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Open access

Jessica Murphy, Karen A. Patte, Philip Sullivan, and Scott T. Leatherdale

The mental health benefits of physical activity may relate more to the context of the behavior, rather than the behavior of being active itself. The association between varsity sport (VS) participation, depression, and anxiety symptoms was explored using data from 70,449 high school students from the Cannabis use, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary behavior study. The model adjusted for potential covariates; interactions by sex and participation in outside of school sport (OSS) were explored. Overall, 70% and 24% of respondents met or exceeded cutoff values for depression and anxiety, respectively. Students participating in VS had lower symptoms of anxiety and depression compared with nonparticipants. Results were consistent regardless of OSS participation; associations were strongest among students who participated in both VS and OSS and males. Participation in VS may prove beneficial for the prevention and/or management of depression or anxiety symptoms, particularly among males. An additive beneficial effect of OSS on depression and anxiety scores may exist.

Open access

Noah Wexler, Yingling Fan, Kirti V. Das, and Simone French

Background: Neighborhood parks are important locations to encourage and stimulate physical activity (PA) among the urban population. This study aims to evaluate the impact of an informational intervention on adult park use and PA behaviors in 3 low-income, racially diverse urban neighborhoods in Minneapolis, MN. Method: The study employed a household-level randomized controlled trial and collected baseline and follow-up data from 171 participants. Within each neighborhood, participants were randomized to an informational intervention or to a no-intervention comparison. Intervention households received monthly, neighborhood-specific newsletters about park-based PA opportunities, park program brochures, trail maps, and activity guides. Results: The average treatment effect of the newsletter intervention was positive yet moderated by respondent age. For a 20-year-old resident, treatment was associated with 0.97 (P < .05) additional park visits and 31.24 (P < .05) additional minutes of park-based PA over a 3-day recall period. For 40-year-old respondents, these positive effects are smaller at 0.36 (P < .05) additional visits and 4.66 (P < .05) additional minutes, respectively. Conclusions: An intervention to increase awareness about park-based PA opportunities and benefits increased self-reported park visits and in-park PA among adults who lived in low-income, racially diverse neighborhoods.

Open access

Karen Milton, Nick Cavill, Anna Chalkley, Charlie Foster, Sjaan Gomersall, Maria Hagstromer, Paul Kelly, Tracy Kolbe-Alexander, Jacqueline Mair, Matthew McLaughlin, James Nobles, Lindsey Reece, Trevor Shilton, Ben J. Smith, and Jasper Schipperijn

Background: The International Society for Physical Activity and Health (ISPAH) is a leading global organization working to advance research, policy, and practice to promote physical activity. Given the expanding evidence base on interventions to promote physical activity, it was timely to review and update a major ISPAH advocacy document—Investments that Work for Physical Activity (2011). Methods: Eight investment areas were agreed upon through consensus. Literature reviews were conducted to identify key evidence relevant to policymakers in each sector or setting. Results: The 8 investment areas were as follows: whole-of-school programs; active transport; active urban design; health care; public education; sport and recreation; workplaces; and community-wide programs. Evidence suggests that the largest population health benefit will be achieved by combining these investments and implementing a systems-based approach. Conclusions: Establishing consensus on ‘what works’ to change physical activity behavior is a cornerstone of successful advocacy, as is having appropriate resources to communicate key messages to a wide range of stakeholders. ISPAH has created a range of resources related to the new investments described in this paper. These resources are available in the ‘advocacy toolkit’ on the ISPAH website (

Open access

Sebastien F.M. Chastin, Duncan E. McGregor, Stuart J.H. Biddle, Greet Cardon, Jean-Philippe Chaput, Philippa M. Dall, Paddy C. Dempsey, Loretta DiPietro, Ulf Ekelund, Peter T. Katzmarzyk, Michael Leitzmann, Emmanuel Stamatakis, and Hidde P. Van der Ploeg

Background: Crucial evidence gaps regarding: (1) the joint association of physical activity and sedentary time with health outcomes and (2) the benefits of light-intensity physical activity were identified during the development of recommendations for the World Health Organization Guidelines on physical activity and sedentary behavior (SB). The authors present alternative ways to evidence the relationship between health outcomes and time spent in physical activity and SB and examine how this could be translated into a combined recommendation in future guidelines. Methods: We used compositional data analysis to quantify the dose–response associations between the balance of time spent in physical activity and SB with all-cause mortality. The authors applied this approach using 2005–2006 National Health and Nutrition Examination Survey accelerometer data. Results: Different combinations of time spent in moderate- to vigorous-intensity physical activity, light-intensity physical activity, and SB are associated with similar all-cause mortality risk level. A balance of more than 2.5 minutes of moderate- to vigorous-intensity physical activity per hour of daily sedentary time is associated with the same magnitude of risk reduction for all-cause mortality as obtained by being physically active according to the current recommendations. Conclusion: This method could be applied to provide evidence for more flexible recommendations in the future with options to act on different behaviors depending on individuals’ circumstances and capacity.

Open access

Jason P. Brandenburg, Iris A. Lesser, Cynthia J. Thomson, and Luisa V. Giles

Background: Regular physical activity and higher cardiorespiratory (CR) fitness enhance immune function, possibly reducing coronavirus disease 2019 (COVID-19) infection severity. The aim was to assess the association between physical activity and self-reported CR fitness on COVID-19 infection characteristics. Methods: Participants formerly testing positive for COVID-19 completed an online questionnaire measuring COVID-19 infection characteristics and complications, self-reported CR fitness level, physical activity, and sociodemographic and health-related characteristics. Self-reported CR fitness was determined as the pace to cover 4.8 km without becoming overly fatigued (with slow walking, brisk walking, jogging, and running corresponding to low, moderate, good, and excellent levels of fitness, respectively). Results: A total of 263 individuals completed the survey. Compared with the lowest level of self-reported CR fitness, the odds of hospitalization significantly decreased by 64% (odds ratio = 0.36; 95% confidence interval, 0.13–0.98; P = .04) in individuals reporting the ability to maintain a brisk walk. In individuals reporting the ability to maintain a jogging pace, the further reduction in hospitalization was not significant (odds ratio = 0.22; 95% confidence interval, 0.05–1.04; P = .05). For COVID-19 symptom severity and number, there were no significant associations with self-reported CR fitness or physical activity levels. Conclusions: For individuals with low self-reported CR fitness, improving CR fitness represents a strategy to reduce the risk of hospitalization from COVID-19.

Full access

S. Maria O’Kane, Ian M. Lahart, Alison M. Gallagher, Angela Carlin, Maria Faulkner, Russell Jago, and Marie H. Murphy

Background: To suppress the transmission of coronavirus, many governments, including that of the island of Ireland, implemented a societal lockdown, which included school closures, limits on social gatherings, and time outdoors. This study aimed to evaluate changes in physical activity (PA), mental health, sleep, and social media use among adolescent girls during lockdown. Methods: 281 female pupils (12–14 y) taking part in the ongoing Walking In Schools study on the island of Ireland self-reported PA, mental health, sleep, and social media use before (September–October 2019) and during lockdown (May–June 2020), via questionnaires. These were supplemented with open-ended structured interviews conducted with 16 girls during lockdown. Results: During the period of lockdown and school closures, pupils tried new forms of PA and undertook PA with family, but there was no significant change in self-reported PA. There was a decline in health-related quality of life and motivation for exercise; however, self-efficacy for walking and happiness with appearance increased. There was no change in sleep quality or social media usage. Conclusions: Despite the many challenges that schools face as they reopen, there is a need to continue to prioritize PA and motivation for exercise to support health and well-being in adolescent girls.

Open access

Pauliina Husu, Kari Tokola, Henri Vähä-Ypyä, Harri Sievänen, Jaana Suni, Olli J. Heinonen, Jarmo Heiskanen, Kaisu M. Kaikkonen, Kai Savonen, Sami Kokko, and Tommi Vasankari

Background: Studies measuring physical activity (PA) and sedentary behavior on a 24/7 basis are scarce. The present study assessed the feasibility of using an accelerometer at the hip while awake and at the wrist while sleeping to describe 24/7 patterns of physical behavior in working-aged adults by age, sex, and fitness. Methods: The study was based on the FinFit 2017 study where the physical behavior of 20- to 69-year-old Finns was assessed 24/7 by triaxial accelerometer (UKKRM42; UKK Terveyspalvelut Oy, Tampere, Finland). During waking hours, the accelerometer was kept at the right hip and, during time in bed, at the nondominant wrist. PA variables were based on 1-min exponential moving average of mean amplitude deviation of the resultant acceleration signal analyzed in 6-s epochs. The angle for the posture estimation algorithm was used to identify sedentary behavior and standing. Evaluation of time in bed was based on the wrist movement. Fitness was estimated by the 6-min walk test. Results: A total of 2,256 eligible participants (mean age 49.5 years, SD = 13.5, 59% women) wore the accelerometer at the hip 15.7 hr/day (SD = 1.4) and at the wrist 8.3 hr/day (SD = 1.4). Sedentary behavior covered 9 hr 18 min/day (SD = 1.8 hr/day), standing nearly 2 hr/day (SD = 0.9), light PA 3.7 hr/day (SD = 1.3), and moderate to vigorous PA 46 min/day (SD = 26). Participants took 7,451 steps per day (SD = 2,962) on average. Men were most active around noon, while women had activity peaks at noon and at early evening. The low-fit tertile took 1,186 and 1,747 fewer steps per day than the mid- and high-fit tertiles (both p < .001). Conclusions: One triaxial accelerometer with a two wear-site approach provides a feasible method to characterize hour-by-hour patterns of physical behavior among working-aged adults.

Open access

Paul Mackie, Gary Crowfoot, Prajwal Gyawali, Heidi Janssen, Elizabeth Holliday, David Dunstan, and Coralie English

Background: Interrupting prolonged sitting can attenuate postprandial glucose responses in overweight adults. The dose–response effect in stroke survivors is unknown. The authors investigated the effects of interrupting 8 hours of prolonged sitting with increasingly frequent bouts of light-intensity standing-based exercises on the postprandial glucose response in stroke survivors. Methods: Within-participant, laboratory-based, dose-escalation trial. Participants completed three 8-hour conditions: prolonged sitting and 2 experimental conditions. Experimental conditions involved light-intensity standing-based exercises of increasing frequency (2 × 5 min to 6 × 5 min bouts). Postprandial glucose is reported. Results: Twenty-nine stroke survivors (aged 66 y) participated. Interrupting 8 hours of prolonged sitting with light-intensity standing-based exercises every 90 minutes significantly decreased postprandial glucose (positive incremental area under the curve; −1.1 mmol/L·7 h; 95% confidence interval, −2.0 to −0.1). In the morning (08:00–11:00), postprandial glucose decreased during the 4 × 5 minutes and 6 × 5 minutes conditions (positive incremental area under the curve; −0.8 mmol/L·3 h; 95% confidence interval, −1.3 to −0.3 and −0.8 mmol/L·3 h; 95% confidence interval, −1.5 to −0.2, respectively) compared with prolonged sitting. Conclusion: Interrupting 8 hours of prolonged sitting at least every 90 minutes with light-intensity standing-based exercises attenuates postprandial glucose in stroke survivors. During the morning, postprandial glucose is attenuated when sitting is interrupted every 60 and 90 minutes.