PURPOSEWe examined total activity, light activity, and moderate-to-vigorous physical activity (MVPA) as predictors of mortality in a nationally representative sample of older adults. Then we explored ...the theoretical consequences of replacing sedentary time with the same duration of light activity or MVPA.
METHODSUsing accelerometer-measured activity, the associations between total activity, light activity (100–2019 counts per minute), and MVPA (>2019 counts per minute) counts and mortality were examined in adults age 50 to 79 yr in the National Health and Nutrition Examination Survey, 2003–2006 (n = 3029), with mortality follow-up through December 2011. Cox proportional hazard models were fitted to estimate mortality risks. An isotemporal substitution model was used to examine the theoretical consequences of replacing sedentary time with light activity or MVPA on mortality.
RESULTSAfter adjusting for potential confounders, including age, sex, race/ethnicity, education, BMI, and the presence of comorbid conditions, those in the highest tertile of total activity counts had one fifth the risk of death of those in the lowest tertile (hazard ratio HR = 0.21, 95% confidence interval CI = 0.12–0.38), and those in the middle tertile had one third the risk of death (HR = 0.36, 95% CI = 0.30–0.44). In addition, replacing 30 min of sedentary time with light activity was associated with significant reduction in mortality risk (after 5 yr of follow-upHR = 0.80, 95% CI = 0.75–0.85). Replacing 30 min of sedentary time with MVPA was also associated with reduction in mortality risk (HR = 0.49, 95% CI = 0.25–0.97).
CONCLUSIONSGreater total activity is associated with lower all-cause mortality risk. Replacing sedentary time with light activity or MVPA may reduce mortality risk for older adults.
Aging is associated with changes in body composition and muscle strength. This review aimed to determine the relation between different body composition measures and muscle strength measures and ...functional decline in older men and women. By use of relevant databases (PubMed, Embase, and CINAHL) and keywords in a search from 1976 to April 2012, 50 articles were reviewed that met the inclusion criteria (written in English, a prospective, longitudinal design, involving older persons aged 65 years or more, and at least one of the measures that follow: body mass index (BMI), waist circumference, waist/hip ratio, midarm circumference, fat mass, muscle fat infiltration, muscle mass, or strength as independent variables and a measure of functional decline as outcome measure). Meta-analyses were performed and revealed that BMI ≥30 and low muscle strength were associated with functional decline (pooled odds ratio (OR) = 1.60, 95% confidence interval (CI): 1.43, 1.80, for BMI ≥30 and OR = 1.86, 95% CI: 1.32, 2.64, for muscle strength). Low muscle mass was not significantly associated with functional decline (pooled OR = 1.19, 95% CI: 0.98, 1.45). Future intervention research should focus on positive changes in body composition to prevent onset or worsening of functional decline in old age.
PURPOSESedentary behavior is an emerging independent health risk factor. The accuracy of measuring sedentary time using accelerometers may depend on the wear location. This study in older adults ...evaluated the accuracy of various hip- and wrist-worn ActiGraph accelerometer cutoff points to define sedentary time using the activPAL as the reference method.
METHODSData from 62 adults (mean age, 78.4 yr) of the Aging Research Evaluating Accelerometry study were used. Participants simultaneously wore an activPAL accelerometer on the thigh and ActiGraph accelerometers on the hip, dominant, and nondominant wrist for 7 d in a free-living environment. Using the activPAL as the reference criteria, we compared classification of sedentary time to hip-worn and wrist-worn ActiGraph accelerometers over a range of cutoff points for both 60-s and 15-s epochs.
RESULTSThe optimal cutoff point for the hip vertical axis was <22 counts per minute with an area under the curve (AUC) of 0.85; the optimal hip vector magnitude cutoff point was <174 counts per minute with an AUC of 0.89. For the dominant wrist, the optimal vector magnitude cutoff point to define sedentary time was <2303 counts per minute (AUC, 0.86) and for the nondominant wrist <1853 counts per minute (AUC, 0.86). The optimal 15-s cutoff points resulted in lower agreements compared with activPAL.
CONCLUSIONSHip- and wrist-worn ActiGraph data may be used to define sedentary time with a moderate to high accuracy when compared with activPAL. The observed optimal cutoff point for hip vertical axis <22 counts per minute is substantially lower than the standard <100 counts per minute. It is unknown how these optimal cutoff points perform in different populations. Results on an individual basis should therefore be interpreted with caution.
Sedentary behavior has emerged as a novel health risk factor independent of moderate to vigorous physical activity (MVPA). Previous studies have shown self-reported sedentary time to be associated ...with mortality; however, no studies have investigated the effect of objectively measured sedentary time on mortality independent of MVPA. The objective our study was to examine the association between objectively measured sedentary time and all-cause mortality.
7-day accelerometry data of 1906 participants aged 50 and over from the U.S. nationally representative National Health and Nutrition Examination Survey (NHANES) 2003-2004 were analyzed. All-cause mortality was assessed from the date of examination through December 31, 2006.
Over an average follow-up of 2.8 years, there were 145 deaths reported. In a model adjusted for sociodemographic factors, lifestyle factors, multiple morbidities, mobility limitation, and MVPA, participants in third quartile (hazard ratio (HR):4.05; 95%CI:1.55-10.60) and fourth quartile (HR:5.94; 95%CI: 2.49-14.15) of having higher percent sedentary time had a significantly increased risk of death compared to those in the lowest quartile.
Our study suggests that sedentary behavior is a risk factor for mortality independent of MVPA. Further investigation, including studies with longer follow-up, is needed to address the health consequences of sedentary behavior.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The Maastricht Study is an extensive phenotyping study that focuses on the etiology of type 2 diabetes (T2DM), its classic complications, and its emerging comorbidities. The study uses ...state-of-the-art imaging techniques and extensive biobanking to determine health status in a population-based cohort of 10,000 individuals that is enriched with T2DM individuals. Enrollment started in November 2010 and is anticipated to last 5-7 years. The Maastricht Study is expected to become one of the most extensive phenotyping studies in both the general population and T2DM participants worldwide. The Maastricht study will specifically focus on possible mechanisms that may explain why T2DM accelerates the development and progression of classic complications, such as cardiovascular disease, retinopathy, neuropathy and nephropathy and of emerging comorbidities, such as cognitive decline, depression, and gastrointestinal, musculoskeletal and respiratory diseases. In addition, it will also examine the association of these variables with quality of life and use of health care resources. This paper describes the rationale, overall study design, recruitment strategy and methods of basic measurements, and gives an overview of all measurements that are performed within The Maastricht Study.
ObjectivesPhysical activity is associated with the aging workers' ability to work and predicts working beyond retirement age. To better understand physical activity behaviour in this growing ...population group, we aimed at characterising 24-hour physical activity patterns among aging workers, and to describe the association between occupational category and total, occupational and leisure-time physical activities.MethodsWe included 878 workers (mean age 62.4 years, SD 1.1, 85% women) from the Finnish Retirement and Aging Study, who wore an accelerometer on their non-dominant wrist for 1 week. We plotted mean hourly activity counts per minute (CPM) for working days and days off. We also compared mean daily CPM between genders and occupations between working days and days off, and work and leisure time by using repeated measures analysis of variance.ResultsActivity patterns were different between genders, occupations and types of the day. Women (2580, 95% CI 2540 to 2620) had higher daily mean CPM than men (2110, 95% CI 2020 to 2000). Women in manual occupations were more active than women in non-manual occupations during working days. The differences among men were in the same direction but less pronounced than among women. We found no differences in activity levels between occupations during days off and leisure time on working days.ConclusionsIn aging workers, physical activity differs by gender and occupation during working time, but not during leisure time. As low physical activity is associated with increased risk of early exit from employment, physical activity should be promoted at workplaces, especially among men and people in non-manual occupations.
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BFBNIB, CMK, NMLJ, NUK, PNG, SAZU, UL, UM, UPUK
Employment and Physical Activity in the U.S Van Domelen, Dane R., BS; Koster, Annemarie, PhD; Caserotti, Paolo, PhD ...
American journal of preventive medicine,
08/2011, Volume:
41, Issue:
2
Journal Article
Peer reviewed
Open access
Background Physical inactivity is a risk factor for obesity, cardiovascular disease, hypertension, and other chronic diseases that are increasingly prevalent in the U.S. and worldwide. Time at work ...represents a major portion of the day for employed people. Purpose To determine how employment status (full-time, part-time, or not employed) and job type (active or sedentary) are related to daily physical activity levels in American adults. Methods Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) were collected in 2003–2004 and analyzed in 2010. Physical activity was measured using Actigraph uniaxial accelerometers, and participants aged 20–60 years with ≥4 days of monitoring were included (N=1826). Accelerometer variables included mean counts/minute during wear time and proportion of wear time spent in various intensity levels. Results In men, full-time workers were more active than healthy nonworkers ( p =0.004), and in weekday-only analyses, even workers with sedentary jobs were more active ( p =0.03) and spent less time sedentary ( p <0.001) than nonworkers. In contrast with men, women with full-time sedentary jobs spent more time sedentary ( p =0.008) and had less light and lifestyle intensity activity than healthy nonworkers on weekdays. Within full-time workers, those with active jobs had greater weekday activity than those with sedentary jobs (22% greater in men, 30% greater in women). Conclusions In men, full-time employment, even in sedentary occupations, is positively associated with physical activity compared to not working, and in both genders job type has a major bearing on daily activity levels.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Background Reduced estimated glomerular filtration rate (eGFR) and albuminuria have been associated with worse cognitive performance. However, few studies have examined whether these associations are ...confined to older individuals or may be extended to the middle-aged population. Study Design Cross-sectional analyses of a prospective population-based cohort study. Setting & Participants 2,987 individuals aged 40 to 75 years from the general population (The Maastricht Study). Predictor eGFR and urinary albumin excretion (UAE). Outcomes Memory function, information processing speed, and executive function. Measurements Analyses were adjusted for demographic variables (age, sex, and educational level), lifestyle factors (smoking behavior and alcohol consumption), depression, and cardiovascular disease risk factors (glucose metabolism status, waist circumference, total to high-density lipoprotein cholesterol ratio, triglyceride level, use of lipid-modifying medication, systolic blood pressure, use of antihypertensive medication, and prevalent cardiovascular disease). Results UAE was <15 mg/24 h in 2,439 (81.7%) participants, 15 to <30 mg/24 h in 309 (10.3%), and ≥30 mg/24 h in 239 (8.0%). In the entire study population, UAE ≥ 30 mg/24 h was associated with lower information processing speed as compared to UAE < 15 mg/24 h (β SD difference = −0.148; 95% CI, −0.263 to −0.033) after full adjustment, whereas continuous albuminuria was not. However, significant interaction terms ( P for interaction < 0.05) suggested that albuminuria was most strongly and extensively associated with cognitive performance in older individuals. Mean (±SD) eGFR, estimated by the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) creatinine–cystatin C equation (eGFRcr-cys ), was 88.4 ± 14.6 mL/min/1.73 m2 . eGFRcr-cys was not associated with any of the domains of cognitive performance after full adjustment. However, significant interaction terms ( P for interaction < 0.05) suggested that eGFRcr-cys was associated with cognitive performance in older individuals. Limitations Cross-sectional design, which limited causal inferences. Conclusions In the entire study population, albuminuria was independently associated with lower information processing speed, whereas eGFRcr-cys was not associated with cognitive performance. However, both were more strongly and extensively associated with cognitive performance in older individuals.
Aims/hypothesis
We aimed to examine associations of cardiometabolic risk factors, and (pre)diabetes, with (sensorimotor) peripheral nerve function.
Methods
In 2401 adults (aged 40–75 years) we ...previously determined fasting glucose, HbA
1c
, triacylglycerol, HDL- and LDL-cholesterol, inflammation, waist circumference, blood pressure, smoking, glucose metabolism status (by OGTT) and medication use. Using nerve conduction tests, we measured compound muscle action potential, sensory nerve action potential amplitudes and nerve conduction velocities (NCVs) of the peroneal, tibial and sural nerves. In addition, we measured vibration perception threshold (VPT) of the hallux and assessed neuropathic pain using the DN4 interview. We assessed cross-sectional associations of risk factors with nerve function (using linear regression) and neuropathic pain (using logistic regression). Associations were adjusted for potential confounders and for each other risk factor. Associations from linear regression were presented as standardised regression coefficients (
β
) and 95% CIs in order to compare the magnitudes of observed associations between all risk factors and outcomes.
Results
Hyperglycaemia (fasting glucose or HbA
1c
) was associated with worse sensorimotor nerve function for all six outcome measures, with associations of strongest magnitude for motor peroneal and tibial NCV,
β
fasting glucose
= −0.17 SD (−0.21, −0.13) and
β
fasting glucose
= −0.18 SD (−0.23, −0.14), respectively. Hyperglycaemia was also associated with higher VPT and neuropathic pain. Larger waist circumference was associated with worse sural nerve function and higher VPT. Triacylglycerol, HDL- and LDL-cholesterol, and blood pressure were not associated with worse nerve function; however, antihypertensive medication usage (suggestive of history of exposure to hypertension) was associated with worse peroneal compound muscle action potential amplitude and NCV. Smoking was associated with worse nerve function, higher VPT and higher risk for neuropathic pain. Inflammation was associated with worse nerve function and higher VPT, but only in those with type 2 diabetes. Type 2 diabetes and, to a lesser extent, prediabetes (impaired fasting glucose and/or impaired glucose tolerance) were associated with worse nerve function, higher VPT and neuropathic pain (
p
for trend <0.01 for all outcomes).
Conclusions/interpretation
Hyperglycaemia (including the non-diabetic range) was most consistently associated with early-stage nerve damage. Nonetheless, larger waist circumference, inflammation, history of hypertension and smoking may also independently contribute to worse nerve function.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Aims/hypothesis
Biomarkers of endothelial dysfunction and low-grade inflammation are important in the pathogenesis of CVD and can potentially be modified by physical activity and sedentary behaviour. ...Effects of physical activity on biomarkers of endothelial dysfunction may be especially prominent in type 2 diabetes.
Methods
In the population-based Maastricht Study (
n
= 2363, 51.5% male, 28.3% type 2 diabetes, 15.1% prediabetes defined as impaired glucose tolerance and impaired fasting glucose), we determined biomarkers of endothelial dysfunction and low-grade inflammation, and combined
z
scores were calculated. Physical activity and sedentary behaviour were measured by activPAL. Linear regression analyses were used with adjustment for demographic, lifestyle and cardiovascular risk factors.
Results
The association between total, light, moderate-to-vigorous and vigorous intensity physical activity and sedentary time on the one hand and biomarkers of endothelial dysfunction on the other were generally significant and were consistently stronger in prediabetes and type 2 diabetes as compared with normal glucose metabolism status (
p
for interaction <0.05). Associations between physical activity and sedentary behaviour on the one hand and low-grade inflammation on the other were also significant and were similar in individuals with and without (pre)diabetes (
p
for interaction >0.05).
Conclusions/interpretation
Physical activity and sedentary behaviour are associated with biomarkers of endothelial dysfunction and low-grade inflammation. For biomarkers of endothelial dysfunction, associations between physical activity and sedentary behaviour were consistently stronger in (pre)diabetes than in normal glucose metabolism. Whether increasing physical activity or decreasing sedentary time can positively influence biomarkers of endothelial dysfunction in individuals with prediabetes and type 2 diabetes requires further study.
Graphical abstract
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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