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  • Author: Paul D. Loprinzi x
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Meghan K. Edwards and Paul D. Loprinzi

Objective:

Examine the independent association of sedentary behavior and cognitive function in older adults, as well as whether physical activity attenuates this potential association.

Methods:

Data from the 1999–2002 National Health and Nutrition Examination Survey were used (N = 2472 adults 60 to 85 yrs). Sedentary behavior was subjectively assessed and the Digit Symbol Substitution Test (DSST) was employed to assess cognitive function.

Results:

Among an unadjusted and an adjusted model not accounting for physical activity, only 5+ hrs/day (vs. < 1 hr) of sedentary time was independently associated with lower DSST scores (β = –3.1; 95% CI: –5.8 to –0.4; P= .02). However, a fully adjusted model (adding in moderate-to-vigorous physical activity as a covariate) did not yield a statistically significant association between 5+ hrs/day of sedentary time and DSST scores (β = –2.5; 95% CI: –5.1 to 0.2; P = .07).

Conclusion:

Accumulated daily sedentary behavior of 5+ hrs is associated with lower cognitive function in an older adult population when physical activity is not taken into account. However, physical activity may account for 19% of the total association between sedentary behavior and cognitive function, thus attenuating the sedentary-cognitive function association. Efforts should be made to promote physical activity in the aging population.

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Paul D. Loprinzi and Jeremy P. Loenneke

Objective:

Examine the association between grip strength and type 2 diabetes prevalence and severity.

Methods:

Using data from NHANES 2011–2012, objectively-determined hand grip strength was assessed using the Takei digital grip strength dynamometer, with diabetes assessed via physician diagnosis and glycohemoglobin A1C.

Results:

A 5 kg greater grip strength was associated with a 14% lower odds of having diabetes for men (ORadjusted = 0.86; 95% CI: 0.79 to 0.94; P = .002). Similarly, for women, a 5 kg greater grip strength was associated with an 18% lower odds of having diabetes (ORadjusted = 0.82; 95% CI: 0.69 to 0.97; P = .03). Grip strength was also associated with glycohemoglobin A1C among women with diabetes (βadjusted = –0.26, 95% CI: –0.39 to –0.12; P = .001), which suggests that grip strength is associated with diabetes severity among women.

Conclusions:

For both men and women, grip strength is associated with type 2 diabetes presence, and among women, grip strength is associated with severity of type 2 diabetes.

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Robert E. Davis and Paul D. Loprinzi

Objectives:

To examine whether accelerometer-measured physical activity–based reactivity was present in a nationally representative sample of U.S. children (6–11 yrs), adolescents (12–17 yrs), and adults (≥20 yrs).

Methods:

Data from the 2003–2006 National Health and Nutrition Examination Survey (N = 674, 6–85 yrs) were used. Physical activity (PA) was assessed using the ActiGraph 7164 accelerometer, with PA assessed over 7 days of monitoring. Two PA metrics were assessed, including activity counts per day (CPD) and time spent in moderate-to-vigorous PA. Evidence of reactivity was defined as a statistically significantly change in either of these 2 PA metrics from day 1 of monitoring to days 2 or 3, with day 1 of monitoring being a Monday.

Results:

Suggestion of reactivity was observed only for the adult population where CPD from days 2 and 3 (297,140.6 ± 7920.3 and 295,812.9 ± 8364.9), respectively, differed significantly from day 1 (309,611.5 ± 9134.9) over the monitoring period (4.0% to 4.5% change). The analysis was conducted 2 additional times with differing start days (Tuesday and Wednesday), and this approach failed to demonstrated a reactive presence.

Conclusion:

In this national sample of U.S. children, adolescents and adults, we did not observe sufficient evidence of accelerometer reactivity.

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Paul D. Loprinzi and Jeremy P. Loenneke

Objective:

Leukocyte telomere length (LTL) shortening is characteristic of aging and is associated with morbidity and mortality, independent of age. Research demonstrates that lower extremity muscular strength is associated with mobility, morbidity and mortality; however, no study, to our knowledge, had examined the association between lower extremity muscular strength and LTL, which was the purpose of this brief study.

Methods:

Data from the 1999–2002 NHANES was used (N = 2410; 50–85 years). Peak isokinetic knee extensor strength (IKES) was objectively measured with LTL assessed from a blood sample.

Results:

After adjustments, for every 50 N increase in IKES, participants had a 9% reduced odds (P = .04) of being in the 1st (vs. 4th) LTL quartile.

Discussion:

Lower extremity muscular strength is associated with LTL, suggesting a possible mechanism through which lower extremity muscular strength may be associated with morbidity and mortality.

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Meghan K. Edwards and Paul D. Loprinzi

Objective: Muscular strength has been shown to inversely associate with mortality. The purpose of this study was to examine the association between muscular strength and residual-specific mortality among a national sample of US adults, which has yet to be investigated. Here, residual-specific mortality is identified as deaths not inclusive of the 9 leading causes of death as identified by the International Classification of Diseases, 10th revision. Methods: Data from the 1999–2002 National Health and Nutrition Examination Survey were used (N = 2171 adults, aged 50–85 y). Participants were followed through 2011, including a median follow-up of 125 months. Lower extremity muscular strength was assessed using maximal isokinetic contractions. Results: After adjusting for all covariates (age, gender, race/ethnicity, body mass index, C-reactive protein, mean arterial pressure, self-report of meeting aerobic-based physical activity guidelines, and physician diagnoses of diabetes), the Cox proportional hazard model demonstrated that for every 25 N increase in lower extremity muscular strength, individuals had a 14% reduced risk of residual-specific death (hazard ratio = 0.86; 95% confidence interval, 0.78–0.96; P = .008). Conclusion: Lower body muscular strength is inversely and independently associated with residual-specific mortality risk, underscoring the importance of adequate muscular strength to prolong survival.

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Paul D. Loprinzi, Gina Pariser and Pradeep Y. Ramulu

Background:

To examine the association between accelerometer-assessed physical activity and visual acuity among a nationally representative sample of adults with evidence of diabetes.

Methods:

Six hundred seventy adult participants with diabetes (age 20 to 85) from the 2003–2006 NHANES cycles constituted the analyzed sample. Participants wore an accelerometer for 7 days to quantify time spent in sedentary behavior, light-intensity physical activity and moderate-to-vigorous physical activity. Visual acuity was objectively assessed for each eye.

Results:

In multivariable models, every 1-hour increment in daily sedentary behavior was associated with 23% greater likelihood (OR = 1.23; 95% CI: 1.01–1.52) of having uncorrected refractive error as opposed to normal sight. Performing more than 5 minutes of daily moderate-to-vigorous physical activity was associated with a 82% lower likelihood of having vision impairment as opposed to normal sight (OR = 0.18; 95% CI: 0.06–0.50) while every 1-hour increment in daily light-intensity physical activity was, after adjustments, independently associated with a 38% lower likelihood of vision impairment (OR = 0.62; 95% CI: 0.42–0.92).

Conclusion:

People with diabetes spending more time in sedentary behavior and less time performing light or moderate-to-vigorous physical activity are more likely to have poorer vision.

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Scott J. Dankel, Jeremy P. Loenneke and Paul D. Loprinzi

Background: Skeletal muscle strength and engagement in muscle-strengthening activities are each inversely associated with all-cause mortality; however, less is known on their relationship with cancer-specific mortality. Methods: Data from the 1999–2002 National Health and Nutrition Examination Survey were used assessing 2773 individuals aged 50 years or older. Individuals being dichotomized at the 75th percentile for knee extensor strength, and engagement in muscle-strengthening activities was acquired through self-report with ≥2 sessions per week were classified as meeting guidelines. Results: With respect to cancer-specific mortality, individuals in the upper quartile for muscle strength were at a 50% reduced risk (hazard ratio = 0.50; 95% confidence interval, 0.29–0.85; P = .01) and those meeting muscle-strengthening activities were at a nonsignificant 8% reduced risk (hazard ratio = 0.92; 95% confidence interval, 0.45–1.86, P = .81) of cancer-specific mortality after adjusting for covariates. Conclusions: Clinicians should routinely assess lower extremity strength and promote engagement in muscle-strengthening activities aimed at increasing muscle strength.

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Stewart G. Trost, Rebecca Tang and Paul D. Loprinzi

Background:

This study evaluated the feasibility and preliminary efficacy of a church-based intervention to promote physical activity (PA) in children.

Methods:

The study was conducted in 4 churches located in 2 large metropolitan areas and 2 regional towns in Kansas. Churches in the intervention condition implemented the “Shining Like Stars” physical activity curriculum module during their regularly scheduled Sunday school classes. Churches in the control condition delivered the same content without integrating physical activity into the lessons. In addition to the curriculum, the intervention churches completed a series of weekly family devotional activities designed to promote parental support for PA and increase PA outside of Sunday school.

Results:

Children completing the Shining Like Stars curriculum exhibited significantly greater amounts of MVPA than those in the control condition (20 steps/min vs. 7 steps/min). No intervention effects were observed for PA levels outside of Sunday school or parental support for PA; however, relative to controls, children in the intervention churches did exhibit a significant reduction in screen time.

Conclusion:

The findings confirm that the integration of physical activity into Sunday school is feasible and a potentially effective strategy for promoting PA in young children.

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Hyo Lee, Bradley J. Cardinal and Paul D. Loprinzi

Background:

Socioeconomic status (SES) and acculturation are potential contributors of adolescent physical activity disparity among ethnic groups in the U.S. However, studies relying on self-report physical activity measures have reported inconsistent findings regarding sociocultural predictors of physical activity. Therefore, the current study examined the main and interactive effects of SES and acculturation on accelerometer-measured moderate-to-vigorous intensity physical activity (MVPA) among Mexican American adolescents.

Methods:

The National Health and Nutrition Examination Survey 2003–2004 was analyzed. Samples of 153 and 169 Mexican American boys and girls, respectively, were analyzed. SES was indicated by poverty-to-income ratio (PIR); and acculturation was measured by 5-item English preference scales and adolescent and parental country of birth. Regression models were tested separately for boys and girls.

Results:

U.S.-born boys compared with immigrants did more MVPA (β = .48, P < .01). On the contrary, the effect of English preference on MVPA in boys was negative (β = –.05, P < .01) and amplified by higher SES (β = –.02, P < .01). For girls, none of the tested variables were significant.

Conclusions:

Higher SES was a risk factor for physical inactivity in Mexican American adolescents, by a moderating mechanism. In addition, physical activity promotion efforts need to consider English speaking and immigrant Mexican American adolescent boys as a target population.

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Paul D. Loprinzi, Bradley J. Cardinal, Carlos J. Crespo, Gary R. Brodowicz, Ross E. Andersen and Ellen Smit

Background:

The exclusion of participants with invalid accelerometry data (IAD) may lead to biased results and/or lack of generalizability in large population studies. The purpose of this study was to investigate whether demographic, behavioral, and biological differences occur between those with IAD and valid accelerometry data (VAD) among adults using a representative sample of the civilian noninstitutionalized U.S. population.

Methods:

Ambulatory participants from NHANES (2003−2004) who were 20−85 years of age were included in the current study and wore an ActiGraph 7164 accelerometer for 7 days. A “valid person” was defined as those with 4 or more days of at least 10+ hrs of monitoring per day. Among adults (20−85 yrs), 3088 participants provided VAD and 987 provided IAD. Demographic, behavioral, and biological information were obtained from the household interview or from data obtained in a mobile examination center.

Results:

Differences were observed in age, BMI, ethnicity, education, smoking status, marital status, use of street drugs, current health status, HDL-cholesterol, C-reactive protein, self-reported vigorous physical activity, and plasma glucose levels between those with VAD and IAD.

Conclusions:

Investigators should take into consideration the potential cut-off bias in interpreting results based on data that excludes IAD participants.