Physical Activity and Exercise for Optimal Disease Prevention: Clinical Evidence

Previous physical activity guidelines from health organizations provide general physical activity and exercise intensity and duration recommendations. These guidelines have experienced very little change over the last two decades, despite significant changes in technology, more specifically wearable technology. The guidelines typical refer to exercise intensity as low, moderate and vigorous intensity based on a metabolic equivalent scale (MET) or a subjective scale. With wearable technology being accessible, affordable, reliable, and accurate, more attention should be given address recommendations that are multifaceted and specific. Most wearable technology can easily track sleep, steps, calories, hear rate, and exercise time within certain heart rate training zones. Research has shown that monitoring exercise and physical activity with wearable technology can improve health outcomes3.

“Worn-out but happy”: Postpartum Women's Mental Health and Well-Being During COVID-19 Restrictions in Australia

Background: From late 2019, COVID-19 disease has infiltrated the global population causing widespread challenges to public health. One cohort that has received less attention, but who may be more vulnerable to the mental and physical health related impacts of COVID-19 restrictions are postpartum mothers. The aim of this study was to explore the mental health, well-being, and health behaviours of mothers up to 12 months postpartum whilst living in Australia under COVID-19 level 3 and 4 restrictions.Methods: 351 women in their first year postpartum residing in Australia whilst under level 3/4 social distancing restrictions (during April 13 and June 11, 2020) were recruited to participate in an online questionnaire. The survey measured symptoms of depression, anxiety, and stress (DASS), wellness (SF-36), physical activity (Godin-Shephard score), perceived value of health outcomes, diet, and sleep. Descriptive statistics and linear regressions were performed.Results: Data was analysed for 139 eligible women. Of these women, 74% scored “normal” for depression, 84% for anxiety, and 72% for stress. Over half (58%) of women reported being worn out all, most, or a good bit of the time and 77% reported being a happy person all, most, or a good bit of the time. Analysis of the perceived values of health outcome revealed women had high value for “getting out of the house,” “achieving a better overall mood,” and “to feel better physically.” Women were considered physically active according to the Godin Leisure score, however only 41% of women met the current Australian national physical activity guidelines of 150 min.week−1.Conclusions: Overall the majority of postpartum mums that were surveyed, have normal mental health symptoms, and despite being worn out most are happy at least a good bit of the time. This study highlights the importance of health values in maintaining leisure physical activity and mental health. In addition it appears women may benefit from virtual group exercise and community programs to encourage being physically active and socialising with friends simultaneously.

Association Between Meeting Physical Activity Guidelines with Ambulation and Quality of Life in Claudication

We determined if meeting the 2018 physical activity guidelines was associated with better ambulatory function, health-related quality of life, and inflammation than failing to meet the guidelines in patients with peripheral artery disease and claudication. Secondly, we determined the optimal number of total daily steps that are needed to meet the physical activity guidelines. Five hundred seventy-two patients were assessed on their daily ambulatory activity for one week with a step activity monitor, and were grouped according to whether they achieved less than 150 minutes of moderate intensity physical activity per week (Group 1=Do Not Meet Guidelines; n=397), or whether they were above this threshold (Group 2=Meet Guidelines; n=175). Treadmill peak walking time (mean±SD) was significantly higher (p<0.001) in Group 2 (709±359 sec) than in Group 1 (427±281 sec). The health-related quality of life score for physical function was significantly higher (p<0.001) in Group 2 (61±22%) than in Group 1 (44±21%). High sensitivity C-reactive protein was significantly lower (p<0.001) in Group 2 (3.6±4.5 mg/L) than in Group 1 (5.9±6.1 mg/L). Finally, 7,675 daily steps was the optimal threshold associated with meeting the physical activity guidelines, with a sensitivity of 82.9% and a specificity of 88.4%. In conclusion, patients with claudication who meet the 2018 physical activity guidelines for US adults had better ambulation, HRQoL, and inflammation outcomes than those who failed to meet the guidelines. From a practical standpoint, patients with claudication best achieved the physical activity guidelines by taking a total of 7,675 daily steps.

Factors Associated With Engaging in Regular Physical Activity Among Women Family Caregivers

Regular physical activity is important for promoting the health of family caregivers. In this study, we used data from the 2015 and 2017 Behavioral Risk Factor Surveillance System Questionnaire-Caregiver module to examine factors associated with meeting physical activity guidelines among women caregivers. Meeting physical activity guidelines was defined as participating in 150 minutes (or vigorous equivalent minutes) of physical activity weekly. We used survey-weighted multivariate regression analyses to examine relationships between sociodemographic, caregiving, and health characteristics and meeting physical activity guidelines. All variables were entered into the model simultaneously. The Wald test was used to test the significance of interactions between race and ethnicity and other covariates. 50.7% of 10,542 women caregivers met physical activity guidelines. The amount of time spent caregiving each week was not associated with the odds of meeting guidelines. Caregivers in the paid workforce had decreased odds (OR=0.73, 95%CI [0.62-0.87]) of meeting guidelines. Compared to women caregiving for <6months, women caregiving for 6 months to 2 years had increased odds of meeting guidelines (OR =1.33, 95%CI [1.08-1.64]). Increasing education was associated with an increased odds of meeting guidelines, but being college educated had a more positive effect for Hispanic than white caregivers (pinteraction=0.03). Having children did not affect the odds of meeting guidelines for white caregivers, but for black caregivers having two or more children decreased the odds (pinteraction=0.03). Understanding how sociodemographic, caregiving, and health characteristics impact engagement in regular physical activity is critical to designing effective interventions and ultimately improving the health of caregivers.

Stakeholder perspectives on adapting and disseminating Ghana’s physical activity guidelines: a qualitative study

Background Ghana is facing the public health “double burden” of both communicable and chronic diseases. To combat increased chronic disease prevalence, physical activity promotion efforts are necessary. The Ministry of Health (MOH) developed physical activity guidelines in 2009, but community members are unaware of the guidelines and sample activities (e.g., ballroom dancing) are not culturally appropriate. The purposes of this study were to investigate 1) dissemination of the physical activity guidelines through MOH and Ghana Health Service (GHS) and 2) culturally appropriate physical activities. Methods Data were collected in urban and rural areas of Ghana through focus groups (N = 2) with community representatives and in-depth interviews (N = 15) with GHS health workers. Focus group and interview questions included recommended types of physical activity; interview questions included dissemination factors based on Diffusion of Innovations. The research team analyzed the data through an inductive, grounded theory approach. Results Together, the focus groups and in-depth interviews generated 942 meaning units coded into themes of Physical Activity Perceptions (N = 337 meaning units), Suggested Physical Activities (N = 317), and Dissemination and Implementation Factors (N = 290). Participants had positive perceptions of physical activity but expressed concerns over individual abilities; barriers included the built environment and a lack of time. Suggested physical activities included walking, jogging, football, and dancing for adults; traditional games and football for youth, and walking and daily chores for older adults. Participants noted that guideline implementation was influenced by leadership engagement at multiple levels, relative advantage, and compatibility. Respondents suggested implementation strategies to resolve barriers, including involving partner organizations and developing an implementation plan. Participants were largely unaware of the physical activity guidelines; typical dissemination methods included written materials and the internet. Conclusions The results of this study suggest that physical activity guidelines should include familiar physical activities such as traditional games. Results also suggest that public health workers within GHS experience challenges in disseminating the physical activity guidelines. Adapting, disseminating, and implementing physical activity guidelines is a necessary step in increasing physical activity levels and preventing chronic diseases. These results contribute to understanding translation of physical activity policy to practice.

Is greater public transport use associated with higher levels of physical activity in a regional setting? Findings from a pilot study

Background Public transport users often accumulate more physical activity than motor vehicle users, but most studies have been conducted in large metropolitan areas with multiple public transport options with limited knowledge of the relationship in regional and rural areas. In a regional city, this pilot study aimed to (1) test the feasibility of preliminary hypotheses to inform future research, (2) test the utility of survey items, and (3) establish stakeholder engagement. Methods Data were collected via a cross-sectional online survey of 743 Tasmanian adults. Physical activity outcomes were walking (min/week), total moderate- to vigorous-intensity physical activity (min/week) and attainment of physical activity guidelines (yes/no). Transport variables were frequency of public and private transport use per week. Truncated and log binomial regression examined associations between public/private transport use and physical activity. Results Neither frequency of public nor private transport use was associated with minutes of walking (public transport: B − 24.4, 95% CI: − 110.7, 61.9; private transport: B − 1.1, 95% CI: − 72.4, 70.1), minutes of total physical activity (public transport: B − 90.8, 95% CI: − 310.0, 128.5; private transport: B 0.4, 95% CI: − 134.0, 134.9) or not meeting physical activity guidelines (public transport: RR 1.02, 95%CI: 0.95, 1.09; private transport: RR 1.02, 95%CI: 0.96, 1.08). Conclusions The hypothesis that public transport users would be more physically active than private transport users was not supported in this pilot study. Stakeholders were engaged and involved in various phases of the research including development of research questions, participant recruitment, and interpretation of findings. Further studies using representative samples and refined measures are warranted to confirm or refute findings.

Novel Applications of Accelerometry Data for Health Outcomes in Older Adults: Thinking Beyond MVPA

Physical activity is a well-established predictor of health and longevity. Wearable accelerometers produce high-frequency, time series data that capture multiple aspects of daily physical activity across the spectrum of intensity. Historically, the majority of accelerometry-based physical activity research has employed summary threshold metrics such as moderate-to-vigorous physical activity, or “MVPA.” Although these measures are important for understanding compliance with physical activity guidelines, they underutilize the potential of this data. To advance the science of physical activity in older adults, more sensitive, clinically translatable measures are needed. This symposium will examine the associations between novel measures of accelerometry-derived physical activity and various aging-related health outcomes. Dr. Wanigatunga will discuss the association of physical activity volume and fragmentation with the frailty phenotype in the Study to Understand Vitamin D and Fall Reduction in You (STURDY). Dr. Cai will present evidence on the association of physical activity quantities and patterns with measures of visual impairment in the Baltimore Longitudinal Study of Aging. Ms. Qiao will present a novel accelerometry-derived measure of performance fatigability in the Developmental Epidemiologic Cohort Study. Finally, Dr. Urbanek will discuss the role of accelerometry-derived free-living gait cadence in defining fall risk in STURDY. Collectively, these presentations highlight critical associations between objective measures of physical activity and health outcomes in older adults and illuminate the need for thinking beyond MVPA to improve prevention and intervention efforts.

The Associations Between Access to Recreational Facilities and Adherence to the American Heart Association's Physical Activity Guidelines in US Adults

Physical activity decreases the risk of long-term health consequences including cardiac diseases. According to the American Health Association (AHA), adults should perform at least 75 min of vigorous physical activity (PA) or 150 min of moderate PA per week to impact long-term health. Results of previous studies are varied and have yet to integrate perceived access to facilities with AHA PA guidelines. We investigated whether access to free or low-cost recreational facilities was associated with meeting the AHA PA guidelines.Methodology: This cross-sectional study utilized data extracted from the Family Life, Activity, Sun, Health, and Eating (FLASHE) database collected in 2017 (n = 1,750). The main exposure variable was access to free or low-cost recreational facilities. The main outcome variable was meeting the AHA guidelines of 150 min moderate PA or 75 min vigorous PA per week. Covariates included age, sex, level of education, overall health, BMI, ethnicity, hours of work per week, income, and time living at current address. Unadjusted and adjusted logistic regression analysis were used to calculate measures of odds ratio (OR) and corresponding 95% confidence interval (CI).Results: Of the 1,750 included participants, 61.7% (n = 1,079) reported to have access to recreational facilities. Of those with access to facilities, 69.9% met AHA PA guidelines while 30.4% did not. After adjusting for covariates, participants who reported access to recreational facilities were 42% more likely to meet AHA PA guidelines compared with participants who did not (adjusted OR 1.42; 95% CI 1.14–1.76). Secondary results suggest that healthier individuals were more likely to have met AHA PA guidelines.Conclusions: Having access to free or low-cost recreational facilities such as parks, walking trails, bike paths and courts was associated with meeting the AHA PA guidelines. Increasing prevalence and awareness of neighborhood recreational facilities could assist in access to these facilities and increase the ability of individuals to meet AHA PA guidelines. Future research should determine which types of recreational facilities impact physical activity strongest and discover methods of increasing their awareness.