Reduction in Incident Stroke Risk With Vigorous Physical Activity: Evidence From 7.7-Year Follow-Up of the National Runners' Health Study

Abstract People differ from each other to the extent to which momentary factors, such as context, mood, and cognitions, influence momentary health behaviors. However, statistical models to date are limited in their ability to test whether the association between two momentary variables (i.e., subject-level slopes) predicts a subject-level outcome. This study demonstrates a novel two-stage statistical modeling strategy that is capable of testing whether subject-level slopes between two momentary variables predict subject-level outcomes. An empirical case study application is presented to examine whether there are differences in momentary moderate-to-vigorous physical activity (MVPA) levels between the outdoor and indoor context in adults and whether these momentary differences predict mean daily MVPA levels 6 months later. One hundred and eight adults from a multiwave longitudinal study provided 4 days of ecological momentary assessment (during baseline) and accelerometry data (both at baseline and 6 month follow-up). Multilevel data were analyzed using an open-source program (MixWILD) to test whether momentary strength between outdoor context and MVPA during baseline was associated with average daily MVPA levels measured 6 months later. During baseline, momentary MVPA levels were higher in outdoor contexts as compared to indoor contexts (b = 0.07, p < .001). Participants who had more momentary MVPA when outdoors (vs. indoors) during baseline (i.e., a greater subject-level slope) had higher daily MVPA at the 6 month follow-up (b = 0.09, p < .05). This empirical example shows that the subject-level momentary association between specific context (i.e., outdoors) and health behavior (i.e., physical activity) may contribute to overall engagement in that behavior in the future. The demonstrated two-stage modeling approach has extensive applications in behavioral medicine to analyze intensive longitudinal data collected from wearable sensors and mobile devices.

Download Full-text

Determinants of student’s physical activity: a 12-month follow-up study in Ningxia province

BMC Public Health ◽

10.1186/s12889-021-10525-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wei Huang ◽

Xiangrong Shi ◽

Yujie Wang ◽

Xiaoling Li ◽

Pengpeng Gao ◽

...

Keyword(s):

Physical Activity ◽

Children And Adolescents ◽

Vigorous Physical Activity ◽

Skill Training ◽

Critical Role ◽

School Factors ◽

Factors Associated ◽

Students Attitudes ◽

Sport Events

Abstract Background Physical activity has many health benefits for children and adolescents. However, the prevalence of physical inactivity in school-aged children and adolescents remains high in China. Many factors impact the levels of moderate and vigorous physical activity (MVPA) among students. This study investigated the factors associated with students’ MVPA levels and the determinants of changes in their MVPA behaviour. Methods This is a longitudinal study with a 12-month follow-up. The study samples were obtained from 2016 and 2017 Physical Activity and Fitness in China—The Youth Study, and they included 1597 students (aged 9–18 years) from 31 primary, junior high, and high schools in Ningxia Province. Factors related to the individual (Age, Sex, BMI and attitude to PA), school (school exercise facility, PE class, teacher support, PA time and PA environment) and neighbourhood (free skill training, sport events, sport organization, sport facility) factors were measured via questionnaire at baseline and after 12 months. Multiple logistic regression was performed to examine the factors that impact students’ MVPA level and the determinants of changes in students’ MVPA behaviour. Results There was no difference in students’ MVPA levels between 2016 and 2017. Boys were more physically active than girls at baseline (RR 1.55, 95% CI 1.10, 2.20). Neighbourhood factors associated students’ MVPA levels were significant, but all of these factors (neighbourhood sport events, organizations, facilities, etc.) were removed from the longitudinal model. Individual and school factors were important for students’ MVPA maintenance and positive development (e.g., gender, attitude, school PE class and PA time). Conclusions In conclusion, both neighbourhood and school factors may affect students’ MVPA, but school appears to plays a more critical role in maintaining and promoting students’ MVPA levels. In addition, individual factors may be more important than school and neighbourhood factors in influencing students’ MVPA levels. Our research demonstrates that students’ attitudes towards PA and school factors should be considered targets for future intervention programmes to promote MVPA. More education programmes may help enhance students’ attitudes towards PA, but more studies with large samples and objective assessments are needed to explore the determinants of MVPA.

Download Full-text

Accelerometry and Self-Report Are Congruent for Children’s Moderate-to-Vigorous and Higher Intensity Physical Activity

Journal for the Measurement of Physical Behaviour ◽

10.1123/jmpb.2020-0017 ◽

2021 ◽

pp. 1-8

Author(s):

Claudio R. Nigg ◽

Xanna Burg ◽

Barbara Lohse ◽

Leslie Cunningham-Sabo

Keyword(s):

Physical Activity ◽

Repeated Measures ◽

Vigorous Physical Activity ◽

Fourth Grade ◽

Assessment Method ◽

Self Report ◽

Upper Elementary ◽

Upper Elementary School ◽

Intensity Physical Activity

Purpose: This study used different analytic approaches to compare physical activity (PA) metrics from accelerometers (ACC) and a self-report questionnaire in upper elementary youth participating in the Fuel for Fun intervention. Methods: The PA questionnaire and ACC were assessed at baseline/preintervention (fall fourth grade), Follow-up 1/postintervention (spring fourth grade), and Follow-up 2 (fall fifth grade) of 564 fourth grade students from three elementary schools (50% females, 78% White, and 28% overweight or obese). Different analytic approaches identified similarities and differences between the two methods. Results: On average, self-report was higher than ACC for vigorous PA (range = 9–15 min/day), but lower than ACC for moderate PA (range = 24–30 min/day), light PA (range = 30–36 min/day), and moderate-to-vigorous physical activity (MVPA; range = 9–21 min/day). Spearman’s correlations for vigorous PA (.30, .26, and .32); moderate PA (.12, .13, and .14); and MVPA (.25, .25, and .24) were significant at each time point (all ps ≤ .01), whereas correlations for light PA were not significant (.06, .04, and .07; all ps > .05). In repeated-measures analyses, ACC and questionnaire measures were significantly different from each other across the three time points; however, change difference of the two measures over time was only 5.5 MVPA min/day. Conclusions: The PA questionnaire and ACC validated each other and can be used to assess MVPA in upper elementary school children in a similar population to the current study. However, each assessment method captures unique information, especially for light-intensity PA. Multiple PA measurement methods are recommended to be used in research and application to provide a more comprehensive understanding of children’s activity.

Download Full-text

Abstract MP35: Physical Activity Before and After Cancer Diagnosis and Total and Cause-Specific Mortality

Circulation ◽

10.1161/circ.137.suppl_1.mp35 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Paulette D Chandler ◽

Deirdre Tobias ◽

Jule E Buring ◽

I-Min Lee ◽

Daniel Chasman ◽

...

Keyword(s):

Physical Activity ◽

Cancer Diagnosis ◽

Cancer Mortality ◽

Total Mortality ◽

Health Study ◽

Specific Mortality ◽

Before And After ◽

After Cancer ◽

Cvd Mortality

Background: Given the increased prevalence of cancer survivors in the United States, it is imperative to define risk factors for potential reductions in total and cause-specific mortality. Physical activity (PA) represents a promising target for intervention. Design: We prospectively evaluated PA from questionnaires before and after cancer diagnosis with total and cause-specific mortality among 13,297 subjects diagnosed with invasive cancer combined from the Physicians’ Health Study (PHS) (n=6328), Physicians’ Health Study II (PHS II) (n=912), and Women's Health Study (WHS) (n=6057). WHS and PHS participants were free of baseline cancer; PHS II participants reported no active cancer at baseline. We ascertained PA before and after an incident cancer diagnosis based on reports on repeated follow-up questionnaires. Death was ascertained by medical records and death certificates. Cox regression estimated combined hazard ratios (HRs) of mortality by PA adjusted for age, randomized treatments, BMI, and other lifestyle/demographic factors. We evaluated the interaction between PA before and after cancer diagnosis by comparing PA ≤1 versus ≥2 times/wk. Results: The mean follow-up after cancer diagnosis was 8.0, 7.5, and 5.2 y for WHS, PHS, and PHS II, respectively, during which there were 5623 deaths (WHS, 2164; PHS, 3269; PHS II; 190). Higher PA before cancer diagnosis was associated with significantly lower mortality. Compared with PA ≤ once/wk, the HRs (95% CIs) associated with PA 2-4 and >4 times/wk were 0.87 (0.82-0.93) and 0.88 (0.82-0.94) for total mortality; 0.77 (0.63-0.95) and 0.79 (0.62-0.997) for CVD mortality, and 0.90 (0.83-0.98) and 0.90 (0.83-0.98) for cancer mortality. Higher PA after cancer diagnosis was associated with significantly lower total and cancer mortality and non-significantly lower CVD mortality, with HRs (95% CIs) of 0.65 (0.58-0.72) and 0.66 (0.59-0.73) for total mortality; 0.78 (0.59-1.03) and 0.82 (0.61-1.10) for CVD mortality, and 0.66 (0.57-0.77) and 0.64 (0.55-0.74) for cancer mortality. There was a significant interaction of PA before and after cancer diagnosis for total (p int =0.02) and cancer (p int =0.007) mortality, but not CVD mortality (p int =0.38). Conclusions: Greater PA both before and after cancer diagnosis were significantly associated with lower total and cancer mortality. Higher PA before cancer diagnosis was also associated with lower CVD mortality. PA may be an important target for lower mortality after cancer diagnosis.

Download Full-text

Evaluation of a Walking-Track Intervention to Increase Children’s Physical Activity during Primary School Break Times

Children ◽

10.3390/children5100135 ◽

2018 ◽

Vol 5 (10) ◽

pp. 135

Author(s):

Emma Powell ◽

Lorayne Woodfield ◽

Alexander Powell ◽

Alan Nevill ◽

Tony Myers

Keyword(s):

Physical Activity ◽

Vigorous Physical Activity ◽

Structured Interview ◽

Systematic Observation ◽

Daily Routines ◽

Mixed Method Design ◽

School Playgrounds ◽

Recommended Guidelines ◽

Children’S Physical Activity

Despite the known benefits of engaging in daily moderate to vigorous physical activity (MVPA), only 22% of children in England are meeting the recommended guidelines. School break times have been advocated as a key part of children’s daily routines in which their MVPA can be increased. The main aim of this study was to evaluate the effect of installing a walking-track on children’s MVPA during school break times. A mixed method design was employed which allowed for the quantitative measurement of children’s PA at three time points (baseline, mid-intervention (1–5 weeks) and follow-up (6–9 weeks)), using pedometers (n = 81, 5–9 years) and systematic observation (n = 23, 7–9 years). A semi-structured interview (n = 1) was also conducted at 10 weeks’ follow-up. The installation of the walking-track was grounded in a unique set of theoretical constructs to aid the behaviour change of the teachers. Short term positive increases in girls’ and boys’ MVPA and longer term increases in boys’ vigorous PA (VPA) were found. Qualitative data highlighted that boys dominated the walking-track and the inconsistent behaviour of school staff negatively impacted upon children’s MVPA. A set of principles to guide the installment of walking-tracks in school playgrounds are recommended.

Download Full-text

Longitudinal Changes in Sitting Patterns, Physical Activity, and Health Outcomes in Adolescents

Children ◽

10.3390/children6010002 ◽

2018 ◽

Vol 6 (1) ◽

pp. 2 ◽

Cited By ~ 5

Author(s):

Ana Contardo Ayala ◽

Jo Salmon ◽

David Dunstan ◽

Lauren Arundell ◽

Kate Parker ◽

...

Keyword(s):

Physical Activity ◽

Vigorous Physical Activity ◽

Activity Patterns ◽

Sitting Time ◽

Linear Regression Models ◽

Anthropometric Measures ◽

Prolonged Sitting ◽

Intensity Physical Activity ◽

Changes Over Time

This study examined two-year changes in patterns of activity and associations with body mass index (BMI) and waist circumference (WC) among adolescents. Inclinometers (activPAL) assessed sitting, sitting bouts, standing, stepping, and breaks from sitting. ActiGraph-accelerometers assessed sedentary time (SED), light-intensity physical activity (LIPA, stratified as low- and high-LIPA), and moderate-to-vigorous physical activity (MVPA). Anthropometric measures were objectively assessed at baseline and self-reported at follow-up. Data from 324 and 67 participants were obtained at baseline and follow-up, respectively. Multilevel mixed-effects linear regression models examined changes over time, and associations between baseline values and BMI and WC at follow-up. There were significant increases in BMI (0.6 kg/m2) and durations of prolonged sitting (26.4 min/day) and SED (52 min/day), and significant decreases in stepping (−19 min/day), LIPA (−33 min/day), low-LIPA (−26 min/day), high-LIPA (−6.3 min/day), MVPA (−19 min/day), and the number of breaks/day (−8). High baseline sitting time was associated (p = 0.086) with higher BMI at follow-up. There were no significant associations between baseline sitting, prolonged sitting, LIPA, or MVPA with WC. Although changes in daily activity patterns were not in a favourable direction, there were no clear associations with BMI or WC. Research with larger sample sizes and more time points is needed.

Download Full-text

Do overweight/obesity and low levels of leisure-time vigorous physical activity moderate the effect of occupational physical activity on self-rated health of construction workers?

International Archives of Occupational and Environmental Health ◽

10.1007/s00420-021-01771-2 ◽

2021 ◽

Author(s):

M. Van den Berge ◽

S. H. Van Oostrom ◽

H. F. Van der Molen ◽

S. J. W. Robroek ◽

C. T. J. Hulshof ◽

...

Keyword(s):

Physical Activity ◽

Material Handling ◽

Vigorous Physical Activity ◽

Construction Workers ◽

Low Level ◽

Self Rated Health ◽

Manual Material Handling ◽

Strenuous Work ◽

Low Levels

Abstract Purpose To investigate the combined effects of occupational physical activity (OPA) and either overweight/obesity or low levels of leisure-time vigorous physical activity (LTVPA) on self-rated health. Methods A longitudinal study was performed among 29,987 construction workers with complete data on 2 Workers’ Health Surveillance Programs during 2010–2018. Self-reported OPA involved strenuous work postures and manual material handling. Low level of LTVPA was defined as self-reported vigorous activity for less than three times per week lasting at least 20 min per session. Overweight and obesity were based on Body Mass Index (BMI) (25.0 ≤ BMI < 30.0 kg/m2 and BMI ≥ 30.0 kg/m2, respectively) using measured body height and weight. Self-rated health was measured using a single item question. Logistic regression analysis was used to investigate the associations between the separate risk factors at baseline and self-rated health at follow-up. The combined effects of demanding OPA and either overweight/obesity or low level of LTVPA on self-rated health were analyzed using the relative excess risk due to interaction (RERI). Results Mean follow-up duration was 31.7 (SD = 14.9) months. Construction workers with strenuous work postures (OR 1.35 95% CI 1.25–1.46), manual material handling (OR 1.29 95% CI 1.19–1.40), obesity (OR 1.31 95% CI 1.17–1.47) and low LTVPA (OR 1.13 95% CI 1.01–1.25) were more likely to report poor self-rated health at follow-up. No statistically significant interaction effects were found for OPA and obesity or low LTVPA. Conclusions OPA, obesity and low level of LTVPA were separate risk factors for poor self-rated health, but did not appear to have a synergistic effect.

Download Full-text

Objectively measured physical activity, sedentary behaviour and all-cause mortality in older men: does volume of activity matter more than pattern of accumulation?

British Journal of Sports Medicine ◽

10.1136/bjsports-2017-098733 ◽

2018 ◽

Vol 53 (16) ◽

pp. 1013-1020 ◽

Cited By ~ 67

Author(s):

Barbara J Jefferis ◽

Tessa J Parsons ◽

Claudio Sartini ◽

Sarah Ash ◽

Lucy T Lennon ◽

...

Keyword(s):

Physical Activity ◽

Sedentary Behaviour ◽

Vigorous Physical Activity ◽

Older Men ◽

Population Based ◽

Physical Activity Guidelines ◽

All Cause Mortality ◽

Sedentary Breaks ◽

Objectively Measured

ObjectivesTo understand how device-measured sedentary behaviour and physical activity are related to all-cause mortality in older men, an age group with high levels of inactivity and sedentary behaviour.MethodsProspective population-based cohort study of men recruited from 24 UK General Practices in 1978–1980. In 2010–2012, 3137 surviving men were invited to a follow-up, 1655 (aged 71–92 years) agreed. Nurses measured height and weight, men completed health and demographic questionnaires and wore an ActiGraph GT3x accelerometer. All-cause mortality was collected through National Health Service central registers up to 1 June 2016.ResultsAfter median 5.0 years’ follow-up, 194 deaths occurred in 1181 men without pre-existing cardiovascular disease. For each additional 30 min in sedentary behaviour, or light physical activity (LIPA), or 10 min in moderate to vigorous physical activity (MVPA), HRs for mortality were 1.17 (95% CI 1.10 to 1.25), 0.83 (95% CI 0.77 to 0.90) and 0.90 (95% CI 0.84 to 0.96), respectively. Adjustments for confounders did not meaningfully change estimates. Only LIPA remained significant on mutual adjustment for all intensities. The HR for accumulating 150 min MVPA/week in sporadic minutes (achieved by 66% of men) was 0.59 (95% CI 0.43 to 0.81) and 0.58 (95% CI 0.33 to 1.00) for accumulating 150 min MVPA/week in bouts lasting ≥10 min (achieved by 16% of men). Sedentary breaks were not associated with mortality.ConclusionsIn older men, all activities (of light intensity upwards) were beneficial and accumulation of activity in bouts ≥10 min did not appear important beyond total volume of activity. Findings can inform physical activity guidelines for older adults.

Download Full-text

Abstract P070: Longer Sleep Duration Is Associated With Less Myosteatosis In African Caribbean Adults

Circulation ◽

10.1161/circ.143.suppl_1.p070 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Adrianna I Acevedo-Fontanez ◽

Ryan Cvejkus ◽

Allison L Kuipers ◽

Joseph Zmuda ◽

Victor Wheeler ◽

...

Keyword(s):

Physical Activity ◽

Skeletal Muscle ◽

Sleep Duration ◽

Vigorous Physical Activity ◽

Health Study ◽

Muscle Area ◽

Subjective Data ◽

Muscle Density ◽

Intermuscular Adipose Tissue ◽

African Caribbean

Introduction: Skeletal muscle is the largest organ in the human body and vital to maintaining metabolic homeostasis. Increased skeletal muscle fat infiltration (i.e. myosteatosis) is now recognized as a major risk factor for cardio-metabolic diseases, independent of general obesity. Modifications in lifestyle, such as sleep, to reduce myosteatosis would be of great public health importance. However, studies of this relationship often use subjective data and are lacking in minority populations. The aim of this study was to examine the relation between objectively measured sleep duration and myosteatosis at the calf among African Caribbeans. Methods: Data were collected on men (n=393) and women (n=438) from the Tobago Health Study. Sleep duration and physical activity was collected using a SenseWear Pro Armband (BodyMedia, Inc.). Participants were instructed to wear the armband at all times, except in water, for 4-7 days. Measures of muscle density, intermuscular adipose tissue (IMAT), and area were obtained by peripheral QCT scans of the calf (Stratec XCT-2000). Model covariates included age, sex, BMI, diabetes, alcohol intake, smoking, and moderate to vigorous physical activity (MVPA). Linear regression was used to assess the relationship of sleep duration on skeletal muscle. Results: Mean sleep duration was 5.5 hours/day (Min 2.2, Max 11.6). Overall, participants were aged 58.7 years, had a BMI of 30.2 kg/m 2 , spent an average of 42 min/day in MVPA, and 18% were diabetic. In fully adjusted models, longer sleep duration was associated with smaller muscle area, but greater muscle density and less IMAT (all P<0.03). There was no interaction of sleep and sex on muscle density, area and IMAT (p-value=0.5184; 0.2730; 0.0954). Conclusions: In African Caribbean men and women, longer sleep duration was associated with less myosteatosis, as well as, less muscle area at the calf. Further research is warranted to understand this relationship longitudinally in order to determine how it may inform lifestyle guidelines in the Caribbean.

Download Full-text

Physical activity, sedentary behavior, and incidence of obstructive sleep apnea in three prospective US cohorts

European Respiratory Journal ◽

10.1183/13993003.00606-2021 ◽

2021 ◽

pp. 2100606

Author(s):

Yue Liu ◽

Lin Yang ◽

Meir J. Stampfer ◽

Susan Redline ◽

Shelley S. Tworoger ◽

...

Keyword(s):

Physical Activity ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Sedentary Behavior ◽

Sitting Time ◽

Health Study ◽

Metabolic Factors ◽

Obstructive Sleep ◽

Watching Tv

Reduced physical activity and increased sedentary behavior may independently contribute to development of obstructive sleep apnea (OSA) through increased adiposity, inflammation, insulin resistance and body fluid retention. However, epidemiologic evidence remains sparse, and is primarily limited to cross-sectional studies.We prospectively followed 50 332 women from the Nurses’ Health Study (2002–2012), 68 265 women from the Nurses’ Health Study II (1995–2013), and 19 320 men from the Health Professionals Follow-up Study (1996–2012). Recreational physical activity (quantified by metabolic equivalent of task [MET]-hours/week) and sitting time spent watching TV and at work/away from home were assessed by questionnaires every 2–4 years. Physician-diagnosed OSA was identified by validated self-report. Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for OSA incidence associated with physical activity and sedentary behavior.During 2 004 663 person-years of follow-up, we documented 8733 incident OSA cases. After adjusting for potential confounders, the pooled HR for OSA comparing participants with ≥36.0 versus <6.0 MET-hours/week of physical activity was 0.46 (95% CI: 0.43, 0.50; ptrend<0.001). Compared with participants spending <4.0 h/week sitting watching TV, the multivariable-adjusted HR (95% CI) was 1.78 (1.60, 1.98) for participants spending ≥28.0 h/week (ptrend<0.001). The comparable HR (95% CI) was 1.49 (1.38, 1.62) for sitting hours at work/away from home (ptrend<0.001). With additional adjustment for several metabolic factors including BMI and waist circumference, the associations with physical activity and sitting hours at work/away from home were attenuated but remained significant (ptrend<0.001), whereas the association with sitting hours watching TV was no longer statistically significant (ptrend=0.18).Higher levels of physical activity and fewer sedentary hours were associated with lower OSA incidence. The potential mediating role of metabolic factors in the association between sedentary behavior and OSA incidence may depend on type of sedentary behavior. Our results suggest that promoting an active lifestyle may reduce OSA incidence.

Download Full-text