Search

The escalating burden of lifestyle‐related diseases stands as a critical global public health challenge, contributing substantially to the prevalence of chronic conditions and a large portion of premature mortality. Despite this, concise evidence‐based lifestyle interventions targeting physical inactivity, nutrition, alcohol and smoking continue to be underutilised. Although good evidence exists for addressing the four lifestyle‐related risk factors independently, rarely do these present in isolation. Evidence is lacking regarding how to integrate interventions targeting multiple risk factors. Consequently, this paper aims to provide an overview of the evidence for delivering multiple interventions in primary healthcare settings. Different lifestyle factors are inter‐related, with decisions around ordering of the delivery of multiple lifestyle interventions an important consideration. There is evidence supporting the effectiveness of addressing some lifestyle factors simultaneously (e.g., physical activity and nutrition), although smoking cessation may be delivered best in a sequential approach. While the World Health Organisation highlights four key lifestyle factors (nutrition, physical activity, alcohol and smoking), incorporating additional elements such as sleep, mental well‐being and social connectedness offers a holistic framework for promoting well‐being. Despite the presentation of multiple behaviour risk factors being commonplace in healthcare settings, the evidence (outlined in the paper) for how best to deliver interventions to address this is limited, with further research and subsequent clinical guidance required. In order to address the barriers to delivering lifestyle interventions in primary care, innovation will be required. The use of non‐medical personnel, social prescribers and health coaches has the potential to alleviate time constraints, whilst mounting evidence exists for group consultations for addressing lifestyle‐related non‐communicable diseases (NCDs). If the challenges to implementation can be addressed, and if healthcare systems can adapt for the promotion of healthy lifestyles, the impact of NCDs can be mitigated. [ABSTRACT FROM AUTHOR]

Background: Time spent in sleep, sedentary behaviour (SB), and physical activity are exhaustive and mutually exclusive parts of a 24-h day that need to be considered in a combination. The aim of this study was to identify validated self-reported tools for assessment of movement behaviours across the whole 24-h day, and to review their attributes and measurement properties. Methods: The databases PubMed, Scopus, and SPORTDiscus were searched until September 2023. Inclusion criteria were: (i) published in English language, (ii) per-reviewed paper, (iii) assessment of self-reported time spent in sleep, SB, and physical activity, (iv) evaluation of measurement properties of all estimates across the full 24-h day, and (v) inclusion of adolescents, adults, or older adults. The methodological quality of included studies was assessed using the Consensus-based Standards for the selection of health Measurement Instruments checklist. Results: Our search returned 2064 records. After studies selection, we included 16 articles that reported construct validity and/or test-retest reliability of 12 unique self-reported tools – eight questionnaires, three time-use recalls, and one time-use diary. Most tools enable assessment of time spent in sleep, and domain-specific SB and physical activity, and account that sum of behaviours should be 24 h. Validity (and reliability) correlation coefficients for sleep ranged between 0.22 and 0.69 (0.41 and 0.92), for SB between 0.06 and 0.57 (0.33 and 0.91), for light-intensity physical activity between 0.18 and 0.46 (0.55 and 0.94), and for moderate- to vigorous-intensity physical activity between 0.38 and 0.56 (0.59 and 0.94). The quality of included studies being mostly fair-to-good. Conclusions: This review found that only a limited number of validated self-reported tools for assessment of 24-h movement behaviours are currently available. Validity and reliability of most tools are generally adequate to be used in epidemiological studies and population surveillance, while little is known about adequacy for individual level assessments and responsiveness to behavioural change. To further support research, policy, and practice, there is a need to develop new tools that resonate with the emerging 24-h movement paradigm and to evaluate measurement properties by using compositional data analysis. Systematic review registration: PROSPERO CRD42022330868. [ABSTRACT FROM AUTHOR]

PATHFit or Physical Activity for Health and Fitness is a new program designed by CHED for tertiary level physical education. The unique features of this program lie along its standards for (1) active and healthy living that is characterized by progressively intensifying student's physical activity and (2) advocacy and action plan where college students are encouraged to share their learning to their community. Both standards express CHED's support of the Global Action Plan for Physical Activity (GAPPA) initiated by the WHO in 2018 to reduce physical inactivity and sedentary lifestyle by 15% before the year 2030. The purpose of this paper is to look into the 2-year trial implementation of PATHFit at West Visayas State University (WVSU) to investigate on the curriculum practices that were used to deliver the new PE program and see how these practices aligned with CHED's standards and outcomes in order to contribute to the GAPPA. Results revealed that the new program ushered in a new era of teaching PE. The blending of PATHFit standards with the university's hallmarks resulted in the delivery of kinesthetic intelligence, intensified physical fitness, nurturance of creative minds, awareness of health and social responsibilities, student independent learning, and empowerment of student leaders. This kind of physical literacy supports attributes of lifelong independent learning and real life experiences for future engagement to recreation to lower sedentary lifestyle that sets GAPPA in progress. [ABSTRACT FROM AUTHOR]

Background: A sedentary lifestyle is commonly associated with a higher risk of chronic disease development. Among school-aged children from European countries, screen-time represents a significant portion of sedentary time with 39.8% of children spending more than 2h/day in front of a screen on average. Therefore, effective solutions to reduce sedentary behavior (SB) must be found. Multilevel interventions based on the socio-ecological model (SEM) are particularly relevant to take into account influences of the social environment on individuals' SB. Moreover, the trans-contextual model (TCM) can offer complementary levers for individuals' behavior change. The CIPRES study is a theory-based multilevel intervention designed to decrease the SB in French primary school children aged 8–10 years. The present paper describes the protocol of a randomized controlled study to evaluate the effectiveness of the CIPRES multilevel intervention on SB. Methods: The CIPRES study is a cluster-randomized controlled trial comparing intervention vs control groups. A total of 700 children are targeted for inclusion, distributed in four municipalities considered as clusters. The study consists of two successive phases: 1) co-building of a SB prevention intervention by using a participatory approach involving representatives of each level of the SEM (e.g., children, parents, staff from municipalities, teachers) and 2) implementation and evaluation of the intervention. The intervention will last for 6 weeks in each involved class. Primary outcome will be the sedentary time of children per week, assessed by accelerometry. In addition, children and their parents will be asked to fill out questionnaires concerning children's physical activity level, screen time, quality-of-life and variables of the TCM. Discussion: This study will give information on the effectiveness of a theory-based intervention, involving multiple levels of actors in the co-construction and the implementation of the intervention, that may interest schools and public health officers looking for innovative sedentary prevention programs. [ABSTRACT FROM AUTHOR]

Introduction: Chronic pain is a prevalent issue among older adults in the United States that impairs quality of life. Physical activity has emerged as a costeffective and non-pharmacological treatment for chronic pain, offering benefits such as improved physical functioning, weight loss, and enhanced mood. However, promoting physical activity in older individuals with chronic pain is challenging, given the cyclical relationship between pain and sedentary behavior. The Mobile Intervention to Reduce Pain and Improve Health (MORPH) trial was designed as an innovative, mobile health (mHealth) supported intervention to address this issue by targeting daylong movement, weight loss, and mindfulness to manage pain in older adults with chronic multisite pain. The objective of this paper is to provide the result of a qualitative analysis conducted on post-intervention interviews with MORPH participants. Methods: At the conclusion of the MORPH study, 14 participants were interviewed regarding their experience with the program. All interviews were conducted by phone before being transcribed and verified. A codebook of significant takeaways was created based on these accounts. Summaries were further synthesized into themes using the principles of thematic analysis. Results: Three key themes of the MORPH intervention emerged from the qualitative interviews: MORPH technology (smart scales, Fitbit, MORPH Companion App) facilitated program adherence and accountability; MORPH intervention components (food tracking and mindfulness activities) facilitated program adherence and awareness, respectively; and, group meetings provided motivational support and accountability. Mobile health technologies, including a dedicated MORPH app, facilitated self-monitoring strategies, helped to break the cycle of old habits, and provided participants with immediate feedback on successes; however, technical issues required timely support to maintain engagement. Food tracking contributed to adherence and accountability for weight loss. Mindfulness activities increased participants' awareness of anxiety provoking thoughts and pain triggers. Finally, social support via group meetings and connection, played a crucial role in behavior change, but participants noted consistency in the delivery medium was essential to fostering genuine connections. Conclusion: Overall, the study results highlight the key considerations related to program technology, intervention components, and the value of social support that can help to guide the development of future interventions similar to MORPH. [ABSTRACT FROM AUTHOR]

This paper aims to analyse studies and research conducted in EU and non-EU member states to identify and compare trends in physical activity and motor skills. Thus, a comparative overview of the state of the art in the two pre-pandemic decades that can facilitate an understanding of the different territorial realities and training needs to be conducted, considering the different cultural situations. A scoping review was conducted by analysing a series of studies published between 1990 and 2022, including only those studies that collected data in the pre-pandemic period. The search was carried out on databases such as PubMed, Google Scholar, and ScienceDirect. The following keywords were used for the acquisition of relevant studies: children, decline, motor skills, physical activity, and young people. From the literature review emerged clearly in all the longitudinal surveys a negative trend of body mass index (BMI), which was increasing in all the countries analysed, and cardiorespiratory fitness, which, in close relation to the increase in overweight levels, was in decline. If an unambiguous trend could be declared for the variables just mentioned, it was not possible to declare the same trend for the other variables analysed, which showed discordant results between the different countries. [ABSTRACT FROM AUTHOR]

Background: Improving physical activity and reducing sedentary behavior represent important areas for intervention in childhood in order to reduce the burden of chronic disease related to obesity and physical inactivity in later life. This paper aims to determine the cost-effectiveness of a multi-arm primary school-based intervention to increase physical activity and/or reduce sedentary time in 8–9 year old children (Transform-Us!). Methods: Modelled cost-utility analysis, using costs and effects from a cluster randomized controlled trial of a 30-month intervention that used pedagogical and environmental strategies to reduce and break up sedentary behaviour (SB-I), promote physical activity (PA-I), or a combined approach (PA + SB-I), compared to current practice. A validated multiple-cohort lifetable model (ACE-Obesity Policy model) estimated the obesity and physical activity-related health outcomes (measured as change in body mass index and change in metabolic equivalent task minutes respectively) and healthcare cost-savings over the cohort's lifetime from the public-payer perspective, assuming the intervention was delivered to all 8–9 year old children attending Australian Government primary schools. Sensitivity analyses tested the impact on cost-effectiveness of varying key input parameters, including maintenance of intervention effect assumptions. Results: Cost-effectiveness results demonstrated that, when compared to control schools, the PA-I and SB-I intervention arms were "dominant", meaning that they resulted in net health benefits and healthcare cost-savings if the intervention effects were maintained. When the costs and effects of these intervention arms were extrapolated to the Australian population, results suggested significant potential as obesity prevention measures (PA-I: 60,780 HALYs saved (95% UI 15,007-109,413), healthcare cost-savings AUD641M (95% UI AUD165M-$1.1B); SB-I: 61,126 HALYs saved (95% UI 11,770 − 111,249), healthcare cost-savings AUD654M (95% UI AUD126M-1.2B)). The PA-I and SB-I interventions remained cost-effective in sensitivity analysis, assuming the full decay of intervention effect after 10 years. Conclusions: The PA-I and SB-I Transform-Us! intervention arms represent good value for money and could lead to health benefits and healthcare cost-savings arising from the prevention of chronic disease in later life if intervention effects are sustained. Trial registration: International Standard Randomized Controlled Trial Number (ISRCTN83725066). Australia and New Zealand Clinical Trials Registry Number (ACTRN12609000715279). [ABSTRACT FROM AUTHOR]

The aim of this paper is to provide a narrative review of the effects of physical exercise in the treatment of chronic musculoskeletal pain. Physical inactivity and sedentary behavior are associated with chronic musculoskeletal pain and can aggravate it. For the management of musculoskeletal pain, physical exercise is an effective, cheap, and safe therapeutic option, given that it does not produce the adverse effects of pharmacological treatments or invasive techniques. In addition to its analgesic capacity, physical exercise has an effect on other pain-related areas, such as sleep quality, activities of daily living, quality of life, physical function, and emotion. In general, even during periods of acute pain, maintaining a minimum level of physical activity can be beneficial. Programs that combine several of the various exercise modalities (aerobic, strengthening, flexibility, and balance), known as multicomponent exercise, can be more effective and better adapted to clinical conditions. For chronic pain, the greatest benefits typically occur with programs performed at light-to-moderate intensity and at a frequency of two to three times per week for at least 4 weeks. Exercise programs should be tailored to the specific needs of each patient based on clinical guidelines and World Health Organization recommendations. Given that adherence to physical exercise is a major problem, it is important to empower patients and facilitate lifestyle change. There is strong evidence of the analgesic effect of physical exercise in multiple pathologies, such as in osteoarthritis, chronic low back pain, rheumatoid arthritis, and fibromyalgia. [ABSTRACT FROM AUTHOR]

Interest in gamified physical activity has been driven by its potential to benefit student mental health. Integrating gamified practices for mental health improvement represents a significant innovation within multidisciplinary approaches to enhancing mental well-being. This review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was conducted using the Scopus and Web of Science (WOS) databases, primary sources for education-related studies. Thirteen papers were analyzed, yielding important insights into the relationship between gamified physical activity and mental health. The findings indicate that gamified physical activity positively influences adolescents' mental health and well-being. Additionally, there is a need for improved application and game design to enhance learning within school contexts. Tailoring exergames to fit specific disciplines and school-related characteristics can promote healthier mobile application usage and offer significant benefits for the mental health of young individuals. The difference between this study and previous ones is that it focuses on mobile applications for encouraging active living to improve quality of life and mental health. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper evaluates the effectiveness of an educational intervention based on the transtheoretical model aimed at increasing physical activity (PA) participation among female employees in Bandar Abbas city (Iran) healthcare centers in December 2017 and August 2018. Using a semi-experimental interventional study design with a randomized and multi-stage method, 100 participants were included in both the intervention (n  = 50) and control groups (n  = 50). Data collection involved questionnaires assessing demographic information (age, gender, marital status and education), stages of change in PA behavior, Perceived Benefits, Barriers and Self-efficacy. The data were analyzed using SPSS-16, employing both descriptive (mean, SD, frequency, percentage) and inferential statistics (t -tests, chi-squared tests, etc.). Prior to the educational intervention, 19 participants (0.38%) in the intervention group engaged consistently in PA (stages 4–5). After 3 and 6 months of intervention, these numbers increased to 29 (0.58%) and 25 (0.50%), respectively. This improvement was statistically significant compared to the pre-intervention stage (P  < 0.001). The findings highlight the importance of theory-based behavior change models and health education programs in promoting PA and combating sedentary lifestyles. Although focused on a specific population in Bandar Abbas, the intervention can serve as a model for similar programs targeting diverse social classes and populations. [ABSTRACT FROM AUTHOR]

Background: Non-communicable diseases (NCDs) are the leading causes of death worldwide. Systems approaches have potential for creating sustainable outcomes at scale but have rarely been used to support scale up in physical activity/nutrition promotion or NCD prevention more generally. This review aimed to: (i) synthesise evidence on the use of systems approaches in scaling up interventions targeting four behavioural risk factors for NCDs; and (ii) to explore how systems approaches have been conceptualised and used in intervention implementation and scale up. Method: Seven electronic databases were searched for studies published 2016–2021. Eligible studies targeted at least one of four NCD behavioural risk factors (physical inactivity, tobacco use, alcohol consumption, diet), or described evaluation of an intervention planned for or scaled up. Studies were categorised as having a (i) high, (ii) moderate, or (iii) no use of a systems approach. A narrative synthesis of how systems approaches had been operationalised in scale up, following PRISMA guidelines. Results: Twenty-one intervention studies were included. Only 19% (n = 4) of interventions explicitly used systems thinking to inform intervention design, implementation and scale up (targeting all four risk factors n = 2, diet n = 1, tobacco use n = 1). Five studies ('high use') planned and implemented scale up with an explicit focus on relations between system elements and used system changes to drive impact at scale. Seven studies ('moderate use') considered systems elements impacting scale-up processes or outcomes but did not require achieving system-level changes from the outset. Nine studies ('no use') were designed to work at multiple levels among multiple agencies in an intervention setting, but the complexity of the system and relations between system elements was not articulated. We synthesised reported barriers and facilitators to scaling up, and how studies within each group conceptualised and used systems approaches, and methods, frameworks and principles for scaling up. Conclusion: In physical activity research, and NCD prevention more broadly, the use of systems approaches in scale up remains in its infancy. For researchers, practitioners and policymakers wishing to adopt systems approaches to intervention implementation at scale, guidance is needed on how to communicate and operationalise systems approaches in research and in practice. Trial registration: PROSPERO (CRD42021287265). [ABSTRACT FROM AUTHOR]

Background: The Nyakaza-Move-for-Health intervention program was developed in response to the alarming rise in non-communicable diseases (NCDs) globally, in sub-Saharan Africa and South Africa. The rise in NCDs is attributed to the low levels of participation in physical activity (PA) among adolescents. Therefore, this study aimed to design a culturally tailored PA intervention for adolescents, guided by the Intervention Mapping (IM) protocol. The intervention program aims to address the multifaceted determinants of physical activity behavior, promote healthy lifestyles and improve adolescent fitness levels. Methods: The Intervention Mapping protocol was applied to design the intervention program. The IM has 6 steps: (1) Needs assessment, (2) developing a logic model of the problem (LMP), (3) Formulating program outcomes and objectives, (4) Program design and production, (5) Generating implementation plan, and (6) Generating intervention evaluation plan. Participants included (n = 48) adolescent learners recruited from 8 (n = 8) participating schools. Adolescent learners participated in focus group discussions (FGD) to identify personal, interpersonal and environmental determinants of physical inactivity. Twenty-six (n = 26) key informant stakeholders participated in a stakeholder engagement workshop (SEW) to determine the motivators and constraints in implementing physical activity interventions. Results: The Nyakaza intervention program's process development involved extensive stakeholder engagement, capacity development training, and integration of community feedback into the design. The intervention included a social marketing campaign and structured after-school physical activity sessions based on the Health Belief Model (HBM) and Transtheoretical Model (TTM). Implementation and evaluation plans were created, emphasizing real-time monitoring and adaptations. Strategies to enhance parental and community support were developed to address participation barriers. Although not tested in this study, these plans laid a robust foundation for fostering sustainable behavior change and improving physical activity among adolescents in resource-constrained settings. Conclusion: The Nyakaza-Move-for-Health intervention demonstrates a promising framework for promoting adolescent physical activity and addressing Non-Communicable Diseases in a culturally relevant manner. The systematic approach, grounded in the intervention mapping protocol, ensured a robust and replicable intervention design. Future research should focus on long-term follow-up, integrating objective physical activity measures, and expanding the program to include nutrition education. Addressing identified barriers, such as parental involvement, is crucial for enhancing the intervention's effectiveness and sustainability. [ABSTRACT FROM AUTHOR]

Background: Delayed neurocognitive recovery (dNCR) can result in unfavorable outcomes in elderly surgical patients. Physical activity (PA) has been shown to improve cognitive function, potentially by reducing systemic inflammatory responses. However, there is a lack of supportive data indicating whether PA has a protective effect against dNCR. Aims: To examine the correlation between dNCR and PA, and to further analyze if pro-inflammatory cytokines mediate this relationship. Methods: This study is a prospective nested case-control investigation of elderly patients who had knee replacement surgery. dNCR was defined as a decline in cognitive function compared with baseline by using a battery of neuropsychological tests. PA was assessed with the Physical Activity Scale for the Elderly (PASE). Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum concentrations of IL-6, IL-1β, and TNF-α. Multivariable logistic regression analysis was conducted to assess the association between PA and dNCR. Mediation analysis was employed to evaluate whether pro-inflammatory cytokines mediate the relationship between them. Results: A cohort of 152 patients was included, resulting in an incidence rate of dNCR of 23.68%. PA was associated with dNCR after full adjustment [OR = 0.199, (95% CI, 0.061; 0.649), P = 0.007]. Mediation analysis showed that the IL-6 mediated the statistical association between PA and dNCR, with mediation proportions (%) of 77.68 (postoperative concentration of IL-6) or 27.58 (the absolute change in IL-6 before and after surgery). Conclusions: PA serves as a protective factor against dNCR, possibly through the reduction of pro-inflammatory cytokine concentrations. The Chinese Clinical Trail Registry: : www.http://chictr.org.cn, Registration No. ChiCTR2300070834, Registration date: April 24, 2023. [ABSTRACT FROM AUTHOR]

Physical inactivity can lead to frailty and negative health outcomes in middleaged to older adults. Sedentary individuals have double the risk of death compared to those who engage in high levels of physical activity (PA). The advantages of practicing PA in older age are significant, with regular, moderate-intensity activity (150 min per week)being consistently linked with a decreased risk of chronic disease, cognitive decline, and mortality. Therefore, the study aimed to carry out a bibliometric review related to the terms "Physical activity," "Functional capacity" and "Aging" including all the documents published in the Web of Science Core Collection until 31st December 2023. The sample was made up of 231 studies related to the topic. The results reported that the first document was published in 1994. However, there was no continuity in the publication of the documents till 1998, which was the first year with at least one document published. Considering 1998 as the first year, it is observed an exponential growth of 77.4%, between the oldest (1997-2008) and contemporaneous studies (2008-2023), in which "Geriatric Gerontology" was the Web of Science category with the highest number of documents (n = 59). The journal "Experimental Gerontology" was associated with the largest number of published documents (n = 7), being indexed in Quartil 2. The years 2009 had the highest number of citations (n = 1811), with a total of 7 documents published and 2018 with the higher number of documents (n = 25). These results reported the importance of PA in elderly people, and how it influences the risk of falls, improving the balance and the functional capacity. Thus, it is important to carry out programmes to promote physical activity to this population and reduce the risk of falls and the presence of diseases. [ABSTRACT FROM AUTHOR]

Background: Among elementary-aged children (5-12yrs), summer vacation is associated with accelerated gains in Body Mass Index (BMI). A key behavioral driver of BMI gain is a lack of physical activity (PA). Previous studies indicate PA decreases during summer, compared to the school year but whether this difference is consistent among boys and girls, across age, and by income status remains unclear. This study examined differences in school and summer movement behaviors in a diverse cohort of children across three years. Methods: Children (N = 1,203, age range 5–14 years, 48% girls) wore wrist-placed accelerometers for a 14-day wear-period during school (April/May) and summer (July) in 2021 to 2023, for a total of 6 timepoints. Mixed-effects models examined changes in school vs. summer movement behaviors (moderate-to-vigorous physical activity [MVPA], sedentary) for boys and girls, separately, and by age and household income groups (low, middle, and upper based on income-to-poverty ratio). Results: Children provided a total of 35,435 valid days of accelerometry. Overall, boys (+ 9.1 min/day, 95CI 8.1 to 10.2) and girls (+ 6.2 min/day, 95CI 5.4 to 7.0) accumulated more MVPA during school compared to summer. Boys accumulated less time sedentary (-9.9 min/day, 95CI -13.0 to -6.9) during school, while there was no difference in sedentary time (-2.7 min/day, 95CI -5.7 to 0.4) for girls. Different patterns emerged across ages and income groups. Accumulation of MVPA was consistently greater during school compared to summer across ages and income groups. Generally, the difference between school and summer widened with increasing age, except for girls from middle-income households. Accumulation of sedentary time was higher during school for younger children (5-9yrs), whereas for older children (10-14yrs), sedentary time was greater during summer for the middle- and upper-income groups. For boys from low-income households and girls from middle-income households, sedentary time was consistently greater during summer compared to school across ages. Conclusions: Children are less active and more sedentary during summer compared to school, which may contribute to accelerated BMI gain. However, this differs by biological sex, age, and income. These findings highlight the complex factors influencing movement behaviors between school and summer. [ABSTRACT FROM AUTHOR]

Objective Physical activity is recommended for recipients of a kidney transplant. However, ADHERE BRAZIL study found a high prevalence (69%) of physical inactivity in Brazilian recipients of a kidney transplant. To tackle this behavior, a broad analysis of barriers is needed. This study aimed to identify factors (patient and transplant center levels) associated with physical inactivity among recipients of a kidney transplant. Methods This was a subproject of the ADHERE BRAZIL study, a cross-sectional, multicenter study of 1105 recipients of a kidney transplant from 20 kidney transplant centers. Using a multistage sampling method, patients were proportionally and randomly selected. Applying the Brief Physical Activity Assessment questionnaire, patients were classified as physically active (≥150 min/wk) or physically inactive (<150 min/wk). On the basis of an ecological model, 34 factors associated with physical inactivity were analyzed by sequential logistic regression. Results At the patient level, physical inactivity was associated with smoking (odds ratio = 2.43; 95% CI = 0.97–6.06), obesity (odds ratio = 1.79; 95% CI = 1.26–2.55), peripheral vascular disease (odds ratio = 3.18; 95% CI = 1.20–8.42), >3 posttransplant hospitalizations (odds ratio = 1.58; 95% CI = 1.17–2.13), family income of >1 reference salary ($248.28 per month; odds ratio = 0.66; 95% CI = 0.48–0.90), and student status (odds ratio = 0.58; 95% CI = 0.37–0.92). At the center level, the correlates were having exercise physiologists in the clinical team (odds ratio = 0.54; 95% CI = 0.46–0.64) and being monitored in a teaching hospital (undergraduate students) (odds ratio = 1.47; 95% CI = 1.01–2.13). Conclusions This study identified factors associated with physical inactivity after kidney transplantation that may guide future multilevel behavioral change interventions for physical activity. Impact In a multicenter sample of recipients of a kidney transplant with a prevalence of physical inactivity of 69%, we found associations between this behavior and patient- and center-level factors. At the patient level, the chance of physical inactivity was positively associated with smoking, obesity, and patient morbidity (peripheral vascular disease and hospitalization events after kidney transplantation). Conversely, a high family income and a student status negatively correlated with physical inactivity. At the center level, the presence of a dedicated professional to motivate physical activity resulted in a reduced chance of physical inactivity. A broad knowledge of barriers associated with physical inactivity can allow us to identify patients at a high risk of not adhering to the recommended levels of physical activity. [ABSTRACT FROM AUTHOR]

Background/Objectives: Childhood and adolescence are important stages of life for acquiring healthy habits. There is a high prevalence of sedentary lifestyles worldwide during these ages, which negatively impacts health. This is attributed, in part, to excessive time spent engaging in sedentary behaviors. The aim of this study was to assess the time spent on sedentary behaviors and their relationship with physical activity levels in children and adolescents in the Community of Madrid. Methods:A total of 26,729 participants aged 10–17 from various schools and institutes took part in this study. The International Physical Activity Questionnaire Short Form (IPAQ-SF) was used, and they were asked about the time they spent on different leisure time habits (specific sedentary behaviors and organized physical activity). A generalized linear model was used to analyze the association between the time spent in sedentary activities and the time spent in physical activity. Results: The results revealed that children and adolescents engage in low levels of physical activity and most of them spend considerable time in sedentary behaviors such as studying, watching television, or using social media. Completing school homework (Coef: 1.23, 95% CI: −0.51 to 2.97, p = 0.167) or using social media for more than 2 h (Coef: 1.29, 95% CI: −2.98 to 0.40, p = 0.133) compared to not dedicating time to them did not show a significant association with daily physical activity time. Watching television for more than 2 h was associated with a decrease of 2.60 min (95% CI: −4.41 to −0.78, p = 0.005). Thus, no or only irrelevant associations were found between time spent in sedentary activities and physical activity time. Conclusions: Despite the drawbacks of spending time engaging in sedentary behaviors, they seem to be compatible with physical activity levels. Therefore, it is important to continue research on physical activity adherence strategies to promote overall health and well-being. [ABSTRACT FROM AUTHOR]

Background: Obesity is becoming an alarming problem in contemporary society, affecting both adults and children, with roots deep in an unhealthy lifestyle. Medical students and future medical professionals face a lack of educational resources on healthy lifestyle in a hectic and demanding context. Limited time for exercise and healthy eating leads to fatigue and the adoption of unhealthy habits. Solving this problem requires an educational approach and finding a balance.This research investigates the relationship between student life, eating habits and sedentary lifestyle among medical students. Focusing on understanding the reasons behind obesity trends and identifying strategies to motivate students towards a balanced lifestyle, the paper also explores psychosocial issues related to nutrition and physical activity, tailored to the pressures specific to the medical field. This research has wide-ranging implications, highlighting the need for effective strategies to promote health among medical students and prevent long-term health problems. Material and methods: We conducted a study of 100 medical students, aged 19-24+ years, from diverse backgrounds. The extensive questionnaire, completed by participants from general medicine, military medicine, dental medicine, and pharmacy programs, addressed issues such as demographics, weight trends, eating habits, exercise, and access to obesity information. These findings represent a valuable resource for the development of future health education interventions and programs, providing an in- depth understanding of the implications of obesity in this population. Results: In the study, 100 medical students, evenly distributed between men (42%) and women (58%), revealed significant obesity and healthy lifestyle concerns. An impressive 86.5% perceive obesity as a serious problem, and 33.3% have had obesity-related problems before college. Looking at eating habits, 67.4% adopt a moderately healthy diet, while 10.1% have unhealthy eating habits. Regarding physical activity, 34.8% exercise occasionally, 21.3% rarely, and 5.6% not at all. Interestingly, 33.3% adopted unhealthy eating habits after starting college. Perceptions related to obesity and academic performance indicate that 48.3% believe that obesity negatively affects academic performance, 31.5% see the problem as complex and influenced by individual factors, and 46.7% believe that academic stress contributes to the development of obesity. In conclusion, 48.9% support the need for an education programme to promote a balanced lifestyle in the academic environment. These results highlight the importance of a comprehensive approach to health promotion and awareness among medical students. Conclusions: The results of this research reveal a significant concern among medical students regarding obesity and healthy lifestyle. The high percentage of those who perceive obesity as a serious problem, as well as the frequency of obesity-related problems among this group, highlights the need for educational and preventive interventions. In light of these findings, the implementation of education and financial support programmes, together with the promotion of healthy eating habits and physical activity, could significantly contribute to improving the health and well-being of future health professionals. [ABSTRACT FROM AUTHOR]

Background: Despite the well-known benefits of physical activity, physical inactivity is presently a global health pandemic. Allied healthcare providers, such as chiropractors, knowingly recognise the importance of physical activity and are prepared to routinely discuss and/or counsel patients on this topic; however, little is known about Australian chiropractors in the physical activity setting. Our aim was to explore and identify factors associated with physical activity promotion among Australian chiropractors, including their knowledge of the physical activity and sedentary behaviour guidelines and their own levels of physical activity. Methods: From February to May 2021, a convenience sample of Australian chiropractors completed an online survey. Items assessed by Likert scale included: physical activity promotion frequency, with the type, quantity, barriers, perceptions, and feasibility. We asked questions about their familiarity with, and knowledge of, Australian Physical Activity and Sedentary Behaviour Guidelines, chiropractors' own physical activity, and whether the chiropractors met activity guidelines. Survey responses were descriptively reported. Univariable logistic regression models explored factors explaining frequent physical activity promotion. Results: Of 217 respondents, 64% reported that they frequently (≥ 70%) recommended a more physically active lifestyle. Only 15% often performed pre-exercise screening, 73% frequently prescribed resistance exercise, 19% reported time as the most frequent barrier, while 37% reported being not at all familiar with the guidelines. Univariable logistic regression models found male chiropractors were more likely to promote physical activity, [odds ratio (OR) = 2.33; 95% confidence interval (CI): 1.32–4.12)], while chiropractors who frequently treat children 0–3 years (OR = 0.5; 95% CI: 0.28–0.87), children 4–18 years (OR = 0.42; 95% CI: 0.21–0.86), and pregnant women (OR = 0.5; 95% CI: 0.26–0.94) were less likely. Chiropractors were more likely to promote physical activity if they were familiar with the activity guidelines (OR = 2.9; 95% CI: 1.32–6.41), were confident promoting (OR = 11.6; 95% CI: 1.37–98.71) and prescribing physical activity programs (OR = 4.5; 95% CI: 2.03–9.99). Conclusion: Most chiropractors confidently and regularly integrate physical activity into practice. Yet, despite acknowledging its importance, one third of chiropractors reported poor knowledge of the Physical Activity and Sedentary Behaviour Guidelines. Identifying barriers to the awareness, and implementation of physical activity guidelines should be further explored within chiropractic clinical settings. [ABSTRACT FROM AUTHOR]

Background: Although inadequate sleep increases the risk of obesity in children, the mechanisms remain unclear. The aims of this study were to assess how sleep loss influenced dietary intake in children while accounting for corresponding changes in sedentary time and physical activity; and to investigate how changes in time use related to dietary intake. Methods: A randomized crossover trial in 105 healthy children (8–12 years) with normal sleep (~ 8–11 h/night) compared sleep extension (asked to turn lights off one hour earlier than usual for one week) and sleep restriction (turn lights off one hour later) conditions, separated by a washout week. 24-h time-use behaviors (sleep, wake after sleep onset, physical activity, sedentary time) were assessed using waist-worn actigraphy and dietary intake using two multiple-pass diet recalls during each intervention week. Longitudinal compositional analysis was undertaken with mixed effects regression models using isometric log ratios of time use variables as exposures and dietary variables as outcomes, and participant as a random effect. Results: Eighty three children (10.2 years, 53% female, 62% healthy weight) had 47.9 (SD 30.1) minutes less sleep during the restriction week but were also awake for 8.5 (21.4) minutes less at night. They spent this extra time awake in the day being more sedentary (+ 31 min) and more active (+ 21 min light physical activity, + 4 min MVPA). After adjusting for all changes in 24-h time use, losing 48 min of sleep was associated with consuming significantly more energy (262 kJ, 95% CI:55,470), all of which was from non-core foods (314 kJ; 43, 638). Increases in sedentary time were related to increased energy intake from non-core foods (177 kJ; 25, 329) whereas increases in MVPA were associated with higher intake from core foods (72 kJ; 7,136). Changes in diet were greater in female participants. Conclusion: Loss of sleep was associated with increased energy intake, especially of non-core foods, independent of changes in sedentary time and physical activity. Interventions focusing on improving sleep may be beneficial for improving dietary intake and weight status in children. Trial Registration: Australian New Zealand Clinical Trials Registry ANZCTR ACTRN12618001671257, Registered 10th Oct 2018, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367587&isReview=true [ABSTRACT FROM AUTHOR]

The transition from school to university brings significant adjustments in lifestyle, body weight, and living environment for young adults, potentially impacting their quality of life. Emerging evidence suggests the coronavirus disease of 2019 (COVID-19) pandemic may have exacerbated these changes. This cross-sectional study involved 361 young adults (18–25 years) from Malaysian tertiary institutions, aiming to identify factors associated with health-related quality of life (HRQOL) post-COVID-19 restrictions. Data were collected online between April and July 2022, utilizing the WHOQOL-BREF for HRQOL assessment. Participants, with a median age of 23, scored highest in the physical health domain (mean: 63.2, SD = 16.2) and lowest in psychological health (mean: 58.2, SD = 16.9). Physical health domain scores varied by ethnicity, the field of study, weight category, and prescription medicine usage; environmental health scores by ethnicity and household income; and social health scores by age. Moderate perceived stress and low perceived support were significant predictors of poor HRQOL. Across the weight categories, sleep quality, perceived stress, and support have consistently impacted the HRQOL domain scores. This study underscores the multifaceted influences on young adults' quality of life during the transition to university, especially in post-pandemic adjustments, highlighting the importance of addressing factors such as perceived stress and support to enhance overall well-being. [ABSTRACT FROM AUTHOR]

Parent–child patterns in objectively measured movement behaviours were the highlight of this study. A total of 381 families (337 mothers, 256 fathers, 190 daughters, and 191 sons) from 36 randomly selected schools and kindergartens provided valid accelerometer data. Sedentary behaviour and physical activity (PA) were assessed using ActiGraph accelerometers. Spearman's rho was used to evaluate parent–child associations, while logistic regression analysis (the backward LR method) was used to recognize factors related to children's achievement of PA recommendations. Results indicated that girls engaged more in light PA, while boys showed higher levels of moderate and vigorous PA. Mothers spent less time sitting and more time in light PA compared to fathers, resulting in higher total PA levels. Father–son pairs showed a stronger association in total PA than mother–son pairs. Children aged 6–10 years and those with mothers who engaged in more vigorous PA were more likely to meet PA recommendations compared to younger children and those with less active mothers. [ABSTRACT FROM AUTHOR]

Early childhood is a crucial time for children to develop their fundamental motor skills (FMS), serving as a foundation for engagement in lifelong physical activity (PA). With increasing concerns over the declining levels of PA and motor competence (MC), the aim of this study was to explore the predictors of PA in children in a play-based curriculum. A secondary purpose was to explore levels of PA and MC during the school day. The final aim was to explore whether there were sex differences. Children (N = 94; Mage = 68.96 months, SD = 8.25) in five classes from four different schools in Wales were tested on the TGMD-2, standing long jump, and MABC-2. Levels of PA were measured using ActiGraph GT3X-BT accelerometers, and 85 children met the wear time criteria. Object control (OC) skills, standing long jump, and age significantly predicted the percentage of time spent performing sedentary behaviours F(10,73) = 3.026, p = 0.003, R 2 = 0.29 (adj R 2 = 0.20) and time spent on MVPA F(10,73) = 3.597, p < 0.001, R 2 = 0.33 (adj R 2 = 0.24). Children spent an average of 48.7% of the school day performing sedentary behaviours and 9.1% performing moderate to vigorous physical activity (MVPA) and did not achieve 60 min of MVPA. The MABC revealed that 67% were below the 15th percentile. Girls spent more time than boys performing sedentary behaviours (p = 0.014), and boys spent more time than girls on MVPA (p = 0.004). Boys outperformed girls at OC skills (p < 0.001), while girls outperformed boys at locomotor skills (p < 0.001). These findings reinforce the pivotal role teachers and parents play in providing opportunities for children to be PA. OC skills and jump were positively associated with PA, emphasising the importance of developing FMS in early childhood. There were also sex disparities for both PA and MC, along with low levels of MC, highlighting the need for investing in comprehensive programmes and initiatives that prioritise the development of FMS during early childhood. [ABSTRACT FROM AUTHOR]

We investigated the acceptability of bodyweight resistance exercise breaks (REB) to disrupt prolonged sedentary behavior in the workplace. Twenty-nine individuals completed a REB, where they performed 3-min REB 4, 8, and 16 times on days 1–2, 3–4, and 5 of the workweek, respectively, and a control condition (i.e., SIT). Productivity was assessed on days 1 and 5 each week. The acceptability of each REB frequency was assessed. When asked to complete 4, 8, and 16 REB, participants completed (mean values) 3.2, 6.2, and 9.2 REB/day, respectively. Moreover, 88%, 40%, and 9% of participants expressed that the 4-, 8-, and 16-REB frequencies were acceptable, respectively. Decision-making ability and concentration levels increased from day 1–5 of the REB week (p=0.048) but were stable during SIT. REB (4/day) are highly acceptable and could be a promising intervention strategy for reducing occupational sitting, thus decreasing sedentary-behavior-induced risk. [ABSTRACT FROM AUTHOR]

Background: Patterns of physical activity and sedentary behavior among postmenopausal women are not well characterized. Objectives: To describe the patterns of accelerometer-assessed physical activity and sedentary behavior among postmenopausal women. Design: Cross-sectional study. Methods: Women 63–97 years (n = 6126) wore an ActiGraph GT3X + accelerometer on their hip for 1 week. Latent class analysis was used to classify women by patterns of percent of wake time in physical activity and sedentary behavior over the week. Results: On average, participants spent two-thirds of their day in sedentary behavior (62.3%), 21.1% in light low, 11.0% in light high, and 5.6% in moderate-to-vigorous physical activity. Five classes emerged for each single-component model for sedentary behavior and light low, light high, and moderate-to-vigorous physical activity. Six classes emerged for the multi-component model that simultaneously considered the four behaviors together. Conclusion: Unique profiles were identified in both single- and multi-component models that can provide new insights into habitual patterns of physical activity and sedentary behavior among postmenopausal women. Implications: The multi-component approach can contribute to refining public health guidelines that integrate recommendations for both enhancing age-appropriate physical activity levels and reducing time spent in sedentary behavior. [ABSTRACT FROM AUTHOR]

6–11-year-old children provide a critical window for physical activity (PA) interventions. The Virtual Fitness Buddy ecosystem is a precision health PA intervention for children integrating mixed reality technology to connect people and devices. A cluster randomized, controlled trial was conducted across 19 afterschool sites over two 6-month cohorts to test its efficacy in increasing PA and decreasing sedentary behavior. In the treatment group, a custom virtual dog via a mixed reality kiosk helped children set PA goals while sharing progress with parents to receive feedback and support. Children in the control group set PA goals using a computer without support from the virtual dog or parents. 303 children had 8+ hours of PA data on at least one day of each of the 3 intervention time intervals. Conversion of sedentary time was primarily to light-intensity PA and was strongest for children with low baseline moderate-to-vigorous PA than children above 45 min of baseline moderate-to-vigorous PA. Findings suggest that the VFB ecosystem can promote sustainable PA in children and may be rapidly diffused for widespread public health impact. [ABSTRACT FROM AUTHOR]

Background: Regulatory actions are increasingly used to tackle issues such as excessive alcohol or sugar intake, but such actions to reduce sedentary behaviour remain scarce. World Health Organization (WHO) guidelines on sedentary behaviour call for system-wide policies. The Chinese government introduced the world's first nation-wide multi-setting regulation on multiple types of sedentary behaviour in children and adolescents in July 2021. This regulation restricts when (and for how long) online gaming businesses can provide access to pupils; the amount of homework teachers can assign to pupils according to their year groups; and when tutoring businesses can provide lessons to pupils. We evaluated the effect of this regulation on sedentary behaviour safeguarding pupils. Methods: With a natural experiment evaluation design, we used representative surveillance data from 9- to 18-year-old pupils before and after the introduction of the regulation, for longitudinal (n = 7,054, matched individuals, primary analysis) and repeated cross-sectional (n = 99,947, exploratory analysis) analyses. We analysed pre-post differences for self-reported sedentary behaviour outcomes (total sedentary behaviour time, screen viewing time, electronic device use time, homework time, and out-of-campus learning time) using multilevel models, and explored differences by sex, education stage, residency, and baseline weight status. Results: Longitudinal analyses indicated that pupils had reduced their mean total daily sedentary behaviour time by 13.8% (95% confidence interval [CI]: -15.9 to -11.7%, approximately 46 min) and were 1.20 times as likely to meet international daily screen time recommendations (95% CI: 1.01 to 1.32) one month after the introduction of the regulation compared to the reference group (before its introduction). They were on average 2.79 times as likely to meet the regulatory requirement on homework time (95% CI: 2.47 to 3.14) than the reference group and reduced their daily total screen-viewing time by 6.4% (95% CI: -9.6 to -3.3%, approximately 10 min). The positive effects were more pronounced among high-risk groups (secondary school and urban pupils who generally spend more time in sedentary behaviour) than in low-risk groups (primary school and rural pupils who generally spend less time in sedentary behaviour). The exploratory analyses showed comparable findings. Conclusions: This regulatory intervention has been effective in reducing total and specific types of sedentary behaviour among Chinese children and adolescents, with the potential to reduce health inequalities. International researchers and policy makers may explore the feasibility and acceptability of implementing regulatory interventions on sedentary behaviour elsewhere. [ABSTRACT FROM AUTHOR]

This brief narrative review assesses how digital technologies—such as wearables, mobile health apps, and various digital tools such as computers, game consoles, tablets, smartphones, and extended reality systems—can influence sedentary and physical activity behaviors among community-dwelling older adults. Each section highlights the central role of these technologies in promoting active aging through increased motivation, engagement and customized experiences. It underlines the critical importance of functionality, usability and adaptability of devices and confirms the effectiveness of digital interventions in increasing physical activity and reducing sedentary behavior. The sustainable impact of these technologies needs to be further investigated, with a focus on adapting digital health strategies to the specific needs of older people. The research advocates an interdisciplinary approach and points out that such collaborations are essential for the development of accessible, effective and ethical solutions. This perspective emphasizes the potential of digital tools to improve the health and well-being of the aging population and recommends their strategic integration into health promotion and policy making. [ABSTRACT FROM AUTHOR]

Systemic hypertension has been considered mainly as an adult health issue for a long time, but it is now being increasingly acknowledged as a significant problem also among pediatric patients. The frequency of pediatric hypertension has grown mostly because of increases in childhood obesity and sedentary lifestyles, but secondary forms of hypertension play a role as well. Considering that unaddressed hypertension during childhood can result in enduring cardiovascular complications, timely identification and intervention are essential. Strategies for addressing this disease encompass not only lifestyle adjustments, but also the use of medications when needed. Lifestyle modifications entail encouraging a nutritious diet, consistent physical activity, and the maintenance of a healthy weight. Moreover, educating both children and their caregivers about monitoring blood pressure at home can aid in long-term management. Thus, the aim of this review is to discuss the etiologies, classification, and principles of the treatment of hypertension in pediatric patients. [ABSTRACT FROM AUTHOR]

Background: Sedentary behavior (SB) is a recognized risk factor for many chronic diseases. ActiGraph and activPAL are two commonly used wearable accelerometers in SB research. The former measures body movement and the latter measures body posture. The goal of the current study is to quantify the pattern and variation of movement (by ActiGraph activity counts) during activPAL-identified sitting events, and examine associations between patterns and health-related outcomes, such as systolic and diastolic blood pressure (SBP and DBP). Methods: The current study included 314 overweight postmenopausal women, who were instructed to wear an activPAL (at thigh) and ActiGraph (at waist) simultaneously for 24 hours a day for a week under free-living conditions. ActiGraph and activPAL data were processed to obtain minute-level time-series outputs. Multilevel functional principal component analysis (MFPCA) was applied to minute-level ActiGraph activity counts within activPAL-identified sitting bouts to investigate variation in movement while sitting across subjects and days. The multilevel approach accounted for the nesting of days within subjects. Results: At least 90% of the overall variation of activity counts was explained by two subject-level principal components (PC) and six day-level PCs, hence dramatically reducing the dimensions from the original minute-level scale. The first subject-level PC captured patterns of fluctuation in movement during sitting, whereas the second subject-level PC delineated variation in movement during different lengths of sitting bouts: shorter (< 30 minutes), medium (30 -39 minutes) or longer (> 39 minute). The first subject-level PC scores showed positive association with DBP (standardized β ^ : 2.041, standard error: 0.607, adjusted p = 0.007), which implied that lower activity counts (during sitting) were associated with higher DBP. Conclusion: In this work we implemented MFPCA to identify variation in movement patterns during sitting bouts, and showed that these patterns were associated with cardiovascular health. Unlike existing methods, MFPCA does not require pre-specified cut-points to define activity intensity, and thus offers a novel powerful statistical tool to elucidate variation in SB patterns and health. Trial registration: ClinicalTrials.gov NCT03473145; Registered 22 March 2018; https://clinicaltrials.gov/ct2/show/NCT03473145; International Registered Report Identifier (IRRID): DERR1-10.2196/28684 [ABSTRACT FROM AUTHOR]

Background and Objectives: In Iran, childhood obesity is an emerging problem that the primary health care (PHC) system is not well equipped for yet. The purpose of this study was to design and evaluate the effect of a PHC-based behavioral management intervention to control overweight and obesity in children. Materials and Methods: This quasi-experimental trial was performed on 200 overweight or obese 6-8 yr. old children, in 5 urban PHC centers (3 interventions and 2 controls) for 12 months. A convenient sampling frame was applied from elementary schools of districts 7 and 8 (as intervention and control groups, respectively) in the northeast of Tehran city, the capital of Iran. Mothers were trained on parenting style and healthy lifestyle behaviors through a 5-session training workshop. Anthropometrics (Weight, Height, Body Mass Index (BMI), and Waist Circumference (, as well as blood pressure of children were measured at the beginning, 3rd, 6th, and 12th months, thereafter. Physical activity, sedentary behaviors, and dietary habits of children were also assessed. Results: Of the total, 20.8% (n=41) of children were overweight and 79.2 % (n=156) were obese. Compared with controls, the intervention group had smaller BMI-Z scores. The slope of BMI-Z score reduction was more impressive in the intervention group compared to the control group. The systolic and diastolic blood pressure of the intervention group was significantly lower compared to the control group in all three measurements. In the intervention group, a significant decrease in the frequency of fast-food consumption and sedentary behaviors time was observed (p-value= 0.022 and 0.055, respectively). There was no significant difference between the two groups in waist circumference, fruit, vegetable, and breakfast consumption, calorie intake, and physical activity at the end of the study. Conclusions: The protocol of the study is being used as a basis for developing childhood obesity management programs within the health system in Iran. [ABSTRACT FROM AUTHOR]

Wearable devices are increasingly being integrated to improve prevention, chronic disease management and rehabilitation. Inferences about individual differences in device-measured physical activity depends on devices being worn long enough to obtain representative samples of behavior. Little is known about how psychological factors are associated with device wear time adherence. This study evaluated associations between identity, behavioral regulations, and device wear adherence during an ambulatory monitoring period. Young adults who reported insufficient physical activity (N = 271) were recruited for two studies before and after the SARS-COVID-19 pandemic declaration. Participants completed a baseline assessment and wore an Actigraph GT3X + accelerometer on their waist for seven consecutive days. Multiple linear regression indicated that wear time was positively associated with age, negatively associated with integrated regulation for physical activity, and greater after (versus before) the pandemic declaration. Overall, the model accounted for limited variance in device wear time. Exercise identity and exercise motivation were not associated with young adults' adherence to wearing the physical activity monitors. Researchers and clinicians can use wearable devices with young adults with minimal concern about systematic motivational biases impacting adherence to device wear. [ABSTRACT FROM AUTHOR]

Introduction The aim of this systematic review was to summarize the current literature on wearable technologies in oncology patients for the purpose of prognostication, treatment monitoring, and rehabilitation planning. Methods A search was conducted in Medline ALL, Cochrane Central Register of Controlled Trials, Embase, Emcare, CINAHL, Scopus, and Web of Science, up until February 2022. Articles were included if they reported on consumer grade and/or non-commercial wearable devices in the setting of either prognostication, treatment monitoring or rehabilitation. Results We found 199 studies reporting on 18 513 patients suitable for inclusion. One hundred and eleven studies used wearable device data primarily for the purposes of rehabilitation, 68 for treatment monitoring, and 20 for prognostication. The most commonly-reported brands of wearable devices were ActiGraph (71 studies; 36%), Fitbit (37 studies; 19%), Garmin (13 studies; 7%), and ActivPAL (11 studies; 6%). Daily minutes of physical activity were measured in 121 studies (61%), and daily step counts were measured in 93 studies (47%). Adherence was reported in 86 studies, and ranged from 40% to 100%; of these, 63 (74%) reported adherence in excess of 80%. Conclusion Wearable devices may provide valuable data for the purposes of treatment monitoring, prognostication, and rehabilitation. Future studies should investigate live-time monitoring of collected data, which may facilitate directed interventions. [ABSTRACT FROM AUTHOR]

Purpose: Cerebrospinal fluid (CSF) clearance is essential for maintaining a healthy brain and cognition by removal of metabolic waste from the central nervous system. Physical exercise has been shown to improve human health; however, the effect of physical exercise on intrinsic CSF outflow in humans remains unexplored. The purpose of this study was to investigate intrinsic CSF outflow pathways and quantitative metrics of healthy individuals with active and sedentary lifestyles. In addition, the effect of exercise was investigated among the sedentary subjects before and after 3 weeks of physical activity. Methods: This study was performed on 18 healthy adults with informed consent, using a clinical 3-Tesla MRI scanner. We classified participants into two groups based on reported time spent sitting per day (active group: < 7 hours sitting per day and sedentary group: = 7 hours sitting per day). To elucidate the effect of exercise, sedentary individuals increased their activity to 3.5 hours for 3 weeks. Results: We show that there are two intrinsic CSF egress pathways of the dura mater and lower parasagittal dura (PSD). The adults with an active lifestyle had greater intrinsic CSF outflow metrics than adults with a more sedentary lifestyle. However, after increased physical activity, the sedentary group showed improved CSF outflow metrics. This improvement was particularly notable at the lower PSD, where outflow metrics were highest among the active group. Conclusion: Our findings describe the relationship between physical activity and intrinsic CSF outflow and show a potential selective outflow pathway with increasing physical activity in the lower PSD pathway, potentially from the perivascular space or cortical venous subpial space. [ABSTRACT FROM AUTHOR]

Fibromyalgia is a chronic disease that causes widespread pain throughout the body, as well as fatigue and a variety of other accompanying symptoms. Physical activity is one of the most useful non-pharmacological treatments for pain and symptom reduction. Therefore, the main objective of this research was to analyse the objective levels of sedentary lifestyle and physical activity, as well as the study of heart rate variability as a predictor of health. A total of 21 women previously diagnosed with fibromyalgia (FM) and 10 healthy women of the same age range participated in the study. Accelerometry was used for the determination of physical activity and sedentary lifestyle as well as the study of heart rate variability (HRV) at rest for the assessment of cardiovascular health. The results show that participants with fibromyalgia have higher levels of sedentary lifestyles and worse cardiovascular health outcomes compared to healthy participants not diagnosed with fibromyalgia. In conclusion, it is observed that the analysis of heart rate variability is a good predictor for the determination of cardiovascular health in patients diagnosed with fibromyalgia. A debate is open to whether sedentary lifestyles and being overweight accentuate the fibromyalgia disease or whether it is the disease itself that favors increased physical inactivity, reflected in inferior cardiovascular health. Future research is needed to deepen this analysis in order to improve the quality of life of these patients. [ABSTRACT FROM AUTHOR]

Background: Globally, just one in five adolescents meet physical activity guidelines and three-quarters of the school day is spent sitting. It is unclear which types of school-based interventions strategies increase physical activity and reduce sedentary time among adolescents, or how these interventions are implemented influences their effectiveness. Objective: The three aims of our systematic review were to (a) identify intervention strategies used within secondary school settings to improve students' movement behaviours throughout school-based initiatives, delivered at or by the school; (b) determine the overall effect of the interventions (meta-analysis) on physical activity (all intensities), sedentary time, cognitive/academic, physical health and/or psychological outcomes; and (c) describe factors related to intervention implementation. Methods: Searches were conducted in MEDLINE complete, EMBASE, CINAHL, SPORTDiscus, APA PsycINFO, and ERIC in January 2023 for studies that (a) included high school-aged adolescents; (b) involved a school-based intervention to increase physical activity and/or decrease sedentary time; and (c) were published in English. Reported effects were pooled in meta-analyses where sufficient data were obtained. Results: Eighty-five articles, representing 61 interventions, met the inclusion criteria, with 23 unique intervention strategies used. Interventions that involved whole-school approaches (i.e., physical activity sessions, environmental modifications, teacher training, peer support and/or educational resources) were favourably associated with most of the outcomes. The meta-analyses showed: (a) non-significant effects for sedentary time (Standardized mean difference [SMD] = -0.02; 95%CI, -0.14, 0.11), physical activity at all intensities (light: SMD= -0.01; 95%CI, -0.08, 0.05; moderate: SMD = 0.06; 95%CI, -0.09, 0.22; vigorous: SMD = 0.08; 95%CI, -0.02, 0.18; moderate-to-vigorous: SMD = 0.05; 95%CI, -0.01, 0.12) and waist circumference (SMD = 0.09; 95%CI, -0.03, 0.21), and (b) a small statistically significant decrease in body mass index (SMD= -0.09, 95%CI -0.16, -0.0). Factors related to intervention implementation were reported in 51% of the articles. Conclusion: While some intervention approaches demonstrated promise, small or null effects were found in meta-analyses. Future school-based interventions should utilize a whole-school approach designed to increase adolescents' activity across the day. Consistent reporting of implementation will increase understanding of how interventions are adopted, implemented and sustained. Registration: PROSPERO (CRD42020169988). Key Points: School-based interventions with adolescents have had null effects on increasing physical activity and reducing sedentary time. The impact on physical and psychological outcomes has been poorly reported among secondary school students. This review included articles with all experimental study designs, any intervention length, and that reported a variety of outcomes among adolescents in secondary schools (11–18 years old). Although meta-analyses showed that these interventions did not increase physical activity or reduce sedentary time, studies that quantify adiposity markers showed a small decrease in body mass index. The review identified that additional physical activity sessions, environmental modifications, teacher training, peer support, educational resources and/or active lesson strategies were associated with greater benefits. Fidelity and participant responses were the most commonly reported implementation factors, adaptation was the least commonly reported; however, factors associated with effective implementation were not a focus of the included studies. [ABSTRACT FROM AUTHOR]

Increasing physical activity in patients offers dual benefits, fostering improved patient health and recovery, while also bolstering healthcare system efficiency by minimizing costs related to extended hospital stays, complications, and readmissions. Wearable activity trackers offer valuable opportunities to enhance physical activity across various healthcare settings and among different patient groups. However, their integration into healthcare faces multiple implementation challenges related to the devices themselves, patients, clinicians, and systemic factors. This article presents the Wearable Activity Tracker Checklist for Healthcare (WATCH), which was recently developed through an international Delphi study. The WATCH provides a comprehensive framework for implementation and evaluation of wearable activity trackers in healthcare. It covers the purpose and setting for usage; patient, provider, and support personnel roles; selection of relevant metrics; device specifications; procedural steps for issuance and maintenance; data management; timelines; necessary adaptations for specific scenarios; and essential resources (such as education and training) for effective implementation. The WATCH is designed to support the implementation of wearable activity trackers across a wide range of healthcare populations and settings, and in those with varied levels of experience. The overarching goal is to support broader, sustained, and systematic use of wearable activity trackers in healthcare, therefore fostering enhanced physical activity promotion and improved patient outcomes. [ABSTRACT FROM AUTHOR]

Poor health behaviours in childhood, including sedentary behaviour, low physical activity levels, inadequate sleep, and unhealthy diet, are established risk factors for both chronic diseases and mental illness. Scant studies have examined the importance of such health behaviour patterns for health-related quality of life (HRQoL). This study aimed to examine the association of health behaviour patterns with HRQoL among Canadian children. Data from 2866 grade five students were collected through a provincially representative school-based survey of the 2014 Raising Healthy Eating and Active Living Kids in Alberta study. Latent class analysis was used to identify health behaviour patterns based on 11 lifestyle behaviours: sedentary behaviour (using a computer, playing video games, watching TV), physical activity (with and without a coach), sleep (bedtime on weekdays and weekends), and diet (fruit and vegetables intake, grain products, milk and alternatives, meat and alternatives). Multivariable multilevel logistic regression was applied to examine the associations of health behaviour patterns with HRQoL. Three groupings with distinct health behaviour patterns were identified: the first grouping (55%) is characterized by relatively healthy levels of sedentary behaviour, physical activity, and sleep, but a less healthy diet ("activity-focused" group). The second grouping (24%) is characterized by a relatively healthy diet, but moderately healthy levels of sedentary behaviour, physical activity, and sleep ("diet-focused" group). The third grouping (21%) is characterized by mostly unhealthy behaviours ("not health-focused" group). Students in the third and second groupings ("not health-focused" and "diet-focused") were more likely to report lower HRQoL relative to students in the first grouping ("activity-focused"). The findings suggest that health promotion strategies may be more effective when considering the patterns of health behaviours as distinct targets in the efforts to improve HRQoL. Future research should include prospective observational and intervention studies to further elucidate the relationship between health behaviour patterns and HRQoL among children. [ABSTRACT FROM AUTHOR]

Background: Physical inactivity is associated with feelings of burnout and fatigue, which in turn are associated with reduced performance among healthcare practitioners. This study explored movement behaviours of general practitioners (GPs) and the association between these behaviours with burnout and fatigue. Methods: GPs in Northern Ireland were asked to wear a thigh-worn accelerometer for seven days and complete validated questionnaires to assess the association between daily number of steps, time spent sitting and standing with feelings of burnout and fatigue. Results: Valid accelerometer data were obtained from 47 (77.0%) participants. Average workday sitting time, standing time and number of steps were 10.6 h (SD 1.5), 3.8 h (SD 1.3), and 7796 steps (SD 3116) respectively. Participants were less sedentary (8.0 h (SD 1.6)) and more active (4.7 h (SD 1.4) standing time and 12,408 steps (SD 4496)) on non-workdays. Fourteen (30.4%) participants reported burnout and sixteen (34.8%) reported severe fatigue. There were no significant associations between sitting, standing and step counts with burnout or fatigue (p > 0.05). Conclusion: GPs were less active on workdays compared to non-workdays and exhibited high levels of sitting. Feelings of burnout and fatigue were highly prevalent, however movement behaviours were not found to be associated with burnout and fatigue. Given the increased sedentariness among GPs on workdays compared to non-workdays, GPs should consider how they can improve their movement behaviours on workdays to help optimise their wellbeing. [ABSTRACT FROM AUTHOR]

The Mediterranean Diet (MD) has been linked to numerous health benefits. This umbrella review aims to synthesize evidence from systematic reviews on the MD's impact on children and adolescents aged 6 to 19 years. Following Joanna Briggs Institute guidelines, we included 11 systematic reviews focusing on the MD's effects on health outcomes, such as asthma, anthropometric measures, physical fitness, and inflammatory markers. The results indicate a protective role of the MD against childhood asthma due to its antioxidant-rich components. However, evidence for its impact on allergic conditions like rhinitis and eczema is inconclusive. Findings regarding anthropometric outcomes, particularly BMI, are limited and inconsistent. A positive correlation was observed between MD adherence and increased physical activity, improved physical fitness, quality of life, and reduced sedentary behavior. Additionally, the MD showed an inverse relationship with pro-inflammatory biomarkers, suggesting anti-inflammatory benefits. The inconsistency in BMI findings and the potential anti-inflammatory properties of the MD warrant further longitudinal research. Future studies should explore the MD's impact on cognitive functions, academic performance, and mental health in this age group, highlighting the significance of establishing healthy eating habits early in life. [ABSTRACT FROM AUTHOR]

Background: Physical inactivity and a sedentary lifestyle are common among people with heart failure (HF), which may lead to worse prognosis. On an already existing mHealth platform, we developed a novel tool called the Activity coach, aimed at increasing physical activity. The aim of this study was to evaluate the usability of the Activity coach and assess feasibility of outcome measures for a future efficacy trial. Methods: A mixed-methods design was used to collect data. People with a HF diagnosis were recruited to use the Activity coach for four weeks. The Activity coach educates the user about physical activity, provides means of registering daily physical activity and helps the user to set goals for the next week. The usability was assessed by analysing system user logs for adherence, reported technical issues and by interviews about user experiences. Outcome measures assessed for feasibility were objective physical activity as measured by an accelerometer, and subjective goal attainment. Progression criteria for the usability assessment and for the proposed outcomes, were described prospectively. Results: Ten people with HF were recruited, aged 56 to 78 with median age 72. Data from nine of the ten study participants were included in the analyses. Usability: The Activity coach was used 61% of the time and during the first week two study participants called to seek technical support. The Activity coach was found to be intuitive and easy to use by all study participants. An increased motivation to be more physically active was reported by six of the nine study participants. However, in spite of feeling motivated, four reported that their habits or behaviours had not been affected by the Activity coach. Feasibility: Data was successfully stored in the deployed hardware as intended and the accelerometers were used enough, for the data to be analysable. One finding was that the subjective outcome goal attainment, was challenging to collect. A proposed mitigator for this is to use pre-defined goals in future studies, as opposed to having the study participants be completely free to formulate the goals themselves. Conclusions: It was confirmed that the Activity coach was easy to use. Furthermore, it might stimulate increased physical activity in a population of people with HF, who are physically inactive. The outcomes investigated seem feasible to include in a future efficacy trial. Trial registration: ClinicalTrials.gov identifier: NCT05235763. Date of first registration: 11/02/2022. [ABSTRACT FROM AUTHOR]

Previous studies have reported that low levels of physical activity result in sarcopenic obesity (SO). However, the effects of specific intensities of physical activity on SO and the optimal amount of physical activity for lowering the prevalence of SO have not been well studied. This study aimed to identify the effects of physical activity levels and intensity on SO and the optimal amount of physical activity related to a lower prevalence of SO. This cross-sectional study used data from the nationwide Korean Frailty and Aging Cohort Study (KFACS), which included 2071 older adults (1030 men, 1041 women). SO was defined according to the criteria of the European Society for Clinical Nutrition Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO). Multivariate logistic regression analysis was performed to investigate the association between the physical activity level and SO. The high activity group had a significantly lower prevalence of SO than the non-high activity (low and moderate activity) group. On the other hand, moderate-intensity physical activity was associated with a lower prevalence of SO. A total physical activity energy expenditure of > 3032 kcal/week (433 kcal/day) for men and 2730 kcal/week (390 kcal/day) for women was associated with a reduced prevalence of SO. The high physical activity and total physical energy expenditure described above may be beneficial for reducing the prevalence of SO. [ABSTRACT FROM AUTHOR]

Background: The longitudinal associations between physical behaviours and lean muscle mass indices need to be better understood to aid healthy ageing intervention development. Methods: We assessed physical behaviours (total physical activity, moderate-to-vigorous physical activity (MVPA), light physical activity, total sedentary time and prolonged sedentary bout time) for 7 days using hip-worn accelerometers. We also assessed domain-specific physical behaviours (walking, cycling, gardening and housework time) with self-report questionnaires at baseline (2006–2011) and follow-up (2012–2016) in the European Prospective Investigation into Cancer (EPIC)-Norfolk study. We assessed body composition using dual-energy X-ray absorptiometry (DEXA) at follow-up in 1535 participants (≥ 60 years at baseline). From this, we derived appendicular lean muscle mass (ALM) indices (% relative ALM = (ALM/total body weight)*100), body mass index (BMI)-scaled ALM (ALM/BMI, kg/kg/m2) and height-scaled ALM (ALM/height2, kg/m2)). We evaluated the prospective associations of both baseline and change in physical behaviours with follow-up muscle mass indices using multivariable linear regression. Results: Over 5.5 years (SD 14.8) follow-up, higher baseline accelerometer-measured physical activity and lower sedentary time were associated with higher subsequent relative ALM and BMI-scaled ALM, but not height-scaled ALM (e.g. 0.02% higher subsequent relative ALM per minute/day of baseline MVPA for men). Greater increases in physical activity and greater declines in sedentary time variables were associated with higher subsequent relative ALM and BMI-scaled ALM, but not height-scaled ALM (e.g. 0.001 kg/kg/m2 subsequent BMI-scaled ALM and 0.04% subsequent relative ALM per min/day/year increases in LPA over follow-up; 0.001 kg/kg/m2 subsequent BMI-scaled ALM and -0.03% subsequent relative ALM per min/day/year less of total sedentary time over follow-up). Greater increases in women's cycling and gardening over follow-up were associated with greater subsequent relative ALM (cycling 0.9% per hour/week/year; gardening 0.2% per hour/week/year) and BMI-scaled ALM (cycling 0.03 kg/kg/m2 per hour/week/year; gardening 0.004 kg/kg/m2 per hour/week/year). Conclusion: Physical behaviours across all intensities, and in women more specifically cycling and gardening, may help prevent age-related declines in muscle mass. [ABSTRACT FROM AUTHOR]

The Annual Report on Cardiovascular Health and Diseases in China (2022) intricate landscape of cardiovascular health in China. This is the first section of the report, which dissects influential factors across diverse domains. The investigation identifies tobacco use as a paramount concern, portraying China as the global epicenter of tobacco consumption. Cigarette smoking, exacerbated by second-hand smoke exposure, emerges as a critical and preventable risk factor, contributing to a surge in attributable deaths over the past three decades. In the realm of dietary nutrition, the study discerns an overall improvement, yet discerns worrisome deviations, notably an escalating fat intake surpassing recommended guidelines. The shifting dietary structure reveals diminished consumption of cereals and vegetables juxtaposed with an uptick in animal foods, while excessive intake of cooking oil and salt persists, straying substantially from endorsed levels. The exploration of physical activity patterns unfolds a nuanced narrative. Varied trends are observed among students, with concerns arising from sedentary behaviors and inadequate adherence to recommended guidelines. The analysis spans a trajectory of declining physical activity in Chinese adults, coupled with an alarming surge in sedentary leisure time, ultimately linking these factors to heightened risks of cardiovascular diseases and increased adiposity. An examination of overweight and obesity trends uncovers a relentless upward trajectory, projecting substantial prevalence by 2030. Noteworthy prevalence rates underscore the imperative for targeted interventions to curtail this burgeoning health crisis, with the anticipated prevalence extending to nearly two-thirds of the adult population. Psychological factors, notably depression, constitute an integral facet of cardiovascular health. Prevalence rates among patients with coronary artery disease and acute myocardial infarction underscore the intricate interplay between mental health and cardiovascular outcomes. Additionally, persistent depressive symptoms are shown to significantly elevate the risk of cardiovascular diseases and mortality. This first section underscores the multifaceted challenges facing cardiovascular health in China, emphasizing the imperative for tailored interventions across tobacco control, dietary habits, physical activity, obesity management, and psychological well-being to mitigate the escalating burden of cardiovascular diseases in the population. [ABSTRACT FROM AUTHOR]

BACKGROUND: Computers are ubiquitous in the workplace and facilitate prolonged sitting, which has adverse health consequences. Various computer-prompt software programs are designed to decrease sedentary behaviors and increase physical activity in the workplace. However, specific guidelines that would improve research in this area have not been published. OBJECTIVE: The objective of this article is to present recommendations for improving computer-prompt software research, to decrease sedentary behaviors and increase physical activity in the workplace. METHODS: Ten domains were identified based on deficiencies in the current literature combined with quality assessment tools to reduce the risk for bias. The ten domains include composition of the research team, behavioral sciences theoretical frameworks, research design, alert types, outcome measures, confounding factors, intervention duration, carryover effects, racial/ethnic composition, and organizational culture. RESULTS: Specific recommendations are presented for each domain. The research team should include all stakeholders contributing as copartners in designing the intervention. For theory, a systems science framework was presented. Clustered randomized controlled trials were recommended, rather than randomization at the individual level. Distinct types of alerts (visual, auditory, or both) and frequency of alerts (hourly, randomly generated, or based on prolonged sitting patterns) are described. Outcome measures include average duration of sitting bouts, longest sitting bout, and number of sitting bouts. CONCLUSION: Prolonged sitting and physical inactivity at work lead to major health problems. Adherence to the recommendations presented here should facilitate high-quality research and improve the health of desk-based workers by decreasing sedentary behaviors and increasing physical activity. [ABSTRACT FROM AUTHOR]

Background: Recently, research focus has shifted to the combination of all 24-h movement behaviors (physical activity, sedentary behavior and sleep) instead of each behavior separately. Yet, no reliable and valid proxy-report tools exist to assess all these behaviors in 0–4-year-old children. By involving end-users (parents) and key stakeholders (researchers, professionals working with young children), this mixed-methods study aimed to 1) develop a mobile application (app)-based proxy-report tool to assess 24-h movement behaviors in 0–4-year-olds, and 2) examine its content validity. Methods: First, we used concept mapping to identify activities 0–4-year-olds engage in. Parents (n = 58) and professionals working with young children (n = 21) generated a list of activities, sorted related activities, and rated the frequency children perform these activities. Second, using multidimensional scaling and cluster analysis, we created activity categories based on the sorted activities of the participants. Third, we developed the My Little Moves app in collaboration with a software developer. Finally, we examined the content validity of the app with parents (n = 14) and researchers (n = 6) using focus groups and individual interviews. Results: The app has a time-use format in which parents proxy-report the activities of their child, using eight activity categories: personal care, eating/drinking, active transport, passive transport, playing, screen use, sitting/lying calmly, and sleeping. Categories are clarified by providing examples of children's activities. Additionally, 1–4 follow-up questions collect information on intensity (e.g., active or calm), posture, and/or context (e.g., location) of the activity. Parents and researchers considered filling in the app as feasible, taking 10–30 min per day. The activity categories were considered comprehensive, but alternative examples for several activity categories were suggested to increase the comprehensibility and relevance. Some follow-up questions were considered less relevant. These suggestions were adopted in the second version of the My Little Moves app. Conclusions: Involving end-users and key stakeholders in the development of the My Little Moves app resulted in a tailored tool to assess 24-h movement behaviors in 0–4-year-olds with adequate content validity. Future studies are needed to evaluate other measurement properties of the app. [ABSTRACT FROM AUTHOR]