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Longitudinal Changes in Moderate to Vigorous Physical Activity in Community-Dwelling Older Men and Women: A 2-Year Prospective Cohort Study in Japan

Tao Chen, Sanmei Chen, Takanori Honda, Yu Nofuji, Hiro Kishimoto, and Kenji Narazaki

Background: To examine longitudinal changes in accelerometer-measured moderate to vigorous physical activity (MVPA) and associated factors of changes in MVPA among community-dwelling older Japanese men and women over 2 years of follow-up. Methods: In total, 601 participants (72.2 [5.4] y, 40.6% men) were included. MVPA was assessed at baseline (2011) and follow-up (2013) using triaxial accelerometers. Sex-stratified multiple linear regression models were used to identify associated factors of changes in MVPA. Results: On average, a significant decrease in MVPA over 2 years was observed only in women (P < .001). Higher baseline MVPA levels and older age were significantly associated with a decrease in MVPA over 2 years in both men and women. Men who were currently drinking (vs no) and had faster maximum gait speed showed statistically significant increases in MVPA. Women who had very poor/poor economic status (vs fair/good) and were socially isolated (vs no) showed statistically significant increases in MVPA over 2 years, while those who had fear of falling (vs no) and poor/fair self-rated health (vs good/very good) showed statistically significant decreases in MVPA over 2 years. Conclusions: Our findings showed different associated factors of changes in MVPA by sex, suggesting the importance of accounting for sex differences in terms of developing specific intervention strategies for promoting MVPA among older men and women.

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The Potential Impact of Physical Activity on the Burden of Osteoarthritis and Low Back Pain in Australia: A Systematic Review of Reviews and Life Table Analysis

Mary Njeri Wanjau, Holger Möller, Fiona Haigh, Andrew Milat, Rema Hayek, Peta Lucas, and J. Lennert Veerman

Objective: The objectives were (1) to establish the strength of the association between incident cases of osteoarthritis (OA) and low back pain (LBP), and physical activity (PA) and to assess the likelihood of the associations being causal; and (2) to quantify the impact of PA on the burden of OA and LBP in Australia. Methods: We conducted a systematic literature review in EMBASE and PubMed databases from January 01, 2000, to April 28, 2020. We used the Bradford Hill viewpoints to assess causality. We used a proportional multistate life table model to estimate the impact of changes in the PA levels on OA and LBP burdens for the 2019 Australian population (aged ≥ 20 y) over their remaining lifetime. Results: We found that both OA and LBP are possibly causally related to physical inactivity. Assuming causality, our model projected that if the 2025 World Health Organization global target for PA was met, the burden in 25 years’ time could be reduced by 70,000 prevalent cases of OA and over 11,000 cases of LBP. Over the lifetime of the current adult population of Australia, the gains could add up to approximately 672,814 health-adjusted life years (HALYs) for OA (ie, 27 HALYs per 1000 persons) and 114,042 HALYs for LBP (ie, 5 HALYs per 1000 persons). The HALY gains would be 1.4 times bigger if the 2030 World Health Organization global target for PA was achieved and 11 times bigger if all Australians adhered to the Australian PA guidelines. Conclusion: This study provides empirical support for the adoption of PA in strategies for the prevention of OA and back pain.

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Volume 20 (2023): Issue 6 (Jun 2023)

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A Decomposition Analysis of Racial Disparities in Physical Activity Among Cancer Survivors: National Health Interview Survey 2009–2018

Yves Paul Vincent Mbous, Rowida Mohamed, and Ruchi Bhandari

Purpose: In light of the known benefits of physical activity (PA) for cancer survivors, this exploratory study sought to investigate the uptake of PA among this population in the United States. Methods: Using the National Health Interview Survey data from 2009 to 2018, lung, breast, colorectal, prostate, ovarian, and lymphoma cancer survivors were identified, and their PA adherence measured per the standards of the American College of Sports Medicine. Logistic regression and the Fairlie decomposition were used, respectively, to identify correlates of PA and to explain the difference in PA adherence between races. Results: Uptake of PA was significantly different between Whites and minorities. Blacks had lower odds than Whites (adjusted odds ratio: 0.77; 95% confidence interval, 0.66–0.93), whereas Mixed Race had twice the odds of Whites (adjusted odds ratio: 1.94; 95% confidence interval, 0.27–0.98) of adhering to PA recommendations. Decomposition identified education, family income-to-poverty ratio, body mass index, number of chronic conditions, alcohol use, and general health as key factors accounting for the PA disparity between cancer survivors of White and Black or Multiple/Mixed racial group. Conclusion: These findings could help inform behavioral PA interventions to improve their design and targeting to different racial groups of cancer survivors.

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Healthier Energy Balance Behaviors Most Important for Health-Related Quality of Life in Rural Cancer Survivors in Central Pennsylvania

Jenny L. Olson, Michael Robertson, Minxing Chen, David E. Conroy, Kathryn H. Schmitz, and Scherezade K. Mama

Background: Rural cancer survivors face a greater number of health disparities, including poorer health-related quality of life (HRQoL), than urban cancer survivors. Engagement in healthy lifestyle behaviors also varies between rural and urban cancer survivors. Lifestyle behaviors can improve HRQoL; however, the combination of behaviors most important for HRQoL in rural survivors is unclear. This study examined clusters of lifestyle behaviors in rural cancer survivors, and differences in HRQoL between behavioral clusters. Methods: Rural cancer survivors in the United States (N = 219) completed a cross-sectional survey. Lifestyle behaviors were classified into unhealthy/healthy binary categories (inactive/active, longer/shorter sedentary time, excessive/acceptable fat intake, very low/higher fruit and vegetable intake, some/no alcohol consumption, and poor/good sleep quality). Behavioral clusters were identified by latent class analysis. HRQoL differences between behavioral clusters were assessed by ordinary least squares regression. Results: The 2-class model demonstrated the best fit and interpretability. The “mostly unhealthy behaviors” class (38.5% of sample) had higher probabilities of all unhealthy behaviors, except alcohol consumption. The “healthier energy balance” class (61.5% of sample) had higher probabilities of active, shorter sedentary, higher fruit and vegetable consumption, excessive fat intake, some alcohol consumption, and poor sleep categories, and reported better HRQoL. Conclusions: Healthier energy balance behaviors were particularly relevant for HRQoL in rural cancer survivors. Multiple behavior change interventions to improve HRQoL in rural cancer survivors should focus on supporting energy balance behaviors. Many rural cancer survivors may lead very unhealthy lifestyles, placing them at high risk of adverse outcomes. This subpopulation should be prioritized to help alleviate cancer health disparities.

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Physical Activity for Health Promotion and Disease Prevention in Africa and Cameroon: A Call to Action

Maurice Douryang, Kelly J. Tsafack Nanfosso, and Yagaï Bouba

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Awareness and Knowledge of the Physical Activity Guidelines for Americans, 2nd Edition

Tiffany J. Chen, Geoffrey P. Whitfield, Kathleen B. Watson, Janet E. Fulton, Emily N. Ussery, Eric T. Hyde, and Ken Rose

Background: Assessing awareness and knowledge of the Physical Activity Guidelines for Americans, 2nd edition (Guidelines), released in 2018, is important for monitoring factors that contribute to increasing physical activity. Methods: We estimated prevalence of awareness and knowledge of the adult aerobic guideline (≥150 min/wk of moderate-intensity equivalent aerobic physical activity preferably spread out over a week) among adults (n = 3471) and of the youth aerobic guideline (≥60 min/d of mostly moderate- to vigorous-intensity aerobic physical activity) among a subset of parents (n = 744) from a nationwide sample of US adults in the 2019 FallStyles survey. We estimated odds ratios using logistic regression, adjusting for demographic and other characteristics. Results: Approximately 1 in 10 US adults and parents reported being aware of the Guidelines. Only 3% of adults knew the correct adult aerobic guideline. The most common responses were “don’t know/not sure” (44%) and “30 minutes a day, 5 or more days a week” (28%). Among parents, 15% knew the youth aerobic guideline. Awareness and knowledge tended to be lower with lower education and income. Conclusions: Limited awareness and knowledge of the Guidelines suggest communication about the Guidelines could be strengthened, especially among adults with low income or education.

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Physical Inactivity, Inequalities, and Disparities Across Districts of Iran: A STEPs Survey-Based Analysis

Amirali Hajebi, Maryam Nasserinejad, Sina Azadnajafabad, Erfan Ghasemi, Negar Rezaei, Moein Yoosefi, Azin Ghamari, Mohammad Keykhaei, Ali Ghanbari, Esmaeil Mohammadi, Mohammad-Mahdi Rashidi, Fateme Gorgani, Mana Moghimi, Alireza Namazi Shabestari, and Farshad Farzadfar

Background: We aimed to estimate the prevalence of physical inactivity in all districts of Iran and the disparities between subgroups defined by various measures. Methods: Small area estimation method was employed to estimate the prevalence of physical inactivity in districts based on the remaining districts in which data on the level of physical inactivity were available. Various comparisons on the estimations were done based on socioeconomic, sex, and geographical stratifications to determine the disparities of physical inactivity among districts of Iran. Results: All districts of Iran had a higher prevalence of physical inactivity compared with the world average. The estimated prevalence of physical inactivity among all men in all districts was 46.8% (95% uncertainty interval, 45.9%–47.7%). The highest and lowest estimated disparity ratio of physical inactivity were 1.95 and 1.14 in males, and 2.25 and 1.09 in females, respectively. Females significantly had a higher prevalence of 63.5% (62.7%–64.3%). Among both sexes, the poor population and urban residents significantly had higher prevalence of physical inactivity than rich population and rural residents, respectively. Conclusions: The high prevalence of physical inactivity among Iranian adult population suggests the urgent need to adopt population-wide action plans and policies to handle this major public health problem and avert the probable burden.

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2022 French Report Card on Physical Activity and Sedentary Behaviors in Children and Youth: From Continuous Alarming Conclusions to Encouraging Initiatives

Alicia Fillon, Jeremy Vanhelst, Pauline Genin, Benjamin Larras, Michéle Tardieu, Marion Porcherie, Maxime Luiggi, Salomé Aubert, Charlotte Verdot, Olivier Rey, Lena Lhuisset, Julien E. Bois, Guillaume Y. Millet, Martine Duclos, and David Thivel

Background: Scientific evidence and public health reports keep highlighting the continuous and alarming worldwide progression of physical inactivity and sedentary behaviors in children and adolescents. The present paper summarizes findings from the 2022 French Report Card (RC) on physical activity for children and youth and compares them to the 2016, 2018, and 2020 RCs. Methods: The 2022 edition of the French RC follows the standardized methodology established by the Active Healthy Kids Global Matrix. Ten physical activity indicators have been evaluated and graded based on the best available evidence coming from national surveys, peer-reviewed literature, government and nongovernment reports, and online information. The evaluation was also performed in children and adolescents with disabilities. Indicators were graded from A (high level of evidence) to F (very low level of evidence) or INC for incomplete. Results: The evaluated indicators received the following grades: overall physical activity: D−; organized sport participation and physical activity: C; active play: F; active transportation: C; sedentary behaviors: D−; family and peers: D; physical fitness: C; school: C−; community and the built environment: F; government: B. Conclusions: While this 2022 French RC shows progression for 7 out of the 10 indicators considered, it also underlines the continuous need for actions at the local, regional, and national levels to develop better surveillance systems and favor a long-term improvement of youth movement behaviors.

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Associations Between Adolescent Sport and Exercise Participation and Device-Assessed Physical Activity in Adulthood: Evidence From the 1970 British Cohort Study

Nicholas Scicluna, Mark Hamer, and Joanna M. Blodgett

Background: Adolescence is a critical period filled with life changes. Early implementation of effective health promotion strategies could help alleviate the morbidity and mortality associated with inactivity. This study investigated whether adolescent participation in exercise and sport is associated with device-assessed physical activity (PA) levels in midlife. Methods: A total of 2984 participants (41.2% male) from the 1970 British Cohort Study were included. Participants were surveyed at age 16 years on 5 indicators of exercise and sport participation. Total daily PA and moderate to vigorous PA (MVPA) at age 46 years were measured using a thigh-worn accelerometer, worn for 7 days. Associations between each adolescent exercise or sport indicator and adulthood total daily PA and MVPA were examined using linear regressions, adjusting for sex, wear time, body mass index, smoking, disability, malaise, alcohol consumption, social class, education, and self-rated health. Results: In fully adjusted models, adolescents who reported exercising “much more” than others (8.6 min/d; 95% confidence interval, −0.1 to 17.1), who played sports at the park/playground more than once a week (8.5 [3.0–14.0] min/d), and who exercised on the most recent Saturday (3.8 [0.7–6.9] min/d) had higher adult total PA levels than those who reported the lowest activity levels. There was no evidence of an association between greater sport and exercise participation at age 16 y and MVPA at age 46 y. There was no association between sports at school and either measure of adult PA. Conclusion: Active adolescents, particularly those who engaged in out-of-school exercise, had higher total daily PA levels, but not MVPA levels, in midlife. This highlights the potential of early PA interventions to improve PA levels in adulthood.