5 Years of Exercise Intervention Did Not Benefit Cognition Compared to the Physical Activity Guidelines in Older Adults, but Higher Cardiorespiratory Fitness Did. A Generation 100 Substudy

Background: Aerobic exercise is proposed to attenuate cognitive decline in aging. We investigated the effect of different aerobic exercise interventions and cardiorespiratory fitness (CRF) upon cognition throughout a 5-year exercise intervention in older adults.Methods: 106 older adults (52 women, age 70-77 years) were randomized into high-intensity interval training (HIIT; ∼90% peak heart rate), moderate-intensity continuous training (MICT; ∼70% peak heart rate), or control for 5 years. The HIIT and MICT groups performed supervised training twice weekly, while the control group was asked to follow the national physical activity guidelines (30 min of physical activity/day). At baseline, 1-, 3-, and 5-year follow-up, participants partook in cognitive testing (spatial memory, verbal memory, pattern separation, processing speed, working memory, and planning ability), underwent clinical testing, and filled out health-related questionnaires. Linear mixed models were used to assess the effects of the exercise group and CRF (measured as peak and max oxygen uptake) on each cognitive test. The effects of changes in CRF on changes in each cognitive test score throughout the intervention were also assessed. The associations between baseline CRF and cognitive abilities at the follow-ups were investigated using linear regressions.Results: There was no group-by-time interaction on the cognitive measures, and neither HIIT nor MICT participation was associated with better cognitive performance than control at any time point during the 5-year intervention. All groups increased their CRF similarly during the 1st year and subsequently declined back to baseline levels after 5 years. A higher CRF was associated with higher processing speed throughout the intervention while increasing CRF during the intervention was associated with better working memory and worse pattern separation. Higher CRF at baseline predicted consistently better processing speed and verbal memory performance.Conclusion: In this first 5-year randomized controlled trial investigating the effects of HIIT, MICT, and physical activity according to national guidelines on cognition, we observed no effect of exercise intervention group on cognition when compared to following the national physical activity guidelines. Still, the results showed that higher CRF and increasing CRF benefited multiple, but not all, cognitive abilities in older adults.Clinical Trial Registration:www.ClinicalTrials.gov, identifier [NCT01666340].

Ramadan daily intermittent fasting reduces objectively assessed habitual physical activity among adults

Background Muslims around the world practice intermittent fasting during the month of Ramadan each year. We hypothesized that daily physical activity could be reduced among Muslims due to the inability to refuel and rehydrate in the fasting state. Methods A cohort study design among adults registered with national physical activity community program. Data from a pedometer-based community program was used to extract 3 months of daily step counts before, during, and after Ramadan for the past years (2013–2019). A survey was conducted among participants to determine fasting practice and other health and environmental factors. Results A total of 209 participants completed the survey and provided valid data on physical activity. During Ramadan, the average steps per day decreased significantly (− 385 ± SE 158) among participants who fasted (n = 151) p = 0.046 and increased (+ 731 ± SE 247) for the non- fasting participants (n = 58) p = 0.010. Fasting participants preferred before sunset (33.8%) or evening (39.7%) for physical activity. Whereas, non-fasting participants preferred early morning (34.5%). Conclusion Fasting during Ramadan impacts the daily physical activity behavior among Muslims. Interventions should focus on creating awareness of the importance of maintenance of adequate physical activity for adults fasting during Ramadan.

Ramadan daily intermittent fasting reduces objectively assessed habitual physical activity among adults

Background: Muslims around the world practice intermittent fasting during the month of Ramadan once each year. We hypothesized that daily physical activity could be impacted due to the inability to refuel and rehydrate in the fasting state. Therefore, this study aimed to determine the effects of Ramadan fasting on daily physical activity in the adult community of Qatar. Methods: A cohort study design among adults registered with national physical activity community program. Data from a pedometer-based community program was used to extract 3 months of daily step counts before, during, and after Ramadan for the past five years (2015-2019). A survey was conducted among participants to determine fasting practice and other health and environmental factors. Results: A total of 209 participants completed the survey and provided valid data on physical activity. During Ramadan, the average steps per day decreased significantly (-385± SE 158) among participants who fasted (n=155) p=0.046 and increased (+731.4± SE 247) for the non- fasting participants (n=48) p=0.010. Conclusion: Fasting during Ramadan impacts the daily physical activity behavior among Muslims. Interventions should focus on creating awareness of the importance of maintenance of adequate physical activity for adults fasting during Ramadan.

Development of national physical activity recommendations in 18 EU member states: a comparison of methodologies and the use of evidence

ObjectivesThe aim of the study is to compare how member states of the European Union (EU) develop their national physical activity (PA) recommendations and to provide an overview of the methodologies they apply in doing so. Information was collected directly from the physical activity focal points of EU member states in 2018. Five countries were chosen for detailed case study analysis of development processes.DesignCross-sectional survey.ParticipantsThe representatives of the 28 EU member state governments to the EU physical activity Focal Point Network.Outcome measuresFrom national documents we extracted data on (1) the participants of the development process, (2) the different methods used during development, and (3) on which sources national PA recommendations were based. An additional survey for case study countries provided details on (1) anonymised information on the participants of development process, (2) methods employed and rationale for choosing them, (3) development process and timeline, and (4) main source documents used for recommendation development.ResultsEighteen national documents on PA recommendations contained information about development process. The results showed that countries used different approaches to develop national recommendations. The main strategies were (1) adoption of WHO 2010 recommendations or (2) a combination of analysis and adoption of other national and international recommendations and literature review. All of the five case study countries relied on review processes rather than directly adopting WHO recommendations.ConclusionsWhile there are arguments for the use of particular strategies for PA recommendation development, there is currently no evidence for the general superiority of a specific approach. Instead, our findings highlight the broad spectrum of potential development methods, resources utilisation and final recommendations design currently available to national governments. These results may be a source of inspiration for other countries currently planning the development or update of national PA recommendations.

A Critique of National Physical Activity Policy in Oman Using 3 Established Policy Frameworks

Background: This paper aimed to assess the development process, content, and early implementation of Oman’s national physical activity plan of action to identify strengths and areas for improvement. Methods: Data were extracted from 4 documents: national noncommunicable diseases policy, physical activity plan of action, and 2 World Health Organization Mission Reports. Three policy frameworks and approaches (physical activity content analysis grid, health-enhancing physical activity policy audit tool, and policy cube approach for diet-related noncommunicable diseases) were used. Results: The findings demonstrated that policymakers engaged a broad range of sectors in developing a national plan. It aligned with many of the elements from the 3 policy frameworks (ie, multisectoral approach, political commitment/leadership, identification of national goals and targets, time frame for implementation). The main gaps included the lack of a specified sustainable funding mechanism, systems for monitoring progress, and an emphasis on general interventions, with limited focus on specific target groups. Conclusion: A range of sectors were engaged in the development of Oman’s national physical activity plan of action, with strong political commitment and using global guidance and local evidence. Establishing a strong accountability framework, including a clear financing mechanism, is critical for Oman to meet its target for a 10% relative reduction in physical inactivity by 2025.

Physical Activity Recommendations for Adults in Yemen

Background: Physical inactivity is one of the most crucial global problems in spite of the approved impact of physical activity in enhancing health and preventing NCDs, osteoporosis and many other diseases. Thus, WHO encouraged the countries to set their own physical activity guidelines based on the international physical activity recommendations, however, many countries do not have their national Physical activity recommendations such as Yemen in Eastern Mediterranean Region.Objectives: To suggest proper physical activity recommendations for adults in Yemen based on physical activity recommendations in different countries in WHO regions particularly the Eastern Mediterranean Region.Discussion: Prevalence of national physical activity guidelines and physical activity factors vary among WHO regions. The absence of physical activity recommendations and statistical data in Yemen is obvious and surveillance using validated tools should be done to assess the recent PA and related factors. However, although Yemen has its own issues such as Khat chewing habit and conflict, it shares many factors with other Eastern Mediterranean Region countries in general and Qatar in particular such as unsupportive physical activity environment and limited outdoor activities for women. Conclusion: Qatar national physical activity guidelines can be suggested as applicable and affordable guidelines for adults in Yemen. According to Qatar guidelines, adults should do (30–60) min of moderate exercise ≥ 5 days per week or (20–60) min of vigorous exercise for ≥3 days per week and in case of promoting or maintaining weight loss, they should do (50-60) minutes daily exercise. Many studies should be done to assess recent physical activity and related barriers to draw evidence-based physical activity guidelines for adults in Yemen.Background: Physical inactivity is one of the most crucial global problems in spite of the approved impact of physical activity in enhancing health and preventing NCDs, osteoporosis and many other diseases. Thus, WHO encouraged the countries to set their own physical activity guidelines based on the international physical activity recommendations, however, many countries do not have their national Physical activity recommendations such as Yemen in Eastern Mediterranean Region.Objectives: To suggest proper physical activity recommendations for adults in Yemen based on physical activity recommendations in different countries in WHO regions particularly the Eastern Mediterranean Region.Discussion: Prevalence of national physical activity guidelines and physical activity factors vary among WHO regions. The absence of physical activity recommendations and statistical data in Yemen is obvious and surveillance using validated tools should be done to assess the recent PA and related factors. However, although Yemen has its own issues such as Khat chewing habit and conflict, it shares many factors with other Eastern Mediterranean Region countries in general and Qatar in particular such as unsupportive physical activity environment and limited outdoor activities for women. Conclusion: Qatar national physical activity guidelines can be suggested as applicable and affordable guidelines for adults in Yemen. According to Qatar guidelines, adults should do (30–60) min of moderate exercise ≥ 5 days per week or (20–60) min of vigorous exercise for ≥3 days per week and in case of promoting or maintaining weight loss, they should do (50-60) minutes daily exercise. Many studies should be done to assess recent physical activity and related barriers to draw evidence-based physical activity guidelines for adults in Yemen.

National physical activity and sedentary behaviour policies in 76 countries: availability, comprehensiveness, implementation, and effectiveness

Background Evidence on current, national physical activity (PA) and sedentary behaviour (SB) policies is limited. We, therefore, analysed availability, comprehensiveness, implementation, and effectiveness of PA and SB policies internationally. Methods In this cross-sectional study, Global Observatory for Physical Activity (GoPA!) Country Contacts from 173 countries were asked to provide data on their national PA and SB policies by completing GoPA! Policy Inventory. Data were collected for 76 countries (response rate = 44%). Results Formal written policies for PA and SB were found in 92% (95% confidence interval [CI]: 86, 98) and 62% (95% CI: 50, 75) of countries, respectively. Sixty-two percent (95% CI: 51, 73) of countries have national PA guidelines, while 40% (95% CI: 29, 52) have SB guidelines. Fifty-two (95% CI: 40, 64) and 11% (95% CI: 3, 19) of countries have quantifiable national targets for PA and SB, respectively. The most represented ministries/departments involved in the promotion of more PA and/or less SB were in the sport (reported by 99% countries; 95% CI: 96, 100), health (97%; 95% CI: 94, 100), education (94%; 95% CI: 88, 100), and recreation and leisure (85%; 95% CI: 71, 99) sectors. The median score (0–10) for the comprehensiveness of PA and SB policies was 4 (95% CI: 4, 5) and 2 (95% CI: 2, 3), respectively. For PA and SB policy implementation it was 6 (95% CI: 5, 6). For the effectiveness of PA and SB policies it was 4 (95% CI: 3, 5) and 3 (95% CI: 2, 4), respectively. PA and SB policies were generally best developed in high-income countries and countries of European and Western-Pacific regions. Conclusions Most of the included countries have PA policies, but their comprehensiveness, implementation, and effectiveness are generally low-to-moderate. SB policies are less available, comprehensive, implemented, and effective than PA policies. PA and SB policies are better developed in high-income countries, compared with low- and lower-middle-income countries, and in countries of European and Western-Pacific regions, compared with other world regions. More investment is needed in development and implementation of comprehensive and effective PA and SB policies, particularly in low- and lower-middle-income countries.

Why Physical Inactivity Level Has Increased in the Iranian Population During the Past Decade? A Delphi Technique

Background: Considering the well-established benefits of physical activity in the health domain, the economy, and environment, physical activity programs should be considered as an important agenda in public health policymaking. Objectives: The objective of this qualitative study was to identify “Why the prevalence of physical inactivity has increased during the past decade in Iran, despite having various national physical activity documents? "using a Delphi technique. Methods: The “Delphi technique” process in this study consisted of literature review, selecting the research question, selection and recruitment of panel members, pilot study and conduction of round one (using an open question), round 2 (using a 5-point Likert scale), and round three (final ranking). Results: Statements with the highest scores in round three were recognized as the most important causes of the decreased level of physical activity based on the experts’ responses in Iran. Conclusions: The absence of executive support, coordination mechanisms, and appropriate infrastructure for conducting physical activity were the top challenges in improving the physical activity level in Iran.

Participación ciudadana en la elaboración de las políticas públicas de actividad física y deporte: el caso de Chile (Citizen participation in the elaboration of public policies for physical activity and sports: the case of Chile)

El objetivo del trabajo es presentar los procesos de participación ciudadana que el Estado chileno ha implementado para elaborar la reciente política pública nacional de actividad física (AF) y deporte, considerando el desarrollo histórico de la institucionalidad deportiva del país. Se utilizó la metodología cualitativa descriptiva, utilizando como procedimientos la revisión bibliográfica y la técnica de análisis documental. El trabajo permite indicar que existe un avance en el tratamiento de las políticas públicas en deporte y recreación en Chile, toda vez que en la elaboración de las mismas han participado diferentes carteras ministeriales, organizaciones sociales y personas naturales. Se concluye que, a partir de la incorporación, apropiación y desarrollo del deporte moderno en Chile, se observan esfuerzos desde el aparato público por generar espacios de participación y monitoreo del deporte y sus manifestaciones, teniendo como corolario, la actual Política Nacional de Actividad Física y Deporte, vigente entre los años 2016-2025, inclusive.Abstract. The aim of this work is to show citizen participation processes that the Chilean State has implemented to elaborate the current national public policies for physical activity and sports, considering the historical development of the country's sports institutions. The qualitative descriptive methodology was used, performing literature review and documentary analysis technique as the procedures. The work indicates that there is an improvement in the elaboration of public policies in sports and recreation in Chile when different ministerial cabinets, social organizations, and natural persons participated in it. It is concluded that, from the incorporation, appropriation, and development of modern sport in Chile, efforts are observed from the public apparatus towards generating spaces for participation and monitoring of sports and its manifestations, keeping the current National Physical Activity and Sport Policy, in force between 2016-2025, as a corollary.