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(1) Background: We investigated the effects of a 12-week exercise intervention with or without vitamin D supplementation on insulin resistance and the plasma lipidome of participants with type 2 diabetes. We further explored whether the effects of the intervention on glycemic parameters could be associated with the baseline lipidome. (2) Methods: Sixty-one participants were randomly allocated to control (Con), exercise (EX), vitamin D (VD), and EX + VD groups. Multiple glycemic and anthropometric parameters were evaluated before and after intervention. The homeostasis model assessment of insulin resistance (HOMA-IR) was the primary outcome. The plasma lipidome was analyzed before, after, and at an additional 12-week follow-up. Machine learning was applied to establish prediction models for responsiveness of glycemic control. (3) Results: Our interventions failed to improve the HOMA-IR index while fasting glucose was reduced in the EX + VD group (change%, −11.9%; effect size, 0.65; p < 0.05). Both EX and VD interventions altered the plasma lipidome, with EX + VD intervention considerably affecting levels of lyso-phosphatidylcholines and triglycerols containing long-chain unsaturated fatty acids. Such effects could last until 12 weeks after intervention. Notably, there was high inter-individual variability in glycemic parameters including HOMA-IR in response to the interventions, which could be predicted with great accuracy using an optimal panel of baseline lipid predictors alone or in combination with clinical indices, as assessed by an area under the receiver operating characteristic curve value of over 0.9. (4) Conclusions: Although substantial alterations were observed in the plasma lipidome related to glycemic control, our intervention failed to improve HOMA-IR scores, which may have been predominately due to the large inter-individual variability in responses. Basal plasma lipid levels could potentially predict an individual’s response to intervention, highlighting the necessity of personalized nutrition.

Myocardial fibrosis is a pathological phenomenon associated with cardiovascular disease (CVD) that plays a crucial role in the development of heart diseases. Vitamin D deficiency can promote the development of CVD and exercise plays a role in the treatment of CVD. This study aimed to explore the effects of 12-week aerobic exercise training on myocardial fibrosis in vitamin D-deficient mice. A vitamin D-deficient mouse model was induced by a vitamin D-deficient (0 IU Vitamin D3/kg) diet. Twenty-four C57BL/6J male mice were randomly divided into three groups: a control sedentary group (CONS, n = 8), a vitamin D-deficient sedentary group (VDDS, n = 8), and a vitamin D-deficient exercise group (VDDE, n = 8) which was aerobically trained for 12 weeks. The results showed that the serum 25-hydroxyvitamin D [25(OH)D] levels of the VDDS group were

The 2011 Compendium presents MET values for sedentary behaviors (SBs) and light-intensity physical activities (LIPAs). Some entries have estimated METs, others have multiple activities in a single entry, and newer activities are not in the Compendium. Accurate MET values are needed to increase the validity and generalizability of the Compendium. This study measured and analyzed SBs and LIPAs’ energy costs in reclining, sitting, standing postures, and fidgeting. Indirect calorimetry measured the energy costs (VO(2), ml·kg(−1.)min(−1)) in 11 males and seven females (30.7 ± 7.6 y). Two groups of 9 participants each completed 17 randomly assigned activities (9 in group 1; 8 in group 2) for 5 minutes with a 2-minute rest between tasks. Standard METs were calculated as VO(2) ml·kg(−1.)min(−1)/3.5 ml·kg(−1.)min(−1). Results showed mean MET values for doing nothing (recline: 1.3, sit: 1.3. stand: 1.3); Watching TV on a mobile phone (recline: 1.3, sit: 1.3); Reading (recline; 1.5, sit: 1.0); Writing (recline: 1.5, sit: 1.3, stand: 1.3); Texting or viewing websites on a mobile phone (recline: 1.3, sit: 1.3, stand: 1.3); Fidgeting (sit hands only: 1.5, sit feet only: 1.8, stand hands and feet: 2.0); Typing (stand: 1.3). Measured vs. Compendium METs were the same for five SBs and LIPAs, higher for three SBs and LIPAs (by 0.2 METs), and lower for one SB (by 0.3 METs). In conclusion, the activities ranged from 1.0 to 2.0 METs, categorized as sedentary and light-intensity. Increasing the accuracy of Compendium MET values increases its utility for the correct classification of SB and LIPAs.

Highlights • This study provides the prevalence estimates of physical activity, sedentary behavior, and sleep duration (isolation and combination) in a nationally representative sample (n = 114,072) of Chinese children and adolescents of grades 4–12. • Only about 5% of Chinese children and adolescents show the most ideal combination of 24-h movement behaviors. • Chinese children and adolescents with younger ages, higher parental education levels, and higher family incomes exhibit favorable 24-h movement behaviors. • Chinese children and adolescents with the most ideal 24-h movement behaviors have lower risks of overweight and obesity, especially in children of grades 4–6 and girls of grades 7–9., Background Meeting 24-h movement guidelines by children and adolescents has been associated with improved indicators of health, although it has been under-studied in China. Hence, this study aimed to investigate the prevalence of meeting the 24-h movement guidelines, its correlates, and its relationships with body mass index in children and adolescents in China. Methods Cross-sectional data from the 2017 Youth Study in China of 114,072 children and adolescents (mean age = 13.75 years, 49.18% boys) were used. Meeting 24-h movement guidelines (≥60 min of daily moderate-to-vigorous physical activity, ≤2 h of daily leisure screen time, 9–11 h and 8–10 h nightly sleep duration for 6–13-year-olds and 14–17-year-olds, respectively) and height and weight of all participants were assessed. The prevalence of meeting the 24-h movement guidelines and World Health Organization weight status categories were determined. Generalized linear models were used to determine the correlates of meeting the 24-h movement guidelines and the relationships of meeting the 24-h movement guidelines with overweight (OW) and obesity (OB). Results Only 5.12% of Chinese children and adolescents met the 24-h movement guidelines, and 22.44% were classified as OW/OB. Older children and adolescents were less likely to meet the 24-h movement guidelines. Parental education level and family income were positively related to meeting the 24-h movement guidelines. Children and adolescents meeting the 24-h movement guidelines showed lower odds ratios for OW/OB. Compared with participants meeting the 24-h movement guidelines, boys in 4th–6th grades met none of the recommendations (OR = 1.22, 95%CI: 1.06–1.40), met the screen time recommendation only (OR = 1.13, 95%CI: 1.01–1.28), met the nightly sleep duration recommendation only (OR = 1.14, 95%CI: 1.03–1.28), and had significantly higher odds ratios for OW/OB. Similar trends were observed for girls in 4th–6th grades: meeting none of the guidelines (OR = 1.35, 95%CI: 1.14–1.59), meeting sleep duration guidelines only (OR = 1.23, 95%CI: 1.08–1.39), and meeting moderate-to-vigorous physical activity + nightly sleep duration guidelines (OR = 1.24, 95%CI: 1.01–1.54). For girls in 7th–9th grades, the following trend was observed: meeting none of the guidelines (OR = 1.30, 95%CI: 1.01–1.67). Conclusion Very few Chinese children and adolescents met the 24-h movement guidelines. Age (negatively correlated), parental education level, and family income (both positively correlated) were correlates of meeting the 24-h movement guidelines. Children and adolescents meeting the 24-h movement guidelines were more likely to have lower risks for OW/OB, especially in the youngest age group (Grades 4–6); and girls in the middle age group (Grades 7–9) were also more likely to have lower risks for OW/OB. Further research studies should explore additional correlates and determinants for meeting the 24-h movement guidelines. Also, future studies should use longitudinal or interventional designs to determine the relationships between meeting the 24-h movement guidelines and OW/OB and other health indicators, while taking sex and age differences into account., Graphic Abstract Image, graphical abstract

Objectives: To examine compensatory changes of different exercise durations on non-exercise physical activity (NEPA), appetite, and energy intake (EI) in normal and overweight adults, and to determine if different body mass index of individuals interact with these compensatory effects.Methods: Ten normal weight adults (nine females and one male; age: 24.0 ± 0.4 years; BMI: 20.7 ± 0.5 kg/m2) and ten overweight adults (six females and four males; age: 24.5 ± 0.9 years; BMI: 25.9 ± 0.4 kg/m2) participated in this study. The participants completed two exercise trials: short-duration continuous training (SDCT) and long-duration continuous training (LDCT), i.e., a 40 min short-duration and an 80 min long-duration continuous training in a randomized order. Total physical activity and NEPA were monitored using an accelerometer for seven consecutive days, which involved a two-day baseline observation period (C-pre-Ex), three-day exercise intervention period (Ex), and two-day follow-up period (C-post-Ex). Blood samples were collected for appetite-related hormone analysis. Appetite score was assessed using the visual analogue scale. Energy intake was evaluated by weighing the food and recording diaries.Results: The NEPA evaluation showed that it was higher for SDCT than for LDCT in the C-post-Ex period (F (1, 19) = 8.508, p = 0.009) in the total sample. Moreover, results also indicated that NEPA was lower for LDCT (F (2, 18) = 6.316, p = 0.020) and higher for SDCT (F (2, 18) = 3.889, p = 0.026) in the C-post-Ex period than in the C-pre-Ex and Ex periods in overweight group. Acyl-ghrelin revealed a main effect of time in the total sample and in normal weight and overweight groups; it was lower in the C-post-Ex period than in the C-pre-Ex and Ex periods (all p < 0.05). Total EI analysis revealed no significant changes in either the total sample or in the normal weight and overweight groups.Conclusion: These findings demonstrate that short duration exercise led to a compensatory increment in NEPA, whereas long duration exercise induced a compensatory decrease in NEPA. Moreover, there was a higher and delayed compensatory response in overweight adults than in normal weight adults. Nevertheless, energy intake was not changed across time, regardless of exercise duration.

Background The associations between various kinds of parental support and children and adolescents’ physical activity (PA) are inconclusive. This study aimed 1) to examine the associations between various kinds of parental support and children and adolescents’ moderate-to-vigorous physical activity (MVPA), and 2) to examine gender and age differences in the association between each specific kind of parental support and MVPA. Methods Using a multi-stage stratified and random cluster sampling method, 711 schools in Shanghai were selected (data were collected from October 2014 to February 2015). In total, 61,429 school-aged children (6–18 years old, 50.7% boys) and their parents were included. Self-reported questionnaires were used to measure sociodemographic characteristics, MVPA and various kinds of parental support, including parental encouragement (PAEN), parental involvement (PAIV), parental financial support (PAFS) and, parental modeling (PAMD). Descriptive statistics and Chi-square were used to report the level of MVPA and its difference across various kinds of parental support by gender groups. The logistic regression analysis was used to examine the associations between parental support and MVPA with odds ratios (ORs) and 95% confidence intervals (CIs). Results Overall, 19.4% of children and adolescents accumulated MVPA at least 60 min/day. Boys were more physically active than girls (21.4% > 17.4%, p Conclusions Less than one fifth of children and adolescents accumulated 60 min MVPA per day. Various kinds of parental support have important effects on children and adolescents’ MVPA, which varied by gender and grades. PAMD, in particular, should be emphasized more than PAEN, PAIV and PAFS in family-based interventions aiming at increasing PA in the future.

PurposeTo assess the acute effect of pre-sleep protein supplementation combined with resistance exercise on energy metabolism (including 24-h total energy expenditure (TEE), sleep energy expenditure (SEE), basal energy expenditure (BEE), glycolipid oxidation, and appetite of sedentary adults.MethodsA total of thirty-one sedentary participants completed this randomized, double-blind, crossover study. Participants completed the following 24-h experimental conditions in random order in the Human Calorimeter chamber: (1) 40-g protein supplementation with dinner before a nighttime resistance exercise, and followed by pre-sleep placebo intake (PRO-PLA); (2) placebo intake with dinner before a nighttime resistance exercise, and followed by pre-sleep 40-g protein supplementation (PLA-PRO); and (3) placebo supplementation both with dinner and pre-sleep combined with a nighttime resistance exercise (PLA). Subjective appetite score before breakfast the next day was evaluated using the visual analog scale.ResultsThe SEE values were significantly higher by a mean of 21.7 kcal and 33.3 kcal in PRO-PLA (318.3 ± 44.3 kcal) and PLA-PRO (329.9 ± 45.2 kcal), respectively, than in PLA (296.6 ± 46.6 kcal). In addition, the SEE values for PLA-PRO was also significantly higher by 11.6 kcal than that for PRO-PLA. Further, the fullness the next morning was significantly higher by 30.8% in PLA-PRO (43.9 ± 23.5 mm) than in PLA (33.5 ± 26.6 mm). These effects remained after adjustment for 24-h energy intake.ConclusionPre-sleep protein supplementation combined with resistance exercise can significantly increase the SEE and fullness in the next morning, indicating a possible strategy to improve sleep energy metabolism in the sedentary population.

Background: The 2011 Compendium of Physical Activities provides metabolic equivalent (MET) values for household and eldercare activities (physical activities [PAs]). METs are from published studies, estimated if values are not published, or combined with other PAs with different METs in a single entry. Some PAs are missing from the Compendium. This study measures the energy costs for 15 household and eldercare PAs with estimated METs, PAs in combined entries, and new PAs. Methods: Participants were 30 adults (14 males and 16 females), ages 22–58 years (33.7 [11.2] y). PAs were measured in a laboratory for 8 minutes with a 4-minute rest between PAs. A portable indirect calorimeter measured oxygen uptake (in milliliters per kilogram per minute). Standard METs were computed as activity VO2/3.5 mL·kg−1·min−1. Results: Cooking, meal tasks, laundry, light cleaning, and watering plants ranged from 1.8 to 2.3 METs. Sweeping, walking, and carrying groceries and boxes on the ground and stairs ranged from 3.0 to 5.5 METs. Eldercare ranged from 1.8 to 3.0 METs. Measured METs differed from estimated values by ±0.3 to 2.2 METs. Most measured METs were lower than estimated METs. Conclusion: Updating estimated METs with measured values and separating PAs from combined entries increases the accuracy of household and eldercare PAs presented in the Compendium.

PURPOSE This study aimed to determine whether interrupting prolonged sitting with three different walking-bout schedules improves glycemic metabolism relative to continuous prolonged sitting in sedentary adults. METHODS In a randomized, crossover trial, 16 inactive healthy adults (7 men, 24 ± 3 yr old) completed four 26-h laboratory sessions, including 22.5 h in an energy expenditure (EE)-testing calorimeter chamber. The four 9-h intervention periods were as follows: 9-h uninterrupted sitting (SIT), 30-min sitting/3-min brisk (60% V˙O2max) treadmill walk (WALK3), 45-min sitting/5-min (WALK5), or 60-min sitting/8-min (WALK8). Coprimary outcomes included the difference in the mean interstitial glucose concentration, total area under the curve (tAUC), and incremental area under the curve (iAUC) for the entire 26 and 9 h (intervention period) during three activity-bout conditions compared with SIT. RESULTS Compared with SIT, the 26-h mean glucose concentration was attenuated in WALK8 (Δmean -0.22 mmol·L [95% confidence interval = -0.43 to -0.001], P = 0.048) without adjustment for EE and attenuated in WALK3 (Δ-0.47 mmol·L [-0.75 to -0.10]), WALK5 (Δ-0.47 mmol·L [-0.83 to -0.10]), and WALK8 (Δ-0.53 mmol·L [-0.92 to -0.13]) after adjustment for EE (all P < 0.01). The 26-h tAUC was reduced in WALK3 (Δ-11.18 mmol·L per 26 h [-20.07 to -2.29]), WALK5 (2.12.67 mmol·L per 26 h [-22.54 to -2.79]), and WALK8 (Δ-13.85 mmol·L per 26 h [-24.60 to -3.10]) (all P < 0.01), as well as the iAUC (all P < 0.05), only after adjustment for EE. The 9-h mean glucose concentration, tAUC, and iAUC decreased in the three activity-break conditions regardless of EE adjustment (all P < 0.05). CONCLUSIONS All three walking-bout conditions improved glycemic metabolism compared with SIT, independent of EE, in inactive, healthy adults.

Background We examined the correlations between living arrangement and the physical activity (PA) levels of youth aged 9–19 years while accounting for demographic factors such as age, sex, and socioeconomic status in Shanghai, China. Methods Cross-sectional analyses of data from the 2014 Physical Activity and Fitness in Shanghai China—The Youth Study was conducted. Participants were 33,213 primary (9–11-year-olds; n = 13,237), junior middle (12–14-year-olds; n = 11,157), and junior high school students (15–19-year-olds; n = 8819). Youth (boys = 49%) and their guardians were randomly sampled from 17 districts in Shanghai, China. Youths’ moderate-to-vigorous PA (MVPA) levels, information about living arrangement, and guardians’ sociodemographic factors were collected via questionnaires. Results Only 17.8% of school-aged youths in Shanghai met MVPA recommendations, with significantly more boys (20.6%) meeting recommendations than girls (p

Background Although approximately 50% of Chinese with type 2 diabetes mellitus (T2DM) patients have vitamin D deficiency, studies regarding vitamin D supplementation on insulin resistance (IR) have mainly focused on non-Asians. Endurance exercise training (ET) enhances insulin-mediated glucose metabolism, which plays a critical role in T2DM prevention and control. However, the combined effects of vitamin D supplementation and ET on IR in T2DM patients are unclear. The objectives of this study is to investigate the synergistic effect of vitamin D supplementation combined with exercise training intervention on IR in T2DM patients. Methods and analysis We propose a 3-month randomized controlled trial among 60 T2DM patients aged 40–65, newly diagnosed with T2DM ≤ 1 year, and with stable HbA1c level (≤ 8.0%) in the past 3 months. The participants will be randomly allocated to the vitamin D group, vitamin D combined with exercise training group, exercise training group, and control group (CG) using a computer-generated random number sequence. At baseline, participants will undergo a medical review, anthropometric measurements, dual X-ray absorptiometry, a 75-g oral glucose tolerance test (OGTT), ankle-brachial index measurements, and physical fitness measurements and will complete related lifestyle questionnaires. Fasting blood lipid and glucose levels were also measured. In a 3-month intervention period, vitamin D intervention group will receive a dose of 1000 IU daily; exercise group will perform a 1-h endurance exercise 3 times per week (maximal heart rate, 60–80%), and the control group will receive apparently identical tablets. Additionally, all participants will be advised to maintain their normal diet and physical activities during the intervention. All measurements will be repeated at 3-month follow-up after the intervention with the primary outcome measure expressed as a change from baseline in insulin sensitivity and secretion. Secondary outcome measures will compare the changes in anthropometry, ankle-brachial index, and physical fitness factors (e.g., peak oxygen uptake, hand grip strength). Data will be managed and analyzed using the Statistical Package for the Social Sciences. Discussion This is the first study to conduct a randomized trial to clearly determine the independent and combined effects of vitamin D supplementation and endurance exercise trial on IR in Chinese T2DM patients as measured by OGTT. The findings from the proposed study will not only provide new evidences that vitamin D supplementation plays an important role in IR management but also develop a simple and efficient method to improve IR-associated metabolic diseases for T2DM patients. Trial registration Chinese Clinical Trial Registry ChiCTR1800015383, Registered on 28 March 2018

Vitamin D deficiency has become a widespread public health problem owing to its potential adverse health effects. Generally, the nutritional status of vitamin D depends on sunlight exposure and dietary or supplementary intake. However, recent studies have found that exercise can influence circulating 25(OH)D levels; although, the results have been inconclusive. In this review, we focused on the effect of exercise on circulating vitamin D metabolites and their possible mechanisms. We found that endurance exercise can significantly increase serum 25(OH)D levels in vitamin D-deficient people but has no significant effect on vitamin D-sufficient people. This benefit has not been observed with resistance training. Only chronic endurance exercise training can significantly increase serum 1,25(OH)2D, and the effect may be sex-dependent. Exercise may influence 25(OH)D levels in the circulation by regulating either the vitamin D metabolites stored in tissues or the utilization by target tissues. The effects of exercise on 25(OH)D levels in the circulation may be dependent on many factors, such as the vitamin D nutritional status, exercise type and intensity, and sex. Therefore, further research on the effects and mechanisms of exercise on vitamin D metabolites is required.

To determine whether interrupting prolonged sitting with three different activity breaks has both acute and chronic effects on postprandial lipid metabolism immediately after the activity-break period and on the following day, this study is a secondary analysis of an experimental research, which included 16 sedentary healthy adults (7 men, 24 ± 3 years, BMI 22.2 ± 2.3 kg/m2 ) who completed four 26-h laboratory trials. Participants spent 22.5 hours in a whole room calorimeter for testing energy expenditure (EE), including a 9-h activity-break period: (a) 9-h prolonged sitting (SIT); (b) 3 minutes of brisk walking (60% VO2max ) in between every 30-min sitting bout (WALK3), (c) 5 minutes every 45-min (WALK5), and (d) 8 minutes every 60-min (WALK8). Total area under the curve (tAUC) and incremental AUC (iAUC) for 2-h postprandial serum triglyceride (TG) levels and non-esterified fatty acid (NEFA) levels were examined immediately after the 9-h trial (post-dinner) and the next morning (post-breakfast). WALK8 reduced the post-breakfast TG tAUC by 11% (P = .041) relative to SIT, and the effect was attenuated after adjustment for EE. The tAUC and iAUC indicated no significant treatment effects on post-dinner TG and NEFA, and post-breakfast NEFA in any of the activity-break trials. EE was positively associated with the post-breakfast NEFA iAUC (unstandardized β = 0.17 µmol/L/MJ [0.05-0.28], P = .006). There was a chronic effect of interrupting sitting with short bouts (8 minutes) of brisk walking every 60 minutes on postprandial lipemia the following morning after intervention, and higher activity bout-induced EE may be more effective in sedentary, healthy adults.

Background Previous studies indicated that serum 25-hydroxyvitamin D [25(OH)D] concentrations are positively associated with physical activity levels independent of sun exposure. However, the effect of resistance training on serum 25(OH) D concentrations remains unclear. Thus, this study aimed to examine the effect of chronic resistance training on serum 25(OH) D concentrations and determine whether 25(OH) D concentration variations are influenced by body composition changes. Methods Eighteen young men aged 19–39 years were randomly divided into a 12-week resistance training group (RT, n = 9) and non-exercise control group (CON, n = 9). The trial was undertaken in Shanghai University of Sport in Shanghai, China. Randomization and allocation to trial group were carried out by a central computer system. Serum 25(OH) D and intact parathyroid hormone concentrations were measured using commercially available enzyme-linked immunosorbent assay kits. Body composition was measured by dual-energy X-ray absorptiometry. Results The average serum 25(OH) D concentrations were 26.6 nmol/L at baseline. After the 12-week intervention program, serum 25(OH) D concentrations significantly increased in both groups. Serum 25(OH) D concentrations at midpoint (6-week) increased significantly only in the CON group (P r = − 0.565, P = 0.015) and muscle mass (mid-pre) (r = − 0.554, P = 0.017). Conclusions There were no beneficial effects of the 12-week resistance training on serum 25(OH) D concentration in vitamin D deficient young men, and an indication that seasonal increase in serum 25(OH) D concentrations during the early phase of resistance training was transiently inhibited, which may partly be attributed to resistance training-induced muscle mass gain. Trial registration Chinese Clinical Trial Registry, ChiCTR2000030876. Registered 16 March 2020 - Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=50504.

Purpose This study was to present national estimates of participating in moderate-to-vigorous physical activity (MVPA) and adherence to the recommendations of 60 min/day of MVPA among Chinese school-aged children and to assess demographic differences in MVPA. Methods Cross-sectional analyses of data from the 2016 Physical Activity and Fitness in China—The Youth Study. Participants were 90,712 primary, junior middle, and junior high school children (boy: 47%; girl: 53%), recruited from 1204 rural and urban schools across 32 administrative provinces and regions in the Mainland of China. Main outcomes were (a) average MVPA minutes per day in the previous 7 days by self-reports and (b) percentage meeting MVPA recommendations. Results Average MVPA time was 45.4 min/day, with boys having more MVPA (47.2 min/day) than girls (43.7 min/day) overall and across the 3 school grade categories. About 30% of participants met MVPA recommendations, with a higher percentage of boys (32%) than girls (28%) overall and across the 3 grades categories. Urban school children outperformed rural children in terms of MVPA time. Overall, boys were more likely to meet MVPA recommendations (adjusted odds ratio (aOR) = 1.19, 95% confidence interval (CI): 1.16–1.22) compared with girls; children in higher grades (junior middle (aOR = 0.92, 95%CI: 0.87–0.98) and junior high (aOR = 0.59, 95%CI: 0.53–0.66)) were less likely to meet recommendations compared with primary school children. The odds of meeting recommendations did not differ between urban and rural children ( p = 0.07), but urban boys were found to be more likely to meet recommendations compared with rural boys (aOR = 1.14, 95%CI: 1.06–1.19). Conclusion Overall, the average MVPA minutes per day among Chinese school-aged children is low, and less than one-third of them meet MVPA recommendations. These results were most evident among junior middle and junior high school children and those living rural areas.

Higher levels of physical activity and cardiorespiratory fitness are positively related to serum 25-hydroxyvitamin D [25(OH)D] concentrations; however, the response of 25(OH)D concentrations to chronic endurance exercise training is unclear. Therefore, the purpose of this study was to elucidate whether serum 25(OH)D concentrations were directly increased by 5 weeks of endurance exercise training and influenced by changes in body fat in elderly men. Twenty elderly Japanese men were randomized to either the 5-week endurance exercise training group (ET group; N = 10) or the sedentary control group (SC group; N = 10). Fasting blood samples were collected to determine serum 25(OH)D and other blood parameters. The visceral fat area and hepatic fat content were assessed by magnetic resonance imaging and proton magnetic resonance spectroscopy, respectively. After 5 weeks of endurance exercise training, the levels of maximal oxygen uptake (VO2 max) were significantly increased from 23.3 at baseline to 28.1 mL/kg/min at the endpoint for the ET group; levels were unchanged for the SC group. A significant seasonal reduction in serum 25(OH)D concentrations was observed in the SC group (P

ContextRegular exercise or high physical activity levels are associated with higher serum 25-hydroxyvitamin D [25(OH)D] concentrations; however, the effect of acute exercise on serum 25(OH)D concentrations remains unclear.ObjectiveWe aimed to clarify whether acute endurance exercise has a direct effect on the circulating 25(OH)D concentrations in young adults.Design and SettingExercise intervention trial in an institutional practice.PatientsTwenty young, active adults (males, n = 10; females, n = 10).InterventionsParticipants were asked to perform a cycling exercise for 30 minutes at 70% maximal oxygen uptake.Main Outcome MeasuresThe serum concentrations of 25(OH)D and other blood parameters were assessed before exercise and at 0, 0.5, 1, 3, and 24 hours after exercise.ResultsThe serum 25(OH)D concentrations were significantly increased not only at 0 (P < 0.01), 1 (P < 0.05), and 3 hours (P < 0.01) after exercise, but they were also increased at 24 hours (P < 0.05) after acute endurance exercise in young adults. A significant sex × time interaction effect was observed (P < 0.05), and the incremental areas under the curve for the 25(OH)D concentrations were significantly higher in men than in the women (P < 0.01).ConclusionsThere is a direct effect of endurance exercise on serum 25(OH)D concentrations. In addition, sex disparity was observed in the serum 25(OH)D response to acute endurance exercise, and the increase in 25(OH)D concentrations was greater in men than in women.

Background The rapid advancements in science and technology of wrist-wearable activity devices offer considerable potential for clinical applications. Self-monitoring of physical activity (PA) with activity devices is helpful to improve the PA levels of adolescents. However, knowing the accuracy of activity devices in adolescents is necessary to identify current levels of PA and assess the effectiveness of intervention programs designed to increase PA. Objective The study aimed to determine the validity of the 11 commercially available wrist-wearable activity devices for monitoring total steps and total 24-hour total energy expenditure (TEE) in healthy adolescents under simulated free-living conditions. Methods Nineteen (10 male and 9 female) participants aged 14 to 18 years performed a 24-hour activity cycle in a metabolic chamber. Each participant simultaneously wore 11 commercial wrist-wearable activity devices (Mi Band 2 [XiaoMi], B2 [Huawei], Bong 2s [Meizu], Amazfit [Huamei], Flex [Fitbit], UP3 [Jawbone], Shine 2 [Misfit], GOLiFE Care-X [GoYourLife], Pulse O2 [Withings], Vivofit [Garmin], and Loop [Polar Electro]) and one research-based triaxial accelerometer (GT3X+ [ActiGraph]). Criterion measures were total EE from the metabolic chamber (mcTEE) and total steps from the GT3X+ (AGsteps). Results Pearson correlation coefficients r for 24-hour TEE ranged from .78 (Shine 2, Amazfit) to .96 (Loop) and for steps ranged from 0.20 (GOLiFE) to 0.57 (Vivofit). Mean absolute percent error (MAPE) for TEE ranged from 5.7% (Mi Band 2) to 26.4% (Amazfit) and for steps ranged from 14.2% (Bong 2s) to 27.6% (Loop). TEE estimates from the Mi Band 2, UP3, Vivofit, and Bong 2s were equivalent to mcTEE. Total steps from the Bong 2s were equivalent to AGsteps. Conclusions Overall, the Bong 2s had the best accuracy for estimating TEE and total steps under simulated free-living conditions. Further research is needed to examine the validity of these devices in different types of physical activities under real-world conditions.

BACKGROUND The rapid advancements in science and technology of wrist-wearable activity devices offer considerable potential for clinical applications. Self-monitoring of physical activity (PA) with activity devices is helpful to improve the PA levels of adolescents. However, knowing the accuracy of activity devices in adolescents is necessary to identify current levels of PA and assess the effectiveness of intervention programs designed to increase PA. OBJECTIVE The study aimed to determine the validity of the 11 commercially available wrist-wearable activity devices for monitoring total steps and total 24-hour total energy expenditure (TEE) in healthy adolescents under simulated free-living conditions. METHODS Nineteen (10 male and 9 female) participants aged 14 to 18 years performed a 24-hour activity cycle in a metabolic chamber. Each participant simultaneously wore 11 commercial wrist-wearable activity devices (Mi Band 2 [XiaoMi], B2 [Huawei], Bong 2s [Meizu], Amazfit [Huamei], Flex [Fitbit], UP3 [Jawbone], Shine 2 [Misfit], GOLiFE Care-X [GoYourLife], Pulse O2 [Withings], Vivofit [Garmin], and Loop [Polar Electro]) and one research-based triaxial accelerometer (GT3X+ [ActiGraph]). Criterion measures were total EE from the metabolic chamber (mcTEE) and total steps from the GT3X+ (AGsteps). RESULTS Pearson correlation coefficients r for 24-hour TEE ranged from .78 (Shine 2, Amazfit) to .96 (Loop) and for steps ranged from 0.20 (GOLiFE) to 0.57 (Vivofit). Mean absolute percent error (MAPE) for TEE ranged from 5.7% (Mi Band 2) to 26.4% (Amazfit) and for steps ranged from 14.2% (Bong 2s) to 27.6% (Loop). TEE estimates from the Mi Band 2, UP3, Vivofit, and Bong 2s were equivalent to mcTEE. Total steps from the Bong 2s were equivalent to AGsteps. CONCLUSIONS Overall, the Bong 2s had the best accuracy for estimating TEE and total steps under simulated free-living conditions. Further research is needed to examine the validity of these devices in different types of physical activities under real-world conditions.

The aim of this study is (a) to develop, test, and employ a combined method of unsupervised machine learning to objectively assess the condition of sports facility in primary schools (PSSFC) and (b) examine the examine the geographical and typological association with PSSFC. Based on the Sixth National Sports Facility Census (NSFC), six PSSFC indicators (indoor and outdoor facility included) were selected as the measurements and decomposed by using the t-stochastic neighbor embedding (t-SNE). Thereafter, the Fuzzy C-mean (FCM) algorithm was used to cluster the same type of PSSFC with selecting the optimum numbers of evaluation level. Overall 845 primary schools in Shanghai, China were recruited and tested by this combined approach of unsupervised machine learning. In addition, the two-way analysis of covariance was used to examine the location and types of school associated with PSSFC variables in each level. The combined method was found to have acceptable reliability and good interpretability, differentiating PSSFC into five gradient levels. The characteristics of PSSFC differ by the location and school type of individual school. Our findings are conducive to the regionalized and personalized intervention and promotion on the children’s physical activity (PA) upon the practical situation of particular schools.

The studies investigated the association between serum 25-hydroxyvitamin D (25(OH)D) concentrations and cardiorespiratory fitness (CRF) are few, and the results are controversial. We aim to evaluate the association of serum 25(OH)D concentrations with CRF in adults, and assess whether the associations vary with ageing.The study included 78 middle-aged (30-64 years) and 83 elderly (65-79 years) Japanese men. Hand grip strength and leg extension power were measured using hand grip and leg dynamometers, respectively. CRF was measured via a maximal graded exercise test and quantified as the peak oxygen uptake (VO2peak). Fasting serum 25(OH)D concentrations were determined by enzyme-linked immunosorbant assay.Serum 25(OH)D concentrations were positively related to hand grip strength (r=0.331, p0.001), leg extension power (r=0.353, p0.001), CRF (r=0.285, p0.001) in all adults after adjustment for age. Significant interaction between 25(OH)D and age on CRF was observed (p0.05). Age-related reduction of CRF was prevented in high 25(OH)D group (p0.05). In the elderly, subjects in high 25(OH)D group had higher CRF compared with those in low group (p0.05).We found that serum 25(OH)D concentrations significantly related with leg extension power, hand grip strength and CRF after adjustment for age. The relationship of vitamin D and CRF was affected by ageing. Higher serum 25(OH)D concentrations are a key predictor for CRF in the elderly, but not in middle-aged men.

Introduction: This study aimed to clarify whether 1 year of vitamin D3 supplementation has a direct effect on body composition and physical fitness in healthy adults. Methods: Ninety-five participants randomly received either 420 IU vitamin D3 per day (n = 48) or placebo (n = 47) in a double-blind manner for 1 year. Lean body mass and percentage body fat were determined. Physical fitness including hand grip strength, leg extension power and cardiorespiratory fitness (CRF) were assessed. Serum 25-hydroxyvitamin D (25[OH]D) and 1,25-dihydroxyvitamin D (1,25[OH]2D) concentrations were assessed using ELISA kits. Results: Serum 25(OH)D and (1,25[OH]2D) concentrations significantly increased by approximately 11.2 ± 9.2 ng/mL (pinteraction pinteraction 3 supplementation respectively. Lean body mass significantly increased from 43.8 ± 9.6 to 44.3 ± 9.8 kg in vitamin D group, while no change was observed in placebo group (from 42.6 ± 8.9 to 42.4± 8.9 kg) after 1 year intervention. Furthermore, no treatment effects on other indicators of body composition and physical fitness were observed. Conclusions:One year of vitamin D supplementation effectively improves lean body mass, but not muscle strength and CRF in healthy adults.

Low serum 25-hydroxyvitamin D [25(OH)D] concentrations are associated with a high risk of insulin resistance and Type 2 diabetes mellitus in adults. However, it is unknown whether this is the case for American collegiate football and rugby football athletes. This study investigated the associations between serum 25(OH)D concentrations and glucose profiles in male collegiate football athletes. Thirty-four collegiate athletes (13 American football players and 21 rugby football players) aged 21 years were recruited. Their body fat percent and visceral fat area were measured by dual-energy X-ray absorptiometry and magnetic resonance imaging, respectively. The participants completed an oral glucose tolerance test (75 g glucose) with venous blood samples obtained at time points 0, 30, 60, 90, and 120 min for the determination of plasma glucose and serum insulin concentrations. Fasting serum 25(OH)D concentrations were also measured. The prevalence of vitamin D deficiency and insufficiency was 17.6% and 58.8%, respectively. The serum 25(OH)D concentrations were negatively associated with the increments in the areas under the curve (iAUC) for glucose (r = −.429, p = .011) and were borderline significantly correlated with the Matsuda index (r = −.303, p = .082). No relationships were observed between the serum 25(OH)D concentrations and other glucose profiles. Multiple stepwise regression analysis of glucose iAUC concentrations as the dependent variable indicated that the serum 25(OH)D concentrations, but not body fat indicators, were independently associated with glucose iAUC (β = −0.390, p = .025). The serum 25(OH)D concentrations were only an independent predictor for glucose iAUC in male collegiate football athletes, suggesting that increased 25(OH)D concentrations would be helpful for maintaining glucose homeostasis.

Background There is limited evidence for the prevalence of the co-existence of physical activity (PA) and sedentary behavior (SED), and its correlates among children and adolescents. This study has two aims: 1) to investigate the prevalence of PA and SED, and their co-existence, and 2) to examine the associations between PA or SED, or both with gender and age among children and adolescents in Shanghai, China. Methods Using a cross-sectional study design (conducted from September to December 2014), 50,090 children and adolescents (10–18 years old, 50.4% boys) were included in this study. A self-reporting questionnaire was used to measure participants’ sociodemographic characteristics, PA, and SED. Descriptive statistics were used to describe sample characteristics, the prevalence of PA and SED, and their co-existence. A Generalized Linear Model was conducted to explore the associations between the prevalence of PA and SED, and their co-existence with gender and age separately. Results Of the children and adolescents studied, only 18.4% met the guidelines for PA, 25.5% met the guidelines for SED, and 5.7% met the guidelines for both. Boys were more physically active (aOR = 1.43, 95% CI: 1.36–1.50), and girls were less sedentary (aOR = 1.29, 95%CI: 1.24–1.34). The prevalence of PA, SED, or both all declined as age increased (p

This study aimed to compare the accuracy for predicting body composition using single-frequent segmental bioelectrical impedance analysis (BIA) between pre- and postmenopausal women. A total f 559 Japanese women aged 30-88yr were divided into 4 groups by questionnaire: natural menopause, pathological menopause, regular menstruation, or irregular menstruation. The measurement values by dual-energy X-ray absorptiometry were used as a reference of the body composition. In terms of the results, regardless of the menopausal status, BIA slightly but significantly overestimated the percentage of body fat (standard error of estimate: 5.3%-6.7%) and the leg lean soft tissue mass (LSTM; 5.1%-6.1%), and underestimated the LSTM in the whole body (6.2%-7.6%) and arm (2.8%-3.7%). The absolute values of the predictive error for leg LSTM were significantly higher in postmenopausal groups than in the premenopausal ones. The corresponding values for the whole body and arm LSTM, and the percentage of body fat were higher in premenopausal groups than in postmenopausal ones. In conclusion, the predictive accuracy of BIA for postmenopausal women is not inferior to that for premenopausal ones, unless we target the leg LSTM.

Low circulating 25-hydroxyvitamin D [25(OH)D] concentration has been linked to a high prevalence of cardiovascular disease. One explanation for this phenomenon is that there is an association between the serum 25(OH)D level and lipid profiles. However, studies examining this relationship are limited and have yielded inconsistent results. We thus aimed to evaluate the association between the serum 25(OH)D concentration and lipid profiles in Japanese men taking into consideration confounding factors, including the visceral fat area (VFA) and cardiorespiratory fitness.A total of 136 men (age range: 20-79 years) participated in our study. Fasting blood samples were analyzed to determine the 25(OH)D, oxidized low-density lipoprotein (oxLDL), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), apolipoprotein (Apo)A-1 and ApoB levels. The VFA was evaluated on magnetic resonance imaging (MRI), and cardiorespiratory fitness was assessed by measuring the peak oxygen uptake (VO2 peak).The median 25(OH)D concentration was 35.6 nmol/L, and the prevalence of 25(OH)D deficiency was 78.7%. A multiple linear regression analysis revealed that the serum 25(OH)D concentration was inversely related to the LDL-C/HDL-C, TG, ApoB and ApoB/ApoA-1 values, even after adjusting for age, season, smoking status, alcohol consumption, medication use, vitamin D intake, calcium intake, VFA and cardiorespiratory fitness.Serum 25(OH)D level is inversely correlated with the LDL-C/HDL-C, TG, ApoB and ApoB/ApoA-1 values in Japanese men, independent of the VFA and cardiorespiratory fitness.

The aim of the study is to investigate the relationship between physical activity as assessed by accelerometers and cognitive development across the human age ranges (from children and adolescents to adults). Additionally, this study seeks to explore whether physical activity contributes to cognitive development via modification of plasma insulin-like growth factor 1 (IGF-1) and brain-derived neurotrophic factor (BDNF). In the study, 500 preschool children (3.5–5.5 years old) are taking part in 6 triennial assessment waves over the span of 15 years. At each wave, participant measures included (a) 7-day physical activity monitoring using ActiGraph’s GT3X accelerometers, (b) the evaluation of cognitive development, (c) anthropometric and physical fitness assessments, (d) plasma IGF-1 and BDNF concentrations, and (e) retrospective questionnaires. Linear regression models are used to examine the effect of physical activity on cognitive development; plasma IGF-1 and BDNF concentrations are considered as mediators into data analyses. The results of the study may help to inform future health interventions that utilize physical activity as a means to improve cognitive development in children, adolescents, and adults. Additionally, the study may assist in determining whether the putative effects occur via modification of plasma IGF-1 or BDNF concentrations.

Fibroblast growth factor-21 (FGF21) is an important metabolic regulator suggested to improve glucose metabolism and prevent dyslipidemia. An FGF21-resistant state that increases circulating FGF21 has been reported in obese patients. Although regular exercise prevents metabolic disease, the relationship of the fitness level to serum FGF21 level and body fat distribution in humans remains poorly understood.The objective of the study was to determine the relationship among the serum FGF21 concentration, cardiorespiratory fitness (CRF) level, and visceral fat area (VFA).Serum FGF21 was measured by an ELISA in 166 middle-aged and elderly Japanese men (aged 30-79 y) and 25 untrained and 21 endurance-trained young men (aged 19-29 y). CRF was assessed by measuring the peak oxygen uptake (VO2peak) and VFA by magnetic resonance imaging.In the middle-aged and elderly subjects, the serum FGF21 level correlated with the VO2peak (r = -0.355, P.001) and VFA (r = 0.487, P.001). Stepwise multiple regression analysis showed VFA to be most strongly associated with the serum FGF21 level (β = .360, P.001), and VO2peak was also an independent predictor of the serum FGF21 level (β = -.174, P = .019). Furthermore, the proportion of subjects with an FGF21 level below the limit of detection was significantly higher among the endurance-trained than among the untrained young men (71.4% vs 24.0%, P = .001), and the VO2peak and VFA were independently associated with an undetectable FGF21 level (P.05).CRF and VFA are key determinants of the circulating FGF21 concentration.

Background:This study aimed to determine the optimal number of steps per day needed to meet the current physical activity guidelines in a large population sample of Japanese adults.Methods:An accelerometer-based activity monitor (Kenz Lifecorder) was used to simultaneously measure moderate-to-vigorous intensity physical activity (MVPA) and step counts in 940 Japanese adults (480 women) aged 20 to 69 years. The step count per day equivalents to 2 different physical activity recommendations (23 MET-h/wk and 150 min/wk of MVPA) were derived using linear regression analysis and receiver operating characteristic (ROC) methodology.Results:Linear regression analysis showed that daily step counts correlated with weekly PAEE (r = .83) and daily minutes of MVPA (r = .83). Linear regression analysis also showed that 23 MET-h/wk of MVPA is equivalent to 11,160 steps/d, and 150 min/wk of MVPA is equivalent to 7716 steps/d. ROC analysis yielded similar findings: 10,225 steps/d are required to accumulate ≥ 23 MET-h/wk of MVPA and 7857 steps/d are needed to meet the recommendation of ≥ 150 min/wk of MVPA.Conclusions:The findings suggest that 10,000 to 11,000 and 7700 to 8000 steps/d represent the optimal thresholds for accumulating ≥ 23 MET-h/wk of MVPA and ≥ 150 min/wk of MVPA, respectively, for Japanese adults.

High cardiorespiratory fitness (CRF) is associated with a reduced risk of Type 2 diabetes mellitus (T2DM) and improved β-cell function; genetic factors also determine these risks. This cross-sectional study investigated whether CRF modifies the association of polygenic risk of T2DM with glucose metabolism in nondiabetic Japanese men. Fasting plasma glucose, insulin, and glycated hemoglobin (HbA1c) levels were measured in 174 Japanese men (age: 20–79 yr). β-Cell function and insulin resistance were evaluated by calculating HOMA-β and HOMA-IR, respectively. CRF was assessed by measuring maximal oxygen uptake (V̇o2max). Subjects were divided into the low and high CRF groups within each age group according to the median V̇o2max. Eleven single nucleotide polymorphisms (SNPs) associated with T2DM were analyzed and used to calculate genetic risk score (GRS); subjects were divided into the low, middle, and high GRS groups. The high GRS group had higher HbA1c levels than the low GRS group in both the low and high CRF groups ( P < 0.05). Furthermore, the individuals with a high GRS had a lower HOMA-β than those with a low GRS regardless of CRF ( P < 0.05). In multiple linear regression analysis, although GRS was a significant predictor of HbA1c ( β = 0.153, P = 0.025), V̇o2max was also associated with HbA1c ( β = −0.240, P = 0.041) independent of GRS. These results suggest that CRF is associated with HbA1c levels independent of GRS derived from T2DM-related SNPs; however, it does not modify the association of GRS with increased HbA1c or impaired β-cell function.

Objective This cross-sectional study analyzed the association of serum irisin concentrations with cardiorespiratory fitness levels and common single nucleotide polymorphisms (SNPs) in the FNDC5 gene and examined the relationships between cardiorespiratory fitness levels, common SNPs in FNDC5, and glucose metabolism. Materials/Methods Cardiorespiratory fitness was assessed by measuring peak oxygen uptake (VO2peak) and serum irisin levels by ELISA in 163 Japanese men (age, 21–79 years). Subjects were divided into low- and high-fitness groups within each age group according to the median VO2peak value. Common SNPs (rs3480 and rs16835198) of the FNDC5 gene were genotyped with the TaqMan assay. Glucose metabolism was evaluated by measuring HbA1c, fasting plasma glucose (FPG), insulin levels, and HOMA-IR. Results Serum irisin levels were negatively correlated with age (p

Purpose. To evaluate the relationships between objectively measured physical activity and physical fitness among preschool children. Methods. A total of 346 participants (201 boys and 145 girls) aged 3.5–5.5 years (M=4.5 yr, SD = 0.47) from Shanghai, China, completed physical fitness assessments, including triceps skinfold thickness (TSFT), grip strength, tennis throwing, sit and reach test, standing long jump, balance beam, 10mSRT, and 20mSRT. Physical activity was objectively measured by ActiGraphGT3X+ accelerometer. Multiple linear regression models were used to explore the cross-sectional associations between PA and physical fitness after adjusting for age, gender, BMI, and valid wearing time. Results. Positive associations were observed between stand long jump (p<.01), tennis throwing (p<.01), laps in 20mSRT (p<.01), and MVPA. However, TSFT (p<.05), time in 10mSRT (p<.01), and balance beam (p<.05) were negatively associated with MVPA. Furthermore, positive associations were found between stand long jump (p<.01), tennis throwing (p<.01), and MVPA only in boys. Negative associations were found between time on balance beam (p<.01) and MVPA only in girls. Conclusions. MVPA appears to be an effective and reliable predictor of preschoolers’ physical fitness. Boys’ body composition, muscular strength, explosive strength, agility, aerobic fitness, girls’ agility, aerobic fitness, and balance could improve as MVPA increases.

Background:Internationally comparable evidence is important to advocate for young people’s physical activity. The aim of this article is to present the inaugural Shanghai (China) Report Card on Physical Activity for Children and Youth.Methods:Since no national data are available, the working group developed the survey questionnaire and carried out the school surveys for students (n = 71,404), parents (n = 70,346), and school administrators and teachers (n = 1398). The grades of 9 report card indicators were assigned in accordance with the survey results against a defined benchmark: A is 81% to 100%; B is 61% to 80%; C is 41% to 60%, D is 21% to 40%; F is 0% to 20%.Results:The 9 indicators were graded as follows: Overall Physical Activity Levels (F), Organized Sport Participation (F), Active Play (D-), Active Transportation (C-), Sedentary Behavior (F), Family and Peers (B), School (B+), Community and the Built Environment (D+), and Government (D).Conclusions:Levels of physical activity and sedentary behavior were low and below the respective recommended guidelines. Interventions and policies at the community level should be encouraged to promote physical activity and reduce sedentary behavior. Future national surveys should be encouraged to strengthen Shanghai’s Report Card on Physical Activity for Children and Youth.

Metabolic syndrome (MetS) is a complex interrelated risk factor for cardiovascular disease and type 2 diabetes mellitus. High cardiorespiratory fitness is known to contribute to prevention of MetS. However, little is known regarding the association between muscular fitness and MetS in Japanese adults. The purpose of this study was to examine the associations between muscular fitness and MetS in Japanese women and men. This cross-sectional study included 335 women and 209 men aged 30 - 79 y. MetS was determined according to the 2009 criteria of the International Diabetes Federation. Muscular fitness was evaluated by muscular fitness composite score (MFS), which was determined using Z scores from grip strength and sit-ups. Participants were classified by MFS tertile into low, middle, and high MFS groups. We used multiple logistic regression analysis to estimate odds ratios for the incidence of MetS in each group. The prevalence of MFS was 27.2% in women and 27.3% in men. Adjusted odds ratios for MetS prevalence in the low, middle, and high MFS groups, after adjusting for age, smoking status, alcohol intake, and exercise habits, were 1.0 (referent), 0.90 (95% confidence interval [CI], 0.50 - 1.62), and 0.49 (95% CI, 0.25 - 0.94; P for trend = 0.03) in women; in men, they were 1.0 (referent), 0.49 (0.23 - 1.04), and 0.42 (0.18 - 0.97; P for trend = 0.04), respectively. Muscular fitness is inversely associated with the prevalence of MetS in Japanese women and men.