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Objective: To investigate the relationship between long-term weight training and mortality in male health professionals with and without type 2 diabetes.Research Design and Methods: We analyzed 31,140 men without type 2 diabetes and 2,588 with type 2 diabetes from the Health Professionals Follow-up Study (1992-2018). Information on weight training was repeatedly assessed using a biennial questionnaire. Cox regression was used to estimate hazard ratios (HRs) and 95% CIs.Results: During up to 26 years of follow-up, we documented 12,607 deaths (988 deaths among men with type 2 diabetes). Among participants without type 2 diabetes, 1-59 and 60-149 min/week of long-term weight training were associated with 14% (HR 0.86; 95% CI 0.82-0.89) and 8% (HR 0.92; 95% CI 0.85-0.99) lower mortality versus no weight training, respectively, after adjustment for aerobic activity. However, ≥150 min/week of weight training was not significantly associated with mortality (HR 1.05; 95% CI 0.91-1.20; overall P trend = 0.94; P quadratic < 0.001). Meeting the recommended aerobic physical activity guideline (≥150 min/week) and performing any weight training were associated with 20-34% lower mortality. Among participants with type 2 diabetes, a moderate level of pre-diagnosis weight training was associated with lower mortality, whereas post-diagnosis weight training showed no association. Performing both weight training and aerobic activity before and after diagnosis was associated with lower mortality.Conclusions: A moderate level of long-term weight training was associated with lower mortality, independently of aerobic activity, among male health professionals with and without type 2 diabetes. Addition of weight training to aerobic activities may provide further benefit in mortality risk reduction. Studies are required to confirm our findings in diverse populations. [ABSTRACT FROM AUTHOR]

Background Little is known about the association between physical activity before cancer diagnosis and survival among lung cancer patients. In this pooled analysis of 11 prospective cohorts, we investigated associations of prediagnosis leisure-time physical activity (LTPA) with all-cause and lung cancer–specific mortality among incident lung cancer patients. Methods Using self-reported data on regular engagement in exercise and sports activities collected at study enrollment, we assessed metabolic equivalent hours (MET-h) of prediagnosis LTPA per week. According to the Physical Activity Guidelines for Americans, prediagnosis LTPA was classified into inactivity, less than 8.3 and at least 8.3 MET-h per week (the minimum recommended range). Cox regression was used to estimate hazard ratios (HRs) and 95% confidence interval (CIs) for all-cause and lung cancer–specific mortality after adjustment for major prognostic factors and lifetime smoking history. Results Of 20 494 incident lung cancer patients, 16 864 died, including 13 596 deaths from lung cancer (overall 5-year relative survival rate = 20.9%, 95% CI = 20.3% to 21.5%). Compared with inactivity, prediagnosis LTPA of more than 8.3 MET-h per week was associated with a lower hazard of all-cause mortality (multivariable-adjusted HR = 0.93, 95% CI = 0.88 to 0.99), but not with lung cancer–specific mortality (multivariable-adjusted HR = 0.99, 95% CI = 0.95 to 1.04), among the overall population. Additive interaction was found by tumor stage (P interaction =.008 for all-cause mortality and.003 for lung cancer–specific mortality). When restricted to localized cancer, prediagnosis LTPA of at least 8.3 MET-h per week linked to 20% lower mortality: multivariable-adjusted HRs were 0.80 (95% CI = 0.67 to 0.97) for all-cause mortality and 0.80 (95% CI = 0.65 to 0.99) for lung cancer–specific mortality. Conclusions Regular participation in LTPA that met or exceeded the minimum Physical Activity Guidelines was associated with reduced hazards of mortality among lung cancer patients, especially those with early stage cancer. [ABSTRACT FROM AUTHOR]

Background: Lifestyle risk factors have been associated with increased all-cause and cause-specific mortality, but the influence of reverse causation has been underappreciated as a limitation in epidemiological studies. Methods: Prospective cohort study including 457,021 US adults from the National Health Interview Survey 1997–2013 linked to the National Death Index records through December 31, 2015. Multivariable Cox models were performed to examine the association of lifestyle risk factors with all-cause and cause-specific mortality. Participants with prevalent diseases and the first 2, 5, 10, and 15 years of follow-up were excluded to account for reverse causation. Results: During 4,441,609 person-years, we identified 60,323 total deaths. Heavy alcohol drinking (HR 1.12; 95% CI 1.08 to 1.16), smoking (HR 1.78; 95% CI 1.74 to 1.83) and lack of physical activity (HR 1.51; 95% CI 1.47 to 1.54) were associated with increased all-cause mortality. Overweight was associated with lower all-cause mortality (HR 0.88; 95% CI 0.86 to 0.90). After exclusion of participants with diseases and first 10 years of follow-up, associations changed to: heavy alcohol drinking (HR 1.31; 95% CI 1.20 to 1.43), smoking (HR 1.99; 95% CI 1.87 to 2.11), lack of physical activity (HR 1.21; 95% CI 1.15 to 1.27), and overweight (HR 1.05; 95% CI 1.00 to 1.10). Conclusions: Methods to account for reverse causation suggest different effects of reverse causation on the associations between lifestyle risk factors and mortality. Exclusion of participants with diseases at baseline, and exclusion of 5–10 years of follow-up may be necessary to mitigate reverse causation. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the association between domain-specific physical activity (PA) and diabetes in Korean adults. We analyzed 26,653 men and women (aged > 18 years) from the Korea National Health and Nutrition Examination Survey (2014–2018). PA was measured using a validated Global PA Questionnaire. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) after adjustment for various confounders. Transport PA accounted for the majority of total PA (46%, men; 58%, women), followed by leisure-time PA (30%; 22%) and work PA (24%; 20%). In men, ORs (95% CI) of diabetes comparing ≥ 600 metabolic task of equivalent (MET)-min/week vs. no activity were 0.82 (0.71–0.95) for leisure-time PA, 0.85 (0.75–0.96) for transport PA, and 0.88 (0.78–0.99) for leisure-time + transport PA. In women, ORs (95% CI) of diabetes comparing the same groups were 0.73 (0.60–0.89) for leisure-time PA, 0.97 (0.85–1.10) for transport PA, and 0.88 (0.78–1.00) for leisure-time + transport PA. However, work PA showed no association with diabetes. In conclusion, leisure-time PA was inversely associated with diabetes in both men and women, while transport PA was inversely associated only in men. But work PA was not associated with diabetes in Korean adults. [ABSTRACT FROM AUTHOR]

Individual lifestyle risk factors have been associated with an increased risk of mortality. However, limited evidence is available on the combined association of lifestyle risk factors with mortality in non-Western populations. The analysis included 37,472 participants (aged ≥19 years) in the Korea National Health and Nutrition Examination Surveys (2007–2014) for whom the data were linked to death certificates/medical records through December 2016. A lifestyle risk score was created using five unhealthy behaviors: current smoking, high-risk alcohol drinking, unhealthy weight, physical inactivity, and insufficient/prolonged sleep. Cox proportional hazards models were used to estimate hazard ratio (HR) and 95% confidence interval (CI). During up to 9 years of follow-up, we documented 1,057 total deaths. Compared to individuals with zero lifestyle risk factor, those with 4–5 lifestyle risk factors had 2.01 times (HR = 2.01, 95% CI = 1.43–2.82) and 2.59 times (HR = 2.59, 95% CI = 1.24–5.40) higher risk of all-cause and cardiovascular mortality, respectively. However, higher lifestyle risk score was not significantly associated with cancer mortality (p-trend >0.05). In stratified analyses, the positive associations tended to be stronger in adults aged <65 years, unemployed, and those with lower levels of education. In conclusion, combined unhealthy lifestyle behaviors were associated with substantially increased risk of total and cardiovascular mortality in Korean adults. [ABSTRACT FROM AUTHOR]

Various physical activity (PA) guidelines recommend leisure PA and resistance exercise (RE). However, the impact of PA and RE on the prevalence of depressive symptoms remains unclear. We investigated whether meeting PA and RE guidelines is associated with the prevalence of depressive symptoms using nationally representative samples. We analyzed data from 11,829 (5111 male and 6718 female) participants aged 19+ years in the Korean National Health and Nutrition Examination Survey (2016 and 2018). Those with doctor's diagnosis of depression or with a cut-off score of ≥11 on the Patient Health Questionnaire-9 were defined as having depressive symptoms. PA and RE were measured using a validated Global PA Questionnaire. Logistic regression analysis was used to examine the association between participating in leisure PA, simultaneously meeting RE guidelines, and experiencing depressive symptoms. Those who participated in leisure PA and met RE guidelines had a lower prevalence of depressive symptoms than those who did not (p for trend <0.001). After adjusting for covariates, those who participated in leisure PA and met RE guideline were significantly less likely to have depressive symptoms in male (OR = 0.52, 95 % CI 0.32–0.84) and female (OR = 0.71, 95 % CI 0.48–1.06), compared with those who did not participate in leisure PA but also did not meet RE guideline. The cross-sectional nature of the data prevented causal claims. Participation in leisure PA and RE was associated with a lower prevalence of depressive symptoms. This suggests both leisure PA and RE should be encouraged as effective means for preventing depression. • Both participating leisure PA & meeting RE guideline show lower depressive symptoms. • Lower ratio of RE guideline meeting in the depressive symptoms population • Meeting RE guidelines was associated with lower prevalence of depression. • Need for support to encourage both leisure PA and RE for people with depression. [ABSTRACT FROM AUTHOR]

Several biological mechanisms linking physical activity with cancer have been proposed. However, the influence of specific components of physical activity (volume, type and intensity), and their interaction with adiposity and diet, on cancer‐related biomarkers remain unclear. We used cross‐sectional data on 7,219 men in the Health Professionals Follow‐up Study (1992–1994) with C‐reactive protein (CRP), interleukin‐6 (IL6), tumor necrosis factor alpha receptor 2 (TNFαR2), adiponectin, C‐peptide and triglycerides/high‐density lipoprotein cholesterol ratio (TG/HDL). Details on physical activity, diet and adiposity were assessed by questionnaires. We used multivariable‐adjusted linear regression analyses to estimate relative concentrations of biomarkers by physical activity. Total physical activity was favorably associated with all biomarkers in a fairly linear manner. Comparing the highest (63+ metabolic equivalent (MET)‐hr/week) to the lowest (0‐8.9 MET‐hr/week) physical activity groups, the percent relative difference in concentration of biomarkers was −31% for CRP, −22% for IL6, −8% for TNFαR2, +9% for adiponectin, −22% for C‐peptide, and −20% for TG/HDL. These differences were modestly attenuated after adjustment for adiposity. For the same total MET‐hours of physical activity, the association was stronger for men engaging in both aerobic and resistance exercises compared to those engaging in aerobic only. However, no difference was found between those engaging in vigorous activities (≥20% of total MET‐hours) compared to those who did smaller amount of vigorous activities. Physical activity showed similar associations for these biomarkers regardless of adiposity and dietary pattern. In conclusion, high physical activity, preferably aerobic plus resistance training, was associated with favorable cancer‐related biomarkers. What's new? Physical activity is strongly suspected of protecting against cancer, especially cancers associated with increased body fatness. The underlying mechanism linking physical activity and cancer, however, remains uncertain. Here, physical activity, specifically volume, type, and intensity of activity, was investigated for both interactions with adiposity and diet and associations with cancer‐related biomarkers. Analyses of data on more than 7,200 men show that high levels of physical activity, especially aerobic and resistance exercise, are associated with favorable biomarkers of inflammation and insulin response. Physical activity has similar associations regardless of adiposity and diet, and optimal results can be achieved by maximizing all three. [ABSTRACT FROM AUTHOR]

We thank Du et al for their comments on our article.[1] Du et al mentioned that stroke is not significantly associated with most of the subgroups stratified by the duration of exercise per week (Table S5[1]), and thus, the results do not suggest a definite association between physical activity (PA) and reduced risk of stroke. In multivariable models without mutual adjustment for vigorous and moderate PA and for body mass index, we observed stronger inverse associations between PA and stroke ( I P i SB trend sb <0.001 for vigorous PA and 0.002 for moderate PA). [Extracted from the article]

Although considerable evidence suggests that leisure-time physical activity is associated with a reduced risk of endometrial cancer (EC), the shape of dose-response relationship has not been investigated and previous meta-analyses have not accounted for differences in measures of physical activity. To address such issues, we conducted linear and nonlinear dose-response meta-analyses by metabolic equivalent of task (MET)-hour/week and hour/week, respectively, based on observational studies published up to September 2013 identified from PubMed and Embase databases. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. In the linear dose-response analysis, an increase in leisure-time physical activity by 3 MET-hour/week was associated with an ∼2% reduced risk of EC (summary RR = 0.98, p = 0.02, 95% CI = 0.95-1.00, I2 = 53%, pheterogeneity = 0.06, three case-control studies and three cohort studies, 3,460 cases, range of activity = 0-50 MET-hour/week) and an increase by an hour/week was associated with an ∼5% reduced risk of EC (summary RR = 0.95, p < 0.001, 95% CI = 0.93-0.98, I2 = 31%, pheterogeneity = 0.20, four case-control studies and two cohort studies, 3,314 cases, range of activity = 0-12 hour/week). Nonlinear dose-response meta-analysis suggested that the curve may plateau at 10 MET-hour/week ( pchange in slope = 0.04) but this statistical significance was sensitive to one study. No evidence of a nonlinear association was indicated by hour/week ( pchange in slope > 0.69). In conclusion, an increase in leisure-time physical activity may continue to decrease EC risk, within the range of 0-50 MET-hour/week or 0-15 hour/week. Future studies should evaluate possible independent role of intensity of physical activity and effect modification by obesity. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the associations of domain-specific physical activity (PA) with the prevalence of depressive symptoms.Methods: We analyzed data from 11,679 (5,056 men and 6,623 women) participants aged ³19 years in the Korea National Health and Nutrition Examination Survey (2016 and 2018 waves). Depressive symptoms were measured using the Korean version of the Patient Health Questionnaire-9 (PHQ-9), with a cut-off score for depression of 11. The participants were first categorized by sex, and then by their PA level in different PA domains into three different groups. We examined the correlations between domain-specific PA and depressive symptoms using logistic regression analysis after controlling for confounders.Results: Total amount of PA was not associated with depressive symptoms. However, in both sexes, those high in leisure and transport PA had lower levels of depressive symptoms compared with those with no leisure and transport PA (p for trend <0.001). After adjusting for covariates, those high in work PA showed a significantly higher likelihood of having depressive symptoms both in male (OR= 2.74, 95% CI 1.56-4.82) and female participants (OR= 2.84, 95% CI 1.70-4.49), compared to those with no work PA.Limitation: Cross-sectional nature of the data prevents causal associations.Conclusions: Although the total amount of PA participation was not associated with depressive symptoms, domain-specific PAs were differently associated with depressive symptoms. Specifically, higher amount of work PA was significantly associated with higher prevalence of depressive symptoms; this topic deserves further attention and future investigation. [ABSTRACT FROM AUTHOR]

Abstract: Background: The role of pentraxin-3 (PTX3) in the development of insulin resistance is still not clear. We aimed to test 1) whether circulating PTX3 levels are associated with insulin resistance and 2) whether changes in PTX3 levels after the physical activity are associated with changes in insulin resistance. Methods: Fifty-seven overweight or obese children (39 boys, 18 girls; age: 12.04±0.82y, BMI: 26.5±1.2kg/m2) participated in the study. All participants were housed together and their amount of physical activity (1823.5±1.34kcal/day) and food intake (1882±68.8kcal/day) were tightly controlled. Results: Circulating PTX3 levels at baseline were negatively associated with fasting insulin (r =−.336, p =0.012) and homeostasis model assessment of insulin resistance (HOMA-IR) (r =−.334, p =0.014) even after adjustment for BMI and Tanner stage. The degree of change in PTX3 levels notably associated with changes in fasting insulin (r =−.280, p =0.035) and HOMA-IR (r =−.281, p =.034) in response to the physical activity intervention. Subgroup analysis further indicates that HOMA-IR was improved more in subjects whose PTX3 levels were increased compared with subjects who PTX3 levels were decreased (HOMA-IR delta: −2.33±1.3 vs −1.46±0.70, p =0.004). Conclusion: PTX3 is negatively associated with insulin resistance and associated with changes in insulin resistance induced by physical activity in overweight and obese children. [Copyright &y& Elsevier]