WHO Physical Activity Research Articles

Walking for transportation in large Latin American cities: walking-only trips and total walking events and their sociodemographic correlates

ABSTRACT Walking for transportation is a common and accessible means of achieving recommended physical activity levels, while providing important social and environmental co-benefits. Even though walking in rapidly growing urban areas has become especially challenging given the increasing dependence on motorised transportation, walking remains a major mode of transportation in Latin American cities. In this paper we aimed to quantify self-reported walking for transportation in Mexico City, Bogota, Santiago de Chile, Sao Paulo, and Buenos Aires, by identifying both walking trips that are conducted entirely on foot and walking events involved in trips mainly conducted on other means of transportation (e.g. private vehicle, public transit) among individuals ≥5-years old. We show how walking-only trips account for approximately 30% trips in the analysed cities, and we evidence how the pedestrian dimension of mobility is largely underestimated if walking that is incidental to other transportation modes is not accounted for: when considering all walking events, we observed an increase between 73% and 217% in daily walking time. As a result, we estimated that between 19% and 25% of residents in these cities meet the WHO physical activity guidelines solely from walking for transportation. The results of the study also suggest that the promotion of public transportation in large Latin American cities can especially help certain population groups achieve the daily recommended levels of physical activity, while among low-income groups accessibility and safety seem to be the key challenges to be addressed.

Physical activity levels and sociodemographic factors associated with meeting recommended levels among shop attendants in Mbarara municipality, Uganda.

BackgroundShop attendants are urban dwellers who may spend significant periods in sedentary lifestyles exposing them to non-communicable diseases. This study assessed the physical activity levels and sociodemographic factors associated with meeting the WHO recommended physical activity levels among shop attendants in Mbarara municipality, Uganda.MethodsWe conducted a cross-sectional study among 301 shop attendants. We used the global physical activity questionnaire to assess participants’ physical activity levels. Modified Poisson regression was used to assess the sociodemographic factors associated with meeting recommended physical activity levels.ResultsOf the 301 participants, 234 (77.7%) met the WHO physical activity recommendations, especially through work-related physical activity of moderate intensity 194 (64.5%). The median weekly duration of all moderate-intensity physical activity was 180 min (IQR=90 to 360). The median daily sedentary time was 300 min (IQR=300 to 360). Being male (adjusted prevalence ratio=1.33, 95% CI 1.17 to 1.51) was significantly associated with meeting recommended physical activity levels.ConclusionThe physical activity levels among shop attendants were high and were mostly achieved through work-related activities of moderate intensity, with males being more likely to meet recommended physical activity levels. Findings suggest a need for gender-sensitive initiatives to increase physical activity levels, especially among female shop attendants.

Physical activity and fitness in survivors of head and neck cancer.

The purposes of the study were (1) to assess the physical activity (PA) status, muscle strength (MS), and flexibility of survivors of head and neck cancer (HNC) and compare these findings with normative data from national labor fitness measures; (2) to examine the differences among PA subgroups, as categorized using Godin's scores; and (3) to examine the association between stretching exercises and cervical range of motion (CROM). A cross-sectional study with consecutive sampling was used to recruit HNC survivors from a medical center in Northern Taiwan who had completed either radiation therapy (RT) or multimodality treatments including RT within the current 5 years. The level of PA, daily function, fatigue, quality of life (QOL), MS (handgrip and hip flexor), BMI, and flexibility (CROM and fingertip-to-floor tests) of the participants were assessed. A total of 108 participants completed the assessments from 135 eligible patients (80% response rate). Although 60.2% reported engaging in PA, only 16.7% met WHO guidelines. Compared to subjects in the normative data, the survivors of HNC in this study had poorer handgrip strength, BMI, and CROM, but better forward flexion. The participants who were consistent with WHO PA guidelines reported less fatigue, better right hip flexor MS, and better QOL than those who did not engage in any PA. Lack of sufficient PA and generally poorer fitness were found in study subjects. Longitudinal research to explore changes in fitness and barriers to PA compliance is strongly suggested to better enhance HNC patients' PA and fitness.

Impact of Covid-19 Lockdown Measures on Lifestyle Behavior in Children and Adolescents With Severe Obesity

Introduction: During the COVID-19 pandemic, lockdown measures were implemented with large impact on lifestyle behaviors and well-being of children (including adolescents). The impact on children with severe obesity, who plausibly are at even larger risk, has not yet been described. Aim of this study was to investigate the impact of COVID-19 lockdown on eating behaviors, physical activity, screen time and quality of life (QoL) of children with severe obesity. Methods: In this mixed-methods study, questionnaires and semi-structured telephone interviews were used to investigate impact of COVID-19 during the first wave in the Netherlands (April 2020) on children with severe obesity (adult BMI-equivalent ≥35kg/m2) treated at our obesity center. The Dutch Eating Behavior Questionnaire - Child, Pediatric Quality of Life Inventory, and Dutch Physical Activity Questionnaire were filled out by their families pre-pandemic and during lockdown. Changes over time in percentile scores, weekly physical activity and screen time were assessed. Qualitative analyses were performed according to the Grounded Theory. Results: We included 83 families, of which 75 participated in the interviews. Their children’s characteristics were mean age 11.5years (SD 4.6), 52% female, mean BMI SD score 3.8 (SD 1.0), indicating severe obesity. On group level, no changes in scores for emotional, restrained, external eating, and QoL nor in screen time were observed (Δ scores +9.2, +3.9, +0.3; and +3.0, respectively; -0.3 hr/wk; all p>0.05). Weekly physical activity decreased (Δ -1.9 hr/wk, p=0.02). Age, pre-existent psychosocial problems and pre-pandemic questionnaire scores were associated with improved or deteriorated questionnaire scores in specific subgroups. For example, children who did not fulfill WHO physical activity criteria pre-pandemic showed a further decline from 2.8 to 0.7 h/wk (p=0.001). Children with high emotional and external eating during lockdown had the lowest QoL scores (p-values <0.01). Qualitative data showed that an increased demand for food was frequently observed (n=21), mostly in children aged <10 years (19/21). This was attributed to loss of daily structure, increased stress, or emotional eating. Families who reported no changes (n=15) or improved eating behaviors (n=11) attributed this to already existing strict eating schemes that they kept adhering to. Conclusion: This study shows differential response profiles to COVID-19 lockdown in children with severe obesity. Although on group level lifestyle scores averaged out, a substantial part of families reported deterioration in physical activity and eating behaviors. Children with pre-existent psychosocial problems, high external or emotional eating scores were most at risk. Health care professionals should target these vulnerable children to minimize short- and long-term negative physical and mental health consequences.

Validity of Japanese version of a two-item 60-minute moderate-to-vigorous physical activity screening tool for compliance with WHO physical activity recommendations

Validity of Japanese version of a two-item 60-minute moderate-to-vigorous physical activity screening tool for compliance with WHO physical activity recommendations

Behaviour Determinants in the Research for Health-Related Quality of Life and Physical Activity of Urban Adults from Single-Person Households

Purpose: The aim of the study is to identify the relationships between quality of life and physical activity levels in urban adults from single-person households. Design/Methodology/Approach: The cross-sectional study involved 1828 single respondents, 1000 women and 828 men, from Wroclaw, Poland. The diagnostic tools included the World Health Organization Quality of Life-BREF and International Physical Activity Questionnaire - Short Version. Respondents’ physical activity was assessed following WHO recommendations. The main statistical method was logistic regression analysis. Findings: Most respondents assessed their overall quality of life, perceived health condition and quality of life in the physical, psychological, social, and environmental domains as average or above average. The majority of single female (73.2%) and male (77.3%) respondents also met the WHO physical activity recommendations. The level of physical activity had a statistically significant impact on men's overall quality of life, women's perceived health condition, and men's quality of life in the psychological and environmental domains. Practical Implications: The study results suggest that the assessment of quality of life and physical activity in people of different marital status should be continued. This will make it possible to take effective preventive and therapeutic measures in relation to groups at the highest risk of hypokinesia, which can also be important for their quality of life. Originality/value: The results of the conducted research make it possible to diagnose and forecast human behaviors, especially those related to psychophysical activity.

The relationship between physical performance and quality of life and the level of physical activity among the elderly.

BACKGROUND:Loss of physical function during the process of aging might affect the quality of life. Physical function assessment tests predicts outcomes such as falls, institutionalization, and death. Studies assessing the association of physical function with quality of life and physical activity level of elderly population in India is scarce. Hence we aimed to assess the physical function of community dwelling older adults and to determine its association with physical activity levels and quality of life.MATERIALS AND METHODS:This was a cross-sectional analytical study. 89 community dwelling older adults between 60 and 80 years of age were recruited. Physical function was assessed by standing balance, walking speed, and grip strength. Quality of life was assessed by WHO QOL BREF questionnaire and physical activity level was assessed by International Physical activity Questionnaire.RESULTS:Standing balance was reduced in 24% and walking speed was decreased in 33% of the participants. Males had higher walking speed, and grip strength. Quality of life was better among males. Standing balance, walking speed and grip strength was significantly higher in moderate – heavy activity levels. There was positive correlation between physical function and quality of life. There was also positive correlation between physical activity level and quality of life.CONCLUSION:Physical function, quality of life and physical activity level were decreased. Males had better physical function and quality of life. Physically active individuals had better physical function and quality of life. Early detection of decreased physical function and increase in physical activity level could result in better quality of life among elderly.

Knowledge, attitude and practice of physical activity promotion among physiotherapists in India during COVID 19

IntroductionCoronavirus disease (COVID-19) pandemic and the nationwide lockdown has increased sedentary time and physical inactivity. Physiotherapists are one of the essential health professionals who are actively involved in promoting physical activities. The study objectives included assessing knowledge of physical activity guidelines, physiotherapist attitude towards involvement in physical activities and practice of routine physical activity assessment, and its promotion among physiotherapists in India during COVID-19. MethodIn this cross-sectional survey study, the study tool was prepared using Google Forms. It consisted of sixteen questions on knowledge, attitude, and practice of physical activities among physiotherapists. Study participants were physiotherapists with a minimum of a bachelor's degree qualification and practicing in India. ResultsOne hundred and eighty responses were received from sixteen states of India. The average age of respondents was 28 years, and the average work experience of five years. This study found that only 19% of physiotherapists could give the correct answer in all three domains of WHO PA guidelines. 70% of physiotherapists found with an appropriate attitude as they met the 150 min of moderate PA per week. 68% reported that they promote physical activities in routine practice. ConclusionThis study suggested the majority of physiotherapists perform physical activity assessment and promotion in routine practice in India. Most of them have an appropriate attitude towards physical activity, but very few physiotherapists have adequate knowledge of WHO physical activity guidelines. Physiotherapists should actively promote physical activities in routine practice to reduce the impairment due to physical inactivity especially during the Corona virus disease pandemic in India. Efforts should be made to increase the physical activity awareness in terms of knowledge of WHO physical activity guidelines, different assessment, and promotion strategies.

Assessing physical activity, nutrient intake and obesity in middle-aged adults in Akuse, Lower Manya Krobo, Ghana

PurposeThe purpose of this paper is to assess physical activity and nutrient intake and their association with obesity in apparently healthy middle-aged adults in Akuse, a rural community in the Eastern region of Ghana.Design/methodology/approachThis cross-sectional study assessed demography and anthropometry, nutrient intakes using a 3-day repeated 24 h dietary recall and physical activity using the global physical activity questionnaire (GPAQ). Data were entered into Microsoft excel and analyzed with SPSS version 25.FindingsThere were 118 respondents (55 males, 46.6% and 63 females, 53.4%) in the study with mean age of 45.62 ± 6.88 years. About 90% of respondents were physically active based on WHO physical activity recommendation. Prevalence of overweight/obesity was higher among inactive participants compared to active participants and sitting/reclining hours was significantly (p-value = 0.042) associated positively with BMI after a bivariate correlation analysis, suggesting that physical activity plays a role in obesity. About one in five respondents were obese. Mean energy intake exceeded RDA for females. Sodium intake far exceeded RDA for both males and females, putting the population at potential risk of hypertension.Practical implicationsThis study demonstrates the need for intensifying health education and other obesity prevention interventions to curb the rising obesity prevalence in rural communities.Originality/valueThe study revealed that overweight/ obesity in this rural community is higher than previously reported for rural Ghana.

Physical Activity and Sedentary Behavior of Children in Afterschool Programs: An Accelerometer-Based Analysis in Full-Day and Half-Day Elementary Schools in Germany.

Background: Regular physical activity (PA) and reduced sedentary behavior (SB) are positively related to children's health and considered as pillars of a healthy lifestyle. Full-day schools with their afterschool programs (ASPs) have an impact on children's daily PA and SB. Studies investigating PA and SB in ASPs, which compare PA and SB between the organizational forms full-day and half-day schools, are rare. The aim of this study is to describe elementary school children's PA and SB during ASPs and to compare the results to other time periods of the day, e.g., teaching hours and leisure time. Additionally, PA and SB of children in full-day and half-day schools are compared. Further, relevant factors influencing the achievement of the World Health Organization's (WHO's) PA guidelines for children, e.g., time spent in ASPs, are investigated.Methods: PA and SB of 332 German students (n = 198 full-day school children; n = 134 half-day school children) from 11 different elementary schools were measured via accelerometry for 5 consecutive days within one school week in 2017. PA and SB during ASPs and other times of the day were analyzed via one-way and factorial ANOVA, correlation, and logistic regression.Results: Children attending full-day schools show the highest percentage of moderate-to-vigorous PA (MVPA) (13.7%) and the lowest percentage of SB (49.5%) during ASPs, in comparison with teaching hours and leisure time. In the afternoon hours, full-day school children show 20 min less SB than half-day school children. Children spending more time in ASPs obtain significantly more SB (r = 0.23) and less MVPA (r = −0.15). Further, they less likely reach WHO's PA guidelines odds ratio (OR = 0.98).Conclusion: Peers and the choice as well as offer of extracurricular activities promote PA in ASPs. Media availability leads to higher SB in leisure time. ASPs help to be more active and less sedentary. Time spent in ASPs should be limited, so that full-day school children still have the possibility to join other PA offers in leisure time. ASP time should contain a certain minimum amount of MVPA in line with ASP guidelines.

Acculturation And Leisure-time Physical Activity Among Asian American In The United States, 2011-2016

The Asian population has become the fastest growing ethnic group in the United States (US). However, less than a quarter of Asian Americans met WHO Physical Activity (PA) Guideline. Few studies have examined the association between acculturation and leisure-time PA among Asian Americans. PURPOSE: To examine the association between acculturation and leisure-time PA among Asian American adults. METHODS: Data concerning 1,989 Asian Americans aged 20 years and older, came from the 2011- 2016 National Health and Nutrition Examination Survey (NHANES). Acculturation was assessed in three dimensions: the language preference at home (only Non-English language, both English and Non-English language, and only English), length of residency in the US (<10 years, 10-29 years, ≥30 years, US born), and birth locations (US-born, foreign-born). Using self-reported minutes/day and days/week moderate and vigorous leisure-time PA, we calculated moderate-to-vigorous PA (MVPA) MET minutes/week. MVPA was analyzed as a continuous variable and a categorical variable (i.e., meeting WHO PA guidelines, ≥600 MET minutes/week) in multiple linear and logistic regression models after controlling for covariates, respectively. RESULTS: Among participants, 24.5% of Asian Americans spoke only English at home, while 47.8% spoke only non-English at home. 13.0% of participants were born in the US. The odds of meeting PA guidelines were higher among Asians speaking only English (adjusted OR [AOR]=1.8, 95% confidence interval [CI]: 1.4, 2.4) and those speaking both non-English and English at home (AOR=1.6, 95% CI: 1.3, 2.0), compared to those who spoke only non-English at home. US-born Asians were more likely to meet PA guidelines than foreign-born Asians (AOR=1.8, 95% CI: 1.3, 2.6) and on average they performed 137 more minutes of leisure-time MVPA each week than foreign-born Asians. Asians in the US since birth had higher odds to meet PA guidelines than Asians stayed in US for less than 10 years (AOR=2.2, 95% CI: 1.5, 3.3). CONCLUSIONS: More acculturated Asian Americans such as those who spoke more English at home and US-born Asians, perform more leisure-time MVPA than less acculturated Asian Americans. Interventions are needed to promote PA among non-English speaking Asian immigrants and those who stayed in the US for less than 10 years.

Cardiorespiratory Fitness and Physical Activity following Lung Transplantation: A National Cohort Study

Background: Low cardiorespiratory fitness and inactivity are common after lung transplantation (LTx). The causes of exercise intolerance are incompletely understood. Objectives: The aim of this study was to objectively assess cardiorespiratory fitness and physical activity, evaluate causes of exercise intolerance, and explore clinical factors associated with cardiorespiratory fitness after bilateral LTx (BLTx). Materials and Methods: Peak oxygen uptake (V∙O_2peak) and exercise-limiting factors were evaluated by a treadmill cardiopulmonary exercise test (CPET) 6–60 months after BLTx. Physical activity was measured with accelerometers, and results were compared with Norwegian normative data and the World Health Organization’s (WHO) recommendations for physical activity. Results: In 54 included BLTx recipients (mean age 50 ± 15 years, 50% females), V∙O_2peak (mL × kg^–1 × min^–1) was 21.8 ± 7.7 for men and 22.4 ± 6.2 for women, corresponding to 57 ± 17 and 70 ± 12% of predicted, respectively. Three patients (6%) met criteria for normal V∙O_2peak. Deconditioning limited V∙O_2peak in 22 patients (41%), while ventilatory limitation and abnormal gas exchange were observed in 14 (26%) and 20 (37%) patients, respectively (some had more than 1 finding). Forty-three patients (86%) did not meet the WHO physical activity recommendations. There was a moderate correlation between V∙O_2peak and physical activity (r = 0.642, p < 0.01). Body mass index, physical activity, forced expiratory volume after 1 second, sex, and hemoglobin together accounted for 73% of the variability in V∙O_2peak. Conclusions: Low cardiorespiratory fitness was observed in the majority of BLTx recipients. Both deconditioning and cardiopulmonary limitations were common findings. Nearly 90% were classified as being inactive according to physical activity recommendations. CPET appears to identify a deconditioned subgroup of BLTx recipients for whom exercise training may be especially beneficial.

Perception of Safety and Its Association With Physical Activity in Adolescents in Mexico

Low levels of physical activity are associated with several noncommunicable diseases. In Mexico, 39.5% of adolescents do not meet WHO physical activity guidelines. Previous literature suggests an association between perception of safety and physical activity. This paper examines the association between perceived crime and pedestrian safety and physical activity in Mexican adolescents. This cross-sectional study used data from 4,079 adolescents aged 15-18 years in Mexico. Physical activity was measured with the Youth Physical Activity Questionnaire and was grouped into the following 5 domains: (1) moderate-to-vigorous physical activity, (2) sports activity, (3) leisure time activity, (4) physical education class, and (5) active commuting to school. Perception of safety was measured as pedestrian safety and crime safety, using the Neighborhood Environment Walkability Scale-Youth. Confirmatory factor analysis was performed to examine the construct validity of this scale on the Mexican population. Data were collected in 2017 and analyzed in 2018. Associations between physical activity and perception of safety were examined using linear regression models. Low perception of pedestrian safety was associated with lower moderate-to-vigorous physical activity per week (coefficient= -0.12, 95% CI= -0.19, -0.05) and lower sports activity per week (coefficient= -0.13, 95% CI= -0.23, -0.03) in female adolescents. There was no association between perception of safety and physical activity among male adolescents. Pedestrian safety was negatively associated with moderate-to-vigorous physical activity and sports participation in female youth. Environments with better lighting, crosswalks, and walking/cycle trails could increase physical activity in female youth.

Age differences of arterial trauma – Selection of the most appropriate age classification

Introduction: Studies on age differences of arterial trauma (AT) carry significant methodological differences in terms of selection of the most appropriate age classification. Aim: This study aims to verify the most optimal age classification when comparing clinical patterns of the civil AT. Material and methods: 222 AT patients were identified from the Lviv Clinical Regional Hospital. In each case the following clinical patterns were identified: patient age, etiology, mechanism, AT type, topography, diagnostics mode, treatment type. Patients were distributed using six age classifications (Erikson 1950, UN 1989, Quinn 1994, Craig 2000, WHO physical activity recommendations 2010, by decades of life). Generalized linear models (GLMs) were created, with age distributions as predictors and clinical patterns as dependent factors. Akaike information criterion (AIK) was used to compare the quality of statistical sets. Results and discussion: Six GLMs were obtained, in each age of them age classifications were compared using the AIK. Rating list of age classifications was developed (starting with the most appropriate and ending with the least appropriate): E. Erikson (1950) → V. Quinn (1994) → G. Craig (2000) → UN (1989) → Decades → WHO (2010). Conclusions: Human development classifications may be preferable in assessing the age differences of AT in patients of wide range.

Clinical determinants of physical activity and sedentary behaviour in individuals with schizophrenia.

Modifiable lifestyle factors such as physical activity (PA) have ameliorative effects on commonly reported health conditions in schizophrenia like cardiovascular diseases and diabetes. Similarly, reduction in sedentary behaviour (SB) promotes better physical health. However, engaging individuals with schizophrenia in PA and less SB can be challenging because of symptoms of schizophrenia. The aims of the present study are (i) to examine the profiles of PA and SB in individuals with schizophrenia; and (ii) to identify their respective clinical determinants. 157 individuals with schizophrenia were recruited. PA and SB were examined via the Global Physical Activity Questionnaire (GPAQ). Psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS). Potential clinical predictors of PA and SB were identified via univariate regression analyses and subsequently included in the final multiple regression models for PA and SB respectively. 63.7% met the WHO PA guidelines. Work-related activity was the largest domain specific contribution towards PA. Mean duration of SB was approximately 9 h and about 57.3% reported at least 8 h or more of SB daily. Positive symptom was associated with engagement in PA and reduced duration of SB. Negative symptom was associated with greater SB. With emerging evidence of deleterious health effects of SB independent of PA, it is important to monitor SB in individuals with schizophrenia, particularly those presenting with negative symptoms. While the lack of treatment response for negative symptoms remains a challenge, effort should be made to reduce duration of SB.

Physiotherapists lack knowledge of the WHO physical activity guidelines. A local or a global problem?

BackgroundPhysical inactivity is a significant cause of premature deaths globally, yet many physiotherapists)PT's) have little knowledge of the World Health Organization's physical activity guidelines (PA). ObjectivesTo assess the knowledge of Israeli PT's regarding the World Health Organization's (WHO) recommendations for PA for adults and adolescents. Secondary aims were to determine how many Israeli PT's, are recommending PA for their patients and to evaluate the knowledge level of Israeli PT's in relation to PT's in other countries. DesignCross-sectional online survey. ParticipantsOf the 1413 Israeli PT's offered the survey, 1062 (75%) completed it, which represents 16.4% of the 6450 licensed PT's in Israel. ResultsA mere 6.8% physiotherapists were aware of the WHO-recommended level of adult PA, and only 4% were knowledgeable of the recommendations for adolescents. Novice PT's (5 > years of experience) knew significantly more about adult PA recommendations (P < 0.05) than did the more senior physiotherapists. Nine out of every ten (90%) PT's routinely initiate conversations about PA, 83.5% signpost to PA support elsewhere, and 70.5% deliver brief intervention themselves for PA. The main barriers to promoting PA were (1) the belief that promotion would not change patient behavior, (2) lack of time, and (3) perceived lack of skills at counseling for behavior change. ConclusionsIsraeli PT's have poor knowledge of the WHO's adults and adolescent guidelines for PA. Lack of knowledge among PT's regarding the WHO's PA guidelines is a recurrent global problem that requires immediate attention.

Leisure Time Physical Activity Is Associated with Substantial Reduction in Risk of Breast Cancer and Breast Cancer Subtypes in Nigerian Women (P16-007-19)

ObjectivesTo examine the association between leisure-time physical activity (LTPA) and breast cancer in Nigerian women.The hypothesis was that LTPA decreased breast cancer cases in Nigerian women.To examine the association between LTPA and estrogen receptor positive (ER+), triple negative breast cancer (TNBC+), Luminal A breast cancer in Nigerian women.The hypothesis was that LTPA decreased breast cancer subtypes in Nigerian women. MethodsWe enrolled 739 newly diagnosed primary invasive breast cancer and 739 age-matched controls in Nigeria from 01/2014 to 07/2016. This analysis is restricted to the 40% of cases for whom we have complete ER, TNBC, and Luminal-A data and their matched controls. We derived the average amount of time per week spent on LTPA over the past year using a modified Nurses’ Health Study II PA questionnaire. LTPA was calculated from the total metabolic equivalent (METs) assigned for each reported physical activity hour/week (i.e., walking, cycling, and dancing). We examined LTPA by comparing participants who attained the WHO physical activity recommendations of at least 150 minutes of moderate-intensity or/and 75 minutes of vigorous-intensity aerobic activity weekly with those who did not. We used conditional logistic regression to estimate the adjusted Odds Ratio (OR) of LTPA and overall as well as subtypes of breast cancer. ResultsThe mean (SD) age of cases was 41.6 (9.1) and controls 43.9 (11.8) years. Women who attained the WHO physical activity recommendations had 43% decreased the risk of breast cancer (OR = 0.57, 95% CI:0.42–0.77) compared with those who did not, after controlling for demographic, anthropometric and fertility-related factors. LTPA was also associated with reduced risk of breast cancer subtypes by 41% for ER+, 59% for TNBC+and 59% for Luminal A. ConclusionsPhysical activity is associated with reduced risk of breast cancer overall and by subtypes in Nigerian women. Funding SourcesTraining Program in Nigeria for Non-Communicable Diseases Research (TRAPING NCD) grant number FIC/NIH D43TW009106 from the Fogarty International Centre. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Fogarty International Centre or the National Institutes of Health.

Medical Students’ Knowledge and Attitudes to Physical Activity and Health and to Physical Activity Counseling

PURPOSE: Physical activity (PA) counseling in the health care setting is regarded as a promising avenue to increase population level PA. Equipping future physicians with the necessary knowledge is crucial. The aim of this survey was to assess the knowledge on and attitude towards PA and health, as well as PA counseling at a large German Medical School. METHODS: a 15-item online survey was conducted. The study has been approved by the University Ethics Committee. RESULTS: 145 students (106 females,73% ) returned the questionnaire. 118 (81%) reported not knowing the WHO PA recommendations. Only 15 (10,3%) respondents could identify the recommendations correctly. 108 (74%) reported having learnt anything on the health effects of PA. 106 (73%) wished more information on this topic. 97% and 96% of respondents considered PA to be important or very important in the prevention and therapy of chronic diseases respectively. 99% judged PA counseling to be physicians’ task. Weekly reported PA was as follows: 9 (6%) no exercise, 19 (13%) > 1 hr, 47 (32%) 1-2 hrs, 41 (28%) 2-4 hrs, and 29 (20%) ˂4 hours. 32 (22%) respondents were in the entry phase of their studies, 87 (60%) in the midphase and 26 (18%) in their final, practical year. Gender was not associated with the importance of PA in prevention and therapy, with physicians’ PA counseling role and with perceived need for more information on PA and health. High overall PA volume was only associated with physicians’ PA counseling role (Spearman’s rho ,224, p > 0,01.). The importance of PA in therapy was associated with the importance of PA in prevention (Spearman’s rho ,595, p > 0,01.). PA counseling as physicians’ role was associated with PA in prevention (Spearman’s rho,402, p > 0,01) and PA in therapy (Spearman’s rho ,406 p > 0,01) respectively. CONCLUSIONS: Medical students are interested in learning about the health effects of PA, consider PA important in the prevention and therapy of chronic diseases, and see PA counseling as physicians’ task, with no difference between males and females and students according to their study phase. Also no association was found between respondents’ PA and health related views and their volume of PA. A self-selection bias in respondents cannot be ruled out.

Association of leisure time physical activity with breast cancer risk and breast cancer sub-types in Nigerian women.

e13085 Background: The association between physical activity and breast cancer has not been studied among Nigerian women and in particular by breast cancer sub-types. Therefore are studies aims are to examine the association between leisure time physical activity (LTPA) and breast cancer in Nigerian women and to examine the association between LTPA and estrogen receptor positive (ER+), triple negative breast cancer (TNBC+), Luminal A breast cancer in Nigerian women. Methods: We enrolled 739 newly diagnosed primary invasive breast cancer and 739 age-matched controls in Nigeria from 01/2014 to 07/2016. This analysis is restricted to the 40% of cases for whom we have complete ER, TNBC and Luminal-A data and their matched controls. We derived the average amount of time per week spent on LTPA over the past one year using a modified Nurses’ Health Study II PA questionnaire. LTPA was calculated from the total metabolic equivalent (METs) assigned for each reported physical activity hour/week (i.e. walking, cycling, and dancing). We examined LTPA by comparing participants who attained the WHO physical activity recommendations of at least 150 minutes of moderate-intensity or/and 75 minutes of vigorous-intensity aerobic activity weekly with those who did not. We used conditional logistic regression to estimate the adjusted Odds Ratio (OR) of LTPA and overall as well as subtypes of breast cancer. Results: The mean (SD) age of cases was 41.6 (9.1) and controls was 43.9 (11.8) years. Women who attained the WHO physical activity recommendations had 43% decreased risk of breast cancer (OR = 0.57 95% CI:0.42-0.77) compared with those who did not, after controlling for demographic, anthropometric and fertility related factors. LTPA was also associated with reduced risk of breast cancer subtypes by 41% for ER+, 59% for TNBC+ and 59% for Luminal A. Conclusions: Physical activity is associated with reduced risk of breast cancer overall and by subtypes in Nigerian women.

Testing compliance to WHO guidelines for physical activity in Flanders: insights from time-use diaries

BackgroundRegular physical activity decreases the risk for numerous non-communicable diseases. The World Health Organization has suggested physical activity (PA) guidelines that, based on previous research, would provide health benefits to those who comply. The first guideline for health benefits suggests 150 min of moderate PA or equivalent per week. The guideline for additional health benefits suggests 300 min of PA or equivalent per week. The objective of this paper is to analyze to what extent these two WHO PA guidelines for adults are met in the Belgian region of Flanders. Furthermore, we are interested to see which groups are more or less likely to meet the PA guidelines.MethodsCrosstables and logistic regressions are used on a sample of 3028 adults in the Belgian region of Flanders. All respondents filled in a 7-day time-diary in which they continuously recorded all their activities.ResultsFirstly, men are more likely than women to comply to both PA guidelines. Secondly, living with a partner increases the odds to comply to the guidelines. For men, this is the case for both guidelines, while for women, this only applies to the first guideline. Thirdly, women with a young child have lower odds to comply to the guidelines, while having a young child doesn’t have an effect for men.ConclusionPrevious research on meeting PA guidelines in Flanders shows diverging results. Time-diary data allows researchers to strictly follow the WHO definition when operationalizing compliance to PA guidelines. There is a need for future research that combines time-diaries with a PA questionnaire and accelerometer data to gain more insights on the benefits and pitfalls of both methodologies.