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Deb Nath N, Odoi A. Predictors of county-level diabetes-related mortality risks in Florida, USA: a retrospective ecological study. PeerJ 2025; 13:e18537. [PMID: 39830967 PMCID: PMC11742252 DOI: 10.7717/peerj.18537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 10/25/2024] [Indexed: 01/22/2025] Open
Abstract
Background Diabetes is an increasingly important public health problem due to its socioeconomic impact, high morbidity, and mortality. Although there is evidence of increasing diabetes-related deaths over the last ten years, little is known about the population level predictors of diabetes-related mortality risks (DRMR) in Florida. Identifying these predictors is important for guiding control programs geared at reducing the diabetes burden and improving population health. Therefore, the objective of this study was to identify geographic disparities and predictors of county-level DRMR in Florida. Methods The 2019 mortality data for the state of Florida were obtained from the Florida Department of Health. The 10th International Classification of Disease codes E10-E14 were used to identify diabetes-related deaths which were then aggregated to the county-level. County-level DRMR were computed and presented as number of deaths per 100,000 persons. Geographic distribution of DRMR were displayed in choropleth maps and ordinary least squares (OLS) regression model was used to identify county-level predictors of DRMR. Results There was a total 6,078 diabetes-related deaths in Florida during the study time period. County-level DRMR ranged from 9.6 to 75.6 per 100,000 persons. High mortality risks were observed in the northern, central, and southcentral parts of the state. Relatively higher mortality risks were identified in rural counties compared to their urban counterparts. Significantly high county-level DRMR were observed in counties with high percentages of the population that were: 65 year and older (p < 0.001), current smokers (p = 0.032), and insufficiently physically active (p = 0.036). Additionally, percentage of households without vehicles (p = 0.022) and percentage of population with diabetes (p < 0.001) were significant predictors of DRMR. Conclusion Geographic disparities of DRMR exist in Florida, with high risks being observed in northern, central, and southcentral counties of the state. The study identified county-level predictors of these identified DRMR disparities in Florida. The findings are useful in guiding health professionals to better target intervention efforts.
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Affiliation(s)
- Nirmalendu Deb Nath
- Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville, TN, United States of America
| | - Agricola Odoi
- Biomedical and Diagnostic Sciences, University of Tennessee, Knoxville, TN, United States of America
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Bassin SR, Srinath R. The Impact of Physical Activity in Patients With Type 2 Diabetes. Am J Lifestyle Med 2025; 19:147-161. [PMID: 39822318 PMCID: PMC11733108 DOI: 10.1177/15598276231180541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2025] Open
Abstract
Most patients with type 2 diabetes (T2DM) do not meet guideline-driven exercise recommendations. Physical activity (PA) is any form of bodily movement via skeletal muscle contraction. It can include walking, gardening, leisure activity, exercise, or movement for transportation or an occupation. Aerobic and resistance exercise have been well studied and are known to improve glycemic control in patients with T2DM. While data is less substantial, low-intensity PA such as walking, yoga, tai-chi, qigong, and activity for household tasks have also been shown to be effective methods of reducing hyperglycemia. Additionally, PA to break up sedentary behaviors can also have glycemic benefits. Healthcare providers should encourage patients to increase their PA as a more sustainable means of meeting guideline-directed exercise and activity recommendations. Discussing these changes with patients involves identifying motivators, setting goals, removing barriers, monitoring progress, and understanding the patient's social support and environment.
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Affiliation(s)
- Sandhya Rao Bassin
- Department of Endocrine, Diabetes, and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Reshmi Srinath
- Department of Endocrine, Diabetes, and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Yokoyama M, Kusuba Y, Hashizume K, Matsuura E. Evaluation of physical activity with the International Physical Activity Questionnaire among outpatients with type 2 diabetes mellitus in Japan. J Rural Med 2025; 20:20-27. [PMID: 39781300 PMCID: PMC11704600 DOI: 10.2185/jrm.2024-002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 10/02/2024] [Indexed: 01/12/2025] Open
Abstract
Objective This study aimed to investigate the amount of physical activity, including daily movement, and the factors related to the amount of physical activity undertaken by patients with type 2 diabetes mellitus at an outpatient clinic. Patients and Methods A self-administered questionnaire was distributed to 111 patients, aged 20 years or older, with type 2 diabetes mellitus, who visited a diabetes outpatient clinic. The amount of physical activity was investigated using the International Physical Activity Questionnaire-Long Version. Influencing factors were divided into individual attributes (age, sex, and employment status), disease-related factors (body mass index, treatment period, medication usage, insulin usage, symptoms of fatigue, and lethargy), and emotion-related factors (depression and optimism). These were tested using stepwise regression analysis. Results Daily physical activity was 288 metabolic equivalents of task/minute. The sub-scores by the time of day showed "physical activity within the household" and "physical activity during leisure time" as the highest, with 51 metabolic equivalent of tasks/minute. Employment status, medication usage, and depression status were found to have a significant influence and explained 17.9% of the distribution of the entire model. Conclusion The results suggest that the amount of daily physical activity among non-working patients should increase. Moreover, we highlight the need to provide diabetes education from the early treatment stages and the importance of early detection and care of patients' psychological needs.
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Affiliation(s)
- Miki Yokoyama
- Health Sciences (Master Course), Graduate School of Biomedical Sciences, Nagasaki University, Japan
- Present address: Department of Nursing, Faculty of Health Sciences, Junshin Gakuen University, Japan
| | - Yoko Kusuba
- Health Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Japan
- Present address: Department of Nursing, Graduate School, International University of Health and Welfare Fukuoka, Japan
| | - Kaori Hashizume
- Health Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Japan
- Present address: Department of Nursing, Graduate School, International University of Health and Welfare Fukuoka, Japan
| | - Emi Matsuura
- Health Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Japan
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Waghorn J, Schwartz BD, Shivgulam ME, Wu Y, Kimmerly DS, O’Brien MW. Meeting international self-report muscle strengthening guidelines is associated with better cardiovagal baroreflex sensitivity in adults. Front Sports Act Living 2024; 6:1509784. [PMID: 39722741 PMCID: PMC11668578 DOI: 10.3389/fspor.2024.1509784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2024] [Accepted: 11/26/2024] [Indexed: 12/28/2024] Open
Abstract
Engaging in muscle strengthening activities (e.g., resistance training) at least twice/week is promoted by (Inter)national movement guidelines. Cardiovagal baroreflex sensitivity (cvBRS) reflects the ability to modulate R-R interval in response to changes in systolic blood pressure. Given the current conflicting literature, this study posed to explore the relationship between self-report muscle strengthening frequency and spontaneous cvBRS. 114 adults (62 females; age: 33 ± 19 years, 22% >55 years; body mass index: 24.2 ± 3.7 kg/m2) self-reported their weekly muscle strengthening activity frequencies via the Physical Activity and Sedentary Behaviour Questionnaire. Supine beat-by-beat R-R intervals [electrocardiography; 1.00 ± 0.18 s (0.90-1.50 s)] and systolic blood pressure [via finger photoplethysmography; 116 ± 11 mmHg (93-151 mmHg)] were recorded for 10.7 ± 2.0 min (5.3-14.5 min). Spontaneous cvBRS was assessed using the sequence technique. Data were analyzed using multiple regressions adjusted for age, sex, body mass index. Participants completed 2 ± 2 (0-7) days/week of muscle strengthening activities (56% met guidelines), and average overall cvBRS was 14.9 ± 9.1 (3.1-48.4) ms/mmHg. Higher reported frequencies were positively associated with overall cvBRS (Adjusted R2 = 0.40, p < 0.001; β = 2.24, p < 0.001). Meeting muscle strengthening activity guidelines was associated with improved overall cvBRS (Adjusted R2 = 0.29, p < 0.001; β = 7.68, p < 0.001). All results were unchanged if cvBRS for up-sequences or down-sequences only were used (all, p < 0.001). In conclusion, engaging in muscle strengthening exercises and particularly meeting existing guidelines were associated with better beat-by-beat vagally-mediated blood pressure regulation.
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Affiliation(s)
- Jocelyn Waghorn
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Beverly D. Schwartz
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Madeline E. Shivgulam
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada
- Geriatric Medicine Research, Dalhousie University & Nova Scotia Health, Halifax, NS, Canada
| | - Yanlin Wu
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada
- Geriatric Medicine Research, Dalhousie University & Nova Scotia Health, Halifax, NS, Canada
| | - Derek S. Kimmerly
- Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Myles W. O’Brien
- Geriatric Medicine Research, Dalhousie University & Nova Scotia Health, Halifax, NS, Canada
- Department of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Formation Médicale du Nouveau-Brunswick, Université de Sherbrooke, Moncton, NB, Canada
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Ni Z, Zhu X, Shen Y, Zhu X, Xie S, Yang X. Effects of activities participation on frailty of older adults in China. Front Public Health 2024; 12:1483166. [PMID: 39635216 PMCID: PMC11614733 DOI: 10.3389/fpubh.2024.1483166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2024] [Accepted: 11/04/2024] [Indexed: 12/07/2024] Open
Abstract
Objective Frailty represents a significant health challenge among older adults, necessitating effective interventions to enhance their overall wellbeing. This study aims to investigate the impact of various types of activity participation on frailty in older adults and to elucidate their intrinsic associations, thereby providing a basis for targeted interventions. Methods This study constructed a classification of activities based on the framework proposed by the WHO regarding functional ability in healthy aging, innovatively dividing activities into five categories: physical activity, social activity, economic activity, information activity and sleep activity. Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS 2020), the research employed multiple linear regression and mediation analysis to explore the effects of these activities on the frailty status of older adults and their underlying mechanisms. Furthermore, propensity score matching was conducted to robustly test the regression results. Results The study found that physical activity (β = -0.006, p < 0.01), social activity (β = -0.007, p < 0.01), economic activity (β = -0.017, p < 0.01), information activity (β = -0.040, p < 0.01) and sleep activity (β = -0.044, p < 0.01) all had significant positive effects on the frailty status of older adults. Additionally, sleep activity mediated the relationship between physical activity and frailty status, accounting for 4.819%. Social activity mediated the relationship between information activity and frailty status, accounting for 7.692%. Conclusion Older adults should enhance their participation in various activities to alleviate frailty. This can be further improved through the following three aspects: engaging in moderate physical exercise, fostering and promoting awareness of volunteer services, and popularizing the use of information technology.
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Affiliation(s)
- Zihan Ni
- School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiuyuan Zhu
- School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuxin Shen
- School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiaoying Zhu
- School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, China
- Nossal Institute for Global Health, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Shiyu Xie
- School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiaoguang Yang
- Chinese Hospital Development Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Mahe J, Xu A, Liu L, Hua L, Tu H, Huo Y, Huang W, Liu X, Wang J, Tang J, Zhao Y, Liu Z, Hong Q, Ye R, Hu P, Jia P, Huang J, Kong X, Ge Z, Xu A, Wu L, Du C, Shi F, Cui H, Wang S, Li Z, Wang L, Zhang L, Zhang L. Association between weekend warrior physical activity pattern and all-cause mortality among adults living with type 2 diabetes: a prospective cohort study from NHANES 2007 to 2018. Diabetol Metab Syndr 2024; 16:226. [PMID: 39267148 PMCID: PMC11391736 DOI: 10.1186/s13098-024-01455-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/22/2024] [Indexed: 09/14/2024] Open
Abstract
BACKGROUND It is uncertain whether the weekend warrior pattern is associated with all-cause mortality among adults living with type 2 diabetes. This study explored how the 'weekend warrior' physical activity (PA) pattern was associated with all-cause mortality among adults living with type 2 diabetes. METHODS This prospective cohort study investigated US adults living with type 2 diabetes in the National Health and Nutrition Examination Survey (NHANES). Mortality data was linked to the National Death Index. Based on self-reported leisure-time and occupational moderate-to-vigorous PA (MVPA), participants were categorized into 3 groups: physically inactive (< 150 min/week of MVPA), weekend warrior (≥ 150 min/week of MVPA in 1 or 2 sessions), and physically active (≥ 150 min/week of MVPA in 3 or more sessions). RESULTS A total of 6067 participants living with type 2 diabetes [mean (SD) age, 61.4 (13.5) years; 48.0% females] were followed for a median of 6.1 years, during which 1206 deaths were recorded. Of leisure-time and occupational activity, compared with inactive individuals, hazard ratios (HRs) for all-cause mortality were 0.49 (95% CI 0.26-0.91) and 0.57 (95% CI 0.38-0.85) for weekend warrior individuals, and 0.55 (95% CI 0.45-0.67) and 0.64 (95% CI 0.53-0.76) for regularly active individuals, respectively. However, when compared leisure-time and occupational weekend warrior with regularly active participants, the HRs were 0.82 (95% CI 0.42-1.61) and 1.00 (95% CI 0.64-1.56) for all-cause mortality, respectively. CONCLUSIONS Weekend warrior PA pattern may have similar effects on lowering all-cause mortality as regularly active pattern among adults living with type 2 diabetes, regardless of leisure-time or occupational activity. Therefore, weekend warrior PA pattern may be sufficient to reduce all-cause mortality for adults living with type 2 diabetes.
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Affiliation(s)
- Jinli Mahe
- The School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Suzhou Industrial Park Monash Research Institute of Science and Technology, Monash University, Suzhou, China
| | - Ao Xu
- Monash University-Southeast University Joint Research Institute (Suzhou), Southeast University, Suzhou, China
| | - Li Liu
- Data Centre, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Lei Hua
- Data Centre, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Huiming Tu
- Department of Gastroenterology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Yujia Huo
- The School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Suzhou Industrial Park Monash Research Institute of Science and Technology, Monash University, Suzhou, China
- Monash University-Southeast University Joint Research Institute (Suzhou), Southeast University, Suzhou, China
| | - Weiyuan Huang
- The School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Suzhou Industrial Park Monash Research Institute of Science and Technology, Monash University, Suzhou, China
| | - Xinru Liu
- The School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Suzhou Industrial Park Monash Research Institute of Science and Technology, Monash University, Suzhou, China
| | - Jian Wang
- The School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Suzhou Industrial Park Monash Research Institute of Science and Technology, Monash University, Suzhou, China
| | - Jinhao Tang
- International College, Krirk University, Bangkok, Thailand
| | - Yang Zhao
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- The George Institute for Global Health, Beijing, China
| | - Zhining Liu
- Anhui Medical University Affiliated Hospital, Hefei, China
| | - Qiaojun Hong
- Anhui No.2 Provincial People's Hospital, Hefei, China
| | - Rong Ye
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Collaborative Innovation Canter of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Panpan Hu
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Collaborative Innovation Canter of Neuropsychiatric Disorders and Mental Health, Hefei, China
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Peng Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China
- Hubei Luojia Laboratory, Wuhan, China
- School of Public Health, Wuhan University, Wuhan, China
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
| | - Junjie Huang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hongkong, China
| | - Xiangyi Kong
- Department of Breast Surgical Oncology, National Cancer Centre/National Clinical Research Centre for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zongyuan Ge
- Faculty of Engineering, Monash University, Melbourne, Australia
| | - Aimin Xu
- College of Big Data and Software Engineering, Zhejiang Wanli University, Ningbo, China
| | - Longfei Wu
- Centre for Genetic Epidemiology and Genomics, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - Chaopin Du
- Department of Neurology, Nantong Third Hospital Affiliated to Nantong University, Nantong, China
| | - Feng Shi
- Department of Surgery, Civil Aviation General Hospital, Shanghai, China
| | - Hanbin Cui
- Department of Cardiovascular Medicine, First Affiliated Hospital, Ningbo University, Ningbo, China
| | - Shengfeng Wang
- School of Public Health, Peking University, Beijing, China
| | - Zhihui Li
- Tsinghua Vanke School of Public Health, Beijing, China
| | - Liang Wang
- Department of Public Health, Marshall University, Huntington, WV, USA
| | - Lei Zhang
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
- Clinical Medical Research Centre, Children's Hospital of Nanjing Medical University, Nanjing, China.
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia.
| | - Lin Zhang
- The School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
- Suzhou Industrial Park Monash Research Institute of Science and Technology, Monash University, Suzhou, China.
- Monash University-Southeast University Joint Research Institute (Suzhou), Southeast University, Suzhou, China.
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Bopp M, Elliott LD, Peterson KT, Duffey M, Wilson OWA. Domain matters: An examination of college student physical activity participation patterns by gender and race/ethnicity. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38848576 DOI: 10.1080/07448481.2024.2362317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/19/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Physical activity (PA) consists of multiple domains, including leisure-time PA (LTPA), occupational PA (OPA), and transportation PA (TPA), though limited research has examined these domains among college students. METHODS This cross sectional, online survey asked undergraduate students to self-report demographics (gender, race/ethnicity, employment) and PA (LTPA, TPA, and OPA). Participants were categorized as meeting/not meeting current aerobic PA recommendations with only LTPA and with all domains of PA. Analyses examined differences by domain and demographics. RESULTS For participants (n = 3732) when only considering LTPA, 79% met recommendations, while considering all forms of PA resulted in 94% of students meeting recommendations. Gender and race/ethnicity differences in the odds of meeting PA recommendations were present with only LTPA, however when considering all PA domains, some disparities were no longer present. CONCLUSIONS These findings highlight how different domains of activity contribute to overall PA and the relationship with gender and race/ethnicity.
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Affiliation(s)
- Melissa Bopp
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Lucas D Elliott
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Keegan T Peterson
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Michele Duffey
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Oliver W A Wilson
- Te Hau Kori, Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
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Clemente-Suárez VJ, Beltrán-Velasco AI, Redondo-Flórez L, Martín-Rodríguez A, Tornero-Aguilera JF. Global Impacts of Western Diet and Its Effects on Metabolism and Health: A Narrative Review. Nutrients 2023; 15:2749. [PMID: 37375654 PMCID: PMC10302286 DOI: 10.3390/nu15122749] [Citation(s) in RCA: 227] [Impact Index Per Article: 113.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
The Western diet is a modern dietary pattern characterized by high intakes of pre-packaged foods, refined grains, red meat, processed meat, high-sugar drinks, candy, sweets, fried foods, conventionally raised animal products, high-fat dairy products, and high-fructose products. The present review aims to describe the effect of the Western pattern diet on the metabolism, inflammation, and antioxidant status; the impact on gut microbiota and mitochondrial fitness; the effect of on cardiovascular health, mental health, and cancer; and the sanitary cost of the Western diet. To achieve this goal, a consensus critical review was conducted using primary sources, such as scientific articles, and secondary sources, including bibliographic indexes, databases, and web pages. Scopus, Embase, Science Direct, Sports Discuss, ResearchGate, and the Web of Science were used to complete the assignment. MeSH-compliant keywords such "Western diet", "inflammation", "metabolic health", "metabolic fitness", "heart disease", "cancer", "oxidative stress", "mental health", and "metabolism" were used. The following exclusion criteria were applied: (i) studies with inappropriate or irrelevant topics, not germane to the review's primary focus; (ii) Ph.D. dissertations, proceedings of conferences, and unpublished studies. This information will allow for a better comprehension of this nutritional behavior and its effect on an individual's metabolism and health, as well as the impact on national sanitary systems. Finally, practical applications derived from this information are made.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (J.F.T.-A.)
| | | | - Laura Redondo-Flórez
- Department of Health Sciences, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, C/Tajo s/n, 28670 Villaviciosa de Odón, Spain;
| | - Alexandra Martín-Rodríguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (V.J.C.-S.); (J.F.T.-A.)
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Li G, Xing Y, Wang G, Wu Q, Ni W, Jiao N, Chen W, Liu Q, Gao L, Chao C, Li M, Wang H, Xing Q. Does recurrent gestational diabetes mellitus increase the risk of preterm birth? A population-based cohort study. Diabetes Res Clin Pract 2023; 199:110628. [PMID: 36965710 DOI: 10.1016/j.diabres.2023.110628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/07/2023] [Accepted: 03/14/2023] [Indexed: 03/27/2023]
Abstract
AIMS To investigate whether recurrent gestational diabetes mellitus (GDM) is associated with an increased risk of preterm birth. METHODS We conducted a prospective population-based cohort study covering all live singleton births born to nulliparous and multiparous mothers aged 20 years and older in Qingdao, from 2018 to 2020 (n = 105,528). Preterm birth (<37 gestational weeks) was classified into moderate preterm birth (32-36 weeks of gestation) and very preterm birth (<32 weeks). Logistic regression analysis was performed to estimate the risk and severity of prematurity in relation to parity among mothers with previous GDM, current GDM, and recurrent GDM (previous and current GDM), using mothers without GDM as the reference group. Z-test and ratio of odds ratios (ROR) were used to determine subgroup differences. RESULTS Maternal GDM increased the risk of preterm birth in both nullipara (ORadj = 1.28, 95 %CI: 1.14-1.45) and multipara (ORadj = 1.26, 95 %CI: 1.14-1.40). However, the risk of premature delivery in multiparous mothers with recurrent GDM and those with current GDM did not differ significantly, with a ROR of 0.89 (95 %CI: 0.71-1.12). The risk of recurrent GDM on preterm birth was most pronounced among multiparous mothers with pre-pregnancy BMI above 30 kg/m2 (ORadj = 2.18, 95 %CI: 1.25-3.82) as compared with those with current GDM alone (ROR = 2.20, 95 %CI: 1.07-4.52). The risk of GDM for moderate preterm birth was similar to that of overall preterm birth. In contrast, GDM was not associated with very preterm birth irrespective of parity (all P values > 0.05). CONCLUSIONS Maternal GDM increased the risk of preterm birth in nullipara and multipara, whereas recurrent GDM was not associated with a further increase in the risk of prematurity in multiparous mothers. Maternal GDM did not contribute to very preterm birth irrespective of parity. Our findings can be useful for facilitating more targeted preventive strategies for adverse pregnancy outcomes.
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Affiliation(s)
- Guoju Li
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao City, Shandong Province, China
| | - Yuhan Xing
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Guolan Wang
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao City, Shandong Province, China
| | - Qin Wu
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao City, Shandong Province, China
| | - Wei Ni
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao City, Shandong Province, China
| | - Na Jiao
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao City, Shandong Province, China
| | - Wenjing Chen
- Qingdao Women and Children's Health Care and Family Planning Service Center, Qingdao City, Shandong Province, China
| | - Qing Liu
- Qingdao Women and Children's Health Care and Family Planning Service Center, Qingdao City, Shandong Province, China
| | - Li Gao
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao City, Shandong Province, China
| | - Cong Chao
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao City, Shandong Province, China
| | - Minyu Li
- Medical College of Qingdao University, Gate 2, Haoyuan, Ningde Road, Qingdao, China
| | - Hong Wang
- Medical College of Qingdao University, Gate 2, Haoyuan, Ningde Road, Qingdao, China
| | - Quansheng Xing
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao City, Shandong Province, China.
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Occupational Physical Activity and Cardiometabolic Risk Factors: A Cross-Sectional Study. Nutrients 2023; 15:nu15061421. [PMID: 36986151 PMCID: PMC10055795 DOI: 10.3390/nu15061421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
Contradictory data exist on the impact of occupational physical activity (OPA) on cardiovascular health. We aimed to evaluate the association between OPA and cardiometabolic risk factors. A cross-sectional study was performed in an environmental services company in 2017 (Spain). OPA was classified by work categories as being low (≤3 METs) or moderate−high (>3 METs). Multiple linear and logistic binary regression models were used to assess the associations between OPA and cardiometabolic risk factors related to obesity, blood pressure, blood lipids, and associated medical conditions, adjusted by age, sex, alcohol consumption, and global physical activity. In total, 751 employees were included (547 males and 204 females), and 55.5% (n = 417) had moderate−high OPA. Significant inverse associations were observed between OPA and weight, body mass index, waist circumference, waist−hip ratio, and total cholesterol both overall and in males. OPA was significantly inversely related to dyslipidemia overall and in both sexes, while the overweight plus obesity rate was inversely related only in the total and male populations. OPA was associated with a better cardiometabolic risk factor profile, particularly in males. The fact that our models were also adjusted by global physical activity highlights the associations obtained as being independent of leisure time physical activity effects.
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He F, Li Y, Hu Z, Zhang H. Association of domain-specific physical activity with depressive symptoms: A population-based study. Eur Psychiatry 2022; 66:e5. [PMID: 36503700 PMCID: PMC9879900 DOI: 10.1192/j.eurpsy.2022.2350] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND It remains unclear whether all physical activity (PA) domains (e.g., occupation-related PA [OPA], transportation-related PA [TPA], and leisure-time PA [LTPA]) have equivalent beneficial relationships. We aimed to investigate the associations of OPA, TPA, and LTPA with depressive symptoms in adults. METHODS We included and analyzed 31,221 participants (aged ≥18 years) from the cross-sectional 2007-2018 U.S. National Health and Nutrition Examination Survey (NHANES). The PA domains were assessed by a self-report questionnaire and categorized based on the PA guidelines. Depressive symptoms were measured by the nine-item Patient Health Questionnaire. RESULTS Participants achieving PA guidelines (≥150 min/week) were 26% (odds ratio [OR] 0.74, 95% confidence interval [CI] 0.68-0.80) and 43% (OR 0.57, 95% CI 0.51-0.62) less likely to have depressive symptoms depending on total PA and LTPA, respectively, while OPA or TPA did not demonstrate lower risks of depressive symptoms. LTPA at levels of 1-149, 150-299, and ≥300 min/week was associated with 31% (OR 0.69, 95% CI 0.60-0.78), 43% (OR 0.57, 95% CI 0.49-0.67), and 51% (OR 0.49, 95% CI 0.43-0.55) lower odds of depressive symptoms, respectively. CONCLUSION LTPA, but not OPA or TPA, was associated with a lower risk of depressive symptoms at any amount, suggesting that significant mental health would benefit from increased PA, even at levels below the recommendation.
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Affiliation(s)
- Fan He
- Human Phenome Institute, Zhangjiang Fudan International Innovation Centre, Fudan University, Shanghai, China
| | - Yi Li
- Human Phenome Institute, Zhangjiang Fudan International Innovation Centre, Fudan University, Shanghai, China
| | - Zixin Hu
- Human Phenome Institute, Zhangjiang Fudan International Innovation Centre, Fudan University, Shanghai, China.,Artificial Intelligence Innovation and Incubation Institute, Fudan University, Shanghai, China
| | - Hui Zhang
- Human Phenome Institute, Zhangjiang Fudan International Innovation Centre, Fudan University, Shanghai, China.,National Clinical Research Centre for Ageing and Medicine, Huashan Hospital, Fudan University, Shanghai, China
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12
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Rietz M, Lehr A, Mino E, Lang A, Szczerba E, Schiemann T, Herder C, Saatmann N, Geidl W, Barbaresko J, Neuenschwander M, Schlesinger S. Physical Activity and Risk of Major Diabetes-Related Complications in Individuals With Diabetes: A Systematic Review and Meta-Analysis of Observational Studies. Diabetes Care 2022; 45:3101-3111. [PMID: 36455117 PMCID: PMC9862380 DOI: 10.2337/dc22-0886] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 09/19/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Physical activity is a cornerstone in diabetes management; however, evidence synthesis on the association between physical activity and long-term diabetes-related complications is scarce. PURPOSE To summarize and evaluate findings on physical activity and diabetes-related complications, we conducted a systematic review and meta-analysis. DATA SOURCES We searched PubMed, Web of Science, and the Cochrane Library for articles published up to 6 July 2021. STUDY SELECTION We included prospective studies investigating the association between physical activity and incidence of and mortality from diabetes-related complications, i.e., cardiovascular disease (CVD), coronary heart disease, cerebrovascular events, heart failure, major adverse cardiovascular events, and microvascular complications such as retinopathy and nephropathy, in individuals with diabetes. DATA EXTRACTION Study characteristics and risk ratios with 95% CIs were extracted. Random-effects meta-analyses were performed, and the certainty of evidence and risk of bias were evaluated with use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) and Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tools. DATA SYNTHESIS Overall, 31 studies were included. There was moderate certainty of evidence that high versus low levels of physical activity were inversely associated with CVD incidence, CVD mortality (summary risk ratio 0.84 [95% CI 0.77, 0.92], n = 7, and 0.62 [0.55, 0.69], n = 11), and microvascular complications (0.76 [0.67, 0.86], n = 8). Dose-response meta-analyses showed that physical activity was associated with lower risk of diabetes-related complications even at lower levels. For other outcomes, similar associations were observed but certainty of evidence was low or very low. LIMITATIONS Limitations include residual confounding and misclassification of exposure. CONCLUSIONS Physical activity, even below recommended amounts, was associated with reduced incidence of diabetes-related complications.
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Affiliation(s)
- Marlene Rietz
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Research Unit for Exercise Epidemiology (ExE), Department of Sports Science and Clinical Biomechanics, Syddansk Universitet, Odense, Denmark
| | - Alexander Lehr
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Eriselda Mino
- Department of Sport Science and Sport, Division Exercise and Health, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Alexander Lang
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Edyta Szczerba
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
| | - Tim Schiemann
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Christian Herder
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
- Institute of Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Nina Saatmann
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
- Institute of Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Wolfgang Geidl
- Department of Sport Science and Sport, Division Exercise and Health, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Janett Barbaresko
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Manuela Neuenschwander
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
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13
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Park S, Lee JH. Associations of occupational and leisure-time physical activity with self-rated health in Korea. Prev Med 2022; 158:107022. [PMID: 35307369 DOI: 10.1016/j.ypmed.2022.107022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 03/07/2022] [Accepted: 03/13/2022] [Indexed: 11/16/2022]
Abstract
Recent findings have suggested that not all physical activity (PA) types improve health and that the health effects of occupational PA (OPA) and leisure-time PA (LTPA) can be different. However, few studies have been reported the association of OPA and LTPA with self-rated health (SRH). Therefore, we aimed to examine the association between different PA domains and general health and the impact of LTPA on the relationship between health and OPA. In total, 33440 adults from the Korea National Health and Nutrition Examination Survey 2014-2019 were analyzed in September 2021. SRH was dichotomized into "poor" and "good." Sedentary behavior (SB) was evaluated by measuring the daily sitting time. Multiple logistic regression was used to investigate the relationship of SRH with OPA, LTPA, and SB, stratified by LTPA to identify its impact on the relationship. In the fully adjusted model, OPA was found to increase the risk of poor SRH, while LTPA was found to lower the risk. In those who did not engage in LTPA, OPA and poor SRH were significantly associated. Poor SRH was not significantly associated with OPA in those who engaged in LTPA. SB was also associated with poor SRH, independent of LTPA. To improve health, it is important to promote LTPA and reduce OPA and SB. In particular, for workers with a higher level of OPA, additional LTPA should be introduced to prevent SRH from worsening.
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Affiliation(s)
- Sungjin Park
- Department of Occupational and Environmental Medicine, Incheon Nasaret International Hospital, Incheon, Republic of Korea
| | - June-Hee Lee
- Department of Occupational and Environmental Medicine, Soonchunhyang University Hospital, Seoul, Republic of Korea.
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14
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Chen Y, Su J, Qin Y, Luo P, Shen C, Pan E, Lu Y, Miao D, Zhang N, Zhou J, Yu X, Wu M. Fresh fruit consumption, physical activity, and five-year risk of mortality among patients with type 2 diabetes: A prospective follow-up study. Nutr Metab Cardiovasc Dis 2022; 32:878-888. [PMID: 35078677 DOI: 10.1016/j.numecd.2021.10.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 10/19/2021] [Accepted: 10/27/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIMS We explored the associations among fruit consumption, physical activity, and their dose-response relationship with all-cause and cardiovascular disease (CVD) mortality in type 2 diabetic patients. METHODS AND RESULTS We prospectively followed 20,340 community-dwelling type 2 diabetic patients aged 21-94 years. Information on diets and physical activity was collected using standardized questionnaires. All-cause and CVD mortality were assessed. Hazard ratios (HRs) for all-cause mortality were estimated with Cox regression models, and HRs for CVD mortality were derived from a competing risk model. Restricted cubic spline regression was used to analyze dose-response relationships. We identified 1362 deaths during 79,844 person-years. Compared to non-consumption, fruit consumption >42.9 g/d was inversely associated with all-cause mortality (HR 0.76; 95% CI 0.64-0.88), CVD mortality (HR 0.69, 0.51-0.94) and stroke mortality (HR 0.57, 0.36-0.89), but not with heart disease mortality (HR 0.93, 0.56-1.52). The HRs comparing the top vs bottom physical activity quartiles were 0.44 (0.37-0.53) for all-cause mortality, 0.46 (0.33-0.64) for CVD mortality, 0.46 (0.29-0.74) for stroke mortality and 0.51 (0.29-0.88) for heart disease mortality. Lower fruit consumption combined with a lower physical activity level was associated with a greater mortality risk. A nonlinear threshold of 80 g fruit/day was identified; all-cause mortality risk was reduced by approximately 24% at this value. A physical activity threshold of eight metabolic equivalents (MET) h/day was also identified, after which the risk of mortality did not decrease. CONCLUSIONS Fruit consumption and physical activity may reduce all-cause, CVD, and stroke mortality in type 2 diabetic patients.
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Affiliation(s)
- Yijia Chen
- Department of Non-communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, 210003, China
| | - Jian Su
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Yu Qin
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Pengfei Luo
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Chong Shen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Enchun Pan
- Department of Chronic Disease Prevention and Control, Huai'an City Center for Disease Control and Prevention, Huai'an, 223001, China
| | - Yan Lu
- Department of Chronic Disease Prevention and Control, Suzhou City Center for Disease Control and Prevention, Suzhou, 215003, China
| | - Dandan Miao
- Department of Chronic Disease Prevention and Control, Huai'an City Center for Disease Control and Prevention, Huai'an, 223001, China
| | - Ning Zhang
- Changshu County Center for Disease Control and Prevention, Suzhou, 215500, China
| | - Jinyi Zhou
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Xiaojin Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Ming Wu
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China.
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15
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von Loeffelholz C, Roth J, Coldewey SM, Birkenfeld AL. The Role of Physical Activity in Nonalcoholic and Metabolic Dysfunction Associated Fatty Liver Disease. Biomedicines 2021; 9:biomedicines9121853. [PMID: 34944668 PMCID: PMC8698784 DOI: 10.3390/biomedicines9121853] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 12/17/2022] Open
Abstract
Sedentary behavior constitutes a pandemic health threat contributing to the pathophysiology of obesity and type 2 diabetes (T2D). Sedentarism is further associated with liver disease and particularly with nonalcoholic/metabolic dysfunction associated fatty liver disease (NAFLD/MAFLD). Insulin resistance (IR) represents an early pathophysiologic key element of NAFLD/MAFLD, prediabetes and T2D. Current treatment guidelines recommend regular physical activity. There is evidence, that physical exercise has impact on a variety of molecular pathways, such as AMP-activated protein kinase and insulin signaling as well as glucose transporter 4 translocation, modulating insulin action, cellular substrate flow and in particular ectopic lipid and glycogen storage in a positive manner. Therefore, physical exercise can lead to substantial clinical benefit in persons with diabetes and/or NAFLD/MAFLD. However, experience from long term observational studies shows that the patients’ motivation to exercise regularly appears to be a major limitation. Strategies to integrate everyday physical activity (i.e., nonexercise activity thermogenesis) in lifestyle treatment schedules might be a promising approach. This review aggregates evidence on the impact of regular physical activity on selected molecular mechanisms as well as clinical outcomes of patients suffering from IR and NAFLD/MAFLD.
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Affiliation(s)
- Christian von Loeffelholz
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, 07747 Jena, Germany; (J.R.); (S.M.C.)
- Correspondence: ; Tel.: +49-3641-9323-177; Fax: +49-3641-9323-102
| | - Johannes Roth
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, 07747 Jena, Germany; (J.R.); (S.M.C.)
| | - Sina M. Coldewey
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, 07747 Jena, Germany; (J.R.); (S.M.C.)
- Septomics Research Center, Jena University Hospital, 07747 Jena, Germany
- Center for Sepsis Control and Care, Jena University Hospital, 07747 Jena, Germany
| | - Andreas L. Birkenfeld
- Department of Diabetology Endocrinology and Nephrology, Internal Medicine IV, University Hospital Tübingen, Eberhard Karls University Tübingen, 72074 Tübingen, Germany;
- Division of Translational Diabetology, Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, Eberhard Karls University Tübingen, 72074 Tübingen, Germany
- Department of Diabetes, School of Life Course Science and Medicine, Kings College London, London WC2R 2LS, UK
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16
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The Association Between Active Transportation and Serum Total 25-Hydroxyvitamin D Levels Among US Childbearing-Aged Women. J Phys Act Health 2021; 19:20-28. [PMID: 34702787 DOI: 10.1123/jpah.2021-0292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 09/03/2021] [Accepted: 09/08/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Serum total 25-hydroxyvitamin D (25[OH]D) and physical activity (PA) both play important roles in maternal-fetal health. However, a high prevalence of vitamin D and PA insufficiency has been observed in women of childbearing age. Active transportation may increase overall PA levels and potentially boost serum 25(OH)D levels. METHODS Data from the National Health and Nutrition Examination Survey between 2007 and 2014 were used. A total of 5601 women aged 18-49 years were included. Transportation PA (TPA) was quantified as metabolic equivalents of task and serum 25(OH)D levels was measured. Multivariable logistic regression models adjusted for potential confounders were conducted. RESULTS The corresponding adjusted odds ratios associated with vitamin D insufficiency (<50 nmol/L) were 1.09 (95% confidence interval, 0.87-1.37) for 1 to 499 MET minutes per week of TPA, 0.69 (0.52-0.91) for 500 to 1000 MET minutes per week of TPA, and 0.95 (0.72-1.26) for >1000 MET minutes per week of TPA, respectively, compared with no TPA. Using vitamin D deficiency (<30 nmol/L) as the outcome led to similar results. The association between TPA and serum 25(OH)D levels was more robust in high sedentary time. CONCLUSIONS A moderate level of TPA is related to lower odds of suboptimal vitamin D status among women of childbearing age.
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Ried-Larsen M, Rasmussen MG, Blond K, Overvad TF, Overvad K, Steindorf K, Katzke V, Andersen JLM, Petersen KEN, Aune D, Tsilidis KK, Heath AK, Papier K, Panico S, Masala G, Pala V, Weiderpass E, Freisling H, Bergmann MM, Verschuren WMM, Zamora-Ros R, Colorado-Yohar SM, Spijkerman AMW, Schulze MB, Ardanaz EMA, Andersen LB, Wareham N, Brage S, Grøntved A. Association of Cycling With All-Cause and Cardiovascular Disease Mortality Among Persons With Diabetes: The European Prospective Investigation Into Cancer and Nutrition (EPIC) Study. JAMA Intern Med 2021; 181:1196-1205. [PMID: 34279548 PMCID: PMC8290339 DOI: 10.1001/jamainternmed.2021.3836] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 05/15/2021] [Indexed: 12/23/2022]
Abstract
Importance Premature death from all causes and cardiovascular disease (CVD) causes is higher among persons with diabetes. Objective To investigate the association between time spent cycling and all-cause and CVD mortality among persons with diabetes, as well as to evaluate the association between change in time spent cycling and risk of all-cause and CVD mortality. Design, Setting, and Participants This prospective cohort study included 7459 adults with diabetes from the European Prospective Investigation into Cancer and Nutrition study. Questionnaires regarding medical history, sociodemographic, and lifestyle information were administered in 10 Western European countries from 1992 through 2000 (baseline examination) and at a second examination 5 years after baseline. A total of 5423 participants with diabetes completed both examinations. The final updated primary analysis was conducted on November 13, 2020. Exposures The primary exposure was self-reported time spent cycling per week at the baseline examination. The secondary exposure was change in cycling status from baseline to the second examination. Main Outcomes and Measures The primary and secondary outcomes were all-cause and CVD mortality, respectively, adjusted for other physical activity modalities, diabetes duration, and sociodemographic and lifestyle factors. Results Of the 7459 adults with diabetes included in the analysis, the mean (SD) age was 55.9 (7.7) years, and 3924 (52.6%) were female. During 110 944 person-years of follow-up, 1673 deaths from all causes were registered. Compared with the reference group of people who reported no cycling at baseline (0 min/wk), the multivariable-adjusted hazard ratios for all-cause mortality were 0.78 (95% CI, 0.61-0.99), 0.76 (95% CI, 0.65-0.88), 0.68 (95% CI, 0.57-0.82), and 0.76 (95% CI, 0.63-0.91) for cycling 1 to 59, 60 to 149, 150 to 299, and 300 or more min/wk, respectively. In an analysis of change in time spent cycling with 57 802 person-years of follow-up, a total of 975 deaths from all causes were recorded. Compared with people who reported no cycling at both examinations, the multivariable-adjusted hazard ratios for all-cause mortality were 0.90 (95% CI, 0.71-1.14) in those who cycled and then stopped, 0.65 (95% CI, 0.46-0.92) in initial noncyclists who started cycling, and 0.65 (95% CI, 0.53-0.80) for people who reported cycling at both examinations. Similar results were observed for CVD mortality. Conclusion and Relevance In this cohort study, cycling was associated with lower all-cause and CVD mortality risk among people with diabetes independent of practicing other types of physical activity. Participants who took up cycling between the baseline and second examination had a considerably lower risk of both all-cause and CVD mortality compared with consistent noncyclists.
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Affiliation(s)
- Mathias Ried-Larsen
- Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark
- University of Southern Denmark, Odense, Denmark
| | | | - Kim Blond
- Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Thure F. Overvad
- Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Kim Overvad
- Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark
- Aarhus University, Aarhus, Denmark
| | | | - Verena Katzke
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | | | - Dagfinn Aune
- Imperial College London, London, England, United Kingdom
| | - Kostas K. Tsilidis
- Imperial College London, London, England, United Kingdom
- University of Ioannina School of Medicine, Ioannina, Greece
| | | | - Keren Papier
- University of Oxford, Oxford, England, United Kingdom
| | | | | | - Valeria Pala
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | | | | | | | - W. M. Monique Verschuren
- National Institute for Public Health and the Environment, Utrecht, the Netherlands
- Utrecht University, Utrecht, the Netherlands
| | - Raul Zamora-Ros
- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Sandra M. Colorado-Yohar
- Biomedical Research Institute of Murcia(IMIB-Arrixaca), Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- University of Antioquia, Medellín, Colombia
| | | | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Eva M. A. Ardanaz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Institute of Navarra, Navarra, Spain
- Navarra Institute for Health Research, Navarra, Spain
| | | | - Nick Wareham
- University of Cambridge, Cambridge, England, United Kingdom
| | - Søren Brage
- University of Cambridge, Cambridge, England, United Kingdom
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Li G, Xing Y, Wang G, Zhang J, Wu Q, Ni W, Jiao N, Chen W, Liu Q, Gao L, Zhang Z, Wang Y, Xing Q. Differential effect of pre-pregnancy low BMI on fetal macrosomia: a population-based cohort study. BMC Med 2021; 19:175. [PMID: 34344359 PMCID: PMC8335988 DOI: 10.1186/s12916-021-02046-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The differential effect of pre-pregnancy low BMI on macrosomia has not been fully addressed. Herein, we conducted a city-wide population-based cohort study to illuminate the association between pre-pregnancy low BMI and macrosomia, stratifying by maternal age, parity, and GDM status. METHODS All pregnant women who paid their first prenatal visit to the hospital in Qingdao during August 1, 2018, to June 30, 2020, were recruited to this study. The interactive effect of maternal age and pre-pregnancy low BMI on macrosomia was evaluated using logistic regression models, followed by strata-specific analyses. RESULTS A total of 105,768 mother-child pairs were included, and the proportion of fetal macrosomia was 11.66%. The interactive effect of maternal pre-pregnancy BMI and age was statistically significant on macrosomia irrespective of parity (nullipara: Padjusted=0.0265; multipara: Padjusted=0.0356). The protective effect of low BMI on macrosomia was most prominent among nullipara aged 35 years and above (aOR=0.16, 95% CI 0.05-0.49) and multipara aged 25 years and below (aOR=0.17, 95% CI 0.05-0.55). In nullipara without GDM, the risk estimates gradually declined with increasing conception age (20-to-24 years: aOR=0.64, 95% CI 0.51-0.80; 25-to-29 years: aOR=0.43 95% CI 0.36-0.52; 30-to-34 years: aOR=0.40 95% CI 0.29-0.53; and ≥35 years: aOR=0.19, 95% CI 0.06-0.60). A similar pattern could also be observed in nullipara with GDM, where the aOR for low BMI on macrosomia decreased from 0.54 (95% CI 0.32-0.93) in pregnant women aged 25-29 years to 0.30 (95% CI 0.12-0.75) among those aged 30-34 years. However, younger multiparous mothers, especially those aged 25 years and below without GDM (aOR=0.21, 95% CI 0.06-0.68), were more benefited from a lower BMI against the development of macrosomia. CONCLUSIONS Maternal low BMI is inversely associated with macrosomia irrespective of maternal age and parity. The impact of pre-pregnancy low BMI on macrosomia varied by maternal age and parity. The protective effect of a lower maternal BMI against fetal macrosomia was more prominent in nulliparous mothers aged 35 years and above, whereas multiparous mothers younger than 25 years of age were more benefited.
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Affiliation(s)
- Guoju Li
- Qingdao Women and Children's Hospital, Qingdao University, No.6 Tongfu Road, Qingdao, 266000, Shandong Province, China
| | - Yuhan Xing
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Guolan Wang
- Qingdao Women and Children's Hospital, Qingdao University, No.6 Tongfu Road, Qingdao, 266000, Shandong Province, China
| | - Jun Zhang
- Qingdao Women and Children's Health Care and Family Planning Service Center, Qingdao, Shandong Province, China
| | - Qin Wu
- Qingdao Women and Children's Hospital, Qingdao University, No.6 Tongfu Road, Qingdao, 266000, Shandong Province, China
| | - Wei Ni
- Qingdao Women and Children's Hospital, Qingdao University, No.6 Tongfu Road, Qingdao, 266000, Shandong Province, China
| | - Na Jiao
- Qingdao Women and Children's Hospital, Qingdao University, No.6 Tongfu Road, Qingdao, 266000, Shandong Province, China
| | - Wenjing Chen
- Qingdao Women and Children's Health Care and Family Planning Service Center, Qingdao, Shandong Province, China
| | - Qing Liu
- Qingdao Women and Children's Health Care and Family Planning Service Center, Qingdao, Shandong Province, China
| | - Li Gao
- Qingdao Women and Children's Hospital, Qingdao University, No.6 Tongfu Road, Qingdao, 266000, Shandong Province, China
| | - Zhenhong Zhang
- Public Health School, Medical College of Qingdao University, Qingdao, China
| | - Yao Wang
- Public Health School, Medical College of Qingdao University, Qingdao, China
| | - Quansheng Xing
- Qingdao Women and Children's Hospital, Qingdao University, No.6 Tongfu Road, Qingdao, 266000, Shandong Province, China.
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19
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Li Q, Li R, Zhang S, Zhang Y, He P, Zhang Z, Liu M, Zhou C, Li H, Liu C, Qin X. Occupational Physical Activity and New-Onset Hypertension: A Nationwide Cohort Study in China. Hypertension 2021; 78:220-229. [PMID: 34058853 DOI: 10.1161/hypertensionaha.121.17281] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Qinqin Li
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China (Q.L., Y.Z., P.H., Z.Z., M.L., C.Z., H.L., C.L., X.Q.).,Institute of Biomedicine, Anhui Medical University, Hefei, China (Q.L., R.L., S.Z., C.L., X.Q.)
| | - Rui Li
- Institute of Biomedicine, Anhui Medical University, Hefei, China (Q.L., R.L., S.Z., C.L., X.Q.)
| | - Shaojie Zhang
- Institute of Biomedicine, Anhui Medical University, Hefei, China (Q.L., R.L., S.Z., C.L., X.Q.)
| | - Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China (Q.L., Y.Z., P.H., Z.Z., M.L., C.Z., H.L., C.L., X.Q.)
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China (Q.L., Y.Z., P.H., Z.Z., M.L., C.Z., H.L., C.L., X.Q.)
| | - Zhuxian Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China (Q.L., Y.Z., P.H., Z.Z., M.L., C.Z., H.L., C.L., X.Q.)
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China (Q.L., Y.Z., P.H., Z.Z., M.L., C.Z., H.L., C.L., X.Q.)
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China (Q.L., Y.Z., P.H., Z.Z., M.L., C.Z., H.L., C.L., X.Q.)
| | - Huan Li
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China (Q.L., Y.Z., P.H., Z.Z., M.L., C.Z., H.L., C.L., X.Q.)
| | - Chengzhang Liu
- Institute of Biomedicine, Anhui Medical University, Hefei, China (Q.L., R.L., S.Z., C.L., X.Q.)
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangzhou, China (Q.L., Y.Z., P.H., Z.Z., M.L., C.Z., H.L., C.L., X.Q.).,Institute of Biomedicine, Anhui Medical University, Hefei, China (Q.L., R.L., S.Z., C.L., X.Q.)
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20
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Saif‐Ur‐Rahman KM, Mamun R, Li Y, Matsunaga M, Ota A, Yatsuya H. Work-related factors among people with diabetes and the risk of cardiovascular diseases: A systematic review. J Occup Health 2021; 63:e12278. [PMID: 34599639 PMCID: PMC8487164 DOI: 10.1002/1348-9585.12278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Diabetes is a major risk factor for cardiovascular diseases (CVD). This systematic review aims to explore the work-related factors among people with diabetes in developing CVD. METHODS Four electronic databases were searched on 1 February 2021 using a comprehensive search strategy without any time restriction. Two independent researchers screened the articles and extracted data. The risk of bias was assessed independently using the risk of bias assessment tool for non-randomized studies (RoBANS). A narrative synthesis was conducted considering the heterogeneity of the included articles. RESULTS A total of five articles incorporating 4 409 810 participants from three geographic regions were included that highlights the research gap. As per the included studies, Occupational drivers with diabetes were at a higher risk of CVD in comparison to the nondrivers, workers with diabetes having a long working hour were at a higher risk of CVD mortality, workers with a lower occupational status were at a higher risk of 10-years stroke risk, and occupational physical activity and occupational commuting lowered the risk of CVD deaths. CONCLUSIONS This systematic review summarized the available evidence on work-related factors influencing the risk of CVD in people with diabetes. The findings should be interpreted cautiously pondering the limited evidence and imprecision. We identified only five articles related to the topic, and there were no studies from Japan. The scarcity of studies on work-related factors on the prognosis of diabetic patients implies the need for more research in this field. We recommend further exploration of the topic designing primary studies.
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Affiliation(s)
- KM Saif‐Ur‐Rahman
- Department of Public Health and Health SystemsGraduate School of MedicineNagoya UniversityNagoyaJapan
- Health Systems and Population Studies DivisionICDDRBDhakaBangladesh
| | - Razib Mamun
- Department of Public Health and Health SystemsGraduate School of MedicineNagoya UniversityNagoyaJapan
| | - Yuanying Li
- Department of Public HealthFujita Health University School of MedicineToyoakeAichiJapan
| | - Masaaki Matsunaga
- Department of Public HealthFujita Health University School of MedicineToyoakeAichiJapan
| | - Atsuhiko Ota
- Department of Public HealthFujita Health University School of MedicineToyoakeAichiJapan
| | - Hiroshi Yatsuya
- Department of Public Health and Health SystemsGraduate School of MedicineNagoya UniversityNagoyaJapan
- Department of Public HealthFujita Health University School of MedicineToyoakeAichiJapan
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21
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Dutheil F, Pélangeon S, Duclos M, Vorilhon P, Mermillod M, Baker JS, Pereira B, Navel V. Protective Effect on Mortality of Active Commuting to Work: A Systematic Review and Meta-analysis. Sports Med 2020; 50:2237-2250. [PMID: 33034873 DOI: 10.1007/s40279-020-01354-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Sedentary behaviour is a major risk of mortality. However, data are contradictory regarding the effects of active commuting on mortality. OBJECTIVES To perform a systematic review and meta-analysis on the effects of active commuting on mortality. METHODS The PubMed, Cochrane Library, Embase, and Science Direct databases were searched for studies reporting mortality data and active commuting (walking or cycling) to or from work. We computed meta-analysis stratified on type of mortality, type of commuting, and level of commuting, each with two models (based on fully adjusted estimates of risks, and on crude or less adjusted estimates). RESULTS 17 studies representing 829,098 workers were included. Using the fully adjusted estimates of risks, active commuting decreased all-cause mortality by 9% (95% confidence intervals 3-15%), and cardiovascular mortality by 15% (3-27%) (p < 0.001). For stratification by type of commuting, walking decreased significantly all-cause mortality by 13% (1-25%), and cycling decreased significantly both all-cause mortality by 21% (11-31%) and cardiovascular mortality by 33% (10-55%) (p < 0.001). For stratification by level of active commuting, only high level decreased all-cause mortality by 11% (3-19%) and both intermediate and high level decreased cardiovascular mortality. Low level did not decrease any type of mortality. Cancer mortality did not decrease with walking or cycling, and the level of active commuting had no effect. Low level walking did not decrease any type of mortality, intermediate level of walking decreased only all-cause mortality by 15% (2-28%), and high level of walking decreased both all-cause and cardiovascular mortality by 19% (8-30%) and by 31% (9-52%), respectively. Both low, intermediate and high intensities of cycling decreased all-cause mortality. Meta-analysis based on crude or less fully adjusted estimates retrieved similar results, with also significant reductions of cancer mortality with cycling (23%, 5-42%), high level of active commuting (14%, 4-24%), and high level of active commuting by walking (16%, 0-32%). CONCLUSION Active commuting decreases mainly all-cause and cardiovascular mortality, with a dose-response relationship, especially for walking. Preventive strategies should focus on the benefits of active commuting.
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Affiliation(s)
- Frédéric Dutheil
- CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Preventive and Occupational Medicine, Université Clermont Auvergne, Witty Fit, 63000, Clermont-Ferrand, France. .,Faculty of Health, School of Exercise Science, Melbourne, Australia2 General Medicine, AMUAC, Australian Catholic University, 63000, Clermont-Ferrand, France.
| | | | - Martine Duclos
- INRA, UMR 1019, CRNH-Auvergne, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Sport Medicine and Functional Explorations, Université Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - Philippe Vorilhon
- Université Clermont Auvergne, UPU ACCePPT, 63000, Clermont-Ferrand, France
| | - Martial Mermillod
- Université Grenoble Alpes, Université Savoie Mont Blanc, CNRS, LPNC, 38000, Grenoble, France.,Institut Universitaire de France, Paris, France
| | - Julien S Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Bruno Pereira
- CHU Clermont-Ferrand, Clinical Research and Innovation Direction, University Hospital of Clermont Ferrand, 63000, Clermont-Ferrand, France
| | - Valentin Navel
- CNRS, INSERM, GReD, Translational Approach To Epithelial Injury and Repair, CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Ophthalmology, Université Clermont Auvergne, 63000, Clermont-Ferrand, France
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22
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Geidl W, Schlesinger S, Mino E, Miranda L, Pfeifer K. Dose-response relationship between physical activity and mortality in adults with noncommunicable diseases: a systematic review and meta-analysis of prospective observational studies. Int J Behav Nutr Phys Act 2020; 17:109. [PMID: 32843054 PMCID: PMC7448980 DOI: 10.1186/s12966-020-01007-5] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 07/29/2020] [Indexed: 12/18/2022] Open
Abstract
Background This study aims to investigate the relationship between post-diagnosis physical activity and mortality in patients with selected noncommunicable diseases, including breast cancer, lung cancer, type 2 diabetes, ischemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), osteoarthritis, low back pain and major depressive disorder. Methods A systematic search was conducted of PubMed, Scopus and the Web of Science from their inception to August 2018. Additionally, the search was updated in August 2019. Eligibility criteria included prospective observational studies examining the relationship between at least three physical activity categories (e.g. low, moderate, high) and all-cause mortality as the primary outcome. Results In total, 28 studies were included in the meta-analysis: 12 for breast cancer, 6 for type 2 diabetes, 8 for ischemic heart disease and 2 for COPD. The linear meta-analysis revealed that each 10 metabolic equivalent task hours increase of physical activity per week was associated with a 22% lower mortality rate in breast cancer patients (Summary Hazard Ratio [HR], 0.78; 95% CI: 0.71, 0.86; I2: 90.1%), 12% in ischemic heart disease patients (HR, 0.88; 95% CI: 0.83, 0.93; I2: 86.5%), 30% in COPD patients (HR, 0.70; 95% CI: 0.45, 1.09; I2: 94%) and 4% in type 2 diabetes patients (HR, 0.96; 95% CI: 0.93, 0.99; I2: 71.8%). There was indication of a non-linear association with mortality risk reductions even for low levels of activity, as well as a flattening of the curve at higher levels of activity. The certainty of evidence was low for breast cancer, type 2 diabetes and ischemic heart disease but only very low for COPD. Conclusion Higher levels of post-diagnosis physical activity are associated with lower mortality rates in breast cancer, type 2 diabetes, ischemic heart disease and COPD patients, with indication of a no-threshold and non-linear dose–response pattern.
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Affiliation(s)
- Wolfgang Geidl
- Department of Sport Science and Sport, Division Exercise and Health, Friedrich-Alexander University Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany.
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich Heine University, Düsseldorf, Auf´m Hennekamp 65, 40225, Düsseldorf, Germany
| | - Eriselda Mino
- Department of Sport Science and Sport, Division Exercise and Health, Friedrich-Alexander University Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - Lorena Miranda
- Department of Sport Science and Sport, Division Exercise and Health, Friedrich-Alexander University Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Division Exercise and Health, Friedrich-Alexander University Erlangen-Nürnberg, Gebbertstraße 123b, 91058, Erlangen, Germany
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23
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Rosen P, Dohrn I, Hagströmer M. Latent profile analysis of physical activity and sedentary behavior with mortality risk: A 15‐year follow‐up. Scand J Med Sci Sports 2020; 30:1949-1956. [DOI: 10.1111/sms.13761] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/18/2020] [Accepted: 06/26/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Philip Rosen
- Department of Neurobiology, Care Sciences, and Society (NVS) Division of Physiotherapy Karolinska Institutet Huddinge Sweden
| | - Ing‐Mari Dohrn
- Department of Neurobiology, Care Sciences, and Society (NVS) Division of Physiotherapy Karolinska Institutet Huddinge Sweden
| | - Maria Hagströmer
- Department of Neurobiology, Care Sciences, and Society (NVS) Division of Physiotherapy Karolinska Institutet Huddinge Sweden
- Medical unit, Occupational Therapy and Physiotherapy Karolinska University HospitalAllied Health Professional Function Stockholm Sweden
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24
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Chang PY, Lyu SY, Lin YF, Huang CC. High Level of Physical Activity Reduces the Risk of Renal Progression in Hypertensive Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1669. [PMID: 32143399 PMCID: PMC7084568 DOI: 10.3390/ijerph17051669] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/29/2020] [Accepted: 03/01/2020] [Indexed: 11/16/2022]
Abstract
Physical activity has long been associated with chronic diseases. However, the association between physical activity and renal progression in hypertensive patients remains unclear. This study investigated the relationship between the level of physical activity and renal function in hypertensive patients. We analyzed 3543 patients with hypertension. Data on patients' demographic characteristics, comorbidities, physical activity, and lifestyle characteristics were collected via questionnaires. An estimated glomerular filtration rate (eGFR) that was reduced by more than 25% from the baseline eGFR was defined as renal progression. This study divided physical activity into three levels (low, moderate, and high) based on their metabolic equivalent of tasks (METs) levels. The mean age was 63.32 ± 12.29 years. After we adjusted for covariates, renal progression was significantly higher among patients with low levels of physical activity (odds ratio (OR), 1.39; 95% confidence interval (CI), 1.01-1.90)) and moderate levels of physical activity (OR, 1.39; 95% CI, 1.04-1.86) than among patients with high levels of physical activity. We found a significant association between physical activity and renal progression in hypertensive patients, especially in elderly patients and men. Therefore, to reduce the risk of renal progression, we recommend that clinicians should encourage patients to improve their physical activity.
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Affiliation(s)
- Po-Ya Chang
- Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences, Taipei City 11219, Taiwan; (P.-Y.C.); (S.-Y.L.)
| | - Shu-Yu Lyu
- Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences, Taipei City 11219, Taiwan; (P.-Y.C.); (S.-Y.L.)
| | - Yuh-Feng Lin
- Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei City 11031, Taiwan;
| | - Chun-Ching Huang
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei City 11219, Taiwan
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25
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Chen YC, Lin KC, Chen CJ, Wang CH. Effects of leisure-time physical activity interventions on frailty-related characteristics of frail older adults in long-term care: a systematic review. Contemp Nurse 2020; 56:34-48. [PMID: 32124658 DOI: 10.1080/10376178.2020.1737555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: The proportion of frailty in older adults is increasing in many countries. Demand for institutional long-term care followed by an increasing globally. Aims: The effects of leisure-time physical activity (LTPA) interventions on frail older adults in long-term care facilities (LTCFs) of randomized controlled trials. Design: A literature searches of the published articles indexed in CINAHL, MEDLINE, PsycINFO, ProQuest, and Google Scholar between 2000 and 2017 was conducted. Methods: The inclusion criteria were divided into four sections: (1) design: randomized controlled trials; (2) sample population: LTCF adults aged 60 years or over with frailty; (3) intervention: LTPA; and (4) body composition: physical, functional or neuropsychological tests as either the primary or the secondary outcomes. Results: Three main themes were identified (the particular monitor, intervention duration and outcome measurement dimensions). Impact statement and conclusions: LTPA interventions effectively improved the physical performance and body composition of frail older adults in LTCFs. Nevertheless, an optimal combination of intensity, duration and frequency is crucial.
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Affiliation(s)
- Yi-Chang Chen
- School of Occupational Therapy, National Taiwan University, 3F.-3, No.20-3, Ln. 128, Sec. 3, Taichung Port Rd., Situn Dist., Taichung, Taipei 40764, Taiwan
| | - Keh-Chung Lin
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Chen-Jung Chen
- Department of Nursing, Mackay Medical College, 46, Sec. 3, Zhongzheng Rd., Sanzhi Dist., Taipei 252, Taiwan
| | - Chih-Hung Wang
- Graduate Institute of Education, National Changhua University of Education, Zhang Hua, Taiwan
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26
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Byambasukh O, Snieder H, Corpeleijn E. Relation Between Leisure Time, Commuting, and Occupational Physical Activity With Blood Pressure in 125 402 Adults: The Lifelines Cohort. J Am Heart Assoc 2020; 9:e014313. [PMID: 32067583 PMCID: PMC7070226 DOI: 10.1161/jaha.119.014313] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 10/29/2019] [Indexed: 01/11/2023]
Abstract
Background Whether all domains of daily-life moderate-to-vigorous physical activity (MVPA) are associated with lower blood pressure (BP) and how this association depends on age and body mass index remains unclear. Methods and Results In the population-based Lifelines cohort (N=125 402), MVPA was assessed by the Short Questionnaire to Assess Health-Enhancing Physical Activity, a validated questionnaire in different domains such as commuting, leisure-time, and occupational PA. BP was assessed using the last 3 of 10 measurements after 10 minutes' rest in the supine position. Hypertension was defined as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or use of antihypertensives. In regression analysis, higher commuting and leisure-time but not occupational MVPA related to lower BP and lower hypertension risk. Commuting-and-leisure-time MVPA was associated with BP in a dose-dependent manner. β Coefficients (95% CI) from linear regression analyses were -1.64 (-2.03 to -1.24), -2.29 (-2.68 to -1.90), and finally -2.90 (-3.29 to -2.50) mm Hg systolic BP for the low, middle, and highest tertile of MVPA compared with "No MVPA" as the reference group after adjusting for age, sex, education, smoking and alcohol use. Further adjustment for body mass index attenuated the associations by 30% to 50%, but more MVPA remained significantly associated with lower BP and lower risk of hypertension. This association was age dependent. β Coefficients (95% CI) for the highest tertiles of commuting-and-leisure-time MVPA were -1.67 (-2.20 to -1.15), -3.39 (-3.94 to -2.82) and -4.64 (-6.15 to -3.14) mm Hg systolic BP in adults <40, 40 to 60, and >60 years, respectively. Conclusions Higher commuting and leisure-time but not occupational MVPA were significantly associated with lower BP and lower hypertension risk at all ages, but these associations were stronger in older adults.
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Affiliation(s)
- Oyuntugs Byambasukh
- Department of EpidemiologyUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
- Department of Internal MedicineMongolian National University of Medical SciencesUlaanbaatarMongolia
| | - Harold Snieder
- Department of EpidemiologyUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Eva Corpeleijn
- Department of EpidemiologyUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
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27
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Li G, Li J, Gao F. Exercise and Cardiovascular Protection. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1228:205-216. [PMID: 32342460 DOI: 10.1007/978-981-15-1792-1_14] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Accumulating evidence has demonstrated that exercise training not only reduces cardiovascular disease risk but also provides direct endogenous cardiovascular protection. The mechanisms that have been proposed to be responsible for exercise-induced cardioprotection include intrinsic myocardial changes such as increased cytosolic antioxidant capacity and altered mitochondrial phenotype, myokine-mediated metabolic and anti-inflammatory effects in the cardiovascular system, and systemic effects on the cardiovascular system via interorgan cross talk. There remains much to be elucidated in the mechanisms for exercise-afforded cardioprotection. This chapter reviews exercise-induced acute and chronic responses in cardiovascular system, the epidemiological evidence of exercise training and cardiorespiratory fitness in the primary and secondary prevention of cardiovascular diseases, and the current understanding of the mechanisms of exercise-induced cardiovascular protective effects.
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Affiliation(s)
- Guohua Li
- School of Aerospace Medicine, The Fourth Military Medical University, Xi'an, China
| | - Jia Li
- School of Aerospace Medicine, The Fourth Military Medical University, Xi'an, China
| | - Feng Gao
- School of Aerospace Medicine, The Fourth Military Medical University, Xi'an, China.
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28
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Li G, Wei T, Ni W, Zhang A, Zhang J, Xing Y, Xing Q. Incidence and Risk Factors of Gestational Diabetes Mellitus: A Prospective Cohort Study in Qingdao, China. Front Endocrinol (Lausanne) 2020; 11:636. [PMID: 33042010 PMCID: PMC7516372 DOI: 10.3389/fendo.2020.00636] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/06/2020] [Indexed: 12/21/2022] Open
Abstract
Background: Obesity and maternal age are the two most important factors independently affecting the risk of gestational diabetes mellitus (GDM). However, the age differences in the association between obesity and GDM remain unclear. The objectives of this cohort study included: (1) to determine the current incidence of GDM in Qingdao; and (2) to evaluate the risk factors for GDM, such as the interaction between pre-pregnancy body mass index (BMI) and age. Methods: The cohort included 17,145 pregnant women who registered at 15 to 20 gestational weeks from August 1, 2018, to March 1, 2019. A 75-g 2-h oral glucose tolerance test (OGTT) was conducted for each participant at 24-28 gestational weeks. The age-adjusted incidence of GDM was calculated using logistic regression. Multivariate logistic regression analysis was used to identify risk factors. Interaction between age (reference group <30 years) and BMI (reference group <25 kg/m2) was determined using strata-specific analysis. Results: The incidence and age-adjusted incidence of GDM in Qingdao were 17.42 and 17.45%, respectively. The incidence of GDM appeared to increase steadily with age in all pre-pregnancy BMI groups (all P < 0.05). Older age (≥30 years), gestational BMI gain from pre-pregnancy to 15-20 weeks of gestation, history of GDM and thyroid diseases were risk factors for GDM. There were significant interactions between pre-pregnancy BMI and age (P < 0.05) after adjustment for other confounders. The odds ratio (OR) of pre-pregnancy BMI ≥ 30 kg/m2 at the age of <30 years, 30-34 years and ≥35 years was 1.30 (95% CI: 0.74-2.28, P = 0.36), 3.21 (95% CI: 2.28-4.52, P < 0.0001) and 1.55 (95% CI: 1.02-2.36, P = 0.0424), respectively. This indicated that pre-pregnancy BMI ≥ 30 kg/m2 had a stronger effect on GDM in the group aged 30-34 years than those under 30 years old. Conclusions: The incidence of GDM was high in Qingdao. Overweight and obesity prior to pregnancy, gestational BMI gain from conception to 15-20 weeks of gestation and older age were correlated with an increased risk of GDM. Public health measures may be helpful to prevent excessive gestational weight gain.
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Affiliation(s)
- Guoju Li
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao City, China
| | - Tao Wei
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao City, China
| | - Wei Ni
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao City, China
| | - Ai Zhang
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao City, China
| | - Jun Zhang
- Qingdao Women and Children's Health Care and Family Planning Service Center, Qingdao City, China
| | - Yuhan Xing
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- *Correspondence: Yuhan Xing
| | - Quansheng Xing
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao City, China
- Quansheng Xing
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Joseph G, Marott JL, Torp-Pedersen C, Biering-Sørensen T, Nielsen G, Christensen AE, Johansen MB, Schnohr P, Sogaard P, Mogelvang R. Dose-Response Association Between Level of Physical Activity and Mortality in Normal, Elevated, and High Blood Pressure. Hypertension 2019; 74:1307-1315. [DOI: 10.1161/hypertensionaha.119.13786] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
It has been a challenge to verify the dose of exercise that will produce the maximum health benefits in hypertension. This study aimed to explore the association between level of daily physical activity, all-cause mortality and cardiovascular outcome at different blood pressure levels. A random sample of 18 974 white men and women aged 20 to 98 years were examined in a prospective cardiovascular population study. Self-reported activity level in leisure-time was drawn from the Physical Activity Questionnaire (level I: inactivity; II: light activity; and III: moderate/high-level activity). Blood pressure was defined as normal blood pressure: <120/<80 mm Hg; Prehypertension: 120–139/80–89 mm Hg; Stage I hypertension: 140–159/90–99 mm Hg; Stage II hypertension ≥160/≥100 mm Hg. The mean follow-up time was 23.4±11.7 years. At all levels of blood pressure, higher levels of physical activity were associated with lower all-cause mortality in a dose-response pattern. The pattern remained unchanged after adjustment for following confounders: sex, age, smoking status, education, diabetes mellitus, previous cardiovascular disease, body mass index, and calendar time. Compared with inactivity, following hazard ratios were found for stage I hypertension: light activity, hazard ratio 0.78 (0.72–0.84;
P
<0.001), moderate/high-level activity, hazard ratio 0.69 (0.63–0.75;
P
<0.001). At all levels of blood pressure, the risk of cardiovascular events was significantly reduced independent of the level of physical activity. In conclusion, the association between physical activity and all-cause mortality was present in an inverse dose-response pattern at all levels of blood pressure. Physical activity was associated with reduction in cardiovascular events independent of the level of physical activity.
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Affiliation(s)
- Gowsini Joseph
- From the Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital (G.J., J.L.M., T.B.-S., P. Schnohr, R.M.), University of Copenhagen, Denmark
- Department of Cardiology, Rigshospitalet (G.J., R.M.), University of Copenhagen, Denmark
- Department of Clinical Medicine (G.J., C.T.-P., P. Sogaard), Aalborg University Hospital, Denmark
- Department of Cardiology & Centre for Clinical Research, North Denmark Regional Hospital, Hjorring, Denmark (G.J., G.N.)
| | - Jacob Louis Marott
- From the Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital (G.J., J.L.M., T.B.-S., P. Schnohr, R.M.), University of Copenhagen, Denmark
| | - Christian Torp-Pedersen
- Department of Clinical Medicine (G.J., C.T.-P., P. Sogaard), Aalborg University Hospital, Denmark
- Unit of Epidemiology and Biostatistics (C.T.-P., A.-E.C.), Aalborg University Hospital, Denmark
- Department of Cardiology, North Zealand Hospital, University of Copenhagen, Hillerod, Denmark (C.T.-P)
| | - Tor Biering-Sørensen
- From the Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital (G.J., J.L.M., T.B.-S., P. Schnohr, R.M.), University of Copenhagen, Denmark
- Department of Cardiology, Herlev and Gentofte Hospital (T.B.-S.), University of Copenhagen, Denmark
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences (T.B.-S.), University of Copenhagen, Denmark
| | - Gitte Nielsen
- Department of Cardiology & Centre for Clinical Research, North Denmark Regional Hospital, Hjorring, Denmark (G.J., G.N.)
| | - Ann-Eva Christensen
- Unit of Epidemiology and Biostatistics (C.T.-P., A.-E.C.), Aalborg University Hospital, Denmark
| | | | - Peter Schnohr
- From the Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital (G.J., J.L.M., T.B.-S., P. Schnohr, R.M.), University of Copenhagen, Denmark
| | - Peter Sogaard
- Department of Clinical Medicine (G.J., C.T.-P., P. Sogaard), Aalborg University Hospital, Denmark
- Department of Cardiology (P. Sogaard), Aalborg University Hospital, Denmark
| | - Rasmus Mogelvang
- From the Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital (G.J., J.L.M., T.B.-S., P. Schnohr, R.M.), University of Copenhagen, Denmark
- Department of Cardiology, Rigshospitalet (G.J., R.M.), University of Copenhagen, Denmark
- Cardiovascular Research Unit, Odense University Hospital Svendborg, Denmark (R.M.)
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von Rosen P, Dohrn IM, Hagströmer M. Association between physical activity and all-cause mortality: A 15-year follow-up using a compositional data analysis. Scand J Med Sci Sports 2019; 30:100-107. [PMID: 31581345 DOI: 10.1111/sms.13561] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 09/18/2019] [Accepted: 09/23/2019] [Indexed: 01/07/2023]
Abstract
The association between the composition of movement behaviors and mortality risk, acknowledging the composition nature of daily time data, is limited explored. The aim was to investigate how the composition of time spent in sedentary behaviors (SB), light intensity physical activity (LIPA), and moderate-to-vigorous physical activity (MVPA) is associated with all-cause mortality, in a cohort with 15 years follow-up time, using compositional data analysis. Eight hundred fifty-one participants (56% women, mean age 53 years) provided objectively assessed physical activity data using an ActiGraph accelerometer and were followed for 15 years. Association of daily time composition of movement behaviors with risk of mortality was explored using compositional data analysis and hazard ratios (HR) of mortality were estimated based on a cox regression model. A significant (P < .001) positive association between time spent in SB relative to time in other behaviors and a significant (P = .018) negative association between time spent in LIPA relative to time in other behaviors, with all-cause mortality, were found. Substituting time spent in LIPA or MVPA with time in SB increased the hazard for all-cause mortality, with greater effect found for MVPA (20 minutes replacement; HR 1.26, 95% CI 1.04-1.52) than for LIPA (20 minutes replacement; HR 1.06, 95% CI 0.65-1.73). In a public health perspective, it is recommended to substitute SB with either LIPA or MVPA, but for individuals with little time spent in MVPA, the most important message may be to try to maintain that behavior.
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Affiliation(s)
- Philip von Rosen
- Division of Physiotherapy, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Huddinge, Sweden
| | - Ing-Mari Dohrn
- Aging Research Center, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Maria Hagströmer
- Division of Physiotherapy, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, Huddinge, Sweden.,Allied Health Professional Function, Function area Occupational Therapy and Physiotherapy, Karolinska University Hosptial, Stockholm, Sweden.,Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
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31
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Effect of total, domain-specific, and intensity-specific physical activity on all-cause and cardiovascular mortality among hypertensive adults in China. J Hypertens 2019; 36:793-800. [PMID: 29120959 PMCID: PMC5862003 DOI: 10.1097/hjh.0000000000001601] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES We aimed to prospectively examine the associations of total, domain-specific, and intensity-specific physical activity with all-cause and cardiovascular mortality among Chinese hypertensive adults. METHODS We performed a prospective cohort study in 150 391 hypertensive participants aged 30-79 years from the China Kadoorie Biobank study of 512 891 participants recruited from 10 diverse areas across China during 2004-2008. Participants with heart disease, stroke, chronic obstructive pulmonary disease, and cancer at baseline were excluded. RESULTS During 1069 863 person-years of follow-up (median 7.1 years), a total of 5332 men and 4384 women died. Compared with hypertensive participants in the lowest level of total physical activity, the hazard ratios for all-cause mortality were 0.80 (0.76-0.84), 0.69 (0.65-0.73), and 0.67 (0.62-0.72) for those in quartiles 2-4 (Ptrend < 0.001), respectively. Inverse associations were also observed for cardiovascular mortality. Being active in occupational, domestic, and leisure time were associated with lower risk of all-cause and cardiovascular mortality. However, the adjusted ratio for active commuting was 1.08 (1.02-1.15) for all-cause mortality. High levels of low-intensity, moderate-intensity, and vigorous-intensity physical activity were consistently associated with lower risks of all-cause and cardiovascular mortality. CONCLUSION Among Chinese hypertensive adults, a higher level of physical activity reduces all-cause and cardiovascular mortality, independent of intensities of physical activity. Not only leisure-time but also occupational and domestic physical activities were benefited.
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Tokunaga-Nakawatase Y, Taru C, Tsutou A, Nishigaki M, Miyawaki I. Self-management behavior concerning physical activity of Japanese type 2 diabetes patients, characterized by sex, daily energy intake and body mass index. Diabetol Int 2018; 10:206-212. [PMID: 31275787 DOI: 10.1007/s13340-018-0381-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 11/01/2018] [Indexed: 11/24/2022]
Abstract
Objectives We assess differences in physical activity self-management behavior in association with dietary intake and BMI between the sexes in patients with type 2 diabetes. Methods Patients with type 2 diabetes (n = 145) completed a self-administrated questionnaire. Patients were classified into four groups by BMI and dietary intake: non-obesity and non-overeating (NO/NOE); non-obesity and overeating (NO/OE); obesity and non-overeating (O/NOE); obesity and overeating (O/OE). Differences in physical activity self-management behavior between the four groups were determined by the analysis of variance using a Tukey-Kramer post hoc test. Results Male O/OE group showed higher HbA1c (p = 0.001) than the other groups. Male NO/OE group had higher steps/day than O/NOE (p = 0.036) and score of "Exercising to stimulate the enjoyment of eating" was higher than O/OE (p = 0.031). Female NO/OE group showed higher HbA1c (p = 0.001) than NO/NOE and O/NOE. Conclusions BMI and dietary intake were associated with frequencies of physical activity self-management strategies in men. Self-management behavior peculiar to male NO/OE group is "Exercising to stimulate the enjoyment of eating". Health professionals should assess sex, BMI, and dietary intake of patients and endeavor to improve individuals' ability to regulate their caloric balance based on physical activity level.
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Affiliation(s)
- Yuri Tokunaga-Nakawatase
- 1Department of Adult Nursing, Nursing Course, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004 Japan.,2Division of Development Sciences for Practical Nursing, Department of Nursing, Faculty of Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142 Japan
| | - Chiemi Taru
- 2Division of Development Sciences for Practical Nursing, Department of Nursing, Faculty of Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142 Japan
| | - Akimitsu Tsutou
- 3Division of Preventive Health Science, Department of Community Health Sciences, Faculty of Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142 Japan
| | - Masakazu Nishigaki
- 4Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8397 Japan
| | - Ikuko Miyawaki
- 2Division of Development Sciences for Practical Nursing, Department of Nursing, Faculty of Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142 Japan
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33
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Panter J, Mytton O, Sharp S, Brage S, Cummins S, Laverty AA, Wijndaele K, Ogilvie D. Using alternatives to the car and risk of all-cause, cardiovascular and cancer mortality. Heart 2018; 104:1749-1755. [PMID: 29785956 PMCID: PMC6241630 DOI: 10.1136/heartjnl-2017-312699] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/14/2018] [Accepted: 02/25/2018] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To investigate the associations between using alternatives to the car which are more active for commuting and non-commuting purposes, and morbidity and mortality. METHODS We conducted a prospective study using data from 3 58 799 participants, aged 37-73 years, from UK Biobank. Commute and non-commute travel were assessed at baseline in 2006-2010. We classified participants according to whether they relied exclusively on the car or used alternative modes of transport that were more active at least some of the time. The main outcome measures were incident cardiovascular disease (CVD) and cancer, and CVD, cancer and all-cause mortality. We excluded events in the first 2 years and conducted analyses separately for those who regularly commuted and those who did not. RESULTS In maximally adjusted models, regular commuters with more active patterns of travel on the commute had a lower risk of incident (HR 0.89, 95% CI 0.79 to 1.00) and fatal (HR 0.70, 95% CI 0.51 to 0.95) CVD. Those regular commuters who also had more active patterns of non-commute travel had an even lower risk of fatal CVD (HR 0.57, 95% CI 0.39 to 0.85). Among those who were not regular commuters, more active patterns of travel were associated with a lower risk of all-cause mortality (HR 0.92, 95% CI 0.86 to 0.99). CONCLUSIONS More active patterns of travel were associated with a reduced risk of incident and fatal CVD and all-cause mortality in adults. This is an important message for clinicians advising people about how to be physically active and reduce their risk of disease.
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Affiliation(s)
- Jenna Panter
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | - Oliver Mytton
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | - Stephen Sharp
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Søren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Steven Cummins
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | | | - David Ogilvie
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
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Cheng W, Zhang Z, Cheng W, Yang C, Diao L, Liu W. Associations of leisure-time physical activity with cardiovascular mortality: A systematic review and meta-analysis of 44 prospective cohort studies. Eur J Prev Cardiol 2018; 25:1864-1872. [PMID: 30157685 DOI: 10.1177/2047487318795194] [Citation(s) in RCA: 123] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Many cohort studies within the past few decades have shown the protective effect of leisure-time physical activity on cardiovascular mortality. To summarise the evidence from prospective cohort studies on the relationship between the amount of leisure-time physical activity and the risk of cardiovascular mortality, a dose–response meta-analysis was conducted in this study. Methods and results Electronic databases, including PubMed and Embase databases, Scopus and Cochrane Library, were systemically retrieved by two investigators from inception to 14 June 2018 for related studies. The maximum adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted, and a dose–response analysis was conducted using the restricted cubic splines. Finally, a total of 44 studies comprising 1,584,181 participants was enrolled into this meta-analysis. The HRs of cardiovascular mortality for moderate and high leisure-time physical activity were 0.77 (95% CI 0.74–0.81) and 0.73 (95% CI 0.69–0.77), respectively. Among these 44 studies, 19 were eligible for the dose–response meta-analysis, which suggested a linear negative correlation of leisure-time physical activity with cardiovascular mortality, regardless of age, gender and the presence of underlying cardiovascular disease or not. Conclusions Leisure-time physical activity shows a linear negative correlation with the risk of cardiovascular mortality regardless of age, gender and the presence of cardiovascular disease or not. However, the cardiovascular benefits of leisure-time physical activity is decreased for those aged over 65 years or those with a history of cardiovascular disease. Moreover, leisure-time physical activity displays more cardiovascular benefits to people followed up for over 10 years than to those followed up for less than 10 years. Besides, high-intensity leisure-time physical activity has more obvious cardiovascular benefits than those of moderate-intensity leisure-time physical activity.
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Affiliation(s)
- Wenke Cheng
- Department of Cardiology, Affiliated Hospital of Qinghai University, China
| | - Zhen Zhang
- Department of Oncology, Affiliated Hospital of Qinghai University, China
| | - Wensi Cheng
- School of Nursing, Heze Medical College, China
| | - Chong Yang
- Department of Obstetrics, Zaozhuang Municipal Hospital, China
| | - Linlin Diao
- Department of Cardiology, Zaozhuang Municipal Hospital, China
| | - Weijun Liu
- Department of Cardiology, Affiliated Hospital of Qinghai University, China
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Poggio R, Melendi S, Gutierrez L, Elorriaga N, Irazola V. Occupational Physical Activity and Cardiovascular Risk Factors Profile in the Adult Population of the Southern Cone of Latin America: Results From the CESCAS I Study. J Occup Environ Med 2018; 60:e470-e475. [PMID: 30020215 DOI: 10.1097/jom.0000000000001398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE We explore the association between occupational physical activity (OPA) and cardiovascular risk factors in four cities of the Southern Cone. METHODS Robust multivariable linear regression models were used to examine the associations. RESULTS The working population was constituted by 1868 men and 1672 women. Men performing high levels of OPA showed higher levels of high-density lipoprotein (HDL; mean adj. diff. = 2.24 mg/dL; P = 0.004), lower levels of triglycerides (-24.59 mg/dL; P = 0.006), and total cholesterol (TC)/HDL ratio values (-0.21; P = 0.015) than reference. Women in the highest category of OPA had higher levels of HDL (2.85 mg/dL; P = 0.006), lower TC/HDL (0.27; P = 0.001), and low-density lipoprotein/HDL ratios (-0.18; P = 0.003) than sedentary activities. CONCLUSION Individuals who performed high levels of OPA did not exhibit a worse cardiovascular risk profile and an improvement on selected biomarkers was observed when compared with those performing sedentary activities.
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Affiliation(s)
- Rosana Poggio
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
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Swift DL, McGee JE, Earnest CP, Carlisle E, Nygard M, Johannsen NM. The Effects of Exercise and Physical Activity on Weight Loss and Maintenance. Prog Cardiovasc Dis 2018; 61:206-213. [PMID: 30003901 DOI: 10.1016/j.pcad.2018.07.014] [Citation(s) in RCA: 288] [Impact Index Per Article: 41.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 07/08/2018] [Indexed: 01/12/2023]
Abstract
Obesity represents a major health problem in the United States and is associated with increased prevalence of cardiovascular (CV) disease risk factors. Physical activity (PA) and exercise training (ET) are associated with reduced CV risk, improved cardiometabolic risk factors, and facilitated weight loss through creating a negative energy balance. Clinicians need to counsel overweight and obese patients on how much PA/ET is needed to promote weight loss and weight loss maintenance. This will help establish realistic expectations and maximize improvements in CV risk factors. Although the minimum guidelines for aerobic PA (150 min of moderate or 75 min of vigorous physical activity per week) can improve CV health, these levels are generally inadequate for clinically significant weight loss or weight maintenance without caloric restriction. The purpose of this review is to evaluate the role of ET to promote clinically significant weight loss and promote weight maintenance. In particular, we will evaluate the likelihood of weight loss from ET programs composed of aerobic training only, resistance training only and programs that combine diet and ET. We will also explore the role of PA in promoting short-term and long-term weight maintenance.
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Affiliation(s)
- Damon L Swift
- Department of Kinesiology, East Carolina University, Greenville, NC, United States of America; Human Performance Laboratory, East Carolina University, Greenville, NC, United States of America.
| | - Joshua E McGee
- Department of Kinesiology, East Carolina University, Greenville, NC, United States of America; Human Performance Laboratory, East Carolina University, Greenville, NC, United States of America
| | - Conrad P Earnest
- Department of Kinesiology, Texas A&M University, College Station, TX, United States of America
| | - Erica Carlisle
- Department of Kinesiology, East Carolina University, Greenville, NC, United States of America; Human Performance Laboratory, East Carolina University, Greenville, NC, United States of America
| | - Madison Nygard
- Department of Kinesiology, East Carolina University, Greenville, NC, United States of America; Human Performance Laboratory, East Carolina University, Greenville, NC, United States of America
| | - Neil M Johannsen
- Department of Kinesiology, Louisiana State University, Baton Rouge, LA, United States of America
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Liu G, Li Y, Hu Y, Zong G, Li S, Rimm EB, Hu FB, Manson JE, Rexrode KM, Shin HJ, Sun Q. Influence of Lifestyle on Incident Cardiovascular Disease and Mortality in Patients With Diabetes Mellitus. J Am Coll Cardiol 2018; 71:2867-2876. [PMID: 29929608 PMCID: PMC6052788 DOI: 10.1016/j.jacc.2018.04.027] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/29/2018] [Accepted: 04/03/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Evidence is limited regarding the impact of healthy lifestyle practices on the risk of subsequent cardiovascular events among patients with diabetes. OBJECTIVES The purpose of this study was to examine the associations of an overall healthy lifestyle, defined by eating a high-quality diet (top two-fifths of Alternative Healthy Eating Index), nonsmoking, engaging in moderate- to vigorous-intensity physical activity (≥150 min/week), and drinking alcohol in moderation (5 to 15 g/day for women and 5 to 30 g/day for men), with the risk of developing cardiovascular disease (CVD) and CVD mortality among adults with type 2 diabetes (T2D). METHODS This prospective analysis included 11,527 participants with T2D diagnosed during follow-up (8,970 women from the Nurses' Health Study and 2,557 men from the Health Professionals Follow-Up Study), who were free of CVD and cancer at the time of diabetes diagnosis. Diet and lifestyle factors before and after T2D diagnosis were repeatedly assessed every 2 to 4 years. RESULTS There were 2,311 incident CVD cases and 858 CVD deaths during an average of 13.3 years of follow-up. After multivariate adjustment of covariates, the low-risk lifestyle factors after diabetes diagnosis were each associated with a lower risk of CVD incidence and CVD mortality. The multivariate-adjusted hazard ratios for participants with 3 or more low-risk lifestyle factors compared with 0 were 0.48 (95% confidence interval [CI]: 0.40 to 0.59) for total CVD incidence, 0.53 (95% CI: 0.42 to 0.66) for incidence of coronary heart disease, 0.33 (95% CI: 0.21 to 0.51) for stroke incidence, and 0.32 (95% CI: 0.22 to 0.47) for CVD mortality (all p trend <0.001). The population-attributable risk for poor adherence to the overall healthy lifestyle (<3 low-risk factors) was 40.9% (95% CI: 28.5% to 52.0%) for CVD mortality. In addition, greater improvements in healthy lifestyle factors from pre-diabetes to post-diabetes diagnosis were also significantly associated with a lower risk of CVD incidence and CVD mortality. For each number increment in low-risk lifestyle factors there was a 14% lower risk of incident total CVD, a 12% lower risk of coronary heart disease, a 21% lower risk of stroke, and a 27% lower risk of CVD mortality (all p < 0.001). Similar results were observed when analyses were stratified by diabetes duration, sex/cohort, body mass index at diabetes diagnosis, smoking status, and lifestyle factors before diabetes diagnosis. CONCLUSIONS Greater adherence to an overall healthy lifestyle is associated with a substantially lower risk of CVD incidence and CVD mortality among adults with T2D. These findings further support the tremendous benefits of adopting a healthy lifestyle in reducing the subsequent burden of cardiovascular complications in patients with T2D.
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Affiliation(s)
- Gang Liu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Yanping Li
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Yang Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Geng Zong
- Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Shanshan Li
- Boston University School of Medicine, Clinical Epidemiology Unit, Boston, Massachusetts
| | - Eric B Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - JoAnn E Manson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Kathryn M Rexrode
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Hyun Joon Shin
- Department of Medicine, Brigham and Women's Hospital, Veterans Affairs Boston Healthcare System, Harvard Medical School, Boston, Massachusetts
| | - Qi Sun
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
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38
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Caru M, Kern L, Bousquet M, Curnier D. Preventive fraction of physical fitness on risk factors in cardiac patients: Retrospective epidemiological study. World J Cardiol 2018; 10:26-34. [PMID: 29707165 PMCID: PMC5919890 DOI: 10.4330/wjc.v10.i4.26] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/15/2018] [Accepted: 04/01/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To quantify the preventive fraction of physical fitness on the risk factors in patients with cardiovascular diseases (CVDs).
METHODS A total of 249 subjects (205 men and 44 women) suffering from CVD were categorized into four groups, according to their percentage of physical fitness. We calculated the odds ratio to obtain the preventive fraction in order to evaluate the impact of the physical fitness level on the risk factors (i.e., abdominal obesity, depression, diabetes, dyslipidemia, hypertension, obesity, overweight and smoking).
RESULTS It is observed that a normal physical fitness level is sufficient to induce a preventive action on abdominal obesity (38%), diabetes (12%), hypertension (33%), obesity (12%) and overweight (11%). Also, the preventive fraction increases with the level of physical fitness, in particular for hypertension (36%) and overweight (16%). A high physical fitness level does not necessarily induce a preventive action in most risk factors, excluding depression.
CONCLUSION This is the first study which demonstrates that reaching a normal physical fitness level is enough to induce a protection for some risk factors, despite having a CVD.
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Affiliation(s)
- Maxime Caru
- Department of Science and Technology of Physical Activities and Sports, University Paris Nanterre, Nanterre 92000, France
- Department of Kinesiology, University of Montreal, Montreal H2X 0A9, Canada
| | - Laurence Kern
- Department of Science and Technology of Physical Activities and Sports, University Paris Nanterre, Nanterre 92000, France
| | - Marc Bousquet
- Clinic of Saint-Orens, Cardiovascular and Pulmonary Rehabilitation Center, Saint-Orens-de-Gameville 31650, France
| | - Daniel Curnier
- Department of Kinesiology, University of Montreal, Montreal H2X 0A9, Canada
- University of Montreal Hospital Research Center, Montreal H2X 0A9, Canada
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Chastin SFM, De Craemer M, De Cocker K, Powell L, Van Cauwenberg J, Dall P, Hamer M, Stamatakis E. How does light-intensity physical activity associate with adult cardiometabolic health and mortality? Systematic review with meta-analysis of experimental and observational studies. Br J Sports Med 2018; 53:370-376. [PMID: 29695511 PMCID: PMC6579499 DOI: 10.1136/bjsports-2017-097563] [Citation(s) in RCA: 274] [Impact Index Per Article: 39.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2018] [Indexed: 12/27/2022]
Abstract
Aim To assess the relationship between time spent in light physical activity and cardiometabolic health and mortality in adults. Design Systematic review and meta-analysis. Data sources Searches in Medline, Embase, PsycInfo, CINAHL and three rounds of hand searches. Eligibility criteria for selecting studies Experimental (including acute mechanistic studies and physical activity intervention programme) and observational studies (excluding case and case–control studies) conducted in adults (aged ≥18 years) published in English before February 2018 and reporting on the relationship between light physical activity (<3 metabolic equivalents) and cardiometabolic health outcomes or all-cause mortality. Study appraisal and synthesis Study quality appraisal with QUALSYST tool and random effects inverse variance meta-analysis. Results Seventy-two studies were eligible including 27 experimental studies (and 45 observational studies). Mechanistic experimental studies showed that short but frequent bouts of light-intensity activity throughout the day reduced postprandial glucose (−17.5%; 95% CI −26.2 to −8.7) and insulin (−25.1%; 95% CI −31.8 to –18.3) levels compared with continuous sitting, but there was very limited evidence for it affecting other cardiometabolic markers. Three light physical activity programme intervention studies (n ranging from 12 to 58) reduced adiposity, improved blood pressure and lipidaemia; the programmes consisted of activity of >150 min/week for at least 12 weeks. Six out of eight prospective observational studies that were entered in the meta-analysis reported that more time spent in daily light activity reduced risk of all-cause mortality (pooled HR 0.71; 95% CI 0.62 to 0.83). Conclusions Light-intensity physical activity could play a role in improving adult cardiometabolic health and reducing mortality risk. Frequent short bouts of light activity improve glycaemic control. Nevertheless, the modest volume of the prospective epidemiological evidence base and the moderate consistency between observational and laboratory evidence inhibits definitive conclusions.
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Affiliation(s)
- Sebastien F M Chastin
- School of Health and Life Science, Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK.,Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Marieke De Craemer
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Katrien De Cocker
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.,Research Foundation Flanders, Brussels, Belgium.,Institute for Resilient Regions, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Lauren Powell
- Epidemiology Unit, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.,Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Jelle Van Cauwenberg
- Research Foundation Flanders, Brussels, Belgium.,Department of Public Health, Ghent University, Ghent, Belgium
| | - Philippa Dall
- School of Health and Life Science, Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK
| | - Mark Hamer
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Emmanuel Stamatakis
- Epidemiology Unit, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.,Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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40
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Oktay AA, Akturk HK, Esenboğa K, Javed F, Polin NM, Jahangir E. Pathophysiology and Prevention of Heart Disease in Diabetes Mellitus. Curr Probl Cardiol 2018; 43:68-110. [DOI: 10.1016/j.cpcardiol.2017.05.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Pitanga FJG, Matos SMA, Almeida MDC, Barreto SM, Aquino EML. Leisure-Time Physical Activity, but not Commuting Physical Activity, is Associated with Cardiovascular Risk among ELSA-Brasil Participants. Arq Bras Cardiol 2018; 110:36-43. [PMID: 29412240 PMCID: PMC5831300 DOI: 10.5935/abc.20170178] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 07/04/2017] [Indexed: 12/04/2022] Open
Abstract
Background Despite reports in the literature that both leisure-time physical activity
(LTPA) and commuting physical activity (CPA) can promote health benefits,
the literature lacks studies comparing the associations of these domains of
physical activity with cardiovascular risk scores. Objective To investigate the association between LTPA and CPA with different
cardiovascular risk scores in the cohort of the Longitudinal Study of Adult
Health ELSA-Brasil. Methods Cross-sectional study with data from 13,721 participants of both genders,
aged 35-74 years, free of cardiovascular disease, from ELSA Brazil. Physical
activity was measured using the International Physical Activity
Questionnaire (IPAQ). Five cardiovascular risk scores were used: Framingham
score - coronary heart disease (cholesterol); Framingham score - coronary
heart disease (LDL-C); Framingham score - cardiovascular disease
(cholesterol); Framingham score - cardiovascular disease (body mass index,
BMI); and pooled cohort equations for atherosclerotic cardiovascular disease
(ASCVD). Associations adjusted for confounding variables between physical
activity and different cardiovascular risk scores were analyzed by logistic
regression. Confidence interval of 95% (95%CI) was considered. Results LTPA is inversely associated with almost all cardiovascular risk scores
analyzed, while CPA shows no statistically significant association with any
of them. Dose-response effect in association between LTPA and cardiovascular
risk scores was also found, especially in men. Conclusions LTPA was shown to be associated with the cardiovascular risk scores analyzed,
but CPA not. The amount of physical activity (duration and intensity) was
more significantly associated, especially in men, with cardiovascular risk
scores in ELSA-Brasil.
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Assessing Physical Activity as a Core Component in Cardiac Rehabilitation: A POSITION STATEMENT OF THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION. J Cardiopulm Rehabil Prev 2017; 36:217-29. [PMID: 27307067 DOI: 10.1097/hcr.0000000000000191] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Physical inactivity is a well-established major risk factor for cardiovascular disease. As such, physical activity counseling is 1 of the 10 core components of cardiac rehabilitation/secondary prevention programs recommended by the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR). In addition, the ability to perform a physical activity assessment and report outcomes is 1 of the 10 core competencies of cardiac rehabilitation/secondary prevention professionals published by the AACVPR. Unfortunately, standardized procedures for physical activity assessment of cardiac rehabilitation patients have not been developed and published. Thus, the objective of this AACVPR statement is to provide an overview of physical activity assessment concepts and procedures and to provide a recommended approach for performing a standardized assessment of physical activity in all comprehensive cardiac rehabilitation programs following the core components recommendations.
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Huang JH, Li RH, Huang SL, Sia HK, Lee SS, Wang WH, Tang FC. Relationships between different types of physical activity and metabolic syndrome among Taiwanese workers. Sci Rep 2017; 7:13735. [PMID: 29061986 PMCID: PMC5653817 DOI: 10.1038/s41598-017-13872-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 10/03/2017] [Indexed: 11/24/2022] Open
Abstract
This study aimed to investigate the relationships between different types of physical activity (PA) and metabolic syndrome (MetS). In this cross-sectional study, 3,296 Taiwanese workers were enrolled. A self-reported questionnaire was used to assess nutritional health behavior and PA levels related to occupation, leisure time, and commuting. Anthropometric measures, blood pressure and biochemical determinations of the blood were also obtained. Multiple logistic regression was used to evaluate the adjusted odds ratios (ORs) and 95% confidence intervals (CI) of MetS and its components associated with different types of PA. The prevalence of MetS was 16.6% in workers. Compared with a low level of leisure-time PA, a high level of leisure-time PA showed a significantly lower risk of high triglycerides (OR 0.73, 95% CI 0.61-0.87) and MetS (OR 0.76, 95% CI 0.62-0.95). Compared with a low level of occupational PA, a high level of occupational PA represented a significantly lower risk of both abdominal adiposity (OR 0.64, 95% CI 0.49-0.84) and high triglycerides (OR 0.71, 95% CI 0.55-0.90). However, commuting PA levels were not significantly associated with MetS and its components. In conclusion, occupational PA as well as leisure-time PA could be important for the prevention of MetS.
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Affiliation(s)
- Jui-Hua Huang
- Occupational Health Center, Changhua Christian Hospital, Changhua, 500, Taiwan
| | - Ren-Hau Li
- Department of Psychology, Chung Shan Medical University, Taichung, 402, Taiwan
| | - Shu-Ling Huang
- Department of Psychology, Chung Shan Medical University, Taichung, 402, Taiwan
- Room of Clinical Psychology, Chung Shan Medical University Hospital, Taichung, 402, Taiwan
| | - Hon-Ke Sia
- Division of Endocrinology and Metabolism, Changhua Christian Hospital, Changhua, 500, Taiwan
| | - Su-Shiang Lee
- Department of Leisure Services Management, Chaoyang University of Technology, Taichung, 413, Taiwan
| | - Wei-Hsun Wang
- Department of Orthopedic, Changhua Christian Hospital, Changhua, 500, Taiwan
- Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung, 821, Taiwan
- Department of Golden-Ager Industry Management, Chaoyang University of Technology, Taichung, 413, Taiwan
| | - Feng-Cheng Tang
- Department of Leisure Services Management, Chaoyang University of Technology, Taichung, 413, Taiwan.
- Department of Occupational Medicine, Changhua Christian Hospital, Changhua, 500, Taiwan.
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Childhood Socioeconomic Disadvantage, Occupational, Leisure-Time, and Household Physical Activity, and Diabetes in Adulthood. J Phys Act Health 2017; 14:766-772. [PMID: 28513316 DOI: 10.1123/jpah.2016-0438] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Regular physical activity is a key way to prevent disease. However, we have a limited understanding of the socioeconomic precursors and glucoregulatory sequelae of engaging in physical activity in different domains. METHODS We examined the associations among life course socioeconomic disadvantage; meeting the physical activity guidelines with leisure-time physical activity, occupational physical activity, or household physical activity; and prediabetes and diabetes in the Midlife in the United States national study (N = 986). RESULTS Childhood disadvantage was associated with lower odds of meeting the guidelines with leisure-time physical activity (odds ratio = 0.75; 95% confidence interval, 0.65-0.86). Adulthood disadvantage was associated with higher odds of meeting the guidelines with occupational physical activity (odds ratio = 1.94; 95% confidence interval, 1.49-2.53). Importantly, while meeting the guidelines with leisure-time physical activity was associated with lower odds of prediabetes and diabetes, we found no evidence for associations among occupational physical activity, household physical activity, and glucoregulation. CONCLUSION Current US physical activity guidelines do not differentiate between physical activity for leisure or work, assuming that physical activity in any domain confers comparable health benefits. We documented important differences in the associations among lifetime socioeconomic disadvantage, physical activity domain, and diabetes, suggesting that physical activity domain potentially belongs in the guidelines, similar to other characteristics of activity (eg, type, intensity).
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Nygaard H, Grindaker E, Rønnestad BR, Holmboe-Ottesen G, Høstmark AT. Long-term effects of daily postprandial physical activity on blood glucose: a randomized controlled trial. Appl Physiol Nutr Metab 2017; 42:430-437. [PMID: 28177728 DOI: 10.1139/apnm-2016-0467] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Previous studies have shown that a bout of moderate or light postprandial physical activity effectively blunts the postprandial increase in blood glucose. The objective of this study was to test whether regular light postprandial physical activity can improve glycemia in persons with hyperglycemia or with a high risk of hyperglycemia. We randomized 56 participants to an intervention or a control group. They were diagnosed as hyperglycemic, not using antidiabetics, or were categorized as high-risk individuals for type 2 diabetes. The intervention group was instructed to undertake a minimum 30 min of daily light physical activity, starting a maximum of 30 min after a meal in addition to their usual physical activity for 12 weeks. The control group maintained their usual lifestyle. Blood samples were taken pre- and post-test. Forty participants completed the study and are included in the results. The self-reported increase in daily physical activity from before to within the study period was higher in the intervention group compared with control (41 ± 25 vs. 2 ± 16 min, p < 0.001). Activity diaries and accelerometer recordings supported this observation. The activity in the intervention group started earlier after the last meal compared with control (30 ± 13 vs. 100 ± 57 min, p = 0.001). There were no within- or between-group differences in any glycemic variable from pre- to post-test. In conclusion, the present study does not seem to support the notion that regular light postprandial physical activity improves blood glucose in the long term in persons with hyperglycemia or with high risk of hyperglycemia.
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Affiliation(s)
- Håvard Nygaard
- a Department of Sport Science, Lillehammer University College, PB 952 2604 Lillehammer Norway
| | - Eirik Grindaker
- a Department of Sport Science, Lillehammer University College, PB 952 2604 Lillehammer Norway
| | - Bent Ronny Rønnestad
- a Department of Sport Science, Lillehammer University College, PB 952 2604 Lillehammer Norway
| | - Gerd Holmboe-Ottesen
- b Institute of Health and Society, Department of Community Medicine, University of Oslo, Norway
| | - Arne Torbjørn Høstmark
- b Institute of Health and Society, Department of Community Medicine, University of Oslo, Norway
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Suwanpasu S, Aungsuroch Y, Jitapanya C. Post-surgical physical activity enhancing program for elderly patients after hip fracture: a randomized controlled trial. ASIAN BIOMED 2017. [DOI: 10.5372/1905-7415.0804.323] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Abstract
Background: Hip fracture seriously influences an elderly person’s life and mobility, independent living, and causes earlier mortality. Although surgery is generally successful, many of the elderly suffer from decreased physical ability after surgery for hip fracture.
Objectives: To determine the effects of a physical activity enhancing program (PEP) on the level of physical activity of elderly patients after surgical treatment of hip fracture.
Methods: A randomized controlled trial of 46 elderly patients was conducted at King Chulalongkorn Memorial Hospital from January 2012 to February 2013 to evaluate the effectiveness of the Resnick self-efficacy model (2009) compared with standard care in improving physical activity. The participants were enrolled on a criteria basis and were block randomized into two groups. The intervention group attended four phases of physical training and efficacy based intervention comprising assessment, preparation, practicing, and evaluation phases with face-to-face contact and five telephone calls during seven weeks post-surgery.
Results: Six weeks after discharge, the physical activity of the intervention group increased by significantly more than the control group (F1,43 = 9.63, P < 0.01), with an effect size of 0.18 after controlling for preoperative physical activity. The ratio of the effect on physical activity induced by the PEP was higher than that induced by usual care (65.2% vs. 47.8%).
Conclusion: PEP is effective at improving physical activity. Efforts to follow up for longer periods and with studies using larger populations are recommended.
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Affiliation(s)
- Sunee Suwanpasu
- Nursing Department, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
| | - Yupin Aungsuroch
- Yupin Aungsuroch, Faculty of Nursing, Chulalongkorn University, Bangkok 10330, Thailand
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Barengo NC, Antikainen R, Borodulin K, Harald K, Jousilahti P. Leisure-Time Physical Activity Reduces Total and Cardiovascular Mortality and Cardiovascular Disease Incidence in Older Adults. J Am Geriatr Soc 2016; 65:504-510. [PMID: 28024086 DOI: 10.1111/jgs.14694] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine whether leisure-time physical activity (LTPA) is independently associated with all-cause and cardiovascular mortality and with incidence of cardiovascular disease (CVD) and stroke in older adults. DESIGN Population-based cohort study (median follow-up 11.8 years). SETTING Community, five Finnish provinces. PARTICIPANTS Men and women aged 65 to 74 who participated in a baseline risk factor survey between 1997 and 2007 in Finland (N = 2,456). MEASUREMENTS The study protocol included a self-administered questionnaire, health examination at the study site, and blood sample for laboratory analysis. LTPA was classified into three levels: low, moderate, high. Mortality data were obtained from the National Causes of Death Register and data on incident CVD (coronary heart disease, stroke) events from the National Hospital Discharge Register. RESULTS Multifactorial-adjusted (age, area, study year, sex, smoking, body mass index, systolic blood pressure, serum cholesterol, education, marital status) risks of total mortality (moderate: hazard ratio (HR) = 0.61, 95% confidence interval (CI) = 0.50-0.74; high: HR = 0.47, 95% CI = 0.34-0.63, P for trend <.001), CVD mortality (moderate: HR = 0.46, 95% CI = 0.33-0.64; high: HR = 0.34, 95% CI = 0.20-0.59, P for trend <.001), and an incident CVD event (moderate HR = 0.69, 95% CI = 0.54-0.88; high: HR = 0.55, 95% CI = 0.38-0.79, P for trend <.001) were lower for those with moderate or high LTPA levels than for those with low LTPA levels. Further adjustment for self-reported inability to perform LTPA did not change the associations remarkably. CONCLUSIONS Baseline LTPA reduces the risk of total and CVD mortality and incident CVD events in older adults independently of the major known CVD risk factors. The protective effect of LTPA is dose dependent.
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Affiliation(s)
- Noël C Barengo
- Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida.,Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Riitta Antikainen
- Center for Life Course Health Research/Geriatrics, Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.,Oulu City Hospital, Oulu, Finland
| | - Katja Borodulin
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Kennet Harald
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Pekka Jousilahti
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
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48
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Bogatyrev SN. Physical activity and type 2 diabetes mellitus risk: population studies review. DIABETES MELLITUS 2016. [DOI: 10.14341/dm8030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Physical activity is one of the most important components of a healthy lifestyle. Regular physical activity helps to maintain normal blood glucose levels and reduce the risk of type 2 diabetes mellitus. This review presents population studies investigating physical activity as a factor for type 2 diabetes mellitus risk. A search using the keywords ‘physical activity’, ‘type 2 diabetes mellitus’ and ‘risk’ identified more than 40 relevant original studies and meta-analyses, which are presented in this review. Different types of physical activity have positive protective effects on type 2 diabetes mellitus risk and reduce the risk of death in patients with type 2 diabetes mellitus.
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Wennberg P, Lindahl B, Hallmans G, Messner T, Weinehall L, Johansson L, Boman K, Jansson JH. The effects of commuting activity and occupational and leisure time physical activity on risk of myocardial infarction. ACTA ACUST UNITED AC 2016; 13:924-30. [PMID: 17143124 DOI: 10.1097/01.hjr.0000239470.49003.c3] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Risk reduction of myocardial infarction has been shown for leisure time physical activity. The results of studies on occupational physical activity and risk of myocardial infarction are incongruous and studies on commuting activity are scarce. The aim of this study was to investigate how commuting activity, occupational physical activity and leisure time physical activity were associated with risk of future first myocardial infarction. DESIGN We used a prospective incident case-referent study design nested in Västerbotten Intervention Program and the Northern Sweden MONICA study. METHODS Commuting habits, occupational physical activity, leisure time physical activity and cardiovascular risk factors were assessed at baseline screening and compared in 583 cases (20% women) with a first myocardial infarction and 2098 matched referents. RESULTS Regular car commuting was associated with increased risk of myocardial infarction versus commuting by bus, cycling or walking [odds ratio (OR) 1.74; 95% confidence interval (CI), 1.20-2.52] after multivariate adjustment. High versus low leisure time physical activity was associated with reduced risk of myocardial infarction (OR 0.69; 95% CI, 0.50-0.95) after adjustment for occupational physical activity and commuting activity, but the association was not statistically significant after further multivariate adjustment. After multivariate adjustment we observed a reduced risk for myocardial infarction in men with moderate (OR 0.70; 95% CI, 0.50-0.98) or high (OR 0.67; 95% CI, 0.42-1.08) versus low occupational physical activity. CONCLUSIONS We found a clear association between car commuting and a first myocardial infarction and a corresponding inverse association with leisure time physical activity, while the impact of occupational physical activity on the risk of myocardial infarction was weaker.
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50
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Thakkar J, Redfern J, Thiagalingam A, Chow CK. Patterns, predictors and effects of texting intervention on physical activity in CHD - insights from the TEXT ME randomized clinical trial. Eur J Prev Cardiol 2016; 23:1894-1902. [PMID: 27512051 DOI: 10.1177/2047487316664190] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 07/25/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mobile phone text message interventions are used to support behaviour change including physical activity, but we have less insight into how these interventions work and what factors predict response. AIMS To study the effect of TEXT ME (Tobacco EXercise and dieT Messages) text message intervention on physical activity domains, consistency of effects across sub-groups and its additive value in patients that received traditional cardiac rehabilitation programme. METHODS This is a secondary analysis of the TEXT ME, a randomized clinical trial of lifestyle-focused text message intervention compared with usual care in patients with coronary heart disease. A quarter of the messages were designed specifically to encourage physical activity. Sedentary time and physical activity were assessed using the Global Physical Activity Questionnaire. RESULTS At baseline, 85% of the 710 participants reported low physical activity levels. At six months, compared with controls, the intervention arm reported higher recreational physical activity (471 vs. 307 metabolic equivalent-min/week, p = 0.001) and travel physical activity (230 vs. 128 MET-min/week, p = 0.002), similar work-related physical activity and lower sedentary times (494 vs. 587 min, p < 0.001). Male gender, high baseline physical activity, cardiac rehabilitation participation and text message intervention predicted physically active status at six months. Subjects that received both cardiac rehabilitation and text messaging intervention were more likely to achieve target physical activity levels compared with cardiac rehabilitation alone (odds ratio 7.07 vs. 1.80, p < 0.001). CONCLUSIONS The TEXT ME intervention improved recreational and travel physical activity, reduced sedentary times but had no effects on work-related physical activity. It had incremental benefits at achieving target physical activity levels even in patients participating in the traditional cardiac rehabilitation programme.
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Affiliation(s)
- Jay Thakkar
- Westmead Hospital, Sydney, Australia.,The George Institute for Global Health, Sydney, Australia.,The University of Sydney, Australia
| | - Julie Redfern
- The George Institute for Global Health, Sydney, Australia.,The University of Sydney, Australia
| | | | - Clara K Chow
- Westmead Hospital, Sydney, Australia .,The George Institute for Global Health, Sydney, Australia.,The University of Sydney, Australia
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