Body mass index and cognitive decline among community-living older adults: the modifying effect of physical activity

Objective To examine the associations between BMI categories and subsequent 3-year cognitive decline among older adults, and to test whether physical activity modifies the associations. Methods Study sample included n = 1028 cognitively unimpaired older adults participating in the Étude sur la Santé des Aînés (ESA)-Services longitudinal study and followed 3 years later. Cognitive decline was defined as a decrease of > 3 points in MMSE scores between baseline and follow-up. BMI categories (normal weight (reference), underweight, overweight, obese) were derived from self-reported weight and height. Moderate to vigorous physical activity of ≥20 min (# of times per week) was self-reported. The presence of chronic disorders was ascertained from administrative and self-reported data. Logistic regression analyses were used to study the risk of cognitive decline associated with BMI categories stratified by weekly physical activity (≥140 min), the presence of metabolic, cardiovascular and anxio-depressive disorders. Results In the overall sample, there was no evidence that underweight, overweight, or obesity, as compared to normal weight, was associated with cognitive decline, after adjusting for sociodemographic, lifestyle factors, and comorbidities. Individuals with overweight reporting high physical activity had lower odds of cognitive decline (OR = 0.25, 95% CI = 0.07–0.89), whereas no association was observed in individuals with overweight reporting low physical activity (OR = 0.85, 95% CI = 0.41–1.75). Among participants with metabolic and cardiovascular disorders, individuals with overweight reporting high physical activity had lower odds of cognitive decline (OR = 0.09, 95% CI = 0.01–0.59 and OR = 0.03, 95% CI = 0.01–0.92 respectively), whereas no association was observed in those with low physical activity. Conclusion Physical activity modifies the association between overweight and cognitive decline in older adults overall, as in those with metabolic and cardiovascular disorders. Results highlight the importance of promoting and encouraging regular physical activity in older adults with overweight as prevention against cognitive decline.

Effects of voluntary exercise on the expression of browning markers in visceral and subcutaneous fat tissue of normotensive and spontaneously hypertensive rats

High physical activity is important to optimize the function of adipose tissue. Dysfunctional adipose tissue contributes to the development of metabolic stress, chronic inflammation, and hypertension. To improve our current understanding of the interaction between physical exercise and adipose tissue, we analyzed the effect of 10 months voluntary running wheel activity of rats on uncoupling protein (UCP) 1 negative white adipose tissue (visceral and subcutaneous adipose tissue, VWAT and SWAT). Analysis was performed via RT-PCR and immunoblot from adipose tissues depicted from adult normotensive and spontaneously hypertensive female rats. UCP1 negative VWAT differed from UCP1 positive WAT and brown adipose tissue (BAT) from interscapular fat depots, by lacking the expression of UCP1 and low expression of Cidea, a transcriptional co-activator of UCP1. High physical activity affected the expression of five genes in SWAT (Visfatin (up), RBP5, adiponectin, Cidea, and Nrg4 (all down)) but only one gene (Visfatin, up) in VWAT. Furthermore, the expression of these genes is differentially regulated in VWAT and SWAT of normotensive and spontaneously hypertensive rats (SHR) under sedentary conditions (UCP2) and exercise (Visfatin, Cidea, Nrg4). Keeping the animals after 6 months of voluntary exercise under observation for an additional period of 4 months without running wheels, Visfatin, Cidea, and Nrg4 were stronger expressed in VWAT of SHRs than in sedentary control rats. In summary, our study shows that SWAT is more responsible to exercise than VWAT.

Comparisons of physical activity and understanding of the importance of exercise according to dialysis modality in maintenance dialysis patients

Data regarding the status of physical activity or understanding of the importance of exercise, such as barriers of exercise or enablers of exercise, in dialysis patients were insufficient. This study aimed to evaluate the status of physical activity and the understanding of the importance of exercise in Korean dialysis patients. The study participants were recruited from 27 hospitals or dialysis centers (n = 1611). Physical activity was evaluated using the Korean version of the International Physical Activity Questionnaire-Short Form. High physical activity was defined as ≥ 600 metabolic equivalent of task (MET). Knowledge about the importance of exercise, enabler for regular exercise, benefits of exercise, and barrier to exercise was evaluated. Health-related quality of life (HRQoL) was assessed by the Kidney Disease Quality of Life version 1.3. The number of participants in the hemodialysis (HD) and peritoneal dialysis (PD) groups was 1247 and 364, respectively. The intensity of physical activity did not differ between the two modalities. The time of physical activity was longer in HD patients than in PD patients, which resulted in greater MET values and the number of high physical activity. There were 762 (61.1%) HD patients and 281 (77.2%) PD patients who heard of the importance of exercise (P < 0.001). In both HD and PD patients, dialysis staff played the most significant role as educators on the importance of exercise and enablers of exercise. The most important barriers to exercise were poor motivation and fatigue in both modalities. HD patients exhibited greater differences in HRQoL scales across two physical activity levels, compared to PD patients. Our study showed that the barrier to exercise and the enablers of exercise were poor motivation/fatigue and encouragement from dialysis staff, respectively.

Subjective Health, Physical Activity, Body Image and School Wellbeing among Adolescents in South of Sweden

This study aimed to investigate subjective health and its associations with perceived body image (body appearance and body functioning), physical activity, perceived wellbeing in school, perceived family financial situation, and body mass index among 13- to 15-year-old boys and girls. The study was a cross-sectional study performed in four municipalities in Southern Sweden. Data were obtained from questionnaires completed by adolescents (median age 14; range: 13–15) in Sweden (n = 1518, 51% girls), with a participation rate of 73%. Body weight and body height were measured by school nurses and body mass index was calculated. Logistic regression analyses were carried out with subjective health as the dependent variable. Independent variables included in the model were perceived wellbeing in school, perceived family financial situation, perceived body image, physical activity, body mass index, sex, and residency. Variables significantly associated with good subjective health were good wellbeing in school, a perceived good family financial situation, perceived positive body appearance, perceived positive body functioning, being a boy, and high physical activity. Residency and body mass index were not associated with subjective health. Good subjective health is associated with good wellbeing in school, good family financial situation, positive body image, and high physical activity levels. The results highlight the importance of good school climates, the promotion of positive body image, and increased physical activity for adolescents.

Evaluation of the Relationship Between Daily Physical Activity Level and Laboratory Factors and the Length of Hospitalization in Patients with COVID-19

Background: Different degrees of disorders are reported in the respiratory, physical, and psychological functions of patients with corona virus disease 2019 (COVID-19). With the experience of improved and discharged COVID-19 patients, physical activity and sports are considered as one of the factors in controlling chronic mental and physical illnesses. Objectives: This study was aimed at investigating the impact of the level of physical activity on some important clinical parameters and convalescence. Methods: Overall, 71 patients with COVID-19 under the age of 65 years admitted to the hospital with positive PCR were included in the study. Based on Beck’s questionnaire, patients were divided into two groups of (1) low and (2) moderate to high physical activity. The duration of hospitalization and some important clinical tests were examined at the time of hospitalization and discharge. The patients were then monitored until discharge. Results: Statistical analyses showed that people with moderate to high physical activity were discharged earlier than the group with low physical activity (P < 0.01). Moreover, patients with moderate to high physical activity had lower erythrocyte sedimentation rate than the group with low physical activity at discharge (P = 0.01). Conclusions: Moderate to high physical activity can significantly reduce the length of hospitalization by improving the immune system to fight COVID-19. However, the factors that can be examined in expressing the reason for this finding need further studies.

Pro-inflammatory Vascular Stress in Spontaneously Hypertensive Rats Associated With High Physical Activity Cannot Be Attenuated by Aldosterone Blockade

The effect of high physical activity, performed as voluntary running wheel exercise, on inflammation and vascular adaptation may differ between normotensive and spontaneously hypertensive rats (SHRs). We investigated the effects of running wheel activity on leukocyte mobilization, neutrophil migration into the vascular wall (aorta), and transcriptional adaptation of the vascular wall and compared and combined the effects of high physical activity with that of pharmacological treatment (aldosterone antagonist spironolactone). At the start of the 6th week of life, before hypertension became established in SHRs, rats were provided with a running wheel over a period of 10-months'. To investigate to what extent training-induced changes may underlie a possible regression, controls were also generated by removal of the running wheel for the last 4 months. Aldosterone blockade was achieved upon oral administration of Spironolactone in the corresponding treatment groups for the last 4 months. The number of circulating blood cells was quantified by FACS analysis of peripheral blood. mRNA expression of selected proteins was quantified by RT-PCR. Histology and confocal laser microscopy were used to monitor cell migration. Although voluntary running wheel exercise reduced the number of circulating neutrophils in normotensive rats, it rather increased it in SHRs. Furthermore, running wheel activity in SHRs but not normotensive rats increased the number of natural killer (NK)-cells. Except of the increased expression of plasminogen activator inhibitor (PAI)-1 and reduction of von Willebrand factor (vWF), running wheel activity exerted a different transcriptional response in the vascular tissue of normotensive and hypertensive rats, i.e., lack of reduction of the pro-inflammatory IL-6 in vessels from hypertensive rats. Spironolactone reduced the number of neutrophils; however, in co-presence with high physical activity this effect was blunted. In conclusion, although high physical activity has beneficial effects in normotensive rats, this does not predict similar beneficial effects in the concomitant presence of hypertension and care has to be taken on interactions between pharmacological approaches and high physical activity in hypertensives.

Behavioral and Sociodemographic Determinants of Hypertension and Its Burden among Bank Employees in Metropolitan Cities of Amhara Regional State, Ethiopia

Background. Hypertension is the leading cause of cardiovascular disease and premature death worldwide. Bank workers are at higher risk of hypertension because of their work sedentary characteristics. However, little is known about the prevalence and determinants of hypertension among this group of population. Therefore, this study aimed to assess the prevalence and associated factors of hypertension among bank employees in metropolitan cities in Amhara Regional State of Ethiopia. Method. An institution-based cross-sectional study was conducted among 368 bank employees. A simple random sampling technique was used to select participants. A pretested self-administered questionnaire and biophysical measurements were employed to collect the data. Descriptive statistics and logistic regression analyses were done to summarize the data and identify factors associated with hypertension, respectively. Result. The overall prevalence of hypertension among bank employees was 52.4% (95% CI: 47.2, 57.7). Increased age (AOR = 1.1, 95% CI: 1.03, 1.11), male sex (AOR = 2.5, 95% CI: 1.2, 5.1), overweight (AOR = 2.7, 95% CI: 1.5, 5.2), obesity (AOR = 5.6, 95% CI: 2.0, 11.3), moderate/high physical activity (AOR = 0.36, 95% CI: 0.2, 0.62), daily fruit intake (AOR = 0.1, 95% CI: 0.04, 0.3), stressful life event experience (AOR = 1.8, 95% CI: 1.01, 3.4), family history of hypertension (AOR = 2.8, 95% CI: 1.5, 5.4), and poor knowledge of CVDs (AOR = 2.4, 95% CI: 1.2, 4.8) were significantly associated with hypertension. Conclusion. The prevalence of hypertension among bank workers was very high. Increased age, male sex, overweight and obesity, daily fruit intake, moderate/high physical activity, the experience of stressful events, familial history of hypertension, and poor CVDs knowledge were associated with hypertension. Thus, raising awareness about cardiovascular disorders and behavior change interventions that enhance bank workers’ engagement in physical exercise, screening behavior, and a healthy diet is urgently required for this group of population.

P–640 High physical activity and ovarian reserve: A prospective study of normo-ovulatory professional athletes

Study question Is high physical activity (HPA) associated with low ovarian reserve in normo-ovulatory, reproductive-age women? Summary answer HPA does not affect ovarian reserve negatively. What is known already HPA is associated with menstrual irregularities and subsequent potential infertility, probably through hypothalamic neuroendocrine pathways. However, it is not yet known whether HPA influences the ovarian reserves of normo-ovulatory, reproductive-age women. Study design, size, duration This observational, cross-sectional study compared 30 professional female athletes who were engaged in HPA for at least 3 years prior to study recruitment, with high International Physical Activity Questionnaire (IPAQ) scores and 30 women who did not engage in physical activity. The study was conducted at a tertiary medical center from 2017–2020. Participants/materials, setting, methods Physically active, normo-ovulatory women (n = 30), ages 20–35 years were recruited from The Wingate Institute, the Israeli National Institute for Sport Excellence. Non-physically active women (n = 30), matched by age and BMI to the HPA group, were recruited from the hospital staff. Both groups were evaluated for ovarian reserve markers on day 2–5 of the menstrual cycle, including follicular stimulating hormone (FSH), antral follicle count (AFC), anti-Mullerian hormone (AMH) and Inhibin B. Main results and the role of chance The average age of the athletes (HPA group) was 30.1±2.1 years and of the nonactive (control) group 31.6±3.8 years (p = 0.071). BMI of the 2 groups was similar (22.6±2.4 vs. 21.3±2.6; p = 0.075) for the HPA and control groups, respectively. Regarding ovarian reserve, no significant differences were observed between the HPA group and the control group with respect to FSH (p = 0.304), AFC (p = 0.27), AMH (0.507) or Inhibin B (p = 0.074). For the HPA group, older age at menarche was positively associated with AFC (p = 0.008) and AMH (p = 0.009) and not with FSH levels (p = 0.313). For the nonactive group, no significant association between age at menarche and FSH levels, AFC or AMH was found (p = 0.433, p = 0.274 and p = 0.163, respectively). Additionally, for the HPA group, duration of physical activity per week (hours) was not significantly associated with FSH levels, AFC or AMH (p = 0.619, p = 0.608 or p = 0.997, respectively). Limitations, reasons for caution Although we investigated the ovarian reserves of 30 women engaged in HPA, a larger cohort would provide more information. Information on diet and sleep habits was not evaluated and may result in some confounding. Moreover, it would be more informative if we also followed these women regarding fecundability and fertility. Wider implications of the findings: This study demonstrated that HPA may not negatively affect ovarian reserve markers. These findings may provide reassurance for women who are engaged in HPA and attempting pregnancy. Further research needs s to be confuted. Trial registration number 0247–16