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A tale of two pandemics: How will COVID-19 and global trends in physical inactivity and sedentary behavior affect one another?
... [5][6][7][8][9][10][11][12][13] A particular health behavior that has been associated with worse COVID-19 outcomes is physical inactivity. [14][15][16][17][18][19][20][21] Once preventive vaccination and options for targeted therapeutics were developed, the potential mechanisms for better outcomes among individuals who acquired COVID-19 and were regularly physically active include better immune function, reduced systemic inflammation, and improved cardiovascular health, muscle strength, glucose regulation, and lung function. 18,21 Overall, physically active individuals may be better equipped to withstand the physical and mental health challenges imposed by the virus. ...
... 18,21 Overall, physically active individuals may be better equipped to withstand the physical and mental health challenges imposed by the virus. 6,[18][19][20][21][22] Cardiorespiratory fitness (CRF) is in part a consequence of regular physical activity. [23][24][25] In recent years, CRF has been found to be a powerful predictor of risk for mortality and other adverse health outcomes. ...
... These observations provide additional support for the concept that a more physically active lifestyle offers protection from more severe symptoms and a more complicated medical course among individuals infected with the COVID-19 virus. [13][14][15][16][17][18][19][20][21][22][30][31][32][33][34] To our knowledge, the current study is the largest to assess the relationship between objectively determined CRF from a maximal exercise test and outcomes related to COVID-19. The effects of CRF on long COVID require further exploration. ...
... Long-term physical inactivity can reduce the immune function of individuals (Brolinson & Elliott, 2007). This indicates that physical inactivity can worsen the effects of pandemics (Hall et al., 2020). On the other hand, considering the changes in daily life, it is thought that the pandemic has the potential to further affect and accelerate the inadequacy of physical activity (Hall et al., 2020). ...
... This indicates that physical inactivity can worsen the effects of pandemics (Hall et al., 2020). On the other hand, considering the changes in daily life, it is thought that the pandemic has the potential to further affect and accelerate the inadequacy of physical activity (Hall et al., 2020). ...
Objective: The aim of this study was to investigate the physical activity levels of healthy individuals and the factors affecting these levels during the Coronavirus-19 pandemic period. Materials and Methods: Individuals between the ages of 18 and 65 were included in the study. The International Physical Activity Questionnaire–Short Form, the Coronavirus-19 Phobia Scale, and the Physical Activity Barriers Questionnaire were used to assess the individuals. A decision tree model made using the Chi-Squared Automatic Interaction Detection Method was used to analyze how the variables explain the total physical activity score.Results: In this study, 267 individuals (199 females 74.53%, 68 males 25.47%) with a mean age of 26.71±9.67 were included. It was observed that 77.15% of the individuals did not have sufficient levels of physical activity. According to the decision tree analysis, gender was the factor that most differentiated the total physical activity scores of the participants (p<0.001). Physical activity levels of men were found to be higher than women. It was observed that the physical activity levels of women differed in accordance with the Personal subscale of the Physical Activity Barriers Questionnaire (p=0.002). Those who reported more personal barriers among women had lower physical activity levels.Conclusions: It was determined that most individuals had insufficient levels of physical activity, and gender and personal barriers were the most important determinants. Our study reveals that to increase the physical activity level of healthy individuals, it is necessary to focus on factors related to internal motivation.
... Additionally, 21.3% of adults reported staying seated more than seven hours/day (instead of one out of three hours during lockdown) [32]. Hall et al. (2021) noted that the COVID-19 pandemic may have accelerated ongoing physical inactivity and sedentary behaviors [33]. For prevention, this collective awareness could be used by decision-makers and the public for behavioral changes towards a healthier lifestyle, taking into consideration that COVID-19 pandemic gave several examples of lockdown-related behaviors driven by the socio-economic characteristics of the population [34]. ...
... Additionally, 21.3% of adults reported staying seated more than seven hours/day (instead of one out of three hours during lockdown) [32]. Hall et al. (2021) noted that the COVID-19 pandemic may have accelerated ongoing physical inactivity and sedentary behaviors [33]. For prevention, this collective awareness could be used by decision-makers and the public for behavioral changes towards a healthier lifestyle, taking into consideration that COVID-19 pandemic gave several examples of lockdown-related behaviors driven by the socio-economic characteristics of the population [34]. ...
Populations undergoing extensive and rapid socio-economic transitions including historically disadvantaged communities face an increased risk of type-2 diabetes (T2D). In recent years, sedentary behavior and physical inactivity have been considered modifiable determinants when developing primary prevention programs to reduce T2D incidence. Reunion Island is a French overseas department with an increasing T2D population and a high level of socio-economic inequality. The objectives of our study were to identify the individual, social, and environmental factors associated with sedentary behavior and physical inactivity among the Reunion Island adult population, and to highlight these findings in order to propose T2D primary prevention strategies aiming at alleviating local social inequalities in health (SIH). In 2021, we conducted a population-based cross-sectional telephone survey using random sampling. Participants included adults over 15 years old living in ordinary accommodation on Reunion Island (n = 2,010). Using a sequential approach, multinomial logistic regression model (explaining 3 profiles of interest: sedentary/inactive, sedentary/active, non-sedentary/inactive), and sampling-design weighted estimates, we found that 53.9% [95% confidence interval: 51.1 to 56.7%] of participants had sedentary behavior and 20.1% [95% CI: 17.8 to 22.5%] were inactive. Abandoning physical activity due to the COVID-19 pandemic (p<0.001), final secondary school diploma or above (p = 0.005), student as professional status (p≤0.005) and living in fewer poor neighborhoods located far from city centers (p = 0.030) were four conditions independently associated with sedentary/inactive and/or sedentary/active profiles. Based on these findings, to help reduce SIH, we used a typology of actions based on the underlying theoretical interventions including four main action categories: strengthening individuals (using person-based strategies), strengthening communities, improving living and working conditions, and promoting health-based macro-policies. Our findings suggest several directions for reducing lifestyle risk factors and enhancing T2D primary prevention programs targeting psychosocial, behavioral, and structural exposures.
... The Covid-19 pandemic is undoubtedly among the most significant obstacles that governments and businesses have encountered in this century [3]. Covid-19 results in numerous significant psychological, social, and professional shifts, including unemployment, decreased savings, anxiety and stress when going out, uncertainty about future health, both physical and mental [4]. ...
... Allah Ta'ala commanded to trust Him after trying and exerting all his abilities and God loved those who trust him. (QS Ali Imran [3]: 159). "Mutawakkil" is a term for people who rely in Ara-bic. ...
... For children, this meant the loss of access to parks and school playgrounds, key venues for their daily physical activity. Instead, children were confined indoors, raising concerns about the emergence of a sedentary lifestyle and its potential health implications [6][7][8]. ...
... Quality education emphasizes the cultivation of moral, intellectual, physical and aesthetic comprehensive development of students, advocating that teachers in the development of students' intelligence at the same time should pay attention to students' physical fitness, healthy physique is the prerequisite and foundation of everything. In such a background, college physical education teachers must timely adjust the traditional ideological concepts to enhance the physical health of young people oriented curriculum reform, give full play to the nurturing value of physical education courses [14][15][16]. However, in terms of the current implementation of college physical education curriculum teaching, it is still far from meeting the requirements of quality education, and plays a limited role in helping the development of adolescent physical health, so how to study the reform of physical education curriculum based on the physical health of adolescents is very necessary [17][18][19]. ...
The reform of college physical education courses in the context of big data is of great significance to improve the quality of teaching and meet the needs of students. The study is based on the K-medus clustering algorithm to personalize the teaching content of college physical education courses. The standard deviation is used to define the initial centroid candidate set, and the initial centroids are determined in a stepwise increasing manner, which ensures that the sample points with greater densities are selected as the initial clustering centroids. Students with similar body types are clustered together by the method, and teachers can create targeted individualized teaching content based on students with different body types. After the implementation of personalized teaching, the physical fitness of both boys and girls improved. The excellent and good rates of boys’ physical health increased by 7.75% and 4.34%, respectively. The excellent and good rates of physical health among female students increased by 14.03%. It shows that students’ physical fitness has significantly improved after reforming the physical education program in the context of big data.
... This outcome is in line with a number of other research [12,13,14]. In the context of support networks, the findings demonstrated that older persons who take part in group activities get respect, attention, and care, building their social networks and minimizing social isolation [15]. This was in line with a previous study, which urged senior citizens to engage in community events and form positive interpersonal connections [16]. ...
Objective: The best strategy to increase physical and mental health in older persons is by participating in group physical exercise, which also benefits relationships and health. This study used a multi-component exercise program as an intervention to better understand how physical activity, social bonds, and support networks relate to elderly individuals' expressive ability for health behavior. Methods: This research included 100 healthy adults (50 men and 50 women, average ages 76.57±1.46 and 74.73±1.68 respectively) over the age of 65. Participants in an eight-week multi-component physical activity program completed the Senior Physical Fitness Test for Older People, the Physical Activity, Social Bond, and Support Network Questionnaire for elderly people, and the Health Behavior Inventory for Older Adults before and after the intervention. Results: The study's findings suggested that SFT data in older men and women might aid in strengthening the muscles in both the lower and upper extremities and enhancing balance. Every participant might exercise for more than 30 minutes, mostly outdoors, a minimum of 3 days a week with the goal to refrain from using cigarettes, alcohol, or drugs before the HBI test. Conclusions: In this research, older people's health behaviors were most significantly predicted by their support network and social bond behaviors, which also had a strong explanatory power on older adults' health behaviors. Exercise behavior came in second. Last but not least, it was discovered that the multi-component exercise program's treatments had a good impact on older persons' exercise
... Even during the COVID-19 epidemic, WHO and other academic sources have still recommended that people should perform at least 150 min of moderate-intensity exercise, 75 min of high-intensity exercise, or a combination of the two per week. However, as group meeting was prohibited and isolation was enforced in multiple countries due to COVID-19, physical activities in different areas reduced considerably [2,30], thereby leading to reduced exercise and prolonged sedentary behavior that might have exerted negative physical and mental effects [31]. Previous research has explored coach-supervised training versus online video training and found that the coach-supervised group made significant strength gains, while the online video group did not [32]. ...
Purpose
COVID-19 has rampaged the world. Nowadays, a lot of people in Taiwan still experience working from home, as well as exercising from home (EFH) to maintain their physical health. This study aimed to investigate the difference in training efficacy by joining online workout courses and coach supervision.
Methods
Twenty participants were recruited in this study. The subjects were randomly divided into coach supervision and online training groups. A pretest was first conducted, followed by a post-test after 8 weeks of training intervention. The tests were to measure the participant’s body composition and sports performance, with the former including InBody body composition analysis, and the latter including the assessment of jumping ability, 20-m sprint, bench press, and squat performances. All tests were conducted at the National Pingtung University of Science and Technology (Pingtung, Taiwan). The two-way mixed design measures ANOVA was applied for statistical measurement. If the correlation between the two factors was significant, the Bonferroni post hoc test will be applied to determine the main effects (α = 0.05).
Results
There was no significant difference between the two training groups (p = 0.130, p = 0.125, p = 0.319, p = 0.460). However, substantial differences were observed between the jumping ability (p = 0.000), bench press performance (p = 0.003), and squat performance (p = 0.000) of the pre- and post-tests in both groups, with the participants generally performing better in the latter case. In terms of body composition and muscle circumference, no significant changes were found between both tests (p > 0.05).
Conclusion
Participating online training courses at home is recommended when exercising outdoor is forbidden. Moreover, online training not only reduces the transmission of coronavirus, but also helps increase the physical activity in a safe environment.
... Students have, therefore, switched their learning mode to online mode. This paradigm shift has led to people starting to suffer from psychological issues amid the ongoing lockdown and has led to fears about the future (1,2). However, the continued isolation has restricted people's physical activities. ...
... Second, the study did not assess three crucial factors that could affect lipid parameters: physical activity levels, the participants' dietary patterns, and the pubertal stage, which can significantly influence lipid levels, especially in adolescents. Although these factors are relevant, the data were collected during the peak of the Coronavirus 2019 pandemic, when drastic lifestyle changes -including reduced school attendance and the level of physical activity 54,55 , and increased food insecurity 54,56 -made it challenging to gather accurate information on lifestyle habits. Additionally, a DAG model was used to identify and control for a minimal set of confounding variables, which excluded these factors from the final analysis to prevent over-adjustment and estimation errors. ...
Atherosclerotic vascular changes can begin during childhood, providing risk for cardiovascular disease (CVD) in adulthood. Identifiable risk factors such as dyslipidemia accelerate this process for some children. The apolipoprotein B (APOB) gene could help explain the inter-individual variability in lipid levels among young individuals and identify groups that require greater attention to prevent CVD. A cross-sectional study was conducted with school-aged children and adolescents in Ouro Preto, Minas Gerais. The study evaluated cardiovascular risk factors’ variables and XbaI polymorphism in the APOB gene for associations with increased total cholesterol (TC). The prevalence of increased TC was notably high, reaching 68.9% in the study population. Carriers of the variant T allele were 1.45 times more likely to develop increased TC in a dominant model (1.09–1.94, p = 0.011). After adjustments, excess weight and a family history of dyslipidemia interacted significantly with XbaI polymorphism in increased TC, resulting in Odds Ratio of 1.74 (1.11–2.71, p = 0.015) and 2.04 (1.14–3.67, p = 0.016), respectively. The results suggest that XbaI polymorphism in the APOB gene may affect the lipid profile of Brazilian children and adolescents and could contribute to the CVD in adulthood.
... From a population health perspective, it is essential to identify malleable determinants of the adoption of healthy lifestyle habits in young adulthood. important repercussions for health, including greater risk of cardiovascular disease (Hall et al., 2021), specific types of cancers (Biller et al., 2021;Schmid & Leitzmann, 2014), and type 2 diabetes (Biswas et al., 2015). Studies have also shown associations between sedentary behaviors and mental health outcomes, including higher risks of depression (Zhou et al., 2023), anxiety (Allen et al., 2019), and higher levels of stress (Hoare et al., 2017). ...
Sedentary lifestyle is one of the greatest contributors to global mortality. From a public health perspective, identifying modifiable factors that reduce sedentary is important. The objective is to examine associations between postsecondary students’ physical activity environments, including joint physical activity with parents during childhood, engagement in physical activity during adolescence, current parental physical activity, and adherence to screen time and physical activity recommendations during young adulthood. We used a community-based sample of 1,514 Canadian students, aged 17-22 years (60.8% female) enrolled during Fall 2021 and Winter 2022. Participants reported joint physical activity with parents during childhood, engagement in physical activity during adolescence, and current parental physical activity. Participants also self-reported screen time (hours/day), physical activity (minutes of moderate to vigorous intensity/week), and sociodemographic characteristics (age, sex, disability, employment status). Multivariate logistic regressions modeled associations between physical activity environments and adherence to screen time and physical activity recommendations while controlling for sociodemographic characteristics. Engagement in physical activity during adolescence showed a stronger relation with adherence to screen time and physical activity recommendations (odds ratio = 1.42, 95% CI, 1.09-1.83; odds ratio = 2.76, 95% CI, 2.11-3.60). Parental involvement in childhood physical activity was associated with adherence to screen time (odds ratio = 1.30, 95% CI, 1.03–1.64) and physical activity recommendations (odds ratio = 1.32, 95% CI, 1.03–1.68). There were no associations with current parental physical activity. Findings highlight the importance of family support for physical activity during childhood and continued activity during adolescence in promoting health.
... [7][8][9] However, the prevalence of ST among adults worldwide is concerning. 10 A survey of four European countries showed that the average ST among adults was as high as 530 min/day, with 23% exceeding 10 hours/ ...
Objectives
This study aimed to compare the effectiveness of different wearable intervention strategies in reducing sedentary time (ST) and prolonged sitting (PS) on healthy adults.
Design
A network meta-analysis (NMA).
Data sources
PubMed, Web of Science, SPORTDiscus, ProQuest, Opengrey, Medline and Cochrane Central Register of Controlled Trials were searched up to 1 June 2024.
Eligibility criteria for selecting studies
Randomised controlled trials (RCTs) that examined the effect of wearable device interventions on ST and PS among healthy adults were included.
Data extraction and synthesis
Two independent reviewers used standardised methods to search, screen and code included studies. Bias risks were assessed using Cochrane tools (Risk of Bias 2.0). Data were analysed using a frequentist framework NMA to directly and indirectly compare the effects of the five different intervention strategies (comparators). The results were reported as standardised mean differences (SMDs) with 95% CI and surface under cumulative ranking curve (SUCRA) was used to rank the best interventions. The five comparators were as follows: (1) wearable-only intervention (only using wearable devices for self-monitoring); (2) wearable combined with online intervention (ie, online coaching and social media support); (3) wearable combined with offline intervention (ie, face-to-face seminars and courses); (4) comparison group (ie, traditional, non-wearable interventions); (5) control group (ie, maintaining daily routine, waitlist).
Results
12 RCTs with a total of 2957 participants were included. Results of NMA showed that the ‘wearable+online’ has significantly better effects in reducing ST compared with control group, comparison group and ‘wearable only’, with moderate to large effect sizes (SMD=0.96, 95% CI 0.65 to 1.27; SMD=0.87, 95% CI 0.21 to 1.53; SMD=0.78, 95% CI 0.14 to 1.42, respectively). However, no significant differences were identified between the groups in reducing PS. The SUCRA values were ranked as wearable+online (98.1%), wearable+offline (64.4%,), ‘wearable only’ (40.5%), comparison group (25.9%) and control group (21.1%) for ST reduction. Similar rankings were observed for PS reduction, with probabilities of 69.9%, 61.1%, 59.7%, 37.1% and 22.1%, respectively.
Conclusions
Wearable+online is the best intervention strategy for reducing ST in healthy adults. Additionally, none of the wearable-based interventions effectively reduced PS in healthy adults, but as there is little research on PS, it should receive more attention in the future.
PROSPERO registration number: CRD42021290017.
... 11 This situation has been referred as the occurrence of two simultaneous pandemicsphysical inactivity and COVID-19. 12 However, the longitudinal association between PA and the development of multimorbidity has been poorly documented, with conflicting evidence. [13][14][15] As a result, it remains unclear how the sharp decline in PA levels during the pandemic might have impacted the multimorbidity scenario. ...
Objectives: We aimed to investigate the association between physical activity (PA) and the risk of incident multimorbidity in adults from southern Brazil during the COVID-19 pandemic.
Study design: Prospective Study.
Methods: We analyzed data from the Prospective Study about Physical and Mental Health (PAMPA) cohort, a longitudinal study of adults living in southern Brazil. The baseline assessment occurred in June/July 2020, and further data collection occurred 6 and 12 months later. Participants with no multimorbidity (2 or more simultaneous chronic conditions) at baseline were included in the present analysis. PA weekly volume, status, type, and place were also assessed at baseline.
Results: Over one year, 30.8 % of participants developed multimorbidity. Men participants, classified as physically active before or during the pandemic, had reduced risk of multimorbidity. Practicing PA at home reduced the risk in both genders, while PA at and out of home only reduced the risk in women participants. Endurance and combined activities reduced the risk among women, while strength activities reduced the risk in both genders.
Conclusions: PA reduced the risk of incident multimorbidity among adults in southern Brazil, with different parameters moderating this effect between genders.
... For example, students completed the questionnaire after COVID-19. This period was defined as a period of controlled social life and brought many restrictions, including PA. Undoubtedly, pandemic conditions have brought negative effects that will increase physical inactivity and risks related to sedentary lifestyle in both genders and all age groups [38]. In a previous study, it was found that COVID-19 negatively affected the PA levels of university students, and adequate PA rates in the HEPA category were only 4.8% [39]. ...
This study examined the relationship between physical activity (PA) level, free time management, mental well-being, and perceptions of barriers to PA among university students. A cross-sectional survey was conducted with 723 Turkish university students, which included four questionnaires to assess participants’ PA levels, conditions of mental well-being, free time management, and perceived barriers to PA. Multivariate linear regression was performed to identify factors associated with the participants’ PA level. The study found that 216 (29.9%) of participants were inactive, 325 (45%) were minimally active, and 182 (25.1%) were health-enhancing active. While 25.23% of males were inactive, 42.02% were minimally active, and 31.45% were health-enhancing active, these rates were 31.4, 45.98, and 22.62% for females, respectively. These findings highlight that 3/4 of university students have inadequate PA levels. Changes in barriers to PA (p < 0.001), free time management (p = 0.040), and mental well-being (p < 0.001) were associated with PA levels. According to the regression analysis, only increased barriers to PA was a significant predictor of PA (p < 0.001). Given the role of health science students in public health, this study could help policymakers develop new strategies to promote healthy living and address barriers to PA, such as students' free time and mental health.
... During the global COVID-19 pandemic, the UK enforced a nationwide lockdown in spring 2020, leading to "forced inactivity" for older adults, particularly the clinically vulnerable, urban residents, and those attending community-based exercise classes. This may have worsened the ongoing "physical inactivity pandemic" (2,3), as several studies reported reduced physical activity among older adults during the pandemic (4)(5)(6)(7). Social contact restrictions also significantly impacted the physical and mental well-being of both younger and older adults (8)(9)(10)(11)(12). ...
Introduction: This study investigated older adults' emotional and social experiences of physical activity and exercise during the first Covid-19 lockdown in England.
Methods: Participants were 24 older adults (M = 74 years, SD = 5.0) either physically active or inactive before lockdown. Semi-structured interviews were conducted at the start of the pandemic in England, and when restrictions were lifted eight weeks later.
Results: Template analysis revealed three main themes: a Sense of Purpose for Being Physically Active, Routes for Engagement, and Inactive by Force? with different sub-themes for active and inactive participants. The lockdown restrictions emphasised the need to keep physically active in both active and inactive participants, but they perceived barriers differently. Both active and inactive participants found a renewed sense of purpose in walking outdoors for exercise when restrictions eased, enhancing their physical and mental well-being.
Discussion: To reduce barriers and emphasise that exercise is for all ages and all levels of mobility, multi-modal recommendations are presented for educating, promoting, supporting, and enabling older adults to engage in physical activity and exercise.
... Additionally, safety concerns when engaging in outdoor physical activities may have been a more significant barrier for women than for men. Hall et al. 34 reported that women were more concerned about safety and were more likely to avoid outdoor activities during the pandemic. Heinzelmann et al. 35 highlighted that Portuguese women faced significant challenges during the pandemic, particularly regarding unpaid work and domestic responsibilities, which may explain the greater reduction in physical activity among women. ...
RESUMO O presente estudo objetivou analisar o comportamento de praticantes de exercício físico em Portugal durante a pandemia de Covid-19, com um foco particular nas variáveis sociodemográficas e no nível de atividade física antes e durante a pandemia. Trata-se de um estudo de cunho descritivo-correlacional, de corte transversal e de abordagem quantitativa. A pesquisa incluiu 274 adultos de ambos os sexos (masculino=122, feminino=152) com idades variando entre 18 e 67 anos e que estavam envolvidos em alguma forma de exercício físico. Para avaliar o comportamento de atividade física e as informações sociodemográficas, foi utilizado um questionário elaborado pelos próprios pesquisadores, composto por 13 questões objetivas, divididas em três seções, sem o uso de escala Likert. As opções de resposta foram apresentadas em categorias específicas, permitindo aos participantes escolher aquela que melhor descrevesse sua situação, de acordo com cada questão. A primeira seção explicou os objetivos da pesquisa e obteve o consentimento informado. A segunda seção coletou dados sociodemográficos, enquanto a terceira seção abordou o comportamento de exercícios físicos antes e durante a pandemia da Covid-19. Nossos resultados mostraram uma queda significativa nos níveis de atividade física durante a pandemia. Antes da pandemia, 71,53% dos indivíduos eram suficientemente ativos, enquanto durante a pandemia esse número caiu para 47,45%. Os resultados evidenciaram um declínio significativo nos níveis de atividade física durante a pandemia de Covid-19 entre os praticantes de exercício físico em Portugal, com diferenças notáveis entre os gêneros e uma maior resiliência entre aqueles com mais tempo de prática. Palavras-chave: Exercício físico; Pandemia; Atividade física; Medidas restritivas. ABSTRACT The present study aimed to analyze the behavior of physical exercise practitioners in Portugal during the Covid-19 pandemic, with a particular focus on sociodemographic variables and the level of physical activity before and during the pandemic. This is a descriptive-correlational study, cross-sectional and with a quantitative approach. The research included 274 adults of both sexes (male=122, female=152) aged between 18 and 67 years old and who were involved in some form of physical exercise. To assess physical activity behavior and sociodemographic information, a questionnaire designed by the researchers themselves was used, consisting of 13 objective questions, divided into three sections, without the use of a Likert scale. The answer options were presented in specific categories, allowing participants to choose the one that best described their situation, according to each question. The first section explained the objectives of the research and obtained informed consent. The second section collected sociodemographic data, while the third section addressed physical exercise behavior before and during the Covid-19 pandemic. Our results showed a significant drop in physical activity levels during the pandemic. Before the pandemic, 71.53% of individuals were sufficiently active, while during the pandemic this number dropped to 47.45%. The results showed a significant decline in physical activity levels during the Covid-19 pandemic among exercise practitioners in Portugal, with notable differences between genders and greater resilience among those with more practice time.
... La profundización de los hábitos de inactividad física y sedentarismo condicionados por el distanciamiento social, los aforos reducidos en los espacios para realizar AF y el mayor tiempo de permanencia en los hogares en actividades sedentarias, condujo a introducción del concepto de "las dos pandemias" (14) para referirse a estas dos condiciones (COVID-19 e inactividad y sedentarismo) que tuvieron y, se supone tendrán a futuro, un fuerte impacto en la salud de la población mundial. ...
INTRODUCCIÓN Se evaluó el efecto de las medidas implementadas durante la pandemia de COVID-19 sobre el nivel de actividad física (AF) y el tiempo de sedentarismo (TS) en dos semanas consecutivas con distintos grados de restricciones. Materiales y métodos: Se aplicó el cuestionario International Physical Activity Questionnaire versión corta (IPAQ-S) Se recabaron datos demográficos y referentes al nivel de AF y al TS de los individuos en dos fases de restricción: fase 1 (F1), de confinamiento estricto y fase 3 (F3), de menores restricciones. Resultados: Respondieron a la encuesta 1746 individuos, 1178 mujeres (68%) y 568 hombres (32%). La edad media de la población fue de 32 ±14 años. Al aplicar el cuestionario IPAQ-S correspondiente a la semana de F3, se encontró un 16% de personas físicamente inactivas mientras que en la semana de F1, fue de 33% La AF disminuyó cuando se implementaron mayores restricciones, tanto en hombres como en mujeres y en distintos rangos etarios. En los sujetos menores de 25 años se produjo la disminución más importante en el porcentaje de AF moderada e intensa al aumentar las restricciones (90% vs 69%, p= 0,000). El TS fue mayor en F1 respecto de F3 (22% vs 18%, p= 0,000), tanto de hombres como de mujeres. Conclusiones: Las medidas implementadas para mitigar la diseminación del COVID-19 tuvieron un impacto negativo sobre el nivel de AF en la población estudiada que mostró también un aumento del TS. Resulta especialmente preocupante la disminución del nivel de AF en el grupo de jóvenes. ABSTRACT Introduction: We assess the effect of the measures implemented during the COVID-19 pandemic on the level of physical activity (PA) and the time of sedentarism (TS) in two consecutive weeks with different degrees of restrictions. Materials and methods: We use The International Physical Activity Questionnaire short version (IPAQ-S). We collected demographic data and data related to physical activity (PA) and sedentary time (ST) developed by individuals in two phases of restriction: Phase 1 (P1), strict confinement and Phase 3 (P3), with fewer restrictions. Results: 1746 individuals responded to the survey, 1178 women (68%) and 568 men (32%). The mean age of the population was 32 ±14 years. 79% of the individuals were residents of the city of Bahía Blanca. When applying the IPAQ-S questionnaire corresponding to the week of P 3, we found that physically inactive people were 16%. When the IPAQ-S was applied to the week corresponding to P 1, the percentage of physically inactive people was 33%. A statistically significant decrease in the time spent on PA was observed when greater restrictions were implemented, both in men and women and in different age ranges. In subjects under 25 years of age, the most important decrease in the percentage of moderate and intense PA occurred when restrictions were increased (90% vs 69%, p= 0.000). ST was higher in P1 versus P3 (22% vs 18%, p= 0,000) both in men and women. Conclusions: The measures implemented to mitigate the spread of COVID-19 had a negative impact on the level of PA in the population studied, which also showed an increase in sedentary time. Is especially concerning the decrease in the PA level in the group of young people.
... Sepenuhnya ditunjukkan pada Gambar 2. Tentang persentase tanggapan guru mengenai pertimbangan perubahan rencana pembelajaran olahraga selama pandemi COVID-19. Hasil ini mengindikasikan pergeseran prioritas pendidikan selama pandemi, memperkuat argumen tentang tujuan utama dari Pendidikan adalah untuk mendukung peningkatan kesehatan sehingga memiliki kekebalan tubuh dan tidak terpapar virus di masa pandemi COVID-19 (Hall, et al. 2021). ...
Learning planning must be adjusted to students’ conditions to achieve educational goals. The COVID-19 pandemic brought significant changes requiring high adaptability, especially in education. This study aims to identify planning and implementation patterns of the Physical Education and Health (PJOK) curriculum in elementary schools during the post-COVID-19 pandemic. Using a descriptive survey method, the research explored how PJOK teachers plan and implement home-based learning during this period. Data was collected via a Google Forms questionnaire from 33 PJOK teachers who participated in a Focus Group Discussion on post-pandemic curriculum planning. The study’s findings reveal that most teachers adjusted their planning based on the available facilities and infrastructure in students' homes. The curriculum was simplified to emphasize life skills relevant to the post-pandemic context. Implementing the PJOK curriculum requires collaboration with parents to monitor and support student learning at home. Teachers predominantly use WhatsApp to deliver instructional materials and rely on YouTube as a learning resource. This research highlights the need for adaptive curriculum strategies that accommodate challenges in post-pandemic education while ensuring effective learning despite limited resources. Abstrak Perencanaan pembelajaran harus menyesuaikan dengan kondisi siswa untuk mencapai tujuan pembelajaran. Pandemi COVID-19 menyebabkan perubahan lingkungan yang memerlukan adaptasi tinggi, terutama dalam pendidikan. Tujuan penelitian ini adalah untuk mengidentifikasi pola perencanaan dan implementasi kurikulum Pendidikan Jasmani dan Kesehatan di sekolah dasar pada masa pasca pandemi COVID-19. Metode yang digunakan adalah metode survei deskriptif untuk menggambarkan pola perencanaan yang dilakukan oleh guru Pendidikan Jasmani dan Kesehatan serta implementasi dalam pembelajaran di rumah pada masa pasca pandemi COVID-19. Instrumen yang digunakan adalah kuesioner yang diterapkan menggunakan google form kepada 33 guru Pendidikan Jasmani dan Kesehatan yang mengikuti Focus Group Discussion perencanaan kurikulum Pendidikan Jasmani dan Kesehatan di masa pasca pandemi COVID-19. Hasil penelitian ini menunjukkan bahwa sebagian besar guru Pendidikan Jasmani dan Kesehatan melakukan penyesuaian perencanaan berdasarkan kondisi sarana dan prasarana pendukung yang dimiliki orangtua. Penyederhanaan kurikulum yang berfokus pada kecakapan hidup peserta didik dalam situasi dan kondisi pasca pandemi COVID-19. Implementasi kurikulum PJOK di masa pasca pandemi COVID-19 membutuhkan kolaborasi dengan orang tua dalam proses penyampaian dan pemantauan kegiatan belajar siswa selama di rumah. Guru banyak menggunakan media aplikasi WhatsApp dalam menyampaikan informasi bahan ajar dan menggunakan YouTube sebagai sumber belajar. Kata Kunci: COVID-19; implementasi kurikulum; pendidikan jasmani dan kesehatan
... Currently, there are very few empirical studies conducted in Malaysia looking at the influence of gender and BMI on the physical activity levels of university students. As there is still no conclusive data on the changes in physical activity levels of university students, it is imperative to conduct this study to determine the levels and variations of BMI and gender among Malaysian university students (Hall et al., 2021). ...
The decline in physical activity has adversely impacted physical health, with university students being particularly affected. Thus, this study examined the effect of gender and Body Mass Index (BMI) on physical activity levels among Malaysian universities and Medan State University students. The research involved 130 students from education universities in Malaysia and Medan State Universities. The data were collected using the Physical Activity Questionnaire for Adolescents (PAQ-A). The study indicated significant differences in physical activity levels among university students. This difference might be affected by gender, with male students showing significantly higher physical activity levels than female students (Sig. = 0.001 and η² = 0.082). Therefore, it is important for universities to consider such factors in designing health and wellness programs, especially to increase female students' participation in physical activity. Nonetheless, the statistical test showed no significant difference was found in physical activity levels among the different Body Mass Index (BMI) categories. This finding indicates that, unlike gender, BMI does not significantly affect the physical activity levels of university students (Sig. = 0.310). The implications of these findings suggest an urgent need for tailored health interventions in university settings, particularly Medan State University. The university can create an environment that supports active lifestyles and contributes significantly to improving students' health and well-being by providing accessible sports facilities, organizing fitness classes, and promoting active transportation options. This strategy is expected to address the challenges of participation in physical activity, particularly among female students, thereby increasing awareness and participation in overall physical activity. Keywords: Physical Activity, University Students, Gender Disparities, BMI Effects, Education
... The unhealthy lifestyle and chronic disease pandemics are currently two of the leading population-level health challenges facing the United States (U.S.), and there is no viable solution on the horizon for either [1][2][3]. In fact, the unhealthy lifestylechronic disease crises are core components of a leading syndemic [4,5], meaning these issues are intricately linked and must be addressed simultaneously. ...
Objectives
There are numerous population health challenges confronting the United States (U.S.), including the unhealthy lifestyle – chronic disease pandemics. However, the impact of unhealthy lifestyle behaviors and the increased prevalence of chronic diseases that result from them affect many facets of life outside of the health domain, and their scope remains under-appreciated. The current analysis contributes to addressing this knowledge gap by comparing the newly developed Lifestyle Health Index (LHI) to U.S. county-level voter turnout rates in the 2020 presidential election.
Study design
Descriptive, cross-sectional, retrospective analysis.
Methods
County-level data on the LHI, percent voter turnout, and the American Nations regional cultures model schematic was used in the current analysis.
Results
Pearson correlations between county-level LHI scores and sub scores and Democratic, Republican, and overall voter turnout were all statistically significant and of similar strength (r > 0.63, p < 0.001). All counties in the worst performing LHI quartile had a voter turnout <60 %. Higher LHIs were consistently assocaited with lower voter turnout across the regional cultures, although heterogeneity was evident across the American Nations.
Conclusions
A large percentage of the U.S. population is afflicted with poor health, and unhealthy lifestyle behaviors are a primary driver. Poor health does not occur in a vacuum and impacts many other facets of an individual's life. The current study further demonstrates the potential detrimental impact of poor health on civic engagement, specifically participation in the electoral process (i.e, citizens' health may influence voter turnout). Health care professionals and institutions in the U.S. should uniformly embrace the recent policy brief by the American College of Physicians on participation in the electoral process for patients receiving care. This paradigm shift has the potential to substantially improve voter turnout during U.S. elections.
... Given the widespread detrimental changes to both PA and SB as a result of COVID-19, some researchers cited the need for "aggressive efforts" to getting individuals to be physically active during this time (Hall et al., 2021). One potentially transformative solution to designing and delivering PA interventions is the use of eHealth interventions. ...
In response to COVID-19 social distancing restrictions, digitally delivered health interventions present as a potential solution for maintaining or improving individuals’ physical activity. This study explored the feasibility of a web-based intervention, informed by the multi-process action control (M-PAC) framework to promote PA among individuals affected by social distancing. Fifty adults self-reporting as insufficiently active were randomized to a 6-week web-intervention (n = 27) or wait-list control (n = 23). Primary feasibility outcomes included recruitment and retention rates and usability and satisfaction scores; secondary outcomes of MVPA and M-PAC constructs and tertiary outcomes of mental health and wellbeing were also assessed. Overall, feasibility of the intervention was high, with a 96% recruitment rate, 84% retention rate, high satisfaction and usability scores, and comparable website usage to similar eHealth interventions. Intervention participants trended towards improved MVPA and M-PAC constructs and outcomes of mental health and wellbeing. Findings suggest study extension to a full-scale RCT.
... Advances in technology have resulted in significant lifestyle changes, including an increased prevalence of LSB and a reduced level of PA. The coronavirus disease 2019 pandemic has further exacerbated this trend by limiting opportunities for PA while promoting LSB (11). Scientific evidence has shown that LSB is associated with higher all-cause mortality rates, while PA can lower this risk (12). ...
Background
Previous observational studies have shown a correlation between leisure sedentary behaviors (LSB) and physical activity (PA) with the incidence of obstructive sleep apnea (OSA). However, the causal associations remain unknown. Therefore, our study used bidirectional two-sample Mendelian randomization (MR) to identify potential causal relationships between LSB/PA and OSA.
Methods
We sourced genetic variation data for LSB and PA from the UK Biobank, while data on OSA were collected from the FinnGen study. The primary analysis method employed was the inverse variance weighted (IVW) approach, complemented by the weighted median and MR-Egger methods. For sensitivity analyses, we conducted Cochran’s Q test, the MR-Egger intercept test, the MR-PRESSO global test, and the leave-one-out analysis.
Results
IVW analyses showed that genetically predicted leisure television watching (odds ratio [OR] = 1.38, 95% confidence interval [CI] = 1.09–1.75, p = 0.007) and computer use (OR = 1.48, 95% CI = 1.15–1.92, p = 0.002) significantly increased the risk of OSA. Conversely, self-reported vigorous physical activity (VPA) (OR = 0.33, 95% CI = 0.11–0.98, p = 0.046) may reduce the risk of OSA. No causal effects on OSA risk were observed for driving or self-reported moderate-to-vigorous physical activity. Furthermore, the reverse MR analysis indicated no significant causal relationship between OSA and any LSB/PA phenotype. Sensitivity tests showed no significant heterogeneity or horizontal pleiotropy.
Conclusion
This study suggests that leisurely television watching and computer use are risk factors for OSA, while VPA may be a protective factor. Additionally, OSA does not affect PA or LSB levels. We recommend reducing sedentary activities, particularly television watching and computer use, and prioritizing VPA to reduce the risk of OSA. Further research in diverse populations and settings is needed to validate these findings.
... It has also been shown that the high mortality rate from COVID-19 is significantly associated with age, such that most deaths occur among older adults. Significantly impacting all aspects of the quality of life of older adults (Hall et al., 2021). Since pandemics threaten many people with a similar disease, they affect communities differently from classic diseases. ...
Objective: The coronavirus and its variants continue to threaten the physical and mental health of many individuals, particularly among older adults with COVID-19. The current study aimed to investigate the mediating role of psychological well-being in explaining the effect of perceived social support on death anxiety among the elderly with COVID-19 experience in Tehran. Methods and Materials: This descriptive correlational study's population comprised all elderly men and women aged 65 to 75 years living at home in Tehran in 2022, who had experienced COVID-19 in the past six months. Among them, 400 individuals were purposively selected as the sample group and responded to the Death Anxiety Scale (Templer, 1970), the Perceived Social Support Scale (Zimet et al., 1988), and the Psychological Well-Being Scale (Ryff, 1989). For data analysis, the structural equation modeling method was used. The data obtained through confirmatory factor analysis and AMOS24 software showed that the research's structural model fits with the collected data. Findings: There was a positive and significant relationship between perceived social support and psychological well-being, a negative and significant relationship between perceived social support and death anxiety, and a negative and significant relationship between psychological well-being and death anxiety. Also, the indirect pathways between death anxiety and perceived social support, and death anxiety were proven (p = 0.001). Conclusion: Considering the results of the present study, it can be said that perceived social support influences death anxiety among the elderly with COVID-19 experience through psychological well-being. The findings of the current study can be utilized by counselors, psychologists, and health specialists.
... 2,3 Sedentary behaviour has steadily increased due to changes in physical, social and economic-environmental conditions, and has also been amplified by the COVID-19 pandemic. [4][5][6] Recently, studies have highlighted that young adults seem to be at high risk of uninterrupted, prolonged sitting times, 7,8 and regular prolonged sedentary behaviour has been identified as an independent risk factor for increased mortality in general and specifically for cardiovascular disease and cancer incidence, as well as type 2 diabetes (T2D) and obesity. [9][10][11] Studies have demonstrated that prolonged sitting has detrimental effects on glucose metabolism, endogenous insulin, and vascular function. ...
Aims
To investigate how a change in body position with light‐intensity physical activity (PA) ‘snacks’ (LIPAS, alternate sitting and standing, walking or standing continuously) compared with uninterrupted prolonged sitting affects glucose metabolism and heart rate variability (HRV) parameters in young adults with overweight and obesity.
Materials and Methods
We conducted a four‐arm randomized controlled crossover trial. The following conditions were tested during an 8‐h simulated workday: uninterrupted prolonged sitting (SIT), alternate sitting and standing (SIT‐STAND; 2.5 h total), continuous standing (STAND), and continuous walking (1.0 mph; WALK). The primary outcome was to investigate how a change in body position (alternate sitting and standing, walking or standing continuously) compared with uninterrupted sitting affects mean 8‐h glucose metabolism. Secondary outcomes included the effects on 2‐h postprandial glucose concentrations, as well as on 8‐h/24‐h heart rate and HRV parameters, in the respective study arms. Capillary blood samples were drawn from an hyperemised earlobe in the fasted state and once every hour during each trial intervention by puncturing the earlobe with a lancet and collecting 20 μL of blood (Biosen S‐Line Lab+; EKF diagnostics, Barleben, Germany). HRV was assessed for 24 h including the 8‐h intervention phase, and a home phase by means of a Holter electrocardiogram. All participants received the same standardized non‐relativised breakfast and lunch during the four trial visits.
Results
Seventeen individuals (eight women, mean age 23.4 ± 3.3 years, body mass index 29.7 ± 3.8 kg/m ² , glycated haemoglobin level 34.8 ± 3.1 mmol/mol [5.4 ± 0.3%], body fat 31.8 ± 8.2%) completed all four trial arms. Compared with SIT (89.4 ± 6.8 mg/dL), 8‐h mean glucose was lower in all other conditions ( p < 0.05) and this was statistically significant compared with WALK (86.3 ± 5.2 mg/dL; p = 0.034). Two‐hour postprandial glucose after breakfast was approximately 7% lower for WALK compared with SIT ( p = 0.002). Furthermore, significant time × condition effects on HRV parameters favouring light‐intensity walking were observed ( p < 0.001).
Conclusions
Replacement and interruption of prolonged sitting with light‐intensity walking showed a significant blood glucose‐lowering effect and improved HRV during an 8‐h work environment in young adults with overweight and obesity.
... This outcome may be attributed to the prolonged pandemic, ongoing restrictions, and quarantines, exacerbating negative psychosocial effects and heightening adverse conditions, potentially affecting physical and mental health [24], thereby diminishing social engagement among AWD. Pandemic-induced restrictions limited access to rehabilitation and therapy centers, curbing physical activity and promoting a sedentary lifestyle [25]. Moreover, sport-specific factors, such as disruptions in routines, particularly for those in long-term sports development, suspended or reduced during the pandemic, and reduced interaction with trainers or caregivers [11], could contribute to increasing levels of loneliness during In all models analyzed, EO coping style consistently showed strong associations with loneliness across seven instances. ...
The study aimed to assess loneliness experiences among athletes with disabilities (AWD) during the different phases of the pandemic and to understand its relationship with coping styles. Ninety‐one AWD participated in a longitudinal study spanning 10 months, covering three time points: April (A), June (Time B), and November (Time C) 2021. The study used the Coping Inventory for Stressful Situations and the revised University of California Los Angeles Loneliness Scale–Revised (UCLA‐R) to measure coping mechanisms and feelings of loneliness, respectively. Loneliness levels peaked during the most intense phase of the pandemic, showing significant differences between consecutive time points (χ² = 20.29, p < 0.001, d = 0.24). The most robust regression models were built in Time B, using the “intimate contacts” dimension of loneliness as the dependent variable and “emotion‐oriented coping”, “avoidance‐oriented coping”, and “impairment” as independent variables, explaining 44% of the variance (p < 0.001). Loneliness among Paralympic athletes fluctuated during various phases of the pandemic. The findings highlight the significant influence of coping styles, particularly emotional styles which heightened perceived loneliness, and task‐oriented styles which reduced it, on athletes' experiences of loneliness. These results underscore the need for longitudinal studies to delve deeper into the relationship between loneliness and mental health. Moreover, they stress the importance of developing tailored interventions that promote effective coping mechanisms in AWD during challenging times amid to COIVID‐19.
... One of the main trends is the increase in diseases associated with passive lifestyles and lack of physical activity (e.g. obesity, cardiovascular disease, and diabetes) caused by sedentary work, vehicle use, and highcalorie food consumption [11]. However, a noticeable trend was an increase in interest in fitness and a healthy lifestyle [12]. ...
Relevance. The relevance of the study is conditioned by the rapid development of the field of physical education and sports, and the growing requirements for the qualification of specialists.Purpose. The purpose of the study is to develop a methodology for assessing the quality of training of specialists, based on a review of the best world practices.Methodology. The following research methods were used: systematisation method, analysis, comparison, synthesis, deduction, classification, and questionnaires.Results. In the course of the study, current trends in the field of physical education and sports were revealed, modern approaches to training and trends in the fitness industry were considered, and the role of physical education and sports specialists was updated. The international experience of such leading countries in the field of education as the USA, France, and Japan considered in the paper helped to identify both strengths in the Ukrainian system of professional training of specialists, and to justify that in the system of training specialists in the field of physical education in Ukraine have problems and shortcomings, which consist in the lack of an integrated approach to professional training, limited use of innovative methods, and adaptation to individual needs of students. Based on the data obtained, a way to improve existing educational programmes was proposed to bring them in line with the best international practices. The developed scheme of key elements and ways of their implementation for training specialists in the field of physical education and sports in Ukraine became the basis for creating a methodology for evaluating the effectiveness of Ukrainian educational programmes in the field of physical education and sports according to six key stages.Conclusions. The research materials can be used for direct assessment of existing educational programmes in the field of physical education and sports and their further improvement.
... However, globally, the level of physical activity has remained stable or declined, despite several efforts to promote physical activity [7,8]. In addition, social distancing during the COVID-19 pandemic has caused changes in lifestyle and social behavior [9]. The level of physical activity among older adults in Japan is reported to have declined due to the COVID-19 pandemic [10,11] and needs to be increased. ...
Background
The use of mobile apps has promoted physical activity levels. Recently, with an increasing number of older adults accessing the internet, app-based interventions may be feasible in older populations. Peer support–based interventions have become a common method for promoting health-related behavior change. To our knowledge, the feasibility of using digital peer support apps (DPSAs) to increase physical activity among older adults and its impact on physical activity and physical function have not been investigated.
Objective
This study aims to assess the feasibility of using DPSAs in older adults and to assess changes in physical activity and physical function in DPSA users.
Methods
We conducted a nonrandomized controlled trial of older adults aged ≥65 years. We recruited participants for 2 distinct 12-week programs designed to increase physical activity. Participants could choose between an intervention group (app program and exercise instruction) or a control group (exercise instruction only). DPSA creates a group chat for up to 5 people with a common goal, and participants anonymously post to each other in the group. Once a day, participants posted a set of their step counts, photos, and comments on a group chat box. The intervention group used the DPSA after receiving 2 face-to-face lectures on its use. The participants were characterized using questionnaires, accelerometers, and physical function assessments. The feasibility of the DPSA was assessed using retention and adherence rates. Physical activity was assessed using accelerometers to measure the daily step count, light intensity physical activity, moderate to vigorous intensity physical activity (MVPA), and sedentary behavior. Physical function was assessed using grip strength and the 30-second chair-stand test.
Results
The participants in the intervention group were more frequent users of apps, were more familiar with information and communication technology, and had a higher baseline physical activity level. The retention and adherence rates for the DPSA intervention were 88% (36/41) and 87.7%, respectively, indicating good feasibility. Participants in the intervention group increased their step count by at least 1000 steps and their MVPA by at least 10 minutes using the DPSA. There was a significant difference in the interaction between groups and intervention time points in the daily step count and MVPA (step count, P=.04; duration of MVPA, P=.02). The DPSA increased physical activity, especially in older adults with low baseline physical activity levels.
Conclusions
The feasibility of DPSA was found to be good, with the intervention group showing increases in daily steps and MVPA. The effects of DPSA on step count, physical activity, and physical function in older adults with low baseline physical activity should be investigated using randomized controlled trials.
... The world has been living with a pandemic other than COVID-19 for years, the physical inactivity and sedentary behaviors pandemic (Hall et al., 2021). In 2018 the Global Matrix 3.0 Physical Activity Report highlighted that children worldwide were not getting enough physical activity (Aubert et al., 2018). ...
Schools are pivotal stakeholders in increasing the amount of student physical activity, an attribution especially relevant while the COVID-19 pandemic is not overcome. This article evaluates how the use of physically active academic lessons impacted mathematics learning and the amount of physical activity during the transition to face-to-face classes. The objective was also to analyze students, parents, and teachers’ perceptions of this experience. Therefore, for at least 6 weeks in mid-2021, 290 Chilean elementary school students from different schools, together with their 11 teachers, learned and practiced a choreography on geometry during the school routine. Both quantitative and qualitative instruments were used to evaluate this experience. The results from the pre- and post-test showed that students increased their geometry scores significantly (Z = 13.116, p < .001) by an average of 24.28 percentage points with an increase of 7.33 percentage points if the student attended face-to-face classes. Moreover, the results of the focus groups revealed a positive perception of the experience and increased physical activity. Overall, the study suggests that incorporating physically active academic lessons positively affect both academic performance and students’ physical activity levels during the transition to face-to-face classes.
... In addition, the choice of physical exercise for the elderly should follow the guidance of the public health management department, such as during the COVID-19 pandemic, the elderly should be more reasonable to adjust the place of physical exercise, and choose the physical exercise activities suitable for home, [45][46][47][48] in order to better maintain their own health. ...
The aim of this study is to investigate the relationship between the perceived value of outdoor activities and exercise persistence among elderly Chinese individuals. Specifically, the study aims to explore whether motivation for active social adaptation mediates this relationship. Three hundred twenty-five subjects were randomly chosen and invited to complete 3 questionnaires about the perceived value of outdoor activity, the motivation for active social adaptation, and the adherence to physical exercise. The results showed that older people’s perception of the value of outdoor activity (function, landscape, and cost) has a statistically significant effect on their adherence to exercise. The mediating role of motivation for active social adaptation was also statistically significant, and the mediating role of active environmental adaptation motivation affected the perceived functional value, perceived landscape value of outdoor activities on adherence to exercise. Hence, it is concluded that older Chinese adults’ perception of the value of outdoor activities promotes their adherence to exercise and reinforces it based on active social adaptation motivation.
... The WHO estimated that 31% of the world population aged 15 years or older is physically inactive, and this unhealthy lifestyle contributes to nearly 3.2 million deaths annually [25] . Most adults are reported to spend the majority of their daily waking hours sitting [26] , while the total sitting time has increased by almost 1 h per day among adults in the US over the past decade according to research based on NHANES survey data [27,28] . ...
Background
Kidney stones are among the most common urological conditions affecting approximately 9% of the world population. Although some unhealthy diets and unhealthy lifestyles are reportedly risk factors for kidney stone, the association between daily sitting time and kidney stone has not been explored.
Materials and Methods
This large-scale, cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) database 2007-2016. Kidney stone history and daily sitting time were retrieved from the questionnaire and 24-hour recall interviews. Logistic regression and subgroup analysis were conducted to investigate the association. The analysis was further stratified by vigorous recreational activity.
Results
A total of 19188 participants aged ≥20 years with complete information were included in this study. The overall prevalence of kidney stone was 9.6%. Among participants without vigorous recreational activity, a trend towards an increasing prevalence of kidney stone was observed with increased daily sitting time. However, the trend was not observed in individuals who participated in vigorous recreational activity, as they experienced a decreased risk of kidney stone despite having a daily sitting time of 6 to 8 hours (crude model OR=0.659, 95% CI: 0.457 to 0.950, P =0.028), indicating that vigorous recreational activity may partially attenuate the detrimental effect of prolonged sitting time.
Conclusion
Our study revealed an increasing trend of prevalence of kidney stone with increased daily sitting time among the population not performing vigorous recreational activity despite the difference was nonsignificant. Vigorous recreational activity may modify the association between daily sitting time and kidney stone. More prospective cohort studies are warranted to further examine this association.
... 11 Both are also independently associated with health status among youth. [12][13][14] In addition, a sedentary lifestyle, including high levels of screen time and low levels of physical activity, is considered one of the world's leading causes of mortality, 15 and is linked to cardiovascular disease, 16,17 type 2 diabetes, 18 and certain types of cancers. 19,20 Sedentary behaviors are also associated with higher risks of anxiety, 21 depression, 22 and indicators of psychological distress such as low self-esteem, feelings of loneliness, and high levels of stress. ...
It is known that the transition to adulthood represents a critical period of life when acquiring healthy behaviors can influence lifestyle and health throughout adulthood. Given the importance of the consequences of a sedentary lifestyle, identifying influence factors is key to improving healthy behaviors. The objective of this study is to explore the role of postsecondary students’ motivation toward physical activity in the association with their screen time and out-of-school physical activity practice. A total of 1522 postsecondary students (90% were aged 17-20 years) recruited from 17 postsecondary institutions completed the self-reported questionnaire during course time. Multivariate linear regression was used to assess the association between motivation to move including additional predictors of behavior such as intention and tendency to self-activate and self-reported screen time and physical activity controlling for age and sex. Motivation including all 3 motivational variables (interest, utility, competence) was negatively associated with screen time, b = −0.498 (95% CI between −0.635 and −0.361) and positively associated with moderate-to-vigorous physical activity, b = 133.986, (95% CI between 102.129 and 165.843). Of the 3 motivational variables, interest had the strongest negative association with screen time, b = −0.434 (95% CI between −0.551 and −0.317), and the strongest positive association with physical activity, b = 113.671, (95% CI between 86.396 and 140.946). These findings indicate that the motivation of postsecondary students toward physical activity significantly influences their behaviors, including screen time and physical activity engagement.
My academic career has largely focused on the importance of healthy lifestyle behaviors, in both primary and secondary prevention, to reduce the risk of poor health outcomes and improve quality of life. Despite the evidence and clear value of adopting healthy living medicine as a primary component of healthcare delivery, much of the world, particularly the United States, has remained mired in a secondary, reactive model, where unhealthy lifestyles and chronic disease are often allowed to run rampant before healthcare management is initiated. I was recently at a scientific meeting where a fellow attendee stated that our scientific writing would benefit from new perspectives and approaches, with a hope of resonating with audiences on a different level and hopefully facilitating meaningful change that has previously not been realized. This comment inspired me to consider science fiction as an approach to illustrate a real-life health crisis faced by humanity. There is an important non-fiction component to the science fiction story presented herein—unhealthy lifestyle behaviors have a substantial negative impact on human resiliency and, if drastic measures are not taken, these behaviors may in fact drive humanity to a tipping point from which we will not recover.
Our global society faced big challenges and threats during the first major pandemic. The outbreak of COVID-19 has forced governments to impose lockdown policies worldwide. Social isolation became a new normal form of living. The consequences of this pandemic had a global impact on all areas of our social, economic, and personal development in the post-pandemic era. Under such circumstances, the big issue became how to maintain physical and mental health and cope with the new reality. The big challenge became the question of how to make better decisions towards sustainability.
Therefore, it is urgent to analyze the extent of the pandemic's impact on each Sustainable Development Goal and address the post-pandemic situation to accelerate progress on each of the 17 SDGs.
The monography is based on the realization of five scientific and social projects with practical implementation during the lockdown periods:
“Psychological Responses, Coping Strategies, and Physical Activity during the COVID–19 Pandemic” - the joint research study of the Foundation for Global Community Health with Ohio State University, USA, realized in eleven countries.
The global challenge is “How to stay connected through culture, art, and sports activities!” BWELL BKIND BRAIN BREAKS CHALLENGE, supported by The Future Leaders Volunteer Program of GCH Foundation.
“HOPSports Brain Breaks® Physical Activity Solutions” – implementation of the platform during online education with the collaboration between the GCH Foundation and Sofia Municipality, “Vazrajdane” District.
“Digital Innovations for Social Integration Among Adolescents” – creating video materials adapted for deaf pupils, establishing the partnership between the GCH Foundation, Bulgarian Academy of Science, and Sofia municipality.
“The attitudes of the pupils regarding their participation in online PE classes” - the joint research study and practical implementation of the digital content in terms of online PE education with the teachers of PE in Vocational School of Transport and Energy "Henry Ford".
The present monography can be used to develop models leading to correct policies serving the full development of our society in the emerging modern complex situation related to a global health pandemic and its consequences, as well as an escalation of military conflicts on a global scale. To establish the linking of the theoretical with the practical approach in research and their practical implementation, international partnerships have been created to create sustainable strategies following SDG 11: Sustainable Cities and Communities and SDG 17: Partnerships for the Goals.
Objective This study aimed to examine the correlation of sitting time with cardiovascular disease (CVD) risk and to elucidate whether vigorous activity can reduce the risk of CVDs. Method A large, cross-sectional study was carried out with the National Health and Nutrition Examination Survey database 2007–2018 derived data. Meanwhile, daily sitting time, CVD history, and vigorous activity in daily life were retrieved based on 24-h recall interviews and questionnaires, whereas to investigate the correlation, subgroup and logistic regression analyses were performed. For stratifying analysis, vigorous recreational activity was employed. Results A total of 29622 participants aged ≥ 20 years who had sufficient data were enrolled in the present study. The total prevalence of CVD was 12.7%. In overall and non-vigorous recreational activity participants, the prevalence of CVD increased with the elevation of a daily sitting time ( P <0.001). Nonetheless, such a trend could not be detected among patients taking vigorous recreational activity ( P >0.05). Moreover, the risk of CVDs is dramatically reduced by vigorous activity ( P <0.001). Conclusion According to our findings, the prevalence of CVDs increases as daily sitting time elevates in overall participants especially those not having vigorous activity. Vigorous recreational activity may balance the risk of CVDs, which is because of prolonged daily sitting time.
Objectives: Daegu Metropolitan City was a region that experienced the pandemic in the early stages of the COVID-19 outbreak, and the rate of physical activity practice decreased significantly compared with other metropolitan cities in 2020. In 2023, when it transitioned to an endemic, the proportion of people diagnosed with hypertension (standardized) increased the most among metropolitan cities. Methods: Using data from the Community Health Survey in Daegu, we examined changes in the proportion of people diagnosed with hypertension before and after the COVID-19 pandemic and changes according to sociodemographic characteristics. Results: The proportion of people diagnosed with hypertension, adjusted for gender, age, obesity, income, and occupation, was not different in 2019 and 2020 compared to 2018, and was likely to be higher in 2021, 2022, and 2023. The proportion of people diagnosed with hypertension was higher among men and women, ages in the 30s, 40s, and 50s, and income level in the 2 million won, 3 million won, and 4 million won and occupation in simple labor, others (students, housewives, unemployed) after the COVID-19 outbreak (2019-2023) than before the COVID-19 outbreak (2015-2019). In particular, there was a significant increase among women, 30s, 3 million won, and those in simple labor.Conclusions: In this study, the proportion of people diagnosed with hypertension increased significantly compared to before the outbreak of COVID-19, not only in vulnerable groups but also in younger age groups and high-income groups. In the physical activity aspect alone, the reason is interpreted as the result of the discontinuation of intense exercise, which can prevent hypertension by stimulating the cardiovascular system. Therefore, public health intervention is needed for vulnerable groups and maintain an intensity of exercise that can prevent hypertension. There is also a need to prepare to prevent a pandemic of chronic diseases from being caused by new infectious diseases.
A BSTRACT
Background
The COVID-19 pandemic has profoundly affected the physical activity (PA) levels and dietary habits of individuals, particularly children and adolescents in Saudi Arabia, owing to widespread closures and social distancing measures, including school closures.
Methods
A cross-sectional study was conducted to assess the impact of distance learning (DL) on PA and dietary habits among public middle school girls during the pandemic. The Arab Teens Lifestyle Questionnaire (ATLS) was used to assess habitual PA, sedentary behavior, and dietary habits.
Results
A total of 300 middle school female students, with an average age of 14 years, participated in the study. The results indicated a generally low level of PA among students during DL and after school reopening, with a significant decrease in specific types of PA, such as walking and stair climbing during DL. However, after schools reopened, there was a significant increase in students’ participation in activities such as swimming, dancing, and housework (P < 0.05). Moreover, sleep hours and TV-watching time increased compared to the DL period. Despite the prevalence of students frequently consuming soft drinks, sugary treats, fried and fast foods, as well as sweets and chocolates during the lockdown, middle school girls also consumed a lot of fruits and vegetables.
Conclusion
Assessing students’ habitual PA and dietary habits during the lockdown may provide insights into their future health and well-being post-pandemic. This assessment can help in identifying strategies to redirect current PA levels to maintain health and prevent potential long-term health implications.
Amaç: Bu araştırmada COVID-19 pandemi sürecinde 65 yaş ve üstü kişilerin uyku ve yaşam kalitesinin düzeyi ve sosyodemografik özellikleriyle ilişkisinin değerlendirilmesi amaçlanmıştır. Yöntem: Bu çalışmaya 135 kişi katılmıştır. Araştırmada veriler Pittsburgh Uyku Kalitesi İndeksi (PUKİ), Kısa Form-36 Yaşam Kalitesi Ölçeği (SF-36) ve dokuz soruluk sosyodemografik veri formu kullanılarak toplanmıştır. Toplanan veriler SPSS 20.0 kullanılarak incelenmiştir. Analizde tanımlayıcı istatistikler ile Kolmogorov-Smirnov, Spearman Korelasyon Analizi, Pearson Ki Kare Testi ve Mann Whitney-U testi kullanılmıştır. Bulgular: Bu araştırmada 135 kişinin yaş ortalaması 70,8±6,7 (min:65, max:91) olarak bulunmuştur. Katılımcıların %66,7'si kadın olup bu kadınların %59,3'ü kronik bir hastalığı olduğunu belirtmiştir. Araştırmaya katılanların %60,7'sinin ilkokul ve altı eğitime sahip olduğu belirlenmiştir. Katılımcıların PUKİ toplam puan ortalaması 6,94±3,74 ve PUKİ’ye göre %54,8'inde kötü uyku kalitesi olduğu saptanmıştır. Kadınların uyku kalitesinin erkeklerden daha kötü olduğu ve SF-36’nın tüm alt boyutlarında daha düşük puana sahip olduğu saptanmıştır (p
The COVID-19 pandemic has pushed the population to adopt increasingly sedentary lifestyles. Faced with this problem, remote training appears as a practical and inexpensive strategy to promote physically active lifestyles. The aim of this research was to compare the effects of remote versus in-person training on metabolic profiles and body composition of physically inactive adults. This research was conducted through a randomized, single-blind clinical trial with balanced block randomization. The sample consisted of 30 physically inactive subjects of both sexes between 18 and 30 years of age. The sample was selected using a voluntary public call. The 30 subjects were randomized into three groups of 10 people each. One group trained for 36 sessions remotely, and the other did so in person. The control group did not have a training plan. The variables evaluated pre- and post-intervention were body composition by bioimpedance, grip strength through dynamometry, primary outcome, and metabolic profile assessed from a capillary sample using the CARDIOCHEK equipment. In the remote training group, significant gains were evident in the variables of weight (p = 0.042, d = 1.119), muscle percentage (p = 0.032, d = 0.499), and fat percentage (p = 0.001, d = 1.132), visceral fat (p = 0.032, d = 0.424), total cholesterol (p = 0.001, d = 1.213), HDL (p = 0.001, d = 0.534), LDL (p = 0.001, d = 0.973), triglycerides (p = 0.001, d = 0.583), and grip strength (p = 0.001, d = 1.201). When comparing the effects between the remote and in-person training groups, it is evident that the improvements were similar in all variables, except for glucose, in which the in-person group had a greater value reduction.
The rise of Generative Artificial Intelligence, including Large Language Models (LLMs), has enabled users to engage in self-guided learning of sports skills through conversation-based interactions. However, studies have identified a phenomenon known as "hallucination" in which LLMs generate feedback that is inaccurate or non-existent. While this phenomenon has been observed in various domains, including medicine, academia, and news, its existence and implications in the context of physical exercises, particularly motor skill learning, remain unexplored. This study investigates the presence of LLM hallucinations in badminton skill learning and examines their potential impact on learning outcomes. This study aims to investigate whether LLMs hallucinations exist in the motor skill learning of physical exercises and what impact they may have. Eighty university freshmen with no prior badminton experience participated in a 16-week experiment, with 40 students assigned to the Experimental Group (EG) utilizing LLM-based applications (ChatGPT or New Bing) for self-guided learning, and 40 students in the Control Group (CG) learning under the supervision of 12 university sports teachers and 8 experts that specialized in badminton. Evaluation criteria for badminton skills were established, and assessments were conducted at baseline and 16 weeks using independent sample t-tests and paired-sample t-tests. One-way analysis of variance (One-Way ANCOVA) was employed to compare learning outcomes between the two groups. Interviews were conducted to gain insights into the causes of any observed differences in learning efficiency. Both CG and EG groups demonstrated motor skill improvement (clear: p < 0.001; smash: p < 0.001; footwork: p < 0.001). CG exhibited significantly higher scores in long-distance shots and smashes in the post-test. No significant difference was observed in footwork scores between the two groups. High accordance in specific skill points among students in both groups indicated the common usage of prompts. Interviews with EG students revealed hallucinations in the text generated by LLMs, particularly in the context of "forearm internal rotation swing." LLMs exhibit hallucinations in the context of intricate motor skill learning, such as badminton, where limited corpus data is available. These hallucinations can mislead users and impact learning outcomes. Future research should explore strategies to mitigate LLM hallucinations in physical exercise learning applications.
COVID-19 is a highly contagious virus that uses Angiotensin-converting enzyme 2 (ACE2) as a receptor to enter human cells. The virus leads to an increase in inflammatory cytokines (i.e. IL-6) and an impaired coagulation system, which can cause serious complications during and after the disease. Physical exercise has been shown to improve COVID-19 complications through various mechanisms, such as modulation of the immune and coagulation systems. Therefore, this study investigated the effects of 8 weeks of training on inflammatory, coagulation, and physical factors in patients with COVID-19 during the recovery phase. Twenty-seven male and female volunteers (age 20–45 years) who recently recovered from COVID-19 were assigned to the control (n = 13) or the training group (n = 14). Blood samples, aerobic capacity and muscle endurance were collected 24 h before the start of the interventions and 24 h after the final training session in week 4 and 48 h after the final training session in week 8. IL-6, ACE2, fibrinogen, and D-dimer were measured using ELISA. The training group showed a significant increase in muscle endurance (p = 0.004) and aerobic capacity (p = 0.009) compared to the control group. Serum levels of IL-6 and fibrinogen decreased in the training group but this decrease was not statistically significant (p > 0.05). Despite a slight increase in the quality of life and sleep in the training group, no statistically significant difference was observed between the training and the control group. It appears that physical training has beneficial effects on the coagulation system, inflammatory factors, and sleep quality and can facilitate the recovery of COVID-19 patients.
Healthy habits during early childhood are essential for a healthy adolescence and adulthood. Before the COVID-19 pandemic, the number of children who met the 24-h movement behavior (physical activity [PA], sedentary behavior, and sleep) guidelines was low worldwide. Despite a lack of evidence, the restriction measures imposed during the COVID-19 pandemic are claimed to have further reduced the number, especially among preschoolers. Thus, this study was designed to compare the time spent on movement behaviors before and during the COVID-19 pandemic in low-income preschoolers from the Northeast Region of Brazil. Forty mothers provided data on their preschoolers' sleep, sedentary behavior, and outdoor and indoor PA. To compare indoor and outdoor PA, sleep duration, and sedentary time during the weekdays and weekends, before and during the pandemic, generalized estimation equations were used. During the weekdays, a significant increase in sleep duration (553.7 vs. 627.0; p < 0.01) and sedentary times (225.0 vs. 409.5; p < 0.01) were observed. Further, an increase in the sedentary time during the weekend (319.5 vs. 406.5; p < 0.01) and the total time between the pre-pandemic and pandemic periods (249.0 vs. 409.5; p < 0.01) was observed. Our findings also unveiled that preschoolers were seven times more likely to be active outdoors for an hour or more before than during the pandemic (OR = 6.55; 95% CI = 2.07-20.73). In summary, the pandemic has altered preschoolers' routines, leading to changes in their health behaviors over time.
Background
The World Health Organization announced coronavirus disease 2019 (COVID-19) was a global pandemic in March 2020. Like other countries around the world, the Saudi Arabian Government imposed measures to control the spread of the virus, including lockdowns and limits on people’s physical activity (PA).
Aim
The study aimed to explore changes in self-reported PA behavior during the COVID-19 lockdown compared with prelockdown among physically active adults in Saudi Arabia, and understand the barriers for those who performed less or no PA during lockdown.
Design
A cross-sectional survey.
Materials and Methods
This study included 213 physically active adults (aged 18–64 years) living in Saudi Arabia, the majority of whom were male (65.70%; n = 140). The researcher distributed an online version of the international PA questionnaire (short form) through social media platforms between November 5, 2021, and December 15, 2021.
Results
The study’s results showed: (1) 40.8% (n = 87) of study participants did not perform any PA during lockdown; (2) there was a significant reduction in the frequency of all PA intensity (vigorous, moderate, and a combination of both) during lockdown compared with before; (3) there was a significant reduction in the duration of all PA intensity except for vigorous PA intensity during lockdown compared with before; (4) almost 70% (n = 148) of participants did not meet the international recommendation for PA during lockdown; and (5) the lack of appropriate equipment/space and closed sports infrastructure were the most significant barriers that led to participants performing less or no PA during lockdown.
Conclusion
The COVID-19 lockdown negatively impacted the PA behaviors of physically active adults in Saudi Arabia, while the majority of participants (70%) did not meet the international recommendation for PA during lockdown.
Aim
As more of the world’s population are living longer, supporting the mental and physical health of older adults is becoming increasingly important in public health. Resilience is a dynamic process encompassing positive adaptation in the face of adverse experiences that would otherwise lead to poor outcomes. The aim of the study is to explore the association between physical activity and resilience in older adults.
Subject and methods
The data used in this study was taken from the results of the Self Completed Questionnaires and Computer Assisted Personal Interviews from the Northern Ireland Cohort for the Longitudinal Study of Ageing. A secondary analysis was conducted on a sample of 4040 participants to examine the association between resilience (Brief Resilience Scale) and on moderate/vigorous physical activity (International Physical Activity Questionnaire – Short Form) through chi-square and Mann–Whitney U tests and an ordinal regression being conducted.
Results
Data was included for 4040 participants, of whom 90% did not meet the recommended moderate physical activity guidelines. The findings of this study indicated that higher resilience levels are associated with higher levels of moderate and vigorous physical activity levels.
Conclusion
Worryingly, a large percentage of the older adult population are not sufficiently active and this is something that needs to be addressed. The findings suggest that with these low levels of physical activity, interventions should be created to target this population.
On March 11, 2020, the World Health Organization declared Coronavirus Disease 2019 (COVID-19) a pandemic (1). As of March 28, 2020, a total of 571,678 confirmed COVID-19 cases and 26,494 deaths have been reported worldwide (2). Reports from China and Italy suggest that risk factors for severe disease include older age and the presence of at least one of several underlying health conditions (3,4). U.S. older adults, including those aged ≥65 years and particularly those aged ≥85 years, also appear to be at higher risk for severe COVID-19-associated outcomes; however, data describing underlying health conditions among U.S. COVID-19 patients have not yet been reported (5). As of March 28, 2020, U.S. states and territories have reported 122,653 U.S. COVID-19 cases to CDC, including 7,162 (5.8%) for whom data on underlying health conditions and other known risk factors for severe outcomes from respiratory infections were reported. Among these 7,162 cases, 2,692 (37.6%) patients had one or more underlying health condition or risk factor, and 4,470 (62.4%) had none of these conditions reported. The percentage of COVID-19 patients with at least one underlying health condition or risk factor was higher among those requiring intensive care unit (ICU) admission (358 of 457, 78%) and those requiring hospitalization without ICU admission (732 of 1,037, 71%) than that among those who were not hospitalized (1,388 of 5,143, 27%). The most commonly reported conditions were diabetes mellitus, chronic lung disease, and cardiovascular disease. These preliminary findings suggest that in the United States, persons with underlying health conditions or other recognized risk factors for severe outcomes from respiratory infections appear to be at a higher risk for severe disease from COVID-19 than are persons without these conditions.
We examined the relationship between social isolation and health among parents and their adolescent children. Data came from the 2014 Family Life, Activity, Sun, Health, and Eating Study (FLASHE), a cross-sectional internet study from the National Cancer Institute. Parents and their adolescent children (ages 12–17) completed surveys about demographics, physical activity, and diet; analyses include all dyads in which at least one member provided information for any of the analyzed variables (N = 1851). Actor Partner Interdependence Models in Mplus with demographic covariates tested whether parent and adolescent perceived social isolation (2 items from the UCLA Loneliness Scale) were associated with each person’s self-reported health. Most dyads included a mother (38% mother–daughter, 36% mother–son). Most parents were non-Hispanic White (69%), married/partnered (77%), and reported household income below $100,000 (79%). Both social isolation and self-reported health were significantly correlated between parents and their adolescent children (Pearson correlation = .38 for isolation, .32 for health). There were negative associations between parent isolation and parent health, adolescent isolation and adolescent health, and parent isolation and adolescent health (all ps < .05), but no association between adolescent isolation and parent health. The finding that parents’ social isolation was linked to lower self-reported health not only for themselves but also for their adolescent children highlights the importance of addressing social isolation in clinical social work practice. Family interventions, or interventions to reduce adults’ negative social cognitions or promote social connections, may improve health for both adults and their adolescent children.
Importance
The updated 2018 Physical Activity Guidelines for Americans (PAG) reaffirmed key recommendations regarding aerobic activity in the 2008 edition and recently introduced health risks of sedentary behaviors and their association with physical activity.
Objective
To examine the concurrent changing trends in adherence to the PAG for aerobic activity and time spent on sedentary behavior in US adults from 2007 to 2016.
Design, Setting, and Participants
This study used data from a series of cross-sectional, nationally representative surveys on adults 18 years or older from the National Health and Nutrition Examination Surveys from 2007 to 2016. Data analysis was performed from September 1, 2018, to March 31, 2019.
Main Outcomes and Measures
Duration, frequency, and intensity of leisure-time, work-related, and transportation-related aerobic activity were ascertained by a standardized questionnaire and summed as minutes per week. Adherence to the PAG for aerobic activity was defined as engaging in at least 150 minutes a week of moderate-intensity or 75 minutes a week of vigorous-intensity aerobic physical activity or an equivalent combination of moderate- and vigorous-intensity aerobic physical activity. Time spent on sedentary behavior was estimated by hours spent sitting on a typical day.
Results
Among 27 343 participants 18 years or older (13 630 [52.0%] female; 14 628 [66.6%] non-Hispanic white), the weighted adherence rate to the PAG for aerobic activity was 65.2% (95% CI, 62.3%-68.2%) in 2015-2016, with no significant change from 2007-2008 (63.2%; 95% CI, 60.2%-66.1%) to 2015-2016 (P = .15 for trend). Time spent on sedentary behavior significantly increased over time from a weighted mean (SE) of 5.7 (0.3) hours per day in 2007-2008 to 6.4 (0.2) hours per day in 2015-2016 (P < .001 for trend). The weighted proportion of people not adhering to the PAG for aerobic activity and reporting long sedentary time (>6 hours per day) increased from 16.1% (95% CI, 14.4%-17.8%) in 2007-2008 to 18.8% (95% CI, 17.7%-20.0%) in 2015-2016.
Conclusions and Relevance
The findings suggest that the adherence rate to the PAG for aerobic activity in US adults has not improved since the release of the first edition in 2008 but that time spent on sedentary behavior has significantly increased over time. Further nationwide efforts appear to be warranted to not only promote physical activity but also reduce sedentary time in the United States.
Loneliness is an individual and social problem associated with an unhealthy lifestyle among adolescents. We examined the association between loneliness, physical activity, and participation in physical education lessons among school-going adolescents. Participants included 2517 adolescents aged 14-19 years selected from state public high schools in Amazonas, Brazil. Participants answered a questionnaire containing demographic information, physical activity, and participation in physical education lessons and loneliness. Our results showed that physically inactive adolescents and those who did not participate in physical education lessons were more likely to feel lonely. These findings underscore the need to target physically inactive adolescents and those non-engaged in physical education lessons when developing interventions to address loneliness.
Background
The impact of social isolation and loneliness on health risk may be mediated by a combination of direct biological processes and lifestyle factors. This study tested the hypothesis that social isolation and loneliness are associated with less objective physical activity and more sedentary behavior in older adults.
Methods
Wrist-mounted accelerometers were worn over 7 days by 267 community-based men (n = 136) and women (n = 131) aged 50–81 years (mean 66.01), taking part in the English Longitudinal Study of Ageing (ELSA; wave 6, 2012–13). Associations between social isolation or loneliness and objective activity were analyzed using linear regressions, with total activity counts and time spent in sedentary behavior and light and moderate/vigorous activity as the outcome variables. Social isolation and loneliness were assessed with standard questionnaires, and poor health, mobility limitations and depressive symptoms were included as covariates.
Results
Total 24 h activity counts were lower in isolated compared with non-isolated respondents independently of gender, age, socioeconomic status, marital status, smoking, alcohol consumption, self-rated health, limiting longstanding illness, mobility limitations, depressive symptoms, and loneliness (β = − 0.130, p = 0.028). Time spent in sedentary behavior over the day and evening was greater in isolated participants (β = 0.143, p = 0.013), while light (β = − 0.143, p = 0.015) and moderate/vigorous (β = − 0.112, p = 0.051) physical activity were less frequent. Physical activity was greater on weekdays than weekend days, but associations with social isolation were similar. Loneliness was not associated with physical activity or sedentary behavior in multivariable analysis.
Conclusions
These findings suggest that greater social isolation in older men and women is related to reduced everyday objective physical activity and greater sedentary time. Differences in physical activity may contribute to the increased risk of ill-health and poor wellbeing associated with isolation.
Background:
Insufficient physical activity is a leading risk factor for non-communicable diseases, and has a negative effect on mental health and quality of life. We describe levels of insufficient physical activity across countries, and estimate global and regional trends.
Methods:
We pooled data from population-based surveys reporting the prevalence of insufficient physical activity, which included physical activity at work, at home, for transport, and during leisure time (ie, not doing at least 150 min of moderate-intensity, or 75 min of vigorous-intensity physical activity per week, or any equivalent combination of the two). We used regression models to adjust survey data to a standard definition and age groups. We estimated time trends using multilevel mixed-effects modelling.
Findings:
We included data from 358 surveys across 168 countries, including 1·9 million participants. Global age-standardised prevalence of insufficient physical activity was 27·5% (95% uncertainty interval 25·0-32·2) in 2016, with a difference between sexes of more than 8 percentage points (23·4%, 21·1-30·7, in men vs 31·7%, 28·6-39·0, in women). Between 2001, and 2016, levels of insufficient activity were stable (28·5%, 23·9-33·9, in 2001; change not significant). The highest levels in 2016, were in women in Latin America and the Caribbean (43·7%, 42·9-46·5), south Asia (43·0%, 29·6-74·9), and high-income Western countries (42·3%, 39·1-45·4), whereas the lowest levels were in men from Oceania (12·3%, 11·2-17·7), east and southeast Asia (17·6%, 15·7-23·9), and sub-Saharan Africa (17·9%, 15·1-20·5). Prevalence in 2016 was more than twice as high in high-income countries (36·8%, 35·0-38·0) as in low-income countries (16·2%, 14·2-17·9), and insufficient activity has increased in high-income countries over time (31·6%, 27·1-37·2, in 2001).
Interpretation:
If current trends continue, the 2025 global physical activity target (a 10% relative reduction in insufficient physical activity) will not be met. Policies to increase population levels of physical activity need to be prioritised and scaled up urgently.
Funding:
None.
Purpose:
To estimate the strength and shape of the dose-response relationship between sedentary behaviour and all-cause, cardiovascular disease (CVD) and cancer mortality, and incident type 2 diabetes (T2D), adjusted for physical activity (PA). Data Sources: Pubmed, Web of Knowledge, Medline, Embase, Cochrane Library and Google Scholar (through September-2016); reference lists. Study Selection: Prospective studies reporting associations between total daily sedentary time or TV viewing time, and ≥ one outcome of interest. Data Extraction: Two independent reviewers extracted data, study quality was assessed; corresponding authors were approached where needed. Data Synthesis: Thirty-four studies (1,331,468 unique participants; good study quality) covering 8 exposure-outcome combinations were included. For total sedentary behaviour, the PA-adjusted relationship was non-linear for all-cause mortality (RR per 1 h/day: were 1.01 (1.00-1.01) ≤ 8 h/day; 1.04 (1.03-1.05) > 8 h/day of exposure), and for CVD mortality (1.01 (0.99-1.02) ≤ 6 h/day; 1.04 (1.03-1.04) > 6 h/day). The association was linear (1.01 (1.00-1.01)) with T2D and non-significant with cancer mortality. Stronger PA-adjusted associations were found for TV viewing (h/day); non-linear for all-cause mortality (1.03 (1.01-1.04) ≤ 3.5 h/day; 1.06 (1.05-1.08) > 3.5 h/day) and for CVD mortality (1.02 (0.99-1.04) ≤ 4 h/day; 1.08 (1.05-1.12) > 4 h/day). Associations with cancer mortality (1.03 (1.02-1.04)) and T2D were linear (1.09 (1.07-1.12)).
Conclusions:
Independent of PA, total sitting and TV viewing time are associated with greater risk for several major chronic disease outcomes. For all-cause and CVD mortality, a threshold of 6-8 h/day of total sitting and 3-4 h/day of TV viewing was identified, above which the risk is increased.
This review proposes that physical inactivity could be considered a behavior selected by evolution for resting, and also selected to be reinforcing in life-threatening situations in which exercise would be dangerous. Underlying the notion are human twin studies and animal selective breeding studies, both of which provide indirect evidence for the existence of genes for physical inactivity. Approximately 86% of the 325 million in the United States (U.S.) population achieve less than the U.S. Government and World Health Organization guidelines for daily physical activity for health. Although underappreciated, physical inactivity is an actual contributing cause to at least 35 unhealthy conditions, including the majority of the 10 leading causes of death in the U.S. First, we introduce nine physical inactivity-related themes. Next, characteristics and models of physical inactivity are presented. Following next are individual examples of phenotypes, organ systems, and diseases that are impacted by physical inactivity, including behavior, central nervous system, cardiorespiratory fitness, metabolism, adipose tissue, skeletal muscle, bone, immunity, digestion, and cancer. Importantly, physical inactivity, itself, often plays an independent role as a direct cause of speeding the losses of cardiovascular and strength fitness, shortening of healthspan, and lowering of the age for the onset of the first chronic disease, which in turn decreases quality of life, increases health care costs, and accelerates mortality risk.
Epidemiological evidence is accumulating that indicates greater time spent in sedentary behavior is associated with all-cause and cardiovascular morbidity and mortality in adults such that some countries have disseminated broad guidelines that recommend minimizing sedentary behaviors. Research examining the possible deleterious consequences of excess sedentary behavior is rapidly evolving, with the epidemiology-based literature ahead of potential biological mechanisms that might explain the observed associations. This American Heart Association science advisory reviews the current evidence on sedentary behavior in terms of assessment methods, population prevalence, determinants, associations with cardiovascular disease incidence and mortality, potential underlying mechanisms, and interventions. Recommendations for future research on this emerging cardiovascular health topic are included. Further evidence is required to better inform public health interventions and future quantitative guidelines on sedentary behavior and cardiovascular health outcomes.
The purpose of this study is to examine the change in physical activity levels among children and adolescents living in the area affected by the 2011 earthquake and tsunami for 3. years immediately following the disaster. Children and adolescents graded four to nine and attending school in the Pacific coastal area of northern Japan were included in a total of four serial prevalence investigations: the first at 6. months after the earthquake/tsunami (I, n = 434) and additional surveys at 1. year (II, n = 437), 2. years (III, n = 401), and 3. years (IV, n = 365) after the earthquake. Students were also required to undergo assessment of their accelerometer-determined daily steps and sedentary time using a self-administrated questionnaire. Accelerometer-determined median daily steps of children and adolescents were significantly different (p< 0.05) on both weekdays and weekends over 3. years. The median daily steps of children of both genders on weekdays and those of girls on weekends at period IV were significantly lower than those at period I. In addition, the median daily steps of adolescents on weekdays among girls and weekends among boys at period IV were significantly lower than those at period I. It appears that children and adolescents who survive the earthquake and tsunami experience a decrease in physical activity levels. Future research should elucidate longitudinal demographic and sociocultural factors that contribute to changes in physical activity levels among children and adolescents living in the areas affected by these disasters.
Objective:
To examine whether self-reported sitting time is related to various health indicators, health costs, and utilization in adults over age 65.
Methods:
A retrospective cross-sectional cohort study was conducted using the electronic health record (EHR) from an integrated health system in Washington State. Members who completed an online health risk assessment (HRA) between 2009 and 2011 (N = 3538) were eligible. The HRA assessed sitting time, physical activity, and health status. Diagnosis codes for diabetes and cardiovascular disease (CVD), height and weight for body mass index (BMI) calculations, health care utilization and health costs were extracted from the EHR. Linear regression models with robust standard errors tested differences in sitting time by health status, BMI category, diabetes and CVD, health costs, and utilization adjusting for demographic variables, BMI, physical activity, and health conditions.
Results:
People classified as overweight and obese, that had diabetes or CVD, and with poorer self-rated health had significantly higher sitting time (p < .05). Total annual adjusted health care costs were $126 higher for each additional hour of sitting (p < .05; not significant in final models including health conditions).
Conclusion:
Sitting time may be an important independent health indicator among older adults.
Physical inactivity is the fourth leading cause of death worldwide. We summarise present global efforts to counteract this problem and point the way forward to address the pandemic of physical inactivity. Although evidence for the benefits of physical activity for health has been available since the 1950s, promotion to improve the health of populations has lagged in relation to the available evidence and has only recently developed an identifiable infrastructure, including efforts in planning, policy, leadership and advocacy, workforce training and development, and monitoring and surveillance. The reasons for this late start are myriad, multifactorial, and complex. This infrastructure should continue to be formed, intersectoral approaches are essential to advance, and advocacy remains a key pillar. Although there is a need to build global capacity based on the present foundations, a systems approach that focuses on populations and the complex interactions among the correlates of physical inactivity, rather than solely a behavioural science approach focusing on individuals, is the way forward to increase physical activity worldwide.
Importance
It is unclear whether the number of steps per day and the intensity of stepping are associated with lower mortality.
Objective
Describe the dose-response relationship between step count and intensity and mortality.
Design, Setting, and Participants
Representative sample of US adults aged at least 40 years in the National Health and Nutrition Examination Survey who wore an accelerometer for up to 7 days ( from 2003-2006). Mortality was ascertained through December 2015.
Exposures
Accelerometer-measured number of steps per day and 3 step intensity measures (extended bout cadence, peak 30-minute cadence, and peak 1-minute cadence [steps/min]). Accelerometer data were based on measurements obtained during a 7-day period at baseline.
Main Outcomes and Measures
The primary outcome was all-cause mortality. Secondary outcomes were cardiovascular disease (CVD) and cancer mortality. Hazard ratios (HRs), mortality rates, and 95% CIs were estimated using cubic splines and quartile classifications adjusting for age; sex; race/ethnicity; education; diet; smoking status; body mass index; self-reported health; mobility limitations; and diagnoses of diabetes, stroke, heart disease, heart failure, cancer, chronic bronchitis, and emphysema.
Results
A total of 4840 participants (mean age, 56.8 years; 2435 [54%] women; 1732 [36%] individuals with obesity) wore accelerometers for a mean of 5.7 days for a mean of 14.4 hours per day. The mean number of steps per day was 9124. There were 1165 deaths over a mean 10.1 years of follow-up, including 406 CVD and 283 cancer deaths. The unadjusted incidence density for all-cause mortality was 76.7 per 1000 person-years (419 deaths) for the 655 individuals who took less than 4000 steps per day; 21.4 per 1000 person-years (488 deaths) for the 1727 individuals who took 4000 to 7999 steps per day; 6.9 per 1000 person-years (176 deaths) for the 1539 individuals who took 8000 to 11 999 steps per day; and 4.8 per 1000 person-years (82 deaths) for the 919 individuals who took at least 12 000 steps per day. Compared with taking 4000 steps per day, taking 8000 steps per day was associated with significantly lower all-cause mortality (HR, 0.49 [95% CI, 0.44-0.55]), as was taking 12 000 steps per day (HR, 0.35 [95% CI, 0.28-0.45]). Unadjusted incidence density for all-cause mortality by peak 30 cadence was 32.9 per 1000 person-years (406 deaths) for the 1080 individuals who took 18.5 to 56.0 steps per minute; 12.6 per 1000 person-years (207 deaths) for the 1153 individuals who took 56.1 to 69.2 steps per minute; 6.8 per 1000 person-years (124 deaths) for the 1074 individuals who took 69.3 to 82.8 steps per minute; and 5.3 per 1000 person-years (108 deaths) for the 1037 individuals who took 82.9 to 149.5 steps per minute. Greater step intensity was not significantly associated with lower mortality after adjustment for total steps per day (eg, highest vs lowest quartile of peak 30 cadence: HR, 0.90 [95% CI, 0.65-1.27]; P value for trend = .34).
Conclusions and Relevance
Based on a representative sample of US adults, a greater number of daily steps was significantly associated with lower all-cause mortality. There was no significant association between step intensity and mortality after adjusting for total steps per day.
Research has highlighted the importance of peers for determining health behaviors in adolescents, yet these behaviors have typically been investigated in isolation. We need to understand common network processes operating across health behaviors collectively, in order to discern how social network processes impact health behaviors. Thus, this systematic review of studies investigated adolescent peer social networks and health behaviors. A search of six databases (CINAHL, Education Resources Information Centre, Embase, International Bibliography of the Social Sciences, Medline and PsycINFO) identified 55 eligible studies. The mean age of the participants was 15.1 years (range 13-18; 51.1% female). Study samples ranged from 143 to 20,745 participants. Studies investigated drinking (31%), smoking (22%), both drinking and smoking (13%) substance use (18%), physical activity (9%) and diet or weight management (7%). Study design was largely longitudinal (n = 41, 73%) and cross-sectional (n = 14, 25%). All studies were set in school and all but one study focused on school-based friendship networks. The Newcastle-Ottawa Scale was used to assess risk of bias: studies were assessed as good (51%), fair (16%) or poor (33%). The synthesis of results revolved around two network behavior patterns: 1) health behavior similarity within a social network, driven by homophilic social selection and/or social influence, and 2) popularity: health behavior engagement in relation to changes in social status; or network popularity predicting health behaviors. Adolescents in denser networks had statistically significant lower levels of harmful behavior (n = 2/2, 100%). Findings suggest that social network processes are important factors in adolescent health behaviors.
Objective:
To examine the relationship between physical activity, sedentary behaviors, and social isolation in a representative sample of Brazilian adolescents.
Method:
Cross sectional analyses using data from the Brazilian Scholar Health Survey conducted in 2015. The sample included 100,839 adolescents (mean age: 14.3 y, 51.4% Female) from 3040 schools. Information about social isolation (number of close friends and perceived loneliness), physical activity (International Physical Activity Questionnaire) and sedentary behaviors (total sitting time and TV viewing) were self-reported. Chronological age, race and type of city (state capital or other) were co-variables. Logistic regression models were used to analyze the data (results are presented as odds ratios (OR) with 95% confidence intervals).
Results:
Physical activity was associated with lower odds of both social isolation indicators in boys, and with lower likelihood of having few friends in girls. Greater sitting time was associated with higher likelihood of social isolation, as was low (<1 h/d) [boys: OR: 1.54 (95% CI: 1.33 to 1.77); girls: OR: 1.31 (95% CI: 1.17 to 1.48] and high TV viewing (≥8 h/d) [boys: OR: 1.75 (95% CI: 1.47 to 2.09)]; girls: OR: 1.58 (95% CI: 1.37 to 1.82)]. More than 300 min/week of physical activity was sufficient to eliminate the association of high TV viewing and high sitting time with markers of social isolation in boys.
Conclusion:
Physical activity is associated with a lower prevalence of social isolation, especially among boys. Both high and low amounts of TV viewing increase the likelihood of social isolation. Physical activity reduced the association between TV viewing and sitting with social isolation among boys.
Sedentary behavior and physical inactivity are among the leading modifiable risk factors worldwide for cardiovascular disease and all-cause mortality. The promotion of physical activity and exercise training (ET) leading to improved levels of cardiorespiratory fitness is needed in all age groups, race, and ethnicities and both sexes to prevent many chronic diseases, especially cardiovascular disease. In this state-of-the-art review, we discuss the negative impact of sedentary behavior and physical inactivity, as well as the beneficial effects of physical activity /ET and cardiorespiratory fitness for the prevention of chronic noncommunicable diseases, including cardiovascular disease. We review the prognostic utility of cardiorespiratory fitness compared with obesity and the metabolic syndrome, as well as the increase of physical activity /ET for patients with heart failure as a therapeutic strategy, and ET dosing. Greater efforts at preventing sedentary behavior and physical inactivity while promoting physical activity, ET, and cardiorespiratory fitness are needed throughout the healthcare system worldwide and particularly in the United States in which the burden of cardiometabolic diseases remains extremely high.
Substantial evidence shows that physical inactivity (PI) and sedentary behavior (SB) increases the risk of many chronic diseases and shortens life expectancy. We describe evidence that certain domains of physical activity (PA) in the United States (US) population have declined substantially over 5 decades. The prevalence of PI is very high worldwide, which has contributed to 6%–10% of the burden of many chronic diseases and premature mortality. Reduction or elimination of PI would likely produce substantial increases in life expectancy of the world's population. Great efforts are needed to reduce PI and SB and increase levels of PA in the US and worldwide.
Importance
Approximately 80% of US adults and adolescents are insufficiently active. Physical activity fosters normal growth and development and can make people feel, function, and sleep better and reduce risk of many chronic diseases.
Objective
To summarize key guidelines in the Physical Activity Guidelines for Americans, 2nd edition (PAG).
Process and Evidence Synthesis
The 2018 Physical Activity Guidelines Advisory Committee conducted a systematic review of the science supporting physical activity and health. The committee addressed 38 questions and 104 subquestions and graded the evidence based on consistency and quality of the research. Evidence graded as strong or moderate was the basis of the key guidelines. The Department of Health and Human Services (HHS) based the PAG on the 2018 Physical Activity Guidelines Advisory Committee Scientific Report.
Recommendations
The PAG provides information and guidance on the types and amounts of physical activity to improve a variety of health outcomes for multiple population groups. Preschool-aged children (3 through 5 years) should be physically active throughout the day to enhance growth and development. Children and adolescents aged 6 through 17 years should do 60 minutes or more of moderate-to-vigorous physical activity daily. Adults should do at least 150 minutes to 300 minutes a week of moderate-intensity, or 75 minutes to 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. They should also do muscle-strengthening activities on 2 or more days a week. Older adults should do multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities. Pregnant and postpartum women should do at least 150 minutes of moderate-intensity aerobic activity a week. Adults with chronic conditions or disabilities, who are able, should follow the key guidelines for adults and do both aerobic and muscle-strengthening activities. Recommendations emphasize that moving more and sitting less will benefit nearly everyone. Individuals performing the least physical activity benefit most by even modest increases in moderate-to-vigorous physical activity. Additional benefits occur with more physical activity. Both aerobic and muscle-strengthening physical activity are beneficial.
Conclusions and Relevance
The Physical Activity Guidelines for Americans, 2nd edition, provides information and guidance on the types and amounts of physical activity that provide substantial health benefits. Health professionals and policy makers should facilitate awareness of the guidelines and promote the health benefits of physical activity and support efforts to implement programs, practices, and policies to facilitate increased physical activity and to improve the health of the US population.
Physical inactivity is one of the leading modifiable risk factors for global mortality, with an estimated 20% to 30% increased risk of death compared with those who are physically active. The “behavior” of physical activity (PA) is multifactorial, including social, environmental, psychological, and genetic factors. Abundant scientific evidence has demonstrated that physically active people of all age groups and ethnicities have higher levels of cardiorespiratory fitness, health, and wellness, and a lower risk for developing several chronic medical illnesses, including cardiovascular disease, compared with those who are physically inactive. Although more intense and longer durations of PA correlate directly with improved outcomes, even small amounts of PA provide protective health benefits. In this state-of-the-art review, the authors focus on “healthy PA” with the emphasis on the pathophysiological effects of physical inactivity and PA on the cardiovascular system, mechanistic/triggering factors, the role of preventive actions through personal, education/environment, and societal/authoritative factors, as well as factors to provide guidance for caregivers of health promotion regarding PA. Sustainable and comprehensive programs to increase PA among all individuals need to be developed and implemented at local, regional, national, and international levels to effect positive changes and improve global health, especially the reduction of cardiovascular disease.
Background
The associations of social isolation and loneliness with premature mortality are well known, but the risk factors linking them remain unclear. We sought to identify risk factors that might explain the increased mortality in socially isolated and lonely individuals.
Methods
We used prospective follow-up data from the UK Biobank cohort study to assess self-reported isolation (a three-item scale) and loneliness (two questions). The main outcomes were all-cause and cause-specific mortality. We calculated the percentage of excess risk mediated by risk factors to assess the extent to which the associations of social isolation and loneliness with mortality were attributable to differences between isolated and lonely individuals and others in biological (body-mass index, systolic and diastolic blood pressure, and handgrip strength), behavioural (smoking, alcohol consumption, and physical activity), socioeconomic (education, neighbourhood deprivation, and household income), and psychological (depressive symptoms and cognitive capacity) risk factors.
Findings
466 901 men and women (mean age at baseline 56·5 years [SD 8·1]) were included in the analyses, with a mean follow-up of 6·5 years (SD 0·8). The hazard ratio for all-cause mortality for social isolation compared with no social isolation was 1·73 (95% CI 1·65–1·82) after adjustment for age, sex, ethnic origin, and chronic disease (ie, minimally adjusted), and was 1·26 (95% CI 1·20–1·33) after further adjustment for socioeconomic factors, health-related behaviours, depressive symptoms, biological factors, cognitive performance, and self-rated health (ie, fully adjusted). The minimally adjusted hazard ratio for mortality risk related to loneliness was 1·38 (95% CI 1·30–1·47), which reduced to 0·99 (95% CI 0·93–1·06) after full adjustment for baseline risks.
Interpretation
Isolated and lonely people are at increased risk of death. Health policies addressing risk factors such as adverse socioeconomic conditions, unhealthy lifestyle, and lower mental wellbeing might reduce excess mortality among the isolated and the lonely.
Funding
Academy of Finland, NordForsk, and the UK Medical Research Council.
Objectives: Social isolation is an increasing concern in older community-dwelling adults. There is growing need to determine effective interventions addressing social isolation. This study aimed to determine whether a relationship exists between physical activity (recreational and/or household-based) and social isolation. An examination was conducted for whether group- or home-based falls prevention exercise was associated with social isolation.
Methods: Cross-sectional analysis of telephone survey data was used to investigate relationships between physical activity, health, age, gender, living arrangements, ethnicity and participation in group- or home-based falls prevention exercise on social isolation. Univariable and multivariable ordered logistic regression analyses were conducted.
Results: Factors found to be significantly associated with reduced social isolation in multivariable analysis included living with a partner/spouse, reporting better general health, higher levels of household-based physical activity (OR = 1.03, CI = 1.01–1.05) and feeling less downhearted/depressed. Being more socially isolated was associated with symptoms of depression and a diagnosis of congestive heart failure (pseudo R² = 0.104).
Discussion: Findings suggest that household-based physical activity is related to social isolation in community-dwelling older adults. Further research is required to determine the nature of this relationship and to investigate the impact of group physical activity interventions on social isolation.
Background:
The pandemic of physical inactivity is associated with a range of chronic diseases and early deaths. Despite the well documented disease burden, the economic burden of physical inactivity remains unquantified at the global level. A better understanding of the economic burden could help to inform resource prioritisation and motivate efforts to increase levels of physical activity worldwide.
Methods:
Direct health-care costs, productivity losses, and disability-adjusted life-years (DALYs) attributable to physical inactivity were estimated with standardised methods and the best data available for 142 countries, representing 93·2% of the world's population. Direct health-care costs and DALYs were estimated for coronary heart disease, stroke, type 2 diabetes, breast cancer, and colon cancer attributable to physical inactivity. Productivity losses were estimated with a friction cost approach for physical inactivity related mortality. Analyses were based on national physical inactivity prevalence from available countries, and adjusted population attributable fractions (PAFs) associated with physical inactivity for each disease outcome and all-cause mortality.
Findings:
Conservatively estimated, physical inactivity cost health-care systems international (INT) 53·8 billion worldwide in 2013, of which 12·9 billion by the private sector, and 13·7 billion in productivity losses, and physical inactivity was responsible for 13·4 million DALYs worldwide. High-income countries bear a larger proportion of economic burden (80·8% of health-care costs and 60·4% of indirect costs), whereas low-income and middle-income countries have a larger proportion of the disease burden (75·0% of DALYs). Sensitivity analyses based on less conservative assumptions led to much higher estimates.
Interpretation:
In addition to morbidity and premature mortality, physical inactivity is responsible for a substantial economic burden. This paper provides further justification to prioritise promotion of regular physical activity worldwide as part of a comprehensive strategy to reduce non-communicable diseases.
Funding:
None.
With non-communicable conditions accounting for nearly two-thirds of deaths worldwide, the emergence of chronic diseases as the predominant challenge to global health is undisputed. In the USA, chronic diseases are the main causes of poor health, disability, and death, and account for most of health-care expenditures. The chronic disease burden in the USA largely results from a short list of risk factors-including tobacco use, poor diet and physical inactivity (both strongly associated with obesity), excessive alcohol consumption, uncontrolled high blood pressure, and hyperlipidaemia-that can be effectively addressed for individuals and populations. Increases in the burden of chronic diseases are attributable to incidence and prevalence of leading chronic conditions and risk factors (which occur individually and in combination), and population demographics, including ageing and health disparities. To effectively and equitably address the chronic disease burden, public health and health-care systems need to deploy integrated approaches that bundle strategies and interventions, address many risk factors and conditions simultaneously, create population-wide changes, help the population subgroups most affected, and rely on implementation by many sectors, including public-private partnerships and involvement from all stakeholders. To help to meet the chronic disease burden, the US Centers for Disease Control and Prevention (CDC) uses four cross-cutting strategies: (1) epidemiology and surveillance to monitor trends and inform programmes; (2) environmental approaches that promote health and support healthy behaviours; (3) health system interventions to improve the effective use of clinical and other preventive services; and (4) community resources linked to clinical services that sustain improved management of chronic conditions. Establishment of community conditions to support healthy behaviours and promote effective management of chronic conditions will deliver healthier students to schools, healthier workers to employers and businesses, and a healthier population to the health-care system. Collectively, these four strategies will prevent the occurrence of chronic diseases, foster early detection and slow disease progression in people with chronic conditions, reduce complications, support an improved quality of life, and reduce demand on the health-care system. Of crucial importance, with strengthened collaboration between the public health and health-care sectors, the health-care system better uses prevention and early detection services, and population health is improved and sustained by solidifying collaborations between communities and health-care providers. This collaborative approach will improve health equity by building communities that promote health rather than disease, have more accessible and direct care, and focus the health-care system on improving population health.
Social network analysis has been used to better understand the influence of friends and peer groups in a wide range of health behaviors. This systematic review synthesizes findings from various social network analyses of child and adolescent physical activity, to determine the extent to which social network structure is associated with physical activity behaviors.
Medical and social science databases were searched and screened between September and November 2011. Eligible studies collected a measure of physical activity and a measure of an individual's social network, either through friendship nominations or social ratings, and reported analyses investigating the association between physical activity and the social network measure.
A total of 1767 articles yielded nine publications from seven eligible studies, which were synthesized and analyzed in December 2011. Three research themes were identified: (1) friendship similarities in physical activity; (2) peer group influences on physical activity; and (3) social preference (i.e., popularity) and physical activity. Synthesis of findings across studies found strong evidence for similarities in physical activity levels between an individual and their friends and within peer groups. There was mixed evidence for an association between social preference and physical activity levels.
Friendship plays an important role in shaping physical activity behaviors. Physical activity interventions targeted at peer groups and that account for the influence of friendship groups might have utility as a means of increasing youth physical activity.
The present study sought to formulate a precise definition of sedentarism and to identify activities performed by active people that could serve as effective preventive goals.
A population-based sample of 919 residents of Geneva, Switzerland, aged 35 to 74 years, completed a 24-hour recall. Sedentary people were defined as those expending less than 10% of their daily energy in the performance of moderate- and high-intensity activities (at least 4 times the basal metabolism rate).
The rates of sedentarism were 79.5% in men and 87.2% in women. Among sedentary and active men, average daily energy expenditures were 2600 kcal (95% confidence interval [CI] = 2552, 2648) and 3226 kcal (95% CI = 3110, 3346), respectively; the corresponding averages for women were 2092 kcal (95% CI = 2064, 2120) and 2356 kcal (95% CI = 2274, 2440). The main moderate- and high-intensity activities among active people were sports (tennis, gymnastics, skiing), walking, climbing stairs, gardening, and (for men only) occupational activities.
The definition of sedentarism outlined in this article can be reproduced in other populations, allows comparisons across studies, and provides preventive guidelines in that the activities most frequently performed by active people are the ones most likely to be adopted by their sedentary peers.
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