Physical inactivity is the fourth leading cause of death worldwide. We summarise present global efforts to counteract this problem and point the way forward to address the pandemic of physical ...inactivity. Although evidence for the benefits of physical activity for health has been available since the 1950s, promotion to improve the health of populations has lagged in relation to the available evidence and has only recently developed an identifiable infrastructure, including efforts in planning, policy, leadership and advocacy, workforce training and development, and monitoring and surveillance. The reasons for this late start are myriad, multifactorial, and complex. This infrastructure should continue to be formed, intersectoral approaches are essential to advance, and advocacy remains a key pillar. Although there is a need to build global capacity based on the present foundations, a systems approach that focuses on populations and the complex interactions among the correlates of physical inactivity, rather than solely a behavioural science approach focusing on individuals, is the way forward to increase physical activity worldwide.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
To examine the association between sedentary behavior and cardiometabolic risk, while taking into account cardiorespiratory fitness (fitness) and physical activity.
We examined the association of ...sedentary behavior, physical activity, and fitness (exposure variables) to cardiometabolic biomarkers and metabolic syndrome (outcome measures) among a historic cohort (January 2, 1981, through October 16, 2012) of men. First, we estimated the association (cross-sectionally and longitudinally) of sedentary behavior along with physical activity and fitness to lipids and lipoproteins, glucose, blood pressure, and markers of adiposity, including body mass index, waist circumference, and body fat percentage. We then prospectively examined the effects of baseline sedentary time on the incidence of metabolic syndrome, while adjusting for physical activity, fitness, and other covariates in multivariate models.
Multivariate analysis of baseline data revealed that in comparison with the reference group (≤9 h/wk of sedentary time), more sedentary behavior was significantly associated with a higher triglyceride level, a higher triglycerides-high-density lipoprotein cholesterol ratio, and a higher body mass index, waist circumference, and body fat percentage (P<.05 for trend), after adjusting for physical activity and covariates. When adjusting for fitness and covariates, prolonged sedentary time was only associated with a higher triglyceride-high-density lipoprotein cholesterol ratio (P=.02 for trend). Sedentary time was not associated with the incidence of metabolic syndrome in multivariate models. Longitudinal analyses revealed that a 1-metabolic equivalent increase in fitness was significantly (P<.05) associated with almost all biomarkers when adjusting for sedentary behavior, with little moderation observed.
The association between prolonged sedentary time and cardiometabolic biomarkers is markedly less pronounced when taking fitness into account. Further exploration of the effects of sedentary behavior on cardiometabolic risk is warranted in cohorts with available fitness data. Furthermore, our findings underscore the need to encourage achieving higher fitness levels through meeting physical activity guidelines to decrease disease risk factors.
No reviews have quantified the specific amounts of physical activity required for lower risks of coronary heart disease when assessing the dose-response relation. Instead, previous reviews have used ...qualitative estimates such as low, moderate, and high physical activity.
We performed an aggregate data meta-analysis of epidemiological studies investigating physical activity and primary prevention of CHD. We included prospective cohort studies published in English since 1995. After reviewing 3194 abstracts, we included 33 studies. We used random-effects generalized least squares spline models for trend estimation to derive pooled dose-response estimates. Among the 33 studies, 9 allowed quantitative estimates of leisure-time physical activity. Individuals who engaged in the equivalent of 150 min/wk of moderate-intensity leisure-time physical activity (minimum amount, 2008 U.S. federal guidelines) had a 14% lower coronary heart disease risk (relative risk, 0.86; 95% confidence interval, 0.77 to 0.96) compared with those reporting no leisure-time physical activity. Those engaging in the equivalent of 300 min/wk of moderate-intensity leisure-time physical activity (2008 U.S. federal guidelines for additional benefits) had a 20% (relative risk, 0.80; 95% confidence interval, 0.74 to 0.88) lower risk. At higher levels of physical activity, relative risks were modestly lower. People who were physically active at levels lower than the minimum recommended amount also had significantly lower risk of coronary heart disease. There was a significant interaction by sex (P=0.03); the association was stronger among women than men.
These findings provide quantitative data supporting US physical activity guidelines that stipulate that "some physical activity is better than none" and "additional benefits occur with more physical activity."
Background It is presumed that physical activity (PA) level declines during the lifespan, particularly in adolescence. However, currently, there is no study that quantifies these changes and pools ...results for a common interpretation. Therefore, the purpose was to systematically review the international literature regarding PA change during adolescence, and to quantify that change according to a series of study variables, exploring gender-and-age differences.
Methods An electronic search was conducted in the Medline/PubMed and Web of Science databases. Longitudinal studies with, at least, two PA measures throughout adolescence (10-19 years old) or the first PA measure during childhood and the second one during adolescence were selected. From each article, study project name, country, year of the first data collection, sample size, baseline age, follow-up duration, characteristics of the instrument (type, recall time, PA intensity and PA domain), unit of PA measure and report of statistical significance were collected.
Results Overall, 26 studies matched the inclusion criteria. Most were carried out in the USA, assessed PA by questionnaire, and found a decline in PA levels during the adolescence. On average, the mean percentage PA change per year, across all studies, was −7.0 (95% confidence interval: −8.8 to −5.2), ranging from −18.8 to 7.8. The decline was significant according to most sub-groups of variables analysed. Although earlier studies revealed a higher PA decline in boys, the decline has been greater in girls in more recent studies (commenced after 1997). Moreover, although the decline among girls was higher in younger ages at baseline (9-12 years), it was higher in older ages (13-16 years) among boys.
Conclusions The decline of PA during adolescence is a consistent finding in the literature. Differences between boys and girls were observed and should be explored in future studies. Interventions that attempt to attenuate the PA decline, even without an increase in PA levels, could be considered as effective.
Latinx children in the United States are at high risk for nature-deficit disorder, heat-related illness, and physical inactivity. We developed the Green Schoolyards Project to investigate how green ...features-trees, gardens, and nature trails-in school parks impact heat index (i.e., air temperature and relative humidity) within parks, and physical activity levels and socioemotional well-being of these children. Herein, we present novel methods for a) observing children's interaction with green features and b) measuring heat index and children's behaviors in a natural setting, and a selection of baseline results.
During two September weeks (high temperature) and one November week (moderate temperature) in 2019, we examined three joint-use elementary school parks in Central Texas, United States, serving predominantly low-income Latinx families. To develop thermal profiles for each park, we installed 10 air temperature/relative humidity sensors per park, selecting sites based on land cover, land use, and even spatial coverage. We measured green features within a geographic information system. In a cross-sectional study, we used an adapted version of System for Observing Play and Recreation in Communities (SOPARC) to assess children's physical activity levels and interactions with green features. In a cohort study, we equipped 30 3rd and 30 4th grade students per school during recess with accelerometers and Global Positioning System devices, and surveyed these students regarding their connection to nature. Baseline analyses included inverse distance weighting for thermal profiles and summing observed counts of children interacting with trees.
In September 2019, average daily heat index ranged 2.0 °F among park sites, and maximum daily heat index ranged from 103.4 °F (air temperature = 33.8 °C; relative humidity = 55.2%) under tree canopy to 114.1 °F (air temperature = 37.9 °C; relative humidity = 45.2%) on an unshaded playground. 10.8% more girls and 25.4% more boys interacted with trees in September than in November.
We found extreme heat conditions at select sites within parks, and children positioning themselves under trees during periods of high heat index. These methods can be used by public health researchers and practitioners to inform the redesign of greenspaces in the face of climate change and health inequities.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
BACKGROUND: Public schools provide opportunities for physical activity and fitness surveillance, but are evaluated and funded based on students' academic performance, not their physical fitness. ...Empirical research evaluating the connections between fitness and academic performance is needed to justify curriculum allocations to physical activity programs.
METHODS: Analyses were based on a convenience sample of 254,743 individually matched standardized academic (TAKS™) and fitness (FITNESSGRAM®) test records of students, grades 3–11, collected by 13 Texas school districts. We categorized fitness results in quintiles by age and gender and used mixed effects regression models to compare the academic performance of the top and bottom fitness groups for each test.
RESULTS: All fitness variables except body mass index (BMI) showed significant, positive associations with academic performance after adjustment for socio‐demographic covariates, with standardized mean difference effect sizes ranging from .07 to .34. Cardiovascular fitness showed the largest interquintile difference in TAKS score (32–75 points), followed by curl‐ups. Additional adjustment for BMI and curl‐ups showed dose‐response associations between cardiovascular fitness and academic scores (p < .001 for both genders and outcomes). Analysis of BMI demonstrated limited, nonlinear association with academic performance after socio‐demographic and fitness adjustments.
CONCLUSIONS: Fitness was strongly and significantly related to academic performance. Cardiovascular fitness showed a dose‐response association with academic performance independent of other socio‐demographic and fitness variables. The association appears to peak in late middle to early high school. We recommend that policymakers consider physical education (PE) mandates in middle high school, school administrators consider increasing PE time, and PE practitioners emphasize cardiovascular fitness.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Abstract Objective To describe the worldwide prevalence of physical inactivity and to analyze its association with development level of each country. Methods Pooled analysis of three multicenter ...studies, conducted between 2002 and 2004, which investigated the prevalence of physical inactivity in 76 countries, and comprised almost 300,000 individuals aged 15 years or older. Each study used the International Physical Activity Questionnaire to assess physical inactivity. The level of development of each country was analyzed by the Human Development Index (HDI). Results The crude worldwide prevalence of physical inactivity was 21.4% (95%CI 18.4–24.3), being higher among women (mean = 23.7%, 95%CI 20.4–27.1) than men (mean = 18.9%, 95%CI 16.2–21.7). It ranged from 2.6% (in Comoros) to 62.3% (in Mauritania), with a median equal to 18%. After weighting for the total population of each country, the worldwide prevalence of physical inactivity was 17.4% (95%CI 15.1–19.7). There was a positive association between HDI and prevalence of physical inactivity (rho = 0.27). Less developed countries showed the lowest prevalence of physical inactivity (18.7%), while physical inactivity was more prevalent among the most developed countries (27.8%). Conclusions One out of five adults around the world is physically inactive. Physical inactivity was more prevalent among wealthier and urban countries, and among women and elderly individuals.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Studies indicate that individuals with chronic conditions and specific baseline characteristics may not mount a robust humoral antibody response to SARS-CoV-2 vaccines. In this paper, we used data ...from the Texas Coronavirus Antibody REsponse Survey (Texas CARES), a longitudinal state-wide seroprevalence program that has enrolled more than 90,000 participants, to evaluate the role of chronic diseases as the potential risk factors of non-response to SARS-CoV-2 vaccines in a large epidemiologic cohort.
A participant needed to complete an online survey and a blood draw to test for SARS-CoV-2 circulating plasma antibodies at four-time points spaced at least three months apart. Chronic disease predictors of vaccine non-response are evaluated using logistic regression with non-response as the outcome and each chronic disease + age as the predictors.
As of April 24, 2023, 18,240 participants met the inclusion criteria; 0.58% (N = 105) of these are non-responders. Adjusting for age, our results show that participants with self-reported immunocompromised status, kidney disease, cancer, and "other" non-specified comorbidity were 15.43, 5.11, 2.59, and 3.13 times more likely to fail to mount a complete response to a vaccine, respectively. Furthermore, having two or more chronic diseases doubled the prevalence of non-response.
Consistent with smaller targeted studies, a large epidemiologic cohort bears the same conclusion and demonstrates immunocompromised, cancer, kidney disease, and the number of diseases are associated with vaccine non-response. This study suggests that those individuals, with chronic diseases with the potential to affect their immune system response, may need increased doses or repeated doses of COVID-19 vaccines to develop a protective antibody level.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
We examined the association between time spent in physical education and academic achievement in a longitudinal study of students in kindergarten through fifth grade.
We used data from the Early ...Childhood Longitudinal Study, Kindergarten Class of 1998 to 1999, which employed a multistage probability design to select a nationally representative sample of students in kindergarten (analytic sample = 5316). Time spent in physical education (minutes per week) was collected from classroom teachers, and academic achievement (mathematics and reading) was scored on an item response theory scale.
A small but significant benefit for academic achievement in mathematics and reading was observed for girls enrolled in higher amounts (70-300 minutes per week) of physical education (referent: 0-35 minutes per week). Higher amounts of physical education were not positively or negatively associated with academic achievement among boys.
Among girls, higher amounts of physical education may be associated with an academic benefit. Physical education did not appear to negatively affect academic achievement in elementary school students. Concerns about adverse effects on achievement may not be legitimate reasons to limit physical education programs.
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CEKLJ, DOBA, FSPLJ, IZUM, KILJ, NUK, ODKLJ, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ