical fitness (PF), which comprises cardiorespiratory fitness (CRF) and muscular fitness (MF), may have potential in preventing and managing job strain. The current study aimed to investigate whether LTPA, CRF and MF predict perceived job strain. In addition, the study examines reverse associations, that is, whether job strain predicts LTPA, CRF and MF. We used longitudinal population-based data from a Northern Finland birth cohort of 1966 (n=5363) to analyse LTPA, CRF and MF as well as job strain and its components, job demands and job control, at age 31years (1997) and 46years (2012). Leisure-time physical activity was measured with a self-reported questionnaire whereas CRF and MF were measured as part of clinical examination. Linear regression analyses were used to analyse the data. In both men (n=2548) and women (n=2815), higher baseline MF predicted lower job strain and job demands 15years later. In women, higher baseline total LTPA predicted higher job demands, whereas in men, higher CRF predicted lower job strain and higher job control. These associations remained significant, also when adjusted for education and occupational status. In the analyses on reverse associations, higher job control and higher job demands were linked to higher leisure-time moderate-to-vigorous physical activity (MVPA) and total LTPA 15years later among both men and women, except for the association between job demands and total LTPA among women. These associations remained significant after adjustment for education and occupational status, except for the association of job control with MVPA and total LTPA among men. The association of higher job demands and total LTPA became significant in women. We conclude that LTPA and PF seem beneficial in preventing and managing job strain.

Evaluating an Adapted Physical Activity Program for University Students and Staff Living with a Physical Disability and/or Chronic Condition through a Self-Determination Theory Lens

The purpose of this mixed-method study was to (1) examine the effect of an adapted physical activity program, Fitness Access McGill (FAM), on leisure-time physical activity (LTPA), autonomous and controlled motivation, and the basic psychological needs of self-determination theory among university students/staff with a physical disability and/or chronic conditions, and (2) explore participants’ experiences after completing FAM. Nineteen participants completed validated questionnaires for all study outcomes pre- and post-FAM. Nine participants partook in a 30–60 min semi-structured interview conducted within three months of completing FAM. Quantitative data were analyzed using repeated measures effect size calculations. Qualitative data were analyzed using directed content analysis. Participants reported an increase in total LTPA (dRMpooled = 0.58), with the greatest positive change on strenuous intensity (dRMpooled = 0.81). Large effects were found for changes in autonomous motivation (dRMpooled = 0.52), autonomy (dRMpooled = 0.79), competence (dRMpooled = 0.79), and relatedness (dRMpooled = 0.89). Participants reported FAM being supportive towards their psychological needs, the development of a LTPA routine, and enhanced overall well-being. Future research can be built upon this study to develop a robust understanding as to how need-supportive, adapted LTPA programs could be implemented within community settings or out-patient rehabilitation to support exercise engagement, physical health and overall well-being among adults with disabilities.

Sex disparities in physical activity domains and hypertension prevalence

BackgroundThis study aimed to examine the associations of leisure time physical activity (LTPA) and occupational physical activity (OPA) with the prevalence of hypertension, while exploring the sex disparities in these associations.MethodsA cross-sectional study was conducted using data from the Korea National Health and Nutrition Examination Survey between 2014 and 2019 (n = 26,534). Hypertension was defined as the use of antihypertensive drugs or systolic and diastolic blood pressure ≥ 140/90 mm Hg. Self-reported physical activity (PA), assessed by the global PA questionnaire, was categorized into three domains: total PA, LTPA and OPA. Each PA domain was classified based on METs-min/wk and intensity.ResultsIn a multivariable adjusted model, the odds ratio (OR) with 95% confidence intervals (CIs) for the prevalence of hypertension in the active versus inactive group, based on METs, was 0.92 (95% CI 0.85–0.99) for total PA, 0.90 (95% CI 0.83–0.98) for LTPA and 1.21 (95% CI 1.05–1.38) for OPA. Compared to the inactive group, moderate to vigorous intensity was associated with a lower odds of hypertension for total PA and LTPA (total PA: OR 0.95, 95% CI 0.89-1.00 and LTPA: OR 0.92, 95% CI 0.86–0.98), but a higher odd for OPA (OR 1.17, 95% CI 1.05–1.30). Subgroup analyses showed significant evidence of effect modification by sex on the associations of total PA and LTPA (METs and intensity) with hypertension prevalence (p-values for interaction < 0.01); the associations were generally stronger for women. OPA was associated with a higher prevalence of hypertension in women, but not in men (p-value for interaction > 0.05).ConclusionsHigher levels of total PA and LTPA were associated with lower prevalence of hypertension in both men and women, with slightly stronger associations for women. However, higher OPA was associated with a higher prevalence of hypertension in women. These findings support the PA health paradox hypothesis and highlight the sex disparities in the association between OPA and hypertension prevalence.

LIFESTYLE-RELATED PREDICTORS OF TESTOSTERONE DEFICIENCY AMONG MALE PATIENTS WITH CHRONIC SPINAL CORD INJURY

Objectives: In the current study, the author evaluated the prevalence of low testosterone and its independent predictors among male patients with chronic spinal cord injury (SCI). Design: This descriptive type of observational study was conducted in the department of PMR at SMS Medical College. Methods: In this cross-sectional study, 120 patients with chronic SCI were recruited, serum testosterone levels were assessed, and testosterone levels below 300 ng/dL were considered low. The following eight suspected independent predictors for low testosterone levels were assessed: age, body mass index (BMI), nicotine users, total lipid profile, level of injury, American Spinal Injury Association (ASIA) impairment scale, leisure-time physical activity (LTPA) score (h/week) via LTPA questionnaire, and aging male’s symptom (AMS) score via AMS questionnaire. Results: The mean age of the patients was 33.2±7.8 years. Patients with low testosterone exhibited a significant association with dorsal SCI (70.9%), motor complete (ASIA A and B) SCI (76.4%), nicotine use (65.5%), a higher triglyceride (TG) level (168.5 mg/dL), a higher total lipid level (712.9 mg/dL), and a higher AMS score (35.7). Patients with low testosterone were found to be engaged in lower (9.4 h/week) LTPA. A significant negative correlation of total testosterone levels was observed with TG (r=−0.184, p=0.044), total lipid (r=−0.570, p&lt;0.001), BMI (r=−0.504, p&lt;0.001), and AMS scores (r=−0.549, p&lt;0.001). Whereas there was a significant positive correlation observed between total testosterone and LTPA (r=0.380, p&lt;0.001). Conclusion: The prevalence of low testosterone is found at 45.8%, and BMI, LPTA, AMS, and total lipids are identified as independent predictors of low testosterone.

Dose-response association of leisure time physical activity with mortality in adults with major chronic diseases.

We aimed to evaluate the association between leisure-time physical activity (PA) and mortality risk in adults with major chronic diseases. A total of 170,579 adults with major chronic diseases aged 30-84 years from the U.S. National Health Interview Surveys (1997-2014) with linkage to the National Death Index (NDI) through December 31, 2015 were included in this study. During a median follow-up of 7.25 years, 36,914 adults with chronic diseases died from all causes, 8,767 died from cardiovascular disease (CVD), and 9,090 died from cancer. Compared with participants with no leisure-time PA, those with a low level (10-59 min/week) of total leisure-time PA had a 23% [hazard ratio (HR) 0.77, 95% confidence interval (CI) 0.73-0.82] reduced risk of all-cause mortality. Adults with higher levels of leisure time had more reduced risk of all-cause mortality, as well as CVD-specific and cancer-specific mortality. Adults with leisure-time PA ≥ 1,500 min/week had more reduced risk of CVD-specific mortality (61%) but less reduced risk of cancer-specific mortality (29%) compared with the reduced risk of all-cause mortality (43%). There was an inversely non-linear dose-response relationship between leisure-time PA and all-cause and cause-specific mortality. Reduced risk of all-cause and cancer-specific mortality between leisure-time light-to-moderate PA and vigorous-intensity PA time were largely comparable. Low and high levels of leisure-time PA showed substantial survival benefits compared with no leisure-time PA in adults with major chronic diseases. The light-to-moderate-intensity leisure-time PA is largely comparable with vigorous PA to provide survival benefits for all-cause and cancer-specific mortality.

Asociación de la actividad física con la funcionalidad de las lipoproteínas de alta densidad en una cohorte de base poblacional: el estudio REGICOR

Introduction and objectivesTo determine the dose-response association between current and past leisure-time physical activity (LTPA), total and at different intensities, and high-density lipoprotein (HDL) functionality parameters. MethodsStudy participants (n=642) were randomly drawn from a large population-based survey. Mean age of the participants was 63.2 years and 51.1% were women. The analysis included data from a baseline and a follow-up visit (median follow-up, 4 years). LTPA was assessed using validated questionnaires at both visits. Two main HDL functions were assessed: cholesterol efflux capacity and HDL antioxidant capacity, at the follow-up visit. Linear regression and linear additive models were used to assess the linear and nonlinear association between LTPA and HDL functionality. ResultsTotal LTPA at follow-up showed an inverse and linear relationship between 0 and 400 METs x min/d with HDL antioxidant capacity (regression coefficient [beta]: −0.022; 95%CI, −0.030, −0.013), with a plateau above this threshold. The results were similar for moderate (beta: −0.028; 95%CI, −0.049, −0.007) and vigorous (beta: −0.025; 95%CI, −0.043, −0.007), but not for light-intensity LTPA. LTPA at follow-up was not associated with cholesterol efflux capacity. Baseline LTPA was not associated with any of the HDL functionality parameters analyzed. ConclusionsCurrent moderate and vigorous LTPA showed a nonlinear association with higher HDL antioxidant capacity. Maximal benefit was observed with low-intermediate doses of total LTPA (up to 400 METs x min/d). Our results agree with current recommendations for moderate-vigorous LTPA practice and suggest an association between PA and HDL functionality in the general population.Full English text available from:www.revespcardiol.org/en

Association of physical activity with high-density lipoprotein functionality in a population-based cohort: the REGICOR study

Introduction and objectivesTo determine the dose-response association between current and past leisure-time physical activity (LTPA), total and at different intensities, and high-density lipoprotein (HDL) functionality parameters. MethodsStudy participants (n=642) were randomly drawn from a large population-based survey. Mean age of the participants was 63.2 years and 51.1% were women. The analysis included data from a baseline and a follow-up visit (median follow-up, 4 years). LTPA was assessed using validated questionnaires at both visits. Two main HDL functions were assessed: cholesterol efflux capacity and HDL antioxidant capacity, at the follow-up visit. Linear regression and linear additive models were used to assess the linear and nonlinear association between LTPA and HDL functionality. ResultsTotal LTPA at follow-up showed an inverse and linear relationship between 0 and 400 METs x min/d with HDL antioxidant capacity (regression coefficient [beta]: −0.022; 95%CI, −0.030, −0.013), with a plateau above this threshold. The results were similar for moderate (beta: −0.028; 95%CI, −0.049, −0.007) and vigorous (beta: −0.025; 95%CI, −0.043, −0.007), but not for light-intensity LTPA. LTPA at follow-up was not associated with cholesterol efflux capacity. Baseline LTPA was not associated with any of the HDL functionality parameters analyzed. ConclusionsCurrent moderate and vigorous LTPA showed a nonlinear association with higher HDL antioxidant capacity. Maximal benefit was observed with low-intermediate doses of total LTPA (up to 400 METs x min/d). Our results agree with current recommendations for moderate-vigorous LTPA practice and suggest an association between PA and HDL functionality in the general population.

Leisure-time physical activities and the risk of cardiovascular mortality in the Malm\xf6 diet and Cancer study

BackgroundThe association between leisure-time physical activity and cardiovascular mortality has been previously studied, but few studies have focused on specific activities and intensities.MethodsThe association between different leisure-time physical activities and cardiovascular mortality was investigated among 25,876 individuals without diabetes or cardiovascular disease from the population-based Malmö Diet and Cancer Study cohort. The individuals estimated the average duration spent on 17 physical activities at baseline in 1991–1996 and after 5 years. Cardiovascular mortality was obtained from a register during a mean of 20 years of follow-up.ResultsA total leisure-time physical activity of 15–25 metabolic equivalent task (MET) hours/week was associated with a decreased risk of cardiovascular mortality (HR 15–25 vs < 7.5 MET-h/week =0.80, 95% CI 0.69–0.93), with no further risk reduction at higher levels. Several high-intensity activities (i.e., lawn tennis and running) and moderate-intensity activities (i.e., golf, cycling and gardening) were associated with a reduced risk. Individuals who engaged in high-intensity physical activity for an average of 2.29 MET h/week (30 min/week) had an 18% (95% CI 0.72–0.93) reduced risk of cardiovascular mortality compared with non-participants, and no further risk reductions were observed at higher levels. Decreased risk was observed among individuals who had started (HR 0.56, 95% CI 0.32–0.97) or continued (HR 0.49, 95% CI 0.36–0.66) high-intensity activities at the five-year follow-up.ConclusionsModerate- and high-intensity leisure-time physical activities reduced the risk of cardiovascular mortality. With regard to total leisure-time physical activity, the largest risk reduction was observed for 15–25 MET-h/week (equivalent to walking for approximately 5 h/week).

Prospective Associations of Leisure-Time Physical Activity With Psychological Distress and Well-Being: A 12-Year Cohort Study.

This study aimed to investigate the associations of leisure-time physical activity with psychological distress and well-being, and potential mediators. We used data from the 1970 British Cohort Study (n = 5197; 2688 men), including waves 34y (2004), 42y (2012), and 46y (2016). Participants reported leisure-time physical activity frequency and intensity (exposure) at age 34 years (baseline); cognition (vocabulary test), body mass index, disability, mobility and pain perception (potential mediators) at age 42 years; and psychological distress (Malaise Inventory) and well-being (Warwick-Edinburgh scale) at age 46 years. Baseline confounders included sex, country, education, employment status, alcohol use, tobacco smoking, and psychological distress. Main analyses included logistic regression and mediation models. Higher leisure-time physical activity intensity at baseline was associated with lower psychological distress at 46y (β = -0.038 [95% confidence interval {CI} =-0.069 to -0.007]), but not leisure-time physical activity frequency. Baseline leisure-time physical activity frequency and intensity were associated with higher psychological well-being at 46y (frequency: β = 0.089 [95% CI = 0.002 to 0.176]; intensity: β = 0.262 [95% CI = 0.123 to 0.401]); and total: β = 0.041 [95% CI = 0.013 to 0.069]). Only body mass index at 42y partially mediated the association between leisure-time physical activity frequency (15.7%) and total leisure-time physical activity (6.2%) at 34y, with psychological well-being at 46y. Our findings highlight the role of leisure-time physical activity in psychological distress and well-being, with greater effect sizes associated with higher frequency and intensity of leisure-time physical activity. Future interventions should consider examining potential mediators of the association of leisure-time physical activity with psychological well-being, such as body mass index.

Longitudinal Examination of Leisure-Time Physical Activity (LTPA), Participation, and Social Inclusion Upon Joining a Community-based LTPA Program for Adults With Physical Disabilities

ObjectiveFirst, to examine whether participants reported changes in (1) leisure-time physical activity (LTPA) participation and social inclusion variables and (2) well-being outcomes before and after joining a community-based LTPA program for adults with physical disabilities. Second, to explore the longitudinal relationship between LTPA and the other aforementioned outcomes. DesignA double baseline longitudinal design with measurements at 4-6 weeks (baseline 1) and immediately (baseline 2) before and 2 and 4 months after joining the community-based LTPA program. SettingCommunity. ParticipantsAdults (N=43) with a physical disability who reported no cognitive impairment, were new members of the community-based LTPA program, and spoke English or French. InterventionsA community-based physical activity program for adults with physical disabilities. Participants were provided an individualized exercise program and accessed the program at designated times during the week. Main Outcome MeasuresPrimary: LTPA (LTPA Questionnaire for People with Spinal Cord Injury), participation (Patient-Perceived Participation in Daily Activities Questionnaire), and social inclusion. Secondary: depression severity, self-esteem, resilience, and life satisfaction. ResultsAfter joining the program, participants reported an increase in total LTPA (meanbaseline2, 177.80±211.32; mean2months, 299.31±298.70; mean4months, 288.14±292.14), moderate-to-vigorous LTPA (meanbaseline2, 83.95±123.95; mean2months, 142.00±198.38; mean4months, 163.23±182.08), and participation in health (meanbaseline2, 6.24±1.16; mean2months, 6.58±1.25; mean4months, 6.97±0.82) and family-related activities (meanbaseline2, 12.18±2.43; mean2months, 12.60±2.30; mean4months, 13.47±2.01). A significant increase (β=3.46, P<.001) in social inclusion before joining the program was followed by a decrease (β=−1.09, P<.05) 4 months later. Improvements related to depression severity were noted (βbaseline1−baseline2=−1.51, P<.05; βbaseline2−4 months=−0.28, P>.05). ConclusionsThe results support the role of a community-based LTPA program in increasing LTPA levels and enhancing participation in some activities among adults with physical disabilities.

The Association of Different Types of Leisure Time Physical Activities with Cardiometabolic Outcomes in Singapore—Findings from the Multi-Ethnic Cohort Study

The study aimed to investigate the association between leisure time physical activity (LTPA) subtypes and cardiometabolic outcomes in the Singapore Multi-Ethnic Cohort (MEC). Self-reported data on socio-demographics, lifestyle factors, LTPA subtypes, and health screening data on body-mass index (BMI), waist circumference (WC), systolic and diastolic blood pressure (SBP and DBP), triglycerides (TG), and HDL-and LDL cholesterol were collected. Multivariable linear regression analyses were used adjusting for confounders. The mean age of 9768 participants was 45.2 ± 12.5 years (57.3% female, 47.3% Chinese, 26.0% Malay, and 26.8% Indians). Overall, 65.8% engaged in LTPA, and walking, strength/fitness and running were most common. Higher total LTPA was associated with lower WC, DBP, TG, a trend towards lower BMI, and higher SBP and HDL. Running was beneficially associated with all outcomes except for SBP and LDL. Balance exercises (BMI, SBP and DBP), cycling (BMI, WC and HDL), and strength/fitness (BMI, WC, TG and HDL) were also favorably associated with a number of outcomes, whereas ball games (DBP and TG), dancing (HDL) and other LTPA (DBP) were only favorably associated with selected outcomes. Unfavorable associations were found for total LTPA (SBP), strength/fitness (SBP), golf (DBP) and swimming (BMI and WC). Further research is warranted to inform future health promotion efforts.

Physical activity may not be associated with long-term risk of dementia and Alzheimer's disease.

BackgroundWhile it is well established that physical activity is associated with reduced risk of vascular and nonvascular outcomes as well as mortality, evidence on the association between physical activity and dementia is inconsistent. We aimed to assess the associations of physical activity with the risk of dementia and Alzheimer's disease (AD).Material and methodsWe analysed data on 2394 apparently healthy men with good baseline cognitive function from the prospective population‐based Kuopio Ischaemic Heart Disease study. We assessed habits of physical activity at baseline using a 12‐month leisure time physical activity (LTPA) questionnaire. Using Cox regression, we calculated hazard ratios adjusted for body mass index, systolic blood pressure, smoking status, history of type‐2 diabetes, total cholesterol, high‐density lipoprotein cholesterol, alcohol consumption, history of coronary heart disease and high‐sensitivity C‐reactive protein.ResultsDuring a median follow‐up of 24.9 years (interquartile range: 18.3‐26.9), 208 men developed dementia and 128 developed AD. Multivariable adjusted hazard ratios for dementia comparing top vs bottom tertiles of physical activity were 0.97 (95% confidence intervals: 0.69‐1.38) for total physical activity volume, 0.96 (0.69‐1.34) for conditioning LTPA volume and 1.13 (0.80‐1.61) for total LTPA volume. Corresponding hazard ratios for AD were 1.19 (0.76‐1.85), 0.98 (0.64‐1.49) and 1.22 (0.77‐1.93). Associations were consistent in analyses restricted to participants with ≥10 years of follow‐up.ConclusionsIn middle‐aged Caucasian men, various physical activity exposures were not associated with all‐cause dementia or AD. Future studies should address biases due to reverse causation and regression dilution and should involve objective measures of physical activity.

Physical activity and health-related quality of life among postmenopausal women with breast cancer treated with aromatase inhibitors.

Breast cancer is the most common non-cutaneous cancer in women with an estimated 268,600 new cases diagnosed in 2019, joining the over 3 million women living with the disease. To reduce cancer recurrence, postmenopausal women (highest incidence and prevalence of breast cancer) who test positive for hormone receptors in their tumors are candidates for adjuvant endocrine therapy (i.e., aromatase inhibitors [AIs]). Despite the benefits of AIs in the treatment for breast cancer, many women remain at risk for complications, including osteoporosis and fractures, all of which can adversely affect health-related quality of life (HRQoL). Increased attention is being paid to the role physical activity (PA) may have in improving health outcomes in survivors of breast cancer, but few studies focus on postmenopausal women. We sought to examine (1) the percentage of women in our sample meeting (or not meeting) the American College of Sports Medicine (ACSM) PA recommendations, (2) the relationship between AI use and three types of PA (leisure time, strength training, and walking), and (3) the relationship between PA and HRQoL by AI use, controlling for covariates. Postmenopausal women with breast cancer (n = 170), ages 50-95 years (M = 68.7), diagnosed with stage 1-3 disease, 45% on AIs, were recruited. Demographic, HRQoL, and PA data were collected via patient self-report, while clinical data (AI use) were abstracted from patient medical records. To address study aims, we utilized descriptive statistics, chi-square analyses, and multiple linear regressions, respectively. Half of the sample met the ACSM recommendations for total leisure-time PA (vigorous and moderate intensity combined), and 65.3% (n = 111) weekly walking. With regard to strength training, 36.5% of the women met these ACSM recommendations. Generally, there were positive relationships between AI use and most HRQoL domains. There were no statistically significant relationships between PA (meeting recommendations or not) and HRQoL by AI use. The proportion of women meeting guidelines for walking activity was encouraging. It is imperative that healthcare professionals providing care to breast cancer survivors follow up regarding symptoms, side effects, and physical activity in tandem to fully understand their relationship on an individual level.

Associations Of Occupational And Leisure-time Physical Activity With Cardiovascular Disease

PURPOSE: Emerging evidence describes opposing effects of occupational and leisure-time physical activity (LTPA) on cardiovascular health although little research has been done in the U.S. This analysis examines cardiovascular disease (CVD) prevalence associated with occupational physical activity and LTPA in a nationally representative U.S. sample. METHODS: This is a cross-sectional analysis of the 2015 National Health Interview Survey (NHIS) data and its occupational health supplement from the National Institute for Occupational Safety and Health (NIOSH) (n=19,429). Logistic regression estimated the odds of self-reported composite CVD (coronary heart disease, heart attack, stroke, or angina) with self-reported total occupational activity (TOA), occupational exertion (OE), occupational standing (OS), and LTPA. Occupational activity was measured using two questions: “How often does your job involve repeated lifting, pushing, pulling, or bending?” (OE) and "How often does your job involve standing or walking around?” (OS) where participants responded to a 5-item Likert scale (0=Never, 4=Always). Total occupational activity (TOA) was categorized similarly after summing the individual OE and OS scores. LTPA was defined as three categories: 0, 1-149, or ≥150 minutes/week of reported moderate-to-vigorous activity. Additional analyses were stratified by sex, smoking status, and LTPA level. All models were adjusted for age, sex, race/ethnicity, smoking status, alcohol consumption, family income, body mass index, education, U.S. nativity, LTPA, and TOA. RESULTS: “Always” performing TOA, OE, and OS was associated with higher odds for CVD, compared to “never” (OR=1.65, p=0.026, OR=1.63, p=0.003, and OR=1.56, p=0.031, respectively). LTPA level was not associated with odds of CVD (p>0.05). Associations of high OE with CVD outcomes were equally apparent in females and males and stronger in lower LTPA levels. Associations between TOA, OE, and OS with CVD were stronger in the sample restricted to never smokers. CONCLUSIONS: While LTPA was not associated, individuals with higher TOA, OE, and OS had higher rates of CVD. While uncontrolled confounding is still possible even after adjustment, the seemingly paradoxical adverse associations with occupational activity and CVD should be investigated further.

Examining The Perceived Barriers To Physical Activity Among Older Adults: Moderating Effects Of Body Mass Index

Lack of physical activity (PA) is a major public health concern, especially for older people. However, data on possible factors limiting older adults’ engagement in PA are still under-investigated. PURPOSE: The purpose of this study is twofold: 1) to examine the association of perceived PA barriers with leisure-time PA (LTPA) in a sample of older adults; and 2) to explore the possible moderating effect of body mass index (BMI). METHODS: 296 older adults aged ≥60 years old took part in a cross-sectional survey. LTPA was measured by the International Physical Activity Questionnaire and participants were categorized into the three groups, no-LTPA group for individual who did not report LTPA; and below/upper 50th percentile of total LTPA MET values for low- and high-LTPA groups, respectively. Barriers to being active questionnaire (BBAQ) was used to assess perceived PA barriers in a binary manner (i.e., no barrier/at least 1 barrier) for each of the seven domains (i.e., time, social, energy, will, injury, skill, and resources). BMI (kg/m2) was calculated by self-reported height and weight and used to create the three BMI groups (BMI <25, 25 -29.99, and ≥30). Using a no-LTPA group as a referent, a multinomial logistic regression model predicting the likelihoods of being low- and high LTPA groups was established after adjusting for study covariates, followed by stratified analyses by BMI groups. RESULTS: In general, “lack of will” (49.66%) was the most frequently cited PA barrier followed by “social influence” (38.51%) and “fear of injury” (36.49%). In the fully adjusted multinomial logistic regression model, greater perceived barrier in “social influence” was associated with lower odds of reporting high-LTPA (odds ratio (OR) = 0.41). In the follow-up stratified analyses demonstrated that PA barriers differently affect LTPA levels by BMI groups. Among individuals with BMI between 25 and 29.99, “lack of time” (OR = 0.11) was the significant predictor of LTPA level. Whereas, “fear of injury” (OR = 0.11) and “lack of energy” (OR = 0.18) were the significant factors associated with LTPA among those with BMI≥30. CONCLUSIONS: The present study provides relevant data on barriers to LTPA for older adults. Promotion and intervention strategies should consider the exposed barriers of older adults in order to reduce their obstacles to PA.

Dimensions of leisure-time physical activity and risk of depression in the \u201cSeguimiento Universidad de Navarra\u201d (SUN) prospective cohort

BackgroundAn inverse association between total leisure-time physical activity (LTPA) and depression has been previously documented in the scientific literature. Our objective was to prospectively assess the association of LTPA with the risk of depression, focusing on several dimensions of LTPA (intensity, duration and type).MethodsThe SUN (Seguimiento Universidad de Navarra) project is a prospective cohort study formed by Spanish university graduates. A total of 15,488 adults (40.2% men, mean age 37 ± 12 years) initially free of depression were assessed. A report of a validated medical diagnosis of depression or the habitual use of antidepressants (any of both) were considered as incident cases of depression. LTPA was estimated through previously validated self-reported questionnaires. Participants were classified following Physical Activity recommendations from the World Health Organization, and according to the intensity, duration and type of LTPA. Cox proportional hazards regression models were run, adjusted for demographic, lifestyle, and dietary factors, to estimate adjusted hazard ratios (HR) of depression and 95% confidence intervals (CI).ResultsDuring 163,059 person-years of follow-up we registered 870 incident cases of depression. Participants with higher total LTPA (METs-h/wk) and higher duration of LTPA (hours/wk) exhibited a lower risk of depression HR = 0.84 (95% CI: 0.72–0.99) and HR = 0.83 (0.70–0.99) respectively, whereas intensity of LTPA (MET) did not show any association with depression.ConclusionParticipants with higher LTPA had a lower risk of depression. The inverse association was stronger for total LPTA time than for its intensity. Higher duration of LTPA should be encouraged to prevent depression.

Different Types of Physical Activity and Metabolic Control in People With Type 1 Diabetes Mellitus.

BackgroundThe aim of presented cross-sectional study was to determine the association of different types of physical activity (PA) with metabolic control in people with type 1 diabetes.Materials and MethodsA total of 109 adult subjects with type 1 diabetes were asked to complete the non-exercise activity thermogenesis (NEAT) questionnaire, the hypoglycemia questionnaire, and the World Health Organization Global PA Questionnaire (GPAQ) which was used to assess moderate PA (MPA) and vigorous PA (VPA).ResultsNEAT score (p < 0.001) and total duration of work as assessed with GPAQ (p = 0.007) were positively associated with chronic glycemic control when controlled for sex, BMI, and continuous glucose monitoring system (CGMS) use. We could not confirm such association with total leisure time PA (LTPA) assessed with GPAQ (p = 0.443), though. Multivariate regression model controlled for sex showed positive effects of HbA1c (p = 0.011) and age (p = 0.035), and negative effect of NEAT score (p = 0.001) on BMI. Systolic blood pressure was positively associated with duration of MPA (p = 0.009) and VPA (p = 0.012), but not with NEAT score (p = 0.830) when controlled for sex and BMI. NEAT score and VPA were positively associated with HDL levels when controlled for sex and BMI. Controlled for sex and BMI, higher values of VPA were significantly associated with lower levels of total cholesterol (p = 0.009) and LDL (p = 0.005).ConclusionHigher levels of NEAT are associated with some favorable metabolic effects in adult people with type 1 diabetes, but may also present an additional burden for them with more challenging environment regarding glycemic control.

Associations between leisure time physical activity and cardiovascular risk factors among older adults with long-term spinal cord injury.

This is a cross-sectional study. To describe the association between cardiovascular risk factors (body mass index (BMI), waist circumference (WC), blood pressure, blood glucose and lipids) and leisure time physical activity (LTPA) in older adults with long-term spinal cord injury (SCI). Community settings, southern Sweden. Data from the baseline data collection of the Swedish Aging with Spinal Cord Injury Study (SASCIS) (n = 123, 71% men, injury levels C1-L5, American Spinal Injury Association Impairment Scale A-D, mean age 63 years, mean time since injury 24 years). Data were collected through home interviews, assessments and blood samples. The Physical Activity Recall Assessment for People with SCI was used to assess LTPA. Associations were investigated using multivariable linear regression analyses adjusted for age, gender, level and severity of injury, cause of injury, time since injury and tobacco use. More minutes per day of moderate-to-heavy LTPA were significantly associated with a lower BMI (Beta = -0.31; p = 0.001) and a lower WC (Beta = -0.24; p = 0.009). More minutes per day of total LTPA (mild intensity or greater) were associated with a higher systolic blood pressure (Beta = 0.27; p = 0.041) among participants with tetraplegia. No other significant associations between the cardiovascular risk factors and total LTPA were found. Participation in daily LTPA is associated with better cardiovascular health with regard to BMI and WC in older adults with long-term SCI. Further studies are needed to establish the specific amount of activity needed to obtain positive health effects in this group and the directional causality of the associations. Not applicable.

Exploring the cross-sectional association between outdoor recreational facilities and leisure-time physical activity: the role of usage and residential self-selection

BackgroundThe availability of outdoor recreational facilities is associated with increased leisure-time physical activity (PA). We investigated how much of this association is attributable to selection effects, and explored whether usage of recreational facilities was an explanatory mechanism.MethodsWe analysed data from 5199 participants in the SPOTLIGHT survey residing in five European urban regions. Adults completed a survey and a Google Street View-based virtual audit was conducted to objectively measure the availability of outdoor recreational facilities in the residential neighbourhood. We used negative binomial GEE models to examine the association between objective and subjective availability of outdoor recreational facilities and leisure-time PA, and explored whether this association was attenuated after adjustment for socioeconomic status and preference for neighbourhoods with recreational facilities (as indicators of self-selection). We examined whether reported use of recreational facilities was associated with leisure-time PA (as explanatory mechanism), and summarized the most important motivations for (not) using recreational facilities.ResultsSubjective – but not objective – availability of outdoor recreational facilities was associated with higher levels of total leisure-time PA. After adjustment for self-selection (which attenuated the association by 25%), we found a 25% difference in weekly minutes of total leisure-time PA between individuals with and without self-reported availability of outdoor recreational facilities. For our study population, this translates to about 28 min per week. Participants who reported outdoor recreational facilities to be present but indicated not to use them (RR = 1.19, 95% CI = 1.03;1.22), and those reporting outdoor recreational facilities to be present and to use them (RR = 1.33, 95% CI = 1.22, 1.45) had higher levels of total leisure-time PA than those who reported outdoor recreational facilities not to be present. Proximity to outdoor recreational facilities was the most important motivation for use.ConclusionThe modest attenuation in the association between availability of outdoor recreational facilities and self-reported leisure-time PA suggests that individuals’ higher activity levels may be due more to the perceived availability of outdoor recreational facilities than to self-selection. The use of these facilities seemed to be an important underlying mechanism, and proximity was the main motivator for using recreational facilities.

Association between Access to Public Open Spaces and Physical Activity in a Mediterranean Population at High Cardiovascular Risk.

Background: Regular physical activity is an important preventive factor of cardiovascular disease. Proximity and density of public open spaces are important modifying factors on the practice of physical activity. This article explores the cross-sectional relationship between access to public open spaces (POS) and leisure time physical activity (LTPA) in elderly participants at high cardiovascular risk from PREDIMED-Baleares. Method: 428 elderly subjects at high cardiovascular risk, participating in the PREDIMED trial, from Palma de Mallorca (Spain) were assessed using Geographic Information Systems, and access to POS was determined. The quantity and intensity of LTPA was calculated using the Minnesota Leisure-Time Physical Activity Questionnaire. In order investigate the association between access to POS and LTPA, generalized linear regression models were used. Results: Better access to POS was not consistently associated with total LTPA. Only distance to the nearest park showed a borderline significant positive associated with total LTPA and moderate-vigorous LTPA but was not associated with light LTPA. Conclusions: Although living near POS was not associated to total LTPA, higher levels of moderate-vigorous LTPA were associated to distances to the nearest park. Future work should be conducted on a larger sample size, integrating a longitudinal design, and greater heterogeneity in POS access and introducing objective measures of physical activity.