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Effect of a Customized Physical Activity Promotion Program on Visceral Fat and Glycemic Parameters in Individuals With Prediabetes: A Randomized Controlled Trial

Radhika A. Jadhav, G. Arun Maiya, Shashikiran Umakanth, and K.N. Shivashankara

Background: Physical activity of any amount results in substantial health benefits. However, public awareness of physical activity benefits in chronic diseases is inadequate in India. Prediabetes is a significant health issue on a global scale. Visceral fat (VF) is considered as an early predictor of prediabetes. Ethnicity and race have a substantial impact on VF. Hence, this study intended to evaluate the effect of a customized physical activity promotion program on VF and glycemic parameters in individuals with prediabetes. Methods: In the current, parallel group randomized controlled trial, a total of 158 participants were recruited: 79 in intervention and 79 in control group. The study included the prediabetes individuals based on American Diabetes Association criteria. Participants from the intervention group received the customized physical activity promotion program for 24 weeks. The primary outcome measures of the study were VF level and glycemic parameters that included fasting blood sugar and glycosylated hemoglobin. Two-way mixed analysis of variance was used to study the mean difference of an outcome between 2 groups over time. Results: The study found a statistically significant interaction between the intervention and times on VF level, F 1,136 = 23.564, fasting blood sugar levels, F 1,136 = 8.762, and glycosylated hemoglobin levels, F 1,136 = 64.582 at the end of 24 weeks (P < .05). Conclusions: This study concluded that a customized physical activity promotion program was effective in reducing VF in individuals with prediabetes as compared with controls. It improved glycemic control by reducing fasting blood sugar and glycosylated hemoglobin levels.

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Inequalities in Leisure-Time Physical Activity and Television Viewing According to Age Among a Brazilian Adult Population

Andrea Wendt, Adriana K.F. Machado, Bruna G.C. da Silva, Caroline S. Costa, Luiza I.C. Ricardo, and Shana Ginar da Silva

Background: The present study aims to estimate leisure-time physical activity and television (TV) viewing curves according to age stratified by sex, area of residence, and socioeconomic position. Methods: Using data from the Brazilian National Health Survey, we estimated the prevalence of leisure-time physical activity and TV viewing according to continuous age. The estimates were calculated using fractional polynomials and stratified by sex, wealth, skin color, and area of residence. Results: The sample included 87,376 adults (aged 18 y or over). In general, leisure-time physical activity decreased according to age while TV viewing increased. Regarding behavior of curves according to stratifiers, for leisure-time physical activity the disadvantaged groups maintained a pattern of low physical activity across all age groups or presented the decrease earlier when compared to groups in social advantage. On the other hand, for TV viewing, women presented an increase in prevalence before men, and individuals living in the urban area and the wealthiest group were those with a higher increase according to age. Conclusions: Our findings may help researchers and policymakers further explore inequalities in physical activity across life in different settings, as well as develop sensitive cultural actions to support more vulnerable people to adopt public health recommendations.

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“Post or Perish”? An Early Career Researcher’s Guide to Using Social Media

Emma S. Cowley, Kelly McNulty, Ciaran M. Fairman, and Lee Stoner

Social media usage has soared in the last decade, with the majority of adults having an account on at least one platform. Sites such as LinkedIn, X, and TikTok allow users to share content using different forms, for example, written or video, long form or short form. Social media can be used by researchers to forge collaborations, rapidly disseminate new research, and demonstrate societal impact. This opinion piece aims to highlight the value of social media, in particular for early career researchers, and offer suggestions on how early career researchers can strategically use social media to build a network and an online presence. We reflect on our own experiences of social media and include some of the reasons we have been deterred from it in the past, such as fear of making a mistake, being misunderstood, or painted as being an overconfident “know it all.” As the demonstration of impact and engagement becomes ever more important in grant applications and job security, social media competency is a powerful professional skill that will be important for all scientists.

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Charting a Course: Navigating Rigor and Meaning in Global Health Research

Tiago Canelas, Motlatso Godongwana, Feyisayo A. Wayas, Estelle Victoria Lambert, Yves Wasnyo, and Louise Foley

In the rapidly evolving landscape of global health research, the tension between scientific rigor and contextual meaning presents a critical challenge. Drawing on our work with the Global Diet and Physical Activity Network, this commentary explores the complexities of conducting environmental audits for physical activity and diet in 4 rapidly urbanizing African cities: Yaoundé, Lagos, Cape Town, and Soweto. We illustrate the competing demands and tensions that researchers face in balancing rigor and meaning. We discuss the adaptation of internationally validated audit tools to local contexts and the importance of area-level deprivation in interpreting data. We also examine the feasibility of virtual assessment tools, emphasizing the value of local expertise. We argue for a balanced approach that marries research rigor with contextual meaning, advocating for transparency, humility, and meaningful community engagement.

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Participant Bias in Community-Based Physical Activity Research: A Consistent Limitation?

Iris A. Lesser, Amanda Wurz, Corliss Bean, Nicole Culos-Reed, Scott A. Lear, and Mary Jung

Physical activity is a beneficial, yet complex, health behavior. To ensure more people experience the benefits of physical activity, we develop and test interventions to promote physical activity and its associated benefits. Nevertheless, we continue to see certain groups of people who choose not to, or are unable to, take part in research, resulting in “recruitment bias.” In fact, we (and others) are seemingly missing large segments of people and are doing little to promote physical activity research to equity-deserving populations. So, how can we better address recruitment bias in the physical activity research we conduct? Based on our experience, we have identified 5 broad, interrelated, and applicable strategies to enhance recruitment and engagement within physical activity interventions: (1) gain trust, (2) increase community support and participation, (3) consider alternative approaches and designs, (4) rethink recruitment strategies, and (5) incentivize participants. While we recognize there is still a long way to go, and there are broader community and societal issues underlying recruitment to research, we hope this commentary prompts researchers to consider what they can do to try to address the ever-present limitation of “recruitment bias” and support greater participation among equity-deserving groups.

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Effect of Yoga or Physical Exercise on Muscle Function in Rural Indian Children: A Randomized Controlled Trial

Sonal Kasture, Anuradha Khadilkar, Raja Padidela, Ketan Gondhalekar, Radhika Patil, and Vaman Khadilkar

Background: Synergistic effects of yoga or physical exercise (PE) along with protein supplementation on children’s muscle function in rural India have not been studied. Hence, we aimed to study the effect of yoga and PE along with protein supplementation on muscle function in healthy 6- to 11-year-old rural Indian children post 6 months of intervention. Methods: A randomized controlled trial on 232 children, recruited into 3 groups, each receiving 1 protein-rich ladoo (148 kcal, 7 g protein/40 g ladoo–an Indian sweet snack) daily and performing (1) yoga (n = 78) for 30 minutes 5 times per week, (2) PE (n = 76) for 30 minutes 5 times per week, or (3) control group (n = 78) no additional exercise. Maximum power, maximum voluntary force (Fmax), and grip strength (GS) were measured. Data were analyzed using paired t tests and a 2-way mixed analysis of variance with post hoc Bonferroni adjustment. Results: GS, maximum power, and Fmax within yoga group increased significantly (P < .05) from baseline to endline. GS and Fmax increased significantly within PE group postintervention (P < .001). In controls, GS increased (P < .05) at endline. No significant effect of the intervention was observed on the change in maximum power (P > .05) postintervention. The 2 exercise groups showed significant increase in Fmax compared with the control group (P < .05). Similarly, increase in GS was significantly higher in both the exercise groups compared with the control group (P < .05). No significant difference was observed in change in muscle function between the 2 exercise groups (P > .05). Conclusions: Structured physical activity along with protein supplementation resulted in improved muscle function in children. Yoga and PE showed a comparable impact on muscle force.

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Clustering of Multilevel Factors Among Children and Adolescents: Associations With Health-Related Physical Fitness

Shan Cai, Yunfei Liu, Jiajia Dang, Panliang Zhong, Di Shi, Ziyue Chen, Peijin Hu, Jun Ma, Yanhui Dong, Yi Song, and Hein Raat

Background: To identify the clustering characteristics of individual-, family-, and school-level factors, and examine their associations with health-related physical fitness. Methods: A total of 145,893 Chinese children and adolescents aged 9–18 years participated in this cross-sectional study. The 2-step cluster analysis was conducted to identify clusters among individual-, family-, and school-level factors. Physical fitness indicator was calculated through sex- and age-specific z scores of forced vital capacity, standing long jump, sit-and-reach flexibility, body muscle strength, endurance running, and body mass index. Results: Three, 3, and 5 clusters were automatically identified at individual, family, and school levels, respectively. Students with low physical fitness indicator were more likely to be in the “longest sedentary time and skipping breakfast” cluster (odds ratio [OR] = 1.18; 95% confidence interval [CI], 1.12–1.24), and “physical inactivity and insufficient protein consumption” cluster (OR = 1.07; 95% CI, 1.02–1.12) at individual level, the “single children and high parental education level” cluster (OR = 1.15; 95% CI, 1.10–1.21), and “no physical activity support and preference” cluster (OR = 1.30; 95% CI, 1.25–1.36) at family level, and the “physical education occupied” cluster (OR = 1.06; 95% CI, 1.01–1.11), and “insufficient physical education frequency” cluster (OR = 1.16; 95% CI, 1.08–1.24) at school level. Girls were more vulnerable to individual- and school-level clusters, while boys were more susceptible to family clusters; the younger students were more sensitive to school clusters, and the older students were more susceptible to family clusters (P-interaction < .05). Conclusions: This study confirmed different clusters at multilevel factors and proved their associations with health-related physical fitness, thus providing new perspective for developing targeted interventions.

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Leisure-Time Physical Activity in a Southern Brazilian City (2004–2021): Applying an Equity Lens to Time-Trend Analyses

Andrea Wendt, Alan G. Knuth, Bruno P. Nunes, Mario Renato de Azevedo Jr, Helen Gonçalves, Pedro C. Hallal, and Inácio Crochemore-Silva

Background: This study aimed to verify leisure-time physical activity trends over 15 years and monitor inequalities according to gender, self-reported skin color, and socioeconomic position in a Southern Brazilian city. A secondary aim is to evaluate intersectionalities in physical activity. Methods: Trend analysis using 3 population-based surveys carried out in 2004, 2010, and 2021. Main outcome assessed was the prevalence of physical activity according to recommendations (150 min/wk). Inequalities dimensions measured were sex, self-reported skin color, and wealth. Intersectionalities were evaluated using Jeopardy index combining all inequality dimensions. Trend analysis was performed using least-squares weighted regression. Results: We included data from 3090, 2656, and 5696 adults in 2004, 2010, and 2021, respectively. Prevalence of physical activity remains stable around 25% in the 3 years. In the 3 periods evaluated, men presented a prevalence in average 10 percentage points higher than women (SII2004 = −11.1 [95% confidence interval, CI, −14.4 to −7.8], SII2021 = −10.7 [95% CI, −13.7 to −7.7]). Skin color inequalities did not present a clear pattern. Richest individuals, in general presented a prevalence of leisure-time physical activity level 20pp higher than poorest ones (SII2004 = 20.5 [95% CI, 13.7 to 27.4]; SII2021 = 16.7 [95% CI, 11.3 to 22.0]). Inequalities were widely marked, comparing the most privileged group (represented by men, the wealthiest, and White) and the most socially vulnerable group (represented by women, the poorest, and Black/Brown). The Slope Index of Inequality for intersectionalities was −24.5 (95% CI, −31.1 to −17.9) in 2004 and −18.8 in 2021 (95% CI, −24.2 to −13.4). Conclusions: Our analysis shows that women, Black/Brown, and poor present lower leisure-time physical activity level. This group is often neglected regarding other health and social outcomes.

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Striking a Balance: Physical Activity and Planetary Health

Katja Siefken and Karim Abu-Omar

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Biopsychosocial Effects of a Conventional Exercise Program and Culturally Relevant Activities in Older Women From Mozambique

Timóteo Daca, Antônio Prista, Paulo Farinatti, Matheus Maia Pacheco, Ricardo Drews, Taru Manyanga, Albertino Damasceno, and Go Tani

Aim: This randomized controlled trial compared the effects of a Conventional Exercise Program (CEP) and Culturally Relevant Activities (CRA) on body mass, cardiovascular risk, functional fitness (strength, flexibility, cardiorespiratory fitness, and agility), self-efficacy, and self-esteem in older women dwelling in Mozambique. Methods: Fifty-seven women (67 [7] y) underwent 60-minute sessions of CEP (n = 28) or CRA (n = 29) performed 3 days per week for 12 weeks. CRA included Mozambican traditional dances and games (intensity corresponding to scores 3–4 of BORG-CR10 scale), and CEP included 20-minute stationary cycling (65%–75% heart rate reserve) and a resistance training circuit (8 exercises, 15-repetition maximum). Results: CEP and CRA (P < .05) showed increased percent fat (3.4% and 5.3%), waist circumference (3.3% and 5.8%), and cardiorespiratory fitness (14.4% and 9.4%), and decreased triglycerides (−20.0% and −77.8%). In CEP (P < .05), body mass (2.9%), body mass index (3.2%), and high-density lipoprotein (10.0%) increased, while glycemia (−4.8%) and total cholesterol (−9.8%) decreased. Blood pressure slightly increased in CEP (6.2%, P > .05) and CRA (4.3%, P < .05). Self-efficacy and self-esteem increased to similar levels in both groups (15%, P < .05). Conclusions: CEP and CRA were capable to improve biopsychosocial health-related variables in Mozambican older women. Culturally referenced PA interventions should be considered as an alternative in African countries.