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There is much evidence showing that physical activity is related to optimal health, including physical and mental function, and quality of life. Additionally, data are accumulating with regard to the detrimental health impacts of sedentary behavior. Much of the evidence related to long-term health outcomes, such as cardiovascular disease and cancer—the two leading causes of death in the United States and worldwide—comes from observational epidemiologic studies and, in particular, prospective cohort studies. Few data on these outcomes are derived from randomized controlled trials, conventionally regarded as the “gold standard” of research designs. Why is there a paucity of data from randomized trials on physical activity or sedentary behavior and long-term health outcomes? A further issue to consider is that prospective cohort studies investigating these outcomes can take a long time to accrue sufficient numbers of endpoints for robust and meaningful findings. This contrasts with the rapid pace at which technology advances. Thus, while the use of devices for measuring physical behaviors has been an important development in large-scale epidemiologic studies over the past decade, cohorts that are now publishing results on health outcomes related to accelerometer-assessed physical activity and sedentary behavior may have been initiated years ago, using “dated” technology. This paper, based on a keynote presentation at 8th International Conference on Ambulatory Monitoring of Physical Activity and Movement 2022, discusses the issues of study design and slow pace of discovery in prospective cohort studies and suggests some possible ways to maximize the utility and comparability of “dated” device data from prospective cohort studies for research investigations using the Women’s Health Study as an example.

Regular physical exercise is known to lower the incidence of age-related eye diseases. We aimed to assess the acute chorioretinal alterations in older adults following intense physical strain. Seventeen senior elite athletes were recruited who underwent an aerobic exercise on a cycle ergometer and macular scanning by optical coherence tomography. A significant thinning of the entire retina was observed 1 min after exercise, followed by a thickening at 5 min, after which the thickness returned to baseline. This trend was similar in almost every single retinal layer, although a significant change was observed only in the inner retina. Choroidal thickness changes were neither significant nor did they correlate with the thickness changes of intraretinal layers. The mechanism of how these immediate retinal changes chronically impact age-related sight-threatening pathologies that, in turn, result in a substantially reduced quality of life warrants further investigation on nontrained older adults as well.

Background: Extreme heat may discourage physical activity of children while shade may provide thermal comfort. The authors determined the associations between ambient temperature, shade, and moderate to vigorous physical activity (MVPA) of children during school recess. Methods: Children aged 8–10 (n = 213) wore accelerometers and global positioning system monitors during recess at 3 school parks in Austin, Texas (September–November 2019). Weather data originated from 10 sensors per park. The authors calculated shade from imagery using a geographic information system (GIS) and time-matched physical activity, location, temperature, and shade data. The authors specified piecewise multilevel regression to assess relations between average temperature and percentage of recess time in MVPA and shade. Results: Temperature ranged 11 °C to 35 °C. Each 1 °C higher temperature was associated with a 0.7 percentage point lower time spent in MVPA, until 33 °C (91 °F) when the association changed to a 1.5 lower time (P < .01). Each 1 °C higher temperature was associated with a 0.3 percentage point higher time spent under shade, until 33 °C when the association changed to a 3.4 higher time (P < .001). At 33 °C or above, the direct association between shade and MVPA weakened (P < .05), with no interaction effect above 33 °C (P > .05). Children at the park with the most tree canopy spent 6.0 percentage points more time in MVPA (P < .01). Conclusions: Children engage in less MVPA and seek shade during extreme heat and engage in more MVPA in green schoolyards. With climate change, schools should consider interventions (eg, organizing shaded play, tree planting) to promote heat safe MVPA.

The consequences of multiple sclerosis (MS), particularly gait and walking dysfunction, may obfuscate (i.e., make unclear in meaning) the measurement of physical activity using body-worn motion sensors, notably accelerometers. This paper is based on an invited keynote lecture given at the 8th International Conference on Ambulatory Monitoring of Physical Activity and Movement, June 2022, and provides an overview of studies applying accelerometers for the measurement of physical activity behavior in MS. The overview includes initial research uncovering a conundrum with the interpretation of activity counts from accelerometers as a measure of physical activity. It then reviews research on calibration of accelerometer output based on its association with energy expenditure in yielding a biologically based metric for studying physical activity in MS. The paper concludes with other applications and lessons learned for guiding future research on physical activity measurement using accelerometry in MS and other populations with neurological diseases and conditions.

Background: Physical activity (PA) surveillance, policy, and research efforts need to be periodically appraised to gain insight into national and global capacities for PA promotion. The aim of this paper was to assess the status and trends in PA surveillance, policy, and research in 164 countries. Methods: We used data from the Global Observatory for Physical Activity (GoPA!) 2015 and 2020 surveys. Comprehensive searches were performed for each country to determine the level of development of their PA surveillance, policy, and research, and the findings were verified by the GoPA! Country Contacts. Trends were analyzed based on the data available for both survey years. Results: The global 5-year progress in all 3 indicators was modest, with most countries either improving or staying at the same level. PA surveillance, policy, and research improved or remained at a high level in 48.1%, 40.6%, and 42.1% of the countries, respectively. PA surveillance, policy, and research scores decreased or remained at a low level in 8.3%, 15.8%, and 28.6% of the countries, respectively. The highest capacity for PA promotion was found in Europe, the lowest in Africa and low- and lower-middle-income countries. Although a large percentage of the world’s population benefit from at least some PA policy, surveillance, and research efforts in their countries, 49.6 million people are without PA surveillance, 629.4 million people are without PA policy, and 108.7 million live in countries without any PA research output. A total of 6.3 billion people or 88.2% of the world’s population live in countries where PA promotion capacity should be significantly improved. Conclusion: Despite PA is essential for health, there are large inequalities between countries and world regions in their capacity to promote PA. Coordinated efforts are needed to reduce the inequalities and improve the global capacity for PA promotion.

Background: Our study investigated the effect of elite sport on physical activity (PA) practice in the general population. Methods: Structured Boolean searches were conducted across 5 electronic databases (PubMed, JSTOR, Web of Science, SPORTDiscus, and PsycInfo) from January 2000 to August 2021. Peer-reviewed studies in English were included if the effects of hosting elite sport events, elite sport success, and elite sport role modeling on PA/sport practice in the general population were measured. Results: We identified 12,563 articles and included 36 articles. Most studies investigated the effect of hosting elite sport events (n = 27), followed by elite sport success (n = 16) and elite sport role modeling (n = 3). Most studies did not observe a positive effect of hosting elite sport events, elite sport success, or elite sport role modeling on PA/sport practice in the general population. No evidence of a lagged effect of elite sport was observed. No evidence of elite sport effects was observed according to age range and geographical scale. Conclusion: There is no evidence supporting the effect of elite sport in increasing PA or sport participation in the general population. Decision makers and policymakers should be aware of this and invest in strategies such as those recommended by the World Health Organization.

Background: There is limited understanding of the challenges experienced and supports required to aid effective advocacy of the Global Action Plan on Physical Activity (GAPPA). The purpose of this study was to assess the challenges experienced and supports needed to advocate for the GAPPA across countries of different income levels. Methods: Stakeholders working in an area related to the promotion of physical activity were invited to complete an online survey. The survey assessed current awareness and engagement with the GAPPA, factors related to advocacy, and the perceived challenges and supports related to advocacy for implementation of the GAPPA. Closed questions were analyzed in SPSS, with a Pearson’s chi-square test used to assess differences between country income level. Open questions were analyzed using inductive thematic analysis. Results: Participants (n = 518) from 81 countries completed the survey. Significant differences were observed between country income level for awareness of the GAPPA and perceived country engagement with the GAPPA. Challenges related to advocacy included a lack of support and engagement, resources, priority, awareness, advocacy education and training, accessibility, and local application. Supports needed for future advocacy included guidance and support, cooperation and alliance, advocacy education and training, and advocacy resources. Conclusions: Although stakeholders from different country income levels experience similar advocacy challenges and required supports, how countries experience these can be distinct. This research has highlighted some specific ways in which those involved in the promotion of physical activity can be supported to scale up advocacy for the GAPPA. When implementing such supports, consideration of regional, geographic, and cultural barriers and opportunities is important to ensure they are effective and equitable.