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This study aimed to determine the relationship between bone mineral content, habitual physical activity, and calcium intake in children. Fifty-seven children, aged 8-11 years, wore pedometers for seven days to assess activity. Calcium intake was estimated by a 4-day food diary. Bone mineral content (BMC) and areal density (BMD) were measured at the total proximal femur and femoral neck using dual energy X-ray absorptiometry. Regression analysis was used to assess contributions of physical activity and calcium intake to BMC, residualized for bone area and body mass. Physical activity explained 11.6% of the variance in residualized BMC at the proximal femur and 14.3% at the femoral neck (p < 0.05). Calcium intake added to the variance explained at the proximal femur only (9.8%, p < 0.05). This study provides evidence for an association between BMC and habitual physical activity. [ABSTRACT FROM AUTHOR]

Objectives: Affect-regulated exercise to feel 'good' can be used to control exercise intensity amongst both active and sedentary individuals and should support exercise adherence. It is not known, however, whether affect-regulated exercise training can lead to physical health gains. The aim of this study was to examine if affect-regulated exercise to feel 'good' leads to improved fitness over the course of an 8-week training programme.Design: A repeated measures design (pretest-posttest) with independent groups (training and control).Methods: 20 sedentary females completed a submaximal graded exercise test and were then allocated to either a training group or control group. The training group completed two supervised sessions and one unsupervised session per week for 8 weeks. Exercise intensity was affect-regulated to feel 'good'. Following the 8 weeks of training, both groups completed a second submaximal graded exercise test.Results: Repeated measures analyses of variance indicated a significant increase in the time to reach ventilatory threshold in the training group (318 ± 23.7s) compared to control (248 ± 16.9s). Overall compliance to training was high (>92%). Participants in the training group exercised at intensities that would be classified as being in the lower range of the recommended guidelines (≈ 50% V˙O(2) max) for cardiovascular health.Conclusions: Affect-regulated exercise to feel 'good' can be used in a training programme to regulate exercise intensity. This approach led to a 19% increase in time to reach ventilatory threshold, which is indicative of improved fitness. [ABSTRACT FROM AUTHOR]

Objective: To assess whether the activity pattern differs between normal weight and overweight boys across weekdays and weekend days. Methods: Physical activity was recorded every 2 s by accelerometry in 32 normal weight and 15 overweight boys aged 8-10 years for four weekdays and two weekend days (South-West England 2007). Summary activity measures and activity pattern characteristics (frequency, intensity and duration of > or =4 s (short) and > or =5-min (long) bouts of > or =light, > or =moderate, > or =vigorous, and > or =hard activity) were recorded. Results: Normal weight boys accumulated more > or =hard activity (p<0.05) but other summary measures did not differ by weight status. However, the activity pattern differed in overweight relative to normal weight boys. The most frequent short bouts were shorter and less intense (p<0.05). All long bouts were less intense and > or =moderate long bouts were shorter and less frequent (p<0.05). Overall, less activity was accumulated on weekends (frequency of more intense short bouts, intensity of most frequent long bouts and duration of > or =light, > or =moderate (and for overweight boys > or =vigorous) short bouts dropped-off) (p<0.05). Conclusion: Despite equivalent summary activity measures overweight boys exhibited fewer and shorter bouts, particularly sustained > or =moderate bouts, relative to normal weight boys suggesting that the activity pattern may be important for weight control. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess whether maximal oxygen uptake (V.O2max) could be predicted from submaximal ratings of perceived exertion (RPE) elicited during the multistage fitness test (MFT). Eleven female volunteers completed three maximal exercise tests in random order; the MFT, a simulated MFT on a motorised treadmill and a graded exercise test to volitional exhaustion (GXT), also on a motorised treadmill. RPE values were recorded at the end of each 1 min stage in all three tests. Oxygen consumption (VO2) was recorded continuously during the treadmill tests. Measured V.O2max values from the GXT and simulated MFT were not significantly different (48.2 and 47.5 ml/kg/min, respectively), but they were significantly higher than V.O2max values predicted by the MFT (41.2 ml/kg/min, p<0.05). Regression of submaximal RPE values (7DS17) elicited from the MFT and VO2 values predicted by the MFT were extrapolated to RPE 20 to predict V.O2max. The RPE-predicted V.O2max from the MFT (47.5 ml/kg/min) was similar to measured V.O2max. The findings suggest that submaximal RPE values can be used to provide acceptable estimates of V.O2max which are more accurate than the published table values for the MFT. Furthermore, the use of RPE measures in conjunction with the MFT enhances the accuracy of V.O2max prediction by the MFT. [ABSTRACT FROM AUTHOR]

OBJECTIVE.: To characterize the pattern of activity in boys and girls across weekdays and weekend days. METHODS.: Physical activity was recorded every 2 s by uniaxial accelerometry in 84 children, aged 9-11 years, for up to four weekdays and two weekend days. Activity bouts (>/=4 s and >/=5 min) greater than light (>/=LIGHT), moderate (>/=MOD) and vigorous (>/=VIG) intensity were recorded. The study took place in the South-West of England in 2007. RESULTS.: The mean duration of activity bouts decreased as intensity increased from 11.0+/-1.3 s for >/=LIGHT activity to 6.1+/-1.0 s for >/=VIG activity. The frequency, duration and intensity of bouts were greater in boys than girls, and the frequency and duration of bouts were greater on weekdays than weekend days. Girls accumulated more activity sporadically than boys, whereas boys accumulated more activity in >/=5-min bouts. CONCLUSION.: Sex differences and weekday/weekend differences in activity were largely due to the intensity of the most frequent bouts of activity and frequency of the most intense bouts. Information regarding the pattern of children's habitual activity can be used to inform activity interventions and assess the aspects of the activity pattern that are related to health. Copyright © 2007 by Elsevier Inc. [ABSTRACT FROM AUTHOR]

Motive8 is a health and fitness company that provides in-school PE/sport provision. The primary aim of this study was to assess the quantity and quality of physical activity during Motive8 PE lessons compared to PE lessons taught by the school PE specialist. A secondary aim was to assess whether PE lessons impact on daily activity levels. Physical activity was measured for 2 weeks in 19 children, aged 10-11 years, using accelerometry. In week 1, half of the children undertook a normal week of lessons, including two School PE lessons (football-based and dance-based); the other half also followed their normal timetable, except that Motive8 led their PE lessons. In week 2, this was reversed. Motive8 classes provided 20.5 ± 3.8 minutes of moderate and 7.9 ± 2.6 minutes of vigorous activity. This was greater than the 15.9 ± 6.1 minutes of moderate and 5.1 ± 3.8 minutes of vigorous activity experienced in the School PE lessons (p < 0.005). Seventy-five percent of children achieved 22 minutes of moderate to vigorous activity in Motive8 PE lessons, compared with the 9 minutes of moderate to vigorous activity achieved by 75% of children in School PE classes. Days containing football classes contained fewer minutes of moderate activity than days containing dance classes or no PE (football, 46.4 ± 14.6 minutes; dance, 51.8 ± 15.4 minutes; no PE, 50.7 ± 10.5 minutes; p < 0.05). In conclusion, physical activity during Motive8 lessons was more consistent between children than in School PE lessons, reflecting increased physical activity in the least active children. PE lessons had little impact on overall daily physical activity. [ABSTRACT FROM AUTHOR]

Exercise-induced muscle damage (EIMD) is characterized by loss of strength, increase in muscle stiffness, swelling, and soreness. The aim of this study was to assess the effects of flexibility training of the hamstring muscle group on symptoms of EIMD. Fourteen males (mean ± standard deviation: age = 20.6 ± 0.8 years; mass = 77.3 ± 10.4 kg; height = 1.77 ± 0.05 m) were randomly assigned to a 5-week flexibility (proprioceptive neuromuscular facilitation [PNF]) training or control group. Pre- and post-measures of peak static muscle force at knee joint angles representing decreasing muscle lengths of the hamstrings (25 deg, 30 deg, 40 deg, 80 deg) and flexibility were taken. Flexibility increased significantly following PNF flexibility training (pre-test = 19.4 ± 6.2 cm, post-test = 26.6 ± 6.9 cm), whereas it stayed constant in the control group (pre-test = 16.0 ± 9.3 cm, posttest = 16.7 ± 7.6 cm). Both groups underwent a damaging exercise protocol incorporating six sets of 10 isokinetic eccentric contractions of the hamstrings. Measurements of isometric strength, flexibility, and perceived soreness were recorded prior to and 1, 24, 48 and 72 hours after damage. There was a tendency for the PNF group to recover from strength loss earlier at longer muscle lengths (25 deg, p = 0.06; 30 deg, p = 0.05), but not at shorter muscle lengths. There was no evidence of a protective effect of PNF training on flexibility and soreness. In conclusion, an increase in flexibility of the hamstring muscle group led to some protection from strength loss at long muscle lengths following EIMD. [ABSTRACT FROM AUTHOR]

PURPOSE: The aims of this study were to assess and compare the validity of the RT3 accelerometer for the assessment of physical activity in boys and men, to compare RT3 and Tritrac accelerometer counts, and to determine count cut-off values for moderate (> or =3 < 6 METs) and vigorous (> or =6 METs) activity. METHODS: Nineteen boys (age: 9.5 +/- 0.8 yr) and 15 men (age: 20.7 +/- 1.4 yr) walked and ran on a treadmill, kicked a ball to and fro, played hopscotch, and sat quietly. An RT3 was worn on the right hip; boys also wore a Tritrac on the left hip. Oxygen consumption was expressed as a ratio of body mass raised to the power of 0.75 (S VO2). RESULTS: RT3 counts correlated significantly with S VO2 in boys (r = 0.87, P < 0.01) and men (r = 0.85, P < 0.01). However, during treadmill activities, RT3 counts were significantly higher for boys (P < 0.05). RT3 counts corresponding to 'moderate' and 'vigorous' activity were similar for boys and men for all activities (moderate = 970.2 for boys and 984.0 for men; vigorous = 2333.0 for boys and 2340.8 for men) but approximately 400 counts lower in men when only treadmill activities were considered. Tritrac counts correlated significantly with S VO2 in boys (r = 0.87, P < 0.01), but were significantly lower than RT3 counts across most activities (P < 0.05). CONCLUSIONS: The RT3 accelerometer is a good measure of physical activity for boys and men. However, moderate and vigorous intensity count thresholds differ for boys and men when the predominant activities are walking and running. RT3 counts are significantly higher than Tritrac counts for a number of activities. These findings have implications when comparing activity counts between studies using the different instruments. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate the reliability and variability of eight RT3 accelerometers. METHODS: The RT3 were subjected to two repeated trials of six activities: rest, walking (4 and 6 km x h-1), running (8 and 10 km x h-1), and sit-stand position (20 min). One person performed all trials (female: age 24 yr, height 158.0 cm, mass 48.2 kg). Each activity lasted 12 min. The middle 10 min were taken from each 12-min trial and used as the output measure (cts x min-1). Data were analyzed for activity ( 6), monitor ( 8), and trial ( 2) effects using four three-way ANOVA: vector magnitude, X (vertical), Y (anterioposterior), and Z (mediolateral) axes. RESULTS: Intermonitor coefficient of variation was <6% during locomotive activities, however, increased to 8-25% during sit-stand. A three-way interaction was found for vector magnitude (F35,315=88945.7, P < 0.001) and Y (F35,315=978435.6, P < 0.001) and Z axes (F35,315=103802.8, P < 0.001). A two-way activity x monitor interaction was found for the X axis (F35,315=1037787.0, P < 0.001). Follow-up tests revealed no differences between trials 1 and 2 for vector magnitude, X and Z axes. One monitor recorded significantly lower activity counts in trial 1 compared with trial 2 along the Y axis. Intermonitor differences were evident at 4, 6, 8, and 10 km x h-1 for the Y and Z axes, and at 6, 8, and 10 km x h-1 for the vector magnitude and X axis. Variability between monitors at each activity increased as intensity increased. CONCLUSION: Reliability of the RT3 is good; however, intermonitor variability exists. The vertical axis of the RT3 accelerometer showed the least variability and was the most reliable. It is recommended that intermonitor variability and reliability of RT3 on each axis be assessed before use. [ABSTRACT FROM AUTHOR]

Background and Aims: Although extreme cardiac adaptions mirroring phenotypes of cardiomyopathy have been observed in endurance athletes, adaptions to high levels of physical activity within the wider population are under-explored. Therefore, in this study, associations between device-measured physical activity and clinically relevant cardiac magnetic resonance volumetric indices were investigated., Methods: Individuals without known cardiovascular disease or hypertension were included from the UK Biobank. Cardiac magnetic resonance data were collected between 2015 and 2019, and measures of end-diastolic chamber volume, left ventricular (LV) wall thickness, and LV ejection fraction were extracted. Moderate-to-vigorous-intensity physical activity (MVPA), vigorous-intensity physical activity (VPA), and total physical activity were assessed via wrist-worn accelerometers., Results: A total of 5977 women (median age and MVPA: 62 years and 46.8 min/day, respectively) and 4134 men (64 years and 49.8 min/day, respectively) were included. Each additional 10 min/day of MVPA was associated with a 0.70 [95% confidence interval (CI): 0.62, 0.79] mL/m2 higher indexed LV end-diastolic volume (LVEDVi) in women and a 1.08 (95% CI: 0.95, 1.20) mL/m2 higher LVEDVi in men. However, even within the top decile of MVPA, LVEDVi values remained within the normal ranges [79.1 (95% CI: 78.3, 80.0) mL/m2 in women and 91.4 (95% CI: 90.1, 92.7) mL/m2 in men]. Associations with MVPA were also observed for the right ventricle and the left/right atria, with an inverse association observed for LV ejection fraction. Associations of MVPA with maximum or average LV wall thickness were not clinically meaningful. Results for total physical activity and VPA mirrored those for MVPA., Conclusions: High levels of device-measured physical activity were associated with cardiac remodelling within normal ranges., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Aims: To investigate how physical activity (PA) volume, intensity, duration, and fragmentation are associated with the risk of all-cause and cardiovascular disease mortality. To produce centile curves for PA volume and intensity representative of US adults., Methods and Results: This study is based on the observational 2011-2014 National Health and Nutrition Examination Survey (NHANES). Adults (age, ≥20) with valid accelerometer, covariate, and mortality data were included. Average acceleration (AvAcc), intensity gradient (IG), and total PA served as proxies for volume, intensity, and duration of PA, respectively. Weighted Cox proportional hazard models estimated associations between outcome and PA metrics. In 7518 participants (52.0% women, weighted median age of 49), there were curvilinear inverse dose-response relationships of all-cause mortality risk (81-month follow-up) with both AvAcc [-14.4% (95% CI, -8.3 to -20.1%) risk reduction from 25th to 50th percentile] and IG [-37.1% (95% CI, -30.0 to -43.4%) risk reduction from 25th to 50th percentile], but for cardiovascular disease (CVD) mortality risk (n = 7016, 82-month follow-up) only with IG [-41.0% (95% CI, -26.7 to -52.4%) risk reduction from the 25th to 50th percentile]. These relationships plateau at AvAcc: ∼35-45 mg and IG: -2.7 to -2.5. Associations of PA with all-cause and cardiovascular disease mortality are primarily driven by intensity and secondary by volume. Centile curves for volume and intensity were generated., Conclusion: Intensity is a main driver of reduced mortality risk suggesting that the intensity of PA rather than the quantity matters for longevity. The centile curves offer guidance for achieving desirable PA levels for longevity., Competing Interests: Conflict of interest: none declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Background: Following shoulder surgery, controlled and protected mobilisation for an appropriate duration is crucial for appropriate recovery. However, methods for objective assessment of sling wear and use in everyday living are currently lacking. In this pilot study, we aim to determine if a sling-embedded triaxial accelerometer and/or wrist-worn sensor can be used to quantify arm posture during sling wear and adherence to sling wear., Methods: Four participants were asked to wear a GENEActiv triaxial accelerometer on their non-dominant wrist for four hours in an office environment, and, for two of those hours, they also wore a sling in which an additional GENEActiv accelerometer was secured. During sling wear, they were asked to move their arm in the sling through a series of pre-specified arm postures., Results: We found that upper arm angle and posture type during sling wear can be predicted from a sling sensor alone (R 2 = 0.79, p < 0.001 and Cohen's kappa = 0.886, respectively). The addition of a wrist-worn sensor did not improve performance. The optimisation of an existing non-wear algorithm accurately detected adherence (99.3%)., Conclusions: the remote monitoring of sling adherence and the quantification of immobilisation is practical and effective with digital health technology.

Background: Aircraft noise is a growing concern for communities living near airports., Objectives: This study aimed to explore the impact of aircraft noise on heart structure and function., Methods: Nighttime aircraft noise levels (L night ) and weighted 24-hour day-evening-night aircraft noise levels (L den ) were provided by the UK Civil Aviation Authority for 2011. Health data came from UK Biobank (UKB) participants living near 4 UK major airports (London Heathrow, London Gatwick, Manchester, and Birmingham) who had cardiovascular magnetic resonance (CMR) imaging starting from 2014 and self-reported no hearing difficulties. Generalized linear models investigated the associations between aircraft noise exposure and CMR metrics (derived using a validated convolutional neural network to ensure consistent image segmentations), after adjustment for demographic, socioeconomic, lifestyle, and environmental confounders. Mediation by cardiovascular risk factors was also explored. Downstream associations between CMR metrics and major adverse cardiac events (MACE) were tested in a separate prospective UKB subcohort (n = 21,360), to understand the potential clinical impact of any noise-associated heart remodeling., Results: Of the 3,635 UKB participants included, 3% experienced higher L night (≥45 dB) and 8% higher L den (≥50 dB). Participants exposed to higher L night had 7% (95% CI: 4%-10%) greater left ventricular (LV) mass and 4% (95% CI: 2%-5%) thicker LV walls with a normal septal-to-lateral wall thickness ratio. This concentric LV remodeling is relevant because a 7% greater LV mass associates with a 32% greater risk of MACE. They also had worse LV myocardial dynamics (eg, an 8% [95% CI: 4%-12%] lower global circumferential strain which associates with a 27% higher risk of MACE). Overall, a hypothetical individual experiencing the typical CMR abnormalities associated with a higher L night exposure may have a 4 times higher risk of MACE. Findings were clearest for L night but were broadly similar in analyses using L den . Body mass index and hypertension appeared to mediate 10% to 50% of the observed associations. Participants who did not move home during follow-up and were continuously exposed to higher aircraft noise levels had the worst CMR phenotype., Conclusions: Higher aircraft noise exposure associates with adverse LV remodeling, potentially due to noise increasing the risk of obesity and hypertension. Findings are consistent with the existing literature on aircraft noise and cardiovascular disease, and need to be considered by policymakers and the aviation industry., Competing Interests: Funding Support and Author Disclosures This project was funded by the Medical Research Council (MRC) ANCO (Aircraft Noise and Cardiovascular Outcomes) study grant (principal investigator: Dr Hansell). Dr Topriceanu was supported by a British Cardiovascular Society Heart Research UK Fellowship and by a University College London (UCL) Charlotte and Yule Bogue Research Fellowship. Dr Captur was supported by the British Heart Foundation (MyoFit46 Special Programme Grant SP/20/2/34841), a National Institute for Health and Care Research (NIHR) iFAST grant (187075), and by the NIHR UCL Hospitals Biomedical Research Centre. Drs Hansell, Gulliver, and Gong were funded by the NIHR Health Protection Research Unit in Environmental Exposures and Health at the University of Leicester development award, a partnership between the UK Health Security Agency, the Health and Safety Executive, and the University of Leicester. Dr Hansell was funded by the NIHR Leicester Biomedical Research Centre. Dr Blangiardo was partially supported by the MRC Centre for Environment and Health funded by the UK Medical Research Council (grant no. MR/L01341X/1). Dr Hughes was supported by the British Heart Foundation, the Horizon 2020 and Horizon Europe Programmes of the European Union, the NIHR UCL Hospitals Biomedical Research Centre, the UK Medical Research Council, the NIHR, and the Wellcome Trust, and works in a unit that receives support from the UK Medical Research Council. None of the funders were involved in the study design, collection, analysis, interpretation of the data, or decision to submit the article for publication. The views expressed in this publication are those of the authors and not necessarily those of the funders. The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Aims: To examine the associations of substituting sedentary behaviour (SB) for sleep, light physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) with physical function and wellbeing., Methods: Cross-sectional data from 808 adults with Type 2 Diabetes Mellitus, (T2DM) were included. 24-hour behaviours were ascertained through accelerometery. Isotemporal substitution was used to estimate the theoretical substitution of SB for other 24-hour behaviours on associations with physical function and wellbeing markers., Results: Reallocating 30 min of SB to sleep was beneficially associated with 1.0% (95% CI: 0.1-1.9) higher sit-to-stand-60 (STS60) and 1.2% (0.1-2.3) Duke Activity Status Index (DASI) scores, 3.6% (1.5-5.5) lower Patient Hospital Questionnaire-9 (PHQ9) and 1.9% lower (0.1-3.7) Diabetes Distress scores. Whilst substituting SB with MVPA was associated with 3.8% (2.2-5.4) higher STS60 and 3.9% (2.0-5.9) DASI scores, and 4.7% (0.3-9.0) lower PHQ9 score. Replacing SB with LPA was associated with 4.1% (1.0-7.1) lower PHQ9 score., Conclusion: In adults with T2DM, theoretically replacing SB with sleep and physical activity, particularly MVPA is beneficially associated with markers of physical function and wellbeing. For wellbeing, associations for sleep were comparable (depression), or greater (diabetes distress), than for MVPA., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Competing Interests: Competing interests Both authors declare that they have no competing interests.

Aims: Incorrectly fitting footwear (IFF) poses a risk of trauma to at-risk feet with diabetes. The aim of this systematic review was to summarise and assess the evidence that IFF is a statistically significant cause of ulceration., Methods: We searched PubMed, Scopus, Web of Science and Google Scholar for English-language peer-reviewed studies reporting the number or percentage of people with diabetes-related foot ulceration (DFU) attributed to wearing IFF and included a physical examination of the footwear worn. Two independent reviewers assessed the risk of bias using the Newcastle-Ottawa scale., Results: 4318 results were retrieved excluding duplicates with 45 studies shortlisted. Ten studies met the inclusion criteria with most rated as fair (n = 6) or good (n = 3). There is some evidence that DFU is significantly associated with IFF, but this is limited: only 3 of 10 included studies found a statistically significant percentage of those with DFU were wearing IFF or inappropriate footwear which included fastening, material, type or fit (15.0%-93.3%). Risk of bias in these three studies ranged from 'fair' to 'poor'. IFF definitions were often unreported or heterogeneous. Only one study reported IFF-related ulcer sites: 70% were at plantar hallux/toes and 10% at plantar metatarsal heads., Conclusions: There is some evidence that IFF is a cause of DFU, but further research is needed, which defines IFF, and methodically records footwear assessment, ulcer location and physical activity. Researchers need to uncover why IFF is worn and if this is due to economic factors, a need for footwear education or other reasons., (© 2024 Diabetes UK.)

Background: Higher accelerometer-assessed volume and intensity of physical activity (PA) have been associated with a longer life expectancy but can be difficult to translate into recommended doses of PA. We aimed to: (a) improve interpretability by producing UK Biobank age-referenced centiles for PA volume and intensity; (b) inform public-health messaging by examining how adding recommended quantities of moderate and vigorous PA affect PA volume and intensity., Methods: 92,480 UK Biobank participants aged 43-80 years with wrist-worn accelerometer data were included. Average acceleration and intensity gradient were derived as proxies for PA volume and intensity. We generated sex-specific centile curves using Generalized Additive Models for Location Scale and Shape (GAMLSS) and modeled the effect of adding moderate (walking) or vigorous (running) activity on the combined change in the volume and intensity centiles (change in PA profile)., Results: In men, volume was lower as age increased while intensity was lower after age 55; in women, both volume and intensity were lower as age increased. Adding 150 min of moderate PA weekly (5 × 30 min walking) increased the PA profile by 4 percentage points. Defining moderate PA as brisk walking approximately doubled the increase (9 percentage points) while 75 min of vigorous PA weekly (5 × 15 min running) trebled the increase (13 percentage points)., Conclusion: These UK Biobank reference centiles provide a benchmark for interpretation of accelerometer data. Application of our translational methods demonstrate that meeting PA guidelines through shorter duration vigorous activity is more beneficial to the PA profile (volume and intensity) than longer duration moderate activity., (Copyright © 2025. Production and hosting by Elsevier B.V.)

Background: Nighttime aircraft noise may affect people's sleep, yet large-scale evidence using objective and subjective measures remains limited., Objective: Our aim was to investigate associations between nighttime aircraft noise exposure and objectively measured sleep disturbance using a large UK cohort., Methods: We used data from 105,770 UK Biobank cohort participants exposed and unexposed to aircraft noise who lived in 44 local authority districts near 4 international airports in England. We used a generalized linear regression model to examine cross-sectional associations between aircraft noise L night (23:00 hours-07:00 hours) and 7-d actimetric measures collected 2013-2015 ( n = 22,102 ). We also used Logit and generalized estimating equations models to examine associations between L night and self-reported sleep measures at enrollment (2006-2010) and follow-up (2012-2013). This approach allowed us to compare and contrast the results and support potential future meta-analyses on noise-related sleep disturbance., Results: Cross-sectional analyses of actimetric data suggested sleep disturbance associated with L night , showing higher level of movements during the least active continuous 8-h time period [ β : 0.12 milligravitational units; 95% confidence interval (CI): 0.013, 0.23]. We also saw disrupted sleep-wake cycles as indicated by index scores of lower relative amplitude ( β : - 0.006 ; 95% CI: - 0.007 , - 0.005 ), poorer interdaily stability ( β : - 0.010 ; 95% CI: - 0.014 , - 0.006 ), and greater intradaily variability ( β : 0.021; 95% CI: 0.019, 0.023), comparing L night ≥ 55 dB with < 45 dB. Repeated cross-sectional analyses found a 52% higher odds of more frequent daytime dozing [odds ratio (OR) = 1.52 ; 95% CI: 1.32, 1.75] for L night ≥ 55 dB in comparison with < 45 dB, whereas the likelihood for more frequent sleeplessness was more uncertain ( OR = 1.13 ; 95% CI: 0.92, 1.39). Higher effect sizes were seen in preidentified vulnerable groups, including individuals > 65 y of age and those with diabetes or dementia., Conclusion: Individuals exposed to higher levels of aircraft noise experienced objectively higher levels of sleep disturbance and changes in sleep-wake cycle. https://doi.org/10.1289/EHP14156.

Background: There is a lack of research examining the interplay between objectively measured physical activity volume and intensity with life expectancy. The purpose of the study was to investigate the interplay between objectively measured PA volume and intensity profiles with modeled life expectancy in women and men within the UK Biobank cohort study and interpret findings in relation to brisk walking., Methods: Individuals from UK Biobank with wrist-worn accelerometer data were included. The average acceleration and intensity gradient were extracted to describe the physical activity volume and intensity profile. Mortality data were obtained from national registries. Adjusted life expectancies were estimated using parametric flexible survival models., Results: 40,953 (57.1%) women (median age = 61.9 years) and 30,820 (42.9%) men (63.1 years) were included. Over a median follow-up of 6.9 years, there were 1719 (2.4%) deaths (733 in women; 986 in men). At 60 years, life expectancy was progressively longer for higher physical activity volume and intensity profiles, reaching 95.6 years in women and 94.5 years in men at the 90th centile for both volume and intensity, corresponding to 3.4 additional years (95% confidence interval (95%CI): 2.4-4.4) in women and 4.6 additional years (95%CI: 3.6-5.6) in men compared to those at the 10th centiles. An additional 10-min or 30-min daily brisk walk was associated with 0.9 (95%CI: 0.5-1.3) and 1.4 years (95%CI: 0.9-1.9) longer life expectancy, respectively, in inactive women; and 1.4 years (95%CI: 1.0-1.8) and 2.5 (95%CI: 1.9-3.1) in inactive men., Conclusion: Higher physical activity volumes were associated with longer life expectancy, with a higher physical activity intensity profile further adding to a longer life. Adding as little as a 10-min brisk walk to daily activity patterns may result in a meaningful benefit to life expectancy., Competing Interests: Competing interests The authors declare that they have no competing interests., (Copyright © 2025. Production and hosting by Elsevier B.V.)

Diabetic Foot Ulcers (DFUs) are a major complication of diabetes, with treatment requiring offloading. This study aimed to capture how the accelerometer-assessed physical activity profile differs in those with DFUs compared to those with diabetes but without ulceration (non-DFU). Participants were requested to wear an accelerometer on their non-dominant wrist for up to 8days. Physical activity outcomes included average acceleration (volume), intensity gradient (intensity distribution), the intensity of the most active sustained (continuous) 5-120 min of activity (MX CONT ), and accumulated 5-120 min of activity (MX ACC ). A total of 595 participants (non-DFU = 561, DFU = 34) were included in the analysis. Average acceleration was lower in DFU participants compared to non-DFU participants (21.9 mg [95%CI:21.2, 22.7] vs. 16.9 mg [15.3, 18.8], p < 0.001). DFU participants also had a lower intensity gradient, indicating proportionally less time spent in higher-intensity activities. The relative difference between DFU and non-DFU participants was greater for sustained activity (MX CONT ) than for accumulated (MX ACC ) activity. In conclusion, physical activity, particularly the intensity of sustained activity, is lower in those with DFUs compared to non-DFUs. This highlights the need for safe, offloaded modes of activity that contribute to an active lifestyle for people with DFUs.

Aim: To investigate how 24-h physical behaviours differ across type 2 diabetes (T2DM) subtypes., Materials and Methods: We included participants living with T2DM, enrolled as part of an ongoing observational study. Participants wore an accelerometer for 7 days to quantify physical behaviours across 24 h. We used routinely collected clinical data (age at onset of diabetes, glycated haemoglobin level, homeostatic model assessment index of beta-cell function, homeostatic model assessment index of insulin resistance, body mass index) to replicate four previously identified subtypes (insulin-deficient diabetes [INS-D], insulin-resistant diabetes [INS-R], obesity-related diabetes [OB] and age-related diabetes [AGE]), via k-means clustering. Differences in physical behaviours across the diabetes subtypes were assessed using generalized linear models, with the AGE cluster as the reference., Results: A total of 564 participants were included in this analysis (mean age 63.6 ± 8.4 years, 37.6% female, mean age at diagnosis 53.1 ± 10.0 years). The proportions in each cluster were as follows: INS-D: n = 35, 6.2%; INS-R: n = 88, 15.6%; OB: n = 166, 29.4%; and AGE: n = 275, 48.8%. Compared to the AGE cluster, the OB cluster had a shorter sleep duration (-0.3 h; 95% confidence interval [CI] -0.5, -0.1), lower sleep efficiency (-2%; 95% CI -3, -1), lower total physical activity (-2.9 mg; 95% CI -4.3, -1.6) and less time in moderate-to-vigorous physical activity (-6.6 min; 95% CI -11.4, -1.7), alongside greater sleep variability (17.9 min; 95% CI 8.2, 27.7) and longer sedentary time (31.9 min; 95% CI 10.5, 53.2). Movement intensity during the most active continuous 10 and 30 min of the day was also lower in the OB cluster., Conclusions: In individuals living with T2DM, the OB subtype had the lowest levels of physical activity and least favourable sleep profiles. Such behaviours may be suitable targets for personalized therapeutic lifestyle interventions., (© 2024 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.)

For the first time, the latest American Diabetes Association/European Association for the Study of Diabetes (ADA/EASD) consensus guidelines have incorporated a growing body of evidence linking health outcomes associated with type 2 diabetes to the movement behavior composition over the whole 24-h day. Of particular note, the importance of sleep as a key lifestyle component in the management of type 2 diabetes is promulgated and presented using three key constructs: quantity, quality, and timing (i.e., chronotype). In this narrative review we highlight some of the key evidence justifying the inclusion of sleep in the latest consensus guidelines by examining the associations of quantity, quality, and timing of sleep with measures of glycemia, cardiovascular disease risk, and mortality. We also consider potential mechanisms implicated in the association between sleep and type 2 diabetes and provide practical advice for health care professionals about initiating conversations pertaining to sleep in clinical care. In particular, we emphasize the importance of measuring sleep in a free-living environment and provide a summary of the different methodologies and targets. In summary, although the latest ADA/EASD consensus report highlights sleep as a central component in the management of type 2 diabetes, placing it, for the first time, on a level playing field with other lifestyle behaviors (e.g., physical activity and diet), the evidence base for improving sleep (beyond sleep disorders) in those living with type 2 diabetes is limited. This review should act as a timely reminder to incorporate sleep into clinical consultations, ongoing diabetes education, and future interventions., (© 2024 by the American Diabetes Association.)

Purpose: Accelerometer-assessed physical activity (PA) can be summarized using cut-point-free or population-specific cut-point-based outcomes. We aimed to 1) examine the interrelationship between cut-point-free (intensity gradient (IG) and average acceleration (AvAcc)) and cut-point-based accelerometer metrics, 2) compare the association between cardiorespiratory fitness (CRF) and cut-point-free metrics to that with cut-point-based metrics in healthy adults aged 20 to 89 yr and patients with heart failure, and 3) provide age-, sex-, and CRF-related reference values for healthy adults., Methods: In the COmPLETE study, 463 healthy adults and 67 patients with heart failure wore GENEActiv accelerometers on their nondominant wrist and underwent cardiopulmonary exercise testing. Cut-point-free (IG: distribution of intensity of activity across the day; AvAcc: proxy of volume of activity) and traditional (moderate-to-vigorous and vigorous activity) metrics were generated. The "interpretablePA" R-package was developed to translate findings into clinical practice., Results: IG and AvAcc yield complementary information on PA with both IG ( P = 0.009) and AvAcc ( P < 0.001) independently associated with CRF in healthy individuals (adjusted R2 = 73.9%). Only IG was independently associated with CRF in patients with heart failure ( P = 0.043, adjusted R2 = 38.4%). The best cut-point-free and cut-point-based model had similar predictive value for CRF in both cohorts. We produced age- and sex-specific reference values and percentile curves for IG, AvAcc, moderate-to-vigorous PA, and vigorous PA for healthy adults., Conclusions: IG and AvAcc are strongly associated with CRF and thus indirectly with the risk of noncommunicable diseases and mortality, in healthy adults and patients with heart failure. However, unlike cut-point-based metrics, IG and AvAcc are comparable across populations. Our reference values provide a healthy age- and sex-specific comparison that may enhance the translation and utility of cut-point-free metrics in clinical practice., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Sports Medicine.)

Purpose: To estimate time spent in various cardiovascular disease (CVD) and cancer states, according to self-reported walking pace., Methods: In total, 391,744 UK Biobank participants were included (median age = 57 years; 54.7% women). Data were collected 2006-2010, with follow-up collected in 2021. Usual walking pace was self-defined as slow, steady, average, or brisk. Multistate modeling determined the transition rate and mean sojourn time in and across three different states (healthy, CVD or cancer, and death) upon a time horizon of 10 years., Results: The mean sojourn time in the healthy state was longer, while that in the CVD or cancer state was shorter in individuals reporting an average or brisk walking pace (vs. slow). A 75-year-old woman reporting a brisk walking pace spent, on average, 8.4 years of the next 10 years in a healthy state; an additional 8.0 (95% CI: 7.3, 8.7) months longer than a 75-year-old woman reporting a slow walking pace. This corresponded to 4.3 (3.7, 4.9) fewer months living with CVD or cancer. Similar results were seen in men., Conclusions: Adults reporting an average or brisk walking pace at baseline displayed a lower transition to disease development and a greater proportion of life lived without CVD or cancer., Availability of Data and Materials: Research was conducted using the UK Biobank resource under Application #33266. The UK Biobank resource can be accessed by researchers on application. Variables derived for this study have been returned to the UK Biobank for future applicants to request. No additional data are available., Competing Interests: Declaration of Competing Interest The authors declare no competing interests, (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Self-reported adherence to sling wear is unreliable due to recall bias. We aim to assess the feasibility and accuracy of quantifying sling wear and non-wear utilising slings pre-fitted with a GENEActiv accelerometer that houses triaxial acceleration and temperature sensors., Methods: Ten participants were asked to wear slings for 480 min (8 h) incorporating 180 min of non-wear time in durations varying from 5-120 min. GENEActiv devices were fitted in sutured inner sling pockets and participants logged sling donning and doffing times. An algorithm based on variability in acceleration in three axes and temperature change was developed to identify sling wear and non-wear and compared to participants' logs., Results: There was no significant difference between algorithm detected non-wear duration (mean ± standard deviation = 172.0 ± 6.8 min/participant) and actual non-wear (179.7 ± 1.0 min/participant). Minute-by-minute agreement of sensor-detected wear and non-wear with participant reported wear was 97.3 ± 1.5% (range = 93.9-99.0), with mean sensitivity 94.3 ± 3.5% (range = 86.1-98.3) and specificity 99.1 ± 0.8% (range = 93.7-100)., Conclusion: An algorithm based on accelerometer-assessed acceleration and temperature can accurately identify shoulder sling wear/non-wear times. This method may have potential for assessing whether sling wear adherence after shoulder surgeries have any bearing on patient functional outcomes.